PubMed Health⌕ Search

Biomedical subjects

Sean P Clarke

Publications and source records attributed to Sean P Clarke.

At least 19 recordsLinked to original sources
PubMed2007

Front-line management, staffing and nurse-doctor relationships as predictors of nurse and patient outcomes. a survey of Icelandic hospital nurses.

OBJECTIVE: To investigate aspects of nurses' work environments linked with job outcomes and assessments of quality of care in an Icelandic hospital. BACKGROUND: Prior research suggests that poor working environments in hospitals significantly hinder retention of nurses and high quality patient care. On the other hand, hospitals with high retention rates (such as Magnet hospitals) show supportive management, professional autonomy, good inter-professional relations and nurse job satisfaction, reduced nurse burnout and improved quality of patient care. METHODS: Cross-sectional survey of 695 nurses at Landspitali University Hospital, Reykjavík. Nurses' work environments were measured using the nursing work index-revised (NWI-R) and examined as predictors of job satisfaction, the Maslach burnout inventory (MBI) and nurse-assessed quality of patient care using linear and logistic regression approaches. RESULTS: An Icelandic adaptation of the NWI-R showed a five-factor structure similar to that of Lake (2002). After controlling for nurses' personal characteristics, job satisfaction, emotional exhaustion and nurse rated quality of care were found to be independently associated with perceptions of support from unit-level managers, staffing adequacy, and nurse-doctor relations. CONCLUSIONS: The NWI-R measures elements of hospital nurses' work environments that predict job outcomes and nurses' ratings of the quality of patient care in Iceland. Efforts to improve and maintain nurses' relations with nurse managers and doctors, as well as their perceptions of staffing adequacy, will likely improve nurse job satisfaction and employee retention, and may improve the quality of patient care.

Cross-Sectional Studies↗
PubMed2006

Outcomes of variation in hospital nurse staffing in English hospitals: cross-sectional analysis of survey data and discharge records.

CONTEXT: Despite growing evidence in the US, little evidence has been available to evaluate whether internationally, hospitals in which nurses care for fewer patients have better outcomes in terms of patient survival and nurse retention. OBJECTIVES: To examine the effects of hospital-wide nurse staffing levels (patient-to-nurse ratios) on patient mortality, failure to rescue (mortality risk for patients with complicated stays) and nurse job dissatisfaction, burnout and nurse-rated quality of care. DESIGN AND SETTING: Cross-sectional analysis combining nurse survey data with discharge abstracts. PARTICIPANTS: Nurses (N=3984) and general, orthopaedic, and vascular surgery patients (N=118752) in 30 English acute trusts. RESULTS: Patients and nurses in the quartile of hospitals with the most favourable staffing levels (the lowest patient-to-nurse ratios) had consistently better outcomes than those in hospitals with less favourable staffing. Patients in the hospitals with the highest patient to nurse ratios had 26% higher mortality (95% CI: 12-49%); the nurses in those hospitals were approximately twice as likely to be dissatisfied with their jobs, to show high burnout levels, and to report low or deteriorating quality of care on their wards and hospitals. CONCLUSIONS: Nurse staffing levels in NHS hospitals appear to have the same impact on patient outcomes and factors influencing nurse retention as have been found in the USA.

Adult↗
PubMed2006

Internet research in an international context.

Computers and the Internet provide researchers with new options in surveying. When using electronic surveys, several practical and methodological issues need to be considered such as whether the majority of the surveyed population has Internet access and whether an e-mail or a Web-based survey is most appropriate. Other important considerations relate to Internet security issues and, in international research, the possibility of language barriers. Despite these challenges, electronic surveys offer a promising alternative to conventional mail surveys.

Data Collection↗
PubMed2006

Organizational climate and culture factors.

Nurses and others have expressed a great deal of interest in the potential for incorporating notions about organizational culture and climate in research and practice aiming to improve health care safety. In this review, definitions and measures of these terms are explored, the state of the research literature connecting culture and climate with safety is reviewed, and directions for future research and leadership practice are outlined.

Ergonomics↗
PubMed2005

Surgeons' and nurses' use of e-mail communication with head and neck cancer patients.

BACKGROUND: "Telephone tag" for questions about postoperative symptoms and other concerns often engenders dissatisfaction. E-mail use may improve communication between patients and clinicians. This study aimed to describe surgeons' and nurses' use of E-mail with patients and their caregivers after head and neck cancer surgery. METHODS: We conducted a cross-sectional national survey of head and neck nurses and surgeons. RESULTS: Ninety-six percent of surgeon and 87% of nurse respondents used E-mail, but only 40% and 25%, respectively, used it with patients. More than 50% of both clinician groups that used E-mail with patients have done so for 2 to 5 years and began this practice at the request of patients. Surgeons not using E-mail with patients were twice as likely as nurses to cite privacy and liability issues, as well as time management and miscommunication concerns. CONCLUSIONS: Some clinicians use E-mail with patients, most often by patient request. Medicolegal and clinical ramifications require further study.

Adult↗
PubMed2005

Head and neck cancer patient and family member interest in and use of E-mail to communicate with clinicians.

BACKGROUND: E-mail is actively discussed as a promising method for clinical communication, but little study of patient and family preferences regarding its use has been done. This study aimed to describe patients' and family members' interest in and use of E-mail with their surgeons and nurses after head and neck cancer surgery. METHODS: Surveys were distributed to patients and family members attending postoperative clinic visits. Seventy-four patients and 35 caregivers completed the surveys. RESULTS: Although one in three patients expressed interest in E-mailing their clinicians, only 9.5% reported actually doing so. Symptom management and prescription refills were the most common issues addressed by E-mail. Few family members expressed any interest in using E-mail. CONCLUSIONS: The findings suggest that E-mail communication between patients with head and neck cancer or their family members with surgeons and nurses is not common. Interest in using E-mail tends to be stronger among patients than family members.

Attitude to Computers↗
PubMed2004

Nurse burnout and patient satisfaction.

BACKGROUND: Amid a national nurse shortage, there is growing concern that high levels of nurse burnout could adversely affect patient outcomes. OBJECTIVES: This study examines the effect of the nurse work environment on nurse burnout, and the effects of the nurse work environment and nurse burnout on patients' satisfaction with their nursing care. RESEARCH DESIGN/SUBJECTS: We conducted cross-sectional surveys of nurses (N=820) and patients (N=621) from 40 units in 20 urban hospitals across the United States. MEASURES: Nurse surveys included measures of nurses' practice environments derived from the revised Nursing Work Index (NWI-R) and nurse outcomes measured by the Maslach Burnout Inventory (MBI) and intentions to leave. Patients were interviewed about their satisfaction with nursing care using the La Monica-Oberst Patient Satisfaction Scale (LOPSS). RESULTS: Patients cared for on units that nurses characterized as having adequate staff, good administrative support for nursing care, and good relations between doctors and nurses were more than twice likely as other patients to report high satisfaction with their care, and their nurses reported significantly lower burnout. The overall level of nurse burnout on hospital units also affected patient satisfaction. CONCLUSIONS: Improvements in nurses' work environments in hospitals have the potential to simultaneously reduce nurses' high levels of job burnout and risk of turnover and increase patients' satisfaction with their care.

Adult↗
PubMed2004

Nurses' working conditions: implications for infectious disease.

Staffing patterns and nurses' working conditions are risk factors for healthcare-associated infections as well as occupational injuries and infections. Staffing shortages, especially of nurses, have been identified as one of the major factors expected to constrain hospitals' ability to deal with future outbreaks of emerging infections. These problems are compounded by a global nursing shortage. Understanding and improving nurses' working conditions can potentially decrease the incidence of many infectious diseases. Relevant research is reviewed, and policy options are discussed.

Communicable Diseases↗
PubMed2003

Educational levels of hospital nurses and surgical patient mortality.

CONTEXT: Growing evidence suggests that nurse staffing affects the quality of care in hospitals, but little is known about whether the educational composition of registered nurses (RNs) in hospitals is related to patient outcomes. OBJECTIVE: To examine whether the proportion of hospital RNs educated at the baccalaureate level or higher is associated with risk-adjusted mortality and failure to rescue (deaths in surgical patients with serious complications). DESIGN, SETTING, AND POPULATION: Cross-sectional analyses of outcomes data for 232 342 general, orthopedic, and vascular surgery patients discharged from 168 nonfederal adult general Pennsylvania hospitals between April 1, 1998, and November 30, 1999, linked to administrative and survey data providing information on educational composition, staffing, and other characteristics. MAIN OUTCOME MEASURES: Risk-adjusted patient mortality and failure to rescue within 30 days of admission associated with nurse educational level. RESULTS: The proportion of hospital RNs holding a bachelor's degree or higher ranged from 0% to 77% across the hospitals. After adjusting for patient characteristics and hospital structural characteristics (size, teaching status, level of technology), as well as for nurse staffing, nurse experience, and whether the patient's surgeon was board certified, a 10% increase in the proportion of nurses holding a bachelor's degree was associated with a 5% decrease in both the likelihood of patients dying within 30 days of admission and the odds of failure to rescue (odds ratio, 0.95; 95% confidence interval, 0.91-0.99 in both cases). CONCLUSION: In hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to-rescue rates.

Cross-Sectional Studies↗