Healthcare Introduction America has a highly developed health care system, which is available to all people. Although it can be very complex and frustrating at times it has come a long way from the health care organizations of yesterday. Previously most health care facilities were a place where the sick were housed and cared for until death.
Healthcare quality and patient safety Introduction Healthcare quality and patient safety are top priorities within healthcare worldwide. Demographic and technological development have increased the requirements for health services and have put the healthcare system under pressure 1.
Growing demands for advanced treatments, more complex nursing, high quality and safety, better patient satisfaction along with short hospital stays, high production, and reduced consumption of resources are some of the challenges the healthcare system is faced with 1.
Healthcare policy priorities and management should be supported by research on organization and structure to contribute to a higher degree of evidence-based decision making in order to improve healthcare quality and efficiency 2;3. An increasing body of research in health service evaluate how different organizational factors affect the healthcare quality, the outcomes or costs.
Adequate nurse staffing has been found important for optimal health services and treatments, which leads to better quality, patient safety, and patient outcomes. Although this relation is convincing and has appeared in several studies during the past 30 years across different hospitals and countriesno overall consensus on a valid and reliable tool to assess the demand for nurses has been found.
Furthermore, most studies have been limited to retrospective studies or studies including data at hospital level.
There is a lack of research at nursing unit level that explore the relationship of healthcare quality, nurse staffing and related organizational factors. The identification of organizational factors and the development, validation and tools to test reliability for the daily assessment of organizational factors can assist in predicting staffing needs to ensure a better distribution of the limited healthcare resources, when planning interventions to improve outcome.
Despite the evidence on the relationship between adequate nurse staffing and patient outcomes, nurse staffing is in Denmark often determined on the basis of tradition, economy or simple calculations such as number of nurses per bed or per patient No previous published studies on nurse staffing in Denmark were found.
The model included the three dimensions: Donabedian postulated that each of the three dimensions is a necessary condition for Quality of relationship in homecare essay next. An optimal structural setting or organization in which healthcare takes place is a prerequisite for improved process of healthcare performed, which leads to better patient outcomes.
Based on the model, studies of patient outcomes assess either association with process variables, or indirectly associations with structural factors that affects process variables that are measured or not measured Nursing care are processes that will affect patient outcomes, but structural variables that support or hinder nursing care will also predict patient outcomes.
Hence, it is not enough to focus on optimizing nursing care processes, optimal structural conditions are also necessary for optimal patient outcomes. Structural variables include a work environment with adequate nurse staffing levels.
Magnet hospitals The Donabedian model has been used as the basis for solid research on Magnet hospitals in the United States. This research had emphasized the importance of structural factors for both process and outcome.
The research about Magnet hospitals can be traced back to the eighties 25; Due to a shortage of nurses, researchers examined why some hospitals were better at attracting and retaining skilled nurses thus termed Magnet hospitals.
A number of organizational conditions such as better communication, higher nurse staffing levels, a flat structure, a better work environment, and more educated nurses were characteristic for magnet hospitals as opposed to non-magnet hospitals Further, researchers also found better patient outcomes in Magnet hospitals compared to Non-Magnet hospitals The better outcome in Magnet hospitals was ascribed to better nursing care provided processwhich again was explained by a better organizational support structure for nursing care.
Magnet hospitals are regarded as prime examples of positive organizational conditions with excellent patient care quality, nurses with a high job satisfaction, and good recruitment and retention of nurses.
In a study from Kalisch showed that low nurse staffing was a predictor for missed nursing care, when controlling for unit characteristics. These findings are the first ones to clarify, that the process of nursing care is hindered when nurse staffing is insufficient.
Kalish showed that when nurses have to prioritize required nursing care interventions, patients are exposed to a risk of delayed or lack of care, medication and treatment and complications as a result.
In a systematic review from including 42 studies, the prevalence of missed nursing appears to be high.
However, the kind of missed care varied depending on the different measurements, most frequently missing interventions were related to teaching the patient, emotional care needs and surveillance activities. Patient outcomes that were significantly associated with missed care were: Most frequently factors predicting missed care were staffing resource adequacy, the safety climate, nurse-reported care quality, and teamwork.
Although no evidence from intervention studies have been found, the findings from these studies indicate that units with better nurse staffing have reduced missed nursing care and consequently better patient outcomes 29 Nurse staffing and patient outcome International research has exposed several organizational factors that influence patient outcome, nurse outcome and costs.
Several systematic reviews and meta-analysis of studies mostly from the USA and Canada support the relationship between nurse staffing and mortality 6;7;9;30 ,but in the last decade European countries have also contributed to the research area 31; In a recent European study RN4CAST from with nine participating countries and hospitals includingpatients, the effects of staffing and education were associated with mortality adjusted for different factors Further, studies have reported preventable events associated with nurse staffing, however, the results are less consistent.
Nurse sensitive outcomes associated to nurse staffing were falls, urinary tract infection pneumonia, wound infection and pressure ulcers 7;22; Patients were also reported to be more satisfied in units with better nurse staffing 39; In a Finnish study, the total patient satisfaction decreased when nurses in day shift had to care for more than eight patients Although, a large number of studies have described the relationship between nurse sensitive outcomes and nurse staffing, other studies only found a few significant associations or no associations between staffing and outcomes at all Reasons for conflicting findings may lie in the methodological challenges within this research area.
A review attempt to analyze explanations for inconsistencies from 29 reviews Although the overall conclusion in the reviews was that a significant association between nurse staffing and patient outcomes exists, different definitions and methodological disparities were the main reason for the variations.Vol.7, No.3, May, Mathematical and Natural Sciences.
Study on Bilinear Scheme and Application to Three-dimensional Convective Equation (Itaru Hataue and Yosuke Matsuda). quality of relationship in homecare Essay. and primary care involvements are equally significant.
The indication presented in this essay will serve to establish why the quality of the relationship affects the quality of the care given. the quality of health services are key to reaching this goal 2. Although there is a general assumption by most Americans that the quality of health care provided in the U.S.
is very high, it is now well-documented that this is.
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