Parvin Ebrahimi; Mohammadali Taghi Nattaj Darzi Naghibi; Soudabeh Vatankhah; Ghassem Faghanzadeh Ganji
Abstract
Background: Open heart surgery is a prevalent therapeutic intervention for cardiovascular diseases. Significant adverse effects occur after heart surgery, one of which is patient readmission to the hospital. Objective: The present study aimed to determine the relationship between performance indicators ...
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Background: Open heart surgery is a prevalent therapeutic intervention for cardiovascular diseases. Significant adverse effects occur after heart surgery, one of which is patient readmission to the hospital. Objective: The present study aimed to determine the relationship between performance indicators and the readmission of patients with open heart surgery in a teaching hospital in Iran. Methods: This study was performed using a cross-sectional and descriptive method with a retrospective approach. Data was collected on a data collection form. The statistical population of this study comprised all patients who underwent open heart surgery from mid-September 2015 to mid-September 2016 in a teaching hospital in the north of Iran (n=849). Those patients readmitted to the hospital within 90 days after discharge, based on a review of patient records, were included in the study. Descriptive statistics and Spearman correlation coefficient were used for data analysis by SPSS 20. Results: Among the patients who had open heart surgery in the selected hospital, 12.5% were readmitted within 90 days after discharge. The most important reasons for readmission in this study were infection in surgery place (25.8%), pleural effusion (18.7%), warfarin toxicity (9.8%), and tamponade (8.9%). There were inverse relationships between patient readmission and the two performance indicators of bed occupancy percentage (r = -0.594, P = 0.042) and bed turnover rate (r = -0.664, P = 0.018). There were no statistically significant relationships between any of the other indicators (length of stay, mortality, and bed turnover interval) and readmission rate (P > 0.1). Conclusion: Hospital authorities can use these results for bed management and targeting interventions to reduce costs and readmissions as a measure of hospital quality. However, further research into readmission factors in other hospitals is recommended.
Parvin Ebrahimi; Zainab Malmoon; Rouhollah Zaboli
Abstract
Background: The high workload of nurses in hospitals has been identified as a patient safety and worker stress problem. Psychological empowerment is a motivational concept demonstrated in four dimensions: meaning, competence, self-determination, and impact. Objective: This study investigated the relationship ...
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Background: The high workload of nurses in hospitals has been identified as a patient safety and worker stress problem. Psychological empowerment is a motivational concept demonstrated in four dimensions: meaning, competence, self-determination, and impact. Objective: This study investigated the relationship between nurses’ workloads and psychological empowerment using structural equations modeling (SEM). Methods: This descriptive correlation study was conducted using SEM. The study was conducted at 17 public hospitals affiliated with Iran University of Medical Sciences (IUMS) in the city of Tehran. The population study was nurses employed in critical care departments. Two questionnaires were used to gather data: the NASA and the Psychological Empowerment Questionnaires. Differences in categorical variables were analyzed using one-way analysis of variance (ANOVA). Confirmatory factor analyses were used to confirm the relationships between latent variables and indicator variables; SEM was used to find the direct and indirect effects of nurse’s workload on psychological empowerment. Data analyses were performed using SPSS 18, and all models were tested in LISREL 8.8. Results: Correlations among indicators of nurse’s workload showed that highest correlations were performances (0.61), and the highest correlations among psychological empowerment were competence (0.03). The overall correlations among nursing workloads and psychological empowerment were 0.74. The proposed structural model fit was acceptable (χ2 = 525.5, df = 89, RMSEA = 0.13, GFI = 0.91). Conclusion: Increasing the workload of nurses in hospitals will better engage the nurses and allow them to face new problems they encounter in their jobs.