Safety and satisfaction of patients with nurse's care in the perioperative

Sillero-Sillero, Amalia; Zabalegui, Adelaida

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Brasil

Revista Latino-Americana de Enfermagem

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Brasil

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Original Article • Rev Lat Am Enfermagem 27 • 2019 • https://doi.org/10.1590/1518-8345.2646.3142 copy

Safety and satisfaction of patients with nurse's care in the perioperative^* * Paper extracted from doctoral dissertation “Application of magnetism values to the surgical area of a high-tech hospital”, presented to University of Jaume I, Castellón, Spain.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

to investigate the safety and satisfaction of patients and their relationship with nurse's care in the perioperative period.

Method:

cross-sectional, multi-level, correlational study with 105 nurses in the surgical area and 150 patients operated in a Spanish tertiary hospital. For the nurses the sociodemographic variables, the perception of the work environment, the professional burnout and the satisfaction in the work were collected. For patients, the safety of adverse events and level of satisfaction, through the application of questionnaires. Univariate and multivariate analysis were used.

Results:

job satisfaction, professional commitment, and participation in hospital issues were negative predictors for adverse events related to the patient, while postoperative nurse care was a positive predictor.

Conclusion:

there is an increase in adverse events when nurses are dissatisfied at work, less professional commitment and low availability to participate in the subjects of their unit. On the other hand, adverse events decrease when nurses perform the care in the postoperative period. Satisfaction was good and there was no association with the characteristics of nurses’ attention. It is recommended to improve these predictors to increase the safety of surgical patients.

Descriptors:
Perioperative Nursing; Patient Safety; Patient Satisfaction; Adverse Events; Perioperative Care; Health Facility Environment

Patient Variables		Presence of AE^* * AE: Adverse Event, %	Absence of AE^* * AE: Adverse Event, %	p^† † p: p-value significance,
Sex	Female	38.0	62.0	0.408
Sex	Male	40.1	59.9	0.408
Comorbidity	Yes	43.5	56.6	<0.001^† † p: p-value significance,
Comorbidity	No	35.2	64.8
Expertise	General surgery	41.8	58.2	<0.001^† † p: p-value significance,
	Traumatology	41.2	58.8
	Gynecology	31.7	68.3
	Thoracic surgery	28.6	71.4
	Vascular surgery	33.3	66.7
	Neurosurgery	52.4	47.6
	Plastic surgery	0	100
Age (years)	Mean (SD)^‡ ‡ SD: Standard deviation.	63.5(14.33)	63.3(17.17)	0.900
Stay (hours)	Mean (SD)^‡ ‡ SD: Standard deviation.	25.04(3.73)	24.8 (4.0)	0.321

Nurses’ variables		Presence of AE^* * AE: Adverse Event;	Absence of AE^* * AE: Adverse Event;	p^† † p: p-value significance;
Age (years)	Mean (SD)^‡ ‡ SD: standard deviation;	47.21 (12.23)	45.23 (13.09)	0.004
Nurse - Pre-operative	Yes No	27.1 % 40.8 %	73 % 59.2%	<0.001^† † p: p-value significance;
Nurse - Post-operative	Yes No	44.7 % 34.8 %	55% 65.2 %	<0.001^† † p: p-value significance;
Type of contract	Eventual	40.4 %	59.6%	0.004
PES-NWI^§ § PES-NWI: Scale of the nurse's practice environment; factor1	Mean (SD)^‡ ‡ SD: standard deviation;	2.08 (0.62)	2.27 (0.57)	<0.001^† † p: p-value significance;
PES-NWI^§ § PES-NWI: Scale of the nurse's practice environment; factor2	Mean (SD)^‡ ‡ SD: standard deviation;	2.28 (0.78)	2.50 (0.67)	<0.001^† † p: p-value significance;
PES-NWI^§ § PES-NWI: Scale of the nurse's practice environment; factor3	Mean (SD)^‡ ‡ SD: standard deviation;	2.20 (0.79)	2.55 (0.66)	<0.001^† † p: p-value significance;
PES-NWI^§ § PES-NWI: Scale of the nurse's practice environment; factor4	Mean (SD)^‡ ‡ SD: standard deviation;	2.53 (0.58)	2.80 (0.55)	<0.001^† † p: p-value significance;
PES-NWI^§ § PES-NWI: Scale of the nurse's practice environment; factor5	Mean (SD)^‡ ‡ SD: standard deviation;	1.91 (0.46)	2.16 (0.48)	<0.001^† † p: p-value significance;
MBI^‖ ‖ MBI: Maslach Burnout Inventory. Emotional Exhaustion	Mean (SD)^‡ ‡ SD: standard deviation;	1.92 (0.87)	1.56 (0.81)	<0.001^† † p: p-value significance;
Current satisfaction	Mean (SD)^‡ ‡ SD: standard deviation;	2.10 (0.35)	2.24 (0.47)	<0.001^† † p: p-value significance;
Flexibility of time	Mean (SD)^‡ ‡ SD: standard deviation;	2.42 (0.65)	2.59 (0.74)	<0.001^† † p: p-value significance;
Professional development	Mean (SD)^‡ ‡ SD: standard deviation;	2.15 (0.56)	2.24 (0.69)	<0.001^† † p: p-value significance;
Autonomy at work	Mean (SD)^‡ ‡ SD: standard deviation;	2.15 (0.74)	2.41 (0.81)	<0.001^† † p: p-value significance;
Salary	Mean (SD)^‡ ‡ SD: standard deviation;	2.04 (0.24)	2.02 (0.22)	0.351
Training	Mean (SD)^‡ ‡ SD: standard deviation;	1.99 (0.21)	2.04 (0.31)	<0.001^† † p: p-value significance;
Vacations	Mean (SD)^‡ ‡ SD: standard deviation;	2.10 (0.35)	2.24 0.47)	< 0.001^† † p: p-value significance;
Sick leave	Mean (SD)^‡ ‡ SD: standard deviation;	2.04 (0.26)	2.08 (0.31)	0.042
Permission to study	Mean (SD)^‡ ‡ SD: standard deviation;	2.13 (0.43)	2.22 (0.50)	< 0.001^† † p: p-value significance;
Professional commitment	Mean (SD)^‡ ‡ SD: standard deviation;	3.37 (1.20)	3.92 (1.14)	< 0.001^† † p: p-value significance;

Predictors (fixed effects factors)	Unadjusted values			Adjusted values
Predictors (fixed effects factors)	Coe^* * Coe: Regression coefficient;	S.E^† † S.E: Standard error;	p-value^‡ ‡ p: p-value: significance;	Coe^* * Coe: Regression coefficient;	S.E^† † S.E: Standard error;	p^‡ ‡ p: p-value: significance;
Age	0.250	0.232	0.325	--	--	--
Preoperative nurse	-0.481	0.467	0.302	--	--	--
Postoperative nurse	0.903	0.248	<0.001^‡ ‡ p: p-value: significance;	0.710	0.217	<0.001^‡ ‡ p: p-value: significance;
Type of eventual contract	-0.722	0.684	0.295	--	--	--
PESNWI^§ § PES-NWI: Scale of nurses’ practice environment; Fator1	-0.367	0.183	0.044	-0.124	0.175	0.477
PESNWI^§ § PES-NWI: Scale of nurses’ practice environment; Factor2	-0.224	0.175	0.200	--	--	--
PESNWI^§ § PES-NWI: Scale of nurses’ practice environment; Factor3	-0.527	0.157	<0.001^‡ ‡ p: p-value: significance;	-0.014	0.198	0.942
PESNWI^§ § PES-NWI: Scale of nurses’ practice environment; Factor4	-0.504	0.217	0.020	0.254	0.254	0.319
PESNWI^§ § PES-NWI: Scale of nurses’ practice environment; Factor5	-0.888	0.252	<0.001^‡ ‡ p: p-value: significance;	-0.640	0.235	0.007
MBI^‖ ‖ MBI: Maslach Burnout Inventory. Exhaustion	0.511	0.140	<0.001^‡ ‡ p: p-value: significance;	0.152	0.135	0.260
Current satisfaction	-0.656	0.289	0.023	-0.780	0.270	0.004
Flexibility of time	-0.377	0.173	0.030	-0.261	0.155	0.094
Professional development	-0.348	0.156	0.025	0.215	0.144	0.136
Autonomy at work	-0.212	0.203	0.296	--	--	--
Training	-0.518	0.505	0.305	--	--	--
Vacations	-0.448	0.235	0.057	--	--	--
Sick leave	0.695	0.361	0.054	--	--	--
Permission to study	1.136	0.805	0.158	--	--	--
Professional commitment	0.392	0.103	<0.001^‡ ‡ p: p-value: significance;	-0.280	0.098	0.004
Patient Comorbidity	0.274	0.129	0.033	0.230	0.128	0.074
Neurosurgery Patient	0.946	0.242	<0.001^‡ ‡ p: p-value: significance;	0.880	0.240	<0.01

Patient variable		Satisfacción total	P
Patient variable		(Media 3.66; DE^* * SD: Standard deviation; 0.37)	P
Sex	Female	3.68 (0.39)	0.008^† † p-value: Student t test;
	Male	3.63 (0.35)	0.008^† † p-value: Student t test;
Comorbidity	Yes	3.63 (0.42)	0.007^† † p-value: Student t test;
	No	3.68 (0.33)	0.007^† † p-value: Student t test;
Specialty of the surgery	General surgery	3.65
	Traumatology	3.66
	Gynecological surgery	3.64
	Surgery. Thoracic	3.68
	Vascular surgery	3.57
	Neurosurgery	3.82
	Plastic surgery	3.39	<0.001^‡ ‡ P value: chi-square test;
Age (years)		r −0.050^§ § r: Pearson's correlation coefficient;	0.057^‖ ‖ Z normal.
Length of stay (hours)		r −0.140^§ § r: Pearson's correlation coefficient;	<0.001^‖ ‖ Z normal.

Nurses’ variables		Satisfacción total	Contrast test
Nurses’ variables		(Mean 3.66, SD^* * SD: Standard deviation; 0.37)	p-value
Sex	Fémale	3.66 (0.37)	0.687^† † p-value of Student t test;
	Male	3.67 (0.41)
Postgraduate/master's degree	Yes/No	3.66 (0.37)	0.855^† † p-value of Student t test;
Transoperative nurse	Yes/No	3.66 (0.40)	0.826^† † p-value of Student t test;
Preoperative nurse	Yes/No	3.66 (0.37)	0.213^† † p-value of Student t test;
Postoperative nurse	Yes/No	3.66 (0.37)	0.908^† † p-value of Student t test;
Contract Type	Permanent/Eventual	3.66 (0.37)	0.675^† † p-value of Student t test;
Age		-0,006^‡ ‡ r: Pearson's correlation coefficient;	0.812^§
Work experience		0.001^‡ ‡ r: Pearson's correlation coefficient;	0.982^§
Current work experience		0.020^‡ ‡ r: Pearson's correlation coefficient;	0.441^§
PES-NWI^‖ ‖ PES-NWI: Nursing Practice Environment Scale factor1		0.004^‡ ‡ r: Pearson's correlation coefficient;	0.889^§
PES-NWI^‖ ‖ PES-NWI: Nursing Practice Environment Scale factor2		-0.025^‡ ‡ r: Pearson's correlation coefficient;	0.339^§
PES-NWI^‖ ‖ PES-NWI: Nursing Practice Environment Scale factor3		-0.038^‡ ‡ r: Pearson's correlation coefficient;	0.148^§
PES-NWI^‖ ‖ PES-NWI: Nursing Practice Environment Scale factor4		0.002^‡ ‡ r: Pearson's correlation coefficient;	0.938^§
PES-NWI^‖ ‖ PES-NWI: Nursing Practice Environment Scale factor5		-0.013^‡ ‡ r: Pearson's correlation coefficient;	0.627^§
MBI^¶ ¶ MBI: Burnout Maslach Inventory Depersonalization		0.015^‡ ‡ r: Pearson's correlation coefficient;	0.581^§
MBI^¶ ¶ MBI: Burnout Maslach Inventory Personal accomplishment		0.006^‡ ‡ r: Pearson's correlation coefficient;	0.824^§
Satisfaction in the current job		0.003^‡ ‡ r: Pearson's correlation coefficient;	0.909^§
Flexibility of time		-0.029^‡ ‡ r: Pearson's correlation coefficient;	0.276^§
Professional development		-0.044^‡ ‡ r: Pearson's correlation coefficient;	0.100^§
Autonomy at work		-0.010^‡ ‡ r: Pearson's correlation coefficient;	0.708^§
Salary		0.003^‡ ‡ r: Pearson's correlation coefficient;	0.906^§
Training		-0.012^‡ ‡ r: Pearson's correlation coefficient;	0.649^§
Vacations		-0.029^‡ ‡ r: Pearson's correlation coefficient;	0.278^§
Sick leave		-0.013^‡ ‡ r: Pearson's correlation coefficient;	0.630^§
Permission to study		-0.026^‡ ‡ r: Pearson's correlation coefficient;	0.328^§
Professional commitment		-0.034^‡ ‡ r: Pearson's correlation coefficient;	0.199^§

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding author: Amalia Sillero-Sillero E-mail: asillero@santpau.cat

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Safety and satisfaction of patients with nurse's care in the perioperative* * Paper extracted from doctoral dissertation “Application of magnetism values to the surgical area of a high-tech hospital”, presented to University of Jaume I, Castellón, Spain.

Objective:

Method:

Results:

Conclusion:

Safety and satisfaction of patients with nurse's care in the perioperative^* * Paper extracted from doctoral dissertation “Application of magnetism values to the surgical area of a high-tech hospital”, presented to University of Jaume I, Castellón, Spain.