Strategies for nurse aide job satisfaction.

With average turnover costs equaling four times an employee's salary, administrators cannot afford to lose nurse aides. This study explored why aides leave and ways to improve your facility's work environment.

Nurturing the nurturers.

The nurse-retention problem plagues hospitals nationwide, but nowhere is the crisis more evident than in rural areas, where, if nothing is done, more hospitals likely will join the growing numbers that have simply closed. Researchers designed a study to identify effective strategies for managers and administrators to pursue in retaining nurses in rural hospitals. They asked nurses to rate 43 strategies according to the degree of influence each would have on the decision to remain on the job. "Winning" strategies fit into four major categories: (1) self- and professional development, (2) monetary needs, including benefits, (3) internal management, and (4) staffing and scheduling. Among the study's suggestions are these: Managers should increase opportunities for upward mobility to alleviate some of the nurses' frustrations at feeling trapped in one position. If a higher educational level is a prerequisite for upward mobility, hospital managers should simplify the process of obtaining that education. Rural nurses clearly do not believe they are being compensated enough for their efforts. Hospitals must respond accordingly if they intend to maintain an adequate nursing staff. Nurses want to know that when conflicts or disruptions arise, they will have a simple, direct means of resolution. Hospitals should manage conflict through communication and training and support at all primary care levels. Because nurses provide the majority of client care, they must have a more active, participative role in staffing and scheduling policies.

Management strategies to minimize nursing turnover.

The nursing shortage continues nationwide. Many factors contribute to the recurring crisis. Some realistic recommendations for short- and long-term solutions are presented here.

One more time--solutions to the nursing shortage.

The shortage of registered nurses continues nationwide. Reviewing factors that contribute to the recurring crisis, the authors recommend short- and long-term solutions, which focus on retention as more effective and less expensive than recruitment. The authors also discuss the complex issues of employing agency RNs and recruiting of foreign-educated RNs.

Pictures of performance: the key to improved nursing productivity.

A useful way to measure, track, and control nursing productivity is available, in addition to techniques for establishing productivity objectives and visualizing and displaying daily productivity performance. Many incentives for productivity improvement are available as well.

The development and management uses of a patient classification system for a high-risk perinatal center.

A patient classification system for a labor and delivery unit, a maternal-fetal intensive care unit, and an antepartum monitored unit is a complex but necessary component for staffing units with frequently changing patient census and varying patient acuity. This article describes the processes used to develop such a classification system and to predict staffing needs, in advance, in four-hour time blocks in the labor and delivery unit and in eight-hour time frames in the maternal-fetal intensive care unit and the antepartum monitored unit. The article also identifies direct nursing care and indirect nursing care activities and defines the levels of care needed.

Patient classification systems in burn care.

Patient classification systems (PCSs) are required by the Joint Commission for the Accreditation of Hospitals. Usually computerized, PCSs can project staffing needs, insure equitable patient care assignments, and provide a basis for nursing charges. Two types of PCS are currently in use: prototype and factor. Prototype systems seem to be more practical for burn units, which require high levels of nursing care. Essential to a successful PCS is a well-trained and committed staff and enough time to develop a classification checklist and time standards that reflect the reality of that particular burn unit.

Variance analysis. Using standards to predict nurse staffing patterns.

The use of standards to predict required nurse staffing patterns has received attention in recent years because of pressures for cost containment, revenue limitations and the increased availability of data. The establishment of a standard hour system can lead to a comparison of actual hours to the standard hours predicted and adjusted for case mix and changes in volume. The authors previously developed nurse staffing prediction models based on information from a 220-bed short-term hospital. Further study in terms of variance analysis (standard hours to actual hours) is explored in this article.