scholarly journals Nurse staffing and patient-perceived quality of nursing care: a cross-sectional analysis of survey and administrative data in German hospitals

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e051133
Author(s):  
Vera Winter ◽  
Karina Dietermann ◽  
Udo Schneider ◽  
Jonas Schreyögg
Keyword(s):  
Nursing Care ◽  
Nurse Staffing ◽  
Perceived Quality ◽  
Secondary Outcome ◽  
Skill Mix ◽  
Staffing Levels ◽  
Hospital Units ◽  
The Impact ◽  
Quality Of Nursing

ObjectiveTo examine the impact of nurse staffing on patient-perceived quality of nursing care. We differentiate nurse staffing levels and nursing skill mix as two facets of nurse staffing and use a multidimensional instrument for patient-perceived quality of nursing care. We investigate non-linear and interaction effects.SettingThe study setting was 3458 hospital units in 1017 hospitals in Germany.ParticipantsWe contacted 212 554 patients discharged from non-paediatric, non-intensive and non-psychiatric hospital units who stayed at least two nights in the hospital between January and October 2019. Of those, 30 174 responded, yielding a response rate of 14.2%. Our sample included only those patients. After excluding extreme values for our nurse staffing variables and removing observations with missing values, our final sample comprised 28 136 patients ranging from 18 to 97 years of age (average: 61.12 years) who had been discharged from 3458 distinct hospital units in 1017 hospitals.Primary and secondary outcome measuresPatient-perceived quality of nursing care (general nursing care, guidance provided by nurses, and patient loyalty to the hospital).ResultsFor all three dimensions of patient-perceived quality of nursing care, we found that they significantly decreased as (1) nurse staffing levels decreased (with decreasing marginal effects) and (2) the proportion of assistant nurses in a hospital unit increased. The association between nurse staffing levels and quality of nursing care was more pronounced among patients who were less clinically complex, were admitted to smaller hospitals or were admitted to medical units.ConclusionsOur results indicate that, in addition to nurse staffing levels, nursing skill mix is crucial for providing the best possible quality of nursing care from the patient perspective and both should be considered when designing policies such as minimum staffing regulations to improve the quality of nursing care in hospitals.

Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units

2009 ◽  
Vol 18 (12) ◽  
pp. 1729-1737 ◽  
Author(s):  
Sung-Hyun Cho ◽  
Kyung Ja June ◽  
Yun Mi Kim ◽  
Yong Ae Cho ◽  
Cheong Suk Yoo ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Nursing Care ◽  
Nurse Staffing ◽  
Job Outcomes ◽  
Quality Of Nursing

scholarly journals Hospital nurse staffing and staff–patient interactions: an observational study

2019 ◽  
Vol 28 (9) ◽  
pp. 706-713 ◽  
Author(s):  
Jackie Bridges ◽  
Peter Griffiths ◽  
Emily Oliver ◽  
Ruth M Pickering
Keyword(s):  
Nurse Staffing ◽  
Care Quality ◽  
Multilevel Regression ◽  
Negative Interaction ◽  
Skill Mix ◽  
Staffing Levels ◽  
Patient Interactions ◽  
Number Of Patients ◽  
The Relationship

BackgroundExisting evidence indicates that reducing nurse staffing and/or skill mix adversely affects care quality. Nursing shortages may lead managers to dilute nursing team skill mix, substituting assistant personnel for registered nurses (RNs). However, no previous studies have described the relationship between nurse staffing and staff–patient interactions.SettingSix wards at two English National Health Service hospitals.MethodsWe observed 238 hours of care (n=270 patients). Staff–patient interactions were rated using the Quality of Interactions Schedule. RN, healthcare assistant (HCA) and patient numbers were used to calculate patient-to-staff ratios. Multilevel regression models explored the association between staffing levels, skill mix and the chance of an interaction being rated as ‘negative’ quality, rate at which patients experienced interactions and total amount of time patients spent interacting with staff per observed hour.Results10% of the 3076 observed interactions were rated as negative. The odds of a negative interaction increased significantly as the number of patients per RN increased (p=0.035, OR of 2.82 for ≥8 patients/RN compared with >6 to <8 patients/RN). A similar pattern was observed for HCA staffing but the relationship was not significant (p=0.056). When RN staffing was low, the odds of a negative interaction increased with higher HCA staffing. Rate of interactions per patient hour, but not total amount of interaction time, was related to RN and HCA staffing levels.ConclusionLow RN staffing levels are associated with changes in quality and quantity of staff–patient interactions. When RN staffing is low, increases in assistant staff levels are not associated with improved quality of staff–patient interactions. Beneficial effects from adding assistant staff are likely to be dependent on having sufficient RNs to supervise, limiting the scope for substitution.

scholarly journals Patient perceived quality of nursing care in hemodialysis: A meta-synthesis

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Abbas Balouchi ◽  
Abbas Ebadi ◽  
Soroor Parvizy ◽  
Hamid Sharif Nia
Keyword(s):  
Nursing Care ◽  
Perceived Quality ◽  
Care Quality ◽  
Resource Quality ◽  
Nursing Care Quality ◽  
Structure Dimension ◽  
Efficient Care ◽  
Nursing Quality ◽  
Quality Of Nursing

This study was done with the purpose of clarifying the concept of patient perceived quality of nursing care in hemodialysis. In this meta-synthesis study, qualitative studies was searched in the four interntional databases from January 1st, 2000 to December 30th, 2019. The keywords used were: nursing care quality, and hemodialysis. Studies which had been done with the purpose of understanding the patient perceived quality of nursing care concept aomg hemodialysis patients were included. Two researchers were evaluate the quality of included studies separately using JBI tool, required information were extracted using the designed table. The main themes in the structure dimension include Sufficient Human resource, quality of equipment, financial support from patient and quality of the patient care environment. Process dimension consisted of continuous monitoring of the syndromes, effective patient education, efficient care, effective therapeutic relationship, and patient’s empowerment and participation in the process, and in the outcome dimension included high dialysis adequecy, patient burnout reduction, and increased patient satisfaction from services. The results of the study indicated a comprehensive, deep and interactive dimensions about the concept of nursing quality of care.

Nurse Staffing Levels: Skill Mix and Nursing Care Hours Per Patient Day

2018 ◽  
pp. 465-488
Author(s):  
Alberto Lucchini ◽  
Michele Pirovano ◽  
Christian De Felippis ◽  
Irene Comisso
Keyword(s):  
Nursing Care ◽  
Nurse Staffing ◽  
Skill Mix ◽  
Staffing Levels

scholarly journals Perceived quality of nursing care and patient education: a cross-sectional study of hospitalised surgical patients in Finland

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e023108 ◽  
Author(s):  
Weronica Gröndahl ◽  
Hanna Muurinen ◽  
Jouko Katajisto ◽  
Riitta Suhonen ◽  
Helena Leino-Kilpi
Keyword(s):  
Patient Education ◽  
Nursing Care ◽  
Family Members ◽  
Perceived Quality ◽  
Surgical Patients ◽  
Cross Sectional ◽  
Hospital District ◽  
Hospital Patients ◽  
Quality Of Nursing

ObjectivesThis study aims to analyse the relationship between patient education and the quality of surgical nursing care as perceived by patients. The background of the study lies in the importance of a patient-centred approach for both patient education and quality evaluation.DesignThis was a cross-sectional descriptive correlational study with surgical patients.SettingData were collected in 2013 in one hospital district in Finland.Participants480 hospitalised surgical patients.MethodsThe data were collected using two structured instruments: one measuring the perceived quality of nursing care experienced by patients (Good Nursing Care Scale) and one measuring the received knowledge of hospital patients (RKhp). Data were analysed statistically using descriptive and inferential statistics to describe the sample and study variables. Pearson’s correlation coefficients were used to analyse the association between the scales.ResultsSurgical hospital patients evaluated the level of the quality of nursing care as high; this was especially true with reference to the environment and staff characteristics, but not to collaboration with family members. Most (85%) of the patients had received sufficient knowledge preoperatively and they were familiar with the proceeding of their care and treatment after discharge; in particular, they had received bio-physiological knowledge, consisting of knowledge of the disease, symptoms and the physiological elements of care. The positive correlation between the perceived quality of surgical nursing care and received knowledge was strong, suggesting a positive relationship between patient education and improvement of the quality of nursing care.ConclusionsBased on the results, the quality of nursing care and patient education are interconnected. Thus, by improving patient education, the quality of nursing care can also be improved. It is particularly important to improve collaboration with family members and patients’ own management strategies as well as the multidimensionality of educational knowledge.

scholarly journals DAMPAK IMPLEMENTASI MODEL PRAKTIK KEPERAWATAN PROFESIONAL TERHADAP MUTU ASUHAN KEPERAWATAN DI RUMAH SAKIT

2014 ◽  
Vol 7 (2) ◽  
pp. 41-47
Author(s):  
Ratna Sitorus
Keyword(s):  
Nursing Care ◽  
Care Delivery ◽  
Intervention Group ◽  
Family Satisfaction ◽  
Control Group ◽  
Chi Square ◽  
Post Test ◽  
The Impact ◽  
Quality Of Nursing

AbstrakPeningkatkan mutu asuhan keperawatan di rumah sakit memerlukan restructuring, reengineering, dan redesigning sistem pemberian asuhan keperawatan melalui implementasi Model Praktik Keperawatan Profesional (MPKP). Tujuan penelitian ini ialah untuk menilai dampak implementasi MPKP terhadap mutu asuhan keperawatan di rumah sakit. Disain penelitian adalah kuasi eksperimen dalam bentuk pre and post test with control group. Uji statistik yang digunakan adalah uji Chi-square dan uji t. Hasil penelitian menunjukkan bahwa pada kelompok intervensi (MPKP) terdapat peningkatan kepuasan klien dan keluarga (OR=114,24) yang lebih besar dibandingkan dengan peningkatan kepuasan klien dan keluarga pada kelompok kontrol (OR=3,78). Demikian juga terdapat peningkatan kepatuhan perawat terhadap standar yang lebih tinggi pada kelompok intervensi (OR=235,5) dibandingkan dengan kelompok kontrol (OR=0). Lama hari rawat lebih pendek pada kelompok intervensi. Angka infeksi nosokomial juga lebih rendah pada kelompok intervensi dibandingkan dengan kelompok kontrol. Penelitian ini menyimpulkan bahwa implementasi MPKP dapat meningkatkan mutu asuhan keperawatan di rumah sakit. Berdasarkan hasil tersebut, untuk memicu implementasi MPKP di berbagai rumah sakit, disarankan agar implementasi MPKP menjadi salah satu kriteria penilaian pada akreditasi rumah sakit khususnya pelayanan keperawatan AbstractIn order to improve the quality of nursing care in the hospital, nursing care delivery system need restructuring, reengineering, and redesigning through the implementation of Professional Nursing Practice Model (PNPM). The study was aimed to evaluate the impact of the PNPM on the quality of nursing care in the hospital. The design used was quasi experiment in pre and post test with control group. The statistic used are Chi-square and t-test. The result showed that in the intervention group, the improvement of client/family satisfaction with nursing care (OR = 114,28) was higher than the improvement in the control group (OR = 3,78). It was founded there was an improvement of the compliance of nurses to the standard was higher in the intervention group (OR = 235,5) compare to control group (OR = 0). The length of stay shorter in the intervention group, and also the nosocomial infection rate is lower in the intervention group compare to control group. The study concluded that the implementation of the PNPM could improve the quality of nursing care in the hospital. Based on this result, in order to challenge the implementation of PNPM in the hospital it was suggested that the implementation of PNPM becomes an evaluation criteria for hospital accreditation specifically for nursing service.

Defining Patient-Perceived Quality of Nursing Care

2001 ◽  
Vol 16 (1) ◽  
pp. 34-60 ◽  
Author(s):  
June H. Larrabee ◽  
Lois V. Bolden
Keyword(s):  
Nursing Care ◽  
Perceived Quality ◽  
Quality Of Nursing

scholarly journals Impact Of Nurse Unionization On Fiscal Viability And Selected Measures Of Quality In Hospitals

2011 ◽  
Vol 6 (3) ◽  
Author(s):  
Jim Morey ◽  
Gary Scherzer ◽  
Hoseoup Lee ◽  
Kenneth Wallis ◽  
Laura Francis Gladney
Keyword(s):  
New York ◽  
Quality Of Care ◽  
Institutional Care ◽  
Nurse Staffing ◽  
Financial Variables ◽  
Staffing Levels ◽  
Union Status ◽  
The Impact ◽  
The Relationship

<p class="MsoNormal" style="margin: 0in 0.5in 0pt;"><span style="font-size: 10pt;"><span style="font-family: Times New Roman;">Seventy-three New York hospitals were examined to determine if a difference existed between hospitals with nursing unions versus those without as it pertains to fiscal viability and quality of care.<span style="mso-spacerun: yes;">&nbsp; </span>Several financial variables were used to construct a fiscal viability index; and a quality index was created from selected mortality and procedural measures that may be used to measure specific aspects of institutional care.<span style="mso-spacerun: yes;">&nbsp; </span>The premise that the union status of a hospital&rsquo;s nursing staff will influence fiscal viability and quality is based on the impact that unionization may have on staffing and cost per patient.<span style="mso-spacerun: yes;">&nbsp; </span>The literature is replete with studies that assess the relationship between nurse staffing levels and quality.<span style="mso-spacerun: yes;">&nbsp; </span>In some cases there is a clear and compelling relationship, but in others, it is indeterminate. <span style="mso-spacerun: yes;">&nbsp;</span>Utilizing union status, selected employee variables, and financial and quality of care indices, four statistical models were prepared to explain these the interaction of these variables <span style="mso-spacerun: yes;">&nbsp;</span></span></span></p>

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