Background: Operational failures, defined as the inability of the work system to reliably provide information, services, and supplies needed when, where, and to who, are a pervasive problem in U.S. hospitals that disrupt nurses' ability to provide safe and effective care.
Objectives: We examined the relationship between operational failures, patient satisfaction, nurse-reported quality and safety, and nurse job outcomes (e.g., burnout and job satisfaction) and whether differences in hospital work environments explained the relationship.
Methods: We conducted a cross-sectional analysis using population-based survey data from 11,709 registered nurses in 415 hospitals who participated in the RN4CAST-US nurse survey (2015-2016) and the 2016 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The RN4CAST-US nurse survey focused on hospital quality and safety, job outcomes, and hospital work environments. The HCAHPS survey collected publicly reported patient data on their satisfaction with their care. Operational failures were evaluated using an eight-item composite measure that assessed missing supplies, orders, medication, missing/wrong patient diet, electronic documentation problems, insufficient staff, and time spent on workarounds and nonnursing tasks. Multilevel regression models were used to test the hypothesized relationships.
Results: Operational failures were associated with low patient satisfaction scores, poor quality and safety outcomes, and poor nurse job outcomes, and those associations were partly accounted for by hospital work environments.
Discussion: Operational failures prevent high-quality care and positive patient and nurse outcomes. Operational failures and the hospital work environment should be targeted simultaneously to maximize quality improvement efforts. Hospital leadership should work with frontline staff to identify and target the sources of operational failures in nursing units. Improvements to hospital work environments may reduce the occurrence of operational failures.
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http://dx.doi.org/10.1097/NNR.0000000000000626 | DOI Listing |
Tissue Eng Regen Med
January 2025
Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 172 Dolma-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.
Background: Traditionally, dental implants require a healing period of 4 to 9 months for osseointegration, with longer recovery times considered when bone grafting is needed. This retrospective study evaluates the clinical efficacy of demineralized dentin matrix (DDM) combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) during dental implant placement to expedite the osseointegration period for early loading.
Methods: Thirty patients (17 male, 13 female; mean age 55.
Rev Gastroenterol Peru
January 2025
Department of Pathology, Santa Casa Hospital, Porto Alegre, Brazil.
Pancreatic ductal adenocarcinoma during pregnancy is extremely rare. Overall, including our case, only 19 cases confirmed antepartum have been reported to date. We report the case of a 37 year-old woman at 24 weeks of pregnancy in whom a pancreatic adenocarcinoma was identified during investigation of a suspected acute pancreatitis.
View Article and Find Full Text PDFUnited European Gastroenterol J
January 2025
Sheba Medical Center, Institute of Gastroenterology, Ramat-Gan, Israel.
Background: The Montreal classification has been widely used in Crohn's disease since 2005 to categorize patients by the age of onset (A), disease location (L), behavior (B), and upper gastrointestinal tract and perianal involvement. With evolving management paradigms in Crohn's disease, we aimed to assess the performance of gastroenterologists in applying the Montreal classification.
Methods: An online survey was conducted among participants at an international educational conference on inflammatory bowel diseases.
J Esthet Restor Dent
January 2025
Operative Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
Objective: To investigate the effect of cervical margin relocation with four different injectable restorative materials on the fracture resistance of molars receiving mesio-occluso-distal CAD/CAM nanoceramic onlay restorations.
Materials And Methods: One hundred and five sound mandibular molars received a standardized mesio-occluso-distal onlay preparation, with cervical margins located 2 mm apical to the cemento-enamel junction. The molars were randomly allocated into five groups (n = 21) according to the cervical relocating materials used: Group I had no cervical margin relocation; Group II used a highly viscous glass ionomer; Group III used a highly-filled injectable resin composite; Group IV used a resin-modified glass ionomer; and Group V used a bioactive ionic resin.
Xenotransplantation
January 2025
Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Advancements in xenotransplantation intersecting with modern machine perfusion technology offer promising solutions to patients with liver failure providing a valuable bridge to transplantation and extending graft viability beyond current limitations. Patients facing acute or acute chronic liver failure, post-hepatectomy liver failure, or fulminant hepatic failure often require urgent liver transplants which are severely limited by organ shortage, emphasizing the importance of effective bridging approaches. Machine perfusion is now increasingly used to test and use genetically engineered porcine livers in translational studies, addressing the limitations and costs of non-human primate models.
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