PMID: 9423404Jan 10, 1998Paper

Substitution in nursing practice: clinical, management and research implications

Journal of Nursing Management
S J Cavanagh, M Bamford

Abstract

The introduction of market forces into health care delivery systems has had a number of important influences on the roles nurses perform. There have been increasing efforts to find alternative and more cost-effective ways of delivering care. One facet of this situation has been the examination of the roles and responsibilities of registered nurses (RNs) with the view of exploring different ways of using professional skills and determining if RN services are always required. One result of this has been the increased use of unlicensed personnel. The substitution of professional nursing staff by unlicensed personnel has become a major concern for practitioner, manager and client alike. This paper reviews some of the concepts of economic substitution as well as the assumptions advanced for the use of unlicensed personnel in clinical areas as a substitute for nursing services. While there has been increased use of unlicensed staff, the evaluation of clinical outcomes has been poor. This paper reviews primarily the hospital-based evidence about the impact of using unlicensed personnel in practice, and suggests there are methodological problems with the research published to date. Findings suggest that substitute service providers gen...Continue Reading

Citations

Nov 24, 1998·Trends in Genetics : TIG·L AravindE V Koonin
Dec 30, 1998·Trends in Biochemical Sciences·L Aravind, E V Koonin
May 10, 2005·Journal of the American Geriatrics Society·David A DorrRandall J Smout
Oct 14, 2006·Journal of Clinical Nursing·Aggie T G PaulusFemke B Keijzer
Jul 25, 2008·Policy, Politics & Nursing Practice·Susan D Horn
Mar 24, 2018·Worldviews on Evidence-based Nursing·Zainab LulatMichelle Rey
Apr 28, 2001·Journal of Speech, Language, and Hearing Research : JSLHR·T M Loucks, L F De Nil
Sep 17, 2003·BMC Genomics·Olga Zhaxybayeva, J Peter Gogarten
Oct 6, 2020·Frontiers in Public Health·Sylvia G ElkhuizenJoris J van de Klundert

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