Relationship between nurses’ moral sensitivity and the quality of care

2018 ◽  
Vol 26 (4) ◽  
pp. 1265-1273 ◽  
Author(s):  
Elham Amiri ◽  
Hossein Ebrahimi ◽  
Maryam Vahidi ◽  
Mohamad Asghari Jafarabadi ◽  
Hossein Namdar Areshtanab
Keyword(s):  
Quality Of Care ◽  
Inverse Relationship ◽  
Quality Care ◽  
Care Quality ◽  
Moral Sensitivity ◽  
Medical Sciences ◽  
Mean Values ◽  
Significant Inverse Relationship ◽  
Medical Wards

Background: To provide care with high quality, nurses face a number of moral issues requiring them to have moral abilities in professional performance. Moral sensitivity is the first step in moral performance. However, its relation to the quality of care patients receive is controversial. Research objective: This study aims to determine the relationship between the moral sensitivity of nurses and the quality of care received by patients in the medical wards. Research design: A descriptive correlational study using validated tools, including Moral Sensitivity Questionnaire and the Quality Patient Quality Scale. Participants and research context: In total, 198 nurses and 198 patients in 17 medical wards of hospitals affiliated with Tabriz University of Medical Sciences, Iran. Ethical considerations: The study was reviewed and approved by the Ethics Committee of Tabriz University of Medical Sciences. Findings: The mean values of nurses’ moral sensitivity and nurses’ quality care were 136.47 ± 13.30 and 196.36 ± 44.10, respectively. There was no significant relationship between the patient care quality and nurses’ moral sensitivity ( r = −.14, p = .5). However, there was a significant inverse relationship between the dimension of “Experiencing moral conflicts” and the overall score of quality care ( r = −.50, p = .04), the dimensions of “psychosocial ( r = −.50, p = .04)” and “physical ( r = −.50, p = .03).” Conclusion: Considering the significant inverse relationship between the score of patient quality care and the dimension of moral conflict experience, it seems when nurses make moral decisions, they experience a conflict between personal and professional values in their careers and thus experience moral tension. If this tension is not resolved properly, it can provide a way for them to distance themselves from patients, thereby making nurses indifferent to moral care.

scholarly journals Person-Centred Care Transformation in a Nursing Home for Residents with Dementia

2021 ◽  
pp. 1-9
Author(s):  
Peiyan Ho ◽  
Rachel Chin Yee Cheong ◽  
Siew Pei Ong ◽  
Carol Fusek ◽  
Shiou Liang Wee ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Quality Care ◽  
Well Being ◽  
Care Quality ◽  
Care Recipient ◽  
Staff Retention ◽  
Term Care

<b><i>Background:</i></b> Conventional nursing homes in Singapore adopt an institutional and medical model of care with a focus on safety and risk management. As such, less regard is placed on upholding the dignity and autonomy of the resident, which compromises quality of care and the well-being of the resident. Today, person-centred care (PCC) has become synonymous with high-quality care that sustains the well-being and personhood of the care recipient. <b><i>Objectives:</i></b> To describe the model of PCC adopted by a nursing home, Apex Harmony Lodge (AHL), with a logic model and evaluate outcomes on residents’ well-being, care quality, and staff attrition by comparing pre-PCC initiation (2015) to post-implementation (2016). <b><i>Methods:</i></b> Male residents in a 30-bed assisted living facility for persons with dementia in AHL were assessed using Dementia Care Mapping. Residents’ well-being and staff attrition were measured before and after PCC implementation. <b><i>Results:</i></b> There were statistically significant improvements in resident well-being (Δ = 0.44, <i>p</i> = 0.029), Positive Engagement Potential (Δ = 0.17, <i>p</i> = 0.002), and Occupational Diversity (Δ = 0.12, <i>p</i> = 0.014) in 2016. Withdrawal and Passive Engagement in the residents were reduced significantly as were Care Detractors. There was also a 55% reduction in staff attrition rates post-PCC. <b><i>Conclusions:</i></b> Post-PCC implementation, the outcomes indicate a superior quality of care, enhanced resident well-being, and better staff retention. The AHL PCC model could serve as a roadmap for other nursing homes aspiring to raise the quality of care and influence long-term care standards and regulations for policy makers and legislators.

scholarly journals Association between moral intelligence, burnout and quality of nursing care

2021 ◽  
pp. 147775092110401
Author(s):  
Tahereh Heidari ◽  
Hamideh Azimilolaty ◽  
Majid Khorram ◽  
Soraya Rezaei ◽  
Seyed-Nouraddin Mousavinasab ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Nursing Care ◽  
Inverse Relationship ◽  
Quality Care ◽  
Maslach Burnout Inventory ◽  
Personal Accomplishment ◽  
Holistic Nursing ◽  
Moral Intelligence ◽  
Quality Of Nursing

Background Providing quality care is of the fundamental elements of holistic nursing practice, and burnout and moral intelligence of nurses be mentioned as the important factors influencing the quality of nursing care. The present study was conducted to investigate the relationship between moral intelligence, burnout, and the quality of nursing care. Methods This descriptive-correlative study was conducted on 125 nurses working in Sari-based Educational hospitals affiliated to Mazandaran University of Medical Sciences, Iran, between June and August 2020. The sample was selected via random sampling. The data were collected by the Maslach Burnout Inventory, Lennick and Kiel Moral Intelligence Scale, and Quality of Patient Care Scale. The data were analyzed by SPSS-21 and Amos-24. Results A direct and significant relationship was found between the quality of nursing care and moral intelligence ( r = 0.285, p = 0.001). Quality of care had an inverse relationship with subscales of frequency of burnout including emotional exhaustion ( r = −0.369, p < 0.001) and depersonalization ( r = −0.471, p < 0.001) and also, a direct relationship with personal accomplishment ( r = 0.226, p = 0.011). The findings also showed an inverse relationship between quality of care and subscales of the intensity of burnout. Amos software yielded results that demonstrated moral intelligence as a robust mediator between burnout and the quality of care. Conclusion The findings implied the necessity for more attention to moral intelligence as a mediator in order to come up with properly managing the personality traits influencing the nurses’ burnout reduction, which can ultimately lead to improved quality of nursing care.

scholarly journals The Relationship between Nurses’ Moral Sensitivity and Patients’ Satisfaction with the Care Received in the Medical Wards

2019 ◽  
Vol 9 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Elham Amiri ◽  
Hossein Ebrahimi ◽  
Hossein Namdar Areshtanab ◽  
Maryam Vahidi ◽  
Mohamad Asghari Jafarabadi
Keyword(s):  
Patient Satisfaction ◽  
Quality Care ◽  
Daily Practice ◽  
Care Quality ◽  
Ethical Challenges ◽  
Moral Sensitivity ◽  
Moral Conflicts ◽  
Patients Satisfaction ◽  
Medical Wards ◽  
The Relationship

Introduction: The quality of care affects patients’ satisfaction. To provide high quality care, nurses face ethical challenges in daily practice. Moral sensitivity is the first phase in moral implementation. This study aimed to determine the relationship between nurses’ moral sensitivity and patients’ satisfaction in medical wards. Methods: In descriptive correlational study 198 nurses and 198 patients in 17 medical wards filled out the Moral Sensitivity Questionnaire (MSQ) and Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ), respectively. Nurses were sampled by the census method. For each nurse, a patient was selected randomly from the same ward. Data were analyzed using SPSS version 13. Results: The highest scores were in the dimensions of “relational orientation” and “following the rules”, and the lowest scores were in the dimensions of “autonomy” and “experiencing moral conflicts”. The highest level of patients’ satisfaction was with “nurses’ professional performance” 3.98 (1.09), and the lowest level was with “nurses’ routine work” 2.69 (1.22). There was no significant relationship between the mean of patient satisfaction and moral sensitivity of nurses. Conclusion: Considering that nurses had a higher score in dimension of “following the rules” and a lower score in dimension of “autonomy”, it seems ethical performance in the real situation is not merely due to the nurses’ moral sensitivity and it seems the complexity of the organization causes nurses face difficulties in making decisions related to clinical practice; therefore, policy makers in the health system should be able to identify barriers.

scholarly journals A CROSS SECTIONAL STUDY TO MEASURE PATIENTS' PERCEPTION OF QUALITY OF NURSING CARE AT MEDICAL WARDS

2014 ◽  
Vol 04 (01) ◽  
pp. 021-023
Author(s):  
Tamilselvi A. ◽  
Rajee Reghunath
Keyword(s):  
Quality Of Care ◽  
Nursing Education ◽  
Nursing Care ◽  
Skill Training ◽  
Care Quality ◽  
Cross Sectional ◽  
Perception Of Quality ◽  
Medical Wards ◽  
Quality Of Nursing

Abstract:Traditionally quality of care has been measured against expectations of health professionals and standards rather than being grounded in the perspectives of patients. The most important aspect on which patients' perspective on quality of care depends is “nursing care” because nurses are involved in every aspect of patients' care in hospital. Thus, it is important to measure patients' perception of quality of nursing care in medical wards. A cross sectional descriptive study design was used and total of 50 patients recruited for the study by using purposive sampling technique. Patients' satisfaction with nursing care quality (PSNCQQ) questionnaire was used to measure the patients' perception of quality of nursing care after obtaining reliability. The results revealed that 34% of patients were between the age group of 21-40 years and half of them were males. The total mean score of patients' perception of quality of nursing care was 64.8 with standard deviation of (+) or (-) 13.2 and 40 patients' (80%) perceived overall aspect of quality of nursing care. There were 19 (38%) perceived low quality in the dimensions of providing information and skill and competency. This was supported by the results of the study revealed that almost 1/3 patients (31.6%) perceived that nurses did not offer adequate “explanation and information” about their treatment in hospital and home care and follow up advice. Thus, it was concluded that nurses need to improve their skill and competency and update their knowledge by attending continuing nursing education program and skill training workshops

scholarly journals Parental Involvement Policies for Minors Seeking Abortion in the Southeast and Quality of Care

2021 ◽  
Author(s):  
Kari White ◽  
Subasri Narasimhan ◽  
Sophie A. Hartwig ◽  
Erin Carroll ◽  
Alexandra McBrayer ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Parental Involvement ◽  
Service Delivery ◽  
Quality Care ◽  
Health Service Delivery ◽  
Policy Implications ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Staff Members

Abstract Introduction Thirty-seven states require minors seeking abortion to involve a parent, either through notification or consent. Little research has examined how implementation of these laws affect service delivery and quality of care for those who involve a parent. Methods Between May 2018 and September 2019, in-depth interviews were conducted with 34 staff members involved in scheduling, counseling, and administration at abortion facilities in three Southeastern states. Interviews explored procedures for documenting parental involvement, minors’ and parents’ reactions to requirements, and challenges with implementation and compliance. Both inductive and deductive codes, informed by the Institute of Medicine’s healthcare quality framework, were used in the thematic analysis. Results Parental involvement laws adversely affected four quality care domains: efficiency, patient-centeredness, timeliness, and equity. Administrative inefficiencies stemmed from the extensive documentation needed to prove an adult’s relationship to a minor, increasing the time and effort needed to comply with state reporting requirements. If parents were not supportive of their minor’s decision, participants felt they had a duty to intervene to ensure the minor’s decision and needs remained centered. Staff further noted that delays to timely care accumulated as minors navigated parental involvement and other state mandates, pushing some beyond gestational age limits. Lower income families and those with complex familial arrangements had greater difficulty meeting state requirements. Conclusions Parental involvement mandates undermine health service delivery and quality for minors seeking abortion services in the Southeast. Policy Implications Removing parental involvement requirements would protect minors’ reproductive autonomy and support the provision of equitable, patient-centered healthcare.

Content of antenatal care and perception about services provided by primary hospitals in Nepal: a convergent mixed methods study

2021 ◽  
Vol 33 (2) ◽  
Author(s):  
Yubraj Acharya ◽  
Nigel James ◽  
Rita Thapa ◽  
Saman Naz ◽  
Rishav Shrestha ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Mixed Methods ◽  
Antenatal Care ◽  
Quality Care ◽  
National Level ◽  
Poor Quality ◽  
Public Hospitals ◽  
World Health ◽  
Outcome Variable

Abstract Background Nepal has made significant strides in maternal and neonatal mortality over the last three decades. However, poor quality of care can threaten the gains, as maternal and newborn services are particularly sensitive to quality of care. Our study aimed to understand current gaps in the process and the outcome dimensions of the quality of antenatal care (ANC), particularly at the sub-national level. We assessed these dimensions of the quality of ANC in 17 primary, public hospitals across Nepal. We also assessed the variation in the ANC process across the patients’ socio-economic gradient. Methods We used a convergent mixed methods approach, whereby we triangulated qualitative and quantitative data. In the quantitative component, we observed interactions between providers (17 hospitals from all 7 provinces) and 198 women seeking ANC and recorded the tasks the providers performed, using the Service Provision Assessments protocol available from the Demographic and Health Survey program. The main outcome variable was the number of tasks performed by the provider during an ANC consultation. The tasks ranged from identifying potential signs of danger to providing counseling. We analyzed the resulting data descriptively and assessed the relationship between the number of tasks performed and users’ characteristics. In the qualitative component, we synthesized users’ and providers’ narratives on perceptions of the overall quality of care obtained through focus group discussions and in-depth interviews. Results Out of the 59 tasks recommended by the World Health Organization, providers performed only 22 tasks (37.3%) on average. The number of tasks performed varied significantly across provinces, with users in province 3 receiving significantly higher quality care than those in other provinces. Educated women were treated better than those with no education. Users and providers agreed that the overall quality of care was inadequate, although providers mentioned that the current quality was the best they could provide given the constraints they faced. Conclusion The quality of ANC in Nepal’s primary hospitals is poor and inequitable across education and geographic gradients. While current efforts, such as the provision of 24/7 birthing centers, can mitigate gaps in service availability, additional equipment, infrastructure and human resources will be needed to improve quality. Providers also need additional training focused on treating patients from different backgrounds equally. Our study also points to the need for additional research, both to document the quality of care more objectively and to establish key determinants of quality to inform policy.

scholarly journals The relationship between inequitable gender norms and provider attitudes and quality of care in maternal health services in Rwanda: a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kate Doyle ◽  
Shamsi Kazimbaya ◽  
Ruti Levtov ◽  
Joya Banerjee ◽  
Myra Betron ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Care Provider ◽  
Quality Care ◽  
Gender Norms ◽  
Mixed Methods Study ◽  
Gender Attitudes ◽  
Power Dynamics ◽  
Health Providers ◽  
Men’S Involvement

Abstract Background Rwanda has made great progress in improving reproductive, maternal, and newborn health (RMNH) care; however, barriers to ensuring timely and full RMNH service utilization persist, including women’s limited decision-making power and poor-quality care. This study sought to better understand whether and how gender and power dynamics between providers and clients affect their perceptions and experiences of quality care during antenatal care, labor and childbirth. Methods This mixed methods study included a self-administered survey with 151 RMNH providers with questions on attitudes about gender roles, RMNH care, provider-client relations, labor and childbirth, which took place between January to February 2018. Two separate factor analyses were conducted on provider responses to create a Gender Attitudes Scale and an RMNH Quality of Care Scale. Three focus group discussions (FGDs) conducted in February 2019 with RMNH providers, female and male clients, explored attitudes about gender norms, provision and quality of RMNH care, provider-client interactions and power dynamics, and men’s involvement. Data were analyzed thematically. Results Inequitable gender norms and attitudes – among both RMNH care providers and clients – impact the quality of RMNH care. The qualitative results illustrate how gender norms and attitudes influence the provision of care and provider-client interactions, in addition to the impact of men’s involvement on the quality of care. Complementing this finding, the survey found a relationship between health providers’ gender attitudes and their attitudes towards quality RMNH care: gender equitable attitudes were associated with greater support for respectful, quality RMNH care. Conclusions Our findings suggest that gender attitudes and power dynamics between providers and their clients, and between female clients and their partners, can negatively impact the utilization and provision of quality RMNH care. There is a need for capacity building efforts to challenge health providers’ inequitable gender attitudes and practices and equip them to be aware of gender and power dynamics between themselves and their clients. These efforts can be made alongside community interventions to transform harmful gender norms, including those that increase women’s agency and autonomy over their bodies and their health care, promote uptake of health services, and improve couple power dynamics.

scholarly journals Quality of Care for Comorbid Conditions During the Transition to Survivorship: Differences Between Cancer Survivors and Noncancer Controls

2013 ◽  
Vol 31 (9) ◽  
pp. 1140-1148 ◽  
Author(s):  
Claire F. Snyder ◽  
Kevin D. Frick ◽  
Robert J. Herbert ◽  
Amanda L. Blackford ◽  
Bridget A. Neville ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Quality Of Care ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Care Quality ◽  
Comorbid Condition ◽  
Cancer Type ◽  
Fee For Service ◽  
To Receive

Purpose Building on previous research documenting differences in preventive care quality between cancer survivors and noncancer controls, this study examines comorbid condition care. Methods Using data from the Surveillance, Epidemiology, and End Results (SEER) –Medicare database, we examined comorbid condition quality of care in patients with locoregional breast, prostate, or colorectal cancer diagnosed in 2004 who were age ≥ 66 years at diagnosis, who had survived ≥ 3 years, and who were enrolled in fee-for-service Medicare. Controls were frequency matched to cases on age, sex, race, and region. Quality of care was assessed from day 366 through day 1,095 postdiagnosis using published indicators of chronic (n = 10) and acute (n = 19) condition care. The proportion of eligible cancer survivors and controls who received recommended care was compared by using Fisher's exact tests. The chronic and acute indicators, respectively, were then combined into single logistic regression models for each cancer type to compare survivors' care receipt to that of controls, adjusting for clinical and sociodemographic variables and controlling for within-patient variation. Results The sample matched 8,661 cancer survivors to 17,322 controls (mean age, 75 years; 65% male; 85% white). Colorectal cancer survivors were less likely than controls to receive appropriate care on both the chronic (odds ratio [OR], 0.88; 95% CI, 0.81 to 0.95) and acute (OR, 0.72; 95% CI, 0.61 to 0.85) indicators. Prostate cancer survivors were more likely to receive appropriate chronic care (OR, 1.28; 95% CI, 1.19 to 1.38) but less likely to receive quality acute care (OR, 0.75; 95% CI, 0.65 to 0.87). Breast cancer survivors received care equivalent to controls on both the chronic (OR, 1.06; 95% CI, 0.96 to 1.17) and acute (OR, 0.92; 95% CI, 0.76 to 1.13) indicators. Conclusion Because we found differences by cancer type, research exploring factors associated with these differences in care quality is needed.

scholarly journals Perceived Support Among Families Deciding About Organ Donation for Their Loved Ones: Donor Vs Nondonor Next Of Kin

2010 ◽  
Vol 19 (5) ◽  
pp. e52-e61 ◽  
Author(s):  
Liva Jacoby ◽  
James Jaccard
Keyword(s):  
Quality Of Care ◽  
Organ Donation ◽  
Demographic Data ◽  
Quality Care ◽  
Family Members ◽  
Care Staff ◽  
Next Of Kin ◽  
Perceived Quality Of Care ◽  
Brain Dead

BackgroundFamilies’ experiences in the hospital influence their decisions about donating organs of brain-dead relatives. Meeting families’ support needs during this traumatic time is an obligation and a challenge for critical care staff.Objectives(1) To elicit family members’ accounts of various types of support received and perceived quality of care for themselves and their loved ones when they made the donation decision, and (2) to examine the relationship between these factors and the families’ donation decision.MethodsRetrospective telephone interviews of 199 families from different regions of the country were completed. Aside from demographic data, the survey addressed perceptions of informational, emotional, and instrumental support and quality of care.ResultsOne hundred fifty-four study participants consented to donation; 45 declined. White next of kin were significantly more likely than African Americans to consent. Specific elements of reported support were significantly associated with consent to donate. Donor and nondonor families had differing perceptions of quality care for themselves and their loved ones. Receiving understandable information about organ donation was the strongest predictor of consent.ConclusionsSpecific supportive behaviors by staff as recounted by family members of potential donors were significantly associated with consent to donation. These behaviors lend themselves to creative training and educational programs for staff. Such interventions are essential not only for next of kin of brain-dead patients, but also for staff and ultimately for the public as a whole.

scholarly journals Optimalisasi peran & fungsi manajemen kepala ruangan dalam supervisi dokumentasi asuhan keperawatan di rumah sakit x Jakarta

2021 ◽  
Vol 14 (4) ◽  
pp. 536-544
Author(s):  
Teresa Teresa ◽  
Tuti Afrianti ◽  
Tini Suminarti
Keyword(s):  
Quality Of Care ◽  
Nursing Care ◽  
Health Care Quality ◽  
Descriptive Analysis ◽  
Pilot Project ◽  
Poor Quality ◽  
Care Quality ◽  
Nursing Documentation ◽  
Head Nurse

The role of a head nurse in optimizing of management function in supervision of nursing care documentation at X hospital in JakartaBackground: Nursing documentation is important thing that  is indicator quality of care. Since the nursing documentation is still a poor quality, it requires a supervision by the head nurse.Purpose: The head of nursing is responsible for the direction, organization and strategic planning collaborate with nursing staffs in ensuring the quality of nursing care to achieve accurate, effective and efficient documentation and to complete supervision.Method: A pilot project using questionnaire and observation methods was conducted at difference times on two hospital units in Jakarta.Results: The descriptive analysis results showed that among 18 nurses, 4 nurses believed that nursing documentation is an important, effective and clear way to  ease their job. Hence, supervision is continuity needed to support the improvement of health care quality. The innovative projects will be applied in health care.Conclusion:  Nursing documentation must show continuity and quality of  care nursing under the control and supervision of the head nurse and EMR is used as the instrument for documentation.Keywords :  The role; Head nurse; Management; Supervision; Nursing care; DocumentationPendahuluan: Dokumentasi asuhan keperawatan adalah hal yang penting karena menjadi indikator kualitas perawatan. Penerapan dokumentasi asuhan keperawatan saat ini belum optimal sehingga membutuhkan arahan dan supervisi dari Kepala Ruang/Kepala Unit.Tujuan: Tercapainya supervisi dan keberhasilan pelaksanaan dokumentasi asuhan keperawatan yang komprehensif, berkesinambungan, efektif dan  efisien.Metode: Metode pilot project di salah satu Rumah Sakit di Jakarta dengan pengambilan data melalui  observasi dan kuestioner. Instrumen diujikan pada dua ruangan dalam  waktu yang berbeda.Hasil: Analisis deskripsi pada  sejumlah 18 perawat, 4 orang menyatakan bermanfaat, penting dan mudah dalam penerapannya. Supervisi dilakukan untuk memberikan support terhadap kelangsungan pendokumentasian asuhan keperawatan yang berkesinambungan. Proyek inovasi akan ditindaklanjuti dan diaplikasikan dalam program kerja bidang pelayanan keperawatan.Simpulan: Asuhan keperawatan yang berkualitas memerlukan adanya supervisi. Sarannya penggunaan Instrumen Supervise Dokumentasi Asuhan Keperawatan akan disesuaikan dengan penggunaan pencatatan asuhan keperawatan Elektronic Medical Record/EMR

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