Search results

The purpose of the study was to explore in literature what different leadership styles and behaviors of head nurses have a positive influence on the outcomes of patient safety or quality of care.

We reviewed the literature from January 2000 until September 2011. We searched Pubmed, Embase, Cinahl, Psychlit, and Econlit.

We found 10 studies addressing the relationship between head nurse leadership and safety and quality. A wide array of styles and practices were associated with different patient outcomes. Transformational leadership was the most used concept in the studies. A trend can be observed over these studies suggesting that a trustful relationship between the head nurse and subordinates is an important driving force for the achievement of positive patient outcomes. Furthermore, the effects of these trustful relationships seem to be amplified by supporting mechanisms, often objective conditions like clinical pathways and, especially, staffing level.

This study offers an up-to-date review of the limited number of studies on the relationship between nurse leadership and patient outcomes. Although mostly transformational leadership was found to be responsible for positive associations with outcomes, also contingent reward had positive influence on outcomes. We formulated some comments on the predominance of the transformational leadership concept and suggested the application of complexity theory and political leadership for the current context of care. We formulated some implications for practice and further research, mainly the need for more systematic empirical and cross cultural studies and the urgent need for the development of a validated set of nurse-sensitive patient outcome indicators.

The forensic nursing role is complex, creates tensions within itself and is underpinned by core values, knowledge, skills and personal attributes; often referred to as ‘good nurse’ characteristics (Smith & Godfrey, 2002). Forensic nurses perform unique, multifaceted roles; they are viewed by patients as ‘a source of treatment, comfort and advice’, but also as ‘part of the system that deprives them of their liberty’ (United Kingdom Central Council for Nursing, Midwifery and Health Visiting & University of Central Lancashire (UKCC & UCLAN), 1999: 42). This is problematic both for nurses and patients. Although appearing as opposites, security and therapeutic characteristics of nurses can and do co‐exist in forensic nursing (Peternelji‐Taylor & Johnson, 1996). Through critical analysis of dialogue from interviews and focus groups, this paper depicts forensic practice with people with a learning disability through a study that explores apparent ‘truths’ about such people detained in forensic settings (here referred to as ‘the men’) and the staff who work with them. Beliefs about nursing characteristics were exposed through discourses present in dialogue between the men and the staff. General research questions included: (1) What are the discourses related to learning disability and forensic practice? (2) What ideologies underpin and justify forensic practice? (3) What in particular are the positive discourses? Related discussion is primarily concerned with the way that staff and men share relationships and with characteristics of the nursing staff. Findings generally suggest that the staff may be viewed as prison wardens, leading to relationships of mistrust. Paradoxically, there are also positive discourses identifying warm and therapeutic relationships and good nurse characteristics of the staff. This may have practice implications, such as enabling staff to hear positive views expressed by the men and begin to develop metrics of ‘good’ forensic nurse characteristics that may positively affect treatment.

User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on whether and how the organizational model of healthcare service delivery can affect the patient experience is at an early stage. This study investigates the relationship between healthcare service provision models and patient experience by focusing on the nursing care delivery.

65 nurses' coordinators were involved to map the nursing models adopted in the healthcare organizations of in an Italian region, Tuscany. This dataset was merged with patient experience measures reported by 9,393 individuals discharged by the same organizations and collected through a Patient-Reported Experience Measures Observatory. The authors run a series of logistic regression models to test the relationships among variables.

Patients appreciate those characteristics of care delivery related to a specific professional nurse. Having someone who is in charge of the patient, both the reference nurse and the supervisor, makes a real difference. Purely organizational features, for instance those referring to the team working, do not significantly predict an excellent experience with healthcare services.

Different features referring to different nursing models make the difference in producing an excellent user experience with the service.

These findings can support managers and practitioners in taking decisions on the service delivery models to adopt. Instead of applying monolithic pure models, mixing features of different models into a hybrid one seems more effective in meeting users' expectations.

This is one of the first studies on the relationship between provision models of high-contact and relational-intensive services (the healthcare services) and users' experience. This research contributes to the literature on healthcare service management suggesting to acknowledge the importance of hybridization of features from different, purely theoretical service delivery models, in order to fit with providers' practice and users' expectations.

• This is one of the first studies on the relationship between provision models of nursing care and patient experience.

• Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.

• Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.

• Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.

This is one of the first studies on the relationship between provision models of nursing care and patient experience.

Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.

Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.

Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.

Promoting patient satisfaction is crucial for healthcare quality improvement. However, literature on patient satisfaction with nursing care in Ghana is limited. The aim of this study was to assess patient satisfaction with perioperative nursing care in Korle-Bu Teaching Hospital, the largest tertiary hospital in Ghana.

The study was a cross-sectional study. A sample of one hundred (n = 100) in-patients in the surgical department were interviewed. Statistical Package for Social Science (SPSS), version 22, was used to analyze the data. The results were presented using univariate, bivariate and multivariate analyses.

It was found that majority of the respondents were males (53%), employed (56%) and insured (85%). It was also found that eight in ten respondents were satisfied with the perioperative nursing care. Overall patient satisfaction with perioperative nursing care was significantly associated with information provision (p < 0.001), nurse–patient relationship (p < 0.001), fear and concern (p < 0.05) and discomfort and need (p < 0.05). At the multivariate level, overall patient satisfaction was significantly influenced by nurse–patient relationship (β = 0.430, p = 0.002).

There is limited literature on nursing care in surgical departments and rarely are patients' views considered in assessing quality of perioperative care, especially in Low- and Middle- Income Countries (LMICs). This study is a modest contribution to the literature on patient satisfaction with perioperative nursing care in Ghana.

ABSTRACT Providing nursing care for patients with personality disorders is seen by many nursing staff as a highly undesirable job. This paper reviews the available literature and attempts to explore why the task of providing nursing care to these clients is so unpopular. Five core areas of difficulty are identified in the literature and each of these will be elaborated upon within the paper: i) these patients are perceived as less reinforcing and more demanding than mentally ill patients, ii) nurse training is inadequate preparation for this type of work, iii) the role of nursing personality‐disordered patients is high in conflict, iv) this type of nursing is traumatising and v) this type of nursing requires specific skills and qualities.The paper will then outline the implications that these challenges have for a nursing service that provides care for personality‐disordered patients. These include the impact upon i) the retention of staff, ii) the recruitment of staff, iii) the patients and iii) an organisation. The paper will also suggest some potential solutions to these challenges.

This paper presents a research study that demonstrates the inadequacy of the traditional biomedical approach to caring for older people and shows the benefits of using a more holistic, bio‐psychosocial approach. An ethnographic inductive approach was taken. Non‐participant observation was performed on complete episodes of nursing practice, followed by semi‐structured interviews to explore and ratify theories in use. Phase one of the data analysis used qualitative inductive analysis to generate main categories and themes. Phase two was a process of factor isolation, which identified factors of practice theories in use. The themes identified were: nursing therapeutics; preventative nursing; communication; nurse‐patient relationships; collaborative nursing; nursing assessment; decision making; and management of patient care. Further analysis identified that important theoretical factors included: encouraging; responding; comforting; explaining; maintaining ability; judgement in action; and collaborating. This knowledge is embedded in the practice theories of practitioners but it is only by exploring and critiquing these that we can hope to understand the complex nature of nursing practice as it relates to the care of older people.

Purpose – This paper aims to explore the ways in which practice nurses engage in identity work in the context of chronic disease management in primary care and assess the extent to which this is compatible with the identities promoted in government policy. Design/methodology/approach – The paper draws on qualitative interviews with nurses applying the concepts of “identity threat” and Hegel's Master‐Slave dialectic to explore the implications of nurse‐patient interdependence for identity in a policy context which aims to promote self‐management and patient empowerment. Findings – The nurses in the study showed little sign of adapting their identities in line with government policies intended to empower health care “consumers”. Instead, various aspects of identity work were identified which can be seen as helping to defend against identity threat and maintain and reproduce the traditional order. Practical implications – The paper provides information on barriers to self‐management that are likely to inhibit the implementation of government policy. Originality/value – Whilst much has been written on the extent to which patients are dependent on health professionals, the issue of professional dependence on patients has received much less attention. The paper hightlights how viewing the nurse‐patient relationship in the context of a struggle for mastery related to identity represents a departure from traditional approaches and sheds light on hitherto unexplored barriers to self‐management.

Telecare is a growing practice defined as diagnosis, treatment and monitoring among doctors, nurses and patients, which is mediated through ICT and without face-to-face interaction. The purpose of this study is to provide empirically based knowledge about the organization of the use of ICT and dilemmas of this increasingly common practice in healthcare.

The study draws on observations, interviews and desk research in relation to a large €4.5m pilot project at four hospitals in Copenhagen regarding care of 120 patients with chronic obstructive pulmonary disorder (COPD). The empirical study was carried out over four months. Online video consultations were observed alongside workshops focusing on nurses’ photo elucidation of the telecare practice. The analytical ambition was to start the study in the middle of things and explore the emergent design of telecare.

Telecare not only embraces new standards and possibilities for professional responsibility and accountability for nurses but also alters the relationship between doctors and nurses. This leads to a dilemma we characterize as “paradoxical accountability”.

The study draws on Star’s notion of “infrastructure”. In this perspective, infrastructure comprises human and non-human conduct embedded in organizational conventions, relations and sites. The analysis demonstrates that nurses are not only exposed to a new responsibility as all-round case managers but they also have less access to clinical decision makers. The notion of “paradoxical accountability” is developed to account for this dilemma.

Globally, acute abdominal pain (AAP) is one of the most common reasons for emergency admissions, yet little is known about how this patient group experiences the delivery of fundamental care across the acute care delivery chain. The purpose of this paper is to describe how patients with AAP experienced fundamental care across their acute care presentation, and to explicate the health professional behaviours, reported by patients, that contributed to their positive experiences.

A qualitative descriptive study, using repeated reflective interviews, was analysed thematically (n=10 patients).

Two themes were identified: developing genuine, caring relationships with health professionals and being informed about one’s care. Patients reported that health professionals established genuine professional–patient relationships despite the busy care environment but perceived this environment as impeding information-provision. Patients were typically accepting of a lack of information, whereas poor professional–patient relationships were seen as inexcusable.

To provide positive fundamental care experiences for patients with AAP, health professionals should establish caring relationships with patients, such as by using humour, being attentive, and acknowledging patients’ physical pain and emotional distress; and should inform patients about their care, including allowing patients to ask questions and taking time to answer those questions.

This is the first Australian study to explore the experiences of patients with AAP across the acute care delivery chain, using a novel method of repeated interviews, and to demonstrate how fundamental care can be delivered, in clinical practice, to ensure positive patient experiences.