This large cross-sectional survey of policy analysts working in Quebec ministries (Canada) shows that direct interactions with academic researchers are among the most significant correlates of the consultation of scientific articles, academic research reports and academic books/chapters, but by very little compared to other correlates such as reported access to electronic bibliographic databases, training type, continuing professional development and perceived relevance of research evidence. Many correlates were found to have similar predictive power and, taken individually, all correlates have somewhat low predictive power. Interestingly, statistical simulations show that to achieve a larger predictive power, significant correlates must be manipulated simultaneously. Large variations were observed across policy sectors.
This study sets the stage for new initiatives aiming at filling current gaps in operationalization of nursing care performance. The next milestone is to set up the infrastructure required to collect data on these indicators and make effective use of them.
Objetivo descrever as atividades desenvolvidas pelas enfermeiras de ligação para a continuidade do cuidado após a alta hospitalar. Método estudo descritivo, qualitativo, pautado no referencial teórico Cuidado Baseado nas Forças. A amostra compreendeu 23 enfermeiras de ligação. Os dados foram coletados por meio de um questionário semiestruturado via plataforma eletrônica Survey Monkey e analisados por meio da técnica de Análise de Conteúdo, com categorias pré-definidas. Resultados entre as enfermeiras de ligação, nove (39,14%) possuíam de 35 a 44 anos de idade; 17 (73,91%) eram do sexo feminino; 15 (65,22%) trabalhavam há onze ou mais anos como enfermeira e 11 (47,82%) atuavam de seis a dez anos como enfermeira de ligação. As profissionais participam da identificação dos pacientes que necessitam de cuidados pós-alta hospitalar, coordenam o planejamento da alta hospitalar e transferem as informações do paciente para um serviço extra-hospitalar. Conclusão as atividades desenvolvidas pelas enfermeiras de ligação centram-se nas necessidades do paciente e na articulação com os serviços extra-hospitalares e podem ser adaptadas ao contexto brasileiro como uma estratégia para minimizar a descontinuidade do cuidado por ocasião da alta hospitalar.
Objective analyze how studies have approached the results obtained from the application of the Nursing Activities Score (NAS) based on Donabedian's model of healthcare organization and delivery. Method CINAHL and PubMed databases were searched for papers published between 2003 and March 2015. Results 36 articles that met the inclusion criteria were reviewed and double-coded by three independent coders and analyzed based on the three elements of Donabedian's health care quality framework: structure, process and outcome. The most frequently addressed, but not always tested, variables were those that fell into the structure category. Conclusion variables that fell into the process category were used less frequently. Beside NAS, the most frequently used variables in the outcome category were mortality and length of stay. However, no study used a quality framework for healthcare or NAS to evaluate costs, and it is recommended that further research should explore this approach.
the identification of clinical competences and the way nursing assistants acquire these competences can be important resources for managing people, which can be used by nurse managers to better allocate these professionals and provide th e opportunity for their professional development.
Background
Home-based hospitalization (HBH) offers an alternative delivery model to hospital care. There has been a remarkable increase in pilot initiatives and deployment of this model to optimize services offered to a population with a variety of progressive and chronic diseases. Our objectives were to systematically summarize the indicators of HBH as well as the factors associated with the successful implementation and use of this model.
Methods
We used a two-stage process. First, five databases were consulted, with no date delimitation. We included systematic reviews of quantitative, qualitative, and mixed studies published in English, French, Spanish, or Portuguese. We followed guidance from PRISMA and the Cochrane Collaboration. Second, we used the Nursing Care Performance Framework to categorize the indicators, a comprehensive grid of barriers and facilitators to map the factors affecting HBH implementation, and a thematic synthesis of the qualitative and quantitative findings.
Results
Fifteen reviews were selected. We identified 26 indicators related to nursing care that are impacted by the use of HBH models and 13 factors related to their implementation. The most frequently documented indicators of HBH were cost of resources, problem and symptom management, comfort and quality of life, cognitive and psychosocial functional capacity, patient and caregiver satisfaction, hospital mortality, readmissions, and length of stay. Our review also highlighted new indicators, namely use of hospital beds, new emergency consultations, and use of healthcare services as indicators of resources of cost, and bowel complications, caregiver satisfaction, and survival time as indicators of change in the patient’s condition. The main facilitators for HBH implementation were related to internal organizational factors (multidisciplinary collaboration and skill mix of professionals) whereas barriers were linked to the characteristics of the HBH, specifically eligibility criteria (complexity and social situation of the patient).
Conclusion
To the best of our knowledge, this is the first review that synthesizes both the types of indicators associated with HBH and the factors that influence its implementation. Considering both the processes and outcomes of HBH will help to identify strategies that could facilitate the implementation and evaluation of this innovative model of care delivery.
Systematic review registration
PROSPERO CRD42018103380
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.