Nurses’ work environments, care rationing, job outcomes, and quality of care on neonatal units

Rochefort, Christian M.; Clarke, Sean P.

doi:10.1111/j.1365-2648.2010.05376.x

Cited by 179 publications

(230 citation statements)

References 41 publications

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“…1 Medical professionals in the critical care setting are at risk for burnout, 2,3 fueled by frequent changes in technology and guidelines, endeavors for high-quality care, and emotional challenges of dealing with critical ill patients and their families. [4][5][6] Burnout affects 25% to 50% of NICU providers, 1,5 with up to one-half of nurses and physicians meeting criteria for severe burnout in all specialties. 7 -10 Burnout among health care providers has been linked to adverse patient events in multiple settings, including increased rates of health care-associated infections 11,12 and self-reported errors.…”

Section: What This Study Addsmentioning

confidence: 99%

Factors Associated With Provider Burnout in the NICU

Tawfik¹,

Phibbs²,

Sexton

et al. 2017

Pediatrics

118

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Section: What This Study Addsmentioning

confidence: 99%

Factors Associated With Provider Burnout in the NICU

Tawfik¹,

Phibbs²,

Sexton

et al. 2017

Pediatrics

118

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“…Studies exploring missed care under the implicit rationing approach have found that nursing activities related to surveillance are among the top five most frequently left undone (Jones et al., 2015; Rochefort & Clarke, 2010; Schubert et al., 2012). These findings resonate with analysis by Smith (2010) about the acute problem regarding frequency of physiological observations.…”

Section: Introductionmentioning

confidence: 99%

What impact does nursing care left undone have on patient outcomes? Review of the literature

Recio‐Saucedo

Dall’Ora

Maruotti

et al. 2017

Journal of Clinical Nursing

329

304

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Aims and objectivesSystematic review of the impact of missed nursing care on outcomes in adults, on acute hospital wards and in nursing homes.BackgroundA considerable body of evidence supports the hypothesis that lower levels of registered nurses on duty increase the likelihood of patients dying on hospital wards, and the risk of many aspects of care being either delayed or left undone (missed). However, the direct consequence of missed care remains unclear.DesignSystematic review.MethodsWe searched Medline (via Ovid), CINAHL (EBSCOhost) and Scopus for studies examining the association of missed nursing care and at least one patient outcome. Studies regarding registered nurses, healthcare assistants/support workers/nurses’ aides were retained. Only adult settings were included. Because of the nature of the review, qualitative studies, editorials, letters and commentaries were excluded. PRISMA guidelines were followed in reporting the review.ResultsFourteen studies reported associations between missed care and patient outcomes. Some studies were secondary analyses of a large parent study. Most of the studies used nurse or patient reports to capture outcomes, with some using administrative data. Four studies found significantly decreased patient satisfaction associated with missed care. Seven studies reported associations with one or more patient outcomes including medication errors, urinary tract infections, patient falls, pressure ulcers, critical incidents, quality of care and patient readmissions. Three studies investigated whether there was a link between missed care and mortality and from these results no clear associations emerged.ConclusionsThe review shows the modest evidence base of studies exploring missed care and patient outcomes generated mostly from nurse and patient self‐reported data. To support the assertion that nurse staffing levels and skill mix are associated with adverse outcomes as a result of missed care, more research that uses objective staffing and outcome measures is required.Relevance to clinical practiceAlthough nurses may exercise judgements in rationing care in the face of pressure, there are nonetheless adverse consequences for patients (ranging from poor experience of care to increased risk of infection, readmissions and complications due to critical incidents from undetected physiological deterioration). Hospitals should pay attention to nurses’ reports of missed care and consider routine monitoring as a quality and safety indicator.

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“…The national and international literature has made consistent recommendations, especially to hospital institutions, regarding the work environment, and emphasize that nurses and effective care contribute to the process of patient recovery (2)(3) . Other studies stress that in environments favorable to the professional practice, patient safety and quality of care are improveds (4)(5) , which contributes to promote an safety climate (6) , reducing the occurrence of adverse events (7) . In this context, the environment of health organizations is a determining factor in the quality and safety of health care, and the nursing team provides a significant contribution to the creation of a safety environment for health.…”

Section: Introductionmentioning

confidence: 99%

Ambiente de trabalho da enfermagem, segurança do paciente e qualidade do cuidado em hospital pediátrico

Alves

Guirardello

2016

Rev. Gaúcha Enferm.

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How to cite this article:Alves DFS, Guirardello EB. Nursing work environment, patient safety and quality of care in pediatric hospital. Rev Gaúcha Enferm. 2016 jun;37 (2) RESUMEN Objetivos:Describir las características del ambiente de trabajo, las actitudes hacia la seguridad, el cuidado de la calidad medida por el personal de enfermería de las unidades de pediatría, así como analizar la evolución de los indicadores de bienestar y desempeño de los hospitales. Métodos: Estudio descriptivo con 136 profesionales en un asilo de ancianos hospital pediátrico, realizado a través de la forma de caracterización personal y profesional, Enfermería Índice de Trabajo -Revisado, Actitudes Seguridad Cuestionario -Short Form 2006 y los indicadores de calidad. Resultados: Los profesionales perciben el ambiente tan favorable a la práctica profesional y de la buena calidad de la atención, una reducción de los eventos adversos y la estancia hospitalaria. Satisfacción en el trabajo se consideró favorable para la seguridad del paciente. Conclusiones: El ambiente de trabajo es propicio para la práctica de los profesionales de enfermería que aprueban la calidad de la atención y la reducción de puntos de indicadores de los eventos adversos y la estancia hospitalaria Palabras clave: Ambiente de instituciones de salud. Seguridad del paciente. Calidad de la atención de salud. Satisfacción en el trabajo. Evaluación del resultado de la atención al paciente.

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Nurses’ work environments, care rationing, job outcomes, and quality of care on neonatal units

Cited by 179 publications

References 41 publications

Factors Associated With Provider Burnout in the NICU

Factors Associated With Provider Burnout in the NICU

What impact does nursing care left undone have on patient outcomes? Review of the literature

Ambiente de trabalho da enfermagem, segurança do paciente e qualidade do cuidado em hospital pediátrico

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