Dataset Information

U.S. Hospital Employment of Foreign-Educated Nurses and Patient Experience: A Cross-Sectional Study.

ABSTRACT: Introduction:For over half a century, hospitals in the United States have actively recruited foreign-educated nurses (FENs) in response to nurse shortages in hospitals and nursing homes. Little attention has been paid to the quality of care in the United States related to employment of FENs. Aims:The purpose of this retrospective study was to determine whether employment of FENs in U.S. hospitals is associated with patient care experience. Method:This study used cross-sectional data from three sources in 425 hospitals in four large states to evaluate the relationship between patient perceptions of care and hospital employment of FENs. The study linked data from publicly reported patient experience of care surveys, nurse surveys, and administrative data using unique hospital identifiers common across the data sets. Results:Patient-reported care experience was found to be more negative in hospitals employing more FENs, after controls for other possible explanations. Each 10% increase in FENs was associated with a decrease in the percentage of patients who would recommend their hospital and a decrease in the percentage of patients giving favorable reports on five nursing-specific aspects of patient experience. Conclusions:The results of this study suggest that employment of substantial numbers of nurses educated outside the United States may have implications for quality of care. The findings suggest that research on the outcomes of transition programs for FENs would be useful to inform regulatory policies.

SUBMITTER: Germack HD

PROVIDER: S-EPMC5860668 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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U.S. Hospital Employment of Foreign-Educated Nurses and Patient Experience: A Cross-Sectional Study.

Germack Hayley D HD McHugh Matthew D MD Sloane Douglas M DM Aiken Linda H LH

Journal of nursing regulation 20171004 3

<h4>Introduction</h4>For over half a century, hospitals in the United States have actively recruited foreign-educated nurses (FENs) in response to nurse shortages in hospitals and nursing homes. Little attention has been paid to the quality of care in the United States related to employment of FENs.<h4>Aims</h4>The purpose of this retrospective study was to determine whether employment of FENs in U.S. hospitals is associated with patient care experience.<h4>Method</h4>This study used cross-secti ...[more]

PMID: 29568672

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Project description:ObjectivesThe aim of this study was to investigate the scope and severity of the second victim problem among nurses by examining the experiences and effects of patient safety incidents (PSIs) on them.Participants/setting492 nurses who had experienced PSIs and provide direct care in South Korean medical institutions.DesignA cross-sectional study with anonymous online self-report questionnaires was conducted to nurses in order to examine the experiences and effects of PSIs. Scales measuring post-traumatic stress disorder (PTSD) and post-traumatic embitterment disorder (PTED) were used for a more quantitative examination of the effects of PSIs. A ?2 test was administered to find any difference in responses to difficulties due to PSIs between the direct and indirect experience of PSIs. Furthermore, linear regression analysis was conducted to investigate the factors related to scores on the PTSD and PTED scales.ResultsA statistically significant difference was observed for participants who reported having experienced sleeping disorders, with those with direct experience showing 42.4% sleeping disorders and indirect experience at 21.0%. Also, there was a statistically significant difference between the 34.3% with direct experience and the 22.1% with indirect experience regarding having considered duty or job changes (resignation). Regression analysis showed total PTSD scores for indirect experience at 11.97 points (95% CI: -17.31 to -6.63), lower than direct experience. Moreover, those who thought the medical error was not involved in PSI had a total PTED score 4.39 points (95% CI: -7.23 to -1.55) lower than those who thought it was involved.ConclusionsA considerable number of nurses experienced psychological difficulties due to PSIs at levels that could interfere with their work. The effect of PSIs on nurses with direct experience of PSIs was greater compared with those with indirect experience. There need to be psychological support programmes for nurses to alleviate the negative effects of PSIs.

Project description:Background and aimShift work, especially including night shifts, has been found associated with several diseases, including obesity, diabetes, cancers, and cardiovascular, mental, gastrointestinal and sleep disorders. Metabolomics (an omics-based methodology) may shed light on early biological alterations underlying these associations. We thus aimed to evaluate the effect of night shift work (NSW) on serum metabolites in a sample of hospital female nurses.MethodsWe recruited 46 nurses currently working in NSW in Milan (Italy), matched to 51 colleagues not employed in night shifts. Participants filled in a questionnaire on demographics, lifestyle habits, personal and family health history and work, and donated a blood sample. The metabolome was evaluated through a validated targeted approach measuring 188 metabolites. Only metabolites with at least 50% observations above the detection limit were considered, after standardization and log-transformation. Associations between each metabolite and NSW were assessed applying Tobit regression models and Random Forest, a machine-learning algorithm.ResultsWhen comparing current vs. never night shifters, we observed lower levels of 21 glycerophospholipids and 6 sphingolipids, and higher levels of serotonin (+171.0%, 95%CI: 49.1-392.7), aspartic acid (+155.8%, 95%CI: 40.8-364.7), and taurine (+182.1%, 95%CI: 67.6-374.9). The latter was higher in former vs. never night shifters too (+208.8%, 95%CI: 69.2-463.3). Tobit regression comparing ever (i.e., current + former) and never night shifters returned similar results. Years worked in night shifts did not seem to affect metabolite levels. The Random-Forest algorithm confirmed taurine and aspartic acid among the most important variables in discriminating current vs. never night shifters.ConclusionsThis study, although based on a small sample size, shows altered levels of some metabolites in night shift workers. If confirmed, our results may shed light on early biological alterations that might be related to adverse health effects of NSW.

Project description:BackgroundPatient safety has been identified as a global priority area. It is one of the most health care challenges. There is a rising number of patients' mortality in hospitals each year because of lapses in patient safety practice. Therefore, the purpose of the present study was to assess knowledge, attitude, practice, and associated factors towards patient safety among nurses working at Asella Referral and Teaching Hospital.MethodsInstitution based cross-sectional study was conducted on 172 nurses working at Asella Referral and Teaching Hospital, Arsi Zone, Oromia Regional State, Ethiopia. The data were collected from nurses from December 28, 2020 to January 05, 2021 by using a pretested questionnaire. The data were entered into Epi-Data version 4.2.0.0 and analyzed using the SPSS version 23.0 software.ResultsA total of 172 nurses were enrolled in to the study, resulting a response rate of 99.4%. The mean age of the nurses was 32.53 years. More than half 94(54.7%) of them were female. The majority 133(77.3%) of them were qualified for degrees and above. The majority 155(90.1%) of them had working experience of ≤13years. The nurse's level of good knowledge, positive attitude, and good practice towards patient safety was 58.7% (n = 101, [95% CI; 51.7, 66.7]), 52.9% (n = 91, [95% CI; 43.6, 61.4]), and 50% (n = 86, [95% CI; 43.6, 57%]) respectively. The multivariable logistic regression analysis showed; working in the operation theatre unit [AOR = 5.01, 95% CI; 1.36, 18.46], having information on patient safety during initial education [AOR = 4.99, 95%CI; 1.87, 13.31], and having information on patient safety during continuing education [AOR = 2.85, 95% CI; 1.14, 7.12] were factors significantly associated with knowledge towards patient safety. Being male [AOR = 3.09, 95% CI; 1.38, 6.95], having working experience of >13 years [AOR = 8.37, 95% CI; 1.36, 51.70], having information on patient safety during initial education [AOR = 3.36, 95%CI; 1.11, 10.15], having information on patient safety during continuing education [AOR = 3.33, 95% CI; 1.25, 8.85], and having good Knowledge towards patient safety [AOR = 2.74, 95% CI; 1.21, 6.21] were factors significantly associated with attitude towards patient safety. Having information on patient safety during initial education [AOR = 5.35, 95%CI; 1.77, 16.17] and having a positive attitude towards patient safety [AOR = 3.02, 95% CI; 1.32, 6.91] were factors significantly associated with practice towards patient safety.ConclusionIn the present study, more than half of the nurse's had good knowledge and positive attitude towards patient safety. However, only half of the nurses had good practice towards patient safety. Educational programs and training on patient safety may need to take place for nurses to abate these problems.

Project description:ObjectiveTo 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.DesignCross sectional surveys of patients and nurses.SettingNurses 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.Participants33 659 nurses and 11 318 patients in Europe; 27 509 nurses and more than 120 000 patients in the US.Main outcome measuresNurse 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).ResultsThe 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.ConclusionsDeficits 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.

Dataset Information

U.S. Hospital Employment of Foreign-Educated Nurses and Patient Experience: A Cross-Sectional Study.

Publications

U.S. Hospital Employment of Foreign-Educated Nurses and Patient Experience: A Cross-Sectional Study.

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