https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)62631-8.pdf

Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study

The extent to which member states transpose EU directives in a timely fashion is often argued to be strongly associated with the general effectiveness of national bureaucracies. But what kind of institutional solutions ensure better performance? This paper examines the patterns and effects of departmental oversight across 28 ministries in Estonia, Hungary, Poland and Slovenia. In mapping the strength of oversight, it relies on around 90 structured interviews regarding the rules-in-use on transposition planning, legal review and monitoring of deadlines. The analysis of the impact of departmental oversight is based on an original dataset of over 300 directives with transposition deadlines between January 2005 and December 2008.

On the european union

Five subscales were derived from the Nursing Work Index (NWI) to measure the hospital nursing practice environment, using 1985-1986 nurse data from 16 magnet hospitals. The NWI comprises organizational characteristics of the original magnet hospitals. The psychometric properties of the subscales and a composite measure were established. All measures were highly reliable at the nurse and hospital levels. Construct validity was supported by higher scores of nurses in magnet versus nonmagnet hospitals. Confirmatory analyses of contemporary data from 11,636 Pennsylvania nurses supported the subscales. The soundness of the new measures is supported by their theoretical and empirical foundations, conceptual integrity, psychometric strength, and generalizability. The measures could be used to study how the practice environment influences nurse and patient outcomes.

Practice Environment Scale of the Nursing Work Index

Nurses’ reports of working conditions and hospital quality of care in 12 countries in Europe

Determinants and prevalence of burnout in emergency nurses: A systematic review of 25 years of research

Objective To determine whether hospitals with a good organisation of care (such as improved nurse staffing and work environments) can affect patient care and nurse workforce stability in European countries. Design Cross sectional surveys of patients and nurses. Setting Nurses were surveyed in general acute care hospitals (488 in 12 European countries; 617 in the United States); patients were surveyed in 210 European hospitals and 430 US hospitals. Participants 33 659 nurses and 11 318 patients in Europe; 27 509 nurses and more than 120 000 patients in the US. Main outcome measures Nurse outcomes (hospital staffing, work environments, burnout, dissatisfaction, intention to leave job in the next year, patient safety, quality of care), patient outcomes (satisfaction overall and with nursing care, willingness to recommend hospitals). Results The percentage of nurses reporting poor or fair quality of patient care varied substantially by country (from 11% (Ireland) to 47% (Greece)), as did rates for nurses who gave their hospital a poor or failing safety grade (4% (Switzerland) to 18% (Poland)). We found high rates of nurse burnout (10% (Netherlands) to 78% (Greece)), job dissatisfaction (11% (Netherlands) to 56% (Greece)), and intention to leave (14% (US) to 49% (Finland, Greece)). Patients’ high ratings of their hospitals also varied considerably (35% (Spain) to 61% (Finland, Ireland)), as did rates of patients willing to recommend their hospital (53% (Greece) to 78% (Switzerland)). Improved work environments and reduced ratios of patients to nurses were associated with increased care quality and patient satisfaction. In European hospitals, after adjusting for hospital and nurse characteristics, nurses with better work environments were half as likely to report poor or fair care quality (adjusted odds ratio 0.56, 95% confidence interval 0.51 to 0.61) and give their hospitals poor or failing grades on patient safety (0.50, 0.44 to 0.56). Each additional patient per nurse increased the odds of nurses reporting poor or fair quality care (1.11, 1.07 to 1.15) and poor or failing safety grades (1.10, 1.05 to 1.16). Patients in hospitals with better work environments were more likely to rate their hospital highly (1.16, 1.03 to 1.32) and recommend their hospitals (1.20, 1.05 to 1.37), whereas those with higher ratios of patients to nurses were less likely to rate them highly (0.94, 0.91 to 0.97) or recommend them (0.95, 0.91 to 0.98). Results were similar in the US. Nurses and patients agreed on which hospitals provided good care and could be recommended. Conclusions Deficits in hospital care quality were common in all countries. Improvement of hospital work environments might be a relatively low cost strategy to improve safety and quality in hospital care and to increase patient satisfaction.

/pdf/patient-safety-satisfaction-and-quality-of-hospital-care-569u8f4bow.pdf

Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States.

A systematic survey instrument translation process for multi-country, comparative health workforce studies

The main purpose of this work is to develop an Electronic Health Record (EHR), for the registration of clinical data, combined spatial Databases and GIS techniques. The main idea behind this work is the development of a real time efficient EHR environment in which clinical data could be analyzed and combined directly providing sections like statistical analysis, graphical presentation and GIS representation introducing disease monitoring. These monitoring results could be used as pilot directions for the spatial epidemiological analysis taking advantage geographical information for understanding the dynamics of health. Moreover the role of spatial information in the health sector in relation to the benefits of the GIS systems is illustrated combined with the spatial assumptions introducing a real-time health monitoring tools and geographic information systems. The EHR includes demographic data of the patients, followed by clinical data of the current and previous hospital admissions (like blood test data, medical actions, biological examinations, etc). The data can easily be extracted from the database for the implementation of statistical analysis with the use of the appropriate software. Demonstration of the system based on a short patient dataset was performed showing the benefits of the HER.

/pdf/an-electronic-health-record-model-for-the-spatial-4o7tw9i0tu.pdf

Dimitris Zikos

Papers

Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States.

A systematic survey instrument translation process for multi-country, comparative health workforce studies

An Electronic Health Record Model for the Spatial Epidemiological Analysis of Clinical Data

Integrating a Geographic Information System (gis ) with ElectronicvHealth Record: Application for Spatial Epidemiological Data