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https://www.readbyqxmd.com/read/29333500/improving-the-written-medical-handover
#1
Rhys Martin, Melanie Huddart, Cara Garbett, Wendell Storr, Olivia Watts, Sanjeev Gupta
The handover of large numbers of medical patients, during on call periods when staffing levels are reduced, is a challenge for all acute medical services. At the Royal Cornwall Hospital, a large district general hospital, we identified that foundation doctors were reviewing medical inpatients during weekend on call periods with limited written handover information. We chose to address this problem by developing an intervention, a weekend handover sticker, and piloting it. We used the review of documentation to measure improvement and feedback from users to assess the processes involved...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29331220/-impact-of-chronic-illness-on-hospital-nursing-workloads
#2
S Vallés, E Valdavida, C Menéndez, C Natal
OBJECTIVES: To evaluate the short-term impact of chronic illness in hospital units and to establish a method that allows nursing workloads to be adapted according to the care needs of patients. METHODS: A descriptive study of the evolution of workloads of nursing staff associated with the care needs of patients between 1 July 2014 and 30 June 2016, in a county hospital. The care needs of the patients were assessed daily using an adaptation of the Montesinos scheme...
January 10, 2018: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/29326413/-impact-of-increased-supply-of-newly-licensed-nurses-on-hospital-nurse-staffing-and-policy-implications
#3
Yunmi Kim, Sunju You, Jinhyun Kim
PURPOSE: This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014. METHODS: Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression...
December 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/29326193/patient-satisfaction-with-hospital-care-and-nurses-in-england-an-observational-study
#4
Linda H Aiken, Douglas M Sloane, Jane Ball, Luk Bruyneel, Anne Marie Rafferty, Peter Griffiths
OBJECTIVES: To inform healthcare workforce policy decisions by showing how patient perceptions of hospital care are associated with confidence in nurses and doctors, nurse staffing levels and hospital work environments. DESIGN: Cross-sectional surveys of 66 348 hospital patients and 2963 inpatient nurses. SETTING: Patients surveyed were discharged in 2010 from 161 National Health Service (NHS) trusts in England. Inpatient nurses were surveyed in 2010 in a sample of 46 hospitals in 31 of the same 161 trusts...
January 11, 2018: BMJ Open
https://www.readbyqxmd.com/read/29326190/a-qualitative-study-of-patients-feedback-about-outpatient-parenteral-antimicrobial-therapy-opat-services-in-northern-england-implications-for-service-improvement
#5
Maureen Twiddy, Carolyn J Czoski Murray, Samantha J Mason, David Meads, Judy M Wright, Elizabeth D Mitchell, Jane Minton
OBJECTIVE: Outpatient parenteral antimicrobial therapy (OPAT) provides opportunities for improved cost savings, but in the UK, implementation is patchy and a variety of service models are in use. The slow uptake in the UK and Europe is due to a number of clinical, financial and logistical issues, including concern about patient safety. The measurement of patient experience data is commonly used to inform commissioning decisions, but these focus on functional aspects of services and fail to examine the relational aspects of care...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29325441/five-year-experience-of-an-inpatient-palliative-care-unit-at-an-academic-referral-center
#6
Myrick C Shinall, Sara F Martin, Jill Nelson, Richard S Miller, Matthew W Semler, Eli E Zimmerman, Christy C Noblit, E Wesley Ely, Mohana Karlekar
BACKGROUND: Palliative care units (PCUs) staffed by specialty-trained physicians and nurses have been established in a number of medical centers. The purpose of this study is to review the 5-year experience of a PCU at a large, urban academic referral center. METHODS: We retrospectively reviewed a prospectively collected database of all admissions to the PCU at Vanderbilt University Medical Center in the first 5 years of its existence, from 2012 through 2017. RESULTS: Over these 5 years, there were 3321 admissions to the PCU...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29322579/the-employee-retention-triad-in-healthcare-exploring-relationships-among-organizational-justice-affective-commitment-and-turnover-intention
#7
Tyrone A Perreira, Whitney Berta, Monique Hebert
BACKGROUND: Turnover in healthcare is a serious concern, as it is contributes to the global nursing shortage and is associated with declines in quality of care, patient safety, and patient outcomes. Turnover also impacts care teams and is associated with decreased staff cohesion and morale. PURPOSE: The purpose of this study is to increase understanding of the relationships between organizational justice, affective commitment and turnover intention in healthcare...
January 10, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29322572/burnout-among-direct-care-workers-in-nursing-homes-influences-of-organizational-work-place-interpersonal-and-personal-characteristics
#8
Dale E Yeatts, Gul Seckin, Yuying Shen, Michael Thompson, Dana Auden, Cynthia M Cready
AIMS AND OBJECTIVES: The many negative effects of burnout have prompted researchers to better understand the factors contributing to it. The purpose of this paper is to add to this body of knowledge through the study of burnout among direct care workers (DCWs) in nursing homes (NH). BACKGROUND: Perhaps the factor most often associated with employee burnout is the level of staffing-insufficient staffing results in work overload and eventually employee burnout. A closer look at research findings suggest that there are many other factors also contributing to burnout...
January 10, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29318685/longitudinal-associations-of-nursing-staff-turnover-with-patient-outcomes-in-long-term-care-hospitals-in-korea
#9
Yoonseo Kim, Kihye Han
AIMS: To describe the characteristics of long-term care hospitals in 2010-2013 and to examine the longitudinal associations of nursing staff turnover with patient outcomes. BACKGROUND: The number of long-term care hospitals has exploded in Korea since the national long-term care insurance was launched in 2008. The care quality deviation across long-term care hospitals is large. METHODS: This was a longitudinal secondary data analysis using the Health Insurance Review and Assessment Service's data...
January 10, 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29318326/-reimbursement-of-intensive-care-services-in-austria-use-of-the-lkf-system
#10
REVIEW
M Joannidis, S J Klein, P Metnitz, A Valentin
In Austria, the reimbursement of intensive care services is based on a Diagnosis-Related Groups (DRG) system which has been adapted to the Austrian framework conditions. Compared to Germany where economic considerations had led to personnel cuts, mandatory targets outlined in both the LKF ("Leistungsorientierte Krankenanstaltenfinanzierung", Performance-oriented Hospital Financing) and ÖSG ("Österreichischer Strukturplan Gesundheit", Austrian Health Care Structure Plan) plans ensure a high level of medical and intensive care...
January 9, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29303821/sustained-hospital-performance-on-hospital-consumer-assessment-of-healthcare-providers-and-systems-survey-measures-what-are-the-determinants
#11
Mona Al-Amin, Melody K Schiaffino, Sinyoung Park, Jeffrey Harman
This study examines hospital characteristics associated with sustained superior performance on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures. We classified hospitals as sustainers if they remained in the top 25th percentile of overall patient ratings of inpatient experience from 2009 through 2013. We classified hospital characteristics as modifiable or unmodifiable. Modifiable characteristics are operational measures that hospitals can change to improve performance; these characteristics include registered nurse (RN) staffing levels, presence of hospitalists, and level of physician integration...
January 2018: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29289914/incidence-outcomes-and-outcome-prediction-of-unplanned-extubation-in-critically-ill-children-an-11year-experience
#12
R Al-Abdwani, C B Williams, C Dunn, J Macartney, K Wollny, H Frndova, N Chin, D Stephens, C S Parshuram
PURPOSE: Unplanned extubation represents loss of control in the ICU, is associated with harm and is used as a measure of quality of care. We evaluated the rates and consequences of unplanned extubation. MATERIALS AND METHODS: Eligible patients were intubated, <18years, and in ICU. Patient, care-related and environmental characteristics were compared in patients who did and did not receive positive pressure ventilation in the 24h after events. Rates are expressed per 100 intubation-days...
December 24, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29282830/redesigning-the-patient-classification-system-in-china-a-pilot-study
#13
Yamei Bai, Aaron Yao, Yulei Song, Guihua Xu
The current prototype patient classification system in China has not been updated for over six decades. In the present study, we adopted a hybrid patient classification method using both disease severity and activities of daily living scores to classify patients. The time motion approach was used to measure the direct nursing time of 551 general acute care patients. We found that patients in old Categories according to ability of self-care and disease severity 1-4 received approximately 7.1, 4.6, 3.4, and 4...
December 28, 2017: Nursing & Health Sciences
https://www.readbyqxmd.com/read/29277951/rationing-nurses-realities-practicalities-and-nursing-leadership-theories
#14
Olive Fast, Janet Rankin
In this paper, we examine the practicalities of nurse managers' work. We expose how managers' commitments to transformational leadership are undermined by the rationing practices and informatics of hospital reform underpinned by the ideas of new public management. Using institutional ethnography, we gathered data in a Canadian hospital. We began by interviewing and observing frontline leaders, nurse managers, and expanded our inquiry to include interviews with other nurses, staffing clerks, and administrators whose work intersected with that of nurse managers...
December 25, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/29277137/effects-of-stress-on-critical-care-nurses-a-national-cross-sectional-study
#15
Amir Vahedian-Azimi, Mohammadreza Hajiesmaeili, Mari Kangasniemi, Joana Fornés-Vives, Rita L Hunsucker, Farshid Rahimibashar, Mohammad A Pourhoseingholi, Leily Farrokhvar, Andrew C Miller
BACKGROUND: Health care is a demanding field, with a high level of responsibility and exposure to emotional and physical danger. High levels of stress may result in depression, anxiety, burnout syndrome, and in extreme cases, post-traumatic stress disorder. The aim of this study was to determine which personal, professional, and organizational variables are associated with greater perceived stress among critical care nurses for purposes of developing integrative solutions to decrease stress in the future...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29275350/workflow-interruptions-and-stress-atwork-a-mixed-methods-study-among-physicians-and-nurses-of-a-multidisciplinary-emergency-department
#16
Matthias Weigl, Joana Beck, Markus Wehler, Anna Schneider
OBJECTIVES: Dealing with multiple workflow interruptions is a major challenge in emergency department (ED) work. This study aimed to establish a taxonomy of workflow interruptions that takes into account the content and purpose of interruptive communication. It further aimed to identify associations of workflow interruptions with ED professionals' work stress. DESIGN: Combined data from expert observation sessions and concomitant self-evaluations of ED providers...
December 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29273453/predicting-pediatric-emergency-severity-index-level-based-on-emergency-department-pre-arrival-information
#17
Amber Hyatt, Kristen Carlin, Kimberly Stone
PURPOSE: This study examines the use of phone referral information to predict Emergency Severity Index triage levels as a proxy to anticipate emergency department nursing resource allocation in a pediatric hospital. It also assesses the relationship between these pre-arrival triage levels and hospital admission. DESIGN AND METHODS: Emergency nurses with specialized training used standardized phone referral information to assign triage levels to 481 patients before their arrival...
December 19, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29258521/long-term-trends-in-supply-and-sustainability-of-the-health-workforce-in-remote-aboriginal-communities-in-the-northern-territory-of-australia
#18
Yuejen Zhao, Deborah J Russell, Steven Guthridge, Mark Ramjan, Michael P Jones, John S Humphreys, Timothy A Carey, John Wakerman
BACKGROUND: International evidence suggests that a key to improving health and attaining more equitable health outcomes for disadvantaged populations is a health system with a strong primary care sector. Longstanding problems with health workforce supply and turnover in remote Aboriginal communities in the Northern Territory (NT), Australia, jeopardise primary care delivery and the effort to overcome the substantial gaps in health outcomes for this population. This research describes temporal changes in workforce supply in government-operated clinics in remote NT communities through a period in which there has been a substantial increase in health funding...
December 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29258519/ethical-challenges-experienced-by-uk-military-medical-personnel-deployed-to-sierra-leone-operation-gritrock-during-the-2014-2015-ebola-outbreak-a-qualitative-study
#19
Heather Draper, Simon Jenkins
BACKGROUND: As part of its response to the 2014 Ebola outbreak in west Africa, the United Kingdom (UK) government established an Ebola treatment unit in Sierra Leone, staffed by military personnel. Little is known about the ethical challenges experienced by military medical staff on humanitarian deployment. We designed a qualitative study to explore this further with those who worked in the treatment unit. METHOD: Semi-structured, face-to-face and telephone interviews were conducted with 20 UK military personnel deployed between October 2014 and April 2015 in one of three roles in the Ebola treatment unit: clinician; nursing and nursing assistant; and other medical support work, including infection control and laboratory and mortuary services...
December 19, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29246795/acccn-workforce-standards-for-intensive-care-nursing-systematic-and-evidence-review-development-and-appraisal
#20
Diane Chamberlain, Wendy Pollock, Paul Fulbrook
BACKGROUND: The intensive care nursing workforce plays an essential role in the achievement of positive healthcare outcomes. A growing body of evidence indicates that inadequate nurse staffing and poor skill mix are associated with negative outcomes for patients, and potentially compromises nurses' ability to maintain the safety of those in their care. In Australia, the Australian College of Critical Care Nurses (ACCCN) has previously published a position statement on intensive care staffing...
December 12, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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