Model testing on the crisis interventions and actions to prevent medical disputes: a Taiwanese nursing perspective.
OBJECTIVE
This study investigated the contributions of comprehensiveness and necessity scales on crisis interventions and actions toward nursing practice-related medical disputes in Taiwanese hospitals and institutions' demographic characteristics, to overall satisfaction toward nursing-related crisis management policies and interventions and overall satisfaction toward their institution's crisis management system.


BACKGROUND
In a health-care environment that is focused on cost containment, for overworked nurses and understaffed medical wards, patients still expect nurses to provide high quality, compassionate care. Patients usually regard nurses as the principal link between the technical and interpersonal aspects of their care. However, current hospital systems tend to require patients to be self-reliant in managing their own care. Patient mistrust of medical care providers might have contributed to the current medical error/dispute crisis.


METHODS
In this cross-sectional study, the subjects were nursing directors of Taiwanese hospitals (197 valid subjects). The author developed the questionnaire used in this study.


RESULTS
The ordinal logistic regression analyses demonstrated that being a public hospital managed by the government, being a hospital operated by a corporate body, the more comprehensive the technical/structural aspect and the assessment aspect and the more needed the psychological aspect, contribute to higher general satisfaction levels toward nursing-related crisis management. The more comprehensive the strategic aspect and having more acute beds, contributes to higher satisfaction levels with their institution's overall crisis management activities.


CONCLUSIONS
These findings inferred a possible change in a hospital's resource allocation or power structure when dealing with issues of patient care quality, including nursing practice-related crisis management policies, interventions and actions. RELEVANT TO CLINICAL PRACTICE: A good crisis management system may help to keep a crisis from worsening, which might lead to a serious situation that includes malpractice litigation. It is believed that the questionnaire used in this study may be used as a diagnostic tool for assessing a crisis management system within a hospital's nursing environment.
Tzeng
Huey-Ming
HM
Nursing Department, I-Shou University, Kaohsiung, Taiwan. tzeng_hueyming@yahoo.com
D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003419:Crisis Intervention / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D034462:Dissent and Disputes; D004509:Education, Nursing, Continuing; D006272:Health Facility Environment / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006779:Hospitals, Public / Q000458:organization & administration; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D016015:Logistic Models; D019300:Medical Errors / Q000451:nursing / Q000517:prevention & control*; D016294:Models, Nursing; D009718:Nurse Administrators / Q000458:organization & administration / Q000523:psychology*; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D016134:Organizational Policy; D017060:Patient Satisfaction; D011787:Quality of Health Care / Q000458:organization & administration; D018570:Risk Assessment; D012308:Risk Management / Q000458:organization & administration; D011795:Surveys and Questionnaires; D013624:Taiwan