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Thematic nursing wards

Olsman Willems, U. (2013) Thematic nursing wards.

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Abstract:OBJECTIVE The objective of this research is an advice on managing the nursing staff when developing a Thematic Nursing Ward (TNW) and guaranteeing or improving current quality, safety, patient and nurse satisfaction. BACKGROUND Demographic, technologic and socioeconomic changes demand adjustments of traditional health care organizations (WHO, 2013). Aging and the increase of co- and multi morbidity changes the health care demand. Increase of severe and complex diseases requires more intensive and multidisciplinary treatment. The complexity and variety in demand requires a flexible use of resources. Elective beds should no longer be specialty labeled in order to create greater bed aggregates that are more flexible and can admit different patient types (Molema, 2009). Reducing costs is not similar to reducing resources but can be achieved by reducing variability and increasing resource flexibility. METHOD A systematic literature search is performed to determine the influence that input variables (i.e. education, certification, skills and knowledge, support and recognition, working with clinical competent colleagues, autonomy, professional development and nurse physician relationships), have on nurse sensitive outcomes, patient and nurse satisfaction. A model is designed displaying the influence an input variable has on outcome variable(s). This model is validated by five hospitals that have experience with a TNW. These five TNW practices are asked which measures are taken in order to maintain or improve outcome. The model is discussed with managers of two nursing wards in the Isala Klinieken that are to be combined in a proposed TNW. By using the model it is systematically determined which consequences the TNW is expected to have on outcome variables. Managers of the nursing wards are asked which measures are required in order to guarantee or improve current outcome variables at their ward and what the expected results, feasibility, duration and costs of these measures are. RESULTS Influence of input variables on outcome variables According to literature nurse variables and nurse work environment variables that influence nurse sensitive outcomes, patient and nurse satisfaction are education, certification, skills and knowledge, support and recognition, working with clinical competent colleagues, autonomy, professional development and nurse physician relationships. A model is developed that displays the nurse variables and nurse work environment variables and their influence on outcome variables. Measures taken by TNW practices to guarantee or improve outcome variables Respondents from the five TNW practices recognized the influences of input variables on outcome as displayed in the model. Measures taken by the TNW practices regarding nurse variables are  Increasing nurses’ level of education  Increasing the number of nurses’ certification  Using difference in skill and knowledge within the nursing team These measures improve nurse sensitive outcomes, patients and nurse satisfaction at the TNW practices. Measures taken by the five TNW practices regarding nurse work environment variables are  Supporting the nursing staff by listening to nurses need and facilitate whenever possible  Stimulating and facilitating personal development (e.g., by training or attending symposia) These measures improve nurse satisfaction and are considered to subsequently improve the nurse sensitive outcomes and patient satisfaction of the TNW practices. The measures taken by the TNW practices are inextricably linked to the mission statement and vision of the hospital, specified for nursing care and the nursing staff and translated into a nurse staffing strategy. The respondents recommend to make an inventory of the nurses’ education, certification, skills and knowledge. This enables the hospital to manage the nursing staff at an individual level. Measures taken by the TNW practices and their results are summarized in table 16, page 33. Expected consequences of a TNW on outcome in the Isala A TNW is expected to decrease the current nurse sensitive outcomes, to decrease patient satisfaction and decrease nurse satisfaction. Lack of specific knowledge of the patient groups hinders nurses to provide the current level of nursing care. An overview of expected consequences of a TNW on outcome variables is summarized in table 17, page 41. CONCLUSION Required measures in order to guarantee or improve outcome at a TNW in the Isala Managers use their own experience and goals to staff nurses at the ward. The hospital does not have a mission statement and vision on nursing care and the nursing staff. There is no nurse staffing strategy at the tactical level that for instance describes the desired level of nursing care. Also an inventory of available skills and knowledge of the nursing staff is not available. Therefore the detail and the extent of the measures that are required to employ the current nursing staff on a TNW cannot be determined. Based on the current situation the required measures are increasing nurses’ level of education, certification skills and knowledge in order to secure nurses’ skills and knowledge of all patient groups. This is expected to improve nurse sensitive outcomes, patient and nurse satisfaction. These measures are considered to be feasible and vary in amount of time and costs. An overview can be found in paragraph 3.4.2, page 40 and table 17, page 41.
Item Type:Essay (Master)
Clients:
Isala Klinieken, Zwolle, the Netherlands
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/63722
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