Current Issue : October - December Volume : 2020 Issue Number : 4 Articles : 6 Articles
The level of registered nurse (RN) staffing is a fundamental factor influencing patient safety.\nCraniotomy patients need intensive care after surgery, the majority of which is provided by RNs.\nMethods: This study was conducted to investigate the relationship of the RN staffing level of general wards and\nintensive care units (ICUs) with in-hospital mortality after craniotomy using Korean National Health Insurance claim\ndata. The RN staffing level was categorized based on the bed-to-RN ratio.\nResults: The in-hospital mortality rate of craniotomy patients was elevated at hospitals with a high bed-to-RN ratio\nin general wards, ICUs, and hospitals overall. It was determined that in-hospital mortality of craniotomy patients\ncould be decreased by more than 50% by reducing the bed-to-RN ratio from 4.5 or more to less than 3.5 in general\nwards, from 1.25 or more to less than 0.88 in ICUs, and from 2.5 or more to less than 1.67 in hospitals overall.\nConclusions: Since the RN staffing level is related to the in-hospital mortality rate of craniotomy patients, a\nsufficient staffing level of RNs should be ensured to reduce the mortality of craniotomy patients....
Dialysis patients have a high pill burden, increasing their care complexity. A previous study in our\ninstitutionâ??s dialysis unit found notable discrepancies between medication prescriptions, purchases and patient\nreports of medication use: overall adherence to medication was 57%, on average; staff reported patients took 3.1\nmore medication types than actual purchases; concordance of patient purchases and nurse reports was found in\n5.7 out of 23.6 months of patient follow-up. We sought to investigate patients and staff concepts and attitudes\nregarding medication care and to understand better the previously identified inconsistencies.\nMethods: We performed a qualitative research based on the grounded theory approach, using semi-structured,\nin-depth, interviews with patients and staff from the same dialysis unit studied previously, at the Hadassah Medical\nCenter, Jerusalem, Israel.\nResults: Though all respondents described a seemingly synchronized system of care, repeated questioning revealed\nthat staff distrust patient medication reports. Patients, on their part, felt that their monitoring and supervision were\nbothersome and belittling. Along with patients, nurses and physicians, we identified a â??fourthâ? factor, which influences\nmedication care - the laboratory tests. They serve both as biological parameters of health, but also as parameters of\npatient adherence to the prescribed medication regimens.\nConclusions: Participant responses did not clearly resonate with previous findings from the quantitative study. The\ncentral role of laboratory tests should be carefully considered by the staff when interacting with patients. An\ninteraction process, less adversarial, centering on the patient attitudes to medication care, might establish better\ncommunication, better cooperation and better patient outcomes....
To analyze the clinical features of falls in hospitalized patients\nwith chronic kidney disease (CKD), and to provide basis for preventing the\noccurrence of falls in hospitalized patients with CKD. Method: A retrospective\nstudy was conducted to analyze the 27 adverse events of falls in hospitalized\npatients from the department of nephrology in Peking University\nShenzhen Hospital during May 2009 and May 2019. Results: Among the 27\npatients with falls, people over 65 years old accounted for 55.56%; 74.07% of\nthe patients had caregivers; the peak period of falls was from June to August,\naccounting for 40.74%, mainly occurring from 7:00 to 8:00, 12:00 to 13:30 and\n19:00 to 21:00; the locations of falls were mostly near the bed and in the\nbathroom, accounting for 33.33% and 22.22%, respectively; suffering from\nanemia, hypoproteinemia, abnormal serum potassium, calcium-phosphorus\nmetabolism disorders accompanied by abnormal parathyroid hormone and\nhypertension accounted for 88.89%, 85.19%, 29.63%, 96.30% and 81.48% respectively.\nThe inpatients on dialysis therapy accounted for 66.67%. Conclusion:\nThe occurrence of falls in hospitalized patients with CKD was not only\nrelated to age, caregivers, time, months, locations or other conventional factors,\nbut also the complications and dialysis therapies. To effectively reduce\nthe occurrence of falls, itâ??s necessary to enhance the sense of safety and responsibility\nof caregivers. Besides, nurses should strengthen the inspection of\nwards for inpatients engaging in some intensive activities, and nurses should\nalso pay more attention to the inpatients with anemia, hypoproteinemia, calcium-\nphosphorus metabolism disorders and those on dialysis therapies....
Nurses and midwives are a critical part of the healthcare team and make up the largest section of\nhealth professionals. Leadership styles are believed to be an important determinant of job satisfaction and retention\nmaking effective leadership within nursing and midwifery crucial to health systems success. In Rwanda, there are\ngaps in knowledge of managerial leadership styles of nurses and midwives and the influence of these styles on job\nsatisfaction and retention for nurses and midwives who report to them, as well as their influence on the provision\nof health services. This study describes the managerial leadership styles adopted by nurses/midwives and examines\nthe relationship between managerial leadership styles and job satisfaction, intention to stay, and service provision.\nMethods: The Path-Goal Leadership questionnaire was adopted and used to collect data on leadership styles while\nother questionnaires with high validity and reliability were used to collect data on job satisfaction, intention to stay\nand service provision. The study involved 162 full-time nurses and midwives practicing in 5 selected hospitals with\na minimum of 6 months of experience working with their current direct managers. Regression analysis was used to\ndraw conclusions on relationships between variables.\nResults: Nurses and midwives managers were more inclined to the directive leadership style followed by a\nsupportive leadership style, and the participative leadership style. The nurse and midwifeâ??s managerial leadership\nstyles together significantly explained 38, 10 and 23% of the variance in job satisfaction, intention to stay and\nservice provision, respectively.\nConclusion: The findings of this study indicate that managerial leadership styles play a substantial role in\nenhancing job satisfaction, intention to stay and service provision.\nThere is a need to develop a comprehensive formal\nprofessional continuous development course on leadership styles and ensure that all nurses and midwives\nmanagers benefit from this course prior to or immediately after being appointed as a manager. Having such a\ncourse may even prepare future leaders for their role early in their career. Effective leadership in nursing and\nmidwifery should be enhanced at all levels to improve the job satisfaction of nurses and midwives, address the\nissue of retention in their respective health facilities and strengthen service provision....
Pressure ulcer is largely avoidable, but its prevalence rate increased more than 80% in a 13 years\nstudy. Nurses have a great position to advance best practices towards the prevention of pressure ulcers. Therefore\nthey should be knowledgeable of the signs and symptoms of pressure ulcers, and preventive strategies to reduce\nits incidence, but there is limited evidence on nursesâ?? knowledge and its associated factors to prevent pressure\nulcers in Ethiopia......................
Studies have highlighted deficiencies in the information given by nurses to surgical patients. Studies\nalso show that the role of the nurse in connection with the discharge of patients after surgery is unclear. The aim\nof the study was therefore to elicit and to explore registered nursesâ?? conceptions of the phenomenon of nursing\ncare information given to surgical patients in connection with hospital discharge.\nMethod: Semi-structured interviews were conducted with fifteen nurses at surgical unites at the southern parts of\nSweden. The interviews were transcribed and then analysed according to the phenomenographic approach.\nResult: The analysis resulted into three descriptive categories which conjointly may be said to express the general\nconceptions of the informants. Thus, according to the informants, the provision of nursing care information in\nconnection with the discharge of surgical patients is: (i) not a nursing priority, (ii) adapted to the context of care,\nand (iii) a possible enhancement of the nursing process and the quality of care.\nConclusion: The result of the study implies that the discharge conversation may be seen as an opportunity for the\nnursing profession to formalise and to enhance the quality of care in connection with the discharge of surgical patients...
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