How can the knowledge of economic theory be utilized by advanced practice nurses? How can economic theory be applied in analysis of interventions?
Economic theory is used to describe and explain decision making in the context of scarce resources.
This paper presents two applications of economic theory to the delivery of nursing services in acute care hospitals and evaluates its usefulness in guiding nursing administration research.
SOURCES OF INFORMATION
The description of economic theory and the proposed applications for nursing are based on current nursing, healthcare, and economic literature. Evaluation of the potential usefulness of economic theory in guiding nursing administration research is based on the criteria of significance and testability as described by Fawcett and Downs.
While economic theory can be very useful in explaining how decisions about nursing time allocation and nursing care production are made, it will not address the issue of how they should be made. Normative theories and ethical frameworks also must be incorporated in the decision-making process around these issues. Economic theory and nursing administration are a good fit when balanced with the values and goals of nursing.
Search terms: Economic theory, nursing administration, nursing care
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Concern about the quality and safety of patient care in acute care hospitals has received widespread attention since the publication of the landmark Institute of Medicine (IOM) report, which estimated that over 98,000 Americans die annually as a result of errors in their care (IOM, 2000). The nature of the hospital work environment and workforce were subsequently identified as significant contributing factors to unsafe and poor quality care. Nursing services, representing the largest proportion of the hospital workforce and the provider patients spend the most time with, were recognized as being indispensable to patient safety and quality (IOM, 2001). The research community has responded with a host of investigations exploring the effect of nursing services on healthcare outcomes.
Much of this research, termed “nursing administration research” (Jennings, 2004), has involved secondary analyses of large administrative data sets. The yield from this approach is a body of evidence demonstrating an association between nurse staffing and selected adverse patient outcomes (Kane, Shamliyan, Mueller, Duval, & Wilt, 2007). Evidence sufficient to establish underlying causal mechanisms between nursing services and patient outcomes, however, has yet to be demonstrated. Despite the forward progress, historical approaches to nursing administration research have received criticism. One such criticism involves the absence of a clearly defined theoretical framework to guide inquiry (Mark, Hughes, & Jones, 2004).
The characterization of nursing administration research as largely atheoretical has validity and warrants thoughtful consideration. The world today is complex and dynamic. We understand this world through not one, but multiple theories from multiple disciplines including the physical, biological, and social sciences. This is no less true for the world of healthcare delivery and nursing administration. Rising costs, declining quality, rising demand, and declining personnel pools collectively cry for a better understanding of the world of health care to create sustainable solutions. Those interested in advancing the science in nursing administration and healthcare delivery must identify theories that best contribute to our current understanding of this environment and are useful guides for research. Gaps in our understanding can then be identified, and data on essential elements can be intentionally collected to help close those gaps.
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