1,721,002 research outputs found
The Relationship Between Nursing Characteristics and Pain Care Quality
Get PDFThe purpose of this study is to examine relationships between unit-level nursing characteristics (e.g. RN education, certification, RN hours per patient day) and hospital characteristics (e.g. Magnet designated, academic institution) with the unit average of patients' self-rated perception of pain and pain care quality. The study is a correlational analysis of cross-sectional data from the National Database of Nursing Quality Indicators (NDNQI) combined with data on pain care quality. The sample was a convenience sample that covered 170 hospitals across the U.S. with 725 reporting units. . The study found significant clinical relationships, although weak, between several variables. Strong relationships included: patient's average pain rating and nursing care hours per patient day; average pain and having pain medications available when needed. The strongest relationship was between percent pain relief and having pain medications available when needed. The study's findings that no significant differences presented across various unit types reinforce the point that pain is pervasive. Pain is also unique to each individual's subjective experience. Therefore, each patient's plan of care should be individualized, patient-centric, and unique to his or her experience.University of Kansas School of Nursing. Bachelor of Science in Nursing Honors Progra
Assaults on Nursing Personnel
Get PDFPaper submitted to the University of Kansas School of Nursing in partial fulfillment of the requirements for the Nursing Honors Program.Introduction: Nurses are frequent victims of workplace violence. Little research has been done that examines multiple factors related to assaults against nurses. Purpose: The purpose of this study was to examine the relationship of the rate of physical injury assault against hospital nurses with characteristics of assailants, of the nursing workforce, unit types, and hospital types. By providing insight into the factors that are associated with assaults on nursing staff, hospitals may be able to develop initiatives that decrease the number of assaults or decrease the severity of injuries. Methodology: This was a cross-sectional, correlational study based on unit-level analysis. A convenience sample of 372 eligible units in 33 hospital members of the National Database of Nursing Quality Indicators (NDNQI) were invited to participate. Eligible unit types included adult and pediatric medical, surgical, and medical-surgical, neonate, obstetrics, perioperative, psychiatric, and emergency services. Twenty-seven hospitals submitted data from 180 units. Data were collected under a protocol approved by the University of Kansas Medical Center's Institutional Review Board. Incidents of physical and sexual assaults were recorded in a log available at the nurses' station of each participating unit during October 2012 Findings: The analysis revealed the frequency of assaults, the characteristics of the nursing staff most frequently assaulted, unit types on which assaults are most common, and characteristics of assailants. Teaching hospitals in this sample accounted for the most cases of assaults with 68.3% of the total reported, whereas non-teaching hospitals had 22% and academic medical centers 9.8% of the total incidents. Among unit types, neonate, pediatric and obstetric units reported no assaults. Emergency departments, adult and psychiatric units reported the most assaults. All reported assaults were of a physical nature. Out of 92 assaults, 24 resulted in injury, of which 23 were minor and 1 was moderate. Patients were assailants 89 times with the remaining 3 being visitors or other. Assailants were usually male (55.4%) and assaultees were usually female (66.3%). The assaultees were mostly registered nurses (78.3%). Discussion: Most assaults on nurses occurred on adult medical and surgical units, psychiatric units, and in emergency services. Most assaults did not result in injury. Most assailants were patients. To reduce the incidence of assaults on nurses, hospitals could target interventions on these four unit types. Potential interventions could include implementing easy-to-use reporting systems, staff training on patient de-escalation, increase surveillance and security measures. Disclosures: Research was sponsored by the NDNQI under contract to the American Nurses Association.The University of Kansas School of Nursing Bachelor of Science Nursing Honors Progra
Agreement of fall classifications among staff in U.S. hospitals
No full textBACKGROUND: Patient falls in hospitals are a performance measure endorsed by the National Quality Forum. Agreement of staff classifications of fall situations is not documented. OBJECTIVES: The aims of this study were to (a) investigate how experts classify fall scenarios according to the fall definition of the National Quality Forum; (b) investigate how nursing staff classifies the same fall scenarios; and (c) assess the extent to which fall classifications differ among units, hospitals, and individuals. METHODS: Twenty video scenarios of falls were embedded in an online video survey. A panel of 24 experts and 6,342 hospital staff members from 362 units in 170 U.S. hospitals were asked to classify fall and nonfall scenarios. Experts consisted of nurses, physicians, physical therapists, and statisticians. Hospital staff were registered nurses (78%), unlicensed staff (15%), and other staff (7%). RESULTS: Experts unambiguously classified 14 out of 20 scenarios according to the National Quality Forum fall definition, whereas hospital staff clearly classified 12 scenarios. Experts and hospital staff did not agree on 4 out of 20 scenarios. The sensitivity was 0.90, the specificity was 0.88, and the mean probability for classifying a scenario as a fall was 0.60. DISCUSSION: Results indicate that the National Quality Forum fall definition needs further refinement to classify all scenarios properly. Although variability between individuals indicates some potential for fall reporting training, variability between units and hospitals does not seem to affect fall reporting
Identifying nurse staffing research in Medline: development and testing of empirically derived search strategies with the PubMed interface
No full textBackground: The identification of health services research in databases such as PubMed/Medline is a cumbersome task. This task becomes even more difficult if the field of interest involves the use of diverse methods and data sources, as is the case with nurse staffing research. This type of research investigates the association between nurse staffing parameters and nursing and patient outcomes. A comprehensively developed search strategy may help identify nurse staffing research in PubMed/Medline.Methods: A set of relevant references in PubMed/Medline was identified by means of three systematic reviews. This development set was used to detect candidate free-text and MeSH terms. The frequency of these terms was compared to a random sample from PubMed/Medline in order to identify terms specific to nurse staffing research, which were then used to develop a sensitive, precise and balanced search strategy. To determine their precision, the newly developed search strategies were tested against a) the pool of relevant references extracted from the systematic reviews, b) a reference set identified from an electronic journal screening, and c) a sample from PubMed/Medline. Finally, all newly developed strategies were compared to PubMed's Health Services Research Queries (PubMed's HSR Queries).Results: The sensitivities of the newly developed search strategies were almost 100% in all of the three test sets applied; precision ranged from 6.1% to 32.0%. PubMed's HSR queries were less sensitive (83.3% to 88.2%) than the new search strategies. Only minor differences in precision were found (5.0% to 32.0%).Conclusions: As with other literature on health services research, nurse staffing studies are difficult to identify in PubMed/Medline. Depending on the purpose of the search, researchers can choose between high sensitivity and retrieval of a large number of references or high precision, i.e. and an increased risk of missing relevant references, respectively. More standardized terminology (e.g. by consistent use of the term "nurse staffing") could improve the precision of future searches in this field. Empirically selected search terms can help to develop effective search strategies. The high consistency between all test sets confirmed the validity of our approach.<br/
Midnight census revisited: Reliability of patient day measurements in US hospital units
No full textBackground: Patient days are widely used in nurse staffing research and for nursing quality measurement. Nursing hours per patient day (NHPPD) and fall rates incorporate patient days in the denominator and are endorsed by the US National Quality Forum (NQF) as nursing sensitive consensus measures. Measurement error introduced by patient days would affect the accuracy of these nursing quality indicators.Objectives: The aim of this study was to assess the reliability of five patient day reporting methods accepted by the National Database of Nursing Quality Indicators (NDNQI). The specific aims were (1) to investigate the agreement of five patient day measurements with a defined quasi-gold standard, (2) to explore method bias by investigating the association of potential confounding variables with the differences between the routine measurements and the quasi-gold standard, and (3) to extrapolate the potential effect of bias of the patient day methods on nursing quality indicators.Design: A multiple census study with a national convenience sample of hospital units in the US was conducted.Setting: 260 out of 282 units (92%) from 54 hospitals sent bi-hourly patient census data for seven randomly selected days in September 2008.Methods: The multiple census data comprised the quasi-gold standard and was compared with data routinely submitted to the database. Intraclass correlations were calculated for an agreement analysis. A Bayesian regression analysis was conducted to explore the impact of different data collection methods and the degree of short stay patients.Results: Overall agreement between routine data and the quasi-gold standard was excellent (ICC [95% CI]: 0.967 [0.958–0.974]). A Bayesian regression analysis identified that two methods underestimated patient days and an interaction between the degrees of short stay patients and one of the data collection methods also affected patient day measurement by up to 7.6%.<br/
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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