Maria Schubert | University of Basel, Switzerland (original) (raw)
Papers by Maria Schubert
Pflege, 2005
Die Auswirkungen von Kosteneinsparungsstrategien und Stellenbesetzung im stationären Akutpflegebe... more Die Auswirkungen von Kosteneinsparungsstrategien und Stellenbesetzung im stationären Akutpflegebereich auf die Behandlungsergebnisse von Patienten und auf die arbeitsbezogenen Ergebnisse von Pflegefachperso-nen wurden in der Schweiz bisher nicht untersucht. Das Institut für ...
Pflege, 2009
This article describes the development and content of the portfolio of the Surgical Intensive Car... more This article describes the development and content of the portfolio of the Surgical Intensive Care Unit. The first step was to evaluate clinical practice using a SWOT (strengths, weakness, opportunities and threats) analysis; development and trends within surgical intensive care were analyzed with a literature search. From these results, three areas were identified as essential for the development of practice: (1) best practice/best care, (2) research, and (3) development into a reference center. For each area, clearly specified objectives, outcomes, measures, responsibilities, and resources were defined and an extensive multi-year action plan was established. Best Practice/Best Care consisted of the improvement of performance and patient outcomes, the support and promotion of personnel, and the implementation of evidence-based nursing practice. Combining Best Practice/Best Care with the goals and measures of the second area, Research, formed the basis for realizing the vision of th...
European Journal of Cardiovascular Nursing, 2003
1. Eur J Cardiovasc Nurs. 2003 Apr;2(1):3-5. Transformational leadership: worthwhile the investme... more 1. Eur J Cardiovasc Nurs. 2003 Apr;2(1):3-5. Transformational leadership: worthwhile the investment! De Geest S, Claessens P, Longerich H, Schubert M. PMID: 14622643 [PubMed - indexed for MEDLINE]. Publication Types: Editorial; Review. MeSH Terms: ...
Current human resources planning models in nursing are unreliable and ineffective as they conside... more Current human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care. Methods/Design; A multi-country, multilevel cross sectional design is used to obtain important unmeasured factors in forecasting models including how features of hospital work environments impact on nurse recruitment, retention and patient outcomes. In each of the 12 participating European countries, at least 30 general acute hospitals were sampled. Data are gathered via four data sources (nurse, patient and organizational surveys and via routinely collected hospital discharge data). All staff nurses of a random selection of medical and surgical units (at least 2 per hospital) were surveyed. The nurse survey has the purpose to measure the experiences of nurses on their job (e.g. job satisfaction, burnout) as well as to allow the creation of aggregated hospital level measures of staffing and working conditions. The patient survey is organized in a sub-sample of countries and hospitals using a one-day census approach to measure the patient experiences with medical and nursing care. In addition to conducting a patient survey, hospital discharge abstract datasets will be used to calculate additional patient outcomes like in-hospital mortality and failure-to-rescue. Via the organizational survey, information about the organizational profile (e.g. bed size, types of technology available, teaching status) is collected to control the analyses for institutional differences. This information will be linked via common identifiers and the relationships between different aspects of the nursing work environment and patient and nurse outcomes will be studied by using multilevel regression type analyses. These results will be used to simulate the impact of changing different aspects of the nursing work environment on quality of care and satisfaction of the nursing workforce .
International journal of nursing studies, 2013
International journal of nursing studies, 2009
Patient falls are frequent incidents in hospitals, and various measurement methods are described ... more Patient falls are frequent incidents in hospitals, and various measurement methods are described in the literature to assess in-patient fall rates. However, the literature includes no validation of nurses' estimates of fall frequencies, which are the preferred assessment method in multi-centre surveys. To explore the concordance of nurses' estimated fall frequencies with continuously collected data. Cross-sectional, correlational secondary data analysis. Patient fall data from 21 wards in 2 Swiss acute care hospitals participating in the RICH Nursing Study. Registered nurses' (N=233) estimated fall frequencies, assessed by the International Hospital Outcome Study questionnaire in absolute number of falls over the last month, and, using a four-point Likert scale (never=1; frequently=4), over the last year, were compared to standardized hospital fall incident reports compiled over the same periods. Fall incident reports for the last month were assessed in absolute numbers ...
Nursing research
Financial constraints and other forces affecting health care in many countries have led to nurses... more Financial constraints and other forces affecting health care in many countries have led to nurses implicitly limiting their care in some instances. In the absence of an accepted definition and theoretical framework of implicit rationing of nursing care, a framework and the Basel Extent of Rationing of Nursing Care (BERNCA) instrument were developed. This instrument was used in the Swiss part of the International Hospital Outcome Study, in which implicit rationing of nursing care was studied. To examine the validity and reliability of the newly developed BERNCA instrument. Psychometric analysis was performed on data from 957 nurses in five Swiss acute care hospitals enrolled in a larger hospital organization study. An explanatory factor analysis with varimax rotation was used to investigate the instrument's internal structure, Spearman correlations were used to test relationships between implicit rationing and two related concepts, and Cronbach's alpha and interitem correlati...
International Journal of Nursing Studies, 2009
In the Rationing of Nursing Care in Switzerland Study, implicit rationing of care was the only fa... more In the Rationing of Nursing Care in Switzerland Study, implicit rationing of care was the only factor consistently significantly associated with all six studied patient outcomes. These results highlight the importance of rationing as a new system factor regarding patient safety and quality of care. Since at least some rationing of care appears inevitable, it is important to identify the thresholds of its influences in order to minimize its negative effects on patient outcomes. To describe the levels of implicit rationing of nursing care in a sample of Swiss acute care hospitals and to identify clinically meaningful thresholds of rationing. Descriptive cross-sectional multi-center study. Five Swiss-German and three Swiss-French acute care hospitals. 1338 nurses and 779 patients. Implicit rationing of nursing care was measured using the newly developed Basel Extent of Rationing of Nursing Care (BERNCA) instrument. Other variables were measured using survey items from the International Hospital Outcomes Study battery. Data were summarized using appropriate descriptive measures, and logistic regression models were used to define a clinically meaningful rationing threshold level. For the studied patient outcomes, identified rationing threshold levels varied from 0.5 (i.e., between 0 ('never') and 1 ('rarely') to 2 ('sometimes')). Three of the identified patient outcomes (nosocomial infections, pressure ulcers, and patient satisfaction) were particularly sensitive to rationing, showing negative consequences anywhere it was consistently reported (i.e., average BERNCA scores of 0.5 or above). In other cases, increases in negative outcomes were first observed from the level of 1 (average ratings of rarely). Rationing scores generated using the BERNCA instrument provide a clinically meaningful method for tracking the correlates of low resources or difficulties in resource allocation on patient outcomes. Thresholds identified here provide parameters for administrators to respond to whenever rationing reports exceed the determined level of '0.5' or '1'. Since even very low levels of rationing had negative consequences on three of the six studied outcomes, it is advisable to treat consistent evidence of any rationing as a significant threat to patient safety and quality of care.
Pflege, 2008
Pflegeforschung entwickelt, um die Forschung auf gesundheitspolitische Zielsetzungen der Länder a... more Pflegeforschung entwickelt, um die Forschung auf gesundheitspolitische Zielsetzungen der Länder auszurichten. In der Schweiz erschwerte das Fehlen einer landesweiten gesundheitspolitischen Zielsetzung eine gemeinsame Ausrichtung der Pflegeforschung. Im Projekt «Swiss Research Agenda for Nursing (SRAN)» wurde deshalb zwischen 2005 und 2007 die erste nationale Agenda entwickelt. Basierend auf Literaturreviews, Expertenbefragungen und einer nationalen Umfrage entwickelte ein Projektteam die Agenda, die an einer Konsensuskonferenz verabschiedet wurde.
Pflege, 2010
Competent nursing and effective leadership are essential attributes for the provision of high-qua... more Competent nursing and effective leadership are essential attributes for the provision of high-quality care which is patient-centred, evidence-based and outcome-oriented. The Department of Clinical Nursing science (DCN) of the University Hospital Basel (USB) initiated and implemented programmes of targeted practice development to promote competence in nursing and leadership. With the aim of generating data on nursing and leadership competencies, as well as on the quality of nursing care and the nursing work environment, an evaluation study with a mixed-method design was implemented in 2007. Within the quantitative portion of the study 679 nurses and 27 nurse managers participated. The descriptive results showed that nurses rated their overall level of competence on the Nurse Competence Scale high with a mean score of 75.1 (VAS 0 - 100). The rating of leadership competencies of nurse managers on the Leadership Practice Inventory was in the upper third of the 10-point Likert scale with mean scores of 40 to 50 (6 - 60). In order to permit ongoing monitoring of practice development, follow-up evaluations at regularly scheduled intervals are planned. With the introduction of a reimbursement system on the basis of Diagnosis Related Groups into Swiss health care, effective monitoring of nursing service contextual factors is crucial, now and in the future.
Nursing Research, 2007
Financial constraints and other forces affecting health care in many countries have led to nurses... more Financial constraints and other forces affecting health care in many countries have led to nurses implicitly limiting their care in some instances. In the absence of an accepted definition and theoretical framework of implicit rationing of nursing care, a framework and the Basel Extent of Rationing of Nursing Care (BERNCA) instrument were developed. This instrument was used in the Swiss part of the International Hospital Outcome Study, in which implicit rationing of nursing care was studied. To examine the validity and reliability of the newly developed BERNCA instrument. Psychometric analysis was performed on data from 957 nurses in five Swiss acute care hospitals enrolled in a larger hospital organization study. An explanatory factor analysis with varimax rotation was used to investigate the instrument's internal structure, Spearman correlations were used to test relationships between implicit rationing and two related concepts, and Cronbach's alpha and interitem correlations were used to test the reliability of the scale. Expert feedback confirmed that the BERNCA covered the implicit rationing of nursing care domain adequately and that its questions were fully comprehensible. The single-factor solution confirmed the instrument's unidimensional internal structure. A moderate to strong correlation in the expected direction was found between the BERNCA implicit rationing data and the quality of the nurse work environment as measured by the Nursing Work Index-Revised, particularly the perceived adequacy of nursing resources, although a significant but low correlation was also shown with patient-to-nurse ratios. Cronbach's alphas (.93) and interitem correlations indicated internal consistency and homogeneity. Initial evidence of the validity and reliability of the BERNCA instrument was provided.
International Journal for Quality in Health Care, 2008
Objectives. To explore the association between implicit rationing of nursing care and selected pa... more Objectives. To explore the association between implicit rationing of nursing care and selected patient outcomes in Swiss hospitals, adjusting for major organizational variables, including the quality of the nurse practice environment and the level of nurse staffing. Rationing was measured using the newly developed Basel Extent of Rationing of Nursing Care (BERNCA) instrument. Additional data were collected using an adapted version of the International Hospital Outcomes Study questionnaire.
Infection Control and Hospital Epidemiology, 2007
To compare sharp-device injury rates among hospital staff nurses in 4 Western countries. Cross-se... more To compare sharp-device injury rates among hospital staff nurses in 4 Western countries. Cross-sectional survey. Acute-care hospital nurses in the United States (Pennsylvania), Canada (Alberta, British Columbia, and Ontario), the United Kingdom (England and Scotland), and Germany. A total of 34,318 acute-care hospital staff nurses in 1998-1999. Survey-based rates of retrospectively-reported needlestick injuries in the previous year for medical-surgical unit nurses ranged from 146 injuries per 1,000 full-time equivalent positions (FTEs) in the US sample to 488 injuries per 1,000 FTEs in Germany. In the United States and Canada, very high rates of sharp-device injury among nurses working in the operating room and/or perioperative care were observed (255 and 569 injuries per 1,000 FTEs per year, respectively). Reported use of safety-engineered sharp devices was considerably lower in Germany and Canada than it was in the United States. Some variation in injury rates was seen across nursing specialties among North American nurses, mostly in line with the frequency of risky procedures in the nurses' work. Studies conducted in the United States over the past 15 years suggest that the rates of sharp-device injuries to front-line nurses have fallen over the past decade, probably at least in part because of increased awareness and adoption of safer technologies, suggesting that regulatory strategies have improved nurse safety. The much higher injury rate in Germany may be due to slow adoption of safety devices. Wider diffusion of safer technologies, as well as introduction and stronger enforcement of occupational safety and health regulations, are likely to decrease sharp-device injury rates in various countries even further.
BMC Nursing, 2011
Background: Current human resources planning models in nursing are unreliable and ineffective as ... more Background: Current human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care.
Background Little is known of the extent to which nursing-care tasks are left undone as an intern... more Background Little is known of the extent to which nursing-care tasks are left undone as an international phenomenon. Aim The aim of this study is to describe the prevalence and patterns of nursing care left undone across European hospitals and explore its associations with nurse-related organisational factors. Methods Data were collected from 33 659 nurses in 488 hospitals across 12 European countries for a large multicountry cross-sectional study. Results Across European hospitals, the most frequent nursing care activities left undone included 'Comfort/talk with patients' (53%), 'Developing or updating nursing care plans/care pathways' (42%) and 'Educating patients and families' (41%). In hospitals with more favourable work environments (B=−2.19; p<0.0001), lower patient to nurse ratios (B=0.09; p<0.0001), and lower proportions of nurses carrying out nonnursing tasks frequently (B=2.18; p<0.0001), fewer nurses reported leaving nursing care undone. Conclusions Nursing care left undone was prevalent across all European countries and was associated with nurse-related organisational factors. We discovered similar patterns of nursing care left undone across a cross-section of European hospitals, suggesting that nurses develop informal task hierarchies to facilitate important patient-care decisions. Further research on the impact of nursing care left undone for patient outcomes and nurse well-being is required.
Pflege, 2005
Die Auswirkungen von Kosteneinsparungsstrategien und Stellenbesetzung im stationären Akutpflegebe... more Die Auswirkungen von Kosteneinsparungsstrategien und Stellenbesetzung im stationären Akutpflegebereich auf die Behandlungsergebnisse von Patienten und auf die arbeitsbezogenen Ergebnisse von Pflegefachperso-nen wurden in der Schweiz bisher nicht untersucht. Das Institut für ...
Pflege, 2009
This article describes the development and content of the portfolio of the Surgical Intensive Car... more This article describes the development and content of the portfolio of the Surgical Intensive Care Unit. The first step was to evaluate clinical practice using a SWOT (strengths, weakness, opportunities and threats) analysis; development and trends within surgical intensive care were analyzed with a literature search. From these results, three areas were identified as essential for the development of practice: (1) best practice/best care, (2) research, and (3) development into a reference center. For each area, clearly specified objectives, outcomes, measures, responsibilities, and resources were defined and an extensive multi-year action plan was established. Best Practice/Best Care consisted of the improvement of performance and patient outcomes, the support and promotion of personnel, and the implementation of evidence-based nursing practice. Combining Best Practice/Best Care with the goals and measures of the second area, Research, formed the basis for realizing the vision of th...
European Journal of Cardiovascular Nursing, 2003
1. Eur J Cardiovasc Nurs. 2003 Apr;2(1):3-5. Transformational leadership: worthwhile the investme... more 1. Eur J Cardiovasc Nurs. 2003 Apr;2(1):3-5. Transformational leadership: worthwhile the investment! De Geest S, Claessens P, Longerich H, Schubert M. PMID: 14622643 [PubMed - indexed for MEDLINE]. Publication Types: Editorial; Review. MeSH Terms: ...
Current human resources planning models in nursing are unreliable and ineffective as they conside... more Current human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care. Methods/Design; A multi-country, multilevel cross sectional design is used to obtain important unmeasured factors in forecasting models including how features of hospital work environments impact on nurse recruitment, retention and patient outcomes. In each of the 12 participating European countries, at least 30 general acute hospitals were sampled. Data are gathered via four data sources (nurse, patient and organizational surveys and via routinely collected hospital discharge data). All staff nurses of a random selection of medical and surgical units (at least 2 per hospital) were surveyed. The nurse survey has the purpose to measure the experiences of nurses on their job (e.g. job satisfaction, burnout) as well as to allow the creation of aggregated hospital level measures of staffing and working conditions. The patient survey is organized in a sub-sample of countries and hospitals using a one-day census approach to measure the patient experiences with medical and nursing care. In addition to conducting a patient survey, hospital discharge abstract datasets will be used to calculate additional patient outcomes like in-hospital mortality and failure-to-rescue. Via the organizational survey, information about the organizational profile (e.g. bed size, types of technology available, teaching status) is collected to control the analyses for institutional differences. This information will be linked via common identifiers and the relationships between different aspects of the nursing work environment and patient and nurse outcomes will be studied by using multilevel regression type analyses. These results will be used to simulate the impact of changing different aspects of the nursing work environment on quality of care and satisfaction of the nursing workforce .
International journal of nursing studies, 2013
International journal of nursing studies, 2009
Patient falls are frequent incidents in hospitals, and various measurement methods are described ... more Patient falls are frequent incidents in hospitals, and various measurement methods are described in the literature to assess in-patient fall rates. However, the literature includes no validation of nurses' estimates of fall frequencies, which are the preferred assessment method in multi-centre surveys. To explore the concordance of nurses' estimated fall frequencies with continuously collected data. Cross-sectional, correlational secondary data analysis. Patient fall data from 21 wards in 2 Swiss acute care hospitals participating in the RICH Nursing Study. Registered nurses' (N=233) estimated fall frequencies, assessed by the International Hospital Outcome Study questionnaire in absolute number of falls over the last month, and, using a four-point Likert scale (never=1; frequently=4), over the last year, were compared to standardized hospital fall incident reports compiled over the same periods. Fall incident reports for the last month were assessed in absolute numbers ...
Nursing research
Financial constraints and other forces affecting health care in many countries have led to nurses... more Financial constraints and other forces affecting health care in many countries have led to nurses implicitly limiting their care in some instances. In the absence of an accepted definition and theoretical framework of implicit rationing of nursing care, a framework and the Basel Extent of Rationing of Nursing Care (BERNCA) instrument were developed. This instrument was used in the Swiss part of the International Hospital Outcome Study, in which implicit rationing of nursing care was studied. To examine the validity and reliability of the newly developed BERNCA instrument. Psychometric analysis was performed on data from 957 nurses in five Swiss acute care hospitals enrolled in a larger hospital organization study. An explanatory factor analysis with varimax rotation was used to investigate the instrument's internal structure, Spearman correlations were used to test relationships between implicit rationing and two related concepts, and Cronbach's alpha and interitem correlati...
International Journal of Nursing Studies, 2009
In the Rationing of Nursing Care in Switzerland Study, implicit rationing of care was the only fa... more In the Rationing of Nursing Care in Switzerland Study, implicit rationing of care was the only factor consistently significantly associated with all six studied patient outcomes. These results highlight the importance of rationing as a new system factor regarding patient safety and quality of care. Since at least some rationing of care appears inevitable, it is important to identify the thresholds of its influences in order to minimize its negative effects on patient outcomes. To describe the levels of implicit rationing of nursing care in a sample of Swiss acute care hospitals and to identify clinically meaningful thresholds of rationing. Descriptive cross-sectional multi-center study. Five Swiss-German and three Swiss-French acute care hospitals. 1338 nurses and 779 patients. Implicit rationing of nursing care was measured using the newly developed Basel Extent of Rationing of Nursing Care (BERNCA) instrument. Other variables were measured using survey items from the International Hospital Outcomes Study battery. Data were summarized using appropriate descriptive measures, and logistic regression models were used to define a clinically meaningful rationing threshold level. For the studied patient outcomes, identified rationing threshold levels varied from 0.5 (i.e., between 0 (&amp;#39;never&amp;#39;) and 1 (&amp;#39;rarely&amp;#39;) to 2 (&amp;#39;sometimes&amp;#39;)). Three of the identified patient outcomes (nosocomial infections, pressure ulcers, and patient satisfaction) were particularly sensitive to rationing, showing negative consequences anywhere it was consistently reported (i.e., average BERNCA scores of 0.5 or above). In other cases, increases in negative outcomes were first observed from the level of 1 (average ratings of rarely). Rationing scores generated using the BERNCA instrument provide a clinically meaningful method for tracking the correlates of low resources or difficulties in resource allocation on patient outcomes. Thresholds identified here provide parameters for administrators to respond to whenever rationing reports exceed the determined level of &amp;#39;0.5&amp;#39; or &amp;#39;1&amp;#39;. Since even very low levels of rationing had negative consequences on three of the six studied outcomes, it is advisable to treat consistent evidence of any rationing as a significant threat to patient safety and quality of care.
Pflege, 2008
Pflegeforschung entwickelt, um die Forschung auf gesundheitspolitische Zielsetzungen der Länder a... more Pflegeforschung entwickelt, um die Forschung auf gesundheitspolitische Zielsetzungen der Länder auszurichten. In der Schweiz erschwerte das Fehlen einer landesweiten gesundheitspolitischen Zielsetzung eine gemeinsame Ausrichtung der Pflegeforschung. Im Projekt «Swiss Research Agenda for Nursing (SRAN)» wurde deshalb zwischen 2005 und 2007 die erste nationale Agenda entwickelt. Basierend auf Literaturreviews, Expertenbefragungen und einer nationalen Umfrage entwickelte ein Projektteam die Agenda, die an einer Konsensuskonferenz verabschiedet wurde.
Pflege, 2010
Competent nursing and effective leadership are essential attributes for the provision of high-qua... more Competent nursing and effective leadership are essential attributes for the provision of high-quality care which is patient-centred, evidence-based and outcome-oriented. The Department of Clinical Nursing science (DCN) of the University Hospital Basel (USB) initiated and implemented programmes of targeted practice development to promote competence in nursing and leadership. With the aim of generating data on nursing and leadership competencies, as well as on the quality of nursing care and the nursing work environment, an evaluation study with a mixed-method design was implemented in 2007. Within the quantitative portion of the study 679 nurses and 27 nurse managers participated. The descriptive results showed that nurses rated their overall level of competence on the Nurse Competence Scale high with a mean score of 75.1 (VAS 0 - 100). The rating of leadership competencies of nurse managers on the Leadership Practice Inventory was in the upper third of the 10-point Likert scale with mean scores of 40 to 50 (6 - 60). In order to permit ongoing monitoring of practice development, follow-up evaluations at regularly scheduled intervals are planned. With the introduction of a reimbursement system on the basis of Diagnosis Related Groups into Swiss health care, effective monitoring of nursing service contextual factors is crucial, now and in the future.
Nursing Research, 2007
Financial constraints and other forces affecting health care in many countries have led to nurses... more Financial constraints and other forces affecting health care in many countries have led to nurses implicitly limiting their care in some instances. In the absence of an accepted definition and theoretical framework of implicit rationing of nursing care, a framework and the Basel Extent of Rationing of Nursing Care (BERNCA) instrument were developed. This instrument was used in the Swiss part of the International Hospital Outcome Study, in which implicit rationing of nursing care was studied. To examine the validity and reliability of the newly developed BERNCA instrument. Psychometric analysis was performed on data from 957 nurses in five Swiss acute care hospitals enrolled in a larger hospital organization study. An explanatory factor analysis with varimax rotation was used to investigate the instrument&amp;#39;s internal structure, Spearman correlations were used to test relationships between implicit rationing and two related concepts, and Cronbach&amp;#39;s alpha and interitem correlations were used to test the reliability of the scale. Expert feedback confirmed that the BERNCA covered the implicit rationing of nursing care domain adequately and that its questions were fully comprehensible. The single-factor solution confirmed the instrument&amp;#39;s unidimensional internal structure. A moderate to strong correlation in the expected direction was found between the BERNCA implicit rationing data and the quality of the nurse work environment as measured by the Nursing Work Index-Revised, particularly the perceived adequacy of nursing resources, although a significant but low correlation was also shown with patient-to-nurse ratios. Cronbach&amp;#39;s alphas (.93) and interitem correlations indicated internal consistency and homogeneity. Initial evidence of the validity and reliability of the BERNCA instrument was provided.
International Journal for Quality in Health Care, 2008
Objectives. To explore the association between implicit rationing of nursing care and selected pa... more Objectives. To explore the association between implicit rationing of nursing care and selected patient outcomes in Swiss hospitals, adjusting for major organizational variables, including the quality of the nurse practice environment and the level of nurse staffing. Rationing was measured using the newly developed Basel Extent of Rationing of Nursing Care (BERNCA) instrument. Additional data were collected using an adapted version of the International Hospital Outcomes Study questionnaire.
Infection Control and Hospital Epidemiology, 2007
To compare sharp-device injury rates among hospital staff nurses in 4 Western countries. Cross-se... more To compare sharp-device injury rates among hospital staff nurses in 4 Western countries. Cross-sectional survey. Acute-care hospital nurses in the United States (Pennsylvania), Canada (Alberta, British Columbia, and Ontario), the United Kingdom (England and Scotland), and Germany. A total of 34,318 acute-care hospital staff nurses in 1998-1999. Survey-based rates of retrospectively-reported needlestick injuries in the previous year for medical-surgical unit nurses ranged from 146 injuries per 1,000 full-time equivalent positions (FTEs) in the US sample to 488 injuries per 1,000 FTEs in Germany. In the United States and Canada, very high rates of sharp-device injury among nurses working in the operating room and/or perioperative care were observed (255 and 569 injuries per 1,000 FTEs per year, respectively). Reported use of safety-engineered sharp devices was considerably lower in Germany and Canada than it was in the United States. Some variation in injury rates was seen across nursing specialties among North American nurses, mostly in line with the frequency of risky procedures in the nurses&amp;#39; work. Studies conducted in the United States over the past 15 years suggest that the rates of sharp-device injuries to front-line nurses have fallen over the past decade, probably at least in part because of increased awareness and adoption of safer technologies, suggesting that regulatory strategies have improved nurse safety. The much higher injury rate in Germany may be due to slow adoption of safety devices. Wider diffusion of safer technologies, as well as introduction and stronger enforcement of occupational safety and health regulations, are likely to decrease sharp-device injury rates in various countries even further.
BMC Nursing, 2011
Background: Current human resources planning models in nursing are unreliable and ineffective as ... more Background: Current human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care.
Background Little is known of the extent to which nursing-care tasks are left undone as an intern... more Background Little is known of the extent to which nursing-care tasks are left undone as an international phenomenon. Aim The aim of this study is to describe the prevalence and patterns of nursing care left undone across European hospitals and explore its associations with nurse-related organisational factors. Methods Data were collected from 33 659 nurses in 488 hospitals across 12 European countries for a large multicountry cross-sectional study. Results Across European hospitals, the most frequent nursing care activities left undone included 'Comfort/talk with patients' (53%), 'Developing or updating nursing care plans/care pathways' (42%) and 'Educating patients and families' (41%). In hospitals with more favourable work environments (B=−2.19; p<0.0001), lower patient to nurse ratios (B=0.09; p<0.0001), and lower proportions of nurses carrying out nonnursing tasks frequently (B=2.18; p<0.0001), fewer nurses reported leaving nursing care undone. Conclusions Nursing care left undone was prevalent across all European countries and was associated with nurse-related organisational factors. We discovered similar patterns of nursing care left undone across a cross-section of European hospitals, suggesting that nurses develop informal task hierarchies to facilitate important patient-care decisions. Further research on the impact of nursing care left undone for patient outcomes and nurse well-being is required.