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Found 650 results
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Content ArticleThis report by the Royal College of Nursing (RCN) outlines 10 indicators that NHS is under unsustainable pressure. It refutes claims by Government ministers that pressures on health and care services are sustainable, stating that disaster for the NHS can only be prevented by addressing workforce shortages.
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Burnout in nursing: a theoretical review (5 June 2020)
Patient Safety Learning posted an article in Staff safety
Workforce studies often identify burnout as a nursing ‘outcome’. Yet, burnout itself—what constitutes it, what factors contribute to its development, and what the wider consequences are for individuals, organisations, or their patients—is rarely made explicit. Dall'Ora et al. aimed to provide a comprehensive summary of research that examines theorised relationships between burnout and other variables, in order to determine what is known (and not known) about the causes and consequences of burnout in nursing, and how this relates to theories of burnout. -
Content ArticleThe Joint Commission implemented medication management titration standards in 2017, with revisions in 2020. Researchers surveyed critical care nurses about their experiences with medication titration, use of clinical judgment when titrating, nurses’ scope and autonomy, and their moral distress. Of 781 respondents, 80% perceived the titration standards caused delays in patient care and 68% reported suboptimal care, both of which significantly and strongly predicted moral distress.
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Content ArticleThe aim of this study was to derive a comprehensive list of nursing-sensitive patient outcomes (NSPOs) from published research on nurse staffing levels and from expert opinion. The authors identified strong evidence for a significant association between nurse staffing levels and NSPOs. The results may guide researchers in selecting NSPOs they might wish to prioritise in future studies.
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Content ArticleA lay person commented recently that ‘seeing how nurse practitioners were so clever why didn't they rename themselves as something other than a type of nurse’. A sobering comment indeed, but one that has, on occasions, been uttered by nurse practitioners (NPs) themselves from around the world. In this editorial, Jenny Carryer and Sue Adams tease out the thinking behind this idea and consider the implications for the nursing discipline. In doing so, they draw essentially on the New Zealand experience of NP establishment but believe these ideas have international significance.
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Content ArticleThis is the recording of a Royal College of Nursing (RCN) online event with actor David Harewood in conversation with mental health workers Simon Arday and Kojo Bonsu. Drawing on expertise from Black health care professionals and those with lived experience, the event explored what needs to be done to improve black people's experiences of mental health services. The event was chaired by Catherine Gamble RCN Fellow and Associate Director of Nursing Education South West London and St George's Mental Health NHS Trust.
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Content ArticleThis article from the book 'Patient Safety and Quality: An Evidence-Based Handbook for Nurses' looks at the impact of the architectural design of a hospital facility on patient safety. This includes considering the design of hospital technology and equipment. The authors highlight the ways in which physical design can make healthcare systems and processes safer for patients and staff. They also identify indirect benefits of system design that may contribute to this, including improved staff wellbeing and making patients feel safer while in care environments.
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The Buurtzorg Model
Patient Safety Learning posted an article in International patient safety
Buurtzorg is a pioneering healthcare organisation established in 2006 with a nurse-led model of holistic care that revolutionised community care in the Netherlands. Self-management, continuity, building trusting relationships, and building networks in the neighbourhood are all important and logical principles for the teams. -
Content ArticleResearch shows that patient safety walk rounds are an appropriate and common method to improve safety culture. This observational study in The Joint Commission Journal on Quality and Patient Safety combined walk rounds with observations of specific aspects of patient safety and measured the safety and teamwork climate. Healthcare workers were observed in specific aspects of patient safety on walk rounds in eight settings in a Swiss hospital. They were also surveyed using safety and teamwork climate scales before the initial walk rounds and six to nine months later. The authors evaluated the implementation of planned improvement actions following the walk rounds. The authors found that walk rounds with structured in-person observations identified safe care practices and issues in patient safety. However, improvement action plans to address these issues were not fully implemented nine months later, and there were no significant changes in the safety and teamwork climate.
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Content ArticleThis systematic review in Nursing Open synthesises the best available evidence on the impact of nurses' safety attitudes on patient outcomes in acute care hospitals. The review included nine studies and found that nurses with positive safety attitudes reported: fewer patient falls and medication errors fewer pressure injuries and healthcare-associated infections fewer mortalities fewer physical restraints and vascular access device reactions higher patient satisfaction. The authors also found that effective teamwork led to a reduction in adverse patient outcomes. They conclude that a positive safety culture results in fewer reported adverse patient outcomes, and that nurse managers can improve nurses' safety attitudes by promoting a non-punitive response to error reporting and promoting effective teamwork and good communication.
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Content ArticleIn October 2001 government chief nurses and other delegates from 66 countries met to discuss how best to deal with a common challenge—the global growth of nursing shortages. In this article, James Buchan looks at potential solutions and limitations. Although written in 2002, this is still relevant for today.
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Content ArticleThis cross-sectional study in BMJ Quality & Safety examines the association of hospital nursing skill mix with patient mortality and quality of care. The study analysed patient discharge data, hospital characteristics and nurse and patient survey data from adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. The authors found that a bedside care workforce with a greater proportion of professional nurses is associated with better outcomes for patients and nurses. They suggest that having a higher proportion of assistive nursing personnel without professional nurse qualifications reduces the skill mix and may: contribute to preventable deaths erode quality and safety of hospital care contribute to hospital nurse shortages.
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Content ArticleThis research by the Nuffield Trust, commissioned by NHS England and NHS Improvement, explores the business case for overseas recruitment and looks at the factors that attract or deter nurses from choosing to work in the UK. With a current NHS nursing vacancy rate of 10% and ambitious national goals to expand the workforce, recruiting nurses from overseas is an essential part of the picture. In this research, the authors look at the costs and benefits of overseas recruitment and present their findings as a briefing paper, research report and review on factors that attract or deter staff from moving to the UK.
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Patient safety is fundamental to the delivery and outcomes of effective health care. But what happens when things go wrong? What can we learn from the data and how does nursing ensure effective incident reporting takes place to protect patients and staff? Chair of Patient Safety Learning and Datix expert Jonathan Hazan joins us to discuss how data is key to patient safety and the importance of a just culture in health care. Nursing Matters is presented by PNC Chair Rachel Hollis and PNC member Alison Leary. -
Content ArticleThis chapter from Patient Safety and Quality: An Evidence-Based Handbook for Nurses describes a framework for understanding how human factors affect patient safety. It illustrates how different cumulative factors result in errors and suggests that nurses have a unique role to play in identifying problems and their causes. The authors highlight staff mindfulness as a tool to transform healthcare organisations into 'highly reliable organisations'.
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Content ArticleHealthcare associated infections (HAI), such as ventilator-associated pneumonia (VAP), are the most common and most preventable complication of a patient’s hospital stay. Their frequency and potential adverse effects increase in critically ill patients because of impaired physiology, including a blunted immune response and multi-organ dysfunction. Traditionally, VAP rates have been measured as an indicator of quality of care. Despite recent initiatives to measure complications of mechanical ventilation and a decrease in incidence over the past few years, VAP remains an issue for critically ill adults, with mortality estimated as high as 10%. This article from Boltey et al. reviews the top five evidence-based nursing practices for reducing VAP risk in critically ill adults.
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Content ArticleSubstantial evidence indicates that patient outcomes are more favourable in hospitals with better nurse staffing. One policy designed to achieve better staffing is minimum nurse-to-patient ratio mandates, but such policies have rarely been implemented or evaluated. In 2016, Queensland (Australia) implemented minimum nurse-to-patient ratios in selected hospitals. In a study published in the Lancet, McHugh et al. aimed to assess the effects of this policy on staffing levels and patient outcomes and whether both were associated.
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Content ArticleThe Royal College of Nursing (RCN)’s 'Nursing Workforce Standards' have been created to explicitly set out what must happen within workplaces to ensure the delivery of safe and effective patient care. The RCN's Nursing Workforce Standards are the first ever blueprint for tackling the nursing staff shortage levels across the UK. They set the standard for excellent patient care and nursing support in all settings, and all UK countries. Developed by the RCN's Professional Nursing Committee, the Nursing Workforce Standards suggest a roadmap for designing a workforce in both the NHS and the wider health and social care sector that can offer patients the quality of care they deserve. The 14 standards – the first of their kind – have been designed for use by those who fund, plan, commission, design, review and provide services which require a nursing workforce. They can also be used to help nursing staff understand what they should expect to be in place to enable them to do their jobs safely and effectively. The standards apply across the whole of the UK and to every setting where nursing care is delivered. They’re being launched as new polling reveals seven in 10 people believe there are too few nurses to provide safe care. Of the 1,752 members of the public who were surveyed, more than a quarter said they felt themselves or their families may not get the care required when needed.
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Content ArticleHospitals across the US are grappling with nurse shortages as the pandemic continues to change the healthcare system as we know it. Two intensive care unit nurses who left their jobs shared their experiences in Becker's Hospital Review.
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Content ArticleAmiri et al. analysed the role of nurse staffing in improving patient safety due to reducing surgical complications in member countries of Organization for Economic Co-operation and Development (OECD). They found that a higher proportion of nurses is associated with higher patient safety resulting from lower surgical complications and adverse clinical outcomes in OECD countries.
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Content ArticleFew empirical studies have directly examined the relationship between staff experiences of providing healthcare and patient experience. Present concerns over the care of older people in UK acute hospitals – and the reported attitudes of staff in such settings – highlight an important area of study. Maben et al. examine the links between staff experience of work and patient experience of care in a ‘Medicine for Older People’ (MfOP) service in England.
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Gavin Portier is Head of Nursing Quality at Barnsley Hospital NHS Foundation Trust. In this interview, Gavin explains how his approach to auditing has moved beyond measuring negative outcomes, instead focusing on standards of care. -
Content ArticleHealthcare workers are among the heroes of the pandemic. One year in, many of us are experiencing stress, fatigue, and grief. But this can pale in comparison to the toll faced by those caring for the sick and dying on a daily basis. On the latest episode of The Dose, we listen to the stories of one group of frontline health workers: nurses. Often dealing with inadequate PPE and staff shortages, nurses are putting their own lives at risk — and many are experiencing burnout and exhaustion. In this podcast, guest, Mary Wakefield, takes us on a journey from rural hospitals to clinics in underserved areas, all through the eyes of nurses.
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Content ArticleMore than 30 years have passed since the near-fatal medication error but Michael Villeneuve, CEO Canadian Nursing Association, recalls the moment with absolute clarity.
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Content ArticleEndometriosis is a chronic disease affecting approximately 10% of fertile women. These women often have negative health care experiences. This study from Bach et al. adds new knowledge about endometriosis care in a hospital setting and nurses’ attitudes toward the disease. To explore how the personal attitudes of gynaecological nurses, their specialised knowledge, and their clinical experiences influenced the way they conceptualised and cared for women with endometriosis, participant observations and semi-structured interviews were conducted. Categorisation of patients into certain kinds, with more or less legitimate needs, provided an important framework for practice. Specialised knowledge qualified the nurses’ views of their patients and seemed to be conducive to sustained patient involvement. However, the organisation of care based solely on medical specialisation restricted a holistic approach. An important goal is, therefore, to investigate patients’ perspectives of health and illness and to create participatory relationships with patients, regardless of their diagnosis.
