Variation of Care Time Between Nursing Units in Classification-Based Nurse-to-Resident Ratios: A Multilevel Analysis.

PubMed

Brühl, Albert; Planer, Katarina; Hagel, Anja

2018-01-01

A validity test was conducted to determine how care level-based nurse-to-resident ratios compare with actual daily care times per resident in Germany. Stability across different long-term care facilities was tested. Care level-based nurse-to-resident ratios were compared with the standard minimum nurse-to-resident ratios. Levels of care are determined by classification authorities in long-term care insurance programs and are used to distribute resources. Care levels are a powerful tool for classifying authorities in long-term care insurance. We used observer-based measurement of assignable direct and indirect care time in 68 nursing units for 2028 residents across 2 working days. Organizational data were collected at the end of the quarter in which the observation was made. Data were collected from January to March, 2012. We used a null multilevel model with random intercepts and multilevel models with fixed and random slopes to analyze data at both the organization and resident levels. A total of 14% of the variance in total care time per day was explained by membership in nursing units. The impact of care levels on care time differed significantly between nursing units. Forty percent of residents at the lowest care level received less than the standard minimum registered nursing time per day. For facilities that have been significantly disadvantaged in the current staffing system, a higher minimum standard will function more effectively than a complex classification system without scientific controls.

Patient perception of nursing service quality; an applied model of Donabedian's structure-process-outcome approach theory.

PubMed

Kobayashi, Hideyuki; Takemura, Yukie; Kanda, Katsuya

2011-09-01

Nursing is a labour-intensive field, and an extensive amount of latent information exists to aid in evaluating the quality of nursing service, with patients' experiences, the primary focus of such evaluations. To effect further improvement in nursing as well as medical care, Donabedian's structure-process-outcome approach has been applied. To classify and confirm patients' specific experiences with regard to nursing service based on Donabedian's structure-process-outcomes model for improving the quality of nursing care. Items were compiled from existing scales and assigned to structure, process or outcomes in Donabedian's model through discussion among expert nurses and pilot data collection. With regard to comfort, surroundings were classified as structure (e.g. accessibility to nurses, disturbance); with regard to patient-practitioner interaction, patient participation was classified as a process (e.g. expertise and skill, patient decision-making); and with regard to changes in patients, satisfaction was classified as an outcome (e.g. information support, overall satisfaction). Patient inquiry was carried out using the finalized questionnaire at general wards in Japanese hospitals in 2005-2006. Reliability and validity were tested using psychometric methods. Data from 1,810 patients (mean age: 59.7 years; mean length of stay: 23.7 days) were analysed. Internal consistency reliability was supported (α = 0.69-0.96), with factor analysis items of structure aggregated to one factor and overall satisfaction under outcome aggregated to one. The remaining items of outcome and process were distributed together in two factors. Inter-scale correlation (r = 0.442-0.807) supported the construct validity of each structure-process-outcome approach. All structure items were represented as negative-worded examples, as they dealt with basic conditions under Japanese universal health care system, and were regarded as representative related to concepts of dissatisfaction and no dissatisfaction. Patients' experiences with nursing service were confirmed using Donabedian's approach and can therefore be applied to improve quality of nursing practice by practitioners, managers and policy makers. © 2010 The Authors. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.

NCLEX-RN performance: predicting success on the computerized examination.

PubMed

Beeman, P B; Waterhouse, J K

2001-01-01

Since the adoption of the Computerized Adaptive Testing (CAT) format of the National Certification Licensure Examination for Registered Nurses (NCLEX-RN), no studies have been reported in the literature on predictors of successful performance by baccalaureate nursing graduates on the licensure examination. In this study, a discriminant analysis was used to identify which of 21 variables can be significant predictors of success on the CAT NCLEX-RN. The convenience sample consisted of 289 individuals who graduated from a baccalaureate nursing program between 1995 and 1998. Seven significant predictor variables were identified. The total number of C+ or lower grades earned in nursing theory courses was the best predictor, followed by grades in several individual nursing courses. More than 93 per cent of graduates were correctly classified. Ninety-four per cent of NCLEX "passes" were correctly classified, as were 92 per cent of NCLEX failures. This degree of accuracy in classifying CAT NCLEX-RN failures represents a marked improvement over results reported in previous studies of licensure examinations, and suggests the discriminant function will be helpful in identifying future students in danger of failure. J Prof Nurs 17:158-165, 2001. Copyright 2001 by W.B. Saunders Company

Nursing home case mix. Patient classification by nursing resource use.

PubMed

Arling, G; Nordquist, R H; Brant, B A; Capitman, J A

1987-01-01

A model is presented for classifying nursing home patients according to nursing resource use. The model is derived from a study of 558 Medicaid nursing home patients in 12 facilities in Virginia. Data were obtained from self-reports of nursing staff for care delivered over a 52-hour period. The measure of care time was validated through concurrent work sampling. Project staff also assessed the patients' health and functional status using a standardized instrument. Using AID analysis patients were classified into six groups that were homogeneous in their use of nursing resources. Patients were initially categorized by presence or absence of conditions requiring specialized care (e.g., nutritional intake problems, quadriplegia, wounds or lesions, coma, and physical rehabilitation potential). For the specialized care category, two groups were formed by presence or absence of a catheter/ostomy. In the nonspecialized care category, four groups were formed by ADL impairment score and assistance required in eating/feeding. Mean resource use for the highest group was nearly four times that of the lowest group. The model accounted for 53% of the variance in nursing resource use.

Power and empowerment in nursing: three theoretical approaches.

PubMed

Kuokkanen, L; Leino-Kilpi, H

2000-01-01

Definitions and uses of the concept of empowerment are wide-ranging: the term has been used to describe the essence of human existence and development, but also aspects of organizational effectiveness and quality. The empowerment ideology is rooted in social action where empowerment was associated with community interests and with attempts to increase the power and influence of oppressed groups (such as workers, women and ethnic minorities). Later, there was also growing recognition of the importance of the individual's characteristics and actions. Based on a review of the literature, this paper explores the uses of the empowerment concept as a framework for nurses' professional growth and development. Given the complexity of the concept, it is vital to understand the underlying philosophy before moving on to define its substance. The articles reviewed were classified into three groups on the basis of their theoretical orientation: critical social theory, organization theory and social psychological theory. Empowerment seems likely to provide for an umbrella concept of professional development in nursing.

Core Values in Nursing Care Based on the Experiences of Nurses Engaged in Neonatal Nursing: A Text-mining Approach for Analyzing Reflection Records

PubMed Central

Watanabe, Hiromi; Okuda, Reiko; Hagino, Hiroshi

2018-01-01

Background Strong feelings about and enthusiasm for nursing care are reflected in nurses’ thoughts and behaviors in clinical practice and affect their profession. This study was conducted to identify the characteristics of core values in nursing care based on the experiences of nurses engaged in neonatal nursing through a process for recognizing the conceptualization of nursing. Methods We conceptualized nursing care in 43 nurses who were involved in neonatal nursing using a reflection sheet. We classified descriptions on a sheet based on the Three-Staged Recognition scheme and analyzed them using a text-mining approach. Results Nurses involved in neonatal nursing recognized that they must take care of the “child,” “mother,” and “family.” Important elements of nursing in nurses with less than 5 years versus 5 or more years of neonatal nursing experience were classified into seven clusters, respectively. These elements were mainly related to family members in both groups. In nurses with less than 5 years of experience, four clusters of one-way communication by nurses were observed in the analysis of the key elements in nursing. On the other hand, five clusters of mutual relationships between patients, their family members, and nurses were observed in nurses with 5 or more years of experience. Conclusion In conclusion, the core value of nurses engaged in neonatal nursing is family-oriented nursing. Nurses with 5 or more years of neonatal nursing experience understand patients and their family members well through establishing relationships and providing comfort and safety while taking care of them. PMID:29599621

Exploring correlates of turnover among nursing assistants in the National Nursing Home Survey.

PubMed

Temple, April; Dobbs, Debra; Andel, Ross

2011-01-01

High turnover of nursing assistants (NAs) has implications for the quality of nursing home care. Greater understanding of correlates of NA turnover is needed to provide insight into possible retention strategies. This study examined nursing home organizational characteristics and specific job characteristics of staff in relation to turnover of NAs. Cross-sectional data on 944 nationally representative nursing homes were derived from the 2004 National Nursing Home Survey. Using a 3-month turnover rate, 25% of the facilities with the lowest turnover rates were classified as low turnover, 25% of the facilities with the highest turnover were classified as high turnover, and the remaining 50% of the facilities were classified as moderate turnover. Multinomial logistic regression was used to examine organizational and job characteristics associated with low and high turnover compared with moderate turnover. One organizational characteristic, staffing levels at or greater than 4.0 hours per patient day, was associated with greater odds of low NA turnover and reduced odds of high NA turnover. Job characteristics including higher wages and union membership were associated with greater odds of low NA turnover, whereas wages, fully paid health insurance, employee assistance benefits, and involvement in resident care planning were associated with reduced odds of high NA turnover. The results of this study suggest that job characteristics of NA staff may be particularly important for turnover. Specifically, the provision of competitive wages and benefits (particularly health insurance) and involvement of NAs in resident care planning could potentially reduce NA turnover, as could maintaining high levels of nurse staffing.

Exploring correlates of turnover among nursing assistants in the National Nursing Home Survey.

PubMed

Temple, April; Dobbs, Debra; Andel, Ross

2009-01-01

High turnover of nursing assistants (NAs) has implications for the quality of nursing home care. Greater understanding of correlates of NA turnover is needed to provide insight into possible retention strategies. This study examined nursing home organizational characteristics and specific job characteristics of staff in relation to turnover of NAs. Cross-sectional data on 944 nationally representative nursing homes were derived from the 2004 National Nursing Home Survey. Using a 3-month turnover rate, 25% of the facilities with the lowest turnover rates were classified as low turnover, 25% of the facilities with the highest turnover were classified as high turnover, and the remaining 50% of the facilities were classified as moderate turnover. Multinomial logistic regression was used to examine organizational and job characteristics associated with low and high turnover compared with moderate turnover. One organizational characteristic, staffing levels at or greater than 4.0 hours per patient day, was associated with greater odds of low NA turnover and reduced odds of high NA turnover. Job characteristics including higher wages and union membership were associated with greater odds of low NA turnover, whereas wages, fully paid health insurance, employee assistance benefits, and involvement in resident care planning were associated with reduced odds of high NA turnover. The results of this study suggest that job characteristics of NA staff may be particularly important for turnover. Specifically, the provision of competitive wages and benefits (particularly health insurance) and involvement of NAs in resident care planning could potentially reduce NA turnover, as could maintaining high levels of nurse staffing.

Congruence between nursing problems in nursing care plans and NANDA nursing diagnoses.

PubMed

Varsi, Cecilie; Ruland, Cornelia M

2009-01-01

This study abstracted nursing problems documented in cancer patients' nursing care plans to analyze (1) which nursing problems were documented and (2) the degree of congruence between the abstracted problems and NANDA nursing diagnoses. 236 unique nursing problems were identified and could be mapped to 32 NANDA nursing diagnoses. However, only 4.3% had a precise match with NANDA, Thirty-eight percent were classified as similar and the rest were broader, narrower or no match. Thus NANDA only partially covered problems written by nurses in the care plans for this group of patients.

Reframing women's health in nursing education: a feminist approach.

PubMed

Morse, G G

1995-01-01

To operate from a feminist paradigm is a new way of thinking for nurse educators. Feminist perspectives in nursing provide a new stage of consciousness--one that values women's voices, their way of knowing, and their life experiences, and, most important, one that challenges traditional patriarchal practices. Furthermore, nursing curricula with feminist perspectives provides a biopsychosocial approach that encourages the full recognition of variables that can influence women's health, such as socioeconomic status, racial and ethnic background, and biobehavioral factors. The debate in medicine over a specialty in women's health is not unique. The history of academia abounds with descriptions of struggles to establish new fields and disciplines. Recent specialties, such as pediatrics and gerontology, which are distinguished by age rather than specific organ or system, struggled for establishment and recognition. Historically, nursing curricula has emulated the biomedical model that is reductionistic and contradictory to nursing's holistic mission. Rather than classifying women's health into a separate entity, women's health may be introduced into present curricula by employing feminist ideals and pedagogy throughout the curriculum. This approach would provide a mechanism to explore women's health issues that were previously minimally addressed at best, or not addressed at all. More important, students would be provided with an opportunity to examine the societal effects of racism, sexism, and classism, and this education would potentially lead to a growing awareness of concerns specific to women and minorities.

Resilience: synthesis of concept analyses and contribution to nursing classifications.

PubMed

Caldeira, S; Timmins, F

2016-06-01

To synthetize elements of research on concept analyses of resilience; and to propose a definition of resilience to NANDA International (NANDA-I) and International Classification for Nursing Practice (ICNP(®) ). Nursing classifications represent nursing knowledge that is clinically relevant and in continuous development. Nursing is considered holistic and there is always the need to consider human responses to health and life processes. Continuously there are new and emerging concepts concerning humans and health that should be considered within the organization and delivery of health care as resilience. In March 2015, the authors performed a synthesis of the findings of research concept analysis research derived from a systematic literature search of electronic databases (PsycINFO, CINAHL and PubMed). Search terms used in the title were: 'resilience' AND 'analysis' AND 'concept'. Papers written in Portuguese or English were included. A total of 27 papers were identified and eight papers were included. Of these, seven papers used Walker & Avant's () model and one used Rodger's () model. Resilience emerged as a fundamental concept across the lifespan that is closely related to health and well-being. Resilience is a phenomenon of interest for nurses. Similar attributes, antecedents, consequents and definitions were synthesized into a new proposal of a definition of resilience. While some diagnoses related to resilience are classified in NANDA-I, the concept is not included in ICNP(®) . The inclusion of the concept into ICNP(®) and the update in NANDA-I is a contribution for nursing knowledge through education and for clinical practice, as this could promote the effectiveness of interventions in several contexts. © 2016 International Council of Nurses.

[ABC supplies classification: a managment tool of costs in nursing].

PubMed

Lourenço, Karina Gomes; Castilho, Valéria

2006-01-01

The implementation of costs management systems has been extremely helpful to healthcare area owing to their efficacy in cutting expenditures as well as improving service quality. The ABC classification is an applied strategy to stocktaking and control. The research, which consists of an exploratory/descriptive quantitative analysis, has been carried out in order to identify, in a year time period, the demand for supplies at Universidade de Sao Paulo's Hospital. Of 1938 classified materials, 67 itens had been classified that they correspond to the materials with bigger costs for the hospital. 31.3% of these A-Class supplies catalogued items are the nursing materials, more used for the nursing team.

STUDIES ON THE RELATIONSHIP OF STREPTOCOCCUS HEMOLYTICUS TO THE RHEUMATIC PROCESS

PubMed Central

Coburn, Alvin F.; Pauli, Ruth H.

1932-01-01

To determine the nature of the organisms associated with outbreaks of rheumatism at The Pelham Home, in a large number of individuals at the Presbyterian Hospital Nurses' Training School and among rheumatic subjects in New York City under continuous clinical observation, studies of the throat flora have been conducted. Hemolytic streptococcus in most instances appeared in the pharynx from 1 to 5 weeks before the onset of the rheumatic attack. These organisms have been investigated with the usual types of bacteriological tests and, in addition, have been classified serologically according to Lancefield's technique. The results have demonstrated that the organisms were not of a single type, but fell into six antigenic groups. The majority of the freshly isolated strains tested were strong toxin producers. The organisms producing the strongest toxin were cultures from the patients who developed extremely intense rheumatism. About 70 per cent of these toxins were neutralized by a monovalent streptococcus antiserum. PMID:19870090

Nurse practitioners' focus on health care in terms of cure and care: analysis of graduate theses using the International Classification of Functioning, Disability and Health.

PubMed

Stallinga, Hillegonda A; Jansen, Gerard J; Kastermans, Marijke C; Pranger, Albert; Dijkstra, Pieter U; Roodbol, Petrie F

2016-07-01

To explore the focus of nurse practitioners on health care in terms of cure and care. Nurse practitioners are expected to act on the intersection of cure and care. However, in clinical practice and education, a clear model covering this area is lacking; therefore, it is unknown to what extent nurse practitioners are focused on this specific area. Graduate theses may reflect the focus of nurse practitioners. Sequential exploratory mixed method. In total, 413 published abstracts of graduate theses of a Dutch Master of Advanced Nursing Practice (2000-2015) were analysed using the International Classification of Functioning, Disability and Health. Data source included aim, question and outcome of each thesis and graduates' characteristics. A qualitative deductive approach was used for the analyses. Theses were classified as focused on cure, care, or on the intersection of cure and care. A small majority of 53% (N = 219) of the graduate theses addressed patient's health status and could be classified in the International Classification of Functioning, Disability and Health. Of the classified theses, 48% were focused on cure, 39% on the intersection of cure and care and 13% on care. While the percentage of theses addressing health status increased significantly over the 15-year period, the percentage of theses focused on cure, care and on the intersection of cure and care remained the same. The graduate theses reflected that nurse practitioners are increasingly oriented towards patients' health status. However, their focus is predominantly on cure rather than on the intersection of cure and care. © 2016 John Wiley & Sons Ltd.

Task uncertainty and communication during nursing shift handovers.

PubMed

Mayor, Eric; Bangerter, Adrian; Aribot, Myriam

2012-09-01

We explore variations in handover duration and communication in nursing units. We hypothesize that duration per patient is higher in units facing high task uncertainty. We expect both topics and functions of communication to vary depending on task uncertainty. Handovers are changing in modern healthcare organizations, where standardized procedures are increasingly advocated for efficiency and reliability reasons. However, redesign of handover should take environmental contingencies of different clinical unit types into account. An important contingency in institutions is task uncertainty, which may affect how communicative routines like handover are accomplished. Nurse unit managers of 80 care units in 18 hospitals were interviewed in 2008 about topics and functions of handover communication and duration in their unit. Interviews were content-analysed. Clinical units were classified into a theory-based typology (unit type) that gradually increases on task uncertainty. Quantitative analyses were performed. Unit type affected resource allocation. Unit types facing higher uncertainty had higher handover duration per patient. As expected, unit type also affected communication content. Clinical units facing higher uncertainty discussed fewer topics, discussing treatment and care and organization of work less frequently. Finally, unit type affected functions of handover: sharing emotions was less often mentioned in unit types facing higher uncertainty. Task uncertainty and its relationship with functions and topics of handover should be taken into account during the design of handover procedures. © 2011 Blackwell Publishing Ltd.

[Nursing diagnosis "impaired walking" in elderly patients: integrative literature review].

PubMed

Marques-Vieira, Cristina Maria Alves; de Sousa, Luís Manuel Mota; de Matos Machado Carias, João Filipe; Caldeira, Sílvia Maria Alves

2015-03-01

The impaired walking nursing diagnosis has been included in NANDA International classification taxonomy in 1998, and this review aims to identify the defining characteristics and related factors in elderly patients in recent literature. Integrative literature review based on the following guiding question: Are there more defining characteristics and factors related to the nursing diagnosis impaired walking than those included in NANDA International classification taxonomy in elderly patients? Search conducted in 2007-2013 on international and Portuguese databases. Sample composed of 15 papers. Among the 6 defining characteristics classified at NANDA International, 3 were identified in the search results, but 13 were not included in the classification. Regarding the 14 related factors that are classified, 9 were identified in the sample and 12 were not included in the NANDA International taxonomy. This review allowed the identification of new elements not included in NANDA International Taxonomy and may contribute to the development of taxonomy and nursing knowledge.

[Work-related stress according to the Demand-Control Model and Minor Psychic Disorder in nursing workers].

PubMed

Urbanetto, Janete de Souza; Magalhães, Maria Cristina Cademartori; Maciel, Vanessa Oreda; Sant'Anna, Viviane Massena; Gustavo, Andréia da Silva; Poli-de-Figueiredo, Carlos Eduardo; Magnago, Tânia Solange Bosi de Souza

2013-10-01

This was a cross-sectional study that aimed to assess the association between work-related stress according to the Demand-Control Model, and the occurrence of Minor Psychic Disorder (MPD) in nursing workers. The participants were 335 professionals, out of which 245 were nursing technicians, aged predominantly between 20 and 40 years. Data were collected using the Job Stress Scale and the Self-Reporting Questionnaire-20. The analysis was performed using descriptive and analytical statistics. The prevalence of suspected MPD was 20.6%. Workers classified in the quadrants active job and high strain of the Demand-Control Model presented higher potential for developing MPD compared with those classified in the quadrant low strain. In conclusion, stress affects the mental health of workers and the aspects related to high psychological demands and high control still require further insight in order to understand their influence on the disease processes of nursing workers.

Classifying clinical decision making: a unifying approach.

PubMed

Buckingham, C D; Adams, A

2000-10-01

This is the first of two linked papers exploring decision making in nursing which integrate research evidence from different clinical and academic disciplines. Currently there are many decision-making theories, each with their own distinctive concepts and terminology, and there is a tendency for separate disciplines to view their own decision-making processes as unique. Identifying good nursing decisions and where improvements can be made is therefore problematic, and this can undermine clinical and organizational effectiveness, as well as nurses' professional status. Within the unifying framework of psychological classification, the overall aim of the two papers is to clarify and compare terms, concepts and processes identified in a diversity of decision-making theories, and to demonstrate their underlying similarities. It is argued that the range of explanations used across disciplines can usefully be re-conceptualized as classification behaviour. This paper explores problems arising from multiple theories of decision making being applied to separate clinical disciplines. Attention is given to detrimental effects on nursing practice within the context of multidisciplinary health-care organizations and the changing role of nurses. The different theories are outlined and difficulties in applying them to nursing decisions highlighted. An alternative approach based on a general model of classification is then presented in detail to introduce its terminology and the unifying framework for interpreting all types of decisions. The classification model is used to provide the context for relating alternative philosophical approaches and to define decision-making activities common to all clinical domains. This may benefit nurses by improving multidisciplinary collaboration and weakening clinical elitism.

Efficient and sparse feature selection for biomedical text classification via the elastic net: Application to ICU risk stratification from nursing notes.

PubMed

Marafino, Ben J; Boscardin, W John; Dudley, R Adams

2015-04-01

Sparsity is often a desirable property of statistical models, and various feature selection methods exist so as to yield sparser and interpretable models. However, their application to biomedical text classification, particularly to mortality risk stratification among intensive care unit (ICU) patients, has not been thoroughly studied. To develop and characterize sparse classifiers based on the free text of nursing notes in order to predict ICU mortality risk and to discover text features most strongly associated with mortality. We selected nursing notes from the first 24h of ICU admission for 25,826 adult ICU patients from the MIMIC-II database. We then developed a pair of stochastic gradient descent-based classifiers with elastic-net regularization. We also studied the performance-sparsity tradeoffs of both classifiers as their regularization parameters were varied. The best-performing classifier achieved a 10-fold cross-validated AUC of 0.897 under the log loss function and full L2 regularization, while full L1 regularization used just 0.00025% of candidate input features and resulted in an AUC of 0.889. Using the log loss (range of AUCs 0.889-0.897) yielded better performance compared to the hinge loss (0.850-0.876), but the latter yielded even sparser models. Most features selected by both classifiers appear clinically relevant and correspond to predictors already present in existing ICU mortality models. The sparser classifiers were also able to discover a number of informative - albeit nonclinical - features. The elastic-net-regularized classifiers perform reasonably well and are capable of reducing the number of features required by over a thousandfold, with only a modest impact on performance. Copyright © 2015 Elsevier Inc. All rights reserved.

Informing Leadership Models: Nursing and Organizational Characteristics of Neonatal Intensive Care Units in Freestanding Children's Hospitals.

PubMed

Toole, Cheryl A; DeGrazia, Michele; Connor, Jean Anne; Gauvreau, Kimberlee; Kuzdeba, Hillary Bishop; Hickey, Patricia A

Neonatal intensive care units (NICUs) located in freestanding children's hospitals may exhibit significant variation in nursing and organizational characteristics, which can serve as opportunities for collaboration to understand optimal staffing models and linkages to patient outcomes. Adopting methods used by Hickey et al in pediatric cardiovascular critical care, the purpose of this study was to provide a foundational description of the nursing and organizational characteristics for NICUs located in freestanding children's hospitals in the United States. Clinical nurse leaders in NICUs located in freestanding children's hospitals were invited to participate in an electronic cross-sectional survey. Descriptive analyses were used to summarize nursing and organizational characteristics. The response rate was 30% (13/43), with 69.2% of NICUs classified as level III/IV and 30.8% classified as level II/III. Licensed bed capacity varied significantly (range, 24-167), as did the proportion of full-time equivalent nurses (range, 71.78-252.3). Approximately three-quarters of staff nurses held baccalaureate degrees or higher. A quarter of nurses had 16 or more years (26.3%) of experience, and 36.9% of nurses had 11 or more years of nursing experience. Nearly one-third (29.2%) had 5 or less years of total nursing experience. Few nurses (10.6%) held neonatal specialty certification. All units had nurse educators, national and unit-based quality metrics, and procedural checklists. This study identified (1) variation in staffing models signaling an opportunity for collaboration, (2) the need to establish ongoing processes for sites to participate in future collaborative efforts, and (3) survey modifications necessary to ensure a more comprehensive understanding of nursing and organizational characteristics in freestanding children's hospital NICUs.

Classification of residents in nursing homes in Tuscany (Italy) using Resource Utilization Groups Version III (RUG-III).

PubMed

Francesconi, Paolo; Cantini, Elisabetta; Bavazzano, Emanuela; Lauretani, Fabrizio; Bandinelli, Stefania; Buiatti, Eva; Ferrucci, Luigi

2006-04-01

Samples of nursing homes in Tuscany (Italy) classify their residents and determine their case-mix according to the Resource Utilization Groups System, Version III (RUG-III). A large sample of nursing homes was selected, based on willingness to participate, representation of both public and private institutions, and wide geographic representation. Two registered nurses assessed all residents using the RUG questionnaire. The information collected was then used to group residents into 44 RUGs, and facility-specific case-mix indices were calculated using the RUG-specific weights previously validated in Italy. A total of 3981 residents from 93 nursing homes were assessed. Most residents were over 75 years old (87.4%) and women (68.6%). A large percentage was classified into RUGs within the following primary categories: reduced physical function (33.6%), impaired cognition (17.6%) and clinically complex (17.6%). The resulting nursing home case-mix indices ranged from 0.627 to 1.108 (mean 0.807+/-0.110). No significant association was found between type of facility, level of fees, or extent of staff in the nursing homes and their case-mix indices. RUGIII can provide information on types of nursing home residents and their care needs. This is useful for monitoring and evaluating long-term care services for the elderly, and allows for more effective planning and allocation of staffing and financial resources.

Magnet status and registered nurse views of the work environment and nursing as a career.

PubMed

Ulrich, Beth T; Buerhaus, Peter I; Donelan, Karen; Norman, Linda; Dittus, Robert

2007-05-01

To compare how registered nurses view the work environment and the nursing shortage based on the Magnet status of their organizations. The upsurge in organizations pursuing and obtaining Magnet recognition provides increased opportunities to investigate whether and how registered nurses who are employed in Magnet organizations and organizations pursuing Magnet status perceive differences in the nursing shortage, hospitals' responses to the shortage, characteristics of the work environment, and professional relationships. A nationally representative sample of registered nurses licensed to practice in the United States was surveyed. The views of registered nurses who worked in Magnet organizations, organizations in the process of applying for Magnet status, and non-Magnet organizations were analyzed as independent groups. Significant differences were found. Although there is a clear Magnet difference, there are also identifiable differences that occur during the pursuit of Magnet recognition. Many organizations in the process of applying for Magnet status rated higher than Magnet organizations, indicating that there is much to do to maintain the comparative advantages for Magnet hospitals.

Magnet status and registered nurse views of the work environment and nursing as a career.

PubMed

Ulrich, Beth T; Buerhaus, Peter I; Donelan, Karen; Norman, Linda; Dittus, Robert

2009-01-01

To compare how registered nurses view the work environment and the nursing shortage based on the Magnet status of their organizations. The upsurge in organizations pursuing and obtaining Magnet recognition provides increased opportunities to investigate whether and how registered nurses who are employed in Magnet organizations and organizations pursuing Magnet status perceive differences in the nursing shortage, hospitals' responses to the shortage, characteristics of the work environment, and professional relationships. A nationally representative sample of registered nurses licensed to practice in the United States was surveyed. The views of registered nurses who worked in Magnet organizations, organizations in the process of applying for Magnet status, and non-Magnet organizations were analyzed as independent groups. Significant differences were found. Although there is a clear Magnet difference, there are also identifiable differences that occur during the pursuit of Magnet recognition. Many organizations in the process of applying for Magnet status rated higher than Magnet organizations, indicating that there is much to do to maintain the comparative advantages for Magnet hospitals.

[Pharmacotherapy in nursing homes].

PubMed

Kersten, Hege; Ruths, Sabine; Wyller, Torgeir Bruun

2009-09-10

There is a high risk of drug-related problems in nursing homes due to polypharmacy, multi-morbidity and age-related changes. We describe the drug use and compare the pharmacotherapy in two nursing homes with different staffing of physicians. We included 48 long-term patients from two nursing homes in Oslo; i.e. nursing home A (24 patients) and nursing home B (24 patients). A pharmacist recorded information on patients' drug use, identified and classified drug-related problems, and classified the drugs used according to their anticholinergic burden. Two physicians (with experience in geriatrics and nursing home medicine) assessed the clinical importance of the drug-related problems independently from each other. The physicians were blinded with respect to which nursing home the patients came from. Patients in nursing home A used a median (interquartile range [IQR]) of 7.0 (5.3-11.0) drugs, and those in nursing home B used 9.5 (8.0-12.8); the median difference was 2.0, 95% CI 1.0-4.0, p = 0.006). Patients also had lower anticholinergic drug scores in nursing home A (1.0 [0.0-2.0]) than in nursing home B (2.0 [2.0-3.8]); median difference 1.0, 95% CI 0.0-2.0, p = 0.009). Patients in home A also had lower numbers of drug-related problems (3.0 [2.0-4.0]) than those in home B (5.5 [3.3-8.0]); median difference 1.0, 85% CI 0.0-3.0, p = 0.007. No significant differences were found between the nursing homes with regard to patients' age, co-morbidity, kidney function, or dementia state, but nursing home A had a better staffing of physicians. The number of drugs used as well as the quality indicators varied considerably between the nursing homes assessed. Differences in physician staffing might be one reasonable explanation. Our study highlights the importance of systematic multidisciplinary medication reviews for quality improvement in nursing homes.

Classifying clinical decision making: interpreting nursing intuition, heuristics and medical diagnosis.

PubMed

Buckingham, C D; Adams, A

2000-10-01

This is the second of two linked papers exploring decision making in nursing. The first paper, 'Classifying clinical decision making: a unifying approach' investigated difficulties with applying a range of decision-making theories to nursing practice. This is due to the diversity of terminology and theoretical concepts used, which militate against nurses being able to compare the outcomes of decisions analysed within different frameworks. It is therefore problematic for nurses to assess how good their decisions are, and where improvements can be made. However, despite the range of nomenclature, it was argued that there are underlying similarities between all theories of decision processes and that these should be exposed through integration within a single explanatory framework. A proposed solution was to use a general model of psychological classification to clarify and compare terms, concepts and processes identified across the different theories. The unifying framework of classification was described and this paper operationalizes it to demonstrate how different approaches to clinical decision making can be re-interpreted as classification behaviour. Particular attention is focused on classification in nursing, and on re-evaluating heuristic reasoning, which has been particularly prone to theoretical and terminological confusion. Demonstrating similarities in how different disciplines make decisions should promote improved multidisciplinary collaboration and a weakening of clinical elitism, thereby enhancing organizational effectiveness in health care and nurses' professional status. This is particularly important as nurses' roles continue to expand to embrace elements of managerial, medical and therapeutic work. Analysing nurses' decisions as classification behaviour will also enhance clinical effectiveness, and assist in making nurses' expertise more visible. In addition, the classification framework explodes the myth that intuition, traditionally associated with nurses' decision making, is less rational and scientific than other approaches.

Identifying Nursing Interventions in a Cancer Screening Program Using Nursing Interventions Classification Taxonomy.

PubMed

Benito, Llucia; Lluch, María Teresa; Falcó, Anna Marta; García, Montse; Puig, Montse

2017-04-01

This study aimed to investigate which Nursing Interventions Classification (NIC) labels correspond to specific nursing interventions provided during cancer screening to establish a nursing documentation system. This descriptive study was conducted to identify and classify the interventions that cancer screening nurses perform based on an initial list. The initial list was grouped into 15 interventions that corresponded to four domains and eight classes. The study found expert consensus regarding the duties of cancer screening nurses and identified 15 interventions that should be implemented in clinical practice for cancer screening care, according to the NIC taxonomy. This study is the first step in developing indicators to assess nursing performance in cancer screening, and it helps to establish the core competency requirements for cancer screening nurses. © 2015 NANDA International, Inc.

ICU Nurses' Knowledge, Attitude, and Practice Towards their Role in the Organ Donation Process from Brain-Dead Patients and Factors Influencing it in Iran.

PubMed

Masoumian Hoseini, S T; Manzari, Z; Khaleghi, I

2015-01-01

Nowadays, ICU nurses play a significant role in the care of brain-dead patients and their families. Therefore, their knowledge, attitude and practice towards this issue are extremely important to the success of organ donation. To assess ICU nurses' knowledge, attitude and practice towards their role in the organ donation process from brain-dead patients and factors influencing it in Iran. In a cross-sectional analytical study, 90 ICU nurses working in Ghaem and Emam Reza Hospitals affiliated to Mashhad University of Medical Sciences were selected through a stratified random sampling. Data were collected from the participants by a questionnaire included demographic information, and factors influencing the nurses knowledge, attitude, and practice towards their roles in the organ donation process. 90 nurses participated in this study. 70% of the research subjects had spoken with their own families about organ donation; 20% had organ donation cards. The mean±SD score of nurses' knowledge was 49.13±9.6, attitude 21.49±14.32, and practice was 3.66±6.04. 80% of nurses had a mean knowledge about their roles in the organ donation process; 82% agreed with their roles in this process, and 97% showed weak practice in this regard. Nurses did not have adequate knowledge, attitude, and practice towards their role in organ donation process. It is suggested to include nursing courses on the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the organ donation process.

Importance of patient education on home medical care waste disposal in Japan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ikeda, Yukihiro, E-mail: yuyu@med.kindai.ac.jp

Highlights: • Attached office nurses more recovered medical waste from patients’ homes. • Most nurses educated their patients on how to store home medical care waste in their homes and on how to separate them. • Around half of nurses educated their patients on where to dispose of their home medical care waste. - Abstract: To determine current practices in the disposal and handling of home medical care (HMC) waste, a questionnaire was mailed to 1965 offices nationwide. Of the office that responded, 1283 offices were analyzed. Offices were classified by management configuration: those attached to hospitals were classified asmore » ”attached offices” and others as “independent offices”. More nurses from attached offices recovered medical waste from patients’ homes than those from independent offices. Most nurses educated their patients on how to store HMC waste in their homes (79.3% of total) and on how to separate HMC waste (76.5% of total). On the other hand, only around half of nurses (47.3% from attached offices and 53.2% from independent offices) educated their patients on where to dispose of their HMC waste. 66.0% of offices replied that patients had separated their waste appropriately. The need for patient education has emerged in recent years, with education for nurses under the diverse conditions of HMC being a key factor in patient education.« less

The role of clinical nurse educators in organ procurement organizations.

PubMed

Swain, Sharon

2011-12-01

Clinical nurse educators are advanced practice nurses with preparation at the master's level or higher. Such nurses play an important role in organ procurement organizations. As leaders and members of the team, they provide structure and design to the training process. These educators oversee orientation of new employees, serve as mentors to preceptors, assess the learning needs of the organization, and provide ongoing training to veteran staff. Clinical nurse educators also contribute to continuous quality improvement for the organization and help to comply with regulatory standards.

Peer-to-peer nursing rounds and hospital-acquired pressure ulcer prevalence in a surgical intensive care unit: a quality improvement project.

PubMed

Kelleher, Alyson Dare; Moorer, Amanda; Makic, MaryBeth Flynn

2012-01-01

We conducted a quality improvement project in order to evaluate the effect of nurse-to-nurse bedside "rounding" as a strategy to decrease hospital-acquired pressure ulcers (HAPU) in a surgical intensive care unit. We instituted weekly peer-to-peer bedside skin rounds in a 17-bed surgical intensive care unit. Two nurses were identified as skin champions and trained by the hospital's certified WOC nurse to conduct skin rounds. The skin champion nurses conducted weekly peer-to-peer rounds that included discussions about key elements of our patients' skin status including current Braden Scale for Pressure Sore Risk score, and implementation of specific interventions related to subscale risk assessment. If a pressure ulcer was present, the current action plan was reevaluated for effectiveness. Quarterly HAPU prevalence studies were conducted from January 2008 to December 2010. Nineteen patients experienced a HAPU: 17 were located on the coccyx and 2 on the heel. Ten ulcers were classified as stage II, 3 PU were stage IV, 5 were deemed unstageable, and 1 was classified as a deep tissue injury. The frequency of preventive interventions rose during our quality improvement project. Specifically, the use of prevention surfaces increased 92%, repositioning increased 30%, nutrition interventions increased 77%, and moisture management increased 100%. Prior to focused nursing rounds, the highest HAPU prevalence rate was 27%. After implementing focused nursing rounds, HAPU rates trended down and were 0% for 3 consecutive quarters.

Indian ICU nurses' perceptions of and attitudes towards organ donation.

PubMed

Vijayalakshmi, Poreddi; Nagarajaiah; Ramachandra; Math, Suresh Bada

Nurses play a significant role in identifying and securing potential organ donors in the clinical environment. Research among Indian nurses related to organ donation is sparse. The present study aimed to investigate nurses' attitudes towards organ donation. A cross-sectional descriptive survey was carried out among nurses (n=184) at a tertiary care centre. Data were collected through self-report questionnaire. A majority (81%) of the respondents were 'willing to sign the card' for organ donation; however, only 3.8% (n=7) of them actually 'signed the organ donation card'. There were significant associations found between intentions to sign the organ donation card and gender (x2=5.852; p<0.054), religion (x2=40.175; p<0.000), and experience caring for brain-dead patients (x2=22.790; p<0.001). The researchers strongly suggest continuing education for nurses to enhance skills and knowledge, as well as sensitivity to cultural, ethical, social, and religious issues, and advocacy in the area of organ donation. Furthermore, nurse administrators must take the initiative to develop guidelines clarifying the role of nurses in the organ donation and transplantation process to promote organ donation and improve rates.

Nurse work environment and quality of care by unit types: A cross-sectional study.

PubMed

Ma, Chenjuan; Olds, Danielle M; Dunton, Nancy E

2015-10-01

Nursing unit is the micro-organization in the hospital health care system in which integrated patient care is provided. Nursing units of different types serve patients with distinct care goals, clinical tasks, and social structures and norms. However, empirical evidence is sparse on unit type differences in quality of care and its relation with nurse work environment. Nurse work environment has been found as an important nursing factor predicting nurse and patient outcomes. To examine the unit type differences in nurse-reported quality of care, and to identify the association between unit work environment and quality of care by unit types. This is a cross-sectional study using nurse survey data (2012) from US hospitals nationwide. The nurse survey collected data on quality of care, nurse work environment, and other work related information from staff nurses working in units of various types. Unit types were systematically classified across hospitals. The unit of analysis was the nursing unit, and the final sample included 7677 units of 14 unit types from 577 hospitals in 49 states in the US. Multilevel regressions were used to assess the relationship between nurse work environment and quality of care across and by unit types. On average, units had 58% of the nurses reporting excellent quality of care and 40% of the nurses reporting improved quality of care over the past year. Unit quality of care varied by unit types, from 43% of the nurses in adult medical units to 73% of the nurses in interventional units rating overall quality of care on unit as excellent, and from 35% of the nurses in adult critical care units to 44% of the nurses in adult medical units and medical-surgical combined units reporting improved quality of care. Estimates from regressions indicated that better unit work environments were associated with higher quality of care when controlling various hospital and unit covariates; and this association persisted among units of different types. Unit type differences exist in the overall quality of care as well as achievement in improving quality of care. The low rates of nurses reporting improvement in the quality of nursing care to patients suggest that further interventions focusing at the unit-level are needed for achieving high care quality. Findings from our study also suggest that improving nurse work environments can be an effective strategy to improve quality of care. Copyright © 2015 Elsevier Ltd. All rights reserved.

Black Women in Nursing Education Completion Programs: Issues Affecting Participation.

ERIC Educational Resources Information Center

Aiken, Lolita Chappel; Cervero, Ronald M.; Johnson-Bailey, Juanita

2001-01-01

Interviews with 10 black women enrolled in or graduated from baccalaureate nursing programs identified intrapersonal and cultural factors encouraging their participation. Hindrances were classified as the experience of being the "other" and the culture of racism. Findings show that individual and institutional racism is a barrier in registered…

Security giving in surrogacy motherhood process as a caring model for commissioning mothers: A theory synthesis.

PubMed

Zandi, Mitra; Vanaki, Zohreh; Shiva, Marziyeh; Mohammadi, Eesa; Bagheri-Lankarani, Narges

2016-07-01

Despite the increasing use of surrogacy, there are no caring theories/models that serve as the basis for nursing care to surrogacy commissioning mothers. This study has designed a model for caring of surrogacy commissioning mothers in 2013. The theory synthesis of Walker and Avant's strategies of theory construction (2011) was used to design a caring model/theory. The theory synthesis includes three stages: (i) selection of focal concept (the concept of "security giving in motherhood" was selected); (ii) review of studies in order to identify factors related to focal concept relevant studies (42 articles and 13 books) were reviewed, statements and concepts related to focal concept were then extracted and classified, and their relations were specified; and (iii) organization of concepts and statements within a relevant general and effective manifestation of the phenomenon under study which led to developing of a model. In this caring model/theory, entitled "security giving in surrogacy motherhood", nurses roles were conceptualized within the conceptual framework that includes three main roles: (i) coordination; (ii) participation; and (iii) security giving (physical, emotional, and legal support; empowerment; presence; relationship management between both parties and advocacy). Training surrogacy specialist nurses and establishment of surrogacy care centers are important factors for implementation of the model. This model could help to provided better caring for surrogacy clients, especially for commissioning mothers. © 2016 Japan Academy of Nursing Science.

How to Manage Hospital-Based Palliative Care Teams Without Full-Time Palliative Care Physicians in Designated Cancer Care Hospitals: A Qualitative Study.

PubMed

Sakashita, Akihiro; Kishino, Megumi; Nakazawa, Yoko; Yotani, Nobuyuki; Yamaguchi, Takashi; Kizawa, Yoshiyuki

2016-07-01

To clarify how highly active hospital palliative care teams can provide efficient and effective care regardless of the lack of full-time palliative care physicians. Semistructured focus group interviews were conducted, and content analysis was performed. A total of 7 physicians and 6 nurses participated. We extracted 209 codes from the transcripts and organized them into 3 themes and 21 categories, which were classified as follows: (1) tips for managing palliative care teams efficiently and effectively (7 categories); (2) ways of acquiring specialist palliative care expertise (9 categories); and (3) ways of treating symptoms that are difficult to alleviate (5 categories). The findings of this study can be used as a nautical chart of hospital-based palliative care team (HPCT) without full-time PC physician. Full-time nurses who have high management and coordination abilities play a central role in resource-limited HPCTs. © The Author(s) 2015.

Determination of nursing diagnoses used by students in the first clinical practice.

PubMed

Türk, Gülengün; Tuğrul, Emel; Sahbaz, Muazzez

2013-10-01

This study was carried out descriptively with the purpose of determining nursing diagnoses that nursing freshmen students used in their first clinical practice. The sample of the study consisted of 61 nursing students. Data of the study were collected with the examination of 208 care plans that the students had prepared. Nursing diagnoses in the examined care plans were classified according to nursing diagnoses grouped under the domains of Taxonomy II NANDA-I. Students determined 31 different diagnoses in nine domains of NANDA-I. Total nursing diagnoses used in care plans were 635. It was determined that the nursing diagnoses that the students mostly used, according to classification of NANDA-I, were in the domains of safety/protection, activity/rest, comfort, elimination and exchange, and nutrition. © 2013 NANDA International.

Transforming the image of nursing: the evidence for assurance.

PubMed

Wocial, Lucia D; Sego, Kelly; Rager, Carrie; Laubersheimer, Shellee; Everett, Linda Q

2014-01-01

A nurse's uniform influences perceptions about nursing practice and thus contributes significantly to the overall image of a nurse. A nurse's uniform also can represent the brand of an organization, the tangible and intangible attributes that distinguish an organization from its competitors. The rebranding of a major health care system provided a unique opportunity to refine the "image of nurses" within the organization. This article describes the planning, evidence gathering, and implementation of a major initiative to promote professional nursing practice.

Job control, work-family balance and nurses' intention to leave their profession and organization: A comparative cross-sectional survey.

PubMed

Yamaguchi, Yoshiko; Inoue, Takahiro; Harada, Hiroko; Oike, Miyako

2016-12-01

The shortage of nurses is a problem in many countries. In Japan, the distribution of nurses across different care settings is uneven: the shortage of nurses in home healthcare and nursing homes is more serious than in hospitals. Earlier research has identified numerous factors affecting nurses' intention to leave work (e.g., job control, family-related variables, work-family conflict); however, these factors' levels and effect size may vary between nurses in hospitals, home healthcare, and nursing homes. This study measured job control, family-related variables, and work-family conflict among nurses in hospitals, home healthcare, and nursing homes, and compared these variables' levels and effect size on nurses' intention to leave their organization or profession between these care settings. The research design was cross-sectional. Participating nurses from hospitals, home healthcare facilities, and nursing homes self-administered an anonymous questionnaire survey; nurses were recruited from the Kyushu district of Japan. Nurses from nine hospitals, 86 home healthcare offices, and 107 nursing homes participated. We measured nurses' intention to leave nursing or their organization, perceived job control, family variables and work-family conflict. We analyzed 1461 participants (response rate: 81.7%). The level of job control, family variables, and work-family conflict affecting nurses varied between hospitals, home healthcare, and nursing homes; additionally, these variables' effect on nurses' intention to leave their organization or profession varied between these care settings. Work-family conflict, family variables, and job control most strongly predicted nurses' intention to leave their organization or profession in hospitals, home healthcare, and nursing homes, respectively. Interventions aiming to increase nurse retention should distinguish between care settings. Regarding hospitals, reducing nurses' work-family conflict will increase nurse retention. Regarding home healthcare, allowing nurses to fulfill family responsibilities will increase nurse retention. Regarding nursing home nurses, increasing nurses' job control will increase nurse retention. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Impact of Person-Organization Fit on Nurse Job Satisfaction and Patient Care Quality.

PubMed

Risman, K L; Erickson, Rebecca J; Diefendorff, James M

2016-08-01

In the current healthcare context, large health care organizations may increasingly emphasize profit, biomedicine, efficiency, and customer service in the delivery of care. This orientation toward nursing work by large organizations may be perceived by nurses as incompatible with professional caring. Ordinary Least Squares regression was used to explore the impact of person-organization fit (i.e., value congruence between self and employing organization) on nurses' general job satisfaction and quality of patient care (n=753). Nurses' perceived person-organization fit is a significant predictor of general job satisfaction and quality of patient care. The implications of our findings are discussed and recommendations for nursing leaders and future research are made. Copyright © 2015 Elsevier Inc. All rights reserved.

Ethical conflicts with hospitals: the perspective of nurses and physicians.

PubMed

Gaudine, Alice; LeFort, Sandra M; Lamb, Marianne; Thorne, Linda

2011-11-01

Nurses and physicians may experience ethical conflict when there is a difference between their own values, their professional values or the values of their organization. The distribution of limited health care resources can be a major source of ethical conflict. Relatively few studies have examined nurses' and physicians' ethical conflict with organizations. This study examined the research question 'What are the organizational ethical conflicts that hospital nurses and physicians experience in their practice?' We interviewed 34 registered nurses, 10 nurse managers, and 31 physicians as part of a larger study, and asked them to describe their ethical conflicts with organizations. Through content analysis, we identified themes of nurses' and physicians' ethical conflict with organizations and compared the themes for nurses with those for physicians.

Virginia Henderson's principles and practice of nursing applied to organ donation after brain death.

PubMed

Nicely, Bruce; DeLario, Ginger T

2011-03-01

Registered nurses were some of the first nonphysician organ transplant and donation specialists in the field, both in procurement and clinical arenas. Nursing theories are abundant in the literature and in nursing curricula, but none have been applied to the donation process. Noted nursing theorist Virginia Henderson (1897-1996), often referred to as the "first lady of nursing," developed a nursing model based on activities of living. Henderson had the pioneering view that nursing stands separately from medicine and that nursing consists of more than simply following physicians' orders. Henderson's Principles and Practice of Nursing is a grand theory that can be applied to many types of nursing. In this article, Henderson's theory is applied to the intensely focused and specialized area of organ donation for transplantation. Although organ donation coordinators may have backgrounds as physicians' assistants, paramedics, or other allied health professions, most are registered nurses. By virtue of the inherent necessity for involvement of the family and friends of the potential donor, Henderson's concepts are applied to the care and management of the organ donor, to the donor's family and friends, and in some instances, to the caregivers themselves.

Bridging the Research-to-Practice Gap: The Role of the Nurse Scientist.

PubMed

Brant, Jeannine M

2015-11-01

To describe the emerging role of the nurse scientist in health care organizations. Historical perspectives of the role are explored along with the roles of the nurse scientist, facilitators, barriers, and future implications. Relevant literature on evidence-based practice and research in health care organizations; nurse scientist role; interview with University of Colorado nurse scientist. The nurse scientist role is integral for expanding evidence-based decisions and nursing research. A research mentor is considered the most important facilitator for a successful nursing research program. Organizations should consider including the nurse scientist role to facilitate evidence-based practice and expand opportunities for nursing research. Copyright © 2015 Elsevier Inc. All rights reserved.

Does international family nursing need a professional organization?

PubMed

Curry, Donna Miles

2007-11-01

An International Family Nursing Conference has been held on a periodic basis since the 1980s. It started with several nursing professionals with a common interest: wanting to meet to share research and practice ideas. The organization of these conferences has been completely voluntary and sponsored by some very benevolent individuals and an institution of higher education. The fact that any of these conferences came off is attributed to considerable personal financial support and an untold number of volunteer hours. A group met in 2005 at the 7th International Family Nursing Conference in Victoria, British Columbia, Canada, to discuss whether there was any interest in forming a professional organization for family nursing. This article explores the cost/ benefits of such an endeavor. Input from other small newly created professional nursing organizations is shared. Conclusions provide summative questions related to development of a formal international professional nursing organization that family nurses must address.

Nurse Knowledge, Work Environment, and Turnover in Highly Specialized Pediatric End-of-Life Care.

PubMed

Lindley, Lisa C; Cozad, Melanie J

2017-07-01

To examine the relationship between nurse knowledge, work environment, and registered nurse (RN) turnover in perinatal hospice and palliative care organizations. Using nurse intellectual capital theory, a multivariate analysis was conducted with 2007 National Home and Hospice Care Survey data. Perinatal hospice and palliative care organizations experienced a 5% turnover rate. The professional experience of advanced practice nurses (APNs) was significantly related to turnover among RNs (β = -.032, P < .05). Compared to organizations with no APNs professional experience, clinical nurse specialists and nurse practitioners significantly reduced RN turnover by 3 percentage points. No other nurse knowledge or work environment variables were associated with RN turnover. Several of the control variables were also associated with RN turnover in the study; Organizations serving micropolitan (β = -.041, P < .05) and rural areas (β = -.037, P < .05) had lower RN turnover compared to urban areas. Organizations with a technology climate where nurses used electronic medical records had a higher turnover rate than those without (β = .036, P < .05). The findings revealed that advanced professional experience in the form of APNs was associated with reductions in RN turnover. This suggests that having a clinical nurse specialist or nurse practitioner on staff may provide knowledge and experience to other RNs, creating stability within the organization.

Morphological, histological, and ultrastructural studies of the ovary of the cattle-tick Boophilus microplus (Canestrini, 1887) (Acari: Ixodidae).

PubMed

Saito, Kelly Cristina; Bechara, Gervásio Henrique; Nunes, Erika Takagi; de Oliveira, Patricia Rosa; Denardi, Sandra Eloisi; Mathias, Maria Izabel Camargo

2005-05-15

This study presents the morphology of the ovary, as well as the dynamics of the vitellogenesis process in oocytes of the cattle-tick Boophilus microplus. The ovary of these individuals is of the panoistic type; therefore, it lacks nurse cells. This organ consists of a single tubular structure, continuous, and composed of a lumen delimitated by a wall of small epithelial cells with rounded nuclei. In this tick species, the oocytes were classified into six stages varying from I to VI and according to: cytoplasm appearance and presence of the germ vesicle, yolk granules, and chorion. Oocytes of various sizes and at different developmental stages remain attached to the ovary through a cellular pedicel until completing stage V. Afterwards, they are liberated into the lumen and from there to the exterior. Some oocytes (classified as type VI) showed an atypical appearance indicating that some of the cellular components would be undergoing a degenerative process and/or reabsorption.

Hartford Gerontological Nursing Leaders: From Funding Initiative to National Organization.

PubMed

Van Cleave, Janet H; Szanton, Sarah L; Shillam, Casey; Rose, Karen; Rao, Aditi D; Perez, Adriana; O'Connor, Melissa; Walker, Rachel; Buron, Bill; Boltz, Marie; Bellot, Jennifer; Batchelor-Murphy, Melissa

2016-01-01

In 2000, the John A. Hartford Foundation established the Building Academic Geriatric Nursing Capacity Program initiative, acknowledging nursing's key role in the care of the growing population of older adults. This program has supported 249 nurse scientists with pre- and postdoctoral awards. As a result of the program's success, several Building Academic Geriatric Nursing Capacity Program awardees formed an alumni organization to continue to advance the quality care of older adults. This group of Building Academic Geriatric Nursing Capacity Program awardees joined others receiving support from the John A. Hartford Foundation nursing initiatives to grow a formal organization, the Hartford Gerontological Nursing Leaders (HGNL). The purpose of this article is to present the development, accomplishments, and challenges of the HGNL, informing other professional nursing organizations that are experiencing similar accomplishments and challenges. This article also demonstrates the power of a funding initiative to grow an organization dedicated to impact gerontological health and health care through research, practice, education, and policy. Copyright © 2016 Elsevier Inc. All rights reserved.

Rest break organization in geriatric care and turnover: a multimethod cross-sectional study.

PubMed

Wendsche, Johannes; Hacker, Winfried; Wegge, Jürgen; Schrod, Nadine; Roitzsch, Katharina; Tomaschek, Anne; Kliegel, Matthias

2014-09-01

Various determinants of nurses' work motivation and turnover behavior have been examined in previous studies. In this research, we extend this work by investigating the impact of care setting (nursing homes vs. home care services) and the important role of rest break organization. We aimed to identify direct and indirect linkages between geriatric care setting, rest break organization, and registered nurses' turnover assessed over a period of one year. We designed a multimethod cross-sectional study. 80 nursing units (n=45 nursing homes, n=35 home care) in 51 German geriatric care services employing 597 registered nurses. We gathered documentary, interview, and observational data about the organization of rest breaks, registered nurses' turnover, and additional organizational characteristics (type of ownership, location, nursing staff, clients, and client-to-staff-ratio). The findings show that the rest break system in geriatric nursing home units is more regularly as well as collectively organized and causes less unauthorized rest breaks than in home care units. Moreover, the feasibility of collective rest breaks was, as predicted, negatively associated with registered nurses' turnover and affected indirectly the relation between care setting and registered nurses' turnover. Care setting, however, had no direct impact on turnover. Furthermore, registered nurses' turnover was higher in for-profit care units than in public or non-profit units. This study reveals significant differences in rest break organization as a function of geriatric care setting and highlights the role of collective rest breaks for nursing staff retention. Our study underlines the integration of organizational context variables and features of rest break organization for the analysis of nursing turnover. Copyright © 2014 Elsevier Ltd. All rights reserved.

Role of internal marketing, organizational commitment, and job stress in discerning the turnover intention of Korean nurses.

PubMed

Lee, Haejung; Kim, Myoung-Soo; Yoon, Jung-A

2011-06-01

The purpose of this study was to examine the discriminating factors of Korean nurses' turnover intention (TI) among internal marketing (IM), organizational commitment (OC), and job stress (JS). Nurses (n = 185) who had worked for 1-10 years were surveyed from six general hospitals in South Korea. The data were collected by using questionnaires and were analyzed with descriptive statistics and discriminant analysis. The participants were grouped into three groups, depending on the level of their TI: "low TI group" (n = 58), "moderate TI group" (n = 96), and "high TI group" (n = 31). One function significantly discriminated between the high TI and low TI groups. The function correctly classified 84.3% of the participants into the two groups and 75.3% were correctly classified in the cross-validation. Organizational commitment was the most important factor. Job stress and the IM components of staffing-promotion, reward, management philosophy, working environment, and segmentation were significant discriminant factors of TI. Based on the findings of this study, we could conclude that OC, JS, and IM play important roles in the TI of nurses. Implying a career development system as an OC management strategy, an innovative promotion policy to change conservative organizational climates and a balance of effort-reward can be considered as managerial interventions to reduce nurses' TI. © 2010 The Authors. Japan Journal of Nursing Science © 2010 Japan Academy of Nursing Science.

Resource utilization groups (RUGs): defining chronic care, rehabilitation and nursing home case mix in Canada.

PubMed

Botz, C K; Bestard, S; Demaray, M; Molloy, G

1993-01-01

The two major purposes of this study were: (1) to evaluate Resource Utilization Groups (RUGs III) as a unified method for classifying all residential, chronic care and rehabilitation patients at the St. Joseph's Health Centre, London, and (2) to compare the potential funding implications of RUGs and other patient/resident classification systems. RUGs were used to classify a total of 336 patients/residents in residential, extended care, chronic care and rehabilitation beds at the Health Centre. Patients were also concurrently classified according to the Alberta Long Term Care Classification System and the Medicus Long Term Care System. Results show that RUGs provide relatively more credit for higher acuity patients than do the Alberta or Medicus systems. If used as a basis for funding, chronic care and rehabilitation hospitals would be entitled to more funding (relative to residential/nursing homes) under RUGs than under the other two patient classification mechanisms.

Nursing Services Delivery Theory: an open system approach

PubMed Central

Meyer, Raquel M; O’Brien-Pallas, Linda L

2010-01-01

meyer r.m. & o’brien-pallas l.l. (2010)Nursing services delivery theory: an open system approach. Journal of Advanced Nursing66(12), 2828–2838. Aim This paper is a discussion of the derivation of the Nursing Services Delivery Theory from the application of open system theory to large-scale organizations. Background The underlying mechanisms by which staffing indicators influence outcomes remain under-theorized and unmeasured, resulting in a ‘black box’ that masks the nature and organization of nursing work. Theory linking nursing work, staffing, work environments, and outcomes in different settings is urgently needed to inform management decisions about the allocation of nurse staffing resources in organizations. Data sources A search of CINAHL and Business Source Premier for the years 1980–2008 was conducted using the following terms: theory, models, organization, organizational structure, management, administration, nursing units, and nursing. Seminal works were included. Discussion The healthcare organization is conceptualized as an open system characterized by energy transformation, a dynamic steady state, negative entropy, event cycles, negative feedback, differentiation, integration and coordination, and equifinality. The Nursing Services Delivery Theory proposes that input, throughput, and output factors interact dynamically to influence the global work demands placed on nursing work groups at the point of care in production subsystems. Implications for nursing The Nursing Services Delivery Theory can be applied to varied settings, cultures, and countries and supports the study of multi-level phenomena and cross-level effects. Conclusion The Nursing Services Delivery Theory gives a relational structure for reconciling disparate streams of research related to nursing work, staffing, and work environments. The theory can guide future research and the management of nursing services in large-scale healthcare organizations. PMID:20831573

Nursing Services Delivery Theory: an open system approach.

PubMed

Meyer, Raquel M; O'Brien-Pallas, Linda L

2010-12-01

This paper is a discussion of the derivation of the Nursing Services Delivery Theory from the application of open system theory to large-scale organizations. The underlying mechanisms by which staffing indicators influence outcomes remain under-theorized and unmeasured, resulting in a 'black box' that masks the nature and organization of nursing work. Theory linking nursing work, staffing, work environments, and outcomes in different settings is urgently needed to inform management decisions about the allocation of nurse staffing resources in organizations. A search of CINAHL and Business Source Premier for the years 1980-2008 was conducted using the following terms: theory, models, organization, organizational structure, management, administration, nursing units, and nursing. Seminal works were included. The healthcare organization is conceptualized as an open system characterized by energy transformation, a dynamic steady state, negative entropy, event cycles, negative feedback, differentiation, integration and coordination, and equifinality. The Nursing Services Delivery Theory proposes that input, throughput, and output factors interact dynamically to influence the global work demands placed on nursing work groups at the point of care in production subsystems. THE Nursing Services Delivery Theory can be applied to varied settings, cultures, and countries and supports the study of multi-level phenomena and cross-level effects. The Nursing Services Delivery Theory gives a relational structure for reconciling disparate streams of research related to nursing work, staffing, and work environments. The theory can guide future research and the management of nursing services in large-scale healthcare organizations. © 2010 Blackwell Publishing Ltd.

Attitude and Impact Factors Toward Organ Transplantation and Donation Among Transplantation Nurses in China.

PubMed

Xie, J-F; Wang, C-Y; He, G-P; Ming, Y-Z; Wan, Q-Q; Liu, J; Gong, L-N; Liu, L-F

Health workers' awareness and knowledge of transplantation medicine can improve people's sensitivity and reduce their degree of opposition to donations. The medical literature contains numerous examples of attitudes toward organ transplantation and donation aimed at university students or medical staff members, but rarely for transplantation nurses. The purposes of the study were to investigate the attitudes toward organ transplantation and donation among transplantation nurses and to explore the impact factors. The study was conducted in 37 transplantation surgery wards in 22 hospitals using cross-sectional approach. SPSS (International Business Machines Corporation, Armonk, New York, USA) 7.0 software was used to analysis descriptive and inferential statistics for data. Five hundred thirty-six effective questionnaires were received and the effective rate was 89.33%. Nurses' mean age was 28.40 years with a mean service length of 6.54 years. Among these nurses, 66.6% and 78.0% were willing to accept organ transplantation surgery for themselves and their relatives, respectively. Of these nurses, 33.4% would donate their organs after death; whereas 39.9% were uncertain. Only 38.2% were willing to register in the national organ donation system. Of these nurses, 28.2% were willing to sign the organ donation consent forms when their relatives became potential organ donors, and 45.7% were uncertain. Eight independent variables that affected nurses' attitudes toward donating their organs from most to least significant were: ratio of nurse to bed, title, employment form, age, length of service, position, monthly income, and the highest educational degree earned. Pearson correlation analysis showed a significant correlation among nurses' attitudes toward organ transplantation, organ donation, and online registration. The attitude toward donation and transplantation in the hospitals was not too optimistic, and an improvement in the training regarding transplantation and donation among nurses in China is necessary. Nurses are an important group who generate opinion in the patient population, and their negative attitudes can have a significant negative impact on society's attitudes toward organ donation. Copyright © 2017 Elsevier Inc. All rights reserved.

Work organization in hospital wards and nurses' emotional exhaustion: A multi-method study of observation-based assessment and nurses' self-reports.

PubMed

Stab, Nicole; Hacker, Winfried; Weigl, Matthias

2016-09-01

Ward organization is a major determinant for nurses' well-being on the job. The majority of previous research on this relationship is based on single source methods, which have been criticized as skewed estimations mainly due to subjectivity of the ratings and due to common source bias. To investigate the association of ward organization characteristics and nurses' exhaustion by combining observation-based assessments with nurses' self-reports. Cross-sectional study on 25 wards of four hospitals and 245 nurses. Our multi-method approach to evaluate hospital ward organization consisted of on-site observations with a standardized assessment tool and of questionnaires to evaluate nurses' self-reports and exhaustion. After establishing the reliability of our measures, we applied multi-level regression analyses to determine associations between determinant and outcome variables. We found substantial convergence in ward organization between the observation-based assessments and nurses' self-reports, which supports the validity of our external assessments. Furthermore, two observation-based characteristics, namely participation and patient-focused care, were significantly associated with lower emotional exhaustion among the nurses. Our results suggest that observation-based assessments are a valid and feasible way to assess ward organization in hospitals. Nurses' self-reported as well as observation-based ratings on ward organization were associated with nurses' emotional exhaustion. This is of interest mainly for identifying alternative measures in evaluating nurses' work environments, to inform health promotion activities and to evaluate job redesign intervention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Workarounds and obstacles: unexpected source of innovation.

PubMed

Lalley, Cathy

2014-01-01

Nurse leaders are aware that nurses are finding ways to adapt health information technology to patient care activities. Previous literature has presented nurses' response to technology obstacles as a work-around, characterized as a negative behavior. Using narrative inquiry, this article examines 9 direct care nurses' interactions on a medical/surgical/telemetry unit. Specifically, nurses' encounters with technology obstacles will be addressed from a complexity science perspective. Four support staff including the clinical nurse manager, pharmacist, quality nurse, and project manager who is also a nurse were interviewed as part of data collection. Complexity science provides nurse leaders' insight into nurses' behavior where outcomes emerge from tensions in the environment through multidirectional and self-organizing interactions. Innovation was found when nurses responded to health information technology obstacles with self-organizing interactions, sensitivity to initial conditions, and multidirectionality. Their actions were also influenced by many sets of rules. Nurses self-organized with coworkers to find better ways to deliver care to patients when using technology. Opportunities exist for nurse leaders to facilitate interactions among nurses and other members of the organization to realize better use of health information technology that improves the patient experience.

Community nursing research. Nuevo Leon, Mexico.

PubMed

Rappsilber, C; Castillo, A A; Gallegos, E C

1998-01-01

After a 10-year history of community health nursing research conducted by graduate students at the Universidad Autónoma de Nuevo León in Monterrey, Mexico, the faculty recognized a need to synthesize their work into a monograph. The purpose was to guide nursing practice, incorporate the findings into the body of nursing knowledge, and identify future research needs. Starting in 1994, three faculty members reviewed 29 theses written by community nursing majors from 1986 to 1993 to meet the requirements for the master's degree in nursing. They classified the studies according to their principal focus and synthesized the findings to derive common phenomena and themes. The endeavor resulted in a 40-page document and a proposed model in the form of an unpublished monograph.

Withdrawal Phenomena: A Concept Analysis for the Development of a Nursing Diagnosis.

PubMed

Dändliker, This; Kolbe, Nina

This study explored the concept of withdrawal phenomena from the perspective of nurses, with the aim of developing a nursing diagnosis. Concept analysis was used as the framework of the study, a systematized review was conducted to identify relevant studies, and interpretation was based on qualitative content analysis. Specifying aspects, defining characteristics, related factors, and risk factors were extracted and classified into categories. Thirteen studies were identified as a basis for the construction of two nursing diagnoses: "withdrawal phenomena" and "risk of withdrawal complications." The proposed nursing diagnoses require further discussion. The NANDA International Diagnosis Development Committee was asked to examine the proposed diagnoses. However, it was too early to determine implications for nursing practice based on the results of this study.

Nurse knowledge, work environment, and turnover in highly specialized pediatric end-of-life care

PubMed Central

Lindley, Lisa C.; Cozad, Melanie J.

2016-01-01

Objective To examine the relationship between nurse knowledge and work environment and Registered Nurse (RN) turnover in perinatal hospice and palliative care organizations. Methods Using nurse intellectual capital theory, a multivariate analysis was conducted with 2007 National Home and Hospice Care Survey data. Results Perinatal hospice and palliative care organizations experienced a 5% turnover rate. The professional experience of advanced practice nurses (APNs) was significantly related to turnover among RNs (β= −0.032, P< 0.05). Compared to organizations with no APNs professional experience, clinical nurse specialists and nurse practitioners significantly reduced RN turnover by 3-percentage points. No other nurse knowledge or work environment variables were associated with RN turnover. Several of the control variables were also associated with RN turnover in the study: organizations serving micropolitan (β= −0.041, P< 0.05) and rural areas (β= −0.037, P< 0.05) had lower RN turnover, compared to urban areas. Organizations with a technology climate where nurses used electronic medical records had a higher turnover rate than those without (β= 0.036, P< 0.05). Conclusions The findings revealed that advanced professional experience in the form of APNs were associated with reductions in RN turnover. This suggests that having a clinical nurse specialist or nurse practitioner on staff may provide knowledge and experience to other RNs, creating stability within the organization. PMID:27188758

[The style of leadership of nurses: description of an experience].

PubMed

Chaves, Enaura Helena Brandão; de Moura, Gisela S

2003-12-01

This study identify the leadership style is adopt for nurses which frequent Post-Graduation Courses offer by Schools of Nursing of Metropolitan region of Porto Alegre, Brazil. The data collection used an instrument proposed by David R. Frew was used in a sample of 184 nurses. The instrument classify the leadership in five styles: very autocratic, autocratic moderate mixed, democratic moderate and very democratic. The results shows the predominant utilization of the mixed style (83.15%) followed by autocratic moderate (4.89%). The styles very autocratic and very democratic were less expressive (1.63%) and (0.54%) of the sample.

A Conceptual Model of the Information Requirements of Nursing Organizations

PubMed Central

Miller, Emmy

1989-01-01

Three related issues play a role in the identification of the information requirements of nursing organizations. These issues are the current state of computer systems in health care organizations, the lack of a well-defined data set for nursing, and the absence of models representing data and information relevant to clinical and administrative nursing practice. This paper will examine current methods of data collection, processing, and storage in clinical and administrative nursing practice for the purpose of identifying the information requirements of nursing organizations. To satisfy these information requirements, database technology can be used; however, a model for database design is needed that reflects the conceptual framework of nursing and the professional concerns of nurses. A conceptual model of the types of data necessary to produce the desired information will be presented and the relationships among data will be delineated.

Morphological characterization of the ovary and oocytes vitellogenesis of the tick Rhipicephalus sanguineus (Latreille, 1806) (Acari: Ixodidae).

PubMed

de Oliveira, Patrícia Rosa; Bechara, Gervásio Henrique; Denardi, Sandra Eloisi; Nunes, Erika Takagi; Camargo Mathias, Maria Izabel

2005-06-01

This study presents the morphology of the ovary, as well as the process of the vitellogenesis in oocytes of the tick Rhipicephalus sanguineus. The ovary of these individuals is of the panoistic type; therefore, it lacks nurse cells. This organ consists of a single tubular structure, continuous, and composed of a wall formed by small epithelial cells with rounded nuclei which delimit the lumen. The oocytes in the different developmental stages in this tick species were classified into five stages (I-V). They remain attached to the ovary during vitellogenesis by a cellular pedicel and afterwards the mature oocytes (stage V) are released into the ovary lumen.

Ovary and oocyte maturation of the tick Amblyomma brasiliense Aragão, 1908 (Acari: Ixodidae).

PubMed

Seron Sanches, Gustavo; Bechara, Gervásio Henrique; Camargo-Mathias, Maria Izabel

2010-01-01

This study describes the ovary anatomy and dynamics of oocytes maturation process of Amblyomma brasiliense ticks. The ovary is of panoistic type lacking nurse and follicular cells. This organ consists of a single continuous tubular structure comprising a lumen delimited by the ovarian wall. Oocytes of this tick species are classified into five stages (I-V) and described based on cytoplasm appearance, presence of germ vesicle, yolk granules aspects, and chorium deposition. Oocytes of various sizes and at different developmental stages remain attached to the ovary by a cellular pedicel until completing stage V. Then they are released into the ovary lumen and from there into the exterior.

Saudi Nursing and Medical Student’s Knowledge and Attitude toward Organ Donation- A Comparative Cross-Sectional study

PubMed Central

Majeed, Farrukh

2016-01-01

Objectives Proper awareness among health professionals about organ donation is important for increasing organ procurement. Personal commitment and attitude of nurses are imperative as they have key role in identifying potential donors. The aim of this study was to compare prevailing knowledge and attitude of undergraduate female Saudi nursing and medical students’ toward organ donation. Methodology A cross sectional questionnaire using 29 item were filled by nursing (n=46) and medical (n=63) students’ at University of Dammam (KSA) during academic year 2014–15, to check and compare their knowledge and attitude about organ donation. The data were analyzed by descriptive statistics; chi square test and bivariate analysis to find out correlation. Results Level of knowledge of nursing group were significantly lower (p=0.000) than medical group while no significant difference in attitude score (p=0.591) between the two groups were found. Major source of knowledge for nursing was media (65.2%) and college/university for medical (50.8%) group. Both groups chose “anyone in need” as preferred recipients’ upon donation (nursing 60.3% and medical 52.2%) and opted “anyone” as donor in case of recipient (nursing 52.2% and medical 49.2%). The results indicate positive correlation between level of knowledge and attitude toward organ donation. Conclusions Nursing students have low knowledge toward organ donation as compared to medical students although they shows positive attitude toward this issue. This study ascertains the need of an effective educational program for nursing students of Saudi Arabia to improve their knowledge regarding organ donation and to raise organ procurement. PMID:27103903

Assessing advantages and barriers to telemedicine adoption in the practice setting: A MyCareTeam(TM) exemplar.

PubMed

L'Esperance, Shaun T; Perry, Donna J

2016-06-01

Telemedicine is an evolving field that holds great potential to improve patient outcomes. The National Organization of Nurse Practitioner Faculties core competencies now require all nurse practitioners (NPs) to be competent utilizing telemedicine to address various patient and healthcare system needs. While telemedicine offers advantages to patient care, adoption of new technologies can be challenging. An assessment of perceived advantages and barriers to MyCareTeam, an online diabetes management system, was conducted at an adult diabetes clinic. Two survey questionnaires were developed based on the Diffusion of Innovations (DOI) theory. The surveys were administered to patients in the clinic waiting room and sent to all clinical staff via an e-mail link. The findings of this project suggested a novel way to classify patients with regard to their use of the technology with implications for practice. Recommendations include outreach to enhance knowledge and awareness of MyCareTeam, reinforcing the full scope of the system, and improved technical support. DOI theory is a framework that may be utilized by NPs as a tool for assessing advantages and barriers to telemedicine applications in the practice setting in order to identify strategies to promote adoption and use. ©2015 American Association of Nurse Practitioners.

Nurse practitioner malpractice data: Informing nursing education.

PubMed

Sweeney, Casey Fryer; LeMahieu, Anna; Fryer, George E

Nurse practitioners (NPs) are often identified in medical malpractice claims. However, the use of malpractice data to inform the development of nursing curriculum is limited. The purpose of this study is to examine medical errors committed by NPs. Using National Practitioner Data Bank public use data, years 1990 to 2014, NP malpractice claims were classified by event type, patient outcome, setting, and number of practitioners involved. The greatest proportion of malpractice claims involving nurse practitioners were diagnosis related (41.46%) and treatment related (30.79%). Severe patient outcomes most often occurred in the outpatient setting. Nurse practitioners were independently responsible for the event in the majority of the analyzed claims. Moving forward, nurse practitioner malpractice data should be continuously analyzed and used to inform the development of nurse practitioner education standards and graduate program curriculum to address areas of clinical weakness and improve quality of care and patient safety. Copyright © 2017 Elsevier Inc. All rights reserved.

Using a nursing balanced scorecard approach to measure and optimize nursing performance.

PubMed

Jeffs, Lianne; Merkley, Jane; Richardson, Sandy; Eli, Jackie; McAllister, Mary

2011-04-01

The authors give an overview of one healthcare organization's experience in developing a nursing strategic plan and nursing balanced scorecard (NBS) using a focused planning process involving strategy mapping. The NBS is being used at this organization to manage the nursing strategic plan by leveraging and improving nursing processes and organizational capabilities as required, based on data and transparent communication of performance results to key stakeholders. Key strategies and insights may help other nurse leaders in developing or refining strategic approaches to measuring nursing performance. Vital to the success of an organization's strategic plan are ongoing endorsement, engagement and visibility of senior leaders. Quality of decisions made depends on the organization's ability to collect data from multiple sources using standardized definitions, mine data and extract them for statistical analysis and effectively present them in a compelling and understandable way to users and decision-makers.

Stressors in clinical nursing education in Iran: A systematic review.

PubMed

Changiz, Tahereh; Malekpour, Alireza; Zargham-Boroujeni, Ali

2012-09-01

Clinical education is a critical and complex component of nursing education that is influenced by many variables. One of them is stress, which may disturb students' learning, too. Stressors may differ according to the learning situation and environment, and recognizing them, seems to be essential for corrective interventions. The present work was performed to identify stressors in clinical nursing education in Iran, according to the published research reports. In this systematic review, all published research reports available in Iranian and International web-based data bases and search engines were searched. Also, the archives of peer reviewed Iranian nursing and medical education journals (published between 1989 and 2009) were hand searched. Out of 1104 retrieved records (by a more general terms of clinical education AND Nursing), after stepwise screening, 15 original research articles were selected for content analysis. Coded data were classified and their frequency was represented in Tables. THE FOLLOWING THEMES WERE OBTAINED TO CLASSIFY MAIN AREAS OF IMPORTANCE FOR FACTORS RELATED TO STRESS IN CLINICAL NURSING EDUCATION: a) clinical competence and ability to play one's roles, b) care load, or stress due to care, c) main area of education, d) interpersonal relationships and interactions, e) clinical environment (facilities and equipments, space, learning opportunities, etc,…). Subthemes were also identified in each theme. Published studies in Iran provide appropriate background evidences for planning and evaluating interventional programs to reduce stress among nursing students and instructors. Each identified theme in this study could be considered as a subject for planned interventions. Among them, it seems that interpersonal relationships and interactions is of the highest priority.

Factors affecting membership in specialty nursing organizations.

PubMed

White, Mary Joe; Olson, Rhonda S

2004-01-01

A discouraging trend in many specialty nursing organizations is the stagnant or declining membership. The research committee of the Southeast Texas Chapter of the Association of Rehabilitation Nurses (ARN) collected data and studied this trend to determine what changes would be necessary to increase membership. Using Herzberg's motivational theory as a framework, a review of the literature was initiated. There were few current studies on this issue, but relevant information was found about nursing's emerging workforce, as well as implications of the growth of magnet hospitals, which affect whether nurses join specialty nursing organizations. A multifaceted data-collection approach using convenience samples was designed. First, relevant literature was reviewed. Second, a survey was sent by e-mail to other ARN chapters. Third, a telephone survey on other specialty organizations in the geographic region was completed. Finally, members of the local ARN chapter and four other specialty organizations, as well staff nurses in the geographic area, were given questionnaires to complete. Descriptive statistics and cross tabulations were used to determine why nurses do and do not join specialty organizations (N = 81). The most frequent reasons for joining an organization were to increase knowledge, benefit professionally, network, and earn continuing education units. Reasons for choosing not to participate were family responsibilities, lack of information about these organizations, and lack of time. Ways to reverse the decline in membership are discussed.

FRED: an innovative approach to nursing home level-of-care assignments.

PubMed

Morris, J N; Sherwood, S; May, M I; Bernstein, E

1987-04-01

A clear need currently exists to consider new approaches for classifying nursing home residents. The traditional intermediate care facility/skilled nursing facility (ICF/SNF) dichotomy cannot provide adequate information on the type of care required by any one individual, and it provides only the most limited information required to address the care and quality-of-life needs of the total patient population within a facility, as well as the level of reimbursement appropriate for their care. This article describes an alternative procedure for allocating nursing home residents according to a more comprehensive array of internally homogeneous categories. This system is based on an operational perspective focused on the total nursing and staffing requirements for types of nursing home residents. The tool is titled "Functionally Ranked Explanatory Designations," or FRED.

FRED: an innovative approach to nursing home level-of-care assignments.

PubMed Central

Morris, J N; Sherwood, S; May, M I; Bernstein, E

1987-01-01

A clear need currently exists to consider new approaches for classifying nursing home residents. The traditional intermediate care facility/skilled nursing facility (ICF/SNF) dichotomy cannot provide adequate information on the type of care required by any one individual, and it provides only the most limited information required to address the care and quality-of-life needs of the total patient population within a facility, as well as the level of reimbursement appropriate for their care. This article describes an alternative procedure for allocating nursing home residents according to a more comprehensive array of internally homogeneous categories. This system is based on an operational perspective focused on the total nursing and staffing requirements for types of nursing home residents. The tool is titled "Functionally Ranked Explanatory Designations," or FRED. PMID:3570811

Teaching Pediatric Nursing Concepts to Non-Pediatric Nurses Using an Advance Organizer

ERIC Educational Resources Information Center

Bell, Julie Ann

2013-01-01

Non-pediatric nurses in rural areas often care for children in adult units, emergency departments, and procedural areas. A half-day program about pediatric nursing using constructivist teaching strategies including an advance organizer, case studies, and simulation was offered at a community hospital in Western North Carolina. Nurses reported a…

Nursing's next advance: an internal classification for nursing practice.

PubMed

Clark, J; Lang, N

1992-01-01

An International Classification of Nursing Practice (ICNP) is needed to support the processes of nursing practice and advance the knowledge necessary for cost-effective delivery of quality nursing care. Below, the authors present their case for developing such a system that will provide nursing with a nomenclature, a language and a classification that can be used to describe and organize nursing data. It is their belief that this landmark project is achievable and that ICN should lead the work in collaboration with its member associations, the World Health Organization and key national, international, governmental and nongovernmental groups. But to ensure that the system will be adaptable across borders, nurses and organizations are being encouraged to share their ideas and research on such a system.

Nursing recruitment: relationship between perceived employer image and nursing employees' recommendations.

PubMed

Van Hoye, Greet

2008-08-01

This paper is a report of a study to examine the relationship between nursing employees' perceptions of instrumental and symbolic dimensions of employer image on the one hand and their intentions to recommend their organization as an employer and their willingness to testify in their organization's recruitment materials on the other. Previous research suggests that word-of-mouth recommendations by current nursing employees can enhance healthcare organizations' attractiveness as an employer for potential applicants. However, it is not known what motivates employees to provide positive word-of-mouth comments and to endorse their employer in recruitment testimonials. The instrumental-symbolic framework was applied to identify relevant dimensions of perceived employer image that might relate to employee recommendations. A questionnaire was administered in 2006 to 106 nurses and nursing aides from four non-profit nursing homes in Belgium. The response rate was 55%. Overall, nursing employees were more willing to recommend their nursing home to others than to testify in recruitment materials. Both instrumental and symbolic employer image dimensions predicted nursing employees' recommendation intentions. Conversely, willingness to testify was only predicted by symbolic image dimensions. Specifically, the more the nursing employees perceived that their nursing home offers task diversity, offers the possibility to help people and is prestigious, the more they intended to recommend their organization to others. The more they perceived their nursing home as competent, the higher were their recommendation intentions and their willingness to testify in recruitment communication. To increase nursing employees' willingness to recommend their employer to potential applicants, organizations should enhance their perceived employer image.

Academic service partnerships: organizational efficiency and efficacy between organizations.

PubMed

Fetsch, Susan H; DeBasio, Nancy O

2011-01-01

Two leading nursing organizations, the Greater Kansas City Area Collegiate Nurse Educators and the Kansas City Area Nurse Executives, represent the Kansas City metropolitan area nursing programs and area employers. These two organizations have been engaged in collaborative workforce planning and strategy development around key nursing issues for over 25 years. This model of collaboration is unique in that the partnership is between organizations representing 17 nursing programs and 28 hospitals. The collaborative partnership has enhanced organizational efficiency and efficacy between the groups, which has directly benefited the organizational members. Most importantly, it has had a transformative impact on both nursing education and professional practice in the Kansas City metropolitan area. This article describes the evolution of the partnership and the collaborative work that has led to the accomplishment of mutual goals. Copyright © 2011 Elsevier Inc. All rights reserved.

American Organization of Nurse Executives Care Innovation and Transformation program: improving care and practice environments.

PubMed

Oberlies, Amanda Stefancyk

2014-09-01

The American Organization of Nurse Executives conducted an evaluation of the hospitals participating in the Care Innovation and Transformation (CIT) program. A total of 24 hospitals participated in the 2-year CIT program from 2012 to 2013. Reported outcomes include increased patient satisfaction, decreased falls, and reductions in nurse turnover and overtime. Nurses reported statistically significant improvements in 4 domains of the principles and elements of a healthful practice environment developed by the Nursing Organizations Alliance.

Regulating the Flow of Change to Reduce Fontline Nurse Stress and Burnout.

PubMed

Koppel, Jenna; Virkstis, Katherine; Strumwasser, Sarah; Katz, Marie; Boston-Fleischhauer, Carol

2015-11-01

The nursing workforce is at the center of many changes associated with care delivery transformation. To achieve this transformation, frontline nursing staff must be engaged in their work, committed to their organization's mission, and capable of delivering high-quality care. To identify top opportunities for driving nursing engagement, researchers from The Advisory Board Company analyzed engagement survey responses from more than 343 000 employees at 575 healthcare organizations. In this article, the authors describe 3 strategies for addressing 1 of the greatest opportunities for improving nurse engagement: ensuring nurses feel their organization helps them reduce stress and burnout.

Duty and dilemma: Perioperative nurses hiding an objection to participate in organ procurement surgery.

PubMed

Smith, Zaneta

2017-07-01

Perioperative nurses assist in organ procurement surgery; however, there is a dearth of information of how they encounter making conscientious objection requests or refusals to participate in organ procurement surgery. Organ procurement surgical procedures can present to the operating room ad hoc and can catch a nurse who may not desire to participate by surprise with little opportunity to refuse as a result of staffing, skill mix or organizational work demands. This paper that stems from a larger doctoral research study exploring the experiences of perioperative nurses participating in multi-organ procurement surgery used a grounded theory method to develop a substantive theory of the nurses' experiences. This current paper aimed to highlight the experiences of perioperative nurses when confronted with expressing a conscientious objection towards their participation in these procedures. A number of organizational and cultural barriers within the healthcare organization were seen to hamper their ability in expressing a conscience-based refusal, which lead to their reluctant participation. Perioperative nurses must feel safe to express a conscientious objection towards these types of surgical procedures and feel supported in doing so by their respective hospital organizations and not be forced to participate unwillingly. © 2016 John Wiley & Sons Ltd.

Developing an organizing framework to guide nursing research in the Children’s Oncology Group (COG)

PubMed Central

Kelly, Katherine Patterson; Hooke, Mary C.; Ruccione, Kathleen; Landier, Wendy; Haase, Joan

2014-01-01

Objectives To describe the development and application of an organizing research framework to guide COG Nursing research. Data Sources Research articles, reports and meeting minutes Conclusion An organizing research framework helps to outline research focus and articulate the scientific knowledge being produced by nurses in the pediatric cooperative group. Implication for Nursing Practice The use of an organizing framework for COG nursing research can facilitate clinical nurses’ understanding of how children and families sustain or regain optimal health when faced with a pediatric cancer diagnosis through interventions designed to promote individual and family resilience. The Children’s Oncology Group (COG) is the sole National Cancer Institute (NCI)-supported cooperative pediatric oncology clinical trials group and the largest organization in the world devoted exclusively to pediatric cancer research. It was founded in 2000 following the merger of the four legacy NCI-supported pediatric clinical trials groups (Children’s Cancer Group [CCG], Pediatric Oncology Group [POG], National Wilms Tumor Study Group, and Intergroup Rhabdomyosarcoma Study Group). The COG currently has over 200 member institutions across North America, Australia, New Zealand and Europe and a multidisciplinary membership of over 8,000 pediatric, radiation, and surgical oncologists, nurses, clinical research associates, pharmacists, behavioral scientists, pathologists, laboratory scientists, patient/parent advocates and other pediatric cancer specialists. The COG Nursing Discipline was formed from the merger of the legacy CCG and POG Nursing Committees, and current membership exceeds 2000 registered nurses. The discipline has a well-developed infrastructure that promotes nursing involvement throughout all levels of the organization, including representation on disease, protocol, scientific, executive and other administrative committees (e.g., nominating committee, data safety monitoring boards). COG nurses facilitate delivery of protocol-based treatments for children enrolled on COG protocols, and Nursing Discipline initiatives support nursing research, professional and patient/family education, evidence-based practice, and a patient-reported outcomes resource center. The research agenda of the Nursing Discipline is enacted through a well-established nursing scholar program. PMID:24559776

The child welfare system: through the eyes of public health nurses.

PubMed

Schneiderman, Janet U

2005-01-01

This qualitative descriptive study investigates how public health nurses working within the child welfare system view the organization and the organization's effect on their case management practice. Semistructured interviews were conducted utilizing the Bolman-Deal Organizational Model. This model identifies four frames of an organization: symbolic, human resources, political, and structural. A purposive sample of nine nurses and one social worker was selected to participate in comprehensive interviews. Data analysis identified two main themes. The first theme was the presence of organizational structural barriers to providing case management. The second theme was the lack of political influence by the nurses to change the structure of the organization; hence, their skills could be more completely utilized. Public health nurses who work in child welfare will need to systematically analyze their role within the organization and understand how to work in "host settings." Nursing educators need to prepare public health nurses to work in non-health care settings by teaching organizational analysis.

Psychological, Behavioral, and Educational Considerations for Children with Classified Disabilities and Diabetes within the School Setting

ERIC Educational Resources Information Center

Wyckoff, Leah; Hanchon, Timothy; Gregg, S. Renee

2015-01-01

School nurses are answering a call to action to provide day-to-day care for an increasing number of students diagnosed with chronic illnesses. Diabetes mellitus is one of the most prevalent chronic health conditions identified among school-age children and presents a host of complex challenges for the school nurse, educators, and other support…

Information Technology Strategies for Honor Society and Organization Membership Retention in Online Nursing Programs.

PubMed

Hopkins, Emily E; Wasco, Jennifer J

Membership retention in an honor society or organization is of utmost importance for sustainability. However, retaining members in organizations that serve online education nursing students can be a challenging task. Understanding the importance of creating a sense of community to promote retention within an honor society chapter, nursing faculty at a small private university implemented different online approaches. This article highlights successful information technology strategies to promote membership retention in organizations for online nursing students.

[Effects of residents' care needs classification (and misclassification) in nursing homes: the example of SOSIA classification].

PubMed

Nebuloni, G; Di Giulio, P; Gregori, D; Sandonà, P; Berchialla, P; Foltran, F; Renga, G

2011-01-01

Since 2003, the Lombardy region has introduced a case-mix reimbursement system for nursing homes based on the SOSIA form which classifies residents into eight classes of frailty. In the present study the agreement between SOSIA classification and other well documented instruments, including Barthel Index, Mini Mental State Examination and Clinical Dementia Rating Scale is evaluated in 100 nursing home residents. Only 50% of residents with severe dementia have been recognized as seriously impaired when assessed with SOSIA form; since misclassification errors underestimate residents' care needs, they determine an insufficient reimbursement limiting nursing home possibility to offer care appropriate for the case-mix.

The nursing shortage revisioning the future.

PubMed

Purnell, M J; Horner, D; Gonzalez, J; Westman, N

2001-04-01

A severe shortage of nurses is being experienced nationally and globally. In South Florida, one of the most severely impacted regions in the world, a group of healthcare organizations, educational institutions, and nursing organizations formed the Nursing Shortage Consortium to combat the nursing shortage. Strategic efforts to recruit and retain nurses are underway, with a focus on nurturing interest among young people and increasing opportunities to stimulate their interest, to increase the supply of appropriately prepared professional nurses.

Promotion of Evidence-Based Nursing by Polish and foreign nursing organizations.

PubMed

Wasowska, Iga; Repka, Iwona

2014-01-01

The aim of the review was to obtain information on specific activities undertaken by professional nursing organizations, in order to promote and develop Evidence-Based Nursing (EBN). The foreign organizations featured in the study actively promote EBN within their countries of origin. This activity is currently focused on the structural and financial measures (focused on extrinsic factors). Some organizations are lobbying governments for grants and general support, in order to further their use and development of EBN. Educational activities are still ongoing, which include the creation of the creation of new guidelines and publishing research in journals, along with the organization of periodic conferences. Polish Nurses Association was the only one not involved in any structural and financial activities.

ICU Nurses’ Knowledge, Attitude, and Practice Towards their Role in the Organ Donation Process from Brain-Dead Patients and Factors Influencing it in Iran

PubMed Central

Masoumian Hoseini, S. T.; Manzari, Z.; Khaleghi, I.

2015-01-01

Background: Nowadays, ICU nurses play a significant role in the care of brain-dead patients and their families. Therefore, their knowledge, attitude and practice towards this issue are extremely important to the success of organ donation. Objective: To assess ICU nurses’ knowledge, attitude and practice towards their role in the organ donation process from brain-dead patients and factors influencing it in Iran. Methods: In a cross-sectional analytical study, 90 ICU nurses working in Ghaem and Emam Reza Hospitals affiliated to Mashhad University of Medical Sciences were selected through a stratified random sampling. Data were collected from the participants by a questionnaire included demographic information, and factors influencing the nurses knowledge, attitude, and practice towards their roles in the organ donation process. Results: 90 nurses participated in this study. 70% of the research subjects had spoken with their own families about organ donation; 20% had organ donation cards. The mean±SD score of nurses’ knowledge was 49.13±9.6, attitude 21.49±14.32, and practice was 3.66±6.04. 80% of nurses had a mean knowledge about their roles in the organ donation process; 82% agreed with their roles in this process, and 97% showed weak practice in this regard. Conclusion: Nurses did not have adequate knowledge, attitude, and practice towards their role in organ donation process. It is suggested to include nursing courses on the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the organ donation process. PMID:26306156

[Nursing Care Sistematization: accident by Loxosceles gaucho].

PubMed

Kamimura, Helayne Mika; Paiva, Bianca Sakamoto Ribeiro; Ayres, Jairo Aparecido

2009-01-01

Experience report carried out at a university hospital involving a patient victimized by an accident with a spider of the Loxosceles gaucho genus. This type of accident can be classified as mild, moderate and severe, depending on the period of time elapsed between the occurrence of the accident and the moment of care provision. We aimed at applying nursing care systematization in a comprehensive and humanized manner. The following nursing diagnoses were established: acute pain, damaged skin integrity, risks for infection, constipation and low self-esteem. The therapeutic relationship favored student/patient interactions and enabled the recognition of the needs that deserved nursing interventions. The nursing process was a valuable instrument and provided important elements for the patient's daily development and planning adjustment by prioritizing care quality.

What predicts nurse faculty members' intent to stay in the academic organization? A structural equation model of a national survey of nursing faculty.

PubMed

Candela, Lori; Gutierrez, Antonio P; Keating, Sarah

2015-04-01

To investigate the relations among several factors regarding the academic context within a nationally representative sample of U.S. nursing faculty. Correlational design using structural equation modeling to explore the predictive nature of several factors related to the academic organization and the work life of nursing faculty. A survey was used to evaluate several aspects of the work life of U.S. nursing faculty members. Nursing faculty members in academic organizations across the U.S. serving at either CCNE- or NLNAC-accredited institutions of higher education. Standard confirmatory factor analysis was used to assess the validity of a proposed measurement model, and structural equation modeling was used to evaluate the validity of a structural/latent variable model. Several direct and indirect effects were observed among the factors under investigation. Of special importance, perceptions of nurse administration's support and perceived teaching expertise positively predicted U.S. nursing faculty members' intent to stay in the academic organization. Understanding the way that nursing faculty members' perceptions of the various factors common to the academic context interact with intent to stay in the academic organization is essential for faculty and nursing administrators. This information can assist administrators in obtaining more resources for faculty development to lobby for additional faculty in order to meet the teaching, research, and service missions of the organization; and to personalize relationships with individual faculty members to understand their needs and acknowledge their efforts. Published by Elsevier Ltd.

Empowering leadership, perceived organizational support, trust, and job burnout for nurses: a study in an Italian general hospital.

PubMed

Bobbio, Andrea; Bellan, Maria; Manganelli, Anna Maria

2012-01-01

A strong nursing leadership that instills trust in the leader and in the organization is an important component for an effective leadership, particularly for health care organizations, because trust defines the heart of health care workplaces by promoting patient safety, excellence in care, recruitment, and retention of the nursing staff. This study aimed to test the impact of perceived empowerment leadership style expressed by the nurse supervisor, nurses' perceived organizational support, trust in the leader, and trust in the organization on nurses' job burnout. A group of 273 nurses from an Italian public general hospital took part in a cross-sectional study on a voluntary basis by filling out an anonymous questionnaire. Empowering leadership was an important predictor of trust in the leader. Trust in the organization was influenced by perceived organizational support and by the Informing dimension of the empowering leadership style. Trust in the leader and trust in the organization showed a negative impact on job burnout and also mediated the effects of some empowering leadership dimensions and perceived organizational support on job burnout. The central role of trust in health care organizations was corroborated, as well as the beneficial effects of adopting specific features of empowerment leadership behaviors toward the nursing staff. Empowering leadership could be successfully proposed in training programs directed to nurses' supervisors and health care managers.

How hospitalized children and parents perceive nurses and hospital amenities: A qualitative descriptive study in Poland.

PubMed

Marcinowicz, Ludmiła; Abramowicz, Paweł; Zarzycka, Danuta; Abramowicz, Magdalena; Konstantynowicz, Jerzy

2016-03-01

A qualitative descriptive design using an interview guide approach was adopted to investigate the patient-nurse relationship and paediatric ward amenities from the perspective of parents and hospitalised children in Poland. The study included 26 parents or caregivers of hospitalised children (between 13 months and 15 years old) and 22 children (from 10 to 16 years old). Qualitative content analysis was used to analyse the recorded verbal data. Data from patients' transcripts were coded and classified in terms of topics on the patient-nurse relationship and hospital care. We identified five main topics. 1. Nurse qualities; 2. Nurse verbal behaviour; 3. Nurse tone of voice and non-verbal behaviour; 4. Hospital amenities; 5. Parents' expectations towards nurses. Our study contributes to increased understanding of parents' and children's experiences of paediatric hospital care. © The Author(s) 2014.

Nursing diagnoses in patients with cerebral vascular accident: an integrative review.

PubMed

Lima, Ana Carolina Maria Araújo Chagas Costa; Silva, Aurilene Lima da; Guerra, Débora Rodrigues; Barbosa, Islene Victor; Bezerra, Karine de Castro; Oriá, Mônica Oliveira Batista

2016-01-01

to verify the nursing diagnoses in patients affected by CVAs. this is an integrative review of the literature. The search was conducted on LILACS, Scielo, Medline, CINAHL, and Scopus databases between February and March 2015, using the following keywords: "Enfermagem", "Acidente Vascular Cerebral", "Diagnóstico de Enfermagem"; and "Nursing", "Stroke", and "Nursing Diagnosis". we found 9 articles published between 2009 and 2015; most of them were Brazilian, cross-sectional, and exploratory, with a level of evidence of 6. The evidence from the publications was classified as: "Evaluation and validation of specific nursing diagnoses for subjects affected by CVAs" and "Application of the nursing process on subjects affected by CVAs". we noticed the publications focused on nursing diagnoses related to motor disorders, such as risk of falls and impaired physical mobility. Domains regarding safety/protection (domain 11) and sleep/resting (domain 4) were present in most evaluated publications.

The Perception of Aversiveness of Surgical Procedure Pictures Is Modulated by Personal/Occupational Relevance

PubMed Central

Paes, Juliana; de Oliveira, Leticia; Pereira, Mirtes Garcia; David, Isabel; Souza, Gabriela Guerra Leal; Sobral, Ana Paula; Machado-Pinheiro, Walter; Mocaiber, Izabela

2016-01-01

It is well established that emotions are organized around two motivational systems: the defensive and the appetitive. Individual differences are relevant factors in emotional reactions, making them more flexible and less stereotyped. There is evidence that health professionals have lower emotional reactivity when viewing scenes of situations involving pain. The objective of this study was to investigate whether the rating of pictures of surgical procedure depends on their personal/occupational relevance. Fifty-two female Nursing (health discipline) and forty-eight Social Work (social science discipline) students participated in the experiment, which consisted of the presentation of 105 images of different categories (e.g., neutral, food), including 25 images of surgical procedure. Volunteers judged each picture according to its valence (pleasantness) and arousal using the Self-Assessment Manikin scale (dimensional approach). Additionally, the participants chose the word that best described what they felt while viewing each image (discrete emotion perspective). The average valence score for surgical procedure pictures for the Nursing group (M = 4.57; SD = 1.02) was higher than the score for the Social Work group (M = 3.31; SD = 1.05), indicating that Nursing students classified those images as less unpleasant than the Social Work students did. Additionally, the majority of Nursing students (65.4%) chose “neutral” as the word that best described what they felt while viewing the pictures. In the Social Work group, disgust (54.2%) was the emotion that was most frequently chosen. The evaluation of emotional stimuli differed according to the groups' personal/occupational relevance: Nursing students judged pictures of surgical procedure as less unpleasant than the Social Work students did, possibly reflecting an emotional regulation skill or some type of habituation that is critically relevant to their future professional work. PMID:27518897

The Perception of Aversiveness of Surgical Procedure Pictures Is Modulated by Personal/Occupational Relevance.

PubMed

Paes, Juliana; de Oliveira, Leticia; Pereira, Mirtes Garcia; David, Isabel; Souza, Gabriela Guerra Leal; Sobral, Ana Paula; Machado-Pinheiro, Walter; Mocaiber, Izabela

2016-01-01

It is well established that emotions are organized around two motivational systems: the defensive and the appetitive. Individual differences are relevant factors in emotional reactions, making them more flexible and less stereotyped. There is evidence that health professionals have lower emotional reactivity when viewing scenes of situations involving pain. The objective of this study was to investigate whether the rating of pictures of surgical procedure depends on their personal/occupational relevance. Fifty-two female Nursing (health discipline) and forty-eight Social Work (social science discipline) students participated in the experiment, which consisted of the presentation of 105 images of different categories (e.g., neutral, food), including 25 images of surgical procedure. Volunteers judged each picture according to its valence (pleasantness) and arousal using the Self-Assessment Manikin scale (dimensional approach). Additionally, the participants chose the word that best described what they felt while viewing each image (discrete emotion perspective). The average valence score for surgical procedure pictures for the Nursing group (M = 4.57; SD = 1.02) was higher than the score for the Social Work group (M = 3.31; SD = 1.05), indicating that Nursing students classified those images as less unpleasant than the Social Work students did. Additionally, the majority of Nursing students (65.4%) chose "neutral" as the word that best described what they felt while viewing the pictures. In the Social Work group, disgust (54.2%) was the emotion that was most frequently chosen. The evaluation of emotional stimuli differed according to the groups' personal/occupational relevance: Nursing students judged pictures of surgical procedure as less unpleasant than the Social Work students did, possibly reflecting an emotional regulation skill or some type of habituation that is critically relevant to their future professional work.

Leadership initiatives to disseminate the institute of medicine's future of nursing report.

PubMed

Folan, Patricia; Tarraza, Marianne DeCain; Delaney, Margaret; Fardellone, Christine; Leners, Colleen; Ross, Erin; Fitzpatrick, Joyce J

2012-02-01

This article discusses the critical role professional nurses will play and the tremendous impact nursing education and leadership development will have on the future of health care, as outlined in the recommendations of the Institute of Medicine's report, "The future of nursing: Leading change, and advancing health." Six doctorate of nursing practice students from Case Western Reserve University analyzed the Institute of Medicine (IOM) report and developed projects to disseminate key components to selected organizations. The students developed two primary initiatives. One initiative involved presenting the report to various professional organizations, including a local chapter of an international honor society, a specialty organization, and a health care organization. The second initiative included interviewing several nurse leaders within a large multihospital health system, and a nursing leader in academia to determine (a) the level of awareness about the IOM report and (b) strategies these leaders have implemented or envisioned to address the report recommendations.

Brazilian nursing history on the shoulders of giants.

PubMed

Oguisso, T; de Freitas, G F

2015-03-01

This study describes the route followed by nursing in Brazil, through the foundation of nursing organizations and the emergence of nursing leaders and pioneers. To present the origins of modern nursing in Brazil, identifying the main nurse-leaders and analysing their performance for the creation and consolidation of the nursing organizations. It is a historical and social study with descriptive approach, to describe the process of Brazilian nursing professionalization and leadership through a literature review. The oldest nursing organization is the Brazilian Nursing Association that holds scientific and cultural activities. There are also nurses' unions and nursing specialty associations, such as the Brazilian Academy for the History of Nursing, and the Federal Nursing Council. The latter has compulsory membership for controlling nursing services according to the qualifications of the personnel. The very first school for nurses in the Nightingale system was created in São Paulo, 1894, at the Samaritan Hospital, and by the government in 1923, in Rio de Janeiro, for which American nurses, led by Ethel Parsons, sponsored by the Rockefeller Foundation, were essential for the creation of the Anna Nery Nursing School, still in operation within a federal university. Some nurses pioneered these works such as Edith Fraenkel, Maria Rosa Pinheiro, Amalia Carvalho and others. The work done by nursing leaders has brought to the profession a better status and made it more recognized by the society. © 2014 International Council of Nurses.

The use of acuity and frailty measures for district nursing workforce plans.

PubMed

David, Ami; Saunders, Mary

2018-02-02

This article discusses the use of Quest acuity and frailty measures for community nursing interventions to quantify and qualify the contributions of district nursing teams. It describes the use of a suite of acuity and frailty tools tested in 8 UK community service trusts over the past 5years. In addition, a competency assessment tool was used to gauge both capacity and capability of individual nurses. The consistency of the results obtained from the Quest audits offer significant evidence and potential for realigning community nursing services to offer improvements in efficiency and cost-effectiveness. The National Quality Board (NQB) improvement resource for the district nursing services ( NQB, 2017 ) recommends a robust method for classifying patient acuity/frailty/dependency. It is contended the Quest tools and their usage articulated here offer a suitable methodology.

Time management strategies in nursing practice.

PubMed

Waterworth, Susan

2003-09-01

With the increasing emphasis on efficiency and effectiveness in health care, how a nurse manages her time is an important consideration. Whilst time management is recognized as an important component of work performance and professional nursing practice, the reality of this process in nursing practice has been subject to scant empirical investigation. To explore how nurses organize and manage their time. A qualitative study was carried out, incorporating narratives (22 nurses), focus groups (24 nurses) and semi-structured interviews (22 nurses). In my role as practitioner researcher I undertook observation and had informal conversations, which provided further data. Study sites were five health care organizations in the United Kingdom during 1995-1999. Time management is complex, with nurses using a range of time management strategies and a repertoire of actions. Two of these strategies, namely routinization and prioritizing, are discussed, including their implications for understanding time management by nurses in clinical practice. Ignoring the influence of 'others', the team and the organization perpetuates a rather individualistic and self-critical perspective of time management. This may lead to a failure to address problems in the organizing of work, and the co-ordinating of care involving other health care workers.

Career planning and development for nurses: the time has come.

PubMed

Donner, G J; Wheeler, M M

2001-06-01

Developments in how the nursing profession is perceived by nurses and by society, along with unparalleled changes in health care systems, have created an environment in which individual nurses must take control of their careers and futures. Educators, employers and professional organizations also have a key role to play in fostering the career planning and development of nurses, usually the largest employee group in most health care organizations. This article provides an overview of what career planning and development is and why it is important for nurses. A career planning and development model is described that provides nurses with a focused strategy to take greater responsibility for engaging in the ongoing planning process that is crucial throughout the major stages of their career. Finally, educators, employers and professional organizations are challenged to collaborate with individual nurses on career-development activities that will enable nurses to continue to provide high-quality care in ever-changing health care systems.

Stressors in clinical nursing education in Iran: A systematic review

PubMed Central

Changiz, Tahereh; Malekpour, Alireza; Zargham-Boroujeni, Ali

2012-01-01

Background: Clinical education is a critical and complex component of nursing education that is influenced by many variables. One of them is stress, which may disturb students’ learning, too. Stressors may differ according to the learning situation and environment, and recognizing them, seems to be essential for corrective interventions. The present work was performed to identify stressors in clinical nursing education in Iran, according to the published research reports. Materials and Methods: In this systematic review, all published research reports available in Iranian and International web-based data bases and search engines were searched. Also, the archives of peer reviewed Iranian nursing and medical education journals (published between 1989 and 2009) were hand searched. Out of 1104 retrieved records (by a more general terms of clinical education AND Nursing), after stepwise screening, 15 original research articles were selected for content analysis. Coded data were classified and their frequency was represented in Tables. Results: The following themes were obtained to classify main areas of importance for factors related to stress in clinical nursing education: a) clinical competence and ability to play one’s roles, b) care load, or stress due to care, c) main area of education, d) interpersonal relationships and interactions, e) clinical environment (facilities and equipments, space, learning opportunities, etc,…). Subthemes were also identified in each theme. Conclusion: Published studies in Iran provide appropriate background evidences for planning and evaluating interventional programs to reduce stress among nursing students and instructors. Each identified theme in this study could be considered as a subject for planned interventions. Among them, it seems that interpersonal relationships and interactions is of the highest priority. PMID:23922579

A mixed-methods study of the causes and impact of poor teamwork between junior doctors and nurses.

PubMed

O'connor, Paul; O'dea, Angela; Lydon, Sinéad; Offiah, Gozie; Scott, Jennifer; Flannery, Antoinette; Lang, Bronagh; Hoban, Anthony; Armstrong, Catherine; Byrne, Dara

2016-06-01

This study aimed to collect and analyse examples of poor teamwork between junior doctors and nurses; identify the teamwork failures contributing to poor team function; and ascertain if particular teamwork failures are associated with higher levels of risk to patients. Critical Incident Technique interviews were carried out with junior doctors and nurses. Two teaching hospitals in the Republic of Ireland. Junior doctors (n = 28) and nurses (n = 8) provided descriptions of scenarios of poor teamwork. The interviews were coded against a theoretical framework of healthcare team function by three psychologists and were also rated for risk to patients by four doctors and three nurses. A total of 33 of the scenarios met the inclusion criteria for analysis. A total of 63.6% (21/33) of the scenarios were attributed to 'poor quality of collaboration', 42.4% (14/33) to 'poor leadership' and 48.5% (16/33) to a 'lack of coordination'. A total of 16 scenarios were classified as high risk and 17 scenarios were classified as medium risk. Significantly more of the high-risk scenarios were associated with a 'lack of a shared mental model' (62.5%, 10/16) and 'poor communication' (50.0%, 8/16) than the medium-risk scenarios (17.6%, 3/17 and 11.8%, 2/17, respectively). Poor teamwork between junior doctors and nurses is common and places patients at considerable risk. Addressing this problem requires a well-designed complex intervention to develop the team skills of doctors and nurses and foster a clinical environment in which teamwork is supported. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Motivational pathways of occupational and organizational turnover intention among newly registered nurses in Canada.

PubMed

Fernet, Claude; Trépanier, Sarah-Geneviève; Demers, Mireille; Austin, Stéphanie

Staff turnover is a major issue for health care systems. In a time of labor shortage, it is critical to understand the motivational factors that underlie turnover intention in newly licensed nurses. To examine whether different forms of motivation (the reasons for which nurses engage in their work) predict intention to quit the occupation and organization through distinct forms (affective and continuance) and targets (occupation and organization) of commitment. Cross-sectional data were collected from a sample of 572 French-Canadian newly registered nurses working in public health care in the province of Quebec, Canada. The hypothesized model was tested by structural equation modeling. Autonomous motivation (nurses accomplish their work primarily out of a sense of pleasure and satisfaction or because they personally endorse the importance or value of their work) negatively predicts intention to quit the profession and organization through target-specific affective commitment. However, although controlled motivation (nurses accomplish their work mainly because of internal or external pressure) is positively associated with continuance commitment to the occupation and organization, it directly predicts, positively so, intention to quit the occupation and organization. These results highlight the complexity of the motivational processes at play in the turnover intention of novice nurses, revealing distinct forms of commitment that explain how motivation quality is related simultaneously to intention to quit the occupation and organization. Health care organizations are advised to promote autonomous over controlled motivation to retain newly recruited nurses and sustain the future of the nursing workforce. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

A Study of the Practical Nursing Programs in Vermont.

ERIC Educational Resources Information Center

Carr, Ruby C.

The purpose of the study was to review the entire practical nursing program and to make recommendations for its long-term organization and objectives. Relevant information concerned (1) the history of practical nursing, (2) purpose, membership, and related information on four professional nursing organizations, (3) state and federal legislation…

Gender Regimes in Ontario Nursing Homes: Organization, Daily Work, and Bodies.

PubMed

Storm, Palle; Braedley, Susan; Chivers, Sally

2017-06-01

Today more men work in the long-term care sector, but men are still in the minority. Little is known about men's experiences in care work, and the dilemmas and opportunities they face because of their gender. This article focuses on men care workers' integration into the organization and flow of nursing home work as perceived by these workers and staff members. Using a rapid ethnography method in two Ontario nursing homes, we found work organization affected interpretations of gender and race, and that workers' scope for discretion affected the integration and acceptance of men as care workers. In a nursing home with a rigid work organization and little worker discretion, women workers perceived men workers as a problem, whereas at a nursing home with a more flexible work organization that stressed relational care, both women and men workers perceived men workers as a resource in the organization.

The contribution of organization theory to nursing health services research.

PubMed

Mick, Stephen S; Mark, Barbara A

2005-01-01

We review nursing and health services research on health care organizations over the period 1950 through 2004 to reveal the contribution of nursing to this field. Notwithstanding this rich tradition and the unique perspective of nursing researchers grounded in patient care production processes, the following gaps in nursing research remain: (1) the lack of theoretical frameworks about organizational factors relating to internal work processes; (2) the need for sophisticated methodologies to guide empirical investigations; (3) the difficulty in understanding how organizations adapt models for patient care delivery in response to market forces; (4) the paucity of attention to the impact of new technologies on the organization of patient care work processes. Given nurses' deep understanding of the inner workings of health care facilities, we hope to see an increasing number of research programs that tackle these deficiencies.

Prospective payment based on case mix: will it work in nursing homes?

PubMed

Rosko, M D; Broyles, R W; Aaronson, W E

1987-01-01

This article evaluates the potential efficacy of implementing a prospective payment system based on case mix in the nursing home industry. The analysis of structural differences between the nursing home and hospital industries suggests that the mechanism of compensating long-term care facilities should be based on functional health status rather than on diagnosis and that incentives to improve quality and access should be strengthened. The article assesses several systems of classifying patients that have been proposed as the basis for implementing a prospective payment system in the nursing home industry. The article concludes with a discussion of policy issues related to the appropriate unit of payment and the scope of regulatory authority.

A university and health care organization partnership to prepare nurses for evidence-based practice.

PubMed

Missal, Bernita; Schafer, Beth Kaiser; Halm, Margo A; Schaffer, Marjorie A

2010-08-01

This article describes a partnership model between a university and health care organizations for teaching graduate nursing research from a framework of evidence-based practice. Nurses from health care organizations identified topics for graduate students to search the literature and synthesize evidence for guiding nursing practice. Nurse educators mentored graduate students in conducting critical appraisals of the literature. Students learned how to search for the evidence, summarize the existing research findings, and translate the findings into practice recommendations. Through presenting and discussing their findings with key stakeholders, students learned how nurses planned to integrate the evidence into practice. Nurses used the evidence-based results to improve their practice in the two partner hospitals. The partnership stimulated action for further inquiry into best practices.

Creating infrastructure supportive of evidence-based nursing practice: leadership strategies.

PubMed

Newhouse, Robin P

2007-01-01

Nursing leadership is the cornerstone of successful evidence-based practice (EBP) programs within health care organizations. The key to success is a strategic approach to building an EBP infrastructure, with allocation of appropriate human and material resources. This article indicates the organizational infrastructure that enables evidence-based nursing practice and strategies for leaders to enhance evidence-based practice using "the conceptual model for considering the determinants of diffusion, dissemination, and implementation of innovations in health service delivery and organization." Enabling EBP within organizations is important for promoting positive outcomes for nurses and patients. Fostering EBP is not a static or immediate outcome, but a long-term developmental process within organizations. Implementation requires multiple strategies to cultivate a culture of inquiry where nurses generate and answer important questions to guide practice. Organizations that can enable the culture and build infrastructure to help nurses develop EBP competencies will produce a professional environment that will result in both personal growth for their staff and improvements in quality that would not otherwise be possible.

[Competencies of the nurse in the management of cognitive and capital knowledge].

PubMed

Ruthes, Rosa Maria; Cunha, Isabel Cristina Kowal Olm

2009-01-01

The article presents a review of nurse's management competencies and the practical management of knowledge and the human capital and the applicability of the management for competencies. Globalization and competitiveness makes health organizations to search adaptative forms to the transformations of the management. For the nurse it is expected to consider solutions nursing team related to health organizations problems. The management of the intellectual capital must take care that the personnel is applying the knowing in benefit of the organization and the professional growth. If it will not have necessary competences for generalized application of knowledge, this is useless. The nurses must be prepared to evaluate technological, organizational and human resources and to develop competencies, knowledge, abilities, attitudes, and values to plan, to organize, to direct, to control the knowledge in the organizations.

County level socioeconomic position, work organization and depression disorder: a repeated measures cross-classified multilevel analysis of low-income nursing home workers.

PubMed

Muntaner, Carles; Li, Yong; Xue, Xiaonan; Thompson, Theresa; O'Campo, Patricia; Chung, Haejoo; Eaton, William W

2006-12-01

This study simultaneously tests the effect of county, organizational, workplace, and individual level variables on depressive disorders among low-income nursing assistants employed in US nursing homes. A total of 482 observations are used from two waves of survey data collection, with an average two-year interval between initial and follow-up surveys. The overall response rate was 62 percent. The hierarchically structured data was analyzed using multilevel modeling to account for cross-classifications across levels of data. Nursing assistants working in nursing homes covered by a single union in three states were asked about aspects of their working conditions, job stress, physical and mental health status, individual and family health-care needs, household economics and household strain. The 241 nursing assistants who participated in this study were employed in 34 nursing homes and lived in 49 counties of West Virginia, Ohio and Kentucky. The study finds that emotional strain, related to providing direct care to elderly and disabled clients, is associated with depressive disorder, as is nursing home ownership type (for-profit versus not-for-profit). However, when controlling for county level socioeconomic variables (Gini index and proportion of African Americans living in the county), neither workplace nor organizational level variables were found to be statistically significant associated with depressive disorder. This study supports previous findings that emotional demand in health-care environments is an important correlate of mental health. It also adds empirical evidence to support a link between financial strain and depression in US women. While this study does not find that lack of a seniority wage benefits--a factor that can conceivably exacerbate financial strain over time--is associated with depressive disorder among low-income health-care workers, it does find county level measures of poverty to be statistically significant predictors of depressive disorder. Longitudinal county level measures of low-income as predictors of depression may even offer a methodological advantage in that they are presumably more stable indicators of cumulative exposure of low income than are more transient workplace indicators. Incorporating measures of cumulative exposure to low income into empirical studies would be particularly timely given the global changes that are currently restructuring the labor force and influencing work organization and labor processes--most notably the growth in low income jobs and the deskilling of labor. Though this study provides evidence that workplace and organizational level variables are associated with depressive disorder among low-wage nursing assistants in US nursing homes, the fact that these relationships do not hold once county level measures of poverty are controlled for, suggests that more distal upstream determinants of workplace mental health problems, such economic inequality, may be at play in determining the mental health of low wage workers.

Engaging clinical nurses in quality and performance improvement activities.

PubMed

Albanese, Madeline P; Evans, Dietra A; Schantz, Cathy A; Bowen, Margaret; Disbot, Maureen; Moffa, Joseph S; Piesieski, Patricia; Polomano, Rosemary C

2010-01-01

Nursing performance measures are an integral part of quality initiatives in acute care; however, organizations face numerous challenges in developing infrastructures to support quality improvement processes and timely dissemination of outcomes data. At the Hospital of the University of Pennsylvania, a Magnet-designated organization, extensive work has been conducted to incorporate nursing-related outcomes in the organization's quality plan and to integrate roles for clinical nurses into the Department of Nursing and organization's core performance-based programs. Content and strategies that promote active involvement of nurses and prepare them to be competent and confident stakeholders in quality initiatives are presented. Engaging clinical nurses in the work of quality and performance improvement is essential to achieving excellence in clinical care. It is important to have structures and processes in place to bring meaningful data to the bedside; however, it is equally important to incorporate outcomes into practice. When nurses are educated about performance and quality measures, are engaged in identifying outcomes and collecting meaningful data, are active participants in disseminating quality reports, and are able to recognize the value of these activities, data become one with practice.

Nurses' creativity: advantage or disadvantage.

PubMed

Shahsavari Isfahani, Sara; Hosseini, Mohammad Ali; Fallahi Khoshknab, Masood; Peyrovi, Hamid; Khanke, Hamid Reza

2015-02-01

Recently, global nursing experts have been aggressively encouraging nurses to pursue creativity and innovation in nursing to improve nursing outcomes. Nurses' creativity plays a significant role in health and well-being. In most health systems across the world, nurses provide up to 80% of the primary health care; therefore, they are critically positioned to provide creative solutions for current and future global health challenges. The purpose of this study was to explore Iranian nurses' perceptions and experiences toward the expression of creativity in clinical settings and the outcomes of their creativity for health care organizations. A qualitative approach using content analysis was adopted. Data were collected through in-depth semistructured interviews with 14 nurses who were involved in the creative process in educational hospitals affiliated to Jahrom and Tehran Universities of Medical Sciences in Iran. Four themes emerged from the data analysis, including a) Improvement in quality of patient care, b) Improvement in nurses' quality of work, personal and social life, c) Promotion of organization, and d) Unpleasant outcomes. The findings indicated that nurses' creativity in health care organizations can lead to major changes of nursing practice, improvement of care and organizational performance. Therefore, policymakers, nurse educators, nursing and hospital managers should provide a nurturing environment that is conducive to creative thinking, giving the nurses opportunity for flexibility, creativity, support for change, and risk taking.

Terms used by nurses to describe patient problems: can SNOMED III represent nursing concepts in the patient record?

PubMed Central

Henry, S B; Holzemer, W L; Reilly, C A; Campbell, K E

1994-01-01

OBJECTIVE: To analyze the terms used by nurses in a variety of data sources and to test the feasibility of using SNOMED III to represent nursing terms. DESIGN: Prospective research design with manual matching of terms to the SNOMED III vocabulary. MEASUREMENTS: The terms used by nurses to describe patient problems during 485 episodes of care for 201 patients hospitalized for Pneumocystis carinii pneumonia were identified. Problems from four data sources (nurse interview, intershift report, nursing care plan, and nurse progress note/flowsheet) were classified based on the substantive area of the problem and on the terminology used to describe the problem. A test subset of the 25 most frequently used terms from the two written data sources (nursing care plan and nurse progress note/flowsheet) were manually matched to SNOMED III terms to test the feasibility of using that existing vocabulary to represent nursing terms. RESULTS: Nurses most frequently described patient problems as signs/symptoms in the verbal nurse interview and intershift report. In the written data sources, problems were recorded as North American Nursing Diagnosis Association (NANDA) terms and signs/symptoms with similar frequencies. Of the nursing terms in the test subset, 69% were represented using one or more SNOMED III terms. PMID:7719788

Developing leadership talent: a statewide nurse leader mentorship program.

PubMed

Rich, Mary; Kempin, Bettyann; Loughlin, Mary Jo; Vitale, Tracy R; Wurmser, Theresa; Thrall, Terese Hudson

2015-02-01

Nurse leaders continue to seek support programs essential for advancement to senior roles. Providing such support presents a challenge for the future of nursing in the state of New Jersey and on a national level. This article discusses the creation of a mentorship program by the Organization of Nurse Executives of New Jersey (ONE NJ). In recognition of the program, which has contributed to the advancement of New Jersey nursing leadership, the ONE NJ received the 2014 American Organization of Nurse Executives Chapter Achievement Award.

Nursing: caring or codependent?

PubMed

Caffrey, R A; Caffrey, P A

1994-01-01

Can nurses practice caring within a healthcare system that promotes codependency? Caring promotes mutual empowerment of all participants while codependent caring disempowers. Nurses are expected to practice caring with clients, The authors contend, however, that nursing, as historically and currently practiced within bureaucratic/patriarchal organizations, is founded on a value system that fosters codependency. Until nursing is practiced within the context of caring organizations and a caring healthcare system, nurses will continue to be powerless to shape their own practice as carers and burnout will continue to be a problem.

Building a strong nursing organization in a merged, service line structure.

PubMed

Fitzpatrick, M J; McElroy, M J; DeWoody, S

2001-01-01

In an increasingly complex healthcare environment, the discipline of nursing is difficult to define. Although a designated "department of nursing" may be absent on the organizational chart, the functional elements of the discipline remain. Nursing leaders will benefit from a framework to define and operationalize the core elements of nursing. The authors offer a five-phase methodology to enable the creation of a strong nursing organization in the face of mergers, service lines, and complex reporting structures.

A Two-Pronged Approach to Retaining Millennial Nurses.

PubMed

Koppel, Jenna; Deline, Marisa; Virkstis, Katherine

2017-12-01

Despite increased staff engagement and improved new hire on-boarding, organizations struggle to retain millennial nurses. One dominant trait is shared by organizations that have successfully reduced turnover for this group: investment in select strategies that cement loyalty to the organization. In this article, the authors describe 2 strategies for retaining early-tenure millennial nurses. In the 1st article of this series, the authors described why nursing leaders must supplement their organization's current investments in engagement with strategies targeted at millennials in their 1st 3 years. This 2nd part of the series will outline these strategies.

A critical competency: determining and communicating the number of nurses you must hire.

PubMed

Beglinger, Joan Ellis

2007-01-01

Nurse leaders must understand and articulate critical concepts of budgeting and staffing to provide credible leadership to our nursing organizations. Determining the ideal number of nurses to hire on any given unit is as much an art as it is a science. Understanding the relationship between hiring requirements and the budget can lead your nursing organization to achieve important results for your hospital.

A normative analysis of nursing knowledge.

PubMed

Zanotti, Renzo; Chiffi, Daniele

2016-03-01

This study addresses the question of normative analysis of the value-based aspects of nursing. In our perspective, values in science may be distinguished into (i) epistemic when related to the goals of truth and objectivity and (ii) non-epistemic when related to social, cultural or political aspects. Furthermore, values can be called constitutive when necessary for a scientific enterprise, or contextual when contingently associated with science. Analysis of the roles of the various forms of values and models of knowledge translation provides the ground to understand the specific role of values in nursing. A conceptual framework has been built to classify some of the classical perspectives on nursing knowledge and to examine the relationships between values and different forms of knowledge in nursing. It follows that adopting a normative perspective in the analysis of nursing knowledge provides key elements to identify its proper dimension. © 2015 John Wiley & Sons Ltd.

Survey and coping strategies for job stress of new nurses in pharmacy intravenous admixture service: a pilot study.

PubMed

Wang, Feng-Shuang; Jin, Ou; Feng, Hua; Wang, Feng-Hua; Ren, Chun-Hui

2015-01-01

To survey the nurse stress and analyze stressors in new nurses from pharmacy intravenous admixture service (PIAS). A questionnaire survey referring to the revised stressor scale was carried out on 52 new nurses of PIAS in four hospitals in Harbin. The average stress score for all participants was 2.43±0.63, as medium level of stress. The stressors were classified into 6 categories: ensuring up-to-date knowledge of professional nursing skills, increased workload and work-time, interpersonal relationship, ensuring knowledge of equipments, attending educational programs, and decreased occupational demand. The most important stressors included fear of medical accident occurrence, fear of failure in performance assessment, fear of occupational injuries, feeling fatigue and lack of sleep. Considering the various kinds of stressors in the working places, it was necessary for managers' to use appropriate strategies to cope with the job stress in new nurses of PIAS.

Experience of nurses in the process of donation of organs and tissues for transplant.

PubMed

de Moraes, Edvaldo Leal; dos Santos, Marcelo José; Merighi, Miriam Aparecida Barbosa; Massarollo, Maria Cristina Komatsu Braga

2014-01-01

to investigate the meaning of the action of nurses in the donation process to maintain the viability of organs and tissues for transplantation. this qualitative study with a social phenomenological approach was conducted through individual interviews with ten nurses of three Organ and Tissue Procurement Services of the city of São Paulo. the experience of the nurses in the donation process was represented by the categories: obstacles experienced in the donation process, and interventions performed. The meaning of the action to maintain the viability of organs and tissues for transplantation was described by the categories: to change paradigms, to humanize the donation process, to expand the donation, and to save lives. knowledge of the experience of the nurses in this process is important for healthcare professionals who work in different realities, indicating strategies to optimize the procurement of organs and tissues for transplantation.

Nurse administrators: leading environmental change.

PubMed

Tullai-McGuinness, Susan; Ballard, Karen A; Gallagher, Rita Munley; Carpenter, Holly

2010-01-01

Evidence is building about the impact of environmental contaminants on patients and health care providers. The nurse administrator has a professional responsibility to provide leadership in assuring that the health care organization does not have a negative impact on health. This article presents critical environmental health concerns and an overview of the nursing profession efforts to improve the environment, which includes development of the American Nurses Association's Principles of Environmental Health for Nursing Practice with Implementation Strategies. An example is provided as to how the nurse administrator can use Appreciative Inquiry to harness the nurses collaborative energy for an environmentally healthy organization.

Public health nursing competencies 1953-1966: effective and efficient.

PubMed

Weierbach, Florence M

2007-01-01

The Quad Council of Public Health Nursing Organizations developed public health nursing competencies in 2003. They are guides for determining skills at two levels, and they identify public health nurses as providing care to individuals and families or to populations and systems with the nurse having proficiency, awareness, or knowledge. The primary purpose of this paper is to discuss historical nursing roles and qualifications as judged by the 2003 competencies, including educational preparation and experience for the administrative and staff nurse. The historical exemplar for the nursing roles is a combination public/private nursing association, referred to as the partnership, that took place in 1953-1966. Primary sources include archived material from the Instructive Visiting Nurse Association, Richmond, VA. Administrative responsibilities were divided between the chief nurse and the nursing supervisors. Staff nurse responsibilities included clinic activities, home visitation, and referral coordination between health care organizations. The delineation of nursing roles demonstrates nurses' meeting the 2003 competencies. Based on the Quad Council's 2003 public health nursing competencies, the partnership nurses were competent.

Putting conflict management into practice: a nursing case study.

PubMed

Vivar, Cristina García

2006-04-01

This paper is intended to put knowledge in conflict management into practice through reflecting on a nursing case study. Nursing organizations are particularly vulnerable to conflict as the context of nurses' work may be difficult and stressful. Power conflict is argued to be an important source of tension within nursing units. Learning to manage conflict at an early stage is therefore crucial to the effective functioning of nursing organizations. A nursing case study that illustrates power conflict in an oncology nursing unit is displayed and reflection on conflict management from the case is provided. There is no appropriate or inappropriate strategy to deal with conflict. However, detecting initial symptoms of conflict and adopting the most effective behaviour to conflict resolution is essential in nursing units. Further nursing education in conflict management for staff nurses and nurse managers is greatly needed.

Workplace bullying experienced by Massachusetts registered nurses and the relationship to intention to leave the organization.

PubMed

Simons, Shellie

2008-01-01

This descriptive study examines bullying behavior among nurses and tests the relationship between bullying and a nurse's intention to leave their organization. Data were collected from 511 randomly selected newly licensed registered nurses by using the Revised Negative Acts Questionnaire, an instrument that measures perceived exposure to bullying at work. Results found that 31% of respondents reported being bullied and that bullying is a significant determinant in predicting intent to leave the organization (B = 3.1, P < .0005). Data suggest that effective interventions are needed to stop workplace bullying that contributes to high rates of nurse turnover.

We cannot staff for 'what ifs': the social organization of rural nurses' safeguarding work.

PubMed

MacKinnon, Karen

2012-09-01

Rural nurses play an important role in the provision of maternity care for Canadian women. This care is an important part of how rural nurses safeguard the patients who receive care in small rural hospitals. This study utilized institutional ethnography as an approach for describing rural nursing work and for exploring how nurses' work experiences are socially organized. Rural nurses advocated for safe healthcare environments by ensuring that skilled nurses were available for every shift, day and night, at their local hospital. Rural nurses noted that this work was particularly difficult for the provision of maternity care. This article explores two threads or cues to institutional organization that were identified in our interviews and observations; namely staffing and safety standards, and the need for flexibility in staffing in small rural hospitals. Rural nurses' concerns about ensuring that skilled nurses are available in small rural hospitals do not enter into current management discourses that focus on efficiency and cost savings or find a home within current discourses of patient safety 'competencies'. © 2011 Blackwell Publishing Ltd.

Australian perioperative nurses' experiences of assisting in multi-organ procurement surgery: a grounded theory study.

PubMed

Smith, Zaneta; Leslie, Gavin; Wynaden, Dianne

2015-03-01

Multi-organ procurement surgical procedures through the generosity of deceased organ donors, have made an enormous impact on extending the lives of recipients. There is a dearth of in-depth knowledge relating to the experiences of perioperative nurses working closely with organ donors undergoing multi-organ procurement surgical procedures. The aim of this study was to address this gap by describing the perioperative nurses experiences of participating in multi-organ procurement surgical procedures and interpreting these findings as a substantive theory. This qualitative study used grounded theory methodology to generate a substantive theory of the experiences of perioperative nurses participating in multi-organ procurement surgery. Recruitment of participants took place after the study was advertised via a professional newsletter and journal. The study was conducted with participants from metropolitan, rural and regional areas of two Australian states; New South Wales and Western Australia. Thirty five perioperative nurse participants with three to 39 years of professional nursing experience informed the study. Semi structured in-depth interviews were undertaken from July 2009 to April 2010 with a mean interview time of 60 min. Interview data was transcribed verbatim and analysed using the constant comparative method. The study results draw attention to the complexities that exist for perioperative nurses when participating in multi-organ procurement surgical procedures reporting a basic social psychological problem articulated as hiding behind a mask and how they resolved this problem by the basic social psychological process of finding meaning. This study provides a greater understanding of how these surgical procedures impact on perioperative nurses by providing a substantive theory of this experience. The findings have the potential to guide further research into this challenging area of nursing practice with implications for clinical initiatives, management practices and education. Copyright © 2014 Elsevier Ltd. All rights reserved.

Safety organizing, emotional exhaustion, and turnover in hospital nursing units.

PubMed

Vogus, Timothy J; Cooil, Bruce; Sitterding, Mary; Everett, Linda Q

2014-10-01

Prior research has found that safety organizing behaviors of registered nurses (RNs) positively impact patient safety. However, little research exists on how engaging in safety organizing affects caregivers. While we know that organizational processes can have divergent effects on organizational and employee outcomes, little research exists on the effects of pursuing highly reliable performance through safety organizing on caregivers. Specifically, we examined whether, and the conditions under which, safety organizing affects RN emotional exhaustion and nursing unit turnover rates. Subjects included 1352 RNs in 50 intensive care, internal medicine, labor, and surgery nursing units in 3 Midwestern acute-care hospitals who completed questionnaires between August and December 2011 and 50 Nurse Managers from the units who completed questionnaires in December 2012. Cross-sectional analyses of RN emotional exhaustion linked to survey data on safety organizing and hospital incident reporting system data on adverse event rates for the year before survey administration. Cross-sectional analysis of unit-level RN turnover rates for the year following the administration of the survey linked to survey data on safety organizing. Multilevel regression analysis indicated that safety organizing was negatively associated with RN emotional exhaustion on units with higher rates of adverse events and positively associated with RN emotional exhaustion with lower rates of adverse events. Tobit regression analyses indicated that safety organizing was associated with lower unit level of turnover rates over time. Safety organizing is beneficial to caregivers in multiple ways, especially on nursing units with high levels of adverse events and over time.

European nursing organizations stand up for family presence during cardiopulmonary resuscitation: a joint position statement.

PubMed

Moons, Philip; Norekvål, Tone M

2008-01-01

Empirical evidence suggests that family presence during cardiopulmonary resuscitation (CPR) has beneficial effects. Although many American professional organizations have endorsed the idea of family presence, there is less formal support in Europe. In addition, the attitude of nurses from Anglo-Saxon countries, such as United Kingdom and Ireland, is more positive toward family presence than the attitude of nurses of mainland Europe. In order to support existing guidelines and to stimulate health care organizations to develop a formal policy with respect to family witnessed CPR, 3 important European nursing organizations have recently developed a joint position statement.

Effective strategies for nurse retention in acute hospitals: a mixed method study.

PubMed

Van den Heede, Koen; Florquin, Mieke; Bruyneel, Luk; Aiken, Linda; Diya, Luwis; Lesaffre, Emmanuel; Sermeus, Walter

2013-02-01

The realization of an organizational context that succeeds to retain nurses within their job is one of the most effective strategies of dealing with nursing shortages. First, to examine the impact of nursing practice environments, nurse staffing and nurse education on nurse reported intention to leave the hospital. Second, to provide understanding of which best practices in the organization of nursing care are being implemented to provide sound practice environments and to retain nurses. 3186 bedside nurses of 272 randomly selected nursing units in 56 Belgian acute hospitals were surveyed. A GEE logistic regression analysis was used to estimate the impact of organization of nursing care on nurse reported intention to leave controlling for differences in region (Walloon, Flanders, and Brussels), hospital characteristics (technology level, teaching status, and size) and nurse characteristics (experience, gender, and age). For the second objective, in-depth semi-structured interviews with the chief nursing officers of the three high and three low performing hospitals on reported intention to leave were held. 29.5% of Belgian nurses have an intention-to-leave the hospital. Patient-to-nurse staffing ratios and nurse work environments are significantly (p<0.05) associated with intention-to-leave. Interviews with Chief Nurse Officers revealed that high performing hospitals showing low nurse retention were--in contrast to the low performing hospitals--characterized by a flat organization structure with a participative management style, structured education programs and career opportunities for nurses. This study, together with the international body of evidence, suggests that investing in improved nursing work environments is a key strategy to retain nurses. Copyright © 2011 Elsevier Ltd. All rights reserved.

Chief nursing officer turnover: chief nursing officers and healthcare recruiters tell their stories.

PubMed

Havens, Donna Sullivan; Thompson, Pamela A; Jones, Cheryl B

2008-12-01

Chief nursing officers (CNOs) develop environments in which quality patient care is delivered and nurses enjoy professional practice. Because of the growing turbulence in this vital role, the American Organization of Nurse Executives conducted a study to examine CNO turnover as described in interviews with CNOs and healthcare recruiters to inform the development of strategies to improve CNO recruitment and retention and ease transition for those who turn over. The authors present the findings from this research and describe American Organization of Nurse Executives' initiatives to address the identified needs.

Factors affecting professional ethics in nursing practice in Iran: a qualitative study.

PubMed

Dehghani, Ali; Mosalanejad, Leili; Dehghan-Nayeri, Nahid

2015-09-09

Professional ethics refers to the use of logical and consistent communication, knowledge, clinical skills, emotions and values in nursing practice. This study aimed to explore and describe factors that affect professional ethics in nursing practice in Iran. This qualitative study was conducted using conventional content analysis approach. Thirty nurses with at least 5 years of experience participated in the study; they were selected using purposive sampling. Data were collected through semi-structured interviews and analyzed using thematic analysis. After encoding and classifying the data, five major categories were identified: individual character and responsibility, communication challenges, organizational preconditions, support systems, educational and cultural development. Awareness of professional ethics and its contributing factors could help nurses and healthcare professionals provide better services for patients. At the same time, such understanding would be valuable for educational administrators for effective planning and management.

Development and testing of a scale for assessing the quality of home nursing.

PubMed

Chiou, Chii-Jun; Wang, Hsiu-Hung; Chang, Hsing-Yi

2016-03-01

To develop a home nursing quality scale and to evaluate its psychometric properties. This was a 3-year study. In the first year, 19 focus group interviews with caregivers of people using home nursing services were carried out in northern, central and southern Taiwan. Content analysis was carried out and a pool of questionnaire items compiled. In the second year (2007), study was carried out on a stratified random sample selected from home nursing organizations covered by the national health insurance scheme in southern Taiwan. The study population was the co-resident primary caregivers of home care nursing service users. Item analysis and exploratory factor analysis were carried out on data from 365 self-administered questionnaires collected from 13 selected home care organizations. In the third year (2008), a random sample of participants was selected from 206 hospital-based home care nursing organizations throughout Taiwan, resulting in completion of 294 questionnaires from 27 organizations. Confirmatory factor analysis was then carried out on the scale, and the validity and reliability of the scale assessed. The present study developed a reliable and valid home nursing quality scale from the perspective of users of home nursing services. The scale comprised three factors: dependability, communication skills and service usefulness. This scale is of practical value for the promotion of long-term community care aging in local policies. The scale is ready to be used to assess the quality of services provided by home care nursing organizations. © 2015 Japan Geriatrics Society.

Enemies of ethics equals environmental exodus, part 1.

PubMed

Ramsey, Suzanne

2015-01-01

Nursing is known as a respected profession in society. Nursing is also ranked as a leading career fostering unethical behavior amongst one another. Historically, nurses are known to "eat their young," meaning new graduate nurses may undergo a brief period of hazing conducted by the experienced nurse. In the past two decades, research demonstrates an increasing trend, often acceptable within an organization, of bullying, lateral violence and mobbing amongst nurses. This type of intentional repetitive harassment inflicts physical and psychological harm to nursing colleagues. It is important for nurses to be familiar with signs of bullying, feel confident in sharing the observation with leadership, and possess the knowledge to make an ethical decision. This type of aggression within an organization affects all employees, the organization's finances and reputation, and most importantly, the quality of patient care, all negatively. The culture of an organization reflects the leadership. Transformational management style, open communication, behavioral expectations, policies and procedures, along with a zero-tolerance course of action for bullying behaviors, are necessary when developing a healthy workplace environment. Laws and regulations in certain states are in place supporting healthy workplace environments. Public awareness concerning bullying, mobbing, and harassment within the workplace has increased secondary to the media's publicity on the subject. Nurses should reflect on the theoretical frameworks of the nursing profession and strive to role model virtues of integrity, ethics and civility within their personal and professional life.

[REBEn: space of diffusion of hospital nursing knowledge --from 1951 to 2001].

PubMed

Porto, Isaura Setenta; de Catrib, Paula Regina Virgínio Moraes; de Oliveira, Lilian Felippe Duarte; de Figueiredo, Nébia Maria Almeida

2003-01-01

Research on the scientific production on Hospital Nursing published by REBEn. Classify the articles published from 1951 to 2001 and analyze this Review as a space for the diffusion of knowledge in that area. Concept of cultural diffusion and its constituent historical processes. Form applied in 254 articles. Data were submitted to descriptive statistics and led to the following categories: "production of articles in the concerning areas", "articles' scope", "types of articles", and "articles' origin". Our findings showed significant scientific production in those areas within the focused scopes and types of articles. Our conclusions indicate REBEn as a representative space of national diffusion of knowledge on hospital nursing and professional culture, contributing to the development of Nursing as a science.

Toward a model for improved targeting of aged at risk of institutionalization.

PubMed Central

Weissert, W G; Cready, C M

1989-01-01

A national sample of institutionalized and noninstitutionalized aged was created by merging the 1977 National Nursing Home Survey and its counterpart, the National Health Interview Survey for the same year. A weighted logistic regression analysis was conducted to identify factors that might be useful in calculating home- and community-based long-term care clients' risk of institutionalization. A model containing patient characteristics, nursing home bed supply, and a climate variable correctly classified 98.2 percent of cases residing in nursing homes or the community. Physical dependency, mental disorder and degenerative disease, lack of spouse, being white, poverty, old age, unoccupied nursing home beds, and climate all appear to be determinants of institutional residency among the aged. PMID:2807934

Adverse events during air and ground neonatal transport: 13 years' experience from a neonatal transport team in Northern Sweden.

PubMed

van den Berg, Johannes; Olsson, Linn; Svensson, Amelie; Håkansson, Stellan

2015-07-01

To study the prevalence of adverse events (AEs) associated with neonatal transport, and to categorize, classify and assess the risk estimation of these events. Written comments in 1082 transport records during the period 1999-2011 were reviewed. Comments related to events that infringed on patient and staff safety were included as AEs, and categorized and further classified as complaint, imminent risk of incident/negative event, actual incident or actual negative event. AEs were also grouped into emergency or planned transports, and risk estimation was calculated according to a risk assessment tool and defined as low, intermediate, high or extreme risk. AEs (N = 883) were divided into five categories: logistics (n = 337), organization (n = 177), equipment (n = 165), vehicle (n = 129) and medical/nursing care (n = 75). Eighty-five percent of AEs were classified as incidents or negative events. The majority of AEs were estimated to be of low or intermediate risk in both planned and emergency transports. AEs estimated to be of high or extreme risk were significantly more frequent in emergency transports (OR = 10.1; 95% CI: 5.0-20.9; p < 0.001). AEs are common in both planned and emergency neonatal transport, often related to imperfect transport logistics or equipment failure. AEs of high or extreme risk were more frequent in emergency transports.

The changing roles of registered nurses in Pioneer Accountable Care Organizations.

PubMed

Pittman, Patricia; Forrest, Emily

2015-01-01

This study focuses on whether and how Pioneer Accountable Care Organization (ACO) leaders believe the deployment of the registered nurse workforce is changing in response to the shared savings incentives. Semistructured phone interviews with leaders from 18 of the original 32 Pioneer ACOs were conducted. Narrative analysis suggests that all of the organizations are developing new and enhanced roles for registered nurses across the continuum of care. Overall, eight types of changes were reported: enhancement of roles, substitution, delegation, increased numbers of nurses, relocation of services, transfer of nurses from one setting to another, the use of liaison nurses across settings, and partnerships between nurses coordinating care in primary and acute care settings. This exploratory study suggests that Pioneer ACO leaders believe that payment models are affecting the deployment of the health workforce and that these changes are, in turn, driving outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

The importance of civilian nursing organizations: integrative literature review.

PubMed

Santos, James Farley Estevam Dos; Santos, Regina Maria Dos; Costa, Laís de Miranda Crispim; Almeida, Lenira Maria Wanderley Santos de; Macêdo, Amanda Cavalcante de; Santos, Tânia Cristina Franco

2016-06-01

to identify and analyze evidence from studies about the importance of civilian nursing organizations. an integrative literature review, for which searches were conducted in the databases LILACS, PubMed/MEDLINE, SciELO, BDENF, and Scopus. sixteen articles published between the years 2004-2013 were selected, 68.75% of which were sourced from Brazilian journals and 31.25% from American journals. civilian nursing organizations are important and necessary, because they have collaborated decisively in nursing struggles in favor of the working class and society in general, and these contributions influence different axes of professional performance.

Applicability of the NANDA-I and Nursing Interventions Classification taxonomies to mental health nursing practice.

PubMed

Thomé, Emi da Silva; Centena, Renata Cardoso; Behenck, Andressa da Silva; Marini, Maiko; Heldt, Elizeth

2014-10-01

To assess the applicability of the systematization of nursing care (NCS) to outpatient nursing appointments using the NANDA-I and Nursing Interventions Classification (NIC) taxonomies. Data were collected from 40 patients who had appointments with a nurse who specialized in mental health. Nursing diagnoses (NDs) and interventions were classified using the NANDA-I and NIC taxonomies, respectively. A total of 14 different NDs were detected (minimum of one and maximum of three per appointment). The most frequently made diagnoses were impaired social interaction (00052), anxiety (00146), and ineffective self-health management (00078). A total of 23 nursing interventions were prescribed (approximately two per appointment), of which the most frequent were socialization enhancement (5100), self-care assistance (1800), and exercise promotion (0200). Significant associations were found between the most frequently detected NDs and the most commonly prescribed interventions (p > .05). The NCS through the use of classification systems allows mental health nurses to better identify and assist poorly adjusted patients. The assessment of the applicability of the NCS to different areas of health care and types of medical assistance contributes significantly to the quality of nursing care. © 2014 NANDA International, Inc.

A Framework for Categorizing Social Interactions Related to End-of-Life Care in Nursing Homes

PubMed Central

Bern-Klug, Mercedes

2009-01-01

Purpose: Almost half of people age 85 and older who die annually in the United States die as nursing home residents, yet because it is not always clear who is close to death, not all residents who might benefit from end-of-life care receive it. The purpose of this study is to develop a framework for organizing social interactions related to end-of-life care and to characterize the social construction of dying in two nursing homes. Design: Secondary analysis of qualitative ethnographic data collected before the death of 45 residents who were selected for the study on account of their “declining” health status. Methods: Field notes, medical chart data, and transcribed interviews corresponding to 45 residents in two nursing homes in a large Midwestern city were analyzed using qualitative descriptive methods guided by symbolic interaction and role theory. The data were also grouped by resident to facilitate the development of cases that illustrate the categories of social interactions. A second reader also categorized all the resident cases into one of five categories as a means of verifying the model. Results: A new framework of five categories to name the stance toward the possibility of dying is presented and illustrated with cases. The categories include: dying allowed, dying contested, mixed message dying, not dying, and not enough information. Cases are provided to illustrate the importance of recognizing the impact that social interactions can have on care. Over half the resident cases were classified as mixed message dying or not enough information, which speaks to the ambiguity regarding care plan goals found in the two nursing homes in the study. Implications: Social interactions related to the health care and dying status of a nursing home resident help to construct a social reality, and that social reality can affect the care the nursing home resident receives. Conversations about goals of care, and how these goals will be operationalized are important issues for discussion among residents (to the extent able), family, staff, and physicians. Social interactions, or the lack thereof, matter. PMID:19491358

The effects of authentic leadership, organizational identification, and occupational coping self-efficacy on new graduate nurses' job turnover intentions in Canada.

PubMed

Fallatah, Fatmah; Laschinger, Heather K S; Read, Emily A

Nurses' turnover has a costly impact on organizations, patients, and nurses. Numerous studies have highlighted the critical role of nursing leadership in enhancing new nurses' retention. To examine the influence of authentic leadership on new nurses' job turnover intentions through their personal identification with the leader, organizational identification, and occupational coping self-efficacy. Secondary data analysis of a cross-sectional national study of Canadian new graduate nurses was conducted using structural equation modeling. Authentic leadership had a significant positive effect on nurses' personal identification with their leader and their organization. Personal identification mediated the relationship between authentic leadership and organizational identification. Organizational identification had a significant positive effect on occupational coping self-efficacy, which, in turn, had a negative effect on new graduate nurses' job turnover intentions. The findings demonstrate the vital role authentic leadership plays in retaining new graduate nurses. Authentic leaders foster personal and organizational identification among new graduate nurses, leading to increase in the confidence in their ability to manage work-related challenges, which subsequently results in positive outcomes in both new graduate nurses and the organization. Copyright © 2016 Elsevier Inc. All rights reserved.

The knowledge of expert nurses and the practical-reflective rationality.

PubMed

Pina Queirós, Paulo Joaquim

2015-01-01

To identify the characteristics of an expert nurse. A group of 49 nurses starting their Master's degree was asked to answer the following question: ''Which characteristics and skills distinguish a novice from an expert nurse?'' The answers were analyzed and classified based on Bardin's content analysis. Through a three-stage classification process, the competences and skills assigned to expert nurses were divided into 17 categories. These nurses showed wide-ranging skills and acquired meta-competencies. Expert nurses are characterized by their leadership, supervision and ability to manage change, as well as their communication and relational skills. They have the ability to act reflectively, plan, systematize and consistently assess; they also show more dexterity. They have more adaptive skills, confidence and achieve a broader view. They are competent while managing conflicts and stress, as well as articulating theory and practice; they create knowledge, make use of research, respond to complex situations and are capable of making decisions. Expert nurses have anticipation skills, insight, use detailed observation, take immediate action and are able to define priorities; they keep context in mind and have a tendency for specialization.

Nurse and resident satisfaction in magnet long-term care organizations: do high involvement approaches matter?

PubMed

Rondeau, Kent V; Wagar, Terry H

2006-04-01

This study examines the association of high involvement nursing work practices with employer-of-choice (magnet) status in a sample of Canadian nursing homes. In response to a severe shortage of registered nursing personnel, it is imperative for health care organizations to more effectively recruit and retain nursing personnel. Some long-term care organizations are developing employee-centred cultures that allow them to effectively enhance nurse and resident satisfaction. At the same time, many nursing homes have adopted progressive nursing workplace practices (high involvement work practices) that emphasize greater employee empowerment, participation and commitment. A mail survey was sent to the director of nursing in 300 nursing homes in western Canada. In total, 125 useable questionnaires were returned and constituted the data set for this study. Separate ordinary least squares regressions are performed with magnet strength, nurse satisfaction and resident satisfaction used as dependent variables. Nursing homes that demonstrate strong magnet (employer-of-choice) characteristics are more likely to have higher levels of nurse and patient satisfaction, even after controlling for a number of significant factors at the establishment level. Magnet nursing homes are more likely to have progressive participatory decision-making cultures and much more likely to spend considerable resources on job-related training for their nursing staff. The presence of high involvement work practices is not found to be a significant predictor in magnet strength, nurse or resident satisfaction. Merely adopting more high involvement nursing work practices may be insufficient for nursing homes, which desire to become 'employers-of-choice' in their marketplaces, especially if these practices are adopted without a concomitant investment in nurse training or an enhanced commitment to establishing a more democratic and participatory decision-making style involving all nursing staff.

Readiness of organizations for change, motivation and conflict-handling intentions: senior nursing students' perceptions.

PubMed

Mrayyan, Majd T; Modallal, Rola; Awamreh, Khitam; Atoum, Maysoun; Abdullah, Muna; Suliman, Samah

2008-03-01

This study examined the perceptions of 62 senior nursing students of the readiness of Jordanian organizations for change, students' motivators and their conflict-handling intentions. Such concepts should be taught at Schools of Nursing in order to prepare the students as nurses in the near future. It is found that the course of "Nursing Leadership and Management" has positive influence on students' understanding of the studied concepts. This descriptive study was conducted in seven hospitals. Grossman and Valiga's (2000) [Grossman, S., Valiga, T.M., 2000. The New Leadership Challenge: Creating the Future of Nursing. F.A. Davis, Philadelphia, pp. 147-148.] instrument was used to measure the readiness of organizations for change. As they progress in the course, the students' perceptions about the organizational readiness to change increased; the students "somehow" perceived that the Jordanian organizations were ready to change. The students were asked what motivates and they were asked about their conflict-handling techniques. Senior nursing students reported that private hospitals were better than governmental hospitals in their readiness for change. In general, male students perceived the readiness of organizations for change more positively than female students. The students were mainly motivated by "achievement" and used "collaboration" as a primary conflict-handling technique. Further studies are needed to explore in-depth the concept of the readiness of organizations for change. Achievement is a strong motivator that should be encouraged among students. Conflict-handling techniques in general and collaboration in particular should be taught for nursing students as these techniques will influence their future professional lives.

Nurse managers: the ties that bind.

PubMed

Simons, Sherri Lee

2003-01-01

The staff nurses' immediate manager directly influences an NICU's ability to attract and retain professional nurses. This makes it especially important that nurse executives and administrators identify opportunities to better meet the needs of their nurse managers and measure the impacts of their decisions. Data about front-line manager turnover need to be measured, reported, and examined. No longer can organizations afford to view managers as another expense; they are an asset on the balance sheet. Strategic planning for the recruitment and retention of nurse managers will be vital both to an organization's healthy bottom line and to the quality of its patient care.

Developing leadership in nursing: the impact of education and training.

PubMed

Curtis, Elizabeth A; Sheerin, Fintan K; Vries, Jan de

This is the second of two articles on developing leadership in nursing; this article explores the role and impact of training and education on nursing leadership. Nursing leadership education has been identified as much needed, and can be provided by universities (at Masters, diploma and certificate levels), healthcare organizations or hospitals. Research demonstrates that where leadership has been effectively taught and integrated into nursing, it has a positive impact on nurses' leadership skills and practice. It is suggested that healthcare organizations continue to develop and support leadership training, while also seeking ways of maintaining and promoting leadership development in practice.

Taking charge: front-line nurse leadership development.

PubMed

Schwarzkopf, Ruth; Sherman, Rose O; Kiger, Anna J

2012-04-01

The recent Institute of Medicine (2010) report, The Future of Nursing: Leading Change, Advancing Health, included a recommendation that nurses at all levels should be prepared and enabled to lead change to advance health care in the United States. Historically, in most organizations, nursing leadership development programs have focused on nurses in management or executive roles rather than those working in front-line leadership roles. This article describes a front-line leadership development initiative developed by Tenet Healthcare Corporation and attended by 400 charge nurses. Program development, evaluation, and lessons learned that can be applied in other organizations are discussed. Copyright 2012, SLACK Incorporated.

Establishing a nursing strategic agenda: the whys and wherefores.

PubMed

Young, Claire

2008-01-01

The health system nursing leader is responsible for providing high-quality, service-oriented nursing care to deliver such care with disciplined cost management; to lead and develop a group of nursing executives and managers at the facility level; to establish nursing professional development programs; to build and maintain an effective supply of nurses; and to advocate for nurses and patients. Balancing these imperatives requires thoughtful strategic planning and disciplined execution. In their absence, organizations flounder to address a single problem in isolation and struggle to perform against outcomes. One organization approached the challenge by engaging in a comprehensive, accelerated strategic planning process. The experience brought together 11 hospital nursing executives in consensus around a prioritized strategic agenda. This article is a case study of the approach used to define a nursing agenda.

A comparison of the impact of CPOE implementation and organizational determinants on doctor-nurse communications and cooperation.

PubMed

Pelayo, Sylvia; Anceaux, Françoise; Rogalski, Janine; Elkin, Peter; Beuscart-Zephir, Marie-Catherine

2013-12-01

To compare the impact of CPOE implementation and of the workplace organizational determinants on the doctor-nurse cooperation and communication processes. A first study was undertaken in eight different wards aimed to identify the different workplace organizations that support doctor-nurse communications'. A second study compared the impact of these organizations and of a CPOE on medication-related doctor-nurse communications. The doctor-nurse communications could be structured into three typical workplace organizations: the common round, the briefing and the opportunistic exchange organizations. The results (i) confirmed the impact of the organizational determinants on the cooperative activities and (ii) demonstrated the CPOE system has no significant impact within a given workplace organization. The success of the implementation of HIT applications relies partly on the identification of the actual (and sometimes hidden) structuring variables of teamwork and ultimately on their control at the time of implementation to ensure the quality and safety of the patient care provided. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Financial literacy as an essential element in nursing management practice.

PubMed

Talley, Linda B; Thorgrimson, Diane H; Robinson, Nellie C

2013-01-01

Grooming nurses at all levels of the organization to master health care executive skills is critical to the organization's success and the individual's growth. Selecting and executing next steps for nursing leadership team development is critical to success. Leaders must make it their responsibility to provide nurses with increased exposure to quality, safety, and financial data, thereby allowing nurses to translate data while achieving and sustaining successful outcomes. The work of the CNO Dashboard to measure, report, trend, and translate clinical and non-clinical outcomes must be integrated throughout all levels of nursing staff so that nursing practice is positioned to continually strive for best practice. The education and evolution of nurses as business managers is critical to building a strong RN workforce.

The Social Organization of Nurses' Pain Management Work in Qatar.

PubMed

Yassin, Khadra; Rankin, Janet; Al-Tawafsheh, Atef

2015-10-01

The purpose of this study was to explore the social organization of nurses' pain management work in Qatar. The research data drew our attention to unacceptable delays in intervening with patients in pain. We describe and analyze delays in opioid administration. Institutional ethnography was the method of inquiry used to guide the study. The main findings of the study reveal that there is a socially organized system of delays built into nurses' work to manage pain. Nurses are subject to time-consuming processes of securing, handling, and administering opioids. This study's innovative approach introduces a promising "alternate" analysis to prior work investigating hospital nurses' pain management practices. Both the method of inquiry and the findings have international relevance for researchers interested in undertreated pain. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Perspectives on global nursing leadership: international experiences from the field.

PubMed

Buckner, E B; Anderson, D J; Garzon, N; Hafsteinsdóttir, T B; Lai, C K Y; Roshan, R

2014-12-01

Nursing leaders from six countries engaged in a year-long discussion on global leadership development. The purpose of these dialogues was to strengthen individual and collective capacity as nursing leaders in a global society. Field experiences in practice and education were shared. Perspectives on global leadership can strengthen nurses' contributions to practice, workplace and policy issues worldwide. Transformational leadership empowers nurses' increasing confidence. Mentoring is needed to stimulate leadership development but this is lacking in many settings where nurses practice, teach and influence policy. Organizations with global mission provide opportunity for nurses' professional growth in leadership through international dialogues. Dialogues among participants were held monthly by conference calls or videoconferences. Example stories from each participant illustrated nursing leadership in action. From these exemplars, concepts were chosen to create a framework. Emerging perspectives and leadership themes represented all contexts of practice, education, research and policy. The cultural context of each country was reflected in the examples. Themes emerged that crossed global regions and countries. Themes were creativity, change, collaboration, community, context and courage. Relationships initially formed in professional organizations can be extended to intentionally facilitate global nursing leadership development. Exemplars from the dialogues demonstrated nursing leadership in health policy development within each cultural context. Recommendations are given for infrastructure development in organizations to enhance future collaborations. © 2014 International Council of Nurses.

Solving work-related ethical problems.

PubMed

Laukkanen, Laura; Suhonen, Riitta; Leino-Kilpi, Helena

2016-12-01

Nurse managers are responsible for solving work-related ethical problems to promote a positive ethical culture in healthcare organizations. The aim of this study was to describe the activities that nurse managers use to solve work-related ethical problems. The ultimate aim was to enhance the ethical awareness of all nurse managers. The data for this descriptive cross-sectional survey were analyzed through inductive content analysis and quantification. Participants and research context: The data were collected in 2011 using a questionnaire that included an open-ended question and background factors. Participants were nurse managers working in Finnish healthcare organizations (n = 122). Ethical considerations: Permission for the study was given by the Finnish Association of Academic Managers and Experts of Health Sciences. Nurse managers identified a variety of activities they use to solve work-related ethical problems: discussion (30%), cooperation (25%), work organization (17%), intervention (10%), personal values (9%), operational models (4%), statistics and feedback (4%), and personal examples (1%). However, these activities did not follow any common or systematic model. In the future, nurse managers need a more systematic approach to solve ethical problems. It is important to establish new kinds of ethics structures in organizations, such as a common, systematic ethical decision-making model and an ethics club for nurse manager problems, to support nurse managers in solving work-related ethical problems.

Nurse executive transformational leadership found in participative organizations.

PubMed

Dunham-Taylor, J

2000-05-01

The study examined a national sample of 396 randomly selected hospital nurse executives to explore transformational leadership, stage of power, and organizational climate. Results from a few nurse executive studies have found nurse executives were transformational leaders. As executives were more transformational, they achieved better staff satisfaction and higher work group effectiveness. This study integrates Bass' transformational leadership model with Hagberg's power stage theory and Likert's organizational climate theory. Nurse executives (396) and staff reporting to them (1,115) rated the nurse executives' leadership style, staff extra effort, staff satisfaction, and work group effectiveness using Bass and Avolio's Multifactor Leadership Questionnaire. Executives' bosses (360) rated executive work group effectiveness. Executives completed Hagberg's Personal Power Profile and ranked their organizational climate using Likert's Profile of Organizational Characteristics. Nurse executives used transformational leadership fairly often; achieved fairly satisfied staff levels; were very effective according to bosses; were most likely at stage 3 (power by achievement) or stage 4 (power by reflection); and rated their hospital as a Likert System 3 Consultative Organization. Staff satisfaction and work group effectiveness decreased as nurse executives were more transactional. Higher transformational scores tended to occur with higher educational degrees and within more participative organizations. Transformational qualities can be enhanced by further education, by achieving higher power stages, and by being within more participative organizations.

[Subjectivity of nursing college students' awareness of gender equality: an application of Q-methodology].

PubMed

Yeun, Eun Ja; Kwon, Hye Jin; Kim, Hyun Jeong

2012-06-01

This study was done to identify the awareness of gender equality among nursing college students, and to provide basic data for educational solutions and desirable directions. A Q-methodology which provides a method of analyzing the subjectivity of each item was used. 34 selected Q-statements from each of 20 women nursing college students were classified into a shape of normal distribution using 9-point scale. Subjectivity on the equality among genders was analyzed by the pc-QUANL program. Four types of awareness of gender equality in nursing college students were identified. The name for type I was 'pursuit of androgyny', for type II, 'difference-recognition', for type III, 'human-relationship emphasis', and for type IV, 'social-system emphasis'. The results of this study indicate that different approaches to educational programs on gender equality are recommended for nursing college students based on the four types of gender equality awareness.

[Managment in nursing and the administration of third sector organizations].

PubMed

Ruthes, Rosa Maria; Cunha, Isabel Cristina Kowal Olm

2006-01-01

In this article of bibliographical revision it was aimed at verifying the evolution of the third sector and the relations between nursing management in that organizations. It is observed a growing of this sector in health area, bringing a market anplification in the work of the nurse. Thus, it is considered the need for warning the nurses to be prepared for the management in these organizations, seeking for development in hospital management. Third sector is being valued as a form of social promotion in the health, education, social assistance and others segments, congregating individuals and institutions in a participative form.

Nurses in corporate America: embracing power through influence.

PubMed

Weaver, Charlotte A

2002-06-01

Executive positions in corporate America offer nurse leaders the opportunity to influence product development and services delivered to ensure that the best possible solutions are provided to health care organizations, providers, and patients. This opportunity to "make a difference" is a critical component for nurses' attraction to migrating to the business side of the health care industry. However, making the transition from leadership positions in health care delivery organizations to corporate businesses carries big challenges. A major demand is for nurse leaders to adjust from direct span of control organizational models to matrix management structures used in complex business organizations.

Use of a professional organization (Council of International Neonatal Nurses) for global networking.

PubMed

Boykova, Marina

2010-01-01

The article illustrates the need to belong to professional specialty organizations to foster collaborations across the globe. The Council of International Neonatal Nurses is the exemplar for this professional group. The personal journey of the author to the global community of neonatal nurses is presented.

Designing nursing excellence through a National Quality Forum nurse scholar program.

PubMed

Neumann, Julie A; Brady-Schluttner, Katherine A; Attlesey-Pries, Jacqueline M; Twedell, Diane M

2010-01-01

Closing the knowledge gap for current practicing nurses in the Institute of Medicine (IOM) core competencies is critical to providing safe patient care. The National Quality Forum (NQF) nurse scholar program is one organization's journey to close the gap in the IOM core competencies in a large teaching organization. The NQF nurse scholar program is positioned to provide a plan to assist current nurses to accelerate their learning about quality improvement, evidence-based practice, and informatics, 3 of the core competencies identified by the IOM, and focus on application of skills to NQF nurse-sensitive measures. Curriculum outline, educational methodologies, administrative processes, and aims of the project are discussed.

The role of high-involvement work practices and professional self-image in nursing recruits' turnover: A three-year prospective study.

PubMed

Chênevert, Denis; Jourdain, Geneviève; Vandenberghe, Christian

2016-01-01

The retention of young graduate nurses has become a major management challenge among hospitals in Western countries, which is amplified in a context of aging of populations and an increasing demand for services from patients. Moreover, as it has been reported that 50% of experienced nurses do not recommend a career in nursing, it is likely that retention problems occur not only at the level of the organization, but also at the level of the nursing profession. Although research has identified some predictors of nurse turnover, it is unclear which factors influence nurses' turnover from the organization and from the profession and how these factors interrelate with one another over time. The present study extends previous research on nurse turnover by looking at the combined effects of nurses' pre-entry expectations, perceived high-involvement work practices, and professional self-image, on intended and actual turnover from the organization and the profession. A prospective, longitudinal study of a sample of 160 graduated nurses affiliated with the Quebec Nurses' Association, Canada, was conducted. Participants were surveyed at three points in time, spread over a 3-year period. Graduated nurses' pre-entry expectations and professional self-image were surveyed at graduation (Time 1), while perceived high-involvement work practices, professional self-image, and intention to leave the organization and the profession were captured six months following nurses' entry into the labor market (Time 2). Finally, participants were surveyed with respect to organizational and professional turnover three years after the Time 2 survey (Time 3). Structural equations modeling was used to examine the structure of the measures and the relationships among the constructs. Although pre-entry expectations had no effect, perceived high-involvement work practices were positively related to Time 2, professional self-image (controlling for pre-entry professional self-image). Moreover, high-involvement work practices exerted an indirect, negative effect on organizational and professional turnover through intention to leave the organization, and an indirect negative effect on intention to leave the profession through professional self-image. Nonetheless, professional self-image did not affect turnover. The current study indicates that hospitals and nurse directors can take advantage of developing high-involvement work practices as these practices foster a stronger professional self-image among nurses, thereby contributing to their sense of value as care providers, and indirectly reduce intended and actual turnover from the organization and the profession. Copyright © 2015 Elsevier Ltd. All rights reserved.

Learning organizations, internal marketing, and organizational commitment in hospitals.

PubMed

Tsai, Yafang

2014-04-04

Knowledge capital is becoming more important to healthcare establishments, especially for hospitals that are facing changing societal and industrial patterns. Hospital staff must engage in a process of continual learning to improve their healthcare skills and provide a superior service to their patients. Internal marketing helps hospital administrators to improve the quality of service provided by nursing staff to their patients and allows hospitals to build a learning culture and enhance the organizational commitment of its nursing staff. Our empirical study provides nursing managers with a tool to allow them to initiate a change in the attitudes of nurses towards work, by constructing a new 'learning organization' and using effective internal marketing. A cross-sectional design was employed. Two hundred questionnaires were distributed to nurses working in either a medical centre or a regional hospital in Taichung City, Taiwan, and 114 valid questionnaires were returned (response rate: 57%). The entire process of distribution and returns was completed between 1 October and 31 October 2009. Hypothesis testing was conducted using structural equation modelling. A significant positive correlation was found between the existence of a 'learning organization', internal marketing, and organizational commitment. Internal marketing was a mediator between creating a learning organization and organizational commitment. Nursing managers may be able to apply the creation of a learning organization to strategies that can strengthen employee organizational commitment. Further, when promoting the creation of a learning organization, managers can coordinate their internal marketing practices to enhance the organizational commitment of nurses.

Nursing Diagnosis of "Spiritual Distress" in Women With Breast Cancer: Prevalence and Major Defining Characteristics.

PubMed

Caldeira, Sílvia; Timmins, Fiona; de Carvalho, Emília C; Vieira, Margarida

2016-01-01

Spirituality and spiritual needs of cancer patients are frequently mentioned in the nursing literature, but the most significant defining characteristics of spiritual distress in the context of clinical reasoning and nursing diagnosis are rarely explored. Understanding of these is important for effective spiritual intervention. The aim of this study was to identify the prevalence and the defining characteristics of the nursing diagnosis "spiritual distress," as classified according to NANDA International, among women with breast cancer. This was a quantitative and cross-sectional study, comprising the third phase of a larger study investigating the clinical validation of spiritual distress in cancer patients undergoing chemotherapy. Fehring's clinical diagnostic validation model was used to identify the prevalence and the major defining characteristics of the diagnosis. A convenience sample was used, and data were collected by structured interview. A total of 70 women participated; most were married (62.9%) and had a mean age of 54 years, and 55.7% reported having at least 1 person depending on them. The average length of time since the cancer diagnosis was 30.9 months. Twenty-seven participants were experiencing spiritual distress (38.6%). Eleven defining characteristics were classified as major. The prevalence of spiritual distress and the major defining characteristics give clinical evidence about the nurse's role in providing spiritual care. The results are useful for the improved use of the NANDA International diagnoses within this domain. The findings highlight the importance of assessing the defining characteristics of the diagnosis as an objective strategy to improve clinical reasoning related to spirituality and to facilitate more effective interventions.

Analysis of team types based on collaborative relationships among doctors, home-visiting nurses and care managers for effective support of patients in end-of-life home care.

PubMed

Fujita, Junko; Fukui, Sakiko; Ikezaki, Sumie; Otoguro, Chizuru; Tsujimura, Mayuko

2017-11-01

To define the team types consisting of doctors, home-visiting nurses and care managers for end-of-life care by measuring the collaboration relationship, and to identify the factors related to the team types. A questionnaire survey of 43 teams including doctors, home-visiting nurses and care managers was carried out. The team types were classified based on mutual evaluations of the collaborative relationships among the professionals. To clarify the factors between team types with the patient characteristics, team characteristics and collaboration competency, univariate analysis was carried out with the Fisher's exact test or one-way analysis and multiple comparison analysis. Three team types were classified: the team where the collaborative relationships among all healthcare professionals were good; the team where the collaborative relationships between the doctors and care managers were poor; and the team where the collaborative relationships among all of the professionals were poor. There was a statistically significant association between the team types and the following variables: patient's dementia level, communication tool, professionals' experience of working with other team members, home-visiting nurses' experience of caring for dying patients, care managers' background qualifications, doctor's face-to-face cooperation with other members and home-visiting nurses' collaborative practice. It is suggested that a collaborative relationship would be fostered by more experience of working together, using communication tools and enhancing each professional's collaboration competency. Geriatr Gerontol Int 2017; 17: 1943-1950. © 2017 Japan Geriatrics Society.

Evaluating Nurses Acceptance of Hospital Information Systems: A Case Study of a Tertiary Care Hospital.

PubMed

Khalifa, Mohamed

2016-01-01

This study aims at evaluating hospital information systems (HIS) acceptance factors among nurses, in order to provide suggestions for successful HIS implementation. The study used mainly quantitative survey methods to collect data directly from nurses through a questionnaire. The availability of computers in the hospital was one of the most influential factors, with a special emphasis on the unavailability of laptop computers and computers on wheels to facilitate immediate data entry and retrieval when nurses are at the point of care. Nurses believed that HIS might frequently slow down the process of care delivery and increase the time spent by patients inside the hospital especially during slow performance and responsiveness phases. Recommendations were classified into three main areas; improving system performance and availability of computers in the hospital, increasing organizational support in the form of providing training and protected time for nurses' to learn and enhancing users' feedback by listening to their complaints and considering their suggestions.

[Cost of nursing turnover in a Teaching Hospital].

PubMed

Ruiz, Paula Buck de Oliveira; Perroca, Marcia Galan; Jericó, Marli de Carvalho

2016-02-01

To map the sub processes related to turnover of nursing staff and to investigate and measure the nursing turnover cost. This is a descriptive-exploratory study, classified as case study, conducted in a teaching hospital in the southeastern, Brazil, in the period from May to November 2013. The population was composed by the nursing staff, using Nursing Turnover Cost Calculation Methodology. The total cost of turnover was R$314.605,62, and ranged from R$2.221,42 to R$3.073,23 per employee. The costs of pre-hire totaled R$101.004,60 (32,1%), and the hiring process consumed R$92.743,60 (91.8%) The costs of post-hire totaled R$213.601,02 (67,9%), for the sub process decreased productivity, R$199.982,40 (93.6%). The study identified the importance of managing the cost of staff turnover and the financial impact of the cost of the employee termination, which represented three times the average salary of the nursing staff.

Developing an information systems strategy for nursing.

PubMed

Callanan, K M; Hughes, S J

1995-01-01

With the rapidly changing health care environment and information technology advances, organizations need to engage in strategic, planned change in order to allocate limited resources, achieve the organization's goals, and fulfill its mission [1]. One of the most important aspects of the organization's planned strategies for change concerns the information systems. The involvement of the nursing department in this process is critical. This poster presentation will communicate how nurses can develop an information systems strategic plan that will enable them to play an active role as contributors and vital participants in the strategic and business planning processes for information systems. This information systems strategy for nursing will: a) provide direction and purpose, b) guide nursing in identifying the kinds of information technology needed, c) assist in timely implementation of a system that supports nursing, and d) identify desired outcomes and benefits of an information system. The nursing information systems plan must be built on, and support, the organization's mission and business plan and integrate into the over-all information systems plans [2]. Components of the nursing strategic plan include the nursing mission statement and vision, an assessment of the current environment to identify supporting technology needed to achieve the nursing vision, expectations/anticipated outcomes, environmental considerations, and special staffing/expertise considerations. The nursing vision and mission statement is an articulation of the overall direction and purpose of the nursing organization. An assessment of the nursing organization, problem areas, opportunities for growth, the physical environment, existing systems, communications requirements, and resources is carried out to help identify areas where new technologies and automated methods of managing information could be applied. Special staffing and expertise not currently available in the organization, but necessary to the successful implementation of the plan, should be identified, and plans for filling those needs should be included in the planning and prioritization process. Based on the mission and assessment findings, goals or anticipated outcomes are developed. These goals must be realistic, financially feasible, and logistically achievable; they should also provide direction for action and decision-making [3]. Measurable objectives and detailed action plans can then be developed from these goals when implementation of this aspect of the strategic plan is begun. It is especially important, even at a strategic planning level, to consider change management techniques, including specific steps to involve individuals who will be affected by the change and to ensure open communication throughout the process. Efforts to collaborate with all affected departments and to offer input and educational opportunities to the various members of the health care team should be included in the strategic plan. A business plan describing the mission, goals, and objectives for a specific system implementation is the final step in the strategic planning process. The business plan includes expected outcomes and cost justification and may be done in cooperation with other departments (in the organization) that will be involved with this system. The business plan is used to communicate the information system's needs to the administration and governing board of the organization. With a good information systems strategy, nursing will be prepared to make more timely and better informed decisions related to applying information technology within the nursing department. The end results of this planning should be evident in the improved utilization of information technology to support the nursing vision and mission.

Nurse-Led Programs to Facilitate Enrollment to Children's Oncology Group Cancer Control Trials.

PubMed

Haugen, Maureen; Kelly, Katherine Patterson; Leonard, Marcia; Mills, Denise; Sung, Lillian; Mowbray, Catriona; Landier, Wendy

2016-09-01

The progress made over the past 50 years in disease-directed clinical trials has significantly increased cure rates for children and adolescents with cancer. The Children's Oncology Group (COG) is now conducting more studies that emphasize improving quality of life for young people with cancer. These types of clinical trials are classified as cancer control (CCL) studies by the National Cancer Institute and require different resources and approaches to facilitate adequate accrual and implementation at COG institutions. Several COG institutions that had previously experienced problems with low accruals to CCL trials have successfully implemented local nursing leadership for these types of studies. Successful models of nurses as institutional leaders and "champions" of CCL trials are described. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

Effects of a computerized cardiac teletriage decision support system on nurse performance: results of a controlled human factors experiment using a mid-fidelity prototype.

PubMed

Somoza, Kirsten Carroll; Momtahan, Kathryn; Lindgaard, Gitte

2007-01-01

A gap exists in cardiac care between known best practices and the actual level of care administered. To help bridge this gap, a proof of concept interface for a PDA-based decision support system (DSS) was designed for cardiac care nurses engaged in teletriage. This interface was developed through a user-centered design process. Quality of assessment, quality of recommendations, and number of questions asked were measured. Cardiac floor nurses' assessment quality performance, but not their recommendation quality performance, improved with the DSS. Nurses asked more questions with the DSS than without it, and these additional questions were predominantly classifiable as essential or beneficial to a good assessment. The average participant satisfaction score with the DSS was above neutral.

Nurse Managers' prerequisite for nursing development: a survey on pressure ulcers and contextual factors in hospital organizations.

PubMed

Gunningberg, Lena; Brudin, Lars; Idvall, Ewa

2010-09-01

To describe and compare pressure ulcer prevalence in two county councils and concurrently explore Nurse Managers' perspective of contextual factors in a hospital organization. Despite good knowledge about risk factors and prevention of pressure ulcers, the prevalence of pressure ulcers remains high. Nurse Managers' have a key role in implementing evidence-based practice. The present study included five hospitals in two Swedish county councils: county council A (non-university setting) and county council B (university setting). A pressure ulcer prevalence study was conducted according to the methodology developed by the European Pressure Ulcer Advisory Panel. The Nurse Managers' answered a (27-item) questionnaire on contextual factors. County council B had significantly less pressure ulcers grade (2-4) (7.7%) than county council A (11.3%). The Nurse Managers' assessed only two out of the 27 general contextual items significantly differently. Some significant differences were observed in ward organization. In county council B, the Nurse Managers' seemed more aware of prevention strategies compared with Nurse Managers' in county council A. The Nurse Managers' should take more responsibility to develop the prerequisite for quality improvement in nursing. Nursing outcomes (e.g. pressure ulcers) should be incorporated into national quality registries for benchmarking and Nurse Managers' competence in evidence-based practice and research methodology increased. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

The future of nursing: monitoring the progress of recommended change in hospitals, nurse-led clinics, and home health and hospice agencies.

PubMed

Pittman, Patricia; Bass, Emily; Hargraves, John; Herrera, Carolina; Thompson, Pamela

2015-02-01

The objective of this study was to assess the implementation of recommendations of the Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health. In 2010, the IOM made a series of recommendations aimed at transforming the role of nurses in healthcare delivery. We conducted a multiyear survey, in 2011 and 2013, with nurse leaders who were members of the American Organization of Nurse Executives, the National Nursing Centers Consortium, or the Visiting Nurses Association of America. When comparing 2013 to 2011, we find progress in instituting the IOM's recommendations in 3 areas: (1) raising the proportion of employed RNs with at least a bachelor's degree; (2) expanding the proportion of healthcare institutions with nurse residency programs; and (3) offering opportunities for continuing nurse education Our findings suggest that healthcare organizations are transforming to support the recommendations of the IOM.

Use of Motivational Interviewing by Nurse Leaders: Coaching for Performance, Professional Development, and Career Goal Setting.

PubMed

Niesen, Cynthia R; Kraft, Sarah J; Meiers, Sonja J

Motivational interviewing (MI) is a mentoring style used in various health care settings to guide patients toward health promotion and disease management. The aims of this project were (1) to identify evidence supporting the application of MI strategies and principles by nurse leaders to promote healthful leadership development among direct-report staff and (2) to report outcomes of an educational pilot project regarding MI use for new nurse leaders. Correlations between MI and the American Organization of Nurse Executives nurse executive competencies are reviewed and summarized. These competencies shape the roles, responsibilities, and skills required for nurse executives to function proficiently and successfully within health care organizations. Survey responses were gathered from new nurse supervisors and nurse managers following the MI educational session for nurse leaders. The results show acceptability for MI use in professional development of direct-report staff and in other aspects of nursing leadership roles.

Assessment of dementia in nursing home residents by nurses and assistants: criteria validity and determinants.

PubMed

Sørensen, L; Foldspang, A; Gulmann, N C; Munk-Jørgensen, P

2001-06-01

To describe the criterion validity of nursing home staff's assessment of organic disorder compared with ICD-10 criteria, and to identify determinants of staff assessment of organic disorder. Two hundred and eighty-eight residents were diagnosed using the GMS-AGECAT. Nursing staff members were interviewed about the residents' activities of Daily Living, behavioural problems, orientation in surroundings and communication skills, and asked if the resident had an organic disorder. Multiple logistic regression was used to select the items that most strongly determined staff assessment of organic disorder. Sixty-two per cent of the residents were diagnosed by GMS-AGECAT as having organic disorder, 78% of these were correctly identified by the staff. Whether analysed among residents with or without organic disorder, or in the total group of residents, the staff assessment of the presence of organic disorder depended on a limited set of behavioural characteristics of the resident, namely 'going to the toilet in inappropriate places', 'saying things that do not make sense' and impairment in orientation. Staff comprehension of organic disorder resulted in over- as well as under-labelling of residents, a tendency that will affect communication with medical personnel and may lead to inadequate or wrong medical treatment and to negative performance as well as negative role expectations in everyday life in nursing homes.

International Nursing: How Much Power Do Nurse Managers Have?

PubMed

Trus, Marija; Martinkenas, Arvydas; Suominen, Tarja

This study was conducted to explore issues of nurse managers' power and empowerment. Data were collected from nurse managers by way of a questionnaire consisting of background factors, work-related questions, and power-related questions at the unit and organization levels. The degree of empowerment was evaluated using 2 established instruments (CWEQ-II and Work Empowerment Questionnaire). The overall level of managers' personal power within their own units was relatively high. Nurse managers' perception of their power at an organizational level was found to be at a moderate level. Several factors related to an individual's professional background were correlated to power issues, both at the unit and organizational levels. Structural and psychological empowerment correlated with the overall level of power at a unit level and the overall level of power at an organizational level. Nurse managers self-reported their own general power at a unit level as high, which offers them possibilities to lead the development of nursing care in their units. Organizations may benefit more from nurse managers' leadership by more fully integrating them in the development processes of the entire organization.

The 'big dip': decrements in RN satisfaction at mid-career.

PubMed

Coshow, Suzanne M; Davis, Paul; Wolosin, Robert J

2009-01-01

In response to nurse turnover, hospitals have taken steps to ensure that their nurses are satisfied with their jobs. On-boarding may not be the most pressing retention issue facing health care organizations as the loss of mid-career nurses may be the larger problem. There are some areas of work satisfaction for nurses which may be more responsive to organizational efforts to reach higher aggregate levels of satisfaction. Health care organizations may due well to focus on the relative satisfaction of their mid-career nurses. Opportunities to increase nurse job satisfaction across different facets of work may be an effective strategy to address retention.

Developing human capital: what is the impact on nurse turnover?

PubMed

Rondeau, Kent V; Williams, Eric S; Wagar, Terry H

2009-09-01

To investigate the impact that increasing human capital through staff training makes on the voluntary turnover of registered nurses. Healthcare organizations in Canada, the United Kingdom, the United States, and Australia are experiencing turbulent nursing labour markets characterized by extreme staff shortages and high levels of turnover. Organizations that invest in the development of their nursing human resources may be able to mitigate high turnover through the creation of conditions that more effectively develop and utilize their existing human capital. A questionnaire was sent to the chief nursing officers of 2208 hospitals and long-term care facilities in every province and territory of Canada yielding a response rate of 32.3%. The analysis featured a three-step hierarchical regression with two sets of control variables. After controlling for establishment demographics and local labour market conditions, perceptions of nursing human capital and the level of staff training provided were modestly associated with lower levels of establishment turnover. and implications for Nursing Management The results suggest that healthcare organizations that have made greater investments in their nursing human capital are more likely to demonstrate lower levels of turnover of their registered nursing personnel.

Inductions Buffer Nurses' Job Stress, Health, and Organizational Commitment.

PubMed

Kamau, Caroline; Medisauskaite, Asta; Lopes, Barbara

2015-01-01

Nurses suffer disproportionate levels of stress and are at risk of sickness-absence and turnover intentions, but there is a lack of research clarifying preventions. This study investigated the impact of inductions (job preparation courses) about mental health for nurses' job stress, general health, and organizational commitment. Data from 6,656 nurses were analyzed using structural equation modeling (SEM), showing that mental health inductions increase nurses' job satisfaction, which reduces their occupational stress and improves their health. SEM showed that these occupational health benefits increase the nurses' commitment to the organization. Job satisfaction (feeling valued, rewarded) also had a direct effect on nurses' intentions to continue working for the organization. Mental health inductions are therefore beneficial beyond job performance: they increase occupational health in the nursing profession.

[Outsourcing of nursing human resources from ethical to management: a survey in a Lazio Region Hospital].

PubMed

d'Amore, Maurizia; Peroni, Antonia

2008-01-01

In 2006, 279 nurses of a Lazio Region Hospital were assessed to verify whether certain Human Resources decisions, such as outsourcing, can negatively influence their working motivation and sense of belonging to a health organization and whether any dissatisfaction can be attributed to poor ethical information within the health service. The research method had a descriptive basis and for data collection a questionnaire with 35 questions was issued. Results showed that nurses felt strongly involved in the study and interesting aspects for management of human resources emerged, depicting an organization lacking in motivation : this confirmed one of the aspects of the study : poor levels of motivation and sense of belonging can be correlated to insufficient ethical information in local health organizations. The main working needs that emerged among the nurses of this hospital regarded economical retribution (90%), security and success (88%) , belonging (86%) and self-satisfaction (77%): the need for power was relatively low (40%). The strong points of the study were : the strong involvement of nurses, the value of the information gathered regarding working motivation, sense of belong to a nursing organization , working needs , ethical information in health environments, organization according to targets. The limits of the study were: limited number of nurses in outsourcing at the time of the study (12%), impossibility of comparing the results with data prior to the outsourcing choices made by the hospital in question.

Referring patients to nurses: Outcomes and evaluation of a nurse flexible sigmoidoscopy training program for colorectal cancer screening

PubMed Central

Dobrow, Mark J; Cooper, Mary Anne; Gayman, Karen; Pennington, Jason; Matthews, Joanne; Rabeneck, Linda

2007-01-01

Colorectal cancer is a significant health burden. Several screening options exist that can detect colorectal cancer at an early stage, leading to a more favourable prognosis. However, despite years of knowledge on best practice, screening rates are still very low in Canada, particularly in Ontario. The present paper reports on efforts to increase the flexible sigmoidoscopy screening capacity in Ontario by training nurses to perform this traditionally physician-performed procedure. Drawing on American, British and local experience, a professional regulatory framework was established, and training curriculum and assessment criteria were developed. Training was initiated at Princess Margaret Hospital and Sunnybrook and Women’s College Health Sciences Centre in Toronto, Ontario. (During the study, Sunnybrook and Women’s College Health Sciences Centre was deamalgamated into two separate hospitals: Women’s College Hospital and Sunnybrook Health Sciences Centre.) Six registered nurses participated in didactic, simulator and practical training. These nurses performed a total of 77 procedures in patients, 23 of whom had polyps detected and biopsied. Eight patients were advised to undergo colonoscopy because they had one or more neoplastic polyps. To date, six of these eight patients have undergone colonoscopy, one patient has moved out of the province and another patient is awaiting the procedure. Classifying the six patients according to the most advanced polyp histology, one patient had a negative colonoscopy (no polyps found), one patient’s polyps were hyperplastic, one had a tubular adenoma, two had advanced neoplasia (tubulovillous adenomas) and one had adenocarcinoma. All these lesions were excised completely at colonoscopy. Overall, many difficulties were anticipated and addressed in the development of the training program; ultimately, the project was affected most directly by challenges in encouraging family physicians to refer patients to the program. As health human resource strategies continue to evolve, it is believed that lessons learned from experience make an important contribution to the knowledge of how nontraditional health services can be organized and delivered. PMID:17505566

Attitudes towards rotating shift work in clinical nurses: a Q-methodology study.

PubMed

Ha, Eun-Ho

2015-09-01

To identify clinical nurses' attitudes towards rotating shift work. Many hospitals worldwide employ rotating shift work patterns to staff their facilities. Attitudes of clinical nurses towards rotating shift work vary. To understand clinical nurses' attitudes towards rotating shift work, Q-methodology, a method for the analysis of subjective viewpoints with the strengths of both qualitative and quantitative methods, was used. Forty-six selected Q-statements from each of the 39 participants were classified into a normal distribution using an 11-point bipolar scale. The collected data were analysed using pc-QUANL program. Three discrete factors emerged as follows: factor I (rotating shift work is frustrating: objectionable perspective), factor II (rotating shift work is satisfactory: constructive perspective) and factor III (rotating shift work is problematic, but necessary: ambivalent perspective). The subjective viewpoints of the three identified factors can be applied in developing various roster designs for nurses engaging in rotating shift work. The findings provide the baseline for nurse leaders in helping nurses adjust and deal with rotating shift work. © 2015 John Wiley & Sons Ltd.

Impact of Advocacy Initiatives on Nurses' Motivation to Sustain Momentum in Public Policy Advocacy.

PubMed

Taylor, Melissa R S

2016-01-01

The purpose of this study is to elicit insight from the public policy leaders of 2 regional professional nursing organizations on key qualities of their current advocacy initiatives that motivate nurses to sustain momentum in public policy advocacy beyond a single episode. The goal is to inform quality improvement in the development of future advocacy initiatives to increase sustained engagement of nurses. Social cognitive theory was used as the rationale for this qualitative, descriptive study. A purposive convenience sample of executive leadership and board committee members from 2 regional professional nursing organizations were recruited to complete an initial Web-based electronic survey, followed by separate semistructured interview focus groups. One organization was composed primarily of advanced practice registered nurses, and the other group composed of diverse, multispecialty nursing members with varied educational levels. Nine themes emerged, categorized as facilitators or challenges to the positive impact of advocacy initiatives on nurses' motivation. Highlighting and marketing facilitators to the positive impact of advocacy initiatives on nurses' motivation to sustain momentum in public policy advocacy, while designing and testing new initiatives that address the challenges, may increase the number of nurses who sustain engagement in the policy advocacy process. Copyright © 2016 Elsevier Inc. All rights reserved.

The examination of nursing work through a role accountability framework.

PubMed

White, Deborah E; Jackson, Karen; Besner, Jeanne; Norris, Jill M

2015-07-01

To use work analysis data to describe the amount of time registered nurses (RNs) and health care aides (HCA) spent on key clinical role accountabilities and other work activities. Health care providers are not effectively utilized. To improve their efficiency and effectiveness, it is necessary to understand how nursing providers enact their role accountabilities. Using palm pilot Function Analysis technology, observers recorded the activities of 35 registered nurse and 17 health care aides shifts on a second-by-second basis over 5 days. Work activities were classified using the Nursing Role Effectiveness Model, which conceptualizes nursing practice in terms of clinical role accountabilities. The registered nurses spent a considerable amount of time on bio-medical assessment/surveillance, relatively little time was spent on patient and family psycho-social-cultural-spiritual assessment/surveillance and support. Unlike other work sampling studies, this research project examined nursing work within a role accountability framework; an important first step in the call for the measurement of the impact of nursing care. Changes to how registered nurses and health care aides enact their role will require a clear vision by unit managers and their staff of their role accountabilities, and the gap between ideal and actual practice. © 2013 John Wiley & Sons Ltd.

Nursing diagnoses for the elderly using the International Classification for Nursing Practice and the activities of living model.

PubMed

de Medeiros, Ana Claudia Torres; da Nóbrega, Maria Miriam Lima; Rodrigues, Rosalina Aparecida Partezani; Fernandes, Maria das Graças Melo

2013-01-01

To develop nursing diagnosis statements for the elderly based on the Activities of Living Model and on the International Classification for Nursing Practice. Descriptive and exploratory study, put in practice in two stages: 1) collection of terms and concepts that are considered clinically and culturally relevant for nursing care delivered to the elderly, in order to develop a database of terms and 2) development of nursing diagnosis statements for the elderly in primary health care, based on the guidelines of the International Council of Nurses and on the database of terms for nursing practice involving the elderly. 414 terms were identified and submitted to the content validation process, with the participation of ten nursing experts, which resulted in 263 validated terms. These terms were submitted to cross mapping with the terms of the International Classification for Nursing Practice, resulting in the identification of 115 listed terms and 148 non-listed terms, which constituted the database of terms, from which 127 nursing diagnosis statements were prepared and classified into factors that affect the performance of the elderly's activities of living - 69 into biological factors, 19 into psychological, 31 into sociocultural, five into environmental, and three into political-economic factors. After clinical validation, these statements can serve as a guide for nursing consultations with elderly patients, without ignoring clinical experience, critical thinking and decision-making.

Helping nurses cope with grief and compassion fatigue: an educational intervention.

PubMed

Houck, Dereen

2014-08-01

Oncology nurses may experience intense physical and emotional exhaustion, identified in the literature as symptoms of cumulative grief and compassion fatigue, with significant consequences for both nurses and organizations. The first step in preventing these consequences is recognition. Organizations should provide nurses with resources including education, counseling, and opportunities to grieve. Nurses need to learn the importance of work-life balance, self-care strategies, and communication skills. Using recommendations from the literature, an educational intervention was designed with the purpose of providing nurses with knowledge, skills, and resources to practice effective self-care and recognize when assistance is needed. The program's objective was to help nurses develop the coping skills and inner resources necessary to maintain their emotional and physical health.

An ethical framework for nursing service administration.

PubMed

Christensen, P J

1988-04-01

Nurses as administrators are responsible for creating an ethical work environment in which nurses' human welfare is promoted. Bureaucratic organizations can dehumanize people, wherein human welfare suffers in the midst of institutional constraints. Amid these conditions nurses' ethical competence cannot develop nor can nurses maintain a sense of personal integrity. Applying concepts from nursing and general ethics to administrative practice provides a basis for developing an ethical framework for management. The proposed framework involves ethical awareness, principled reasoning, moral commitment to the profession and to one another, and primary consideration for human welfare with strategies to promote it. Use of these components when making decisions in daily practice and on a policy level enhances the well-being of nurses working in organizations.

What can we learn from the existing evidence of the business case for investments in nursing care: importance of content, context, and policy environment.

PubMed

Yakusheva, Olga; Wholey, Douglas; Frick, Kevin D

2013-04-01

Decisions of health care institutions to invest in nursing care are often guided by mixed and conflicting evidence of effects of the investments on organizational function and sustainability. This paper uses new evidence generated through Interdisciplinary Nursing Quality Research Initiative (INQRI)-funded research and published in peer-reviewed journals, to illustrate where the business case for nursing investments stands and to discuss factors that may limit the existing evidence and its transferability into clinical practice. We conclude that there are 3 limiting factors: (1) the existing business case for nursing investments is likely understated due to the inability of most studies to capture spillover and long-run dynamic effects, thus causing organizations to forfeit potentially viable nursing investments that may improve long-term financial stability; (2) studies rarely devote sufficient attention to describing the content and the organization-specific contextual factors, thus limiting generalizability; and (3) fragmentation of the current health care delivery and payment systems often leads to the financial benefits of investments in nursing care accruing outside of the organization incurring the costs, thus making potentially quality-improving and cost-saving interventions financially unattractive from the organization's perspective. The payment reform, with its emphasis on high-quality affordable patient-centered care, is likely to strengthen the business case for investments in nursing care. Methodologically rigorous approaches that focus on broader societal implications of investments in nursing care, combined with a thorough understanding of potential barriers and facilitators of nursing change, should be an integral part of future research and policy efforts.

Staying in nursing: what factors determine whether nurses intend to remain employed?

PubMed

Carter, Matthew R; Tourangeau, Ann E

2012-07-01

To test a model of eight thematic determinants of whether nurses intend to remain in nursing roles. Despite the dramatic increase in the supply of nurses in England over the past decade, a combination of the economic downturn, funding constraints and more generally an ageing nursing population means that healthcare organizations are likely to encounter long-term problems in the recruitment and retention of nursing staff. Survey. Data were collected from a large staff survey conducted in the National Health Service in England between September-December 2009. A multi-level model was tested using MPlus statistical software on a sub-sample of 16,707 nurses drawn from 167 healthcare organizations. Findings were generally supportive of the proposed model. Nurses who reported being psychologically engaged with their jobs reported a lower intention to leave their current job. The perceived availability of developmental opportunities, being able to achieve a good work-life balance and whether nurses' encountered work pressures were also influencing factors on their turnover intentions. However, relationships formed with colleagues and patients displayed comparatively small relationships with turnover intentions. The focus at the local level needs to be on promoting employee engagement by equipping staff with the resources (physical and monetary) and control to enable them to perform their tasks to standards they aspire to and creating a work environment where staff are fully involved in the wider running of their organizations, communicating to staff that patient care is important and the top priority of the organization. © 2012 Blackwell Publishing Ltd.

Ethical problems in nursing management: The views of nurse managers.

PubMed

Aitamaa, Elina; Leino-Kilpi, Helena; Iltanen, Silja; Suhonen, Riitta

2016-09-01

Nurse managers have responsibilities relating to the quality of care, the welfare of the staff and running of the organization. Ethics plays significant role in these responsibilities. Ethical problems are part of daily management, but research in this area is limited. The aim of this study was to identify and describe ethical problems nurse managers encounter in their work to get more detailed and extensive view of these problems. The data consisted of nine interviews with nurse managers at different management levels in primary healthcare and specialized healthcare organizations, and it was analysed by inductive content analysis. Permission to conduct the interviews including ethical approval was given at all participating organizations according to national standards. The respondents were informed about the aim of the study, and voluntary participation, anonymous response and confidentiality were explained to them. Four main categories were found: conflicts in practical situations, lack of appreciation, disregard of problems and experienced inadequacy. Problems could also be divided to patient-related, staff-related, organization-related and other problems. The findings correspond with results from earlier studies but add knowledge of the nature and details of nurse managers' ethical problems. New information is produced related to the ethical problems with nurse managers' own courage, motivation and values. Nurse managers identified a variety of different ethical problems in their work. This information is useful in the development of ethics in nursing management. Further research about the frequency and intensity of nurse managers' ethical problems is needed as well as possible differences in different levels of management. © The Author(s) 2015.

Development of a Canadian deceased donation education program for health professionals: a needs assessment survey.

PubMed

Hancock, Jennifer; Shemie, Sam D; Lotherington, Ken; Appleby, Amber; Hall, Richard

2017-10-01

The purpose of this survey was to determine how Canadian healthcare professionals perceive their deficiencies and educational requirements related to organ and tissue donation. We surveyed 641 intensive care unit (ICU) physicians, 1,349 ICU nurses, 1,561 emergency room (ER) physicians, and 1,873 ER nurses. The survey was distributed by the national organization for each profession (the Canadian Association of Emergency Physicians, the Canadian Association of Critical Care Nurses, and the National Emergency Nurses Association). Canadian Blood Services developed the critical care physician list in collaboration with the Canadian Critical Care Society. Survey development included questions related to comfort with, and knowledge of, key competencies in organ and tissue donation. Eight hundred thirty-one (15.3%) of a possible 5,424 respondents participated in the survey. Over 50% of respondents rated the following topics as highly important: knowledge of general organ and tissue donation, neurological determination of death, donation after cardiac death, and medical-legal donation issues. High competency comfort levels ranged from 14.7-50.9% for ICU nurses and 8.0-34.6% for ER nurses. Competency comfort levels were higher for ICU physicians (67.5-85.6%) than for ER physicians who rated all competencies lower. Respondents identified a need for a curriculum on national organ donation and preferred e-learning as the method of education. Both ICU nurses and ER practitioners expressed low comfort levels with their competencies regarding organ donation. Intensive care unit physicians had a much higher level of comfort; however, the majority of these respondents were specialty trained and working in academic centres with active donation and transplant programs. A national organ donation curriculum is needed.

Enemies of Ethics Equals Environmental Exodus, Part 2.

PubMed

Ramsey, Suzanne

2015-01-01

Bullying and mobbing in the workplace have accelerated at alarming rates around the world in the past decade. Health care workers, nurses, managers, physicians, and owners of organizations, sometimes choose unethical methodology as a means to obtain personal and/or organizational goals. The consequences of these unethical decisions have a profound impact on the victim, bystanders, the organization, as well as the nursing profession. As a result, victims (nurses) often suffer from physiological and psychological distress, posttraumatic stress disorder, suicide, and erosion of professional confidence; patient's quality of care is undermined; nurses exit the profession; and organizations suffer from decreased morale, decline in productivity, financial loss, and a tarnished reputation.

38 CFR 51.130 - Nursing services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Nursing services. 51.130... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.130 Nursing services. The facility management must provide an organized nursing service with a sufficient number of qualified nursing personnel...

38 CFR 51.130 - Nursing services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Nursing services. 51.130... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.130 Nursing services. The facility management must provide an organized nursing service with a sufficient number of qualified nursing personnel...

38 CFR 51.130 - Nursing services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Nursing services. 51.130... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.130 Nursing services. The facility management must provide an organized nursing service with a sufficient number of qualified nursing personnel...

42 CFR 482.23 - Condition of participation: Nursing services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Nursing services. 482... Hospital Functions § 482.23 Condition of participation: Nursing services. The hospital must have an organized nursing service that provides 24-hour nursing services. The nursing services must be furnished or...

42 CFR 482.23 - Condition of participation: Nursing services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Nursing services. 482... Hospital Functions § 482.23 Condition of participation: Nursing services. The hospital must have an organized nursing service that provides 24-hour nursing services. The nursing services must be furnished or...

42 CFR 482.23 - Condition of participation: Nursing services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Condition of participation: Nursing services. 482... Hospital Functions § 482.23 Condition of participation: Nursing services. The hospital must have an organized nursing service that provides 24-hour nursing services. The nursing services must be furnished or...

38 CFR 51.130 - Nursing services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Nursing services. 51.130... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.130 Nursing services. The facility management must provide an organized nursing service with a sufficient number of qualified nursing personnel...

38 CFR 51.130 - Nursing services.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Nursing services. 51.130... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.130 Nursing services. The facility management must provide an organized nursing service with a sufficient number of qualified nursing personnel...

42 CFR 482.23 - Condition of participation: Nursing services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Condition of participation: Nursing services. 482... Hospital Functions § 482.23 Condition of participation: Nursing services. The hospital must have an organized nursing service that provides 24-hour nursing services. The nursing services must be furnished or...

42 CFR 482.23 - Condition of participation: Nursing services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Nursing services. 482... Hospital Functions § 482.23 Condition of participation: Nursing services. The hospital must have an organized nursing service that provides 24-hour nursing services. The nursing services must be furnished or...

The hidden treasure in nursing leadership: informal leaders.

PubMed

Downey, Marty; Parslow, Susan; Smart, Marcia

2011-05-01

The goal of the present article was to generate awareness of characteristics of informal leaders in healthcare with the emphasis on nurses in acute care settings. There is limited research or literature regarding informal leaders in nursing and how they positively impact nursing management, the organization and, ultimately, patient care. Identification of nurses with leadership characteristics is important so that leadership development and mentoring can occur within the nursing profession. More than ever, nursing needs energetic, committed and dedicated leaders to meet the challenges of the healthcare climate and the nursing shortage. This requires nurse leaders to consider all avenues to ensure the ongoing profitability and viability of their healthcare facility. This paper discusses clinical nurses as informal leaders; characteristics of the informal nurse leader, the role they play, how they impact their unit and how they shape the organization.   Informal nurse leaders are an underutilized asset in health care. If identified early, these nurses can be developed and empowered to impact unit performance, efficiency and environmental culture in a positive manner. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Undergraduate nursing students' knowledge and attitudes towards organ donation in Korea: Implications for education.

PubMed

Kim, Jung-Ran Theresa; Fisher, Murray J; Elliott, Doug

2006-08-01

Organ donation from brain dead patients is a contentious issue in Korea within the cultural context of Confucian beliefs. Each year thousands of patients wait for organ donation note poor donation rates and importance of nurses in identifying potential donors. It is therefore important to identify knowledge levels and attitudes towards organ donation from brain dead patients of nursing students as future health workers. Using a 38-item instrument previously developed by the researchers, 292 undergraduate students in a Korean nursing college were surveyed in 2003 in Korea (response rate 92%). Validity and reliability of the instrument was demonstrated using a multiple analytical approach. A lack of knowledge regarding diagnostic tests and co-morbid factors of brain death were noted among students. Their attitudes toward organ donation were somewhat mixed and ambiguous, but overall they were positive and willing to be a potential donor in the future. While this study identified that an effective educational program is necessary for nursing students in Korea to improve their knowledge of brain death and organ donation, further research is also required to verify these single-site findings and improve the generalisability of results.

The aging nursing workforce: How to retain experienced nurses.

PubMed

Cohen, Jeremye D

2006-01-01

In the face of an anticipated nursing shortage, healthcare organizations must evaluate their culture, operations, and compensation system to ensure that these elements align with organizational efforts to retain nurses who are approaching retirement age. Management should focus on enhancing elements of job satisfaction and job embeddedness that will motivate nurses to remain both in the workforce and with their employer. Although much of this responsibility falls on the nurse manager, nurse managers are often not provided the necessary support by top management and are neither recognized nor held accountable for nurse turnover. Other retention initiatives can include altering working conditions to reduce both physical and mental stress and addressing issues of employee health and safety. As for compensation, organizations may be well-served by offering senior nursing staff flexible working hours, salary structures that reward experience, and benefit programs that hold value for an aging workforce.

The World Health Organization: Is It Still Relevant?

PubMed

Ferguson, Stephanie L

2015-01-01

The World Health Organization (WHO) is the United Nation's lead agency for directing and coordinating health. As leaders, nurse executives must advocate for a stronger nursing and midwifery health policy agenda at the global level and a seat at the table on WHO's technical advisory bodies and expert committees. There are no more borders as nurse executives; we are global citizens, leading global change. Nurse leaders hold the master key to shape the world's policies for sustainable global development.

The structural relationships between organizational commitment, global job satisfaction, developmental experiences, work values, organizational support, and person-organization fit among nursing faculty.

PubMed

Gutierrez, Antonio P; Candela, Lori L; Carver, Lara

2012-07-01

GUTIERAIM: The aim of this correlational study was to examine the relations between organizational commitment, perceived organizational support, work values, person-organization fit, developmental experiences, and global job satisfaction among nursing faculty. The global nursing shortage is well documented. At least 57 countries have reported critical shortages. The lack of faculty is finally being recognized as a major issue directly influencing the ability to admit and graduate adequate numbers of nurses. As efforts increase to both recruit and retain faculty, the concept of organizational commitment and what it means to them is important to consider. A cross-sectional correlational design was used. The present study investigated the underlying structure of various organizational factors using structural equation modelling. Data were collected from a stratified random sample of nurse faculty during the academic year 2006-2007. The final model demonstrated that perceived organizational support, developmental experiences, person-organization fit, and global job satisfaction positively predicted nurse faculty's organizational commitment to the academic organization. Cross-validation results indicated that the final full SEM is valid and reliable. Nursing faculty administrators able to use mentoring skills are well equipped to build positive relationships with nursing faculty, which in turn, can lead to increased organizational commitment, productivity, job satisfaction, and perceived organizational support, among others. © 2012 Blackwell Publishing Ltd.

Nursing Home Medical Staff Organization: Correlates with Quality Indicators

PubMed Central

Katz, Paul R.; Karuza, Jurgis; Lima, Julie; Intrator, Orna

2015-01-01

Objectives Little is known about the relationship between how medical care is organized and delivered in nursing homes. Taking a lead from the acute care arena, we hypothesize that nursing home medical staff organization (NHMSO) is an important predictor of clinical outcomes in the nursing home. Methods A total of 202 usable surveys from a two-wave survey process using the Dillman Method were returned from medical directors who were randomly selected from the AMDA membership and were asked to fill out a survey on the structure of medical organization in their primary nursing home practice. Quality measures that are likely to be affected by physician practice patterns were culled from NH Compare and OSCAR data sets and matched to the physician surveys, i.e., long stay residents' prevalence of pain, restraint use, catheter use, pressure ulcers, pneumococcal vaccination, influenza vaccination, presence of advanced directives, prescription of antibiotics, and prevalence of depression. Results Using a series of hierarchical multiple regressions, significant R2 changes were found when the medical staff organization dimensions were added in the regressions after controlling for nursing home structural characteristics for the following outcomes: pneumococcal vaccination and restraint use. Near significant findings were noted for pain prevalence among long stay residents, catheter use and prevalence of pressure ulcers. Conclusions This study is the first to demonstrate a relationship between medical staff organizational dimensions and clinical outcomes in the nursing home setting and as such represents an initial “proof of concept.” NHMSO should be considered as a potentially important mediating or moderating variable in the quality of care equation for nursing homes. PMID:21450190

Exploring Research Topics and Trends in Nursing-related Communication in Intensive Care Units Using Social Network Analysis.

PubMed

Son, Youn-Jung; Lee, Soo-Kyoung; Nam, SeJin; Shim, Jae Lan

2018-05-04

This study used social network analysis to identify the main research topics and trends in nursing-related communication in intensive care units. Keywords from January 1967 to June 2016 were extracted from PubMed using Medical Subject Headings terms. Social network analysis was performed using Gephi software. Research publications and newly emerging topics in nursing-related communication in intensive care units were classified into five chronological phases. After the weighting was adjusted, the top five keyword searches were "conflict," "length of stay," "nursing continuing education," "family," and "nurses." During the most recent phase, research topics included "critical care nursing," "patient handoff," and "quality improvement." The keywords of the top three groups among the 10 groups identified were related to "neonatal nursing and practice guideline," "infant or pediatric and terminal care," and "family, aged, and nurse-patient relations," respectively. This study can promote a systematic understanding of communication in intensive care units by identifying topic networks. Future studies are needed to conduct large prospective cohort studies and randomized controlled trials to verify the effects of patient-centered communication in intensive care units on patient outcomes, such as length of hospital stay and mortality.

Predicting patient aggression against nurses in all hospital areas.

PubMed

Chapman, Rose; Perry, Laura; Styles, Irene; Combs, Shane

Workplace violence directed at nurses is an alarming phenomenon across the world. To intervene and manage these episodes as quickly as possible, nurses need to identify those factors that can alert them to the possibility that a violent event may occur. However, frameworks to help nurses predict episodes of workplace violence are limited. This article presents the findings of a study of nurses experience of workplace violence and identifies those factors and behaviours that nurses reported as indicating that an episode of workplace violence is likely to occur. A case study approach was used involving quantitative and qualitative data. One hundred and thirteen questionnaires were completed and 20 interviews were conducted in 2006. Nurses identified nine behaviours and factors that assist them to predict workplace violence. The first five factors comprising staring, tone of voice, anxiety, mumbling and pacing (STAMP) matched those identified in a previous study. However, the last four factors, comprising emotions, disease process, assertive/non-assertive behaviour and resources (EDAR) expand upon that study. Therefore, the acronym STAMPEDAR was used to classify the nine components. Being alert to these behaviours and factors may help nurses predict that an episode of workplace violence is likely to occur.

Evidence-based human resource management: a study of nurse leaders' resource allocation.

PubMed

Fagerström, Lisbeth

2009-05-01

The aims were to illustrate how the RAFAELA system can be used to facilitate evidence-based human resource management. The theoretical framework of the RAFAELA system is based on a holistic view of humankind and a view of leadership founded on human resource management. Nine wards from three central hospitals in Finland participated in the study. The data, stemming from 2006-2007, were taken from the critical indicators (ward-related and nursing intensity information) for national benchmarking used in the RAFAELA system. The data were analysed descriptively. The daily nursing resources per classified patient ratio is a more specific method of measurement than the nurse-to-patient ratio. For four wards, the nursing intensity per nurse surpassed the optimal level 34% to 62.2% of days. Resource allocation was clearly improved in that a better balance between patients' care needs and available nursing resources was maintained. The RAFAELA system provides a rational, systematic and objective foundation for evidence-based human resource management. Data from a systematic use of the RAFAELA system offer objective facts and motives for evidence-based decision making in human resource management, and will therefore enhance the nurse leaders' evidence and scientific based way of working.

Multidrug-resistant bacteria infection and nursing quality management application in the department of physical examination.

PubMed

Xu, Li; Luo, Qiang; Chen, Liangzhen; Jiao, Lingmei

2017-09-01

The main problem of clinical prevention and control of multi drug resistant bacteria infection is to strengthen the monitoring of pathogenic bacteria spectrum, this study research on the multi drug-resistant bacteria infection and nursing quality management application in the department of physical examination. The results of this study showed that the number of patients with multiple drug resistant infections showed an increasing trend. Therefore, once the patients with multiple drug-resistant bacteria infection are found, the prevention and control of the patients with multiple drug-resistant bacteria should be strictly followed, and the patient's medication care should be highly valued. Also, the nurses need to be classified based on the knowledge and skill characteristics of the nurses in the department of physical examination, and compare the nursing effect before and after classification and grouping. The physicians and individuals receiving physical examinations in the department of physical examination had a higher degree of satisfaction for nursing effect after classification compared with those before classification. Classification and grouping management helps improve the nursing quality and overall quality of the nurses in the department of physical examination.

What does nurse turnover rate mean and what is the rate?

PubMed

Kovner, Christine T; Brewer, Carol S; Fatehi, Farida; Jun, Jin

2014-01-01

Registered nurse turnover is an important indicator of the nurse job market. Despite its wide use as a measure for health-care system analysis, there is a lack of consistency in the definition of turnover. Some definitions include any nurse leaving an organization; others may include involuntary and voluntary leaving. These inconsistent definitions also result in various turnover rates. The RN Work Project is a 10-year panel study of new nurses. Data were collected from the new nurses, rather than from a specific organization. About 17.5% of new nurses leave their first job within 1 year of starting their jobs. Consistent and accurate measurement of turnover is an important step in addressing organizational work environments and policies about the nursing workforce. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Scaling up the global nursing health workforce: contributions of an international organization.

PubMed

Rukholm, Ellen E; Stamler, Lynnette Leeseberg; Talbot, Lise R; Bednash, Geraldine; Raines, Fay; Potempa, Kathleen; Nugent, Pauline; Clark, Dame Jill Macleod; Bernhauser, Sue; Parfitt, Barbara

2009-01-01

In this paper key highlights of the scholarly work presented at the Toronto 2008 Global Alliance for Nursing Education & Scholarship (GANES) conference are summarized, challenges opportunities and issues facing nursing education globally arising from the conference discourse are outlined and initial steps are suggested as a way forward to a shared global view of baccalaureate and graduate nursing education and scholarship. This shared view arises from beginning understandings of the issues and opportunities we face globally starting with and building upon the lessons learned from the literature and from the experiences of nursing educators and nursing education organization locally, regionally, nationally and internationally. The theme of the groundbreaking GANES Toronto conference was "Educating the future nursing and health workforce: A global challenge". One hundred seventy delegates from 17 countries attended the event, with over 80 papers presented. A primary focus of GANES is the contribution of a strategic alliance of national nursing education organizations to contribute to nursing education leading practices and policy that address the scaling up of global nursing and health workforce. The founding members of GANES see a clear link between a strong educational infrastructure and strong scholarship activities in nursing and the ability of a society to be healthy and prosperous. Evidence presented at the recent GANES conference supports that belief. Through the strength of partnerships and other capacity-building efforts, member countries can support each other to address the global nursing education and health challenges while respecting the local issues.

The History of Preconception Care: Evolving Guidelines and Standards

PubMed Central

Moos, Merry-K.; Curtis, Michele

2006-01-01

This article explores the history of the preconception movement in the United States and the current status of professional practice guidelines and standards. Professionals with varying backgrounds (nurses, nurse practitioners, family practice physicians, pediatricians, nurse midwives, obstetricians/gynecologists) are in a position to provide preconception health services; standards and guidelines for numerous professional organizations, therefore, are explored. The professional nursing organization with the most highly developed preconception health standards is the American Academy of Nurse Midwives (ACNM); for physicians, it is the American College of Obstetricians and Gynecologists (ACOG). These guidelines and standards are discussed in detail. PMID:16710764

The American Organization of Nurse Executives and Emergency Nurses Association Guiding Principles on Mitigating Violence in the Workplace.

PubMed

Chappell, Stacey

2015-01-01

Violence in the workplace, including violence toward staff from patients and families as well as lateral violence, has become a serious safety issue for hospitals in the United States. Concerned about this issue, the Emergency Nurses Association and the American Organization of Nurse Executives convened a Day of Dialogue to discuss ways to mitigate violence in the workplace. The result of the discussion was the development of guiding principles and a toolkit to assist nurse leaders in systemically reducing lateral violence and patient and family violence in hospitals.

Understanding nurses' and physicians' fear of repercussions for reporting errors: clinician characteristics, organization demographics, or leadership factors?

PubMed

Castel, Evan S; Ginsburg, Liane R; Zaheer, Shahram; Tamim, Hala

2015-08-14

Identifying and understanding factors influencing fear of repercussions for reporting and discussing medical errors in nurses and physicians remains an important area of inquiry. Work is needed to disentangle the role of clinician characteristics from those of the organization-level and unit-level safety environments in which these clinicians work and learn, as well as probing the differing reporting behaviours of nurses and physicians. This study examines the influence of clinician demographics (age, gender, and tenure), organization demographics (teaching status, location of care, and province) and leadership factors (organization and unit leadership support for safety) on fear of repercussions, and does so for nurses and physicians separately. A cross-sectional analysis of 2319 nurse and 386 physician responders from three Canadian provinces to the Modified Stanford patient safety climate survey (MSI-06). Data were analyzed using exploratory factor analysis, multiple linear regression, and hierarchical linear regression. Age, gender, tenure, teaching status, and province were not significantly associated with fear of repercussions for nurses or physicians. Mental health nurses had poorer fear responses than their peers outside of these areas, as did community physicians. Strong organization and unit leadership support for safety explained the most variance in fear for both nurses and physicians. The absence of associations between several plausible factors including age, tenure and teaching status suggests that fear is a complex construct requiring more study. Substantially differing fear responses across locations of care indicate areas where interventions may be needed. In addition, since factors affecting fear of repercussions appear to be different for nurses and physicians, tailoring patient safety initiatives to each group may, in some instances, be fruitful. Although further investigation is needed to examine these and other factors in detail, supportive safety leadership appears to be central to reducing fear of reporting errors for both nurses and physicians.

A review of research on religious and spiritual variables in two primary gerontological nursing journals: 1991 to 1997.

PubMed

Weaver, A J; Flannelly, L T; Flannelly, K J

2001-09-01

All articles published between 1991 and 1997 in the Journal of Gerontological Nursing and Geriatric Nursing were classified as qualitative research, quantitative research, or non-research. Of the 784 articles reviewed, 5.1% mentioned religion or spirituality. Research articles (7.7%) were more likely than non-research articles (2.8%) to address religion and spirituality. No statistical difference was found between the percentage of qualitative (10.7%) and quantitative (6.8%) studies addressing religious and spiritual factors. The percentage of quantitative studies including religious and spiritual variables was found to be higher than that found by systematic reviews of the research literature in various health professions.

Work motivation for Japanese nursing assistants in small- to medium-sized hospitals.

PubMed

Kudo, Yasushi; Kido, Shigeri; Shahzad, Machiko Taruzuka; Yoshimura, Emiko; Shibuya, Akitaka; Aizawa, Yoshiharu

2011-12-01

Nursing assistants can work without a professional certification to help registered nurses and licensed practical nurses. Nursing assistants engage in various tasks, e.g., washing laundry, cleaning up, and clerk tasks regarding nursing. Enhancing work motivation among nursing assistants is essential for every hospital, because when nursing assistants do their jobs well, it allows registered nurses and licensed practical nurses to complete their own specialized jobs. We examined the predictors significantly associated with nursing assistants' work motivation. For those predictors, we produced items to examine job satisfaction. Those items are classified into intrinsic and extrinsic facets. The subjects for this study were Japanese nursing assistants working in 26 hospitals with 62-376 beds (4 public and 22 private hospitals). A total of 516 nursing assistants were analyzed, with the average age and standard deviation of 42.7 ± 12.9 years; the age of 456 female subjects was 43.8 ± 12.7 years and that of 60 male subjects was 34.3 ± 11.0 years. Our results show that "work motivation" is significantly associated with "free time to do one's own things," "nursing assistants as important partners on the job," "feeling helpful to patients," "participating in decision making," and "job-skill improvement." Free time to do one's own things is an extrinsic item. Hospital administrators must monitor the workload and their quality of life among nursing assistants. All the other significant items are intrinsic. Nursing assistants are not only motivated by money. They highly value the intrinsic nature and experience of their jobs.

Second-hand smoke: how damaging is it to health?

PubMed

Percival, Jennifer; Queally, Bridget

In the 20th century, over half the English population smoked, but this figure has now dropped to a quarter (Office for National Statistics, 2003). A combination of scientific evidence, health education campaigns and larger warnings on cigarette packets has contributed to achieving this change. Public opinion has also shifted dramatically, and most people now accept that being a smoker is damaging to health. In 1992, the World Health Organization International Agency for Research and Cancer classified second-hand smoke as being 'carcinogenic' to humans (WHO International Agency for Research on Cancer, 2002). Following this report, New York became one of the first cities in the world to introduce a comprehensive ban on smoking in public places to protect employees. In the UK, however, many employees, including nurses, are still routinely exposed to tobacco smoke in the workplace.

High reliability and implications for nursing leaders.

PubMed

Riley, William

2009-03-01

To review high reliability theory and discuss its implications for the nursing leader. A high reliability organization (HRO) is considered that which has measurable near perfect performance for quality and safety. The author has reviewed the literature, discussed research findings that contribute to improving reliability in health care organizations, and makes five recommendations for how nursing leaders can create high reliability organizations. Health care is not a safe industry and unintended patient harm occurs at epidemic levels. Health care can learn from high reliability theory and practice developed in other high-risk industries. Viewed by HRO standards, unintended patient injury in health care is excessively high and quality is distressingly low. HRO theory and practice can be successfully applied in health care using advanced interdisciplinary teamwork training and deliberate process design techniques. Nursing has a primary leadership function for ensuring patient safety and achieving high quality in health care organizations. Learning HRO theory and methods for achieving high reliability is a foremost opportunity for nursing leaders.

Influenza vaccination and decisional conflict among regulated and unregulated direct nursing care providers in long-term-care homes.

PubMed

Sullivan, Shannon M; Pierrynowski-Gallant, Donna; Chambers, Larry; O'Connor, Annette; Bowman, Sherry; McNeil, Shelly; Strang, Robert; Knoefel, Frank

2008-02-01

The purpose of this study was to determine whether direct nursing care providers have decisional conflict about receiving influenza vaccinations and characteristics associated with decisional conflict. The researchers used a self-administered questionnaire mailed to direct nursing care providers in two long-term-care organizations. Most direct nursing care providers in both organizations (80% and 93%, respectively) intended to get the influenza vaccine. Unregulated direct nursing care providers had more decisional conflict than regulated providers, especially related to feeling uninformed about the pros and cons of influenza vaccination. Unclear valuing of the pros and cons of influenza vaccination was related to the age of the direct care providers in both organizations. Decisional conflict and influenza vaccination practices may be determined, in part, by age and by the culture of a health care organization. A decision aid to improve knowledge and clarify values may improve decision quality and increase influenza vaccination rates.

Minor psychiatric disorders among nurses university faculties.

PubMed

Tavares, Juliana Petri; Beck, Carmem Lúcia Colomé; Magnago, Tânia Solange Bosi de Souza; Zanini, Roselaine Ruviaro; Lautert, Liana

2012-01-01

This cross-sectional study addresses 130 nursing faculty members in federal universities from Rio Grande do Sul, Brazil. It investigated the psychological demands and decision latitude (the Demand-Control Model by Karasek) and their association with Minor Psychological Disorders (MPDs). The Brazilian versions of the Self-Report-Questionnaire-20 and the Job Stress Scale were used. MPDs were prevalent in 20% of the studied individuals. After adjusting for potential confounders, the chances of participants presenting mental disorders were higher in the quadrant 'active strain jobs' (OR=14.23, 95% CI 1.55 to 130.73), followed by the 'high strain jobs' quadrant (OR=10.05, 95% CI 1.23 to 82.44), compared to nursing professors classified in the 'low strain jobs' quadrant. We conclude that high psychological demands and low control over work can cause disorders in nursing professors, among them, MPDs.

Analysis of the decision-making process of nurse managers: a collective reflection.

PubMed

Eduardo, Elizabete Araujo; Peres, Aida Maris; de Almeida, Maria de Lourdes; Roglio, Karina de Dea; Bernardino, Elizabeth

2015-01-01

to analyze the decision-making model adopted by nurses from the perspective of some decision-making process theories. qualitative approach, based on action research. Semi-structured questionnaires and seminars were conducted from April to June 2012 in order to understand the nature of decisions and the decision-making process of nine nurses in position of managers at a public hospital in Southern Brazil. Data were subjected to content analysis. data were classified in two categories: the current situation of decision-making, which showed a lack of systematization; the construction and collective decision-making, which emphasizes the need to develop a decision-making model. the decision-making model used by nurses is limited because it does not consider two important factors: the limits of human rationality, and the external and internal organizational environments that influence and determine right decisions.

Assimilating to Hierarchical Culture: A Grounded Theory Study on Communication among Clinical Nurses.

PubMed

Kim, MinYoung; Oh, Seieun

2016-01-01

The purpose of this study was to generate a substantive model that accounts for the explanatory social processes of communication in which nurses were engaged in clinical settings in Korea. Grounded theory methodology was used in this study. A total of 15 clinical nurses participated in the in-depth interviews. "Assimilating to the hierarchical culture" emerged as the basic social process of communication in which the participants engaged in their work environments. To adapt to the cultures of their assigned wards, the nurses learned to be silent and engaged in their assimilation into the established hierarchy. The process of assimilation consisted of three phases based on the major goals that nurses worked to achieve: getting to know about unspoken rules, persevering within the culture, and acting as senior nurse. Seven strategies and actions utilized to achieve the major tasks emerged as subcategories, including receiving strong disapproval, learning by observing, going silent, finding out what is acceptable, minimizing distress, taking advantages as senior nurse, and taking responsibilities as senior nurse. The findings identified how the pattern of communication in nursing organizations affected the way in which nurses were assimilated into organizational culture, from individual nurses' perspectives. In order to improve the rigid working atmosphere and culture in nursing organizations and increase members' satisfaction with work and quality of life, managers and staff nurses need training that focuses on effective communication and encouraging peer opinion-sharing within horizontal relationships. Moreover, organization-level support should be provided to create an environment that encourages free expression.

Nursing to achieve organizational performance: Consider the role of nursing intellectual capital.

PubMed

Harris, Alexandra

2016-05-01

The success and performance of healthcare organizations relies on the strategic management of knowledge. Nursing Intellectual Capital (NIC) has emerged as a concept involving nursing knowledge resources that create value in healthcare organizations. This article aims to discuss the importance of considering knowledge resources in the context of healthcare performance, with specific reference to NIC. Reflections are then provided on how leaders can look to advance NIC for improved performance. © 2016 The Canadian College of Health Leaders.

Transplant tourism and organ trafficking: Ethical implications for the nursing profession.

PubMed

Corfee, Floraidh Ar

2016-11-01

Organ availability for transplantation has become an increasingly complex and difficult question in health economics and ethical practice. Advances in technology have seen prolonged life expectancy, and the global push for organs creates an ever-expanding gap between supply and demand, and a significant cost in bridging that gap. This article will examine the ethical implications for the nursing profession in regard to the procurement of organs from an impoverished seller's market, also known as 'Transplant Tourism'. This ethical dilemma concerns itself with resource allocation, informed consent and the concepts of egalitarianism and libertarianism. Transplant Tourism is an unacceptable trespass against human dignity and rights from both a nursing and collective viewpoint. Currently, the Australian Nursing and Midwifery Council, the Royal college of Nursing Australia, The Royal College of Nursing (UK) and the American Nurses Association do not have position statements on transplant tourism, and this diminishes us as a force for change. It diminishes our role as advocates for the most marginalised in our world to have access to care and to choice and excludes us from a very contemporary real debate about the mismatch of organ demand and supply in our own communities. As a profession, we must have a voice in health policy and human rights, and according to our Code of Ethics in Australia and around the world, act to promote and protect the fundamental human right to healthcare and dignity. © The Author(s) 2015.

Opportunities for improving patient care through lateral integration: the clinical nurse leader.

PubMed

Begun, James W; Tornabeni, Jolene; White, Kenneth R

2006-01-01

Today, healthcare organizations are faced with the growing realization that functional and professional silos within the organization are counter to the provision of efficient and effective patient care and are fertile grounds for errors or sentinel events to occur. The improvement of patient care and prevention of errors require that collaboration among professionals occur at the patient care delivery level, not just within the leadership team. A new nursing role-the clinical nurse leader, the first new nursing role advanced nationally in more than three decades--currently is under development in more than 180 pilot healthcare delivery sites across the United States and Puerto Rico. The clinical nurse leader is a master's-prepared nurse who assumes accountability for healthcare outcomes for a specific group of clients within a unit or setting through the assimilation and application of research-based information to design, implement, and evaluate client plans of care. The clinical nurse leader serves as a lateral integrator for the healthcare team and facilitates, coordinates, and oversees the care provided by the healthcare team. Healthcare administrators should seize the opportunity to work with nurses in healthcare delivery organizations to influence the early evolution and diffusion of this new role.

Challenges and Strategies for Prevention of Multidrug-Resistant Organism Transmission in Nursing Homes.

PubMed

Dumyati, Ghinwa; Stone, Nimalie D; Nace, David A; Crnich, Christopher J; Jump, Robin L P

2017-04-01

Nursing home residents are at high risk for colonization and infection with bacterial pathogens that are multidrug-resistant organisms (MDROs). We discuss challenges and potential solutions to support implementing effective infection prevention and control practices in nursing homes. Challenges include a paucity of evidence that addresses MDRO transmission during the care of nursing home residents, limited staff resources in nursing homes, insufficient infection prevention education in nursing homes, and perceptions by nursing home staff that isolation and contact precautions negatively influence the well being of their residents. A small number of studies provide evidence that specifically address these challenges. Their outcomes support a paradigm shift that moves infection prevention and control practices away from a pathogen-specific approach and toward one that focuses on resident risk factors.

Forensic Nursing State of the Science: Research and Practice Opportunities.

PubMed

Drake, Stacy A; Koetting, Cathy; Thimsen, Kathi; Downing, Nancy; Porta, Carolyn; Hardy, Peggy; Valentine, Julie L; Finn, Cris; Engebretson, Joan

The International Association of Forensic Nurses (IAFN) is the only nursing organization advancing the forensic nursing specialty. The organization seeks to advance the profession, and one mechanism for doing so is development of a research agenda. The purpose of this action-based research study was to aid in the development of a forensic nursing research agenda. The study was carried out in two integral stages: (a) focus groups with IAFN members attending the annual conference and (b) reviewing posted IAFN member listserv material. The findings of this study identified similar gaps of other nursing specialties experiencing "growing pains," including role confusion and variation in educational preparation. Findings from this study will inform development of the IAFN 5-year research agenda to advance forensic nursing science and evidence-based practice.

Analysis of the organization of nursing care provided for disabled children in special education institutions in northwest Poland.

PubMed

Gawłowska-Lichota, Katarzyna; Wróbel, Agnieszka; Brodowski, Jacek; Karakiewicz, Beata

2009-06-01

It often happens that handicapped children and teenagers need to be taught in special educational centres. One of the specialists working in a special school should be a nurse having appropriate professional and methodical skills. The research involved nurses employed in 36 special education institutions in 2006/2007 in the area of North-West Poland. The organization of work was analysed on the basis of specially constructed questionnaires. The average working time of nurses employed in special education institutions was 16 hours and 12 minutes per week. In the group of nurses examined, 69% persons have completed qualifications and 5% specialty courses. Nurses cooperate mainly with speech therapists, educationalists, psychologists, rehabilitators, specialists in surdo-pedagogy and oligophreno-pedagogy. However, they attended meetings with parents very occasionally (8%) and rarely participated in staff meetings (8%). Besides, 29% of participants met with parents exclusively in case of emergency. Nurses' working time in special education institutions according to the norms or work organization. Not all nurses working with disabled pupils have the required qualifications such as the completed specialty or qualification courses. Nurses working in special education do not fully use the possibility of cooperation with the families of disabled pupils and specialists in the therapeutic team.

Engaging Nursing Voice and Presence During the Federal Election Campaign 2015.

PubMed

Whyte, Nora B; Duncan, Susan M

2016-01-01

During the Canadian federal election in 2015, we conducted a systematic inquiry into the methods and messages developed by national nursing organizations to communicate their policy platforms and their strategies for member and public engagement. Throughout the campaign and in the post-election period, the nursing organizations presented an outward-looking view to improve health and healthcare for Canadians. We observed ways in which they adopted a nursing lens on the issues by showcasing background research, by drawing on relevant nursing knowledge and by communicating clear policy messages based on nursing expertise. The organizations and their members were effective in using social media as a primary tool for reaching out to the candidates, the public and the opinion leaders. The increasing engagement of nursing students in political action is noted as a promising sign for the future impact of the profession. Although the nursing presence was visible in this election, healthcare did not become a strong issue for the public and the political parties. We include a section on post-election uptake of issues raised during the campaign. We conclude with a call for a policy research agenda that deepens our knowledge of political advocacy with a view to identifying how patterns of engagement are defining nursing's collective influence and contributions to health equity.

Triage level assignment and nurse characteristics and experience.

PubMed

Gómez-Angelats, Elisenda; Miró, Òscar; Bragulat Baur, Ernesto; Antolín Santaliestra, Alberto; Sánchez Sánchez, Miquel

2018-06-01

To study the relation between nursing staff demographics and experience and their assignment of triage level in the emergency department. One-year retrospective observational study in the triage area of a tertiary care urban university hospital that applies the Andorran-Spanish triage model. Variables studied were age, gender, nursing experience, triage experience, shift, usual level of emergency work the nurse undertakes, number of triage decisions made, and percentage of patients assigned to each level. Fifty nurses (5 men, 45 women) with a mean (SD) age of 45 (9) years triaged 67 803 patients during the year. Nurses classified more patients in level 5 on the morning shift (7.9%) than on the afternoon shift (5.5%) (P=.003). The difference in the rate of level-5 triage classification became significant when nurses were older (β = 0.092, P=.037) and experience was greater (β = 0.103, P=.017). The number of triages recorded by a nurse was significantly and directly related to the percentage of patients assigned to level 3 (β = 0.003, P=.006) and inversely related to the percentages assigned to level 4 (β = -0.002, P=.008) and level 5 (β = -0.001, P=.017). We found that triage level assignments were related to age, experience, shift, and total number of patients triaged by a nurse.

Disparities in Perinatal Quality Outcomes for Very Low Birth Weight Infants in Neonatal Intensive Care

PubMed Central

Lake, Eileen T; Staiger, Douglas; Horbar, Jeffrey; Kenny, Michael J; Patrick, Thelma; Rogowski, Jeannette A

2015-01-01

Objective To determine if hospital-level disparities in very low birth weight (VLBW) infant outcomes are explained by poorer hospital nursing characteristics. Data Sources Nurse survey and VLBW infant registry data. Study Design Retrospective study of 8,252 VLBW infants in 98 Vermont Oxford Network hospital neonatal intensive care units (NICUs) nationally. NICUs were classified into three groups based on their percent of infants of black race. Two nurse-sensitive perinatal quality standards were studied: nosocomial infection and breast milk. Data Collection Primary nurse survey (N = 5,773, 77 percent response rate). Principal Findings VLBW infants born in high-black concentration hospitals had higher rates of infection and discharge without breast milk than VLBW infants born in low-black concentration hospitals. Nurse understaffing was higher and practice environments were worse in high-black as compared to low-black hospitals. NICU nursing features accounted for one-third to one-half of the hospital-level health disparities. Conclusions Poorer nursing characteristics contribute to disparities in VLBW infant outcomes in two nurse-sensitive perinatal quality standards. Improvements in nursing have potential to improve the quality of care for seven out of ten black VLBW infants who are born in high-black hospitals in this country. PMID:25250882

Academic stress and active learning of nursing students: A cross-sectional study.

PubMed

Magnavita, Nicola; Chiorri, Carlo

2018-06-08

The active role of nursing students is particularly important in the delivery of health care, since playing an active role at the bedside and the use of active and collaborative engagement of students in the nursing activities has been associated with improved student learning. This is consistent with Karasek's learning hypothesis, but it has never been tested on nursing students. This study aimed at investigating whether nursing students in high control conditions reported lower levels of work impairment than students in the conditions with low control, compared them with a group of healthcare workers (HCWs), and tested the moderating role of social support at work. 633 nursing students and 160 HCWs completed the Nursing Work Functioning Questionnaire (NWFQ), and the Demand-Control-Support questionnaire (DCS). Results showed that nursing students reported higher levels of work impairment and were less likely to be classified as active (high demand/high control) or low strain (low demand/high control) than HCWs, and that social support at work moderated the association between being in active or low strain condition and work impairment. Programs to enhance the learning of nursing students must not only fight strain and isolation but must also promote active learning, by increasing the control over the job, team work, and support from teachers. Copyright © 2018. Published by Elsevier Ltd.

Retaining nurses through conflict resolution. Training staff to confront problems and communicate openly can improve the work climate.

PubMed

Fowler, A R; Bushardt, S C; Jones, M A

1993-06-01

The way nurses resolve conflict may be leading them to quit their jobs or leave the profession altogether. Conflict is inevitable in a dynamic organization. What is important is not to avoid conflict but to seek its resolution in a constructive manner. Organizational conflict is typically resolved through one of five strategies: withdrawal, force, conciliation, compromise, or confrontation. A recent study of nurses in three different hospitals showed that the approach they use most is withdrawal. This might manifest itself in a request to change shifts or assignments and may lead to a job change and, eventually, abandonment of the field altogether. Given this scenario, changing nurses' conflict resolution style may help administrators combat the nursing shortage. Healthcare organizations must examine themselves to determine why nurses so frequently use withdrawal; then they must restructure work relationships as needed. Next, organizations need to increase nurses' awareness of the problem and train them to use a resolution style more conducive to building stable relationships: confrontation. Staff should also be trained in effective communications skills to develop trust and openness in their relationships.

Content and factor validation of the Sieloff-King-Friend Assessment of Group Empowerment within Educational Organizations.

PubMed

Friend, Mary Louanne; Sieloff, Christina Leibold; Murphy, Shannon; Leeper, James

2016-07-01

Nursing education programs have responsibilities to their stakeholders to prepare graduates who can provide safe, effective patient centered care while leading health care changes. Empowered nurses have been associated with low nurse turnover and higher patient satisfaction; however, less is currently known about group empowerment in nursing education. In order to examine group empowerment in schools of nursing, the Sieloff-King Assessment of Group Empowerment in Organizations (SKAGEO©) was adapted and tested for content validity and confirmatory factor analysis. The adapted instrument, the Sieloff-King-Friend Assessment of Group Empowerment within Educational Organizations (SKFAGEEO) was first reviewed by nurse experts who provided quantitative and qualitative data regarding each item. A total of 320 nurse deans and faculty comprised the final sample for the second order confirmatory 8 factor analysis. Findings revealed factor loadings ranging from .455 to .960.The overall fit of the propose model was Chi Square=1383. 24, df=566, p<.001; GFI=.786, RMSEA=0.69. The study results indicated that the SKFAGEEO has acceptable psychometric properties. Copyright © 2016 Elsevier Ltd. All rights reserved.

The retention of the older nursing workforce: a literature review exploring factors which influence the retention and turnover of older nurses.

PubMed

Moseley, Amanda; Jeffers, Lesley; Paterson, Jan

2008-08-01

In an era of nursing shortages and increased health care demands, it is important to explore factors which contribute to the retention of nursing staff, especially older nurses who contribute a wealth of knowledge and experience to their employing organization. This literature review explored the factors that influence older nurses to leave an organization or to retire early and identified a number of key issues which can influence this decision. These included the need to respect and recognise the achievements of older staff, specific managerial characteristics which influence staff retention, the importance of empowerment and autonomy, the valuing of expertise, the provision of challenges, creating a sense of community within an organization, the importance of education and peer development, the impact of work demands and environment, the influence of flexible working and shift options and the issue of adequate financial reimbursement. From this review, a variety of recommendations have been generated which it is hoped will help to inform the creation of policies and practices that specifically address the issue of retention of older nursing staff.

Turnover and vacancy rates for registered nurses: do local labor market factors matter?

PubMed

Rondeau, Kent V; Williams, Eric S; Wagar, Terry H

2008-01-01

Turnover of nursing staff is a significant issue affecting health care cost, quality, and access. In recent years, a worldwide shortage of skilled nurses has resulted in sharply higher vacancy rates for registered nurses in many health care organizations. Much research has focused on the individual, group, and organizational determinants of turnover. Labor market factors have also been suggested as important contributors to turnover and vacancy rates but have received limited attention by scholars. This study proposes and tests a conceptual model showing the relationships of organization-market fit and three local labor market factors with organizational turnover and vacancy rates. The model is tested using ordinary least squares regression with data collected from 713 Canadian hospitals and nursing homes. Results suggest that, although modest in their impact, labor market and the organization-market fit factors do make significant yet differential contributions to turnover and vacancy rates for registered nurses. Knowledge of labor market factors can substantially shape an effective campaign to recruit and retain nurses. This is particularly true for employers who are perceived to be "employers-of-choice."

[Assessment of geriatric patients' care needs based on sosia classification: the reality of the lombardy region in nursing home.

PubMed

Vanalli, Mariangela

2016-11-01

The increased demand to care that originates from demographic changes called in Italy a rapid development in Nursing Home with particular emergency the problem of programme the welfare response. It is essential the development of a classification system able to describe the stratification of the case mix on the basis of the care requirements, allowing a remuneration in function of the complexity care. Since 2003, the Lombardy region has introduced a case-mix reimbursement system for nursing homes based on the SOSIA form which classifies residents into eight classes of frailty. In the present study the agreement between SOSIA classification and other well documented instruments, including Barthel Index, Mini-Mental State Examination on the basis of three indicators (mobility, cognition, comorbidity) is evaluated in eight classes of frailty. However, it is not any research project was published in order to assess the agreement between SOSIA classification and other measuring instruments. Although various methods exist by which researchers have attempted to measure the need for nursing care, there is no nationally accepted system for determining the total amount of registered nursing resources required by residents in long-term care. The aim of this study was to evaluate the correlation between SOSIA and filing systems widely used, such as the degree of Barthel disability rating scale, the Mini-Mental State Examination to offer care appropriate for the case-mix. Only the higher complexity care has classified in the first two classes, while the remaining levels has categorized in the lowest paid. Misclassification therefore induces an underestimation of the real care needs and, consequently, inadequate remuneration.

Organizational configuration of hospitals succeeding in attracting and retaining nurses.

PubMed

Stordeur, Sabine; D'Hoore, William

2007-01-01

This paper contrasts structural and managerial characteristics of low- and high-turnover hospitals, and describes the organizational configuration of attractive hospitals. In countries facing nurse shortages and turnover, some hospitals succeed in recruiting and retaining nurses. In Magnet Hospitals, managerial practices and environmental characteristics increase nurses' job satisfaction and their commitment to the organization, which in turn decreases nurse turnover. Such an approach suggests that organizations are best understood as clusters of interconnected structures and practices, i.e. organizational configurations rather than entities whose components can be understood in isolation. From a sample of 12 hospitals whose nurse turnover was studied for 1 year, structural and organizational features of hospitals in the first and fourth quartiles, i.e. attractive (turnover <3.1%) vs. conventional (turnover >11.8%) were contrasted. A questionnaire, including perceptions of health-related factors, job demands, stressors, work schedules, organizational climate, and work adjustments antecedent to turnover, was received from 401 nurses working in attractive hospitals (response rate = 53.8%) and 774 nurses in conventional hospitals (response rate = 54.5%). Structural characteristics did not differentiate attractive and conventional hospitals, but employee perceptions towards the organization differed strikingly. Differences were observed for risk exposure, emotional demands, role ambiguity and conflicts, work-family conflicts, effort-reward imbalance and the meaning of work, all in favour of attractive hospitals (P < 0.001). Relationships with nursing management, work ability and satisfaction with working time, handover shifts and schedules were also better in attractive hospitals (P < 0.001). Job satisfaction and commitment were higher in attractive hospitals, whereas burnout and intention to leave were lower (P < 0.001). Organizational characteristics are key factors in nurse attraction and retention. Nurses face difficulties in their work situations, but some hospitals are perceived as healthy organizations. The concept of attractive institutions could serve as a catalyst for improvement in nurses' work environments in Europe.

Recognizing surgeon's actions during suture operations from video sequences

NASA Astrophysics Data System (ADS)

Li, Ye; Ohya, Jun; Chiba, Toshio; Xu, Rong; Yamashita, Hiromasa

2014-03-01

Because of the shortage of nurses in the world, the realization of a robotic nurse that can support surgeries autonomously is very important. More specifically, the robotic nurse should be able to autonomously recognize different situations of surgeries so that the robotic nurse can pass necessary surgical tools to the medical doctors in a timely manner. This paper proposes and explores methods that can classify suture and tying actions during suture operations from the video sequence that observes the surgery scene that includes the surgeon's hands. First, the proposed method uses skin pixel detection and foreground extraction to detect the hand area. Then, interest points are randomly chosen from the hand area so that their 3D SIFT descriptors are computed. A word vocabulary is built by applying hierarchical K-means to these descriptors, and the words' frequency histogram, which corresponds to the feature space, is computed. Finally, to classify the actions, either SVM (Support Vector Machine), Nearest Neighbor rule (NN) for the feature space or a method that combines "sliding window" with NN is performed. We collect 53 suture videos and 53 tying videos to build the training set and to test the proposed method experimentally. It turns out that the NN gives higher than 90% accuracies, which are better recognition than SVM. Negative actions, which are different from either suture or tying action, are recognized with quite good accuracies, while "Sliding window" did not show significant improvements for suture and tying and cannot recognize negative actions.

Student nurses' experiences of the clinical learning environment in relation to the organization of supervision: a questionnaire survey.

PubMed

Sundler, Annelie J; Björk, Maria; Bisholt, Birgitta; Ohlsson, Ulla; Engström, Agneta Kullén; Gustafsson, Margareta

2014-04-01

The aim was to investigate student nurses' experiences of the clinical learning environment in relation to how the supervision was organized. The clinical environment plays an essential part in student nurses' learning. Even though different models for supervision have been previously set forth, it has been stressed that there is a need both of further empirical studies on the role of preceptorship in undergraduate nursing education and of studies comparing different models. A cross-sectional study with comparative design was carried out with a mixed method approach. Data were collected from student nurses in the final term of the nursing programme at three universities in Sweden by means of a questionnaire. In general the students had positive experiences of the clinical learning environment with respect to pedagogical atmosphere, leadership style of the ward manager, premises of nursing, supervisory relationship, and role of the nurse preceptor and nurse teacher. However, there were significant differences in their ratings of the supervisory relationship (p<0.001) and the pedagogical atmosphere (p 0.025) depending on how the supervision was organized. Students who had the same preceptor all the time were more satisfied with the supervisory relationship than were those who had different preceptors each day. Students' comments on the supervision confirmed the significance of the preceptor and the supervisory relationship. The organization of the supervision was of significance with regard to the pedagogical atmosphere and the students' relation to preceptors. Students with the same preceptor throughout were more positive concerning the supervisory relationship and the pedagogical atmosphere. © 2013.

[Development of a measurement of intellectual capital for hospital nursing organizations].

PubMed

Kim, Eun A; Jang, Keum Seong

2011-02-01

This study was done to develop an instrument for measuring intellectual capital and assess its validity and reliability in identifying the components, human capital, structure capital and customer capital of intellectual capital in hospital nursing organizations. The participants were 950 regular clinical nurses who had worked for over 13 months in 7 medical hospitals including 4 national university hospitals and 3 private university hospitals. The data were collected through a questionnaire survey done from July 2 to August 25, 2009. Data from 906 nurses were used for the final analysis. Data were analyzed using descriptive statistics, Cronbach's alpha coefficients, item analysis, factor analysis (principal component analysis, Varimax rotation) with the SPSS PC+ 17.0 for Windows program. Developing the instrument for measuring intellectual capital in hospital nursing organizations involved a literature review, development of preliminary items, and verification of validity and reliability. The final instrument was in a self-report form on a 5-point Likert scale. There were 29 items on human capital (5 domains), 21 items on customer capital (4 domains), 26 items on structure capital (4 domains). The results of this study may be useful to assess the levels of intellectual capital of hospital nursing organizations.

Hints for the aspiring public health nurse. 1923.

PubMed

Abrams, Sarah E

2010-01-01

The original article from which these excerpts were taken, "Some Hints to the Nurse Who Seeks to Become a Successful Partner in the Community Health Program," by Mary Margaret Muckley, was published the 1923 volume of the original Public Health Nursing journal. The paper listed practical pointers to nurses wanting to work in the area of public or community health nursing. The author's advice involved personal attributes, professional engagement, skills, effective organization, and community relations. Much of the original article contained sound advice for aspirants to nursing work in community settings, but some advice may be considered too idealistic even for this optimistic time period. While the particular references to organizations and agencies existing in Helena, Montana have been omitted, the nurse reading the paper in 1923 had a general guide to her key stakeholders. The excerpts from this paper may give contemporary readers an appreciation of the endurance of what Muckley terms the public health nurse's "Valuable Assets."

The effects of a prelicensure extern program and nurse residency program on new graduate outcomes and retention.

PubMed

Friday, Laura; Zoller, James S; Hollerbach, Ann D; Jones, Katherine; Knofczynski, Greg

2015-01-01

Organizations are looking to new graduate nurses to fill expected staffing shortages over the next decade. Creative and effective onboarding programs will determine the success or failure of these graduates as they transition from student to professional nurse. This longitudinal quantitative study with repeated measures used the Casey-Fink Graduate Nurse Experience Survey to investigate the effects of offering a prelicensure extern program and postlicensure residency program on new graduate nurses and organizational outcomes versus a residency program alone. Compared with the nurse residency program alone, the combination of extern program and nurse residency program improved neither the transition factors most important to new nurse graduates during their first year of practice nor a measure important to organizations, retention rates. The additional cost of providing an extern program should be closely evaluated when making financially responsible decisions.

Exploring the Best Practices of Nursing Research Councils in Magnet® Organizations: Findings From a Qualitative Research Study.

PubMed

Day, Jennifer; Lindauer, Cathleen; Parks, Joyce; Scala, Elizabeth

2017-05-01

The objective of this descriptive qualitative study was to identify best practices of nursing research councils (NRCs) at Magnet®-designated hospitals. Nursing research (NR) is essential, adding to the body of nursing knowledge. Applying NR to the bedside improves care, enhances patient safety, and is an imperative for nursing leaders. We interviewed NR designees at 26 Magnet-recognized hospitals about the structure and function of their NRCs and used structural coding to identify best practices. Most organizations link NR and evidence-based practice. Council membership includes leadership and clinical nurses. Councils conduct scientific reviews for nursing studies, supporting nurse principal investigators. Tracking and reporting of NR vary widely and are challenging. Councils provide education, sponsor research days, and collaborate interprofessionally, including with academic partners. Findings from this study demonstrate the need to create formal processes to track and report NR and to develop outcome-focused NR education.

Effects of job rotation and role stress among nurses on job satisfaction and organizational commitment

PubMed Central

Ho, Wen-Hsien; Chang, Ching Sheng; Shih, Ying-Ling; Liang, Rong-Da

2009-01-01

Background The motivation for this study was to investigate how role stress among nurses could affect their job satisfaction and organizational commitment, and whether the job rotation system might encourage nurses to understand, relate to and share the vision of the organization, consequently increasing their job satisfaction and stimulating them to willingly remain in their jobs and commit themselves to the organization. Despite the fact that there have been plenty of studies on job satisfaction, none was specifically addressed to integrate the relational model of job rotation, role stress, job satisfaction, and organizational commitment among nurses. Methods With top managerial hospital administration's consent, questionnaires were only distributed to those nurses who had had job rotation experience. 650 copies of the questionnaire in two large and influential hospitals in southern Taiwan were distributed, among which 532 valid copies were retrieved with a response rate of 81.8%. Finally, the SPSS 11.0 and LISREL 8.54 (Linear Structural Relationship Model) statistical software packages were used for data analysis and processing. Results According to the nurses' views, the findings are as follows: (1) job rotation among nurses could have an effect on their job satisfaction; (2) job rotation could have an effect on organizational commitment; (3) job satisfaction could have a positive effect on organizational commitment; (4) role stress among nurses could have a negative effect on their job satisfaction; and (5) role stress could have a negative effect on their organizational commitment. Conclusion As a practical and excellent strategy for manpower utilization, a hospital could promote the benefits of job rotation to both individuals and the hospital while implementing job rotation periodically and fairly. And when a medical organization attempts to enhance nurses' commitment to the organization, the findings suggest that reduction of role ambiguity in role stress has the best effect on enhancing nurses' organizational commitment. The ultimate goal is to increase nurses' job satisfaction and encourage them to stay in their career. This would avoid the vicious circle of high turnover, which is wasteful of the organization's valuable human resources. PMID:19138390

Effects of job rotation and role stress among nurses on job satisfaction and organizational commitment.

PubMed

Ho, Wen-Hsien; Chang, Ching Sheng; Shih, Ying-Ling; Liang, Rong-Da

2009-01-12

The motivation for this study was to investigate how role stress among nurses could affect their job satisfaction and organizational commitment, and whether the job rotation system might encourage nurses to understand, relate to and share the vision of the organization, consequently increasing their job satisfaction and stimulating them to willingly remain in their jobs and commit themselves to the organization. Despite the fact that there have been plenty of studies on job satisfaction, none was specifically addressed to integrate the relational model of job rotation, role stress, job satisfaction, and organizational commitment among nurses. With top managerial hospital administration's consent, questionnaires were only distributed to those nurses who had had job rotation experience. 650 copies of the questionnaire in two large and influential hospitals in southern Taiwan were distributed, among which 532 valid copies were retrieved with a response rate of 81.8%. Finally, the SPSS 11.0 and LISREL 8.54 (Linear Structural Relationship Model) statistical software packages were used for data analysis and processing. According to the nurses' views, the findings are as follows: (1) job rotation among nurses could have an effect on their job satisfaction; (2) job rotation could have an effect on organizational commitment; (3) job satisfaction could have a positive effect on organizational commitment; (4) role stress among nurses could have a negative effect on their job satisfaction; and (5) role stress could have a negative effect on their organizational commitment. As a practical and excellent strategy for manpower utilization, a hospital could promote the benefits of job rotation to both individuals and the hospital while implementing job rotation periodically and fairly. And when a medical organization attempts to enhance nurses' commitment to the organization, the findings suggest that reduction of role ambiguity in role stress has the best effect on enhancing nurses' organizational commitment. The ultimate goal is to increase nurses' job satisfaction and encourage them to stay in their career. This would avoid the vicious circle of high turnover, which is wasteful of the organization's valuable human resources.

Audiovisual Review

ERIC Educational Resources Information Center

Physiology Teacher, 1976

1976-01-01

Lists and reviews recent audiovisual materials in areas of medical, dental, nursing and allied health, and veterinary medicine; undergraduate, and high school studies. Each is classified as to level, type of instruction, usefulness, and source of availability. Topics include respiration, renal physiology, muscle mechanics, anatomy, evolution,…

Selected Health Service Occupations.

ERIC Educational Resources Information Center

Coleman, Arthur D.

Prepared by an occupational analyst of the Utah Department of Employment Security, this manual provides job guides for 39 health service occupations concerned mainly with doctors, nurses, and related hospital-medical-health consultants and services. Classified according to "The Dictionary of Occupational Titles," each occupational…

Coping and caring: support resources integral to perioperative nurses during the process of organ procurement surgery.

PubMed

Smith, Zaneta; Leslie, Gavin; Wynaden, Dianne

2017-11-01

To discuss and explore the levels of support provided to perioperative nurses when participating in multi-organ procurement surgery and the impact to their overall well-being. Assisting within multi-organ procurement surgical procedures has been recognised to impact on the well-being of perioperative nurses leaving little opportunity for them to recover from their participation or to seek available support resources. To date, this area has remained largely unexplored with limited evidence of how nurses manage and cope with these procedures, in addition to the support received in the workplace. A qualitative grounded theory method. The study was informed by perioperative nurses (n = 35) who had previous participatory experience in these surgical procedures from two Australian states. Theoretical sampling directed the collection of data via semistructured in-depth interviews. Data were analysed using the constant comparative method. Three components of levels of support were identified from the data: lacking support within the operating room organisation; surgical team support and access to external professional support. These findings offer new insights into how nurses manage and cope with their participation in organ procurement surgical procedures and what types of support resources can be seen as barriers or enablers to their overall experiences. The need for timely and adequate support is vital to their overall well-being and future participation in organ procurement surgery. These findings have the potential to guide further research with implications for clinical initiatives and practices, looking at new ways of supporting perioperative nurses within the clinical environment both locally and internationally. Healthcare organisations need to acknowledge the emotional, psychosocial and psychological health and well-being of nurses impacted by these surgical procedures and provide appropriate and timely clinical support within the work environment. © 2016 John Wiley & Sons Ltd.

[Systematization of nursing assistance in critical care unit].

PubMed

Truppel, Thiago Christel; Meier, Marineli Joaquim; Calixto, Riciana do Carmo; Peruzzo, Simone Aparecida; Crozeta, Karla

2009-01-01

This is a methodological research, which aimed at organizing the systematization of nursing assistance in a critical care unit. The following steps were carried out: description of the nursing practice; transcription of nursing diagnoses; elaboration of a protocol for nursing diagnosis based in International Classification for Nursing Practice (ICNP); determination of nursing prescriptions and the elaboration of guidelines for care and procedures. The nursing practice and care complexity in ICU were characterized. Thus, systematization of nursing assistance is understood as a valuable tool for nursing practice.

The impact of university provided nurse electronic medical record training on health care organizations: an exploratory simulation approach.

PubMed

Abrahamson, Kathleen; Anderson, James G; Borycki, Elizabeth M; Kushniruk, Andre W; Malovec, Shannon; Espejo, Angela; Anderson, Marilyn

2015-01-01

Training providers appropriately, particularly early in their caregiving careers, is an important aspect of electronic medical record (EMR) implementation. Considerable time and resources are needed to bring the newly hired providers 'up to speed' with the actual use practices of the organization. Similarly, universities lose valuable clinical training hours when students are required to spend those hours learning organization-specific EMR systems in order to participate in care during clinical rotations. Although there are multiple real-world barriers to university/health care organization training partnerships, the investment these entities share in training care providers, specifically nurses, to use and understand EMR technology encourages a question: What would be the cumulative effect of integrating a mutually agreed upon EMR system training program in to nursing classroom training on downstream hospital costs in terms of hours of direct caregiving lost, and benefits in terms of number of overall EMR trained nurses hired? In order to inform the development of a large scale study, we employed a dynamic systems modeling approach to simulate the theoretical relationships between key model variables and determine the possible effect of integrating EMR training into nursing classrooms on hospital outcomes. The analysis indicated that integrating EMR training into the nursing classroom curriculum results in more available time for nurse bedside care. Also, the simulation suggests that efficiency of clinical training can be potentially improved by centralizing EMR training within the nursing curriculum.

38 CFR 52.130 - Nursing services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Nursing services. 52.130... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program management must provide an organized nursing service with a sufficient number of qualified nursing personnel...

38 CFR 52.130 - Nursing services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Nursing services. 52.130... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program management must provide an organized nursing service with a sufficient number of qualified nursing personnel...

38 CFR 52.130 - Nursing services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Nursing services. 52.130... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program management must provide an organized nursing service with a sufficient number of qualified nursing personnel...

38 CFR 52.130 - Nursing services.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Nursing services. 52.130... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program management must provide an organized nursing service with a sufficient number of qualified nursing personnel...

38 CFR 52.130 - Nursing services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Nursing services. 52.130... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program management must provide an organized nursing service with a sufficient number of qualified nursing personnel...

Change of focus: from intensive care towards organ donation.

PubMed

Meyer, Käthe; Bjørk, Ida T

2008-02-01

To progress from identifying a potential organ donor to implementing the actual organ donation effectively is a challenging process for all involved. The nurses might find the change of focus difficult, as the donor organ acquisition process often starts before the relatives had been informed and have had the time to reorient themselves about the severe situation of the patient and have been briefed on the option of organ donation. The purpose was to investigate the hospital-based education in organ donation at the 28 Norwegian donor hospitals, and elicit the needs of the intensive care nurses for imparting of required knowledge and support in shifting their focus from intensive care towards the process of organ procurement. Hospital-based education and guidelines in organ donation were analyzed by scrutinizing the documents available. Eleven units were found to have their own guidelines and only three hospitals had organ donation in their educational programme. Intensive care nurses at three hospitals participated in focus groups. The main finding was the need for collaboration and mutual understanding within the treatment team. Nurses expounded the multiple responsibilities that they discharged during the course of intensive care. In reorienting their focus from intensive care to donor organ procurement, the time of death was explained as the crucial turning point. The knowledge of intensive care staff and professional competence were crucial in winning the relatives' trust and were central in the communication processes. Donor hospitals should implement systematic training and debriefing, where both nurses and physicians contribute to this process. Well-prepared protocols for organ donation at hospitals can define responsibilities assigned to different members of the donor organ acquisition team.

A Study on Nursing Students' Knowledge, Attitude, and Educational Needs for Brain-Death Organ Transplantation and Donation and Intent to Donate Organs.

PubMed

Ju, M K; Sim, M K; Son, S Y

2018-05-01

The purpose of this study was to identify the knowledge, attitude, educational needs, and will of nursing students on organ donation from brain-dead donors. Data were collected by using a 40-item questionnaire to measure knowledge, attitude, educational needs, and will for organ donation of 215 nursing college students in one university in Dangjin city from May 11 to May 31, 2017. The data were analyzed using SPSS 22 program (Data Solution Inc, Seoul). In the general characteristics, 85.1% of the subjects did not receive education on donation, and 99.5% of the subjects responded that education is needed. The desired methods of education were special lecture in school (55.3%), "webtoons" on the Internet (19.5%), formal curriculum (15.8%). Points to improve to increase brain-death organ transplantation and donation included "active publicity through pan-national campaign activities" (56.3%), "respecting prior consent from brain-dead donors" (21.9%), and "encouragement and increased support for organ donors" (12.1%). There was a significant difference in knowledge according to will for organ donation (t = 3.29, P = .001) and consent to brain-death organ donation in family members (t = 3.29, P = .001). There was a statistically significant positive correlation between attitude and knowledge of the subjects regarding brain-death organ donation. The knowledge, attitude, educational need, and will for organ donation of nursing students revealed in this study will be used as basic data to provide systematic transplant education including contents about organ transplantation in the regular nursing curriculum in the future. It will contribute to the activation of organ donation. Copyright © 2018 Elsevier Inc. All rights reserved.

Assimilating to Hierarchical Culture: A Grounded Theory Study on Communication among Clinical Nurses

PubMed Central

2016-01-01

The purpose of this study was to generate a substantive model that accounts for the explanatory social processes of communication in which nurses were engaged in clinical settings in Korea. Grounded theory methodology was used in this study. A total of 15 clinical nurses participated in the in-depth interviews. “Assimilating to the hierarchical culture” emerged as the basic social process of communication in which the participants engaged in their work environments. To adapt to the cultures of their assigned wards, the nurses learned to be silent and engaged in their assimilation into the established hierarchy. The process of assimilation consisted of three phases based on the major goals that nurses worked to achieve: getting to know about unspoken rules, persevering within the culture, and acting as senior nurse. Seven strategies and actions utilized to achieve the major tasks emerged as subcategories, including receiving strong disapproval, learning by observing, going silent, finding out what is acceptable, minimizing distress, taking advantages as senior nurse, and taking responsibilities as senior nurse. The findings identified how the pattern of communication in nursing organizations affected the way in which nurses were assimilated into organizational culture, from individual nurses’ perspectives. In order to improve the rigid working atmosphere and culture in nursing organizations and increase members’ satisfaction with work and quality of life, managers and staff nurses need training that focuses on effective communication and encouraging peer opinion-sharing within horizontal relationships. Moreover, organization-level support should be provided to create an environment that encourages free expression. PMID:27253389

Organization of nursing and quality of care for veterans at the end of life.

PubMed

Kutney-Lee, Ann; Brennan, Caitlin W; Meterko, Mark; Ersek, Mary

2015-03-01

The Veterans Health Administration (VA) has improved the quality of end-of-life (EOL) care over the past several years. Several structural and process variables are associated with better outcomes. Little is known, however, about the relationship between the organization of nursing care and EOL outcomes. To examine the association between the organization of nursing care, including the nurse work environment and nurse staffing levels, and quality of EOL care in VA acute care facilities. Secondary analysis of linked data from the Bereaved Family Survey (BFS), electronic medical record, administrative data, and the VA Nursing Outcomes Database. The sample included 4908 veterans who died in one of 116 VA acute care facilities nationally between October 2010 and September 2011. Unadjusted and adjusted generalized estimating equations were used to examine associations between nursing and BFS outcomes. BFS respondents were 17% more likely to give an excellent overall rating of the quality of EOL care received by the veteran in facilities with better nurse work environments (P ≤ 0.05). The nurse work environment also was a significant predictor of providers listening to concerns and providing desired treatments. Nurse staffing was significantly associated with an excellent overall rating, alerting of the family before death, attention to personal care needs, and the provision of emotional support after the patient's death. Improvement of the nurse work environment and nurse staffing in VA acute care facilities may result in enhanced quality of care received by hospitalized veterans at the EOL. Copyright © 2015 American Academy of Hospice and Palliative Medicine. All rights reserved.

Stressful episodes reported by first-year student nurses: a descriptive account.

PubMed

Parkes, K R

1985-01-01

This article examines stressful episodes reported by student nurses (N = 150) interviewed during the early stages of their training at two general hospitals. The approach is qualitative rather than empirical, and the paper focuses on how students perceive and interpret the day-to-day demands and frustrations they encounter in the course of their work in the wards. The episodes were classified into six major content areas. Three of these (the care of dying patients; interpersonal conflicts with other nurses; and insecurity about professional skills and competence) were found to account for two-thirds of the total episodes reported. The types of episodes are discussed in the context of literature findings relating to nursing stress. Underlying factors common to many episodes were the inadequate support and guidance given by senior nurses and clinical tutors, coupled with the students' lack of experience and the demanding nature of the ward environment. Ways in which adverse effects of stress among student nurses might be alleviated, including improving communication skills, enhancing social support, and the use of stress management techniques, are discussed in the light of this material.

An analysis of the management and leadership roles of nurses relative to the health insurance portability and accountability act.

PubMed

Kiel, Joan M

2015-01-01

Nurses have a great deal of interaction with patients. Given this, nurses play a vital role in conveying to patients knowledge of their privacy, security, and confidentiality of patient health information rights under the Health Insurance Portability and Accountability Act (HIPAA). Nurses also can be "at the head of the table" in their own organization and professional organizations in regard to facilitating the implementation of the HIPAA and making access to patient information more "consumer friendly." This article discusses the role that nurses can develop into concerning HIPAA implementation in an ever-burgeoning arena of consumer advocacy and consumer information.

Menstrual characteristics and night work among nurses.

PubMed

Moen, Bente E; Baste, Valborg; Morken, Tone; Alsaker, Kjersti; Pallesen, Ståle; Bjorvatn, Bjørn

2015-01-01

Night work has been associated with adverse effects in terms of reproductive health. Specifically, menstruation has been suggested to be negatively impacted by night work, which again may influence fertility. This study investigated whether working nights is related to menstrual characteristics and if there is a relationship between shift work disorder (SWD) and menstruation. The study was cross-sectional, response rate 38%. The sample comprised female nurses who were members of the Norwegian Nurses Association; below 50 yr of age, who were not pregnant, did not use hormonal pills or intrauterine devices and who had not reached menopause (n=766). The nurses answered a postal survey including questions about night work and menstrual characteristics. Fifteen per cent reported to have irregular menstruations. Thirty-nine per cent of the nurses were classified as having SWD. Logistic regression analyses concerning the relationship between irregular menstruations and night work did not show any associations. Furthermore, no associations were found between cycle length or bleeding period and night work parameters. No associations were found between menstrual characteristics and SWD.

[Stress in nurses at a hemodynamics ward in Rio Grande do Sul, Brazil].

PubMed

Linch, Graciele Fernanda da Costa; Guido, Laura de Azevedo

2011-03-01

This study aimed to evaluate the relationship between stress and symptoms reported by nurses working in units hemodynamics. Data were collected through a questionnaire. For analysis, the results were considered statistically significant if p < 0.05, with an interval of 95% confidence. The population consisted of 63 nurses with a predominance of females (90.5%) and average age of 35.24 (+/- 8.21) years. Most participants werepostgraduate (77.8%) and did not have another job (77.8%). In relation to stress, 52.4% of nurses had an average between 1.11 and 1.97, classified as medium stress, and the critical situations domain presented the highest score (1.63 +/- 0.29). Regarding symptoms, the domain skeletal muscle had a higher average (1.39 +/- 0.94). In this study, there was high significant positive correlation between stress and symptoms (r = 0.629, p < 0.001), thus it is concluded that stress is directly related to the symptomspresented by the nurses.

Nurses’ experiences of humour in clinical settings

PubMed Central

Ghaffari, Fatemeh; Dehghan-Nayeri, Nahid; Shali, Mahboubeh

2015-01-01

Background: Providing holistic nursing care when there is a shortage of personnel and equipment exposes nurses to stress and a higher risk of occupational burnout. Humour can promote nurses’ health and influence nursing care. The aim of this study was to describe nurses’ experiences of humour in clinical settings and factors affecting it. Methods: This qualitative study investigated nurses’ experiences of humour. Five hospitals affiliated to Tehran University of Medical Sciences provided the setting for this study. The participants comprised of 17 nurses with master’s and Baccalaureate degrees (BSN) in nursing. These nurses worked at educational hospitals affiliated to Tehran University of Medical Sciences and had minimum work experience of 12 months in various clinical wards. Nurses from all wards were invited to participate in this study. The data were collected through semi structure interviews using guides comprising probing questions. Telephonic interviews were used to further supplement the data. The data were analysed using conventional content analysis. Results: The data were classified into five themes including the dynamics of humour, condition enforcement, Risk making probability, Instrumental use and Change: opportunities and threats. Conclusion: Understanding nurses’ perceptions and experiences of humour helps identify its contributing factors and provides valuable guidelines for enhancing nurses and patients’ mental, emotional and physical health. Spreading a culture of humour through teaching methods can improve workplace cheerfulness and highlights the importance of humour in patient care in nurses and nursing students. PMID:26034735

Immigration policy and internationally educated nurses in the United States: A brief history

PubMed Central

Masselink, Leah E.; Jones, Cheryl B.

2015-01-01

Since the 1980s, U.S. policy makers have used immigration policy to influence the supply of nurses by allowing or restricting the entry of internationally educated nurses (IENs) into the U.S. workforce. The methods pursued have shifted over time from temporary visa categories in the 1980s and 1990s to permanent immigrant visas in the 2000s. The impact of policy measures adopted during nursing shortages has often been blunted by political and economic events, but the number and representation of IENs in the U.S. nursing workforce has increased substantially since the 1980s. Even as the United States seeks to increase domestic production of nurses, it remains a desirable destination for IENs and a target market for nurse-producing source countries. Hiring organizations and nurse leaders play a critical role in ensuring that the hiring and integration of IENs into U.S. health care organizations is constructive for nurses, source countries, and the U.S. health care system. PMID:24345614

Retired RNs: perceptions of volunteering.

PubMed

Cocca-Bates, Katherine C; Neal-Boylan, Leslie

2011-01-01

A qualitative study was done to explore the perceptions of volunteering among retired registered nurses (RNs) in Kansas. Participants were volunteers in formal nursing roles or were using their nursing knowledge and experience in non-nursing roles, such as church work. Regardless of the type of volunteer position, retired RNs reported that they use what they have learned as nurses when they volunteer. Volunteering benefits include enhanced self-worth, intellectual stimulation, reduced social isolation, and opportunities to help others. Increased paperwork, new technology, difficulty finding nursing-specific volunteer opportunities, resistance from health care organizations, and a lack of respect for what these nurses know are challenges and barriers to volunteering. Retired RNs have accumulated years of clinical nursing experience and can be helpful to employed nurses. Health care organizations should launch targeted efforts to recruit and utilize retired RN volunteers. Health care professionals who care for older adults should recommend volunteering as a healthful endeavor. Copyright © 2011 Mosby, Inc. All rights reserved.

An exploration of ruling relations and how they organize and regulate nursing education in the high-fidelity patient simulation laboratory.

PubMed

Limoges, Jacqueline

2010-03-01

Recently, schools of nursing have adopted the use of high-fidelity human patient simulators in laboratory settings to teach nursing. Although numerous articles document the benefits of teaching undergraduate nursing students in this way, little attention has been paid to the discourses and texts organizing this approach. This institutional ethnography uses the critical feminist sociology of Dorothy E. Smith to examine the literature and interviews with Practical and Bachelor of Science in Nursing students, and their faculty about this experience. The research shows how discourses rationalize and sustain certain processes at the expense of others. For example, ruling discourses such as biomedicine, efficiency, and the relational ontology are activated to construct the simulation lab as part of nursing and nursing education. The analysis also highlights the intended and unintended effects of these discourses on nursing education and discusses how emphasizing nursing knowledges can make the simulation lab a positive place for learning.

An analysis of the writings of Janet Geister and Mary Roberts regarding the problems of private duty nursing.

PubMed

Baas, L S

1992-01-01

Fifty years ago there were two widely circulated nursing journals, each with a unique purpose and style. The Trained Nurse and Hospital Review was the privately owned older journal, and the American Journal of Nursing was the voice of the professional organization. Each journal was edited by a strong nursing leader, Janet Geister and Mary Roberts, respectively. Each editor had many years of service to the nursing profession in varied capacities. Naturally, each had distinctly different interests, visions, and styles of communication. These editors witnessed and commented on the change in the sphere of nursing practice from a private duty and public health orientation to one that eventually became dominated by the hospital. Although their approaches differed, both recognized the need for organization, versatility, and creative problem solving. However, the legacy of these leaders must be considered in view of the gap that continues to exist between practicing nurses and the American Nurses' Association leadership.

[Clinical Work Experience of Korean Immigrant Nurses in U.S. Hospitals].

PubMed

Seo, Kumsook; Kim, Miyoung

2016-04-01

The purpose of this qualitative study was to explore the meaning of the experience of Korean immigrant nurses working in US hospitals. Purposive sampling yielded 15 Korean immigrant nurses who had more than one year of clinical experience in US hospitals. Data were collected from March to August 2012 through in-depth interviews and thematic analysis was conducted using van Manen's hermeneutic phenomenological approach. The findings were classified into eight themes: 'struggling from staff at workplace being territorial to outsiders', 'feeling oppressed due to language barrier', 'accepting rational and horizontal relationships at work', 'staying alert in the environment where lawsuits are rife', 'feeling a sense of stability from the social system that values human dignity', 'maintaining self-confidence from prominent nursing practices and senior Korean nurses' professional reputation', 'performing essential comprehensive nursing care', 'promoting self-development to be equipped with professionalism.' The findings indicate that the Korean immigrant nurses were able to excel in their workplace when their clinical experience at US hospitals was combined with the lived space in US politics and environment, lived time of patience, lived body to be alert, and lived others with multi cultural characteristics.

[Study on empowerment factors for career continuity of hospital nurses].

PubMed

Kato, Hirosato; Ito, Yukie; Yoshida, Aki; Mizuno, Shizue; Ogoshi, Kumiko; Imamura, Tomoaki

2015-01-01

The resignation rate of nurses working in hospitals is extremely high. This study aims to identify both the factors related to the resignation of nurses and the empowerment factors supporting their job retention. In 2011 we conducted a Web-based questionnaire survey of nurses with less than 10 years of working experience. There were 25 survey items including the following reasons for choosing the current employment position, intention of continuing work, sense of fulfillment and the presence or absence of problems in the current workplace. In addition, nurses who previously had resigned were asked why they left their last workplace. The reasons why they chose the current workplace were markedly different between the not-resigned (A group) and previously resigned (B group) nurses. As a result of cluster analysis, the reasons for resignation were classified into six clusters; "overwork", "burnout", "bad atmosphere", "work life balance factors", "working conditions" and "marriage". In this study, it is shown that there is a positive correlation between the sense of fulfillment at work and the intention to do research work. It is suggested that encouragement of nurses to undertake research work is one of the empowerment factors supporting their job retention.

Differences and commonalities in difficulties faced by clinical nursing educators and faculty in Japan: a qualitative cross-sectional study

PubMed Central

2012-01-01

Background To clarify the current state of communication between clinical nursing educators and nursing faculty members and the perceived difficulties encountered while teaching nursing students in clinical training in Japan. Methods We collected data via focus group interviews with 14 clinical nursing educators, two nursing technical college teachers, and five university nursing faculty members. Interview transcripts were coded to express interview content as conclusions for each unit of meaning. Similar compiled content was categorized. Results Difficulties in providing clinical training mentioned by both clinical educators and faculty members were classified into four categories: “difficulties with directly exchanging opinions,” “mismatch between school-required teaching content and clinical teaching content,” “difficulties with handling students who demonstrate a low level of readiness for training,” and “human and time limitations in teaching.” In some categories, the opinions of educators matched those of the faculty members, whereas in others, the problems differed according to position. Conclusions The Japanese culture and working conditions may affect communication between clinical educators and faculty members; however, a direct “opinion exchange” between them is crucial for improving the clinical teaching environment in Japan. PMID:23098211

Nursing home residents' self-perceived resources for good sleep.

PubMed

Herrmann, Wolfram J; Flick, Uwe

2011-12-01

To explore the nursing home residents' self-perceived resources for good sleep. A qualitative research design. Episodic interviews were conducted, and analysis was done using thematic coding. Five German nursing homes from different providers. Thirty nursing home residents who were at least 64 years old and oriented to place and person. The nursing home residents' self-perceived resources for good sleep can be classified into three general patterns: calmness, daily activity, and environmental factors. The residents see calmness as a psychological state and a prerequisite for good sleep. Rumination was reported as the main reason for disruption of calmness. Daily activity is also seen by residents to foster sleep, but most residents do not know how to be physically active. Environmental factors such as fresh air, silence, or the type of bed contribute individually to good sleep; however, nursing home residents usually lack strategies to foster these resources by themselves. The nursing home residents' self-perceived resources for good sleep--calmness, daily activity, and environmental factors--can be starting points for non-pharmacological treatment of sleep disorders. The residents' primary care physicians should explore these individual resources during consultation and attempt to foster them.

The impact of safety organizing, trusted leadership, and care pathways on reported medication errors in hospital nursing units.

PubMed

Vogus, Timothy J; Sutcliffe, Kathleen M

2011-01-01

Prior research has found that safety organizing behaviors of registered nurses (RNs) positively impact patient safety. However, little research exists on the joint benefits of safety organizing and other contextual factors that help foster safety. Although we know that organizational practices often have more powerful effects when combined with other mutually reinforcing practices, little research exists on the joint benefits of safety organizing and other contextual factors believed to foster safety. Specifically, we examined the benefits of bundling safety organizing with leadership (trust in manager) and design (use of care pathways) factors on reported medication errors. A total of 1033 RNs and 78 nurse managers in 78 emergency, internal medicine, intensive care, and surgery nursing units in 10 acute-care hospitals in Indiana, Iowa, Maryland, Michigan, and Ohio who completed questionnaires between December 2003 and June 2004. Cross-sectional analysis of medication errors reported to the hospital incident reporting system for the 6 months after the administration of the survey linked to survey data on safety organizing, trust in manager, use of care pathways, and RN characteristics and staffing. Multilevel Poisson regression analyses indicated that the benefits of safety organizing on reported medication errors were amplified when paired with high levels of trust in manager or the use of care pathways. Safety organizing plays a key role in improving patient safety on hospital nursing units especially when bundled with other organizational components of a safety supportive system.

The organizational transformative power of nurse residency programs.

PubMed

Kramer, Marlene; Maguire, Pat; Halfer, Diana; Budin, Wendy C; Hall, Debra S; Goodloe, Lauren; Klaristenfeld, Jessica; Teasley, Susan; Forsey, Lynn; Lemke, Johanna

2012-01-01

Residency programs for newly licensed registered nurses (NLRNs) have been strongly advocated by the Institute of Medicine, American Organization of Nurse Executives, and other professional organizations. Their cost-effectiveness as well as their impact on NLRN retention, job and practice satisfaction, improved performance, and reduction in environmental reality shock has been demonstrated. This qualitative study sought answers to the question: what people, components, processes and activities of Nurse Residency Programs (NRPs), and the work environment are instrumental in the transition and integration of NLRNs into the professional practice role and into professional communities? In the course of interviewing 907 nurses-NLRNs, experienced nurses, managers, and educators-practicing on clinical units with confirmed "very healthy work environments" in 20 Magnet hospitals, it became evident that not only did NRPs positively impact the professional socialization of NLRNs, they led to transformative changes in the organization and in the practice of other health care professionals. The organizational transformative changes described by the interviewees are presented for each of the 7 major challenges identified by NLRNs-delegation, prioritization, managing patient care delivery, autonomous decision-making, collaboration with other disciplines, constructive conflict resolution, and utilizing feedback to restore self-confidence. If it can be demonstrated that these transformative changes stimulated by NRPs also lead to improved patient outcomes, NRPs may be the most significant organization transformation instituted by nurse leaders in recent years.

A History of the Western Institute of Nursing and Its Communicating Nursing Research Conferences.

PubMed

McNeil, Paula A; Lindeman, Carol A

The Western Institute of Nursing (WIN) celebrated its 60th anniversary and the 50th Annual Communicating Nursing Research Conference in April 2017. The purpose of this article is to provide a brief history of the origin, development, and accomplishments of WIN and its Communicating Nursing Research conferences. Historical documents and conference proceedings were reviewed. WIN was created in 1957 as the Western Council on Higher Education for Nursing under the auspices of the Western Interstate Commission for Higher Education. The bedrock and enduring value system of the organization is the interrelated nature of nursing education, practice, and research. There was a conviction that people in the Western region of the United States needed nursing services of excellent quality and that nursing education must prepare nurses capable of providing that care. Shared goals were to increase the science of nursing through research and to produce nurses who could design, conduct, and supervise research-all to the end of improving quality nursing care. These goals were only achieved by collaboration and resource sharing among the Western region states and organizations. Consistent with the goals, the first research conferences were held between 1957 and 1962. Conference content focused on seminars for faculty teaching research, on the design and conduct of research in patient care settings, and on identification of priority areas for research. The annual Communicating Nursing Research conferences began in 1968 and grew over the years to a total 465 podium and poster presentations on a wide array of research topics-and an attendance of 926-in 2016. As WIN and its Communicating Nursing Research conferences face the next 50 years, the enduring values on which the organization was created will stand in good stead as adaptability, adjustments, and collaborative effort are applied to inevitable change for the nursing profession. It is the Western way.

Changes in hospital nurse work environments and nurse job outcomes: an analysis of panel data.

PubMed

Kutney-Lee, Ann; Wu, Evan S; Sloane, Douglas M; Aiken, Linda H

2013-02-01

One strategy proposed to alleviate nursing shortages is the promotion of organizational efforts that will improve nurse recruitment and retention. Cross-sectional studies have shown that the quality of the nurse work environment is associated with nurse outcomes related to retention, but there have been very few longitudinal studies undertaken to examine this relationship. To demonstrate how rates of burnout, intention to leave, and job dissatisfaction changed in a panel of hospitals over time, and to explore whether these outcomes were associated with changes in nurse work environments. A retrospective, two-stage panel design was chosen for this study. Survey data collected from large random samples of registered nurses employed in Pennsylvania hospitals in 1999 and 2006 were used to derive hospital-level rates of burnout, intention to leave current position, and job dissatisfaction, and to classify the quality of nurses' work environments at both points in time. A two-period difference model was used to estimate the dependence of changes in rates of nurse burnout, intention to leave, and job dissatisfaction on changes in nurse work environments between 1999 and 2006 in 137 hospitals, accounting for concurrent changes in nurse staffing levels. In general, nurse outcomes improved between 1999 and 2006, with fewer nurses reporting burnout, intention to leave, and job dissatisfaction in 2006 as compared to 1999. Our difference models showed that improvements in work environment had a strong negative association with changes in rates of burnout (β=-6.42%, p<0.01) intention to leave (β=-4.10%, p<0.01), and job dissatisfaction (β=-8.00%, p<0.01). Improvements in nurse work environments over time are associated with lower rates of nurse burnout, intention to leave current position, and job dissatisfaction. Copyright © 2012 Elsevier Ltd. All rights reserved.

The role of the chief nursing officer in leading the practice: lessons from the Benner tradition.

PubMed

Cathcart, Eloise Balasco

2008-01-01

There is a real danger that measurable tasks and procedures can be misconstrued for nursing practice in contemporary healthcare organizations focused on the measurement of quality, safety, and productivity. This study uses the work of Patricia Benner to address the complex nature of nursing practice and discusses why the chief nursing officer must create an environment within the organization for the practice to be fully lived out if he or she is to be successful as the leader of the discipline.

Organized music instruction as a predictor of nursing student success.

PubMed

Cesario, Sandra K; Cesario, Robert J; Cesario, Anthony R

2013-01-01

Stringent admission criteria exist for nursing programs in the United States, but better predictors of success are needed to reduce student attrition. Research indicates that organized music experiences are associated with greater academic success. This exploratory study examined the association between early music experiences and undergraduate nursing student success. Findings suggest that students with a music background were more likely to graduate, have higher grade point averages, and pass the licensure examination. Previous music education might be considered as an additional predictor of nursing student success.

What's changed and what's stayed the same: a case study in nursing and philanthropy.

PubMed

Judge, Kate

2014-01-01

Philanthropic resources can help the nursing profession and nurses advance the health of the nation. While progress has been made by nursing organizations, primarily in academia, to fundraise for nursing-focused projects over the last 20 years, nursing receives little of the total annual US giving. The American Nurses Foundation's recent expansion provides an example of changes in philanthropy within the context of how the core principles of fundraising and market change can leverage giving for nursing activities and nurses.

Building capacity for the conduct of nursing research at a Veterans Administration hospital.

PubMed

Phelan, Cynthia H; Schumacher, Sandra; Roiland, Rachel; Royer, Heather; Roberts, Tonya

2015-05-01

Evidence is the bedrock of nursing practice, and nursing research is the key source for this evidence. In this article, we draw distinctions between the use and the conduct of nursing research and provide a perspective for how the conduct of nursing research in a Veterans Administration hospital can build an organization's capacity for nursing research.

Nurse manager orientation.

PubMed

Hawkins, Anne; Carter, Kelly; Nugent, Mary

2009-01-01

On the basis of the principles of management and leadership, our organization has worked over the years to formalize the orientation program for new nurse managers. This program meets the needs of new nurse managers and responds to today's complex health care system needs. This article describes the components of a nurse manager orientation program for the novice nurse manager and methods for evaluating nurse manager effectiveness.

Beyond profession: nursing leadership in contemporary healthcare.

PubMed

Sorensen, Roslyn; Iedema, Rick; Severinsson, Elisabeth

2008-07-01

To examine nursing leadership in contemporary health care and its potential contribution to health service organization and management. As the nursing profession repositions itself as an equal partner in health care beside medicine and management, its enhanced nursing standards and clinical knowledge are not leading to a commensurate extension of nursing's power and authority in the organization. An ethnographic study of an ICU in Sydney, Australia, comprising: interviews with unit nursing managers (4); focus groups (3) with less experienced, intermediate and experienced nurses (29 in total); and interviews with senior nurse manager (1). Inter- and intra-professional barriers in the workplace, fragmentation of multidisciplinary clinical systems that collectively deliver care, and clinical and administrative disconnection in resolving organizational problems, prevented nurses articulating a model of intensive and end-of-life care. Professional advocacy skills are needed to overcome barriers and to articulate and operationalize new nursing knowledge and standards if nurses are to enact and embed a leadership role. The profession will need to move beyond a reliance on professional clinical models to become skilled multidisciplinary team members and professional advocates for nurses to take their place as equal partners in health care.

Responding to health care reform by addressing the institute of medicine report on the future of nursing.

PubMed

Ellerbe, Suellyn; Regen, Debra

2012-01-01

The current health care environment has heightened the importance of achieving positive patient outcomes and excellent customer satisfaction. To remain competitive, health care organizations must adapt quickly to changing regulatory requirements, quality improvement initiatives, and customer expectations. To ensure nursing practice at the Saint Clare's Health System in Northwest New Jersey is at the forefront of leading change, the nursing staff has embraced the Institute of Medicine report The Future of Nursing: Leading Change. The empowered nursing team has applied Benner's Novice to Expert model and McCauley's Careful Nursing Theory as the foundation for nursing practice. The ability to apply evidence-based nursing research and cultivate professional development at the bedside has resulted in retention of expert nurses at the bedside. Engaging the nursing team has resulted in increased patient satisfaction and improved clinical outcomes. Advanced practice nurses play an important role to mentor the nursing staff and promote an interdisciplinary, collaborative relationship between all health care disciplines and community support programs. Nurses are recognized for their accomplishments and encouraged to obtain specialty certification, advanced degrees, and earn state and national recognition through professional organizations. The professional nurses at the Saint Clare's Health System are prepared to work in whatever environment the new normal creates.

Sexual harassment in healthcare: classification of harassers and rationalizations of sex-based harassment behavior.

PubMed

Madison, J; Minichiello, V

2001-11-01

This study identified how 16 Australian registered nurses classified sex-based harassers and explained their own behavior and the behavior of the harasser. A qualitative research design, relying on in-depth interviews, was used to collect the data. The study found that harassment is linked to gender roles and that the harassed are reluctant to blame the harasser--the harassed had "sound" rationalizations for harassment. Awareness of the interactional dynamics of self-blame and these rationalizations will help nurse executives ensure a harassment-free workplace.

A new contribution to the classification of stressors affecting nursing professionals

PubMed Central

Puerto, Jesús Cremades; Soler, Loreto Maciá; Montesinos, Maria José López; Marcos, Azucena Pedraz; Chorda, Víctor Manuel González

2017-01-01

Objective: to identify and classify the most important occupational stressors affecting nursing professionals in the medical units within a hospital. Method: quantitative-qualitative, descriptive and prospective study performed with Delphi technique in the medical units of a general university hospital, with a sample of 30 nursing professionals. Results: the stressors were work overload, frequent interruptions in the accomplishment of their tasks, night working, simultaneity of performing different tasks, not having enough time to give emotional support to the patient or lack of time for some patients who need it, among others. Conclusion: the most consensual stressors were ranked as work overload, frequent interruptions in the accomplishment of their tasks, night working and, finally, simultaneity of performing different tasks. These results can be used as a tool in the clinical management of hospital units, aiming to improve the quality of life of nursing professionals, organizational models and, in addition, continuous improvement in clinical treatment. PMID:28562702

Priming patient safety: A middle-range theory of safety goal priming via safety culture communication.

PubMed

Groves, Patricia S; Bunch, Jacinda L

2018-05-18

The aim of this paper is discussion of a new middle-range theory of patient safety goal priming via safety culture communication. Bedside nurses are key to safe care, but there is little theory about how organizations can influence nursing behavior through safety culture to improve patient safety outcomes. We theorize patient safety goal priming via safety culture communication may support organizations in this endeavor. According to this theory, hospital safety culture communication activates a previously held patient safety goal and increases the perceived value of actions nurses can take to achieve that goal. Nurses subsequently prioritize and are motivated to perform tasks and risk assessment related to achieving patient safety. These efforts continue until nurses mitigate or ameliorate identified risks and hazards during the patient care encounter. Critically, this process requires nurses to have a previously held safety goal associated with a repertoire of appropriate actions. This theory suggests undergraduate educators should foster an outcomes focus emphasizing the connections between nursing interventions and safety outcomes, hospitals should strategically structure patient safety primes into communicative activities, and organizations should support professional development including new skills and the latest evidence supporting nursing practice for patient safety. © 2018 John Wiley & Sons Ltd.

Unplanned Extubations in Intensive Care Unit: evidences for risk factors. A literature review.

PubMed

Cosentino, Chiara; Fama, Mattia; Foà, Chiara; Bromuri, Giorgia; Giannini, Serena; Saraceno, Marco; Spagnoletta, Angela; Tenkue, Mbemo; Trevisi, Elena; Sarli, Leopoldo

2017-11-30

Unplanned extubations (UE) are getting more and more relevant in Critical Care, becoming a quality and care safeness outcome. This happens because after an UE the patient can face some complications concerning the airway management, respiratory and hemodynamic problems, lengthen in the hospital stay and in the mechanical ventilation time.  The aim of this review is identify and classify the factors that could increase UE risk. A systematic review of scientific articles was performed consulting the databases PubMed, Cinahl, Medline, EBSCOhost and Google Scholar. Articles from 2006 to 2011 were included. Pediatric Care settings were excluded. 21 articles were selected. From the results emerged that risk factors associated to the patient are widely controversial. Yet restlessness, a low level of sedation and a high level of consciousness seem to be highly related to UE. Organizational risk factors, as workload, nurse:patient ratio, and the use of interdisciplinary protocols seem to play an important role in UE. According the current literature, the research on UE still has to handle a wide uncertainty. There is the need for more studies developing conclusive evidences on the role of different risk factors. Anyway, literature highlights the importance of the nurse and of the healthcare system organization in reducing UE incidence.

Safety Hazards During Intrahospital Transport: A Prospective Observational Study.

PubMed

Bergman, Lina M; Pettersson, Monica E; Chaboyer, Wendy P; Carlström, Eric D; Ringdal, Mona L

2017-10-01

To identify, classify, and describe safety hazards during the process of intrahospital transport of critically ill patients. A prospective observational study. Data from participant observations of the intrahospital transport process were collected over a period of 3 months. The study was undertaken at two ICUs in one university hospital. Critically ill patients transported within the hospital by critical care nurses, unlicensed nurses, and physicians. None. Content analysis was performed using deductive and inductive approaches. We detected a total of 365 safety hazards (median, 7; interquartile range, 4-10) during 51 intrahospital transports of critically ill patients, 80% of whom were mechanically ventilated. The majority of detected safety hazards were assessed as increasing the risk of harm, compromising patient safety (n = 204). Using the System Engineering Initiative for Patient Safety, we identified safety hazards related to the work system, as follows: team (n = 61), tasks (n = 83), tools and technologies (n = 124), environment (n = 48), and organization (n = 49). Inductive analysis provided an in-depth description of those safety hazards, contributing factors, and process-related outcomes. Findings suggest that intrahospital transport is a hazardous process for critically ill patients. We have identified several factors that may contribute to transport-related adverse events, which will provide the opportunity for the redesign of systems to enhance patient safety.

[Testing reliability and validity of reduced substitutes for leadership scales(rd-SLS)].

PubMed

Kim, Jeong-Hee

2005-10-01

This paper was conducted to test the reliability and validity of rd-SLS, developed by Podsakoff, et al. (1993) which measured 'substitutes for leadership'. The subjects were 345 nurses in 5 general hospitals. Cronbach's and the Guttman split-half coefficient were used to test the reliability of rd-SLS. Factor analysis, and the correlations of the rv-SLS and SLS with rd-SLS were used for convergent and discriminant validity. Cronbach's data was 0.76 and the Guttman split-half coefficient was 0.52. Twelve factors evolved by factor analysis, which explained 70.4% of the total variance. This result was similar to previous study results. However, 'Indifference toward organizational rewards'-related items were classified two factors. It was not clear t hat the rd-SLS consisted of 13 concepts(factors). The correlations of the rv-SLS and SLS with the rd-SLS were 0.93 and 0.87 respectively. The rd-SLS showed a moderate degree of validity and reliability. Thus, it is recommended to use the rd-SLS in general nursing organizations for screening for leadership substitutes. In addition, it is necessary to clarify the concept of organizational rewards. In a further study, the factor structure of the rd-SLS may be considered.

Lifelong learning strategies in nursing: A systematic review.

PubMed

Qalehsari, Mojtaba Qanbari; Khaghanizadeh, Morteza; Ebadi, Abbas

2017-10-01

Lifelong learning is an expectation in the professional performance of nurses, which is directly related to the success of students in nursing schools. In spite of the considerable attention paid to this issue, lifelong learning strategies are not fully understood. The aim of this study was to clarify lifelong learning strategies of nursing students with respect to international experience. In this systematic review, an extensive investigation was carried out using Persian and English studies in Pub Med, ProQuest, Cochrane, Ovid, Scopus, Web of Science, SID, and Iran Doc using the following keywords: lifelong learning, self-directed learning, lifelong learning model, continuing education, nursing education, and lifelong program. Finally, 22 articles published from 1994 to 2016 were selected for the final analysis. Data extracted from the selected articles was summarized and classified based on the research questions. In this study, 8 main themes, namely intellectual and practical independence, collaborative (cooperative) learning, researcher thinking, persistence in learning, need-based learning, learning management, suitable learning environment, and inclusive growth, were extracted from the article data. Having identified and clarified lifelong learning strategies in nursing, it is recommended to use the research findings in the programs and teaching systems of nursing schools. Use of strategies of lifelong learning will led to increased quality of education, development of nursing competency and finally, increased quality of patient care.

The Nurse Leader Role in Crisis Management.

PubMed

Edmonson, Cole; Sumagaysay, Dio; Cueman, Marie; Chappell, Stacey

2016-09-01

Leaders from the American Organization of Nurse Executives describe the dynamic state of today's healthcare system related to crisis management. Adaptive leadership, driven by strong values and morality, can guide leaders and organizations through the most difficult times.

42 CFR 416.46 - Condition for coverage-Nursing services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Condition for coverage-Nursing services. 416.46... Coverage § 416.46 Condition for coverage—Nursing services. The nursing services of the ASC must be directed and staffed to assure that the nursing needs of all patients are met. (a) Standard: Organization and...

42 CFR 416.46 - Condition for coverage-Nursing services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Condition for coverage-Nursing services. 416.46....46 Condition for coverage—Nursing services. The nursing services of the ASC must be directed and staffed to assure that the nursing needs of all patients are met. (a) Standard: Organization and staffing...

42 CFR 416.46 - Condition for coverage-Nursing services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Condition for coverage-Nursing services. 416.46....46 Condition for coverage—Nursing services. The nursing services of the ASC must be directed and staffed to assure that the nursing needs of all patients are met. (a) Standard: Organization and staffing...

42 CFR 416.46 - Condition for coverage-Nursing services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Condition for coverage-Nursing services. 416.46... Coverage § 416.46 Condition for coverage—Nursing services. The nursing services of the ASC must be directed and staffed to assure that the nursing needs of all patients are met. (a) Standard: Organization and...

42 CFR 416.46 - Condition for coverage-Nursing services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false Condition for coverage-Nursing services. 416.46... Coverage § 416.46 Condition for coverage—Nursing services. The nursing services of the ASC must be directed and staffed to assure that the nursing needs of all patients are met. (a) Standard: Organization and...

Human capital strategy: talent management.

PubMed

Nagra, Michael

2011-01-01

Large organizations, including the US Army Medical Department and the Army Nurse Corps, are people-based organizations. Consequently, effective and efficient management of the human capital within these organizations is a strategic goal for the leadership. Over time, the Department of Defense has used many different systems and strategies to manage people throughout their service life-cycle. The current system in use is called Human Capital Management. In the near future, the Army's human capital will be managed based on skills, knowledge, and behaviors through various measurement tools. This article elaborates the human capital management strategy within the Army Nurse Corps, which identifies, develops, and implements key talent management strategies under the umbrella of the Corps' human capital goals. The talent management strategy solutions are aligned under the Nurse Corps business strategy captured by the 2008 Army Nurse Corps Campaign Plan, and are implemented within the context of the culture and core values of the organization.

Use of electronic information systems in nursing management.

PubMed

Lammintakanen, Johanna; Saranto, Kaija; Kivinen, Tuula

2010-05-01

The purpose of this study is to describe nurse managers' perceptions of the use of electronic information systems in their daily work. Several kinds of software are used for administrative and information management purposes in health care organizations, but the issue has been studied less from nurse managers' perspective. The material for this qualitative study was acquired according to the principles of focus group interview. Altogether eight focus groups were held with 48 nurse managers from both primary and specialized health care organizations. The nurse managers were asked in focus groups to describe the use of information systems in their daily work in addition to some other themes. The material was analyzed by inductive content analysis using ATLAS.ti computer program. The main category "pros and cons of using information systems in nursing management" summarized the nurse managers' perceptions of using electronic information systems. The main category consisted of three sub-categories: (1) nurse managers' perceptions of the use of information technology; (2) usability of management information systems; (3) development of personnel competencies and work processes. The nurse managers made several comments on the implementation of immature electronic information systems which caused inefficiencies in working processes. However, they considered electronic information systems to be essential elements of their daily work. Furthermore, the nurse managers' descriptions of the pros and cons of using information systems reflected partly the shortcomings of strategic management and lack of coordination in health care organizations. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Nurses' professionalism in Canada: a labor process analysis.

PubMed

Campbell, M L

1992-01-01

This article draws on a body of research conducted by the author over the past ten years on the social organization of nursing work. It explores questions surrounding nurses' contemporary labor process control and its meaning for nurses' professionalization and proletarianization. Both are dynamic processes, changing as public administration of the Canadian health care system changes and as nurses are successful in winning more complete self-regulation. Nurses are currently being articulated more and more securely to dominant ideas of public sector management through textually mediated technologies. Nurses find new upwardly mobile careers and challenging, responsible, and more respected work. However, as the generation of objective information for professional accountability, cost-accounting, and managerial decision-making becomes unified in computerized patient information systems, producing and using such information becomes a central and determining core of everyday nursing work. It organizes nurses into a "managed" practice of patient care, contradictory for them in many ways. Outstanding among these contradictions is a new professionalized standpoint of cost-efficiency that subordinates nurses' traditional interests and grounding of their work in the standpoint of care.

Nurses' perceptions of conflict as constructive or destructive.

PubMed

Kim, Wonsun Sunny; Nicotera, Anne M; McNulty, Julie

2015-09-01

The aim of this study was to examine nurses' perceptions of constructive and destructive conflicts and their management among nurses. Conflict among nurses is common and has been associated with lack of collaboration, lack of communication and disruptive behaviour, with the potential to have negative impact teamwork. However, unlike the broader social science literature, positive views of conflict are scarce in the nursing literature. Given the various functions of conflict and the high stakes of ineffective conflict management in nursing, it is necessary to examine how nurses understand both sides of conflict: constructive and destructive. A qualitative descriptive design. Data were collected from 34 full time nurses as part of a conflict skills training course offered over 6 months beginning in October 2009. Each participant was asked to write a weekly journal about conflicts in his/her work place. Data yielded 163 entries (82 classified as constructive and 81 as destructive). Results showed that quality patient care and cooperative communication contributed to the perception that conflict is constructive in nature. The central underlying themes in nurses' perceptions of destructive conflict were time constraints, role conflict and power differences that are not managed through communication. This article helps to identify nursing perceptions of constructive and destructive conflict and to understand complexities nurses face during their interactions with other nurses, physicians and patients. The insight that constructive views are related to constructive processes provides an excellent opportunity for an educational intervention, so that we can educate nurses to analyse problems and learn how to manage conflict with effective collaborative processes. © 2015 John Wiley & Sons Ltd.

Competence areas of nursing students in Europe.

PubMed

Satu, Kajander-Unkuri; Leena, Salminen; Mikko, Saarikoski; Riitta, Suhonen; Helena, Leino-Kilpi

2013-06-01

The focus of this study is on European nursing education, where there have been several reforms over the last two decades attempting to harmonise curricula and degree structures. One of the most powerful reforms was started by the Bologna Declaration in 1999; since then, significant progress has been made towards achieving the European Higher Education Area (EHEA) and the implementation of the European Qualifications Framework (EQF) in education practice. The Directive of recognition of professional qualifications (2005/36/EC) regulates nursing education. All these strategies aim to harmonise nursing education, but specific competence areas in nursing are still missing within the European Union (EU). The purpose of this review was to seek competence areas for nursing students within the EU as identified in previous studies and other documents. Altogether, 67 competence areas were identified and classified into eight main categories: (1) professional and ethical values and practice, (2) nursing skills and intervention, (3) communication and interpersonal skills, (4) knowledge and cognitive ability, (5) assessment and improving quality in nursing, (6) professional development, (7) leadership, management and teamwork, and (8) research utilisation. In order to obtain a comprehensive concept of competence, more research is needed on nursing students' competence areas across the EU due to the fact that the EU is a common labour market and nurses are educated for the EU as a whole. Nursing is a global profession and nurse competence is central to patient care outcomes, so it is also internationally important that nurses have good competence. Copyright © 2013 Elsevier Ltd. All rights reserved.

Appropriateness of ICNP in Korean home care nursing.

PubMed

Kang, Min-Jeoung; Kim, Soon-Lae; Lee, Jong-Eun; Jung, Chai Young; Kim, Sukil

2015-09-01

There are several hospitals in Korea that introduced the ICNP (International Classification for Nursing Practice) as the standard terminology for clinical and home care nursing. This research attempted to determine the appropriateness of ICNP in Korean, hospital based, home care nursing. The data was collected from a home care nursing center from January 1, 2009 to September 21, 2012. The center is operated by a Korean teaching hospital equipped with an ICNP based electronic nursing record (ENR) system. Via a refining process, 40,082 simplified sentences of nursing intervention were acquired from 41,158 nursing records. Among them, 545 preferred nursing statements were extracted, then mapped, to ICNP 2011 at both axis and sentence levels. The mapping results were classified into three categories based on the axis of concept origin and the level of hierarchy. These categories were titled: complete, incomplete and no mapping. Out of 45 unique concepts in the action axis, 42 (93.33%) concepts were completely mapped. However, only 38 (15.08%), out of 252 unique concepts, were completely mapped in the focus axis. At the statement level, only 19.63% of statements were completely mapped. The ICNP is not useful as a tool for home care nursing in its present form. The granularity of ICNP has to be improved and more concepts, specific to home care nursing, need to be added in the focus and action axes. Also, a new measure needs to be introduced to prevent information loss during mapping. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Determinants of nurses' job satisfaction: the role of work-family conflict, job demand, emotional charge and social support.

PubMed

Cortese, Claudio G; Colombo, Lara; Ghislieri, Chiara

2010-01-01

The aim of the present study was to develop a research model explaining the causal relationship between certain antecedents (job and emotional charge, supportive management and colleagues), work-family conflict (WFC) and job satisfaction. Many research projects in health organizations have highlighted the link between high WFC and lower levels of job satisfaction. The study of these variables is important in understanding the processes of professional nurse retention. The survey was conducted using a questionnaire administered to 351 professional nurses working in a major North Italian hospital. The questionnaire measures six variables: WFC, job satisfaction, job demand, emotional charge, supportive management and supportive colleagues. The data confirmed the connection between WFC and job satisfaction, and showed the importance of some WFC predictors, such as supportive management, emotional charge and job demand, not only for their connections with WFC but also for their direct associations with job satisfaction. WFC, in health organizations, can contribute to a decrease of nurses' job satisfaction. Nursing management could achieve its aim of reducing WFC through the improvement of support from nurse coordinators, the specific organization of work models, ad hoc family-friendly policies and individual counselling programmes for nurses.

Organization aesthetics in nursing homes.

PubMed

Hujala, Anneli; Rissanen, Sari

2011-05-01

The aim of this study was to make visible the material dimensions of nursing management.   Management theories have mainly ignored the material dimensions, namely the physical spaces in which management actually takes place as well as the physical bodies of organization members. The perspective of organization aesthetics enhances our understanding of the role of materiality in nursing management. The data were collected in 2009 using observation and interviews in eight nursing homes. Qualitative content analysis with critical interpretations was used. Three main issues of organizational aesthetics related to nursing management were identified: (1) the functionality of working spaces and equipment; (2) the relevance of 'organizational' space; and (3) the emotional-aesthetic dimension of daily work. Materiality is closely related to management topics, such as decision-making, values and identity formation of organizational members. Aesthetic dimensions of care are constructed by management practices which, in their turn, influence the nature of management. Implications for nursing management  Nurse managers need to be aware of the unintended and unnoticed consequences of materiality and aesthetics. Space and body issues may have considerable effects, for example, on the identity of care workers and on the attractiveness of the care branch. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Work-related factors influencing home care nurse intent to remain employed.

PubMed

Tourangeau, Ann E; Patterson, Erin; Saari, Margaret; Thomson, Heather; Cranley, Lisa

Health care is shifting out of hospitals into community settings. In Ontario, Canada, home care organizations continue to experience challenges recruiting and retaining nurses. However, factors influencing home care nurse retention that can be modified remain largely unexplored. Several groups of factors have been identified as influencing home care nurse intent to remain employed including job characteristics, work structures, relationships and communication, work environment, responses to work, and conditions of employment. The aim of this study was to test and refine a model that identifies which factors are related to home care nurse intentions to remain employed for the next 5 years with their current home care employer organization. A cross-sectional survey design was implemented to test and refine a hypothesized model of home care nurse intent to remain employed. Logistic regression was used to determine which factors influence home care nurse intent to remain employed. Home care nurse intent to remain employed for the next 5 years was associated with increasing age, higher nurse-evaluated quality of care, having greater variety of patients, experiencing greater meaningfulness of work, having greater income stability, having greater continuity of client care, experiencing more positive relationships with supervisors, experiencing higher work-life balance, and being more satisfied with salary and benefits. Home care organizations can promote home care nurse intent to remain employed by (a) ensuring nurses have adequate training and resources to provide quality client care, (b) improving employment conditions to increase income stability and satisfaction with pay and benefits, (c) ensuring manageable workloads to facilitate improved work-life balance, and (d) ensuring leaders are accessible and competent.

Feminine Attributes in a Masculine World.

ERIC Educational Resources Information Center

Pinch, Winifred J.

1981-01-01

Nurses must fight society's assumptions about a woman's abilities and be aware of history's influence upon the issues of women's rights and power. Nurses can begin by educating their own members, supporting nursing organizations, and working for public recognition for the nursing profession. (CT)

Meeting the criteria of a nursing diagnosis classification: Evaluation of ICNP, ICF, NANDA and ZEFP.

PubMed

Müller-Staub, Maria; Lavin, Mary Ann; Needham, Ian; van Achterberg, Theo

2007-07-01

Few studies described nursing diagnosis classification criteria and how classifications meet these criteria. The purpose was to identify criteria for nursing diagnosis classifications and to assess how these criteria are met by different classifications. First, a literature review was conducted (N=50) to identify criteria for nursing diagnoses classifications and to evaluate how these criteria are met by the International Classification of Nursing Practice (ICNP), the International Classification of Functioning, Disability and Health (ICF), the International Nursing Diagnoses Classification (NANDA), and the Nursing Diagnostic System of the Centre for Nursing Development and Research (ZEFP). Using literature review based general and specific criteria, the principal investigator evaluated each classification, applying a matrix. Second, a convenience sample of 20 nursing experts from different Swiss care institutions answered standardized interview forms, querying current national and international classification state and use. The first general criterion is that a diagnosis classification should describe the knowledge base and subject matter for which the nursing profession is responsible. ICNP) and NANDA meet this goal. The second general criterion is that each class fits within a central concept. The ICF and NANDA are the only two classifications built on conceptually driven classes. The third general classification criterion is that each diagnosis possesses a description, diagnostic criteria, and related etiologies. Although ICF and ICNP describe diagnostic terms, only NANDA fulfils this criterion. The analysis indicated that NANDA fulfilled most of the specific classification criteria in the matrix. The nursing experts considered NANDA to be the best-researched and most widely implemented classification in Switzerland and internationally. The international literature and the opinion of Swiss expert nurses indicate that-from the perspective of classifying comprehensive nursing diagnoses-NANDA should be recommended for nursing practice and electronic nursing documentation. Study limitations and future research needs are discussed.

Changes in Hospital Nurse Work Environments and Nurse Job Outcomes: An Analysis of Panel Data

PubMed Central

Wu, Evan S.; Sloane, Douglas M.; Aiken, Linda H.; Fagin, Claire M.

2013-01-01

Background One strategy proposed to alleviate nursing shortages is the promotion of organizational efforts that will improve nurse recruitment and retention. Cross-sectional studies have shown that the quality of the nurse work environment is associated with nurse outcomes related to retention, but there have been very few longitudinal studies undertaken to examine this relationship. Objectives To demonstrate how rates of burnout, intention to leave, and job dissatisfaction changed in a panel of hospitals over time, and to explore whether these outcomes were associated with changes in nurse work environments. Methods A retrospective, two-stage panel design was chosen for this study. Survey data collected from large random samples of registered nurses employed in Pennsylvania hospitals in 1999 and 2006 were used to derive hospital-level rates of burnout, intentions to leave current positions, and job dissatisfaction, and to classify the quality of nurses’ work environments at both points in time. A two-period difference model was used to estimate the dependence of changes in rates of nurse burnout, intentions to leave, and job dissatisfaction on changes in nurse work environments between 1999 and 2006 in 137 hospitals, accounting for concurrent changes in nurse staffing levels. Results In general, nurse outcomes improved between 1999 and 2006, with fewer nurses reporting burnout, intentions to leave, and job dissatisfaction in 2006 as compared to 1999. Our difference models showed that improvements in work environment had a strong negative association with changes in rates of burnout (β =−6.42%, p<0.01) intentions to leave (β =−4.10%, p<0.01), and job dissatisfaction (β =−8.00%, p<0.01). Conclusions Improvements in nurse work environments over time are associated with lower rates of nurse burnout, intentions to leave current positions, and job dissatisfaction. PMID:22902135

Internal marketing and the antecedents of nurse satisfaction and loyalty.

PubMed

Peltier, James W; Pointer, Lucille; Schibrowsky, John A

2008-01-01

Employee satisfaction and retention are critical issues that influence the success of any organization. Yet, one of the most critical problems facing the worldwide health care industry is the shortage of qualified nurses. Recent calls have been made within the traditional nursing literature for research that utilizes marketing and business models to better understand nurse satisfaction and retention. The purpose of this study is to develop scales that can be used to empirically test a model of the proposed antecedents of nurse job satisfaction and loyalty which have been used widely in the internal marketing and the relationship-marketing literature. Specifically, the study will investigate the degree to which structural bonding, social bonding, financial bonding activities, and quality of care impact how well nurses are satisfied with their job and their commitment to the organization. The results show that quality of care most impacted nurse satisfaction and loyalty, followed by structural, social, and financial bonds.

Filipino-American Nurses' Knowledge, Perceptions, Beliefs and Practice of Genetics and Genomics.

PubMed

Saligan, Leorey N; Rivera, Reynaldo R

2014-01-01

There is limited information on the knowledge, perceptions, beliefs, and practice, about genetics and genomics among Filipino-American nurses. The National Coalition of Ethnic Minority Organizations (NCEMNA), in which the Philippine Nurses Association of America (PNAA) is a member organization, conducted an online survey to describe the genomic knowledge, perceptions, beliefs, and practice of minority nurses. This study reports on responses from Filipino-American survey participants, which is a subset analysis of the larger NCEMNA survey. The purpose of this study was to explore the knowledge, perceptions, beliefs, practice and genomic education of Filipino-American nurses. An online survey of 112 Filipino-American nurses was conducted to describe the knowledge, perceptions, beliefs, and practice of genetics/genomics. Survey responses were analyzed using descriptive statistics. Most (94%) Filipino-American nurses wanted to learn more about genetics. Although 41% of the respondents indicated good understanding of genetics of common diseases, 60% had not attended any related continuing education courses since RN licensure, and 73% reported unavailability of genetic courses to take. The majority (83%) of PNAA respondents indicated that they would attend genetics/genomics awareness training if it was offered by their national organization during their annual conference, and 86% reported that the national organization should have a visible role in genetics/genomics initiatives in their community. Filipino-American nurses wanted to learn more about genetics and were willing to attend genetics/genomics trainings if offered by PNAA. The study findings can assist PNAA in planning future educational programs that incorporates genetics and genomics information.

Magnet status as a competitive strategy of hospital organizations: marketing a culture of excellence in nursing services.

PubMed

Tropello, Paula Grace Dunn

2003-01-01

With issues of patient safety, the nursing shortage, and managed care fiscal constraints, hospital organizations can strategically capture market share, while insuring best care practices, if they adopt the "Magnet Status" accreditation model. This quality indicator signifies to the consumer a culture of excellence in nursing services and fulfills the priority of customer satisfaction as a marketing strategy objective.

Regulatory Mechanisms for Nursing Training and Practice: Meeting Primary Health Care Needs. World Health Organization Technical Report Series No. 738. Report of a WHO Study Group.

ERIC Educational Resources Information Center

World Health Organization, Geneva (Switzerland).

A report on laws and regulations governing nursing education and practice in 81 countries belonging to the World Health Organization and effects on primary health care is presented by an international group of experts. Suggestions for training and licensure are provided to national governments and nursing regulatory bodies to promote the goal of…

Staff perceptions of leadership during implementation of task-shifting in three surgical units.

PubMed

Henderson, Amanda; Paterson, Karyn; Burmeister, Liz; Thomson, Bernadette; Young, Louise

2013-03-01

Registered nurses are difficult to recruit and retain. Task shifting, which involves reallocation of delegation, can reduce demand for registered nurses. Effective leadership is needed for successful task shifting. This study explored leadership styles of three surgical nurse unit managers. Staff completed surveys before and after the implementation of task shifting. Task shifting involved the introduction of endorsed enrolled nurses (licensed nurses who must practise under registered nurse supervision) to better utilize registered nurses. Implementation of task shifting occurred over 4 months in a 700-bed tertiary hospital, in southeast Queensland, Australia. A facilitator assisted nurse unit managers during implementation. The impact was assessed by comparison of data before (n = 49) and after (n = 72) task shifting from registered nurses and endorsed enrolled nurses (n = 121) who completed the Ward Organization Features Survey. Significant differences in leadership and staff organization subscales across the settings suggest that how change involving task shifting is implemented influences nurses' opinions of leadership. Leadership behaviours of nurse unit managers is a key consideration in managing change such as task shifting. Consistent and clear messages from leaders about practice change are viewed positively by nursing staff. In the short term, incremental change possibly results in staff maintaining confidence in leadership. © 2012 Blackwell Publishing Ltd.

Conflict engagement: a new model for nurses.

PubMed

Gerardi, Debra

2015-03-01

This article is one in a series on conflict. It is part of an ongoing series on leadership coordinated by the American Organization of Nurse Executives (AONE), highlighting topics of interest to nurse managers and emerging nurse leaders. The AONE provides leadership, professional development, advocacy, and research to advance nursing practice and patient care, promote nursing leadership excellence, and shape public policy for health care.

Nurses and subordination: a historical study of mental nurses’ perceptions on administering aversion therapy for ‘sexual deviations’

PubMed Central

Dickinson, Tommy; Cook, Matt; Playle, John; Hallett, Christine

2014-01-01

Nurses and subordination: a historical study of mental nurses’ perceptions on administering aversion therapy for ‘sexual deviations’ This study aimed to examine the meanings that nurses attached to the ‘treatments’ administered to cure ‘sexual deviation’ (SD) in the UK, 1935–1974. In the UK, homosexuality was considered a classifiable mental illness that could be ‘cured’ until 1992. Nurses were involved in administering painful and distressing treatments. The study is based on oral history interviews with fifteen nurses who had administered treatments to cure individuals of their SD. The interviews were transcribed for historical interpretation. Some nurses believed that their role was to passively follow any orders they had been given. Other nurses limited their culpability concerning administering these treatments by adopting dehumanising and objectifying language and by focussing on administrative tasks, rather than the human beings in need of their care. Meanwhile, some nurses genuinely believed that they were acting beneficently by administering these distinctly unpleasant treatments. It is envisaged that this study might act to reiterate the need for nurses to ensure their interventions have a sound evidence base and that they constantly reflect on the moral and value base of their practice and the influence that science and societal norms can have on changing views of what is considered ‘acceptable practice’. PMID:23876127

Transmission of Hepatitis A Virus through Combined Liver–Small Intestine–Pancreas Transplantation

PubMed Central

Weil, Lauren M.; Jin, Sherry; Johnson, Thomas; Hayden-Mixson, Tonya R.; Khudyakov, Yury; Annambhotla, Pallavi D.; Basavaraju, Sridhar V.; Kamili, Saleem; Ritter, Jana M.; Nelson, Noele; Mazariegos, George; Green, Michael; Himes, Ryan W.; Kuhar, David T.; Kuehnert, Matthew J.; Miller, Jeffrey A.; Wiseman, Rachel; Moorman, Anne C.

2017-01-01

Although transmission of hepatitis A virus (HAV) through blood transfusion has been documented, transmission through organ transplantation has not been reported. In August 2015, state health officials in Texas, USA, were notified of 2 home health nurses with HAV infection whose only common exposure was a child who had undergone multi–visceral organ transplantation 9 months earlier. Specimens from the nurses, organ donor, and all organ recipients were tested and medical records reviewed to determine a possible infection source. Identical HAV RNA sequences were detected from the serum of both nurses and the organ donor, as well as from the multi–visceral organ recipient’s serum and feces; this recipient’s posttransplant liver and intestine biopsy specimens also had detectable virus. The other organ recipients tested negative for HAV RNA. Vaccination of the donor might have prevented infection in the recipient and subsequent transmission to the healthcare workers. PMID:28322704

Transmission of Hepatitis A Virus through Combined Liver-Small Intestine-Pancreas Transplantation.

PubMed

Foster, Monique A; Weil, Lauren M; Jin, Sherry; Johnson, Thomas; Hayden-Mixson, Tonya R; Khudyakov, Yury; Annambhotla, Pallavi D; Basavaraju, Sridhar V; Kamili, Saleem; Ritter, Jana M; Nelson, Noele; Mazariegos, George; Green, Michael; Himes, Ryan W; Kuhar, David T; Kuehnert, Matthew J; Miller, Jeffrey A; Wiseman, Rachel; Moorman, Anne C

2017-04-01

Although transmission of hepatitis A virus (HAV) through blood transfusion has been documented, transmission through organ transplantation has not been reported. In August 2015, state health officials in Texas, USA, were notified of 2 home health nurses with HAV infection whose only common exposure was a child who had undergone multi-visceral organ transplantation 9 months earlier. Specimens from the nurses, organ donor, and all organ recipients were tested and medical records reviewed to determine a possible infection source. Identical HAV RNA sequences were detected from the serum of both nurses and the organ donor, as well as from the multi-visceral organ recipient's serum and feces; this recipient's posttransplant liver and intestine biopsy specimens also had detectable virus. The other organ recipients tested negative for HAV RNA. Vaccination of the donor might have prevented infection in the recipient and subsequent transmission to the healthcare workers.

[New nurse turnover intention and influencing factors].

PubMed

Han, Sang Sook; Sohn, In Soon; Kim, Nam Eun

2009-12-01

The study was done to identify turnover intention in new nurses according to characteristics of the nurses and other factors affecting turnover and to provide data to set up a strategy to reduce the turnover. Data were collected from 1,077 new nurses who had less than 12 months employment experience and worked in one of 188 hospitals. Eight research instruments were used. Data analysis was done using SPSS WIN 15.0 program. Several factors influence new nurse turnover intention. The average score for turnover intention was 2.12. The scores for subscales were self efficacy, 3.76, nursing performance, 3.90, job satisfaction, 2.09, organization commitment, 1.28, stress, 1.32, burnout, 2.82 and nursing organizational culture, 3.29. Turnover intention was related to self efficacy, nursing performance, job satisfaction, organization commitment, stress, burnout, nursing organizational culture, duration of in-class training, duration of on the job training, number of hospital beds, length of employment and duration of employment in current workplace. The predicting factors for turnover intention were burnout, stress, duration of employment in the current workplace, self efficacy and nursing performance. Those factors explained 51.6% of turnover intention. New nurse turnover intention can be reduced by mitigating the factors affecting this intention.

The value of bedside shift reporting enhancing nurse surveillance, accountability, and patient safety.

PubMed

Jeffs, Lianne; Acott, Ashley; Simpson, Elisa; Campbell, Heather; Irwin, Terri; Lo, Joyce; Beswick, Susan; Cardoso, Roberta

2013-01-01

A study was undertaken to explore nurses' experiences and perceptions associated with implementation of bedside nurse-to-nurse shift handoff reporting. Interviews were conducted with nurses and analyzed using directed content analysis. Two themes emerged that illustrated the value of bedside shift reporting. These themes included clarifying information and intercepting errors and visualizing patients and prioritizing care. Nurse leaders can leverage study findings in their efforts to embed nurse-to-nurse bedside shift reporting in their respective organizations.

Competency Based Refresher Nurse Curriculum.

ERIC Educational Resources Information Center

Lombardo, Mary C.

This competency-based course is designed to update the skills and knowledge of inactive nurses desiring to return to active practice. Focus of the course is on organizing and managing patient care using the nursing process; performing nursing procedures, including medication administration; and reintegrating oneself into the professional…

Participation in a national nursing outcomes database: monitoring outcomes over time.

PubMed

Loan, Lori A; Patrician, Patricia A; McCarthy, Mary

2011-01-01

The current and future climates in health care require increased accountability of health care organizations for the quality of the care they provide. Never before in the history of health care in America has this focus on quality been so critical. The imperative to measure nursing's impact without fully developed and tested monitoring systems is a critical issue for nurse executives and managers alike. This article describes a project to measure nursing structure, process, and outcomes in the military health system, the Military Nursing Outcomes Database project. Here we review the effectiveness of this project in monitoring changes over time, in satisfying expectations of nurse leaders in participating hospitals, and evaluate the potential budgetary impacts of such a system. We conclude that the Military Nursing Outcomes Database did meet the needs of a monitoring system that is sensitive to changes over time in outcomes, provides interpretable data for nurse leaders, and could result in cost benefits and patient care improvements in organizations.

[Girls from Santa Catarina: losing your life to become a mother].

PubMed

de Souza, Maria de Lourdes; Burgardt, Diego; Ferreira, Luiz Alberto Peregrino; Bub, Maria Bettina Camargo; Monticelli, Marisa; Lentz, Haimée Emerich

2010-06-01

The Maternal Mortality Ratio (MMR) is an indicator that analyses the life conditions and care given to pregnant women, and indicates whether the constitutional rights related to life and health are being complied with. This study shows losses of lives among adolescent women associated with pregnancy, childbirth and the puerperal period, in the state of Santa Catarina between 1994 and 2005. It is an exploratory study of a quantitative nature. There were 72 maternal deaths in adolescents, 67% had a direct obstetric cause, 23% had an indirect obstetric cause and about 9% were classified as accidental or incidental. The Maternal Mortality Ratio in adolescents was high and most could have been prevented and its causes controlled. The identified situation shows an absence of quality health care. To reduce these deaths it is central that nursing action be combined with other professionals and other organized sectors of society.

Advancing the nursing profession begins with leadership.

PubMed

O'Neill, Jennifer A

2013-04-01

This bimonthly department, sponsored by the American Organization of Nurse Executives (AONE), presents information to assist nurse leaders in shaping the future of healthcare through creative and innovative leadership. The strategic priorities of AONE anchor the editorial content. They reflect contemporary healthcare and nursing practice issues that challenge nurse executives as they strive to meet the needs of patients.

Medicaid Reimbursement for School Nursing Services: A Position Paper of the National Association of State School Nurse Consultants.

ERIC Educational Resources Information Center

Journal of School Health, 1996

1996-01-01

This statement of the National Association of State School Nurse Consultants lists those school nursing services and procedures the organization believes should be reimbursable by Medicaid to school districts. Identified services are in the areas of case finding, nursing care procedures, care coordination, patient/student counseling, and emergency…

Evaluation of organizational support for use of online information resources in nursing care.

PubMed

Kahouei, Mehdi; Ahmadi, Zahra; Kazemzadeh, Farzaneh

2014-12-01

While there is general agreement concerning the barriers to use online information resources in nursing decisions, there have not been any studies that demonstrate how healthcare organizations have overcome these obstacles in developing countries. The purpose of this present study was to evaluate organizational support of healthcare organizations after introducing information technology for the use of online information resources in nursing care. This study was performed on nurses and nursing students in hospitals affiliated to the Semnan University of Medical Sciences, Iran. The findings showed that the use of online information resources was not adequately supported by healthcare social networks and the role of leadership has received minimal attention. There appears to be little confidence in the usefulness of evidence-based practice (EBP) in nursing care in Iranian society. The development of organizational norms for EBP behavior within an organization is important, and in order to monitor the development of these behaviors, the cultural competence in the healthcare institutions should be assessed and measured. However, it is far more difficult to develop a robust design, which encompasses the implementation of EBP across an entire organization. Such studies are highly complex and would need to be adapted as the organization changed, in addition, they would be likely to take considerable time to complete. Nevertheless, such studies are essential if a full understanding of organizational approaches to promoting EBP in developing countries is to occur. © 2014 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

The American Organization of Nurse Executives and American Hospital Association Initiatives Work to Combat Violence.

PubMed

Wray, Karen

2018-04-01

Violence affecting healthcare workers and healthcare organizations continues to be a serious safety issue. In this Leadership Perspectives column, Karen Wray, an American Organization of Nurse Executives (AONE) member who has experienced a mass causality incident 1st hand, outlines AONE's continuing work to promote safety and combat violence. She discusses recent work on violence issues by the American Hospital Association, AONE's parent organization.

Job Demand and Job Satisfaction in Latent Groups of Turnover Intention Among Licensed Nurses in Taiwan Nursing Homes.

PubMed

Chen, I-Hui; Brown, Roger; Bowers, Barbara J; Chang, Wen-Yin

2015-10-01

Nurses' turnover intention is not dichotomous; it may reflect intent to leave the profession, intent to leave a type of facility, or intent to leave a specific workplace. In a latent class analysis (LCA) of data from 186 licensed nurses (RNs and LPNs) recruited from 25 nursing homes (NHs) in Taiwan, we classified nurses into turnover intention subgroups based on seven questionnaire items and used a multilevel contrast analysis to characterize the subgroups according to demographic and facility factors, job demand, and job satisfaction. A multilevel probit model was used to examine how job demand and job satisfaction influenced subgroup membership. Three turnover subgroups were identified: high turnover intention (12%), middle turnover intention (57%), and low turnover intention (31%). The high turnover intention subgroup comprised the youngest nurses and had the lowest percentage of registered nurses (RNs); nurses in this subgroup had worked the longest at the current NH and had the greatest likelihood of working at a for-profit facility. Nurses in the middle turnover intention subgroup had the lowest likelihood of working at a for-profit facility. Nurses in the low turnover intention subgroup were primarily RNs and had the shortest work experience in the current facility. Nurses in the high and middle turnover intention subgroups reported lower intrinsic job satisfaction than those with low turnover intention. Extrinsic job satisfaction mediated the relationship between job demand and turnover intention subgroup assignment. The results of this LCA can help target interventions to address heterogeneity of turnover intention and ultimately lessen turnover. © 2015 Wiley Periodicals, Inc.

Marketing in nursing organizations.

PubMed

Chambers, S B

1989-05-01

The purpose of chapter 3 is to provide a conceptual framework for understanding marketing. Although it is often considered to be, marketing is not really a new activity for nursing organizations. What is perhaps new to most nursing organizations is the conduct of marketing activities as a series of interrelated events that are part of a strategic marketing process. The increasingly volatile nursing environment requires a comprehensive approach to marketing. This chapter presents definitions of marketing, the marketing mix, the characteristics of nonprofit marketing, the relationship of strategic planning and strategic marketing, portfolio analysis, and a detailed description of the strategic marketing process. While this chapter focuses on marketing concepts, essential components, and presentation of the strategic marketing process, chapter 4 presents specific methods and techniques for implementing the strategic marketing process.

One hundred years and still counting: the story of NEF--yesterday, today, and tomorrow.

PubMed

Bowar-Ferres, Susan L; Fitzpatrick, M Louise; McClure, Margaret L

2014-01-01

Nurses Educational Funds, Inc (NEF) is the oldest and largest professionally endorsed source of funds for advanced study in nursing, which celebrated its Centennial in 2012. This philanthropic nonprofit organization is notable for its roots; NEF was organized by nurses specifically for nurses. Its history dates back to 1912, when it began in memory of Isabel Hampton Robb at Teacher's College, where the first graduate nursing education programs began. The initial Robb Memorial Fund was incorporated as a nonprofit organization in 1941 and officially became Nursing Educational Funds, Inc, in 1954. The NEF's sole mission is to raise money and give it for graduate-level scholarships in nursing education, service, practice, and research. Since its origin, more than 1000 doctoral and master's students from a broad array of schools across the nation have been recipients of awards. The NEF Board is a totally volunteer, highly dedicated group of nursing, business, and other professional leaders, who are steadfastly committed to this critical effort. Scholarships for graduate nursing education are imperative to meet the need to grow the pipeline of faculty. As charged by the 2010 Institute of Medicine report, the goal to increase the number of baccalaureate nurses to 80% of the workforce and to double the number of nurses with doctoral degrees both by 2020 speak to the heart of NEF. Funds raised currently are largely from Board members, individual donors, modest foundational support, and a number of bequests. As the nursing population grows older, the potential for bequests or planned giving becomes a realistic goal. Former NEF scholars have not unfortunately been a financial source, although pay back is an expectation. Nurses are the best ones to tell this compelling story to corporations and foundations as NEF continues to persist in the commitment to support graduate nursing education.

A taxonomy of nursing care organization models in hospitals

PubMed Central

2012-01-01

Background Over the last decades, converging forces in hospital care, including cost-containment policies, rising healthcare demands and nursing shortages, have driven the search for new operational models of nursing care delivery that maximize the use of available nursing resources while ensuring safe, high-quality care. Little is known, however, about the distinctive features of these emergent nursing care models. This article contributes to filling this gap by presenting a theoretically and empirically grounded taxonomy of nursing care organization models in the context of acute care units in Quebec and comparing their distinctive features. Methods This study was based on a survey of 22 medical units in 11 acute care facilities in Quebec. Data collection methods included questionnaire, interviews, focus groups and administrative data census. The analytical procedures consisted of first generating unit profiles based on qualitative and quantitative data collected at the unit level, then applying hierarchical cluster analysis to the units’ profile data. Results The study identified four models of nursing care organization: two professional models that draw mainly on registered nurses as professionals to deliver nursing services and reflect stronger support to nurses’ professional practice, and two functional models that draw more significantly on licensed practical nurses (LPNs) and assistive staff (orderlies) to deliver nursing services and are characterized by registered nurses’ perceptions that the practice environment is less supportive of their professional work. Conclusions This study showed that medical units in acute care hospitals exhibit diverse staff mixes, patterns of skill use, work environment design, and support for innovation. The four models reflect not only distinct approaches to dealing with the numerous constraints in the nursing care environment, but also different degrees of approximations to an “ideal” nursing professional practice model described by some leaders in the contemporary nursing literature. While the two professional models appear closer to this ideal, the two functional models are farther removed. PMID:22929127

Politics of change: the discourses that inform organizational change and their capacity to silence.

PubMed

McMillan, Kim

2016-09-01

Changes in healthcare organizations are inevitable and occurring at unprecedented rates. Such changes greatly impact nurses and their work, yet these experiences are rarely explored. Organizational change discourses remain grounded in perspectives that explore and explain systems, often not the people within them. Change processes in healthcare organizations informed by such organizational discourses validate only certain perspectives and forms of knowledge. This fosters exclusionary practices, limiting the capacity of certain individuals or groups of individuals to effectively contribute to change discourses and processes. The reliance on mainstream organizational discourses in healthcare organizations has left little room for the exploration of diverse perspectives on the subject of organizational change, particularly those of nurses. Michel Foucault's work challenges dominant discourse and suggest that strong reliance's on specific discourses effectively disqualify certain forms of knowledge. Foucault's writings on disqualified knowledge and parrhesia (truth telling and frank speech) facilitate the critical exploration of discourses that inform change in healthcare organizations and nurses capacities to contribute to organizational discourses. This paper explores the capacity of nurses to speak their truths within rapidly and continuously changing healthcare organizations when such changes are often driven by discourses not derived from nursing knowledge or experience. © 2016 John Wiley & Sons Ltd.

[Differentiation between moisture lesions and pressure ulcers using photographs in a critical area].

PubMed

Valls-Matarín, Josefa; Del Cotillo-Fuente, Mercedes; Pujol-Vila, María; Ribal-Prior, Rosa; Sandalinas-Mulero, Inmaculada

2016-01-01

To identify difficulties for nurses in differentiating between moisture lesions and pressure ulcers, proper classification of pressure ulcers to assess the adequate classification of the Grupo Nacional para el Estudio y Asesoramiento de Úlceras por Presión y Heridas Crónicas (GNEAUPP) and the degree of agreement in the correct assessment by type and category of injury. Cross-sectional study in a critical area during 2014. All nurses who agreed to participate were included. They performed a questionnaire with 14 photographs validated by experts of moisture lesions or pressure ulcers in the sacral area and buttocks, with 6 possible answers: Pressure ulcer category I, II, III, IV, moisture lesions and unknown. Demographics and knowledge of the classification system of the pressure ulcers were collected according to GNEAUPP. It involved 98% of the population (n=56); 98.2% knew the classification system of the GNEAUPP; 35.2% of moisture lesions were considered as pressure ulcers, most of them as a category II (18.9%). The 14.8% of the pressure ulcers photographs were identified as moisture lesions and 16.1% were classified in another category. The agreement between nurses earned a global Kappa index of .38 (95% CI: .29-.57). There are difficulties differentiating between pressure ulcers and moisture lesions, especially within initial categories. Nurses have the perception they know the pressure ulcers classification, but they do not classify them correctly. The degree of concordance in the diagnosis of skin lesions was low. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

The global nursing shortage: an overview of issues and actions.

PubMed

Oulton, Judith A

2006-08-01

Today's global nursing shortage is having an adverse impact on health systems around the world. A major initiative by the International Council of Nurses (ICN) yielded important information regarding the shortage and solutions to it. These are organized into five priority areas: policy intervention; macroeconomics and health sector funding; workforce planning and policy, including regulation; positive practice environments; and retention and recruitment (includes migration); and nursing leadership. Internationally momentum is building, providing the opportunity to bring attention to these issues and to take action. This article presents an overview of the global nursing shortage (which, since 2002, has been termed a global crisis), provides the perspectives of the ICN, and discusses the ICN's initiatives regarding that crisis. Founded in 1899, the ICN is the world's first and largest organization for health professionals. As a federation of national nurses' associations in 129 countries, ICN represents the more than 13 million nurses working worldwide. It works to ensure quality nursing care for all, sound health policies globally, the advancement of nursing knowledge, and the presence worldwide of a respected, competent professional workforce.

The role of the charge nurse manager: a descriptive exploratory study.

PubMed

McCallin, A M; Frankson, C

2010-04-01

To explore the charge nurse manager role. Management in nursing is increasingly challenging. Restructuring of organizations has had an impact on the scope of the charge nurse manager role that has expanded so that managers are now expected to be leaders. If role preparation is inadequate, potential for role confusion and role stress increases, undermining role effectiveness in this key senior nursing position. This descriptive exploratory study investigated the experiences of charge nurse managers. Twelve nurse managers from an acute care hospital in New Zealand were interviewed. Data were analysed thematically. Three themes, role ambiguity, business management deficit and role overload emerged. It was evident that charge nurse managers were appointed into a management role with clinical expertise but without management skills. Findings suggest that role preparation should include postgraduate education and business management training. Role induction requires a formal organizational management trainee programme and ongoing supportive clinical supervision. New approaches to charge nurse manager role development are needed. Organizations must provide formal structural support to facilitate management development. The profession needs to promote succession planning that would reduce these longstanding problems.

Immigration policy and internationally educated nurses in the United States: A brief history.

PubMed

Masselink, Leah E; Jones, Cheryl B

2014-01-01

Since the 1980s, U.S. policy makers have used immigration policy to influence the supply of nurses by allowing or restricting the entry of internationally educated nurses (IENs) into the U.S. workforce. The methods pursued have shifted over time from temporary visa categories in the 1980s and 1990s to permanent immigrant visas in the 2000s. The impact of policy measures adopted during nursing shortages has often been blunted by political and economic events, but the number and representation of IENs in the U.S. nursing workforce has increased substantially since the 1980s. Even as the United States seeks to increase domestic production of nurses, it remains a desirable destination for IENs and a target market for nurse-producing source countries. Hiring organizations and nurse leaders play a critical role in ensuring that the hiring and integration of IENs into U.S. health care organizations is constructive for nurses, source countries, and the U.S. health care system. Copyright © 2014 Elsevier Inc. All rights reserved.

Evolving safety practices in the setting of modern complex operating room: role of nurses.

PubMed

Niu, L; Li, H Y; Tang, W; Gong, S; Zhang, L J

2017-01-01

Operating room (OR) nursing previously referred to patient care provided during the intra-operative phase and the service provided within the OR itself. With the expansion of responsibilities of nurses, OR nursing now includes pre-operative and post-operative periods, therefore peri-operative nursing is accepted as a nursing process in OR in the contemporary medical literature. Peri-operative nurses provide care to the surgical patients during the entire process of surgery. They have several roles including those of manager or a director, clinical practitioner (scrub nurse, circulating nurse and nurse anesthetist), educator as well as researcher. Although, utmost priority is placed on insuring patient safety and well-being, they are also expected to participate in professional organization, continuing medical education programs and participating in research activities. A Surgical Patient Safety Checklist formulated by the World Health Organization serves as a major guideline to all activities in OR, and peri-operative nurses are key personnel in its implementation. Communication among the various players of a procedure in OR is key to successful patient outcome, and peri-operative nurses have a central role in making it happen. Setting up of OR in military conflict zones or places that suffering a widespread natural disaster poses a unique challenge to nursing. This review discusses all aspects of peri-operative nursing and suggests points of improvement in patient care.

Design, Development, and Psychometric Analysis of a General, Organic, and Biological Chemistry Topic Inventory Based on the Identified Main Chemistry Topics Relevant to Nursing Clinical Practice

ERIC Educational Resources Information Center

Brown, Corina E.

2013-01-01

This two-stage study focused on the undergraduate nursing course that covers topics in general, organic, and biological (GOB) chemistry. In the first stage, the central objective was to identify the main concepts of GOB chemistry relevant to the clinical practice of nursing. The collection of data was based on open-ended interviews of both nursing…

Quality pain management outcomes: the power of place.

PubMed

Wild, L R; Mitchell, P H

2000-01-01

This study explores how an organization, as the context of care, influences nursing practice and a nursing-sensitive, quality health outcome-pain management. The results provide important insights into organizational patterns associated with favorable pain management-related outcomes as well as the congruence between and among subunits within the organization. Outcomes were most favorable on units where nurses had attitudes supportive of aggressive pain management and higher levels of coordination and discretion.

Nursing Professional Development Organizational Value Demonstration Project.

PubMed

Harper, Mary G; Aucoin, Julia; Warren, Joan I

2016-01-01

A common question nursing professional development (NPD) practitioners ask is, "How many NPD practitioners should my organization have?" This study examined correlations among facility size and structure, NPD practitioner characteristics and time in service, and organizational outcomes. Organizations with a higher rate of NPD full-time equivalents per bed had higher patient satisfaction with nurses' communication and provision of discharge instruction on their HCAHPS (Hospital Consumer Assessment of Healthcare Provider and Systems) scores.

Longitudinal Study Transformed Onboarding Nurse Graduates.

PubMed

Slate, Kimberly A; Stavarski, Debra H; Romig, Barbara J; Thacker, Karen S

The outcomes of a longitudinal research study on a nurse residency program indicated improvement in the onboarding experience for new graduate nurses. Practice changes and implications for nursing professional development practitioners resulting from the study include the number and orientation of preceptors, program length standardization, and improvement of emergency clinical response education. Additional research studies were implemented to further explore issues novice nurses and their proficient registered nurse colleagues experience throughout the organization.

Nursing home case mix in Wisconsin. Findings and policy implications.

PubMed

Arling, G; Zimmerman, D; Updike, L

1989-02-01

Along with many other states, Wisconsin is considering a case mix approach to Medicaid nursing home reimbursement. To support this effort, a nursing home case mix model was developed from a representative sample of 410 Medicaid nursing home residents from 56 facilities in Wisconsin. The model classified residents into mutually exclusive groups that were homogeneous in their use of direct care resources, i.e., minutes of direct care time (weighted for nurse skill level) over a 7-day period. Groups were defined initially by intense, Special, or Routine nursing requirements. Within these nursing requirement categories, subgroups were formed by the presence/absence of behavioral problems and dependency in activities of daily living (ADL). Wisconsin's current Skilled/Intermediate Care (SNF/ICF) classification system was analyzed in light of the case mix model and found to be less effective in distinguishing residents by resource use. The case mix model accounted for 48% of the variance in resource use, whereas the SNF/ICF classification system explained 22%. Comparisons were drawn with nursing home case mix models in New York State (RUG-II) and Minnesota. Despite progress in the study of nursing home case mix and its application to reimbursement reform, methodologic and policy issues remain. These include the differing operational definitions for nursing requirements and ADL dependency, the inconsistency in findings concerning psychobehavioral problems, and the problem of promoting positive health and functional outcomes based on models that may be insensitive to change in resident conditions over time.

Nursing journal clubs and the clinical nurse specialist.

PubMed

Westlake, Cheryl; Albert, Nancy M; Rice, Karen L; Bautista, Cynthia; Close, Jackie; Foster, Jan; Timmerman, Gayle M

2015-01-01

The purpose of this article was to describe the clinical nurse specialist's role in developing and implementing a journal club. Tools for critiquing clinical and research articles with an application of each are provided. The journal club provides a forum through which nurses maintain their knowledge base about clinically relevant topics and developments in their specific clinical discipline, analyze and synthesize the relevant scientific literature as evidence, and engage in informal discussions about evidence-based and best practices. The value of journal clubs includes nursing staff education, review of and support for evidence-based practice, promotion of nursing research, and fostering of organization-wide nursing practice changes. The process for establishing a journal club and suggested appraisal tools are discussed. In addition, strategies for overcoming barriers to the implementation of a journal club are outlined. Suggested article review questions and a reporting format for clinical and research articles are provided with examples from 2 articles. Finally, a glossary of terms commonly used by research scientists and manuscript writers are listed and additional resources provided. The clinical nurse specialist's role in developing and implementing a journal club will be facilitated through the use of this article. Enhanced nursing staff education, evidence-based practice, organization-wide nursing practice changes, and nursing research may be conducted following the implementation of a nursing journal club.

[Essential data set's archetypes for nursing care of endometriosis patients].

PubMed

Spigolon, Dandara Novakowski; Moro, Claudia Maria Cabral

2012-12-01

This study aimed to develop an Essential Data Set for Nursing Care of Patients with Endometriosis (CDEEPE), represented by archetypes. An exploratory applied research with specialists' participation that was carried out at Heath Informatics Laboratory of PUCPR, between February and November of 2010. It was divided in two stages: CDEEPE construction and evaluation including Nursing Process phases and Basic Human Needs, and archetypes development based on this data set. CDEEPE was evaluated by doctors and nurses with 95.9% of consensus and containing 51 data items. The archetype "Perception of Organs and Senses" was created to represents this data set. This study allowed identifying important information for nursing practices contributing to computerization and application of nursing process during care. The CDEEPE was the basis for archetype creation, that will make possible structured, organized, efficient, interoperable, and semantics records.

[Nurse's concept in the managerial conception of a basic health unit].

PubMed

Passos, Joanir Pereira; Ciosak, Suely Itsuko

2006-12-01

This study is part of a larger survey called "Use of indicators in nurses' managerial practice in Basic Health Care Units in the city of Rio de Janeiro", which was carried out in the Basic Health Care Units of the Planning Area 5.3 and whose objectives were to identify nurses' conception regarding the tools required for management in those units and to discuss the role of management in organizing health services. The study is descriptive and data were collected in interviews with seven nurse managers. The results show that health services actions are organized and directed to the purpose of the working process through the relationship established between the object, the instruments and the final product, and that for those nurses the end result to be achieved is client's satisfaction and the quality of medical and nursing care.

[Nurses and Organizational Citizenship Behavior: contribution to the Italian validation of the Podsakoff et al. scale].

PubMed

Zaghini, F; Biagioli, Valentina; Prandi, Cesarina; Fida, Roberta; Sili, A

2015-11-22

Workers engaging in Organizational Citizenship Behaviour (OCB) can benefit colleagues, organization and stakeholders. Such behavior is vital to the efficacy of health care organizations as they can have a positive effect on the quality of care and users' satisfaction. Therefore, it is important to assess such behaviour with a valid and reliable instrument. The purpose of this study was to test, from a confirmatory perspective, the dimensionality of the Italian version of the Podsakoff et al. OCB scale in a large sample of nurses, and at the same time to evaluate the differences in nurses' OCB considering socio-demographic and job characteristics. The study included 886 nurses from different health organizations in Italy. The psychometric characteristics of the Italian OCB scale were tested through confirmatory factor analysis (CFA). The differences in nurses' OCB, according to several socio-demographic and job characteristics, were evaluated through a series of correlations and analysis of variance. The CFA of the Italian OCB scale confirmed the hypothesized factor structure, consisting of three dimensions: altruism, civic virtue and conscientiousness. Nurses' gender and professional training were positively correlated with OCB, while the amount of extra work was negatively correlated. In regard to clinical work settings, palliative care nurses engaged in OCB more than nurses working in other areas. The Italian OCB scale is a valid and reliable instrument. Its use can support all individuals involved in the promotion of workers' organizational well-being in implementing processes aimed at fostering nurses' OCB.

Measuring Nursing Care Time and Tasks in Long-Term Services and Supports: One Size Does Not Fit All

PubMed Central

Sochalski, Julie A.; Foust, Janice B.; Zubritsky, Cynthia D.; Hirschman, Karen B.; Abbott, Katherine M.; Naylor, Mary D.

2015-01-01

Background Although nursing care personnel comprise the majority of staff in long-term care services and supports (LTSS), a method for measuring the provision of nursing care has not yet been developed. Purpose/Methods We sought to understand the challenges of measuring nursing care across different types of LTSS using a qualitative approach that included the triangulation of data from three unique sources. Results Six primary challenges to measuring nursing care across LTSS emerged: level of detail about time of day, amount of time, or type of tasks varied by type of nursing and organization; time and tasks were documented in clinical records and administrative databases; data existed both on paper and electronically; several sources of information were needed to create the fullest picture of nursing care; data was inconsistently available for contracted providers; documentation of informal caregiving was unavailable. Differences were observed for assisted living facilities and home and community based services compared to nursing homes and across organizations within a setting. A commonality across settings and organizations was the availability of an electronically stored care plan specifying individual needs but not necessarily how these would be met. Conclusions The findings demonstrate the variability of data availability and specificity across three distinct LTSS settings. This study is an initial step toward establishing a process for measuring the provision of nursing care across LTSS to be able to explore the range of nursing care needs of LTSS recipients and how these needs are fulfilled. PMID:22902975

Factors Associated With Medical and Nursing Students' Willingness to Donate Organs.

PubMed

Tumin, Makmor; Tafran, Khaled; Tang, Li Yoong; Chong, Mei Chan; Mohd Jaafar, Noor Ismawati; Mohd Satar, NurulHuda; Abdullah, Nurhidayah

2016-03-01

Malaysia suffers from a chronic shortage of human organs for transplantation. Medical and nursing students (MaNS) are future health professionals and thus their attitude toward organ donation is vital for driving national donation rates. This study investigates MaNS' willingness to donate organs upon death and the factors influencing their willingness. A cross-sectional design was used with a sample of 500 students (264 medical and 236 nursing) at the University of Malaya. A self-administrated questionnaire was used. The responses were analyzed by using descriptive statistics and multiple logistic regression. Of all respondents, 278 (55.6%) were willing to donate organs upon death, while the remaining 222 (44.4%) were unwilling to donate. Only 44 (8.8%) had donor cards. The multiple logistic regression revealed that the minorities ethnic group was more willing to donate organs than Malay respondents (adjusted odds ratio [aOR] = 1.98, P = 0.010). In addition, medical students were more willing to donate than nursing students (aOR = 2.53, P = 0.000). Respondents who have a family member with a donor card were more willing to donate than respondents who do not (aOR = 3.48, P = 0.006). MaNS who believed that their religion permits deceased donation were more willing to donate than their counterparts (aOR = 4.96, P = 0.000). Household income and sex were not significant predictors of MaNS' willingness to donate organs upon death. MaNS have moderate willingness, but low commitment toward deceased organ donation. Strategies for improving MaNS' attitude should better educate them on organ donation, targeting the most the Malay and nursing students, and should consider the influence of family attitude and religious permissibility on MaNS' willingness.

Factors Associated With Medical and Nursing Students’ Willingness to Donate Organs

PubMed Central

Tumin, Makmor; Tafran, Khaled; Tang, Li Yoong; Chong, Mei Chan; Mohd Jaafar, Noor Ismawati; Mohd Satar, NurulHuda; Abdullah, Nurhidayah

2016-01-01

Abstract Malaysia suffers from a chronic shortage of human organs for transplantation. Medical and nursing students (MaNS) are future health professionals and thus their attitude toward organ donation is vital for driving national donation rates. This study investigates MaNS’ willingness to donate organs upon death and the factors influencing their willingness. A cross-sectional design was used with a sample of 500 students (264 medical and 236 nursing) at the University of Malaya. A self-administrated questionnaire was used. The responses were analyzed by using descriptive statistics and multiple logistic regression. Of all respondents, 278 (55.6%) were willing to donate organs upon death, while the remaining 222 (44.4%) were unwilling to donate. Only 44 (8.8%) had donor cards. The multiple logistic regression revealed that the minorities ethnic group was more willing to donate organs than Malay respondents (adjusted odds ratio [aOR] = 1.98, P = 0.010). In addition, medical students were more willing to donate than nursing students (aOR = 2.53, P = 0.000). Respondents who have a family member with a donor card were more willing to donate than respondents who do not (aOR = 3.48, P = 0.006). MaNS who believed that their religion permits deceased donation were more willing to donate than their counterparts (aOR = 4.96, P = 0.000). Household income and sex were not significant predictors of MaNS’ willingness to donate organs upon death. MaNS have moderate willingness, but low commitment toward deceased organ donation. Strategies for improving MaNS’ attitude should better educate them on organ donation, targeting the most the Malay and nursing students, and should consider the influence of family attitude and religious permissibility on MaNS’ willingness. PMID:27015207

Experiential learning not enough for organ procurement surgery: implications for perioperative nursing education.

PubMed

Smith, Zaneta; Leslie, Gavin; Wynaden, Dianne

2015-12-01

Perioperative nurses play a vital role in assisting in surgical procedures for multiorgan procurement, receiving little education apart from on-the-job experiential learning when they are asked to participate in these procedures. Within an Australian context and as part of a larger study, this article describes issues that hindered perioperative nurses' participatory experiences as a result of lacking education, previous exposure, and preparation for assisting in surgical procedures for organ procurement. The grounded theory method was used to develop a substantive theory of perioperative nurses' experiences of participating in surgical procedures for multiorgan procurement. Thirty-five perioperative nurses who had experience in surgical procedures for organ procurement from regional, rural, and metropolitan hospitals of 2 Australian states, New South Wales and Western Australia, participated in the research. Levels of knowledge and experience emerged from the data as an influencing condition and was reported to affect the perioperative nurses' participatory experiences when assisting in procurement surgical procedures. Six components of levels of knowledge and experience were identified and are described. The findings from this study provide a unique contribution to the existing literature by providing an in-depth understanding of the educational needs of perioperative nurses in order to assist successfully in multiorgan procurement procedures. These findings could guide further research with implications for clinical initiatives or education programs specifically targeting the perioperative nursing profession both locally and internationally.

Rapid environmental contamination of a new nursing home with antimicrobial-resistant organisms preceding occupation by residents.

PubMed

Ludden, C; Cormican, M; Austin, B; Morris, D

2013-04-01

Nursing homes are reservoirs for antimicrobial-resistant organisms (AROs). This study examined the time to environmental contamination with AROs in a new-build nursing home. Environmental sites in an occupied nursing home (N = 18) and a newly built replacement nursing home (N = 21) were monitored during an 11-week period before and after residents transferred between buildings. Meticillin-resistant Staphylococcus aureus was detected during commissioning in the new building and was a frequent finding throughout the building after residents had moved in. Extended-spectrum beta-lactamase-producing E. coli O25b:ST131 was detected once. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Nursing and philanthropy: a partnership to advance professional excellence and exceptional care.

PubMed

Janney, Michelle A

2014-01-01

Michelle A. Janney, PhD, RN, NEA-BC, 2013 AONE President, Senior Vice President, and Wood-Prince Family Chief Nurse Executive at Northwestern Memorial Hospital, discusses the impact of engaging institutional leadership in nursing philanthropic and strategic priorities and the importance of developing a culture of philanthropy that permeates the organization and encourages participation from all levels. The article highlights key outcomes of Northwestern Memorial Hospital's collective efforts to build a culture of philanthropy that prioritizes nursing as consequential to the mission of the organization. The outcomes demonstrate how such a culture provides a critical platform for creating opportunities that enable nurses to be indispensable partners in a shared commitment to the highest-quality, scientifically driven, personalized care.

Employee motivation: quality versus business concerns.

PubMed

Gunn, R A; Kazemek, E A

1986-03-01

The traditional factors that influence employee motivation and morale remain important in healthcare organizations. However, the nursing staff tends to be more self-motivated than many employees in other occupations because of values that are intrinsic to the nursing profession. When the humanist values of the nursing profession conflict or compete with business values, erosion of nursing morale and motivation may result with attendant employee "burnout" that undermines the organization's business objectives. There are several steps that both management and nursing educators can take to lessen the cultural conflict and avert motivational breakdowns. The future may teach us that an ideal blend of business and humanist values may result in a situation where good business decisions are good humanist decisions, and vice versa.

Nurses' ethical conflicts in performance of utilization reviews.

PubMed

Bell, Sue Ellen

2003-09-01

This article describes the ethical conflicts that a sample of US nurse utilization reviewers faced in their work, and also each nurse's self-reported ethical orientation that was used to resolve the dilemmas. Data were collected from a sample of 97 registered nurses who were working at least 20 hours per week as utilization reviewers. Respondents were recruited from three managed care organizations that conduct utilization reviews in a large midwestern city. A cross-sectional survey design was used to collect demographic data and to ask closed-response, short-answer and open-ended questions. Ethical conflicts reported by nurses were similar across utilization review settings and many were justice orientated. Self-reported ethical orientations were similar across organizations, with beneficence dominating. Implications of these findings are discussed.

Conflict engagement: workplace dynamics.

PubMed

Gerardi, Debra

2015-04-01

This article is one in a series on conflict. It is part of an ongoing series on leadership coordinated by the American Organization of Nurse Executives (AONE), highlighting topics of interest to nurse managers and emerging nurse leaders. The AONE provides leadership, professional development, advocacy, and research to advance nursing practice and patient care, promote nursing leadership excellence, and shape public policy for health care.

Incivility in nursing: the connection between academia and clinical settings.

PubMed

Luparell, Susan

2011-04-01

Incivility and bullying in nursing are complex problems that have garnered much attention in recent years. Emerging evidence suggests that incivility in the workplace has significant implications for nurses, patients, and health care organizations. Because today's students are tomorrow's colleagues, conversations regarding how to address incivility and bullying should include specific aspects of nursing academia and the preparation of new nurses.

Guide to Camp Nursing: Qualifications, Responsibilities Outlined for the Professional Camp Nurse. Revised.

ERIC Educational Resources Information Center

Auld, Margaret E.; Ehlke, Graceann

This guide was developed to help the nurse in any outdoor setting or organized camp program serving children and youth to: (1) understand the responsibilities of camp nursing; (2) be aware of the nurse's relationships with the camp director and other workers; (3) relate the camp health program to the overall objectives of the camping program; (4)…

The content of the work of clinical nurse specialists described by use of daily activity diaries.

PubMed

Oddsdóttir, Elín Jakobína; Sveinsdóttir, Herdís

2011-05-01

Evaluate the usefulness of the role of clinical nurse specialists and the content of their work by mapping their activities. The clinical work of advanced practice nursing differs in different countries, and a clear picture is lacking on what exactly advanced practice nurses do. Prospective exploratory study. The setting of the study was the largest hospital in Iceland where over half of the country's active nursing workforce are employed, including the only clinical nurse specialists. Of 19 clinical nurse specialists working at the hospital, 15 participated. Data were collected over seven days with a structured activity diary that lists 65 activities, classified into six roles and three domains. In 17 instances, the 'role activities' and 'domain activities' overlap and form 17 categories of practice. The clinical nurse specialists coded their activities at 15-minutes interval and could code up to four activities simultaneously. Daily, the clinical nurse specialists evaluated their clinical nurse specialist background. The roles that occupied the greatest proportion of the clinical nurse specialists' time were education, expert practice and 'other' activities, while the smallest proportions were in counselling, research and practice development. The domain they worked in most was the institutional domain, followed by the client/family domain and the clinical outcome management domain. All of the clinical nurse specialists reported working on two activities simultaneously, 11 of them on three activities and six on four activities. They self-assessed their background as clinical nurse specialists as being very useful. The activity diary is a useful tool for assessing the content of practice. Clinical nurse specialists spend too much time on activities related to the institution. Nurse managers are advised to provide clinical nurse specialists with ample time to develop the direct practice role in the client/family domain. The development of advanced nursing practice requires that clinical nurse specialists take an active and visible part in direct patient care. © 2011 Blackwell Publishing Ltd.

Leadership role of Consultant Nurses working with Older People: a co-operative inquiry.

PubMed

Manley, Kim; Webster, Jonathan; Hale, Nick; Hayes, Nicky; Minardi, Henry

2008-03-01

The aim of the co-operative enquiry undertaken was to explore how the leadership component of the Consultant Nurse for Older People role was reflected in day-to-day working. Leadership is one of the four key elements of the Consultant Nurse role and is the key mechanism for achieving and embedding transformation in practice. However, within the role of the Consultant Nurse this area has not been explored in detail. A 6-month co-operative inquiry approach was used to develop insights into leadership strategies of Consultant Nurses for Older People and involved the five authors of the paper, four Consultant Nurses in Older People nursing and the lead author who was also an experienced Consultant Nurse and practice-based researcher from a different nursing specialism. Through the analysis of the stories shared by the co-authors/participants, two key themes emerged relating to complexity and pathway. These themes provided a major focus for the Consultant Nurses in their leadership role. The outcome of the study is a framework that describes the triggers and enabling factors that precede the use of leadership strategies at the clinical and organizational level and associated outcomes. In defining how leadership is reflected by Consultant Nurses for Older People, a complex picture emerges that is multifaceted and multidimensional. Consultant Nurses need support to make visible the valuable contribution they make to enabling healthcare teams, organizations and work places. Consultant Nurses for Older People are key in ensuring the quality agenda within their organizations as they are well placed to provide leadership at both a strategic and clinical level, while providing influence to operational development. Within the context of the literature this area is under investigated. Understanding how leadership is reflected in the role of Consultant Nurses is complex as Consultant Nurses work across traditional interfaces and between different levels within organizations. Consultant Nurses have been 'challenged' to identify the 'difference' they are making; to do this it is important to understand how leadership (as one element) is reflected in a highly complex, multidimensional role and the links between leadership and enabling, quality person-centred ways of working with Older People within rapidly changing, pressurized healthcare settings.

The relationship between learning organization and organizational commitment among nursing managers in educational hospitals of Isfahan University of Medical Sciences in 2008-9

PubMed Central

Yaghoubi, Maryam; Raeisi, Ahmad Reza; Afshar, Mina; Yarmohammadian, Mohammad Hossein; Hasanzadeh, Akbar; Javadi, Marzi; Ansary, Maryam

2010-01-01

BACKGROUND: Old methods of administrating can’t cover the rapid changes of today. These changes redounded new organizations like learning organizations to be formed. The purpose of this research was to study the relationship between learning organization and organizational commitment among nursing managers. METHODS: This was a descriptive analytic survey. The population of study included 90 nursing managers of 9 educational hospitals. Data gathering was done via learning organizational (LO) and organizational commitment (OC) questionnaires. Data analysis was done using SPSS software. RESULTS: The mean score of LO was 56.9 ± 18.1 among nursing mangers, and the mean score of OC was 62.3 ± 10.1. In general, there was a significant relationship between LO and OC and there was a significant relationship between LO and job experience based on ANOVA test. CONCLUSIONS: In today’s changing environment of very rapid changes which have been seen in different areas of science and technology and the increasing complexity and dynamics of environmental factors, only organizations with active adaptation (dynamic equilibrium) can survive and remain capable of growth. This aim can be fulfilled just in learning organizations. PMID:21589785

Workplace justice and intention to leave the nursing profession.

PubMed

Chin, Weishan; Guo, Yue-Liang Leon; Hung, Yu-Ju; Hsieh, Yueh-Tzu; Wang, Li-Jie; Shiao, Judith Shu-Chu

2017-01-01

Poor psychosocial work environments are considered critical factors of nurses' intention to leave their profession. Workplace injustice has been proven to increase the incidence of psychiatric morbidity among workers. However, few studies have directly investigated the effect of workplace justice on nurses' intention to leave their profession and the population attributable risk among nurses. This study identified factors associated with workplace justice and nurses' intention to leave the profession. A cross-sectional survey was conducted using a self-administered structured questionnaire. Approximately 10% of all secondary referral centers in Taiwan were stratified and randomly sampled. Multiple logistic regression and population attributable risks were preformed to assess the effect of workplace justice on nurses' intention to leave the nursing profession. Ethical considerations: This study was approved by the Research and Ethical Committee of National Taiwan University Hospital. Only nurses who consented to the study participated in the survey. A total of 2268 nurses were recruited, of whom 1417 (62.5%) satisfactorily completed the questionnaire. The participants were classified and 342 (24.1%) of them were placed into the low workplace justice group. Nurses with low workplace justice had a higher intention of leaving the profession (adjusted odds ratio = 1.34, 95% confidence interval = 1.02-1.77). "Employees' opinions are influential in hospital's decision making" and "employees' performance is evaluated fairly" were the most influential factors of the participants' intention to quit. The adjusted population attributable risk was 3.7% for low workplace justice. This study has identified that workplace justice is a protective factor of nurses' leaving their current profession. A fair performance appraisal system and increased autonomy at work are warranted to dissuade nurses from leaving the nursing profession.

Biomarkers: an overview for oncology nurses.

PubMed

Richmond, Ellen S; Dunn, Debra

2012-05-01

To provide an overview of the basic principles of biomarker use in clinical oncology practice and discuss the range of biomarker forms (from genes to constitutional characteristics), biomarker functions (both disease- and drug-related), modalities (protein expression patterns to patient history), the criteria for biomarker validation, and the integral role of bioinformatics. Published nursing and medical literature. The premise of nursing assessment is the same as that of biomarker use - biological variables that appear at one level of biological organization (eg, molecule, organelle, cell, tissue, organ, and organism) correspond to processes or events occurring at other levels of biologic organization. The advent of genomic technologies has logarithmically increased the volume of biomarkers, which are expected to provide new insights that improve patient care. Nurses and patients will benefit greatly from the incorporation of molecular biomarkers into patient care. Nurses will be able to better assess (and anticipate) patient needs with the new insights that are available in the post-genomic, personalized medicine era of health care. Although the rapid rate of technological changes and new discoveries will require continuing concerted educational efforts, the improved quality of patient care will be rewarded by better outcomes. Published by Elsevier Inc.

[Analysis of cost and efficiency of a medical nursing unit using time-driven activity-based costing].

PubMed

Lim, Ji Young; Kim, Mi Ja; Park, Chang Gi

2011-08-01

Time-driven activity-based costing was applied to analyze the nursing activity cost and efficiency of a medical unit. Data were collected at a medical unit of a general hospital. Nursing activities were measured using a nursing activities inventory and classified as 6 domains using Easley-Storfjell Instrument. Descriptive statistics were used to identify general characteristics of the unit, nursing activities and activity time, and stochastic frontier model was adopted to estimate true activity time. The average efficiency of the medical unit using theoretical resource capacity was 77%, however the efficiency using practical resource capacity was 96%. According to these results, the portion of non-added value time was estimated 23% and 4% each. The sums of total nursing activity costs were estimated 109,860,977 won in traditional activity-based costing and 84,427,126 won in time-driven activity-based costing. The difference in the two cost calculating methods was 25,433,851 won. These results indicate that the time-driven activity-based costing provides useful and more realistic information about the efficiency of unit operation compared to traditional activity-based costing. So time-driven activity-based costing is recommended as a performance evaluation framework for nursing departments based on cost management.

A State Nurses' Association Perspective.

ERIC Educational Resources Information Center

Boyer, Cheryl M.

1983-01-01

Discusses the accreditation and evolution of continuing education programs developed by state nurses' associations and other nursing organizations and the value of the accreditation. Also relates current accreditation system to the future of professional continuing education. (JOW)

Longitudinal analysis of personal and work-related factors associated with turnover among nurses.

PubMed

Estryn-Behar, Madeleine; van der Heijden, Beatrice I J M; Fry, Clementine; Hasselhorn, Hans-Martin

2010-01-01

Although many scholars have acknowledged the relationship between personal and work-related factors associated with job search and actual turnover, there is a lack of longitudinal designs that test this relationship empirically. This longitudinal study examines specific determinant factors that differentiate between so-called "stayers" and "leavers" within the nursing profession and identifies risk factors for premature leaving by comparing nurses who have left their job or the nursing profession with nurses who stay. This cross-national exploratory European survey included 34,587 nurses (baseline measurement) working in 623 hospitals, nursing homes, and home care institutions and was composed of two measurements with a 1-year time interval. The final samples for the follow-up measurement included 14,016 stayers and 866 leavers. As regards the leavers, the participating nurses were asked to indicate to what extent personal and work-related factors had contributed to the decision to leave their healthcare institution. Nurses' intent-to-leave scores were higher in the baseline measurement among those who left the organization during the following 12 months than those among nurses who stayed (24.0% vs. 13.5%). A majority of nurses (86.8%) left their profession voluntarily. Involuntary departure occurred more often in Eastern European countries. Nurses indicated that the reasons for leaving were (a) working conditions (e.g., relationship problems, emotional difficulties, time pressure and quality of care, dissatisfaction with use of one's competence and lack of autonomy, work schedule difficulties, and dissatisfaction with pay) and (b) family reasons (e.g., caring for relatives). For a considerable number of nurses, health reasons and the desire for continuing education added to their decision to leave. Healthcare organizations should pay attention to preventive measures to protect labor market potential. Recommendations are made for human resource development in healthcare organizations and for further empirical research to better understand to what extent different policy systems across the European countries explain variance in outcomes.

A nursing career lattice pilot program to promote racial/ethnic diversity in the nursing workforce.

PubMed

Sporing, Eileen; Avalon, Earlene; Brostoff, Marcie

2012-03-01

The nursing career lattice program (NCLP) at Children's Hospital Boston has provided employees with social, educational, and financial assistance as they begin or advance their nursing careers. At the conclusion of a pilot phase, 35% of employees in the NCLP were enrolled in nursing school and 15% completed nursing school. The NCLP exemplifies how a workforce diversity initiative can lead to outcomes that support and sustain a culture rich in diversity and perpetuate excellence in nursing in one organization.

Noise Levels in Patient Rooms and at Nursing Stations at Three VA Medical Centers.

PubMed

Hill, Jennifer N; LaVela, Sherri L

2015-01-01

To conduct an assessment of sound, dB(A) levels, in two areas of the hospital: patient rooms and nurse stations using sound meters (SMs). The World Health Organization (WHO) recommends sound levels of 35 dB(A) during the day and 30 dB(A) during the night; however, many hospitals exceed these recommended levels. Assessing post-occupancy sound levels enables hospital administrators and healthcare workers to identify whether interventions to improve sound levels are needed. Sound assessments were conducted at three healthcare facilities in both patient rooms and nursing stations, and we include information on facility characteristics. An Amprobe SM-20A Sound Level Meter was placed for a 24-hr period and recorded decibel levels every 8 min. These sound levels were averaged for each hour for reporting purposes. Averages as well as highest and lowest readings are reported for both daytime (8 a.m.-10 p.m.) and nighttime (10 p.m.-8 a.m.) for each facility. All three sites are considered urban and are classified with the highest complexity level (1a). Average daytime measurements for patient rooms and their corresponding nurses stations were as follows: Site A-63 dB(A)/56 dB(A), Site B-52 dB(A)/55 dB(A), and Site C-42 dB(A)/59 dB(A). Average nighttime measurements for patient rooms and nurses stations were Site A-62 dB(A)/55 dB(A), Site B-48 dB(A)/55 dB(A), and Site C-42 dB(A)/60 dB(A). Our findings, considered independently and collectively, showed that facilities in this study exceeded the WHO-recommended sound levels for patient rooms of 35 dB(A) during daytime and 30 dB(A) during nighttime. Research has reported negative patient outcomes, for example, decreased satisfaction, sleep disturbance, and higher incidence of rehospitalization in patients staying in areas with higher noise levels. © The Author(s) 2015.

[Nursing manpower and solutions in Taiwan].

PubMed

Teng, Su-Wen

2014-04-01

The shortage of nursing manpower is a long-term problem worldwide that affects Taiwan despite this country's internationally admired achievements in terms of its healthcare and national health insurance systems. This article reviews discussions related to the nursing shortage issue published by the World Health Organization, International Council of Nurses, and Taiwan Ministry of Health and Welfare. Next, an overview is given of the nursing workforce profile, causal factors behind the nursing shortage, and demand for and supply of nursing manpower. Finally, problems, resolutions, and expected outcomes for the nursing shortage in Taiwan are analyzed.

A literature review of disaster nursing competencies in Japanese nursing journals.

PubMed

Kako, Mayumi; Mitani, Satoko

2010-01-01

Competencies is an important concept used for assessing health professionals' capability to perform their role. By means of a literature review of Japanese professional journals this paper will investigate the competencies concept, particularly with relation to disaster nursing. The literature research was conducted using the database ichu-shi (ver. 4). All literature is written and published in Japanese and was published between 2001 and 2008. Due to an unfamiliarity of the term 'competencies' in Japanese, the key words were sought while deconstructing the meaning and concepts of 'competencies' into terms more recognisable in the Japanese context. Twelve key words: disaster, capability, education, practice, licensure, ability, function, prevention, response, planning, emergency, and disaster nursing were chosen as being most likely to find literature relevant to the English Language concept of competencies. The searched articles were then written into the disaster nursing competencies review worksheet for analysis. One hundred and twenty articles were found by searching a combination of these key words. Of these articles, those that were not in the context of disaster nursing were eliminated. As a result, 43 articles were chosen as being suitable for analysis of the context. These articles are classified into four themes. These theme groups indicated a foundation for competencies in disaster nursing. The definition of competencies in Japanese nursing journals was quite varied and cannot be easily defined as common disaster nursing competencies. Given the variety of areas and the distinct phases in disaster nursing, as well as the 'what for' and 'who governs', disaster nursing competencies will need its own discussion in order to establish the common competencies internationally.

How Nurse Gender Influences Patient Priority Assignments in U.S. Emergency Departments

PubMed Central

Vigil, Jacob Miguel; Coulombe, Patrick; Alcock, Joe; Stith, Sarah See; Kruger, Eric; Cichowski, Sara

2016-01-01

The goals of this study were to compare whether emergency department (ED) patients’ pain intensity (PI) is measured differently by male and female nurses and to determine whether PI, heart rate (HR) and respiratory rate (RR) we’re used to prioritize patient urgency differently by male and female nurses. The associations between patients’ PI|HR|RR and the Emergency Severity Index (ESI) scores they were assigned by attending nurses were analyzed using a national database of electronic medical records of U.S. Veterans Affairs ED patients from 2008 to 2012. A total of 129,991 patients presenting for emergency care (Mage = 59.5, 92% males) and their triage nurses (n = 774, Mage = 47.5, 18% males) were analyzed, resulting in a total of 359,642 patient/provider interactions. Patients’ PI did not differ by nurse’s gender; however a cross-classified mixed-effects model showed that nurse gender influenced how PI and RR measurements informed the ESI levels that male patients received. Higher PI levels were associated with more urgent (higher priority) ESI levels by female nurses, yet less urgent ESI levels by male nurses. In contrast, male patients with high RR received more urgent ESI levels by male nurses, while nurse gender did not influence ESI assignments for female patients. These findings show that ED patients receive disparate treatment based on inherent characteristics of their triage nurses, and more standardized (e.g., automated) protocols that can account for implicit social factors on healthcare practice for reliably assessing and prioritizing ED patients may be currently warranted. PMID:28187101

Classifying galaxy spectra at 0.5 < z < 1 with self-organizing maps

NASA Astrophysics Data System (ADS)

Rahmani, S.; Teimoorinia, H.; Barmby, P.

2018-05-01

The spectrum of a galaxy contains information about its physical properties. Classifying spectra using templates helps elucidate the nature of a galaxy's energy sources. In this paper, we investigate the use of self-organizing maps in classifying galaxy spectra against templates. We trained semi-supervised self-organizing map networks using a set of templates covering the wavelength range from far ultraviolet to near infrared. The trained networks were used to classify the spectra of a sample of 142 galaxies with 0.5 < z < 1 and the results compared to classifications performed using K-means clustering, a supervised neural network, and chi-squared minimization. Spectra corresponding to quiescent galaxies were more likely to be classified similarly by all methods while starburst spectra showed more variability. Compared to classification using chi-squared minimization or the supervised neural network, the galaxies classed together by the self-organizing map had more similar spectra. The class ordering provided by the one-dimensional self-organizing maps corresponds to an ordering in physical properties, a potentially important feature for the exploration of large datasets.

The work of accident and emergency nurses: Part 2. A & E maxims: making A & E work unique and special.

PubMed

Sbaih, L

1997-04-01

An ethnomethodological study was undertaken to explore the work of Accident and Emergency (A & E) nurses; the aim of which was to analyse the ordinary, taken for granted, everyday work of those practising A & E nursing. In this second paper on the work of A & E nurses, the specific rules or maxims of nursing work in A & E are introduced. From the analysis of materials gained: fieldwork notes, observations of nurses at work and conversations, a number of maxims of A & E nursing work were identified. Maxims direct, instruct and make nurses accountable for their work and the ways in which it gets done. That is, the presence of maxims underpinning A & E nursing work ensure that A & E nursing is seen and heard as a specific type of work with its own unique approach to talk and organization. Being aware of the maxims of A & E nursing work is not the concern of the nurse practising A & E nursing on a daily basis. Implicit and explicit reference to the maxims when talking about and doing the work provides nurses with impressions of who can do the job. Non-adherence by some nurses to the maxims of A & E nursing work often leads their colleagues to question their commitment to their choice of work setting. Maxims of A & E nursing account for the ways in which the work is seen, heard and talked about. Maxims direct the organization of work and its development within the A & E setting.

Menstrual characteristics and night work among nurses

PubMed Central

MOEN, Bente E.; BASTE, Valborg; MORKEN, Tone; ALSAKER, Kjersti; PALLESEN, Ståle; BJORVATN, Bjørn

2015-01-01

Night work has been associated with adverse effects in terms of reproductive health. Specifically, menstruation has been suggested to be negatively impacted by night work, which again may influence fertility. This study investigated whether working nights is related to menstrual characteristics and if there is a relationship between shift work disorder (SWD) and menstruation. The study was cross-sectional, response rate 38%. The sample comprised female nurses who were members of the Norwegian Nurses Association; below 50 yr of age, who were not pregnant, did not use hormonal pills or intrauterine devices and who had not reached menopause (n=766). The nurses answered a postal survey including questions about night work and menstrual characteristics. Fifteen per cent reported to have irregular menstruations. Thirty-nine per cent of the nurses were classified as having SWD. Logistic regression analyses concerning the relationship between irregular menstruations and night work did not show any associations. Furthermore, no associations were found between cycle length or bleeding period and night work parameters. No associations were found between menstrual characteristics and SWD. PMID:25914071

Herb use in pregnancy: what nurses should know.

PubMed

Born, Diane; Barron, Mary Lee

2005-01-01

During the last decade, there has been a dramatic rise in the availability and use of medicinal herbal preparations. Childbearing women are among those who are asking nurses about herbal use, and therefore nurses need to learn more about this topic. One of the most important points to understand is that in the United States herbs are classified as dietary supplements (not drugs), and manufacturers are therefore not required to provide proof of efficacy or safety before selling these substances. Few studies about effects of herbs have been conducted in the general population, and fewer still have been published about pregnancy use. Because the perinatal nurse has two patients to consider when caring for a pregnant woman, he or she has two equally important mandates: to help the mother without harming the fetus. This article provides an overview of key concepts underlying herbal use in general and also safety in pregnancy. Common herbs that can be safely be used in pregnancy are presented in detail to enable the nurse to better care for the pregnant woman who is considering herbal use.

The meaning of suicidal behaviour from the perspective of senior nursing undergraduate students.

PubMed

Vedana, Kelly G G; Pereira, Camila C M; Dos Santos, José Carlos; Ventura, Carla; Moraes, Sabrina M; Miasso, Adriana I; Zanetti, Ana Carolina G; Borges, Tatiana L

2018-06-01

The meaning ascribed to suicidal behaviours may influence the quality of the care provided to people at risk of suicide. Such a phenomenon has yet to be properly investigated amongst nursing undergraduate students, the aim of this study being to gain an understanding of the meanings of suicidal behaviour for a particular group of nurses. The study, which utilized grounded theory, was conducted in Brazil in 2016-2017 with 30 undergraduate students. The findings indicated that suicidal behaviour, classified according to the individual beliefs and judgements of the participants, presented a significant barrier to the delivery of care and was complex and multifaceted care phenomenon. Participants were often reluctant to discuss the topic, seemingly wanting to distance themselves from the care of persons exhibiting suicidal behaviour, and to avoid professional engagements relating to suicide prevention. Significant work is required in raising both an awareness and knowledge of suicidal behaviour befitting the promotion of tolerance, emotional competency, resilience, and empathy amongst nursing students. © 2017 Australian College of Mental Health Nurses Inc.

Baccalaureate nursing students' perspectives of peer tutoring in simulation laboratory, a Q methodology study.

PubMed

Li, Ting; Petrini, Marcia A; Stone, Teresa E

2018-02-01

The study aim was to identify the perceived perspectives of baccalaureate nursing students toward the peer tutoring in the simulation laboratory. Insight into the nursing students' experiences and baseline data related to their perception of peer tutoring will assist to improve nursing education. Q methodology was applied to explore the students' perspectives of peer tutoring in the simulation laboratory. A convenience P-sample of 40 baccalaureate nursing students was used. Fifty-eight selected Q statements from each participant were classified into the shape of a normal distribution using an 11-point bipolar scale form with a range from -5 to +5. PQ Method software analyzed the collected data. Three discrete factors emerged: Factor I ("Facilitate or empower" knowledge acquisition), Factor II ("Safety Net" Support environment), and Factor III ("Mentoring" learn how to learn). The findings of this study support and indicate that peer tutoring is an effective supplementary strategy to promote baccalaureate students' knowledge acquisition, establishing a supportive safety net and facilitating their abilities to learn in the simulation laboratory. Copyright © 2017 Elsevier Ltd. All rights reserved.

Challenges of postgraduate critical care nursing program in Iran.

PubMed

Dehghan Nayeri, Nahid; Shariat, Esmaeil; Tayebi, Zahra; Ghorbanzadeh, Majid

2017-01-01

Background: The main philosophy of postgraduate preparation for working in critical care units is to ensure the safety and quality of patients' care. Increasing the complexity of technology, decision-making challenges and the high demand for advanced communication skills necessitate the need to educate learners. Within this aim, a master's degree in critical care nursing has been established in Iran. Current study was designed to collect critical care nursing students' experiences as well as their feedback to the field critical care nursing. Methods: This study used qualitative content analysis through in-depth semi-structured interviews. Graneheim and Lundman method was used for data analysis. Results: The results of the total 15 interviews were classified in the following domains: The vision of hope and illusion; shades of grey attitude; inefficient program and planning; inadequacy to run the program; and multiple outcomes: Far from the effectiveness. Overall findings indicated the necessity to review the curriculum and the way the program is implemented. Conclusion: The findings of this study provided valuable information to improve the critical care-nursing program. It also facilitated the next review of the program by the authorities.

The effects of organizational flexibility on nurse utilization and vacancy statistics in Ontario hospitals.

PubMed

Fisher, Anita; Baumann, Andrea; Blythe, Jennifer

2007-01-01

Social and economic changes in industrial societies during the past quarter-century encouraged organizations to develop greater flexibility in their employment systems in order to adapt to organizational restructuring and labour market shifts (Kallenberg 2003). During the 1990s this trend became evident in healthcare organizations. Before healthcare restructuring, employment in the acute hospital sector was more stable, with higher levels of full-time staff. However, in the downsizing era, employers favoured more flexible, contingent workforces (Zeytinoglu 1999). As healthcare systems evolved, staffing patterns became more chaotic and predicting staffing requirements more complex. Increased use of casual and part-time staff, overtime and agency nurses, as well as alterations in skills mix, masked vacancy counts and thus rendered this measurement of nursing demand increasingly difficult. This study explores flexible nurse staffing practices and demonstrates how data such as nurse vacancy statistics, considered in isolation from nurse utilization information, are inaccurate indicators of nursing demand and nurse shortage. It develops an algorithm that provides a standard methodology for improved monitoring and management of nurse utilization data and better quantification of vacancy statistics. Use of standard methodology promotes more accurate measurement of nurse utilization and shortage. Furthermore, it provides a solid base for improved nursing workforce planning, production and management.

An Exploratory Descriptive Study of Registered Nurse Innovation: Implications for Levels of Adoption.

PubMed

Polster, Debra; Villines, Dana

The aims of this study were to describe registered nurses' levels of personal innovativeness and registered nurses' perceived organizational innovativeness and determine the relationship between these 2 variables. There is limited research to describe the levels of innovation of nurses within a hospital. The levels of innovation can determine the likelihood of adoption of evidence-based practices at the bedside. As change agents, clinical nurse specialists can determine successful implementation strategies tailored to nurse levels of innovation. This was a descriptive study at a midwest, urban, teaching, 408-bed Magnet hospital. Surveys were completed by 217 nurses. The participants reported high personal innovativeness ((Equation is included in full-text article.)= 32.1; SD, 6.4), and the institution was perceived as innovative, with 90.3% of scores categorized as positive innovativeness. The statistically significant correlation was in the medical-surgical unit (r = -0.52, P < .01). There is no correlation between personal innovativeness and organizational innovativeness except for medical-surgical nurses (P = .03). They are likely to perceive the organization more innovative than themselves. Determining adopter characteristics can be valuable to the clinical nurse specialist by adapting strategic interventions to advance nursing practice. Exploring levels of adoption can be an innovative strategy to transform nursing at the bedside and throughout the organization.

Advocating to Protect Our Nurses: Addressing Unethical Recruitment of Foreign-Educated Nurses.

PubMed

Shaffer, Franklin; Bakhshi, Mukul; Jacobs, Arielle

Advocacy in the nursing sector is often about advocating for patients. However, nurses have begun to put more effort into protecting their rights as workers. Advocacy on behalf of foreign-educated nurses has been a critical component of this advocacy. While foreign-educated nurses can make our nursing workforce stronger, this can only happen if they are well-treated and well-trained. Organizations across diverse missions and perspectives have come together to promote fair treatment of foreign-educated nurses, which ultimately ensures that all nurses are working as effectively as possible and that patients receive proper care. The Alliance for Ethical International Recruitment Practices' Health Care Code for Ethical Recruitment and Employment Practices represents a bottom-up agreement on which market practices constitute ethical recruitment. From a top-down level, the World Health Organization's Code of Global Practice establishes obligations and reporting requirements for member states that commit to ensuring ethical recruitment. This combination of efforts, bolstered by strong advocacy, is gaining traction as nursing migration grows at the global level. The collaboration across diverse stakeholder groups and the combination of legal, voluntary, and global efforts to promote the rights of foreign-educated nurses provides a model to apply for advocacy in different areas.

Lifelong learning strategies in nursing: A systematic review

PubMed Central

Qalehsari, Mojtaba Qanbari; Khaghanizadeh, Morteza; Ebadi, Abbas

2017-01-01

Background Lifelong learning is an expectation in the professional performance of nurses, which is directly related to the success of students in nursing schools. In spite of the considerable attention paid to this issue, lifelong learning strategies are not fully understood. Objective The aim of this study was to clarify lifelong learning strategies of nursing students with respect to international experience. Methods In this systematic review, an extensive investigation was carried out using Persian and English studies in Pub Med, ProQuest, Cochrane, Ovid, Scopus, Web of Science, SID, and Iran Doc using the following keywords: lifelong learning, self-directed learning, lifelong learning model, continuing education, nursing education, and lifelong program. Finally, 22 articles published from 1994 to 2016 were selected for the final analysis. Data extracted from the selected articles was summarized and classified based on the research questions. Results In this study, 8 main themes, namely intellectual and practical independence, collaborative (cooperative) learning, researcher thinking, persistence in learning, need-based learning, learning management, suitable learning environment, and inclusive growth, were extracted from the article data. Conclusion Having identified and clarified lifelong learning strategies in nursing, it is recommended to use the research findings in the programs and teaching systems of nursing schools. Use of strategies of lifelong learning will led to increased quality of education, development of nursing competency and finally, increased quality of patient care. PMID:29238496

Pediatric Perioperative Nurses and the Ethics of Organ Donation After Cardiac Death.

PubMed

Austin, Elizabeth A; Lovett, Pamela; Moore, Wendy C; Zuzarte, Ingrid

2018-04-01

Pediatric perioperative nurses are experiencing increased opportunities to participate in donations after cardiac death. An increased public awareness regarding transplantation has inspired more people to donate than in previous years. The demand for transplantable organs has led to opportunities that have increased donor candidates including living donors and cardiac death donors. Cardiac death in children is often sudden and unexpected, and is an emotional time not only for the family members but also for the hospital staff members, including perioperative nurses. However, when perioperative nurses adhere to standards and guidelines, they can perform their responsibilities in an ethical and compassionate manner and assist their team in doing so. This article reviews the guiding principles of pediatric organ donation after cardiac death, the phases of the process, and the ethical and moral issues surrounding donation. © AORN, Inc, 2018.

Promoting Usability in Organizations with a New Health Usability Model: Implications for Nursing Informatics

PubMed Central

Staggers, Nancy; Rodney, Melanie

2012-01-01

Usability issues with products such as Electronic Health Records (EHRs) are of global interest to nursing informaticists. Although improvements in patient safety, clinical productivity and effectiveness are possible when usability principles and practices are in place, most organizations do not embrace usability. This paper presents a new Health Usability Maturity Model consisting of 5 phases: unrecognized, preliminary, implemented, integrated and strategic. Within each level various aspects are discussed including focus on users, management, education, resources, processes and infrastructure. Nurse informaticists may use this new model as a guide for assessing their organization’s level of usability and transitioning to the next level. Using tactics outlined here, nurse informaticists may also serve as catalysts for change and lead efforts to improve the user experience in organizations across industry, academe and healthcare settings. PMID:24199128

Cancer biology and implications for practice.

PubMed

Rieger, Paula Trahan

2006-08-01

The media seem to announce a new scientific discovery related to cancer daily. Oncology nurses are challenged to keep up with the explosion of new knowledge and to understand how it ultimately relates to the care of patients with cancer. A framework for classifying new knowledge can be useful as nurses seek to understand the biology of cancer and its related implications for practice. To understand the molecular roots of cancer, healthcare practitioners specializing in cancer care require insight into genes, their messages, and the proteins produced from those messages, as well as the new tools of molecular biology.

Index to Health and Safety Education (Multimedia). First Edition.

ERIC Educational Resources Information Center

University of Southern California, Los Angeles. National Information Center for Educational Media.

More than 16,000 films, videotapes, recordings and multimedia presentations for teaching health and safety education, driver training, medicine and dentistry, home economics, nursing and physical education are listed in this 620-page catalog. Catalog entries are classified alphabetically by title. Each entry provides a summary of the materials,…

Integrating preventive care and nursing standardized terminologies in nursing education: a case study.

PubMed

Burkhart, Lisa; Sommer, Sheryl

2007-01-01

This study investigated the development of a community-focused curriculum integrating primary, secondary, and tertiary prevention and nursing standardized terminologies as an organizing infrastructure. This is a case study of the curriculum redesign of the Marcella Niehoff School of Nursing, Loyola University Chicago. Faculty developed a conceptual framework integrating core concepts into curriculum design, course content, and clinical applications. A coherent curriculum was designed using a community-focused approach; primary, secondary, and tertiary prevention strategies; and standardized terminologies as the organizing infrastructure to teach and apply nursing practice. The curriculum provides a meaningful correlation between the classroom and clinical experience. Students journey with their patients throughout the health care experience, applying nursing concepts using standardized terminologies. Clinical experiences provide students with the opportunity to transfer knowledge to the health experiences of patients in their care. Patient encounters, whether at the primary, secondary, or tertiary level of prevention, are used to assist students in developing critical thinking skills through the use of standardized nursing terminologies.

Workplace Discrimination: An Additional Stressor for Internationally Educated Nurses.

PubMed

Baptiste, Maria M

2015-08-18

Discrimination against internationally educated nurses (IENs) remains a seldom-explored topic in the United States. Yet, the literature describing experiences of IENs indicates that some do experience workplace discrimination as an additional workplace stressor. IENs view this discrimination as an obstacle to career advancement and professional recognition. Consequences of workplace discrimination affect IENs' physical and psychological well being, the quality of patient care, and healthcare organizational costs. In anticipation of future nursing shortages, understanding and minimizing workplace discrimination will benefit nurses, patients, and healthcare organizations. In this article the author addresses motivation and challenges associated with international nurse migration and immigration, relates these challenges to Roy's theoretical framework, describes workplace discrimination, and reviews both consequences of and evidence for workplace discrimination. Next, she considers the significance of this discrimination for healthcare agencies, and approaches for decreasing stress for IENs during their transition process. She concludes that workplace discrimination has a negative, multifaceted effect on both professional nursing and healthcare organizations. Support measures developed to promote mutual respect among all nurses are presented.

Knowledge and attitudes of health care professionals toward organ donation and transplantation.

PubMed

Alsaied, Osama; Bener, Abdulbari; Al-Mosalamani, Yousuf; Nour, Bakr

2012-11-01

To identify and assess the level of knowledge and attitudes of health care professionals (HCP) in Qatar toward organ donation and transplantation, this cross-sectional study was carried out from October 2007 to February 2008 in the Accident and Emergency Departments and Intensive Care Units of the hospitals of the Hamad Medical Corporation (HMC). A representative sample of 585 HCP working in the hospitals of the HMC was approached and 418 staff gave consent to participate in the study (71.5%). 36.8% were physicians, 48.6% nurses and 14.6% Emergency Medical Service (EMS) technicians. Of the surveyed HCP, 40.7% were males and 59.3% were females. Majority of the staff were in the age group of 30-39 years (58.6%). More than half of the physicians (59.7%) and technicians (57.4%) assumed that organs can be bought and sold in the State of Qatar. Most of the physicians (76.6%) and nurses (75.9%) knew that brain-dead persons are eligible for organ donation, whereas only 57.4% of the EMS technicians thought so. Majority of the HCP supported organ donation; physicians (89.0%), nurses (82.3%) and technicians (70.5%). The attitude of the physicians (24.0%) and nurses (20.2%) to donate a kidney to a family member was very poor compared with the attitude of the technicians (44.3%). Although the HCP support organ donation (83%), more than half of the physicians (51.3%), nurses (61.6%) and technicians (54.1%) wanted to be buried with all their organs intact. The findings, although they give cause for hope, suggest that there is much work yet to be done before organ donation and transplantation can become fully accepted by the medical community in Qatar.

Internal or external whistleblowing: nurses' willingness to report wrongdoing.

PubMed

Mansbach, Abraham; Bachner, Yaacov G

2010-07-01

In Israel, whistleblowing in the nursing profession has been largely ignored. This topic is neither part of the professional-ethical discourse nor a subject for research. Focusing on the divide between internal and external whistleblowing, this article presents a study that explores nurses' willingness to disclose an act that could jeopardize the rights or safety of patients. Internal disclosure entails reporting wrongdoing to an authority within the organization. External disclosure involves reporting the offense to an outside agency, such as a professional organization or the press. The study's findings indicate that the nurse respondents viewed both the harmful misconduct of a colleague and that of a manager as being very serious. In such dilemmas the nurses reported a desire to correct the wrongdoing and a concomitant willingness to act. They were, however, much more likely to whistleblow internally rather than externally. This study revealed a pattern of nurses' progressive retraction as the circle of disclosure widened.

Family health nurse project--an education program of the World Health Organization: the University of Stirling experience.

PubMed

Murray, Ian

2008-11-01

This article outlines the delivery of the Family Health Nurse Education Programme of the World Health Organization (WHO) at the University of Stirling, Scotland, from 2001 to 2005. The program was part of the WHO European Family Health Nurse pilot project. The curriculum outlined by the WHO Curriculum Planning Group detailed the broad thrust of the Family Health Nurse Education Programme and was modified to be responsive to the context in which it was delivered, while staying faithful to general principles and precepts. The Family Health Nurse Education Programme is described in its evolving format over the two phases of the project; the remote and rural context occurred from 2001 to 2003, and the modification of the program for the urban phase of the project occurred during 2004 and 2005. The conceptual framework that was foundational to the development of the curriculum to prepare family health nurses will be described.

Nurses' experience with vancomycin-resistant enterococci (VRE).

PubMed

Mitchell, Ann; Cummins, Teresa; Spearing, Natalie; Adams, June; Gilroy, Lisa

2002-01-01

The emergence and spread of resistant organisms, in particular vancomycin-resistant enterococci (VRE), is an issue facing all staff in acute hospitals. This study explored how nurses coped with the responsibility of halting further spread of this organism during an outbreak. VRE-positive patients were cohorted with nurses who cared for them in an endeavour to contain the spread of VRE. The majority of nurses found the situation extremely stressful because of the need to act as 'gatekeepers' responsible for educating and monitoring the practices of staff and visitors. The nurses reported that they felt they were inadequately supported, were blamed for the outbreak, and that they had an increased workload as they took on duties of other staff. The results reinforce the need for a multidisciplinary team approach to education and control of VRE, more support for nursing staff cohorted with VRE-positive patients, and stringent adherence to infection control measures by all hospital staff.

Political participation of registered nurses.

PubMed

Vandenhouten, Christine L; Malakar, Crystalmichelle L; Kubsch, Sylvia; Block, Derryl E; Gallagher-Lepak, Susan

2011-08-01

Level of political participation and factors contributing to participation were measured among Midwest RNs (n = 468) via an online survey (Cronbach's α = .95). Respondents reported engaging in primarily "low cost" activities (e.g., voting, discussing politics, and contacting elected officials), with fewer reporting speaking at public gatherings, participating in demonstrations, and membership in nursing organizations. Psychological engagement was most predictive (p < .001) of political participation with the dimensions of political interest, political efficacy, and political information/knowledge highly significant (p < .001). Resources (time/money/civic skills) significantly contributed to political participation (p < .001). Less than half (40%) felt they could impact local decisions, and fewer (32%) felt they could impact state or national government decisions. Most respondents (80%) indicated their nursing courses lacked political content and did not prepare them for political participation. Findings showed that nurse educators and leaders of professional nursing organizations need to model and cultivate greater psychological engagement among students and nurses.

The American Organization of Nurse Executives System CNE task force: a work in progress.

PubMed

Rudisill, Pamela T; Thompson, Pamela A

2012-01-01

Health care is a complex industry, consequently requiring a diverse group of health care executives leading initiatives for efficiency and effectiveness in patient care delivery. Value-based purchasing and pay for performance are at the top of the list for indicators of success, and many hospitals are merging into health care systems. The role of the system chief nurse executive is an evolving role to lead health care systems in clinical, operational, patient safety, and patient satisfaction processes and outcomes. The American Organization of Nurse Executives, being the voice for nursing leadership, convened a group of system chief nurse executives to address the role, function, and competencies needed for this significant and emerging role in health care. This article describes the role statement and system chief nurse executive competencies needed for success in the role. In addition, the next steps for addressing the needs of this group will be outlined in this article.

Free-lance nursing in Italy.

PubMed

Galli, E; Lindsay, J S

1993-01-01

In 1987 Registered Nurses Ernesta 'Tina' Galli and Joanne Lindsay embarked on a unique venture--a private agency* organized and run by nurses that engages free-lance nurses to fill the need for nursing assistance both at home and in public and private institutions. The response has been overwhelming. Today they have branches throughout Italy and have expanded their services to include research and primary health care. Below, their story.

Conflict engagement: collaborative processes.

PubMed

Gerardi, Debra

2015-05-01

This article is one in a series on conflict. It is part of an ongoing series on leadership coordinated by the American Organization of Nurse Executives (AONE; www.aone.org), highlighting topics of interest to nurse managers and emerging nurse leaders. The AONE provides leadership, professional development, advocacy, and research to advance nursing practice and patient care, promote nursing leadership excellence, and shape public policy for health care.

Conflict Engagement: Creating Connection and Cultivating Curiosity.

PubMed

Gerardi, Debra

2015-09-01

This article is one in a series on conflict. It is part of an ongoing series on leadership coordinated by the American Organization of Nurse Executives (AONE; www.aone.org), highlighting topics of interest to nurse managers and emerging nurse leaders. The AONE provides leadership, professional development, advocacy, and research to advance nursing practice and patient care, promote nursing leadership excellence, and shape public policy for health care.

Conflict Engagement: Emotional and Social Intelligence.

PubMed

Gerardi, Debra

2015-08-01

This article is one in a series on conflict. It is part of an ongoing series on leadership coordinated by the American Organization of Nurse Executives (AONE; www.aone.org), highlighting topics of interest to nurse managers and emerging nurse leaders. The AONE provides leadership, professional development, advocacy, and research to advance nursing practice and patient care, promote nursing leadership excellence, and shape public policy for health care.

The fair factor in matters of trust.

PubMed

Williams, Lauren L

2006-01-01

Communities are bound together by trust among their members. Trust thrives when a pervasive sense of fairness exists. Evidence suggests that trust has social, professional, and economic value for today's organizations, making it worthy of attention. Matters of trust and justice are important and timely for nurse leaders to consider given the challenge to improve practice settings in a manner that enhances nurse satisfaction. The aim of this article is to make explicit the value in building organizational justice and trust within an organization's nursing community. Nursing leadership strategies are integrated, thus offering practical guidance in creating a culture of justice, making trust explicit, and establishing trustworthiness.

The work of accident and emergency nurses: Part I. An introduction to the rules.

PubMed

Sbaih, L

1997-01-01

An ethnomethodological study was undertaken to explore the work of Accident and Emergency nurses, the aim of which was to analyse the ordinary, taken-for-granted and everyday work of those practising A & E nursing. This, the first of two papers, will examine the work of A & E nurses via a description of rules or maxims that underpin work and its everyday organization. Such a description will form the basis for part 2, which explores the specific rules of A & E nursing work. To understand the specific rules and the ways in which they contribute to organization and accomplishment of aspects of the work, the definition and use of rules should be put forward. Defining rules within the context of the work provides a means by which specific rules of work can then be explored. The rules of A & E work ensure that A & E nursing is seen and heard as a specific type of work with its own unique approach to talk and organization. This is tied in with peer and colleague views of what is deemed to be clinical competence within the A & E setting.

Nascent body ego: metapsychological and neurophysiological aspects.

PubMed

Lehtonen, Johannes; Partanen, Juhani; Purhonen, Maija; Valkonen-Korhonen, Minna; Kononen, Mervi; Saarikoski, Seppo; Launiala, Kari

2006-10-01

For Freud, body ego was the organizing basis of the structural theory. He defined it as a psychic projection of the body surface. Isakower's and Lewin's classical findings suggest that the body surface experiences of nursing provide the infant with sensory-affective stimulation that initiates a projection of sensory processes towards the psychic realm. During nursing, somato-sensory, gustatory and olfactory modalities merge with a primitive somatic affect of satiation, whereas auditory modality is involved more indirectly and visual contact more gradually. Repeated regularly, such nascent experiences are likely to play a part in the organization of the primitive protosymbolic mental experience. In support of this hypothesis, the authors review findings from a neurophysiological study of infants before, during and after nursing. Nursing is associated with a significant amplitude change in the newborn electroencephalogram (EEG), which wanes before the age of 3 months, and is transformed at the age of 6 months into rhythmic 3-5 Hz hedonic theta-activity. Sucking requires active physiological work, which is shown in a regular rise in heart rate. The hypothesis of a sensory-affective organization of the nascent body ego, enhanced by nursing and active sucking, seems concordant with neurophysiological phenomena related to nursing.

Implementing an organization-wide quality improvement initiative: insights from project leads, managers, and frontline nurses.

PubMed

Jeffs, Lianne P; Lo, Joyce; Beswick, Susan; Campbell, Heather

2013-01-01

With the movement to advance quality care and improve health care outcomes, organizations have increasingly implemented quality improvement (QI) initiatives to meet these requirements. Key to implementation success is the multilevel involvement of frontline clinicians and leadership. To explore the perceptions and experiences of frontline nurses, project leads, and managers associated with an organization-wide initiative aimed at engaging nurses in quality improvement work. To address the aims of this study, a qualitative research approach was used. Two focus groups were conducted with a total of 13 nurse participants, and individual interviews were done with 10 managers and 6 project leads. Emergent themes from the interview data included the following: improving care in a networked approach; driving QI and having a sense of pride; and overcoming challenges. Specifically, our findings elucidate the value of communities of practice and ongoing mentorship for nurses as key strategies to acquire and apply QI knowledge to a QI project on their respective units. Key challenges emerged including workload and time constraints, as well as resistance to change from staff. Our study findings suggest that leaders need to provide learning opportunities and protected time for frontline nurses to participate in QI projects.

[Balanced scorecard for performance measurement of a nursing organization in a Korean hospital].

PubMed

Hong, Yoonmi; Hwang, Kyung Ja; Kim, Mi Ja; Park, Chang Gi

2008-02-01

The purpose of this study was to develop a balanced scorecard (BSC) for performance measurement of a Korean hospital nursing organization and to evaluate the validity and reliability of performance measurement indicators. Two hundred fifty-nine nurses in a Korean hospital participated in a survey questionnaire that included 29-item performance evaluation indicators developed by investigators of this study based on the Kaplan and Norton's BSC (1992). Cronbach's alpha was used to test the reliability of the BSC. Exploratory and confirmatory factor analysis with a structure equation model (SEM) was applied to assess the construct validity of the BSC. Cronbach's alpha of 29 items was .948. Factor analysis of the BSC showed 5 principal components (eigen value >1.0) which explained 62.7% of the total variance, and it included a new one, community service. The SEM analysis results showed that 5 components were significant for the hospital BSC tool. High degree of reliability and validity of this BSC suggests that it may be used for performance measurements of a Korean hospital nursing organization. Future studies may consider including a balanced number of nurse managers and staff nurses in the study. Further data analysis on the relationships among factors is recommended.

Role for a Labor-Management Partnership in Nursing Home Person-Centered Care

ERIC Educational Resources Information Center

Leutz, Walter; Bishop, Christine E.; Dodson, Lisa

2010-01-01

Purpose: To investigate how a partnership between labor and management works to change the organization and focus of nursing home frontline work, supporting a transition toward person-centered care (PCC) in participating nursing homes. Design and Methods: Using a participatory research approach, we conducted case studies of 2 nursing homes…

Fatigue in Intensive Care Nurses and Related Factors.

PubMed

Çelik, Sevim; Taşdemir, Nurten; Kurt, Aylin; İlgezdi, Ebru; Kubalas, Özge

2017-10-01

Fatigue negatively affects the performance of intensive care nurses. Factors contributing to the fatigue experienced by nurses include lifestyle, psychological status, work organization and sleep problems. To determine the level of fatigue among nurses working in intensive care units and the related factors. This descriptive study was conducted with 102 nurses working in intensive care units in the West Black Sea Region of Turkey. Data were collected between February and May 2014 using a personal information form, the Visual Analogue Scale for Fatigue (VAS-F), the Hospital Anxiety and Depression Scale and the Pittsburg Sleep Quality Index. The intensive care nurses in the study were found to be experiencing fatigue. Significant correlations were observed between scores on the VAS-F Fatigue and anxiety (p=0.01), depression (p=0.002), and sleep quality (p<0.001). Anxiety, depression and quality of sleep were significantly affected by the intensive care nurses' levels of fatigue. These results can be of benefit in taking measures which may be used to reduce fatigue in nurses, especially the fatigue related to work organization and social life.

The Cockcroft difference: an analysis of the impact of a nursing leadership development programme.

PubMed

Chappell, Kate K; Willis, Leah

2013-03-01

Identifying impact areas of nursing leadership development programmes is needed to determine if there are measureable effects on participants. These impact areas help to identify measures to substantiate the benefits of nursing leadership programmes for organization leaders making decisions about support and implementation of such opportunities for their emerging leaders. Using mixed qualitative/quantitative methods, the impact of a nursing leadership development programme, the Amy V. Cockcroft Fellowship, is examined to determine if there are measureable influences. Themes of four areas of impact: improved conflict resolution/negotiation skills, communication skills, personal development and career action or change were identified through content analysis. These themes provide the basis for creating measureable indicators for nursing organizations to use in determining the value of nursing leadership development programmes such as the Amy V. Cockcroft Fellowship. Based on the findings established in this research article, nurse managers can focus on developing themselves and their peer groups through nursing leadership development programmes to prepare for leading in the present and future healthcare environment. © 2012 Blackwell Publishing Ltd.

Constructing a nurse appraisal form: A Delphi technique study

PubMed Central

Zaghloul, Ashraf Ahmad Zaher; AlSokair, May Kosay

2008-01-01

Objective The study was conducted with the aim to construct a unified nurse appraisal format to be used at hospitals performing under different healthcare organizations in the Eastern Province in the Kingdom of Saudi Arabia. Methodology The study included hospitals representing different healthcare organizations within the Eastern Province. The target population included Hospital head nurses and nurse supervisors and the snowball sampling technique was employed to select the panel subjects. Results The final draft resulted into the agreed upon performance dimensions which included namely; quality standards, work habits, supervision/leadership, staff relations and interpersonal skills, attendance and punctuality, problem solving, oral communication, productivity results, coordination, innovation, record keeping. Conclusion Nurse managers have to continuously assess competence of practicing nurses to assure qualified and safe patient care. A nurse appraisal form was constructed concurrently with this study results and was proposed to be used at all Eastern Region hospitals. This study is considered an initial step for further efforts and studies to be conducted to reach both national and international nursing appraisal dimensions and unify them for the sake of best health promotion. PMID:21197327

Learning organizations, internal marketing, and organizational commitment in hospitals

PubMed Central

2014-01-01

Background Knowledge capital is becoming more important to healthcare establishments, especially for hospitals that are facing changing societal and industrial patterns. Hospital staff must engage in a process of continual learning to improve their healthcare skills and provide a superior service to their patients. Internal marketing helps hospital administrators to improve the quality of service provided by nursing staff to their patients and allows hospitals to build a learning culture and enhance the organizational commitment of its nursing staff. Our empirical study provides nursing managers with a tool to allow them to initiate a change in the attitudes of nurses towards work, by constructing a new ‘learning organization’ and using effective internal marketing. Methods A cross-sectional design was employed. Two hundred questionnaires were distributed to nurses working in either a medical centre or a regional hospital in Taichung City, Taiwan, and 114 valid questionnaires were returned (response rate: 57%). The entire process of distribution and returns was completed between 1 October and 31 October 2009. Hypothesis testing was conducted using structural equation modelling. Results A significant positive correlation was found between the existence of a ‘learning organization’, internal marketing, and organizational commitment. Internal marketing was a mediator between creating a learning organization and organizational commitment. Conclusion Nursing managers may be able to apply the creation of a learning organization to strategies that can strengthen employee organizational commitment. Further, when promoting the creation of a learning organization, managers can coordinate their internal marketing practices to enhance the organizational commitment of nurses. PMID:24708601

Association between demographics and resilience - a cross-sectional study among nurses in Singapore.

PubMed

Ang, S Y; Uthaman, T; Ayre, T C; Mordiffi, S Z; Ang, E; Lopez, V

2018-03-08

To give an overview of the level of resilience among nurses in Singapore and to examine associations between various demographics variables and resilience level. The World Health Organization reported a global needs-based shortage of over 9 million nurses and midwives in 2013. Building resilience among nurses has been postulated as one of the ways to support and retain nurses in the profession. A self-reported questionnaire consisting of questions on demographics and the Connor-Davidson Resilience Scale CD-RISC 10 was used. Univariate analysis identified marital status, age group, years of experience in nursing, highest education qualification and job grade to have significant associations with resilience. During multivariate analysis, only marital status, age group, highest educational qualification and job grade remained significant. A strong association was found between highest educational qualification and resilience level; nurses with bachelor's or postgraduate degree were about three times more likely than nurses with only a general nursing certificate to be of moderate/high resilience. The experience of life events (as exemplified by marital status, age and working experience) was associated with higher resilience levels. There is a need for healthcare organizations and nurse leaders to develop programmes focusing on building resilience among younger and less experienced nurses. Nurses should also be supported in their pursuits for higher education, which will in turn lead to higher resilience, and consequently, retention of nurses within the profession and institution. © 2018 International Council of Nurses.

Impact of Fall Prevention on Nurses and Care of Fall Risk Patients.

PubMed

King, Barbara; Pecanac, Kristen; Krupp, Anna; Liebzeit, Daniel; Mahoney, Jane

2018-03-19

Falls are common events for hospitalized older adults, resulting in negative outcomes both for patients and hospitals. The Center for Medicare and Medicaid (CMS) has placed pressure on hospital administrators by identifying falls as a "never event", resulting in a zero falls goal for many hospitals. Staff nurses are responsible for providing direct care to patients and for meeting the hospital no falls goal. Little is known about the impact of "zero falls" on nurses, patients and the organization. A qualitative study, using Grounded Dimensional Analysis (GDA) was conducted to explore nurses' experiences with fall prevention in hospital settings and the impact of those experiences on how nurses provide care to fall risk patients. Twenty-seven registered nurses and certified nursing assistants participated in in-depth interviews. Open, axial and selective coding was used to analyze data. A conceptual model which illustrates the impact of intense messaging from nursing administration to prevent patient falls on nurses, actions nurses take to address the message and the consequences to nurses, older adult patients and to the organization was developed. Intense messaging from hospital administration to achieve zero falls resulted in nurses developing a fear of falls, protecting self and unit, and restricting fall risk patients as a way to stop messages and meet the hospital goal. Results of this study identify unintended consequences of fall prevention message on nurses and older adult patients. Further research is needed understand how nurse care for fall risk patients.

Using Gordon's functional health patterns to organize a critical care orientation program.

PubMed

Recker, D; O'Brien, C

1992-02-01

We have described how we revised our critical care orientation according to Gordon's FHPs. The process will require continuous review and revision. Research is necessary to determine the effectiveness of an orientation organized by a nursing framework in facilitating holistic nursing practice.

Can education alter attitudes, behaviour and knowledge about organ donation? A pretest-post-test study.

PubMed

McGlade, Donal; Pierscionek, Barbara

2013-12-30

The emergence of evidence suggests that student nurses commonly exhibit concerns about their lack of knowledge of organ donation and transplantation. Formal training about organ donation has been shown to positively influence attitude, encourage communication and registration behaviours and improve knowledge about donor eligibility and brain death. The focus of this study was to determine the attitude and behaviour of student nurses and to assess their level of knowledge about organ donation after a programme of study. A quantitative questionnaire was completed before and after participation in a programme of study using a pretest-post-test design. Participants were recruited from a University based in Northern Ireland during the period from February to April 2011. 100 preregistration nurses (female : male=96 : 4) aged 18-50 years (mean (SD) 24.3 (6.0) years) were recruited. Participants' knowledge improved over the programme of study with regard to the suitability of organs that can be donated after death, methods available to register organ donation intentions, organ donation laws, concept of brain death and the likelihood of recovery after brain death. Changes in attitude postintervention were also observed in relation to participants' willingness to accept an informed system of consent and with regard to participants' actual discussion behaviour. The results provide support for the introduction of a programme that helps inform student nurses about important aspects of organ donation.

Predictors of job satisfaction and absenteeism in two samples of Hong Kong nurses.

PubMed

Siu, Oi-Ling

2002-10-01

Stress-related outcomes of job satisfaction and absenteeism among nurses should receive more attention in Hong Kong because absenteeism is costly. Many nurses' complaints are due to organizational change in privatization since the establishment of the Hong Kong Hospital Authority in 1991. Organizational climate is found to be an antecedent of job dissatisfaction and absenteeism in many studies in western societies. To investigate the role of organizational climate and psychological distress on job satisfaction; and the role of climate, distress and job satisfaction on absenteeism in Hong Kong nurses, while controlling for demographic variables. A self-administered questionnaire survey method was used to collect data from two samples of nurses within a 8-month period. They are, respectively, 144 (74 general nurses, 70 psychiatric nurses; 47 males, 97 females) and 114 (85 general nurses, 29 psychiatric nurses; 17 males, 97 females) nurses. Multiple regression analyses revealed that occupational type (psychiatric/general), environment (the physical conditions in the work area) and psychological distress were significant predictors of job satisfaction for sample 1; and well-being (social relations, welfare and health issues) was the only significant predictor of job satisfaction for sample 2. However, age, involvement (the degree of commitment displayed towards employees by the organization), psychological distress and job satisfaction were significant predictors of absenteeism for sample 1; and occupational type, organization (the interaction between the worker and the organization), and involvement were significant predictors of absenteeism for sample 2. The empirical findings provide support for the climate-job satisfaction and climate-absenteeism relationships. Psychological distress could be an antecedent of job satisfaction; and job satisfaction could be an antecedent of absenteeism. Certain climate dimensions should be improved to enhance job satisfaction and reduce distress, which in turn will reduce absenteeism.

[L'impiego dell'ICNP® nella formazione infermieristica con modelli teorici infermieristici: una revisione della letteratura].

PubMed

Macchi, Barbara; Sironi, Cecilia; Di Mauro, Stefania; Ausili, Davide

2016-01-01

The International Classification for Nursing Practice (ICNP®) is the only nursing terminology that has been accepted within the Family of International Classification of the World Health Organization. The academic teaching of ICNP® could contribute to improve nursing clinical practice. However, standards for its implementation in undergraduate nursing education together with a nursing theoretical model are not available. To know the state of the art about the use of ICNP® in undergraduate nursing education and its use with a nursing theoretical model. A narrative literature review was conducted searching main health scientific databases and including monographs, statements from international associations, and published conference papers. Available literature about ICNP® implementation in nursing education and its use with theoretical models is limited. Results supported the organization of a specific course on ICNP® before clinical teaching programs, the development of paper or electronic ICNP® based educational tools, and the use of active learning strategies. Only three experiences reporting the use of ICNP® with theoretical models have been found. Both the use of ICNP® in nursing undergraduate education and its use according to one or more nursing theoretical models, could help students to learn nursing process. However, weak recommendations can be found in the literature to orient ICNP® implementation in undergraduate nursing education and/or with an explicit theoretical framework. Further studies focusing on these issues are strongly needed.

Validation of work pressure and associated factors influencing hospital nurse turnover: a cross-sectional investigation in Shaanxi Province, China.

PubMed

Yang, Huiyun; Lv, Jingwen; Zhou, Xi; Liu, Huitong; Mi, Baibing

2017-02-03

Nurses' turnover is a major contributor to nursing shortages, strongly influenced by nurses' intentions to leave. Several factors influencing the turnover intention have been well identified in Western countries and large cities in China. However, whether these factors also contribute to nurses' work stress in Midwest China are still unclear. The main purpose of this study was to examine the work pressure and associated factors influencing the nurses' intent to leave. A cross-sectional questionnaire-based survey with multistage sampling was conducted by recruiting 800 employed registered nurses with >1 year of work experience. Chi-square test and multi-factor logistic regression were applied to attain the relative comparisons. Sub-group analysis was conducted to explore the different turnover intention patterns in different age groups. The turnover intention was classified as strong/very-strong (19%), weak (62%), and very-weak (19%). Among the factors influencing the nurses' desire to leave the profession, work pressure was the most prominent. The predominantly associated factors contributing the work stress were age, experience, and workload. However, the scale of income did not affect the intent to leave decision. Pediatrics was identified to be the highest tormented department with a significant (P < 0.05) turnover of nurses. Among different age sub-groups, 30-39 age group nurses in Secondary hospitals demonstrate a stronger intent to leave. Nurses' turnover intentions were associated with stress, age, job duty, and career commitment in Shaanxi Province. The intent to leave is dynamically multifactorial, and effective managements and supportive strategies are needed to reduce the nurses work stress accordingly.

Developing optimal nurses work schedule using integer programming

NASA Astrophysics Data System (ADS)

Shahidin, Ainon Mardhiyah; Said, Mohd Syazwan Md; Said, Noor Hizwan Mohamad; Sazali, Noor Izatie Amaliena

2017-08-01

Time management is the art of arranging, organizing and scheduling one's time for the purpose of generating more effective work and productivity. Scheduling is the process of deciding how to commit resources between varieties of possible tasks. Thus, it is crucial for every organization to have a good work schedule for their staffs. The job of Ward nurses at hospitals runs for 24 hours every day. Therefore, nurses will be working using shift scheduling. This study is aimed to solve the nurse scheduling problem at an emergency ward of a private hospital. A 7-day work schedule for 7 consecutive weeks satisfying all the constraints set by the hospital will be developed using Integer Programming. The work schedule for the nurses obtained gives an optimal solution where all the constraints are being satisfied successfully.

Systematization of nursing care and the formation of professional identity.

PubMed

Gutiérrez, Maria Gaby Rivero de; Morais, Sheila Coelho Ramalho Vasconcelos

2017-04-01

The aim of this study is to explore arguments that broaden the understanding of possible links between the organization of nursing care and the structuring of professional identity. For that purpose, some aspects related to these themes are addressed, highlighting issues regarding differences in the concepts of the organization of nursing care and the nursing process, as well as the performance of this activity and its possible impact on the establishment of its relationship with the professional identity. Emphasis is given to the need to stimulate the debate on the subject by nursing professionals involved in the training of human resources and the provision of care, as well as in class entities, in order to deepen understanding of these concepts as significant elements for strengthening our professional identity.

Decision making within a community provider organization.

PubMed

Berggren, Ingela; Carlstrom, Eric

2010-12-01

To explore community nurses' experiences of decision making within the community provider organization. Recent changes in health care with an increasing number of patients being cared for outside of institutions can put considerable pressure on the nurse with respect to decision making. In-depth interviews were performed with 6 registered nurses in two communities. The interviews were analysed by means of phenomenological hermeneutics. The community nurses' experiences of decision making were interpreted as spiders or octopuses, consultants and troubleshooters. The subthemes were; networking and structuring, responsibility, availability and knowledge, assessment power, information selection, avoiding rules and bypassing managers. In accordance with hermeneutical phenomenology, the findings were discussed and explained with reference to Ofstad's philosophy of freedom to make decisions. In their decision making, community nurses are committed to finding administrative solutions that satisfy patient needs.

Associations between physical function and depression in nursing home residents with mild and moderate dementia: a cross-sectional study

PubMed Central

Kvæl, Linda Aimée Hartford; Bergland, Astrid; Telenius, Elisabeth Wiken

2017-01-01

Objectives The primary aim of this study is to describe depression and physical function in nursing home residents with dementia, as well as to examine the associations between depression and balance function, lower limb muscle strength, mobility and activities of daily living. The secondary aim is to examine the differences in physical function between the groups classified as depressed and not depressed. Design The study has a cross-sectional design. Setting A convenience sample of 18 nursing homes in, and around, Oslo, Norway, participated. Participants We included 170 nursing home residents aged 60–100 years with mild or moderate degree of dementia defined by a score of 1 or 2 on the Clinical Dementia Rating Scale (CDR). Outcome measures Assessments used were Cornell Scale for Depression in Dementia (CSDD), Berg Balance Scale (BBS), ‘the 6-metre walking test’ (walking speed), 30 s Chair Stand Test (CST) and the Barthel Index (BI). Results Nursing home residents with dementia are a heterogeneous group in terms of physical function and depression. By applying the recommended cut-off of ≥8 on CSDD, 23.5% of the participants were classified as being depressed. The results revealed significant associations between higher scores on CSDD (indicating more symptoms of depression) and lower scores on BBS (95% CI −0.12 to −0.02, p=0.006), 30 s CST (95% CI −0.54 to −0.07, p=0.001) as well as maximum walking speed (95% CI −4.56 to −0.20, p=0.003) (indicating lower level of physical function). Conclusion Better muscle strength, balance and higher walking speed were significantly associated with less depressive symptoms. The potential interaction of dementia with poor physical function and depression indicates an area to explore in future epidemiological studies with a prospective design. Trial registration number NCT02262104. PMID:28729326

Associations between physical function and depression in nursing home residents with mild and moderate dementia: a cross-sectional study.

PubMed

Kvæl, Linda Aimée Hartford; Bergland, Astrid; Telenius, Elisabeth Wiken

2017-07-20

The primary aim of this study is to describe depression and physical function in nursing home residents with dementia, as well as to examine the associations between depression and balance function, lower limb muscle strength, mobility and activities of daily living. The secondary aim is to examine the differences in physical function between the groups classified as depressed and not depressed. The study has a cross-sectional design. A convenience sample of 18 nursing homes in, and around, Oslo, Norway, participated. We included 170 nursing home residents aged 60-100 years with mild or moderate degree of dementia defined by a score of 1 or 2 on the Clinical Dementia Rating Scale (CDR). Assessments used were Cornell Scale for Depression in Dementia (CSDD), Berg Balance Scale (BBS), 'the 6-metre walking test' (walking speed), 30 s Chair Stand Test (CST) and the Barthel Index (BI). Nursing home residents with dementia are a heterogeneous group in terms of physical function and depression. By applying the recommended cut-off of ≥8 on CSDD, 23.5% of the participants were classified as being depressed. The results revealed significant associations between higher scores on CSDD (indicating more symptoms of depression) and lower scores on BBS (95% CI -0.12 to -0.02, p=0.006), 30 s CST (95% CI -0.54 to -0.07, p=0.001) as well as maximum walking speed (95% CI -4.56 to -0.20, p=0.003) (indicating lower level of physical function). Better muscle strength, balance and higher walking speed were significantly associated with less depressive symptoms. The potential interaction of dementia with poor physical function and depression indicates an area to explore in future epidemiological studies with a prospective design. NCT02262104. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Longitudinal analysis of personal and work-related factors associated with turnover among nurses].

PubMed

Estryn-Behar, Madelaine; Van Der Heijden, Béatrice I J M; Fry, Clémentine; Hasselhorn, Hans-Martin

2010-12-01

While many scholars have acknowledged the relationship between personal and work-related factors associated with job search and actual turnover, there is a lack of longitudinal designs that test this relationship empirically. This longitudinal study examines specific determinant factors that differentiate between so-called 'stayers' and 'leavers' within the nursing profession, and identifies risk factors for premature leaving by comparing nurses who have left their job, or the nursing profession, with nurses who stay. This cross-national exploratory European survey included 34,587 nurses (baseline measurement) working in 623 hospitals, nursing homes, and home care institutions, and comprised two measurements with a one-year time interval. The final samples for the follow-up measurement included 14,016 stayers and 866 leavers. As regards the leavers, the participating nurses were asked to indicate to what extent personal and work-related factors had contributed to the decision to leave their health care institution. Nurses' intent-to-leave scores were higher in the baseline measurement among those who left the organization during the following 12 months, than among those who stayed (24.0% versus 13.5%). A majority of nurses (86.8%) left their profession voluntarily. Involuntary departure occurred more often in Eastern European countries. Nurses indicated that the reasons for leaving were: working conditions (e.g., relationship problems, emotional difficulties,time pressure and quality of care, dissatisfaction with use of one's competence and lack of autonomy, work schedule difficulties, and dissatisfaction with pay) family reasons (e.g., caring for relatives). For a considerable number of nurses, health reasons and the desire for continuing education added to their decision to leave. Health care organizations should pay attention to preventive measures in order to protect labor market potential. Recommendations are made for human resource development in health care organizations and for further empirical research to better understand to what extent different policy systems across the European countries explain variance in outcomes.

Who uses nursing theory? A univariate descriptive analysis of five years' research articles.

PubMed

Bond, A Elaine; Eshah, Nidal Farid; Bani-Khaled, Mohammed; Hamad, Atef Omar; Habashneh, Samira; Kataua', Hussein; al-Jarrah, Imad; Abu Kamal, Andaleeb; Hamdan, Falastine Rafic; Maabreh, Roqia

2011-06-01

Since the early 1950s, nursing leaders have worked diligently to build the Scientific Discipline of Nursing, integrating Theory, Research and Practice. Recently, the role of theory has again come into question, with some scientists claiming nurses are not using theory to guide their research, with which to improve practice. The purposes of this descriptive study were to determine: (i) Were nursing scientists' research articles in leading nursing journals based on theory? (ii) If so, were the theories nursing theories or borrowed theories? (iii) Were the theories integrated into the studies, or were they used as organizing frameworks? Research articles from seven top ISI journals were analysed, excluding regularly featured columns, meta-analyses, secondary analysis, case studies and literature reviews. The authors used King's dynamic Interacting system and Goal Attainment Theory as an organizing framework. They developed consensus on how to identify the integration of theory, searching the Title, Abstract, Aims, Methods, Discussion and Conclusion sections of each research article, whether quantitative or qualitative. Of 2857 articles published in the seven journals from 2002 to, and including, 2006, 2184 (76%) were research articles. Of the 837 (38%) authors who used theories, 460 (55%) used nursing theories, 377 (45%) used other theories: 776 (93%) of those who used theory integrated it into their studies, including qualitative studies, while 51 (7%) reported they used theory as an organizing framework for their studies. Closer analysis revealed theory principles were implicitly implied, even in research reports that did not explicitly report theory usage. Increasing numbers of nursing research articles (though not percentagewise) continue to be guided by theory, and not always by nursing theory. Newer nursing research methods may not explicitly state the use of nursing theory, though it is implicitly implied. © 2010 The Authors. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.

Teaching Culture within the Nursing Curriculum Using the Giger-Davidhizar Model of Transcultural Nursing Assessment.

ERIC Educational Resources Information Center

Davidhizar, Ruth; Giger, Joyce Newman

2001-01-01

Presents a method for integrating cultural competence throughout the nursing curriculum. The model contains six cultural phenomena: communication, space, social organization, time, environmental control, and biological variation. Contains 17 references. (SK)

Successful implementation of new technologies in nursing care: a questionnaire survey of nurse-users

PubMed Central

2011-01-01

Background A growing number of new technologies are becoming available within nursing care that can improve the quality of care, reduce costs, or enhance working conditions. However, such effects can only be achieved if technologies are used as intended. The aim of this study is to gain a better understanding of determinants influencing the success of the introduction of new technologies as perceived by nursing staff. Methods The study population is a nationally representative research sample of nursing staff (further referred to as the Nursing Staff Panel), of whom 685 (67%) completed a survey questionnaire about their experiences with recently introduced technologies. Participants were working in Dutch hospitals, psychiatric organizations, care organizations for mentally disabled people, home care organizations, nursing homes or homes for the elderly. Results Half of the respondents were confronted with the introduction of a new technology in the last three years. Only half of these rated the introduction of the technology as positive. The factors most frequently mentioned as impeding actual use were related to the (kind of) technology itself, such as malfunctioning, ease of use, relevance for patients, and risks to patients. Furthermore nursing staff stress the importance of an adequate innovation strategy. Conclusions A prerequisite for the successful introduction of new technologies is to analyse determinants that may impede or enhance the introduction among potential users. For technological innovations special attention has to be paid to the (perceived) characteristics of the technology itself. PMID:22032728

Successful implementation of new technologies in nursing care: a questionnaire survey of nurse-users.

PubMed

de Veer, Anke J E; Fleuren, Margot A H; Bekkema, Nienke; Francke, Anneke L

2011-10-27

A growing number of new technologies are becoming available within nursing care that can improve the quality of care, reduce costs, or enhance working conditions. However, such effects can only be achieved if technologies are used as intended. The aim of this study is to gain a better understanding of determinants influencing the success of the introduction of new technologies as perceived by nursing staff. The study population is a nationally representative research sample of nursing staff (further referred to as the Nursing Staff Panel), of whom 685 (67%) completed a survey questionnaire about their experiences with recently introduced technologies. Participants were working in Dutch hospitals, psychiatric organizations, care organizations for mentally disabled people, home care organizations, nursing homes or homes for the elderly. Half of the respondents were confronted with the introduction of a new technology in the last three years. Only half of these rated the introduction of the technology as positive.The factors most frequently mentioned as impeding actual use were related to the (kind of) technology itself, such as malfunctioning, ease of use, relevance for patients, and risks to patients. Furthermore nursing staff stress the importance of an adequate innovation strategy. A prerequisite for the successful introduction of new technologies is to analyse determinants that may impede or enhance the introduction among potential users. For technological innovations special attention has to be paid to the (perceived) characteristics of the technology itself.

Integral Nursing: An Emerging Framework for Engaging the Evolution of the Profession.

ERIC Educational Resources Information Center

Fiandt, Kathryn; Forman, John; Megel, Mary Erickson; Pakieser, Ruth A.; Burge, Stephanie

2003-01-01

Proposes the Integral Nursing framework, which combines Wilber's All-Quadrant/All-Level model, a heuristic device to organize human experience, and the Spiral Dynamics model of human development organized around value memes or cultural units of information. Includes commentary by Beth L. Rodgers. (Contains 17 references.) (JOW)

Nurses' Perceptions of the Electronic Health Record

ERIC Educational Resources Information Center

Crawley, Rocquel Devonne

2013-01-01

The implementation of electronic health records (EHR) by health care organizations has been limited. Despite the broad consensus on the potential benefits of EHRs, health care organizations have been slow to adopt the technology. The purpose of this qualitative phenomenological study was to explore licensed practical and registered nurses'…

Self-perceived competency of infection control nurses based on Benner's framework: a nationwide survey in Korea.

PubMed

Kim, Kyung Mi; Choi, Jeong Sil

2015-05-01

The aim of this study was to evaluate the competency level of Korean infection control nurses (ICNs) by comparing the self-perceived competency level based on Benner's framework and the core competency proposed by the Certification Board of Infection Control. Study subjects included 90 ICNs working in Korean hospitals with more than 300 beds. A questionnaire was used to measure self-perceived competency level and core competency level. Using descriptive analysis, the core competency level of ICNs was found to differ significantly according to self-perceived competency level, and core competency level showed a significant increase with the increase of self-perceived competency level. Self-perceived competency level could be useful in classifying the competency level of nursing specialties. These results illustrate the competency levels of Korean ICNs and could serve as a reference to evaluate and expand the application of competency measurement not only for ICNs but also other groups of nurse specialists. Copyright © 2014 Elsevier Inc. All rights reserved.

Work ability in nursing: relationship with psychological demands and control over the work.

PubMed

Prochnow, Andrea; Magnago, Tânia Solange Bosi de Souza; Urbanetto, Janete de Souza; Beck, Carmem Lúcia Colomé; Lima, Suzinara Beatriz Soares de; Greco, Patrícia Bitencourt Toscani

2013-01-01

to evaluate the association between psychological demands, control over the work and the reduction of work ability of nursing professionals. this cross-sectional study involved 498 nursing professionals of a university hospital in the State of Rio Grande do Sul, Brazil. Data collection was carried out in 2009 using the Brazilian versions of the Work Ability Index and Job Stress Scale, with logistic regression models used for the data analysis. the prevalence of 43.3% for reduced work ability and 29.7% for high-strain in the job (high psychological demand and low control) were observed. The chances for professionals presenting reduced work ability under high-strain were higher and significant when compared to those classified as being under low-strain, even after adjusting for potential confounders, except for age and gender. a high prevalence of reduced work ability was observed. This evidence indicates the need for investigation and detailed analysis of the psychosocial aspects of the professionals with regard to the health/disease process of nursing professionals.

Registered Nurses' Experiences With Individuals With Low Health Literacy: A Qualitative Descriptive Study.

PubMed

Toronto, Coleen E; Weatherford, Barbara

2016-01-01

The nursing profession is charged to provide effective communication and education to patients. A qualitative descriptive study that explored what nurses experience when interacting with patients thought to possess low health literacy was performed. Findings suggest that nurses are promoting health literacy using several evidence-based strategies. Major barriers encountered by nurses were limited cultural and linguistic resources within their healthcare organizations. This study provides nursing professional development specialists information about the educational gaps of nurses in practice related to health literacy and the identification of systems barriers.

Practices for caring in nursing: Brazilian research groups.

PubMed

Erdmann, A L; de Andrade, S R; de Mello, A L Ferreira; Klock, P; do Nascimento, K C; Koerich, M Santos; Backes, D Stein

2011-09-01

The present study considers the production of knowledge and the interactions in the environment of research and their relationships in the system of caring in nursing and health. To elaborate a theoretical model of the organization of the practices used for caring, based on the experiences made by the research groups of administration and management in nursing, in Brazil. The study is based on grounded theory. Twelve leaders of research groups, working as professors in public universities in the south and the south-east of Brazil, distributed in sample groups, were interviewed. The core phenomenon 'research groups of administration and management in nursing: arrangements and interactions in the system of caring in nursing' was derived from the categories: conceptual bases and contexts of the research groups; experiencing interactions in the research groups; functionality of the research groups; and outputs of the research groups. The research groups are integrated in the system of caring in nursing. The activities of the Brazilian administration and management in nursing research groups are process oriented and in a process of constant renovation, socially relevant, operate in a complex scenario and contribute to the advancement of the organizations of the system of caring in nursing through strengthening the connection among academia, service and community. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

Administrator turnover and quality of care in nursing homes.

PubMed

Castle, N G

2001-12-01

In this article, I examine the association between turnover of nursing home administrators and five important quality of care outcomes. The data came from a survey of 420 nursing facilities and the 1999 On-line Survey, Certification, and Reporting System. Using multivariate logistic regression analyses, I looked at the effects of turnover of administrators in nursing homes belonging to chain organizations and in nursing homes not belonging to chain organizations. I found the average annual turnover rate of administrators to be 43%. The multivariate logistic regression analyses show that in nursing homes belonging to chains, administrator turnover is associated with a higher than average proportion of residents who were catheterized, had pressure ulcers, and were given psychoactive drugs and with a higher than average number of quality-of-care deficiencies. In nursing homes not belonging to chains I found that turnover of administrators is associated with a higher than average proportion of residents who were restrained, were catheterized, had pressure ulcers, and were given psychoactive drugs. There is a need to improve understanding of how and why better outcomes are achieved in some nursing homes. This investigation serves to focus attention on nursing home administrators. I believe this study provides preliminary evidence that the turnover of administrators may have an important association with quality of care in nursing homes.

[Aims and core contents of basic and post basic courses of nursing management].

PubMed

Saiani, Luisa; Brugnolli, Anna

2006-01-01

The second part of the issue, dedicated to the nursing management offers a discussion on some of the relevant areas of debate for the organization of nursing care. A reflection on the core contents and main aims of basic and post basic (master, advanced level, specialistic degree) nursing courses is proposed in the first contribution. Then a selection of topics is presented, focusing on the main research contributions available in the literature and on the ongoing debate for the following areas: the role of communication at the inter-shift handover and the new model of bedside reporting; the problems and challenges of doctors nurses collaboration in the health care team; the problems and expectations of new nurses joining the health care team and the process of development of practical skills; the hot debate on nursing roles and level of practice and the difficulties in differentiating between elementary, specialist and advanced nursing practice; the new emerging roles: the characteristics and achievements of Nurse Consultant; the new challenges of coordinators of the health care teams with the management of the multigenerational nursing team. For each topic a definition of the problem is presented, an example of relevant study, a critical debate and suggestions for further studies and areas of research. A list of the main journals that deal with nursing management is proposed with comments on the main characteristics of each journal. A study protocol that aims at describing the outcomes of the different styles and models of organization of medical wards on patients and nurses is presented as an example of organizative research; an experience of, and a model for, participation of the nurses to health policy planning is proposed. Nurses were, asked to identify health care problems encountered in their daily practice, their causes and propose solutions at basic and policy level. The session of International Observatory explores the main problems and difficulties of the research on the organization of care, focusing more on opportunities than on the challenges and drawbacks of the available literature.

Gender and professional identity in psychiatric nursing practice in Alberta, Canada, 1930-75.

PubMed

Boschma, Geertje; Yonge, Olive; Mychajlunow, Lorraine

2005-12-01

This paper examines gender-specific transformations of nursing practice in institutional mental health-care in Alberta, Canada, based on archival records on two psychiatric hospitals, Alberta Hospital Ponoka and Alberta Hospital Edmonton, and on oral histories with psychiatric mental health nurses in Alberta. The paper explores class and gender as interrelated influences shaping the work and professional identity of psychiatric mental health nurses from the 1930s until the mid-1970s. Training schools for nurses in psychiatric hospitals emerged in Alberta in the 1930s under the influence of the mental hygiene movement, evolving quite differently for female nurses compared to untrained aides and male attendants. The latter group resisted their exclusion from the title 'nurse' and successfully helped to organize a separate association of psychiatric nurses in the 1950s. Post-World War II, reconstruction of health-care and a de-institutionalization policy further transformed nurses' practice in the institutions. Using social history methods of analysis, the paper demonstrates how nurses responded to their circumstances in complex ways, actively participating in the reconstruction of their practice and finding new ways of professional organization that fit the local context. After the Second World War more sophisticated therapeutic roles emerged and nurses engaged in new rehabilitative practices and group therapies, reconstructing their professional identities and transgressing gender boundaries. Nurses' own stories help us to understand the striving toward psychiatric nursing professionalism in the broader context of changing gender identities and work relationships, as well as shifting perspectives on psychiatric care.

Development of quality standards in inflammatory bowel disease management and design of an evaluation tool of nursing care.

PubMed

Torrejón, Antonio; Oltra, Lorena; Hernández-Sampelayo, Paloma; Marín, Laura; García-Sánchez, Valle; Casellas, Francesc; Alfaro, Noelia; Lázaro, Pablo; Vera, María Isabel

2013-01-01

nursing management of inflammatory bowel disease (IBD) is highly relevant for patient care and outcomes. However, there is evidence of substantial variability in clinical practices. The objectives of this study were to develop standards of healthcare quality for nursing management of IBD and elaborate the evaluation tool "Nursing Care Quality in IBD Assessment" (NCQ-IBD) based on these standards. a 178-item healthcare quality questionnaire was developed based on a systematic review of IBD nursing management literature. The questionnaire was used to perform two 2-round Delphi studies: Delphi A included 27 IBD healthcare professionals and Delphi B involved 12 patients. The NCQ-IBD was developed from the list of items resulting from both Delphi studies combined with the Scientific Committee´s expert opinion. the final NCQ-IBD consists of 90 items, organized in13 sections measuring the following aspects of nursing management of IBD: infrastructure, services, human resources, type of organization, nursing responsibilities, nurse-provided information to the patient, nurses training, annual audits of nursing activities, and nursing research in IBD. Using the NCQ-IBD to evaluate these components allows the rating of healthcare quality for nursing management of IBD into 4 categories: A (highest quality) through D (lowest quality). the use of the NCQ-IBD tool to evaluate nursing management quality of IBD identifies areas in need of improvement and thus contribute to an enhancement of care quality and reduction in clinical practice variations.

A multivariate fall risk assessment model for VHA nursing homes using the minimum data set.

PubMed

French, Dustin D; Werner, Dennis C; Campbell, Robert R; Powell-Cope, Gail M; Nelson, Audrey L; Rubenstein, Laurence Z; Bulat, Tatjana; Spehar, Andrea M

2007-02-01

The purpose of this study was to develop a multivariate fall risk assessment model beyond the current fall Resident Assessment Protocol (RAP) triggers for nursing home residents using the Minimum Data Set (MDS). Retrospective, clustered secondary data analysis. National Veterans Health Administration (VHA) long-term care nursing homes (N = 136). The study population consisted of 6577 national VHA nursing home residents who had an annual assessment during FY 2005, identified from the MDS, as well as an earlier annual or admission assessment within a 1-year look-back period. A dichotomous multivariate model of nursing home residents coded with a fall on selected fall risk characteristics from the MDS, estimated with general estimation equations (GEE). There were 17 170 assessments corresponding to 6577 long-term care nursing home residents. The increased odds ratio (OR) of being classified as a faller relative to the omitted "dependent" category of activities of daily living (ADL) ranged from OR = 1.35 for "limited" ADL category up to OR = 1.57 for "extensive-2" ADL (P < .0001). Unsteady gait more than doubles the odds of being a faller (OR = 2.63, P < .0001). The use of assistive devices such as canes, walkers, or crutches, or the use of wheelchairs increases the odds of being a faller (OR = 1.17, P < .0005) or (OR = 1.19, P < .0002), respectively. Foot problems may also increase the odds of being a faller (OR = 1.26, P < .0016). Alzheimer's or other dementias also increase the odds of being classified as a faller (OR = 1.18, P < .0219) or (OR=1.22, P < .0001), respectively. In addition, anger (OR = 1.19, P < .0065); wandering (OR = 1.53, P < .0001); or use of antipsychotic medications (OR = 1.15, P < .0039), antianxiety medications (OR = 1.13, P < .0323), or antidepressant medications (OR = 1.39, P < .0001) was also associated with the odds of being a faller. This national study in one of the largest managed healthcare systems in the United States has empirically confirmed the relative importance of certain risk factors for falls in long-term care settings. The model incorporated an ADL index and adjusted for case mix by including only long-term care nursing home residents. The study offers clinicians practical estimates by combining multiple univariate MDS elements in an empirically based, multivariate fall risk assessment model.

The costs of nurse turnover: part 1: an economic perspective.

PubMed

Jones, Cheryl Bland

2004-12-01

Nurse turnover is costly for healthcare organizations. Administrators and nurse executives need a reliable estimate of nurse turnover costs and the origins of those costs if they are to develop effective measures of reducing nurse turnover and its costs. However, determining how to best capture and quantify nurse turnover costs can be challenging. Part 1 of this series conceptualizes nurse turnover via human capital theory and presents an update of a previously developed method for determining the costs of nurse turnover, the Nursing Turnover Cost Calculation Method. Part 2 (January 2005) presents a recent application of the methodology in an acute care hospital.

Implementing a Process to Measure Return on Investment for Nursing Professional Development.

PubMed

Garrison, Elisabeth; Beverage, Jodie

Return on investment (ROI) is one way to quantify the value that nursing professional development brings to the organization. This article describes a process to begin tracking ROI for nursing professional development. Implementing a process of tracking nursing professional development practitioners' ROI increased awareness of the financial impact and effectiveness of the department.

Rural Critical Care Nurse Training Project--Four Corners Area, November 14, 1975.

ERIC Educational Resources Information Center

New Mexico Regional Medical Program, Albuquerque.

Project objectives were to train 10 nurses from hospitals in the Four Corners Area in rural critical care nursing, to have a training director organize and coordinate the project, and to utilize the replacement nurse concept. The course curriculum was determined through a needs assessment survey conducted by a team of health professionals from…

Nurse Aide Empowerment Strategies and Staff Stability: Effects on Nursing Home Resident Outcomes

ERIC Educational Resources Information Center

Barry, Theresa; Brannon, Diane; Mor, Vincent

2005-01-01

Purpose: This study examines the moderating effect of staff stability on the relationship between management practices used to empower nurse aides and resident outcomes in a multistate sample of nursing homes. An adaptation of Kanter's theory of structural power in organizations guided the framework for the model used in this study. Design and…

Nurse Preparation and Organizational Support for Supervision of Unlicensed Assistive Personnel in Nursing Homes: A Qualitative Exploration

ERIC Educational Resources Information Center

Siegel, Elena O.; Young, Heather M.; Mitchell, Pamela H.; Shannon, Sarah E.

2008-01-01

Purpose: Nursing supervision of the routine daily care (e.g., grooming, feeding, and toileting) that is delegated to unlicensed assistive personnel (UAP) is critical to nursing home service delivery. The conditions under which the supervisory role is organized and operationalized at the work-unit level, taking into account workloads, registered…

Creating tomorrow's leaders today: the Emerging Nurse Leaders Program of the Texas Nurses Association.

PubMed

Sportsman, Susan; Wieck, Lynn; Yoder-Wise, Patricia S; Light, Kathleen M; Jordan, Clair

2010-06-01

The Texas Nurses Association initiated an Emerging Nurse Leaders Program as an approach to engaging new nurses in the leadership of the professional association. This article explains the program's origin, the commitment of the Texas Nurses Association to this process, the implementation of the plan, and the discussions that launched a new way of connecting leaders across generations. Further, it is an approach that any professional organization can use to encourage the involvement of new leaders.

Nursing under the influence: a relational ethics perspective.

PubMed

Kunyk, Diane; Austin, Wendy

2012-05-01

When nurses have active and untreated addictions, patient safety may be compromised and nurse-health endangered. Genuine responses are required to fulfil nurses' moral obligations to their patients as well as to their nurse-colleagues. Guided by core elements of relational ethics, the influences of nursing organizational responses along with the practice environment in shaping the situation are contemplated. This approach identifies the importance of consistency with nursing values, acknowledges nurses interdependence, and addresses the role of nursing organization as moral agent. By examining the relational space, the tension between what appears to be opposing moral responsibilities may be healed. Ongoing discourse to identify authentic actions for the professional practice issue of nursing under the influence is called upon.

Building a vision for the future: strategic planning in a shared governance nursing organization.

PubMed

Baker, C; Beglinger, J E; Bowles, K; Brandt, C; Brennan, K M; Engelbaugh, S; Hallock, T; LaHam, M

2000-06-01

Today's health care delivery environment is marked by extreme turbulence and ever-increasing complexity. Now, more than ever, an organization's strategic plan must do more than outline a business plan. Rather, the strategic plan is a fundamental tool for building and sustaining an organizational vision for the future. The strong, dynamic strategic plan (1) represents a long-range vision for improving organizational performance, (2) provides a model for planning and implementing structures and processes for the management of outcomes, (3) reflects and shapes the organizational culture and customer focus, (4) provides decision support for difficult operational choices made day to day, and (5) integrates and aligns the work of the organization. This article describes the development, implementation, and evaluation of a methodology for strategic planning within a shared governance nursing organization. Built upon the strategic plan of the hospital, the process undertaken by the nursing organization reflects the following commitments: (1) to develop a strategic plan that is meaningful and part of daily work life at all levels of the nursing organization, (2) to make the plan practical and realistic through incremental building, (3) to locate and articulate accountability for each step, and (4) to build in a process for checking progress toward goal achievement and readjusting the plan as necessary.

Political advocacy and practice barriers: a survey of Florida APRNs.

PubMed

Kung, Ying Mai; Rudner Lugo, Nancy

2015-03-01

This study examined factors aligned with advocacy among advanced practice registered nurses (APRNs) by examining the relationships among demographics, years of RN and APRN experience, education levels, affiliations with professional organizations, perceptions of barriers to practice, political activism, and willingness to speak to the media. This was a secondary analysis of online survey data (N = 884) from APRNs in Florida. All APRNs with an e-mail address with the state nursing board or a Florida Coalition of Advanced Practice Nurses' membership organization received an e-mail requesting their participation to the survey. Having a high educational level and involvement in a professional organization are each individually statistically associated with perceiving practice barriers, engaging in political activism, and willingness to speak with media. Emerging nurse leaders need an understanding of policy issues, an appreciation of the potential of the profession, and enhanced advocacy skills. To address the nation's health needs, APRNs need to recognize practice barriers, develop advocacy skills, and take action for policy changes to enhance the legal authority to practice to full extent of APRNs' education and training. ©2014 American Association of Nurse Practitioners.

Medical staff organization in nursing homes: scale development and validation.

PubMed

Katz, Paul R; Karuza, Jurgis; Intrator, Orna; Zinn, Jacqueline; Mor, Vincent; Caprio, Thomas; Caprio, Anthony; Dauenhauer, Jason; Lima, Julie

2009-09-01

To construct a multidimensional self-report scale to measure nursing home (NH) medical staff organization (NHMSO) dimensions and then pilot the scale using a national survey of medical directors to provide data on its psychometric properties. Instrument development process consisting of the proceedings from the Nursing Home Physician Workforce Conference and focus groups followed by cognitive interviews, which culminated in a survey of a random sample of American Medical Directors Association (AMDA) affiliated medical directors. Analyses were conducted on surveys matched to Online Survey Certification and Reporting (OSCAR) data from freestanding nonpediatric nursing homes. A total of 202 surveys were available for analysis and comprised the final sample. Dimensions were identified that measured the extent of medical staff organization in nursing homes and included staff composition, appointment process, commitment (physiciancohesion; leadership turnover/capability), departmentalization (physician supervision, autonomy and interdisciplinary involvement), documentation, and informal dynamics. The items developed to measure each dimension were reliable (Cronbach's alpha ranged from 0.81 to 0.65).Intercorrelations among the scale dimensions provided preliminary evidence of the construct validity of the scale. This report, for the first time ever, defines and validates NH medical staff organization dimensions, a critical first step in determining the relationship between physician practice and the quality of care delivered in the NH.

Morbidity among nursing personnel and its association with working conditions and work organization.

PubMed

Vasconcelos, S; Marqueze, E; Gonçalves, L; Lemos, L; Araújo, L; Fischer, F M; Moreno, C R C

2012-01-01

Work organization patterns and working conditions experienced by nursing personnel in the hospital settings may be associated to increased morbidity among these health workers. To estimate the prevalence and factors associated with self-reported diseases among nursing personnel at the emergency hospital in Rio Branco/State of Acre, Brazil. A cross-sectional study was conducted involving 272 participants who answered a questionnaire including sociodemographic characteristics, working conditions, lifestyles, work ability, and a fatigue perception scale. The self-reported diseases in the 12 months prior to data collection were considered the dependent variable. A total of 85.7% of the participants reported one or more diseases in the past 12 months. Most prevalent diseases were: musculoskeletal diseases (37.1%), digestive diseases (28.7%), mental disorders (28.3%), work injuries (27.9%), and respiratory diseases (26.8%). The following significant variables remained in the final model: high work demands (OR 2.69), reported fatigue (OR 3.59), night work (OR 6.55) and being a technician or nursing assistant (OR 4.23). Variables related to working conditions and work organization were associated with the occurrence of reported diseases among nursing professionals. Health promotion measures at work require a comprehensive approach including the working conditions and the work organization.

Global Immunizations: Health Promotion and Disease Prevention Worldwide.

PubMed

Macintosh, Janelle L B; Eden, Lacey M; Luthy, Karlen E; Schouten, Aimee E

Immunizations are one of the most important health interventions of the 20th century, yet people in many areas of the world do not receive adequate immunizations. Approximately 3 million people worldwide die every year from vaccine-preventable diseases; about half of these deaths are young children and infants. Global travel is more common; diseases that were once localized now can be found in communities around the world. Multiple barriers to immunizations have been identified. Healthcare access, cost, and perceptions of safety and trust in healthcare are factors that have depressed global immunization rates. Several global organizations have focused on addressing these barriers as part of their efforts to increase immunization rates. The Bill and Melinda Gates Foundation, The World Health Organization, and the United Nations Children's Emergency Fund each have a part of their organization that is concentrated on immunizations. Maternal child nurses worldwide can assist in increasing immunization rates. Nurses can participate in outreach programs to ease the burden of patients and families in accessing immunizations. Nurses can work with local and global organizations to make immunizations more affordable. Nurses can improve trust and knowledge about immunizations in their local communities. Nurses are a powerful influence in the struggle to increase immunization rates, which is a vital aspect of global health promotion and disease prevention.

[Factors related to nurses' patient identification behavior and the moderating effect of person-organization value congruence climate within nursing units].

PubMed

Kim, Young Mee; Kang, Seung Wan; Kim, Se Young

2014-04-01

This research was an empirical study designed to identify precursors and interaction effects related to nurses' patient identification behavior. A multilevel analysis methodology was used. A self-report survey was administered to registered nurses (RNs) of a university hospital in South Korea. Of the questionnaires, 1114 were analyzed. The individual-level factors that had a significantly positive association with patient identification behavior were person-organization value congruence, organizational commitment, occupational commitment, tenure at the hospital, and tenure at the unit. Significantly negative group-level precursors of patient identification behavior were burnout climate and the number of RNs. Two interaction effects of the person-organization value congruence climate were identified. The first was a group-level moderating effect in which the negative relationship between the number of RNs and patient identification behavior was weaker when the nursing unit's value congruence climate was high. The second was a cross-level moderating effect in which the positive relationship between tenure at the unit and patient identification behavior was weaker when value congruence climate was high. This study simultaneously tested both individual-level and group-level factors that potentially influence patient identification behavior and identified the moderating role of person-organization value congruence climate. Implications of these results are discussed.

[A MULTIDISCIPLINARY BIOPSYCHOSOCIAL INTEGRATED APPROACH IN ORGANIZATION OF REHABILITATIVE ACTIVITY IN NURSING HOMES (RSA)].

PubMed

Panella, Lorenzo; Piccioni, Davide; Borcescu, Lidia; Isella, Celeste; Callegari, Camilla

2015-01-01

Objectives, social role and organization of Italian nursing homes (RSA) are characterized by a pronounced regional differentiation that causes situations which are difficult to compare about expected outcomes. The definition of a functional outcome is particularly difficult in institutionalized patients and this is due to the failure of a conclusive moment of the rehabilitative treatment. Furthermore we often take care of patients who have already been admitted to intensive and/or extensive rehabilitation units time after time, without further functional profit margin. The inconstant presence of professional figures of rehabilitation in nursing homes' staff makes difficult the drafting of an adequate rehabilitative project, especially for the multiple needs of frail old people. Starting with these assumptions, authors hypothesize and adopt a model of sanitary organization to consent a correct allocation of available resources, according to the patient's needs. They stratified all nursing home patients, using the Multidimensional Prognostic Index (MPI) and "Scheda di osservazione intermedia assistenza" (SOSIA), and measured the residual function. They concluded that a multidimensional evaluation of patients allows to identify wellness (of the sick person and of caregivers) as the main objective; nursing home organization could be think as a "complex supportive prosthesis for old people", made by the interaction among structure, operators and activities.

Experiences of the fairness of recruitment from unsuccessful applicants in the field of nursing.

PubMed

Kanerva, Anne; Lammintakanen, Johanna; Kivinen, Tuula

2010-04-01

The purpose of this study was to describe the experiences of unsuccessful applicants for permanent nursing positions with regard to the fairness of the recruitment process. The international shortage of recruits in nursing and the rapidly increasing number of nurses retiring implies new challenges for recruitment. The nurses' experiences of fairness affect the availability of nurses and the attractiveness of the organization. The recruitment process is approached through traditional organizational justice theories. The material was gathered from thematic interviews with 12 nurses who had applied for a permanent nursing position but were not selected. The material was analysed using theory-driven content analysis. The nurses felt differently about the result of the recruitment process. The experience of distributive justice alone was not significant in terms of the general sense of justice, since other dimensions of justice compensated for it. The effect of applicants' experiences of fair treatment in the recruitment process affected their future behaviour positively, negatively or not at all. and implications for nursing management It is crucial to recognize applicants' experiences of the fairness of the recruitment process, because unsuccessful applicants constitute a pool of potential new employees. Furthermore, applicants with different experiences cannot be seen as a homogenous group. For example, internal applicants with negative experiences pose challenges for nursing management with regard to retaining them in the organization.

Government chief nursing officers' perceptions of barriers to using research on staffing.

PubMed

Baernholdt, M; Lang, N M

2007-03-01

Current global healthcare problems include nursing shortages contributing to low nurse staffing. Low nurse staffing is associated with poor patient and nurse outcomes, but research utilization using these findings especially at the policy level remains slow. To assess high-ranking government nurses' perceptions of barriers to using research on nurse staffing. An electronic information message about the impact of nurse staffing was presented to government chief nursing officers (CNOs) from 110 countries. The CNOs' perceptions of local barriers to utilizing these research findings were then assessed in an electronic survey. The four factors that influence the first two stages of Rogers's five-stage model of diffusion were examined. The factors, characteristics of the adopter, organization, innovation and communication, were measured using an adapted version of the BARRIERS scale. Barriers were present in all four characteristics. The top barrier was lack of reports and studies in one place. Other barriers were lack of cooperation within the organization and lack of awareness of the research findings. Differences according to Gross National Income were also noted. The CNOs and other health policy advisors can use the findings in planning for adequate nurse staffing. Development of electronic newsletters with summaries of pertinent research for CNOs and other policy advisors is needed. Future studies on nurse staffing are warranted. They should focus on other settings and how best to share research findings with policymakers.

A Contextual Work-Life Experiences Model to Understand Nurse Commitment and Turnover.

PubMed

Aluwihare-Samaranayake, Dilmi; Gellatly, Ian; Cummings, Greta; Ogilvie, Linda

2018-05-17

To present a discussion and model depicting most effecting work life experience contextual factors that influence commitment and turnover intentions for nurses in Sri Lanka. Increasing demand for nurses has made the retention of experienced, qualified nursing staff a priority for health care organizations and highlights the need to capture contextual work-life experiences that influence nurses' turnover decisions. Discussion paper. This discussion paper and model is based on our experiences and knowledge of Sri Lanka and represents an integration of classic turnover research and commitment theory and others published between 1958 - 2017, contextualized to reflect the reality faced by Sri Lanka nurses. The model presents a high-level view of intrinsic, extrinsic, personal and professional antecedents to nurse turnover where relevance can be used by researchers, policy makers, clinicians and educators to establish focused and limited scope models and examine comprehensive contexts. This model emphasizes the role that work-life experiences play to fortify (or weaken) nurses' motivation to remain committed to their organization, profession, family, and country. Understanding of contextual work-life influences on nurses' intent to stay should lead to evidence-based strategies that result in a higher number of nurses wanting to remain in the nursing profession and work in the health sector in Sri Lanka. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The state of collaborative work with nurses in Israel: a mixed method study.

PubMed

Warshawski, Sigalit

2016-10-01

Effective collaboration among health professionals is associated with patient safety, quality of care and professionals' satisfaction. Nurse-physician collaboration has been a topic of substantial research worldwide. In Israel, few studies have examined this subject, but none has explored health professionals' collaborative practice with nurses, although nursing in Israel is experiencing significant professional changes. The aim of this study was to explore health professionals' attitudes toward collaboration with nurses and how these attitudes relate to their perceptions of role overlap, role clarity and feeling of threat. Research data were collected employing both quantitative and qualitative methods. A structured questionnaire was fulfilled by 262 participants, following which 12 personal interviews and 12 observations were conducted in hospital wards. Participants' attitudes toward collaboration with nurses were found statistically related to their perception of role overlap, role clarity and feeling of professional threat. Interviews and observations indicated immediate mutual assistance among professionals instead of collaborative practice. Interactions were brief and purposeful. The results highlight the absence of an organized procedure for collaborative practice with nurses. Therefore, it is necessary to act at the organization and departments, to assimilate nurses' role and the importance of collaborative practice. Nurse leaders and nurse educators must consider pragmatic and effective means to promote and articulate nurses' role in inter-professional clinical settings. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Global Nursing Issues and Development: Analysis of World Health Organization Documents.

PubMed

Wong, Frances Kam Yuet; Liu, Huaping; Wang, Hui; Anderson, Debra; Seib, Charrlotte; Molasiotis, Alex

2015-11-01

To analyze World Health Organization (WHO) documents to identify global nursing issues and development. Qualitative content analysis. Documents published by the six WHO regions between 2007 and 2012 and with key words related to nurse/midwife or nursing/midwifery were included. Themes, categories, and subcategories were derived. The final coding reached 80% agreement among three independent coders, and the final coding for the discrepant coding was reached by consensus. Thirty-two documents from the regions of Europe (n = 19), the Americas (n = 6), the Western Pacific (n = 4), Africa (n = 1), the Eastern Mediterranean (n = 1), and Southeast Asia (n = 1) were examined. A total of 385 units of analysis dispersed in 31 subcategories under four themes were derived. The four themes derived (number of unit of analysis, %) were Management & Leadership (206, 53.5), Practice (75, 19.5), Education (70, 18.2), and Research (34, 8.8). The key nursing issues of concern at the global level are workforce, the impacts of nursing in health care, professional status, and education of nurses. International alliances can help advance nursing, but the visibility of nursing in the WHO needs to be strengthened. Organizational leadership is important in order to optimize the use of nursing competence in practice and inform policy makers regarding the value of nursing to promote people's health. © 2015 Sigma Theta Tau International.

The nurses of the Brazilian expeditionary force and the dissemination of their return home.

PubMed

Oliveira, Alexandre Barbosa de; Santos, Tânia Cristina Franco; Barreira, Ieda de Alencar; Almeida Filho, Antonio José de

2009-01-01

This historical-social study aimed to examine the symbolic elements that express the hierarchizing division between the male and female, contained in newspaper reports published about the return home of the nurses who worked in the Brazilian Expeditionary Force's Health Service, and to discuss the symbolic effects these reports produced. The historical sources of the study, consisting of photographic, written and oral documents, were classified and analyzed in the light of Pierre Bourdieu's Social Theory and Michelle Perrot's studies on Women's History. The research revealed that the way the news reports about the arrival of these nurses to Brazil were disseminated represented the reproduction of a symbolic strategy to enforce political and social interests in force, and that contained the ideas about the hierarchizing division of the social world into male and female.

The impact of protocol on nurses' role stress: a longitudinal perspective.

PubMed

Dodd-McCue, Diane; Tartaglia, Alexander; Veazey, Kenneth W; Streetman, Pamela S

2005-04-01

The study examined the impact of a protocol directed at increasing organ donation on the role stress and work attitudes of critical care nurses involved in potential organ donation cases. The research examined whether the protocol could positively affect nurses' perceptions of role stress, and if so, could the work environment improvements be sustained over time. The Family Communication Coordinator (FCC) protocol promotes effective communication during potential organ donation cases using a multidisciplinary team approach. Previous research found it associated with improved donation outcomes and with improved perceptions of role stress by critical care nurses. However, the previous study lacked methodological rigor necessary to determine causality and sustainability over time. The study used a quasi-experimental prospective longitudinal design. The sample included critical care nurses who had experience with potential organ donation cases with the protocol. Survey data were collected at 4 points over 2 years. Surveys used previously validated and reliable measures of role stress (role ambiguity, role conflict, role overload) and work attitudes (commitment, satisfaction). Interviews supplemented these data. The nurses' perceptions of role stress associated with potential organ donation cases dramatically dropped after the protocol was implemented. All measures of role stress, particularly role ambiguity and role conflict, showed statistically significant and sustained improvement. Nurses' professional, unit, and hospital commitment and satisfaction reflect an increasingly positive workplace. The results demonstrate that the FCC protocol positively influenced the workplace through its impact on role stress over the first 2 years following its implementation. The findings suggest that similar protocols may be appropriate in improving the critical care environment by reducing the stress and uncertainty of professionals involved in other end-of-life situations. However, the most striking implication relates to the reality of the workplace: meeting the goals of improved patient care outcomes and those of improving the healthcare work environment are not mutually exclusive and may be mutually essential.

Primary care nursing role and care coordination: an observational study of nursing work in a community health center.

PubMed

Anderson, Daren R; St Hilaire, Daniel; Flinter, Margaret

2012-05-31

Care coordination is a core element of the Patient-Centered Medical Home and requires an effective, well educated nursing staff. A greater understanding of roles and tasks currently being carried out by nurses in primary care is needed to help practices determine how best to implement care coordination and transform into PCMHs. We conducted an observational study of primary care nursing in a Community Health Center by creating a classification schema for nursing responsibilities, directly observing and tracking nurses' work, and categorizing their activities. Ten nurses in eight different practice sites were observed for a total of 61 hours. The vast majority of nursing time was spent in vaccine and medication administration; telephone work; and charting and paper work, while only 15% of their time was spent in activity that was classified broadly as care coordination. Care coordination work appeared to be subsumed by other daily tasks, many of which could have been accomplished by other, lesser trained members of the health care team. Practices looking to implement care coordination need a detailed look at work flow, task assignments, and a critical assessment of staffing, adhering to the principal of each team member working to the highest level of his or her education and license. Care coordination represents a distinct responsibility that requires dedicated nursing time, separate from the day to day tasks in a busy practice. To fully support these new functions, reimbursement models are needed that support such non visit-based work and provide incentives to coordinate and manage complex cases, achieve improved clinical outcomes and enhance efficiency of the health system. This article describes our study methods, data collection, and analysis, results, and discussion about reorganizing nursing roles to promote care coordination.

Predicting Factors of Depression and Anxiety in Mental Health Nurses: A Quantitative Cross-Sectional Study

PubMed Central

Tsaras, Konstantinos; Papathanasiou, Ioanna V.; Vus, Viktor; Panagiotopoulou, Antigoni; Katsou, Maria Alexandra; Kelesi, Martha; Fradelos, Evangelos C.

2018-01-01

Introduction The nursing profession is characterized as one of the most stressful and emotional dementing professions. It is widely agreed that many nurses are experiencing anxiety and depression as a results of their profession. Purpose The purpose of this study was to assess the prevalence and associated factors of depression and anxiety among mental health nurses working in public psychiatric hospitals, in order to identify independent predictors of mental health disorders risk. Material and Methods A descriptive, cross-sectional study was conducted in which 110 mental health nurses who were working in public psychiatric hospitals of Greece participated. The Patient Health Questionnaire-2 (PHQ-2) and the Generalized Anxiety Disorder-2 (GAD-2) questionnaire along with a sheet with basics demographic, social, and work characteristics, including gender, age, marital status, educational level, working experience in nursing, working position and shift, were used as instrument for data collection. Results The mean age of the nurses was 42.64 years (SD = 5.87 years) and working experience in nursing 15.73 years (SD = 5.64 years). Most participants were women 64.5%, married 59.1% and nursing assistant 53.6%, while 48.2% of them held a higher education degree. A very large percentage found to be classified as depressed (52.7%) and anxious (48.2%) and factors that found to be associated were age, marital status and educational level (for depression and anxiety) and working experience (only for depression). Conclusions Mental health nurses are in high risk for developing psychiatric disorders such as depression and anxiety. Being single, divorced or widowed, older, with many years of experience and a higher education degree can be predicting factors associated with depression and anxiety in mental health nurses. PMID:29416221

Data envelopment analysis model for the appraisal and relative performance evaluation of nurses at an intensive care unit.

PubMed

Osman, Ibrahim H; Berbary, Lynn N; Sidani, Yusuf; Al-Ayoubi, Baydaa; Emrouznejad, Ali

2011-10-01

The appraisal and relative performance evaluation of nurses are very important and beneficial for both nurses and employers in an era of clinical governance, increased accountability and high standards of health care services. They enhance and consolidate the knowledge and practical skills of nurses by identification of training and career development plans as well as improvement in health care quality services, increase in job satisfaction and use of cost-effective resources. In this paper, a data envelopment analysis (DEA) model is proposed for the appraisal and relative performance evaluation of nurses. The model is validated on thirty-two nurses working at an Intensive Care Unit (ICU) at one of the most recognized hospitals in Lebanon. The DEA was able to classify nurses into efficient and inefficient ones. The set of efficient nurses was used to establish an internal best practice benchmark to project career development plans for improving the performance of other inefficient nurses. The DEA result confirmed the ranking of some nurses and highlighted injustice in other cases that were produced by the currently practiced appraisal system. Further, the DEA model is shown to be an effective talent management and motivational tool as it can provide clear managerial plans related to promoting, training and development activities from the perspective of nurses, hence increasing their satisfaction, motivation and acceptance of appraisal results. Due to such features, the model is currently being considered for implementation at ICU. Finally, the ratio of the number DEA units to the number of input/output measures is revisited with new suggested values on its upper and lower limits depending on the type of DEA models and the desired number of efficient units from a managerial perspective.

[Nursing and marketing: an introduction to the subject].

PubMed

de Moura, Gisela Maria Schebella Souto

2003-08-01

The administration of health care services is becoming more and more professional. New models and strategies used by service companies, in other areas, are being introduced in these organizations. Through this importation process of models, marketing concepts and tools have been incorporated. The objective of this theoretical essay is offering the nurses an introductory view about marketing. In order to reach this objective, the text was organized into sections that approach its history and basic concepts, social marketing, a few subjects under discussion currently and studies carried out in the marketing area, which involve nursing and health care services. In this way, it is expected to contribute to the professional improvement of nursing.

Nursing issues in renal replacement therapy: organization, manpower assessment, competency evaluation and quality improvement processes.

PubMed

Graham, Patricia; Lischer, Eileen

2011-01-01

For the patient with acute kidney injury, continuous renal replacement therapy (CRRT) is a treatment option that has application for the hemodynamically unstable critically ill patient. The decision to initiate a continuous renal replacement modality depends not only on the physician, either the nephrologist or intensivist, but also on the availability of specially trained nursing resources. This article will explore the nursing collaborative model of care at a large university-based research and teaching Medical Center in Southern California. The focus will be on nursing issues in CRRT including organization of educational programs, manpower assessment, competency evaluation, and quality improvement processes. © 2011 Wiley Periodicals, Inc.

Organization-based self-development prescriptive model for the promotion of professional development of Iranian clinical nurses.

PubMed

Rahimaghaee, Flora; Nayeri, Nahid Dehghan; Mohammadi, Eesa; Salavati, Shahram

2015-01-01

Professional development is reiterated in the new definition of modern organizations as a serious undertaking of organizations. This article aims to present and describe a prescriptive model to increase the quality of professional development of Iranian nurses within an organization-based framework. This article is an outcome of the results of a study based on grounded theory describing how Iranian nurses develop. The present study adopted purposive sampling and the initial participants were experienced clinical nurses. Then, the study continued by theoretical sampling. The present study involved 21 participants. Data were mainly collected through interviews. Analysis began with open coding and continued with axial coding and selective coding. Trustworthiness was ensured by applying Lincoln and Guba criteria such as credibility, dependability, and conformability. Based on the data gathered in the study and a thorough review of related literature, a prescriptive model has been designed by use of the methodology of Walker and Avant (2005). In this model, the first main component is a three-part structure: Reformation to establish a value-assigning structure, a position for human resource management, and a job redesigning. The second component is certain of opportunities for organization-oriented development. These strategies are as follows: Raising the sensitivity of the organization toward development, goal setting and planning the development of human resources, and improving management practices. Through this model, clinical nurses' professional development can transform the profession from an individual, randomized activity into more planned and systematized services. This model can lead to a better quality of care.

Effectiveness of team nursing compared with total patient care on staff wellbeing when organizing nursing work in acute care wards: a systematic review.

PubMed

King, Allana; Long, Lesley; Lisy, Karolina

2015-11-01

The organization of the work of nurses, according to recognized models of care, can have a significant impact on the wellbeing and performance of nurses and nursing teams. This review focuses on two models of nursing care delivery, namely, team and total patient care, and their effect on nurses' wellbeing. To examine the effectiveness of team nursing compared to total patient care on staff wellbeing when organizing nursing work in acute care wards. Participants were nurses working on wards in acute care hospitals.The intervention was the use of a team nursing model when organizing nursing work. The comparator was the use of a total patient care model.This review considered quantitative study designs for inclusion in the review.The outcome of interest was staff wellbeing which was measured by staff outcomes in relation to job satisfaction, turnover, absenteeism, stress levels and burnout. The search strategy aimed to find both published and unpublished studies from 1995 to April 21, 2014. Quantitative papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute. Data was extracted from papers included in the review using the standardized data extraction tool from the Joanna Briggs Institute. The data extracted included specific details about the interventions, populations, study methods and outcomes of significance to the review question and its specific objectives. Due to the heterogeneity of the included quantitative studies, meta-analysis was not possible. Results have been presented in a narrative form. The database search returned 10,067 records. Forty-three full text titles were assessed, and of these 40 were excluded, resulting in three studies being included in the review. Two of the studies were quasi experimental designs and the other was considered an uncontrolled before and after experimental study. There were no statistically significant differences observed in any study in the overall job satisfaction of nurses using a team nursing model compared with a total patient care model. Some differences in job satisfaction were however observed within different subgroups of nurses. There were no statistically significant differences in either stress or job tension. Within the selected studies, the specific outcomes of absenteeism and burnout were not addressed. Due to the limited number of quantitative studies identified for inclusion in this systematic review it is not possible to determine whether organizing nursing work in a team nursing or total patient care model is more effective in terms of staff wellbeing in acute care settings. Neither a team nursing or total patient care model had a significant influence on nurses' overall job satisfaction, stress levels or staff turnover. This review could not ascertain if the type of model of care affects absenteeism or burnout as these were not addressed in any of the identified studies.Caution should be taken when evaluating which model of care is appropriate and the decision needs to incorporate staff experience levels and staff skill mix. There needs to be clear definition of nursing roles.This review demonstrates the need for further quantitative studies of these models of care that are well designed with sufficient sample sizes to allow for attrition of participants, and that explore the impact each model has on nurse's wellbeing, in particular, studies that address burnout and absenteeism. There is a need for consistent terminology to allow for future comparison and research to occur at an international level. Future studies on models of care should include economic analysis to fully inform policy and practice.

Factors Affecting Attitude Toward Organ Donation Among Nursing Students in Warsaw, Poland.

PubMed

Mikla, M; Rios, A; Lopez-Navas, A; Gotlib, J; Kilanska, D; Martinez-Alarcón, L; Ramis, G; Ramirez, P; Lopez Montesinos, M J

2015-11-01

The opinion of future nursing professionals can influence the number of transplants. The objective of this study was to analyze the attitude of nursing students at the Medical University of Warsaw in the center of Poland toward organ donation and determine the factors that affect this attitude. The study was conducted in the 2011 to 2012 academic year. The study population consisted of nursing students. Type of sampling consisted of sampling in points of compulsory attendance, in the 5 nursing courses with the higher degree of fulfillment of 80%. Measuring instrument used was the validated questionnaire (PCID-DTO Rios). The questionnaire was completed anonymously and was self-administered. The completion rate was 96% (793 of 828). Of the students surveyed (n = 793), 69% (n = 547) were in favor of organ donation and transplantation, 25% (n = 201) were undecided, and 6% (n = 45) were against. This attitude was related to being in favor of donating the organs of a relative (OR = 3.174; P < .001); discussion of the subject with the family (OR = 2.188; P < .001); positive attitude toward donation and transplantation of the father (OR = 3.039; P = .001); considered to having good information on the subject (OR = 8.695; P < .001); being a regular donor blood (OR = 3.597; P = .001); not worried by the possible mutilation of the body after donation (OR = 6.802; P < .001); and accepting other treatment options of the body such as the burial (OR = 1.683; P = .015). More than 30% of the nursing students are not in favor of organ donation, but this attitude is conditioned by several psychosocial factors. Copyright © 2015 Elsevier Inc. All rights reserved.

Development and validation of classifiers and variable subsets for predicting nursing home admission.

PubMed

Nuutinen, Mikko; Leskelä, Riikka-Leena; Suojalehto, Ella; Tirronen, Anniina; Komssi, Vesa

2017-04-13

In previous years a substantial number of studies have identified statistically important predictors of nursing home admission (NHA). However, as far as we know, the analyses have been done at the population-level. No prior research has analysed the prediction accuracy of a NHA model for individuals. This study is an analysis of 3056 longer-term home care customers in the city of Tampere, Finland. Data were collected from the records of social and health service usage and RAI-HC (Resident Assessment Instrument - Home Care) assessment system during January 2011 and September 2015. The aim was to find out the most efficient variable subsets to predict NHA for individuals and validate the accuracy. The variable subsets of predicting NHA were searched by sequential forward selection (SFS) method, a variable ranking metric and the classifiers of logistic regression (LR), support vector machine (SVM) and Gaussian naive Bayes (GNB). The validation of the results was guaranteed using randomly balanced data sets and cross-validation. The primary performance metrics for the classifiers were the prediction accuracy and AUC (average area under the curve). The LR and GNB classifiers achieved 78% accuracy for predicting NHA. The most important variables were RAI MAPLE (Method for Assigning Priority Levels), functional impairment (RAI IADL, Activities of Daily Living), cognitive impairment (RAI CPS, Cognitive Performance Scale), memory disorders (diagnoses G30-G32 and F00-F03) and the use of community-based health-service and prior hospital use (emergency visits and periods of care). The accuracy of the classifier for individuals was high enough to convince the officials of the city of Tampere to integrate the predictive model based on the findings of this study as a part of home care information system. Further work need to be done to evaluate variables that are modifiable and responsive to interventions.

[Knowledge of nurses about the Service for Assistance to Women Victims of Sexual Violence].

PubMed

Monteiro, Claudete Ferreira de Souza; Morais, Sheila Coelho Ramalho Vasconcelos; Ferreira, Maria Tamires Alves; Carvalho, Rodolfo Xavier da Costa; Canuto, Mary Angela de Oliveira; Moreira, Isabel Cristina Cavalcante Carvalho

2008-01-01

This quantitative study is to collect data of the knowledge of nurses about the Service for Assistance to women victims of sexual violence (SAMVVIS), in a public maternity hospital in Teresina, PI. Data was collected in February and March of 2008 from 61 nurses. The results show that the majority are aware of the service (90.14%) but the affirmative percentage decreases when asked about how it functions (80.33%, what its objectives are (72.13%), the role of the nurse (44.26%) and the proposal of the organization (40.98%). It follows that there is a need for the diffusion of the service, especially in the aspect of its objectives, the proposal of the organization and the role of the nurse along with national political attention for the women who are victims of sexual violence.

Regulated wet nursing: managed care or organized crime?

PubMed

Obladen, Michael

2012-01-01

Wet nursing was widely practiced from antiquity. For the wealthy, it was a way to overcome the burdens of breastfeeding and increase the number of offspring. For the poor, it was an organized industry ensuring regular payment, and in some parishes the major source of income. The abuse of wet nursing, especially the taking in of several nurslings, prompted legislation which became the basis of public health laws in the second half of the 19th century. The qualifications demanded from a mercenary nurse codified by Soran in the 2nd century CE remained unchanged for 1,700 years. When artificial feeding lost its threat thanks to sewage disposal, improved plumbing, the introduction of rubber teats, cooling facilities and commercial formula, wet nursing declined towards the end of the 19th century. Copyright © 2012 S. Karger AG, Basel.

42 CFR 431.707 - Standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... be met by individuals in order to be licensed as a nursing home administrator. (b) The standards must be designed to insure that nursing home administrators are— (1) Of good character; (2) Otherwise... ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION State Programs for Licensing Nursing Home...

The Case for Focusing on Millennial Retention.

PubMed

Koppel, Jenna; Deline, Marisa; Virkstis, Katherine

A concern for nurse leaders is rapid turnover of engaged, early-tenure millennial nurses. In this 1st article in a 2-part series, the authors describe why leaders should supplement their organization's current investments in engagement with retention strategies targeted at millennial nurses.

42 CFR 431.707 - Standards.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION State Programs for Licensing Nursing Home... be met by individuals in order to be licensed as a nursing home administrator. (b) The standards must be designed to insure that nursing home administrators are— (1) Of good character; (2) Otherwise...

Mitigating the Impact of Nurse Manager Large Spans of Control.

PubMed

Simpson, Brenda Baird; Dearmon, Valorie; Graves, Rebecca

Nurse managers are instrumental in achievement of organizational and unit performance goals. Greater spans of control for managers are associated with decreased satisfaction and performance. An interprofessional team measured one organization's nurse manager span of control, providing administrative assistant support and transformational leadership development to nurse managers with the largest spans of control. Nurse manager satisfaction and transformational leadership competency significantly improved following the implementation of large span of control mitigation strategies.

Vision 2020, part I: profile of the future nurse leader.

PubMed

Scoble, Kathleen B; Russell, Gail

2003-06-01

The demand for knowledgeable and skilled nursing leaders at the first, middle, and executive levels of management in healthcare organizations drove a multi-phased project about the kinds of nurse managers who will be needed in the future and their educational needs. This first article in a two-part series describes seasoned nurse leaders' opinions about the educational preparation, experiences, and competencies desired in nurse managers for the year 2020.

Development of a Skin Cancer Prevention Program

ERIC Educational Resources Information Center

Hatmaker, Grace

2003-01-01

The Centers for Disease Control and Prevention (CDC) now categorizes skin cancer as epidemic. Nearly 90% of these deadly cancers start from sun exposure during the childhood years. This makes sun exposure in school-age children a serious public health risk, also one that school nurses can address. Solar radiation is now classified as a "known…

Lived Experiences of Iranian Nurses Caring for Brain Death Organ Donor Patients: Caring as “Halo of Ambiguity and Doubt”

PubMed Central

Keshtkaran, Zahra; Sharif, Farkhondeh; Navab, Elham; Gholamzadeh, Sakineh

2016-01-01

Background: Brain death is a concept in which its criteria have been expressed as documentations in Harvard Committee of Brain Death. The various perceptions of caregiver nurses for brain death patients may have effect on the chance of converting potential donors into actual organ donors. Objective: The present study has been conducted in order to perceive the experiences of nurses in care-giving to the brain death of organ donor patients. Methods: This qualitative study was carried out by means of Heidegger’s hermeneutic phenomenology. Eight nurses who have been working in ICU were interviewed. The semi-structured interviews were recorded by a tape-recorder and the given texts were transcribed and the analyses were done by Van-Mannen methodology and (thematic) analysis. Results: One of the foremost themes extracted from this study included ‘Halo of ambiguity and doubt’ that comprised of two sub-themes of ‘having unreasonable hope’ and ‘Conservative acceptance of brain death’. The unreasonable hope included lack of trust (uncertainty) in diagnosis and verification of brain death, passing through denial wall, and avoidance from explicit and direct disclosure of brain death in patients’ family. In this investigation, the nurses were involved in a type of ambiguity and doubt in care-giving to the potentially brain death of organ donor patients, which were also evident in their interaction with patients’ family and for this reason, they did not definitely announce the brain death and so far they hoped for treatment of the given patient. Such confusion and hesitance both caused annoyance of nurses and strengthening the denial of patients’ family to be exposed to death. Conclusion: The results of this study reveal the fundamental perceived care-giving of brain death in organ donor patients and led to developing some strategies to improve care-giving and achievement in donation of the given organ and necessity for presentation of educational and supportive services for nurses might become more evident than ever. PMID:26925919

Contrast media use in the operating room.

PubMed

Bickham, Peggy; Golembiewski, Julie

2010-04-01

Iodinated contrast media is frequently used in the OR, but often is not well understood by health care providers who are administering it. Although used for diagnosis rather than treatment, contrast media is classified as a drug by the FDA, and has indications, contraindications, adverse effects, drug interactions, disease interactions, and laboratory interference issues related to its use. Iodinated contrast media is classified according to osmolarity and ionicity, and these characteristics contribute to potential for adverse effects and choice of agent. Financial and safety concerns are factors to be considered when selecting an appropriate agent. Adverse effects can range from mild and self-limited to severe and life threatening; potentially the most serious of these are anaphylactoid reactions and contrast-induced acute renal failure. Knowledge of risk factors and preventive strategies is vital, as are issues related to substitution of gadolinium-based contrast, an off-label use. It is important for the perianesthesia nurse to become familiar with these commonly used imaging medications. Copyright 2010 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Hospital nurse administrators in Japan: a feminist dimensional analysis.

PubMed

Brandi, C L; Naito, A

2006-03-01

Nursing administration research is scarce in Japan during a time when health care is rapidly reforming and baccalaureate and graduate nursing programmes are rapidly developing. Additionally, nursing administration content relies heavily on Western and non-nursing theories, some of which have been criticized for male bias. The purpose of this article is to present key findings from a qualitative study that explored the perspectives or viewpoints of 16 Japanese senior female nurse administrators in hospitals in order to learn what was happening in their working situations and how they were managing. This feminist study used dimensional analysis strategies for data collection and analysis. Semi-structured, tape-recorded interviews were conducted by both researchers in Japanese, transcribed into Japanese, and translated into English. The resulting explanatory matrix portrayed a story of 16 nurse administrators, most of whom were able successfully to enact a management role in a context of role ambiguity that was congruent with their relational values and beliefs. Important conditions influencing value-based role enactment included organization mission and purpose, organization structure, nurse-doctor relationships, participant-supervisor relationships, and personal attributes. Many participants were able to overcome barriers in these categories using strategies of tempered radicalism and consequently made positive organizational changes. Advanced formal education, better organizational support, and a raised consciousness among nurses that views nurses and midwives as equal partners with other professionals will enable Japanese nurse administrators to help advance patient-centred care and nursing development and empowerment.

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