Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: A systematic review of literature

Stalpers, Dewi; Brouwer, Brigitte Johanna Maria de; Kaljouw, Marian; Schuurmans, Marieke J.

doi:10.1016/j.ijnurstu.2015.01.005

Cited by 172 publications

(177 citation statements)

References 52 publications

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“…Nurse staffing intensity will be defined as the average number of work hours per patient provided by all members of the nursing staff (i.e., RNs, NAs, PCAs, and UAPs) [60, 61]. For each patient, nurse staffing intensity will be measured by dividing the total number of nursing work hours on the unit where the patient was hospitalized on a given shift by the beginning-of-shift patient census on that unit for that shift [61].…”

Section: Methodsmentioning

confidence: 99%

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Improving patient safety by optimizing the use of nursing human resources

2015

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BackgroundRecent ecological studies have suggested that inadequate nurse staffing may contribute to the incidence of adverse events in acute care hospitals. However, longitudinal studies are needed to further examine these associations and to identify the staffing patterns that are of greatest risk. The aims of this study are to determine if (a) nurse staffing levels are associated with an increased risk of adverse events, (b) the risk of adverse events in relationship to nurse staffing levels is modified by the complexity of patient requirements, and (c) optimal nurse staffing levels can be established.Methods/designA dynamic cohort of all adult medical, surgical, and intensive care unit patients admitted between 2010 and 2015 to a Canadian academic health center will be followed during the inpatient and 7-day post-discharge period to assess the occurrence and frequency of adverse events in relationship to antecedent nurse staffing levels. Four potentially preventable adverse events will be measured: (a) hospital-acquired pneumonia, (b) ventilator-associated pneumonia, (c) venous thromboembolism, and (d) in-hospital fall. These events were selected for their high incidence, morbidity and mortality rates, and because they are hypothesized to be related to nurse staffing levels. Adverse events will be ascertained from electronic health record data using validated automated detection algorithms. Patient exposure to nurse staffing will be measured on every shift of the hospitalization using electronic payroll records. To examine the association between nurse staffing levels and the risk of adverse events, four Cox proportional hazards regression models will be used (one for each adverse event), while adjusting for patient characteristics and risk factors of adverse event occurrence. To determine if the association between nurse staffing levels and the occurrence of adverse events is modified by the complexity of patient requirements, interaction terms will be included in the regression models, and their significance assessed. To assess for the presence of optimal nurse staffing levels, flexible nonlinear spline functions will be fitted.DiscussionThis study will likely generate evidence-based information that will assist managers in making the most effective use of scarce nursing resources and in identifying staffing patterns that minimize the risk of adverse events.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-015-0278-1) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

“…Other nurse staffing attributes can potentially be associated with AE occurrence, including nursing staff levels of experience and education [60, 62]. Patient exposure to these staffing attributes will be measured on every shift of a given hospitalization using the following time-varying indicators:…”

Section: Methodsmentioning

confidence: 99%

Improving patient safety by optimizing the use of nursing human resources

2015

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“…(17,18) Diğer önemli bir ölçüt ise hemşirelerin eğitim ve mesleki yetkinlikleri olup eğitimi yüksek ve deneyimi fazla hemşirelerin bakım verdiği hastalarda düşme ve basınç yaralarında azalma olduğu belirlenmiştir. (19) Bu bağlamda, öncelikle hastaların bakım gereksinimlerini en üst düzeyde karşılayacak bir ortam yaratmak ve gerekli hemşire niteliği ve sayısını belirlemek üzere hemşire işyükünün bu kavramlar çerçevesinde belirlenmesi gerekir. (16) Geliştirme ve kariyer planlama: Hemşire insan gücünün nitelikli hasta bakımı vermesi, değişen bilgi ve becerileri kazanması, kanıta dayalı uygulamaları yakından takip edip uygulamaya aktarabilmesi, yaşam boyu öğrenme ilkesi doğrultusunda mesleki ve profesyonel gelişimini sürdürebilmesi ve kariyer hedeflerine erişiminin sağlamasında önemli konulardan birisi de personel geliştirmedir.…”

Section: Hemşire çAlışma Ortamının Hasta Ve Hemşireler üZerine Etkileriunclassified

Development of Healthy Work Environment Standards for Nurses in Turkey

Kocaman¹,

Yürümezoğlu²,

Uncu³

et al. 2018

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ÖZAmaç: Hemşirelere sağlıklı çalışma ortamının sağlanmasında yapılacak düzenlemelere yön verecek, ülkemize özgü "hemşireler için sağlıklı ça-lışma ortamı standartlarının" geliştirilmesidir. Yöntem:Bu çalışmada E-Delphi tekniği kullanılmıştır. Birinci Del turunda panelistlere açık uçlu sorular sorulmuştur. Soruya verilen yanıtlar içerik analizi ile degerlendirilmistir. 2. Delphi turunda elde edilen verilerin analizinde ise medyan, birinci çeyrek, üçüncü çeyrek ve genislik ölçüleri kullanılmıstır. Bulgular: 1. Delphi turuna 93 panelist katılmış ve 298 standart önerisi belirlenmiştir. İçerik analizi sonucunda hemşireler için sağlıklı çalışma ortamı özellikleri 13 ana standart altında 92 alt standart olarak gruplandırılmıştır. Bu standartlar ile ikinci Delphi anketi hazırlanmış ve panelistlere yeniden gönderilmiştir. 2. Delphi turuna 87 panelist katıl-mıştır. Standartlar listesi, özel-üniversite-kamu kurumlarında uygulanabilirlik ve kullanılabilirlik açısından gözden geçirilmiştir. Bu sürecin sonucunda, "6 ana ve 35 alt standarttan oluşan sağlıklı çalışma ortamı standartlar" listesi belirlenmiştir.Sonuç: Bu proje sonucunda, ülkemize özgü ve tüm kurumlarda uygulanabilecek hemşireler için sağlıklı çalışma ortamı standartları geliştirilmiştir. ABSTRACT Aim: To develop healthy work environment standards that are speci c to nursing in Turkey and that will guide the planning for a healthy work environment. Methods:The e-Delphi technique was used in this study. In the rst Delphi round, one open-ended question was asked to the panelists. The responses were evaluated using content analysis. In the analysis of the second Delphi round, the median, the rst and third quartiles, and the width measurements were used.Results: Ninety-three and 87 panelists participated in the rst and second Delphi rounds respectively. As a result of the content analysis of the 298 standards proposed in the rst Delphi round, characteristics of a healthy work environment were grouped under 13 main standards with 92 sub-standards. Based on these standards, the second Delphi survey was prepared and sent back to the panelists. The second list of standards was reviewed if they were applicable to different sectors. Finally, a list of standards for a healthy work environment was prepared, consisting of 6 main standards and 35 sub-standards. Conclusion:As a result of this project, healthy work environment standards speci c to nursing in Turkey were developed and are applicable to all institutions.

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“…Sufficient staffing has a positive impact on patient outcomes. [9,10] For example, social workers provide the necessary psychosocialspiritual support for oncology patients and families, [11] and pharmacists actively participate in the multidisciplinary team to have a positive impact on patients' medical management and medication counseling. [12] …”

Section: Case Analysismentioning

confidence: 99%

Interprofessional collaboration strategies: A hematology unit case study

Xia

Cheng

2016

JNEP

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Interprofessional collaboration is essential to improve patient outcomes in hematology units. We report on the case of a patient with severe aplastic anemia who died after a fall in a hematology unit and explore the events of the case within the context of interprofessional collaboration. Several strategies were taken into consideration suggested by the Interprofessional Education Collaborative Expert Panel. A regular team meeting is helpful for gaining information about patients. Multidisciplinary education can enhance cooperation among medical team members and the use of an interprofessional curriculum at university level is recommended. Team building, interprofessional education, and clinical practice may facilitate health care providers to reach a collaborative level of clinical practice in a more considerate manner, to meet the demands of high quality health care.

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Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: A systematic review of literature

Cited by 172 publications

References 52 publications

Improving patient safety by optimizing the use of nursing human resources

Improving patient safety by optimizing the use of nursing human resources

Development of Healthy Work Environment Standards for Nurses in Turkey

Interprofessional collaboration strategies: A hematology unit case study

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