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Demir M, Håkansson E, Drott J. Nurses' experiences of moral distress and how it affects daily work in surgical care-a qualitative study. J Adv Nurs 2024; 80:2080-2090. [PMID: 37975326 DOI: 10.1111/jan.15966] [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: 06/25/2023] [Revised: 10/26/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
AIM To describe nurses' and specialist nurses' experiences of moral distress and how it affects daily work in surgical care. DESIGN A qualitative descriptive study design was used. METHODS A qualitative study with 12 interviews with nurses and specialist nurses working in surgical care. All interviews were conducted during October and November 2022 in two hospitals in southeastern Sweden. Data were analysed using conventional qualitative content analysis. FINDINGS Three categories and seven subcategories generated from the data analysis. The three categories generated from the analysis were Experiences that lead to moral distress, Perceived consequences of moral distress and Strategies in case of moral distress. The results show that a lack of personnel in combination with people with complex surgical needs is the main source of moral distress. Both high demands on nurses as individuals and the teamwork are factors that generate moral distress and can have severe consequences for the safety of patients, individual nurses and future care. CONCLUSIONS The results show that moral distress is a problem for today's nurses and specialist nurses in surgical care. Action is necessary to prevent nurses from leaving surgical care. Prioritizing tasks is perceived as challenging for the profession, and moral distress can pose a patient safety risk. IMPACT Surgical care departments should design support structures for nurses, give nurses an authentic voice to express ethical concerns and allow them to practice surgical nursing in a way that does not violate their core professional values. Healthcare organizations should take this seriously and work strategically to make the nursing profession more attractive. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution.
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Affiliation(s)
- Maria Demir
- Department of Surgery, Department of Biomedicine and Clinical Sciences, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Elin Håkansson
- Department of Surgery, Regional Hospital of Växjö, Växjö, Sweden
| | - Jenny Drott
- Department of Surgery, Department of Biomedicine and Clinical Sciences, County Council of Östergötland, Linköping University, Linköping, Sweden
- Division of Nursing Science and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Feeley AA, Timon C, Feeley IH, Sheehan E. Extended-Duration Work Shifts in Surgical Specialties: A Systematic Review. J Surg Res 2024; 293:525-538. [PMID: 37827031 DOI: 10.1016/j.jss.2023.08.024] [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: 01/09/2023] [Revised: 07/17/2023] [Accepted: 08/31/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION There has been widespread international implementation of duration-hour restrictions to prevent surgical resident burnout and promote patient safety and wellbeing of doctors. A variety of Extended-Duration Work Shifts (EDWS) have been implemented, with a variety of studies examining the effect of shift systems on both surgical performance and the stress response unestablished in the literature. METHODS This was a systematic review evaluating the impact of extended working hours on surgical performance, cognitive impairment, and physiological stress responses. The review used PubMed, Ovid Medline, Embase, and Google Scholar search engines between September and October 2021 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Filters including studies carried out after 2002 and published in the English language were applied. RESULTS In total, 30 studies were included for analysis. General surgery was the most commonly studied rotation, with Neurosurgical, Orthopedic, and ear, nose and throat specialties also included. The majority of studies found no difference or a significant improvement in post-EDWS on simulated performance. EDWS appeared to have the greatest impact on physiological stress markers in junior surgical trainees. CONCLUSIONS Experience appears to confer a protective element in the postcall period, with preservation of skill demonstrated. More experienced clinicians yielded lower levels of physiological markers of stress, although variability in hierarchical workload should be considered. Heterogeneity of findings across physiological, cognitive, and psychomotor assessments highlights the need for robust research on the optimum shift pattern prevents worker burnout and promotes patient safety. Future research to evaluate correlation between stress, on-call workload, and performance in the postcall period is warranted.
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Affiliation(s)
- Aoife A Feeley
- Department of Plastic Surgery, Connolly Hospital Blanchardstown, Dublin, Ireland; School of Medicine, University College Dublin, Belfield, Dublin, Ireland; School of Medicine, Royal College Surgeons Ireland, Dublin, Ireland.
| | - Charlie Timon
- The Walton Centre, Lower Ln, Fazakerley, Liverpool, United Kingdom
| | - Iain H Feeley
- The Walton Centre, Lower Ln, Fazakerley, Liverpool, United Kingdom
| | - Eoin Sheehan
- Department of Surgery, Midland Regional Hospital Tullamore, Tullamore, Co. Offaly, Ireland
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Avallin T, Muntlin Å, Kitson A, Jangland E. Testing a model for person-centred pain management: A systematic review and synthesis guided by the Fundamentals of Care framework. J Clin Nurs 2023; 32:6811-6831. [PMID: 37245067 DOI: 10.1111/jocn.16770] [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: 01/20/2023] [Revised: 04/25/2023] [Accepted: 05/12/2023] [Indexed: 05/29/2023]
Abstract
AIMS To test a model for person-centred pain management using qualitative evidence in the literature and refine it based on the results. DESIGN A qualitative systematic review with thematic synthesis using the Fundamentals of Care framework. METHODS AND DATA SOURCES A literature search in February 2021 in six scientific databases: CINAHL, PsycInfo, Pubmed, Scopus, Social Science Premium Collection and Web of Science, reported using ENTREQ and PRISMA. Quality assessment was performed for the individual studies. Thematic analysis and the GRADE-CERQual approach were used in the synthesis including the assessment of confidence in the evidence. RESULTS The model was tested against the evidence in 15 studies appraised with moderate or high quality and found represented in the literature but needed to be expanded. A refined model with a moderate/high confidence level of evidence presents elements to be used in a holistic care process; The nurse is guided to establish a trusting relationship with the patient and enable communication to identify and meet pain management needs using pharmacological and non-pharmacological management. Nurse leaders are guided to support this process by providing the right contextual conditions. CONCLUSIONS The strengths of the confidence level in the refined model, and that it is represented from the nurse and patient perspectives in nursing research across countries and cultures, support our recommendation for empirical evaluation. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE The model links the knowledge of pain management elements from individual studies together into actions to be performed in clinical practice. It also outlines the organizational support needed to make this happen. Nurses and nursing leaders are suggested to test the model to implement person-centred pain management in clinical practice. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. IMPACT What Problem Did the Study Address? There is a need to transfer available evidence of person-centred pain management into practice to relieve the patient from pain. What Were the Main Findings? Person-centred pain management is of high priority for patients and nurses around the world and can be performed in a holistic care process including patient-nurse trust and communication, supported by contextual conditions to deliver timely pharmacological and non-pharmacological pain management addressing the patient's physical, psychosocial and relational care needs. Where and on Whom will the Research Have an Impact? The model is to be tested and evaluated in clinical practice to guide the providers to relieve the patient from pain. REPORTING METHOD Relevant EQUATOR guidelines were used to report the study: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.
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Affiliation(s)
- Therese Avallin
- Department of Surgical Sciences, Nursing Research, Uppsala University, Uppsala, Sweden
| | - Åsa Muntlin
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala, Sweden
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Public Health and Caring Sciences/Health Services Research, Uppsala University, Uppsala, Sweden
| | - Alison Kitson
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Eva Jangland
- Department of Surgical Sciences, Nursing Research, Uppsala University, Uppsala, Sweden
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Ji Y, Choi EK, Han SW. The association between nurse continuity and hypospadias repair patient outcomes: A retrospective study. J Adv Nurs 2023; 79:3513-3521. [PMID: 37073854 DOI: 10.1111/jan.15678] [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: 09/06/2022] [Revised: 03/03/2023] [Accepted: 04/07/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND Recently, nurse continuity, the intensity and consistency of a patient's exposure to nurses during hospitalization, has been shown to be associated with patient outcomes. However, little is known about how nurse continuity is related to patients' surgical outcomes. AIMS To examine the association between nurse continuity and outcomes of hypospadias repair to clarify the importance of nurse continuity as a nursing practice. DESIGN This is a retrospective study. METHODS We analysed the data from electronic health records of patients under 1 year who had undergone proximal hypospadias repair between January 2014 and December 2016. Nurse continuity was measured using the Continuity of Care Index. Since approximately half of the patients reportedly needed further operations in the long term, the primary outcome was whether patients with proximal hypospadias repair had two or more additional operations within 3 years of discharge. RESULTS The rate of undergoing two or more follow-up operations in 3 years was significantly higher in patients with low nurse continuity-38.6% versus 12.8% for high continuity. CONCLUSION This study identified nurse continuity as an important factor related to patients' surgical outcomes. These findings suggest that nurse continuity be considered an important nursing strategy for patient outcomes and further research is needed on this topic. IMPACT STATEMENT As empirical evidence regarding the association between nurse continuity and patient outcomes grows, nurse managers and policymakers should view nurse continuity as a critical factor for positive patient outcomes when considering nursing workforce regulations. NO PATIENT OR PUBLIC CONTRIBUTION The data for this study were obtained from electronic health records, and the entire process of this study did not involve patient or public participation.
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Affiliation(s)
- Yoonhye Ji
- Department of Nursing, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Eun Kyoung Choi
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Sang Won Han
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
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Albsoul RA, Safadi RR, Alshyyab MA, FitzGerald G, Hughes JA, Ahmad M. Missed Nursing Care in Medical and Surgical Wards in Jordan: A Cross-Sectional Study. Policy Polit Nurs Pract 2023; 24:140-150. [PMID: 36798019 DOI: 10.1177/15271544231155845] [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] [Indexed: 06/18/2023]
Abstract
Missed nursing care is a multifaceted patient safety issue receiving increased attention among healthcare scholars worldwide. There is limited research on missed nursing care in the Jordanian healthcare context. The current study sought to examine the perceptions of Jordanian nurses toward the amount and types of missed nursing care in medical and surgical wards. We also examined the differences in missed care items between public, private, and university hospitals in Jordan. This was a cross-sectional study using the MISSCARE Survey tool. Data collection spanned 4 months between March and July 2021. The final study sample consisted of 672 registered nurses employed in five public, three private, and two university hospitals in Jordan. Data were analyzed using descriptive statistics, Analysis of variance, and Pearson correlation coefficent test. Of the 672 registered nurses who participated, the majority were females (n = 421; 62.6%). Most participants held a bachelor's degree in nursing (n = 577; 85.9%). The three most common missed nursing activities in the participating hospitals were: ambulation, oral care, and emotional support. Nurses working in public hospitals reported the highest missed nursing care. The age and number of patients under care significantly correlated with missed nursing care. The findings could help nursing managers develop plans to reduce missed nursing care in their healthcare institutions.
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Affiliation(s)
- Rania Ali Albsoul
- Department of Family and Community Medicine, School of Medicine, 54658The University of Jordan, Irbid, Jordan
| | - Reema Rafiq Safadi
- Department of Maternal and Child Health Nursing, School of Nursing, 54658The University of Jordan, Amman, Jordan
| | - Muhammad Ahmed Alshyyab
- Department of Public Health and Community Medicine, Faculty of Medicine, 37251Jordan University of Science and Technology, Amman, Jordan
| | - Gerard FitzGerald
- School of Public Health and Social Work, 1969Queensland University of Technology, Brisbane, Australia
| | - James A Hughes
- School of Nursing, 1969Queensland University of Technology, Brisbane, Australia
| | - Muayyad Ahmad
- Department of Clinical Nursing, School of Nursing, 54658The University of Jordan, Amman, Jordan
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Blomberg AC, Lindwall L, Bisholt B. Operating theatre nurses' with managerial responsibility: Self-reported clinical competence and need of competence development in perioperative nursing. Nurs Open 2021; 9:692-704. [PMID: 34741502 PMCID: PMC8685815 DOI: 10.1002/nop2.1120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/08/2021] [Accepted: 10/14/2021] [Indexed: 01/13/2023] Open
Abstract
Aim The aim of this study was to investigate operating theatre nurses (OTNs) with managerial responsibility, and their self‐rated clinical competence and need for competence development in perioperative nursing. Design A cross‐sectional study was applied using a modified version of Professional Nurse Self‐Assessment Scale of Clinical Core Competence I. Method Data were collected from 303 OTNs in Sweden, 80 of whom indicated that they had managerial responsibility. Statistics analysis was used to identify the relationships between background variables to compare OTNs with and without managerial responsibility and their need for competence development. Results OTNs with an academic degree and managerial responsibility self‐rated their clinical competence higher compared with OTNs without an academic degree. It also turned out that OTNs with RN education and 1‐year advanced nursing in theatre care, and master's 60 credits had a lower need for competence development in cooperation and consultation, professional development and critical thinking.
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Affiliation(s)
| | - Lillemor Lindwall
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Birgitta Bisholt
- Department of Health Sciences, Swedish Red Cross University College, Huddinge, Sweden
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Jangland E, Gunningberg L, Nyholm L. A mentoring programme to meet newly graduated nurses' needs and give senior nurses a new career opportunity: A multiple-case study. Nurse Educ Pract 2021; 57:103233. [PMID: 34678635 DOI: 10.1016/j.nepr.2021.103233] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 10/20/2022]
Abstract
AIM To evaluate the implementation of a multifaceted mentoring programme in a large university hospital and describe its value from the perspectives of newly graduated nurses, experienced nurses and the hospital organisation. BACKGROUND Healthcare organisations need long-term competence-planning strategies to retain nurses, prevent their premature departure from the profession and use their competencies. This paper reports a mentoring programme focused on supporting newly graduated nurse' transition to practice and senior nurses' professional development as supervisors. DESIGN A multiple-case study. METHODS We performed 35 interviews with nurses, supervisors and nurse managers in the five units that implemented the programme, mapped the programme at the hospital level and extracted the nurses' working hours. The interviews were analysed thematically using the theoretical lens of the head-heart-hand model to interpret the results. RESULTS Of 46 units in the hospital, 14 had implemented one or several of the components in the mentoring programme. The programme corresponded to the newly graduated nurses' needs, gave senior nurses a new career opportunity and contributed to an attractive workplace. The main theme, Giving new nurses confidence, experienced nurses a positive challenge and the organisation an opportunity to learn, reflects the value of the programme's supervisory model to new and experienced nurses and to the organisation as a whole. CONCLUSION The mentoring programme appeared to be a promising way to smooth the transition for newly graduated nurses. The experienced supervising nurses were key to the success of this complex programme, supporting the new nurses at the bedside and being available to respond to their questions and reflections. Embedding the supervisors in the units' daily practice was necessary to the success of the different parts of the programme. Despite the strategic and well-designed implementation of this mentoring programme aimed to solve the everyday challenge of nurse shortages in the hospital, it was a challenge to implement it fully in all the units studied.
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Affiliation(s)
- Eva Jangland
- Department of Surgical Sciences, Uppsala University, Uppsala University Hospital, Entrance 15, SE-751 85 Uppsala, Sweden.
| | - Lena Gunningberg
- Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, SE-751 85 Uppsala, Sweden.
| | - Lena Nyholm
- Department of Neuroscience/Neurosurgery, Uppsala University, Uppsala University Hospital, Entrance 85, SE-751 85 Uppsala, Sweden.
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Arakelian E, Rudolfsson G. Managerial challenges faced by Swedish nurse managers in perioperative settings- a qualitative study. BMC Nurs 2021; 20:117. [PMID: 34217294 PMCID: PMC8255012 DOI: 10.1186/s12912-021-00640-0] [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: 08/21/2020] [Accepted: 06/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nurse managers need to create cultures that are worthy, not only of the commitment of everyone who comes to work but also of the trust of everyone who comes to be served. The aim of our study was to describe the challenges faced by Swedish nurse managers in a perioperative setting. METHODS A qualitative study was conducted. The participants were chosen by convenience sampling, and individual in-depth interviews were conducted. Data were analysed by Systematic Text Condensation. The COREQ checklist was consulted throughout the study to optimise the quality. RESULTS Nineteen nurse managers (all women) participated. Six themes were identified: "striving to treat employees with consideration and solicitude"; "the obligation to take care of each employee's individual needs"; "convincing others was an uphill battle", "finding solutions when things seem impossible"; "staff recruitment, allocation, and management"; "working with constantly changing planning". CONCLUSIONS The nurse managers faced challenges because of the overwhelming amount of work tasks, with almost no time for reflection. Having carefully chosen tasks and a realistic time schedule for each work task, plus time to find one's own path to inner peace, are essential for nurse managers. Organisations that provide these prerequisites show that they care about their nurse managers. The results of this study indicate the need for time to reflect, as well as support from superior managers and from the human resources department.
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Affiliation(s)
- Erebouni Arakelian
- Department of Surgical Sciences, Uppsala University, Uppsala University Hospital, Entrance 70, 1st Floor, 751 85, Uppsala, SE, Sweden.
| | - Gudrun Rudolfsson
- Faculty of Nursing and Health Sciences, Nord University, 8049, Bodø, Norway.,Division of Nursing, Department of Health Sciences, University West, SE-461 86, Trollhättan, Sweden
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Afshar M, Sadeghi-Gandomani H, Masoudi Alavi N. A study on improving nursing clinical competencies in a surgical department: A participatory action research. Nurs Open 2020; 7:1052-1059. [PMID: 32587724 PMCID: PMC7308675 DOI: 10.1002/nop2.485] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 02/18/2020] [Accepted: 02/24/2020] [Indexed: 11/30/2022] Open
Abstract
Aims The purpose of the present study was to improve clinical competencies in nursing staff in a selected surgical department in Kashan/Iran during 2016-2018. Design This was a participatory action research. Methods This action research was implemented in four steps of problem identification, planning, action and reflection. Interviews, focus groups and observation were used for the qualitative part. Conditions of Work Effectiveness Questionnaire-II, job satisfaction and patients' satisfaction questionnaires were completed before and after the study. Qualitative content analysis, paired and independent t test were used for data analysis. Results Three main problems could affect the clinical competencies including professional insufficiency, basic shortages and external influences. Three changes were implemented in the surgical department including improving education, involving nursing students in patients' education and increasing the motivations by peer evaluation and selecting the nurse of the week. The changes significantly increased patients' satisfaction, nurses' job satisfaction and work effectiveness.
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Affiliation(s)
- Mohammad Afshar
- Trauma Nursing Research Center Kashan University of Medical Sciences Kashan Iran
| | | | - Negin Masoudi Alavi
- Trauma Nursing Research Center Kashan University of Medical Sciences Kashan Iran
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Conner T, Unsworth J, Machin A. Patient safety from executive hospital management to wards: A qualitative study identifying factors influencing implementation. J Nurs Manag 2020; 28:1134-1143. [PMID: 32492255 DOI: 10.1111/jonm.13062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 05/11/2020] [Accepted: 05/25/2020] [Indexed: 11/27/2022]
Abstract
AIM To examine the journey of safety initiatives from executive hospital management to ward. BACKGROUND Hospital management teams are often responsible for identifying safety priorities and ensuring delivery of these. METHOD Naturalistic study design within a large NHS Hospital Trust. Using semi-structured interviews, focus groups and secondary data analysis, the study examines the implementation of safety initiatives. RESULTS While hospital management developed five safety initiatives, only one of these (falls prevention) was actually seen to permeate all layers of the organisation. Other initiatives stopped one layer down. Both middle management and ward staff added to the list of initiatives developed, resulting in 16 priorities. A range of positive and negative influences to successful implementation are identified. CONCLUSIONS Safety initiatives need positive reinforcement at all levels to be addressed appropriately. The research suggests that a model related to improvement science may prove useful in ensuring that priorities are addressed. IMPLICATIONS FOR NURSING MANAGEMENT Care should be taken to ensure that safety initiatives are successfully implemented at all levels within an organisation. Identifying priorities with staff and sharing values and priorities are a key approach to leading such initiatives.
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Affiliation(s)
- Tony Conner
- Northumbria University, Newcastle-upon-Tyne, UK
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Albsoul R, FitzGerald G, Finucane J, Borkoles E. Factors influencing missed nursing care in public hospitals in Australia: An exploratory mixed methods study. Int J Health Plann Manage 2019; 34:e1820-e1832. [PMID: 31448478 DOI: 10.1002/hpm.2898] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/14/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Missed nursing care (MNC) is a significant health care issue that impacts on the quality of health care and patient safety. It refers to delayed or omitted aspects of nursing care (totally or partially). MNC is an under-researched area in the Australian health care context. OBJECTIVE This research sought to further explore the MNC phenomenon in the context of an acute care hospital and to identify its common elements and the factors influencing its occurrence. DESIGN A convergent parallel mixed methods design was employed involving secondary analysis of routinely collected hospital data and a survey of 44 nursing staff using the MISSCARE survey instrument. The two sources of data were converged to address the objective. FINDINGS The study found that the most common elements of missed nursing care include failure of patient ambulation, emotional support for patients and/or family, and the provision of full documentation. These elements are consistent with previous international studies conducted in acute care hospital settings. This study identified that local context impacting on MNC was also important and included interruptions to workflow, "perceived" lack of management support, poor handover, and communication breakdown between the nursing team and medical staff. CONCLUSION Consideration of the local health care context is foundational in understanding the MNC phenomenon. The findings of this research may help nursing managers mitigate the possible effects of MNC and therefore improve patient safety in their acute care environment. Additional multisite studies are required to further explore factors associated with MNC in both general and local contexts.
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Affiliation(s)
- Rania Albsoul
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Gerard FitzGerald
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Julie Finucane
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Erika Borkoles
- School of Medicine, Griffith University, Gold Coast, QLD, Australia
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Karlsson A, Lindeborg P, Gunningberg L, Jangland E. Evidence‐based nursing—How is it understood by bedside nurses? A phenomenographic study in surgical settings. J Nurs Manag 2019; 27:1216-1223. [DOI: 10.1111/jonm.12802] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/30/2019] [Accepted: 05/19/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Lena Gunningberg
- Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden
| | - Eva Jangland
- Department of Surgical Sciences Uppsala University Uppsala Sweden
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Gröndahl W, Muurinen H, Katajisto J, Suhonen R, Leino-Kilpi H. Perceived quality of nursing care and patient education: a cross-sectional study of hospitalised surgical patients in Finland. BMJ Open 2019; 9:e023108. [PMID: 30948561 PMCID: PMC6500100 DOI: 10.1136/bmjopen-2018-023108] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES This study aims to analyse the relationship between patient education and the quality of surgical nursing care as perceived by patients. The background of the study lies in the importance of a patient-centred approach for both patient education and quality evaluation. DESIGN This was a cross-sectional descriptive correlational study with surgical patients. SETTING Data were collected in 2013 in one hospital district in Finland. PARTICIPANTS 480 hospitalised surgical patients. METHODS The data were collected using two structured instruments: one measuring the perceived quality of nursing care experienced by patients (Good Nursing Care Scale) and one measuring the received knowledge of hospital patients (RKhp). Data were analysed statistically using descriptive and inferential statistics to describe the sample and study variables. Pearson's correlation coefficients were used to analyse the association between the scales. RESULTS Surgical hospital patients evaluated the level of the quality of nursing care as high; this was especially true with reference to the environment and staff characteristics, but not to collaboration with family members. Most (85%) of the patients had received sufficient knowledge preoperatively and they were familiar with the proceeding of their care and treatment after discharge; in particular, they had received bio-physiological knowledge, consisting of knowledge of the disease, symptoms and the physiological elements of care. The positive correlation between the perceived quality of surgical nursing care and received knowledge was strong, suggesting a positive relationship between patient education and improvement of the quality of nursing care. CONCLUSIONS Based on the results, the quality of nursing care and patient education are interconnected. Thus, by improving patient education, the quality of nursing care can also be improved. It is particularly important to improve collaboration with family members and patients' own management strategies as well as the multidimensionality of educational knowledge.
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Affiliation(s)
- Weronica Gröndahl
- Digestive and Urology Clinic, Turku University Hospital, Turku, Finland
| | - Hanna Muurinen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
- City of Turku, Welfare Division, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
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Sahlström M, Partanen P, Azimirad M, Selander T, Turunen H. Patient participation in patient safety-An exploration of promoting factors. J Nurs Manag 2018; 27:84-92. [PMID: 30129073 DOI: 10.1111/jonm.12651] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 04/02/2018] [Accepted: 04/14/2018] [Indexed: 12/11/2022]
Abstract
AIMS To study how internal medicine patients experienced patient safety during their recent periods of care and to identify explanatory factors for patient participation. BACKGROUND Patient participation is recognized as one of the main factors promoting quality and safety and the identification of effective interventions that encourage safe care. METHODS A cross-sectional survey of patients (n = 462) in the internal medicine wards (n = 18) of all five Finnish university hospitals. Data were analysed using principal component analysis and multiple linear regression. RESULTS Most patients (78%) assessed the level of patient safety on their ward as "very good" or "excellent," 20% of patients assessed it as acceptable or worse. The following were considered to be the most important factors explaining higher patient participation: informing patients about the research and encouraging them to participate (β = 0.378, p < 0.001), providing necessary information promptly and comprehensibly (β = 0.393, p < 0.001), and enhancing patients' ability to identify patient safety incident(s) (β = 0.186, p < 0.001). CONCLUSIONS Healthcare workers must improve by encouraging patient participation and providing relevant information to patients. IMPLICATION FOR NURSING MANAGEMENT Nursing leaders must be competent to support, lead, and allocate resources for the creation of an environment where patient participation can occur and is valued by health care workers.
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Affiliation(s)
- Merja Sahlström
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.,Ylä-Savo SOTE Joint Municipal Authority, Iisalmi, Finland
| | - Pirjo Partanen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Mina Azimirad
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Tuomas Selander
- Kuopio University Hospital, Science Service Center, Kuopio, Finland
| | - Hannele Turunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.,Kuopio University Hospital, Kuopio, Finland
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15
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Kvarnström S, Jangland E, Dahlgren MA. Introducing the nurse practitioner into the surgical ward: an ethnographic study of interprofessional teamwork practice. Scand J Caring Sci 2017; 32:765-771. [DOI: 10.1111/scs.12507] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 06/19/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Susanne Kvarnström
- Region Östergötland; Linköping Sweden
- Department of Medicine and Health Sciences; Linköping University; Linköping Sweden
- Jönköping Academy for Improvement of Health and Welfare; Jönköping University; Jönköping Sweden
| | - Eva Jangland
- Department of Surgical Sciences; Uppsala University; Uppsala Sweden
- Department of Surgery; Uppsala University Hospital; Uppsala Sweden
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