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1.
Crit Care Med ; 2021 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-34637424

RESUMO

OBJECTIVES: To determine the impact of coronavirus disease 2019 on burnout syndrome in the multiprofessional ICU team and to identify factors associated with burnout syndrome. DESIGN: Longitudinal, cross-sectional survey. SETTING: All adult ICUs within an academic health system. SUBJECTS: Critical care nurses, advanced practice providers, physicians, respiratory therapists, pharmacists, social workers, and spiritual health workers were surveyed on burnout in 2017 and during the coronavirus disease 2019 pandemic in 2020. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Burnout syndrome and contributing factors were measured using the Maslach Burnout Inventory of Health and Human Service and Areas of Worklife Survey. Response rates were 46.5% (572 respondents) in 2017 and 49.9% (710 respondents) in 2020. The prevalence of burnout increased from 59% to 69% (p < 0.001). Nurses were disproportionately impacted, with the highest increase during the pandemic (58-72%; p < 0.0001) with increases in emotional exhaustion and depersonalization, and personal achievement decreases. In contrast, although burnout was high before and during coronavirus disease 2019 in all specialties, most professions had similar or lower burnout in 2020 as they had in 2017. Physicians had the lowest rates of burnout, measured at 51% and 58%, respectively. There was no difference in burnout between clinicians working in ICUs who treated coronavirus disease 2019 than those who did not (71% vs 67%; p = 0.26). Burnout significantly increased in females (71% vs 60%; p = 0.001) and was higher than in males during the pandemic (71% vs 60%; p = 0.01). CONCLUSIONS: Burnout syndrome was common in all multiprofessional ICU team members prior to and increased substantially during the pandemic, independent of whether one treated coronavirus disease 2019 patients. Nurses had the highest prevalence of burnout during coronavirus disease 2019 and had the highest increase in burnout from the prepandemic baseline. Female clinicians were significantly more impacted by burnout than males. Different susceptibility to burnout syndrome may require profession-specific interventions as well as work system improvements.

2.
J Nurs Adm ; 51(7-8): 362-363, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34405975

RESUMO

This column reviews the concept of humanism in leadership. After surviving a year perceived by many healthcare professionals as the most challenging of a generation, the author reflects on leadership essentials for rebuilding our nursing workforce.


Assuntos
Liderança , Enfermeiras Administradoras/organização & administração , Supervisão de Enfermagem/organização & administração , Inovação Organizacional , Competência Profissional , Atitude do Pessoal de Saúde , Humanos , Relações Interprofissionais
3.
AACN Adv Crit Care ; 31(2): 141-145, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32525995

RESUMO

Burnout, a syndrome resulting from chronic job-related stress in the workplace, is an extensive problem among clinicians working in health care organizations. The 3 dimensions of burnout include emotional exhaustion, depersonalization, and loss of a sense of professional efficacy. Approximately 35% of all nurses experience symptoms of burnout. Critical care nurses are at risk for chronic job stress because of the complexity and pace of the critical care environment. Addressing the individual and systems-related factors that stem from the work environment is essential in order to achieve well-being among all clinicians. Strategies aimed at fostering individual resilience and well-being must be coupled with systemic solutions that create a work environment that removes impediments to ethically grounded practice, restores fulfillment achieved in clinical practice, and fosters resilience and well-being.


Assuntos
Esgotamento Profissional/prevenção & controle , Enfermagem de Cuidados Críticos/normas , Guias como Assunto , Promoção da Saúde/métodos , Estresse Psicológico/prevenção & controle , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
4.
J Nurs Adm ; 50(5): 243-244, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32317564

RESUMO

Innovations in patient care, nursing, and the practice environment are hallmarks of organizations receiving American Nurses Credentialing Center (ANCC) Magnet Recognition. In this month's "Magnet Perspectives" column, the chair and vice-chair of ANCC's Commission on Magnet Recognition examine the growing importance of nursing research on patient care and outcomes and the role of Magnet hospitals as research pacesetters for the nursing profession. The authors discuss the critical difference between research and evidence-based practice, why both are important, and how organizations can develop the structures and processes to inspire and advance a robust culture of clinical inquiry.


Assuntos
Pesquisa em Enfermagem , Credenciamento , Enfermagem Baseada em Evidências , Humanos , Sociedades de Enfermagem , Estados Unidos
6.
Nurs Adm Q ; 43(2): 157-163, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30839452

RESUMO

Development of healthy professional practice/work environments (PPWEs) for nursing practice is critical to optimizing patient safety and workforce satisfaction while limiting turnover. Healthy PPWEs are linked with improved outcomes for patients, the workforce, and organizations. Nurses constitute the greatest professional segment of the US health care workforce and influence PPWEs, patient experience, health care quality, and cost per capita, all aspects of the quadruple aim. This article shares a model of leadership identified by executive nurse leaders to address and foster healthy PPWEs. A focus group of 16 expert nurse leaders convened an invitational meeting in Richmond, Virginia, to discuss nurse leaders' roles in optimizing the quadruple aim. The discussions led to shared perceptions about the prevalence of barriers to optimizing PPWEs; nursing leaders' responsibility to address the barriers to supporting improvement of the work-life of nursing professionals; and the need for early integration of leadership education, theory, and practice in every nurse's career.


Assuntos
Liderança , Enfermeiras Administradoras , Papel do Profissional de Enfermagem , Prática Profissional , Local de Trabalho , Benchmarking , Humanos
9.
Nurs Adm Q ; 42(1): 54-61, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29194333

RESUMO

There is no escaping the fact that the ability to skillfully influence change is a requirement for nurse leaders. This need is intensified as the national health care system reforms and as the morphology of health care systems continues to change, especially in academic health care systems. The purpose of this article was 2-fold. The first objective was to relay the experience of the integration of nursing practice, education, and research within an academic health care system. The second was to, through this story of integration, expose the uniqueness and importance of nurse leader roles influencing innovation across a multisystem enterprise to fulfill the organization's mission.


Assuntos
Prioridades em Saúde , Liderança , Enfermeiras Administradoras , Inovação Organizacional , Humanos , Papel do Profissional de Enfermagem
11.
Nurs Econ ; 33(2): 73-8, 87; quiz 79, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26281277

RESUMO

The presence of hospital-acquired conditions, infections, or other adverse events are a reflection of inadequate patient safety and can have short and long-term impacts of quality of life for patients as well as financial implications for the hospital. Using unit-level information to develop a tool, the Patient Risk Assessment Profile, nurses on an inpatient surgical unit proactively assessed patient risk to guide staffing decisions and nurse-patient assignment with the goal to improve patient value, reduce adverse events, and avoid unnecessary hospital costs. Findings showed decreased adverse event rates for patient falls, catheter-acquired urinary tract infection, central line-acquired blood stream infection, and pressure ulcer prevalence after the intervention was implemented. In addition, end-of-shift over-time and patient cost per case decreased as well yielding an operational impact in hospital financial performance.


Assuntos
Infecções Relacionadas a Cateter/economia , Redução de Custos/economia , Recursos Humanos de Enfermagem no Hospital/provisão & distribuição , Segurança do Paciente/economia , Admissão e Escalonamento de Pessoal/economia , Gestão de Riscos/organização & administração , Acidentes por Quedas/economia , Acidentes por Quedas/prevenção & controle , Infecções Relacionadas a Cateter/prevenção & controle , Técnicas de Apoio para a Decisão , Economia da Enfermagem , Educação Continuada em Enfermagem , Humanos , Projetos Piloto , Lesão por Pressão/economia , Lesão por Pressão/prevenção & controle , Fatores de Risco , Sepse/economia , Sepse/prevenção & controle , Estados Unidos , Infecções Urinárias/economia , Infecções Urinárias/prevenção & controle
12.
Nurs Adm Q ; 37(2): 122-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23454991

RESUMO

This era of health care reform calls for the ability of hospitals to provide quality patient care while managing costs. Nursing practice is a key determinant of patient care quality and associated costs, or simply put, creating value. The value of nursing has been addressed by multiple qualified authors, yet there is no clear, consistent meaning of the term. Researchers and authors have developed some theoretical foundation for the concept of value, which evolved into important research questions that establish value as an important outcome that is sensitive to nursing practice. The opportunity to attend 2 sessions at the Harvard Business School on health care value has prompted the need for nursing to adapt to common thinking on health care value and establish its meaning for the nursing profession. This report summarizes the nursing literature on value, reflects on the executive education, and proposes direction for nursing leaders in education and practice.


Assuntos
Economia da Enfermagem , Custos de Cuidados de Saúde , Avaliação de Resultados em Cuidados de Saúde/economia , Controle de Custos , Reforma dos Serviços de Saúde , Humanos , Estados Unidos
15.
J Nurs Adm ; 38(5): 230-6, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18469616

RESUMO

OBJECTIVE: The aim of this study was to describe the methodology for nursing leaders to determine the cost of adverse events and effective levels of nurse staffing. BACKGROUND: The growing transparency of quality and cost outcomes motivates healthcare leaders to optimize the effectiveness of nurse staffing. Most hospitals have robust cost accounting systems that provide actual patient-level direct costs. These systems allow an analysis of the cost consumed by patients during a hospital stay. By knowing the cost of complications, leaders have the ability to justify the cost of improved staffing when quality evidence shows that higher nurse staffing improves quality. METHODS: An analysis was performed on financial and clinical data from hospital databases of 3,200 inpatients. The purpose was to establish a methodology to determine actual cost per case. Three diagnosis-related groups were the focus of the analysis. Five adverse events were analyzed along with the costs. RESULTS: A regression analysis reported that the actual direct cost of an adverse event was dollars 1,029 per case in the congestive heart failure cases and dollars 903 in the surgical cases. There was a significant increase in the cost per case in medical patients with urinary tract infection and pressure ulcers and in surgical patients with urinary tract infection and pneumonia. The odds of pneumonia occurring in surgical patients decreased with additional registered nurse hours per patient day. CONCLUSION: Hospital cost accounting systems are useful in determining the cost of adverse events and can aid in decision making about nurse staffing. Adverse events add costs to patient care and should be measured at the unit level to adjust staffing to reduce adverse events and avoid costs.


Assuntos
Custos Hospitalares/estatística & dados numéricos , Erros Médicos/economia , Recursos Humanos de Enfermagem no Hospital/organização & administração , Admissão e Escalonamento de Pessoal/economia , Indicadores de Qualidade em Assistência à Saúde/economia , Qualidade da Assistência à Saúde/economia , Acidentes por Quedas/economia , Contabilidade/organização & administração , Adulto , Análise de Variância , Análise Custo-Benefício , Infecção Hospitalar/economia , Feminino , Humanos , Modelos Logísticos , Masculino , Erros Médicos/enfermagem , Pessoa de Meia-Idade , Pesquisa em Administração de Enfermagem , Recursos Humanos de Enfermagem no Hospital/educação , Avaliação de Resultados em Cuidados de Saúde , Lesão por Pressão/economia , Análise de Regressão , Estudos Retrospectivos , Risco Ajustado , Sensibilidade e Especificidade , Carga de Trabalho/economia
16.
J Nurs Adm ; 37(1): 32-40, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17172970

RESUMO

There is limited financial evidence describing the relationship between nursing staffing and patient care costs. In this analysis, the body of knowledge relating costs to nursing practice is described and critiqued. An improved method of describing costs of patient care is presented, and a comparison of costs using each approach illustrates how the magnitude of cost variation between 2 patients differs based on the approach used.


Assuntos
Assistência ao Paciente/economia , Custos e Análise de Custo , Economia da Enfermagem , Honorários Médicos , Hospitalização/economia , Reembolso de Seguro de Saúde , Estados Unidos
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