O'Brien-Pallas Linda, Hayes Laureen
Lawrence S Bloomberg Faculty of Nursing, Nursing Health Human Resources, University of Toronto, Ontario, Canada.
J Clin Nurs. 2008 Dec;17(24):3338-46. doi: 10.1111/j.1365-2702.2008.02641.x.
This paper draws upon empirical research and other published sources to discuss nursing workforce issues, the challenges of using health human resource research in policy decisions and the importance of evidence-based policies and practices for nursing care and outcomes.
Increasing evidence points to the critical relationship between registered nurse care and improved patient outcomes. The negative impact that insufficient nurse staffing has on patient, nursing and system outcomes has influenced health human resource researchers to further examine nurses' work environments to determine factors that are amenable to policy change.
Survey of literature was conducted.
Electronic databases were searched using keywords.
Sustained health human resource planning efforts by policy makers are difficult given changing governments and political agendas. The health human resource conceptual framework provides researchers and planners with a guide to decision-making that considers current circumstances as well as those factors that need to be accounted for in predicting future requirements. However, effective use of research depends on communication of findings between researchers and policymakers.
Health care managers and other decision-makers in health care organisations often lack an understanding of the research process and do not always have easy access to current evidence. Also, managerial decisions are often constrained by organisational requirements such as resource availability and policies and procedures.
Unless nursing workplace issues are addressed, the physiological and psychological stress in the work environments of nurses will continue. Effective health human resource policy and planning (at the macro level) and management strategies (at the micro level) would stabilise the nursing workforce and reduce job stress. Furthermore, the efficiency and cost-effectiveness of the health system could be enhanced through improved health outcomes of care providers and health care clients.
本文借鉴实证研究及其他已发表资料,探讨护理人力问题、在政策决策中运用卫生人力资源研究面临的挑战以及循证政策与实践对护理服务及结果的重要性。
越来越多的证据表明注册护士护理与改善患者结局之间存在关键关系。护士人员配备不足对患者、护理及系统结局产生的负面影响,促使卫生人力资源研究人员进一步审视护士的工作环境,以确定可通过政策改变加以调节的因素。
进行文献综述。
使用关键词检索电子数据库。
鉴于政府更迭和政治议程变化,政策制定者持续开展卫生人力资源规划工作困难重重。卫生人力资源概念框架为研究人员和规划者提供了一个决策指南,该指南既考虑当前情况,也考虑预测未来需求时需要考虑的因素。然而,研究成果的有效应用取决于研究人员与政策制定者之间的结果沟通。
医疗保健机构的管理人员和其他决策者往往对研究过程缺乏了解,也并非总能轻松获取当前的证据。此外,管理决策常常受到诸如资源可用性以及政策和程序等组织要求的限制。
除非解决护理工作场所问题,护士工作环境中的生理和心理压力将持续存在。有效的卫生人力资源政策与规划(宏观层面)及管理策略(微观层面)将稳定护理人力并减轻工作压力。此外,通过改善护理提供者和医疗保健客户的健康结局,可提高卫生系统的效率和成本效益。