51
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Möller G, de Oliveira JLC, Dal Pai D, Azzolin K, de Magalhães AMM. Nursing practice environment in intensive care unit and professional burnout. Rev Esc Enferm USP 2021; 55:e20200409. [PMID: 34407159 DOI: 10.1590/1980-220x-reeusp-2020-00409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/25/2021] [Indexed: 08/23/2023] Open
Abstract
OBJECTIVE To evaluate and compare the nursing practice environments in Intensive Care Units of a public and private hospital and the prevalence of burnout among nursing professionals. METHOD Cross-sectional, descriptive study with a quantitative approach to the data. The data collection took place between October 2018 and March 2019, and it was carried out through a questionnaire with socio-occupational variables and with metrics of intensity. The practice environment was assessed through the Nursing Work Index Revised (NWI-R); and the burnout was assessed by the Maslach Burnout Inventory (IBM). We included professionals with, at least, six months of employment, and those who were on leave or on a fixed-term employment contract were excluded. RESULTS The sample consisted of 296 professionals. We found Favorable environments in both institutions, however, low results in the subscales autonomy, control and organizational support in the private hospital. The prevalence of burnout among nurses was 2.5% in the public hospital and 9.1% in the private hospital, and among nursing technicians, it was 9.5% and 8.5%, respectively. CONCLUSION The control of the environment, autonomy and support were considered critical points, referring to the importance of assessing institutions factors, that can improve the working conditions for the nursing team.
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Affiliation(s)
- Gisele Möller
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Enfermagem, Porto Alegre, RS, Brazil
| | | | - Daiane Dal Pai
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Enfermagem, Porto Alegre, RS, Brazil
| | - Karina Azzolin
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Enfermagem, Porto Alegre, RS, Brazil
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Berry P. What became of the 'eyes and the ears'?: exploring the challenges to reporting poor quality of care among trainee medical staff. Postgrad Med J 2021; 97:695-700. [PMID: 37066753 DOI: 10.1136/postgradmedj-2021-140463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/11/2021] [Indexed: 01/25/2023]
Abstract
The importance of trainee medical staff in alerting Trusts to patient safety risks and low-quality care was established by the Francis Report, yet many remain hesitant about speaking up. Known barriers include lack of feedback, sceptical attitudes to the likelihood of change and fear of consequences. The author explores other factors including moral orientation in the workplace, role modelling by senior clinicians, discontinuity, 'normalisation of deviance', human reactions to burnout/moral injury, loyalty and the spectrum of motivation. The issues of absent feedback and fear are discussed in detail. Challenges met by those receiving reports are also described, such as how to collate soft intelligence, putting concerns into context (the 'bigger picture') and stewardship of resources. Initiatives to encourage reporting of trainees' concerns such as speak up guardians, 'Speak Up for Safety' campaign and simulation training are described. A proposal to embed proactive intelligence-gathering arrangements is presented.
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Affiliation(s)
- Philip Berry
- Gastroenterology, Hepatology and Nutrition, Guy's and St Thomas' Hospitals NHS Trust, London, UK
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53
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Lee H, Baek W, Lim A, Lee D, Pang Y, Kim O. Secondary traumatic stress and compassion satisfaction mediate the association between stress and burnout among Korean hospital nurses: a cross-sectional study. BMC Nurs 2021; 20:115. [PMID: 34193135 PMCID: PMC8243298 DOI: 10.1186/s12912-021-00636-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 06/10/2021] [Indexed: 11/17/2022] Open
Abstract
Background Burnout among nurses is a worldwide public health epidemic that adversely affects nurses’ quality of life as well as the patient’s outcomes. The aim of this study was to evaluate the influence of stress on nurses’ burnout and to identify the mediating effects of secondary traumatic stress and compassion satisfaction among clinical nurses in South Korea. Methods A quantitative, cross-sectional study evaluated the survey data from 10,305 female registered hospital nurses who participated in the Korea Nurses’ Health Study (KNHS) Module 5. The survey included a demographic questionnaire and the Professional Quality of Life version 5 (ProQOL 5). Bootstrap analyses (using the PROCESS macro) were employed to evaluate the mediating effect between variables. Results Stress was significantly associated with burnout and mediated by secondary traumatic stress and compassion satisfaction (βindirect 1 = 0.185, Bootstrap confidence interval (BS CI) [0.175, 0.194]; βindirect 2 = 0.226, BS CI [0.212, 0.241], respectively). In addition, the magnitude of the indirect effects of compassion satisfaction was significantly greater than the magnitude of the indirect effects of secondary traumatic stress (βindirect 1-βindirect 2 = − 0.042, BS CI [− 0.058, − 0.026]). The findings of this study indicate that the positive aspect (compassion satisfaction) of work experiences can offset the negative aspects (secondary traumatic stress), consequently reducing burnout level. Conclusions Our study findings suggest that a multidimensional approach to assessing nurse burnout and implementation of proper management will improve quality of life for nurses and help maintain positive attitudes and quality of patient care.
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Affiliation(s)
- Hyangkyu Lee
- Department of Nursing, Graduate School of Yonsei Univeristy, Seoul, Republic of Korea.,Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Wonhee Baek
- Department of Nursing, Graduate School of Yonsei Univeristy, Seoul, Republic of Korea. .,Department of Nursing, Kyungnam University College of Health Sciences, Changwon, 51767, Republic of Korea. .,Severance Hospital, Seoul, Republic of Korea.
| | - Arum Lim
- Department of Nursing, Graduate School of Yonsei Univeristy, Seoul, Republic of Korea
| | - Dajung Lee
- Severance Hospital, Seoul, Republic of Korea
| | - Yanghee Pang
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | - Oksoo Kim
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea.,Ewha Research Institute of Nursing Science, Seoul, Republic of Korea
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54
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Kim YT, Kim O, Cha C, Pang Y, Sung C. Nurse turnover: A longitudinal survival analysis of the Korea Nurses' Health Study. J Adv Nurs 2021; 77:4089-4103. [PMID: 34118173 DOI: 10.1111/jan.14919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/30/2021] [Accepted: 05/08/2021] [Indexed: 11/30/2022]
Abstract
AIMS To identify factors influencing turnover among Korean female nurses from a longitudinal perspective. DESIGN A national cohort study called the Korea Nurses' Health Study (2013-2020) was used. METHODS A national sample of female nurses from module 1 (N = 20,613, 2013-2014), module 5 (N = 11,527, 2016-2017), module 7 (N = 8,658, 2018-2019) and module 8 (N = 10,253, 2019-2020) was used. Based on a nurse turnover model, individual, health-related, social work environment and work organizational factors were considered explainable variables for nurse turnover. Kaplan-Meier survival analysis and multivariate Cox regression analysis were used to identify the factors influencing female nurse turnover in South Korea. RESULTS Female nurses who had less education, were unmarried, were pregnant, and had higher stress levels and an increased probability of experiencing turnover as they aged. Those who perceived moderate health rather than good/very good health, had depressive symptoms, had a higher salary, were charge nurses/unit managers/supervisors or advanced practice nurses, were advanced practice nurses rather than registered nurses, worked shifts, worked in special care units or outpatient wards/administration as opposed to general wards, and worked in larger hospitals had a decreased probability of experiencing turnover as they aged. A two-way interaction analysis revealed that those who had depressive symptoms and increased perceived stress were more likely to experience turnover as they aged. CONCLUSION Multiple factors influenced female nurse turnover, including individual, health-related, social work environment and work organizational factors. A multidimensional approach is needed to reduce nurse turnover. IMPACT Various factors predict nurse turnover as nurses age, implying that a multifaceted approach is needed to manage nurse turnover. The influence of depressive symptoms on turnover should be evaluated by considering the perceived stress level. Nursing managers and policy makers could use our results to develop programs/policies to reduce nurse turnover.
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Affiliation(s)
| | - Oksoo Kim
- College of Nursing, Ewha Research Institute of Nursing Science, Ewha Womans University, Seoul, Korea
| | - Chiyoung Cha
- College of Nursing, System Health and Engineering Major in Graduate School, Ewha Research Institute of Nursing Science, Ewha Womans University, Seoul, Korea
| | - Yanghee Pang
- College of Nursing, Ewha Womans University, Seoul, Korea
| | - Choa Sung
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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55
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Nilasari P, Hariyati RTS. Systematic review of missed nursing care or nursing care left undone. ENFERMERIA CLINICA 2021. [PMID: 33849186 DOI: 10.1016/j.enfcli.2020.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Comprehensive nursing cares are important to provide total healthcare for the patient. However, there are miss nursing cares that nurses left to be done. This research is aim to discover the varieties of missed nursing care and to understand their possible impacts on nurses and patients. A systematic review was utilized. Data were collected from six databases: ScienceDirect, ProQuest, Scopus, SAGE, PubMed, and Wiley, from 2015 to 2019. Search results from the six databases (n=2934) sorted into 18 collected articles emphasized on three categories: missed nursing care, influencing factors, and impact of nursing care. The factors of missed nursing care are nurses' perception on patient safety, self-accountability, etc. The possible effects are patient and nurse satisfactions decline, and cost swell. Planning, intervention, and documentation are notoriously often missed by nurses. The reasons behind this issue are nurses' characteristics, HR problems, communication, workspace, and manager influence. These will have a great impact on patient satisfaction and nurse job satisfaction. Therefore, the role of nursing managers is large in improving missed nursing care.
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Affiliation(s)
- Putri Nilasari
- Faculty of Nursing Universitas Indonesia, Depok, West Java, Indonesia
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56
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Ansah Ofei AM, Paarima Y, Barnes T, Kwashie AA. Staffing the unit with nurses: the role of nurse managers. J Health Organ Manag 2021; ahead-of-print. [PMID: 33998223 DOI: 10.1108/jhom-04-2020-0134] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore the staffing practices of nurse managers at the unit. DESIGN/METHODOLOGY/APPROACH Introduction: Ensuring that units are staffed with adequate nurses to render quality nursing care to clients has become increasingly challenging for most hospitals. There is growing evidence linking best patient outcomes and fewer adverse events to the presence of nurses at the bedside. Hospitals require to attract and retain nurses in the units to address the issues of quality, staff and patient safety. Methods: The study used a descriptive phenomenological design to purposively select 15 nurse managers (NMs) and 47 nurses for in-depth interviews and focus group discussions respectively. FINDINGS The study found that the demand for nurses to work in the unit was not scientific. Nurses affirmed their frustration of inadequate numbers of staff in the unit especially, at the periphery hospitals. Time can be used as a source of motivation for nurses and nurses should be involved in the development of the duty roster to enable effective compliance. Compensation for additional duties is relevant in nursing. RESEARCH LIMITATIONS/IMPLICATIONS The research was carried only in one region in Ghana, and the findings may not be the same in the other regions. PRACTICAL IMPLICATIONS Inadequate staffing level has serious implications on patient safety, quality of care and staff outcomes. This situation necessitates the implementation of health sector staffing norms to ensure the right calibre of mix staff are recruited and retained. ORIGINALITY/VALUE This study is the first in Ghana that we aware of that explore staffing practices at the unit that identifies factors that impact staff schedules for effective care.
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Affiliation(s)
- Adelaide Maria Ansah Ofei
- Department of Research, Education and Administration, School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Yennuten Paarima
- Department of Research, Education and Administration, School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Theresa Barnes
- Department of Research, Education and Administration, School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Atswei Adzo Kwashie
- Department of Research, Education and Administration, School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Accra, Ghana
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57
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Bartmess M, Myers CR, Thomas SP. Nurse staffing legislation: Empirical evidence and policy analysis. Nurs Forum 2021; 56:660-675. [PMID: 33982311 DOI: 10.1111/nuf.12594] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/21/2021] [Accepted: 04/29/2021] [Indexed: 12/31/2022]
Abstract
Unsafe nurse staffing conditions in hospitals have been shown to increase the risk of adverse patient events, including mortality. Consequently, United States and international professional nursing organizations often advocate for safer staffing conditions. There are a variety of factors to consider when staffing nurses for patient safety, such as the number of patients per nurse, nurse preparation, patient acuity, and nurse autonomy. The complex issue of staffing nurses often is compounded by cost issues and can become politicized. When nurse organizations' recommendations for safe staffing measures are disregarded by hospital administrations, nurse lobbyists and interest groups often pursue legislative action to protect patients and nurses from unsafe staffing conditions. This article presents a narrative review of safe nurse staffing factors and an analysis of nurse staffing legislation. Using a patient-centric lens, three state-level nurse staffing policies (mandated nurse-to-patient ratios, public reporting of staffing plans, and nurse staffing committees) were evaluated by empirical evidence, cost to hospitals and state governments, political feasibility, and potential to affect patient populations. Although nurse staffing policy analysis can be conducted in several ways, it is crucial that nurses consider empirical evidence related to staffing policies as well as evaluations of implemented policies and political influences.
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Affiliation(s)
- Marissa Bartmess
- College of Nursing, University of Tennessee, Knoxville, Tennessee, USA
| | - Carole R Myers
- College of Nursing, University of Tennessee, Knoxville, Tennessee, USA
| | - Sandra P Thomas
- College of Nursing, University of Tennessee, Knoxville, Tennessee, USA
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58
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Bae SH, Cho M, Kim O, Pang Y, Cha C, Jung H, Kim S, Jeong H. Predictors of actual turnover among nurses working in Korean hospitals: A nationwide longitudinal survey study. J Nurs Manag 2021; 29:2102-2114. [PMID: 33894028 DOI: 10.1111/jonm.13347] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 11/26/2022]
Abstract
AIM To examine the factors affecting actual turnover among nurses working in hospitals using the Brewer-Kovner synthesis model. BACKGROUND To increase retention of nurses, it is important to understand factors contributing to actual turnover among nurses. METHODS A longitudinal study design was utilized with 2,633 of 20,613 eligible female hospital nurses who participated in Korea Nurses' Health Study. We created two age groups: a younger group (20-35 years) and an older group (36-49 years). Multivariate logistic regression was used to identify the factors influencing turnover by age group. RESULTS Pregnancy and childbirth increased young nurses' turnover. When we excluded intent to leave, depression and burnout were significant factors affecting young nurses' turnover. Salary and hospital size were factors predicting nurse turnover among nurses older than 36 years. CONCLUSIONS It is essential to develop prevention strategies of female nurse turnover based on the age group in Korea. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers and health care institutes need to develop new managerial and policy strategies to reduce nurse turnover in each age group.
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Affiliation(s)
- Sung-Heui Bae
- College of Nursing, Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Mijung Cho
- College of Nursing, Ewha Research Institute of Nursing Science, Ewha Womans University, Seoul, Korea
| | - Oksoo Kim
- College of Nursing, Ewha Research Institute of Nursing Science, Ewha Womans University, Seoul, Korea
| | - Yanghee Pang
- College of Nursing, Ewha Research Institute of Nursing Science, Ewha Womans University, Seoul, Korea
| | - Chiyoung Cha
- College of Nursing, Ewha Research Institute of Nursing Science, Ewha Womans University, Seoul, Korea
| | - Heeja Jung
- College of Nursing, Konyang University, Daejeon, Korea
| | - Sue Kim
- College of Nursing, Yonsei University, Seoul, Korea
| | - Hyunseon Jeong
- College of Nursing, Ewha Research Institute of Nursing Science, Ewha Womans University, Seoul, Korea
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59
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Peterson H, Uibu E, Kangasniemi M. Care left undone and work organisation: A cross-sectional questionnaire-based study in surgical wards of Estonian hospitals. Scand J Caring Sci 2021; 36:285-294. [PMID: 33894008 DOI: 10.1111/scs.12987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 03/10/2021] [Accepted: 03/26/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Care left undone is a worldwide problem for both the quality of health care and the safety of patients. In surgical nursing, care left undone is a critical issue arising from the intensive pace of work, invasive procedures and the pressure for efficiency. Previous knowledge about care left undone in surgical contexts is missing. OBJECTIVE To describe care left undone and its relationship to nursing and organisational characteristics in the surgical wards of regional and central hospitals in Estonia. METHODS A cross-sectional study with an online questionnaire took place from June to October of 2018. The target population (N = 570) consisted of nurses working in the surgical wards of two regional and three central hospitals at the time of the study. The data were analysed using descriptive statistics and Fisher's exact test. The open-ended questions were analysed with deductive content analysis. RESULTS Nursing care in the surgical wards was reported as having been left undone sometimes or often by 88% of the nurses. Most often, the documentation and evaluation of care plans (33%) were reported as undone and most rarely, disinfection measures were left undone (5%). Nurses with a shorter employment history left care undone more frequently, and when the number of patients per nurse increased, the amount of care left undone increased as well. More than half of the participants (59%) considered work organisation to be the cause of care left undone. CONCLUSIONS Work organisation and staffing in surgical wards require more attention at the management level, as nursing care left undone occurred to a significant degree in the investigated wards, and more than half of the nurses considered work organisation to be the reason for care left undone.
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Affiliation(s)
| | - Ere Uibu
- Department of Nursing Science, Faculty of Medicine, Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Medicine, Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.,Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
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60
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Park JY, Hwang JI. [Relationships among Non-Nursing Tasks, Nursing Care Left Undone, Nurse Outcomes and Medical Errors in Integrated Nursing Care Wards in Small and Medium-Sized General Hospitals]. J Korean Acad Nurs 2021; 51:27-39. [PMID: 33706329 DOI: 10.4040/jkan.20201] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/17/2020] [Accepted: 12/09/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to identify the degree of non-nursing tasks and nursing care left undone in integrated nursing care wards, and examine their relationships with nurses' burnout, job satisfaction, turnover intentions, and medical errors. METHODS A cross-sectional questionnaire survey was conducted. Data were collected using self-report questionnaires from 346 nurses working in 20 wards of seven small and medium-sized general hospitals, and analyzed using multiple regression and multiple logistic regression analysis with the SPSS WIN 25.0 program. RESULTS The mean score for non-nursing tasks was 7.32±1.71, and that for nursing care left undone was 4.42 ± 3.67. An increase in non-nursing tasks (β = .12, p = .021) and nursing care left undone (β = .18, p < .001) led to an increase in nurses' burnout (F = 6.26, p < .001). As nursing care left undone (β = .13, p = .018) increased, their turnover intentions also (F = 3.96, p < .001) increased, and more medical errors occurred (odds ratio 1.08, 95% confidence interval 1.02~1.15). CONCLUSION Non-nursing tasks and nursing care left undone are positively associated with nurses' burnout, turnover intentions, and the occurrence of medical errors. Therefore, it is important to reduce non-nursing tasks and nursing care left undone in order to deliver high quality nursing care and in turn increase patient safety.
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Affiliation(s)
- Ju Young Park
- Department of Nursing, Kunjang University, Gunsan, Korea
| | - Jee In Hwang
- College of Nursing Science, Kyung Hee University, Seoul, Korea.
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61
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Bae SH. Relationships between comprehensive characteristics of nurse work schedules and adverse patient outcomes: A systematic literature review. J Clin Nurs 2021; 30:2202-2221. [PMID: 33616252 DOI: 10.1111/jocn.15728] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 02/05/2021] [Accepted: 02/12/2021] [Indexed: 11/29/2022]
Abstract
AIMS To review the comprehensive characteristics of adverse nurse work schedules and to synthesise the evidence of their relationships with adverse patient outcomes. BACKGROUND To manage nurse shortages and fluctuations in patient censuses, nurses often work overtime. This increases nurses' work hours and causes them to have fewer breaks. Such extended work schedules, long shift length, long weekly work hours and insufficient beaks can be considered as adverse nurse work schedules. Understanding how these adverse nurse work schedules affect patient outcomes is important to ensure patient safety. DESIGN A systematic review of nursing and healthcare literature was conducted in this study. METHODS Eight electronic bibliographic databases (CINAHL, Cochrane Library, DBpia, EBSCO, PubMed, PsycINFO, RISS and Web of Science) were used to search research articles published from 2000 to 2019. The study selection process followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). RESULTS From the search, 2,366 articles were identified, 22 of which were included in this review. Working more than 12 hours in a day had an adverse effect on patient outcomes, as was working more than 40 hours per week. There were mixed findings in the relationship between nurse overtime and adverse patient outcomes. CONCLUSIONS This study found a conclusive relationship between excessive nurse work hours and adverse patient outcomes. This review highlights the importance of managing adverse nurse schedules such as long daily and weekly work hours to improve patient safety and prevent adverse patient outcomes. RELEVANCE TO CLINICAL PRACTICE Study findings support the importance of monitoring and regulating nurse work schedules and adverse scheduling practices to improve nurse well-being and health and to prevent adverse patient outcomes.
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Affiliation(s)
- Sung-Heui Bae
- College of Nursing, Graduate Program in System Health Science and Engineering (BK 21), Ewha Womans University, Seoul, Republic of Korea
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62
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Sováriová Soósová M. Association between nurses' burnout, hospital patient safety climate and quality of nursing care. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2021. [DOI: 10.15452/cejnm.2020.11.0039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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63
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Jackson J. Supporting nurses' recovery during and following the COVID-19 pandemic. Nurs Stand 2021; 36:31-34. [PMID: 33586385 DOI: 10.7748/ns.2021.e11661] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 06/12/2023]
Abstract
Research suggests that working during traumatic events can lead to deteriorating physical and mental health for nurses, a phenomenon that has been demonstrated during the coronavirus 2019 (COVID-19) pandemic. However, research has also shown that there are evidence-based strategies that can be used to assist nurses in their recovery from such events. Promoting awareness among individual nurses about the effects of COVID-19 enables them to adopt positive coping strategies, both on an individual and organisational level. This article details strategies including formal and informal debriefing, taking regular breaks, and using stress mitigation strategies during shifts. The article also discusses the potential for post-traumatic psychological growth. This acknowledges that while working in a healthcare environment during COVID-19 can be extremely challenging, it also enables nurses to experience personal growth such as the development of emotional intelligence. As nurses adapt to the 'new normal' of working during COVID-19, healthcare organisations should ensure that they provide nurses with the support that enables them to recover effectively.
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Kalánková D, Bartoníčková D, Kirwan M, Gurková E, Žiaková K, Košútová D. Undergraduate nursing students' experiences of rationed nursing care - A qualitative study. NURSE EDUCATION TODAY 2021; 97:104724. [PMID: 33348299 DOI: 10.1016/j.nedt.2020.104724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/23/2020] [Accepted: 12/03/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Nursing students are required to spend a significant portion of their educational preparation in clinical practice. Because of the prevalence of missed or rationed care, it seems irrefutable that students are exposed to rationed care during their practice placement, or that they contribute to its prevalence either actively or passively. OBJECTIVES The study aimed to discover how nursing students interpret the concept of rationed care, and their experiences of rationing in practice. DESIGN A descriptive qualitative study. PARTICIPANTS Eighteen final year nursing students from three universities within the Slovak Republic. METHODS Semistructured face-to-face interviews were conducted (n = 18). Data were analyzed using thematic analysis which resulted in the development of themes and subthemes. RESULTS We identified three meaningful themes focused on the phenomenon of rationed care from the perspective of nursing students, namely Incomplete care is normalized; Provision of impersonal patient care; and the Existence of a hidden curriculum for practice placements. CONCLUSIONS Student nurses were quite demanding about the learning experience during their clinical training. They are often frustrated by inconsistencies between their theoretical preparation and the realities of practice. They recognise difficulties for registered nurses in providing safe, high quality care in constrained circumstances, and although they are critical of this, they acknowledge their own acceptance of the situation. Based on this, students must establish an understanding of the theory behind, and reasons for rationed care before commencing clinical placement. A greater understanding would enable students to develop strategies for coping with inconsistencies and voicing concerns.
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Affiliation(s)
- Dominika Kalánková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak Republic.
| | - Daniela Bartoníčková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak Republic; Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Czech Republic
| | - Marcia Kirwan
- School of Nursing and Human Sciences, Dublin City University in Dublin, Ireland.
| | - Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Czech Republic.
| | - Katarína Žiaková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak Republic.
| | - Dominika Košútová
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak Republic
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Brooks Carthon M, Brom H, McHugh M, Sloane DM, Berg R, Merchant R, Girotra S, Aiken LH. Better Nurse Staffing Is Associated With Survival for Black Patients and Diminishes Racial Disparities in Survival After In-Hospital Cardiac Arrests. Med Care 2021; 59:169-176. [PMID: 33201082 PMCID: PMC7855314 DOI: 10.1097/mlr.0000000000001464] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Racial disparities in survival among patients who had an in-hospital cardiac arrest (IHCA) have been linked to hospital-level factors. OBJECTIVES To determine whether nurse staffing is associated with survival disparities after IHCA. RESEARCH DESIGN Cross-sectional data from (1) the American Heart Association's Get With the Guidelines-Resuscitation database; (2) the University of Pennsylvania Multi-State Nursing Care and Patient Safety Survey; and (3) The American Hospital Association annual survey. Risk-adjusted logistic regression models, which took account of the hospital and patient characteristics, were used to determine the association of nurse staffing and survival to discharge for black and white patients. SUBJECTS A total of 14,132 adult patients aged 18 and older between 2004 and 2010 in 75 hospitals in 4 states. RESULTS In models that accounted for hospital and patient characteristics, the odds of survival to discharge was lower for black patients than white patients [odds ratio (OR)=0.70; 95% confidence interval (CI), 0.61-0.82]. A significant interaction was found between race and medical-surgical nurse staffing for survival to discharge, such that each additional patient per nurse lowered the odds of survival for black patients (OR=0.92; 95% CI, 0.87-0.97) more than white patients (OR=0.97; 95% CI, 0.93-1.00). CONCLUSIONS Our findings suggest that disparities in IHCA survival between black and white patients may be linked to the level of medical-surgical nurse staffing in the hospitals in which they receive care and that the benefit of being admitted to hospitals with better staffing may be especially pronounced for black patients.
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Affiliation(s)
- Margo Brooks Carthon
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
| | - Heather Brom
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
| | - Matthew McHugh
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
| | - Douglas M. Sloane
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
| | - Robert Berg
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care, Children’s Hospital of Philadelphia
| | - Raina Merchant
- Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Saket Girotra
- Department of Internal Medicine, Division of Cardiovascular Diseases, University of Iowa Carver College of Medicine Comprehensive Access Delivery Research & Evaluation (CADRE), Iowa City Veterans Affairs Medical Center, Iowa City, IA
| | - Linda H. Aiken
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
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Kim HS, Jang SJ, Kim JI. Integrated and Person-Centered Nursing in the Era of the 4th Industrial Revolution. J Korean Acad Nurs 2021; 51:261-264. [PMID: 34215705 DOI: 10.4040/jkan.51301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Hyoung Suk Kim
- School of Nursing, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Sun Joo Jang
- Red-Cross College of Nursing, Chung-Ang University, Seoul, Korea
| | - Jeung Im Kim
- School of Nursing, College of Medicine, Soonchunhyang University, Cheonan, Korea.
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Cho H, Han K, Ryu E, Choi E. Work Schedule Characteristics, Missed Nursing Care, and Organizational Commitment Among Hospital Nurses in Korea. J Nurs Scholarsh 2020; 53:106-114. [PMID: 33249723 DOI: 10.1111/jnu.12612] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE This study describes Korean nurses' work schedule characteristics and identifies their components to investigate associations of work schedule components with missed nursing care and organizational commitment. DESIGN This cross-sectional secondary analysis used survey data of 1,057 nurses in 111 units at six hospitals in South Korea. Data were collected between April 2017 and March 2018. METHODS A self-administered survey, including seven work schedule characteristic items, the Korean version of the MISSCARE Survey, and the Korean version of the Organizational Commitment Questionnaire, was employed. To construct independent components of work schedule characteristics, a principal component analysis was performed. The associations of work schedule components with missed nursing care and organizational commitment were analyzed using multiple linear regression models with generalized estimating equation methods. FINDINGS The average number of daily work hours was 9.7. Nearly half of the study population worked while sick once or more per month. The two components of nurses' work schedule characteristics were "long work hours" and "lack of rest," and these components showed variations between units. Unhealthy work schedule components were linked to frequently missed nursing care and decreased organizational commitment. CONCLUSIONS This study showed that proper work hours and adequate rest are important to reduce missed nursing care tasks and enhance organizational commitment, both of which are critical for better patient care and organizational outcomes. CLINICAL RELEVANCE Healthcare organizations should provide adequate nursing staff and assign reasonable workloads. Furthermore, hospitals should periodically monitor the work schedule characteristics of nurses and actively intervene in cases of scheduling issues to resolve them.
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Affiliation(s)
- Hyeonmi Cho
- Beta Eta-at-Large, PhD Student, University of Wisconsin-Madison, School of Nursing, WI, USA
| | - Kihye Han
- Lambda Alpha-at-Large, Associate Professor, Chung-Ang University College of Nursing, Seoul, Republic of Korea
| | - Eunjung Ryu
- Professor, Chung-Ang University College of Nursing, Seoul, Republic of Korea
| | - Eunsook Choi
- Unit Manager, National Cancer Center Department of Nursing, Gyeonggi-do, Republic of Korea
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Min A, Kim YM, Yoon YS, Hong HC, Kang M, Scott LD. Effects of Work Environments and Occupational Fatigue on Care Left Undone in Rotating Shift Nurses. J Nurs Scholarsh 2020; 53:126-136. [PMID: 33205904 DOI: 10.1111/jnu.12604] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE This study aimed to examine the effects of work environments and occupational fatigue on care left undone in rotating shift nurses, and to identify the indirect (mediation) effect of work environments on care left undone through nurses' occupational fatigue in South Korean acute care hospitals. DESIGN This study employed a cross-sectional design using an online survey to collect data from 488 rotating shift nurses of acute care hospitals in Korea between November and December 2018. METHODS A mobile schedule management application for shift nurses was used to advertise the study and to send a link to the online survey. The survey included questions on the nurses' work environment characteristics, care left undone activities, and the Korean version of the Occupational Fatigue Exhaustion/Recovery scale. Poisson regression was used to explore the relationships among work environments, occupational fatigue, and care left undone. Hayes' Model 4 and a bootstrapping analysis were used to identify the mediating effect of occupational fatigue on the relationship between work environments and care left undone. FINDINGS The average number of tasks left undone was 3.45 (SD = 2.19). The higher the acute and chronic fatigue levels noted among nurses, the higher were the occurrences of care left undone. Conversely, the higher the intershift recovery level, the lower were the occurrences of care left undone. The results showed a positive relationship between care left undone and overtime hours and the number of patients per nurse. Moreover, nurses' occupational fatigue mediated the relationship between work environments and care left undone. Night shifts per month and the number of consecutive days off had an indirect effect on care left undone through occupational fatigue. CONCLUSIONS High levels of occupational fatigue and poor intershift recovery among nurses can lead to care left undone. Nurses' occupational fatigue mediates the effect of work environment on care left undone. CLINICAL RELEVANCE It is crucial for healthcare administrators and leaders to develop policies and mandatory regulations to facilitate better working conditions for nurses, consequently reducing their occupational fatigue and decreasing the occurrence of care left undone in acute care hospitals.
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Affiliation(s)
- Ari Min
- Assistant Professor, Department of of Nursing, Chung-Ang University, South Korea
| | - Young Man Kim
- Assistant Professor, College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, South Korea
| | - Yea Seul Yoon
- Doctoral Student, Department of Nursing, Graduate School, Yonsei University, South Korea
| | - Hye Chong Hong
- Assistant Professor, Department of Nursing, Chung-Ang University, South Korea
| | - Minkyung Kang
- Assistant Professor, College of Nursing, Keimyung University, South Korea
| | - Linda D Scott
- Dean and Professor, School of Nursing, University of Wisconsin, Madison, WI, USA
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Ree E. What is the role of transformational leadership, work environment and patient safety culture for person-centred care? A cross-sectional study in Norwegian nursing homes and home care services. Nurs Open 2020; 7:1988-1996. [PMID: 33072384 PMCID: PMC7544868 DOI: 10.1002/nop2.592] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/03/2020] [Accepted: 07/23/2020] [Indexed: 11/08/2022] Open
Abstract
Aim To examine how transformational leadership, job demands, job resources and patient safety culture contribute in explaining person-centred care in nursing homes and home care services. Design Cross-sectional study. Methods Healthcare professionals in four Norwegian nursing homes (N = 165) and four home care services (N = 139) participated in 2018. Multiple regression analyses were used to examine to what degree transformational leadership, job demands, job resources and patient safety culture dimensions predicted person-centred care. Results Transformational leadership, job demands and job resources explained 41% of the variance in person-centred care, with work pace as the strongest predictor (β = 0.39 p < .001). The patient safety culture dimensions explained 57.5% of the variance in person-centred care, with staffing being the strongest predictor (β = 0.31 p < .001). There were small differences between nursing homes and home care. In total, transformational leadership, pace of work, staffing and factors related to communication were the strongest predictors for person-centred care.
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Affiliation(s)
- Eline Ree
- SHARE – Centre for Resilience in HealthcareFaculty of Health SciencesUniversity of StavangerStavangerNorway
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Gilbert J, Ward L, Walter R. A labour of love: Reward and satisfaction for nurses: Findings from a grounded theory study in dementia care. DEMENTIA 2020; 20:1697-1710. [DOI: 10.1177/1471301220965557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Aim To understand nurses’ perceptions of quality nursing care in the dementia-specific care unit. As the world’s population ages, the incidence of dementia is projected to rise in tandem. The requirement for skilled, dementia-trained registered nurses who can provide quality nursing care will need to increase accordingly to meet the needs of these individuals. Extensive research has been completed on dementia nursing care in a variety of settings; however, little research has been undertaken into nurses’ perceptions of quality nursing care in the dementia-specific care unit. Understanding how registered nurses perceive quality nursing care in the dementia-specific care unit is important and provides valuable information about nursing practice in this environment for nurses and decision-makers. Gaining a better understanding of quality nursing care in this care unit may result in better nurse education and an improved patient experience. It may also assist nursing organisations, residential aged-care facilities, government bodies and nongovernment agencies that support, manage, and oversee dementia-specific care units. Method A grounded theory study was conducted to understand nurses’ perceptions of quality nursing care in dementia-specific care units. The study involved interviewing nine registered nurses working in two dementia-specific care units on the Gold Coast, Queensland. Data were collected during semi-structured interviews and analysed using both constant comparison and thematic analysis. Findings Three themes emerged from this study— Caring at the Coalface, Labour of love and the Business of Dementia Healthcare. The largest theme, Labour of love, represents the personal reward and feeling of satisfaction six nurses said they experienced when interacting with individuals living in the dementia-specific care unit. They identified and repeatedly discussed the joy and fulfilment they experienced when caring for them, and considered this to be an essential element of quality nursing care. It was evident from the data that the nurses cared very deeply about these individuals, and despite increased risks to personal safety at work, they did not want to work anywhere else. This article reports on the largest and key theme identified in the study Labour of Love.
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Amiri A. Role of nurses and midwives in improving patient safety during childbirth: Evidence from obstetric trauma in OECD countries. Appl Nurs Res 2020; 56:151343. [PMID: 33280786 DOI: 10.1016/j.apnr.2020.151343] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 07/01/2020] [Accepted: 08/22/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To measure the role of nurses and midwives in reducing obstetric trauma as a proxy for safety failures during childbirth in member countries of Organization for Economic Co-operation and Development (OECD). METHODS The number of practicing nurses' and midwives' density per 1000 population and the proportion of third- and fourth-degree obstetric trauma during vaginal delivery with instrument (OT1) and without instrument (OT2) in crude rates per 100 vaginal deliveries for patients aged 15 and over collected from World Development Indicators and OECD Health Statistics in 17 OECD countries during 2010-2017 period. The statistical technique of panel data analysis was applied to estimate the impact of nurses and midwives on improving patient safety during childbirth. The number of physicians per 1000 population, health care expenditure (HCE) per capita and total number of hospital beds per 1000 population were added in data analysis as control variables. RESULTS The results of panel co-integration test and dynamic long-run models confirm that there were meaningful relationships from the level of nursing and midwifery staff to reducing OECD's obstetric trauma indicators with long-run magnitudes of -15.8614 for OT1 and -0.0519 for OT2. In addition, the results of panel error-correction model argue that if the long-run relationships between nursing and midwifery staff and obstetric trauma indicators are disturbed by the shortage in the needed nurses and midwives, then it takes at least 25 years for OT1 and 18 years for OT2 to reduce and restore back to equilibrium; that is quite a long time. CONCLUSION A higher proportion of nursing and midwifery staff is associated with higher patient safety during childbirth in OECD countries. Overall, our findings alert policy makers to consider the deleterious impacts of shortage in the level of nursing and midwifery staff on declining patient safety during childbirth as well as quality of acute care in OECD.
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Affiliation(s)
- Arshia Amiri
- JAMK University of Applied Sciences, Jyväskylä, Finland.
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73
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Gurková E, Kalánková D, Kurucová R, Žiaková K. Assessment of patient safety climate by nurses in Slovak Public and private hospitals. J Nurs Manag 2020; 28:1644-1652. [PMID: 32757476 DOI: 10.1111/jonm.13120] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 07/21/2020] [Accepted: 07/31/2020] [Indexed: 11/29/2022]
Abstract
AIM To examine variations in the safety climate reported by nurses in Slovak hospitals and to analyse the association between dimensions of the patient safety climate and demographic and organisational factors. BACKGROUND A deeper understanding of how safety climate varies across hospitals can be useful in determining areas with a potential for improvement. Staffing and non-punitive response to errors were identified in recent research syntheses as the weakest dimensions of safety climate that require strengthening. METHODS The sample consisted of 1,429 nurses working in public and private hospitals in Slovakia. The Hospital Survey on Patient Safety Culture questionnaire was used for data collection, and descriptive analysis was carried out to examine relationships between variables. RESULTS Nurses working in general private hospitals with a bed capacity of less than 500 beds were more positive about their hospital safety climate than other nurses working in differently organised hospitals. The lowest number of positive responses was scored in the domain of 'Non-Punitive Response to Error'. This result came from a blame-free error-reporting atmosphere. CONCLUSIONS Nurses perceived a higher level of patient safety when they had experienced better sharing of information on event reporting and had better learning opportunities. IMPLICATIONS FOR NURSING MANAGEMENT The results revealed strengths and weaknesses of the patient safety climate in the network of Slovak hospitals from the perspective of nurses working in these hospitals. This knowledge can enable nurse managers to instigate supportive strategies for just reporting, and learning from events, within an enhanced safety culture.
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Affiliation(s)
- Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Czech Republic
| | - Dominika Kalánková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovak Republic
| | - Radka Kurucová
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovak Republic
| | - Katarína Žiaková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovak Republic
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Zahiri Harsini A, Ghofranipour F, Sanaeinasab H, Amin Shokravi F, Bohle P, Matthews LR. Factors associated with unsafe work behaviours in an Iranian petrochemical company: perspectives of workers, supervisors, and safety managers. BMC Public Health 2020; 20:1192. [PMID: 32736619 PMCID: PMC7393823 DOI: 10.1186/s12889-020-09286-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 07/20/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The petrochemical industry is hazardous, in part because of the inherently dangerous nature of the work conducted, and incidents frequently result in significant financial and social losses. The most common immediate cause of incidents and injuries in this industry is unsafe worker behaviour. Identifying the factors encouraging unsafe work behaviours is the first step in taking action to discourage them. The aim of this study was to (a) explore workers', supervisors' and safety managers' attitudes and perceptions of safety in a petrochemical company in Iran, and (b) identify the factors that discourage safe work behaviours. METHODS A qualitative study was conducted by applying the steps described by Graneheim and Lundman (2004). Twenty participants were recruited from an Iranian petrochemical company using a multi-stage approach, with initial purposive sampling followed by snowball sampling to enhance recruitment. Individual face-to-face and semi-structured interviews were conducted to gain an in-depth understanding of factors acting as barriers to safe behaviour. The interviews were recorded and transcribed in Persian and then translated into English. Conventional content analysis was performed. RESULTS The main themes emerging from the interviews were: (i) poor direct safety management and supervision; (ii) unsafe workplace conditions; (iii) workers' perceptions, skills and training; and (iv) broader organisational factors. CONCLUSIONS The findings give insights into practical organisational measures that can be implemented by management to promote workers' commitment to safety and engage in safe behaviours in their workplace. TRIAL REGISTRATION Iranian Registry of Clinical Trials: IRCT20170515033981N2 . Retrospectively registered 19 June 2018.
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Affiliation(s)
- Azita Zahiri Harsini
- grid.412266.50000 0001 1781 3962Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-111, Tehran, Iran
- grid.1013.30000 0004 1936 834XFaculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Fazlollah Ghofranipour
- grid.412266.50000 0001 1781 3962Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-111, Tehran, Iran
| | - Hormoz Sanaeinasab
- grid.411521.20000 0000 9975 294XHealth Research Center, Lifestyle institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Farkhondeh Amin Shokravi
- grid.412266.50000 0001 1781 3962Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-111, Tehran, Iran
| | - Philip Bohle
- grid.1009.80000 0004 1936 826XTasmanian School of Business and Economics, University of Tasmania, Private Bag 84, Hobart, Tasmania 7001 Australia
| | - Lynda R. Matthews
- grid.1013.30000 0004 1936 834XWork and Health Research Team, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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75
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Silva MRG, Marcolan JF. Working conditions and depression in hospital emergency service nurses. Rev Bras Enferm 2020; 73 Suppl 1:e20180952. [PMID: 32667484 DOI: 10.1590/0034-7167-2018-0952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 04/23/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to analyze the presence, intensity and factors related to working conditions for depressive symptoms in hospital emergency nurses in the east of São Paulo. METHODS a descriptive, exploratory, quantitative and qualitative study, which applied psychometric scales and interview script. RESULTS nurses (95.24%) had depressive symptoms by the assessment scales by the observer, most with mild and moderate intensity. Inadequate working conditions led to suffering. Factors that trigger depressive symptoms were: disorganized work; harmful relationship with immediate management; inappropriate physician behavior; aggressions; lack of inputs, infrastructure and human resources; professional devaluation. Identified professionals with depressive symptoms who, because they were unaware of being affected by the disorder, did not seek treatment, continued to perform activities that compromised their physical and mental health, promoting damage to the assistance provided. Final considerations: high frequency of depressive symptoms. The precarious work environment negatively influenced the care and development of depressive symptoms.
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76
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McAllister M, Ryan C, Simes T, Bond S, Ford A, Lee Brien D. Rituals, ghosts and glorified babysitters: A narrative analysis of stories nurses shared about working the night shift. Nurs Inq 2020; 28:e12372. [PMID: 32648309 DOI: 10.1111/nin.12372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 06/18/2020] [Accepted: 06/20/2020] [Indexed: 12/16/2022]
Abstract
Working the night shift can be fraught and experienced as demanding and, yet, is often dismissed as babysitting. Few researchers have explored the social and cultural meanings of night nursing, including storytelling rituals. In 2019, a narrative study was undertaken. The aim was to explore the stories recalled by nurses about working night shifts. Thirteen Australian nurses participated. Data were gathered using the Biographical Narrative Interview Method, and narrative analysis produced forty stories and three themes: strange and challenging experiences; colleagues can be mentors (or not); and textbook knowledge is only part of what is needed on night shift. Nursing students who engage with these stories may come to understand the challenges of the night shift, and the valuable work that nurses engage in throughout a 24-hr period, work that involves adept psychosocial and interpersonal skills alongside technical and physical competence.
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Affiliation(s)
- Margaret McAllister
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Noosaville, QLD, Australia
| | - Colleen Ryan
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Noosaville, QLD, Australia
| | - Tracey Simes
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Noosaville, QLD, Australia
| | - Sue Bond
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Noosaville, QLD, Australia
| | - Abigail Ford
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Noosaville, QLD, Australia
| | - Donna Lee Brien
- School of Education and the Arts, Central Queensland University, Noosaville, QLD, Australia
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Chegini Z, Jafari‐Koshki T, Kheiri M, Behforoz A, Aliyari S, Mitra U, Islam SMS. Missed nursing care and related factors in Iranian hospitals: A cross‐sectional survey. J Nurs Manag 2020; 28:2205-2215. [DOI: 10.1111/jonm.13055] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 05/02/2020] [Accepted: 05/19/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Zahra Chegini
- Social Determinants of Health Research CenterQazvin University of Medical Sciences Qazvin Iran
- National Institute for Health Research Tehran University of Medical Sciences Tehran Iran
| | - Tohid Jafari‐Koshki
- Molecular Medicine Research Center Department of Statistics and Epidemiology Faculty of Health Tabriz University of Medical Science Tabriz Iran
| | - Marzieh Kheiri
- Department of Health Education and Promotion Faculty of Health Iran University of Medical Science Tehran Iran
| | - Ali Behforoz
- Iranian Center of Excellence in Health Management School of Management and Medical Informatics Tabriz University of Medical Sciences Tabriz Iran
| | - Saeedeh Aliyari
- National Institute for Health Research Tehran University of Medical Sciences Tehran Iran
| | - Udita Mitra
- The School of Health in Social Science University of Edinburgh Edinburgh UK
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Kim Y, Lee H. Nurses' Experiences with Disclosure of Patient Safety Incidents: A Qualitative Study. Risk Manag Healthc Policy 2020; 13:453-464. [PMID: 32547276 PMCID: PMC7247718 DOI: 10.2147/rmhp.s253399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 05/02/2020] [Indexed: 11/29/2022] Open
Abstract
Background Patient safety incidents trigger conflict between healthcare providers and patients. Patients and families want to hear detailed explanations and apologies from medical staff, but nurses may face difficulties with disclosure of patient safety incidents. Purpose To identify nurses’ experiences with disclosure of patient safety incidents. Methods Data were collected through in-depth interviews with nine clinical and five head nurses and were analyzed using Colaizzi’s phenomenological method. Findings After formulating 18 themes representing nurses’ experiences with disclosure of patient safety incidents, we clustered them into four theme clusters: “mixed responses from patients and families,” “caught in a swirl of negative emotions,” “facing the reality that hinders disclosure,” and “waiting for a breakthrough that would enable disclosure”. Conclusion Policies, systems, and culture that help both patients and healthcare professionals should be developed.
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Affiliation(s)
- Yujeong Kim
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Haeyoung Lee
- Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Republic of Korea
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Skela‐Savič B, Dobnik M, Kalender‐Smajlović S. Nurses’ work characteristics and self‐assessment of the work environment—Explorative cross‐sectional study. J Nurs Manag 2020; 28:860-871. [DOI: 10.1111/jonm.13010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/11/2020] [Accepted: 03/14/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Brigita Skela‐Savič
- Angela Boškin Faculty of Health Care Angela Boškin Institute for Research in Healthcare Sciences Jesenice Slovenia
| | - Mojca Dobnik
- University Medical Centre Maribor Maribor Slovenia
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Kim C, Lee Y. Effects of compassion competence on missed nursing care, professional quality of life and quality of life among Korean nurses. J Nurs Manag 2020; 28:2118-2127. [DOI: 10.1111/jonm.13004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 03/03/2020] [Accepted: 03/09/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Chanhee Kim
- College of Nursing Dong‐A University Busan South Korea
| | - Youngjin Lee
- College of Nursing Ajou University Suwon South Korea
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Friganovic A, Režić S, Kurtović B, Vidmanić S, Zelenikova R, Rotim C, Konjevoda V, Režek B, Piškor S. Nurses' perception of implicit nursing care rationing in Croatia—A cross‐sectional multicentre study. J Nurs Manag 2020; 28:2230-2239. [DOI: 10.1111/jonm.13002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Adriano Friganovic
- University Hospital Centre Zagreb Zagreb Croatia
- University of Applied Health Sciences Zagreb Croatia
| | - Slađana Režić
- University Hospital Centre Zagreb Zagreb Croatia
- University of Applied Health Sciences Zagreb Croatia
| | | | | | - Renata Zelenikova
- Faculty of Medicine Department of Nursing and Midwifery University of Ostrava Ostrava Czech Republic
| | - Cecilija Rotim
- University of Applied Health Sciences Zagreb Croatia
- Teaching Institute of Public Health Andrija Stampar Zagreb Croatia
| | | | - Biserka Režek
- University Hospital Centre Sestre milosrdnice Zagreb Croatia
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Tønnessen S, Christiansen K, Hjaltadóttir I, Leino-Kilpi H, Scott PA, Suhonen R, Öhlén J, Halvorsen K. Visibility of nursing in policy documents related to health care priorities. J Nurs Manag 2020; 28:2081-2090. [PMID: 32037639 DOI: 10.1111/jonm.12977] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/18/2020] [Accepted: 02/06/2020] [Indexed: 12/01/2022]
Abstract
AIM To explore the visibility of nursing in policy documents concerning health care priorities in the Nordic countries. BACKGROUND Nurses at all levels in health care organisations set priorities on a daily basis. Such prioritization entails allocation of scarce public resources with implications for patients, nurses and society. Although prioritization in health care has been on the political agenda for many years, prioritization in nursing seems to be obscure in policy documents. METHODOLOGY Each author searched for relevant documents from their own country. Text analyses were conducted of the included documents concerning nursing visibility. RESULTS All the Nordic countries have published documents articulating values and criteria relating to health care priorities. Nursing is seldom explicitly mentioned but rather is included and implicit in discussions of health care prioritization in general. CONCLUSION There is a need to make priorities in nursing visible to prevent missed nursing care and ensure fair allocation of limited resources. IMPLICATIONS FOR NURSING MANAGEMENT To highlight nursing priorities, we suggest that the fundamental need for nursing care and what this implies for patient care in different organisational settings be clarified and that policymakers explicitly include this information in national policy documents.
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Affiliation(s)
- Siri Tønnessen
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway
| | - Karin Christiansen
- Faculty of Health, Centre for Health and Welfare Technology, VIA University College, Aarhus, Denmark
| | - Ingibjörg Hjaltadóttir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | | | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland.,Welfare Division, University Hospital of Turku, Turku, Finland
| | - Joakim Öhlén
- Institute of Health and Care Sciences, University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Palliative Centre, Sahlgrenska University Hospital Västra Götaland Region, Gothenburg, Sweden
| | - Kristin Halvorsen
- Faculty of Health Sciences, Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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83
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Kalánková D, Kirwan M, Bartoníčková D, Cubelo F, Žiaková K, Kurucová R. Missed, rationed or unfinished nursing care: A scoping review of patient outcomes. J Nurs Manag 2020; 28:1783-1797. [DOI: 10.1111/jonm.12978] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/09/2020] [Accepted: 02/11/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Dominika Kalánková
- Department of Nursing Jessenius Faculty of Medicine in Martin Comenius University in Bratislava Martin Slovak Republic
| | - Marcia Kirwan
- School of Nursing and Human Sciences Dublin City University in Dublin Glasnevin, Dublin Ireland
| | - Daniela Bartoníčková
- Department of Nursing 2nd Faculty of Medicine Charles University in Prague Prague Czech Republic
| | - Floro Cubelo
- School of Health and Social Studies Jyväskylä University of Applied Sciences Jyväskylä Finland
| | - Katarína Žiaková
- Department of Nursing Jessenius Faculty of Medicine in Martin Comenius University in Bratislava Martin Slovak Republic
| | - Radka Kurucová
- Department of Nursing Jessenius Faculty of Medicine in Martin Comenius University in Bratislava Martin Slovak Republic
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84
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Kalánková D, Suhonen R, Stolt M, Kurucová R, Katajisto J, Žiaková K, Gurková E. Psychometric testing of perceived implicit rationing of nursing care (PIRNCA). J Adv Nurs 2020; 76:1469-1482. [PMID: 32180252 DOI: 10.1111/jan.14351] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/27/2020] [Accepted: 03/04/2020] [Indexed: 11/27/2022]
Abstract
AIMS To evaluate the psychometric properties of the Perceived Implicit Rationing of Nursing Care (PIRNCA) instrument and to report the prevalence of rationed care at university and faculty hospitals. DESIGN A cross-sectional study. METHODS The study was carried out at two university and five faculty hospitals in the Slovak Republic. Participants were 895 Registered Nurses recruited by the purposive sampling method between December 2017-July 2018. Data were collected using the PIRNCA instrument. Construct validity and reliability of the instrument were tested. RESULTS The prevalence of rationed care at university and faculty hospitals was identified as being 42.1%. Furthermore, 87.6% of nurses reported rationing one or more nursing care activities. Using both statistical methods when evaluating the PIRNCA resulted in the confirmation that the tool is valid and reliable. CONCLUSION Rationed care is a common phenomenon at university and faculty hospitals. The PIRNCA is a suitable instrument to measure the phenomenon in adult acute care units because of its high reliability and validity. We recommend using the instrument in different contexts, not only for specific conditions that were presented for this study. IMPACT Rationed care at university and faculty hospitals has never been reported. Psychometric properties of the instrument that measures nurses´ perception of rationed care have never been evaluated by using different approaches. The most frequently rationed nursing care activities are those that nurses are competent to initiate on the basis of their knowledge and skills - the independent ones. The PIRNCA is a valid and reliable instrument. Hospital management can use the instrument to explore the prevalence of rationed care, followed by the application of prevention strategies. Our findings represent the base for further exploration of rationed care using the PIRNCA.
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Affiliation(s)
- Dominika Kalánková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland.,Welfare Division, Turku University Hospital, Turku, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Radka Kurucová
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Katarína Žiaková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic
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85
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Cordeiro R, Pires Rodrigues MJ, Serra RD, Calha A. Good practices to reduce unfinished nursing care: An integrative review. J Nurs Manag 2020; 28:1798-1804. [DOI: 10.1111/jonm.12972] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 01/26/2020] [Accepted: 02/02/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Raul Cordeiro
- Polytechnic Institute of Portalegre (IPP) Portalegre Portugal
- VALORIZA ‐ Research Centre for Endogenous Resource Valorization Portalegre Portugal
| | | | - Ricardo Daniel Serra
- Unidade Local de Saúde do Norte Alentejano Polytechnic Institute of Portalegre (IPP) Portalegre Portugal
| | - António Calha
- Polytechnic Institute of Portalegre (IPP) Portalegre Portugal
- VALORIZA ‐ Research Centre for Endogenous Resource Valorization Portalegre Portugal
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A study of the epidemiology and risk factors for attempted suicide and suicide among non-psychiatric inpatients in 48 general hospitals in Hubei province, China, 2015-2017. Gen Hosp Psychiatry 2020; 63:21-29. [PMID: 31230862 DOI: 10.1016/j.genhosppsych.2019.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 05/06/2019] [Accepted: 06/04/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This was a large-scale epidemiological survey of non-psychiatric inpatient attempted suicides/suicides in general hospitals in China, allowing a detailed quantitative analysis of the characteristics of inpatient attempted suicides/suicides. METHODS The incidence, inpatient demographic and behavioral characteristics, and risk factors for attempted suicide/suicide were explored through a survey of non-psychiatric inpatients admitted to 48 general hospitals, between 2015 and 2017. A Vector Error Correction model was established to explore hospital variables as predictors of inpatient attempted suicide/suicide using the annual numbers of inpatient attempted suicides/suicides, undergraduate or above nurses per total number of nurses, and number of beds per nurse in a tertiary general hospital, between 1998 and 2017. RESULTS The incidence of attempted suicide/suicide among inpatients in general hospitals was 3.26/100,000 admissions. 180 inpatient attempted suicides/suicides were reported, which were associated with particular inpatient demographic and behavioral characteristics and a specific temporal and spatial distribution. Incidence of attempted suicide/suicide was higher in inpatients aged ≥60 years, with junior high school or lower level of education, in secondary general hospitals, suffering from malignant tumors or chronic diseases. Number of beds/nurse had a significant impact on the incidence of inpatient attempted suicide/suicide. CONCLUSION We recommend that general hospital administrators establish a targeted approach to inpatient suicide prevention efforts in their hospitals.
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Amiri A, Vehviläinen-Julkunen K, Solankallio-Vahteri T, Tuomi S. Impact of nurse staffing on reducing infant, neonatal and perinatal mortality rates: Evidence from panel data analysis in 35 OECD countries. Int J Nurs Sci 2020; 7:161-169. [PMID: 32685612 PMCID: PMC7355187 DOI: 10.1016/j.ijnss.2020.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 01/23/2020] [Accepted: 02/26/2020] [Indexed: 01/11/2023] Open
Abstract
Objectives To investigate the magnitude of effect nurse staffing had on decreasing the newborn mortality rates in member countries of Organisation for Economic Co-operation and Development (OECD). Methods The statistical technique of panel data analysis was applied to explore the possibility of association between the number of nurses’ density per 1,000 population and infant, neonatal and perinatal mortality rates (IMR, NMR and PMR) per 1000 births. The observations of 35 OECD countries were collected over the period of 2000 through 2016. Results There were significant associations between nurse staffing and IMR, NMR and PMR i.e. a 1% increase in nurse-staffing level reduced IMR, NMR and PMR by 0.98%, 0.97% and 0.96%, respectively. Furthermore, the role of nursing-related services in declining the average of newborn mortality rates were investigated at the highest level in Slovenia (−5.50), Sweden (−3.34), Iceland (−2.51), Czech Republic (−1.86), Japan (−1.64) and Finland (−1.64). Moreover, if the current relationship between nurse-staffing level and newborn mortality rates are disturbed with nursing shortage (e.g. in Slovak Republic and Israel), then it takes about 17 years for the mortality rates to reduce and restore back to the previous equilibrium. Conclusions A higher proportion of nurses’ density per 1,000 population is associated with lower newborn mortality rates. In addition, the nursing-related services of Slovenia, Sweden, Iceland, Czech Republic, Japan and Finland with the highest impact on improving the health level of newborns would be good patterns for other developed countries in maternity and child health care .
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Affiliation(s)
- Arshia Amiri
- School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
| | | | | | - Sirpa Tuomi
- School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
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Determining Factors That Influence Nurses' Perceptions of Quality Implementations Conducted in Hospitals in Turkey. J Nurs Res 2020; 28:e91. [PMID: 32084044 DOI: 10.1097/jnr.0000000000000368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Quality management program implementations in health services are team endeavors that involve all health service personnel. Because they are direct providers of care, nurses are best able to evaluate the influence of quality management program implementations on the health services and quality of care provided by hospitals. PURPOSE The aim of this study was to develop an instrument to determine how nurses perceive the implementation of quality management programs in hospitals. Furthermore, the nurses' perceptions of the influence of these implementations on the quality of patient care and their job satisfaction were examined. METHODS A descriptive, comparative, cross-sectional online survey was conducted using a convenience sample (N = 388) of practicing nurses working at public and university hospitals where quality management programs were implemented. Nurses' perceptions of the implementations were analyzed using confirmatory factor analysis, whereas the influence of nurses' perceptions of quality management implementations on patient care and job satisfaction was measured using structural equation modeling approaches. RESULTS This study revealed that the instrument is valid and reliable for the measurement of participant perceptions of quality management program implementations. Nurses' perceptions were generally negative, and they exhibited negative attitudes toward the implementation of quality management in the institutions where they work. However, the quality management program implementations had little influence on perceptions of the quality of patient care. Participant job satisfaction was lower than average, and the quality management program implementations conducted in the hospitals negatively affected job satisfaction. On the other hand, participants who worked at university hospitals perceived quality management program implementations more affirmatively; patient care quality and job satisfaction were viewed more positively as well. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Because nurses do not participate effectively in quality management program implementations, they perceive these efforts as unnecessary and the responsibility of the quality control department. It is very important to ensure that all care-service providers participate to effectively implement quality management programs in hospitals and to encourage the adoption of a culture of patient safety in all institutions.
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Novinmehr N, Hasanpour M, Salsali M, Mehrdad N, Qorbani M, Shamsaei F. Older adults' self-advocacy in patient safety: a cross-sectional study. ACTA ACUST UNITED AC 2020; 28:1076-1084. [PMID: 31518535 DOI: 10.12968/bjon.2019.28.16.1076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND patient advocacy is a major nursing role, which is linked to supporting, encouraging and reinforcing self-advocacy in patients. Patient safety is an important nursing outcome, especially in older adults. AIMS older adults' self-advocacy regarding patient safety behaviour and its relationship with some demographic characteristics were assessed. METHODS a valid older adult patients' self-advocacy questionnaire, which included subscales of behaviour, self-efficacy, attitude and outcome efficacy (range of scores=0-63), was used. In this cross-sectional study, 230 patients aged over 60 years were selected using a stratified sampling method. FINDINGS an association was found between total self-advocacy score (mean=40.16; SD=9.6) and rural living (β=-0.168; P=0.016) using multiple linear regression analysis. Similar findings were found between questionnaire subscales and sex, rural living, occupation and age. CONCLUSION older adults, especially women, those of advanced age and those in rural areas, may benefit from nursing interventions to improve their self-advocacy in patient safety.
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Affiliation(s)
- Nasser Novinmehr
- PhD Nursing Candidate, School of Nursing and Midwifery, Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Hasanpour
- Associate Professor, School of Nursing and Midwifery, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahvash Salsali
- Emeritus Professor, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Mehrdad
- Associate Professor, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; and Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Associate Professor, Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Farshid Shamsaei
- Associate Professor, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamedan, Iran
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90
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Sanchis DZ, Haddad MDCFL, Girotto E, Silva AMR. Patient safety culture: perception of nursing professionals in high complexity institutions. Rev Bras Enferm 2020; 73:e20190174. [DOI: 10.1590/0034-7167-2019-0174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 10/01/2019] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objectives: to analyze the perception of nursing professionals about patient safety culture in three highly complex hospital institutions. Methods: descriptive and quantitative study with professionals working in care. The Hospital Survey on Patient Safety Culture questionnaire was applied, classifying its dimensions according to the percentage of positive responses (strengthened: ≥75.0%; potential for improvement: <75.0% to> 50.0%; weakened: ≤50.0%). Results: four hundred sixty-seven professionals (79.6%), mostly women (88.4%), nursing technicians/assistants (57.2%), 20 to 39 years (60.8%), less than five years in the institution (57.8%) and exclusive bond (79.2%) participated in the study. Safety culture was considered fragile, seven dimensions assessed as such, highlighting “Openness to communication” and “Non-punitive responses to errors” with <30.0% positive responses. Conclusions: evidence of the need for discussion of the subject and strategies for change that promote quality and safety of care.
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91
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Abstract
BACKGROUND Patient-centeredness is emphasized in both health policies and practice, calling for reliable instruments for the evaluation of the quality of nursing care. PURPOSE The purpose was to analyze the psychometric properties of the Good Nursing Care Scale (GNCS) in a sample of surgical patients and nurses. METHODS An explorative cross-sectional study design was used. Data were collected with the 40-item GNCS from surgical patients (n = 476) and nurses (n = 167) in Finland. The data were analyzed with Rasch analysis. RESULTS The GNCS provided evidence of unidimensionality with acceptable goodness-of-fit to the Rasch model in both samples. Person-separation validity was acceptable. Person misfit was reasonable. The Rasch-equivalent Cronbach α was 0.81 (patient data) and 0.88 (nurse data). CONCLUSIONS The findings support that the GNCS is a psychometrically sound instrument that can be used in measuring the quality of nursing care, from the perspective of both patients and nurses.
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92
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Cho S, Lee J, You SJ, Song KJ, Hong KJ. Nurse staffing, nurses prioritization, missed care, quality of nursing care, and nurse outcomes. Int J Nurs Pract 2019; 26:e12803. [DOI: 10.1111/ijn.12803] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 09/09/2019] [Accepted: 11/05/2019] [Indexed: 01/05/2023]
Affiliation(s)
- Sung‐Hyun Cho
- College of Nursing, Research Institute of Nursing ScienceSeoul National University South Korea
| | - Ji‐Yun Lee
- College of NursingKangwon National University South Korea
| | - Sun Ju You
- Department of NursingMokpo National University South Korea
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93
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Zhao Y, Ma D, Wan Z, Sun D, Li H, Sun J. Associations between work environment and implicit rationing of nursing care: A systematic review. J Nurs Manag 2019; 28:1841-1850. [DOI: 10.1111/jonm.12895] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/20/2019] [Accepted: 10/31/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Yingnan Zhao
- School of Nursing Jilin University Changchun China
| | - Dongfei Ma
- School of Nursing Jilin University Changchun China
| | - Zhenzhen Wan
- School of Nursing Jilin University Changchun China
| | - Dan Sun
- School of Nursing Jilin University Changchun China
| | - Huanhuan Li
- School of Nursing Jilin University Changchun China
| | - Jiao Sun
- School of Nursing Jilin University Changchun China
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Vincelette C, Thivierge-Southidara M, Rochefort CM. Conceptual and methodological challenges of studies examining the determinants and outcomes of omitted nursing care: A narrative review of the literature. Int J Nurs Stud 2019; 100:103403. [DOI: 10.1016/j.ijnurstu.2019.103403] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/30/2019] [Accepted: 08/19/2019] [Indexed: 10/26/2022]
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Bagnasco A, Dasso N, Rossi S, Galanti C, Varone G, Catania G, Zanini M, Aleo G, Watson R, Hayter M, Sasso L. Unmet nursing care needs on medical and surgical wards: A scoping review of patients’ perspectives. J Clin Nurs 2019; 29:347-369. [DOI: 10.1111/jocn.15089] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/13/2019] [Accepted: 10/20/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Nicoletta Dasso
- Department of Health Sciences University of Genoa Genoa Italy
| | - Silvia Rossi
- Department of Health Sciences University of Genoa Genoa Italy
| | | | - Gloria Varone
- Department of Interventional Radiology IRCCS Ospedale Policlinico San Martino Genoa Italy
| | | | - Milko Zanini
- Department of Health Sciences University of Genoa Genoa Italy
| | - Giuseppe Aleo
- Department of Health Sciences University of Genoa Genoa Italy
| | - Roger Watson
- Faculty of Health and Social Care University of Hull Hull UK
| | - Mark Hayter
- Faculty of Health and Social Care University of Hull Hull UK
| | - Loredana Sasso
- Department of Health Sciences University of Genoa Genoa Italy
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Womack DM, Vuckovic NN, Steege LM, Eldredge DH, Hribar MR, Gorman PN. Subtle cues: Qualitative elicitation of signs of capacity strain in the hospital workplace. APPLIED ERGONOMICS 2019; 81:102893. [PMID: 31422247 PMCID: PMC6834115 DOI: 10.1016/j.apergo.2019.102893] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 06/20/2019] [Accepted: 07/03/2019] [Indexed: 06/10/2023]
Abstract
Through everyday care experiences, nurses develop expertise in recognition of capacity strain in hospital workplaces. Through qualitative interview, experienced nurses identify common activity changes and adaptive work strategies that may signal an imbalance between patient demand and service supply at the bedside. Activity change examples include nurse helping behaviors across patient assignments, increased volume of nurse calls from patient rooms, and decreased presence of staff at the nurses' station. Adaptive work strategies encompass actions taken to recruit resources, move work in time, reduce work demands, or reduce thoroughness of task performance. Nurses' knowledge of perceptible signs of strain provides a foundation for future exploration and development of real-time indicators of capacity strain in hospital-based work systems.
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Affiliation(s)
- Dana M Womack
- Oregon Health & Science University, Department of Medical Informatics & Clinical Epidemiology, 3181 S.W. Sam Jackson Park Rd, Portland, OR, 97239-3098, USA.
| | - Nancy N Vuckovic
- Cambia Health Solutions, 100 SW Market St, Portland, OR, 97201, USA
| | - Linsey M Steege
- University of Wisconsin - Madison, School of Nursing, 701 Highland Avenue, Madison, WI, 53705, USA
| | - Deborah H Eldredge
- Oregon Health & Science University Hospital, 3181 S.W. Sam Jackson Park Rd, Portland, OR, 97239-3098, USA
| | - Michelle R Hribar
- Oregon Health & Science University, Department of Medical Informatics & Clinical Epidemiology, 3181 S.W. Sam Jackson Park Rd, Portland, OR, 97239-3098, USA
| | - Paul N Gorman
- Oregon Health & Science University, Department of Medical Informatics & Clinical Epidemiology, 3181 S.W. Sam Jackson Park Rd, Portland, OR, 97239-3098, USA; Oregon Health & Science University Hospital, 3181 S.W. Sam Jackson Park Rd, Portland, OR, 97239-3098, USA
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Flo J, Landmark B, Tønnessen S, Fagerström L. Patient classification systems used to classify nursing intensity and assess nursing staffing resources in home health care: A scoping review. Int J Nurs Stud 2019; 99:103361. [DOI: 10.1016/j.ijnurstu.2019.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/12/2019] [Accepted: 05/14/2019] [Indexed: 11/27/2022]
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Comparing the Two Techniques for Nursing Staff Rescheduling to Streamline Nurse Managers' Daily Work in Finland. Comput Inform Nurs 2019; 38:148-156. [PMID: 31652140 DOI: 10.1097/cin.0000000000000567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study was to identify nurse managers' daily tasks during the rescheduling of sudden nursing staff absences by comparing two techniques: a paper-based system as phone calls and emails or information technology-based staffing systems. In addition, it is intended to evaluate the usability of information technology-based staffing solutions and evaluate estimated cost savings by using hospital permanent staff to cover sudden absences. A quasi-experimental pretest and posttest one-group study design was used to evaluate nurse managers' (n = 61) daily tasks (n = 5800) during rescheduling nursing staff sudden absences (n = 2628); furthermore, we engaged in observations and provided estimates of cost savings generated by our proposed intervention. The number of nurse manager tasks during rescheduling decreased significantly (P < .001) as well as unstaffed shifts (P < .001) and unplanned shift changes (P < .001) after the information technology-based scheduling system was implemented. The usability score ranged from 76 to 100, showing that the information technology-based scheduling solution has good usability. The use of information technology-based staffing solution can streamline the rescheduling process, save nurse managers time for other activities, and offer organizations opportunities for cost savings.
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The Mediating Role of Burnout in the Relationship between Perceived Patient-safe, Friendly Working Environment and Perceived Unsafe Performance in an Obstetric Unit. Adv Health Care Manag 2019; 18. [PMID: 32077647 DOI: 10.1108/s1474-823120190000018005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Medical errors in obstetric departments are commonly reported and may involve both mother and neonate. The complexity of obstetric care, the interactions between various disciplines, and the inherent limitations of human performance make it critically important for these departments to provide patient-safe and friendly working environments that are open to learning and participative safety. Obstetric care involves stressful work, and health care professionals are prone to develop burnout, this being associated with unsafe practices and lower probability for reporting safety concerns. This study aims to test the mediating role of burnout in the relationship of patient-safe and friendly working environment with unsafe performance. The full population of professionals working in an obstetrics department in Malta was invited to participate in a cross-sectional study, with 73.6% (n = 184) of its members responding. The research tool was adapted from the Sexton et al.'s Safety Attitudes Questionnaire - Labor and Delivery version and surveyed participants on their working environment, burnout, and perceived unsafe performance. Analysis was done using Structural Equation Modeling. Results supported the relationship between the lack of a perceived patient-safe and friendly working environment and unsafe performance that is mediated by burnout. Creating a working environment that ensures patient safety practices, that allows communication, and is open to learning may protect employees from burnout. In so doing, they are more likely to perceive that they are practicing safely. This study contributes to patient safety literature by relating working environment, burnout, and perceived unsafe practice with the intention of raising awareness of health managers' roles in ensuring optimal clinical working environment for health care employees.
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Amiri A, Solankallio-Vahteri T. Nurse staffing and life expectancy at birth and at 65 years old: Evidence from 35 OECD countries. Int J Nurs Sci 2019; 6:362-370. [PMID: 31728387 PMCID: PMC6838842 DOI: 10.1016/j.ijnss.2019.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 07/04/2019] [Accepted: 07/16/2019] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To measure the possible magnitude of the role nurse staffing has on increasing life expectancy at birth and at 65 years old. METHODS The statistical technique of panel data analysis was applied to investigate the relationship from the number of practicing nurses' density per 1000 population to life expectancy at birth and at 65 years old. Five control variables were used as the proxies for the levels of medical staffing, health care financial and physical resources, and medical technology. The observations of 35 member countries of Organization for Economic Co-operation and Development (OECD) were collected from OECD Health Statistics over 2000-2016 period. RESULTS There were meaningful relationships from nurse staffing to life expectancy at birth and at 65 years with the long-run elasticities of 0.02 and 0.08, respectively. Overall, the role of nursing characteristics in increasing life expectancy indicators varied among different health care systems of OECD countries and in average were determined at the highest level in Japan (0.25), followed by Iceland (0.24), Belgium (0.21), Czech Republic (0.21), Slovenia (0.20) and Sweden (0.18). CONCLUSION A higher proportion of nursing staff is associated with higher life expectancy in OECD countries and the dependency of life expectancy to nursing staff would increase by aging. Hence, the findings of this study warn health policy makers about ignoring the effects nursing shortages create e.g. increasing the risk of actual age-specific mortality, especially in care of elderly people.
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Affiliation(s)
- Arshia Amiri
- JAMK University of Applied Sciences, Jyväskylä, Finland
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