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Aim: This study aimed to determine the influence of personal factors such as grit, calling, and resilience on nurses' retention intention in South Korean general hospitals. Background: The global shortage and high turnover rate of nurses have become significant concerns with no clear solutions for increasing retention. Introduction: Determining the factors related to the f general hospital nurses and retention intention is important for solving the problem of inadequate nursing personnel and improving the quality of nursing services. Methods: This study was a descriptive survey of 221 nurses working at a general hospital in South Korea from July 2021 to February 2022. Data were collected using self‐reported online questionnaires, with measurement tools focusing on grit, calling, resilience, and retention intention. The STROBE checklist was used for reporting this study. Results: The average retention intention score was 5.35 ± 1.52 out of 8 points. Significant correlations were found between retention intention and grit, calling, and resilience. The factors influencing retention intention were job satisfaction, calling, marital status, and total career length, explaining 31.9% of the variance. Conclusions: To enhance nurses' intention to remain at general hospitals, their job satisfaction and sense of a calling should be improved. Further research should be conducted to identify factors that influence retention intention, particularly among groups with low job retention, with consideration of individual characteristics that might affect retention intention. Implications for nursing and health policy: Increasing nurses' retention intention would alleviate the nursing shortage, help hospitals retain competent nurses, reduce turnover‐related costs, and improve organizational efficiency. Resolving the nursing shortage is critical for improving patient safety and nursing service quality at general hospitals. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has prompted significant changes in healthcare, particularly affecting psychiatric and psychological Consultation-Liaison (CL) services in general hospital settings. Aim: To assess the effects of COVID-19-related restrictions on utilization of psychiatric and psychological CL services in Northeast Italy during 2020, and to compare it to the use of services in the previous year (2019). Methods: The study collected data on psychiatric and psychological consultations in 2019 and 2020 from a hospital database. It categorizes consultations by type of patient (inpatient or outpatient) and referral source (hospital wards, general practitioners, other specialists). Pandemic-related restrictions were classified as "lockdown," "intermediate restrictions," and "no or reduced restrictions" based on the Covid Stringency Index (CSI). Poisson regression models were employed to analyze the data. Results: The findings reveal a significant 28% increase in the number of psychiatric and psychological consultations in 2020. Consultations for outpatients increased by 51%, while those for inpatients decreased by 11%. However, the lockdown and intermediate restriction phases were deemed responsible of a decrease of 42.9% and 19.5% in consultations respectively. Discussion: This study highlights the persistent psychological burden during the COVID-19 pandemic, alongside reduced CL services due to lockdown measures. Integrating telemedicine into these types of services becomes imperative for meeting patient needs during restrictions. These findings can inform policies and practices to improve effective mental health care delivery during and beyond pandemics. Future research should explore the impact of pandemic-related restrictions on mental healthcare across settings and clinical factors affecting service accessibility. [ABSTRACT FROM AUTHOR]

Abstract Background Occupational stress can affect specialty nurses’ quality of work, especially for those working in care units. This study, therefore, investigated role stress and its related factors among specialty nurses working in tertiary general hospitals. Methods This cross-sectional descriptive study used convenience sampling to recruit 795 Chinese specialty nurses in 11 tertiary general hospitals (from February to March 2023). A questionnaire survey was conducted using the Basic Information Questionnaire and the Role Stress Scale. Multiple linear regression analyses were performed on the survey data to explore the factors affecting role stress. Results The total role stress score of specialty nurses in tertiary general hospitals was 52.05 ± 19.98. The highest mean item score was quantitative overload, followed by qualitative overload, role conflict, and role ambiguity, which had the lowest score. Multiple linear regression analysis revealed that gender (β = -0.085, p

Background: Occupational stress can affect specialty nurses' quality of work, especially for those working in care units. This study, therefore, investigated role stress and its related factors among specialty nurses working in tertiary general hospitals. Methods: This cross-sectional descriptive study used convenience sampling to recruit 795 Chinese specialty nurses in 11 tertiary general hospitals (from February to March 2023). A questionnaire survey was conducted using the Basic Information Questionnaire and the Role Stress Scale. Multiple linear regression analyses were performed on the survey data to explore the factors affecting role stress. Results: The total role stress score of specialty nurses in tertiary general hospitals was 52.05 ± 19.98. The highest mean item score was quantitative overload, followed by qualitative overload, role conflict, and role ambiguity, which had the lowest score. Multiple linear regression analysis revealed that gender (β = -0.085, p < 0.05), educational background (β = 0.077, p < 0.05), and work experience (β = -0.104, p < 0.05) were the main factors influencing role stress among specialty nurses. Conclusions: Specialty nurses in tertiary general hospitals had higher levels of role stress than general nurses. Their role stress was primarily reflected in role overload, followed by role conflict and ambiguity. The factors affecting specialty nurses' role stress included gender, work experience, and educational background. Nursing managers should monitor the role stress experienced by specialty nurses in tertiary general hospitals. Providing psychological support for male specialty nurses, performance rewards and learning opportunities for highly educated specialty nurses, and continuous training for inexperienced specialty nurses are essential measures to relieve role stress. [ABSTRACT FROM AUTHOR]

BackgroundThe COVID-19 pandemic has prompted significant changes in healthcare, particularly affecting psychiatric and psychological Consultation-Liaison (CL) services in general hospital settings.AimTo assess the effects of COVID-19-related restrictions on utilization of psychiatric and psychological CL services in Northeast Italy during 2020, and to compare it to the use of services in the previous year (2019).MethodsThe study collected data on psychiatric and psychological consultations in 2019 and 2020 from a hospital database. It categorizes consultations by type of patient (inpatient or outpatient) and referral source (hospital wards, general practitioners, other specialists). Pandemic-related restrictions were classified as “lockdown,” “intermediate restrictions,” and “no or reduced restrictions” based on the Covid Stringency Index (CSI). Poisson regression models were employed to analyze the data.ResultsThe findings reveal a significant 28% increase in the number of psychiatric and psychological consultations in 2020. Consultations for outpatients increased by 51%, while those for inpatients decreased by 11%. However, the lockdown and intermediate restriction phases were deemed responsible of a decrease of 42.9% and 19.5% in consultations respectively.DiscussionThis study highlights the persistent psychological burden during the COVID-19 pandemic, alongside reduced CL services due to lockdown measures. Integrating telemedicine into these types of services becomes imperative for meeting patient needs during restrictions. These findings can inform policies and practices to improve effective mental health care delivery during and beyond pandemics. Future research should explore the impact of pandemic-related restrictions on mental healthcare across settings and clinical factors affecting service accessibility.

Objective: As aging in the Chinese population increases, the hospitalization rates of patients with dementia have also risen. Research on the difficulties of nurses who care for patients with dementia in Chinese general hospitals is limited. This study aimed to develop a scale to measure the difficulties nurses face in nursing patients with dementia in Chinese general hospitals and to verify its reliability and validity. Methods: Guided by the biopsychosocial theory, an initial scale was created through a literature review, qualitative interviews, and expert consultation. A web-based survey for psychometric testing was conducted with 394 nurses from 11 general hospitals during September to November 2021. Validity was verified using content validity, exploratory factor analysis, the known-groups method, and concurrent validity. Cronbach’s α coefficient and split-half reliability were used to assess reliability. Results: The Item-level Content Validity Index was 0.833–1.000. The Scale-level Content Validity Index was 0.929. Twenty-one items with four factors were extracted from the item analysis and exploratory factor analysis. According to the known-groups method, the difficulty of the experienced group and the group with training experience was significantly lower than that of the less experienced group and the group without training experience. Based on external standards, the correlation coefficient was 0.387 with the Nursing Job Stress Scale and −0.239 with the Dementia Care Attitude Scale. Cronbach’s α coefficient for each factor ranged from 0.889 to 0.905, and the total was 0.959. The split-half reliability for each factor ranged from 0.814 to 0.894, and the total was 0.911. Conclusion: This study discovered a four-factor structure related to the difficulty scale of dementia nursing practice, and the scale’s reliability and validity were confirmed. The scale can be utilized to assess the difficulty of dementia nursing practice in general hospitals and may be employed in future research to improve dementia nursing practices.

High-quality healthcare is essential for community well-being and positive health outcomes. Healthcare settings, therefore, should deliver timely, equitable, integrated, efficient, effective, safe, and people-centered service. As in other countries, the COVID-19 pandemic and the nursing shortage crisis have impacted Myanmar's nursing care quality. A cross-sectional study was conducted to examine the predictability of nurse staffing, educational levels, work experience, nurse work environment, and job satisfaction on the quality of nursing care among 218 registered nurses from five general hospitals in the Republic of the Union of Myanmar during July and September 2022. Data were collected using the Demographic and Nurse Staffing Data Form, the Practice Environment Scale of the Nursing Work Index, the Job Satisfaction Survey, and the Good Nursing Care Scale. The data were examined using descriptive statistics and a stepwise multiple regression analysis. Results revealed that the overall quality of nursing care as perceived by nurses was high. The significant predictors of the quality of nursing care from the highest to the lowest were nurse work environment, nurse staffing, work experience, and job satisfaction, explaining 56% of the variance in the quality of nursing care. This study provides vital evidence for creating strategies to enrich and sustain the quality of nursing care in Myanmar and possibly other countries. Nursing directors should work with the government to produce and recruit more nurses, allocate budgets for care, and create a supportive work environment for nurses to improve healthcare quality. [ABSTRACT FROM AUTHOR]

OBJECTIVE To investigate the effect of leadership styles on strategic leadership, as well as the integration and commitment to a change plan within a hospital environment. METHOD A quantitative study was conducted to measure the impact of leadership styles on the following factors: (a) strategic leadership, (b) integration of change, and (c) commitment to change. The research sample consisted of 280 employees working in general hospitals located in the area of Thessalia, Greece. The questionnaire used included several tools to measure the variables mentioned above. RESULTS The research revealed that the transformational leadership style's idealized influence and inspirational motivation characteristics were the most frequently adopted, while the passive laissez-faire style was the least utilized. Furthermore, the findings of this study showed a positive connection between both transactional and transformational leadership styles with the factors of strategic leadership, integration of change, and commitment to change. In contrast, the laissezfaire style exhibited a negative relationship with the variables of strategic leadership, integration of change, and commitment to change. CONCLUSIONS Effective leadership plays a crucial role in managing a health institute and successfully implementing a strategic organizational change plan. The commitment and integration of healthcare employees are essential assets for the successful execution of organizational change. [ABSTRACT FROM AUTHOR]

Dysphagia is a common complication of various clinical conditions, with an increased incidence as age advances. Complications such as aspiration, malnutrition, and aspiration pneumonia caused by dysphagia significantly affect the overall treatment outcomes of patients. Scholars both domestically and internationally are increasingly focusing on early rehabilitation for dysphagia. This article summarizes common conditions causing dysphagia, clinical manifestations, complications, screening assessment, diagnosis, rehabilitation, and nutritional support related to dysphagia. It emphasizes the arrival at a multidisciplinary collaborative diagnosis and formulation of a rehabilitation management plan for dysphagia in general hospitals in order to provide strategic suggestions for establishing a multidisciplinary collaborative model for swallowing disorder management in general hospitals. [ABSTRACT FROM AUTHOR]

Objective Delirium and pain are common in older adults admitted to hospital. The relationship between these is unclear, but clinically important. We aimed to systematically review the association between pain (at rest, movement, pain severity) and delirium in this population. Methods PubMed, EMBASE, CINAHL, PsycINFO, Cochrane and Web of Science were searched (January 1982–November 2022) for Medical Subject Heading terms and synonyms ('Pain', 'Analgesic', 'Delirium'). Study eligibility: (1) validated pain measure as exposure, (2) validated delirium tool as an outcome; participant eligibility: (1) medical or surgical (planned/unplanned) inpatients, (2) admission length ≥ 48 h and (3) median cohort age over 65 years. Study quality was assessed with the Newcastle Ottawa Scale. We collected/calculated odds ratios (ORs) for categorical data and standard mean differences (SMDs) for continuous data and conducted multi-level random-intercepts meta-regression models. This review was prospectively registered with PROSPERO [18/5/2020] (CRD42020181346). Results Thirty studies were selected: 14 reported categorical data; 16 reported continuous data. Delirium prevalence ranged from 2.2 to 55%. In the multi-level analysis, pain at rest (OR 2.14; 95% confidence interval [CI] 1.39–3.30), movement (OR 1.30; 95% CI 0.66–2.56), pain categorised as 'severe' (OR 3.42; 95% CI 2.09–5.59) and increased pain severity when measured continuously (SMD 0.33; 95% CI 0.08–0.59) were associated with an increased delirium risk. There was substantial heterogeneity in both categorical (I2 = 0%–77%) and continuous analyses (I2 = 85%). Conclusion An increase in pain was associated with a higher risk of developing delirium. Adequate pain management with appropriate analgesia may reduce incidence and severity of delirium. [ABSTRACT FROM AUTHOR]

Purpose: This descriptive research study attempted to determine how general hospital nurses’ awareness of the importance of patient safety management and patient safety competency affected patient safety management activities. Methods: From September 13 to 26, 2022, a survey was administered to 230 ward nurses who provided direct care to patients at five non-accredited general hospitals being evaluated for accreditation located in metropolitan cities. The collected data were analyzed with descriptive statistics, the t-test, one-way analysis, the Scheffé test, Pearson correlation coefficients, and hierarchical regression using SPSS for Windows version 26.0. Results: In total, 221 (96.1%) respondents were female. The average age was 32.2 years, and the average clinical experience was 3.5 years; 196 participants (85.2%) were general nurses. Patient safety competency (β = .44, p < .001), awareness of the importance of safety management (β = .31, p < .001), and medication error experience (β = -.15, p = .002) all had statistically significant associations with patient safety management activities. The explanatory power of these variables for patient safety management activities was 50.7%. Conclusion: This study confirmed that patient safety competency, awareness of the importance of patient safety management, and experience with medication errors significantly influenced patient safety management activities. [ABSTRACT FROM AUTHOR]

Abstract Background A good health care system and, especially, the provision of efficient hospital care are the goals of national and regional health policies. However, the scope of general hospital care in the 16 federal states in Germany varies considerably from region to region. The objectives of this paper are to evaluate the technical efficiencies of all general hospitals of the 16 federal states for the period from 2015 to 2020, to find out the relation between the exogenous factors and score of efficiency, and also the influence of the COVID-19 pandemic on the results of the technical efficiency of hospital care in the German states. Methods A two-step approach was used. First, an input-oriented Data Envelopment Analysis model with constant returns to scale and variable returns to scale was applied for the 6-year period from 2015 to 2020. The calculation of technical efficiency according to the input-oriented DEA model contains the three components—total technical efficiency (TTE), pure technical efficiency (PTE) and scale efficiency (SE). In the second stage, the influence of exogenous variables on the previously determined technical efficiency was evaluated by applying the tobit regression analysis. Results Although the level of average technical efficiency of about 90% is high, total technical efficiency deteriorated steadily from 2015 to 2020. Its lowest point at around 78%, was in the year 2020. The deterioration of the average technical efficiency is notably influenced by the lower results in the years 2019 and 2020. The decomposition of technical efficiency also revealed that the deterioration of overall average efficiency was influenced by both pure technical efficiency (PTE) and scale efficiency (SE). Based on the tobit regression analysis performed, it was possible to conclude that the change in the efficiency score can be explained by the influence of exogenous factors only from 6.4% for overall efficiency and from 7.1% for scale efficiency. Conclusions The results of the analysis of the overall technical efficiency reveal that the aggregated data of all general hospitals of all 16 federal states show a steadily worsening total technical efficiency every year since 2015. Although, especially, the deterioration of the year 2020 with the occurrence of COVID-19 pandemic, contributes to a deteriorated efficiency average, the deterioration of the efficiency values, based on the analysis performed, is also observable between the years 2016 and 2019. Considering the output generated, for inefficient units and the relevant policy authorities in the hospital sector, it can be recommended that the number of beds and in particular the number of physicians, should be reduced as inputs. Based on this study, it is also recommended that decisions to increase the efficiency of general hospitals should be made with consideration of exogenous factors such as the change in the number of general hospitals or the population density in the respective state, as these had explanatory value in connection with the increase in efficiency values. Due to the wide variation in the size of the federal states, the recommendation is more appropriate for federal states with low population density.

Abstract Background Patients with moderate and severe traumatic brain injury (TBI) are admitted to general hospitals (GHs) without neurosurgical services, but few studies have addressed the management of these patients. This study aimed to describe these patients, the rate of and reasons for managing patients entirely at the GH, and differences between patients managed entirely at the GH (GH group) and patients transferred to the regional trauma centre (RTC group). We specifically examined the characteristics of elderly patients. Methods Patients with moderate (Glasgow Coma Scale score 9–13) and severe (score ≤ 8) TBIs who were admitted to one of the seven GHs without neurosurgical services in central Norway between 01.10.2004 and 01.10.2014 were retrospectively identified. Demographic, injury-related and outcome data were collected from medical records. Head CT scans were reviewed. Results Among 274 patients admitted to GHs, 137 (50%) were in the GH group. The transferral rate was 58% for severe TBI and 40% for moderate TBI. Compared to the RTC group, patients in the GH group were older (median age: 78 years vs. 54 years, p

The article focuses on a study that analyzes impact of nosocomial infection in patient during treatment and cost of hospitalization of the patient. Topics discused include measures for reduction of associated costs and nosocomial infection, impact of reduced infection on reduction and saving in medical costs associated with work process of patient isolation, and study of patients in intensive care units (ICU) due to the infection.

In the context of the covid-19 pandemic, health professionals have been exposed to situations that can produce psychological suffering, such as risk of contamination, extended working time, absence of personal protective equipment, stress, and anxiety. This research studies the impacts of the Covid-19 pandemic on the performance of professionals who work in the psychiatric unit into a general hospital. It is a qualitative research built up from interviews with health professionals whose script contained, among others, the following question: "Has Covid-19 pandemic brought changes in your professional performance?". In order to analyze the findings, we have chosen the thematic analysis approach. Data findings pointed out that the challenges for care in the pandemic encompass changes in the practices of care, staff reduction, increased workload, lack of safety equipment, fear, and anxiety in the team, which implies the need for psychosocial support for the professionals, once the pandemic has deepened the experience of pre-existing difficult situations. Based on the above, there was a need for some new adaptations for doing the work in the researched unit, which faces both an atmosphere of tension hovering in the workplace and a reduced team of health professionals. [ABSTRACT FROM AUTHOR]

Objective To establish the evaluation index of nursing quality in imaging specialty of general hospital, so as to provide scientific basis for the evaluation of the evaluation of nursing quality management effect in imaging specialty. Methods Through literature research, group discussion, semi-structural interview and two rounds of Delphi expert consultation, the evaluation index system of nursing quality in imaging specialty of general hospital was established. Results The effective recovery rate of the two rounds of expert letter inquiry questionnaire was 100%,and the expert authority coefficient was 0.92 and 0.93,respectively.The coefficient of variation of all levels of indicators was 0-0.1,and the coordination coefficient was 0.567,ultimately including 3 first-level indicators,13 second-level indicators and 39 third-level indicators. Conclusion The evaluation index system of imaging nursing quality in general hospital is reliable, scientific and comprehensive, and the items of nursing quality evaluation of imaging specialty are defined, which provides a scientific basis for the quality inspection and evaluation of imaging specialty nurses. [ABSTRACT FROM AUTHOR]

Few researchers have investigated the incidence of and risk factors for hospital-acquired pneumonia (HAP) among inpatients with mental disorders in a general hospital. This study included patients with mental disorders hospitalized in a large mental health center (situated in a general hospital) between January 1, 2017, and July 31, 2021 (excluding January 1, 2020- May 31, 2020). Risk factors for HAP were identified by logistic regression analysis after propensity score matching (PSM, 1:4) for gender, age, duration of observation, and hospital ward. The study included 16,864 patients. HAP incidence rate was 1.15% overall, 2.11% in closed wards, 0.75% in open wards, 4.45% in patients with organic mental disorders, 1.80% in patients with schizophrenia spectrum disorders, and 0.84% in patients with mood disorders. Risk factors for HAP after PSM were hypoproteinemia, chronic liver disease, use of clozapine, hospitalization during the previous 180 days, body mass index (BMI) ≤18.5 kg/m2, cholinesterase inhibitor use, and mood stabilizer use. HAP was common among inpatients with mental disorders. Risk factors for HAP in patients with mental disorders include hypoproteinemia, chronic liver disease, hospitalization during the past 180 days, BMI ≤18.5 kg/m2, and use of clozapine, cholinesterase inhibitors, or mood stabilizers. • Hospital-acquired pneumonia (HAP) was common in inpatients with mental disorders. • HAP incidence was higher in patients in closed wards than in those in open wards. • HAP was prevalent in patients with organic mental disorders or schizophrenia. • HAP prolonged the hospitalization of inpatients with mental disorders. • Patients with mental disorders have unique risk factors for HAP. [ABSTRACT FROM AUTHOR]

Objective: To determine if increases in hospital discharge prices are associated with improvements in clinical quality or patient experience. Data Sources: This study used Medicare cost report data and publicly available Medicare.gov Care Compare quality measures for approximately 3000 short‐term care general hospitals between 2011 and 2018. Study Design: We separately regressed quality measure scores on a lag of case mix adjusted discharge price, hospital fixed effects, and year indicators. Clinical quality measures included 30‐day readmission rates for acute myocardial infarction, chronic obstructive pulmonary disease, heart failure, hip and knee replacement, and pneumonia; risk‐adjusted 30‐day mortality rates for acute myocardial infarction, chronic obstructive pulmonary disease, heart failure, and stroke; and 90‐day complication rate for hip and knee replacement. Patient experience measures included the summary star rating and 10 domain measures reported through the Hospital Consumer Assessment of Healthcare Providers and Systems survey. We tested for heterogeneous effects by hospital ownership, number of beds, the commercial share of overall discharges, and market concentration. Data Collection/Extraction Methods: We linked hospitals identified in Medicare cost reports to Medicare.gov Care Compare quality measures. We excluded hospitals for which we could not identify a discharge price or that had an unrealistic price. Principal Findings: There was no positive association between lagged discharge price and any clinical quality measure. For patient experience measures, a 2% increase in discharge price was not associated with overall patient satisfaction but was associated with small, statistically significant increases ranging from 0.01% to 0.02% (relative to mean scores) for seven of ten domain measures. There was a positive association for five of ten patient experience measures in competitive markets and one measure in both moderately concentrated and heavily concentrated markets. Conclusions: We found no evidence that hospitals use higher prices to make investments in clinical quality; patient experience improved, but only negligibly. [ABSTRACT FROM AUTHOR]

Background: In December 2022, the Ministry of Health and Welfare of the Korean government announced the "action plan for essential medicine (EM)," featuring that the regional emergency centers in tertiary general hospitals would be responsible for emergency medical care. There have been several limitations in regional emergency centers because of lacking operating rooms, intensive care units, and wards during weekdays and surgery staff during the nighttime and holidays. Thus, this plan may be insufficient to achieve the goal. Current Concepts: This paper proposes special hospitals for EM, especially essential surgery in which there are no scheduled surgeries and outpatient clinics during weekdays. At least half of wards should be reserved for EM patients because of lacking wards, and these empty wards should be financially rewarded. During weekends, a team of five surgical specialists works 16 h per day to prevent the so-called weekend or Friday effect because of lacking surgeons. The special hospital would operate 365 days and 24 hours with an EM surgeon pool in the digital twin system--virtual and real hospitals (so-called smart essential surgery metaverse hospital). Discussion and Conclusion: This paper proposes a pilot project to establish a smart essential surgery metaverse hospital to compare the efficiency of EM with the regional emergency centers in tertiary general hospitals. [ABSTRACT FROM AUTHOR]

Background: A good health care system and, especially, the provision of efficient hospital care are the goals of national and regional health policies. However, the scope of general hospital care in the 16 federal states in Germany varies considerably from region to region. The objectives of this paper are to evaluate the technical efficiencies of all general hospitals of the 16 federal states for the period from 2015 to 2020, to find out the relation between the exogenous factors and score of efficiency, and also the influence of the COVID-19 pandemic on the results of the technical efficiency of hospital care in the German states. Methods: A two-step approach was used. First, an input-oriented Data Envelopment Analysis model with constant returns to scale and variable returns to scale was applied for the 6-year period from 2015 to 2020. The calculation of technical efficiency according to the input-oriented DEA model contains the three components—total technical efficiency (TTE), pure technical efficiency (PTE) and scale efficiency (SE). In the second stage, the influence of exogenous variables on the previously determined technical efficiency was evaluated by applying the tobit regression analysis. Results: Although the level of average technical efficiency of about 90% is high, total technical efficiency deteriorated steadily from 2015 to 2020. Its lowest point at around 78%, was in the year 2020. The deterioration of the average technical efficiency is notably influenced by the lower results in the years 2019 and 2020. The decomposition of technical efficiency also revealed that the deterioration of overall average efficiency was influenced by both pure technical efficiency (PTE) and scale efficiency (SE). Based on the tobit regression analysis performed, it was possible to conclude that the change in the efficiency score can be explained by the influence of exogenous factors only from 6.4% for overall efficiency and from 7.1% for scale efficiency. Conclusions: The results of the analysis of the overall technical efficiency reveal that the aggregated data of all general hospitals of all 16 federal states show a steadily worsening total technical efficiency every year since 2015. Although, especially, the deterioration of the year 2020 with the occurrence of COVID-19 pandemic, contributes to a deteriorated efficiency average, the deterioration of the efficiency values, based on the analysis performed, is also observable between the years 2016 and 2019. Considering the output generated, for inefficient units and the relevant policy authorities in the hospital sector, it can be recommended that the number of beds and in particular the number of physicians, should be reduced as inputs. Based on this study, it is also recommended that decisions to increase the efficiency of general hospitals should be made with consideration of exogenous factors such as the change in the number of general hospitals or the population density in the respective state, as these had explanatory value in connection with the increase in efficiency values. Due to the wide variation in the size of the federal states, the recommendation is more appropriate for federal states with low population density. [ABSTRACT FROM AUTHOR]

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Background: Patients with moderate and severe traumatic brain injury (TBI) are admitted to general hospitals (GHs) without neurosurgical services, but few studies have addressed the management of these patients. This study aimed to describe these patients, the rate of and reasons for managing patients entirely at the GH, and differences between patients managed entirely at the GH (GH group) and patients transferred to the regional trauma centre (RTC group). We specifically examined the characteristics of elderly patients. Methods: Patients with moderate (Glasgow Coma Scale score 9–13) and severe (score ≤ 8) TBIs who were admitted to one of the seven GHs without neurosurgical services in central Norway between 01.10.2004 and 01.10.2014 were retrospectively identified. Demographic, injury-related and outcome data were collected from medical records. Head CT scans were reviewed. Results: Among 274 patients admitted to GHs, 137 (50%) were in the GH group. The transferral rate was 58% for severe TBI and 40% for moderate TBI. Compared to the RTC group, patients in the GH group were older (median age: 78 years vs. 54 years, p < 0.001), more often had a preinjury disability (50% vs. 39%, p = 0.037), and more often had moderate TBI (52% vs. 35%, p = 0.005). The six-month case fatality rate was low (8%) in the GH group when transferral was considered unnecessary due to a low risk of further deterioration and high (90%, median age: 87 years) when neurosurgical intervention was considered nonbeneficial. Only 16% of patients ≥ 80 years old were transferred to the RTC. For this age group, the in-hospital case fatality rate was 67% in the GH group and 36% in the RTC group and 84% and 73%, respectively, at 6 months. Conclusions: Half of the patients were managed entirely at a GH, and these were mainly patients considered to have a low risk of further deterioration, patients with moderate TBI, and elderly patients. Less than two of ten patients ≥ 80 years old were transferred, and survival was poor regardless of the transferral status. [ABSTRACT FROM AUTHOR]

Abstract Background Non-moderated alcohol use is more prevalent among hospitalized patients compared to the general population. However, many hospitals fail to find and intervene with people with alcohol problems. We aimed to conduct an exploration of impeding and facilitating factors experienced by healthcare professionals in implementation of alcohol interventions in Dutch general hospitals. In addition, we explored the alcohol interventions used in the selected hospitals and involved stakeholders. Methods Through a qualitative study, semi-structured telephone interviews were conducted with twenty healthcare professionals working in or in collaboration with six different general hospitals. Results Healthcare professionals indicated impeding and facilitating factors in the areas of motivation, knowledge and skills, patient characteristics, protocol, internal and external collaboration/support, resources, role suitability and societal support. Five different categories of approaches to identify and intervene with non-moderated alcohol use and 18 involved stakeholders from both inside and outside the hospital were found. Conclusions Implementation of alcohol interventions for patients in Dutch general hospitals still seems to be in its infancy. Respondents emphasized the importance of one clear protocol on how to tackle alcohol problems within their hospital, repeated training on alcohol-related knowledge and skills, (clinical) “champions” that support healthcare professionals and developing and maintaining collaborations with stakeholders within and outside the hospital.

This paper summarized the promotion and application experience of appropriate health technology of Traditional Chinese Medicine(TCM)in general hospitals. A carefully designed organizational structure was established, and TCM knowledge and skills training was carried out to liaison nurses in the TCM nursing group. A doctor-nurse team model was adopted in promotion of appropriate health technology of TCM in general hospitals, and great efforts were made to improve the development of TCM nursing. (本文总结了综合医院推广中医适宜技术的相关经验, 通过组建中医护理小组的组织体系, 以“知信行”模式为理论框架, 对中医护理小组联络护士进行中医知识技能培训, 以“医护团队会诊”的模式推广中医适宜技术, 打开了中医适宜技术在综合医院广泛应用的新局面, 促进中医护理的发展。)

Mental Health Nurse Consultants are advanced practice mental health nurses who consult with nurses and other health professionals in a general hospital setting. The aim of this review was to analyse and synthesize the available evidence related to the impact of Mental Health Nurse Consultants on the care of general hospital patients experiencing concurrent mental health conditions. The integrative literature review method was utilized as it allows for the inclusion and integration of quantitative, qualitative, and mixed methods research which produces a synthesized understanding of data to inform practice, policy, and research. The Preferred Reporting Items of Systematic Review and Meta‐Analyses guided the search strategy. All published studies examining the impact of clinical consultations provided by Mental Health Nurse Consultants on the mental health care of general hospital patients were included. The 19 selected articles were from North America, Australia, the United Kingdom, and Europe. Fifteen were quantitative, three were qualitative, and one used mixed methods. The findings highlight the role is generally positively received by hospital staff. The results indicate that clinical consultations provided by Mental Health Nurse Consultants (i) may improve patient experiences of mental health conditions, (ii) influence aspects of care delivery, (iii) are valued by staff, particularly nurses, and (iv) increase staff competence and confidence in the provision of mental health care. The review highlighted significant limitations of the available evidence, the need for contemporary discussion and debate of MHNC theory and practice, and further evaluation of the role to inform future service delivery. [ABSTRACT FROM AUTHOR]

This study aimed to determine the effects of job characteristics and work engagement on the nursing performance of nurses working in general hospitals.

Introduction: Community-acquired pneumonia (CAP) is an important cause of hospitalization and death in patients with mental disorders. It is critical to understand the risk factors of CAP and determine prevention strategies to reduce CAP. The aim of this study is to explore the characteristics of inpatients with mental disorders who have CAP and analyze the risk factors. Methods: This retrospective study included 16,934 inpatients with mental disorders who were admitted for the first time to a tertiary general hospital between January 2017 and July 2021 (excluding January 2020-May 2020). Risk factors for CAP were identified by logistic regression analysis after propensity score matching (PSM, 1:4) for age, gender, and BMI. Results: The CAP rate of inpatients with mental disorders was 1.78%. Inpatients who had CAP had a significantly prolonged hospital stay, and were more often admitted to a closed ward or the ICU. After PSM, the multivariable analysis revealed that clozapine use (OR = 3.212, 95% CI = 1.744-5.915, P < 0.001), schizophrenia spectrum disorder (OR = 2.785, 95% CI = 1.684-4.607, P < 0.001), alcohol consumption (OR = 2.549, 95% CI = 1.586-4.096, P < 0.001), cardiovascular disease (OR = 2.299, 95% CI = 1.362-3.879, P = 0.002), Charlson comorbidity index (CCI) = 3 (OR = 2.092, 95% CI = 1.342-3.260, P = 0.001), organic mental disorder (OR = 1.941, 95% CI = 1.194-3.156, P = 0.007), antipsychotic drug use (OR = 1.886, 95% CI = 1.312-2.711, P = 0.001), unmarried status (OR = 1.720, 95% CI = 1.164-2.541, P = 0.006) and junior high school education (OR = 1.591, 95%CI = 1.010-2.508, P = 0.045) were independent risk factors for CAP in inpatients with mental disorders. Conclusion: CAP was common in inpatients with mental disorders. Patients with mental disorders have unique risk factors for CAP. Further research is required to explore the relationship and mechanism between different mental disorders, antipsychotic drugs and CAP. [ABSTRACT FROM AUTHOR]

Copyright of TSG: Tijdschrift Voor Gezondheidswetenschappen is the property of Springer Nature 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.)

Background: Patient satisfaction occupies a central position in measuring the quality of care as it provides information on the provider’s success, meeting the patient’s values and expectations. Hence, it is an essential tool for assessing health services outcomes. This study aimed to assess patients’ satisfaction level and factors influencing healthcare quality of general hospitals in the Jazan region, Saudi Arabia (SA). Methods: This observational cross-sectional study was conducted on a sample of 423 patients selected through stratified random sampling from general hospitals of the Jazan region. Results: The overall satisfaction rate among the study participants was 80.9%. Satisfaction with food services was the highest (91.15%) followed by doctor services (81.0%), reception and entry procedures (80%), and nursing services (78.15%). The various aspects of satisfaction with doctors and nurses included the treatment prescribed by physicians, clarity in communication with patients, compassion and providing clear explanation of what they were doing. However, about 27.3% of the patients were dissatisfied with the length of waiting period before seeing a doctor. Binary logistic regression analysis suggested that uneducated patients and patients with secondary school education were more likely to have higher satisfaction level than university-educated patients (OR = 3.40, 95% C.I. [1.56–7.45], p = 0.002), (OR = 2.66, 95% C.I. [1.28–5.55], p = 0.009), and (OR = 2.29, 95% C.I. [1.40–3.73], p = 0.001), respectively. Conclusion: The health services satisfaction level was high in the Jazan population. However, some aspects of dissatisfaction were reported, such as the long waiting period before seeing a doctor. These aspects are recommended to be improved to ensure that the services provided by general hospitals are of high quality. [ABSTRACT FROM AUTHOR]

Background Patient safety events (PSE) are opportunities to improve patient care but physicians rarely report them. In a previous study, residents identified knowledge regarding what constitutes a PSE, perceived lack of time, complexity of the reporting process, lack of feedback, and perceived failure to resolve the issue despite reporting to be barriers limiting their PSE reporting. The residency programs and system patient safety and quality improvement departments created targeted interventions to address identified barriers. Objective Assess effectiveness of targeted interventions on improving PSE reporting rates amongst residents. Methods As part of a multi-residency patient safety project, interventions were created to focus on the removal of barriers to reporting PSE identified previously. Post-interventions, an identical cross-sectional survey of the residents at the same two community teaching hospitals was conducted from Sept to Dec 2018 through an online questionnaire tool. Results 78 out of 149 residents (52.3%) completed the survey. We found a significant improvement in the number of residents who endorsed reporting a PSE in the past 1 year (51.2% vs 23.5%, p = 0.001), as well as during the course of their training (52.6% vs 26.5%, P = 0.001). There was also a significant decrease in the number of residents who were unsure of how to report a PSE (p = 0.031) as well as those who viewed medical error as a sign of incompetence (p = 0.036). Conclusion Our study demonstrates that simplifying the PSE reporting process, improving knowledge and acceptance of patient safety/quality improvement principles and promotion of a just culture improves resident PSE reporting.

Aim: As conflict caused by cultural diversity among patients in China continues to rise, hospitals are in urgent need for improvement of transcultural efficacy among nurses. This study aims to evaluate the transcultural self-efficacy of nurses working in the tertiary general hospital in Guizhou Province, an ethnic minority region in western China, and to identify whether nurses’ demographic characteristics affect their transcultural self-efficacy. Method: We used the Chinese version of the Transcultural Self-Efficacy Tool (TSET-CV) to survey 1,190 in-service nurses. Results: Results showed that the level of transcultural self-efficacy of the nurses was generally moderate; few of the nurses had high or low transcultural self-efficacy. The nurses’ transcultural self-efficacy was affected by demographic variables, including age, marital status, employment type, income, work experience, and whether or not they were head nurses. Having a stable work environment, a stable marriage, a good educational background, and a high-ranked professional title were associated with increased transcultural self-efficacy. Conclusion: Nursing administrators in hospitals should offer continuing education on transcultural nursing according to nurses’ demographic characteristics and the SEST scores.

Palliative care, as a proposal for comprehensive treatment, represents a challenge for its performance in the hospital context from the multiplicity of factors involved. The objective of this study was to characterize the institutional and relational dynamics of palliative care in a general hospital in southern Brazil. Ethnographic research was carried out through participant observation in the institution and registration in a field diary. Data were organized and analyzed based on Grounded Theory and the ATLAS. ti 7.5 software. A hospital routine was evidenced, crossed by the unpredictability of vital events, influenced by patient-family-staff interrelationships, observing the hospital corridors as a singular space made invisible by its protagonists, where both relational plots and professional conversations take place. Such plots, immersed in hospital functioning, highlight the challenges of comprehensive care in the general hospital since they affect how care is performed by professionals, as well as the reactions of patients and family members in the face of death and mourning. It is understood that, given the complexity that involves the general hospital, comprehensive care can be compromised since there is not always the necessary understanding for the development of such care. Therefore, the importance of recognizing the phenomena related to the experiences of illness, palliative care, death in the general hospital, and the visualization of their relationships with the complexity of the context is highlighted. [ABSTRACT FROM AUTHOR]

Background: Non-moderated alcohol use is more prevalent among hospitalized patients compared to the general population. However, many hospitals fail to find and intervene with people with alcohol problems. We aimed to conduct an exploration of impeding and facilitating factors experienced by healthcare professionals in implementation of alcohol interventions in Dutch general hospitals. In addition, we explored the alcohol interventions used in the selected hospitals and involved stakeholders.Methods: Through a qualitative study, semi-structured telephone interviews were conducted with twenty healthcare professionals working in or in collaboration with six different general hospitals.Results: Healthcare professionals indicated impeding and facilitating factors in the areas of motivation, knowledge and skills, patient characteristics, protocol, internal and external collaboration/support, resources, role suitability and societal support. Five different categories of approaches to identify and intervene with non-moderated alcohol use and 18 involved stakeholders from both inside and outside the hospital were found.Conclusions: Implementation of alcohol interventions for patients in Dutch general hospitals still seems to be in its infancy. Respondents emphasized the importance of one clear protocol on how to tackle alcohol problems within their hospital, repeated training on alcohol-related knowledge and skills, (clinical) "champions" that support healthcare professionals and developing and maintaining collaborations with stakeholders within and outside the hospital. [ABSTRACT FROM AUTHOR]

Background: Cystic echinococcosis is a parasitic disease that develops in endemic areas due to the transmission of Echinococcus granulosus. The liver is the organ most affected. The most frequent symptoms include pain, palpable mass, jaundice, and fever. Diagnosis is based on epidemiologic history, examination, imaging, and serologic tests. Patients and Methods: We conducted a retrospective study of patients with hepatic echinococcosis diagnosed in our center. We collected data from our patients regarding personal history, cyst characteristics, surgery performed, and post-operative complications. Results: Sixteen patients were diagnosed with hepatic echinococcosis, 11 of whom underwent surgery. We found multiple cysts in six patients (37.5%) and a single cyst in 10 (62.5%). In 14 patients the cysts were found only in the right hepatic lobe (87.5%) and in two patients they were found in both lobes (12.5%). Segment 4 was affected in seven cases. The sizes ranged from 2.7 to 20 cm. Endoscopic retrograde cholangiopancreatography was prior to surgery in five patients. The interventions performed were partial cyst-pericystectomies in eight patients, a total cyst-pericystectomy in one case, and drains were placed in two cases of rupture. Post-operative fistulas were evident in five patients, four of which were closed. The fifth, which occurred after emergency surgery for rupture of the cyst, has maintained suppuration. The mean follow-up was 3.5 years. There was no post-operative mortality or recurrence to date. Conclusions: We can state that center without highly specialized hepato-biliary surgery units can assume the surgery of hydatid liver cysts excluding those with well-defined characteristics. The establishment of recommendations for the referral of patients with complex hydatid cysts may help in the optimal management of this pathology. [ABSTRACT FROM AUTHOR]

Objective: The impact of a change in service delivery in a psychogeriatric service, moving from a consultation model to liaison model of care, was examined in a naturalistic study. Methods: The study period was divided into two phases, defined by the change in service delivery. The impact of the change on (1) referral rate, (2) referrals seen, (3) extent of intervention and (4) clinical characteristics was examined. Results: While we did not see a dramatic improvement in time waiting for assessment (2.9 vs. 2.4 days), the enhanced team provided significantly more clinical input. The number of assessments completed increased by 60% (39 vs. 66). Most significantly, during phase I, more than half of all referrals were not seen (54%), while during phase II only one patient referred was not assessed (1%). The number of reviews undertaken also increased significantly. Conclusions: The results of the present study suggest improved outcomes for patients and improved satisfaction in the clinical teams. Further clinical effectiveness and cost-effectiveness studies are needed. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives: to understand, from a worker’s health perspective, the knowledge of nursing professionals about the use of antineoplastic drugs in a general hospital. Methods: a descriptive and exploratory study with a qualitative approach. It was conducted at a university hospital, between April and August 2018, with 35 nursing professionals who responded to a semi-structured interview. Thematic analysis was used for data treatment. Results: from the data, three thematic categories emerged, related to the nursing professionals’ knowledge about antineoplastic drugs and their effects on workers’ health; situations in which exposure to these drugs occurs; and protection mechanisms for the patient, the environment, and the worker. Final Considerations: the nursing professionals had little knowledge about antineoplastic drugs. The practices related to handling and the necessary protective measures to deal with these drugs were empirically determined and relatively subsidized the knowledge acquired by the professionals.

Background and Objectives Important decisions about the future care of people living with dementia are routinely made in hospitals. Very little is known about how the care needs of hospitalized people with dementia are understood, or how the perspectives of the person, families, and staff intersect to inform decision-making. This study explores how the care needs of people with dementia are understood by the person, their family, and hospital staff (the care triad), and how these perspectives shape decision-making. Research Design and Methods Ethnographic data were collected from 2 care-of-older-people general hospital wards via observations, conversations, and interviews with people with dementia, families, and staff. In total, 400 hr of observation and 46 interviews were conducted across two 7- to 9-month periods. Results The person's care needs were often understood differently between and within arms of the care triad. A lack of consistent engagement with families and people with dementia reduced opportunities to recognize and integrate this range of views, leading to delays or difficulties in decision-making. People with dementia, particularly those lacking capacity, were most likely to have their perspectives overlooked. Discussion and Implications Early engagement with people with dementia and their families is required to ensure that all perspectives on the person's current and future care needs are understood and represented during decision-making. Particular attention should be paid to involving people living with dementia in discussions and decisions about their care, and to the assessment and involvement of people who may lack capacity. [ABSTRACT FROM AUTHOR]

Abstract Background: Advanced medical imaging technologies (AMIT) are greatly associated with the pace, accuracy and ability of physicians to better diagnose and treat various diseases, and boost the possible potential of non-invasive operational procedures. Accordingly, this study aims to investigate inpatient use of MRI and CT and the effect of their use on inpatient mortality and length of stay (LOS) in Tehran general university hospitals. Methods: The study gathered its data from all general university hospitals in Tehran in 2017. Analysis unit was hospital. Multiple linear Regression model was constructed for each combination of technology and outcomes (mortality and LOS), and all models were Controlled for patients’ demographic and clinical characteristics and structural characteristics of hospital. In calculating Hospital standardized mortality ratio (HSMR) for each of seventy two diagnosis groups related to death, a Binary logistic regression model was fitted with predictors including LOS, admission type, comorbidity level, sex, and age. Results: The use of CT varied from 0.39 to 149.35, and MRI from 0.24 to 80.23 exams per 100 discharges. The HSMR ranged from 76.8 percent to 146 percent and, the average length of stay (ALOS) from 3 to 8.46 days. The use of MRI and CT had no significant effect on the HSMR and ALOS in the studied hospitals. Conclusions: Further use of AMIT has not improved efficiency and quality in health care. This research indirectly assessed the appropriateness of MRI and CT services in the studied hospitals, and it is possible that inappropriate and unnecessary use of these services affected the results. Better management of the use of AMIT requires clear rules and regulations with assertive commitment, in addition to establishing clinical guidelines with the support of insurance companies.

Introduction: To investigate the characteristic of anxiety and depression among patients in general hospitals, and explore the degree of the clinical symptoms and correlated social economic factors.Methods: This is a cross-sectional survey of anxiety and depression in patients with physical diseases, who were suspected of depression and anxiety based on their clinical performance by their physicians and PHQ ≧ 8, from various clinical departments of 57 general hospitals in China. Data regarding demographic characteristics and clinical characteristics were collected. Social and psychological factors and the severity of anxiety or depression were collected through self-rating scales. Finally, we used multivariate logistic regression to identify the factors associated with anxiety and depression in patients with physical diseases.Results: A total of 2,105 (84.6%) valid and completed questionnaires were returned. The proportion of anxiety, depression, combined depression and anxiety, either anxiety or depression among the patients with physical diseases from all clinical departments was 63.3, 75.1, 57.1, and 81.2% respectively. Further regression analysis indicated that gender, monthly income, specific physical diseases, personality traits, social supports and life negative events were related factors of both anxiety and depression.Conclusions: Anxiety and depression were common in patients with physical diseases, with a high proportion of co-morbidity of anxiety and depression. Females, patients with cancer, poor social support and negative life events reported more severe anxiety and depression. The results may help to understand the present situation of anxiety and depression in general hospitals in china, and identify the patients with high risk of depression and anxiety.

Introduction: To investigate the characteristic of anxiety and depression among patients in general hospitals, and explore the degree of the clinical symptoms and correlated social economic factors. Methods: This is a cross-sectional survey of anxiety and depression in patients with physical diseases, who were suspected of depression and anxiety based on their clinical performance by their physicians and PHQ ≧ 8, from various clinical departments of 57 general hospitals in China. Data regarding demographic characteristics and clinical characteristics were collected. Social and psychological factors and the severity of anxiety or depression were collected through self-rating scales. Finally, we used multivariate logistic regression to identify the factors associated with anxiety and depression in patients with physical diseases. Results: A total of 2,105 (84.6%) valid and completed questionnaires were returned. The proportion of anxiety, depression, combined depression and anxiety, either anxiety or depression among the patients with physical diseases from all clinical departments was 63.3, 75.1, 57.1, and 81.2% respectively. Further regression analysis indicated that gender, monthly income, specific physical diseases, personality traits, social supports and life negative events were related factors of both anxiety and depression. Conclusions: Anxiety and depression were common in patients with physical diseases, with a high proportion of co-morbidity of anxiety and depression. Females, patients with cancer, poor social support and negative life events reported more severe anxiety and depression. The results may help to understand the present situation of anxiety and depression in general hospitals in china, and identify the patients with high risk of depression and anxiety. [ABSTRACT FROM AUTHOR]

Objective: Pregnancy is an important psychological and biological phenomenon in women’s life. Pregnancy has many complications jeopardizing the well-being of the mother and the child. Methods: In this retrospective study, the data including demographic information, chief complaint, the initial diagnosis, referral decision, final diagnosis, hospitalization outcome and pregnancy outcomes were studied on 239 pregnant women admitted to the emergency departments of the general hospitals of East Azerbaijan province. Results: The average age of patients was 27.54 years. The time period from the initial presentation to completely leave the emergency department was reported to be 3.66 hours on average. In this study, most patients (74.5%) did not have a history of abortion. Exploring the time of admission for all cases, most patients were admitted from 8 pm to 8 am (67.8%), and 32.2% were referred from 8 am to 8 pm. Concerning the time of pregnancy, 46.4% were at their second trimester of pregnancy. Most of the patients were admitted in cold seasons of the year. The most common chief compliant was abdominal pain with 32.2% frequency. In addition, the most frequent primary diagnoses were an acute abdomen and trauma at 25.5% and 14.2% respectively. Conclusion: Abdominal pain and acute abdomen have the most frequency as the chief compliant and initial diagnosis especially during the second trimester of pregnancy. In this regard, appropriate training and skillful staff are needed to deal with the complaints and complications of abdominal pain. More than half of pregnant women referred to the emergency departments were hospitalized or admitted to the intensive care unit (ICU). This signals the necessity of adequate facilities to provide proper care for this group.

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE 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.)

Purpose: To analyze the effects of average length of stay (ALOS) on RN staffing. Methods: Public data of patient surveys collected 8 times between 1996 and 2016 were analyzed. The sample included 2,408,669 discharged patients from 2,266 general hospitals. The ALOS for each hospital was computed by dividing the sum of inpatient days by the number of discharges. RN staffing was defined as the number of RNs per 100 inpatients. ALOS was transformed into base-2 logarithmic values for regression analysis. Results: ALOS decreased from 13.3 to 9.6 days. Large hospitals in the capital region had the greatest reduction, from 15.7 to 7.4 days. RN staffing increased from 32.7 to 54.8 RNs per 100 patients. ALOS had an inverse relationship with RN staffing. Controlling for other factors, a 50% reduction in ALOS was associated with increases in RN staffing by 12.18 and 13.72 RNs per 100 inpatients in large hospitals in the capital region and elsewhere, respectively. Conclusion: Hospitals may have to increase staffing to respond to the increased workload resulting from the shortened ALOS. It remains uncertain whether such increases in staffing were sufficient for the increased workload. Changes in ALOS should be taken into account when determining appropriate staffing. [ABSTRACT FROM AUTHOR]

In a Coronavirus disease 2019 (COVID-19) epidemic, management of the emergency department is a difficult task in terms of prevention and control of the disease in general hospitals. On top of meeting urgent needs of patients for medical treatment, the emergency department also has to devote resources into investigation and prevention of COVID-19. At the beginning of the epidemic, with the strategy to intercept the chain of infection, Peking University First Hospital (PKUFH) focused on three important aspects: controlling the source of infection, cutting off the route of transmission, and protecting vulnerable populations, to expeditiously draft scientific and proper management measures for the emergency department, followed by real-time dynamic adjustments based on the development trend of the epidemic. These measures effectively ensured a smooth, orderly and safe operation of the emergency department. As of the writing of this manuscript, there has been no active COVID-19 infection in patients and medical staff in the emergency department, and no infection in patients admitted to PKUFH through the emergency department. This study describes the prevention and control measures in the emergency department of PKUFH during the outbreak of COVID-19, aiming to provide some reference for domestic and international medical institutions. [ABSTRACT FROM AUTHOR]

Objectives: to characterize the physical restriction of patients in intensive care units of a general hospital. Method: quantitative, descriptive research conducted in intensive care units of a general hospital in 2019. The researchers observed eighty episodes of physical restriction in 33 patients. A structured instrument was used to collect the data, which were analyzed using simple statistics. Results: all mechanical restrictions were applied to the upper limbs with the use of bracelets, of which 77.5% were made of crepe bandages with surgical compresses; 86.3% of the cases had partial movement restriction. Of the total restrictions, 96.2% occurred in patients with a nasogastric/enteral tube, 67.5% in patients on mechanical ventilation; 53.9% of the cases the patients were under sedation; 33.3% had psychomotor agitation. There were only 5.2% of nurses' records and 42.5% of nursing technicians in the patient's health charts, however there was no medical or nursing prescription for the procedure. Conclusions: it was identified the lack of defined criteria for the use of the' physical restrictions. The lack of a nursing or medical prescription and low quality and quantity of records on the procedure interfered with the understanding of the justification for the use of physical restriction. [ABSTRACT FROM AUTHOR]

Nurses have been urged to participate in public policy‐formulation processes as an integral part of their professional role through collective and personal policy activities. However, there is only limited empirical data on this participation. This cross‐sectional study examined the level and the predictors of the personal policy activities of 200 Israeli hospital‐based registered nurses undertaken in their work setting and aimed at furthering hospital, local or national policies. The nurses completed questionnaires that examined policy activities, policy skills, political interest, political efficacy, political and professional network involvement, and organizational support for policy activities. The overall engagement of nurses in on‐the‐job policy activities was limited and focused primarily on their immediate surroundings, their departments and their hospitals, and much less on local or national policies. The most common policy activities were internal and indirect and included receiving feedback from patients to improve nursing care policy and calling colleagues' attention to policy issues. Positive significant correlations emerged between motivational and organizational factors and personal policy activities, and these contributed 55% to the explained variance. The findings enhance the relevance of integrating motivational and organizational factors in understanding the policy activity of nurses. As such, increasing personal involvement of hospital nurses in policy formulation processes requires professional training that seeks to improve nurses' policy skills, to enhance their political interest and efficacy, and to encourage their involvement in political and professional networks. In addition, hospitals need to cultivate an organizational culture that supports personal policy activities by nurses. [ABSTRACT FROM AUTHOR]

Patient safety events (PSE) are opportunities to improve patient care but physicians rarely report them. In a previous study, residents identified knowledge regarding what constitutes a PSE, perceived lack of time, complexity of the reporting process, lack of feedback, and perceived failure to resolve the issue despite reporting to be barriers limiting their PSE reporting. The residency programs and system patient safety and quality improvement departments created targeted interventions to address identified barriers. Assess effectiveness of targeted interventions on improving PSE reporting rates amongst residents. As part of a multi-residency patient safety project, interventions were created to focus on the removal of barriers to reporting PSE identified previously. Post-interventions, an identical cross-sectional survey of the residents at the same two community teaching hospitals was conducted from Sept to Dec 2018 through an online questionnaire tool. 78 out of 149 residents (52.3%) completed the survey. We found a significant improvement in the number of residents who endorsed reporting a PSE in the past 1 year (51.2% vs 23.5%, p = 0.001), as well as during the course of their training (52.6% vs 26.5%, P = 0.001). There was also a significant decrease in the number of residents who were unsure of how to report a PSE (p = 0.031) as well as those who viewed medical error as a sign of incompetence (p = 0.036). Our study demonstrates that simplifying the PSE reporting process, improving knowledge and acceptance of patient safety/quality improvement principles and promotion of a just culture improves resident PSE reporting. [ABSTRACT FROM AUTHOR]