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Turcato G, Zaboli A, Brigo F, Parodi M, Fulghesu F, Bertorelle L, Sibilio S, Mian M, Ferretto P, Milazzo D, Trentin M, Marchetti M. Is the National Early Warning Score able to identify nursing activity load? A prospective observational study. Int J Nurs Stud 2024; 154:104749. [PMID: 38522185 DOI: 10.1016/j.ijnurstu.2024.104749] [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: 10/07/2023] [Revised: 02/26/2024] [Accepted: 03/02/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND The National Early Warning Score scale correlates well with the intensity of the patient's acute condition. It could also correlate with the nursing activity load and prove useful in defining and redistributing nursing resources based on the acuity of patients. AIM To assess whether patients' National Early Warning Score at hospital admission correlates with objective nursing demands and can be used to optimize the distribution of available care resources. METHODS This single-center prospective study included patients admitted to the Department of Internal Medicine at the Civil Hospital in Altovicentino (Italy) between September 1 and December 31, 2022. Nursing activities were recorded for the first three days after admission and standardized to the daily mean as performance/5 min/patient/day. Linear regression was used to assess the correlation between nursing demands for different National Early Warning Scores. RESULTS This study included 333 patients. Their mean National Early Warning Score was 3.9 (standard deviation: 2.9), with 61 % (203/333) in the National Early Warning Score <5 category, 19.5 % (65/333) in the National Early Warning Score 5-6 category, and 19.5 % (65/333) in the National Early Warning Score >6 category. Their average daily care requirements increased from 22 (16-30) activities/5 min/patient/day in the low National Early Warning Score category to 30 (20-39) activities/5 min/patient/day in the intermediate National Early Warning Score category (p < 0.001) and 35 (23-45) activities/5 min/patient/day in the high National Early Warning Score category (p < 0.001). CONCLUSION The National Early Warning Score correlates with nursing care activities for patients with an acute condition and can be used to optimize the distribution of available care resources.
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Affiliation(s)
- Gianni Turcato
- Department of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Santorso, Italy
| | - Arian Zaboli
- Innovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy.
| | - Francesco Brigo
- Innovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy
| | - Marta Parodi
- Department of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Santorso, Italy
| | - Francesca Fulghesu
- Department of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Santorso, Italy
| | - Lidia Bertorelle
- Department of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Santorso, Italy
| | - Serena Sibilio
- Universitat Basel Department Public Health, Institute of Nursing Science, Basel, BS, Switzerland
| | - Michael Mian
- Innovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy; College of Health Care-Professions Claudiana, Bozen, Italy
| | - Paolo Ferretto
- Department of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Santorso, Italy
| | - Daniela Milazzo
- Department of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Santorso, Italy
| | - Monica Trentin
- Department of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Santorso, Italy
| | - Massimo Marchetti
- Department of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Santorso, Italy
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Zozman M, Stocker R. [Correlation of patient satisfaction with nurses' time spent at the bedside: A prospective observational study]. Pflege 2023; 37:246-255. [PMID: 37476991 DOI: 10.1024/1012-5302/a000951] [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: 07/22/2023]
Abstract
Correlation of patient satisfaction with nurses' time spent at the bedside: A prospective observational study Abstract. Background: Patient satisfaction is of high importance in quality assurance in many hospitals. The existing shortage of nursing staff and the resulting additional workload for individual nurses reduce the time available for patient care. Aim: The aim of this study is to explore a possible relationship of patient satisfaction with the time spent by nurses at the bedside and the influence of other influencing predictors. Methods: In this observational study, nursing attendance time was collected using attendance records which were verified by digital call light logs, and then evaluated using a linear regression model including patient satisfaction. Results: The nursing attendance time showed no significant influence on "patient satisfaction" (p = 0.155). The most important variables influencing "patient satisfaction" were: "no previous hospital experience" (p = 0.001), "importance of care" (p < 0.001) and "Gender" (form male) (p = 0.001). Conclusions: The time spent by nurses at the patient's bedside is not considered decisive enough to have a clear positive influence on patient satisfaction. Adaptations in nursing care are recommended, which enable a holistic relationship building and goal-oriented nursing care that favours patient satisfaction.
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Affiliation(s)
- Martin Zozman
- Clinical Trial Unit, Pflegeforschung, Klinik Hirslanden, Zürich, Schweiz
- Medizinisch-Wissenschaftliche Fakultät, Private Universität im Fürstentum Liechtenstein, Triesen, Fürstentum Liechtenstein
| | - Reto Stocker
- Clinical Trial Unit, Pflegeforschung, Klinik Hirslanden, Zürich, Schweiz
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van der Mark CJEM, Kraan J, Hendriks PHJ, Vermeulen H, Oostveen CJV. Defining adequacy of staffing in general hospital wards: a Delphi study. BMJ Open 2022; 12:e058403. [PMID: 35918122 PMCID: PMC9351332 DOI: 10.1136/bmjopen-2021-058403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To gain consensus on the items that determine adequacy of shift staffing. DESIGN This was a three-round Delphi study to establish consensus on what defines adequacy of shift staffing in a general hospital ward. A literature review, focus group and five semistructured expert interviews were used to generate items for the Delphi study. SETTING Multicentre study in The Netherlands. PARTICIPANTS Nurses, head nurses, nursing managers, and capacity consultants and managers working for Dutch hospitals. RESULTS Twenty-six items were included in the Delphi study. One hundred and sixty-eight, 123 and 93 participants were included in the first, second and third round, respectively. After three rounds, six items were included (mostly related to direct patient care) and nine items were excluded. No consensus was reached on 12 items, including one item that was added after the first round. CONCLUSIONS This is the first study to specify items that determine adequacy of staffing. These items can be used to measure adequacy of staffing, which is crucial for enhancing nurse staffing methods. Further research is needed to refine the items of staffing adequacy and to further develop and psychometrically test an instrument for measuring staffing adequacy.
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Affiliation(s)
- Carmen J E M van der Mark
- Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Radboudumc, Nijmegen, The Netherlands
- Department of Capacity Management, Rijnstate Hospital, Arnhem, The Netherlands
| | - Jocelynn Kraan
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Paul H J Hendriks
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - Hester Vermeulen
- Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Radboudumc, Nijmegen, The Netherlands
- Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Catharina J van Oostveen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Spaarne Gasthuis Academy, Spaarne Gasthuis Hospital, Hoofddorp and Haarlem, The Netherlands
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4
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Park CSY, Kabak M, Kim H, Lee S, Cummings GG. No More Unimplementable Nurse Workforce Planning. Contemp Nurse 2022; 58:237-247. [DOI: 10.1080/10376178.2022.2056067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Claire Su-Yeon Park
- University of Alberta Faculty of Nursing, Edmonton, Canada
- Center for Econometric Optimization in the Nursing Workforce, Seoul, Republic of Korea
- SECURE Team For You (SweEt spot ConsUlting REsearch Team For the next generation, You)
| | - Mehmet Kabak
- Department of Industrial Engineering, Gazi University Faculty of Engineering, Ankara, Turkey
| | - Haejoong Kim
- SECURE Team For You (SweEt spot ConsUlting REsearch Team For the next generation, You)
- Material Handling Automation Group, Samsung Electronics Co., Ltd., Hwaseong-si, Gyeonggi-do, Republic of Korea
| | - Sangmin Lee
- SECURE Team For You (SweEt spot ConsUlting REsearch Team For the next generation, You)
- School of Information Convergence, Kwangwoon University College of Software and Convergence, Seoul, Republic of Korea
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van der Mark CJEM, Vermeulen H, Hendriks PHJ, Oostveen CJV. Measuring perceived adequacy of staffing to incorporate nurses' judgement into hospital capacity management: a scoping review. BMJ Open 2021; 11:e045245. [PMID: 33879488 PMCID: PMC8061817 DOI: 10.1136/bmjopen-2020-045245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Matching demand and supply in nursing work continues to generate debate. Current approaches focus on objective measures, such as nurses per occupied bed or patient classification. However, staff numbers do not tell the whole staffing story. The subjective measure of nurses' perceived adequacy of staffing (PAS) has the potential to enhance nurse staffing methods in a way that goes beyond traditional workload measurement or workforce planning methods. OBJECTIVES To detect outcomes associated with nurses' PAS and the factors that influence PAS and to review the psychometric properties of instruments used to measure PAS in a hospital setting. DESIGN AND METHODS A scoping review was performed to identify outcomes associated with PAS, factors influencing PAS and instruments measuring PAS. A search of PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Business Source Complete and Embase databases identified 2609 potentially relevant articles. Data were independently extracted, analysed and synthesised. The quality of studies describing influencing factors or outcomes of PAS and psychometric properties of instruments measuring PAS were assessed following the National Institute for Health and Care Excellence quality appraisal checklist and the COnsensus-based Standards for the selection of health Measurement INstruments guidelines. RESULTS Sixty-three studies were included, describing 60 outcomes of PAS, 79 factors influencing PAS and 21 instruments measuring PAS. In general, positive PAS was related to positive outcomes for the patient, nurse and organisation, supporting the relevance of PAS as a staffing measure. We identified a variety of factors that influence PAS, including demand for care, nurse supply and organisation of care delivery. Associations between these factors and PAS were inconsistent. The quality of studies investigating the development and evaluation of instruments measuring PAS was moderate. CONCLUSIONS Measuring the PAS may enhance nurse staffing methods in a hospital setting. Further work is needed to refine and psychometrically evaluate instruments for measuring PAS.
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Affiliation(s)
- Carmen J E M van der Mark
- Department of Capacity Management, Rijnstate Hospital, Arnhem, The Netherlands
- Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Radboudumc, Nijmegen, The Netherlands
| | - Hester Vermeulen
- Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Radboudumc, Nijmegen, The Netherlands
- Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Paul H J Hendriks
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - Catharina J van Oostveen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Spaarne Gasthuis Academy, Spaarne Gasthuis Hospital, Hoofddorp and Haarlem, The Netherlands
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Van den Heede K, Cornelis J, Bouckaert N, Bruyneel L, Van de Voorde C, Sermeus W. Safe nurse staffing policies for hospitals in England, Ireland, California, Victoria and Queensland: A discussion paper. Health Policy 2020; 124:1064-1073. [PMID: 32888754 DOI: 10.1016/j.healthpol.2020.08.003] [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: 04/22/2020] [Revised: 08/06/2020] [Accepted: 08/12/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The association between higher registered nurses (RN) staffing (educational level and number) and better patient and nurse outcomes is well-documented. This discussion paper aims to provide an overview of safe staffing policies in various high-income countries to identify reform trends in response to recurring nurse workforce challenges. METHODS Based on a scan of the literature five cases were selected: England (UK), Ireland, California (USA), Victoria and Queensland (Australia). Information was gathered via a review of the grey and peer-reviewed literature. Country experts were consulted for additional information and to review country reports. RESULTS The focus of safe staffing policies varies: increasing transparency about staffing decisions (England), matching actual and required staffing levels based on patient acuity measurement (Ireland), mandated patient-to-nurse ratios at the level of the nurse (California) or the ward (Victoria, Queensland). Calibration of the number of patients by the number of nurses varies across cases. Nevertheless, positive effects on the nursing workforce (increased bedside staffing) and staff well-being (increased job satisfaction) have been consistently documented. The impact on patient outcomes is promising but less well evidenced. CONCLUSION Countries will have to set safe staffing policies to tackle challenges such as the ageing population and workforce shortages. Various approaches may prove effective, but need to be accompanied by a comprehensive policy that enhances bedside nurse staffing in an evidence-based, objective and transparent way.
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Affiliation(s)
- Koen Van den Heede
- Belgian Healthcare Knowledge Centre (KCE), Kruidtuinlaan 55, 1000, Brussels, Belgium; KU Leuven-University of Leuven, Institute for Healthcare Policy, 3000, Leuven, Belgium.
| | - Justien Cornelis
- Belgian Healthcare Knowledge Centre (KCE), Kruidtuinlaan 55, 1000, Brussels, Belgium.
| | - Nicolas Bouckaert
- Belgian Healthcare Knowledge Centre (KCE), Kruidtuinlaan 55, 1000, Brussels, Belgium.
| | - Luk Bruyneel
- KU Leuven-University of Leuven, Institute for Healthcare Policy, 3000, Leuven, Belgium.
| | - Carine Van de Voorde
- Belgian Healthcare Knowledge Centre (KCE), Kruidtuinlaan 55, 1000, Brussels, Belgium.
| | - Walter Sermeus
- KU Leuven-University of Leuven, Institute for Healthcare Policy, 3000, Leuven, Belgium.
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Juvé-Udina ME, González-Samartino M, López-Jiménez MM, Planas-Canals M, Rodríguez-Fernández H, Batuecas Duelt IJ, Tapia-Pérez M, Pons Prats M, Jiménez-Martínez E, Barberà Llorca MÀ, Asensio-Flores S, Berbis-Morelló C, Zuriguel-Pérez E, Delgado-Hito P, Rey Luque Ó, Zabalegui A, Fabrellas N, Adamuz J. Acuity, nurse staffing and workforce, missed care and patient outcomes: A cluster-unit-level descriptive comparison. J Nurs Manag 2020; 28:2216-2229. [PMID: 32384199 PMCID: PMC7754324 DOI: 10.1111/jonm.13040] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 04/20/2020] [Accepted: 05/02/2020] [Indexed: 12/23/2022]
Abstract
AIM To compare the patient acuity, nurse staffing and workforce, missed nursing care and patient outcomes among hospital unit-clusters. BACKGROUND Relationships among acuity, nurse staffing and workforce, missed nursing care and patient outcomes are not completely understood. METHOD Descriptive design with data from four unit-clusters: medical, surgical, combined and step-down units. Descriptive statistics were used to compare acuity, nurse staffing coverage, education and expertise, missed nursing care and selected nurse-sensitive outcomes. RESULTS Patient acuity in general (medical, surgical and combined) floors is similar to step-down units, with an average of 5.6 required RN hours per patient day. In general wards, available RN hours per patient day reach only 50% of required RN hours to meet patient needs. Workforce measures are comparable among unit-clusters, and average missed nursing care is 21%. Patient outcomes vary among unit-clusters. CONCLUSION Patient acuity is similar among unit-clusters, while nurse staffing coverage is halved in general wards. While RN education, expertise and missed care are comparable among unit-clusters, mortality, skin injuries and risk of family compassion fatigue rates are higher in general wards. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers play a pivotal role in hustling policymakers to address structural understaffing in general wards, to maximize patient safety outcomes.
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Affiliation(s)
- Maria-Eulàlia Juvé-Udina
- Nursing Research Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Nursing School, University of Barcelona, Barcelona, Spain.,Catalan Institute of Health, Barcelona, Spain
| | - Maribel González-Samartino
- Nursing Research Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Nursing School, University of Barcelona, Barcelona, Spain.,Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | - Maria Magdalena López-Jiménez
- Nursing Research Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Irene Joana Batuecas Duelt
- Multidisciplinary Nursing Research Group, VHIR Vall d'Hebron Institute of Research, Barcelona, Spain.,Vall d'Hebron University Hospital, Barcelona, Spain
| | - Marta Tapia-Pérez
- Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Emilio Jiménez-Martínez
- Nursing Research Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Susana Asensio-Flores
- Nursing Research Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | - Carme Berbis-Morelló
- Joan XXIII University Hospital, Tarragona, Spain.,School of Nursing, Rovira i Virgili University, Tarragona, Spain
| | - Esperanza Zuriguel-Pérez
- Multidisciplinary Nursing Research Group, VHIR Vall d'Hebron Institute of Research, Barcelona, Spain.,Vall d'Hebron University Hospital, Barcelona, Spain
| | - Pilar Delgado-Hito
- Nursing Research Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Nursing School, University of Barcelona, Barcelona, Spain
| | - Óscar Rey Luque
- Nursing School, University of La Laguna, Tenerife, Spain.,Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain
| | - Adelaida Zabalegui
- Faculty of Medicine and Health Sciences, Nursing School, University of Barcelona, Barcelona, Spain.,IDIBAPS, August Pi i Sunyer Biomedical Research Institute, Hospital Clínic, Barcelona, Spain
| | - Núria Fabrellas
- Faculty of Medicine and Health Sciences, Nursing School, University of Barcelona, Barcelona, Spain.,IDIBAPS, August Pi i Sunyer Biomedical Research Institute, Hospital Clínic, Barcelona, Spain
| | - Jordi Adamuz
- Nursing Research Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Nursing School, University of Barcelona, Barcelona, Spain.,Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
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8
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Leon-Villapalos C, Wells M, Brett S. Exploratory study of staff perceptions of shift safety in the critical care unit and routinely available data on workforce, patient and organisational factors. BMJ Open 2020; 10:e034101. [PMID: 32554719 PMCID: PMC7304836 DOI: 10.1136/bmjopen-2019-034101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 03/19/2020] [Accepted: 05/01/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To explore bedside professional reported (BPR) perceptions of safety in intensive care staff and the relationships between BPR safety, staffing, patient and work environment characteristics. DESIGN An exploratory study of self-recorded staff perceptions of shift safety and routinely collected data. SETTING A large teaching hospital comprising 70 critical care beds. PARTICIPANTS All clinical staff working in adult critical care. INTERVENTIONS Staff recorded whether their shift felt 'safe, unsafe or very unsafe' for 29 consecutive days. We explored these perceptions and relationships between them and routine data on staffing, patient and environmental characteristics. OUTCOME MEASURES Relationships between BPR safety and staffing, patient and work environment characteristics. RESULTS 2836 BPR scores were recorded over 29 consecutive days (response rate 57.7%). Perceptions of safety varied between staff, including within the same shift. There was no correlation between perceptions of safety and two measures of staffing: care hours per patient day (r=0.13 p=0.108) and Safecare Allocate (r=-0.19 p=0.013). We found a significant, positive relationship between perceptions of safety and the percentage of level 3 (most severely ill) patients (r=0.32, p=0.0001). There was a significant inverse relationship between perceptions of safety and the percentage of level 1 patients on a shift (r=-0.42, p<0.0001). Perceptions of safety correlated negatively with increased numbers of patients (r=-0.44, p=0.0006) and higher percentage of patients located side rooms (r=0.63, p<0.0001). We found a significant relationship between perceptions of safety and the percentage of staff with a specialist critical care course (r=0.42. p=0.0001). CONCLUSION Existing staffing models, which are primarily influenced by staff-to-patient ratios, may not be sensitive to patient need. Other factors may be important drivers of staff perceptions of safety and should be explored further.
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Affiliation(s)
| | - Mary Wells
- Imperial College London, London, UK
- Directorate of Nursing, Imperial College Healthcare NHS Trust, London, UK
| | - Stephen Brett
- Department of Critical Care, Imperial College Healthcare NHS Trust, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
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Huber E, Kleinknecht-Dolf M, Kugler C, Spirig R. ["One always has to be watchful": Categorisation of patient-related complexity of nursing care in acute care hospitals]. Pflege 2020; 33:143-152. [PMID: 32356501 DOI: 10.1024/1012-5302/a000738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
"One always has to be watchful": Categorisation of patient-related complexity of nursing care in acute care hospitals Abstract. Background: The increase of chronic illnesses and multimorbidity as well as more challenging treatment methods have caused higher acuity and complexity of nursing care situations. Aim: The aim of this study was to explore and establish categories which describe different levels of patient-related complexity of nursing care in order to broaden the understanding of demands on nursing care due to patient situations. Methods: Using a collective case study design, we asked registered nurses and clinical nurse specialists to assess the complexity of twelve nursing care situations through a questionnaire before interviewing them about their deliberations on how they rated the situation. In this sub-study, we performed a qualitative secondary analysis of these data and looked for categories of comparable degrees of complexity. Results: We found five categories of complexity, ranging from "slightly complex" to "highly complex". "Slightly complex" situations demanded a nurse's attention on routine interventions, while "highly complex" situations demanded their constant attention on poorly assessable and poorly controllable conditions with uncertain outcomes. Conclusions: The five categories of complexity describe characteristics of the different levels of complexity in nursing care situations. They can support nursing managers with allocating nursing staff to patients according to their needs and provide a framework for discussing complex nursing care situations in basic and continuing education.
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Affiliation(s)
- Evelyn Huber
- Department für Pflegewissenschaft, Fakultät für Gesundheit, Universität Witten / Herdecke, Witten.,Departement Public Health, Pflegewissenschaft, Universität Basel
| | | | - Christiane Kugler
- Institut für Pflegewissenschaft, Medizinische Fakultät, Universität Freiburg i. B
| | - Rebecca Spirig
- Department für Pflegewissenschaft, Fakultät für Gesundheit, Universität Witten / Herdecke, Witten.,Departement Public Health, Pflegewissenschaft, Universität Basel
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Huber E, Kleinknecht‐Dolf M, Kugler C, Spirig R. Patient‐related complexity of nursing care in acute care hospitals – an updated concept. Scand J Caring Sci 2020; 35:178-195. [DOI: 10.1111/scs.12833] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/05/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Evelyn Huber
- Department of Nursing Science Faculty for Health University Witten/Herdecke Witten Germany
- Department Public Health, Nursing Science University of Basel Basel Switzerland
| | - Michael Kleinknecht‐Dolf
- Department of Nursing and Allied Health Care Professionals University Hospital Zurich Zurich Switzerland
| | - Christiane Kugler
- Institute of Nursing Science Faculty of Medicine University of Freiburg Freiburg Germany
| | - Rebecca Spirig
- Department of Nursing Science Faculty for Health University Witten/Herdecke Witten Germany
- Department Public Health, Nursing Science University of Basel Basel Switzerland
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11
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The impact of an ageing population on the required hospital capacity: results from forecast analysis on administrative data. Eur Geriatr Med 2019; 10:697-705. [DOI: 10.1007/s41999-019-00219-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 07/10/2019] [Indexed: 10/26/2022]
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