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This large text has 46 contributors and an
editorial board of 10 members to enable the
compilation of a sophisticated manual for
those deeply involved in nursing adminis-
tration at all levels. The need for keen in-
sight and greater management of knowledge
is a strong demand in this time of rapid ex-
pansion of knowledge and the growing need
for sharper insights into its use for the pub-
lic good. The pressure on those in appointed
leadership positions will increase, and thus
persons in these positions will have to be
sophisticated in using organizational knowl-
edge to enhance the precise delivery of care,
even though the scientific components are
undergoing frequent changes. This modula-
tion demand will leap forward when geneal-
ogy therapy emerges as an absolute cure for
some of the illnesses.
The manual is organized around eight
major sections. These are (1) administration,
(2) resource management, (3) ambulatory
services, (4) patient care, (5) home care, (6)
long-term care, (7) centers of excellence,
and (8) new waves. Each of these sections
is further focused on prime subsections of
this topic area. For example, the section
on new waves discusses the maturing of
consumerism, online classes, strategic
performance improvement planning using
electronic meeting support, and patients’
rights and responsibilities. This section will
grow in content, so it is necessary to have
an in-depth knowledge of what constitutes
the present.
The patient care section may interest most
readers because of the need to focus atten-
tively on the issue as a major distinguish-
ing variable to survival as a respected health
care organization. All participants in each or-
ganization, and especially the leaders, must
Book Reviews 83
focus on the future in order to be proactive
instead of reactive in how changes are made.
This observation does not lessen the value of
the other chapters. All aspects of executive
behavior have to be in smooth relationships
to ensure positive outcomes to keep patients
satisfied with resources used in their care,
or the health care organization may not re-
main in existence. This phenomenon of easy
oblivion can be observed in organizations of
all types. Patients are informed much better
today than they were even 20 years ago, so
they have keener observations of how they
were treated.
This text is not limited to executives be-
cause everyone, at every level, must have an
understanding of how organizations function
productively and what must be done to cope
with the rapid increase in behavioral science
knowledge as well as that of the physical sci-
ences. Career advancement largely depends
on the wise use of knowledge. A CD-ROM
with useful information is included with the
text at no extra cost.
Leaders and Health Care Organizational
Change: Art, Politics, and Process, by
Stewart Gabel, New York, Kluwer Aca-
demic/Plenum Publishers, 2001. 206 pages,
hardcover, $42.50.
This book describes the particular chal-
lenges faced in each organizational change,
given the particularity of each setting. The
issues of constant and productive adaptation
to the ever-changing march of science, tech-
nology, and the steady improvement in or-
ganizational understanding as the bases for
survival and growth are deeply explored.
This theme is not limited to health care but
is present in every type of organization in
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84 NURSING ADMINISTRATION QUARTERLY/SPRING 2002
the current society, so health care must show
its needed response. The author emphasizes
that insightful and competent leaders are the
key variables in each type of setting. When
imaginative leadership is not present in an
organization, it becomes mundane and its
survival is at risk. Even if the changes are
unwanted by the staff, they are a necessity
in an environment swirling with great leaps
in new knowledge. The 11 variables focus
on the main situations faced in the constant
need to have transitional plans to cope with
new data that is forcing steady change. It is
a cue to effective leadership when the top
leader can infuse all the other layers of the
organization to be aware of their need for par-
ticipative input and their steady compliance
with all others to manage required steady
change.
Leaders must be effective in behavioral
models in all aspects of change. They must
be able to embrace and use constructive con-
cepts from all levels of the organization to
stimulate bold creativity and adopt change
at all levels. When the organization is im-
bued with this ideology as a way of life, the
organization can keep pace with change with
the least internal stress.
Outcome Assessment in Advanced Prac-
tice Nursing, edited by Ruth M. Kleinpell,
New York, Springer Publishing, 2001. 258
pages, hardcover, $42.95.
This book on advanced practice has nine
chapters covering differing areas of special-
ization with 13 contributors from various
major settings. Each chapter clearly and
carefully reviews the data regarding the dif-
ferences in effect on patients given by nurses
with advanced practice preparation.
Uniformly, the scientific evaluations show
that nurses with advanced practice skills
have positive effects on patient care and their
outcomes. Nurses are not only compared to
other nurses but also with physicians, in-
terns, and fourth-year medical students. In
each case, the advanced practice skills have
held their own or improved on the care ren-
dered by others. In most studies, this care
was more consistent and more comprehen-
sive as compared to nurses without this richer
preparation.
The rigor by which the data were gathered,
as well as the high quality of the outcomes,
raises the question of how effective all the
nursing care of patients might be if all nurses
had this level of preparation and abilities. It
is not difficult to conclude how professional
nurses would be evaluated by members of the
other clinical professions and by patients if
this level of preparation was required as the
minimum for all nurses. Nurses who read
this text may be stimulated to acquire this
level of competence and thus increase the
desired numbers in this category to ensure
more effective care.