Predictors of quality of care provided for older adults

Experiences of Healthcare Workers in Long-Term Care during COVID-19: A Scoping Review

Background: Although healthcare workers (HCWs) in long-term care (LTC) have experienced significant emotional and psychological distress throughout the pandemic, little is known about their unique experiences. Objective: This scoping review synthesizes existing research on the experiences of HCWs in LTC during the COVID-19 pandemic. Method: Following Arksey and O'Malley's framework, data published between March 2020 to June 2022, were extracted from six databases. Results: Among 3808 articles screened, 40 articles were included in the final analysis. Analyses revealed three interrelated themes: carrying the load (moral distress); building pressure and burning out (emotional exhaustion); and working through it (a sense of duty to care). Conclusion: Given the impacts of the pandemic on both HCW wellbeing and patient care, every effort must be made to address the LTC workforce crisis and evaluate best practices for supporting HCWs experiencing mental health concerns during and post-COVID-19.

Work climate in pandemic times: which burdens do German physicians in primary care report?

BACKGROUND

In Germany, general practitioners (GPs) provide basic and primary care in the ambulatory sector and refer patients to other specialists when necessary. Often, GPs present the first point of contact for patients in the German healthcare system. During the COVID-19 pandemic, GPs and other medical specialists in the ambulatory setting suddenly were confronted with unprecedented challenges.

OBJECTIVE

To answer the following research questions: How did COVID-19-related challenges affect the work climate? Do physicians with deteriorated work climate simultaneously report a worsened provision of patient care? Which challenges were the most burdening?

METHODS

In the course of the project COVID-GAMS more than 18 000 physicians of various specialties had been invited to a quantitative cross-sectional online survey (in Summer 2020). Analyses were conducted separately for the groups of GPs and other medical specialists. Group differences were analysed statistically and burdening factors were identified.

RESULTS

1703 participants were included in the analysis. 22.2% of GPs (other medical specialists: 19.9%) stated, their work climate had deteriorated. Physicians with a deteriorated work climate showed a tendency towards poorer personal provision of patient care (M = 3.75, SD = 0.98 versus M = 3.93, SD = 0.99) compared to unchanged or improved work climate. The lack of protective material in March/April 2020, changes in practice management and possible economic impacts on the practice were the most burdening factors reported by GPs.

CONCLUSION

GPs who reported a negative impact on the work climate in the course of the first pandemic lockdown also tend to see own deficits in the provision of patient care.

The Ms. Olsen test: Measurement properties of a short test of nursing staffs' competence in clinical decision-making

AIMS

To assess the measurement properties of the Ms. Olsen test for registered nurses and assistant nurses, respectively, and suggest cut-off points between competence levels.

DESIGN

Cross-sectional study. The results were analysed by implementing the Rasch Measurement Theory.

METHODS

Nursing staff working in various health care settings participated (n = 757). To measure the competence of nursing staff in clinical decision-making, a 19-item scale from the Nursing Older People-Competence Evaluation Tool-the 'Ms. Olsen test'-was used. Data were collected in October 2017, 2018 and 2019.

RESULTS

The Ms. Olsen test showed reasonably good measurement properties for registered nurses and assistant nurses respectively. Results show slightly better measurement properties for registered nurses than for assistant nurses. The cut-off for registered nurses, 0.62, corresponds to managing approximately two-thirds of the items while, for assistant nurses, the cut-off of 0.01 corresponds to managing approximately half of the items.

CONCLUSION

The Ms. Olsen test is a short (7- to 10-min) test measuring competence in clinical decision-making among nursing staff working in older people nursing. Despite reasonably good measurement properties, this should be considered an initial validation in the development of a short test for assessing clinical decision-making among nursing staff in various health care setting.

IMPACT

Several scales aiming to measure nursing competence have been developed over the last decade, but measurement properties (beyond classical test theory) are seldom evaluated, few scales concern other staff groups than registered nurses and few scales have proposed or established cut-offs for safe practice. The Ms. Olsen test is a short test of clinical decision-making that demonstrates reasonably good measurement properties. Cut-off points for registered nurses and assistant nurses were established. The Ms. Olsen test may be used to measure and evaluate competence in clinical decision-making among nursing staff working in older people nursing and educational settings.

The gerontological nurse specialist's core competencies in China: A cross-sectional study

Aim

To describe the core competencies of gerontological nurse specialists and investigate the factors that contribute to the development of core competencies.

Design

A descriptive cross‐sectional study was conducted from August 2015–March 2016.

Methods

The descriptive study of gerontological nurse specialists’ core competencies used a self‐assessment instrument with three first‐level domains (attitude, skill and knowledge) and 9 s‐level dimensions. A total of 225 gerontological nurse specialists from ten provinces in China were selected by a convenience sampling method.

Results

The average core competency score of the gerontological nurse specialists was 3.78, in the middle level(3.30–4.17/5.00). Core competency was associated with gerontological nurse specialists’ age (p = .005), professional title (p = .017), hospital level (p = .006) and passion for geriatric nursing (p = .000). The average scores of attitude, skill and knowledge were 4.45, 4.02 and 4.18, respectively. All first‐level domains were related to age (p ≤ .021) and passion for geriatric nursing (p ≤ .008); knowledge and skill were associated with professional title (p ≤ .045) and attitude and skill were associated with hospital level (p ≤ .020).

Patient safety in Work Environments: Perceptions of Pediatric Healthcare Providers in Taiwan

BACKGROUND

Extensive research on the link between the organizational characteristics of the work environment and patient safety in a healthcare organization has been conducted; yet, only a few studies have concentrated on care providers in a pediatric unit.

OBJECTIVES

To determine the correlation between different work environment factors impacting patient safety in a pediatric care unit from the perspective of registered nurses working in these units.

DESIGN

Cross-sectional design.

DATA SOURCES AND METHODS

The study was conducted with 155 registered nurses from a pediatric unit in a medical center in Taiwan with the Chinese version of the Safety Attitudes Questionnaire (SAQ) 2014-2017.

RESULTS

Teamwork climate, higher job satisfaction, and better working conditions are linked to positive perceptions of patient safety culture. Emotional exhaustion is negatively related to most dimensions of patient safety.

CONCLUSION

Teamwork climate, job satisfaction, working conditions, and emotional exhaustion were identified as critical factors impacting the patient safety climate.

IMPLICATIONS FOR NURSING OR HEALTH POLICY

Investments to improve teamwork climate, job satisfaction, and working conditions and reduce emotional exhaustion may have a positive effect on patient safety in pediatric care units.