JMIR Publications

ABSTRACT

Background:

Quality of care is often poorly assessed in mental health settings. Accurate evaluation requires monitoring and comparison not only of outcomes, but of structures and processes. The resulting data allow hospital administrators to gauge their patient outcome data against those reported nationally. As Swiss psychiatric hospitals are planned and coordinated on the cantonal level, they vary considerably. Also, nursing care structures and processes such as nurse staffing are only reported and aggregated on the national level, while nurse outcomes such as job satisfaction or intention to leave have yet to be assessed in Swiss psychiatric hospitals. Lacking these key figures, psychiatric hospitals’ quality of care cannot reasonably even be described.

Objective:

Therefore, this study’s purpose is to describe a sample of Swiss psychiatric hospitals’ structures, processes, and nurse and patient outcomes and to explore associations between variables of interest.

Methods:

MatchRN Psychiatry is an observational multicenter study in Swiss psychiatric hospitals. The sample includes approximately 1’300 nurses from 113 units of 13 psychiatric hospitals in Switzerland’s German-speaking region. Additionally, each participating hospital’s routine patient assessment data are included. The nurse survey consists of 164 items covering three dimensions: work environment, patient safety climate and rationing of care. The unit-level questionnaire includes 57 items, including number of beds, number of nurses and nurses’ education levels. Routine patient data include items such as main diagnosis, number and duration of freedom-restrictive measures and symptom burden at admission and discharge. Data were collected between September 2019 and April 2020. They will be analyzed descriptively, using multilevel regression linear mixed models (LMMs) and generalized linear mixed models (GLMMs) to explore associations between variables of interest.

Results:

The MatchRN Psychiatry study is funded by the participating psychiatric hospitals and by the Swiss Psychiatric Nursing Leaders Association (VPPS). Data collection is ongoing.

Conclusions:

For the first time, the MatchRN Psychiatry study will systematically evaluate quality of care in psychiatric hospitals in Switzerland in relation to organizational structures, processes, and patient and nurse outcomes. The participating psychiatric hospitals will benefit from relevant findings in view of future planning and regulation of nurse staffing. This study’s findings will contribute to improvement strategies for nurse work environments and patient experiences in Swiss psychiatric hospitals.