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Mohammadi Gonbaki Z, Mirzaie Taklimi M, Taheri-Ezbarami Z, Kazemnejad Leili E, Abadgar Chahardeh M. The quality of nursing care from the perspective of hospitalized school-age children. J Pediatr Nurs 2024; 77:e283-e289. [PMID: 38679507 DOI: 10.1016/j.pedn.2024.04.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE Hospitalized children's satisfaction with the care they receive is the main indicator for evaluating the way nurses should provide services and the quality of these services. The current study aimed to examine school-aged children's perceptions of nursing care quality. METHODS In this cross-sectional study, 144 children aged 7-11 years were selected through a convenience sampling method. The data collection tool included The Child Care Quality at Hospital Questionnaire, and the personal- and family-related and disease-related factors questionnaire. Independent t-test, one-way analysis of variance, Pearson's correlation coefficient and multiple linear regression test were used for data analysis. RESULTS Based on the findings, the highest score of nursing care quality was related to characteristics domain (13 ± 1.7). In addition, the children's age, father's education and history of hospitalization were related to nurses' characteristics domain; mother's education and length of hospital stay were related to nursing activities domain; and mother's education, father's occupation and length of hospital stay were related to nursing environment domain. CONCLUSION The results of the present study showed that children's nurses can provide better quality care to children by paying attention to nurses' characteristics and then the scope of activities and care environment. PRACTICE IMPLICATIONS Considering the factors affecting the nursing care quality, a conscious step should also be taken for strategic planning of care.
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Affiliation(s)
- Zahra Mohammadi Gonbaki
- MSc of Pediatric Nursing, School of Nursing and Midwifery-Guilan University of Medical Sciences, Rasht, Iran.
| | - Mahshid Mirzaie Taklimi
- Assistant Professor, Department of Nursing, School of Nursing and Midwifery-Guilan University of Medical Sciences, Rasht, Iran.
| | - Zahra Taheri-Ezbarami
- Associate Professor, Department of Nursing, School of Nursing and Midwifery-Guilan University of Medical Sciences, Rasht, Iran.
| | - Ehsan Kazemnejad Leili
- Associate Professor, Department of Biostatistics, School of Nursing and Midwifery-Guilan University of Medical Sciences, Rasht, Iran.
| | - Marzieh Abadgar Chahardeh
- MSc of Pediatric Nursing, School of Nursing and Midwifery-Guilan University of Medical Sciences, Rasht, Iran.
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2
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Majamanda MD, Chisoni F, Selemani A, Kearns I, Maree J. Paediatric oncology nursing education and training programmes: a scoping review protocol. BMJ Open 2023; 13:e070694. [PMID: 37813530 PMCID: PMC10565288 DOI: 10.1136/bmjopen-2022-070694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 09/19/2023] [Indexed: 10/13/2023] Open
Abstract
INTRODUCTION The care of children with cancer is a highly specialised field which requires well-educated, trained and dedicated nurses to provide high-quality care. In low/middle-income countries, the survival rate of children with cancer is low as compared with that of high-income countries due to the limited number of specialised oncology healthcare professionals, especially nurses. To address this problem, a number of paediatric oncology education and training programmes have been developed for nurses. The objective of this scoping review is to describe the existing literature focusing on paediatric oncology nursing education and training programmes; to map the content, delivery methods, duration and mode of assessment. METHODS The review will include articles published in English, from 2012 to 2022, that describe a paediatric oncology nursing education programme, from any setting. The review will follow Joanna Briggs Institute methodology for scoping reviews guidelines. A systematic search of literature will be performed in CINAHL, Dimensions, Embase, PubMed and Scopus. A two-stage standardised screening process will be employed to evaluate eligibility of the articles. All abstracts that will be considered relevant will be reviewed in full text form by the two reviewers independently. Conflicts will be resolved by consensus of all reviewers through a meeting. Data will be extracted by two independent reviewers using a developed data extraction tool. The results will be reported in extraction tables and diagrams with a narrative summary. ETHICS AND DISSEMINATION This scoping review is part of the multiphase study which obtained ethical clearance from College of Medicine Research Ethics Committee in Malawi and Human Research Ethics Committee of the University of Witwatersrand, South Africa. The scoping review will be published in a peer reviewed journal. The findings will also be presented at national and international conferences. TRIAL REGISTRATION NUMBER https://doi.org/10.17605/OSF.IO/X3Q4H.
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Affiliation(s)
- Maureen Daisy Majamanda
- Child Health Nursing, Kamuzu University of Health Sciences, Blantyre, Malawi
- Consortium for Advanced Research Training in Africa, Nairobi, Kenya
- Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
| | - Felix Chisoni
- Library, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Apatsa Selemani
- Consortium for Advanced Research Training in Africa, Nairobi, Kenya
- Library, Kamuzu University of Health Sciences, Blantyre, Malawi
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Irene Kearns
- Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
| | - Johanna Maree
- Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
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3
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Bagnasco A, Rossi S, Dasso N, Catania G, Zanini M, Aleo G, Scelsi S, Petralia P, Watson R, Sasso L. Exploring Care Left Undone in Pediatric Nursing. J Patient Saf 2022; 18:e903-e911. [PMID: 35617633 DOI: 10.1097/pts.0000000000001044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to investigate the association between nursing care left undone in pediatrics and factors related to nursing staff characteristics and work environment. METHODS The data of the present study were extracted from our RN4CAST@IT-Ped database, a cross-sectional observational study, which included 13 hospitals belonging to the Italian Association of Paediatric Hospitals. Through convenience sampling, nurses and pediatric nurses providing direct care in routine pediatric wards were enrolled in the study. Data aggregated by clinical care area were analyzed, through descriptive and inferential statistics methods using IBM SPSS 22.0 software. RESULTS We collected data from 399 pediatric nurses working in surgical wards, 1208 in medical wards, and 631 in critical care units. Some of the investigated factors have shown an association with the risk of omitting essential nursing activities, like health care judged of poor quality, patient safety judged as poor, and nurses' intention-to-leave the job. For every nursing activity under investigation, we found some significant statistical associations. CONCLUSIONS Our results are consistent with the international literature showing that nurses miss some activities more frequently. Understanding the associations underpinning care left undone could be a starting point for the implementation of patient-centered care and the improvement of the quality and safety of care in pediatric settings, as well as the work environment.
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Affiliation(s)
| | - Silvia Rossi
- From the Department of Health Sciences, University of Genoa
| | | | | | - Milko Zanini
- From the Department of Health Sciences, University of Genoa
| | - Giuseppe Aleo
- From the Department of Health Sciences, University of Genoa
| | | | | | - Roger Watson
- Faculty of Health and Social Care, University of Hull, Hull, England, United Kingdom
| | - Loredana Sasso
- From the Department of Health Sciences, University of Genoa
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4
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Lake ET, Roberts KE, Agosto PD, Ely B, Bettencourt A, Schierholz E, Frankenberger W, Catania G, Aiken LH. The Association of the Nurse Work Environment and Patient Safety in Pediatric Acute Care. J Patient Saf 2021; 17:e1546-e1552. [PMID: 30601233 PMCID: PMC6599539 DOI: 10.1097/pts.0000000000000559] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Eighteen years ago, the Institute of Medicine estimated that medical errors in hospital were a major cause of mortality. Since that time, reducing patient harm and improving the culture of patient safety have been national health care priorities. The study objectives were to describe the current state of patient safety in pediatric acute care settings and to assess whether modifiable features of organizations are associated with better safety culture. METHODS An observational cross-sectional study used 2015-2016 survey data on 177 hospitals in four U.S. states, including pediatric care in general hospitals and freestanding children's hospitals. Pediatric registered nurses providing direct patient care assessed hospital safety and the clinical work environment. Safety was measured by items from the Agency for Healthcare Research and Quality's Culture of Patient Safety survey. Hospital clinical work environment was measured by the National Quality Forum-endorsed Practice Environment Scale. RESULTS A total of 1875 pediatric nurses provided an assessment of safety in their hospitals. Sixty percent of pediatric nurses gave their hospitals less than an excellent grade on patient safety; significant variation across hospitals was observed. In the average hospital, 46% of nurses report that mistakes are held against them and 28% do not feel safe questioning authority regarding unsafe practices. Hospitals with better clinical work environments received better patient safety grades. CONCLUSIONS The culture of patient safety varies across U.S. hospital pediatric settings. In better clinical work environments, nurses report more positive safety culture and higher safety grades.
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Affiliation(s)
- Eileen T. Lake
- University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, Pennsylvania
| | | | - Paula D. Agosto
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Beth Ely
- University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, Pennsylvania
| | - Amanda Bettencourt
- University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, Pennsylvania
| | - Elizabeth Schierholz
- University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, Pennsylvania
| | | | - Gianluca Catania
- University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, Pennsylvania
- University of Genoa, School of Medicine and Pharmaceutical Sciences, Genoa, Italy
| | - Linda H. Aiken
- University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, Pennsylvania
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5
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Gampetro PJ, Segvich JP, Jordan N, Velsor-Friedrich B, Burkhart L. Perceptions of Pediatric Hospital Safety Culture in the United States: An Analysis of the 2016 Hospital Survey on Patient Safety Culture. J Patient Saf 2021; 17:e288-e298. [PMID: 30933017 DOI: 10.1097/pts.0000000000000602] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Medical errors in the pediatric population can quickly cause harm. Research identified that hospitals with positive safety cultures work collaboratively to reduce errors. Strategies that identify gaps in hospital's safety culture within the pediatric milieu have not been initiated. This study addressed this gap from an interprofessional perspective. METHODS This cross-sectional descriptive study used data from the Agency for Healthcare Research and Quality's 2016 Hospital Patient Safety Culture survey measuring 12 safety culture dimensions for registered nurses (RNs), physician assistants/nurse practitioners (PAs/NPs), physicians (MDs), and administrators/managers (n = 6682) in the United States that were employed in 287 (42%) pediatric hospitals or specialty units. RESULTS Findings indicated that in the United States, the overall safety culture had low levels of agreement. Pairings between pediatric RNs, PAs/NPs, and MDs had similar levels of agreement for all dimensions but the perceptions of these three practitioners differed when compared with pediatric administrators/managers in nine of the 12 dimensions. The perceptions of pediatric RNs and MDs differed in six of the 12 dimensions, with MDs indicating higher levels of agreement. All four professional groups rated teamwork within hospital units with the highest level of agreement (mean, 4.14), with hospital handoffs and transitions rated the lowest (mean, 2.64). All four professional groups found punitive cultures (mean, 2.71) throughout the pediatric specialty. CONCLUSIONS Variations regarding pediatric professional's perception of safety culture exist within U.S. hospitals. Effective and creative management will support cultures that prevents harm and improves the overall safety of children's care with initiatives that are dedicated to excellence.
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Affiliation(s)
- Pamela J Gampetro
- From the Department of Women, Children and Family Health Sciences, College of Nursing, University of Illinois at Chicago
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6
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Abstract
BACKGROUND Evidence suggests that Magnet and non-Magnet hospitals differ with respect to quality of care. PURPOSE Our study examined registered nurse (RN) staffing over time in Magnet and non-Magnet hospitals using unit-level, publicly available data in New Jersey. METHODS A secondary analysis of longitudinal RN staffing data was conducted using mandated, publicly reported data of 64 hospitals representing 12 nursing specialties across 8 years (2008-2015). Staffing ratios were trended over time to compare RN staffing changes in Magnet and non-Magnet hospitals. RESULTS Staffing was comparable in Magnet and non-Magnet hospitals for 9 of 12 specialties. On average, from 2008 until 2015, RN staffing slightly increased, with a greater percent increase in Magnet hospitals (6.9%) than in non-Magnet hospitals (4.7%). CONCLUSIONS Over 8 years in New Jersey, RN staffing improved in Magnet and non-Magnet hospitals. Although there was a slight increase for Magnet hospitals, there was no meaningful difference in staffing for all 12 specialties.
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7
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Lasater KB, Clark RRS, McCabe MA, Frankenberger WD, Agosto PM, Riman KA, Aiken LH. Predictors of specialty certification among paediatric hospital nurses. J Clin Nurs 2020; 30:200-206. [PMID: 33090594 DOI: 10.1111/jocn.15540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To evaluate differences in hospitals' proportion of specialty certified nurses and to determine whether and to what extent individual nurse characteristics and organisational hospital characteristics are associated with a nurse's likelihood of having specialty certification. BACKGROUND Prior research has shown that patients in hospitals with high proportions of specialty certified nurses have better outcomes including lower mortality and fewer adverse events, yet less is known about what motivates nurses to obtain specialty certification. METHODS AND DESIGN Cross-sectional study of paediatric nurses in 119 acute care hospitals. Multivariate logistic regression models were used to determine the association between individual nurse characteristics, organisational hospital characteristics and an individual nurses' likelihood of holding a specialty certification. STROBE was followed. RESULTS The proportion of certified nurses varies substantially among hospitals, with Magnet® hospitals being significantly more likely, on average, to have higher proportions of certified nurses. Nurses in children's hospitals were no more likely than paediatric nurses in general hospitals to be certified. A nurse's years of experience and bachelors-preparation were significantly associated with higher odds of having certification. The strongest predictors of certification were favourable nurse work environments and Magnet® -designation of the hospital. CONCLUSIONS While individual attributes of the nurse were associated with a nurse's likelihood of having a specialty certification, the strongest predictors of certification were modifiable attributes of the hospital-a favourable nurse work environment and Magnet® -designation. RELEVANCE TO CLINICAL PRACTICE Hospital administrators seeking to increase the proportion of specialty certified nurses in their organisation should look to improvements in the organisation's nurse work environment as a possible mechanism.
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Affiliation(s)
- Karen B Lasater
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca R S Clark
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Margaret A McCabe
- Center for Pediatric Nursing Research and Evidenced-Based Practice, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Paula M Agosto
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kathryn A Riman
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Linda H Aiken
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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8
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Lasater KB, McCabe MA, Lake ET, Frankenberger WD, Roberts KE, Agosto PD, Riman KA, Bettencourt AP, Schierholz ES, Catania G, Aiken LH. Safety and Quality of Pediatric Care in Freestanding Children's and General Hospitals. Hosp Pediatr 2020; 10:408-414. [PMID: 32253353 DOI: 10.1542/hpeds.2019-0234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate quality and safety of care in acute pediatric settings from the perspectives of nurses working at the bedside and to investigate hospital-level factors associated with more favorable quality and safety. METHODS Using data from a large survey of registered nurses in 330 acute care hospitals, we described nurses' assessments of safety and quality of care in inpatient pediatric settings, including freestanding children's hospitals (FCHs) (n = 21) and general hospitals with pediatric units (n = 309). Multivariate logistic regression models were used to estimate the effects of being a FCH on favorable reports on safety and quality before and after adjusting for hospital-level and nurse characteristics and Magnet status. RESULTS Nurses in FCHs were more likely to report favorably on quality and safety after we accounted for hospital-level and individual nurse characteristics; however, adjusting for a hospital's Magnet status rendered associations between FCHs and quality and safety insignificant. Nurses in Magnet hospitals were more likely to report favorably on quality and safety. CONCLUSIONS Quality and safety of pediatric care remain uneven; however, the organizational attributes of Magnet hospitals explain, in large part, more favorable quality and safety in FCHs compared with pediatric units in general acute care hospitals. Modifiable features of the nurse work environment common to Magnet hospitals hold promise for improving quality and safety of care. Transforming nurse work environments to keep patients safe, as recommended by the National Academy of Medicine 20 years ago, remains an unfinished agenda in pediatric inpatient settings.
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Affiliation(s)
- Karen B Lasater
- Center for Health Outcomes and Policy Research, School of Nursing and .,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | | | - Eileen T Lake
- Center for Health Outcomes and Policy Research, School of Nursing and.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | | | | | - Paula D Agosto
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kathryn A Riman
- Center for Health Outcomes and Policy Research, School of Nursing and.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | | | | | - Gianluca Catania
- Center for Health Outcomes and Policy Research, School of Nursing and
| | - Linda H Aiken
- Center for Health Outcomes and Policy Research, School of Nursing and.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania; and
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9
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Bagnasco A, Dasso N, Rossi S, Timmins F, Aleo G, Catania G, Zanini M, Sasso L. A qualitative descriptive inquiry of the influences on nurses' missed care decision-making processes in acute hospital paediatric care. J Nurs Manag 2020; 28:1929-1939. [PMID: 31845542 DOI: 10.1111/jonm.12935] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/29/2019] [Accepted: 12/12/2019] [Indexed: 12/13/2022]
Abstract
AIM To explore influences on nurses' missed care decision-making processes in acute hospital paediatric care. BACKGROUND Many contemporary studies describe the phenomenon of missed care. It is clear that environment and organizational culture influence the nursing activities; however, what influences their decision-making processes has not been investigated. METHOD A descriptive qualitative inquiry was performed using semi-structured interviews with paediatric nurses (n = 20) from one Italian paediatric hospital. FINDINGS Thematic analysis revealed four themes: nurses' value system; hospital logistics, structures and resources; prioritization processes; and the informal caregiver's role. CONCLUSION This paper offers insights into the various factors involved in nurses' decision-making process when contemplating missed care that will be of use to managers when planning care or addressing missed care in the paediatric clinical setting. IMPLICATIONS FOR NURSING MANAGEMENT Knowledge and awareness of missed care in children's nursing needs greater exploration, especially in relation to what influences nurses' decision-making choices around missed care. Overall, a greater understanding of this will help managers to manage situations effectively and ethically so that missed care does not impact on outcomes for children in health care.
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Affiliation(s)
| | - Nicoletta Dasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Silvia Rossi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Fiona Timmins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Italy
| | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
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10
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Marcin JP, Romano PS, Dayal P, Dharmar M, Chamberlain JM, Dudley N, Macias CG, Nigrovic LE, Powell EC, Rogers AJ, Sonnett M, Tzimenatos L, Alpern ER, Andrews-Dickert R, Borgialli DA, Sidney E, Casper TC, Kuppermann N. Provider-Level and Hospital-Level Factors and Process Measures of Quality Care Delivered in Pediatric Emergency Departments. Acad Pediatr 2020; 20:524-531. [PMID: 31760173 PMCID: PMC9701102 DOI: 10.1016/j.acap.2019.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 11/13/2019] [Accepted: 11/16/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Differences in the quality of emergency department (ED) care are often attributed to nonclinical factors such as variations in the structure, systems, and processes of care. Few studies have examined these associations among children. We aimed to determine whether process measures of quality of care delivered to patients receiving care in children's hospital EDs were associated with physician-level or hospital-level factors. METHODS We included children (<18 years old) who presented to any of the 12 EDs participating in the Pediatric Emergency Care Applied Research Network (PECARN) between January 2011 and December 2011. We measured quality of care from medical record reviews using a previously validated implicit review instrument with a summary score ranging from 5 to 35, and examined associations between process measures of quality and physician- and hospital-level factors using a mixed-effects linear regression model adjusted for patient case-mix, with hospital site as a random effect. RESULTS Among the 620 ED encounters reviewed, we did not find process measures of quality to be associated with any physician-level factors such as physician sex, years since medical school graduation, or physician training. We found, however, that process measures of quality were positively associated with delivery at freestanding children's hospitals (1.96 points higher in quality compared to nonfreestanding status, 95% confidence interval: 0.49, 3.43) and negatively associated with higher annual ED patient volume (-0.03 points per thousand patients, 95% confidence interval: -0.05, -0.01). CONCLUSION Process measures of quality of care delivered to children were higher among patients treated at freestanding children's hospitals but lower among patients treated at higher volume EDs.
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11
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Morrissey L, Lurvey M, Sullivan C, Challinor J, Forbes PW, Abramovitz L, Afungchwi GM, Hollis R, Day S. Disparities in the delivery of pediatric oncology nursing care by country income classification: International survey results. Pediatr Blood Cancer 2019; 66:e27663. [PMID: 30786168 DOI: 10.1002/pbc.27663] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND In 2014, a task force of the International Society of Paediatric Oncology (SIOP) Paediatric Oncology in Developing Countries Nursing Workgroup published six baseline standards to provide a framework for pediatric oncology nursing care in low- and lower-middle income countries (L/LMIC). We conducted an international survey in 2016-2017 to examine the association between country income level and nurses' resporting of conformity to the standards at their respective institutions. PROCEDURE Data from a cross-sectional web-based survey completed by nurses representing 54 countries were analyzed (N = 101). Responses were clustered by relevance to each standard and compared according to the 2017 World Bank-defined country income classification (CIC) of hospitals. RESULTS CIC and nurse-to-patient ratios in inpatient wards were strongly associated (P < 0.0001). Nurses in L/LMIC prepared chemotherapy more often (P < 0.0001) yet were less likely to have access to personal protective equipment such as nitrile gloves (P = 0.0007) and fluid-resistant gowns (P = 0.011) than nurses in high-resource settings. Nurses in L/LMIC were excluded more often from physician/caregiver meetings to discuss treatment options (P = 0.04) and at the time of diagnosis (P = 0.002). Key educational topics were missing from nursing orientation programs across all CICs. An association between CIC and the availability of written policies (P = 0.009) was found. CONCLUSIONS CIC and the ability to conform to pediatric oncology baseline nursing standards were significantly associated in numerous elements of the baseline standards, a likely contributor to suboptimal patient outcomes in L/LMIC. To achieve the goal of high-quality cancer care for children worldwide, nursing disparities must be addressed.
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Affiliation(s)
- Lisa Morrissey
- Department of Nursing, Boston Children's Hospital, Boston, Massachusetts
| | - Megan Lurvey
- Department of Nursing, Boston Children's Hospital, Boston, Massachusetts
| | - Courtney Sullivan
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Julia Challinor
- School of Nursing, University of California, San Francisco, California
| | - Peter W Forbes
- Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts
| | - Linda Abramovitz
- School of Nursing, University of California, San Francisco, California.,Global Cancer Program, University of California, San Francisco, California
| | | | - Rachel Hollis
- Department of Nursing, Leeds Children's Hospital, Leeds, United Kingdom
| | - Sara Day
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee.,College of Nursing, University of Tennessee Health Science Center, Memphis, Tennessee
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12
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Bagnasco A, Zanini M, Aleo G, Catania G, Kalisch BJ, Sasso L. Development and validation of the
MISSCARE
survey – Pediatric version. J Adv Nurs 2018; 74:2922-2934. [DOI: 10.1111/jan.13837] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 06/28/2018] [Accepted: 07/05/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | - Milko Zanini
- Department of Health Sciences University of Genoa Genoa Italy
| | - Giuseppe Aleo
- Department of Health Sciences University of Genoa Genoa Italy
| | | | | | - Loredana Sasso
- Department of Health Sciences University of Genoa Genoa Italy
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13
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Aiken LH, Sloane DM, Lake ET, Agosto P, Roberts KE. Is Magnet recognition associated with improved outcomes among critically ill children treated at freestanding children's hospitals? J Crit Care 2017; 43:372. [PMID: 29079325 DOI: 10.1016/j.jcrc.2017.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 10/13/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Linda H Aiken
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States.
| | - Douglas M Sloane
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Eileen T Lake
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Paula Agosto
- Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Kathryn E Roberts
- Children's Hospital of Philadelphia, Philadelphia, PA, United States
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14
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Sasso L, Bagnasco A, Petralia P, Scelsi S, Zanini M, Catania G, Aleo G, Dasso N, Rossi S, Watson R, Sermeus W, Icardi G, Aiken LH. RN4CAST@IT-Ped: Nurse staffing and children's safety. J Adv Nurs 2017; 74:1223-1225. [PMID: 28960392 DOI: 10.1111/jan.13462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Loredana Sasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Paolo Petralia
- General Directorate, Gaslini Children's Hospital, Genoa, Italy
| | - Silvia Scelsi
- General Directorate, Gaslini Children's Hospital, Genoa, Italy
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Nicoletta Dasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Silvia Rossi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Roger Watson
- School of Health & Social Work, University of Hull, Hull, UK
| | - Walter Sermeus
- Department of Public Health & Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Linda H Aiken
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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15
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Lake ET, de Cordova PB, Barton S, Singh S, Agosto PD, Ely B, Roberts KE, Aiken LH. Missed Nursing Care in Pediatrics. Hosp Pediatr 2017; 7:378-384. [PMID: 28611146 DOI: 10.1542/hpeds.2016-0141] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVES A growing literature suggests that missed nursing care is common in hospitals and may contribute to poor patient outcomes. There has been scant empirical evidence in pediatric populations. Our objectives were to describe the frequency and patterns of missed nursing care in inpatient pediatric settings and to determine whether missed nursing care is associated with unfavorable work environments and high nurse workloads. METHODS A cross-sectional study using registered nurse survey data from 2006 to 2008 was conducted. Data from 2187 NICU, PICU, and general pediatric nurses in 223 hospitals in 4 US states were analyzed. For 12 nursing activities, nurses reported about necessary activities that were not done on their last shift because of time constraints. Nurses reported their patient assignment and rated their work environment. RESULTS More than half of pediatric nurses had missed care on their previous shift. On average, pediatric nurses missed 1.5 necessary care activities. Missed care was more common in poor versus better work environments (1.9 vs 1.2; P < .01). For 9 of 12 nursing activities, the prevalence of missed care was significantly higher in the poor environments (P < .05). In regression models that controlled for nurse, nursing unit, and hospital characteristics, the odds that a nurse missed care were 40% lower in better environments and increased by 70% for each additional patient. CONCLUSIONS Nurses in inpatient pediatric care settings that care for fewer patients each and practice in a professionally supportive work environment miss care less often, increasing quality of patient care.
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Affiliation(s)
- Eileen T Lake
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania;
| | - Pamela B de Cordova
- Division of Nursing Science, Rutgers, The State University of New Jersey College of Nursing, New Brunswick, New Jersey
| | - Sharon Barton
- University of Louisville School of Nursing, Louisville, Kentucky; and
| | - Shweta Singh
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Paula D Agosto
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Beth Ely
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Linda H Aiken
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
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16
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Wegner W, Silva MUMD, Peres MDA, Bandeira LE, Frantz E, Botene DZDA, Predebon CM. Patient safety in the care of hospitalised children: evidence for paediatric nursing. ACTA ACUST UNITED AC 2017; 38:e68020. [PMID: 28492813 DOI: 10.1590/1983-1447.2017.01.68020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 01/11/2017] [Indexed: 12/28/2022]
Abstract
Objectives To describe evidence of international literature on the safe care of the hospitalised child after the World Alliance for Patient Safety and list contributions of the general theoretical framework of patient safety for paediatric nursing. Method An integrative literature review between 2004 and 2015 using the databases PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science and Wiley Online Library, and the descriptors Safety or Patient safety, Hospitalised child, Paediatric nursing, and Nursing care. Results Thirty-two articles were analysed, most of which were from North American, with a descriptive approach. The quality of the recorded information in the medical records, the use of checklists, and the training of health workers contribute to safe care in paediatric nursing and improve the medication process and partnerships with parents. Conclusion General information available on patient safety should be incorporated in paediatric nursing care.
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Affiliation(s)
- Wiliam Wegner
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | | | - Merianny de Avila Peres
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Larissa Edom Bandeira
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Elemara Frantz
- Centro Universitário Metodista IPA, Curso de Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | | | - Caroline Maier Predebon
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
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17
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Alavi A, Zargham-Boroujeni A, Yousefy A, Bahrami M. Altruism, the values dimension of caring self-efficacy concept in Iranian pediatric nurses. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2017; 6:8. [PMID: 28546973 PMCID: PMC5433645 DOI: 10.4103/jehp.jehp_142_14] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND Self-efficacy is the most influential among factors affecting nurses' performance. Yet, understanding of the constituent elements of the caring self-efficacy concept was not considered. This study was to introduce altruism as one of the main aspects of caring self-efficacy in pediatric nurses. MATERIALS AND METHODS This is part of a larger study on the concept of caring self-efficacy conducted with qualitative content analysis approach in Iran. Participants included 27 clinical pediatric nurses and instructors, selected purposively. Data were collected using semi-structured interviews and analyzed using conventional content analysis method. RESULTS Theme "altruism" as one of the main themes extracted from the analysis of the interviews in this study. This theme includes two main categories of "humanistic care" and "caring attitude." CONCLUSIONS This paper introduces altruism as one of the values aspects of caring self-efficacy in pediatric nurses. Efficient nurse with features Humanistic care, through the provision of maternal care and family-centered care and caring attitudes resulting from religious beliefs and loving children to care for the children.
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Affiliation(s)
- Azam Alavi
- School of Nursing and Midwifery, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
| | - Ali Zargham-Boroujeni
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Yousefy
- Medical Education Research Center, Isfahan University of Medical Science, Isfahan, Iran
| | - Masoud Bahrami
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
- Address for correspondence: Dr. Masoud Bahrami, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
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18
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Alavi A, Bahrami M, Zargham-Boroujeni A, Yousefy A. Characteristics of caring self-efficacy in pediatric nurses: a qualitative study. J SPEC PEDIATR NURS 2015; 20:157-64. [PMID: 25845908 DOI: 10.1111/jspn.12110] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 02/24/2015] [Accepted: 02/28/2015] [Indexed: 12/11/2022]
Abstract
PURPOSE The present study was conducted to clarify pediatric nurses' characteristics of caring self-efficacy. DESIGN AND METHODS This study was conducted using a qualitative content analysis approach. The participants included 27 pediatric nurses and clinical instructors, selected purposively. Data were collected using semi-structured interviews and were analyzed using the content analysis method. RESULTS Data analysis generated four main themes as attributes of a self-efficient pediatric nurse including: (a) professional communications; (b) management of care; (c) altruism; and (d) proficiency. PRACTICE IMPLICATIONS Nursing managers and instructors can use these results to help develop nurses' empowerment and self-efficacy, especially in pediatric care.
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Affiliation(s)
- Azam Alavi
- Faculty of Nursing and Midwifery, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
| | - Masoud Bahrami
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Zargham-Boroujeni
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Yousefy
- Medical Education Research Center, Isfahan University of Medical Science, Isfahan, Iran
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19
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Alavi A, Bahrami M, Zargham-Boroujeni A, Yousefy A. Threats to Pediatric Nurses' Perception of Caring Self-efficacy: A Qualitative Study. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 18:e25716. [PMID: 27247779 PMCID: PMC4884443 DOI: 10.5812/ircmj.25716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 12/16/2014] [Accepted: 01/04/2015] [Indexed: 11/16/2022]
Abstract
Background: Nurses are considered the largest and most important human resource for healthcare organizations. Self-efficacy as the main predictor of nurses’ behavior plays an important role in nurses’ professional behavior. However, the various dimensions and threats of caring self- efficacy concept have not been taken into consideration. Objectives: The present paper attempts to identify threats to self-efficacy as an important aspect of the concept of pediatric nurses’ caring self-efficacy. Materials and Methods: This study is part of a larger study on the caring self-efficacy concept that was conducted through content analysis and from a qualitative approach in 2014 in Iran. Twenty-seven nurses and pediatric clinical instructors participated in this research according to the purposive sampling method employed in the study. Data were collected through semi-structured interviews. The collected data were analyzed using the conventional content analysis method. Results: “Threats to self-efficacy” was one of the main themes extracted from the interview analysis results in the present study. The theme consists of two main categories “individual barriers,” including not having a caring attitude and not being interested in children, and “organizational barriers,” including an inefficient educational system, not developing professional capabilities, non-valuation of the organization in a caring context, a poor rewards system, and inappropriate managerial policies. Conclusions: Nursing management and custodians of nursing trainings can break through the barriers to self-efficacy by knowing these factors and making changes in the educational programs and providing supporting policies. This can be an important step toward improving nurses’ inefficacy and ultimately improving the provision of quality healthcare services.
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Affiliation(s)
- Azam Alavi
- Faculty of Nursing and Midwifery, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran
| | - Masoud Bahrami
- Faculty of Nursing and Midwifery, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IR Iran
- Corresponding Author: Masoud Bahrami, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IR Iran. Tel: +98-9103143825, Fax: +98-36699398, E-mail:
| | - Ali Zargham-Boroujeni
- Faculty of Nursing and Midwifery, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran
| | - Alireza Yousefy
- Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran
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20
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Pediatric nurses' perception of factors associated with caring self-efficacy: A qualitative content analysis. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2015; 20:232-8. [PMID: 25878702 PMCID: PMC4387649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 09/23/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Nurses, who are considered to form the largest group of professional healthcare providers, face the challenge of maintaining, promoting, and providing quality nursing care and to prepare themselves to function confidently and to care effectively. Among the factors affecting nursing performance, self-efficacy has been expected to have the greatest influence. However, the concept of caring self-efficacy was not considered and no research has been done in this field in Iran. This study was conducted to explore and identify the factors described by pediatric nurses as related to caring self-efficacy. MATERIALS AND METHODS This is a qualitative study conducted through content analysis in 2013 in Iran. Twenty-four participants were selected through purposive sampling method from pediatric nurses and educators. Data were collected through semi-structured interviews. Data were analyzed using conventional content analysis method. RESULTS The analysis of the interviews in this study led to the development of four main themes: (1) Professional knowledge of children caring, (2) experience, (3) caring motivation, and (4) efficient educational system as the factors influencing caring self-efficacy perception of pediatric nurses. CONCLUSIONS This article presents the factors associated with the perception of caring self-efficacy in pediatric nurses' perspective. This finding can be used by nursing administrators and instructors, especially in the area of pediatric caring, to enhance nursing professional practice and the quality of pediatric caring.
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