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Mapping the literature of nursing administration

By Carol J. Galganski, MSLS, MSHSA carol.galganski@osfhealthcare.org Manager Library and Resource Center OSF Saint Francis Medical Center Library and Resource Center 530 Northeast Glen Oak Avenue Peoria, Illinois 61637

Objectives: As part of Phase I of a project to map the literature of nursing, sponsored by the Nursing and Allied Health Resources Section of the Medical Library Association, this study identies the core literature cited in nursing administration and the indexing services that provide access to the core journals. The results of this study will assist librarians and end users searching for information related to this nursing discipline, as well as database producers who might consider adding specic titles to their indexing services. Methods: Using the common methodology described in the overview article, ve source journals for nursing administration were identied and selected for citation analysis over a three-year period, 1996 to 1998, to identify the most frequently cited titles according to Bradfords Law of Scattering. From this core of most productive journal titles, the bibliographic databases that provide the best access to these titles were identied. Results: Results reveal that nursing administration literature relies most heavily on journal articles and on those titles identied as core nursing administrative titles. When the indexing coverage of nine services is compared, PubMed/MEDLINE and CINAHL provide the most comprehensive coverage of this nursing discipline. Conclusions: No one indexing service adequately covers this nursing discipline. Researchers needing comprehensive coverage in this area must search more than one database to effectively research their projects. While PubMed/MEDLINE and CINAHL provide more coverage for this discipline than the other indexing services, none is sufciently broad in scope to provide indexing of nursing, health care management, and medical literature in a single le. Nurse administrators using the literature to research current work issues need to review not only the nursing titles covered by CINAHL but should also include the major weekly medical titles, core titles in health care administration, and general business sources if they wish to adequately cover the many aspects of nursing administration.

INTRODUCTION Traditionally, the purpose of nursing administration has been to design, manage, and facilitate patient care delivery [1]. Nurse managers assume leadership roles in planning, organizing, and implementing care for people across the broad spectrum of health care settings. The aspects of quality outcomes, staff developJ Med Libr Assoc 94(2) Supplement 2006

ment, care management, strategic planning, and research are within the conceptual framework of nursing management and leadership [2]. Administrative nursing personnel may include three types of managers: 1. rst-line managers who are directly responsible for producing nursing services; they are typically known as nurse managers or primary care nurses
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Table 1 Cited format types by source journal and frequency of citations


No. citations in source journals Cited format type Journal articles Books Government documents Internet resources Miscellaneous Total Citations

JONA
2,497 996 68 11 168 3,740

NAQ
844 534 9 12 47 1,446

NE
1,454 475 48 6 61 2,044

NM
1,394 569 61 9 252 2,285

SNM
519 423 13 0 52 1,007

Total 6,708 2,997 199 38 580 10,522

Frequency % 63.8% 28.5% 1.9% 0.3% 5.5% 100.0%

JONA Journal of Nursing Administration. NAQ Nursing Administration Quarterly. NE Nursing Economic$. NM Nursing Management. SNM Seminars for Nurse Managers.

2. middle managers who coordinate the work of several units; job titles are coordinators, clinical nurse managers, or case managers 3. nurse executives who are responsible for the overall operations of patient care services; titles are directors of patient care services or executive vice presidents for nursing [3] The setting for nurse managers has been changing as a result of prospective payment, reduced admissions, and reduced length of stay. With the expansion of nursing care into outpatient clinics, surgicenters, and home health care, nursing administrators in these areas are taking on additional responsibilities for contract negotiation, corporate access for support services, and management of interdisciplinary services [4]. Education for nurse administrators can be acquired in a variety of ways: (1) preparation at the degree levelmasters of science in nursing or masters of health administration, business administration, or public administration; (2) certicate programs that may or may not require a masters prerequisite; or (3) informal programs such as facility-sponsored management programs, self-study, continuing education, or national certication exams [4]. The science of nursing administration has its roots with Florence Nightingales systematic organization for patient care. Historically, nursing administration is grounded in the study by Herman Finer seeking ways to improve nursing services in hospitals [5]. Findings from this study led to further demonstration projects that identied the theories, concepts, and principles of nursing administration, as well as established the graduate curricula for the discipline [6]. Nursing administration is considered to be an applied science and includes components of clinical nursing care, collaborative practice, and management theories and concepts. Today, as nurse administrators respond to changes in health care systems from market forces, political pressures, and consumer demands, nursing administration practice is a compilation of various management practices and theories [7].
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METHODOLOGY The methodology is described in detail in the project overview of the Mapping the Literature of Nursing Project [8]. To select source journals for the study, the Brandon/Hill Selected List of Print Nursing Books and Journals was consulted for journals in nursing administration [9]. Of the ve titles selected for analysis, four were from the Brandon/Hill list. The fth (Seminars for Nurse Managers) was selected to analyze what impact a relative newcomer to the nursing administration journal literature would have on the citation analysis. These nursing administration source journals were evaluated: Journal of Nursing Administration (1971; published monthly) Nursing Management (1970; was Supervisor Nurse from 19701981; published monthly) Nursing Administration Quarterly (1976; published quarterly) Nursing Economic$ (1983; published bimonthly) Seminars for Nurse Managers (19932002; published bimonthly) RESULTS As Table 1 indicates, and as expected, the majority of cited articles were journal articles, representing 63.8% of the total 10,522 citations analyzed. Books were the next most cited format, with 2,997 citations (28.5%). The currency of the literature is presented in Table 2, with approximately 73% of the citations being published from 1990 to 1998. Table 3 identies the distribution of the cited journals by zone according to Bradfords Law of Scattering, with 9 journal titles in Zone 1 accounting for 34% of the analyzed citations. Zone 2 included 66 titles and 33% of the total citations. Zone 3 contained 890 titles and the remaining 33% of the citations. Table 4 reveals the distribution and indexing of cited journals in Zones 1 and 2. Because nursing administration encompasses so many roles and functions, a large number of disciplines are represented in the reJ Med Libr Assoc 94(2) Supplement 2006

Mapping the literature of nursing administration

Table 2 Cited format types by publication year periods


Books No. 483 1,507 678 176 74 49 30 2,997 % 16.1% 50.3% 22.6% 5.8% 2.5% 1.7% 1.0% 100.0% Government documents No. 23 126 33 13 0 0 4 199 % 11.6% 63.3% 16.6% 6.5% 0 0 2.0% 100.0% No. 25 4 0 0 0 0 9 38 Internet % 65.8% 10.5% 0 0 0 0 23.7% 100.0% Journal articles No. 1,063 3,944 1,319 198 54 20 110 6,708 % 15.8% 58.8% 19.7% 2.9% 0.9% 0.3% 1.6% 100.0% Miscellaneous No. 163 296 60 18 4 2 37 580 % 28.1% 51.2% 10.3% 3.1% 0.7% 0.3% 6.3% 100.0% Total citations No. 1,757 5,877 2,090 405 132 71 190 10,522 % 16.7% 55.9% 19.9% 4.0% 1.0% 0.6% 1.9% 100.0%

Publication year 19961998* 19901995 19801989 19701979 19601969 Pre-1960 Not available

* Includes in press materials.

maining titles: education, management, leadership, social sciences, business, legal issues, ethical issues, and current news. DISCUSSION This study found that nursing administration authors cite the core titles in nursing administration most often, as four of the ve analyzed journals were found to be the top four journal titles cited in Zone 1. Seminars for Nurse Managers, the newest nursing administration title, was found in Zone 2, not surprising because it began publication in 1993 and the time frame for publication was 1996 to 1998. As a newcomer to the nursing administration literature, it did not have a strong showing based on citation analysis. The remaining ve journals in Zone 1American Journal of Nursing, Nursing Research, Hospitals & Health Networks, New England Journal of Medicine, and JAMAreected the research, administrative, and clinical management functions of nursing managers and administrators. Nursing administration literature deals with many hot topics as well as legal, ethical, and clinical issues, and this was reected in the number of references to weekly journalsHospital & Health Networks, JAMA, and New England Journal of Medicine. The broad scope of nursing administration could be seen in Zone 2, where sixty-six titles reected these subject categories: clinical nursing, administrative nursing, nursing research, health care administration, general business, social sciences, psychology, and medicine. In a range of 0 to 5, none of the indexing sources scored either a 4 or 5 for this discipline. For Zone 1 titles, PubMed/MEDLINE, with a score of 3.55, most
Table 3 Distribution by zone of cited journals and references
Cited journal references Cited journals Zone Zone 1 Zone 2 Zone 3 Total No. 9 66 890 965 % 1% 7% 92% 100% No. 2,283 2,227 2,198 6,708 % 34% 33% 33% 100% Cumulative total 2,283 4,520 6,708

comprehensively indexed the 9 titles, followed by CINAHL, with a score of 3.44. This was most likely due to the medical titlesJAMA and New England Journal of Medicinebeing selectively indexed by CINAHL. The least effective database for these core titles was PsycINFO (score of 0.56), followed by EBSCOs Health Business FullTEXT (score of 0.78). Indexes in the midrange were HealthSource Plus (score of 2.22), Health Reference Center Academic (score of 2.67), and Social Sciences Citation Index (score of 2.11). When the titles from Zones 1 and 2 are combined and averaged, PubMed/MEDLINE was the most comprehensive index source, followed by CINAHL. The least effective indexes were again PsycINFO and Health Business FullTEXT. CONCLUSION Searching the core databases of PubMed/MEDLINE and CINAHL will provide fairly comprehensive coverage of this discipline. Nurse administrators and managers need to search PubMed/MEDLINE to supplement CINAHLs limited indexing coverage of medical titlessuch as JAMA, New England Journal of Medicine, and the Annals of Internal Medicineand certain core health care management titlesparticularly Hospitals & Health Networks, Modern Healthcare, and Medical Care. Trends in leadership and management theory are borrowed heavily from the business literature. It is important that nursing administration leaders use a business or social sciences literature index to identify articles in titles such as Harvard Business Review, Fortune, Administrative Science Quarterly, and Academic Management Journal for research on management and leadership topics, increasingly important to todays nursing administrator. ACKNOWLEDGMENTS The author would like to thank Carolann Purcell, retired medical librarian, OSF Saint Francis Medical Center, for her assistance with data entry of the citations and journal title verication. The following individuals assisted with searching indexes to determine title coverage: Margaret (Peg) Allen, AHIP, Martha
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Table 4 Distribution and database coverage of cited journals in Zones 1 and 2


Bibliographic databases Total citations CINAHL EBSCO NAH Comp. Health Ref. Center PsycINFO EBSCO Health Business OCLC ArticleFirst

Cited journal Zone 1 1. J Nurs Adm 2. Nurs Manage 3. Nurs Econ 4. Nurs Adm Q 5. Hosp Health Netw 6. Nurs Res 7. JAMA 8. Am J Nurs 9. N Engl J Med Zone 1 average/percent Zone 2 1. J Nurs Scholarsh 2. Med Care 3. J Adv Nurs 4. J Nurs Care Qual 5. Harv Bus Rev 6. Nurs Outlook 7. Mod Healthc 8. J Healthc Manage 9. Health Care Manage Rev 10. Nurs Educ Perspect (2002); continues Nurs Health Care & Nurs Health Care Perspect 11. Gerontologist 12. Healthc Forum J 13. Health Aff 14. Nurs Clin North Am 15. Res Nurs Health 16. J Appl Psychol 17. AORN J 18. Clin Nurs Spec 19. J Prof Nurs 20. ANS Adv Nurs Sci 21. Semin Nurs Managers 22. Bus Health 23. Jt Comm J Qual Saf; formerly, Jt Comm J Qual Improv (19932002) 24. Ann Intern Med 25. J Nurs Staff Dev 26. Heart Lung 27. Inquiry 28. Milbank Q 29. Am J Public Health 30. J Emerg Nurs 31. J Gerontol Nurs 32. Health Serv Res 33. Hastings Cent Rep 34. Nurs Times 35. Appl Nurs Res 36. Am Nurse 37. Adm Sci Q 38. Orthop Nurs 39. J Am Geriatr Soc 40. Health Care Financ Rev 41. Acad Manage J 42. CIN: Comput Inform Nurs; continues Comput Nurs 43. J Nurs Educ 44. Acad Man Rev 45. Healthcare Financ Manage 46. Soc Sci Med 47. Crit Care Med 48. Nurs Policy Forum (19951996); ceased 49. Nurse Pract 50. Managed Care Outlook 51. Public Health Nurs 52. AAOHN J 53. Caring 54. Healthcare Supervisor (19821999) 55. Holistic Nurs Pract 56. Home Healthc Nurs 57. J Contin Educ Nurs

PubMed

SCI

SSCI

784 433 299 209 126 125 109 105 93

4 5 5 5 1 4 1 5 1 3.44 5 0 2 5 0 5 1 1 3 3 2 1 2 5 5 0 5 5 5 5 5 3 4 1 5 5 2 0 4 5 5 0 2 5 5 5 0 5 1 0 0 5 5 0 1 2 0 NA 5 0 5 5 5 0 5 5 5

4 4 3 4 3 4 3 3 4 3.55 4 5 2 4 2 3 2 3 4 2 2 3 4 4 4 2 3 4 4 4 4 3 5 4 4 5 3 4 4 3 4 4 2 4 4 3 0 3 2 1 0 2 5 0 2 3 4 NA 4 0 5 4 3 0 4 4 4

0 4 2 0 5 0 3 4 2 2.22 0 0 3 0 0 0 5 0 0 0 3 5 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 4 0 0 0 3 0 0 0 0 0 0 5 0 0 0 0 5 0 0 NA 0 0 5 0 0 0 0 0 0

0 3 3 5 2 0 5 3 3 2.67 4 0 0 4 0 0 1 3 1 3 5 0 0 0 0 1 5 0 0 4 0 5 0 3 0 0 0 4 4 0 0 0 3 3 0 0 0 3 2 0 0 0 0 0 2 1 0 NA 5 0 0 0 0 0 4 0 0

0 0 0 0 0 3 1 0 1 0.56 1 2 0 0 0 0 0 0 0 0 2 0 0 0 3 5 0 0 0 3 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 2 0 1 0 0 0 0 0 0 2 0 NA 0 0 3 0 1 0 0 0 0

0 0 0 0 0 5 4 0 5 1.56 0 5 0 0 0 0 0 0 0 0 0 0 5 0 5 0 0 0 0 0 0 0 0 5 0 5 4 5 5 0 0 4 0 0 0 0 0 0 5 0 0 0 0 0 0 0 5 NA 0 0 0 0 0 0 0 0 0

5 0 0 0 3 5 1 4 1 2.11 0 5 5 5 5 4 0 5 5 5 4 0 5 5 5 5 0 0 5 5 0 0 0 1 0 1 5 5 5 0 0 5 5 0 5 0 5 0 5 0 5 1 5 5 0 5 1 NA 0 0 5 0 0 0 0 0 0

0 0 2 0 5 0 0 0 0 0.78 0 0 0 0 3 0 5 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 3 0 0 0 0 0 0 5 4 0 0 0 5 0 0 NA 0 0 0 0 0 0 0 0 0

X X X X X X X X X 9 X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X

85 81 77 73 70 66 63 55 53 51 49 49 47 47 46 46 45 44 44 43 40 38 37 37 35 34 34 31 30 30 29 28 27 27 26 26 25 25 24 24 24 23 22 21 21 20 20 20 20 19 19 18 18 18 18 18 18

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Table 4 Continued
Bibliographic databases Total citations CINAHL 18 17 17 17 16 16 16 16 16 5 4 NA 5 5 5 5 5 1 3.10 3.25 EBSCO NAH Comp. 0 0 NA 0 0 0 0 3 0 0.67 1.44 Health Ref. Center PsycINFO 0 0 NA 0 0 0 0 2 0 1.09 1.88 0 0 NA 0 3 0 0 0 0 0.45 0.50 EBSCO Health Business 0 0 NA 0 0 0 0 0 0 0.52 0.65 OCLC ArticleFirst X X X X X X X X 58 89%

Cited journal 58. Can J Nurs Leadersh; continues Can J Nurs Adm (19881998) 59. Ann Emerg Med 60. J Long Term Care Adm (19961997); ceased 61. Oncol Nurs Forum 62. Int J Nurs Stud 63. Nursing Connections (19882000) 64. Annu Rev Nurs Res 65. Nursing 66. J Am Med Inform Assoc Zone 2 average database coverage Average/percent Zones 1 and 2

PubMed 4 4 NA 4 5 5 4 2 1 3.09 3.32

SCI 0 5 NA 0 0 0 0 0 5 0.95 1.25

SSCI 0 1 NA 0 5 0 0 0 5 2.32 2.21

Based on database coverage score: 5 (95%100%); 4 (75%94%); 3 (50%74%); 2 (25%49%); 1 (1%24%); 0 ( 1%). EBSCO NAH Comp. EBSCO Nursing & Allied Health Collection Comprehensive Edition. SCI Science Citation Index. SSCI Social Sciences Citation Index.

(Molly) Harris, AHIP, Melody Allison, and Kristine Alpi, AHIP. REFERENCES
1. WOLPER LF. Health care administration: planning, implementing, and managing organized delivery systems. 3rd ed. Gaithersburg, MD: Aspen, 1999. 2. AMERICAN HOSPITAL ASSOCIATION. Management advisory: role and functions of the hospital nurse executive. Chicago, IL: American Hospital Association, 1990. 3. DOUGLASS LM. The effective nurse. 5th ed. St. Louis, MO: Mosby, 1996. 4. HAYNOR PM, WELLS RW. Will nursing administration programs survive in the 21st century? J Nurs Adm 1998 Jan; 28(1):1524.

5. FINER H. Administration and the nursing services. New York, NY: Macmillan, 1961. 6. WOLPER LF. Health care administration: planning, implementing, and managing organized delivery systems. 3rd ed. Gaithersburg, MD: Aspen, 1999. 7. SULLIVAN EJ, DECKER PJ. Effective leadership and management in nursing. 4th ed. Menlo Park, CA: Addison-Wesley, 1997. 8. ALLEN MP, JACOBS SK, LEVY JR. Mapping the literature of nursing: 19962000. J Med Libr Assoc 2006 Apr;94(2):206 20. 9. HILL DR, STICKLELL HN. Brandon/Hill selected list of print nursing books and journals. Nurs Outlook 2000 Jan/ Feb;48(1):1022.

Received July 2005; accepted December 2005

J Med Libr Assoc 94(2) Supplement 2006

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