1
|
Quiaios L, Krief H, Lamy O, da Rocha CG, Siegle-Authemayou ML, Lang PO. Impact of an early geriatric rehabilitation program in acutely hospitalised vulnerable patients: a real-life study in an ACE unit in Switzerland. Geriatr Psychol Neuropsychiatr Vieil 2023; 21:51-62. [PMID: 37115679 DOI: 10.1684/pnv.2023.1089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
INTRODUCTION Early geriatric rehabilitation programs are potential means to prevent acute hospitalisation-associated functional decline. METHODS The objectives were to measure the impact of an interdisciplinary rehabilitation program on patients' administrative in hospital data and on functional trajectories. With a before-and-after design, we compared all patients admitted from January to August 2018 into the Acute Care for Elders (ACE) unit of an Academic hospital in Switzerland who received this type of program to those admitted during the same period in 2016 and 2017. We considered vulnerable patients aged 75 or older. Functional independency level was assessed at baseline, admission, and discharge according to Katz's basic activities daily living (BADL). RESULTS In total, 378/1,073 patients (mean age 86.6 ± 6.4; 74.6% women; 84% admitted from the emergency department) were prospectively admitted into the ACE unit in 2018. With an adherence rate of 74.0% to functional therapies and compared to the prior years, the program reduced transfers to rehabilitation settings (28.5 vs. 24.3%, p=0.04) and increased direct discharges to home (46.8 vs. 42.4%, p=0.04). Rates of early-unplanned readmission were similar. Between admission to discharge, 89.9% of the patients engaged in the program remained functionally stable or enhanced. Whatever the BADL score at the admission, 46.5% improved their status for at least one BADL. Even though no clinical determinant was identified, patients who engaged ≥ 5 sessions of functional therapy per week were more likely to improve their functional level (OR = 3.05; 95% CI 1.76-5.27). CONCLUSION This real-life study demonstrates arguments to implement early interdisciplinary rehabilitation program in ACE units in particular to prevent functional decline in vulnerable patients. These findings support consideration regarding the interest of switching from the traditional disease-centred approach in acute care for older patients to a modern one, that also put the emphasis on maintaining functional capacities.
Collapse
Affiliation(s)
- Linda Quiaios
- Geriatric Medicine and Geriatric Rehabilitation Division, University Hospital of Lausanne, Lausanne, Switzerland
| | - Hélène Krief
- Geriatric Medicine and Geriatric Rehabilitation Division, University Hospital of Lausanne, Lausanne, Switzerland
| | - Olivier Lamy
- Division of Internal Medicine, Department of Medicine, University Hospital of Lausanne, Lausanne, Switzerland
| | - Carla Gomes da Rocha
- Geriatric Medicine and Geriatric Rehabilitation Division, University Hospital of Lausanne, Lausanne, Switzerland
| | | | | |
Collapse
|
2
|
Ribeiro OMPL, Cardoso MF, de Lima Trindade L, da Rocha CG, Teles PJFC, Pereira S, Coimbra V, Ribeiro MP, Reis A, da Conceição Alves Faria A, da Silva JMAV, Leite P, Barros S, Sousa C. From the first to the fourth critical period of COVID-19: what has changed in nursing practice environments in hospital settings? BMC Nurs 2023; 22:53. [PMID: 36841780 PMCID: PMC9958319 DOI: 10.1186/s12912-023-01207-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 02/14/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic reinforced the need to invest in nursing practice environments and health institutions were led to implement several changes. In this sense, this study aimed to analyze the impact of the changes that occurred in nursing practice environments between the first and fourth critical periods of the pandemic. METHODS Quantitative, observational study, conducted in a University Hospital, with the participation of 713 registered nurses. Data were collected through a questionnaire with sociodemographic and professional characterization and the Scale for the Environments Evaluation of Professional Nursing Practice, applied at two different points in time: from 1 to 30 June 2020 and from 15 August to 15 September 2021. Data were processed using descriptive and inferential statistics. RESULTS Overall, the pandemic had a positive impact on nursing practice environments. However, the Process component remained favourable to quality of care, while the Structure and Outcome components only moderately favourable. Nurses working in Medicine Department services showed lower scores in several dimensions of the Structure, Process and Outcome components. On the other hand, nurses working in areas caring for patients with COVID-19 showed higher scores in several dimensions of the Structure, Process and Outcome components. CONCLUSIONS The pandemic had a positive impact on various dimensions of nursing practice environments, which denotes that regardless of the adversities and moments of crisis that may arise, investment in work environments will have positive repercussions. However, more investment is needed in Medicine Department services, which have historically been characterised by high workloads and structural conditions that make it difficult to promote positive and sustainable workplaces.
Collapse
Affiliation(s)
| | - Maria Filomena Cardoso
- grid.414556.70000 0000 9375 4688Centro Hospitalar Universitário de São João, 4200–319 Porto, Portugal
| | - Letícia de Lima Trindade
- Santa Catarina State University and Regional Community University of Chapecó, Chapecó, Santa Catarina Brazil
| | - Carla Gomes da Rocha
- grid.483301.d0000 0004 0453 2100Institute of Health, School of Health Sciences, HES-SO Valais-Wallis CH, 1950 Sion, Switzerland
| | | | - Soraia Pereira
- North Region Health Administration, 4000-447 Porto, Portugal
| | - Vânia Coimbra
- North Region Health Administration, 4000-447 Porto, Portugal
| | | | - Ana Reis
- grid.414556.70000 0000 9375 4688Centro Hospitalar Universitário de São João, 4200–319 Porto, Portugal
| | | | | | - Paula Leite
- North Region Health Administration, 4000-447 Porto, Portugal
| | - Sónia Barros
- grid.414556.70000 0000 9375 4688Centro Hospitalar Universitário de São João, 4200–319 Porto, Portugal
| | - Clemente Sousa
- grid.410947.f0000 0001 0596 4245Nursing School of Porto (ESEP), CINTESIS@RISE, 4200-072 Porto, Portugal
| |
Collapse
|
3
|
Ribeiro OMPL, Coimbra VMO, Pereira SCDA, Faria ADCA, Teles PJFC, da Rocha CG. Impact of COVID-19 on the Environments of Professional Nursing Practice and Nurses' Job Satisfaction. Int J Environ Res Public Health 2022; 19:16908. [PMID: 36554789 PMCID: PMC9779541 DOI: 10.3390/ijerph192416908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: The repercussions of work environments were widely studied before the pandemic. However, there are still many difficulties to be discovered considering the impact generated by it. Thus, this study aimed to analyse the impact of COVID-19 on nursing practice environments and nurses' job satisfaction. (2) Methods: A correlational study was conducted in a hospital in northern Portugal, with the participation of 416 registered nurses. Data were collected in June 2021 through questionnaires. The study was approved by the Institutional Ethics Committee. (3) Results: COVID-19 had a favourable impact on the structure component of the practice environments; the process component decreased compared to the pre-pandemic period; the outcome component remained moderately favourable to the quality of care. Nurses were not very satisfied or not at all satisfied with their valuation and remuneration; moderately satisfied with the leadership and staffing; and satisfied with the organisation and resources, co-workers and valuation by patients and families. In more favourable environments, nurses' job satisfactions were higher. (4) Conclusions: Identifying the dimensions with the best and worst scores allowed the institution's managers to concentrate efforts on where improvements were needed, thus preparing professional contexts for the recovery of care activities.
Collapse
Affiliation(s)
| | | | | | | | - Paulo João Figueiredo Cabral Teles
- School of Economics, University of Porto, 4200-465 Porto, Portugal
- Laboratory of Artificial Intelligence and Decision Support—INESC Porto LA, 4200-465 Porto, Portugal
| | - Carla Gomes da Rocha
- Institute of Health, School of Health Sciences, HES-SO Valais-Wallis, 1950 Sion, Switzerland
| |
Collapse
|
4
|
Dias MDRJ, Alves Faria ADC, Ferreira MSM, Faleiros F, Novo A, Gonçalves MN, da Rocha CG, Teles PJFC, Ribeiro MP, Ventura da Silva JMA, Ribeiro OMPL. From Health Literacy to Self-Care: Contributions of the Specialist Nurse in Rehabilitation Nursing. IJERPH 2022; 19:ijerph19137767. [PMID: 35805436 PMCID: PMC9265364 DOI: 10.3390/ijerph19137767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 02/05/2023]
Abstract
(1) Background: Initiatives aimed at assessing and intervening in health literacy have the potential to promote adherence to self-care behaviours, which is the main focus of intervention by rehabilitation nurses. Thus, the objectives were to analyse the level of health literacy of working-age citizens and identify priority areas for intervention by rehabilitation nurses. (2) Methods: Quantitative, correlational and cross-sectional study, conducted in a multinational company, with the participation of 161 workers. The data were collected between 14 April and 7 May 2021, using a self-completion questionnaire composed of sociodemographic and clinical characterization and the European Health Literacy Survey, following a favourable opinion from the Ethics Committee and the company’s management. (3) Results: Overall, low to moderate literacy scores were predominant. Age and education were significantly associated with literacy scores. Workers with higher levels of health literacy had no diagnosed illnesses, took less medication, reported less sadness, fewer memory changes and less muscle and joint pain. (4) Conclusions: The fact that higher levels of health literacy trigger self-care behaviours and, consequently, fewer health problems reinforces the need for rehabilitation nurses to invest in this area.
Collapse
Affiliation(s)
| | - Ana da Conceição Alves Faria
- Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal; (A.d.C.A.F.); (J.M.A.V.d.S.)
- North Region Health Administration, 4000-447 Porto, Portugal
| | | | - Fabiana Faleiros
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil;
| | - André Novo
- CINTESIS@RISE, 4200-450 Porto, Portugal;
- Escola Superior de Saúde do Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
| | | | - Carla Gomes da Rocha
- Institute of Health, School of Health Sciences, HES-SO Valais-Wallis, 1950 Sion, Switzerland;
| | | | | | - João Miguel Almeida Ventura da Silva
- Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal; (A.d.C.A.F.); (J.M.A.V.d.S.)
- Medicine Department, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal
| | - Olga Maria Pimenta Lopes Ribeiro
- CINTESIS@RISE, 4200-450 Porto, Portugal;
- Nursing Department, Nursing School of Porto, 4200-072 Porto, Portugal;
- Correspondence: ; Tel.: +351-910050871
| |
Collapse
|
5
|
Ribeiro OMPL, de Lima Trindade L, Fassarella CS, de Abreu Pereira SC, Teles PJFC, da Rocha CG, da Silva Leite PC, Ventura-Silva JMA, Sousa CN. Impact of COVID-19 on professional nursing practice environments and patient safety culture. J Nurs Manag 2022; 30:1105-1114. [PMID: 35411605 PMCID: PMC9115181 DOI: 10.1111/jonm.13617] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/24/2022] [Accepted: 04/04/2022] [Indexed: 11/30/2022]
Abstract
AIM To analyze the impact of COVID-19 on professional nursing practice environments and patient safety culture. BACKGROUND The relationship between work environments and patient safety has been internationally recognized. In 2020, the pandemic imposed enormous challenges, yet the impact on these variables remains unknown. METHOD Quantitative observational study, conducted in a Portuguese hospital, with 403 registered nurses. A self-completion questionnaire was used. RESULTS The impact on the Structure and Outcome components of nursing professional practice environments was positive. Although the Process component remained favorable to quality of care, a negative trend was confirmed in almost all dimensions. The results regarding safety culture showed weaknesses; "teamwork within units" was the only dimension that maintained a positive culture. CONCLUSION Positive responses regarding patient safety were significantly associated with the quality of the nursing professional practice environment. To promoting positive professional environments, the need to invest in all dimensions of safety culture emerges. IMPLICATIONS FOR NURSING MANAGEMENT Improving professional nursing practice environments can be achieved through managers' investment in the participation and involvement of nurses in the policies and functioning of institutions, as well as promoting an open, fair, and participatory safety culture that encourages reporting events and provides adequate support for professionals.
Collapse
Affiliation(s)
- Olga Maria Pimenta Lopes Ribeiro
- PhD, Nursing School of Porto and Center for Health Technology and Services Research Faculty of Medicine, Porto University, Porto, Portugal
| | - Letícia de Lima Trindade
- PhD, Santa Catarina State University and Regional Community University of Chapecó, Chapecó-Santa Catarina, Brasil
| | | | | | | | - Carla Gomes da Rocha
- PhD Student, Institute of Health - School of Health Sciences, HES-SO Valais-Wallis, Sion, Switzerland
| | | | | | - Clemente Neves Sousa
- PhD, Nursing School of Porto and Center for Health Technology and Services Research Faculty of Medicine, Porto University, Porto, Portugal
| |
Collapse
|
6
|
da Rocha CG, Perrenoud B, Ramelet AS. Perceptions of Burden and Preparedness for Caregiving among the Family Caregivers of Hospitalised Older Adults: A Cross-Sectional Study. Geriatrics (Basel) 2022; 7:19. [PMID: 35200524 PMCID: PMC8872519 DOI: 10.3390/geriatrics7010019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/08/2022] [Accepted: 02/14/2022] [Indexed: 12/10/2022] Open
Abstract
BACKGROUND Due to the increasing care needs of older adults, family caregivers are more and more solicited. This can have a negative impact on their quality of life related to a lack of preparedness for caregiving and feelings of burden. OBJECTIVES To measure perceptions of burden and preparedness for caregiving among the family caregivers of hospitalised older adults, and to explore their possible associations. METHODS A cross-sectional study conducted in two university hospital geriatrics wards in Switzerland. Principal family caregivers of hospitalised older adults were invited to complete sociodemographic, the Zarit Burden Interview, and the Preparedness for Caregiving Scale questionnaires. Descriptive and correlational data analyses were performed. RESULTS Of the 38 responding caregivers, 80% provided informal care to their spouse or parent; 45% reported a lack of preparedness to provide care and 61% reported substantial levels of burden. There was no statistically significant correlation between preparedness and burden (ρ ≤ -0.30, p = 0.07). CONCLUSIONS A significant proportion of caregivers reported burden and a lack of preparedness. Healthcare professionals should provide adequate support to help informal caregivers to fulfil their roles.
Collapse
Affiliation(s)
- Carla Gomes da Rocha
- Acute Geriatric Care Unit, Lausanne University Hospital, Avenue Pierre Decker 5, CH-1011 Lausanne, Switzerland
| | - Béatrice Perrenoud
- Nursing Directorate, Lausanne University Hospital, Rue du Bugnon 21, CH-1011 Lausanne, Switzerland;
- La Source Institute and School of Nursing, University of Applied Sciences and Arts Western Switzerland, Avenue Vinet 30, CH-1004 Lausanne, Switzerland
| | - Anne-Sylvie Ramelet
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Biopôle 2, Route de la Corniche 10, CH-1010 Lausanne, Switzerland;
| |
Collapse
|
7
|
Lopes Ribeiro OMP, Trindade LDL, Pinto Novo AFM, da Rocha CG, Sousa CN, Cabral Teles PJF, Reis ACRDS, Perondi AR, Andrigue KCK, Pereira SCDA, Leite PCDS, Ventura-Silva JMA. The COVID-19 Pandemic and Professional Nursing Practice in the Context of Hospitals. Healthcare (Basel) 2022; 10:326. [PMID: 35206940 PMCID: PMC8872092 DOI: 10.3390/healthcare10020326] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 pandemic has imposed challenges to health systems and institutions, which had to quickly create conditions to meet the growing health needs of the population. Thus, this study aimed to assess the impact of COVID-19 on professional nursing practice environments and to identify the variables that affected their quality. Quantitative, observational study, conducted in 16 Portuguese hospitals, with 1575 nurses. Data were collected using a questionnaire and participants responded to two different moments in time: the pre-pandemic period and after the fourth critical period of COVID-19. The pandemic had a positive impact on the Structure and Outcome components, and a negative trend in the Process component. The variables associated with the qualification of the components and their dimensions were predominantly: work context, the exercise of functions in areas of assistance to COVID-19 patients, length of professional experience and length of experience in the service. The investment in professional practice environments impacted the improvement of organizational factors, supporting the development of nurses' work towards the quality of care. However, it is necessary to invest in nurses' participation, involvement and professional qualifications, which are aspects strongly dependent on the institutions' management strategies.
Collapse
Affiliation(s)
| | | | | | - Carla Gomes da Rocha
- Institute of Health, School of Health Sciences, HES-SO Valais-Wallis, CH-1950 Sion, Switzerland;
| | - Clemente Neves Sousa
- Nursing School of Porto, Center for Health Technology and Services Research, 4200-072 Porto, Portugal;
| | | | | | | | | | - Soraia Cristina de Abreu Pereira
- ACES Entre Douro e Vouga I–Feira/Arouca, North Region Health Administration, 4000-447 Porto, Portugal; (S.C.d.A.P.); (P.C.d.S.L.)
| | - Paula Cristina da Silva Leite
- ACES Entre Douro e Vouga I–Feira/Arouca, North Region Health Administration, 4000-447 Porto, Portugal; (S.C.d.A.P.); (P.C.d.S.L.)
| | | |
Collapse
|
8
|
Gomes da Rocha C, von Gunten A, Jopp D, Ribeiro O, Verloo H. Why Centenarians' Depressive Symptoms Must Become a Priority for Nurses. J Am Med Dir Assoc 2021; 22:1118-1119. [PMID: 33689690 DOI: 10.1016/j.jamda.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Carla Gomes da Rocha
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal; School of Health Sciences, HES-SO Valais-Wallis, Sion, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Daniela Jopp
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Swiss National Centre of Competence in Research LIVES, University of Lausanne, Lausanne, Switzerland
| | - Olga Ribeiro
- Nursing School of Porto, Porto, Portugal; Center for Health Technology and Services Research, Porto, Portugal
| | - Henk Verloo
- School of Health Sciences, HES-SO Valais-Wallis, Sion, Switzerland; Service of Old Age Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| |
Collapse
|