nursing workload
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2021 ◽  
Vol 55 (9) ◽  
Author(s):  
Maria Esterlita T. Villanueva-Uy ◽  
Lucille Marie Villanueva-Uy ◽  
Andrea Lauren Tang Chung ◽  
Socorro De Leon-Mendoza

Background. The Philippine General Hospital (PGH) implemented the Kangaroo Mother Care (KMC) Program in 2014, recognizing its benefits in helping low birth weight (LBW) infants survive. Objective. To determine the acceptability and compliance of the stakeholders to the KMC program after one year from implementation. Method. Data were obtained from the NICU Annual statistics, KMC data forms, logbooks, and questionnaires to the stakeholders-doctors rotating at the NICU, NICU nurses, and mothers enrolled in the KMC program. Results. One year into the KMC program implementation, the KMC enrollment increased from 57% in 2014 to 75% in 2015. All mothers enrolled in the program said that they received their KMC knowledge from the health providers and firmly believed that KMC benefited them and their infants. The mothers also became more confident in taking care of their babies after each KMC encounter. Although only 50% said they would continue KMC at home, 85% proceeded. Furthermore, both doctors and nurses believed that KMC was beneficial to both mothers and infants, decreased hospital cost and nursing workload. KMC provision was 0.5-6 hours/day. Also, less than half of the data forms were accomplished. The KMC program was acceptable to all stakeholders who believed in the benefits of KMC to preterm infants. The mothers were very receptive and continued KMC even after discharge. However, there was sub-optimal engagement provided by the health providers with the mothers. There was also low adherence to recommended duration of KMC per day provided by the mothers. KMC data records were frequently not accomplished. PGH has instituted strategies to improve the KMC implementation by providing dedicated KMC rooms and supplying meals to mothers to increase KMC duration and frequency. A computer-based program for data entry was developed for the health providers, and a dedicated encoder was assigned. Conclusion. KMC acceptability was high among stakeholders. Compliance increased after one year, with enrolment going up to 75%. However, adherence to the recommended KMC duration per day and accomplishment of data forms were still sub-optimal.


2021 ◽  
Author(s):  
Marek Wełna ◽  
Andrzej Kübler ◽  
Waldemar Goździk ◽  
Barbara Adamik

Abstract Background: The mNUTRIC score is a nutrition risk assessment tool. The aim of this study was to evaluate mNUTRIC score ability to predict 28-mortality, icu resource utilization and nursing workload for patients with sepsis and septic shock. Methods: We performed a secondary analysis of prospectively collected data from a ICU sepsis registry database. The study included adults diagnosed with sepsis or septic shock, admitted from January to December 2014.Results: The study included 146 patients. In the ROC curve analysis the mNUTRIC score had the ability to predict 28-day mortality with an AUC of 0.833 (95% CI 0.76-0.89). Additionally group of patients with NUTRIC score ≥ 6 points more frequently required vasopressor infusion, mechanical ventilation, renal replacement therapy, thromboprophylaxis and blood products use. Nursing workload was also significantly higher in this group (TISS-28: 36 pts., IQR 33 – 40 vs. 31 pts, IQR 28 – 34, p<0.001).Conclusion: The mNUTRIC score obtained at admission to the ICU provided a good discriminative value for 28-mortality and makes it possible to identify patients who will ultimately require intense use of ICU resources with an associated increase in the nursing workload during ICU sepsis treatment.


Author(s):  
Dhurata Ivziku ◽  
Federica Maria Pia Ferramosca ◽  
Lucia Filomeno ◽  
Raffaella Gualandi ◽  
Maddalena De Maria ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Atiyeh Saboktakin ◽  
Mohammad Mehdi Sepehri ◽  
Roghaye Khasha

Abstract Background Cardiovascular diseases (CVDs) are always considered by healthcare specialists for different reasons, including extensive prevalence, increased costs, chronicity, and high risk of death. The control of CVDs is highly influenced by behavior and lifestyle and it seems necessary to train special abilities about lifestyle and behavior modification to improve self-care skills for patients, and their caregivers. As a result, the development of effective training systems should be considered by healthcare specialists. Methods Hence, in this study, a framework for improving cardiovascular patients’ education processes is presented. Initially, an existing training system for cardiovascular patients is reviewed. Using field observations and targeted interviews with hospital experts, all components of its educating processes are identified, and their process maps are drawn up. After that, challenges in the training system are extracted with the aid of in-depth semi-structured interviews with experts. Due to the importance and different influence of the identified challenges, they are prioritized using a Multiple Criteria Decision-making (MCDM) method, and then their root causes were investigated. Finally, a novel framework is proposed and evaluated with hospital experts' help to improve the main challenges. Results The most important challenges included high nursing workload and shortage of time, lack of understanding of training concepts by patients, lack of attention to training, disruption of the training processes by the patients’ caregivers, and patient's weakness in understanding the standard language. In identifying the root causes, learner, educator, and educational tools are the most effective in the training process; therefore, the improvement scenarios were designed accordingly in the proposed framework. Conclusions Our study indicated that presenting a framework with applying different quantitative and qualitative methods has great potential to improve the processes of patient education for chronic diseases such as cardiovascular disease.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260025
Author(s):  
Bianca B. P. Antunes ◽  
Leonardo S. L. Bastos ◽  
Silvio Hamacher ◽  
Fernando A. Bozza

Background Studies using Data Envelopment Analysis to benchmark Intensive Care Units (ICUs) are scarce. Previous studies have focused on comparing efficiency using only performance metrics, without accounting for resources. Hence, we aimed to perform a benchmarking analysis of ICUs using data envelopment analysis. Methods We performed a retrospective analysis on observational data of patients admitted to ICUs in Brazil (ORCHESTRA Study). The outputs in our data envelopment analysis model were the performance metrics: Standardized Mortality Ratio (SMR) and Standardized Resource Use (SRU); whereas the inputs consisted of three groups of variables that represented staffing patterns, structure, and strain, thus resulting in three models. We compared efficient and non-efficient units for each model. In addition, we compared our results to the efficiency matrix method and presented targets to each non-efficient unit. Results We performed benchmarking in 93 ICUs and 129,680 patients. The median age was 64 years old, and mortality was 12%. Median SMR was 1.00 [interquartile range (IQR): 0.79–1.21] and SRU was 1.15 [IQR: 0.95–1.56]. Efficient units presented lower median physicians per bed ratio (1.44 [IQR: 1.18–1.88] vs. 1.7 [IQR: 1.36–2.00]) and nursing workload (168 hours [IQR: 168–291] vs 396 hours [IQR: 336–672]) but higher nurses per bed ratio (2.02 [1.16–2.48] vs. 1.71 [1.43–2.36]) compared to non-efficient units. Units from for-profit hospitals and specialized ICUs presented the best efficiency scores. Our results were mostly in line with the efficiency matrix method: the efficiency units in our models were mostly in the “most efficient” quadrant. Conclusion Data envelopment analysis provides managers the information needed to identify not only the outcomes to be achieved but what are the levels of resources needed to provide efficient care. Different perspectives can be achieved depending on the chosen variables. Its use jointly with the efficiency matrix can provide deeper understanding of ICU performance and efficiency.


2021 ◽  
Vol 59 ◽  
pp. 101071
Author(s):  
Ane Karoline Silva Bonfim ◽  
Isadora Castilho Moreira de Oliveira Passos ◽  
Carmen Mohamad Rida Saleh ◽  
Katia Grillo Padilha ◽  
Lilia de Souza Nogueira

Author(s):  
Younhee Kang ◽  
Yujin Hur

The behavioral and psychological symptoms of dementia (BPSD), which appear in all dementia patients, demand sizable commitments of time and effort from nurses. This study aims to identify issues related to the workloads of nurses who provide care for dementia patients via qualitative meta-synthesis. Eleven articles were selected using a systematic review flowchart, which were then evaluated for their quality using the Critical Appraisal Skills Program checklist. Collected data were analyzed using a line-of-argument method. Theme clusters were “increased workload due to characteristics of dementia”, “increased mental stress”, “difficulty associated with playing a mediator role in addition to nursing duties”, and “lacking systematic support for dementia patient care”. To reduce the workload and mental stress of nurses in dementia care, supportive measures appropriate for their occupational characteristics should be developed, based on workload estimates that account for the attributes of dementia patients.


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