Newhouse Robin P
The Johns Hopkins Hospital, Baltimore, MD 21287, USA.
J Nurs Adm. 2005 Jul-Aug;35(7-8):350-8.
To explore the impact of legislative, strategic, and organizational changes on nursing in rural hospitals since 1995.
Rural hospitals have faced decreasing financial margins. This economic pressure is due to multiple reasons, and is a major issue for nurse executives. Nurse executives are responsible for assuring quality of nursing care. Nursing care affects patient outcomes. The impact of legislative, economic, and strategy decisions on nursing in rural hospitals is unknown.
A focus group was conducted with 11 nurse executives from rural hospitals who attended the American Organization of Nurse Executives Annual Meeting held on April 20, 2004.
Themes from the content analysis were grouped into 3 major categories: external environmental (physical isolation, patient population, services needed, legislation), internal organizational (patient acuity, volume, services, technology, financial margin and strategy, staffing, leadership, culture, and resources), and nursing infrastructure (staffing, salary, registered nurse-physician conflict, continuity of care, competency, culture, politics and leadership).
Nurse executives in rural hospitals face distinctive issues and challenges. Further study of the impact of policy and strategy decisions on rural nursing is needed.
探讨自1995年以来立法、战略和组织变革对乡村医院护理工作的影响。
乡村医院面临着利润率下降的问题。这种经济压力是由多种原因造成的，是护士管理人员面临的一个主要问题。护士管理人员负责确保护理质量。护理工作会影响患者的治疗结果。立法、经济和战略决策对乡村医院护理工作的影响尚不清楚。
对来自乡村医院的11名护士管理人员进行了焦点小组访谈，这些人员参加了2004年4月20日举行的美国护士管理人员组织年会。
内容分析得出的主题分为三大类：外部环境（地理位置偏远、患者群体、所需服务、立法）、内部组织（患者病情严重程度、工作量、服务、技术、利润率和战略、人员配备、领导能力、文化和资源）以及护理基础设施（人员配备、薪资、注册护士与医生的冲突、护理连续性、能力、文化、政治和领导能力）。
乡村医院的护士管理人员面临着独特的问题和挑战。需要进一步研究政策和战略决策对乡村护理工作的影响。
