BACKGROUND: the International economic crisis has challenged the sustainability of health care systems imposing reforms aimed to reduce costs and increase production efficiency. At the international level, waste reduction is considered to be the basis to ensure the heath care systems sustainability. To reduce waste and increase production efficiency is required to document the types, the extent and the level were they occur. The purpose of this paper is to document the experience of waste in nurses clinical practice. METHODS: a descriptive phenomenological study was conducted. Clinical nursing operating in different care settings of the National Heath Care Service were recruited adopting a maximum variation purposeful sampling. Data saturation was considered as the finish line for the participants recruitment. RESULTS: thirty nurses participated in the study. They were mainly female (n = 28, 93.3%) and with an average age of 41.4 ± 7.3 years. For nurses waste means inadequate allocation of resources. Wastes are caused by individual and organizational choices determining improper, inefficient or ineffective use of material, human or virtual heath care resources and time as well as the incorrect application of clinical pathways, the inadequate use of electricity, food, and the improper disposal of the hospital waste. Wastes generates negative emotional impact on nurses such as frustration, anger and sense of impotence. Avoidable wastes were identified. They were mainly related to the expiration date, the use and the type of drugs and materials. Also unavoidable wastes were identified and they were related to established practices to ensure patients safety and changes in treatment choices due to the clinical instability of the patients. CONCLUSION: within the limits of the qualitative approach, in this study have been identified different types of waste present in clinical practice as perceived by nurses. National Health Service policies could focus on this evidences to improve production efficiency. To involve health care professionals in the choices and their awareness to the conscious and responsible use of public resources available, would avoid linear cuts and enhancing such operators.

Background: la crisi economica internazionale ha messo in discussione la sostenibilità dei sistemi sanitari imponendo riforme mirate alla riduzione dei costi e all'aumento dell'efficienza produttiva. A livello internazionale, il contenimento degli sprechi è considerato il fattore cruciale per assicurare l'effettiva sostenibilità di un sistema sanitario. Per ridurre gli sprechi ed incrementare l'efficienza produttiva è necessario documentarne la tipologia, l'entità e il livello in cui essi occorrono. La finalità di questo lavoro è documentare l'esperienza di spreco vissuta nella pratica dagli infermieri clinici. Metodi: è stato condotto uno studio fenomenologico descrittivo. E' stato adottato un campionamento propositivo di massima variazione includendo infermieri clinici che lavoravano in diversi contesti assistenziali del Servizio Sanitario Nazionale. Il reclutamento dei partecipanti si è concluso a raggiungimento della saturazione dei dati. Risultati: hanno partecipato allo studio 30 infermieri prevalentemente di genere femminile (n = 28, 93.3%) e con un'età media di 41.4 ± 7.3 anni. Per gli infermieri lo spreco assume il significato di inadeguata allocazione delle risorse. Gli sprechi sono riconducibili a scelte individuali ed organizzative che determinano l'uso inappropriato, inefficiente o inefficace di risorse materiali (sanitarie), virtuali, umane e di tempo, nonché l'inadeguata applicazione dei percorsi clinico- assistenziali, l'inadeguato utilizzo di energia elettrica, di alimenti, e il non corretto smaltimento dei rifiuti. Gli sprechi generano vissuti negativi come frustrazione, senso di impotenza e rabbia. Sono stati censiti sprechi evitabili, principalmente legati alla scadenza, all'uso ed alla tipologia di fornitura di farmaci/materiali, e sprechi inevitabili associati a prassi necessarie per la sicurezza degli assisiti e a variazioni delle terapie conseguenti all'instabilità clinica dei pazienti. Conclusioni: pur nei limiti della prospettiva qualitativa adottata, sono state individuate le tipologie di spreco presenti nella pratica clinica così come percepite dagli infermieri su cui politiche di miglioramento dell'efficienza produttiva del Servizio Sanitario Nazionale potrebbero focalizzare l'attenzione. Il coinvolgimento attivo degli operatori sanitari nelle scelte e la loro sensibilizzazione all'uso consapevole e responsabile delle risorse pubbliche disponibili, contribuisce ad evitare tagli lineari e valorizza gli operatori stessi

Gli sprechi nella pratica clinica infermieristica: risultati di uno studio fenomenologico / Dante, Angelo; Mecugni, Daniela; Moga, Maria Mirela; Palese, Alvisa. - In: IGIENE E SANITÀ PUBBLICA. - ISSN 0019-1639. - ELETTRONICO. - 71:(2015), pp. 205-224.

Gli sprechi nella pratica clinica infermieristica: risultati di uno studio fenomenologico

MECUGNI, Daniela;
2015

Abstract

BACKGROUND: the International economic crisis has challenged the sustainability of health care systems imposing reforms aimed to reduce costs and increase production efficiency. At the international level, waste reduction is considered to be the basis to ensure the heath care systems sustainability. To reduce waste and increase production efficiency is required to document the types, the extent and the level were they occur. The purpose of this paper is to document the experience of waste in nurses clinical practice. METHODS: a descriptive phenomenological study was conducted. Clinical nursing operating in different care settings of the National Heath Care Service were recruited adopting a maximum variation purposeful sampling. Data saturation was considered as the finish line for the participants recruitment. RESULTS: thirty nurses participated in the study. They were mainly female (n = 28, 93.3%) and with an average age of 41.4 ± 7.3 years. For nurses waste means inadequate allocation of resources. Wastes are caused by individual and organizational choices determining improper, inefficient or ineffective use of material, human or virtual heath care resources and time as well as the incorrect application of clinical pathways, the inadequate use of electricity, food, and the improper disposal of the hospital waste. Wastes generates negative emotional impact on nurses such as frustration, anger and sense of impotence. Avoidable wastes were identified. They were mainly related to the expiration date, the use and the type of drugs and materials. Also unavoidable wastes were identified and they were related to established practices to ensure patients safety and changes in treatment choices due to the clinical instability of the patients. CONCLUSION: within the limits of the qualitative approach, in this study have been identified different types of waste present in clinical practice as perceived by nurses. National Health Service policies could focus on this evidences to improve production efficiency. To involve health care professionals in the choices and their awareness to the conscious and responsible use of public resources available, would avoid linear cuts and enhancing such operators.
2015
71
205
224
Gli sprechi nella pratica clinica infermieristica: risultati di uno studio fenomenologico / Dante, Angelo; Mecugni, Daniela; Moga, Maria Mirela; Palese, Alvisa. - In: IGIENE E SANITÀ PUBBLICA. - ISSN 0019-1639. - ELETTRONICO. - 71:(2015), pp. 205-224.
Dante, Angelo; Mecugni, Daniela; Moga, Maria Mirela; Palese, Alvisa
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1069288
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