Hospital administration

This article reports an evidence-based practice project using the Iowa Model of Evidence-Based Practice to Promote Quality Care for a common nursing procedure, nasogastric tube placement verification in children. Little research exists regarding the care of nasogastric tubes in children, and traditional verification methods prevail. Auscultation of air insufflation over the abdomen is still used to check placement in many settings, despite research dating back to the 1980s questioning this approach. X-ray remains the only certain way to verify placement, but getting an X-ray before each feeding would be costly and impractical. Additional bedside methods are needed. Project results demonstrate a decrease (93.3% to 46.2%) in the use of auscultation and improved use of other, more reliable methods to determine nasogastric tube placement. Changing practice can be challenging. However, with persistence and re-infusion, this project provides an important example of how the evidence-based ...

Objective: This review summarizes and synthesizes the evidence on follow-up activities regarding patient safety incidents reported in hospitals. Methods: Peer-reviewed papers were retrieved with electronic searches from CINAHL, Web of Science, PubMed and Scopus databases and with manual searches in most relevant journals and in the reference lists of included studies, limiting searches to papers published in English between 2014 and 2018. A systematic review was conducted in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Two authors extracted the data following a predefined extraction form. Results: All together 16 studies were selected for analysis. All studies described incidents and gave insight into problems, risks and unsafe situations which were responded to with recommended improvements. Recommended improvements in response to incidents involved guidelines, staff training, technical improvements and general safety improvements. ...

Objective: Nursing is considered a growing profession worldwide, but nurses in developing world like Pakistan face challenges for their empowerment within and inter professions. The overwhelming feeling of being oppressed shatters nurses’ confidence and self-esteem and hinders their growth and development of the profession as well.Methods: To guide professional growth and empowerment of nursing in Pakistan, a qualitative descriptive study was aimed to discover challenges, strategies and outcomes of empowerment of nurse leaders in Pakistan. Twelve nurses serving as leaders in nursing organization of Pakistan, who fulfilled inclusive criteria were interviewed about their perception of the challenges, strategies and outcomes of empowerment for Pakistani nurses.Results and Conclusions: Nurses in Pakistan are facing great turbulence regarding their professional empowerment, but nursing leaders are striving hard at personal, institutional and government levels to help nurse understand the...

Using both graphical and geometric analyses, this paper examines the extent of inequity in healthcare finance among the Nigerian population. One of the acclaimed plans in healthcare in this teeming community is the mix method of financing but the system in practise is dominated with Object Oriented Programmings (OOPs) meanwhile the degree of income inequality still remain high. Using the Nigerian Living Standard Survey (NLSS) data conducted in 2004, the framework for this study relies on Kakwani Progressivity Index (KPI). A decomposition of the groups into lower and upper bound however, reveal that health payment for lower bound is regressive while payment for upper bound is progressive. Although, the upper bound result dominates the entire result which finally suggests a progressive system arising from the spending habit of the rich in seeking for healthcare services abroad.

Scheduling surgical specialties in a medical facility is a very complex process. The choice of schedules and resource availability impact directly on the number of patients treated by specialty, cancellations, wait times, and the overall performance of the system. In this paper we present a system-wide model developed to allow management to explore trade-offs between OR availability, bed capacity, surgeons’ booking privileges, and wait lists. We developed a mixed integer programming model to schedule surgical blocks for each specialty into ORs and applied it to the hospitals in a British Columbia Health Authority, considering OR time availability and post-surgical resource constraints. The results offer promising insights into resource optimization and wait list management, showing that without increasing post-surgical resources hospitals could handle more cases by scheduling specialties differently.

An appreciation of how human factors affect patient safety has led to development of safety climate surveys and recommendations that hospitals regularly assess safety attitudes among caregivers. A better understanding of variation in patient safety climate across units within hospitals would facilitate internal efforts to improve safety climate. A study was conducted to assess the extent and nature of variation in safety climate across units within an academic medical center. The Agency for Healthcare Research and Quality (AHRQ) Hospital Survey of Patient Safety was administered in 2008 to all nurses and attending physicians (N=4283) in a 900-bed acute care hospital (overall response rate, 69% [n=2961]). Responses were analyzed from the 2,163 physicians and nurses (73% of respondents) who could be assigned to one specific clinical unit. Results were examined for 57 units, categorized into six types. Ratings of various safety climate domains differed markedly across the 57 units, wit...

This study used a qualitative research design to explore hospital policies and practices and the assumption of female heterosexuality. The assumption of heterosexuality is a product of discursive practices that normalize heterosexuality and individualize lesbian sexual identities. Literature indicates that the assumption of female heterosexuality is implicated in both the invisibility and marked visibility of lesbians as service users. This research adds to existing literature by shifting the focus of study from individual to organizational practices and, in so doing, seeks to uncover hidden truths, explore the functional power of language, and allow for the discovery of what we know and--equally as important--how we know.

Background: Very limited data have been published about the design of medication safety programmes in hospitals.

Objective: To describe a template for the structure and operation of a medication safety programme in an acute tertiary setting.

Methods/results: A model of an ideal medication safety programme was developed by combining the lessons learnt by the lead author in the role of medication safety officer in an acute teaching hospital for 7 years with the published accounts of best practice from the literature.

Conclusions: Given the limited guidance currently available regarding the structure and operation of such programmes, this template goes some way towards addressing a gap in the current patient safety literature. It should be of practical value to healthcare organisations considering either introducing a medication safety programme for the first time or expanding an existing system.

Hastane Organizasyon Yapısı
Hospital Organization Structure
Main administrative structure of hospitals
Medical committees of hospitals
Organization of medical services
Organization of paramedical services
Administrative, financial and support services in hospitals

Patients with inadequate health literacy often have poorer health outcomes and increased utilization and costs. The Institute of Medicine has recommended that health literacy assessment be incorporated into health care information systems, which would facilitate large-scale studies of the effects of health literacy, as well as evaluation of system interventions to improve care by addressing health literacy. As part of the Health Literacy Screening (HEALS) study, a Brief Health Literacy Screen (BHLS) was incorporated into the electronic health record (EHR) at a large academic medical center. Changes were implemented to the nursing intake documentation across all adult hospital units, the emergency department, and three primary care practices. The change involved replacing previous education screening items with the BHLS. Implementation was based on a quality improvement framework, with a focus on acceptability, adoption, appropriateness, feasibility, fidelity and sustainability. Supp...

The Latino Healthcare Professionals Project (LHPP) is a privately-funded initiative to provide healthcare management training to first-generation educated Latino bilingual and bicultural upper division university stu- dents planning careers in healthcare. This unique curriculum, scholar- ship, and mentorship program is based in the Healthcare Administration (HCA) Program at California State University Long Beach (CSULB). Initially funded by The Sisters of

Workplace violence (WPV) is a serious threat to the nursing workforce. WPV results in decrease morale, job dissatisfaction, and increase nurse turnover and intentions to leave the profession. WPV has been associated with decrease in the quality of care rendered and could negatively affect patient safety. Given the direct and indirect financial consequences of WPV, it is critical that nursing leaders take actions to reduce WPV by establishing violence prevention programs. Nursing leaders should also reach out to the public, their professional health organization, and the scientific community to provide education and craft regulation to reduce this threat on the nursing workforce and change the perception that violence is part of the job.