A study from the University of Pennsylvania School of Nursing has found that 25 percent of practicing nurses and social workers experience "moral distress" causing them to want to leave their current positions, and fully 41 percent failed to say they would chose their profession again.
In one of the first studies to investigate the relationship between ethics and intent to leave, Penn Nursing assistant professor Connie Ulrich, PhD, RN, found "moral distress" led to feelings of powerlessness (32.5 percent), feeling overwhelmed (34.7 percent), frustration (52.8 percent) and fatigue (40 percent), noting that the nurses' desire to leave is in part fueled by experiencing more "ethical stress" and an inadequate level of institutional support for dealing with ethical decisions, as well as a perception of little respect for their profession. The study's findings were published in Social Science and Medicine.
Issues causing moral distress include protecting patients' rights, supporting them through difficult decisions at the end of life, and fairly distributing resources. "Nurses reported feeling that they cannot adequately protect patient's rights or the informed decisions of patients and must balance these and other conflicting issues with a hospital's bottom line," Ulrich said.
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Wednesday, June 25, 2008
Tuesday, June 24, 2008
How much time do you actually spend at the bedside?
Study Finds Nurses Spend Bulk of Time Away from Bedside
A study in The Permanente Journal finds that nurses devote more than 75 percent of their time to nursing practice but spend only about one-third of that in patient rooms, Modern Healthcare reports.
Supported by the Robert Wood Johnson Foundation and the Gordon and Betty Moore Foundation, the study assigned 767 licensed nurses from 36 medical-surgical units within 17 health care systems in 15 states to carry hand-held computers, four sensors to track movement and an armband that recorded physiological responses for 23 hours each day during one week.
In analyzing nurses' daily activities, researchers found that documentation required the most time, accounting for roughly 2.5 hours of every 10-hour shift. Care coordination was the next most time-intensive activity, occupying roughly 86 minutes per shift, followed by medication administration at about 72 minutes per shift, and patient assessments and the reading of vital signs at roughly 31 minutes per shift. In addition, the researchers found that nurses spent an average of 36 minutes per shift waiting for, delivering or searching for items, activities that the researchers note "are clearly targets for improving efficiency."
In terms of location during nursing practice, nurses spent 37.4 percent of their time in patient rooms, 43.3 percent of their time at the nurse station, 17.6 percent of their time on the patient unit and 1.6 percent of their time off the unit.
Commenting on this breakdown, the researchers note that the majority of documentation and care coordination activities take place at the nurse station. They add, meanwhile, that the nurses walked an average of 3.1 miles per shift, time that the researchers say could be better spent tending to patients. Based on their findings, the researchers identify three main targets for reducing inefficiency, including documentation, medication administration and care coordination. Specifically, they recommend that hospitals focus their efforts on improving technology, work processes, and unit organization and design, noting that changes to those areas could "allow for substantial improvements in the use of nurses' time and the safe delivery of care."
A study in The Permanente Journal finds that nurses devote more than 75 percent of their time to nursing practice but spend only about one-third of that in patient rooms, Modern Healthcare reports.
Supported by the Robert Wood Johnson Foundation and the Gordon and Betty Moore Foundation, the study assigned 767 licensed nurses from 36 medical-surgical units within 17 health care systems in 15 states to carry hand-held computers, four sensors to track movement and an armband that recorded physiological responses for 23 hours each day during one week.
In analyzing nurses' daily activities, researchers found that documentation required the most time, accounting for roughly 2.5 hours of every 10-hour shift. Care coordination was the next most time-intensive activity, occupying roughly 86 minutes per shift, followed by medication administration at about 72 minutes per shift, and patient assessments and the reading of vital signs at roughly 31 minutes per shift. In addition, the researchers found that nurses spent an average of 36 minutes per shift waiting for, delivering or searching for items, activities that the researchers note "are clearly targets for improving efficiency."
In terms of location during nursing practice, nurses spent 37.4 percent of their time in patient rooms, 43.3 percent of their time at the nurse station, 17.6 percent of their time on the patient unit and 1.6 percent of their time off the unit.
Commenting on this breakdown, the researchers note that the majority of documentation and care coordination activities take place at the nurse station. They add, meanwhile, that the nurses walked an average of 3.1 miles per shift, time that the researchers say could be better spent tending to patients. Based on their findings, the researchers identify three main targets for reducing inefficiency, including documentation, medication administration and care coordination. Specifically, they recommend that hospitals focus their efforts on improving technology, work processes, and unit organization and design, noting that changes to those areas could "allow for substantial improvements in the use of nurses' time and the safe delivery of care."
Friday, June 20, 2008
No pay for medical errors
Massachusetts adopts no-pay policy on medical errors
Providence Business News
BOSTON – Under a landmark policy, the Bay State will no longer pay for costs associated with certain “serious reportable health-care events” such as wrong-side surgery. The state also will forbid its providers to bill members for such expenses.
“The alignment of payment policies on serious reportable events was identified as an early priority of HealthyMass and reflects the commonwealth’s commitment to maximizing quality of care,” Secretary of Health and Human Services Dr. JudyAnn Bigby, who chairs the HealthyMass executive committee, said in a statement. “By adopting a consistent policy, Massachusetts is applying the state’s purchasing power in support of patient safety.” Click here to read entire article
Providence Business News
BOSTON – Under a landmark policy, the Bay State will no longer pay for costs associated with certain “serious reportable health-care events” such as wrong-side surgery. The state also will forbid its providers to bill members for such expenses.
“The alignment of payment policies on serious reportable events was identified as an early priority of HealthyMass and reflects the commonwealth’s commitment to maximizing quality of care,” Secretary of Health and Human Services Dr. JudyAnn Bigby, who chairs the HealthyMass executive committee, said in a statement. “By adopting a consistent policy, Massachusetts is applying the state’s purchasing power in support of patient safety.” Click here to read entire article
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