scholarly journals Care Quality, Patient Safety, and Nurse Outcomes at Hospitals Serving Economically Disadvantaged Patients: A Case for Investment in Nursing

2022 ◽  
pp. 152715442110695
Author(s):  
Molly Kreider Viscardi ◽  
Rachel French ◽  
Heather Brom ◽  
Eileen Lake ◽  
Connie Ulrich ◽  
...  
Keyword(s):  
Patient Safety ◽  
Work Environment ◽  
Economically Disadvantaged ◽  
Intent To Leave ◽  
Secondary Data ◽  
Care Quality ◽  
Work Environments ◽  
Cross Sectional ◽  
Nurse Work Environment ◽  
Nurse Outcomes

We sought to evaluate if better work environments or staffing were associated with improvements in care quality, patient safety, and nurse outcomes across hospitals caring for different proportions of patients who are economically disadvantaged. Few actionable approaches for hospitals with quality and resource deficits exist. One solution may be to invest in the nurse work environment and staffing. This cross-sectional study utilized secondary data from 23,629 registered nurses in 503 hospitals from a four-state survey collected in 2005–2008. Each 10% increase in the proportion of patients who are economically disadvantaged was associated with 27% and 22% decreased odds of rating unit-level care quality as excellent and giving an “A” safety grade, respectively. Each 10% increase was also associated with 9%, 25%, and 11% increased odds of job dissatisfaction, intent to leave, and burnout, respectively. The work environment had the largest association with each outcome. Accounting for the nurse work environment lessened or eliminated the negative outcomes experienced at hospitals serving high proportions of patients who are economically disadvantaged. Leaders at hospitals serving high proportions of patients who are economically disadvantaged, as well as state and federal policymakers, should work to improve quality, safety, and nurse outcomes by strengthening nurse work environments. Improving work environments highlights the role of nursing in the health care system, and policies focused on work environments are needed to improve the experiences of patients and nurses, especially at hospitals that care for many patients who are economically disadvantaged.

scholarly journals Association of the Nurse Work Environment, Collective Efficacy, and Missed Care

2017 ◽  
Vol 40 (6) ◽  
pp. 779-798 ◽  
Author(s):  
Jessica G. Smith ◽  
Karen H. Morin ◽  
Leigh E. Wallace ◽  
Eileen T. Lake
Keyword(s):  
Work Environment ◽  
Collective Efficacy ◽  
Hospital Staff ◽  
Work Environments ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Quality Patient Care ◽  
Hospital Staff Nurses ◽  
Nurse Work Environment ◽  
Missed Care

Missed nursing care is a significant threat to quality patient care. Promoting collective efficacy within nurse work environments could decrease missed care. The purpose was to understand how missed care is associated with nurse work environments and collective efficacy of hospital staff nurses. A cross-sectional, convenience sample was obtained through online surveys from registered nurses working at five southwestern U.S. hospitals. Descriptive, correlational, regression, and path analyses were conducted ( N = 233). The percentage of nurses who reported that at least one care activity was missed frequently or always was 94%. Mouth care (36.0% of nurses) and ambulation (35.3%) were missed frequently or always. Nurse work environments and collective efficacy were moderately, positively correlated. Nurse work environments and collective efficacy were associated with less missed care (χ2 = 10.714, p = .0054). Fostering collective efficacy in the nurse work environment could reduce missed care and improve patient outcomes.

scholarly journals Association of Working Hours and Patient Safety Competencies with Adverse Nurse Outcomes: A Cross-Sectional Study

2019 ◽  
Vol 16 (21) ◽  
pp. 4083
Author(s):  
Youn-Jung Son ◽  
Eun Kyoung Lee ◽  
Yukyung Ko
Keyword(s):  
Patient Safety ◽  
Linear Regression Analysis ◽  
Tertiary Care ◽  
Working Hours ◽  
Cross Sectional Study ◽  
Care Quality ◽  
Cross Sectional ◽  
Nursing Leaders ◽  
Work Related ◽  
Nurse Outcomes

The environment of health organizations can determine healthcare quality and patient safety. Longer working hours can be associated with nurses’ health status and care quality, as well as work-related hazards. However, little is known about the association of hospital nurses’ working hours and patient safety competencies with adverse nurse outcomes. In this cross-sectional descriptive study, convenience sampling was employed to recruit 380 nurses from three tertiary care hospitals in South Korea. Data were collected using structured questionnaires from May to June 2016. Hierarchical linear regression analysis was used to identify the association of working hours and patient competencies with adverse nurse outcomes among 364 participants selected for analysis. Most nurses worked over 40 h/week. Working hours (β = 0.202, p < 0.001) had the strongest association with adverse nurse outcomes. Low perceived patient safety competencies (β = −0.179, p = 0.001) and frequently reporting patient safety accidents (β = 0.146, p = 0.018) were also correlated with adverse nurse outcomes. Nursing leaders should encourage work cultures where working overtime is discouraged and patient safety competencies are prioritized. Further, healthcare managers must formulate policies that secure nurses’ rights. The potential association of overtime with nurse and patient outcomes needs further exploration.

scholarly journals Intensive Care Unit Utilization Following Major Surgery and the Nurse Work Environment

2021 ◽  
Vol 32 (4) ◽  
pp. 381-390
Author(s):  
Anna Krupp ◽  
Karen B. Lasater ◽  
Matthew D. McHugh
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Work Environment ◽  
Cross Sectional Study ◽  
Work Environments ◽  
Major Surgery ◽  
Cross Sectional ◽  
Lower Odds ◽  
Nurse Work Environment

Background Across hospitals, there is wide variation in ICU utilization after surgery. However, it is unknown whether and to what extent the nurse work environment is associated with a patient’s odds of admission to an intensive care unit. Purpose To estimate the relationship between hospitals’ nurse work environment and a patient’s likelihood of ICU admission and mortality following surgery. Methods A cross-sectional study of 269 764 adult surgical patients in 453 hospitals was conducted. Logistic regression models were used to estimate the effects of the work environment on the odds of patients’ admission to the intensive care unit and mortality. Results Patients in hospitals with good work environments had 16% lower odds of intensive care unit admission and 15% lower odds of mortality or intensive care unit admission than patients in hospitals with mixed or poor environments. Conclusions Patients in hospitals with better nurse work environments were less likely to be admitted to an intensive care unit and less likely to die. Hospitals with better nurse work environments may be better equipped to provide postoperative patient care on lower acuity units.

scholarly journals Risk Analysis for Patient Safety in Surgical Departments: Cross-Sectional Design Usefulness

2020 ◽  
Vol 17 (7) ◽  
pp. 2516
Author(s):  
Verónica Aranaz Ostáriz ◽  
María Teresa Gea Velázquez de Castro ◽  
Francisco López Rodríguez-Arias ◽  
José Lorenzo Valencia Martín ◽  
Carlos Aibar Remón ◽  
...  
Keyword(s):  
Patient Safety ◽  
Adverse Events ◽  
Latin American ◽  
Health Care Quality ◽  
Health Impact ◽  
Cross Sectional Study ◽  
Care Quality ◽  
Cross Sectional ◽  
Improve Health Care Quality ◽  
Health Organization

(1) Background: Identifying and measuring adverse events (AE) is a priority for patient safety, which allows us to define and prioritise areas for improvement and evaluate and develop solutions to improve health care quality. The aim of this work was to determine the prevalence of AEs in surgical and medical-surgical departments and to know the health impact of these AEs. (2) Methods: A cross-sectional study determining the prevalence of AEs in surgical and medical-surgical departments was conducted and a comparison was made among both clinical areas. A total of 5228 patients were admitted in 58 hospitals in Argentina, Colombia, Costa Rica, Mexico, and Peru, within the Latin American Study of Adverse Events (IBEAS), led by the Spanish Ministry of Health, the Pan American Health Organization, and the WHO Patient Safety programme. (3) Results: The global prevalence of AEs was 10.7%. However, the prevalence of AEs in surgical departments was 11.9%, while in medical-surgical departments it was 8.9%. The causes of these AEs were associated with surgical procedures (38.6%) and nosocomial infections (35.4%). About 60.6% of the AEs extended hospital stays by 30.7 days on average and 25.8% led to readmission with an average hospitalisation of 15 days. About 22.4% resulted in death, disability, or surgical reintervention. (4) Conclusions: Surgical departments were associated with a higher risk of experiencing AEs.

scholarly journals A Parsonian Approach to Patient Safety: Transformational Leadership and Social Capital as Preconditions for Clinical Risk Management—the GI Factor

2020 ◽  
Vol 17 (11) ◽  
pp. 3989 ◽  
Author(s):  
Holger Pfaff ◽  
Jeffrey Braithwaite
Keyword(s):  
Social Capital ◽  
Risk Management ◽  
Transformational Leadership ◽  
Patient Safety ◽  
Goal Attainment ◽  
Safety Management ◽  
Secondary Data ◽  
Clinical Risk Management ◽  
Cross Sectional ◽  
Clinical Risk

The purpose of this study is to investigate the role of the combination of transformational leadership and social capital in safety capacity building. Drawing on the A-G-I-L concept of Talcott Parsons, we test a model for patient safety. The hypothesis is, that good safety management needs a combination of goal attainment (G) and integration (I), here called the GI factor. We tested this hypothesis by using transformational leadership as a surrogate for goal attainment and social capital as a surrogate for integration in a study of the perceptions of chief medical officers in 551 German hospitals. We conducted a cross-sectional hospital survey combined with secondary data analysis in all German hospitals with at least one internal medicine unit and one surgery unit (N = 1224 hospitals) in the year 2008 with a response rate of 45% (N = 551). The regression model explained 17.9% of the variance in perceived clinical risk management. We found that if both requirements for goal-oriented collective action—transformational leadership and social capital—are met, good safety management is more likely. The tentative conclusion is that it takes transformative leaders and cohesive followers together as a social basis to improve safety in hospitals.

scholarly journals THE IMPACT ANALYSIS OF MOTIVATION, TRAINING, AND WORK ENVIRONMENT TO NURSES PERFORMANCE IN PATIENT SAFETY

2019 ◽  
Vol 2 (1) ◽  
pp. 54
Author(s):  
Fushen Fushen ◽  
Meylona Verawaty Zendrato
Keyword(s):  
Patient Safety ◽  
Work Environment ◽  
Public Hospital ◽  
Impact Analysis ◽  
Working Environment ◽  
Cross Sectional ◽  
The Public ◽  
Increasing Demand ◽  
And Performance ◽  
The Impact

The development of hospitals in health industry as economic institutions and the establishment of many new hospitals increase the number of nurses needed while the number of nurses produced cannot keep pace with the increasing demand. In hospital services, nurse is the most frequently interacted person with patients and are fully responsible for patient care, including in terms of patient safety. This study aims to obtain empirical evidence about the effect of motivation, training and work environment on the performance of nurses in patient safety in the Public Hospital. Expected output from this study can be used as a reference to determine the policy for nurse management at the hospital. This is a correlational analytic study with a cross-sectional approach and descriptive method of verification. The research was conducted in a Public Hospital in Jakarta. The research sample are 90 nurses working in inpatient wards. The hypothesis of this study were analyzed with path analysis methods. The results of this study showed a significant positive effect between motivation and performance (20.7%), training and performance (21.8%), working environment and performance (20.7%), and the simultaneous influence from motivation, training, and working environment on the performance (63.2% ).

scholarly journals FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN TEKANAN DARAH PEKERJA DI PLTD/G

2016 ◽  
Vol 1 (3) ◽  
Author(s):  
Putri Sahara Harahap
Keyword(s):  
Blood Pressure ◽  
Work Environment ◽  
Working Conditions ◽  
Sampling Method ◽  
Secondary Data ◽  
Primary Data ◽  
P Value ◽  
Variable Intensity ◽  
Cross Sectional ◽  
Factors Associated

<p align="center"><strong><em>ABSTRACT</em></strong></p><p><strong><em><br /> Many diseases that afflict workers with regard to employment and working conditions are not safe, One is noise. Noise is sound or noise that is not desired, and therefore the noise will cause disruption for anyone who works on the noisy work environment. The purpose of this study was to determine the factors associated with blood pressure in workers in diesel / G Payo Selincah Jambi city in 2016. This type of research was an observational with cross sectional approach. Samples are all workers in the diesel / G Payo Selincah Jambi city is 48 people. How sampling mengguankan total sampling method. The collection of data by taking the primary data and secondary data. Analyzed using univariate and bivariate results showed no significant correlation between the intensity of noise with a p-value = 0.000 (p &lt;0.05), duration of exposure denagn pressure and blood pressure with a p-value = 0.020 (p &lt; 0.05), tenure and blood pressure with a p-value = 0.000 (p &lt;0.05). The study concluded that the variable intensity of noise, long exposure and a working relationship with blood pressure.</em></strong></p><p><strong><em><br /> <br /> Keywords: noise intensity, length of exposure, length of employment and blood pressure</em></strong></p><h1> </h1><p> </p><p align="center"><strong>ABSTRAK</strong></p><p align="center"><strong> </strong></p><p><strong><em>Banyak </em></strong><strong><em>penyakit yang menimpa pekerja berkaitan dengan pekerjaan dan kondisi tempat kerja yang tidak aman, Salah satunya adalah kebisingan. Kebisingan adalah suara atau bunyi yang tidak dikehendaki, maka dari itu kebisingan akan menyebabkan gangguan bagi siapa saja yang bekerja pada lingkungan kerja yang bising tersebut. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan tekanan darah pada pekerja di PLTD/G Payo Selincah kota Jambi tahun 2016. Jenis penelitian ini yang digunakan adalah observasional dengan pendekatan cross sectional.  Sampel pada penelitian ini adalah semua pekerja di PLTD/G Payo Selincah kota Jambi yaitu 48 orang. Cara pengambilan sampel dengan mengguankan metode total sampling. Pengumpulan data dengan cara mengambil data primer dan data sekunder. Analisis data menggunakan analisis univariat dan bivariat Hasil penelitian ini menunjukkan ada hubungan yang signifikan antara intensitas kebisingan dengan nilai p-value = 0,000 (p &lt; 0,05), lama pajanan denagn tekanan dan tekanan darah dengan nilai p-value = 0,020 (p&lt;0,05), masa kerja dan tekanan darah dengan nilai p-value = 0,000 (p &lt; 0,05). Penelitian ini menyimpulkan bahwa variabel intensitas kebisingan, lama pajanan dan masa kerja memiliki hubungan dengan tekanan darah.</em></strong></p><p> </p><p><strong>Kata kunci : intensitas kebisingan, lama pajanan, masa kerja dan tekanan darah</strong></p><p><strong> </strong></p>

Dementia care worker stress associations with unit type, resident, and work environment characteristics: a cross-sectional secondary data analysis of the Swiss Nursing Homes Human Resources Project (SHURP)

2016 ◽  
Vol 29 (3) ◽  
pp. 441-454 ◽  
Author(s):  
Barbara Vogel ◽  
Sabina De Geest ◽  
Katharina Fierz ◽  
Sonja Beckmann ◽  
Franziska Zúñiga
Keyword(s):  
Data Analysis ◽  
Nursing Homes ◽  
Human Resources ◽  
Work Environment ◽  
Secondary Data ◽  
Cross Sectional ◽  
Unit Type ◽  
Care Workers ◽  
Worker Stress ◽  
Care Worker

ABSTRACTBackground:Although caring for residents with dementia in nursing homes is associated with various stressors for care workers, the role of the unit type, and particularly the proportion of residents with dementia, remains unclear. This study aimed to explore associations between unit type and care worker stress, taking into account additional potential stressors.Methods:This cross-sectional study was a secondary data analysis in the Swiss Nursing Homes Human Resources Project, which included data from 3,922 care workers from 156 Swiss nursing homes. Care workers’ stress was measured with a shortened version of the Health Professions Stress Inventory. Generalized estimating equation models were used to assess care worker stress and its relationships with three unit types (special care units and others with high or low proportions of residents with dementia), work environment factors, and aggressive resident behavior.Results:After including all potential stressors in the models, no significant differences between the three unit types regarding care worker stress were found. However, increased care worker stress levels were significantly related to lower ratings of staffing and resources adequacy, the experience of verbal aggression, and the observation of verbal or physical aggression among residents.Conclusions:Although the unit type plays only a minor role regarding care worker stress, this study confirms that work environment and aggressive behavior of residents are important factors associated with work-related stress. To prevent increases of care worker stress, interventions to improve the work environment and strengthen care workers’ ability to cope with aggressive behavior are suggested.

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