Moral distress in nurses at an acute care hospital in Switzerland

2014 ◽  
Vol 22 (1) ◽  
pp. 77-90 ◽  
Author(s):  
Michael Kleinknecht-Dolf ◽  
Irena Anna Frei ◽  
Elisabeth Spichiger ◽  
Marianne Müller ◽  
Jacqueline S Martin ◽  
...  
Keyword(s):  
Acute Care ◽  
Moral Distress ◽  
Diagnosis Related Groups ◽  
Acute Care Hospital ◽  
Face Validity ◽  
University Hospital ◽  
Work Place ◽  
Care Hospital ◽  
Cross Sectional ◽  
German Speaking

Background: In the context of new reimbursement systems like diagnosis-related groups, moral distress is becoming a growing problem for healthcare providers. Moral distress can trigger emotional and physical reactions in nurses and can cause them to withdraw emotionally from patients or can cause them to change their work place. Objective: The aim of this pilot study was to develop an instrument to measure moral distress among acute care nurses in the German-speaking context, to test its applicability, and to obtain initial indications of the instrument’s validity. Method: The study was designed in 2011 as a cross-sectional pilot survey. Conducted on eight units of one university hospital in German-speaking Switzerland, 294 registered nurses were asked to fill out a web-based questionnaire on moral distress. Ethical considerations: The study proposal was approved by the cantonal ethics committee. All participating nurses provided informed consent and were assured of data confidentiality. Results: The survey had a response rate of 55%. The results show the prevalence of statements on the questionnaire indicating situations with the potential to trigger moral distress. The entire range of answers was used in the responses. Most participants found the questionnaire comprehensible, while some criticized the phraseology of certain statements. Many more found the registration process prior to online access to be too time consuming. Nurses confirmed that the results reflect their subjective assessment of their situation and their experience of moral distress. Conclusion: The newly developed moral distress questionnaire appears to produce face validity and is sufficiently applicable for use in our study. The results indicate that moral distress appears to be a relevant phenomenon also in Swiss hospitals and that nurses were experiencing it prior to the introduction of Swiss diagnosis-related groups.

scholarly journals Long-term acute care hospitals and Georgia Medicaid: Utilization, outcomes, and cost

2016 ◽  
Vol 4 ◽  
pp. 205031211667092
Author(s):  
Evan S. Cole ◽  
Carla Willis ◽  
William C Rencher ◽  
Mei Zhou
Keyword(s):  
Acute Care ◽  
Diagnosis Related Groups ◽  
Acute Care Hospital ◽  
Acute Care Hospitals ◽  
Risk Scores ◽  
Average Risk ◽  
Care Hospital ◽  
Hospital Patients ◽  
Medicaid Population

Objectives: Because most research on long-term acute care hospitals has focused on Medicare, the objective of this research is to describe the Georgia Medicaid population who received care at a long-term acute care hospital, the type and volume of services provided by these long-term acute care hospitals, and the costs and outcomes of these services. For those with select respiratory conditions, we descriptively compare costs and outcomes to those of patients who received care for the same services in acute care hospitals. Methods: We describe Georgia Medicaid recipients admitted to a long-term acute care hospital between 2011 and 2012. We compare them to a population of Georgia Medicaid recipients admitted to an acute care hospital for one of five respiratory diagnosis-related groups. Measurements used include patient descriptive information, admissions, diagnosis-related groups, length of stay, place of discharge, 90-day episode costs, readmissions, and patient risk scores. Results: We found that long-term acute care hospital admissions for Medicaid patients were fairly low (470 90-day episodes) and restricted to complex cases. We also found that the majority of long-term acute care hospital patients were blind or disabled (71.2%). Compared to patients who stayed at an acute care hospital, long-term acute care hospital patients had higher average risk scores (13.1 versus 9.0), lengths of stay (61 versus 38 days), costs (US$143,898 versus US$115,056), but fewer discharges to the community (28.4% versus 51.8%). Conclusion: We found that the Medicaid population seeking care at long-term acute care hospitals is markedly different than the Medicare populations described in other long-term acute care hospital studies. In addition, our study revealed that Medicaid patients receiving select respiratory care at a long-term acute care hospital were distinct from Medicaid patients receiving similar care at an acute care hospital. Our findings suggest that state Medicaid programs should carefully consider reimbursement policies for long-term acute care hospitals, including bundled payments that cover both the original hospitalization and long-term acute care hospital admission.

Associations between patient symptoms and falls in an acute care hospital: A cross-sectional study

2018 ◽  
Vol 27 (9-10) ◽  
pp. 1826-1835 ◽  
Author(s):  
Anners Lerdal ◽  
Line Wangsvik Sigurdsen ◽  
Heidi Hammerstad ◽  
Tove Irene Granheim ◽  
Caryl L Gay ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospital ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Restraint use in the acute-care hospital setting: A cross-sectional multi-centre study

2021 ◽  
Vol 114 ◽  
pp. 103807
Author(s):  
Silvia Thomann ◽  
Sandra Zwakhalen ◽  
Dirk Richter ◽  
Silvia Bauer ◽  
Sabine Hahn
Keyword(s):  
Acute Care ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Cross Sectional ◽  
Multi Centre Study ◽  
Centre Study ◽  
Restraint Use

scholarly journals Patients’ evaluation of hospital foodservice quality in Italy: what do patients really value?

2012 ◽  
Vol 16 (4) ◽  
pp. 730-737 ◽  
Author(s):  
Gabriele Messina ◽  
Roberto Fenucci ◽  
Francesco Vencia ◽  
Fabrizio Niccolini ◽  
Cecilia Quercioli ◽  
...  
Keyword(s):  
Service Quality ◽  
Food Quality ◽  
Acute Care Hospital ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Care Hospital ◽  
Cross Sectional ◽  
Staff Support ◽  
Patients Satisfaction ◽  
And Gender

AbstractObjectivePatients often do not eat/drink enough during hospitalization. To enable patients to meet their energy and nutritional requirements, food and catering service quality and staff support are therefore important. We assessed patients’ satisfaction with hospital food and investigated aspects influencing it.DesignWe conducted a cross-sectional study collecting patients’ preferences using a slightly modified version of the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ). Factor analysis was carried out to reduce the number of food-quality and staff-issue variables. Univariate and multivariate ordinal categorical regression models were used to assess the association between food quality, staff issues, patients’ characteristics, hospital recovery aspects and overall foodservice satisfaction (OS).SettingA university hospital in Florence, Italy, in the period November–December 2009.SubjectsHospital patients aged 18+ years (n927).ResultsOf the 1288 questionnaires distributed, 927 were returned completely or partially filled in by patients and 603 were considered eligible for analysis. Four factors (explained variance 64·3 %, Cronbach's alphaαC= 0.856), i.e. food quality (FQ;αC= 0·74), meal service quality (MSQ;αC= 0·73), hunger and quantity (HQ;αC= 0·74) and staff/service issues (SI;αC= 0·65), were extracted from seventeen items. Items investigating staff/service issues were the most positively rated while certain items investigating food quality were the least positively rated. After ordinal multiple regression analysis, OS was only significantly associated with the four factors: FQ, MSQ, HQ and SI (OR = 17·2, 6·16, 3·09 and 1·75, respectively,P< 0·001), and gender (OR = 1·53,P= 0·024).ConclusionsThe most positively scored aspects of foodservice concerned staff/service, whereas food quality was considered less positive. The aspects that most influenced patients’ satisfaction were those related to food quality.

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