Off-Shift Nursing and Quality Patient Outcomes

Acute care hospitals function 24-hours-a-day, 7-days-a-week. A majority of that time is characterized as off-shifts (i.e., nights, weekends, and/or holidays). Researchers have found that patient outcomes are generally worse on off-shifts as compared to regular hours. However, the underlying mechanism of why these outcomes are worse remains unclear. This dissertation explores off-shift care including nurse staffing and human capital variables and their impact on patient safety in acute care hospitals. The importance of off-shift quality care in acute care hospitals is discussed in the first chapter. In the second chapter, findings from a systematic literature review are presented. The third chapter describes mixed methods and the theoretical framework that guided the development of an interview guide and the quantitative portion of the dissertation. The fourth chapter includes the qualitative study of off-shift nursing and the fifth chapter, is a quantitative study of testing variations in nursing inputs (i.e., staffing and human capital variables) by shift and their impact on length of stay. Finally, in the sixth chapter, the findings from Chapter 2, 4, and 5 are summarized and synthesized into a concluding chapter of the dissertation

Health policy engagement among graduate nursing students in the United States

Aim The aim was to understand how health policy education is currently being delivered in the United States’ graduate nursing programs. Methods This exploratory cross‐sectional design used an anonymous online survey to target graduate nursing students attending American Association of College of Nursing (AACN) member institutions. Results Over 75% of the sample (n = 140) reported taking a dedicated health policy course and 71.5% ( n = 131) of the sample responded that a health policy course was required and an equal distribution among master’s and doctoral students. There was no significant difference between type of graduate degree sought and the requirement to take a health policy course ( P = 0.37). For students involved in health policy, there was a greater proportion of master’s students involved at the state level, than doctorate of nursing practice (DNP) or PhD students ( P = 0.04). Conclusions Health policy and advocacy education are important aspects of graduate nursing curriculum and have been integrated into curricula. Graduate nursing students at all levels reported that health policy AACN Essential competencies are being included in their program, either as stand‐alone health policy courses or integrated health policy learning activities during matriculation