RESUMO
BACKGROUND: Clinicians are encouraged to use the Centers for Medicare & Medicaid Services early management bundle for severe sepsis and septic shock (SEP-1); however, it is unclear whether this process measure improves patient outcomes. PURPOSE: The purpose of this study was to evaluate whether compliance with the SEP-1 bundle is a predictor of hospital mortality, length of stay (LOS), and intensive care unit LOS at a suburban community hospital. METHODS: A retrospective observational study was conducted. RESULTS: A total of 577 patients were included in the analysis. Compliance with the SEP-1 bundle was not a significant predictor for patient outcomes. CONCLUSIONS: SEP-1 compliance may not equate with quality of health care. Efforts to comply with SEP-1 may help organizations develop systems and structures that improve patient outcomes. Health care leaders should evaluate strategies beyond SEP-1 compliance to ensure continuous improvement of outcomes for patients experiencing sepsis.
Assuntos
Fidelidade a Diretrizes , Mortalidade Hospitalar , Hospitais Comunitários , Unidades de Terapia Intensiva , Tempo de Internação , Pacotes de Assistência ao Paciente , Sepse , Humanos , Estudos Retrospectivos , Masculino , Feminino , Pacotes de Assistência ao Paciente/normas , Tempo de Internação/estatística & dados numéricos , Idoso , Pessoa de Meia-Idade , Estados UnidosRESUMO
OBJECTIVES: Study objectives were to explore nurses' perceptions of self-care, co-worker, and leader caring within healthcare work environments and assess reliability of 3 Watson Caritas Scores. BACKGROUND: Assessing caring in an organization where Watson's Theory of Human Caring guides nursing practice offers insight into the professional practice environment. METHOD: This study reports quantitative data from mixed-methods descriptive, cross-sectional survey of 1307 RNs at a large healthcare system. RESULTS: Mean scores were self = 5.46, co-worker = 5.39, and leader score = 5.53, and median scores were >5.6 (range, 1-7). All scales had a positive and significant correlation to likelihood to recommend the organization, with the largest being feeling cared for by leaders. Internal reliability of the 3 scales was ≥0.9. CONCLUSION: Nurse perceptions of caring may influence the organization's reputation. Assessing the perception of caring among nursing staff after the introduction and enculturation of this framework is needed. Results support psychometric value for 3 Watson Caritas Scores.
Assuntos
Enfermeiras e Enfermeiros , Recursos Humanos de Enfermagem , Humanos , Estudos Transversais , Reprodutibilidade dos Testes , Relações Enfermeiro-PacienteRESUMO
The care of the pediatric patient with a severe traumatic brain injury (TBI) is an all-encompassing nursing challenge. Nursing vigilance is required to maintain a physiological balance that protects the injured brain. From the time a child and family first enter the hospital, they are met with the risk of potential death and an uncertain future. The family is subjected to an influx of complex medical and nursing terminology and interventions. Nurses need to understand the complexities of TBI and the modalities of treatment, as well as provide patients and families with support throughout all phases of care.
