Susan Letvak

Nurses’ Presenteeism and Its Effects on Self-Reported Quality of Care and Costs

ObjectiveAlthough research has been conducted on how nurse staffing levels affect outcomes, there has been little investigation into how the health-related productivity of nurses is related to quality of care. Two major causes of worker presenteeism (reduced on-the-job productivity as a result of health problems) are musculoskeletal pain and mental health issues, particularly depression. This study sought to investigate the extent to which musculoskeletal pain or depression (or both) in RNs affects their work productivity and self-reported quality of care and considered the associated costs. MethodsUsing a cross-sectional survey design, a random sample of 2,500 hospital-employed RNs licensed in North Carolina were surveyed using a survey instrument sent by postal mail. Specific measures included questions on individual and workplace characteristics, self-reported quality of care, and patient safety; a numeric pain rating scale, a depression tool (the Patient Health Questionnaire), and a presenteeism tool (the Work Productivity and Activity Impairment Questionnaire: General Health) were also incorporated. A total of 1,171 completed surveys were returned and used for analysis. ResultsAmong respondents, the prevalence of musculoskeletal pain was 71%; that of depression was 18%. The majority of respondents (62%) reported a presenteeism score of at least 1 on a 0-to-10 scale, indicating that health problems had affected work productivity at least “a little.” Pain and depression were significantly associated with presenteeism. Presenteeism was significantly associated with a higher number of patient falls, a higher number of medication errors, and lower quality-of-care scores. Baseline cost estimates indicate that the increased falls and medication errors caused by presenteeism are expected to cost

Retaining the older nurse

1,346 per North Carolina RN and just under

THE IMPORTANCE OF SOCIAL SUPPORT FOR RURAL MENTAL HEALTH

2 billion for the United States annually. Upper-boundary estimates exceed

Depression in hospital-employed nurses.

9,000 per North Carolina RN and

Perceptions of Barriers in Managing Diabetes Perspectives of Hispanic Immigrant Patients and Family Members

13 billion for the nation annually. ConclusionMore attention must be paid to the health of the nursing workforce to positively influence the quality of patient care and patient safety and to control costs.

An Innovative Strategy to Enhance NEW FACULTY SUCCESS

The nursing workforce is aging more rapidly than the workforce as a whole, and fewer young people are entering the profession. It is imperative that older nurses be retained, not only for their experience and expertise, but also to prevent worsening an already critical nursing shortage. A descriptive survey design was used to determine the knowledge base and plans for the aging RN workforce by North Carolina hospitals and nursing homes. Nurses over age 55 made up 14.1% of the respondents’ RN staff. Most administrators are aware of the aging workforce and wish to retain older nurses. Unfortunately, 94% of facilities have no policies in place to address the needs of older nurses, and 87% admitted to having no immediate plans to do so. Specific recommendations are made to assist nurse managers in retaining the older RN.

The Experience of Being an Older Staff Nurse

While the mentally ill are considered to be vulnerable as a group, those who are mentally ill and reside in rural communities are at a greater disadvantage due to limited access to health care, a scarcity of resources, and traditional cultural belief systems. Social support has been found to have a direct effect on the well-being of families and individuals. Specific strategies are presented which will assist rural health nurses in providing the support systems necessary to help rural residents in managing and coping with stress and mental health problems.

Perceptions within a mentorship program.

Depression impacts 9.4% of the adult population in the United States, and it is known to impact work performance. Nurses with depression are not only likely to suffer themselves, but their illness may have an impact on their coworkers and potentially the quality of care they provide. Thus, the purpose of this study was to determine the prevalence of depression in a random sample of hospital-employed nurses to determine individual and workplace characteristics that are associated with depression. A cross-sectional survey design of 1171 registered nurses was used. Measures included individual characteristics, workplace characteristics, work productivity, and depression (9-item Patient Health Questionnaire). Data analysis demonstrated a depressive symptom rate of 18%. The linear regression model accounted for 60.6% of the variation in the 9-item Patient Health Questionnaire depression scores. Body mass index, job satisfaction, number of health problems, mental well-being, and health-related productivity had significant relationships with depression (P < .05). Hospital-employed nurses have higher rates of depressive symptoms than national norms. Advanced practice nurses can assist with educating nurses on recognizing depression and confidential interventions, including the use of computerized cognitive-based therapy.

A Community’s Awareness and Perceptions of Genomic Medicine

Purpose Hispanics show poorer self-management of type 2 diabetes than non-Hispanic whites. Although previous studies have reported socioeconomic and cultural barriers to diabetes self-management by Hispanics, little is known about perceived barriers to diabetes self-management from the perspectives of both Hispanics and their family members. The purpose of the study was to explore perceived barriers among Hispanic immigrants with diabetes and their family members. Methods A qualitative study using 5 focus groups was conducted. A total of 73 Hispanic immigrants with type 2 diabetes (n = 36) and family members (n = 37) were recruited in the southeastern United States for a family-based intervention study of diabetes-self management. Participants were asked to describe their perceptions of barriers to self-management. The 5 sessions were audiotaped and transcribed, translated from Spanish into English, and analyzed using standard content analysis. Demographics, hemoglobin A1C levels, blood pressure, and body mass index (BMI) were obtained both for participants with diabetes and for their family members. Results Barriers to diabetes self-management identified by participants with diabetes were in 3 major themes categorized as: suffering from diabetes, difficulties in managing the disease, and lack of resources/support. Two key themes emerged pertaining to family members: we can provide support and we lack knowledge. Conclusions Perceived barriers to diabetes self-management described by Hispanic immigrants with diabetes and family members indicate a lack of intervention strategies to meet their needs. Interventions should include culturally relevant resources, family support, and diabetes self-management skills education.

Myths and Realities of Ageism and Nursing

Faculty stress is a factor in the current shortage of nursing faculty. New faculty members in schools of nursing are subject to stress from many sources. This article reports on an innovative strategy that decreases stress for new faculty while facilitating faculty tenure success.