Hospital safety climate from nurses' perspective in four European countries.

BACKGROUND: Nursing shortages, the substitution of practical nurses for registered nurses, an ageing workforce, the decreasing number of nurse graduates and the increasing migration of young nurses are important factors associated with the hospital safety climate in Central European countries. AIMS: The aim of the study was to investigate nurses' perceptions of the safety climate in four selected central European countries (Croatia, the Czech Republic, Poland and Slovakia) and to determine the relationship between safety climate and unfinished nursing care. METHODS: A cross-sectional study was used. The sample consisted of 1353 European nurses from four countries. Instruments used were the Hospital Survey on Patient Safety Culture and the Perceived Implicit Rationing of Nursing Care. Data were analysed using descriptive statistics and multiple regression analyses. RESULTS: Significant differences were found between countries in all unit/hospital/outcome dimensions. 'Perceived Patient Safety' and 'Reporting of Incident Data' were associated with aspects of 'Organizational Learning' and 'Feedback and Communication about Error'. Higher prevalence of unfinished nursing care is associated with more negative perceptions of patient safety climate. CONCLUSIONS: Cross-cultural comparisons allow us to examine differences and similarities in safety dimensions across countries. The areas with potential for initiating strategies for improvement in all four countries are 'Staffing', 'Non-punitive Response to Error' and 'Teamwork across Hospital Units'. IMPLICATIONS FOR NURSING AND HEALTH POLICY: 'Feedback and Communicating about Error' and 'Organizational Learning - Continuous Improvement' were the main predictors of 'Overall Perception of Patient Safety' and 'Reporting of Incident Data'. Therefore, nurse managers should focus on how to empower nurses in these areas in order to foster a no-blame culture and effective reporting. In addition, it is important for policymakers to update nursing education standards in order to address patient safety.

Job satisfaction and leaving intentions of Slovak and Czech nurses.

INTRODUCTION: Shortages of healthcare workers in Czech and Slovak Republics are associated with factors such as raised migration of professional nurses, decreased number of nurse graduates and ageing workforce. The specific problem is migration of Slovak nurses to the Czech Republic, motivated by higher salaries. AIM: The study aims to investigate the relationship between turnover intentions and job satisfaction among Czech and Slovak nurses and to determine how the related variables differ between the two groups. DESIGN: A cross-sectional descriptive survey was used to investigate the intended turnover and job satisfaction relationship among 1055 hospital nurses recruited from the Czech and Slovak Republics. METHODS: Data were collected using a set of questionnaires that included questions regarding leaving intentions of nurses and The McCloskey/Mueller Satisfaction Scale; three further sets of questionnaires were used. For determining the associations between variables, the Pearson correlations and multiple regression analyses were used. For group comparisons, one-way and multifactorial analysis of variance and Pearson's Chi-square test procedure were performed. FINDINGS: The intention to leave the workplace, the nursing profession and work abroad were predicted by the levels of satisfaction of nurses with their control/responsibility and scheduling. Czech nurses reported higher satisfaction in all subscales of the job satisfaction and less frequent intention to work abroad. An inverse relationship was confirmed between age and turnover intentions. Job satisfaction was positively associated with age and years of experience. Job satisfaction differed by all of three turnover intentions. CONCLUSION: Results highlight the importance of understanding nurses' leaving intentions and related factors and their impact on nurses' lives in both countries so that health care organizations can implement effective strategies to improve the retention of their nursing workforce.

[Dehiscence of laparotomy after hysterectomy - wound management]. / Dehiscencia laparotómie po hysterektómii - manazment hojenia rany.

Authors of the paper present prospective case report about nursing process and healing of extensive dehiscence of middle lower laparotomy wound in patient after surgical procedure for endometrial carcinoma. The aim of the paper is to describe, analyse and evaluate the process of complicated postoperative wound healing using negative pressure and moist therapy. They emphasize importance of cooperation between particular departments in complicated postoperative wound therapy management. They point out using new and easily available techniques and methods, risk factors elimination and maintenance of the factors that have a positive influence on wound healing.Key words: postoperative wound dehiscence, negative pressure wound therapy, moist therapy, case report.