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Hemşire İstihdamının Hasta ve Hemşire Sonuçları ile Organizasyonel Çıktılara Etkisi: Yataklı Tedavi Kurumlarında Hemşire İnsan Gücünü Planlama

Year 2015, Volume: 2 Issue: 3, 69 - 80, 22.03.2016

Abstract

Hastanelerde, kaliteli ve güvenli hasta bakımının sağlanmasında hemşire insan gücü önemli bir yer tutmaktadır. Yapılan çalışmalar, hemşire istihdamı ve hemşire çalışma ortamı özellikleri ile hasta, hemşire ve organizasyonel çıktılar arasında ilişki olduğunu göstermektedir. Hastanelerde hasta başına hemşirelik saati ile karma hemşirelik ekibi içinde eğitim düzeyi ve deneyimi fazla olan hemşire oranı yüksek ise bası yarası, infeksiyon gibi hasta çıktılarının da iyi olduğu bildirilmektedir. Olumlu hemşire çalışma ortamına bağlı olarak hemşire iş doyumu artmakta, hemşirelerde tükenme ve hemşire devir hızı azalmaktadır. Ayrıca, organizasyonel çıktılar olarak hastaların hastanede yatış süresi kısalmakta, hastaneye geriş dönüşü azalmakta ve maliyetler düşmektedir. Türkiye’de, mevcut hemşire insan gücü yapısı ile hasta, hemşire ve organizasyonel çıktıları ilişkilendiren çok az sayıda çalışma vardır. Bu makalede, hastanelerde hemşire istihdamı ile ilgili özellikler ya da ölçütler, hemşire istihdamının hasta, hemşire ve organizasyonel çıktılara etkisi ele alınacak ve ülkemizde konu ile ilgili mevcut uygulamalar tartışılacaktır.

References

  • 1. Akdağ R. The Progress So Far: Turkey Health Transformation Programme. Ankara, Ministry of Health in Turkey. 2010. URL: http://www.saglik.gov.tr/EN/dosya/2-1251/h/ healthtransformationprogrammeinturkey.pdf November 15, 2015.
  • 2. Atunes V, Moreira JP. Skill mix in healthcare: An international update for the management debate. International Journal of Healthcare Management 2013; 6(1):12-17.
  • 3. WHO. The World health report 2013: Research for universal health coverage. Genava, World Health Organization. 2013. URL: http://apps.who.int/iris/bitstream/10665/85761/2/9789240690837_eng. pdf?ua=1 November 15, 2015.
  • 4. Hall LM, Doran D, Pink GH. Nurse staffing models, nursing hours, and patient safety outcomes. Journal of Nursing Administration 2004; 34(1): 41-45.
  • 5. Milne P. Devolution and nursing workforce policy and planning in the four countries of the United Kingdom 1997-2009. School of Health Sciences, Nursing, PhD thesis. Edinburgh: Queen Margaret University; 2013.
  • 6. Welton JM. Hospital nursing workforce costs, wages, occupational mix, and resource utilization. Journal of Nursing Administration 2011; 41(7/8): 309-314.
  • 7. Duffield C, Diers D, O’Brian-Pallas L, Aisbelt C, Roche M, King M, Aisbelt K. Nursing staffing, nursing workload, the work environment and patient outcomes. Applied Nursing Research 2011; 24(4):244-255.
  • 8. AIHW. Australian Government, Australian Institute of Healh and Welfare. URL: http://www.aihw.gov. au/workforce/nursing-and-midwifery/how-many/ November 13, 2015.
  • 9. The U.S. Nursing Workforce: Trends in Supply and Education. Health Resources and Services Administration Bureau of Health Professions National Center for Health Workforce Analysis. October 2013. URL: http://bhpr.hrsa.gov/healthworkforce/supplydemand/nursing/nursingworkforce/ nursingworkforcefullreport.pdf November 12, 2015.
  • 10. Wilson S, Bremner A, Hauck Y, Finn J. The effect of nurse staffing on clinical outcomes of children in hospital: a systematic review. Int J Evid Based Healthcare 2011; 9:97-121.
  • 11. Van den Heede K, Clarke SP, Sermeus W, Vleugels A, Aiken LH. International experts’ perspectives on the state of the nurse staffing and patient outcomes literature. Journal of Nursing Scholarship 2007; 39(4):290-297.
  • 12. Sermeus W, Aiken LH, Van den Heede K, Rafferty AM; Griffiths P, Moreno-Casbas MT, Busse R, et al. Nurse forecasting in Europe (RN4CAST): Rationale, design and methodology. BMC Nursing 2011; 10(6). URL: http://www.biomedcentral.com/1472-6955/10/6. November 12, 2015.
  • 13. Coffman JM, Seago JA, Spetz J. Minimum nurse-to-patient ratios in acute care hospitals in California. Health Affairs 2002; 21(5):53-64.
  • 14. Gerdtz MF, Nelson S. 5–20: a model of minimum nurse-to-patient ratios in Victoria, Australia. Journal of Nursing Management 2007; 15(1):64-71.
  • 15. Sağlık Bakanlığı (SB). Yataklı sağlık tesislerinde yoğun bakım hizmetlerinin uygulama usul ve esasları hakkında tebliğde değişiklik yapılmasına dair tebliğ. 2013. URL: http://www.resmigazete.gov.tr/ eskiler/2013/05/20130529-25.htm 10 Ağustos 2015.
  • 16. Özel Hastaneler Yönetmeliği. Resmi Gazete Tarihi: 27.03.2002 Resmi Gazete Sayısı: 24708 URL: http:// www.mevzuat.gov.tr/Metin.Aspx?MevzuatKod=7.5.4854&MevzuatIliski=0&sourceXmlSearch=%C3% B6zel%20hastane 10 Ağustos 2015.
  • 17. Baumann A. International Council of Nurses (ICN) positive practice environments: Quality workplaces = quality patient care, information an action tool kit [Electronic version]. Retrieved September 13, 2009. URL: http://www.icn.ch/indkit2007.pdf August 10, 2015.
  • 18. American Nurses Credentialing Center (ANCC) Magnet manuel_addendum_v19.pdf URL: http://www. nursecredentialing.org/Magnet/MagnetManualUpdates/2014-MagnetManualUpdates.pdf November 10, 2015.
  • 19. American Nurses Credentialing Center (ANCC). URL: 20. http://www.nursecredentialing.org/Magnet/FindaMagnetFacility November 10, 2015.
  • 21. Twigg DE, Gelder L, Myers H. The impact of understaffed shifts on nurse‐sensitive outcomes. J Adv Nurs 2015; 71(7):1564-1572.
  • 22. Lucero RJ, Lake ET, Aiken LH. Nursing care quality and adverse events in US hospitals. Journal of Clinical Nursing 2010; 19:2185-2195.
  • 23. Yakusheva O, Lindrooth R, Weiss M. Economic evaluation of the 80% baccalaureate nurse workforce recommendation: a patient-level analysis. Med Care 2014; 52(10): 864-869.
  • 24. Cho E, Sloane DM, Kim EY, Kim S, Choi M, Yoo IY, Lee HS, Aiken LH. Effects of nurse staffing, work environments, and education on patient mortality: An observational study. International Journal of Nursing Studies 2015; 52(2):535-542.
  • 25. Boyle DK, Cramer E, Potter C, Gatua MW, Stobinski JX. The relationship between direct-care RN specialty certification and surgical patient outcomes. AORN Journal 2014; 100(5):511-528.
  • 26. Bolton LB, Aydin CE, Donaldson N, Brown DS, Sandhu M, Fridman M, Aronow HU. Mandated nurse staffing ratios in California: a comparison of staffing and nursing-sensitive outcomes pre-and postregulation. Policy, Politics, & Nursing Practice 2007; 8(4):238-250.
  • 27. Aiken LH, Sloane DM, Cimiotti JP, Clarke SP, Flynn L, Seago JA. Implications of the California nurse staffing mandate for other states. Health services Research 2010; 45(4):904-921.
  • 28. Mark BA, Harless DW, Berman WF. Nurse staffing and adverse events in hospitalized children. Policy, Politics, & Nursing Practice 2007; 8(2):83-92.
  • 29. Institute of Medicine (IOM) of the National Academies. The future of nursing focus on education. 2010. URL: https://iom.nationalacademies.org/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/ Nursing%20Education%202010%20Brief.pdf November 10, 2015.
  • 30. TC Sağlık Bakanlığı, Sağlık Hizmetleri Genel Müdürlüğü, Sağlıkta Akreditasyon Daire Başkanlığı. Sağlıkta kalite standartları, hastane. 1. baskı. Ankara: Pozitif Matbaa; 2015. URL: https://kalite.saglik. gov.tr/index.php?lang=tr&page=355 10 Ekim 2015.
  • 31. Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA 2002; 288(16):1987-1993.
  • 32. Rothberg MB, Abraham I, Lindenauer PK, Rose DN. Improving nurse-to-patient staffing ratios as a cost-effective safety intervention. Medical Care 2005; 43(8):785-791.
  • 33. Aiken LH, Sermeus W, Van den Heede K, Sloane DM, Busse R, McKee M, et al. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ 2012; 344: e1717.
  • 34. Zhang LF, You LM, Liu K, Zheng J, Fang JB, Lu MM, et al. The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave. Nursing Outlook 2014; 62(2):128-137.
  • 35. Coomber B, Barriball KL. Impact of job satisfaction components on intent to leave and turnover for hospital-based nurses: a review of the research literature. International Journal of Nursing Studies 2007; 44(2):297-314.
  • 36. Hinno S, Partanen P, Vehviläinen-Julkunen K. Hospital nurses’ work environment, quality of care provided and career plans. International Nursing Review 2011; 58(2):255-262.
  • 37. Kanai-Pak M, Aiken LH, Sloane DM, Poghosyan L. Poor work environments and nurse inexperience are associated with burnout, job dissatisfaction and quality deficits in Japanese hospitals. Journal of Clinical Nursing 2008; 17(24):3324-3329.
  • 38. Choi J, Bakken S, Larson E, Du Y, Stone PW. Perceived nursing work environment of critical care nurses. Nursing Research 2004; 53(6):370-378.
  • 39. Schmalenberg C, Kramer M. Essentials of a productive nurse work environment. Nursing Research 2008; 57(1):2-13.
  • 40. Kramer M, Maguire P, Brewer BB. Clinical nurses in Magnet hospitals confirm productive, healthy unit work environments. Journal of Nursing Management 2011; 19(1):5-17.
  • 41. Cho SH, June KJ, Kim YM, Cho Y, Yoo CS, Yun SC, Sung YH. Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units. Journal of Clinical Nursing 2009; 18(12):1729-1737
  • 42. Cowden T, Cummings G, Profetto-Mcgrath J. Leadership practices and staff nurses’ intent to stay: a systematic review. Journal of Nursing Management 2011; 19(4):461-477.
  • 43. Spence Laschinger HK, Leiter M, Day A, Gilin D. Workplace empowerment, incivility, and burnout: Impact on staff nurse recruitment and retention outcomes. Journal of Nursing Management 2009; 17(3):302-311.
  • 44. Baernholdt M, Mark BA. The nurse work environment, job satisfaction and turnover rates in rural and urban nursing units. Journal of Nursing Management 2009; 17(8):994-1001
  • 45. Bakır B, Ozer M, Ozcan CT, Cetin M, Fedai T. The association between burnout, and depressive symptoms in a Turkish military nurse sample. Bulletin of Clinical Psychopharmacology 2010; 20(2):160163.
  • 46. Çalışkan A. Yeni mezun hemşirelerde iş doyumu tüknmişlik ve gerçeklik şokunun incelenmesi. İstanbul: Marmara Üniversitesi Sağlık Bilimleri Enstitüsü, Yüksek lisans tezi. 2010.
  • 47. Günüşen NP, ÜstünB. Türkiye’de ikinci basamak sağlık hizmetlerinde çalışan hemşire ve hekimlerde tükenmişlik: literatür incelemesi. DEUHYO ED 2010; 3(1):40-51.
  • 48. Tunç A, Gündüz B. Maslach Tükenmişlik Modeline dayalı müdahale çalışmalarının incelenmesi. Ege Eğitim Dergisi 2010; 11(1):84-106.
  • 49. Öner S. Psikiyatri hastanelerinde çalışan hemşirelerde hasta agresyonuna gösterilen tepkiler ile tükenmişlik arasındaki ilişkinin incelenmesi. Düzce: Düzce Üniversitesi Sağlık Bilimleri Enstitüsü, Yüksek lisans tezi. 2011.
  • 50. Kocaman G, Seren Ş, Kurt S, Danış B, Erer T. Üç üniversite hastanesinde hemşire devir hızı. Hemşirelikte Eğitim ve Araştırma Dergisi 2010; 7(1):34-38.
  • 51. Kebapçı A, Akyolcu N. Acil birimlerde çalışan hemşirelerde çalışma ortamının tükenmişlik düzeylerine etkisi. Türkiye Acil Tıp Dergisi 2011; 11(2):59-67.
  • 52. Uğur GöK A, Kocaman G. Reasons for leaving nursing: a study among Turkish nurses. Contemporary Nurse 2011; 39(1):65-74.
  • 53. Twigg DE, Geelhoed E, Bremner A, Duffield CM. The economic benefits of increased levels of nursing care in the hospital setting. Journal of Advanced Nursing 2013; 69(10):2253-2261.
  • 54. Duffield CM, Roche MA, Homer C, Buchan J, Dimitrelis S. A comparative review of nurse turnover rates and costs across countries. Journal of Advanced Nursing 2014; 70(12):2703-2712.

The Relationship Between Nurse Staffing and Patient, Nurse and Organizational Outcomes: Nurse Workforce Planning at Acute Care Hospitals

Year 2015, Volume: 2 Issue: 3, 69 - 80, 22.03.2016

Abstract

The nursing workforce plays an important role in providing high-quality and safe patient care in hospitals.  Studies have revealed that there is a relationship between nurse staffing, nurse work environment, and patient, nurse and organizational outcomes. Patient outcomes such as pressure ulcers and infections improve when there is an increase in nursing hours per patient and in the proportion of highly-educated and experienced nurses.  There is an increase in job satisfaction and a decrease in nurse burnout and turnover in positive nursing practice environments. Additionally, as for organizational outcomes, there is a decrease in the lengthof-stay at hospital and re-admission to the hospital. In Turkey, few studies have examined the relationship between nursing staffing and patient, nurse and organizational outcomes. This article reviews nurse staffing measures, the impact of nurse staffing on patient, nurse and organizational outcomes at hospitals related to the literature, and discusses nurse staffing practices in our country. 

References

  • 1. Akdağ R. The Progress So Far: Turkey Health Transformation Programme. Ankara, Ministry of Health in Turkey. 2010. URL: http://www.saglik.gov.tr/EN/dosya/2-1251/h/ healthtransformationprogrammeinturkey.pdf November 15, 2015.
  • 2. Atunes V, Moreira JP. Skill mix in healthcare: An international update for the management debate. International Journal of Healthcare Management 2013; 6(1):12-17.
  • 3. WHO. The World health report 2013: Research for universal health coverage. Genava, World Health Organization. 2013. URL: http://apps.who.int/iris/bitstream/10665/85761/2/9789240690837_eng. pdf?ua=1 November 15, 2015.
  • 4. Hall LM, Doran D, Pink GH. Nurse staffing models, nursing hours, and patient safety outcomes. Journal of Nursing Administration 2004; 34(1): 41-45.
  • 5. Milne P. Devolution and nursing workforce policy and planning in the four countries of the United Kingdom 1997-2009. School of Health Sciences, Nursing, PhD thesis. Edinburgh: Queen Margaret University; 2013.
  • 6. Welton JM. Hospital nursing workforce costs, wages, occupational mix, and resource utilization. Journal of Nursing Administration 2011; 41(7/8): 309-314.
  • 7. Duffield C, Diers D, O’Brian-Pallas L, Aisbelt C, Roche M, King M, Aisbelt K. Nursing staffing, nursing workload, the work environment and patient outcomes. Applied Nursing Research 2011; 24(4):244-255.
  • 8. AIHW. Australian Government, Australian Institute of Healh and Welfare. URL: http://www.aihw.gov. au/workforce/nursing-and-midwifery/how-many/ November 13, 2015.
  • 9. The U.S. Nursing Workforce: Trends in Supply and Education. Health Resources and Services Administration Bureau of Health Professions National Center for Health Workforce Analysis. October 2013. URL: http://bhpr.hrsa.gov/healthworkforce/supplydemand/nursing/nursingworkforce/ nursingworkforcefullreport.pdf November 12, 2015.
  • 10. Wilson S, Bremner A, Hauck Y, Finn J. The effect of nurse staffing on clinical outcomes of children in hospital: a systematic review. Int J Evid Based Healthcare 2011; 9:97-121.
  • 11. Van den Heede K, Clarke SP, Sermeus W, Vleugels A, Aiken LH. International experts’ perspectives on the state of the nurse staffing and patient outcomes literature. Journal of Nursing Scholarship 2007; 39(4):290-297.
  • 12. Sermeus W, Aiken LH, Van den Heede K, Rafferty AM; Griffiths P, Moreno-Casbas MT, Busse R, et al. Nurse forecasting in Europe (RN4CAST): Rationale, design and methodology. BMC Nursing 2011; 10(6). URL: http://www.biomedcentral.com/1472-6955/10/6. November 12, 2015.
  • 13. Coffman JM, Seago JA, Spetz J. Minimum nurse-to-patient ratios in acute care hospitals in California. Health Affairs 2002; 21(5):53-64.
  • 14. Gerdtz MF, Nelson S. 5–20: a model of minimum nurse-to-patient ratios in Victoria, Australia. Journal of Nursing Management 2007; 15(1):64-71.
  • 15. Sağlık Bakanlığı (SB). Yataklı sağlık tesislerinde yoğun bakım hizmetlerinin uygulama usul ve esasları hakkında tebliğde değişiklik yapılmasına dair tebliğ. 2013. URL: http://www.resmigazete.gov.tr/ eskiler/2013/05/20130529-25.htm 10 Ağustos 2015.
  • 16. Özel Hastaneler Yönetmeliği. Resmi Gazete Tarihi: 27.03.2002 Resmi Gazete Sayısı: 24708 URL: http:// www.mevzuat.gov.tr/Metin.Aspx?MevzuatKod=7.5.4854&MevzuatIliski=0&sourceXmlSearch=%C3% B6zel%20hastane 10 Ağustos 2015.
  • 17. Baumann A. International Council of Nurses (ICN) positive practice environments: Quality workplaces = quality patient care, information an action tool kit [Electronic version]. Retrieved September 13, 2009. URL: http://www.icn.ch/indkit2007.pdf August 10, 2015.
  • 18. American Nurses Credentialing Center (ANCC) Magnet manuel_addendum_v19.pdf URL: http://www. nursecredentialing.org/Magnet/MagnetManualUpdates/2014-MagnetManualUpdates.pdf November 10, 2015.
  • 19. American Nurses Credentialing Center (ANCC). URL: 20. http://www.nursecredentialing.org/Magnet/FindaMagnetFacility November 10, 2015.
  • 21. Twigg DE, Gelder L, Myers H. The impact of understaffed shifts on nurse‐sensitive outcomes. J Adv Nurs 2015; 71(7):1564-1572.
  • 22. Lucero RJ, Lake ET, Aiken LH. Nursing care quality and adverse events in US hospitals. Journal of Clinical Nursing 2010; 19:2185-2195.
  • 23. Yakusheva O, Lindrooth R, Weiss M. Economic evaluation of the 80% baccalaureate nurse workforce recommendation: a patient-level analysis. Med Care 2014; 52(10): 864-869.
  • 24. Cho E, Sloane DM, Kim EY, Kim S, Choi M, Yoo IY, Lee HS, Aiken LH. Effects of nurse staffing, work environments, and education on patient mortality: An observational study. International Journal of Nursing Studies 2015; 52(2):535-542.
  • 25. Boyle DK, Cramer E, Potter C, Gatua MW, Stobinski JX. The relationship between direct-care RN specialty certification and surgical patient outcomes. AORN Journal 2014; 100(5):511-528.
  • 26. Bolton LB, Aydin CE, Donaldson N, Brown DS, Sandhu M, Fridman M, Aronow HU. Mandated nurse staffing ratios in California: a comparison of staffing and nursing-sensitive outcomes pre-and postregulation. Policy, Politics, & Nursing Practice 2007; 8(4):238-250.
  • 27. Aiken LH, Sloane DM, Cimiotti JP, Clarke SP, Flynn L, Seago JA. Implications of the California nurse staffing mandate for other states. Health services Research 2010; 45(4):904-921.
  • 28. Mark BA, Harless DW, Berman WF. Nurse staffing and adverse events in hospitalized children. Policy, Politics, & Nursing Practice 2007; 8(2):83-92.
  • 29. Institute of Medicine (IOM) of the National Academies. The future of nursing focus on education. 2010. URL: https://iom.nationalacademies.org/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/ Nursing%20Education%202010%20Brief.pdf November 10, 2015.
  • 30. TC Sağlık Bakanlığı, Sağlık Hizmetleri Genel Müdürlüğü, Sağlıkta Akreditasyon Daire Başkanlığı. Sağlıkta kalite standartları, hastane. 1. baskı. Ankara: Pozitif Matbaa; 2015. URL: https://kalite.saglik. gov.tr/index.php?lang=tr&page=355 10 Ekim 2015.
  • 31. Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA 2002; 288(16):1987-1993.
  • 32. Rothberg MB, Abraham I, Lindenauer PK, Rose DN. Improving nurse-to-patient staffing ratios as a cost-effective safety intervention. Medical Care 2005; 43(8):785-791.
  • 33. Aiken LH, Sermeus W, Van den Heede K, Sloane DM, Busse R, McKee M, et al. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ 2012; 344: e1717.
  • 34. Zhang LF, You LM, Liu K, Zheng J, Fang JB, Lu MM, et al. The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave. Nursing Outlook 2014; 62(2):128-137.
  • 35. Coomber B, Barriball KL. Impact of job satisfaction components on intent to leave and turnover for hospital-based nurses: a review of the research literature. International Journal of Nursing Studies 2007; 44(2):297-314.
  • 36. Hinno S, Partanen P, Vehviläinen-Julkunen K. Hospital nurses’ work environment, quality of care provided and career plans. International Nursing Review 2011; 58(2):255-262.
  • 37. Kanai-Pak M, Aiken LH, Sloane DM, Poghosyan L. Poor work environments and nurse inexperience are associated with burnout, job dissatisfaction and quality deficits in Japanese hospitals. Journal of Clinical Nursing 2008; 17(24):3324-3329.
  • 38. Choi J, Bakken S, Larson E, Du Y, Stone PW. Perceived nursing work environment of critical care nurses. Nursing Research 2004; 53(6):370-378.
  • 39. Schmalenberg C, Kramer M. Essentials of a productive nurse work environment. Nursing Research 2008; 57(1):2-13.
  • 40. Kramer M, Maguire P, Brewer BB. Clinical nurses in Magnet hospitals confirm productive, healthy unit work environments. Journal of Nursing Management 2011; 19(1):5-17.
  • 41. Cho SH, June KJ, Kim YM, Cho Y, Yoo CS, Yun SC, Sung YH. Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units. Journal of Clinical Nursing 2009; 18(12):1729-1737
  • 42. Cowden T, Cummings G, Profetto-Mcgrath J. Leadership practices and staff nurses’ intent to stay: a systematic review. Journal of Nursing Management 2011; 19(4):461-477.
  • 43. Spence Laschinger HK, Leiter M, Day A, Gilin D. Workplace empowerment, incivility, and burnout: Impact on staff nurse recruitment and retention outcomes. Journal of Nursing Management 2009; 17(3):302-311.
  • 44. Baernholdt M, Mark BA. The nurse work environment, job satisfaction and turnover rates in rural and urban nursing units. Journal of Nursing Management 2009; 17(8):994-1001
  • 45. Bakır B, Ozer M, Ozcan CT, Cetin M, Fedai T. The association between burnout, and depressive symptoms in a Turkish military nurse sample. Bulletin of Clinical Psychopharmacology 2010; 20(2):160163.
  • 46. Çalışkan A. Yeni mezun hemşirelerde iş doyumu tüknmişlik ve gerçeklik şokunun incelenmesi. İstanbul: Marmara Üniversitesi Sağlık Bilimleri Enstitüsü, Yüksek lisans tezi. 2010.
  • 47. Günüşen NP, ÜstünB. Türkiye’de ikinci basamak sağlık hizmetlerinde çalışan hemşire ve hekimlerde tükenmişlik: literatür incelemesi. DEUHYO ED 2010; 3(1):40-51.
  • 48. Tunç A, Gündüz B. Maslach Tükenmişlik Modeline dayalı müdahale çalışmalarının incelenmesi. Ege Eğitim Dergisi 2010; 11(1):84-106.
  • 49. Öner S. Psikiyatri hastanelerinde çalışan hemşirelerde hasta agresyonuna gösterilen tepkiler ile tükenmişlik arasındaki ilişkinin incelenmesi. Düzce: Düzce Üniversitesi Sağlık Bilimleri Enstitüsü, Yüksek lisans tezi. 2011.
  • 50. Kocaman G, Seren Ş, Kurt S, Danış B, Erer T. Üç üniversite hastanesinde hemşire devir hızı. Hemşirelikte Eğitim ve Araştırma Dergisi 2010; 7(1):34-38.
  • 51. Kebapçı A, Akyolcu N. Acil birimlerde çalışan hemşirelerde çalışma ortamının tükenmişlik düzeylerine etkisi. Türkiye Acil Tıp Dergisi 2011; 11(2):59-67.
  • 52. Uğur GöK A, Kocaman G. Reasons for leaving nursing: a study among Turkish nurses. Contemporary Nurse 2011; 39(1):65-74.
  • 53. Twigg DE, Geelhoed E, Bremner A, Duffield CM. The economic benefits of increased levels of nursing care in the hospital setting. Journal of Advanced Nursing 2013; 69(10):2253-2261.
  • 54. Duffield CM, Roche MA, Homer C, Buchan J, Dimitrelis S. A comparative review of nurse turnover rates and costs across countries. Journal of Advanced Nursing 2014; 70(12):2703-2712.
There are 53 citations in total.

Details

Journal Section Articles
Authors

Emine Türkmen

Publication Date March 22, 2016
Submission Date August 1, 2017
Published in Issue Year 2015 Volume: 2 Issue: 3

Cite

Vancouver Türkmen E. Hemşire İstihdamının Hasta ve Hemşire Sonuçları ile Organizasyonel Çıktılara Etkisi: Yataklı Tedavi Kurumlarında Hemşire İnsan Gücünü Planlama. JOHUFON. 2016;2(3):69-80.