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Søndergaard SF, Andersen AB, Frederiksen K. APN nurses' core competencies for general clinical health assessment in primary health care. A scoping review. Scand J Caring Sci 2024; 38:258-272. [PMID: 38246856 DOI: 10.1111/scs.13235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 11/28/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND The field of Advanced Practice Nursing (APN) has developed over the past six decades. However, the definition of roles and responsibilities of APN nurses seem to be contested due to both a lack of a clear definition of the concept and to institutional and cultural barriers that restrict the nurses' opportunities to practise to the full extent of their competencies. AIM The objective of this scoping review was to identify, examine and conceptually map the available literature on APN nurses' core competencies for general health assessment in primary health care. METHOD We performed a scoping review, following the methodological guidance for reporting as it is described by the Joanna Briggs Institute (JBI). Furthermore, the PRISMA-ScR statement and checklist for reporting scoping reviews were followed. Guiding the initial process for the search, we used the Population, Concept and Context mnemonic (PCC) to clarify the focus and context of the review. RESULTS We found three areas of core competencies on which APN nurse draw in performing general health assessments in primary health care: (1) 'Collaborative, leadership and management skills' (2) 'Person-centred nursing care skills' and (3) 'Academic and educational skills'. Furthermore, we found that the three areas are interrelated, because it is crucial that APN nurses draw on collaborative competencies related to leadership and management to meet the service users' needs and deliver high-quality and person-centred care. CONCLUSION There is a need for a more specific investigation into how APN nurses' core competencies play a role during general health assessments of patients in primary care. We suggest an evaluation of what works for whom in what circumstances looking into the interrelation between competencies, skills and knowledge when an APN nurse performs a general health assessment in a primary healthcare setting.
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Affiliation(s)
- Susanne Friis Søndergaard
- Section for Nursing and Health Care, Institute for Public Health, Aarhus University, Aarhus, Denmark
| | - Anne Bendix Andersen
- VIA University College, School of Nursing and Research Centre for Health and Welfare Technology, Viborg, Denmark
| | - Kirsten Frederiksen
- Section for Nursing and Health Care, Institute for Public Health, Aarhus University, Aarhus, Denmark
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Delgado SA, Blake NT, Brown T, Clark L, Needleman J, Cassidy L. Diverse perspectives on unit-level nurse staffing ratios in medical-surgical units: A Delphi policy analysis. Nurs Outlook 2024; 72:102184. [PMID: 38810534 DOI: 10.1016/j.outlook.2024.102184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 04/21/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Appropriate staffing is essential to acute care delivery. Staffing ratio policy generates controversy. PURPOSE This study examines perspectives on unit-level nurse-to-patient ratio policy in adult medical-surgical units. METHOD Delphi methodology uses an invited diverse panel to analyze a policy's effects. Panelists completed iterative surveys about the impact they expect from unit-level ratio policy. FINDINGS Panelists demonstrated moderate agreement that the proposed policy could increase staffing levels, decrease patient length of stay, and reduce nurse attrition. Other potential outcomes included reducing staffing in units above the minimum and increasing short-term costs. Panelists agreed that the policy could increase patient safety and nurse satisfaction and did not agree about the effect on long-term cost and innovation. Panelists also anticipated a mostly positive effect on patients and nurses. DISCUSSION Policies that set unit-level nurse-to-patient ratios offer a potential strategy to improve medical-surgical staffing. Policy design should consider the range of expected outcomes.
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Affiliation(s)
- Sarah A Delgado
- American Association of Critical-Care Nurses, Aliso Viejo, CA.
| | - Nancy T Blake
- University of California Los Angeles, School of Nursing, Los Angeles, CA; Los Angeles General Medical Center, Los Angeles, CA
| | - Theresa Brown
- University of California Los Angeles, School of Nursing, Los Angeles, CA
| | - Lauren Clark
- University of California Los Angeles, School of Nursing, Los Angeles, CA
| | - Jack Needleman
- University of California Los Angeles, School of Nursing, Los Angeles, CA; Department of Health Policy, and Management, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Linda Cassidy
- American Association of Critical-Care Nurses, Aliso Viejo, CA
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Doyle BR, Smith LM, Marshall JL, Carlisle BA, Perera AC. Consistently Exploring Nurse Staffing and Neurocritical Care Unit Turnover. J Neurosci Nurs 2024; 56:54-59. [PMID: 38232239 DOI: 10.1097/jnn.0000000000000742] [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: 01/19/2024]
Abstract
ABSTRACT BACKGROUND: Staffing models within nursing units have long been a hot topic of discussion. The COVID-19 pandemic exacerbated this discussion by straining the national nursing environment and workforce. Before the pandemic, the neuroscience intensive care unit (NSICU) primarily used an acuity-adjusted staffing model and aimed for a nurse-to-patient ratio of 1:1.5. During and after the pandemic, the NSICU was forced to primarily use a centralized staffing model because of the increased turnover in the hospital at large and a rise in patient census. METHODS : Unit census data in an NSICU were tracked before, during, and after the pandemic alongside utilization of a centralized staffing model in the hospital at large. RESULTS : During this time, the NSICU saw a statistically significant increase in average nurse-to-patient ratio and incidences of both floating and tripled assignments. The NSICU simultaneously saw a 180% increase in nursing turnover. CONCLUSION : Although we cannot prove that a centralized staffing model is directly responsible for higher nursing turnover, its utilization led to greater incidence of poor staffing-reflected in deviation from the nurse-to-patient ratio goal of the unit. Nurse staffing concerns play a large role in nurse satisfaction in the workforce: staffing shortages have been described both as a precursor to and as a consequence of increased nursing turnover.
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Tait D, Davis D, Roche MA, Paterson C. Nurse/midwife-to-patient ratios: A scoping review. Contemp Nurse 2024:1-13. [PMID: 38408182 DOI: 10.1080/10376178.2024.2318361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/08/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND A significant body of work has linked high nurse or midwife workload to negative patient outcomes. Anecdotal reports suggest that mandated ratio models enhance patient care and improve nurse job satisfaction. However, there is limited focused research. OBJECTIVE To identify key outcomes, implementation processes, and research needs regarding nurse/midwife-to-patient ratios in the Australian healthcare context. DESIGN Scoping review. METHODS Data sources were CINAHL, Open Dissertations, Medline, and Scopus. 289 articles screened, and 53 full text documents independently assessed against criteria by two reviewers and conflicts resolved by a third reviewer, using Covidence™. Three studies were included in this review. RESULTS Studies focused on nurse (job satisfaction, burnout), patient (mortality, readmission, length of stay) and system (costs) outcomes with limited information on implementation processes and no midwifery research. CONCLUSIONS Ratios provide benefits for patients, nurses, and hospitals although there is limited research in Australia. Implementation was poorly reported..
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Affiliation(s)
- Darcy Tait
- Australian Catholic University, School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Watson, Australian Capital Territory, Australia
| | - Deborah Davis
- University of Canberra, School of Nursing, Midwifery and Public Health, Faculty of Health & ACT Government Health Directorate, Bruce, Australian Capital Territory, Australia
| | - Michael A Roche
- University of Canberra, School of Nursing, Midwifery and Public Health, Faculty of Health & ACT Government Health Directorate, Bruce, Australian Capital Territory, Australia
- University of Technology Sydney, School of Nursing and Midwifery, Faculty of Health, Ultimo, New South Wales, Australia
| | - Catherine Paterson
- University of Canberra, School of Nursing, Midwifery and Public Health, Faculty of Health & ACT Government Health Directorate, Bruce, Australian Capital Territory, Australia
- Robert Gordon University, School of Nursing, Midwifery & Paramedic Practice, Garthdee, UK
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Hooper V. 2024: Moving to a New Reimbursement Model for Nursing. J Perianesth Nurs 2024; 39:1-2. [PMID: 38307695 DOI: 10.1016/j.jopan.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 02/04/2024]
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Al-Anati A, Molloy L, Lafleur C, Watts G, Elmir H, Frost SA. Regarding '10 years on from the publication of the Francis report'. It is interesting to read 'Nursing Notes on a Scandal' (Rafferty & Leary, 2023). Int Nurs Rev 2024. [PMID: 38174930 DOI: 10.1111/inr.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024]
Affiliation(s)
- Abdelrahman Al-Anati
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Luke Molloy
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | | | | | - Hind Elmir
- Liverpool Hospital, Liverpool, Australia
| | - Steven A Frost
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
- South Western Sydney Nursing and Midwifery Research Alliance, Ingham Institute of Applied Medical Research, Liverpool Hospital, Wollongong, Australia
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Molla F, Temesgen WA, Kerie S, Endeshaw D. Nurses' Documentation Practice and Associated Factors in Eight Public Hospitals, Amhara Region, Ethiopia: A Cross-Sectional Study. SAGE Open Nurs 2024; 10:23779608241227403. [PMID: 38268952 PMCID: PMC10807310 DOI: 10.1177/23779608241227403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/12/2023] [Accepted: 01/02/2024] [Indexed: 01/26/2024] Open
Abstract
Background Nursing care documentation, which is the record of nursing care that is planned for and delivered to individual patients, can enhance patient outcomes while advancing the nursing profession. However, its practice and associated factors among Ethiopian nurses are not well investigated. Objective To assess the level of nursing care documentation practice and associated factors among nurses working at public hospitals in Ethiopia. Methods An institutional-based cross-sectional study was conducted from May 1 to 30, 2022. A total of 378 nurses and corresponding charts were randomly selected with a multistage sampling technique. Self-administered structured questionnaires and structured checklists were used to collect data about independent variables and nurses' documentation practice, respectively. Epi Data 4.6 was used for data entry and SPSS version 25 for analysis. Descriptive statistics and binary logistic regression analysis have been employed. The STROBE checklist was used to report the study. Results In this study, 372 nurses participated, and 30.4% (95% confidence interval [CI]: 26%-35%) of them had good nursing care documentation practice. Adequate knowledge about nursing care documentation(adjusted odds ratio [AOR] = 4.16, 95% CI: [2.36-7.33]), favorable attitude toward nursing care documentation (AOR = 3.43, 95% CI: [1.85-6.36]), adequacy of documenting sheets (AOR = 2.02, 95% CI: [1.14-3.59]), adequacy of time (AOR = 3.85, 95% CI: [2.11-7.05]), nurse-to-patient ratio (AOR = 2.78, 95% CI: [1.13-6.84]), and caring patients who had no stress, anxiety, pain, and distress (AOR = 3.56, 95% CI: [1.69-7.52]) were significantly associated with proper nursing care documentation practices. Conclusion Nursing documentation practice was poor in this study compared to the health sector transformation in quality standards due to the identified factors. Improving nurses' knowledge and attitude toward nursing care documentation and increasing access to documentation materials can contribute to improving documentation practice.
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Affiliation(s)
- Fitalew Molla
- Debark Hospital, Amhara Regional Health Bureau, Debark, Ethiopia
| | - Worku Animaw Temesgen
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Sitotaw Kerie
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Destaw Endeshaw
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Alanazi FK, Lapkin S, Molloy L, Sim J. The impact of safety culture, quality of care, missed care and nurse staffing on patient falls: A multisource association study. J Clin Nurs 2023; 32:7260-7272. [PMID: 37309059 DOI: 10.1111/jocn.16792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/08/2023] [Accepted: 05/29/2023] [Indexed: 06/14/2023]
Abstract
AIMS To examine the association between nursing unit safety culture, quality of care, missed care and nurse staffing levels, and inpatient falls using two data sources: incidence of falls and nurses' perceptions of fall frequency in their units. The study explores the association between the two sources of patient falls and identifies if nurses' perceptions of patient fall frequency reflect the actual patient falls recorded in the incident management system. BACKGROUND Inpatient falls are associated with severe complications that result in extended hospitalisation and increased financial consequences for patients and healthcare services. DESIGN A multi-source cross-sectional study guided by the STROBE guidelines. METHODS A purposive sample of 33 nursing units (619 nurses) from five hospitals completed an online survey from August to November 2021. The survey measured safety culture, quality of care, missed care, nurse staffing levels and nurses' perceptions of patient fall frequency. In addition, secondary data on falls from participating units between 2018 and 2021 were also collected. Generalised linear models were fitted to examine the association between study variables. RESULTS Nursing units with strong safety climate and working conditions and lower missed care were associated with lower rates of falls using both data sources. Nurses' perceptions of the frequency of falls in their units were reflective of the actual incidence rate of falls, but the association was not statistically significant. CONCLUSION Nursing units with a strong safety climate and better collaborations between nurses and other professionals, including physicians and pharmacists, were associated with lower incidents of patient falls. RELEVANCE TO CLINICAL PRACTICE This study provided evidence for healthcare services and hospital managers to minimise patient falls. PATIENT OR PUBLIC CONTRIBUTION Patients who had experienced a fall, which was reported in the incident management system, from the included units in the five hospitals were part of this study.
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Affiliation(s)
| | - Samuel Lapkin
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
- Discipline of Nursing, Faculty of Health, Southern Cross University, Gold Coast, Queensland, Australia
| | - Luke Molloy
- Discipline of Nursing, Faculty of Health, Southern Cross University, Gold Coast, Queensland, Australia
| | - Jenny Sim
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
- World Health Organization Collaborating Centre for Nursing, Midwifery & Health Development, University of Technology Sydney, Ultimo, New South Wales, Australia
- School of Nursing & Midwifery, University of Newcastle, Callaghan, New South Wales, Australia
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Alanazi FK, Lapkin S, Molloy L, Sim J. Safety culture, quality of care, missed care, nurse staffing and their impact on pressure injuries: A cross-sectional multi-source study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2023. [DOI: 10.1016/j.ijnsa.2023.100125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
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Lee SE, Hyunjie L, Sang S. Nurse Managers' Leadership, Patient Safety, and Quality of Care: A Systematic Review. West J Nurs Res 2023; 45:176-185. [PMID: 35876005 DOI: 10.1177/01939459221114079] [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: 12/27/2022]
Abstract
This review examined relationships between nurse unit managers' leadership and patient safety and quality of care outcomes in hospital settings. Employing four databases (CINAHL, Embase, PubMed, and Web of Science) and ancestry searches, we identified 14 English-language, peer-reviewed, primary studies that examined such relationships using quantitative analyses. The studies were published between 2012 and 2021, and most used a cross-sectional design. Each study's quality was assessed using the Mixed-Method Appraisal Tool. In synthesizing results by categorizing outcomes, we found a positive trend in associations between effective nurse unit manager leadership and better outcomes, including fewer patient adverse events, increased nurse error reporting, and higher patient satisfaction and care quality. However, the heterogeneity of leadership measurement approaches and outcomes limited integration of study findings. Future researchers should clearly define study concepts to support interpretation of their findings and should use a suitable theoretical framework to help determine appropriate units of analysis.
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Affiliation(s)
- Seung Eun Lee
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Lee Hyunjie
- Severance Hospital, College of Nursing, Graduate School, Yonsei University, Seoul, South Korea
| | - Somin Sang
- College of Nursing, Graduate School, Yonsei University, Seoul, South Korea
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Stock G, McDermott C. The effects of physicians on operational and financial performance in United States hospitals: staffing, human capital and knowledge spillovers. INTERNATIONAL JOURNAL OF OPERATIONS & PRODUCTION MANAGEMENT 2023. [DOI: 10.1108/ijopm-07-2022-0457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PurposeThe authors examine how physician staffing, human capital and knowledge spillovers are related to multiple dimensions of hospital operational and financial performance at the organizational level.Design/methodology/approachThe authors use a data set assembled from multiple sources for more than 1,300 US hospitals and employ hierarchical linear regression to test this study’s hypotheses. The authors use multiple quality, efficiency and financial measures of performance for these hospitals.FindingsThe authors find that higher levels of staffing, skills and knowledge spillovers associated with physicians were positively associated with multiple dimensions of hospital performance. The authors find linear and nonlinear relationships between experience and performance, with the relationships primarily negative, and nonlinear relationships between spillovers and quality performance.Practical implicationsHospital managers should consider increasing physician staffing levels if possible. In addition, the overall Final MIPS Score from the Centers for Medicare and Medicaid Services might be included as a factor in determining which physicians practice in a hospital. Finally, if possible, encouraging physicians to practice at multiple hospitals will likely be beneficial to hospital performance.Originality/valueThis study’s findings are original in that they explore how physician-specific staffing and human capital, which have received comparatively little attention in the literature, are related to several different dimensions of hospital-level operational and financial performance. To the best of the authors’ knowledge, this paper is also the first to examine the relationship between the construct of physician knowledge spillovers and hospital-level operational and financial performance.
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Ali M, Neo C, Rajeev A, Bhatnagar S. The Role of Frailty Scores to Predict the Outcomes in Non Operative Treatment of Valgus Impacted Neck of Femur Fractures. ACTA MEDICA (HRADEC KRALOVE) 2023; 66:112-116. [PMID: 38511421 DOI: 10.14712/18059694.2024.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
OBJECTIVES The management of valgus-impacted neck of femur fracture is controversial between operative and conservative treatments. This study aimed to investigate the usefulness of the Clinical frailty Score for predicting the prognosis of patients who underwent non-operative treatment for the valgus-impacted neck of femur fracture (NOF). METHODS A single-centred retrospective review of patients admitted with valgus impacted NOF. Data were collected from patients' records, including demographics, Clinical Frailty Score (CFS), Nottingham Hip Fracture Score (NHFS) and Abbreviated Mental Test Score (AMTS). Patients were followed up to 24 months postoperatively. RESULTS Fifty-eight patients who were treated non-operatively with a mean follow-up of 2.6 years met our inclusion criteria. Twenty-nine patients failed the non-operative treatment and required replacement surgeries, while 29 had successful outcomes (50%). There were no differences between the two groups' mean age and gender distributions (P 0.527 and 0.139, respectively). The successful group had significantly higher CFS (P 0.013), worse AMTS and higher mortality risk based on the NHFS (P 0.006 and P < 0.001, respectively). CONCLUSION This study demonstrates that CFS, AMTS and NHFS can be used as predictors when considering non-operative treatment for the valgus-impacted neck of femur fracture. Patients who are frail, demented and high risk based on the NHFS have higher success rates with non-operative treatment.
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Affiliation(s)
- Mohammed Ali
- Department of Trauma and Orthopaedics, Royal Victoria Infirmary, Newcastle, United Kingdom.
| | - Chryssa Neo
- Department of Trauma and Orthopaedics, Gateshead health Foundation NHS Trust, Gateshead, United Kingdom
| | - Aysha Rajeev
- Department of Trauma and Orthopaedics, Gateshead health Foundation NHS Trust, Gateshead, United Kingdom
| | - Sharad Bhatnagar
- Department of Trauma and Orthopaedics, Royal Victoria Infirmary, Newcastle, United Kingdom
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Effect of Stress on Quality of Life of Shift Nurses in Tertiary General Hospital: The Mediating Effect of Mindfulness. Healthcare (Basel) 2022; 11:healthcare11010071. [PMID: 36611531 PMCID: PMC9819357 DOI: 10.3390/healthcare11010071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
The purpose of this study was to examine the mediating effects of mindfulness on the relationships between stress and quality of life among shift nurses. A descriptive cross-sectional survey design was conducted using purposive sampling of 206 shift nurses in a tertiary general hospital in Korea. Data were analyzed with descriptive statistics, Pearson correlation and multiple regression analysis using SPSS/WIN 26.0 program. There were significant correlations among stress, mindfulness and quality of life. The quality of life had a positive correlation with mindfulness (r = 0.52, p < 0.001) and a negative correlation with stress among nurses. Mindfulness acts as a mediator in explaining relationship between stress and quality of life. This study provide evidence for the role of mindfulness in the relationship between stress and quality of life in shift nurses. Mindfulness appears to be a protective factor against nurses’ stress. If mindfulness-based interventions are developed and applied to improve the quality of life of shift nurses based on this study, it can help reduce their stress and improve the quality of life, which could ultimately improve the quality of nursing care for patients.
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Hellín Gil MF, Roldán Valcárcel MD, Seva Llor AM, Ibáñez-López FJ, Mikla M, López Montesinos MJ. Validation of a Nursing Workload Measurement Scale, Based on the Classification of Nursing Interventions, for Adult Hospitalization Units. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15528. [PMID: 36497604 PMCID: PMC9737816 DOI: 10.3390/ijerph192315528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/12/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
UNLABELLED We conducted validation of a scale to measure nursing workloads, previously designed using NIC interventions within the four nursing functions (patient care, teaching, management, and research). METHODS This is an analytical, descriptive, prospective, and observational study using qualitative methodology (focus groups and in-depth interviews) with a quantitative and qualitative section (committee of experts and real application of the scale through a validation pilot and with multicentric application, including hospitalization units of internal medicine and surgery of four hospitals). Qualitative analysis was performed with Atlas.ti8 and quantitative analysis with R. RESULTS Qualitatively, all the participants agreed on the need to measure workloads in all nursing functions with standardized terminology. The expert committee found greater relevance (91.67%) in "prevention" and "health education" as well as consistency with the construct and adequate wording in 99% of the selected items. In the pilot test and multicenter application, the nurses spent more time on the caring dimension, in the morning shift, and on the items "self-care", "medication", "health education", "care of invasive procedures", "wounds care", "comfort", and "fluid therapy". Cronbach's alpha 0.727, composite reliability 0.685, AVE 0.099, and omega coefficient 0.704 were all acceptable. Construct validity: KMO 0.5 and Bartlett's test were significant. CONCLUSIONS The scale can be considered valid to measure nursing workloads, both qualitatively in obtaining the consensus of experts and health personnel and quantitatively, with acceptable reliability and validity superior to other similar scales.
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Affiliation(s)
- María Fuensanta Hellín Gil
- Faculty of Nursing, University of Murcia, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - María Dolores Roldán Valcárcel
- Faculty of Nursing, University of Murcia, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Ana Myriam Seva Llor
- Faculty of Nursing, University of Murcia, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | | | - Marzena Mikla
- Faculty of Nursing, University of Murcia, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - María José López Montesinos
- Faculty of Nursing, University of Murcia, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
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Imam A, Obiesie S, Aluvaala J, Maina JM, Gathara D, English M. Identifying gaps in global evidence for nurse staffing and patient care outcomes research in low/middle-income countries: an umbrella review. BMJ Open 2022; 12:e064050. [PMID: 36223964 PMCID: PMC9562716 DOI: 10.1136/bmjopen-2022-064050] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To identify nurse staffing and patient care outcome literature in published systematic reviews and map out the evidence gaps for low/middle-income countries (LMICs). METHODS We included quantitative systematic reviews on nurse staffing levels and patient care outcomes in regular ward settings published in English. We excluded qualitative reviews or reviews on nursing skill mix. We searched the Cochrane Register of Systematic Reviews, the Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, Medline, Embase and Cumulative Index to Nursing and Allied Health Literature from inception until July 2021. We used the A Measurement Tool to Assess Systematic Reviews -2 (AMSTAR-2) criteria for risk of bias assessment and conducted a narrative synthesis. RESULTS From 843 papers, we included 14 in our final synthesis. There were overlaps in primary studies summarised across reviews, but overall, the reviews summarised 136 unique primary articles. Only 4 out of 14 reviews had data on LMIC publications and only 9 (6.6%) of 136 unique primary articles were conducted in LMICs. Only 8 of 23 patient care outcomes were reported from LMICs. Less research was conducted in contexts with staffing levels that are typical of many LMIC contexts. DISCUSSION Our umbrella review identified very limited data for nurse staffing and patient care outcomes in LMICs. We also identified data from high-income countries might not be good proxies for LMICs as staffing levels where this research was conducted had comparatively better staffing levels than the few LMIC studies. This highlights a critical need for the conduct of nurse staffing research in LMIC contexts. LIMITATIONS We included data on systematic reviews that scored low on our risk of bias assessment because we sought to provide a broad description of the research area. We only considered systematic reviews published in English and did not include any qualitative reviews in our synthesis. PROSPERO REGISTRATION NUMBER CRD42021286908.
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Affiliation(s)
- Abdulazeez Imam
- Health Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sopuruchukwu Obiesie
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Jalemba Aluvaala
- Health Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | | | - David Gathara
- Wellcome Trust Research Program, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Maternal Adolescent Reproductive and Child Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Mike English
- Health Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Nhongo D, Holt A, Flenady T, Rebar A, Bail K. Nurse staffing and adverse events in residential aged care: Retrospective multi-site analysis. Collegian 2022. [DOI: 10.1016/j.colegn.2022.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Zaranko B, Sanford NJ, Kelly E, Rafferty AM, Bird J, Mercuri L, Sigsworth J, Wells M, Propper C. Nurse staffing and inpatient mortality in the English National Health Service: a retrospective longitudinal study. BMJ Qual Saf 2022; 32:254-263. [PMID: 36167797 PMCID: PMC10176371 DOI: 10.1136/bmjqs-2022-015291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/15/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To examine the impact of nursing team size and composition on inpatient hospital mortality. DESIGN A retrospective longitudinal study using linked nursing staff rostering and patient data. Multilevel conditional logistic regression models with adjustment for patient characteristics, day and time-invariant ward differences estimated the association between inpatient mortality and staffing at the ward-day level. Two staffing measures were constructed: the fraction of target hours worked (fill-rate) and the absolute difference from target hours. SETTING Three hospitals within a single National Health Service Trust in England. PARTICIPANTS 19 287 ward-day observations with information on 4498 nurses and 66 923 hospital admissions in 53 inpatient hospital wards for acutely ill adult patients for calendar year 2017. MAIN OUTCOME MEASURE In-hospital deaths. RESULTS A statistically significant association between the fill-rate for registered nurses (RNs) and inpatient mortality (OR 0.9883, 95% CI 0.9773 to 0.9996, p=0.0416) was found only for RNs hospital employees. There was no association for healthcare support workers (HCSWs) or agency workers. On average, an extra 12-hour shift by an RN was associated with a reduction in the odds of a patient death of 9.6% (OR 0.9044, 95% CI 0.8219 to 0.9966, p=0.0416). An additional senior RN (in NHS pay band 7 or 8) had 2.2 times the impact of an additional band 5 RN (fill-rate for bands 7 and 8: OR 0.9760, 95% CI 0.9551 to 0.9973, p=0.0275; band 5: OR 0.9893, 95% CI 0.9771 to 1.0017, p=0.0907). CONCLUSIONS RN staffing and seniority levels were associated with patient mortality. The lack of association for HCSWs and agency nurses indicates they are not effective substitutes for RNs who regularly work on the ward.
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Affiliation(s)
| | - Natalie Jean Sanford
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, UK
| | - Elaine Kelly
- Institute for Fiscal Studies, London, UK.,The Health Foundation, London, UK
| | - Anne Marie Rafferty
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, UK
| | - James Bird
- Imperial College Healthcare NHS Trust, London, UK
| | - Luca Mercuri
- Research Informatics Team, Imperial College Healthcare NHS Trust, London, UK
| | | | - Mary Wells
- Imperial College Healthcare NHS Trust, London, UK
| | - Carol Propper
- Institute for Fiscal Studies, London, UK .,Department of Economics and Public Policy, Imperial College Business School, London, UK
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18
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Arsat N, Chua BS, Wider W, Dasan N. The Impact of Working Environment on Nurses' Caring Behavior in Sabah, Malaysia. Front Public Health 2022; 10:858144. [PMID: 35462810 PMCID: PMC9021378 DOI: 10.3389/fpubh.2022.858144] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/02/2022] [Indexed: 11/25/2022] Open
Abstract
Aims This study aims to investigate 5 types of work environment influencing nurses' caring behavior, namely (i) participation in hospital affairs, (ii) foundations for quality of care, (iii) manager ability, leadership, and support of nurses, (iv) staffing and resource adequacy, and (v) nurse-physician relations. Design This research is a cross-sectional study using the survey method. Methods Data were collected from 3,532 nurses working in public hospitals and health clinics within Sabah, Malaysia in 2015. The hypothesized model was evaluated using partial least squares method. Results The findings reveal that all forms of work environment have a positive effect on nurses' caring behavior except for staffing and resource adequacy which shows a negative effect on caring behavior. Conclusion Overall, this study has added to theoretical contributions in the academic and research fields as well as in practical implications in the field of nursing practice by addressing the influence of work environments on caring behavior. Implications for Nursing Management The present research has provided convergent evidence on the role of the working environment in influencing the behavior of nurses working in hospitals and health clinics in Sabah, Malaysia.
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Affiliation(s)
- Norkiah Arsat
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Bee Seok Chua
- Faculty of Psychology and Education, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Walton Wider
- Faculty of Business and Communication, INTI International University, Nilai, Malaysia
- *Correspondence: Walton Wider
| | - Norsimah Dasan
- Faculty of Psychology and Education, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
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Correlation of the US News and World Report–Calculated Nurse Staffing Index With Actual Hospital-Reported Nurse Staffing. J Nurs Care Qual 2022; 37:195-198. [DOI: 10.1097/ncq.0000000000000619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Cañón-Montañez W. Contributions of Systematic Reviews and Meta-analyses to Nursing Education, Research, and Practice. AQUICHAN 2021. [DOI: 10.5294/aqui.2021.21.4.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Systematic reviews and meta-analyses are helpful methodological alternatives that combine, discuss, and assess the quality of the best available evidence through adequate and exhaustive searches of the literature. In the last decade, there has been an increase in systematic reviews and meta-analyses in nursing research. This article intends to reflect on the contributions of systematic reviews and meta-analyses to nursing education, research, and practice. Synthesizing the evidence through high-quality systematic reviews and meta-analyses adds to the disciplinary development of nursing; therefore, students and professionals in the field should be encouraged to employ these methodological tools in education and research and implement the results of these methods in clinical practice for making better decisions regarding the individual needs of patients.
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