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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
461

STATISTISKT SAMBAND MELLAN INTENSIVVÅRDSSJUKSKÖTERSKANS ARBETSBELASTNING OCH PATIENTSÄKERHET : En nationell studie

Edsäker Persdotter, Johanna, Johansson, Elin January 2017 (has links)
Bakgrund: Under de senaste åren har det blivit allt mer uppmärksammat i media om patienters rättigheter i vården och att patientsäkerheten hotas på grund av bristen på sjuksköterskor. Det framhävs att det är särskilt stor brist på specialistutbildade sjuksköterskor och att arbetsbelastningen på intensivvårdsavdelningarna ökar, vilket kan leda till allvarliga konsekvenser för bedrivandet av intensivvård och för att upprätthålla en god patientsäkerhet.   Syfte: Syftet med studien var att undersöka statistiskt samband mellan intensivvårdssjuksköterskans arbetsbelastning och patientsäkerhet.   Metod: Studien genomfördes med en kvantitativ metod med deduktiv ansats och en tvärsnittsstudie gjordes med hjälp av webbenkäter. Alla allmänna intensivvårdsavdelningar i Sverige inkluderades och intensivvårdssjuksköterskorna var tvungna att ha arbetat minst två år. Sammanlagt distribuerades 372 enkäter och 258 svar erhölls vilket gav en svarsprocent på 69.4 procent. Dataanalys utfördes med deskriptiv statistik och korstabulering. Med hjälp av en bivariat analys kunde vi jämföra om det fanns statistiskt samband mellan patientsäkerhet och arbetsbelastning.   Resultat: Resultatet visar att det finns statistiskt samband mellan patientsäkerhet och arbetsbelastning. Patientsäkerheten påverkas negativt av en högre arbetsbelastning. Intensivvårdssjuksköterskorna uppger att de tvingas utföra ett sämre jobb relaterat till tidspressen och att arbetsbelastning är för hög. Resultatet visar att intensivvårdssjuksköterskorna anser att det finns välfungerande system för rutiner och avvikelser men på grund av en hög arbetsbelastning kan inte systemen och rutinerna följas vilket påverkar patientsäkerheten negativt.   Slutsats:Den här studien ger belägg att lyfta intensivvårdssjuksköterskornasarbetsbelastning i förhållande till patientsäkerhet och underlag för att vidta åtgärder inom berörda verksamheter. Åtgärder i form av en attraktivare, hälsosammare och patientsäkrare arbetsplats. Exempelvis arbetstidsförkortning som ger möjlighet till återhämtning mellan arbetspassen.Det är nödvändigt att se över arbetsbelastningen på intensivvårdsavdelningar nationellt för att inte mer omfattande patientsäkerhetsbrister ska ske. / Background: In recent years there has been increasing attention in the media about the right of patients in health care and that the safety of a patient is threatened because of the shortage of nurses. In particular, the current lack of specialized nurses and the increased workload in the intensive care units could lead to serious consequences regarding the provision of intensive care and maintaining high patient safety.   Objective: The objective of this study was to investigate the statistical connection between the workload of an intensive care nurse and the patient safety.   Method: The study was performed by a quantitative method with a deductive approach and a cross-sectional study was done using surveys on the web. All general intensive care units in Sweden were included and the intensive care nurses needed to have worked for at least two years. A total of 372 surveys were distributed and 258 responses were received giving a response rate of 69.4 percent. Data analysis was performed by descriptive statistics and cross tabulation. Using a two-dimensional analysis, the authors could compare whether there was a link between the patient safety and the workload.   Result: The result indicates that there is a statistical connection between patient safety and workload. Patient safety is negatively affected by a higher workload. The intensive care nurses state that they are forced to do a worse job related to time pressure and because of that the workload is too high. The result shows that today it is felt that there is a well functioning system of procedures and divergences but because of a high workload, the system and the procedures cannot be followed which affect patient safety negatively.   Conclusion: This study demonstrates proof to highlight critical care nurses' workload in relation to patient safety and evidence to take action within the relevant business. Arrangements such as an attractive, healthier and safer workplace for the patient. For an example, shorter working hours that allows recovery between shifts. It is a necessity to revise the workload in the intensive care units nationwide for not more extensive patient safety defects to occur.
462

Slut, kom : En intervjustudie om kommunikation mellan ambulansdirigenter och ambulanssjuksköterskor

Hultqvist, Anna, Åberg, Caroline January 2017 (has links)
Introduktion: Dagens sjukvård består av olika vårdkedjor där larmcentralen och ambulanssjukvården utgör den första länken för många patienter. Larmcentralen ansvarar för att ta emot, hantera och prioritera nödsamtal som sedan dirigeras ut till ambulansverksamheten. God interprofessionell kommunikation är en förutsättning för att länken ska vara intakt och därmed främja en patientsäker vård. Den forskningsbrist som råder i området motiverar studiens genomförande.   Syfte: Att beskriva förutsättningar för kommunikation mellan ambulansdirigenter och ambulanspersonal utifrån ambulansdirigenters och ambulanssjuksköterskors erfarenheter.   Metod: Studien är en kvalitativ intervjustudie med induktiv ansats. Ett bekvämlighetsurval tillämpades och tolv semistrukturerade intervjuer genomfördes. Analysen utgick ifrån en latent innehållsanalys i enlighet med Lundman och Hällgren Graneheim (2012).   Resultat: Ett tema formades ur den latenta analysen, vilket benämns Mot samma mål trots olika förutsättningar. Resultatet redovisas utifrån två huvudkategorier; teknikens förtjänster och begränsningar samt personliga förmågor. Dessa bygger på sex underkategorier som beskriver informanternas erfarenheter gällande kommunikationen dem emellan. Underkategorierna benämns vara beroende av kommunikationsteknik, behov av samtal, bemötande, hantera stress, ifrågasättande och bristande tillit samt förståelse för varandras uppdrag. Det framkom att fungerande teknik och korrekt hantering av den är centralt för kommunikationen. Oavsett vad rutiner säger så finns det i vissa situationer ett behov av muntlig kommunikation. De personliga egenskaperna påverkar hur kommunikationen fortlöper.   Slutsats: Tekniken måste fungera och personalen måste vara välutbildade inom det tekniska handhavandet. Möjligheten till hospitering inom de båda verksamheterna anses vara av stor vikt för att bidra till en ökad förståelse, vilket på sikt kan förbättra den interprofessionella kommunikationen mellan dem. / Introduction: Today's health care consists of different care chains where SOS Alarm and the ambulance service constitute the first link for many patients. SOS Alarm is responsible for receiving, manage and prioritize emergency calls which are then routed out to the ambulance. Good interprofessional communication is a prerequisite for the link to be intact and thereby achieve a safe care for the patient. The lack of research in the area justifies the implementation of this study.   Aim: To describe the conditions for communication between ambulance conductors and ambulance staff based on the experiences of ambulance conductors and ambulance nurses.   Method: The study is a qualitative interview study with an inductive approach. A convenience sample was applied and twelve semi-structured interviews were conducted. The analysis was based on a latent content analysis in accordance with Lundman and Hällgren Graneheim (2012).   Result: A theme was formed from the latent analysis, which is called Towards the same goals despite different conditions. The result is reported on two main categories: The benefits and limitations of the technology as well as personal abilities. These are based on six subcategories which describes the informants' experiences regarding communication between them. The subcategories are called dependency on communication technology, need for conversation, attitude, dealing with stress, questioning and lack of confidence, and understanding of each other's assignments. It emerged that working technology and proper handling of it are central to communication. Regardless of what routines say, there is a need for oral communication in certain situations. Personal qualities affect how communication progresses.   Conclusion: Is that the technology must be working and the staff must be well-trained in the technical handling. The possibility of visits in each other’s organizations are considered to be of great importance to contribute to a greater understanding, which ultimately can improve communication between them.
463

Sjuksköterskors upplevelser av kommunikation i traumateam- En kvalitativ intervjustudie

Gunnarsson, Liselotte, Arvidsson, Victoria January 2017 (has links)
Bakgrund: Traumavård innebär vård av allvarligt somatiskt skadade patienter. För att vårda dessa patienter samlas multiprofessionella team, vilket ställer krav på teamarbete och god kommunikation för ett säkert och strukturerat omhändertagande. Kommunikation och informationsöverföring är ett riskområde inom vården och sambandet mellan bristande kommunikation och bristande behandlingsresultat är väldokumenterat. Traumaomhändertagande är en stressfylld situation, som ställer stora krav på sjuksköterskan på akutmottagningen, och innebär utmaningar för att uppnå en välfungerande kollaborativ kommunikation. Syfte: Syftet var att belysa sjuksköterskors upplevelser av kommunikation i traumateam. Metod: Studien genomfördes med en kvalitativ ansats, där semistrukturerade intervjuer genomfördes med 11 sjuksköterskor som arbetar på två akutmottagningar. En kvalitativ innehållsanalys genomfördes av datamaterialet. Resultat: Studiens resultat genererade i ett tema Kommunikation – ett komplext samspel, vilket belyser komplexiteten av kommunikation i traumateam. Resultatet presenteras i tre huvudkategorier: Kollaborativ kommunikation utmanar, Struktur- att förhålla sig till vissa ramar och Kommunikationen påverkar patienten. Komplexiteten i kommunikationen inom teamet beror på personliga egenskaper samt hur teamarbetet fungerar i övrigt. Vikten av struktur och att förhålla sig till riktlinjer och rutiner påverkar kommunikationen, och ledarskapet spelar här en central roll. Kommunikationens kvalitet påverkar utfallet för patienten och är något som förbättras genom traumaövning. Slutsats: Studien identifierar komplexiteten av kommunikationen inom traumateamet. Ett tydligt ledarskap och teamets samspel spelar en avgörande roll för utfallet för patienten, och vikten ligger i att kommunicera rakt och tydligt. Brister i kommunikation leder till ett försämrat teamarbete och negativa påföljder för patient. Genom traumaövning kan kommunikationen främjas och sjuksköterskan stärker sin yrkesroll. / Background: Trauma care involves the care of seriously somatic injured patients. To care for these patients a multi-disciplinary team is gathered, which requires teamwork and good communication skills for a safe and structured care of the patient. Communication and the transmit of information comprise a risk in healthcare and the relationship between bad communication and lacking treatment results is widely documented. Trauma care is a stressful situation that put demands on the nurse at the emergency department, and means challenges to achieve an effective collaborative communication. Aim: The aim was to illustrate nurses´ experiences of communication in the trauma team. Method: The study was conducted with a qualitative approach, where semi-structured interviews were performed with 11 nurses working in two emergency departments. All the data was analyzed by the help of qualitative content analysis method. Result: Study results generated in a theme Team communication -and its complexity. The result is presented in three main categories: The challenges of collaborative communication, Structure- to relate to certain rules and The Communication affects the patient. The complexity of communication within the team depends on personal characteristics and how teamwork otherwise functions. The value of leadership is essential as well as a structured approach and how to relate to policies and routines. The communication quality affects the care process for the patient and can be improved by trauma training.    Conclusion: The study identifies the complexity of communication within the trauma team. Leadership and team interaction plays a crucial role for the outcome of the patient. It is of importance to communicate direct and clear. Lack of communication leads to impaired teamwork and adverse consequences for the patient safety. By trauma training, communication can be promoted and the nurses develop professional skills.
464

Självständighet förutsätter delaktighet : Perioperativa sjuksköterskors upplevelser av hur förståelse påverkar teamarbetet

Arvidson Svensson, Annie, Johansson, Emma January 2017 (has links)
Bakgrund: På en operationssal är teamarbetet viktigt, dels för att arbetet ska fungera men också för att säkerställa patientsäkerheten. En viktig aspekt i teamarbetet är att de perioperativa sjuksköterskorna känner att de andra i teamet har förståelse för deras arbetsuppgifter. Syfte: Syftet med studien var att belysa perioperativa sjuksköterskors upplevelser av teamarbetet utifrån förståelse för deras arbetsuppgifter. Metod: En kvalitativ induktiv intervjustudie genomfördes med 16 perioperativa sjuksköterskor från tre små till mellanstora sjukhus i södra Sverige. Datamaterialet analyserades utifrån en kvalitativ latent innehållsanalys. Resultat: Studien visar att det finns flera saker som påverkar teamarbetet och sjuksköterskorna upplever att även om förståelsen för deras arbete från andra teammedlemmar oftast är bra, finns det möjligheter till förbättring. Ur resultatet framträdde det övergripande temat självständighet förutsätter delaktighet, med kategorierna yrkesroll, samverkan, arbetsmiljö och patientsäkerhet och därtill hörande underkategorier. Slutsats: Nyttan är att ge perioperativ personal en insikt i vad som kan underlätta teamarbetet. Det behövs fortsatt forskning inom ämnet, men det är också viktigt att utbildningar och arbetsplatser satsar på att träna teamarbete för att öka kunskapen och förståelsen mellan professionerna. / Background: In an operating theatre teamwork is important, partly to get the job done, but also to ensure patient safety. An important aspect of teamwork is that perioperative nurses feel that the other members of the team understand their work assignments. Aim: The aim of this study was to highlight perioperative nurses' experiences of teamwork based on an understanding of their work assignments. Method: A qualitative inductive interview study was conducted with 16 perioperative nurses from three small to medium-sized hospitals in southern Sweden. The data were analyzed based on a qualitative latent content analysis. Results: The study shows that there are several aspects that affect teamwork and nurses feel that although understanding of their work assignments from other team members usually are good, there are possibilities for improvement. The overall theme independence requires participation emerged from the result, as well as the categories profession, collaboration, work environment and patient safety with related subcategories. Conclusion: To give perioperative personnel an insight into what might facilitate teamwork can be beneficial.  Further research on the topic is required, but it is also important that schools and workplaces practice teamwork to increase knowledge and understanding between different professions.
465

Sjuksköterskors erfarenheter av att vårda satellitpatienter : Jakten på vårdplatser i den svenska hälso- och sjukvården. / Nurses’ Experiences of Caring for Outlocated Patients : – The chase after hospital beds in the Swedish healthcare.

Alexandersson, Sofie, Brickarp, Louise January 2017 (has links)
Bakgrund: Just nu råder brist på vårdplatser på flera svenska sjukhus. Detta har lett till att vårdavdelningar överbeläggs, vilket hittills lösts bland annat genom att utlokalisera patienter till andra avdelningar än den dit de egentligen tillhör. Följande studie behandlar olika aspekter relaterade till vården av dessa patienter, även kallade satellitpatienter. Syfte: Syftet med studien var att beskriva sjuksköterskors erfarenheter av att vårda satellitpatienter. Metod: En intervjustudie med deduktiv ansats genomfördes, där data samlades in via semistrukturerade intervjuer med åtta sjuksköterskor. Intervjuerna spelades in, transkriberades och analyserades slutligen utifrån Hsieh och Shannons beskrivning av kvalitativ innehållsanalys. Resultat: Sex huvudkategorier har identifierats; Effekter av att utlokalisera patienter, Kommunikation mellan vårdgivare, Vårdpersonalens kompetens, Arbetsmiljö, Teamarbete samt Förslag till förbättringar. Dessa beskriver tillsammans sjuksköterskornas erfarenheter av att vårda satellitpatienter. Konklusion: I studien framkom att sjuksköterskornas erfarenheter i samband med vården av denna patientgrupp främst genomsyras av en oro kring en bristande patientsäkerhet. Deltagarna lyfter vidare att sjuksköterskors arbetsmiljö och arbetsvillkor behöver förbättras för att kunna öppna upp vårdplatser, minska antalet satellitpatienter och därmed kunna bedriva en patientsäker vård. / Background: A shortage of hospital beds prevails in Swedish hospitals at the moment. This has led to care unit overcrowdings, which so far has been solved by outlocation of patients. This study’s background presents a variety of aspects related to these patients’ care, who sometimes also are called satellite patients. Aim: To describe nurses’ experiences of caring for satellite patients. Method: An interview study with a deductive approach has been conducted. Data was collected by semi-structured interviews with eight registered nurses. The interviews were recorded, transcribed and lastly analyzed from Hsieh and Shannon’s description of qualitative content analysis. Result: Six categories were identified; Effects of Outlocating Patients, Communication Between Caregivers, Competence Among Nursing Staff, Work Environment, Teamwork and Suggestions for Improvement. Together, these describe the nurses’ experiences of caring for satellite patients. Conclusion: Nurses’ experiences of caring for these patients were mainly characterized by a concern for patient safety. The participants also mentioned that nurses’ work environment and work terms needs to improve in order to open hospital beds, reduce the number of satellite patients and thereby maintain a safe and equivalent care.
466

Factors That Predict Incident Reporting Behavior in Certified Registered Nurse Anesthetists

Damico, Nicole K 01 January 2014 (has links)
Improving patient safety through reduction of medical errors is a national priority. One of the strategies widely utilized to address this issue is the use of incident reporting systems. The purpose of this study was to describe factors that predict the likelihood that Certified Registered Nurse Anesthetists (CRNAs) will use incident reporting systems, guided by the theory of planned behavior (Ajzen, 1991). A non-experimental, correlational research design was utilized to achieve the study aims. Following IRB approval, a cross-sectional survey was administered electronically to a random sample of practicing CRNAs. Correlational analyses and a standard logistic regression were utilized to determine the relationship between cognitive factors and CRNAs' use of incident reporting systems. Two hundred and eighty-three practicing CRNAs participated in this study. These CRNAs value incident reporting, perceive social pressure to report, and feel in control over reporting, yet had not consistently used existing incident reporting systems in the past 12 months. A CRNA’s attitude toward reporting and the degree to which he or she perceived social pressure to report, were determined to be significant predictors of the likelihood that a CRNA would use an incident reporting system. Social pressure to report was the most important factor in the prediction model. The results of this study revealed that there are missed opportunities for learning from patient safety incidents in anesthesia practice. The information gained in this study has the potential to assist organizations in the design of strategies to promote incident reporting by practicing CRNAs.
467

Sécurité du patient en chirurgie thyroïdienne : intérêt du suivi des complications par cartes de contrôle / Patient safety in thyroid surgery : value of complications monitoring using control charts

Duclos, Antoine 29 April 2010 (has links)
A l’hôpital, le bloc opératoire représente un environnement à risque pour le patient. La réalisation d’une chirurgie thyroïdienne demeure une tâche complexe dont le résultat dépend de la combinaison d’une multitude de facteurs qui demeurent mal connus. L’application des méthodes de contrôle qualité développées dans l’industrie peut être utile à leur découverte. Pendant quatre années, nous avons suivi la performance collective et individuelle d’une équipe chirurgicale à l’aide de cartes de contrôle. Des cartes de Shewhart et des cartes CUSUM ont été conçues pour analyser les variations des complications de la thyroïdectomie au cours du temps. Leur mise en place s’est accompagnée d’une réduction immédiate des hypocalcémies postopératoires, puis d’une stabilisation progressive des paralysies récurrentielles. La suractivité chirurgicale a été identifiée comme cause à l’origine d’une dégradation momentanée de la performance de l’équipe. Cette expérience de terrain a montré l’applicabilité des cartes de contrôle à la chirurgie thyroïdienne ainsi que leur intérêt pour aider les chirurgiens à interpréter la variabilité de leurs résultats et à maitriser les facteurs y concourant. Cependant, seules des actions concrètes destinées à améliorer la qualité de la prise en charge peuvent réduire la survenue de complications opératoires. Leur conception implique de mieux comprendre les facteurs influençant la performance du chirurgien et le travail en équipe au bloc opératoire pour garantir la sécurité du patient. / The operating room represents a high risk environment for the patient. Thyroid surgery remains a complex task whose outcome depends on the combination of poorly understood factors. Implementation of industrial quality control methods can be helpful in discovering them. For four years, we have monitored the individual and collective performance of a surgical team using control charts. Shewhart and CUSUM charts have been designed for analyzing the variations of thyroidectomy related complications over time. Their introduction immediately led to a reduction of postoperative hypocalcaemia, and then to a gradual stabilization of recurrent nerve palsy. The surgical overactivity was identified as a root cause of a temporary worsening of the team performance. This field study has shown the applicability of control charts in thyroid surgery and their value to assist surgeons in interpreting and controlling their results' variability. However, only concrete actions aiming at improving the quality of care may reduce the incidence of surgical complications. Designing these actions involves understanding the factors that influence the surgeon's performance and teamwork within operating room to ensure the patient safety.
468

Horizontal Violence in the Nursing Work Environment: Beyond Oppressed Group Behavior

Mendez, Therese M 17 December 2011 (has links)
The United States has been experiencing a nursing shortage since the mid-1990s. The shortage is expected to deepen as the provisions of the 2010 Patient Protection and Affordable Care Act are enacted. Horizontal violence is a negative phenomenon in the nursing workplace that contributes to difficulty in recruiting and retaining nurses in hospitals. Horizontal violence has been described as a form of mistreatment, spoken or unspoken, that is threatening, humiliating, disrespectful or accusatory towards a peer. The effects of this nurse on nurse aggression can be devastating for the nurse involved and also for the patients under the nurse's care. Nursing and social science literature have advanced oppressed‐group behaviors as a motivating factor driving this phenomenon in nursing. Workplace stress has also been implicated in these negative behaviors. This study used a grounded theory approach to examine how nurses explain, through semi‐structured and open ended interviews, the phenomenon of horizontal violence in the nursing workplace. The primary outcome of this study was a small scale theory focused specifically on horizontal violence in the nursing work environment. The theory that emerged from this analysis was that horizontal violence can be influenced by other environmental factors beyond oppression theory. The results from the data indicated that these behaviors, described as horizontal violence, may be employed as a method of manipulating the care environment in an effort to enhance patient outcomes while maintaining group or individual perception of security through a sense of environmental control.
469

Ett glapp i vårdkedjan? : En systematisk litteraturstudie som belyser patientsäker utskrivning från intensivvård till vårdavdelning / A gap in the chain of care? : A systematic literature review that illuminate patient safety during discharge from intensive care to ward

Elofsson, Isabelle, Fagher, Rebecca January 2019 (has links)
Bakgrund: Utskrivning från en intensivvårdsavdelning (IVA) till vårdavdelning kan vara ett kritiskt moment för patienten och involverad personal då det är mycket som kan gå fel i utskrivningsprocessen. Att bibehålla patientsäkerheten i samband med utskrivning ses idag som en utmaning då det är flera olika aktörer som är med i vårdkedjan, vilket ställer höga krav på samarbetet sinsemellan. Brister i utskrivningsprocessen ökar risken för återinläggningar till intensivvården vilket är förknippat med ökad mortalitet. Syfte: Att undersöka vårdpersonalens upplevelse kring vad som påverkarpatientsäkerheten i utskrivningsprocessen från IVA till vårdavdelning. Metod: En systematisk litteraturstudie baserad på analys av kvalitativ data utifrån Bettany-Saltikov och McSherry metod (2016). Resultat: Vårdpersonalen upplevde en skillnad i vårdnivå mellan IVA och vårdavdelning, vilket påverkade patientsäkerheten då det orsakade glapp ivårdkedjan vid utskrivning. En nivå mellan IVA och vårdavdelning upplevdes som fördelaktigt - men existerade sällan. Vårdavdelningen kunde upplevas som en sårbar destination på grund av mindre resurser och kompetens. Brister i informationsöverföringen i samband med utskrivning upplevdes äventyra patientsäkerheten. Planering och uppföljning i samband med utskrivningsprocessen upplevdes betydelsefullt för att minska glappet i vårdkedjan. Slutsats: Utskrivning från IVA till vårdavdelning innefattar ett glapp i vårdkedjan vilket upplevs äventyra patientsäkerheten då det kan leda till vårdskador i samband med utskrivning. Utifrån systemteorin så hade mycket kunnat undvikas genom att se över den organisatoriska strukturen i sjukvården. Utskrivningsprocessen är komplex och alla delar i systemet påverkar varandra cirkulärt. Ingen (vård)kedja är starkare än sin svagaste länk. / Background: Discharge from intensive care unit (ICU) to a general ward might be a critical moment for both the patients and staff involved and there’s a lot that can go wrong in the discharge process. To maintain patient safety in the connection of discharge is a great challenge because the numbers of actors involved. This requires a high ability to cooperate. Deficiencies in the discharge process increases the risk for readmissions which is associated with increased mortality. Aim: To investigate healthcare personnel experience about what affects patient safety in the discharge process from ICU to ward. Method: A systematic review based on analysis of qualitative data after Bettany-Saltikov and McSherry (2016) method. Result: The ward personnel experienced a difference in the level of care between ICU and ward, which caused a gap that affected patient safety in the discharge process. An in-between level of care could reduce the gap, but seldom existing. The ward could be experienced as vulnerable, because lack of resources and competence. Shortcomings in the information transfer occurred during the discharge process, which was experienced to jeopardize patient safety. Planning and follow-upservice were experienced as important to avoid a gap in the care of chain. Conclusion: Discharge from ICU to ward comprises a gap in the care of chain which is experienced to jeopardize patient safety. This could lead to adverse events.The framework of system theory shows that much could be avoided by overlooking the organizational structures in healthcare, which often is the underlying cause to failure in patient safety. The discharge process is complex and all the parts affects each other circularly. No care of chain is stronger than the weakest link.
470

Clima organizacional e ocorrência de acidentes com materiais perfurocortantes num hospital público do Estado de São Paulo / Organizational climate and occurrence of sharps injuries in a hospital in São Paulo State

Souza, Letícia Silva de 09 December 2016 (has links)
Atualmente, a avaliação do clima organizacional tem sido considerada importante ferramenta de gestão nas instituições de saúde. O objetivo deste estudo foi avaliar o clima organizacional e a sua relação com a ocorrência de acidentes de trabalho com material perfurocortante entre os profissionais de enfermagem em um hospital público de média complexidade do interior do Estado de São Paulo. Trata-se de um estudo de abordagem quantitativa, descritivo e transversal. Para a coleta de dados, foi utilizada a versão validada e adaptada para o contexto brasileiro do Safety Attitudes Questionnaire (SAQ) - Short Form, denominada Questionário de Atitudes de Segurança - QAS. Por meio do QAS foi possível avaliar a percepção dos trabalhadores acerca do clima de trabalho em equipe, clima de segurança, satisfação profissional, percepção do estresse, ações da gerência quanto às questões de segurança e as condições de trabalho. As respostas foram dadas por meio da escala Likert de cinco pontos e o processamento e a análise dos dados foram realizados com o auxílio do programa Statistical Package for Social Science (SPSS), versão 17.0. Para relacionar o clima organizacional com a ocorrência de acidentes de trabalho, inicialmente, foi realizado levantamento junto ao Serviço Especializado de Medicina e Segurança do Trabalho - SESMT dos registros de acidentes de trabalho ocorridos no período 2008-2014 e foram identificados os trabalhadores de enfermagem vítimas desses acidentes. Após este levantamento, foram constituídos dois grupos: Grupo 1 - profissionais de enfermagem que sofreram acidentes de trabalho envolvendo perfurocortantes; Grupo 2 - profissionais de enfermagem que não sofreram acidente de trabalho com perfurocortantes. A análise dos dados foi realizada por meio de estatística descritiva com testes de comparação entre as variáveis dos grupos. A amostra do estudo foi constituída por 116 participantes, técnicos de enfermagem e enfermeiros atuantes em unidades de internação hospitalar, sendo o Grupo 1 composto por 21 participantes e o Grupo 2 composto por 95 participantes. Predominaram participantes do sexo feminino, técnicos de enfermagem e profissionais com cinco a 10 anos de atuação na instituição. A percepção dos participantes quanto ao clima organizacional foi considerada desfavorável; no entanto, foi considerada satisfação no trabalho pela maioria dos participantes. Os resultados não indicaram relação direta entre o clima organizacional e a ocorrência de acidentes com perfurocortante, mas foi possível observar que o grupo que não sofreu acidentes apresentou maior satisfação no trabalho. Considera-se que este estudo permitiu ampliar o conhecimento acerca da percepção de profissionais de enfermagem sobre o clima organizacional, contribuindo para a discussão sobre formas de melhoria da assistência segura, de redução de eventos adversos e sobre a qualidade da assistência de enfermagem / Recently, evaluation of organizational climate has been considered an important management tool in health institutions. The aim of this study was to evaluate the organizational climate and its relationship with the occurrence of accidents with needlestick materials among nursing professionals in a public hospital of medium complexity in the state of São Paulo. It is a study of quantitative, descriptive and cross-sectoral approach. The instrument Safety Attitudes Questionnaire (SAQ) was used - Short Form, 2006, validated and adapted version for the Portuguese language (Safety Attitudes Questionnaire - QAS). Through the areas of QAS was possible to assess attitudes about the working environment in staff, safety climate, job satisfaction, perceived stress, management actions regarding safety issues and working conditions. The answers were given by Likert scale of five points, processing and data analysis was performed with the aid of the Statistical Package for Social Sciences (SPSS) version 17.0. To relate the organizational climate with the occurrence of accidents with sharps survey was carried out by the Specialized Service of Medicine and Safety - SESMT with records of work accidents in the period 2008-2014 and workers were identified nursing victims of these accidents. Constituted two groups: Group 1 - nursing professionals who were victims of work accidents involving sharps; Group 2 - nursing professionals who did not undergo occupational accidents with needlestick during the study period. After conformal groups, the data analysis was performed using descriptive statistics with correlation tests between the variables of the groups in order to analyze possible relationship between accidents and the adoption of safety measures by the professional. The study sample consisted of 116 participants, nursing technicians and nurses working in hospital units. Group 1 consisted of 21 participants and Group 2 consists of 95 participants. Predominated female participants, nursing technicians and professionals with five to 10 years of experience in this institution. The perception of the participants about the organizational climate was considered unfavorable, however it was observed that job satisfaction was evidenced by most of the participants, demonstrating how they feel during the exercise of the profession in this institution. On the relationship between organizational climate and the occurrence of accidents with needlestick materials, the results indicated no direct relationship between organizational climate and the occurrence of such accidents, however it was observed that the group that did not suffer sharps injuries was the group that presented greater job satisfaction. Thus, this study promotes the opportunity to meet the professionals\' perception of the organizational climate and can contribute to improvement of safe care, reduce adverse events and improve the quality of patient care

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