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Lee MO, Schertzer K, Khanna K, Wang NE, Camargo CA, Sebok-Syer SS. Using In Situ Simulations to Improve Pediatric Patient Safety in Emergency Departments. Acad Med 2021; 96:395-398. [PMID: 33116057 DOI: 10.1097/acm.0000000000003807] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PROBLEM Given the complex interaction among patients, individual providers, health care teams, and the clinical environment, patient safety events with serious consequences are most likely to occur in intensive care units, operating rooms, and emergency departments (EDs). With low-frequency, high-risk events such as pediatric resuscitations, health care teams working in EDs may not have the clinical opportunity to identify deficiencies, review and reinforce knowledge and skills, and problem solve in authentic clinical conditions. Without creating opportunities to safely practice, hospitals run the risk of having health care teams and environments that are not prepared to provide optimal patient care. APPROACH Researchers employed a case series design and used a train-the-trainer model for in situ simulation. They trained health care professionals (instructors) in 3 general, nonacademic EDs in the San Francisco Bay area of California to perform pediatric resuscitation in situ simulations in 2018-2019. In situ simulations occur in the clinical work environment with simulation participants (teams) who are health care professionals taking care of actual patients. OUTCOMES Teams made up of physicians, nurses, and ED technicians were evaluated for clinical performance, teamwork, and communication during in situ simulations conducted by instructors at baseline, 6 months, and 12 months. Debriefing after the simulations identified multiple latent safety threats (i.e., unidentified potential safety hazards) that were previously unknown. Each ED's pediatric readiness-its ability to provide emergency care for children-was evaluated at baseline and 12 months. NEXT STEPS The authors will continue to monitor and examine the impact and sustainability of the pediatric in situ simulation program on pediatric readiness scores and its possible translation to other high-risk clinical settings, as well as explore the relationship between in situ simulations and patient outcomes.
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Affiliation(s)
- Moon O Lee
- M.O. Lee is associate professor, Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California
| | - Kimberly Schertzer
- K. Schertzer is assistant professor, Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California
| | - Kajal Khanna
- K. Khanna is associate professor, Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California
| | - N Ewen Wang
- N.E. Wang is professor, Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California
| | - Carlos A Camargo
- C.A. Camargo Jr is professor, Departments of Emergency Medicine, Medicine, and Epidemiology, Harvard University, Boston, Massachusetts
| | - Stefanie S Sebok-Syer
- S.S. Sebok-Syer is instructor, Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California
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Fenta EH, Endris BS, Mengistu YG, Sadamo FE, Gelan EH, Beyene TG, Gebreyesus SH. Landscape analysis of nutrition services at Primary Health Care Units (PHCUs) in four districts of Ethiopia. PLoS One 2020; 15:e0243240. [PMID: 33270764 PMCID: PMC7714176 DOI: 10.1371/journal.pone.0243240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 11/17/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Good nutrition and healthy growth during the first 1000days have lasting benefit throughout life. For this, equally important is the structural readiness of health facilities. However, structural readiness and nutrition services provision during the first 1000 days in Ethiopia is not well understood. The present study was part of a broader implementation research aimed at developing model nutrition districts by implementing evidence based, high impact and cost-effective package of nutrition interventions through the continuum of care. This study was aimed at assessing structural readiness of health facilities and the extent of nutrition service provision in the implementation districts. METHODS This assessment was conducted in four districts of Ethiopia. We used mixed method; a quantitative study followed by qualitative exploration. The quantitative part of the study addressed two-dimensions, structural readiness and process of nutrition service delivery. The first dimension assessed attributes of context in which care is delivered by observing availability of essential logistics. The second dimension assessed the service provision through direct observation of care at different units of health facilities. For these dimensions, we conducted a total of 380 observations in 23 health centers and 33 health posts. The observations were conducted at the Integrated Management of Neonatal and Childhood Illnesses unit, immunization unit, Antenatal care unit and Postnatal care unit. The qualitative part included a total of 60 key informant interviews with key stakeholders and service providers. RESULT We assessed structural readiness of 56 health facilities. Both quantitative and qualitative findings revealed poor structural readiness and gap in nutrition services provision. Health facilities lack essential logistics which was found to be more prominent at health posts compared to health centers. The process evaluation showed a critical missed opportunity for anthropometric assessment and preventive nutrition counselling at different contact points. This was particularly prominent at immunization unit (where only 16.4% of children had their weight measured and only 16.2% of mothers with children under six month of age were counselled about exclusive breastfeeding). Although 90.4% of pregnant women who came for antenatal care were prescribed iron and folic acid supplementation, only 57.7% were counselled about the benefit and 42.4% were counselled about the side effect. The qualitative findings showed major service provision bottlenecks including non-functionality of the existing district nutrition coordination body and technical committees, training gaps, staff shortage, high staff turnover resulting in work related burden, fatigue and poor motivation among service providers. CONCLUSION We found a considerable poor structural readiness and gaps in delivering integrated nutrition services with a significant missed opportunity in nutrition screening and counselling. Ensuring availability of logistics and improving access to training might improve delivery of nutrition services. In addition, ensuring adequate human resource might reduce missed opportunity and enable providers to provide a thorough preventive counselling service.
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Affiliation(s)
- Esete Habtemariam Fenta
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bilal Shikur Endris
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yalemwork Getenet Mengistu
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fekadu Elias Sadamo
- Department of Reproductive Health and Nutrition, School of Public Health, College of Health Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Endashaw Hailu Gelan
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tsegaye Gebrezgher Beyene
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Seifu Hagos Gebreyesus
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Abstract
OBJECTIVE The aim of this systematic review was to assess how inpatients were affected by the built environment design during their hospitalization. BACKGROUND Over the last decade, the healthcare system has become increasingly aware of how focus on healthcare environment might affect patient satisfaction. The focus on environmental design has become a field with great potential because of its possible impact on cost control while improving quality of care. METHODS A systematic literature search was conducted to identify current and past studies about evidence-based healthcare design. The following databases were searched: Medline/PubMed, Cinahl, and Embase. Inclusion criteria were randomized clinical trials (RCTs) investigating the effect of built environment design interventions such as music, natural murals, and plants in relation to patients' health outcome. RESULTS Built environment design aspects such as audio environment and visual environment had a positive influence on patients' health outcomes. Specifically the studies indicated a decrease in patients' anxiety, pain, and stress levels when exposed to certain built environment design interventions. CONCLUSIONS The built environment, especially specific audio and visual aspects, seems to play an important role in patients' outcomes, making hospitals a better healing environment for patients. KEYWORDS Built environment, evidence-based design, healing environments, hospitals, literature review.
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Affiliation(s)
- Jannie Laursen
- CORRESPONDING AUTHOR: Jannie Laursen, Department of Surgery, Herlev Ringvej 75, DK-2730 Herlev;
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Abstract
OBJECTIVE In this review the impact of the design of the built environment on people with dementia in long-term care settings is systematically analyzed and summarized. Architects and designers will be provided with credible evidence on which they can confidently base their design decisions. Researchers will be able to determine which environmental aspects have been well investigated and where there are gaps in the current state of the research. BACKGROUND A great number of studies have established a relationship between the design of the physical environment of long-term care settings and outcomes of people with dementia. However, the methods employed are heterogeneous and the results are often conflicting. Consequently, the process of integrating the best evidence available into architectural designs may be hindered. METHODS A systematic literature search was conducted reviewing studies that meet certain inclusion criteria. Using an evidence-based approach, the methodical quality of the studies was rated. RESULTS One hundred sixty-nine studies were found. They were thematically summarized into four main categories: basic design decisions, environmental attributes, ambience, and environmental information. The effectiveness of the interventions on the behavior, cognition, function, well being, social abilities, orientation, and care outcomes on people with dementia was illustrated by matrices. CONCLUSIONS Results of this review indicate that, with the exception of cognition, specific design interventions are beneficial to the outcomes of people with dementia. Overall, the field of environmental design for people with dementia is well researched in many aspects and only few gaps in knowledge were identified.
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Abstract
As a result of the demise of the two-tier system of clinical teacher and lecturer, all teachers were assigned to clinical areas in which they facilitate the development of an educational milieu to support student learning in practice. This article highlights the role of the link lecturer within the perioperative environment. It focuses on how this multi-faceted position can assist students to link theory and practice, and addresses key issues relating to mentorship, clinical credibility and educational audit.
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Affiliation(s)
- Suzanne J Hughes
- School of Nursing & Midwifery Studies, University of Wales College of Medicine, Cardiff
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Van der Heijden BI, Mulder RH, König C, Anselmann V. Toward a mediation model for nurses' well-being and psychological distress effects of quality of leadership and social support at work. Medicine (Baltimore) 2017; 96:e6505. [PMID: 28403079 PMCID: PMC5403076 DOI: 10.1097/md.0000000000006505] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Given the lack of active nurses in industrialized countries throughout the world, in combination with demographic changes, it is of utmost importance to protect nurses' well-being and to prevent psychological distress, because of their strong association with premature occupational leave. The aim of this study was to investigate the effects of quality of leadership and social support at work on well-being and psychological distress of nurses and to determine whether nurses' overcommitment mediates the relationship between the abovementioned determinants and the outcomes. A cross-sectional survey design was used to gather our data. This study utilized part of the database of the Nurses' Early Exit Study. A total of 34,771 nurses (covering all nurse qualifications) working in hospitals, nursing homes, and home-care institutions in 8 European countries filled out a questionnaire (response rate = 51.4%). For all model variables (job satisfaction, satisfaction with salary, positive affectivity, personal burnout, negative affectivity, quality of leadership, social support from immediate supervisor, social support from near colleagues, and overcommitment), psychometrically sound, that is, valid and reliable measures were used. Outcomes from testing a structural equation mediation model indicated that, respectively, positive and negative influences of leadership quality and social support from supervisor and colleagues on nurses' well-being and psychological distress are partially mediated, that is, reduced, by nurses' overcommitment. Social work environment is highly important in relation to nurses' well-being and psychological distress.
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Affiliation(s)
- Beatrice I.J.M. Van der Heijden
- Institute for Management Research, Radboud University, Nijmegen
- Open University of the Netherlands, Heerlen, The Netherlands
- Kingston University, London, UK
| | - Regina H. Mulder
- Institute of Educational Science, University of Regensburg, Regensburg
| | - Christoph König
- Department of Research Methods in Education, Friedrich Schiller University Jena, Jena, Germany
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Kudchadkar SR, Beers MC, Ascenzi JA, Jastaniah E, Punjabi NM. Nurses' Perceptions of Pediatric Intensive Care Unit Environment and Work Experience After Transition to Single-Patient Rooms. Am J Crit Care 2016; 25:e98-e107. [PMID: 27587429 DOI: 10.4037/ajcc2016463] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND The architectural design of the pediatric intensive care unit may play a major role in optimizing the environment to promote patients' sleep while improving stress levels and the work experience of critical care nurses. OBJECTIVES To examine changes in nurses' perceptions of the environment of a pediatric critical care unit for promotion of patients' sleep and the nurses' work experience after a transition from multipatient rooms to single-patient rooms. METHODS A cross-sectional survey of nurses was conducted before and after the move to a new hospital building in which all rooms in the pediatric critical care unit were single-patient rooms. RESULTS Nurses reported that compared with multipatient rooms, single-patient private rooms were more conducive to patients sleeping well at night and promoted a more normal sleep-wake cycle (P < .001). Monitors/alarms and staff conversations were the biggest factors that adversely influenced the environment for sleep promotion in both settings. Nurses were less annoyed by noise in single-patient rooms (33%) than in multipatient rooms (79%; P < .001) and reported improved exposure to sunlight. CONCLUSIONS Use of single-patient rooms rather than multipatient rooms improved nurses' perceptions of the pediatric intensive care unit environment for promoting patients' sleep and the nurses' own work experience.
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Affiliation(s)
- Sapna R Kudchadkar
- Sapna R. Kudchadkar is an assistant professor, Department of Anesthesiology and Critical Care Medicine and Pediatrics, and Naresh M. Punjabi is a professor, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. M. Claire Beers is nurse manager of the pediatric intensive care unit and Judith A. Ascenzi is a clinical nurse specialist, Johns Hopkins Charlotte R. Bloomberg Children's Center, Baltimore, Maryland. Ebaa Jastaniah is a resident physician, Department of Pediatrics, Tufts Baystate Medical Center, Boston, Massachusetts.
| | - M Claire Beers
- Sapna R. Kudchadkar is an assistant professor, Department of Anesthesiology and Critical Care Medicine and Pediatrics, and Naresh M. Punjabi is a professor, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. M. Claire Beers is nurse manager of the pediatric intensive care unit and Judith A. Ascenzi is a clinical nurse specialist, Johns Hopkins Charlotte R. Bloomberg Children's Center, Baltimore, Maryland. Ebaa Jastaniah is a resident physician, Department of Pediatrics, Tufts Baystate Medical Center, Boston, Massachusetts
| | - Judith A Ascenzi
- Sapna R. Kudchadkar is an assistant professor, Department of Anesthesiology and Critical Care Medicine and Pediatrics, and Naresh M. Punjabi is a professor, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. M. Claire Beers is nurse manager of the pediatric intensive care unit and Judith A. Ascenzi is a clinical nurse specialist, Johns Hopkins Charlotte R. Bloomberg Children's Center, Baltimore, Maryland. Ebaa Jastaniah is a resident physician, Department of Pediatrics, Tufts Baystate Medical Center, Boston, Massachusetts
| | - Ebaa Jastaniah
- Sapna R. Kudchadkar is an assistant professor, Department of Anesthesiology and Critical Care Medicine and Pediatrics, and Naresh M. Punjabi is a professor, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. M. Claire Beers is nurse manager of the pediatric intensive care unit and Judith A. Ascenzi is a clinical nurse specialist, Johns Hopkins Charlotte R. Bloomberg Children's Center, Baltimore, Maryland. Ebaa Jastaniah is a resident physician, Department of Pediatrics, Tufts Baystate Medical Center, Boston, Massachusetts
| | - Naresh M Punjabi
- Sapna R. Kudchadkar is an assistant professor, Department of Anesthesiology and Critical Care Medicine and Pediatrics, and Naresh M. Punjabi is a professor, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. M. Claire Beers is nurse manager of the pediatric intensive care unit and Judith A. Ascenzi is a clinical nurse specialist, Johns Hopkins Charlotte R. Bloomberg Children's Center, Baltimore, Maryland. Ebaa Jastaniah is a resident physician, Department of Pediatrics, Tufts Baystate Medical Center, Boston, Massachusetts
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Abstract
This longitudinal study examined how nursing students' moral judgment changes after they become qualified nurses working in a hospital environment. The sample used was a group of 80 nursing students attending a university in Suwon, Korea, between 2001 and 2003. By using a Korean version of the Judgment About Nursing Decisions questionnaire, an instrument used in nursing care research, moral judgment scores based on Ketefian's six nursing dilemmas were determined. The results were as follows: (1) the qualified nurses had significantly higher idealistic moral judgment scores than the nursing students; (2) the qualified nurses showed significantly higher realistic moral judgment scores than the nursing students; and (3) when comparing idealistic and realistic moral judgment scores, both the qualified nurses and the nursing students had higher scores for idealistic moral judgment. Further study is recommended to examine changes in moral judgment.
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MESH Headings
- Analysis of Variance
- Attitude of Health Personnel
- Clinical Competence
- Curriculum
- Decision Making
- Education, Nursing, Baccalaureate
- Ethics, Nursing/education
- Health Facility Environment/organization & administration
- Health Knowledge, Attitudes, Practice
- Health Services Needs and Demand
- Humans
- Judgment/ethics
- Korea
- Longitudinal Studies
- Moral Development
- Nursing Assessment
- Nursing Methodology Research
- Nursing Staff, Hospital/education
- Nursing Staff, Hospital/ethics
- Nursing Staff, Hospital/psychology
- Nursing Staff, Hospital/statistics & numerical data
- Organizational Culture
- Self Efficacy
- Socioeconomic Factors
- Students, Nursing/psychology
- Surveys and Questionnaires
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Abstract
Five registered nurses were interviewed as part of a comprehensive investigation by five researchers into the narratives of five enrolled nurses (study 1, published in Nursing Ethics 2004), five registered nurses (study 2) and 10 patients (study 3) describing their experiences in an acute care ward at one university hospital in Sweden. The project was developed at the Centre for Nursing Science at Ö rebro University Hospital. The ward in question was opened in 1997 and provides care for a period of up to three days, during which time a decision has to be made regarding further care elsewhere or a return home. The registered nurses were interviewed concerning their experience of being in ethically difficult care situations in their work. Interpretation of the theme ‘ethical problems’ was left to the interviewees to reflect upon. A phenomenological hermeneutic method (inspired by the French philosopher Paul Ricoeur) was used in all three studies. The most prominent feature revealed was the enormous responsibility present. When discussing their responsibility, their working environment and their own reactions such as stress and conscience, the registered nurses focused on the patients and the possible negative consequences for them, and showed what was at stake for the patients themselves. The nurses demonstrated both directly and indirectly what they consider to be good nursing practices. They therefore demand very high standards of themselves in their interactions with their patients. They create demands on themselves that they believe to be identical to those expected by patients.
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Abstract
This study examined the relationship between moral distress intensity, moral distress frequency and the ethical work environment, and explored the relationship of demographic characteristics to moral distress intensity and frequency. A group of 106 nurses from two large medical centers reported moderate levels of moral distress intensity, low levels of moral distress frequency, and a moderately positive ethical work environment. Moral distress intensity and ethical work environment were correlated with moral distress frequency. Age was negatively correlated with moral distress intensity, whereas being African American was related to higher levels of moral distress intensity. The ethical work environment predicted moral distress intensity. These results reveal a difference between moral distress intensity and frequency and the importance of the environment to moral distress intensity.
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MESH Headings
- Adult
- Age Factors
- Attitude of Health Personnel
- Burnout, Professional/prevention & control
- Burnout, Professional/psychology
- Conflict, Psychological
- Deception
- Ethics, Nursing
- Factor Analysis, Statistical
- Health Facility Environment/ethics
- Health Facility Environment/organization & administration
- Health Knowledge, Attitudes, Practice
- Humans
- Mid-Atlantic Region
- Morals
- Nurse's Role/psychology
- Nursing Methodology Research
- Nursing Staff, Hospital/ethics
- Nursing Staff, Hospital/organization & administration
- Nursing Staff, Hospital/psychology
- Organizational Culture
- Patient Advocacy/ethics
- Patient Advocacy/psychology
- Personnel Turnover
- Power, Psychological
- Professional Autonomy
- Risk Factors
- Social Responsibility
- Surveys and Questionnaires
- Workplace/organization & administration
- Workplace/psychology
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Jablonski RA, Munro CL, Grap MJ, Elswick RK. The Role of Biobehavioral, Environmental, and Social Forces on Oral Health Disparities in Frail and Functionally Dependent Nursing Home Elders. Biol Res Nurs 2016; 7:75-82. [PMID: 15920005 DOI: 10.1177/1099800405275726] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this article is to review the literature on and discuss how interactions between bio-behavioral aging, nursing home environments, and social forces shaping current health care policies have contributed to oral health disparities in frail and functionally dependent elders who reside in nursing homes. Emerging empirical evidence suggests links between poor oral health with dental plaque deposition and systemic disease, such as nursing home-acquired pneumonia. The majority of nursing home residents lack either the functional ability or the mental capacity to perform their own mouth care and therefore must rely on others to perform mouth care for them. Certified nursing assistants (CNAs), who provide the majority of care activities, were unsure how to provide care to residents who engaged in care-resistive behaviors. The nurses who supervise the CNAs have limited knowledge regarding the provision of mouth care in general, and they specifically lack knowledge regarding the provision of mouth care to elders exhibiting care-resistant behavior. Elders in nursing homes have limited options when paying for dental care; Medicare does not generally cover routine dental care. Medicaid coverage varies widely between individual states; even when coverage exists, low Medicaid reimbursements discourage dentists from accepting Medicaid patients. The strategies needed to reduce these oral health disparities are complicated but not unrealistic. Investigators willing to embrace this cause will have no shortage of opportunities to test methods to improve the delivery of oral care as well as to monitor and reassess these methods.
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Affiliation(s)
- Rita A Jablonski
- School of Nursing, Virginia Commonwealth University, Richmond 23298, USA.
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Abstract
This cross-sectional study explored relations between environmental ambiance and locomotion behaviors of elders with dementia (EWD), addressing the larger goal of developing theory explaining how environment affects wandering and other behaviors, thereby illuminating a pathway to intervention. A sample of 47 EWD (older than age 65, Mini-Mental State Examination [MMSE] ≤ 23) from nursing homes and assisted-living facilities were studied through a random, cluster, sampling strategy. Participants were measured once for stable characteristics and videotaped for 12, randomly chosen, 20-minute periods over 2 separate days at least 48 hours apart. Hierarchical liner modeling was used to analyze data that focused on the observation as the unit of analysis, with repeated observations nested within participants. Results validated an influence of ambiance on locomoting behaviors, highlighting the importance of addressing the emotional valence of social and physical environments in care of EWD.
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Affiliation(s)
- Lan Yao
- University of Michigan School of Nursing, Ann Arbor 48109-0482, USA.
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Abstract
An exploratory study was conducted with 886 nurses at eight Korean teaching hospitals to describe nurses' perception of frequency of error reporting and patient safety culture in their hospitals and to identify relationships between the nurses' perception and work-related factors. The authors found that the majority of nurses were not comfortable reporting errors or communicating concerns about safety issues. A significant portion reported concerns about patient safety issues in their working unit. Nurses on the front line evaluated various aspects related to patient safety culture as being more of a problem than nurses who are older ( p < .01) and who work in management positions ( p < .05). The authors conclude that error reporting and the safety culture in Korean teaching hospitals are not emphasized enough. The authors suggest that patient safety could be improved in a nonpunitive culture where individuals can openly discuss medical errors and potential hazards.
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Abstract
Humor has been identified as an intrinsic social phenomenon occurring in all groups throughout human history. It is among the most prevalent forms of human social behavior yet one of the least understood or defined. Although researchers in a number of disciplines have studied the effects of humor on patients, limited work has focused on end-of-life care. The present study investigated social interactions involving humor in hospice settings using nonparticipant observation. Results revealed that humor was present in 85 percent of 132 observed nurse-based hospice visits. Of these, hospice patients initiated humor 70 percent of the time. These findings were consistent regardless of hospice setting. Humor was spontaneous and frequent, and instances of humorous interactions were a prevalent part of everyday hospice work.
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Sariyar M. How to justify avoidance of communications related to death anxiety in the health care system. Med Health Care Philos 2015; 18:353-359. [PMID: 25400257 DOI: 10.1007/s11019-014-9609-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
It might seem obvious that dealing with death anxiety in the health care system is desirable. Hence, there are either voices that demand more research on how this openness can be fostered or those who consider this topic unworthy of further investigations because of its triviality. The idea behind both deficient perspectives is that the health care system as a communication system can assume the position of a second-order observer who can account for his deficits. However, in terms of Luhmannian systems theory, external perturbations cannot force a functional system to reflect and change the structure of his communications in a certain way. The health care system as a communication system cannot do more than integrating the topic of death anxiety in terms of its functional perpetuation. For example, in hospitals, neither health care staff nor external counselors are able to address existential issues without being affected by functional and structural requirements of the hospital. We present an outline for the justification of the avoidance of death-anxiety related talk in the health care system by reference to systems theory and existential philosophy.
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Affiliation(s)
- Murat Sariyar
- Institute of Pathology, Charite - University Medicine Berlin, Campus Benjamin Franklin, 12200, Berlin, Germany,
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Abstract
OBJECTIVE This article discusses the use of positive distraction, an evidence-based design approach, in rehabilitation hospitals in Brazil through the work of João Filgueiras Lima ("Lelé"). BACKGROUND In many parts of the world architects may not formally incorporate theories of positive distraction and evidence-based design, but there are multiple international examples of health facility architects and designers that use nature, daylighting, art, and social interaction to enhance the healing experience. The work of the Brazilian architect João Filgueiras Lima is a particularly salient example. Lima has been a dominant figure in 20th and 21st century Brazilian architecture and the architect of several rehabilitation facilities. METHODS First positive distraction is defined as it relates to nature and art, and in the context of rehabilitation hospitals. Second, rehabilitation facilities are defined. The discussion then focuses on awareness of evidence-based design in Latin America. Next, Brazilian healthcare architecture is discussed along with the history of the Brazilian Sarah rehabilitation hospitals designed by Lelé and Lelé's role in the history of Brazilian architecture. Last we look at Lelé's use of positive distraction. RESULTS Despite Lelé's recognition in Brazil, his work has not gained much international exposure. Lelé played a critical role in the design of the Sarah facilities and served on the board of directors for the Technological Center of the Sarah Network (CTRS) in Brazil from 1992 to 2009. Based on our review of his work it was clear that Lelé used positive distraction as a tool for creating healing environments. CONCLUSIONS In spite of the lack of formal integration of evidence-based design in healthcare architecture in Latin America, many of its basic tenets have been incorporated in Brazilian rehabilitation hospitals. Lelé's projects are a clear example of this phenomenon and demonstrate an alignment between research and practitioner objectives. The presence of nature, art, and natural light in his rehabilitation hospitals serves as a model for evidence-based design in facilities throughout the world and presents an opportunity to measure the benefits of positive distraction on rehabilitation patient outcomes.
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Russell SS. Educational Planning for Establishing a Health-Promoting Workplace (HPW). Medsurg Nurs 2015; 24:8-9. [PMID: 26306352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Academy of Medical-Surgical Nurses (AMSN) has had an ongoing series of articles related to Healthy Practice Environments. The AMSN website (www.amsn.org) also has a number of articles and documents about initiatives that AMSN has undertaken to promote healthy practice environments in health care settings. This articles will focus on the educational work necessary for nurses who desire to increase the healthiness of their workplace. The work is not easy, but the end result could be one that leaves a lasting legacy for those who work in that environment.
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Abstract
The Nursing Station is a puzzling structure fulfilling a variety of roles throughout the day. At times, it resembles a communal market place with staff standing around chatting. Yet, once a shift commences, regulatory characteristics emerge to control a person's entry and exit from the ward, by ensuring that they have an authentic reason for being there. This paper juxtaposes the role of the Nursing Station with Strauss et al.'s (1964) notion of shape. In this way, is intended to examine in detail how the Nursing Station can influence the normal and natural flow of work within a ward.
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Affiliation(s)
- Ann Wakefield
- The School of Nursing, Midwifery and Health, The University of Manchester England
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Ferguson L, Calvert J, Davie M, Fallon M, Fred N, Gersbach V, Sinclair L. Clinical leadership: Using observations of care to focus risk management and quality improvement activities in the clinical setting. Contemp Nurse 2014; 24:212-24. [PMID: 17563330 DOI: 10.5172/conu.2007.24.2.212] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In an era when patient safety and quality of care are a daily concern for health care professionals, it is important for nurse managers and other clinical leaders to have a repertoire of skills and interventions that can be used to motivate and engage clinical teams in risk assessment and continuous quality improvement at the level of patient care delivery. This paper describes how a cohort of clinical leaders who were undertaking a leadership development program used a relatively simple, patient-focused intervention called the 'observation of care' to help focus the clinical team's attention on areas for improvement within the clinical setting. The main quality and safety themes arising out of the observations that were undertaken by the Clinical Leaders (CLs) were related to the environment, occupational health and safety, communication and team function, clinical practice and patient care. The observations of care also provided the CLs with many opportunities to acknowledge and celebrate exemplary practice as it was observed as a means of enhancing the development of a quality and safety culture within the clinical setting. The 'observation of care' intervention can be used by Clinical Leader's to engage and motivate clinical teams to focus on continuously improving the safety and quality of their own work environment and the care delivered to patients within that environment.
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Affiliation(s)
- Lorraine Ferguson
- School of Nursing, University of Western Sydney and Sydney West Area Health Service, Sydney NSW, Australia
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Benoit B, Semenic S. Barriers and facilitators to implementing the Baby-Friendly hospital initiative in neonatal intensive care units. J Obstet Gynecol Neonatal Nurs 2014; 43:614-624. [PMID: 25143255 DOI: 10.1111/1552-6909.12479] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2014] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To explore manager, educator, and clinical leader perceptions of barriers and facilitators to implementing Baby-Friendly practice in the neonatal intensive care unit (NICU). DESIGN Qualitative, descriptive design. SETTING Two university-affiliated level-III NICUs in Canada. PARTICIPANTS A purposive sample of 10 medical and nursing managers, nurse educators, lactation consultants, and neonatal nurse practitioners. METHODS In-depth, semistructured interviews transcribed and analyzed using qualitative content analysis. RESULTS Participants valued breastfeeding and family-centered care yet identified numerous contextual barriers to Baby-Friendly care including infant health status, parent/infant separation, staff workloads and work patterns, gaps in staff knowledge and skills, and lack of continuity of breastfeeding support. Facilitators included breastfeeding education, breastfeeding champions, and interprofessional collaboration. CONCLUSION Despite identifying numerous barriers, participants recognized the potential value of expanding the Baby-Friendly Hospital Initiative (BFHI) to the NICU setting. Recommendations include promoting BFHI as a facilitator of family-centered care, interdisciplinary staff education, increasing access to lactation consultants, and establishing a group of NICU champions dedicated to BFHI implementation.
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Peck TA. More than 40 years of change in ES. Health Facil Manage 2014; 27:46. [PMID: 25141447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Paine B. A deciding role. ES involvement in the design and construction process. Health Facil Manage 2014; 27:44-47. [PMID: 25137980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Felk NC. Applying Lean principles to ES operations. Health Facil Manage 2014; 27:42. [PMID: 25137979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Clayman S. Data-driven planning. Statistical research an Lean concepts help determine space needs. Health Facil Manage 2014; 27:26-30. [PMID: 25137974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Brys S. Annual showcase highlights safety, patient flow, and community integration. Behav Healthc 2014; 34:16-8, 20-2, 24-30 passim. [PMID: 25065150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Newman A. CHP project brings substantial savings. Health Estate 2014; 68:38-42. [PMID: 24620490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
With the NHS having committed to reduce its carbon footprint by 10% by 2015, Alan Newman, a partner at building services engineers, Troup Bywaters + Anders (TB+A), describes how, with the company's expertise and help, customer, the East and North Hertfordshire NHS Trust, 'surpassed the targets two years in advance'. As he explains, the key element of an ambitious carbon reduction scheme that won the 2013 IHEEM Healthcare Estates Sustainability Award (HEJ - November 2013) was a new combined heat and power-based energy centre at the Trust's Lister Hospital in Stevenage.
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Call R. 'Lean' approach gives greater efficiency. Health Estate 2014; 68:23-25. [PMID: 24620487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Adapting the 'Lean' methodologies used for many years by many manufacturers on the production line - such as in the automotive industry - and deploying them in healthcare 'spaces' can, Roger Call, an architect at Herman Miller Healthcare in the US, argues, 'easily remedy many of the inefficiencies' found within a healthcare facility. In an article that first appeared in the September 2013 issue of The Australian Hospital Engineer, he explains how 'Lean' approaches such as the 'Toyota production system', and 'Six Sigma', can be harnessed to good effect in the healthcare sphere.
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Morris CC. Partnering between ES and facilities teams. Health Facil Manage 2014; 27:44. [PMID: 24665555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Abstract
AIMS The aim of this study was to use the concept of Maslow's hierarchy of needs and apply this to Type 1 diabetes. METHODS Qualitative methods were employed using semi-structured interviews with 101 people from 13 countries. Grounded theory was used for data collection and analysis, with thematic analysis employed to identify the interviewees' needs. RESULTS Sixteen needs were identified and links between these were mapped. Aligning these with Maslow's hierarchy allowed for a hierarchy to be developed for Type 1 diabetes with 'Policies', 'Organization of health system', 'Insulin', 'Delivery of insulin', 'Control', 'Healthcare workers' and 'Information and education' at the base, as they were needed for survival. Next came 'Community, family and peers' and changing roles for 'Healthcare workers' in their approach to care and delivering 'Information and education'. This enabled people to learn how to use 'Insulin', 'Delivery of insulin' and 'Control' flexibly. People's 'Experience' and 'Personality' then helped them 'Adapt' and 'Be open' about their diabetes, allowing for 'Acceptance' and viewing 'Diabetes as something positive'. CONCLUSIONS Despite limitations, this work highlights that some needs are required for survival and others for well-being. Some are tangible as they can be directly provided, whereas others are intangible and cannot be provided directly by the health system. These results might be used for policy and practice in identifying needs that are met within a health system or what needs are lacking for the individual to then implement targeted interventions.
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Affiliation(s)
- D Beran
- Division of International and Humanitarian Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Downing J, Marston J, Fleming E. Children's palliative care: considerations for a physical therapeutic environment. J Palliat Care 2014; 30:116-124. [PMID: 25058989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Reed CA. Energy matters. The path to efficiency starts with EPA benchmarking tool. Interview by Jeff Ferenc. Health Facil Manage 2013; 26:13-14. [PMID: 24260899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Ford L. Developing staff members into leaders. Health Facil Manage 2013; 26:50. [PMID: 24260903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Lisa Ford
- Our Lady of Lourdes Medical Center, Camden, NJ, USA
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Hurst D. A nurse's perspective. How HCAHPS surveys relate to health care's mission. Health Facil Manage 2013; 26:53-56. [PMID: 24260904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Debbie Hurst
- Infection Control Department, Asante Rogue Regional Medical Center, Medfort, Ore., USA.
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Environment of care management plans. Making sure your plans get the job done. Jt Comm Perspect 2013; 33:6-8. [PMID: 23785958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Morris T. Delivering solutions outside the box. For Children's Medical Center in Dallas, using a combination of more than 100 strategically positioned, customized workstations has resulted in positive feedback from the hospital's doctors and nurses. Health Manag Technol 2012; 33:12-13. [PMID: 23301416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Sofranec D. Improving the patient experience. Staff attitude, atmosphere vital to building patient satisfaction, experts say. Med Econ 2012; 89:32-34. [PMID: 23488395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Anthony G. Are you effectively using the space you have? Behav Healthc 2012; 32:38-40. [PMID: 22550788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Gayle Anthony
- Healthcare Space Planning Consultants, LLC, Memphis, Tenn., USA.
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Abstract
The important goals of Magnet hospitals are to create supportive professional nursing care environments. A recently published paper found little difference in work environments between Magnet and non-Magnet hospitals. The aim of this study was to determine whether work environments, staffing, and nurse outcomes differ between Magnet and non-Magnet hospitals. A secondary analysis of data from a 4-state survey of 26,276 nurses in 567 acute care hospitals to evaluate differences in work environments and nurse outcomes in Magnet and non-Magnet hospitals was conducted. Magnet hospitals had significantly better work environments (t = -5.29, P < .001) and more highly educated nurses (t = -2.27, P < .001). Magnet hospital nurses were 18% less likely to be dissatisfied with their job (P < .05) and 13% less likely to report high burnout (P < .05). Magnet hospitals have significantly better work environments than non-Magnet hospitals. The better work environments of Magnet hospitals are associated with lower levels of nurse job dissatisfaction and burnout.
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Abstract
This article discusses the effects of long-term care facility traits on the maltreatment of older people. Participants in this quantitative, descriptive study were staff working at 24 of the 300 long-term facilities for older people in Israel. Slightly more than half of the sample reported abuse of older residents in the previous 12 months, manifesting in one or more types of maltreatment. High staff turnover was associated with a greater risk of mental or physical neglect, and the total number of maltreatment incidents.
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Affiliation(s)
- Merav Ben Natan
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
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Jarousse LA. Optimal healing environments. Hosp Health Netw 2010; 84:8-32. [PMID: 21268502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Kehoe B. Patient satisfaction. Hospital performance moves from good to great. Hosp Health Netw 2010; 84:16. [PMID: 21166110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Bicket MC, Samus QM, McNabney M, Onyike CU, Mayer LS, Brandt J, Rabins P, Lyketsos C, Rosenblatt A. The physical environment influences neuropsychiatric symptoms and other outcomes in assisted living residents. Int J Geriatr Psychiatry 2010; 25:1044-54. [PMID: 20077498 PMCID: PMC3143504 DOI: 10.1002/gps.2460] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Although the number of elderly residents living in assisted living (AL) facilities is rising, few studies have examined the AL physical environment and its impact on resident well-being. We sought to quantify the relationship of AL physical environment with resident outcomes including neuropsychiatric symptoms (NPS), quality of life (QOL), and fall risk, and to compare the effects for demented and non-demented residents. METHODS Prospective cohort study of a stratified random sample of 326 AL residents living in 21 AL facilities. Measures included the Therapeutic Environmental Screening Scale for Nursing Homes and Residential Care (TESS-NH/RC) to rate facilities and in-person assessment of residents for diagnosis (and assessment of treatment) of dementia, ratings on standardized clinical, cognitive, and QOL measures. Regression models compared environmental measures with outcomes. TESS-NH/RC is modified into a scale for rating the AL physical environment AL-EQS. RESULTS The AL Environmental Quality Score (AL-EQS) was strongly negatively associated with Neuropsychiatric Inventory (NPI) total score (p < 0.001), positively associated with Alzheimer Disease Related Quality of Life (ADRQL) score (p = 0.010), and negatively correlated with fall risk (p = 0.042). Factor analysis revealed an excellent two-factor solution, Dignity and Sensory. Both were strongly associated with NPI and associated with ADRQL. CONCLUSION The physical environment of AL facilities likely affects NPS and QOL in AL residents, and the effect may be stronger for residents without dementia than for residents with dementia. Environmental manipulations that increase resident privacy, as well as implementing call buttons and telephones, may improve resident well-being.
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Affiliation(s)
- Mark C Bicket
- Johns Hopkins School of Medicine, Johns Hopkins Medicine, MD, USA
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Henderson A, Creedy D, Boorman R, Cooke M, Walker R. Development and psychometric testing of the Clinical Learning Organisational Culture Survey (CLOCS). Nurse Educ Today 2010; 30:598-602. [PMID: 20064678 DOI: 10.1016/j.nedt.2009.12.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Revised: 09/04/2009] [Accepted: 12/03/2009] [Indexed: 05/28/2023]
Abstract
AIM This paper describes the development and psychometric testing of the Clinical Learning Organisational Culture Survey (CLOCS) that measures prevailing beliefs and assumptions important for learning to occur in the workplace. METHOD Items from a tool that measured motivation in workplace learning were adapted to the nursing practice context. The tool was tested in the clinical setting, and then further modified to enhance face and content validity. PARTICIPANTS Registered nurses (329) across three major Australian health facilities were surveyed between June 2007 and September 2007. DATA ANALYSIS An exploratory factor analysis identified five concepts--recognition, dissatisfaction, affiliation, accomplishment, and influence. VALIDITY AND RELIABILITY: Internal consistency measures of reliability revealed that four concepts had good internal consistency: recognition (alpha=.914), dissatisfaction (alpha=.771), affiliation (alpha=.801), accomplishment (alpha=.664), but less so for influence (alpha=.529). RESULTS This tool effectively measures recognition, affiliation and accomplishment--three concepts important for learning in practice situations, as well as dissatisfied staff across all these domains. Testing of additional influence items identify that this concept is difficult to delineate. CONCLUSION The CLOCS can effectively inform leaders about concepts inherent in the culture important for maximising learning by staff.
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Affiliation(s)
- Amanda Henderson
- Nursing Practice Development Unit, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia.
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Waller S, Summers L. A change of scenery. Interview by Louise Hunt. Nurs Stand 2010; 24:18-20. [PMID: 20860209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Enhancing environments brings health benefits to patients but can also improve the quality of care given.
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Hume V. Creative care: the role of the arts in hospital. Nurs Manag (Harrow) 2010; 17:16-20. [PMID: 20945629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Hospital patients often experience many different art forms, from the simple placing of sculpture in hospital grounds to the involvement of patients and staff in exhibitions, performances or workshops. In this article, the author refers to the work of Royal Brompton & Harefield Arts to improve the wellbeing of patients and staff at Royal Brompton Hospital, in Chelsea, London, and Harefield Hospital, near Uxbridge, Middlesex, which together form the Royal Brompton & Harefield NHS Foundation Trust, the largest specialist heart and lung centre in the U.K.
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Affiliation(s)
- Victoria Hume
- Royal Brompton & Harefield NHS Foundation Trust, London
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Affiliation(s)
- Kathleen Hudson
- Kathleen Hudson is a nursing faculty member at the University of Texas at Tyler in Tyler, TX, USA
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Abstract
A significant amount of burnout and attrition of nurses occurs in healthcare systems. Nursing leadership has a significant impact on these factors. The purpose of this article is to present an evidence review to determine the impact of transformational leadership on staff satisfaction and burnout. It was found that transformational leadership is significantly related to increased satisfaction, increased staff well-being, decreased burnout, and decreased overall stress in staff nurses.
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Affiliation(s)
- Dan Weberg
- Academy for Continuing Education, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA.
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Adams JM, Denham D, Neumeister IR. Applying the Model of the Interrelationship of Leadership Environments and Outcomes for Nurse Executives: a community hospital's exemplar in developing staff nurse engagement through documentation improvement initiatives. Nurs Adm Q 2010; 34:201-207. [PMID: 20562569 DOI: 10.1097/naq.0b013e3181e7026e] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The Model of the Interrelationship of Leadership, Environments & Outcomes for Nurse Executives (MILE ONE) was developed on the basis of existing literature related to identifying strategies for simultaneous improvement of leadership, professional practice/work environments (PPWE), and outcomes. Through existing evidence, the MILE ONE identifies the continuous and dependent interrelationship of 3 distinct concept areas: (1) nurse executives influence PPWE, (2) PPWE influence patient and organizational outcomes, and (3) patient and organizational outcomes influence nurse executives. This article highlights the application of the MILE ONE framework to a community district hospital's clinical documentation performance improvement projects. Results suggest that the MILE ONE is a valid and useful framework yielding both anticipated and unexpected enhancements to leaders, environments, and outcomes.
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Affiliation(s)
- Jeffrey M Adams
- The Yvonne L. Munn Center for Nursing Research at Massachusetts General Hospital, Boston, and The Bogart Group, Inc, Monterey, California, USA.
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Affiliation(s)
- Judith Smith
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry.
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