Impacts of Rationing and Missed Nursing Care: Challenges and Solutions


Book Description

This book reveals how economic restrictions and limited healthcare resources, combined with growing care demands due to advanced technology and more care options, have to a great extent contributed to increased workloads for healthcare professionals and put them under pressure to prioritize their work. This has led to the rationing of care, i.e., to decision-making processes on the allocation of scarce resources, especially human resources, and on which care activities take priority over others; in turn, these processes have led to unfinished or missed care, which has serious implications for quality of care and patient safety. Concerns related to nursing shortages and lean staffing practices have increased the awareness of the problem, as patient outcomes are affected by the quality and quantity of care that they receive and led to intensified scientific inquiry into this phenomenon. This book is written by the members of the Rancare Cost Action group, whose aim is to facilitate discussion about rationing of nursing care based on a cross-national comparative approach with implications for practice and professional development. Four working groups investigated four areas for four years: a) the conceptualization of care rationing and methodological inquiries concerning the investigation of the phenomenon, b) exploration of possible solutions and intervention studies, c) the ethical perspective of care rationing and missed care including patients’ rights and possible discrimination, and d) the educational implications, based on an exploration of the level of patient safety training and care rationing, as well as preparing guidelines for managers. The book will be a valuable resource for nurses, allied healthcare professionals, managers, policymakers, researchers, ethical committees, and educators whose goal is to provide better and safer care.




The Skills and Ethics of Professional Touch


Book Description

This book introduces readers to the ethical and goal-oriented functions of touch in professional practice. Touch is both an increasingly visible topic today and a core skill in many professions, especially in health, education and social work. This book combines helpful theoretical discussions and practical information, offering a balanced and culturally-informed introduction to an issue that both students and professionals often find difficult to navigate. Chapters discuss the various functions of touch and its uses, giving readers a deeper understanding of the potential of tactile work practices. The authors offer clear legal and ethical guidance to empower learners. They discuss key issues such as harmful touch and the increasing digitisation of patient work. Activities, case studies and further readings promote learning and help readers reflect on their own relationship to touch. This book will be an invaluable resource for students in undergraduate and graduate courses in healthcare, nursing, education and social work, and to practitioners looking for guidance on this topic.




Connecting Healthcare Worker Well-Being, Patient Safety and Organisational Change


Book Description

This volume delineates the ways in which key areas of healthcare, well-being, patient safety and organisational change overlap with and contribute to unhealthy workplaces for healthcare professionals. There is a growing realisation within healthcare that healthcare worker well-being, patient outcomes and organisational change are symbiotically linked. Burnout and stress in healthcare workers and toxic organisational cultures can lead to a cycle of patient neglect, medical errors, sub-optimal care and further stress. This topical volume therefore outlines the ways in which worker well-being, patient outcomes and organisational change can be aligned to contribute to a healthy workplace and therefore better medical care. The volume includes an array of authors from different disciplines including primary care, clinical medicine, psychology, sociology, management, clinical governance, health policy and health services research. It succeeds in integrating different voices and reaches meaningful conclusions to address the challenges facing the healthcare workforce.




Fragility Fracture and Orthogeriatric Nursing


Book Description

This second edition, in Open Access, aims to provide a comprehensive and practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture, with additional focus on those who are frail. It considers this from the perspectives of all the clinical and home care settings in which this group of patients receive care and is relevant to all global locations. The concept of orthogeriatric care is explored in detail. Global estimates suggest that there were 21 million men and 137 million women aged 50 years or more at high fracture risk in 2010. This incidence is expected to double by 2040, with the most significant increase in Asia. Fragility fracture is one of the foremost challenges for health care providers and thehe global demand for nursing care for patients with fragility fractures across the world is immense. Hip fracture is particularly challenging as these significant injuries often occur in frail older people requiring hospitalisation and orthopaedic surgery. Such injuries and associated surgery result in increased frailty, worsening health and wellbeing, pain, disability, reduced quality of life, loss of independence, and decreased life expectancy. Care providers need to understand the experience of fragility fracture from the perspective of patients and families so that direct improvements in care can be based on the perspectives of the users. Expert care of patients following fractures that require hospitalisation and orthopaedic surgery involves skill in the care and treatment of frail older people as we as individuals with an injury and undergoing surgery. Nurses have a significant role in interdisciplinary collaborative care provided through orthogeriatric models of care. There is increasing evidence that such models significantly improve patient outcomes. High quality, evidence-based orthogeriatric care is increasingly shown to have positive impact on outcomes for recovery, rehabilitation, and secondary prevention of further fracture. This book significantly supports the aims and values of the Fragility Fracture Network and, as such, supports the learning needs of nurses and other allied health professionals which will enable a comprehensive approach to nursing practice in orthogeriatric and fragility fracture care.




Errors of Omission


Book Description




Individualized Care


Book Description

This contributed book is based on more than 20 years of researches on patient individuality, care and services of the continuously changing healthcare system. It describes how research results can be used to respond to challenges on individuality in healthcare systems. Service users’, patients’ or clients’ point of views on care and health services are urgently needed. This book describes the conceptualisation of the individualized nursing care phenomenon and the process development of the measuring instruments of that phenomenon in different contexts. It describes results from a variety of clinical contexts about individualized nursing care and explains factors associated with the perceptions and delivery of individualized nursing care from different point of views. This book may appeal to clinicians, nurses practitioners and researchers from many fields.




Approaching Death


Book Description

When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."




Nursing Leadership and Management


Book Description

This comprehensive text explores the philosophy that all nurses are leaders who use creative decision making, entrepreneurship, and life-long learning to create a work environment that is efficient, cost-effective, and committed to quality care. Broad and comprehensive coverage encompasses leadership and management theories and processes by synthesizing information from nursing, health care, general administration and management, and leadership literature. Activities teach them how to research decision-making data (participatory action research process) and analyze and make reliable choices in managing their work environment. Theory-based, scholarly yet practical, this is the most comprehensive and engaging baccalaureate text on the market.




Key Concepts and Issues in Nursing Ethics


Book Description

Short case studies, based on real stories from the health care arena, ensure that each chapter of this book is rooted in descriptions of nursing practise that are grounded, salient narratives of nursing care. The reader is assisted to explore the ethical dimension of nursing practice: what it is and how it can be portrayed, discussed, and analysed within a variety of practice and theoretical contexts. One of the unique contributions of this book is to consider nursing not only in the context of the individual nurse – patient relationship but also as a social good that is of necessity limited, due to the ultimate limits on the nursing and health care resource. This book will help the reader consider what good nursing looks like, both within the context of limitations on resources and under conditions of scarcity. Indeed, any discussion of ethical issues in nursing should be well grounded in a conceptualisation of nursing that nursing students and practising nursing can recognise, accept and engage with. Nursing, like medicine, social work and teaching has a clear moral aim – to do good. In the case of nursing to do good for the patient. However it is vital that in the pressurised, constrained health service of the 21st century, we help nurses explore what this might mean for nursing practice and what can reasonably be expected of the individual nurse in terms of good nursing care.




Communities in Action


Book Description

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.