Associations between rationing of nursing care and inpatient mortality in Swiss hospitals

Schubert, Maria; Clarke, Sean P.; Aiken, Linda H.; Geest, Sabina De

doi:10.1093/intqhc/mzs009

Cited by 131 publications

(123 citation statements)

References 25 publications

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“…These findings are consistent with Aiken's initial report over a decade ago on the relationship between nurse education and patient mortality, 6 a number of smaller studies conducted in Europe, [7][8][9][10][11] as well as with a substantial body of international reports, [12][13][14][15] including more recent studies [16][17][18][19] that continue to affirm the beneficial relationship between higher percentages of nursing staff with bachelor's degrees and lower patient mortality.…”

Section: Study On Nurse Staffing and Education And Patient Mortalitysupporting

confidence: 87%

Nurse Education and Patient Mortality: Sorting Fact From Fury

Alspach¹

2014

Critical Care Nurse

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Section: Study On Nurse Staffing and Education And Patient Mortalitysupporting

confidence: 87%

Nurse Education and Patient Mortality: Sorting Fact From Fury

Alspach¹

2014

Critical Care Nurse

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“…(11) Given the various activities performed due to the demand for health care, time constraints and limited resources, the nurse is often distant from direct assistance and may omit important aspects of care. (12) The amount of missed care is related to the increased workload, and those activities are generally considered as being exclusively within the competence of nurses. This omission indicates a deficiency in the quality of care and represents a potential risk for adverse patient events.…”

Section: Discussionmentioning

confidence: 99%

Fatores intervenientes na produção do cuidado em enfermagem

Cucolo

Perroca

2015

Acta paul. enferm.

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Objective: To identify the main factors involved in the delivery of nursing care, aiming at the development of items for an instrument. Methods: This was a qualitative study conducted with four sessions of focus groups involving 20 clinical nurses. The guiding questions included perceptions and experiences of nurses on the quality (high or poor) of care delivered during their work shift. The statements were studied using thematic content analysis, based on the reference of the complex adaptive system. Results: Four thematic categories emerged: (1) planning, intervention and evaluation of care; (2) design and qualification of the nursing staff; (3) resources to perform health care; and (4) multi-professional interaction. Those aspects involved in the production of care were characterized as systemic, multifactorial and related primarily to inadequate human resources, work conditions and organization. Conclusions: The factors involved in the delivery of nursing care were identified for the development of items for an instrument, and show the potential to guide nurses and assist management decisions. ResumoObjetivo: Identificar os principais fatores intervenientes na produção do cuidado em Enfermagem para geração de itens de instrumento. Métodos: Estudo qualitativo totalizando quatro sessões de grupos focais com a participação de 20 enfermeiros clínicos. As questões norteadoras incluíam percepções e experiências dos enfermeiros sobre a qualidade (ótimo ou ruim) de seu turno de trabalho. Os discursos foram examinados por meio da análise de conteúdo na modalidade temática, apoiando-se no referencial sobre sistema adaptativo complexo. Resultados: Emergiram quatro categorias temáticas: (1) planejamento, intervenção e avaliação do cuidado; (2) dimensionamento e qualificação da equipe de enfermagem; (3) recursos necessários para prestar assistência; e (4) interação multiprofissional. Os aspectos intervenientes na produção do cuidado revelaramse multifatoriais e sistêmicos e relacionados, principalmente, à insuficiência de pessoal e às inadequadas condição e organização do trabalho. Conclusão: Os fatores intervenientes na produção do cuidado de Enfermagem para geração de itens de instrumento foram identificados e poderão nortear os enfermeiros em decisões assistencias e gerenciais.

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“…7 In a recent study involving a large US tertiary academic medical center, even a small increase in the patient-to-nurse ratio was found to increase mortality. 8 We examined Denmark's bed occupancy rates and patient mortality to determine whether there was an association between the two.…”

mentioning

confidence: 98%

High Levels Of Bed Occupancy Associated With Increased Inpatient And Thirty-Day Hospital Mortality In Denmark

2014

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High bed occupancy rates have been considered a matter of reduced patient comfort and privacy and an indicator of high productivity for hospitals. Hospitals with bed occupancy rates of above 85 percent are generally considered to have bed shortages. Little attention has been paid to the impact of these shortages on patients' outcomes. We analyzed all 2.65 million admissions to Danish hospitals' departments of medicine in the period 1995-2012. We found that high bed occupancy rates were associated with a significant 9 percent increase in rates of in-hospital mortality and thirty-day mortality, compared to low bed occupancy rates. Being admitted to a hospital outside of normal working hours or on a weekend or holiday was also significantly associated with increased mortality. The health risks of bed shortages, including mortality, could be better documented as a priority health issue. Resources should be allocated to researching the causes and effects of bed shortages, with the aim of creating greater interest in exploring new methods to avoid or reduce bed shortages.

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Associations between rationing of nursing care and inpatient mortality in Swiss hospitals

Abstract: Measures of rationing may reflect care conditions that place hospital patients at risk of negative outcomes and thus deserve attention in future hospital outcomes research studies.

Cited by 131 publications

References 25 publications

Nurse Education and Patient Mortality: Sorting Fact From Fury

Nurse Education and Patient Mortality: Sorting Fact From Fury

Fatores intervenientes na produção do cuidado em enfermagem

High Levels Of Bed Occupancy Associated With Increased Inpatient And Thirty-Day Hospital Mortality In Denmark

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