RESUMO
Workplace bullying affects workers' lives, causing several mental and physical health problems and job-related issues. Therefore, a summary of the evidence on the consequences of workplace bullying on workers' lives is essential to improve working conditions. The literature lacks systematic reviews and meta-analyses on the association between workplace bullying and job stress and the professional quality of life of nurses. Thus, we aimed to quantitatively summarize the data on the association between workplace bullying, job stress, and professional quality of life. We performed our study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The review protocol was registered with PROSPERO (CRD42024495948). We searched PubMed, Medline, Scopus, Cinahl, and Web of Science up to 4 January 2024. We calculated pooled correlation coefficients and 95% confidence intervals [CI]. We identified nine studies with a total of 3730 nurses. We found a moderate positive correlation between workplace bullying and job stress (pooled correlation coefficient = 0.34, 95% CI = 0.29 to 0.39). Moreover, a small negative correlation between workplace bullying and compassion satisfaction (pooled correlation coefficient = -0.28, 95% CI = -0.41 to -0.15) was identified. Additionally, our findings suggested a moderate positive correlation between workplace bullying and job burnout (pooled correlation coefficient = 0.43, 95% CI = 0.32 to 0.53) and secondary traumatic stress (pooled correlation coefficient = 0.36, 95% CI = 0.11 to 0.57). Our findings can help nursing managers and policy-makers to draw attention to workplace bullying by implementing effective interventions, so as to reduce the bullying of nurses.
RESUMO
Ventilator-associated pneumonia (VAP) remains a common risk in mechanically ventilated patients. Different care bundles have been proposed to succeed VAP reduction. We aimed to identify the combined interventions that have been used to by ICUs worldwide from the implementation of "Institute for Healthcare Improvement Ventilator Bundle", i.e., from December 2004. A search was performed on the PubMed, Scopus and Science Direct databases. Finally, 38 studies met our inclusion criteria. The most common interventions monitored in the care bundles were sedation and weaning protocols, semi-recumbent positioning, oral and hand hygiene, peptic ulcer disease and deep venus thrombosis prophylaxis, subglottic suctioning, and cuff pressure control. Head-of-bed elevation was implemented by almost all studies, followed by oral hygiene, which was the second extensively used intervention. Four studies indicated a low VAP reduction, while 22 studies found an over 36% VAP decline, and in ten of them, the decrease was over 65%. Four of these studies indicated zero or nearly zero after intervention VAP rates. The studies with the highest VAP reduction adopted the "IHI Ventilator Bundle" combined with adequate endotracheal tube cuff pressure and subglottic suctioning. Multifaced techniques can lead to VAP reduction at a great extent. Multidisciplinary measures combined with long-lasting education programs and measurement of bundle's compliance should be the gold standard combination.
RESUMO
OBJECTIVES: To review the studies, which calculated the total intensive care unit costs and indicated the main cost drivers in the intensive care by using either top-down, bottom-up approach or the combination of them. RESEARCH METHODOLOGY/DESIGNS: A systematic review of papers published until October 2020 was conducted. Search was performed on PubMed, Medline, Scopus and Science Direct databases. SETTING: This review i examined costs in adult intensive care units, in countries belonging to the Organisation for Economic Co-operation and Development (OECD) (medical, surgical or general adult , paediatric and neonatal were not included). MAIN OUTCOME MEASURES: Eighteen articles were included in the review. RESULTS: Eight of the studies used the top-down costing methodology, six of them used the bottom-up approach and four of them used both of them. The mean total patient cost per day ranged from 200.75 to 4321.91 (all costs are presented in 2020 values for euro). Human resources were identified as the largest proportion of total costs. Length of stay, mechanical ventilation, continuous haemodialysis and severe illness are the main cost drivers of intensive care unit total costs. CONCLUSION: There are a variety of methods and study designs used to calculate costs of an intensive care unit stay.t It is necessary to evolve standardised costing methods in order to make comparisons and succeed in cost-effective management.
