Scandinavian journal of caring sciences
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Multicenter Study Comparative Study
The professional nursing practice environment and nurse-reported job outcomes in two European countries: a survey of nurses in Finland and the Netherlands.
The working environment of nurses is receiving international interest, because there is a growing consensus that identifying opportunities for improving working conditions in hospitals is essential to maintain adequate staffing, high-quality care, nurses' job satisfaction and hence their retention. Thus, the aim of this study was to investigate the relationship between nurse work environment characteristics and nurse-reported job outcomes in hospital settings in Finland and the Netherlands and to compare these results. A comparative cross-sectional nurse survey was conducted. ⋯ Favourable evaluations of the adequacy of resources and supportiveness of management were positively correlated with nurse-assessed quality of care and job-related positive feelings and negatively correlated with intentions to leave a unit, organization or the entire profession. In neither of the participating countries were adverse incidents affecting nurses related to nurses' evaluations of their current professional practice environment. Compared with Finland, in the Netherlands, RN appears to evaluate the majority of work environment characteristics more positively; nevertheless, to some extent, the results were uniform as adequacy of resources and supportiveness of management were main predictors for nurse-reported job outcomes considered.
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Multicenter Study Clinical Trial
Accuracy and concordance of nurses in emergency department triage.
In the emergency department (ED) Registered Nurses (RNs) often perform triage, i.e. the sorting and prioritizing of patients. The allocation of acuity ratings is commonly based on a triage scale. To date, three reliable 5-level triage scales exist, of which the Canadian Triage and Acuity Scale (CTAS) is one. ⋯ Of the 7,550 triage ratings, 57.6% were triaged in concordance with the expected outcome and no scenario was triaged into the same triage level by all RNs. Inter-rater agreement for all RNs was kappa = 0.46 (unweighted) and kappa = 0.71 (weighted). The fact that the kappa-values are only moderate to good and the low concordance between the RNs call for further studies, especially from a patient safety perspective.
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Multicenter Study Clinical Trial Controlled Clinical Trial
Effects of resident-oriented care on quality of care, wellbeing and satisfaction with care.
In a resident-oriented care model applied in nursing homes, the residents are assigned to primary nurses. These primary nurses are responsible for the total care of the residents assigned to them. The purpose of the present study, using a pretest, post-test and control group quasi-experimental design, was to evaluate the effects of the implementation of resident-oriented care on the following aspects of quality of care: coordination of care, instrumental aspects, expressive aspects, resident wellbeing and satisfaction with care, and family satisfaction with care. ⋯ Furthermore, there was an indication that 'expressive aspects' changed in favour of the experimental wards. The implementation of resident-oriented care had no effect on resident wellbeing and satisfaction or on family satisfaction. Finally, the results are discussed in the light of some methodological limitations that often go together with intervention studies in the real world.
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Multicenter Study Clinical Trial Controlled Clinical Trial
Effects of 'pain-advisers': district nurses' opinions regarding their own knowledge, management and documentation of patients in chronic pain.
This study investigated whether district nurses' opinions changed after the education and introduction of district nurses as 'pain-advisers' at primary health care centres (PHCCs) regarding working conditions and satisfaction with pain control management at their PHCCs, their own knowledge of pain control and satisfaction with their own pain control management, pain assessment and nursing documentation of patients with chronic pain conditions. A study area (SA) with five PHCCs and a control area (CA) with seven PHCCs were selected. In the SA, 28 and in the CA, 25 district nurses answered a questionnaire both before and after the introduction of the 'pain-advisers' into the SA. ⋯ According to the district nurses in the SA, several statistically significant improvements were achieved after the introduction of the 'pain-advisers'; more district nurses reported that pain policies or other written information were now available at their PHCCs, that they were more satisfied with present overall routines at their PHCCs, that a better pain control was applied at their PHCCs regarding patients with leg ulcers, that they themselves to a greater extent performed individual pain assessments of the patients and that they more often used pain visual analogue scales to assess the patients' pain and to evaluate the results of the pain treatment. They also reported an increased satisfaction with their own nursing documentation. Although much remains to be done, it must be acknowledged that the 'pain-advisers', with relatively small resources, managed to make significant improvements.