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Influence of managed care on professional nursing practice
1University of San Diego, California 92110-2492, USA. jkharri@acusd.edu
Image--The Journal of Nursing Scholarship
|June 25, 1999
Summary
Managed care influenced nursing practice, with nurses seeing opportunities in cost-effective quality care and expanded roles. However, administrative burdens and job market concerns were identified as significant threats.
Area of Science:
- Nursing Practice and Healthcare Management
- Health Services Research
Background:
- Managed care significantly impacts healthcare delivery and professional roles.
- Nurses are challenged to demonstrate their value in cost-effective outcomes.
- Understanding nurse perceptions is crucial for navigating healthcare system changes.
Purpose of the Study:
- To explore how managed care influenced professional nursing in California.
- To identify perceived benefits and threats of managed care on nursing practice.
Main Methods:
- A 1996 Delphi survey was conducted with 84 clinical nurse specialists (CNSs) and nurse practitioners (NPs) in California.
- Participants contributed to identifying managed care influences on nursing.
- 57 (68%) completed all three survey rounds.
Main Results:
- Highest agreement was on exploring cost-effective quality care, expanding nurse practitioner roles in primary care, and enhancing client self-responsibility.
- Greatest perceived threats included authorization hassles, payment denials, a tenuous job market, and practice encroachment.
Conclusions:
- Findings can guide nurses in lower managed-care states to shape their future roles.
- A highly educated nursing workforce is essential for future healthcare systems, particularly for care outside hospitals.