Management decision-making in nursing

This study developed a new, valid and reliable evaluation instrument to measure the level, type and pattern of management decisions of fifteen nursing students. The management decision score achieved using this instrument was correlated with two psychological determinants of management decision making: creativity and problem-solving ability. The instrument was a written patient management problem in case format, answered by a free form written response. The student responses were classified for type of management decision according to the sub-categories of technical, inter-personal, environmental and unique. Using statistical analysis a significant difference was found in the type of management decisions most frequently selected by the study sample. The students predominantly selected technical type decisions. This preference for one type of management decision may be due to a number of psychological and environmental factors. These factors may program and mold the type of management decisions student nurses make early in their career. Low but positive correlations were found between the total management score and the two psychological tests. This finding supports the authors cited in the literature who state that although creativity augments the type of management decision making, it is not present or encouraged widely in the nursing profession. These factors are worth considering when the profession becomes concerned over ritualization and lack of individuality in patient care. The tool is easy to administer, lends itself to a variety of professional settings and shows promise with further refinement for computer application.

Nursing staffs' perceptions of a generic service manager position

The recent reengineering within the health care industry has challenged many assumptions regarding traditional structures and roles. Within a product-line management structure, the traditional viewpoint that those who manage patient care areas must have a nursing background, is an example of one such assumption being challenged. The nursing profession is often seen as the greatest obstacle to the implementation of a product-line management structure and generic manager positions (does not require a nursing background), due to the perceived loss of professional identity. This qualitative study focused on how nursing staff within a chronic care and rehabilitation facility perceived a generic service manager position. Focus groups were conducted in three phases, over a 14 month period of time. The data collected from the focus groups were then coded according to common themes. Each phase was analyzed independently, with the study concluding with an analysis and interpretation of the collective results. The results of this study revealed a significant shift in how the nursing staff perceived their professional identity and accountability in light of the implementation of the generic Service Manager position. Initial reactions of personal and professional vulnerability and resentment were seen to transform into an increased ability to explicitly articulate the role of nursing. Changes in behavior that were described included: increased consultation and collaboration with other

In-reach nursing services improve older patient outcomes and access to emergency care

Aims: To identify the impact of in-reach services providing specialist nursing care on outcomes for older people presenting to the emergency department from residential aged care. Methods: Retrospective cohort study compared clinical outcomes of 2278 presentations from 2009 with 2051 presentations from 2011 before and after the implementation of in-reach services. Results: Median emergency department length of stay decreased by 24 minutes (7.0 vs 6.6 hours, P<0.001) and admission rates decreased by 23% (68 vs 45%, P<0.001). The proportion of people with repeat emergency department visits within six months decreased by 12% (27 vs 15%). The proportion of admitted patients who were discharged with an end of life palliative care plan increased by 13% (8 vs 21%, P=0.007). Conclusions: There was a significant reduction in the median length of stay, fewer hospital admissions and fewer repeat visits for people from residential aged care following implementation of in-reach services.

Sale of Carson City silver dollars by the General Services Administration : hearing before the Subcommittee on Consumer Affairs of the Committee on Banking, Finance, and Urban Affairs, House of Representatives, Ninety-sixth Congress, second session, August 19, 1980.

Mode of access: Internet.

Controls over vocational rehabilitation training services need improvement, Rehabilitation Services Administration, Department of Health, Education and Welfare : report to the Congress /

Date on cover: May 5, 1977.

The U.S. General Services Administration's fiscal year 2003 Capital Investment Program : hearing before the Subcommittee on Economic Development, Public Buildings, and Emergency Management of the Committee on Transportation and Infrastructure, House of Representatives, One Hundred Seventh Congress, second session, June 5, 2002.

"107-83."

Reauthorization of the Substance Abuse and Mental Health Services Administration : hearing before the Subcommittee on Substance Abuse and Mental Health Services of the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Eighth Congress, first session, on examining proposed legislation authorizing funds for the Substance Abuse and Mental Health Services Administration, focusing on the importance of substance abuse prevention, July 15, 2003.

Shipping list no.: 2004-0105-P.

Reorganization plan no. 16 of 1950 : transferring the functions of the General Services Administration relating to assistance to local school districts and water pollution control to the Federal Security Agency : report.

Also in Congressional serial volume 11368.

General Services Administration annual report.

First report covers six month period only.

Public information in the national information infrastructure : report to the Regulatory Information Service Center, General Services Administration, and to the administrator of the Office of Information and Regulatory Affairs, Office of Management and Budget /

Mode of access: Internet.

Management audit : Department of Central Management Services' administration of the state's space utilization program.

"This is our report of the Management Audit of the Department of Central Management Services' Administration of the State's Space Utilization Program. The audit was conducted pursuant to Legislative Audit Commission Resolution Number 126, which was adopted December 11, 2002. This audit was conducted in accordance with generally accepted government auditing standards and the audit standards promulgated by the Office of the Auditor General at 74 Ill. Adm. Code-420.310. The audit report is transmitted in conformance with Section 3-14 of the Illinois State Auditing Act."--Cover letter.

Report of the Community Integrated Living Arrangement Nursing Services Reimbursement Work Group to the Secretary of the Department of Human Services, the Illinois General Assembly, and the Honorable Rod R. Blagojevich, Governor : in response to Senate Resolution 514 /

This report presents the findings and recommendations of the Work Group; it evaluates the Division of Developmental Disabilities' CILA rate model in terms of the sufficiency of nursing services included in the model, as well as the competitiveness of the wage levels assumed by the model for nurses working in the CILAs. In accordance with Resolution 514, the report is the product of the Working Group's discussions and requests for information and has been facilitated by the Department of Human Services, Division of Developmental Disabilities. As such, the report does not represent the recommendations of the Department of Human Services, nor can the Department of Human Services make any commitment to implement any of the report recommendations or commit funding without executive and legislative direction and a funding appropriation. However, the recommendations of the Work Group are consistent with the nursing services structures of the CILA rate-model and would enhance nursing services reimbursement in CILA, if adopted.

Continued investigation into fraud and mismanagement in General Services Administration : hearings before the Subcommittee on Federal Spending Practices and Open Government of the Committee on Governmental Affairs, United States Senate, Ninety-sixth Congress, second session, October 2, 1980, Part 6.

Mode of access: Internet.

Fraud and abuse in community services administration : hearing before the Subcommittee on Federal Spending Practices and Open Government of the Committee on Governmental Affairs, United States Senate, Ninety-sixth Congress, first session, October 19, 1979 [and second session, June 5, 1980].

Mode of access: Internet.