Nursing Staff in Hospitals and Nursing Homes Is It Adequate? (1996) / Chapter Skim
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Pages 533-542
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From page 533... ...
, 17, 97-100, 248, 342 barriers to practice, 7, 100, 325, 348, 353 education, 90, 336, 340, 342, 347, 348, 349 533 see Clinical nurse specialists; Geriatric and gerontological nursing; Nurse practitioners Adverse incidents, 319-320 Age, of nurses, 72-74, 340, 350-351, see also Elderly population Agency for Health Care Policy Research (AHCPR) , 17, 12 a, 352 AIDS in nursing home case mix, 379 special care units, 58, 120 staff attitudes toward patients, 510512 see HIV transmission Almshouses, 362 Alzheimer's disease and other dementia, 39, 363-364, 366 special care units (SCU)
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From page 534... ...
ack injuries and pain, 173- 175, 505509 Barriers to practice, 7, 100, 325, 348, 353 Black population, 34, 35, 38 in nursing homes, 78, 373 Blood and body fluids handling, 511-512 Board and care facilities, 63, 364-365 Boren Amendment, 61, 479 Bureau of Health Professions, Division of Nursing, 106, 122 Burnout, 183, 184, 185-186, 347, 388389, 519-521, 523, 524 C Career development and mobility, 106, 34O, 345, 354 Care planning, 96, 316 in nursing homes, 131, 134, 146 INDEX Care teams, 1-2, 89, 95, 96, 101, 322323, 352, 363-364 Case management, 6, 89, 95, 96-97, 321, 434 Case-mix acuity, 261 hospitals, 54-55, 79, 84-85, 93 nursing homes, 58, 129, 131-132, 147, 363, 366, 378-379, 434435 Case-mix reimbursement, 61-62, 368, 400-401 under Medicaid, 163- 165, 479-480, 482-484 Certificate of Need (CON) program, 43, 61, 476 Certification, see Licensing and certification Chronic conditions, 38-39, 40, 58 Clinical nurse specialists, 97-99, 249, 342 Closures, of hospitals, 52, 53 Collaboration, see Care teams Community college programs, 77, 8788, 335, 340, 350 Community-oriented care, 89-90, 261, 345, 351-352, 354 Competencies in graduate programs, 342, 351352 of nurse assistants (NA)
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From page 535... ...
, 69, 7376, 83, 87-88, 300-302, 335, 338, 339, 350-351, 433 in research skills, 336, 337, 342, 346, 349, 352-353 teaching and faculties, 345, 349, 351 Elderly population, 2, 20, 31, 32-41 abuse of, 180, 374-375 aged 85 and over, 32, 33, 34, 38, 40, 58, 59, 366 health and disability status, 38-39 home health services use, 63 hospital use, 39-40, 54, 282-283, 292 nursing home demand and use, 38, 39, 40, 41, 58, 59, 366, 378-379 see Geriatric and gerontological nursing Emergency rooms, stress and violence in, 178, 184, 513-514 Employment in health occupations, 4, 69, 72, 304-305 registered nurses (RN) , 71-72, 93, 304-305 Enrollments in nursing programs, 75, 76, 301, 302, 303 Ethnic groups, see Racial and ethnic groups Evaluation research, 17, 106, 342, 345, 352-353
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From page 536... ...
, 43, 45, 47, 48, 49, 125, 290 Health promotion, 343, 352 Hepatitis transmission, 175, 176, 509 Hispanic population, 34, 35, 38, 374 in nursing homes, 351, 374 HIV transmission, 175, 176, 509, 510 Home health care, 54, 63-64, 70, 365 Home health services, of hospitals, 56, 57, 58, 287 Hospices, 56, 57, 58, 288-289 Hospitals, 22, 51-58, 79-81, 83-85 abuse and violence in, 178-179, 184, 513-514 INDEX beds, 54, 55, 79, 284-286, 292 case mix, 54-55, 79, 84-85, 93 closures, 52, 53 continuum of care, 51, 55-58, 9697 discharge planning, 39-40, 97, 98 home health services offered, 56, 57, 58, 287 hospice services offered, 56, 57, 58, 288-289 injuries among staff, 170, 171, 175, 503 inpatient activity, 1, 53-55, 279283, 292 licensed practical nurses (LPN) in, 77, 78, 93, 106, 294-297 mergers, 53 nurse assistants (NA)
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From page 537... ...
, 69 of nurse assistants, 17, 70, 102, 181-182 of nursing homes, 133, 136, 460 of registered nurses (RN', 69, 71, 337 Life expectancy, 32, 34 Lifting injuries, 15, 18, 171, 174, 175, 177, 505, 507-508 Living arrangements, 36-37 Long-term care, see Assisted living services; Nursing homes M Managed care, 1, 19, 45, 47-49, 52, 96, 261-262, 348 Master' s degree programs, 83, 335-336, 337, 338, 339, 341, 351, see also Advanced practice nurses (APN) Medicaid, 23, 38, 46, 51, 60, 61-62, 133, 163-165, 353, 362, 377378, 463, 475-484 passim case-mix reimbursement, 163- 165, 479-480, 482-484
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From page 538... ...
, 520-521 Nurse anesthetists, 85, 100 Nurse assistants (NA) and ancillary nursing personnel, 2n, 69-70, 72, 73, 78, 304-305, 347-348 abuse and violence involvement, 16, 18, 180-182, 376, 514 INDEX competencies, 17, 70, 102-103 conflict management training, 17, 18, 102, 158 and culturally sensitive care, 17, 18, 102, 103, 158, 372-373 in hospitals, 7, 17, 70, 100- 103, 294-297 injuries among, 15, 171, 172, 174, 503-504, 505-506 occupational safety training, 15, 17, 18, 102, 158 training, 7, 18, 70, 78, 100-101, 102, 157-158, 181, 391, 432, 468 wages, 156, 160, 370, 371 Nurse midwives, 85, 100 Nurse practitioners, 85, 97, 99-100, 342, 347, 350 Nursing Home Reform Act, 68, 83 Nursing Home Resident Assessment System, 135, 459-460 Nursing homes, 58-66, 362-366, 426429, 471-473, 477-479 abuse and violence in, 179-183, 374-377 access issues, 59, 164, 377-378, 476-477 alternative services, 40, 42-43, 6465, 365-366, 472 bed supply and occupancy, 58-59, 472-476 case mix, 58, 129, 131-132, 147, 363, 366, 378-379, 434-435 complex technologies in, 59, 65 conflict management, 183 cultural issues, 372-374, 411, 413414 directors of nursing in, 14-15, 18, 141, 158-159, 391, 397 injuries among staff, 170, 171, 173-174, 269, 503 and Medicaid, 23, 46, 60, 61-62, 133, 163- 165, 362, 377-378, 463, 475-484 passim and Medicare, 46, 60, 62, 133, 362, 363, 377, 484-485 mergers and acquisitions, 64
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From page 539... ...
presence, 18, 83, 141-142, 153155, 162, 199-204, 369, 381, 403 see Quality of nursing home care Nursing shortage, 71, 353, 371 educational component, 349 and nursing homes, 141 539 o Occupational health, see Injuries and illness among staff; Stress Older persons, see Elderly population Ombudsmen, 167, 250n, 394 Omnibus Budget Reconciliation Act (OBRA) , 12, 61, 62, 133-134, 168, 181- 182, 364, 367-368, 381, 383, 457, 459 implementation, 140- 141 nursing coverage requirements, 12, 141-142, 383-384, 462-463 waivers, 141-142, 369, 381-382, 382 Oncology clinical nurse specialists, 98 Organizational factors, 17, 118, 121, 122, 308-309, 314 Outcome measures, 23-24, 344, 345, 346 hospitals, 108-109, 111, 123-124, 313-315, 325-328 nursing homes, 130, 131, 383, 456 Outpatient care, 55, 56-57, 99, 289, 292 Overexertion, 170, 171, 174 Ownership of facilities, 50, 247 nursing homes, 50, 162, 364, 403, 485-489 p Partners-in-practice models, 101 - 102, 344 Patient-centered care, 94-95, 101 Patient satisfaction, 322-323, 325 with managed care, 48, 49 with nursing homes, 131 and restructuring, 17, 106 Peer Review Organizations (PRO)
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, 60 impacts on staffing, 44, 79 under Medicaid, 61, 62, 163, 479, 480-481 under Medicare, 43-44, 62, 79, 114 Psychiatric clinical nurse specialists, 342, 348 Public health nursing, 90 Q Quality assurance and quality improvement (QA/QI) , 10- 11, 104, 107 in nursing home assessment, 135136, 460 Quality of hospital care, 28, 113-116, 245-250, 265-267 advanced practice nurses role in, 17, 97-100 and ancillary nursing personnel, 17, 100-103 elements of, 107-109, 110-111 legislation and regulation, 11, 102103, 124-126 measurement of, 8-9, 106-113, 325-328 and organizational restructuring, 56, 94-106, 113 performance indicators and standards, 122- 124 prospective payment system impacts, 9, 114-115 INDEX research needs, 8, 10-11, 17, 106, 116, 121-122, 127 and staffing level and mix, 9-12, 113, 116-122 Quality of nursing home care, 12, 28, 132-146, 250-256, 267-269, 456-457 elements of, 129- 131 families' roles in, 131, 165- 167, 268, 384-386, 410-411, 413 and geriatric specialists, 18, 155156, 381-382, 396-398, 414415, 467-468 and job satisfaction, 386-387, 399 and job stress, 387-390 legislation and regulation, 133 - 136, 141-142, 367-368, 381-382, 457, 459-461 management issues, 18, 158- 159, 403-405 measurement of, 129- 132, 382-385, 407-409, 454-457 and nurse assistants (NA)
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From page 541... ...
Registries, 181 - 182 Regulation of hospital operations, 11, 102- 103, 124-126 of hospital staffing, 11, 125 of nursing home operations, 133136, 141-142, 367-368, 381382, 457, 459-461 of nursing home staffing, 141-142, 167-168, 253, 369-370, 381382, 427, 462-463, 470-471, 491 -492 541 Rehabilitative care, 42-43, 64-65, 134, 367, 379, 412-413 Rehospitalization rates, 131, 133 Reimbursement mechanisms, 43-44, see also Case-mix reimbursement; Prospective payment system (PPS) Report cards, 122- 124 Research needs, 192 for quality of hospital care, 8, 1011, 17, 106, 116, 121-122, 127 for quality of nursing home care, 18, 407-411 Resident assessment instrument (RAI)
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From page 542... ...
programs; Baccalaureate programs Unemployment in nursing, 72, 73, 78, 105 Unions, 245-248, 251-252 University programs, 340, 345-347, 348-349, 350 Urethral catheterization, 132, 140 V Ventilator care, 57, 59, 65 Violence, see Abuse and violence Volunteers, 166, 191 W Wages, see Salaries and compensation Waivers home- and community-based care, 63 nursing home staff requirements, 14, 141-142, 154, 200, 202-203, 369-370, 381-382 Weapons, 178-179, 513-514 White population, 34 elderly, 34, 35, 38, 373 elderly, 36, 38, 375 home health services use, 63 as informal caregivers, 37 in nursing, 72, 156 occupational injuries among, 171, 172 and violence, 178, 375 Workplace hazards, see Injuries and illness among staff; Stress
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