Browsing by Person "Duffield, Christine M."

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Instability in patient and nurse characteristics, unit complexity and patient and system outcomes
(John Wiley & Sons Ltd., 2015-06) Duffield, Christine M.; Roche, Michael A.; Dimitrelis, Sofia; Homer, Caroline; Buchan, James
Aims: To explore key factors related to nursing unit instability, complexity and patient and system outcomes. Background: The relationship between nurse staffing and quality of patient outcomes is well known. The nursing unit is an important but different aspect that links to complexity and to system and patient outcomes. The relationship between the instability, complexity and outcomes needs further exploration. Design: Descriptive. Methods: Data were collected via a nurse survey, unit profile and review of patient records on 62 nursing units (wards) across three states of Australia between 2008-2010. Two units with contrasting levels of patient and nurse instability and negative system and patient outcomes, were profiled in detail from the larger sample. Results: Ward A presented with greater patient stability (low occupancy, high planned admissions, few ICU transfers, fewer changes to patient acuity/work re-sequencing) and greater nurse instability (nurses changing units, fewer full-time staff, more temporary/casual staff) impacting system outcomes negatively (high staff turnover). In contrast, Ward B had greater patient instability, however, more nurse stability (greater experienced and permanent staff, fewer casuals), resulting in high rates for falls, medication errors and other adverse patient outcomes with lower rates for system outcomes (lower intention to leave). Conclusion: Instability in patient and nurse factors can contribute to ward complexity with potentially negative patient outcomes. The findings highlight the variation of many aspects of the system where nurses work and the importance of nursing unit managers and senior nurse executives in managing ward complexity. 2014 John Wiley & Sons Ltd.
Nurse turnover: A literature review - An update
(Elsevier, 2012-07) Hayes, L. J.; O'Brien-Pallas, L.; Duffield, Christine M.; Shamian, J.; Buchan, James; Hughes, F.; Laschinger, H. K. S.; North, N.
Background: Concerns related to the complex issue of nursing turnover continue to challenge healthcare leaders in every sector of health care. Voluntary nurse turnover is shown to be influenced by a myriad of inter-related factors, and there is increasing evidence of its negative effects on nurses, patients and health care organizations. Objectives: The objectives were to conduct a comprehensive review of the related literature to examine recent findings related to the issue of nursing turnover and its causes and consequences, and to identify on methodological challenges and the implications of new evidence for future studies. Design: A comprehensive search of the recent literature related to nursing turnover was undertaken to summarize findings published in the past six years. Data sources: Electronic databases: MEDLINE, CINAHL and PubMed, reference lists of journal publications. Review methods: Keyword searches were conducted for publications published 2006 or later that examined turnover or turnover intention in employee populations of registered or practical/enrolled or assistant nurses working in the hospital, long-term or community care areas. Literature findings are presented using an integrative approach and a table format to report individual studies. Results: From about 330 citations or abstracts that were initially scanned for content relevance, 68 studies were included in this summary review. The predominance of studies continues to focus on determinants of nurse turnover in acute care settings. Recent studies offer insight into generational factors that should be considered in strategies to promote stable staffing in healthcare organizations. Conclusions: Nursing turnover continues to present serious challenges at all levels of health care. Longitudinal research is needed to produce new evidence of the relationships between nurse turnover and related costs, and the impact on patients and the health care team. 2011 Elsevier Ltd. All rights reserved.
Policies to sustain the nursing workforce: an international perspective
(2015-01) Buchan, James; Twigg, D.; Dussault, G.; Duffield, Christine M.; Stone, P.W.
Aim: Examine metrics and policies regarding nurse workforce across four countries. Background: International comparisons informs health policy makers. Methods: Data from the OECD were used to compare expenditure, workforce and health in: Australia, Portugal, the United Kingdom (UK) and the United States (US). Workforce policy context was explored. Results: Public spending varied from less than 50% of gross domestic product in the US to over 80% in the UK. Australia had the highest life expectancy. Portugal has fewer nurses and more physicians. The Australian national health workforce planning agency has increased the scope for co-ordinated policy intervention. Portugal risks losing nurses through migration. In the UK, the economic crisis resulted in frozen pay, reduced employment, and reduced student nurses. In the US, there has been limited scope to develop a significant national nursing workforce policy approach, with a continuation of State based regulation adding to the complexity of the policy landscape. The US is the most developed in the use of nurses in advanced practice roles. Ageing of the workforce is likely to drive projected shortages in all countries. Limitations: There are differences as well as variation in the overall impact of the global financial crisis in these countries. Conclusion: Future supply of nurses in all four countries is vulnerable. Implications for nursing and health policy: Work force planning is absent or restricted in three of the countries. Scope for improved productivity through use of advanced nurse roles exists in all countries
"Solving" nursing shortages: do we need a New Agenda?
(2015) Buchan, James; Duffield, Christine M.; Jordan, Amy
The rate and cost of nurse turnover in Australia
(2014-06) Roche, Michael A.; Duffield, Christine M.; Homer, Caroline; Buchan, James; Dimitrelis, Sofia
Nurse turnover is a critical issue facing workforce planners across the globe, particularly in light of protracted and continuing workforce shortages. An ageing population coupled with the rise in complex and chronic diseases, have contributed to increased demands placed on the health system and importantly, nurses who themselves are ageing. Costs associated with nurse turnover are attracting more attention; however, existing measurements of turnover show inconsistent findings, which can be attributed to differences in study design, metrics used to calculate turnover and variations in definitions for turnover. This paper will report the rates and costs of nurse turnover across three States in Australia. 2014.