World views on shortage in nursing resource: Challenges and opportunities.

BACKGROUND: Shortage in nursing resource results from the combination of a lack of nurses, an increased patient volume and workload, and other factors. This seems to be a worldwide phenomenon, leading to multiple health care related challenges and a decreased quality of care, but is different in extent in high- vs. low-income countries. An international perspective can alleviate challenges to keep our patients safe through increasing our health workers' safety. PURPOSE & METHOD: To exchange experiences with the shortage in nursing resource globally, an international online conference event was hosted. Speakers from Germany, the Philippines, Poland, Tanzania, the United Kingdom and the United States presented their national challenges and strategies to deal with this phenomenon. RESULTS: Conference presentations included information about the health care systems, comparable numbers of hospital beds, nurses, and nursing education. Speakers reported challenges such as an imbalance between a high nurse vacancy rate and demands, but also war and refugees, high human immunodeficiency virus (HIV) and other infection rates, or nurses' migration to other countries; the solutions reported included buy-in from other countries, nurses-attracting projects such as Magnet hospitals, improved job opportunities like higher wages, career prospects, or improved education, and others. CONCLUSIONS: Shortage in nursing resource seems to be a global phenomenon. Nursing managers and researchers should exchange and communicate challenges and solutions continuously and cooperate globally.

Job demands at the patient's bedside and their effects on stress and satisfaction of nurses.

AIM: The study aimed to assess job demands at the patient's bedside and to evaluate the contribution of this central workplace to the stress and satisfaction of nurses. DESIGN: In this cross-sectional survey study, a questionnaire was compiled and all registered nurses from intensive, general and intermediate care wards at a large German hospital were invited to participate. METHODS: The questionnaire used a list of care activities to assess nurses' workload at the patient's bed. The German Copenhagen Psychosocial Questionnaire and an adapted version of the German Perceived Stress Scale were used to measure nurses' stress and burn-out, and single items to assess health status, organisational commitment, job satisfaction, and satisfaction with the quality of care. The questionnaire was returned by 389 nurses. RESULTS: Expected correlations of workload at the patient's bed with stress, burn-out and satisfaction of the nurses were shown. A moderating effect of organisational commitment was non-existent but was shown for the self-assessed health on the correlation between workload and satisfaction with the quality of care. Organisational commitment correlated negatively with stress and burn-out and positively with satisfaction. The study provides evidence that rates of burn-out and stress do not differ based on the work area of nurses. Because job demands at the patient's bed correlated with all outcomes, measures to improve this specific workspace are sensible.

[Inter-Professional Communication Between Nursing Therapists and other Therapeutic Professions (Physio-, Occupation and Speech Therapy) in Neurological Early Rehabilitation]. / Interprofessionelle Kommunikation zwischen therapeutisch Pflegenden und anderen therapeutischen Berufsangehörigen (Physiotherapie, Ergotherapie und Logopädie) in der neurologischen Frührehabilitation.

PURPOSE: A comparison of inter-professional communication within the core therapeutic teams including nurses in 5 neurological early rehabilitation hospitals of one non-profit organization was supposed to indicate factors facilitating and impairing cooperation. METHODS: Data collection was conducted through analysis of architecture plans, passive participating observation in 10 wards and through partly standardized interviews (N=39). Participants were nurses, physio-, occupational and speech therapists. Data analysis used the method of Thick Description [1]. RESULTS: A permanent team, daily team conferences, treatments in cooperation, ward based training and informal talks influence interprofessional communication. Organizational and structural preconditions have effects on the quality of communication. CONCLUSION: Daily inter-professional briefings and the organization of training sessions within the team improve inter-professional communication, a confrontation nurses vs. therapists impairs it.

Inter-professional communication and interaction in the neurological rehabilitation team: a literature review.

Background: Neurological early rehabilitation aims at regaining cooperativity and acquiring rehabilitation capability with brain-injured patients, most of whom are transferred from Intensive Care Units, most of whom still require intensive care and suffer from disorders of consciousness. In neurological early rehabilitation, therapeutic nursing is an integral part of the therapeutic team. Other than the specialized therapists, nurses are present on the ward 24/7, which gives them a closer perspective on the patient. The research question was how do nurses, physiotherapists, occupational therapists and speech therapists communicate and interact as teams in neurological rehabilitation wards. A literature review was conducted aiming at inter-professional communication and interaction with special regard to the role of these four professionals being the core team members in these settings.Methods: A literature search was conducted in the period from August to October 2016 within the following electronic Databases: Medline, CINAHL, PSYNDEX, SpeechBITE, PEDro und OTseeker. Further searches were undertaken in the reference lists of obtained studies to locate other relevant material. The aim was to gather and evaluate the evidence about inter-professional teamwork in neurological early rehabilitation. The main inclusion criterion was the presence of the following professionals as participants in the study: Nurses, physiotherapists, occupational therapists and speech therapists. Twenty-seven studies were found relevant, of which 17 (12 qualitative and five quantitative) bore empirical results that related to the research questions. These 17 studies were qualitatively analysed for the grade of evidence, methods and the relevance for the conditions and processes in rehabilitation units. Out of 17 studies, four were performed in neurological rehabilitation settings, five in stroke units, six in general rehabilitation, one in short-term care rehabilitation and one in geriatric rehabilitation. Due to the scarcity of material, all these studies were analysed under the perspective of relevance for neurological early rehabilitation.Results: The results of this exploratory literature review indicate that the efficiency and quality of cooperation in rehabilitation teams could be improved through a better patient-oriented inter-professional communication. This is achieved through cross-professional team organization, team supervision and by including team communication in vocational and on-the-job-training. Profession-specific terminologies and differences in understanding of roles could be barriers for collaboration in teams.Conclusions: According to this literature review, successful inter-professional patient-orientated care is promoted by being informed about the various functions of team members from different disciplines, about the role each member plays within the team and communication styles. Means of improving communication are being outlined.Implications for RehabilitationInter-professional communication is promoted by cross-professional team organization.Inter-professional communication should be included in vocational and on-the-job-training and supervision.Barriers for communication in teams are different terminologies and differences in role perception.