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Antoszewska A, Gutysz-Wojnicka A. Rationing of nursing care and assessment of work safety and a healthy work environment in intensive care units: A cross-sectional, correlational study. Intensive Crit Care Nurs 2024; 83:103667. [PMID: 38471399 DOI: 10.1016/j.iccn.2024.103667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 02/23/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Rationing of nursing care, whichrefers to the aspects of care not delivered by nurses in an intensive care unit (ICU), has implicationsfor patient outcomes and experiences. OBJECTIVES This study aimed to identify the extent to which nursing care is rationed in intensive care units, as well as asses quality of nursing care, and the level of job satisfaction and its correlation with an assessment of the climate of work safety, teamwork, and a healthy work environment. METHODOLOGY A cross-sectional, correlational study was conducted. The study included 226 ICU nurses. It was conducted with the use of three instruments: the Perceived Implicit Rationing of Nursing Care (PRINCA) questionnaire on the rationing of nursing care, assessment of patient care quality and job satisfaction, American Association of Critical-Care Nurses Healthy Work Environment Assessment Tool (HWEAT) and the Safe Attitudes and Behaviours Questionnaire questionnaire in the version: Teamwork and Safety Climate (BePoZa). SETTINGS Intensive Care Units in Warmia and Mazury Region in Poland. MAIN OUTCOME MEASURES Level of Nursing Care Rationing in Intensive Care Units. RESULTS The majority of participants were women (89.82 %) with a mean age of 42.47 years. The average score for nursing care rationing across all groups was 0.58. The mean score for the HWEAT was 2.7 and BePoZa was 3.72. The scores from the questionnaires were negatively correlated with the nursing care rationing scores, being -0.36 for the HWEAT and -0.45 for BePoZa. All correlation coefficients were statistically significant at a p-value of less than 0.05. CONCLUSIONS It is important to monitor work safety, teamwork climate, and standards of a healthy work environment in ICUs to minimise the risk of rationing nursing care. IMPLICATIONS FOR CLINICAL PRACTICE Interventions that enhance work organisation and teamwork can elevate nursing quality and job satisfaction in ICUs, while underestimating patient care tasks; thus, highlighting the need for further research on the factors influencing nursing performance.
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Affiliation(s)
- Anna Antoszewska
- School of Public Health, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Department of Nursing, Żołnierska 14c Street, 10-561 Olsztyn, Poland.
| | - Aleksandra Gutysz-Wojnicka
- School of Public Health, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Department of Nursing, Żołnierska 14c Street, 10-561 Olsztyn, Poland.
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Fattahi Ardakani M, Sotoudeh A, Asadian A, Heydari S, Zareipour M. The Effect of an Educational Intervention Based on the Health Action Process Approach on Nurses' Communication Skills. INVESTIGACION Y EDUCACION EN ENFERMERIA 2024; 42:e13. [PMID: 39083825 PMCID: PMC11290895 DOI: 10.17533/udea.iee.v42n1e13] [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: 11/16/2023] [Accepted: 02/06/2024] [Indexed: 08/02/2024]
Abstract
Objective This study aimed to the effects of the Health Action Process Approach (HAPA) in promoting the quality of nurses' communication skills among nurses. Methods The present quasi-experimental research was conducted on 148 nurses (76 in the intervention and 72 in the control group) in Yazd province (Iran). In this study, the total number of nurses in one hospital was selected as the intervention group, while the nurses from another hospital were chosen as the control group. The participants were recruited from public hospitals in Ardakan and Meibod cities. The data collection instrument was a questionnaire based on the Health Action Process Approach (HAPA) Constructs and a communicative skill questionnaire. The data were collected from the two groups before, one month after, and four months after the intervention. The control group did not receive any educational training during the course of the study. Results In the pretest, no statistically significant difference was found between the intervention and control groups regarding the behavioral stages of effective communication with patients. In the posttest, the mean task self-efficacy score was significantly increased in the intervention group compared to the control (p<0.001). The mean coping self-efficacy score was also significantly higher in the intervention group than the control in the posttest (p<0.001). Moreover, the mean coping planning score was significantly increased in the post-test intervention group(p < 0.001). The mean communicative skill score was also significantly increased in the intervention group compared to the post-test control (p=0.03). Conclusion The intervention used in the present study based on the target model (HAPA) significantly affected nurses' self-efficacy and communicative skills in the experimental group.
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Affiliation(s)
| | - Ahmad Sotoudeh
- Department of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Ali Asadian
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Sara Heydari
- Assistant Professor of Medical Education, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Moradali Zareipour
- Department of public Health, Khoy University of Medical Sciences, Khoy, Iran.
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Uchmanowicz I, Lisiak M, Wleklik M, Pawlak AM, Zborowska A, Stańczykiewicz B, Ross C, Czapla M, Juárez-Vela R. The Impact of Rationing Nursing Care on Patient Safety: A Systematic Review. Med Sci Monit 2024; 30:e942031. [PMID: 38196186 PMCID: PMC10787575 DOI: 10.12659/msm.942031] [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: 01/11/2024] Open
Abstract
BACKGROUND Rationing of nursing care (RONC) has been associated with poor patient outcomes and is a growing concern in healthcare. The aim of this systematic study was to investigate the connection between patient safety and the RONC. MATERIAL AND METHODS A thorough search of electronic databases was done to find research that examined the relationship between restricting nurse services and patient safety. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers (M.L. and A.P.) independently screened the titles and abstracts, and full-text articles were assessed for eligibility. Data were extracted, and a quality assessment was performed using appropriate techniques. RESULTS A total of 15 studies met the inclusion criteria. The studies included in the review demonstrated a correlation between rationing of nursing care and patient safety. The results of these studies revealed that there is an inverse relationship between rationing of nursing care and patient safety. The review found that when nursing care is rationed, there is a higher incidence of falls, medication errors, pressure ulcers, infections, and readmissions. In addition, the review identified that the work characteristics of nurses, such as workload, staffing levels, and experience, were associated with RONC. CONCLUSIONS RONC has a negative impact on patient safety outcomes. It is essential for healthcare organizations to implement effective strategies to prevent the RONC. Improving staffing levels, workload management, and communication amo0ng healthcare providers are some of the strategies that can support this.
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Affiliation(s)
- Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Magdalena Lisiak
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
- Institute of Heart Diseases, University Hospital, Wrocław, Poland
| | - Marta Wleklik
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
- Institute of Heart Diseases, University Hospital, Wrocław, Poland
| | - Andrzej Maciej Pawlak
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Agnieszka Zborowska
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Bartłomiej Stańczykiewicz
- Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, Wrocław Medical University, Wrocław, Poland
| | - Catherine Ross
- The Centre for Cardiovascular Health, School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Michał Czapla
- Institute of Heart Diseases, University Hospital, Wrocław, Poland
- Department of Emergency Medical Service, Wrocław Medical University, Wrocław, Poland
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, Logroño, Spain
| | - Raúl Juárez-Vela
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, Logroño, Spain
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Jędrzejczyk M, Guzak B, Czapla M, Ross C, Vellone E, Juzwiszyn J, Chudiak A, Sadowski M, Uchmanowicz I. Rationing of nursing care in Internal Medicine Departments-a cross-sectional study. BMC Nurs 2023; 22:455. [PMID: 38044434 PMCID: PMC10694866 DOI: 10.1186/s12912-023-01617-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Implicit rationing of nursing care refers to a situation in which necessary nursing care is not performed to meet all of the patients' needs. PURPOSE To examine the factors influencing the rationing of nursing care, nurses' assessment of the quality of patient care, and their job satisfaction in Internal Medicine Departments. METHODS A cross-sectional descriptive study was undertaken. The study included 1164 nurses working in the Internal Medicine Departments in 8 hospitals (Lower Silesia, Poland). The Perceived Implicit Rationing of Nursing Care instrument was used. RESULTS Respondents rarely ration nursing care, with a mean score of 1.12 (SD = 0.68). The mean score for quality of patient care was 6.99 (SD = 1.92). In contrast, the mean job satisfaction score was 6.07 points (SD = 2.22). The most important predictors of high rates of rationing of nursing care were work experience of 16-20 years (regression parameter: 0.387) and a Bachelor's degree in nursing (regression parameter: 0.139). Nurses' assessment of the quality of patient care ratings were increased by having a Master's degree in nursing (regression parameter: 0.41), and significantly decreased by work experience of 16-20 years (regression parameter: -1.332). Independent predictors of job satisfaction ratings in both univariate and multivariate analysis were Master's degree and long-shift working patterns. CONCLUSION The factors that influence an increased level of nursing care rationing on medical wards are nurse seniority, exceeding 16 years and female gender. Obtaining a Master's degree in nursing indicates improved nurses' assessment of the quality of patient care.
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Affiliation(s)
- Maria Jędrzejczyk
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Beata Guzak
- Center of Postgraduate Education for Nurses and Midwives, Warsaw, Poland
| | - Michał Czapla
- Institute of Heart Diseases, University Hospital, Wroclaw, 50-566, Poland.
- Department of Emergency Medical Service, Wroclaw Medical University, ul. Parkowa 34, Wroclaw, 51-616, Poland.
- Group of Research in Care (GRUPAC), Faculty of Health Science, University of La Rioja, Logroño, 26006, Spain.
| | - Catherine Ross
- The Centre for Cardiovascular Health, School of Health and Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, UK
| | - Ercole Vellone
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
- Department of Biomedicine and Prevention, University of Roma Tor Vergata, Rome, Italy
| | - Jan Juzwiszyn
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Anna Chudiak
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Mikołaj Sadowski
- Department of Anaesthesiology and Intensive Care, University Hospital, Wrocław, 50-556, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
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Moradi T, Adib-Hajbaghery M, Dianati M, Moradi F. Rationing of nursing care: A concept analysis. Heliyon 2023; 9:e15861. [PMID: 37180901 PMCID: PMC10172910 DOI: 10.1016/j.heliyon.2023.e15861] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 04/23/2023] [Accepted: 04/24/2023] [Indexed: 05/16/2023] Open
Abstract
Rationing of nursing care (RONC) refers to necessary nursing tasks that nurses refuse or fail to do because of limited time, staffing level, or skill mix. As an important process factor, it affects the quality of patient care. The concept of rationing of nursing care has not yet been clearly defined and analyzed and there are different views regarding this issue. Using Walker and Avant's eight-step method, this concept analysis was conducted to analyze the meaning, attributes, dimensions, antecedents, and consequences of nursing care rationing. The literature was collected by searching in electronic databases including PubMed, ScienceDirect, Web of Science, Scopus, and Google Scholar with no date limitation. Both qualitative and quantitative studies on rationing of nursing care, which were open-access and published in English, were included in this study. Thirty-three articles were investigated in the present study. The four defining attributes of RONC included the duty of performing nursing care, dealing with problems of doing nursing care, decision-making and prioritizing, and outcome. The antecedents included nurse-related, organization-related, care-related, and patient-related antecedents. A theoretical definition and a conceptual model of RONC were developed. The attributes, antecedents, and consequences of RONC identified in this study can be used in nursing education, research, and managerial and organizational planning.
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Affiliation(s)
- Tayebeh Moradi
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Adib-Hajbaghery
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Corresponding author.
| | - Mansour Dianati
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Fatemeh Moradi
- Department of English Language and Literature, Allameh Tabataba'i University, Tehran, Iran
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He H, Zhu N, Lyu B, Zhai S. Relationship between nurses’ psychological capital and satisfaction of elderly cancer patients during the COVID-19 pandemic. Front Psychol 2023; 14. [DOI: https:/doi.org/10.3389/fpsyg.2023.1121636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023] Open
Abstract
IntroductionAs a special vulnerable group, the physical and mental health of elderly cancer patients has attracted much attention. However, few studies have focused on the impact of nurses’ mental state on the mental health of elderly cancer patients during the COVID-19 pandemic. In response to this literature gap, this study aims to explore the impact of nurses’ psychological capital on the satisfaction of elderly cancer patients. The job demands-resources model (JD-R) is used to further investigate how work engagement and job resources of nurses affect this relationship.MethodsThe questionnaire survey was used to collect data, participants included 230 elderly cancer patients and their nurses from a tertiary first-class cancer hospital in China. Partial least squares structural equation modeling (PLS-SEM) was conducted with SmartPLS 3.3.9.ResultsNurses’ psychological capital has a significant positive impact on the satisfaction of elderly cancer patients during the COVID-19 pandemic. Nurses’ work engagement is an important mechanism for their psychological capital to affect the satisfaction of elderly cancer patients. In addition, nurses’ job resources positively moderate the relationship between their psychological capital and work engagement. The positive relationship between psychological capital and work engagement of nurses is stronger when they have abundant job resources.DiscussionThese findings suggest that healthcare organizations should take the psychological capital of medical staff as an important means to improve their competitive advantage. It can improve the quality of medical services to obtain good performance by effectively developing and managing the psychological capital of medical staff. In addition, healthcare organizations should recognize the importance of providing adequate job resources for medical staff.
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He H, Zhu N, Lyu B, Zhai S. Relationship between nurses' psychological capital and satisfaction of elderly cancer patients during the COVID-19 pandemic. Front Psychol 2023; 14:1121636. [PMID: 36777226 PMCID: PMC9911544 DOI: 10.3389/fpsyg.2023.1121636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/10/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction As a special vulnerable group, the physical and mental health of elderly cancer patients has attracted much attention. However, few studies have focused on the impact of nurses' mental state on the mental health of elderly cancer patients during the COVID-19 pandemic. In response to this literature gap, this study aims to explore the impact of nurses' psychological capital on the satisfaction of elderly cancer patients. The job demands-resources model (JD-R) is used to further investigate how work engagement and job resources of nurses affect this relationship. Methods The questionnaire survey was used to collect data, participants included 230 elderly cancer patients and their nurses from a tertiary first-class cancer hospital in China. Partial least squares structural equation modeling (PLS-SEM) was conducted with SmartPLS 3.3.9. Results Nurses' psychological capital has a significant positive impact on the satisfaction of elderly cancer patients during the COVID-19 pandemic. Nurses' work engagement is an important mechanism for their psychological capital to affect the satisfaction of elderly cancer patients. In addition, nurses' job resources positively moderate the relationship between their psychological capital and work engagement. The positive relationship between psychological capital and work engagement of nurses is stronger when they have abundant job resources. Discussion These findings suggest that healthcare organizations should take the psychological capital of medical staff as an important means to improve their competitive advantage. It can improve the quality of medical services to obtain good performance by effectively developing and managing the psychological capital of medical staff. In addition, healthcare organizations should recognize the importance of providing adequate job resources for medical staff.
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Affiliation(s)
- Hui He
- School of Public Administration, Xiangtan University, Xiangtan, China
| | - Na Zhu
- School of Public Administration, Xiangtan University, Xiangtan, China
| | - Bei Lyu
- School of Economics and Management, Huaibei Normal University, Huaibei, China,Chinese Graduate School, Panyapiwat Institute of Management, Nonthaburi, Thailand,*Correspondence: Bei Lyu, ✉
| | - Shengbao Zhai
- School of Economics and Management, Huaibei Normal University, Huaibei, China,Shengbao Zhai, ✉
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BAGNASCO ANNAMARIA, ROSSI SILVIA, LANNA SARA, DASSO NICOLETTA, OTTONELLO GIULIA, CATANIA GIANLUCA, ZANINI MILKO, ALEO GIUSEPPE, TIMMINS FIONA, SASSO LOREDANA. How do undergraduate nursing students learn about the fundamentals of care? A pilot cross-sectional attitudinal study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E448-E455. [PMID: 36415294 PMCID: PMC9648557 DOI: 10.15167/2421-4248/jpmh2022.63.3.2153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/01/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Despite the growing importance of nursing fundamentals of care, nurses often overlook these aspects of care. In this study, we explored why this happens precisely where nursing education is initially provided. In fact, little is known about how undergraduate nursing students perceive the teaching of fundamentals of care and how they value them. METHODS This pilot cross-sectional study used a questionnaire adapted and validated in Italian to assess the perceptions of first, second, and third-year undergraduate nursing students (n=150) in an Italian university about the teaching of fundamentals of care during theoretical lessons and clinical practice. RESULTS In the first section of the tool, on general fundamentals of care (nutrition, hygiene, mobility, rest and sleep, the expression of sexuality, safety, etc), students reported high levels of agreement for all items: range between 61.2% (95% CI: 57.1-65.3) and 100%.In the section on nutrition, divided into nutrition, oral intake of fluids, and malnutrition high percentages of agreement from 53.1% (95% CI: 46.0-60.2) to 91.8% (95% CI: 87.9-95.7%) were obtained, but for questions regarding 'learning how to document food and fluid intake', first-year students reported low levels of agreement.With regard to the 'Communication Section', the item about 'learning how to inform minor patients' presented low percentages of agreement throughout the three-year programOf the first-year students, between 71.4% (95% CI: 64.9-77.9) and 77.6% (95% CI: 71.6-83.6) declared they had not received instructions about this. CONCLUSIONS Understanding how nursing students perceive the importance of learning of fundamentals of care during their curriculum and how their multidimensional nature is highlighted by teachers and clinical supervisors, will enable educators to address the gaps in the way they taught and prioritized within the curriculum.
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Affiliation(s)
| | - SILVIA ROSSI
- Department of Health Sciences, University of Genoa, Genoa Italy
- IRCCS Istituto Giannina Gaslini, Genoa Italy
| | - SARA LANNA
- Department of Health Sciences, University of Genoa, Genoa Italy
| | - NICOLETTA DASSO
- Department of Health Sciences, University of Genoa, Genoa Italy
| | | | | | - MILKO ZANINI
- Department of Health Sciences, University of Genoa, Genoa Italy
- Correspondence: Milko Zanini, PhD, MSN, MSoc, RN, Assistant Professor and Researcher, Department of Health Sciences Department, University of Genoa, Via A. Pastore, 1, 16132 Genoa, Italy. - Tel.: 0039 010 3538590 - Mobile: 0039 347 2453563 - E-mail:
| | - GIUSEPPE ALEO
- Department of Health Sciences, University of Genoa, Genoa Italy
| | - FIONA TIMMINS
- School of Nursing, Midwifery and Health Systems, UCD College of Health Sciences, University College Dublin, Dublin Ireland
| | - LOREDANA SASSO
- Department of Health Sciences, University of Genoa, Genoa Italy
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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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Jomaa C, Dubois CA, Caron I, Prud'Homme A. Staffing, teamwork and scope of practice: Analysis of the association with patient safety in the context of rehabilitation. J Adv Nurs 2021; 78:2015-2029. [PMID: 34841549 PMCID: PMC9300032 DOI: 10.1111/jan.15112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 10/04/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022]
Abstract
Aims To describe the organization of nursing services (staffing, scope of practice, teamwork) and its association with medication errors and falls, in rehabilitation units. Background The healthcare system is greatly impacted by the ageing population and the complexity of care associated with chronic diseases. It is therefore necessary to have enough staff who are using their full scope of practice and who are operating in a favourable working environment. However, these conditions are not always met, which can lead to threats to patient safety. Design A correlational descriptive study. Methods Staffing data and reported safety incidents were collected by shift from 01 October 2019 until 15 January 2020 in five rehabilitation units. In addition, a total of 75 nursing staff members responded to a missed care and teamwork survey. Descriptive analysis and logistic regression analysis were performed. Results The mean staff hours per patient shift was 1.39 (SD = 0.60). The teams reported a global missed care score as ‘rarely missed’ at 1.14 (SD = 0.07) and a moderate teamwork score at 3.36 (SD = 0.58) on a five‐point scale. The safety incidents decreased 10‐fold with a predominance of bachelor compared with technician nurses and decreased by 67% when there was an increase of 1 h of care per patient shift. Conclusions This study showed that the organization of nursing services in the observed rehabilitation units is characterized by a moderate staffing intensity, a moderate perception of teamwork level and a relatively low level of missed care. It indicated the key role of the staffing in reducing the risk of occurrence of safety incidents. Future research specific to rehabilitation hospitals are greatly needed to improve patient outcomes in this setting. Impact Nurse Managers should consider all the aspects of the organization of nursing services (staffing, scope of practice and teamwork) in their efforts to improve patient safety in rehabilitation settings. A central finding of this study is that the staffing intensity, the proportion of bachelor prepared nurses and the proportion of agency staff were positively associated with a reduction of safety incidents.
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Affiliation(s)
- Carla Jomaa
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada.,Centre Intégré Universitaire de Santé et des Services Sociaux du Centre-Ouest de l'île de Montréal, Montreal, QC, Canada
| | - Carl-Ardy Dubois
- School of Public Health, University of Montreal (ESPUM), Montreal, QC, Canada
| | - Isabelle Caron
- Centre Intégré Universitaire de Santé et des Services Sociaux du Centre-Ouest de l'île de Montréal, Montreal, QC, Canada
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Gurková E, Bartoníčková D, Mikšová Z. Nursing work environment and unfinished nursing care in hospital settings - a scoping review. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2021. [DOI: 10.15452/cejnm.2021.12.0015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Similarities and Differences in Nurse-Reported Care Rationing Between Critical Care, Surgical, and Medical Specialties. J Patient Saf 2021; 16:e162-e168. [PMID: 27811591 DOI: 10.1097/pts.0000000000000295] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to determine the similarities and differences in elements of nursing care that are commonly rationed in the critical care, medical, and surgical specialties within an acute hospital environment. METHODS Registered nurses who provide bedside nursing care within the medical, surgical, and critical specialties at a single center were invited to anonymously complete the self-administered MISSCARE questionnaire. The frequency of rationing for each individual care element within the 4 broader care groups (assessment, intervention-individual needs, intervention-basic care, and planning) of the MISSCARE questionnaire was determined. A mean score for each care group was also determined, and multiple regression analysis was undertaken to determine the demographic predictors of care rationing. RESULTS Interventions related to basic care was the most frequently rationed care group in the critical care/emergency specialty (missed care mean of 50.1%), whereas planning was the most frequently rationed care group among both the medical (missed care mean of 43.6%) and surgical (missed care mean of 44.8%) specialties. Assessment was the least frequently rationed care group among all 3 specialties (missed care mean of 19.7%-26.7%). Length of time practicing as a registered nurse was an independent predictor of care rationing in the critical care/emergency specialty, and age older than 50 was an independent predictor in the medical specialty. CONCLUSIONS There are numerous similarities and differences in care rationing between critical care, surgical, and medical nurses. The development and implementation of specialty-based strategies should be undertaken to reduce the incidence of nursing care rationing.
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Vaisi-Raygani A, Dalvandi A, Nourozi K, Ebadi A, Rahgozar M, Jalali R, Salari N, Abdi A. Validation of the Persian version of the Compassionate Care Assessment Tool. Int J Nurs Sci 2021; 8:95-101. [PMID: 33575450 PMCID: PMC7859547 DOI: 10.1016/j.ijnss.2020.12.004] [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: 04/11/2020] [Revised: 11/04/2020] [Accepted: 12/08/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES The present study aimed to translate and determine the psychometric properties of the Persian version of the Compassionate Care Assessment Tool (CCAT) ©. METHODS The study was carried out to translate and validate of the CCAT©. After securing permission from the designer of the tool and translating it, the psychometric properties were determined through examining face validity, construct validity, internal consistency, and test/retest reliability. With regard to construct validity, confirmatory factor analysis was used so that 300 patients in internal and surgery wards were selected by a simple random sampling method from three hospitals. Data were analyzed using SPSS (v.24.0) and LISREL statistical software version 8.8. RESULTS The results of the confirmatory factor analysis supported the validity and reliability of the Persian version of the CCAT© and its four factors. The reliability of the tool and internal consistency were confirmed through test/retest method with two weeks' interval. At the two areas of importance and provision of compassionate care, Cronbach's α coefficient equaled to 0.918 and 0.933 and intraclass consistency equaled to 0.848 and 0.907 respectively. CONCLUSION The results showed that the Persian version of the CCAT© was adequately valid and reliable for Iranian patients. Given the acceptable psychometric parameters of the tool, using it in future studies to measure importance and provision of compassionate nursing care to Iranian patients at internal and surgery wards is recommended.
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Affiliation(s)
- Aliakbar Vaisi-Raygani
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Asghar Dalvandi
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Kian Nourozi
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Teheran, Iran
| | - Mahdi Rahgozar
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Rostam Jalali
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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14
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Pereira Lima Silva R, Gonçalves Menegueti M, Dias Castilho Siqueira L, Araújo TR, Auxiliadora‐Martins M, Mantovani Silva Andrade L, Laus AM. Omission of nursing care, professional practice environment and workload in intensive care units. J Nurs Manag 2020; 28:1986-1996. [DOI: 10.1111/jonm.13005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Renata Pereira Lima Silva
- General and Specialized Nursing Department College of Nursing at Ribeirão Preto University of São Paulo São Paulo Brazil
| | - Mayra Gonçalves Menegueti
- General and Specialized Nursing Department College of Nursing at Ribeirão Preto University of São Paulo São Paulo Brazil
| | | | - Thamiris Ricci Araújo
- General and Specialized Nursing Department College of Nursing at Ribeirão Preto University of São Paulo São Paulo Brazil
| | - Maria Auxiliadora‐Martins
- Division of Intensive Medicine of Hospital das Clínicas Department of Surgery and Anatomy of Medical School at Ribeirão Preto University of São Paulo São Paulo Brazil
| | | | - Ana Maria Laus
- General and Specialized Nursing Department College of Nursing at Ribeirão Preto University of São Paulo São Paulo Brazil
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15
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Tønnessen S, Christiansen K, Hjaltadóttir I, Leino-Kilpi H, Scott PA, Suhonen R, Öhlén J, Halvorsen K. Visibility of nursing in policy documents related to health care priorities. J Nurs Manag 2020; 28:2081-2090. [PMID: 32037639 DOI: 10.1111/jonm.12977] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/18/2020] [Accepted: 02/06/2020] [Indexed: 12/01/2022]
Abstract
AIM To explore the visibility of nursing in policy documents concerning health care priorities in the Nordic countries. BACKGROUND Nurses at all levels in health care organisations set priorities on a daily basis. Such prioritization entails allocation of scarce public resources with implications for patients, nurses and society. Although prioritization in health care has been on the political agenda for many years, prioritization in nursing seems to be obscure in policy documents. METHODOLOGY Each author searched for relevant documents from their own country. Text analyses were conducted of the included documents concerning nursing visibility. RESULTS All the Nordic countries have published documents articulating values and criteria relating to health care priorities. Nursing is seldom explicitly mentioned but rather is included and implicit in discussions of health care prioritization in general. CONCLUSION There is a need to make priorities in nursing visible to prevent missed nursing care and ensure fair allocation of limited resources. IMPLICATIONS FOR NURSING MANAGEMENT To highlight nursing priorities, we suggest that the fundamental need for nursing care and what this implies for patient care in different organisational settings be clarified and that policymakers explicitly include this information in national policy documents.
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Affiliation(s)
- Siri Tønnessen
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway
| | - Karin Christiansen
- Faculty of Health, Centre for Health and Welfare Technology, VIA University College, Aarhus, Denmark
| | - Ingibjörg Hjaltadóttir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | | | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland.,Welfare Division, University Hospital of Turku, Turku, Finland
| | - Joakim Öhlén
- Institute of Health and Care Sciences, University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Palliative Centre, Sahlgrenska University Hospital Västra Götaland Region, Gothenburg, Sweden
| | - Kristin Halvorsen
- Faculty of Health Sciences, Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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16
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Gustafsson N, Leino-Kilpi H, Prga I, Suhonen R, Stolt M. Missed Care from the Patient's Perspective - A Scoping Review. Patient Prefer Adherence 2020; 14:383-400. [PMID: 32161449 PMCID: PMC7049852 DOI: 10.2147/ppa.s238024] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 01/20/2020] [Indexed: 12/16/2022] Open
Abstract
Missed care, defined as any aspect of patient care that is omitted or delayed, is receiving increasing attention. It is primarily caused by the imbalance between patients' nursing care needs and the resources available, making it an ethical issue that challenges nurses' professional and moral values. In this scoping review, conducted using the five-stage approach by Arksey and O'Malley, our aim is to analyze the patients' perspective to missed care, as the topic has been mainly examined from nurses' perspective. The search was conducted in April 2019 in PubMed, CINAHL, PsycINFO, Web of Science, ProQuest and Philosophers Index databases using the following terms: omitted care, unfinished nursing care, care undone, care unfinished, missed care, care left undone, task undone and implicit rationing with no time limitation. The English-language studies where missed care was examined in the nursing context and had patients as informants on patient-reported missed care or patients' perceptions on nurse-reported missed care were selected for the review. Thirteen studies were included and analyzed with thematic content analysis. Twelve studies were quantitative in nature. Patients were able to report missed care, and mostly reported missed basic care, followed by missed communication with staff and problems with timeliness when they had to wait to get the help they needed. In statistical analysis, missed care was associated with patient-reported adverse events and patients' perceptions of staffing adequacy, and in patients' perception, it was mainly caused by lack of staff and insufficient experience. Furthermore, patients' health status, as opposed to gender, predicted missed care. The results concerning patients' age and education level were conflicting. Patients are able to identify missed care. However, further research is needed to examine patient-perceived missed care as well as to examine how patients identify missed care, and to get a clear definition of missed care.
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Affiliation(s)
- Noora Gustafsson
- Department of Nursing Science, University of Turku, Turku, Finland
- Correspondence: Noora Gustafsson Department of Nursing Science, 2 University of Turku, Turku20041, FinlandTel +358 440 276 600 Email
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | - Ivana Prga
- Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
- Welfare Division, Healthcare Services, Turku, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
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17
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Zeleníková R, Gurková E, Friganovic A, Uchmanowicz I, Jarošová D, Žiaková K, Plevová I, Papastavrou E. Unfinished nursing care in four central European countries. J Nurs Manag 2019; 28:1888-1900. [PMID: 31680373 PMCID: PMC7754486 DOI: 10.1111/jonm.12896] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 10/27/2019] [Accepted: 10/31/2019] [Indexed: 12/02/2022]
Abstract
Aim The main aim of the research was to describe and compare unfinished nursing care in selected European countries. Background The high prevalence of unfinished nursing care reported in recently published studies, as well as its connection to negative effects on nurse and patient outcomes, has made unfinished care an important phenomenon and a quality indicator for nursing activities. Methods A cross‐sectional descriptive study was undertaken. Unfinished nursing care was measured using the Perceived Implicit Rationing of Nursing Care questionnaire (PIRNCA). The sample included 1,353 nurses from four European countries (Croatia, the Czech Republic, Poland and Slovakia). Results The percentage of nurses leaving one or more nursing activities unfinished ranged from 95.2% (Slovakia) to 97.8% (Czech Republic). Mean item scores on the 31 items of the PIRNCA in the total sample ranged from 1.13 to 1.92. Unfinished care was significantly associated with the type of hospital and quality of care. Conclusion The research results confirmed the prevalence of unfinished nursing care in the countries surveyed. Implications for Nursing Management The results are a useful tool for enabling nurse managers to look deeper into nurse staffing and other organizational issues that may influence patient safety and quality of care.
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Affiliation(s)
- Renáta Zeleníková
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacky University in Olomouc, Olomouc, Czech Republic
| | - Adriano Friganovic
- University Hospital Zagreb, Zagreb, Croatia.,University of Applied Health Sciences, Zagreb, Croatia
| | - Izabella Uchmanowicz
- Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Darja Jarošová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Katarína Žiaková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Ilona Plevová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Evridiki Papastavrou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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18
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Mandal L, Seethalakshmi A, Rajendrababu A. Rationing of nursing care, a deviation from holistic nursing: A systematic review. Nurs Philos 2019; 21:e12257. [DOI: 10.1111/nup.12257] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 01/23/2023]
Affiliation(s)
- Lata Mandal
- Faculty of Nursing Sri Ramachandra Institute of Higher Education and Research Chennai India
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19
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Patients' satisfaction with the quality of nursing care in thalassemia units. Appl Nurs Res 2019; 47:46-51. [DOI: 10.1016/j.apnr.2019.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 03/29/2019] [Accepted: 05/07/2019] [Indexed: 11/17/2022]
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20
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Dalvandi A, Vaisi-Raygani A, Nourozi K, Ebadi A, Rahgozar M. The Importance and Extent of Providing Compassionate Nursing Care from The Viewpoint of Patients Hospitalized in Educational Hospitals in Kermanshah - Iran 2017. Open Access Maced J Med Sci 2019; 7:1047-1052. [PMID: 30976359 PMCID: PMC6454181 DOI: 10.3889/oamjms.2019.204] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 02/23/2019] [Accepted: 03/03/2019] [Indexed: 12/02/2022] Open
Abstract
AIM This study is an attempt to determine the importance and extent of providing compassionate nursing care from the hospitalised patients' viewpoint in educational hospitals in Kermanshah-Iran 2017. METHODS The study was carried out as a descriptive, analytical work in the hospitals affiliated to Kermanshah University of Medical Sciences on 300 patients in 2017. The patients were selected through convenient sampling, and Burnell Compassionate Care Scale was filled by the participants. The collected data was analysed in SPSS (v.20) using descriptive and inferential statistics. RESULTS The results showed that the mean and standard deviation score of importance and extent of compassionate care were 3.27 ± 0.526 and 2.80 ± 0.647 respectively. There was a significant difference between these two scores (p < 0.001). About all the factors in compassionate nursing care, there was a significant difference between the importance and extent of compassionate nursing care. The mean score of the importance of compassionate nursing care from female patients' viewpoint was higher than that of men (p = 0.032). The observers with college educations perceived the extent of compassionate nursing care less than the other groups of participants (p = 0.008). CONCLUSIONS There was a significant difference between the importance and extent of compassionate nursing care from the patients' point of view. This highlights negligence by the nurses of this critical aspect of care. It is recommended, therefore, to add compassionate nursing care to nursing programs and commission more research works on other groups of health care personnel.
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Affiliation(s)
- Asghar Dalvandi
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Aliakbar Vaisi-Raygani
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Kian Nourozi
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Teheran, Iran
| | - Mahdi Rahgozar
- Department of Biostatistics and Computer, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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21
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Omondi GB, Serem G, Abuya N, Gathara D, Stanton NA, Agedo D, English M, Murphy GAV. Neonatal nasogastric tube feeding in a low-resource African setting - using ergonomics methods to explore quality and safety issues in task sharing. BMC Nurs 2018; 17:46. [PMID: 30479560 PMCID: PMC6240229 DOI: 10.1186/s12912-018-0314-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 10/31/2018] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Sharing tasks with lower cadre workers may help ease the burden of work on the constrained nursing workforce in low- and middle-income countries but the quality and safety issues associated with shifting tasks are rarely critically evaluated. This research explored this gap using a Human Factors and Ergonomics (HFE) method as a novel approach to address this gap and inform task sharing policies in neonatal care settings in Kenya. METHODS We used Hierarchical Task Analysis (HTA) and the Systematic Human Error Reduction and Prediction Approach (SHERPA) to analyse and identify the nature and significance of potential errors of nasogastric tube (NGT) feeding in a neonatal setting and to gain a preliminary understanding of informal task sharing. RESULTS A total of 47 end tasks were identified from the HTA. Sharing, supervision and risk levels of these tasks reported by subject matter experts (SMEs) varied broadly. More than half of the tasks (58.3%) were shared with mothers, of these, 31.7% (13/41) and 68.3% were assigned a medium and low level of risk by the majority (≥4) of SMEs respectively. Few tasks were reported as 'often missed' by the majority of SMEs. SHERPA analysis suggested omission was the commonest type of error, however, due to the low risk nature, omission would potentially result in minor consequences. Training and provision of checklists for NGT feeding were the key approaches for remedying most errors. By extension these strategies could support safer task shifting. CONCLUSION Inclusion of mothers and casual workers in care provided to sick infants is reported by SMEs in the Kenyan neonatal settings. Ergonomics methods proved useful in working with Kenyan SMEs to identify possible errors and the training and supervision needs for safer task-sharing.
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Affiliation(s)
| | - George Serem
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Nancy Abuya
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Nairobi City County Government, Nairobi, Kenya
| | - David Gathara
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Neville A. Stanton
- Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
| | | | - Mike English
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Georgina A. V. Murphy
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
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22
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Griffiths P, Ball J, Bloor K, Böhning D, Briggs J, Dall’Ora C, Iongh AD, Jones J, Kovacs C, Maruotti A, Meredith P, Prytherch D, Saucedo AR, Redfern O, Schmidt P, Sinden N, Smith G. Nurse staffing levels, missed vital signs and mortality in hospitals: retrospective longitudinal observational study. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [DOI: 10.3310/hsdr06380] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background
Low nurse staffing levels are associated with adverse patient outcomes from hospital care, but the causal relationship is unclear. Limited capacity to observe patients has been hypothesised as a causal mechanism.
Objectives
This study determines whether or not adverse outcomes are more likely to occur after patients experience low nurse staffing levels, and whether or not missed vital signs observations mediate any relationship.
Design
Retrospective longitudinal observational study. Multilevel/hierarchical mixed-effects regression models were used to explore the association between registered nurse (RN) and health-care assistant (HCA) staffing levels and outcomes, controlling for ward and patient factors.
Setting and participants
A total of 138,133 admissions to 32 general adult wards of an acute hospital from 2012 to 2015.
Main outcomes
Death in hospital, adverse event (death, cardiac arrest or unplanned intensive care unit admission), length of stay and missed vital signs observations.
Data sources
Patient administration system, cardiac arrest database, eRoster, temporary staff bookings and the Vitalpac system (System C Healthcare Ltd, Maidstone, Kent; formerly The Learning Clinic Limited) for observations.
Results
Over the first 5 days of stay, each additional hour of RN care was associated with a 3% reduction in the hazard of death [hazard ratio (HR) 0.97, 95% confidence interval (CI) 0.94 to 1.0]. Days on which the HCA staffing level fell below the mean were associated with an increased hazard of death (HR 1.04, 95% CI 1.02 to 1.07), but the hazard of death increased as cumulative staffing exposures varied from the mean in either direction. Higher levels of temporary staffing were associated with increased mortality. Adverse events and length of stay were reduced with higher RN staffing. Overall, 16% of observations were missed. Higher RN staffing was associated with fewer missed observations in high-acuity patients (incidence rate ratio 0.98, 95% CI 0.97 to 0.99), whereas the overall rate of missed observations was related to overall care hours (RN + HCA) but not to skill mix. The relationship between low RN staffing and mortality was mediated by missed observations, but other relationships between staffing and mortality were not. Changing average skill mix and staffing levels to the levels planned by the Trust, involving an increase of 0.32 RN hours per patient day (HPPD) and a similar decrease in HCA HPPD, would be associated with reduced mortality, an increase in staffing costs of £28 per patient and a saving of £0.52 per patient per hospital stay, after accounting for the value of reduced stays.
Limitations
This was an observational study in a single site. Evidence of cause is not definitive. Variation in staffing could be influenced by variation in the assessed need for staff. Our economic analysis did not consider quality or length of life.
Conclusions
Higher RN staffing levels are associated with lower mortality, and this study provides evidence of a causal mechanism. There may be several causal pathways and the absolute rate of missed observations cannot be used to guide staffing decisions. Increases in nursing skill mix may be cost-effective for improving patient safety.
Future work
More evidence is required to validate approaches to setting staffing levels. Other aspects of missed nursing care should be explored using objective data. The implications of findings about both costs and temporary staffing need further exploration.
Trial registration
This study is registered as ISRCTN17930973.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 6, No. 38. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Peter Griffiths
- Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Wessex, Southampton, UK
| | - Jane Ball
- Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Wessex, Southampton, UK
| | - Karen Bloor
- Health Sciences, University of York, York, UK
| | - Dankmar Böhning
- Mathematical Sciences, University of Southampton, Southampton, UK
| | - Jim Briggs
- Centre for Healthcare Modelling and Informatics, University of Portsmouth, Portsmouth, UK
| | - Chiara Dall’Ora
- Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Wessex, Southampton, UK
| | - Anya De Iongh
- Independent lay researcher c/o National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, Southampton, UK
| | - Jeremy Jones
- Health Sciences, University of Southampton, Southampton, UK
| | - Caroline Kovacs
- Centre for Healthcare Modelling and Informatics, University of Portsmouth, Portsmouth, UK
| | | | - Paul Meredith
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Wessex, Southampton, UK
- Clinical Outcomes Research Group, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - David Prytherch
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Wessex, Southampton, UK
- Centre for Healthcare Modelling and Informatics, University of Portsmouth, Portsmouth, UK
- Clinical Outcomes Research Group, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - Alejandra Recio Saucedo
- Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Wessex, Southampton, UK
| | - Oliver Redfern
- Centre for Healthcare Modelling and Informatics, University of Portsmouth, Portsmouth, UK
| | - Paul Schmidt
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Wessex, Southampton, UK
- Clinical Outcomes Research Group, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - Nicola Sinden
- Clinical Outcomes Research Group, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - Gary Smith
- Health and Social Sciences, Bournemouth University, Bournemouth, UK
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23
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Zuriguel-Pérez E, Lluch-Canut MT, Agustino-Rodríguez S, Gómez-Martín MDC, Roldán-Merino J, Falcó-Pegueroles A. Critical thinking: A comparative analysis between nurse managers and registered nurses. J Nurs Manag 2018; 26:1083-1090. [PMID: 30198624 DOI: 10.1111/jonm.12640] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 11/26/2022]
Abstract
AIM To analyse the levels of critical thinking among nurse managers and registered nurses and to explore the association between these levels and socio-demographic and occupational factors. BACKGROUND Critical thinking is an essential skill in advanced clinical nursing. However, few studies to date have explored critical thinking levels in nurse managers or compared them with those recorded in registered nurses. METHODS A randomized sample of 44 nurse managers and 295 registered nurses from a tertiary hospital in Barcelona participated in this study. The Nursing Critical Thinking in Clinical Practice Questionnaire was used to measure the level of critical thinking. The data were analysed using multivariate analysis by logistic regression. RESULTS Levels of critical thinking were higher in nurse managers than in registered nurses. Age, work shift schedule and educational level were associated with a higher level of critical thinking in nurse managers and were predictor factors. CONCLUSIONS This study identified age, work shift schedule and educational level as factors that impact on the acquisition of critical thinking skills among nurse managers. IMPLICATIONS FOR NURSING MANAGEMENT This study provides substantive evidence of the levels of critical thinking among nurse managers. When introducing strategies to enhance these skills, the associated occupational factors should be taken into account.
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Affiliation(s)
- Esperanza Zuriguel-Pérez
- Department of Nursing Informatics and Knowledge Management, Hospital Vall d'Hebron, Barcelona, Spain.,Health Care Research, Vall d'Hebron Research Institute, Barcelona, Spain
| | - M Teresa Lluch-Canut
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Consolidated Research Group on Measurement Invariance and Analysis of Change (GEIMAC: 2014-1139), University of Barcelona, Barcelona, Spain
| | - Sandra Agustino-Rodríguez
- Department of Nursing Informatics and Knowledge Management, Hospital Vall d'Hebron, Barcelona, Spain
| | | | - Juan Roldán-Merino
- Consolidated Research Group on Measurement Invariance and Analysis of Change (GEIMAC: 2014-1139), University of Barcelona, Barcelona, Spain.,Sant Joan de Deu School of Nursing, University of Barcelona, Barcelona, Spain
| | - Anna Falcó-Pegueroles
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Consolidated Research Group on Advanced Techniques Applied Psychology (GTEAAP: 2014-326), University of Barcelona, Barcelona, Spain
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24
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Tang FWK, Ling GCC, Lai ASF, Chair SY, So WKW. Four Es of caring in contemporary nursing: Exploring novice to experienced nurses. Nurs Health Sci 2018; 21:85-92. [DOI: 10.1111/nhs.12561] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 06/12/2018] [Accepted: 06/28/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Fiona Wing Ki Tang
- The Nethersole School of Nursing; The Chinese University of Hong Kong; New Territories Hong Kong
| | - Gigi Cheuk Chi Ling
- The Nethersole School of Nursing; The Chinese University of Hong Kong; New Territories Hong Kong
| | - Adela Shuet Fun Lai
- The Nethersole School of Nursing; The Chinese University of Hong Kong; New Territories Hong Kong
| | - Sek Ying Chair
- The Nethersole School of Nursing; The Chinese University of Hong Kong; New Territories Hong Kong
| | - Winnie Kwok Wei So
- The Nethersole School of Nursing; The Chinese University of Hong Kong; New Territories Hong Kong
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25
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Boonpracom R, Kunaviktikul W, Thungjaroenkul P, Wichaikhum O. A causal model for the quality of nursing care in Thailand. Int Nurs Rev 2018; 66:130-138. [DOI: 10.1111/inr.12474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- R. Boonpracom
- Faculty of Nursing; Naresuan University; Phitsanulok Thailand
| | - W. Kunaviktikul
- Faculty of Nursing; Chiang Mai University; Chiang Mai Thailand
| | | | - O. Wichaikhum
- Faculty of Nursing; Chiang Mai University; Chiang Mai Thailand
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26
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Blackman I, Lye CY, Darmawan IGN, Henderson J, Giles T, Willis E, Toffoli L, Xiao L, Verrall C. Modeling Missed Care: Implications for Evidence‐Based Practice. Worldviews Evid Based Nurs 2018; 15:178-188. [DOI: 10.1111/wvn.12285] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Ian Blackman
- Adjunct Lecturer, College of Nursing and Health SciencesFlinders University Adelaide South Australia Australia
| | - Che Yee Lye
- Lecturer, School of EducationUniversity of Adelaide Adelaide South Australia Australia
| | - I Gusti Ngurah Darmawan
- Senior Lecturer, School of EducationUniversity of Adelaide Adelaide South Australia Australia
| | - Julie Henderson
- Research Associate, School of Health SciencesFlinders University Adelaide South Australia Australia
| | - Tracey Giles
- Senior Lecturer, College of Nursing and Health SciencesFlinders University Adelaide South Australia Australia
| | - Eileen Willis
- Emeritus Professor, School of Health SciencesFlinders University Adelaide South Australia Australia
| | - Luisa Toffoli
- Senior Lecturer, School of Nursing and MidwiferyUniversity of South Australia Adelaide South Australia Australia
| | - Lily Xiao
- Associate Professor, College of Nursing and Health SciencesFlinders University Adelaide South Australia Australia
| | - Claire Verrall
- Lecturer, College of Nursing and Health SciencesFlinders University Adelaide South Australia Australia
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27
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Zwakhalen SM, Hamers JP, Metzelthin SF, Ettema R, Heinen M, de Man-Van Ginkel JM, Vermeulen H, Huisman-de Waal G, Schuurmans MJ. Basic nursing care: The most provided, the least evidence based - A discussion paper. J Clin Nurs 2018; 27:2496-2505. [DOI: 10.1111/jocn.14296] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Sandra M.G. Zwakhalen
- Department of Health Services Research; Research School CAPHRI; Maastricht University; Maastricht The Netherlands
| | - Jan P.H. Hamers
- Department of Health Services Research; Research School CAPHRI; Maastricht University; Maastricht The Netherlands
| | - Silke F. Metzelthin
- Department of Health Services Research; Research School CAPHRI; Maastricht University; Maastricht The Netherlands
| | - Roelof Ettema
- University of Professional Education Utrecht; Utrecht The Netherlands
| | - Maud Heinen
- Radboud University Medical Center; Radboud Institute for Health Sciences; IQ Healthcare; Nijmegen The Netherlands
| | - Janneke M. de Man-Van Ginkel
- Department of Rehabilitation, Nursing Science and Sport; Nursing Science; University Medical Center Utrecht; Brain Center Rudolf Magnus; Utrecht The Netherlands
- Nursing Science; Program in Clinical Health Sciences; University Medical Center Utrecht; Utrecht The Netherlands
| | - Hester Vermeulen
- Radboud University Medical Center; Radboud Institute for Health Sciences; IQ Healthcare; Nijmegen The Netherlands
| | - Getty Huisman-de Waal
- Radboud University Medical Center; Radboud Institute for Health Sciences; IQ Healthcare; Nijmegen The Netherlands
| | - Marieke J. Schuurmans
- Department of Rehabilitation, Nursing Science and Sport; Nursing Science; University Medical Center Utrecht; Brain Center Rudolf Magnus; Utrecht The Netherlands
- Nursing Science; Program in Clinical Health Sciences; University Medical Center Utrecht; Utrecht The Netherlands
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28
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Magalhães AMMD, Costa DGD, Riboldi CDO, Mergen T, Barbosa ADS, Moura GMSSD. Association between workload of the nursing staff and patient safety outcomes. Rev Esc Enferm USP 2017; 51:e03255. [PMID: 29211232 DOI: 10.1590/s1980-220x2016021203255] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 05/04/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe the workload of the nursing team and relate it with patient safety outcomes in clinical and surgical inpatient units of a university hospital. METHOD Cross-sectional study, carried out from October 2013 to September 2015. The factor under study was the workload, expressed as the ratio between the mean number of patients and the number of nursing professionals in 24 hours and in the day shifts. RESULTS The sample consisted of 157,481 patients, 502 nursing professionals and 264 observations of safety outcomes. The ratios of patients per nurse and per nursing technician in day shifts indicate a mean estimate of 14-15 and 5-6 patients per professional, respectively. There was a significant association between the workloads in the inpatient units and average length of stay, urinary infection related to invasive procedure and the satisfaction of patients with nursing care. CONCLUSION The increase in the workload of the nursing team had an impact on quality of care and safety for patients. An adequate staffing promotes a safer care environment.
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Affiliation(s)
| | - Diovane Ghignatti da Costa
- Programa de Pós-Graduação em Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Thiane Mergen
- Hospital de Clínicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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29
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De Simone S, Planta A, Cicotto G. The role of job satisfaction, work engagement, self-efficacy and agentic capacities on nurses' turnover intention and patient satisfaction. Appl Nurs Res 2017; 39:130-140. [PMID: 29422148 DOI: 10.1016/j.apnr.2017.11.004] [Citation(s) in RCA: 173] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 10/26/2017] [Accepted: 11/02/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Nurses' voluntary turnover is a worrying global phenomenon which affects service quality. Retaining nursing staff within a hospital is important to eliminate the negative influence of voluntary turnover on the quality of care and organisation costs. OBJECTIVES This research helps explain nurses' voluntary turnover by analysing the role of self-efficacy, agentic capacities, job satisfaction, and work engagement on hospital turnover intention, and to study the relationships between these variables and patient satisfaction. SETTING AND PARTICIPANTS This study gathered data from 194 nurses and 181 patients from 22 inpatient wards at two hospitals in southern Italy. RESULTS Correlation analysis revealed that job satisfaction, work engagement, self-efficacy and agentic capacities were positively interrelated and negatively correlated with turnover intention. Path analysis showed that self-efficacy, some agentic capacities (anticipation and self-regulation), job satisfaction, and work engagement had direct or indirect effects on nurses' turnover intention, and that job satisfaction exerted a stronger effect on turnover intention. Also, patient satisfaction was positively correlated with nurses' job satisfaction, work engagement, self-efficacy, self-regulation and anticipation and negatively correlated with nurses' turnover intention. CONCLUSION Results highlighted the importance of implementing actions (for example through feedforward methodology and the goal setting technique) to improve self-efficacy, self-regulation skill, work engagement and job satisfaction in order to reduce nurses' turnover intention and increase patient satisfaction with nursing care.
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Affiliation(s)
- Silvia De Simone
- University of Cagliari, Via Is Mirrionis, 1, 09123 Cagliari, Italy.
| | - Anna Planta
- University of Cagliari, Via Is Mirrionis, 1, 09123 Cagliari, Italy
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30
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Recio-Saucedo A, Dall'Ora C, Maruotti A, Ball J, Briggs J, Meredith P, Redfern OC, Kovacs C, Prytherch D, Smith GB, Griffiths P. What impact does nursing care left undone have on patient outcomes? Review of the literature. J Clin Nurs 2017; 27:2248-2259. [PMID: 28859254 PMCID: PMC6001747 DOI: 10.1111/jocn.14058] [Citation(s) in RCA: 224] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2017] [Indexed: 01/21/2023]
Abstract
Aims and objectives Systematic review of the impact of missed nursing care on outcomes in adults, on acute hospital wards and in nursing homes. Background A considerable body of evidence supports the hypothesis that lower levels of registered nurses on duty increase the likelihood of patients dying on hospital wards, and the risk of many aspects of care being either delayed or left undone (missed). However, the direct consequence of missed care remains unclear. Design Systematic review. Methods We searched Medline (via Ovid), CINAHL (EBSCOhost) and Scopus for studies examining the association of missed nursing care and at least one patient outcome. Studies regarding registered nurses, healthcare assistants/support workers/nurses’ aides were retained. Only adult settings were included. Because of the nature of the review, qualitative studies, editorials, letters and commentaries were excluded. PRISMA guidelines were followed in reporting the review. Results Fourteen studies reported associations between missed care and patient outcomes. Some studies were secondary analyses of a large parent study. Most of the studies used nurse or patient reports to capture outcomes, with some using administrative data. Four studies found significantly decreased patient satisfaction associated with missed care. Seven studies reported associations with one or more patient outcomes including medication errors, urinary tract infections, patient falls, pressure ulcers, critical incidents, quality of care and patient readmissions. Three studies investigated whether there was a link between missed care and mortality and from these results no clear associations emerged. Conclusions The review shows the modest evidence base of studies exploring missed care and patient outcomes generated mostly from nurse and patient self‐reported data. To support the assertion that nurse staffing levels and skill mix are associated with adverse outcomes as a result of missed care, more research that uses objective staffing and outcome measures is required. Relevance to clinical practice Although nurses may exercise judgements in rationing care in the face of pressure, there are nonetheless adverse consequences for patients (ranging from poor experience of care to increased risk of infection, readmissions and complications due to critical incidents from undetected physiological deterioration). Hospitals should pay attention to nurses’ reports of missed care and consider routine monitoring as a quality and safety indicator.
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Affiliation(s)
- Alejandra Recio-Saucedo
- National Institute for Health Research (NIHR) Collaboration for Applied Health Research and Care (CLAHRC) Wessex, University of Southampton, Southampton, UK.,Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Chiara Dall'Ora
- National Institute for Health Research (NIHR) Collaboration for Applied Health Research and Care (CLAHRC) Wessex, University of Southampton, Southampton, UK
| | - Antonello Maruotti
- Faculty of Health Sciences, University of Southampton, Southampton, UK.,Dipartimento di Scienze Economiche, Politiche e delle Lingue Moderne - Libera Università Maria Ss Assunta, Roma, Italy
| | - Jane Ball
- National Institute for Health Research (NIHR) Collaboration for Applied Health Research and Care (CLAHRC) Wessex, University of Southampton, Southampton, UK.,Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Jim Briggs
- School of Computing, University of Portsmouth, Portsmouth, Hampshire, UK
| | - Paul Meredith
- TEAMS Centre, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Oliver C Redfern
- School of Computing, University of Portsmouth, Portsmouth, Hampshire, UK
| | - Caroline Kovacs
- School of Computing, University of Portsmouth, Portsmouth, Hampshire, UK
| | - David Prytherch
- School of Computing, University of Portsmouth, Portsmouth, Hampshire, UK
| | - Gary B Smith
- Faculty of Health and Social Sciences, University of Bournemouth, Bournemouth, Dorset, UK
| | - Peter Griffiths
- National Institute for Health Research (NIHR) Collaboration for Applied Health Research and Care (CLAHRC) Wessex, University of Southampton, Southampton, UK.,Faculty of Health Sciences, University of Southampton, Southampton, UK
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31
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Blackman I, Papastavrou E, Palese A, Vryonides S, Henderson J, Willis E. Predicting variations to missed nursing care: A three-nation comparison. J Nurs Manag 2017; 26:33-41. [DOI: 10.1111/jonm.12514] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Ian Blackman
- School of Nursing & Midwifery; Flinders University; Adelaide SA Australia
| | - Evridiki Papastavrou
- Department of Nursing; School of Health Sciences; Cyprus University of Technology; Limassol Cyprus
| | | | - Stavros Vryonides
- Department of Nursing; School of Health Sciences; Cyprus University of Technology; Limassol Cyprus
| | - Julie Henderson
- Southgate Institute for Health, Society and Equity; Flinders University; Adelaide SA Australia
| | - Eileen Willis
- Faculty of Medicine, Nursing and Health Sciences; Flinders University; Adelaide SA Australia
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32
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Kullberg A, Sharp L, Johansson H, Brandberg Y, Bergenmar M. Patient satisfaction after implementation of person-centred handover in oncological inpatient care - A cross-sectional study. PLoS One 2017; 12:e0175397. [PMID: 28384314 PMCID: PMC5383334 DOI: 10.1371/journal.pone.0175397] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 03/25/2017] [Indexed: 11/18/2022] Open
Abstract
Effective nurse shift-to-shift handover is a prerequisite for high-quality inpatient care. Combining person-centeredness with the need for improved handover rituals, we introduced and evaluated person-centered handover (PCH) in an oncological inpatient setting. PCH is the shift-to-shift nursing report performed together with the patient according to a set structure focused on patient participation, relevant clinical information, and patient safety. Non-verbal handover, standard at the department, is conducted via the electronic health record, in absence of the patient, and without a set structure. The aim of the study was to compare person-centered handover with non-verbal handover in an oncological inpatient setting with regard to patient satisfaction. A cross-sectional design featuring two points of measurement at one intervention ward and two control wards was applied. The EORTC IN-PATSAT32 questionnaire was used for measuring patient satisfaction. Baseline measurements were taken during the spring of 2014, when all three wards used a non-verbal handover model, and included responses from 116 patients. Follow-up measurements (comparing PCH and non-verbal handover) involved 209 patients and were on-going from September 2014 to May 2015. After the introduction of PCH, one change in patient satisfaction was detected regarding the subscale measuring exchange of information between caregivers. Patients from the intervention ward scored statistically higher after the implementation of PCH when compared to the control wards (p = .0058). The difference remained after a multivariate regression analysis controlling for clinical variables. In conclusion, PCH is feasible in oncological inpatient care but does not seem to affect patient satisfaction.
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Affiliation(s)
- Anna Kullberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Lena Sharp
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Regional Cancer Centre, Stockholm-Gotland, Stockholm, Sweden
| | - Hemming Johansson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - Yvonne Brandberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Mia Bergenmar
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Center for Digestive Diseases, Karolinska Univserity Hospital, Stockholm, Sweden
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33
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Luthy C, Francis Gerstel P, Pugliesi A, Piguet V, Allaz AF, Cedraschi C. Bedside or not bedside: Evaluation of patient satisfaction in intensive medical rehabilitation wards. PLoS One 2017; 12:e0170474. [PMID: 28170431 PMCID: PMC5295719 DOI: 10.1371/journal.pone.0170474] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 01/06/2017] [Indexed: 12/03/2022] Open
Abstract
Background Concerns that bedside presentation (BsP) rounds could make patients uncomfortable led many residency programs to move daily rounds outside the patients’ room (OsPR). We performed a prospective quasi-experimental controlled study measuring the effect of these two approaches on patient satisfaction. Methods Patient satisfaction was measured using the Picker questionnaire (PiQ). Results are expressed in problematic percentage scores scaled from 0 = best-100 = worst. During three months, 3 wards of a 6 ward medical rehabilitation division implemented BsP and 3 control wards kept their usual organization of rounds. In total, 90 patients of each group were included in the study and completed the PiQ. Results Socio-clinical characteristics were similar in both groups: mean age = 67 years (SD = 13), mean Charlson comorbidity index = 8.6 (2.4); mean length of stay = 22 days (12). During their stay, patients in the BsP units had a mean of 14.3 (8) BsP rounds and 0.5 (0.8) OsPR; control patients had a mean of 0.9 (0.7) BsP and 14.8 (7.3) OsPR (p<0.0001). Patients in BsP units reported lower problematic scores regarding coordination of care (39% vs 45%, p = 0.029), involvement of family/friends (29 vs 41%, p = 0.006) and continuity/transition (44% vs 54%, p = 0.020); two questions of the PiQ had worse scores in the BsP: trust in nurses (46.7% vs 30 %, p = 0.021) and recommendation of the institution (61.1% vs 44.4%. p = 0.025). No worsening in dimensions such as respect for patient preferences was seen. Conclusions BsP rounds influenced the patient-healthcare professionals’ encounter. These rounds were associated with improved patient satisfaction with care, particularly regarding interprofessional collaboration and discharge planning.
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Affiliation(s)
- Christophe Luthy
- Division of General Medical Rehabilitation, Geneva University Hospitals & University of Geneva, Geneva, Switzerland
- * E-mail:
| | | | - Angela Pugliesi
- Division of Oncology, Geneva University Hospitals, Geneva, Switzerland
| | - Valérie Piguet
- Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals & University of Geneva, Geneva, Switzerland
| | - Anne-Françoise Allaz
- Division of General Medical Rehabilitation, Geneva University Hospitals & University of Geneva, Geneva, Switzerland
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Geneva University Hospitals & University of Geneva, Geneva, Switzerland
- Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals & University of Geneva, Geneva, Switzerland
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34
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Seabra PRC, Sá LO, Amendoeira JJP, Ribeiro AL. Satisfação com os cuidados de enfermagem em usuários de drogas: evolução de uma escala. Rev Gaucha Enferm 2017; 38:e58962. [DOI: 10.1590/1983-1447.2017.02.58962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 04/04/2017] [Indexed: 05/29/2023] Open
Abstract
RESUMO Objetivos Identificar o grau de satisfação com os cuidados de enfermagem, as variáveis significativas e contribuir para a evolução da escala. Métodos Pesquisa descritiva, correlacional, transversal com 180 usuários de drogas. Dados coletados com a escala “Satisfação dos Utentes com os Cuidados de Enfermagem no Centro de Saúde26”, entre fevereiro e dezembro de 2012, em três unidades de tratamento na região de Lisboa e Vale do Tejo, em Portugal. Resultados Os usuários assinalaram 83,3% de satisfação. A dimensão “Individualização da informação” foi a mais assinalada (98,5%). Quanto mais estabilidade nos programas, abstinência de estimulantes e benzodiazepinas e mais intervenções de enfermagem, maior a satisfação. Contribuíram ainda para a satisfação, melhores condições de trabalho, especialização em saúde mental, menor idade e menor experiência profissional dos enfermeiros. Extraíram-se 4 itens da escala assumindo nova designação SUCECS22. Conclusões A satisfação foi elevada, influenciada por variáveis estruturais dos usuários, dos enfermeiros e das condições de trabalho. A escala revelou-se adequada à avaliação nesta população.
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35
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dos Santos Alves DF, da Silva D, de Brito Guirardello E. Nursing practice environment, job outcomes and safety climate: a structural equation modelling analysis. J Nurs Manag 2016; 25:46-55. [DOI: 10.1111/jonm.12427] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2016] [Indexed: 12/19/2022]
Affiliation(s)
| | - Dirceu da Silva
- Education Faculty; State University of Campinas; Campinas SP Brazil
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36
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Lin LY, Wang RH. Patient Education Competence Scale for Registered Nurses in Taiwan: Scale development and psychometric validation. Jpn J Nurs Sci 2016; 14:117-125. [DOI: 10.1111/jjns.12141] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 05/05/2016] [Accepted: 05/13/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Li-Ying Lin
- Department of Nursing, Kaohsiung Veterans General Hospital College of Nursing; Kaohsiung Medical University; Kaohsiung Taiwan
- College of Nursing; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Ruey-Hsia Wang
- College of Nursing; Kaohsiung Medical University; Kaohsiung Taiwan
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37
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Converso D, Loera B, Viotti S, Martini M. Do positive relations with patients play a protective role for healthcare employees? Effects of patients' gratitude and support on nurses' burnout. Front Psychol 2015; 6:470. [PMID: 25954227 PMCID: PMC4404725 DOI: 10.3389/fpsyg.2015.00470] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/01/2015] [Indexed: 11/04/2022] Open
Abstract
Background: A growing number of studies reveal that there are significant associations between a patient's perception of quality of care and a health professional's perceived quality of work life. Previous studies focused on the patients or on the workers. Alternatively, they center the discussion on either the negative or the positive effects, both on patients and care workers. This research work focuses on the positive relationship with patients—a possible resource for care workers. Method:Study 1: A CFA was conducted to test the factorial structure and the tenure of the Italian version for patients of the Customer-initiated Support scale. Study 2: Using a multi-group path analysis, the effects of work characteristics and of the relationship with patients on burnout were tested in two different contexts: emergency and oncology ward. Results:Study 1: The one-factor instrument shows good reliability, convergent, and divergent validity. Study 2: for oncology nurses cognitive demands, job autonomy, and support from patients have direct effects on emotional exhaustion and job autonomy; interactions between cognitive demands and patients' support have an effect on depersonalization. For emergency nurses cognitive demands and interactions between job autonomy and support from patients have effects on emotional exhaustion; job autonomy, patients support and gratitude have direct effects on personal accomplishment. Conclusions: Results confirm expectations about the role of patients' support and gratitude in reducing nurses' burnout, with differences in the two contexts: emergency nurses show higher burnout and lower perception of positive relationship with patients, but present more intense protective effects of the interaction between job autonomy and support/gratitude. Suggestions can be offered to managers in developing interventions to promote “healthy organization” culture that consider jointly employees and patients' needs.
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Affiliation(s)
- Daniela Converso
- Work and Organizational Psychology, Department of Psychology, University of Turin Turin, Italy
| | - Barbara Loera
- Psychometrics, Department of Psychology, University of Turin Turin, Italy
| | - Sara Viotti
- Work and Organizational Psychology, Department of Psychology, University of Turin Turin, Italy
| | - Mara Martini
- Work and Organizational Psychology, Department of Psychology, University of Turin Turin, Italy
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38
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Vieira RC, Teixeira MJ, Paiva WS. Assessment of selected quality fields of nursing care in neurosurgical wards. Patient Prefer Adherence 2015; 9:245-7. [PMID: 25709409 PMCID: PMC4332256 DOI: 10.2147/ppa.s78706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Rita Cassia Vieira
- School of Nursing, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | | | - Wellingson Silva Paiva
- Division of Neurological Surgery, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Correspondence: Wellingson S Paiva, 255 Eneas Aguiar Street, Office 4079, Sao Paulo 05403010, Brazil, Tel +55 11 2661 7226, Fax +55 11 2548 6906, Email
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