scholarly journals Calculation of the Optimal Number of Nurses Based on Nursing Intensity by Patient Classification Groups in General Units in South Korea: a Cross-sectional Study

2021 ◽  
Author(s):  
Yukyung Ko ◽  
Bohyun Park
Keyword(s):  
Internal Medicine ◽  
Cross Sectional Study ◽  
Optimal Number ◽  
Nursing Workload ◽  
Patient Classification ◽  
Nursing Time ◽  
Cross Sectional ◽  
Hospital Nursing ◽  
Surgical Unit ◽  
Internal Medicine Unit

Abstract Background: Calculating the accurate number of nursing personnel based on a patient classification system that clearly reflects the nursing needs of patients is a problem directly related to the nursing unit’s budget management, productivity, etc. This study aimed to calculate the total daily nursing workload and the optimal number of nurses per general unit based on the nursing intensity and direct nursing time per inpatient through patient classification.Methods: Three units at one general hospital were investigated. To calculate nursing intensity, patient classification according to nursing needs was performed for over 10 days in each unit in September 2018. The direct and non-direct nursing time and nursing intensity scores were analyzed using descriptive statistics (e.g. frequency, percentage, and average) generated using Microsoft Excel.Results: For the internal medicine unit, the average direct nursing time per patient was 1.0, 1.5, 2.2, and 2.9 hours for Groups 1, 2, 3 and 4, respectively. For the surgical unit, the average direct nursing time per patient was 0.9, 1.4, 2.1, and 2.6 hours for Groups 1, 2, 3, and 4, respectively. For the comprehensive nursing care unit, the average direct nursing time per patient was 0.8, 1.2, 1.7, and 2.2 hours for Groups 1, 2, 3, and 4. The optimal number of nurses was 25 in the internal medicine unit, 37 in the surgical unit, and 22 in the comprehensive nursing unit. There was a shortage of five nurses in the internal medicine unit and nine in the surgical unit.Conclusion: Based on the nursing time according to patient classification groups, this study confirmed that the optimal number of nurses cannot be secured and that the nursing intensity is very high. The results of this study suggest that long-term efforts, such as improving the nursing environment, should be made to secure an optimal number of nurses in various hospital nursing units.

scholarly journals Dimensioning of hospital nursing personnel: study with brazilian official parameters of 2004 and 2017

2017 ◽  
Vol 21 (4) ◽  
Author(s):  
Raíssa Ottes Vasconcelos ◽  
Denise de Fátima Hoffmann Rigo ◽  
Luis Guilherme Sbrolini Marques ◽  
Anair Lazzari Nicola ◽  
Nelsi Salete Tonini ◽  
...  
Keyword(s):  
Nursing Staff ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Actual Condition ◽  
Patient Classification ◽  
Cross Sectional ◽  
Hospital Unit ◽  
Hospital Nursing ◽  
Patient Classification System ◽  
Negative Difference

Abstract Objective: To investigate the dimensions of the nursing team of a hospital unit according to the official Brazilian parameters of 2004 and 2017 and compare the dimensioned conditions to the actual condition existing. Method: A cross-sectional study with data from patients (n = 325) hospitalized in the Neurology and Orthopedics unit of a university hospital in Paraná, Brazil. Data from the Patient Classification System related to nursing work, as well as sociodemographic and clinical variables of the clientele were compiled. The dimensioning of the nursing staff followed the Federal Nursing Council Resolutions of 2004 and 2017. Results: The profile of the patients showed predominantly men (66.46%) hospitalized for Orthopedics (49.58%). The negative difference of professionals dimensioned compared to the actual condition was more evident for the category of nurses, below both the parameters of 2004 (-8) and 2017 (-11). Conclusions: The number of nursing staff in the unit was insufficient.

scholarly journals Nurses’ Experiences of Nonpatient Factors That Affect Nursing Workload: A Study of the PAONCIL Instrument’s Nonpatient Factors

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Lisbeth Fagerström ◽  
Paula Vainikainen
Keyword(s):  
Working Conditions ◽  
Cross Sectional Study ◽  
Self Control ◽  
Nursing Workload ◽  
Intensity Level ◽  
Patient Classification ◽  
Cross Sectional ◽  
Professional Assessment ◽  
Outpatient Settings ◽  
Patient Classification System

In the RAFAELA patient classification system, the professional assessment of optimal nursing care intensity level (PAONCIL) instrument is used to assess the optimal nursing intensity level per unit. The PAONCIL instrument contains an overall assessment of the actual nursing intensity level and an additional list of central nonpatient factors that may increase or decrease the total nursing workload (NWL). The aim of this cross-sectional study was to assess and determine which nonpatient factors affect nurses’ experiences of their total NWL in both outpatient settings and hospitals, as captured through the PAONCIL instrument. The data material consisted of PAONCIL questionnaires from 38 units and 37 outpatient clinics at 11 strategically selected hospitals in Finland, and included nurses’ answers(n=1307)to the question of which factors, other than nursing intensity, affect total NWL. The methods for data analyses were qualitative content analyses. The nonpatient factors that affected nurses’ experiences of total NWL are “organization of work,” “working conditions,” “self-control,” and “cooperation.” The actual list of nonpatient factors in the PAONCIL instrument is to a reasonable extent relevant, but the list should be improved to include nurses’ actual working conditions and self-control.

Learning Electrocardiogram Interpretation: Insights from Residents and a Proposed Solution in an Observational Study (Preprint)

2020 ◽  
Author(s):  
Mohammad Alakchar ◽  
Abdisamad M. Ibrahim ◽  
Mohsin Salih ◽  
Mukul Bhattarai ◽  
Nitin Tandan ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Correlation Coefficient ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Resident Attitudes ◽  
Internal Medicine Residents ◽  
Life Threatening ◽  
Degree Of Participation ◽  
Electrocardiogram Interpretation

BACKGROUND Interpretation of electrocardiograms (EKG) is an essential tool for every physician. Despite this, the diagnosis of life-threatening pathology on EKG remains suboptimal in trainees. The purpose of this study is to study resident attitudes and behaviours towards EKGs, and describe an innovative way to teach EKGs. OBJECTIVE Study attitudes and behaviours towards EKGs. Describe an innovative way to teach EKGs. METHODS Design: An observational cross-sectional study through an anonymous online survey of resident attitudes and comfort with EKG interpretation. This was followed by creation of a WhatsApp group for discussion and interpretation of EKGs with peers. At the end of the day, the official EKG interpretation was posted. Setting: Internal medicine residency at Southern Illinois University. Participants: Internal medicine residents Interventions: Creation of WhatsApp group to aid with EKG interpretation Measurements: A 17 item questionnaire, followed by detection of degree of participation in a WhatsApp group. RESULTS Forty-one out of 63 residents (65%) completed the survey. 85% of respondents thought that an interactive way to teach EKGs is the best method of teaching, and 73% did not feel confident interpreting EKGs. 30% often rely on automated EKG interpretation. Further analysis indicated that PGY-1 residents reported ordering fewer EKGs (correlation coefficient -0.399, p = 0.012) and were uncomfortable diagnosing QT prolongation on an EKG (correlation coefficient -0.310, p = 0.049). Residents in the third or greater year of training ordered more EKGs (correlation coefficient 0.379, p = 0.015), less frequently relied on the computer for EKG diagnosis (correlation coefficient 0.399, p = 0.010), and were comfortable diagnosing an acute myocardial infarction and atrial arrhythmias. CONCLUSIONS In conclusion, most IM trainees do not feel comfortable interpreting EKG, however, this does improve with PGY year. WhatsApp is a possible platform for teaching EKGs.

scholarly journals 980. Drexel Medicine Resident Knowledge, Practices and Attitudes Regarding Pre-exposure prophylaxis (PrEP)

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S518-S518
Author(s):  
Jen E Mainville ◽  
Ed Gracely ◽  
Zsofia Szep
Keyword(s):  
Internal Medicine ◽  
Male Partner ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Major Barrier ◽  
Medicine Resident ◽  
Highly Effective ◽  
Prevention Method ◽  
Exposure Prophylaxis

Abstract Background Pre-exposure prophylaxis (PrEP) is a highly effective daily oral antiretroviral medication that was approved by the FDA in 2012 and has been shown to reduce the risk of HIV by 95% in real-world studies. Despite this, many healthcare providers are not offering PrEP to their patients who are at risk for HIV. Methods We performed a cross-sectional study among Drexel Internal Medicine, Family Medicine, and Obstetrics and Gynecology residents. The survey included questions about experience, knowledge, attitudes toward and barriers to using PrEP. The survey was adapted from previous studies regarding medical providers’ attitudes and knowledge about PrEP (Petroll, 2016; Seifman, 2016; Blumenthal, 2105). A Likert 5-point scale was used for attitude and barriers questions. Results Among 143 participants, 80% specialized in Internal Medicine. 43% of participants were in their first year of training and the mean age (+ SD) was 28.8 + 2. 76% reported never initiating a conversation about PrEP with a patient and only 18% reported ever prescribing PrEP to their patients. 92% reported being very or extremely willing to prescribe PrEP to a male with a current male partner known to be HIV positive. Only 43% of residents reported being moderately likely to prescribe PrEP to a patient coming in for a STI exposure. 68% of residents reported their knowledge about PrEP was a major barrier to prescribing PrEP. Conclusion We found that most residents have minimal experience with prescribing PrEP, and knowledge was identified as the largest barrier. Additional education and a better understanding of PrEP indications is necessary to ensure eligible PrEP patients have access to this highly effective HIV prevention method. Disclosures All Authors: No reported disclosures

scholarly journals Thinker, Soldier, Scribe: cross-sectional study of researchers' roles and author order in the Annals of Internal Medicine

BMJ Open ◽  
2017 ◽  
Vol 7 (6) ◽  
pp. e013898 ◽  
Author(s):  
Thomas V Perneger ◽  
Antoine Poncet ◽  
Marc Carpentier ◽  
Thomas Agoritsas ◽  
Christophe Combescure ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Increased frequency of fibromyalgia among patients with chronic pain presenting to internal medicine clinics of a tertiary care hospital: a cross sectional study

2022 ◽  
Vol 71 (12) ◽  
Author(s):  
Sana Javed ◽  
Muhammad Zaid ◽  
Sumera Imran ◽  
Ayesha Hai ◽  
Muhammad Junaid Patel
Keyword(s):  
Internal Medicine ◽  
Tertiary Care ◽  
Chronic Fatigue ◽  
Cross Sectional Study ◽  
National Language ◽  
P Value ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio

Objective: To estimate the frequency of patients with fibromyalgia (by using the 2010 Modified Criteria for Fibromyalgia by American College of Rheumatology ( ACR ) presenting to Internal Medicine clinics  Methods: A cross-sectional study conducted in the department of Internal Medicine, the Indus Hospital, khi, Pakistan between December 2016 and March 2018. Patients who visited internal medicine clinics, met the selection criteria, were included in the study. After taking informed consent patients were assessed for fibromyalgia according to the new 2010 Fibromyalgia Diagnostic criteria questionnaire. The patients were asked the questions in the national language, Urdu. Data analyzed using SPSS version 21. P value of < 0.05 was considered significant. Results: Of the 267 patients presenting to the internal medicine clinics and consenting for participating in the study 149 (55.80%) met at least one of the 2010 Fibromyalgia Criteria. The prevalence of fibromyalgia as estimated in this study was 56% with no difference in gender. Mean age of patients with fibromyalgia was 42.3 ± 14.6 and patients without fibromyalgia was 38.9 ± 13.7 which was statistically significant (p-value = 0.05, 10% level of significance). Of the 267 patient 197 (73.8%) were female and 70 (26.2%) were males, a male to female ratio of 1:2.81.  Conclusion: All patients with generalized pain should be evaluated for fibromyalgia and a diagnosis made to reduce the cost of further referrals and investigations and delay in the management of this debilitating disorder. Keywords: Fibromyalgia, Chronic fatigue, Generalized Pain  

scholarly journals 2536. Evaluation of Anticipatory Guidance Provided by Internal Medicine Residents for the Care of Patients with Fever

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S881-S882
Author(s):  
Luis Rubio ◽  
Emily Abdoler ◽  
Brian Schwartz ◽  
Brian Schwartz
Keyword(s):  
Internal Medicine ◽  
Educational Interventions ◽  
Cross Sectional Study ◽  
Anticipatory Guidance ◽  
Cross Sectional ◽  
Specific Content ◽  
Management Guidance ◽  
Chi Squared ◽  
Primary Hospital ◽  
Work Up

Abstract Background Overnight fever is common in hospitalized patients. Past work has analyzed cross-covering resident practices regarding overnight fever, but little is known about how residents provide anticipatory guidance for overnight fever. We aimed to further our understanding of resident sign-out practices for overnight fever by analyzing the specific content of the guidance they provide and evaluating whether the presence of infection impacts the guidance provided. Methods We performed a cross-sectional study of resident sign-outs on an inpatient Internal Medicine service between September 2018 and April 2019 using a data collection tool we developed. Data collected included patient’s primary reason for hospitalization, whether fever was an anticipated problem, whether a differential diagnosis for fever was included, evaluation and management instructions for fever, and any rationale provided for the instructions. We analyzed the data using descriptive statistics and chi-squared analysis. Results Among 216 sign-outs reviewed, 38% indicated infection was the primary hospital diagnosis. Fever was an anticipated issue in 169 (78%) of sign-outs (Table 1). Of sign-outs recommending fever evaluation, 79% specified at least one diagnostic test but 34% still utilized a nonspecific phrase such as “full fever work-up” (Table 2). Only 62% of fever sign-outs included antibiotic guidance. In addition, rationales were provided for evaluation or management guidance in only 41% and 61% of sign-outs, respectively (Table 3). Chi-squared analysis did not show a statistically significant association between primary hospital problem and the sign-out including fever anticipatory guidance (P = 0.78), recommending in-person assessment (P = 0.11), or providing antibiotic guidance (P = 0.15). Conclusion Fever anticipatory guidance is commonly included in resident-written sign-out regardless of primary hospital problem. Specific evaluation instructions for fever are used more commonly than nonspecific fever work-up terms, but rationales for testing are given uncommonly. Future educational interventions around signing-out and evaluating fever overnight may lead to more effective anticipatory guidance and rationale testing and treatment. Disclosures All authors: No reported disclosures.

scholarly journals Clinic Design and Continuity in Internal Medicine Resident Clinics: Findings of the Educational Innovations Project Ambulatory Collaborative

2015 ◽  
Vol 7 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Maureen D. Francis ◽  
Mark L. Wieland ◽  
Sean Drake ◽  
Keri Lyn Gwisdalla ◽  
Katherine A. Julian ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Linear Regression Analysis ◽  
Internal Medicine Resident ◽  
Cross Sectional Study ◽  
Analysis Of Covariance ◽  
Block Model ◽  
Cross Sectional ◽  
Educational Innovations ◽  
Medicine Resident ◽  
Multivariable Linear Regression Analysis

Abstract Background Many internal medicine (IM) programs have reorganized their resident continuity clinics to improve trainees' ambulatory experience. Downstream effects on continuity of care and other clinical and educational metrics are unclear. Methods This multi-institutional, cross-sectional study included 713 IM residents from 12 programs. Continuity was measured using the usual provider of care method (UPC) and the continuity for physician method (PHY). Three clinic models (traditional, block, and combination) were compared using analysis of covariance. Multivariable linear regression analysis was used to analyze the effect of practice metrics and clinic model on continuity. Results UPC, reflecting continuity from the patient perspective, was significantly different, and was highest in the block model, midrange in combination model, and lowest in the traditional model programs. PHY, reflecting continuity from the perspective of the resident provider, was significantly lower in the block model than in combination and traditional programs. Panel size, ambulatory workload, utilization, number of clinics attended in the study period, and clinic model together accounted for 62% of the variation found in UPC and 26% of the variation found in PHY. Conclusions Clinic model appeared to have a significant effect on continuity measured from both the patient and resident perspectives. Continuity requires balance between provider availability and demand for services. Optimizing this balance to maximize resident education, and the health of the population served, will require consideration of relevant local factors and priorities in addition to the clinic model.

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