Examining Adverse Patient Outcomes in Nurses: The Role of Patient Acuity, Shift and Fatigue

2021 ◽  
Vol 65 (1) ◽  
pp. 1205-1209
Author(s):  
Aaron Doudna ◽  
Diana Schwerha
Keyword(s):  
Patient Outcomes ◽  
Current Data ◽  
Patient Acuity ◽  
Patient Falls ◽  
Nursing Unit ◽  
Western Hospital ◽  
Case Mix Index ◽  
Two Phases ◽  
Nurse Fatigue ◽  
The Impact

This study identified key factors contributing to adverse patient outcomes (APOs) at a mid-western hospital. Understanding risk factors that contribute to increased nurse fatigue can provide solutions to reduce the impact that fatigue has on nurse performance and patient outcome. This study was comprised of two phases: 1) a database analysis of current data collected at a mid-western hospital, and 2) three focus groups to identify nurse perceptions pertaining to task demand and fatigue. The APOs analyzed in this study were medical administration errors (MAEs) and patient falls. A comparison of the data from both phases was then conducted to determine whether data reflected in the database correlated with nurse perceptions. This analysis documents significant results with respect to APOs in the following workload factors such as: hours worked, case mix index (CMI), shift, and nursing unit type.

scholarly journals The Impact of Heavy Perceived Nurse Workloads on Patient and Nurse Outcomes

2017 ◽  
Vol 7 (1) ◽  
pp. 7 ◽  
Author(s):  
Maura MacPhee ◽  
V. Dahinten ◽  
Farinaz Havaei
Keyword(s):  
Patient Outcomes ◽  
Patient Acuity ◽  
Cross Sectional ◽  
Job Level ◽  
Patient Dependency ◽  
Tract Infections ◽  
The Impact ◽  
Nurse Outcomes ◽  
Task Level ◽  
And Task

This study investigated the relationships between seven workload factors and patient and nurse outcomes. (1) Background: Health systems researchers are beginning to address nurses’ workload demands at different unit, job and task levels; and the types of administrative interventions needed for specific workload demands. (2) Methods: This was a cross-sectional correlational study of 472 acute care nurses from British Columbia, Canada. The workload factors included nurse reports of unit-level RN staffing levels and patient acuity and patient dependency; job-level nurse perceptions of heavy workloads, nursing tasks left undone and compromised standards; and task-level interruptions to work flow. Patient outcomes were nurse-reported frequencies of medication errors, patient falls and urinary tract infections; and nurse outcomes were emotional exhaustion and job satisfaction. (3) Results: Job-level perceptions of heavy workloads and task-level interruptions had significant direct effects on patient and nurse outcomes. Tasks left undone mediated the relationships between heavy workloads and nurse and patient outcomes; and between interruptions and nurse and patient outcomes. Compromised professional nursing standards mediated the relationships between heavy workloads and nurse outcomes; and between interruptions and nurse outcomes. (4) Conclusion: Administrators should work collaboratively with nurses to identify work environment strategies that ameliorate workload demands at different levels.

The Impact of Diabetes on Patient Outcomes After Ankle Fracture

2006 ◽  
Vol 2006 ◽  
pp. 102-103
Author(s):  
M.F. Swiontkowski
Keyword(s):  
Patient Outcomes ◽  
Ankle Fracture ◽  
The Impact

Russia - European Union: The continuation ofthe sanctions standoff

2017 ◽  
pp. 114-127
Author(s):  
M. Klinova ◽  
E. Sidorova
Keyword(s):  
European Union ◽  
Economic Recession ◽  
Economic Sanctions ◽  
Current Data ◽  
The State ◽  
The European Union ◽  
The Impact ◽  
The Eu ◽  
Year 2013

The article deals with economic sanctions and their impact on the state and prospects of the neighboring partner economies - the European Union (EU) and Russia. It provides comparisons of current data with that of the year 2013 (before sanctions) to demonstrate the impact of sanctions on both sides. Despite the fact that Russia remains the EU’s key partner, it came out of the first three partners of the EU. The current economic recession is caused by different reasons, not only by sanctions. Both the EU and Russia have internal problems, which the sanctions confrontation only exacerbates. The article emphasizes the need for a speedy restoration of cooperation.

Awareness-Raising in the TEFL Phonology Classroom

2004 ◽  
Vol 145-146 ◽  
pp. 219-268 ◽  
Author(s):  
Lawrence Zhang
Keyword(s):  
Native Speaker ◽  
Psychological Needs ◽  
British English ◽  
Linguistic Imperialism ◽  
Teacher Student ◽  
Suprasegmental Features ◽  
Discourse Intonation ◽  
Awareness Raising ◽  
Two Phases ◽  
The Impact

This paper reports on two phases of a study of a group of advanced TEFL (teachers-of-English-as-a-foreign-language) students. To raise their awareness of the importance of discourse intonation while they were receiving teacher training, this study focuses on examining their sociocultural and psychological inclinations in the choice of phonological models. The first phase is an exploration of their attitudes toward, a native-speaker variety (British English) and a nonnative (Chinese EFL-speaker) variety of English pronunciation and intonation. The second reports on a didactic intervention study of the impact of activities that engaged the students in the awareness-raising of the importance of suprasegmental features, especially discourse intonation, on self-perceptions of their efficacy and confidence in communication. The results showed a systematic pattern of participant endorsement for a native-speaker model and a clear improvement in theIr perceptions of the importance of suprasegmental features of standard English because of teacher-student co-construction of meaning through interactive awareness-raising activities. The findings are discussed with reference to the students' sociocultural and psychological needs in TEFL training, particularly with reference to recent academic discourse on the issue of “linguistic imperialism” (Canagarajah, 1999; Phillipson, 1992, 1996) and ElL in pedagogy (Jenkins, 1998, 2002) and their wider implications in typical EFL contexts.

Psychosomatic Features, Compliance and Complementary Therapies in Rheumatoid Arthritis

2020 ◽  
Vol 16 (3) ◽  
pp. 215-223
Author(s):  
Rostislav A. Grekhov ◽  
Galina P. Suleimanova ◽  
Andrei S. Trofimenko ◽  
Liudmila N. Shilova
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Interpersonal Relationships ◽  
Behavioral Therapy ◽  
Current Data ◽  
Psychotherapeutic Interventions ◽  
And Coping ◽  
Regulation Of Emotion ◽  
The Impact

This review highlights the issue of psychosomatic conditions in rheumatoid arthritis, paying special attention to new researches and trends in this field. Emerging concepts in all the major parts of the problem are covered consecutively, from the impact of chronic musculoskeletal pain on the emotional state to disease influence over quality of life, socio-psychological, and interpersonal relationships. Chronic pain is closely related to emotional responses and coping ability, with a pronounced positive effect of psychotherapeutic interventions, family and social support on it. Psychosexual disorders, anxiety, depression also commonly coexist with rheumatoid arthritis, leading to further decrease in quality of life, low compliance, and high suicide risk. Influence of psychosomatic conditions on the overall treatment effect is usually underestimated by rheumatologists and general practitioners. Psychosomatic considerations are of great importance for up-to-date management of rheumatoid arthritis, as they strongly influence the quality of life, compliance, and thereby disease outcomes. Two major approaches of psychological rehabilitation exist, both coping with pain through the regulation of emotion and psychotherapeutic intervention, which not only helps patients in coping with the disease, but also aimed at improving the overall adaptation of the patient. It includes techniques of relaxation, cognitive-behavioral therapy, and biofeedback therapy. Current data about the efficacy of the additional correcting therapies for patients with rheumatoid arthritis, both emerging and common ones, are discussed in the review.

Diabetes Discharge Planning and Transitions of Care: A Focused Review

2019 ◽  
Vol 15 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Robin L. Black ◽  
Courtney Duval
Keyword(s):  
Patient Outcomes ◽  
Hospital Admissions ◽  
Discharge Planning ◽  
Medication Management ◽  
Hospital Readmissions ◽  
The United States ◽  
Transitions Of Care ◽  
Discharge Process ◽  
The Impact ◽  
Diabetes Patients

Background: Diabetes is a growing problem in the United States. Increasing hospital admissions for diabetes patients demonstrate the need for evidence-based care of diabetes patients by inpatient providers, as well as the importance of continuity of care when transitioning patients from inpatient to outpatient providers. Methods: A focused literature review of discharge planning and transitions of care in diabetes, conducted in PubMed is presented. Studies were selected for inclusion based on content focusing on transitions of care in diabetes, risk factors for readmission, the impact of inpatient diabetes education on patient outcomes, and optimal medication management of diabetes during care transitions. American Diabetes Association (ADA) guidelines for care of patients during the discharge process are presented, as well as considerations for designing treatment regimens for a hospitalized patient transitioning to various care settings. Results: Multiple factors may make transitions of care difficult, including poor communication, poor patient education, inappropriate follow-up, and clinically complex patients. ADA recommendations provide guidance, but an individualized approach for medication management is needed. Use of scoring systems may help identify patients at higher risk for readmission. Good communication with patients and outpatient providers is needed to prevent patient harm. A team-based approach is needed, utilizing the skills of inpatient and outpatient providers, diabetes educators, nurses, and pharmacists. Conclusion: Structured discharge planning per guideline recommendations can help improve transitions in care for patients with diabetes. A team based, patient-centered approach can help improve patient outcomes by reducing medication errors, delay of care, and hospital readmissions.

scholarly journals Measuring frailty in younger populations: a rapid review of evidence

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e047051
Author(s):  
Gemma F Spiers ◽  
Tafadzwa Patience Kunonga ◽  
Alex Hall ◽  
Fiona Beyer ◽  
Elisabeth Boulton ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Predictive Validity ◽  
Data Extraction ◽  
Grey Literature ◽  
Frailty Index ◽  
Study Data ◽  
Rapid Review ◽  
Eligibility Criteria ◽  
Adult Age ◽  
The Impact

ObjectivesFrailty is typically assessed in older populations. Identifying frailty in adults aged under 60 years may also have value, if it supports the delivery of timely care. We sought to identify how frailty is measured in younger populations, including evidence of the impact on patient outcomes and care.DesignA rapid review of primary studies was conducted.Data sourcesFour databases, three sources of grey literature and reference lists of systematic reviews were searched in March 2020.Eligibility criteriaEligible studies measured frailty in populations aged under 60 years using experimental or observational designs, published after 2000 in English.Data extraction and synthesisRecords were screened against review criteria. Study data were extracted with 20% of records checked for accuracy by a second researcher. Data were synthesised using a narrative approach.ResultsWe identified 268 studies that measured frailty in samples that included people aged under 60 years. Of these, 85 studies reported evidence about measure validity. No measures were identified that were designed and validated to identify frailty exclusively in younger groups. However, in populations that included people aged over and under 60 years, cumulative deficit frailty indices, phenotype measures, the FRAIL Scale, the Liver Frailty Index and the Short Physical Performance Battery all demonstrated predictive validity for mortality and/or hospital admission. Evidence of criterion validity was rare. The extent to which measures possess validity across the younger adult age (18–59 years) spectrum was unclear. There was no evidence about the impact of measuring frailty in younger populations on patient outcomes and care.ConclusionsLimited evidence suggests that frailty measures have predictive validity in younger populations. Further research is needed to clarify the validity of measures across the adult age spectrum, and explore the utility of measuring frailty in younger groups.

scholarly journals The impact of nurse staffing methodologies on nurse and patient outcomes: A systematic review

2021 ◽  
Author(s):  
Diane E. Twigg ◽  
Lisa Whitehead ◽  
Gemma Doleman ◽  
Sonia El‐Zaemey
Keyword(s):  
Systematic Review ◽  
Patient Outcomes ◽  
Nurse Staffing ◽  
The Impact

scholarly journals A Retrospective Experience of Helicobacter pylori Histology in a Large Sample of Subjects in Northern Italy

Life ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 650
Author(s):  
Davide Giuseppe Ribaldone ◽  
Carlo Zurlo ◽  
Sharmila Fagoonee ◽  
Chiara Rosso ◽  
Angelo Armandi ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Large Population ◽  
Population Data ◽  
Signet Ring Cell ◽  
Current Data ◽  
Low Grade ◽  
Gastric Cardia Adenocarcinoma ◽  
Significant Difference ◽  
H Pylori ◽  
The Impact

Updated data about the prevalence of Helicobacter pylori (H. pylori) and its correlation with histological results are scarce. The aim of our study was to provide current data on the impact of H. pylori in a third-level endoscopy service. We performed a large, retrospective study analyzing the results of all histological samples of gastroscopy from the year 2019. In total, 1512 subjects were included. The prevalence of H. pylori was 16.8%. A significant difference between the prevalence in subjects born in Italy and those from eastern Europe, south America, or Africa was found (p < 0.0001, p = 0.006, and p = 0.0006, respectively). An association was found between H. pylori and active superficial gastritis (p < 0.0001). Current H. pylori and/or a previous finding of H. pylori was related to antral atrophy (p < 0.0001). Fifteen patients had low-grade dysplasia. There were no statistically significant associations with current or past H. pylori infection. One patient presented gastric cardia adenocarcinoma with regular gastric mucosa. One patient, H. pylori positive, was diagnosed with gastric signet ring cell adenocarcinoma in a setting of diffuse atrophy, without metaplasia.. Our study provides updated, solid (biopsy diagnosis and large population) data on the prevalence of H. pylori infection in a representative region of southern Europe.

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