Critical Care Nurse Burnout in Veterans Health Administration: Relation to Clinician and Patient Outcomes

2021 ◽  
Vol 30 (6) ◽  
pp. 435-442
Author(s):  
David C. Mohr ◽  
Lakshmana Swamy ◽  
Edwin S. Wong ◽  
Meredith Mealer ◽  
Marc Moss ◽  
...  
Keyword(s):  
Critical Care ◽  
Patient Outcomes ◽  
Employee Satisfaction ◽  
Veterans Health Administration ◽  
Critical Care Nurses ◽  
Veterans Health ◽  
Health Administration ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Nurse Burnout

Background Critical care nurses have a burnout rate among the highest of any nursing field. Nurse burnout may impact care quality. Few studies have considered how temporal patterns may influence outcomes. Objective To test a longitudinal model of burnout clusters and associations with patient and clinician outcomes. Methods An observational study analyzed data from annual employee surveys and administrative data on patient outcomes at 111 Veterans Health Administration intensive care units from 2013 through 2017. Site-level burnout rates among critical care nurses were calculated from survey responses about emotional exhaustion and depersonalization. Latent trajectory analysis was applied to identify clusters of facilities with similar burnout patterns over 5 years. Regression analysis was used to analyze patient and employee outcomes by burnout cluster and organizational context measures. Outcomes of interest included patient outcomes (30-day standardized mortality rate and observed minus expected length of stay) for 2016 and 2017 and clinician outcomes (intention to leave and employee satisfaction) from 2013 through 2017. Results Longitudinal analysis revealed 3 burnout clusters among the 111 sites: low (n = 37), medium (n = 68), and high (n = 6) burnout. Compared with sites in the low-burnout cluster, those in the high-burnout cluster had longer patient stays, higher employee turnover intention, and lower employee satisfaction in bivariate models but not in multivariate models. Conclusions In this multiyear, multisite study, critical care nurse burnout was associated with key clinician and patient outcomes. Efforts to address burnout among nurses may improve patient and employee outcomes.

Quality assurance and the critical care nurse

1991 ◽  
Vol 11 (9) ◽  
pp. 34-40
Author(s):  
P Brown-Stewart
Keyword(s):  
Quality Assurance ◽  
Critical Care ◽  
Critically Ill ◽  
Monitoring And Evaluation ◽  
Critical Care Nurses ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Appropriateness Of Care ◽  
External Sources ◽  
The Way

Care of the critically ill has become increasingly challenging due to demands from external sources to measure the quality and appropriateness of care provided. Quality assurance is the responsibility of every critical care nurse and requires vigilance as well as a knowledge of the principles of standards, monitoring and evaluation. Through quality assurance activities, the contribution of critical care nurses in the achievement of patient outcomes can be measured. Quality assurance challenges us to evaluate the way we practice, and assists us to continuously improve the way we provide care to critically ill patients.

Perceptions and significance of patient deaths for pediatric critical care nurses

1992 ◽  
Vol 12 (3) ◽  
pp. 72-75 ◽  
Author(s):  
SW Benica ◽  
CB Longo ◽  
JH Barnsteiner
Keyword(s):  
Critical Care ◽  
Stress Management ◽  
Critical Care Nurses ◽  
The Other ◽  
Recruitment Strategies ◽  
Pediatric Critical Care ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Hospital Administrator ◽  
Dying Patients

This study provides nursing administrators with data regarding stressors of the pediatric critical care nurse in order of priority. Death of patients was the only item isolated and compared to the other stress categories. It is suggested that death of patients be compared to all other items on the audit. The authors recommend expanding this study by asking two additional questions: Does the amount of time spent caring for dying patients correlate with the nurses' estimate of patient deaths and is there a relationship between the time spent caring for patients who die and perception of death as a stressor? This information can be utilized at the unit level in the development of stress management activities. At the hospital administrator level, this information can assist in the expansion of retention and recruitment strategies.

Critical Care Nursing in Sri Lanka: Brief History and Recent Advances

2019 ◽  
Vol 13 (3) ◽  
pp. 110-117
Author(s):  
Gerald Williams ◽  
P. N. Sajeewani
Keyword(s):  
Critical Care ◽  
Sri Lanka ◽  
Critical Care Nurses ◽  
Policy Support ◽  
Critical Care Nursing ◽  
Nurse Training ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Career Development Plan ◽  
Care Nursing

This article summarizes the development of critical care nursing in Sri Lanka. After years of development, Sri Lanka steadily progresses to establish critical care medicine as a separate specialty with fully trained Intensivists and nurses playing pivotal roles. However, courses of critical care nurse training are still lacking. Other barriers in developing critical care nursing in Sri Lanka include lacking career development plan, financial and policy support. The formulation of the Sri Lanka Society of Critical Care Nurses is helpful to fill this gap and to build up a local critical care nursing community in Sri Lanka.

scholarly journals Adherence to dabigatran therapy and longitudinal patient outcomes: Insights from the Veterans Health Administration

2014 ◽  
Vol 167 (6) ◽  
pp. 810-817 ◽  
Author(s):  
Supriya Shore ◽  
Evan P. Carey ◽  
Mintu P. Turakhia ◽  
Cynthia A. Jackevicius ◽  
Fran Cunningham ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Dabigatran Therapy

scholarly journals Critical Care Nurse Work Environments 2018: Findings and Implications

2019 ◽  
Vol 39 (2) ◽  
pp. 67-84 ◽  
Author(s):  
Beth Ulrich ◽  
Connie Barden ◽  
Linda Cassidy ◽  
Natasha Varn-Davis
Keyword(s):  
Job Satisfaction ◽  
Critical Care ◽  
Work Environment ◽  
Critical Care Nurses ◽  
Work Environments ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Healthy Work Environment ◽  
Healthy Work ◽  
Nurse Outcomes

BACKGROUNDThe health of critical care nurse work environments affects patient and nurse outcomes. The results of the 2018 Critical Care Nurse Work Environment Study are reported here with comparisons to previous studies and recommendations for continued improvement.OBJECTIVETo evaluate the current state of critical care nurse work environments.METHODSAn online survey was used to collect quantitative and qualitative data for this mixed-methods study. A total of 8080 American Association of Critical-Care Nurses (AACN) members and constituents responded to the survey.RESULTSThe health of critical care nurse work environments has improved since the previous study in 2013; however, there are still areas of concern and opportunities for improvement. Key findings include documented absence of appropriate staffing by more than 60% of participants; an alarming number of physical and mental well-being issues (198 340 incidents reported by 6017 participants); one-third of the participants expressed intent to leave their current positions in the next 12 months; and evidence of the positive outcomes of implementing the AACN Healthy Work Environment standards.CONCLUSIONEvidence of the relationship between healthy nurse work environments and patient and nurse outcomes continues to increase. The results of this study provide evidence of the positive relationship between implementation of the AACN Healthy Work Environment standards and the health of critical care nurse work environments, between the health of critical care nurse work environments and job satisfaction, and between job satisfaction and the intent of critical care nurses to leave their current positions or stay.

scholarly journals Using electronic medical record notes to measure ICU telemedicine utilization

2017 ◽  
Vol 24 (5) ◽  
pp. 969-974 ◽  
Author(s):  
Amy MJ O’Shea ◽  
Mary Vaughan Sarrazin ◽  
Boulos Nassar ◽  
Peter Cram ◽  
Lynelle Johnson ◽  
...  
Keyword(s):  
Patient Care ◽  
Patient Outcomes ◽  
Veterans Health Administration ◽  
Initiation Site ◽  
Future Research ◽  
Veterans Health ◽  
Health Administration ◽  
Bedside Nurse ◽  
High Acuity ◽  
Care Change

Abstract Given the complexity of high-acuity health care, designing an effective clinical note template can be beneficial to both document patient care and clarify how telemedicine is used. We characterized documented interactions via a standardized note template between bedside intensive care unit (ICU) providers and teleintensivists in 2 Veterans Health Administration ICU telemedicine support centers. All ICUs linked to support centers and providing care from October 2012 through September 2014 were considered. Interactions were assessed based on initiation site, bedside initiator, contact type, and patient care change. Of 14 511 ICU admissions with teleintensivist access, teleintensivist interaction was documented in 21.6% (N = 3136). In particular, contacts were primarily initiated by bedside staff (74.4%), use increased over time, and of contacts resulting in changes in patient care, most were initiated by a bedside nurse (84.3%). Given this variation, future research necessitates inclusion of utilization in evaluation of Tele-ICU and patient outcomes.

Critical Care Nurse Work Environments 2013: A Status Report

2014 ◽  
Vol 34 (4) ◽  
pp. 64-79 ◽  
Author(s):  
Beth T. Ulrich ◽  
Ramón Lavandero ◽  
Dana Woods ◽  
Sean Early
Keyword(s):  
Job Satisfaction ◽  
Critical Care ◽  
Work Environment ◽  
Critical Care Nurses ◽  
Work Environments ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Healthy Work ◽  
Nurse Work Environment

Background The health of critical care nurse work environments has been shown to affect patient care outcomes as well as the job satisfaction and retention of registered nurses. The American Association of Critical-Care Nurses (AACN) Critical Care Nurse Work Environment Survey was first conducted in 2006 following the release of the AACN Standards for Establishing and Sustaining a Healthy Work Environment and was conducted again in 2008. This article reports the results of the third AACN Critical Care Nurse Work Environment Survey conducted in 2013. Objective To evaluate the current state of critical care nurse work environments. Methods A total of 8444 AACN members and constituents responded to an online survey. Results The overall health of critical care nurses’ work environments has declined since 2008, as have nurses’ perceptions of the quality of care. Respondents rated their overall work environment and factors associated with healthy work environments including quality of patient care, staffing, communication and collaboration, respect, physical and mental safety, moral distress, nursing leadership, support for certification and continuing education, meaningful recognition, job satisfaction, and career plans. Although some factors improved, declines in any factors are a concern. Conclusions An increasing body of evidence has shown relationships between healthy nurse work environments and patient outcomes. The results of this 2013 survey identified areas in which the health of critical care nurse work environments needs attention and care, requiring the relentless true collaboration of everyone involved.

Complementary Health Practitioners in the Acute and Critical Care Setting: Nursing Considerations

2017 ◽  
Vol 37 (3) ◽  
pp. 60-65 ◽  
Author(s):  
Debra Kramlich
Keyword(s):  
Critical Care ◽  
Care Setting ◽  
Critical Care Nurses ◽  
Therapeutic Touch ◽  
Pet Therapy ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Complementary Health Approaches ◽  
Health Practitioners ◽  
Healing Environments

In response to the rising demand by patients and their families for complementary health approaches, hospitals are increasingly integrating complementary health approaches with their conventional medical practices to create healing environments. Results of the 2010 Complementary and Alternative Medicine Survey of Hospitals indicated that the top 6 inpatient modalities included pet therapy, massage therapy, music or art therapy, guided imagery, relaxation therapy, and Reiki and therapeutic touch. Whether complementary health approaches are provided by complementary health practitioners through hospital-based integrative medicine programs, volunteer practitioners, or bedside nurses, the regulatory, legal, ethical, and safety concerns remain constant. Previous articles in this column of Critical Care Nurse provided an overview of complementary health approaches that nurses may encounter in their practices, with specific attention to implications for acute and critical care nurses, as well as important legal, ethical, safety, quality, and financial implications that acute and critical care nurses should consider when integrating complementary health approaches with conventional care. This column provides the acute and critical care nurse with key information about validation of credentials, experience, and competence of nurses and volunteers providing complementary health approaches, as well as about institutional policies and scope of practice.

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