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1.
BMC Palliat Care ; 20(1): 155, 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34641826

RESUMO

BACKGROUND: Provision of palliative care to individuals with late-stage serious illnesses is critical to reduce suffering. Palliative care is slowly gaining momentum in Jamaica but requires a highly skilled workforce, including nurses. Out-migration of nurses to wealthier countries negatively impacts the delivery of health care services and may impede palliative care capacity-building. This critical review aimed to explore the evidence pertaining to the nurse migration effect on the integration of palliative care services in Jamaica and to formulate hypotheses about potential mitigating strategies. METHODS: A comprehensive search in the PubMed, CINAHL, and ProQuest PAIS databases aimed to identify articles pertinent to nurse migration in the Caribbean context. Grant and Booth's methodologic framework for critical reviews was used to evaluate the literature. This methodology uses a narrative, chronologic synthesis and was guided by the World Health Organization (WHO) Public Health Model and the Model of Sustainability in Global Nursing. RESULTS: Data from 14 articles were extracted and mapped. Poorer patient outcomes were in part attributed to the out-migration of the most skilled nurses. 'Push-factors' such as aggressive recruitment by wealthier countries, lack of continuing educational opportunities, disparate wages, and a lack of professional autonomy and respect were clear contributors. Gender inequalities negatively impacted females and children left behind. Poor working conditions were not necessarily a primary reason for nurse migration. Four main themes were identified across articles: (a) globalization creating opportunities for migration, (b) recruitment of skilled professionals from CARICOM by high income countries, (c) imbalance and inequities resulting from migration, and (d) mitigation strategies. Thirteen articles suggested education, partnerships, policy, and incentives as mitigation strategies. Those strategies directly align with the WHO Public Health Model drivers to palliative care integration. CONCLUSION: Emerged evidence supports that nurse migration is an ongoing phenomenon that strains health systems in Caribbean Community and Common Market (CARICOM) countries, with Jamaica being deeply impacted. This critical review demonstrates the importance of strategically addressing nurse migration as part of palliative care integration efforts in Jamaica. Future studies should include targeted migration mitigation interventions and should be guided by the three working hypotheses derived from this review.

2.
J Nurs Care Qual ; 2021 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-34611108

RESUMO

BACKGROUND: COVID-19 negatively impacts many organ systems including the skin. One of the most significant skin-associated adverse events related to hospitalization are pressure injuries. PURPOSE: The aim of this study was to determine 8 risk factors that would place hospitalized patients at a higher risk for hospital-acquired pressure injuries (HAPIs) during the COVID-19 pandemic. METHODS: A retrospective, descriptive analysis was conducted in an urban academic health science center located in the southeastern United States. RESULTS: There were 247 of 23 093 patients who had pressure injuries and 1053 patients who had a positive COVID-19 diagnosis. Based on the generalized estimating equation model, diagnosis of COVID-19, age, male gender, risk of mortality, severity of illness, and length of stay are statistically significant factors associated with the development of HAPIs. CONCLUSIONS: Further study should explore pathology of COVID-19 skin changes and what interventions are effective against HAPIs in the COVID-19 population taking into consideration current treatments.

3.
J Nurs Meas ; 2021 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-34518401

RESUMO

BACKGROUND AND PURPOSE: In two previous studies, the Certified Registered Nurse Anesthetist (CRNA) Workload Perception Scale (CWPS) was developed. The purpose of this paper is to report the final psychometric validation of the CWPS. METHODS: An 11-item CWPS was tested in a population of CRNAs. Classical psychometrics were performed on the 11-item instrument piloted in a sample of 393 CRNAs. RESULTS: Parametric and nonparametric analysis indicated 7 of 11 items were a good fit to measure perception of workload. CONCLUSIONS: A revised 7-item final CWPS was developed.

4.
Nurs Open ; 8(3): 1005-1022, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34482649

RESUMO

AIM: To provide a systematic review of the literature from 1997 to 2017 on nursing-sensitive indicators. DESIGN: A qualitative design with a deductive approach was used. DATA SOURCES: Original and Grey Literature references from Cochrane Library, Medline/PubMed, Embase, and CINAHL, Google Scholar Original and Grey Literature. REVIEW METHODS: Quality assessment was performed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. RESULTS: A total of 3,633 articles were identified, and thirty-nine studies met the inclusion criteria. The quantitative assessment of investigated relationships in these studies suggests that nursing staffing, mortality, and nosocomial infections were the most frequently reported nursing-sensitive indicators. CONCLUSION: This review provides a comprehensive list of nursing-sensitive indicators, their frequency of use, and the associations between these indicators and various outcome variables. Stakeholders of nursing research may use the findings to streamline the indicator development efforts and standardization of nursing-sensitive indicators. IMPACT: This review provides evidence-based results that health organizations can benefit from nursing care quality.


Assuntos
Cuidados de Enfermagem , Pesquisa em Enfermagem , Recursos Humanos de Enfermagem , Estudos Transversais , Humanos , MEDLINE
5.
ANS Adv Nurs Sci ; 2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34387213

RESUMO

African American women experience higher lifetime exposure to chronic stressors, such as perceived racial discrimination. Clearly defining perceived racial discrimination in the pregnant African American population has the potential to better explain the phenomenon and how it relates to adverse birth outcomes such as preterm birth. The purpose of this concept analysis is to more clearly define perceived racial discrimination in the pregnant African American population using Rodgers' evolutionary method. Defining the concept of interest has the potential to uncover modifiers that may help close the gap in the Black-White infant mortality rates in the United States.

6.
J Nurs Care Qual ; 2021 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-34149033

RESUMO

BACKGROUND: Burnout impacts nurses' health as well as brain structures and functions including cognitive function, which could lead to work performance and patient safety issues. Yet, few organization-level factors related to patient safety have been identified. PURPOSE: This study examined nurse-reported patient safety grade and its relationship to both burnout and the nursing work environment. METHODS: A cross-sectional electronic survey was conducted among nurses (N = 928) in acute care Alabama hospitals. RESULTS: In multilevel ordinal mixed-effects models with nurses nested within hospitals, all burnout dimensions of the Copenhagen Burnout Inventory (OR for +1 SD ranging 0.63-0.78; P < .05) and work environment (OR for +1 SD ranging 4.35-4.89; P < .001) were related to the outcome of patient safety grade after controlling for nurse characteristics. CONCLUSIONS: Results indicate that health care organizations may reduce negative patient safety ratings by reducing nurse burnout and improving the work environment at the organization level.

7.
Nurs Forum ; 2021 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-34056718

RESUMO

AIM: To provide an analysis of the concept of medication errors that occur during the nursing task of medication administration. BACKGROUND: Medication errors occurring during medication administration have an increased risk for an adverse patient outcome. Many terms are associated with medication errors, with limited clarification for a medication administration error at the point of care delivery. DATA SOURCES: Twenty-seven sources were chosen from database searches of PubMed, CINAHL, EMBASE, and Scopus. Key search terms used to narrow the search consist of the following terminology: ("bedside" OR "point-of-care" OR "nursing care*") AND "medication administration errors" AND ("acute care"). REVIEW METHODS: Rodger's evolutionary method of concept analysis was used to clarify the concept of medication administration error. RESULTS: The concept analysis identified three attributes of a medication administration error: nurse-provided care, administration, and point of care. Antecedents identified in the analysis are organizational factors and nurse factors. Consequences identified in the analysis are patient, nurse and organizational themes. CONCLUSION: The continued occurrence of medication administration errors warrants the need for an investigation into existing safety measures. Using this concept analysis may help guide the study of the healthcare environment and determine empirical measures to assess the impact that a medication administration error has.

8.
J Healthc Qual ; 43(3): 137-144, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33955955

RESUMO

ABSTRACT: The impact of COVID-19, on the health and safety of patients, staff, and healthcare organizations, has yet to be fully uncovered. Patient adverse events, such as hospital-acquired pressure injuries (HAPIs), have been problematic for decades. The introduction of a pandemic to an environment that is potentially at-risk for adverse events may result in unintended patient safety and quality concerns. We use the learning health system framework to motivate our understanding of the impact of the COVID-19 pandemic on the incidence of HAPIs within our health system. Using a retrospective, observational design, we used descriptive statistics to evaluate trends in HAPI from March to July 2020. Hospital-acquired pressure injury numbers have fluctuated from a steady increase from March-May 2020, hitting a peak high of 90 cases in the month of May. However, the trend in the total all stage HAPIs began to decline in June 2020, with a low of 51 in July, the lowest number since March 2020. Patients evaluated in this study did not have a longitudinal increase in HAPIs from March-July 2020 during the COVID-19 pandemic, despite similarities in illness severity between the two time points. Our experience has demonstrated the ability of our organizational leaders to learn quickly during crisis.


Assuntos
COVID-19/epidemiologia , Doença Iatrogênica/epidemiologia , Lesão por Pressão/epidemiologia , Centros Médicos Acadêmicos , Adulto , Idoso , Feminino , Hospitais Urbanos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sudeste dos Estados Unidos/epidemiologia
9.
West J Nurs Res ; : 193945921994158, 2021 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-33745388

RESUMO

Quality improvement is paramount for patient safety. Leading change for quality improvement requires nurses with knowledge and skills beyond the clinical management of patients. In this study, staff nurses working in hospitals throughout Alabama were asked via an online survey to rate their quality improvement knowledge and skills using the new 10-item Quality Improvement Self-Efficacy Inventory (QISEI) and their perceptions of the nursing work environment using the Practice Environment Scale of the Nursing Work Index. Nurses (N = 886) rated the basic quality improvement items higher than the more advanced items. Several nurse characteristics and the nursing work environment were associated with nurses' ratings of their quality improvement knowledge and skills. Educators and administrators in health care organizations can use QISEI to gauge their nurses' knowledge and skills and then develop continuous professional development opportunities aimed at improving quality and safety competencies.

10.
Res Nurs Health ; 44(2): 308-318, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33598963

RESUMO

Worldwide, nurses have been reporting high levels of burnout. Given the high prevalence of nurse burnout, measurements of burnout need to be carefully considered for their validity and reliability. Our research team used a relatively new instrument to measure burnout among nurses: the Copenhagen Burnout Inventory (CBI). This 19-item instrument measures burnout in three dimensions: Personal, Work-related, and Client-related Burnout. However, the psychometric properties of the CBI have not been examined in nurses. Thus, the purpose of this study was to determine the psychometric properties of the CBI in a state-wide survey of inpatient staff nurses. A total of 928 registered nurses working in Alabama-area hospitals (N = 42 hospitals) participated in this study. Confirmatory factor analysis resulted in an adequate fit to the data and supported construct validity. As evidence of convergent validity, the CBI was moderately to highly correlated with measures of the overall work environment, job satisfaction, and intent to leave, in the anticipated directions. The Cronbach's alphas for Personal Burnout, Work-related Burnout, and Client-related Burnout were 0.91, 0.89, and 0.92, respectively, demonstrating excellent internal consistency reliability for the subscales. Based on our data, the CBI demonstrates adequate validity and reliability for measuring burnout among frontline nurses. As nurses provide care to the most vulnerable patients in healthcare systems, their psychological well-being is important due to the impact on quality of care on patient outcomes. The availability of the CBI on its website allows nurses, nurse managers, and researchers to evaluate burnout in a variety of nursing populations with no licensing costs.


Assuntos
Esgotamento Profissional/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Psicometria , Adulto , Idoso , Alabama , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto Jovem
11.
Res Nurs Health ; 44(2): 319-328, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33634480

RESUMO

Efforts to decrease nurse-reported workplace bullying (WPB) is an interest among researchers, nursing leaders, and healthcare organizations. Varying conceptual definitions and measurement approaches of WPB, however, have created barriers for researchers to provide reliable and consistent information regarding WPB. In this paper, the authors aim to (1) evaluate the reliability and construct validity of the Short Negative Acts Questionnaire (SNAQ) in a sample of U.S. nurses working in hospitals located throughout Alabama, (2) determine targets and non-targets of WPB, and (3) evaluate the criterion validity of the SNAQ based on WPB classification. The internal consistency reliability and construct validity of the SNAQ in 943 Alabama registered nurses was evaluated using Cronbach's α and confirmatory factor analysis. An exploratory factor analysis was conducted to explore the underlying structure of the SNAQ. Targets and non-targets of WPB were identified using latent class analysis of the SNAQ and by the self-labeling item. Agreement between the two methods was evaluated with Cohen's κ. Using both methods, the association between WPB classification and outcomes empirically associated with nurse-reported WPB was evaluated with random effects multiple logistic regression to determine criterion validity. The results indicate that the SNAQ is a reliable and valid instrument to explore WPB in a sample of U.S. registered nurses working in hospitals throughout Alabama.


Assuntos
Bullying/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital , Inquéritos e Questionários , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estados Unidos , Adulto Jovem
12.
J Healthc Qual ; 43(1): 13-23, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33394839

RESUMO

BACKGROUND: Every one out of 10 nurses reported suffering from high levels of burnout worldwide. It is unclear if burnout affects job performance, and in turn, impairs patient safety, including medication safety. The purpose of this study is to determine whether nurse burnout predicts self-reported medication administration errors (MAEs). METHODS: A cross-sectional study using electronic surveys was conducted from July 2018 through January 2019, using the Copenhagen Burnout Inventory. Staff registered nurses (N = 928) in acute care Alabama hospitals (N = 42) were included in this study. Descriptive statistics, correlational, and multilevel mixed-modeling analyses were examined. RESULTS: All burnout dimensions (Personal, Work-related, and Client-related Burnout) were significantly correlated with age (r = -0.17 to -0.21), years in nursing (r = -0.10 to -0.17), years of hospital work (r = -0.07 to -0.10), and work environment (r = -0.24 to -0.57). The average number of self-reported MAEs in the last 3 months was 2.13. Each burnout dimension was a statistically significant predictor of self-reported MAEs (p < .05). CONCLUSIONS: Nurse burnout is a significant factor in predicting MAEs. This study provides important baseline data for actionable interventions to improve nursing care delivery, and ultimately health care, for Alabamians.


Assuntos
Esgotamento Profissional/psicologia , Cuidados Críticos/estatística & dados numéricos , Hospitais Especializados/estatística & dados numéricos , Erros de Medicação/psicologia , Erros de Medicação/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital/psicologia , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Adulto , Idoso , Alabama , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Inquéritos e Questionários , Adulto Jovem
13.
Acad Med ; 96(1): 68-74, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-32769476

RESUMO

Despite the need for leaders in health care improvement across health professions, there are no standards for the knowledge and skills that should be achieved through advanced interprofessional health care improvement training. Existing health care improvement training competencies focus on foundational knowledge expected of all trainees or for specific career pathways. Health care improvement leaders fill multiple roles within organizations and promote interprofessional improvement practice. The diverse skill set required of modern health care improvement leaders necessitates the development of training competencies specifically for fellowships in applied health care improvement. The authors describe the development of the revised national Veterans Affairs Quality Scholars (VAQS) Program competencies. The VAQS Program is an interprofessional, postdoctoral training program whose mission is to develop leaders and scholars to improve health care. An interprofessional committee of VAQS faculty reviewed and revised the competencies over 4 months beginning in fall 2018. The first draft was developed using 111 competencies submitted by 11 VAQS training sites and a review of published competencies. The final version included 22 competencies spanning 5 domains: interprofessional collaboration and teamwork, improvement and implementation science, organization and system leadership, methodological skills and analytic techniques for improvement and research, and teaching and coaching. Once attained, the VAQS competencies will guide the skill development that interprofessional health care improvement leaders need to participate in and lead health care improvement scholarship and implementation. These broad competencies are relevant to advanced training programs that develop health care improvement leaders and scholars and may be used by employers to understand the knowledge and skills expected of individuals who complete advanced fellowships in applied health care improvement.


Assuntos
Competência Clínica/normas , Currículo , Educação Médica Continuada/normas , Bolsas de Estudo/normas , Médicos/normas , Melhoria de Qualidade/normas , Qualidade da Assistência à Saúde/normas , Adulto , Feminino , Guias como Assunto , Humanos , Liderança , Masculino , Pessoa de Meia-Idade , Melhoria de Qualidade/estatística & dados numéricos , Estados Unidos , United States Department of Veterans Affairs
14.
Workplace Health Saf ; 69(5): 224-234, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33357068

RESUMO

BACKGROUND: Intensive care unit (ICU) nurses are at an increased risk of post-traumatic stress disorder (PTSD) due to their stressful work environment. Using the Walker and Avant conceptual analysis method, we sought to review the literature to better understand PTSD as it pertained to ICU nurses and its impact on their lives, patient care, and health care organizations. METHODS: For the review, we searched the Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, and PsycINFO. The keyword searches included the terms "post-traumatic stress disorder" AND "psychological stress" AND "intensive care unit nurses." Abstract and full text reviews were conducted. Ten articles met our inclusion criteria of being published in the past 10 years (2010-2020), peer reviewed, written in English, and referred specifically to PTSD and psychological stress in ICU nurses. FINDINGS: Antecedents for PTSD in ICU nurses are their stressful work environment, where exposure to traumatic events is experienced, and a lack of support from their manager, coworkers, and organization. Defining attributes for ICU nurses with PTSD included reexperiencing, avoidance, negative alterations in cognition and mood, and hyperarousal. Consequences identified included burnout, job dissatisfaction, and the intention to leave their job. The conceptual definition of PTSD in ICU nurses was illustrated by the attributes, antecedents, consequences, model case, empirical referents, and by the negative impact on the nurse, patients, and the health care organization. CONCLUSION/APPLICATION TO PRACTICE: Hospital administrators, nurse managers, and occupational health nurses should ensure that policies and interventions are in place to recognize and reduce the risk of PTSD among ICU nurses.


Assuntos
Unidades de Terapia Intensiva , Recursos Humanos de Enfermagem no Hospital/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Esgotamento Profissional , Humanos , Exposição Ocupacional , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/etiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Local de Trabalho/psicologia
15.
Am J Nurs ; 120(10): 24-28, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32976149

RESUMO

BACKGROUND: Suicide is now the 10th leading cause of death in the United States. Suicide rates for health care providers are thought to be higher than for people in other occupations because of job strain and burnout. Despite the National Academy of Medicine's Action Collaborative on Clinician Well-Being and Resilience, which focuses on reducing stress and preventing suicide, a shortage of data limits our understanding of nurse suicide. Neither employers nor professional nursing associations track suicide data. PURPOSE: To determine the number of suicides and estimated rate of suicide among RNs, using data from the National Violent Death Reporting System (NVDRS). METHODS: We extracted data from the NVDRS, which is based on death certificates, coroner reports, and law enforcement reports, for the year 2015. The National Institute for Occupational Safety and Health's Industry and Occupation Computerized Coding System was used to code the data. Industry and occupation coding experts reviewed the coding for accuracy. RESULTS: Analysis of 2015 NVDRS data from 17 states showed that among civilian employed nurses ages 16 to 64 years, the estimated suicide rates for female and male nurses (11.4 and 29.3 per 100,000 nurses, respectively) were each higher than the rates for the comparable total population (8.2 and 26.1 per 100,000 people, respectively). CONCLUSIONS: Our findings indicate that RNs may die by suicide at higher rates than the total employed population in the 16-to-64-year age range. Implementation of evidence-based approaches to prevent suicide are warranted.


Assuntos
Enfermeiras e Enfermeiros/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Adolescente , Adulto , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Distribuição por Sexo , Estados Unidos/epidemiologia , Adulto Jovem
16.
J Hosp Palliat Nurs ; 22(6): 465-472, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32976315

RESUMO

Burnout, a condition characterized by emotional exhaustion, depersonalization, and decreased personal accomplishment, has been studied in many disciplines in health care, including nursing, medicine, and social work. The purpose of this study was to examine the relationship between perceived organizational support, coworker social support, the nursing practice environment, and nurse demographics (age, years of nursing experience, education level, marital status, and sex) on burnout in a national sample of palliative care nurses. The study aims were (1) to examine the relationship between perceived organizational support, coworker social support, and nursing practice environment on burnout in palliative care nurses; (2) to examine the relationship between age, years of nursing experience, education level, marital status, and sex on burnout in palliative care nurses; and (3) to examine potential moderators (perceived organizational support and coworker social support) on the relationship between demographic characteristics and palliative care nurse burnout. A convenience sample of 73 Hospice and Palliative Nurses Association registered nurses who were bedside caregivers was recruited from Hospice and Palliative Nurses Association's membership. Data were analyzed using Pearson correlation and regression modeling. Findings indicated palliative care nurses had moderate to high levels of burnout. There was a negative correlation between burnout and perceived organizational support, and between burnout and coworker social support. The nursing practice environment of palliative care nurses was favorable; perceived organizational support and coworker social support were not moderators for demographics of age and years of experience and their relationship to burnout.

17.
J Clin Nurs ; 29(21-22): 4148-4160, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32757394

RESUMO

AIMS AND OBJECTIVES: To explore how workplace bullying influences nurses' abilities to provide patient care. BACKGROUND: Nurses' experiences of workplace bullying undermine nursing work environments and potentially threaten patient care. Although there is a link between nurses' experiences of workplace bullying and poor patient care, additional exploration is necessary as current evidence remains underdeveloped and inconclusive. DESIGN: Qualitative descriptive study. METHODS: Fifteen inpatient staff nurses who have experienced workplace bullying while working in one hospital located in the southern region of the USA participated in individual, semi-structured interviews. Inductive thematic analysis was used to analyse interview transcripts in NVivo 12 software. The COREQ checklist for qualitative studies has been used in reporting this study. RESULTS: Three themes, and respective subthemes, were generated from data analysis: (a) workplace bullying as part of the nursing work environment, (b) workplace bullying's influence on nurses and (c) workplace bullying's influence on patient care. Workplace bullying was perceived to be inherent in the nursing work environment; nurses felt that they were targets of workplace bullying because (a) they were new nurses, (b) there was an abuse of power, or (c) the nature of the work occasioned it. Nurses were mentally and emotionally influenced by the bullying. Some nurses perceived that workplace bullying did influence their ability to provide patient care; however, others did not. CONCLUSIONS: Organisations must support new nurses and manage relational attributes of the nursing work environment to reduce workplace bullying. Nursing leaders should receive education on fostering and sustaining favourable nursing work environments and be held accountable for behavioural expectations of the organisation. RELEVANCE TO CLINICAL PRACTICE: Understanding how nurses perceive the work environment to influence their experiences of workplace bullying informs the development of organisational interventions to reduce the behaviour. Furthermore, exploring how nurses' experiences of workplace bullying influences their abilities to provide patient care increases our understanding of workplace bullying implications.

18.
J Patient Exp ; 7(2): 263-269, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32851150

RESUMO

This study examined the association between interdepartmental transfers and the perceptions of care received by adult patients who were admitted and discharged from a 300-bed, not-for-profit community tertiary hospital in the Midwest. Transfers of patient care are daily and frequent hospital processes. However, limited attention has focused on the effect that intrahospital transfers of care have on the patient experience. Understanding this relationship is important, since value-based purchasing models directly tie patient experience measures into hospital reimbursements. The key finding of this study indicates that as patients' transfers increase, their perceptions of care decrease. Therefore, by reducing the frequency of interdepartmental transfers, patient satisfaction may increase. This research provides clinicians and administrators a better understanding of the relationship between a frequent and a daily hospital process (ie, interdepartmental transfers) and its influence on patients' perceptions of their experience.

19.
Nurs Adm Q ; 44(3): 257-267, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32511185

RESUMO

The Veterans Health Administration (VHA) led implementation of the Clinical Nurse Leader (CNL) role nationally with the goal to meet system needs for strong clinical leadership across all settings. After a decade of CNL role implementation, the VHA supported this evaluation to determine the current state, the successes, the challenges, and the fidelity to the original intent of the role. The team used mixed methods to evaluate the state of the CNL initiative. Ten evaluation activities were undertaken including a facility survey directed toward chief nurse executives at all VHA facilities, and a second survey directed at registered nurses who completed a CNL graduate program, were certified as a CNL, or were currently enrolled in a CNL graduate program. The evaluation results suggest the CNL initiative had not yet accomplished the stated goals to improve cost and financial outcomes, increase patient satisfaction, increase staff satisfaction and retention, improve quality and internal processes, and facilitate practice model transformation including evidence-based practice and collaborative, interdisciplinary practice across the system. Observed CNL practices within the VHA could serve as exemplars for developing a care delivery model that could achieve these goals and offer potential paths to move this role forward.


Assuntos
Liderança , Enfermeiras Clínicas/tendências , Papel do Profissional de Enfermagem , United States Department of Veterans Affairs/tendências , Humanos , Avaliação de Programas e Projetos de Saúde/métodos , Estados Unidos , United States Department of Veterans Affairs/organização & administração
20.
J Nurs Manag ; 28(4): 927-937, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32255219

RESUMO

AIM: The purpose of this dimensional concept analysis was to identify preferences for favourable nursing work environments by Baby Boomer, Generation X and Millennial nurses. BACKGROUND: Favourable nursing work environments have been associated with better nurse and patient outcomes. Researchers have reported differences among generations related to the work environment, but the extent to which there are differences in preferences, not just perceptions, is less certain. METHOD: A dimensional concept analysis was performed, in which one concept was analysed from multiple points of view. Articles were obtained from PubMed, CINAHL and PsycINFO. Articles published in the last ten years were included if they reported preferences, desires or ideals for the nursing work environment and were categorized by generational cohort. Eight articles qualified for review. RESULTS: Four major themes were identified: nursing practice/unit characteristics, managers/leadership, team/professional interactions and pay/benefits. An additional theme of personal/self emerged among Millennials. CONCLUSIONS: All generations reported preferences related to benefits/pay, manager/leadership, nursing practice/unit characteristics and team/interactions. Only Millennials reported aspects related to self. IMPLICATIONS FOR NURSING MANAGEMENT: All generations desired the first four themes. To address each, nursing leaders should consider the following: (a) ensure adequate staffing and resources are in place for nursing staff; (b) obtain input from all generations about their level of satisfaction with benefits/pay and examine ways to provide better benefits or pay when possible; (c) encourage leadership self-development, such as educational opportunities and mentorship; and (d) determine opportunities to improve interactions among staff members. For Millennials, the only group who had expectations in the area of 'self', provide individualized attention and opportunities that allow them to create a better work-life balance, such as self-scheduling.


Assuntos
Formação de Conceito , Relação entre Gerações , Relações Interprofissionais , Cuidados de Enfermagem/psicologia , Adulto , Idoso , Feminino , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Cuidados de Enfermagem/normas , Cuidados de Enfermagem/estatística & dados numéricos , Local de Trabalho
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