Access to personal health services is only possible if there are an adequate number
and distribution of qualified nurses. However, most work on access has been conceptualized
as access to physician services or particular types of settings such as hospital care,
not as access to nurses. In this paper I have used the Institute of Medicine Access
framework to conceptualize the relationship of the nursing workforce to several aspects
of access, and evaluated both the current state of research and existing gaps. Some
of the gaps identified in the research that need to be included in a health services
research agenda for nursing are: (1) the effect of regional market factors (such as
physician ratios and poverty), or attitudes on the supply of nurses; (2) the lack
of a critical analysis of staffing and outcome research, and measures of utilization
and access specific to nurses in a variety of settings; (3) the need for more and
better data to evaluate nurse career patterns, nursing workforce educational capacity,
and effectiveness; and (4) relevant workforce policies.
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Biography
Carol S. Brewer, PhD, is Associate Professor, University at Buffalo School of Nursing, Buffalo, NY.
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© 2005 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
