The Impact of Short-Term Solutions of Nursing Shortage on Nursing Outcome, Nurse Perceived Quality of Care, and Patient Safety

Rationale and Objectives: Patients with chronic diseases re-admitted for acute events are associated with a high use of hospital resources and represent a challenge for healthcare systems. In such cases, follow-up interventions at discharge can be effective. The widespread adoption of follow-up procedures not involving telemonitoring may greatly decrease re-admissions rates without the costs associated with telemedicine. To assess the impact of a structured follow-up programme on patient-perceived healthcare quality, treatment adherence, re-admissions and Emergency Department attendances.Methods: This was a before and after study of 242 patients at risk of re-admission for chronic obstructive pulmonary disease (COPD) or heart failure (HF), recruited between 1st July 2009 and 30th June 2010 at Donostia Tertiary University Hospital (Gipuzkoa, Spain). The follow-up ended on 30th December 2010. The intervention involved identifying independent re-admitted patients, providing personalised information and a direct number to call in the event of clinical worsening, assigning specialists and liaison nurses, structured follow-up by telephone and appointments and contact with general practitioners. Patient perceived quality of care estimated was analyzed using a focus group technique. To assess the number of re-admissions and the Emergency Department attendances we estimated the relative risk reduction as a percentage and corresponding 95% confidence intervals.Results: In terms of perceived quality of care, the most valued elements were related to having an assigned doctor/nurse and easy access in the event of worsening. Overall, 97.9% of patients reported full adherence to treatment (95% CI: 95.4-98.83).Hospital bed days and Emergency Department attendances decreased by 60.7% (95% CI: 58.7-62.7) and 77% (95% CI: 73.2-80.3), respectively.Conclusions: The intensive multidisciplinary care programme can reduce Emergency Department attendances and improve perceived quality of care in patients with HF and COPD.

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A tale of two systems—Nurses practice environment, well being, perceived quality of care and patient safety in private and public hospitals in South Africa: A questionnaire survey

International Journal of Nursing Studies ◽

10.1016/j.ijnurstu.2012.11.002 ◽

2013 ◽

Vol 50 (2) ◽

pp. 162-173 ◽

Cited By ~ 62

Author(s):

Siedine K. Coetzee ◽

Hester C. Klopper ◽

Suria M. Ellis ◽

Linda H. Aiken

Keyword(s):

South Africa ◽

Patient Safety ◽

Quality Of Care ◽

Questionnaire Survey ◽

Well Being ◽

Perceived Quality ◽

Public Hospitals ◽

Perceived Quality Of Care ◽

Private And Public

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Assessing the impact of general practitioner team service on perceived quality of care among patients with non-communicable diseases in China: a natural experimental study

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzw075 ◽

2016 ◽

Vol 28 (5) ◽

pp. 554-560 ◽

Cited By ~ 7

Author(s):

Jia Yin ◽

Xiaolin Wei ◽

Haitao Li ◽

Yanling Jiang ◽

Chunfang Mao

Keyword(s):

Experimental Study ◽

Quality Of Care ◽

General Practitioner ◽

Perceived Quality ◽

Communicable Diseases ◽

Non Communicable Diseases ◽

Perceived Quality Of Care ◽

The Impact ◽

Natural Experimental Study

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A Narrative Review of Clinical Decision Support for Inpatient Clinical Pharmacists

Applied Clinical Informatics ◽

10.1055/s-0041-1722916 ◽

2021 ◽

Vol 12 (02) ◽

pp. 199-207

Author(s):

Liang Yan ◽

Thomas Reese ◽

Scott D. Nelson

Keyword(s):

Patient Safety ◽

Quality Of Care ◽

Decision Support ◽

Clinical Decision Support ◽

Clinical Decision ◽

Controlled Trials ◽

Clinical Pharmacists ◽

Randomized Controlled ◽

The Impact

Abstract Objective Increasingly, pharmacists provide team-based care that impacts patient care; however, the extent of recent clinical decision support (CDS), targeted to support the evolving roles of pharmacists, is unknown. Our objective was to evaluate the literature to understand the impact of clinical pharmacists using CDS. Methods We searched MEDLINE, EMBASE, and Cochrane Central for randomized controlled trials, nonrandomized trials, and quasi-experimental studies which evaluated CDS tools that were developed for inpatient pharmacists as a target user. The primary outcome of our analysis was the impact of CDS on patient safety, quality use of medication, and quality of care. Outcomes were scored as positive, negative, or neutral. The secondary outcome was the proportion of CDS developed for tasks other than medication order verification. Study quality was assessed using the Newcastle–Ottawa Scale. Results Of 4,365 potentially relevant articles, 15 were included. Five studies were randomized controlled trials. All included studies were rated as good quality. Of the studies evaluating inpatient pharmacists using a CDS tool, four showed significantly improved quality use of medications, four showed significantly improved patient safety, and three showed significantly improved quality of care. Six studies (40%) supported expanded roles of clinical pharmacists. Conclusion These results suggest that CDS can support clinical inpatient pharmacists in preventing medication errors and optimizing pharmacotherapy. Moreover, an increasing number of CDS tools have been developed for pharmacists' roles outside of order verification, whereby further supporting and establishing pharmacists as leaders in safe and effective pharmacotherapy.

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Perceived quality of care among people with type 2 diabetes mellitus in the north east region of peninsular Malaysia

BMC Public Health ◽

10.1186/s12889-021-10320-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Noorfariza Nordin ◽

Suhaily Mohd Hairon ◽

Najib Majdi Yaacob ◽

Anees Abdul Hamid ◽

Seoparjoo Azmel Mohd Isa ◽

...

Keyword(s):

Quality Of Care ◽

Perceived Quality ◽

Peninsular Malaysia ◽

North East ◽

The North ◽

East Region ◽

Perceived Quality Of Care ◽

Significant Difference

Abstract Background People with type 2 diabetes mellitus (T2DM) are best managed by a chronic care model that is associated with enhanced quality of care and improved patient outcome. Assessing patients’ perceived quality of care is crucial in improving the healthcare delivery system. Hence, this study determined the perceived quality of care among people with T2DM and explored its associations with (i) sociodemographic and clinical characteristics and (ii) types of healthcare clinics to guide future planning. Methods A cross-sectional study involving 20 primary healthcare clinics in the North East Region of Peninsular Malaysia and people with T2DM as the sampling unit was conducted from February to May 2019. The pro forma checklist, interview-guided Skala Kepuasan Interaksi Perubatan-11, and Patient Assessment of Chronic Illness Care (Malay version; PACIC-M) questionnaire were used for data collection. Univariate analysis and linear regression were used to determine the status of perceived quality of care and the factors associated with the perceived quality of care, respectively. Results Overall, data from 772 participants were analyzed. The majority was from the Malay ethnic group (95.6%) with a mean (standard deviation [SD]) glycated hemoglobin A1c (HbA1c) level of 8.91% (2.30). The median (interquartile range [IQR]) of the number of medical officers available at each clinic was 6 (7), with Family Doctor Concept (FDC) clinics having a higher number of medical officers than non-FDC clinics (p = 0.001). The overall mean (SD) PACIC-M score was 2.65 (0.54) with no significant difference between scores of patients treated in the two clinic types (p = 0.806). Higher perceived quality of care was associated with lower number of medical officers (adjusted regression coefficient [Adj.β], − 0.021; p-value [p], 0.001), and greater doctor–patient interaction in all domains: distress relief (Adj.β, 0.033; p, < 0.001), rapport (Adj.β, 0.056; p, < 0.001), and interaction outcome (Adj.β, 0.022; p, 0.003). Conclusion Although there was no significant difference found between clinic type, this study reflects that patients are comfortable when managed by the same doctor, which may support a better doctor-patient interaction. A larger specialized primary care workforce could improve diabetes care in Malaysia.

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Perceived quality of surgical care in association with patient-related factors and correlation to reported postoperative complications in Finland: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-037708 ◽

2020 ◽

Vol 10 (11) ◽

pp. e037708

Author(s):

Ira Helena Saarinen ◽

Jaana-Maija Koivisto ◽

Antti Kaipia ◽

Elina Haavisto

Keyword(s):

Quality Of Care ◽

Postoperative Complications ◽

Cross Sectional Study ◽

Perceived Quality ◽

Living Alone ◽

Sectional Study ◽

Related Factors ◽

Cross Sectional ◽

Perceived Quality Of Care

ObjectiveTo study if patient-related factors are associated with patient-evaluated quality of care in surgery. To examine if there is an association with postoperative complications and patient-evaluated low quality of care.DesignA correlation cross-sectional study, in addition, a phone call interview at 30 days postoperatively to examine complications.SettingThe data on patients admitted for non-cardiac general and orthopaedic surgery at a central hospital in Southwestern Finland were collected in two phases during an 8-month period.Participants436 consecutive consenting and eligible in-ward non-cardiac general surgery and orthopaedic surgery adult patients. Ambulatory, paediatric and memory disorder patients were excluded. 378 patients completed the questionnaire (Good Nursing Care Scale for Patients (GNCS-P)).MethodsPerceived quality of care was examined by the GNCS-P questionnaire. Patient-related factors were obtained from electronic patient records and questionnaire. A telephone interview related to postdischarge complications was conducted 30 days after discharge.Main outcome measuresPatient evaluation of quality of care at discharge, its association with patient-related factors and patient-reported postdischarge complications.ResultsThe overall quality was evaluated high or very high by the patients. The lowest overall quality of care rate was assessed by surgical patients living alone (p=0.0088) and patients who evaluated their state of health moderate or poor (p=0.0047). Surgical patients reporting postoperative complications after discharge evaluated lower overall quality of care (p=0.0105) than patients with no complications.ConclusionPatient demographic factors do not seem to influence the perceptions of the quality of care. Instead, subjective state of health and living conditions (living alone) may have an influence on the patient experience of quality of care. The perceived quality of care in healthcare staff technical and communication skills may have an association with reported postoperative complications.

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