Patient Care In Hospital Setting Research Articles

Implemented machine learning tools to inform decision-making for patient care in hospital settings: a scoping review

ObjectivesTo identify ML tools in hospital settings and how they were implemented to inform decision-making for patient care through a scoping review. We investigated the following research questions: What ML...

Rheumatoid Arthritis Disease Activity Index-5: an easy and effective way of monitoring patients with rheumatoid arthritis

ObjectiveTo study the utility of the Rheumatoid Arthritis Disease Activity Index-5 (RADAI-5) as a valid tool for daily rheumatoid arthritis (RA) monitoring and to compare its predictability to assess RA activity with respect to Disease Activity Score 28 (DAS28) and Clinical Disease Activity Index (CDAI).Patients and methodsA total of 100 patients with RA (diagnosed as per American College of Rheumatology 1987 criteria) were enrolled in the study group. Each patient was assessed two times with 3-month interval for disease activity (DA) using DAS28, CDAI, and RADAI-5. Spearman’s correlation coefficient (p) for correlation and kappa for agreement between different activity measures were assessed.ResultsIn our study group, 19% patients were men and 81% patients were women, with male to female ratio of 1 :4.3. Their mean age was 44.4±11.8 years, and their mean disease duration was 67.5±59.8 months. On initial visit, that is, baseline, mean DA as per RADAI-5, DAS28, and CDAI were 5.14±2.17, 5.58±1.55, and 27.96±15.46, respectively, and on follow-up visit, the readings were 3.76±1.92, 4.54±1.41, and 17.67±12.46, respectively. The mean changes in DA at follow-up visit were -1.37 ±2.15 by RADAI-5, -1.04±1.58 by DAS28, and -10.29±15.75 by CDAI. Changes in DA indices correlated significantly with each other with p ranging from 0.8 to 0.9 (P<0.001). An average agreement was found among all three measures at different DA level.ConclusionRADAI-5 seems to be an effective tool with high tendency to assess the changes in RA DA in routine patient care in hospital settings as well as in home-based settings.

From the lab to the field: the challenges of the take-off process for a bedside mobility app

The implementation of mobile phone apps for patient care in hospital settings requires careful consideration of many challenges. The authors developed and pilot-tested a mobile app to support nursing workflow at the bedside in their institution,

Nurses Need Training and Policies to Address Barriers to Use of Mobile Devices and Apps for Direct Patient Care in Hospital Settings

Nurses Need Training and Policies to Address Barriers to Use of Mobile Devices and Apps for Direct Patient Care in Hospital Settings

The Environmental Services Perspective on Hospital Room Design: A Mixed-Methods Approach

Our aim is to enhance the safety and efficiency of all healthcare staff by designing patient rooms that meet the physical and cognitive needs of those providing direct and indirect patient care in hospital settings. A mixed-methods study was employed, where findings were compiled from twenty-six environmental services personnel across study activities. The insights were grouped into six categories of challenges with the design of hospital rooms in acute care settings: room cleaning, bathroom, room size, furniture, communication, and a miscellaneous ‘other’ category. There are design implications for storage, room design features, locations of room items, and fabrics and finishes.

Power and resistance within the hospital's hierarchical system: the experiences of chronically ill patients.

To explore experiences of chronically ill patients and registered nurses when they negotiate patient care in hospital settings. Specifically, we explored how social and institutional discourses shape power relations during the negotiation process. The hospital system is embedded in a hierarchical structure where the voice of the healthcare provider as expert is often given more importance than the patient. This system has been criticised as being oppressive to patients who are perceived to be lower in the hierarchy. In this study, we illustrate how the hospital's hierarchical system is not always oppressing but can also create moments of empowerment for patients. A feminist poststructuralist approach informed by the teaching of Foucault was used to explore power relations between nurses and patients when negotiating patient care in hospital settings. Eight individuals who suffered from chronic illness shared their stories about how they negotiated their care with nurses in hospital settings. The interviews were tape-recorded. Discourse analysis was used to analyse the data. Patients recounted various experiences when their voices were not heard because the current hospital system privileged the healthcare provider experts' advice over the patients' voice. The hierarchical structure of hospital supported these dynamics by privileging nurses as gatekeepers of service, by excluding the patients' input in the nursing notes and through a process of self-regulation. However, patients in this study were not passive recipients of care and used their agency creatively to resist these discourses. Nurses need to be mindful of how the hospital's hierarchical system tends to place nurses in a position of power, and how their authoritative position may positively or adversely affect the negotiation of patient care.

The experiences of chronically ill patients and registered nurses when they negotiate patient care in hospital settings: a feminist poststructural approach: A qualitative study that explores negotiation of patient care between patients and chronically ill patients in hospital settings.

The aim of this study was to understand the experiences of chronically ill patients and registered nurse in negotiating patient care in hospital. Specifically, we explored how social and institutional discourses shaped power relations and negotiation of patient care. Current literature indicates that although nurses embrace this notion, such partnerships are not easily implemented. Most existing studies focus on the role of the nurse as the leader of the partnership with little attention paid to how social and institutional values, beliefs and practices shape nurse/patient power relations; or how these relationships are negotiated between nurses and patients. The theoretical and methodological approaches used in this study are based on the precepts of Foucault and feminist poststructural theorists. In depth interviews were conducted with eight chronically ill patients and 10 registered nurses. Both nurses and patients commented about the relationships that develop between nurses and chronically ill patients and how these relationships facilitate negotiation of patient care. Both parties described challenging moments and how institutional discourses may hinder positive negotiations of care. In this paper we highlight three themes that emerged: getting to know each other, they are not the sickest patients and finding time to listen. This study offers an innovative way of unpacking negotiation of care between chronically ill patients and registered nurses. It exposes how social and institutional discourses play a pivotal role in shaping negotiations between nurses and chronically ill patients. Negotiating care with chronically ill patients is not as asymmetric as portrayed in some of the literature and tends to be based on mutual agreements between nurses and patients. Nurses make it a point to listen to patients' needs and resist institutional discourses that preclude them from spending time with patients.

Nurses' perceptions of usefulness of nursing information system: module of electronic medical record for patient care in two university hospitals of iran.

Introduction:For almost fifteen years, the application of computer in hospitals increasingly has become popular. Nurses’ beliefs and attitudes towards computer is one of the most important indicators of the application of nursing information system. The purpose of this study was to investigate the perceptions of nurses on the usefulness of nursing information system for patient care.Methods:Here, a descriptive study was carried out. Sample was consisted of 316 nurses working in teaching hospitals in an urban area of Iran. This study was conducted during 2011 to 2012. A reliable and valid questionnaire was developed as a data collection tool. The collected data was analyzed using descriptive and inferential statistics.Results:It was not believed that nursing information system was useful for patient care. However, it was mentioned that nursing information system is useful in some aspects of patient care such as expediting care, making early diagnosis and formulating diet plan. A significant association was found between the demographic background of sample and their perceptions of the usefulness of nursing information system (P<0.05).Conclusion:Totally, it can be concluded that nursing information system has a potential for improving patient care in hospital settings. Therefore, policy makers should consider implementing nursing information system in teaching hospitals.

Nurse Dose

Inconsistent findings in more than 100 studies have made it difficult to explain how variation in nurse staffing affects patient outcomes. Nurse dose, defined as the level of nurses required to provide patient care in hospital settings, draws on variables used in staffing studies to describe the influence of many staffing variables on outcomes. The aim of this study was to examine the construct validity of nurse dose by determining its association with methicillin-resistant Staphylococcus aureus (MRSA) infections and reported patient falls on a sample of inpatient adult acute care units. Staffing data came from 26 units in Ontario, Canada, and Michigan. Financial and human resource data were data sources for staffing variables. Sources of data for MRSA came from infection control departments. Incident reports were the data source for patient falls. Data analysis consisted of bivariate correlations and Poisson regression. Bivariate correlations revealed that nurse dose attributes (active ingredient and intensity) were associated significantly with both outcomes. Active ingredient (education, experience, skill mix) and intensity (full-time employees, registered nurse [RN]:patient ratio, RN hours per patient day) were significant predictors of MRSA. Coefficients for both attributes were negative and almost identical. Both attributes were significant predictors of reported patient falls, and coefficients were again negative, but coefficient sizes differed. By conceptualizing nurse and staffing variables (education, experience, skill mix, full-time employees, RN:patient ratio, RN hours per patient day) as attributes of nurse dose and by including these in the same analysis, it is possible to determine their relative influence on MRSA infections and reported patient falls.

Adaptive coordination in cardiac anaesthesia: a study of situational changes in coordination patterns using a new observation system

Patient care in hospital settings requires coordinated team performance. Studies in other industries show that successful teams adapt their coordination processes to the situational task requirements. This prospective field study aimed to test a new observation system and investigate patterns of adaptive coordination within operating room teams. A trained observer recorded coordination activities during 24 cardiac surgery procedures. The study tested whether different patterns occur during different phases of and between different types of surgical procedures (two-way multivariate ANOVA with repeated measure). A statistically significant increase was found in clinical and coordination activities in phases of the operation with high task interdependence. The highest level of ‘coordination via the work environment’ (i.e. an implicit coordination mechanism) was recorded during the actual procedure on the beating heart. These findings prove the sensitivity of the observation system developed and evaluated in this study and provide insight into patterns of adaptive coordination in cardiac anaesthesia. This study furthers our understanding of adaptive coordination as a cornerstone of effective team performance in complex work environments. Using a new observation system, it describes patterns employed by health care professionals in response to changing task demands in an acute patient care setting.

Content Analysis of Quality Nursing Care Perceived by Nurses

【Purpose: This study was designed to explore the perceptions of quality nursing care among nurses. Method: The data were analyzed using content analysis. The data were collected from 19 nurses who worked at diverse clinical areas in 8 general and university hospitals with over 400 beds. Result: 1. The attributes of quality nursing care were categorized into 7 hierarchies in the order of 'caring' (40.65%), 'specialty' (29.03%), 'nurse attainments' (15.48%), 'patient- centered nursing management' (6.45%), 'sincerity' (5.16%), 'kindness' (2.58%), 'satisfaction' (0.65%). 2. The concept of quality nursing care were defined as 'giving a satisfaction both to patients and nurses through patient-centered nursing management with specialty and caring in the ground of the kindness and sincerity'. Conclusion: Based on there findings, we suggest that the study results should be used for development of a quality assurance tool in nursing practice, patient care in hospital setting, education of nurses and nursing students. In addition, further repeated studies need to be conducted.】

The relationship between health care reform and nurses' interest in union representation: the role of workplace climate.

Market-based reforms are rapidly changing the landscape of the American health care system. Over the last decade, a great deal of attention has been paid to these reforms, particularly the advent and rapid growth of managed care and the vertical and horizontal integration of provider institutions. The ramifications of these changes on both individual and institutional consumers has also been widely considered by scholars and policymakers. Yet, although these market reforms are driving the massive restructuring of work in hospitals and other health care organizations, comparatively little attention has been paid to the impact these changes have on health care employees and the environment in which they work. This article reports the results of an exploratory study examining the relationship between health care market reforms, nurses' perceptions of the climate for patient care in hospital settings, and nurses' interest in union representation. A model is proposed to help explain nurses' support for union representation in the presence of market-based reforms.

The Social Worker in the Private Practice of Internal Medicine

COMPREHENSIVE medical care is the goal of the internist in private practice today. Such care must often include attention to the emotional and socioeconomic factors that may complicate effective treatment of the patient's physical problems. In an attempt to cope more effectively with these factors, a social worker has been employed in the senior author's private practice. This paper presents our experiences in this relatively undocumented area. 1-3 Social workers have been part of the medical team for many years and their contribution to good patient care in hospital settings and in agencies has been amply demonstrated. The extension of the social worker's services to the field of private office practice seems a logical next step. It is not the purpose of this preliminary report to prove the effectiveness of the social worker per se, but rather to suggest that the private patient treated in the physician's office can derive