The concept of 'person-centredness' has become established in approaches to the delivery of healthcare, particularly with nursing, and is embedded in many international healthcare policy frameworks ...and strategic plans. This book explores person-centred nursing using a framework that has been derived from research and practice. Person-centred Nursing is a theoretically rigorous and practically applied text that aims to increase nurses' understanding of the principles and practices of person-centred nursing in a multiprofessional context. It advances new understandings of person-centred nursing concepts and theories through the presentation of an inductively derived and tested framework for person-centred nursing. In addition it explores a variety of strategies for developing person-centred nursing and presents case examples of the concept in action. This is a practical resource for all nurses who want to develop person-centred ways of working.
Summary Background Austerity measures and health-system redesign to minimise hospital expenditures risk adversely affecting patient outcomes. The RN4CAST study was designed to inform decision making ...about nursing, one of the largest components of hospital operating expenses. We aimed to assess whether differences in patient to nurse ratios and nurses' educational qualifications in nine of the 12 RN4CAST countries with similar patient discharge data were associated with variation in hospital mortality after common surgical procedures. Methods For this observational study, we obtained discharge data for 422 730 patients aged 50 years or older who underwent common surgeries in 300 hospitals in nine European countries. Administrative data were coded with a standard protocol (variants of the ninth or tenth versions of the International Classification of Diseases) to estimate 30 day in-hospital mortality by use of risk adjustment measures including age, sex, admission type, 43 dummy variables suggesting surgery type, and 17 dummy variables suggesting comorbidities present at admission. Surveys of 26 516 nurses practising in study hospitals were used to measure nurse staffing and nurse education. We used generalised estimating equations to assess the effects of nursing factors on the likelihood of surgical patients dying within 30 days of admission, before and after adjusting for other hospital and patient characteristics. Findings An increase in a nurses' workload by one patient increased the likelihood of an inpatient dying within 30 days of admission by 7% (odds ratio 1·068, 95% CI 1·031–1·106), and every 10% increase in bachelor's degree nurses was associated with a decrease in this likelihood by 7% (0·929, 0·886–0·973). These associations imply that patients in hospitals in which 60% of nurses had bachelor's degrees and nurses cared for an average of six patients would have almost 30% lower mortality than patients in hospitals in which only 30% of nurses had bachelor's degrees and nurses cared for an average of eight patients. Interpretation Nurse staffing cuts to save money might adversely affect patient outcomes. An increased emphasis on bachelor's education for nurses could reduce preventable hospital deaths. Funding European Union's Seventh Framework Programme, National Institute of Nursing Research, National Institutes of Health, the Norwegian Nurses Organisation and the Norwegian Knowledge Centre for the Health Services, Swedish Association of Health Professionals, the regional agreement on medical training and clinical research between Stockholm County Council and Karolinska Institutet, Committee for Health and Caring Sciences and Strategic Research Program in Care Sciences at Karolinska Institutet, Spanish Ministry of Science and Innovation.
Drawing on the universal values in health care, the second edition of Quality and Safety in Nursing continues to devote itself to the nursing community and explores their role in improving quality of ...care and patient safety. Edited by key members of the Quality and Safety Education for Nursing (QSEN) steering team, Quality and Safety in Nursing is divided into three sections. Itfirst looks at the national initiative for quality and safety and links it to its origins in the IOM report. The second section defines each of the six QSEN competencies as well as providing teaching and clinical application strategies, resources and current references. The final section now features redesigned chapters on implementing quality and safety across settings. New to this edition includes: Instructional and practice approaches including narrative pedagogy and integrating the competencies in simulation A new chapter exploring the application of clinical learning and the critical nature of inter-professional teamwork A revised chapter on the mirror of education and practice to better understand teaching approaches This ground-breaking unique text addresses the challenges of preparing future nurses with the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the health care system in which they practice.
ABSTRACT Objective: To understand the perception and experience of health professionals regarding fall prevention practices in hospital inpatient units. Method: This is a qualitative exploratory and ...descriptive case study based on the Canadian framework of interprofessional competences. Data was collected from two focus groups, with different health professionals in each group, and thematic content analysis was used. Results: Five categories were drawn up which showed intense convergence between the participants of the two focus groups, within the context of fall prevention practices: communication between professionals and patients/carers for fall prevention, interprofessional communication for fall prevention, clarification of roles for fall prevention, health education about risk and fall prevention and continuing education for fall prevention. Conclusion: Teamwork and collaborative practice are important for achieving good results in the prevention of falls in hospital care, but for this to happen, health professionals need to acquire the necessary competences for collaborative action.
RESUMO Objetivo: Compreender a percepção e a experiência vivenciada pelos profissionais de saúde quanto às práticas de prevenção de quedas na unidade de internação hospitalar. Método: Trata-se de um estudo qualitativo do tipo exploratório e descritivo, na modalidade estudo de caso, desenvolvido com base no referencial canadense de competências interprofissionais. Os dados foram coletados através de dois grupos focais, com profissionais de saúde diferentes em cada grupo, utilizando análise de conteúdo temática. Resultados: Foram elaboradas cinco categorias que mostraram intensa convergência entre os participantes dos dois grupos focais, dentro do contexto das práticas para prevenção de quedas: comunicação entre profissionais e pacientes/acompanhantes para a prevenção de quedas, comunicação interprofissional para a prevenção de quedas, clarificação de papéis para a prevenção de quedas, educação em saúde sobre risco e prevenção de quedas e educação permanente para a prevenção de quedas. Conclusão: O trabalho em equipe e a prática colaborativa são importantes para atingir bons resultados na prevenção de quedas na assistência hospitalar, mas para isso os profissionais de saúde precisam se apropriar das competências necessárias para o agir colaborativo.
RESUMEN Objetivo: Conocer la percepción y experiencia de los profesionales de la salud en relación a las prácticas de prevención de caídas en unidades de internación hospitalaria. Método: Se trata de un estudio de caso cualitativo, exploratorio y descriptivo, basado en el marco canadiense de competencias interprofesionales. Se recogieron datos de dos grupos focales, con diferentes profesionales sanitarios en cada grupo, y se utilizó el análisis de contenido temático. Resultados: Se elaboraron cinco categorías que mostraron una intensa convergencia entre los participantes de los dos grupos focales, en el contexto de las prácticas de prevención de caídas: comunicación entre profesionales y pacientes/cuidadores para la prevención de caídas, comunicación interprofesional para la prevención de caídas, clarificación de roles para la prevención de caídas, educación sanitaria sobre riesgos y prevención de caídas y formación continuada para la prevención de caídas. Conclusión: El trabajo en equipo y la práctica colaborativa son importantes para conseguir buenos resultados en la prevención de caídas en la atención hospitalaria, pero para ello es necesario que los profesionales sanitarios adquieran las competencias necesarias para la acción colaborativa.
Die Beiträge in diesem Open-Access-Sammelband beschreiben und analysieren aus multidisziplinärer Sicht die Herausforderungen und Bewältigungsstrategien von Alterung und Pflege in japanischen und ...deutschen Gemeinden. Thematisiert werden rechtliche Rahmenbedingungen, zivilgesellschaftliches Engagement, Pflegekräftemangel, Technologiekonzepte für die Pflege und schließlich auch der Einfluss der Covid-19 Pandemie auf die Situation älterer und pflegebedürftiger Bürgerinnen und Bürger. Die Gegenüberstellung der Ansätze und Erfahrungen beider Länder erweitert das Spektrum an Gestaltungsmöglichkeiten und kann Impulse für eine Neuausrichtung bestehender Lösungsstrategien geben.
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