Factors related to the patient safety climate in an emergency hospital.
ABSTRACT: OBJECTIVE:to verify the relationship between the socio-demographic and work profile of the nursing professionals and the patient safety climate in a public emergency hospital. METHOD:a cross-sectional study carried out with 177 nursing professionals from a public emergency hospital. For data collection, the Safety Attitudes Questionnaire - Short Form 2006 was used, validated and cross-culturally adapted to the Portuguese language. To check the factors related to the instrument's domains, bivariate and multivariate analyses were performed. RESULTS:working in the medical and surgical clinic or emergency room, on a night shift, and having the intention to leave nursing, reduced the general safety climate in the multiple regression analysis. The younger professionals, with less than four years in the institution, and those who worked in the night shift had a lower safety climate related to the perception of the management. On the other hand, having a work contract with a hired worker improved the general safety climate and workplace satisfaction. CONCLUSION:identifying predictors on patient safety scores is an important management tool that allows diagnosing, planning and executing activities from the domains that need to be improved.
Project description:The objective of this research was to analyse the quality of life of nursing professionals and its relationship with socio-demographic variables and the work context. A multi-centre, descriptive, cross-sectional design was used. Questionnaires were administered to 1521 nurses working in the Andalusian Public Health System (APHS), Spain. Professional quality of life (ProQOL v. IV) was measured, as well as several socio-demographic and work-related variables. To this end, a descriptive analysis and multiple exploratory analyses were conducted. The levels of compassion fatigue (CF) and burnout (BO) were elevated. The level of compassion satisfaction (CS) was below the estimated mean. Marital status, the healthcare setting, the area where the centre is located, and the work shift are variables associated with CF. According to the multiple linear regression model, the predicting factors for the occurrence of CF were being married, working in primary care, in urban areas, and working a morning/evening/night shift. The variables related to CS were the professional's age, sex, marital status, the healthcare setting of the centre, the location of the centre, and the work shift. Specifically, according to the exploratory model, the factors that predicted a reduction in CS were working in primary care, in urban areas, and working a morning/evening/night shift. However, being divorced increased CS. BO was influenced only by the work shift. Nursing professionals are exposed to certain factors that may influence professional quality of life. Some of these factors are related to the work context.
Project description:This study aimed to evaluate the associations between types of night shift work and different indices of obesity using the baseline information from a prospective cohort study of night shift workers in China.A total of 3,871 workers from five companies were recruited from the baseline survey. A structured self-administered questionnaire was employed to collect the participants' demographic information, lifetime working history, and lifestyle habits. Participants were grouped into rotating, permanent and irregular night shift work groups. Anthropometric parameters were assessed by healthcare professionals. Multiple logistic regression models were used to evaluate the associations between night shift work and different indices of obesity.Night shift workers had increased risk of overweight and obesity, and odds ratios (ORs) were 1.17 (95% CI, 0.97-1.41) and 1.27 (95% CI, 0.74-2.18), respectively. Abdominal obesity had a significant but marginal association with night shift work (OR = 1.20, 95% CI, 1.01-1.43). A positive gradient between the number of years of night shift work and overweight or abdominal obesity was observed. Permanent night shift work showed the highest odds of being overweight (OR = 3.94, 95% CI, 1.40-11.03) and having increased abdominal obesity (OR = 3.34, 95% CI, 1.19-9.37). Irregular night shift work was also significantly associated with overweight (OR = 1.56, 95% CI, 1.13-2.14), but its association with abdominal obesity was borderline (OR = 1.26, 95% CI, 0.94-1.69). By contrast, the association between rotating night shift work and these parameters was not significant.Permanent and irregular night shift work were more likely to be associated with overweight or abdominal obesity than rotating night shift work. These associations need to be verified in prospective cohort studies.
Project description:INTRODUCTION:Although it seems logical to assume that working in an emergency service implies having a great capacity to face extreme situations, resilience in health care workers has been shown to be related not only to individual personality characteristics but also with external factors. The objective of this study was to determine the resilience of professional health workers in emergency services and its relationships with sociodemographic and working conditions. METHODS:This cross-sectional study included emergency physicians, nurses, and nursing assistants. Sociodemographic variables and the Resilience Scale-25 were analyzed. RESULTS:A total of 320 professionals participated. Their mean age was 43.5 years (SD 8.9), and 81.87% were women. The mean resilience score was 133.52 (SD 7.22), which corresponds to moderately low to moderate levels. An association was found between the highest resilience scores and being a physician (?2 8.84; P = 0.01) and a higher capacity if working in emergency mobile units (?2 6.29; P = 0.04). Working the day shift and being a nurse (beta = -5.71; P = 0.02) were associated with lower resilience scores. Age (odds ratio 1.095; P = 0.02; 95% confidence interval 1.015, 1.184), and not having a partner decreased resilience (being divorced odds ratio 5.17; P = 0.01; 95% confidence interval 1.503, 18.235 and being single odds ratio 3.371; P = 0.01; 95% confidence interval 1.259, 9.257). However, more work experience increased the resilience levels (odds ratio 0.906; P = 0.02; 95% confidence interval 0.833, 0.983). DISCUSSION:Resilience in professional health workers was related to personal and working conditions. The scores of emergency staff were low and should be improved with specific strategies.
Project description:BACKGROUND:Missed nursing care is considered an error of omission and is defined as any aspect of required patient care that is omitted (either in part or whole) or significantly delayed. Nursing care missed in the perinatal setting can cause negative outcomes and repercussions for the quality and safety of care. This has been reported in multiple settings and countries and is tied to negative maternal outcomes. Preventing missed nursing care requires in-depth research considering the clinical setting. OBJECTIVE:The main aim of the study was to assess commonly missed nursing care elements, reasons, and factors for the omission in the obstetric and gynecologic units of general hospitals in Tigray 2017/18. METHODS AND MATERIALS:A cross-sectional study was conducted in eight randomly selected general hospitals in Tigray, Ethiopia. A total of 422 nurses and midwives were selected through simple random sampling using the staff list as a sampling frame. To identify the commonly missed nursing care and related factors, the MISSCARE survey tool was used. Descriptive, bivariate, and multivariate logistic regression analysis was performed to assess potential risk factors of nursing cares omission. RESULT:The study results showed that 299 (74.6%) participants commonly missed at least one nursing care in the perinatal setting. Labor resources 386(96.3%), teamwork 365(91%), material resources 361 (90%) and communication 342 (85.3%) were the reasons identified for commonly missing care. In the multivariate analyses, sex (p-value <0.001), educational level (p-value 0.034), working shift (p-value <0.001) and having an intention to leave the institution (p-value <0.001) showed a significant association with commonly missing care. CONCLUSION:The proportion of commonly missed nursing care was high. After adjusting for demographic variables, labor resources, material resources, and communication were reasons for commonly missed nursing care. Increasing male professional proportion, investing in nurses/midwives training, and harmonizing nursing service administration through appropriate working shift arrangement and timely assessment of professionals' stability and satisfaction could minimize frequent omission of nursing care.
Project description:INTRODUCTION:Safety climates are perceptions of safety culture shared by staff in organizational units. Measuring staff perceptions of patient safety culture by using safety climate surveys is a possible way of addressing patient safety. Studies have documented that patient safety climates vary significantly between work sites in hospitals. Across-ward variations in the measurements of safety climate factor scores may indicate ward-specific risk of adverse events related to patient care routines, work environment, staff behaviour, and patient results. Variation in patient safety climates has not yet been explored in nursing homes. OBJECTIVES:To investigate whether the Norwegian translation of the Safety Attitudes Questionnaire-Ambulatory Version is useful to identify significant variation in the patient safety climate factor scores: Teamwork climate, Safety climate, Job satisfaction, Working conditions, Stress recognition, and Perceptions of management, across wards in nursing homes. METHODS:Four hundred and sixty three employees from 34 wards in five nursing homes were invited to participate. Cronbach alphas were computed based on individual respondents' scores on the six patient safety climate factor scores. Intraclass correlation coefficients were calculated by multilevel analysis to measure patient safety climate variance at ward level. RESULTS:Two hundred and eighty eight (62.2%) returned the questionnaire. At ward level Intraclass correlation coefficients (ICCs) for the factors were 10.2% or higher for the factors Safety climate, Working conditions and Perceptions of management, 2.4% or lower for Teamwork climate, Job satisfaction, and zero for Stress recognition. ICC for variance at nursing home level was zero or less than one per cent for all factor scores. CONCLUSIONS:Staff perceptions of Safety climate, Working conditions and Perceptions of management varied significantly across wards. These factor scores may, therefore, be used to identify wards in nursing homes with high and low risk of adverse events, and guide improvement resources to where they are most needed.
Project description:A survey was conducted among 345 nursing officers working in hospitals of Army, Navy and Air Force to find out their preferences on type of shift system, working hours in each shift, duration of night duties, entitlement of compensatory 'off days' and distribution of 'off days'. Majority of them has demanded a change from the existing pattern of duty system, split shift to a 'modified shift' system. The 'modified shift' will have 6 hours each in first and second shifts and 12 hours in the third shift (night). Their preference for night duties is for a duration of two weeks with two compensatory 'off days' at the end of the night duties in one instalment. But they opt for the compensatory 'off days' of day shifts in instalments of one per week.
Project description:BACKGROUND:Patient safety culture involves leader and staff interaction, routines, attitudes, practices and awareness that influence risks of adverse events in patient care. The Safety Attitudes Questionnaire (SAQ) is an instrument to measure safety attitudes among health care providers. The instrument aims to identify possible weaknesses in clinical settings and motivate quality improvement interventions leading to reductions in medical errors. The Ambulatory Version of the SAQ (SAQ-A) was developed to measure safety climate in the primary care setting. The original version of the SAQ includes six major patient safety factors: Teamwork climate, Safety climate, Job satisfaction, Perceptions of management, Working conditions, and Stress recognition. Patients in nursing homes are particularly vulnerable to adverse events. We present the psychometric properties of the Norwegian translation of the SAQ-A for the nursing home setting. METHODS:The study was conducted in five nursing homes in Tønsberg, Norway, in February 2016. A total of 463 employees working more than 20% received a paper version of the translated SAQ-A adapted to the Norwegian nursing home setting and responded anonymously. Filled-in questionnaires were scanned and transferred to an SPSS file. SPSS was used to estimate Cronbach alphas, corrected item-total correlations, item-to-own and item-to-other correlations, and item-descriptive statistics. The confirmatory factor analysis was done by AMOS. RESULTS:Of the 463 health care providers, 288 (62.2%) responded to the questionnaire. The confirmatory factor analysis showed that the total model of the six factors Teamwork climate, Safety climate, Job satisfaction, Perceptions of management, Working conditions, and Stress recognition had acceptable goodness-of-fit values in the nursing home setting. CONCLUSIONS:The results of our study indicate that the Norwegian translated version of the SAQ-A, with the confirmed six factor model, is an appropriate tool for measuring patient safety climate in the nursing home setting. Future research should study whether there is an association between patient safety climate in nursing homes and occurrence of adverse events among the patients.
Project description:The purpose of this study was to investigate the correlations between nursing staff's mental health, number of years worked, night shifts performed, and pleasant activities at the workplace. One hundred forty-three subjects who had no missing data were analyzed. Questions consisted of basic attributes, subjective happiness scale (SHS), and pleasant activities conducted at the workplace. Denouements of SHS indicated a significant trend for the main effect, with more pleasant activities in the high SHS group than the low SHS group. The interaction was significant, with fewer pleasant activities in participants in the low SHS group who worked the night shift compared with those who worked the night shift regardless of work experience. The outcomes of this study suggest that it is essential to expand the repertoire of pleasant activities at the workplace to increase the subjective happiness of nursing staff for older individuals.
Project description:The objective is to evaluate the sleep characteristics of the staff working in a pediatric intensive care unit (PICU). They were asked to complete an anonymous survey concerning the characteristics and quality of their sleep, as well as the impact of sleep disturbances on their work and social life, assessed by Functional Outcomes of Sleep Questionnaire (FOSQ)-10 questionnaire. The response rate was 84.6% (85% females): 17% were doctors, 57% nurses, 23% nursing assistants, and 3% porters. 83.8% of them worked on fix shifts and 16.2% did 24-h shifts. 39.8% of workers considered that they had a good sleep quality and 39.8% considered it to be poor or bad. The score was good in 18.2% of the staff and bad in 81.8%. Night shift workers showed significantly worse sleep quality on both the objective and subjective evaluation. There was a weak concordance (kappa 0.267; p?=?0.004) between the perceived quality of sleep and the FOSQ-10 evaluation. Sleep disorders affected their emotional state (30.2% of workers) and relationships or social life (22.6%). In conclusion, this study finds that a high percentage of health professionals from PICU suffer from sleep disorders that affect their personal and social life. This negative impact is significantly higher in night shift workers. Many health workers are not aware of their bad sleep quality.
Project description:Practical alternatives to gold-standard measures of circadian timing in shift workers are needed. We assessed the feasibility of applying a limit-cycle oscillator model of the human circadian pacemaker to estimate circadian phase in 25 nursing and medical staff in a field setting during a transition from day/evening shifts (diurnal schedule) to 3-5 consecutive night shifts (night schedule). Ambulatory measurements of light and activity recorded with wrist actigraphs were used as inputs into the model. Model estimations were compared to urinary 6-sulphatoxymelatonin (aMT6s) acrophase measured on the diurnal schedule and last consecutive night shift. The model predicted aMT6s acrophase with an absolute mean error of 0.69?h on the diurnal schedule (SD?=?0.94?h, 80% within ±1?hour), and 0.95?h on the night schedule (SD?=?1.24?h, 68% within ±1?hour). The aMT6s phase shift from diurnal to night schedule was predicted to within ±1?hour in 56% of individuals. Our findings indicate the model can be generalized to a shift work setting, although prediction of inter-individual variability in circadian phase shift during night shifts was limited. This study provides the basis for further adaptation and validation of models for predicting circadian phase in rotating shift workers.