title: [Monitoring of nursing service context factors: first descriptive results of a cross-sectional Swiss study prior the introduction of SwissDRG].
abstract: BACKGROUND
  The adoption of DRG-based payment systems has narrowed hospitals' financial margins, necessitating streamlining and process optimization. The experience of other countries shows that this restructuring can influence context factors essential to the delivery of nursing care. As a result, nursing care quality and patient safety may be impacted.
  
  
  OBJECTIVE
  The Sinergia Project aims to develop a monitoring model and related instruments to continuously monitor the impact of DRG-based reimbursement on central nursing service context factors.
  
  
  METHODS
  The descriptive, quantitative results were collected within the framework of a study with a mixed methods design by means of an online survey in which nurses from five hospitals participated.
  
  
  RESULTS
  The results show that the nursing service context factors examined (nursing care complexity, quality of the work environment, management, moral distress and job satisfaction), have relevance in all practice areas as regards practice setting and nursing care delivery. Patterns can be recognized that are consistent with those found in the literature and which could be an indication of the relationships between the context factors above, as was hypothesized in the model.
  
  
  CONCLUSIONS
  The study has provided the participating hospitals with useful data upon which to base discussions on ensuring quality of nursing care and practice development, in addition to information important to the further development of the model and the instruments employed.
authors: Zentrum Klinische Pflegewissenschaft, UniversitätsSpital Zürich und Departement für Pflegewissenschaft, Fakultät für Gesundheit, Universität Witten/Herdecke,Witten.
authors: Michael
authors: M
authors: Kleinknecht-Dolf
authors: Institut für Pflegewissenschaft, Universität Basel und Bereich Fachentwicklung, Direktion Pflege/MTT, Inselspital Universitätsspital, Bern.
authors: Elisabeth
authors: E
authors: Spichiger
authors: Abteilung Praxisentwicklung Pflege, Universitätsspital Basel.
authors: Irena Anna
authors: IA
authors: Frei
authors: Institut für Datenanalyse und Prozess Design, School of Engineering, Zürcher Hochschule für Angewandte Wissenschaften, Winterthur.
authors: Marianne
authors: M
authors: Müller
authors: Ressort Pflege/MTT, Universitätsspital Basel.
authors: Jacqueline S
authors: JS
authors: Martin
authors: Institut für Pflegewissenschaft, Universität Basel und Direktion Pflege & MTTB, UniversitätsSpital Zürich.
authors: Rebecca
authors: R
authors: Spirig
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D015400:Clinical Nursing Research; D003430:Cross-Sectional Studies; D003953:Diagnosis-Related Groups / Q000191:economics* / Q000458:organization & administration*; D005260:Female; D005380:Financing, Government / Q000191:economics* / Q000458:organization & administration*; D006801:Humans; D007355:Insurance, Nursing Services / Q000191:economics*; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics* / Q000458:organization & administration*; D015401:Nursing Administration Research; D011785:Quality Assurance, Health Care / Q000191:economics / Q000458:organization & administration; D011795:Surveys and Questionnaires; D013557:Switzerland
keywords: Akutspital; Diagnosis Related Groups; Mixed-Methods-Design; Monitoring; Pflege; acute-care hospital; diagnosis related groups; mixed methods design; nursing administration research; nursing service