Anne Rafferty - Academia.edu (original) (raw)

Papers by Anne Rafferty

International Journal of Nursing Studies, Jan 1, 2011

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Quality in Health Care, 1998

The full back archive is now available for all BMJ Journals. Institutional subscribers may access... more The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all ...

Journal of health services research & policy, 2003

Add to CiteULike CiteULike Add to Complore Complore Add to Connotea Connotea Add to Delicious Del... more Add to CiteULike CiteULike Add to Complore Complore Add to Connotea Connotea Add to Delicious Delicious Add to Digg Digg Add to Facebook Facebook Add to Reddit Reddit Add to Technorati Technorati Add to Twitter Twitter What's this?

International Journal of Nursing Studies, 2007

Context-Despite growing evidence in the US, little evidence has been available to evaluate whethe... more Context-Despite growing evidence in the US, little evidence has been available to evaluate whether internationally, hospitals in which nurses care for fewer patients have better outcomes in terms of patient survival and nurse retention.

International Journal of Nursing Studies, 2013

Background: As health services research (HSR) expands across the globe, researchers will adopt he... more Background: As health services research (HSR) expands across the globe, researchers will adopt health services and health worker evaluation instruments developed in one country for use in another. This paper explores the cross-cultural methodological challenges involved in translating HSR in the language and context of different health systems. Objectives: To describe the pre-data collection systematic translation process used in a twelve country, eleven language nursing workforce survey. Design and settings: We illustrate the potential advantages of Content Validity Indexing (CVI) techniques to validate a nursing workforce survey developed for RN4CAST, a twelve country (

International journal of nursing studies, 2014

To investigate whether the size of the workforce (nurses, doctors and support staff) has an impac... more To investigate whether the size of the workforce (nurses, doctors and support staff) has an impact on the survival chances of critically ill patients both in the intensive care unit (ICU) and in the hospital. Investigations of intensive care outcomes suggest that some of the variation in patient survival rates might be related to staffing levels and workload, but the evidence is still equivocal. Information about patients, including the outcome of care (whether the patient lived or died) came from the Intensive Care National Audit & Research Centre (ICNARC) Case Mix Programme. An Audit Commission survey of ICUs conducted in 1998 gave information about staffing levels. The merged dataset had information on 65 ICUs and 38,168 patients. This is currently the best available dataset for testing the relationship between staffing and outcomes in UK ICUs. A cross-sectional, retrospective, risk adjusted observational study. Multivariable, multilevel logistic regression. ICU and in-hospital m...

The current nursing shortage, high hospital nurse job dissatisfac- tion, and reports of uneven qu... more The current nursing shortage, high hospital nurse job dissatisfac- tion, and reports of uneven quality of hospital care are not uniquely American phenomena. This paper presents reports from 43,000 nurses from more than 700 hospitals in the United States, Canada, England, Scotland, and Germany in 1998-1999. Nurses in countries with distinctly different health care systems report similar shortcomings in their work environments and the quality of hospital care. While the competence of and relation between nurses and physi- cians appear satisfactory, core problems in work design and workforce manage- ment threaten the provision of care. Resolving these issues, which are amena- ble to managerial intervention, is essential to preserving patient safety and care of consistently high quality.

Journal of Nursing Management, 2004

Aim This paper attempts to illuminate some of the factors necessary to influence policy, using re... more Aim This paper attempts to illuminate some of the factors necessary to influence policy, using recent changes in the UK research policy as a case study. Background Changes in the UK research policy have shown how the profession can successfully influence a government agenda. Methods The paper critically reviews recent UK research policy with relevance for nursing. Results Successful policy change in nursing requires a contingent alignment of professional and governmental agendas. Conclusions Although nursing research has made significant gains over the last 10 years, there is need for the continued development of politically minded research leadership, lest these gains be lost.

Journal of Advanced Nursing, 1996

Theory/practice issues have a long-standing history in nurse education, and are a chronic source ... more Theory/practice issues have a long-standing history in nurse education, and are a chronic source of contioversy to which there is no easy or perfect solution We have argued that it is the tension between theory and practice and research which can be usefully exploited in teaching and research Students need to be introduced to the debates surrounding the genesis and generation of nursing knowledge They need to gam an appreciation of what counts as nursing knowledge at different points in time and the politics which drive the legitimation of nursing theory and practice Such an approach has much to offer m helping students deal with reality shock and make sense of their experience as they confront the ambiguities, imcertainties and contiadictions that characterize the stock-in-trade of professional life TKTTB r»r»TTr"rTr»KT needs to be analysed withm the context of the policy pressures that shape changes in the funding and organization The theory/practice 'gap' in nursmg has long been con-of educational programmes more generally We need to sidered as a problematic, even embarrassmg sign of failure understand the power relations that regulate the resources withm education, practice and research A range of solu-devoted to nursing education and practice, and to address tions has been offered to 'seal' the gap, but these have met the political and orgamzational factors that promote or with only partial success Persistence of the gap would constram the development of nursing practice at any given suggest that it is either inevitable or much more complex time Only by doing so can we set ourselves realistic goals than we have hitherto thought Part of tbe problem, then, and move beyond self-blame and self-recrimmation m of the tbeory/practice gap might be the way m which it crafting solutions to the theory/practice divide has been theorized We conclude that the theory/practice gap can never be We mamtam that the theory/practice gap needs to be sealed entirely, that theory and practice are by tbeir nature retheonzed, and seen less as a philosophical than as a always in dynamic tension, and that this tension is political problem By tbis we mean that nursmg education essential for change in clinical practice to occur

Journal of Advanced Nursing, 2001

This paper uses the findings of a recent bibliometric analysis of published UK nursing research t... more This paper uses the findings of a recent bibliometric analysis of published UK nursing research to ask whether the field is characterized by a fundamental split between two underlying areas of research interest. These can be termed 'endogenous' and 'exogenous'. The former term describes research which tends to be concerned with problems and issues to do with nursing as a profession; the latter is concerned with problems and issues centring around the nursing of patients. Papers in the Wellcome Trust's Research Outputs Database (ROD), a database of UK biomedical research, were analysed. Nursing papers published between 1988 and 1995 numbered 1,845, just less than 1% of the total papers in the ROD. Analysis of the subfield identified that nursing research was atypical of biomedical research as a whole in a number of ways. One difference was that usually in biomedical research there is a general correlation between numbers of funders acknowledged on a paper, numbers of authors, and esteem of the journal in which a paper appears. In nursing there was, if anything, a tendency for highly esteemed papers to have fewer authors and be less likely to have acknowledged funding. However, the apparently endogenous and exogenous papers have quite different characteristics. This paper explores this apparent difference and possible reasons for this difference and will briefly compare nursing research with some other newly emerging social and academic groups. Thinking of nursing research outputs in this way can provide insight into the existence of different reward systems influencing nurse researchers. However, it is impossible to draw too confident a differentiation without reading each individual paper and making judgements about whether they are 'endogenous' or 'exogenous', a practice generally beyond the scope of bibliometric practice.

BMJ, 2003

the risks beforehand. Equally we need to ensure that patients at higher risk are not denied surge... more the risks beforehand. Equally we need to ensure that patients at higher risk are not denied surgery because no one is willing to operate on them. We need to work collectively to develop a truly open system that limits the incidence of error, recognises risk, allows surgeons (and all healthcare professionals) to learn from mistakes, and replaces blame and retribution with an opportunity for learning and training.

BMJ, 2011

Nothing can excuse the reprehensible nursing care described by Delamothe. 1 Nurses providing depl... more Nothing can excuse the reprehensible nursing care described by Delamothe. 1 Nurses providing deplorable care are not worthy of their title, but the issues are wider. Why has this type of behaviour gone unchallenged by senior health professionals and managers, and ...

BMJ, 2012

Objective To determine whether hospitals with a good organisation of care (such as improved nurse... more Objective To determine whether hospitals with a good organisation of care (such as improved nurse staffing and work environments) can affect patient care and nurse workforce stability in European countries.

BMC Nursing, 2011

Background: Current human resources planning models in nursing are unreliable and ineffective as ... more Background: Current human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care. Methods/Design: A multi-country, multilevel cross-sectional design is used to obtain important unmeasured factors in forecasting models including how features of hospital work environments impact on nurse recruitment, retention and patient outcomes. In each of the 12 participating European countries, at least 30 general acute hospitals were sampled. Data are gathered via four data sources (nurse, patient and organizational surveys and via routinely collected hospital discharge data). All staff nurses of a random selection of medical and surgical units (at least 2 per hospital) were surveyed. The nurse survey has the purpose to measure the experiences of nurses on their job (e.g. job satisfaction, burnout) as well as to allow the creation of aggregated hospital level measures of staffing and working conditions. The patient survey is organized in a sub-sample of countries and hospitals using a one-day census approach to measure the patient experiences with medical and nursing care. In addition to conducting a patient survey, hospital discharge abstract datasets will be used to calculate additional patient outcomes like in-hospital mortality and failure-to-rescue. Via the organizational survey, information about the organizational profile (e.g. bed size, types of technology available, teaching status) is collected to control the analyses for institutional differences. This information will be linked via common identifiers and the relationships between different aspects of the nursing work environment and patient and nurse outcomes will be studied by using multilevel regression type analyses. These results will be used to simulate the impact of changing different aspects of the nursing work environment on quality of care and satisfaction of the nursing workforce. Discussion: RN4CAST is one of the largest nurse workforce studies ever conducted in Europe, will add to accuracy of forecasting models and generate new approaches to more effective management of nursing resources in Europe.

Background Austerity measures and health-system redesign to minimise hospital expenditures risk a... more Background Austerity measures and health-system redesign to minimise hospital expenditures risk adversely affecting patient outcomes. The RN4CAST study was designed to inform decision making about nursing, one of the largest components of hospital operating expenses. We aimed to assess whether differences in patient to nurse ratios and nurses' educational qualifications in nine of the 12 RN4CAST countries with similar patient discharge data were associated with variation in hospital mortality after common surgical procedures. Methods For this observational study, we obtained discharge data for 422 730 patients aged 50 years or older who underwent common surgeries in 300 hospitals in nine European countries. Administrative data were coded with a standard protocol (variants of the ninth or tenth versions of the International Classification of Diseases) to estimate 30 day in-hospital mortality by use of risk adjustment measures including age, sex, admission type, 43 dummy variables...