Rene Schwendimann

Universitätsspital Basel · Chief Medical and Chief Nursing Office

Objectives Inpatient falls are a major patient safety issue in acute care hospitals. Multifactorial in-hospital fall prevention programs have shown reductions in falls and related risks. One common element of successful programs is active patient involvement. This study objective was to explore patients’ and nurses’ experiences with a structured in...

Die Studie MatchRN Psychiatrie zeigt, dass die Pflegenden in der stationären Psychiatrie mit ihrer Arbeitsumgebung grundsätzlich zufrieden sind. Jedoch ist nur etwa knapp die Hälfte der Meinung, dass ausreichend Pflegepersonal auf ihrer Abteilung vorhanden ist, um eine gute Pflegequalität zu gewährleisten. Bei der Dienstplangestaltung fühlen sich d...

Aim To identify current key areas for nursing research in Switzerland, we revised the Swiss Research Agenda for Nursing (SRAN) initially published in 2008. Background By developing a research agenda, nursing researchers internationally prioritize and cluster relevant topics within the research community. The process should be collaborative and sys...

Introduction: Nursing care left undone occurs when nurses omit activities because of resource shortfalls. Higher levels of nursing care left undone are associated with worse nurse staffing and organizational factors. Plentiful evidence from acute, long-term and community care supports such associations; however, mental healthcare settings are unde...

Background Managing nurses' work schedules in hospitals is challenging because employer needs, like shift changes at short notice and overtime, may conflict with nurses' desires for a predictable and stable schedule. Nurses should have a certain degree of control over their work schedules, and their supervisors should support their needs in schedul...

Background: Managing nurses’ work schedules in hospitals is challenging because employer needs, like shift changes at short notice and overtime, may conflict with nurses’ desires for a predictable and stable schedule. Nurses should have a certain degree of control over their work schedules, and their supervisors should support their needs in schedu...

Background Falls are a common, costly global public health burden. In hospitals, multifactorial fall prevention programs have proved effective in reducing falls’ incidence; however, translating those programs accurately into daily clinical practice remains challenging. This study’s aim was to identify ward-level system factors associated with imple...

Background High bed-occupancy (capacity utilization) rates are commonly thought to increase in-hospital mortality; however, little evidence supports a causal relationship between the two. This observational study aimed to assess three time-varying covariates—capacity utilization, patient turnover and clinical complexity level— and to estimate causa...

Background Adverse event (AE) detection is a major patient safety priority. However, despite extensive research on AEs, reported incidence rates vary widely. Objective This study aimed: (1) to synthesize available evidence on AE incidence in acute care inpatient settings using Trigger Tool methodology; and (2) to explore whether study characterist...

Introduction: Critical incident reporting systems (CIRS) are in use worldwide. They are designed to improve patient care by detecting and analyzing critical and adverse patient events and by taking corrective actions to prevent reoccurrence. Critical incident reporting systems have recently been criticized for their lack of effectiveness in achiev...

Adverse events (AEs)-healthcare caused events leading to patient harm or even death-are common in healthcare. Although it is a frequently investigated topic, systematic knowledge on this phenomenon in stroke patients is limited. To determine cumulative incidence of no-harm incidents and AEs, including their severity and preventability, a cohort stu...

Purpose: As recommended by the WHO and many national healthcare authorities, health care institutions of most industrialised countries have employed a critical incident reporting system (CIRS). However, little is known about differences in critical incidents across clinical specialties, the use of CIRSs amongst different professional groups, the t...

Purpose: The purpose of the study was to develop and implement an institution-specific trigger tool based on the Institute for Healthcare Improvement medication module trigger tool (IHI MMTT) in order to detect and monitor ADEs. Methods: We performed an investigator-driven, single-center study using retrospective and prospective patient data to...

Average patient clinical complexity levels by days, days of the week (Monday to Sunday) and weekdays vs weekends over a year for five Swiss general hospital types. https://jmir.org/api/download?alt_name=jmir_v23i8e27163_app3.pdf&filename=7a56aa6ae3a695bb1a7a0e4f6c56797b.pdf

Background Patient safety is essential for the reliable delivery of health care. One way to positively influence patient safety is to improve the safety and teamwork climate of a clinical area. Research shows that Safety WalkRounds (WRs) are an appropriate and common method to improve safety culture. The aim of this study was to combine WRs with ob...

Background The quality of care is often poorly assessed in mental health settings, and accurate evaluation requires the monitoring and comparison of not only the outcomes but also the structures and processes. The resulting data allow hospital administrators to compare their patient outcome data against those reported nationally. As Swiss psychiatr...

Background: Variations in hospitals care demand relies not only on the patient’s volume but also on the disease severity. Understanding both daily severity and patients’ volume in hospitals could help to identify pressure zones in hospitals for better hospital capacity planning and policymaking. Objective: This longitudinal study explores daily...

Background: Medication errors are a common problem in hospitals and a major driver of adverse patient outcomes. Barcode verification technology is a promising strategy to help ensure safe medication preparation practices. Objectives: The objectives of this study were (i) to assess the effects of a barcode-assisted medication preparation and admi...

Zusammenfassung Hintergrund Die Patientensicherheit zu gewährleisten ist ein zentrales Anliegen in der Gesundheitsversorgung, deren Behandlungsprozesse eine komplexe und mit vielen Risiken behaftete Aufgabe darstellt. Im Spitalalltag kommt es denn auch immer wieder zu unerwünschten, kritischen Ereignissen, die Patienten schädigen. Hierbei untersuc...

BACKGROUND Variations in hospitals’ care demand relies not only on the patient volume but also on the disease severity. Understanding both daily severity and patient volume in hospitals could help to identify hospital pressure zones to improve hospital-capacity planning and policy-making. OBJECTIVE This longitudinal study explored daily care deman...

Background Understanding how comorbidity measures contribute to patient mortality is essential both to describe patient health status and to adjust for risks and potential confounding. The Charlson and Elixhauser comorbidity indices are well-established for risk adjustment and mortality prediction. Still, a different set of comorbidity weights migh...

Background: "Second victims" are healthcare professionals traumatized by involvement in significant adverse events. Associated burdens, e.g., guilt, can impair professional performance, thereby endangering patient safety. To date, however, a model of second victims' experiences toward a deeper understanding of qualitative studies is missing. Theref...

BACKGROUND The quality of care is often poorly assessed in mental health settings, and accurate evaluation requires the monitoring and comparison of not only the outcomes but also the structures and processes. The resulting data allow hospital administrators to compare their patient outcome data against those reported nationally. As Swiss psychiatr...

Background When chronic conditions are associated with outcomes such as mortality, comorbidity measures are essential both to describe patient health status and to adjust for potential confounding. The Charlson and Elixhauser comorbidity indices are well-established for risk adjustment and mortality prediction. Still, as optimal comorbidity weighti...

Background: Understanding how comorbidity measures contribute to patient mortality are essential both to describe patient health status and to adjust for risks and potential confounding. The Charlson and Elixhauser comorbidity indices are well-established for risk adjustment and mortality prediction. Still, a different set of comorbidity weights mi...

Background: Understanding how comorbidity measures contribute to patient mortality is essential both to describe patient health status and to adjust for risks and potential confounding. The Charlson and Elixhauser comorbidity indices are well-established for risk adjustment and mortality prediction. Still, a different set of comorbidity weights mig...

Background: Understanding how comorbidity measures contribute to patient mortality is essential both to describe patient health status and to adjust for risks and potential confounding. The Charlson and Elixhauser comorbidity indices are well-established for risk adjustment and mortality prediction. Still, a different set of comorbidity weights mig...

STUDY AIM The aim of this study was to identify the prevalence of organisational structures and processes for the support of second victims in Swiss hospitals. METHODS To identify institutional policies and support for health professionals who have been involved in an adverse patient event and become traumatised from the event, also called second v...

Background Preparing a 21st century nursing workforce demands future-oriented curricula that address the population’s evolving health care needs. With their advanced clinical skill sets and broad scope of practice, Advanced Practice Nurses strengthen healthcare systems by providing expert care, especially to people who are older and/or have chronic...

Safety Walk Rounds - Clinical unit visits with a focus on patient safety Abstract. Background: Safety Walk Rounds are a promising strategy to promote the safety culture and optimising patient safety. The purpose of this study was to explore patient safety attributes in various clinical areas including recommendations for improvement and leadership...

Background: High performance work systems (HPWSs) are successful work systems in the context of safety climate and patient safety. The 10-item HPWS questionnaire is a validated instrument developed to assess existing HPWS structures in hospitals. The objectives of this cross-sectional study were to translate the English HPWS questionnaire into Ger...

Zusammenfassung Hintergrund Critical Incident Reporting Systeme (CIRS) dienen dazu, unerwünschte Ereignisse im Krankenhaus zu melden, zu analysieren und Verbesserungsmaßnahmen abzuleiten. Die Auseinandersetzung mit CIRS-Meldungen durch designierte Teams und die weiterführenden Maßnahmen ermöglichen ein Lernen aus unerwünschten Ereignissen. Um eine...

Background The World Health Organization (WHO) Surgical Safety Checklist is used globally to ensure patient safety during surgery. Two years after its implementation in the University Hospital Basel’s operating rooms, adherence to the protocol was evaluated. Methods This mixed method observational study took place in the surgical department of the...

Background: Adverse events (AEs) seriously affect patient safety and quality of care, and remain a pressing global issue. This study had three objectives: (1) to describe the proportions of patients affected by in-hospital AEs; (2) to explore the types and consequences of observed AEs; and (3) to estimate the preventability of in-hospital AEs. Me...

Background: Adverse events in health care entail substantial burdens to health care systems, institutions, and patients. Retrospective trigger tools are often manually applied to detect AEs, although automated approaches using electronic health records may offer real-time adverse event detection, allowing timely corrective interventions. Objective...

Background: Emotional exhaustion among healthcare workers is a widely investigated, well-recognized problem, the incidence of which has recently been linked to work environment factors, particularly work/family conflict. However, another environmental feature that may be equally influential, but that is more amenable to nurse manager action, remain...

Zusammenfassung In der vorliegenden Untersuchung sind in einem Schweizer Universitätsspital potentielle, die Asepsis gefährdende Ereignisse bei Operationen systematisch erfasst worden. Im Jahr 2016 wurden insgesamt 18‘535 operative Eingriffe durchgeführt. Dabei sind bei 483 (2.6%) Patienten potentiell Asepsis kompromittierende Ereignisse beobachtet...

BACKGROUND Adverse events in health care entail substantial burdens to health care systems, institutions, and patients. Retrospective trigger tools are often manually applied to detect AEs, although automated approaches using electronic health records may offer real-time adverse event detection, allowing timely corrective interventions. OBJECTIVE...

Background There is a poorly understood relationship between Leadership WalkRounds (WR) and domains such as safety culture, employee engagement, burnout and work-life balance. Methods This cross-sectional survey study evaluated associations between receiving feedback about actions taken as a result of WR and healthcare worker assessments of patien...

The emerging care personnel shortage in Swiss nursing homes is aggravated by high turnover rates. As intention to leave is a predictor of turnover, awareness of its associated factors is essential. This study applied a secondary data analysis to evaluate the prevalence and variability of 3,984 nursing home care workers' intention to leave. Work env...

Background: Intensive care unit (ICU) personnel have an elevated prevalence of job-related burn-out and post-traumatic stress disorder, which can ultimately impact patient care. To strengthen healthcare workers’ skills to deal with stressful events, it is important to focus not only on minimising suffering but also on increasing happiness, as this...

Aim: The aim of this study was to examine how patient safety indicators and processes and structures of nursing care have changed since the 2012 introduction of Swiss Diagnosis-Related Groups. Background: Diagnosis-Related Groups have been implemented worldwide; yet, research findings regarding their impact on efficiency and quality of care remain...

Aim: To investigate career paths and nurses' reasons to quit their job in Switzerland. Background: Increasing the duration of employment is the most efficient measure to reduce the worldwide nursing shortage. The results of the pilot phase for the retrospective cohort nurses at work study are presented. Methods: In 2012, 1085 graduates' names...

Background: As a category of bullying, mobbing is a form of violence in the workplace that damages the employing organization as well as the targeted employee. In Europe, the overall prevalence of mobbing in healthcare is estimated at 4%. However, few studies have explored mobbing among long-term care workers. Objectives: This study aims to exam...

To explore associations between care workers' health and implicit rationing of care. Diverse studies have linked impaired health to reduced work performance – a factor measured through omission of required tasks. This cross-sectional study gathered data from 3239 care workers in 162 Swiss nursing homes. Data were analyzed via a linear logistic regr...

Background While the relationship between nurses’ job satisfaction and their work in hospital environments is well known, it remains unclear, which factors are most influential in the nursing home setting. The purpose of this study was to describe job satisfaction among care workers in Swiss nursing homes and to examine its associations with work e...

Dans un contexte de pénurie infirmière, l’étude nurses at work a pour but de fournir des informations sur les choix de carrière des infirmières en Suisse et leurs raisons de rester dans le secteur de la santé ou de le quitter. Quelque 15 000 infirmières y ont participé, pour la plupart diplômées en Suisse.

AimTo develop and test psychometrically the Basel Extent of Rationing of Nursing Care for Nursing Homes instrument, providing initial evidence on the validity and reliability of the German, French and Italian-language versions. Background In the hospital setting, implicit rationing of nursing care is defined as the withholding of nursing activities...

Purpose: To address the gap in evidence-based information required to support the development of advanced practice nursing (APN) roles in Switzerland, stakeholders identified the need for guidance to generate strategic evaluation data. This article describes an evaluation framework developed to inform decisions about the effective utilization of A...

Unerwünschte Ereignisse und Fehler führen bei Patientinnen und Patienten nicht selten zu Schädigungen und sogar zum Tod. Als Folge müssen nicht nur die Sicher- heitslücken im System geschlossen werden. Unterstützung brauchen auch die invol- vierten Gesundheitsfachpersonen, die zweiten Opfer («Second Victims»), damit sie sich mit dem Geschehenen aus...

Background: Nursing workforce data are scarce in Switzerland, with no active national registry of nurses. The worldwide nursing shortage is also affecting Switzerland, so that evidence-based results of the nurses at work project on career paths and retention are needed as part of the health care system stewardship; nurses at work is a retrospectiv...

Background: Worker productivity is central to the success of organizations such as healthcare institutions. However, both absenteeism and presenteeism impair that productivity. While various hospital studies have examined the prevalence of presenteeism and absenteeism and its associated factors among care workers, evidence from nursing home settin...

Background: The Emergency Severity Index (ESI) is an English language emergency department patient triage tool. After translation, it has been adapted for use to triage patients in growing numbers of emergency departments in non-English-speaking countries. Few reports of the proficiency of triage nurses to score an ESI exist. We sought to determin...

Objectives: To describe care worker–reported quality of care and to examine its relationship with staffing variables, work environment, work stressors, and implicit rationing of nursing care. Design: Cross-sectional study. Setting: National, randomly selected sample of Swiss nursing homes, stratified according to language region and size. Participa...

Background: Implicit rationing of nursing care refers to the withdrawal of or failure to carry out necessary nursing care activities due to lack of resources, in the literature also described as missed care, omitted care, or nursing care left undone. Under time constraints, nurses give priority to activities related to vital medical needs and the...

Objective: Falls and related injuries remain a considerable health risk for in-patients. Numerous studies link falls with nurse staffing levels, but the results are inconsistent. The purpose of this study was to explore the associations between fall prevalence and injurious falls on medical wards and three unit-level system factors: daily nurse sta...

Changing demographic and economic factors are producing serious challenges to Switzerland’s primary care providers: meeting the population’s growing needs will require redevelopment and reorganization. Large-scale community-based care can be expanded via alternative care models, including walk-in-clinics (WIC) stuffed by interdisciplinary teams, wi...

The aim of this study was to explore the associations between hospital management support for patient safety, registered nurses' trust in hospital management, and their overall perception of patient safety, considering aspects of safety communication as possible mediating variables. Limited research exists regarding how key elements of a patient sa...

No study has systematically examined how researchers address cross-cultural adaptation of burnout. We conducted an integrative review to examine how researchers had adapted the instruments to the different contexts. We reviewed the Content Validity Indexing scores for the Maslach Burnout Inventory-Human Services Survey from the 12 country comparati...

Background Austerity measures and health-system redesign to minimise hospital expenditures risk adversely aff ecting patient outcomes. The RN4CAST study was designed to inform decision making about nursing, one of the largest components of hospital operating expenses. We aimed to assess whether diff erences in patient to nurse ratios and nurses' ed...

Leadership WalkRounds (WR) are widely used in healthcare organisations to improve patient safety. The relationship between WR and caregiver assessments of patient safety culture, and healthcare worker burnout is unknown. This cross-sectional survey study evaluated the association between receiving feedback about actions taken as a result of WR and...