Background: The demand for nursing care is rising in the long-term care setting. Nurse staffing is a crucial measure linked to health care quality measure outcomes.
Purpose: To assess for associations between nursing hours per patient day (NHPPD) and outcome measures in the Veterans Health Administration Community Living Centers.
Methods: A retrospective data review of NHPPD and quality measures for 134 community living centers was conducted. Linear regression was used to assess for linear associations between average total NHPPD and 6 quality measures.
Results: A significant linear association was found between average total NHPPD and falls with major injury ( P = .02) and help with activities of daily living ( P = .01). No associations were found between nurse staffing and 4 other quality measures.
Conclusions: This study adds to the body of literature regarding the impact of nurse staffing on quality measures.
Background: End-of-life planning helps nurses meet the needs of their patients at a crucial time of life.
Purpose: This article presents a conceptual model of end-of-life care planning for nurses, especially those in palliative and hospice care, focusing on holistic nursing views.
Methods: Based on a literature review, we developed a new conceptual model illustrating the concepts and dimensions of end-of-life care planning among diverse individuals across countries, life spans and age groups, ethnographies, and residential statuses.
Results: This conceptual model includes 3 concepts: personal factors, stakeholders, and environmental and social factors. Each concept encompasses multiple dimensions. The concepts are interrelated and directly related to end-of-life care planning.
Conclusion: This work addresses the need for a comprehensive end-of-life care planning model and can help enhance the quality of end-of-life care. This article identifies implications for nursing education, practice, and research.
Background: Compassion fatigue, stress, and burnout have an adverse impact on nurse managers.
Purpose: To evaluate the impact of a compassion fatigue resiliency program on nurse managers and to obtain their views of the program.
Methods: This mixed-methods study was conducted with 16 nurse managers. The compassion fatigue resiliency program was implemented; compassion fatigue, compassion satisfaction, burnout, perceived stress, and resilience were assessed before and after implementation of the program.
Results: The mean compassion fatigue and perceived stress scores of nurses decreased significantly after the intervention. Four themes were identified from qualitative analysis, including awareness, coping with stress, effective communication skills in team management, and recommendations.
Conclusions: The current study shows the training program reduced nurse managers' compassion fatigue and stress and enabled nurse managers to improve their coping skills and awareness.
Background: Intensive care unit (ICU) nurses faced an increased risk of compassion fatigue and ethical concerns during the COVID-19 pandemic.
Purpose: To evaluate compassion fatigue of ICU nurses and their ethical attitudes in care during the COVID-19 pandemic and analyze contributing factors.
Methods: An exploratory cross-sectional research design was used.
Results: A total of 103 ICU nurses participated. The nurses' compassion fatigue and ethical attitude scores were high. Compassion fatigue was explained by the following variables: considering resigning, receiving support for ethical decisions, willingness to work in the ICU, duration of providing activities of daily living in a shift, and number of patients per nurse.
Conclusions: Compassion fatigue was high in nurses working in the ICU during COVID-19. The high level of ethical attitudes shows commitment to professional ethics and reflects the development of the nurses' professional identity. Implementation of interventions that help improve compassion fatigue among nurses is needed.
Background: Emergency department (ED) health care workers experience high rates of workplace violence (WPV).
Local problem: Patient-to-staff physical assaults at an urban, academic adult ED ranged between 1 and 5 per month, with a rate of 0.265 per 1000 patient visits.
Methods: A quality improvement initiative, guided by the Social Ecological Model framework that contextualized WPV in the ED setting, informed the development of a Risk for Violence Screening Tool (RVST) to screen adult patients presenting to the ED.
Interventions: Plan-Do-Study-Act cycles were utilized to implement a violence prevention bundle that incorporated the RVST, an alert system, and focused assault reduction strategies.
Results: Patient-to-staff physical assaults decreased to a rate of 0.146 per 1000 patient visits.
Conclusions: Risk for violence screening, an alert system, and assault prevention strategies provide opportunities for nurse leaders to promote ED workplace safety.
Background: Nationwide nursing shortages have led to higher patient-to-nurse ratios, nursing burnout, and decreased quality of care.
Local problem: Staffing challenges and nursing burnout were becoming growing concerns and success was contingent upon efficient use of existing resources.
Methods: Direct observation current state assessment was completed on medical-surgical specialty units to better understand work activities of registered nurses (RNs) and unlicensed assistive personnel (UAPs).
Results: RNs spent more time performing indirect care (eg, documentation) than direct patient care. Interruptions and problems consumed 17.4% and 5.6% of their time, respectively. UAPs performed more direct patient care but had a higher proportion of downtime. RNs underdelegated nonclinical tasks.
Conclusions: Direct observation current state assessment offers a better understanding of workflow and workload inefficiencies. This information is critical to provide informed, evidence-based recommendations to develop future patient care models with more capacity to deliver high-quality care with greater efficiency and lessen nursing burden and burnout during the nursing shortage crisis.
Background: The clinical nurse leader (CNL) care model has existed since 2007. However, there is limited understanding how the model can best be implemented.
Purpose: A validated CNL Practice Survey measuring domains theorized to influence CNL implementation was used to examine the link between CNL domains and CNL implementation success.
Methods: Mixed methods were used to analyze data from a nationwide 2015 survey administered to clinicians and administrators involved in CNL initiatives.
Results: Of total respondents (n = 920), 543 (59%) provided success scores, with 349 (38%) providing comments. Respondents with negative comments gave significantly lower average CNL success scores. The majority of negative comments mapped onto Readiness and Structuring domains, providing details of barriers to CNL implementation success.
Conclusions: Findings provide information about structural domains that can be strategically targeted to better prepare settings for CNL implementation and success.
Background: The impact of aggressive and violent behaviors directed toward staff in psychiatric facilities has layers of implications tied to recruitment and retention, cost, quality and safety.
Local problem: Increased patient aggressive behaviors contributed to staff dissatisfaction and high turnover rates, triggering an analysis of current aggression management approaches.
Methods: The Plan-Do-Study-Act quality improvement method was used for this project.
Interventions: The Dynamic Appraisal of Situational Aggression (DASA) risk assessment tool was implemented.
Results: Daily aggression risk identification increased by 69%, and aggressive incidents toward staff and patients decreased by 64% and 28%, respectively, when the tool was completed more consistently. Surveys revealed acceptance of the tool by nurses.
Conclusions: Quality improvement statistical tools supported evidence-based strategies. A risk for aggression assessment laid the foundations for implementing strategies for reducing aggression and violence.
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：