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Clancy TL. Deconstructing nursing's paradoxical relationship with the concept of complexity. Nurs Philos 2024; 25:e12487. [PMID: 38952204 DOI: 10.1111/nup.12487] [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: 03/05/2024] [Revised: 05/09/2024] [Accepted: 06/18/2024] [Indexed: 07/03/2024]
Abstract
Although nursing seems to understand itself and its practice as complex, the literature is less clear about what this actually means. While complexity is discussed as an attribute of nursing, it is also suggested that complexity in nursing remains misunderstood and poorly articulated, is devalued, is not considered as a measure of health outcomes and remains invisible. Despite the overarching lack of a definition, some nurse scholars have conceptualized complexity as a complex intervention. For these authors, complexity becomes a complex intervention defined as that which is composed of component parts interacting in a variety of ways that influence the delivery of and outcomes of health-related interventions for populations. Conceptualizing complexity as a complex intervention forces nursing to embrace and adopt a received interpretation of complexity as expressed through complexity theory and complexity science. While complexity theory may afford us some tools for thinking about complexity, when we deconstruct nursing complexity to explicitly determinate and quantifiable tasks, this artificially narrowed orientation to complexity reveals an oversimplified explanation of the complexities associated with nursing and serves to blind us to its real qualities. Through a consideration of complexity from a Western philosophical tradition, I demonstrate that when nursing adopts the received interpretation of complexity as a complex intervention, this perspective on complexity contains nursing epistemologically and ontologically. I offer an extended conceptualization of complexity framed upon the consideration that nurses assume complexity and do not reduce it; that nurses have the capacity to not be paralysed by complexity and have developed logics to mobilize it in productive ways. Mobilizing complexity through navigating paradox and contradiction shapes an orientation to complexity that embraces an extended epistemology. This extended epistemology is characterized by a 'yes/and' mindset that expresses the dynamic and generative relationship between forms of knowledge which reflects complexity that characterizes nursing.
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Cesare M, D’agostino F, Maurici M, Zega M, Zeffiro V, Cocchieri A. Standardized Nursing Diagnoses in a Surgical Hospital Setting: A Retrospective Study Based on Electronic Health Data. SAGE Open Nurs 2023; 9:23779608231158157. [PMID: 36824318 PMCID: PMC9941607 DOI: 10.1177/23779608231158157] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/06/2022] [Accepted: 01/30/2023] [Indexed: 02/22/2023] Open
Abstract
Introduction In electronic health records (EHRs), standardized nursing terminologies (SNTs), such as nursing diagnoses (NDs), are needed to demonstrate the impact of nursing care on patient outcomes. Unfortunately, the use of NDs is not common in clinical practice, especially in surgical settings, and is rarely included in EHRs. Objectives The aim of the study was to describe the prevalence and trend of NDs in a hospital surgical setting by also analyzing the relationship between NDs and hospital outcomes. Methods A retrospective study was conducted. All adult inpatients consecutively admitted to one of the 15 surgical inpatient units of an Italian university hospital across 1 year were included. Data, including the Professional Assessment Instrument and the Hospital Discharge Register, were collected retrospectively from the hospital's EHRs. Results The sample included 5,027 surgical inpatients. There was a mean of 6.3 ± 4.3 NDs per patient. The average distribution of NDs showed a stable trend throughout the year. The most representative NANDA-I ND domain was safety/protection. The total number of NDs on admission was significantly higher for patient whose length of stay was longer. A statistically significant correlation was observed between the number of NDs on admission and the number of intra-hospital patient transfers. Additionally, the mean number of NDs on admission was higher for patients who were later transferred to an intensive care unit compared to those who were not transferred. Conclusion NDs represent the key to understanding the contribution of nurses in the surgical setting. NDs collected upon admission can represent a prognostic factor related to the hospital's key outcomes.
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Affiliation(s)
- Manuele Cesare
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Fabio D’agostino
- Unicamillus, Saint Camillus International University of Health Sciences, Rome, Italy
| | - Massimo Maurici
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Maurizio Zega
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Valentina Zeffiro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Antonello Cocchieri
- Section of Hygiene, Woman and Child Health and Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy,Antonello Cocchieri, Section of Hygiene, Woman and Child Health and Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy.
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Kim J, Kang T, Seo HJ, Seo SY, Kim M, Jung Y, Kim J, Lee JB. Measuring patient acuity and nursing care needs in South Korea: application of a new patient classification system. BMC Nurs 2022; 21:332. [PMID: 36447217 PMCID: PMC9707110 DOI: 10.1186/s12912-022-01109-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND An accurate and reliable patient classification system (PCS) can help inform decisions regarding adequate assignments for nurse staffing. This study aimed to evaluate the criterion validity of the Asan Patient Classification System (APCS), a new tertiary hospital-specific PCS, by comparing its rating and total scores with those of KPCS-1 and KPCS-GW for measuring patient activity and nursing needs. METHODS We performed a retrospective analysis of the medical records of 50,314 inpatients admitted to the general wards of a tertiary teaching hospital in Seoul, South Korea in March, June, September, and December 2019. Spearman's correlation and Kappa statistics according to quartiles were calculated to examine the criterion validity of the APCS compared with the KPCS-1 and KPCS-GW. RESULTS The average patient classification score was 28.3 points for APCS, 25.7 points for KPCS-1, and 21.6 points for KPCS-GW. The kappa value between APCS and KPCS-1 was 0.91 (95% CI:0.9072, 0.9119) and that between APCS and KPCS-GW was 0.88 (95% CI:0.8757, 0.8810). Additionally, Spearman's correlation coefficients among APCS, KPCS-1, and KPCS-GW showed a very strong correlation. However, 10.8% of the participants' results were inconsistent, and KPCS-1 tended to classify patients into groups with lower nursing needs compared to APCS. CONCLUSION This study showed that electronic health record-generated APCS can provide useful information on patients' severity and nursing activities to measure workload estimation. Additional research is needed to develop and implement a real-world EHR-based PCS system to accommodate for direct and indirect nursing care while considering diverse population and dynamic healthcare system.
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Affiliation(s)
- Jeounghee Kim
- grid.413967.e0000 0001 0842 2126Department of Nursing, Asan Medical Center, Seoul, Republic of Korea
| | - TaeRim Kang
- grid.413967.e0000 0001 0842 2126Department of Nursing, Asan Medical Center, Seoul, Republic of Korea
| | - Hyun-Ju Seo
- grid.254230.20000 0001 0722 6377College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, 301-747 Daejeon, Republic of Korea
| | - So-Young Seo
- grid.413967.e0000 0001 0842 2126Department of Nursing, Asan Medical Center, Seoul, Republic of Korea
| | - Myoungsook Kim
- grid.413967.e0000 0001 0842 2126Department of Nursing, Asan Medical Center, Seoul, Republic of Korea
| | - Youngsun Jung
- grid.413967.e0000 0001 0842 2126Department of Nursing, Asan Medical Center, Seoul, Republic of Korea
| | - Jinhyun Kim
- grid.31501.360000 0004 0470 5905College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Jung- Bok Lee
- grid.267370.70000 0004 0533 4667Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Danielis M, Fantini M, Sbrugnera S, Colaetta T, Maestra MR, Mesaglio M, Palese A. Missed nursing care in a long-term rehabilitation setting: findings from a cross-sectional study. Contemp Nurse 2022; 57:407-421. [PMID: 35023449 DOI: 10.1080/10376178.2022.2029515] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: There is a growing amount of literature that links missed nursing care (MNC) to negative patient outcomes, reduced patient safety, and poor quality of care. However, only few studies have investigated this phenomenon in long-term rehabilitation settings.Aim: To explore MNC occurrence, type, reasons, and predictors in three rehabilitation units.Design: A cross-sectional study was performed between August and September 2017.Method: 95 registered nurses and nursing assistants completed section A (interventions missed) and section B (perceived reasons for MNC) of the MISSCARE Survey tool. Descriptive, bivariate, and linear regression analyses were performed.Findings: The top missed elements were patient ambulation (score 2.4 out of 5, Standard Deviation [SD] 0.8), mouth care (2.3, SD 0.8), and participation to multidisciplinary meetings (2.3, SD 1.1). Lack of personnel was the most frequent reason reported for MNC with a score of 2.9 out of 4 (SD 0.9). At the linear regression analysis, advanced nursing education (β = 3.58, CI 95% 1.32-5.84) and inadequate handovers (β = 3.64, CI 95% 0.37-6.91) both increased the perception of MNC occurrence.Conclusion: MNC occurrence in rehabilitation settings appears to be lower than in other contexts; however, the most commonly missed elements are similar to those reported in other settings. As good strategies to detect the difference between expected nursing care and the one delivered to patients, advanced education and good quality handovers seem beneficial. Further research is needed to establish more evidence on predictors by developing longitudinal study designs.
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Affiliation(s)
- Matteo Danielis
- Nurse Educator, Department of Medical Sciences, Udine University, Italy
| | - Michela Fantini
- Nurse Coordinator, Department of Rehabilitation Medicine, Gervasutta Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Sonia Sbrugnera
- Nurse Coordinator, Department of Rehabilitation Medicine, Gervasutta Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Tiziana Colaetta
- Nurse Coordinator, Department of Rehabilitation Medicine, Gervasutta Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Maria Rosa Maestra
- Nurse Coordinator, Department of Rehabilitation Medicine, Gervasutta Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Maura Mesaglio
- Chief Nursing Officer, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Alvisa Palese
- Associate Professor, Department of Medical Sciences, Udine University, Italy
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Albsoul RA, FitzGerald G, Hughes JA, Ahmed Alshyyab M. Missed nursing care and complexity theory: a conceptual paper. J Res Nurs 2021; 26:809-823. [DOI: 10.1177/17449871211013073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Missed nursing care is a complex healthcare problem. Extant literature in this area identifies several interventions that can be used in acute hospital settings to minimise the impact of missed nursing care. However, controversy still exists as to the effectiveness of these interventions on reducing the occurrence of missed nursing care. Aim This theoretical paper aimed to provide a conceptual understanding of missed nursing care using complexity theory. Methods The method utilised for this paper is based on a literature review on missed care and complexity theory in healthcare. Results We found that the key virtues of complexity theory relevant to the missed nursing care phenomenon were adaptation and self-organisation, non-linear interactions and history. It is suggested that the complex adaptive systems approach may be more useful for nurse managers to inform and prepare nurses to meet uncertain encounters in their everyday clinical practice and therefore reduce instances of missed care. Conclusions This paper envisions that it is time that methods used to explore missed care changed. Strategies proposed in this paper may have an important impact on the ability of nursing staff to provide quality and innovative healthcare in the modern healthcare system.
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Affiliation(s)
- Rania Ali Albsoul
- Assistant Professor in Healthcare Management, Department of Family and Community Medicine, Jordan University, Jordan
| | - Gerard FitzGerald
- Professor in Public Health, School of Public Health and Social Work, Queensland University of Technology, Australia
| | - James A Hughes
- Nurse Researcher, Emergency and Trauma Centre, Royal Brisbane and Women's Hospital and Conjoint Senior Research Fellow, School of Nursing, Queensland University of Technology, Australia
| | - Muhammad Ahmed Alshyyab
- Assistant Professor in Health Services Management, Department of Public Health and Community Medicine, Jordan University of Science and Technology, Jordan
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Yildiz B, Yildiz H, Ayaz Arda O. Relationship between work-family conflict and turnover intention in nurses: A meta-analytic review. J Adv Nurs 2021; 77:3317-3330. [PMID: 33855744 DOI: 10.1111/jan.14846] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/21/2021] [Indexed: 01/29/2023]
Abstract
AIM This meta-analytic review aimed to synthesize and analyse studies that explored the relationship between nurses' work-family conflicts and turnover intentions. DESIGN This meta-analytical review was conducted according to the Joanna Briggs Institute guidelines and PRISMA checklist. DATA SOURCES A total of 191 (k = 14) publications published between 2005 and 2019 in English, including grey literature on turnover intention and work-family conflict, were retrieved from PubMed, PsycINFO, Web of Science, ProQuest and Scopus databases. REVIEW METHODS Studies on the relationship between work-family conflict and turnover intention were summarized. RESULTS An overall effect size of r = .28 (N = 5781, 95% CI [0.23-0.33]) was obtained, indicating a moderate, positive and significant relationship between work-family conflict and turnover intention. The moderator analysis showed that individualism and long-term orientation accounted for 90% of effect size heterogeneity of work-family conflict and turnover intention relationship. CONCLUSION Exploring the correlation between work-family conflict and turnover intention can provide guidelines and recommendations for the development of strategies to promote nurse retention and alleviate the nursing shortage. National culture, particularly individualism and long-term orientation, were found to play a significant moderator role in this relationship. Cultures that are highly individualistic and have a long-term orientation have a diminishing effect on the relationship between work-family conflict and turnover intention. IMPACT Work-family conflict and turnover intention are significantly correlated factors regardless of the studies' cultural characteristics examined in this study. Policymakers and managers should consider this finding and develop strategies that provide a balance-oriented work design to prevent nurse shortage.
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Affiliation(s)
- Bora Yildiz
- Faculty of Economics, Department of Management, Istanbul University, Istanbul, Turkey
| | - Harun Yildiz
- Ömer Seyfettin Faculty of Applied Sciences, Bandırma Onyedi Eylül University, Bandırma/Balıkesir, Turkey
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Ocagli H, Lanera C, Lorenzoni G, Prosepe I, Azzolina D, Bortolotto S, Stivanello L, Degan M, Gregori D. Profiling Patients by Intensity of Nursing Care: An Operative Approach Using Machine Learning. J Pers Med 2020; 10:jpm10040279. [PMID: 33327412 PMCID: PMC7768500 DOI: 10.3390/jpm10040279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/26/2020] [Accepted: 12/09/2020] [Indexed: 11/16/2022] Open
Abstract
Physical function is a patient-oriented indicator and can be considered a proxy for the assignment of healthcare personnel. The study aims to create an algorithm that classifies patients into homogeneous groups according to physical function. A two-step machine-learning algorithm was applied to administrative data recorded between 2015 and 2018 at the University Hospital of Padova. A clustering-large-applications (CLARA) algorithm was used to partition patients into homogeneous groups. Then, machine learning technique (MLT) classifiers were used to categorize the doubtful records. Based on the results of the CLARA algorithm, records were divided into three groups according to the Barthel index: <45, >65, ≥45 and ≤65. The support vector machine was the MLT showing the best performance among doubtful records, reaching an accuracy of 66%. The two-step algorithm, since it splits patients into low and high resource consumption, could be a useful tool for organizing healthcare personnel allocation according to the patients' assistance needs.
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Affiliation(s)
- Honoria Ocagli
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan, 18, 35121 Padova, Italy; (H.O.); (C.L.); (G.L.); (I.P.); (D.A.); (S.B.)
| | - Corrado Lanera
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan, 18, 35121 Padova, Italy; (H.O.); (C.L.); (G.L.); (I.P.); (D.A.); (S.B.)
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan, 18, 35121 Padova, Italy; (H.O.); (C.L.); (G.L.); (I.P.); (D.A.); (S.B.)
| | - Ilaria Prosepe
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan, 18, 35121 Padova, Italy; (H.O.); (C.L.); (G.L.); (I.P.); (D.A.); (S.B.)
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan, 18, 35121 Padova, Italy; (H.O.); (C.L.); (G.L.); (I.P.); (D.A.); (S.B.)
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
| | - Sabrina Bortolotto
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan, 18, 35121 Padova, Italy; (H.O.); (C.L.); (G.L.); (I.P.); (D.A.); (S.B.)
| | - Lucia Stivanello
- Health Professional Management Service (DPS) of the University Hospital of Padova, 35128 Padova, Italy; (L.S.); (M.D.)
| | - Mario Degan
- Health Professional Management Service (DPS) of the University Hospital of Padova, 35128 Padova, Italy; (L.S.); (M.D.)
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan, 18, 35121 Padova, Italy; (H.O.); (C.L.); (G.L.); (I.P.); (D.A.); (S.B.)
- Correspondence: ; Tel.: +39-049-8275384
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Bagnasco A, Catania G, Zanini M, Dasso N, Rossi S, Aleo G, Timmins F, Sermeus W, Aiken LH, Sasso L. Are data on missed nursing care useful for nursing leaders? The RN4CAST@IT cross-sectional study. J Nurs Manag 2020; 28:2136-2145. [PMID: 32881131 DOI: 10.1111/jonm.13139] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/04/2020] [Accepted: 08/20/2020] [Indexed: 11/30/2022]
Abstract
AIM To describe nurses' reported missed nursing care activities among hospitalized adult patients medical and surgical wards and explore gaps in service provision. BACKGROUND In 2015, Italy replicated the RN4CAST study, which heralded the exposition of missed care as an international phenomenon. In Italy, nurse-patient workload is high, with high levels of burnout and dissatisfaction reported, all factors associated with missed care. METHODS A cross-sectional study (n = 3,590) was conducted using the 13-item online Task Left Undone Tool aimed at collecting data on missed nursing care. RESULTS The frequency of omission of activities ranged between 7% and 50%. There were significant differences between morning, afternoon and night shifts and the various clinical settings. Oral care was the most frequently missed care activity. CONCLUSIONS This study takes step forward in identifying and reducing missed care on medical and surgical wards, both in Italy and also internationally, which needs to take into account the specific organisational characteristics of each setting. IMPLICATIONS FOR NURSING MANAGEMENT Although more essential activities are missed less frequently, much is known about the relational deficits such as information giving, education, communication and discharge advice, which managers ought to spearhead through local initiatives to improve these practices.
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Affiliation(s)
- Annamaria Bagnasco
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Gianluca Catania
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Milko Zanini
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Nicoletta Dasso
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Silvia Rossi
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Giuseppe Aleo
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Fiona Timmins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Walter Sermeus
- Department of Public Health & Primary Care, KU Leuven, Leuven, Belgium
| | - Linda H Aiken
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Loredana Sasso
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
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Lima JCD, Silva AEBDC, Caliri MHL. Omission of nursing care in hospitalization units. Rev Lat Am Enfermagem 2020; 28:e3233. [PMID: 32074206 PMCID: PMC7021482 DOI: 10.1590/1518-8345.3138.3233] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 09/18/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to describe the prevalence and reasons for omission of nursing care, according to the perception of nursing professionals working in a teaching hospital. METHOD a cross-sectional study was carried out with 267 professionals from ten hospitalization units. Data were collected by the MISSCARE-Brasil instrument. Descriptive statistics and Pearson's Chi-square or Fisher's exact tests were used to compare differences in the prevalence of omission among professional categories. RESULTS among the elements of nursing care, the highest prevalence of omission consisted in: to sit up the patient out of bed (70.3%), ambulation three times a day (69.1%), and participation in the discussion of the interdisciplinary team on patient's health care (67.2%). The most frequent reasons were: inadequate number of staff (85.4%), inadequate number of staff for providing care or in administrative tasks (81.6%), and unexpected increase in the number and/or greater severity of patients (79.8%). Nurses reported major omission than nursing technicians/auxiliaries in four elements of care (p<0.05). CONCLUSION according to our study, there is high prevalence of omission of nursing care elements from the professionals' perspective. Factors related to human and material resources were more reported as causes for such omission.
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Affiliation(s)
| | | | - Maria Helena Larcher Caliri
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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Bagnasco A, Dasso N, Rossi S, Galanti C, Varone G, Catania G, Zanini M, Aleo G, Watson R, Hayter M, Sasso L. Unmet nursing care needs on medical and surgical wards: A scoping review of patients’ perspectives. J Clin Nurs 2019; 29:347-369. [DOI: 10.1111/jocn.15089] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/13/2019] [Accepted: 10/20/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Nicoletta Dasso
- Department of Health Sciences University of Genoa Genoa Italy
| | - Silvia Rossi
- Department of Health Sciences University of Genoa Genoa Italy
| | | | - Gloria Varone
- Department of Interventional Radiology IRCCS Ospedale Policlinico San Martino Genoa Italy
| | | | - Milko Zanini
- Department of Health Sciences University of Genoa Genoa Italy
| | - Giuseppe Aleo
- Department of Health Sciences University of Genoa Genoa Italy
| | - Roger Watson
- Faculty of Health and Social Care University of Hull Hull UK
| | - Mark Hayter
- Faculty of Health and Social Care University of Hull Hull UK
| | - Loredana Sasso
- Department of Health Sciences University of Genoa Genoa Italy
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Houchens N, Gupta A, Meddings J. Quality & safety in the literature: May 2019. BMJ Qual Saf 2019; 28:424-428. [PMID: 30842266 DOI: 10.1136/bmjqs-2019-009401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 01/30/2019] [Indexed: 11/03/2022]
Affiliation(s)
- Nathan Houchens
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA .,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Ashwin Gupta
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jennifer Meddings
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
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12
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Barisone M, Bagnasco A, Aleo G, Catania G, Bona M, Gabriele Scaglia S, Zanini M, Timmins F, Sasso L. The effectiveness of web-based learning in supporting the development of nursing students' practical skills during clinical placements: A qualitative study. Nurse Educ Pract 2019; 37:56-61. [PMID: 31085383 DOI: 10.1016/j.nepr.2019.02.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 01/29/2019] [Accepted: 02/16/2019] [Indexed: 10/27/2022]
Abstract
Web-based learning, on its own or in combination with traditional teaching methods, has become a consolidated practice in many countries, and has been described as a valid and effective method that supports practical learning in undergraduate nursing students. The aim of this study was to explore the perception and effectiveness of web-based learning in facilitating the development of clinical skills in undergraduate nursing students. A qualitative descriptive study was conducted including online videos in three nursing schools of a university in Northern Italy. The participants were 26 undergraduate nursing students. A dedicated website was built including four videos and the respective checklists of four nursing techniques: insertion of a urinary catheter; insertion of a nasogastric tube; taking a blood sample; and the insertion of a peripheral intravenous line. Three Focus Groups were conducted, one for each nursing school. Thanks to its ease of use and unlimited access, web-based learning effectively supported students' clinical learning process by offering additional virtual visual support. Web-based learning could be effectively used to reduce the gap between theory and practice, and even as an upgrade for already qualified nurses.
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Affiliation(s)
- Michela Barisone
- Department for Health Sciences, University of Genoa, Via Pastore 1, Genoa, 16132, Italy.
| | - Annamaria Bagnasco
- Department for Health Sciences, University of Genoa, Via Pastore 1, Genoa, 16132, Italy.
| | - Giuseppe Aleo
- Department for Health Sciences, University of Genoa, Via Pastore 1, Genoa, 16132, Italy.
| | - Gianluca Catania
- Department for Health Sciences, University of Genoa, Via Pastore 1, Genoa, 16132, Italy.
| | - Massimo Bona
- Centre of Nursing Education in Pietra Ligure, University of Genoa, Via Pastore 1, Genoa, 16132, Italy.
| | - Stefano Gabriele Scaglia
- Department of Cardiology, Istituto Clinico Humanitas, Via A. Manzoni, 56, Rozzano, 20089, Rozzano, Milan, Italy.
| | - Milko Zanini
- Department for Health Sciences, University of Genoa, Via Pastore 1, Genoa, 16132, Italy.
| | - Fiona Timmins
- School of Nursing and MCdwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland.
| | - Loredana Sasso
- Department for Health Sciences, University of Genoa, Via Pastore 1, Genoa, 16132, Italy.
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13
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D'Agostino F, Vellone E, Cocchieri A, Welton J, Maurici M, Polistena B, Spandonaro F, Zega M, Alvaro R, Sanson G. Nursing Diagnoses as Predictors of Hospital Length of Stay: A Prospective Observational Study. J Nurs Scholarsh 2018; 51:96-105. [PMID: 30411479 DOI: 10.1111/jnu.12444] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE To investigate whether the number of nursing diagnoses on hospital admission is an independent predictor of the hospital length of stay. DESIGN A prospective observational study was carried out. A sample of 2,190 patients consecutively admitted (from July to December 2014) in four inpatient units (two medical, two surgical) of a 1,547-bed university hospital were enrolled for the study. METHODS Data were collected from a clinical nursing information system and the hospital discharge register. Two regression analyses were performed to investigate if the number of nursing diagnoses on hospital admission was an independent predictor of length of stay and length of stay deviation after controlling for patients' sociodemographic characteristics (age, gender), clinical variables (disease groupers, disease severity morbidity indexes), and organizational hospital variables (admitting inpatient unit, modality of admission). FINDINGS The number of nursing diagnoses was shown to be an independent predictor of both the length of stay (β = .15; p < .001) and the length of stay deviation (β = .19; p < .001). CONCLUSIONS The number of nursing diagnoses is a strong independent predictor of an effective hospital length of stay and of a length of stay longer than expected. CLINICAL RELEVANCE The systematic inclusion of standard nursing care data in electronic health records can improve the predictive ability on hospital outcomes and describe the patient complexity more comprehensively, improving hospital management efficiency.
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Affiliation(s)
- Fabio D'Agostino
- Mu Upsilon, Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Assistant Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - John Welton
- Professor & Senior Scientist Health Systems Research, University of Colorado College of Nursing, Aurora, CO, USA
| | - Massimo Maurici
- Assistant Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Barbara Polistena
- Research Fellow, Department of Economics and Finance, University of Rome Tor Vergata, C.R.E.A. Sanità, Rome, Italy
| | - Federico Spandonaro
- Aggregate Professor, Department of Economics and Finance, University of Rome Tor Vergata, Chair C.R.E.A. Sanità, Rome, Italy
| | - Maurizio Zega
- Director of Health Professions, University Hospital Agostino Gemelli, Rome, Italy
| | - Rosaria Alvaro
- Associate Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Gianfranco Sanson
- Adjunct Professor, School of Nursing, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
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14
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Li H, Shi Y, Li Y, Xing Z, Wang S, Ying J, Zhang M, Sun J. Relationship between nurse psychological empowerment and job satisfaction: A systematic review and meta-analysis. J Adv Nurs 2018; 74:1264-1277. [DOI: 10.1111/jan.13549] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Huanhuan Li
- Nursing School of Jilin University; Changchun China
| | - Ying Shi
- Nursing School of Jilin University; Changchun China
| | - Yuan Li
- Nursing School of Jilin University; Changchun China
| | | | - Shouqi Wang
- Nursing School of Jilin University; Changchun China
| | - Jie Ying
- Nursing School of Jilin University; Changchun China
| | | | - Jiao Sun
- Nursing School of Jilin University; Changchun China
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15
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D'Agostino F, Zeffiro V, Vellone E, Ausili D, Belsito R, Leto A, Alvaro R. Cross‐Mapping of Nursing Care Terms Recorded in Italian Hospitals into the Standardized NNN Terminology. Int J Nurs Knowl 2018; 31:4-13. [DOI: 10.1111/2047-3095.12200] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Fabio D'Agostino
- Department of Biomedicine and PreventionUniversity of Rome Tor Vergata Rome Italy
| | - Valentina Zeffiro
- Department of Biomedicine and PreventionUniversity of Rome Tor Vergata Rome Italy
| | - Ercole Vellone
- Department of Biomedicine and PreventionUniversity of Rome Tor Vergata Rome Italy
| | - Davide Ausili
- Department of Medicine and SurgeryUniversity of Milan Bicocca Milan Italy
| | - Romina Belsito
- Department of NeonatologyS. Giovanni Addolorata Hospital Complex Rome Italy
| | | | - Rosaria Alvaro
- Department of Biomedicine and PreventionUniversity of Rome Tor Vergata Rome Italy
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