The association between patient shortage and patient satisfaction with general practitioners

OBJECTIVE: The aim of the study was to explore whether or not the influx of patients to a GP's practice is associated with satisfaction with the GP. DESIGN: Persons in the Norwegian Living Condition Survey answered a questionnaire on satisfaction with their GP. The data on satisfaction were merged with registered information on the GPs and the GPs' patient lists from the National Insurance Administration, with registered information on the sample's sociodemographic background, and on their resident municipality from Statistics Norway. SETTING: A representative sample of 2326 persons answered the questionnaire. This constituted persons in the survey who had visited their GP during the last six months. MAIN OUTCOME MEASURE: Satisfaction with the GP's interpersonal skills, the GP's medical skills, the GP's use of time, general accessibility to the GP, and the GP's role as a gatekeeper. RESULTS: Persons listed with a GP who experience patient shortage were less satisfied than others along four dimensions of satisfaction: the GP's interpersonal skills, the GP's medical skills, the GP's referral practices, and the consultation lengths the GP offered. The GP's age and gender, characteristics of the patient, and characteristics of the organization of primary care had minor influence. CONCLUSION: Whether or not a GP experiences patient shortage is associated with patient satisfaction. Whether or not the lower patient satisfaction is a result of patient shortage or vice versa is not known.     

Maintaining patient welfare of the chemotherapy patient

ABSTRACT

Modern veterinary medicine now means pets are living longer, and in turn the profession is diagnosing and treating more diseases such as cancer. Receiving the diagnosis of cancer in their beloved pet is a stressful and emotional time for the owners. The Registered Veterinary Nurse (RVN) plays a role in supporting the client and pet through this emotional journey and assists in ensuring patient welfare is considered at all times during the treatment. The RVN will be suitably trained to deliver a high level of care in all areas of nursing and will consider quality of life when caring for oncology patients.     

Knowing the patient and the impact on patient participation: A grounded theory study

Henderson S. International Journal of Nursing Practice 1997; 3: 111–118
Knowing the patient and the impact on patient participation: A grounded theory study
Currently, there is an emphasis on patient participation. Studies have demonstrated that when patients participate in their care, they experience positive outcomes such as greater satisfaction with care and decreased vulnerability. Nurses are of the opinion that patients should participate in their care. Literature and research indicate, however, that there is an incongruence between nurses' pro-participatory attitudes and actual practice. Grounded theory was used to identify factors relevant to patient participation from the nurses' and patients' perspectives. Using purposive sampling from four hospitals in Western Australia, in-depth interviews and participant observation were conducted. The constant comparative method of analysis was used. As this study is in progress, the core category and sub-categories are still being refined. One category that has emerged strongly is 'knowing the patient' and the outcome on patient participation. This paper will discuss this category from the nurses and patients perspective including recommendations.     

An approach to consistent patient education

Patient education is instrumental to postoperative recovery. To that end, the nurse must be able to decipher the discharge instructions and the patient and caregivers must be able to understand them. Ambulatory surgery patients are in the clinical setting for shorter periods; therefore, nurses need to provide these patients with effective educational tools that will assist them in achieving optimal surgical outcomes. In an effort to improve our perioperative and discharge orders, which were being handwritten, I created standardized forms that require little handwriting and allow surgeons to complete their orders by checkmarking the items. Use of these forms has improved turnover time, provided nurses and patients with orders that are easier to read and understand, and produced fewer incidences in which information is left off orders or misunderstood. Following up with patients to ensure their comprehension and active participation in their postsurgical care allows the nurses to assess the success of surgical care and patient satisfaction.     

急诊科护士对患者参与患者安全认知现状调查分析

目的了解急诊科护士对患者参与患者安全的认知状况及存在的阻碍因素,为制订具体有效干预策略提供依据。方法采用护理人员对患者参与患者安全认知现状调查表于2016年9月对陕西省34所医院的735名急诊护士进行调查。结果急诊护士对患者参与患者安全的整体认知得分为(3.74±0.48)分,在具体参与内容上,护士感知的患者现实参与方面,决策性参与(3.90±0.68)分高于照护性参与(3.89±0.70)分,并高于诉求性参与(3.55±0.93);而在护士对患者参与的支持和鼓励方面,照护性参与条目均分均高于决策性参与,并高于诉求性参与,患者参与患者安全存在的障碍因素,急诊科护士认为媒体有失公正的报道和患者疾病相关的认知水平占主要因素。结论急诊科护士认为患者参与患者安全的利大于弊,建议未来应呼吁媒体客观报道,加强护患沟通,提升患者参与患者安全的能力及意愿,引导患者理性参与,充分发挥患者在保障患者安全方面的能动作用。     

Patient turnover and the relationship between nurse staffing and patient outcomes

High patient turnover (patient throughput generated by admissions, discharges, and transfers) contributes to increased demands and resources for care. We examined how the relationship between registered nurse (RN) staffing and failure-to-rescue (FTR) varied with patient turnover levels by analyzing quarterly data from the University HealthSystem Consortium. The data included 42 hospitals, representing 759 nursing units and about 1 million inpatients. Higher RN staffing was associated with lower FTR. When patient turnover increased from 48.6% to 60.7% on nonintensive units (non-ICUs), the beneficial effect of non-ICU RN staffing on FTR was reduced by 11.5%. RN staffing should be adjusted according to patient turnover because turnover increases patient care demand beyond that presented by patient count, and outcomes may be adversely affected.     

护理人员患者安全文化现状的研究

目的 调查护理人员患者安全文化认知现状,探索其影响因素,为推动患者安全文化建设、保障患者安全提供理论依据.方法 采用一般资料调查表、医院患者安全文化调查问卷对陕西省5所实施"5+1"S精益管理的三级甲等医院517名护理人员进行调查.结果 护理人员患者安全文化总均分为(3.76±0.41)分,积极反应率为76.21％处于...     

The development and piloting of a patient held record with adult mental health users

This article reports on the development and piloting of a patient held record for adult mental health users. Development of the format and content of the record was determined in consultation with a user group. Piloting and subsequent evaluation of the record with users revealed a number of issues which need to be addressed in the promotion of a patient held record.     

病人参与病人安全管理的研究进展

描述全球病人安全工作现状,对病人参与病人安全的组织发展及相关任务、病人参与病人安全的角色定位、影响因素、意愿、提高诊疗效果及减少不良事件等国内外研究进展进行综述,以倡导病人成为医疗安全合作伙伴,帮助医护人员识别和纠正不良事件,避免医疗过失,共同维护自身医疗安全。     

Hindrance for patient participation in nursing care

THE STUDY'S RATIONALE: Patients' influence in health care through participation, freedom of choice and information, is laid down in laws, national and local directives. In nursing care situations, the degree to which a patient participates depends on the nursing staff. Accordingly, hindrances for patient's participation during nursing care is an important question for the nursing profession. AIMS AND OBJECTIVES: The aim was to focus on Swedish Registered Nurses opinion of hindrances for patient participation in nursing care and to uncover the informants' perspectives in depth. METHODOLOGICAL DESIGN AND JUSTIFICATION: The study was limited to inpatient somatic care and has a qualitative approach. Data were collected through seven focus group interviews with 31 Registered Nurses from five hospitals. An analysis of the tape-recorded interview material was made, combining elements of content analysis with aspects of the Grounded Theory approach. ETHICAL ISSUES AND APPROVAL: The ethics of scientific work was followed. The participants gave informed consent. Verbal and written information was given as a guarantee that all information would be treated confidentially outside the focus group. Formal approval by ethical committee was not required according to national and local directives. RESULTS: Hindrance for patient participation in nursing care comprised three themes: Competence, Influence of significant others and Organization and work environment, and their seven underlying subthemes. CONCLUSIONS: The study clarified factors, which individually or combined may be hindrance for patient participation in nursing practice. Professional nurses must be able to find a balance for their patients' participation in nursing care activities through identification and coping with the hindrances. The three themes and seven subthemes here identified, can be used in patient care and its' evaluation, like also quality assurance of care and work organization and in nursing education. For further development replication studies are needed, like additional studies of patients and significant others.     

Towards a comprehensive theory of nurse/patient empowerment: applying Kanter's empowerment theory to patient care

spence laschinger h.k., gilbert s., smith l.m. & leslie k. (2010) Journal of Nursing Management 18, 4–13
Towards a comprehensive theory of nurse/patient empowerment: applying Kanter's empowerment theory to patient care
Aim  The purpose of this theoretical paper is to propose an integrated model of nurse/patient empowerment that could be used as a guide for creating high-quality nursing practice work environments that ensure positive outcomes for both nurses and their patients.
Background  There are few integrated theoretical approaches to nurse and patient empowerment in the literature, although nurse empowerment is assumed to positively affect patient outcomes.
Evaluation  The constructs described in Kanter's (1993) work empowerment theory are conceptually consistent with the nursing care process and can be logically extended to nurses' interactions with their patients and the outcomes of nursing care.
Key issues  We propose a model of nurse/patient empowerment derived from Kanter's theory that suggests that empowering working conditions increase feelings of psychological empowerment in nurses, resulting in greater use of patient empowerment strategies by nurses, and, ultimately, greater patient empowerment and better health outcomes.
Conclusions  Empirical testing of the model is recommended prior to use of the model in clinical practice.
Implications for Nursing Management  We argue that empowered nurses are more likely to empower their patients, which results in better patient and system outcomes. Strategies for managers to empower nurses and for nurses to empower patients are suggested.     

Patients' and health care professionals' attitudes towards the PINK patient safety video

Rationale, aims and objectives Patients can play an important role in reducing health care harm. Finding strategies to encourage patients to take on an active role in issues related to the quality and safety of their care is therefore essential. The aim of this study was to examine patients' and health care professionals' attitudes towards a video aimed at promoting patient involvement in safety‐related behaviours. Method A within‐subjects design was used where participants were required to complete a questionnaire pre and post screening of a patient safety video. Participants are 201 patients aged 19–103 years (mean 52) and 95 health care professionals aged 23–48 years (mean 32). Main outcome measures include (i) patients' willingness to participate and perceived importance in participating in safety‐related behaviours; and (ii) health care professionals' willingness to support patient involvement. Results After watching the video patients elicited more positive attitudes towards asking doctors and nurses if they had washed their hands and notifying them about issues to do with personal hygiene. No significant effects were observed in relation to patients notifying staff if they have not received their medication or if they were in pain or feeling unwell. In relation to health care professionals, doctors and nurses were more willing to support patient involvement in asking about hand hygiene after they had watched the video. Conclusion Video may be effective at changing patients' and health care professionals' attitudes towards patient involvement in some, but not all safety‐related behaviours. Our findings suggest video may be most effective at encouraging involvement in behaviours patients are less inclined to participate in and health care professionals are less willing to support.     

成立“病人服务中心”的做法与成效

目的完善护理服务，提高病人满意度。方法成立“病人服务中心”，对住院病人进行床前访视；对出院病人实施电话随访及上门访视：开展免费服务项目，尽力满足病人需求。结果病人满意度提高（P〈0．01）。2005年与2004年相比、2006年与2005年相比，住院病人增长率分别为15．31％、30．20％；业务收入增长率分别为30．20％、19．59％；床位周转增长率分别为53．19％、20．37％。结论“病人服务中心”在优化医院服务流程、提高病人满意度、提升医院服务品牌等方面起到了重要作用。     

Detecting nurse-perceived patient treatment difficulty of psychiatric patients in hospital: an evaluation of a patient assessment sheet

Many changes have occurred in hospital psychiatric care, including decreased length of hospital stay and increased patient acuity. These changes highlight the need for nurses to adequately assess and formally document patient treatment difficulties. The purposes of this study were to determine the ability of the Patient Assessment Sheet (PAS) to predict patient 'problems' that psychiatric nurses perceived as associated with patient treatment difficulty, and to identify the patient problems missing from the PAS. These purposes were accomplished by comparing the PAS to the Hospital Treatment Rating Scale (HTRS). A correlational design and multiple linear regression technique were used. Eight psychiatric registered nurses assessed a total of 110 patients, admitted consecutively to one inpatient psychiatric unit. The HTRS and the PAS were used independently for each patient. Four PAS items (active affect, passive affect, aggression toward self, and patient confusion) significantly predicted 38% of the variance from the HTRS; and three HTRS items (isolation and withdrawal from relationships, noninvolvement in treatment, and wide variability in mood) significantly predicted 22% of the residual variance from the HTRS. The identified PAS and HTRS items help to make visible patient problems associated with nurse-perceived patient treatment difficulty. This identification is potentially important for both clinical and political purposes.     

护理领导力在患者护理中的应用现状

总结护理领导力在患者病死率、安全、舒适度、并发症等方面的应用现状,指出护理领导力在患者护理中的应用启示,为我国护理人员发展、应用护理领导力提供借鉴。