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Swart, Reecë Pearl. "The relationship between nurses educational background and the safety and quality of patient care in surgical units in private hospitals in Gauteng / Reecë Pearl Swart." Thesis, North-West University, 2012. http://hdl.handle.net/10394/9215.
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Background: International literature seems to agree that nurses are the backbone of quality patient care and safety. Moreover, the appropriate training of nurses is vital to providing high quality and safe patient care. South Africa has a dual healthcare system and different categories of nurses. The perceptions of the safety and quality of care of the different categories of nurses are not known in the South African context.
Objective: To determine the relationship between the educational background of nurses and their perceptions on the safety and quality of patient care in private surgical units in South Africa.
Methods: This study followed a comparative descriptive design. Data was collected by means of a questionnaire as part of an international collaborative study, Nurse Forecasting in Europe (RN4CAST). Hierarchical linear modelling was used to examine the relationships among the variables in the 304 completed and returned questionnaires.
Results: Overall, both registered- and enrolled nurses seemed satisfied with the safety and quality of care delivered in their units. Registered nurses (RNs) scored higher in the occurrence of incidents in surgical wards, whilst enrolled nurses (ENs) were of the opinion that current efforts to prevent errors are adequate.
Conclusions: This study provides information that RN’s and EN’s have different perceptions in some areas on the quality and safety of patient care. A statistically significant difference was found between RN’s and EN’s perceptions on the prevention of errors in the unit, namely, losing patient information between shifts and patient incidents related to medication errors, pressure ulcers and falls with injury.Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.
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Mereigh-Frederick, Florianne. "Nursing Faculty's Integration of Quality and Safety Competencies as a Curricular Framework." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5378.
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The call to better prepare nurses in safety and quality performance resulted from the concern of the Institute of Medicine regarding egregious gaps and errors in U.S. hospitals that resulted in serious injuries and patient deaths. Quality and safety education for nursing (QSEN) competencies were set forth in 2005 to enhance nursing curricula and nursing students' preparation for practice; however, QSEN's integration and implementation have been gradual and inconsistent. This qualitative interpretive study was guided by Senge's principles of the learning organization and Benner's professional development model. Using face-to-face interviews, the perspectives of 9 full-time nursing faculty members at 2 private nursing colleges in the Northeast United States were obtained about QSEN integration into their curriculum. Data analysis employed the use of open in vivo coding, categorizing, and the formation of themes. The results indicated that QSEN integration was perceived as complex and daunting due to faculty's limited knowledge about QSEN, lack of adequate preparation to develop and employ instructional strategies, lack of adequate time to teach, and limited learning opportunities at clinical sites to develop competencies such as teamwork and collaboration and informatics. Meaningful reform in nursing education may occur as leaders engage faculty members in meaningful dialogue to better understand the complexity and challenges of QSEN integration, including faculty members' needs for successful implementation. Nursing students may then be better trained to understand the nature and consequences of human and system errors and appreciate higher standards of care that will result in a decrease in preventable injuries, medication errors, and patient deaths.
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Shanks, Staci. "Wright's Competency Model and Quality and Safety Competencies." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6667.
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Competent nurses are instrumental in assuring that a patient receives safe patient care of the highest quality. Patient care that lacks quality places patients at risk of poor health outcomes and results in negative financial impacts for the organization. The purpose of this staff education project was to develop nurse competency education for a facility's competency program, which merged the Wright competency model with quality and safety education for nurses' competencies. The nurse competency staff education program was evaluated by the organization's stakeholders for inclusion in the competency program. The whole-part-whole model, Knowles's adult learning theory, and Lewin's change theory were used to guide this project. Pre- and posttest data were collected from 16 organization stakeholders, including nurse managers, directors, clinical nurse specialists, nursing professional development specialists, and preceptors, who participated in an in-person education session. Data were analyzed by calculating the mean test scores and calculating the percent change. Results indicated a 32% increase in knowledge from pre- to posttest. Findings supported implementation through the nursing departments and may furthermore support implementation across other healthcare disciplines within the organization. The project promoted social change by developing and providing education to improve nurses' knowledge regarding competent practice, ensuring safe and high quality nursing practice and supporting improved patient outcomes.
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Fisher, Melanie. "An exploration into student nurses' perception of patient safety and experience of raising concerns." Thesis, Northumbria University, 2017. http://nrl.northumbria.ac.uk/36280/.
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Background: Patient safety is of paramount importance in healthcare delivery. Following the inquiry into the Mid Staffordshire Health Trust (Francis 2013, 2015), there has been an increasing demand for nurses and other healthcare professionals to be open and candid in a transparent culture where harm and error are minimised. Despite this drive for openness, there is evidence that health care professionals remain reluctant to raise concerns and this includes student nurses as well as registrants. There is however paucity in research focusing upon the underlying factors which prevent student nurses from raising concerns about suboptimal practice. In an attempt to contribute to the discussion, this study will focus upon student nurses. Aim: The overall aim of this research is to understand student nurses’ perception of what they believe is a patient safety incident in their practice placements and understand the reasons that influence their willingness or reluctance to raise concerns about patient safety. Findings: Four main themes emerged from analysing the data: the context of patient safety; team culture; hierarchy and fear of retribution. Analysis and discussion of the data revealed that students were driven to raise concerns as they possessed strong moral and ethical beliefs to uphold patient safety. However, they had an overwhelming desire to fit in with their clinical colleagues and feared retribution and failure if they voiced concerns regarding care. This demonstrated that student nurses were subject to a fluctuating moral compass which was determined by psychological and sociological determinants. Conclusion: This research study has provided information which contributes to our understanding of student nurses’ beliefs about patient safety. It also helps us to recognise the factors that influence student nurses’ willingness or reluctance to speak up. This is important because with an increased understanding of their experiences and beliefs, we are better informed to broaden our teaching on this topic and develop effective policies to protect student nurses who raise concerns.
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Moore, Sheila Marjean. "Impact of Simulation Training on Novice Nurses." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3114.
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In 1999, the Institute of Medicine released its report on building a safer health system. Since then, safety in patient care has become a paramount interest. Given the growing support for increasing patient safety, simulation training has become a common part of novice nurses' orientation program. This simulation training is designed to mimic situations in the acute care setting where novice nurses can practice in a patient safe environment. In this DNP project, a stroke simulation scenario and supporting patient chart was developed as an addition to a novice nurses' orientation program. The National League for Nursing simulation template was used to ensure successful incorporation of the League's standards and evidence-based practices. Five local experts were chosen to review the developed stroke simulation and corresponding patient chart. After reviewing, the experts were given a Likert-types evaluation survey to complete. The results of these surveys revealed that all experts strongly agreed that the simulation scenario was easy to follow and that the simulation patient chart provided the supporting information needed for the scenario. All experts strongly agreed that the simulation scenario would be easy to incorporate into the existing simulation programs and that the simulation scenario would enhance the critical thinking and decision making of the novice nurse. Lastly, all five of the participants strongly agreed the simulation scenario would increase patient safety when novice nurses are faced with similar situations in the acute care setting. The products of this project have been made available to the local healthcare facility for incorporation into its existing orientation program for novice nurses. The purpose of developing this simulation training is to improve the novice nurse ability and confidence to make a positive social change.
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Ray, Dr Tiney Elizabeth. "Education Program for Nurses Working in an Immigration Detention Facility." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3000.
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Nursing response to medical emergencies has been an ongoing issue in immigration detention centers. Lack of teamwork and poor communication with medical and security staff have resulted in detainees sustaining injuries during medical emergencies. This project was developed to persuade Immigration and Customs Enforcement Health Service Corps (IHSC) leaders to consider piloting the TeamSTEPPS emergency response curriculum for nurses working in the immigration detention center. Tuckman and Jensen's model of group development will provide guidance to IHSC leaders in understanding the transformational stages of forming a successful team. TeamSTEPPS will address gaps in emergency health care competency by improving collaboration, communication, and detainee outcomes. Evaluation questionnaires will be offered after each training module and several months after the conclusion of the program. Questionnaires will be distributed, analyzed, and interpreted by IHSC leadership or their designee. Implementation of the Team STEPPS curriculum may result in increased staff morale, decreased staff turnover, and improved detainee outcomes.
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Gant, April. "Educating Nurses About Spirituality's Effects on Quality of Life With Chronic Illness." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2151.
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Spirituality has been associated with wholeness, inner peace, and key elements of well-being or quality of life. Spirituality support is particularly important for patients with chronic illness and patients who view spirituality as a way of coping with suffering. Evidence-based education is lacking in schools of nursing and in places of nursing employment on spirituality interventions that nurses can use to improve patient quality of life. The purpose of this project was to determine whether an educational intervention would increase knowledge of spiritual care in a small sample of clinic nurses (n = 37). This project used Watson's caring theory, which is an explanatory, middle-range theory focused on human caring. Watson's caring theory supports the relationship between spirituality and quality of life in patients with a chronic illness. Staff nurses completed the Spirituality Care Competence Scale as a pretest evaluation of spirituality knowledge. Spirituality training, which included evidence-based handouts, articles, and assessments, was followed by a second completion of the Spirituality Care Competence Scale as a posttest evaluation of the training effectiveness. The pretest to posttest knowledge of spiritual care significantly increased (p < .0001) on the 10 questions as measured by a t test statistic. These findings may contribute to social change by guiding training strategies to meet organizational goals for increased nurses' knowledge of and skills in spiritual care delivery for chronically ill patients. Nurses will have increased competency to provide patients with quality holistic care that includes support of spirituality.
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Tukay, Remeliza Navarrete. "Diabetes Mellitus Type 2: A Quality Improvement and Patient Safety Initiative." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3213.
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The purpose of the quality improvement (QI) project was to examine the relationship between amended nursing education concerning diabetes mellitus (DM) Type 2 self-care management incorporating Tune in, Explore, Assist, Communicate, and Honor (TEACH) and Motivational Interviewing (MI) strategies and techniques and the Glycosylated hemoglobin (HgbA1C) of veteran patients with uncontrolled diabetes. The target sample included the 2 licensed practical nurses and 2 registered nurses assigned to 2 primary care teams, and the 10 purposively sampled patients with uncontrolled DM Type 2 from each team. The nurses' competencies were measured through descriptive comparison before and after nursing education implementation using the instrument Patient Education: TEACH for Success Self-Assessment Questionnaire. The nurses' confidence and their perceived importance of the TEACH and MI skills application and skill assessment for promoting health behavior change were tested inferentially with a paired t test before and after nursing education implementation using the instrument Clinician Importance and Confidence Regarding Health Behavior Counseling Questionnaire. The primary care team developed their skills tailored to each patient's needs, considering the guiding principles and premises of the health belief model (HBM). Patients' self-care management knowledge, skills and confidence were improved. The project decreased the elevated HgbA1C of patients measured after the project initiative. The QI project leads to positive social change by decreasing the number of patients with uncontrolled diabetes among the veteran population. The patients and their providers can develop individualized plans of care for diabetes management by educating, redirecting, and evoking behavioral changes in the veteran patients by using a team approach.
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Chacko, Mary Laly. "Orientation of Nurses Transitioning into Hospital Specialty Units." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2399.
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Competency-based nurse orientation programs focus on the new nursing graduate and experienced nurse employees' ability to perform skills necessary in a new work setting. The purpose of this project was to develop a learner-focused and competency-based orientation program for new nursing employees at a large urban hospital to enhance patient safety and nurse retention. The Johns Hopkins nursing evidence-based practice model and guideline were used in the selection of articles with higher levels of evidence and research quality for the critical appraisal of literature in support of the program development. The best practices for nursing orientation content and delivery for positive effects on hospital finances, nurse turnover rates, and patient safety were the focus of the literature review. Benner's model of 5 levels of skill development was the theoretical framework for advancing skills of nurses who enter the orientation program with different expertise and skill sets. Nurse orientation materials and processes, comprising a collaborative team approach to orientation and a guideline for preceptor selection, were developed as the essential components for successful orientation at the project hospital. A nursing orientation based on the evidence may provide an infrastructure and operational process for the organization in developing the competencies of all levels of nurses, including experienced nurses transitioning to new units or duties. The social change resulting from the project will be a supportive and seamless transition of nurses into the new practice role and work environment. When implemented, this project is anticipated to increase nurse satisfaction, improve quality of health care delivery, decrease anxiety related to the new nursing role, and improve collegiality among all levels of nurses.
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Cooley, Janet, Samuel F. Stolpe, Amber Montoya, Angela Walsh, Ana L. Hincapie, Vibhuti Arya, Melissa L. Nelson, and Terri Warholak. "An Analysis of Quality Improvement Education at US Colleges of Pharmacy." AMER ASSOC COLL PHARMACY, 2017. http://hdl.handle.net/10150/624022.
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Objective. Analyze quality improvement (QI) education across US pharmacy programs. Methods. This was a two stage cross-sectional study that inspected each accredited school website for published QI curriculum or related content, and e-mailed a questionnaire to each school asking about QI curriculum or content. T-test and chi square were used for analysis with an alpha a priori set at .05. Results. Sixty responses (47% response rate) revealed the least-covered QI topics: quality dashboards /sentinel systems (30%); six-sigma or other QI methodologies (45%); safety and quality measures (57%); Medicare Star measures and payment incentives (58%); and how to implement changes to improve quality (60%). More private institutions covered Adverse Drug Events than public institutions and required a dedicated QI class; however, required QI projects were more often reported by public institutions. Conclusion. Despite the need for pharmacists to understand QI, it is not covered well in school curricula.
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Parkkonen, Armas. "Vietnamese Nurses’ and Nursing students’ conceptions about healthcare associated infections : An empirical research study in patient safety and quality of care." Thesis, Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-70739.
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Introduction: Healthcare associated infections (HAIs) are a global problem and lead to a large burden for the patients, healthcare systems and society. In low and middle-income countries the burden and prevalence is higher than in high-income countries. It is possible with good prevention to reduce the prevalence and burden of healthcare associated infections. Aim: Investigate Vietnamese Nurses’ and Nursing students’ conceptions about healthcare associated infections and their role in prevention of healthcare associated infections. Method: Qualitative research with a cross-sectional design and the data was collected through eight semi-structured interviews and unstructured observations. The data was analyzed by content analysis. Results: Four categories were identified in the data analysis: Understanding and conceptions about HAI, Hinders for the prevention of HAI, How to work in a preventive way for HAI, Responsibility for patient safety. Conclusion: The study showed hinders for the nurses to perform their work correctly, limitations in the environment, lack of time, and equipment and supplies. The need for improvements are more nurses, make equipment and supplies more available and more rooms for patients. The participants acknowledge about responsibility and the importance of following guidelines at the hospitals are identified in the result.
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Hutson, Hendy Dionne. "Compassion Fatigue in Emergency Department Nurses." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2984.
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Compassion fatigue (CF) is a problem seen within healthcare institutions worldwide, especially critical care units and emergency departments (EDs). The problem identified in this quality improvement (QI) project was CF, experienced by nurses in the ED. The effects of CF cross nurse-patient boundaries and negatively impact a patient's expectations of having a quality care experience. The Iowa model's evidence-based team approach was used to guide the development of the education initiative for nurses on recognizing, preventing, and identifying methods of coping with CF in the ED. The outcome products for the project included an extensive review of the literature, a curriculum plan to educate ED nurses on CF, and a pretest/posttest to validate ED nurses knowledge about CF. The content of the project was measured by 2 master's-level prepared education experts using a dichotomous scale. The format evaluated content material using total scores of 1 for content (not met) and total scores of 2 for content (met). The average score was 2, which demonstrated the objectives for the education initiative were identified and the goals were met. The content experts also conducted content validation of each of the 14 pretest/posttest items using a 4-point Likert scale ranging from 1 (not relevant) to 4 (highly relevant) that resulted in a content validation index of 1.00, showing that the test items were covered in the curriculum. Recommendations were made for item construction improvement and omission of the Iowa model from the curriculum plan and pretest/posttest. The project promotes social change through the facilitation of patient satisfaction, quality of patient care, and prevention of CF on nursing staff.
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Limongiello, Jennifer Rose. "Perceived Job Stress and Life Style Behaviors' Effects on the Quality of Life of Registered Nurses." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3901.
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The purpose of this quantitative study was to examine to what extent work demands as measured by perceived job stress affected the health-related quality of life (HRQOL) as determined by the number of unhealthy days of registered nurses in the United States. This study was also an investigation of the extent to which other variables such as body-mass index (BMI) and certain lifestyle behaviors affected the HRQOL (number of unhealthy days). The independent variables were perceived job stress, weight (BMI), and lifestyle factors such as tobacco and alcohol use, physical inactivity, and the mindful eating score, and the dependent variable was the HRQOL (measured by the summary index of unhealthy days) of the RNs. This study was guided by the enhanced DRIVE model which describes how individual differences interact with perceived job stress to affect health outcomes. A cross-sectional study design was used and relevant data to answer the research question were collected from 95 participants via a SurveyMonkey survey that was advertised in an e-newsletter from the Nurse Practitioner Association of Continuing Education as well as posted on LinkedIn groups. Logistic regression and Spearman's correlation were used to test the hypothesized associations. There were no statistically significant associations between BMI, alcohol use, smoking, inactivity, and the HRQOL. However, there was a weak correlation between perceived job stress, the mindful eating score, BMI, the total number of unhealthy days and the total number of days that the nurses' daily activities were affected by unhealthy days. The positive social change implication of this study is that, for nurses, awareness of perceived job stress is important in promoting a healthy lifestyle and reducing the risk of chronic diseases.
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Leveille, Deborah. "Deliberate Practice of IV Medication Procedures by Student Nurses: Feasibility, Acceptability, and Preliminary Outcomes: A Dissertation." eScholarship@UMMS, 2015. https://escholarship.umassmed.edu/gsn_diss/42.
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Background: Medication errors continue to be one of the most prevalent problems in healthcare related to patient safety, often resulting in injury or death, with higher incidences of error occurring with intravenous medications. The purpose of this study was to explore the use of deliberate practice (DP) with second-degree nursing students in developing and maintaining fundamental intravenous medication management practices required for safe practice.
Method: This was a feasibility study using a two-arm, single-blind, randomized controlled trial design. Vygotsky’s Zone of Proximal Development model was used to explore the use of a DP teaching intervention to achieve competency in skills associated with safe IV medication management. A convenience sample of first-year, first-semester nursing students enrolled in an accelerated graduate program (N = 32) were invited to participate; 19 enrolled, and 12 completed the study. Students (n = 12) received three 30- minute one-on-one practice sessions at 2-week intervals with an expert nurse (the intervention group focused on IV skills and the control group on skills unrelated to IVs). Pre- and post-intervention instruments tested participants’ confidence with IV management and safety skills. The primary outcome was their ability to safely administer and monitor IV medications during a 20-minute videotaped medication administration scenario.
Results: Low recruitment (19 of 32) and high attrition (37%) were observed. Participants completing the study (5 in the intervention group and 7 in the control group) reported that the time required to attend the sessions was not burdensome (91.7%); time allotted was adequate (100%); 100% reported positive experience; 91.7% found the DP sessions essential to learning. Change in confidence scores for IV skills were not significant (P = 0.210), but were higher in the intervention group (2.97–4.14 = 1.50 change) compared to the control group (2.71–3.77 = 1.04 change). Significant differences were found in overall medication administration skills between the control and intervention groups (t [-2.302], p = 0.044) in favor of the intervention group, particularly with medication preparation skills (p = 0.039). Overall raw scores were low in both groups; only 16–42 (26%–70%) of the total 60 steps required for safe practice were completed. Participants scored lowest in the evaluation phase, with all participants performing less than 50% of the 14 steps.
Conclusion: Even though participant satisfaction was high, significant attrition occurred. Students reported the DP sessions to be beneficial and they felt more confident in performing skills, but three 30-minute sessions (90 minutes) were not adequate to develop, maintain, or refine all the IV-management skills associated with safe medication practices. Determining the length and duration of DP sessions as well as comparing the efficacy of DP sessions between individual and group sessions with varying doses and frequencies is needed to advance our understanding of using DP within nursing education.
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Blignaut, Alwiena Johanna. "The relationship between the qualifications of professional nurses and their perception of patient safety and quality of care in medical and surgical units in South Africa / Alwiena Johanna Blignaut." Thesis, North-West University, 2012. http://hdl.handle.net/10394/7711.
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Background: Several international studies have been published on the importance of exploring and describing the perceptions of professional nurses to improve patient safety and quality of care. There is also a growing body of literature that has established the associations of qualifications on patient safety and quality of care. However, no comparable research has been conducted in South Africa, and little is known about the influence of personal characteristics, such as qualifications of the professional nurse, on his/her perception of patient safety and quality of care.
Objective: To investigate the perceptions of professional nurses regarding patient safety and quality of care as well as the relationship between the qualifications of professional nurses and these perceptions in medical and surgical units in public and private hospitals in South Africa.
Design: Cross-sectional survey of nurses.
Setting and participants: 1187 professional nurses (161 Baccalaureate degree and 956 diploma-prepared) working in medical and surgical units of 55 private hospitals and 7 public national referral hospitals in South Africa completed the survey.
Measurements: Perceptions of patient safety, quality of care and occurrence of adverse events, qualifications, age, job satisfaction, emotional exhaustion, experience, personal accomplishment and depersonalization.
Results: 54.1% (n = 87) of Baccalaureate professional nurses and 51.2% (n = 490) diploma nurses feel as if their mistakes are held against them. 37.9% (n = 61) of Baccalaureate professional nurses and 42.4% (n = 404) diploma nurses perceive important information to be lost during shift changes. 39.1% (n = 63) of Baccalaureate professional nurses and 38.6% (n = 369) diploma nurses feel that things “fall between the cracks” when transferring patients from one unit to another. 43.5% (n = 70) of Baccalaureate professional nurses and 48.7% (n = 465) diploma nurses feel that their hospital‟s managements are not approachable. Almost half of professional nurses (49% [n = 79] Baccalaureate and 44.4% [n = 418] diploma) do not have confidence in hospital management to resolve reported problems regarding patient care. 26.6% (n = 26.8) of Baccalaureate professional nurses and 25.5% (n = 237) of diploma professional nurses perceive the quality of care in their hospitals to have deteriorated. Both Baccalaureate and diploma professional nurses reported adverse events to occur a few times a year or less. Verbal abuse towards nurses is reported to occur once a month or less. Qualifications revealed no correlation with perceptions of patient safety and quality of care, though emotional exhaustion and depersonalization showed a small to medium negative correlation and personal accomplishment a small to medium positive correlation with these perceptions.
Conclusions: Supportive leadership and development of an environment in which professional nurses can freely report adverse events and hindering factors with regard to quality of care might benefit patients in terms of safety and better quality care.Thesis(M.Cur.)--North-West University, Potchefstroom Campus, 2012.
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Miller, Kristi, Lisa Haddad, and Kenneth D. Phillips. "Educational Strategies for Reducing Medication Errors Committed by Student Nurses: A Literature Review." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/ijhse/vol3/iss1/2.
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Medication errors cause harm, yet most of them are preventable (Institute of Medicine, 2006). Nurses spend 40% of their time administering medications; therefore they play a key role in the reduction of medication errors. Little empirical evidence has been collected about the effectiveness of nursing education in reducing medication errors committed by nursing students. Traditional educational interventions focus on the five rights of medication administration; however, the literature shows that interventions focused on instilling a culture of safety have a greater impact on reducing medication errors. The purpose of this article is to review educational strategies that have been implemented and tested in pre-licensure nursing programs to reduce medication errors committed by nursing students.
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Lobo, Rosale. "The Effects of Structured Health Policy Education on Connecticut Registered Nurses' Clinical Documentation." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4530.
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Registered Nurses use clinical documentation to describe care planning processes, measure quality outcomes, support reimbursement, and defend litigation. The Connecticut Department of Health, guided by federal Conditions of Participation, defines state-level healthcare policy to include required care planning processes. Nurses are educated in care planning process standards, however no policy-required competency verification processes in academia or employers exists. Guided by the advocacy coalition framework, the purpose of this quasi-experimental study was to determine if the quality of nurse coalition actors’ clinical documentation, a relatively stable parameter, would increase after attending policy-centered structured education. Data were extracted from 272 electronic medical records (136 pre - 136 post attendance) and mean quality scores were computed using the Müller-Staub Q-DIO scale from 17 nurse coalition actors. A two group dependent t test was used to examine quality score differences and linear regression was used to isolate process education subsections that significantly predicted post mean score improvements. Findings indicate a statistically significant difference between pre and post education quality scores (p < .001) and improvement drivers of the post-education quality scores were identified in the subscales of ‘diagnosis as a process’ (p < .001) and ‘interventions’ (p < .001). Implications for positive social change include recommendations to state-level policy makers to mandate confirmation of graduating nurses’ documentation quality and to install continuing education requirements as a condition of bi-annual license renewal; each area acting to reduce non-compliant clinical documentation in light of federal Conditions of Participation rules.
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Tshivhandekano, Itani. "Water quality in the City of Tshwane, South Africa and its role in food safety for vegetable production." Pretoria : [s.n.], 2006. http://upetd.up.ac.za/thesis/available/etd-07092008-151025.
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Hall, Katherine C., Sandy K. Diffenderfer, April Stidham, and Christine M. Mullins. "Student and Preceptor Advancement in a Dedicated Education Site (SPADES): Innovation in Clinical Education for Advanced Practice Nurses." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/7095.
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In the 1990s, dedicated education units transformed undergraduate preceptorships, but graduate preceptorships remain static. The dyadic nurse practitioner preceptorship model supports an environment where faculty, students, and preceptors may overlook nuances that affect the teaching-learning process. This article describes an innovative clinical education model, Student and Preceptor Advancement in a Dedicated Education Site, designed to improve preceptorships for advanced practice nurses. The focus is on adaptations made to facilitate use in advanced practice nursing programs.
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Ngesa, Anna Adhiambo. "The management of blood and body fluids in a Kenyan university hospital : a nursing perspective." Thesis, Link to the online version, 2008. http://hdl.handle.net/10019/884.
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Johansson, Pauline. "Mobil IKT inom omvårdnad : studier om sjuksköterskors och studenters användning av handdatorer." Doctoral thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap, HV, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-22399.
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Background: In nursing care, the steady increase of health related information implies aneed for useful Information and Communication Technology (ICT) tools that easilyprovide mobile access to accurate information. Updated information is usually available onthe Internet but personal computers are rarely available at the patients’ bedside. In Sweden,although handheld devices provide mobile access to information, they are rarely used innursing practice. Aim: This thesis aimed to explore the views of nurses and nursingstudents of using handheld devices in nursing practice. Method: Four intervention studieswere carried out during the years 2006 to 2008; a total of 30 nurses and 63 nursing studentsused handheld devices for 5-15 weeks in nursing practice, and answered questionnairesand/or participated in interviews. In 2012, a cross sectional study was undertaken with 111nurses and 287 nursing students answering a questionnaire about their views of usinghandheld devices. Quantitative data were analyzed using descriptive statistics andqualitative data were analyzed by content analysis. Results: The handheld device wasregarded to facilitate nursing practice and to be a useful tool with benefits for the patients,the nurses and for the nursing students. Independent of time and place, nurses and nursingstudents were able to access necessary information and also to make notes, plan their workand save time. The handheld device was regarded to improve patient safety and quality ofcare. The participants would not have to leave their patients to look up information,subsequently giving a more complete encounter. Additionally, the handheld device waspresumed to imply increased confidence, and support learning for nurses and nursingstudents. Conclusion: In order to continuously improve the safety and quality of healthcare,it is important to implement handheld devices in nursing practice. This issue is importantat all levels in the healthcare systems, from nurses to nursing management, policy makersand moreover for educators. Handheld devices adjusted for nursing, technical, statutory,cultural, and language country specific conditions, should be further developed,implemented, and evaluated in future research.Omvårdnad är ett informationsintensivt område och sjuksköterskor hanterardagligen en omfattande mängd information. Kunskapsmassan växer stadigtoch behovet av tillgång till aktuell information ökar. Vanligen finns aktuellinformation tillgänglig via Internet men det är inte alltid som en dator finns tillhands vid patientens sängkant. Mobil informations- och kommunikationsteknik(IKT) såsom en handdator kan lätt ge tillgång till den information sombehövs. Trots att det finns flera fördelar med att använda mobil IKT som stödinom omvårdnad, framför allt avseende tillgång till information, såsombeslutsstöd och för lärandet, används det ännu i ringa omfattning i Sverige.Avhandlingens övergripande syfte var att undersöka sjuksköterskors ochsjuksköterskestudenters uppfattningar om att använda handdatorer inomomvårdnad.Fyra av avhandlingens fem studier genomfördes från 2006 till 2008. Sammanlagtanvände 30 sjuksköterskor och 63 sjuksköterskestudenter handdatorer5-15 veckor i arbete eller verksamhetsförlagd utbildning (VFU). Deltagarnabesvarade enkäter före och efter användningen, och intervjuades individuellteller i grupp. I den femte studien, som genomfördes 2012, besvarade 111sjuksköterskor och 287 sjuksköterskestudenter en enkät om sin uppfattning omhanddatorer. Kvantitativ data analyserades med beskrivande statistik ochkvalitativ data analyserades med innehållsanalys.Studierna visade att en handdator kan vara ett stöd i det dagliga arbetet och iVFU som informations-, antecknings- och planeringsverktyg, och kan enkeltge en översikt av patienters läkemedelsanvändning. Sjuksköterskorna ochsjuksköterskestudenterna ansåg att handdatorn kan bidra till ökad patientsäkerhetoch vårdkvalitet på grund av den snabba tillgången till aktuellinformation, oberoende av tid och plats. Patientmötet kan bli mer helt dåpatienterna inte behöver lämnas och samtalet inte behöver avbrytas;vårdrelationer kan bli vårdande relationer. Deltagarna ansåg att handdatornkan vara ett stöd avseende trygghet, minskad stress och kontinuerligt lärande. Iframtiden bör sjuksköterskor och sjuksköterskestudenter ges tillgång till mobilIKT som stöd i sitt arbete och VFU, och införandet bör därför prioriteras påalla nivåer inom vård och utbildning. IKT-kompetensen måste ökas ochslutanvändarna måste vara delaktiga i utvecklingen och införandet. Fortsattforskning behövs avseende avancerade mobila IKT-stöd; anpassade försjuksköterskans arbete.
Nurse Companion
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Steiner, Linda. "DEVELOPMENT OF A WEB BASED EDUCATION MATERIAL TO HORSE OWNERS CONCERNING FEED SAFETY AND HYGIENIC QUALITY IN HORSE FEEDS." Thesis, Uppsala University, Department of Medical Biochemistry and Microbiology, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-9174.
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The most common disease causing elements in feed is of microbial nature. Therefore it is of great importance for horse owners to be familiar with the fundamental requirements for microbial growth in feeds and the problems that can originate in case of insufficient handling. However, horse owners are not organized in a way that makes it easy to reach them with information as a target group. Additionally, most horse owners only have one horse and limited possibilities for education in feed safety. Thus, there is need for an easy accessed education material that is explicitly directed towards horse owners. The fundamental content of such an education material was composed in this project. Focus was on the importance of good microbial quality in horse feed and the material was structured into three chapters; FEED SAFETY, MICROORGANISMS IN FEEDS and CONSERVATION, STORING AND FEEDING. The aim was to publish the material as part of a larger web based education package on the web page, http://www.sva.se of the Swedish National Veterinary Institute. The basic structure for such a web education was also composed in this project.
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Shaw, Courtney J. "Towards Dementia Friendly Emergency Departments: A mixed method exploratory study identifying opportunities to improve the quality and safety of care for people with dementia in emergency departments." Thesis, University of Bradford, 2018. http://hdl.handle.net/10454/17445.
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This project provides the first comprehensive investigation into the
experiences of people with dementia (PWD), their carers, and the staff who
provide care in emergency departments (ED) in the UK. This is a mixed
methods study which used a national survey (N=403) followed by ED
observation (32 hours) and qualitative interviews with health professionals
(N=29), in an iterative and sequential design to present a holistic evaluation of
the current experiences of the key parties- patients, carers, and ED staff
involved in receiving and providing care. The theoretical perspective of the
Human Factors Approach to patient safety underpins this work. The project
included people with dementia and carers as collaborators and co-designers in
both the development of the research tools and in shaping the project outputs.
This research explores the barriers and facilitators to safe and effective care,
concluding that here are a number of barriers (poor integration of
communication systems, inappropriate physical environments, misalignment of
staff training and workplace staffing models), which may affect the healthcare
team’s ability to provide effective dementia care. These systemic challenges
both give rise to and exacerbate poor organisational and safety cultures.
However, despite these challenges, there are examples of safe and effective
care (positive deviants) where uncommonly good outcomes for this patient
population are achieved. Examining these examples offers valuable insight into
potential adaptions, which could be used to improve existing care.
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Johansson, Linn, and Angelika Johansson. "Nurses experience of applying professional competence and influencing the quality of nursing care in terms of diabetes in an Indian rural hospital - an interview study." Thesis, Karlstads universitet, Institutionen för hälsovetenskaper, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-35926.
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Introduction - India is beginning to resemble the western worlds’ way of living and that leads to an increased risk of chronic diseases such as diabetes. Due to its very large population India has the world second largest number of people with diabetes; 61, 3 million people. Studies have shown that the awareness of diabetes is poor, especially in rural areas. Aim - To investigate nurses’ experience of applying professional competence in patient education with focus on diabetes type II in an Indian rural hospital. Method – Data was gathered through twelve qualitative interviews. The interviews were tape recorded, transcribed verbatim and then analyzed through content analysis. Result – Three main categories were identified; Acquired competence to meet the patients, Helping the patients manage their disease and Nurses’ ideas for quality improvements regarding diabetes care. Conclusion - This study identified different obstacles that could have a negative effect on the care and treatment of patients with diabetes type II. The nurses had many ideas for quality improvements which could raise the awareness of the disease among patients, improve clinical outcomes and the work environment for the nurses. The nurses are willing to get more education about the disease and implement quality improvements if the resources and equipment are provided by the hospital.
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Hyatt, Rick D. "Nurse Perceptions: The Relationship Between Patient Safety Culture, Error Reporting and Patient Safety in U.S. Hospitals." Franklin University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=frank1607988520967849.
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Hansson, Tina, and Lari Masomeh Amini. "Smärtskattning av barn på sjukhus : om utbildningens betydelse för att uppnå kvalitetsmålen om smärta på Akademiska Barnsjukhuset." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-155182.
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Syfte: Att undersöka om en utbildning om barn och smärta förbättrade sjuksköterskors kunskap och följsamhet till Akademiska Barnsjukhusets kvalitetsmål gällande smärta. Metod: De 23 sjuksköterskorna som ingick i studien var anställda på en barnakutmottagning och två vårdavdelningar på Akademiska Barnsjukhuset. Sjuksköterskorna besvarade frågeformulär om kvalitetsmålen om smärta och barn före och efter en utbildning. Journalgranskningar av sjuksköterskornas dokumentation av smärtskattningar genomfördes före och efter utbildningen. Skillnader med avseende på kunskap om kvalitetsmål och dokumenterade smärtskattningar före och efter utbildning analyserades med Exakt teckentest. Resultat: Dokumenterade smärtskattningar fanns i 20% av de granskade journalerna både före och efter utbildning. Sjuksköterskor rapporterade dock bättre kunskap om Akademiska Barnsjukhusets kvalitetsmål om smärta efter jämfört med före utbildning . Slutsats: Omfattning och dokumentation av barns smärtskattningar behöver uppmärksammas. Studien belyser behovet av en diskussion bland smärtgrupp, smärtombud och ledning om gemensamma strategier för implementering av uppsatta kvalitetsmål avseende barn och smärta. I ett nationellt perspektiv behöver diskussioner föras om smärta ska ingå som den femte vitalparametern och därmed jämställas med andning, blodtryck, puls och syresättning.Aim: To study if an education about children and pain improved the knowledge of registered nurses including compliance to the quality objectives of the Uppsala University Children’s Hospital concerning pain. Methods: The 23 nurses were employed within a children’s emergency unit and in two in-wards within the Uppsala University Children’s Hospital. The nurses answered to a questionnaire about the quality objectives concerning children and pain before and after a training-intervention. The nurses’ documentation of pain measurement in hospital records were analyzed before and after the intervention. Differences before and after training were analyzed using Exact Sign Test. Findings: Assessments of pediatric pain were found in 20% of the reviewed hospital records both before and after the training-intervention. However, nurses’ knowledge of the quality objectives was improved. Conclusion: Pediatric pain assessments need to be addressed. The study highlights the need of a discussion amongst pain representatives from the staff and managers on common strategies to implement decided quality objectives concerning children and pain. In a national perspective pain should be included as the fifth vital parameter and thus treated as breathing, blood pressure, heart rate and saturation.
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Jaarsma, Tiny. "Heart failure: nurses care effects of education and support by a nurse on self-care, resource utilization and quality of life of patients with heart failure /." [Maastricht : Maastricht : Universiteit Maastricht] ; University Library, Maastricht University [Host], 1999. http://arno.unimaas.nl/show.cgi?fid=6874.
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Galindez, Araujo Luis J. "Factors surrounding and strategies to reduce recapping used needles by nurses at a Venezuelan public hospital." [Tampa, Fla] : University of South Florida, 2009. http://purl.fcla.edu/usf/dc/et/SFE0003166.
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Barbosa, Valquíria Vicente da Cunha. "As potencialidades e fragilidades do processo de acreditação hospitalar na perspectiva dos enfermeiros." Universidade Federal de Goiás, 2018. http://repositorio.bc.ufg.br/tede/handle/tede/8804.
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Health facilities have sought to achieve improvements in their services through quality management, aiming at safer patient care. In this context, the accreditation process emerges as a method to evaluate the resources of these establishments, aiming to guarantee the quality of the assistance through pre- established standards. The objective of this research was to analyze nurses' perceptions about the accreditation process in public hospitals of a state in the Midwest region of the country, to verify the meaning of this process for nurses and to identify the potentialities and fragilities arising from this process from the perspective of the nurses. A descriptive, exploratory qualitative approach was carried out. Data were collected through focal groups in March 2018, with nurses from two public hospitals accredited by the National Accreditation Organization (levels I and III). The Bardin content analysis method was used, considering the following steps: pre-analysis, material exploration and treatment and interpretation of results. The following categories were apprehended, with their respective subcategories: meaning of the accreditation process - premises, organization and tools of this process; potentialities of the accreditation process - advantages of the process for the professional, institution and patient; weaknesses of the accreditation process - negative impact on the professional, for institution and deficient knowledge about this process. It was identified that the nurses had knowledge about the accreditation process; that the most outstanding potentialities were professional development, continuous improvement and safety for the patient and professional; and that the most mentioned weaknesses were an increase in the workload, a lack of professionals' insertion in the process, an increase in bureaucracy and a decrease in the quality of patient care due to this process itself. Another important finding was that, although the participants affirmed, on several occasions, that the accreditation process aims to offer patients more safety, more advantages were scored for the professionals and institution than for the patients themselves. It is concluded that the potentialities seized were more prominent than fragilities, evidencing that the accreditation process offers more benefits to the health sector, than harm.
Os estabelecimentos de saúde têm procurado o alcance de melhorias em seus serviços, por meio da gestão da qualidade, objetivando uma assistência mais segura aos pacientes. Nesse contexto, o processo de acreditação surge como um método de avaliação de recursos desses estabelecimentos, visando garantir a qualidade da assistência por meio de padrões pré estabelecidos. Objetivou-se com essa pesquisa analisar a percepção dos enfermeiros sobre o processo de acreditação em hospitais públicos de um estado da região Centro Oeste do país, verificar o significado desse processo para os enfermeiros e identificar as potencialidades e fragilidades advindas desse processo sob a ótica dos enfermeiros. Para tanto foi realizada uma pesquisa descritiva, exploratória de abordagem qualitativa, sendo os dados coletados por meio de grupos focais, em março de 2018, com enfermeiros de dois hospitais públicos acreditados pela Organização Nacional de Acreditação (níveis I e III). Utilizou- se o método de análise de conteúdo segundo Bardin contemplando as seguintes etapas: pré análise, exploração do material e tratamento e interpretação dos resultados obtidos. Foram apreendidas as seguintes categorias, com suas respectivas subcategorias: significado do processo de acreditação – premissas, organização e ferramentas desse processo; potencialidades do processo de acreditação – vantagens do processo para o profissional, instituição e paciente; fragilidades do processo de acreditação – impacto negativo para o profissional, para instituição e conhecimento deficiente sobre esse processo. Identificou-se que os enfermeiros possuíam conhecimento acerca do processo de acreditação; que as potencialidades mais destacadas foram desenvolvimento profissional, melhoria contínua e segurança para o profissional e paciente; e que as fragilidades mais mencionadas foram aumento de carga de trabalho, falta de inserção dos profissionais no processo, aumento da burocracia e diminuição da qualidade na assistência ao paciente em virtude desse próprio processo. Outro achado importante foi que, apesar dos participantes afirmarem, por várias vezes, que o processo de acreditação visa oferecer mais segurança aos pacientes, foram pontuadas mais vantagens para os profissionais e instituição do que para os próprios pacientes. Conclui-se que as potencialidades apreendidas foram mais destacadas que as fragilidades, evidenciando que o processo de acreditação oferece mais benefícios ao setor saúde, do que malefícios.
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Ross, Tammy. "Increasing Medication Adherence in Hypertensive Patients With Million Hearts® Health Literacy Program." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5259.
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Healthy People 2020 identified hypertension (HTN) as a controllable risk factor to prevent cardiovascular disease and stroke. Adhering to regular antihypertensive (AHT) medications improves outcomes in patients diagnosed with HTN by controlling blood pressure, reducing hospital visits, and promoting patient wellness. Medication adherence occurs when prescribed medicine regimens are utilized by the patient as directed to manage illness or disease, as evidenced by patients receiving medications at their pharmacy. The practice-focused question for this quality improvement project asked whether implementation of health literacy tools from Million Hearts® HTN Control: Action Steps for Clinicians, increased medication adherence as evidenced by regular medication pickups by adult hypertensive patients. Additionally, this project provided an assessment to identify the patient's current health literacy level using the Newest Vital Sign. The purpose of this quality improvement project was to improve health literacy about AHT medications to increase medication adherence in adults diagnosed with HTN. The logic model allowed for communication of resources, activities, and guidance during project implementation. Data related to medication pickups from adult participants, 1 male and 4 females aged 21-76, were analyzed using descriptive statistics via percent difference pre-post program. Results showed an 80% rate of medication adherence, however increased medication adherence was not achieved. Results also revealed a knowledge deficit in 20% of participants indicating they were unaware they had been prescribed combination AHT medication to control their blood pressure, and not knowing their most recent blood pressure results, or how their specific AHT medication regimen worked at controlling their HTN needs. These findings could lead to exploring additional underlying factors that impede medication adherence such as income, medication cost, insurance cost, and transportation needs. This project supports the need for health literacy to be addressed to improve knowledge and understanding about HTN, and implied the need to address the problem of low health literacy in patients with HTN. Implications for nursing practice include health literacy tools for community-based ambulatory clinics to influence medication adherence and self-care management of adults with HTN. Positive social change was demonstrated by providing health literacy to adult HTN population to improve medication adherence thus reducing health risk.
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Massoco, Eliana Cristina Peixoto. "Percepção de docentes e discentes acerca da temática segurança do paciente em cursos de graduação em saúde." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-18092017-154707/.
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Introdução: A segurança do paciente tem sido discutida amplamente no âmbito da assistência e da gerência de serviços de saúde, frente a sua magnitude no cenário nacional e internacional. Nesse sentido, o incremento da temática segurança do paciente no ensino e na pesquisa vem sendo também debatido e disseminado, a fim de gerar uma força de trabalho consciente e capaz de atender as demandas das instituições de saúde. Objetivo: Compreender a percepção do corpo docente e discente acerca dessa temática nos cursos de graduação em Enfermagem, Nutrição, Biomedicina, Farmácia, Fisioterapia e Psicologia de uma Instituição de Ensino Superior (IES) privada do interior do Estado de São Paulo. Percurso metodológico: Trata-se de um estudo qualitativo, exploratório, descritivo na modalidade estudo de caso, cujo cenário foi o Centro Universitário Nossa Senhora do Patrocínio. Os participantes foram seis docentes e seis discentes dos cursos supracitados da referida IES. Os dados foram coletados após a anuência do Comitê de Ética, por meio de entrevista semiestruturada, no período de agosto a dezembro de 2015. Os achados foram apresentados na forma de narrativa e analisados segundo Minayo, e à luz do referencial teórico da integralidade em saúde proposto por Ceccim. Resultados: Das narrativas dos participantes emergiram quatro categorias, a saber: visão da temática segurança do paciente nos conteúdos programáticos de cursos de graduação em saúde; valorização da interdisciplinaridade; interface entre a visão holística e a segurança do paciente; lacuna da temática segurança do paciente nos conteúdos programáticos. Desse modo, constatamos que a percepção da temática segurança do paciente esteve associada à importância da interdisciplinaridade e à necessidade do ensino dessa temática de forma articulada. Considerações finais: O estudo permitiu conhecer a percepção de docentes e discentes a respeito da temática segurança do paciente, destacando-se a necessidade de fomentar a inclusão dessa temática nas matrizes curriculares. Por conseguinte, acreditamos que cabe às IES a implantação e a implementação de estratégias de ensino concernentes à segurança do paciente, com a finalidade de verticalizar o conhecimento entre os futuros profissionais da área da saúde e, consequentemente, contribuir para a efetiva incorporação da cultura de segurança nos estabelecimentos de atenção à saúde.Introduction: Patient Safety has been widely discussed in the context of managing and assistance in health services, due to its magnitude in national and international scenario. Considering this, the debate around the theme \"patient safety\" has raised in order to create and improve a workforce that should be conscious and able to meet the need of Health Institutions. Objective: Understanding teachers and students perceptions about patient safety, in undergraduate courses, specifically in Nursing, Nutrition, Biomedicine, Pharmacy, Physiotherapy and Psychology, from a private college in São Paulo State heartland. Methodology: Qualitative, exploratory and descriptive study, based on case study, that took place at Centro Universitário Nossa Senhora do Patrocínio. The participants were six teachers and six students from the graduation courses mentioned before. All the data were collected after Ethics Committee approval, through semi-structured interviews, from August to December 2015. The findings of this study were presented into the narrative form and analyzed according to Minayo\'s studies, assisted by the Health Integrality theoretical scheme proposed by Ceccim. Results: Four categories emerged from participants\' narratives: perspective about the theme \"patient safety\" in Global Health Courses\' curricula; interdisciplinarity appreciation; interface between holistic perspective and patient safety; the lack of the theme \"patient safety\" in courses\' curricula. Therefore, we could observe that this theme has always been connected to the importance of interdisciplinarity and to the need of teaching and discussing it in an articulated manner. Final comments: This study showed teachers and students perceptions about the theme \"patient safety\", emphasizing the need to stimulate discussions and the inclusion of this theme in courses curricula. Consequently, we believe it is colleges responsibility to include and initiate teaching and researching strategies about it, in order to spread this knowledge to future Global Health professionals and, as a result, contribute to the internalization of patient safety culture in health care places.
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Koehn, Amy R. "To report or not report : a qualitative study of nurses' decisions in error reporting." Thesis, Indiana University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3665927.
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This qualitative study was successful in utilization of grounded theory methodology to ascertain nurses' decision-making processes following their awareness of having made a medical error, as well as how and/or if they corrected and reported the error. Significant literature documents the existence of medical errors; however, this unique study interviewed thirty nurses from adult intensive care units seeking to discover through a detailed interview process their individual stories and experiences, which were then analyzed for common themes. Common themes led to the development of a theoretical model of thought processes regarding error reporting when nurses made an error. Within this theoretical model are multiple processes that outline a shared, time-orientated sequence of events nurses encounter before, during, and after an error. One common theme was the error occurred during a busy day when they had been doing something unfamiliar. Each nurse expressed personal anguish at the realization she had made an error, she sought to understand why the error happened and what corrective action was needed. Whether the error was reported on or told about depended on each unit's expectation and what needed to be done to protect the patient. If there was no perceived patient harm, errors were not reported. Even for reported errors, no one followed-up with the nurses in this study. Nurses were left on their own to reflect on what had happened and to consider what could be done to prevent error recurrence. The overall impact of the process of and the recovery from the error led to learning from the error that persisted throughout her nursing career. Findings from this study illuminate the unique viewpoint of licensed nurses' experiences with errors and have the potential to influence how the prevention of, notification about and resolution of errors are dealt with in the clinical setting. Further research is needed to answer multiple questions that will contribute to nursing knowledge about error reporting activities and the means to continue to improve error-reporting rates.
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Garzin, Ana Cláudia Alcântara. "Ensino da temática segurança do paciente na formação dos profissionais de saúde na perspectiva de discentes." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-23112018-124729/.
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Introdução: A segurança do paciente é reconhecida como uma dimensão intrínseca da qualidade e responsabilidade de todos os envolvidos na assistência à saúde, devendo, portanto, ser amplamente integrada à formação dos profissionais que atuam nessa área. Objetivos: Compreender a percepção de discentes de graduação de uma Instituição de Ensino Superior (IES), integrantes dos cursos de enfermagem, medicina, fisioterapia, farmácia, nutrição, terapia ocupacional e biomedicina, acerca do ensino da temática segurança do paciente; propor uma intervenção para a inserção da temática segurança do paciente, de forma interdisciplinar, nos cursos da área da saúde. Percurso metodológico: Trata-se de uma pesquisa qualitativa, com delineamento exploratório-descritivo, na modalidade estudo de caso, desenvolvida em uma IES privada, localizada no município de São Paulo, cujos participantes foram 21 discentes dos cursos supracitados. Após a aprovação nos Comitês de Ética em Pesquisa e concordância formal de cada participante, os dados foram coletados no período de agosto a outubro de 2016, por meio de entrevistas semiestruturadas, conduzidas com o apoio de um material ilustrativo elaborado a partir dos 11 tópicos para segurança do paciente elencados no Guia Curricular da World Health Organization. Os dados foram transformados em narrativas validadas pelos participantes e, posteriormente, analisadas quanto ao seu conteúdo, de acordo com Bardin. O referencial teórico da interdisciplinaridade de Edgar Morin foi adotado para fundamentar a análise interpretativa dos achados. Resultados: Emergiram das narrativas sete categorias, a saber: inserção da temática segurança do paciente durante a formação acadêmica; falibilidade humana e o aprendizado acerca dos riscos e erros assistenciais; atuação da equipe de saúde e a inclusão do paciente como parceiro nas tomadas de decisão; sistemas organizacionais e sua interface com a qualidade assistencial; protocolos como ferramentas para segurança do paciente; segurança e qualidade como elementos fundamentais na cadeia medicamentosa; e abordando a temática segurança do paciente: estratégias e metodologias de ensino. A análise interpretativa nos remeteu à necessidade da inserção formal da segurança do paciente, articulada com as diferentes disciplinas nos cursos de graduação elencados neste estudo, bem como da capacitação dos docentes para incorporá-la no processo ensino-aprendizagem. Considerações finais: O estudo propiciou a compreensão da percepção dos discentes de graduação acerca da abordagem da segurança do paciente durante a sua formação profissional, permitiu destacar a falta de uniformidade na maneira com a qual essa temática está inserida nos diferentes cursos e ainda a necessidade de sensibilizar os docentes para integrar a segurança do paciente de forma contextualizada nas disciplinas teóricas ou técnicas sob sua responsabilidade, de modo que contribua para a incorporação de atitudes e práticas conscientes e colaborativas por parte dos futuros profissionais, para o fortalecimento da cultura de segurança e por melhores resultados assistenciais nas diferentes áreas de atuação em saúde.Introduction: Patient safety is recognized as an intrinsic dimension of the quality and responsibility of all those involved in health care and should therefore be broadly integrated into the training of professionals working in this area. Aims: To understand the perception of undergraduate students of a Higher Education Institution (HEI), members of nursing, medicine, physiotherapy, pharmacy, nutrition, occupational therapy and biomedicine courses on the teaching of patient safety; to propose an intervention for the insertion of the theme of patient safety, in an interdisciplinary way, in the courses of the health area. Methodological approach: It is a qualitative research, with an exploratory-descriptive design, in the case study modality, developed in a private HEI, located in the city of São Paulo. The participants were 21 students from the courses mentioned above. After approval by the Research Ethics Committees and formal agreement of each participant, the data were collected from August to October 2016, through semi-structured interviews, conducted with the support of an illustrative material elaborated from the 11 topics for patient safety listed in the World Health Organization Curriculum Guide. The data were transformed into narratives validated by the participants and then analyzed for their content, according to Bardin. Edgar Morin\'s theoretical framework of interdisciplinarity was adopted to support the interpretative analysis of the findings. Results: Seven categories emerged from the narratives, namely: insertion of the theme of patient safety during the academic formation; human fallibility and learning about care risks and errors; performance of the health team and the inclusion of the patient as a partner in decision making; organizational systems and their interface with the quality of care; protocols as tools for patient safety; safety and quality as key elements in the drug chain; and addressing the topic of patient safety: strategies and teaching methodologies. The interpretative analysis referred to the need for formal insertion of patient safety, articulated with the different disciplines in the undergraduate courses listed in this study, as well as the training of teachers to incorporate it into the teaching-learning process. Final considerations: The study provided an understanding of undergraduate students\' perception about the patient safety approach during their professional training, highlighting the lack of uniformity in the way in which this theme is inserted in the different courses and also the need to sensitize teachers to integrate patient safety in a contextualized way in the theoretical or technical disciplines under their responsibility, so that it contributes to the incorporation of conscious and collaborative attitudes and practices on the part of the future professionals, for the strengthening of safety culture and for better care results in different areas of health care.
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Dal, Pozzo Monique Junges. "Educação permanente em saúde: Estratégia para implantar protocolos de segurança do paciente em um hospital público." Universidade do Vale do Rio dos Sinos, 2014. http://www.repositorio.jesuita.org.br/handle/UNISINOS/3911.
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Nenhuma
A aplicação de Protocolos Assistenciais de Cuidado em Enfermagem (PACE) busca qualificar as práticas de cuidado, e para isso, a Educação Permanente em Saúde (EPS) é utilizada como uma ferramenta educativa, no sentido de promover o conhecimento sobre segurança do paciente. Objetivos: Implantar no Hospital Universitário de Canoas - RS (HU), os PACE adotados na Rede Mãe de Deus, com vistas ao processo de certificação; verificar como os técnicos vivenciam a aplicação dos PACE identificar contribuições que os PACE podem trazer para o HU; propor um plano de EPS com vistas à aplicação dos PACE. Método: Estudo desenvolvido com dez técnicos de enfermagem, do tipo exploratório-descritivo, enfoque qualitativo. Resultados: Dos Grupos Focais emergiram categorias: interferência da infraestrutura do hospital na assistência de enfermagem; interferência do trabalho desenvolvido pela equipe de enfermagem na assistência ao paciente; EPS como transformadora no cotidiano de trabalho da equipe de enfermagem; elaboração de uma ferramenta que favorece a aplicação das Metas Internacionais de Segurança, e um plano de sugestão de EPS com vistas à aplicação dos PACE. Conclusão: o Estudo servirá de guia para implantar melhorias na prática assistencial. Existem dificuldades, mas os processos de trabalho que dependem das pessoas estão ocorrendo.
The Application of Nursing Care Protocols (NCP) seeks to qualify the care practices, and for this, the Permanent Health Education (PHE) is used as a working tool, to promote knowledge about patient safety. Objectives: Implement in Hospital Universitário de Canoas - RS (HU), NCPs adopted in Network Mãe de Deus, with view to certification process; verify how technical team identifies the application od NCPs; identify contributions that NCPs may bring to HU; propose a PHE plan towards the implementation of NCP. Method: Study conducted with ten practical nurses, exploratory-descriptive, qualitative approach. Results: From the focus groups, categories were emerged: interference of the hospital infrastructure in nursing care; interference of nursing staff work in patient care; PHE as a modifier in the daily work of the nursing staff; development of a tool that promotes the implementation of the International Safety Goals and a PHE cue plan towards the implementation of NCPs. Conclusion: This study will serve as a guide to implement improvements in care practice. There are difficulties, but the work processes that depend on people are happening.
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Bonnel, Galadriel. "L'évolution des infirmières de la pratique avancée et leur rôle dans le système de santé français : perspective internationale." Thesis, Aix-Marseille, 2012. http://www.theses.fr/2012AIXM5060.
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Objectifs: Etudier l'évolution de l'introduction du rôle de l'IPA et proposer des recommandations pour les études ultérieures.Méthodes: Une revue de la littérature française et internationale concernant l'IPA. Participation à un groupe de travail national concernant l'avancement de ce rôle et les réformes éducationnelles. Une étude rétrospective comparant la prise en charge de patients hypoglycémiques en milieu pré-hospitalier par infirmiers et physiciens. Un questionnaire étudiant les perceptions des premiers étudiants en cursus IPA.Résultats: Différents niveaux de transferts de compétence et de collaboration médecin/infirmière existent déjà en France. Dans l'étude rétrospective, la qualité de soin des infirmières a été similaire à celle des médecins. Dans l'étude sur l'IPA, la majorité des étudiants a indiqué que les autres infirmières et docteurs ne sont pas au courant du rôle de l'IPA, et que des barrières bloquent son développement.Conclusions: La création du rôle d'IPA et le développement de la formation des infirmières en France peuvent répondre aux défis de santé publique, telle l'incidence croissante des maladies chroniques et la pénurie de médecins. Les recommandations suivantes furent proposées pour le développement du rôle de l'IPA : définir et faire reconnaître le rôle de la pratique infirmière avancée et ses compétences, promouvoir le rôle plus largement dans les disciplines médicales, soutenir les efforts de communication entre l'état et les professionnels de santé, développer des programmes au niveau master et doctorat, et promouvoir des travaux de recherche infirmiers et interdisciplinairesBackground: In the context of public health challenges and health care reforms in France, the evolving advanced practice nurse (APN) role may be a solution. Objectives: To study the introduction of the ANP role and provide evidence-based recommendations for future research.Methods: A review of the international and French APN literature was performed. Participation in a national task force concerned advancement of the role and education reforms. In a retrospective study, nurses and physicians were compared in the pre-hospital management of hypoglycemic patients. Finally, a survey was administered to the first French APN Master's students to identify their perceptions of the APN role.Results: Variables levels of skill transfer and doctor-nurse collaboration currently exist in France. In the retrospective study, the pre-hospital quality of care of nurses was comparable to that of doctors. In the APN student survey, the majority indicated that other nurses and doctors were not aware of the APN role, and that barriers exist in role development. Conclusions: Creation of the APN role and advancement of nursing education in France can respond to public health challenges including the rising incidence of chronic diseases and an impending physician shortage. The following recommendations were proposed for APN role development: to define and recognize the advanced practice nurse role and related competencies, promote the role in a wider range of medical disciplines, facilitate clear communication between government and health care professionals, develop nursing Master's and Doctorate programs, and promote nursing and interdisciplinary research
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Salles, Roseluci Santos de. "Educação permanente: potencialidades para a cultura da qualidade em uma instituição pública de saúde." Universidade Federal Fluminense, 2013. https://app.uff.br/riuff/handle/1/1235.
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Mestrado Profissional em Ensino na Saúde
Os processos de Educação Permanente surgem para os serviços em geral e seus setores de treinamento ou capacitação com a necessidade da adoção da concepção pedagógica problematizadora, com o propósito de estimular a reflexão da prática e a construção do conhecimento. Nas instituições de saúde não é diferente, porquanto seus trabalhadores cotidianamente precisam também aplicar adequadamente seus conhecimentos à realidade, o que frequentemente ocorre em um cenário complexo, onde a habilidade técnica deve-se aliar à de realizar ações que assegurem a continuidade do processo de trabalho. Nesse contexto, a segurança do paciente internado em um hospital está ligada ao desenvolvimento de algumas ações preventivas, que devem estar baseadas em princípios universais e na realidade específica da unidade de saúde. O gerenciamento do uso seguro de medicamentos é uma prioridade quando se trata de minimizar riscos para o paciente. Nesse cenário, foi delimitado como objetivo principal descrever sobre uma educação permanente fundada na cultura institucional da qualidade, a partir do cotidiano de profissionais envolvidos no processo de medicação do paciente internado; como objetivos secundários: relacionar as principais questões/problemas ligadas ao processo de educação permanente; conhecer possíveis estratégias adotadas pelos profissionais envolvidos com a saúde dos pacientes internados, no enfrentamento de questões ligadas ao processo de medicação e sua efetividade e; identificar estratégias educacionais com potencial de promover a interação/discussão e a solução multiprofissional de questões e problemas ligados ao processo de medicação dos pacientes internados. Metodologia: estudo descritivo de abordagem qualitativa, desenvolvido no Instituto Nacional de Traumatologia e Ortopedia (INTO), instituição pública de saúde, acreditada há seis anos, de referência nacional no atendimento de alta complexidade, localizado no município do Rio de Janeiro. Utilizaram-se como técnicas de coleta de dados: entrevistas em profundidade e grupo focal, em amostra intencional composta por 15 profissionais de saúde. Os dados foram tratados por análise de conteúdo conforme Bardin. Resultados: Da análise dos dados emergiram três categorias, a saber: A Educação Permanente para o compromisso; A Educação Permanente para o convívio e; A Educação Permanente para a mudança. As categorias emergidas mostraram as perspectivas do fenômeno estudado no que compete às dificuldades, ações multiprofissionais para resolução de problemas e para geração da mudança do processo de trabalho no que se relaciona ao processo de medicação do paciente internado. Conclusão: A concepção de Educação Permanente em um serviço de saúde no cumprimento de seu objetivo transformador de ações cotidianas prevê o conhecimento contínuo sobre seus trabalhadores e os aspectos que os tornam participantes do processo na construção de mudanças. A reflexão sobre educação em serviços de saúde dialoga com a que se dá sobre a qualidade da assistência em tais serviços. Assim, o desenvolvimento dos processos de trabalho de uma unidade hospitalar que prima pela qualidade na assistência prestada ao seu cliente, vai além de implementar uma metodologia de gestão que garanta a realização das tarefas conforme os padrões pré-estabelecidos em manuais, rotinas e protocolos.
The processes of Permanent Education for services in general and their training sectors or capacity with the need to adopt the questionable instructional design, in order to stimulate reflection on practice and knowledge construction. In health institutions is no different, because its workers daily need also appropriately apply their knowledge to reality, which often occurs in a complex scenario, where technical skill should be combined with actions to ensure continuity of the work process. In this context, the safety of the patient at hospital is linked to the development of some preventive actions, which must be based on universal principles and the specific reality of the health unit. Manage the safe use of medicines is a priority when it comes to minimizing risks to the patient. Main aim: to describe about one permanent education founded on institutional quality culture, from the everyday lives of professionals involved in medication process of the in-patient. Secondary aims: relate the main issues related to the process of education permanent; know possible strategies adopted by professionals involved with the health of hospitalized patients, in coping of issues related to the medication process and its effectiveness and; identify educational strategies with potential to promote interaction / discussion and multidisciplinary solution of issues and problems related to medication process of inpatients. Methodology: A descriptive qualitative study, developed at the National Institute of Traumatology and Orthopaedics (INTO), public health institution, accredited for six years, national reference in high-complexity care, located in the municipality of Rio de Janeiro. Were used as techniques of data collection: in-depth interviews and focus groups in intentional sample of 15 health professionals. Data were treated by content analysis according to Bardin. Results: Data analysis revealed three categories, namely: Permanent Education for commitment; Permanent Education for socializing and; Permanent Education for change. The categories that emerged showed the prospects of the studied phenomenon related to difficulties, multidisciplinary actions for problem solving and generation change in the working process as it relates to the process of inpatient medication. Conclusion: The concept of Permanent Education in a health service in fulfilling its goal of transforming everyday actions provides the continued knowledge about its employees and the aspects that make them participants in the construction process of change. The reflection about education in health services dialogues with a reflection that occurs about the quality of care in such services. Thus, the development of work processes within a hospital unit that excels in quality of care provided to your customer goes beyond implementing a management methodology that ensures the tasks according to pre-established standards in manuals, routines and protocols.
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Duszka, Christopher Damian. "School Climate in the School Choice Era: A Comparative Analysis of District-Run Public Schools and Charter Schools." FIU Digital Commons, 2018. https://digitalcommons.fiu.edu/etd/3922.
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Comparative analyses of district-run public schools and charter schools are limited to performance outcomes. There is a dearth of research on how the school-types vary on factors consequential to performance such as school climate. Public-private distinctions, such as in organizational autonomy, value orientations, funding structures, and management practices, could result in school climate dissimilarities between district-run public schools and charter schools.
The aim of this dissertation is to assess the influence organizational factors have on school climate and determine if school-type affects school climate. Student and staff school climate survey data from the Miami-Dade school district were utilized for this dissertation. Structural equation modeling was employed to test theoretical models of students’ and staffs’ perceptions of school climate using data from 2001-2002 through 2015-2016 academic years. Within-between effects panel regression was utilized to test the effect of school-type on school climate constructs over time using data from 2005-2006 through 2015-2016 academic years.
The structural equation results demonstrate that milieu, ecology, culture, and organizational structure influence students’ and staffs’ perceptions of their schools’ climates. Ecology has the strongest association with students’ perceptions of school climate. Job satisfaction, a part of milieu and culture, has the strongest association with staffs’ perceptions of school climate. The results indicate that the theoretical models of school climate employed by this study are sound.
The within-between effects panel regression results demonstrate that characteristics inherent to school-type have a plausible influence on students’ perceptions of school climate, but not for staff. Charter school students rated their school climates more favorably than traditional public schools, but when other factors are controlled, traditional public schools and magnet schools had more favorable ratings. Public-sector values, collective bargaining, and school district oversight may be beneficial to schools’ climates.
This dissertation underscores the impact management and funding structures have on school climate. The author recommends that the school climate concept and evaluations of schools’ organizational practices be incorporated into school improvement policies. The milieu, culture, ecology, and organizational structures of schools should be reviewed when assessing school quality.
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Smith, A., S. Latter, and Alison Blenkinsopp. "Safety and quality of nurse independent prescribing: a national study of experiences of education, continuing professional development clinical governance." 2014. http://hdl.handle.net/10454/10665.
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NoAim. To determine the adequacy of initial nurse independent prescribingeducation and identify continuing professional development and clinicalgovernance strategies in place for non-medical prescribing.Background. In 2006, new legislation in England enabled nurses with anindependent prescribing qualification to prescribe, within their competence. In 2006,non-medical prescribing policies released by the Department of Health outlinedthe recommendations for education, continuing professional development andgovernance of non-medical prescribing; however, there was no evidence on a nationalscale about the exte nt of implementation and effectiveness of these strategies.Design. National surveys of: (i) nurse independent prescribers; and (ii) non-medical prescribing leaders in England.Methods. Questionnaire surveys (August 2008–February 2009) coveringeducational preparation, prescribing practice (nurse independent prescribers) andstructures/processes for support and governance (non-medical prescribing leaders).Results. Response rates were 65% (976 prescribers) and 52% (87 leaders). Mostnurses felt their prescribing course met their learning needs and stated courseoutcomes and that they had adequate development and support for prescribing tomaintain patient safety. Some types of community nurse prescribers had less accessto support and development. The prescribing leaders reported lacking systems toensure continuity of non-medical prescribing and monitoring patient experience.Conclusion. Educational programmes of preparation for nurse prescribing werereported to be operating satisfactorily and providing fit-for-purpose preparationfor the expansion to the scope of nurse independent prescribing. Most clinicalgovernance and risk management strategies for prescribing were in place inprimary and secondary care.
Department of Health (UK)
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Chikutuma, Tendai. "The quality of early childhood development programmes in Harare primary schools in Zimbabwe." Thesis, 2013. http://hdl.handle.net/10500/13511.
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The study sought to establish the quality of Early Childhood Development (ECD)
programmes. It was therefore important that the researcher investigates whether the
ECD programmes were meeting the expectations of the quality indicators and
consequently the holistic needs of ECD children. The qualitative design methodology
was used in this study. Self-constructed observation checklists and in-depth interview
guides were used. The participants in the study were 10 school heads, 10 ECD
teachers and 10 ECD parents, one from each of the ten schools under study from
Harare low and high density suburbs. The data were content analysed. The findings
of the study revealed that school heads incompetently managed the ECD curriculum.
It was also revealed in the study that ECD policies existed in schools but some were
not adhered to which impacted negatively on the quality of ECD programmes.
Findings of the study also revealed that the components of a quality ECD programme
which included; nutrition, health and safety, parental involvement, stakeholder
involvement, guidance and counselling in ECD were compromised. The study showed
that ECD personnel qualifications were varied. The study also revealed that teaching
methods in ECD were all child-centred though some ECD parents and school heads
criticised the play-way and child-centred method of teaching. Findings revealed that
material, financial and human resources were scarce. It was concluded that the
quality of ECD programmes in Harare primary schools was compromised. It was
recommended that training of all stakeholders on ECD management and organisation
would bring about a better understanding of ECD programmes, mounting staff
development workshops on practical skills training in guidance and counselling of
ECD children for ECD teachers, school heads and counsellors and, inviting parents as
resource persons when teaching certain concepts would improve the quality of ECD
programmes. Recommendations for further study were madeEducational Studies
D.Ed. (Psychology of Education)
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Michaud-Hamilton, Nicole. "Developing a Standardized Electronic Reporting System for Visiting Nurses." Thesis, 2014. http://hdl.handle.net/1828/5387.
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Handover from one healthcare professional is an essential component of patient care. This can be a challenge in community care where staff provide interventions in the patient’s home and do not have the benefit of face-to-face interactions with colleagues. The purpose of this quantitative study was to explore the perceptions of nurses working in community care about handover and their views on using an electronic handover tool as opposed to their current email system. The goal of the study, to assess whether nurses would have a greater understanding of their patients’ needs through standardized reporting as opposed to emailed narratives of time and tasks was studied. Nurses completed a pre, post likert-type survey, and reviewed an electronic handover tool. Both surveys were analyzed by nursing professional designation and age to explore whether either factor influenced opinions. Nurses reported that handover was important and they supported a standardized communication tool as opposed to relying on an email system without structure.Graduate
0569
nmichaudhamilton@gmail.com
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Chen, Tzu-Chun, and 陳慈君. "The Effect of Flip Teaching on Dialysis Patient Safety Education for Dialysis Nurses." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/38374412303476651927.
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碩士國立臺北護理健康大學
醫護教育研究所
104
This study aimed to investigate the effect of flipped teaching on recognition and care skills of patient safety as well as satisfaction of patient safety course in dialysis nurses. Quasi-experimental design was employed. A total 74 dialysis nurses from single medical center in Taipei and two of its branches were recruited and randomized to either flipped or traditional learning. All participants received survey about patient safety recognition and self-evaluation about care skills of patient safety before and after the learning course. All statistical analyses were performed using SPSS version 21.0. Pearson test, Chi Square test, Fisher’s exact test and unpaired t test were introduced for test of homogeneity. For significant difference between groups in age, seniority (nurses, dialysis nurses or clinical teachers), confidence in conducting correct nursing for patient safety and helping patients with empathy, analysis of covariance was made by ANCONA. Difference within group was analyzed via paired t test. Our result showed participants underwent flipped learning had significantly higher score on the test of patient safety recognition but those underwent traditional learning had more marked progress. Although there was no significant difference in self-evaluation about care skills after completion of learning course between the two groups, participants with traditional learning had more progress. No difference between the two groups in satisfaction was noted. Accordingly, further study may be suggested to investigate the effect of flipped teaching in dialysis nurses. Otherwise, participants underwent traditional learning had higher academic motivation about the topics which resulted in significantly different learning effect within group. Therefore,learning course design should be based on the demand of learners. Besides, widely-used video containing medical knowledge and technology may narrow the urban-rural gap in teaching and education recourses. Finally, application of flipped teaching to the learning course of other specialties may be suggested.
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Aiken, L. H., W. Sermeus, den Heede K. Van, D. M. Sloane, R. Busse, M. McKee, A. M. Rafferty, et al. "Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States." 2012. http://hdl.handle.net/10454/10362.
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YesObjective To determine whether hospitals with a good organisation of care (such as improved nurse staffing and work environments) can affect patient care and nurse workforce stability in European countries. Design Cross sectional surveys of patients and nurses. Setting Nurses were surveyed in general acute care hospitals (488 in 12 European countries; 617 in the United States); patients were surveyed in 210 European hospitals and 430 US hospitals. Participants 33 659 nurses and 11 318 patients in Europe; 27 509 nurses and more than 120 000 patients in the US. Main outcome measures Nurse outcomes (hospital staffing, work environments, burnout, dissatisfaction, intention to leave job in the next year, patient safety, quality of care), patient outcomes (satisfaction overall and with nursing care, willingness to recommend hospitals). Results The percentage of nurses reporting poor or fair quality of patient care varied substantially by country (from 11% (Ireland) to 47% (Greece)), as did rates for nurses who gave their hospital a poor or failing safety grade (4% (Switzerland) to 18% (Poland)). We found high rates of nurse burnout (10% (Netherlands) to 78% (Greece)), job dissatisfaction (11% (Netherlands) to 56% (Greece)), and intention to leave (14% (US) to 49% (Finland, Greece)). Patients’ high ratings of their hospitals also varied considerably (35% (Spain) to 61% (Finland, Ireland)), as did rates of patients willing to recommend their hospital (53% (Greece) to 78% (Switzerland)). Improved work environments and reduced ratios of patients to nurses were associated with increased care quality and patient satisfaction. In European hospitals, after adjusting for hospital and nurse characteristics, nurses with better work environments were half as likely to report poor or fair care quality (adjusted odds ratio 0.56, 95% confidence interval 0.51 to 0.61) and give their hospitals poor or failing grades on patient safety (0.50, 0.44 to 0.56). Each additional patient per nurse increased the odds of nurses reporting poor or fair quality care (1.11, 1.07 to 1.15) and poor or failing safety grades (1.10, 1.05 to 1.16). Patients in hospitals with better work environments were more likely to rate their hospital highly (1.16, 1.03 to 1.32) and recommend their hospitals (1.20, 1.05 to 1.37), whereas those with higher ratios of patients to nurses were less likely to rate them highly (0.94, 0.91 to 0.97) or recommend them (0.95, 0.91 to 0.98). Results were similar in the US. Nurses and patients agreed on which hospitals provided good care and could be recommended. Conclusions Deficits in hospital care quality were common in all countries. Improvement of hospital work environments might be a relatively low cost strategy to improve safety and quality in hospital care and to increase patient satisfaction.
Dr McIntosh is a member of the the RN4CAST Consortium.
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ChengHsiuChun and 鄭琇君. "The relationships amomg the Knowledge and Attitudes toward Food Safety, and the Willingness to Promote Nutrition Education of School Nurses." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/99484161065290470255.
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碩士朝陽科技大學
應用化學系
102
The purpose of this study is to explore the current situation and to see the relationships amomg the school nurses’ knowledge and attitudes toward food safety, and willingness to participate in the promotion of nutrition education in Taichung City. Structured questionnaire was used as the measure for the examination in the study. "Food safety knowledge scale", "food safety attitude scale", and "willingness to participate in the promotion of nutrition education scale" were used as the instruments to investigate the results. Paritcipants were school nurses in the 343 schools in Taichung City as the population. 237 valid questionnaires from the stratified random sampling were used to be analyzed through descriptive statistics, t-tests, one-way ANOVA, and Pearson product-moment correlation. The major findings are addressed as following. First, the degree of the school nurses’ knowledge about food safety goes to the performance of "good" in Taichung City. Second, the results of school nurses’attitudes toward food safety shows positively. Third, the willingness of school nurses’ participation of promting nutrition education in Taichung City is active. They do have the willingness to promote the nutrion education. Forth, there is significant difference in the middle of the school nurses’ food safety knowledge and different frequency of them having the nutrtion education classes. Participants who had better understanding about the food safety had more than three times of the nutrtion education classes’ experiences before than participants who had none or once. Furthermore, significant difference is also shown in the school nurses’different frequency of having the nutrtion education class and the willingness to have contribution in promoting the nutrition education. Participants who showed up more than three times in the nutrtition education classes have higher willingness to promote the nutrtition education than those who only appeared none or once before. Moreover, there’s also a significant result in the relationships between the frequency of school nurses joined the promotion of nutrtion education in the previous experiences and the willingness to promote the nutrition education. Particiapants who promoted the nutrtion education more than three times are more willingly to promote nutrition education than those who had none or once. At last, the relationships amomg the school nurses’ knowledge and attitudes toward food safety, and the willingness to promote nutrition education are positive correlated.
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Liphosa, Winnifred Matsidiso. "Perceptions of the nurses' continuing professional development and its contribution to quality patient care." Diss., 2013. http://hdl.handle.net/10500/10611.
Full textAbstract:
Aim: The aim of the study is to explore the perceptions of the nurses’ CPD and its
contribution to quality patient care in the Gauteng province of the Republic of South
Africa.
Significance of the study: The significance of the study is to highlight the
importance of CPD as one of the contributing factors to the quality of patient care
through on-going competence. The researcher hopes the recommendations from the
study may serve as a motivation to health institutions that are not actively involved in
continuing professional development.
Method and data analysis: Quantitative descriptive explorative design was used to
achieve the objectives of the study.
The study involved registered professional nurses (n =105) and enrolled nurses
(n=56) employed in a state health institution. Data was collected by means of a
structured questionnaire.A total of 200 questionnaire were distributed and 162
completed questionnaires were returned, giving a response rate of 162/200=81%.
Statistical analysis was conducted using the SAS software version 9.3.The internal
and external validity was enhanced by selecting a large homogenous sample.
Ethical issues: An information leaflet indicating the key elements of the study such
as the research title, the purpose of the study, voluntary participation and when to
withdraw from the study was distributed to all the participants. Results: The study found that nurses participate in CPD activities to maintain their
professional competence, thereby contributing to quality patient care. The findings
are consistent with the findings from other studiesHealth Studies
M.A. (Health Studies)
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Slater, B. L., R. Lawton, Gerry R. Armitage, J. Bibby, and J. Wright. "Training and action for patient safety: embedding interprofessional education for patient safety within an improvement methodology." 2012. http://hdl.handle.net/10454/7014.
Full textAbstract:
INTRODUCTION: Despite an explosion of interest in improving safety and reducing error in health care, one important aspect of patient safety that has received little attention is a systematic approach to education and training for the whole health care workforce. This article describes an evaluation of an innovative multiprofessional, team-based training program that embeds patient safety within quality improvement methods. METHODS: Kirkpatrick's "levels of evaluation" model was adopted to evaluate the program in health organizations across one city in the north of England. Questionnaires were used to assess reaction of participants to the program (Level 1). Improvements in patient safety knowledge and patient safety culture (Level 2) were assessed using a 12-item multiple-choice questionnaire and a culture questionnaire. Interviews and project-specific quantitative measurements were used to assess changes in professional practice and patient outcomes (Levels 3 and 4). RESULTS: All aspects of the program were positively received by participants. Few participants completed the MCQ at both time points, but those who did showed improvement in knowledge. There were some small but significant improvements in patient safety culture. Interviews revealed a number of additional benefits beyond the specific problems addressed. Most importantly, 8 of the 11 teams showed improvements in patient safety practices and/or outcomes. DISCUSSION: This program is an example of interprofessional education in practice and demonstrates that team-based learning using quality improvement methods is feasible and can be effective in improving patient safety, but requires time and space for participants. Alignment with continuing education arrangements could support mainstream adoption of this approach within organizations.
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Kao, Zhang. "Promoting medical service quality with high performance work systems: The role of safety learning climate and participatory safety." Master's thesis, 2020. http://hdl.handle.net/10071/20713.
Full textAbstract:
Improving the quality of medical care is a very important priority for any hospital. This is a matter that needs long-term pursuit and persistence and is mostly dependent on people and how they are managed. Alongside with the service quality in healthcare is the issue of safety. This study explores the mediation role of safety learning climate and the moderating role of participatory safety in the relationship between HPWS and service quality. Using the data collected from 135 physicians working in Public Chinese hospitals, findings show positive effects of HPWS on service quality, mediated also by safety learning climate. Findings also show the indispensability of participatory safety. Finally, the significance of these findings is discussed.Melhorar a qualidade dos cuidados médicos é uma prioridade muito importante para qualquer hospital. É uma questão que precisa de continuidade e persistência no longo prazo e que é muito dependente de pessoas muitos qualificadas e da forma como são geridas. Este estudo explora o papel mediador do clima de aprendizagem de segurança e o papel moderador da segurança participativa na relação entre as HPWS e a qualidade do serviço. Usando os dados recolhidos de 135 médicos que trabalham em hospitals públicos na China, os resultados mostraram efeitos positivos da HPWS na qualidade do serviço, igualmente por via do clima de aprendizagem de segurança. Os resultados mostraram também a indispensabilidade da segurança participativa. Finalmente, o significado destes resultados é discutido.
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Covell, Christine Lynn. "The Relationship of Nursing Intellectual Capital to the Quality of Patient Care and the Recruitment and Retention of Registered Nurses." Thesis, 2011. http://hdl.handle.net/1807/29692.
Full textAbstract:
To ensure quality patient care hospitals invest in nursing intellectual capital by allocating financial, human and material resources for nurses to acquire the knowledge and skills necessary to provide safe patient care. This study’s purpose was to test selected propositions of the middle-range theory of nursing intellectual capital which provides a conceptualization of the influence of nurses’ knowledge, skills and experience (nursing human capital) to patient and organizational outcomes. The theory was systematically developed after a critical review of the literature. It proposes that nursing human capital (registered nurses’ experience, and knowledge and skills acquired from continuing professional development including university courses, conferences, workshops, in-services, specialty certification) is related to variables within the work environment (nurse staffing, employer support for nurse continuing professional development), which in turn, is associated with the quality of patient care (adverse events) and the recruitment and retention of nurses. The theory also proposes that nursing structural capital, nursing knowledge available within practice guidelines, is associated with the quality of patient care. A cross-sectional design was used to test the proposed relationships. The study took place in 6 acute care hospitals in two provinces of Canada. Financial, human resource and risk management data were collected from hospital departmental databases and a survey of unit managers. Data from 91 inpatient units were used with structural equation modeling to test the theory’s propositions. The results indicated that nurses’ knowledge and skills represented by the proportion of RNs with degrees and proportion of RNs with specialty certification were directly associated with low hospital-acquired infection rates. Nurse experience, measured as mean years RN professional experience and RN unit tenure, was found to be significantly related to higher RN recruitment and retention. The proportion of RNs with degrees was found to partially mediate the influence of nurse staffing on hospital-acquired infections. The results provide preliminary evidence of the association of nursing intellectual capital with patient and organizational outcomes. The findings may assist administrators with fiscal and human resource decision-making related to the education of nurses within acute care hospitals, and professional organizations with policies governing nursing education and continuing professional development.
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Kadango, Alice. "A critical analysis of the competencies of upgrading nurses from Malawi College of Health Sciences in Malawi." Diss., 2007. http://hdl.handle.net/10500/1810.
Full textAbstract:
The purpose of the study was to analyse if the two year upgrading programme done at Malawi College of Health Sciences attended by Nurse Midwife Technicians (NMTs) is able to improve the competencies, knowledge, skills and attitude of the graduates when providing comprehensive nursing and midwifery care. The main objectives of this study were
• to determine the effectiveness of the Upgrading Diploma in Nursing and Midwifery programme in preparing the competencies of State Registered Nurse Midwifes (SRNMs)
• to make recommendations on the training of Upgrading Diploma in Nursing and Midwifery programme
The researcher used a quantitative, exploratory, descriptive design. A questionnaire with closed and open-ended questions was used to collect data from SRNMs who completed the upgrading programme.
The findings indicated that the upgrading programme has a significant impact to improve the competencies of the NMTs to work as SRNMs.Health Studies
M.A. (Health Studies)
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Meira, Hugo Alexandre Neves Fortes Guimarães. "Numa procura pela qualidade." Master's thesis, 2019. http://hdl.handle.net/10400.14/31627.
Full textAbstract:
Este relatório insere-se no âmbito da Unidade Curricular – Estágio Final e Relatório, do 11º Curso de Mestrado em Enfermagem com Especialização em Enfermagem Médico- Cirúrgica da Universidade Católica Portuguesa, Instituto de Ciências da Saúde do Porto, com vista à obtenção do referido grau, através da aquisição e desenvolvimento de competências pessoais e profissionais no contacto direto com a prática, neste caso, e por ordem cronológica, no Instituto Nacional de Emergência Médica e nas Unidades de Cuidados Intensivos dos serviços de Cirurgia Cárdio-Torácica e de Doenças Infeciosas. Tem como objetivos apresentar o percurso de aquisição e desenvolvimento de competências com vista à aquisição do grau de mestre e título de enfermeiro especialista em enfermagem Médico-Cirúrgica, contribuir para a continuidade da construção do saber em Enfermagem, em ordem à evolução profissional e pessoal contínua, centrada na prática refletida e fundamentada. Encontra-se organizado por domínios de competência, nos quais são identificados os objetivos e descritas as atividades desenvolvidas. A temática da qualidade dos cuidados, numa perspetiva de segurança dos doentes, por ser uma área em franco desenvolvimento ao longo dos últimos anos, foi selecionada como tema central deste relatório, com vista ao atingimento de competências da Especialidade em Enfermagem Médico-Cirúrgica. Na premissa que os enfermeiros são uma peça fundamental na garantia da segurança dos doentes, foram diversas as problemáticas evidenciadas ao longo dos contextos de estágio como potenciais focos de risco para a qualidade e continuidade dos cuidados, resultando em propostas de melhoria que, de modo formal e informal, foram apresentadas aos serviços. Assim, no que se refere à emergência pré-hospitalar, foi realçada a pertinência da informação para a qualidade e continuidade dos cuidados, através de um trabalho críticoreflexivo, com recurso a revisão da literatura, intitulado Sistemas de Informação: Um projeto de reflexão sobre a prática. Nos cuidados intensivos, por sua vez, foi realçada a importância das competências dos Enfermeiros Especialistas em Enfermagem Médico-Cirúrgica como garantia da qualidade das práticas e como mecanismo de promoção e evolução da profissão, através de um trabalho crítico-reflexivo, com recurso à revisão da literatura e à aplicação de instrumentos de auditoria às práticas dos enfermeiros, intitulado Pela Qualidade dos Cuidados: Numa perspetiva de gestão. Importa ainda referenciar que nesta unidade curricular foi dada continuidade a um estudo relativo aos riscos psicossociais dos enfermeiros que prestam assistência ao doente crítico, o qual tinha sido iniciado no estágio do segundo semestre. Com o objetivo de desenvolver competências no âmbito da melhoria da qualidade, bem como no âmbito da investigação em saúde, os resultados são apresentados, possibilitando uma leitura acerca dos fatores que podem influenciar a qualidade dos cuidados prestados pelos enfermeiros ao doente crítico. Deste modo, por serem diversos os fatores que têm potencial de afetar os cuidados, quer sejam eles pessoais ou organizacionais, a passagem pelos contextos supra referenciados, assim como a possibilidade dos trabalhos desenvolvidos, constituiu uma mais valia no atingimento de competências no âmbito do Mestrado em Enfermagem com Especialização em Enfermagem Médico-Cirúrgica. Concluído o percurso, considero que foram desenvolvidas as competências adequadas para a prestação de cuidados especializados na área da Enfermagem Médico-Cirúrgica, através de processos de tomada de decisão, assentes numa ação refletida e na prática baseada na evidência científica.This report reflects the personal and professional skills developed and acquired by experiencing direct contact with the following services, National Institute of Medical Emergency and the Intensive Care Unit of the Cardio-Thoracic Surgery department and the Intensive Care Unit of the Infectious Diseases department, by chronological order, during the Curricular Unit - Final Internship and Report of the 11th Master Degree Course in Nursing with Specialization in Medical-Surgical Nursing of the Institute of Health Sciences, Universidade Católica Portuguesa. This report aims to describe the skill acquisition and development, in order to achieve master’s degree and become nurse specialist in Medical-Surgical Nursing, contributing to the continuity and construction of knowledge in nursing and maintain the professional and personal continuous development, focused in a reflected and justified practice. It's organized by competence domains, wherein the goals are identifiable and the activities described. As a means of acquiring skills in the Specialty of Medical-Surgical Nursing, the quality of care theme, in a patient safety perspective, was chosen as the central subject of this report since it has been a subject of particular interest in the last few years. With the premise that nurses are key players in warranting patient safety, several problems were identified during the course of the internship, such as potential risk factors that affect the quality and continuity of care, resulting in improvement proposals that were presented to the services, both formal and informally. Therefore, regarding pre-hospital emergency, it has been highlighted the importance of information for the quality and continuity of care, through a written critical-reflexive work, supported by the literature, entitled Sistemas de Informação: Um projeto de reflexão sobre a prática. Regarding intensive care, it was highlighted the importance of nurses specialized in Medical-Surgical Nursing skills as a warranty of quality care and as a means of job promotion and evolution, through a written critical-reflexive work, supported by the literature and the application of auditing instruments to the nurses procedures, entitled Pela Qualidade dos Cuidados: Numa perspetiva de gestão. It is also important to refer that a study involving psicossocial risks in nurses that work with critic patients, which had been started in the last semester, was given continuity. The study was developed with the goal to acquire skills in the field of quality improvement, as well as health investigation, and the results will be presented in a subchapter of this report, allowing a reading about the factors that might influence patient care provided by nurses to critic patients. The chance to have experienced several work environments, as well as the reports developed during these internships, constituted a key factor in acquiring skills in the field of the Master Degree Course in Nursing with Specialization in Medical-Surgical Nursing, since the elements with potential to affect patient care, whether they are personal or institutional, are diverse. Now that the journey has finished, I believe that I was able to develop skills inherent to specialized nurses, being able to provide specialized care in the field of Medical-Surgical Nursing, through decision making processes built not only in reflected action but also in scientific evidences.
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Spang, Freda Maria. "Verkenning van die ervaring van kinderversorgers in hul rol as opvoeders van kinders in 'n plek van veiligheid (Afrikaans)." Diss., 2006. http://hdl.handle.net/2263/30494.
Full textAbstract:
EXPLORATION OF THE EXPERIENCES OF CHILD CARE WORKERS AS EDUCATORS IN A PLACE OF SAFETY SUMMARY OF THE STUDY: This study aims to explore and describe the experiences of child care workers in their role as educators at a place of safety, in order to gain a better understanding of what they see as their educational task and the difficulties they experience in executing this task. The literature review provides a survey of the purpose of a place of safety, what education of children entails and the specific needs of children who experience trauma in their lives. Some of the factors that influence the way the care workers execute their task as educators, are discussed briefly. This qualitative case study is approached from the interpretative paradigm. Child care workers were engaged in individual interviews and a focus group discussion. The data-analysis leads to the following conclusions: • Although child care workers show understanding for the needs of the children in their care. And have a basic understanding of what education entails, aspects were identified in which they need training and support. • Child care workers show symptoms of burnout and reveal the need for supervision. • The way the institution is managed leaves child care workers dissatisfied, which leads to feelings of passivity, negativity, demotivation and a vengeful attitude.Dissertation (Magister Educationis (Educational Psychology))--University of Pretoria, 2006.
Educational Psychology
unrestricted