Background: Nursing care has a significant impact on patient safety, which affects clinical outcomes, patients’ satisfaction with the care received and nursing personnel’s satisfaction with the care provided. This study aimed to determine the extent of nursing care rationing and its relationship with patient safety including identification of the specific reasons.Methods: This cross-sectional study involved 245 nurses and was performed between April–June 2019 in four hospitals in Wrocław, Poland. The standardized and relevant research tools such as Hospital Survey on Patient Safety Culture (HSOPSC) and the Perceived Implicit Rationing of Nursing Care (PIRNCA) were used. The data was submitted to hierarchical multiple regression analysis. The study was approved by the Bioethics Committee and was followed with the STROBE guidelines.Results: The PIRNCA scores were negatively correlated with the HSOPSC subscales, which indicates that more frequent rationing of nursing care was associated with lower levels of patient safety parameters. It was shown that the highest level of unfinished nursing care was associated with decreases in patient safety factors linked with supervisor manager expectations actions promoting safety (rs = −0.321, p < 0.001), teamwork within hospital units (rs = −0.377, p < 0.001), feedback and communication about error (rs = −0.271, p < 0.001), teamwork across hospital units (rs = −0.221, p < 0.01), and hospital handoffs transitions (rs = −0.179, p < 0.01). Moreover, the strongest association was observed between the PIRNCA scores with patient safety grade (rs = 0.477, p < 0.001). Also, the PIRNCA scores among the internal unit were significantly higher than in the intensive care and surgical units.Conclusion: Our study indicated the presence of nursing care rationing. Regarding patient safety, we found insufficient numbers of medical personnel and excessive personnel workload for providing safe care to patients, a lack of transparency in handling adverse event reports and analyses, and a lack of cooperation between hospital units regarding patient safety.
Aims To assess the effects of nurses’ life satisfaction and life orientation on the level of nursing care rationing. Background Best practice within human resource management argues that striving for a positive orientation within the workforce may create a friendly work environment that could promote the employee's development and job satisfaction in a health care organisation. Methods A total of 547 nurses were enrolled and assessed using three self‐report scales: the Basel Extent of Rationing of Nursing Care‐R (BERCA‐R), the Satisfaction with Life Scale (SWLS) and the Life Orientation Test (LOT‐R). Then, the data were submitted into bivariate analyses. Results More pessimistic nurses with low and moderate levels of life satisfaction, and those with a neutral life orientation, presented with significantly higher BERCA‐R scores than those who were more optimistic and who had high levels of life satisfaction. Conclusions Nursing care rationing depends on psychological factors of life satisfaction and life orientation. Low levels of satisfaction with life and a more pessimistic life orientation negatively contribute towards a higher prevalence of nursing care rationing. Implications for nursing management Nursing management policies, including intervention management, should consider ensuring positive orientation is in place to increase job satisfaction and optimism in health care workers.
Aims To assess the ability to work of Polish nurses by age groups. Background The ability to work is widely discussed in the literature in the context of nurses' productivity; thus, it is necessary to identify the ability to work when facing an increasing demand for services. Methods The observational study involved 349 professionally active nurses aged 46.9 ± 9.7 years, with a length of service of 23.5 ± 9.6 years. The Work Ability Index (WAI) was used to assess the nurses' ability to work. Results The ability to work decreases with age (rs = −0.324, p < .000) and with seniority (rs = −0.257; p < .000). Nurses with higher education presented higher Work Ability Index scores. Also, the age (B = −0.25, p < .001), work seniority (B = −0.19, p < .001) and education (masters' degree: B = 1.41, p = .012; ref. secondary) affect work ability. Conclusions The ageing process and seniority of nurses negatively affect their ability to work. A lack of programmes to maintain physical condition for nurses can result in a shortage of staff. Implications for nursing management Programmes can be developed to create or improve healthy working environments to increase productivity.
Clinical nurses can encounter musculoskeletal pain episodes stemming from regular exposure to workplace risk factors that contribute to overloads. This study aimed to evaluate the occurrence and location of work-related musculoskeletal pain among Polish nurses. An observational and descriptive survey study was conducted among 136 nurses working in the anesthesiology, intensive care, and surgery units. An extended version of the Nordic Musculoskeletal Questionnaire was used to investigate musculoskeletal pain. Only 8% of the participating nurses experienced no musculoskeletal pain, while 85% suffered from pain in more than one location. The lower back (67%), upper back (59%), and neck (66%) were the most common pain locations. In summary, nurses experienced multiple musculoskeletal pain episodes, occurring most frequently in the spinal region (lower and upper back and neck). It is crucial to determine the real causes of musculoskeletal pain and to take appropriate preventive measures to improve workplace ergonomics.
Introduction: The aging of modern societies increases the general healthcare burden due to the growing demand for inpatient services, which lack adequate financing. Material and methods: Data concerning the costs of 312,250 hospitalizations at University Clinical Hospital in Wrocław, Poland in the years 2012-2015 were analyzed according to the age of the patients: below 65 years and 65 years and older, with subgroups (65-74, 75-84 and 85 years and older). Results: The mean length of stay (LOS) differed significantly for patients below 65 years and for patients 65 years old or older (3.5 vs. 4.7 person-days); over the 4 years covered by our data, these increased by 0.4 person-days, mostly among patients 85 years and older (by 0.7 person-days). The mean direct cost of hospitalization differed significantly for patients below 65 years and those 65 years or older (PLN 4,907.12 vs. PLN 6,357.15). The mean cost of laboratory tests and radiologic diagnostics was significantly higher among those in the 65+ group, and the difference had a rising trend. The differences between age groups in cost-related hospitalization characteristics and direct hospitalization costs that have been suggested by the medical literature have also been confirmed in Poland. Conclusions: The mean hospitalization costs of patients aged 65 years and older in Poland are higher than for younger patients due to longer LOS and more complex and expensive treatment, especially laboratory and radiologic diagnostics, which is increasingly common in the oldest age groups. This demands an urgent systemic solution, especially in terms of adjusted financing of elderly patients' hospital treatment.
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