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High-quality health care services would give good health outcomes to society. Nursing service is part of the quality-of-care process. The study aimed to investigate the quality of care in Indonesian hospitals over the last 20 years. The integrative review method was used, and 36 studies in Indonesia were analyzed, following the procedure: problem recognition, literature finding, data assessment, data review, and presentation of the results. Currently, the quality of care in Indonesia is low. The quality of care has increased over time in line with technology and science, and the factors which are related to quality have increased broader. Those factors are hospital management factors, nurse, and nursing organization the hospital management factors, including nurses staffing, environment, and job design. Nursing staffing factors are nursing shortage, workload, job satisfaction, burnout, and turnover. Meanwhile, work environment factors include supervision, empowerment, nurse-physician relationship, managerial, surveillance, and case management. Job design factors are nursing rounds, care delivery, competencies, training needs, roles, and documentation. Besides, personal factors are education, gender, ability/skills, and critical thinking. Therefore, the complicated factors related to nursing quality need further studies to explore whether they give significant results to improve quality of care.

This study aims to clarify the impact of COVID-19 on the mental health of users with mental illness of home visit nursing services. We sent a questionnaire to 1,740 home visit nursing station managers, 374 (21.5%) of whom responded. The total number of valid responses was 328, which amounted to 87.7% of the returned surveys. In total, 103 (31.4%) stations reported that their users' mental health deteriorated owing to the spread of COVID-19. Eighty-nine (86.4%) stations reported that their users' anxiety increased. More than 80% of the stations explained infection control measures to their users, but 194 (59.1%) stations answered that their users found it challenging to practice cleanliness. A total of 207 (63.1%) stations answered that the promotion of strategies for coping with stress is necessary for their users. Users with mental illness are vulnerable to stress and have a higher risk of death due to COVID-19. Thus, they should be carefully observed and referred to facilities if required. Home visit nursing staff have an important role to play in the preservation of the well-being of their users with mental illness during the COVID-19 pandemic.

The great value of home nursing services in the treatment of ailments in elderly patients has attracted increasing attention. This study describes a new mobile internet-based home nursing service system and investigates the reasons for its use among elderly patients. 520 cases of mobile internet-based home nursing services were investigated. The proportion of major reasons to use mobile internet-based home nursing services among the elderly was analyzed and the satisfaction rate was investigated. The constituent ratios of nursing care for pressure ulcers, peripherally inserted central catheter (PICC), subcutaneous injection, general stoma care, psychological care, and intramuscular injection were 61.35%, 28.85%, 6.15%, 1.92%, 1.35%, and 0.38%, respectively. The satisfaction rate with mobile internet-based home nursing services among elderly patients was 100%. Considering the demand for home nursing services for elderly patients, this is the first time that a new mobile internet-based home nursing service has been applied to provide home nursing services to elderly patients and meet their home nursing service needs. Treatment for pressure ulcers, PICC, subcutaneous injection, general stoma care, psychological care, and intramuscular injection were found to be the main reasons to use mobile internet-based home nursing services among the elderly. The new mobile internet-based home nursing service system provides convenient home nursing services to elderly patients and ensures that they get equal rights in home nursing. The results provide basis for healthcare policy makers to formulate new home nursing policies for elderly patients.

Interaktionsarbeit im Bereich personenbezogener (sozialer) Dienste ist von hohem Engagement, aber auch vielen Belastungen geprägt. Inkonsistente wohlfahrtsstaatliche Rahmenbedingungen sorgen systematisch für Spannungen, die das Personal strapazieren und vielfach in Zustände der Zerrissenheit führen. In Fallstudien aus der Altenpflege und der geförderten Weiterbildung demonstrieren die Autor*innen, dass Emotionen hierbei eine kritische Rolle spielen. Sie zeigen zudem, wie diese Zustände darauf einwirken, mit wem sich die Beschäftigten in welcher Weise verbunden fühlen und wie es um deren Widerstandsbereitschaft bestellt ist. Wie die bestehenden Verhältnisse sich ändern ließen, wird anhand sozialpolitischer Alternativen und Veränderungspotenziale durch neue Formen kollektiver Interessenvertretung diskutiert.

Background The interest in and demand for healthcare innovation has heightened amid the COVID-19 pandemic. Organizations are challenged to balance the goals of daily operations with innovation to stay relevant and compete in the marketplace. Innovation is critical for not only the success and sustainability of organizations, but the well-being of the faculty, staff, and clients they serve. Purpose In this article, we present an overview of several Nursing Innovation Centers in the United States as well as examples of colleges without formal innovation centers but who are addressing innovation in their programs. Methods We examined the subjective experience of nursing innovation in seven colleges of nursing using semi-structured intervieweds and thematic analysis. FIndings We discuss four themes for creating an innovation center or innovation focus and six themes important for sustainability and impact. In addition, we provide a working model for these themes and provide lessons learned along with trends and recommendations for the future. Discussion This information provides guidance and a framework for academic and practice organizations aspiring to create opportunities for innovation to flourish in their institutions. We also encourage leadership to critically evaluate and address biases in faculty hiring, research evaluation, publication practices, educational opportunities and mentoring to overcome the diversity innovation paradox.

The fiscalization of the professional exercise of Nursing aims to prevent the occurrence of violations of the legislation that regulates the exercise of the profession and its performance is based on educational, preventive, disciplinary and corrective approaches. It seeks to ensure patient safety and the quality of care provided to society, in addition to guaranteeing the rights of professionals, through Nursing class councils. This scoping review aims to map the studies that analyze the inspection process of nursing councils.

To explore the feasibility of the Internet + nursing service mode in family rehabilitation of elderly patients with osteoarthritic diseases.The control group (n=50) received routine rehabilitation treatment procedures and discharge guidance. For the observation group (n=50), extended nursing rehabilitation service was conducted through the Internet + nursing service platform based on the routine treatment in the control group.(1) The compliance with follow-up of the patients in the observation group was significantly higher than that in the control group; (2) The total satisfaction of patients in the observation group was significantly higher than that in the control group; (3) The VAS (1 month: 4.36±1.15 vs. 5.86±1.61, p0.05; 3 months 4.36±1.15 vs. 5.86±1.61, p0.05), SAS (1 month: 37.21±14.16 vs. 49.31±13.45, p0.05; 3 months 26.73±8.25 vs. 40.33±9.50, p0.05), SDS (1 month: 32.36±10.15 vs. 46.32±12.61, p0.05; 3 months 27.11±8.08 vs. 40.62±11.40, p0.05) and PSQI (1 month: 13.64 ± 1.13 vs. 16.31 ± 3.45, p0.05; 3 months 11.54 ± 1.87 vs. 15.74 ± 1.36, p0.05) scores in the observational group were significantly lower than that in control group at one month and three months after discharge. The ADL (1 month: 86.86 ± 4.13 vs. 74.33 ± 3.44, p0.05; 3 months 90.34 ± 7.87 vs. 78.52 ± 6.36, p0.05) scores in the observational group were significantly higher than that in control group at one month and three months after discharge.The extended rehabilitation nursing management for family rehabilitation of elderly patients with osteoarthritic diseases through the Internet + nursing service is a family rehabilitation model suitable for elderly patients with osteoarthritic diseases in China and has positive significance in developing a diversified medical nursing model.

Background Applicability of comprehensive assessment of integrated care services in real world settings is an unmet need. To this end, a Triple Aim evaluation of Hospital at Home (HaH), as use case, was done. As ancillary aim, we explored use of the approach for monitoring the impact of adoption of integrated care at health system level in Catalonia (Spain). Methods Prospective cohort study over one year period, 2017–2018, comparing hospital avoidance (HaH-HA) with conventional hospitalization (UC) using propensity score matching. Participants were after the first episode directly admitted to HaH-HA or the corresponding control group. Triple Aim assessment using multiple criteria decision analysis (MCDA) was done. Moreover, applicability of a Triple Aim approach at health system level was explored using registry data. Results HaH-HA depicted lower: i) Emergency Room Department (ER) visits (p p = .012); and iii) costs (p p Conclusions We confirmed health value generation of HaH-HA. The study identified actionable factors to enhance applicability of Triple Aim assessment at health system level for monitoring the impact of adoption of integrated care. Registration ClinicalTrials.gov (26/04/2017; NCT03130283).

Aims and objectives\ud \ud To identify barriers and facilitators to implementing community nurses being trained as psychological wellbeing practitioners and integrating this practice into home-based primary care nursing, through key stakeholders’ perceptions.\ud \ud \ud \ud Background\ud \ud Current drivers in UK primary care aim to increase access to mental health services and treatment, to achieve parity of esteem between physical and mental health care for patients who are housebound. However, there remains limited evidence on how to successfully implement this. Training community nurses as psychological wellbeing practitioners to offer mental health care alongside their current home-based services is one option.\ud \ud \ud \ud Design\ud \ud A pluralistic qualitative study. This study followed the COREQ checklist for reporting qualitative research.\ud \ud \ud \ud Methods\ud \ud Twenty key stakeholders were purposively recruited and interviewed including twelve health professionals and eight patients. Semi-structured interviews were analysed using a theoretical thematic analysis informed by normalisation process theory concepts of coherence, cognitive participation, collective action and reflexive monitoring, to explore the barriers and facilitators to implementation.\ud \ud \ud \ud Results\ud \ud Staff and patients reported high coherence and cognitive participation, valuing the integrated roles. Facilitators included the development of clearer referral pathways and increased mental health knowledge in the wider team. However, sustainability and current siloed healthcare systems were identified as barriers to implementation.\ud \ud \ud \ud Conclusions\ud \ud A key obstacle to long-term implementation was the practical structures and financial boundaries of siloed healthcare systems, making long-term sustainability unviable.\ud \ud \ud \ud Relevance to clinical practice\ud \ud Community nurses with additional mental health training can integrate these skills in practice and are valued by their team and patients offering holistic care to patients within their home and informal knowledge transfer to the wider team. However, long-term sustainability is required if this is to be adopted routinely. Further evidence is needed to better understand the positive outcomes to patients and potential cost savings.

Aim This study aims to provide economic evidence of the cost-effectiveness of employing specialist Parkinson's nurses in a regional community in Australia. Study design This retrospective study utilized hospital service usage data to compare outcomes for people with Parkinson's disease before and after the employment of a specialist Parkinson's nurse in a regional community. Methods A representative sample was drawn from the target population of people with a diagnosis of Parkinson's admitted to a regional hospital over a 4-year period (2013-2014 and 2016-2017). A multiple regression approach and cost-benefit analysis were used to examine hospital costs related to length of stay based on hospital records. All costs were attributed to resource allocation according to service category and the national funding system. Quantitative data were analysed using Strata Analytics. Results Statistical findings demonstrated a reduction in hospital length of stay ranging from 0.37 (AUD$1924) to 0.755 day (AUD$3926) after the establishment of the specialist Parkinson's nurse. The cost-benefit analysis showed a net dollar benefit, or savings in hospital costs, of up to $8600.00 per person over a 3-year period, as a result of the specialist Parkinson's nurse intervention. Conclusion The statistical results show significant cost benefits associated with reduced length of hospital stay following introduction of the specialist Parkinson's nurse. These findings support advocacy for sustainable specialist Parkinson's nurse positions and have the potential to inform and influence policy and systemic changes within the health care system. Impact The benefits of embedding specialist nursing services for people with Parkinson's disease in primary health settings include the direct impact on the potential to avoid hospital admissions due to worsening symptoms, improving quality of life for the person with Parkinson's and slowing the trajectory of the disease. Additional benefits are increased access to specialist services and reduced family caregiver burden.

This study aimed to investigate reasons for unfinished nursing care across the whole levels of the nursing service as perceived by clinical nurses, ward managers and executive nurses.Even though unfinished nursing care has been considered an issue affected by the system, no studies to date have attempted to investigate reasons across the whole levels of the nursing service by involving clinical nurses, ward managers and executive nurses.A descriptive qualitative approach was performed in 2021 according to the COnsolidated criteria for REporting Qualitative research guidelines. A large public health care trust was approached, and a purposeful sample of clinical nurses, ward managers and executive nurses was invited to attend face-to-face or online interviews. Twenty-nine interviews were performed (19 clinical nurses, 7 ward managers and 3 executive nurses) and transcribed verbatim. Then, a content analysis was conducted by considering all narratives together followed by an analytic process to identify themes and subthemes at the clinical, ward manager and executive levels.Reasons for unfinished nursing care have emerged at five levels: system (e.g., poor support towards nursing care), unit (e.g., ineffective models of nursing care delivery), nurse managers (e.g., inadequate nurse manager leadership), nurses (e.g., weaknesses in education) and patients (e.g., increased demand for patients' care).The evidence available should be expanded to include also unfinished nursing care reasons identified at the system and at the ward manager levels, that both can complete the perceptions of the clinical nurses.The actors composing the nursing service perceive different reasons and therefore should be involved in detecting and contrasting the unfinished nursing care. The reasons applied or established at the upper level influence the bedside levels: Therefore, strategies to prevent or minimize the unfinished nursing care should be designed at multi-levels in a system-inclusive approach.

A war is a struggle that states or states have made by using all or part of the national defense resources to solve problems that they cannot solve peacefully. The health of individuals is adversely affected in addition to the human losses caused by reasons such as hunger, misery, epidemic disease and war-related injuries during the war. Nurses, who have many functions such as minimizing negative effects, protecting and improving health, and preventing diseases, have touched the lives of individuals in society both during and after the war throughout history. During and after the war, nurses lead the triage of the sick and the wounded and provide security, and play an active role in improving the health of the society in the post-war processes. After the war, nurses are involved in rehabilitation for injuries that are the primary result of war in the long term, and in the treatment process for mental health problems such as general anxiety disorder, post-traumatic stress disorder, and major depression as a secondary result. The purpose of this review; It is the study of nursing services during and after the war that has existed throughout history. With this study, it was concluded that the wars that caused destruction, deaths, injuries and secondary consequences in society not only occurred in the time period but also had an effect for generations, and nurses will continue to have an important function in reducing the negative effects of this process on the health of the individual., Savaş, devlet veya devletlerin barış yoluyla halledemedikleri sorunları çözmek için milli savunma kaynaklarının tamamını ya da bir bölümünü kullanmak suretiyle yapmış oldukları mücadeledir. Savaşta yaşanan açlık, sefalet, salgın hastalık ve savaşa bağlı yaralanma gibi nedenlerle meydana gelen insan kayıplarının yanında bireylerin sağlığı olumsuz etkilenmektedir. Olumsuz etkilerin en aza indirgenmesi, sağlığın korunup geliştirilmesi, hastalıkların önlenmesi gibi birçok işleve sahip olan hemşireler tarih boyunca hem savaş esnasında hem de savaş sonrasında toplumdaki bireylerin yaşamına dokunmuştur. Savaş esnasında ve sonrasında hemşireler, hasta ve yaralıların triyajında, güvenliğin sağlanmasında liderlik etmekte, savaş sonrası süreçlerde ise toplumun sağlığının geliştirilmesinde etkin rol oynamaktadır. Hemşireler, savaştan sonra uzun dönemde savaşın birincil sonucu olan yaralanmalar için rehabilitasyon ile ikincil sonucu olan genel anksiyete bozukluğu, post travmatik stres bozukluğu, majör depresyon gibi ruh sağlığı sorunları için tedavi sürecinde yer almaktadır. Bu derleme tarih boyunca var olan savaş esnasında ve sonrasında hemşirelik hizmetlerinin incelenmesi amacıyla hazırlanmıştır. Bu çalışma ile toplumda yıkımlara, ölümlere, yaralanmalara ve bunların getirdiği ikincil sonuçlara sebep olan savaşların sadece yaşandığı zaman diliminde kalmayıp kuşaklar boyunca etkisini gösterdiği ve hemşirelerin, bu sürecin bireyin sağlığındaki olumsuz etkilerini azaltmada önemli işleve sahip olmaya devam edeceği sonuçlarına varılmıştır.

Annually, the National Association of School Nurses (NASN) sets advocacy goals, including legislative and policy priorities. Activities this past year continued to focus on assistance for school nurses to manage the ongoing pandemic by providing for additional school nurses and supplies. In addition, NASN advocated for legislation to provide grants for school nurses in Title 1 schools, to reduce tobacco use, and to address social determinants of health. This article provides a brief summary of NASN’s 2021-2022 national advocacy efforts.

This study aimed to investigate the mediating effect of compassion competence on the relationship between caring behaviors and the quality of nursing services. Participants included nurses working in South Korean hospitals. Data collected from 1 November to 31 December 2020 were analyzed using a t-test, analysis of variance (ANOVA), Pearson’s correlation coefficients, and hierarchical multiple regression. We found that caring behavior had a positive correlation with the quality of nursing services and compassion competence. Moreover, there was a positive correlation between the quality of nursing services and compassion competence. Compassion competence had a significant mediating effect on the relationship between caring behaviors and quality of nursing services. This suggests that nurses’ caring behaviors can enable high-quality nursing services influenced by compassion. Therefore, in order to improve the quality of nursing services, repeated and continuous implementation of training programs including education that can improve compassion competence is necessary.

Administering insulin in a patient's own home is perceived as a simple nursing intervention, and one that is regularly delegated to newly qualified staff, agency and bank staff. However, without robust processes and clear, easy-to-follow nursing documentation in place, a simple nursing intervention can easily lead to an avoidable medication error and patient safety incident. This article describes the steps one trust has taken to combat insulin administration incidents. The article describes the use of a Plan, Do, Study, Act (PDSA) cycle to help test changes and roll out sustainable transformation. It describes some of the challenges faced, alongside the solutions tested and embedded into practice.

Objective To establish the current management standards needed by nurse managers in Turkey and to share the process of establishing standards. Background Relevant and utilizable nursing management standards are needed for effective and efficient nursing administration to achieve better outcomes in health care. Methods A three-round e-Delphi method was used in this study. First, the experts were asked an open-ended question. In the second and third rounds, data analysis measurements included item-by-item per cent agreement, standard deviation, average, median and interquartile range. Results At the end of the third round, 49 standards were obtained under five main standards for nurse managers: management and organisation; leadership; human resources management; quality management; and professionalism. Conclusion The results of this study, which represent a consensus on nursing management standards drawn from the views of experts across regions and institutions in Turkey, provide a baseline to design, manage and evaluate nursing services. Implications for nursing management Nursing management standards, which are fundamental for designing, leading and evaluating nursing services, give a framework for nurse managers to provide effective and efficient administrative practices.

Community nurses in Singapore support vulnerable older persons with chronic health condition(s). In the situation of scaled-down community health and social services during the COVID-19 outbreak, the community nursing team adopted measures for pandemic preparedness. This report is to share the Singapore General Hospital community nursing experience, preparation and transforming efforts during the pandemic. Team segregation, active screening and triage before visits and other precautionary measures were executed to minimise the risk of exposure to COVID-19. There was a shift from face-to-face to teleconsultation to meet the requirement of safe social-distancing. Community nursing teams continued to play an active role in supporting older persons during the pandemic, despite the challenges. Moving to the lockdown phase (‘circuit breaker’), teleconsultation, virtual meetings and integrated partnerships were essential to ensure healthcare accessibility and continuity of care. The experience gleaned was valuable to advance future community nursing services in the evolving healthcare landscape. Structured teleconsultation and technology advancement are useful to complement the service.

Background & Aims: The work environment of healthcare providers and hospitals is constantly exposed to tremendous work pressure, complexity, and chaos. Due to the changes in various fields of treatment and care, these work environments are constantly changing as well. Meanwhile, bullying is considered to be a serious phenomenon in these organizations, which has also been reported worldwide as an important issue in the nursing profession. Workplace bullying could variably affect nursing. In healthcare organizations, workplace bullying could increase absenteeism, job loss, and job dissatisfaction among the employees. Furthermore, this phenomenon may reduce the quality of nursing care in hospitals and medical centers. These issues are particularly highlighted in the nursing profession since as the largest group of healthcare providers in these organizations and the leading managers of hospitals, nurses play a pivotal role in patient care. Improving the quality of nursing care is the most important factor to accelerate the recovery and return of patients to the community; therefore, the quality assessment of nursing care is essential. In Iran, most of the studies on bullying have been performed on students and teachers in schools, and few studies have been focused on nurses. Given the lack of accurate statistics on the rate of workplace bullying among Iranian nurses and the fact that the quality of nursing care is an important issue that could be affected by the bullying phenomenon, the present study aimed to evaluate the level of workplace bullying among Iranian nurses and its association with the quality of nursing care. Materials & Methods: This cross-sectional, descriptive-correlational study was conducted on 200 emergency department and intensive care unit (ICU) nurses at Imam Khomeini Hospital Complex affiliated to Tehran University of Medical Sciences, Iran in 2019. The sample size included 200 nurses who were selected via simple random sampling. The inclusion criteria were employment as a nurse in the emergency department or ICU of Imam Khomeini Hospital Complex, willingness to participate in the study, and minimum work experience of six months as a nurse in the department. The exclusion criterion was incomplete questionnaires. Data were collected using a demographic questionnaire (age, gender, marital status, admission to the nursing major based on interest/knowledge, education level, clinical ward, service history, type of employment, shift work, duration of employment in the current department, having a managerial position, interest in the workplace, and coercion in the current department), negative acts questionnaire-revised, and SERVQUAL questionnaire. Sampling was performed after the approval of the study protocol and receiving the ethics license from the Joint Organizational Ethics Committee of the School of Nursing and Midwifery and the School of Rehabilitation of Tehran University of Medical Sciences. Eligible nurses were selected after explaining the research objectives and procedures and being assured of the confidentiality of their information with oral consent. The questionnaires were completed anonymously and in a self-report manner. Data analysis was performed in SPSS version 16 using descriptive statistics to describe the samples (frequency distribution tables, mean, and standard deviation). In addition, research objectives were used to describe the samples. To determine the gap between the perceptions and expectations regarding the quality of nursing care, paired t-test was used, and to determine the correlation between workplace bullying and the quality of nursing care, Pearsonchr('39')s correlation-coefficient was employed at the significance level of 0.05. Results: About half of the nurses (51.5%) were female, with the mean age of 32.58 ± 6.38 years. The mean work experience of the subjects was 9.74 ± 5.86 years in the nursing profession and 4.59 ± 3.99 years in their current ward of employment. The majority of the nurses (51%) were formally employed, had rotating work shifts (77%), and worked in the ICU (61.5%). In addition, most of the nurses had a BSc degree (84.5%). Based on the experience of daily or weekly workplace bullying, the mean workplace bullying of the nurses in the work-related bullying dimension was 10.11%, while it was 4.27% in the person-related dimension, and 5.66% in the physical dimension, with an overall mean of 6.68%. The maximum and minimum mean values belonged in the dimensions of work-related bullying and physical dimension, respectively. The results of paired t-test indicated significant differences between the dimensions of the perceptions, expectations, and gaps in the quality of nursing care in the viewpoint of the nurses and the dimensions of reliability (P

Background: To promote excellence in nursing research, setting research priorities is needed to meet the need of community aligned with the national context. Unfortunately, limited number of studies has examined nursing research priorities in Indonesia. Objective: To identify nursing research priorities in Indonesia from the perspectives of nursing experts. Methods: This was a descriptive qualitative study. Focus group discussion was conducted among participants who were purposively selected ( n = 13). Data were analyzed using a consensus-based method. Results: The top ten research priority lists were identified. The priorities were nurse competence, quality of nursing care in nursing services, nursing policy, nurse work environment, nurse mobility, interprofessional education and collaboration, teaching learning evaluation, nursing career, complementary therapy in nursing, and technology and informatics in nursing. Conclusion: Findings of this study could be used as the basis of direction for development of future research in Indonesia.

Objective: To analyze economic feasibility for investing in nursing care. Method: The number of practicing nurses’ density per 1000 population as a proxy for nursing staff and Gross Domestic Product (GDP) per capita (current US$) were collected in 35 member countries of Organization for Economic Co-operation and Development (OECD) over 2000–2016 period. The statistical technique of panel data analysis including unit root test, cointegration analysis, Granger causality test, dynamic long-run model analysis and error correction model were applied to measure economic impact of nursing-related services. Results: There was a committed bilateral relationship between nurse-staffing level and GDP with long-run magnitudes of 1.39 and 0.41 for GDP-lead-nurse and nurse-lead-GDP directions in OECD countries, respectively. Moreover, the highest long-run magnitudes of the effect nursing staff has on increasing GDP per capita were calculated in Finland (2.07), Sweden (1.92), Estonia (1.68), Poland (1.52), Czech Republic (1.48), Norway (1.47) and Canada (1.24). Conclusion: Our findings verify that although the dependency of nursing characteristics to GDP per capita is higher than the reliance of GDP to number of nurses’ density per 1000 population, investing in nursing care is economically feasible in OECD countries i.e. nursing is not only a financial burden (or cost) on health care systems, but also an economic stimulus in OECD countries. Hence, we alert governments and policy makers about the risk of underestimating the economic impacts of nurses on economic systems of OECD countries. Keywords: Gross Domestic Product, Economic growth, Nursing economics, Nursing services, Nursing staff, Organization for Economic Co-operation and Development, Panel data analysis

The COVID-19 pandemic has been one of the greatest challenges to the NHS, creating turmoil in the public health workforce and for all of those who use its services. Its immediate impact was a rapid change in how care in the NHS is planned, delivered and accessed, with no concession for stoma care services. Investment in global resources detailing COVID-19 recovery plans and the steady increase in national data related to the transmission and treatment of the virus has allowed stoma care nurses to better understand the long-term effects of the pandemic and mitigate future risk to specialist nursing services. This article describes how this crisis has provided an opportunity to radically change systems and processes in stoma care through the use of digital technology to continue interaction with patients, communicate with the multidisciplinary team and collaborate with relatives or carers, and as a platform to enhance personal development, training and education.

Background Our aim was to evaluate the effect of setting up a full-time infection control nursing service on reducing the prevalence of multidrug-resistant organism (MDRO) in the orthopedic ward. Methods From January 2015 to March 2019, routine prevention and control measures were taken for patients infected/colonized with MDRO in this ward, which was set as the pre-intervention period. The intervention period was from April 2019 to June 2021. The study was designed to evaluate whether the establishment of a full-time infection control nursing service could reduce the positive density of MDRO in the hospital by using an interrupted time-series model of a quasi experimental study. Results There were 11,759 patients during pre-intervention period and 8142 patients during intervention period. The total number of MDRO isolated before intervention was 177, of which 145 were obtained in hospital and 32 were brought in from outside hospital. The total number of MDRO isolated after intervention was 47, of which 29 were obtained in hospital and 18 were brought in from outside hospital. Before intervention, the positive density of MDRO in the orthopedic ward showed an increasing trend (β1 = 0.02, P = 0.003). After intervention, the positive density of MDRO showed a downward trend (β3 = − 0.05, P = 0.018). Conclusions The establishment of the full-time infection control nursing service in the orthopedic ward can effectively reduce the nosocomial prevalence of MDRO.

The aim of this work is to investigate nurses' perceptions of barriers constraining the implementation of the Internet Plus Nursing Service program.The Internet Plus Nursing Service programme helps meet the demands of an ageing population, people with chronic diseases, the disabled, and home convalescents, and affirms the value of nurses. However, this programme has failed to elicit nurses' active participation, and there is limited knowledge regarding nurses' perceptions of the barriers to the programme's implementation.A qualitative study was conducted. Thematic analysis of the data was performed.The analysis yielded three main themes: a sense of insecurity, role conflict, and a lack of support.This study explores nurses' perspectives on the factors impeding the implementation of the programme, which are identified as being insufficient protection and support on nurses at personal, sociocultural, infrastructural, and organizationallevels.The study results will guide the department of nursing management to foster supportive work and social environment for nurses, which will decrease their feeling of insecurity and role conflicts and provides them enough infrastructural and organizational supports through proposing emergency code system and improving training system and team collaboration.

The objective of this study was to elaborate theoretical propositions to help understanding the Systematization of Nursing Care as a distinct phenomenon of the Nursing Process. It is a reflective, theoretical study that presented two categories: “Systematization of Nursing Care: seeking differentiating contours” and “Systematization of Nursing Care: seeking defining contours”. It was identified that the systematization is not concerned with guiding the professional nursing care itself, since this issue, together with the guidelines regarding the elaboration of clinical documentation resulting from the implemented nursing care, is related to the process. Despite what the Systematization of Nursing Care is, the idea is that it is a field of knowledge that, through its three pillars and constituent elements, supports the structuring of nursing services and, consequently, the organization or reorganization of professional work in nursing. It is concluded that systematization, in the light of the theoretical propositions presented here, is an area of knowledge that represents a particular way of carrying out the management of nursing services when the three pillars that compose it are considered. RESUMEN Se propuso elaborar proposiciones teóricas que auxilien en la comprensión de la Sistematización de la Asistencia de Enfermería como un fenómeno distinto del Proceso de Enfermería. Estudio teórico reflexivo que presentó dos clases: “Sistematización de la Asistencia de Enfermería: buscando contornos diferenciadores” y “Sistematización de la Asistencia de Enfermería: buscando contornos definitorios”. Se identificó que la sistematización no se ocupa en orientar la asistencia profesional de enfermería por si misma, una vez que esa cuestión, sumada a las orientaciones a respecto de la elaboración de la documentación clínica resultante de la asistencia de enfermería implementada, se refiere al proceso. A pesar de lo que es la Sistematización de la Asistencia de Enfermería, se conviene definir como un campo de conocimiento que, por medio de sus tres pilares y elementos que la constituyen, soporta la estructuración de servicios de enfermería y, por así decirlo, la organización o reorganización del trabajo profesional en enfermería. Se concluye que la sistematización, siguiendo las proposiciones teóricas presentadas, constituye área de conocimiento que representa una forma particular de realizar la gestión de servicios de enfermería cuando se consideran los tres pilares que la componen. RESUMO Objetivou-se elaborar proposições teóricas que auxiliem na compreensão da Sistematização da Assistência de Enfermagem enquanto fenômeno distinto do Processo de Enfermagem. Estudo teórico reflexivo que apresentou duas categorias: “Sistematização da Assistência de Enfermagem: buscando contornos diferenciadores” e “Sistematização da Assistência de Enfermagem: buscando contornos definitórios”. Identificou-se que a sistematização não se ocupa em orientar a assistência profissional de enfermagem em si, já que essa questão, aliada às orientações quanto à elaboração da documentação clínica resultante da assistência de enfermagem implementada, diz respeito ao processo. A despeito do que é a Sistematização da Assistência de Enfermagem, tem-se que se trata de um campo de conhecimento que, por meio de seus três pilares e elementos constituintes, suporta a estruturação de serviços de enfermagem e, por consequência, a organização ou reorganização do trabalho profissional em enfermagem. Conclui-se que a sistematização, à luz das proposições teóricas aqui apresentadas, constitui área de conhecimento que representa uma forma particular de realizar a gestão de serviços de enfermagem quando se consideram os três pilares que a compõem.

Nursing has been reported to effectively ameliorate physical movement, significantly decrease postoperative complications, and markedly improve the quality of life in patients with bladder cancer after endoscopic bladder resection. Atezolizumab (ATZ) has been approved as effective therapy for patients with bladder cancer. This study was aimed to assess the efficacy of long-term extended nursing services combined with ATZ in patients with bladder cancer after endoscopic bladder resection.A total of one 126 patients diagnosed with bladder cancer underwent endoscopic bladder resection were recruited in this study. Patients were randomly allocated into the long-term conventional nursing plus atezolizumab (LTCN-ATZ) (n = 60) and long-term extended nursing services plus atezolizumab (LTENS-ATZ) groups (n = 66). The renal function, physical movement, postoperative complications, the quality of life, survival, and recurrence were examined in patients in LTCN-ATZ and LTENS-ATZ groups during 36-month follow up.Data in the current study demonstrated that the renal function, quality of life, satisfaction anxiety and depression for LTENS-ATZ group was significantly improved compared with that of LTCN-ATZ group. The occurrence rate was significantly lower, and the length of hospital stay was shorter for LTENS-ATZ than that of LTCN-ATZ group. Outcomes demonstrated that LTENS-ATZ increased survival and decreased the occurrence compared to those patients in LTENS-ATZ group.In conclusion, outcomes in this study indicate that LTENS-ATZ improves renal function, and quality of life and prognosis in patients with bladder cancer after endoscopic bladder resection.

Orientador: Edineis de Brito Guirardello Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas Resumo: Resumo o processo de hospitalização pode acarretar para o paciente um distanciamento do seu convívio familiar. O fato de permanecer, mesmo que temporariamente, em um ambiente estranho ao seu convívio, com normas e rotinas a que não está habituado e a expectativa com relação ao tratamento, podem gerar sentimentos de insatisfação com relação ao cuidado recebido. A satisfação do paciente com o cuidado de enfermagem, foi definida por RISSER (1975) como sendo o grau de congruência entre as expectativas do paciente e sua percepção sobre o cuidado recebido. Estudos sobre satisfação do paciente na cultura brasileira utilizam-se de uma abordagem genérica, de modo a não valorizar a satisfação do paciente com a assistência de enfermagem. Sendo assim, é importante utilizar instrumentos de medida específicos para avaliar a satisfação do paciente quanto aos cuidados de enfermagem. Considerando a inexistência de instrumentos para este fim, o presente estudo teve por objetivo traduzir e validar o Patient Satisfaction Instrument (PSI), desenvolvido por Hinshaw e Atwood (1982), para a cultura brasileira. É um instrumento composto de 25 itens que aborda situações do cuidado de enfermagem, agrupados em três domínios: Educacional, Profissional e Confiança. O procedimento metodológico de adaptação utilizado seguiu as etapas de: a) tradução do instrumento para a língua portuguesa; b) tradução de volta para a língua original; c) julgamento por um comitê de juízes e d) pré-teste da versão final do instrumento, o qual denominou-se Instrumento de Satisfação do Paciente (ISP). Participaram do estudo 211 pacientes, internados em clínicas médicocirúrgicas de dois hospitais do município de São Paulo. Na análise da confiabilidade do instrumento, obteve-se alta consistência interna para todos os itens do instrumento (a= 0,88) e para os domínios Educacional (a= 0,66) e Confiança a= 0,79). Apenas para o domínio Profissional, obteve-se um coeficiente alfa de Cronbach de 0,62. Quanto a validade de constructo, a análise de fator exploratória mostrou que, apesar da medida de adequação da amostra ter sido estatisticamente significante, (MSA= 0,84), o critério utilizado para selecionar fatores com auto valor maior que 1 demonstrou sete fatores que explicaram 62% variância total. Os resultados da análise de fator confirmatória mostraram que apenas o RMR, obteve valores aceitáveis (0,10). Os resultados desse estudo indicam que o PSI traduzido para a nossa cultura pode ser utilizado para medir satisfação do paciente. Entretanto, é necessário que este instrumento seja aplicado em outras populações com características semelhantes para testar os itens que não foram consistentes na amostra estudada Abstract: The hospitalization process may keep the patient distant from their family. The fact of being in an unfamiliar setting, even for a short period, with established rules and routines that they are not used to and the expectations concerning the treatment, may bring about dissatisfactions. Patient Satisfaction with nursing care was defined by RISSER (1975) as the congruence degree between the patient expectations and their perception concerning the care provided. Studies on patient satisfaction in Brazil adopt a generic approach and do not give value to patient satisfaction with the nursing care. Based on that, it is important to use specific measurement instruments in order to assess the patient satisfaction with the nursing care. As there are no instruments with this purpose, the present study aimed at translating and validating the Patient Satisfaction Instrument (PSI) developed by Hinshaw and Atwood (1982) to the Brazilian culture. The PSI is constituted of 25 items that cover situations related to the nursing care grouped in three domains: Educational, Professional and Trust. The methodological procedure used were a) translation of the instrument into Portuguese; b) back-translation to English c) committee review; d) test of the pre-final version. 211 patients admitted in medical-surgical clinics in two hospitais in São Paulo city made part of the study. The analysis of its reliability scored high internal consistence in ali items (a=0.88), and for Educational domains (oc=0.66); and Trust (oc=0.79). Only for the Professional domain it scored Cronbach's alfa (oc=0.62). In relation to construct validity, the exploratory factor analysis showed that besides the adequacy measure of the sampling been statistically significant (MSA=0,84), the criteria used to select the factors with an eigenvalue of 1.00 or above demonstrate seven factors that explained 62% of the total variance. The results of confirmatory factor analisys showed that only the root mean-squared residual (RMR), met the criteria standards (0.10). The results of this study indicate that the PSI translated to Brazilian culture can be used to measure patient'satisfaction. However, it is necessary to point out that it is important to apply this instrument to other populations with characteristics similar to the ones in the present study in order to review the items which were not consistent in the studied samples Mestrado Enfermagem e Trabalho Mestre em Enfermagem

Background: The quality of management has become a problem and significant issue of the late decade in Indonesia's professional nursing practice. By implementing total quality management (TQM), the organization would identify a health organization system's performance to improve patient satisfaction and patient safety for independent nursing practice services. Objective: This study aimed to assess the quality of independent nursing practice in Indonesia based on TQM indicators.Methods: This study employed a sequential explanatory mixed methods design. Participants were 105 Chief Executive Officers (CEOs) of independent nursing practices who answered a TQM survey using The Malcolm Baldrige Criteria for Performance Excellence (MBCfPE). The quantitative responses were analyzed using SmartPLS version 3.0. For qualitative data, selected six participants from total respondents were interviewed to explore the participants' understanding of TQM. All the responses were transcribed and uploaded using NVIVO ver. 11 for thematic analysis.Results: Leadership positively influenced strategic planning, customer attention, assessment analysis, and information management (focusing on personnel process management and efficiency) (p

The purpose of this essay is to outline two strategies that can be used to increase recognition of nursing excellence—in research, education, and practice. The first strategy is to gain recognition for excellence in nursing in and beyond universities, to collaborate with members of other disciplines, and to publicize what we study and what we teach. The second strategy is to gain recognition for excellence in nursing in and beyond clinical agencies, to publicize what we do when interacting with people who seek our services, and to implement the standards of the Pathway to Excellence Program® and/or the Magnet Recognition Program®.

Aims To examine how felt trust motivates nurses to desire to deliver better nursing services and how perspective taking makes nurses feel trusted by their patients. By introducing the concept of prosocial motivation into nursing research, this study further explored a boundary condition that influences the positive relationship between felt trust from patients and attitudes towards nursing service delivery. Design This study used a cross-sectional and survey design. Method This study was conducted among 339 nurses on medical teams sent to support Hubei, China, during the COVID-19 pandemic in April 2020. Results The results indicate that felt trust from patients mediated the positive relationship between perspective taking and attitudes towards nursing service delivery. In addition, prosocial motivation moderated the relationship between felt trust from patients and attitudes towards nursing service delivery, such that the relationship was stronger when prosocial motivation was high (vs. low). Prosocial motivation also moderated the indirect effects of perspective taking on attitudes towards nursing service delivery via felt trust from patients. Conclusion This study shows that despite the challenges posed by COVID-19, nurses who experience a high level of trust from patients are still eager to deliver high-quality nursing services, and this finding is especially salient among those with high prosocial motivation. Impact This study introduces felt trust from patients as a new motivational mechanism that can induce nurses' willingness to deliver better nursing services. We suggest that nurses and nurse leaders should be aware of the significance of the trust relationship between nurses and patients. Nurses need to be trained to take patients' perspectives in the interaction process, which can make them feel trusted by patients and can consequently be motivated to deliver better nursing services.

Aim: The objective of this study was to investigate if grip strength or the short physical performance battery could predict the rate of receiving two different types of home care services: (a) personal care and (b) home nursing care for community-dwelling older adults aged 75+ years. Methods: A secondary data analysis of a prospective cohort study including 323 community-dwelling older adults. Measures of grip strength and the short physical performance battery were incorporated in a nationally regulated preventive home visit programme. Referral to personal and home nursing care were obtained from an administrative database with an average follow-up of 4.1 years. The rate of receiving the individual home care services and the study measures were determined using multivariable Cox proportional hazards models controlling for a priori selected covariates (age, sex, living status, obesity, smoking and prior use of home care). Results: The mean age was 81.7 years with 58.8% being women. The rate of receiving personal care differed between the short physical performance battery groups but not between the grip strength groups after adjusting for all covariates with hazard ratios (95% confidence intervals) of 1.90 (1.29–2.81) and 1.41 (0.95–2.08), respectively. The rate of receiving home nursing care differed between both the short physical performance battery and grip strength groups after adjusting for all covariates with hazard ratios of 2.03 (1.41–2.94) and 1.48 (1.01–2.16), respectively. Conclusions: The short physical performance battery was associated with the rate of receiving both personal care and home nursing care. The short physical performance battery can be used to predict home care needs of community-dwelling older adults aged 75+ years.

Las prácticas de administración segura de medicamentos hacen parte importante del compendio de actividades para resguardar la seguridad del paciente, por tanto, la búsqueda de un entorno seguro es una preocupación constante de las instituciones de salud, y la práctica de la administración de medicamentos es esencial para evitar errores de medicación. La medición de las prácticas del personal de enfermería respecto a la administración de medicamentos puede generar datos relevantes para la elaboración de estrategias más fidedignas de la necesidad institucional y en consecuencia disminuir notablemente la aparición de errores de medicación. Objetivo: Determinar el cumplimiento de prácticas en administración segura de medicamentos por parte del personal de enfermería de un hospital de segundo nivel de atención. Metodología: Estudio descriptivo transversal en el que se evaluó el grado de cumplimiento de prácticas de administración segura de medicamentos a través de la aplicación de dos listas de chequeo. Resultados: El ejercicio de prácticas de seguridad en administración de medicamentos en este estudio mostró un rendimiento del 61% en personal técnico auxiliar de enfermería y un 49% en profesionales de enfermería, con Prevalencia de no cumplimiento del 27,9% y 42,9%, respectivamente. Coeficiente de correlación de Spearman 0,71 en los resultados de las listas de chequeo. Conclusiones: El personal de enfermería, en este estudio, mostró cumplimiento de prácticas seguras en administración de medicamentos alrededor de la media de cumplimiento, con un rendimiento similar en ambos grupos del personal de enfermería y en ambas listas de chequeo., Safe drug administration practices are an important part of the compendium of activities to protect patient safety, therefore, the search for a safe environment is a constant concern of health institutions, and the practice of drug administration is essential to avoid medication errors. The measurement of the nursing staff's practices regarding the administration of medications can generate relevant data for the elaboration of more reliable strategies of the institutional need and consequently significantly reduce the appearance of medication errors. Objective: To determine compliance with practices in the safe administration of medications by the nursing staff of a second level of care hospital. Methodology: A descriptive cross-sectional study in which the degree of compliance with safe drug administration practices was evaluated through the application of two checklists. Results: The exercise of safety practices in drug administration in this study showed a performance of 61% in nursing auxiliary technical personnel and 49% in nursing professionals, with a prevalence of non-compliance of 27.9% and 42.9 %, respectively. Spearman's correlation coefficient 0.71 in the checklist results. Conclusions: The nursing staff, in this study, showed compliance with safe practices in drug administration around the mean of compliance, with a similar performance in both groups of the nursing staff and in both checklists.

Objective: The aim of this study is to investigate the characteristics of work-flow organization of the Central Sterile Services Department and analyze whether nursing workers are subject to psychosocial risks. Method: Mixed study, carried out between November 2017 and July 2019 with nursing workers of the Department of Central Sterile Services of a university hospital. Sampling for the quantitative stage of this study consisted of 36 professionals who have filled the Prescribed Work Organization Scale form, followed by statistical analysis. Qualitative sampling was obtained through collective interview with 19 members of the nursing team. Results: Of the 36 nursing workers, 68.3% were female, 69.4% were over 45 years of age and 75% of the professionals assessed reported as being exposed to a medium psychosocial risk with the emergence of two categories. The aspects related to pleasure at work were highlighted as being the importance of the unit, indirect patient care, professional recognition, and teamwork. The main reported suffering triggers were the lack of human resources, supplies, maintenance, communication, and the devaluation of the unit. Conclusion: The prevalence of medium psychosocial risks indicated the need for actions aiming at improving work processes. RESUMEN Objetivo: El objetivo del estudio es investigar las características de la organización del trabajo en el Central de Equipos y Esterilización y analizar si los trabajadores de enfermería están sujetos a riesgos psicosociales. Método: Estudio mixto, realizado entre noviembre de 2017 y julio de 2019 con trabajadores de enfermería del centro de materiales y esterilización de un hospital universitario. La muestra de la etapa cuantitativa estuvo conformada por 36 trabajadores que respondieron la Escala de Organización Laboral Prescrita y se realizó análisis estadístico. La recolección de información cualitativa se produjo a través de una entrevista colectiva con 19 integrantes del equipo de enfermería. Resultados: De los 36 trabajadores, el 68,3% eran mujeres, el 69,4% tenían más de 45 años y el 75% de la muestra evaluó el riesgo psicosocial como medio, con la aparición de dos categorías. Los aspectos relacionados con el placer en el trabajo fueron la importancia de la unidad, la atención indirecta al paciente, el reconocimiento profesional y el trabajo en equipo. Los generadores de sufrimiento fueron la falta de recursos humanos, suministros, mantenimiento, comunicación y devaluación de la unidad. Conclusión: El predominio de riesgos psicosociales medios indicó la necesidad de acciones dirigidas a mejorar los procesos de trabajo. RESUMO Objetivo: O objetivo do estudo é investigar as características da organização do trabalho no Centro de Materiais e Esterilização e analisar se os trabalhadores de enfermagem estão submetidos a riscos psicossociais. Método: Estudo misto, realizado entre novembro de 2017 e julho de 2019 com os trabalhadores de enfermagem do centro de materiais e esterilização de um hospital universitário. A amostra da etapa quantitativa foi composta por 36 trabalhadores que responderam à Escala de Organização Prescrita do Trabalho e realizou-se análise estatística. A coleta das informações qualitativas ocorreu por entrevista coletiva com 19 integrantes da equipe de enfermagem. Resultados: Dos 36 trabalhadores, 68,3% eram do sexo feminino, 69,4% com idade superior a 45 anos e 75% da amostra avaliou como médio o risco psicossocial, com surgimento de duas categorias. Os aspectos relacionados ao prazer no trabalho foram a importância da unidade, cuidado indireto ao paciente, reconhecimento profissional e trabalho em equipe. Os geradores de sofrimento foram a falta de recursos humanos, insumos, manutenção, comunicação e desvalorização da unidade. Conclusão: O predomínio de riscos psicossociais médios indicou a necessidade de ações que visem melhorias nos processos de trabalho.

This article analyzes the work methods based on care design, identification of needs, care organization, planning, delivery, evaluation, continuity, safety, and complexity of care, and discharge preparation. It describes the diagnosis of the situation, goal setting, strategy selection, implementation, and outcome evaluation that contribute to adopting a given work conception and/or method for nursing care delivery. Later, the concepts underlying the several methods—management theories and theoretical nursing concepts—are presented, with reference to relevant authors. The process of analysis and selection of the method is explained, highlighting the importance of diagnosis of the situation, goal setting, strategy selection, implementation, and outcome evaluation. The importance of various elements is highlighted, such as structural aspects, nature of care, target population, resources, and philosophy of the institution, which may condition the adoption of a method. The importance of care conceptualization is also underlined. The work methods are presented with a description of the key characteristics, advantages, and disadvantages of the task-oriented method (functional nursing) and patient-centered methods: individual, team nursing, and primary nursing. A critical and comparative analysis of the methods is then performed, alluding to the combination of person-centered methods.

Susanne Christie, Arrhythmia Nurse Specialist, NHS Tayside ( susanne.christie@nhs.scot ), runner-up in the Cardiovascular Nurse of the Year category of the BJN Awards 2020

This literature review aimed to identify the consequences of working in a highly stressful environment within district nursing teams and the implications this has on nursing practice and the welfare of nurses. The review analysed 10 primary research studies, resulting in three emerging themes that formed the foundation of a discussion; burnout and compassion fatigue; reduced job satisfaction and retention; and emotional injury. The results identified that healthy behaviours, emotional intelligence and effective caseload and staffing management can reduce the negative impact that stress can have on nurses. Organisations need to promote healthy behaviours through support and training and need to reassess how caseloads are managed in correlation with staffing levels. Coaching in emotional intelligence skills is vital and should be provided to all nurses within the DN service.

Background The current healthcare sector consists of diverse services to accommodate the high demands and expectations of the users. Nursing plays a major role in catering to these demands and expectations, but nursing costs and service weights are underestimated. Therefore, this study aimed to estimate the nursing costs and service weights as well as identify the factors that influence these costs. Methods A retrospective cross-sectional descriptive study was conducted at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using 85,042 hospital discharges from 2009 to 2012. A casemix costing method using the step-down approach was used to derive the nursing costs and service weights. The cost analysis was performed using the hospital data obtained from five departments of the UKMMC: Finance, Human Resource, Nursing Management, Maintenance and Medical Information. The costing data were trimmed using a low trim point and high trim point (L3H3) method. Results The highest nursing cost and service weights for medical cases were from F-4-13-II (bipolar disorders including mania - moderate, RM6,129; 4.9871). The highest nursing cost and service weights for surgical cases were from G-1-11-III (ventricular shunt - major, RM9,694; 7.8880). In obstetrics and gynaecology (O&G), the highest nursing cost and service weights were from O-6-10-III (caesarean section - major, RM2,515; 2.0467). Finally, the highest nursing cost and service weights for paediatric were from P-8-08-II (neonate birthweight > 2499 g with respiratory distress syndrome congenital pneumonia - moderate, RM1,300; 1.0582). Multiple linear regression analysis showed that nursing hours were significantly related to the following factors: length of stay (β = 7.6, p p p p p p Conclusions The results showed that nursing cost and service weights were higher in surgical cases compared to other disciplines such as medical, O&G and paediatric. This is possible as there are significant differences in the nursing activities and work processes between wards and specialities.

This study aimed to clarify the incidence of infectious diseases and the associated risk factors among patients who use visiting nursing services in Japan. We conducted a one-year follow up cohort study with 419 participants. The incidence and period prevalence rate of infectious diseases were 0.63 and 15.0%, respectively. In the multiple logistic regression analysis, the presence of chronic respiratory failure, Parkinson's disease, dermatosis other than pressure ulcers, and the inability to perform oral self-care were significantly related to the contraction of an infectious disease.

Background: Service improvement to enhance care quality is a key nursing responsibility and developing sustainable skills and knowledge to become confident, capable service improvement practitioners is important for nurses in order to continually improve practice. How this happens is an under-researched area. Aim: A hermeneutic, longitudinal study in Northern England aimed to better understand the service improvement lived experiences of participants as they progressed from undergraduate adult nursing students to registrants. Method: Twenty year 3 student adult nurses were purposively selected to participate in individual semi-structured interviews just prior to graduation and up to 12 months post-registration. Hermeneutic circle data analysis were used. Findings: Themes identified were service improvement learning in nursing; socialisation in nursing practice; power and powerlessness in the clinical setting; and overcoming service improvement challenges. At the end of the study, participants developed seven positive adaptive behaviours to support their service improvement practice and the ‘model of self-efficacy in service improvement enablement’ was developed. Conclusion: This study provides a model to enable student and registered nurses to develop and sustain service improvement capability.

Key indicators of performance (KPI) can be used to show the contribution of each employee or department/department to productivity in areas where quality or effectiveness can be measured. Performance indicators are usually agreed at the national or local level. When choosing a performance indicator for a nursing service, an analysis of the recommendations for testing effectiveness was required. As part of the introduction of a new model of management of nursing services in the Republic of Kazakhstan in 2018, the working group developed key indicators of performance assessment of the nursing service in order to try to demonstrate the impact of nursing on the quality of care. In 2019, in order to monitor the activities of nursing specialists in pilot medical organizations, work was carried out to assess the performance indicators of nursing specialists. These indicators were aimed at assessing the structure of nursing services, nursing process and the results of activities of nursing specialists in organizations providing outpatient and inpatient care.

Objective To develop a casemix classification to underpin a new funding model for residential aged care in Australia. Design, setting Cross-sectional study of resident characteristics in thirty non-government residential aged care facilities in Melbourne, the Hunter region of New South Wales, and northern Queensland, March 2018 - June 2018. Participants 1877 aged care residents and 1600 residential aged care staff. Main outcome measures The Australian National Aged Care Classification (AN-ACC), a casemix classification for residential aged care based on the attributes of aged care residents that best predict their need for care: frailty, mobility, motor function, cognition, behaviour, and technical nursing needs. Results The AN-ACC comprises 13 aged care resident classes reflecting differences in resource use. Apart from the class that included palliative care patients, the primary branches were defined by the capacity for mobility; further classification is based on physical capacity, cognitive function, mental health problems, and behaviour. The statistical performance of the AN-ACC was good, as measured by the reduction in variation statistic (RIV; 0.52) and class-specific coefficients of variation. The statistical performance and clinical acceptability of AN-ACC compare favourably with overseas casemix models, and it is better than the current Australian aged care funding model, the Aged Care Funding Instrument (64 classes; RIV, 0.20). Conclusions The care burden associated with frailty, mobility, function, cognition, behaviour and technical nursing needs drives residential aged care resource use. The AN-ACC is sufficiently robust for estimating the funding and staffing requirements of residential aged care facilities in Australia.

Aim To compare the patient acuity, nurse staffing and workforce, missed nursing care and patient outcomes among hospital unit-clusters. Background Relationships among acuity, nurse staffing and workforce, missed nursing care and patient outcomes are not completely understood. Method Descriptive design with data from four unit-clusters: medical, surgical, combined and step-down units. Descriptive statistics were used to compare acuity, nurse staffing coverage, education and expertise, missed nursing care and selected nurse-sensitive outcomes. Results Patient acuity in general (medical, surgical and combined) floors is similar to step-down units, with an average of 5.6 required RN hours per patient day. In general wards, available RN hours per patient day reach only 50% of required RN hours to meet patient needs. Workforce measures are comparable among unit-clusters, and average missed nursing care is 21%. Patient outcomes vary among unit-clusters. Conclusion Patient acuity is similar among unit-clusters, while nurse staffing coverage is halved in general wards. While RN education, expertise and missed care are comparable among unit-clusters, mortality, skin injuries and risk of family compassion fatigue rates are higher in general wards. Implications for nursing management Nurse managers play a pivotal role in hustling policymakers to address structural understaffing in general wards, to maximize patient safety outcomes.

RESUMEN: Los expertos en gestión sostienen que, profesionalizar la gestión, estableciendo perfiles claros de puesto, procesos de selección que tengan en cuenta las competencias, así como mecanismos de evaluación del desempeño, garantizaría que los profesionales de enfermería en gestión poseyesen estas competencias y se aplicasen día a día en su trabajo. La profesionalización de la gestión debe basarse tanto en la formación como en la experiencia gestora, siendo, más relevante la formación en gestión que la experiencia para puestos de gestión a nivel de supervisión de unidad. Una vez desempeñados esos puestos, la experiencia y la formación continuada específica en gestión harán que el profesional se encuentre más preparado para acceder a puestos de alta dirección. Objetivos: Evaluar el nivel formativo y la experiencia profesional de los profesionales de enfermería del Servicio Cántabro de Salud que desempeñan puestos de gestión y describir el perfil del enfermero gestor en el Servicio Cántabro de Salud. Metodología: Estudio transversal, descriptivo y observacional dirigido a los profesionales de Enfermería de Atención Especializada del Servicio Cántabro de Salud que desempeñan puestos de gestión. Para ello, se tomará una muestra de 108 sujetos. Las variables a estudiar serán recogidas a través de un cuestionario de 27 preguntas cerradas, elaborado para tal fin, alojado en una plataforma online. Se analizarán los datos mediante el programa SPSS 26.0, estimando las proporciones de las variables discretas con el intervalo de confianza 95% y para las variables continuas, se estimarán medias con su desviación estándar o su mediana y rangos intercuartílicos en caso de distribución anormal. Para todos los test estadísticos se considerará estadísticamente significativo cuando el valor de p sea

Background In 2000, the United Nations (UN) introduced the Millennium Development Goals (MDG), described as a global movement with the primary aim of ending world-wide poverty (“Millennium Summit,” 2000). The second phase of the project, known as the post-2015 Sustainable Development Goals (SDG) agenda offers an increased emphasis on lessening the mitigating factors associated with climate change and adapting to the negative effects of climate change. Nurses are in the unique position to address the health-related impacts related to climate change through community health approaches aimed at education and promotion of environmental stewardship. Purpose The purpose of this scoping review was to examine the relationships among the health consequences of climate change, nursing literature on climate change, and nursing implications. The following will be addressed: “What is nursing's role in policy, practice, and advocacy when addressing the effects of climate change? What is the importance of the SDGs as a framework for addressing climate change in the role of nursing?” Method This scoping review of the literature was conducted which included the evaluation of a broad range of articles using scoping methods as frameworks. Findings An overarching theme regarding the nursing community's responsibility in addressing the effects of climate change and their role as advocates, educators, and global citizens was extracted from the scoping review. Discussion There are many opportunities for nurses to become actively involved in efforts aimed at mitigation, adaptation, and resilience efforts in climate change, including becoming involved in policy, advocacy, research, and practice opportunities.

Background The purpose of this study will be to improve diabetes prevention, access to care and advocacy through a novel cost-effective nurse-led continuum of care approach that incorporates diabetes prevention, awareness, screening and management for low-income settings, and furthermore utilizes the endeavor to advocate for establishing a standard diabetes program in Nepal. Methods We will conduct a two-arm, parallel group, stratified cluster randomized controlled trial of the NUrse-led COntinuum of care for people with Diabetes (N1 = 200) and prediabetes (N2 = 1036) (NUCOD) program, with primary care centers (9 outreach centers and 17 government health posts) as a unit of randomization. The NUCOD program will be delivered through the trained diabetes nurses in the community to the intervention group and the outcomes will be compared with the usual treatment group at 6 and 12 months of the intervention. The primary outcome will be the change in glycated hemoglobin (HbA1c) level among diabetes individuals and progression to type 2 diabetes among prediabetes individuals, and implementation outcomes measured using the RE-AIM (reach, effectiveness, adoption, implementation and maintenance) framework. Outcomes will be analyzed on an intention-to-treat basis. Discussion The results of this trial will provide information about the effectiveness of the NUCOD program in improving clinical outcomes for diabetes and prediabetes individuals, and implementation outcomes for the organization. The continuum of care model can be used for the prevention and management of diabetes and other noncommunicable diseases within and beyond Nepal with similar context. Trial registration ClinicalTrials.gov, NCT04131257. Registered on 18 October 2019.