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1.
Rio de Janeiro; s.n; 20200100. 60 p. ilus, tab, graf.
Monografia em Português | Coleciona SUS | ID: biblio-1049879

RESUMO

A Ergonomia busca o ajuste mútuo entre o homem e seu ambiente de trabalho de forma confortável, produtiva e segura. Em relação à saúde do trabalhador, a desatenção com a Ergonomia, implica em maior afastamento por licença médica gerando custos por parte das Empresas e Instituições. Dito isto, durante a visita técnica ao setor de internação do Instituto Nacional de Câncer- Unidade III foi observada situações de trabalho causadoras de desconforto e fadiga relacionadas à organização do trabalho, ao ritmo e a produtividade. O estudo do absenteísmo revelou que os profissionais de enfermagem (enfermeiros e técnicos de enfermagem) eram os mais acometidos por doenças osteomusculares e distúrbios psicossociais. Diante desta constatação, houve a necessidade de realizar a Análise Ergonômica do Trabalho e a aplicação de questionário estruturado e distribuído à equipe de enfermagem para que externassem suas percepções quanto ao ambiente de trabalho. Em seguida, foram entrevistados os mesmos profissionais, tendo sido convidados de forma aleatória dois trabalhadores por função. Posteriormente, foi utilizado o método REBA (Rapid Entire Body Assessment) para analisar o conjunto das posições adotadas pelos membros superiores, tronco, coluna cervical e pernas. Por se tratar de uma Instituição de tratamento de pacientes oncológicos, os fatores organizacionais e psicossociais/cognitivos foram os mais prevalentes. Além disso, ficou evidente que, a alta demanda de trabalho com a exigência de concentração e atenção, associada à constante necessidade de tomada de decisão, impõe um ritmo acelerado e estressante para os trabalhadores. A complexidade do conteúdo das tarefas e a incorporação de novos tratamentos e tecnologias, também exigem aperfeiçoamento e treinamento constantes. Os fatores relacionados à Ergonomia Física e Ambiental, embora tenham sido menos valorizados, foram estudados através do método REBA, que avalia os riscos relacionados ao sistema musculoesquelético. Esse método apontou a necessidade de intervenção no ambiente de trabalho ao receber a pontuação cinco, o que significa risco médio de adoecimento por doenças osteomusculares. Assim sendo, será elaborado um plano de ação com propostas de melhorias a serem implantadas a curto, médio e longo prazo que contemple orientações sobre a necessidade de mudança de normas, métodos e processos de trabalho.(AU)


Ergonomics pursues the mutual matching between man and his work environment in a comfortable, productive and safe manner. In terms of labor health, disregarding ergonomics implies a greater absence due to sick leave, generating costs on the part of companies and institutions. That said, during a technical visit to the hospitalization sector of the National Institute of Cancer - Unit III, workplace situations causing discomfort and fatigue related to work organization, rhythm and productivity were observed. The absenteeism study revealed that nursing professionals (nurses and nursing technicians) were the professionals the most affected by musculoskeletal and psychosocial disorders. Given this finding, it was necessary to perform the Ergonomic Work Analysis and the application of a structured questionnaire to the nursing team to allow them to express their perceptions about the work environment. Subsequently, the professionals were interviewed by randomly inviting two workers per function. Afterward, the REBA (Rapid Entire Body Assessment), was used to analyze the set of positions performed by the upper limbs, trunk, cervical spine and legs. Since it is an institution for cancer treatment, the organizational and psychosocial/cognitive factors were the most prevalent. Moreover, the high work demand, with concentration and attention requirements, associated with the constant need for decision making impose a fast imposes a fast and stressful pace for workers. The tasks complexity and the incorporation of new treatments and technologies also require continuous professional improvement and training. Factors related to Physical and Environmental Ergonomics, although less valued, were studied through the REBA method, which assesses the risks related to the musculoskeletal system. This method pointed to the need for intervention in the workplace after receiving a score of five, translating an average risk of getting sick with musculoskeletal diseases. Therefore, an action plan will be prepared with improvement proposals to be implemented in short, medium and long terms, and that will provide guidance on the need of modifying norms, methods and work processes.


Assuntos
Humanos , Masculino , Feminino , Ergonomia , Riscos Ocupacionais , Saúde do Trabalhador , Absenteísmo , Profissionais de Enfermagem
2.
J Oncol Pharm Pract ; 26(1): 116-123, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31096855

RESUMO

PURPOSE: Nurse practitioners, physician assistants, and pharmacists are advanced practice providers who are highly trained and qualified healthcare professionals that can help support traditional demands on oncologists' increased time in direct patient care. The purpose of this study was to detail and assess the creation of a privileging process for this group of medical professionals within an academic medical center. Obtaining the designation of limited oncology practice provider (LOPP) gives the right to modify chemotherapy orders and to order supportive care medications. METHODS: An interdisciplinary team developed a comprehensive training process inclusive of required educational domains, knowledge goals, and educational activities to become an LOPP. In 2018, five years after the implementation of the privileging process, a survey was distributed to assess perceptions of the training process and integration of LOPPs within oncology practice. RESULTS: Most oncologists noted that working with LOPPs is beneficial to oncology practice (94%) and that they make modifying chemotherapy orders more efficient (87%). Greater than 82% of LOPPs also reported that their privileges streamline the chemotherapy process and make them feel valuable. CONCLUSION: The creation of the LOPP designation is an effective way to integrate nurse practitioners, physician assistants, and pharmacists within oncology practice. The inclusion of a focused privileging process ensures the safety of cancer care provided and has created a streamlined process for chemotherapy modifications and supportive care.


Assuntos
Centros Médicos Acadêmicos/normas , Prática Avançada de Enfermagem/normas , Oncologia/normas , Profissionais de Enfermagem/normas , Farmacêuticos/normas , Assistentes Médicos/normas , Centros Médicos Acadêmicos/métodos , Prática Avançada de Enfermagem/métodos , Antineoplásicos/administração & dosagem , Feminino , Humanos , Masculino , Oncologia/métodos , Inquéritos e Questionários
3.
J Nurs Adm ; 50(1): 22-27, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31809453

RESUMO

This article describes a practice improvement initiative (PII) demonstrating the impact of doctorate of nursing practice (DNP) skills beyond direct patient care. The Donna Wright Competency Assessment Model, AACN DNP Essentials, and National Organization of Nurse Practitioner Faculties nurse practitioner competencies framed the PII. The DNP graduates planned, implemented, and evaluated an assessment of 1,055 staff nurses on shift hand-off, physical assessment, and hand hygiene. Results indicated that 95% of the staff nurses scored 100% on competency assessment. The PII model was adopted for future competency evaluation.


Assuntos
Benchmarking , Modelos de Enfermagem , Profissionais de Enfermagem , Recursos Humanos de Enfermagem no Hospital/normas , Padrões de Prática em Enfermagem/normas , Humanos , Estados Unidos
4.
J Nurs Adm ; 50(1): 40-44, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31809455

RESUMO

The purpose of the Aging Well Nursing-Interprofessional Salon was to explore current local community healthcare issues for older adults and to develop innovative strategies that support and enhance their health. An initiative emerged from the salon that focuses on identifying caregivers to ensure their awareness of available support resources. We are in the process of developing a pilot plan that includes collaboration of PhD and doctorate of nursing practice students, nursing faculty, and community agencies that support older adults.


Assuntos
Cuidadores , Serviços de Saúde Comunitária , Serviços de Saúde para Idosos , Profissionais de Enfermagem , Idoso , Feminino , Humanos , Masculino , Massachusetts
5.
Hu Li Za Zhi ; 66(6): 33-42, 2019 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-31802453

RESUMO

BACKGROUND: The gap between the expectation and the development of role competency is a dilemma that nurse practitioners (NPs) face in clinical settings. PURPOSE: This study was designed to explore the perceived importance and actual practice of the role competencies of NPs and to compare the differences between the ideal and practical domains as well as related factors. METHODS: This cross-sectional design study used Q-sort to collect data. A 56-item "Nurse Practitioner Role Capacity Questionnaire" was used as the research tool. Two questionnaires: Perceptions of Important Role Competencies and Actual Execution of Role Competencies were distributed to NPs twice, at times that were 2 weeks apart. A total of 40 participants were recruited, including 21(52.5%) internal medicine NPs and 19 (47.5%) surgical medicine NPs. RESULTS: The significant differences that were identified in this study between the perceived importance and actual practice of role competencies were, by domain: medical assistance (t = -5.62, p < .001), clinical research (t = 4.14, p < .001), professional consultation (t = 2.29, p = .027), and direct care (t = 2.21, p = .033). The correlative factors for these differences were: education level (t = -2.17, p = .036) and membership in the Nurse Practitioner Association (t = -2.36, p = .017). NPs with higher levels of education and with membership in the Nurse Practitioner Association earned higher scores for self-expectation in important clinical competency. CONCLUSIONS: NPs face discrepancies in their role expectations, in important part due to their role as providers of medical assistance in clinical practical settings. NPs need to learn and demonstrate the roles and functions of advanced nursing practice to enhance nursing professionalism profoundly.


Assuntos
Competência Clínica , Profissionais de Enfermagem/psicologia , Papel do Profissional de Enfermagem/psicologia , Estudos Transversais , Humanos , Q-Sort , Inquéritos e Questionários
6.
Rev Infirm ; 68(256): 45-46, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31870482

RESUMO

Catherine is an advanced nurse practitioner working in a large general practice in the north of England. She works alongside her medical colleagues and receives and treats patients with undifferentiated complaints. Tom, a 33 year-old man, is presenting today with respiratory symptoms.


Assuntos
Medicina Geral , Profissionais de Enfermagem , Adulto , Feminino , Humanos , Masculino , Motivação , Satisfação do Paciente
7.
J Opioid Manag ; 15(6): 455-468, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31850507

RESUMO

OBJECTIVE: The goal of the study was to assess knowledge gaps and practice patterns of US-based addiction specialists, primary care physicians (PCPs), nurse practitioners (NPs), and physician assistants (PAs) who treat patients with opioid use disorder (OUD). DESIGN: As part of a prospective study, the authors developed a survey tool consisting of case-vignettes and questions designed to reveal practice patterns and highlight gaps in clinician knowledge. SETTING: The primary study setting included clinicians practicing in outpatient care. PARTICIPANTS: The surveys were distributed via email between August and September 2017 to a national sample of addiction specialists, PCPs, and NPs/PAs that see at least one patient per week and at least 1 percent of their patient population had to be diagnosed with OUD. RESULTS: The knowledge assessment results varied among the clinicians surveyed. Addiction specialists saw more patients with OUD than PCPs, NPs, or PAs. They also demonstrated a higher level of understanding and knowledge of the various domains assessed. CONCLUSIONS: There are multiple educational intervention strategies that can support the clinicians; including reducing restrictions to access treatment for OUD, care coordination programs for patients to improve early access to treatment and education, and frequent chart audit and feedback programs to support clinician decision making and education.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Transtornos Relacionados ao Uso de Opioides , Analgésicos Opioides , Humanos , Profissionais de Enfermagem/psicologia , Transtornos Relacionados ao Uso de Opioides/terapia , Assistentes Médicos/psicologia , Médicos de Atenção Primária/psicologia , Padrões de Prática Médica , Estudos Prospectivos
8.
Policy Polit Nurs Pract ; 20(4): 191, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31766948
9.
Br J Nurs ; 28(19): 1251-1255, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31680575

RESUMO

This article describes how one NHS trust in northern England developed the advanced nurse practitioner (ANP) role within its memory services. It discusses how ANP roles were developed and implemented across four localities of a large NHS trust that provides a number of locally based memory services to improve the diagnostic pathway for people referred to the service and their carers. Advanced practice is considered more broadly followed by a review of the literature related to the role of the ANP and non-medical prescriber in mental health and, more specifically, memory assessment and diagnostic services. Challenges to gaining the requisite competency to work as an ANP are discussed. The need for a clear agreed strategy to ensure practitioner competence and effective governance for the introduction of these roles is described. It is argued that using this model allowed for mental health nurses within memory services to make a major contribution to the transformation of such services and receive recognition for the expansion of their role and appropriate remuneration linked to national NHS employment role profiles. The potential benefit of the ANP role more broadly in mental health services is discussed, together with factors that may have previously hindered their contribution to the transformation of services. The strategic development and planning process that led to implementing the ANP role within memory services is presented, together with a description of how the relevant higher level clinical skills required for the roles were achieved and formally accredited.


Assuntos
Transtornos da Memória/enfermagem , Serviços de Saúde Mental/organização & administração , Profissionais de Enfermagem , Papel do Profissional de Enfermagem , Inglaterra , Humanos , Medicina Estatal/organização & administração
10.
Medicine (Baltimore) ; 98(48): e18129, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770244

RESUMO

BACKGROUND: This study aims to assess the effect of Balint training (BT) in gastroenterology intern nurse practitioners (GINP) systematically. METHODS: This study will search EMBASE, MEDLINE, PsycINFO, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, and China National Knowledge Infrastructure from inception to the September 30, 2019 with no language limitation. In addition, we will also search grey records, such as conference abstracts and dissertations. Study quality will be checked using Cochran risk of bias tool. Statistical analysis will be performed using RevMan 5.3 software. RESULTS: This study will systematically evaluate the effect of BT in GINP and will provide evidence to judge whether BT is effective for GINP clinically. CONCLUSION: The results of this study may provide helpful evidence of BT in GINP in the clinical training.


Assuntos
Gastroenterologia/educação , Profissionais de Enfermagem/educação , Terapia Psicanalítica/educação , Avaliação Educacional , Humanos , Projetos de Pesquisa , Revisão Sistemática como Assunto
11.
JAAPA ; 32(12): 1, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31770311
12.
Nurs Outlook ; 67(6): 707-712, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31607371

RESUMO

BACKGROUND: The research findings about nurse practitioner (NP) patient experiences (satisfaction) are limited to small sample sizes from local community clinics. No national studies with large sample sizes were found. PURPOSE: To analyze responses from the Consumer Assessment of Healthcare Providers and Systems survey and compare the patient experiences from four different provider categories. METHODS: Secondary data analysis was completed on survey responses from 53,885 patients. FINDINGS: In the sample, medical doctor providers were disproportionately represented in greater number than NPs, doctor of osteopathy, or physician assistant. Further analysis comparing patient experiences between providers revealed NP to be rated significantly higher than their colleagues. DISCUSSION: Recognizing the factors associated with patient satisfaction with their providers can lead to improvements in patient-provider interactions that can result in increased quality of care. CONCLUSION: Policy makers should find opportunities to employ NP in primary care settings and achieve greater patient satisfaction that can influence outcomes associated with patient-centered care initiatives.


Assuntos
Profissionais de Enfermagem/estatística & dados numéricos , Relações Enfermeiro-Paciente , Satisfação do Paciente/estatística & dados numéricos , Relações Médico-Paciente , Médicos/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados Unidos
15.
Br J Nurs ; 28(19): 1151-1155, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31647730

RESUMO

This article describes how one NHS trust in northern England developed the advanced nurse practitioner (ANP) role within its memory services. It discusses how ANP roles were developed and implemented across four localities of a large NHS trust that provides a number of locally based memory services to improve the diagnostic pathway for people referred to the service and their carers. Advanced practice is considered more broadly followed by a review of the literature related to the role of the ANP and non-medical prescriber in mental health and, more specifically, memory assessment and diagnostic services. Challenges to gaining the requisite competency to work as an ANP are discussed. The need for a clear agreed strategy to ensure practitioner competence and effective governance for the introduction of these roles is described. It is argued that using this model allowed for mental health nurses within memory services to make a major contribution to the transformation of such services and receive recognition for the expansion of their role and appropriate remuneration linked to national NHS employment role profiles. The potential benefit of the ANP role more broadly in mental health services is discussed, together with factors that may have previously hindered their contribution to the transformation of services. The strategic development and planning process that led to implementing the ANP role within memory services is presented, together with a description of how the relevant higher level clinical skills required for the roles were achieved and formally accredited.


Assuntos
Transtornos da Memória/enfermagem , Serviços de Saúde Mental/organização & administração , Profissionais de Enfermagem , Papel do Profissional de Enfermagem , Inglaterra , Humanos , Medicina Estatal/organização & administração
16.
JAAPA ; 32(2): 52, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31579253

RESUMO

PAs and NPs have broad prescribing authority in the United States, yet little is known about how the quality of their prescribing practices compares with that of physicians. The quality of prescribing practices of physicians, PAs, and NPs was investigated through a serial cross-sectional analysis of the 2006-2012 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS). Ambulatory care services in physician offices, hospital EDs, and outpatient departments were evaluated using a nationally representative sample of patient visits to physicians, PAs, and NPs. Main outcome measures were 13 validated outpatient quality indicators focused on pharmacologic management of chronic diseases and appropriate medication use. The study sampled 701,499 patient visits during the study period, representing about 8.3 billion visits nationwide. Physicians were the primary provider for 96.8% of all outpatient visits examined; PAs and NPs each accounted for 1.6% of these visits. The proportion of eligible visits in which quality standards were met ranged from 34.1% (angiotensin-converting enzyme inhibitor use for patients with heart failure) to 89.5% (avoidance of inappropriate medications in older adults). The median overall performance across all indicators was 58.7%. On unadjusted analyses, differences in quality of care between PAs, NPs, and physicians for each indicator did not consistently favor one practitioner type over others. After adjustment for potentially confounding patient and provider characteristics, the quality of prescribing by PAs and NPs was similar to the care delivered by physicians for 10 of the 13 indicators evaluated, and no consistent directional association was found between provider type and indicator fulfillment for the remaining measures. Although significant shortfalls exist in the quality of ambulatory prescribing across all practitioner types, the quality of care delivered by PAs, NPs, and physicians was generally comparable.1.


Assuntos
Profissionais de Enfermagem , Assistentes Médicos , Médicos , Idoso , Assistência Ambulatorial , Estudos Transversais , Pesquisas sobre Serviços de Saúde , Humanos , Estados Unidos
17.
Med Care ; 57(11): 905-912, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31568165

RESUMO

BACKGROUND: It is unclear whether Medicare data can be used to identify type and degree of collaboration between primary care providers (PCPs) [medical doctors (MDs), nurse practitioners, and physician assistants] in a team care model. METHODS: We surveyed 63 primary care practices in Texas and linked the survey results to 2015 100% Medicare data. We identified PCP dyads of 2 providers in Medicare data and compared the results to those from our survey. Sensitivity, specificity, and positive predictive value (PPV) of dyads in Medicare data at different threshold numbers of shared patients were reported. We also identified PCPs who work in the same practice by Social Network Analysis (SNA) of Medicare data and compared the results to the surveys. RESULTS: With a cutoff of sharing at least 30 patients, the sensitivity of identifying dyads was 27.8%, specificity was 91.7%, and PPV 72.2%. The PPV was higher for MD-nurse practitioner/physician assistant pairs (84.4%) than for MD-MD pairs (61.5%). At the same cutoff, 90% of PCPs identified in a practice from the survey were also identified by SNA in the corresponding practice. In 5 of 8 surveyed practices with at least 3 PCPs, about ≤20% PCPs identified in the practices by SNA of Medicare data were not identified in the survey. CONCLUSIONS: Medicare data can be used to identify shared care with low sensitivity and high PPV. Community discovery from Medicare data provided good agreement in identifying members of practices. Adapting network analyses in different contexts needs more validation studies.


Assuntos
Assistência à Saúde/estatística & dados numéricos , Medicare/estatística & dados numéricos , Equipe de Assistência ao Paciente/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Interpretação Estatística de Dados , Assistência à Saúde/métodos , Humanos , Colaboração Intersetorial , Profissionais de Enfermagem/estatística & dados numéricos , Assistentes Médicos/estatística & dados numéricos , Médicos de Atenção Primária/estatística & dados numéricos , Atenção Primária à Saúde/métodos , Texas , Estados Unidos
18.
Support Care Cancer ; 27(12): 4389-4391, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31511982

RESUMO

BACKGROUND: Currently the entire treatment of a child with cancer is carried out in a specialized hospital. It would be ideal to conduct part of the treatment at home. This can only be done with adequately trained personnel. In the Netherlands, specialized pediatric oncology home care nurse practitioners have been trained to deliver this kind of care. Therefore, a pilot study was conducted to administer intravenous chemotherapy at home. PURPOSE: This study aimed to safely administer chemotherapy intravenously (iv) at home by specialized nurse practitioners and aimed to increase the quality of life (QOL) of the child and decrease the social burden in families with a child with acute lymphoblastic leukemia (ALL). METHOD: The pilot study was performed by well-trained home care nurse practitioners. Low-dose methotrexate iv and low-dose cytarabine iv were administered to 11 included children with ALL in their home environment. RESULTS: QOL increased whereas social burden decreased for patients and parents. Chemotherapy administration in the home environment was safe with the help of well-trained nurse practitioners. CONCLUSION: It is feasible to administer intravenous chemotherapy at home in a safe and efficient way. The role of the specialized pediatric oncology nurse practitioner is an essential one.


Assuntos
Antimetabólitos Antineoplásicos/administração & dosagem , Serviços de Assistência Domiciliar/organização & administração , Profissionais de Enfermagem , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/enfermagem , Administração Intravenosa , Antimetabólitos Antineoplásicos/efeitos adversos , Criança , Pré-Escolar , Citarabina/administração & dosagem , Citarabina/efeitos adversos , Feminino , Serviços de Assistência Domiciliar/normas , Humanos , Masculino , Metotrexato/administração & dosagem , Metotrexato/efeitos adversos , Países Baixos , Projetos Piloto , Qualidade de Vida
19.
Hu Li Za Zhi ; 66(5): 54-64, 2019 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-31549381

RESUMO

BACKGROUND: Many hospitals in Taiwan currently use the nurse practitioner (NP) care model to ameliorate the chronic shortage of resident physicians. However, no healthcare service quality scale is presently available that allows the evaluation of the healthcare quality provided by NPs from the perspective of patients. A scale of this type is necessary in order to effectively monitor and improve care outcomes. PURPOSE: This project was designed to develop the Nurse Practitioner Healthcare Service Quality Scale (NPHSQS) and then to test its validity and reliability. METHODS: A cross-sectional design combined with Parasuraman, Zeithaml, and Berry's Service Quality Model was adopted to construct the NPHSQS. After expert evaluation and confirmation of the model's content validity, 200 valid questionnaires were collected from a convenience sample of patients from medical center wards in northern Taiwan that regularly used the NP care model. The data were analyzed by group using item analysis, construct validity, internal consistency, and discriminant validity. RESULTS: The 25-item NPHSQS developed in this study earned a CVI (content validity index) of .91 and a good CR (critical ratio). Exploratory factor analysis revealed that four factors extracted in the expectation level, including reliable responsiveness, assurance, empathy, and tangibility, explained 62.47% of the total variance. Furthermore, three factors extracted in the perception level, including reliable responsiveness, trust, and tangibility, explained 67.71% of the total variance. The NPHSQS has a good overall internal consistency coefficient and may also significantly distinguish differences in patient satisfaction between good and bad healthcare service quality groups (p < .001). CONCLUSIONS: The developed NPHSQS has good reliability and validity and is a reliable instrument for assessing the quality of NP-provided healthcare services from the perspective of healthcare recipients.


Assuntos
Profissionais de Enfermagem , Garantia da Qualidade dos Cuidados de Saúde , Inquéritos e Questionários , Estudos Transversais , Humanos , Psicometria , Reprodutibilidade dos Testes , Taiwan
20.
Am Surg ; 85(7): 747-751, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31405421

RESUMO

The ACGME work hour restrictions facilitated increased utilization of service-based advanced practice providers (APPs) to offset reduced general surgery resident work hours. Information regarding attending surgeon perceptions of APP impact is limited. The aim of this survey was to gauge these perceptions with respect to workload, length of stay (LOS), safety, best practice, level of function, and clinical judgment. Attending surgeons on surgical teams that employ service-based APPs at an urban tertiary referral center responded to a survey at the completion of academic year 2016. Perceptions regarding APP impact on workload, LOS, safety, best practice, level of function, and clinical judgment were examined. Twenty-two attending surgeons (40%) responded. Respondents agreed that APPs always/usually decrease their workload (77%), decrease LOS (64%), improve safety (68%), contribute to best practice (82%), and decrease near misses (71%). They also agreed that APPs decrease resident workload (87%), but fewer agreed that APPs contribute to resident education (68%). The majority perceived APPs function at the PGY1/2 (43%) or PGY3 (39%) level and always/usually trust their clinical judgment (72%), and felt there was variability in level of function among APPs (56%). This single-center study illustrates that attending surgeons perceive a positive impact on patient care by service-based APPs.


Assuntos
Atitude do Pessoal de Saúde , Internato e Residência , Admissão e Escalonamento de Pessoal/organização & administração , Adulto , Feminino , Cirurgia Geral/educação , Pesquisas sobre Serviços de Saúde , Humanos , Tempo de Internação , Masculino , Profissionais de Enfermagem , Segurança do Paciente/normas , Qualidade da Assistência à Saúde , Carga de Trabalho
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