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https://www.readbyqxmd.com/read/28534543/-evolution-of-patient-safety-culture-in-a-medium-stay-hospital-monitoring-indicators
#1
M J Merino-Plaza, F J Carrera-Hueso, M Castillo-Blasco, A Martínez-Asensi, R Martínez-Capella, N Fikri-Benbrahim
BACKGROUND: Patient safety is a challenge for health care. The aim of this study is to identify the dimensions with the greatest impact on patient safety culture of healthcare staff in a medium-stay hospital; to asses its evolution over time and to check the sensitivity of monitoring indicators. METHODS: Two cross-sectional studies (2013 to 2015) were conducted. The safety culture assessment tool used was the Spanish version of the "Hospital Survey on Patient Safety" (AHRQ)...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28515601/quality-indicators-compliance-survey-in-indian-intensive-care-units
#2
Munta Kartik, Palepu B N Gopal, Rahul Amte
CONTEXT: The quality of health care and outcomes of Intensive Care Unit (ICU) have been a major subject of discussion in the past decade. Quality indicators in ICUs maintain an order of uniformity and standard care of delivery across ICUs. AIMS: In this study, we tried to analyze the percentage compliance of quality indicators in ICU across our country. METHODS: Four hundred complete questionnaire forms were collected in two stages by means of conducting a survey and through email responses to the survey questionnaire...
April 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28492412/patients-in-prehospital-transport-to-the-emergency-department-a-cohort-study-of-risk-factors-for-7-day-mortality
#3
Camilla L Noergaard Bech, Mikkel Brabrand, Søren Mikkelsen, Annmarie Lassen
BACKGROUND: Ambulance transfer is the first contact with the healthcare system for many patients in emergency conditions.We aimed to identify prognostic risk factors accessible in the prehospital phase that indicate an increased risk of 7-day mortality. PATIENTS AND METHODS: We included patients aged 18 years or older, transferred by ambulance to the emergency department at Odense University Hospital, from 1 April 2012 to 30 September 2014. We carried out multivariate logistic regressions, adjusted for age and sex, to describe the relationship between vital sign values recorded in the prehospital setting and 7-day mortality...
May 10, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28485906/-complexity-of-care-and-organizational-effectiveness-a-survey-among-medical-care-units-in-nine-lombardy-region-hospitals
#4
Sara Pasquali, Enrica Capitoni, Giuseppina Tiraboschi, Adriana Alborghetti, Giuseppe De Luca, Stefania Di Mauro
AIM: Eleven medical care units of nine Lombardy Region hospitals organized by levels of care model or by the traditional departmental model have been analyzed, in order to evaluate if methods for complexity of patient-care evaluation represent an index factor of nursing organizational effectiveness. METHOD: Survey with nine Nurses in managerial position was conducted between Nov. 2013-Jan. 2014. The following factors have been described: context and nursing care model, staffing, complexity evaluation, patient satisfaction, staff well-being...
January 2017: Professioni Infermieristiche
https://www.readbyqxmd.com/read/28481826/the-impact-of-nurse-staffing-on-in-hospital-mortality-of-stroke-patients-in-korea
#5
Wankyo Chung, Min Sohn
BACKGROUND: Stroke is one of the leading causes of death in Korea, and a well-qualified, adequate nursing force achieves better patient outcomes. STUDY PURPOSES: This study examined the association between nurse staffing and in-hospital mortality among stroke patients in a nationally representative sample. METHODS: This cross-sectional retrospective study was conducted using 2009 National Health Insurance claims data of stroke patients admitted to variously sized Korean hospitals...
May 5, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28471925/improving-staffing-and-nurse-engagement-in-a-neuroscience-intermediate-unit
#6
Charles Nadolski, Pheraby Britt, Leah C Ramos
The neuroscience intermediate unit is a 23-bed unit that was initially staffed with a nurse-to-patient ratio of 1:4 to 1:5. In time, the unit's capacity to care for the exceeding number of progressively acute patients fell short of the desired goals in the staff affecting the nurse satisfaction. The clinical nurses desired a lower nurse-patient ratio. The purpose of this project was to justify a staffing increase through a return on investment and increased quality metrics. METHODS: This initiative used mixed methodology to determine the ideal staffing for a neuroscience intermediate unit...
June 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28466462/are-high-nurse-workload-staffing-ratios-associated-with-decreased-survival-in-critically-ill-patients-a-cohort-study
#7
Anna Lee, Yip Sing Leo Cheung, Gavin Matthew Joynt, Czarina Chi Hung Leung, Wai-Tat Wong, Charles David Gomersall
BACKGROUND: Despite the central role of nurses in intensive care, a relationship between intensive care nurse workload/staffing ratios and survival has not been clearly established. We determined whether there is a threshold workload/staffing ratio above which the probability of hospital survival is reduced and then modeled the relationship between exposure to inadequate staffing at any stage of a patient's ICU stay and risk-adjusted hospital survival. METHODS: Retrospective analysis of prospectively collected data from a cohort of adult patients admitted to two multi-disciplinary Intensive Care Units was performed...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28466290/-evaluation-of-care-conditions-in-intensive-care-units-results-of-an-online-questionnaire-of-critical-care-nurses
#8
REVIEW
M Isfort
In the following article, selected results of a descriptive study on personnel staffing and patients' care in intensive care units in Germany are presented and discussed. The main focus is laid on comparing features of personnel staffing with indicators of job satisfaction and patients' care. The study is based on an online questionnaire of critical care nurses run in 2017. The article represents the data of 2233 included German critical care nurses. The main results are the following: a low nurse patient ratio (≥1:3) in intensive care units has the tendency to cause higher risks in patients' care and shows lower job satisfaction than nurses with higher nurse-patient ratio (≤1:2)...
May 2, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28455091/differences-in-test-ordering-between-nurse-practitioners-and-attending-emergency-physicians-when-acting-as-provider-in-triage
#9
Tomer Begaz, David Elashoff, Tristan R Grogan, David Talan, Breena R Taira
STUDY OBJECTIVES: To compare diagnostic test ordering practices of NPs with those of physicians in the role of Provider in Triage (PIT). METHODS: This was a secondary analysis of data from a prospective RCT of waiting room diagnostic testing, where 770 patients had diagnostic studies ordered from the waiting room. The primary outcome was the number of test categories ordered by provider type. Other outcomes included total tests ordered by the end of ED stay, and time in an ED bed...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28398697/effects-of-targeting-lower-versus-higher-arterial-oxygen-saturations-on-death-or-disability-in-preterm-infants
#10
REVIEW
Lisa M Askie, Brian A Darlow, Peter G Davis, Neil Finer, Ben Stenson, Maximo Vento, Robin Whyte
BACKGROUND: The use of supplemental oxygen in the care of extremely preterm infants has been common practice since the 1940s. Despite this, there is little agreement regarding which oxygen saturation (SpO₂) ranges to target to maximise short- or long-term growth and development, while minimising harms. There are two opposing concerns. Lower oxygen levels (targeting SpO₂ at 90% or less) may impair neurodevelopment or result in death. Higher oxygen levels (targeting SpO₂ greater than 90%) may increase severe retinopathy of prematurity or chronic lung disease...
April 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28388827/relationships-between-nurse-staffing-and-patients-experiences-and-the-mediating-effects-of-missed-nursing-care
#11
Sung-Hyun Cho, Barbara A Mark, George Knafl, Hyoung Eun Chang, Hyo-Jeong Yoon
PURPOSE: The aims of this study were to examine the relationships between nurse staffing and patients' experiences, and to determine the mediating effects of patient-reported missed care on the relationship between nurse staffing and patients' experiences. DESIGN: The study included 362 nurses and 208 patients from 23 nursing units of six hospitals in South Korea. METHODS: Nurse staffing was measured by patient-to-nurse ratios and by nurse- and patient-perceived staffing adequacy...
May 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28380716/dietary-service-staffing-impact-nutritional-quality-in-nursing-homes
#12
Kelly M Smith, Kali S Thomas, Shanthi Johnson, Hongdao Meng, Kathryn Hyer
OBJECTIVE: To examine the relationship between dietary service staff and dietary deficiency citations in nursing homes (NHs). METHOD: 2007-2011 Online Survey and Certification and Reporting data for 14,881 freestanding NHs were used to examine the relationship between dietary service staff and the probability of receiving a dietary service-related deficiency citation. An unconditional logit model with random effects was employed. RESULTS: Findings suggest that higher staffing levels for dietitians (odds ratio [OR] = ...
January 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28376546/association-of-nursing-overtime-nurse-staffing-and-unit-occupancy-with-health-care-associated-infections-in-the-nicu
#13
Marc Beltempo, Régis Blais, Guy Lacroix, Michèle Cabot, Bruno Piedboeuf
Objective This study aims to assess the association of nursing overtime, nurse staffing, and unit occupancy with health care-associated infections (HCAIs) in the neonatal intensive care unit (NICU). Study Design A 2-year retrospective cohort study was conducted for 2,236 infants admitted in a Canadian tertiary care, 51-bed NICU. Daily administrative data were obtained from the database "Logibec" and combined to the patient outcomes database. Median values for the nursing overtime hours/total hours worked ratio, the available to recommended nurse staffing ratio, and the unit occupancy rate over 3-day periods before HCAI were compared with days that did not precede infections...
April 4, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28375852/postoperative-complications-and-outcomes-associated-with-a-transition-to-24-7-intensivist-management-of-cardiac-surgery-patients
#14
Marc A Benoit, Sean M Bagshaw, Colleen M Norris, Mohamad Zibdawi, Wu Dat Chin, David B Ross, Sean van Diepen
OBJECTIVES: Nighttime intensivist staffing does not improve patient outcomes in general ICUs. Few studies have examined the association between dedicated in-house 24/7 intensivist coverage on outcomes in specialized cardiac surgical ICUs. We sought to evaluate the association between 24/7 in-house intensivist-only management of cardiac surgical patients on postoperative complications and health resource utilization. DESIGN: Before-and-after propensity matched cohort study...
April 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28348492/hospital-resource-intensity-and-cirrhosis-mortality-in-united-states
#15
Amit K Mathur, Apurba K Chakrabarti, Jessica L Mellinger, Michael L Volk, Ryan Day, Andrew L Singer, Winston R Hewitt, Kunam S Reddy, Adyr A Moss
AIM: To determine whether hospital characteristics predict cirrhosis mortality and how much variation in mortality is attributable to hospital differences. METHODS: We used data from the 2005-2011 Nationwide Inpatient Sample and the American Hospital Association Annual survey to identify hospitalizations for decompensated cirrhosis and corresponding facility characteristics. We created hospital-specific risk and reliability-adjusted odds ratios for cirrhosis mortality, and evaluated patient and facility differences based on hospital performance quintiles...
March 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28340503/risk-factors-for-lymph-node-metastases-in-women-with-endometrial-cancer-a-population-based-nation-wide-register-study-on-behalf-of-the-swedish-gynecological-cancer-group
#16
K Stålberg, P Kjølhede, M Bjurberg, C Borgfeldt, P Dahm-Kähler, H Falconer, E Holmberg, C Staf, B Tholander, E Åvall-Lundqvist, P Rosenberg, T Högberg
The role of lymphadenectomy in the management of early endometrial cancer remains controversial. In the recent ESMO-ESGO-ESTRO guidelines, lymphadenectomy is recommended for patients with endometrioid adenocarcinoma Grade 3 with deep myometrial invasion, but complete agreement was not achieved. In Sweden, DNA aneuploidy has been included as a high-risk factor. The aim of our study was to evaluate the impact of tumor histology, FIGO grade, DNA ploidy and myometrial invasion (MI) on occurrence of lymph node metastasis (LNM) in patients with endometrial cancer...
March 24, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28336014/clinical-significance-of-fibrinogen-degradation-product-among-traumatized-patients
#17
Kouhei Ishikawa, Kazuhiko Omori, Kei Jitsuiki, Hiromichi Ohsaka, Hiroshi Ito, Katsuhito Shimoyama, Toru Fukunaga, Norikazu Urabe, Souichirou Kitamura, Youichi Yanagawa
OBJECTIVE: We retrospectively analyzed trauma patients who were transported by a physician-staffed helicopter (doctor helicopter) to investigate the clinical significance of the fibrinogen degradation product (FDP) level on arrival. METHODS: From February 2011 to July 2016, a medical chart review was retrospectively performed for all patients with trauma who were transported by the doctor helicopter. The subjects were divided into 2 groups: a survival group and a fatal group...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28294028/only-mandated-ratios-will-enable-proper-workforce-planning
#18
Susan Osborne
On 7 February, NHS staff were asked by Unison to record nurse-to-patient ratios as part of the union's sixth annual safe staffing survey.
March 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28288172/the-impact-of-an-intervention-to-introduce-malaria-rapid-diagnostic-tests-on-fever-case-management-in-a-high-transmission-setting-in-uganda-a-mixed-methods-cluster-randomized-trial-prime
#19
Clare I R Chandler, Emily L Webb, Catherine Maiteki-Sebuguzi, Susan Nayiga, Christine Nabirye, Deborah D DiLiberto, Emmanuel Ssemmondo, Grant Dorsey, Moses R Kamya, Sarah G Staedke
BACKGROUND: Rapid diagnostic tests for malaria (mRDTs) have been scaled-up widely across Africa. The PRIME study evaluated an intervention aiming to improve fever case management using mRDTs at public health centers in Uganda. METHODS: A cluster-randomized trial was conducted from 2010-13 in Tororo, a high malaria transmission setting. Twenty public health centers were randomized in a 1:1 ratio to intervention or control. The intervention included training in health center management, fever case management with mRDTs, and patient-centered services; plus provision of mRDTs and artemether-lumefantrine (AL) when stocks ran low...
2017: PloS One
https://www.readbyqxmd.com/read/28275860/parameters-affecting-length-of-stay-in-a-pediatric-emergency-department-a-retrospective-observational-study
#20
Kevin D Hofer, Rotraud K Saurenmann
Prolonged emergency department (ED) length of stay (LOS) is used as a proxy for ED overcrowding and is associated with adverse outcomes of patients requiring therapy and reduced patient satisfaction. Our aim was to identify and quantify variables which affect ED-LOS. Patients admitted to the pediatric ED of a large regional Swiss hospital during a 1-year period were analyzed for LOS (in minutes). Predictor variables included patient-associated parameters (time of admission and discharge, ED occupancy, triage score, diagnosis, and demographic data) and external factors (weekday, time, and season)...
May 2017: European Journal of Pediatrics
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