Factors determining the patients' care intensity for surgeons and surgical nurses: a conjoint analysis

Efficiency evaluation of surgical nursing wards based on data envelopment analysis

AIMS

This study aimed to evaluate the efficiency and influencing factors of surgical ward nursing.

BACKGROUND

High-quality development of public hospitals and implementation of nursing fine management require improvements to promote nursing efficiency.

METHOD

This study examined input data, such as number of beds, nurses, and nursing hours, and output data on discharged person-times, surgical output, and case mix index of released patients, in 40 surgical wards in China between September 2020 and August 2021. Nursing efficiency was assessed and analyzed using data envelopment analysis, and changes in efficiency were dynamically evaluated using Malmquist index analysis.

RESULTS

The average total technical efficiency, pure technical efficiency, and scale efficiency were 78%, 94%, and 82%, respectively. In addition, 81% and 67% of surgical wards had input redundancy and output insufficiency, respectively. The monthly average total factor productivity was 118%, and the overall efficiency increased month after month.

CONCLUSION

Overall, nursing service efficiency was low, which was limited by scale efficiency, pure technical efficiency, or both.

IMPLICATIONS FOR NURSING MANAGEMENT

Data envelopment analysis could help nursing managers optimize nursing human resource allocation and nursing performance allocation.

The relationship of delirium and risk factors for cardiology intensive care unit patients with the nursing workload

AIMS AND OBJECTIVES

To evaluate the relationship of delirium and risk factors for cardiology intensive care unit (ICU) patients with the nursing workload.

BACKGROUND

Delirium is a common syndrome in patients with cardiac problems. The risk factors causing delirium and the presence and type of delirium affect the nurse workload and patient care quality adversely.

DESIGN

This cross-sectional study was conducted with 133 patients staying at the cardiology ICU of a university hospital between 5 January-31 March 2017.

METHOD

The study data were collected using the Patient Information Form, Delirium Risk Factors' Form and Therapeutic Intervention Scoring System-28 (TISS-28) scale to identify the nurse workload. The statistical analysis of the data was performed using frequency, chi-square, Mann-Whitney U, correlation and regression analyses.

RESULTS

It was found that patients who developed delirium were 65 years or older, they had more nasogastric/total parenteral nutrition (NG/TPN), benzodiazepine and physical restraints in comparison with those with no delirium development, and that the prevalence of hypoxia and hypoalbuminemia were higher in these patients. The mean TISS-28 score was higher in patients with delirium, compared with those without delirium. There was a positive correlation between the mean Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and the mean TISS-28 score of the patients. The mean TISS-28 score was found to significantly increase with being at the age of 65 and above and the administration of mechanical ventilation. The patients with delirium required a mean of 60-min additional care.

CONCLUSIONS

Our study results suggest that the presence of delirium and the delirium risk factors, irrespective of delirium, increase the nurse workload.

RELEVANCE TO CLINICAL PRACTICE

An effective management of delirium risk factors can improve the patient care quality by reducing delirium occurrence and nurse workload.