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Jean Ann Seago

Publications and source records attributed to Jean Ann Seago.

16 recordsLinked to original sources
PubMed2006

Can the use of LPNs alleviate the nursing shortage? Yes, the authors say, but the issues--involving recruitment, education, and scope of practice--are complex.

OVERVIEW: LPNs may be able to help fill some of the gaps caused by the nursing shortage, but little research has been conducted on the demographic characteristics of LPNs, their education and scope of practice, and the demand for their services, all of which vary from state to state. In 2002 and 2003, the authors conducted a comprehensive national study, Supply, Demand, and Use of Licensed Practical Nurses, and have summarized that study's findings in this article. They found that RNs and LPNs are similar in age and tend to have similar numbers of children, but that racial and ethnic minorities, particularly African Americans, and those who are single, widowed, divorced, or separated are better represented among LPNs. Expanding LPN educational programs might draw more people into nursing. Some LPNs would like to become RNs, so expanding LPN-to-RN "ladder" programs could also be beneficial. LPNs can't replace RNs entirely, but they could perform much of the work now performed by RNs. While long-term care facilities already depend heavily on LPNs, hospitals could benefit from employing more LPNs. The authors make several specific policy recommendations to improve the education and employment of LPNs.

Adult↗
PubMed2006

Longitudinal analyses of nurse staffing and patient outcomes: more about failure to rescue.

BACKGROUND: Numerous studies have examined cross-sectional data to determine the relationships between nurse staffing and patient outcomes. Questions have been raised about some of the studies now in the literature regarding the use of the hospital as the unit of analysis and the cross-sectional design of the studies. Additionally, there is a concern that the primary outcomes being studied are negative. OBJECTIVE: Objectives of this study are to (1) compare the relationships between nurse staffing and positive patient outcomes for 3 adult medical-surgical nursing units in one university teaching hospital across 4 years (16 fiscal quarters); and (2) explore the use of 2 new failure-to-rescue (FTR) rates as outcomes, specifically FTR from medication errors and FTR from decubitus ulcers. DESIGN: This study uses secondary analyses of data viewed retrospectively with a longitudinal repeated-measures design to estimate the relationships between nurse staffing and the outcomes of interest. RESULTS: Accounting for total dollars and case mix, all patient satisfaction measures increased as total hours of care per patient day increased, and as the skill mix became richer (more RN hours/total hours) there was a higher satisfaction with pain management and physical care requests. There was an increase in FTR from medication error as the non-RN (Other) hours of care per patient day increased and there was an increase in FTR from decubitus ulcers as patient severity increased. CONCLUSION: The overall conclusion is that it will likely be necessary to vary staffing hours and staffing mix depending on which positive patient outcome or outcomes you wish to achieve.

Adult↗
PubMed2006

Hospital demand for licensed practical nurses.

Despite evidence that hospital use of licensed practical nurses (LPNs) declined in the 1990s, the current registered nurse (RN) shortage has prompted interest in LPNs as substitutes for RNs. Hospitals, being the dominant employer of RNs, have an economic incentive to use less expensive LPNs as substitutes. Beside wages, there are several forces underlying hospital demand for LPNs. In this article, the authors model and estimate hospital demand for LPNs as a function of nurse wages and hospital, market, and patient characteristics using a longitudinal data set of short-term general hospitals in the United States. The authors find evidence that higher RN wages increase hospital demand for LPNs, both in levels and relative to RNs, suggesting that hospitals at least partially substitute RNs with LPNs.

Employment↗
PubMed2006

College students' perceptions of nursing: a GEE approach.

The nursing shortage has stimulated renewed attention to understanding factors that may enhance the recruitment of students into nursing programs and the retention of registered nurses in the workforce. Many activities have been initiated to address the shortage of nurses, including increasing recruitment of students to study nursing. This paper has two major goals: (1) to answer the research question, "To what extent do college students' characteristics explain the differences in their attitudes towards four service occupations (nursing, medicine, physical therapy and high school teaching)?" and (2) to demonstrate statistical methods appropriate for performing multivariate analyses of clustered data and merging independent survey items into a clustered, multivariate analysis for direct comparison of the different items. Results indicate that the more favourable rating of nursing as an occupation relative to physical therapy is due to the sample, including a large number of students majoring in nursing. Students who are not nursing majors do not appear to hold a more favourable attitude towards nurses relative to physical therapists. The lower rating of high school teachers and higher rating of physicians on most items persists even after adjusting for all the control variables, including whether or not students are nursing majors. Additionally, results support the need for a statistical method such as generalized estimating equations (GEE) to account for individual and interaction confounders, repeated measures, clustering and correlated data.

Adult↗
PubMed2005

California's minority majority and the White face of nursing.

Of the 33 million people in California, the nation's most populous state, minority groups now constitute the majority of the population. Many sources predict that by 2060, the entire country will mirror the diversity of California today. Like the rest of the country, California is experiencing a critical shortage of nurses that is predicted to increase in the coming years, and California's nursing workforce does not represent the racial and ethnic diversity of the state's population as a whole. If the nursing profession is to thrive in the coming years, educators and leaders must create a way to embrace people from diverse ethnicities and cultures. The purposes of this article are to determine whether ethnic minority groups have different success rates in California nursing programs, whether nursing programs with high percentages of diverse students have differing success rates, and to describe the institutional predictors of on-time completion rates, attrition rates, and NCLEX-RN first-time pass rates in California community colleges.

Attitude of Health Personnel↗
PubMed2004

Nurse staffing and hospital ownership in California.

OBJECTIVE: The purpose of this study is to describe the relationship between nurse staffing and owner type or specific corporate owner in California acute care hospitals. BACKGROUND: Little empirical data exist regarding nurse staffing as it relates to owner type or specific corporate owner. With minimum staffing ratios scheduled to be implemented in January 2004, this study provides baseline data for evaluating the impact of minimum staffing ratios in California. METHODS: The study design is descriptive and cross-sectional. Data used in this study are for short-term general hospitals that reported to the California Office of Statewide Health Planning and Development database for fiscal years ending in 1997 through 1999. Six regression models were estimated using pooled data from the 3 years of data. RESULTS: The most consistent significant findings are: increased patient days or patient discharges predict increased registered nurse (RN) hours; lower RN wages predict increased RN hours; higher technology scores predict increased RN hours; and in 1998 there was an across-the-board decrease in RN hours. Other significant findings include that for-profit hospitals and for-profit systems had fewer RN productive hours for medical-surgical nursing, and select corporate owners, unrelated to profit status, had consistently fewer RN productive hours for medical-surgical nursing. CONCLUSIONS/IMPLICATIONS: For-profit hospitals and systems behaved differently in the healthcare market environment of the late 1990s. Select nonprofit systems were also using significantly less RN staffing. Other findings support the implication that as technology sophistication increases, there will be a need for increased RN hours to manage the advanced technology. This runs counter to the argument that increasing technology will decrease the need for RN hours. Finally, as discharges go up, the need for RN hours increases.

California↗
PubMed2002

The California experiment: alternatives for minimum nurse-to-patient ratios.

In making policy, it is ideal to study a problem, test solutions, and then implement the best solution. In California there is legislation regarding nurse staffing that requires implementation of a solution before the problem has been accurately stated and before alternative solutions have been tested. Assembly Bill 394 directs the California Department of Health Services to establish "minimum, specific, and numerical licensed nurse-to-patient ratios by licensed nurse classification and by hospital unit" and have these ratios in place January 1, 2002. This law is scheduled for implementation before there is specific evidence of optimal staffing levels for various patient populations. The author presents a comprehensive literature review of activities related to nurse staffing in the United States, provides data related to existing patient classification systems in California, and suggests an alternative to staffing ratios to protect consumers.

California↗
PubMed2002

Registered nurse unions and patient outcomes.

Although research shows substantial relationships between several organizational characteristics in hospitals and patient outcomes, the relationship between nurse unions and patient outcomes has not been explored. Because of the workplace chaos of the last half of the 1990s, some nurses are rethinking their relationships with unions; some have the perception that union activity has increased. It is not always clear whether changes in healthcare are associated with patient outcomes, but it is clear that hospitals/health systems with unions often engage in spirited rhetoric about what is best for patients with little objective evidence to support either view. This study examines the relationship between the presence of a bargaining unit for registered nurses and the acute myocardial infarction mortality rate for acute care hospitals in California. The authors also discuss how registered nurse wage, hospital bed size, volume of patients, and other organizational factors may influence and confound this relationship.

Acute Disease↗
PubMed2002

A comparison of two patient classification instruments in an acute care hospital.

OBJECTIVE: Patient classification systems are alternately praised and vilified by staff nurses, nurse managers, and nurse executives. Most nurses agree that substantial resources are used to create or find, implement, manage, and maintain the systems, and that the predictive ability of the instruments is intermittent. The purpose of this study is to compare the predictive validity of two types of patient classification instruments commonly used in acute care hospitals in California. BACKGROUND: Acute care hospitals in California are required by both the Joint Commission on Accreditation of Healthcare Organizations and California Title 22 to have a reliable and valid patient classification system (PCS). The two general types of systems commonly used are the summative task type PCS and the critical incident or criterion type PCS. There is little to assist nurse executives in deciding which type of PCS to choose. There is modest research demonstrating the validity and reliability of different PCSs but no published data comparing the predictive validity of the different types of systems. The unit of analysis is one patient shift called the study shift. The study shift is defined as the first day shift after the patient has been in the hospital for a full 24 hours. Data were collected using medical record review only. Both types, criterion and summative, of PCS data collection instruments were completed for all patients at both collection points. Each patient had a before and after score for each type of instrument. Three hundred forty-nine medical records for inpatients meeting the inclusion criteria were examined. RESULTS: The average patient age was 76 years, the average length of stay was 6.6 days with an average of 6.7 secondary diagnoses recorded. Fifty-five percent of the sample was female and the most common primary diagnosis was CHF, followed by COPD, CVA, and pneumonia. There was a difference in mean summative predictor score and the mean summative actual score of 1.57 points with the predictor score higher (P =.001; CI =.62--2.5). For the criterion instrument, 68.4% of the predictor criterion scores were in category 2 compared to 65.5% of the actual criterion scores. The criterion predictor agreed with the criterion actual score 45% of the time for category 1 patients, 87.3% of the time for category 2 patients, 77.1% of the time for category 3 patients and 72.7% of the time for category 4 patients, with an overall agreement between predictor and actual criterion scores of 79.9% (Kappa P <.001, indicating agreement is not by chance). CONCLUSIONS: The most significant finding of this study is that there are virtually no differences in the predictive ability of summative versus criterion patient classification instruments. Using the same patients, both types of instruments predicted the actual score over 78% of the time.

Aged↗
PubMedDate not supplied

New graduates in critical care. The success of one hospital.

The cycles of registered nurse (RN) shortage and surplus continues into the new century, and nurse executives, managers, and staff development educators are under extreme pressure to respond to the staffing issues. Specialty areas in hospitals are typically the first to experience fewer than needed RNs. The purpose of this article is to describe how the managers, staff development educators, and staff of one large public hospital created a training program for new graduate RNs so they could function safely and efficiently in the adult intensive care environment.

Adult↗
PubMedDate not supplied

Minimum nurse-to-patient ratios in acute care hospitals in California.

Many registered nurses believe that nurse staffing in acute care hospitals is inadequate. In 1999 California became the first state to mandate minimum nurse-to-patient ratios in hospitals. State officials announced draft ratios in January 2002 and expect to implement the legislation by July 2003. We estimate that the direct costs of compliance will be small. However, mandatory ratios could generate opportunity costs that are not easily measured and that may outweigh their benefits. Policymakers elsewhere should consider other strategies to address nurses' concerns, because other approaches may be less costly and produce greater benefits to nurses and patients.

California↗
PubMedDate not supplied

The nursing shortage: is it really about image?

A poor public "image" of the nurse is believed to contribute to nurse shortages. We surveyed more than 3,000 college students in science and math courses in a seven-county region of California's Central Valley to assess their perceptions of a career as a nurse in relation to a career as a physical therapist, a high school teacher, or a physician. Students generally had favorable perceptions of nursing, with two-thirds agreeing that nursing has good income potential, job security, and interesting work. However, nursing lagged behind the other occupations in perceptions of independence at work and was more likely to be perceived as a "women's" occupation. Our findings suggest that these college students have generally gotten the message that nursing is a financially rewarding and desirable career, although they also perceive nursing to be less attractive on some important occupational characteristics such as job independence. Unless nursing training capacity expands substantially, the projected nurse shortage will occur. With continued aggressive marketing of nursing as a career, there is a risk of engendering a backlash from prospective students frustrated in their effort to find a slot in a nursing training program. Much work remains to be done to alter the image of nursing as a women's occupation and to transform the work environment of nurses to make a career in nursing more attractive.

Adult↗