To understand how to create a stabile workforce achieving excellent quality of care and patient safety, associations between practice environments and nurse and patient outcomes have been widely studied in acute and p...To understand how to create a stabile workforce achieving excellent quality of care and patient safety, associations between practice environments and nurse and patient outcomes have been widely studied in acute and psychiatric care hospitals. Knowing residential aged care services are challenged to tackle complex patients’ needs within certain working conditions, to what extent do nurses perceive their practice environment in geriatric care? In a cross-sectional survey, a sample of 709 registered nurses, licensed practical nurses and nurse aides employed in 25 residential aged care services completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality and patient adverse events. Associations between variables across residential aged care services were examined using multilevel modelling techniques. Associations were identified between practice environment factors, work characteristics, burnout dimensions, and reported outcome variables across residential aged care services. Multiple multilevel models showed independent variables (nursing management at the unit level, workload, decision latitude, social capital, emotional exhaustion and depersonalization) as important predictors of nurse reported outcome (job satisfaction, turnover intensions), quality of care (at the unit, the last shift, and in the service within the last year) and patient adverse events (patient and family complaints, patient falls, pulmonary and urinary tract infections, and medications errors). Results suggested the importance of nurse practice environment factors, nurse work characteristics and perception of burnout on nurse and patient outcomes across their nurse practice environment. Challenging the complex care of a vulnerable and frail population executives, physicians, nursing leaders as well as nurses in their nurse practice environment shared responsibility to create working conditions achieving excellent quality and patient safety.展开更多
目的探讨质控前移应用于呼吸与危重症医学科(Respiratory and Critical Care Medicine,RCCM)管理中的效果分析。方法选取2021年12月—2023年12月永州市中心医院呼吸与危重症医学科的30名护理人员为研究对象,根据不同的质控方法分为两组...目的探讨质控前移应用于呼吸与危重症医学科(Respiratory and Critical Care Medicine,RCCM)管理中的效果分析。方法选取2021年12月—2023年12月永州市中心医院呼吸与危重症医学科的30名护理人员为研究对象,根据不同的质控方法分为两组,两组为同一批护理人员。2021年12月—2022年12月进行常规质控,为对照组;2023年1—12月进行质控前移,为研究组。比较两组护理文书质量评分、护理考核指标(基础护理评分、急救物品管理评分、消毒隔离管理评分)、职业倦怠量表(成就感降低、去个体化、情绪消化)评分。结果研究组护理文书质量评分高于对照组,差异有统计学意义(P<0.05)。研究组基础护理评分、急救物品管理评分、消毒隔离管理评分均高于对照组,差异有统计学意义(P均<0.05)。研究组成就感降低评分、去个体化评分、情绪消化评分均低于对照组,差异有统计学意义(P均<0.05)。结论质控前移能够提高RCCM护理人员的护理文书的书写质量,改善对基础护理、急救物品和消毒隔离的管理,且降低护理人员的职业倦怠感。展开更多
文摘To understand how to create a stabile workforce achieving excellent quality of care and patient safety, associations between practice environments and nurse and patient outcomes have been widely studied in acute and psychiatric care hospitals. Knowing residential aged care services are challenged to tackle complex patients’ needs within certain working conditions, to what extent do nurses perceive their practice environment in geriatric care? In a cross-sectional survey, a sample of 709 registered nurses, licensed practical nurses and nurse aides employed in 25 residential aged care services completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality and patient adverse events. Associations between variables across residential aged care services were examined using multilevel modelling techniques. Associations were identified between practice environment factors, work characteristics, burnout dimensions, and reported outcome variables across residential aged care services. Multiple multilevel models showed independent variables (nursing management at the unit level, workload, decision latitude, social capital, emotional exhaustion and depersonalization) as important predictors of nurse reported outcome (job satisfaction, turnover intensions), quality of care (at the unit, the last shift, and in the service within the last year) and patient adverse events (patient and family complaints, patient falls, pulmonary and urinary tract infections, and medications errors). Results suggested the importance of nurse practice environment factors, nurse work characteristics and perception of burnout on nurse and patient outcomes across their nurse practice environment. Challenging the complex care of a vulnerable and frail population executives, physicians, nursing leaders as well as nurses in their nurse practice environment shared responsibility to create working conditions achieving excellent quality and patient safety.
文摘目的探讨质控前移应用于呼吸与危重症医学科(Respiratory and Critical Care Medicine,RCCM)管理中的效果分析。方法选取2021年12月—2023年12月永州市中心医院呼吸与危重症医学科的30名护理人员为研究对象,根据不同的质控方法分为两组,两组为同一批护理人员。2021年12月—2022年12月进行常规质控,为对照组;2023年1—12月进行质控前移,为研究组。比较两组护理文书质量评分、护理考核指标(基础护理评分、急救物品管理评分、消毒隔离管理评分)、职业倦怠量表(成就感降低、去个体化、情绪消化)评分。结果研究组护理文书质量评分高于对照组,差异有统计学意义(P<0.05)。研究组基础护理评分、急救物品管理评分、消毒隔离管理评分均高于对照组,差异有统计学意义(P均<0.05)。研究组成就感降低评分、去个体化评分、情绪消化评分均低于对照组,差异有统计学意义(P均<0.05)。结论质控前移能够提高RCCM护理人员的护理文书的书写质量,改善对基础护理、急救物品和消毒隔离的管理,且降低护理人员的职业倦怠感。
