title: [Nursing care in the run-up to Swiss DRG – Nurses' experiences with interprofessional collaboration, leadership, work load and job satisfaction].
abstract: BACKGROUND
  The literature reports critically on the consequences of the introduction of case-based hospital reimbursement systems, which hamper the delivery of professional nursing care. For this reason, we examined the characteristics of nursing service context factors (work environment factors) in acute care hospitals with regards to the introduction of the new reimbursement system in Switzerland.
  
  
  OBJECTIVE
  This qualitative study describes practice experiences of nurses in the context of the characteristics of the nursing service context factors interprofessional collaboration, leadership, workload and job satisfaction.
  
  
  METHODS
  Twenty focus group interviews were conducted with a total of 146 nurses in five acute care hospitals.
  
  
  RESULTS
  The results indicated that for quite some time the participants had observed an increase in complexity of nursing care and a growing invasiveness of clinical diagnostics and treatment. At the same time they noticed a decrease in patient length of stay. They strived to offer high quality nursing care even in situations where demands outweighed resources. Good interprofessional collaboration and supportive leadership contributed substantially to nurses' ability to overcome daily challenges. Job satisfaction was bolstered by interactions with patients. Also, the role played by the nursing team itself is not to be underestimated.
  
  
  CONCLUSIONS
  From the participants' point of view, context factors harbor great potential for attaining positive patient outcomes and higher job satisfaction and have to be monitored repeatedly.
authors: 1 Zentrum Klinische Pflegewissenschaft, UniversitätsSpital Zürich.
authors: Horst
authors: H
authors: Rettke
authors: Irena Anna
authors: IA
authors: Frei
authors: Kathrin
authors: K
authors: Horlacher
authors: Michael
authors: M
authors: Kleinknecht-Dolf
authors: Elisabeth
authors: E
authors: Spichiger
authors: Rebecca
authors: R
authors: Spirig
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D003363:Cost Control / Q000191:economics / Q000458:organization & administration; D003953:Diagnosis-Related Groups / Q000191:economics / Q000458:organization & administration*; D005260:Female; D017721:Hospital Costs / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D033183:Interdisciplinary Communication; D007588:Job Satisfaction; D007857:Leadership; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration*; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000191:economics / Q000458:organization & administration* / Q000523:psychology*; D009746:Nursing, Team / Q000191:economics / Q000458:organization & administration; D011785:Quality Assurance, Health Care / Q000191:economics / Q000458:organization & administration; D013557:Switzerland
keywords: Arbeitszufriedenheit; Diagnose bezogene Fallgruppen; Fokusgruppen; Pflege; Qualitative Forschung; diagnosis-related groups; focus groups; job satisfaction; nursing care; qualitative research