Issue link: https://beckershealthcare.uberflip.com/i/1255100
31 PATIENT EXPERIENCE Improved work environments linked to better nurse, patient satisfaction By Mackenzie Bean I nvesting in better work environments for nurses could help improve patient satisfaction, according to a study published in the Journal of Nursing Care Quality. To assess how organizational factors affect nurse burn- out and patient satisfaction, researchers from the Univer- sity of Pennsylvania School of Nursing in Philadelphia conducted a cross-sectional analysis of 463 hospitals in four states. Researchers measured burnout using the Maslach Burnout Inventory and referred to HCAHPS scores for satisfaction ratings. They found 50 percent of hospitals with high nurse burnout rates have poor work environments. High levels of nurse burnout were also linked to lower patient satis- faction ratings. Efforts to obtain Magnet designation or implement Magnet-like initiatives could help hospitals improve work environments for nurses, the researchers suggested. "This includes fostering relationships between nurses, administrators and physicians, and ensuring that nurses have decision-making authority in their practice and ad- equate resources and time to do their work," lead author Margo Brooks Carthon, PhD, RN, associate professor at Penn Nursing, said in a press release. n Comfort amid the chaos: How 4 systems are helping patients connect with loved ones during the pandemic By Mackenzie Bean and Molly Gamble C OVID-19 visitor restrictions are forcing hospitals to find new ways for all patients — not just those with the virus — to con- nect with their loved ones and, in some cases, say goodbye. ese connections come in many different shapes and forms — a dying patient video-chatting with her incarcerated son or clinicians playing a family member's recorded voice message in a critically ill pa- tient's ear — but they all have the same goal: to maintain patient-cen- tered, holistic care, even amid the grim realities of the pandemic. How four health systems are helping patients connect with their loved ones: Note: Responses were lightly edited for length and clarity. Stephanie Conners, RN, executive vice president and COO at Philadelphia-based Jefferson Health: Like most health systems, we have instituted strict no-visitor guidelines during this pandemic. However, we will do everything we can to allow a loved one in the room when someone may be near the end of life, including patients who are COVID-positive. We do not limit family members from coming in and saying goodbye, but do ask for one visitor at a time. Our percentage of patients at the end of life is small, so our personal protective equipment supply is robust enough to ensure those last goodbyes. As crucial as all of our decisions are right now during the COVID-19 pandemic, this one was relatively easy. It was not made lightly, but it was made in the best interest of our patients and families. We feel that as life enters and leaves the world, we need to take care of the person — the person is far bigger than their medical events. Families should be able to say goodbye to their families. If patients are ill, but not critically, we use technology so they can com- municate with their family. FaceTime and iPads are key resources. Sunita Puri, MD, medical director of palliative medicine at Los Angeles-based Keck Medical Center of USC: Right now, no visitors are allowed at Keck Medicine of USC, regardless of if they want to visit a COVID-19 patient or not. But that does not include people who are at the end of life. We shouldn't be in the position where people who are in comfort care can't see their families. For other patients with laptops, tablets, etc., we encourage them to use FaceTime or Zoom to connect with their families if they are awake and alert. I just met with a family who has a sick loved one in the hospital they can't visit. We told them to make voice recordings, which we played in their family member's ear. ere's no concrete proof, but I think things like this bring patients comfort and provide relief for loved ones. e majority of our patients with COVID-19 are not in critical care right now. But some can take a turn for the worse fairly quickly and require intubation. If somebody comes in really sick and hasn't had a discussion about their care preferences before, we oen are obligated to intubate them and then have a conversation with their families. Un- fortunately, this means physicians must talk with families over Zoom or by the phone to give them tough updates or have difficult conversa- tions about loved ones' wishes. This pandemic is going to underscore the importance of ad- vanced care planning. Healthcare is really feeling the effects of people not doing advanced care planning; it's getting put on phy- sicians' shoulders to make these decisions. One thing I can't stress enough is having these discussions before patients get really sick. Naomi Tzril Saks, a clinical healthcare chaplain in the division of palliative medicine at University of California, San Fran- cisco: Providers' security blanket has always been thinking, "Well, if I can't save a life, I can at least bring the family in and give them a gentle death." But that has been taken away due to COVID-19 protocols. We're still focused on how we keep the notion of whole-person care alive and best support people, even when we can't necessarily be there in person or pick up on the energy in the room. Technology is really taking a new place in our work. In some ways, it's become the touch, voice and connection that we can't have. Chaplains and social workers are using telemedicine to have individual counseling sessions with patients and their families. In one instance, we brought in about seven to 10 family