920 research outputs found
Associations between rationing of nursing care and inpatient mortality in Swiss hospitals
Objectives To explore the relationship between inpatient mortality and implicit rationing of nursing care, the quality of nurse work environments and the patient-to-nurse staffing ratio in Swiss acute care hospitals. Design Cross-sectional correlational design. Setting Eight Swiss acute care hospitals examined in a survey-based study and 71 comparison institutions. Participants A total of 165 862 discharge abstracts from patients treated in the 8 RICH Nursing Study (the Rationing of Nursing Care in Switzerland Study) hospitals and 760 608 discharge abstracts from patients treated in 71 Swiss acute care hospitals offering similar services and maintaining comparable patient volumes to the RICH Nursing hospitals. Main outcome measures The dependent variable was inpatient mortality. Logistic regression models were used to estimate the effects of the independent hospital-level measures. Results Patients treated in the hospital with the highest rationing level were 51% more likely to die than those in peer institutions (adjusted OR: 1.51, 95% CI: 1.34-1.70). Patients treated in the study hospitals with higher nurse work environment quality ratings had a significantly lower likelihood of death (adjusted OR: 0.80, 95% CI: 0.67-0.97) and those treated in the hospital with the highest measured patient-to-nurse ratio (10:1) had a 37% higher risk of death (adjusted OR: 1.37, 95% CI: 1.24-1.52) than those in comparison institutions. Conclusions Measures of rationing may reflect care conditions that place hospital patients at risk of negative outcomes and thus deserve attention in future hospital outcomes research studie
ΠΡΠΎΠ±Π»ΠΈΠ²ΠΎΡΡΡ ΡΠΌΡΠ½ΠΎ-Π³ΠΎΡΠΌΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ° ΠΌΡΠΊΡΠΎΠ±ΡΠΎΠ»ΠΎΠ³ΡΡΠ½ΠΎΠ³ΠΎ ΡΡΠ°ΡΡΡΡ Ρ ΠΆΡΠ½ΠΎΠΊ Π· ΡΡΠ·Π½ΠΈΠΌΠΈ ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΡΡΠ½ΠΈΠΌΠΈ ΡΠΎΡΠΌΠ°ΠΌΠΈ ΠΏΠΎΠ»ΡΠΏΡΠ² Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΡΡ
ΠΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΎ 58 ΠΆΠ΅Π½ΡΠΈΠ½ Ρ ΠΏΠΎΠ»ΠΈΠΏΠ°ΠΌΠΈ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΡ. ΠΡΡΠ²Π»Π΅Π½Ρ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΠΌΠΈΠΊΡΠΎΠ±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ
ΠΏΠ΅ΠΉΠ·Π°ΠΆΠ°, Π³ΠΎΡΠΌΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈ ΠΈΠΌΠΌΡΠ½Π½ΠΎΠ³ΠΎ ΡΡΠ°ΡΡΡΠ° Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΡΠΌ ΠΏΠΎΠ»ΠΈΠΏΠΎΠ² ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΡ.
ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ» Π²ΡΠ΄Π΅Π»ΠΈΡΡ Π³ΡΡΠΏΠΏΡ ΡΠΈΡΠΊΠ° ΠΏΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΏΠΎΠ»ΠΈΠΏΠΎΠ² ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΡ. ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ
ΠΏΠΎΠ»ΠΈΠΏ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΡ ΡΠ»Π΅Π΄ΡΠ΅Ρ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°ΡΡ Π½Π΅ ΠΊΠ°ΠΊ ΠΌΠ΅ΡΡΠ½ΡΠΉ ΠΏΡΠΎΡΠ΅ΡΡ, Π° ΠΊΠ°ΠΊ ΡΠ΅Π°ΠΊΡΠΈΡ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΡ Π² ΠΎΡΠ²Π΅Ρ Π½Π°
ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠ΅ Π³ΠΎΡΠΌΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈ ΠΈΠΌΠΌΡΠ½Π½ΠΎΠ³ΠΎ Π³ΠΎΠΌΠ΅ΠΎΡΡΠ°Π·Π°, ΡΡΠΎ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΡΡΠΈΡΡΠ²Π°ΡΡ ΠΏΡΠΈ Π²ΡΠ±ΠΎΡΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΡ
Π΄Π°Π½Π½ΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ58 women with endometrial polyps were investigated. Specific microflora and hormonal and immune status
depending on the morphological forms of endometrial polyps were found. The analysis performed allowed to
allocate risk groups according to development of endometrial polyp. It was shown that endometrial polyp shall be
considered as endometrial reaction in response to hormonal and immune homeostasis disorder, rather than local
process. This should be borne in mind when choosing treatment for this patholog
Rationing of nursing care and its relationship to patient outcomes: the Swiss extension of the International Hospital Outcomes Study
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. Design Multi-hospital cross-sectional surveys of patients and nurses. Setting Eight Swiss acute care hospitals Participants Nurses (1338) and patients (779) on 118 medical, surgical and gynecological units. Main outcome measures Patient satisfaction, nurse-reported medication errors, patient falls, nosocomial infections, pressure ulcers and critical incidents involving patients over the previous year. Results Generally, nurses reported rarely having omitted any of the 20 nursing tasks listed in the BERNCA over their last 7 working days. However, despite relatively low levels, implicit rationing of nursing care was a significant predictor of all six patient outcomes studied. Although the adequacy of nursing resources was a significant predictor for most of the patient outcomes in unadjusted models, it was not an independent predictor in the adjusted models. Low nursing resource adequacy ratings were a significant predictor for five of the six patient outcomes in the unadjusted models, but not in the adjusted ones. Conclusion As a system factor in acute general hospitals, implicit rationing of nursing care is an important new predictor of patient outcomes and merits further stud
The Impact of Socioeconomic Status, Surgical Resection and Type of Hospital on Survival in Patients with Pancreatic Cancer:A Population-Based Study in The Netherlands
The influence of socioeconomic inequalities in pancreatic cancer patients and especially its effect in patients who had a resection is not known. Hospital type in which resection is performed might also influence outcome. Patients diagnosed with pancreatic cancer from 1989 to 2011 (n = 34,757) were selected from the population-based Netherlands Cancer Registry. Postal code was used to determine SES. Multivariable survival analyses using Cox regression were conducted to discriminate independent risk factors for death. Patients living in a high SES neighborhood more often underwent resection and more often were operated in a university hospital. After adjustment for clinicopathological factors, risk of dying was increased independently for patients with intermediate and low SES compared to patients with high SES. After resection, no survival difference was found among patients in the three SES groups. However, survival was better for patients treated in university hospitals compared to patients treated in non-university hospitals. Low SES was an independent risk factor for poor survival in patients with pancreatic cancer. SES was not an adverse risk factor after resection. Resection in non-university hospitals was associated with a worse prognosis.</p
Systeembalans 2017: Milieu-uitdagingen voor het energie-, mobiliteits- en voedingssysteem in Vlaanderen
Reconstruction of Sound Source Pressures in an Enclosure Using the Phased Beam Tracing Method
Plasminogen activation by staphylokinase enhances local spreading of S. aureus in skin infections
Associations between aortic pulse wave velocity and aortic and carotid vessel wall thickness in patients with hypertension: assessment with MRI
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