Management of nursing care in hemotherapy in a hospital nursing service / Gestión de los cuidados de enfermería en hemoterapia en un servicio de enfermería hospitalaria / Gerência do cuidado de enfermagem na hemoterapia em serviço hospitalar de enfermagem

Objective: analyzing the management of nursing care in hemotherapy in a university hospital. Method: a descriptive, exploratory study with a qualitative approach conducted with 29 nurses from the University Hospital of Belém, Pará, Brazil. Semi-structured interviews were applied between August/2018 and January/2019. The collected data were submitted to thematic content analysis. Results: coordination of care/supervision and provision of complex care were the most mentioned actions regarding hemotherapy procedures. Team dimensioning, Materials management, Nursing care planning and Evaluation of the results of nursing actions were actions absent in the nurses' statements. Training/education of the team was weakened. Leadership was not explicitly mentioned, but it could be present, albeit in a fragile way. Final considerations: the actions most represented in the nurses' statements were related to the technical competencies acquired in the formative context, while the less mentioned actions were related to the competencies and skills that commonly permeate gaps in formal education.

Objetivo: analizar el manejo de los cuidados de enfermería en hemoterapia en un hospital universitario. Método: se trata de un estudio descriptivo, exploratorio con enfoque cualitativo realizado con 29 enfermeras del Hospital Universitario de Belém, Pará, Brasil. Se aplicaron entrevistas semiestructuradas entre agosto/2018 y enero/2019. Los datos recopilados se sometieron a análisis de contenido temático. Resultados: la coordinación de la atención/supervisión y la prestación de cuidados complejos fueron las acciones más mencionadas con respecto a los procedimientos de hemoterapia. El dimensionamiento del equipo, la gestión de materiales, la planificación de los cuidados de enfermería y la evaluación de los resultados de las acciones de enfermería fueron acciones ausentes en las declaraciones de las enfermeras. La capacitación/educación del equipo se debilitó. El liderazgo no se menciona explícitamente, pero podría estar presente, aunque de una manera frágil. Consideraciones finales: las acciones más representadas en las declaraciones de las enfermeras se relacionaron con las competencias técnicas adquiridas en el contexto formativo, mientras que las acciones menos mencionadas se relacionaron con las competencias y habilidades que comúnmente impregnan las brechas en la educación formal.

Objetivo: analisar a gerência do cuidado de Enfermagem na hemoterapia em um hospital universitário. Método: estudo descritivo, exploratório de abordagem qualitativa, realizado com 29 enfermeiros de Hospital Universitário de Belém, Pará, Brasil. Foram aplicadas entrevistas semiestruturadas entre agosto/2018 e janeiro/2019. Os dados coletados foram submetidos à análise de conteúdo temática. Resultados: Coordenação do cuidado/Supervisão e Prestação do cuidado complexo foram as ações mais mencionadas quanto aos procedimentos hemoterápicos. Dimensionamento da equipe, Gestão de materiais, Planejamento do cuidado de enfermagem e Avaliação dos resultados das ações de enfermagem foram ações ausentes nas falas dos enfermeiros. Treinamento/educação da equipe mostrou-se fragilizado. Já Liderança não foi mencionada explicitamente, mas pôde estar presente, ainda que de forma fragilizada. Considerações finais: as ações mais representadas nas falas dos enfermeiros estavam relacionadas às competências técnicas adquiridas no contexto formativo, enquanto as ações menos mencionadas relacionaram-se às competências e habilidades que comumente permeiam lacunas da educação formal.

Design and Implementation of Hospital Automatic Nursing Management Information System Based on Computer Information Technology.

Clinical nursing work fails to integrate various nursing tasks such as basic care, observation of patients' conditions, medication, treatment, communication, and health guidance to provide continuous and full nursing care for patients. Based on this, this paper uses the Internet of Things (IoT) technology to optimize the infusion process and achieve closed-loop management of medications and improve the efficiency and safety of infusion and medication administration by using a rational and effective outpatient and emergency infusion and medication management system. The system was built by applying wireless network, barcode technology, RFID, infrared tube sensing, and other technologies and was combined with actual nursing work to summarize application techniques and precautions. The application of this system will become a new highlight of medical informatization, improve patient experience, monitor infusion safety, enhance nursing care, reduce emergency medical disputes, improve patient satisfaction, and will create good social and economic benefits for the hospital.

A Qualitative Exploration of Chief Nursing Officer Perspectives on Maintaining Magnet® Designation.

OBJECTIVE: The purpose of this study was to determine chief nursing officer (CNO) perspectives on how to sustain the infrastructure required for successful American Nurses Credentialing Center (ANCC) Magnet® redesignation. BACKGROUND: American Nurses Credentialing Center Magnet designation is a prestigious achievement reflective of years of dedication, innovation, mentoring, and leadership support. As challenging as the initial attainment of Magnet status can be, sustaining the success and becoming redesignated is considered even more difficult by many CNOs. However, there have been no published reports indicating how to be successful in Magnet redesignation. METHOD: A grounded theory qualitative approach was used, and data were collected through telephone interviews with CNOs who had successfully attained at least 1 redesignation. RESULTS: Fourteen CNOs participated; data were organized into 6 themes and 15 subthemes describing the critical elements for Magnet redesignation. CONCLUSION: Relationships among the 6 themes and subthemes are theorized in the form of a wheel with 6 spokes. When "set in motion," the wheel gathers momentum and all of the model elements become coalesced into the organizational ethos.

[Management and leadership of nursing services in the emergency plan for the pandemic COVID-19: the experience of the Clinic Hospital of Barcelona]. / Gestión y liderazgo de los servicios de Enfermería en el plan de emergencia de la pandemia COVID-19: la experiencia del Hospital Clínic de Barcelona.

At the international level, the enormous demand to manage the COVID-19 pandemic has posed a challenge both in the provision of personnel and in supplies and sanitary material. There is no precedent or publication related to the management and leadership of nursing services in Spain within the emergency plan for the COVID-19 pandemic. This article describes the experience of the Hospital Clinico de Barcelona in the current extraordinary circumstances that undoubtedly constitute a nursing management of enormous magnitude and unprecedented due to the high number of people affected and the extraordinary risk of healthcare personnel. Following national and international guidelines to alleviate the pandemic, protect health and prevent the spread of the outbreak. The ability to work as a team, emotional management and respect for organizational decisions have made it possible to face the challenges that the pandemic has put in place and that the Nursing Department can lead in a calm and orderly manner the different actions to perform. Lastly, it will be necessary to continue with an in-depth analysis of the situation and of the actions carried out in order to identify the areas for improvement as well as to evaluate the overall nature of the process.

A Multicentre Study of Nursing Leadership in Andalusian Hospitals from a Gender-based Perspective

ABSTRACT Introduction: Leadership is the ability to guide subordinates in a direction or decision so that they can perform a task or achieve a goal that leaves them feeling empowered and accomplished. Leaders are capable of producing changes and at the same time, they inspire others to do the same. This research analysed gender-based differences and dimensions of nursing leadership styles in 18 hospitals in Andalusia, a region of southern Spain. Methods: The sample population of the study comprised 335 subjects, who were middle managers in 18 public regional hospitals in Andalusia. The instrument used to measure different leadership styles was the Multifactor Leadership Questionnaire (MLQ 5X-Short form), which is composed of 45 items. Results: The study showed that the most predominant leadership style was transactional leadership with a mean value of M = 4.22 (standard deviation [SD] = 0.42) followed by transformational leadership with a mean value of M = 3.97 (SD 0.45). Of the three styles analysed, transactional leadership had the highest statistical median for both male and female subjects. From a gender-based perspective, transformational leadership showed statistically significant differences (p < 0.01) between men and women. This was true for leadership styles as well as for the dimensions that define each style. Conclusion: The most frequent leadership style in middle nursing management in Andalusian hospitals was transactional leadership. In regard to the three leadership styles as well as their dimensions, the female subjects obtained the highest scores. This means that from a gender-based perspective, female nursing managers had better performance levels than their male counterparts in the regional hospital system in Andalusia.

Cultura de seguridad del paciente en la perspectiva del equipo de enfermería en una maternidad pública / Cultura de segurança do paciente na perspectiva da equipe de enfermagem em uma maternidade pública / Patient safety culture from the perspective of the nursing team in a public maternity hospital

OBJETIVO: Evaluar las dimensiones de la cultura de seguridad del paciente desde la perspectiva del equipo de enfermería en un hospital público de maternidad. MÉTODO: Estudio transversal realizado en un hospital público de maternidad con 69 profesionales de enfermería, de junio a agosto de 2017, aplicando el cuestionario de la Encuesta hospitalaria sobre cultura de seguridad del paciente. RESULTADOS: El promedio de puntajes positivos varió de 33.0% a 69.6%, y las mejores evaluaciones fueron en las dimensiones: aprendizaje organizacional, trabajo en equipo entre unidades y respuestas no punitivas al error. Las evaluaciones más frágiles incluyen: transferencias internas y cambio de turno, además de la frecuencia de los eventos informados. CONCLUSIÓN: El estudio señaló una cultura de seguridad débil en todas las áreas. Por lo tanto, destaca la importancia de planificar estrategias específicas para lograr una cultura de seguridad de calidad para el binomio madre / hijo

OBJETIVO: Avaliar as dimensões da cultura de segurança do paciente na perspectiva da equipe de Enfermagem, em uma maternidade pública. MÉTODO: Estudo transversal realizado em uma maternidade pública, com 69 profissionais de Enfermagem, no período de junho a agosto de 2017, mediante aplicação do questionário Hospital Survey on Patient Safety Culture. RESULTADOS: A média dos escores positivos variou de 33,0 % a 69,6%, sendo que as melhores avaliações foram nas dimensões: aprendizado organizacional, trabalho em equipe entre as unidades e respostas não punitivas ao erro. Das avaliações com maiores fragilidades, destacam-se: transferências internas e passagem de plantão, além da frequência de eventos relatados. CONCLUSÃO: O estudo apontou para a cultura de segurança sem nenhuma área de força em todas as áreas. Assim, evidencia a importância do planejamento de estratégias direcionadas, a fim de alcançar a cultura de segurança com qualidade para o binômio mãe/filho

OBJECTIVE: To evaluate the dimensions of patient safety culture from the perspective of the nursing team in a public maternity hospital. METHOD: Cross-sectional study conducted in a public maternity hospital with 69 nursing professionals, from June to August 2017, through the application of the Hospital Survey on Patient Safety Culture. RESULTS: The average of positive scores ranged from 33.0% to 69.6%, and the best evaluations were made in the following dimensions: organizational learning, teamwork between units, and non-punitive responses to the error. The most fragile evaluations were made in: internal transfers and shift reports, in addition to the frequency of reported events. CONCLUSION: The study pointed to a weak safety culture in all areas, and indicated that planning targeted strategies in order to achieve quality safety culture for the mother/child binomial is important

The Relationship between Patient Safety Climate and Medical Error Reporting Rate among Iranian Hospitals Using a Structural Equation Modeling.

BACKGROUND: Improving patient safety is a global health imperative, and patient safety climate is one of the components one that plays an important role in promoting patient safety. Medical error reporting is a way through which it can be evaluated and prevented in the future. The aim of this study was to assess the relationship between patient safety climate and medical error reporting in military and civilian hospitals. METHODS: This research was conducted by using structural equation modeling in the selected hospitals of Iran in 2018. The study community consisted of 200 nurses in the military and 400 nurses in the civilian hospitals. By using Structural Equation Modeling, the relationship between patient safety climate and the rate of medical error reporting in the hospitals was measured by a questionnaire. Data was analyzed using SPSS 17 and LISREL 8.8 software. RESULTS: The mean score of patient safety climate was moderate in the hospitals. There was no significant relationship between the rate of medical error reporting and patient safety climate, while a significant difference was found between patient safety climate score and age, sex, job category, and type of hospital (P < 0.05). CONCLUSION: The results suggested that patient safety climate and the rate of reporting errors were not favorable in the studied hospitals, while there was a difference between safety climate dimensions.

Análise do processo de implantação do serviço de atenção ao paciente com COVID-19 / Análisis del proceso de implementación del servicio de atención al paciente com COVID-19 / Analysis of the process of implementing the patient care service with COVID-19

A pandemia COVID-19 vem exigindo enorme esforço dos gestores hospitalares, desafiando-os a agir e pensar fluxos de atendimento de maneira rápida, adotando estratégias seguras de cuidar. OBJETIVO: Analisar o processo de planejamento e implantação de um serviço de atenção ao paciente com COVID-19 em um hospital universitário, através da experiência cotidiana de gestão. MÉTODO: Trata-se de um relato sistemático de experiência sobre o processo de implantação de fluxo de atendimento e tratamento em um hospital universitário de pessoas acometidas pela COVID-19. Registrou-se em diário de campo a experiência, sendo as narrativas submetidas à análise de conteúdo. RESULTADOS: a análise das narrativas permitiu organizar os dados nas seguintes categorias: necessidade de segurança dos profissionais, capacitação, empatia e gestão participativa. CONCLUSÃO: É importante utilizar os processos de trabalho e a Educação Permanente em Saúde como ferramentas para a orientação do cuidado assistencial ao paciente com COVID-19. O raciocínio clínico, o trabalho interdisciplinar e a tomada de decisão de forma participativa permitiu a adequada implantação do atendimento, apesar do temor da equipe frente aos desafios da pandemia.

La pandemia de COVID-19 ha exigido un enorme esfuerzo por parte de los administradores de los hospitales, desafiándolos a actuar y pensar en los flujos de atención rápidamente, adoptando estrategias de atención segura. OBJETIVO: Analizar el proceso de planificación e implementación de un servicio de atención al paciente con COVID-19 en un hospital universitario, a través de la experiencia de gestión diaria. MÉTODO: Este es un reporte sistemático de experiencia sobre el proceso de implementación de un flujo de atención y tratamiento en un hospital universitario para personas afectadas por COVID-19. La experiencia se registró en un diario de campo y las narrativas se sometieron a análisis de contenido. RESULTADOS: el análisis de las narrativas permitió organizar los datos en las siguientes categorías: necesidad de seguridad profesional, formación, empatía y gestión participativa. CONCLUSIÓN: Es importante utilizar los procesos de trabajo y la Educación Permanente en Salud como herramientas para orientar la atención brindada a los pacientes con COVID-19. El razonamiento clínico, el trabajo interdisciplinario y la toma de decisiones de manera participativa permitieron la adecuada implementación de la atención, a pesar del temor del equipo ante los desafíos de la pandemia.

The COVID-19 pandemic has demanded enormous effort from hospital managers, challenging them to act and think about care flows in a timely manner while adopting safe care strategies. OBJECTIVE: To analyze the planning and implementation process of a patient care service with COVID-19 in a university hospital, through the experience of daily management. METHOD: This is a systematic experience report on the care implementation and treatment flow process in a university hospital of people affected by COVID-19. The experience was recorded in a field diary, and the narratives were submitted to content analysis. RESULTS: the analysis of the narratives lead to the organization of data in the following categories: need for professional safety, training, empathy and participatory management. CONCLUSION: It is important to use work processes and Continuing Health Education as tools for guiding care to COVID-19 patients. Clinical reasoning, interdisciplinary work and decision-making in a participatory manner allowed the proper care implementation, despite the team's fear of the challenges caused by the pandemic.

The Client Capital in Nursing Management in Hospitals / El capital del cliente en la Gestión de Enfermería en Hospitales / O Capital do Cliente na Gestão de Enfermagem em Hospitais

Abstract Objective: To analyze how the components of the client's capital are used in the management of nursing in hospitals. Method: A qualitative research carried out in five public hospitals, four private hospitals and three philanthropic hospitals in the period from October 2014 to May 2015. Data were collected through a semi-structured interview with twelve nursing managers and analyzed according to content analysis. Results: The components of the Client's Capital were used by the nurses when performing the management of the client service to promote changes and improve the service after evaluating the satisfaction of the nursing care through active systematic search, with its own evaluation tools and the ombudsman's information and in the interaction with suppliers of materials, equipment and services. Conclusion and implications for practice: The managers use managerial actions for the development of the client's capital of organizations. In order to improve them, they must evaluate the nursing care in a continuous and strategic process to satisfy the clients, throughout their trajectory in the organization, since clients are permanent sources of innovation that affect professional and organizational development and productivity.

Resumen Objetivo: Analizar cómo se utilizan los componentes de capital del cliente en la gestión de enfermería hospitalaria. Método: Investigación cualitativa, realizada en cuatro hospitales privados, cinco hospitales públicos y tres hospitales filantrópicos, de octubre de 2014 a mayo de 2015. Los datos fueron recolectados a través de entrevista semiestructurada con 12 gestoras de enfermería y analizados según el análisis de contenido. Resultados: Los componentes del Capital del Cliente fueron utilizados por las enfermeras al realizar la gestión de la atención al cliente para promover cambios y mejorar el servicio después de realizar la evaluación de la satisfacción de la atención de enfermería a través de búsqueda activa, sistemática, con instrumentos de evaluación propios e informaciones de la Oidoría y en la interacción con proveedores de materiales, equipos y servicios. Conclusión e implicaciones para la práctica: Las gestoras utilizan acciones gerenciales para el desarrollo del capital del cliente de las organizaciones. Para perfeccionarlas, deben evaluar la atención de enfermería en proceso continuo y estratégico para satisfacer a los clientes durante toda su trayectoria en la organización, una vez que los clientes son fuentes permanentes de innovación que generan impacto en el desarrollo y productividad profesional y organizacional.

Resumo Objetivo: Analisar como os componentes do capital do cliente são utilizados na gestão da enfermagem em hospitais. Método: Pesquisa qualitativa, realizada em quatro hospitais privados, cinco hospitais públicos e três hospitais filantrópicos, de outubro de 2014 a maio de 2015. Os dados foram coletados através de entrevista semiestruturada com 12 gestoras de enfermagem e analisados segundo a análise de conteúdo. Resultados: Os componentes do Capital do Cliente foram utilizados pelas enfermeiras ao realizar a gestão do atendimento ao cliente para promover mudanças e aprimorar o serviço após realizar a avaliação da satisfação do atendimento de enfermagem através de busca ativa, sistemática, com instrumentos de avaliação próprios e informações da Ouvidoria e na interação com fornecedores de materiais, equipamentos e serviços. Conclusão e implicação para a prática: As gestoras utilizam ações gerenciais para o desenvolvimento do capital do cliente das organizações. Para aperfeiçoá-las, devem avaliar o atendimento de enfermagem em processo contínuo e estratégico para satisfazer os clientes, durante toda a sua trajetória na organização, uma vez que clientes são fontes permanentes de inovação que geram impacto no desenvolvimento e produtividade profissional e organizacional.

A nova gestão pública e os cuidados de saúde: o empenhamento dos enfermeiros / The new public management and health care: the commitment of nurses

Ao longo dos últimos anos, as organizações sofreram mudanças estruturais e organizacionais devido, entre outros, aos novos modelos de gestão. Os hospitais não foram exceção, com as alterações introduzidas para contenção de custos, redução de recursos humanos e maior eficiência e eficácia, visando a melhoria da qualidade dos serviços prestados. Os enfermeiros gestores viram o seu papel alterar-se em função de indicadores e metas de desempenho, sendo confrontados com o cumprimento dos requisitos e melhoria da qualidade. Existem evidências de que o empenhamento organizacional tem implicações no desempenho dos colaboradores e, enquanto comportamento positivo assume um caracter relevante para a competitividade da organização daí, a importância do seu estudo e da identificação dos seus antecedentes em contexto hospitalar. Para este estudo definiu-se o seguinte objetivo: "Avaliar o empenhamento organizacional dos enfermeiros em contexto hospitalar e como se relaciona com a autonomia de funções e a justiça procedimental". Como objetivos específicos foram delineados os seguintes: "Avaliar o empenhamento organizacional dos enfermeiros nas suas três dimensões, afetiva, normativa e instrumental"; "Analisar a autonomia nas funções como antecedente significativo para o empenhamento organizacional"; "Analisar a justiça procedimental como antecedente significativo para o empenhamento organizacional". O estudo foi quantitativo descritivo-correlacional. A amostra é constituída por 141 enfermeiros de um hospital da região de Lisboa e Vale do Tejo. Aplicado um questionário com uma escala de Likert. Os enfermeiros apresentaram moderado empenhamento organizacional afetivo (3.81), e fracamente empenhados normativamente (2.77) e instrumentalmente (2.70). A autonomia de funções (ß =.1925, p =.019) e a justiça procedimental (ß =.485, p =.001) revelaram-se preditores significativos do empenhamento afetivo.

Over the past few years, organizations have undergone structural and organizational changes due, among others, to new management models. Hospitals were no exception, with changes introduced to contain costs, reduce human resources and increase efficiency and effectiveness, aiming to improve the quality of services provided. The nurse managers saw their role change according to performance indicators and goals, being confronted with the fulfillment of requirements and quality improvement. There is evidence that organizational commitment has implications on employee performance and, as a positive behavior it assumes a relevant role for the organization's competitiveness, hence the importance of its study and identification of its antecedents in an hospital context. The aim of this study was to Evaluation the organizational commitment of nurses in the hospital context, and how it relates to the autonomy of job functions and procedural justice". The following specific objectives were outlined: "Evaluation of organizational commitment of nurses in their three dimensions, affective, normative and instrumental"; "Analysis of job autonomy as a significant antecedent for organizational commitment"; "Analysis of procedural justice as a significant antecedent for organizational commitment." The study was quantitative descriptive-correlational. The sample consisted of 141 nurses from an hospital in the Lisbon and Tagus Valley region. A questionnaire using Likert scale was applied. The nurses presented moderate affective organizational commitment (3.81), and weak normative (2.77) and instrumental (2.70) commitment. Autonomy of job functions (ß = .1925, p = .019) and procedural justice (ß = .485, p = .001) revealed to be significant predictors of affective commitment.

The effect of collegial solidarity among nurses on the organizational climate.

AIM: This research was carried out in a descriptive and relationship-seeking design to examine the effect on the organizational climate of collegial solidarity among the nurses. BACKGROUND: It is important that nurses work in an organizational climate where they can be in solidarity with their colleagues to offer quality service and to deal with all the problems they face. However, the impact of collegial solidarity on the organizational climate is not yet clear enough. METHODS: This study was performed with a cohort of 333 nurses working in a university hospital in Turkey. Data were collected using the personal information form, the Colleague Solidarity of Nurses' Scale and the Organizational Climate Scale. The data were evaluated using Cronbach's α coefficient, frequency and percentage distribution, the Pearson product-moment correlation coefficient and a simple linear regression analysis. RESULTS: A relationship was identified between the collegial solidarity among nurses and the organizational climate. We have determined that collegial solidarity effects organizational commitment, teamwork, supportive climate, stress, negative interaction, human relations, job satisfaction, hierarchy, and the communication and innovative climate. CONCLUSION: Collegial solidarity among nurses has effects on the organizational climate. IMPLICATION FOR NURSING POLICY AND HEALTH POLICY: It is recommended that executive nurses support the colleague solidarity between nurses in healthcare settings, in particular by reducing stress in nurses, strengthening teamwork and communication and, thus, making the organizational climate more positive.

Reducing RN Vacancy Rate: A Nursing Recruitment Office Process Improvement Project.

OBJECTIVE: The aim of this study was to reduce the RN vacancy rate at an academic medical center by improving the hiring process in the Nursing Recruitment Office. BACKGROUND: Inability to fill RN positions can lead to higher vacancy rates and negatively impact staff and patient satisfaction, quality outcomes, and the organization's bottom line. METHODS: The Model for Improvement was used to design and implement a process improvement project to improve the hiring process from time of interview through the position being filled. RESULTS: Number of days to interview and check references decreased significantly, but no change in overall time to hire and time to fill positions was noted. RN vacancy rate also decreased significantly. Nurse manager satisfaction with the hiring process increased significantly. CONCLUSION: Redesigning the recruitment process supported operational efficiencies of the organization related to RN recruitment.

AMA Resolution Opposes Independent Practice by APRNs.

An old debate heats up again.

Patient complaints as a means to improve quality of hospital care. Results of a qualitative content analysis / Patientenrückmeldung als Möglichkeit die Versorgungsqualität von Spitalpatienten zu verbessern. Ergebnisse einer qualitativen Inhaltsanalyse

Background: Many hospitals have defined procedures for a complaint management. A systematic analysis of patient complaints helps to identify similar complaints and patterns so that targeted improvement measures can be derived (Gallagher & Mazor, 2015). Aim: Our three-month, nurse-led practice development project aimed 1) to identify complaints regarding communication issues, 2) to systemise and prioritise complaints regarding communication issues, and 3) to derive clinic-specific recommendations for improvement. Method: We analysed 273 complaints of patients documented by the quality management (secondary data analysis). Using content analysis and applying the coding taxonomy for inpatient complaints by Reader, Gillespie and Roberts (2014), we distinguished communication-related complaints. By further inductive differentiation of these complaints, we identified patterns and prioritised fields of action. Results: We identified 186 communication-related complaints divided into 16 subcategories. For each subcategory, improvement interventions were derived, discussed and prioritised. Conclusions: Thus, patient complaints provided an excellent opportunity for reflection and workplace learning for nurses. The analysis gave impulse to exemplify the subject "person-centered care" for nurses.

Quantification of nursing care and creation of economic indicators: an observational study protocol.

BACKGROUND: The literature on hospital admissions costs shows that classification of hospitalization systems such as the DRG system used in Italy, do not reflect the real cost of the production factors used, including those of nursing care in relation to the complexity of the hospital effort. OBJECTIVE: This concept paper outlines the study protocol and the methodology used to measure nursing care in economic terms. The objective of the study is developed on the assumption of creating economic indicators from a quantitative analysis of nursing activities provided to specific patients, in order to determine not only who costs but also the reasons for the cost, and demonstrate the variability of nursing not only for DRG, but also each individual patient. METHODS: A retrospective study and a longitudinal prospective study will be performed. In the first phase of the study, using a bottom-up Microcosting methodology the type, volume, time and costs of nursing activities for DRG will be determined and the incidence of nursing costs on reimbursement will be highlighted.In the second phase, the above analysis will be supplemented by the recognition of the complexity of individual cases measured through the Corridor Triage(Tri-CO), in order to figure out the incidence of costs of nursing activities on the reimbursement in relation to the level of care complexity. Main sources of data: hospital discharge card (SDO); Professional Assessment Instrument (PAI); datasets for collecting the time of delivery of nursing activities on PAI. Power calculation: For retrospective study, the survey will be conducted on a sample of 150 patients hospitalized in the first quarter of 2016. For the longitudinal prospective study, 150 patients will be included in the first quarter of 2017 after the structured introduction of Tri-CO as a valuation tool of care complexity. The sample examined is approximately 30% of the total number of admissions per year. RESULTS: The study started in February 2016 and the results are expected for May 2017. Through this study it is expected to verify whether by implementing a unbundling approach, ie the "unpacking" of the production factors (nursing activity costs) used for the explication of hospitalization, and by adopting a methodology based on standard analytical costs, a more detailed knowledge of the overall DRG rate data available today will be obtained, which is currently lacking of explicit notation of all the amounts that make up it.

Bringing the OhioHealth Nursing Strategic Plan to Life With the AONE Care Innovation and Transformation Program.

Contemporary CNOs are committed to developing the next generation of nurse leaders. At OhioHealth, the nursing strategic vision includes the belief that every nurse will be a leader in improving health across the care continuum. In 2016, the OhioHealth System partnered with AONE to participate in the Care Innovation and Transformation program resulting in bedside nurses living this strategic vision and creating positive changes in quality, safety, and satisfaction for patients and families.

Will Rural Community Hospitals Survive?

Low patient volume and reimbursement issues drive closures.

Human capital in the nursing management of hospitals.

OBJECTIVE: To analyze how the components of human capital are used in the nursing management of hospital organizations. METHOD: This was an exploratory and qualitative study. Data collection took place between October 2014 and May 2015 using semi-structured interviews. The data were analyzed according to content analysis. RESULTS: Twelve nurse managers participated. The components of human capital used by the nurses in personnel management were: during the hiring process, when requiring specialized education in the field and prior professional experience; when retaining talents with promotion strategies; in building capacities of professionals through support and training; and in collective work to construct processes and outcome assessment. CONCLUSION: The components of human capital need to be managed strategically with a focus on professional skills and development, with the aim of transforming individual and collective knowledge into new technology. OBJETIVO: Analisar como os componentes do capital humano são utilizados na gestão de enfermeiras em organizações hospitalares. MÉTODO: Estudo exploratório, com abordagem qualitativa. A coleta de dados ocorreu de outubro de 2014 a maio de 2015 com a utilização de entrevistas semiestruturadas. Os dados foram analisados segundo a análise de conteúdo. RESULTADOS: Participaram 12 gestoras de enfermagem. Os componentes do capital humano utilizados pelas enfermeiras na gestão de pessoas foram: no processo admissional ao utilizar como critérios para contratação a exigência de especialização na área e experiência profissional prévia; na manutenção de talentos com estratégias de promoção; na capacitação de profissionais com apoio e treinamento; e no trabalho coletivo para a construção dos processos e avaliação dos resultados. CONCLUSÃO: Os componentes do capital humano precisam ser gerenciados estrategicamente com foco nas competências e no desenvolvimento do profissional, visando transformar os conhecimentos individuais e coletivos em novas tecnologias.

Mitigating the Impact of Nurse Manager Large Spans of Control.

Nurse managers are instrumental in achievement of organizational and unit performance goals. Greater spans of control for managers are associated with decreased satisfaction and performance. An interprofessional team measured one organization's nurse manager span of control, providing administrative assistant support and transformational leadership development to nurse managers with the largest spans of control. Nurse manager satisfaction and transformational leadership competency significantly improved following the implementation of large span of control mitigation strategies.