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CE 2_Nov REV 12/10/10 8:16 AM Page 24 to be accountable for the provision of care according to the true art and science of nursing as described by Florence Nightingale. Evidence-based practice can be defined as the conscientious integration of best research evidence with clinical expertise and patient values and needs in the delivery of healthcare. The best research evidence is produced by the conduct and synthesis of numerous, highquality studies. Improved staffing has a significant and positive correlation with improved patient outcomes; research has shown quality of care is improved when staffing is adequate (Tourangeau, Cranley, and Jeffs, 2006). There is a dearth of valid and reliable empirical studies which demonstrate a correlation between scripting and rounding schemes, patient satisfaction surveys, and improved health outcomes. Script- References Agency for Healthcare Research and Quality (AHRQ). (2008). The CAHPS hospital survey (H-CAHPS). (2008). Retrieved September 8, 2010, from http://www.cahps.ahrq.gov/content/products/HOSP/PROD_HOSP_Intro.asp Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H., (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Journal of the American Medical Association, 288: 1987-93. Aiken, L. H., Sloane, D. M., Cimiotti, J. P., Clarke, S. P., Flynn, L., Seago, J. A. , Spetz, J. , & Smith, H. L., (2010). Implications of the California nurse staffing mandate for other states. Health Services Research, 45 (4). 904-21. Berwick, D.M. (2002). A User's Manual for the IOM's 'Quality Chasm' Report. Health Affairs, 21 (3): 80 – 90. Dall, T. M., Chen, Y. J., Seifurt, R. F., Maddox, P. J., & Hogan, P. F. (2009). The economic value of professional nursing. Medical Care, 47 (1), 97-104. Dumpel, H. (2010). Hospital magnet status: Impact on RN autonomy and patient advocacy. National Nurse. pp. 22-27. Eastabrooks, C. A., Midodzi, W. K., Cummings, G. C., Tickler, K. L., & Giovannetti, P. (2005). The impact of hospital nursing characteristics on 30 day mortality. Nursing Research 54 (2); 74-84. Ford, B. (2010). Hourly Rounding: A Strategy to Improve Patient Satisfaction Scores. Med/Surg Nursing, 19 (3). 188-191. Guadagnino, C. (2003). Role of patient satisfaction. Physician's News Digest; pp 1-12. Retrieved on July 25, 2010, from http://www.physicansnews.com/cover/1203.html HCAHPS: Hospital Care Quality Information from the Consumer Perspective. Centers for Medicare and Medicaid Services, Baltimore, MD. Website accessed on September 10, 2010, from http://www.hcahpsonline Institute of Medicine (IOM). (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press. Jha, A. K. , Orav, E. J. , Zheng, J. , & Epstein, A. M., (2008). Patients' perception of hospital care in the United States. New England Journal of Medicine, 359:1921-31. 24 N AT I O N A L N U R S E ing and rounding schemes, when taken together with the mandated implementation and coercive enforcement of them in lieu of, or as a substitute for, increasing nurse-to-patient ratios creates a hostile work environment for RNs and an unsafe care environment for patients. In the field of patient safety, management tactics of fear, intimidation, and threat of retaliation have long been recognized as detrimental to safe practice. Scripting and rounding schemes are a creation of for-profit commercial interests whose priority is to reap the economic incentives of corporate healthcare. Such schemes provide continuing cover for the commodification of healthcare and the failed health policies that continue to pose a significant barrier to the RNs' ability to control the practice of nursing and RNs' efforts to winning a single-payer Kohn LT, Corrigan JM, Donaldson MS. (1999). Committee on Quality of Healthcare in America. Institute of Medicine of the National Academies. To err is human: building a safer health system. Washington, DC: National Academy Press. McCue, M., Mark, B.A., & Harless, D. W. (2003). Nurse staffing, quality, and financial performance. Journal of Healthcare Finance, 29, 54-76. McGillis-Hall, L., Doran, D., & Pink, G. (2004). Nurse staffing, care delivery model, and patient care quality. Journal of Nursing Care Quarterly, 19 (1), 27-33. Meade, C. M., Bursell, A. L., & Ketelsen, L. (2006). Effects of nursing rounds: On patient call light use, satisfaction, and safety. American Journal of Nursing, 106 (9), 58-70. Melnyk, B. M., (2007). The latest evidence on hourly rounding and rapid response teams in decreasing adverse events in hospitals. World Views on Evidence-Based Nursing: Evidence Digest, (Fourth Quarter) . 220-223. Needleman, J., Buerhaus, P., Mattke, S., Stewart, M., & Zelevinsky, K. (2002). Nurse staffing and the quality of care in hospitals. New England Journal of Medicine, 346; 1715-22. Needleman, J, Buerhaus, P. I., Stewart, M., Zlevinsky K., & Mattke, S. (2006). Nurse staffing in hospitals: Is there a business case for quality? Health Affairs, 25 (1); 204-211. Outzen, R. (2005). Quint Studer: The story of a fire starter. Fire Starter, 5(27). Accessed September 8, 2010 from http://www.inweekly.net/article.asp?artID=1624 Stanton M.W. & Rutherford M. K. , (2004). Hospital nurse staffing and quality of care. Rockville (MD): Agency for Healthcare Research and Quality; Research in Action Issue 14. AHRQ Pub. No. 04-0029. Studor Group (2010). The Nurse Leader Handbook: The Art and Science of Nurse Leadership. Gulf Breeze, Florida: Firestarter Publishing. Tourangeau, A. E., Cranley, L. A., & Jeffs, L. (2006). Impact of nursing on hospital patient mortality: A focused review and related policy implications. Quality and Safety in Healthcare, 15 (1); 4-8. Vahey, D.C., Aiken, L.H., Sloane, D.M., Clarke, S.P., & Vargas, D. (2004). Nurse burnout and patient satisfaction. Medical Care, 42 (2)11-57, 11-66. W W W. N A T I O N A L N U R S E S U N I T E D . O R G NOVEMBER 2010