BMJ quality & safety
-
BMJ quality & safety · Jul 2017
Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care.
To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. ⋯ A bedside care workforce with a greater proportion of professional nurses is associated with better outcomes for patients and nurses. Reducing nursing skill mix by adding nursing associates and other categories of assistive nursing personnel without professional nurse qualifications may contribute to preventable deaths, erode quality and safety of hospital care and contribute to hospital nurse shortages.
-
BMJ quality & safety · Jul 2017
Beyond hand hygiene: a qualitative study of the everyday work of preventing cross-contamination on hospital wards.
Hospital-acquired infections are the most common adverse event for inpatients worldwide. Efforts to prevent microbial cross-contamination currently focus on hand hygiene and use of personal protective equipment (PPE), with variable success. Better understanding is needed of infection prevention and control (IPC) in routine clinical practice. ⋯ Attention to the logistics of moving people and objects around healthcare spaces, especially into vulnerable areas, allows for a more comprehensive approach to IPC through better contextualisation of hand hygiene and PPE protocols, better identification of transmission risks, and the design and promotion of a wider range of preventive strategies and solutions.