scholarly journals Factors Associated with Bed-Blocking at a University Hospital (Cantabria, Spain) between 2007 and 2015: A Retrospective Observational Study

2019 ◽  
Vol 16 (18) ◽  
pp. 3304 ◽  
Author(s):  
Amada Pellico-López ◽  
David Cantarero ◽  
Ana Fernández-Feito ◽  
Paula Parás-Bravo ◽  
Joaquín Cayón de las Cuevas ◽  
...  
Keyword(s):  
Functional Ability ◽  
Service Use ◽  
Discharge Planning ◽  
Current System ◽  
Organizational Factors ◽  
University Hospital ◽  
Initial Increase ◽  
Northern Spain ◽  
Related Factors ◽  
Delayed Discharge

Current studies on bed-blocking or delayed discharge for non-medical reasons report important variations depending on the country or setting under study. Research on this subject is clearly important as the current system reveals major inefficiencies. Although there is some agreement on the patient-related factors that contribute to the phenomenon, such as older age or a lack of functional ability, there is greater variability regarding environmental or organizational factors. This study sought to quantify the number of cases and days inappropriately spent in hospital and identify patient characteristics and healthcare service use associated with the total length of stay. All cases of delayed discharge were studied at the hospitalization units of a general university hospital in Northern Spain between 2007 and 2015. According to regression estimates, the following characteristics were related to a longer stay: higher complexity through (Diagnosis-Related Group) DRG weight, a diagnosis that implied a lack of functional ability, surgical treatment, having to wait for a destination upon final discharge or return home. After an initial increase, a reduction in delayed discharge was observed, which was maintained for the duration of the study period. Multi-component interventions related with discharge planning can favor a reduced inefficiency with fewer unnecessary stays.

scholarly journals STANDARD PRECAUTION ADHERENCE BY NURSING WORKERS: A MIXED METHODS STUDY

2021 ◽  
Vol 30 ◽  
Author(s):  
Quézia Boeira da Cunha ◽  
Etiane de Oliveira Freitas ◽  
Camila Pinno ◽  
Karen Emanueli Petry ◽  
Rosângela Marion da Silva ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Hiv Transmission ◽  
Organizational Factors ◽  
Structured Interview ◽  
University Hospital ◽  
Standard Precautions ◽  
Related Factors ◽  
Work Related ◽  
Standard Precaution ◽  
The Individual

ABSTRACT Objective: to analyze standard precaution adherence and associated factors of nursing workers at a university hospital. Method: this is a study of mixed methods of convergent parallel strategy, carried out in Southern Brazil. The quantitative stage had 602 participants, using the instrument of sociodemographic and professional variables and the Instrument of Variables Related to Standard Precautions, analyzed using descriptive statistics. In the qualitative stage, a semi-structured interview was conducted with 24 workers, analyzed through content analysis. Results: the data showed an intermediate standard precaution adherence. In the Individual Factors dimension, the Prevention Effectiveness Scale showed high scores and the Risk Personality, Risk Perception and Knowledge about Occupational HIV Transmission scales, intermediate scores. In the dimension Work-related factors, both in the Obstacles to Following Standard Precautions Scale and in the Workload Scale, the scores were intermediate. In the Organizational Factors dimension, low scores were found for Climate of Safety and Training in Prevention of Exposure to the Human Immunodeficiency Virus and intermediate for Personal Protective Equipment Availability. Qualitative data showed that workers often select patients who they think are at greatest risk for occupational transmission to use standard precautions. Conclusion: standard precaution adherence does not occur fully among participants. Data integration allowed to conclude that, among the main elements that influence this phenomenon, is the lack of clarity of participants as to the purpose, indication and principles of standard precautions.

scholarly journals Delay in Hospital Discharge of Trauma Patients: A Prospective Observational Study

2020 ◽  
Author(s):  
Islam Elabbassy ◽  
Wafaa M. Hussein ◽  
Maged El-Setouhy ◽  
Jon Mark Hirshon ◽  
Mohamed El-Shinawi
Keyword(s):  
Observational Study ◽  
Medical Records ◽  
Prospective Observational Study ◽  
Injury Severity ◽  
University Hospital ◽  
Trauma Patients ◽  
Related Factors ◽  
Medical Factors ◽  
Delayed Discharge ◽  
Discharge Potential

Abstract Background: "Delayed discharge" is defined as patients who remain hospitalized beyond the time of being fit for discharge. There is no standardized amount of time defining delayed discharge documented in the literature, and there is a lack of evidence about this topic in Egypt. This study aims to identify the factors associated with discharge delays.Methods: A prospective observational study included all trauma patients admitted to a University Hospital in Egypt over two months. The time of the decision of discharge and actual discharge time were recorded by reviewing patients' medical records. The patients and their caregivers were asked to fill in a questionnaire about the reasons for delayed discharge. Potential reasons for the delayed discharge were classified into system-related, medical and family-related factors. Results: The study included 498 patients with a median age of 41 years (9 – 72). The median time until the actual discharge was three hours. System-related factors were documented in 48.8% of cases, followed by medical factors (36.3%), and family-related factors (28.1%). When controlling for age, gender and injury severity score using a logistic regression analysis, longer time to discharge (≥ 3 hours) showed a stronger association with medical factors [adjusted OR (95% CI) = 5.44 (2.73-10.85)] and family-related factors [adjusted OR (95% CI) = 7.94 (3.40-18.54)] compared to system-related factors [adjusted OR (95% CI) = 2.20 (1.12-4.29)].Conclusion: Although system-related factors were more prevalent, medical and family-related factors appear to be associated with longer discharge delays compared to system-related factors.

scholarly journals Declared Reasons for Cessation of Breastfeeding during the First Year of Life: An Analysis Based on a Cohort Study in Northern Spain

2021 ◽  
Vol 18 (16) ◽  
pp. 8414
Author(s):  
Carolina Lechosa-Muñiz ◽  
María Paz-Zulueta ◽  
Joaquín Cayón-De las Cuevas ◽  
Javier Llorca ◽  
María Jesús Cabero-Pérez
Keyword(s):  
Cohort Study ◽  
Milk Production ◽  
Smoking Habit ◽  
University Hospital ◽  
First Year ◽  
Northern Spain ◽  
Related Factors ◽  
Work Related ◽  
Duration Of Breastfeeding ◽  
First Year Of Life

Background: Breastfeeding is the gold standard of infant feeding due to the many advantages it offers to both the child and the mother. Objective: To identity the main reasons for cessation of breastfeeding reported by mothers during the first year of life. Design: A prospective cohort study was conducted, recruiting 970 infants from a university hospital in Spain. The main maternal variables studied were maternal age, parity, educational level, work occupation, smoking habit, weeks of gestation at birth, birth weight, feeding type, and duration of breastfeeding. All participants were followed for one year to determinate the duration of breastfeeding and to gather reasons for abandoning breastfeeding. Results: At six months, the percentage of breastfeeding experienced a decline of 50%, and only 24.5% of these mothers maintained breastfeeding. Up to 15.8% of the mothers decided to give up exclusive breastfeeding by their own choice, whereas 15.4% did so because they suspected low milk production. Work-related causes represent the third reason of abandonment. Conclusions: Our results highlight the need to improve the health policies for the promotion, protection, and support for the initiation and maintenance of breastfeeding. In particular, our results highlight the importance of researching women’s low milk production and work-related factors, with particular emphasis on improving conciliation measures.

Frailty and Autonomy among the Oldest Old: Evidence from the Multicenter Prospective AgeCoDe-AgeQualiDe Study

Gerontology ◽  
2021 ◽  
pp. 1-8
Author(s):  
André Hajek ◽  
Christian Brettschneider ◽  
Tina Mallon ◽  
Hanna Kaduszkiewicz ◽  
Birgitt Wiese ◽  
...  
Keyword(s):  
Old Age ◽  
Service Use ◽  
Oldest Old ◽  
Strong Association ◽  
Total Sample ◽  
Sociodemographic Factors ◽  
Related Factors ◽  
Clinical Frailty Scale ◽  
Related Quality ◽  
Health Related

Introduction: There is a lack of studies examining the link between perceived autonomy and frailty among the oldest old. Therefore, our objective was to fill this gap. Methods: Data were used from the multicenter prospective cohort study “Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)” (AgeQualiDe; follow-up [FU] wave 9; n = 510 observations in the analytical sample). The average age was 90.3 years (SD: 2.7 years). The Canadian Study of Health and Aging (CSHA) Clinical Frailty Scale (CFS) was used to assess frailty. Socioeconomic and health-related covariates were included in our regression model. The autonomy scale developed by Schwarzer was used to assess perceived autonomy in old age. Results: Adjusting for various confounders, multiple linear regressions showed that lower perceived autonomy was associated with increased levels of frailty (total sample: β = −0.13, p < 0.001; women: β = −0.14, p < 0.001; and men: β = −0.12, p < 0.001). Furthermore, lower perceived autonomy was associated with more depressive symptoms, higher cognitive impairment, and being institutionalized (except for men) in the total sample and in both sexes, but it was not significantly associated with age, sex, marital status, educational level, and social support. Conclusion: Findings indicate that frailty is associated with lower autonomy among the oldest old. More generally, while health-related factors were consistently associated with autonomy, sociodemographic factors (except for being institutionalized) were not associated with autonomy among the oldest old. We should be aware of the strong association between autonomy and physical as well as mental health in very old age.

scholarly journals Pre-pregnancy BMI, gestational weight gain and body image are associated with dietary under-reporting in pregnant Japanese women

2018 ◽  
Vol 7 ◽  
Author(s):  
Mie Shiraishi ◽  
Megumi Haruna ◽  
Masayo Matsuzaki ◽  
Ryoko Murayama ◽  
Satoshi Sasaki
Keyword(s):  
Weight Gain ◽  
Urinary Excretion ◽  
Gestational Weight Gain ◽  
Multiple Logistic Regression Analysis ◽  
Japanese Women ◽  
Portion Size ◽  
Assessment Tools ◽  
University Hospital ◽  
Related Factors ◽  
Gestational Weight

AbstractDietary under-reporting is a common problem when using self-reported dietary assessment tools. However, there are few studies regarding under-reporting during pregnancy. This study aimed to explore the demographic and psychosocial characteristics related to dietary under-reporting in pregnant Japanese women. A cross-sectional study was conducted between 2010 and 2011 at a university hospital in Tokyo, Japan. Nutrient intake was assessed using a self-administered Diet History Questionnaire (DHQ), which had questions about the consumption frequency and portion size of selected food items. The 24-h urinary excretion levels of urea N and K were used as the dietary protein and K intake reference values, respectively. Under-reporting of protein and K was defined as the bottom 25 % of the reporting accuracy (the ratio of reported intake on the DHQ to the estimated intake based on urinary excretion). Under-reporters were defined as participants who under-reported both protein and K intake. Multiple logistic regression analysis was performed to examine the factors associated with under-reporters. Of 271 healthy women at 19–23 weeks of gestation, thirty-five participants (12·9 %) were identified as under-reporters. Under-reporters had a lower pre-pregnancy BMI (adjusted OR (AOR) = 0·81) and lower gestational weight gain (AOR = 0·82); they also reported managing their gestational weight gain with the aim to return to their pre-pregnancy weight soon after childbirth (AOR = 2·99). Healthcare professionals should consider the potential for dietary under-reporting and the possible related factors when assessing the dietary intakes of pregnant Japanese women using self-administered questionnaires.

scholarly journals The Relationship between Healthcare Organizational Culture and Nurses' Empowerment

2021 ◽  
Vol 6 (4) ◽  
pp. 87
Author(s):  
Doha E. Harhash ◽  
Hayam A.El shrief ◽  
Manal Z. Ahmed
Keyword(s):  
Organizational Culture ◽  
Psychological Empowerment ◽  
Organizational Factors ◽  
Moderate Level ◽  
University Hospital ◽  
Healthcare Organizations ◽  
Organizational Goals ◽  
Work Effectiveness ◽  
Study Results ◽  
The Relationship

Background: Nowadays, healthcare organizations are affected by changes and reforms, thus new challenges arise for nurses. Nurses need to have the power to achieve their personal and organizational goals. Furthermore, healthcare organizational culture shapes the organization and provides a complex understanding of crucial organizational factors that affect nurses' empowerment.Aim: Identify the relationship between healthcare organizational culture and nurses' empowerment at hospital setting.Methods: Descriptive correlational research design was used. A convenient sample of 225 nurses was recruited from University Hospital in the Delta of Egypt. Denison Organizational Culture Survey (DOCS), the Condition of Work Effectiveness Questionnaire (CWEQ-II), the Psychological Empowerment Instrument were used to collect data for the current study. Results: There were a strong healthcare organizational culture among study sample, moderate level of structure empowerment, and moderate level of psychological empowerment. Conclusion: There were positive correlations between healthcare organizational culture, structural, and psychological empowerment. There was a positive correlation between structure and psychological empowerment. Only gender that did not vary with psychological empowerment. Sustaining a strong healthcare organizational culture enhances structure and psychological empowerment among nurses.

QUALITY OF LIFE AND ITS RELATED FACTORS FOR PATIENTS WITH CONGESTIVE HEART FAI LURE AT BENHA UNIVERSITY HOSPITAL

2016 ◽  
Vol 3 (1) ◽  
pp. 231-248
Author(s):  
Ashgan Elgohary ◽  
Kamelia Abd–Allah ◽  
Fawzy Megahed Khalil Fawzy Megahed Khalil ◽  
Samah Ghonaem
Keyword(s):  
Quality Of Life ◽  
University Hospital ◽  
Related Factors

scholarly journals Social- and healthcare managers' work wellbeing – literature review and key informant interviews

2020 ◽  
Vol 13 (6) ◽  
pp. 633-648
Author(s):  
Niina Herttuala ◽  
Lauri Kokkinen ◽  
Anne Konu
Keyword(s):  
Literature Review ◽  
Literature Search ◽  
Organizational Factors ◽  
International Studies ◽  
Systematic Literature Search ◽  
Healthcare Organizations ◽  
Related Factors ◽  
Content Type ◽  
Factors Affecting ◽  
Work Related

PurposeThe purpose of this study was to describe factors that support and prevent managers' work wellbeing by reviewing international studies and interviewing Finnish social- and healthcare managers.Design/methodology/approachTwenty-two studies were identified in the systematic literature search. Seven social care and healthcare managers were recruited to participate in thematic interviews. Data were analyzed by using content analysis.FindingsSupportive and preventive factors for managers' work wellbeing were identified in the literature review, including managerial position, decision latitude, job control, social support and ethical culture at the workplace. The interviews further suggested that the supportive and preventive factors affecting social and healthcare managers' work wellbeing could be divided into five broad categories: (1) Individual factors, (2) Social factors, (3) Professional support from one's own manager, (4) Work-related factors and (5) Organizational factors.Originality/valueWe conducted a systematic literature search together with expert interviews to find the factors most crucial to managers' work wellbeing. These findings can assist social and healthcare organizations and policymakers to pay attention to these factors as well as in policies guiding them.

scholarly journals ED visits and hospital admissions of foreigners for psychiatric disorders in Rome from 2007 to 2018

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Nardi ◽  
G Migliara ◽  
A Angelozzi ◽  
S Caminada ◽  
M Giffi ◽  
...  
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Hospital Admission ◽  
Psychiatric Disorders ◽  
Service Use ◽  
Hospital Admissions ◽  
Mental Health Service Use ◽  
Related Factors ◽  
Ed Visits ◽  
And Migration

Abstract Background First generation immigrants are at high risk of psychiatric disorders (PD). Moreover, cultural and migration related factors can act as barriers in the access to care. The aim of this study was to analyze the emergency department (ED) visits and the subsequent admissions to Umberto I, a large teaching hospital in Rome, for PD from 2007 to 2018 and to highlight the differences between Italian citizens and foreigners. Methods Adult patients were divided in 11 Nationality Groups (NGs). Basing on ICD9 codes, PD were classified in 5 categories: psychotic, mood, anxiety, personality and substance abuse disorders. Descriptive statistics were conducted for gender, age, educational level and triage. Poisson regression models, adjusted for sociodemographic variables, were used to estimate incidence rate ratios (IRRs) of different NGs, both for visits and hospital admissions, for the five psychiatric categories and for PD as a whole. Results In the period of interest there were 11,965 ED visits for PD, of which 19.2% made by foreigners. Compared to Italians, all NGs showed higher percentages of ED visits for PDs, except for Southern Asian (SA) and East-Southern east Asian (ESA); SA and ESA, together with Other Africa population, showed also higher proportion of psychosis. Regarding admissions, ESA had the highest percentage overall, while more than half of foreigner nationality groups had higher percentages of admissions for psychosis than Italians. Poisson regressions showed that only EU citizens have greater risk of ED visit (IRR 1.69, IC95% 1.46-1.96) and of hospital admission for PD (IRR 1.23, IC95% 1.02-1.49) than Italians, while Romanians, SA and ESA have lower risk. Conclusions Different risk in ED visits for PDs among NGs can be due to heterogeneity in psychopathology, cultural factors, barriers, and migrant status. More studies are necessary to better understand the needs of foreigners and to enhance their mental health service use. Key messages The risk of ED visit and hospital admission for psychiatric disorders differ among foreign populations. Different study design are needed to understand which cultural and migration related factors influence the risks, in order to provide more tailored mental health services for high risk populations.

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