...Wolters Kluwer Health | Lippincott Williams & Wilkins Missed Nursing Care, Staffing, and Patient Falls Beatrice J. Kalisch, PhD, RN, FAAN; Dana Tschannen, PhD, RN; Kyung Hee Lee, MPH, RN Patient falls in hospitals continue to be a major and costly problem. This study tested the mediating effect of missed nursing care on the relationship of staffing levels (hours per patient day [HPPD]) and patient falls. The sample was 124 patient units in 11 hospitals. The HPPD was negatively associated with patient falls (r = − 0.36, P < .01), and missed nursing care was found to mediate the relationship between HPPD and patient falls. Key words: falls, missed nursing care, staffing P to 12% of hospitalized patients experience at least 1 fall during their hospital stay.1 A fall is defined as any event in which patients are found on the floor (observed or unobserved) or an unplanned lowering of the patient to the floor by staff or visitors.2 In 2008, and 2010, falls were identified as one of the top 10 sentinel event categories by the Joint Commission.3 Fall rates in hospitals range from 4 to 14 falls per 1000 patient days.4 With the adoption of the Centers of Medicare and Medicaid rule, which no longer reimburses hospitals at the higher diagnosis related group for the care and treatment associated with patient falls that occur during hospitalization, a clearer understanding of what factors U Author Affiliations: School of Nursing, University of Michigan, Ann Arbor, Michigan (Drs Kalisch and...
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...TEMPORARY STAFFING SERVICE FOR THE DOMESTIC DEPARTMENT. MICHAEL OKOROMADU ROYALFREE HOSPTAL CMI DIPLOMA LEVEL 5 M5006 HYPOTHESIS: The Domestics department will benefit, from the creation of temporary staffing service (bank staff). AIMS AND OBJECTIVE: To demonstrate, the benefits of setting up a temporary staff servicing system in the Domestics department. The Bank Staffing services, will not only help reduce financial expenditure on staffing, but would also help improve and maintain quality standards expected by the Trust. The aims will be achieved by the following objectives; • Analyse the data and information • Look at the option or alternative for agency staffing • Discuss the impact of the research to the domestic department • Recommend a course of action to meet the project aim • Evaluate the research to make conclusions METHODOLOGY: • Identify the problems faced by the department from staff shortages. • Analyse the methods currently employed by the Domestics department in recruiting and allocating of staff, to manage these absences. • Look into the recruitment of agency staff and the legislations guarding this process. • Analyse the Temporary staff recruitment services; the process involved in recruitment, the terms and conditions of employment, and how it would be incorporated in the Domestic Services department. The SWOT analysis in Figure...
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...2009 Nursing Turnover: Costs, Causes, & Solutions Steven T. Hunt, Ph.D., SPHR Director of Business Transformation SuccessFactors Inc. (www.successfactors.com) E-mail: shunt@successfactors.com Copyright © 2009 SuccessFactors, Inc. Invest in People …. Drive Business Results SuccessFactors Healthcare Executive Summary Nursing turnover is a major issue impacting the performance and profitability of healthcare organizations. Healthcare organizations require a stable, highly trained and fully engaged nursing staff to provide effective levels of patient care. The financial cost of losing a single nurse has been calculated to equal about twice the nurse’s annual salaryi. The average hospital is estimated to lose about $300,000 per year for each percentage increase in annual nurse turnoverii. Losing these critical employees negatively impacts the bottom line of healthcare organizations in a variety of ways including: Decreased quality of patient care Increased contingent staff costs Increased staffing costs Loss of patients Increased nurse and medical staff turnover Increased accident and absenteeism rates The primary causes of nurse turnover can be analyzed by I) understanding why nurses choose to work for an organization and ensuring this ‘employee value proposition’ is met; and II) identifying things that occur after nurses are hired that lead them to quit even though their initial job expectations were met. I. Primary factors that influence...
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...that will provide the foundation for developing the nursing organization as a "health-promoting organization." The background and significance, theoretical framework, study findings, and executive strategies are discussed. The results and implications are intended to guide executive strategies, including organizational interventions, to build the nursing organization for quality patient care and positive working environments. Background and Significance The glue that holds the hospital together are the first-line managers. However, these managers are caught in a crossfire. Torn between multiple needs — patient, the staff, and the administration — nurse managers have been downsized and stretched over multiple units (Curtin, 2001). Nurse managers responsible for multiple units are severely challenged to maintain the needed blend and balance of clinical and business management, which is essential to staff nurse retention. Report after report identifies the importance of the nurse manager in retaining nursing staff (Boyle, Bott, Hansen, Woods, & Taunton, 1999; Corser, 1998; Cullen, 1999; Flannery & Grace, 1999; Fletcher, 2001; Kerfoot, 2000; Leveck & Jones, 1996; Slaughter, 2002; Taunton, Boyle, Woods, Hansen, & Bott, 1997). Further, staff nurses report burnout and dissatisfaction with their jobs and a concern about decreasing quality of care (Aiken et al., 2001; First Consulting Group, 2002). The data on the nursing shortage portends a health care delivery system...
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...APPENDIX Checklists A Checklist A-1 Reviewing a Budget 1. Is this budget static (not adjusted for volume) or flexible (adjusted for volume during the year)? 2. Are the figures designated as fixed or variable? 3. Is the budget for a defined unit of authority? 4. Are the line items within the budget all expenses (and revenues, if applicable) that are controllable by the manager? 5. Is the format of the budget comparable with that of previous periods so that several reports over time can be compared if so desired? 6. Are actual and budget for the same period? 7. Are the figures annualized? 8. Test one line-item calculation. Is the math for the dollar difference computed correctly? Is the percentage properly computed based on a percentage of the budget figure? 333 334 APPENDIX A Checklists Checklist A-2 Building a Budget 1. What is the proposed volume for the new budget period? 2. What is the appropriate inflow (revenues) and outflow (cost of services delivered) relationship? 3. What will the appropriate dollar cost be? (Note: this question requires a series of assumptions about the nature of the operation for the new budget period.) 3a. Forecast service-related workload. 3b. Forecast non–service-related workload. 3c. Forecast special project workload if applicable. 3d. Coordinate assumptions for proportionate share of interdepartmental projects. 4. Will additional resources be available? 5. Will this budget accomplish the appropriate managerial objectives for...
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...the OPD form which includes Patient’s Name, Age, Address, Consultants name etc. Pays the required amount at OPD registration counter OPD file preparation by OPD executive Prescription is given by the doctor Further investigation (pathological/radiological) is done if prescribed Consultation charges are to be repaid on every 14th day of previous consultation. Functions of OPD • General Diagnosis and Treatment. • Prescription for further investigation and diagnosis. Organization of OPD Staff of OPD is made up of four major organizational components: 1. Medical Staff. o Most important and central to the organization. o Include the Doctors and Consultants. 2. Nursing staff: It includes registered nurses. 3. Ancillary staff: It includes Lab technicians. 4. Clerical Staff: It includes Staff which carries out registration, Billing, Cashiering, Secretarial and Medical record functions. II. RECEPTION AND ENQUIRY Reception is the main place of contact between patient and the hospital. An outpatient is usually a frightened person who needs reassurance...
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...to their organization’s orientation process, job satisfaction, and the effects of job retention rates. Identifying these challenges are significant noting that low retention rates are costly for health care facilities as well as for the economy. According to Gemberling, Tretter-Long, Reiner, Potylycki, and Davidson in their article Clinical Support for the Off-Shift Nurse and the Graduate Nurse: The Clinical Rock Stars, “Depending on the specialty, estimated replacement costs for an RN were $42,000-$64,000 [in 2005]” Gemberling et al. (2011). This topic is especially important for new graduate nurses when considering a first place of employment. Nursing educators and health care managers have been analyzing and designing new ways to combat low retention rates specifically for newly graduated nurses. Review of Literature Several factors influence job satisfaction, which is a key characteristic that effects job retention rates. Gemberling et al. (2011) found that most new nurses leave their first job because of stress related to feeling overwhelmed, lack of guidance and support from management and seasoned nursing staff, limited clinical skills, feeling of unpreparedness, and fear of causing harm to the patient. These complications are mainly related to a general lack of confidence by new graduate nurses when practicing under minimal supervision. Even though most of these concerns are acquired with experience,...
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...leveraging our stronger talent, capabilities and infrastructure as a meaningful differentiator in the market, and have earned the privilege of serving the largest and most diverse group of clients and clinicians nationwide. A REVIEW OF 2011 growth in Travel Nursing, there were a number of other key highlights during 2011: • We expanded our national leadership position in clinical managed services programs by adding over 20 new MSP clients, representing an estimated $80 million in projected annualized gross spend under management. In 2011, our revenues through MSP contracts grew by 38% on a pro forma basis to $185 million, representing a third of our Nurse and Allied Healthcare Staffing business. Penetration of MSP revenues is primarily in Nurse Staffing at this time, and we believe over the next three years there will be a similar shift in the Allied Staffing and Locum Tenens businesses. AMN is well-positioned to capitalize on this continuing trend. Because we typically achieve higher fill rates in MSP contracts than in traditional contracts, we are able to grow faster during periods of expansion, while enjoying some protection during economic downturns. • Our largest business segment, Nurse and Allied Healthcare Staffing, did very well with revenues and operating profit increasing 19% and 48%, respectively, on a pro forma basis over...
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...Needs Assessment for Quality In order for a hospital to survive the competition in today’s healthcare world, a hospital must be aware of opportunities to grow and reduce costs and be supported by Total Quality Management Process. The TQM process helps the hospital to create new products, ensure the standards of quality and client satisfaction and deliver improved services. In addition, the TQM process also helps in improving a company's bottom line profits by increasing operating efficiencies, eliminating waste, and creating working conditions conductive to productivity and company growth. The employees must work in healthy environments, which maximizes their efficiencies and enables them to perform at their best levels. In both the short-term and long-term, the quality improvement process pushes the company from different angles to achieve strategic goals and plans. One of the important processes of patient care is proper medical documentation and updated medical records. Description of chosen process Accurate and complete medical documentation is the responsibility of medical transcriptionists. However, the challenges to medical transcriptionists and the medical transcription industry are complex and varied. Pressures associated with cost, demand, workforce limitations, technological development, globalization, policy and awareness issues come together to create a picture that changes depending on one’s perspective and point of view. Trying to assemble these factors...
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...,demand, capacityFlow of Essay We will be first introducing our topic “Managing Demand and Capacity” through papers - “Managing the Tug of War between supply and demand in services industries” by “Gabriel Bitran” and “Susana Mondschein” and “Managing Service Organizations” by John Bowen and Robert C Ford. These papers explains the general challenges faced by services firms in managing capacity, demand and also describes generalized solution to solve those issues. After introducing our topic, we will delve in to specifics of “Managing Demand” and “Managing Capacity” through different research papers. Under the topic “Managing demand”, we have discussed two research papers- “Strategies for Managing Demand in Capacity-Constrained Services Organizations” by “Christopher H. Lovelock” and “Impact of demand management on the service system performance” by “David M Rhyne”. Under capacity management, we have discussed 2 research papers – “Capacity Management in Services Organizations” by Hans Corsten and Stephan Stuhlmann and “Capacity as a Strategic Marketing Variable” by Steven M. Shugan. .After this, we have discussed papers based on the solutions to manage both demand and capacity. We reviewed research papers “Optimum service capacity and demand management with price incentives “ by Özgür Özlük, Abdelghani A. Elimam, Eduardo Interaminense, and “Demand and capacity management decisions in services”, by Kenneth J. Klassen and Thomas R. Rohlede. In the end, we have picked up a specific...
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...with different management styles and the different range of cultures or values implemented within the workplace. The impact of it had affected me to pursue on the management career, helped me reflect on what leadership and management style I would be developing on in which I came up with this study. I would be looking at a detailed study on the elements of the different range of organisational objectives, values and culture and their impact on the management and leadership role in my organisation. Evaluate these leadership and management skills to the attainment of the organisational objective and to assess my personal leadership and management skill and identify any personal development plan that supports the organisational goal. On the second task, I need to assess any opportunities on the development of my leadership and management skills. Construct my personal development plan to develop leadership and management skills even to manage personal development of leadership and management skills. The third task is a review on my personal development plan against the original objectives. Evaluate the effectiveness of my personal...
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...improvements, and governance and anticorruption. It is commonly believed that BD results in a decrease in tax revenue to the government... I actually have a different view on this matter. From the remittances is it first of all the households that are benefitting from it, but secondly the government is benefitting as well. I will explain this in more detail. The remittances spent on the consumption of both domestically produced goods and imports increase the tax base, which in turn increases revenues from sales taxes, value-added taxes and import duties and other indirect taxes. (stroomdiagram) With the remittances, the individuals/society determine their spending priorities as opposed to the agenda of the government as is the case with taxes and foreign aid. Besides this, governments are now able to increase their debts, because of the constant inflow generated by tax, or governments can spend more on infrastructure. (Abdih et al, 2012) In other words, remittances can provide the (indirect) tax revenues (increase), which allowed some countries to increase spending. This effect is explained in more detail as the (Keynesian) multiplier effect. (Lowell, 2001), (Clemens, 2013), (Ebeke, 2010). Actually, Sophie, that brings up an interesting point. Many people don’t realise just how significant the contribution of remittances is to the GDP of a...
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...Recruitment Plan and Selection Method | Course Project – Assignment 2 | Qiana C. Weaver – HR 590 | HR Receptionist Job Ad Job Title: | Human Resource Receptionist | Department: | Human Resource | Location: | Orland Park, IL | Description: This position is responsible for performing human resource related duties at the administrative level, answering incoming calls and directing calls to appropriate associates.A teammate in this position must have the ability to: * Perform data entry of payroll including the handling of teammate inquiries regarding payroll, teammate time and attendance maintenance, and time off requests. * Scan and data entry of confidential file documents into on-base employee files. * Answer telephone and direct the caller to the appropriate teammate. * Sign-in and notify appropriate teammates of guest arrival. * Maintain badge system and create replacement badges. * Sort incoming mail by department and prepare outgoing mail for mail carrier. * Create divisional articles and PowerPoint presentations for the company magazine, bulletin boards, and divisional communication tools. * Communicate company policies and practices (as appropriate) to supervisors and teammates. * Organize special projects which may include, but are not limited to; annual holiday events, philanthropy assignments, health and wellness projects and events. | Qualifications: * Have a high school diploma or GED. * Have excellent verbal and written communication...
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...ELDER ABUSE IN NURSING HOMES: THE IMPACT OF DEMENTIA/SPECIAL CARE UNITS BY CHRISTINA KAY FALK THESIS Submitted in partial fulfillment of the requirements for the degree of Master of Science in Community Health in the Graduate College of the University of Illinois at Urbana-Champaign, 2013 Urbana, Illinois Adviser: Stephen J. Notaro, Ph.D. ii ELDER ABUSE IN NURSING HOMES: THE IMPACT OF DEMENTIA/SPECIAL CARE UNITS By: Christina K. Falk Elder abuse is a topic that impacts everyone in America at some point in their life. Special care units also called dementia units are protected areas in a nursing home that are specially designed for dementia/Alzheimer patients. This thesis reviewed how a special care unit in a nursing home affect the number and severity of deficiencies reported to Medicare. The data was collected from Medicare’s Nursing Home Compare system and the Illinois Public Health Department. This study reviewed 770 nursing homes in Illinois were reviewed, 141 had special care units during the time of data collection. The facilities had a range of total deficiencies from one to 74 with Level of Harm ratings ranging from one to four on a four-point scale. The results showed that residents in a nursing facility that has a special care unit are at a greater risk of a higher Level of Harm but no difference in the number of deficiencies. Possible causes of this greater risk are due to the intrinsic nature of the population in special care units, the need for policy and procedural...
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...TABLE OF CONTENTS A. Four Functions of Management 1 1. Planning 2 Planning Terminology 3 Vision 3 Mission 3 Objective 3 Goals 3 Strategic Planning 4 2. Organizing 4 Organizational Structure 5 Division of Labor 5 Delegation of Authority 6 Departmentation 7 Informal Structure 8 Leading 8 Staffing 9 Staffing Success – More than Luck 10 Starting with Self Assessment 10 Know yourself 11 Know your business 11 Know Advantage & Disadvantage of Employment 11 Directing 12 Motivation 13 Removing Barrier of Communications 13 Facilitating Communication 16 Controlling 17 B. Management Plan (Intro) 20 Security Management Plan 22 -oOo- Ils-pwu-2012 Principles of Organization & Management: Four Functions of Management Planning means looking ahead and chalking out future courses of action to be followed. It is a preparatory step. It is a systematic activity which determines when, how and who is going to perform a specific job. Planning is a detailed programme...
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