scholarly journals Intensive Care Nurses' Belief Systems Regarding the Health Economics: A Focused Ethnography

2016 ◽  
Vol 8 (9) ◽  
pp. 172
Author(s):  
Abbas Heydari ◽  
Ali Vafaee-Najar ◽  
Mahmoud Bakhshi
Keyword(s):  
Intensive Care ◽  
Quality Of Care ◽  
Health Economics ◽  
Nursing Care ◽  
Cost Management ◽  
Belief Systems ◽  
Focused Ethnography ◽  
High Quality ◽  
Supply Chain Management System

<p><strong>BACKGROUND: </strong>Health care beliefs can have an effect on the efficiency and effectiveness of nursing practices. Nevertheless, how belief systems impact on the economic performance of intensive care unit (ICU) nurses is not known. This study aimed to explore the ICU nurses' beliefs and their effect on nurse<strong>'s</strong> practices and behavior patterns regarding the health economics.</p><p><strong>METHODS:</strong> In this study, a focused ethnography method was used. Twenty-four informants from ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations were used for data collection. Data analysis was performed using the methods described by Miles and Huberman (1994).</p><p><strong>FINDINGS:</strong> Eight beliefs were found that gave meaning to ICU nurse's practices regarding the health economics. 1. The registration of medications and supplies disrupt the nursing care; 2.Monitoring and auditing improve consumption; 3.There is a fear of possible shortage in the future; 4.Supply and replacement of equipment is difficult; 5.Higher prices lead to more accurate consumption; 6.The quality of care precedes the costs; 7. Clinical Guidelines are abundant but useful; and 8.Patient economy has priority over hospital economy. Maintaining the quality of patient care with least attention to hospital costs was the main focus of the beliefs formed up in the ICU regarding the health economics.</p><p><strong>CONCLUSIONS:</strong> ICU nurses’ belief systems have significantly shaped in relation to providing a high-quality care. Although high quality of care can lead to a rise in the effectiveness of nursing care, cost control perspective should also be considered in planning for improve the quality of care. Therefore, it is necessary to involve the ICU nurses in decision-making about unit cost management. They must become familiar with the principles of heath care economics and productivity by applying an effective cost management program. It may be optimal to implement the reforms in various aspects, such as the hospital's strategic plan and supply chain management system.</p>

Nurses’ Perceptions of a Care Plan Information Technology Solution With Hundreds of Clinical Practice Guidelines in Adult Intensive Care Units: Survey Study (Preprint)

2018 ◽  
Author(s):  
Azizeh Khaled Sowan ◽  
Meghan Leibas ◽  
Albert Tarriela ◽  
Charles Reed
Keyword(s):  
Intensive Care ◽  
Quality Of Care ◽  
Clinical Practice ◽  
Nursing Care ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Care Plan ◽  
System Use ◽  
Nurses Perceptions

BACKGROUND The integration of clinical practice guidelines (CPGs) into the nursing care plan and documentation systems aims to translate evidence into practice, improve safety and quality of care, and standardize care processes. OBJECTIVE This study aimed to evaluate nurses’ perceptions of the usability of a nursing care plan solution that includes 234 CPGs. METHODS A total of 100 nurses from 4 adult intensive care units (ICUs) responded to a survey measuring nurses’ perceptions of system usability. The survey included 37 rated items and 3 open-ended questions. RESULTS Nurses’ perceptions were favorable with more than 60.0% (60/100) in agreement on 12 features of the system and negative to moderate with 20.0% (20/100), to 59.0% (59/100) in agreement on 19 features. The majority of the nurses (80/100, 80.0% to 90/100, 90.0%) agreed on 4 missing safety features within the system. More than half of the nurses believed they would benefit from refresher classes on system use. Overall satisfaction with the system was just above average (54/100, 54.0%). Common positive themes from the narrative data were related to the system serving as a reminder for complete documentation and individualizing patient care. Common negative aspects were related to duplicate charting, difficulty locating CPGs, missing unit-specific CPGs, irrelevancy of information, and lack of perceived system value on patient outcomes. No relationship was found between years of system use or ICU experience and satisfaction with the system (P=.10 to P=.25). CONCLUSIONS Care plan systems in ICUs should be easy to navigate; support efficient documentation; present relevant, unit-specific, and easy-to-find information; endorse interdisciplinary communication; and improve safety and quality of care.

scholarly journals Effect of Evidence-Based Nursing Care Guidelines on the Quality of Care of Patients in Neurosurgical Intensive Care Units

2020 ◽  
Vol 24 (1) ◽  
pp. 56-67
Author(s):  
Zahra Tayebi Myaneh ◽  
◽  
Maryam Azadi ◽  
Seyedeh Zahra Hosseinigolafshani ◽  
Farnoosh Rashvand ◽  
...  
Keyword(s):  
Intensive Care ◽  
Quality Of Care ◽  
Intensive Care Units ◽  
Nursing Care ◽  
Evidence Based ◽  
Neurosurgical Intensive Care ◽  
Care Guidelines ◽  
The Mean ◽  
Evidence Based Nursing

Background: Evidence-based nursing care guidelines are important tools for increasing the quality of nurses’ clinical work. Objective: The aim of this study was to investigate the effect of implementing evidence-based nursing care guidelines on the quality of care of patients admitted to the Neurosurgical Intensive Care Units (NICUs). Methods: This is a quasi-experimental study on 54 nurses in NICUs of hospitals affiliated to Qazvin University of Medical Sciences selected using a convenience sampling technique and divided into two groups of intervention and control. The intervention included the teaching of evidence-based nursing guidelines and their implementation by the nurses. Before and two months after the intervention, the demographic characteristics and the quality of nurses’ patient care in both groups was evaluated by using a demographic form and a standard checklist with 37 items designed based on the standards of practice for All Registered Nurses (ANA). Data were analyzed in SPSS software using descriptive statistics (Mean±SD), and paired t-test, independent t-test and chi-square test. Findings: The mean score of nursing care quality in the two groups was not significantly different before intervention (P>0.05). After intervention, the mean score was 25.11±6.2 in the intervention group and 20.29±5.3 in the control group, and the difference was statistically significant (P<0.05). Conclusion: Implementation of evidence-based nursing care guidelines can improve the quality of nursing care. Therefore, it is recommended that the teaching of evidence-based nursing care guidelines should be on the agenda of the hospitals’ education unit and related departments.

Evaluation of the nursing care plan in a thyroidectomy surgical case

2021 ◽  
Vol 12 (4) ◽  
pp. 156-160
Author(s):  
Emma McCluskey
Keyword(s):  
Quality Of Care ◽  
Nursing Care ◽  
Care Plan ◽  
Nursing Interventions ◽  
High Quality ◽  
Care Plans ◽  
Surgical Case ◽  
Post Surgery ◽  
Potential Problems

Veterinary nurses work closely with their patients to deliver a high quality of care. This care is implemented using nursing care plans (NCPs). This article aims to evaluate the use of a nursing care plan and its value in practice as well as enhancing nurses' understanding of them. Within this article the author will be discussing the actual and potential problems and implementing the nursing interventions in a nursing care plan pre, post surgery and at discharge in a thyroidectomy case. Veterinary nurses play an important role in making sure the NCP is successful and patients receive the best quality of care. This article evaluates the benefits and disadvantages of NCPs to determine whether they are useful for nursing care of surgical cases.

Experience of clinical testing of personal telemedicine system ‘Obereg’ for remote monitoring of patients in intensive care units

2020 ◽  
pp. 52-58 ◽  
Author(s):  
A. A. Eryomenko ◽  
N. V. Rostunova ◽  
S. A. Budagyan ◽  
V. V. Stets
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Remote Monitoring ◽  
Clinical Testing ◽  
Transportation Of Patients ◽  
High Quality ◽  
Telemedicine System ◽  
Accuracy Of Measurements ◽  
Hospital Equipment

The experience of clinical testing of the personal telemedicine system ‘Obereg’ for remote monitoring of patients at the intensive care units of leading Russian clinics is described. The high quality of communication with the remote receiving devices of doctors, the accuracy of measurements, resistance to interference from various hospital equipment and the absence of its own impact on such equipment were confirmed. There are significant advantages compared to stationary patient monitors, in particular, for intra and out-of-hospital transportation of patients.

scholarly journals Effective coverage and budget implications of skill-mix change to improve neonatal nursing care: an explorative simulation study in Kenya

2019 ◽  
Vol 4 (6) ◽  
pp. e001817 ◽  
Author(s):  
Apostolos Tsiachristas ◽  
David Gathara ◽  
Jalemba Aluvaala ◽  
Timothy Chege ◽  
Edwine Barasa ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Neonatal Mortality ◽  
Nursing Care ◽  
Public Hospitals ◽  
Sensitivity Analyses ◽  
Full Time ◽  
Skill Mix ◽  
Neonatal Nursing ◽  
Low Middle Income Countries

IntroductionNeonatal mortality is an urgent policy priority to improve global population health and reduce health inequality. As health systems in Kenya and elsewhere seek to tackle increased neonatal mortality by improving the quality of care, one option is to train and employ neonatal healthcare assistants (NHCAs) to support professional nurses by taking up low-skill tasks.MethodsMonte-Carlo simulation was performed to estimate the potential impact of introducing NHCAs in neonatal nursing care in four public hospitals in Nairobi on effectively treated newborns and staff costs over a period of 10 years. The simulation was informed by data from 3 workshops with >10 stakeholders each, hospital records and scientific literature. Two univariate sensitivity analyses were performed to further address uncertainty.ResultsStakeholders perceived that 49% of a nurse full-time equivalent could be safely delegated to NHCAs in standard care, 31% in intermediate care and 20% in intensive care. A skill-mix with nurses and NHCAs would require ~2.6 billionKenyan Shillings (KES) (US$26 million) to provide quality care to 58% of all newborns in need (ie, current level of coverage in Nairobi) over a period of 10 years. This skill-mix configuration would require ~6 billion KES (US$61 million) to provide quality of care to almost all newborns in need over 10 years.ConclusionChanging skill-mix in hospital care by introducing NHCAs may be an affordable way to reduce neonatal mortality in low/middle-income countries. This option should be considered in ongoing policy discussions and supported by further evidence.

scholarly journals Correlation of Neonatal Intensive Care Unit Performance Across Multiple Measures of Quality of Care

2013 ◽  
Vol 167 (1) ◽  
pp. 47 ◽  
Author(s):  
Jochen Profit ◽  
John A. F. Zupancic ◽  
Jeffrey B. Gould ◽  
Kenneth Pietz ◽  
Marc A. Kowalkowski ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Of Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Multiple Measures ◽  
Unit Performance

scholarly journals Development and validation of the predictive risk of death model for adult patients admitted to intensive care units in Japan: an approach to improve the accuracy of healthcare quality measures

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Hideki Endo ◽  
Shigehiko Uchino ◽  
Satoru Hashimoto ◽  
Yoshitaka Aoki ◽  
Eiji Hashiba ◽  
...  
Keyword(s):  
Intensive Care ◽  
Quality Of Care ◽  
Generalized Linear Model ◽  
Healthcare Quality ◽  
Brier Score ◽  
Linear Predictor ◽  
Risk Of Death ◽  
Apache Iii ◽  
Funnel Plots

Abstract Background The Acute Physiology and Chronic Health Evaluation (APACHE) III-j model is widely used to predict mortality in Japanese intensive care units (ICUs). Although the model’s discrimination is excellent, its calibration is poor. APACHE III-j overestimates the risk of death, making its evaluation of healthcare quality inaccurate. This study aimed to improve the calibration of the model and develop a Japan Risk of Death (JROD) model for benchmarking purposes. Methods A retrospective analysis was conducted using a national clinical registry of ICU patients in Japan. Adult patients admitted to an ICU between April 1, 2018, and March 31, 2019, were included. The APACHE III-j model was recalibrated with the following models: Model 1, predicting mortality with an offset variable for the linear predictor of the APACHE III-j model using a generalized linear model; model 2, predicting mortality with the linear predictor of the APACHE III-j model using a generalized linear model; and model 3, predicting mortality with the linear predictor of the APACHE III-j model using a hierarchical generalized additive model. Model performance was assessed with the area under the receiver operating characteristic curve (AUROC), the Brier score, and the modified Hosmer–Lemeshow test. To confirm model applicability to evaluating quality of care, funnel plots of the standardized mortality ratio and exponentially weighted moving average (EWMA) charts for mortality were drawn. Results In total, 33,557 patients from 44 ICUs were included in the study population. ICU mortality was 3.8%, and hospital mortality was 8.1%. The AUROC, Brier score, and modified Hosmer–Lemeshow p value of the original model and models 1, 2, and 3 were 0.915, 0.062, and < .001; 0.915, 0.047, and < .001; 0.915, 0.047, and .002; and 0.917, 0.047, and .84, respectively. Except for model 3, the funnel plots showed overdispersion. The validity of the EWMA charts for the recalibrated models was determined by visual inspection. Conclusions Model 3 showed good performance and can be adopted as the JROD model for monitoring quality of care in an ICU, although further investigation of the clinical validity of outlier detection is required. This update method may also be useful in other settings.

scholarly journals Kepuasan Orang Tua Terhadap Pelayanan Keperawatan di Ruang Perinatologi

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Erna Julianti ◽  
Fajar Tri Waluyanti ◽  
Allenidekania Allenidekania
Keyword(s):  
Quality Of Care ◽  
Nursing Care ◽  
Sampling Technique ◽  
Parental Satisfaction ◽  
Nursing Service ◽  
Consecutive Sampling ◽  
Premature Babies ◽  
Pearson Test ◽  
Quality Of Nursing

The Parents' satisfaction of premature babies is very important as one of the basic steps in determining the quality of nursing service. This study aims to identify parental satisfaction in the perinatology. Consecutive sampling technique was conducted to select 59 parents of premature babies as research respondents. Instrument in this study uses EMPATHIC N. The data was analyzed with Pearson test. The results showed that the average of premature babies’ care score was 161.93 and the average of parents’ satisfaction score was 280.07. Nursing care should be evaluated to improve the performance of nurses and the quality of care of premature babies and parents’ satisfaction.

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