Analysis of the influence of workload and the quality of the nurse with the quality of medical services in the inpatient building B general hospital Royal Prima Medan 2019

Background: Workload and quality of peer care has an important role in improving the quality of medical services in terms of patient satisfaction in hospital services, especially in the inpatient room. RSU. Royal Prima is a private type B hospital with a BOR of 87% based on the high number of patient visits in the inpatient room. The aim of the study was to determine the analysis of the influence of the workload and the quality of medical services in the inpatient building B RSU, Royal Prima Medan 2019.Methods: This type of quantitative research with a correlation study research design. On the workload of nurses with a total sampling technique of 148 nurses. On the quality of nurses using a purposive sampling technique, a sample of 148 people was taken from one month's patient population.Results: The results of this study on nurse workload from the measurement results based on the chi square test nurses workload has a statistically significant effect on the quality of medical services (p=0.005) and the quality of nurses has no influence on the quality of being able (p=0.950). Based on logistic regression odds ratio 1.025, which means nurses with light workloads will improve the quality of service 1.0 times compared to nurses with heavy workloads.Conclusions: It was concluded that the heavy workload can affect the quality of inpatient services marked by the number of patients not proportional to the number of nurses so it is necessary to increase the number of nursing human resources in the inpatient room of B building at RS, Royal Prima Medan in 2019.

Kepatuhan Perawat dalam Melakukan Oral Hygiene di Unit Perawatan Intensif

This study aims to identify factors that influence nurse compliance and find the best solution to improve adherence to oral hygiene. The research method begins with searching scientific articles in 4 databases, namely PubMed, Wiley, science direct, and google scholar. The results of the study of 7 included articles, 42.85% (3 pieces) stated that nurses' knowledge and perceptions were the main factors that influenced nurse compliance, and 14.3% (1 article) indicated that service practices/facilities affected adherence. Other factors were found including; limited time, motivation, nurse workload, unavailability of oral hygiene procedures, and lack of interprofessional collaboration, so the best solution is to increase the knowledge and competence of nurses with training, workshops, and monitoring systems in the implementation of the VAP bundle. In conclusion, nurses' knowledge and perceptions are the main factors that affect nurse compliance in performing oral hygiene, so increasing knowledge and competence is the best solution as a joint effort to reduce the incidence of VAP. Keywords: VAP Bundle, Compliance, Intensive Care Unit, Oral Hygiene

Developing an Approach to Quantify Nurse Workload and Quality of Care Using Discrete Event Simulation

Intensive workload for nurses due to high demands directly impacts the quality of care and nurses’ health. To better manage workload, it is necessary to understand the drivers of workload. This multidisciplinary research provides an adaptable nurse-focused approach to discrete event simulation (DES) modelling that can quantify the effects of changing technical design and operational policies in terms of nurse workload and quality of care. In the first phase of this research, a demonstrator model was developed that explored the impact of nurse-patient ratios. As the number of patients per nurse (nurse-patient ratio) increased, nurse workload increased, and the quality of care deteriorated. In the second phase of this research, the DES model tested the interaction of patient acuity and nurse-patient ratios. As the levels of patient acuity and number of patients per nurse increased, nurse workload increased, and quality of care deteriorated – a result that was not surprising but an ability to quantify this proactively, was conceived. In the third phase of this research, the DES model was validated by means of an external field validation study by adapting the model to a real-world unit. The DES model showed excellent consistency between modelling and real-world outcomes (Intraclass iv Correlation Coefficient = 0.85 to 0.99; Spearman Rank-order Correlation Coefficient = 0.78). The fourth phase of this research used the validated simulation model to test the design implication of geographical patient bed assignment. As nurses were assigned to patient beds further away from the center of the unit or spread further apart, nurse workload increased as the nurse had to walk more leading to a deterioration in the quality of care. The DES modelling capability showed that both aspects of assignment were important for patient bed assignment. The fifth phase of this research combined Digital Human Modelling (DHM) and DES to produce a time-trace of biomechanical load and peak biomechanical load (‘activity’) for a full shift of nursing work. As the nurse was assigned to beds further away from the center of the unit, the cumulative biomechanical load decreased as the nurse spent more time walking yielding a reduced biomechanical load in comparison to the task group ‘activity’. As patient acuity is increased, a decrease in L4/L5 moment is observed as the task duration and frequency of most care task increase. Due to increased care demands, nurses must now spend more time delivering care. Since the care demands are much higher than the current capability of nurses, quality of care is deteriorated. As number of patients per nurse, increased a ‘ceiling’ effect on biomechanical load can be observed as nurses do not have the time to attend to this extra demand for care. The use of this adaptable DES modeling approach can assist decision makers by providing quantifiable information on the potential impact of these decisions on nurse workload and quality of care. Thereby, assisting decision makers to create technical design and operational policies for hospital units that do not compromise patient safety and health of nurses. Keywords: Behavioural operations research; Discrete Event Simulation; Nurse Workload; Quality of care; Healthcare Ergonomics; Human Factors Engineering; Nurses; Healthcare policy

Developing an Approach to Quantify Nurse Workload and Quality of Care Using Discrete Event Simulation

Intensive workload for nurses due to high demands directly impacts the quality of care and nurses’ health. To better manage workload, it is necessary to understand the drivers of workload. This multidisciplinary research provides an adaptable nurse-focused approach to discrete event simulation (DES) modelling that can quantify the effects of changing technical design and operational policies in terms of nurse workload and quality of care. In the first phase of this research, a demonstrator model was developed that explored the impact of nurse-patient ratios. As the number of patients per nurse (nurse-patient ratio) increased, nurse workload increased, and the quality of care deteriorated. In the second phase of this research, the DES model tested the interaction of patient acuity and nurse-patient ratios. As the levels of patient acuity and number of patients per nurse increased, nurse workload increased, and quality of care deteriorated – a result that was not surprising but an ability to quantify this proactively, was conceived. In the third phase of this research, the DES model was validated by means of an external field validation study by adapting the model to a real-world unit. The DES model showed excellent consistency between modelling and real-world outcomes (Intraclass iv Correlation Coefficient = 0.85 to 0.99; Spearman Rank-order Correlation Coefficient = 0.78). The fourth phase of this research used the validated simulation model to test the design implication of geographical patient bed assignment. As nurses were assigned to patient beds further away from the center of the unit or spread further apart, nurse workload increased as the nurse had to walk more leading to a deterioration in the quality of care. The DES modelling capability showed that both aspects of assignment were important for patient bed assignment. The fifth phase of this research combined Digital Human Modelling (DHM) and DES to produce a time-trace of biomechanical load and peak biomechanical load (‘activity’) for a full shift of nursing work. As the nurse was assigned to beds further away from the center of the unit, the cumulative biomechanical load decreased as the nurse spent more time walking yielding a reduced biomechanical load in comparison to the task group ‘activity’. As patient acuity is increased, a decrease in L4/L5 moment is observed as the task duration and frequency of most care task increase. Due to increased care demands, nurses must now spend more time delivering care. Since the care demands are much higher than the current capability of nurses, quality of care is deteriorated. As number of patients per nurse, increased a ‘ceiling’ effect on biomechanical load can be observed as nurses do not have the time to attend to this extra demand for care. The use of this adaptable DES modeling approach can assist decision makers by providing quantifiable information on the potential impact of these decisions on nurse workload and quality of care. Thereby, assisting decision makers to create technical design and operational policies for hospital units that do not compromise patient safety and health of nurses. Keywords: Behavioural operations research; Discrete Event Simulation; Nurse Workload; Quality of care; Healthcare Ergonomics; Human Factors Engineering; Nurses; Healthcare policy

Explaining the Variability in School Nurse Workload and Educational Outcomes

This secondary analysis examined the variability in the effects of school nurse workload on individual student outcomes of 9th grade attendance, being on track to graduate, and high school graduation. A principal axis factor analysis of the variables underlying school nurse workload and a structural equation model of the latent construct school nurse workload in 5th grade and the three outcome variables was tested using data from student records ( N = 3,782). Two factors explained 82% of the variability in school nurse workload: acuity and volume factor and social determinants of health factor. The model had acceptable fit indices and school nurse workload explained between 35% and 52% of the variability in the outcomes with a moderate effect size (.6–.72). Creating school nurse workload assignments that maximize student educational outcomes may improve graduation from high school, which in turn increases the resources available for lifelong health.

The Association of School Nurse Workload With Student Health and Academic Outcomes: A Cross-Sectional Study

This study assessed associations between school nurse workload and student health and academic outcomes. We hypothesized that lower school nurse workload would be associated with better student outcomes, with associations being greater for members of groups who experience health disparities. Our methods entailed secondary analysis of data for New York City school students in kindergarten through 12th grade during 2015–2016 ( N = 1,080,923), using multilevel multivariate regression as the analytic approach. Results demonstrated lower school nurse workload was associated with better outcomes for student participation in asthma education but not chronic absenteeism, early dismissals, health office visits, immunization compliance, academic achievement, or overweight/obesity. Our findings suggest school nurses may influence proximal outcomes, such as participation in disease-related education, more easily than downstream outcomes, such as absenteeism or obesity. While contrary to our hypotheses, results align with the fact that school nurses deliver community-based, population health–focused care that is inherently complex, multilevel, and directly impacted by social determinants of health. Future research should explore school nurses’ perspectives on what factors influence their workload and how they can best impact student outcomes.

HUBUNGAN BEBAN KERJA DENGAN KEPATUHAN PERAWAT DALAM PENERAPAN SURGICAL SAFETY CHECKLIST DI KAMAR OPERASI RUMAH SAKITAWAL BROS BATAM TAHUN 2020

Impact Workload that is too excessive will result in adverse effects, which will cause physical and mental fatigue and emotional reactions such as headaches, digestive disorders, and irritability. While the workload is too little where the work happens because reduced motion will lead to boredom. Boredom in the work done or too little work results in a lack of attention to work that can potentially endanger workers and conversely the many burdens in work make other jobs neglected and forget some things to do because of high workload (Ma-nuaba , in Prihatini, 2017) nurse workload is strongly correlated with the large number of patients who have filled out the form before the surgery, and the length of treatment in the recovery room and the rapid process of dropping patients into the operating room before the patient's recovery from the operating room is complete.The study aims to determine the relationship between workload and nurse compliance . Methods The study is cross sectional. Instrument of research is using the instrument, sample research is 30 nurses . The results of this study get more than 70% of the workload and compliance of nurses 67% in this case the results of the Chi-square test conducted in there can be a significant relationship between workload with nurse compliance with a significant value of p <0.05 i.e. = 0, 004 .