Cost-Effectiveness Analysis of Improving Nurses' Education Level in the Context of In-Hospital Mortality

Economic evaluation of the prevention of falls resulting from missed care in polish hospitals

Objectives

Falls are associated with increased morbidity, mortality, prolonged hospitalization and an increase in the cost of treatment in hospitals. They contribute to the deterioration of fitness and quality of life, especially among older patients, thus posing a serious social and economic problem. They increase the risk of premature death. Falls are adverse, costly, and potentially preventable. The aim of the study was to analyze the cost-effectiveness of avoiding one fall by nurse care provided by the nurses with higher education, from the perspective of the health service provider.

Methods

The economic analysis included and compared only the cost of nurse intervention measured by the hours of care provided with higher education in non-surgical departments (40.5%) with higher time spend by nurses with higher education level an increase in the number of hours by 10% (50.5%) to avoid one fall. The time horizon for the study is 1 year (2021). Cost-effectiveness and Cost-benefit analysis were performed. All registered falls of all hospitalized patients were included in the study.

Results

In the analyzed was based on the case control study where, 7,305 patients were hospitalized, which amounted to 41,762 patient care days. Care was provided by 100 nurses, including 40 nurses with bachelor's degrees and nurses with Master of Science in Nursing. Increasing the hours number of high-educated nurses care by 10% in non-surgical departments decreased the chance for falls by 9%; however, this dependence was statistically insignificant (OR = 1.09; 95% CI: 0.72-1.65; p = 0.65). After the intervention (a 10% increase in Bachelor's Degrees/Master of Science in Nursing hours), the number of additional Bachelor's Degrees/Master of Science hours was 6100.5, and the cost was USD 7630.4. The intervention eliminated four falls. The cost of preventing one fall is CER = USD 1697.1.

Conclusion

The results of these studies broaden the understanding of the relationship among nursing education, falls, and the economic outcomes of hospital care. According to the authors, the proposed intervention has an economic justification.

The learning experiences and career development expectations of Chinese nursing master's degree students: A qualitative investigation

AIM

To explore the learning experiences and career development expectations of nursing master's degree students.

BACKGROUND

With increasing demands for improved quality of life, there is a growing need for nursing graduate programs in clinical care. However, the existing training programs for nursing master's students in China require improvement. It is essential to analyze students' learning experiences, perceptions of the current status of nursing and expectations of the nursing profession to enhance and develop university training programs.

DESIGN

A descriptive qualitative study employing semi-structured interviews.

METHOD

Semi-structured interviews were conducted with 14 nursing master's degree students. The data obtained were analyzed using Colaizzi's seven-step phenomenological analysis method. The study adhered to the consolidated criteria for reporting qualitative research (COREQ).

RESULTS

Three main themes emerged from the analysis-Theme 1: Career expectations, encompassing motivations for pursuing the nursing master's program and career aspirations; Theme 2: Study experiences, including nursing professional ability, nursing management ability, self-awareness ability and moral literacy; Theme 3: Occupational dilemmas, encompassing the current challenges and coping strategies.

CONCLUSION

The learning experiences of nursing master's students in universities are closely linked to their training programs. A disparity exists between students' career expectations and the actual employment landscape for nursing master's degree students.

Nurses retrospective view on nursing education: A repeated cross-sectional study over three decades

Background

As the healthcare landscape undergoes transformative shifts due to factors like ageing demographics, technological innovations, rapid global dissemination of infectious diseases, and imperatives for accessible, cost-effective care, a pressing need emerges for the contemporisation of nursing education. Notably, there is a paucity of research delving into nurses' introspective evaluations of their educational experiences after their immersion in professional settings.

Objective

This study aimed to examine nurses' evaluations of their educational background over 30 years and identify relationships between their assessments and their demographic.

Design

The study embraced a recurrent cross-sectional survey methodology, encompassing three distinct quantitative cross-sectional evaluations conducted in the years 1999, 2009, and 2021.

Context/participants

The cohort for this inquiry consisted of nurses stationed in Estonian general hospitals and inpatient departments of developmental plan institutions, each with at least one year of professional experience. Cumulatively, 832 nurses were engaged across three sequential evaluations: Study I (n = 463), Study II (n = 198), and Study III (n = 171).

Methods

Data procurement was executed via a structured survey, with subsequent analytical procedures encompassing descriptive and correlational methodologies.

Results

A discernible augmentation in the educational calibre of nurses was observed with each successive evaluation. This escalation concomitated enhanced positive assessments in areas like evidence-informed education, skill development, and autonomous operational capabilities. Yet, a critical appraisal persisted concerning their competencies in navigating complex patient interactions and addressing socio-religious dilemmas.

Conclusions

The merit of this investigation lies in its illumination of nursing education's evolution, as perceived retrospectively by nurses who have operationalized their academic learnings in real-world scenarios. Their vantage point, inherently informed by practice, uniquely positions them to earmark avenues of refinement. This exploration paves the way for enrichments in nursing education, spotlighting the imperative of equipping nurses to adeptly manage intricate situations.

Barriers to the completion of bachelor thesis for bachelor nursing students during their internship: A qualitative study from dual student and faculty perspectives

BACKGROUND

Bachelor thesis are among the most important ways of exercising Chinese nursing students' research skills and developing critical thinking. However, there is a mismatch between the expectations and abilities of clinical nursing teachers and nursing students. Exploring the impediments to nursing students' research skills can provide a basis for developing targeted improvements.

OBJECTIVE

To identify barriers to the completion of research projects among nursing undergraduates during their internships from the dual student and instructor perspectives.

DESIGN

Descriptive qualitative design.

SETTING

Affected by the COVID-19 pandemic, we conducted this study at a tertiary hospital in Fuzhou, Fujian Province.

PARTICIPANTS

The study was conducted using a purposive sample of 16 nursing interns and six instructors.

METHODS

Data were collected through semi-structured interviews to provide nursing students and instructors with various perspectives. The collected data were analysed using thematic analysis methods.

RESULTS

This study included 16 students (two male and 14 female; age 21.75 ± 0.66 years), six instructors (age 34.33 ± 1.97 years), which was sufficient to reach data saturation. We identified 126 codes from the interview data and obtained seven subcategories among three categories: a) Lack of scientific research training: lack of clinical instructors' experience, lack of academic training courses, and lack of necessary scientific research resources support; b) Poor communication: excessive workload, poor instructor-student relationship, and lack of communication skills; and c) Lack of support systems: lack of support from other disciplines and negative coping patterns.

CONCLUSIONS

The findings of this study will help nursing interns develop an interest in scientific research throughout their internships. Reducing barriers will also strengthen teacher training programmes, improve the teaching process, promote teacher-student communication, and provide students with necessary social support.

Experience in developing innovative practical ability for Master of Nursing Specialist degree program in China: A qualitative descriptive study of postgraduates

BACKGROUND

Nursing talent training should be adjusted in accordance with policies and regulations, the priority areas of health care, the development of nursing disciplines, and changes in nurses' roles. Experience from nursing education stakeholders indicates that postgraduate education faces numerous challenges. Thus, it is necessary to discuss postgraduates' experience in cultivating innovative practical ability.

OBJECTIVES

To analyze the experiences of nursing specialist postgraduates in cultivating innovative practical ability to provide a reference for further improvement of the Master of Nursing Specialist program.

DESIGN

A qualitative study.

SETTING

A university and its three affiliated tertiary hospitals in H city, China.

PARTICIPANTS AND METHODS

Individual, semi-structured interviews were conducted face-to-face with 12 postgraduates currently in clinical practice and six postgraduate nurses within two years of graduation between April and June 2022. All interviews were audio-recorded and transcribed verbatim, and the data were analyzed using the Colaizzi method.

RESULTS

Three key themes emerged: (1) the cognition of innovative practical ability; (2) the experience of cultivating innovative practical ability at school; and (3) the experience of cultivating innovative practical ability in the hospital.

CONCLUSIONS

With a full understanding of the training experience of postgraduates' innovative practical ability, policymakers and training units can clarify the shortcomings of the training model, make targeted improvements, and work together to build a more scientific and complete MNS training model. Our findings have the potential to inform faculty structure, catalyze curriculum reform, optimize clinical practice to facilitate the development of Master of Nursing Specialist programs, improve the quality of care, and promote patient recovery.

The Effectiveness of Healthcare System Resilience during the COVID-19 Pandemic: A Case Study

Introduction: The outbreak of the COVID-19 pandemic was a period of uncertainty and stress for healthcare managers due to the lack of knowledge (about the transmission of the virus, etc.) and also due to the lack of uniform organisational and treatment procedures. It was a period where the ability to prepare for a crisis, to adapt to the existing conditions, and to draw conclusions from the situation were of critical importance to keep ICUs (intensive care units) operating. The aim of this project is to compare the pandemic response to COVID-19 in Poland during the first and second waves of the pandemic. This comparison will be used to identify the strengths and weaknesses of the response, including challenges presented to health professionals and health systems and ICUs with COVID-19 patients according to the European Union Resilience Model (2014) and the WHO Resilience Model (2020). The WHO Resilience model was suitable to the COVID-19 situation because it was developed based on this experience. Methods: A matrix of 6 elements and 13 standards assigned to them was created using the EC and WHO resilience guidelines. Results: Good governance in resilient systems ensures access to all resources without constraints, free and transparent flow of information, and a sufficient number of well-motivated human resources. Conclusions: Appropriate preparation, adaptation to the existing situation, and effective management of crisis situations are important elements of ensuring the resilience of ICUs.

The Influence of Nurse Education Level on Hospital Readmissions-A Cost-Effectiveness Analysis

Background: Readmissions are adverse, costly, and potentially preventable. The study aimed to evaluate the cost-effectiveness of reducing readmissions resulting from missed care, depending on the level of education of nurses, from the perspective of the service provider. Methods: We calculated missed care resulting in additional readmissions based on the longitudinal study conducted between 2012 and 2014, as well as readmissions that could have been potentially prevented by adding a 10% increase in hours of nursing care provided by BSN/MSc nurses for 2014. The cost-effectiveness analysis (CEA) was performed to calculate the cost-effectiveness of preventing one hospitalization in non-surgical and surgical wards by increasing the number of nursing hours provided by BSN/MSc nurses. Cost−benefit analysis (CBA) was performed, and the CBR (cost−benefit ratio) and BCR (benefit−cost ratio) were calculated. Results: Increasing the number of hours of nursing care (RN) by 10% decreased the chance for an unplanned readmission by 11%; (OR = 0.89; 95% CI: 0.78−1.01; p = 0.08) in non-surgical wards and 43% (OR = 0.57; 95% CI: 0.49−0.67; p < 0.001) in surgical wards. In non-surgical wards, the number of readmissions that were preventable with extra hours provided by BSN/MSc nurses was 52, and the cost-effectiveness ratio (CER) was USD 226.1. The number of preventable readmissions in surgical wards was 172, and the CER was USD 54.96. In non-surgical wards, the CBR was USD 0.07, while the BCR was USD 1.4. In surgical wards, the CBR was USD 0.02, and the BCR was USD 4.4. Conclusions: The results of these studies broaden the understanding of the relationship among nursing education, patient readmission, and the economic outcomes of hospital care. According to the authors, the proposed intervention has an economic justification. Hence, the authors recommend it for approval by the service provider.