BMJ quality & safety
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BMJ quality & safety · Mar 2014
Staffing and resource adequacy strongly related to RNs' assessment of patient safety: a national study of RNs working in acute-care hospitals in Sweden.
Although registered nurses (RNs) are central in patient care, we have not found prior research that specifically addresses how RNs assess the safety of patient care at their workplace and how factors in RNs' work environment are related to their assessments. This study aims to address these issues. ⋯ While previous research emphasises patient-to-nurse ratios in strengthening patient safety practices, this study complements this by emphasising RNs' own perception of having enough staff and resources to provide quality nursing care, as well as having good collegial nurse-physician relations and the presence of visible and competent nursing leadership-all factors highly related to RNs' assessment of the safety of patient care at their workplace.
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BMJ quality & safety · Mar 2014
Do variations in hospital mortality patterns after weekend admission reflect reduced quality of care or different patient cohorts? A population-based study.
Proposed causes for increased mortality following weekend admission (the 'weekend effect') include poorer quality of care and sicker patients. The aim of this study was to analyse the 7 days post-admission time patterns of excess mortality following weekend admission to identify whether distinct patterns exist for patients depending upon the relative contribution of poorer quality of care (care effect) or a case selection bias for patients presenting on weekends (patient effect). ⋯ The excess mortality patterns of the weekend effect vary widely for different diagnostic groups. Recognising these different patterns should help identify at-risk diagnoses where quality of care can be improved in order to minimise the excess mortality associated with weekend admission.