Requirement for Nursing Care Services and Associated Costs in Acute Spinal Cord Injury

Richmond, Therese S.; Metcalf, Judith A.; Daly, Margaret

doi:10.1097/01376517-199502000-00008

Cited by 2 publications

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“…Nurse staffing is a major factor in ensuring hospital production efficiency because nurses directly participate in the core technology of hospitals—the delivery of patient care—and also represent a significant portion of a hospital's operating budget (Aiken et al, 2001; Bloom, Alexander, & Nuchols, 1997; Jackson, Chiarello, Gaynes, & Gerberding, 2002). Richmond, Metcalf, and Daly (1995) studied acutely injured spinal cord injury (SCI) patients and found that there were hidden costs within the overall hospital budget regarding nursing care. “In this era of health care reform, it is important to uncover the costs of nursing care of the acute spinal cord injury patient and identify variables that influence the amount of nursing care resources consumed” (Richmond et al, 1995, p. 47).…”

Section: Literature Reviewmentioning

confidence: 99%

“…Richmond, Metcalf, and Daly (1995) studied acutely injured spinal cord injury (SCI) patients and found that there were hidden costs within the overall hospital budget regarding nursing care. “In this era of health care reform, it is important to uncover the costs of nursing care of the acute spinal cord injury patient and identify variables that influence the amount of nursing care resources consumed” (Richmond et al, 1995, p. 47). Gross, Faulkner, Goodrich, and Kain (2001) also developed a patient acuity and staffing tool for stroke patients based on FIM™ scores and determined the system to be an effective and efficient guide for staff scheduling on a stroke rehabilitation unit.…”

Section: Literature Reviewmentioning

confidence: 99%

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Nursing Time and Work in an Acute Rehabilitation Setting

Neatherlin¹,

Prater²

2003

Rehabilitation Nursing

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Nursing staffing has long been recognized as a significant variable in a hospital budget even through the era of increased productivity and efficiency. In addition, patient acuity has been rising, and increasing demands on nursing personnel have been documented. These increased demands have affected nurse staffing, patient outcomes, and nurse retention, all of which have an impact on our healthcare system. Therefore, it is imperative that nursing time and work be examined in the acute rehabilitation setting--a setting in which research has been sparse. To estimate patient acuity, the activities of nursing personnel must be examined to establish timeframes for the care needed by patients. Previous studies have examined time and work according to pre-established patient acuity categories. California has passed legislation that requires mandatory nurse-staffing ratios in response to the concerns about the adequacy of patient care and safety. We did this study to assess the time and work related to patients with different diagnoses that are typically found in a rehabilitation unit. The data collected can be used to develop a patient acuity system. This study sought to identify how nurses spend their time so that hidden costs and important interventions can be addressed by an institution's administration.

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Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Nursing Time and Work in an Acute Rehabilitation Setting

Neatherlin¹,

Prater²

2003

Rehabilitation Nursing

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“…Current studies concerning economics and costs of nursing care for the most part refer to outcome aspects such as length of stay (Seitz & Edwardson 1987, Grillo‐Peck & Risner 1995, Richmond et al . 1995, Petryshen et al .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the QALY model for analysis of cost-effectiveness of eating training after stroke

2001

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New methods developed and insights gained in research are of increasing significance in health care and the question is which services and methods are to be implemented. If eating training after stroke is to be implemented it must be given priority in relation to other measures. Otherwise there is a risk that patients with eating difficulties after stroke will be fed by personnel or permanently receive nourishment via tube. This may lead to expensive measures or costs for the tube feeding as well as costs for the personnel needed for feeding, and patients' well-being will be reduced if they do not have the opportunity to eat as independently as possible. Economic analyses should not guide the priorities to be made, but can be one of several bases for resource allocation. The estimation of cost-effectiveness must, however, be made by means of a method which in its ethical foundation is in line with nursing and the Swedish Government Bill for guiding priorities in health care. The aim of this paper is to discuss the ethical foundation of nursing care and the ethical principles proposed by the Swedish Government Bill for guiding priorities in health care and the model of Quality Adjusted Life Years (QALYs) related to eating training after stroke. The findings showed that there was a considerable difference in the ways health and health maximization were discussed in the QALY model and in specific nursing care. There are two aspects underpinning the QALY model that are not in line with either the ethical foundations of nursing or the principles proposed by the Swedish Government Bill for guiding priorities in health care. However, a new method called Equity Adjusted Life Years (EQALYs) can be a tool for evaluation in specific nursing care. Cost per EQALY is based on a compromise between initial severity of disease and treatment effect that is very close to the distribution rule applied in specific nursing care. In conclusion it is obvious that cost per EQALY, a balance between health maximization and severity of disease and treatment effects, can be a tool for the evaluation of eating training after stroke.

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Requirement for Nursing Care Services and Associated Costs in Acute Spinal Cord Injury

Cited by 2 publications

References 0 publications

Nursing Time and Work in an Acute Rehabilitation Setting

Nursing Time and Work in an Acute Rehabilitation Setting

Evaluation of the QALY model for analysis of cost-effectiveness of eating training after stroke

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