Category Archives: Health Care Workers

Economic Cost and Health Care Workforce Effects of School Closures in the U.S.

Source: Howard Lempel, Ross A. Hammond, Joshua M. Epstein, Brookings Institution, September 30, 2009

From the abstract:
School closure is an important component of U.S. pandemic flu mitigation strategy. The benefit is a reduction in epidemic severity through reduction in school-age contacts. However, school closure involves two types of cost. First is the direct economic impact of the worker absenteeism generated by school closures. Second, many of the relevant absentees will be health care workers themselves, which will adversely affect the delivery of vaccine and other emergency services. Neither of these costs has been estimated in detail for the United States. We offer detailed estimates, and improve on the methodologies thus far employed in the non-U.S. literature. We give estimates of both the direct economic and health care impacts for school closure durations of 2, 4, 8, and 12 weeks under a range of assumptions. We find that closing all schools in the U.S. for four weeks could cost between $10 and $47 billion dollars (0.1-0.3% of GDP) and lead to a reduction of 6% to 19% in key health care personnel. These should be considered conservative (i.e., low) economic estimates in that earnings rather than total compensation are used to calculate costs. We also provide per student costs, so regionally heterogeneous policies can be evaluated. These estimates permit the epidemiological benefits of school closure to be compared to the costs at multiple scales and over many durations.

Nurse Working Conditions and Nursing Unit Costs

Source: Barbara A. Mark, Lisa Lindley, Cheryl B. Jones, Policy, Politics, & Nursing Practice, Vol. 10, No. 2, May 2009
(subscription required)

From the abstract:
The authors examined the relationship between nurse working conditions and nursing unit costs in 210 general medical, general surgical, and general medical surgical units in 112 randomly selected U.S. hospitals. Data were collected from registered nurses (N = 3,747 and 2,878), patients (N = 2,100), study coordinators, and secondary data sources. After controlling for relevant hospital, nursing unit, and patient characteristics, the authors found that good working conditions did not increase nursing unit costs. Teaching status was associated with higher costs, whereas larger unit size was associated with lower costs. Higher proportions of registered nurses and licensed practical nurse staffing were also associated with higher costs. Patient variables were not significantly related to costs. We suggest a variety of strategies that managers may use to improve working conditions.

Estimating Costs and Benefits of School District Services

Source: Ralph A. Hanson, Fred Niedermeyer, 3RsPlus, Inc., February 4, 2009

From the abstract:
Public schools provide many services in addition to academic instruction and childcare for which they receive little credit. School nursing services is one such area, and provides important benefits to individual students and the general citizenry. However, the extent to which these services are delivered to students are seldom clearly described, and the costs of delivering them are buried deep in administrative budgets. Thus, what taxpayers are getting for their money is unknown. As a results, nursing and many other school services are easily targeted for downsizing and budget cutbacks. This is not good educational policy, and it is poor management.

The three-year study presented here was a programmatic R&D effort to help a large, urban school district develop and implement the Nursing Accomplishment Information System (NAIS), an information management system that allowed the district to (a) clearly define its nursing services, (b) track the extent to which these services were actually delivered, and (c) calculate the costs of these services. As a result, the district found, and was able to communicate its constituencies, that it was delivering an impressive array of nursing services to students in a very cost-effective manner. Thus, the study yielded an operational prototype that can be used to determine and manage the costs and benefits of any service provided by a public school district.

7 Ways that Nurse Staffing Impacts Profitability

Source: Marcia Faller, AMN Healthcare, September 23, 2009

Because quality is increasingly linked to a hospital’s financial health, adverse outcomes related to inadequate staffing will have a growing impact on a hospital’s bottom line. The most direct example of the quality-finance link can be seen in the Center for Medicare & Medicaid Services’ (CMS) 2008 Inpatient Prospective Payment System rules, which state that hospitals will no longer be reimbursed for any patient care needed as a result of a hospital-acquired condition, such as certain mistakes called “never events.” Many of these events can be directly tied to or influenced by nursing care. A study, done by the American Nurses Association in 2000, showed that hospital-acquired events like postoperative infections, urinary tract infections, pneumonia and pressure ulcers were preventable conditions that could be reduced with increased nurse staffing.

Roundup of H1N1 Resources for Nurses

Source: Robert Wood Johnson Foundation, August 31, 2009

With the traditional flu season fast approaching, the nation’s pedal-to-the-metal effort to produce a sufficient supply of vaccine and put measures in place to prepare for a new H1N1 virus outbreak is about to be tested. A heavier than expected load of cases during the summer months has health care providers and public health officials concerned.

A number of government agencies and health organizations are doing their part to prepare. Following is a roundup of online H1N1 resources for nurses and other health care providers.

Nurses in the Workplace: Expectations and Needs

Source: International Council of Nurses (ICN), May 2009

From the press release:
Nurses believe that heavy workloads and insufficient staff are impacting patient care and health outcomes around the world, according to research presented today at the International Council of Nurses (ICN) 24th Quadrennial Congress. The results are part of an extensive global attitudinal survey, which asked more than 2,000 nurses about the challenges and opportunities that face nurses.

The Real Effects of Today’s Economy on the Healthcare Industry

Source: Amy N. Kaminski, Compdata Surveys, 2009

Less than a year ago, many were concerned with hiring shortages in the healthcare industry. At the onset of the recession, some thought healthcare would remain impervious to the increasing economic pressures. The 2009 Compensation Data Healthcare results have found the industry is not as immune as many had once suspected. Pay increase budgets have fallen and healthcare costs are up placing mounting pressure on the industry. Organizations are looking for ways to enhance their compensation packages without affecting their bottom line. This whitepaper will give you a clearer picture of what’s really happening in healthcare by covering topics, such as:

• Workforce demands
• Pay increase budgets
• Healthcare premium increases
• Cost containment and reduction measures
• Trends in wellness programs
• Time off packages
See also:
Press release

Investing in California’s Direct Care Workforce by Increasing Geriatric Training Opportunities

Source: SCAN Foundation, August 2009

On any given day, 126,000 Californians in nursing homes receive care from Certifed Nursing
Assistants (CNAs). An additional number of the State’s residents receive care in their own homes from the 54,260 registered Home Health Aides (HHAs). Each of these persons is dependent on Direct Care Workers (DCWs) to address at least some of their most fundamental human needs. The DCW is also a liaison to the nursing staff, reporting the care-receiver’s medical and emotional status and she or he may also be the person’s key connection to the outside world.

This paper was developed as a “think piece” to stimulate dialogue among stakeholders who are
discussing the needed components of training for DCWs. For 35 years, NCCNHR has maintained this kind of dialogue with long-term care consumers including nursing home and board and care residents, their families, and their advocates, and more recently those receiving services in their own homes. As our experience has shown in this paper, DCWs are essential to the quality of life for and quality of care of older adults. Furthermore, there is a critical need to better support DCWs through cultural sensitivity, involvement in care planning, by addressing systemic issues and through comprehensive training opportunities.

Nurse Labor Data: The Collection and Interpretation of Nurse-to-Patient Ratios

Source: Ann F. Minnick, Lorraine C. Mion, JONA: The Journal of Nursing Administration, Volume 39 – Issue 9, September 2009
(subscription required)

From the abstract:
Nurse labor has been shown to be related to some patient outcomes, but varying definitions and measurement approaches have resulted in conflicting findings about the nature of the relationship. Nurse administrators and researchers need to know rates of missing data and error in labor data to better inform decision making. The authors compare the degree of completeness and the agreement between these approaches (nurse survey and nurse-to-patient ratio staffing plans) to obtain patient-to-nurse ratios at the unit level.

Violence Against Nurses Working in US Emergency Departments

Source: Jessica Gacki-Smith, Altair M. Juarez, Lara Boyett, Cathy Homeyer, Linda Robinson, Susan L. MacLean, JONA: The Journal of Nursing Administration, Volume 39 – Issue 7/8, July/August 2009
(subscription required)

From the abstract:
The objective of this study was to investigate emergency nurses’ experiences and perceptions of violence from patients and visitors in US emergency departments (EDs).

Approximately 25% of respondents reported experiencing physical violence more than 20 times in the past 3 years, and almost 20% reported experiencing verbal abuse more than 200 times during the same period. Respondents who experienced frequent physical violence and/or frequent verbal abuse indicated fear of retaliation and lack of support from hospital administration and ED management as barriers to reporting workplace violence.

Violence against ED nurses is highly prevalent. Precipitating factors to violent incidents identified by respondents is consistent with the research literature; however, there is considerable potential to mitigate these factors. Commitment from hospital administrators, ED managers, and hospital security is necessary to facilitate improvement and ensure a safer workplace for ED nurses.