Challenges in getting workforce research in nursing used for decision-making in policy and practice: a Canadian perspective

The allocation and fairness of hospital pharmacist human resources in China: a time-series study

BACKGROUND

To address the rational use of medicines in healthcare institutions, the Chinese government enacted legislation for pharmacists in 2021, emphasizing the importance of pharmacists in medical services. The allocation and equity of pharmacist human resources in healthcare institutions directly affect people's accessibility to pharmaceutical services. The study aims to analyze the supply and demand of pharmacist human resources in Chinese healthcare institutions and evaluate the equity of their distribution to provide a reference for the rational management of pharmacist resources.

METHODS

This was a time-series study that was conducted using data obtained from Health and Health Statistical Yearbook that is performed every year by the National Health Commission of the People's Republic of China. The study included 31 provinces, municipalities, and autonomous regions and 34,354 medical institutions in mainland China, which were classified into different economic regions based on their level of economic development. The study collected healthcare technicians and pharmacist data from national healthcare institutions between 2016 and 2020. The study evaluated the level of pharmacist human resource allocation using the health resource density index. The study explored the equity of pharmacist human resource allocation from two aspects: population and geographic area, using the Gini coefficient and Theil index.

RESULTS

The average annual growth rates of healthcare technical staff and pharmacists in Chinese medical institutions from 2016 to 2020 were 5.67% and 3.03%, respectively. The Gini coefficients of healthcare personnel resources based on population distribution were all below 0.119, while those based on geographical area were all above 0.655. The total Theil indexes of pharmacist human resources based on population distribution were all below 0.010, while those based on geographical area were all above 0.511. In addition, the contribution rates of the within-group Theil indexes of pharmacist human resources based on population and geographical area distributions to the total Theil index were all greater than or equal to 50%.

CONCLUSIONS

The allocation level of pharmacist human resources in China continues to improve, but there are differences in different economic development areas. Currently, allocation based on population shows equity, but allocation based on geographic area shows inequity. In the future, more attention should be paid to the geographic accessibility of pharmacist human resources, and resource allocation should consider both the population served and geographic area.

The allocation and fairness of health human resources in Chinese maternal and child health care institutions: a nationwide longitudinal study

BACKGROUND

In response to an aging population, the Chinese government implemented the three-child policy in 2021 based on the comprehensive two-child policy. With the implementation of the new birth policy, people's maternal and child health (MCH) needs will also increase. The allocation and fairness of MCH human resources directly affect people's access to MCH services. The purpose of this study is to analyze the allocation of health human resources in Chinese maternal and child health care institutions, evaluate the fairness of the allocation, to provide a reference for the rational allocation of MCH human resources.

METHODS

The data of health technicians, licensed (assistant) physicians, and registered nurses in maternal and child health care institutions nationwide from 2016 to 2020 were included. The health resource density index (HRDI) is used to evaluate the allocation level of MCH human resources. The Gini coefficient (G) and Theil index (T) are used to evaluate the fairness of the allocation of MCH human resources from the perspectives of population and geographic area.

RESULTS

From 2016 to 2020, the average annual growth rate of the number of health technicians, licensed (assistant) physicians, and registered nurses in Chinese maternal and child health care institutions was 7.53, 6.88, and 9.12%, respectively. The Gini coefficient (G) of the three types of MCH human resources allocated by population were all below 0.23, and the Gini coefficient (G) allocated by geographical area were all above 0.65. The Theil index (T) of the three types of MCH human resources allocated by population was all lower than 0.06, and the Theil index (T) allocated by geographical area was all higher than 0.53. In addition, the three types of MCH human resources allocated by population and geographic area contributed more than 84% of the Theil index within the group (T_intra) to the Theil index (T).

CONCLUSIONS

China's MCH human resources were fair in terms of population allocation, but unfair in terms of geographical area allocation. In the future, more attention should be paid to the geographical accessibility of MCH human resources, and the allocation of resources should comprehensively consider the two factors of serving the population and geographical area.

Bibliometric analysis of six nursing journals from the Web of Science, 2012-2017

AIM

The purpose of this study was to perform a bibliometric analysis of the six most important nursing journals according to the impact factor of the Science Citation Index through Web of Science^® . The following journals were included: International Journal of Nursing Studies, Nurse Education Today, Journal of Nursing Scholarship, Nursing Outlook, Worldviews on Evidence-Based Nursing and the Journal of Advanced Nursing.

BACKGROUND

In the nursing field, bibliometric analysis and maps have been used to analyse the production of some journals but not for the comparison of different journals.

DESIGN/METHOD

Using descriptive bibliometrics, we studied scientific production of different journals and bibliometric maps were used to visualize the content of published articles.

RESULTS

The six journals included showed that 3,937 articles were written by 1,1371 authors from 2,980 institutions and 84 countries from 2012 - 2017. Journal of Advanced Nursing had a greater number of publications and citations. The most prolific authors showed a tendency to publish first in Journal of Advanced Nursing and then in International Journal of Nursing Studies and Nurse Education Today. The frequency of citation was higher in International Journal of Nursing Studies followed by Journal of Advanced Nursing. The most collaborative authors and those with the most co-citations published more than half of their publications in Journal of Advanced Nursing. The topics most commonly researched by these authors were job satisfaction, collaborative practices, and nurse leaders.

CONCLUSION

This bibliometric analysis contributes to the understanding of the current state of nursing research and its evolution.

Stress in nurses: The 100 top-cited papers published in nursing journals

AIM

To identify and analyse the 100 most cited papers on stress in nurses published in nursing journals.

BACKGROUND

The number of citations an article receives is an index of its impact on the scientific community. An analysis of the most cited articles on stress in nursing would allow us to identify the most important articles and to obtain information about this area of knowledge.

DESIGN

A retrospective bibliometric analysis.

DATA SOURCES

In 2016, 111 journals belonging to the "nursing" category were identified in the Science and Social Science Citation Index. A search was performed of the Science Core Collection Website for articles on stress published in these journals.

REVIEW METHODS

The topic, type of article, publishing journal, countries and institutions of origin and year of publication were extracted from the articles. The impact factor, immediacy index, journal country and publisher and h index were collected from the Institute for Scientific Information. The citation density, citation tendency and Bradford's law were calculated.

RESULTS

They identified articles were mostly empirical quantitative studies with a transversal design, published from 1975 - 2011 in 23 journals. They were signed by 233 authors, most of whom are English-speaking from the USA and UK. The core distribution of the publications comprises a single journal, the Journal of Advanced Nursing.

CONCLUSION

The study of stress in nursing has shown increased visibility and recognition each decade. The most recent articles have the highest number of citations, are the highest in rank and have the higher citation densities.

A scoping review of nursing workforce planning and forecasting research

AIM

This study will critically evaluate forecasting models and their content in workforce planning policies for nursing professionals and to highlight the strengths and the weaknesses of existing approaches.

BACKGROUND

Although macro-level nursing workforce issues may not be the first thing that many nurse managers consider in daily operations, the current and impending nursing shortage in many countries makes nursing specific models for workforce forecasting important.

METHOD

A scoping review was conducted using a directed and summative content analysis approach to capture supply and demand analytic methods of nurse workforce planning and forecasting. The literature on nurse workforce forecasting studies published in peer-reviewed journals as well as in grey literature was included in the scoping review.

RESULTS

Thirty six studies met the inclusion criteria, with the majority coming from the USA. Forecasting methods were biased towards service utilization analyses and were not consistent across studies.

CONCLUSION

Current methods for nurse workforce forecasting are inconsistent and have not accounted sufficiently for socioeconomic and political factors that can influence workforce projections. Additional studies examining past trends are needed to improve future modelling.

IMPLICATIONS FOR NURSING MANAGEMENT

Accurate nursing workforce forecasting can help nurse managers, administrators and policy makers to understand the supply and demand of the workforce to prepare and maintain an adequate and competent current and future workforce.

Promoting the legitimacy and agency of new graduate nurses' participation in nursing research

AIM

This paper explores the legitimacy and agency of new graduate mental health nurses to participate in research activities as a regular part of their professional nursing role.

BACKGROUND

There is a wealth of literature describing personal and organisational factors that act as barriers to nurses' engagement in research and overcoming these barriers remains a challenge for health organisations. Some new graduate nurses are well positioned to contribute to research and yet the literature has given little attention to this specific cohort.

RESULTS

This paper will show how facilitating new graduates' participation in research benefits the new graduate and the health service.

CONCLUSION

New graduates learn research skills from experienced researchers and this ensures a sustainable future workforce of researchers. Employers who support staff to pursue professional challenges such as research are more likely to generate organisational commitment and loyalty amongst staff.

The relationship between nurse staffing and inpatient complications

AIM

To compare characteristics of hospitalizations with and without complications and examine the impact of nurse staffing on inpatient complications across different unit types.

BACKGROUND

Studies investigating the relationship between nurse staffing and inpatient complications have not shown consistent results. Methodological limitations have been cited as the basis for this lack of uniformity. Our study was designed to address some of these limitations.

DESIGN

Retrospective longitudinal hospitalization-level study.

METHOD

Adult hospitalizations to high intensity, general medical and general surgical units at three metropolitan tertiary hospitals were included. Data were sourced from Western Australian Department of Health administrative data collections from 2004-2008. We estimated the impact of nurse staffing on inpatient complications adjusted for patient and hospital characteristics and accounted for patients with multiple hospitalizations.

RESULTS

The study included 256,984 hospitalizations across 58 inpatient units. Hospitalizations with complications had significantly different demographic characteristics compared with those without. The direction of the association between nurse staffing and inpatient complications was not consistent for different inpatient complications, nurse skill mix groups or for hospitalizations with different unit movement patterns.

CONCLUSION

Our study design addressed limitations noted in the field, but our results did not support the widely held assumption that improved nurse staffing levels are associated with decreased patient complication rates. Despite a strong international focus on improving nurse staffing to reduce inpatient complications, our results suggest that adding more nurses is not a panacea for reducing inpatient complications to zero.

Use of modified Delphi to plan knowledge translation for decision makers: an application in the field of advanced practice nursing

Disseminating research to decision makers is difficult. Interaction between researchers and decision makers can identify key messages and processes for dissemination. To gain agreement on the key findings from a synthesis on the integration of advanced practice nurses, we used a modified Delphi process. Nursing decision makers contributed ideas via e-mail, discussed and clarified ideas face to face, and then prioritized statements. Sixteen (89%) participated and 14 (77%) completed the final phase. Priority key messages were around access to care and outcomes. The majority identified "NPs increase access to care" and "NPs and CNSs improve patient and system outcomes" as priority messaging statements. Participants agreed policy makers and the public were target audiences for messages. Consulting with policy makers provided the necessary context to develop tailored policy messages and is a helpful approach for research dissemination.

The influence of a wound care teleassistance service on nursing practice: a case study in Quebec

BACKGROUND

Although telehealth is a promising solution for healthcare professionals who work in remote and rural regions, the influence of specific telehealth applications on the nursing workforce remains unknown. This case study aimed to explore the potential influence of a teleassistance service in wound care (the acronym in French is TASP) on nursing practices and on nurse retention in peripheral areas.

MATERIALS AND METHODS

We carried out an exploratory single case study based on 16 semistructured interviews with two promoters of TASP, five nursing managers, and nine nurses from three levels of expertise associated with this service.

RESULTS

According to participants, the main positive influences of TASP were observed in quality of care, professional autonomy, professional development, and decrease of professional isolation. Participants mentioned increased workload associated with global patient data collection at first consultation as a negative effect of TASP. Finally, three possible effects of TASP on nurse retention were identified: none or minimal, imprecise, or mostly positive.

CONCLUSIONS

This case study highlights the positive influence of TASP on several dimensions of nursing practice, in addition to its essential role in improving the quality of care. However, it is important to consider that the service cannot be considered as a solution to or replacement for the shortage of nurses.

Measuring the qualities of nurses: development and testing of the Qualities of Nurses Scale

AIM

This paper reports on the creation, development and testing of a new instrument to measure qualities of nurses, known as the Qualities of Nurses (QON) scale, applicable to student nurses.

BACKGROUND

High attrition rates within nursing programs and during early postgraduate years are an international phenomena. Mismatches between idealized perceptions of nursing and the realities of education and clinical experiences have been identified as contributing factors.

METHOD

A survey method was used to elicit responses to scale items from 678 first-year nursing students at a large university.

RESULTS

A one-factor 12-item solution explaining 47 percent of variance in the construct was demonstrated.

CONCLUSION

The QON can assist in the initial assessment and ongoing monitoring of changes in students' perceptions of nurses. Using the QON, researchers and educators can identify initial student nurses' perceptions and any changes associated in educational or other events that ultimately could be manipulated to reduce attrition.

Israeli registered nurse workforce

This commentary on the article by Nirel, Riba, Reicher and Toren, "Registered nurses in Israel - workforce employment characteristics and projected supply", describes major findings from this important Israeli study and links findings to other nursing workforce studies worldwide. Israeli projections include a 25% decrease in RNs in the workforce by 2028; the greater likelihood of leaving the progression of young nurses compared to older nurses, and the greater likelihood of leaving the profession by those nurses with no advanced training. Suggestions are made for future workforce analysis to triangulate economic analysis and policy planning, work design, and workforce management; for policy and planning and budget allocation at the macro level to go hand-in-hand with work design and management strategies at the micro level; and for the development of a national nursing workforce plan for investment and reform with a timeline and specific dates for accomplishing separate goals for recruitment and retention.

This is a commentary on http://www.ijhpr.org/content/1/1/11/.

[Emotional climate and internal communication in a clinical management unit compared with two traditional hospital services]

BACKGROUND AND OBJECTIVE

The aim of this study is to compare the emotional climate, quality of communication and performance indicators in a clinical management unit and two traditional hospital services.

MATERIAL AND METHODS

Quantitative study.

INSTRUMENT

questionnaire of 94 questions.

PARTICIPANTS

83 health professionals (63 responders) from the clinical management unit of breast pathology and the hospital services of medical oncology and radiation oncology.

ANALYSIS

descriptive statistics, comparison of means, correlation and linear regression models.

RESULTS

The clinical management unit reaches higher values compared with the hospital services about: performance indicators, emotional climate, internal communication and evaluation of the leadership. An important gap between existing and desired sources, channels, media and subjects of communication appear, in both clinical management unit and traditional services.

CONCLUSIONS

The clinical management organization promotes better internal communication and interpersonal relations, leading to improved performance indicators.