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Required employers with more than 25 employees to offer HMO health coverage, all employees to pay the same premiums.
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The 1980s were years of takeovers and increased health regulation. Smaller insurance companies and hospitals became huge HMOs and care systems.
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Healthcare costs increase drastically as technology booms.
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Managed care has pushed hospitals to decrease cost by increasing nurse/pt ratios. Travel nursing emerges.
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The Balanced Budget Act (BBA) of 1997 was introduced as a cost-saving measure that significantly cut Medicare reimbursements to hospitals, physicians, home health agencies, and skilled nursing facilities, with planned net spending reductions of $116.4 billion from 1998 to 2002 (Rivers and Tsai 2002).
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Part 2 of the development a healthcare improvement strategy regarding patient safety
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Not enough nurses working currently, not enough nursing students enrolled and not enough nursing faculty.
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Phase 3 of QI--One of its foci is the interface between clinicians and patients.
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Formed to "transform professional nursing education and create a nursing workforce capable of meeting healthcare demands" (Bartels & Bednash, 2005).
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Aiken et al find that nursing dissatisfaction and uneven quality of hospital care is not uniquely American(People to People Health Foundation, 2001). "Fundamental problems in the design of work" were plaguing the profession of nursing. "Reengineering has moved to reduce front-line nurse leadership roles" at a time when they are most needed.
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JCAHO "Creates awareness of the need to assess whether a simple focus on the number of professionals should be replaced by a concern for assuring the critical nurse competencies are present to deliver high quality and safe patient care" (Bartels & Bednash, 2005).
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Landmark study by Linda Aiken reported that "hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to rescue rates" (JAMA, 2003).
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Proposal regarding the education and role of the Clinical Nurse Leader from which our current curriculum has been developed.
