Room at the top?

Nurse executives have joined hospital administrative teams, but are they accepted as fully integrated team executives? Learn how nurse executives and their influential colleagues view integration and its influences.

The ADA and the health care workplace.

T Employment related exposures are quickly becoming one of the largest liability exposures facing health care organizations, because employment claims as a whole are increasing in the courts and health care employees are usually highly paid professionals. The Americans with Disabilities Act (ADA) presents its own particular exposure implications, particularly because a health care employer's decision as to whether its employed health care professional is qualified to continue working can often affect patient care. The focus of this article is on how Title I of the ADA affects employment decisions in the health care workplace and what a health care employer can do to mitigate its ADA exposure. This article describes the scope and effect that the ADA has on the health care workplace. It also outlines an ADA compliance program with protocols and procedures for addressing ADA issues that arise in a health care practice.

Implementing a caring model to improve patient satisfaction.

OBJECTIVE: To evaluate the effect of implementing a Caring Model on patient satisfaction. BACKGROUND: Patient satisfaction has become an important indicator of quality care and financial success of healthcare institutions. Acknowledging the importance of nurse caring behaviors and the impact on patient satisfaction has been relatively recent. Based on a synthesis of the literature, five caring behaviors have been formulated into a model; no single study identified the five selected behaviors included in this study. METHODS: In an acute care setting, eight patient satisfaction attributes were incorporated into a Caring Model. Implementation of the model among nursing staff members included an educational in-service, printing of the behaviors on the name badge, reminders in monthly staff meetings and nursing rounds, and inclusion of the caring behaviors in patient care documentation, job descriptions, and performance appraisals. The impact upon patient satisfaction was compared 6 months' preintervention to 6 months' postintervention. RESULTS: Postintervention, the patient satisfaction attributes of Nurses Anticipating Needs and Responds to Requests significantly increased. Attributes that began preintervention as immediate priorities for improvement became major strengths postintervention. CONCLUSIONS/IMPLICATIONS: Results of this study provide evidence that nurse caring behaviors can influence patient satisfaction. For a Caring Model to be effective, it must become an integral part of strategic planning and be implemented throughout the entire organization. To sustain the effects of the model, there must be frequent reminders among staff members. Nurse caring is an important predictor of patient satisfaction. The authors discuss the effect of implementing a caring model on patient satisfaction. In an acute care setting, eight patient satisfaction attributes incorporated into five nurse caring behaviors were evaluated pre- and postintervention. Results of the study indicated the patient satisfaction attributes of Nurses Anticipating Needs and Responds to Requests significantly increased. Attributes that began as immediate priorities for improvement before intervention became major strengths after intervention.

Satisfaction with managed care.

This article reports the findings of 1996, 1997, and 1998 patient satisfaction surveys administered to managed care enrollees in Utah. More than 14,000 managed care enrollees (both Medicaid and commercial) were selected randomly and contacted by telephone. The 38-question survey was based on Health Plan Employer Data and Information Set (HEDIS) and the National Committee for Quality Assurance (NCQA) measures. Demographic differences between the commercial and Medicaid population were identified. Medicaid enrollees were found to be higher users of health care services. Individuals reporting the greatest health plan satisfaction tended to be healthier. However, Medicaid enrollees reported greater overall health plan satisfaction than commercial enrollees.

Effect of ozone and histamine on airway permeability to horseradish peroxidase in guinea pigs.

Airway permeability was studied in groups of male guinea pigs at 2, 8, and 24 h after a 1-h exposure to 1 ppm ozone or at 2 h after a 1-h exposure to filtered air (control). Intratracheal administration of 2 mg horseradish peroxidase (HRP) was followed by blood sampling at 5-min intervals up to 30 min. The rate of appearance of HRP in plasma was significantly higher at 2 and 8 h after ozone exposure than that found in animals examined 2 h after air exposure or 24 h after ozone exposure. A dose of 0.12 mg/kg of subcutaneous histamine given after the 15 min blood sample significantly increased the already elevated permeability seen at 2 h post ozone, but had no effect on animals exposed to filtered air 2 h earlier or to ozone 24 h earlier. No difference was seen in the amount of subcutaneous radiolabeled histamine in the lungs of animals exposed 2 h earlier either to air or to ozone. These data indicate that a short-term exposure to ozone produced a reversible increase in respiratory epithelial permeability to HRP in guinea pigs. The potentiation of this increased permeability by histamine may be another manifestation of ozone-induced hyperreactivity.