1
|
Li M, Zhao R, Wei J, Zhou L, Yang S, Tian Y, Wang L, Zhang W, Xiong X, Huang C, Pan Z, Song R. Nurses' perspectives on workplace environment needs associated to resilience: a qualitative descriptive study. Front Psychiatry 2024; 15:1345713. [PMID: 38404475 PMCID: PMC10884228 DOI: 10.3389/fpsyt.2024.1345713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/24/2024] [Indexed: 02/27/2024] Open
Abstract
Objective The purpose of this study was to explore the demands of nurses on the workplace environment related to psychological resilience. Methods A qualitative descriptive design was employed for this study. Purposeful sampling was chosen from a tertiary hospital in Henan Province, China. Semi-structured in-depth interviews were conducted with 20 nurses. The interview data was analyzed using the Colaizzi's method and results were reported following the COREQ standards. Results Analysis of the interview data revealed three main themes: (1) Career Support and Development, (2) Practical Support & Development, and (3) Personal Support and Development. Conclusion The perspectives of nurses for a workplace environment demands needs to be appreciated, and in addition, it is worth noting that the key role of building a good workplace environment in strengthening the resilience of nurses emphasizes the need for careful consideration. Nursing administrators should formulate policies and measures from multiple perspectives based on the real needs of nurses in terms of professional, practical, and personal dimensions.
Collapse
Affiliation(s)
- Meng Li
- Nursing Department, The Third People’s Hospital of Henan Province, Zhengzhou, China
| | - Runze Zhao
- School of Medicine, Zhengzhou University of Industrial Technology, Zhengzhou, China
| | - Junfan Wei
- The Seventh Clinical Medicine College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Linghan Zhou
- Nursing Department, The Third People’s Hospital of Henan Province, Zhengzhou, China
| | - Shuhua Yang
- Nursing Department, The Third People’s Hospital of Henan Province, Zhengzhou, China
| | - Yuan Tian
- Nursing Department, The Third People’s Hospital of Henan Province, Zhengzhou, China
| | - Lingning Wang
- School of Medicine, Maanshan University, Maanshan, China
| | - Wenling Zhang
- Operating Room, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Xiaoyun Xiong
- Nursing Department, The Third People’s Hospital of Henan Province, Zhengzhou, China
| | - Chuzhen Huang
- The Seventh Clinical Medicine College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Zhongjie Pan
- School of Medicine, Zhengzhou University of Industrial Technology, Zhengzhou, China
| | - Ruipeng Song
- Nursing Department, The Third People’s Hospital of Henan Province, Zhengzhou, China
| |
Collapse
|
2
|
Jolles DR, Niemczyk N, Hoehn Velasco L, Wallace J, Wright J, Stapleton S, Flynn C, Pelletier-Butler P, Versace A, Marcelle E, Thornton P, Bauer K. The birth center model of care: Staffing, business characteristics, and core clinical outcomes. Birth 2023; 50:1045-1056. [PMID: 37574794 DOI: 10.1111/birt.12745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 02/28/2023] [Accepted: 06/24/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVES Interest in expanding access to the birth center model is growing. The purpose of this research is to describe birth center staffing models and business characteristics and explore relationships to perinatal outcomes. METHODS This descriptive analysis includes a convenience sample of all 84 birth center sites that participated in the AABC Site Survey and AABC Perinatal Data Registry between 2012 and 2020. Selected independent variables include staffing model (CNM/CM or CPM/LM), legal entity status, birth volume/year, and hours of midwifery call/week. Perinatal outcomes include rates of induction of labor, cesarean birth, exclusive breastfeeding, birthweight in pounds, low APGAR scores, and neonatal intensive care admission. RESULTS The birth center model of care is demonstrated to be safe and effective, across a variety of staffing and business models. Outcomes for both CNM/CM and CPM/LM models of care exceed national benchmarks for perinatal quality with low induction, cesarean, NICU admission, and high rates of breastfeeding. Within the sample of medically low-risk multiparas, variations in clinical outcomes were correlated with business characteristics of the birth center, specifically annual birth volume. Increased induction of labor and cesarean birth, with decreased success breastfeeding, were present within practices characterized as high volume (>200 births/year). The research demonstrates decreased access to the birth center model of care for Black and Hispanic populations. CONCLUSIONS FOR PRACTICE Between 2012 and 2020, 84 birth centers across the United States engaged in 90,580 episodes of perinatal care. Continued policy development is necessary to provide risk-appropriate care for populations of healthy, medically low-risk consumers.
Collapse
Affiliation(s)
- Diana R Jolles
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
- Clinical Faculty, Frontier Nursing University, Hyden, Kentucky, USA
| | - Nancy Niemczyk
- Nurse-Midwife Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Jacqueline Wallace
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| | - Jennifer Wright
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| | - Susan Stapleton
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| | - Cynthia Flynn
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| | | | | | - Ebony Marcelle
- Community of Hope, Washington, District of Columbia, USA
| | | | - Kate Bauer
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| |
Collapse
|
3
|
Stock G, McDermott C. The effects of physicians on operational and financial performance in United States hospitals: staffing, human capital and knowledge spillovers. INTERNATIONAL JOURNAL OF OPERATIONS & PRODUCTION MANAGEMENT 2023. [DOI: 10.1108/ijopm-07-2022-0457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PurposeThe authors examine how physician staffing, human capital and knowledge spillovers are related to multiple dimensions of hospital operational and financial performance at the organizational level.Design/methodology/approachThe authors use a data set assembled from multiple sources for more than 1,300 US hospitals and employ hierarchical linear regression to test this study’s hypotheses. The authors use multiple quality, efficiency and financial measures of performance for these hospitals.FindingsThe authors find that higher levels of staffing, skills and knowledge spillovers associated with physicians were positively associated with multiple dimensions of hospital performance. The authors find linear and nonlinear relationships between experience and performance, with the relationships primarily negative, and nonlinear relationships between spillovers and quality performance.Practical implicationsHospital managers should consider increasing physician staffing levels if possible. In addition, the overall Final MIPS Score from the Centers for Medicare and Medicaid Services might be included as a factor in determining which physicians practice in a hospital. Finally, if possible, encouraging physicians to practice at multiple hospitals will likely be beneficial to hospital performance.Originality/valueThis study’s findings are original in that they explore how physician-specific staffing and human capital, which have received comparatively little attention in the literature, are related to several different dimensions of hospital-level operational and financial performance. To the best of the authors’ knowledge, this paper is also the first to examine the relationship between the construct of physician knowledge spillovers and hospital-level operational and financial performance.
Collapse
|
4
|
Martínez-Sabater A, Saus-Ortega C, Masiá-Navalon M, Chover-Sierra E, Ballestar-Tarín ML. Spanish Version of the Scale “Eventos Adversos Associados às Práticas de Enfermagem” (EAAPE): Validation in Nursing Students. NURSING REPORTS 2022; 12:112-124. [PMID: 35225898 PMCID: PMC8883960 DOI: 10.3390/nursrep12010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/31/2022] [Accepted: 02/09/2022] [Indexed: 11/16/2022] Open
Abstract
Healthcare carried out by different health professionals, including nurses, implies the possible appearance of adverse events that affect the safety of the patient and may cause damage to the patient. In clinical practice, it is necessary to have measurement instruments that allow for the evaluation of the presence of these types of events in order to prevent them. This study aims to validate the “Eventos adversos associados às práticas de enfermagem” (EAAPE) scale in Spanish and evaluate its reliability. The validation was carried out through a cross-sectional study with a sample of 337 nursing students from the University of Valencia recruited during the 2018–19 academic year. An exploratory factor analysis was carried out using principal components and varimax rotation. The factor analysis extracted two factors that explained 32.10% of the total variance. Factor 1 explains 22.19% and refers to the “adverse results” of clinical practice (29 items), and factor 2 explains 9.62% and refers to “preventive practices” (24 items). Both factors presented high reliability (Cronbach’s alpha 0.902 and 0.905, respectively). The Spanish version of the EAAPE is valid and reliable for measuring the perception of adverse events associated with nursing practice and the presence of prevention measures.
Collapse
Affiliation(s)
- Antonio Martínez-Sabater
- Nursing Department, Facultat d’Infermeria i Podologia, Universitat de València, 46010 València, Spain; (A.M.-S.); (M.L.B.-T.)
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 València, Spain;
- Grupo Investigación en Cuidados (INCLIVA), Hospital Clínico Universitario de Valencia, 46010 València, Spain
| | - Carlos Saus-Ortega
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 València, Spain;
- Nursing School “La Fe”, Generalitat Valenciana, 46026 València, Spain
| | | | - Elena Chover-Sierra
- Nursing Department, Facultat d’Infermeria i Podologia, Universitat de València, 46010 València, Spain; (A.M.-S.); (M.L.B.-T.)
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 València, Spain;
- Internal Medicine, Consorcio Hospital General Universitario de Valencia, 46014 València, Spain
- Correspondence: ; Tel.: +34-96-3864182
| | - María Luisa Ballestar-Tarín
- Nursing Department, Facultat d’Infermeria i Podologia, Universitat de València, 46010 València, Spain; (A.M.-S.); (M.L.B.-T.)
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 València, Spain;
| |
Collapse
|
5
|
Rochefort CM, Bourgon Labelle J, Farand P. Nurse Staffing Practices and Postoperative Atrial Fibrillation Among Cardiac Surgery Patients: A Multisite Cohort Study. CJC Open 2022; 4:37-46. [PMID: 35072026 PMCID: PMC8767127 DOI: 10.1016/j.cjco.2021.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/25/2021] [Indexed: 12/02/2022] Open
Abstract
Background Postoperative atrial fibrillation (POAF) is a frequent complication of cardiac surgery that is associated with increased morbidity, mortality, and costs. Recent studies suggest that nurse staffing practices are associated with adverse postoperative events, but whether these practices are also related to POAF occurrence is unknown. Methods To fill this knowledge gap, a cohort of 6401 cardiac surgery patients admitted to 2 Canadian university health centres (UHC A and UHC B) between 2014 and 2018 was studied. Patients’ cumulative exposure to 4 staffing practices (registered nurse [RN] understaffing, education, experience, and non-RN skill mix) was measured every shift over the first 6 postoperative days, during which 96% of POAF cases occur. The associations of these exposures with in-hospital POAF occurrence were estimated using site-specific multivariable logistic regression models and a mixed-effect model combining data from both sites. Results Overall, 563 (27.2%) and 1336 (30.8%) cases of POAF occurred at UHC A and UHC B, respectively. In site-specific models, every 5% increase in the cumulative proportion of understaffed shifts over the first 6 postoperative days was associated with a 3.5% increase in the odds of POAF (adjusted odds ratio [aOR] for UHC A: 1.035; 95% confidence interval [CI]: 1.000-1.070, P = 0.0472; aOR for UHC B: 1.035; 95% CI: 1.013-1.057, P = 0.0019). In the mixed-effect model combining data from both sites, RN understaffing remained significant and was associated with a 3.1% increase in the odds of POAF (aOR: 1.031; 95% CI: 1.014-1.048, P = 0.0003). No other staffing practices were significantly associated with POAF occurrence. Conclusion Higher RN understaffing postoperatively is associated with increased POAF occurrence among cardiac surgery patients.
Collapse
Affiliation(s)
- Christian M. Rochefort
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre de Recherche Charles-Le Moyne Saguenay-Lac-St-Jean sur les innovations en santé, Longueuil, Quebec, Canada
- Corresponding author: Dr Christian M. Rochefort, School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12e Avenue Nord, Pavillon Gérald-Lasalle, Sherbrooke, Québec J1H 5N4, Canada.
| | - Jonathan Bourgon Labelle
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre de Recherche Charles-Le Moyne Saguenay-Lac-St-Jean sur les innovations en santé, Longueuil, Quebec, Canada
- Division of Cardiology, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Paul Farand
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Division of Cardiology, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| |
Collapse
|
6
|
Rochefort CM, Abrahamowicz M, Biron A, Bourgault P, Gaboury I, Haggerty J, McCusker J. Nurse staffing practices and adverse events in acute care hospitals: The research protocol of a multisite patient-level longitudinal study. J Adv Nurs 2020; 77:1567-1577. [PMID: 33305473 PMCID: PMC7898788 DOI: 10.1111/jan.14710] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 11/16/2020] [Indexed: 12/27/2022]
Abstract
Aims We describe an innovative research protocol to: (a) examine patient‐level longitudinal associations between nurse staffing practices and the risk of adverse events in acute care hospitals and; (b) determine possible thresholds for safe nurse staffing. Design A dynamic cohort of adult medical, surgical and intensive care unit patients admitted to 16 hospitals in Quebec (Canada) between January 2015–December 2019. Methods Patients in the cohort will be followed from admission until 30‐day postdischarge to assess exposure to selected nurse staffing practices in relation to the subsequent occurrence of adverse events. Five staffing practices will be measured for each shift of an hospitalization episode, using electronic payroll data, with the following time‐varying indicators: (a) nursing worked hours per patient; (b) skill mix; (c) overtime use; (d) education mix and; and (e) experience. Four high‐impact adverse events, presumably associated with nurse staffing practices, will be measured from electronic health record data retrieved at the participating sites: (a) failure‐to‐rescue; (b) in‐hospital falls; (c) hospital‐acquired pneumonia and; and (d) venous thromboembolism. To examine the associations between the selected nurse staffing exposures and the risk of each adverse event, separate multivariable Cox proportional hazards frailty regression models will be fitted, while adjusting for patient, nursing unit and hospital characteristics, and for clustering. To assess for possible staffing thresholds, flexible non‐linear spline functions will be fitted. Funding for the study began in October 2019 and research ethics/institutional approval was granted in February 2020. Discussion To our knowledge, this study is the first multisite patient‐level longitudinal investigation of the associations between common nurse staffing practices and the risk of adverse events. It is hoped that our results will assist hospital managers in making the most effective use of the scarce nursing resources and in identifying staffing practices that minimize the occurrence of adverse events.
Collapse
Affiliation(s)
- Christian M Rochefort
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.,Centre de recherche Charles-LeMoyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, Longueuil, QC, Canada.,Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Michal Abrahamowicz
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Alain Biron
- McGill University Health Centre, Montréal, QC, Canada.,Ingram School of Nursing, McGill University, Montréal, QC, Canada
| | - Patricia Bourgault
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.,Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Isabelle Gaboury
- Centre de recherche Charles-LeMoyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, Longueuil, QC, Canada.,Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada.,Département de médecine de famille et de médecine d'urgence, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jeannie Haggerty
- Department of Family Medicine, McGill University, Montreal, QC, Canada.,St. Mary's Research Centre, Montréal, QC, Canada
| | - Jane McCusker
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada.,St. Mary's Research Centre, Montréal, QC, Canada
| |
Collapse
|