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Biomedical subjects

Judith Shamian

Publications and source records attributed to Judith Shamian.

16 recordsLinked to original sources
PubMed2006

Nurse turnover: a literature review.

Ongoing instability in the nursing workforce is raising questions globally about the issue of nurse turnover. A comprehensive literature review was undertaken to examine the current state of knowledge about the scope of the nurse turnover problem, definitions of turnover, factors considered to be determinants of nurse turnover, turnover costs and the impact of turnover on patient, and nurse and system outcomes. Much of the research to date has focused on turnover determinants, and recent studies have provided cost estimations at the organizational level. Further research is needed to examine the impact of turnover on health system cost, and how nurse turnover influences patient and nurse outcomes.

Costs and Cost Analysis↗
PubMed2006

The impact of nurse turnover on patient, nurse, and system outcomes: a pilot study and focus for a multicenter international study.

Research about the economic impact of nurse turnover has been compromised by a lack of consistent definitions and measurement. This article describes a study that was designed to refine a methodology to examine the costs associated with nurse turnover. Nursing unit managers responded to a survey that contained items relating to budgeted full-time equivalents, new hires, and turnover, as well as direct and indirect costs. The highest mean direct cost was incurred through temporary replacements, whereas the highest indirect cost was decreased initial productivity of the new hire. The study allowed the identification of the availability of data and where further refinement of data definition of variables is needed. The results provided significant evidence to justify increased emphasis on nurse retention strategies and the creation of healthy work environments for nurses.

Australia↗
PubMed2006

Accountability agenda must include home and community based care.

Wait times and the wait times agenda are on the Canadian schedule. Although most Canadians support our healthcare system, they are concerned about access. Resolving the wait times agenda might help increase Canadian confidence in the system's ability to provide timely access to care. While the paper by Trypuc, MacLeod and Hudson demonstrates well how quickly governments can mobilize tools and resources to address pressing policy needs, it also reveals the limited and narrow approach taken by governments to the wait times agenda. The Ontario government should recognize that a more integrated and comprehensive approach can significantly advance the wait times agenda and make the system more accountable. Only a broad-based approach will ultimately succeed in reducing wait times and building a sustainable system. A shift in values needs to take place away from the current emphasis on acute care and toward an inclusive vision of home- and community-based care that puts more emphasis on disease management, chronic care and independent living, if there is ever to be any real progress in the battle. Governments will ultimately be held accountable by Canadian healthcare consumers if they fail to make this important shift.

Canada↗
PubMed2006

Broadening the patient safety agenda to include home care services.

Caring for an individual in the home is inherently complex. The physical environment, family dynamics and the cognitive abilities of the client and family members are only a few of the factors to be considered in delivering services. Although targeted initiatives have been established to reduce preventable injuries and deaths in the hospital sector, there has not been a corresponding level of research or patient safety initiatives in other healthcare delivery sectors. A coordinated and collaborative approach to generate new knowledge pertaining to safety in home care in Canada has therefore been undertaken by the Canadian Patient Safety Institute (CPSI), VON Canada, and Capital Health (Edmonton). Actions included the development of a background paper (Lang and Edwards 2006) that informed an invitational roundtable discussion, where key safety issues in home care were identified and priority actions discussed. Over 40 individuals from across Canada participated, reflecting various disciplinary and organizational affiliations in the delivery of home care services. This paper describes key findings from the background paper, outcomes from the ensuing roundtable discussions and implications for practice, research and policy.

Canada↗
PubMed2005

New strategies for monitoring the health of Canadian nurses: results of collaborations with key stakeholders.

The aim of this descriptive study was to help policy- and decision-makers enhance the health of the Canadian nursing workforce by highlighting key factors of concern and exploring options for collecting and utilizing nurses' health data. This paper describes the views of 62 nursing stakeholders from a diverse spectrum of professional, labour, management and government perspectives from across Canada, regarding key factors contributing to work-related health problems in the nursing profession, particularly those relating to the work environment and hospital restructuring. The results were combined with a synthesis of existing information sources about the health of nurses in Canada. With respect to the key concerns, musculoskeletal conditions/injuries and stress and burnout were identified as nurses' major work-related health problems. An examination of the data synthesis inventory revealed that no existing data sources can adequately profile nurses' health, especially in relation to the components of the Conceptual Model of Nurses' Health developed in the study. Three strategies for monitoring nurses' health are proposed.

Age Factors↗
PubMed2005

Registered nurse and registered practical nurse evaluations of their hospital practice environments and their responses to these environments.

In 2003, over 13,000 Ontario nurses were surveyed to explore how they evaluated their hospital work environments and their responses to these practice environments. The purpose of this paper is to describe and compare these nurses' evaluations and responses. Sixty-five percent of nurses who were mailed surveys completed and returned a survey. Significant differences were found between registered nurse and registered practical nurse characteristics such as mean age, full-time employment rates, mean years of nursing experience and proportion enrolled in university or college educational programs. Both groups reported weak professional practice environments; however, there were some significant differences between the evaluations by registered nurses and those of registered practical nurses. Although both groups reported weak job satisfaction and moderate levels of burnout, there were significan differences in other responses. Study findings have implications for managing and leading nurses and for strengthening human resources practices.

Acute Disease↗
PubMed2004

Work-related disability in Canadian nurses.

PURPOSE: To determine factors contributing to high registered nurse (RN) injury claim rates in Canadian hospitals. DESIGN: Cross-sectional study of secondary 1998-99 data for RNs (N = 8,044) in Ontario, Canada, linked at the hospital level (n = 127). METHODS: Descriptive statistics, correlations, and logistic regression analyses were conducted. RESULTS: The odds of a high RN lost-time claim rate increased by 70% for each quartile increase in the percentage of RNs reporting more than 1 hour of overtime per week. The odds of a high RN musculoskeletal lost-time claim rate decreased by 64% for every one unit increase in the hospital-level score on the nurse-physician relationship subscale. CONCLUSIONS: To retain and optimize scarce hospital nursing resources, strategies to address overtime, sick time, and nurse-physician relationships might provide fiscal and human benefits.

Absenteeism↗
PubMed2003

Feasibility of using existing Statistics Canada surveys to describe the health and work of nurses.

Reorganization of nurses' work has raised questions about the effects of working conditions on their health. Nurses, for example, are more likely to miss work because of illness and disability than employees in other occupations. The overall purpose of this descriptive study was to investigate the feasibility of using existing Statistics Canada surveys regularly to describe and monitor the health and working conditions of nurses. Our findings identified significant limitations in existing Statistics Canada surveys, for the study of nurses, including nonspecific or no occupational coding, small samples and partial content related to the work environment. As a result, some estimates would need to be accompanied by statements indicating that the findings do not meet quality standards and that the conclusions would be unreliable and most likely invalid. Additional data are required for a comprehensive assessment of the health status of nurses and the work environment factors that influence their health. These data can be obtained through several vehicles, including using over-sampling strategies for extant and recurring Statistics Canada surveys, adding additional content to those surveys or implementing new surveys specific to nurses and their work. The authors describe the advantages and disadvantages of each of these approaches and conclude that monitoring the health and work environment of nurses in Canada in sufficient detail to inform policy decisions requires a dedicated national survey.

Bias↗
PubMed2003

Climbing Mount Everest: on our way to the summit.

The key to climbing Mount Everest is not one individual striving for the peak. Teamwork, leadership, and meticulous planning are what take climbers to the summit. They are key, as well, to solving the problems of human resources in the healthcare system.

Canada↗
PubMed2002

Measuring the hospital practice environment: a Canadian context.

The primary purpose of this study is to document the psychometric properties of the revised Nursing Work Index (NWI-R) in the context of a large Canadian sample of registered nurses. A self-administered survey containing the NWI-R was completed by 17,965 registered nurses working in 415 hospitals in three Canadian provinces. Using exploratory principal components analysis, with a forced one-factor solution, the practice environment index was obtained. In addition, key assumptions were tested from previous work about the rationale for the aggregation of NWI-R responses. In the Canadian context the one-factor solution provides a parsimonious index of the practice environment of registered nurses working in acute care hospitals. Further work is needed to determine the predictive capability of this index and its relevance to cross-national organizational contexts.

Acute Disease↗