title: Evaluating improvements in nursing staff at a state psychiatric hospital.
abstract: In response to federal intervention in 1990, Hawaii initiated a number of changes at the state's psychiatric hospital. The process of change that was undertaken by the hospital's department of nursing from 1990 through 1994 to meet federal mandates was described in an earlier article in this journal. The present study evaluated the degree to which court-ordered improvements in nursing staff at the hospital were actually achieved between 1995 and 1997. Seven quantitative measures of compliance with federal mandates were evaluated, based on the court orders. Significant improvements were found on six of the seven measures during the 30-month study period. These included increases in nursing staff as measured by (1) the number of staff and (2) full-time equivalents, as well as increases in (3) the hours of nursing care per patient, (4) the number of staff per patient on each shift, and (5) the percent of RNs per shift. Use of agency personnel decreased significantly, as ordered, but overtime use increased significantly, contrary to court orders.
authors.affiliation: School of Nursing, Webster Hall, University of Hawaii at Manoa, Honolulu, Hawaii 96822, USA. flannel@hawaii.edu
authors.forename: L T
authors.initials: LT
authors.lastname: Flannelly
authors.forename: K J
authors.initials: KJ
authors.lastname: Flannelly
authors.forename: B A
authors.initials: BA
authors.lastname: Cox
mesh_terms: D006254:Hawaii; D006778:Hospitals, Psychiatric / Q000331:legislation & jurisprudence; D006783:Hospitals, State / Q000331:legislation & jurisprudence; D006801:Humans; D001523:Mental Disorders / Q000451:nursing*; D009741:Nursing Staff, Hospital / Q000331:legislation & jurisprudence*; D011568:Psychiatric Nursing / Q000331:legislation & jurisprudence*; D011785:Quality Assurance, Health Care / Q000331:legislation & jurisprudence*