Shaping Funding Policy for Nursing Services

Shaping Funding Policy for Nursing Services

Virginia Plummer (Monash University, Australia)
Copyright: © 2009 |Pages: 20
DOI: 10.4018/978-1-60566-234-3.ch009
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This chapter is about the major policy issue of nursing resource allocation for hospitals. Health service executives have different views about whether systems based on ratios or those based on patient dependency are more accurate. This chapter reports on a statistical analysis of almost 2 million hours of nursing data provided by 22 acute care public and private hospitals in Australia, New Zealand, and Thailand. The TrendCare informatics system was selected because it has the capacity to simultaneously measure nurse patient ratios and nursing workloads by a dependency method of nursing hours per patient day. The results showed that TrendCare predicts actual direct nursing care requirements with greater accuracy than ratios for all hospital and patient types, facilitating better allocation of nursing resources and demonstrating that the cost of nursing care would be less for hospitals using that system than for ratios. This is an important outcome for nursing informatics.
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Insights Into An Information Deficit

The objective of this chapter is to illustrate the influence nurses can have on policy development and refinement in a climate of contrasting views and practices, using data and trends analysis from an Australian patient level workload informatics system. A study was designed to inform the debate about future policy directions in workforce planning. It is expected to be of interest to all stakeholders and notably to funding agencies that have established nursing policy using either of these two systems to measure and allocate nursing workloads. Examples of these policies include the introduction of mandated nurse patient ratios in Victoria (Australia’s second most populated state) by the Department of Human Services (DHS), the Safe Staffing Law governing hospitals and nurse patient ratios in California, USA and a staffing by TrendCare agreement incorporated in the Enterprise Bargaining Agreements of some regional Victorian public hospitals (Plummer, 2005)..

This study was set in the policy arena of the Victorian public hospital experience where a staffing ratio law had been passed that trumped acuity based staffing. It was conducted from the perspective of an observer, attempting to understand the political and clinical landscape of mandated nurse patient ratios and was designed to shed light on a situation where policy has been established in the absence of data and the alternative was never tested. The study was grounded in nursing resource allocation and costs frameworks and is in effect a simulation of two different policy approaches. This was a correlational study of a retrospective cohort of nursing workload reports for the same patients and staff, during the same cross-sectional period of time. It was a study that will inform policy decisions on workloads.

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Editorial Advisory Board
Table of Contents
Peter J. Murray
Bettina Staudinger
Chapter 1
Wanda Sneed
Nursing informaticists can be leaders in promoting prevention of illness and diseases in the 21st century. Developing an infrastructure for... Sample PDF
A Treatise on Rural Public Health Nursing
Chapter 2
Elfriede Fritz, Daniela Deufert, Johannes Hilbe
Experience in nursing practice shows that, in Austria, there are still problems with assessment in computer-based nursing documentation. Nursing... Sample PDF
Assessment in a Computer-Based Nursing Documentation
Chapter 3
Dawn Dowding, Rebecca Randell, Natasha Mitchell, Rebecca Foster, Valerie Lattimer, Carl Thompson
Increasingly, new and extended roles and responsibilities for nurses are being supported through the introduction of clinical decision support... Sample PDF
Clinical Decision Support Systems in Nursing
Chapter 4
Jerono P. Rotich
This chapter will give an overview of the healthcare-related challenges that most newcomer immigrants and refugees encounter as they acculturate... Sample PDF
Culturally Sensitive Healthcare for Newcomer Immigrants
Chapter 5
Pammla Petrucka, Sandra Bassendowski, Thomas F. James, Hazel Roberts, June Anonson
This chapter presents the imperatives of mobile technologies in healthcare as these impact (or potentially) impact on development. It presents the... Sample PDF
Mobile Technology in a Developing Context: Impacts and Directions for Nursing
Chapter 6
Kenric W. Hammond, Charlene R. Weir, Efthimis N. Efthimiadis
Computerized patient care documentation (CPD) is a vital part of a Patient Care Information System (PCIS). Studying CPD in a well-established PCIS... Sample PDF
Nursing Documentation in a Mature EHR System
Chapter 7
Sisira Edirippulige, Anthony C. Smith, Mark Bensink, Nigel R. Armfield, Richard Wootton
Nurses play a pivotal role in the provision of healthcare. Home telehealth, the use of information and communication technologies to deliver and... Sample PDF
Nurses and Telehealth: Current Practice and Future Trends
Chapter 8
Mary D. Oriol, Gail Tumulty
This chapter presents a theoretical framework and research base for the successful transition of an established Master of Science in Nursing program... Sample PDF
Successful Online Teaching and Learning Strategies
Chapter 9
Virginia Plummer
This chapter is about the major policy issue of nursing resource allocation for hospitals. Health service executives have different views about... Sample PDF
Shaping Funding Policy for Nursing Services
Chapter 10
Elizabeth M. Borycki, Andre W. Kushniruk, Shigeki Kuwata, Hiromi Watanabe
A range of new technologies/information systems are increasingly being used by nurses in healthcare organizations. These technologies/information... Sample PDF
Simulations to AssessMedication Administration Systems
Chapter 11
Peter Jones
This chapter explores the potential of a conceptual framework – Hodges’ model – both as a socio-technical structure and means to explore such... Sample PDF
Socio-Technical Structures, 4Ps and Hodges' Model
Chapter 12
Beth Perry Mahler, Margaret Edwards
Teaching nursing online requires teachers to purposefully use strategies that facilitate the development of virtual learning communities. The... Sample PDF
Strategies for Creating Virtual Learning Communities
Chapter 13
Roberta Cuel, Roberta Ferrario
In this chapter a case study is presented, in which the ethnomethodological approach is used to analyze the impact of the implementation of an... Sample PDF
The Impact of Technology in Organizational Communication
Chapter 14
Boris A. Kobrinsky, Nikolay V. Matveev
Telemedicine, or distant medical consultations using communication via electronic networks, is gradually becoming a standard of medical care... Sample PDF
The Roles of a Nurse in Telemedical Consultations
Chapter 15
Daniel Carbone
The purpose of this chapter is to broadly discuss the need for enhanced evidence-based medicine (EBM) by nurses in the context of rural Australia... Sample PDF
The Role of EBM and Nursing Informatics in Rural Australia
Chapter 16
Maureen Farrell
The use of mobile technologies in nursing education is rapidly increasing. Handheld computers are the most frequently used of these technologies as... Sample PDF
Use of Handheld Computers in Nursing Education
Chapter 17
Elizabeth Rogerson, Linda Martindale, Carolyn Waltz
This chapter addresses issues relating to nursing informatics as used and applied in nursing education. This includes the use of information... Sample PDF
Using Information Technology in Nursing Education
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