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• W1504308341 abstract "On the basis of nurse reports indicating the occurrence of implicit rationing of nursing care inSwiss hospitals, the Swiss Federal Office of Public Health asked the Institute of Nursing Scienceof the University of Basel to conduct the Rationing of Nursing Care in Switzerland Study (RICHNursing Study). The resulting study is an extension of the International Hospital OutcomesStudy (IHOS), an international study of the organization of nursing care in hospitals and itsimpact on patient outcomes [1-3]. The IHOS study is led by the Center for Health Outcomes andPolicy Research at the University of Pennsylvania (USA). The RICH Nursing study, and with itthe research program of this dissertation, extended the IHOS research protocol by developing anew empirical measure of implicit rationing of nursing care.This thesis is comprised of ten chapters. Chapters 3 and 5-9 have been published or submitted asindividual articles. Therefore, some repetition in the description of the background and methodologycould not be avoided.The first three chapters describe the thesis’ background, its aims, and the available evidence oneffects of cost saving strategies and changes in staffing levels and skill mixes on patient andnurse outcomes.• Chapter 1 gives a literature based overview of relevant developments in the healthcaresystem, including cost saving strategies, reductions of nursing resources, and their effects onpatient and nurse outcomes• Chapter 2 describes the aims of this research program• Chapter 3 is a literature review and analysis, examining the available evidence on the effectsof cost saving strategies and changes in staffing levels and skill mix in the inpatient caresetting on selected patient and nurse outcomes.Chapters 4 and 5 explore the first two aims of this research program – to develop a conceptualframework of implicit rationing of nursing care, as well as an instrument to measure it as anempirical factor, and to evaluate the psychometric properties of the newly developed instrument.• Chapter 4 presents the definition and conceptual framework of implicit rationing of nursingcare, upon which the proposed measurement tool was based.• Chapter 5 explores the development of the Basel Extent of Rationing of Nursing Care(BERNCA) instrument and its validity and reliability along lines of evidence suggested inStandards for educational and psychological testing.The central aim of this research program, ‘to explore the association between implicit rationingof nursing care in Swiss acute care hospitals and patient outcomes, with consideration for majororganisational variables’, and the related aim, ‘to examine the levels of rationing in Swiss acutecare hospitals, identifying clinically meaningful rationing thresholds for selected patientoutcomes using a standardized rationing tool’ are explored in chapters 5 and 6.• Chapter 6 explores the associations between implicit rationing of nursing care and itsrelationships with patient outcomes as a new empirical factor, as well as with major organisationalsystem factors.• Chapter 7 discusses the identified clinically meaningful rationing thresholds and theirimplications for clinical nursing practice.• Chapter 8 Discusses the mechanism of implicit rationing of nursing care, the occurrence ofrationing in Swiss acute care hospitals and its consequences.• Chapter 9 explores the additional aim of this research program – ‘to compare sharp-deviceinjuries rates among hospital staff nurses across four Western countries’ using data from theIHOS study.• To conclude, Chapter 10 discusses the findings of the program as a whole, identifyingrelated methodological issues, implications for research and clinical practice, and possiblefuture steps to explore the causes, processes and effects of the rationing of nursing care." @default.
• W1504308341 created "2016-06-24" @default.
• W1504308341 creator A5066499258 @default.
• W1504308341 date "2010-01-01" @default.
• W1504308341 modified "2023-09-25" @default.
• W1504308341 title "Rationierung von Pflege Assoziationen mit der Patientensicherheit und der Betreuungsqualität in Spitälern" @default.
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