scholarly journals Case for hospital nurse-to-patient ratio legislation in Queensland, Australia, hospitals: an observational study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036264 ◽  
Author(s):  
Matthew D McHugh ◽  
Linda H Aiken ◽  
Carol Windsor ◽  
Clint Douglas ◽  
Patsy Yates
Keyword(s):  
Quality Of Care ◽  
Emotional Exhaustion ◽  
Nurse Staffing ◽  
Patient Characteristics ◽  
Public Hospitals ◽  
Job Dissatisfaction ◽  
Additional Patient ◽  
Cross Sectional ◽  
Hospital Size

ObjectivesTo determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients and nurses.DesignAnalysis of cross-sectional data derived from nurse surveys linked with admitted patient outcomes data.SettingPublic hospitals in Queensland.Participants4372 medical-surgical nurses and 146 456 patients in 68 public hospitals.Main outcome measures30-day mortality, quality and safety indicators, nurse outcomes including emotional exhaustion and job dissatisfaction.ResultsMedical-surgical nurse-to-patient ratios before implementation of ratio legislation varied significantly across hospitals (mean 5.52 patients per nurse; SD=2.03). After accounting for patient characteristics and hospital size, each additional patient per nurse was associated with 12% higher odds of 30-day mortality (OR=1.12; 95% CI 1.01 to 1.26). Each additional patient per nurse was associated with poorer outcomes for nurses including 15% higher odds of emotional exhaustion (OR=1.15; 95% CI 1.07 to 1.23) and 14% higher odds of job dissatisfaction (OR=1.14; 95% CI 1.02 to 1.28), as well as higher odds of concerns about quality of care (OR=1.12; 95% CI 1.01 to 1.25) and patient safety (OR=1.32; 95% CI 1.11 to 1.57).ConclusionsBefore ratios were implemented, nurse staffing varied considerably across Queensland hospital medical-surgical wards and higher nurse workloads were associated with patient mortality, low quality of care, nurse emotional exhaustion and job dissatisfaction. The considerable variation across hospitals and the link with outcomes suggests that taking action to improve staffing levels was prudent.

Impact of safe nurse staffing on the quality of care in Portuguese public hospitals: A cross‐sectional study

2021 ◽  
Author(s):  
Teresa Margarida Almeida Neves ◽  
Pedro Miguel Santos Dinis Parreira ◽  
Victor José Lopes Rodrigues ◽  
João Manuel Garcia Nascimento Graveto
Keyword(s):  
Quality Of Care ◽  
Nurse Staffing ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Quality of Care Delivered to Tuberculosis Patients among Public Hospitals in Central Northeast Ethiopia

2020 ◽  
Vol 30 (5) ◽  
Author(s):  
Balkew Asegidew Tegegn ◽  
Betregiorgis Zegeye Hailu ◽  
Birhanu Damtew Tsegaye ◽  
Gashaw Garedew Woldeamanuel ◽  
Wassie Negash
Keyword(s):  
Quality Of Service ◽  
Quality Of Care ◽  
Quality Of Healthcare ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional ◽  
The Mean ◽  
Process Dimension

BACKGROUND: Inappropriate Tuberculosis (TB) diagnosis and treatment contributes to unfavorable health outcome among TB patients. Improving quality of healthcare service helps to avert TB related morbidity. Despite these facts, the level of quality of service is not known in the hospitals. Hence, the present study was conducted to assess the quality of care delivered to TB patients among publichospitals.METHODS: A facility-based cross-sectional study was conducted from March 15 to April 30, 2019 in North Shewa Zone, Amhara region, Ethiopia. All TB patients who had follow-up in the hospitals were included. This resulted in the involvement of 82 TB patients. Data was collected by trained data collectors using facility audit, clinical observation checklists, structured questionnaire and in-depth interview. Data was analyzed using SPSS version 20. Binary logistic regression analysis was done to identify the predictors of patients’ satisfaction.RESULTS: In this study, 82 respondents with a mean age of 36.48 (±13.27) years were participated. The mean quality score for structural dimension was 59.5%, and 53.7% of participants were found to be satisfied in outcome dimension. The mean score for process dimension of quality of service were 67.9%. Having TB symptoms were significantly associated with the level of patientsatisfaction towards TB care [AOR = 0.217, p = 0.015].CONCLUSION:Quality of TB services from structural and outcome dimension were low and higher in process dimension. Thus, careful attention on the quality of services will help to reduce the burden of TB.

Nurse Staffing, Missed care, Quality of Care and Adverse Events: A Cross Sectional Study

2021 ◽  
Author(s):  
Apiradee Nantsupawat ◽  
Lusine Poghosyan ◽  
Orn‐Anong Wichaikhum ◽  
Wipada Kunaviktikul ◽  
Yaxuan Fang ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Adverse Events ◽  
Nurse Staffing ◽  
Cross Sectional Study ◽  
Care Quality ◽  
Sectional Study ◽  
Cross Sectional ◽  
Missed Care

scholarly journals Professional exhaustion, quality and intentions among family health nurses

2018 ◽  
Vol 71 (suppl 5) ◽  
pp. 2295-2301 ◽  
Author(s):  
Vera Regina Lorenz ◽  
Marcos Oliveira Sabino ◽  
Heleno Rodrigues Corrêa Filho
Keyword(s):  
Quality Of Care ◽  
Human Resources ◽  
Emotional Exhaustion ◽  
Family Health ◽  
Maslach Burnout Inventory ◽  
Current Work ◽  
Cross Sectional ◽  
Assess Quality ◽  
Estimate Prevalence

ABSTRACT Objective: to analyze how family health nurses assess quality of care; check if they have any intention of leaving their current job and nursing; estimate prevalence of professional exhaustion; and correlate these variables. Method: cross-sectional and correlational study with 198 nurses. The Maslach Burnout Inventory was applied, as it has questions for characterizing nurses, assessing perception on quality of care and of material and human resources, and verifying intention of leaving current work and nursing. Results: most nurses assess quality of care as good, 28.0% present emotional exhaustion, there is intention of leaving current work and nursing. Conclusions: family health nurses experience professional exhaustion, which in turn presents correlation with decreased quality of care and increased intentions of leaving current work and nursing.

scholarly journals Health-Literate Healthcare Organizations and Quality of Care in Hospitals: A Cross-Sectional Study Conducted in Tuscany

2020 ◽  
Vol 17 (7) ◽  
pp. 2508
Author(s):  
Guglielmo Bonaccorsi ◽  
Anna Romiti ◽  
Francesca Ierardi ◽  
Maddalena Innocenti ◽  
Marco Del Riccio ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Organizational Health ◽  
Cross Sectional Study ◽  
Perceived Quality ◽  
Public Hospitals ◽  
Sectional Study ◽  
Healthcare Organizations ◽  
Cross Sectional ◽  
Perceived Quality Of Care

The concept of Health-Literate Healthcare Organization (HLHO) concerns the strategies by which healthcare organizations make it easier for people to navigate, understand, and use information and services to take care of their health. The aims of this study were to validate the HLHO-10 questionnaire in the Italian language; to measure the degree of implementation of the 10 attributes of HLHOs in a sample of hospitals placed in Tuscany; and to assess the association between the degree of implementation of the 10 attributes of HLHOs and the perceived quality of care. This was a cross-sectional study where data were collected using a self-administered questionnaire including three sections: a descriptive section, a section focused on the perceived quality, and the Italian version of the HLHO-10 questionnaire. A total amount of 405 healthcare managers answered the questionnaire (54.9%). The analysis shows that the HLHO score is significantly associated with the type of hospitals: accredited private hospitals have higher HLHO scores. Moreover, the perceived quality increases with the increasing of the HLHO score, with the highest coefficient for local public hospitals. In conclusion, Organizational Health Literacy culture should be an integral element for the management to improve the quality of care.

scholarly journals Financial Performance of Public Hospitals: A Cross-Sectional Study among Polish Providers

2020 ◽  
Vol 17 (7) ◽  
pp. 2188 ◽  
Author(s):  
Katarzyna Dubas-Jakóbczyk ◽  
Ewa Kocot ◽  
Anna Kozieł
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Financial Performance ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Legal Form

There is growing evidence of a positive association between health care providers’ financial standing and the quality of care. In Poland, the instable financial situation and growing debt of public hospitals has been a source of concern for more than two decades now. The objectives of this paper were to compare the financial performance of public hospitals in Poland, depending on the ownership and organizational form; and analyze whether there is an association between financial performance and the chosen variables. We conducted a cross sectional study covering the whole population of public hospitals operating in 2018. The total number of included units was 805. The hospitals’ financial outcomes were measured by several variables; Spearman’s rank correlation was calculated, and a multivariable logistic regression model was performed. In 2018, the majority of public hospitals in Poland (52%) generated a gross loss, while 40% hospitals had overdue liabilities. There were statistically significant differences between hospital groups, with university hospitals and those owned by counties (local hospitals) being in the most disadvantageous situation. Additionally, corporatized public hospitals performed worse than those functioning in the classic legal form of independent health care units. Urgent actions are needed to measure and monitor the potential impact of financial performance on the quality of care.

scholarly journals Financial performance of public hospitals: a cross-sectional study among Polish providers

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Dubas-Jakóbczyk ◽  
E Kocot ◽  
A Kozieł
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Financial Performance ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Sectional Study ◽  
Cross Sectional ◽  
Financial Situation ◽  
Research Institutes

Abstract Background there is growing evidence of a positive association between health care providers' financial standing and the quality of care. In Poland, the instable financial situation and growing debt of public hospitals has been a source of concern for more than two decades now. The objectives were: (1) to compare the financial performance of public hospitals, depending on the ownership and organizational form; (2) to analyze whether there is an association between financial performance and the chosen variables (e.g., total assets, revenues). Methods we conducted a cross sectional study covering the whole population of public hospitals operating in 2018. The total number of included units was 805 (659 classic public hospitals, 17 research institutes and 129 corporatized). The hospitals' financial outcomes were measured by several variables and compared between the hospital groups; Spearman's rank correlation was calculated and a multivariable logistic regression model was performed. Results in 2018, the majority of public hospitals in Poland (52%) generated a gross loss, while 40% hospitals had overdue liabilities. There were statistically significant differences between hospital groups, with university hospitals and those owned by counties (local hospitals) being in the most disadvantageous situation. Also, corporatized public hospitals performed worse than those functioning in the classic legal form of independent health care units. All three variables which can be used as proxy indicators of hospital size (total assets, revenues or costs) were positively correlated with the value of overdue liabilities and the debt ratio, and negatively correlated with the gross profit margin. Conclusions there is high diversity in public hospital financial standing in Poland, with numerous units facing liquidity problems in 2018. Urgent actions are needed to measure and monitor the potential impact of financial performance on the quality of care. Key messages The instable financial situation and growing debt of public hospitals in Poland has been a source of concern for more than two decades now. In 2018, local hospitals owned by counties as well as highly-specialized university clinics and research institutes were in the most disadvantageous financial situation.

scholarly journals Midwifery and nurse staffing of inpatient maternity services : a systematic scoping review of associations with outcomes and quality of care

2021 ◽  
Author(s):  
Lesley Y Turner ◽  
Peter Griffiths ◽  
Ellen Kitson-Reynolds
Keyword(s):  
Quality Of Care ◽  
Cohort Studies ◽  
Patient Outcomes ◽  
Nurse Staffing ◽  
Service Planning ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Cross Sectional ◽  
Staffing Levels

Objective To undertake a scoping literature review of studies examining the quantitative association between staffing levels and outcomes for mothers, neonates, and staff. The purpose was to understand the strength of the available evidence, the direction of effects, and to highlight gaps for future research. Data Sources Systematic searches were conducted in Medline (Ovid), Embase (Ovid), CINAHL (EBCSCO), Cochrane Library, TRIP, Web of Science and Scopus. Study Selection and Review methods To be eligible, staffing levels had to be quantified for in-patient settings, such as ante-natal, labour/delivery or post-natal care. Staff groups include registered midwives, nurse midwives or equivalent, and assistant staff working under the supervision of registered professionals. Studies of the quality of care, patient outcomes and staff outcomes were included. All quantitative designs were included, including controlled trials, time series, cross-sectional, cohort studies and case controlled studies. Data were extracted and sources of bias identified by considering the study design, measurement of exposure and outcomes, and risk adjustment. Studies were grouped by outcome noting the direction and significance of effects. Results The search yielded a total of 3280 records and 21 studies were included in this review. There were three randomised controlled trials, eleven cohort studies, one case control study and six cross sectional studies. Seventeen were multicentre studies and nine of them had over 30,000 participants. Reduced incidence of epidural use, augmentation, perineal damage at birth, postpartum haemorrhage, maternal readmission, and neonatal resuscitation were associated with increased midwifery staff. Few studies have suggested a negative impact of increasing staffing rates, although a number of studies have found no significant differences in outcomes. Impact on the mode of birth were unclear. Increasing midwifery support staff was not associated with improved patient outcomes. No studies were found on the impact of low staffing levels for the midwifery workforce. Conclusions and Implications for practice Although there is some evidence that higher midwifery staffing is associated with improved outcomes, current research is insufficient to inform service planning. Studies mainly reported outcomes relating to labour, highlighting a gap in research evidence for the antenatal and postnatal periods. Further studies are needed to assess the costs and consequences of variations in maternity staffing, including the deployment of maternity care assistants and other staff groups. Keywords Midwife ; Nurse; Staffing; Workload; Workforce planning; Patient safety

scholarly journals Nurse staffing and quality of care in UK general practice: cross-sectional study using routinely collected data

2010 ◽  
Vol 60 (570) ◽  
pp. e36-e48 ◽  
Author(s):  
Peter Griffiths ◽  
Trevor Murrells ◽  
Jill Maben ◽  
Simon Jones ◽  
Mark Ashworth
Keyword(s):  
General Practice ◽  
Quality Of Care ◽  
Nurse Staffing ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Routinely Collected Data
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