Category Archives: Frontline workforce
Health care workers who have not attained bachelor’s degrees will have an opportunity for expanded roles and upward mobility in the changing health care landscape, which emphasizes increased efficiency and lower costs, according to a new Brookings Institution report. Less educated workers can take on more responsibility for screening, patient education, health coaching and care navigation, the report says, freeing up physicians and other advanced practitioners to focus on more complex medical issues.
The report examines health care occupations with high concentrations of pre-baccalaureate workers in the nation’s top 100 metropolitan areas. Those workers in the 10 largest occupations—including nursing aides, associate-degree registered nurses, personal care aides, licensed practical and licensed vocational nurses, medical assistants, and paramedics—number 3.8 million, accounting for nearly half of the total health care workforce in those metro areas. (The report notes that, “in the near future, the registered nurse may not be considered a ‘pre-baccalaureate’ occupation, given the Institute of Medicine’s recommendation that 80 percent of RNs have bachelor’s degrees by 2020.)
Health care worker fatigue was a factor in more than 1,600 events reported to the Pennsylvania Patient Safety Authority, according to an analysis in the June issue of the Pennsylvania Patient Safety Advisory. Thirty-seven of those events, which occurred over a nine-year period, were categorized as harmful, with four resulting in patient deaths.
“Recent literature shows that one of the first efforts made to reduce events related to fatigue was targeted to limiting the hours worked,” Theresa V. Arnold, DPM, manager of clinical analysis for the Authority, said in a news release. “However, further study suggests a more comprehensive approach is needed, as simply reducing hours does not address fatigue that is caused by disruption in sleep and extended work hours.”
In the Pennsylvania analysis, the most common medication errors involving worker fatigue were wrong dose given, dose omission, and extra dose given. The most common errors related to a procedure, treatment, or test were lab errors. Other errors included problems with radiology/imaging and surgical invasive procedures.
More information on health care worker fatigue and patient safety is available here.
Susan B. Hassmiller, PhD, RN, FAAN, is senior adviser for nursing at the Robert Wood Johnson Foundation, and director of the Future of Nursing: Campaign for Action.
I flew to Florida years ago to be with my father at the end of his life. He lay in a hospital bed, at times conscious of the family members gathered at his side and other times unaware of his loved ones surrounding him. I watched a nurse I didn’t know lean over and kiss his forehead.
At another hospital bed years later, I watched a nurse comfort my daughter as she labored to bring my first granddaughter into the world. “You’ll be okay,” she whispered to my daughter, giving her a hug.
The end of life and the beginning of life, marked by a compassionate nurse keeping vigil and offering comfort. In the midst of machines, a nurse provides a human touch and caring to patients and their family members.
The essence of caring is what first attracted me to the nursing profession. Now, more than 35 years later, the essence of caring still propels me in my work as the director of the Future of Nursing: Campaign for Action, a joint initiative of RWJF and AARP to transform health through nursing. One of the Campaign’s major focus areas is promoting nursing leadership.
The Robert Wood Johnson Foundation’s LEAP National Program is working to create a culture of health by discovering, documenting, and sharing innovations in the primary care workforce. Across the country, innovative practices have found ways to make care more efficient and effective for both patients and providers, which can lead to improved health outcomes and health savings. The LEAP project has identified and visited practices based in large health systems and rural community clinics ranging from Maine to California, and has brought the sites together in person and via webinars to discuss their innovations.
LEAP stands for The Primary Care Team: Learning from Effective Ambulatory Practices. Over the past six months, the 31 “exemplar sites” have been actively engaged in discussing their workforce best practices. The goal is to allow others across the country to learn from and replicate these innovations, ultimately via a dissemination website.
Are you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the latest nursing news, research and trends. Here’s a review of what’s in the January issue:
Read about the remarkable journey of RWJF Community Health Leader Jamie Kamailani Boyd, who made a long and arduous climb out of poverty and is now helping others do the same. She has created an academic program called Pathway Out of Poverty, which helps disadvantaged Hawaiians become nurse’s aides and registered nurses.
Several alumni of the RWJF Executive Nurse Fellows program are using the leadership and risk-taking skills they gained in the program to support Partners Investing in Nursing's Future projects in their home states.
This piece examines some of the early work that laid the foundation for even more innovative and ambitious RWJF programs to build nursing leadership, improve nurse education, strengthen the nursing workforce and, ultimately, improve health and health care. Read about former RWJF staff member Terrance Keenan, who influenced the Foundation’s early investments in nursing programs and initiatives.
As the economic downturn made hunger and food insecurity more common last year, RWJF Scholars and alumni stepped up to help in their communities. Read about their work, individually and through their nursing schools.
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