Staffing, teamwork and scope of practice: Analysis of the association with patient safety in the context of rehabilitation

The Effects of a Simulation-Based Patient Safety Education Program on Compliance with Patient Safety, Perception of Patient Safety Culture, and Educational Satisfaction of Operating Room Nurses

BACKGROUND

Operating rooms (ORs) are healthcare areas that are high-risk regarding patient safety (PS). The prevention of PS errors such as wrong-site surgery, medication errors, and patient falls is important in the OR. Causes such as having insufficient information, not taking enough care and precautions, and inattention may lead to errors. Ensuring PS in an organization depends on the composition of a PS culture.

METHOD

This study, as equivalent-control-group pretest-posttest research, aimed to develop and apply a simulation-based patient safety education program for operating room nurses and then to examine the influence of the program on patient safety management and compliance. Participants included a total of 45 operating room nurses: 22 in the experimental group and 23 in the control group. In the program, each member of the experimental and control groups underwent two 60 min sessions for a total of 120 min. Person-to-person individual lectures and simulation-based practice were provided to the experimental group, whereas booklets and person-to-person individual lectures were provided to the control group. Compliance with patient safety, the perception of patient safety culture, and satisfaction were measured using a structured Likert questionnaire. Intervention effects were analyzed using a t-test and ANCOVA.

RESULTS

As a result of the analysis, we found that the experimental group was significantly higher in terms of compliance with patient safety (p = 0.021), the perception of patient safety culture (p = 0.039), and education satisfaction (p < 0.001) than the control group.

CONCLUSIONS

The results indicate that implementing a simulation-based patient safety education program can improve the patient safety competency of operating room nurses and, ultimately, prevent patient safety accidents in the operating room.

The Relationship of Nursing Teamwork and Job Satisfaction in Hospitals

Introduction

Teamwork is identified as a key contributor to patient safety and good teamwork is recognized as one of the presumptions of healthy work environment in nursing. The importance of job satisfaction in nursing has repeatedly been confirmed, but only recently has the association of job satisfaction and nursing teamwork been identified.

Objective

To identify the level of nursing teamwork in hospitals in Iceland and its relationship with job satisfaction.

Methods

This was a quantitative descriptive cross-sectional study. Data were collected with the Nursing Teamwork Survey administered to nursing staff in medical, surgical, and intensive care units in hospitals in Iceland. This study is based on data from 567 participants.

Results

A logistic regression analysis indicated that work experience on current unit and perceived staffing adequacy contributes to job satisfaction and when controlling for unit type, role, experience on current unit and staffing adequacy, those reporting better teamwork are significantly more likely to be satisfied with their current position. With an additional unit for overall nursing teamwork, participants are almost five times likelier to be satisfied with their current position.

Conclusion

Study findings show that there is a significant relationship between nursing teamwork and job satisfaction. The findings of this study confirm the importance of adequate staffing and good teamwork for nurses' job satisfaction. Staffing however, will remain the most challenging part of the equation as lack of nursing staff is foreseen globally in the coming decades turning the spotlight to teamwork. All stakeholders, including clinical nurse leaders, administrators, and instructors, need to emphasize on strengthening nursing teamwork. Good teamwork with increased job satisfaction may prevent turnover and shortage of nurses, an issue expected to grow during and following the COVID-19 pandemic. Facilitating good teamwork should be one of the priorities of every nurse leader.

Trabalho de equipa no cuidado a pessoas idosas: especificidades do especialista em enfermagem de reabilitação

Introdução: Perante os desafios da sociedade atual cada vez mais envelhecida, o trabalho em equipa entre enfermeiros e enfermeiros especialistas de reabilitação é imprescindível para garantir qualidade na assistência à saúde dos idosos. Objetivo: Analisar a diferença entre a prática profissional dos enfermeiros de cuidados gerais e dos enfermeiros especialistas de reabilitação, no trabalho de equipa desenvolvido no cuidado a pessoas idosas. Metodologia: Estudo quantitativo, descritivo-exploratório, comparativo, de corte. Amostra não probabilística, por conveniência, constituída por 192 enfermeiros a exercerem funções com idosos em contexto hospitalar e comunitário, na região norte de Portugal. Utilizado um questionário ad hoc de autopreenchimento, contemplando variáveis: características sociodemográficas, atividades/práticas desenvolvidas pelos enfermeiros na assistência aos idosos e a escala de interdependência de tarefas. Resultados: Amostra composta por 85,9% enfermeiros e 14,1% enfermeiros especialistas; 76,0% exerce funções em saúde comunitária e 24,0% em hospitais. Existem diferenças entre as informações partilhadas em equipa, valorizando os enfermeiros de reabilitação o pedido de colaboração para continuidade assistencial, as condições sociais e a medicação, enquanto os demais, a alteração da situação de doença. São unânimes as opiniões sobre o contacto direto como estratégia preferencial para a partilha de informações em equipa. Sobre a interdependência de tarefas, a diferença é que os enfermeiros de reabilitação dependem de ajuda e suporte dos colegas, para concretizarem a sua prática profissional. Conclusão: Há especificidades na ação dos enfermeiros de reabilitação, no cuidado a idosos, sugerindo que sejam líderes no seio das equipas. As lacunas identificadas no trabalho de equipa exigem (re)pensar as práticas.

Recommendations to support the mental wellbeing of nurses and midwives in the United Kingdom: A Delphi study

AIM

To use the Delphi technique to identify and prioritize recommendations for research and practice to improve the mental wellbeing of nurses and midwives in the United Kingdom (UK).

BACKGROUND

Although there is evidence that self-reported mental wellbeing among nurses and midwives in the UK is poor, interventions have not adequately considered the wider context in which they work. The wide range of individual, organizational, occupational and wider sector-level factors that can influence wellbeing requires the involvement of different stakeholders to identify the most pressing actions required.

DESIGN

A three-round Delphi technique was conducted in 2019.

METHODS

In the first round, 16 subject matter experts generated, reviewed and discussed recommendations from a review of the research evidence with potential to support the mental wellbeing of nurses. A second group with 23 stakeholder representatives then rated and provided feedback on the developed recommendations through two additional rounds. Recommendations that received an 'essential' or 'important' rating from at least 80% of participants were retained and prioritized.

RESULTS

In total, 45 recommendations met the consensus agreement and were retained. More than half (57%) involved action at the organizational level, 27% to public policy and 13% to research. Only one recommendation is related to the individual. Collectively, these recommendations highlight the importance of taking direct action to tackle poor mental wellbeing among the workforce and initiating change at the policy and organizational level.

CONCLUSION

Our findings emphasize the need to take a systemic approach to improving the mental health of nurses and midwives in the UK with input from different stakeholders. There is a clear consensus that action is needed at the organization and policy levels, rather than at the individual level as is current practice.

IMPACT

This study provides a framework, alongside a set of practical recommendations, that provides a starting point for different stakeholders to understand, address and support the mental wellbeing of nurses and midwives. Although UK-focused, it has relevance to healthcare workforces internationally.