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Foreign-Educated Nurses: Effects on Nurse, Quality of Care, and Patient-Safety-Indicator Outcomes

      Approximately 8% of nurses in the United States were educated abroad, and in Florida and California, foreign-educated nurses (FENs) represent large percentages of the nurse labor force. It is important to know whether these nurses are prepared to care for patients who have complex needs; communicate successfully with other nurses, physicians, patients, and families; adapt to high technology in today's acute-care settings; and successfully transition to practice in the United States. It has been noted there is no comparative outcomes research on FENs and U.S.-educated nurses. The purpose of this study was to examine the effects of hospitals' proportions of FENs on nurse outcomes, hospital quality of care, perceptions of work environment, and patient-safety incidences.
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      References

        • Aiken L.H.
        U.S. nurse labor market dynamics are key to global nurse sufficiency.
        Health Services Research. 2007; 42: 1299-1320
        • Aiken L.H.
        • Cimiotti J.P.
        • Sloane D.M.
        • Smith H.L.
        • Flynn L.
        • Neff D.F.
        Effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments.
        Medical Care. 2011; 49: 1046-1053
        • Aiken L.H.
        • Clarke S.P.
        • Cheung R.B.
        • Sloane D.M.
        • Silber J.H.
        Education levels of hospital nurses and surgical patient mortality.
        Journal of the American Medical Association. 2003; 290: 1617-1623
        • Aiken L.H.
        • Clarke S.P.
        • Sloane D.M.
        Hospital staffing, organization, and quality of care: Cross-national findings.
        International Journal for Quality in Health Care. 2000; 14: 5-13
        • Aiken L.H.
        • Clarke S.P.
        • Sloane D.M.
        • Lake E.T.
        • Cheney T.
        Effects of hospital care environment on patient mortality and nurse outcomes.
        Journal of Nursing Administration. 2008; 38: 223-229
        • Aiken L.H.
        • Clarke S.P.
        • Sloane D.M.
        • Sochalski J.
        • Silber J.H.
        Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction.
        Journal of the American Medical Association. 2002; 288: 1987-1993
        • Berg J.A.
        • Rodriguez D.
        • Kading V.
        • Guzman C.D.
        Demographic survey of Filipino American nurses.
        Nursing Administration Quarterly. 2004; 28: 199-206
        • Buerhaus P.I.
        Current and future state of the US nursing workforce.
        Journal of the American Medical Association. 2008; 300: 2422-2424
        • Buerhaus P.I.
        • Auerbach D.I.
        The recession’s effect on hospital registered nurse employment growth.
        Nursing Economics. 2011; 29: 163-167
        • Davis C.R.
        • Nichols B.L.
        Foreign educated nurses and the changing U.S. nursing workforce.
        Nursing Administration Quarterly. 2002; 26: 43-51
        • Dillman D.A.
        Mail and telephone surveys: The total design method. Wiley, New York, NY1978
        • Flynn L.
        • Aiken L.H.
        Does international nurse recruitment influence practice values in U.S. hospitals?.
        Health Policy and Systems. 2002; 34: 67-73
        • Friese C.R.
        • Lake E.T.
        • Aiken L.H.
        • Silber J.H.
        • Sochalski J.
        Hospital nurse practice environments and outcomes for surgical oncology patients.
        Health Research andEducational Trust. 2008; 1–19
        • Huber P.J.
        The behavior of maximum likelihood estimates under non-standard conditions. Paper presented at: Fifth Berkeley Symposium on Mathematical Statistics and Probability.
        (Berkeley, CA. Retrieved from)
        • Institute of Medicine
        Keepingpatients safe: Transforming the work environment of nurses. The National Academies Press, Washington, DC2004
        • Institute of Medicine
        The future of nursing: Focus on education.
        (Retrieved from)
        • Kane R.L.
        • Shamiliyan T.A.
        • Mueller C.
        • Duval S.
        • Wilt T.J.
        The association of registered nurse staffing levels and patient outcomes: Systematic review and meta-analysis.
        Medical Care. 2007; 45: 1195-1204
        • Kutney-Lee A.
        • Wu E.S.
        • Sloane D.M.
        • Aiken L.H.
        Changes in hospital nurse work environments and nurse job outcomes: An analysis of panel data.
        International Journal of Nursing Studies. 2013; 50: 195-201
        • Lake E.T.
        Development of the practice environment scale of the Nursing Work Index.
        Research in Nursing and Health. 2002; 25: 176-188
        • Lashinger H.K.
        • Leiter M.P.
        The impact of nursing work environments on patient safety outcomes: The mediating role of burnout/ engagement.
        Journal of Nursing Administration. 2006; 36: 259-276
        • Maslach C.
        • Jackson S.E.
        Maslach burnout inventory manual. 2nd ed. Consulting Psychologists Press, Palo Alto, CA1986
        • Neff D.F.
        • Cimiotti J.P.
        • Heusinger A.H.
        • Aiken L.H.
        Nurse reports from the frontlines: Analysis of a statewide survey.
        Nursing Forum. 2011; 46: 4-10
        • National Council of State Boards of Nursing
        NCSBN embarks on an innovative multi-site transition to practice study to examine the effects of nurse transition to practice programs on patient outcomes.
        (Retrieved from)
        • Polsky D.
        • Ross S.J.
        • Brush B.L.
        • Sochalski J.
        Trends in characteristics and country of origin among foreign-trained nurses in the United States, 1990 and 2000.
        American Journal of Public Health. 2007; 97: 895-899
        • Shang J.
        • Friese C.R.
        • Wu E.
        • Aiken L.H.
        Nursing practice environment and outcomes for oncology nursing.
        Cancer Nursing. 2012, June 29; ([Epub ahead of print])
        • Wanous J.P.
        • Reichers A.E.
        Overall job satisfaction: How good are single-item measures?.
        Journal of Applied Psychology. 1997; 82: 247-252
        • Xu Y.
        Is transition of internationally educated nurses a regulatory issue?.
        Policy, Politics, & Nursing Practice. 2010; 11: 62-70
        • Xu Y.
        • Kwak C.
        Trended profiles of internationally educated nurses in the United States: Implications for the nurse shortage and beyond.
        Journal of Nursing Administration. 2006; 36: 522-525
        • Xu Y.
        • Zaikina-Montgomery H.
        • Shen J.J.
        Characteristics of internationally educated nurses in the United States: An update from the 2004 National Sample Survey of Registered Nurses.
        Nursing Economics. 2010; 28 (43): 19-25
        • Yi M.
        • Jezewski M.A.
        Korean nurses’ adjustment to hospitals in the United States of American.
        Journal of Advanced Nursing. 2000; 32: 721-729