Subject(s)
COVID-19 Nucleic Acid Testing/methods , COVID-19/diagnosis , Lung/diagnostic imaging , Radiology Information Systems/statistics & numerical data , Tomography, X-Ray Computed/methods , Aged , COVID-19/diagnostic imaging , Emergency Service, Hospital , Female , Humans , Male , Middle Aged , Retrospective Studies , Risk Assessment , Tomography, X-Ray Computed/statistics & numerical dataABSTRACT
The International Association of Gerontology and Geriatrics held its first conference on nursing home research in St Louis, MO, in November 2013. This article provides a summary of the presentations.
Subject(s)
Geriatrics , Health Services Research/trends , Nursing Homes , Cognitive Behavioral Therapy , Drug Therapy , Health Education , Home Care Services , Nursing Homes/standards , Patient Education as Topic , Quality Assurance, Health Care/methods , Quality Improvement/organization & administration , Quality of Life , Societies, Medical , Staff DevelopmentABSTRACT
QUESTIONS UNDER STUDY: Measuring the patient safety climate in the organisation of healthcare can help to identify problematic issues with a view to improving patient safety. We aimed (1) to describe the nurse-reported engagement in safety behaviours, (2) to describe the prevailing nurse-reported patient safety climate of general medical, surgical and mixed medical-surgical units in Swiss acute-care hospitals and (3) to explore differences between hospital type, unit type and language regions. METHODS: This substudy utilised data from the nurse survey (N = 1,633) of the multicentre-cross sectional RN4CAST study. Patient safety climate was measured with the 9-item Safety Organizing Scale (SOS) which captured registered nurses' engagement in safety behaviours and practices at the unit level. RESULTS: A total of 35 Swiss hospitals participated in the study. Of the 120 eligible units included in the analysis, only on 33 units (27.5%) did at least 60% of the nurses report a positive patient safety climate. A majority of nurses (51.2-63.4%, n = 1,564) reported that they were "consistently engaged" in only three of the nine measured patient safety behaviours. Our multilevel regression analyses revealed both significant between-unit and between-hospital variability. From our three variables of interest (hospital type, unit type and language regions) only language regions was consistently related to nurse-reported patient safety climate. Nurses in the German-speaking region reported a more positive patient safety climate than nurses in the French- and Italian-speaking language regions. CONCLUSIONS: The findings of this study suggest a need to improve the patient safety climate on many units in Swiss hospitals. Leaders in hospitals should strengthen the patient safety climate at unit level by implementing methods, such as root cause analysis or patient safety leadership walk rounds, to improve individual and team skills and redesign work processes. The impact of these efforts should be measured by periodically assessing the patient safety climate with the SOS.
Subject(s)
Attitude of Health Personnel , Hospital Administrators/psychology , Leadership , Nursing Staff, Hospital/standards , Outcome Assessment, Health Care/methods , Patient Safety/standards , Safety Management/methods , Adult , Cross-Sectional Studies , Female , Humans , Interprofessional Relations , Male , Nursing Staff, Hospital/psychology , Organizational Culture , Retrospective Studies , Surveys and Questionnaires , Switzerland , Young AdultABSTRACT
BACKGROUND: Magnet hospitals share nurse work environment characteristics associated with superior patient, nurse and financial outcomes. In Switzerland, however, it is uncertain how nurses appraise their work environments. OBJECTIVES: To describe the quality of the nurse work environment in 35 Swiss acute care hospitals and to benchmark findings based on international Magnet hospital research. METHOD: This study used two data sources: (1) the Swiss arm of the RN4CAST study; and (2) a structured literature review. Hospitals were categorised based on Magnet and non-Magnet data. Our outcome variable of interest was the quality of nurse work environment measured with the Practice Environment Scale of the Nurse Work Index (PES-NWI). RESULTS: We reviewed 13 American, Canadian, and Australian studies of acute-care hospitals. Three provided Magnet hospitals' nurse work environment data, and all included non-Magnet hospitals' data. Swiss hospitals' evaluations on nurse work environment quality varied widely, but 25% achieved scores indicating "Magnet nurse work environments". Swiss hospitals' average "Nursing manager ability" subscale scores fulfilled Magnet hospital criteria, although "Nurse participation in hospital affairs" and "Nursing staffing and resource adequacy" scores neared non-Magnet levels. CONCLUSION: On average, our results indicated high quality nurse work environments in Swiss hospitals. Implementing Magnet model organisational principles might be a valuable approach for Swiss acute-care hospitals to both improve mixed and unfavourable nurse work environments and to improve nurse and patient outcomes. National benchmarking of nurse work environments and other nurse-sensitive indicators may facilitate evaluating the impact of current developments in Swiss healthcare.
