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Biomedical subjects

B A Mark

Publications and source records attributed to B A Mark.

At least 19 recordsLinked to original sources
PubMed2000

Market, hospital, and nursing unit characteristics as predictors of nursing unit skill mix: a contextual analysis.

The objective was to examine the relative contributions of market, hospital, and nursing unit characteristics to the prediction of nursing unit skill mix. The strongest predictors of nursing skill mix were found to be the technological sophistication of the hospital, the volume of services offered, and the percentage of patients covered by managed care payors. The results suggest that skill mix on nursing units is buffered from market forces but is highly sensitive to hospital characteristics. These factors need to be taken into account when decisions are made about the allocation of personnel resources. In this article, the terms "nursing skill mix" and "nurse staffing" are used interchangeably.

Clinical Competence↗
PubMed1999

Nursing in the nineties: managing the uncertainty.

OBJECTIVE: This study examined qualitative data on nurses' work lives from 53 hospitals that participated in the National Institutes of Health (NIH)-funded Outcomes Research in Nursing Administration Project (ORNA). BACKGROUND: The ORNA project examines the impact of nursing unit organizational structure on outcomes. The information reported in this article amplifies the quantitative data with qualitative data that enhances understanding of nurses' work lives. METHODS: Site coordinators at all participating hospitals were requested to send monthly journal entries for 6 months. Data were documented according to an agreed-on content outline that consisted of critical incidents and implications. Data were collected from 53 of the 65 study site coordinators (response rate 81.5%). Content analysis of all collected data was conducted by the research team. RESULTS: Study site coordinators in 53 hospitals characterize the acute care environment as turbulent and uncertain. Contributing factors include: 1) work load (fluctuating census, staff preparation, turnover); 2) loss of workplace identity (unit consolidation, hospital buy-outs, and system mergers); and 3) re-engineering (skill mix, new equipment/system changes, new documentation systems, rumored changes). CONCLUSIONS: This study adds to the growing body of literature that portrays environmental uncertainty from the narrative perspective. Although there is an ongoing need for the employment of fiscally accountable, quality enhancing organizational/management strategies, all initiatives are at risk unless personnel needs are attended to and seen as unique in each care setting. Some strategies are offered to meet this dual imperative.

Attitude of Health Personnel↗
PubMed1997

Environmental turbulence: staff nurse perspectives.

The purpose of this qualitative study was to explore staff nurses' perceptions of how turbulence in the internal environment affected their ability to provide patient care. The themes that emerged from the data point toward multiple factors impinging on a staff nurse's ability to provide quality care in today's healthcare environment. The authors discuss these factors, the consequences for staff nurses, patients, and the organization, and the implications for nursing administrators and their colleagues in hospital administration.

Adult↗
PubMed1997

Graduate management education for nurses: a comparative study.

This paper examines graduate management education programs for nurses using two programs of one University as a case study. Historically, Schools of Nursing have provided educational programs for nurse executives. More recently, a combination of nursing and business programs have gained popularity. A survey of nurses with the Master of Science (MS) from a School of Nursing and the Master of Science in Health Administration (MSHA) from a Department of Health Administration was conducted to assess demographic variables and job characteristics. Differences in job characteristics of the alumni of the two programs are evaluated and discussed.

Adult↗
PubMed1997

Outcomes research. Clues to quality and organizational effectiveness?

Outcomes research has often been touted as the best response to concerns about quality in today's health care organizations. Yet, outcomes research is accompanied by its own set of problems. These problems must be addressed if outcomes research is, in fact, to guide assessments of quality and of organizational effectiveness. One question is how quality and organizational effectiveness should be defined. In addition, measurement issues are particularly problematic in outcomes research, as is the availability of appropriate data. This article discusses each of these areas, and concludes by presenting an integrated model to guide the assessment of outcomes, quality, and organizational effectiveness.

Data Collection↗
PubMed1996

A theoretical model for nursing systems outcomes research.

Nursing research on patient and administrative outcomes has typically examined the relationships between selected structural characteristics and outcomes, without taking into account the organization's context. In contrast, health services research has focused on the relationships between the organization's context and outcomes, most often mortality, without taking into account structural characteristics. Although widely used, both approaches develop fragmented knowledge. This article describes a comprehensive theoretical model that takes into account the relationships among the organization's context, its structure, and both patient and nursing administrative outcomes.

Humans↗
PubMed1995

Measurement of patient outcomes: data availability and consistency across hospitals.

In a random sample of 20 hospitals, the availability and consistency of five patient outcome indicators were examined, including medication administration errors, patient falls, occurrence of new decubitus ulcers, nosocomial infections, and unplanned readmission to the hospital. The results indicate that information about only two outcome indicators--medication errors and patient falls--were collected consistently by the sampled hospitals. The findings are discussed in the context of implications for the study of patient outcomes research.

Accidental Falls↗
PubMed1994

The emerging role of the nurse manager. Implications for educational preparation.

What trends are evident in redesigning the nurse manager role and what will it look like in the year 2000? The author compares data from several different sources in identifying trends. The data suggest that the nurse manager role will continue to increase in complexity and importance. Implications of trends for graduate programs preparing nurse managers and suggested guidelines for planning programs are detailed.

Curriculum↗
PubMed1994

Technological and environmental characteristics of intensive care units. Implications for job redesign.

Nurse executives are experiencing severe pressures to create systems of care delivery that provide services in more cost-conscious ways. Before care systems can be restructured, a systematic assessment of the work and the environment of the nursing unit must take place. This study found significant differences among nine intensive care units regarding both the nature of their work and their environments. These differences provided information that can be used in staffing decisions, nurse/physician interaction, and staff nurse and managerial recruitment.

Academic Medical Centers↗
PubMed1992

Psychometric examination of instruments using aggregated data.

The techniques used to examine the psychometric properties of instruments that measure concepts where individual responses are aggregated to form an index describing a group level phenomenon are reviewed. This examination includes assessing the content validity of items to determine how well they measure group level concepts as well as analyzing reliability and validity at the aggregated rather than individual level. Additional techniques to test for within and between group variability are presented. The latter approaches are useful in determining the consistency and adequacy of individual responses at the group level.

Group Processes↗
PubMed1992

Characteristics of nursing practice models.

Are there differences among the nursing practice dimensions of the three major nursing practice models--team nursing, case management, and total patient care? The author, whose study found few differences, discusses reasons for the similarity among models and suggests approaches to designing future nursing practice models.

Ancillary Services, Hospital↗
PubMed1990

Knowledge and skills for nurse administrators.

How should nurse administrators be educated for practice in today's complex environment? Mark, Turner, and Englebardt provide a thoughtful perspective on that question. The authors analyze the educational needs of two levels: the nurse executive and the nurse manager, and they look at all aspects of an effective graduate program for both career choices.

Administrative Personnel↗