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1.
Emerg Nurse ; 27(2): 21-25, 2019 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-31468802

RESUMO

The UK has a serious shortage of nurses and for the first time in recent nursing history 27% more UK registrants left the register in 2016-2017 than joined it. Emergency nurses are particularly affected as their environment is unpredictable, fast-paced and increasingly crowded. This article reports the results of a study of a successful initiative to retain senior emergency nurses in a London trust.


Assuntos
Enfermagem em Emergência/estatística & dados numéricos , Mão de Obra em Saúde/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Reorganização de Recursos Humanos/estatística & dados numéricos , Adulto , Feminino , Humanos , Londres , Masculino , Pessoa de Meia-Idade
2.
Int Emerg Nurs ; 45: 25-30, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30987880

RESUMO

BACKGROUND: Early warning Score is a bedside track and trigger system used to facilitate early detection and management of deteriorating patients. Although emergency department nurses are the key to implement this task, their interaction and contribution to provide an estimate of patients' severities is still suboptimal and neglected. AIM: This study aimed to introduce an educational programme using the Modified Early Warning Score (MEWS) to nurses working in the emergency departments and to assess the programme impact on nurses' self-efficacy and perceived role. METHODS: This non-equivalent, multi-centre, quasi-experimental study, assigned two groups of emergency nurses into intervention and control. The intervention group received three interactive educational sessions totalling 12 h relevant to the application of MEWS in emergency situations using a validated programme called 'COMPASs'. The other group received no intervention. Both groups were assessed for self-efficacy and perceived role in the pre-test, immediate post-test, and three months later follow-up phase. RESULTS: A total of 232 participants were divided into intervention and control groups (118 and 114, respectively), having no variations in age, gender, or experience as registered nurses. The intervention group showed a significant improvement in the self-efficacy scores for the nurses (F: 152.21, df: 2, p < 0.001). Similarly, the intervention nurses exhibited a significant improvement in the perceived role scores after the intervention (F: 121.20, df: 2, p < 0.001). The control group showed no changes in either variable across the three phases. While older nurses with longer experience showed higher self-efficacy after the programme, the perceived role explained an additional 57.0% of the variance in self-efficacy after controlling these two demographics (Beta: 0.743, p < 0.001, CI: 1.18-1.66). CONCLUSION: The existence of an early warning system in the emergency department is able to enhance nurses' self-efficacy and perceived role coinciding with nursing interactions with the multidisciplinary team.


Assuntos
Enfermeiras e Enfermeiros/psicologia , Percepção , Autoeficácia , Adulto , Atitude do Pessoal de Saúde , Enfermagem em Emergência/organização & administração , Enfermagem em Emergência/estatística & dados numéricos , Enfermagem em Emergência/tendências , Feminino , Humanos , Jordânia , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/tendências , Gravidade do Paciente
3.
PLoS One ; 14(4): e0215153, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30964916

RESUMO

The organisational context of healthcare settings has an essential role in how research evidence is used in clinical practice. The Alberta Context Tool (ACT) measures 10 concepts of organisational context with higher scores indicating a more positive work environment and potentially better use of research evidence in patient care. We assessed the psychometric properties of the ACT in Emergency Departments (EDs). This validation study was conducted as part of a multi-centre trial of triage, treatment and transfer (T3 Trial) of patients with stroke admitted to EDs. Stratified sampling with proportional allocation was used to recruit ED nurses from 26 participating hospitals at baseline. Nurses completed a survey containing the ACT. Structural validity was investigated by exploratory and confirmatory factor analysis. Reliability was assessed using Cronbach's alpha and intraclass correlation coefficients. Item-rest correlations and the average inter-item correlations were also assessed. 558 ED nurses completed the survey, comprised of 433 surveys without missing data. Our exploratory factor analysis produced a 14-factor structure, explaining 62% of variance of organisational context. For eight of ten concepts, item loadings matched the factor structure of the original ACT. Confirmatory factor analysis of the 10 ACT concepts showed moderate model fit (p = 0.001, root mean square error of approximation: 0.049, standardised root mean squared residual: 0.048). Cronbach's alphas showed very good internal consistency for nine of ten ACT concepts (α>0.7; 0.45-0.90). Item-rest correlations indicated that most ACT items (50 of 56 items) within any concept related well to the total score of the concept. Average inter-item correlations indicated potential redundant items for three concepts (feedback processes, leadership, staffing) that were above the threshold of 0.5. While identifying a few shortcomings for some ACT concepts in an ED context, the majority of findings confirm reliability and validity of the original ACT in an Australian population of ED nurses.


Assuntos
Interpretação Estatística de Dados , Enfermagem em Emergência/organização & administração , Enfermagem em Emergência/estatística & dados numéricos , Prática Clínica Baseada em Evidências , Enfermeiras e Enfermeiros/psicologia , Psicometria/métodos , Acidente Vascular Cerebral/enfermagem , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
4.
Int Emerg Nurs ; 43: 106-112, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30733005

RESUMO

AIM: Sepsis is a significant and time-sensitive clinical concern for patients who present to Emergency Departments (EDs). Existing guidelines do not define nurses' roles in managing sepsis. This study explored ED nurses' experiences and perceptions around recognising and responding to patients with sepsis, and their awareness of sepsis screening and prognostic tools. The knowledge and insights gained from this study may be used to inform local and international ED policies, and enrich nursing educational packages that may be used to improve quality of patient care and patient outcomes. METHODS: Qualitative design incorporating semi-structured interviews with 14 ED nurses was undertaken. Thematic and consensus-based content analyses were used to explore transcripts. FINDINGS: Six key themes were identified; (1) contribution of the organisation, (2) appreciation of knowledge, (3) appreciation of clinical urgency, (4) appreciation of importance of staff supervision, (5) awareness of the importance of staff experience, and (6) awareness of the need to seek advice. CONCLUSION: ED nurses' identified deficits in their capacity to recognise and respond to patients with sepsis, despite their vital role within the multidisciplinary team that cares for patients with sepsis. The knowledge and insights gained from this study can be used to inform ED policies, to enrich context-specific educational packages that aim to improve quality of patient care and outcomes and identify areas for further research. Development and implementation of a nurse-inclusive sepsis pathway may address many deficits identified in this study.


Assuntos
Enfermagem em Emergência/normas , Papel do Profissional de Enfermagem/psicologia , Sepse/enfermagem , Adolescente , Adulto , Criança , Pré-Escolar , Competência Clínica/normas , Enfermagem em Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/organização & administração , Feminino , Humanos , Lactente , Entrevistas como Assunto/métodos , Masculino , Pesquisa Qualitativa , Queensland
5.
Int Emerg Nurs ; 45: 50-55, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30797732

RESUMO

BACKGROUND: Emergency department personnel are exposed to high risk of workplace violence (WPV) and nurses are the main victims. Few researchers have investigated the effects of WPV on job satisfaction and turnover intention among nurses. AIMS: To describe WPV, job satisfaction and turnover intention of emergency nurses and clarify the relationship between them. METHODS: A cross-sectional study was used to collect data on WPV, job satisfaction and turnover intention among 385 nurses working in emergency department in 13 general hospitals in Beijing. Structural equation modeling was used to test the relationship between them. RESULTS: Among them, 89.9% had experienced WPV in the previous year. WPV had short-term and long-term impacts on over 80% of them. The score of job satisfaction and turnover intention was 2.48 ±â€¯0.49, 2.75 ±â€¯0.58 respectively. WPV had significant direct effect on turnover intention (ß = 0.105) and job satisfaction (ß = -0.161). Job satisfaction had a significant negative effect on turnover intention (ß = -0.604) and it mediated the relationship between WPV and turnover intention. CONCLUSION: Emergency nurses in China are at great risk of WPV. Their job satisfaction is low and turnover intention is high. Job satisfaction plays the mediator role between WPV and turnover intention among emergency nurses.


Assuntos
Intenção , Satisfação no Emprego , Enfermeiras e Enfermeiros/psicologia , Reorganização de Recursos Humanos/estatística & dados numéricos , Violência no Trabalho/psicologia , Adulto , Estudos Transversais , Enfermagem em Emergência/métodos , Enfermagem em Emergência/normas , Enfermagem em Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Inquéritos e Questionários , Violência no Trabalho/estatística & dados numéricos
6.
Eur J Emerg Med ; 26(1): 29-33, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28915163

RESUMO

OBJECTIVES: The aim of this study was to investigate the agreement on triage level between prehospital providers and emergency department (ED) nurses in clinical practice when using the same triage system. The objectives were as follows: (a) What is the agreement of triage between prehospital providers and ED nurses, when using Danish Emergency Process Triage (DEPT) correctly? (b) Which part of the triage process yields the highest agreement regarding the final triage? METHODS: The study was a prospective and observational efficacy study. Patients transported to the ED by ambulances were included. They were triaged by prehospital providers while being transported by ambulance to the ED, and by ED nurses upon arrival. Triage was done using the DEPT - a five-level triage system based on vital signs and a presenting complaint algorithm. An agreement analysis was performed. RESULTS: DEPT was used correctly by both professions in 292 patients. In 182 (62%) patients the prehospital providers and the ED nurses agreed on the same triage level. This equals to κ=0.47 [95% confidence interval (CI): 0.41-0.56]. When considering the triage based on vital signs the agreement was 72% (κ=0.46; 95% CI: 0.41-0.47), and based on presenting complaint the agreement was 46% (κ=0.41; 95% CI: 0.37-0.44). CONCLUSION: There was a moderate interrater agreement on triage assignment between ED nurses and prehospital providers. They agreed on final triage more often if they agreed on triage based on vital signs rather than presenting complaints.


Assuntos
Serviços Médicos de Emergência/estatística & dados numéricos , Enfermagem em Emergência/estatística & dados numéricos , Triagem/estatística & dados numéricos , Idoso , Autoavaliação Diagnóstica , Feminino , Humanos , Masculino , Estudos Prospectivos , Triagem/métodos , Sinais Vitais
7.
J Nurs Manag ; 27(4): 792-805, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30430675

RESUMO

AIM: To analyse the dimensions and characteristics of violence towards Emergency nurses in a national context (Italy). BACKGROUND: Nurses are the most exposed to workplace violence, especially in Emergency Department contexts. METHODS: A cross-sectional study was conducted in all Italian regions. Descriptive analyses were used to examine violence from patients and relatives (Type II violence) concerning personal characteristics of the Emergency nurses and perpetrators, environmental and organisational factors. Multinomial logistic regression analysis was used to investigate risk factors. RESULTS: About 76.0% of Emergency nurses experienced verbal violence, 15.5% both verbal and physical violence and only 8.5% denied having experienced either. Older age and more experience in Emergency settings are protective factors. Working in the South of Italy significantly increases the probability of being exposed. DISCUSSION: There are many factors explaining violence, but some correlations are not clear. CONCLUSION: Factors that have a positive effect on this problem include: specific training for younger nurses, a strong alliance between users and health personnel to restore a relationship of trust between parties, physical barriers and appropriate architectural measures. IMPLICATIONS FOR NURSING MANAGEMENT: Comprehensive approaches can represent an effective strategy to counteract workplace violence.


Assuntos
Enfermagem em Emergência/estatística & dados numéricos , Violência no Trabalho/psicologia , Adulto , Estudos Transversais , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Violência no Trabalho/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia
8.
J Emerg Nurs ; 45(2): 132-136, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30529292

RESUMO

INTRODUCTION: In Australia, on any given day, there are more than 300 advertised emergency nursing positions, and this situation can be replicated in nearly every country internationally. The nursing shortage globally is known. The importance of not only why nurses specialize in the field of emergency nursing but also why they remain in the field requires an understanding of the evidence and research into nursing recruitment and retention. Leadership within the emergency department has a strong correlation to staff retention. It is hoped that, by gaining a greater understanding of the elements that influence staff retention, we will be able to lay down a strong foundation for the future of emergency nursing. METHODS: This literature review used a bibliographic search as well as the author's own experience. RESULTS: This article presents the key factors that have impact on emergency nursing retention: workplace environment, demands on emergency nurses, resilience, and education and training. DISCUSSION: Emergency nursing recruitment and retention is a multifaceted issue that requires urgent attention to develop tools and strategies to support organizations to build a sustainable workforce. This literature review has highlighted the need for further studies to understand why emergency nurses lack the knowledge or capability for a long-term career in emergency nursing.


Assuntos
Atitude do Pessoal de Saúde , Enfermagem em Emergência/estatística & dados numéricos , Mão de Obra em Saúde/estatística & dados numéricos , Reorganização de Recursos Humanos/estatística & dados numéricos , Enfermagem em Emergência/tendências , Mão de Obra em Saúde/tendências , Humanos , Internacionalidade , Satisfação no Emprego , Reorganização de Recursos Humanos/tendências , Local de Trabalho/estatística & dados numéricos
9.
J Emerg Nurs ; 45(2): 137-143, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30591243

RESUMO

INTRODUCTION: Studies show that nurse rounding is an effective means to increase patient satisfaction and quality of care and decrease patient-safety events. There is evidence to support that daily leader rounding improves patients' hospital experience as well. Patients' experience increased confidence in their care providers, and leaders are able to address service concerns proactively. Furthermore, recent studies have addressed patient satisfaction in the ED setting as having an impact on patients' perceptions of the health care institution as a whole. Our objective was to demonstrate the effect of hourly nursing rounds and daily leader rounds on the ED patient experience. METHODS: We used a pre- and postintervention evaluation of Hospital Consumer Assessment of Healthcare Providers and Services (HCAHPS) survey scores. Two groups of stakeholders developed standard work for rounding. The leader group and the bedside nursing care groups used the evidence cited in this article to create their standard processes. RESULTS: During the 2-month pilot period, patient experience scores-as measured by 5 survey questions-all improved. Results will continue to be tracked monthly and reported to all stakeholders in real time to help hardwire the process change. DISCUSSION: Through collaboration and a participative approach, nurses and leaders used the current evidence from scholarly nursing literature as well as Lewin's theory of change to guide a successful approach to rounding and improving patients' experiences when receiving emergency care.


Assuntos
Comportamento Cooperativo , Enfermagem em Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência , Liderança , Relações Enfermeiro-Paciente , Satisfação do Paciente/estatística & dados numéricos , Humanos
10.
Belo Horizonte; s.n; 2019. 132 p. ilus, tab, graf.
Tese em Português | LILACS, BDENF - Enfermagem | ID: biblio-998517

RESUMO

Objetivo: Trata-se de uma pesquisa quantitativa observacional de corte transversal, que teve como objetivo analisar as interrupções nas atividades primárias dos enfermeiros de uma unidade de Pronto Atendimento (PA) de um hospital universitário de Minas Gerais. Método: Os participantes foram 40 enfermeiros, dos turnos diurno e noturno, que atuavam na unidade. A coleta de dados foi realizada de 8 de junho a 23 de julho de 2018, por meio da observação direta não participante das interrupções nas atividades primárias dos enfermeiros, após aprovação do Comitê de Ética em Pesquisa e do hospital. A análise descritiva foi feita utilizando planilha eletrônica da plataforma Microsoft Excel e realizada distribuição de frequência absoluta e relativa. Resultados: Durante as 113,2 horas de coleta de dados, foram observadas 736 atividades primárias, sendo 277 (37,6%) de cuidado indireto ao paciente; 211 (28,7%) de cuidado direto; 144 (19,6%) de atividades administrativas; 99 (13,5%) de atividades pessoais; e 5 (0,7%) de atividades de ensino e pesquisa. Quanto ao tempo das interrupções, constatou-se que os enfermeiros gastaram mais tempo durante o cuidado indireto (34,9%). Das 736 atividades, 426 (57,9%) foram interrompidas, com média de 1,8 interrupções por atividade primária, totalizando 1.334 ocorrências (11,8 por hora). O cuidado indireto foi o mais interrompido (53,5%), seguido pelo cuidado direto (29,8%), atividade administrativa (13,2%) e atividade pessoal (3,5%). A atividade com maior número de interrupções foi registro de enfermagem (28,1%), seguida da avaliação do paciente (13,7%) e realização de procedimentos ou cuidado ao paciente (10,6%). As interrupções corresponderam a 41% do tempo de trabalho dos enfermeiros durante o período de observação. A mediana da duração das atividades primárias interrompidas foi de oito minutos e as não interrompidas foi de 2,5 minutos. O número de interrupções foi maior no turno da manhã (36%), mas a duração das interrupções foi maior no horário noturno (4,1%). As principais fontes de interrupções foram a equipe de enfermagem (40,6%) e a autointerrupção (13,3%), sendo as fontes que mais demandaram o tempo do enfermeiro, 41,2% e 12,3%, respectivamente. Os motivos de interrupções mais frequentes foram os relacionados ao paciente (31%), administrativo (24%), pessoal (18%), ajuda (17%), ambiente (8%) e ensino e pesquisa (2%). Os principais motivos foram fornecer e receber informações relacionadas ao paciente (18,1%), conversa paralela (12,5%) e alarmes (6,1%). O motivo que mais consumiu o tempo do enfermeiro foi conversa paralela (32,3%). Após as interrupções, os enfermeiros não retornaram à atividade primária em 1,8% dos casos, sendo necessário atender de uma a 30 interrupções antes de retornar à atividade inicial. Ao comparar a frequência das interrupções do PA Subunidades e PA Unidade de Terapia Intensiva, notou-se que o segundo correspondeu a 54% das interrupções, representando 61,5% do tempo total das interrupções. Conclusão: O conhecimento das interrupções no trabalho do enfermeiro pode contribuir para se elencar interrupções que propiciam a segurança do paciente e aquelas que geram problemas para a concentração e interferem na qualidade da assistência e na segurança do paciente. O profissional deve ater-se à atividade em execução e avaliar a pertinência da intervenção de acordo com a situação.(AU)


Objective: This is a cross-sectional, observational quantitative study, whose objective was to analyze the interruptions in the primary activities of nurses at an Emergency Care Unit at a university hospital in Minas Gerais. Method: There were 40 nurses participating in the study, from both day and night shifts, who worked in the unit. Data collection was performed from June 8th to July 23rd, 2018, through the direct non-participant observation of interruptions in nurses primary activities, after approval of the Research Ethics Committee and the hospital. The descriptive analysis was done using Microsoft Excel. In addition to that, it was performed absolute and relative frequency distribution. Results: During the 113.2 hours of data collection, 736 primary activities were observed, being: 277 (37.6%) of indirect care to the patient; 211 (28.7%) of direct care; 144 (19.6%) of administrative activities; 99 (13.5%) of personal activities; and 5 (0.7%) of teaching and research activities. Regarding the time of interruptions, it was found that nurses spent more time during indirect care (34.9%). Of the 736 activities, 426 (57.9%) were interrupted, with an average of 1.8 interruptions per primary activity, at a total of 1,334 occurrences (11.8 interruptions per hour). The indirect care was the most interrupted (53.5%), followed by direct care (29.8%), administrative activity (13.2%) and personal activity (3.5%). The activity with the highest number of interruptions was the nursing record (28.1%), followed by patient evaluation (13.7%), and procedures or patient care (10.6%). The interruptions corresponded to 41% of nurses' work time during the observation period. The median duration of interrupted primary activities was eight minutes and the non-interrupted was 2.5 minutes. The number of interruptions was higher in the morning shift (36%), but the duration of interruptions was higher at the night shift (34.1%). The main sources of interruptions were the nursing team (40.6%) and self-interruption (13.3%), being the sources that most demanded the nurses' time, 41.2% and 12.3%, respectively. Regarding the reasons for the interruptions, the most frequent were those related to the patient (31%), administrative (24%), personal (18%), help (17%), environment (8%) and teaching and research (2%). The main reasons were providing and receive information related to the patient (18.1%), parallel conversation (12.5%) and alarms (6.1%). The reason that most consumed the nurse's time was the parallel conversation (32.3%). After the occurrence of interruptions, the nurses did not return to primary activity in 1.8% of the cases, being necessary to attend from one to 30 interruptions before returning to the initial activity. When comparing the frequency of interruptions of the Emergency Care Subunits and the Intensive Care Unit of the Emergency Care Unit, it was observed that the second corresponded to 54% of the interruptions, besides representing 61.5% of the total time of the interruptions. Conclusion: The knowledge of the interruptions in the work of the nurse can contribute to list interruptions that promote patient safety and those that generate problems for concentration and interfere in the quality of care and in the patient safety. The professional should stick to the activity in execution and evaluate the pertinence of the intervention according to the situation.(AU)


Assuntos
Humanos , Qualidade da Assistência à Saúde , Enfermagem em Emergência/estatística & dados numéricos , Segurança do Paciente , Ambiente de Instituições de Saúde , Inquéritos e Questionários , Dissertação Acadêmica
11.
Rev. Rol enferm ; 41(10): 666-670, oct. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-179758

RESUMO

Objetivos: Medir la intensidad de los cuidados enfermeros que precisan los intoxicados que acuden a Urgencias. Método: Durante cuatro meses se registraron los intoxicados remitidos a Urgencias y se seleccionó un subgrupo en el que se midieron los tiempos consumidos por enfermería en cada una de las actividades asistenciales. Resultados: Se registraron 155 intoxicados. La intoxicación medicamentosa fue más frecuente en días laborables (p < 0.05) y la alcohólica en los no laborables (p < 0.05). Al 72 % se les realizó una extracción de sangre y al 55 % de orina para identificar la presencia de tóxicos. Al 79 % se le administró alguna medicación y al 25% carbón activado. El consumo de tiempo en la comunicación verbal fue mayor en el grupo intoxicado con fármacos (p < 0.001). Conclusiones: La ingesta de fármacos ha sido la intoxicación atendida con mayor frecuencia, en particular en días laborables. El intoxicado por medicamentos es el que requiere más tiempo de comunicación verbal


Objectives: To describe and measure the intensity of nursing care in intoxicated patients attended by different levels of emergency care, depending on the day of admission and type of poison involved. Methods: Observational, cross-sectional, descriptive study. For four months, patients referred to the emergency department for acute poisoning were recorded. Of the total patients, a subgroup in which the nursing time used in each activity of the care process were measured was selected. Epidemiological variables (sex, age, date and time of admission to the emergency room), toxicology (type of poison), level of triage, nursing activities and patient outcomes were recorded. Results: 155 cases of poisoning were recorded. Drug poisoning was more common in working days (p < 0.05) and alcoholic in nonworking (p < 0.05). 72 % of patients underwent a blood test and 55 % a urine test to detect the presence of toxic substances. 79 % was administered any medication and 25 % activated carbon. The use of time in verbal communication was greater in patients consuming medicaments (p < 0.001) compared with patients consuming alcohol or illicit drugs. Conclusions: The intake of drugs has been the most frequently attended poisoning, particularly on working days. The intoxicated by drugs is the most time-consuming verbal communication


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Tratamento de Emergência/enfermagem , Enfermagem em Emergência/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos , Envenenamento/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Envenenamento/enfermagem , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Custos de Cuidados de Saúde/estatística & dados numéricos
12.
Artigo em Inglês | MEDLINE | ID: mdl-30104524

RESUMO

Knowing professionals' attitudes is the basis for the development of skills for dealing with drug dependence. These attitudes may affect patients' clinical safety and the cost-benefit ratio of the interventions. The goal of this study was to assess emergency and mental health nurses' attitudes and perceptions towards alcoholics. A multicenter prospective descriptive study was conducted in six hospitals with 167 emergency and mental health nurses. Nurses classified alcoholics as sick individuals, although there was a tendency to feel uncomfortable working with them. Results indicated that these professionals had a rejecting attitude towards moderate alcohol consumption. It found that there was a significant association between the attitude of the nurse and gender, with the degree of rejection towards the alcoholic being higher in men than in women, and with less punitive attitudes in professionals with 0 to 11 years of professional experience.


Assuntos
Alcoolismo , Atitude do Pessoal de Saúde , Enfermagem em Emergência/estatística & dados numéricos , Enfermeiras e Enfermeiros/psicologia , Enfermagem Psiquiátrica/estatística & dados numéricos , Feminino , Humanos , Masculino , Estudos Prospectivos , Fatores Sexuais , Percepção Social , Inquéritos e Questionários
13.
Enferm. glob ; 17(50): 361-374, abr. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-173559

RESUMO

Investigación cuantitativa, descriptiva y exploratoria, llevada a cabo en una unidad de emergencia de la ciudad de Curitiba, Estado de Paraná - Brasil, que tuvo como objetivo identificar la percepción del personal de enfermería acerca de su entorno de trabajo y comparar la percepción del entorno de trabajo de las enfermeras y técnicos de enfermería. Para la recolección de datos se utilizó el instrumento Nursing Work Index - revisado y adaptado al contexto brasileño (B- NWIR), compuesto por 57 elementos que se dividen en cuatro subescalas: autonomía, control sobre el medio ambiente, relación entre los médicos y las enfermeras y apoyo organizativo. Los puntajes inferiores a 2,5 se consideran positivos y por encima de este valor, negativo. Los datos se introdujeron en la hoja de cálculo Excel y se analizaron mediante el software SPSS v.20. La investigación mostró opinión ética favorable conforme a la legislación nacional existente para los estudios en humanos. Los participantes fueron 17 enfermeras y 46 técnicos de enfermería. Hubo un predominio de mujeres jóvenes; sólo la subescala "autonomía" tuvo un promedio de menos de 2,5 y evaluada positivamente por el personal de enfermería. Entre los ítems que componen el instrumento 11 obtuvieron resultados satisfactorios en cuanto a la percepción del ambiente de trabajo, pero no hubo acuerdo entre los grupos estudiados para las medias por ítem. El ambiente de trabajo se evaluó negativamente para la práctica profesional del personal de enfermería y los resultados pueden ayudar a las acciones futuras de los profesionales de enfermería y gestores de servicios con el fin de proporcionar un entorno adecuado para la atención en la unidad de emergencia y de emergencia


Pesquisa quantitativa, descritiva e exploratória, realizada em uma Unidade de Pronto Atendimento do Município de Curitiba, Paraná - Brasil, que objetivou identificar a percepção da equipe de enfermagem quanto ao seu ambiente de trabalho e comparar a percepção do ambiente de trabalho entre enfermeiros e técnicos de enfermagem. Para a coleta de dados foi utilizado o instrumento Nursing Work Index - versão revisada e adaptada ao contexto brasileiro (B- NWIR), composto por 57 itens o qual é subdividido em quatro subescalas: autonomia, controle sobre o ambiente, relação entre médicos e enfermeiros e suporte organizacional. Escores abaixo de 2.5 são considerados positivos e acima deste valor, negativos. Os dados obtidos foram inseridos em planilha Excel(R) e analisados pelo software SPSS Statistics v.20. A pesquisa apresentou parecer ético favorável, conforme a legislação nacional vigente para estudos com seres humanos. Participaram 17 enfermeiros e 46 técnicos de enfermagem. Houve o predomínio de mulheres jovens; apenas a subescala "Autonomia" obteve média inferior a 2,5 e avaliada positivamente por técnicos de enfermagem. Entre os itens que compõem o instrumento, 11 obtiveram resultados satisfatórios quanto à percepção do ambiente de trabalho, contudo não houve concordância entre os grupos estudados para as médias por item. O ambiente de trabalho foi avaliado de forma negativa para a prática profissional da equipe de enfermagem e os resultados podem subsidiar futuras ações dos profissionais de enfermagem e gestores do serviço com vistas a proporcionar um ambiente adequado ao atendimento em unidade de urgência e emergencia


A quantitative, descriptive and exploratory study was carried out in an Emergency Care Unit of the Municipality of Curitiba, Paraná, Brazil, which aimed to identify the perception of the nursing team regarding their work environment and to compare the perception of the working environment among nurses And nursing technicians. For data collection, the Nursing Work Index - a revised version adapted to the Brazilian context (B-NWIR) was used, composed of 57 items, which is subdivided into four subscales: autonomy, control over the environment, relationship between doctors and nurses And organizational support. Scores below 2.5 are considered positive and above this negative value. The data obtained inserted in an Excel(R) worksheet and analyzed by SPSS Statistics software v.20. The research presented a favorable ethical opinion, according to the national legislation in force for studies with human beings. Participants were 17 nurses and 46 nursing technicians. There was a predominance of young women, only the subscale "Autonomy" obtained an average of less than 2.5 and evaluated positively by nursing technicians. Among the items that make up the instrument, 11 obtained satisfactory results regarding the perception of the work environment, however there was no agreement among the groups studied for the averages per item. The work environment evaluated in a negative way for the professional practice of the nursing team and the results can subsidize future actions of the nursing professionals and managers of the service with a view to providing an adequate environment to the attendance in an emergency and emergency unit


Assuntos
Humanos , Ambiente de Trabalho , Avaliação de Desempenho Profissional , Enfermagem em Emergência/organização & administração , Enfermeiras e Enfermeiros/estatística & dados numéricos , Tratamento de Emergência/enfermagem , Enfermagem em Emergência/estatística & dados numéricos
14.
J Emerg Nurs ; 44(4): 394-401, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29478850

RESUMO

INTRODUCTION: Patient experience ratings are important to health care organizations from both a clinical and financial perspective. Studies examining the relationship between patient experience and nurse staffing are prevalent in the inpatient setting, but not as much is known about how staffing affects these ratings in the emergency department. METHODS: Using responses from 3,120 adult patients who visited the emergency department of a large academic medical center in the southeastern United States between March 1, 2015, and November 30, 2015, this study examined the relationships between ED RN staffing and patient experience ratings. Ordinal logistic regression models were used to examine the relationship between 2 nurse staffing variables and patient ratings of care. RESULTS: Overall, higher levels of RN staffing in the emergency department were associated with better patient ratings of their care experiences, but the strength and significance of this relationship varied as a function of different factors (eg, how staffing is measured, discharge status of the patient). DISCUSSION: Higher levels of ED RNs may enable nurses to better meet the expectations of patients presenting to the emergency department, highlighting a number of opportunities for allocating nursing resources.


Assuntos
Enfermagem em Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência , Enfermeiras e Enfermeiros/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Centros Médicos Acadêmicos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sudeste dos Estados Unidos , Adulto Jovem
15.
Air Med J ; 37(1): 51-53, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29332778

RESUMO

OBJECTIVE: Airway management is a requisite skill set for helicopter emergency medical service (HEMS) providers. Cricothyrotomy is a potentially lifesaving skill that is used when other airway maneuvers fail. The authors reviewed all transports by a helicopter program in which cricothyrotomy was performed to assess the frequency, success, and technique. METHODS: This was a retrospective chart review of air medical patient records from an electronic medical record system over a 112-month period. RESULTS: During the study period, 22,434 patients were transported, 13 (.057%) of whom underwent cricothyrotomy. The typical patient was a male trauma victim with a mean Glasgow Coma Score of 5 transported from an accident scene with a mean age of 34.3 years. Six (46%) of the patients were alive at 24 hours. All patients (13/100%) received attempted endotracheal intubation; the mean number of attempts per patient was 2. The success rate was 100% with all patients ventilated via cricothyrotomy. CONCLUSION: This study shows cricothyrotomy is a rarely performed skill but that HEMS providers are able to successfully learn the skill with proper training and oversight.


Assuntos
Resgate Aéreo , Manuseio das Vias Aéreas/estatística & dados numéricos , Adulto , Resgate Aéreo/estatística & dados numéricos , Auxiliares de Emergência/estatística & dados numéricos , Enfermagem em Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Estudos Retrospectivos
16.
J Emerg Nurs ; 44(2): 156-163, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28755762

RESUMO

INTRODUCTION: Emergency nurses play an important role in the care of critically ill and injured patients, and their competency to perform clinical skills is vital to safe and effective patient care. The aim of this study was to evaluate the frequency of clinical skills performed and perceived competency levels among Iranian emergency nurses. In addition, attitudes toward expanding the professional roles of Iranian emergency nurses were also assessed. METHODS: In this descriptive correlational study, 319 emergency nurses from 30 hospitals in northwest Iran participated. Data were collected using a self-report questionnaire. Descriptive statistics and Pearson's correlation coefficient were used to present the findings. RESULTS: Overall competency of the emergency nurses was 73.31 ± 14.2, indicating a good level of perceived competence. The clinical skills most frequently performed were in the domains of organizational and workload competencies (3.43 ± 0.76), diagnostic function (3.25 ± 0.82), and the helping role (3.17 ± 0.83). A higher level of perceived competence was found for skills within these domains. Less frequently, participants performed skills within the domains of effective management of rapidly changing situations (2.70 ± 0.94) and administering and monitoring therapeutic interventions (2.60 ± 0.97); a lower perceived level of competence was noted for these clinical skills. There was a significant correlation between frequency of performing clinical skills and perceived competency level (r = 0.651, P < .001). Participants had positive attitudes toward expanding their professional roles (2.13 ± 0.92), with 81.5% agreeing it would improve their job satisfaction. DISCUSSION: Higher perceived competency levels were significantly associated with more frequent performance of clinical skills. This has implications for nurse managers and educators who may consider offering more frequent experiential and educational opportunities to emergency nurses. Expansion of nurses' roles could also result in increased experience in clinical skills and higher levels of competency. Research is needed to investigate nurses' clinical competence using direct and observed measures.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica/estatística & dados numéricos , Enfermagem em Emergência/estatística & dados numéricos , Satisfação no Emprego , Papel do Profissional de Enfermagem/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Adulto , Enfermagem em Emergência/métodos , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Inquéritos e Questionários , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos , Adulto Jovem
17.
Worldviews Evid Based Nurs ; 15(2): 97-103, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29266786

RESUMO

BACKGROUND: Patient-visitor violence (PVV) committed against nurses is a worldwide problem. Registered nurses in emergency departments (EDs) are particularly susceptible. The frequency and severity of PVV against emergency nurses (ENs) internationally is well documented. Little is known about factors that make ENs feel safe from PVV. AIM: Examine the psychometric properties of the Personal Workplace Safety Instrument for Emergency Nurses (PWSI-EN), developed to measure ENs' perceptions of safety from PVV. METHODS: Instrument development was based on a literature review, input from ENs, and expert opinion. An online version of the PWSI-EN was distributed to a convenience sample of ENs practicing in EDs across the United States. Psychometric testing included measures of internal consistency reliability, construct validity to support subscales, and comparisons on demographic variables. RESULTS: Three-hundred and five (N = 305) ENs from 16 hospitals responded to the original 31-item PWSI-EN. Based on item analysis and exploratory factor analysis (EFA), the instrument was reduced to 23 items with Cronbach's α = .912. EFA delineated six subscales relevant to perception of safety from PVV with factor loadings from .342 to .879. Low to moderate subscale correlations showed a degree of independence for concept domains. Known groups approach for construct validity revealed statistically significant differences (p < .05) for five subscales and the total score between community and academic or teaching hospitals. Hospital type, organizational confidence, and fear for patient safety were significant predictors of greater perceptions of safety from PVV. LINKING EVIDENCE TO ACTION: The PWSI-EN is a valid and reliable survey instrument to assess EN perceptions of safety. ED and hospital leaders can use this instrument to determine specific areas to focus efforts in order to improve ENs' perception of safety from PVV. Researchers exploring interventions aimed at improving perceptions of safety from PVV for ENs may find the PWSI-EN useful.


Assuntos
Enfermeiras e Enfermeiros/psicologia , Saúde do Trabalhador/normas , Psicometria/instrumentação , Psicometria/normas , Violência no Trabalho/prevenção & controle , Enfermagem em Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Análise Fatorial , Humanos , Enfermeiras e Enfermeiros/estatística & dados numéricos , Saúde do Trabalhador/estatística & dados numéricos , Percepção , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes , Inquéritos e Questionários , Estados Unidos , Recursos Humanos , Local de Trabalho/psicologia , Local de Trabalho/normas , Local de Trabalho/estatística & dados numéricos , Violência no Trabalho/estatística & dados numéricos
18.
J Emerg Nurs ; 44(1): 37-45, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29167032

RESUMO

ABSTRACTINTRODUCTION: Patient satisfaction and patient experience goals are often linked to financial consequences. Although the link does exist, the bottom line is not only about money; it's about providing a quality experience for ED patients and creating an environment that engages staff. Evidence-based practice (EBP) strategies that have positive impact on patient perceptions of their ED care and increased satisfaction ratings include AIDET, Hourly Rounding, and Bedside Shift Report, which incorporate updates of test results and explanations of events occurring during a patient's visit. In addition to these outcomes, Hourly Rounding and Bedside Shift Report have been linked to patient safety improvements. Combining these strategies, our team created and implemented the service nursing bundle as a quality improvement (QI) initiative, with the goal of having a positive effect on patient experiences in emergency departments, represented by at least a 5% increase in overall quality-of-care ranking and ratings. METHODS: This QI project involved comparing professional research consultant (PRC) patient- satisfaction phone survey ratings from patients before and after ED staff members completed a 1-hour service nursing bundle class. In addition to the patient-satisfaction ratings, 1,104 audits evaluating staff use of the service bundle implementation were collected over an 8-week period.reading document: RESULTS: The random observational audits showed the adoption of the service nursing bundle as staff compliance started at 65% in week 1 compared with 100% by week 8. Before intervention (July 2015): 50% of patients rated their overall quality of care as excellent, yielding a benchmark ranking of 42.5 percentile. Postservice bundle education implementation (September 2015): 60% of patients rated their overall quality of care as excellent, increasing our ranking to the 85.5 percentile. The postservice bundle group was 1.5 times more likely to respond "excellent" to all 5 survey questions, which was statistically significant (z =2.82, P = 0.004). The patients' perceptions of total time spent in the emergency department and ratings of "excellent" revealed a significant statistical difference (before: 35.0%, after: 49.5%, X2 (1) = 4.24, P < 0.05). DISCUSSION: With the implementation of the bundle, our emergency department experienced an 11.8% increase in the number of patients rating their overall quality of care as excellent. This upsurge resulted in a 40% increase in overall quality of care, propelling our emergency department's ranking to the 85th percentile.


Assuntos
Enfermagem em Emergência/métodos , Prática Clínica Baseada em Evidências/métodos , Pesquisas sobre Serviços de Saúde/métodos , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Melhoria de Qualidade/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Enfermagem em Emergência/normas , Enfermagem em Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/normas , Segurança do Paciente/estatística & dados numéricos , Adulto Jovem
19.
Australas Emerg Nurs J ; 20(3): 107-113, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28705687

RESUMO

INTRODUCTION: Workplace violence is one of the most significant and hazardous issues faced by nurses globally. It is a potentially life-threatening and life-affecting workplace hazard often downplayed as just "part of the job" for nurses. METHODS: A cross-sectional design was used and data were collected using a purpose developed survey tool. Surveys were distributed to all members of the College of Emergency Nurses' Australasia (CENA) in 2010 and 537 eligible responses were received (RR=51%). RESULTS: Patient-related violence was reported by 87% of nurses in the last six months. Precipitants and antecedents for episodes of violence were reported in three categories: nurse-related; patient-related and emergency-department specific factors. Triaging was identified as the highest risk nursing activity, and the triage area identified as the highest risk location in the department. Patients who presented with alcohol intoxication, substance misuse or mental health issues were identified as the groups at greatest risk for potential violence. DISCUSSION: Patient-related violence was reported by the majority of emergency nurses surveyed. A number of precipitants and antecedents perceived to be risk factors by participants were found to be significant and are unavoidable in the working lives of emergency department nurses.


Assuntos
Agressão , Enfermagem em Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/organização & administração , Relações Enfermeiro-Paciente , Recursos Humanos de Enfermagem no Hospital/psicologia , Violência no Trabalho/estatística & dados numéricos , Adulto , Intoxicação Alcoólica , Austrália , Distribuição de Qui-Quadrado , Estudos Transversais , Humanos , Modelos Logísticos , Pessoas Mentalmente Doentes/estatística & dados numéricos , Pessoa de Meia-Idade , Saúde do Trabalhador , Fatores de Risco , Inquéritos e Questionários , Triagem/estatística & dados numéricos , Adulto Jovem
20.
Enferm. clín. (Ed. impr.) ; 27(3): 172-178, mayo-jun. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-163214

RESUMO

Objetivo: Determinar los niveles de estrés e identificar si existe relación entre la inteligencia emocional y el estrés laboral en enfermeras y auxiliares de enfermería del Servicio de Urgencias del Complexo, Hospitalario Universitario de Ourense. Método: Estudio observacional, descriptivo transversal con enfoque cuantitativo. La población de estudio fueron las enfermeras y auxiliares de enfermería del Servicio de Urgencias del Complexo Hospitalario Universitario de Ourense. La recogida de datos se llevó a cabo entre enero y mayo de 2016. Como instrumento se utilizó un cuestionario anónimo y autoadministrado que incluía el Trait Meta-Mood Scale y el Cuestionario breve de burnout. Se realizó un análisis descriptivo y de asociación de variables utilizando el programa SPSS 15.0. El estudio fue aprobado por el CEIC de Galicia. Resultados: Participaron un total de 60 profesionales, de los cuales, 36 eran enfermeras y 24 técnicos en cuidados auxiliares de Enfermería. La tasa de respuesta fue de un 68,1%. Los resultados mostraron un déficit en el área de atención emocional, con una puntuación de 22,87, situándose la claridad emocional y la reparación de emociones en valores normales, con valores de 26,42 y 26,60, respectivamente. Los niveles de burnout muestran unas puntuaciones totales medias entre los 22,11 puntos para las enfermeras y 22,96 para los técnicos auxiliares de cuidados. La puntuación media obtenida en la dimensión de despersonalización fue de 8,05, en cansancio emocional 6,90 y en el componente de realización profesional 7,50. Se encontraron correlaciones positivas estadísticamente significativas entre la situación laboral y la claridad emocional (r=0,276; p=0,033) y entre esta y la realización personal (r=0,277; p=0,032) y la organización (r=0,316; p=0,014). Conclusiones: Los profesionales de Enfermería del servicio de urgencias presentan niveles medios-altos de burnout, siendo la despersonalización el síntoma que refleja los valores más elevados. La inteligencia emocional está relacionada con el estrés laboral y, de manera específica, la comprensión de los propios estados emocionales influye en la realización personal. Los profesionales con más estabilidad laboral muestran una mejor capacidad para sentir y expresar sus sentimientos (AU)


Objective: To determine stress levels and to identify if there is a relationship between emotional intelligence and work stress in nurses and healthcare assistants of the Emergency Department. Method: Observational, descriptive and cross-sectional study with a quantitative approach. The population were nurses and healthcare assistants of the Emergency Department of the University Hospital of Ourense. The data were collected between January and May 2016. The tool used was a validated, anonymous, and self-administered questionnaire that included the Trait Meta-Mood Scale and Moreno's Brief Burnout Questionnaire. The study was approved by the Clinical Research Ethics Committee of Galicia. Descriptive and association analyses were performed using the SPSS 15.0 statistics program. Results: A total of 60 professionals participated, of whom 36 were qualified nurses and 24 were auxiliary nurses. The response rate was 68.1%. The results showed a deficiency in emotional care, with a score of 22.87, while emotional clarity and reparation of emotions were situated within normal levels, with values of 26.42 and 26.60, respectively. The burnout levels of the sample were medium-high. The mean score in the depersonalisation dimension was 8.05, whereas emotional fatigue obtained a mean of 6.90, with a value of 7.50 for professional fulfilment. Significant positive correlations were found between the employment situation and emotional clarity (r=.276; P=.033), and between the latter and personal fulfilment (r=.277; P=.032), and organisation (r=.316; P=.014). Conclusions: Nurses and healthcare assistants of the Emergency Department showed medium-high average levels of burnout, with depersonalisation being the symptom that reflects the highest values. Emotional Intelligence is related to work stress and, specifically, the understanding of one's own emotional states influences personal fulfilment. Professionals with more job stability show a better capacity to feel and express their feelings (AU)


Assuntos
Humanos , Inteligência Emocional , Adaptação Psicológica , Estresse Psicológico/epidemiologia , Esgotamento Profissional/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Enfermagem em Emergência/estatística & dados numéricos
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