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Rainbow JG, Chou K, Bethel C, Rothers J, Sans-Fuentes MA, Dudding KM. More Than Just a Pain in the Back: Pain Among American Nurses and Its Relationship to Modifiable Work Factors and Work Performance. Nurs Adm Q 2024; 48:336-346. [PMID: 39213407 DOI: 10.1097/naq.0000000000000623] [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: 09/04/2024]
Abstract
Nursing is a profession with high rates of workplace injuries, hazards, and turnover. Improving the health and safety of nurses at work is vital to retain and grow the workforce to meet future demands. The purpose of this study was to describe the breadth of pain among American nurses and explore the relationships between this pain and modifiable work factors and perceived work performance. We used a cross-sectional descriptive design of 2312 nurses from across the United States. Nurses completed a survey containing questions about demographics, the presence of pain in the past week, the number of pain sites, pain locations, severity, and the impact on work performance. The median number of pain locations reported was 2, back pain was the most reported pain site, and average pain severity ranged from 4 to 5. Significant modifiable work factors associated with pain were average patient load and shift length. Many participants indicated that their pain impacted work performance, while a smaller proportion acknowledged that their pain impacted patient care. Pain among nurses spans multiple locations, is moderately severe, and impacts work performance. Addressing related modifiable work factors may decrease pain and the impact on the health, safety, and work performance of the nursing workforce.
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Affiliation(s)
- Jessica G Rainbow
- College of Nursing, University of Arizona, Tucson (Drs Rainbow, Bethel, and Rothers and Mr Chou); School of Nursing, The University of Alabama at Birmingham (Dr Dudding); and BIO5 Institute, University of Arizona, Tucson (Drs Rothers and Sans-Fuentes). Dr Bethel is now the Magnet Program Director at UPMC Community Osteopathic Hospital in Harrisburg, Pennsylvania
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Vleminckx S, Van Bogaert P, De Meulenaere K, Willem L, Haegdorens F. Factors influencing the formation of balanced care teams: the organisation, performance, and perception of nursing care teams and the link with patient outcomes: a systematic scoping review. BMC Health Serv Res 2024; 24:1129. [PMID: 39334182 DOI: 10.1186/s12913-024-11625-5] [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: 07/04/2023] [Accepted: 09/20/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND The composition of care teams is crucial for delivering patient-centered healthcare, yet assembling a well-balanced team remains a challenge. This difficulty stems from the intricate dynamics of team capacity, culture, context, and the demands of the job. The current literature offers limited guidance for decision-makers on how to effectively navigate these dynamics to compose a balanced care team. METHODS We conducted a systematic scoping review of literature spanning from 2009 to 2022. The aim was to identify factors that significantly influence the work environment, team performance, nursing outcomes, and patient outcomes within healthcare settings. Our review focused on extracting and synthesizing evidence to uncover these influencing factors. RESULTS Our analysis identified 35 factors that play a significant role in shaping the work environment and influencing team performance, nursing outcomes, and patient outcomes. These factors were categorized into nine key domains: workload, leadership, team composition, stress and demands, professional relationships, safety, logistics and ergonomics, autonomy and responsibility, and transparency and task clearness. CONCLUSIONS To improve patient care and nursing job satisfaction, policymakers and decision-makers can consider these influencing factors in the design and management of care teams. The findings advocate for strategic adjustments in these domains to enhance a team's balance. Furthermore, our review underscores the need for further research to fill the identified gaps in knowledge, offering a directive for future studies into optimal care team composition. This systematic approach to team composition can significantly impact patient outcomes and nurse satisfaction, providing a roadmap for creating more effective and harmonious teams.
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Affiliation(s)
- Senne Vleminckx
- Centre for Research and Innovation in Care (CRIC), Department of Nursing and Midwifery Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium.
| | - Peter Van Bogaert
- Centre for Research and Innovation in Care (CRIC), Department of Nursing and Midwifery Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium
| | - Kim De Meulenaere
- Faculty of Business and Economics - Management Department, University of Antwerp, Antwerp, Belgium
| | - Lander Willem
- Department of Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), University of Antwerp, Antwerp, Belgium
| | - Filip Haegdorens
- Centre for Research and Innovation in Care (CRIC), Department of Nursing and Midwifery Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium
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Vanckavičienė A, Blaževičienė A, Zagurskienė D, Stašaitis K. Health workforce forecast in the university hospital: evidence from Lithuania. BMC Nurs 2024; 23:663. [PMID: 39294692 PMCID: PMC11409753 DOI: 10.1186/s12912-024-02326-9] [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: 04/04/2024] [Accepted: 09/04/2024] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND The increasing shortage of staff in healthcare facilities worldwide calls for a human resource planning strategy in order to ensure safe, timely and patient-centred care. The purpose of this paper is to provide an analysis and supply and demand projections of nurses, midwives, and radiographers within the labor market of the largest university hospital in the Baltic States by 2030. METHODS The staff supply was calculated on the intake and outflow of persons in the labour market annually for various factors. Projections for the demand of nurses, midwives, and radiographers took into account the different needs of the population, categorized by gender and age, for the services offered within the institution. RESULTS The analysis highlights significant projected shortages in the supply of nurses and radiographers by 2030, while the supply of midwives is expected to meet the demand. The projected supply of nurses in 2030 will be lower than in 2021. Projected nurses demand in 2025 according medium scenario - shortage of 59 nurses, on prospective scenario - of 331 nurses. In 2030 according medium scenario - shortage of 173 nurses on prospective - of 772 nurses. The projected supply of radiographers in 2030 will be higher than in 2021. Projected radiographers demand in prospective scenario which is the most likely in 2025 - shortage of 26 and in 2030 - shortage of 52 radiographers. The projected supply of midwives in 2030 will be higher than in 2021. The variables influencing the increase in the demand for midwives did not exceed the projected supply in the institution, indicating a balanced supply-demand scenario for midwives. CONCLUSIONS Due to the rising demand for nurse and radiographer services from the aging population, the predicted supply of nurses and radiographers will be insufficient. To ensure the projected demand for nurses in the medium and prospective scenarios, the nurses recruited each year should increase up to 38% in the medium scenario and 69% in the prospective scenario from 2022. In the prospective demand scenario, the recruitment of radiographers should increase three-fold and the recruitment of midwives should be reduced by 30%.
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Affiliation(s)
- Aurika Vanckavičienė
- Department of Nursing, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | | | - Daiva Zagurskienė
- Department of Nursing, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Kęstutis Stašaitis
- Department of Emergency Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Nadeau M, Madden MW, Glassman EL. How clinical resource nurses can support new nurses and address safety concerns. Nursing 2024; 54:47-53. [PMID: 39186162 DOI: 10.1097/nsg.0000000000000061] [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: 08/27/2024]
Abstract
ABSTRACT Inexperienced nursing staff can jeopardize patient safety and contribute to burnout. This quality improvement project evaluated a clinical resource nurse (CRN) role designed to address disparities in nurses' skills and experience. Survey results suggested that the CRN role effectively supported novice nurses.
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Affiliation(s)
- Michelle Nadeau
- At the University of Vermont Medical Center, Michelle Nadeau is a nurse educator, Marissa Madden is an RN, and Emily Glassman is an RN and a clinical assistant professor at the University of Vermont
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Anåker A, Fagerström L, Wangensteen S, Andersen IA, Henriksen J, Svavarsdóttir MH, Thorsteinsson HS, Strandell-Laine C. The Professional Nurse Self-Assessment Scale II - Translation and cultural adaptation for Nordic countries. Scand J Caring Sci 2024; 38:648-656. [PMID: 38240122 DOI: 10.1111/scs.13234] [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: 06/01/2023] [Revised: 11/13/2023] [Accepted: 01/04/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND It is important to map the clinical competence of newly graduated nurses in Nordic countries. The use of a common Nordic instrument could provide insights into nurses' levels of self-assessed clinical competence and perceptions of their need for professional development. AIM To translate and culturally adapt the original Norwegian version of the Professional Nurse Self-Assessment Scale II (PROFFNurse SAS II) into (1) Danish, (2) Finnish and (3) Icelandic versions. METHOD The PROFFNurse SAS II was translated and cross-culturally adapted. This translation was inspired by the process used in the Guidelines for Cross-Cultural Adaptation. RESULT The translation and cultural adaptation processes employed the required steps and provided specific details. In addition, practical issues encountered during the translation process while translating and adapting instruments that may influence future translations were revealed. This study found that having a professional bilingual/bicultural agency translator was partly problematic in the process of translation and found that it is important to adjust the translations to each country's specific words used in nursing. CONCLUSION Translating the PROFFNurse SAS II instrument into all Nordic languages enables us to use the instrument from a Nordic perspective and across various countries. This is important when comparing self-awareness and reflecting on nurses' clinical competencies. Professional development is central to valuing and developing clinical competence and allowing for the discovery of gaps in clinical competence.
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Affiliation(s)
- Anna Anåker
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Lisbeth Fagerström
- Åbo Akademi University, Vaasa, Finland
- University of South-Eastern Norway, Drammen, Norway
| | | | | | | | | | | | - Camilla Strandell-Laine
- Novia University of Applied Sciences, Turku, Finland
- Lovisenberg Diaconal University College, Oslo, Norway
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Yakusheva O, Lee KA, Weiss M. The Nursing Human Capital Value Model. Int J Nurs Stud 2024; 160:104890. [PMID: 39316994 DOI: 10.1016/j.ijnurstu.2024.104890] [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: 02/04/2024] [Revised: 08/10/2024] [Accepted: 08/28/2024] [Indexed: 09/26/2024]
Abstract
Nursing's economic value is presently framed within the dominant "outcomes-over-cost" value framework. Within this context, organizations employing nurses often use nursing budget reductions as a cost-minimization strategy, with the intent of retaining high quality outcomes. However, persistent issues such as nurse understaffing, burnout, and turnover threaten healthcare systems' capacity to deliver the quality, equitable, affordable patient care that the public requires. In this paper, we propose a new conceptual model and definition of nursing's economic value. The model development is guided by the convergence of three classic economic frameworks: human capital theory, production theory, and value theory. Grounded in these theories, we envision nursing as a value-adding human capital asset and explicitly link nursing staff characteristics and allocation to the production of healthcare services and organizational financial outcomes. We redefine nursing's economic value as the return on investment (ROI) in nursing human capital reflected in the improvement of consumer, nurse, and organizational outcomes. This new conceptual model, termed the Nursing Human Capital Value Model, presents a cycle of value creation that starts with investments in growing, developing and sustaining an organization's nursing human capital. Nurses, as a human capital asset, deliver nursing care-a foundational ingredient to the production of healthcare services and consumer outcomes. Improved outcomes, subsequently, drive organizational revenue growth. Finally, the accrued revenue is reinvested in nursing, further propelling the cycle's continuation. This innovative model, which is applicable across health systems financed through both governmental and private/non-governmental payor sources, highlights that investment in nursing human capital development is essential for sustainable value generation, identifying opportunities for optimizing nurses' contributions to the value cycle. By directly incorporating economic theories of human capital, production, and value, our model paves the way for future research on the dynamic scope of nursing's economic contribution within healthcare organizations and systems and underscores its necessity for the long-term sustainability and growth of the nursing profession. Tweetable abstract: The economic value of nursing lies in the return on investment in nursing human capital. #nurses #ROI #healthcare.
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Affiliation(s)
- Olga Yakusheva
- Johns Hopkins University, School of Nursing, Baltimore, MD, United States of America.
| | - Kathryn A Lee
- Johns Hopkins University, School of Nursing, Baltimore, MD, United States of America.
| | - Marianne Weiss
- Marquette University College of Nursing, Milwaukee, WI, United States of America.
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Babaei F, Nayeri ND, Hajibabaee F, Sharifi F. Investigating the relationship between missed/rationed nursing care and organizational commitment in Iranian nurses. BMC Nurs 2024; 23:540. [PMID: 39113029 PMCID: PMC11304906 DOI: 10.1186/s12912-024-02199-y] [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: 12/15/2023] [Accepted: 07/24/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND AND OBJECTIVE The primary objective of the nursing profession is to provide comprehensive and appropriate nursing care that meets the individual needs of patients. However, instances of missed/rationed nursing care can jeopardize the delivery of complete and safe healthcare, potentially putting patients' lives at risk. The level of organizational commitment demonstrated by nurses is likely to impact various personnel and organizational factors. Therefore, this study aims to predict instances of missed/rationed nursing care by examining the influence of organizational commitment. METHOD This descriptive and cross-sectional study will be conducted in 2023. Three hundred nurses working in general and intensive critical care units at Tehran University of Medical Sciences hospitals were randomly selected. Data collection included Allen and Mayer's organizational commitment questionnaires, Kalish's missed care questionnaire, and demographic variables. A multiple linear regression model was used to analyze the prediction of missed care by commitment and other variables. The relationship between these variables was also explored using SPSS version 26 software. FINDINGS Half of the nurses reported occasionally missing nursing care. Moreover, more than half of the nurses reported moderate organizational commitment in all dimensions. The most significant reasons identified by nurses for missed care were financial resources, human resources, and communication (p < 0.001). There was a significant relationship between missed/rationed nursing care and organizational commitment (p = 0.042). In the multiple regression equation, a significant portion of missed care due to commitment was predicted when considering demographic variables (p < 0.001). CONCLUSION By understanding the relationship between organizational commitment and missed care, and identifying the factors contributing to missed/rationed care, managers can improve the efficiency of human resources and allocate appropriate financial resources. Establishing effective communication with employees can also enhance their commitment to addressing neglected care, ultimately reducing instances of oversight.
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Affiliation(s)
- Faranak Babaei
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Dehghan Nayeri
- Department of Nursing Management, School of Nursing & Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Hajibabaee
- Department of Nursing Management, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Giese A, Khanam R, Nghiem S, Rosemann T, Havranek MM. Patient-reported experience is associated with higher future revenue and lower costs of hospitals. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:1031-1039. [PMID: 38070018 PMCID: PMC11283410 DOI: 10.1007/s10198-023-01646-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 11/06/2023] [Indexed: 07/28/2024]
Abstract
BACKGROUND Despite the established positive association between patient experience and patient volume, the relationship between patient experience and the financial performance of hospitals has not been studied thoroughly. METHODS To investigate this relationship, we used longitudinal data from 132 Swiss acute-care hospitals from 2016 to 2019 to examine the associations between patient experience and the proportion of elective patients, revenue, costs, and profits of hospitals. To account for a potential time lag effect, we utilized annual patient experience data and employed multilevel mixed-effects regression modeling to investigate its association with the aforementioned financial performance indicators for the following year. RESULTS Data for private and public hospitals were analyzed both separately and in combination, to account for the different proportions of elective patients in these types of hospitals. The resulting mixed models, revealed that for each year studied, the previous year's patient experience was positively associated with the current year's proportion of elective patients (β = 0.09, p = 0.004, all hospitals) and revenue (β = 1789.83, p = 0.037, private hospitals only), and negatively associated with costs (β = - 1191.13, p = 0.017, all hospitals); but not significantly associated with future profits (β = 629.12, p = 0.240, all hospitals). CONCLUSIONS This analysis showed that better patient experience is associated with a higher proportion of elective patients, greater revenue, and lower costs. Our findings may assist hospital managers and regulators in identifying strategies to increase revenue and reduce costs.
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Affiliation(s)
- Alice Giese
- University of Southern Queensland, Toowoomba, Australia.
- Competence Center for Health Data Science, Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, Postfach, 6002, Lucerne, Switzerland.
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland.
| | | | - Son Nghiem
- Department of Health Economics, Wellbeing & Society, Australian National University, Canberra, Australia
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Michael M Havranek
- Competence Center for Health Data Science, Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, Postfach, 6002, Lucerne, Switzerland
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Costa IAP, Nóbrega JF, Bentes CML, Lynn FA, Bentes MDN, Souza MDL. COVID-19 Nursing Staff Sizing Technology. Comput Inform Nurs 2024; 42:567-573. [PMID: 38934847 DOI: 10.1097/cin.0000000000001160] [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: 06/28/2024]
Abstract
This study shows the development of a software for calculating the number of nursing team members required for providing care during the coronavirus disease 2019 pandemic. Study about the development of a technology based on the literature about data and indicators. The indicators were systematized in the following dimensions: institutional, professional, and occupational structure, all with a focus on coronavirus disease 2019. The software was created to be used on the Web, client-server, in browsers such as Internet Chrome, Explorer, and/or Mozilla Firefox, accessing via an Internet address and also allowing access by Windows, Android, and Linux operating systems, with MySQL database used for data storage. The data and indicators related to the institutional structure for coronavirus disease 2019 were systematized with 10 dimensions and indicators, and the professional and occupational structure, with 14 dimensions and indicators. The construction of computer requirements followed the precepts of software engineering, with theoretical support from the area. In the evaluation of the software, data simulation revealed points that had to be adjusted to ensure security, data confidentiality, and easy handling. The software provides to calculate the size and quality of the team, nursing sizing required due to the needs generated by the coronavirus disease 2019 pandemic.
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Affiliation(s)
- Inácio Alberto Pereira Costa
- Author Affiliations: Federal Institute of Santa Catarina (Dr Costa; and Dr Nobrega), Florianópolis, Santa Catarina, Brazil; University of the State of Amazonas (UEA) and University Nilton Lins (Dr C.L. Bentes), Manaus, Amazonas, Brazil; School of Nursing and Midwifery, Queen's University (Dr Lynn), Belfast, United Kingdom; HEMOAM Foundation (Ms M.d.N. Bentes), Manaus, Brazil; Program in Nursing, Federal University of Santa Catarina (Dr Souza). Manaus, Brazil
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Al-Ghraiybah T, Lago L, Fernandez R, Sim J. Effects of the nursing practice environment, nurse staffing, patient surveillance and escalation of care on patient mortality: A multi-source quantitative study. Int J Nurs Stud 2024; 156:104777. [PMID: 38772288 DOI: 10.1016/j.ijnurstu.2024.104777] [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: 04/12/2023] [Revised: 03/08/2024] [Accepted: 04/13/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND A favourable nursing practice environment and adequate nurse staffing have been linked to reduced patient mortality. However, the contribution of nursing care processes such as patient surveillance and escalation of care, on patient mortality is not well understood. OBJECTIVE The aim of this study was to investigate the effect of the nursing practice environment, nurse staffing, missed care related to patient surveillance and escalation of care on 30-day inpatient mortality. DESIGN A multi-source quantitative study including a cross-sectional survey of nurses, and retrospective data extracted from an audit of medical and admission records. SETTING(S) A large tertiary teaching hospital (600 beds) in metropolitan Sydney, Australia. METHODS Data on the nursing practice environment, nurse staffing and missed care were obtained from the nursing survey. Patient deterioration data and patient outcome data were collected from the medical and admission records respectively. Logistic regression models were used to examine the association between the nursing practice environment, patient deterioration and 30-day inpatient mortality accounting for clustering of episodes within patients using generalised estimating equations. RESULTS Surveys were completed by 304 nurses (84.5 % female, mean age 34.4 years, 93.4 % Registered Nurses) from 16 wards. Patient deterioration data was collected for 30,011 patient deterioration events and 63,847 admitted patient episodes of care. Each additional patient per nurse (OR = 1.22, 95 % CI = 1.04-1.43) and the presence of increased missed care for patient surveillance (OR = 1.13, 95 % CI = 1.03-1.23) were associated with higher risk of 30-day inpatient mortality. The use of a clinical emergency response system reduced the risk of mortality (OR = 0.82, 95 % CI = 0.76-0.89). A sub-group analysis excluding aged care units identified a 38 % increase in 30-day inpatient mortality for each additional patient per nurse (OR = 1.38, 95 % CI = 1.15-1.65). The nursing practice environment was also significantly associated with mortality (OR = 0.79, 95 % CI: 0.72-0.88) when aged care wards were excluded. CONCLUSIONS Patient mortality can be reduced by increasing nurse staffing levels and improving the nursing practice environment. Nurses play a pivotal role in patient safety and improving nursing care processes to minimise missed care related to patient surveillance and ensuring timely clinical review for deteriorating patients reduces inpatient mortality. TWEETABLE ABSTRACT Patient mortality can be reduced by improving the nursing practice environment & increasing the number of nurses so that nurses have more time to monitor patients. Investing in nurses results in lower mortality and better outcomes. #PatientSafety #NurseStaffing #WorkEnvironment #Mortality.
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Affiliation(s)
- Tamer Al-Ghraiybah
- School of Nursing, University of Wollongong, Northfields Ave, Wollongong, Australia; School of Nursing & Midwifery, Faculty of Health, University of Technology Sydney, Australia.
| | - Luise Lago
- Centre for Health Research Illawarra Shoalhaven Population, Innovation Campus, University of Wollongong, Australia.
| | - Ritin Fernandez
- School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia.
| | - Jenny Sim
- School of Nursing, University of Wollongong, Northfields Ave, Wollongong, Australia; School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia; School of Nursing, Midwifery & Paramedicine, Australian Catholic University, North Sydney, Australia.
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Kirk K. Time for a rebalance: psychological and emotional well-being in the healthcare workforce as the foundation for patient safety. BMJ Qual Saf 2024; 33:483-486. [PMID: 38653549 DOI: 10.1136/bmjqs-2024-017236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 04/25/2024]
Affiliation(s)
- Kate Kirk
- University of Leicester, Leicester, UK
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Fröjd C, Jangland E, Gunnarsson AK. Employers' requests when advertising for nurses-A national mapping of recruitment advertising for nurses in Sweden. PLoS One 2024; 19:e0303255. [PMID: 38995934 PMCID: PMC11244837 DOI: 10.1371/journal.pone.0303255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 04/14/2024] [Indexed: 07/14/2024] Open
Abstract
INTRODUCTION There is a shortage of nurses and many are leaving the profession. Maintaining sufficient nursing staff is a major healthcare challenge for societies worldwide. Work conditions, job orientation, and career opportunities all factor into nurses' rates of attrition, exit, and turnover. Newly graduated nurses have requested structured introductory and/or mentoring programmes to ease their transition from education to work life and develop the skills and knowledge necessary in their particular work setting. Nurses also seek opportunities to continue learning and developing professionally. AIMS To map and describe the content of recruitment advertisements for nurses. Research questions were: 'What qualifications do healthcare employers request when recruiting nurses?' and 'What sorts of professional development do healthcare employers offer nurses? MATERIALS AND METHODS A comprehensive national mapping of recruitment advertisements for nurses in Sweden where all advertisements, N = 450, on 20 of the 21 regional hospital websites were collected. A qualitative and a quantitative content analysis was performed. RESULTS Personal characteristics dominated requested competence in recruitment advertisements. Employers offered general nursing opportunities with unspecific work content and focused more on recruiting newly registered, rather than experienced, nurses. In only a few advertisements, employers asked for a master's degree. No employer requested nurses with a PhD or research experience. CONCLUSION While the World Health Organization stresses the need for a sustainable recruitment and attainment of nurses to secure health care, employers' recruitment of mostly newly graduated nurses and offering little professional development and few career opportunities may be one explanation for the difficulties in securing safe nurse staffing.
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Affiliation(s)
- Camilla Fröjd
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Eva Jangland
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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Greenley R, McKee M. How will expansion of physician associates affect patient safety? BMJ 2024; 386:q1377. [PMID: 38969359 DOI: 10.1136/bmj.q1377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2024]
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Gawronski O, Parshuram CS, Cecchetti C, Tiozzo E, Szadkowski L, Ciofi Degli Atti ML, Dryden-Palmer K, Dall'Oglio I, Raponi M, Joffe AR, Tomlinson G. Evaluating associations between patient-to-nurse ratios and mortality, process of care events and vital sign documentation on paediatric wards: a secondary analysis of data from the EPOCH cluster-randomised trial. BMJ Open 2024; 14:e081645. [PMID: 38964797 PMCID: PMC11227805 DOI: 10.1136/bmjopen-2023-081645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 06/11/2024] [Indexed: 07/06/2024] Open
Abstract
OBJECTIVE To describe the associations between patient-to-nurse staffing ratios and rates of mortality, process of care events and vital sign documentation. DESIGN Secondary analysis of data from the evaluating processes of care and outcomes of children in hospital (EPOCH) cluster-randomised trial. SETTING 22 hospitals caring for children in Canada, Europe and New Zealand. PARTICIPANTS Eligible hospitalised patients were aged>37 weeks and <18 years. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was all-cause hospital mortality. Secondary outcomes included five events reflecting the process of care, collected for all EPOCH patients; the frequency of documentation for each of eight vital signs on a random sample of patients; four measures describing nursing perceptions of care. RESULTS A total of 217 714 patient admissions accounting for 849 798 patient days over the course of the study were analysed. The overall mortality rate was 1.65/1000 patient discharges. The median (IQR) number of patients cared for by an individual nurse was 3.0 (2.8-3.6). Univariate Bayesian models estimating the rate ratio (RR) for the patient-to-nurse ratio and the probability that the RR was less than one found that a higher patient-to-nurse ratio was associated with fewer clinical deterioration events (RR=0.88, 95% credible interval (CrI) 0.77-1.03; P (RR<1)=95%) and late intensive care unit admissions (RR=0.76, 95% CrI 0.53-1.06; P (RR<1)=95%). In adjusted models, a higher patient-to-nurse ratio was associated with lower hospital mortality (OR=0.77, 95% CrI=0.57-1.00; P (OR<1)=98%). Nurses from hospitals with a higher patient-to-nurse ratio had lower ratings for their ability to influence care and reduced documentation of most individual vital signs and of the complete set of vital signs. CONCLUSIONS The data from this study challenge the assumption that lower patient-to-nurse ratios will improve the safety of paediatric care in contexts where ratios are low. The mechanism of these effects warrants further evaluation including factors, such as nursing skill mix, experience, education, work environment and physician staffing ratios. TRIAL REGISTRATION NUMBER EPOCH clinical trial registered on clinical trial.gov NCT01260831; post-results.
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Affiliation(s)
- Orsola Gawronski
- Professional Development, Continuing Education and Nursing Research Unit, Bambino Gesù Children's Hospital, IRCCS, Roma, Lazio, Italy
| | - Christopher S Parshuram
- Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Corrado Cecchetti
- Critical Care, Bambino Gesù Children's Hospital, IRCCS, Roma, Lazio, Italy
| | - Emanuela Tiozzo
- Professional Development, Continuing Education and Nursing Research Unit, Bambino Gesù Children's Hospital, IRCCS, Roma, Lazio, Italy
| | - Leah Szadkowski
- Biostatistics Research Unit, Toronto General Hospital, Toronto, Ontario, Canada
| | | | - Karen Dryden-Palmer
- Paediatric Intensive Care Unit, Hospital for Sick Children, Barrie, Ontario, Canada
| | - Immacolata Dall'Oglio
- Professional Development, Continuing Education and Nursing Research Unit, Bambino Gesù Children's Hospital, IRCCS, Roma, Lazio, Italy
| | - Massimiliano Raponi
- Medical Directorate, Bambino Gesù Children's Hospital, IRCCS, Roma, Lazio, Italy
| | - Ari Robin Joffe
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
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15
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Lasater KB, Muir KJ, Sloane DM, McHugh MD, Aiken LH. Alternative Models of Nurse Staffing May Be Dangerous in High-Stakes Hospital Care. Med Care 2024; 62:434-440. [PMID: 38848137 PMCID: PMC11155279 DOI: 10.1097/mlr.0000000000001990] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
BACKGROUND Hospitals are resurrecting the outdated "team nursing" model of staffing that substitutes lower-wage staff for registered nurses (RNs). OBJECTIVES To evaluate whether reducing the proportion of RNs to total nursing staff in hospitals is in the best interest of patients, hospitals, and payers. RESEARCH DESIGN Cross-sectional, retrospective. SUBJECTS In all, 6,559,704 Medicare patients in 2676 general acute-care US hospitals in 2019. MEASURES Patient outcomes: in-hospital and 30-day mortality, 30-day readmission, length of stay, and patient satisfaction. Avoidable Medicare costs associated with readmissions and cost savings to hospitals associated with shorter stays are projected. RESULTS A 10 percentage-point reduction in RNs was associated with 7% higher odds of in-hospital death, 1% higher odds of readmission, 2% increase in expected days, and lower patient satisfaction. We estimate a 10 percentage-point reduction in RNs would result in 10,947 avoidable deaths annually and 5207 avoidable readmissions, which translates into roughly $68.5 million in additional Medicare costs. Hospitals would forgo nearly $3 billion in cost savings annually because of patients requiring longer stays. CONCLUSIONS Reducing the proportion of RNs in hospitals, even when total nursing personnel hours are kept the same, is likely to result in significant avoidable patient deaths, readmissions, longer lengths of stay, and decreased patient satisfaction, in addition to excess Medicare costs and forgone cost savings to hospitals. Estimates represent only a 10 percentage-point dilution in skill mix; however, the team nursing model includes much larger reductions of 40-50 percentage-points-the human and economic consequences of which could be substantial.
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Affiliation(s)
- Karen B. Lasater
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA
- The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - K. Jane Muir
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA
- The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
- National Clinician Scholars Program, University of Pennsylvania, Philadelphia, PA
| | - Douglas M. Sloane
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Matthew D. McHugh
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA
- The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Linda H. Aiken
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA
- The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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16
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Boone A, Lavreysen O, De Vries N, De Winter P, Mazzucco W, Matranga D, Maniscalco L, Miceli S, Savatteri A, Kowalska M, Szemik S, Baranski K, Godderis L. Retaining Healing Hands: A Transnational Study on Job Retention Interventions for the Healthcare Workforce. QUALITATIVE HEALTH RESEARCH 2024:10497323241254253. [PMID: 38857417 DOI: 10.1177/10497323241254253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
Healthcare organizations worldwide face challenges in retaining their healthcare workforce, with individual and organizational factors influencing their intentions to leave. This study conducted eight online co-creation workshops and four Delphi sessions to gain qualitative and in-depth insights into job retention interventions, involving healthcare workers, hospital managers, and policymakers. A thematic analysis was conducted, resulting in multiple interventions that were clustered in four pre-defined themes: professional and personal support, education, financial incentives, and regulatory measures. Professional and personal support interventions included regular interprofessional team meetings, leadership training programs, self-scheduling and sabbaticals, support for administrative and non-clinical work, and the provision of psychological counselling. Educational interventions encompassed facilitating development opportunities, periodic evaluations, onboarding, mentorship programs, and peer support groups. Financial incentives included the provision of competitive salaries, adequate infrastructure, extra benefits, transport possibilities, and permanent employment contracts. Regulatory measures addressed the need for complementary legislation across various levels, fixed healthcare worker-to-patient ratio, and instruments to monitor workload. To optimize retention strategies, healthcare organizations should tailor these interventions to address the unique factors influencing their workforce's intentions to leave within their specific context. The study concludes that combining personal and professional support, educational opportunities, financial incentives, and regulatory measures is necessary because there is no one-size-fits-all solution.
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Affiliation(s)
- Anke Boone
- Centre for Environment and Health, University of Leuven (KU Leuven), Leuven, Belgium
| | - Olivia Lavreysen
- Centre for Environment and Health, University of Leuven (KU Leuven), Leuven, Belgium
| | - Neeltje De Vries
- Department of Internal Medicine, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands
- Spaarne Gasthuis Academy, Haarlem and Hoofdorp, The Netherlands
| | - Peter De Winter
- Spaarne Gasthuis Academy, Haarlem and Hoofdorp, The Netherlands
- Department of Paediatrics, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands
- Leuven Child and Health Institute, University of Leuven (KU Leuven), Leuven, Belgium
- Department of Development and Regeneration, University of Leuven (KU Leuven), Leuven, Belgium
| | - Walter Mazzucco
- Clinical Epidemiology Unit and Regional Reference Laboratory, University Hospital "P. Giaccone", Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy
| | - Domenica Matranga
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy
| | - Laura Maniscalco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy
| | - Silvana Miceli
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Alessandra Savatteri
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy
| | - Małgorzata Kowalska
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Szymon Szemik
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Kamil Baranski
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Lode Godderis
- Centre for Environment and Health, University of Leuven (KU Leuven), Leuven, Belgium
- IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium
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17
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Gruneir A, Chamberlain SA, Jensen C, Cummings G, Hoben M, Boamah S, Bosco C, Ekhlas S, Bolt SR, Rappon T, Berta WB, Squires J, Estabrooks CA. Burnout Among Nursing Home Care Aides and the Effects on Resident Outcomes. Med Care Res Rev 2024; 81:233-244. [PMID: 38158788 PMCID: PMC11092296 DOI: 10.1177/10775587231220072] [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: 04/25/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024]
Abstract
While burnout among health care workers has been well studied, little is known about the extent to which burnout among health care workers impacts the outcomes of their care recipients. To test this, we used a multi-year (2014-2020) survey of care aides working in approximately 90 nursing homes (NHs); the survey focused on work-life measures, including the Maslach Burnout Inventory (MBI) and work-unit identifier. Resident Assessment Instrument Minimum Data Set (RAI-MDS 2.0) data were obtained on all residents in the sampled NHs during this time and included a unit identifier for each resident. We used multi-level models to test associations between the MBI emotional exhaustion and cynicism sub-scales reported by care aides and the resident outcomes of antipsychotics without indication, depressive symptoms, and responsive behaviors among residents on units. In 2019/2020, our sample included 3,547 care aides and 10,117 residents in 282 units. The mean frequency of emotional exhaustion and cynicism across units was 43% and 50%, respectively. While residents frequently experienced antipsychotics without indication 1,852 (18.3%), depressive symptoms 2,089 (20.7%), and responsive behaviors 3,891 (38.5%), none were found to be associated with either emotional exhaustion or cynicism among care aides.
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Affiliation(s)
| | | | | | | | - Matthias Hoben
- University of Alberta, Edmonton, Canada
- York University, Toronto, Ontario, Canada
| | | | | | | | | | - Tim Rappon
- McMaster University, Hamilton, Ontario, Canada
| | | | - Janet Squires
- Ottawa Health Research Institute, Ontario, Canada
- University of Ottawa, Ontario, Canada
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18
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Partsch S, Einig C. [Nursing Competence as a Developmental Task of Nursing Students in Nursing Education: A Qualitative Panel Study]. Pflege 2024; 37:168-175. [PMID: 37401543 DOI: 10.1024/1012-5302/a000947] [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: 07/05/2023]
Abstract
Nursing Competence as a Developmental Task of Nursing Students in Nursing Education: A Qualitative Panel Study Abstract: Background: One of the key challenges of nursing education is to foster the development of professional nursing competency. Currently, there is a lack of empirical knowledge about nursing students' subjective educational processes to be able to specifically support them in this development. Method: To reconstruct the developmental processes of nursing students, a qualitative panel study was conducted with 26 students of the three-year nursing training in Germany. Data were collected at the end of the 1st, 2nd, and 3rd year of nursing students' training through episodic interviews, and analysed using reconstructive-hermeneutical analysis (Kruse, 2015). Results: 'Developing nursing competency' was identified as one of the five developmental tasks. In the perception of the students, this development task focuses on the acquisition of medical knowledge, skills to carry out nursing actions and the ability to organise processes. In doing so, they ignore the subjective perspective of the people to be cared for. Conclusion: Through a cross-training overarching analyses, it becomes clear that nursing students do not succeed in developing a patient-oriented understanding of nursing regarding nursing competency. Hence, it must be examined whether the perspectives of the nursing students have changed due the stronger process orientation in the new legal nursing requirements.
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Affiliation(s)
- Sebastian Partsch
- Institut für Public Health und Pflegeforschung (IPP), Universität Bremen, Deutschland
| | - Claudia Einig
- Institut für Public Health und Pflegeforschung (IPP), Universität Bremen, Deutschland
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Moradi T, Rezaei M, Alavi NM. Delegating care as a double-edged sword for quality of nursing care: a qualitative study. BMC Health Serv Res 2024; 24:592. [PMID: 38715066 PMCID: PMC11075185 DOI: 10.1186/s12913-024-11054-4] [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: 12/03/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Considering the significance of care delegation in enhancing the quality of nursing care and ensuring patient safety, it is imperative to explore nurses' experiences in this domain. As such, this study aimed to explore the experiences of Iranian nurses regarding the delegation of care. METHODS This qualitative study was conducted between 2022 and 2023, employing the content analysis method with a conventional approach. The study utilized purposeful sampling method to select qualified participants. Data collection was carried out through in-depth and semi-structured interviews utilizing open-ended questions. The data analysis process followed the steps proposed by Graneheim and Lundman (2004) and involved the use of MAXQDA version 12 software. To ensure the trustworthiness of the data, the study employed the four rigor indices outlined by Lincoln and Guba (1985). RESULTS In the present study, a total of 15 interviews were conducted with 12 participants, the majority of whom were women. The age range of the participants fell between 25 and 40 years. Through qualitative data analysis, eight subcategories and three main categories of "insourcing of care", "outsourcing of care" and "delegating of care to non-professionals" were identified. Additionally, the overarching theme that emerged from the analysis was "delegation of care, a double-edged sword". CONCLUSIONS The results of the study revealed that the delegation of care occurred through three distinct avenues: to colleagues within the same unit, to colleagues in other units, and to non-professionals. Delegating care was found to have potential benefits, such as reducing the nursing workload and fostering teamwork. However, it was also observed that in certain instances, delegation was not only unhelpful but also led to missed nursing care. Therefore, it is crucial to adhere to standardized principles when delegating care to ensure the maintenance of high-quality nursing care.
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Affiliation(s)
- Tayebeh Moradi
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahboubeh Rezaei
- 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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20
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Guevara-Lozano M, Pérez-Giraldo B, Arroyo-Marlés LP, Nonsoque-Cholo MA, Sánchez-Herrera B. The Nursing Inter Shift Handover: A Moment of Care for Patients and Their Family Caregivers. HISPANIC HEALTH CARE INTERNATIONAL 2024:15404153241246804. [PMID: 38711274 DOI: 10.1177/15404153241246804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Precedents: The transfer between nursing shifts must guarantee the quality of care for patients and their families in the hospital. This study aimed to transform the handover between nursing shifts to strengthen the care capacity of patients and their family caregivers, and improve the care capacity of nursing staff, in a Latin American university hospital. Methods: This is a Nursing Methodology Research developed in the following phases: (a) identification of the best handover practices between nursing shifts to apply them within the institutional culture; (2) diagnosis of the transfer between shifts in the hospital; (3) design and validation of the transformation proposal; (4) measurement of transfer indicators; and (5) definition of a path to improve this transfer. Results: The proposal developed focuses on the patient and their family caregiver. The proposed protocol considered the perspective of the care recipients, the nursing staff, and the best available evidence. The overall transfer rating over 10 months went from 65% to 84%. Conclusions: The adjustment to the transfer process made it possible to strengthen the care capacity of patients and their family caregivers and improve the care capacity of the nursing staff.
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Affiliation(s)
- Maryory Guevara-Lozano
- School of Nursing and Rehabilitation, Universidad de La Sabana, Chía Cundinamarca, Colombia
| | - Beatriz Pérez-Giraldo
- School of Nursing and Rehabilitation, Universidad de La Sabana, Chía Cundinamarca, Colombia
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21
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Richards DA, Bollen J, Jones B, Melendez-Torres GJ, Hulme C, Cockcroft E, Cook H, Cooper J, Creanor S, Cruickshank S, Dawe P, Doris F, Iles-Smith H, Kent M, Logan P, O'Connell A, Onysk J, Owens R, Quinn L, Rafferty AM, Romanczuk L, Russell AM, Shepherd M, Singh SJ, Sugg HVR, Coon JT, Tooze S, Warren FC, Whale B, Wootton S. Evaluation of a COVID-19 fundamental nursing care guideline versus usual care: The COVID-NURSE cluster randomized controlled trial. J Adv Nurs 2024; 80:2137-2152. [PMID: 37986547 DOI: 10.1111/jan.15959] [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: 06/14/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
AIM To evaluate the impact of usual care plus a fundamental nursing care guideline compared to usual care only for patients in hospital with COVID-19 on patient experience, care quality, functional ability, treatment outcomes, nurses' moral distress, patient health-related quality of life and cost-effectiveness. DESIGN Parallel two-arm, cluster-level randomized controlled trial. METHODS Between 18th January and 20th December 2021, we recruited (i) adults aged 18 years and over with COVID-19, excluding those invasively ventilated, admitted for at least three days or nights in UK Hospital Trusts; (ii) nurses caring for them. We randomly assigned hospitals to use a fundamental nursing care guideline and usual care or usual care only. Our patient-reported co-primary outcomes were the Relational Aspects of Care Questionnaire and four scales from the Quality from the Patient Perspective Questionnaire. We undertook intention-to-treat analyses. RESULTS We randomized 15 clusters and recruited 581 patient and 418 nurse participants. Primary outcome data were available for 570-572 (98.1%-98.5%) patient participants in 14 clusters. We found no evidence of between-group differences on any patient, nurse or economic outcomes. We found between-group differences over time, in favour of the intervention, for three of our five co-primary outcomes, and a significant interaction on one primary patient outcome for ethnicity (white British vs. other) and allocated group in favour of the intervention for the 'other' ethnicity subgroup. CONCLUSION We did not detect an overall difference in patient experience for a fundamental nursing care guideline compared to usual care. We have indications the guideline may have aided sustaining good practice over time and had a more positive impact on non-white British patients' experience of care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE We cannot recommend the wholescale implementation of our guideline into routine nursing practice. Further intervention development, feasibility, pilot and evaluation studies are required. IMPACT Fundamental nursing care drives patient experience but is severely impacted in pandemics. Our guideline was not superior to usual care, albeit it may sustain good practice and have a positive impact on non-white British patients' experience of care. REPORTING METHOD CONSORT and CONSERVE. PATIENT OR PUBLIC CONTRIBUTION Patients with experience of hospitalization with COVID-19 were involved in guideline development and writing, trial management and interpretation of findings.
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Affiliation(s)
- David A Richards
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Jess Bollen
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Ben Jones
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | | | - Claire Hulme
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Emma Cockcroft
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Heather Cook
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Joanne Cooper
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Siobhan Creanor
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | | | - Phoebe Dawe
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Faye Doris
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | | | - Merryn Kent
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Pip Logan
- Community Health Sciences, University of Nottingham, Nottingham, UK
| | - Abby O'Connell
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Jakub Onysk
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Rosie Owens
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Lynne Quinn
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Anne Marie Rafferty
- Florence Nightingale School of Nursing and Midwifery, Kings College University London, London, UK
| | | | | | - Maggie Shepherd
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Sally J Singh
- Department of Respiratory Science, University of Leicester, Leicester, UK
- University Hospitals of Leicester NHS Trust, Biomedical Research Centre - Respiratory, Glenfield Hospital, Leicester, UK
| | - Holly V R Sugg
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Jo Thompson Coon
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
- The National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC), Exeter, UK
| | - Susannah Tooze
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Fiona C Warren
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Bethany Whale
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Stephen Wootton
- Institute of Human Nutrition, University of Southampton, Southampton, UK
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Hakkarainen T, Salminen L, Alastalo M, Virtanen H. Online degree programmes in nurse education-Students' perceptions and academic performance: An integrative review. NURSE EDUCATION TODAY 2024; 136:106148. [PMID: 38442641 DOI: 10.1016/j.nedt.2024.106148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 02/12/2024] [Accepted: 02/27/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVES The aim of this integrative review is to identify, describe, and synthesise evidence regarding students' perceptions of online degree programmes in nurse education, their academic performance, and the factors associated with their academic performance. DESIGN Integrative review. DATA SOURCES Four databases, CINAHL, ERIC (Ebsco), PubMed/MEDLINE, and Web of Science were searched. The reference lists of included studies were reviewed to identify other relevant studies. REVIEW METHODS Whittemore and Knafl's method was used as a guideline for the integrative review. Peer-reviewed studies describing students' perceptions of-or academic performance in-online degree programmes in nurse education were included in the review without time limitations. The quality of the selected article was assessed using the Mixed Method Appraisal Tool. RESULTS Nursing students' perceptions of online degree programmes were categorised into enabling career development, content delivered online, and community belonging. Factors related to student's academic performance were associated with individual students and the characteristics of online learning environments. Factors associated with students' academic performance were individual self-direction, formal communication skills, and working and educational backgrounds. Factors associated with academic performance in an online learning environment were categorised into regular feedback and methods for learning. CONCLUSIONS Online degree programmes in nurse education contribute to developing pedagogy through a satisfactory work-life balance, students' experiences of community and support, pleasant digital content, and various teaching methods by faculties. The study findings of this review have implications for educators to develop and adopt strategies for advancing digital environments with the pedagogy that supports community building to meet the needs of individual students.
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Affiliation(s)
- Tanja Hakkarainen
- Faculty of Medicine, Department of Nursing Science, University of Turku, Turku, Finland.
| | - Leena Salminen
- Faculty of Medicine, Department of Nursing Science, University of Turku, Turku University Hospital, Turku, Finland.
| | - Mika Alastalo
- Laurea University of Applied Sciences, Ratatie 22, 01300 Vantaa, Finland.
| | - Heli Virtanen
- Faculty of Medicine, Department of Nursing Science, University of Turku, Turku, Finland.
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Rosenbaum KEF, Lasater KB, McHugh MD, Lake ET. Hospital Performance on Hospital Consumer Assessment of Healthcare Providers and System Ratings: Associations With Nursing Factors. Med Care 2024; 62:288-295. [PMID: 38579145 PMCID: PMC11141206 DOI: 10.1097/mlr.0000000000001966] [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] [Indexed: 04/07/2024]
Abstract
OBJECTIVE To determine which hospital nursing resources (staffing, skill mix, nurse education, and nurse work environment) are most predictive of hospital Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS) performance. BACKGROUND HCAHPS surveying is designed to quantify patient experience, a measure of patient-centered care. Hospitals are financially incentivized through the Centers for Medicare and Medicaid Services to achieve high HCAHPS ratings, but little is known about what modifiable hospital factors are associated with higher HCAHPS ratings. PATIENTS AND METHODS Secondary analysis of multiple linked data sources in 2016 providing information on hospital HCAHPS ratings, hospital nursing resources, and other hospital attributes (eg, size, teaching, and technology status). Five hundred forty non-federal adult acute care hospitals in California, Florida, New Jersey, and Pennsylvania, and 11,786 registered nurses working in those hospitals. Predictor variables included staffing (ie, patient-to-nurse ratio), skill mix (ie, the proportion of registered nurses to all nursing staff), nurse education (ie, percentage of nurses with a bachelor's degree or higher), and nurse work environment (ie, the quality of the environment in which nurses work). HCAHPS ratings were the outcome variable. RESULTS More favorable staffing, higher proportions of bachelor-educated nurses, and better work environments were associated with higher HCAHPS ratings. The work environment had the largest association with higher HCAHPS ratings, followed by nurse education, and then staffing. Superior staffing and work environments were associated with higher odds of a hospital being a "higher HCAHPS performer" compared with peer hospitals. CONCLUSION Improving nursing resources is a strategic organizational intervention likely to improve HCAHPS ratings.
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Affiliation(s)
- Kathleen E. Fitzpatrick Rosenbaum
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- National Clinician Scholars Program, Yale University, New Haven, CT, USA
- Yale School of Public Health, Yale University, New Haven, CT, USA
- Yale New Haven Hospital, New Haven, CT, USA
- Yale School of Nursing, Yale University, New Haven CT, USA
| | - Karen B. Lasater
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Mathew D. McHugh
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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Daliri DB, Laari TT, Abagye N, Afaya A. Exploring the experiences of mental health nurses in the management of schizophrenia in the Upper East Region of Ghana: a qualitative study. BMJ Open 2024; 14:e079933. [PMID: 38503418 PMCID: PMC10952925 DOI: 10.1136/bmjopen-2023-079933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/06/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVE Schizophrenia is a chronic condition, of which the diagnosis and management require comprehensive care. The role mental health nurses play in this management cannot be overemphasised. In an effort to give their best, several challenges confront them which need to be sought and addressed. This study aimed to explore the factors that influence the management of schizophrenia by mental health nurses in the Upper East Region. DESIGN AND PARTICIPANTS A descriptive phenomenology design was used in this study. Individual in-depth interviews were conducted among 18 purposively sampled mental health nurses using a semistructured interview guide. Audio-recorded interviews were transcribed verbatim and analysed thematically using Colaizzi's approach. SETTING The study was conducted in five primary and secondary-level health facilities in the Upper East Region of Ghana. FINDINGS Five themes were deduced from the theoretical framework, which were as follows: individual factors, interpersonal factors, organisational factors, community-level factors, and policy-level factors. At the individual level, factors such as the condition of the patient at presentation, medication side effects, inadequate knowledge, and poor adherence were identified. Interpersonal factors identified were poor communication, lack of mutual respect, and poor communication, while organisational factors such as inadequate staff, inadequate infrastructure and logistics, and unavailability of antipsychotics were reported. Moreover, the study identified community-level factors such as stigma and cultural beliefs, while policy-level factors such as laws regarding suicide, patient rights, and non-inclusion of mental health services into the National Health Insurance Scheme were reported as factors influencing the management of schizophrenia by mental health nurses. CONCLUSIONS Addressing these factors is essential to ensure sustainable improvements and the effective management of schizophrenia. It is imperative to consider these factors when designing interventions and policies to optimise the management of schizophrenia by mental health nurses in Ghana.
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Affiliation(s)
- Dennis Bomansang Daliri
- Presbyterian Psychiatric Hospital, Bolgatanga, Ghana
- Department of International and Global Health, University for Development Studies, Tamale, Ghana
| | | | - Nancy Abagye
- Department of Midwifery, University of Ghana, Legon, Ghana
| | - Agani Afaya
- Department of Nursing, University of Health and Allied Sciences, Ho, Ghana
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Randell R, McVey L, Wright J, Zaman H, Cheong VL, Woodcock DM, Healey F, Dowding D, Gardner P, Hardiker NR, Lynch A, Todd C, Davey C, Alvarado N. Practices of falls risk assessment and prevention in acute hospital settings: a realist investigation. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-194. [PMID: 38511977 DOI: 10.3310/jwqc5771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Background Falls are the most common safety incident reported by acute hospitals. The National Institute of Health and Care Excellence recommends multifactorial falls risk assessment and tailored interventions, but implementation is variable. Aim To determine how and in what contexts multifactorial falls risk assessment and tailored interventions are used in acute National Health Service hospitals in England. Design Realist review and multisite case study. (1) Systematic searches to identify stakeholders' theories, tested using empirical data from primary studies. Review of falls prevention policies of acute Trusts. (2) Theory testing and refinement through observation, staff interviews (n = 50), patient and carer interviews (n = 31) and record review (n = 60). Setting Three Trusts, one orthopaedic and one older person ward in each. Results Seventy-eight studies were used for theory construction and 50 for theory testing. Four theories were explored. (1) Leadership: wards had falls link practitioners but authority to allocate resources for falls prevention resided with senior nurses. (2) Shared responsibility: a key falls prevention strategy was patient supervision. This fell to nursing staff, constraining the extent to which responsibility for falls prevention could be shared. (3) Facilitation: assessments were consistently documented but workload pressures could reduce this to a tick-box exercise. Assessment items varied. While individual patient risk factors were identified, patients were categorised as high or low risk to determine who should receive supervision. (4) Patient participation: nursing staff lacked time to explain to patients their falls risks or how to prevent themselves from falling, although other staff could do so. Sensitive communication could prevent patients taking actions that increase their risk of falling. Limitations Within the realist review, we completed synthesis for only two theories. We could not access patient records before observations, preventing assessment of whether care plans were enacted. Conclusions (1) Leadership: There should be a clear distinction between senior nurses' roles and falls link practitioners in relation to falls prevention; (2) shared responsibility: Trusts should consider how processes and systems, including the electronic health record, can be revised to better support a multidisciplinary approach, and alternatives to patient supervision should be considered; (3) facilitation: Trusts should consider how to reduce documentation burden and avoid tick-box responses, and ensure items included in the falls risk assessment tools align with guidance. Falls risk assessment tools and falls care plans should be presented as tools to support practice, rather than something to be audited; (4) patient participation: Trusts should consider how they can ensure patients receive individualised information about risks and preventing falls and provide staff with guidance on brief but sensitive ways to talk with patients to reduce the likelihood of actions that increase their risk of falling. Future work (1) Development and evaluation of interventions to support multidisciplinary teams to undertake, and involve patients in, multifactorial falls risk assessment and selection and delivery of tailored interventions; (2) mixed method and economic evaluations of patient supervision; (3) evaluation of engagement support workers, volunteers and/or carers to support falls prevention. Research should include those with cognitive impairment and patients who do not speak English. Study registration This study is registered as PROSPERO CRD42020184458. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129488) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 5. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Rebecca Randell
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Lynn McVey
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Hadar Zaman
- Faculty of Life Sciences, University of Bradford, Bradford, UK
| | | | | | | | - Dawn Dowding
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
| | - Peter Gardner
- Wolfson Centre for Applied Health Research, Bradford, UK
- Faculty of Life Sciences, University of Bradford, Bradford, UK
| | - Nicholas R Hardiker
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Alison Lynch
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Chris Todd
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
| | | | - Natasha Alvarado
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
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26
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Labrague LJ. Relationship between transformational leadership, adverse patient events, and nurse-assessed quality of care in emergency units: The mediating role of work satisfaction. Australas Emerg Care 2024; 27:49-56. [PMID: 37598031 DOI: 10.1016/j.auec.2023.08.001] [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: 06/22/2023] [Revised: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Effective leadership plays a pivotal role in healthcare settings, particularly in the fast-paced and high-pressure environment of the emergency room, as it is closely linked to patient safety and the overall quality of care. This study assessed the mediating role of work satisfaction in the relationship between nurses' perceptions of their nurse managers' transformational leadership, reported adverse patient events, and the nurse-assessed quality of care in the emergency units. METHODS A cross-sectional survey design was carried out involving 283 emergency room nurses from the Philippines, utilizing standardized scales. Mediation testing was performed using Hayes' PROCESS macro in SPSS (Model 4). RESULTS Emergency room nurses perceived their nurse managers as highly transformational. Nurses' perceptions of transformational leadership in their nurse managers were associated with a reduction in reported adverse patient events and an increase in nurse-assessed nursing care quality. Work satisfaction partially mediated the relationship between transformational leadership and nurse-assessed nursing care quality, but it did not serve as a mediator between transformational leadership and reported adverse patient events. CONCLUSION The results suggested that enhancing transformational leadership behaviors among nurse leaders can foster work satisfaction in ER nurses, which, in effect, contributes to enhanced nursing quality of care provision in emergency settings.
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Affiliation(s)
- Leodoro J Labrague
- Clinical Assistant Professor, Marcella Niehoff School of Nursing, Loyola University Chicago, USA.
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Kõrgemaa U, Sisask M, Ernits Ü. Nurses retrospective view on nursing education: A repeated cross-sectional study over three decades. Heliyon 2024; 10:e26211. [PMID: 38404896 PMCID: PMC10884450 DOI: 10.1016/j.heliyon.2024.e26211] [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: 06/01/2023] [Revised: 02/03/2024] [Accepted: 02/08/2024] [Indexed: 02/27/2024] Open
Abstract
Background As the healthcare landscape undergoes transformative shifts due to factors like ageing demographics, technological innovations, rapid global dissemination of infectious diseases, and imperatives for accessible, cost-effective care, a pressing need emerges for the contemporisation of nursing education. Notably, there is a paucity of research delving into nurses' introspective evaluations of their educational experiences after their immersion in professional settings. Objective This study aimed to examine nurses' evaluations of their educational background over 30 years and identify relationships between their assessments and their demographic. Design The study embraced a recurrent cross-sectional survey methodology, encompassing three distinct quantitative cross-sectional evaluations conducted in the years 1999, 2009, and 2021. Context/participants The cohort for this inquiry consisted of nurses stationed in Estonian general hospitals and inpatient departments of developmental plan institutions, each with at least one year of professional experience. Cumulatively, 832 nurses were engaged across three sequential evaluations: Study I (n = 463), Study II (n = 198), and Study III (n = 171). Methods Data procurement was executed via a structured survey, with subsequent analytical procedures encompassing descriptive and correlational methodologies. Results A discernible augmentation in the educational calibre of nurses was observed with each successive evaluation. This escalation concomitated enhanced positive assessments in areas like evidence-informed education, skill development, and autonomous operational capabilities. Yet, a critical appraisal persisted concerning their competencies in navigating complex patient interactions and addressing socio-religious dilemmas. Conclusions The merit of this investigation lies in its illumination of nursing education's evolution, as perceived retrospectively by nurses who have operationalized their academic learnings in real-world scenarios. Their vantage point, inherently informed by practice, uniquely positions them to earmark avenues of refinement. This exploration paves the way for enrichments in nursing education, spotlighting the imperative of equipping nurses to adeptly manage intricate situations.
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Affiliation(s)
- Ulvi Kõrgemaa
- Tallinn Health Care College, Chair of Nursing, Estonia
- Tallinn University, School of Governance, Law and Society, Estonia
| | - Merike Sisask
- Tallinn University, School of Governance, Law and Society, Estonia
| | - Ülle Ernits
- Tallinn Health Care College, Chair of Nursing, Estonia
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Aiken LH, Sermeus W, McKee M, Lasater KB, Sloane D, Pogue CA, Kohnen D, Dello S, Maier CBB, Drennan J, McHugh MD. Physician and nurse well-being, patient safety and recommendations for interventions: cross-sectional survey in hospitals in six European countries. BMJ Open 2024; 14:e079931. [PMID: 38346890 PMCID: PMC10862305 DOI: 10.1136/bmjopen-2023-079931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/30/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES To determine the well-being of physicians and nurses in hospital practice in Europe, and to identify interventions that hold promise for reducing adverse clinician outcomes and improving patient safety. DESIGN Baseline cross-sectional survey of 2187 physicians and 6643 nurses practicing in 64 hospitals in six European countries participating in the EU-funded Magnet4Europe intervention to improve clinicians' well-being. SETTING Acute general hospitals with 150 or more beds in six European countries: Belgium, England, Germany, Ireland, Sweden and Norway. PARTICIPANTS Physicians and nurses with direct patient contact working in adult medical and surgical inpatient units, including intensive care and emergency departments. MAIN OUTCOME MEASURES Burnout, job dissatisfaction, physical and mental health, intent to leave job, quality of care and patient safety and interventions clinicians believe would improve their well-being. RESULTS Poor work/life balance (57% physicians, 40% nurses), intent to leave (29% physicians, 33% nurses) and high burnout (25% physicians, 26% nurses) were prevalent. Rates varied by hospitals within countries and between countries. Better work environments and staffing were associated with lower percentages of clinicians reporting unfavourable health indicators, quality of care and patient safety. The effect of a 1 IQR improvement in work environments was associated with 7.2% fewer physicians and 5.3% fewer nurses reporting high burnout, and 14.2% fewer physicians and 8.6% fewer nurses giving their hospital an unfavourable rating of quality of care. Improving nurse staffing levels (79% nurses) and reducing bureaucracy and red tape (44% physicians) were interventions clinicians reported would be most effective in improving their own well-being, whereas individual mental health interventions were less frequently prioritised. CONCLUSIONS Burnout, mental health morbidities, job dissatisfaction and concerns about patient safety and care quality are prevalent among European hospital physicians and nurses. Interventions to improve hospital work environments and staffing are more important to clinicians than mental health interventions to improve personal resilience.
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Affiliation(s)
- Linda H Aiken
- Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Walter Sermeus
- Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium
| | - Martin McKee
- London School of Hygiene & Tropical Medicine, London, UK
| | - Karen B Lasater
- Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Douglas Sloane
- Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Colleen A Pogue
- Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Dorothea Kohnen
- Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium
| | - Simon Dello
- Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium
| | | | - Jonathan Drennan
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Matthew D McHugh
- Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Snogren M, Ek K, Browall M, Eriksson I, Lindmark U. Impacts on oral health attitude and knowledge after completing a digital training module among Swedish healthcare professionals working with older adults. BMC Health Serv Res 2024; 24:174. [PMID: 38326878 PMCID: PMC10851574 DOI: 10.1186/s12913-024-10639-3] [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: 06/20/2023] [Accepted: 01/25/2024] [Indexed: 02/09/2024] Open
Abstract
Oral health care is essential, and digital training may influence healthcare professionals' attitudes to and knowledge of oral health. The aim, therefore, was to evaluate the impact on attitudes to and knowledge of oral health after using a digital training module among Swedish healthcare professionals working within a municipality-run healthcare service for older adults. A secondary aim was to explore the healthcare professionals' experiences of using the digital module. The study comprised a survey of healthcare professionals (registered nurses (RNs), assistant nurses, and care assistants) caring for older adults in a municipality in Sweden. Pre-post-tests were conducted to evaluate the outcomes for attitudes to and knowledge of oral health and of their experiences of completing the digital training module in oral health. These were statistically explored by comparing differences between the pre-post-tests, while the open-ended questions were analysed with qualitative content analysis. The findings of this study indicate that healthcare professionals had similar perceptions of their attitudes to and knowledge of oral health both before and after the digital training module in oral health. The study also indicates that healthcare professionals experienced that it is easier to perform practical oral health care after completing the digital training. The results also show that healthcare professionals value oral health knowledge and that the digital training module was easy to use and to disseminate knowledge throughout the municipality. The findings have implications for developing, implementing, and promoting healthcare professionals' attitudes to and knowledge of oral health and in using a digital training module in combination with practical exercises in oral health in municipality health care.
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Affiliation(s)
- Maria Snogren
- School of Health Sciences, University of Skövde, Högskolevägen, 541 28, Skövde, Box 408, Sweden.
- Research School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Kristina Ek
- School of Health Sciences, University of Skövde, Högskolevägen, 541 28, Skövde, Box 408, Sweden
| | - Maria Browall
- Department of Nursing, School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
- Affiliated with the Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Irene Eriksson
- School of Health Sciences, University of Skövde, Högskolevägen, 541 28, Skövde, Box 408, Sweden
| | - Ulrika Lindmark
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
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Harley J. How to design and deliver a small group teaching session. Nurs Manag (Harrow) 2024; 31:27-32. [PMID: 37646085 DOI: 10.7748/nm.2023.e2106] [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] [Accepted: 06/20/2023] [Indexed: 11/19/2023]
Abstract
RATIONALE AND KEY POINTS Small group teaching sessions are commonly used in healthcare to deliver education, provide practice updates and support continuing professional development. Such sessions can provide opportunities for participants to acquire new knowledge, foster peer relationships, consolidate learning and develop skills. This article provides a step-by-step guide for nurses and other healthcare professionals on designing and delivering a small group teaching session. • A small group teaching session requires considered, detailed and methodical preparation. • When designing a small group teaching session, it is important to determine its aims, learning outcomes, group characteristics, location and timeframe. • A well-planned small teaching session includes learning activities that are constructively aligned to the aims and intended learning outcomes. • Assessing participant learning and addressing gaps in their understanding is essential during the delivery of small group teaching. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article could improve your practice when designing and delivering a small group teaching session. • How you could use this information to educate your colleagues on small group teaching methods.
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Affiliation(s)
- Jacqueline Harley
- Higher Education Department, Government of Jersey Health and Community Services, Harvey Besterman Education Centre, St Helier, Jersey
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31
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Köstler C, Kuhlmey A, Scupin O. [Remaining in the nursing profession depends on vocational training and continuing education: A cross-sectional study]. Pflege 2024; 37:3-10. [PMID: 36000262 DOI: 10.1024/1012-5302/a000905] [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: 01/23/2024]
Abstract
Remaining in the nursing profession depends on vocational training and continuing education: A cross-sectional study Abstract. Background: The public discussion about nurses leaving the profession has shown increasing dynamics for years. Burdens on the caregivers, political and (vocational) educational policy mistakes and financial as well as structural framework conditions are given as reasons. However, little is known about the influence of the educational biography on remaining in the nursing profession. Aim: This study examines data on formal and alternative sources of education, the timing of educational measures and the changes of nurses' interests in education over time and thus focuses on the group of nursing staff remaining in the profession. Methods: Nurses with many years of experience in their profession were surveyed (N = 200). Results: The results show that 77.6% of long-term nurses have the minimum required school leaving certificate with average final grades. 65.3% of the nurses have attended specialized training and 74.5% vocational training, which was completed over the entire period of employment. The training topics and the sources of education change over the course of the working life. Conclusions: It turns out that the group of nursing staff who have remained in the profession for a long time is characterized by a high willingness to undertake vocational training, with and without relevance to remuneration.
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Affiliation(s)
- Cornelia Köstler
- Institut für Medizinische Soziologie und Rehabilitationswissenschaften, Charité - Universitätsmedizin Berlin, Deutschland
- Fachbereich Gesundheit und Pflege, Ernst-Abbe-Hochschule Jena, Deutschland
| | - Adelheid Kuhlmey
- Institut für Medizinische Soziologie und Rehabilitationswissenschaften, Charité - Universitätsmedizin Berlin, Deutschland
| | - Olaf Scupin
- Fachbereich Gesundheit und Pflege, Ernst-Abbe-Hochschule Jena, Deutschland
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Schwartz RL, Hamlin SK, Vozzella GM, Randle LN, Klahn S, Maris GJ, Waterman AD. Utilizing Telenursing to Supplement Acute Care Nursing in an Era of Workforce Shortages: A Feasibility Pilot. Comput Inform Nurs 2024; 42:151-157. [PMID: 38252545 DOI: 10.1097/cin.0000000000001097] [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: 01/24/2024]
Abstract
Hospitals are experiencing a nursing shortage crisis that is expected to worsen over the next decade. Acute care settings, which manage the care of very complex patients, need innovations that lessen nurses' workload burden while ensuring safe patient care and outcomes. Thus, a pilot study was conducted to evaluate the feasibility of implementing a large-scale acute care telenurse program, where a hospital-employed telenurse would complete admission and discharge processes for hospitalized patients virtually. In 3 months, almost 9000 (67%) of patient admissions and discharges were conducted by an acute care telenurse, saving the bedside nurse an average of 45 minutes for each admission and discharge. Preliminary benefits to the program included more uninterrupted time with patients, more complete hospital admission and discharge documentation, and positive patient and nurse feedback about the program.
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Affiliation(s)
- Roberta L Schwartz
- Author Affiliations: Administration (Drs Schwartz and Vozzella and Ms Maris); Center for Nursing Research, Education and Practice (Dr Hamlin); Virtual Medicine Department (Ms Randle and Mr Klahn); J. C. Walter Jr. Transplant Center and Department of Surgery (Dr Waterman), Houston Methodist, TX
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Labrague LJ, T Kostovich C. A Global Overview of Missed Nursing Care During the COVID-19 Pandemic: A Systematic Review. West J Nurs Res 2024; 46:133-142. [PMID: 38014816 DOI: 10.1177/01939459231214598] [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: 11/29/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has placed unparalleled pressure on many countries' healthcare systems, impacting the delivery of health and nursing care services. Despite the growing number of missed care studies during the pandemic, a broader perspective is essential when designing theory-driven strategies to improve nursing care delivery. This review aimed to synthesize evidence of missed nursing care during the COVID-19 pandemic in acute care settings through a systematic review and narrative synthesis. An electronic search of articles published since the emergence of the pandemic was conducted using 5 databases (Scopus, PubMed, Web of Science, CINAHL, and PsycINFO). A total of 470 articles were identified during the initial search, and 10 articles were included in the review. The sample sizes of the studies ranged from 37 to 536 nurses. Results of the content analysis were grouped into 5 categories: (1) prevalence of missed care, (2) frequency of missed care, (3) reasons for missed care, (4) nurses' and organizational variables contributing to missed care, and (5) work environment elements contributing to missed care. The review's findings revealed a shift in the nature of missed nursing care during the pandemic, with an emphasis on nursing care tasks vital for the recovery of patients with COVID-19. Despite the unique circumstances brought about by the pandemic, an inadequate nursing workforce continued to be identified as the primary reason for missed care, consistent with the pre-pandemic period.
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Affiliation(s)
- Leodoro J Labrague
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
| | - Carol T Kostovich
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
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Lundell Rudberg S, Sormunen T, Scheja M, Lachmann H, Westerbotn M. Nursing students experienced academic emotions during education - a longitudinal descriptive study from a nursing bachelor's program in Sweden. BMC Nurs 2024; 23:52. [PMID: 38238730 PMCID: PMC10795204 DOI: 10.1186/s12912-024-01729-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/11/2024] [Indexed: 01/22/2024] Open
Abstract
AIM To explore nursing students' academic emotions during ongoing learning activities focusing on perceived challenge and competence. BACKGROUND Emotions plays an important part in learning. Positive emotions can be beneficial while negative emotions can be detrimental to educational outcomes. Optimal experiences are situations when learners simultaneously experience sufficient challenge and competence. Since various learning activities are performed in different learning environments during the nursing program, it is of interest to investigate students' ongoing emotions in the occurring contexts. DESIGN A longitudinal descriptive study. METHODS By using the Contextual Activity Sampling System, data was collected every third week on a three-year nursing program. From August 2015 to January 2020, a total of 2, 947 questionnaires were answered by 158 students. Experiences of positive and negative academic emotions were calculated for the entire program. Optimal experience was calculated for courses where high discrepancy between positive and negative experiences were identified. RESULTS Students self-reported academic emotions varied over time and in relation to learning activities. High ratings of negative emotions were reported during clinical practice in all semesters except the final. Students' positive academic emotions and optimal experience in clinical practice increased after having deepened their academic knowledge. CONCLUSION Nursing students had an increased positive experience when they themselves practice a learning activity and it appeared that they benefit from academic preparation prior to entering internship. Nursing students need an academic competence to develop their skills during training in the clinical reality. Increased collaboration between academia and clinic would be beneficial for students' clinical development.
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Affiliation(s)
- Susanne Lundell Rudberg
- Department of Learning, Informatics, Management and Ethics, Karolinska University, Stockholm, 171 77, Sweden.
- Department of Health Promoting Science, Sophiahemmet University, P. O. Box 5605, Stockholm, 114 86, Sweden.
| | - Taina Sormunen
- Department of Health Promoting Science, Sophiahemmet University, P. O. Box 5605, Stockholm, 114 86, Sweden
| | - Max Scheja
- Department of Education of Stockholm University, Stockholm, 106 91, Sweden
| | - Hanna Lachmann
- Department of Learning, Informatics, Management and Ethics, Karolinska University, Stockholm, 171 77, Sweden
| | - Margareta Westerbotn
- Department of Nursing Science, Sophiahemmet University, P. O. Box 5605, Stockholm, 114 86, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, 118 83, Sweden
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Darmann-Finck I, Hülsmann L, Nikolajev S. [Task Profiles of Nurses in Germany With a Bachelor's Degree]. DAS GESUNDHEITSWESEN 2024; 86:43-48. [PMID: 37816381 PMCID: PMC11248582 DOI: 10.1055/a-2098-3357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
Since more than ten years, German universities have been offering courses that enable students to become qualified professional nurses but without an academic degree or to acquire an academic bachelor's degree in nursing. However, there is still a lack of clarity regarding the task profiles of professionally qualified nursing professionals without an academic degree and of those nursing professionals with a bachelor's or master's degree. In order to identify task profiles for nurses with a bachelor's degree, a multi-stage literature search was first conducted as well as a content-analytical evaluation of the literature found. The results were then analyzed in terms of the level of qualification required for this purpose, and the tasks thus identified for the bachelor's level were reviewed and adjusted using three focus groups. The study concluded that the literature often recommended tasks that were not skill-appropriate. Moreover, there was a tendency to suggest tasks in indirect care. Through the study, five tasks for direct care and five tasks for indirect care were identified. In direct nursing, nursing process control/design in highly complex nursing situations was ranked first on a scientific basis. Based on the difficulties in determining appropriate tasks in direct nursing, it is concluded that the indicators for highly complex nursing situations need further operationalization. In addition, the practical parts of the study degree course must be better prepared than before with regard to the tasks that the graduates need to take on later.
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Affiliation(s)
- Ingrid Darmann-Finck
- Universität Bremen, Institut für Public Health und Pflegeforschung (IPP), Germany
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SKELA-SAVIČ B. Nursing Development should Now Become a Priority for Health Systems in Europe. Zdr Varst 2023; 62:162-166. [PMID: 37799413 PMCID: PMC10549248 DOI: 10.2478/sjph-2023-0023] [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: 08/07/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023] Open
Abstract
The vast majority of European countries are struggling to embrace nursing as a profession and as a science. There are still not enough nurses with bachelor's degrees and advanced practical skills, and clinical specialisations for nurses are being developed at the master's level. Attention should be paid to recognising nurses as an equal healthcare workforce who need to be empowered to advance their profession and be provided with professional development opportunities. Changes needed include improving pay and working conditions, providing opportunities to improve skills and professional recognition, empowering nurses to deliver care, and harnessing the power of technology to better support nurses. The declining interest in nursing education and the often stereotypical and condescending view of the role and work of nurses on the healthcare team should be a warning signal to all who are working on healthcare reform.
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Affiliation(s)
- Brigita SKELA-SAVIČ
- Angela Boškin Faculty of Health Care, Spodnji Plavž 3, 4270Jesenice, Slovenia
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St Marie BJ, Bai J, Knisely MR, Booker SQ, Saravanan A, Sowicz TJ. Experiences of Pain Management Nurses during the COVID-19 Pandemic: A Qualitative Study. Pain Manag Nurs 2023; 24:603-609. [PMID: 37806899 DOI: 10.1016/j.pmn.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 08/22/2023] [Accepted: 09/03/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The knowledge and skills of pain management nurses positions them well to manage people's pain and provide critical services to patients with COVID-19. AIM To understand the personal and professional experiences and the support pain management nurses received during the COVID-19 pandemic. METHODS Between July 2020 and 2021, data were collected through semi-structured telephone interviews from members of the American Society for Pain Management Nursing. Content analysis was used. RESULTS Eighteen pain management nurses who worked during the early stages of the pandemic were interviewed. Three main categories were identified: experiencing stress and burden, pain management strategies changed, learning to cope with support. Pain management nurses reported fear of exposure, difficulties with staff shortages, the complex social milieu, and how pain management took a backseat to other symptoms of COVID-19. They coped through support from their colleagues, organizational leaders, and community members. Pain management nurses provided recommendations for future care of patients' pain during a pandemic. CONCLUSIONS Pain management nurses shared their professional and personal experiences and the support they received while managing patients' pain during the COVID-19 pandemic. Their experiences provided findings on the importance of pain management and to support nurses during personal and professional vulnerabilities during crises. Key recommendations on the care of patients' pain in future pandemics included developing expertise in pain management and health-related emergencies; engaging nurses in supportive mental health services, infectious disease testing, and vaccine efforts; and planning for surge capacity to reach out to underserved people living with pain.
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Affiliation(s)
| | - Jinbing Bai
- Emory University, Nell Hodgson Woodruff School of Nursing, Atlanta, GA
| | | | - Staja Q Booker
- University of Florida, College of Nursing, Gainesville, FL
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Desmet K, Bracke P, Deproost E, Goossens PJJ, Vandewalle J, Vercruysse L, Beeckman D, Van Hecke A, Kinnaer LM, Verhaeghe S. Associated factors of nurse-sensitive patient outcomes: A multicentred cross-sectional study in psychiatric inpatient hospitals. J Psychiatr Ment Health Nurs 2023; 30:1231-1244. [PMID: 37409521 DOI: 10.1111/jpm.12951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 06/06/2023] [Accepted: 06/22/2023] [Indexed: 07/07/2023]
Abstract
WHAT IS ALREADY KNOWN?: The nurse-patient relationship in mental health care is an important focus of mental health nursing theories and research. There is limited evidence about which factors influence nurse-sensitive patient outcomes of the nurse-patient relationship. This hinders the development, planning, delivering, and quality assurance of the nurse-patient relationship in nursing practice and nursing education. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: To our best knowledge, this is the first study to examine associations between nurse-sensitive patient outcomes of the nurse-patient relationship and a range of patient characteristics and relationship-contextual factors. In this study, we found that gender, age, hospital characteristics, nurse availability when needed, nurse contact, and nurse stimulation were associated with the scores on the nurse-sensitive patient outcome scale. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Having insight into the factors associated with nurse-sensitive patient outcomes of the nurse-patient relationship can help nurses, nursing students, nursing management and also patients to enhance the nurse-patient relationship, trying to influence outcomes of nursing care. ABSTRACT: Introduction The lack of evidence on patient characteristics and relational-contextual factors influencing nurse-sensitive patient outcomes of a nurse-patient relationship is a possible threat to the quality and education of the nurse-patient relationship. Aim To measure nurse-sensitive patient outcomes of the nurse-patient relationship and to explore the associations between nurse-sensitive patient outcomes and a range of patient characteristics and relational-contextual factors. Method In a multicenter cross-sectional study, 340 inpatients from 30 units in five psychiatric hospitals completed the Mental Health Nurse-Sensitive Patient Outcome Scale. Descriptive, univariate and Linear Mixed Model analyses were conducted. Results Overall, patient-reported outcomes were moderate to good. Female participants, nurse availability when needed, more nurse contact and nurse stimulation were associated with higher outcomes. Age differences were observed for some of the outcomes. Outcomes also varied across hospitals but were not related to the number of times patients were hospitalized or to their current length of stay in the hospital. Discussion The results may help nurses to become more sensitive and responsive to factors associated with nurse-sensitive patient outcomes of the nurse-patient relationship. Implications The nurse-sensitive results can support nurses in designing future nurse-patient relationships.
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Affiliation(s)
- Karel Desmet
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- AZ Damiaan, Ostend, Belgium
| | - Piet Bracke
- Department of Sociology, Ghent University, Ghent, Belgium
| | - Eddy Deproost
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Centre for Psychiatry and Psychotherapy Clinic Sint-Jozef, Pittem, Belgium
| | - Peter J J Goossens
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Dimence Mental Health Center for Bipolar Disorder, Deventer, the Netherlands
| | | | - Lieke Vercruysse
- Centre for Psychiatry and Psychotherapy Clinic Sint-Jozef, Pittem, Belgium
| | - Dimitri Beeckman
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- School of Health Sciences, Örebro University, Örebro, Sweden
- School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
- Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Ann Van Hecke
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Lise-Marie Kinnaer
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Sofie Verhaeghe
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Department of Nursing, VIVES University College, Roeselare, Belgium
- Faculty of Medicine and Life Science, University Hasselt, Hasselt, Belgium
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Cho DD, Bretthauer KM, Schoenfelder J. Patient-to-nurse ratios: Balancing quality, nurse turnover, and cost. Health Care Manag Sci 2023; 26:807-826. [PMID: 38019329 DOI: 10.1007/s10729-023-09659-y] [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: 05/17/2022] [Accepted: 10/04/2023] [Indexed: 11/30/2023]
Abstract
We consider the problem of setting appropriate patient-to-nurse ratios in a hospital, an issue that is both complex and widely debated. There has been only limited effort to take advantage of the extensive empirical results from the medical literature to help construct analytical decision models for developing upper limits on patient-to-nurse ratios that are more patient- and nurse-oriented. For example, empirical studies have shown that each additional patient assigned per nurse in a hospital is associated with increases in mortality rates, length-of-stay, and nurse burnout. Failure to consider these effects leads to disregarded potential cost savings resulting from providing higher quality of care and fewer nurse turnovers. Thus, we present a nurse staffing model that incorporates patient length-of-stay, nurse turnover, and costs related to patient-to-nurse ratios. We present results based on data collected from three participating hospitals, the American Hospital Association (AHA), and the California Office of Statewide Health Planning and Development (OSHPD). By incorporating patient and nurse outcomes, we show that lower patient-to-nurse ratios can potentially provide hospitals with financial benefits in addition to improving the quality of care. Furthermore, our results show that higher policy patient-to-nurse ratio upper limits may not be as harmful in smaller hospitals, but lower policy patient-to-nurse ratios may be necessary for larger hospitals. These results suggest that a "one ratio fits all" patient-to-nurse ratio is not optimal. A preferable policy would be to allow the ratio to be hospital-dependent.
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Affiliation(s)
- David D Cho
- Department of Management, College of Business and Economics, California State University, Fullerton, Fullerton, CA, 92831, USA.
| | - Kurt M Bretthauer
- Operations and Decision Technologies Department, Kelley School of Business, Indiana University, Bloomington, IN, 47405, USA
| | - Jan Schoenfelder
- Health Care Operations / Health Information Management, University of Augsburg, 86159, Augsburg, Germany
- School of Management, Lancaster University Leipzig, 04109, Leipzig, Germany
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Labrague LJ. Toxic leadership and its relationship with outcomes on the nursing workforce and patient safety: a systematic review. Leadersh Health Serv (Bradf Engl) 2023; ahead-of-print. [PMID: 37796287 DOI: 10.1108/lhs-06-2023-0047] [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: 10/06/2023]
Abstract
PURPOSE This study aims to appraise and synthesize evidence examining the effects of toxic leadership on the nursing workforce and patient safety outcomes. DESIGN/METHODOLOGY/APPROACH This is a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Five electronic databases (SCOPUS, PubMed, Web of Science, CINAHL and Psych INFO) were searched to identify relevant articles. Two independent researchers conducted the data extraction and appraisal. A content analysis was used to identify toxic leadership outcomes. FINDINGS The initial literature search identified 376 articles, 16 of which were deemed relevant to the final review. Results of the content analysis identified 31 outcomes, which were clustered into five themes: satisfaction with work; relationship with organization; psychological state and well-being; productivity and performance; and patient safety outcomes. Seven mediators between toxic leadership and five outcomes were identified in the included studies. PRACTICAL IMPLICATIONS Organizational strategies to improve outcomes in the nursing workforce should involve measures to build and develop positive leadership and prevent toxic behaviors among nurse managers through theory-driven strategies, human resource management efforts and relevant policy. ORIGINALITY/VALUE The review findings have provided modest evidence suggesting that working under a leader who exhibits toxic behaviors may have adverse consequences in the nursing workforce; however, more research examining if this leadership style influences patient safety and care outcomes is warranted.
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Affiliation(s)
- Leodoro J Labrague
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, Illinois, USA
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Poku CA, Attafuah PYA, Anaba EA, Abor PA, Nketiah-Amponsah E, Abuosi AA. Response to patient safety incidents in healthcare settings in Ghana: the role of teamwork, communication openness, and handoffs. BMC Health Serv Res 2023; 23:1072. [PMID: 37803364 PMCID: PMC10559624 DOI: 10.1186/s12913-023-10000-0] [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: 02/14/2023] [Accepted: 09/04/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Patient safety incidents (PSIs) in healthcare settings are a critical concern globally, and Ghana is no exception. Addressing PSIs to improve health outcomes requires various initiatives to be implemented including improving patient safety culture, teamwork and communication between healthcare providers during handoffs. It is essential to acknowledge the significance of teamwork, communication openness, and effective handoffs in preventing and managing such incidents. These factors play a pivotal role in ensuring the well-being of patients and the overall quality of healthcare services. AIM This study assessed the occurrence and types of PSIs in health facilities in Ghana. It also examined the role of teamwork, handoffs and information exchange, and communication openness in response to PSIs by health professionals. METHODS A cross-sectional study was conducted among 1651 health workers in three regions of Ghana. Using a multi-staged sampling technique, the Survey on Patient Safety Culture Hospital Survey questionnaire and the nurse-reported scale were used to collect the data and it was analysed by descriptive statistics, Pearson correlation, and linear multiple regression model at a significance of 0.05. RESULTS There was a reported prevalence of PSIs including medication errors (30.4%), wound infections (23.3%), infusion reactions (24.7%), pressure sores (21.3%), and falls (18.7%) at least once a month. There was a satisfactory mean score for responses to adverse events (3.40), teamwork (4.18), handoffs and information exchange (3.88), and communication openness (3.84) among healthcare professionals. Teamwork, handoffs and information exchange and communication openness were significant predictors of response to PSIs, accounting for 28.3% of the variance. CONCLUSIONS Effective teamwork, handoffs and information exchange, and communication openness in the healthcare environment are critical strategies to enhance PSI response. Creating a culture that encourages error response through teamwork, communication and handoffs provides healthcare professionals with opportunities for learning and improving patient outcomes. Training programs should therefore target health professionals to improve patient safety and competency. Through the implementation of evidence-based practices and learning from past incidents, the healthcare system will be able to deliver safe and high-quality care to patients nationwide. Patient safety must be recognized as an ongoing process. Therefore, a meaningful improvement in patient outcomes requires all stakeholders' commitment.
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Affiliation(s)
- Collins Atta Poku
- Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Emmanuel Anongeba Anaba
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Patience Aseweh Abor
- Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, Accra, Ghana
| | | | - Aaron Asibi Abuosi
- Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, Accra, Ghana
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Alanazi FK, Lapkin S, Molloy L, Sim J. Healthcare-associated infections in adult intensive care units: A multisource study examining nurses' safety attitudes, quality of care, missed care, and nurse staffing. Intensive Crit Care Nurs 2023; 78:103480. [PMID: 37379679 DOI: 10.1016/j.iccn.2023.103480] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES This study examined the association between safety attitudes, quality of care, missed care, nurse staffing levels, and the rate of healthcare-associated infection (HAI) in adult intensive care units (ICUs). METHODS A cross-sectional study was conducted in five hospitals. Nurses completed a validated survey on safety attitudes, quality of care, missed care, nurse staffing levels, and the frequency of HAIs. Secondary data were collected on the incidence of central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (VAP) in participating units. Descriptive analysis and generalized linear models were performed. RESULTS A total of 314 nurses from eight ICUs participated in this study. The mean safety culture score was 60.85 (SD = 3.53). ICUs with strong job satisfaction had lower incidence and nurse-reported frequency of CLABSI, CAUTI, and VAP. Missed care was common, with 73.11% of nurses reporting missing at least one required care activity on their last shift. The mean patient-to-nurse ratio was 1.95. Increased missed care and higher workload were associated with higher HAIs. Nurses' perceptions of CLABSI and VAP frequency were positively associated with the actual occurrence of CLABSI and VAP in participating units. CONCLUSION Positive safety culture and better nurse staffing levels can lower the rates of HAIs in ICUs. Improvements to nurse staffing will reduce nursing workloads, which may reduce missed care, increase job satisfaction, and, ultimately, reduce HAIs. IMPLICATIONS FOR CLINICAL PRACTICE Higher levels of job satisfaction among ICU nurses, lower proportions of missed nursing care and higher nurse staffing are associated with lower rates of HAIs. Nurse-reported HAI frequency was positively associated with the incidence of HAIs; therefore, nurses provide reliable data on infection control outcomes in ICU settings.
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Affiliation(s)
| | - Samuel Lapkin
- School of Nursing, University of Wollongong, Wollongong, NSW 2500 Australia; Discipline of Nursing, Faculty of Health, Southern Cross University, Gold Coast, QLD 4225, Australia
| | - Luke Molloy
- School of Nursing, University of Wollongong, Wollongong, NSW 2500 Australia
| | - Jenny Sim
- School of Nursing, University of Wollongong, Wollongong, NSW 2500 Australia; School of Nursing & Midwifery, University of Newcastle, Callaghan, NSW Australia; World Health Organization Collaborating Centre for Nursing, Midwifery & Health Development, University of Technology Sydney, Ultimo, New South Wales, Australia.
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Danski MTR, Pontes L, Secco IL, Pereira HP, Vieira SCM, Freitas ED, de Azevedo JS, Afonso RQ. Fugulin scale for classifying pediatric patients in a respiratory inpatient unit: experience report. Rev Esc Enferm USP 2023; 57:e20220454. [PMID: 37738313 PMCID: PMC10516481 DOI: 10.1590/1980-220x-reeusp-2022-0454en] [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: 12/13/2022] [Accepted: 07/12/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE To describe the use of the Fugulin scale to classify pediatric patients hospitalized in a respiratory unit as a subsidy for the allocation of human resources given the increase in cases of Severe Acute Respiratory Syndrome. METHOD Experience report conducted in a children's hospital in the Metropolitan Region of Curitiba with data collection from medical records and approved by the Institution and by the Research Ethics Committee. RESULTS Between February and May 2022, the percentage of patients categorized in minimal and intermediate care decreased by 53 and 11.4%, respectively, while those in high dependency and semi-intensive care expanded by 31.2 and 84.2%. In addition, in just four months, there was a considerable increase in the positivity of virologies compared to the twelve months of 2021. The susceptibility of children to the development of severe respiratory infection was proven through the decrease in virologies with undetectable results. CONCLUSION The results obtained allowed us to conclude there was a significant increase in the complexity of patients admitted to the respiratory unit, showing it is essential to provide a nursing team compatible with the care needs.
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Affiliation(s)
| | - Letícia Pontes
- Universidade Federal do Paraná, Programa de Pós-Graduação em
Enfermagem, Curitiba, PR, Brazil
| | - Izabela Linha Secco
- Universidade Federal do Paraná, Programa de Pós-Graduação em
Enfermagem, Curitiba, PR, Brazil
- Hospital Infantil Doutor Waldemar Monastier, Campo Largo, PR,
Brazil
| | - Higor Pacheco Pereira
- Universidade Federal do Paraná, Programa de Pós-Graduação em
Enfermagem, Curitiba, PR, Brazil
- Hospital Infantil Doutor Waldemar Monastier, Campo Largo, PR,
Brazil
| | | | | | - Juliana Szreider de Azevedo
- Universidade Federal do Paraná, Programa de Pós-Graduação em
Enfermagem, Curitiba, PR, Brazil
- Hospital Infantil Doutor Waldemar Monastier, Campo Largo, PR,
Brazil
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Liu Y, Lang Z, Peng X, Zhang Z, Fu J, Zhou C. The impact of link quality management on healthcare quality: a comparative study at The Fourth Hospital of Harbin Medical University. Am J Transl Res 2023; 15:5930-5939. [PMID: 37854209 PMCID: PMC10579025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/13/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To explore the impact of link quality management on healthcare quality. METHODS In 2021, The Fourth Hospital of Harbin Medical University followed various regulations and systems to manage the quality of hospital links. In 2022, the hospital upgraded and strengthened the quality management of hospital links. We collected and compared data from 2021 and 2022 on several observation indicators, including error rates in medical records, outpatient and inpatient numbers, surgical volumes, adverse event reporting, dispute complaints, inpatient medical records and outpatient prescriptions grading, timely filing rate of medical records, inpatient satisfaction rate, average length of hospital stay, rate of level 3-4 surgeries, admission rate of critically ill patients, workload index, work efficiency index, diagnostic quality index, treatment quality index, antimicrobial drug use rate, staff satisfaction rate, patient satisfaction rate, composite index, and Case Mix Index (CMI). RESULTS In 2021, the error rate of the first page of the general surgery medical records in The Fourth Hospital of Harbin Medical University was 27.91%, while in 2022 it significantly improved to 9.60% (P<0.05). The error rates of the main diagnosis, major surgical operations, other diagnoses, and other surgical operations on the medical records were all significantly different between 2021 and 2022 (all P<0.05). In 2022, the outpatient volume, inpatient volume, surgical volume, and adverse event reporting increased significantly compared to those in 2021, while the number of dispute complaints decreased significantly. The first-grade rate of inpatient medical records, first-grade rate of outpatient prescriptions, timely filing rate of medical records, inpatient satisfaction rate, average length of hospital stay, rate of level 3-4 surgeries, and admission rate of critically ill patients in 2022 were all significantly higher than those in 2021 (all P<0.05). The workload index, work efficiency index, diagnostic quality index, and treatment quality index in 2022 were all significantly higher than those in 2021 (all P<0.05). The outpatient antimicrobial drug use rate, emergency department antimicrobial drug use rate, and inpatient antimicrobial drug use rate in 2022 were significantly lower than those in 2021 (all P<0.05). In 2022, the satisfaction rate of medical staff was 93.57%, which was significantly higher than 81.16% in 2021 (P<0.05). In 2022, the patient satisfaction rate was 91.53%, which was significantly higher than 82.17% in 2021 (P<0.05). In 2022, the composite index and CMI values increased, while the error rate decreased significantly, as compared to those in 2021 (P<0.05). CONCLUSION After upgrading and strengthening the link quality management, The Fourth Hospital of Harbin Medical University has achieved significant improvements in management level, medical quality, technical level, and staff satisfaction.
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Affiliation(s)
- Yi Liu
- Department of Medical, The Fourth Hospital of Harbin Medical UniversityHarbin 150000, Heilongjiang, China
| | - Zhenyu Lang
- Dean Office, The Fourth Hospital of Harbin Medical UniversityHarbin 150000, Heilongjiang, China
| | - Xiaoxuan Peng
- Department of Medical, The Fourth Hospital of Harbin Medical UniversityHarbin 150000, Heilongjiang, China
| | - Zhipeng Zhang
- Department of Medical, The Fourth Hospital of Harbin Medical UniversityHarbin 150000, Heilongjiang, China
| | - Junwei Fu
- Department of Medical, The Fourth Hospital of Harbin Medical UniversityHarbin 150000, Heilongjiang, China
| | - Chunhe Zhou
- Three Areas of Respiratory Oncology, Harbin Medical University Cancer HospitalHarbin 150000, Heilongjiang, China
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Thurgate C, Griggs C. Nursing associates 6 years on: A review of the literature. J Clin Nurs 2023; 32:6028-6036. [PMID: 37132115 DOI: 10.1111/jocn.16735] [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: 08/26/2022] [Revised: 12/14/2022] [Accepted: 04/11/2023] [Indexed: 05/04/2023]
Abstract
AIM This paper reviews the empirical research evidence relating to the nursing associate (NA) role since its implementation in England in 2017. BACKGROUND The NA role arose from the findings of the Raising the Bar: Shape of Caring Review (Willis, 2015). The roles' aim is to bridge the gap between healthcare assistant and registered nurse as part of the nursing team, working with people of all ages in a variety of health and social care settings. NAs must successfully complete a trainee programme (usually a Foundation Degree) which, for many, has been completed as an apprentice while remaining in their place of work. METHODS A literature search was performed using the British Nursing Index and CINAHL Plus, along with Google Scholar. Exact key words were 'Nursing Associates' and papers were refined to primary research only. Data restrictions were applied from 2017 to the end of September 2022. Each paper was critically appraised to assess the robustness and validity of the search processes and then thematic analysis was undertaken using Braun and Clarke's (Qualitative Research in Psychology, 3, 2006 and 77) six stages of analysis. RESULTS Nineteen papers were identified; six key themes emerged: lack of support from others; career development; organisational readiness; resilience in the face of adversity; cost; and worker and learner identity. CONCLUSION The NA role is allowing career progression for those who would have historically been prevented from accessing the nursing workforce because of entry qualifications and financial limitations. There is a need for organisational readiness to ensure trainee nursing associates (TNA) are supported during their training, that they have equal opportunities to learn, and they are given the status and recognition as a learner. Organisations need to raise awareness among staff to allow the nursing team to understand the NA role. RELEVANCE TO CLINICAL PRACTICE This literature review has relevance for those who employ Nursing Associates or who are considering introducing the role. NO PATIENT OR PUBLIC CONSULTATION Due to being a literature review no patient or public consultation took place; however, local employers identified the need for a review of the literature pertaining to the Nursing Associate role.
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Affiliation(s)
| | - Chloe Griggs
- Canterbury Christ Church University, Canterbury, UK
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Pai DR, Dissanayake CK, Anna AM. A comparison of critical access hospitals and other rural acute care hospitals in Pennsylvania. J Rural Health 2023; 39:719-727. [PMID: 36916142 DOI: 10.1111/jrh.12755] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
PURPOSE As the Flex Program celebrates its 25th anniversary, we examined changes in critical access hospital (CAH) financial performance, investigated whether CAH status has reduced hospitals' financial vulnerability, and identified factors influencing financial performance. METHODS We collected data on acute care hospitals in Pennsylvania's rural counties for 2000-20. Our sample contained 1,444 hospital-year observations. We used trend analysis to compare the financial performance of CAHs and rural prospective payment system (PPS) hospitals (non-CAHs). We investigated the effect of CAH status on financial performance and identified the time-variant factors impacting financial performance using fixed-effects regression analysis. RESULTS The median total margin of CAHs lagged behind that of non-CAHs. When compared to non-CAH costs over the same period, the median cost per patient day incurred by CAHs has increased, with the rate of increase being significantly higher in the most recent decade. Our findings show that while CAH status does not appear to have a direct impact on the total margin, it is significantly associated with a higher cost per patient day. CONCLUSIONS CAHs in Pennsylvania appear to be facing a double whammy of declining margins and rising costs compared to non-CAHs. Our findings demonstrate how crucial the Flex program has been in sustaining CAHs in Pennsylvania ever since its inception. Our findings have implications for rural health care delivery as well. While providing financial support and operational flexibility to CAHs should be a continuing policy priority, a long-term policy goal should be to envision an economic development strategy that capitalizes on the unique strengths of each of the rural archetypes.
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Affiliation(s)
- Dinesh R Pai
- Penn State Harrisburg, School of Business Administration, Middletown, Pennsylvania, USA
| | | | - Anna M Anna
- Rural Health Redesign Center Organization, Harrisburg, Pennsylvania, USA
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Fangonil-Gagalang E, Brady M, Vaughn S, Hul TV, Ringl K, Baker S, Burch T, Weismuller P, Weeks G, Riley A. Concurrent enrollment pathway: A model for ADN-BSN programs. J Prof Nurs 2023; 48:99-106. [PMID: 37775248 DOI: 10.1016/j.profnurs.2023.06.004] [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: 11/05/2022] [Revised: 06/06/2023] [Accepted: 06/13/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION The purpose of this article is to share the collaborative planning and execution of these two public universities and one community college in developing an innovative program to increase BSN-prepared nurses. The aim of the collaboration is to offer a high quality, affordable, and time-saving pre-licensure, concurrent enrollment program (CEP) which allows community college ADN students direct access to BSN study, while maintaining excellent program outcomes, and increasing diverse baccalaureate-prepared nurses in practice. METHODS Key stakeholders in two public educational systems met to discuss the development of a regional collaboration between two state universities and one local community college. The group designed university-specific, concurrent curricular roadmaps for each university. Students admitted in ADN program chose if they want to attend a concurrent enrollment or a traditional plan of study. RESULTS In Fall 2019, the CEP program was launched admitting 40 ADN students concurrently enrolled in one university. Subsequently, another cohort started in Spring 2020 with 39 students dually enrolled at the other state university. All students in both cohorts resided in the region. Over 75 % of the total CEP enrollees came from diverse backgrounds, 49 % Hispanics, 16 %, Asians, and 8 % African Americans and 4 % native Hawaiians. Forty-four percent were first generation college students. The average age was 25 with a range of 21-39. Twenty percent of the students were male which is above the national average of 12 %. After four semesters, students completed their ADN degree, passed the licensure exam, and transitioned to earn their BSN degree in the university for another two semesters. CONCLUSION The literature reveals that BSN-prepared nurses contribute to safe patient care. The current number of cost-effective and accessible nursing programs are not sufficient to reach the IOM 80/20 goal, which contributes to the ongoing shortage of BSN-prepared nurses in the nation, including California. Creativity and open collaboration of nurse leaders, faculty, and staff across different levels of education was instrumental in the success of the students and the program.
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Affiliation(s)
- Evangeline Fangonil-Gagalang
- California State University, Fullerton, CA, United States of America; California State University, San Bernardino, CA, United States of America; Riverside City College, Riverside, CA, United States of America.
| | - Margaret Brady
- California State University, Fullerton, CA, United States of America; California State University, San Bernardino, CA, United States of America; Riverside City College, Riverside, CA, United States of America; California State University, Office of the Chancellor, United States of America
| | - Stephanie Vaughn
- California State University, Fullerton, CA, United States of America; California State University, San Bernardino, CA, United States of America; Riverside City College, Riverside, CA, United States of America
| | - Tammy Vant Hul
- California State University, Fullerton, CA, United States of America; California State University, San Bernardino, CA, United States of America; Riverside City College, Riverside, CA, United States of America
| | - Karen Ringl
- California State University, Fullerton, CA, United States of America; California State University, San Bernardino, CA, United States of America; Riverside City College, Riverside, CA, United States of America
| | - Sandy Baker
- California State University, Fullerton, CA, United States of America; California State University, San Bernardino, CA, United States of America; Riverside City College, Riverside, CA, United States of America
| | - Terese Burch
- California State University, Fullerton, CA, United States of America; California State University, San Bernardino, CA, United States of America; Riverside City College, Riverside, CA, United States of America
| | - Penny Weismuller
- California State University, Fullerton, CA, United States of America; California State University, San Bernardino, CA, United States of America; Riverside City College, Riverside, CA, United States of America
| | - Gina Weeks
- California State University, Fullerton, CA, United States of America; California State University, San Bernardino, CA, United States of America; Riverside City College, Riverside, CA, United States of America
| | - Ashley Riley
- California State University, Fullerton, CA, United States of America; California State University, San Bernardino, CA, United States of America; Riverside City College, Riverside, CA, United States of America
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Delgado-Hito P, Alcalà-Jimenez I, Martinez-Momblan MA, de la Cueva-Ariza L, Adamuz-Tomás J, Cuzco C, Benito-Aracil L, Romero-García M. Satisfaction of intensive care unit patients linked to clinical and organisational factors: A cross-sectional multicentre study. Aust Crit Care 2023; 36:716-722. [PMID: 36456425 DOI: 10.1016/j.aucc.2022.10.013] [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: 05/17/2022] [Revised: 10/17/2022] [Accepted: 10/17/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The satisfaction of critical care patients with the nursing care they receive is a key indicator of the quality of hospital care. OBJECTIVES The objectives of this study were to analyse the level of satisfaction of critical care patients in relation to the nursing care received and to determine the relationship between the level of satisfaction and sociodemographic, clinical, and organisational variables. DESIGN This was a prospective, descriptive correlational study. SETTING AND METHODS The population consisted of all patients discharged from the intensive care units (ICUs) of 19 hospitals in Spain between December 2018 and December 2019. The level of satisfaction was measured using the validated Nursing Intensive Care Satisfaction Scale, and sociodemographic, clinical, and organisational data were collected. RESULTS Participants' mean age (n = 677) was 59.7 (standard deviation: 16.1), and 62.8% of them were men (n = 426). Satisfaction with the nursing care received was 5.66 (SD: 0.68) out of a possible 6. The score for overall satisfaction presented statistically significant relationships with the hours of mechanical ventilation (p = 0.034), with the participant's perception of own health status (p = 0.01), with the participant's perceived degree of own recovery (p = 0.01), with the hospital's complexity level (p = 0.002), with the type of hospital (p = 0.005), and with the type of ICU (p = 0.004). Finally, the logistic regression model shows that the Nursing Intensive Care Satisfaction Scale score was not linked to age or sex but did have a statistically significant relationship with the perceived degree of recovery (p < 0.001) and the type of ICU (p=<0.001). The variables that predicted satisfaction were age, degree of recovery, and the type of ICU. CONCLUSION Several studies show that patient satisfaction is related to the patient's perceived health status and perceived degree of recovery, a finding that is confirmed in our study. Our study moves beyond these outcomes to show that the hours of mechanical ventilation and the characteristics of the hospital also have a significant relationship with patients' satisfaction.
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Affiliation(s)
- Pilar Delgado-Hito
- School of Nursing, University of Barcelona (Barcelona), Spain; Fundamental Care and Medical-Surgical Nursing Department, Spain; IDIBELL, Institute of Biomedical Research, Spain; International Research Project for the Humanization of Health Care, Proyecto HU-CI, Spain
| | | | - Maria Antonia Martinez-Momblan
- School of Nursing, University of Barcelona (Barcelona), Spain; Fundamental Care and Medical-Surgical Nursing Department, Spain; IDIBELL, Institute of Biomedical Research, Spain
| | - Laura de la Cueva-Ariza
- School of Nursing, University of Barcelona (Barcelona), Spain; Fundamental Care and Medical-Surgical Nursing Department, Spain; IDIBELL, Institute of Biomedical Research, Spain; International Research Project for the Humanization of Health Care, Proyecto HU-CI, Spain
| | - Jordi Adamuz-Tomás
- Nursing Knowledge Management and Information Systems Department, Bellvitge University Hospital (IDIBELL), L'Hospitalet de Llobregat, Catalunya, Spain; School of Nursing, Medicine and Health Science Faculty, University of Barcelona, Barcelona, Spain
| | - Cecilia Cuzco
- Department of Fundamental and Medical-Surgical Nursing, School of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Llúcia Benito-Aracil
- School of Nursing, University of Barcelona (Barcelona), Spain; Fundamental Care and Medical-Surgical Nursing Department, Spain; IDIBELL, Institute of Biomedical Research, Spain.
| | - Marta Romero-García
- School of Nursing, University of Barcelona (Barcelona), Spain; Fundamental Care and Medical-Surgical Nursing Department, Spain; IDIBELL, Institute of Biomedical Research, Spain; International Research Project for the Humanization of Health Care, Proyecto HU-CI, Spain
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Maier CB, Köppen J, Kleine J, McHugh MD, Sermeus W, Aiken LH. Recruiting and retaining bachelor qualified nurses in German hospitals (BSN4Hospital): protocol of a mixed-methods design. BMJ Open 2023; 13:e073879. [PMID: 37562928 PMCID: PMC10423778 DOI: 10.1136/bmjopen-2023-073879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/23/2023] [Indexed: 08/12/2023] Open
Abstract
INTRODUCTION Many countries in Europe are facing a shortage of nurses and seek effective recruitment and retention strategies. The nursing workforce is increasingly diverse in its educational background, ranging from 3-year vocational training (diploma) to bachelor and master educated nurses. This study analyses recruitment and retention strategies for academically educated nurses (minimum bachelor), including intention to leave, job satisfaction and work engagement compared with diploma nurses in innovative German hospitals; it explores recruitment and retention challenges and opportunities, and identifies lessons on recruitment and retention taking an international perspective. METHODS AND ANALYSIS The study will apply a convergent mixed-methods design, including qualitative and quantitative methods. The qualitative study will include semistructured interviews among hospital managers, nurses, students and stakeholders in Germany. In addition, expert interviews will be conducted internationally in countries with a higher proportion of bachelor/master nurses in hospitals. The quantitative, cross-sectional study will consist of a survey among professional nurses (bachelor/master, diploma nurses) in German hospitals. Study settings are hospitals with a higher-than-average proportion of bachelor nurses or relevant recruitment, work environment or retention strategies in place. Analyses will be conducted in several phases, first in parallel, then combined via triangulation: the parallel analysis technique will analyse the qualitative and quantitative data separately via content analyses (interviews) and descriptive, bivariate and multivariate analyses (survey). Subsequently, data sources will be collectively analysed via a triangulation matrix focusing on developing thematic exploratory clusters at three systemic levels: microlevel, mesolevel and macrolevel. The analyses will be relevant for generating lessons for clinical nursing, management and policy in Germany and internationally. ETHICS AND DISSEMINATION Ethics approval was obtained by the Charité Ethics Committee.Several dissemination channels will be used, including publications and presentations, for the scientific community, nursing management, clinical nurses and the wider public in Germany and internationally.
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Affiliation(s)
- Claudia B Maier
- Department of Healthcare Management, Technische Universität Berlin, Berlin, Germany
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Julia Köppen
- Department of Healthcare Management, Technische Universität Berlin, Berlin, Germany
| | - Joan Kleine
- Department of Healthcare Management, Technische Universität Berlin, Berlin, Germany
| | - Matthew D McHugh
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Walter Sermeus
- Institute for Healthcare Policy, KU Leuven, Leuven, Vlaams Brabant, Belgium
| | - Linda H Aiken
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Ahsan A, Rahmawati IN, Noviyanti LW, Harwiati Ningrum E, Nasir A, Harianto S. The Effect of the Application of the Team-STEPPS-Based Preceptorship Guidance Model on the Competence of Nursing Students. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:817-826. [PMID: 37534334 PMCID: PMC10392907 DOI: 10.2147/amep.s416847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/21/2023] [Indexed: 08/04/2023]
Abstract
Objective Student competence is an important topic of discussion during the implementation of counseling in the clinic. The purpose of this study was to analyze the effect of the Team-STEPPS-based preceptorship guidance model on student competency. Methods A comparative study was used to analyze the quantitative data. Participants were clinical practice students at "Ngudi Waluyo" Public Hospital with a total of 92 registered students divided into treatment and control groups. The Wilcoxon Signed Rank Test and the Mann-Whitney U-Test were used to assess differences between the intervention and control groups. Results There were post-test differences between the intervention group and the control group, namely clinical competence p-value (0.003), nursing management p (0.000), technical competence p (0.008), self-management p (0.000), and care-oriented patients p (0.000). Conclusion The Team-STEPPS-based preceptorship guidance model is very important in increasing student competency, not only in mastering clinical competence, but also in mastering technical skill competencies, nursing management, self-management, and patient-oriented care skills, and therefore, can increase student independence.
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Affiliation(s)
- Ahsan Ahsan
- Department of Nursing, Faculty of Health Sciences, Brawijaya University, Malang, Indonesia
| | - Ike Nesdia Rahmawati
- Department of Nursing, Faculty of Health Sciences, Brawijaya University, Malang, Indonesia
| | - Linda Wieke Noviyanti
- Department of Nursing, Faculty of Health Sciences, Brawijaya University, Malang, Indonesia
| | - Evi Harwiati Ningrum
- Department of Nursing, Faculty of Health Sciences, Brawijaya University, Malang, Indonesia
| | - Abd Nasir
- Faculty of Vocational Studies, Airlangga University, Surabaya, Indonesia
| | - Susilo Harianto
- Faculty of Vocational Studies, Airlangga University, Surabaya, Indonesia
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