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Han KT, Kim S. Does improved nurse staffing impact patient outcomes in cancer? Association between chronic diseases and mortality among older adult patients with lung cancer in Korea. PLoS One 2024; 19:e0301010. [PMID: 38718027 PMCID: PMC11078420 DOI: 10.1371/journal.pone.0301010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 03/09/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Evidence regarding the impact of nurse staffing on the health outcomes of older adult patients with cancer is scarce. Therefore, this study aimed to evaluate the impact of nurse staffing on long-term and short-term mortality in elderly lung cancer patients. METHODS This study analyzed data from 5,832 patients with lung cancer in Korea from 2008 to 2018. Nursing grade was considered to assess the effect of nursing staff on mortality in older adult patients with lung cancer. The Cox proportional hazards model was used to evaluate the effect of the initial treatment hospital's nursing grade on one- and five-year mortality. Additionally, economic status and treatment type of patients were analyzed. RESULTS Approximately 31% of older adult patients with lung cancer died within one year post-diagnosis. Patients in hospitals with superior nursing grades (lower nurse-to-bed ratios) exhibited lower mortality rates. Hospitals with nursing grades 2 and 3 exhibited approximately 1.242-1.289 times higher mortality than grade 1 hospitals. Further, the lower the nursing grade (higher nurse-to-bed ratio), the higher the five-year mortality rate. CONCLUSION Both short- and long-term mortality rates for older adult patients with lung cancer increased at inferior nursing grades. Treatment in hospitals having inferior nursing grades, upon initial hospitalization, may yield better outcomes. This study provides valuable insight into the quality of adequate staffing to improve the quality of care for elderly cancer patients.
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Affiliation(s)
- Kyu-Tae Han
- Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Seungju Kim
- Department of Health System, College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
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Tan AK, Capezuti E, Samuels WE, Backhaus R, Wagner LM. Intent to stay, moral distress, and nurse practice environment among long-term care nurses: A cross-sectional questionnaire survey study. J Nurs Scholarsh 2024; 56:430-441. [PMID: 38169102 DOI: 10.1111/jnu.12953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/07/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Many long-term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed, at least in part, to moral distress and a negative nurse practice environment. OBJECTIVE The purpose of the study was divided into two parts: first, to investigate the relationships among nurse practice environment, moral distress, and intent to stay; second, to explore the potential mediating effect of the nurse practice environment on the intent to stay among those with high levels of moral distress. DESIGN This study was a descriptive, cross-sectional survey using targeted sampling. PARTICIPANTS A total of 215 participants completed the surveys. Participants were nationally representative of long-term care nurses by age, years of experience, employment status, and type of health setting. METHODS This study was an online national survey of long-term care nurses' perceptions of their intent to stay, moral distress level (Moral Distress Questionnaire), and nurse practice environment (Direct Care Staff Survey). Structural equation modeling analysis explored intent to stay, moral distress, and the nurse practice environment among long-term care nurses. RESULTS The mean moral distress score was low, while the mean nurse practice environment and intent to stay scores were high. Moral distress had a significant, moderately negative association with the nurse practice environment (β = -0.41), while the nurse practice environment had a significant, moderately positive association with intent to stay (β = 0.46). The moral distress had a significant, moderately negative association with intent to stay (β = -0.20). The computed structural equation modeling suggested a partially mediated model (indirect effect = -0.19, p = 0.001). CONCLUSION Since the nurse practice environment partially mediates the relationship between moral distress and intent to stay, interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession. CLINICAL RELEVANCE Our study demonstrated that the nurse practice environment mediates moral distress and intent to stay. Interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.
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Affiliation(s)
- Amil Kusain Tan
- The Graduate Center, City University of New York, New York, New York, USA
- Hunter-Bellevue School of Nursing, Hunter College of CUNY, New York, New York, USA
| | - Elizabeth Capezuti
- The Graduate Center, City University of New York, New York, New York, USA
- Hunter-Bellevue School of Nursing, Hunter College of CUNY, New York, New York, USA
| | - William Ellery Samuels
- The Graduate Center, City University of New York, New York, New York, USA
- Hunter-Bellevue School of Nursing, Hunter College of CUNY, New York, New York, USA
| | - Ramona Backhaus
- Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, Netherlands
| | - Laura M Wagner
- University of California San Francisco, San Francisco, California, USA
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Bachnick S, Unbeck M, Ahmadi Shad M, Falta K, Grossmann N, Holle D, Bartakova J, Musy SN, Hellberg S, Dillner P, Atoof F, Khorasanizadeh M, Kelly-Pettersson P, Simon M. TAILR (Nursing-Sensitive Events and Their Association With Individual Nurse Staffing Levels) Project: Protocol for an International Longitudinal Multicenter Study. JMIR Res Protoc 2024; 13:e56262. [PMID: 38648083 PMCID: PMC11074892 DOI: 10.2196/56262] [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: 01/19/2024] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Nursing-sensitive events (NSEs) are common, accounting for up to 77% of adverse events in hospitalized patients (eg, fall-related harm, pressure ulcers, and health care-associated infections). NSEs lead to adverse patient outcomes and impose an economic burden on hospitals due to increased medical costs through a prolonged hospital stay and additional medical procedures. To reduce NSEs and ensure high-quality nursing care, appropriate nurse staffing levels are needed. Although the link between nurse staffing and NSEs has been described in many studies, appropriate nurse staffing levels are lacking. Existing studies describe constant staffing exposure at the unit or hospital level without assessing patient-level exposure to nurse staffing during the hospital stay. Few studies have assessed nurse staffing and patient outcomes using a single-center longitudinal design, with limited generalizability. There is a need for multicenter longitudinal studies with improved potential for generalizing the association between individual nurse staffing levels and NSEs. OBJECTIVE This study aimed (1) to determine the prevalence, preventability, type, and severity of NSEs; (2) to describe individual patient-level nurse staffing exposure across hospitals; (3) to assess the effect of nurse staffing on NSEs in patients; and (4) to identify thresholds of safe nurse staffing levels and test them against NSEs in hospitalized patients. METHODS This international multicenter study uses a longitudinal and observational research design; it involves 4 countries (Switzerland, Sweden, Germany, and Iran), with participation from 14 hospitals and 61 medical, surgery, and mixed units. The 16-week observation period will collect NSEs using systematic retrospective record reviews. A total of 3680 patient admissions will be reviewed, with 60 randomly selected admissions per unit. To be included, patients must have been hospitalized for at least 48 hours. Nurse staffing data (ie, the number of nurses and their education level) will be collected daily for each shift to assess the association between NSEs and individual nurse staffing levels. Additionally, hospital data (ie, type, teaching status, and ownership) and unit data (ie, service line and number of beds) will be collected. RESULTS As of January 2024, the verification process for the plausibility and comprehensibility of patients' and nurse staffing data is underway across all 4 countries. Data analyses are planned to be completed by spring 2024, with the first results expected to be published in late 2024. CONCLUSIONS This study will provide comprehensive information on NSEs, including their prevalence, preventability, type, and severity, across countries. Moreover, it seeks to enhance understanding of NSE mechanisms and the potential impact of nurse staffing on these events. We will evaluate within- and between-hospital variability to identify productive strategies to ensure safe nurse staffing levels, thereby reducing NSEs in hospitalized patients. The TAILR (Nursing-Sensitive Events and Their Association With Individual Nurse Staffing Levels) study will focus on the optimization of scarce staffing resources. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56262.
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Affiliation(s)
- Stefanie Bachnick
- Department of Nursing Science, University of Applied Sciences, Bochum, Germany
| | - Maria Unbeck
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Maryam Ahmadi Shad
- Institute of Nursing Science, Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Katja Falta
- Department of Nursing Science, University of Applied Sciences, Bochum, Germany
| | - Nicole Grossmann
- Institute of Nursing Science, Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Daniela Holle
- Department of Nursing Science, University of Applied Sciences, Bochum, Germany
| | - Jana Bartakova
- Institute of Nursing Science, Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland
- Health Economics Facility, Department of Public Health, University of Basel, Basel, Switzerland
| | - Sarah N Musy
- Institute of Nursing Science, Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Sarah Hellberg
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
- Department of Orthopaedics, Danderyd University Hospital, Stockholm, Sweden
| | - Pernilla Dillner
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Fatemeh Atoof
- Social Determinants of Health Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Paula Kelly-Pettersson
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
- Department of Orthopaedics, Danderyd University Hospital, Stockholm, Sweden
| | - Michael Simon
- Institute of Nursing Science, Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland
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Gomez-Rexrode AE, Lane M, Ashbaugh K, Kamdar N, Sears ED. The Impact of COVID-19 on Rates of Pressure Injuries Among Hospitalized Patients across the US. Adv Skin Wound Care 2024; 37:1-9. [PMID: 38393707 DOI: 10.1097/asw.0000000000000109] [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: 02/25/2024]
Abstract
OBJECTIVE To determine the impact of the COVID-19 pandemic on hospital-acquired pressure injury (HAPI) rates and composition of HAPI stages among hospitalized patients across the US. METHODS Using encounter-level data from a nationwide healthcare insurance claims database, the authors conducted a retrospective cohort study and an interrupted time-series analysis to determine HAPI rates among hospitalized patients within 90 days of admission before (January 2018 to February 2020) and after (March 2020 to December 2020) the onset of the COVID-19 pandemic. Of 3,418,438 adult patients assessed for inclusion in the study, 1,750,494 met the inclusion criteria. Outcomes measured included the presence of a HAPI within 90 days of admission and HAPI stage based on the International Classification of Diseases, 10th Revision diagnosis codes. RESULTS The authors identified HAPIs in 59,175 episodes of care, representing 59,019 unique patients and corresponding to an overall HAPI rate of 2.65%. Baseline characteristics did not vary significantly across the two time periods. Further, HAPI rates were consistent across the time periods analyzed with no significant differences in rates following the onset of the pandemic (P = .303). Composition of HAPI stages remained consistent across the pandemic (unspecified, stages 1-4, Ps = .62, .80, .22, .23, and .52, respectively) except for a significant decrease in unstageable/deep tissue pressure injuries (-0.088%, P = .0134). CONCLUSIONS Although hospital resources were strained at the peak of the COVID-19 pandemic, no differences were identified in HAPI rates among the study's cohort of privately insured patients.
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Affiliation(s)
- Amalia E Gomez-Rexrode
- Amalia E. Gomez-Rexrode, BS, is Medical Student, University of Michigan Medical School, Ann Arbor, Michigan. Megan Lane, MD, is Resident Physician, Department of Surgery, University of Michigan, and Researcher, Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan. Also at the Institute for Healthcare Policy and Innovation, Kathryn Ashbaugh, BA, is Data Architect, and Neil Kamdar, MA, is Statistical Analysis Manager. Erika D. Sears, MD, MS, is Associate Professor of Surgery and Program Associate Department of Surgery, University of Michigan. Acknowledgments: Amalia E. Gomez-Rexrode received one-time research funding as a medical student through the NIH Supported Short Term Biomedical Research Training Program. The authors have disclosed no other financial relationships related to this article. Submitted February 25, 2023; accepted in revised form April 27, 2023
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Khatatbeh H, Al‐Dwaikat T, Rababah J, Oláh A, Pakai A. Paediatric nurses' burnout, quality of life and perceived patient adverse events during the COVID-19 pandemic: Testing an integrated model using structural equation modelling. J Clin Nurs 2024; 33:255-264. [PMID: 34719846 PMCID: PMC8662054 DOI: 10.1111/jocn.16114] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/30/2021] [Accepted: 10/14/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE A model was hypothesised by integrating two theoretical models: the compassion satisfaction-compassion fatigue and empowerment models. This study aimed to assess the extent to which this integrated model can explain the relationships between paediatric nurses' burnout quality of life, perceived patient safety and work-related variables during the COVID-19 pandemic. BACKGROUND Nurses' burnout is negatively associated with quality of life (QOL) and positively with patient safety. Several theoretical models were introduced to explain burnout determinants and outcomes such as Golembiewski, Munzenrider and Stevenson model, Leiter and Maslach's process model, and Lee and Ashforth's model. However, few models described burnout in relation to QOL or patient safety. METHODS A sample of 225 paediatric nurses responded to questionnaires about burnout, QOL, adverse events and work-related variables. Compassion satisfaction - compassion fatigue and empowerment models were integrated into a single model and tested using structural equation modelling analysis. This study was prepared and is reported according to the STROBE checklist. RESULTS The final model explained 65% of the variance of burnout and 37% of the variance of QOL. The work-related variables (co-workers' support, job satisfaction, satisfaction with the monthly salary, participation in continuous education and exposure to violence) are predicting paediatric nurses' burnout and quality of life. CONCLUSION The Compassion satisfaction - compassion fatigue -Empowerment integrated model allows for assessing the different paths in the relationship between work-related variables and burnout. RELEVANCE TO CLINICAL PRACTICE These results might be essential for nursing managers to develop strategies that improve nurses' work environment and minimise their burnout during COVID-19 pandemic. These strategies should focus on enhancing co-workers' support, job satisfaction and participation in continuous education. Furthermore, paediatric nurses should be protected from any violence.
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Affiliation(s)
- Haitham Khatatbeh
- Doctoral School of Health SciencesFaculty of Health SciencesUniversity of PécsPécsHungary
| | - Tariq Al‐Dwaikat
- Department of Community and Mental HealthFaculty of NursingJordan University of Science and TechnologyIrbidJordan
| | - Jehad Rababah
- Department of Adults HealthFaculty of NursingJordan University of Science and TechnologyIrbidJordan
| | - András Oláh
- Faculty of Health SciencesInstitute of Nursing SciencesBasic Health Sciences and Health VisitingUniversity of PécsPécsHungary
| | - Annamária Pakai
- Faculty of Health SciencesInstitute of Nursing SciencesBasic Health Sciences and Health VisitingUniversity of PécsPécsHungary
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Han KT, Kim S. The effect of fragmented cancer care and change in nurse staffing grade on cancer patient mortality. Worldviews Evid Based Nurs 2023; 20:610-620. [PMID: 37691136 DOI: 10.1111/wvn.12676] [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: 03/29/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Continuity of patient care ensures timely and appropriate care and is associated with better patient outcomes among cancer patients. However, the impact of nurse staffing grade changes on patient outcomes remains unknown. AIMS This retrospective cohort study aimed to evaluate the effect of fragmented care and changes in nurse staffing grade on the survival of colorectal cancer patients who underwent surgery. METHODS This study included 2228 newly diagnosed colorectal cancer patients. Fragmented care was defined as the receipt of treatment in multiple hospitals and was divided into three categories based on changes in nurse staffing grade. Five-year survival rates were used to evaluate the effect of fragmented care and nurse staffing grade on outcomes of cancer patients. Survival analysis was performed by adjusting for covariates using the Cox proportional hazards model for 5-year mortality. RESULTS Approximately 18.5% of patients died within 5 years; the mortality rate during cancer treatment was higher in patients who received fragmented care, especially in those transferred to hospitals with fewer nurses. Patients who received fragmented care had shorter survival times, and those transferred to hospitals with fewer nurses had higher risks of 5-year mortality (hazard ratio: 1.625; 95% CI: [1.095, 2.412]). Transfers to hospitals with fewer nurses were associated with increased mortality rates in low-income patients, hospitals located in metropolitan and rural areas, and high-severity groups. LINKING EVIDENCE TO ACTION Receipt of fragmented care and change in nurse staffing grade due to patients' transfer to different hospitals were associated with increased mortality rates in cancer patients, thus underlining the importance of ensuring continuity and quality of care. Patients from rural areas, from low-income families, and with high disease severity may have better outcomes if they receive treatment in well-staffed hospitals.
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Affiliation(s)
- Kyu-Tae Han
- Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, South Korea
| | - Seungju Kim
- Department of Health System, College of Nursing, The Catholic University of Korea, Seoul, South Korea
- Research Institute for Hospice/Palliative Care, The Catholic University of Korea, Seoul, South Korea
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Yun Y, Hong KJ. Factors related to career interruption and Re-employment of women in human health and social work activities sector: Comparison with other industry sectors. Nurs Open 2023; 10:2656-2666. [PMID: 36463429 PMCID: PMC10006648 DOI: 10.1002/nop2.1526] [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: 07/29/2022] [Revised: 10/26/2022] [Accepted: 11/20/2022] [Indexed: 12/07/2022] Open
Abstract
AIMS This study aims to examine the factors related to career interruption and re-employment of women who had worked or were working in the human health sector and to compare them with those in other industrial sectors. DESIGN Secondary data analysis study. METHODS Data from the 2019 economic activities survey of career-interrupted women of South Korea was used, and 2570 participants were included in the analysis. RESULTS Women who had majored in health care and had worked, or were working, in the human health and social work activities sector showed a higher tendency to work more than 40 h per week, compared to the mean of all participants. Moreover, parental leave and flexible working time were related to career interruption and re-employment. PATIENT OR PUBLIC CONTRIBUTION Policies that encourage the use of parental leave and flexible shift work systems should be developed and implemented to prevent career interruption of women in the health sector.
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Affiliation(s)
- Younghee Yun
- School of Nursing, University of California, San Fransisco, USA
| | - Kyung Jin Hong
- College of Nursing, Kangwon National University, Chuncheon-si, South Korea
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Nilsson L, Lindblad M, Johansson N, Säfström L, Schildmeijer K, Ekstedt M, Unbeck M. Exploring nursing-sensitive events in home healthcare: A national multicenter cohort study using a trigger tool. Int J Nurs Stud 2023; 138:104434. [PMID: 36630873 DOI: 10.1016/j.ijnurstu.2022.104434] [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: 10/07/2022] [Revised: 12/10/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND The provision of home healthcare is increasing in response to the growing aging population with the need for chronic disease management in their homes. Safety work differs from hospital care. The incidence of adverse events in home healthcare is sparsely studied but is estimated to occur in-one third of patients, and most are deemed preventable. Although nursing care is crucial for risk assessment and preventive work in the home environment, the role of registered nurses in the prevention of no-harm incidents and adverse events has not received sufficient scientific attention. OBJECTIVES To explore nursing-sensitive events in patients receiving home healthcare. DESIGN, SETTING AND PARTICIPANTS A Swedish national multicenter study based on a structured record review of 600 randomly chosen healthcare records from 10 organizations in different regions of the country. METHODS Ten trained teams, each including physician(s) and registered nurses, undertook a review based on the Global Trigger Tool method. The review covered a maximum of 90 days from admission to home healthcare. First, each record was screened for the presence of 38 predefined triggers. In the second step, every potential event was assessed according to preventability, types of events, severity, time of occurrence, consequences of the event, and potential contributing causes. RESULTS In total, 699 events were identified in the study. Of these, 495 (74.0%) were classified as nursing-sensitive (227 no-harm incidents and 268 adverse events) and affected 267 (44.5%) patients, with a mean of 1.9 events per patient. The majority (n = 367, 73.1%) were considered preventable. The most prominent types of nursing-sensitive event were falls (n = 138, 27.9%), pressure ulcers (n = 62, 12.5%), healthcare-associated infections (n = 58, 11.7%) and medication management (n = 50, 10.1%). Concerning severity, 45.9% were classified as no-harm incidents and another 36.6% resulted in temporary harm that required extra healthcare resources: 226 hospital days, 66 physician visits in outpatient care, and 99 in home healthcare. All severity types occurred from day 1, except death, which included only one patient. The most frequent contributing factors were deficiencies in nursing care, treatment & diagnosis, with the subgroups nursing care, observation, treatment & follow-up, followed by deficiencies in the organization. CONCLUSIONS Nursing-sensitive events in home healthcare are common, often preventable, and occur from the start of the care period. This study contributes to increased knowledge of patient safety shortcomings and points to the important role that registered nurses play in patient safety work.
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Affiliation(s)
- Lena Nilsson
- Department of Anaesthesiology and Intensive Care, Department of Medical and Health Sciences, Faculty of Medicine and Health Science, Linköping University, Linköping, Sweden.
| | - Marléne Lindblad
- Department of Health Sciences, Swedish Red Cross University, Stockholm, Sweden
| | - Nathalie Johansson
- School of Health and Welfare, Dalarna University, Falun, Sweden; Örsundsbro Health Center, Region Uppsala, Sweden
| | - Lisa Säfström
- School of Health and Welfare, Dalarna University, Falun, Sweden; Heby Home Health Care, Heby, Sweden
| | | | - Mirjam Ekstedt
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Maria Unbeck
- School of Health and Welfare, Dalarna University, Falun, Sweden; Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
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Pol-Castañeda S, Rodriguez-Calero MA, Villafáfila-Gomila CJ, Blanco-Mavillard I, Zaforteza-Lallemand C, Ferrer-Cruz F, De Pedro-Gómez JE. Impact of advanced practice nurses in hospital units on compliance with clinical practice guidelines: a quasi-experimental study. BMC Nurs 2022; 21:331. [PMID: 36447167 PMCID: PMC9706842 DOI: 10.1186/s12912-022-01110-x] [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: 07/22/2022] [Accepted: 11/15/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Incorporating the best available evidence into clinical practice is a determining challenge for healthcare professionals and organisations. The role of advanced practice nurses is viewed as a facilitator to adapt guideline recommendations to suit specific contexts and to overcome barriers to implementation. In this study, we evaluate the impact of advanced practice nurses on clinical indicators of hospitalised patients and on adherence to recommendations derived from two clinical practice guidelines (pressure ulcer prevention and treatment and vascular access device management). METHODS Quasi-experimental study in five intervention (IU) and five control (CU) hospital units at three hospitals in Spain (period 2018-19). Five advanced practice nurses were incorporated into IU, with the intention that would produce attitudinal changes and enhance the skills and knowledge of the nursing team regarding 18 clinical practice recommendations. In this study, 41 indicators were evaluated through direct observation of all patients admitted, at monthly intervals for 1 year. Outcomes were assessed by means of a descriptive, multi-line regression and association analysis. RESULTS The study population was composed of 3742 inpatients admitted for pressure ulcer assessment and 2631 fitted with vascular access devices. By the end of the study period, all variables had improved in the IU, where average compliance with recommendations was statistically significantly higher (pressure ulcer guidance 7.9 ± 1.9 vs 6.0 ± 1.7. OR 1.86, 95% CI 1.67-2.05; vascular access devices guidance 5.4 ± 1.4 vs 4.4 ± 1,6. OR 1.06, 95% CI 0.95-1.17). The prevalence of pressure lesions and catheter-related adverse events decreased statistically significantly in the IU compared to the CU. The prevalence of pressure ulcers decreases (5.7% in IU vs 8.7% in CU p < 0.005) as well as the prevalence of adverse events related to the catheter (14% In IU vs 21.6% in CU p < 0.005). The unnecessary catheters decressed in IU 10.9% VS CU 15.8% (p < 0.005). CONCLUSIONS The incorporation of an advanced practice nurse statistically significantly improves clinical indicators related to the prevention and treatment of pressure ulcers and to the management of vascular access devices. TRIAL REGISTRATION ISRCTN18259923 retrospectively registered on 11/02/2022.
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Affiliation(s)
- Sandra Pol-Castañeda
- grid.413457.0Hospital Son Llàtzer, 07198 Palma, Balearic Islands Spain ,grid.507085.fCare, Chronicity and Health Evidences (CuRES) Research Group, Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Balearic Islands Spain
| | - Miguel Angel Rodriguez-Calero
- grid.507085.fCare, Chronicity and Health Evidences (CuRES) Research Group, Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Balearic Islands Spain ,Balearic Islands Health Services, 07003 Palma, Balearic Islands Spain
| | | | - Ian Blanco-Mavillard
- grid.507085.fCare, Chronicity and Health Evidences (CuRES) Research Group, Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Balearic Islands Spain ,Hospital Manacor, 07500 Manacor, Balearic Islands Spain
| | - Concepción Zaforteza-Lallemand
- grid.507085.fCare, Chronicity and Health Evidences (CuRES) Research Group, Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Balearic Islands Spain ,Hospital Comarcal d’Inca, 07300 Inca, Balearic Islands Spain
| | | | - Joan Ernest De Pedro-Gómez
- grid.507085.fCare, Chronicity and Health Evidences (CuRES) Research Group, Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Balearic Islands Spain ,grid.9563.90000 0001 1940 4767Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma, Balearic Islands Spain
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Kim MS, Cho YO, Park J. Combination Relationship between Features of Person-Centered Care and Patient Safety Activities of Nurses Working in Small-Medium-Sized Hospitals: A Cross-Sectional Study. NURSING REPORTS 2022; 12:861-872. [PMID: 36412802 PMCID: PMC9680421 DOI: 10.3390/nursrep12040083] [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: 09/02/2022] [Revised: 10/26/2022] [Accepted: 11/07/2022] [Indexed: 11/17/2022] Open
Abstract
Perceived safety culture and nursing work environment are considered important prerequisites for a patient safety activity. Patient safety is also associated with person-centered care; however, few studies apply the person-centered care framework which includes staff attributes and care environment. This study aimed to examine the canonical correlations of person-centered care factors, including professional self-concept, patient safety culture, nursing work environment, and patient safety activities of nurses working in small-medium-sized hospitals. A cross-sectional survey was used. Participants included 171 nurses from seven small-medium-sized hospitals in Busan metropolitan city, in Korea. Data were analyzed using descriptive statistics, t-test, one-way analysis of variance (ANOVA), Pearson's correlation coefficients, and canonical correlations. Two significant canonical variates were found. First, better professional self-concept, a positive patient safety culture, and better nursing work environment were associated with better patient safety care activities. Second, a negative patient safety culture and healthy nursing work environment were associated with a lack of communication between medical staff. Person-centered framework factors such as staff attributes and care environment were positively associated with patient safety activities. Based on the results, nurses in small-medium-sized hospitals should be highly aware of their professional self-concept. Moreover, nurses should be equipped with psychological safety and a healthy work environment to enhance patient safety activities.
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Affiliation(s)
- Myoung Soo Kim
- Department of Nursing, Pukyong National University, Busan 48513, Republic of Korea
| | - Young Ok Cho
- Hyosung City Hospital, Busan 48055, Republic of Korea
| | - Jiwon Park
- Department of Nursing, Pukyong National University, Busan 48513, Republic of Korea
- Correspondence:
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Abuosi AA, Poku CA, Attafuah PYA, Anaba EA, Abor PA, Setordji A, Nketiah-Amponsah E. Safety culture and adverse event reporting in Ghanaian healthcare facilities: Implications for patient safety. PLoS One 2022; 17:e0275606. [PMID: 36260634 PMCID: PMC9581362 DOI: 10.1371/journal.pone.0275606] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/20/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Recognizing the values and norms significant to healthcare organizations (Safety Culture) are the prerequisites for safety and quality care. Understanding the safety culture is essential for improving undesirable workforce attitudes and behaviours such as lack of adverse event reporting. The study assessed the frequency of adverse event reporting, the patient safety culture determinants of the adverse event reporting, and the implications for Ghanaian healthcare facilities. METHODS The study employed a multi-centre cross-sectional survey on 1651 health professionals in 13 healthcare facilities in Ghana using the Survey on Patient Safety (SOPS) Culture, Hospital Survey questionnaire. Analyses included descriptive, Spearman Rho correlation, one-way ANOVA, and a Binary logistic regression model. RESULTS The majority of health professionals had at least reported adverse events in the past 12 months across all 13 healthcare facilities. Teamwork (Mean: 4.18, SD: 0.566) and response to errors (Mean: 3.40, SD: 0.742) were the satisfactory patient safety culture. The patient safety culture dimensions were statistically significant (χ2 (9, N = 1642) = 69.28, p < .001) in distinguishing between participants who frequently reported adverse events and otherwise. CONCLUSION Promoting an effective patient safety culture is the ultimate way to overcome the challenges of adverse event reporting, and this can effectively be dealt with by developing policies to regulate the incidence and reporting of adverse events. The quality of healthcare and patient safety can also be enhanced when healthcare managers dedicate adequate support and resources to ensure teamwork, effective communication, and blame-free culture.
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Affiliation(s)
- Aaron Asibi Abuosi
- Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, Ghana
| | - Collins Atta Poku
- Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Research, Education, and Administration, School of Nursing and Midwifery, University of Ghana, Legon, Ghana
| | - Priscilla Y. A. Attafuah
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Legon, Ghana
| | - Emmanuel Anongeba Anaba
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Ghana
| | - Patience Aseweh Abor
- Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, Ghana
| | - Adelaide Setordji
- Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, Ghana
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Khatatbeh H, Al-Dwaikat T, Alfatafta H, Ali AM, Pakai A. Burnout, quality of life and perceived patient adverse events among paediatric nurses during the COVID-19 pandemic. J Clin Nurs 2022. [PMID: 36123307 PMCID: PMC9538583 DOI: 10.1111/jocn.16540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/20/2022] [Accepted: 08/31/2022] [Indexed: 01/03/2023]
Abstract
PURPOSE This cross-sectional, descriptive, correlational study aimed to measure burnout, quality of life (QOL) and perceptions of patient-related adverse events among paediatric nurses amid the COVID-19 pandemic and assess the relationships between these scores and participants' demographic and work-related characteristics. BACKGROUND The mental health of most nurses may severely suffer due to the significant adversities that they struggle with while they care for their patients amid the COVID-19 pandemic. Mental distress negatively affects nurses' relationships and work performance, which may adversely influence the quality of care and patient safety. METHODS A convenient sample of 225 Jordanian paediatric nurses completed a test batter comprising the Copenhagen Burnout Inventory, the Brief Version of the World Health Organisation's Quality of Life questionnaire and the nurse-perceived patient adverse events' questionnaire. This study was prepared and is reported according to the STROBE checklist. RESULTS Paediatric nurses reported high levels of burnout, low QOL and high occurrence of hospital-acquired infections. Participants' age and hospital/unit capacity were significantly associated with burnout and QOL. CONCLUSION Personal traits, perceived salary insufficiency and hospital/unit capacity represent factors that aggravate burnout, lower quality of life and worsen perceived patient safety among paediatric nurses. RELEVANCE TO CLINICAL PRACTICE Policymakers should promote nurses' mental integrity and patient safety by addressing issues of workload and financial sufficiency and by provide interventions aimed to increase nurses' resilience. PATIENT OR PUBLIC CONTRIBUTION Patients or public were not involved in setting the research question, the outcome measures, the design or implementation of the study. However, paediatric nurses responded to the research questionnaires.
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Affiliation(s)
- Haitham Khatatbeh
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Tariq Al-Dwaikat
- Department of Community and Mental Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Huda Alfatafta
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Annamária Pakai
- Institute of Nursing Sciences, Basic Health Sciences and Health Visiting, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
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Standards for Professional Registered Nurse Staffing for Perinatal Units. Nurs Womens Health 2022; 26:e1-e94. [PMID: 35750618 DOI: 10.1016/j.nwh.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Standards for Professional Registered Nurse Staffing for Perinatal Units. J Obstet Gynecol Neonatal Nurs 2022; 51:e5-e98. [PMID: 35738987 DOI: 10.1016/j.jogn.2022.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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15
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Bae SY, Yoon H, Kim Y, Kim J. Posttraumatic stress disorder and related factors among nurses working during the COVID‐19 pandemic. J Nurs Manag 2022; 30:1096-1104. [PMID: 35403266 PMCID: PMC9115141 DOI: 10.1111/jonm.13615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 11/27/2022]
Abstract
Aim To analyse the prevalence of posttraumatic stress disorder (PTSD) and examine its related factors among nurses who worked during the coronavirus disease 2019 (COVID‐19) pandemic in Daegu, South Korea. Background Nurses are a high‐risk population for PTSD, especially during the COVID‐19 pandemic. This study was conducted to identify the nursing work environmental factors that should be addressed to reduce PTSD. Methods Using a cross‐sectional design, 365 nurses were enrolled. Their characteristics (intrapersonal, interpersonal, organizational, and COVID‐19‐related) and PTSD Checklist‐5 scores were analysed. Results The average PTSD score was 14.98 ± 15.94, and 16.5% of the participants had a high risk of PTSD. Nurses were more likely to have PTSD if they were married (odds ratio = 3.02, p = .013) and when nurse managers' abilities, leadership, and support of nurses were low (odds ratio = 3.81, p < .001). Conclusions The nursing work environment was found to be associated with PTSD. Therefore, interventions are necessary to increase nurse managers' abilities, leadership, and support for nurses to reduce the risk of PTSD among nurses. Implications for Nursing Management Effective professional and social support and interventions to improve nurse managers' abilities, leadership, and support of nurses are needed to reduce PTSD.
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Affiliation(s)
| | - Hyo‐Jeong Yoon
- Department of Nursing Yeungnam University College Daegu South Korea
| | - Yunjung Kim
- Yeungnam University Medical Center Daegu South Korea
| | - Jisun Kim
- Yeungnam University Medical Center Daegu South Korea
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Martínez-Sabater A, Saus-Ortega C, Masiá-Navalon M, Chover-Sierra E, Ballestar-Tarín ML. Spanish Version of the Scale "Eventos Adversos Associados às Práticas de Enfermagem" (EAAPE): Validation in Nursing Students. NURSING REPORTS 2022; 12:112-124. [PMID: 35225898 PMCID: PMC8883960 DOI: 10.3390/nursrep12010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/31/2022] [Accepted: 02/09/2022] [Indexed: 11/16/2022] Open
Abstract
Healthcare carried out by different health professionals, including nurses, implies the possible appearance of adverse events that affect the safety of the patient and may cause damage to the patient. In clinical practice, it is necessary to have measurement instruments that allow for the evaluation of the presence of these types of events in order to prevent them. This study aims to validate the "Eventos adversos associados às práticas de enfermagem" (EAAPE) scale in Spanish and evaluate its reliability. The validation was carried out through a cross-sectional study with a sample of 337 nursing students from the University of Valencia recruited during the 2018-19 academic year. An exploratory factor analysis was carried out using principal components and varimax rotation. The factor analysis extracted two factors that explained 32.10% of the total variance. Factor 1 explains 22.19% and refers to the "adverse results" of clinical practice (29 items), and factor 2 explains 9.62% and refers to "preventive practices" (24 items). Both factors presented high reliability (Cronbach's alpha 0.902 and 0.905, respectively). The Spanish version of the EAAPE is valid and reliable for measuring the perception of adverse events associated with nursing practice and the presence of prevention measures.
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Affiliation(s)
- Antonio Martínez-Sabater
- Nursing Department, Facultat d’Infermeria i Podologia, Universitat de València, 46010 València, Spain; (A.M.-S.); (M.L.B.-T.)
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 València, Spain;
- Grupo Investigación en Cuidados (INCLIVA), Hospital Clínico Universitario de Valencia, 46010 València, Spain
| | - Carlos Saus-Ortega
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 València, Spain;
- Nursing School “La Fe”, Generalitat Valenciana, 46026 València, Spain
| | | | - Elena Chover-Sierra
- Nursing Department, Facultat d’Infermeria i Podologia, Universitat de València, 46010 València, Spain; (A.M.-S.); (M.L.B.-T.)
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 València, Spain;
- Internal Medicine, Consorcio Hospital General Universitario de Valencia, 46014 València, Spain
| | - María Luisa Ballestar-Tarín
- Nursing Department, Facultat d’Infermeria i Podologia, Universitat de València, 46010 València, Spain; (A.M.-S.); (M.L.B.-T.)
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 València, Spain;
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Porcel-Gálvez AM, Allande-Cussó R, Fernández-García E, Naharro-Álvarez A, Barrientos-Trigo S. Predictive validity of the INTEGRARE scale in identifying the risk of hospital-acquired pressure ulcers in acute care hospital settings. J Tissue Viability 2022; 31:339-345. [PMID: 35000818 DOI: 10.1016/j.jtv.2022.01.001] [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: 11/04/2021] [Revised: 12/07/2021] [Accepted: 01/01/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Hospital-acquired pressure ulcers (HAPUs) are prevalent around the world and are an indicator of care quality. Numerous instruments are available to predict their appearance, but few evaluate predictive validity. No instruments based on Nursing Outcomes Classification indicators have been found, despite these indicators reflecting the patient's condition. The aim of the study was to analyse the predictive validity of the INTEGRARE scale in preventing the risk of HAPUs. METHODS A multicentre prospective observational cohort study design was used. 1,004 patients from 11 public hospitals in Andalusia (Spain) were recruited between February 2015 and October 2017. Participants were aged over 18 and had been admitted to medical and surgical units, with a predicted stay exceeding 48 h. Predictive validity was checked using a multivariate logistic regression model and a receiver operating characteristic curve, with development of pressure ulcers during the hospital stay as the dependent variable. RESULTS The INTEGRARE scale obtained an area under the curve of 0.886 (95% CI = 0.85-0.923). Within the 30-point range, the optimal cut-off value is 23 points with a sensitivity of 80.8% and a specificity of 80%. The odds ratio was 16.86 (95% CI = 8.54-33.28). Among the patient variables, age was significant, while among the hospital variables, the type of unit and the Nurse Staffing Level (NSL) were significant. CONCLUSIONS The INTEGRARE scale has robust predictive validity when patients are admitted to medical and surgical inpatient units. Patients with a higher risk of developing HAPUs are in surgical units, are elderly, and have an NSL exceeding 10.4.
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Affiliation(s)
- Ana María Porcel-Gálvez
- Department of Nursing, University of Seville, Research Group PAIDI-CTS 1050, "Complex Care, Chronocity and Health Outcomes", 41009, Avenzoar st., Seville, Spain.
| | - Regina Allande-Cussó
- Department of Nursing, University of Seville, Research Group PAIDI-CTS 1050, "Complex Care, Chronocity and Health Outcomes", 41009, Avenzoar st., Seville, Spain.
| | - Elena Fernández-García
- Department of Nursing, University of Seville, Research Group PAIDI-CTS 1050, "Complex Care, Chronocity and Health Outcomes", 41009, Avenzoar st., Seville, Spain.
| | - Alonso Naharro-Álvarez
- Department of Nursing, University of Seville, Research Group PAIDI-CTS 1050, "Complex Care, Chronocity and Health Outcomes", 41009, Avenzoar st., Seville, Spain.
| | - Sergio Barrientos-Trigo
- Department of Nursing, University of Seville, Research Group PAIDI-CTS 1050, "Complex Care, Chronocity and Health Outcomes", 41009, Avenzoar st., Seville, Spain.
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Lee SE, Havaei F, Astivia OLO, Shin JA. Psychometric Evaluation of the Korean Version of Hospital Survey on Patient Safety Culture. J Patient Saf 2022; 18:26-32. [PMID: 33044256 DOI: 10.1097/pts.0000000000000792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study evaluated the psychometric properties of the Korean-language version of the Hospital Survey on Patient Safety Culture (HSOPSC) among Korean nurses. METHODS We analyzed secondary data from 801 direct care nurses working at a tertiary, private, nonprofit, teaching hospital in South Korea. Descriptive statistics, internal consistency coefficients, and intercorrelations were calculated. The latent factor structure of the HSOPSC was examined using exploratory structural equation modeling techniques, which account for the noncontinuous nature of ordinal data. RESULTS Although a majority of subscales showed acceptable to good internal consistency, 4 dimensions (staffing, overall perceptions of patient safety, organizational learning-continuous improvement, and nonpunitive response to errors) had reliability levels less than 0.6. The HSOPSC items loaded somewhat diffusely on 3 subscales: staffing, teamwork across units, and organizational learning-continuous improvement. Correlations between the 12 HSOPSC factors indicated discriminant validity. Convergent validity was supported by correlations between the 12 subscales and a single-item outcome variable, namely, patient safety grade. Several items did not load well on their respective subscales, but most items fit the underlying theoretical model implied by the HSOPSC, resulting in an acceptable model fit (confirmatory fit index = 0.985, root mean square error of approximation = 0.034, weighted root mean square residual = 0.54). CONCLUSIONS Despite the acceptable model fit of the Korean version of HSOPSC, the psychometric properties of this instrument require further investigation to ensure it is an effective tool to measure patient safety culture and identify areas for improvement in the Korean health care system.
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Affiliation(s)
- Seung Eun Lee
- From the Mo-Im KIM Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Farinaz Havaei
- School of Nursing, University of British Columbia, Vancouver, Canada
| | | | - Jeong Ae Shin
- Division of Quality Improvement, Inha University Hospital, Incheon, South Korea
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The relationship between the nurses' work environment and the quality and safe nursing care: Slovenian study using the RN4CAST questionnaire. PLoS One 2021; 16:e0261466. [PMID: 34928992 PMCID: PMC8687596 DOI: 10.1371/journal.pone.0261466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 12/02/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction The safety and quality of patient care are basic guidelines in finding new and improved solutions in nursing. Important and influential factors shape the nurses’ work environment in hospitals. Purpose With the study, we intended to investigate whether the perception of nurses’ work environment is related to the safety culture and the quality of patient care and whether it differs according to nurses’ level of education. Methods of work The study with a quantitative research method was conducted at the six clinical departments of the University Medical Centre, Ljubljana in 2019. We used a survey questionnaire from the European survey Nurse forecasting in Europe (RN4CAST). Results 270 nurses were included in the study. The response rate was 54%. The study confirmed that there is a correlation between the assessment of the nurses’ work environment and the general assessment of patient safety (r = 0.36; p <0.001), the general assessment of the quality of nursing care (r = 0.32; p <0.001), the confidence in patient self-care at discharge (r = 0.29; p <0.001) and the quality of patient care in the previous year (r = 0.27; p = 0.001). The results showed frequent verbal abuse of nurses, in 44.9% by patients and their relatives and in 35.4% by staff. Graduate nurses rated the work environment more negatively than healthcare technicians (p = 0.003). Discussion and conclusion We confirmed the correlation between the assessment of nurses’ work environment and patient safety and the quality of health care, and that employees’ education influences the assessment and perception of the work environment.
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Kakemam E, Albelbeisi AH, Davoodabadi S, Azarmi M, Zolghadr F, Mamene M. The impact of nurses' perceptions of systems thinking on occurrence and reporting of adverse events: a cross-sectional study. J Nurs Manag 2021; 30:482-490. [PMID: 34817095 DOI: 10.1111/jonm.13524] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/08/2021] [Accepted: 11/18/2021] [Indexed: 11/28/2022]
Abstract
AIMS To assess systems thinking level and its relationship with occurrence and reporting of adverse events in Iranian nurses. BACKGROUND Systems thinking has recently emerged important element of patient safety and quality improvement in health care systems. It helps healthcare professionals to understand the different elements of healthcare systems, the interrelatedness, and interdependencies of these elements in the healthcare systems. METHODS This cross-sectional survey was carried out in ten teaching hospitals in Tehran, Iran. A total of 511 nurses were selected using simple random sampling. Systems thinking was measured using the validated Systems Thinking Scale. Data analysis was performed by descriptive analyses, independent t-test, and logistic regression analysis. RESULTS The average score for total systems thinking was a mean of 49.45 (SD = 12.10; range 0-80). In total, 67.5% of participants reported the experience of the occurrence of adverse events leading to harm to patients and 65.2% of them responded as having appropriate adverse events reporting behaviors. Nurses who had higher scores in systems thinking were found to be more likely to report adverse events (Odds ratio = 1.07; 95% CI = 1.05 - 1.09), whereas they were less prone to experience adverse events (Odds ratio = 0.97; 95% CI = 0.95 - 0.98). CONCLUSION Our results indicated that the nurses' systems thinking level was moderate. Systems thinking had a significant role in preventing the occurrence of adverse events as well as improving the reporting of adverse events. Therefore, it is recommended to enhance the competency of nurses' thinking systems to prevent the occurrence of adverse events and to improve the reporting of adverse events. IMPLICATIONS FOR NURSING MANAGEMENT Nursing managers need to focus on the systems thinking weaknesses and the occurrence and the reporting of adverse events in policymaking, practice, and research. Also, systems thinking should be integrated with the health care system for preventing the occurrence of adverse events and improving reporting of adverse events. They should support, lead, and allocate the essential pragmatic strategies and resources for the involvement of all health care members in policymaking.
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Affiliation(s)
- Edris Kakemam
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmed Hassan Albelbeisi
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran
| | - Samane Davoodabadi
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Azarmi
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Zolghadr
- Department of Medical-Surgical Nursing, School of Nursing & Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Mamene
- Department of Nursing, Faculty of Nursing & Midwifery, Ilam University of Medical sciences, Ilam, Iran
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Jarrar M, Al-Bsheish M, Aldhmadi BK, Albaker W, Meri A, Dauwed M, Minai MS. Effect of Practice Environment on Nurse Reported Quality and Patient Safety: The Mediation Role of Person-Centeredness. Healthcare (Basel) 2021; 9:healthcare9111578. [PMID: 34828624 PMCID: PMC8618501 DOI: 10.3390/healthcare9111578] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/11/2021] [Accepted: 11/16/2021] [Indexed: 11/18/2022] Open
Abstract
This study aims to explore the potential mediation role of person-centeredness between the effects of the work environment and nurse reported quality and patient safety. A quantitative cross-sectional survey collected data from 1055 nurses, working in medical and surgical units, in twelve Malaysian private hospitals. The data collection used structured questionnaires. The Hayes macro explored the mediation effect of person-centeredness between the associations of work environment dimensions and care outcomes, controlling nurses’ demographics and practice characteristics. A total of 652 nurses responded completely to the survey (61.8% response rate). About 47.7% of nurses worked 7-h shifts, and 37.0% were assigned more than 15 patients. Higher workload was associated with unfavorable outcomes. Nurses working in 12-h shifts reported a lower work environment rating (3.46 ± 0.41, p < 0.01) and person-centered care (3.55 ± 0.35, p < 0.01). Nurses assigned to more than 15 patients were less likely to report a favorable practice environment (3.53 ± 0.41, p < 0.05), perceived lower person-centered care (3.61 ± 0.36, p < 0.01), and rated lower patient safety (3.54 ± 0.62, p < 0.05). Person-centeredness mediates the effect of nurse work environment dimensions on quality and patient safety. Medical and surgical nurses, working in a healthy environment, had a high level of person-centeredness, which, in turn, positively affected the reported outcomes. The function of person-centeredness was to complement the effects of the nurse work environment on care outcomes. Improving the nurse work environment (task-oriented) with a high level of person-centeredness (patient-oriented) was a mechanism through which future initiatives could improve nursing care and prevent patient harm.
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Affiliation(s)
- Mu’taman Jarrar
- Vice Deanship for Quality and Development, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
- Correspondence: or
| | - Mohammad Al-Bsheish
- Healthcare Administration Department, Batterjee Medical College, Jeddah 21442, Saudi Arabia;
| | - Badr K. Aldhmadi
- Department of Health Management, College of Public Health and Health Informatics, University of Ha’il, Ha’il 81451, Saudi Arabia;
| | - Waleed Albaker
- Department of Internal Medicine/Endocrinology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia;
| | - Ahmed Meri
- Department of Medical Instrumentation Techniques Engineering, Al-Hussain University College, Karbala 56001, Iraq;
| | - Mohammed Dauwed
- Department of Medical Instrumentation Techniques Engineering, Dijlah University College, Baghdad 10022, Iraq;
- Department of Computer Science, College of Science, University of Baghdad, Baghdad 10070, Iraq
| | - Mohd Sobri Minai
- College of Business, Universiti Utara Malaysia, Kedah 06010, Malaysia; or
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Choi S, Cho E, Kim E, Lee K, Chang SJ. Effects of registered nurse staffing levels, work environment, and education levels on adverse events in nursing homes. Sci Rep 2021; 11:21458. [PMID: 34728676 PMCID: PMC8563772 DOI: 10.1038/s41598-021-00946-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022] Open
Abstract
This study examined the effects of nurse staffing levels, work environment, and education levels on adverse events in nursing homes. A cross-sectional study was conducted involving 216 nurses working in 62 nursing homes in South Korea, using self-reported questionnaires and data from the National Health Insurance Service of South Korea. A logistic regression model was used to investigate the effects of nurse staffing levels, work environment, and nursing education levels on the adverse events experienced by residents. An increase of one resident per nurse was significantly associated with a higher incidence of medication error, pressure ulcers and urinary tract infections. A poor work environment increased the incidence of adverse events. Compared to nurses with a bachelor’s degree or higher, those with diplomas reported increased incidence rates of pressure ulcers. Improving the health outcomes of residents in nursing homes requires efforts that strengthen the nursing workforce in terms of numbers and educational level, and which improve their work environment at institutional and policy levels.
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Affiliation(s)
- Seonhwa Choi
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemoon-Gu, Seoul, 03722, South Korea
| | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50-1, Yonsei-ro, Seodaemoon-Gu, Seoul, 03722, South Korea
| | - Eunkyo Kim
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemoon-Gu, Seoul, 03722, South Korea
| | - Kyongeun Lee
- Department of Nursing, Tongmyong University, 428, Sinseon-ro, Nam-gu, Busan, 48520, South Korea
| | - Soo Jung Chang
- Department of Nursing, Gangneung-Wonju National University, 150, Namwon-ro, Heungeop-myeon, Wonju, 26403, South Korea.
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Khatatbeh H, Al‐Dwaikat T, Oláh A, Onchonga D, Hammoud S, Amer F, Prémusz V, Pakai A. The relationships between paediatric nurses' social support, job satisfaction and patient adverse events. Nurs Open 2021; 8:3575-3582. [PMID: 33934553 PMCID: PMC8510783 DOI: 10.1002/nop2.907] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/03/2021] [Accepted: 04/14/2021] [Indexed: 11/17/2022] Open
Abstract
AIMS To explore the relationships of family, co-worker and manager support with paediatric nurses' satisfaction and their perception of adverse events. Furthermore, this study aimed to assess the job satisfaction, social support and the perceived patient adverse events. DESIGN This study used a cross-sectional correlational design. METHODS A convenient sample of 225 paediatric nurses was selected from nine hospitals in Jordan. Both the Pearson correlations and multiple regression tests were used in the analysis. The study was prepared and is reported according to the STROBE checklist. RESULTS Significant and positive correlations were found between paediatric nurses' job satisfaction and the social support they receive. Significant negative correlations were also found between adverse events and both family and manager support. The multiple regression results showed that manager support is a significant negative predictor of both pressure ulcers and patient falls, and family support significantly predicted paediatric nurses' job satisfaction.
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Affiliation(s)
- Haitham Khatatbeh
- Doctoral School of Health SciencesFaculty of Health SciencesUniversity of PécsPécsHungary
| | - Tariq Al‐Dwaikat
- Department of Community and Mental HealthFaculty of NursingJordan University of Science and TechnologyIrbidJordan
| | - András Oláh
- Institute of Nursing Sciences, Basic Health Sciences and Health VisitingFaculty of Health SciencesUniversity of PécsPécsHungary
| | - David Onchonga
- Doctoral School of Health SciencesFaculty of Health SciencesUniversity of PécsPécsHungary
| | - Sahar Hammoud
- Doctoral School of Health SciencesFaculty of Health SciencesUniversity of PécsPécsHungary
| | - Faten Amer
- Doctoral School of Health SciencesFaculty of Health SciencesUniversity of PécsPécsHungary
| | - Viktória Prémusz
- Doctoral School of Health SciencesFaculty of Health SciencesUniversity of PécsPécsHungary
| | - Annamária Pakai
- Institute of Nursing Sciences, Basic Health Sciences and Health VisitingFaculty of Health SciencesUniversity of PécsPécsHungary
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Labrague LJ, Al Sabei S, Al Rawajfah O, AbuAlRub R, Burney I. Interprofessional collaboration as a mediator in the relationship between nurse work environment, patient safety outcomes and job satisfaction among nurses. J Nurs Manag 2021; 30:268-278. [PMID: 34601772 DOI: 10.1111/jonm.13491] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND As an important organisational feature, the nurse work environment has been associated with increased work effectiveness, reduced patient safety issues and improved care quality. However, the mechanism underlying this association remains unexplored. AIM This study aims to assess the mediating role of interprofessional collaboration in the relationships between nurse work environment, select patient safety outcomes and job satisfaction. METHODS This cross-sectional, descriptive study used five standardized scales and included 881 clinical nurses employed in select teaching hospitals in Oman. RESULTS Nurses who worked in teaching hospitals in Oman perceived their work environment as highly favourable. Nurse work environment was directly and indirectly associated with nurse-assessed quality of care, adverse patient events and job satisfaction, through interprofessional collaborations. CONCLUSION Findings of the study suggest that enhancing nurse work environments can be a potential strategy to foster interprofessional collaboration and improve job satisfaction and patient safety outcomes. IMPLICATIONS FOR NURSING MANAGEMENT Organisational strategies to improve patient safety outcomes and job satisfaction in nurses can be facilitated by improving nurses' work conditions and enhancing interprofessional collaboration through supportive leadership, theory-driven approaches, obtaining hospital accreditation/certification and relevant workplace policies.
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Affiliation(s)
- Leodoro J Labrague
- Fundamentals and Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Oman.,Adjunct Faculty, Graduate School, St. Paul University Philippines, Tuguegarao, Philippines
| | - Sulaiman Al Sabei
- Fundamentals and Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Omar Al Rawajfah
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, Muscat, Oman.,College of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Raeda AbuAlRub
- Community and Mental Health Department, College of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Ikram Burney
- Department of Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
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Al Sabei SD, AbuAlRub R, Labrague LJ, Ali Burney I, Al-Rawajfah O. The impact of perceived nurses' work environment, teamness, and staffing levels on nurse-reported adverse patient events in Oman. Nurs Forum 2021; 56:897-904. [PMID: 34350619 DOI: 10.1111/nuf.12639] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fostering a healthy work environment becomes a necessity in health care institutions that value quality care and patient safety. However, limited studies investigated the impact of work environment characteristics including staffing and teamness among healthcare teams on adverse patient events in Oman. AIMS To examine the (1) impact of work environment, interprofessional teamness, staffing levels on adverse patient events and (2) predicting factors of perceptions of work environment among nurses in the Sultanate of Oman. METHOD A cross-sectional descriptive design was utilized to collect data from 2113 nurses. Participants completed a self-report questionnaire that included a set of instruments. RESULTS The results showed a strong positive relationship between work environment and teamness (r = 0.59, p < 0.001). Nurses working in a favorable environment that has positive teamwork reported a reduction in adverse events including patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medication errors (p < 0.001). There was a nonsignificant correlation between staffing and adverse patient events. CONCLUSION Fostering a healthy and supportive work environment continue to be crucial for ensuring patient safety. Nurse administrators should strive to improve work environment through creating a culture that values interprofessional teamwork and collaborative relationships.
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Affiliation(s)
- Sulaiman Dawood Al Sabei
- Department of Fundamentals and Nursing Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Raeda AbuAlRub
- Department of Community and Mental Health Nursing, Faculty of Nursing/Jordan University of Science and Technology, Jordan
| | - Leodoro J Labrague
- Fundamentals and Nursing Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Ikram Ali Burney
- Department of Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Omar Al-Rawajfah
- Department of Adult and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman.,Department of Adult Health Nursing, College of Nursing, Al al-Bayt University, Mafraq, Jordan
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26
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Riley Y, Stitt J, Hill CM, Stutzman SE, Venkatachalam AM, Aguilera V, Ifejika NL. Implementation of the MATRIX Staffing Grid Improves Nurse Satisfaction With Rehabilitation Unit Staffing. J Neurosci Nurs 2021; 53:183-187. [PMID: 34116557 DOI: 10.1097/jnn.0000000000000593] [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: 11/25/2022]
Abstract
ABSTRACT BACKGROUND: Information on nurse satisfaction and unit acuity is scarce in the literature. The purpose of this study is to evaluate the effect of the MATRIX Staffing Grid (MSG) on nurse assignment satisfaction in a 20-bed inpatient rehabilitation facility. METHODS: Prospective systematic implementation study of the MSG occurred in 5 phases: development, baseline, run-in, implementation, and sustainability. Pretest/posttest nursing satisfaction data were analyzed using Wilcoxon-Mann-Whitney tests. RESULTS: Analysis of 128 satisfaction surveys demonstrated that the median total satisfaction score increased by 35% after MSG implementation (P < .05), with no change in patient satisfaction or adverse event rates. CONCLUSION: A systematic approach to implementation of the MSG evidence-based practice significantly improved nursing satisfaction with patient assignment in a way that addressed specific needs. The MSG has now been adopted into practice at our institution. The MSG may be feasible for implementation in inpatient rehabilitation units to improve staffing satisfaction.
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Porcel‐Gálvez AM, Fernández‐García E, Rafferty AM, Gil‐García E, Romero‐Sánchez JM, Barrientos‐Trigo S. Factors That Influence Nurse Staffing Levels in Acute Care Hospital Settings. J Nurs Scholarsh 2021; 53:468-478. [PMID: 33876892 PMCID: PMC8360162 DOI: 10.1111/jnu.12649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/02/2020] [Accepted: 01/15/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE To identify which patient and hospital characteristics are related to nurse staffing levels in acute care hospital settings. DESIGN A cross-sectional design was used for this study. METHODS The sample comprised 1,004 patients across 10 hospitals in the Andalucian Health Care System (southern Spain) in 2015. The sampling was carried out in a stratified, consecutive manner on the basis of (a) hospital size by geographical location, (b) type of hospital unit, and (c) patients' sex and age group. Random criteria were used to select patients based on their user identification in the electronic health record system. The variables were grouped into two categories, patient and hospital characteristics. Multilevel linear regression models (MLMs) with random intercepts were used. Two models were fitted: the first was the null model, which contained no explanatory variables except the intercepts (fixed and random), and the second (explanatory) model included selected independent variables. Independent variables were allowed to enter the explanatory model if their univariate association with the nurse staffing level in the MLM was significant at p < .05. RESULTS Two hierarchical levels were established to control variance (patients and hospital). The model variables explained 63.4% of the variance at level 1 (patients) and 71.8% at level 2 (hospital). Statistically significant factors were the type of hospital unit (p = .002), shift (p < .001), and season (p < .001). None of the variables associated with patient characteristics obtained statistical significance in the model. CONCLUSIONS Nurse staffing levels were associated with hospital characteristics rather than patient characteristics. CLINICAL RELEVANCE This study provides evidence about factors that impact on nurse staffing levels in the settings studied. Further studies should determine the influence of patient characteristics in determining optimal nurse staffing levels.
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Affiliation(s)
- Ana María Porcel‐Gálvez
- Assistant Professor of NursingNursing Department, Faculty of Nursing, Physiotherapy and PodiatryUniversidad de Sevilla, and Research Group under the Andalusian Research, Development and Innovation Scheme PAIDI‐CTS 1050 “Complex Care, Chronic and Health Outcomes”Universidad de SevillaSevilleSpain
| | - Elena Fernández‐García
- Assistant Professor of NursingNursing Department, Faculty of Nursing, Physiotherapy and PodiatryUniversidad de Sevilla, and Research Group under the Andalusian Research, Development and Innovation Scheme PAIDI‐CTS 1050 “Complex Care, Chronic and Health Outcomes”Universidad de SevillaSevilleSpain
| | - Anne Marie Rafferty
- Professor of Nursing PolicyAdult Nursing DepartmentFlorence Nightingale School of Nursing and Midwifery, King’s CollegeLondonUK
| | - Eugenia Gil‐García
- Associate Professor of NursingNursing Department, Faculty of Nursing, Physiotherapy and PodiatryUniversidad de Sevilla, and Research Group under the Andalusian Research, Development and Innovation Scheme PAIDI‐CTS 1050 “Complex Care, Chronic and Health Outcomes”Universidad de SevillaSevilleSpain
| | - José Manuel Romero‐Sánchez
- Assistant Professor of NursingNursing Department, Faculty of Nursing, Physiotherapy and PodiatryUniversidad de Sevilla, Seville, Spain, and Research Group under the Andalusian Research, Development and Innovation Scheme PAIDI‐CTS 1019 “Nursing methods and standardized languages (MELES)”Universidad de CádizCádizSpain
| | - Sergio Barrientos‐Trigo
- Assistant Professor of NursingNursing Department, Faculty of Nursing, Physiotherapy and PodiatryUniversidad de Sevilla, and Research Group under the Andalusian Research, Development and Innovation Scheme PAIDI‐CTS 1050 “Complex Care, Chronic and Health Outcomes”Universidad de SevillaSevilleSpain
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Oner B, Zengul FD, Oner N, Ivankova NV, Karadag A, Patrician PA. Nursing-sensitive indicators for nursing care: A systematic review (1997-2017). Nurs Open 2021; 8:1005-1022. [PMID: 34482649 PMCID: PMC8046086 DOI: 10.1002/nop2.654] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 01/09/2023] Open
Abstract
AIM To provide a systematic review of the literature from 1997 to 2017 on nursing-sensitive indicators. DESIGN A qualitative design with a deductive approach was used. DATA SOURCES Original and Grey Literature references from Cochrane Library, Medline/PubMed, Embase, and CINAHL, Google Scholar Original and Grey Literature. REVIEW METHODS Quality assessment was performed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. RESULTS A total of 3,633 articles were identified, and thirty-nine studies met the inclusion criteria. The quantitative assessment of investigated relationships in these studies suggests that nursing staffing, mortality, and nosocomial infections were the most frequently reported nursing-sensitive indicators. CONCLUSION This review provides a comprehensive list of nursing-sensitive indicators, their frequency of use, and the associations between these indicators and various outcome variables. Stakeholders of nursing research may use the findings to streamline the indicator development efforts and standardization of nursing-sensitive indicators. IMPACT This review provides evidence-based results that health organizations can benefit from nursing care quality.
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Affiliation(s)
- Beratiye Oner
- Department of Health Services AdministrationUniversity of Alabama at BirminghamBirminghamALUSA
| | - Ferhat D. Zengul
- Department of Health Services AdministrationUniversity of Alabama at BirminghamBirminghamALUSA
| | - Nurettin Oner
- Department of Health Services AdministrationUniversity of Alabama at BirminghamBirminghamALUSA
| | - Nataliya V. Ivankova
- Department of Health Services AdministrationUniversity of Alabama at BirminghamBirminghamALUSA
- School of NursingUniversity of Alabama at BirminghamBirminghamALUSA
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García-Altés A, Subirana-Casacuberta M, Llorens D, Bullich I, Brugués A, Teixidor M, Cuxart N, Esteve M, Estrem M. The experience of Catalonia measuring nurse-sensitive indicators: Trends study 2012-2018. J Nurs Manag 2021; 29:2288-2296. [PMID: 33894075 DOI: 10.1111/jonm.13348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 01/09/2023]
Abstract
AIM To describe nursing-sensitive indicators measured in Catalonia. BACKGROUND In Catalonia, since 2012, under the umbrella of the Results Centre, outcomes of every health care setting have been published and made open to health care professionals and citizens. METHODS Trends study of nursing-sensitive indicators was based on data collected systematically from each setting from 2012 to 2018. Percentages and rates were calculated for each of 14 indicators analysed from all primary care, hospitals and long-term care centres. RESULTS Percentage of population aged 60 years or older correctly vaccinated against flu has been decreasing, while percentage of population aged 14 years or under with correct vaccine status is high (over 91%) and has remained stable over time. Mortality in patients who have developed complications has increased, from 27.1% in 2012 to 34.0% in 2017. Most centres achieved functional improvements during the first 30 days of admission. CONCLUSIONS Among all indicators measured in primary care, hospital and long-term care, only 14 analysed are nursing-sensitive; no nursing-sensitive indicators regarding mental health are measured. IMPLICATIONS FOR NURSING MANAGEMENT Research focused on development of nursing-sensitive indicators offers an opportunity to measure and benchmark nurses' quality of care and their contribution in achieving populations' health improvement and health care system sustainability.
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Affiliation(s)
- Anna García-Altés
- Generalitat de Catalunya, Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Mireia Subirana-Casacuberta
- Generalitat de Catalunya, Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain.,Nursing Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.,Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Fsssaculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | - Dolors Llorens
- Consell de Col·legis d'Infermeres i Infermers de Catalunya, Barcelona, Spain
| | - Ingrid Bullich
- Nursing Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.,Grup de Recerca en Cronicitat de la Catalunya Central (C3RG), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | - Alba Brugués
- Consorci de Castelldefels Agents de Salut (CASAP), Avinguda de la Ciutat de Màlaga, Castelldefels, Spain
| | - Montserrat Teixidor
- Fellow of the American Academy of Nursing, Fundació Infermeria i Societat, Barcelona, Spain
| | - Nuria Cuxart
- Consell de Col·legis d'Infermeres i Infermers de Catalunya, Barcelona, Spain
| | - Marga Esteve
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Granados-Plaza M, Gea-Caballero V, Martí-Ejarque MDM, Ferré-Grau C. Association of Nursing Practice Environment on reported adverse events in private management hospitals: A cross-sectional study. J Clin Nurs 2021; 30:2990-3000. [PMID: 33893681 DOI: 10.1111/jocn.15806] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/04/2021] [Accepted: 03/29/2021] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To examine the relationships between nurses' perceptions of their practice environment, other working conditions and reported adverse events in two private management hospitals. BACKGROUND Patient safety is influenced by knowledge, available resources and the context in which nursing care is provided. In this sense, it has been found that certain work environments (e.g., workload, nurse turnover level, patient-to-nurse ratio, nurse staffing, nurse manager ability) influence patient outcomes. The association between nursing practice environment and reported adverse events has not been explored in private management hospitals. DESIGN A cross-sectional study. The STROBE was selected as the checklist in this study. METHODS A total of 219 nurses were included in the study. This study was conducted from June 2018-June 2019 in Spain. Data were collected through questionnaires focusing on work conditions, reported adverse events (falls, medication errors, catheter-related sepsis and pressure ulcer) and Practice Environment Scale of the Nursing Work Index. Binary logistic regression analysis was performed to determine the factors influencing the occurrence of errors. RESULTS Nurses reported poor perception of the professional environment, and 62.1% reported having made at least one error in the previous year. Manager support and leadership and nurse-physician relations were the most favourable aspects of work environment. Medical-surgical units, rotating in the same shift and favourable work environment, were associated with more reporting of adverse events. CONCLUSION The factors of nursing practice (hospital area workload, staff rotating and perception of work environment) associated with reporting adverse events can be worked upon from the organisation and provided an opportunity for safety culture improvement and safer healthcare services. RELEVANCE TO CLINICAL PRACTICE Improving the nurse work environment may reduce adverse patient events in private management hospitals.
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Affiliation(s)
- Montse Granados-Plaza
- Grupo Hospitalario Quirónsalud, Hospital Universitari General de Catalunya, Barcelona, Spain.,Doctoral School, Universitat Rovira i Virgili, Tarragona, Spain
| | - Vicente Gea-Caballero
- Nursing School La Fe, Research Group GREIACC, Health Research Institute La Fe, Adscript Center of University of Valencia, Valencia, Spain
| | - Maria Del Mar Martí-Ejarque
- Grupo Hospitalario Quirónsalud, Hospital Universitari Sagrat Cor, Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Carme Ferré-Grau
- Doctorate Programme coordinator Nursing and Health, Research Group Advanced Nursing, Universitat Rovira i Virgili, Tarragona, Spain
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Park S, Park S, Lee YJ, Park CS, Jung YC, Kim S. Nurse Staffing and Health Outcomes of Psychiatric Inpatients: A Secondary Analysis of National Health Insurance Claims Data. J Korean Acad Nurs 2021; 50:333-348. [PMID: 32632069 DOI: 10.4040/jkan.19203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 01/29/2023]
Abstract
PURPOSE The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Korea by assessing National Health Insurance claims data. METHODS The dataset included 70,136 patients aged 19 years who were inpatients in psychiatric wards for at least two days in 2016 and treated for mental and behavioral disorders due to use of alcohol; schizophrenia, schizotypal and delusional disorders; and mood disorders across 453 hospitals. Nurse staffing levels were measured in three ways: registered nurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomes included length of stay, readmission within 30 days, psychiatric emergency treatment, use of injected psycholeptics for chemical restraint, and hypnotics use. Relationships between nurse staffing levels and patient outcomes were analyzed considering both patient and system characteristics using multilevel modeling. RESULTS Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatients per registered nurse, and adjusted inpatients per nursing staff were associated with longer lengths of stay as well as a higher risk of readmission. More adjusted inpatients per registered nurse and adjusted inpatients per nursing staff were also associated with increased hypnotics use but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injected psycholeptics for chemical restraint. CONCLUSION Lower nurse staffing levels are associated with negative health outcomes of psychiatric inpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatric inpatients in Korea.
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Affiliation(s)
- Suin Park
- College of Nursing, Kosin University, Busan, Korea
| | - Sohee Park
- Department of Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Young Joo Lee
- College of Nursing, Daegu Catholic University, Daegu, Korea.,Research Institute of Nursing Science, Daegu Catholic University, Daegu, Korea
| | - Choon Seon Park
- Department of Quality Assessment Administration, Health Insurance Review and Assessment Service, Wonju, Korea
| | - Young Chul Jung
- Department of Psychiatry, College of Medicine, Yonsei University, Seoul, Korea.,Institute of Behavioral Science in Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Sunah Kim
- College of Nursing, Yonsei University, Seoul, Korea.,Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Korea.
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Campbell AA, Harlan T, Campbell M, Mulekar MS, Wang B. Nurse's Achilles Heel: Using Big Data to Determine Workload Factors That Impact Near Misses. J Nurs Scholarsh 2021; 53:333-342. [PMID: 33786985 DOI: 10.1111/jnu.12652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To explore how big data can be used to identify the contribution or influence of six specific workload variables: patient count, medication count, task count call lights, patient sepsis score, and hours worked on the occurrence of a near miss (NM) by individual nurses. DESIGN A correlational and cross-section research design was used to collect over 82,000 useable data points of historical workload data from the three unique systems on a medical-surgical unit in a midsized hospital in the southeast United States over a 60-day period. Data were collected prior to the start of the Covid-19 pandemic in the United States. METHODS Combined data were analyzed using JMP Pro version 12. Mean responses from two groups were compared using a t-test and those from more than two groups using analysis of variance. Logistic regression was used to determine the significance of impact each workload variable had on individual nurses' ability to administer medications successfully as measured by occurrence of NMs. FINDINGS The mean outcome of each of the six workload factors measured differed significantly (p < .0001) among nurses. The mean outcome for all workload factors except the hours worked was found to be significantly higher (p < .0001) for those who committed an NM compared to those who did not. At least one workload variable was observed to be significantly associated (p < .05) with the occurrence or nonoccurrence of NMs in 82.6% of the nurses in the study. CONCLUSIONS For the majority of the nurses in our study, the occurrence of an NM was significantly impacted by at least one workload variable. Because the specific variables that impact performance are different for each individual nurse, decreasing only one variable, such as patient load, will not adequately address the risk for NMs. Other variables not studied here, such as education and experience, might be associated with the occurrence of NMs. CLINICAL RELEVANCE In the majority of nurses, different workload variables increase their risk for an NM, suggesting that interventions addressing medication errors should be implemented based on the individual's risk profile.
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Affiliation(s)
- Amy A Campbell
- Professor, College of Nursing, Department of Community Mental Health, University of South Alabama, Mobile, AL, USA
| | - Todd Harlan
- Chair and Professor, College of Nursing, Department of Community Mental Health, University of South Alabama, Mobile, AL, USA
| | - Matt Campbell
- Professor, School of Computing, Department of Information Systems Technology, University of South Alabama, Mobile, AL, USA
| | - Madhuri S Mulekar
- Chair and Professor, Department of Mathematics and Statistics, University of South Alabama, Mobile, AL, USA
| | - Bin Wang
- Professor, Department of Mathematics and Statistics, University of South Alabama, Mobile, AL, USA
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Khatatbeh H, Pakai A, Pusztai D, Szunomár S, Fullér N, Kovács Szebeni G, Siket A, Zrínyi M, Oláh A. Burnout and patient safety: A discriminant analysis of paediatric nurses by low to high managerial support. Nurs Open 2021; 8:982-989. [PMID: 33570274 PMCID: PMC7877129 DOI: 10.1002/nop2.708] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/03/2020] [Indexed: 11/11/2022] Open
Abstract
AIM To explore how levels of managerial support discriminate paediatric nurses' burnout, quality of life, intent to leave and adverse patient events. DESIGN A quantitative correlational study. METHODS A total of 225 paediatric nurses were selected from nine major hospitals across Jordan. The main measures used were the Copenhagen Burnout Inventory and the brief version of World Health Organization-Quality of Life Instrument. The study methods were compliant with the STROBE checklist. RESULTS Nurse manager support was negatively associated with adverse patient events, work-related burnout, client-related burnout, and intent to leave; and positively with physical and psychological quality of life. Frequency of nosocomial infections characterized low manager support, whereas medication errors described high support. Greater nurse manager support decreased the likelihood of adverse patient outcomes.
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Affiliation(s)
| | | | | | | | - Noémi Fullér
- Faculty of Health SciencesUniversity of PécsPécsHungary
| | | | - Adrienn Siket
- Faculty of Health SciencesUniversity of DebrecenNyiregyhazaHungary
| | - Miklós Zrínyi
- Faculty of Health SciencesUniversity of PécsPécsHungary
| | - András Oláh
- Faculty of Health SciencesUniversity of PécsPécsHungary
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Neves TMA, Parreira PMSD, Rodrigues VJL, Graveto JMGN. Impact of safe nurse staffing on the quality of care in Portuguese public hospitals: A cross-sectional study. J Nurs Manag 2021; 29:1246-1255. [PMID: 33482037 DOI: 10.1111/jonm.13263] [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: 08/17/2020] [Revised: 01/07/2021] [Accepted: 01/19/2021] [Indexed: 11/30/2022]
Abstract
AIM To assess the impact of safe nurse staffing on the quality of care, based on the structure-process-outcome approach, in Portuguese hospitals. BACKGROUND Safe nurse staffing is essential for the quality of care in hospital settings, together with work environment, organisational commitment and nursing practices. However, there is little evidence of its analysis in the Portuguese context. METHOD A cross-sectional survey study was conducted using a sample of 850 nurses from 12 public hospital units in the central and northern regions of Portugal. RESULTS The proposed structural equation model for quality assessment has a good fit (χ2 /df = 2.37; CFI = 0.88, PCFI = 0.83; PGFI = 0.77, RMSEA = 0.04), showing the impact of safe nurse staffing, work environment, and affective and normative organisational commitment on the quality of care (mortality rate and adverse events). The mediating effect of nursing practices was also found. CONCLUSION Safe nurse staffing, which is compromised in 90% of the units, is a predictor of the quality of care through the mediating effect of nursing practices. IMPLICATIONS FOR NURSING MANAGEMENT The results not only highlight the need for urgent intervention but also support political decision-making with a view to improving the access to quality care.
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Brooks Carthon M, Brom H, McHugh M, Sloane DM, Berg R, Merchant R, Girotra S, Aiken LH. Better Nurse Staffing Is Associated With Survival for Black Patients and Diminishes Racial Disparities in Survival After In-Hospital Cardiac Arrests. Med Care 2021; 59:169-176. [PMID: 33201082 PMCID: PMC7855314 DOI: 10.1097/mlr.0000000000001464] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Racial disparities in survival among patients who had an in-hospital cardiac arrest (IHCA) have been linked to hospital-level factors. OBJECTIVES To determine whether nurse staffing is associated with survival disparities after IHCA. RESEARCH DESIGN Cross-sectional data from (1) the American Heart Association's Get With the Guidelines-Resuscitation database; (2) the University of Pennsylvania Multi-State Nursing Care and Patient Safety Survey; and (3) The American Hospital Association annual survey. Risk-adjusted logistic regression models, which took account of the hospital and patient characteristics, were used to determine the association of nurse staffing and survival to discharge for black and white patients. SUBJECTS A total of 14,132 adult patients aged 18 and older between 2004 and 2010 in 75 hospitals in 4 states. RESULTS In models that accounted for hospital and patient characteristics, the odds of survival to discharge was lower for black patients than white patients [odds ratio (OR)=0.70; 95% confidence interval (CI), 0.61-0.82]. A significant interaction was found between race and medical-surgical nurse staffing for survival to discharge, such that each additional patient per nurse lowered the odds of survival for black patients (OR=0.92; 95% CI, 0.87-0.97) more than white patients (OR=0.97; 95% CI, 0.93-1.00). CONCLUSIONS Our findings suggest that disparities in IHCA survival between black and white patients may be linked to the level of medical-surgical nurse staffing in the hospitals in which they receive care and that the benefit of being admitted to hospitals with better staffing may be especially pronounced for black patients.
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Affiliation(s)
- Margo Brooks Carthon
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
| | - Heather Brom
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
| | - Matthew McHugh
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
| | - Douglas M. Sloane
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
| | - Robert Berg
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care, Children’s Hospital of Philadelphia
| | - Raina Merchant
- Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Saket Girotra
- Department of Internal Medicine, Division of Cardiovascular Diseases, University of Iowa Carver College of Medicine Comprehensive Access Delivery Research & Evaluation (CADRE), Iowa City Veterans Affairs Medical Center, Iowa City, IA
| | - Linda H. Aiken
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
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Al-Faouri I, Obaidat DM, AbuAlRub RF. Missed nursing care, staffing levels, job satisfaction, and intent to leave among Jordanian nurses. Nurs Forum 2020; 56:273-283. [PMID: 33345335 DOI: 10.1111/nuf.12537] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 10/16/2020] [Accepted: 12/04/2020] [Indexed: 10/22/2022]
Abstract
Patient safety is an important outcome for nurses who provide patient care within an environment that may increase the incidence of errors or impose them to omit care; these errors mostly happen because of staff shortage. The purpose of this study is to identify the types and reasons of "missed nursing care" among Jordanian nurses, and to examine the relationships between "missed nursing care", staffing, intent to leave, and job satisfaction. A cross-sectional descriptive design was used. A convenience sample of 300 nurses completed the Arabic version of MISSCARE which included items to measure types and reasons for "missed nursing care", staffing adequacy, job satisfaction, and intent to leave. The results of this study indicated that Labor resources were the most common cause of "missed nursing care". The results also showed that a low number of nurses per shift were associated with a high level of "missed nursing care". Nurse managers need to tackle staffing problems that may increase the rate of missed care and result in negative outcomes on the patients, nurses, as well as organizations. Nurse administrators could conduct evidence-based staffing plans to manage nurse to patient ratio to decrease missed care and enhance satisfaction.
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Affiliation(s)
- Ibrahim Al-Faouri
- Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Dana M Obaidat
- Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Raeda F AbuAlRub
- Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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Esteban-Sepúlveda S, Sesé-Abad A, Lacueva-Pérez L, Domingo-Pozo M, Alonso-Fernandez S, Aquilue-Ballarin M, Barcelo-Martinez AI, Cristobal-Dominguez E, Bujalance-Hoyos J, Dossantos-Sanchez C, Pascual-Pascual MA, Garcia-Arteaga E, Galisteo-Gimenez M, Mas-Dalmau G, Heredia-Reina MP, Roca-Marti S, Riart MP, Albornos-Muñoz L, Gonzalez-Maria E, Fernández-Domínguez JC. Impact of the implementation of best practice guidelines on nurse's evidence-based practice and on nurses' work environment: Research protocol. J Adv Nurs 2020; 77:448-460. [PMID: 33058281 PMCID: PMC7756465 DOI: 10.1111/jan.14598] [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: 06/09/2020] [Revised: 08/19/2020] [Accepted: 08/27/2020] [Indexed: 11/30/2022]
Abstract
AIM To determine the impact of the Best Practice Spotlight Organization® initiative on nurses' perception of their work environment and their attitudes to evidence-based practice. DESIGN Quasi-experimental, multicentre study. The intervention is the participation in Best Prectice Spotilight Organizations to implement Best Practice Guidelines. METHODS The study will include seven centres in the interventional group and 10 in the non-equivalent control group, all of them belonging to the Spanish national health system. The Practice Environment Scale of the Nursing Work Index, and the Health Sciences Evidence-Based Practice Questionnaire will be administered to a sample of 1,572 nurses at the beginning of the programme and at 1 year. This 3-year study started in April 2018 and will continue until December 2021. Statistical analyses will be carried out using the SPSS 25.0. This project was approved by the Drug Research Ethics Committee of the Parc de Salut Mar and registered in Clinical Trials. DISCUSSION The study findings will show the current state of nurses' perception of their work environment and attitudes to evidence-based practice, and possible changes in these parameters due to the programme. IMPACT The findings could provide a strong argument for health policymakers to scale up the Best Practice Spotlight Organization® initiative in the Spanish national health system.
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Affiliation(s)
- Silvia Esteban-Sepúlveda
- Methodology, Quality and Nursing Research Department, Consorci Parc de Salut MAR de Barcelona, Barcelona, Spain.,Research Group in Nursing Care (GRECI), Hospital del Mar Institute of Medical Research (IMIM), Barcelona, Spain
| | - Albert Sesé-Abad
- Faculty of Psychology, Balearic Islands University, Palma, Spain
| | - Laia Lacueva-Pérez
- Methodology, Quality and Nursing Research Department, Consorci Parc de Salut MAR de Barcelona, Barcelona, Spain.,Research Group in Nursing Care (GRECI), Hospital del Mar Institute of Medical Research (IMIM), Barcelona, Spain
| | - Manuela Domingo-Pozo
- Hospital General Universitario de Alicante, Alicante, Spain.,Nursing Department, Universidad de Alicante, Alicante, Spain.,Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - Fundación FISABIO), Alicante, Spain
| | - Sergio Alonso-Fernandez
- Catalan Institute of Health, Germans Trias i Pujol University Hospital, Barcelona, Spain.,Fundamental Care and Medical-Surgical Nursing Department, School of Nursing, University of Barcelona, Barcelona, Spain.,Health Sciences Research Institute Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Marta Aquilue-Ballarin
- Hospital Comarcal de Vinarós, Castello, Spain.,Universitat Jaume I, Castellón de la Plana, Spain
| | - Ana Isabel Barcelo-Martinez
- Facultad de Enfermería, Universidad Católica de Murcia, Murcia, Spain.,Hospital General Universitario Santa Lucía de Cartegena, Murcia, Spain
| | | | - Jesús Bujalance-Hoyos
- Grupo de Investigación en Cuidados de Málaga (INVESCUIDA), Instituto de Investigación Biomédica - IBIMA, Malaga, Spain.,Hospital Regional Universitario de Málaga, Malaga, Spain
| | | | | | | | | | | | | | | | - María Perez Riart
- Methodology, Quality and Nursing Research Department, Consorci Parc de Salut MAR de Barcelona, Barcelona, Spain
| | - Laura Albornos-Muñoz
- Nursing and Healthcare Research Unit (Investén-isciii), Instituto de Salud Carlos III, Madrid, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - Esther Gonzalez-Maria
- Nursing and Healthcare Research Unit (Investén-isciii), Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red, Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Juan Carlos Fernández-Domínguez
- Faculty of Nursing and Physiotherapy, Balearic Islands University, Palma de Mallorca, Spain.,Research Group of Care, Chronicity and Evidence in Health, Balearic Islands Health Research Institute (IdSIBa), Palma de Mallorca, Spain
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Falcó-Pegueroles A, Rodríguez-Martín D, Ramos-Pozón S, Zuriguel-Pérez E. Critical thinking in nursing clinical practice, education and research: From attitudes to virtue. Nurs Philos 2020; 22:e12332. [PMID: 33029860 DOI: 10.1111/nup.12332] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/06/2020] [Accepted: 08/30/2020] [Indexed: 11/28/2022]
Abstract
Critical thinking is a complex, dynamic process formed by attitudes and strategic skills, with the aim of achieving a specific goal or objective. The attitudes, including the critical thinking attitudes, constitute an important part of the idea of good care, of the good professional. It could be said that they become a virtue of the nursing profession. In this context, the ethics of virtue is a theoretical framework that becomes essential for analyse the critical thinking concept in nursing care and nursing science. Because the ethics of virtue consider how cultivating virtues are necessary to understand and justify the decisions and guide the actions. Based on selective analysis of the descriptive and empirical literature that addresses conceptual review of critical thinking, we conducted an analysis of this topic in the settings of clinical practice, training and research from the virtue ethical framework. Following JBI critical appraisal checklist for text and opinion papers, we argue the need for critical thinking as an essential element for true excellence in care and that it should be encouraged among professionals. The importance of developing critical thinking skills in education is well substantiated; however, greater efforts are required to implement educational strategies directed at developing critical thinking in students and professionals undergoing training, along with measures that demonstrate their success. Lastly, we show that critical thinking constitutes a fundamental component in the research process, and can improve research competencies in nursing. We conclude that future research and actions must go further in the search for new evidence and open new horizons, to ensure a positive effect on clinical practice, patient health, student education and the growth of nursing science.
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Affiliation(s)
- Anna Falcó-Pegueroles
- Department of Fundamental Care and Medical Surgital Nursing, Faculty of Medicine and Health Sciences, School of Nursing, Consolidated Research Group Quantitative Psychology (2017-SGR-269), University of Barcelona, Barcelona, Spain
| | - Dolors Rodríguez-Martín
- Department of Fundamental Care and Medical Surgital Nursing, Faculty of Medicine and Health Sciences, School of Nursing, Consolidated Research Group on Gender, Identity and Diversity (2017-SGR-1091), University of Barcelona, Barcelona, Spain
| | - Sergio Ramos-Pozón
- Department of Fundamental Care and Medical Surgital Nursing, Faculty of Medicine and Health Sciences, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Esperanza Zuriguel-Pérez
- Multidisciplinary Nursing Research Group, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron Hospital, Barcelona, Spain
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Wang L, Lu H, Dong X, Huang X, Li B, Wan Q, Shang S. The effect of nurse staffing on patient‐safety outcomes: A cross‐sectional survey. J Nurs Manag 2020; 28:1758-1766. [DOI: 10.1111/jonm.13138] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Limin Wang
- Peking University School of Nursing Beijing China
| | - Han Lu
- Peking University School of Nursing Beijing China
| | - Xu Dong
- Peking University School of Nursing Beijing China
| | - Xiuxiu Huang
- Peking University School of Nursing Beijing China
| | - Bei Li
- Peking University School of Nursing Beijing China
| | - Qiaoqin Wan
- Peking University School of Nursing Beijing China
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Al Mutair A, Amr A, Ambani Z, Salman KA, Schwebius D. Nursing Surge Capacity Strategies for Management of Critically Ill Adults with COVID-19. NURSING REPORTS 2020; 10:23-32. [PMID: 34968261 PMCID: PMC8608109 DOI: 10.3390/nursrep10010004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 01/10/2023] Open
Abstract
Background: There is a vital need to develop strategies to improve nursing surge capacity for caring of patients with coronavirus (COVID-19) in critical care settings. COVID-19 has spread rapidly, affecting thousands of patients and hundreds of territories. Hospitals, through anticipation and planning, can serve patients and staff by developing strategies to cope with the complications that a surge of COVID-19 places on the provision of adequate intensive care unit (ICU) nursing staff—both in numbers and in training. Aims: The aim is to provide an evidence-based starting point from which to build expanding staffing models dealing with these additional demands. Design/Method: In order to address and develop nursing surge capacity strategies, a five-member expert panel was formed. Multiple questions directed towards nursing surge capacity strategies were posed by the assembled expert panel. Literature review was conducted through accessing various databases including MEDLINE, CINAHL, Cochrane Central, and EMBASE. All studies were appraised by at least two reviewers independently using the Joanna Briggs Institute JBI Critical Appraisal Tools. Results: The expert panel has issued strategies and recommendation statements. These proposals, supported by evidence-based resources in regard to nursing staff augmentation strategies, have had prior success when implemented during the COVID-19 pandemic. Conclusion: The proposed guidelines are intended to provide a basis for the provision of best practice nursing care during times of diminished intensive care unit (ICU) nursing staff capacity and resources due to a surge in critically ill patients. The recommendations and strategies issued are intended to specifically support critical care nurses incorporating COVID-19 patients. As new knowledge evidence becomes available, updates can be issued and strategies, guidelines and/or policies revised. Relevance to Clinical Practice: Through discussion and condensing research, healthcare professionals can create a starting point from which to synergistically develop strategies to combat crises that a pandemic like COVID-19 produces.
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Affiliation(s)
- Abbas Al Mutair
- Research Center, Dr. Sulaiman Al Habib Medical Group, Riyadh 91877, Saudi Arabia;
- Nursing School, University of Wollongong, Wollongong, NSW 2522, Australia
- Correspondence:
| | - Anas Amr
- Patient Safety Center, Riyadh 9264, Saudi Arabia;
| | - Zainab Ambani
- Nursing College, King Saud Ben Abdulaziz University for Health Sciences, Al-Hofuf 32641, Saudi Arabia;
| | - Khulud Al Salman
- Nursing Department, Al-Jaber Hospital for Ear, Nose, Throat and Eye, Ministry of Health, Al-Hofuf 36422, Saudi Arabia;
| | - Deborah Schwebius
- Research Center, Dr. Sulaiman Al Habib Medical Group, Riyadh 91877, Saudi Arabia;
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Doo E, Kim M. Effects of hospital nurses' internalized dominant values, organizational silence, horizontal violence, and organizational communication on patient safety. Res Nurs Health 2020; 43:499-510. [DOI: 10.1002/nur.22067] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 08/08/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Eun‐Young Doo
- Department of Nursing Myongji Hospital Goyang‐si Gyeonggi‐do Republic of Korea
| | - Miyoung Kim
- College of Nursing Ewha Womans University Seoul Republic of Korea
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Kakemam E, Kalhor R, Khakdel Z, Khezri A, West S, Visentin D, Cleary M. Occupational stress and cognitive failure of nurses and associations with self-reported adverse events: A national cross-sectional survey. J Adv Nurs 2020; 75:3609-3618. [PMID: 31531990 DOI: 10.1111/jan.14201] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 08/07/2019] [Accepted: 09/04/2019] [Indexed: 11/30/2022]
Abstract
AIM To determine correlations for nurse self-reported occupational stress, prevalence of cognitive failure (CF), and adverse events. DESIGN Cross-sectional nationwide survey. METHODS Tertiary-level public hospitals (N = 115) from 13 provinces in Iran were recruited and 2,895 nurses surveyed (August 2016-December 2017). Participants' self-reported demographic information, occupational stress, CF, and frequency of adverse events were analysed using chi-square, t tests, and binary logistic regression. RESULTS This study showed that 29.1% of nurses had experienced adverse events in the past six months. Significant predictors for reported adverse events from logistic regression were 'Role stressors', 'Interpersonal relations stressors', and 'Action', while 'Working environment stressors' was protective for reported adverse events. Demographic predictors of adverse events were longer work hours and male gender, while those working in critical care units, general wards, and other wards had higher reported adverse events than for emergency wards. CONCLUSIONS Occupational stress and CF are associated with the reporting of adverse events. Further research is needed to assess interventions to address occupational stress and CF to reduce adverse events. IMPACT Adverse events compromise patient safety, lead to increased healthcare costs, and impact nursing staff. Higher self-reported adverse events were associated with higher reported stressors and CF. Understanding the factors that influence occupational stress, CF, and adverse events will support quality patient care and safety.
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Affiliation(s)
- Edris Kakemam
- Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roholla Kalhor
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Zahra Khakdel
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Khezri
- Student Research Committee, School of Nursing and Midwifery, Bam University of Medical Sciences, Bam, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sancia West
- College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia
| | - Denis Visentin
- College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia
| | - Michelle Cleary
- College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia
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Nurses' Well-Being, Health-Promoting Lifestyle and Work Environment Satisfaction Correlation: A Psychometric Study for Development of Nursing Health and Job Satisfaction Model and Scale. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103582. [PMID: 32443758 PMCID: PMC7277543 DOI: 10.3390/ijerph17103582] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/16/2020] [Accepted: 05/17/2020] [Indexed: 11/17/2022]
Abstract
Although promoting healthy work environments to enhance staff members’ health and well-being is a growing trend, no empirical studies on such a model have been conducted in the nursing management field. The purpose of this study was to develop and validate measurement scales and a conceptual model of nurses’ well-being, health-promoting lifestyle, and work environment satisfaction (WHS). A cross-sectional survey was conducted to develop a WHS model and Nursing Health and Job Satisfaction (NHJS) scale. A total of 672 questionnaires were obtained from registered nurses by stratified random sampling for validation analysis. The percentage of total variance explained greater than 92.6%, suggesting a good ability of the scales to explain the variability in participants’ responses. The hypotheses of positive correlations among nurses’ health-promoting lifestyle, well-being, and work environment satisfaction were supported. The WHS model demonstrates the positive correlation with correlation coefficients of 0.57–0.86 among nurses’ health-promoting lifestyle, well-being, and work environment satisfaction. Nurses’ attitudes play a key role in promoting a healthy lifestyle. The most important work environment satisfaction variable for improved sense of well-being is respect from other medical staff. The findings can serve as an instrument for hospital nursing administrators to accurately assess and enhance nurses’ retention rate and health.
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Prapawichar P, Ratinthorn A, Utriyaprasit K, Viwatwongkasem C. Maternal and health service predictors of postpartum hemorrhage across 14 district, general and regional hospitals in Thailand. BMC Pregnancy Childbirth 2020; 20:172. [PMID: 32183723 PMCID: PMC7079495 DOI: 10.1186/s12884-020-2846-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 02/27/2020] [Indexed: 12/28/2022] Open
Abstract
Background Postpartum hemorrhage (PPH) is a preventable complication, however, it remains being the leading cause of maternal mortality and morbidity worldwide including Thailand. Methods A case-control study to examine the risk factors associated with PPH across the hospitals under the Ministry of Public Health in Thailand, was conducted. A total of 1833 patient birth records and hospital profiles including human and physical resources from 14 hospitals were obtained. A multiple logistic regression was used identifing the factors that are significantly associated with PPH. Results The results show that the rate of PPH varied across the hospitals ranging from 1.4 to 10.6%. Women with past history of PPH were more likely to have increased risk of having PPH by 10.97 times (95% CI 2.27,53.05) compared to those who did not. The odds of PPH was higher in district and general hospitals by 14 (95% CI 3.95,50.04) and 7 (95% CI 2.27,23.27) times respectively, compared to regional hospitals. The hospitals which had inadequate nurse midwife to patient ratio (OR 2.31,95% CI 1.08,4.92), lacked nurse midwives with working experience of 6–10 years (OR 2.35, 95% CI 1.41,3.92), as well as inadequate equipment and supplies for emergency obstetric care (OR 6.47, 95% CI 1.93,21.63), had significantly higher incidence of having PPH, respectively. Conclusions This study provides interesting information that the rate of PPH varies across the hospitals in Thailand, in particular where essential nurse midwives, equipment, and supplies are limited. Therefore, improving health care services by allocating sufficient human and physical resources would contribute to significantly reduce this complication.
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Affiliation(s)
- Phat Prapawichar
- Faculty of Nursing Science, Mahidol University, Bangkok, Thailand
| | | | | | - Chukiat Viwatwongkasem
- Department of Biostatistics, Faculty of Public Health, Mahidol University, Bangkok, 10400, Thailand
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Abstract
BACKGROUND The Humpty Dumpty Falls Prevention Program was developed to address an unmet need to identify pediatric patients at risk of a fall event. PURPOSE The aim of this study was to evaluate the performance of the Humpty Dumpty Fall Scale-Inpatient (HDFS) across a diverse, international pediatric population. In addition, the characteristics of patients who experienced a fall were analyzed. METHODS A retrospective, cross-sectional design was used to assess fall risk across 16 hospitals and 2238 pediatric patients. Multiple and simple logistic regressions were performed to evaluate association of individual scale items and total score with falls during hospitalization. Reliability, sensitivity, and specificity of the HDFS were also assessed. RESULTS Several of the HDFS items were significantly associated with the risk of falls in the pediatric population, but specificity of the tool is a concern to consider for future tool enhancement. CONCLUSIONS Characteristics for further refinement of the HDFS were identified.
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Tschannen D, Anderson C. The pressure injury predictive model: A framework for hospital-acquired pressure injuries. J Clin Nurs 2020; 29:1398-1421. [PMID: 31889342 DOI: 10.1111/jocn.15171] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 11/19/2019] [Accepted: 12/20/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Despite decades of research, pressure injuries continue to be a source of significant pain and delayed recovery for patients and substantial quality and cost issues for hospitals. Consideration of the current thinking around pressure injury risk must be evaluated to improve risk assessments and subsequent nursing interventions aimed at reducing hospital-acquired pressure injuries. DESIGN This is a discursive paper using Walker and Avant's (2005) theory synthesis framework to examine the relevance of existing pressure injury models as they align with the current literature. METHODS PubMed and CINAHL indexes were searched, first for conceptual models and then for pressure injury research conducted on hospitalised patients for the years 2006-2016. A synthesis of the searches culminated into a new pressure injury risk model. CONCLUSIONS Gaps in previous models include lack of attention to the environment, contributing episode-of-care factors and the dynamic nature of injury risk for patients. Through theory synthesis, the need for a new model representing the full risk for pressure injury was identified. The Pressure Injury Predictive Model is a representation of the complex and dynamic nature of pressure injury risk that builds on previous models and addresses new patient, contextual and episode-of-care process influences. The Pressure Injury Predictive Model (PIPM) provides a more accurate picture of the complexity of contextual and process factors associated with pressure injury development. RELEVANCE TO CLINICAL PRACTICE Using the PIPM to determine risk can result in improved risk identification. This information can be used to implement targeted, evidence-based pressure injury prevention interventions specific to the patient risk profile, thus limiting unwarranted and unnecessary care.
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Affiliation(s)
- Dana Tschannen
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
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Maldonado XAN, Nascimento ERPD, Lazzari DD. NURSING PROFESSIONALS AND ADVERSE EVENT REPORTING. TEXTO & CONTEXTO ENFERMAGEM 2020. [DOI: 10.1590/1980-265x-tce-2019-0282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to identify how nurses report adverse events; to know what elements influence adverse event reporting and which reporting strategies they suggest. Method: qualitative study with a convergent care research design, conducted in a critical patient unit of a private health center in the region of Magallanes, Chile. Thirteen nurses participate in the study, through interviews and a discussion group. Results: the nurses who report adverse events do so verbally and in writing to the nurse coordinator immediately. Failure to report adverse events is mainly due to lack of knowledge of the safety culture, fear of reprisals and punishment within the workplace. As adverse event reporting strategies, they suggest continuing education about the safety culture, raising awareness and trust in that error reporting will not be met with punishment and that the error will lead to an improvement plan that avoids committing the same error on another occasion, improving communication and leadership. Conclusion: although nurses report adverse events, they are concerned with punishment, indicating the need to review the patient safety culture at a critical care unit in the study context.
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Liu X, Zheng J, Liu K, Baggs JG, Liu J, Wu Y, You L. Associations of nurse education level and nurse staffing with patient experiences of hospital care: A cross sectional study in China. Res Nurs Health 2019; 43:103-113. [DOI: 10.1002/nur.22003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 11/20/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Xu Liu
- School of NursingSun Yat‐sen UniversityGuangzhou China
| | - Jing Zheng
- School of NursingGuangdong Pharmaceutical UniversityGuangzhou China
| | - Ke Liu
- School of NursingSun Yat‐sen UniversityGuangzhou China
| | - Judith G. Baggs
- School of NursingOregon Health & Science UniversityPortland Oregon
| | - Jiali Liu
- Department of Nursing, Sun Yat‐sen University Cancer Center, Collaborative Innovation Center for Cancer MedicineState Key Laboratory of Oncology in South ChinaGuangzhou China
| | - Yan Wu
- School of NursingGuangzhou University of Chinese MedicineGuangzhou China
| | - Liming You
- School of NursingSun Yat‐sen UniversityGuangzhou China
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Kim J, Lee JY, Lee E. Risk factors for newly acquired pressure ulcer and the impact of nurse staffing on pressure ulcer incidence. J Nurs Manag 2019; 30:O1-O9. [PMID: 31811735 PMCID: PMC9545092 DOI: 10.1111/jonm.12928] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 11/29/2019] [Accepted: 12/04/2019] [Indexed: 12/14/2022]
Abstract
Aim To analyse patient factors and nurse staffing‐related issues involving hospital‐acquired pressure ulcers in patients at two types of hospital. Background Hospital‐acquired pressure ulcers are important for the safety of hospitalized patients. Hospital‐acquired pressure ulcers not only cause health problems, but also pose an economic burden to patients. In addition to patient factors such as mobility and skin integrity, hospital factors such as nurse staffing can also affect the management of such patients. Methods This study is a retrospective review of patient data and analysis of factors related to hospital‐acquired pressure ulcers using stratified Cox proportional hazards regression. Results A total of 53,923 patients were included. The incidence of hospital‐acquired pressure ulcers was 0.98 per 1,000 days. Hospital‐acquired pressure ulcers were affected by gender, age, previous falls, low oxygen levels, positioning and toilet use. When the levels of nurse staffing were determined as one of the hospital factors, the daily hours of patient care was increased thereby contributing to the reduced incidents of hospital‐acquired pressure ulcers. Conclusion Strategies for preventing hospital‐acquired pressure ulcers should be based on the analysis of risk factors. Implications for Nursing Management Most individual risk factors for hospital‐acquired pressure ulcers identified cannot be modified easily in a short time. Nurse staffing should be set at adequate levels to prevent hospital‐acquired pressure ulcers.
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Affiliation(s)
- Jinhyun Kim
- College of Nursing, Seoul National University, Seoul, Korea
| | - Jai-Yon Lee
- College of Nursing, Seoul National University, Seoul, Korea
| | - Eunhee Lee
- School of Nursing/Research Institute of Nursing Science, Hallym University, Chuncheon, Korea
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