[Enhanced Recovery After Surgery: An Example of Integrated Care for Coronary Artery Bypass Graft Surgery].

After post-coronary artery bypass surgery, patients often experience physiological issues such as pain and complications as well as psychological issues such as fatigue and depression. These issues may burden family caregivers and impact patient quality of life. Therefore, a comprehensive, multidisciplinary integrated care plan is needed to expedite postoperative recovery and reduce the social burden on patients. In recent years, government promotion of integrated healthcare, including the implementation of postoperative accelerated recovery care models, has led to the introduction of the enhanced recovery after surgery program as part of post-cardiac surgery integrated care. This program, providing combined care that is multidisciplinary and evidence-based, incorporates elements such as the provision of carbohydrate drinks, multimodal pain management, and fluid management. Reducing to a minimum the emotional and physiological stresses on patients facilitates a faster return to normal functionality. In this paper, a literature review is conducted to provide a reference for future post-coronary artery bypass surgery care by clinical teams, with the aim of offering an integrated approach to patient care.

Job satisfaction and perceptions of quality of patient care, collaboration and teamwork in acute care hospitals.

AIM: This paper is a report of a study conducted to compare levels of job satisfaction and perceptions of the quality of patient care, collaboration and teamwork among healthcare professionals in four acute care hospitals and to determine the factors associated with job satisfaction for physicians, nurses and other healthcare professionals. BACKGROUND: Positive inter-professional relationships improve quality of patient care and staff job satisfaction. Understanding how healthcare professionals perceive their relationships with each other, and identifying factors that affect their job satisfaction and perceptions of the quality patient care, inform quality improvements. METHOD: This cross-sectional survey study was conducted in four hospitals in Taiwan. Data were collected in 2007 and analysed using descriptive statistics, one-way anova with the Games-Howell post hoc test and stepwise regression analysis. RESULTS: The survey was completed by 1475 respondent, giving a response rate of 52.2% (180 physicians, 1019 nurses and 276 other healthcare professionals). Physicians were more satisfied with their jobs (F = 26.75, P < 0.05) than either nurses or other healthcare professionals. Conversely, nurses perceived more positive collaborative relationships than did physicians or other healthcare professionals (F = 279.51, P < 0.05). Stepwise regression analysis demonstrated that perceptions of quality of patient care and collaborative relationships were the most important predictors of job satisfaction for healthcare providers. CONCLUSION: These findings provide important clues for improving interdisciplinary collaboration and ensuring quality patient care through good job satisfaction and teamwork among healthcare professionals in acute care hospitals.

Predicting factors related to nurses' intention to leave, job satisfaction, and perception of quality of care in acute care hospitals.

High nursing turnover is a problem facing many countries, including Taiwan, and can be very challenging for nursing leaders and hospital administrators. More than one-third of the nurses participating in this study considered leaving their current jobs. Understanding what factors influenced nurses to leave their jobs should be of interest to nursing leaders and hospital administrators in today's changing health care environment. Factors related to intention to leave, including wage dissatisfaction and work shift, should be addressed by hospital administrators. The findings can help hospital administrators and nursing leaders to develop strategies that minimize nurses' intention to leave behaviors, stabilize the nursing workforce, maintain hospital-employee relationships, and prevent nurses from experiencing burnout.