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Workers employed in clinical healthcare settings often encounter dying and death of patients as a part of their role. This scoping review aimed to explore the physical and psychosocial OHS impacts on health workers exposed to death within their occupational role and their inherent coping strategies. Six electronic databases PsycINFO (Ovid), Medline (Ovid), AMED (EBSCO), CINAHL (EBSCO), and Proquest Social Sciences were searched for peer reviewed research articles published between March 1971 and April 2022. PRISMA-ScR guidelines were followed. Three authors independently assessed articles for inclusion. Fifty-three studies with focus settings in hospitals, hospice, general practice and residential care were identified. Five main themes were developed and organized using and ergonomic systems approach: Cultural Environment, Workplace, Job Demands, Impacts and Coping. The findings demonstrate that caring for dying patients, the dead and their families in clinical settings impacts workers emotionally, physically, behaviorally and spiritually. [ABSTRACT FROM AUTHOR]

Introduction. Little is known about how shifting hospital visitor restrictions issued by national health authorities were communicated, managed, and adapted by hospital charge nurses during the COVID-19 pandemic. Aims. To describe the shifting visitor restrictions and the passing on of restrictions from the national authority level to charge nurses and secondly describe charge nurses' management of the restrictions and their challenges when enforcing them. Methods. The study consisted of a document analysis and a cross-sectional survey including open-ended questions. Descriptive statistics and qualitative content analysis were used. The survey was distributed online to 88 charge nurses in somatic units in a Danish university hospital from March 2020 to April 2021. Results. Restrictions were communicated from national authority level in an effective administrative cascade. The charge nurses led their enforcement in each unit. In total, 71 charge nurses (81%) responded to the survey. For 70%, the wording of the restrictions was clear, while 31% found them challenging to handle. On a weekly or daily basis, 68% of the charge nurses deviated from the restrictions. They identified both upsides and downsides to the absence of relatives. Communication, collaboration, and leadership were experienced as key tools in the ongoing processes of adapting to shifting restrictions. Conclusion. During this severe health crisis, essential information was passed on through well-defined management levels in an effective communication pathway. Charge nurses and their professional values were challenged when balancing shifting national restrictions against individual needs of patients and relatives. Implications for Nursing Management. Charge nurses serve as vital intermediaries between national authorities and frontline nursing practice in managing shifting visitor restrictions during a pandemic. Their experiences can contribute to further qualifying nurse managers' considerations when designing family-centred hospital visitor policies for the future. Also, they may strengthen the handling of future sudden major organizational changes. [ABSTRACT FROM AUTHOR]

Gaps abound in the literature about what happens when people living with deafblindness or dual sensory impairment (DBDSI) go to the hospital. Anecdotally, from my lived experiences and professional work, as well as from within communities, stories are told about how hazardous it is to be a patient in an Australian hospital for those living with DBDSI. This paper outlines a quantitative component of a mixed-methods study examining the intricacies of these experiences. The research objective was to discover what hospital interactions looked like for patients living with DBDSI. A constrained question set was used, namely, the Australian hospital experience question set (AHPEQS 2017). It asked patients about key factors in their hospital interactions. The results form a distressing snapshot of care and communication interactions. Experiences of flouting protective conventions, dehumanisation, neglect, discrimination, disparate care, inaccessible consent forms, and a lack of communication predominate. The participants reported experiences from multiple different hospitals, so these findings suggest a broad culture of failing to provide patient-centred care and accessible-to-the-patient communication. The findings showcase the urgency for more research and remedial actions to be undertaken by both professionals and institutions. [ABSTRACT FROM AUTHOR]

Background and Objectives: Adapting to COVID-19, as a stressful experience, is a challenging process that poses significant problems for affected individuals. One of the crucial issues in diseases, especially during epidemics, is the need to focus on the mental dimension and mental health of society and patients in the face of illness. A key component of mental health is resilience. The present study was designed and implemented to investigate the relationship between spiritual health and resilience of patients with COVID-19 in hospitals accepting COVID-19 patients in Qom Province, Iran. Methods: In this correlational and cross-sectional study, 215 patients with COVID-19 were selected to participate using convenience sampling. The participants were asked to complete a demographic information checklist, as well as Paloutzian and Ellison's spiritual health questionnaire and Connor-Davidson's resilience questionnaire. Spearman's correlation coefficient was used to analyze the data using SPSS software, version 26. Results: The results showed a significant and positive relationship between the score of spiritual health and the level of resilience of patients with COVID-19. The results showed no significant relationship between any of the variables--age, gender, employment status, underlying disease, marital status, economic status, inpatient department and level of education--and the patients' spiritual health scores or their resilience. Conclusion: There is a significant relationship between spiritual health and resilience of patients with COVID-19. Considering the essential role of mental health in enhancing resilience and facilitating the return of these patients to normal life, the healthcare team must pay special attention to this issue. [ABSTRACT FROM AUTHOR]

This paper about social media platforms of Swiss hospitals refers to the period between 10 February 2020 and 6 July 2020. The study included in-depth insights into the use of platforms, content analyses of posts and resonance of the posts. The study's objective was to get insights into social media post creation by and corresponding resonance in pandemic crisis. This study included collection and analyses of posts created by a selection of Swiss hospitals during the period of study. All university hospitals and a variety of private and regional hospitals in all regions of Switzerland are represented. The data collection started before the official shutdown in Switzerland. This study used mixed method approach and content analysis to evaluate 2,326 posts during the study period related to the COVID-19 pandemic. During the first phase of the pandemic, hospitals used social media platforms more frequently than normal. Especially in the first month, the number of posts rose disproportionally. The numbers dropped back to the initial situation after only 4 months into the COVID-19 pandemic. Most hospitals used Facebook and Twitter, whereas Instagram and YouTube's use were marginal. University hospitals used social media platforms differently than regional hospitals. Most posts generated only a very low response with a median of 2. Hospitals were therefore not able to create engagement of their followers. However, hospitals that publish actively were able to build a more active community. Only a small number of posts led to heated discussions in the comments. These viral posts shared information on the illness, the vaccination, children and COVID-19. [ABSTRACT FROM AUTHOR]

This study aims to explore the association of hospital infection prevention and control (IPC) structure (i.e. a dedicated IPC team and/or IPC committee) and IPC capacity in Korean hospitals, as well as its implications in the response and preparedness to COVID-19. This was a cross-sectional study using data collected through a nationwide survey. Participating hospitals completed an online questionnaire. Participation was voluntary. The survey questionnaire was developed by the government in consultation with IPC experts. The questionnaire was distributed to 2108 hospitals, including both acute and long-term care hospitals. The independent variables were the presence of an IPC team and/or IPC committee. The dependent variables were IPC activities and capacity measures, which were based on the World Health Organisation (WHO) recommendations on the core components in IPC. A total of 1442 hospitals completed the survey. Hospitals with IPC structures conducted significantly more IPC activities in all outcome measures compared with hospitals without IPC structures, with the exceptions of monitoring hand hygiene and screening for infectious diseases that showed non-significant differences. Hospitals with IPC structures showed a significant difference in performance in IPC risk assessment, operating outbreak response teams and appraisal of hospital IPC policies compared with hospitals without IPC structures. The presence of a dedicated IPC team and IPC committee was associated with increased IPC activities and IPC capacity. Hospitals with IPC teams and IPC committees showed strong implementation of planning, appraisal, resource management and outbreak response, indicating that strengthening IPC structures within hospitals is the key to more effective IPC and disaster response. [ABSTRACT FROM AUTHOR]

Debates over the value and contribution of community hospitals are hampered by a lack of empirical assessment of the experience of patients using these services. This paper presents findings from a study which included a focus on patient and family‐carer experiences of community hospitals in England. We adopted a qualitative design involving nine case study hospitals. Data collection included interviews with patients (n = 60), carers (n = 28) and staff (n = 89). Through patients and carers highlighting the value of community hospitals feeling 'close to home', providing holistic and personalised care and supporting them through difficult transitions, the study confirms the importance of functional and interpersonal aspects of care, while also highlighting the importance of social and psychological aspects. These included having family, friends and the community close, maintaining social connections during periods of hospital treatment, and feeling less anonymous and anxious when attending the hospital due to the high levels of familiarity and connectedness. Although the experiences uncovered in this study were not uniformly positive, patients and carers placed a high overall value on the care provided by community hospitals, often arguing that these were distinctive when compared to their experiences of using other health and care services. The study suggests the need to weigh the full range of these dimensions of patient experience—functional, interpersonal, social and psychological—when assessing the role and contribution of community hospitals. [ABSTRACT FROM AUTHOR]

This paper develops a scale that measures the perceived service quality of hospitals during a pandemic. To develop the scale, data from 206 respondents from India, was subjected to exploratory and confirmatory factor analysis. The newly developed scale was named PAND-SERVQUAL, which includes factors namely, assistance, facility & layout, trust, empathy, promptness, and knowledge. The resulting scale is likely to be useful for researchers exploring service quality research and health care quality as well. Findings will facilitate understanding patient's expectations regarding the service quality of hospitals during a pandemic. Supplemental data for this article is available online at https://doi.org/10.1080/00185868.2021.1939827. [ABSTRACT FROM AUTHOR]

Background: Ayushman Bharat -- Pradhan Mantri Jan Arogya Yojana has been launched to provide financial protection expenditure to nearly 500 million vulnerable Indians. For expanding the coverage under the scheme, it is necessary to understand the perspective of health care service providers involved in the scheme. Aim & Objective: To find out the bottlenecks in implementation of PMJAY scheme using empanelled hospitals' perspective Settings and Design: Cross sectional study Methods and Material: 8 Public and 23 Private hospitals were selected through Simple Random Sampling from the list of PMJAY empanelled hospitals. The PMJAY Medical Officer co-ordinators in the empanelled hospitals were interviewed using a predesigned and pretested questionnaire. Statistical analysis used: Data was analysed using descriptive statistics in Epiinfo software. Results: Among the 31 empanelled hospitals studied, 93.5% were satisfied with the process for empanelment under PMJAY. 64.5% hospitals were not satisfied with the Health Benefit Packages. 77.4% hospitals perceived the PMJAY to be poorer as compared to private health insurance with reasons being poor grievance reprisal, poor claim processing and settlement, denial of reimbursement of health packages, poor rates of health packages and little information about the scheme. Conclusions: Various hurdles are being faced in the implementation of the scheme. There definitely remains a huge scope for further improvements so as to enhance the insurance coverage in the country. [ABSTRACT FROM AUTHOR]

Background: The emergence of the COVID-19 pandemic has placed increased demands on the NHS workforce, especially in medical and intensive care units. The subsequent redistribution of surgical house officers to accommodate this in a single-centre NHS hospital has possibly negatively impacted on the effective discharge notification of acute surgical patients. Methods: Discharge summaries of all patients directly discharged from a Surgical Assessment Unit were collected on the day of discharge and analysed to identify the date of completion and staff grade of the responsible clinician. Data collection was carried out before the initiation of lockdown measures and continued for a further three weeks during the peak of the COVID-19 pandemic with an interventional period in between. A poster was created and displayed in areas where discharge software could be accessed. Results: In the initial audit, 36.2% of the 246 patients had delayed discharge summaries with an average of 7 days to complete. On re-evaluation, 45.3% of the 223 patients had delayed discharge summaries, taking an average of 12 days to complete. A survey conducted post-re-audit identified that the most common reason for delayed discharge summaries was due to time constraints associated with the increased workload. Conclusion: The reallocation of surgical staff in response to the COVID-19 pandemic has affected communication between primary and secondary care, with a rise in delayed discharge letters of acute surgical patients. Given the potential repercussions of these delays, healthcare systems should be aware of this consequence of the pandemic, especially in preparation for any resurgences. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Traditional Medical Complementary Therapies is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study identifies the internal characteristics of hospitals located in counties with poor socioeconomic conditions that develop collaborative partnerships with a wide range of community organizations, including non-health organizations. Cross-sectional study that conducted Chi-square and logistic regression analyses. Chi-square tests and logistic regression analyses were performed in this cross-sectional research to identify the internal hospital characteristics associated with non-health sector partnership development for hospitals located in U.S. counties in the worst quartile of performance across three socioeconomic conditions. The 2015 American Hospital Association Population Health Survey provided data on hospitals' collaborative arrangements and internal characteristics, including hospital size, teaching status, ownership type, and system affiliation (n = 1,238). The 2014 County Health Rankings were used to identify counties in the worst quartile of performance on educational attainment, unemployment, and child poverty. Chi-square analyses show that larger hospitals, teaching hospitals, hospitals that belong to a system, and not-for profit hospitals are significantly and positively correlated with non-health sector collaborative partnerships across one or more of the county indicators of poor socioeconomic conditions. Logistic regression results show that the only significant internal hospital characteristic associated with such partnerships is hospital size, in counties with poor educational attainment and those with high child poverty. Larger hospitals are more likely to have the resources and strategic perspectives to address community health in counties with poor socioeconomic conditions. [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence of, and reasons for, missed care by nurses and the factors associated with it in Iranian hospitals. Background: Despite providing high‐quality patient care in hospitals, nurses often fail to deliver optimum care, which jeopardizes the safety of patients and increases health care costs. Therefore, identifying missed nursing care is essential if the quality of health services is to be improved. Methods: A cross‐sectional study was conducted among 215 nurses working in the medical–surgical wards of eight public and private hospitals in Tabriz, Iran. The 'MISSCARE' survey tool was used to collect data in relation to the extent of missed care and the related reasons. Logistic regression models were used to assess the association between factors and missed nursing care. Results: Results showed that the mean score of overall missed nursing care was 2.57 and 72.1% of the nurses reported that they missed at least one nursing care item on their last shift. 'Patient discharge planning and teaching', 'emotional support to patient and/or family' and 'attend interdisciplinary care conferences whenever held' were the most common missed items by nurses in Iran. In a 5‐point Likert scale, the most important reasons identified by nurses for missed care were 'human resources', 3.11 (95% CI: 3.03–3.19); 'material resources', 2.7 (95% CI: 2.6–2.8); and 'communication', 2.4 (95% CI: 2.3–2.5), respectively. Missed nursing care was associated with sex (OR for males = 2.83, 95% CI: 1.01–7.89), age (OR = 1.16, 95% CI: 1.01–1.33) and the number of patients under care (OR = 1.11, 95% CI 1.01–1.22). A reverse association was found with the number of patients discharged (OR = 0.89, 95% CI: 0.82–0.96) and satisfaction with teamwork (OR = 0.60, 95% CI: 0.41–0.89). Conclusions: There is a need to identify the factors contributing to the incidence of missed nursing care in hospitals and to develop strategies to address these. Implications for Nursing Management: The results of this study highlighted the importance of addressing missed nursing care in Iranian public and private hospitals. Nursing management should consider improving communication between team members and units. Changes are required regarding task division and payments to the nursing staff. Further research is required to understand the reasons behind missed nursing care, and the development of appropriate policies to address better nursing care in hospitals is recommended. [ABSTRACT FROM AUTHOR]

Influenza is a significant cause of childhood morbidity and death; it contributes to up to 16% of hospitalizations for respiratory illnesses worldwide. Novel rapid viral diagnostic tests, including molecular diagnostic tests, have the potential to significantly affect both time to diagnosis and selection of optimal anti-infective therapy. However, little is known about current treatment algorithms used in US hospitals. In this study, for hospitalized children in the United States, we aimed to define the current approaches to influenza diagnosis and treatment and to explore reasons for their potential variation. In this study, we aimed to define the current approaches to pediatric influenza diagnosis and treatment in US hospitals, and to explore reasons for their potential variation. Our results suggest a rise in the availability and use of rapid molecular diagnostic testing in addition to continued variability in anti-infective management, particularly with regard to antiviral use. [ABSTRACT FROM AUTHOR]

Drawing on the transactional model of stress, we propose that organizational identification and positive affectivity moderate the relationship between abusive supervision and proactive behavior. In Study 1, we collected data from a sample of 165 dentists and 41 supervisors in two Chinese hospitals. In Study 2, we used a sample of 226 employee-supervisor dyads from a large Chinese transportation company. The results of two studies showed that the interaction between abusive supervision and organizational identification on proactive behavior (personal initiative in Study 1 and organizational proactive behavior in Study 2) occurred only when positive affectivity was high. We discuss theoretical and managerial implications and indicate future research directions. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this study was to assess the ability to test patients for carbon monoxide (CO) exposure in all hospitals in three United States (U.S.) Midwestern states. Methods: We surveyed hospitals in three states. Telephone queries assessed processes for measuring carboxyhemoglobin, including capacity for real-time vs send-out testing. Facilities were separated based on their location’s population size for further analysis. Descriptive statistics are reported. Results: Of the 250 hospitals queried, we ultimately excluded 25. Nearly all (220, 97.8%) reported a process in place to test for CO exposure. Over 40% (n=92) lacked real-time testing. Testing ability was positively associated with increasing population size quartile (range 32.6% - 100%). Hospitals in the lowest-quartile population centers were more likely to report that they were unable to test in real time than those in the largest-quartile population centers (67.4% vs 0%). Conclusion: In a large geographic region encompassing three states, hospital-based and real-time capacity to test for CO exposure is not universal. Hospitals in smaller population areas are more likely to lack real-time testing or any testing at all. This may have significant public health, triage, and referral implications for patients. [ABSTRACT FROM AUTHOR]

Background Little is known about variation in use of rehabilitation services provided in acute care hospitals for people who have had a stroke. Objective The objective was to examine patient and hospital sources of variation in acute care rehabilitation services provided for stroke. Design This was a retrospective, cohort design. Methods The sample consisted of Medicare fee-for-service beneficiaries with ischemic stroke admitted to acute care hospitals in 2010. Medicare claims data were linked to the Provider of Services file to gather information on hospital characteristics and the American Community Survey for sociodemographic data. Chi-square tests compared patient and hospital characteristics stratified by any rehabilitation use. We used multilevel, multivariable random effect models to identify patient and hospital characteristics associated with the likelihood of receiving any rehabilitation and with the amount of therapy received in minutes. Results Among 104,295 patients, 85.2% received rehabilitation (61.5% both physical therapy and occupational therapy; 22.0% physical therapy only; and 1.7% occupational therapy only). Patients received 123 therapy minutes on average (median [SD] = 90.0 [99.2] minutes) during an average length of stay of 4.8 [3.5] days. In multivariable analyses, male sex, dual enrollment in Medicare and Medicaid, prior hospitalization, ICU stay, and feeding tube were associated with lower odds of receiving any rehabilitation services. These same variables were generally associated with fewer minutes of therapy. Patients treated by tissue plasminogen activator, in limited-teaching and nonteaching hospitals, and in hospitals with inpatient rehabilitation units, were more likely to receive more therapy minutes. Limitation The findings are limited to patients with ischemic stroke. Conclusion Only 61% of patients with ischemic stroke received both physical therapy and occupational therapy services in the acute setting. We identified considerable variation in the use of rehabilitation services in the acute care setting following a stroke. [ABSTRACT FROM AUTHOR]

Objectives: We sought to develop and implement a Maternity Dashboard to improve the quality of health care at the ground level. Methods:. We conducted a prospective, descriptive cross-sectional study, involving patients with high-risk pregnancies who had been referred to Nizwa Hospital, Oman. The selection of quality indicators was based on the prototype of clinical outcomes from the Royal College of Obstetricians and Gynecologists. The Maternity Dashboard team adapted local parameters and used preselected general parameters, based on clinical observations, to develop the dashboard. Results: The issues posing a threat to Nizwa Hospital in becoming a world- class healthcare facility were: overbooked outpatient department, insufficient staff, and more junior doctors compared to senior doctors and consultants. Additionally, being pioneers, naturally, the dashboard development team faced difficulties while handling adverse situations. More time, guidance, and standardization of quality indicators are desirable. Conclusions: Following the approval for a Maternity Dashboard in Nizwa Hospital, the data compiled in an Excel sheet are transmitted manually every month for display on the dashboard in the delivery suite. It is intended to make data collected and dissemination completely automated in the future with the help of the Al-Shifa Healthcare Information System. Expansion of the idea of a Maternity Dashboard to other hospitals and specialties at the regional and tertiary level of the health care system in Oman and a comparison of the standard of health care provided between hospitals based on similar quality indicators would be the next milestone. [ABSTRACT FROM AUTHOR]

Background and Objectives Lack of blood components requests base on the clinical guidelines are one of the common problems of blood centers that lead to inappropriate distribution of blood products, increases in costs, and blood product wastage. The purpose of this study was to assess tariff setting impact of blood and blood components on the rate of request for blood components in the hospitals of the center of Western Azarbayjan province. Materials and Methods This study is a descriptive retrospective study. All hospitals in the city of Urmia were included. The number of requests and the distribution of blood, platelet and plasma products for the 2 years both prior and after the commencement of the tariff setting program were extracted. The return rate of blood components was also assessed during the same 2 years both prior and after the tariff setting program. The collected data were analyzed by SPSS22 Saftware. Results The findings showed a drop of 0.5% and 7.6% in RBC request rate at the first and second year of the tariff setting program, respectively. The decreasing rates for platelet requests were 3.9% and 10.6% at the first and second year of the tariff setting program, respectively. FFP request rate showed a decrease of 7% in the first year and an increase of 9.4% at the second year. Conclusions The findings show the efficacy of the implementation of tariff setting in the reduction of blood and blood products´ requests by the hospitals of Urmia. [ABSTRACT FROM AUTHOR]

Hospital soundscapes can be difficult environments to assess acoustically due to alarms, medical equipment, and the continuous activity within units. Routinely, patients perceive these soundscapes to be poor when rating their hospital experience on HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) surveys administered after discharge. In this study, five hospital units of widely varying HCAHPS "quietness" performance were analyzed. Sound pressure levels were measured in 15 patient rooms and 5 nursing stations over 24-h periods. HCAHPS "quietness of the hospital environment" patient survey data were correlated with measured acoustical data at a room-level, revealing acoustical metrics linked to patient perceptions of hospital soundscape conditions. Metrics found to be statistically correlated (p < 0.05) included the absolute LAMIN levels in patient rooms, which found significantly higher HCAHPS quietness scores in units with average LAMIN levels below 35 dBA, in addition to specific low frequency octave bands and occurrence rates. Many other standard acoustical metrics (such as LAEQ, LAMAX, LCPEAK, and LA90) were not found to be statistically correlated between measured acoustical data and HCAHPS quietness patient responses. Taken as a whole, this study provides insights into the potential relationships between hospital noise and patient satisfaction. [ABSTRACT FROM AUTHOR]

This ethnographic study of interpretations of stress among hospital social workers reveals concrete ways in which institutional systems take form in the mundane actions and interpretations of individuals embedded in these systems. It also reveals how organizational cultures reflect and reinforce institutional conditions that have been negotiated in the interactions of individuals. Here, the institutional systems of medicine and social work come together in the everyday work of the social workers and result in two patterns of cultural dominance. Within these distinct types of culture emerge two forms of stress experience, including a dominant form, consistent with medical ideology, and a marginalized form, consistent with social work ideology. Some surprising patterns of interpretation emerge, including interpretations of ambiguity and burnout as normal, social, and desirable when the social work ideology is dominant. This institutional analysis of stress has theoretical, practical, and epistemological implications. [ABSTRACT FROM AUTHOR]

The authors reflect on the response of hospitals to the COVID-19 outbreak by focusing on the experiences of medical personnel in Shanghai, China. Also cited are the fever clinics established by the Shanghai Municipal Health Commission in hospitals, as well as the response strategy by Fudan University's Zhongshan Hospital like patient management, staff emotional support, and human resource deployment.

The number of registered nurses (RNs) in the United States is roughly 3 times the number of physicians and surgeons, making RNs a critically important component of the US health care system. Registered nurse burnout--the state of emotional exhaustion in which the individual feels overwhelmed by work to the point of feeling fatigued, unable to face the demands of the job, and unable to engage with others--is a real concern, having been reported in many hospitals. The purpose of this research was to examine the causes and consequences of burnout syndrome among RNs in US hospitals and its role in the RN shortage in hospitals. The methodology involved a review of the literature and semistructured interviews. Seven primary databases, 2 websites, and 43 articles were consulted in this project. Findings indicated that burnout syndrome in RNs can be analyzed in terms of 4 clusters of characteristics: individual, management, organizational, and work. The consequences of burnout syndrome have increased RN turnover rates, poor job performance, and threats to patient safety. Burnout syndrome was more prevalent in hospitals with a higher number of patients per nurse and among younger RNs. Registered nurse burnout in hospitals has negatively impacted the quality of care, patient safety, and the functioning of staff workers in the health care industry. [ABSTRACT FROM AUTHOR]

With an emphasis on Chinese seniors, this article raises awareness of the importance of cultural competency and how this can impact care delivery, as well as strategies healthcare professionals can use to improve cultural competency in their institution. [ABSTRACT FROM AUTHOR]

The article discusses the U.S. mass shooting statistics, nurses' recommended actions, and hospital experiences on such occurrences as of 2018. Topics covered include 200 active shooter incidents between 2000 and 2015, with 578 deaths and 696 wounded, the nurse's role in community emergency preparedness and response to such incidents, and hospital preparedness and response. Also noted are strategies and challenges for hospital response to mass shootings.

Background Several countries have national policies and programmes requiring hospitals to use quality and safety (QS) indicators. To present an overview of these indicators, hospital-wide QS (HWQS) dashboards are designed. There is little evidence how these dashboards are developed. The challenges faced to develop these dashboards in Dutch hospitals were retrospectively studied. Methods 24 focus group interviews were conducted: 12 with hospital managers (n=25; 39.7%) and 12 support staff (n=38; 60.3%) in 12 of the largest Dutch hospitals. Open and axial codings were applied consecutively to analyse the data collected. Results A heuristic tool for the general development process for HWQS dashboards containing five phases was identified. In phase 1, hospitals make inventories to determine the available data and focus too much on quantitative data relevant for accountability. In phase 2, hospitals develop dashboard content by translating data into meaningful indicators for different users, which is not easy due to differing demands. In phase 3, hospitals search for layouts that depict the dashboard content suited for users with different cognitive abilities and analytical skills. In phase 4, hospitals try to integrate dashboards into organisational structures to ensure that data are systematically reviewed and acted on. In phase 5, hospitals want to improve the flexibility of their dashboards to make this adaptable under differing circumstances. Conclusion The literature on dashboards addresses the technical and content aspects of dashboards, but overlooks the organisational development process. This study shows how technical and organisational aspects are relevant in development processes. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the association between paediatric nursing‐sensitive outcomes and nurse staffing levels. Background: Although previous studies have reported an association between low nursing‐sensitive outcomes and high nurse staffing levels in adult populations, there are few studies on paediatric nursing‐sensitive outcomes. Methods: This study used electronic Health insurance review and assessment data for all children under 18 years old admitted at 46 tertiary hospitals in Korea between 2013 and 2014. Multiple logistic regression was used to examine relationships among nurse staffing levels and 11 paediatric nursing‐sensitive outcomes. Results: Nurse staffing levels had a clear relationship with the occurrence of lower respiratory tract infection and gastrointestinal infection. Five paediatric nursing‐sensitive outcomes (pneumonia, sepsis, arrest / shock / respiratory failure, wound infection and postoperative cardiopulmonary complication) showed weak relationships with nurse staffing levels. Pressure ulcers and failure to rescue had the lowest incidences in hospitals with the lowest nurse staffing levels. Conclusions: We demonstrated evidence for the relationships of nurse staffing levels with seven paediatric nursing‐sensitive outcomes. Implications for Nursing Management: For quality paediatric nursing care, nurse staffing improvement is required. The study results could be useful evidence for appropriateness of nursing staffing in paediatric facilities. [ABSTRACT FROM AUTHOR]

Aim: To record the types of conflict management that health professionals in Cyprus hospitals encounter in their daily work and to explore the conflicts, their parameters and causes, and the role ambiguity faced by the hospital employees. Material and Methods: This is a descriptive study in which data were collected with an anonymous self‐referral questionnaire. The study population consisted of 300 health professionals from six different hospitals in Cyprus. Data are presented with averages and standard deviations. Results: The health professionals identified the following causes of conflicts in the workplace in descending order: heavy workload, low pay, and varying instructions from different leaders. To deal with the conflict, 73.2% of the participants reported using avoidance, 54.2% engaged in negotiation for mutual benefit, and 40.5% cited compromise as a method. Conclusions: Identifying the way in which conflicts are managed contributes to the smooth functioning of organisations, and it improves the effectiveness of the services provided. Implications for Nursing Management: It is generally known that the high levels of conflict in hospitals are associated with increased mistakes and low employee satisfaction and performance levels. Managers deal with conflict‐management issues within organisations on a daily basis. It is therefore essential to comprehend the reasons behind conflicts and provide suitable training for the development of communication skills and conflict‐management strategies. [ABSTRACT FROM AUTHOR]

Aim: To critically appraise and synthesize empirical studies that examined conflict‐management styles used by nursing professionals when dealing with conflict. Background: Conflict is an organisational issue not new to the nursing profession. Despite the increasing research interest on this topic, no studies had been conducted to appraise and summarize evidence that examined conflict‐management styles in nursing professionals. Method: An integrative review method was used to analyse the findings. The primary databases used to access articles published from 2000 onwards were CINAHL, Medline, Psych Info, ERIC, Embase and SCOPUS. The search words and MeSH terms included: conflict, management, nursing, nurse manager, nurse, style, and strategy. Results: Twenty‐five studies met the inclusion criteria. Integration was the most frequent style employed by nursing professionals when dealing and managing conflict, followed by accommodation. Avoiding and competing were found to be the least frequently used styles. Mixed and conflicting results were obtained when nurses' demographic variables were considered. Studies are needed to examine how organisational and interpersonal factors influence nurses' choice of style for handling conflicts. Conclusion: Findings demonstrated that nursing professionals used constructive/positive conflict management approaches rather than destructive/negative conflict management approaches. Implications for Nursing Management: This integrative review provided up‐to‐date evidence that is useful when formulating interventions to equip nurses with positive conflict‐management styles necessary to mitigate and manage conflict. Such interventions may include: structured training on conflict management, team building, and conflict coaching activities, continuing professional development, reflective exercises, simulation, and role playing. [ABSTRACT FROM AUTHOR]

Copyright of Enfermagem Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Intensive care unit (ICU) diaries are increasingly being used in UK hospitals as a therapeutic means to address the psychological effects of an ICU stay on patients. The National Institute for Health and Care Excellence recommends that services are developed to meet the psychological needs of patients following critical illness. This article discusses ICU diaries as a service to meet these needs. There is a greater demand for evidence-based research to support the positive effects of the diaries. Equally, there is a need to highlight the negative impact they may have on patients who would not wish to have a diary because of the traumatic experience of critical illness. To gain an insight into the use of patient diaries, an audit was conducted at one ICU, which found compliance with completing them was poor. This article gives an overview of the available literature. Recommendations are made to improve the use of ICU diaries for clinical practice in the future. [ABSTRACT FROM AUTHOR]

Introduction: Oncotype DX® analyses the expression of 21 genes within tumour tissue to determine a Recurrence Score® (RS). RS is a marker of risk for distant recurrence in oestrogen receptor-positive early breast cancer, allowing patient-specific benefit of chemotherapy to be evaluated. Our aim was to determine whether the introduction of Oncotype DX led to a net reduction in chemotherapy use. Methods: Consecutive patients that underwent Oncotype DX at Warwick Hospital were reviewed. Patients were anonymised and re-discussed at a multidisciplinary team meeting (MDM; without RS), and treatment recommendations were recorded. This was compared to the original MDM outcome (recommendations made with RS). Differences were analysed using Wilcoxon signed-rank test. Results: 67 patients were identified. Proportions of high, intermediate and low risk were 28, 33 and 39% (n = 19/22/26), respectively. Without RS, 56 (84%) patients were recommended for chemotherapy and 3 were not. The remaining 8 patients were deemed borderline for requiring chemotherapy and referred for discussion with an oncologist. With availability of RS, 34 (50%) patients were recommended for chemotherapy, and 24 (43%) patients were spared chemotherapy (p < 0.0005). The net reduction in chemotherapy was 33%. Conclusion: There has been a significant reduction in chemotherapy usage in patients at Warwick since the introduction of Oncotype DX. [ABSTRACT FROM AUTHOR]

The Ministry of Health and Welfare announced a plan for community care in March 2018. Community care is a concept of social services that includes residential, welfare, and health care services, as well as direct care. It is a policy to actively prepare for an aged society. Various services must be developed for comprehensive community care. It is especially necessary to ensure that adequate resources are provided for home care and visiting care. To achieve this goal, the benefit policies of health insurance and long-term care insurance must be changed. Community service providers and infrastructure must be expanded, and a diverse professional workforce should be trained. Doctors need training and experience as team leaders, as they will be able to work with nurses, nutritionists, and social workers. It will be particularly important to operate clinics as group practices rather than as solo practices. Change is also needed in community hospitals, which must receive orientations regarding early patient discharge plans and community-centered collaboration. Hospitals should serve as health care safety nets, including short-term stays and same-day care. Regional governance is important for community care. Doctors must work with a variety of institutions, including community health centers, welfare centers, and elderly facilities. Medical professionals should prepare for and lead future social changes. [ABSTRACT FROM AUTHOR]

Background: Despite conservation strategies, shortages of O- red blood cells (RBCs) occur. The goal of this study was to determine how utilization of O- RBCs can be reduced using age- and location-based O+ substitution for routine transfusions in O- patients during O- shortages.Study Design and Methods: Recipient age and ABO and D group were obtained for allogeneic RBC transfusions during the 2016 calendar year from 31 participating centers. ABO and D group of each RBC unit was compared to that of the recipient to determine the number of O- RBC units transfused to all patients, the number of RBC units transfused to O- patients, and the number of O- RBC units transfused to O- patients. O- RBC transfusions to O- patients were further analyzed by patient age and location.Results: The fraction of all transfused RBCs that were O- at the participating centers ranged from 3.0% to 13.9%. The percentage of O- RBCs transfused to O- patients ranged from 36.6% to 93.7%. Hospitals differed in the frequency of issuing O- RBCs for O- patient transfusions (55.9%-100%). Relative to current issuing practice, overall use of O- RBCs could have been reduced by 44.5% if O+ units had been given to all O- patients at least 50 years old, 9.9% for all O- patients at least 80 years old, or 8.7% for all O- critical care patients at least 50 years old.Conclusion: During O- shortages, O+ switching rules based on the recipient's age and hospital location can be applied for routine transfusions to ensure the availability of O- RBC units for O- females of childbearing age. [ABSTRACT FROM AUTHOR]

This outbreak column explores the epidemiology and infection prevention guidance on tuberculosis (TB) in the UK. The column finds that, at present, national guidance leaves UK hospitals ill-prepared to prevent nosocomial TB transmission. Reasons for this conclusion are as follows: (1) while TB is predominantly a disease that affects people with ‘social ills’, it has the potential to infect anyone who is sufficiently exposed; (2) nosocomial transmission is documented throughout history; (3) future nosocomial exposures may involve less treatable disease; and (4) current UK guidance is insufficient to prevent nosocomial transmission and is less than that advocated by the World Health Organization and the Centers for Disease Control and Prevention. [ABSTRACT FROM AUTHOR]

Background: Hospitals constitute workplaces in which working conditions have specific features that favor the appearance of conflict. Objective: In this article, the causes and main factors expected to affect the appearance, characteristics, and size of conflicts in hospitals in Greece are described. It aims at better understanding of the phenomenon of conflict in hospitals, by describing and classifying the determinants of conflicts according to their importance, as this importance is determined by each category of personnel in three Greek hospitals. Also, variations in the significance of determinants are justified for categories of personnel. Methodology: The paper employs statistical data obtained from a survey carried out in three large hospitals in Greece, the AHEPA in Thessaloniki, the University Hospital of Larissa and the Hospital of Karditsa. In this survey, doctors, nurses and other hospital staff participated and questionnaires were distributed to them randomly. Results: The results comes from the analysis bring out the overall characteristics of conflicts that occur in Greek hospitals, the groups connected with these conflicts, the factors contributing to their emergence, as well as the classification of these factors according to their significance. Conclusions: The findings of this study reveal that issues such as workload in the workplace, weaknesses in hospital, competition among employees or attitudes adoption, style of management of hospital manager, problematic behavior of patients and problematic behavior of escorts are important factors contributing to the occurrence and control of the conflict. Implications: The findings of this research may help hospital managers as well as personnel to eliminate the negative effects of conflicts or exploit them for an efficient operation of their hospital or health organization. Originality/value: Literature in conflict management in Greek hospitals is rather poor and consequently, every new research in this scientific field helps to understand this phenomenon and its effective management. [ABSTRACT FROM AUTHOR]

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The third victim phenomenon refers to a system-wide organizational response to a serious untoward event in health care settings. The objective of this report is to describe possible measurable correlates of this phenomenon. A serious incident on one unit in the hospital is described. Utilization of constant observation and rate of discharge in the aftermath throughout the hospital were assessed. There was a hospital-wide uptick in conservative decision making following the serious incident, exemplified by an increase in the utilization of constant observation and decreased rate of discharges. These findings lend support to the validity of the concept of the third victim phenomenon and underscore the imperative for a coherent leadership response to prevent damage to institutional core values, morale, and reputation. Systematic investigation of this phenomenon and its potential effects on clinical practice in the aftermath of serious incidents is warranted. [ABSTRACT FROM AUTHOR]

Background: The instrument called "Hospital Anxiety and Depression Scale" (HADS) is frequently used to evaluate anxious and depressive symptomatology in patients who receive Cancer Genetic Counseling (CGC). However, this instrument cannot identify all of the psychosocial factors, such as the antecedents of the patient's emotional states or their concerns. The objective of the present research was to compare cases detected with psychosocial alterations by means of HADS and a Psychological Health Interview (PHI). Methods: A transversal analytical design was used. One hundred ten participants were included (97.3% females and 2.7% males). The average age was 45 years ±10 years. Results: The PHI identified twice the amount of participants with psychosocial alterations than did HADS, which only detected 43% of these participants. Conclusions: The results of our study suggest that the PHI should be applied in addition to HADS to identify participants who would require psychological support due to recurrent concerns. [ABSTRACT FROM AUTHOR]

This article presents the recently created intercultural consultation at the Medical and Psychological Health Care Service (CMP) of the University Hospital la Grave at Toulouse. The approach of the intercultural consultation was elaborated in response to the increasing diversity of children and families using the service in Toulouse. It is also based on local research that indicates the difficulties service providers encounter when trying to establish a solid therapeutic alliance with families with complex migration backgrounds who accumulate different disadvantaging factors. The intercultural consultation adapts existing models of culture-sensitive consultations in child mental health care in France and Canada to the local context in Toulouse. We describe the underlying principles of the intercultural consultation work, the therapeutic and mediation techniques used, and the way the work is integrated into the global service provision of the CMP. The process is illustrated with a case study followed by a discussion of the innovations. [ABSTRACT FROM AUTHOR]

The article investigates if, and in affirmative case how, Italian hospitals are managing corporate brand communication. Thanks to results of qualitative research, this article offers insights on Italian hospital branding. The pilot study based in the case method is to be considered a starting point for wider investigations on this topic, and it is useful for managers and practitioners who want to understand the role of corporate brand in hospital communication management and to connect health care professionals with the audience in a meaningful way in those countries in which the health care system is a mix of both public and private institutions. [ABSTRACT FROM AUTHOR]

The rehabilitation environment is structured differently from the hospital-based environment in a way that lends itself to interdisciplinary care. Physicians work with other specialists on an interprofessional team while observing patients' participation in activities of daily living. This approach allows a patient to show rather than tell a physician what he or she can do, which helps the physician remove as many medical barriers to rehabilitation as possible. Another difference is the decentering of the physician on the health care team. Because a patient's functional status is beyond the scope of expertise of any individual health care team member, treatment plans are formed collaboratively, with input from every member of the team. The result is more comprehensive and holistic care for medically complex patients. [ABSTRACT FROM AUTHOR]

Purpose: Standard gamble (SG) is the preferred method of assessing preferences in situations with uncertainty and risk, which makes it relevant to patients considered for aortic valve replacement (AVR). The present study assesses SG preferences in patients with severe aortic stenosis (AS).Methods: All patients >18 years old with severe AS referred for AVR to our institution were invited to enroll in the study. The SG was administered by a clinical research nurse. The SF-36, EQ-5D 3L, Hospital Anxiety and Depression Scale (HADS), and AS symptoms were administered by self-completed questionnaire. We hypothesized that SG utilities would have low-to-moderate correlations with physical and mental aspects of health based on our pathophysiological understanding of severe AS. No correlations were expected with echocardiographic measures of the aortic valve.Results: The response rate for SG was 98 %. SG moderately correlated with physical aspects of SF-36 (PCS, role-physical, vitality), health transition, AS symptoms, and EQ-VAS (ρ S = 0.31-0.39, p < 0.001) and had low correlation with mental aspects of SF-36 and EQ-5D (ρ S = 0.17-0.28, p < 0.001). No correlation was found between SG and HADS, echocardiographic measures, age, gender, or education level (ρ S = 0.01-0.06).Conclusions: SG is an acceptable and feasible method of assessing preferences in patients with severe AS that has evidence for validity. The inclusion of uncertainty lends the SG face validity in this population as a direct approach to assessing preferences and basis for QALY calculations. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study examined the impact of shared governance (SG) on the professional nursing practice environment of a small community hospital over time. BACKGROUND: Shared governance has been shown to empower nurses in direct patient care to make decisions about their practice and improve job satisfaction. No research has been found that examined the progression of SG over time in a small community hospital. METHODS: Questionnaires pertaining to the professional practice environment, perception of nursing leadership, nurse empowerment, nurse satisfaction, risk of practice errors, and comfort with evidence-based practice were administered to all nurses employed at a 149-bed community hospital in central North Carolina for 5 consecutive years. RESULTS: Results showed that nursing leadership and SG explained 90% of the variance in the nursing professional practice environment. This relationship held true for 5 years. All variables showed continued improvement for 4 years, until year 5 when the organization experienced disruptive change. Even during this year, the results did not return to baseline. CONCLUSIONS: In order to improve the professional practice environment of nurses, hospitals should focus on strong nursing leadership and a sound SG infrastructure. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. This article describes the initiatives of doctorate of nursing practice (DNP)–prepared nurses in a large healthcare system supporting the DNP competencies as outlined by the American Association of Colleges of Nursing. The goal of this group was to demonstrate the impact of DNP education on the roles for nurse administrators, advanced practice nurses, and educators in a large health system. Exemplars profile nurse administrators, clinical nurse specialists, and a nurse educator. [ABSTRACT FROM AUTHOR]

Many doctors migrate to find work opportunities elsewhere. Before being allowed to practice, these doctors, commonly referred to as International Medical Graduates (IMGs), must gain local registration, which can take considerable time. During this process many IMGs linger on the margins of hospitals, without medical employment. We follow this understudied group of IMGs in Melbourne, Australia, to understand their life on the margins of medicine. This takes us into hospital places on the fringes of clinical activity: a cafeteria, tutorial room and hospital library. We argue that these places are important for the doctors in retaining and strengthening their sense of professional identity in precarious circumstances. The IMGs find creative ways to inhabit familiar settings, creating their own pathways, to find their way into the local medical system. This analysis is in contrast to more common Foucauldian interpretations of hospitals that present the institution as having a structured, disciplining effect on its inhabitants. [ABSTRACT FROM AUTHOR]