unit work environments: Topics by Science.gov

Sample records for unit work environments

Hospital Magnet Status, Unit Work Environment, and Pressure Ulcers.

PubMed

Ma, Chenjuan; Park, Shin Hye

2015-11-01

To identify how organizational nursing factors at different structural levels (i.e., unit-level work environment and hospital Magnet status) are associated with hospital-acquired pressure ulcers (HAPUs) in U.S. acute care hospitals. A cross-sectional observational study used data from the National Database of Nursing Quality Indicators®. Responses from 33,845 registered nurses (RNs) were used to measure unit work environments. The unit of analysis was the nursing unit, and there were 1,381 units in 373 hospitals in the United States. Unit work environment was measured by the Practice Environment Scale of Nurse Working Index (PES-NWI). Multilevel logistic regressions were used to estimate the effects of unit work environment and hospital Magnet status on HAPUs. All models were controlled for hospital and unit characteristics when considering clustering of units within hospitals. Magnet hospital units had 21% lower odds of having an HAPU than non-Magnet hospital units (95% confidence interval [CI], 0.64-0.98). With one unit increase of the PES-NWI score, units had 29% lower odds of having an HAPU (95% CI, 0.55-0.91). When including both hospital Magnet status and unit work environment in the model, hospital Magnet status no longer had a significant effect on HAPUs (odds ratio [OR] = 0.82; 95% CI, 0.66-1.02), whereas the significant effect of unit work environment persisted (OR = 0.73; 95% CI, 0.56-0.93). Both hospital and unit environments were significantly associated with HAPUs, and the unit-level work environment can be more influential in reducing HAPUs. Investment in the nurse work environments at both the hospital level and unit level has the potential to reduce HAPUs; and additional to hospital-level initiatives (e.g., Magnet recognition program), efforts targeting on-unit work environments deserve more attention. © 2015 Sigma Theta Tau International.
The nurse work environment, job satisfaction and turnover rates in rural and urban nursing units.

PubMed

Baernholdt, Marianne; Mark, Barbara A

2009-12-01

The aim of the present study was to determine whether there are differences in hospital characteristics, nursing unit characteristics, the nurse work environment, job satisfaction and turnover rates in rural and urban nursing units. Research in urban hospitals has found an association between the nurse work environment and job satisfaction and turnover rates, but this association has not been examined in rural hospitals. Rural and urban nursing units were compared in a national random sample of 97 United States hospitals (194 nursing units) with between 99 and 450 beds. Significant differences were found between hospital and nursing unit characteristics and the nurse work environment in rural and urban nursing units. Both nursing unit characteristics and the work environment were found to have a significant influence on nurse job satisfaction and turnover rates. Job satisfaction and turnover rates in rural and urban nursing units are associated with both nursing unit characteristics and the work environment. Both rural and urban hospitals can improve nurse job satisfaction and turnover rates by changing unit characteristics, such as creating better support services and a work environment that supports autonomous nursing practice. Rural hospitals can also improve the work environment by providing nurses with more educational opportunities.
Work environment for Chinese nurses in different types of ICUs: a multisite cross-sectional survey.

PubMed

Bai, Jinbing; Zhang, Qing; Wang, Ying; Yu, Li-Ping; Pei, Xian-Bo; Cheng, Lei; Hsu, Lily

2015-05-01

To investigate the current nurse work environment, levels of job satisfaction and quality of patient care, and to identify intensive care units with a healthier work environment in mainland China. A healthy work environment is closely related to a higher nurse job satisfaction and a better patient care quality. The work environment has not been extensively explored among Chinese intensive care unit nurses. The Chinese version of the Essentials of Magnetism II was used to measure the nurse work environment and another two 0-10 single-item scales were used to assess nurses' overall job satisfaction and nurse-assessed quality of care. The study found that the eight essentials of Chinese version of the Essentials of Magnetism II were significantly correlated with each other and also correlated with overall job satisfaction and quality of care. Nurses from medical intensive care units had a healthier work environment with higher scores of overall job satisfaction and quality of care than other intensive care units, while surgical intensive care units showed the least healthy work environment with the lowest overall job satisfaction and quality of care scores identified. The essentials of Chinese version of the Essentials of Magnetism II, overall job satisfaction and quality of care were also correlated with nurses' work experience and their education level. Nurse administrators and health policy-makers should establish a healthy work environment for intensive care units nurses, especially for those from surgical intensive care units. © 2014 John Wiley & Sons Ltd.
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.
Impact of healthy work environments and multistage nurse residency programs on retention of newly licensed RNs.

PubMed

Kramer, Marlene; Halfer, Diana; Maguire, Pat; Schmalenberg, Claudia

2012-03-01

The objective of the study was to examine effects of nurse-confirmed healthy unit work environments and multistage nurse residency programs (NRPs) on retention rates of newly licensed RNs (NLRNs). Establishing a culture of retention and healthy clinical nurse practice environments are two major challenges confronting nurse leaders today. Nurse residency programs are a major component of NLRN work environments and have been shown to be effective in abating nurse turnover. Sample for this study consisted of 5,316 new graduates in initial RN roles in 28 Magnet® hospitals. There were no differences in retention rates by education or patient population on clinical unit. NLRN retention rate was higher in community than in academic hospitals. More than half of NLRNs were placed on units with very healthy work environments. Newly licensed RNs on units with work environments needing improvement resigned at a significantly higher rate than did other NLRNs. The quality of clinical unit work environments is the most important factor in NLRN retention.
[Evaluation of the nurse working environment in health and social care intermediate care units in Catalonia].

PubMed

Bullich-Marín, Ingrid; Miralles Basseda, Ramón; Torres Egea, Pilar; Planas-Campmany, Carme; Juvé-Udina, María Eulalia

A favourable work environment contributes to greater job satisfaction and improved working conditions for nurses, a fact that could influence the quality of patient outcomes. The aim of the study is two-fold: Identifying types of centres, according to the working environment assessment made by nurses in intermediate care units, and describing the individual characteristics of nurses related to this assessment. An observational, descriptive, prospective, cross-sectional, and multicentre study was conducted in the last quarter of 2014. Nurses in intermediate care units were given a questionnaire containing the Practice Environment Scale of the Nursing Work Index (PES-NWI) which assesses five factors of the work environment using 31 items. Sociodemographic, employment conditions, professional and educational variables were also collected. From a sample of 501 nurses from 14 centres, 388 nurses participated (77% response). The mean score on the PES-NWI was 84.75. Nine centres scored a "favourable" working environment and five "mixed". The best valued factor was "work relations" and the worst was "resource provision/adaptation". Rotating shift work, working in several units at the same time, having management responsibilities, and having a master degree were the characteristics related to a better perception of the nursing work environment. In most centres, the working environment was perceived as favourable. Some employment conditions, professional, and educational characteristics of nurses were related to the work environment assessment. Copyright © 2015 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.
Differences in nursing practice environment among US acute care unit types: a descriptive study.

PubMed

Choi, JiSun; Boyle, Diane K

2014-11-01

The hospital nursing practice environment has been found to be crucial for better nurse and patient outcomes. Yet little is known about the professional nursing practice environment at the unit level where nurses provide 24-hour bedside care to patients. To examine differences in nursing practice environments among 11 unit types (critical care, step-down, medical, surgical, combined medical-surgical, obstetric, neonatal, pediatric, psychiatric, perioperative, and emergency) and by Magnet status overall, as well as four specific aspects of the practice environment. Cross-sectional study. 5322 nursing units in 519 US acute care hospitals. The nursing practice environment was measured by the Practice Environment Scale of the Nursing Work Index. The Practice Environment Scale of the Nursing Work Index mean composite and four subscale scores were computed at the unit level. Two statistical approaches (one-way analysis of covariance and multivariate analysis of covariance analysis) were employed with a Tukey-Kramer post hoc test. In general, the nursing practice environment was favorable in all unit types. There were significant differences in the nursing practice environment among the 11 unit types and by Magnet status. Pediatric units had the most favorable practice environment and medical-surgical units had the least favorable. A consistent finding across all unit types except neonatal units was that the staffing and resource adequacy subscale scored the lowest compared with all other Practice Environment Scale of the Nursing Work Index subscales (nursing foundations for quality of care, nurse manager ability, leadership, and support, and nurse-physician relations). Unit nursing practice environments were more favorable in Magnet than non-Magnet hospitals. Findings indicate that there are significant variations in unit nursing practice environments among 11 unit types and by hospital Magnet status. Both hospital-level and unit-specific strategies should be considered to achieve an excellent nursing practice environment in all hospital units. Copyright © 2014 Elsevier Ltd. All rights reserved.
Nursing unit teams matter: Impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events--a cross-sectional survey.

PubMed

Van Bogaert, Peter; Timmermans, Olaf; Weeks, Susan Mace; van Heusden, Danny; Wouters, Kristien; Franck, Erik

2014-08-01

To investigate the impact of nurse practice environment factors, nurse work characteristics, and burnout on nurse reported job outcomes, quality of care, and patient adverse events variables at the nursing unit level. Nurse practice environment studies show growing insights and knowledge about determining factors for nurse workforce stability, quality of care, and patient safety. Until now, international studies have primarily focused on variability at the hospital level; however, insights at the nursing unit level can reveal key factors in the nurse practice environment. A cross-sectional design with a survey. In a cross-sectional survey, a sample of 1108 nurses assigned to 96 nursing units completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality of care, and patient adverse events. Associations between the variables were examined using multilevel modelling techniques. Various unit-level associations (simple models) were identified between nurse practice environment factors, nurse work characteristics, burnout dimensions, and nurse reported outcome variables. Multiple multilevel models showed various independent variables such as nursing management at the unit level, social capital, emotional exhaustion, and depersonalization as important predictors of nurse reported outcome variables such job satisfaction, turnover intentions, quality of care (at the unit, the last shift, and in the hospital within the last year), patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medications errors. Results suggested a stable nurse work force, with the capability to achieve superior quality and patient safety outcomes, is associated with unit-level favourable perceptions of nurse work environment factors, workload, decision latitude, and social capital, as well low levels of burnout. Nurses, physicians, nursing leaders, and executives share responsibility to create an environment supportive of interdisciplinary team development. Copyright © 2013 Elsevier Ltd. All rights reserved.
Effects of work environment on patient and nurse outcomes.

PubMed

Copanitsanou, Panagiota; Fotos, Nikolaos; Brokalaki, Hero

2017-02-09

Several parameters of the nurse's work environment lead to fewer patient complications and lower nurse burnout. The aim of this systematic review was the analysis of research data related to the effect of nurses' work environments on outcomes for both patients and nurses. Medline was searched by using keywords: 'working conditions', 'work environment', 'nurses', 'nursing staff', 'patients', 'outcomes'. In total, 10 studies were included, of which 4 were cross-sectional and the remaining were descriptive correlational studies. Patients who were hospitalised in units with good work environments for the nurses were more satisfied with the nursing care than the patients in units with poor work environments. Nurses who perceived their work environment to be good experienced higher job satisfaction and lower rates of burnout syndrome. A good work environment constitutes a determinant factor for high care quality and, at the same time, relates to improved outcomes for the nurses.
Health care work environments, employee satisfaction, and patient safety: Care provider perspectives.

PubMed

Rathert, Cheryl; May, Douglas R

2007-01-01

Experts continue to decry the lack of progress made in decreasing the alarming frequency of medical errors in health care organizations (Leape, L. L., & Berwick, D. M. (2005). Five years after to err is human: What have we learned?. Journal of the American Medical Association, 293(19), 2384-2390). At the same time, other experts are concerned about the lack of job satisfaction and turnover among nurses (. Keeping patients safe: Transforming the work environment of nurses. Washington, DC: National Academy Press). Research and theory suggest that a work environment that facilitates patient-centered care should increase patient safety and nurse satisfaction. The present study began with a conceptual model that specifies how work environment variables should be related to both nurse and patient outcomes. Specifically, we proposed that health care work units with climates for patient-centered care should have nurses who are more satisfied with their jobs. Such units should also have higher levels of patient safety, with fewer medication errors. We examined perceptions of nurses from three acute care hospitals in the eastern United States. Nurses who perceived their work units as more patient centered were significantly more satisfied with their jobs than were those whose units were perceived as less patient centered. Those whose work units were more patient centered reported that medication errors occurred less frequently in their units and said that they felt more comfortable reporting errors and near-misses than those in less patient-centered units. Patients and quality leaders continue to call for delivery of patient-centered care. If climates that facilitate such care are also related to improved patient safety and nurse satisfaction, proactive, patient-centered management of the work environment could result in improved patient, employee, and organizational outcomes.
Effect on mental health of a participatory intervention to improve psychosocial work environment: a cluster randomized controlled trial among nurses.

PubMed

Uchiyama, Ayako; Odagiri, Yuko; Ohya, Yumiko; Takamiya, Tomoko; Inoue, Shigeru; Shimomitsu, Teruichi

2013-01-01

Improvement of psychosocial work environment has proved to be valuable for workers' mental health. However, limited evidence is available for the effectiveness of participatory interventions. The purpose of this study was to investigate the effect on mental health among nurses of a participatory intervention to improve the psychosocial work environment. A cluster randomized controlled trial was conducted in hospital settings. A total of 434 nurses in 24 units were randomly allocated to 11 intervention units (n=183) and 13 control units (n=218). A participatory program was provided to the intervention units for 6 months. Depressive symptoms as mental health status and psychosocial work environment, assessed by the Job Content Questionnaire, the Effort-Reward Imbalance Questionnaire, and the Quality Work Competence questionnaire, were measured before and immediately after the 6-month intervention by a self-administered questionnaire. No significant intervention effect was observed for mental health status. However, significant intervention effects were observed in psychosocial work environment aspects, such as Coworker Support (p<0.01) and Goals (p<0.01), and borderline significance was observed for Job Control (p<0.10). It is suggested that a 6-month participatory intervention is effective in improving psychosocial work environment, but not mental health, among Japanese nurses.
Nurses' work environments, care rationing, job outcomes, and quality of care on neonatal units.

PubMed

Rochefort, Christian M; Clarke, Sean P

2010-10-01

This paper is a report of a study of the relationship between work environment characteristics and neonatal intensive care unit nurses' perceptions of care rationing, job outcomes, and quality of care. International evidence suggests that attention to work environments might improve nurse recruitment and retention, and the quality of care. However, comparatively little attention has been given to neonatal care, a specialty where patient and nurse outcomes are potentially quite sensitive to problems with staffing and work environments. Over a 6-month period in 2007-2008, a questionnaire containing measures of work environment characteristics, nursing care rationing, job satisfaction, burnout and quality of care was distributed to 553 nurses in all neonatal intensive care units in the province of Quebec (Canada). A total of 339 nurses (61.3%) completed questionnaires. Overall, 18.6% were dissatisfied with their job, 35.7% showed high emotional exhaustion, and 19.2% rated the quality of care on their unit as fair or poor. Care activities most frequently rationed because of insufficient time were discharge planning, parental support and teaching, and comfort care. In multivariate analyses, higher work environment ratings were related to lower likelihood of reporting rationing and burnout, and better ratings of quality of care and job satisfaction. Additional research on the determinants of nurse outcomes, the quality of patient care, and the impact of rationing of nursing care on patient outcomes in neonatal intensive care units is required. The Neonatal Extent of Work Rationing Instrument appears to be a useful tool for monitoring the extent of rationing of nursing care in neonatal units. © 2010 Blackwell Publishing Ltd.
Congressional Testimony: Statement of Stephen J. Nesbitt Before the Committee on Environment and Public Works United States Senate

EPA Pesticide Factsheets

Statement of Stephen J. Nesbitt Assistant Inspector General for Investigations Office of Inspector General U.S. Environmental Protection Agency Before the Committee on Environment and Public Works United States Senate
Using evidence-based leadership initiatives to create a healthy nursing work environment.

PubMed

Nayback-Beebe, Ann M; Forsythe, Tanya; Funari, Tamara; Mayfield, Marie; Thoms, William; Smith, Kimberly K; Bradstreet, Harry; Scott, Pamela

2013-01-01

In an effort to create a healthy nursing work environment in a military hospital Intermediate Care Unit (IMCU), a facility-level Evidence Based Practice working group composed of nursing.Stakeholders brainstormed and piloted several unit-level evidence-based leadership initiatives to improve the IMCU nursing work environment. These initiatives were guided by the American Association of Critical Care Nurses Standards for Establishing and Sustaining Healthy Work Environments which encompass: (1) skilled communication, (2) true collaboration, (3) effective decision making, (4) appropriate staffing, (5) meaningful recognition, and (6) authentic leadership. Interim findings suggest implementation of these six evidence-based, relationship-centered principals, when combined with IMCU nurses' clinical expertise, management experience, and personal values and preferences, improved staff morale, decreased staff absenteeism, promoted a healthy nursing work environment, and improved patient care.
What characterizes the work culture at a hospital unit that successfully implements change - a correlation study.

PubMed

André, Beate; Sjøvold, Endre

2017-07-14

To successfully achieve change in healthcare, a balance between technology and "people ware", the human recourses, is necessary. However, the human aspect of the change implementation process has received less attention than the technological issues. The aim was to explore the factors that characterize the work culture in a hospital unit that successfully implemented change compared with the factors that characterize the work culture of a hospital unit with unsuccessful implementation. The Systematizing Person-Group Relations method was used for gathering and analyzing data to explore what dominate the behavior in a particular work environment identifying challenges, limitations and opportunities. This method applied six different dimensions, each representing different behavior in a work culture: Synergy, Withdrawal, Opposition, Dependence, Control and Nurture. We compared two different units at the same hospital, one that successfully implemented change and one that was unsuccessful. There were significant statistical differences between healthcare personnel working at a unit that successfully implemented change contrasted with the unit with unsuccessful implementation. These significant differences were found in both the synergy and control dimensions, which are important positive qualities in a work culture. The results of this study show that healthcare personnel at a unit with a successful implementation of change have a working environment with many positive qualities. This indicates that a work environment with a high focus on goal achievement and task orientation can handle the challenges of implementing changes.
Exploring the Influence of Nursing Work Environment and Patient Safety Culture on Missed Nursing Care in Korea.

PubMed

Kim, Kyoung-Ja; Yoo, Moon Sook; Seo, Eun Ji

2018-04-20

This study aimed to explore the influence of nurse work environment and patient safety culture in hospital on instances of missed nursing care in South Korea. A cross-sectional design was used, in which a structured questionnaire was administered to 186 nurses working at a tertiary university hospital. Data were analyzed using descriptive statistics, t-test or ANOVA, Pearson correlation and multiple regression analysis. Missed nursing care was found to be correlated with clinical career, nursing work environment and patient safety culture. The regression model explained approximately 30.3 % of missed nursing care. Meanwhile, staffing and resource adequacy (β = -.31, p = .001), nurse manager ability, leadership and support of nurses (β = -.26, p = .004), clinical career (β = -.21, p = .004), and perception on patient safety culture within unit (β = -.19, p = .041) were determined to be influencing factors on missed nursing care. This study has significance as it suggested that missed nursing care is affected by work environment factors within unit. This means that missed nursing care is a unit outcome affected by nurse work environment factors and patient safety culture. Therefore, missed nursing care can be managed through the implementation of interventions that promote a positive nursing work environment and patient safety culture. Copyright © 2018. Published by Elsevier B.V.
Nurses' Perceptions of Pediatric Intensive Care Unit Environment and Work Experience After Transition to Single-Patient Rooms.

PubMed

Kudchadkar, Sapna R; Beers, M Claire; Ascenzi, Judith A; Jastaniah, Ebaa; Punjabi, Naresh M

2016-09-01

The architectural design of the pediatric intensive care unit may play a major role in optimizing the environment to promote patients' sleep while improving stress levels and the work experience of critical care nurses. To examine changes in nurses' perceptions of the environment of a pediatric critical care unit for promotion of patients' sleep and the nurses' work experience after a transition from multipatient rooms to single-patient rooms. A cross-sectional survey of nurses was conducted before and after the move to a new hospital building in which all rooms in the pediatric critical care unit were single-patient rooms. Nurses reported that compared with multipatient rooms, single-patient private rooms were more conducive to patients sleeping well at night and promoted a more normal sleep-wake cycle (P < .001). Monitors/alarms and staff conversations were the biggest factors that adversely influenced the environment for sleep promotion in both settings. Nurses were less annoyed by noise in single-patient rooms (33%) than in multipatient rooms (79%; P < .001) and reported improved exposure to sunlight. Use of single-patient rooms rather than multipatient rooms improved nurses' perceptions of the pediatric intensive care unit environment for promoting patients' sleep and the nurses' own work experience. ©2016 American Association of Critical-Care Nurses.
Congressional Testimony: Statement of Wade T. Najjum Before the Subcommittee on Superfund and Environmental Health Committee on Environment and Public Works United States Senate

EPA Pesticide Factsheets

Statement of Wade T. Najjum Assistant Inspector General for Program Evaluation U.S. EPA Office of Inspector General Before the Subcommittee on Superfund and Environmental Health Committee on Environment and Public Works United States Senate
[A Survey of the Perception of Nurses Toward the Practice Environment at a Regional Teaching Hospital in Central Taiwan].

PubMed

Hung, Jui-Tai; Lin, Ching-Wen; Wen, Wei-Chun; Lin, Esther Ching-Lan

2015-08-01

The nursing practice environment has been shown to wield significant influence on nursing retention and nursing quality of care. Because a large percentage of Taiwan nurses currently work at regional teaching hospitals, exploring the perception toward the practice environment of nurses working at this type of hospital is important. This study explored the perception of nurses working at a regional teaching hospital in central Taiwan toward their practice environment. A cross-sectional research design with a sample of 474 nurses from a regional hospital in central Taiwan was conducted. Instruments including the demographic data and the Chinese-version Practice Environment Scale-Nursing Work Index (CPES-NWI) were anonymously self-administered. Overall, participants were moderately satisfied with their practice environment, with the greatest dissatisfaction focused on staffing and resource adequacy. Work unit and nursing level, respectively, had significant impacts on perceptions regarding the practice environment. Furthermore, discriminant analysis identified two new compound variables: 1) adequate staffing resources and partnership in the workplace and 2) supportive administrative management environment. Participants who worked in medical and surgical units were significantly more dissatisfied with the adequacy of staffing resources and partnership in the workplace than participants who worked in acute/intensive and special units. Participants at the N2 level were significantly more dissatisfied with the supportive nature of the administrative management environment. These findings support that the nursing practice environment of regional hospitals may be improved using several measures, including: modifying the staffing and resource adequacy of nurses, fostering collaborative nurse-physician relationships, and further involving nurses in administrative management and decision-making.
Association of the nurse work environment with nurse incivility in hospitals.

PubMed

Smith, Jessica G; Morin, Karen H; Lake, Eileen T

2018-03-01

To determine whether nurse coworker incivility is associated with the nurse work environment, defined as organisational characteristics that promote nurse autonomy. Workplace incivility can negatively affect nurses, hospitals and patients. Plentiful evidence documents that nurses working in better nurse work environments have improved job and health outcomes. There is minimal knowledge about how nurse coworker incivility relates to the United States nurse work environment. Quantitative, cross-sectional. Data were collected through online surveys of registered nurses in a southwestern United States health system. The survey content included the National Quality Forum-endorsed Practice Environment Scale of the Nursing Work Index and the Workplace Incivility Scale. Data analyses were descriptive and correlational. Mean levels of incivility were low in this sample of 233 staff nurses. Incivility occurred 'sporadically' (mean = 0.58; range 0.00-5.29). The nurse work environment was rated highly (mean = 3.10; range of 1.00-4.00). The nurse work environment was significantly inversely associated with coworker incivility. The nurse manager qualities were the principal factor of the nurse work environment associated with incivility. Supportive nurse managers reduce coworker incivility. Nurse managers can shape nurse work environments to prevent nurse incivility. © 2017 John Wiley & Sons Ltd.

Improving STEM Education and Workforce Development by the Inclusion of Research Experiences in the Curriculum at SWC

DTIC Science & Technology

2016-06-08

server environment. While the college’s two Cisco blade -servers are located in separate buildings, these 1. REPORT DATE (DD-MM-YYYY) 4. TITLE AND...college’s two Cisco blade -servers are located in separate buildings, these units now work as one unit. Critical databases and software packages are...server environment. While the college’s two Cisco blade -servers are located in separate buildings, these units now work as one unit. Critical
The Association between Quality Improvement Initiatives in Dementia Care and Supportive Psychosocial Work Environments in Nursing Homes.

PubMed

Nakanishi, Miharu; Tei-Tominaga, Maki

2018-05-08

Background : Quality improvement initiatives can help nursing homes strengthen psychosocial work environments. The aim of the present study was to examine the association between supportive psychosocial work environment, and professional and organizational characteristics regarding quality improvement initiatives in dementia care. Methods : A paper questionnaire survey was administered to a convenience sample of 365 professional caregivers in 12 special nursing homes in Japan. Psychosocial work environment was assessed using the Social Capital and Ethical Climate at the Workplace Scale to calculate a score of social capital in the workplace, ethical leadership, and exclusive workplace climate. Variables for quality improvement initiatives included type of home (unit-type or traditional), presence of additional benefit for dementia care, and professionalism in dementia care among caregivers evaluated using the Japanese version of the Sense of Competence in Dementia Care Staff Scale. Results : Elevated professionalism and unit-type home were significantly associated with high social capital, strong ethical leadership, and low exclusive workplace climate. The presence of dementia care benefit was not associated with any subscale of psychosocial work environment. Conclusions : Quality improvement initiatives to foster supportive psychosocial work environment should enhance professionalism in dementia care with unit-based team building of professional caregivers in special nursing homes.
Work environment, job satisfaction, stress and burnout among haemodialysis nurses.

PubMed

Hayes, Bronwyn; Douglas, Clint; Bonner, Ann

2015-07-01

To examine the relationships among nurse and work characteristics, job satisfaction, stress, burnout and the work environment of haemodialysis nurses. Haemodialysis nursing is characterised by frequent and intense contact with patients in a complex and intense environment. A cross-sectional online survey of 417 haemodialysis nurses that included nurse and work characteristics, the Brisbane Practice Environment Measure, Index of Work Satisfaction, Nursing Stress Scale and the Maslach Burnout Inventory. Haemodialysis nurses reported an acceptable level of job satisfaction and perceived their work environment positively, although high levels of burnout were found. Nurses who were older and had worked in haemodialysis the longest had higher satisfaction levels, experienced less stress and lower levels of burnout than younger nurses. The in-centre type of haemodialysis unit had greater levels of stress and burnout than home training units. Greater satisfaction with the work environment was strongly correlated with job satisfaction, lower job stress and emotional exhaustion. Haemodialysis nurses experienced high levels of burnout even though their work environment was favourable and they had acceptable levels of job satisfaction. Targeted strategies are required to retain and avoid burnout in younger and less experienced nurses in this highly specialised field of nursing. © 2013 John Wiley & Sons Ltd.
Dementia care worker stress associations with unit type, resident, and work environment characteristics: a cross-sectional secondary data analysis of the Swiss Nursing Homes Human Resources Project (SHURP).

PubMed

Vogel, Barbara; De Geest, Sabina; Fierz, Katharina; Beckmann, Sonja; Zúñiga, Franziska

2017-03-01

Although caring for residents with dementia in nursing homes is associated with various stressors for care workers, the role of the unit type, and particularly the proportion of residents with dementia, remains unclear. This study aimed to explore associations between unit type and care worker stress, taking into account additional potential stressors. This cross-sectional study was a secondary data analysis in the Swiss Nursing Homes Human Resources Project, which included data from 3,922 care workers from 156 Swiss nursing homes. Care workers' stress was measured with a shortened version of the Health Professions Stress Inventory. Generalized estimating equation models were used to assess care worker stress and its relationships with three unit types (special care units and others with high or low proportions of residents with dementia), work environment factors, and aggressive resident behavior. After including all potential stressors in the models, no significant differences between the three unit types regarding care worker stress were found. However, increased care worker stress levels were significantly related to lower ratings of staffing and resources adequacy, the experience of verbal aggression, and the observation of verbal or physical aggression among residents. Although the unit type plays only a minor role regarding care worker stress, this study confirms that work environment and aggressive behavior of residents are important factors associated with work-related stress. To prevent increases of care worker stress, interventions to improve the work environment and strengthen care workers' ability to cope with aggressive behavior are suggested.
A Discussion of Patient Safety Programs in the United States Air Force Ground Medical Expeditionary Environment and an Analysis of Potential Solutions for Increasing Their Effectiveness

DTIC Science & Technology

2017-05-01

and 4N to work Patient Safety together, and it has worked out fine in our environment .” • “It is my opinion that there needs to be a permanent full...GROUND MEDICAL EXPEDITIONARY ENVIRONMENT AND AN ANALYSIS OF POTENTIAL SOLUTIONS FOR INCREASING THEIR EFFECTIVENESS By: James Lee...DISCUSSION OF PATIENT SAFETY PROGRAMS IN THE UNITED STATES AIR FORCE GROUND MEDICAL EXPEDITIONARY ENVIRONMENT AND AN ANALYSIS OF POTENTIAL SOLUTIONS FOR
Understanding significant processes during work environment interventions to alleviate time pressure and associated sick leave of home care workers--a case study.

PubMed

Andersen, Gunn Robstad; Westgaard, Rolf H

2013-11-15

Ergonomic and work stress interventions rarely show long-term positive effect. The municipality participating in this study received orders from the Norwegian Labour Inspectorate due to an identified unhealthy level of time pressure, and responded by effectuating several work environment interventions. The study aim is to identify critical factors in the interaction between work environment interventions and independent rationalization measures in order to understand a potential negative interfering effect from concurrent rationalizations on a comprehensive work environment intervention. The study, using a historic prospective mixed-method design, comprised 6 home care units in a municipality in Norway (138 respondents, response rate 76.2%; 17 informants). The study included quantitative estimations, register data of sick leave, a time line of significant events and changes, and qualitative descriptions of employee appraisals of their work situation gathered through semi-structured interviews and open survey responses. The work environment interventions were in general regarded as positive by the home care workers. However, all units were simultaneously subjected to substantial contextual instability, involving new work programs, new technology, restructurings, unit mergers, and management replacements, perceived by the home care workers to be major sources of stress. Findings suggest that concurrent changes induced through rationalization resulted in negative exposure effects that negated positive work environment intervention effects, causing an overall deteriorated work situation for the home care workers. Establishment and active utilization of communication channels from workers to managers are recommended in order to increase awareness of putative harmful and interruptive effects of rationalization measures.
Understanding significant processes during work environment interventions to alleviate time pressure and associated sick leave of home care workers – a case study

PubMed Central

2013-01-01

Background Ergonomic and work stress interventions rarely show long-term positive effect. The municipality participating in this study received orders from the Norwegian Labour Inspectorate due to an identified unhealthy level of time pressure, and responded by effectuating several work environment interventions. The study aim is to identify critical factors in the interaction between work environment interventions and independent rationalization measures in order to understand a potential negative interfering effect from concurrent rationalizations on a comprehensive work environment intervention. Methods The study, using a historic prospective mixed-method design, comprised 6 home care units in a municipality in Norway (138 respondents, response rate 76.2%; 17 informants). The study included quantitative estimations, register data of sick leave, a time line of significant events and changes, and qualitative descriptions of employee appraisals of their work situation gathered through semi-structured interviews and open survey responses. Results The work environment interventions were in general regarded as positive by the home care workers. However, all units were simultaneously subjected to substantial contextual instability, involving new work programs, new technology, restructurings, unit mergers, and management replacements, perceived by the home care workers to be major sources of stress. Findings suggest that concurrent changes induced through rationalization resulted in negative exposure effects that negated positive work environment intervention effects, causing an overall deteriorated work situation for the home care workers. Conclusions Establishment and active utilization of communication channels from workers to managers are recommended in order to increase awareness of putative harmful and interruptive effects of rationalization measures. PMID:24238560
Environmental congruence and work-related stress in acute care hospital medical/surgical units: a descriptive, correlational study.

PubMed

Dendaas, Nancy

2011-01-01

To describe the degree to which Environmental Congruence (EC) is present in sampled units and considered important/desirable by staff RNs; staff RNs' reported level of work-related stress (WRS); the perceived contribution of the physical environment to WRS; and the relationship between existing levels of EC and WRS. Few studies have focused on how the physical environment might contribute to nurses' WRS and chronic nursing shortages. The construct of EC can be used, within a Person Environment (PE)-Fit framework, to assess the fit among nurses, nursing work, the physical work environment, and WRS. EC was measured using investigator-developed, literature/criterion-based survey instruments. Staff RNs reported WRS variables by using two single-item self-report measures. The final convenience sample consisted of 471 staff RNs from 39 medical/surgical units from 12 hospitals in the upper Midwest. Data were collected over a 7-month period. The mean level of existing EC in the sample was roughly 70% percent of highest capacity and that of important/desired EC in the sample was 93%. Staff RNs' mean level of WRS was 6.7; the mean contribution of the physical environment to WRS was 5.8. Moderate negative correlations were found between EC and WRS (r = -.41, p < .05), and between physical environment contribution to WRS and EC (r = -.55, p <.001). Staff RNs in the sampled units wanted a significantly higher level of EC. They rated their WRS moderately high and the contribution of the physical environment to it as moderate. A moderately negative relationship was found between EC and WRS. EC may be a useful construct in research that attempts to improve hospital nursing work environments.
Organizational change, psychosocial work environment, and non-disability early retirement: a prospective study among senior public employees.

PubMed

Breinegaard, Nina; Jensen, Johan Høy; Bonde, Jens Peter

2017-05-01

Objective This study examines the impact of organizational change and psychosocial work environment on non-disability early retirement among senior public service employees. Methods In January and February 2011, Danish senior public service employees aged 58-64 years (N=3254) from the Capital Region of Denmark responded to a survey assessing psychosocial work environment (ie, social capital, organizational justice, and quality of management). Work-unit organizational changes (ie, change of management, merging, demerging, and relocation) were recorded from January 2009 to March 2011. Weekly data on non-disability early retirement transfer were obtained from the DREAM register database, which holds weekly information about all public benefit payments in Denmark. Hazard ratios (HR) for early retirement following employees' 60 th birthday were estimated with Cox regression adjusted for age, gender, and socioeconomic status. Results Exposure to change of management [HR 1.37, 95% confidence interval (95% CI) 1.13-1.66], mergers (HR 1.23, 95% CI 1.02-1.48), and relocation of work unit (HR 1.24, 95% CI 1.01-1.54) increased rate of non-disability early retirement, while demerging of work unit did not (HR 1.03, 95% CI 0.79-1.33). Work units with lower levels of social capital (HR 1.22, 95% CI 1.05-1.41), organizational justice, (HR 1.18, 95% CI 1.04-1.32), and quality of management (HR 1.14, 95% CI 1.02-1.25) increased rate of early retirement. Conclusion Organizational change and poor psychosocial work environment contribute to non-disability early retirement among senior public service employees, measured at work-unit level.
The relationship between hospital work environment and nurse outcomes in Guangdong, China: a nurse questionnaire survey.

PubMed

Liu, Ke; You, Li-Ming; Chen, Shao-Xian; Hao, Yuan-Tao; Zhu, Xiao-Wen; Zhang, Li-Feng; Aiken, Linda H

2012-05-01

This study examines the relationship between hospital work environments and job satisfaction, job-related burnout and intention to leave among nurses in Guangdong province, China. The nursing shortage is an urgent global problem and also of concern in China. Studies in Western countries have shown that better work environments are associated with higher nurse satisfaction and lower burnout, thereby improving retention and lowering turnover rates. However, there is little research on the relationship between nurse work environments and nurse outcomes in China. This is a cross-sectional study. Survey data were collected from 1104 bedside nurses in 89 medical, surgical and intensive care units in 21 hospitals across the Guangdong province in China. Stratified convenience sampling was used to select hospitals, and systematic sampling was used to select units. All staff nurses working on participating units were surveyed. The China Hospital Nurse Survey, including the Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory, was employed to collect data from nurses. Statistical significance level was set at 0·05. Thirty-seven per cent of the nurses experienced high burnout, and 54% were dissatisfied with their jobs. Improving nurses' work environments from poor to better was associated with a 50% decrease in job dissatisfaction and a 33% decrease in job-related burnout among nurses. Burnout and job dissatisfaction are high among hospital nurses in Guangdong province, China. Better work environments for nurses were associated with decreased job dissatisfaction and job-related burnout, which may successfully address the nursing shortage in China. The findings of this study indicate that improving work environments is essential to deal with the nursing shortage; the findings provide motivation for nurse managers and policy makers to improve work environments of hospital nurses in China. © 2012 Blackwell Publishing Ltd.
The relationship between hospital work environment and nurse outcomes in Guangdong, China: a nurse questionnaire survey

PubMed Central

Liu, Ke; You, Li-Ming; Chen, Shao-Xian; Hao, Yuan-Tao; Zhu, Xiao-Wen; Zhang, Li-Feng; Aiken, Linda H

2012-01-01

Aims and objectives This study examines the relationship between hospital work environments and job satisfaction, job-related burnout and intention to leave among nurses in Guangdong province, China. Background The nursing shortage is an urgent global problem and also of concern in China. Studies in Western countries have shown that better work environments are associated with higher nurse satisfaction and lower burnout, thereby improving retention and lowering turnover rates. However, there is little research on the relationship between nurse work environments and nurse outcomes in China. Design This is a cross-sectional study. Survey data were collected from 1104 bedside nurses in 89 medical, surgical and intensive care units in 21 hospitals across the Guangdong province in China. Methods Stratified convenience sampling was used to select hospitals, and systematic sampling was used to select units. All staff nurses working on participating units were surveyed. The China Hospital Nurse Survey, including the Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory, was employed to collect data from nurses. Statistical significance level was set at 0·05. Results Thirty-seven per cent of the nurses experienced high burnout, and 54% were dissatisfied with their jobs. Improving nurses’ work environments from poor to better was associated with a 50% decrease in job dissatisfaction and a 33% decrease in job-related burnout among nurses. Conclusion Burnout and job dissatisfaction are high among hospital nurses in Guangdong province, China. Better work environments for nurses were associated with decreased job dissatisfaction and job-related burnout, which may successfully address the nursing shortage in China. Relevance to clinical practice The findings of this study indicate that improving work environments is essential to deal with the nursing shortage; the findings provide motivation for nurse managers and policy makers to improve work environments of hospital nurses in China. PMID:22380003
Associations Among Nursing Work Environment and Health-Promoting Behaviors of Nurses and Nursing Performance Quality: A Multilevel Modeling Approach.

PubMed

Cho, Hyeonmi; Han, Kihye

2018-05-14

This study aimed to determine the relationships among the unit-level nursing work environment and individual-level health-promoting behaviors of hospital nurses in South Korea and their perceived nursing performance quality. This study used a cross-sectional design. Data were collected using self-reported questionnaires from 432 nurses in 57 units at five hospitals in South Korea. Nursing performance quality, nursing work environment, and health-promoting behaviors were measured using the Six Dimension Scale of Nursing Performance, Practice Environment Scale of the Nursing Work Index, and Health Promoting Lifestyle Profile-II, respectively. Nurses working in units with nurse managers who were characterized by better ability and by quality leadership, and who provided more support to nurses exhibited significantly greater health responsibility and physical activity. Nurses working with sufficient staffing and resources reported better stress management. Positive collegial nurse-physician relationships in units were significantly associated with more healthy eating among nurses. Nurses working in units with sufficient staffing and resources, and who had a higher level of spiritual growth and health responsibility, were more likely to perceive their nursing performance quality as being higher. To improve the quality of nursing practice, hospitals should focus on helping nurses maintain healthy lifestyles, as well as improving their working conditions in South Korea. Organizational support for adequate human resources and materials, mutual cooperation among nurses and physicians, and workplace health-promotion interventions for spiritual growth and health responsibility are needed. Organizational efforts to provide sufficient staffing and resources, boost the development of personal resources among nurses, and promote nurses' responsibility for their own health could be effective strategies for improving nursing performance quality and patient outcomes. © 2018 Sigma Theta Tau International.
Threading needles in the dark: the effect of the physical work environment on nursing practice.

PubMed

Simmons, Debora; Graves, Krisanne; Flynn, Elizabeth A

2009-01-01

Frequently, the most critical calculations, considerations, and preparations for patient care and medication administration are made in noisy, dimly lit, and chaotic areas of the nursing unit. Healthcare has begun to recognize the impact of the physical work environment plays in the ability of humans to perform reliably and safely. This article reviews the draft guidelines recently released by the United States Pharmacopeia for public comment for the physical environment to promote safe medication administration.
Impact of role-, job- and organizational characteristics on Nursing Unit Managers' work related stress and well-being.

PubMed

Van Bogaert, Peter; Adriaenssens, Jef; Dilles, Tinne; Martens, Daisy; Van Rompaey, Bart; Timmermans, Olaf

2014-11-01

To study the impact of role, job- and organizational characteristics on nurse managers' work related stress and well-being such as feelings of emotional exhaustion, work engagement, job satisfaction and turnover intention. Various studies investigated role-, job- and organizational characteristics influencing nurse-related work environments. Research on nurse managers' related work environments define influencing factors, but, a clear understanding of the impact of nurse-managers' work-environment characteristics on their work related stress and well-being is limited. A cross-sectional design with a survey. A cross-sectional survey (N = 365) was carried out between December 2011-March 2012. The questionnaire was based on various validated measurement instruments identified by expert meetings (e.g. staff nurses, nurse managers and executives and physicians). Hierarchical regression analyses were performed using emotional exhaustion, work engagement, job satisfaction and turnover intentions as outcome variables. Study results showed one out of six nursing unit managers have high to very high feelings of emotional exhaustion and two out of three respondents have high to very high work engagement. Hierarchical regression models showed that role conflict and role meaningfulness were strong predictors of nursing unit managers' work related stress and well-being, alongside with job- and organizational characteristics. Several risk factors and stimulating factors influencing nurse unit managers' work related stress and well-being were identified. Further challenges will be to develop proper interventions and strategies to support nursing unit managers and their team in daily practice to deliver the best and safest patient care. © 2014 John Wiley & Sons Ltd.
Characteristics of the Nursing Practice Environment Associated With Lower Unit-Level RN Turnover.

PubMed

Nelson-Brantley, Heather V; Park, Shin Hye; Bergquist-Beringer, Sandra

2018-01-01

The aim of this study is to examine characteristics of the nursing practice environment associated with lower RN turnover. Identifying characteristics of the practice environment that contribute to lower RN turnover is important for meeting the national quality strategy priority of reducing healthcare costs. Data from 1002 adult care units in 162 National Database of Nursing Quality Indicators participating hospitals were analyzed using multivariate linear regression. The Practice Environment Scale of the Nursing Work Index was used to measure practice environment characteristics. RN turnover was measured at the unit level. Nursing units with higher overall ratings of the nursing practice environment had lower rates of RN turnover. Units with higher RN perceived staffing and resource adequacy experienced significantly lower RN turnover. Unit managers and hospital administrators should consider RN perception of staffing and resource adequacy and the overall practice environment when developing targeted strategies for decreasing RN turnover.
Providing a healthy work environment for nurses: the influence on retention.

PubMed

Cohen, Jayne; Stuenkel, Diane; Nguyen, Quyen

2009-01-01

Differences in registered nurses' (RNs) perceptions of their work environment were measured with the Insel and Moos' Work Environment Scale to identify factors in the work environment that may influence retention. Statistically significant differences for perceptions of supervisor support and innovation were found between those RNs who left their unit or hospital during a 24-month period and those who stayed. Implementing strategies to promote retention of RNs to ensure safe, quality patient care is essential.
Organizational factors impacting job strain and mental quality of life in emergency and critical care units.

PubMed

Bellagamba, Gauthier; Gionta, Guillaume; Senergue, Julie; Bèque, Christine; Lehucher-Michel, Marie-Pascale

2015-01-01

This study measures the association between hospital staff's job strain (JS), mental quality of life (MQL) and how they are influenced by the organization models within emergency and critical care units. This study describes workers employed in emergency departments and intensive care units of a French public hospital. A selfadministered questionnaire was used to survey the demographic and organizational characteristics of their work, as well as work-related mental stress, psychosocial and organizational constraints, and their MQL. Among 145 workers participating in the study, 59.3% of them report job strain and 54.5% of them have low MQL scores. The majority of staff with job strain has reported working more than 2 weekends per month, were regularly on-call, worked in dysfunctional environments and did not participate in regular meetings. The staff with low MQL worked more frequently in dysfunctional environments, had significant complaints regarding employer's efforts to promote communications or provide adequate staffing levels than the workers with a high MQL score. If stress reduction and improved MQL in emergency and intensive care units is to be achieved, hospital management needs to design work schedules that provide a better balance between working and non-working hours. Additionally, ergonomic design, functional environments and improved communications needs to be implemented. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Healthy work environments and staff nurse retention: the relationship between communication, collaboration, and leadership in the pediatric intensive care unit.

PubMed

Blake, Nancy; Leach, Linda Searle; Robbins, Wendy; Pike, Nancy; Needleman, Jack

2013-01-01

A healthy work environment can improve patient outcomes and registered nurse (RN) turnover. Creating cultures of retention and fostering healthy work environments are 2 major challenges facing nurse leaders today. Examine the effects of the healthy work environment (communication, collaboration, and leadership) on RN turnover from data collected from a research study. Descriptive, cross-sectional, correlational design. Pediatric critical care RNs from 10 pediatric intensive care units (PICU) completed the Practice Environment Scale of the Nursing Work Index Revised and a subscale of the Intensive Care Unit Nurse-Physician Communication Questionnaire. These staff nurses were asked whether they intend to leave their current job in the next 6 months. Statistical analysis included correlations, multiple linear regression, t tests (2-tailed), and 1-way analysis of variance. A total of 415 RNs completed the survey. There was a statistically significant relationship between leadership and the intent to leave (P < .05). There was also an inverse relationship between years of experience and intent to leave. None of the communication variables between RNs and among RNs and MDs or collaboration were significantly associated with PICU nurses' intention to leave. Effective leadership in the PICU is important to PICU RNs and significantly influences their decisions about staying in their current job.
40 CFR 63.1568 - What are my requirements for HAP emissions from sulfur recovery units?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 12 2010-07-01 2010-07-01 true What are my requirements for HAP emissions from sulfur recovery units? 63.1568 Section 63.1568 Protection of Environment ENVIRONMENTAL... requirements for HAP emissions from sulfur recovery units? (a) What emission limitations and work practice...
Using the Practice Environment Scale of the Nursing Work Index on Asian nurses.

PubMed

Liou, Shwu-Ru; Cheng, Ching-Yu

2009-01-01

Researchers have used the Practice Environment Scale of the Nursing Work Index (PES-NWI) to examine the perception of practice environment among U.S. nurses in general; however, the scale has not been used to measure perceptions specifically among Asian nurses working in the United States, the largest group of international nurses in the nation. The purpose of this study was to test the reliability and the validity of the PES-NWI scale when applied to Asian nurses working in the United States. The study used a cross-sectional design with snowball sampling. Data from 230 Asian nurses who were born in Far Eastern countries and had worked at least 6 months in their current job at a U.S. hospital were analyzed, using Cronbach's alpha, item-total and interitem correlation, and factor analysis. The Cronbach's alpha for the PES-NWI was.96, and the item-total correlation coefficients ranged from.49 to.79. Five factors, which explained 59.12% of variance in the perception of practice environment, emerged: Nurse Participation and Development; Nurse Manager Ability, Leadership, and Support of Nurses; Nursing Foundations for Quality of Care; Staffing and Resource Adequacy; and Collegial Nurse-Physician Relations. Four derived factors were reconstructed, and one factor was renamed based on the meanings of scale items that were included in the factor. Study findings demonstrate that the PES-NWI is a reliable and a valid scale when applied to Asian nurses working in the United States. Findings also indicate that Asian nurses perceive practice environments differently than do American nurses, most likely due to dissimilar cultural beliefs. A better understanding of these differences may help develop more individualized support for Asian nurses as they adapt to working in the United States.

Linking hospital workers' organisational work environment to depressive symptoms: A mediating effect of effort-reward imbalance? The ORSOSA study.

PubMed

Jolivet, Anne; Caroly, Sandrine; Ehlinger, Virgine; Kelly-Irving, Michelle; Delpierre, Cyrille; Balducci, Franck; Sobaszek, Annie; De Gaudemaris, Régis; Lang, Thierry

2010-08-01

Few studies have analysed the association between the organisational work environment and depression in hospital workers and we still have little understanding of how processes in the practice environment are related to depressive disorders. However, individual perception of an imbalance between efforts made and expected rewards has been associated with incident depression. The main goal of this study was to test the hypothesis that some organisational constraints at the work-unit level may be related to depressive symptoms in hospital workers, either directly or through individual perceptions of effort-reward imbalance (ERI). In 2006, 3316 female registered nurses and nursing aids working in 190 work units in seven French university hospitals, recruited from the baseline screening of an epidemiological cohort study (the ORSOSA study), responded in 2006 to valid self-report questionnaires (CES-D, ERI). The organisational work environment was assessed with the self-rated Nursing Work Index - Extended Organisation (NWI-EO) aggregated at the work unit level. Multilevel models were used. We found that poor relations between workers within work units were associated with higher CES-D score, independently of perceived ERI. Low level of communication between workers in the unit was associated with individual perceptions of ERI and indirectly associated with depressive symptoms. Understaffing and non-respect of planned days off and vacations were associated with perceived ERI but these organisational constraints were not associated with depressive symptoms. Our study allowed us to identify and quantify organisational factors that have a direct effect on hospital workers' depressive symptoms, or an indirect effect through perceived ERI. Better understanding of the effect of organisational factors on health through perceived ERI would provide targets for successful interventions. Organisational approaches may be more effective in improving mental health at work and may also have a longer-lasting impact than individual approaches. Copyright 2010 Elsevier Ltd. All rights reserved.
Possible Futures for Social Work with Children and Families in Australia, the United Kingdom and the United States

ERIC Educational Resources Information Center

Spratt, Trevor

2008-01-01

There has been considerable interest in recent years in comparing the operation of social work services for children and families internationally, particularly between Australia, the United Kingdom and the United States. Reviewing the respective policy environments and drawing on recent research experience in these three nations, the author…
Understanding the Geographic Controls of Hazardous Convective Weather Environments in the United States

NASA Astrophysics Data System (ADS)

Reed, K. A.; Chavas, D. R.

2017-12-01

Hazardous Convective Weather (HCW), such as severe thunderstorms and tornadoes, poses significant risk to life and property in the United States every year. While these HCW events are small scale, they develop principally within favorable larger-scale environments (i.e., HCW environments). Why these large-scale environments are confined to specific regions, particularly the Eastern United States, is not well understood. This can, in part, be related to a limited fundamental knowledge of how the climate system creates HCW environment, which provides uncertainty in how HCW environments may be altered in a changing climate. Previous research has identified the Gulf of Mexico to the south and elevated terrain upstream as key geographic contributors to the generation of HCW environments over the Eastern United States. This work investigates the relative role of these geographic features through "component denial" experiments in the Community Atmosphere Model version 5 (CAM5). In particular, CAM5 simulations where topography is removed (globally and regionally) and/or the Gulf of Mexico is converted to land is compared to a CAM5 control simulation of current climate following the Atmospheric Model Intercomparison Project (AMIP) protocols. In addition to exploring differences in general characteristics of the large-scale environments amongst the experiments, HCW changes will be explored through a combination of high shear and high Convective Available Potential Energy (CAPE) environments. Preliminary work suggests that the removal of elevated terrain reduces the inland extent of HCW environments in the United States, but not the existence of these events altogether. This indicates that topography is crucial for inland HCW environments but perhaps not for their existence in general (e.g., near the Gulf of Mexico). This initial work is a crucial first step to building a reduced-complexity framework within CAM5 to quantify how land-ocean contrast and elevated terrain control HCW environments.
Nurse Burnout and Patient Satisfaction

PubMed Central

Vahey, Doris C.; Aiken, Linda H.; Sloane, Douglas M.; Clarke, Sean P.; Vargas, Delfino

2010-01-01

Background Amid a national nurse shortage, there is growing concern that high levels of nurse burnout could adversely affect patient outcomes. Objectives This study examines the effect of the nurse work environment on nurse burnout, and the effects of the nurse work environment and nurse burnout on patients' satisfaction with their nursing care. Research Design/Subjects We conducted cross-sectional surveys of nurses (N = 820) and patients (N = 621) from 40 units in 20 urban hospitals across the United States. Measures Nurse surveys included measures of nurses' practice environments derived from the revised Nursing Work Index (NWI-R) and nurse outcomes measured by the Maslach Burnout Inventory (MBI) and intentions to leave. Patients were interviewed about their satisfaction with nursing care using the La Monica-Oberst Patient Satisfaction Scale (LOPSS). Results Patients cared for on units that nurses characterized as having adequate staff, good administrative support for nursing care, and good relations between doctors and nurses were more than twice likely as other patients to report high satisfaction with their care, and their nurses reported significantly lower burnout. The overall level of nurse burnout on hospital units also affected patient satisfaction. Conclusions Improvements in nurses' work environments in hospitals have the potential to simultaneously reduce nurses' high levels of job burnout and risk of turnover and increase patients' satisfaction with their care. PMID:14734943
Work environment, volume of activity and staffing in neonatal intensive care units in Italy: results of the SONAR-nurse study.

PubMed

Corchia, Carlo; Fanelli, Simone; Gagliardi, Luigi; Bellù, Roberto; Zangrandi, Antonello; Persico, Anna; Zanini, Rinaldo

2016-04-02

Neonatal units' volume of activity, and other quantitative and qualitative variables, such as staffing, workload, work environment, care organization and geographical location, may influence the outcome of high risk newborns. Data about the distribution of these variables and their relationships among Italian neonatal units are lacking. Between March 2010-April 2011, 63 neonatal intensive care units adhering to the Italian Neonatal Network participated in the SONAR Nurse study. Their main features and work environment were investigated by questionnaires compiled by the chief and by physicians and nurses of each unit. Twelve cross-sectional monthly-repeated surveys on different shifts were performed, collecting data on number of nurses on duty and number and acuity of hospitalized infants. Six hundred forty five physicians and 1601 nurses compiled the questionnaires. In the cross-sectional surveys 702 reports were collected, with 11082 infant and 3226 nurse data points. A high variability was found for units' size (4-50 total beds), daily number of patients (median 14.5, range 3.4-48.7), number of nurses per shift (median 4.2, range 0.7-10.8) and number of team meetings per month. Northern regions performed better than Central and Southern regions for frequency of training meetings, qualitative assessment of performance, motivation within the unit and nursing work environment; mean physicians' and nurses' age increased moving from North to South. After stratification by terciles of the mean daily number of patients, the median number of nurses per shift increased at increasing volume of activity, while the opposite was found for the nurse-to-patient ratio adjusted by patients' acuity. On average, in units belonging to the lower tercile there was 1 nurse every 2.5 patients, while in those belonging to the higher tercile the ratio was 1 nurse every 5 patients. In Italy, there is a high variability in organizational characteristics and work environment among neonatal units and an uneven distribution of human resources in relation to volume of activity, suggesting that the larger the unit the greater the workload for each nurse. Urgent modifications in planning and organization of services are needed in order to pursue more efficient, homogeneous and integrated regionalized neonatal care systems.
Comparison of Reasons for Nurse Turnover in Magnet® and Non-Magnet Hospitals.

PubMed

Park, Shin Hye; Gass, Stephanie; Boyle, Diane K

2016-05-01

The aim of this study is to compare rates and reasons for registered nurse (RN) turnover by Magnet® status. Although lower RN turnover rates in Magnet hospitals have been documented well in the literature, little is known about specific separation reasons for RN turnover and whether the reasons differ between Magnet and non-Magnet hospitals. This descriptive, correlational study analyzed unit-level 2013 National Database of Nursing Quality Indicators® turnover data (2,958 units; 497 hospitals). Poisson regression and Wilcoxon-Mann-Whitney test were used. Registered nurse turnover due to environment-related reasons was higher on units in non-Magnet hospitals than units in Magnet hospitals. Units in non-Magnet hospitals had 4.684 times higher turnover rates due to staffing/workload and 1.439 times higher rates due to work schedules than did units in Magnet hospitals. Nursing administrators in both Magnet and non-Magnet hospitals need to continually strive to improve unit work environments, particularly staffing and workload conditions and work scheduling.
ACCIS Guide to United Nations Information Sources on the Environment.

ERIC Educational Resources Information Center

United Nations, New York, NY.

This is a guide to the organizational units of the United Nations (UN) system that work on environmental issues. Section 1 provides short descriptions of sources of information on the environment from 34 organizations of the UN system. A contact address is given for each organization. Section 2 groups sources of information into 11 subject…
Compassion Fatigue and the Healthy Work Environment.

PubMed

Kelly, Lesly; Todd, Michael

2017-01-01

Burnout is a concern for critical care nurses in high-intensity environments. Studies have highlighted the importance of a healthy work environment in promoting optimal nurse and patient outcomes, but research examining the relationship between a healthy work environment and burnout is limited. To examine how healthy work environment components relate to compassion fatigue (eg, burnout, secondary trauma) and compassion satisfaction. Nurses (n = 105) in 3 intensive care units at an academic medical center completed a survey including the Professional Quality of Life and the American Association of Critical-Care Nurses' Healthy Work Environment standards. Regression models using each Healthy Work Environment component to predict each outcome, adjusting for background variables, showed that the 5 Healthy Work Environment components predicted burnout and that meaningful recognition and authentic leadership predicted compassion satisfaction. Findings on associations between healthy work environment standards and burnout suggest the potential importance of implementing the American Association of Critical-Care Nurses' Healthy Work Environment standards as a mechanism for decreasing burnout. ©2017 American Association of Critical-Care Nurses.
Structural empowerment and patient safety culture among registered nurses working in adult critical care units.

PubMed

Armellino, Donna; Quinn Griffin, Mary T; Fitzpatrick, Joyce J

2010-10-01

The aim of the present study was to examine the relationship between structural empowerment and patient safety culture among staff level Registered Nurses (RNs) within adult critical care units (ACCU). There is literature to support the value of RNs' structurally empowered work environments and emerging literature towards patient safety culture; the link between empowerment and patient safety culture is being discovered. A sample of 257 RNs, working within adult critical care of a tertiary hospital in the United States, was surveyed. Instruments included a background data sheet, the Conditions of Workplace Effectiveness and the Hospital Survey on Patient Safety Culture. Structural empowerment and patient safety culture were significantly correlated. As structural empowerment increased so did the RNs' perception of patient safety culture. To foster patient safety culture, nurse leaders should consider providing structurally empowering work environments for RNs. This study contributes to the body of knowledge linking structural empowerment and patient safety culture. Results link structurally empowered RNs and increased patient safety culture, essential elements in delivering efficient, competent, quality care. They inform nursing management of key factors in the nurses' environment that promote safe patient care environments. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
Reconsidering the Workplace: Faculty Perceptions of Their Work and Working Environments

ERIC Educational Resources Information Center

Kuntz, Aaron M.

2012-01-01

In an effort to foreground the impact of the material environment on faculty activities, this study examines the dynamic intersections among faculty work practices, the academic workplace and professional identity. Drawing on in-depth interviews with 16 social science faculty at one public university in the United States, this study reveals the…
Cross-National Similarities and Differences in Employee Perceptions of Issues in the Work Environment

ERIC Educational Resources Information Center

Ripley, David; Hudson, Irene; Turner, Robin; Osman-Gani, AAhad

2006-01-01

This exploratory study examines cross-national similarities and differences in employee perceptions of issues in the work environment in 17 organizational work settings in seven Asia-Pacific countries; Australia, Malaysia, New Zealand, Singapore, South Korea, Taiwan, and the United States. Employees at these 17 sites indicated their degree of…
40 CFR Table 3 to Subpart Dddd of... - Work Practice Requirements

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 12 2011-07-01 2009-07-01 true Work Practice Requirements 3 Table 3 to Subpart DDDD of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Table 3 to Subpart DDDD of Part 63—Work Practice Requirements For the following process units at...
Family Home Childcare Providers: A Comparison of Subsidized and Non-Subsidized Working Environments and Employee Issues

ERIC Educational Resources Information Center

Shriner, Michael; Schlee, Bethanne M.; Mullis, Ronald L.; Cornille, Thomas A.; Mullis, Ann K.

2008-01-01

Federal and State Governments provide childcare subsidies for low-income working families. This study compares the encountered issues and working environments of family home providers of subsidized and non-subsidized childcare. Questionnaires were distributed throughout a southeastern state in the United States to 548 family home childcare…
The associations of occupational hazards and injuries with work environments and overtime for nurses in China.

PubMed

Wu, Yan; Zheng, Jing; Liu, Ke; Baggs, Judith G; Liu, Jiali; Liu, Xu; You, Liming

2018-06-04

Occupational hazards (OHs) and occupational injuries (OIs) may contribute to nurses needing sick time and to a high financial burden for hospitals. There is little published literature about nurse-reported OHs/OIs and their relationships with work environments and working overtime in China. This study was designed to describe Chinese hospital registered nurses' OHs/OIs and to explore the associations between work environments, working overtime, and nurse-reported OHs/OIs. This cross-sectional study was conducted in Guangdong province in China in 2014. The sample included 1,517 nurses from 111 medical/surgical units in 23 hospitals. The Practice Environment Scale of the Nursing Work Index was used to measure work environment. Overtime was calculated by subtracting scheduled work hours from actual work hours. Six items were used to measure nurse-reported OHs/OIs. Descriptive statistics, Chi-square tests, and two-level logistic regression models were used to analyze the data. The percentages of nurses reporting OHs/OIs occurred in the year before the survey ranged from 47% to 80%. Nurses who worked in good (vs. poor) unit work environments were less likely to experience OHs/OIs (Odds ratio [OR] = 0.65-0.68, p < .05). Nurses who worked overtime (OR = 1.19-1.33, p < .05) and in Level 3 (largest) hospitals (OR = 1.45-1.80, p < .05) were more likely to experience OHs/OIs. We found that OHs/OIs were prevalent among hospital nurses in China. Better work environment and less nurse overtime were associated with fewer nurse OHs/OIs. © 2018 Wiley Periodicals, Inc.
40 CFR 35.917-6 - Acceptance by implementing governmental units.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Acceptance by implementing governmental units. 35.917-6 Section 35.917-6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean...
UNEP's Work to Implement Good Practice at a Regional Level: Contribution to the UNDESD

ERIC Educational Resources Information Center

Ogbuigwe, Akpezi

2010-01-01

This paper outlines the contribution made by the United Nations Environment Programme (UNEP) towards enhancing the integration of sustainable development concerns in Africa through its initiative, the Mainstreaming Environment and Sustainability in Africa (MESA) Universities Partnership, during the United Nations Decade of Education for…
[Continuing training plan in a clinical management unit].

PubMed

Gamboa Antiñolo, Fernando Miguel; Bayol Serradilla, Elia; Gómez Camacho, Eduardo

2011-01-01

Continuing Care Unit (UCA) focused the attention of frail patients, polypathological patients and palliative care. UCA attend patients at home, consulting, day unit, telephone consulting and in two hospitals of the health area. From 2002 UCA began as a management unit, training has been a priority for development. Key elements include: providing education to the workplace, including key aspects of the most prevalent health care problems in daily work, directing training to all staff including organizational aspects of patient safety and the environment, improved working environment, development of new skills and knowledge supported by the evidence-based care for the development of different skills. The unit can be the ideal setting to undertake the reforms necessary conceptual training of professionals to improve the quality of care. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.
Built environment interventions aimed at improving physical activity levels in rural Ontario health units: a descriptive qualitative study.

PubMed

Coghill, Cara-Lee; Valaitis, Ruta K; Eyles, John D

2015-05-03

Few studies to date have explored the relationship between the built environment and physical activity specifically in rural settings. The Ontario Public Health Standards policies mandate that health units in Ontario address the built environment; however, it is unclear how public health practitioners are integrating the built environment into public health interventions aimed at improving physical activity in chronic disease prevention programs. This descriptive qualitative study explored interventions that have or are being implemented which address the built environment specifically related to physical activity in rural Ontario health units, and the impact of these interventions. Data were collected through twelve in-depth semi-structured interviews with rural public health practitioners and managers representing 12 of 13 health units serving rural communities. Key themes were identified using qualitative content analysis. Themes that emerged regarding the types of interventions that health units are employing included: Engagement with policy work at a municipal level; building and working with community partners, committees and coalitions; gathering and providing evidence; developing and implementing programs; and social marketing and awareness raising. Evaluation of interventions to date has been limited. Public health interventions, and their evaluations, are complex. Health units who serve large rural populations in Ontario are engaging in numerous activities to address physical activity levels. There is a need to further evaluate the impact of these interventions on population health.
40 CFR Table 36 to Subpart Uuu of... - Work Practice Standards for HAP Emissions From Bypass Lines

Code of Federal Regulations, 2011 CFR

2011-07-01

... Emissions From Bypass Lines 36 Table 36 to Subpart UUU of Part 63 Protection of Environment ENVIRONMENTAL... Refineries: Catalytic Cracking Units, Catalytic Reforming Units, and Sulfur Recovery Units Pt. 63, Subpt. UUU, Table 36 Table 36 to Subpart UUU of Part 63—Work Practice Standards for HAP Emissions From Bypass Lines...
40 CFR Table 36 to Subpart Uuu of... - Work Practice Standards for HAP Emissions From Bypass Lines

Code of Federal Regulations, 2010 CFR

2010-07-01

... Emissions From Bypass Lines 36 Table 36 to Subpart UUU of Part 63 Protection of Environment ENVIRONMENTAL... Refineries: Catalytic Cracking Units, Catalytic Reforming Units, and Sulfur Recovery Units Pt. 63, Subpt. UUU, Table 36 Table 36 to Subpart UUU of Part 63—Work Practice Standards for HAP Emissions From Bypass Lines...

Nurses' perception of their manager's leadership style and unit climate: are there generational differences?

PubMed

Farag, Amany A; Tullai-McGuinness, Susan; Anthony, Mary K

2009-01-01

To describe and compare how nurses representing four age cohorts perceive their manager's leadership style and unit climate. The current workforce consists of nurses representing four generational cohorts. Nursing literature suggests that nurses from each age cohort think, behave and approach work differently. Limited empirical evidence, however, exists about how nurses from each age cohort perceive two aspects of their work environment: their managers' leadership style and unit climate. This cross-sectional, descriptive survey was conducted using a convenience sample of 475 registered nurses working in different inpatient units in three community non-magnet hospitals. Only nurses from Boomer and Gen-Xers had sufficient representation to be included in the data analysis. Nurses from the two main age cohorts did not differ in their perceptions of their manager's leadership style. Significant differences were found in two unit climate dimensions. The Gen-Xers had a less favourable perception of their unit climate related to warmth and belonging and administrative support. Nurse manager's might reflect on how they interact with different age cohorts; and to involve nurses from various age cohorts in the development of policies to create a flexible work environment.
Effects of unit empowerment and perceived support for professional nursing practice on unit effectiveness and individual nurse well-being: a time-lagged study.

PubMed

Spence Laschinger, Heather K; Nosko, Amanda; Wilk, Piotr; Finegan, Joan

2014-12-01

Recruitment and retention strategies have emphasized the importance of positive work environments that support professional nursing practice for sustaining the nursing workforce. Unit leadership that creates empowering workplace conditions plays a key role in establishing supportive practice environments that increase work effectiveness, and, ultimately, improves job satisfaction. To test a multi-level model examining the effect of both contextual and individual factors on individual nurse job satisfaction. At the unit level, structural empowerment and support for professional nursing practice (organizational resources) were hypothesized to be predictors of unit level effectiveness. At the individual level, core self-evaluation, and psychological empowerment (intrapersonal resources) were modeled as predictors of nurse job satisfaction one year later. Cross-level unit effects on individual nurses' job satisfaction were also examined. This study employed a longitudinal survey design with 545 staff nurses from 49 hospital units in Ontario, Canada. Participants completed a survey at two points in time (response rate of 40%) with standardized measures of the major study variables in the hypothesized model. Multilevel structural equation modeling was used to test the model. Nurses shared perceptions of structural empowerment on their units indirectly influenced their shared perceptions of unit effectiveness (Level 2) through perceived unit support for professional nursing practice, which in turn, had a significant positive direct effect on unit effectiveness (Level 2). Unit effectiveness was also strongly related to individual nurse job satisfaction one year later. At Level 1, higher core self-evaluation had a direct and indirect effect on job satisfaction through increased psychological empowerment. The results suggest that nurses' job satisfaction is influenced by a combination of individual and contextual factors demonstrating utility in considering both sources of nurses' satisfaction with their work in creating effective nursing work environments. Copyright © 2014 Elsevier Ltd. All rights reserved.
The psychosocial work environment and mental health of teachers: a comparative study between the United Kingdom and Hong Kong.

PubMed

Tang, Jessica Janice; Leka, Stavroula; MacLennan, Sara

2013-08-01

There is limited research on teachers' psychosocial work environment and mental health, and most has been conducted in predominantly Western countries that share a number of important common characteristics that distinguish them from countries in many other regions of the world. Within the framework of the effort-reward imbalance (ERI) theoretical model, the relationship between the psychosocial work environment and mental health of teachers in the United Kingdom (UK) and Hong Kong (HK) was investigated. Full-time qualified teachers from both the UK and HK (N = 259) participated in the research. They were asked to fill in a set of questionnaires that measured their perceived stress, mental health, psychosocial work environment and demographic information. Perceived stress was found to predict teachers' mental health. Overcommitment, the intrinsic component of the ERI model, predicted mental health among HK teachers. There were significant differences in the psychosocial variables between UK and HK teachers. The results showed support for the ERI model and in particular for the relationship between stress and mental health and demonstrated the role of overcommitment in the teaching profession. Some implications are discussed for combating cultural differences in managing the psychosocial work environment of teachers.
Nursing professional practice environments: setting the stage for constructive conflict resolution and work effectiveness.

PubMed

Siu, Heidi; Spence Laschinger, Heather K; Finegan, Joan

2008-05-01

The aim of this study was to examine the impact of nurses' perceived professional practice environment on their quality of nursing conflict management approaches and ultimately their perceptions of unit effectiveness from the perspective of Deutsch's theory of constructive conflict management. Rising reports of hostility and conflict among Canadian nurses are a concern to nurses' health and the viability of effective patient care delivery. However, research on the situational factors that influence nurses' ability to apply effective conflict resolution skills that lead to positive results in practice is limited. A nonexperimental, predictive design was used in a sample of 678 registered nurses working in community hospitals within a large metropolitan area in Ontario. The results supported a modified version of the hypothesized model [chi2(1) = 16.25, Goodness of Fit = 0.99, Comparative Fit Index = 0.98, Root-Mean-Square Error of Approximation = 0.15] linking professional practice environment and core self-evaluation to nurses' conflict management and, ultimately, unit effectiveness. Professional practice environment, conflict management, and core-self evaluation explained approximately 46.6% of the variance in unit effectiveness. Positive professional practice environments and high core self-evaluations predicted nurses' constructive conflict management and, in turn, greater unit effectiveness.
Nurses' practice environment and satisfaction with schedule flexibility is related to intention to leave due to dissatisfaction: A multi-country, multilevel study.

PubMed

Leineweber, Constanze; Chungkham, Holendro Singh; Lindqvist, Rikard; Westerlund, Hugo; Runesdotter, Sara; Smeds Alenius, Lisa; Tishelman, Carol

2016-06-01

Nursing turnover is a major issue for health care managers, notably during the global nursing workforce shortage. Despite the often hierarchical structure of the data used in nursing studies, few studies have investigated the impact of the work environment on intention to leave using multilevel techniques. Also, differences between intentions to leave the current workplace or to leave the profession entirely have rarely been studied. The aim of the current study was to investigate how aspects of the nurse practice environment and satisfaction with work schedule flexibility measured at different organisational levels influenced the intention to leave the profession or the workplace due to dissatisfaction. Multilevel models were fitted using survey data from the RN4CAST project, which has a multi-country, multilevel, cross-sectional design. The data analysed here are based on a sample of 23,076 registered nurses from 2020 units in 384 hospitals in 10 European countries (overall response rate: 59.4%). Four levels were available for analyses: country, hospital, unit, and individual registered nurse. Practice environment and satisfaction with schedule flexibility were aggregated and studied at the unit level. Gender, experience as registered nurse, full vs. part-time work, as well as individual deviance from unit mean in practice environment and satisfaction with work schedule flexibility, were included at the individual level. Both intention to leave the profession and the hospital due to dissatisfaction were studied. Regarding intention to leave current workplace, there is variability at both country (6.9%) and unit (6.9%) level. However, for intention to leave the profession we found less variability at the country (4.6%) and unit level (3.9%). Intention to leave the workplace was strongly related to unit level variables. Additionally, individual characteristics and deviance from unit mean regarding practice environment and satisfaction with schedule flexibility were related to both outcomes. Major limitations of the study are its cross-sectional design and the fact that only turnover intention due to dissatisfaction was studied. We conclude that measures aiming to improve the practice environment and schedule flexibility would be a promising approach towards increased retention of registered nurses in both their current workplaces and the nursing profession as a whole and thus a way to counteract the nursing shortage across European countries. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
The culture contributing to interruptions in the nursing work environment: An ethnography.

PubMed

Hopkinson, Susan G; Wiegand, Debra L

2017-12-01

To understand the occurrence of interruptions within the culture of the medical nursing unit work environment. Interruptions may lead to errors in nursing work. Little is known about how the culture of the nursing work environment contributes to interruptions. A micro-focused ethnographic study was conducted. Data collection involved extensive observation of a nursing unit, 1:1 observations of nurses and follow-up interviews with the nurses. Data were analysed from unstructured field notes and interview transcripts. The definitions of interruption and culture guided coding, categorising and identification of themes. A framework was developed that describes the medical nursing unit as a complex culture full of unpredictable, nonlinear changes that affect the entire interconnected system, often in the form of an interruption. The cultural elements contributing to interruptions included (i) the value placed on excellence in patient care and meeting personal needs, (ii) the beliefs that the nurses had to do everything by themselves and that every phone call was important, (iii) the patterns of changing patients, patient transport and coordination of resources and (iv) the normative practices of communicating and adapting. Interruptions are an integral part of the culture of a medical nursing unit. Uniformly decreasing interruptions may disrupt current practices, such as communication to coordinate care, that are central to nursing work. In future research, the nursing work environment must be looked at through the lens of a complex system. Interventions to minimise the negative impact of interruptions must take into account the culture of the nursing as a complex adaptive system. Nurses should be educated on their own contribution to interruptions and issues addressed at a system level, rather than isolating the interruption as the central issue. © 2017 John Wiley & Sons Ltd.
Two Types of Learning Environment: Enabling and Constraining a Study of Care Work

ERIC Educational Resources Information Center

Ellstrom, Eva; Ekholm, Bodil; Ellstrom, Per-Erik

2008-01-01

Purpose: The purpose of this paper is to first elaborate on the notion of a learning environment based on an empirical study of care work. Second, to explore how aspects of a learning environment may differ between and within units in the same organization, and how to understand and explain such differences. Design/methodology/approach: The study…
Evaluation and comparison of health care Work Environment Scale in military settings.

PubMed

Maloney, J P; Anderson, F D; Gladd, D L; Brown, D L; Hardy, M A

1996-05-01

The purpose of this study was to describe health care providers' perceptions of their work environment at a large U.S. Army medical center, and to compare the findings to other military medical centers. The sample (N = 112) consisted of the professional nursing staff working on the nine inpatient units. The Work Environmental Scale (WES) was used to measure perceptions of the workplace relative to gender, position (head nurses, staff nurses, and agency nurses), specialty nursing (intensive care unit [ICU] versus non-ICU), education (MSN, BSN, and ADN), and patterns of differences between the WES subscales of four military medical centers. Results of the study indicate that there were no significant gender differences. Head nurses, non-ICU nurses, and MSN nurses perceived their environment more positively. There were significant differences in the WES subscales between the military hospitals. Implications for nursing using the WES were recommended.
Mission (IM) possible? Nurse civility in the NICU.

PubMed

Simons, Sherri Lee

2008-01-01

Nurses will work in a unit and choose to stay because they feel pride in their work and are respected. Eliminating horizontal hostility at the unit level begins with a commitment from the NICU's leadership. Establishing and maintaining an environment of civility is essential if the unit is to successfully recruit and maintain the best staff to care for the patients entrusted to it.
Prevalence and perpetrators of workplace violence by nursing unit and the relationship between violence and the perceived work environment.

PubMed

Park, Mihyun; Cho, Sung-Hyun; Hong, Hyun-Ja

2015-01-01

To identify the prevalence and perpetrators of workplace violence against nurses and to examine the relationship of work demands and trust and justice in the workplace with the occurrence of violence. This study employed cross-sectional data from a 2013 nurse survey conducted at a university hospital in Seoul, South Korea. The study sample included 970 female nurses from 47 nursing units, including general, oncology, intensive care units (ICUs), operating rooms, and outpatient departments. The second version of the medium-sized Copenhagen Psychosocial Questionnaire (COPSOQ II) was used to measure work demands (i.e., quantitative demands, work pace, and emotional demands), trust and justice, and violence. Relationships among those variables were examined by conducting multiple logistic regression analyses with multilevel modeling. The 12-month prevalence of verbal abuse (63.8%) was highest, followed by threats of violence (41.6%), physical violence (22.3%), and sexual harassment (19.7%), but bullying had the lowest prevalence (9.7%). Physical violence, threats of violence, and verbal abuse occurred most frequently in ICUs, whereas sexual harassment and bullying were highest in operating rooms. The main perpetrators were patients, followed by physicians and patients' families. Nurses perceiving greater work demands and less trust and justice were more likely to have been exposed to violence. The prevalence and perpetrators of violence varied considerably among nursing units. Greater work demands and less trust and justice were associated with nurses' experiences of violence. Adequate work demands and a trusted and just work environment may reduce violence against nurses. In return, reduction of violence will contribute to creating a better nursing work environment. © 2014 Sigma Theta Tau International.
Self-reported environmental health risks of nurses working in hospital surgical units.

PubMed

Azizoğlu, F; Köse, A; Gül, H

2018-06-21

This study investigated the occupational health risk factors among nurses who work in public hospital surgical units. Nursing has a significant place in healthcare systems around the world. Surgical units are environments with certain risks, especially because of the possibility of exposure to various chemical, biologic or physical hazards. This study was conducted with 229 nurses who were working in the 11 surgery units of a big university hospital. In this cross-sectional study, a personal information form and an occupational risk factors scale were administered to respondents. We performed factor and reliability analyses for the scale; the overall reliability of the 41 items was α = 0.924, and the factor analysis found the scale was feasible. Biologic and psychological risk factor levels were found to be high. Physical, chemical, ergonomic and radiation risk factor levels were moderate. The general occupational risk factor score was moderate. Nurses working night duty were confronted with physical and psychological risk factors at a higher rate compared with those working in the daytime. Reported occupational health problems by nurses were correlated with the descriptive properties of the nurses including age, sex, marital status, education level, working hours, mode of working and status of occupational health and safety training. Nurses experience different occupational risks. If these risks are identified, healthier working environments can be provided to the nurses by taking necessary precautions. The health care provided by nurses who work in a healthy environment would be more efficient and of better quality, which will result in better economic and social outcomes for individual and communities. © 2018 International Council of Nurses.
A comparative study of occupancy and patient care quality in four different types of intensive care units in a children's hospital.

PubMed

Smith, Thomas J

2012-01-01

This paper reports a comparative study of occupancy and patient care quality in four types of intensive care units in a children's hospital,: an Infant Care Center (ICC), a Medical/Surgical (Med/Surg) unit, a Neonatal Intensive Care Unit (NICU), and a Pediatric Intensive Care Unit (PICU), each featuring a mix of multi-bed and private room (PR) patient care environments. The project is prompted by interest by the project sponsor in a pre-occupancy analysis, before the units are upgraded to exclusive PR designs. Methods comprised, for each unit: (1) observations of ergonomic design features; (2) task activity analyses of job performance of selected staff; and (3) use of a survey to collect perceptions by unit nursing and house staff (HS) of indicators of occupancy and patient care quality. (1) the five most common task activities are interaction with patients, charting, and interaction with equipment, co-workers and family members; (2) job satisfaction, patient care, work environment, job, patient care team interaction, and general occupancy quality rankings by ICC and/or NICU respondents are significantly higher than those by other staff respondents; and (3) ergonomic design shortcomings noted are excess noise, problems with equipment, and work environment, job-related health, and patient care quality issues.
Evaluating and Implementing Learning Environments: A United Kingdom Experience.

ERIC Educational Resources Information Center

Ingraham, Bruce; Watson, Barbara; McDowell, Liz; Brockett, Adrian; Fitzpatrick, Simon

2002-01-01

Reports on ongoing work at five universities in northeastern England that have been evaluating and implementing online learning environments known as virtual learning environments (VLEs) or managed learning environments (MLEs). Discusses do-it-yourself versus commercial systems; transferability; Web-based versus client-server; integration with…
Should the Army’s Well-Being Programs Be Funded on a Higher Priority

DTIC Science & Technology

2006-03-15

environment that allows Soldiers, civilians, and their families to achieve a satisfying work - life balance and fulfillment in their lives. A healthy...life-style climate allows for a unit to have their unit ready for combat with healthy work - life balance for Soldiers and civilians, as well as their
Leadership and the psychosocial work environment in old age care.

PubMed

Lundgren, Dan; Ernsth-Bravell, Marie; Kåreholt, Ingemar

2016-03-01

To study leadership factors and their associations with psychosocial work environmental among nursing assistants who are engaged in old age care and to analyse (i) differences in the assessment of leadership factors and the assessment of psychosocial work environmental in nursing homes and home help services and (ii) the association between the psychosocial work environment and factors that are related to leadership in nursing homes and home help services. Leadership factors are an important element of the psychosocial work environment in old age care. The physical distance between leaders and nursing assistants is larger in home help services than in nursing homes. Therefore, it is important to study leadership separately in nursing homes and home help services. Assessments from 844 nursing assistants in nursing homes and 288 in home help services (45 nursing homes and 21 home help service units) were analysed. The data were analysed using linear regression. Age, gender, number of staff at the unit, number of years at the current working unit and educational level were controlled in Model 1. Summarised indexes that were based on all independent variables except the main independent variable were additionally controlled in Model 2. Psychosocial work environment was related to leadership factors, but stronger associations occurred more frequently in nursing homes than in home help services. Empowering leadership, support from superiors, the primacy of human resources and control over decisions were associated with higher assessments on all the variables that were related to the psychosocial work environment in both the nursing homes and home help services. Organisational differences in conducting leadership in old age care must be considered. Some leadership characteristics are better prerequisites for creating and maintaining a positive psychosocial work environment for nursing assistants in nursing homes and home help services. Due to the differences in organisational settings, it is important to consider the differences in prerequisites in conducting leadership. To influence nursing assistants' performance and to increase quality in old age care in the long term, appropriate leadership is necessary. © 2015 The Authors. International Journal of Older People Nursing Published by John Wiley & Sons Ltd.
Nurse-perceived quality of care in intensive care units and associations with work environment characteristics: a multicentre survey study.

PubMed

Stalpers, Dewi; Van Der Linden, Dimitri; Kaljouw, Marian J; Schuurmans, Marieke J

2017-06-01

To examine nurse-perceived quality of care, controlling for overall job satisfaction among critical care nurses and to explore associations with work environment characteristics. Nurse-perceived quality of care and job satisfaction have been positively linked to quality outcomes for nurses and patients. Much evidence exists on factors contributing to job satisfaction. Understanding specific factors that affect nurse-perceived quality potentially enables for improvements of nursing care quality. A multicentre survey study was conducted in three Dutch intensive care units. The Dutch version of the Essentials of Magnetism II questionnaire was used; including the single-item indicators: (i) nurse-perceived quality of care; (ii) overall job satisfaction; and (iii) 58 statements on work environments. Data were collected between October 2013 - June 2014. The majority of 123 responding nurses (response rate 45%) were more than satisfied with quality of care (55%) and with their job (66%). No associations were found with nurse characteristics, besides differences in job satisfaction between the units. After controlling for job satisfaction, nurse-perceived quality was positively associated with the work environment characteristics: adequacy of staffing, patient-centeredness, competent peers and support for education. Patient-centeredness and autonomy were the most important predictors for overall job satisfaction. Factors that contribute to nurse-perceived quality of care in intensive care units, independent from the effects of overall job satisfaction, were identified. Hereby, offering opportunities to maximize high quality of care to critically ill patients. Research in a larger sample is needed to confirm our findings. © 2016 John Wiley & Sons Ltd.
Nursing leadership in intensive care units and its relationship to the work environment 1

PubMed Central

Balsanelli, Alexandre Pazetto; Cunha, Isabel Cristina Kowal Olm

2015-01-01

AIM: To establish whether there is any relationship between the work environment and nursing leadership at intensive care units (ICUs). METHOD: Correlational study conducted at four ICUs in southern São Paulo (SP), Brazil. The study population was comprised of 66 pairs (nurses and nursing technicians) established by lottery. The nurses responded to three instruments: 1) characterization; 2) a validated Portuguese version of the Nursing Work Index Revised (B-NWI-R); and 3) Grid & Leadership in Nursing: ideal behavior. The nursing technicians responded to 1) characterization and to 2) Grid and Leadership in Nursing: actual behavior, relative to the corresponding randomly-assigned nurse. The data were analyzed by means of analysis of variance (ANOVA) at p ≤ 0.05. RESULTS: The work environment was not associated with actual nursing leadership (p = 0.852). The public or private nature of the institutions where the investigated ICUs were located had no significant effect on leadership (p = 0.437). Only the nurse-physician relationship domain stood out (p = 0.001). CONCLUSION: The choice of leadership styles by nurses should match the ICU characteristics. Leadership skills could be developed, and the work environment did not exert any influence on the investigated population. PMID:25806638
Leading change to create a healthy and satisfying work environment.

PubMed

Sanders, Carolyn L; Krugman, Mary; Schloffman, Danielle H

2013-01-01

Nurse executives must take a leadership role in creating a healthy work environment for nurses and all disciplines. Engaging in partnerships and empowering clinical nurses to construct the solutions to barriers that may stand in the way of the goal of a satisfied and healthy workforce are important strategies toward success. This publication outlines many projects a 3-time Magnet-designated academic hospital has implemented, working with our shared leadership councils, to meet the standards for a healthy work environment. These initiatives, from the unit to the hospital level, included standardizing a culture change of uninterrupted meal breaks, the creation of intensive care unit Zen rooms, strategies to better manage increased patient volumes, best practices for facility design, enhancing physician-nurse relations, and a hospital wellness program. Data were benchmarked against national nurse and employee surveys to compare progress and report outcomes. Two important nursing organization structures that have contributed to the success of a healthy and satisfied nursing work environment include UEXCEL, a longstanding clinical nurse professional practice program, and the hospital's 11-year participation in the University HealthSystem Consortium/American Association of Colleges of Nursing National Post-Baccalaureate Nurse Residency Program. A highly engaged, well-educated, and committed nursing workforce, nurtured by a strong leadership team, has created a positive work environment characterized by low turnover and high retention.
One size does not fit all: a qualitative content analysis of the importance of existing quality improvement capacity in the implementation of Releasing Time to Care: the Productive Ward™ in Saskatchewan, Canada.

PubMed

Hamilton, Jessica; Verrall, Tanya; Maben, Jill; Griffiths, Peter; Avis, Kyla; Baker, G Ross; Teare, Gary

2014-12-19

Releasing Time to Care: The Productive Ward™ (RTC) is a method for conducting continuous quality improvement (QI). The Saskatchewan Ministry of Health mandated its implementation in Saskatchewan, Canada between 2008 and 2012. Subsequently, a research team was developed to evaluate its impact on the nursing unit environment. We sought to explore the influence of the unit's existing QI capacity on their ability to engage with RTC as a program for continuous QI. We conducted interviews with staff from 8 nursing units and asked them to speak about their experience doing RTC. Using qualitative content analysis, and guided by the Organizing for Quality framework, we describe the existing QI capacity and impact of RTC on the unit environment. The results focus on 2 units chosen to highlight extreme variation in existing QI capacity. Unit B was characterized by a strong existing environment. RTC was implemented in an environment with a motivated manager and collaborative culture. Aided by the structural support provided by the organization, the QI capacity on this unit was strengthened through RTC. Staff recognized the potential of using the RTC processes to support QI work. Staff on unit E did not have the same experience with RTC. Like unit B, they had similar structural supports provided by their organization but they did not have the same existing cultural or political environment to facilitate the implementation of RTC. They did not have internal motivation and felt they were only doing RTC because they had to. Though they had some success with RTC activities, the staff did not have the same understanding of the methods that RTC could provide for continuous QI work. RTC has the potential to be a strong tool for engaging units to do QI. This occurs best when RTC is implemented in a supporting environment. One size does not fit all and administrative bodies must consider the unique context of each environment prior to implementing large-scale QI projects. Use of an established framework, like Organizing for Quality, could highlight the distinctive supports needed in particular care environments to increase the likelihood of successful engagement.
24 CFR 982.401 - Housing quality standards (HQS).

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Elevators must be working and safe. (h) Interior air quality—(1) Performance requirement. The dwelling unit... environment; (E) Illumination and electricity; (F) Structure and materials; (G) Interior air quality; (H... dwelling unit. (e) Thermal environment—(1) Performance requirement. The dwelling unit must have and be...

Development and Testing of the Healthy Work Environment Inventory: A Reliable Tool for Assessing Work Environment Health and Satisfaction.

PubMed

Clark, Cynthia M; Sattler, Victoria P; Barbosa-Leiker, Celestina

2016-10-01

Fostering healthy work environments that enhance job satisfaction and reflect high levels of employee engagement and productivity is imperative for all organizations. This is especially true for health care organizations where unhealthy work conditions can lead to poor patient outcomes. A convenience sample of 520 nursing faculty and practice-based nurses in the United States participated in a study to test the psychometric properties of the Healthy Work Environment Inventory (HWEI). A factor analysis and other reliability analyses support the use of the HWEI as a valid and reliable instrument to measure perceptions of work environment health. The HWEI is a 20-item psychometrically sound instrument to measure perceptions of the health of the work environment. It may be completed either as an individual exercise or by all members of a team to compare perceptions of work environment health, to determine areas of strength and improvement, and to form the basis for interviewing. [J Nurs Educ. 2016;55(10):555-562.]. Copyright 2016, SLACK Incorporated.
[Present state and problems of work environment control in the workplaces using hazardous materials based on the Occupational Safety and Health Act in Japan].

PubMed

Hori, Hajime

2013-10-01

In Japan, working environment measurement is prescribed in the designated workplaces using hazardous materials. Measurements should be carried out periodically and countermeasures are performed depending on the results. By introducing such a system, working environments have remarkably improved. However, in the designated workplaces, measurements should be continued even in work environments found safe. On the other hand, measurement need not be obliged for non-designated workplaces even if hazardous materials are utilized.In the United States of America and many European countries, work environment management and work management are carried out by measuring personal exposure concentrations. In Japan, the Ministry of Health, Labour and Welfare is now discussing the introduction of personal exposure monitoring. However, many problems exist to prevent the simple introduction of American and European methods. This paper describes the brief history, present state and problems of work environment control in Japan, comparing with the systems of American and European countries.
Barriers and facilitators for breastfeeding among working women in the United States.

PubMed

Johnston, Marina L; Esposito, Noreen

2007-01-01

To review the literature and describe the barriers and facilitators to the continuation of breastfeeding for at least 6 months by working women in the United States. A search of PubMed, CINAHL, Sociological Abstracts, ISI, PsychInfo, and ProQuest. Twenty studies based on the inclusion criteria and published between January 1, 1995, and January 2006. An ecologic framework, which includes the individual (microsystem), social support and relationships (mesosystem), and the workplace environment (exosystem). When working mothers possess certain personal characteristics and develop a strategic plan, breastfeeding is promoted. When social support is available and when support groups are utilized, lactation is also facilitated. Part-time work, lack of long mother-infant separations, supportive work environments and facilities, and child care options facilitate breastfeeding. Health care providers can use the findings of this review to promote breastfeeding among working women by using tactics geared toward the mother, her social network, and the entire community.
The relationship between healthy work environments and retention of nurses in a hospital setting.

PubMed

Ritter, Desiree

2011-01-01

The purpose of the present paper was to determine the effect a healthy work environment has on the retention of nurses in a hospital setting. There is a nursing shortage that has been ongoing and is expected to continue, resulting in challenges for the healthcare system in the United States. The significance of this issue is the impact the nursing shortage will have on healthcare organizations and patients. The present paper included an extensive review of the current literature. The literature reviewed encompassed scholarly peer-reviewed journal articles. This article focused on nurses, work environments and the impact of the work environments on retention. Important issues that emerged from this analysis were the dangers of an unhealthy environment, the impact a healthy work environment has on patient outcomes and retention, the Magnet link to healthy work environments and the manager's role in creating and sustaining a healthy work environment. The literature provided evidence of the link between healthy work environments and the retention of nurses in a hospital setting. The implications for management are to implement changes now to create a healthy work environment that will recruit and retain nurses to secure their position in the future. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.
Better Nurse Staffing and Nurse Work Environments Associated With Increased Survival of In-Hospital Cardiac Arrest Patients

PubMed Central

McHugh, Matthew D.; Rochman, Monica F.; Sloane, Douglas M.; Berg, Robert A.; Mancini, Mary E.; Nadkarni, Vinay M.; Merchant, Raina M.; Aiken, Linda H.

2015-01-01

Background Although nurses are the most likely first responders to witness an in-hospital cardiac arrest (IHCA) and provide treatment, little research has been undertaken to determine what features of nursing are related to cardiac arrest outcomes. Objectives To determine the association between nurse staffing, nurse work environments, and IHCA survival. Research Design Cross-sectional study of data from: (1) the American Heart Association’s Get With The Guidelines-Resuscitation database; (2) the University of Pennsylvania Multi-State Nursing Care and and Patient Safety; and (3) the American Hospital Association annual survey. Logistic regression models were used to determine the association of the features of nursing and IHCA survival to discharge after adjusting for hospital and patient characteristics. Subjects A total of 11,160 adult patients aged 18 and older between 2005 and 2007 in 75 hospitals in 4 states (Pennsylvania, Florida, California, and New Jersey). Results Each additional patient per nurse on medical-surgical units was associated with a 5% lower likelihood of surviving IHCA to discharge (odds ratio = 0.95; 95% confidence interval, 0.91–0.99). Further, patients cared for in hospitals with poor work environments had a 16% lower likelihood of IHCA survival (odds ratio = 0.84; 95% confidence interval, 0.71–0.99) than patients cared for in hospitals with better work environments. Conclusions Better work environments and decreased patient-to-nurse ratios on medical-surgical units are associated with higher odds of patient survival after an IHCA. These results add to a large body of literature suggesting that outcomes are better when nurses have a more reasonable workload and work in good hospital work environments. Improving nurse working conditions holds promise for improving survival following IHCA. PMID:26783858
Supporting Self-Improvement in Teaching, Literacy, Language and Numeracy. Tools for Staff Development. Module 3: Resources and the Learning Environment

ERIC Educational Resources Information Center

Basic Skills Agency, 2007

2007-01-01

In unit 1 we consider practical approaches to: (1) creating an effective learning environment; (2) selecting and using resources; (3) using ICT at different stages in the teaching and learning cycle; and (4) getting away from worksheets. Unit 2 looks at effective working with learning supporters and co-workers. [For related reports, see…
The physical environment and patients' activities and care: A comparative case study at three newly built stroke units.

PubMed

Anåker, Anna; von Koch, Lena; Sjöstrand, Christina; Heylighen, Ann; Elf, Marie

2018-04-20

To explore and compare the impact of the physical environment on patients' activities and care at three newly built stroke units. Receiving care in a stroke unit instead of in a general ward reduces the odds of death, dependency and institutionalized care. In stroke units, the design of the physical environment should support evidence-based care. Studies on patients' activities in relation to the design of the physical environment of stroke units are scarce. This work is a comparative descriptive case study. Patients (N = 55) who had a confirmed diagnosis of stroke were recruited from three newly built stroke units in Sweden. The units were examined by non-participant observation using two types of data collection: behavioural mapping analysed with descriptive statistics and field note taking analysed with deductive content analysis. Data were collected from April 2013 - December 2015. The units differed in the patients' levels of physical activity, the proportion of the day that patients spent with health professionals and family presence. Patients were more physically active in a unit with a combination of single and multi-bed room designs than in a unit with an entirely single-room design. Stroke units that were easy to navigate and offered variations in the physical environment had an impact on patients' activities and care. Patients' activity levels and interactions appeared to vary with the design of the physical environments of stroke units. Stroke guidelines focused on health status assessments, avoidance of bed-rest and early rehabilitation require a supportive physical environment. © 2018 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.
[An analysis of appeals against the ruling of the occupational physician's lodged to the Department of Prevention and Safety in the Working Environment--Health Prevention and Occupational Epidemiology Operative Unit within the A.S.P. Palermo (Palermo Health Authority), years 2008-2010].

PubMed

Marsala, M G L; Morici, M; Lacca, G; Curcurù, L; Eduardo, E Costagliola; Ilardo, S; Trapani, E; Caracausi, R; Firenze, A

2012-01-01

The purpose of this study is to analyze the appeals against a "suitability judgment for work" lodged to the U.O.S. "Health Prevention and Occupational Epidemiology Operative Unit" of Department of Prevention and Safety in the Working Environment within the ASP Palermo (U.O.S.), from 2008 to 2010. Studying the appeals gives an indirect view on the occupational physician activity and allows to monitor their actions, analysis aims at highlighting those issues around which any planning and implementation of coordination activities should be focused.
Nuffield Foundation 'Resources for Learning' Project. A Multi-Media Programmed Approach to Environmental Studies.

ERIC Educational Resources Information Center

Kefford, Colin W.

This description of a unit for teaching about the environment at the junior high level is an experimental study. The focus of the program is the integration of several media; films and tapes play a large role in the unit. Students perform a combination of classroom work, field work, and simulated exercises; assessment procedures are described.…
40 CFR 63.2252 - What are the requirements for process units that have no control or work practice requirements?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 12 2010-07-01 2010-07-01 true What are the requirements for process units that have no control or work practice requirements? 63.2252 Section 63.2252 Protection of... Pollutants: Plywood and Composite Wood Products General Compliance Requirements § 63.2252 What are the...
The Political Economy of Work in the 21st Century: Implications for an Aging American Workforce.

ERIC Educational Resources Information Center

Sicker, Martin

The prospective place of the aging worker in the employment environment of the 21st century is examined. The following are among the specific topics discussed: (1) the real world of work and retirement; (2) the changing employment environment; (3) the restructuring of business in the United States; (4) globalization and the economy; (5) downsizing…
Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.

PubMed

Lee, Yuna S H; Stone, Patricia W; Pogorzelska-Maziarz, Monika; Nembhard, Ingrid M

Central line-associated bloodstream infections (CLABSIs) are a common and costly quality problem, and their prevention is a national priority. A decade ago, researchers identified an evidence-based bundle of practices that reduce CLABSIs. Compliance with this bundle remains low in many hospitals. The aim of this study was to assess whether differences in core aspects of work environments-workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%-100% of the time in intensive care units (ICUs). A cross-sectional study of hospital medical-surgical ICUs in the United States was done. Data on work environment and bundle compliance were obtained from the Prevention of Nosocomial Infections and Cost-Effectiveness Refined Survey completed in 2011 by infection prevention directors, and data on ICU and hospital characteristics were obtained from the National Healthcare Safety Network. Factor and multilevel regression analyses were conducted. Reasonable workload and prioritization of quality were positively associated with maximal CLABSI bundle compliance. High-quality relationships, although a significant predictor when evaluated apart from workload and prioritization of quality, had no significant effect after accounting for these two factors. Aspects of the staff work environment are associated with maximal CLABSI bundle compliance in ICUs. Our results suggest that hospitals can foster improvement in ensuring maximal CLABSI bundle compliance-a crucial precursor to reducing CLABSI infection rates-by establishing reasonable workloads and prioritizing quality.
Perceptions of the hospital ethical environment among hospital social workers in the United States.

PubMed

Pugh, Greg L

2015-01-01

Hospital social workers are in a unique context of practice, and one where the ethical environment has a profound influence on the ethical behavior. This study determined the ratings of ethical environment by hospital social workers in large nationwide sample. Correlates suggest by and compared to studies of ethical environment with nurses are explored. Positive ratings of the ethical environment are primarily associated with job satisfaction, as well as working in a centralized social work department and for a non-profit hospital. Religiosity and MSW education were not predictive. Implications and suggestions for managing the hospital ethical environment are provided.
Transition management as an intervention for survivor syndrome.

PubMed

Rogers, K A

2000-01-01

In today's health care environment of merged organizations, downsizing and restructuring, employees can be experiencing a debilitating syndrome called "layoff survivor syndrome." This syndrome can have a crippling effect on workers and organizations as employees struggle to adapt to the changed working environment. This article represents my self-reflection as a nursing unit manager who personally experienced survivor sickness and witnessed its impact on the unit staff that I was leading at the time. The work of Noer (1993) is explored to clarify the syndrome and describe how the nursing staff and I manifested the syndrome. The writings of Bridges (1991), Brockner (1992) and Noer (1993) provide timely and relevant insights into managing the impact of layoffs and downsizing on those left behind to carry on. Noer (1993) sees the adaptation to the change as the ability to make the psychological shift from the old business paradigm that perpetuated codependency to the new business paradigm of fostering empowered employees. Bridges (1991) takes us a step further in making this psychological shift to adapt to the new work environment by providing a three phase process he calls transitions. The works of these three authors hold an important message for organizations and employees working in environments that abound with constant change.
Is working in culturally diverse working environment associated with physicians' work-related well-being? A cross-sectional survey study among Finnish physicians.

PubMed

Aalto, Anna-Mari; Heponiemi, Tarja; Väänänen, Ari; Bergbom, Barbara; Sinervo, Timo; Elovainio, Marko

2014-08-01

International mobility of health care professionals is increasing, though little is known about how working in a culturally diverse team affects the native physicians' psychosocial work environment. We examined Finnish physicians' perceptions of work-related wellbeing according to whether they had foreign-born colleagues (FBCs) in their work unit. We also examined whether work-related resources moderate the potential association between work-related wellbeing and working alongside FBCs. A cross-sectional survey was conducted for a random sample of physicians in Finland in 2010 (3826 respondents, response rate 55%). Analyses were restricted to native Finnish physicians working in public health care. The results were analyzed by ANCOVA. In unadjusted analyses, having FBCs was related to poor team climate (p<0.001) and poor job satisfaction (p=0.001). Those physicians who reported high procedural justice and high job control perceived also higher job satisfaction even if they had many FBCs in the work unit (p=0.007 for interaction between FBCs and procedural justice and p<0.001 for interaction between FBCs and job control). These associations were robust to adjustments for age, sex, health care sector, specialization, on-call duty, employment contract, full-time employment and leadership position. The results indicate that culturally diverse work units face challenges related to team climate and job satisfaction. The results also show that leadership plays an important role in culturally diverse work units. The potential challenges of culturally diverse teams for native physicians may be reduced by fair decision-making and by increasing physicians' job control. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Nursing work environment in Saudi Arabia.

PubMed

Aboshaiqah, Ahmad E

2015-05-01

The purpose of this study was to assess the work environment as perceived by nurses in a large tertiary hospital in Saudi Arabia. The quality of patient care services has been associated with the quality of work environment of nurses. It is therefore important to assess the work environment in order to acquire baseline data and enable the institution to benchmark their status from established quality standards. This study used a descriptive survey with 1007 staff nurses across service units of a 1000-bed government-operated hospital. The American Association of Critical-Care Nurses (AACN) Healthy Work Environment Assessment Questionnaire was used for data collection. Scores were aggregated and interpreted. Effective decision making, authentic leadership, appropriate staffing, true collaboration, skilled communication and meaningful recognition were rated as good (mean range 3.53-3.76). Healthy work environments mutually benefit patients, nurses, nurse managers, health care providers, the health team, administration, the institution and the community at large. Valuable baseline data on the status of the work environment in this setting were generated. This should allow administrators and staff to work together in improving weaknesses and strengthening further whatever gains that are attained to ensure consistent provision of safe and quality patient care. © 2013 John Wiley & Sons Ltd.
The impact of Nursing Rounds on the practice environment and nurse satisfaction in intensive care: pre-test post-test comparative study.

PubMed

Aitken, Leanne M; Burmeister, Elizabeth; Clayton, Samantha; Dalais, Christine; Gardner, Glenn

2011-08-01

Factors previously shown to influence patient care include effective decision making, team work, evidence based practice, staffing and job satisfaction. Clinical rounds have the potential to optimise these factors and impact on patient outcomes, but use of this strategy by intensive care nurses has not been reported. To determine the effect of implementing Nursing Rounds in the intensive care environment on patient care planning and nurses' perceptions of the practice environment and work satisfaction. Pre-test post-test 2 group comparative design. Two intensive care units in tertiary teaching hospitals in Australia. A convenience sample of registered nurses (n=244) working full time or part time in the participating intensive care units. Nurses in participating intensive care units were asked to complete the Practice Environment Scale-Nursing Work Index (PES-NWI) and the Nursing Worklife Satisfaction Scale (NWSS) prior to and after a 12 month period during which regular Nursing Rounds were conducted in the intervention unit. Issues raised during Nursing Rounds were described and categorised. The characteristics of the sample and scale scores were summarised with differences between pre and post scores analysed using t-tests for continuous variables and chi-square tests for categorical variables. Independent predictors of the PES-NWI were determined using multivariate linear regression. Nursing Rounds resulted in 577 changes being initiated for 171 patients reviewed; these changes related to the physical, psychological--individual, psychological--family, or professional practice aspects of care. Total PES-NWI and NWSS scores were similar before and after the study period in both participating units. The NWSS sub-scale of interaction between nurses improved in the intervention unit during the study period (pre--4.85±0.93; post--5.36±0.89, p=0.002) with no significant increase in the control group. Factors independently related to higher PES-NWI included intervention site and less years in critical care (p<0.05). Implementation of Nursing Rounds within the intensive care environment is feasible and is an effective strategy for initiating change to patient care. Application and testing of this strategy, including identification of the most appropriate methods of measuring impact, in other settings is needed to determine generalisability. Copyright © 2010 Elsevier Ltd. All rights reserved.
Best practices to promote occupational safety and satisfaction: a comparison of three North American hospitals.

PubMed

McCaughey, Deirdre; DelliFraine, Jami; Erwin, Cathleen O

2015-01-01

Hospitals in North America consistently have employee injury rates ranking among the highest of all industries. Organizations that mandate workplace safety training and emphasize safety compliance tend to have lower injury rates and better employee safety perceptions. However, it is unclear if the work environment in different national health care systems (United States vs. Canada) is associated with different employee safety perceptions or injury rates. This study examines occupational safety and workplace satisfaction in two different countries with employees working for the same organization. Survey data were collected from environmental services employees (n = 148) at three matched hospitals (two in Canada and one in the United States). The relationships that were examined included: (1) safety leadership and safety training with individual/unit safety perceptions; (2) supervisor and coworker support with individual job satisfaction and turnover intention; and (3) unit turnover, labor usage, and injury rates. Hierarchical regression analysis and ANO VA found safety leadership and safety training to be positively related to individual safety perceptions, and unit safety grade and effects were similar across all hospitals. Supervisor and coworker support were found to be related to individual and organizational outcomes and significant differences were found across the hospitals. Significant differences were found in injury rates, days missed, and turnover across the hospitals. This study offers support for occupational safety training as a viable mechanism to reduce employee injury rates and that a codified training program translates across national borders. Significant differences were found.between the hospitals with respect to employee and organizational outcomes (e.g., turnover). These findings suggest that work environment differences are reflective of the immediate work group and environment, and may reflect national health care system differences.
Attributes of nursing work environment as predictors of registered nurses' job satisfaction and intention to leave.

PubMed

Choi, Sandy Pin-Pin; Cheung, Kin; Pang, Samantha Mei-Che

2013-04-01

To examine how front-line registered nurses' perception of their work environment associates with and predicts nurse outcomes in terms of job satisfaction and turnover intention. Mounting evidence has pointed to an inseparable link between attributes of the nursing work environment and nurse outcomes. However, there is a paucity of research examining nurses' perception of their work environment beyond the Western context. This cross-sectional survey involved 1271 registered nurses working in 135 inpatient units in 10 public hospitals in Hong Kong. The instrument comprised items developed from in-depth interviews with front-line nurses that explored nurses' perception of their work environment. Factor analysis identified five dimensions (professionalism, co-worker relationship, management, staffing and resources, and ward practice) of the nursing work environment. Logistic regression analysis further identified professionalism, management and ward practice as significant factors in predicting nurses' turnover intention, and staffing and resources as an additional factor in predicting their job satisfaction. Attributes of the nursing work environment have a significant bearing on nurses' job satisfaction and intention to leave. Managerial effort should focus on improving nurses' work conditions through detailed resource planning, effective management and removal of work constraints that affect nursing practice. © 2012 Blackwell Publishing Ltd.
Nurses well-being in intensive care units: study of factors promoting team commitment.

PubMed

Galletta, Maura; Portoghese, Igor; Coppola, Rosa C; Finco, Gabriele; Campagna, Marcello

2016-05-01

Intensive care units (ICUs) are challenging work environments because of the critical condition of patients, and ICU nurses frequently lament low job satisfaction and high staff turnover. Nevertheless, organizational and work characteristics, and the quality of relationships with staff can help to maintain nurses' enthusiasm and increase job satisfaction. The aim of this study was to analyse how nursing work environment factors affect identification and commitment among ICU nurses. A cross-sectional study was carried out in 12 ICUs from four Italian urban hospitals. A total of 222 nurses participated and completed a self-reported questionnaire. Results show that nursing work characteristics are directly related to team commitment, and that the nursing work characteristics and team commitment relationship was mediated by both perceived supervisor support and job satisfaction. Our findings may concretely contribute to literature and offer additional suggestions to improve nurses' work conditions and patient health in ICUs. © 2014 British Association of Critical Care Nurses.

Qualitative investigation of the perceptions and experiences of nursing and allied health professionals involved in the implementation of an enriched environment in an Australian acute stroke unit

PubMed Central

Brauer, Sandra G; Fitzhenry, Sarah; Grimley, Rohan S; Hayward, Kathryn S

2017-01-01

Objective An enriched environment embedded in an acute stroke unit can increase activity levels of patients who had stroke, with changes sustained 6 months post-implementation. The objective of this study was to understand perceptions and experiences of nursing and allied health professionals involved in implementing an enriched environment in an acute stroke unit. Design A descriptive qualitative approach. Setting An acute stroke unit in a regional Australian hospital. Participants We purposively recruited three allied health and seven nursing professionals involved in the delivery of the enriched environment. Face-to-face, semistructured interviews were conducted 8 weeks post-completion of the enriched environment study. One independent researcher completed all interviews. Voice-recorded interviews were transcribed verbatim and analysed by three researchers using a thematic approach to identify main themes. Results Three themes were identified. First, staff perceived that ‘the road to recovery had started’ for patients. An enriched environment was described to shift the focus to recovery in the acute setting, which was experienced through increased patient activity, greater psychological well-being and empowering patients and families. Second, ‘it takes a team’ to successfully create an enriched environment. Integral to building the team were positive interdisciplinary team dynamics and education. The impact of the enriched environment on workload was diversely experienced by staff. Third, ‘keeping it going’ was perceived to be challenging. Staff reflected that changing work routines was difficult. Contextual factors such as a supportive physical environment and variety in individual enrichment opportunities were indicated to enhance implementation. Key to sustaining change was consistency in staff and use of change management strategies. Conclusion Investigating staff perceptions and experiences of an enrichment model in an acute stroke unit highlighted the need for effective teamwork. To facilitate staff in their new work practice, careful selection of change management strategies are critical to support clinical translation of an enriched environment. Trial registration number ANZCTN12614000679684; Results. PMID:29273658
Fostering interprofessional learning in a rehabilitation setting: development of an interprofessional clinical learning unit.

PubMed

Vanderzalm, Jeanne; Hall, Mark D; McFarlane, Lu-Anne; Rutherford, Laurie; Patterson, Steven K

2013-01-01

The development and implementation of interprofessional (IP) clinical learning units as a method to enhance IP clinical education and improve patient care in a rehabilitation setting are described. Using a community-based participatory research approach, academia and healthcare delivery agencies formed a partnership to create an IP clinical learning unit in a rehabilitation setting. Preimplementation data from surveys and focus group data identified areas for improvement to enhance IP understanding and collaboration. A working group developed and implemented initiatives to enhance IP practice. Preimplementation, eight themes emerged from which the working group identified goals and implemented strategies to strengthen IP learning. Goals included Creation of an IP Learning Environment, Increased Awareness of IP Practice, Role Clarification, Enhanced IP Communication, and Reflection and Evaluation. Postimplementation data revealed six themes: Communication, Informal IP Learning, Role Awareness, Positive Learning Environment, Logistics, and Challenges. The development of the IP clinical learning unit was successful and rewarding, but not without its challenges. Formal IP education was necessary to enhance collaborative practice, even in a multidisciplinary environment. Commitment and support from all participants, particularly managers and administrators from the healthcare agency, were critical to success. The focus of this unit was on a stroke rehabilitation unit; however, the development and implementation principles identified may be applicable to any team-based clinical setting. © 2013 Association of Rehabilitation Nurses.
Neonatal Intensive Care Unit Layout and Nurses' Work.

PubMed

Doede, Megan; Trinkoff, Alison M; Gurses, Ayse P

2018-01-01

Neonatal intensive care units (NICUs) remain one of the few areas in hospitals that still use an open bay (OPBY) design for patient stays greater than 24 hr, housing multiple infants, staff, and families in one large room. This creates high noise levels, contributes to the spread of infection, and affords families little privacy. These problems have given rise to the single-family room NICU. This represents a significant change in the care environment for nurses. This literature review answers the question: When compared to OPBY layout, how does a single family room layout impact neonatal nurses' work? Thirteen studies published between 2006 and 2015 were located. Many studies reported both positive and negative effects on nurses' work and were therefore sorted by their cited advantages and disadvantages. Advantages included improved quality of the physical environment; improved quality of patient care; improved parent interaction; and improvements in nurse job satisfaction, stress, and burnout. Disadvantages included decreased interaction among the NICU patient care team, increased nurse workload, decreased visibility on the unit, and difficult interactions with family. This review suggests that single-family room NICUs introduce a complex situation in which trade-offs occur for nurses, most prominently the trade-off between visibility and privacy. Additionally, the literature is clear on what elements of nurses' work are impacted, but how the built environment influences these elements, and how these elements interact during nurses' work, is not as well understood. The current level of research and directions for future research are also discussed.
Different contexts, different effects? Work time and mental health in the United States and Germany.

PubMed

Kleiner, Sibyl; Schunck, Reinhard; Schömann, Klaus

2015-03-01

This paper takes a comparative approach to the topic of work time and health, asking whether weekly work hours matter for mental health. We hypothesize that these relationships differ within the United States and Germany, given the more regulated work time environments within Germany and the greater incentives to work long hours in the United States. We further hypothesize that German women will experience greatest penalties to long hours. We use data from the German Socioeconomic Panel and the National Longitudinal Survey of Youth to examine hours effects on mental health score at midlife. The results support our initial hypothesis. In Germany, longer work time is associated with worse mental health, while in the United States, as seen in previous research, the associations are more complex. Our results do not show greater mental health penalties for German women and suggest instead a selection effect into work hours operating by gender. © American Sociological Association 2015.
To designate the United States courthouse under construction at 101 South United States Route 1 in Fort Pierce, Florida, as the "Alto Lee Adams, Sr., United States Courthouse".

THOMAS, 111th Congress

Rep. Rooney, Thomas J. [R-FL-16

2009-07-13

Senate - 09/10/2009 Received in the Senate and Read twice and referred to the Committee on Environment and Public Works. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:
Psychosocial and organizational work factors and incidence of arterial hypertension among female healthcare workers: results of the Organisation des Soins et Santé des Soignants cohort.

PubMed

Lamy, Sébastien; De Gaudemaris, Régis; Lepage, Benoit; Sobaszek, Annie; Caroly, Sandrine; Kelly-Irving, Michelle; Lang, Thierry

2014-06-01

Many studies have supported the role of organizational work factors (OWFs) on the risk of cardiovascular diseases (CVDs) and CVD risk factors, including arterial hypertension. However, a little information is available concerning the role of collective stressors deriving from work organization on nurse's risk of hypertension. This study aimed to test the independent longitudinal relationships linking the 2-year incidence of arterial hypertension to collective stressors at the work unit level, among baseline normotensive female hospital registered nurses and nursing assistants, after adjusting for known individual predictors of CVDs and for occupational stress. Arterial hypertension was defined as the intake of antihypertensive drug or as blood pressure (BP) measures higher than 140 mmHg (SBP) or 90 mmHg (DBP) at both the clinical visit and 1 month later. We analyzed the effect of OWFs at the work unit level, constraints related to the physical work environment and the individual perception of the work environment in 2006 on the risk of arterial hypertension in 2008 among 1882 initially normotensive female healthcare workers followed in the French Organisation des soins et santé des soignants (ORSOSA) cohort. We showed that OWFs at the work unit level may influence the 2-year risk of arterial hypertension independently of work factors at the worker level, baseline BP, age and BMI. In this study, OWFs affected 2-year risk of arterial hypertension only through direct effects. Our results pointed out the possibility of a primary prevention of arterial hypertension through interventions based at the work unit level among healthcare workers.
Work Environment Questionnaires and Army Unit Effectiveness and Satisfaction Measures

DTIC Science & Technology

1977-09-01

satisfaction indices (retention rates and disciplinary actions) and place more emphasis on these outcomes. In balance , the work environment and...last me a year"), and that "effective" supervisors and organizations planned carefully to stay within these constraints and balance expenditures over...scale was out of balance with its higher end. Most instruments reviewed used Likert scales with numerical anchors; very few provided specific descriptive
The Association Between Psychosocial Work Environment and Satisfaction With Old Age Care Among Care Recipients.

PubMed

Lundgren, Dan; Ernsth Bravell, Marie; Börjesson, Ulrika; Kåreholt, Ingemar

2018-06-01

This study examines the association between nursing assistants' perceptions of their psychosocial work environment and satisfaction among older people receiving care in nursing homes and home care. Cross-sectional surveys were conducted among people receiving care ( N = 1,535) and nursing assistants ( N = 1,132) in 45 nursing homes and 21 home care units within municipal old-age care. Better psychosocial work environment was related to higher satisfaction in old-age care among the recipients. Significant and stronger associations were more common in nursing homes than in home care. Perception of mastery and positive challenges at work were associated with higher recipient satisfaction both in home care and in nursing homes: social climate, perception of group work, perception of mastery, and positive challenges at work only in nursing homes. Findings suggest that recipient satisfaction may be increased by improving the psychosocial work environment for nursing assistants, both in nursing homes and in home care.
Use of aromatherapy to promote a therapeutic nurse environment.

PubMed

Johnson, Kari; West, Toni; Diana, Shelly; Todd, Jodi; Haynes, Brianna; Bernhardt, Judy; Johnson, Roberta

2017-06-01

Workplace stress can affect nurse satisfaction. Aroma therapy as a therapeutic use of essential oil can be beneficial in reducing stress. Assess perceived stress pre-post introduction of Essential Oil Lavender among registered nurses, charge nurses, and patient care technicians in a trauma intensive care unit, surgical specialty care unit and an orthopedic trauma unit. Pre-post intervention with a quasi-experimental design. After a pre-survey, Essential Oil Lavender was diffused 24h per day over 30days in a designated nursing area that all nurses were not required to enter on each unit. Dependent sample t-test for "how often do nurses feel stressed a work in a typical week" revealed pre-survey mean 2.97 (SD=0.99) which was significantly higher than post-survey mean 2.70 (SD=0.92) with significance, t(69)=2.36, p=0.021, suggesting a difference in how often staff felt stressed at work in a typical week, trending down from "feeling stressed half of time" to "once in a while". There were no statistically significant differences in pre-post survey scores for TICU, TOU, or SSC as separate units. Use of essential oils to decrease work-related stress among nursing staff may improve retention, workplace environment, and increase nurse satisfaction. Copyright © 2017 Elsevier Ltd. All rights reserved.
Acoustics and psychosocial environment in intensive coronary care

PubMed Central

Blomkvist, V; Eriksen, C; Theorell, T; Ulrich, R; Rasmanis, G

2005-01-01

Aims: To examine the influence of different acoustic conditions on the work environment and the staff in a coronary critical care unit (CCU). Method: Psychosocial work environment data from start and end of each individual shift were obtained from three shifts (morning, afternoon, and night) for a one-week baseline period and for two four-week periods during which either sound reflecting or sound absorbing tiles were installed. Results: Reverberation times and speech intelligibility improved during the study period when the ceiling tiles were changed from sound reflecting tiles to sound absorbing ones of identical appearance. Improved acoustics positively affected the work environment; the afternoon shift staff experienced significantly lower work demands and reported less pressure and strain. Conclusions: Important gains in the psychosocial work environment of healthcare can be achieved by improving room acoustics. The study points to the importance of further research on possible effects of acoustics in healthcare on staff turnover, quality of patient care, and medical errors. PMID:15723873
Perianesthesia Nurses Are My Second Family: A Qualitative Descriptive Study.

PubMed

Seefeldt, Julanne; Wood, Stacey; Bolton, Pamela; Fitzpatrick, Tara; Stegenga, Kristin; Roberts, Cristine

2017-12-01

Identify the perceptions of perianesthesia nurses regarding behaviors that promote or detract from sustaining a safe, efficient, and satisfying work environment. Two focus groups and seven individual interviews (n=14) were conducted exploring the perceptions regarding team behavior of registered nurses in one pediatric perianesthesia unit. Qualitative descriptive data collection, inductive content analysis. Nurses described a responsive, engaged health care team whose leadership is available and directive when needed, as creating an effective, satisfying work environment. Primary themes that emerged were Leadership Sets the Tone, Playing Fair, No One Gets Hurt, and Why We Stay. This nursing team acknowledged that inattentive, distracted team members cause frustration, work inequities, and care delays, potentially undermining patient safety. Results demonstrate the need to create and sustain consistently respectful perianesthesia work cultures. Research focusing on unit specific approaches to work distribution, communication, leadership, and technology use is needed. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.
Nursing work environment, patient safety and quality of care in pediatric hospital.

PubMed

Alves, Daniela Fernanda Dos Santos; Guirardello, Edinêis de Brito

2016-06-01

Objectives To describe the characteristics of the nursing work environment, safety attitudes, quality of care, measured by the nursing staff of the pediatric units, as well as to analyze the evolution of quality of care and hospital indicators. Methods Descriptive study with 136 nursing professionals at a paediatric hospital, conducted through personal and professional characterization form, Nursing Work Index - Revised, Safety Attitudes Questionnaire - Short Form 2006 and quality indicators. Results The professionals perceive the environment as favourable to professional practice, and consider good quality care that is also observed by reducing the incidence of adverse events and decreased length of stay. The domain job satisfaction was considered favourable to patient safety. Conclusions The work environment is favourable to nursing practice, the professionals nursing approve the quality of care and the indicators tended reducing adverse events and length of stay.
Nursing staff's experiences of working in an evidence-based designed ICU patient room-An interview study.

PubMed

Sundberg, Fredrika; Olausson, Sepideh; Fridh, Isabell; Lindahl, Berit

2017-12-01

It has been known for centuries that environment in healthcare has an impact, but despite this, environment has been overshadowed by technological and medical progress, especially in intensive care. Evidence-based design is a concept concerning integrating knowledge from various research disciplines and its application to healing environments. The aim was to explore the experiences of nursing staff of working in an evidence-based designed ICU patient room. Interviews were carried out with eight critical care nurses and five assistant nurses and then subjected to qualitative content analysis. The experience of working in an evidence-based designed intensive care unit patient room was that the room stimulates alertness and promotes wellbeing in the nursing staff, fostering their caring activities but also that the interior design of the medical and technical equipment challenges nursing actions. The room explored in this study had been rebuilt in order to create and evaluate a healing environment. This study showed that the new environment had a great impact on the caring staffs' wellbeing and their caring behaviour. At a time when turnover in nurses is high and sick leave is increasing, these findings show the importance of interior design ofintensive care units. Copyright © 2017 Elsevier Ltd. All rights reserved.
Quality and strength of patient safety climate on medical-surgical units.

PubMed

Hughes, Linda C; Chang, Yunkyung; Mark, Barbara A

2009-01-01

Describing the safety climate in hospitals is an important first step in creating work environments where safety is a priority. Yet, little is known about the patient safety climate on medical-surgical units. Study purposes were to describe quality and strength of the patient safety climate on medical-surgical units and explore hospital and unit characteristics associated with this climate. Data came from a larger organizational study to investigate hospital and unit characteristics associated with organizational, nurse, and patient outcomes. The sample for this study was 3,689 RNs on 286 medical-surgical units in 146 hospitals. Nursing workgroup and managerial commitment to safety were the two most strongly positive attributes of the patient safety climate. However, issues surrounding the balance between job duties and safety compliance and nurses' reluctance to reveal errors continue to be problematic. Nurses in Magnet hospitals were more likely to communicate about errors and participate in error-related problem solving. Nurses on smaller units and units with lower work complexity reported greater safety compliance and were more likely to communicate about and reveal errors. Nurses on smaller units also reported greater commitment to patient safety and participation in error-related problem solving. Nursing workgroup commitment to safety is a valuable resource that can be leveraged to promote a sense of personal responsibility for and shared ownership of patient safety. Managers can capitalize on this commitment by promoting a work environment in which control over nursing practice and active participation in unit decisions are encouraged and by developing channels of communication that increase staff nurse involvement in identifying patient safety issues, prioritizing unit-level safety goals, and resolving day-to-day operational problems the have the potential to jeopardize patient safety.
The work environment of haemodialysis nurses and its impact on patients' outcomes.

PubMed

Prezerakos, Panagiotis; Galanis, Peter; Moisoglou, Ioannis

2015-04-01

The aims of this study were to assess haemodialysis nurses' work environment and investigate the correlation between work environment and patients' outcomes. A cross-sectional study was conducted at the 11 public hospital-based haemodialysis units of the 5th Regional Health Authority of Greece. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to assess work environment. Nurses were asked to report the frequency of a series adverse events and errors. Study population consisted of 133 nurses (response rate 89.3%). The overall PES-NWI scored just < 2.5 (Mean = 2.48, standard deviation = 0.34) indicating a non-favourable haemodialysis workplace. Nurse-physician Relations, nurse manager ability and nursing foundations for quality of care were the most favourable aspects of work environment. Multivariate logistic regression analysis identified that hypotension (odds ratio (OR) = 0.3, 95% confidence interval (CI) = 0.1-0.9, P = 0.03), venous needle disconnection (OR = 0.14, 95% CI = 0.03-0.65, P = 0.012) and patient fall (OR = 0.02, 95% CI = 0.001-0.51, P = 0.018) were associated with a non-favourable work environment. Findings have important implications for improvement of haemodialysis work environment and enhancement of patients' safety. © 2013 Wiley Publishing Asia Pty Ltd.
An underwater work systems package. [remote handling

NASA Technical Reports Server (NTRS)

Estabrook, N. B.

1975-01-01

A modular unit which is adaptable to several existing deep sea submersibles was developed to extend their working abilities and acquire knowledge of components and techniques for working in the deep sea environment. This work systems package is composed of an aluminum pipe structure on which are mounted two six-function grabber arms, a seven function manipulator, tool suit, 1,000/lb. capacity winch, electrohydraulic power supply, electronics housing, lights, and television. The unit is designed to be operated by itself either remotely or with divers, attached to manned submersibles, or mounted on unmanned cable-controlled submersibles.
Work-unit measures of organisational justice and risk of depression--a 2-year cohort study.

PubMed

Grynderup, Matias Brødsgaard; Mors, Ole; Hansen, Åse Marie; Andersen, Johan Hviid; Bonde, Jens Peter; Kærgaard, Anette; Kærlev, Linda; Mikkelsen, Sigurd; Rugulies, Reiner; Thomsen, Jane Frølund; Kolstad, Henrik Albert

2013-06-01

The aim of this study is to analyse if low justice at work, analysed as aggregated workplace means, increases the risk of depression. A total of 4237 non-depressed Danish public employees within 378 different work units were enrolled in 2007. Mean levels of procedural and relational justice were computed for each work unit to obtain exposure measures that were robust to reporting bias related to depression. Two years later in 2009, 3047 (72%) participated at follow-up. Those reporting high levels of depressive, burn-out or stress symptoms were assigned to a psychiatric diagnostic interview. In the interview 58 cases of new onset depression were identified. Depression ORs by work unit level of procedural and relational justice were estimated by multivariable logistic regression accounting for established risk factors for depression. Working in a work unit with low procedural justice (adjusted ORs of 2.50, 95% CI 1.06 to 5.88) and low relational justice (3.14, 95% CI 1.37 to 7.19) predicted onset of depression. Our results indicate that a work environment characterised by low levels of justice is a risk factor for depression.
[Influence of Nurses' Self-leadership on Individual and Team Members' Work Role Performance].

PubMed

Kim, Se Young; Kim, Eun Kyung; Kim, Byungsoo; Lee, Eunpyo

2016-06-01

The purpose of this study was to examine correlations between nurses' self-leadership and individual work role performance and correlations between self-leadership in nursing units and team members' work role performance. Participants were 202 conveniently selected general nurses from 5 general hospitals in Korea. The study was carried out on 35 nursing units. Data were collected during February 2015 with self-report questionnaires. For factors affecting individual work role performance, self-expectation, self-goal setting, constructive thought, clinical career in the present nursing unit and marital status accounted for 44.0% of proficiency, while self-expectation, self-goal setting, constructive thought, and marital status accounted for 42.3% of adaptivity. Self-expectation, self-goal setting, constructive thought, self-reward, clinical career in the present nursing unit and position accounted for 26.4% of proactivity. In terms of team members' work role performance, self-reward and self-expectation in nursing units explained 29.0% of team members' proficiency. Self-reward and self-expectation in nursing units explained 31.6% of team members' adaptivity, and self-reward in nursing units explained 16.8% of team members' proactivity. The results confirm that nurses' self-leadership affects not only individual self-leadership but also team members' work role performance. Accordingly, to improve nurses' work role performance in nursing units of nursing organizations, improvement in nursing environment based on self-leadership education is necessary and nurses' tasks rearranged so they can appreciate work-autonomy and challenges of work.
Effects of nurse work environment on job dissatisfaction, burnout, intention to leave.

PubMed

Nantsupawat, A; Kunaviktikul, W; Nantsupawat, R; Wichaikhum, O-A; Thienthong, H; Poghosyan, L

2017-03-01

The nursing shortage is a critical issue in many countries. High turnover rates among nurses is contributing to the shortage, and job dissatisfaction, intention to leave, and burnout have been identified as some of the predictors of nurse turnover. A well-established body of evidence demonstrates that the work environment for nurses influences nurse job dissatisfaction, intention to leave, and burnout, but there never has been a study undertaken in Thailand to investigate this relationship. To investigate how work environment affects job dissatisfaction, burnout, and intention to leave among nurses in Thailand. The study used a cross-sectional survey to collect data from 1351 nurses working in 43 inpatient units in five university hospitals across Thailand. The participants completed the Practice Environment Scale of the Nursing Work Index, the Maslach Burnout Inventory, and measures of job dissatisfaction and intention to leave. Logistical regression models assessed the association between work environment and nurse-reported job dissatisfaction, burnout, and intent to leave. Nurses working in university hospitals with better work environments had significantly less job dissatisfaction, intention to leave, and burnout. The nurse work environment is a significant feature contributing to nurse retention in Thai university hospitals. Improving the work environment for nurses may lead to lower levels of job dissatisfaction, intention to leave, and burnout. Focusing on these nurse outcomes can be used as a strategy to retain nurses in the healthcare system. Addressing the challenges of poor work environments requires coordinated action from policymakers and health managers. © 2016 International Council of Nurses.
Role of a service corridor in ICU noise control, staff stress, and staff satisfaction: environmental research of an academic medical center.

PubMed

Wang, Zhe; Downs, Betsy; Farell, Ashley; Cook, Kimberly; Hourihan, Peter; McCreery, Shimby

2013-01-01

To investigate the role of a dedicated service corridor in intensive care unit (ICU) noise control and staff stress and satisfaction. Shared corridors immediately adjacent to patient rooms are generally noisy due to a variety of activities, including service deliveries and pickups. The strategy of providing a dedicated service corridor is thought to reduce noise for patient care, but the extent to which it actually contributes to noise reduction in the patient care environment and in turn improves staff performance has not been previously documented. A before-and-after comparison was conducted in an adult cardiac ICU. The ICU was relocated from a traditional hospital environment to a new addition with a dedicated service corridor. A total of 118 nursing staff participated in the surveys regarding pre-move and post-move environmental comfort, stress, and satisfaction in the previous and new units. Acoustical measures of noise within the new ICU and a control environment of the previous unit were collected during four work days, along with on-site observations of corridor traffic. Independent and paired sample t-tests of survey data showed that the perceived noise level was lower and staff reported less stress and more satisfaction in the new ICU (p < 0.01). Analyses of acoustical data confirmed that the new ICU was significantly quieter (p < 0.02). Observations revealed how the service corridor impacted patient care services and traffic. The addition of a dedicated service corridor works in the new unit for improving noise control and staff stress and satisfaction. Critical care/intensive care, noise, satisfaction, staff, work environment.

Using the WEIS-SR to evaluate employee perceptions of their college work environment.

PubMed

Dorsey, Julie; Kaye, Miranda; Barratt, Jennifer; Biondi, Jennifer; Habrial, Amanda; Lane, Amanda; Marinelli, Victoria; Paulino, Tiffany; Singletary, Amanda

2016-04-06

Colleges have been experiencing reduced resource allocations, shifting student expectations, and organizational change. These changes increase employee stress at all levels. Ensuring that employee needs are being met and promoting a healthy and productive workforce has never been more important. To investigate employees' current perceptions of their work environments using the Work Environment Impact Scale-Self Rating (WEIS-SR). Full and part time employees on a small college campus in the United States were surveyed using the WEIS-SR through an online survey program to protect their anonymity. Perception of staffing levels, workplace support for a healthy lifestyle, number of supervisors, and personal health ratings contributed to employee perceptions of their work environment. There were also differences between staff, administration, and tenured and non-tenured faculty. From an occupational performance perspective, valuable information on employees' levels of volition, performance capacity and habituation, and perceptions of their physical and social environment in relation to their work environments was obtained. Further support for the use of the WEIS-SR and psychometric properties of the instrument (reliability and validity) was obtained.
Neonatal Intensive Care Unit Nurses Working in an Open Ward: Stress and Work Satisfaction.

PubMed

Lavoie-Tremblay, Mélanie; Feeley, Nancy; Lavigne, Geneviève L; Genest, Christine; Robins, Stéphanie; Fréchette, Julie

2016-01-01

There is some research on the impact of open-ward unit design on the health of babies and the stress experienced by parents and nurses in neonatal intensive care units. However, few studies have explored the factors associated with nurse stress and work satisfaction among nurses practicing in open-ward neonatal intensive care units. The purpose of this study was to examine what factors are associated with nurse stress and work satisfaction among nurses practicing in an open-ward neonatal intensive care unit. A cross-sectional correlational design was used in this study. Participants were nurses employed in a 34-bed open-ward neonatal intensive care unit in a major university-affiliated hospital in Montréal, Quebec, Canada. A total of 94 nurses were eligible, and 86 completed questionnaires (91% response rate). Descriptive statistics were computed to describe the participants' characteristics. To identify factors associated with nurse stress and work satisfaction, correlational analysis and multiple regression analyses were performed with the Nurse Stress Scale and the Global Work Satisfaction scores as the dependent variables. Different factors predict neonatal intensive care unit nurses' stress and job satisfaction, including support, family-centered care, performance obstacles, work schedule, education, and employment status. In order to provide neonatal intensive care units nurses with a supportive environment, managers can provide direct social support to nurses and influence the culture around teamwork.
Job Satisfaction Among Academic Staff: An International Perspective.

ERIC Educational Resources Information Center

Lacy, Fiona J.; Sheehan, Barry A.

1997-01-01

A study examined aspects of college faculty's satisfaction with their jobs across eight nations (Australia, Germany, Hong Kong, Israel, Mexico, Sweden, United Kingdom, United States) and the implications for governance and administration. Results indicate that factors related to work environment (university atmosphere, morale, sense of community,…
Learning about Acid Rain: A Teacher's Guide for Grades 6 through 8. EPA 430-F-08-002

ERIC Educational Resources Information Center

US Environmental Protection Agency, 2008

2008-01-01

Acid rain is a complex environmental problem which affects the United States and many other countries around the world. The United States Environmental Protection Agency (EPA) was established in 1970 to address environmental issues, such as acid rain. Through its programs, EPA works to protect human health and the environment in the United States…
Factors associated with infant feeding of human milk at discharge from neonatal intensive care: Cross-sectional analysis of nurse survey and infant outcomes data.

PubMed

Hallowell, Sunny G; Rogowski, Jeannette A; Spatz, Diane L; Hanlon, Alexandra L; Kenny, Michael; Lake, Eileen T

2016-01-01

Nurses are principal caregivers in the neonatal intensive care unit and support mothers to establish and sustain a supply of human milk for their infants. Whether an infant receives essential nutrition and immunological protection provided in human milk at discharge is an issue of health care quality in this setting. To examine the association of the neonatal intensive care unit work environment, staffing levels, level of nurse education, lactation consultant availability, and nurse-reported breastfeeding support with very low birth weight infant receipt of human milk at discharge. Cross sectional analysis combining nurse survey data with infant discharge data. A national sample of neonatal intensive care units (N=97), nurses (N=5614) and very low birth weight infants (N=6997). Sequential multivariate linear regression models were estimated at the unit level between the dependent variable (rate of very low birth weight infants discharged on "any human milk") and the independent variables (nurse work environment, nurse staffing, nursing staff education and experience, lactation consultant availability, and nurse-reported breastfeeding support). The majority of very low birth weight infants (52%) were discharged on formula only. Fewer infants (42%) received human milk mixed with fortifier or formula. Only 6% of infants were discharged on exclusive human milk. A 1 SD increase (0.25) in the Practice Environment Scale of the Nursing Work Index composite score was associated with a four percentage point increase in the fraction of infants discharged on human milk (p<0.05). A 1 SD increase (0.15) in the fraction of nurses with a bachelor's degree in nursing was associated with a three percentage point increase in the fraction infants discharged on human milk (p<0.05). The acuity-adjusted staffing ratio was marginally associated with the rate of human milk at discharge (p=.056). A 1 SD increase (7%) in the fraction of infants who received breastfeeding support was associated with an eight percentage point increase in the fraction of infants discharged on human milk (p<0.001). Neonatal intensive care units with better work environments, better educated nurses, and more infants who receive breastfeeding support by nurses have higher rates of very low birth weight infants discharged home on human milk. Investments by nurse administrators to improve work environments and support educational preparation of nursing staff may ensure that the most vulnerable infants have the best nutrition at the point of discharge. Copyright © 2015 Elsevier Ltd. All rights reserved.
Factors associated with infant feeding of human milk at discharge from neonatal intensive care: Cross-sectional analysis of nurse survey and infant outcomes data

PubMed Central

Hallowell, Sunny G.; Rogowski, Jeannette A.; Spatz, Diane L.; Hanlon, Alexandra L.; Kenny, Michael; Lake, Eileen T.

2016-01-01

Context Nurses are principal caregivers in the neonatal intensive care unit and support mothers to establish and sustain a supply of human milk for their infants. Whether an infant receives essential nutrition and immunological protection provided in human milk at discharge is an issue of health care quality in this setting. Objectives To examine the association of the neonatal intensive care unit work environment, staffing levels, level of nurse education, lactation consultant availability, and nurse-reported breastfeeding support with very low birth weight infant receipt of human milk at discharge. Design and setting Cross sectional analysis combining nurse survey data with infant discharge data. Participants A national sample of neonatal intensive care units (N = 97), nurses (N = 5614) and very low birth weight infants (N = 6997). Methods Sequential multivariate linear regression models were estimated at the unit level between the dependent variable (rate of very low birth weight infants discharged on “any human milk”) and the independent variables (nurse work environment, nurse staffing, nursing staff education and experience, lactation consultant availability, and nurse-reported breastfeeding support). Results The majority of very low birth weight infants (52%) were discharged on formula only. Fewer infants (42%) received human milk mixed with fortifier or formula. Only 6% of infants were discharged on exclusive human milk. A 1 SD increase (0.25) in the Practice Environment Scale of the Nursing Work Index composite score was associated with a four percentage point increase in the fraction of infants discharged on human milk (p < 0.05). A 1 SD increase (0.15) in the fraction of nurses with a bachelor’s degree in nursing was associated with a three percentage point increase in the fraction infants discharged on human milk (p < 0.05). The acuity-adjusted staffing ratio was marginally associated with the rate of human milk at discharge (p = .056). A 1 SD increase (7%) in the fraction of infants who received breastfeeding support was associated with an eight percentage point increase in the fraction of infants discharged on human milk (p < 0.001). Conclusions Neonatal intensive care units with better work environments, better educated nurses, and more infants who receive breastfeeding support by nurses have higher rates of very low birth weight infants discharged home on human milk. Investments by nurse administrators to improve work environments and support educational preparation of nursing staff may ensure that the most vulnerable infants have the best nutrition at the point of discharge. PMID:26518107
Preparing Students for Practice in a Managed Care Environment

ERIC Educational Resources Information Center

Claiborne, Nancy; Fortune, Anne

2005-01-01

Managed care has profound effects on health and mental health service delivery in the United States. This article describes the knowledge that students need for effective social work practice within a managed care environment and evaluates a course to deliver the content. (Contains 3 tables.)
40 CFR 63.1366 - Monitoring and inspection requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 11 2010-07-01 2010-07-01 true Monitoring and inspection requirements. 63.1366 Section 63.1366 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... daily or more frequent demonstration that the unit is working as designed and may include the daily...
The effects of arts-in-medicine programming on the medical-surgical work environment

PubMed Central

Sonke, Jill; Pesata, Virginia; Arce, Lauren; Carytsas, Ferol P.; Zemina, Kristen; Jokisch, Christine

2015-01-01

Background: Arts in medicine programs have significant impacts on patients and staff in long-term care environments, but the literature lacks evidence of effectiveness on hospital units with shorter average lengths of stay. Methods: The qualitative study used individual structured interviews to assess the impacts of arts programming on job satisfaction, stress, unit culture, support, quality of care, and patient outcomes on a short-term medical-surgical unit, and used a qualitative cross comparison grounded theory methodology to analyze data. Results: The study confirmed that arts programming can positively affect unit culture, nursing practice, and quality of care on short-stay medical-surgical units. Significant insights related to nursing practice and the art program were found, including that music can cause negative distraction for staff. Conclusions: While positive impacts of arts programming on the medical-surgical environment are clear, potential negative effects also need to be considered in the development of practice protocols for artists. PMID:25544861
Mission Command In A Communications Denied Environment

DTIC Science & Technology

2017-02-16

AIR WAR COLLEGE AIR UNIVERSITY MISSION COMMAND IN A COMMUNICATIONS DENIED ENVIRONMENT by Ramon Ahrens, Lieutenant Colonel, GAF A...centralized execution. Mission Command is particularly helpful in communication denied environments . This paper shows the advantages in situations where...Mission Command needs to be practiced and executed in peacetime for it to work during real world operations. The United States armed forces are
Nursing Unit Environment Associated with Provision of Language Services in Pediatric Hospices.

PubMed

Lindley, Lisa C; Held, Mary L; Henley, Kristen M; Miller, Kathryn A; Pedziwol, Katherine E; Rumley, Laurie E

2017-04-01

Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1251 pediatric hospice agencies. Variable selection was guided by structural contingency theory, which posits that organizational effectiveness is dependent upon how well an organization's structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services. The majority of hospices provided translation services (74.9 %) and interpreter services (87.1 %). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services. Findings indicate that nursing unit environment predicts provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staffs who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency and ultimately reduce ethnic disparities in end-of-life care for children and their families.
Nursing unit environment associated with provision of language services in pediatric hospices

PubMed Central

Lindley, Lisa C.; Held, Mary L.; Henley, Kristen M.; Miller, Kathryn A.; Pedziwol, Katherine E.; Rumley, Laurie E.

2016-01-01

Background Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. Methods Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1,251 pediatric hospice agencies. Variable selection was guided by Structural Contingency Theory, which posits that organizational effectiveness is dependent upon how well an organization’s structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services. Results The majority of hospices provided translation services (74.9%) and interpreter services (87.1%). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services. Conclusions Findings indicate that nursing unit environment predict provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staff who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency, and ultimately reduce ethnic disparities in end-of-life care for children and their families. PMID:27059050
A Harsh and Challenging World of Work: Implications for Counselors.

ERIC Educational Resources Information Center

Jones, Lawrence K.

1996-01-01

Presents some of the health risks and economic and job insecurities involved in working in the United States. Suggests ways for counselors to amend their practices to accommodate the changing work environment and to help clients prepare for and deal with the economic and physical realities of the job market. (Author)
Affective Commitment among Student Affairs Professionals

ERIC Educational Resources Information Center

Boehman, Joseph

2007-01-01

Student affairs professionals in the United States were surveyed to determine the predictive value of overall job satisfaction, organizational support, organizational politics, and work/nonwork interaction on affective organizational commitment. Results indicate that a supportive work environment leads to increased affective attachment to the…
78 FR 19565 - Call for Expert Reviewers to the U.S. Government Review of the Working Group II Contribution to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-01

... Climate Change (IPCC), Impacts, Adaptation & Vulnerability. SUMMARY: The United States Global Change... on Climate Change (IPCC), Impacts, Adaptation & Vulnerability. The United Nations Environment... socio-economic information for understanding the scientific basis of climate change, potential impacts...
To amend title 23, United States Code, with respect to United States Route 78 in Mississippi, and for other purposes.

THOMAS, 113th Congress

Rep. Nunnelee, Alan [R-MS-1

2014-03-14

Senate - 05/20/2014 Received in the Senate and Read twice and referred to the Committee on Environment and Public Works. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:
To designate the United States Courthouse to be constructed in Jackson, Mississippi, as the "R. Jess Brown United States Courthouse".

THOMAS, 111th Congress

Rep. Thompson, Bennie G. [D-MS-2

2009-02-03

Senate - 03/11/2009 Received in the Senate and Read twice and referred to the Committee on Environment and Public Works. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:
Life in the Sharakakpok Village.

ERIC Educational Resources Information Center

Finkel, Doris

1994-01-01

Describes a five-month study unit for eight to nine-year olds that integrates the Native Peoples of Manhattan, New York, into social studies, science, the arts, and literature. The unit includes the area's environment; the area's people; a harvest festival; tribal legends and traditions; literature to expand student's work; and science class…
Commuter migration: work environment factors influencing nurses' decisions regarding choice of employment.

PubMed

Rajacich, D; Freeman, M; Armstrong-Stassen, M; Cameron, S; Wolfe, B

2014-06-01

Nurse migration is of global concern for every country, and study of migration can provide critical information for managers concerned with nurse recruitment and retention. This mixed-methods research examined factors influencing registered nurses' (RNs') decisions to work in their home country, Canada, or to commute daily to a nursing position in the United States. Measures included nurses' feelings about their work environment conditions, work status congruence (the goodness of fit between employer expectations and their own regarding hours and times worked), professional development opportunities, and their perceptions of organizational support and autonomy (freedom and independence) in the workplace. All work environment variables were significantly higher for nurses working in Michigan. Qualitative results supported these survey findings, providing additional information about nurses' satisfaction. Nurses in our sample were more satisfied with all the work environment factors examined, even when stress from commuting out of country was experienced. The environmental issues examined in this study should be considered by nurse managers concerned with recruitment and retention of nurses. Copyright © 2014 Longwoods Publishing.
Cognitive Tools for Assessment and Learning in a High Information Flow Environment.

ERIC Educational Resources Information Center

Lajoie, Susanne P.; Azevedo, Roger; Fleiszer, David M.

1998-01-01

Describes the development of a simulation-based intelligent tutoring system for nurses working in a surgical intensive care unit. Highlights include situative learning theories and models of instruction, modeling expertise, complex decision making, linking theories of learning to the design of computer-based learning environments, cognitive task…

Students' perceived importance of diversity exposure and training in dental education.

PubMed

Novak, Karen F; Whitehead, Albert W; Close, John M; Kaplan, Alan L

2004-03-01

Intercultural competence is an important component of the doctor-patient relationship in the multicultural climate evolving in the United States. We hypothesized that 1) exposure to racial and ethnic diversity in the student body, faculty, staff, and patient population in dental school and 2) a dental school curriculum that includes presentations on issues concerning racial and ethnic diversity will contribute to students' feeling more competent and confident to enter the multicultural work environment that is rapidly developing in the United States. A Likert-type scale questionnaire was administered to 627 fourth-year dental students enrolled in seven dental schools representing geographically diverse regions of the United States. Of these, 376 questionnaires were returned for a response rate of 60 percent. Results indicated that both the perception of diversity in the school environment and the presentation of diversity-specific content in the curriculum had moderately positive and significant correlations with the students' perception of their competency or ability to serve and work with diverse populations. The respective Pearson correlation coefficients for diversity in the school environment and diversity curriculum were .497 (p<.001) and .459 (p<.001). These results support the hypotheses that diversity exposure and training in the dental school environment are important for dental students entering a multicultural workplace.
The Quality of Nurses' Work Environment and Workforce Outcomes From the Perspective of Swiss Allied Healthcare Assistants and Registered Nurses: A Cross-Sectional Survey.

PubMed

Lacher, Stefanie; De Geest, Sabina; Denhaerynck, Kris; Trede, Ines; Ausserhofer, Dietmar

2015-09-01

Anticipating nursing shortages, the Swiss healthcare system recently introduced the position of allied healthcare assistant (AHA). However, indicators of AHAs' integration and stability, particularly their perceptions of their work environment quality and related outcomes (i.e., burnout, job satisfaction, and intention to leave), remain unclear. (a) To describe AHAs' ratings of the quality of the nurse work environment, job satisfaction, burnout, and intention to leave their workplaces; (b) to compare AHAs' and registered nurses' (RNs') work environment quality ratings and related outcomes; and (c) to assess links between AHAs' work environment quality ratings and related workforce outcomes. A secondary analysis of RN4CAST data (October 2009 to June 2010) on 61 AHAs and 466 RNs in 13 Swiss acute care hospitals. We used descriptive statistics to summarize data of AHAs and RNs on their units and hospitals. Via binary logistic regression models, we compared AHAs and RNs and identified associations between work environment ratings and workforce outcomes. AHAs' work environment quality ratings were significantly higher than those of RNs, and were associated with lower odds of burnout and intention to leave their current job and higher odds of reported job satisfaction. This study provides primary evidence linking AHAs' work environment quality ratings to burnout, job satisfaction, and intention to leave in acute care hospitals. Given the increasing importance of AHAs for nursing care provision, hospitals should assess the quality of nurse work environment and nurse outcomes from the perspective of all nurses. © 2015 Sigma Theta Tau International.
Low Energy Technology, A Unit of Instruction in Housing and Home Environment. Insulation, Caulking & Weatherstripping.

ERIC Educational Resources Information Center

Beaulieu, Barbara; And Others

This unit of instruction on insulation, caulking, and weatherstripping homes was designed for use by home economic teachers in Florida high schools and by home economics extension agents as they work with their clientele. It is one of a series of 11 instructional units (see note) written to help teachers and agents to educate their students and…
The nursing work environment and quality of care: A cross-sectional study using the Essentials of Magnetism II Scale in England.

PubMed

Oshodi, Titilayo O; Crockett, Rachel; Bruneau, Benjamin; West, Elizabeth

2017-09-01

To explore the structure of the Essentials of Magnetism II (EOMII) scale using data from nurses working in England; and to describe the impact of different aspects of the nursing work environment on nurse-assessed care quality (NACQ). The EOMII Scale was developed in the United States to measure nursing work environments. It has been widely used in the United States and in a number of other countries, but has not yet been used in the UK. Cross-sectional study. Registered nurses (n = 247) providing direct patient care in two National Health Service hospitals in England completed the EOMII scale and a single-item measuring NACQ. Principal components analysis was used to assess the structure of the scale. Correlation and regression analyses were used to describe the relationships between factors and NACQ. A solution with explanatory variance of 45.25% was identified. Forty items loaded on five factors, with satisfactory consistency: (i) ward manager support; (ii) working as a team; (iii) concern for patients; (iv) organisational autonomy; and (v) constraints on nursing practice. While in univariate analyses, each of the factors was significantly associated with NACQ, in multivariate analyses, the relationship between organisational autonomy and NACQ no longer reached significance. However, a multiple mediation model indicated that the effect of organisational autonomy on NACQ was mediated by nurse manager support, working as a team and concern for patients but not constraints on nursing practice. Subscales of the EOMII identified in an English sample of nurses measured important aspects of the nursing work environment, each of which is related to NACQ. The EOMII could be a very useful tool for measuring aspects of the nursing work environment in the English Trusts particularly in relation to the quality of care. © 2017 John Wiley & Sons Ltd.
Staff Nurse Perceptions of Open-Pod and Single Family Room NICU Designs on Work Environment and Patient Care.

PubMed

Winner-Stoltz, Regina; Lengerich, Alexander; Hench, Anna Jeanine; OʼMalley, Janet; Kjelland, Kimberly; Teal, Melissa

2018-06-01

Neonatal intensive care units have historically been constructed as open units or multiple-bed bays, but since the 1990s, the trend has been toward single family room (SFR) units. The SFR design has been found to promote family-centered care and to improve patient outcomes and safety. The impact of the SFR design NICU on staff, however, has been mixed. The purposes of this study were to compare staff nurse perceptions of their work environments in an open-pod versus an SFR NICU and to compare staff nurse perceptions of the impact of 2 NICU designs on the care they provide for patients/families. A prospective cohort study was conducted. Questionnaires were completed at 6 months premove and again at 3, 9, and 15 months postmove. A series of 1-way analyses of variance were conducted to compare each group in each of the 8 domains. Open-ended questions were evaluated using thematic analysis. The SFR design is favorable in relation to environmental quality and control of primary workspace, privacy and interruption, unit features supporting individual work, and unit features supporting teamwork; the open-pod design is preferable in relation to walking. Incorporating design features that decrease staff isolation and walking and ensuring both patient and staff safety and security are important considerations. Further study is needed on unit design at a microlevel including headwall design and human milk mixing areas, as well as on workflow processes.
Pregnant women in the workplace: distinguishing between normal and abnormal physiologic changes.

PubMed

Draper, London

2006-05-01

The Bureau of Labor Statistics reported in 2001 that 51% of married women return to the work force before their children are 1 year old (Rojjanasrirat, 2004). Women's roles in the United States are rapidly changing, and the workplace environment is also changing to meet the added demands of women in the work force. Many women assimilate the multiple roles of wife, mother, and working professional into a cohesive unit; however, this is often difficult. Occupational health nurses play a vital role advocating for women in the work force. A critical area of advocacy (and education) focuses on providing necessary support to pregnant employees.
DroidSafe

DTIC Science & Technology

2016-12-01

branches of our work . 3.1 Understanding Sensitive API Call and API Information Usage Android applications are written in a type- safe language (Java...directly invoke resolved targets. Because DroidSafe works with a comprehensive model of the Android environment , it supports precise resolution of...STATEMENT. FOR THE CHIEF ENGINEER: / S / / S / MARK K. WILLIAMS WARREN H. DEBANY, JR. Work Unit Manager
Nonnative English-Speaking Teachers in the United States: Issues of Identity

ERIC Educational Resources Information Center

Diniz de Figueiredo, Eduardo Henrique

2011-01-01

The present study investigated how nonnative English-speaking teachers (NNESTs) working in K-12 schools in the United States perceive their identities in relation to the school environment and its norms, their coworkers and administrators and the students and their families. Specific attention was given to the teachers' concerns prior to arrival…
8th Grade Canadian Trip.

ERIC Educational Resources Information Center

Jelinek, Gilbert; Schoenike, Paul

Ideas are offered for helping eighth-grade students incorporate an at-home field trip to Canada into a social studies unit. The teachers who developed the unit state that students can complete the 21-day imaginary trip in five hours of classroom time when appropriate materials are available and the classroom environment is conducive to working on…
78 FR 12807 - Call for Expert Reviewers to the U.S. Government Review of the Working Group III Contribution to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-25

... on Climate Change (IPCC), Mitigation of Climate Change SUMMARY: The United States Global Change... Panel on Climate Change (IPCC), Mitigation of Climate Change. The United Nations Environment Programme...-economic information for understanding the scientific basis of climate change, potential impacts, and...
Voices from the United Arab Emirates: Engineering Graduates' Labour Market Requisite Competencies

ERIC Educational Resources Information Center

EL-Sakran, Tharwat M.; Awad, Asmaa

2012-01-01

This study reports on engineering graduates' labour market requisite communication competences and skills in the work environment in the United Arab Emirates (UAE). Its main purpose was to investigate whether internationally required engineering graduates' communication competences were the same in third world countries or different. It used a…
To designate the United States courthouse located at 131 East 4th Street in Davenport, Iowa, as the "James A. Leach United States Courthouse".

THOMAS, 111th Congress

Rep. Loebsack, David [D-IA-2

2009-02-04

Senate - 03/11/2009 Received in the Senate and Read twice and referred to the Committee on Environment and Public Works. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:
Visibility of Diversity within Association of Research Libraries Websites

ERIC Educational Resources Information Center

Mestre, Lori S.

2011-01-01

Libraries in the United States have worked towards developing more inclusive environments and programs. This inclusiveness should also extend to the online library presence. This article provides results of a web page scan of all Association of Research Libraries (ARL) in the United States to document the visibility of diversity on their pages. A…
Work related and individual predictors for incident neck pain among office employees working with video display units

PubMed Central

Korhonen, T; Ketola, R; Toivonen, R; Luukkonen, R; Hakkanen, M; Viikari-Juntura, E

2003-01-01

Aims: To investigate work related and individual factors as predictors for incident neck pain among office employees working with video display units (VDUs). Methods: Employees in three administrative units of a medium sized city in Finland (n = 515) received mailed questionnaires in the baseline survey in 1998 and in the follow up survey in 1999. Response rate for the baseline was 81% (n = 416); respondents who reported neck pain for less than eight days during the preceding 12 months were included into the study cohort as healthy subjects (n = 232). The follow up questionnaire 12 months later was completed by 78% (n = 180). Incident neck cases were those reporting neck pain for at least eight days during the preceding 12 months. Results: The annual incidence of neck pain was 34.4% (95% CI 25.5 to 41.3). Poor physical work environment and poor placement of the keyboard increased the risk of neck pain. Among the individual factors, female sex was a strong predictor. Smoking showed a tendency for an increased risk of neck pain. There was an interaction between mental stress and physical exercise, those with higher mental stress and less physical exercise having especially high risk. Conclusion: In the prevention of neck disorders in office work with a high frequency of VDU tasks, attention should be given to the work environment in general and to the more specific aspects of VDU workstation layout. Physical exercise may prevent neck disorders among sedentary employees. PMID:12819280
[The working environment control of anhydride hardeners from an epoxy resin system].

PubMed

Matsumoto, Naomi; Yokota, Kozo; Johyama, Yasushi; Takakura, Toshiyuki

2003-07-01

Epoxy resins are widely used in adhesives, coatings, materials for molds and composites, and encapsulation. Acid anhydrides such as methyltetrahydrophthalic anhydride are being used as curing agents for epoxy resins. The anhydride hardeners are well-known industrial inhalant allergens, inducing predominantly type I allergies. In the electronic components industry, these substances have been consumed in large quantities. Therefore, safe use in the industry demands control of the levels of exposure causing allergic diseases in the workshop. We conducted a prospective survey of two electronics plants to clarify how to control the atmospheric level of the anhydrides in the work environment. Measurements of the levels of the anhydrides in air started according to the Working Environment Measurement Standards (Ministry of Labour Notification No. 46, 1976) in April 2000, along with improvements in the work environment. A value of 40 micrograms/m3 was adopted as the administrative control level to judge the propriety of the working environment control. A total of 2 unit work areas in both plants belonged to Control Class III. The exposure originated from manual loading, casting, uncured hot resins, and leaks in an impregnating-machine or curing ovens. In order to achieve the working environment control, complete enclosure of the source, installation of local exhaust ventilation, and improvement or maintenance of the local exhaust ventilation system were performed on the basis of the results of the working environment measurement, with the result that the work environment was improved (Control Class I). It became evident that these measures were effective just like other noxious substances.
Examining Holland's Person-Environment Fit, Workplace Aggression, Interpersonal Conflict, and Job Satisfaction

ERIC Educational Resources Information Center

Pseekos, A. Chantelle; Bullock-Yowell, Emily; Dahlen, Eric R.

2011-01-01

The researchers examined the impact of person-environment (P-E) fit, as defined by Holland's (1997) theory, on interpersonal conflict at work (ICAW) and workplace aggression. In addition, previous relationships found in the job satisfaction literature were examined in the present sample of 244 United States employees. Internet-based surveys were…
Low Energy Technology. A Unit of Instruction in Housing and Home Environment. Single Family Homes--Multi-Family Homes--Mobile Homes.

ERIC Educational Resources Information Center

Beaulieu, Barbara; And Others

This unit of instruction on selection and living styles for energy conservation in single-family and multi-family housing and mobile homes was designed for use by home economics teachers in Florida high schools and by home economics extension agents as they work with their clientele. It is one of a series of 11 instructional units (see note)…
Low Energy Technology. A Unit of Instruction in Housing and Home Environment. Home Energy Usage and Conservation.

ERIC Educational Resources Information Center

Beaulieu, Barbara; And Others

This unit of instruction on home energy usage and conservation was designed for use by home economics teachers in Florida high schools and by home economics extension agents as they work with their clientele. It is one of a series of 11 instructional units (see note) written to help teachers and agents to educate their students and clients about…
Leading and empowering the multicultural work team.

PubMed

Gantz, Nancy Rollins

2002-09-01

The multicultural team clearly is a part of the landscape in many work environments today. This article focuses on the opportunity for leaders to create a climate in which people of diverse cultures are invited into full participation as their unit contributes its very best to the achievement of the mission and goals of the organization. Within this environment, members are valued for who they are and what they share, without bearing on race, religion, ethnicity, and orientation or physical limitations.
An integrative review of nurses' prosocial behaviours contributing to work environment optimization, organizational performance and quality of care.

PubMed

Feather, Janice; McGillis Hall, Linda; Trbovich, Patricia; Baker, G Ross

2018-04-22

To rigorously review the literature on the prosocial workplace behaviours of nurses. Prosocial workplace behaviours, predominantly organisational citizenship behaviours have been theoretically and empirically found to promote individual and group level performance in various industries. However, little consensus exists in the literature regarding the impact of nurses' workplace behaviours on the work environment and organisational performance. An integrative literature review was conducted on studies between 1980 and 2016. Nineteen articles were included related to nurses' prosocial behaviours and performance. A positive relationship was noted between workplace behaviours and individual level performance and unit level performance. Albeit multifactorial, leadership and the social structure of the work environment are important factors contributing to the workplace behaviour-performance relationship. Prosocial behaviours influence the social functioning of the work environment and offer insights into the delivery of quality care. Nurse managers should recognize the influence of leadership style and characteristics in the work environment that encourage employee participation in prosocial behaviours. These additional voluntary efforts by nursing staff may improve organisational effectiveness and quality of care. Inclusion of these behaviours in performance reviews and as cultural norms may help to foster a more collaborative work environment. © 2018 John Wiley & Sons Ltd.

Evaluation of knowledge transfer in an immersive virtual learning environment for the transportation community : research project capsule.

DOT National Transportation Integrated Search

2010-01-01

In 2008 alone, 720 individuals were killed in a : construction or maintenance work zone in the : United States. However, since 2003, the total : number of individuals killed in a construction or : maintenance work zone in the US reached a : staggerin...
Working with Nonsuicidal Self-Injurious Adolescents

ERIC Educational Resources Information Center

Nelson, Mark D.; Piccin, Rian

2016-01-01

Nonsuicidal self-injury (NSSI) has evolved into a serious issue for adolescents, and is encountered in school systems across the United States. The ability of school counselors and other professionals working in the school environment to understand and assist students who exhibit signs of NSSI is critically important. Research remains minimal on…
Work stress, occupational burnout and depression levels: a clinical study of paediatric intensive care unit nurses in Taiwan.

PubMed

Lin, Tzu-Ching; Lin, Huey-Shyan; Cheng, Su-Fen; Wu, Li-Min; Ou-Yang, Mei-Chen

2016-04-01

This study aimed to examine the relationship between work stress and depression; and investigate the mediating effect of occupational burnout among nurses in paediatric intensive care units. The relationships among work stress, occupational burnout and depression level have been explored, neither regarding occupational burnout as the mediating role that causes work stress to induce depression nor considering the paediatric intensive care unit context. A cross-sectional correlational design was conducted. One hundred and forty-four female paediatric intensive care unit nurses from seven teaching hospitals in southern Taiwan were recruited as the participants. Data were collected by structured questionnaires including individual demographics, the Nurse Stress Checklist, the Occupational Burnout Inventory and the Taiwan Depression Questionnaire. The results indicated that after controlling for individual demographic variables, the correlations of work stress with occupational burnout, as well as work stress and occupational burnout with depression level were all positive. Furthermore, occupational burnout may exert a partial mediating effect on the relationship between work stress and depression level. This study provides information about work stress, occupational burnout and depression level, and their correlations, as well as the mediating role of occupational burnout among paediatric intensive care unit nurses. It suggests government departments and hospital administrators when formulating interventions to prevent work stress and occupational burnout. These interventions can subsequently prevent episodes of depression in paediatric intensive care unit nurses, thereby providing patients with a safe and high-quality nursing environment. © 2016 John Wiley & Sons Ltd.
Factors influencing nurses' perceptions of occupational safety.

PubMed

Samur, Menevse; Intepeler, Seyda Seren

2017-01-02

To determine nurses' perceptions of occupational safety and their work environment and examine the sociodemographic traits and job characteristics that influence their occupational safety, we studied a sample of 278 nurses. According to the nurses, the quality of their work environment is average, and occupational safety is insufficient. In the subdimensions of the work environment scale, it was determined that the nurses think "labor force and other resources" are insufficient. In the occupational safety subdimensions "occupational illnesses and complaints" and "administrative support and approaches," they considered occupational safety to be insufficient. "Doctor-nurse-colleague relationships," "exposure to violence," and "work unit" (eg, internal medicine, surgical, intensive care) are the main factors that affect occupational safety. This study determined that hospital administrations should develop and immediately implement plans to ameliorate communication and clinical precautions and to reduce exposure to violence.
Review of noise in neonatal intensive care units regional analysis

NASA Astrophysics Data System (ADS)

Alvarez Abril, A.; Terrón, A.; Boschi, C.; Gómez, M.

2007-11-01

This work is about the problem of noise in neonatal incubators and in the environment in the neonatal intensive care units. Its main objective is to analyse the impact of noise in hospitals of Mendoza and La Rioja. Methodology: The measures were taken in different moments in front of higher or lower severity level in the working environment. It is shown that noise produces severe damages and changes in the behaviour and the psychological status of the new born babies. Results: The noise recorded inside the incubators and the neonatal intensive care units together have many components but the noise of motors, opening and closing of access gates have been considered the most important ones. Values above 60 db and and up to 120 db in some cases were recorded, so the need to train the health staff in order to manage the new born babies, the equipment and the instruments associated with them very carefully is revealed.
New 'patent accelerated care environment' aims to facilitate work flow, free up ED for acute care needs.

PubMed

2012-02-01

Faced with rising acuity levels and surging demand, Virginia Mason Medical Center modified the Clinical Decision Unit concept used in many EDs, and developed a new Patient Accelerated Care Environment (PACE) to care for observation patients, process patients for discharge, and to prepare patients for admission.The approach is designed to utilize ED beds for initial processing of patients, allowing resuscitative care if needed, and treating and releasing the patients with quick care needs. Using the Virginia Mason Production System, a methodology that is modeled after Toyota production techniques, developers designed an optimal work flow pattern and then built infrastructure to facilitate that process. All patients who present to the ED for care are seen by the ED team through a "team greet" approach. Approximately 35% to 40% of patients who come to the ED for care are transferred to the PACE unit. Patients assigned to the PACE unit typically remain there for 4 to 48 hours, depending on their care needs.
A School-to-Work Transition System for the United States. Workforce Skills Program.

ERIC Educational Resources Information Center

Tucker, Marc

The core features of the preindustrial model of school-to-work transition are needed now. An environment must be recreated in which young people see the vital connections among education, training, and work that were once so clear. The emerging consensus model has these features: combined formal schooling and structured on-the-job training leading…
To designate the United States courthouse located at 100 North Church Street in Las Cruces, New Mexico, as the "Edwin L. Mechem United States Courthouse".

THOMAS, 112th Congress

Rep. Pearce, Stevan [R-NM-2

2011-12-20

Senate - 07/24/2012 Received in the Senate and Read twice and referred to the Committee on Environment and Public Works. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:
Applying Lean Six Sigma for innovative change to the post-anesthesia care unit.

PubMed

Haenke, Roger; Stichler, Jaynelle F

2015-04-01

Many healthcare organizations are building or renovating patient care facilities. Using Lean Six Sigma methods, nurse leaders can eliminate unnecessary waste and improve work and patient care environments. Starting with a key department like the post-anesthesia care unit is a good way to expose staff and leaders to the potential of Lean.
To designate the Federal building and United States courthouse located at 101 Barr Street in Lexington, Kentucky, as the "Scott Reed Federal Building and United States Courthouse".

THOMAS, 111th Congress

Rep. Chandler, Ben [D-KY-6

2009-02-04

Senate - 03/11/2009 Received in the Senate and Read twice and referred to the Committee on Environment and Public Works. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:
United Sugpiaq Alutiiq (USA) Video Game: Preserving Traditional Knowledge, Culture, and Language

ERIC Educational Resources Information Center

Hall, Leslie D.; Sanderville, James Mountain Chief

2009-01-01

Video games are explored as a means of reviving dying indigenous languages. The design and production of the place-based United Sugpiaq Alutiiq (USA) video game prototype involved work across generations and across cultures. The video game is one part of a proposed digital environment where Sugcestun speakers in traditional Alaskan villages could…
Haemodialysis work environment contributors to job satisfaction and stress: a sequential mixed methods study.

PubMed

Hayes, Bronwyn; Bonner, Ann; Douglas, Clint

2015-01-01

Haemodialysis nurses form long term relationships with patients in a technologically complex work environment. Previous studies have highlighted that haemodialysis nurses face stressors related to the nature of their work and also their work environments leading to reported high levels of burnout. Using Kanters (1997) Structural Empowerment Theory as a guiding framework, the aim of this study was to explore the factors contributing to satisfaction with the work environment, job satisfaction, job stress and burnout in haemodialysis nurses. Using a sequential mixed-methods design, the first phase involved an on-line survey comprising demographic and work characteristics, Brisbane Practice Environment Measure (B-PEM), Index of Work Satisfaction (IWS), Nursing Stress Scale (NSS) and the Maslach Burnout Inventory (MBI). The second phase involved conducting eight semi-structured interviews with data thematically analyzed. From the 417 nurses surveyed the majority were female (90.9 %), aged over 41 years of age (74.3 %), and 47.4 % had worked in haemodialysis for more than 10 years. Overall the work environment was perceived positively and there was a moderate level of job satisfaction. However levels of stress and emotional exhaustion (burnout) were high. Two themes, ability to care and feeling successful as a nurse, provided clarity to the level of job satisfaction found in phase 1. While two further themes, patients as quasi-family and intense working teams, explained why working as a haemodialysis nurse was both satisfying and stressful. Nurse managers can use these results to identify issues being experienced by haemodialysis nurses working in the unit they are supervising.
Partnering with Carryouts: Implementation of a Food Environment Intervention Targeting Youth Obesity

ERIC Educational Resources Information Center

Perepezko, K.; Tingey, L.; Sato, P.; Rastatter, S.; Ruggiero, C.; Gittelsohn, J.

2018-01-01

Youth obesity is a major public health problem in the United States, especially among urban-based, minority youth. The B'More Healthy Communities for Kids (BHCK) trial worked at multiple levels of the food environment, including carryouts, to increase access to and demand for healthy, affordable foods. The objective of this article is to describe…
Registered nurse job satisfaction and satisfaction with the professional practice model.

PubMed

McGlynn, Karen; Griffin, Mary Quinn; Donahue, Moreen; Fitzpatrick, Joyce J

2012-03-01

This paper describes the initial assessment of job satisfaction and satisfaction with the professional practice environment of registered nurses working on units where a professional practice model was implemented and the relationship between these two variables. The nursing shortage has been linked to overall job satisfaction and specifically to nurses' satisfaction with the professional practice environment. Initiatives to increase retention and recruitment and decrease turnover have been linked to work satisfaction among nurses. A descriptive, cross-sectional design was used with participants (N = 101) from four patient care units; this represented a 55% response rate. The nurses were moderately satisfied with the professional practice environment but had overall low job satisfaction. There was a significant negative relationship between overall work satisfaction and satisfaction with the professional practice environment (P < 0.0001). The introduction of the professional practice model may have raised awareness of the components of job satisfaction that were not being met. Thus, the nurses may have become more knowledgeable about the potential needs in these areas. Nurse managers and leaders must recognize that job satisfaction consists of many dimensions, and each of these dimensions is important to nurse retention. Implementation of a professional practice model may heighten awareness of the missing components within a practice environment and lead to decreased overall satisfaction. A broader understanding of characteristics associated with increased satisfaction may aid in development of organizational change necessary to retain and attract nurses. © 2012 Blackwell Publishing Ltd.
Multigenerational Perceptions of the Academic Work Environment in Higher Education in the United States

ERIC Educational Resources Information Center

Kleinhans, Kelly A.; Chakradhar, Kala; Muller, Susan; Waddill, Paula

2015-01-01

The current workforce composition of the academy is comprised of multiple generational cohorts, Traditionalists, Leading Edge Boomers, Trailing Edge Boomers, Generation Xers and Millennials. Despite the plethora of research identifying a myriad of differences in the way these generational cohorts approach work and social activities little…
40 CFR Table 38 to Subpart Uuu of... - Initial Compliance With Work Practice Standards for HAP Emissions From Bypass Lines

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 12 2011-07-01 2009-07-01 true Initial Compliance With Work Practice Standards for HAP Emissions From Bypass Lines 38 Table 38 to Subpart UUU of Part 63 Protection of... Units Pt. 63, Subpt. UUU, Table 38 Table 38 to Subpart UUU of Part 63—Initial Compliance With Work...
40 CFR Table 38 to Subpart Uuu of... - Initial Compliance With Work Practice Standards for HAP Emissions From Bypass Lines

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Initial Compliance With Work Practice Standards for HAP Emissions From Bypass Lines 38 Table 38 to Subpart UUU of Part 63 Protection of... Units Pt. 63, Subpt. UUU, Table 38 Table 38 to Subpart UUU of Part 63—Initial Compliance With Work...
40 CFR Table 39 to Subpart Uuu of... - Continuous Compliance With Work Practice Standards for HAP Emissions From Bypass Lines

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Continuous Compliance With Work Practice Standards for HAP Emissions From Bypass Lines 39 Table 39 to Subpart UUU of Part 63 Protection of... Units Pt. 63, Subpt. UUU, Table 39 Table 39 to Subpart UUU of Part 63—Continuous Compliance With Work...
40 CFR Table 39 to Subpart Uuu of... - Continuous Compliance With Work Practice Standards for HAP Emissions From Bypass Lines

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 12 2011-07-01 2009-07-01 true Continuous Compliance With Work Practice Standards for HAP Emissions From Bypass Lines 39 Table 39 to Subpart UUU of Part 63 Protection of... Units Pt. 63, Subpt. UUU, Table 39 Table 39 to Subpart UUU of Part 63—Continuous Compliance With Work...
Status report - Geographic retail food environment measures for use in public health.

PubMed

Mahendra, Ahalya; Polsky, Jane Y; Robitaille, Éric; Lefebvre, Marc; McBrien, Tina; Minaker, Leia M

2017-10-01

The Association of Public Health Epidemiologists in Ontario (APHEO) Core Indicators Work Group standardizes definitions and calculation methods for over 120 public health indicators to enhance accurate and standardized community health status reporting across public health units in Ontario. The Built Environment Subgroup is a multi-disciplinary group made up of planners, researchers, policy analysts, registered dietitians, geographic information systems (GIS) analysts and epidemiologists. The Subgroup selected and operationalized a suite of objective, standardized indicators intended to help public health units and regional health authorities assess their community retail food environments. The Subgroup proposed three indicators that use readily available data sources and GIS tools to characterize geographic access to various types of retail food outlets within neighbourhoods in urban settings. This article provides a status report on the development of these food environment indicators.

Two Giants: China and India. Teacher's Guide to World Resources Comprehensive Coursework on the Global Environment.

ERIC Educational Resources Information Center

Snyder, Sarah A.

This teacher's guide presents teaching suggestions and presentation materials about the challenges faced by China and India as they work to sustain their population and ways of life without exhausting the environmental resources each has. The materials may be used as a unit on either nation or integrated into existing units of study. Student…
NEON VISUALIZATION ENVIRONMENT

DTIC Science & Technology

2017-07-28

STINFO COPY AIR FORCE RESEARCH LABORATORY INFORMATION DIRECTORATE AFRL-RI-RS-TR-2017-143  UNITED STATES AIR FORCE  ROME, NY 13441 AIR FORCE...report is available to the general public, including foreign nationals. Copies may be obtained from the Defense Technical Information Center (DTIC) (http...FOR THE CHIEF ENGINEER: / S / / S / PETER A. JEDRYSIK JULIE BRICHACEK Work Unit Manager Chief, Information Systems Division Information
Grade 5: United States--Our Expanding Nation. United States--Interdependence of Regions.

ERIC Educational Resources Information Center

Allegany County Board of Education, Cumberland, MD.

The curriculum guide presents a working draft of the fifth grade component of a K-6 social studies program using the expanding environments approach which was developed by the Allegany County Board of Education in Maryland. The overall objective is to help teachers assist their students in gaining the understanding needed to deal with the problems…
To designate the Federal building and United States courthouse located at 224 South Boulder Avenue in Tulsa, Oklahoma, as the "H. Dale Cook Federal Building and United States Courthouse".

THOMAS, 111th Congress

Rep. Sullivan, John [R-OK-1

2009-07-23

Senate - 11/18/2009 Received in the Senate and Read twice and referred to the Committee on Environment and Public Works. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:
The Cost-Effectiveness of Supported Employment for Adults with Autism in the United Kingdom

ERIC Educational Resources Information Center

Mavranezouli, Ifigeneia; Megnin-Viggars, Odette; Cheema, Nadir; Howlin, Patricia; Baron-Cohen, Simon; Pilling, Stephen

2014-01-01

Adults with autism face high rates of unemployment. Supported employment enables individuals with autism to secure and maintain a paid job in a regular work environment. The objective of this study was to assess the cost-effectiveness of supported employment compared with standard care (day services) for adults with autism in the United Kingdom.…
A bill to designate the Federal building and United States courthouse located at 1300 Victoria Street in Laredo, Texas, as the "George P. Kazen Federal Building and United States Courthouse".

THOMAS, 111th Congress

Rep. Cuellar, Henry [D-TX-28

2009-05-14

Senate - 10/15/2009 Received in the Senate and Read twice and referred to the Committee on Environment and Public Works. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:
Work stress of primary care physicians in the US, UK and German health care systems.

PubMed

Siegrist, Johannes; Shackelton, Rebecca; Link, Carol; Marceau, Lisa; von dem Knesebeck, Olaf; McKinlay, John

2010-07-01

Work-related stress among physicians has been an issue of growing concern in recent years. How and why this may vary between different health care systems remains poorly understood. Using an established theoretical model (effort-reward imbalance), this study analyses levels of work stress among primary care physicians (PCPs) in three different health care systems, the United States, the United Kingdom and Germany. Whether professional autonomy and specific features of the work environment are associated with work stress and account for possible country differences are examined. Data are derived from self-administered questionnaires obtained from 640 randomly sampled physicians recruited for an international comparative study of medical decision making conducted from 2005 to 2007. Results demonstrate country-specific differences in work stress with the highest level in Germany, intermediate level in the US and lowest level among UK physicians. A negative correlation between professional autonomy and work stress is observed in all three countries, but neither this association nor features of the work environment account for the observed country differences. Whether there will be adequate numbers of PCPs, or even a field of primary care in the future, is of increasing concern in several countries. To the extent that work-related stress contributes to this, identification of its organizational correlates in different health care systems may offer opportunities for remedial interventions. Copyright 2010 Elsevier Ltd. All rights reserved.
Work stress of primary care physicians in the US, UK and German health care systems

PubMed Central

Siegrist, Johannes; Link, Carol; Marceau, Lisa; von dem Knesebeck, Olaf; McKinlay, John

2010-01-01

Work-related stress among physicians has been an issue of growing concern in recent years. How and why this may vary between different health care systems remains poorly understood. Using an established theoretical model (effort-reward imbalance), this study analyses levels of work stress among primary care physicians (PCPs) in three different health care systems, the United States, the United Kingdom and Germany. Whether professional autonomy and specific features of the work environment are associated with work stress and account for possible country differences are examined. Data are derived from self-administered questionnaires obtained from 640 randomly sampled physicians recruited for an international comparative study of medical decision making conducted from 2005–2007. Results demonstrate country-specific differences in work stress- with the highest level in Germany, intermediate level in the US and lowest level among UK physicians. A negative correlation between professional autonomy and work stress is observed in all three countries, but neither this association nor features of the work environment account for the observed country differences. Whether there will be adequate numbers of PCPs, or even a field of primary care in the future, is of increasing concern in several countries. To the extent that work-related stress contributes to this, identification of its organizational correlates in different health care systems may offer opportunities for remedial interventions. PMID:20494505
A method for work modeling at complex systems: towards applying information systems in family health care units.

PubMed

Jatobá, Alessandro; de Carvalho, Paulo Victor R; da Cunha, Amauri Marques

2012-01-01

Work in organizations requires a minimum level of consensus on the understanding of the practices performed. To adopt technological devices to support the activities in environments where work is complex, characterized by the interdependence among a large number of variables, understanding about how work is done not only takes an even greater importance, but also becomes a more difficult task. Therefore, this study aims to present a method for modeling of work in complex systems, which allows improving the knowledge about the way activities are performed where these activities do not simply happen by performing procedures. Uniting techniques of Cognitive Task Analysis with the concept of Work Process, this work seeks to provide a method capable of providing a detailed and accurate vision of how people perform their tasks, in order to apply information systems for supporting work in organizations.
Pathways to the Professoriate: The Role of Self, Others, and Environment in Shaping Academic Career Aspirations

ERIC Educational Resources Information Center

Lindholm, Jennifer A.

2004-01-01

The findings reported here are part of a larger study that examined how faculty view the linkages between themselves and their institutional work environments; how they create a sense of personal space and belonging within their academic units and the larger university; and how their self-perceptions of organizational fit affect their professional…
Safe Environment Training: Effects on Catholic Schoolteachers' and Administrators' School Security and Satisfaction

ERIC Educational Resources Information Center

Teague, James Brian

2013-01-01

In 2002, in light of the sexual abuse crisis in the Catholic church, The United States Conference of Catholic Bishops established "The charter for the Protection of Children and Young People" that mandated safe environment training for clergy personnel, and volunteers working in the Catholic church. In this study, under the auspices of a…
Modifying the Weinberger-Powell Doctrine for the Modern Geo-Strategic Environment

DTIC Science & Technology

2017-03-31

Geo-Strategic Environment 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Scott T. Yeatman, Lt Col, USAF 5d...PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER 9... environment , its prescriptive nature, and its misunderstanding of the modern utility of force. This paper examines each of these issues then proposes
Statement of Granta Y. Nakayama Assistant Administrator Office of Enforcement and Compliance Assurance

EPA Pesticide Factsheets

Statement of Granta Y. Nakayama Assistant Administrator Office of Enforcement and Compliance Assurance Before the Committee on Environment and Public Works Subcommittee on Superfund and Environmental Health United States Senate
EPA Collaboration with Mexico

EPA Pesticide Factsheets

EPA works with our Mexican neighbors on the U.S.-Mexico Environmental Program, a collaboration between the United States and Mexico to improve the environment and protect the health of the nearly 12 million people living along the border.
Work experience, work environment, and blood exposure among home care and hospice nurses.

PubMed

Leiss, Jack K

2012-01-01

Blood exposure rates among home care and hospice nurses (RNs) in the United States are markedly lower for nurses with more home care/hospice experience, whether or not they have more total years of nursing experience (i.e., in other work environments). This study examined whether the protective effect of home care/hospice experience was greater for nurses who worked under three types of circumstances that are typical of the home care/hospice work environment and conducive to blood exposure. A mail survey was conducted in 2006 among home care/hospice nurses in North Carolina, a largely rural state in the southeastern U.S. The adjusted response rate was 69% (n=833). Blood exposure rates were higher among nurses with ≤5 years' experience in home care/hospice. Contrary to expectations, the protective effect of more experience was greater among nurses who did not have limited access to safety devices/personal protective equipment, did not have to rush during home visits, and did not often visit homes with unrestrained pets, unruly children, poor lighting, or extreme clutter. These results suggest that characteristics of the home care/hospice work environment limit nurses' ability to use their experience to prevent blood exposure.
Observations on burnout in family medicine and psychiatry residents.

PubMed

Woodside, Jack Richard; Miller, Merry Noel; Floyd, Michael R; McGowen, K Ramsey; Pfortmiller, Debi T

2008-01-01

To investigate the relationship between burnout, work environment, and a variety of personal variables, including age, gender, marital, parental and acculturation status within a population of family medicine and psychiatry resident physicians. Between 2002 and 2005, 155 residents in family medicine and psychiatry at East Tennessee State University College of Medicine were surveyed at intervals using the Maslach Burnout Inventory and Work Environment Scale, form R, to assess their current state of emotional health and job satisfaction. Female residents had lower scores on the Depersonalization scale of the Maslach Burnout Inventory (t=3.37, p=0.001). Parenting was associated with lower Depersonalization (t=3.98, p<0.001) and Emotional Exhaustion (t=2.59, p=0.011). Residents from the United States culture reported higher Depersonalization and Emotional Exhaustion (t=-3.64, p<0.001; t=-3.85, p<0.001). On the Work Environment Scale, residents from United States culture reported less Task Orientation and Control but higher Work Pressure (t=2.89, p=0.005; t=2.24, p=0.027; t=-2.79, p=0.006). Psychiatry residents reported less burnout than family medicine residents on the Depersonalization and Emotional Exhaustion scales (t=2.49, p=0.014: t=2.05, p=0.042) and higher Physical Comfort on the Work Environment Scale (t=-2.60, p=0.011); while family medicine residents reported higher Peer Cohesion, Supervisor Support, and Autonomy (t=3.41, p=0.001; t=2.38, p=0.019; t=2.27, p=0.025). This study design, using well established, standard, and valid measures, identified important issues for further exploration: the relationship between acculturation to burnout, the potential role of parenting as a protective factor from burnout, and the recognition that women residents may not be as vulnerable to burnout as previously reported.
Predicting emotional exhaustion among haemodialysis nurses: a structural equation model using Kanter's structural empowerment theory.

PubMed

Hayes, Bronwyn; Douglas, Clint; Bonner, Ann

2014-12-01

To test an explanatory model of the relationships between the nursing work environment, job satisfaction, job stress and emotional exhaustion for haemodialysis nurses, drawing on Kanter's theory of organizational empowerment. Understanding the organizational predictors of burnout (emotional exhaustion) in haemodialysis nurses is critical for staff retention and improving nurse and patient outcomes. Previous research has demonstrated high levels of emotional exhaustion among haemodialysis nurses, yet the relationships between nurses' work environment, job satisfaction, stress and emotional exhaustion in this population are poorly understood. A cross-sectional online survey. 417 nurses working in haemodialysis units completed an online survey between October 2011-April 2012 using validated measures of the work environment, job satisfaction, job stress and emotional exhaustion. Overall, the structural equation model demonstrated adequate fit and we found partial support for the hypothesized relationships. Nurses' work environment had a direct positive effect on job satisfaction, explaining 88% of the variance. Greater job satisfaction, in turn, predicted lower job stress, explaining 82% of the variance. Job satisfaction also had an indirect effect on emotional exhaustion by mitigating job stress. However, job satisfaction did not have a direct effect on emotional exhaustion. The work environment of haemodialysis nurses is pivotal to the development of job satisfaction. Nurses' job satisfaction also predicts their level of job stress and emotional exhaustion. Our findings suggest staff retention can be improved by creating empowering work environments that promote job satisfaction among haemodialysis nurses. © 2014 John Wiley & Sons Ltd.
Engaging life in two Irish nursing home units for people with dementia: quantitative comparisons before and after implementing household environments.

PubMed

Morgan-Brown, Mark; Newton, Rita; Ormerod, Marcus

2013-01-01

This study compares the Social Engagement and Interactive Occupation of residents with dementia in two Irish nursing homes, before and after conversion to a household model environment. The changes were an open plan design and a functioning unit kitchen, supported by a homemaker role and operational policies which reduced task-based work in favour of person-centred care offering choice. A snapshot observation method was used to obtain quantitative data of resident activity using the Assessment Tool for Occupation and Social Engagement (ATOSE). Residents were assessed for four hours, on seven different weekdays, over a six-week period both pre- and post-renovation. The exception to this was the assessment of the traditional model unit (TMU) for Nursing Home 1 which was reduced to four days due to the early start of the building work. The results were consistent for both nursing homes and data were aggregated. Residents spent more time in the communal living spaces and were more likely to be active and engaged in the household model units (HMUs) compared to the TMUs. Using the independent t-test, these changes were found to be highly significant (p < 0.001). Creating an HMU increased the Interactive Occupation and Social Engagement of residents in the communal areas of the two nursing homes. The physical environment change, in conjunction with supportive staff procedures and organizational initiatives, improved the well-being of residents with dementia. The outcomes must be viewed in context with financial implications.
Army Work Environment Questionnaire (WEQ) Manual

DTIC Science & Technology

1980-05-01

Paul J. Duff an DAHC l9-78-C-ý900 Glenda Y.lNogami rmy Researc -h-In~stitute)D W r_______-9V_-_( AREA A WORK UNIT NUMBEIRS McBer and Company...major stages are: 1. ScoutInF a. Identify potential users. b. Activ...y market services to gain awareness, interest, uses, and limitations of survey
Complexity and the Beginning Principal in the United States: Perspectives on Socialization

ERIC Educational Resources Information Center

Crow, Gary M.

2006-01-01

Purpose: This paper aims to contribute to the literature and practice on beginning principal socialization by identifying the features of post-industrial work that create a more complex work environment for the practice and learning of the principalship in the USA. Design/methodology/approach: Based on recent literature on the changing nature of…

A National Survey of Teaching Artists Working in Schools: Background, Preparation, Efficacy and School Experiences

ERIC Educational Resources Information Center

Snyder, Scott; Fisk, Timarie

2016-01-01

Several studies have described the characteristics and employment situations of teaching artists in the United States. This study adds to that literature by describing the characteristics of teaching artists working in K-12 school environments, the nature of the classroom roles of such teaching artists, the professional development and supervision…
Facing the Long War: Factors that Lead Soldiers to Stay in the Army during Persistent Conflict

DTIC Science & Technology

2011-05-19

increases productivity, job satisfaction , and organizational commitments, all of which buffer the negative effects of work - life conflicts. Moreover...The predicted relationship with family-friendly work environment as a moderator between work - life conflict and outcome measures. Family Friendly...Command and General Staff College, the United States Army, the Department of Defense, or any other US government agency. Cleared for public release
Effects of Unit Design on Acute Care Nurses' Walking Distances, Energy Expenditure, and Job Satisfaction: A Pre-Post Relocation Study.

PubMed

Copeland, Darcy; Chambers, Misty

2017-07-01

The purpose of this study was to determine what differences occurred in steps taken and energy expenditure among acute care nurses when their work environment moved from a hospital with centralized nurses' stations to a hospital with decentralized nurses' stations. Additional goals were to determine design features nurses perceived as contributing to or deterring from their work activities and what changes occurred in reported job satisfaction. Since design features can also affect patient outcomes, patient falls were monitored. The construction of a replacement facility for a 224-bed Level 1 trauma center provided the opportunity to compare the effects of centralized versus decentralized nurses' stations on nurses' experiences of their work environments. A pre-post quasi-experimental design was used. RN participants completed an open-ended questionnaire and recorded pedometer data at the end of each shift, working for 3-month pre-relocation and for 3-month post-relocation. Nine months passed between the move and post-relocation data collection. There were significant reductions in nurses' energy expenditure ( p < .001) and steps taken ( p = .041) post-relocation. Overall, nurses' job satisfaction was high and improved post-relocation, and patient falls decreased by 55%. Post-relocation, a number of the dissatisfiers associated with the physical environment were eliminated, and nurses identified more satisfiers (in general and related to the physical environment). Patients are safer post-relocation as indicated by a decrease in falls. This decrease is even more noteworthy when considering that the numbers of patient beds on each unit is higher post-relocation.
A bill to designate the United States courthouse located at 101 East Pecan Street in Sherman, Texas, as the Paul Brown United States Courthouse.

THOMAS, 113th Congress

Sen. Cruz, Ted [R-TX

2013-10-29

Senate - 10/29/2013 Read twice and referred to the Committee on Environment and Public Works. (All Actions) Notes: For further action, see H.R.185, which became Public Law 113-58 on 12/20/2013. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Assessing and developing critical-thinking skills in the intensive care unit.

PubMed

Swinny, Betsy

2010-01-01

A lot of resources are spent on the development of new staff in the intensive care unit (ICU). These resources are necessary because the environment in the ICU is complex and the patients are critically ill. Nurses need an advanced knowledge base, the ability to accurately define and change priorities rapidly, good communication and teamwork skills, and the ability to work in a stressful environment in order to succeed and give their patients quality care. Critical thinking helps the nurse to navigate the complex and stressful environment of the ICU. Critical thinking includes more than just nursing knowledge. It includes the ability to think through complex, multifaceted problems to anticipate needs, recognize potential and actual complications, and to expertly communicate with the team. A nurse who is able to think critically will give better patient care. Various strategies can be used to develop critical thinking in ICU nurses. Nurse leaders are encouraged to support the development of critical-thinking skills in less experienced staff with the goal of improving the nurse's ability to work in the ICU and improving patient outcomes.
How Nurse Work Environments Relate to the Presence of Parents in Neonatal Intensive Care.

PubMed

Hallowell, Sunny G; Rogowski, Jeannette A; Lake, Eileen T

2017-09-25

Parental presence in the neonatal intensive care unit (NICU) is essential for families to participate in infant care and prepare them to transition from hospital to home. Nurses are the principal caregivers in the NICU. The nurse work environment may influence whether parents spend time with their hospitalized infants. To examine the relationship between the NICU work environment and parental presence in the NICU using a national data set. We conducted a cross-sectional, observational study of a national sample of 104 NICUs, where 6060 nurses reported on 15,233 infants cared for. Secondary analysis was used to examine associations between the Practice Environment Scale of the Nursing Work Index (PES-NWI) (subscale items and with a composite measure) and the proportion of parents who were present during the nurses' shift. Parents of 60% (SD = 9.7%) of infants were present during the nurses' shift. The PES-NWI composite score and 2 domains-Nurse Participation in Hospital Affairs and Manager Leadership and Support-were significant predictors of parental presence. A 1 SD higher score in the composite or either subscale was associated with 2.5% more parents being present. Parental presence in the NICU is significantly associated with better nurse work environments. NICU practices may be enhanced through enhanced leadership and professional opportunities for nurse managers and staff. Future work may benefit from qualitative work with parents to illuminate their experiences with nursing leaders and nurse-led interventions in the NICU and design and testing of interventions to improve the NICU work environment.
Understanding work contextual factors: a short-cut to evidence-based practice?

PubMed

Wallin, Lars; Ewald, Uwe; Wikblad, Karin; Scott-Findlay, Shannon; Arnetz, Bengt B

2006-01-01

It has become increasingly clear that workplace contextual factors make an important contribution to provider and patient outcomes. The potential for health care professionals of using research in practice is also linked to such factors, although the exact factors or mechanisms for enhancing this potential are not understood. From a perspective of implementing evidence-based nursing practice, the authors of this article report on a study examining contextual factors. The objective of this study was to identify predictors of organizational improvement by measuring staff perceptions of work contextual factors. The Quality Work Competence questionnaire was used in a repeated measurement survey with a 1-year break between the two periods of data collection. The sample consisted of 134 employees from four neonatal units in Sweden. Over the study period significant changes occurred among staff perceptions, both within and between units, on various factors. Changes in staff perceptions on skills development and participatory management were the major predictors of enhanced potential of overall organizational improvement. Perceived improvement in skills development and performance feedback predicted improvement in leadership. Change in commitment was predicted by perceived decreases in work tempo and work-related exhaustion. These findings indicate the potential for organizational improvement by developing a learning and supportive professional environment as well as by involving staff in decision-making at the unit level. Such initiatives are also likely to be of importance for enhanced use of research in practice and evidence-based nursing. On the other hand, high levels of work tempo and burnout appear to have negative consequences on staff commitment for improving care and the work environment. A better understanding of workplace contextual factors is necessary for improving the organizational potential of getting research into practice and should be considered in future implementation projects.
USEPA Environmental Quality Index (EQI) and Associated Domain Indices by County for the United States

EPA Pesticide Factsheets

The US Environmental Protection Agency's (EPA) National Health and Environmental Effects Research Laboratory (NHEERL) in the Environmental Public Health Division (EPHD) is currently engaged in research aimed at developing a measure that estimates overall environmental quality at the county level for the United States. This work is being conducted as an effort to learn more about how various environmental factors simultaneously contribute to health disparities in low-income and minority populations, and to better estimate the total environmental and social context to which humans are exposed. This dataset contains the finalized Environmental Quality Index (EQI), and an index for each of the associated domains (air, water, land, built environment, and sociodemographic environment). Indices are at the county level for all counties in the United States.
A Critical Study on the Underground Environment of Coal Mines in India-an Ergonomic Approach

NASA Astrophysics Data System (ADS)

Dey, Netai Chandra; Sharma, Gourab Dhara

2013-04-01

Ergonomics application on underground miner's health plays a great role in controlling the efficiency of miners. The job stress in underground mine is still physically demanding and continuous stress due to certain posture or movement of miners during work leads to localized muscle fatigue creating musculo-skeletal disorders. A good working environment can change the degree of job heaviness and thermal stress (WBGT values) can directly have the effect on stretch of work of miners. Out of many unit operations in underground mine, roof bolting keeps an important contribution with regard to safety of the mine and miners. Occupational stress of roof bolters from ergonomic consideration has been discussed in the paper.
The development and piloting of electronic standardized measures on nursing work: combining engineering and nursing knowledge.

PubMed

Bragadóttir, Helga; Gunnarsdóttir, Sigrún; Ingason, Helgi T

2013-05-01

This paper describes the development and piloting of electronic standardized measures on nursing work (e-SMNW) for rich data gathering on the work and work environment of registered nurses (RNs) and practical nurses (PNs). Efficient and valid methods are needed to measure nursing work to enhance the optimal use of the nursing workforce for safe patient care. The study combined human factors engineering (HFE) and nursing knowledge to develop electronic standardized measures for observational studies on nursing work in acute care. The work and work environment of RNs and PNs in acute care medical and surgical inpatient units was successfully measured using e-SMNW. With predetermined items of work activities and influencing factors in the work of nurses, and full use of computer technology, multi-layered rich standardized data were gathered, analysed and displayed. The combination of nursing knowledge, HFE and computer technology enables observational data collection for a rich picture of the complex work of nursing. Information collected by standardized and multi-layered measures makes it easier to identify potential improvements, with regard to influencing factors and management of the work and work environment of nurses. Further use of computer technology in health services research is encouraged. © 2012 Blackwell Publishing Ltd.
Nursing unit managers, staff retention and the work environment.

PubMed

Duffield, Christine M; Roche, Michael A; Blay, Nicole; Stasa, Helen

2011-01-01

This paper examined the impact of leadership characteristics of nursing unit managers, as perceived by staff nurses, on staff satisfaction and retention. A positive work environment will increase levels of job satisfaction and staff retention. Nurse leaders play a critical role in creating a positive work environment. Important leadership characteristics of the front-line nurse manager include visibility, accessibility, consultation, recognition and support. Secondary analysis of data collected on 94 randomly selected wards in 21 public hospitals across two Australian states between 2004-2006. All nurses (n = 2488, 80·3% response rate) on the selected wards were asked to complete a survey that included the 49-item Nursing Work Index-Revised [NWI-R] together with measures of job satisfaction, satisfaction with nursing and intention to leave. Subscales of the NWI-R were calculated. Leadership, the domain of interest, consisted of 12 items. Wards were divided into those reporting either positive or negative leadership. Data were analysed at the nurse level using spss version 16. A nursing manager who was perceived to be a good leader, was visible, consulted with staff, provided praise and recognition and where flexible work schedules were available was found to distinguish the positive and negative wards. However, for a ward to be rated as positive overall, nurse leaders need to perform well on all the leadership items. An effective nursing unit manager who consults with staff and provides positive feedback and who is rated highly on a broad range of leadership items is instrumental in increasing job satisfaction and satisfaction with nursing. Good nurse managers play an important role in staff retention and satisfaction. Improved retention will lead to savings for the organisation, which may be allocated to activities such as training and mentorship to assist nurse leaders in developing these critical leadership skills. Strategies also need to be put in place to ensure that nurse leaders receive adequate organisational support from nursing executives. © 2010 Blackwell Publishing Ltd.
Nursing practice environment, job outcomes and safety climate: a structural equation modelling analysis.

PubMed

Dos Santos Alves, Daniela Fernanda; da Silva, Dirceu; de Brito Guirardello, Edinêis

2017-01-01

To assess correlations between the characteristics of the nursing practice environment, job outcomes and safety climate. The nursing practice environment is critical to the well-being of professionals and to patient safety, as highlighted by national and international studies; however, there is a lack of evidence regarding this theme in paediatric units. A cross-sectional study, in two paediatric hospitals in Brazil, was conducted from December 2013 to February 2014. For data collection, we used the Nursing Work Index - Revised, Safety Attitudes Questionnaire - Short Form 2006 and the Maslach Burnout Inventory, and for analysis Spearman's correlation coefficient and structural equation modelling were used. Two hundred and sixty-seven professional nurses participated in the study. Autonomy, control over the work environment and the relationship between nursing and medical staff are factors associated with job outcomes and safety climate and can be considered their predictors. Professional nurses with greater autonomy, good working relationships and control over their work environment have lower levels of emotional exhaustion, higher job satisfaction, less intention of leaving the job and the safety climate is positive. Initiatives to improve the professional practice environment can improve the safety of paediatric patients and the well-being of professional nurses. © 2016 John Wiley & Sons Ltd.
Lighting and Nurses at Medical-Surgical Units: Impact of Lighting Conditions on Nurses' Performance and Satisfaction.

PubMed

Hadi, Khatereh; DuBose, Jennifer R; Ryherd, Erica

2016-04-01

This study investigates the perception of nurses about their lighting environment at medical-surgical hospital units in order to understand areas of improvement for lighting at these units. The bulk of the research about nurses and lighting is focused on nighttime nursing, exploring the disruptions of nurses' circadian rhythm and maintaining alertness. The understanding of nurses' perception about lighting and its impact on nurses' task performance and patient examination remains imprecise. This study used an online survey to ask a set of questions about lighting in medical-surgical units at five key locations including centralized nurse stations, decentralized nurse stations (DCNS), patient bedsides, patient bathrooms, and corridors from 393 survey participants. It then explored the survey findings in more depth through conducting focus groups with eight volunteer nurses. Lighting conditions at patient besides and DCNSs were significantly less desirable for nurses compared to other locations. A significant relationship between nurses' access to lighting controls (switches and dimmers) and satisfaction about the lighting environment was found. No significant relationship was observed between the individual characteristics of nurses (such as age, years of experience, etc.) and findings of this study. Thoughtful design of the lighting environment can improve nurses' satisfaction and perception about their working environment. © The Author(s) 2015.
All-Optical Cantilever-Enhanced Photoacoustic Spectroscopy in the Open Environment

NASA Astrophysics Data System (ADS)

Wei, Wei; Zhu, Yong; Lin, Cheng; Tian, Li; Xu, Zhuwen; Nong, Jinpeng

2015-06-01

A novel all-optical cantilever-enhanced photoacoustic spectroscopy technique for trace gas detection in the open environment is proposed. A cantilever is set off-beam to "listen to" the photoacoustic signal, and an improved quadrature-point stabilization Fabry-Perot demodulation unit is used to pick up the vibration signal of the acoustic transducer instead of a complicated Michelson interferometer. The structure parameters of the cantilever are optimized to make the sensing system work more stably and reliably using a finite element method, which is then fabricated by surface micro-machining technology. Finally, related experiments are carried out to detect the absorption of water vapor at one atmosphere in the open environment. It was found that the normalized noise-equivalent absorption coefficient obtained by a traditional Fabry-Perot demodulation unit is , while that by a quadrature- point stabilization Fabry-Perot demodulation unit is , which indicates that the sensitivity is increased by a factor of 3.1 using improved cantilever-enhanced photoacoustic spectroscopy.
The Impact of Automation Reliability and Operator Fatigue on Performance and Reliance

DTIC Science & Technology

2016-09-23

Matthews1 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER H0HJ (53290813) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8... performance . Reliability Reliability of automation is a key factor in an operator’s reliance on automation. Previous work has shown that... Performance in a complex multiple-task environment during a laboratory-based simulation of occasional night work . Human Factors: The Journal of the
Post-photorefractive keratectomy contact lens microbiological findings of individuals who work in a hospital environment.

PubMed

Pereira, Carlos Eduardo Gonçalves; Hida, Richard Yudi; Silva, Cely Barreto; de Andrade, Marizilda Rita; Fioravanti-Lui, Giovana Arlene; Lui-Netto, Adamo

2015-05-01

To describe the microbiological findings from bandage contact lenses in patients who work in a hospital environment submitted to photorefractive keratectomy (PRK). This prospective comparative case series enrolled 43 eyes of 22 volunteers (28.05 ± 3.50 years). Fourteen individuals (n = 27) were health care professionals who work in health care facilities or community physician's offices. Eight individuals (n = 16) were patients who do not work in hospital environment. Photorefractive keratectomy was performed using standard technique, and a silicone hydrogel bandage contact lens was placed on the cornea and evaluated for adequate fit. Seven days after surgery, the bandage lenses were removed and imprinted in the following culture media: blood agar, chocolate agar, anaerobic-selective agar, and Sabouraud agar. When microbial growth was detected, the microorganism was identified, colony-forming units were quantified, and morphology and Gram-staining properties were analyzed. All isolates were tested for susceptibility to various antibiotics. Significance was assessed by Fisher exact test. Microbial growth was detected in 16.27% of all contact lenses samples. No fungi or anaerobes were found. Microbial growth was only observed in bandage lenses removed from patients who work in hospital environments. Most microorganisms found were sensitive to all antibiotics tested. These results suggest that working in hospital environments increase contamination of the contact lenses after PRK.
Professional nursing practice in critical units: assessment of work environment characteristics.

PubMed

Maurício, Luiz Felipe Sales; Okuno, Meiry Fernanda Pinto; Campanharo, Cássia Regina Vancini; Lopes, Maria Carolina Barbosa Teixeira; Belasco, Angélica Gonçalves Silva; Batista, Ruth Ester Assayag

2017-03-02

assess the autonomy, control over environment, and organizational support of nurses' work process and the relationships between physicians and nurses in critical care units. cross-sectional study conducted with 162 nurses working in the intensive care units and emergency service of a university hospital. The workers' satisfaction with their work environment was assessed using Brazilian Nursing Work Index - Revised, translated and adapted for the Brazilian culture. average age was 31.6 ± 3.9 years; 80.2% were women; 68.5% Caucasians and 71.6% worked in intensive care units. The nurses considered autonomy (2.38 ± 0.64) and their relationship with physicians (2.24 ± 0.62) to be characteristics of the work environment that favored professional practice. Control over environment (2.78 ± 0.62) and organizational support (2.51 ± 0.54), however, were considered to be unfavorable. No statistically significant differences were found between the units based on the scores obtained by the professionals on the Brazilian Nursing Work Index - Revised. autonomy, relationship between physicians and nurses, and organizational support were considered by the units to be characteristics that favored nurses' professional practices. On the other hand, control over environment and organizational support were considered unfavorable. evaluar la autonomía, el control sobre el ambiente, el soporte organizacional del proceso de trabajo de los enfermeros y las relaciones entre médicos y enfermeros, en unidades críticas. estudio transversal realizado en 162 enfermeros de las unidades de terapia intensiva y del servicio de emergencia de un hospital universitario. La evaluación de la satisfacción del profesional con el ambiente de trabajo fue realizada utilizando el Brazilian Nursing Work Index - Revised, traducido y adaptado para la cultura brasileña. el promedio de edad fue 31,6 ± 3,9 años, 80,2% eran mujeres, 68,5% blancos y 71,6% trabajaban en la unidad de terapia intensiva. Los enfermeros consideraron que la autonomía (2,38 ± 0,64) y la relación médico y enfermero (2,24 ± 0,62) fueron las características del ambiente de trabajo favorables a la práctica profesional. Entretanto, consideraron como desfavorables el control del ambiente (2,78 ± 0,62) y el soporte organizacional (2,51 ± 0,54). No hubo diferencia estadísticamente significativa en el Brazilian Nursing Work Index - Revised entre la evaluación de los profesionales de las unidades evaluadas. en las unidades evaluadas, la autonomía, la relación médico y enfermero y el soporte organizacional fueron las características que favorecieron la práctica profesional del enfermero. En contrapartida, el control del ambiente y el soporte organizacional fueron relatados como desfavorables. avaliar a autonomia, o controle sobre o ambiente, o suporte organizacional do processo de trabalho dos enfermeiros e as relações entre médicos e enfermeiros em unidades críticas. estudo transversal realizado com 162 enfermeiros das unidades de terapia intensiva e do serviço de emergência de um hospital universitário. A avaliação da satisfação do profissional com o ambiente de trabalho foi realizada por meio do Brazilian Nursing Work Index - Revised, traduzido e adaptado para a cultura brasileira. a média de idade foi 31,6 ± 3,9 anos, 80,2% mulheres, 68,5% brancos e 71,6% trabalhavam em unidade de terapia intensiva. Os enfermeiros consideraram que autonomia (2,38 ± 0,64) e relação médico e enfermeiro (2,24 ± 0,62) foram características do ambiente de trabalho favoráveis à prática profissional. Entretanto, consideraram como desfavoráveis o controle do ambiente (2,78 ± 0,62) e o suporte organizacional (2,51 ± 0,54). Não houve diferença estatisticamente significativa no Brazilian Nursing Work Index - Revised entre a avaliação dos profissionais das Unidades avaliadas. nas unidades avaliadas, a autonomia, relação médico e enfermeiro e o suporte organizacional foram características que favoreceram a prática profissional do enfermeiro. Em contrapartida, o controle do ambiente e o suporte organizacional foram relatados como desfavoráveis.
How Attending Physician Preceptors Negotiate Their Complex Work Environment: A Collective Ethnography.

PubMed

Lemaire, Jane B; Wallace, Jean E; Sargious, Peter M; Bacchus, Maria; Zarnke, Kelly; Ward, David R; Ghali, William A

2017-12-01

To generate an empiric, detailed, and updated view of the attending physician preceptor role and its interface with the complex work environment. In 2013, the authors conducted a modified collective ethnography with observations of internal medicine medical teaching unit preceptors from two university hospitals in Canada. Eleven observers conducted 32 observations (99.5 hours) of 26 preceptors (30 observations [93.5 hours] of 24 preceptors were included in the analysis). An inductive thematic approach was used to analyze the data with further axial coding to identify connections between themes. Four individuals coded the main data set; differences were addressed through discussion to achieve consensus. Three elements or major themes of the preceptor role were identified: (1) competence or the execution of traditional physician competencies, (2) context or the extended medical teaching unit environment, and (3) conduct or the manner of acting or behaviors and attitudes in the role. Multiple connections between the elements emerged. The preceptor role appeared to depend on the execution of professional skills (competence) but also was vulnerable to contextual factors (context) independent of these skills, many of which were unpredictable. This vulnerability appeared to be tempered by preceptors' use of adaptive behaviors and attitudes (conduct), such as creativity, interpersonal skills, and wellness behaviors. Preceptors not only possess traditional competencies but also enlist additional behaviors and attitudes to deal with context-driven tensions and to negotiate their complex work environment. These skills could be incorporated into role training, orientation, and mentorship.
Engaging Direct Care Providers in Improving Infection Prevention and Control Practices Using Participatory Visual Methods.

PubMed

Backman, Chantal; Bruce, Natalie; Marck, Patricia; Vanderloo, Saskia

2016-01-01

The purpose of this quality improvement project was to determine the feasibility of using provider-led participatory visual methods to scrutinize 4 hospital units' infection prevention and control practices. Methods included provider-led photo walkabouts, photo elicitation sessions, and postimprovement photo walkabouts. Nurses readily engaged in using the methods to examine and improve their units' practices and reorganize their work environment.
Seeking Connectivity in Nurses' Work Environments: Advancing Nurse Empowerment Theory.

PubMed

Udod, Sonia

2014-09-01

The purpose of this study was to investigate how staff nurses and their managers exercise power in a hospital setting in order to better understand what fosters or constrains staff nurses' empowerment and to extend nurse empowerment theory. Power is integral to empowerment, and attention to the challenges in nurses' work environment and nurse outcomes by administrators, researchers, and policy-makers has created an imperative to advance a theoretical understanding of power in the nurse-manager relationship. A sample of 26 staff nurses on 3 units of a tertiary hospital in western Canada were observed and interviewed about how the manager affected their ability to do their work. Grounded theory methodology was used. The process of seeking connectivity was the basic social process, indicating that the manager plays a critical role in the work environment and nurses need the manager to share power with them in the provision of safe, quality patient care. Copyright© by Ingram School of Nursing, McGill University.

Ergonomics and nursing in hospital environments.

PubMed

Rogers, Bonnie; Buckheit, Kathleen; Ostendorf, Judith

2013-10-01

This study describes workplace conditions, the environment, and activities that may contribute to musculoskeletal injuries among nurses, as well as identifies solutions to decrease these risks and improve work-related conditions. The study used a mixed-methods design. Participants included nurses and stakeholders from five hospitals. Several focus groups were held with nurses, walk-throughs of clinical units were conducted, and stakeholder interviews with key occupational health and safety personnel were conducted in each of the five hospitals, as well as with representatives from the American Nurses Association, Veterans Health Administration hospital, and National Institute for Occupational Safety and Health. Several key contributing factors, including the physical environment (e.g., layout and organization of work stations), work organization and culture (e.g., heavy workload, inadequate staffing, lack of education), and work activities (e.g., manual lifting of patients, lack of assistive devices), were identified. Recommendations included the need for a multifaceted and comprehensive approach to developing a sound ergonomics program. Copyright 2013, SLACK Incorporated.
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.
The quality of work life of registered nurses in Canada and the United States: a comprehensive literature review

PubMed Central

2016-01-01

Background Workplace environment is related to the physical and psychological well-being, and quality of work life (QWL) for nurses. Objective The aim of this paper was to perform a comprehensive literature review on nurses’ quality of work life to identify a comprehensive set of QWL predictors for nurses employed in the United States and Canada. Methods Using publications from 2004–2014, contributing factors to American and Canadian nurses’ QWL were analyzed. The review was structured using the Work Disability Prevention Framework. Sixty-six articles were selected for analysis. Results Literature indicated that changes are required within the workplace and across the health care system to improve nurses' QWL. Areas for improvement to nurses’ quality of work life included treatment of new nursing graduates, opportunities for continuing education, promotion of positive collegial relationships, stress-reduction programs, and increased financial compensation. Conclusions This review’s findings support the importance of QWL as an indicator of nurses’ broader work-related experiences. A shift in health care systems across Canada and the United States is warranted where health care delivery and services are improved in conjunction with the health of the nurses working in the system. PMID:27734769
The quality of work life of registered nurses in Canada and the United States: a comprehensive literature review.

PubMed

Nowrouzi, Behdin; Giddens, Emilia; Gohar, Basem; Schoenenberger, Sandrine; Bautista, Mary Christine; Casole, Jennifer

2016-10-01

Workplace environment is related to the physical and psychological well-being, and quality of work life (QWL) for nurses. The aim of this paper was to perform a comprehensive literature review on nurses' quality of work life to identify a comprehensive set of QWL predictors for nurses employed in the United States and Canada. Using publications from 2004-2014, contributing factors to American and Canadian nurses' QWL were analyzed. The review was structured using the Work Disability Prevention Framework. Sixty-six articles were selected for analysis. Literature indicated that changes are required within the workplace and across the health care system to improve nurses' QWL. Areas for improvement to nurses' quality of work life included treatment of new nursing graduates, opportunities for continuing education, promotion of positive collegial relationships, stress-reduction programs, and increased financial compensation. This review's findings support the importance of QWL as an indicator of nurses' broader work-related experiences. A shift in health care systems across Canada and the United States is warranted where health care delivery and services are improved in conjunction with the health of the nurses working in the system.
Work engagement supports nurse workforce stability and quality of care: nursing team-level analysis in psychiatric hospitals.

PubMed

Van Bogaert, P; Wouters, K; Willems, R; Mondelaers, M; Clarke, S

2013-10-01

Research in healthcare settings reveals important links between work environment factors, burnout and organizational outcomes. Recently, research focuses on work engagement, the opposite (positive) pole from burnout. The current study investigated the relationship of nurse practice environment aspects and work engagement (vigour, dedication and absorption) to job outcomes and nurse-reported quality of care variables within teams using a multilevel design in psychiatric inpatient settings. Validated survey instruments were used in a cross-sectional design. Team-level analyses were performed with staff members (n = 357) from 32 clinical units in two psychiatric hospitals in Belgium. Favourable nurse practice environment aspects were associated with work engagement dimensions, and in turn work engagement was associated with job satisfaction, intention to stay in the profession and favourable nurse-reported quality of care variables. The strongest multivariate models suggested that dedication predicted positive job outcomes whereas nurse management predicted perceptions of quality of care. In addition, reports of quality of care by the interdisciplinary team were predicted by dedication, absorption, nurse-physician relations and nurse management. The study findings suggest that differences in vigour, dedication and absorption across teams associated with practice environment characteristics impact nurse job satisfaction, intention to stay and perceptions of quality of care. © 2012 John Wiley & Sons Ltd.
Impacts of volcanic gases on climate, the environment, and people

USGS Publications Warehouse

McGee, Kenneth A.; Doukas, Michael P.; Kessler, Richard; Gerlach, Terrence M.

1997-01-01

Gases from volcanoes give rise to numerous impacts on climate, the environment, and people. U.S. Geological Survey (USGS) scientists are inventorying gas emissions at many of the almost 70 active volcanoes in the United States. This effort helps build a better understanding of the dynamic processes at work on the Earth's surface and is contributing important new information on how volcanic emissions affect global change.
Burnout in Nurses Working With Youth With Chronic Pain: A Mixed-Methods Analysis.

PubMed

Rodrigues, Nikita P; Cohen, Lindsey L; Swartout, Kevin M; Trotochaud, Karen; Murray, Eileen

2018-05-01

Nursing is a rewarding but also challenging profession. Nurses are at risk for burnout and premature exit from the profession, which is detrimental to them, their patients, and the healthcare system. There are few studies examining the unique correlates of burnout in nurses working with pediatric populations. The current 2-study project used mixed-methods (qualitative and then quantitative) analysis to explore burnout in nurses working in an inpatient unit with youth with chronic pain. Study I participants included all of the 32 nurses who worked in an inpatient pediatric unit, which admits patients with chronic pain. Qualitative analyses of focus groups were used to extract themes. These themes were examined via a quantitative battery completed by 41 nurses from 2 inpatient pediatric units with youth with chronic pain. The themes were burnout, moral distress, negative beliefs about chronic pain, barriers to pain management, fear of losing compassion, coworker support as a coping method, time worked in the unit, professional self-efficacy, and negative views of the hospital environment. Quantitative results supported most of the qualitative findings, and taken together, the findings supported a model of burnout in nurses working with youth with chronic pain. Conclusions We integrated qualitative and quantitative findings to develop a model of nurse burnout. This model provides a framework for evaluating and targeting burnout in nurses working with pediatric patients with chronic pain.
Cognitive work analysis to evaluate the problem of patient falls in an inpatient setting

PubMed Central

Lopez, Karen Dunn; Cary, Michael P; Kanak, Mary F

2010-01-01

Objective To identify factors in the nursing work domain that contribute to the problem of inpatient falls, aside from patient risk, using cognitive work analysis. Design A mix of qualitative and quantitative methods were used to identify work constraints imposed on nurses, which may underlie patient falls. Measurements Data collection was done on a neurology unit staffed by 27 registered nurses and utilized field observations, focus groups, time–motion studies and written surveys (AHRQ Hospital Survey on Patient Culture, NASA-TLX, and custom Nursing Knowledge of Fall Prevention Subscale). Results Four major constraints were identified that inhibit nurses' ability to prevent patient falls. All constraints relate to work processes and the physical work environment, opposed to safety culture or nursing knowledge, as currently emphasized. The constraints were: cognitive ‘head data’, temporal workload, inconsistencies in written and verbal transfer of patient data, and limitations in the physical environment. To deal with these constraints, the nurses tend to employ four workarounds: written and mental chunking schemas, bed alarms, informal querying of the previous care nurse, and informal video and audio surveillance. These workarounds reflect systemic design flaws and may only be minimally effective in decreasing risk to patients. Conclusion Cognitive engineering techniques helped identify seemingly hidden constraints in the work domain that impact the problem of patient falls. System redesign strategies aimed at improving work processes and environmental limitations hold promise for decreasing the incidence of falls in inpatient nursing units. PMID:20442150
Cognitive work analysis to evaluate the problem of patient falls in an inpatient setting.

PubMed

Lopez, Karen Dunn; Gerling, Gregory J; Cary, Michael P; Kanak, Mary F

2010-01-01

To identify factors in the nursing work domain that contribute to the problem of inpatient falls, aside from patient risk, using cognitive work analysis. A mix of qualitative and quantitative methods were used to identify work constraints imposed on nurses, which may underlie patient falls. Data collection was done on a neurology unit staffed by 27 registered nurses and utilized field observations, focus groups, time-motion studies and written surveys (AHRQ Hospital Survey on Patient Culture, NASA-TLX, and custom Nursing Knowledge of Fall Prevention Subscale). Four major constraints were identified that inhibit nurses' ability to prevent patient falls. All constraints relate to work processes and the physical work environment, opposed to safety culture or nursing knowledge, as currently emphasized. The constraints were: cognitive 'head data', temporal workload, inconsistencies in written and verbal transfer of patient data, and limitations in the physical environment. To deal with these constraints, the nurses tend to employ four workarounds: written and mental chunking schemas, bed alarms, informal querying of the previous care nurse, and informal video and audio surveillance. These workarounds reflect systemic design flaws and may only be minimally effective in decreasing risk to patients. Cognitive engineering techniques helped identify seemingly hidden constraints in the work domain that impact the problem of patient falls. System redesign strategies aimed at improving work processes and environmental limitations hold promise for decreasing the incidence of falls in inpatient nursing units.
Does Finnish hospital staff job satisfaction vary across occupational groups?

PubMed

Kvist, Tarja; Mäntynen, Raija; Vehviläinen-Julkunen, Katri

2013-10-02

Job satisfaction of staff is an essential outcome variable in research when describing the work environment of successful hospitals. Numerous studies have evaluated the topic, but few previous studies have assessed the job satisfaction of all staff in hospital settings. It is important to discover if there are any unsatisfied groups of people working in hospitals, the aspects they are unsatisfied with and why. The aim of this study was to evaluate job satisfaction of all staff working at a Finnish university hospital, identify differences in job satisfaction between staff groups, and explore the relationship between their self-evaluated quality of work and job satisfaction. Data were collected from 1424 employees of the hospital using the web-based Kuopio University Job Satisfaction Scale survey instrument in autumn 2010. The research data were analysed by using SPSS 19.0 for Windows. Frequency and percentage distributions, as well as mean values, were used to describe the data. A non-parametric test (Kruskal-Wallis test) was used to determine the significance of differences in scores between different groups of staff members and between quality evaluations. The overall job satisfaction of the employees was good. They rated both motivating factors of their work and work welfare as excellent. The areas causing most dissatisfaction were work demands and participation in decision making. Physicians formed the most satisfied group, nurses and maintenance staff were the least satisfied, and office and administrative staff were fairly satisfied. Staff who rated the quality of work in their units as high usually also considered their job satisfaction to be excellent. Every staff member has an influence on job satisfaction in her/his unit. A culture of participation should be developed and maintained in the units and the whole hospital to ensure that all staff feel they play important roles in the hospital. A university hospital is a complex, continuously changing work environment. Managers of the hospital should continuously evaluate job satisfaction and quickly react to the results gained.
A Systematic Examination of Food Intake and Adaptation to the Food Environment by Refugees Settled in the United States1234

PubMed Central

Wang, Youfa; Min, Jungwon; Harris, Kisa; Khuri, Jacob; Anderson, Laura M

2016-01-01

The United States is the largest refugee resettlement country in the world. Refugees may face health-related challenges after resettlement in the United States, including higher rates of chronic diseases due to problems such as language barriers and difficulty adapting to new food environments. However, reported refugee diet challenges varied, and no systematic examination has been reported. This study examined refugee food intake pre- and postresettlement in the United States and differences in intake across various refugee groups. We systematically reviewed relevant studies that reported on refugee food intake and adaptation to the US food environment. We searched PubMed for literature published between January 1985 and April 2015, including cross-sectional and prospective studies. Eighteen studies met inclusion criteria. Limited research has been conducted, and most studies were based on small convenience samples. In general, refugees increased meat and egg consumption after resettling in the United States. Changes in refugee intake of vegetables, fruits, and dairy products varied by socioeconomic status, food insecurity, past food deprivation experience, length of stay in the United States, region of origin, and age. South Asians were more likely to maintain traditional diets, and increased age was associated with more conservative and traditional diets. Despite the abundance of food in the United States, postresettlement refugees reported difficulty in finding familiar or healthy foods. More research with larger samples and follow-up data are needed to study how refugees adapt to the US food environment and what factors may influence their food- and health-related outcomes. The work could inform future interventions to promote healthy eating and living among refugees and help to reduce health disparities. PMID:28140324
A Systematic Examination of Food Intake and Adaptation to the Food Environment by Refugees Settled in the United States.

PubMed

Wang, Youfa; Min, Jungwon; Harris, Kisa; Khuri, Jacob; Anderson, Laura M

2016-11-01

The United States is the largest refugee resettlement country in the world. Refugees may face health-related challenges after resettlement in the United States, including higher rates of chronic diseases due to problems such as language barriers and difficulty adapting to new food environments. However, reported refugee diet challenges varied, and no systematic examination has been reported. This study examined refugee food intake pre- and postresettlement in the United States and differences in intake across various refugee groups. We systematically reviewed relevant studies that reported on refugee food intake and adaptation to the US food environment. We searched PubMed for literature published between January 1985 and April 2015, including cross-sectional and prospective studies. Eighteen studies met inclusion criteria. Limited research has been conducted, and most studies were based on small convenience samples. In general, refugees increased meat and egg consumption after resettling in the United States. Changes in refugee intake of vegetables, fruits, and dairy products varied by socioeconomic status, food insecurity, past food deprivation experience, length of stay in the United States, region of origin, and age. South Asians were more likely to maintain traditional diets, and increased age was associated with more conservative and traditional diets. Despite the abundance of food in the United States, postresettlement refugees reported difficulty in finding familiar or healthy foods. More research with larger samples and follow-up data are needed to study how refugees adapt to the US food environment and what factors may influence their food- and health-related outcomes. The work could inform future interventions to promote healthy eating and living among refugees and help to reduce health disparities. © 2016 American Society for Nutrition.
Contributing influences of work environment on sleep quantity and quality of nursing assistants in long-term care facilities: A cross-sectional study

PubMed Central

Zhang, Yuan; Punnett, Laura; McEnany, Geoffry Phillips; Gore, Rebecca

2018-01-01

The effect of shift work on nurses’ sleep is well-studied, but there are other challenging aspects of health care work that might also affect the sleep of direct caregivers. This study examined the influence of the long-term care work environment on sleep quantity and quality of nursing assistants. A cross-sectional survey collected data from 650 nursing assistants in 15 long-term care facilities; 46% reported short sleep duration and 23% reported poor sleep quality. A simple additive index of the number of beneficial work features (up to 7) was constructed for analysis with Poisson regression. With each unit increase of beneficial work features, nursing assistants were 7% less likely to report short sleep duration and 17% less likely to report poor sleep quality. These results suggest that effective workplace interventions should address a variety of work stressors, not only work schedule arrangements, in order to improve nursing assistants’ sleep health. PMID:26384714
Case-control study of prostatic cancer in employees of the United Kingdom Atomic Energy Authority.

PubMed Central

Rooney, C; Beral, V; Maconochie, N; Fraser, P; Davies, G

1993-01-01

OBJECTIVE--To investigate the relation between risk of prostatic cancer and occupational exposures, especially to radionuclides, in employees of the United Kingdom Atomic Energy Authority. DESIGN--Case-control study of men with prostatic cancer and matched controls. Information about sociodemographic factors and exposures to radionuclides and other substances was abstracted and classified for each subject from United Kingdom Atomic Energy Authority records without knowledge of who had cancer. SUBJECTS--136 men with prostatic cancer diagnosed between 1946 and 1986 and 404 matched controls, all employees of United Kingdom Atomic Energy Authority. MAIN OUTCOME MEASURES--Documented or possible contamination with specific radionuclides. RESULTS--Risk of prostatic cancer was significantly increased in men who were internally contaminated with or who worked in environments potentially contaminated by tritium, chromium-51, iron-59, cobalt-60, or zinc-65. Internal contamination with at least one of the five radionuclides was detected in 14 men with prostatic cancer (10%) and 12 controls (3%) (relative risk 5.32 (95% confidence interval 1.87 to 17.24). Altogether 28 men with prostatic cancer (21%) and 46 controls (11%) worked in environments potentially contaminated by at least one of the five radionuclides (relative risk 2.36 (1.26 to 4.43)); about two thirds worked at heavy water reactors (19 men with prostatic cancer and 32 controls (relative risk 2.13 (1.00 to 4.52)). Relative risk of prostatic cancer increased with increasing duration of work in places potentially contaminated by these radionuclides and with increasing level of probable contamination. Prostatic cancer was not associated with exposure to plutonium, uranium, cadmium, boron, beryllium, or organic or inorganic chemicals. CONCLUSIONS--Risk of prostatic cancer risk was increased in United Kingdom Atomic Energy Authority workers who were occupationally exposed to tritium, 51Cr, 59Fe, 60Co, or 65Zn. Exposure to these radionuclides was infrequent, and their separate effects could not be evaluated. PMID:8274891
Evaluation of Personal Multigas Monitors

DTIC Science & Technology

1993-05-01

Edward B. Overton E E T Uf Rene V. Arenas UA414 Louisiana State UniversitySJ~ Institute for Environmental Studies Baton Rouge, LA 70803 National...Name and Address 0. Work Unit No. (TRAIS) Louisiana State University National Oceanic and Atmospheric Institute for Environmental Studies...monitor simply tells the worker whether the environment is safe for continued work. In contrast to this, an advanced mode allows more complicated procedures
China and Latin America: The Other Option

DTIC Science & Technology

2017-06-09

maps, graphics, and any other works incorporated into this manuscript. A work of the United States Government is not subject to copyright, however... government adjust its priorities to mitigate the growing Chinese influence in Latin America. 15. SUBJECT TERMS China, Latin America, national...environment, should the U.S. government adjust its priorities to mitigate the growing Chinese influence in Latin America. v ACKNOWLEDGMENTS No great
40 CFR Table 39 to Subpart Uuu of... - Continuous Compliance With Work Practice Standards for HAP Emissions From Bypass Lines

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 13 2012-07-01 2012-07-01 false Continuous Compliance With Work Practice Standards for HAP Emissions From Bypass Lines 39 Table 39 to Subpart UUU of Part 63 Protection of... Sulfur Recovery Units Pt. 63, Subpt. UUU, Table 39 Table 39 to Subpart UUU of Part 63—Continuous...
40 CFR Table 38 to Subpart Uuu of... - Initial Compliance With Work Practice Standards for HAP Emissions From Bypass Lines

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 13 2012-07-01 2012-07-01 false Initial Compliance With Work Practice Standards for HAP Emissions From Bypass Lines 38 Table 38 to Subpart UUU of Part 63 Protection of... Sulfur Recovery Units Pt. 63, Subpt. UUU, Table 38 Table 38 to Subpart UUU of Part 63—Initial Compliance...
40 CFR Table 38 to Subpart Uuu of... - Initial Compliance With Work Practice Standards for HAP Emissions From Bypass Lines

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 13 2013-07-01 2012-07-01 true Initial Compliance With Work Practice Standards for HAP Emissions From Bypass Lines 38 Table 38 to Subpart UUU of Part 63 Protection of... Sulfur Recovery Units Pt. 63, Subpt. UUU, Table 38 Table 38 to Subpart UUU of Part 63—Initial Compliance...

40 CFR Table 39 to Subpart Uuu of... - Continuous Compliance With Work Practice Standards for HAP Emissions From Bypass Lines

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 13 2014-07-01 2014-07-01 false Continuous Compliance With Work Practice Standards for HAP Emissions From Bypass Lines 39 Table 39 to Subpart UUU of Part 63 Protection of... Sulfur Recovery Units Pt. 63, Subpt. UUU, Table 39 Table 39 to Subpart UUU of Part 63—Continuous...
40 CFR Table 39 to Subpart Uuu of... - Continuous Compliance With Work Practice Standards for HAP Emissions From Bypass Lines

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 13 2013-07-01 2012-07-01 true Continuous Compliance With Work Practice Standards for HAP Emissions From Bypass Lines 39 Table 39 to Subpart UUU of Part 63 Protection of... Sulfur Recovery Units Pt. 63, Subpt. UUU, Table 39 Table 39 to Subpart UUU of Part 63—Continuous...
40 CFR Table 38 to Subpart Uuu of... - Initial Compliance With Work Practice Standards for HAP Emissions From Bypass Lines

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 13 2014-07-01 2014-07-01 false Initial Compliance With Work Practice Standards for HAP Emissions From Bypass Lines 38 Table 38 to Subpart UUU of Part 63 Protection of... Sulfur Recovery Units Pt. 63, Subpt. UUU, Table 38 Table 38 to Subpart UUU of Part 63—Initial Compliance...
United States Fish and Wildlife Service Resource Protection Act

THOMAS, 113th Congress

Sen. Cardin, Benjamin L. [D-MD

2014-06-26

Senate - 07/16/2014 Committee on Environment and Public Works Senate Subcommittee on Water and Wildlife. Hearings held. With printed Hearing: S.Hrg. 113-772. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Opportunities for research to improve employment for people with spinal cord injuries.

PubMed

Frieden, L; Winnegar, A J

2012-05-01

This paper reviews the literature pertaining to the employment of people who experience spinal cord injury (SCI) in the United States and recommending future research. The literature was reviewed with search terms such as SCI, employment, working from home and telework using databases in EBSCO, including Academic Search Complete and the American Psychological Association’s databases. Literature and findings on key factors related to employment illustrate the multiple dimensions of work environments, and health demands, that effect employment outcomes for people with SCI. Employment is important for people with SCI and valued in society. The literature reviewed indicates that researchers understand the work demands for people with SCI and may help to identify suitable supports, training and job opportunities. There remains a need for research focus on understanding future employment demands, necessary work skills, differing work environments and methods for increasing and preserving employment.
Understanding neighbourhoods, communities and environments: new approaches for social work research.

PubMed

Holland, Sally; Burgess, Stephen; Grogan-Kaylor, Andy; Delva, Jorge

2010-06-01

This article discusses some new ways in which social work research can explore the interaction between neighbourhoods and child and adult wellbeing. The authors note that social work practices are often criticised for taking an individualistic approach and paying too little attention to the service user's environment. The article uses examples of research projects from Chile, the United States of America and Wales, to discuss the use of spatially oriented research methods for understanding neighbourhood factors. Quantitative, qualitative and mixed methods approaches that are particularly appropriate for investigating social work relevant topics are discussed in turn, including quantitative and qualitative uses for geographical information systems (GIS), hierarchical linear modelling (HLM) for analysing spatially clustered data and qualitative mobile interviews. The article continues with a discussion of the strengths and limitations of using spatially orientated research designs in social work research settings and concludes optimistically with suggestions for future directions in this area.
Mitigation of Oil in Water Column: Mitigation Prototype Tests

DTIC Science & Technology

2017-06-01

distribution is unlimited. The study was funded in part by the U.S. Department of the Interior, Bureau of Safety and Environmental Enforcement (BSEE) through...James E. Fletcher Environment &Waterways Branch Chief United States Coast Guard Research & Development Center 1 Chelsea Street New London, CT...Research and Development Center 1 Chelsea Street New London, CT 06320 10. Work Unit No. (TRAIS) 11. Contract or Grant No. Task Order #HSCG32-17-J
Broadening Army Leaders for the Volatile, Uncertain, Complex and Ambiguous Environment

DTIC Science & Technology

2012-02-01

5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION ...past, violent extremist organizations (VEO) are actively seeking the ability to use disease as a weapon to attack the West. The fourth condition of...slides as a primary form of communication sets it apart from most other organizations . Saluting followed by a unit greeting when one soldier meets a
Unit Testing for the Application Control Language (ACL) Software

NASA Technical Reports Server (NTRS)

Heinich, Christina Marie

2014-01-01

In the software development process, code needs to be tested before it can be packaged for release in order to make sure the program actually does what it says is supposed to happen as well as to check how the program deals with errors and edge cases (such as negative or very large numbers). One of the major parts of the testing process is unit testing, where you test specific units of the code to make sure each individual part of the code works. This project is about unit testing many different components of the ACL software and fixing any errors encountered. To do this, mocks of other objects need to be created and every line of code needs to be exercised to make sure every case is accounted for. Mocks are important to make because it gives direct control of the environment the unit lives in instead of attempting to work with the entire program. This makes it easier to achieve the second goal of exercising every line of code.
The relationship between work complexity and nurses' participation in decision making in hospitals.

PubMed

Bacon, Cynthia Thornton; Lee, Shoou-Yih Daniel; Mark, Barbara

2015-04-01

The aim of this study is to examine the relationship between work complexity and nurses' participation in decision making in hospital nursing units. Increasing nurses' participation in decision making has been used as a way to manage work complexity; however, the work of nurses in acute care hospitals has become highly complex, and strategies used to manage this complexity have not been fully explored. The relationship between work complexity and nurse participation in decision making was examined using data from the Outcomes Research in Nursing Administration project. The sample included 3,718 RNs in 278 medical-surgical units in 143 hospitals. When work complexity increased, nurses' participation in decision making decreased. When nurses have limited input into decision making, the information available to the care team may be incomplete. Barriers to nurses' participation in decision making should be explored and interventions developed so that nurses may be full participants in decision making affecting both patients and the work environment.
Changes to nurses' practice environment over time.

PubMed

Roche, Michael A; Duffield, Christine; Friedman, Sarah; Twigg, Di; Dimitrelis, Sofia; Rowbotham, Samantha

2016-07-01

To examine changes in the nursing practice environment, retention-related factors, unit stability and patient care tasks delayed or left undone, over two periods between 2004 and 2013. Positive nurse practice environments have been linked to nurse retention and care quality outcomes. The collection of the Practice Environment Scale of the Nursing Work Index, job satisfaction, intent to leave, unit instability and tasks delayed or not done at six acute-care hospitals across three Australian states, in two waves between 2004 and 2013; results from the two waves are compared. On average, practice environment scores declined slightly; nurses reported a greater difficulty in finding another nursing position, lower intent to leave their current job and greater instability in their current position. Rates of delayed tasks increased over the period, whereas rates of tasks left undone have decreased over the period. The decline in nurses' perceptions of the quality of the practice environment is disappointing, particularly given the protracted workforce shortages that have persisted. Significant organisational restructuring and turnover of nurse executives may have contributed to this decline. Managers need to apply existing evidence to improve nurse practice environments and manage instability. © 2016 John Wiley & Sons Ltd.
Changing the work environment in intensive care units to achieve patient-focused care: the time has come.

PubMed

McCauley, Kathleen; Irwin, Richard S

2006-11-01

The American Association of Critical-Care Nurses Standards for Establishing and Sustaining Healthy Work Environments and the American College of Chest Physicians Patient-Focused Care project are complementary initiatives that provide a road map for creating practice environments where interdisciplinary, patient-focused care can thrive. Healthy work environments are so influential that failure to address the issue would result in deleterious effects for every aspect of acute and critical care practice. Skilled communication and true collaboration are crucial for transforming work environments. The American College of Chest Physicians project on patient-focused care was born out of a realization that medicine as currently practiced is too fragmented, too focused on turf battles that hinder communication, and too divorced from a real understanding of what patients expect and need from their healthcare providers. Communication as well as continuity and concordance with the patients' wishes are foundational premises of care that is patient-focused and safe. Some individuals may achieve some level of genuine patient-focused care even when they practice in a toxic work environment because they are gifted communicators who embrace true collaboration. At best, most likely those efforts will be hit-or-miss and such heroism will be impossible to sustain if the environment is not transformed into a model that reflects standards and initiatives set out by the American Association of Critical-Care Nurses and the American College of Chest Physicians. Other innovative models of care delivery remain unreported. The successes and failures of these models should be shared with the professional community.
Immersive Environments in ADL

DTIC Science & Technology

2009-08-20

Tracking and Storing In Browser 3-D 13 Questions or Comments? Peter Smith Team Lead, Immersive Learning Technologies peter.smith.ctr@adlnet.gov +1.407.384.5572 ...Immersive Environments in ADL Mr. Peter Smith, Lead, ADL Immersive Learning Team 08/20/2009 Report Documentation Page Form ApprovedOMB No. 0704-0188...5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Advanced Decision Learning (ADL),1901 N
Design and process integration of organic Rankine cycle utilizing biomass for power generation

NASA Astrophysics Data System (ADS)

Ependi, S.; Nur, T. B.

2018-02-01

Indonesia has high potential biomass energy sources from palm oil mill industry activities. The growing interest on Organic Rankine Cycle (ORC) application to produce electricity by utilizing biomass energy sources are increasingly due to its successfully used for generating electricity from rejected waste heat to the environment in industrial processes. In this study, the potential of the palm oil empty fruit bunch, and wood chip have been used as fuel for biomass to generate electricity based ORC with combustion processes. The heat from combustion burner was transfer by thermal oil heater to evaporate ORC working fluid in the evaporator unit. The Syltherm-XLT thermal oil was used as the heat carrier from combustion burner, while R245fa was used as the working fluid for ORC unit. Appropriate designs integration from biomass combustion unit to ORC unit have been analyzed and proposed to generate expander shaft-work. Moreover, the effect of recuperator on the total system efficiency has also been investigated. It was observed that the fuel consumption was increased when the ORC unit equipped recuperator operated until certain pressure and decreased when operated at high pressure.
To create a cleanroom controlled environment using a mobile air decontamination unit for the preparation of antineoplastic drugs.

PubMed

Lecordier, Julien; Plivard, Claire; Gardeux, Michel; Daouadi, Karim; Lahet, Jean-Jacques

2016-02-01

To use a mobile air decontamination unit (MADU) for a microbial destruction and decreased particle burden making a cleanroom controlled environment in a Centralized Chemotherapy Preparation Unit (CCPU). Good manufacturing practices (GMP) in France specify that the ambient air in the vicinity of a class III biosafety cabinet (isolator) complies with air cleanliness ISO 8 level in CCPU. This guideline has a significant impact because implementing a dedicated air handling unit (AHU) brings some engineering constraints and generates substantial additional costs. Authors have previously studied some technical and economical aspects to evaluate the feasibility of the MADU option. Using a MADU was the chosen option. Qualification of the CCPU showed that results were in compliance with the French GMP. After one year of use, the efficiency of the MADU was confirmed. According to these results, using a MADU constitutes a beneficial option for CCPU previously equipped with an isolator when compared to renovation work involving a standard built-in AHU. © The Author(s) 2014.
[Correlation Between Nursing Work Environment and Nurse Burnout, Job Satisfaction, and Turnover Intention in the Western Region of Mainland China].

PubMed

Chen, Yu-Meng; Fang, Jin-Bo

2016-02-01

Nurse burnout and low job satisfaction are main reasons that cause nurses to leave their current position. Improving the nursing work environment may reduce the severity of job burnout and of job dissatisfaction and thus decrease the turnover intention of nursing staff. The aim of this study was to explore the correlation between the nursing work environment and the outcome variables of burnout, job satisfaction, and turnover intention in the western region of Mainland China. This is a cross-sectional descriptive study. Survey data were collected between February and December 2012 from 1,112 clinical nurses working at 83 medical, surgical, and intensive care units in 20 hospitals across the western region of Mainland China. Multistage sampling was conducted on some of the participants. The research instruments that were used included the Practice Environment Scale of the Nursing Work Index, Maslach Burnout Inventory, Nurse Job Satisfaction Scale, and the self-developed basic information and turnover intention questionnaire. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 19.0. The level of statistical significance was set at p<.05. Among the five dimensions of the nursing work environment, collegial nurse-physician relations earned the most favorable mean scores (3.57±0.68; total=4 points), whereas adequacy of staffing and resources earned the lowest (3.21±0.82). Over half of the participants (58.4%) reported experiencing a high level of emotional exhaustion (EE) burnout, 45.2% reported experiencing a high level of depersonalization (DP) burnout, and 24.6% reported experiencing a high level of personal accomplishment (PA) burnout. About 59% of the participants were satisfied with their work and 3.8% reported intention to leave. Participants in self-reported "favorable" work environments were less likely to report high burnout, less likely to report intention to leave, and more likely to report job satisfaction than their peers in self-reported "poor" work environments. The odds ratio (OR) values were 0.64 (EE), 0.66 (DP), 0.57 (PA), 0.19, and 2.26. The results of the present study support that the nursing work environment affects nurse burnout, job satisfaction, and turnover intention. Therefore, nursing managers should work to improve nursing work environments in order to reduce the turnover intent among their nursing staff.
Impact of nurse work environment and staffing on hospital nurse and quality of care in Thailand.

PubMed

Nantsupawat, Apiradee; Srisuphan, Wichit; Kunaviktikul, Wipada; Wichaikhum, Orn-Anong; Aungsuroch, Yupin; Aiken, Linda H

2011-12-01

To determine the impact of nurse work environment and staffing on nurse outcomes, including job satisfaction and burnout, and on quality of nursing care. Secondary data analysis of the 2007 Thai Nurse Survey. The sample consisted of 5,247 nurses who provided direct care for patients across 39 public hospitals in Thailand. Multivariate logistic regression was used to estimate the impact of nurse work environment and staffing on nurse outcomes and quality of care. Nurses cared for an average of 10 patients each. Forty-one percent of nurses had a high burnout score as measured by the Maslach Burnout Inventory; 28% of nurses were dissatisfied with their job; and 27% rated quality of nursing care as fair or poor. At the hospital level, after controlling for nurse characteristics (age, years in unit), the addition of each patient to a nurse's workload was associated with a 2% increase in the odds on nurses reporting high emotional exhaustion (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.00-1.03; p < .05). Nurses who reported favorable work environments were about 30% less likely to report fair to poor care quality (OR 0.69; 95% CI 0.48-0.98; p < .05) compared with nurses who reported unfavorable work environments. The addition of each patient to a nurse's workload was associated with a 4% increase in the odds on nurses reporting quality of nursing care as fair or poor (OR 1.04; 95% CI 1.02-1.05; p < .001). Improving nurse work environments and nurse staffing in Thai hospitals holds promise for reducing nurse burnout, thus improving nurse retention at the hospital bedside as well as potentially improving the quality of care. Nurses should work with management and policymakers to achieve safe staffing levels and good work environments in hospitals throughout the world. © 2011 Sigma Theta Tau International.
QUEST/Ada (query utility environment for software testing of Ada: The development of a program analysis environment for Ada, task 1, phase 3

NASA Technical Reports Server (NTRS)

Brown, David B.

1991-01-01

The results of research and development efforts of the first six months of Task 1, Phase 3 of the project are presented. The goals of Phase 3 are: (1) to further refine the rule base and complete the comparative rule base evaluation; (2) to implement and evaluate a concurrency testing prototype; (3) to convert the complete (unit-level and concurrency) testing prototype to a workstation environment; and (4) to provide a prototype development document to facilitate the transfer of research technology to a working environment. These goals were partially met and the results are summarized.
Nurse work environment and job-related outcomes in Brazilian hospitals.

PubMed

Dutra, Herica Silva; Cimiotti, Jeannie P; Guirardello, Edinêis de Brito

2018-06-01

It has been reported that a work environment that does not support nurses, and high levels of emotional exhaustion and job dissatisfaction are associated with nurses' intent to leave their job. The aim of this study was to determine if these work-related factors and job-related outcomes are common in Brazilian nurses. This cross-sectional study included a 2015 survey of nursing professionals who worked in 48 units of three Brazilian, acute care hospitals. Descriptive statistics were used to examine the sample and a series of logistic regression models were fit to examine two job-related outcomes of interest: job dissatisfaction and intent to leave during the next 12 months. A total of 450 completed surveys were available, where nurses reported high emotional exhaustion (26%), job dissatisfaction (28%), and an intent to leave (12%). Poor control over the work environment (OR = 2.19) and high emotional exhaustion (OR = 4.47) were associated with an increase in the odds of job dissatisfaction. Inadequate staffing (OR = 2.43), high emotional exhaustion (OR = 2.24) and job dissatisfaction (OR = 5.74) were associated with an increase in the odds that nurses would leave their job in the next 12 months. Features of the nurse work environment and high emotional exhaustion were associated with job dissatisfaction. Job dissatisfaction and inadequate staffing are likely to result in nurses leaving their job. It is imperative that hospital administrators provide a work environment that supports nursing and improves nurse outcomes and the quality of patient care. Copyright © 2018 Elsevier Inc. All rights reserved.
The work compatibility improvement framework: an assessment of the worker-work environment interaction in the manufacturing sector.

PubMed

Genaidy, Ash M; Rinder, Magda M; A-Rehim, Amal D

2008-08-01

The manufacturing sector in the US is challenged by high health care costs and shortage of qualified workers, which are largely attributed to the degree of fit between the worker and work environment. In this regard, a healthy worker-work environment interface is a necessary and sufficient condition for the containment of health care costs and the retaining/attraction of highly qualified knowledge workers and should be based on the principles of optimum physical, cognitive and emotional health for the workers. In prior research, the Work Compatibility Improvement Framework (WCIF) was introduced as a vehicle to address these issues and was defined as the identification, improvement and maintenance of the well-being characteristics of the workforce and its interaction with the work environment through the application of engineering, medicine, management and human sciences methodologies, technologies and best practices. This paper advances WCIF by examining its applications in manufacturing with regard to the evaluation of working conditions impacting musculoskeletal/stress outcome measures. A study was conducted in a machining department of a bag packaging manufacturer in the Midwest of the United States. The work tasks were planned and executed with regard to the following aims: (1) to compute work compatibility as a function of work demands and energisers; (2) to establish whether the prevalence of musculoskeletal/stress disorders increases with a decrease in the quality of worker-work environment interface in terms of work compatibility level and other work factors such as shift and job category. A major finding is that a 'poor' work environment (a function of all work domains) results in musculoskeletal/stress disorders that are 105% and 67% higher than those for a 'good' work environment. The evening shift exhibited the poorest compatibility followed by the night shift relative to the day shift. Application of the work compatibility approach demonstrated the detection of non-added value work. It is essential to evaluate the various domains of worker-work environment interface to uncover the root causes that tend to sub-optimise the physical/cognitive/emotional health of the workforce. The WCIF was used to uncover the non-value added effort in the work process. These findings will have major implications for developing and implementing customised design interventions with the aim to maximise the benefit and reduce the cost of employees in a manufacturing enterprise. The study findings suggest that the WCIF should be pursued as a potential strategic tool for optimising human performance in an enterprise to create healthy workplaces.

Challenges And Lessons Learned From Communities Using Evidence To Adopt Strategies To Improve Healthy Food Environments.

PubMed

Willems Van Dijk, Julie A; Catlin, Bridget; Cofsky, Abbey; Carroll, Carrie

2015-11-01

Communities across the United States are increasingly tackling the complex task of changing their local environments and cultures to improve access to and consumption of healthy food. Communities that have received the Robert Wood Johnson Foundation Culture of Health Prize have deployed numerous evidence-informed strategies to enhance their local food environments. Their experiences can provide lessons for other communities working to improve health. In this article we examine how the prize-winning communities worked in a multidisciplinary collective manner to implement evidence-based strategies, deployed suites of strategies to expand the reach of food-related work, balanced evidence against innovation, and measured their own progress. Most of the communities also faced challenges in using evidence effectively to implement strategies to promote healthy food environments. Policy makers can accelerate the adoption of evidence-informed approaches related to food and health by embedding them in program standards and funding requirements. Establishing opportunities for ongoing training to enhance community practitioners' evaluation skills and collaborative leadership would also improve the effectiveness of community implementation of these strategies. Project HOPE—The People-to-People Health Foundation, Inc.
Evolutionary adaptations: theoretical and practical implications for visual ergonomics.

PubMed

Fostervold, Knut Inge; Watten, Reidulf G; Volden, Frode

2014-01-01

The literature discussing visual ergonomics often mention that human vision is adapted to light emitted by the sun. However, theoretical and practical implications of this viewpoint is seldom discussed or taken into account. The paper discusses some of the main theoretical implications of an evolutionary approach to visual ergonomics. Based on interactional theory and ideas from ecological psychology an evolutionary stress model is proposed as a theoretical framework for future research in ergonomics and human factors. The model stresses the importance of developing work environments that fits with our evolutionary adaptations. In accordance with evolutionary psychology, the environment of evolutionary adaptedness (EEA) and evolutionarily-novel environments (EN) are used as key concepts. Using work with visual display units (VDU) as an example, the paper discusses how this knowledge can be utilized in an ergonomic analysis of risk factors in the work environment. The paper emphasises the importance of incorporating evolutionary theory in the field of ergonomics. Further, the paper encourages scientific practices that further our understanding of any phenomena beyond the borders of traditional proximal explanations.
USEPA Environmental Quality Index (EQI) and Associated Domain Indices by County for the United States

EPA Pesticide Factsheets

This map service displays the results data from the EPA's Environmental Quality Index. The US Environmental Protection Agency's (EPA) National Health and Environmental Effects Research Laboratory (NHEERL) in the Environmental Public Health Division (EPHD) is currently engaged in research aimed at developing a measure that estimates overall environmental quality at the county level for the United States. This work is being conducted as an effort to learn more about how various environmental factors simultaneously contribute to health disparities in low-income and minority populations, and to better estimate the total environmental and social context to which humans are exposed. This dataset contains the finalized Environmental Quality Index (EQI), and an index for each of the associated domains (air, water, land, built environment, and sociodemographic environment). Indices are at the county level for all counties in the United States.
Interactions between lean management and the psychosocial work environment in a hospital setting - a multi-method study.

PubMed

Ulhassan, Waqar; von Thiele Schwarz, Ulrica; Thor, Johan; Westerlund, Hugo

2014-10-22

As health care struggles to meet increasing demands with limited resources, Lean has become a popular management approach. It has mainly been studied in relation to health care performance. The empirical evidence as to how Lean affects the psychosocial work environment has been contradictory. This study aims to study the interaction between Lean and the psychosocial work environment using a comprehensive model that takes Lean implementation information, as well as Lean theory and the particular context into consideration. The psychosocial work environment was measured twice with the Copenhagen Psychosocial Questionnaire (COPSOQ) employee survey during Lean implementations on May-June 2010 (T1) (n = 129) and November-December 2011 (T2) (n = 131) at three units (an Emergency Department (ED), Ward-I and Ward-II). Information based on qualitative data analysis of the Lean implementations and context from a previous paper was used to predict expected change patterns in the psychosocial work environment from T1 to T2 and subsequently compared with COPSOQ-data through linear regression analysis. Between T1 and T2, qualitative information showed a well-organized and steady Lean implementation on Ward-I with active employee participation, a partial Lean implementation on Ward-II with employees not seeing a clear need for such an intervention, and deterioration in already implemented Lean activities at ED, due to the declining interest of top management. Quantitative data analysis showed a significant relation between the expected and actual results regarding changes in the psychosocial work environment. Ward-I showed major improvements especially related to job control and social support, ED showed a major decline with some exceptions while Ward-II also showed improvements similar to Ward-I. The results suggest that Lean may have a positive impact on the psychosocial work environment given that it is properly implemented. Also, the psychosocial work environment may even deteriorate if Lean work deteriorates after implementation. Employee managers and researchers should note the importance of employee involvement in the change process. Employee involvement may minimize the intervention's harmful effects on psychosocial work factors. We also found that a multi-method may be suitable for investigating relations between Lean and the psychosocial work environment.
Organizational climate and intensive care unit nurses' intention to leave.

PubMed

Stone, Patricia W; Larson, Elaine L; Mooney-Kane, Cathy; Smolowitz, Janice; Lin, Susan X; Dick, Andrew W

2006-07-01

The purposes of this study were to a) estimate the incidence of intensive care units nurses' intention to leave due to working conditions; and b) identify factors predicting this phenomenon. Cross-sectional design. Hospitals and critical care units. Registered nurses (RNs) employed in adult intensive care units. Organizational climate, nurse demographics, intention to leave, and reason for intending to leave were collected using a self-report survey. Nurses were categorized into two groups: a) those intending to leave due to working conditions; and b) others (e.g., those not leaving or retirees). The measure of organizational climate had seven subscales: professional practice, staffing/resource adequacy, nurse management, nursing process, nurse/physician collaboration, nurse competence, and positive scheduling climate. Setting characteristics came from American Hospital Association data and a survey of chief nursing officers. A total of 2,323 RNs from 66 hospitals and 110 critical care units were surveyed across the nation. On average, the RN was 39.5 yrs old (SD = 9.40), had 15.6 yrs (SD = 9.20) experience in health care, and had worked in his or her current position for 8.0 yrs (SD = 7.50). Seventeen percent (n = 391) of the respondents indicated intending to leave their position in the coming year. Of those, 52% (n = 202) reported that the reason was due to working conditions. Organizational climate factors that had an independent effect on intensive care unit nurse intention to leave due to working conditions were professional practice, nurse competence, and tenure (p < .05). Improving professional practice in the work environment and clinical competence of the nurses as well as supporting new hires may reduce turnover and help ensure a stable and qualified workforce.
Retooling for the Future

DTIC Science & Technology

2013-05-01

of the 21st century presented a global security environment unanticipated by the end of the Cold War and bipolarity between the United States and...Beijing ended the policy of isolation of the People’s Republic of China (PRC) following the “ping-pong” diplomacy. For almost a century China had been...NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND
Everyday practices at the medical ward: a 16-month ethnographic field study

PubMed Central

2012-01-01

Background Modern hospital care should ostensibly be multi-professional and person-centred, yet it still seems to be driven primarily by a hegemonic, positivistic, biomedical agenda. This study aimed to describe the everyday practices of professionals and patients in a coronary care unit, and analyse how the routines, structures and physical design of the care environment influenced their actions and relationships. Methods Ethnographic fieldwork was conducted over a 16-month period (between 2009 and 2011) by two researchers working in parallel in a Swedish coronary care unit. Observations, informal talks and formal interviews took place with registered nurses, assistant nurses, physicians and patients in the coronary care unit. The formal interviews were conducted with six registered nurses (five female, one male) including the chief nurse manager, three assistant nurses (all female), two cardiologists and three patients (one female, two male). Results We identified the structures that either promoted or counteracted the various actions and relationships of patients and healthcare professionals. The care environment, with its minimalistic design, strong focus on routines and modest capacity for dialogue, restricted the choices available to both patients and healthcare professionals. This resulted in feelings of guilt, predominantly on the part of the registered nurses. Conclusions The care environment restricted the choices available to both patients and healthcare professionals. This may result in increased moral stress among those in multi-professional teams who work in the grey area between biomedical and person-centred care. PMID:22748059
Practice environment as perceived by nurses in acute care hospitals in Sharjah and North Emirates.

PubMed

Al-Maaitah, Rowaida; AbuAlRub, Raeda F; Al Blooshi, Sumaya

2018-04-01

To explore nurses' perceptions of their practice environment in acute care hospitals in Sharjah and North Emirates in the United Arab Emirates (UAE). The health of the environment in which registered nurses' work is critical to nursing outcomes. The interest to examine the practice environment extended to the Gulf area which has a complex healthcare system including the UAE. The study used an exploratory descriptive design with a qualitative part using two focus group interviews. The sample size was 450 nurses selected through a random sampling method. A self-administered questionnaire including the Practice Environment Scale of Nursing Work Index (PES-NWI) was used. In addition, semi-structured interviews for two focus groups were done. The results showed that UAE practicing nurses reported favorable perceptions of most aspects of their practice environment. Unfavorable perceptions were only reported for Staffing and Resource Adequacy. The analysis of focus group discussions resulted in different emerged themes such as Lack of Recognition and Career Promotion, and Nurses' Workload due to Paper and Administrative Work. The findings of this study suggest that strategic interventions are needed to secure adequate staff and resources and implement an effective system for evaluation of performance. © 2018 Wiley Periodicals, Inc.
The inpatient psychiatric unit as both a safe and unsafe place: implications for absconding.

PubMed

Muir-Cochrane, Eimear; Oster, Candice; Grotto, Jessica; Gerace, Adam; Jones, Julia

2013-08-01

Absconding from acute psychiatric inpatient units is a significant issue with serious social, economic, and emotional costs. A qualitative study was undertaken to explore the experiences of people (n = 12) who had been held involuntarily under the local mental health act in an Australian inpatient psychiatric unit, and who had absconded (or attempted to abscond) during this time. The aim of the study was to explore why people abscond from psychiatric inpatient units, drawing on published work from health geography on the significance of the person-place encounter, and in particular the concept of 'therapeutic landscapes'. The findings show that the inpatient unit is perceived as a safe or unsafe place, dependent on the dialectical relationship between the physical, individual, social, and symbolic aspects of the unit. Consumers absconded when the unit was perceived as unsafe. Forming a therapeutic relationship with staff, familiarity with the unit, a comfortable environment, and positive experiences with other consumers all supported perceptions that the unit was safe, decreasing the likelihood of absconding. Findings extend existing work on the person-place encounter within psychiatric inpatient units, and bring new knowledge about the reasons why consumers abscond. Implications for practice are discussed. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.
Educating Special Forces Junior Leaders for a Complex Security Environment

DTIC Science & Technology

2009-07-01

Security Environment 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK...UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) Joint Special Operations University,357 Tully Street Alison Building,Hurlburt Field,FL...32544 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME( S ) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM( S ) 11. SPONSOR
Fabrication, test and demonstration of critical environment monitoring system

NASA Technical Reports Server (NTRS)

Heimendinger, K. W.

1972-01-01

Design and performance of an analytical system for the evaluation of certain environmental constituents in critical environmental areas of the Quality Reliability and Assurance Laboratory are reported. Developed was a self-contained, integrated, minimum sized unit that detects, interrogates, and records those parameters of the environment dictated for control in large storage facilities, clean rooms, temporarily curtained enclosures, and special working benches. The system analyzes humidity, temperature, hydrocarbons particle size, and particle count within prescribed clean areas.
M-Learning--On Path to Integration with Organisation Systems

ERIC Educational Resources Information Center

Srivastava, Shilpa; Gulati, Ved Prakash

2014-01-01

Learning is essential in organizations for them to survive. However, given the changing environment owing to global inter-connectedness, mobile workforce, global unpredictability and complexities, the learning approach must also change. Today the Learning and Development unit must be able to facilitate collaborative work, develop learning…
A comprehensive survey of soft wheat grain quality in United States germplasm

USDA-ARS?s Scientific Manuscript database

Wheat (Triticum aestivum L.) quality is dependent upon both genetic and environmental factors, which work in combination to produce specific grain, milling, and baking characteristics. Along with these genetic and environmental factors, the adaptation of the genetics to the given growing environment...
Congressional Testimony: Unimplemented OIG Recommendations at the U.S. Environmental Protection Agency and the U.S. Chemical Safety and Hazard Investigation Board

EPA Pesticide Factsheets

June 14, 2016. Statement of Alan S. Larsen Counsel to the EPA Inspector General Before the Subcommittee on Superfund, Waste Management, and Regulatory Oversight Committee on Environment and Public Works United States Senate.
Distributed Leadership in Online Groups

ERIC Educational Resources Information Center

Gressick, Julia; Derry, Sharon J.

2010-01-01

We conducted research within a program serving future mathematics and science teachers. Groups of teachers worked primarily online in an asynchronous discussion environment on a 6-week task in which they applied learning-science ideas acquired from an educational psychology course to design interdisciplinary instructional units. We employed an…
The Space Debris Environment for the ISS Orbit

NASA Technical Reports Server (NTRS)

Theall, Jeff; Liou, Jer-Chyi; Matney, Mark; Kessler, Don

2001-01-01

With thirty-five planned missions over the next five years, the International Space Station (ISS) will be the focus for manned space activity. At least 6 different vehicles will transport crew and supplies to and from the nominally 400 km, 51.6 degree orbit. When completed, the ISS will be the largest space structure ever assembled and hence the largest target for space debris. Recent work at the Johnson Space Center has focused on updating the existing space debris models. The Orbital Debris Engineering Model, has been restructured to take advantage of state of the art desktop computing capability and revised with recent measurements from Haystack and Goldstone radars, additional analysis of LDEF and STS impacts, and the most recent SSN catalog. The new model also contains the capability to extrapolate the current environment in time to the year 2030. A revised meteoroid model based on the work of Divine has also been developed, and is called the JSC Meteoroid Model. The new model defines flux on the target per unit angle per unit speed, and for Earth orbit, includes the meteor showers. This paper quantifies the space debris environment for the ISS orbit from natural and anthropogenic sources. Particle flux and velocity distributions as functions of size and angle are be given for particles 10 microns and larger for altitudes from 350 to 450 km. The environment is projected forward in time until 2030.
Cooperative Multi-Agent Mobile Sensor Platforms for Jet Engine Inspection: Concept and Implementation

NASA Technical Reports Server (NTRS)

Litt, Jonathan S.; Wong, Edmond; Krasowski, Michael J.; Greer, Lawrence C.

2003-01-01

Cooperative behavior algorithms utilizing swarm intelligence are being developed for mobile sensor platforms to inspect jet engines on-wing. Experiments are planned in which several relatively simple autonomous platforms will work together in a coordinated fashion to carry out complex maintenance-type tasks within the constrained working environment modeled on the interior of a turbofan engine. The algorithms will emphasize distribution of the tasks among multiple units; they will be scalable and flexible so that units may be added in the future; and will be designed to operate on an individual unit level to produce the desired global effect. This proof of concept demonstration will validate the algorithms and provide justification for further miniaturization and specialization of the hardware toward the true application of on-wing in situ turbine engine maintenance.
Work load and management in the delivery room: changing the direction of healthcare policy.

PubMed

Sfregola, Gianfranco; Laganà, Antonio Simone; Granese, Roberta; Sfregola, Pamela; Lopinto, Angela; Triolo, Onofrio

2017-02-01

Nurse staffing, increased workload and unstable nursing unit environments are linked to negative patient outcomes including falls and medication errors on medical/surgical units. Considering this evidence, the aim of our study was to overview midwives' workload and work setting. We created a questionnaire and performed an online survey. We obtained information about the type and level of hospital, workload, the use of standardised procedures, reporting of sentinel and 'near-miss' events. We reported a severe understaffing in midwives' work settings and important underuse of standard protocols according to the international guidelines, especially in the South of Italy. Based on our results, we strongly suggest a change of direction of healthcare policy, oriented to increase the number of employed midwives, in order to let them fulfil their duties according to the international guidelines (especially one-to-one care). On the other hand, we encourage the adoption of standardised protocols in each work setting.
Nurse work engagement impacts job outcome and nurse-assessed quality of care: model testing with nurse practice environment and nurse work characteristics as predictors

PubMed Central

Van Bogaert, Peter; van Heusden, Danny; Timmermans, Olaf; Franck, Erik

2014-01-01

Aim: To explore the mechanisms through which nurse practice environment dimensions, such as nurse–physician relationship, nurse management at the unit level and hospital management and organizational support, are associated with job outcomes and nurse-assessed quality of care. Mediating variables included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption. Background: Understanding how to support and guide nurse practice communities in their daily effort to answer complex care most accurate, alongside with the demand of a stable and healthy nurse workforce, is challenging. Design: Cross-sectional survey. Method: Based on earlier empirical findings, a structural equation model, designed with valid measurement instruments, was tested. The study population included registered acute care hospital nurses (N = 1201) in eight hospitals across Belgium. Results: Nurse practice environment dimensions predicted nurses’ ratings of job outcome variables as well as quality of care. Features of nurses’ work characteristics, e.g., perceived workload, decision latitude, social capital, and the three dimension of work engagement, played mediating roles between nurse practice environment and outcomes. A revised model, using various fit measures, explained 60% of job outcomes and 47% of nurse-assessed quality of care. Conclusion: The findings in this study show that nurse work characteristics as workload, decision latitude, and social capital, alongside with nurse work engagement (e.g., vigor, dedication, and absorption) influence nurses’ perspective of their nurse practice environment, job outcomes, and quality of care. The results underline aspects to considerate for various stakeholders, such as executives, nurse managers, physicians, and staff nurses, in setting up and organizing health care services. PMID:25431563
Psychosocial work environment and prediction of quality of care indicators in one Canadian health center.

PubMed

Paquet, Maxime; Courcy, François; Lavoie-Tremblay, Mélanie; Gagnon, Serge; Maillet, Stéphanie

2013-05-01

Few studies link organizational variables and outcomes to quality indicators. This approach would expose operant mechanisms by which work environment characteristics and organizational outcomes affect clinical effectiveness, safety, and quality indicators. What are the predominant psychosocial variables in the explanation of organizational outcomes and quality indicators (in this case, medication errors and length of stay)? The primary objective of this study was to link the fields of evidence-based practice to the field of decision making, by providing an effective model of intervention to improve safety and quality. The study involved healthcare workers (n = 243) from 13 different care units of a university affiliated health center in Canada. Data regarding the psychosocial work environment (10 work climate scales, effort/reward imbalance, and social support) was linked to organizational outcomes (absenteeism, turnover, overtime), to the nurse/patient ratio and quality indicators (medication errors and length of stay) using path analyses. The models produced in this study revealed a contribution of some psychosocial factors to quality indicators, through an indirect effect of personnel- or human resources-related variables, more precisely: turnover, absenteeism, overtime, and nurse/patient ratio. Four perceptions of work environment appear to play an important part in the indirect effect on both medication errors and length of stay: apparent social support from supervisors, appreciation of the workload demands, pride in being part of one's work team, and effort/reward balance. This study reveals the importance of employee perceptions of the work environment as an indirect predictor of quality of care. Working to improve these perceptions is a good investment for loyalty and attendance. In general, better personnel conditions lead to fewer medication errors and shorter length of stay. © Sigma Theta Tau International.

Nurse work engagement impacts job outcome and nurse-assessed quality of care: model testing with nurse practice environment and nurse work characteristics as predictors.

PubMed

Van Bogaert, Peter; van Heusden, Danny; Timmermans, Olaf; Franck, Erik

2014-01-01

To explore the mechanisms through which nurse practice environment dimensions, such as nurse-physician relationship, nurse management at the unit level and hospital management and organizational support, are associated with job outcomes and nurse-assessed quality of care. Mediating variables included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption. Understanding how to support and guide nurse practice communities in their daily effort to answer complex care most accurate, alongside with the demand of a stable and healthy nurse workforce, is challenging. Cross-sectional survey. Based on earlier empirical findings, a structural equation model, designed with valid measurement instruments, was tested. The study population included registered acute care hospital nurses (N = 1201) in eight hospitals across Belgium. Nurse practice environment dimensions predicted nurses' ratings of job outcome variables as well as quality of care. Features of nurses' work characteristics, e.g., perceived workload, decision latitude, social capital, and the three dimension of work engagement, played mediating roles between nurse practice environment and outcomes. A revised model, using various fit measures, explained 60% of job outcomes and 47% of nurse-assessed quality of care. The findings in this study show that nurse work characteristics as workload, decision latitude, and social capital, alongside with nurse work engagement (e.g., vigor, dedication, and absorption) influence nurses' perspective of their nurse practice environment, job outcomes, and quality of care. The results underline aspects to considerate for various stakeholders, such as executives, nurse managers, physicians, and staff nurses, in setting up and organizing health care services.
Using Cognitive Work Analysis to Fit Decision Support Tools to Nurse Managers’ Work Flow

PubMed Central

Brewer, Barbara B.; Logue, Melanie D.; Gephart, Sheila; Verran, Joyce A.

2011-01-01

Purpose To better understand the environmental constraints on nurse managers that impact their need for and use of decision support tools, we conducted a Cognitive Work Analysis (CWA). A complete CWA includes system analyses at five levels: work domain, decision-making procedures, decision-making strategies, social organization/collaboration, and worker skill level. Here we describe the results of the Work Domain Analysis (WDA) portion in detail then integrate the WDA with other portions of the CWA, reported previously, to generate a more complete picture of the nurse manager’s work domain. Methods Data for the WDA were obtained from semi-structured interviews with nurse managers, division directors, CNOs, and other managers (n = 20) on 10 patient care units in 3 Arizona hospitals. The WDA described the nurse manager’s environment in terms of the constraints it imposes on the nurse manager’s ability to achieve targeted outcomes through organizational goals and priorities, functions, processes, as well as work objects and resources (e.g., people, equipment, technology, and data). Constraints were identified and summarized through qualitative thematic analysis. Results The results highlight the competing priorities, and external and internal constraints that today’s nurse managers must satisfy as they try to improve quality and safety outcomes on their units. Nurse managers receive a great deal of data, much in electronic format. Although dashboards were perceived as helpful because they integrated some data elements, no decision support tools were available to help nurse managers with planning or answering “what if” questions. The results suggest both the need for additional decision support to manage the growing complexity of the environment, and the constraints the environment places on the design of that technology if it is to be effective. Limitations of the study include the small homogenous sample and the reliance on interview data targeting safety and quality. PMID:21862397
Using Cognitive Work Analysis to fit decision support tools to nurse managers' work flow.

PubMed

Effken, Judith A; Brewer, Barbara B; Logue, Melanie D; Gephart, Sheila M; Verran, Joyce A

2011-10-01

To better understand the environmental constraints on nurse managers that impact their need for and use of decision support tools, we conducted a Cognitive Work Analysis (CWA). A complete CWA includes system analyses at five levels: work domain, decision-making procedures, decision-making strategies, social organization/collaboration, and worker skill level. Here we describe the results of the Work Domain Analysis (WDA) portion in detail then integrate the WDA with other portions of the CWA, reported previously, to generate a more complete picture of the nurse manager's work domain. Data for the WDA were obtained from semi-structured interviews with nurse managers, division directors, CNOs, and other managers (n = 20) on 10 patient care units in three Arizona hospitals. The WDA described the nurse manager's environment in terms of the constraints it imposes on the nurse manager's ability to achieve targeted outcomes through organizational goals and priorities, functions, processes, as well as work objects and resources (e.g., people, equipment, technology, and data). Constraints were identified and summarized through qualitative thematic analysis. The results highlight the competing priorities, and external and internal constraints that today's nurse managers must satisfy as they try to improve quality and safety outcomes on their units. Nurse managers receive a great deal of data, much in electronic format. Although dashboards were perceived as helpful because they integrated some data elements, no decision support tools were available to help nurse managers with planning or answering "what if" questions. The results suggest both the need for additional decision support to manage the growing complexity of the environment, and the constraints the environment places on the design of that technology if it is to be effective. Limitations of the study include the small homogeneous sample and the reliance on interview data targeting safety and quality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Medical surgical nurses describe missed nursing care tasks-Evaluating our work environment.

PubMed

Winsett, Rebecca P; Rottet, Kendra; Schmitt, Abby; Wathen, Ellen; Wilson, Debra

2016-11-01

The purpose of the study was to explore the nurse work environment by evaluating the self-report of missed nursing care and the reasons for the missed care. A convenience sample of medical surgical nurses from four hospitals was invited to complete the survey for this descriptive study. The sample included 168 nurses. The MISSCARE survey assessed the frequency and reason of 24 routine nursing care elements. The most frequently reported missed care was ambulation as ordered, medications given within a 30 minute window, and mouth care. Moderate or significant reasons reported for the missed care were: unexpected rise in volume/acuity, heavy admissions/discharges, inadequate assistants, inadequate staff, meds not available when needed, and urgent situations. Identifying missed nursing care and reasons for missed care provides an opportunity for exploring strategies to reduce interruptions, develop unit cohesiveness, improve the nurse work environment, and ultimately leading to improved patient outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.
Building Health Promotion into the Job of Home Care Aides: Transformation of the Workplace Health Environment

PubMed Central

Muramatsu, Naoko; Yin, Lijuan; Lin, Ting-Ti

2017-01-01

Home care aides (HCAs), predominantly women, constitute one of the fastest growing occupations in the United States. HCAs work in clients’ homes that lack typical workplace resources and benefits. This mixed-methods study examined how HCAs’ work environment was transformed by a pilot workplace health promotion program that targeted clients as well as workers. The intervention started with training HCAs to deliver a gentle physical activity program to their older clients in a Medicaid-funded home care program. Older HCAs aged 50+ reported increased time doing the types of physical activity that they delivered to their clients (stretching or strengthening exercise) (p = 0.027). Almost all (98%) HCAs were satisfied with the program. These quantitative results were corroborated by qualitative data from open-ended survey questions and focus groups. HCAs described how they exercised with clients and how the psychosocial work environment changed with the program. Building physical activity into HCAs’ job is feasible and can effectively promote HCAs’ health, especially among older HCAs. PMID:28379207
Building Health Promotion into the Job of Home Care Aides: Transformation of the Workplace Health Environment.

PubMed

Muramatsu, Naoko; Yin, Lijuan; Lin, Ting-Ti

2017-04-05

Home care aides (HCAs), predominantly women, constitute one of the fastest growing occupations in the United States. HCAs work in clients' homes that lack typical workplace resources and benefits. This mixed-methods study examined how HCAs' work environment was transformed by a pilot workplace health promotion program that targeted clients as well as workers. The intervention started with training HCAs to deliver a gentle physical activity program to their older clients in a Medicaid-funded home care program. Older HCAs aged 50+ reported increased time doing the types of physical activity that they delivered to their clients (stretching or strengthening exercise) ( p = 0.027). Almost all (98%) HCAs were satisfied with the program. These quantitative results were corroborated by qualitative data from open-ended survey questions and focus groups. HCAs described how they exercised with clients and how the psychosocial work environment changed with the program. Building physical activity into HCAs' job is feasible and can effectively promote HCAs' health, especially among older HCAs.
Using team cognitive work analysis to reveal healthcare team interactions in a birthing unit.

PubMed

Ashoori, Maryam; Burns, Catherine M; d'Entremont, Barbara; Momtahan, Kathryn

2014-01-01

Cognitive work analysis (CWA) as an analytical approach for examining complex sociotechnical systems has shown success in modelling the work of single operators. The CWA approach incorporates social and team interactions, but a more explicit analysis of team aspects can reveal more information for systems design. In this paper, Team CWA is explored to understand teamwork within a birthing unit at a hospital. Team CWA models are derived from theories and models of teamwork and leverage the existing CWA approaches to analyse team interactions. Team CWA is explained and contrasted with prior approaches to CWA. Team CWA does not replace CWA, but supplements traditional CWA to more easily reveal team information. As a result, Team CWA may be a useful approach to enhance CWA in complex environments where effective teamwork is required. This paper looks at ways of analysing cognitive work in healthcare teams. Team Cognitive Work Analysis, when used to supplement traditional Cognitive Work Analysis, revealed more team information than traditional Cognitive Work Analysis. Team Cognitive Work Analysis should be considered when studying teams.
Using team cognitive work analysis to reveal healthcare team interactions in a birthing unit

PubMed Central

Ashoori, Maryam; Burns, Catherine M.; d'Entremont, Barbara; Momtahan, Kathryn

2014-01-01

Cognitive work analysis (CWA) as an analytical approach for examining complex sociotechnical systems has shown success in modelling the work of single operators. The CWA approach incorporates social and team interactions, but a more explicit analysis of team aspects can reveal more information for systems design. In this paper, Team CWA is explored to understand teamwork within a birthing unit at a hospital. Team CWA models are derived from theories and models of teamworkand leverage the existing CWA approaches to analyse team interactions. Team CWA is explained and contrasted with prior approaches to CWA. Team CWA does not replace CWA, but supplements traditional CWA to more easily reveal team information. As a result, Team CWA may be a useful approach to enhance CWA in complex environments where effective teamwork is required. Practitioner Summary: This paper looks at ways of analysing cognitive work in healthcare teams. Team Cognitive Work Analysis, when used to supplement traditional Cognitive Work Analysis, revealed more team information than traditional Cognitive Work Analysis. Team Cognitive Work Analysis should be considered when studying teams PMID:24837514
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
Parental employment and work-family stress: Associations with family food environments

PubMed Central

Bauer, Katherine W.; Hearst, Mary O.; Escoto, Kamisha; Berge, Jerica M.; Neumark-Sztainer, Dianne

2013-01-01

Parental employment provides many benefits to children's health. However, an increasing number of studies have observed associations between mothers' full-time employment and less healthful family food environments. Few studies have examined other ways in which parental employment may be associated with the family food environment, including the role of fathers' employment and parents' stress balancing work and home obligations. This study utilized data from Project F-EAT, a population-based study of a socio-demographically diverse sample of 3709 parents of adolescents living in a metropolitan area in the Midwestern United States, to examine cross-sectional associations between mothers' and fathers' employment status and parents' work-life stress with multiple aspects of the family food environment. Among parents participating in Project F-EAT, 64% of fathers and 46% of mothers were full-time employed, while 25% of fathers and 37% of mothers were not employed. Results showed that full-time employed mothers reported fewer family meals, less frequent encouragement of their adolescents' healthful eating, lower fruit and vegetable intake, and less time spent on food preparation, compared to part-time and not-employed mothers, after adjusting for socio-demographics. Full-time employed fathers reported significantly fewer hours of food preparation; no other associations were seen between fathers' employment status and characteristics of the family food environment. In contrast, higher work-life stress among both parents was associated with less healthful family food environment characteristics including less frequent family meals and more frequent sugar-sweetened beverage and fast food consumption by parents. Among dual-parent families, taking into account the employment characteristics of the other parent did not substantially alter the relationships between work-life stress and family food environment characteristics. While parental employment is beneficial for many families, identifying policy and programmatic strategies to reduce parents' work-life stress may have positive implications for the family food environment and for the eating patterns and related health outcomes of children and parents. PMID:22591825
Parental employment and work-family stress: associations with family food environments.

PubMed

Bauer, Katherine W; Hearst, Mary O; Escoto, Kamisha; Berge, Jerica M; Neumark-Sztainer, Dianne

2012-08-01

Parental employment provides many benefits to children's health. However, an increasing number of studies have observed associations between mothers' full-time employment and less healthful family food environments. Few studies have examined other ways in which parental employment may be associated with the family food environment, including the role of fathers' employment and parents' stress balancing work and home obligations. This study utilized data from Project F-EAT, a population-based study of a socio-demographically diverse sample of 3709 parents of adolescents living in a metropolitan area in the Midwestern United States, to examine cross-sectional associations between mothers' and fathers' employment status and parents' work-life stress with multiple aspects of the family food environment. Among parents participating in Project F-EAT, 64% of fathers and 46% of mothers were full-time employed, while 25% of fathers and 37% of mothers were not employed. Results showed that full-time employed mothers reported fewer family meals, less frequent encouragement of their adolescents' healthful eating, lower fruit and vegetable intake, and less time spent on food preparation, compared to part-time and not-employed mothers, after adjusting for socio-demographics. Full-time employed fathers reported significantly fewer hours of food preparation; no other associations were seen between fathers' employment status and characteristics of the family food environment. In contrast, higher work-life stress among both parents was associated with less healthful family food environment characteristics including less frequent family meals and more frequent sugar-sweetened beverage and fast food consumption by parents. Among dual-parent families, taking into account the employment characteristics of the other parent did not substantially alter the relationships between work-life stress and family food environment characteristics. While parental employment is beneficial for many families, identifying policy and programmatic strategies to reduce parents' work-life stress may have positive implications for the family food environment and for the eating patterns and related health outcomes of children and parents. Copyright © 2012 Elsevier Ltd. All rights reserved.
Productive work groups in complex hospital units. Proposed contributions of the nurse executive.

PubMed

Sheafor, M

1991-05-01

The Fiedler and Garcia cognitive resources contingency model of leadership offers a new approach for nurse executives to influence the productivity of work groups led by nurse managers. The author offers recommendations toward achieving the relatively stress-free environment for nurse managers specified by the model using Schmeiding's application of Orlando's communication theory to nursing administration. Suggestions for incorporating these insights into graduate education for nursing administration follow.
Nurses' clinical experiences of the inverse bed position on a neurointensive care unit--a phenomenographic study.

PubMed

Dahl, Asa; Nyberg, Helene; Edéll-Gustafsson, Ulla

2003-10-01

Our knowledge of unstable critically ill patients placed in an inverse bed position on the neurointensive care unit (NICU) is fairly limited. The purpose of this study was to ascertain the variation in nurses' conceptions of the impact of clinical experiences on the care and working environments among patients with the head towards the centre of the room on an NICU. An important research question was: how is the nursing care of patients facing inwards on an NICU perceived? Interviews were conducted and analysed with 15 nurses, using the method of phenomenography. From a nursing perspective, four descriptive categories were found, which partly distinguished the nursing psychosocial environment from the physical environment. These were safety and security of mobile computer tomography (CT) on the NICU, availability and overview, integrated holistic view in an open nursing psychosocial environment and adaptation of practical equipment. In conclusion, inverse bed position is important for more individualised neurointensive nursing care among unstable patients subjected to frequent CT scans on the unit. More stable patients should be turned back to the traditional bed position in order to promote their recovery process. This new knowledge is important for the development of quality assurance, with regard to, amongst other things, the patient's dignity.
Healthy work environments for the ageing nursing workforce.

PubMed

Stichler, Jaynelle F

2013-10-01

The aim of this article is to describe the physical challenges that ageing nurses experience and the facility design features that can promote healthy work environments to motivate nurses to continue working. Older nurses are working longer and beyond the usual retirement age. They often experience chronic fatigue and the usual physical and cognitive changes associated with aging. Nursing is a physically demanding profession and many older nurses work in pain while providing direct patient care. The literature is replete with studies focusing on the organisational factors that retain older nurses, but little research addresses design factors that facilitate nurses working longer and more safely in direct patient care. Electronic databases in medicine, nursing, psychology, and architecture were searched and evidence-based, non-evidence-based, and review articles and government and organisational newsletters were evaluated. Hospital design can help address the physical work challenges that older nurses experience. Older nurses have a wealth of knowledge and expertise, and the design of nursing units can optimize their work experience. Nurse Managers must participate in design efforts and advocate designs that support aging nurses. © 2013 John Wiley & Sons Ltd.
Preparing Students for the New Reality

ERIC Educational Resources Information Center

Miller, Donald S.; Slocombe, Thomas E.

2012-01-01

The purpose of this paper is to explain the hypercompetitive new reality in the global marketplace, discuss cultural changes in the United States leading to declining student performance and graduates who are unprepared for a competitive work environment, and provide helpful ideas to educators functioning as coaches and mentors. We found extensive…
Science to Support Informed Decision-Making: Examples from the US Environmental Protection Agency

EPA Science Inventory

The mission of the United States Environmental Protection Agency (US EPA) is to protect human health and the environment. We work to achieve our mission through a combination of applied research and technical guidance for localities, states, tribes, and regions to best manage the...
How Things Work. Teacher's Guide.

ERIC Educational Resources Information Center

Brown, Mark; And Others

This unit examines the earth's processes and systems from an energy perspective. A technical language for discussion of energy systems is developed. Objectives include the ability of students to discuss earth's carbon/oxygen cycle, hydrological cycle, and heat patterns and the functioning of producers, consumers and decomposers in the environment.…
Public Employees: Facts at a Glance.

ERIC Educational Resources Information Center

American Federation of Labor and Congress of Industrial Organizations, Washington, DC. Public Employee Dept.

Seventeen million people are employed in the delivery of government services in the United States, more than half of these in education, health care, and public safety. Others provide services related to defense, postal service, the environment, housing, and administration. Though 82 percent of public employees work for state and local government,…
40 CFR 63.7886 - What are the general standards I must meet for my affected remediation material management units?

Code of Federal Regulations, 2013 CFR

2013-07-01

... required air pollution controls or have implemented the required work practice to reduce HAP emissions to... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for...
40 CFR 63.7886 - What are the general standards I must meet for my affected remediation material management units?

Code of Federal Regulations, 2012 CFR

2012-07-01

... required air pollution controls or have implemented the required work practice to reduce HAP emissions to... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for...

40 CFR 63.7886 - What are the general standards I must meet for my affected remediation material management units?

Code of Federal Regulations, 2014 CFR

2014-07-01

... required air pollution controls or have implemented the required work practice to reduce HAP emissions to... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for...
40 CFR 63.7886 - What are the general standards I must meet for my affected remediation material management units?

Code of Federal Regulations, 2011 CFR

2011-07-01

... required air pollution controls or have implemented the required work practice to reduce HAP emissions to... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for...
75 FR 50745 - Information Collection; National Survey on Recreation and the Environment (NSRE)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-17

... to: [email protected] . The public may inspect comments received at USDA Forest Service, Research...: H. Ken Cordell, Research Work Unit SRS-4953, 706-559-4263. Individuals who use telecommunication... 8 p.m., Eastern Standard Time, Monday through Friday. SUPPLEMENTARY INFORMATION: Title: National...
The Vocational Personality of School Psychologists in the United States

ERIC Educational Resources Information Center

Toomey, Kristine D.; Levinson, Edward M.; Morrison, Takea J.

2008-01-01

This study represents the first empirical test of the vocational personality of US school psychologists. Specifically, we investigated the personality of school psychologists using Holland's (1997) well-researched theory of vocational personalities and work environments. The sample consisted of 241 randomly selected members of the National…
Evaluating Fuel Leak and Aging Infrastructure at Red Hill, Hawaii, the Largest Underground Fuel Storage Facility in the United States

EPA Pesticide Factsheets

Learn about how EPA Region 9, Hawaii’s Department of Health, U.S. Navy, and Defense Logistics Agency are working tprotect human health and the environment at the Red Hill Bulk Fuel Storage Facility in Hawaii.
Being a Nursing Aide; Student Manual.

ERIC Educational Resources Information Center

American Hospital Association, Chicago, IL.

Developed for students receiving on-the-job training as nursing aides, this illustrated manual contains these chapters: (1) Orientation, (2) Introduction to the Patient, (3) Your Working Environment, (4) The Patient's Unit: Making the Unoccupied Bed, (5) Lifting, Moving, and Transporting Patients: Making the Occupied Bed, (6) Personal Care of the…
The "Redirecting" of International Students: American Higher Education Policy Hindrances and Implications

ERIC Educational Resources Information Center

García, Hugo A.; Villarreal, María de Lourdes

2014-01-01

International student mobility in higher education has gained currency as an important topic in today's global, political, and economic environment. United States postsecondary institutions are working to expand their international student population to increase revenue and diversity. The current higher education and economic context has produced…
Comprehensive Truck Size and Weight (TS&W) Study. Phase 1-synthesis, working paper 11 : environment and truck size and weight regulations

DOT National Transportation Integrated Search

2013-11-01

The United States (US) Department of Transportation (USDOT) and the Road Bureau of Ministry of Land, Infrastructure, Transport, and Tourism (MLIT) of Japan have a long history of sharing information on ITS (Intelligent Transportation Systems) activit...
[The margin of autonomy of nurses in psychiatry: for a clinical approach in the institution].

PubMed

Langellotti, Grégory

2013-01-01

In care units, nurses operate in working environments which offer them a margin of autonomy. When they seize upon this opportunity, they invent therapeutics tools. Their creativity as well as the pleasure given in the care contributes to the clinical dynamics within the institution.
Some Determinants of Employee Turnover in a Psychiatric Facility.

ERIC Educational Resources Information Center

Zautra, Alex J.; And Others

1987-01-01

Used research from illness-prevention and job-enrichment approaches to enhancing quality of work environments to create instruments assessing number of job stressors and level of task interest on psychiatric hospital units. Instruments successfully predicted employee turnover during one year. Job stress and interaction between job stress and task…
The Psychometric Properties and the Development of the Indicators of Quality Nursing Work Environments in Taiwan.

PubMed

Lin, Chiou-Fen; Lu, Meei-Shiow; Huang, Hsiu-Ying

2016-03-01

The nursing shortage in medical institutions in Taiwan averaged 9% in 2012, considerably higher than the 5% indicated in the literature. As a result, many hospitals have been forced to close wards or reduce beds. Despite the acute need, the percentage of registered nurses who are employed as nurses in Taiwan (60.4%) is considerably lower than those in Canada or the United States. This low rate may be because of the poor working environment for nurses in Taiwan. This study aimed to develop a set of nursing work environment quality indicators for Taiwan and to test the reliability and validity of the resulting survey tool. Multiple methods were used in this study. In Phase 1, we organized an expert panel, reviewed the literature, and conducted seven rounds of expert panel discussion and six focus group discussions with nursing directors. The goal was to draft indicators representing a quality nursing work environment to fit current conditions in Taiwan. In Phase 2, we conducted an expert review for content validity, held three public hearings, and conducted a survey. Four hundred twenty-seven questionnaires were sent out, with 381 returned. The goal was to test the content validity, construct validity, and internal consistency reliability. The study produced a set of indicators of a quality nursing work environment with eight dimensions and 65 items. The content validity index for importance and suitability dimensions were 1.0, whereas the internal consistency was 0.91. The eight dimensions were safe practice environment (16 items), quality and quantity of staff (four items), salary and welfare (seven items), professional specialization and teamwork (seven items), work simplification (five items), informatics (five items), career development (nine items), and support and caring (12 items). The overall load for the indicators was 77.57%. The developed indicators may be used to evaluate the quality of nursing work environments. Furthermore, the indicators may be used in hospital surveys to establish baseline conditions and for outcome research that measures improvement in nursing work environments after interventions.
To redesignate the Federal building and United States Courthouse located at 200 East Wall Street in Midland, Texas, as the "George H. W. Bush and George W. Bush United States Courthouse and George Mahon Federal Building".

THOMAS, 112th Congress

Rep. Conaway, K. Michael [R-TX-11

2011-01-20

Senate - 05/03/2011 Received in the Senate and Read twice and referred to the Committee on Environment and Public Works. (All Actions) Notes: For further action, see S.3687, which became Public Law 112-237 on 12/28/2012. Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:
Nursing care of the brain injury patient on a locked neurobehavioral unit.

PubMed

Becker, Christine

2012-01-01

Behavioral problems after a brain injury can be extremely challenging for those working with brain injured people. Nursing staff must be familiar with commonly used post brain injury medications and their effects, behavioral management plans, appropriate use of restrictive devices, and verbal or physical crisis intervention techniques when necessary. Rehabilitation nurses caring for brain injured patients on a locked neurobehavioral unit must maintain continual training and specific competence in this environment to ensure patient and staff safety. © 2012 Association of Rehabilitation Nurses.
Associations between school-level environment and science classroom environment in secondary schools

NASA Astrophysics Data System (ADS)

Dorman, Jeffrey P.; Fraser, Barry J.; McRobbie, Campbell J.

1995-09-01

This article describes a study of links between school environment and science classroom environment. Instruments to assess seven dimensions of school environment (viz., Empowerment, Student Support, Affiliation, Professional Interest, Mission Consensus, Resource Adequacy and Work Pressure) and seven dimensions of classroom environment (viz., Student Affiliation, Interactions, Cooperation, Task Orientation, Order & Organisation, Individualisati n and Teacher Control) in secondary school science classrooms were developed and validated. The study involved a sample of 1,318 students in 64 year 9 and year 12 science classes and 128 teachers of science in Australian secondary schools. Using the class mean as the unit of analysis for student data, associations between school and classroom environment were investigated using simple, multiple and canonical correlational analyses. In general, results indicated weak relationships between school and classroom environments and they reinforced the view that characteristics of the school environment are not transmitted automatically into science classrooms.
Innovative Information Systems in the Intensive Care Unit, King Saud Medical City in Saudi Arabia.

PubMed

Al Saleem, Nouf; Al Harthy, Abdulrahman

2015-01-01

The purpose of this paper is to discuss the experience of implementing innovative information technology to improve the quality of services in one of the largest Intensive Care Units in Saudi Arabia. The Intensive Care Units in King Saud Medical City (ICU-KSMC) is the main ICU in the kingdom that represents the Ministry of Health. KSMC's ICU is also considered one of the largest ICU in the world as it consists of six units with 129 beds. Leaders in KSMC's ICU have introduced and integrated three information technologies to produce powerful, accurate, and timely information systems to overcome the challenges of the ICU nature and improve the quality of service to ensure patients' safety. By 2015, ICU in KSMC has noticed a remarkable improvement in: beds' occupation and utilization, staff communication, reduced medical errors, and improved departmental work flow, which created a healthy professional work environment. Yet, ICU in KSMC has ongoing improvement projects that include future plans for more innovative information technologies' implementation in the department.
Work Related Psychosocial and Organizational Factors for Neck Pain in Workers in the United States

PubMed Central

Yang, Haiou; Hitchcock, Edward; Haldeman, Scott; Swanson, Naomi; Lu, Ming-Lun; Choi, BongKyoo; Nakata, Akinori; Baker, Dean

2016-01-01

Background Neck pain is a prevalent musculoskeletal condition among workers in the United States. This study explores a set of workplace psychosocial and organization-related factors for neck pain. Methods Data used for this study comes from the 2010 National Health interview Survey which provides a representative sample of the US population. To account for the complex sampling design, the Taylor linearized variance estimation method was used. Logistic regression models were constructed to measure the associations. Results This study demonstrated significant associations between neck pain and a set of workplace risk factors including work-family imbalance, exposure to a hostile work environment and job insecurity, non-standard work arrangements, multiple jobs and long work hours. Conclusion Workers with neck pain may benefit from intervention programs that address issues related to these workplace risk factors. Future studies exploring both psychosocial risk factors and physical risk factors with a longitudinal design will be important. PMID:27184340
Heatshield for Extreme Entry Environment Technology (HEEET) for Missions to Saturn and Beyond

NASA Technical Reports Server (NTRS)

Ellerby, D.; Blosser, M.; Chinnapongse, R.; Fowler, M.; Gasch, M.; Hamm, K.; Kazemba, C.; Ma, J.; Milos, F.; Nishioka, O.;

2015-01-01

This poster provides an overview of the requirements, design, development and testing of the 3D Woven TPS being developed under NASAs Heatshield for Extreme Entry Environment Technology (HEEET) project. Under this current program, NASA is working to develop a Thermal Protection System (TPS) capable of surviving entry into Saturn. A primary goal of the project is to build and test an Engineering Test Unit (ETU) to establish a Technical Readiness Level (TRL) of 6 for this technology by 2017.

Heatshield for Extreme Entry Environment Technology (HEEET) - Enabling Missions Beyond Heritage Carbon Phenolic

NASA Technical Reports Server (NTRS)

Ellerby, D.; Beerman, A.; Blosser, M.; Boghozian, T.; Chavez-Garcia, J.; Chinnapongse, R.; Fowler, M.; Gage, P.; Gasch, M.; Gonzales, G.;

2015-01-01

This poster provides an overview of the requirements, design, development and testing of the 3D Woven TPS being developed under NASA's Heatshield for Extreme Entry Environment Technology (HEEET) project. Under this current program, NASA is working to develop a Thermal Protection System (TPS) capable of surviving entry into Venus or Saturn. A primary goal of the project is to build and test an Engineering Test Unit (ETU) to establish a Technical Readiness Level (TRL) of 6 for this technology by 2017.

Heatshield for Extreme Entry Environment Technology (HEEET) Enabling Missions Beyond Heritage Carbon Phenolic

NASA Technical Reports Server (NTRS)

Ellerby, D.; Beerman, A.; Blosser, M.; Boghozian, T.; Chavez-Garcia, J.; Chinnapongse, R.; Fowler, M.; Gage, P.; Gasch, M.; Gonzaes, G.;

2015-01-01

This poster provides an overview of the requirements, design, development and testing of the 3D Woven TPS being developed under NASAs Heatshield for Extreme Entry Environment Technology (HEEET) project. Under this current program, NASA is working to develop a Thermal Protection System (TPS) capable of surviving entry into Venus or Saturn. A primary goal of the project is to build and test an Engineering Test Unit (ETU) to establish a Technical Readiness Level (TRL) of 6 for this technology by 2017.

Heatshield for Extreme Entry Environment Technology (HEEET) Development and Maturation Status for NF Missions

NASA Technical Reports Server (NTRS)

Ellerby, D.; Blosser, M.; Boghozian, T.; Chavez-Garcia, J.; Chinnapongse, R.; Fowler, M.; Gage, P.; Gasch, M.; Gonzales, G.; Hamm, K.;

2016-01-01

This poster provides an overview of the requirements, design, development and testing of the 3D Woven TPS being developed under NASA's Heatshield for Extreme Entry Environment Technology (HEEET) project. Under this current program, NASA is working to develop a Thermal Protection System (TPS) capable of surviving entry into Saturn. A primary goal of the project is to build and test an Engineering Test Unit (ETU) to establish a Technical Readiness Level (TRL) of 6 for this technology by 2017.

Increasing Military Physician Productivity in a Managed Care Environment

DTIC Science & Technology

1992-07-13

allows us to obtain to a common denominator, or one single rating even though the services are dissimilar and the input units are not "weighted." Serway ...many ideas as possible to catalyze the process. In removing barriers to productivity in the work environment, a thorough analysis of the physical ...physician and the organization has increased. The whole text of the book "Doctor’s Decisions and the Cost of Medical Care" is dedicated to this concept
The Orbital Debris Problem and the Challenges for Environment Remediation

NASA Technical Reports Server (NTRS)

Liou, J.-C.

2013-01-01

Orbital debris scientists from major international space agencies, including JAXA and NASA, have worked together to predict the trend of the future environment. A summary presentation was given to the United Nations in February 2013. The orbital debris population in LEO will continue to increase. Catastrophic collisions will continue to occur every 5 to 9 years center dot To limit the growth of the future debris population and to better protect future spacecraft, active debris removal, should be considered.
Heatshield for Extreme Entry Environment Technology (HEEET) Development and Maturation Status

NASA Technical Reports Server (NTRS)

Ellerby, D.; Boghozian, T.; Driver, D.; Chavez-Garcia, J.; Fowler, M.; Gage, P.; Gasch, M.; Gonzales, G.; Kazemba, C.; Kellermann, C.;

2018-01-01

This poster provides an overview of the requirements, design, development and testing of the 3D (Three Dimensional) Woven TPS (Thermal Protection System) being developed under NASA's Heatshield for Extreme Entry Environment Technology (HEEET) project. Under this current program, NASA is working to develop a TPS capable of surviving entry into Saturn. A primary goal of the project is to build and test an Engineering Test Unit (ETU) to establish a Technical Readiness Level (TRL) of 6 for this technology by 2017.

Does Finnish hospital staff job satisfaction vary across occupational groups?

PubMed Central

2013-01-01

Background Job satisfaction of staff is an essential outcome variable in research when describing the work environment of successful hospitals. Numerous studies have evaluated the topic, but few previous studies have assessed the job satisfaction of all staff in hospital settings. It is important to discover if there are any unsatisfied groups of people working in hospitals, the aspects they are unsatisfied with and why. The aim of this study was to evaluate job satisfaction of all staff working at a Finnish university hospital, identify differences in job satisfaction between staff groups, and explore the relationship between their self-evaluated quality of work and job satisfaction. Methods Data were collected from 1424 employees of the hospital using the web-based Kuopio University Job Satisfaction Scale survey instrument in autumn 2010. The research data were analysed by using SPSS 19.0 for Windows. Frequency and percentage distributions, as well as mean values, were used to describe the data. A non-parametric test (Kruskal–Wallis test) was used to determine the significance of differences in scores between different groups of staff members and between quality evaluations. Results The overall job satisfaction of the employees was good. They rated both motivating factors of their work and work welfare as excellent. The areas causing most dissatisfaction were work demands and participation in decision making. Physicians formed the most satisfied group, nurses and maintenance staff were the least satisfied, and office and administrative staff were fairly satisfied. Staff who rated the quality of work in their units as high usually also considered their job satisfaction to be excellent. Conclusions Every staff member has an influence on job satisfaction in her/his unit. A culture of participation should be developed and maintained in the units and the whole hospital to ensure that all staff feel they play important roles in the hospital. A university hospital is a complex, continuously changing work environment. Managers of the hospital should continuously evaluate job satisfaction and quickly react to the results gained. PMID:24088218
Work schedule flexibility is associated with emotional exhaustion among registered nurses in Swiss hospitals: A cross-sectional study.

PubMed

Dhaini, Suzanne R; Denhaerynck, Kris; Bachnick, Stefanie; Schwendimann, René; Schubert, Maria; De Geest, Sabina; Simon, Michael

2018-06-01

Emotional exhaustion among healthcare workers is a widely investigated, well-recognized problem, the incidence of which has recently been linked to work environment factors, particularly work/family conflict. However, another environmental feature that may be equally influential, but that is more amenable to nurse manager action, remains less recognized: shift schedule flexibility. This study's main purposes were to assess variations in work schedule flexibility between Swiss acute care hospital units, and to investigate associations between psychosocial work environment (e.g. work schedule flexibility) and self-reported emotional exhaustion among registered nurses. This is a secondary analysis of data collected for the multi-center observational cross-sectional Match RN study, which included a national sample of 23 hospitals and 1833 registered nurses across Switzerland. Overall, self-reported work schedule flexibility among registered nurses was limited: 32% of participants reported little or no influence in planning their own shifts. Work schedule flexibility (β -0.11; CI -0.16; -0.06) and perceived nurse manager ability (β -0.30; CI -0.49; -0.10) were negatively related to self-reported emotional exhaustion. Work-family conflict (β 0.39; CI 0.33; 0.45) was positively correlated to emotional exhaustion. The study results indicate that managerial efforts to improve working environments, including special efforts to improve work schedule flexibility, might play an important role in promoting nurses' emotional health. Copyright © 2018 Elsevier Ltd. All rights reserved.
Burnout in the intensive care unit professionals: A systematic review.

PubMed

Chuang, Chien-Huai; Tseng, Pei-Chi; Lin, Chun-Yu; Lin, Kuan-Han; Chen, Yen-Yuan

2016-12-01

Burnout has been described as a prolonged response to chronic emotional and interpersonal stress on the job that is often the result of a period of expending excessive effort at work while having too little recovery time. Healthcare workers who work in a stressful medical environment, especially in an intensive care unit (ICU), may be particularly susceptible to burnout. In healthcare workers, burnout may affect their well-being and the quality of professional care they provide and can, therefore, be detrimental to patient safety. The objectives of this study were: to determine the prevalence of burnout in the ICU setting; and to identify factors associated with burnout in ICU professionals. The original articles for observational studies were retrieved from PubMed, MEDLINE, and Web of Science in June 2016 using the following MeSH terms: "burnout" and "intensive care unit". Articles that were published in English between January 1996 and June 2016 were eligible for inclusion. Two reviewers evaluated the abstracts identified using our search criteria prior to full text review. To be included in the final analysis, studies were required to have employed an observational study design and examined the associations between any risk factors and burnout in the ICU setting. Overall, 203 full text articles were identified in the electronic databases after the exclusion of duplicate articles. After the initial review, 25 studies fulfilled the inclusion criteria. The prevalence of burnout in ICU professionals in the included studies ranged from 6% to 47%. The following factors were reported to be associated with burnout: age, sex, marital status, personality traits, work experience in an ICU, work environment, workload and shift work, ethical issues, and end-of-life decision-making. The impact of the identified factors on burnout remains poorly understood. Nevertheless, this review presents important information, suggesting that ICU professionals may suffer from a high level of burnout, potentially threatening patient care. Future work should address the effective management of the factors negatively affecting ICU professionals.
A multilevel analysis of the effects of the Practice Environment Scale of the Nursing Work Index on nurse outcomes.

PubMed

Gabriel, Allison S; Erickson, Rebecca J; Moran, Christina M; Diefendorff, James M; Bromley, Gail E

2013-12-01

Few researchers have examined how the components of the Practice Environment Scale of the Nursing Work Index (PES-NWI) relate to nurses' well-being at multiple organizational levels. The objective of the study was to perform a multilevel assessment of the relationships of the PES-NWI subscales with three nurse outcomes: job satisfaction, emotional exhaustion, and turnover intentions. Additionally, we tested the multilevel factor structure of the PES-NWI. In a sample of 699 full-time registered nurses in 79 units and 9 branches of a hospital system, relationships of the NWI with nurse outcomes were fairly consistent across levels of analysis. However, subscales contributed differently to the three outcomes, demonstrating the complexity of environmental influences on nurses' work experience. © 2013 Wiley Periodicals, Inc.
The relationship of staffing and work environment with implicit rationing of nursing care in Swiss nursing homes--A cross-sectional study.

PubMed

Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René

2015-09-01

Implicit rationing of nursing care refers to the withdrawal of or failure to carry out necessary nursing care activities due to lack of resources, in the literature also described as missed care, omitted care, or nursing care left undone. Under time constraints, nurses give priority to activities related to vital medical needs and the safety of the patient, leaving out documentation, rehabilitation, or emotional support of patients. In nursing homes, little is known about the occurrence of implicit rationing of nursing care and possible contributing factors. The purpose of this study was (1) to describe levels and patterns of self-reported implicit rationing of nursing care in Swiss nursing homes and (2) to explore the relationship between staffing level, turnover, and work environment factors and implicit rationing of nursing care. Cross-sectional, multi-center sub-study of the Swiss Nursing Home Human Resources Project (SHURP). Nursing homes from all three language regions of Switzerland. A random selection of 156 facilities with 402 units and 4307 direct care workers from all educational levels (including 25% registered nurses). We utilized data from established scales to measure implicit rationing of nursing care (Basel Extent of Rationing of Nursing Care), perceptions of leadership ability and staffing resources (Practice Environment Scale of the Nursing Work Index), teamwork and safety climate (Safety Attitudes Questionnaire), and work stressors (Health Professions Stress Inventory). Staffing level and turnover at the unit level were measured with self-developed questions. Multilevel linear regression models were used to explore the proposed relationships. Implicit rationing of nursing care does not occur frequently in Swiss nursing homes. Care workers ration support in activities of daily living, such as eating, drinking, elimination and mobilization less often than documentation of care and the social care of nursing homes residents. Statistically significant factors related to implicit rationing of care were the perception of lower staffing resources, teamwork and safety climate, and higher work stressors. Unit staffing and turnover levels were not related to rationing activities. Improving teamwork and reducing work stressors could possibly lead to less implicit rationing of nursing care. Further research on the relationship of implicit rationing of nursing care and resident and care worker outcomes in nursing homes is requested. Copyright © 2015 Elsevier Ltd. All rights reserved.
Health care aides use of time in a residential long-term care unit: a time and motion study.

PubMed

Mallidou, Anastasia A; Cummings, Greta G; Schalm, Corinne; Estabrooks, Carole A

2013-09-01

Organizational resources such as caregiver time use with older adults in residential long-term care facilities (nursing homes) have not been extensively studied, while levels of nurse staffing and staffing-mix are the focus of many publications on all types of healthcare organizations. Evidence shows that front-line caregivers' sufficient working time with residents is associated with performance, excellence, comprehensive care, quality of outcomes (e.g., reductions in pressure ulcers, urinary tract infections, and falls), quality of life, cost savings, and may be affiliated with transformation of organizational culture. To explore organizational resources in a long-term care unit within a multilevel residential facility, to measure healthcare aides' use of time with residents, and to describe working environment and unit culture. An observational pilot study was conducted in a Canadian urban 52-bed long-term care unit within a faith-based residential multilevel care facility. A convenience sample of seven healthcare aides consented to participate. To collect the data, we used an observational sheet (to monitor caregiver time use on certain activities such as personal care, assisting with eating, socializing, helping residents to be involved in therapeutic activities, paperwork, networking, personal time, and others), semi-structured interview (to assess caregiver perceptions of their working environment), and field notes (to illustrate the unit culture). Three hundred and eighty seven hours of observation were completed. The findings indicate that healthcare aides spent most of their working time (on an eight-hour day-shift) in "personal care" (52%) and in "other" activities (23%). One-to-three minute activities consumed about 35% of the time spent in personal care and 20% of time spent in assisting with eating. Overall, caregivers' time spent socializing was less than 1%, about 6% in networking, and less than 4% in paperwork. Re-organizing healthcare aides' routine practices may minimize the short one-to-three minute intervals spent on direct care activities, which can be interpreted as interruptions to continuity of care or waste of time. Fewer interruptions may allow healthcare aides to use their time with residents more effectively. Copyright © 2012 Elsevier Ltd. All rights reserved.
Mindfulness in Motion (MIM): An Onsite Mindfulness Based Intervention (MBI) for Chronically High Stress Work Environments to Increase Resiliency and Work Engagement.

PubMed

Klatt, Maryanna; Steinberg, Beth; Duchemin, Anne-Marie

2015-07-01

A pragmatic mindfulness intervention to benefit personnel working in chronically high-stress environments, delivered onsite during the workday, is timely and valuable to employee and employer alike. Mindfulness in Motion (MIM) is a Mindfulness Based Intervention (MBI) offered as a modified, less time intensive method (compared to Mindfulness-Based Stress Reduction), delivered onsite, during work, and intends to enable busy working adults to experience the benefits of mindfulness. It teaches mindful awareness principles, rehearses mindfulness as a group, emphasizes the use of gentle yoga stretches, and utilizes relaxing music in the background of both the group sessions and individual mindfulness practice. MIM is delivered in a group format, for 1 hr/week/8 weeks. CDs and a DVD are provided to facilitate individual practice. The yoga movement is emphasized in the protocol to facilitate a quieting of the mind. The music is included for participants to associate the relaxed state experienced in the group session with their individual practice. To determine the intervention feasibility/efficacy we conducted a randomized wait-list control group in Intensive Care Units (ICUs). ICUs represent a high-stress work environment where personnel experience chronic exposure to catastrophic situations as they care for seriously injured/ill patients. Despite high levels of work-related stress, few interventions have been developed and delivered onsite for such environments. The intervention is delivered on site in the ICU, during work hours, with participants receiving time release to attend sessions. The intervention is well received with 97% retention rate. Work engagement and resiliency increase significantly in the intervention group, compared to the wait-list control group, while participant respiration rates decrease significantly pre-post in 6/8 of the weekly sessions. Participants value institutional support, relaxing music, and the instructor as pivotal to program success. This provides evidence that MIM is feasible, well accepted, and can be effectively implemented in a chronically high-stress work environment.
Mindfulness in Motion (MIM): An Onsite Mindfulness Based Intervention (MBI) for Chronically High Stress Work Environments to Increase Resiliency and Work Engagement

PubMed Central

Klatt, Maryanna; Steinberg, Beth; Duchemin, Anne-Marie

2015-01-01

A pragmatic mindfulness intervention to benefit personnel working in chronically high-stress environments, delivered onsite during the workday, is timely and valuable to employee and employer alike. Mindfulness in Motion (MIM) is a Mindfulness Based Intervention (MBI) offered as a modified, less time intensive method (compared to Mindfulness-Based Stress Reduction), delivered onsite, during work, and intends to enable busy working adults to experience the benefits of mindfulness. It teaches mindful awareness principles, rehearses mindfulness as a group, emphasizes the use of gentle yoga stretches, and utilizes relaxing music in the background of both the group sessions and individual mindfulness practice. MIM is delivered in a group format, for 1 hr/week/8 weeks. CDs and a DVD are provided to facilitate individual practice. The yoga movement is emphasized in the protocol to facilitate a quieting of the mind. The music is included for participants to associate the relaxed state experienced in the group session with their individual practice. To determine the intervention feasibility/efficacy we conducted a randomized wait-list control group in Intensive Care Units (ICUs). ICUs represent a high-stress work environment where personnel experience chronic exposure to catastrophic situations as they care for seriously injured/ill patients. Despite high levels of work-related stress, few interventions have been developed and delivered onsite for such environments. The intervention is delivered on site in the ICU, during work hours, with participants receiving time release to attend sessions. The intervention is well received with 97% retention rate. Work engagement and resiliency increase significantly in the intervention group, compared to the wait-list control group, while participant respiration rates decrease significantly pre-post in 6/8 of the weekly sessions. Participants value institutional support, relaxing music, and the instructor as pivotal to program success. This provides evidence that MIM is feasible, well accepted, and can be effectively implemented in a chronically high-stress work environment. PMID:26168365
Nurses supporting nurses: creating a mentoring program for staff nurses to improve the workforce environment.

PubMed

Latham, Christine L; Hogan, Mikel; Ringl, Karen

2008-01-01

The hospital workforce environment has been recognized as an important factor for nurse retention and patient safety, yet there is ongoing evidence that inadequate communication, intraprofessional oppression, and lack of collaboration and conflict resolution continue to disempower nurses and hinder improvement of workforce conditions. A 3-year academic-hospital partnership developed and used a registered nurse (RN) mentor and advocacy program to improve the RN work environment and selected patient outcomes. The partnership initiated mentor-mentee teams and a Workforce Environment Governance Board, and obtained preliminary data on outcomes related to mentor-mentee teamwork, changes in the level of support within each unit, and the impact of improved working conditions on nurse and patient satisfaction, nurse vacancy and turnover rates, and 3 patient safety outcomes related to fall and pressure ulcer prevention and use of restraints. Dedicated mentors not only engaged in supporting fellow nurses but also assisted with enhancing the overall work environment for RNs. The partnership enhanced mutual respect between frontline RNs and managers, and allowed frontline RNs to improve the culture of support. The comprehensive approach to incorporating mentor-mentee teams changes the way fellow nurses and others perceive nurses, augments support by managers and coworkers, and improves patient care outcomes.
Turnover of professional nurses at Mokopane Hospital in the Limpopo Province, South Africa: Experiences of nursing unit managers.

PubMed

Mmamma, Mogale L; Mothiba, Tebogo M; Nancy, Malema R

2015-12-17

Staff turnover of professional nurses remains a concern for public and private hospitals management because it has an impact on the morale of nurses and it may also lead to poor patient care. The objectives of this study were to explore and describe the experiences of nursing unit managers with regard to the turnover of professional nurses who were under their supervision. A qualitative, explorative, descriptive research design was used to determine the experiences of nursing unit managers related to the turnover of professional nurses. Data collection was done by using semi-structured one-to-one interviews with professional nurses .Two groups of participants were interviewed: Those working day duty (n = 9) and those working night duty (n = 3) who were at work on the anticipated days for data collection. The findings revealed that every unit was experiencing a shortage of professional nurses, which caused other nurses to work overtime with an inevitable increase in workload. That led to tiredness, conflict amongst professional nurses, job dissatisfaction, and absenteeism which compromised nursing care. This resulted in patient dissatisfaction and sometimes led to deaths that could have been prevented. It is recommended that staff turnover should be addressed by the hospital top management implementing several strategies. For example, top management could ensure that staff members work in a healthy environment with resources that they need during the provision of care, address the effects of the staff turnover, support the staff members and refrain from putting pressure on nursing unit managers whilst they are attending to problems.
The professional nursing practice environment and nurse-reported job outcomes in two European countries: a survey of nurses in Finland and the Netherlands.

PubMed

Hinno, Saima; Partanen, Pirjo; Vehviläinen-Julkunen, Katri

2012-03-01

The working environment of nurses is receiving international interest, because there is a growing consensus that identifying opportunities for improving working conditions in hospitals is essential to maintain adequate staffing, high-quality care, nurses' job satisfaction and hence their retention. Thus, the aim of this study was to investigate the relationship between nurse work environment characteristics and nurse-reported job outcomes in hospital settings in Finland and the Netherlands and to compare these results. A comparative cross-sectional nurse survey was conducted. Data were collected from the two countries randomly sampling the countries' National Nurses Association' membership databases. In this paper, the results from Registered Nurses working in hospital settings are used. In total, 869 hospital nurses participated: 535 from Finland and 334 from the Netherlands with the response rate of 44.9 and 33.4%, respectively. Fifty-five items from the Nursing Work Index-Revised were used as a main tool for the practice environment. Exploratory factor analysis was used to identify a set of internally consistent subscales. Further, logistic regression analysis and T-tests were used. Three practice environment characteristics were identified: adequacy of resources, supportiveness of management and assurance of care quality via collaborative relationships. Favourable evaluations of the adequacy of resources and supportiveness of management were positively correlated with nurse-assessed quality of care and job-related positive feelings and negatively correlated with intentions to leave a unit, organization or the entire profession. In neither of the participating countries were adverse incidents affecting nurses related to nurses' evaluations of their current professional practice environment. Compared with Finland, in the Netherlands, RN appears to evaluate the majority of work environment characteristics more positively; nevertheless, to some extent, the results were uniform as adequacy of resources and supportiveness of management were main predictors for nurse-reported job outcomes considered. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.
The depositional environment and petrology of the White Rim Sandstone Member of the Permian Cutler Formation, Canyonlands National Park, Utah

USGS Publications Warehouse

Steele-Mallory, B. A.

1982-01-01

The White Rim Sandstone Member of the Cutler Formation of Permian age in Canyonlands National Park, Utah, was deposited in coastal eolian and associated interdune environments. This conclusion is based on stratigraphic relationships primary sedimentary structures, and petrologic features. The White Rim consists of two major genetic units. The first represents a coastal dune field and the second represents related interdune ponds. Distinctive sedimentary structures of the coastal dune unit include large- to medium-scale, unidirectional, tabular-planar cross-bedding; high-index ripples oriented parallel to dip direction of the foresets; coarse-grained lag layers; avalanche or slump marks; and raindrop impressions. Cross-bedding measurements suggest the dunes were deposited as transverse ridges by a dominantly northwest to southeast wind. Distinctive sedimentary structures of the interdune pond unit include wavy, horizontally laminated bedding, adhesion ripples, and desiccation polygons. These features may have been produced by alternate wetting and drying of sediment during water-table fluctuations. Evidence of bioturbation is also present in this unit. Petrologic characteristics of the White Rim helped to define the depositional environment as coastal. A crinoid fragment was identified at one location; both units are enriched in heavy minerals, and small amounts of well rounded, reworked glauconite were found in the White Rim throughout the study area. Earlier work indicates that the White Rim sandstone is late Wolfcampian to early Leonardian in age. During this time, the Canyonlands area was located in a depositional area alternately dominated by marine and nonmarine environments. Results of this study suggest the White Rim represents a coastal dune field that was deposited by predominantly on-shore winds during a period of marine transgression.
Keeping the Books for the Environment and Society: the Unification of Emergy and Financial Accounting Methods

EPA Science Inventory

Development of the concept of emergy established a medium for accounting that made it possible to express economic and environmental work of all kinds on a common basis as solar emjoules. Environmental accounting using emdollars, a combined emergy-monetary unit, can be used to pr...
Communication Skills for Career Education: Junior High/Middle Schools.

ERIC Educational Resources Information Center

Washington State Coordinating Council for Occupational Education, Olympia.

The teacher-developed guide attempts to establish a student-centered learning environment for the development of languaging capabilities through information and insights for students about themselves and the world of work. The flexibly arranged materials can be used as a one-semester course or as separate objectives and units within existing…
Owl Pellet Paleontology

ERIC Educational Resources Information Center

McAlpine, Lisa K.

2013-01-01

In this activity for the beginning of a high school Biology 1 evolution unit, students are challenged to reconstruct organisms found in an owl pellet as a model for fossil reconstruction. They work in groups to develop hypotheses about what animal they have found, what environment it inhabited, and what niche it filled. At the end of the activity,…
World Environmental Quality, A Challenge to the International Community.

ERIC Educational Resources Information Center

Department of State, Washington, DC.

The quality of the world environment cannot be dependent upon the efforts of a single nation. This fact is now recognized by most nations. Only through cooperative international actions can effective pollution control and natural resource conservation be realized. The purpose of this booklet is to publicize the work that the United States and…
Context and Continuity: Changing Perspectives on Children.

ERIC Educational Resources Information Center

Litowitz, Bonnie E.

When studied closely, it is evident that children who seem to be developing through their own interactions with the environment are really benefiting from adult interactions in the process. The developing child must form a dyadic relationship with a caretaking adult. The complex workings of that dyadic unit now preoccupy researchers as they study…

The Impact of New Information Technology on Bureaucratic Organizational Culture

ERIC Educational Resources Information Center

Givens, Mark A.

2011-01-01

Virtual work environments (VWEs) have been used in the private sector for more than a decade, but the United States Marine Corps (USMC), as a whole, has not yet taken advantage of associated benefits. The USMC construct parallels the bureaucratic organizational culture and uses an antiquated information technology (IT) infrastructure. During an…
Let's Meet in Nepantla: The Possibility of Thirdspace as a Place "Others" Call Home

ERIC Educational Resources Information Center

Chávez, Minerva S.

2015-01-01

This autoethnography posits that my presence as a working-class Chicana obtaining an education in the United States consequently created a Thirdspace environment I recognize as Nepantla. Thirdspace allowed me to navigate urban schooling and elite institutions of higher education. Two narratives demonstrate opposing forms of acquired dominant and…
Compassion Satisfaction and Compassion Fatigue Among Critical Care Nurses.

PubMed

Sacco, Tara L; Ciurzynski, Susan M; Harvey, Megan Elizabeth; Ingersoll, Gail L

2015-08-01

Although critical care nurses gain satisfaction from providing compassionate care to patients and patients' families, the nurses are also at risk for fatigue. The balance between satisfaction and fatigue is considered professional quality of life. To establish the prevalence of compassion satisfaction and compassion fatigue in adult, pediatric, and neonatal critical care nurses and to describe potential contributing demographic, unit, and organizational characteristics. In a cross-sectional design, nurses were surveyed by using a demographic questionnaire and the Professional Quality of Life Scale to measure levels of compassion fatigue and compassion satisfaction. Nurses (n = 221) reported significant differences in compassion satisfaction and compassion fatigue on the basis of sex, age, educational level, unit, acuity, change in nursing management, and major systems change. Understanding the elements of professional quality of life can have a positive effect on work environment. The relationship between professional quality of life and the standards for a healthy work environment requires further investigation. Once this relationship is fully understood, interventions to improve this balance can be developed and tested. ©2015 American Association of Critical-Care Nurses.
Availability Performance Analysis of Thermal Power Plants

NASA Astrophysics Data System (ADS)

Bhangu, Navneet Singh; Singh, Rupinder; Pahuja, G. L.

2018-03-01

This case study presents the availability evaluation method of thermal power plants for conducting performance analysis in Indian environment. A generic availability model has been proposed for a maintained system (thermal plants) using reliability block diagrams and fault tree analysis. The availability indices have been evaluated under realistic working environment using inclusion exclusion principle. Four year failure database has been used to compute availability for different combinatory of plant capacity, that is, full working state, reduced capacity or failure state. Availability is found to be very less even at full rated capacity (440 MW) which is not acceptable especially in prevailing energy scenario. One of the probable reason for this may be the difference in the age/health of existing thermal power plants which requires special attention of each unit from case to case basis. The maintenance techniques being used are conventional (50 years old) and improper in context of the modern equipment, which further aggravate the problem of low availability. This study highlights procedure for finding critical plants/units/subsystems and helps in deciding preventive maintenance program.
Influence of workplace culture on nursing-sensitive nurse outcomes in municipal primary health care.

PubMed

Hahtela, Nina; Paavilainen, Eija; McCormack, Brendan; Slater, Paul; Helminen, Mika; Suominen, Tarja

2015-10-01

To explore the influence of workplace culture on sickness absences, overtime work and occupational injuries in municipal primary health care. The need to improve nursing sensitive outcomes has been highlighted. Therefore, an adequate understanding of the influence of workplace culture on nursing-sensitive nurse outcomes is essential for nurse managers to meet the requirements of improving nursing outcomes. A cross-sectional survey design was used to incorporating the data from 21 inpatient acute care units of nine organisations at the Finnish municipal primary health care system from 2011 to 2012. Findings emphasise in particular the importance of the practice environment as being an interpretative factor for nurses' absences owing to sickness, overtime work and occupational injuries. To ensure favourable nursing sensitive outcomes it is essential that there is a shared interest in the unit to invest in the creation of a supportive practice environment. Outcome improvements require a special focus on issues related to nursing management, adequate staffing and resources and intention to leave. © 2014 John Wiley & Sons Ltd.
Management Commitment to Safety, Teamwork, and Hospital Worker Injuries.

PubMed

McGonagle, Alyssa K; Essenmacher, Lynnette; Hamblin, Lydia; Luborsky, Mark; Upfal, Mark; Arnetz, Judith

2016-01-01

Although many studies link teamwork in health care settings to patient safety, evidence linking teamwork to hospital worker safety is lacking. This study addresses this gap by providing evidence linking teamwork perceptions in hospital workers to worker injuries, and further, finds a linkage between manager commitment to safety and teamwork. Organizational records of worker injuries and survey responses regarding management commitment to safety and teamwork from 446 hospital workers within 42 work units in a multi-site hospital system were examined. Results underscored the particular importance of teamwork on worker injuries as well as the importance of management commitment to safety as relating to teamwork. To improve worker safety, organizational leaders and unit managers should work to maintain environments wherein teamwork can thrive.
Management Commitment to Safety, Teamwork, and Hospital Worker Injuries

PubMed Central

McGonagle, Alyssa K.; Essenmacher, Lynnette; Hamblin, Lydia; Luborsky, Mark; Upfal, Mark; Arnetz, Judith

2016-01-01

Although many studies link teamwork in health care settings to patient safety, evidence linking teamwork to hospital worker safety is lacking. This study addresses this gap by providing evidence linking teamwork perceptions in hospital workers to worker injuries, and further, finds a linkage between manager commitment to safety and teamwork. Organizational records of worker injuries and survey responses regarding management commitment to safety and teamwork from 446 hospital workers within 42 work units in a multi-site hospital system were examined. Results underscored the particular importance of teamwork on worker injuries as well as the importance of management commitment to safety as relating to teamwork. To improve worker safety, organizational leaders and unit managers should work to maintain environments wherein teamwork can thrive. PMID:27867448
Development and Evaluation of a Continuing Education Program for Nursing Technicians at a Pediatric Cardiac Intensive Care Unit in a Developing Country.

PubMed

Borim, Bruna Cury; Croti, Ulisses A; Silveira, Patricia C; De Marchi, Carlos H; Moscardini, Airton C; Hickey, Patricia; Jenkins, Kathy

2017-11-01

The nursing profession faces continuous transformations demonstrating the importance of professional continuing education to extend knowledge following technological development without impairing quality of care. Nursing assistants and technicians account for nearly 80% of nursing professionals in Brazil and are responsible for uninterrupted patient care. Extensive knowledge improvement is needed to achieve excellence in nursing care. The objective was to develop and evaluate a continuing education program for nursing technicians at a pediatric cardiac intensive care unit (PCICU) using a virtual learning environment entitled EDUCATE. From July to September 2015, a total of 24 nursing technicians working at the PCICU at a children's hospital located in the northwestern region of São Paulo state (Brazil) fully participated in the continuing education program developed in a virtual learning environment using Wix platform, allowing access to video classes and pre- and post-training theoretical evaluation questionnaires outside the work environment. The evaluation tools recorded participants' knowledge evolution, technological difficulties, educational, and overall rating. Knowledge development was descriptively presented as positive in more than 66.7%. Content and training were considered "excellent" by most participants and 90% showed an interest in the use of technological resources. Technical difficulties were found and quickly resolved by 40% of participants including Internet access, login, and lack of technical expertise. The continuing education program using a virtual learning environment positively contributed to the improvement in theoretical knowledge of nursing technicians in PCICU.
Post-Closure Challenges of U.S. Department of Energy Sites in Desert Environments of the Southwestern United States - 12095

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

Gil, April; Steckley, Deborah; Gauthier, Cassie

2012-07-01

U.S. Department of Energy (DOE) sites located in harsh desert environments of the Four Corners region of the southwestern United States require diligence and continual maintenance to ensure the remediation systems function as designed to protect human health and the environment. The geology and climate of this area create issues that are unique to these sites. Geologic formations contain naturally occurring constituents that are often the same as the residual contaminants remaining from historical milling activities at the sites. Although annual precipitation is low, when precipitation events occur they can be of extreme intensity, resulting in erosion and flooding thatmore » can quickly destroy infrastructure and rapidly change site conditions. Winds can cause sand storms and sand mounding that effect site features. These challenging environmental conditions, along with the remote locations of the sites, require active management beyond what was originally envisioned for uranium disposal sites to address concerns in a safe and cost-effective manner. The unique environment of the Four Corners region creates many challenges to the LTSM of LM sites in southwestern United States. The remediation efforts and approaches to infrastructure have to be specifically structured to work in this environment. Often, the systems and structures have to be modified based on lessons learned on how to best adapt to these difficult conditions and remote locations. These sites require continual maintenance and additional efforts compared to many other LM sites. (authors)« less
Stress, coping and burnout among Intensive Care Unit nursing staff: associated factors.

PubMed

Andolhe, Rafaela; Barbosa, Ricardo Luis; Oliveira, Elaine Machado de; Costa, Ana Lúcia Siqueira; Padilha, Katia Grillo

2015-02-01

Objective To investigate emotional stress, coping and burnout among nursing staff and their association with biosocial factors and characteristics of work in Intensive Care Units (ICU). Method This was a cross-sectional study, conducted in eight ICUs at a teaching hospital in the city of São Paulo, Brazil, in October 2012. Biosocial data and information about the professionals' work was gathered, and they were given the Scale of Occupational Stress, Scale of Occupational Coping, List of Signs and Symptoms of Stress and the Maslach Burnout Inventory. Results The study sample consisted of 287 subjects, predominately women, with partners and children. Most professionals presented moderate stress levels and control as a coping strategy (74.47% and 79.93%, respectively), and burnout was present among 12.54%. Factors associated with stress were related to working conditions. The most prevalent protective factors were having a partner, working in the clinical ICU and liking work, while adequate amount of sleep was a protective factor for burnout. Conclusion Control of the working environment and adequate sleep are decisive and protective factors in dealing with situations of occupational stress.
The thermal environment effect on the comfort of electronic factory worker

NASA Astrophysics Data System (ADS)

Nurul Huda, Listiani

2018-03-01

In this paper, thermal comfort issues of the operators working on one of the electronics companies in the evaporator area are observed. The objective of this study is to reduce Percentage of Dissatisfied (PD) of operators in an effort to improve the work productivity. PD is predicted using CBE Thermal Comfort Tool by measuring the thermal variables around the evaporator area and by calculating the Heat Stress Index (HSI). The operator productivity is analyzed by Wet Bulb Globe Thermometer (WBGT) Work-Rest Chart. The PD of operators before and after improvement is compared. The results showed that the average temperature around the operators area at evaporator station is high with average WBGT of 33,6°C. HSI value is 51.95 indicating that the effect of 8-h exposure is severe strain with work impact is health threat for unit operators and acclimatization is necessary. The PD value is 96% indicating that almost all operators feel uncomfortable at work. These indicate that the thermal environment should be improved. The proposed improvement is by installing water cooled and sprayed into the evaporator area. This installation is able to reduce HSI and PD by more 70% and more 60%, respectively. These findings indicate that improving the thermal environment will be able to improve working comfort which will further affect the level of work productivity.
Physical Work Environment as a Managerial Tool for Decreasing Job-Related Anxiety and Improving Employee-Employer Relations.

PubMed

Sadatsafavi, Hessam; Walewski, John; Shepley, Mardelle

2015-01-01

The expected increase in healthcare needs resulting from the Affordable Care Act and the growing population of older citizens in the United States is challenging owners and operators of hospitals to improve quality of care and reduce operational costs. Meanwhile, studies have indicated a serious shortage in the healthcare workforce and have highlighted the critical role of employees' job-related attitudes and feelings. The main objective of this study was to test whether employees' evaluations of important environments within hospitals were significantly associated with their job-related attitudes and feelings, and whether this relationship varied across different demographic groups. About 700 healthcare professionals from 10 acute-care hospitals run by three healthcare organizations participated in this cross-sectional study. Structural equation modeling found that employees' evaluations of their physical work environment were significantly associated with lower rates of job-related anxiety, higher levels of job satisfaction, and increased rates of organizational commitment. Perceived organizational support was responsible for mediating part of these relationships, indicating that employees can perceive a healthy work environment as a sign of their organization valuing them and caring about their well-being. When distinguishing between different spaces, analysis found that satisfaction with rest areas and work spaces had the largest effect size, while the influence of patient areas was small. Employees newer to the facility and to the organization were more influenced by the physical work environment. This study provides preliminary evidence that facility design can be used as a managerial tool for improving employees' job-related attitudes and feelings and earning their commitment.
Data analysis and integration of environmental sensors to meet human needs

NASA Astrophysics Data System (ADS)

Santamaria, Amilcare Francesco; De Rango, Floriano; Barletta, Domenico; Falbo, Domenico; Imbrogno, Alessandro

2014-05-01

Nowadays one of the main task of technology is to make people's life simpler and easier. Ambient intelligence is an emerging discipline that brings intelligence to environments making them sensitive to us. This discipline has developed following the spread of sensors devices, sensor networks, pervasive computing and artificial intelligence. In this work, we attempt to enhance the Internet Of Things (loT) with intelligence and environments exploring various interactions between humans' beings and the environment they live in. In particular, the core of the system is composed of an automation system, which is made up with a domotic control unit and several sensors installed in the environment. The task of the sensors is to collect information from the environment and to send them to the control unit. Once the information is collected, the core combines them in order to infer the most accurate human needs. The knowledge of human needs and the current environment status compose the inputs of the intelligence block whose main goal is to find the right automations to satisfy human needs in a real time way. The system also provides a Speech Recognition service which allow users to interact with the system by their voice so human speech can be considered as additional input for smart automatisms.
Predictors of nurse manager stress: a dominance analysis of potential work environment stressors.

PubMed

Kath, Lisa M; Stichler, Jaynelle F; Ehrhart, Mark G; Sievers, Andree

2013-11-01

Nurse managers have important but stressful jobs. Clinical or bedside nurse predictors of stress have been studied more frequently, but less has been done on work environment predictors for those in this first-line leadership role. Understanding the relative importance of those work environment predictors could be used to help identify the most fruitful areas for intervention, potentially improving recruitment and retention for nurse managers. Using Role Stress Theory and the Job Demands-Resources Theory, a model was tested examining the relative importance of five potential predictors of nurse manager stress (i.e., stressors). The work environment stressors included role ambiguity, role overload, role conflict, organizational constraints, and interpersonal conflict. A quantitative, cross-sectional survey study was conducted with a convenience sample of 36 hospitals in the Southwestern United States. All nurse managers working in these 36 hospitals were invited to participate. Of the 636 nurse managers invited, 480 responded, for a response rate of 75.5%. Questionnaires were distributed during nursing leadership meetings and were returned in person (in sealed envelopes) or by mail. Because work environment stressors were correlated, dominance analysis was conducted to examine which stressors were the most important predictors of nurse manager stress. Role overload was the most important predictor of stress, with an average of 13% increase in variance explained. The second- and third-most important predictors were organizational constraints and role conflict, with an average of 7% and 6% increase in variance explained, respectively. Because other research has shown deleterious effects of nurse manager stress, organizational leaders are encouraged to help nurse managers reduce their actual and/or perceived role overload and organizational constraints. Copyright © 2013 Elsevier Ltd. All rights reserved.
Improving ward environments and developing skills for discharge with the implementation of self-catering on a low secure forensic unit.

PubMed Central

O'Reilly, Alison

2016-01-01

The opportunities for service users to develop skills for more independent living and take control of their environments are limited in secure mental health units. This paper will outline a quality improvement project that changed how the catering services were delivered in a low secure unit in East London NHS Foundation Trust (ELFT). A Quality Improvement methodology was adopted incorporating the Plan, Do, Study, Act (PDSA) cycle which included the trial of service users preparing their own meals on a daily basis. The participation rates were measured and functional daily living skills were recorded. Following success of the trial, long-term implementation of self-catering was agreed, with service users being supported to prepare a shared evening meal every day on the ward with an average of 60% participation. Functional living skills indicated an improvement in the area of process skills. The project aligned with ELFT's aims of service users working in collaboration with staff to implement changes in service delivery. PMID:28090324
Improving ward environments and developing skills for discharge with the implementation of self-catering on a low secure forensic unit.

PubMed

O'Reilly, Alison

2016-01-01

The opportunities for service users to develop skills for more independent living and take control of their environments are limited in secure mental health units. This paper will outline a quality improvement project that changed how the catering services were delivered in a low secure unit in East London NHS Foundation Trust (ELFT). A Quality Improvement methodology was adopted incorporating the Plan, Do, Study, Act (PDSA) cycle which included the trial of service users preparing their own meals on a daily basis. The participation rates were measured and functional daily living skills were recorded. Following success of the trial, long-term implementation of self-catering was agreed, with service users being supported to prepare a shared evening meal every day on the ward with an average of 60% participation. Functional living skills indicated an improvement in the area of process skills. The project aligned with ELFT's aims of service users working in collaboration with staff to implement changes in service delivery.
A mobile unit for memory retrieval in daily life based on image and sensor processing

NASA Astrophysics Data System (ADS)

Takesumi, Ryuji; Ueda, Yasuhiro; Nakanishi, Hidenobu; Nakamura, Atsuyoshi; Kakimori, Nobuaki

2003-10-01

We developed a Mobile Unit which purpose is to support memory retrieval of daily life. In this paper, we describe the two characteristic factors of this unit. (1)The behavior classification with an acceleration sensor. (2)Extracting the difference of environment with image processing technology. In (1), By analyzing power and frequency of an acceleration sensor which turns to gravity direction, the one's activities can be classified using some techniques to walk, stay, and so on. In (2), By extracting the difference between the beginning scene and the ending scene of a stay scene with image processing, the result which is done by user is recognized as the difference of environment. Using those 2 techniques, specific scenes of daily life can be extracted, and important information at the change of scenes can be realized to record. Especially we describe the effect to support retrieving important things, such as a thing left behind and a state of working halfway.
Safety and Security Concerns of Nurses Working in the Intensive Care Unit: A Qualitative Study.

PubMed

Keys, Yolanda; Stichler, Jaynelle F

Intensive care units (ICUs) exist to serve as a safe place for critically ill patients to receive care from skilled practitioners. In this qualitative study, ICU nurses shared their perspectives on elements that promote safety and security on their units. After obtaining institutional review board approval, participants participated in telephone interviews with a nurse researcher who has experience as a bedside ICU nurse. Five categories and 14 themes were identified and then confirmed using member checking. Results indicate that participants prefer to provide care in ICUs with no more than 12 to 14 beds and provide the following: visibility of patients and coworkers; more than 1 way to exit; and can be locked in case of emergency or threat. Nearly all respondents mentioned adequate staffing as the most important attribute of a safe, secure care environment for patients and families. More research is needed to identify design features that make the most impact on providing a safe, secure ICU environment.
Longitudinal Associations between Maternal Work Stress, Negative Work-Family Spillover, and Depressive Symptoms

PubMed Central

Goodman, W. Benjamin; Crouter, Ann C.

2009-01-01

The current study examined associations over an 18-month period between maternal work stressors, negative work-family spillover, and depressive symptoms in a sample of 414 employed mothers with young children living in six predominantly nonmetropolitan counties in the Eastern United States. Results from a one-group mediation model revealed that a less flexible work environment and greater work pressure predicted higher levels of depressive symptoms, and further, that these associations were mediated by perceptions of negative work-family spillover. Additionally, results from a two-group mediation model suggested that work pressure predicted greater perceptions of spillover only for mothers employed full-time. Findings suggest the need for policies that reduce levels of work stress and help mothers manage their work and family responsibilities. PMID:20161088
Longitudinal Associations between Maternal Work Stress, Negative Work-Family Spillover, and Depressive Symptoms.

PubMed

Goodman, W Benjamin; Crouter, Ann C

2009-07-01

The current study examined associations over an 18-month period between maternal work stressors, negative work-family spillover, and depressive symptoms in a sample of 414 employed mothers with young children living in six predominantly nonmetropolitan counties in the Eastern United States. Results from a one-group mediation model revealed that a less flexible work environment and greater work pressure predicted higher levels of depressive symptoms, and further, that these associations were mediated by perceptions of negative work-family spillover. Additionally, results from a two-group mediation model suggested that work pressure predicted greater perceptions of spillover only for mothers employed full-time. Findings suggest the need for policies that reduce levels of work stress and help mothers manage their work and family responsibilities.

Radiofrequency identification: exploiting an old technology for measuring nurse time and motion.

PubMed

Jones, Terry L

2012-09-01

A national campaign is underway to increase the amount of time staff nurses spend at the bedside of hospitalized patients through redesign of the work environment. This kind of work redesign requires robust data depicting what nurses do and how they spend their time. Historically, these kinds of data have been difficult, costly, and time consuming to collect. Wireless capture of data on the movement of humans within the work environment (ie, time and motion) is now possible through radiofrequency identification technology. When small tracking devices the size of a quarter are affixed to their clothing, the movement of nurses throughout a patient care unit can be monitored. The duration and frequency of patient interaction are captured along with the duration of time spent in other locations of interest to include nurses' station, supply room, medication room, doctors' station, electronic documentation stations, family waiting rooms, and the hallway. Patterns of nurse movement and time allocation can be efficiently identified, and the effects of staffing practices, workflows, and unit layout evaluated. Integration of radiofrequency identification time and motion data with other databases enables nurse leaders to link nursing time to important cost and quality outcomes. Nurse leaders should explore the usefulness of radiofrequency identification technology in addressing data needs for nurse time and motion.
Radiofrequency Identification

PubMed Central

Jones, Terry L.

2017-01-01

A national campaign is underway to increase the amount of time staff nurses spend at the bedside of hospitalized patients through redesign of the work environment. This kind of work redesign requires robust data depicting what nurses do and how they spend their time. Historically, these kinds of data have been difficult, costly, and time consuming to collect. Wireless capture of data on the movement of humans within the work environment (ie, time and motion) is now possible through radiofrequency identification technology. When small tracking devices the size of a quarter are affixed to their clothing, the movement of nurses throughout a patient care unit can be monitored. The duration and frequency of patient interaction are captured along with the duration of time spent in other locations of interest to include nurses’ station, supply room, medication room, doctors’ station, electronic documentation stations, family waiting rooms, and the hallway. Patterns of nurse movement and time allocation can be efficiently identified, and the effects of staffing practices, workflows, and unit layout evaluated. Integration of radiofrequency identification time and motion data with other databases enables nurse leaders to link nursing time to important cost and quality outcomes. Nurse leaders should explore the usefulness of radiofrequency identification technology in addressing data needs for nurse time and motion. PMID:22592451
Personal Cooling for Extra-Vehicular Activities on Mars

NASA Technical Reports Server (NTRS)

Pu, Zhengxiang; Kapat, Jay; Chow, Louis; Recio, Jose; Rini, Dan; Trevino, Luis

2004-01-01

Extra-vehicular activities (EVA) on Mars will require suits with sophisticated thermal control systems so that astronauts can work comfortably for extended periods of time. Any use of consumables such as water that cannot be easily replaced should be of particular concern. In this aspect the EVA suits for Mars environment need to be different from the current Space Shuttle Extra Vehicular Mobility Units (EMU) that depend on water sublimation into space for removing heat from suits. Moreover, Mars environment is quite different from what a typical EMU may be exposed to. These variations call for careful analysis and innovative engineering for design and fabrication of an appropriate thermal control system. This paper presents a thermal analysis of astronaut suits for EVA with medium metabolic intensity under a typical hot and a nominal cold environment on Mars. The paper also describes possible options that would allow conservation of water with low usage of electrical power. The paper then presents the conceptual design of a portable cooling unit for one such solution.
Transforming Care at the Bedside (TCAB): enhancing direct care and value-added care.

PubMed

Dearmon, Valorie; Roussel, Linda; Buckner, Ellen B; Mulekar, Madhuri; Pomrenke, Becky; Salas, Sheri; Mosley, Aimee; Brown, Stephanie; Brown, Ann

2013-05-01

The purpose of this study was to examine the effectiveness of a Transforming Care at the Bedside initiative from a unit perspective. Improving patient outcomes and nurses' work environments are the goals of Transforming Care at the Bedside. Transforming Care at the Bedside creates programs of change originating at the point of care and directly promoting engagement of nurses to transform work processes and quality of care on medical-surgical units. This descriptive comparative study draws on multiple data sources from two nursing units: a Transforming Care at the Bedside unit where staff tested, adopted and implemented improvement ideas, and a control unit where staff continued traditional practices. Change theory provided the framework for the study. Direct care and value-added care increased on Transforming Care at the Bedside unit compared with the control unit. Transforming Care at the Bedside unit decreased in incidental overtime. Nurses reported that the process challenged old ways of thinking and increased nursing innovations. Hourly rounding, bedside reporting and the use of pain boards were seen as positive innovations. Evidence supported the value-added dimension of the Transforming Care at the Bedside process at the unit level. Nurses recognized the significance of their input into processes of change. Transformational leadership and frontline projects provide a vehicle for innovation through application of human capital. © 2012 Blackwell Publishing Ltd.
Work stress, burnout, and perceived quality of care: a cross-sectional study among hospital pediatricians.

PubMed

Weigl, M; Schneider, A; Hoffmann, F; Angerer, P

2015-09-01

Poor hospital work environments affect physicians' work stress. With a focus on hospital pediatricians, we sought to investigate associations between work stress, burnout, and quality of care. A cross-sectional study was conducted in N = 96 pediatricians of a German academic children's hospital (response rate = 73.8 %). All variables were assessed with standardized questionnaires. Multivariate regression analyses were applied to investigate associations after adjusting for potential confounders. Critically high work stress (effort/reward ratio, ERR > 1.0) was reported by N = 25 (28.4 %) participants. Pediatricians in inpatient wards had significantly more work stress than their colleagues in intensive care units and outpatient wards; 10.2 % of surveyed pediatricians reported critically high burnout. Again, inpatient ward staff reported significantly increased emotional exhaustion. After controlling for several confounders, we found that pediatricians with high work stress and emotional exhaustion reported reduced quality of care. Mediation analyses revealed that especially pediatricians' emotional exhaustion partially mediated the effect of work stress on quality of care. Results demonstrate close relationships between increased work stress and burnout as well as diminished quality of care. High work stress environments in pediatric care influence mental health of pediatricians as well as quality of patient care. • The quality of pediatricians' work environment in the hospital is associated with their work stress and burnout. • The consequences of pediatricians' work life for the quality of care need to be addressed in order to inform interventions to improve work life and care quality. • Our study shows associations between increased work stress and burnout with mitigated quality of care. • Beyond indirect effects of work stress through emotional exhaustion on quality of care we also observed direct detrimental effects of pediatricians' work stress on mitigated care quality.
The impact of computer usage on the perceptions of hospital secretaries.

PubMed

Foner, C; Nour, M; Luo, X; Kim, J

1991-09-01

This study explored the perceptions of hospital unit secretaries regarding computer usage. Specifically, six attitudinal variables: performance, resistance, interpersonal relations, satisfaction, challenge, and work overload were examined. The study had two major findings: (1) hospital unit secretaries have positive perceptions of job performance, satisfaction, and challenge as a result of using the PHAMIS computer system and (2) hospital unit secretaries do not feel resistant to the system, overloaded with work, or inclined to increase their interpersonal interaction with coworkers. These two findings might appear contradictory on the surface, but in fact are consistent with overall positive perceptions about the PHAMIS system. The study also considered the impact of two independent variables--age and number of years at work--on the responses of subjects. The analysis indicated that together these two variables explained some variations in the values of at least two of the dependent variables--resistance and challenge. The authors therefore concluded that the installation of the hospital computer system has established a favorable working environment for those whose work is affected by it. The dramatic expansion of computer systems in nonprofit institutions as well as in profit-oriented institutions has made people more familiar with computer technology. This trend can account for the overall positive perception of the unit secretaries toward the new computer system. Moreover, training programs and the support of top management for the system may also have enhanced the positive attitude of the users.
Efficacy beliefs predict collaborative practice among intensive care unit nurses.

PubMed

Le Blanc, Pascale M; Schaufeli, Wilmar B; Salanova, Marisa; Llorens, Susana; Nap, Raoul E

2010-03-01

This paper is a report of an investigation of whether intensive care nurses' efficacy beliefs predict future collaborative practice, and to test the potential mediating role of team commitment in this relationship. Recent empirical studies in the field of work and organizational psychology have demonstrated that (professional) efficacy beliefs are reciprocally related to workers' resources and well-being over time, resulting in a positive gain spiral. Moreover, there is ample evidence that workers' affective commitment to their organization or work-team is related to desirable work behaviours such as citizenship behaviour. A longitudinal design was applied to questionnaire data from the EURICUS-project. Structural Equation Modelling was used to analyse the data. The sample consisted of 372 nurses working in 29 different European intensive care units. Data were collected in 1997 and 1998. However, our research model deals with fundamental psychosocial processes that are not time-dependent. Moreover, recent empirical literature shows that there is still room for improvement in ICU collaborative practice. The hypotheses that (i) the relationship between efficacy beliefs and collaborative practice is mediated by team commitment and (ii) efficacy beliefs, team commitment and collaborative practice are reciprocally related were supported, suggesting a potential positive gain spiral of efficacy beliefs. Healthcare organizations should create working environments that provide intensive care unit nurses with sufficient resources to perform their job well. Further research is needed to design and evaluate interventions for the enhancement of collaborative practice in intensive care units.
Evaluation of the 12-hour shift trial in a regional intensive care unit.

PubMed

Dwyer, Trudy; Jamieson, Lynn; Moxham, Lorna; Austen, Debbie; Smith, Karen

2007-10-01

Given the shortage of critical care nurses, emphasis has been placed upon improving their working lives through the implementation of flexible work hours. This descriptive exploratory study evaluated the effects of the implementation of the 12-hour roster in a regional intensive care unit (ICU). Staff (n = 19) completed a survey 12 weeks following the implementation of the 12-hour roster. The study demonstrated widespread acceptance (92%) positive impact on physical and psychological well-being and increased work satisfaction (58%) for the nursing participants. Similarly, nurses working both the 8- and 12-hour rosters (75%), the doctors and allied health care workers all identified increased continuity of patient care as an outcome of the 12-hour shift. Participants strongly agreed that 12-hour rostering was a good recruitment (67%) and retention (75%) strategy. In an environment with considerable shortages of experienced critical care nurses, the use of flexible shift patterns such as the 12-hour roster was a positive recruitment and recruitment strategy.
Workplace psychosocial and organizational factors for neck pain in workers in the United States.

PubMed

Yang, Haiou; Hitchcock, Edward; Haldeman, Scott; Swanson, Naomi; Lu, Ming-Lun; Choi, BongKyoo; Nakata, Akinori; Baker, Dean

2016-07-01

Neck pain is a prevalent musculoskeletal condition among workers in the United States. This study explores a set of workplace psychosocial and organization-related factors for neck pain. Data used for this study come from the 2010 National Health Interview Survey which provides a representative sample of the US population. To account for the complex sampling design, the Taylor linearized variance estimation method was used. Logistic regression models were constructed to measure the associations. This study demonstrated significant associations between neck pain and a set of workplace risk factors, including work-family imbalance, exposure to a hostile work environment and job insecurity, non-standard work arrangements, multiple jobs, and long work hours. Workers with neck pain may benefit from intervention programs that address issues related to these workplace risk factors. Future studies exploring both psychosocial risk factors and physical risk factors with a longitudinal design will be important. Am. J. Ind. Med. 59:549-560, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Quality management and work environment in Swedish oral and maxillofacial surgery.

PubMed

Pilgård, Göran

2009-01-01

This thesis attempts to describe the opinion of the work with quality, quality management, and work environment among the employees at Oral and Maxillofacial Surgery (OMFS) clinics in Sweden. Analyse if the OMFS clinics in Sweden actively work with quality development and if so which systems they use. Explore the opinion of the employees about quality work. Describe how the employees of OMFS clinics in Sweden perceive good work, i.e., their image of the dimensions that the profession should contain to be really good work. Investigate whether there is a discrepancy between ideal and reality for this group. Describe how the employees of OMFS clinics in Sweden perceive their health. Analyse how work environment influenced attitudes to and knowledge of quality among employees of OMFS clinics in Sweden. The study was based on self-report questionnaires which in 2003 were sent to all OMFS clinics in Sweden. The response rate was 86%. Only at two clinics did all the respondents agree on their system. Surgeons rated intellectually stimulating work as most important, and the hazard-free work environment as least important. The nurses rated stimulating fellowship as most important, and the opportunity for career advancement as least important. The percentage unit differences between the ideal and the reality were largest for the item the work provides opportunities to have an influence on important decisions. There were significant differences between maxillofacial. surgeons and dental nurses and assistant nurses as to muscle- and joint trouble. The differences were also significant between men and women both as to muscle- and joint troubles and somatic trouble. Only work environment was significant for attitude towards quality work. Profession, gender, clinic size, and a factor for hard demand had significant associations to quality management system used or not. More than half of the respondents stated that they worked with a quality system. The dental nurses and assistant nurses had a much more positive view on the potential of quality work as a means to improve their work than had the maxillo-facial surgeons. For a majority of the dental nurses the working situation concerning the physical environment was more important than for the maxillo-facial surgeons. The employees emphasized free, influential, and intellectually stimulating work, but the dissonance between ideal and reality was rather wide concerning good work. OMFS employees are feeling unhealthy, but no worse than other high-risk-groups in human service working and better than female general practice dentists. The women of OMFS employees feel worse than the men.
Studies and Analyses of Aided Adversarial Decision Making. Phase 2: Research on Human Trust in Automation

DTIC Science & Technology

1998-04-01

34AFRL-HE-WP-TR-1999-0216 UNITED STATES AIR FORCE RESEARCH LABORATORY STUDIES AND ANALYSES OF AIDED ADVERSARIAL DECISION MAKING PHASE 2: RESEARCH ON...Analyses of Aided Adversarial Decision Making . C: F41624-94-D-6000 Phase 2: Research on Human Trust in Automation PE: 62202F PR: 7184 6. AUTHOR(S) TA...Buffalo. This work focused on Aided Adversarial Decision Making (AADM) in Information Warfare (1W) environments. Previous work examined informational
Database nurse staffing indicators: explaining risks of staff job dissatisfaction in outpatient care.

PubMed

Kaunonen, Marja; Salin, Sirpa; Aalto, Pirjo

2015-07-01

To explore factors associated with nursing intensity, work environment intensity and nursing resources that may affect nurse job satisfaction and risk of dissatisfaction in outpatient care at one university hospital in Finland. Much research has been done to study how nursing intensity, work environment intensity and nursing resources are associated with nurse job satisfaction, but not in the context of outpatient care. This research used a cross-sectional design. The data were collected from the hospital information systems of outpatient units (n = 12) in autumn 2010. Management style showed a statistically significant association with job satisfaction. The risk of dissatisfaction increased when nursing staff had no influence over the design of their jobs, when conflicts and contradictions were not addressed in the workplace and when feedback was not processed. Nursing intensity and work environment intensity had no effect on nurse job satisfaction. Nursing resources and patient satisfaction, on the other hand, were important to nurses' job satisfaction. The results indicate that nursing management should involve nursing staff in the development of their jobs and the care delivery model. © 2013 John Wiley & Sons Ltd.
Effects of self-recording on attendance and performance in a competitive swimming training environment

PubMed Central

McKenzie, Thomas L.; Rushall, Brent S.

1974-01-01

Swimmers' attendance at training and work rates were described by their coaches as being poor and irregular. Reinforcement contingencies were developed to remedy these unsatisfactory conditions. Two experiments were conducted. A multiple baseline design verified the effects of publicly marking attendance at practice as a sufficient solution for reducing absenteeism, tardiness, and leaving early. Follow-up analyses showed this contingency to have lasting effects. In the second experiment, a reversal design was used to assess the effects of employing program boards as a means of increasing work output during practice. Work rates in eight selected swimmers were elevated by an average of 27.1% when the boards were instituted. Follow-up evaluations showed that the use of the program boards had lasting effects. Publicly checking the completion of each training unit of work changed the nature of the swimming environment to produce a more productive use of time. The role of the coach was subsequently changed as less time was spent in directing and supervising behaviors. PMID:4436167
Effects of self-recording on attendance and performance in a competitive swimming training environment.

PubMed

McKenzie, T L; Rushall, B S

1974-01-01

Swimmers' attendance at training and work rates were described by their coaches as being poor and irregular. Reinforcement contingencies were developed to remedy these unsatisfactory conditions. Two experiments were conducted. A multiple baseline design verified the effects of publicly marking attendance at practice as a sufficient solution for reducing absenteeism, tardiness, and leaving early. Follow-up analyses showed this contingency to have lasting effects. In the second experiment, a reversal design was used to assess the effects of employing program boards as a means of increasing work output during practice. Work rates in eight selected swimmers were elevated by an average of 27.1% when the boards were instituted. Follow-up evaluations showed that the use of the program boards had lasting effects. Publicly checking the completion of each training unit of work changed the nature of the swimming environment to produce a more productive use of time. The role of the coach was subsequently changed as less time was spent in directing and supervising behaviors.
Closeness, chaos and crisis: the attractions of working in acute mental health care.

PubMed

Deacon, M; Warne, T; McAndrew, S

2006-12-01

This paper makes a case for the attractiveness of acute mental health inpatient nursing (acute nursing) and argues that an altered perception of this work is essential if we are to provide the most acutely mentally ill and vulnerable people with a stable and expert nursing workforce. The discussion draws on an ethnographic study conducted in an inner-city psychiatric unit in England and the advantages of this method for understanding nursing work are described. Within our findings, we set out two overarching themes: the contextual realities of the contemporary acute ward and features of attraction that encourage nurses to work in the acute care setting. The former includes nurses' responsibility for the total ward environment and the latter the 'comfort of closeness' and 'surviving and thriving in chaos and crisis'. In conclusion, we argue that despite the unpopularity of the acute inpatient mental health environment, the highly sophisticated skills employed by acute nurses actually ensure the promotion of health for the majority of service users.
Front-line management, staffing and nurse-doctor relationships as predictors of nurse and patient outcomes. a survey of Icelandic hospital nurses.

PubMed

Gunnarsdóttir, Sigrún; Clarke, Sean P; Rafferty, Anne Marie; Nutbeam, Don

2009-07-01

To investigate aspects of nurses' work environments linked with job outcomes and assessments of quality of care in an Icelandic hospital. Prior research suggests that poor working environments in hospitals significantly hinder retention of nurses and high quality patient care. On the other hand, hospitals with high retention rates (such as Magnet hospitals) show supportive management, professional autonomy, good inter-professional relations and nurse job satisfaction, reduced nurse burnout and improved quality of patient care. Cross-sectional survey of 695 nurses at Landspitali University Hospital, Reykjavík. Nurses' work environments were measured using the nursing work index-revised (NWI-R) and examined as predictors of job satisfaction, the Maslach burnout inventory (MBI) and nurse-assessed quality of patient care using linear and logistic regression approaches. An Icelandic adaptation of the NWI-R showed a five-factor structure similar to that of Lake (2002). After controlling for nurses' personal characteristics, job satisfaction, emotional exhaustion and nurse rated quality of care were found to be independently associated with perceptions of support from unit-level managers, staffing adequacy, and nurse-doctor relations. The NWI-R measures elements of hospital nurses' work environments that predict job outcomes and nurses' ratings of the quality of patient care in Iceland. Efforts to improve and maintain nurses' relations with nurse managers and doctors, as well as their perceptions of staffing adequacy, will likely improve nurse job satisfaction and employee retention, and may improve the quality of patient care.
Executive Information Systems for Providing Next Generation Strategic Information: An Evaluation of EIS (Executive Information System) Software and Recommended Applicability within the FAA Computing Environment

DTIC Science & Technology

1989-01-01

the FAA Computing Environment 7. Author(s) S. Performing Organization Report No. MT/O1-89. Al 9. Performing Organization Name and Address 10. Work Unit...him in advance by analysts and developers -- an electronic3 version of the Performance Indicators report. Ease of Use. pcEXPRESS has an automatic link...overcome within the required timeframe. I These advanced features of the EXPRESS system allow the fastest possible response to changing executive information
Are Staffing, Work Environment, Work Stressors, and Rationing of Care Related to Care Workers' Perception of Quality of Care? A Cross-Sectional Study.

PubMed

Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René

2015-10-01

To describe care worker-reported quality of care and to examine its relationship with staffing variables, work environment, work stressors, and implicit rationing of nursing care. Cross-sectional study. National, randomly selected sample of Swiss nursing homes, stratified according to language region and size. A total of 4311 care workers of all educational backgrounds (registered nurses, licensed practical nurses, nurse aides) from 402 units in 155 nursing homes completed a survey between May 2012 and April 2013. Care worker-reported quality of care was measured with a single item; predictors were assessed with established instruments (eg, Practice Environment Scale-Nurse Working Index) adapted for nursing home use. A multilevel logistic regression model was applied to assess predictors for quality of care. Overall, 7% of care workers rated the quality of care provided as rather low or very low. Important factors related to better quality of care were higher teamwork and safety climate (odds ratio [OR] 6.19, 95% confidence interval [CI] 4.36-8.79); better staffing and resources adequacy (OR 2.94, 95% CI 2.08-4.15); less stress due to workload (OR 0.71, 95% CI 0.55-0.93); less implicit rationing of caring, rehabilitation, and monitoring (OR 0.34, 95% CI 0.24-0.49); and less rationing of social care (OR 0.80, 95% CI 0.69-0.92). Neither leadership nor staffing levels, staff mix, or turnover was significantly related to quality of care. Work environment factors and organizational processes are vital to provide high quality of care. The improvement of work environment, support in handling work stressors, and reduction of rationing of nursing care might be intervention points to promote high quality of care in nursing homes. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Two Aspects of Young Children's Thinking about Different Types of Dynamic Triangles: Prototypicality and Inclusion

ERIC Educational Resources Information Center

Kaur, Harpreet

2015-01-01

This paper illustrates how young children (ages 7-8, grade 2/3) can use the potential of dynamic geometry environments to develop an understanding of, and reasoning about, the properties and behaviours of different triangles (scalene, isosceles, equilateral). It provides a detailed description of a geometry unit, during which children worked both…
Understanding the Shift in Personal Identity: A Phenomenological Analysis of Literacy

ERIC Educational Resources Information Center

Miller, Kelli

2011-01-01

At the 1978 United Nations Educational, Scientific, and Cultural Organization conference, literacy was determined as a right as expressed in the foundation of learning and the vital first step to the achievement of other human rights. However, in the state of Georgia, many high school students enter the working environment without minimum literacy…

UNIX as an environment for producing numerical software

NASA Technical Reports Server (NTRS)

Schryer, N. L.

1978-01-01

The UNIX operating system supports a number of software tools; a mathematical equation-setting language, a phototypesetting language, a FORTRAN preprocessor language, a text editor, and a command interpreter. The design, implementation, documentation, and maintenance of a portable FORTRAN test of the floating-point arithmetic unit of a computer is used to illustrate these tools at work.
To name the Jamaica Bay Wildlife Refuge Visitor Contact Station of the Jamaica Bay Wildlife Refuge unit of Gateway National Recreation Area in honor of James L. Buckley.

THOMAS, 112th Congress

Rep. Turner, Robert L. [R-NY-9

2012-06-18

Senate - 07/24/2012 Received in the Senate and Read twice and referred to the Committee on Environment and Public Works. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:
Protecting ecotourism resources in a time of rapid economic and environmental transformation in Asia

Treesearch

Alan Watson; Dave Ostergren; Peter Fix; Bill Overbaugh; Dan McCollum; Linda Kruger; Martha Madsen; He Yang

2009-01-01

In the Far East of Russia, similar to many places in Asia, ecotourism and the environment are in transition. A science team, cooperating with the United Nations Development Programme project "Demonstrating Sustainable Conservation of Biological Diversity in Four Protected Territories in the Kamchatka Region, Russian Federation," is working to provide vital...
Addressing Human Capital Challenges: Assessing the Experiences of Four Countries in the Arab Region. Research Brief

ERIC Educational Resources Information Center

Gonzalez, Gabriella; Karoly, Lynn A.; Constant, Louay; Salem, Hanine; Goldman, Charles A.

2008-01-01

This research brief describes an analysis of the reform efforts of four Arab region nations (Lebanon, Oman, Qatar, the United Arab Emirates) in response to human capital challenges they face in preparing their people to work in a global environment. (Contains 3 tables.) [For associated report, see ED503118.
Our Living Land, Conservation Yearbook Series Volume Number 7.

ERIC Educational Resources Information Center

Preudhomme, Leroy

This yearbook provides highlights of the work done by the various bureaus and offices of the Department of the Interior during 1970. The coverage is broad, relating to many aspects of conservation and the environment in the United States, in a descriptive, non-technical style. General theme of the report is the need for environmental management…
Misunderstanding the Operational Environment: Michigan State University and the South Vietnamese Civil Guard, 1955-1960

DTIC Science & Technology

2014-06-13

ELEMENT NUMBER 6. AUTHOR( S ) Bob Stone, MAJ, USA 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ......political and economic techniques to the problem.”9 The mission reported a dire outlook toward s the political and military situation. It described
Adaptive Model-Predictive Motion Planning for Navigation in Complex Environments

DTIC Science & Technology

2009-08-01

AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Carnegie Mellon University,The...Robotics Institute,Pittsburgh,PA,15213 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR...6 1.5 Assumptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 1.6 Organization
Cultivating a Culture of Awareness: Nurturing Reflective Practices in the NICU

ERIC Educational Resources Information Center

Steinberg, Zina; Kraemer, Susan

2010-01-01

The authors describe the challenges to nurturing reflective practices in a neonatal intensive care unit (NICU)--an environment in which life and death hang in fragile balance and where the need to defend against unbearable realities is natural, even an adaptive response. Working as consultants to this acute setting, the authors describe how they…
The Growing Popularity of Birding in the United States

Treesearch

H. Ken Cordell; Nancy G. Herbert; Francis Pandolfi

1999-01-01

Every 5 to 10 years, several Federal agencies, professional associations, private organizations, and industries work together to conduct a survey of the recreational interests of the American people--the National Survey on Recreation and the Environment (NSRE). The most recent of these national studies indicated that 94.5 percent of people 16 years old or older...
[The general concepts of development and the principle of sustainable development].

PubMed

Romanov, Iu A

1995-01-01

A concept of the sustainable development principle proposed by the United Nations/International Committee on Environment and Development (ICED, 1987) and gained acceptance at the United Nations Conference on Environment and Development (Rio-de-Janeiro, 1992) lies not in the notion of a sustained character of the development but in an understanding of the development as a steadily and long existing and maintained process that is in advocating the stability of the development. It is known, that the state instability of open self-organizing and self-developing systems including the social ones is the the source of the development having a probabilistic, bifurcate and not quite predictable character. Such an understanding of the development should be well represented in the action initiated in the frame work of national and international state ecological policies.
Implementing a Virtual Exchange Project for student nurses in Queensland and Nottingham.

PubMed

Todhunter, Fern; Hallawell, Bob; Pittaway, Debbie

2013-09-01

This paper discusses the design and initial progress made with a virtual learning environment to help student nurses develop an understanding of cultural awareness and globalization. Using a Web-based application the Virtual Exchange Project was designed to facilitate study-elsewhere experiences located in the student's own setting. Promotion of the United Nations' Millennium Development goals provided an opportunity for student nurses to explore changes in global health and disease patterns, nursing education and systems of nurse regulation in the United Kingdom and Australia. A pedagogical framework created for this activity acknowledges the social and academic identities that learners often use, when working together in a virtual environment. The architecture of the Virtual Exchange supports local conversations about nurse education and health and social issues across hemispheres. Copyright © 2012 Elsevier Ltd. All rights reserved.
Navigating Through Chaos: Charge Nurses and Patient Safety.

PubMed

Cathro, Heather

2016-04-01

The aim of this study was to explore actions and the processes charge nurses (CNs) implement to keep patients safe and generate an emerging theory to inform CN job descriptions, orientation, and training to promote patient safety in practice. Healthcare workers must provide a safe environment for patients. CNs are the frontline leaders on most hospital units and can function as gatekeepers for safe patient care. This grounded theory study utilized purposive sampling of CNs on medical-surgical units in a 400-bed metropolitan hospital. Data collection consisted of 11 interviews and 6 observations. The emerging theory was navigating through chaos: CNs balancing multiple roles, maintaining a watchful eye, and working with and leading the healthcare team to keep patients safe. CNs have knowledge of patients, staff, and complex healthcare environments, putting them in opportune positions to influence patient safety.
Praise matters: the influence of nurse unit managers' praise on nurses' practice, work environment and job satisfaction: a questionnaire study.

PubMed

Sveinsdóttir, Herdís; Ragnarsdóttir, Erla Dögg; Blöndal, Katrín

2016-03-01

The aim of this study was to investigate the associations between praise from nurse unit managers and job satisfaction, professional practice, workload, work climate and organizational commitment of nurses caring for surgical patients. Praise influences experiences of employees. Web-based, cross-sectional explorative survey design. A structured questionnaire was used to measure praise given by nurse unit managers as perceived by nurses (n = 383; 49% response rate) working with surgical patients. Data were collected between December 2009-January 2010. Several variables assessed the major concepts under study. Binary logistic regression analysis was employed to compare nurses who receive praise very rarely/rarely as compared with very often/rather often. Praise was received often/very often by 31·6% of participants. Compared with nurses receiving praise rarely/very rarely those who received it often/rather showed more job satisfaction, stated they had more opportunities to practice professionally, described a more positive work climate and were more committed to the organization such as being proud to work at and willing to make effort for the unit and hospital. There was no difference between the groups regarding workload. Main findings of the regression analysis were that nurses display their organizational commitment by not thinking about leaving the current workplace and those who value professional recognition are likelier to receive praise than their counterparts. Nurse unit managers should praise their staff in a realistic fashion. Such praise is cost-effective, takes short time, produces positive influences on members of their staff and may improve patient safety. © 2015 John Wiley & Sons Ltd.
Will musculoskeletal, visual and psychosocial stress change for visual display unit (VDU) operators when moving from a single-occupancy office to an office landscape?

PubMed

Helland, Magne; Horgen, Gunnar; Kvikstad, Tor Martin; Garthus, Tore; Aarås, Arne

2008-01-01

This study investigated the effect of moving from single-occupancy offices to a landscape environment. Thirty-two visual display unit (VDU) operators reported no significant change in visual discomfort. Lighting conditions and glare reported subjectively showed no significant correlation with visual discomfort. Experience of pain was found to reduce subjectively rated work capacity during VDU tasks. The correlation between visual discomfort and reduced work capacity for single-occupancy offices was rs=.88 (p=.000) and for office landscape rs=.82 (p=.000). Eye blink rate during habitual VDU work was recorded for 12 operators randomly selected from the 32 participants in the office landscape. A marked drop in eye blink rate during VDU work was found compared to eye blink rate during easy conversation. There were no significant changes in pain intensity in the neck, shoulder, forearm, wrist/hand, back or headache (.24
Collegial relationship breakdown: a qualitative exploration of nurses in acute care settings.

PubMed

Cowin, Leanne S

2013-01-01

Poor collegial relations can cause communication breakdown, staff attrition and difficulties attracting new nursing staff. Underestimating the potential power of nursing team relationships means that opportunities to create better working environments and increase the quality of nursing care can be missed. Previous research on improving collegiality indicates that professionalism and work satisfaction increases and that staff attrition decreases. This study explores challenges, strengths and strategies used in nursing team communication in order to build collegial relationships. A qualitative approach was employed to gather nurses experiences and discussion of communication within their nursing teams and a constant comparison method was utilised for data analysis. A convenience sampling technique was employed to access both Registered Nurses and Enrolled Nurses to partake in six focus groups. Thirty mostly female nurses (ratio of 5:1) participated in the study. Inclusion criteria consisted of being a nurse currently working in acute care settings and the exclusion criteria included nursing staff currently working in closed specialty units (i.e. intensive care units). Results revealed three main themes: (1) externalisation and internalisation of nursing team communication breakdown, (2) the importance of collegiality for retention of nurses and (3) loss of respect, and civility across the healthcare workplace. A clear division between hierarchies of nurses was apparent in how nursing team communication was delivered and managed. Open, respectful and collegial communication is essential in today's dynamic and complex health environments. The nurses in this study highlighted how important nursing communication can be to work motivation and how leadership fosters teamwork.
The role of work environment in keeping newly licensed RNs in nursing: a questionnaire survey.

PubMed

Unruh, Lynn; Zhang, Ning Jackie

2013-12-01

In prior studies, newly licensed registered nurses (RNs) describe their job as being stressful. Little is known about how their perceptions of the hospital work environment affect their commitment to nursing. To assess the influence of hospital work environment on newly licensed RN's commitment to nursing and intent to leave nursing. Correlational survey. Newly licensed RNs working in hospitals in Florida, United States. 40% random sample of all RNs newly licensed in 2006. The survey was mailed out in 2008. Dependent variables were indicators of professional commitment and intent to leave nursing. Independent variables were individual, organizational, and work environment characteristics and perceptions (job difficulty, job demands and job control). Statistical analysis used ordinary least squares regressions. Level of significance was set at p<0.05. Job difficulty and job demand were significantly related to a lower commitment to nursing and a greater intent to leave nursing, and vice versa for job control. The strongest ranked of the job difficulties items were: incorrect instructions, organizational rules, lack of supervisor support, and inadequate help from others. Workload and other items were significant, but ranked lower. The strongest ranked of the job pressure items were: "having no time to get things done" and "having to do more than can be done well." The strongest ranked of job control items were "ability to act independent of others." Nurses with positive orientation experiences and those working the day shift and more hours were less likely to intend to leave nursing and more likely to be committed to nursing. Significant demographic characteristics related to professional commitment were race and health. Negative perceptions of the work environment were strong predictors of intent to leave nursing and a lower commitment to nursing among newly licensed RNs. These results indicate that retention of newly licensed RNs in nursing can be improved through changes in the work environment that remove obstacles to care-giving, increase resources and autonomy, and reduce workload and other job pressure factors. Copyright © 2013 Elsevier Ltd. All rights reserved.
Centralized vs. decentralized nursing stations: effects on nurses' functional use of space and work environment.

PubMed

Zborowsky, Terri; Bunker-Hellmich, Lou; Morelli, Agneta; O'Neill, Mike

2010-01-01

Evidence-based findings of the effects of nursing station design on nurses' work environment and work behavior are essential to improve conditions and increase retention among these fundamental members of the healthcare delivery team. The purpose of this exploratory study was to investigate how nursing station design (i.e., centralized and decentralized nursing station layouts) affected nurses' use of space, patient visibility, noise levels, and perceptions of the work environment. Advances in information technology have enabled nurses to move away from traditional centralized paper-charting stations to smaller decentralized work stations and charting substations located closer to, or inside of, patient rooms. Improved understanding of the trade-offs presented by centralized and decentralized nursing station design has the potential to provide useful information for future nursing station layouts. This information will be critical for understanding the nurse environment "fit." The study used an exploratory design with both qualitative and quantitative methods. Qualitative data regarding the effects of nursing station design on nurses' health and work environment were gathered by means of focus group interviews. Quantitative data-gathering techniques included place- and person-centered space use observations, patient visibility assessments, sound level measurements, and an online questionnaire regarding perceptions of the work environment. Nurses on all units were observed most frequently performing telephone, computer, and administrative duties. Time spent using telephones, computers, and performing other administrative duties was significantly higher in the centralized nursing stations. Consultations with medical staff and social interactions were significantly less frequent in decentralized nursing stations. There were no indications that either centralized or decentralized nursing station designs resulted in superior visibility. Sound levels measured in all nursing stations exceeded recommended levels during all shifts. No significant differences were identified in nurses' perceptions of work control-demand-support in centralized and decentralized nursing station designs. The "hybrid" nursing design model in which decentralized nursing stations are coupled with centralized meeting rooms for consultation between staff members may strike a balance between the increase in computer duties and the ongoing need for communication and consultation that addresses the conflicting demands of technology and direct patient care.
Art, music, story: The evaluation of a person-centred arts in health programme in an acute care older persons' unit.

PubMed

Ford, Karen; Tesch, Leigh; Dawborn, Jacqueline; Courtney-Pratt, Helen

2018-06-01

To evaluate the impact of an arts in health programme delivered by a specialised artist within an acute older person's unit. Acute hospitals must meet the increasingly complex needs of older people who experience multiple comorbidities, often including cognitive impairment, either directly related to their admission or longer term conditions, including dementia. A focus on physical illness, efficiency and tasks within an acute care environment can all divert attention from the psychosocial well-being of patients. This focus also decreases capacity for person-centred approaches that acknowledge and value the older person, their life story, relationships and the care context. The importance of arts for health and wellness, including responsiveness to individual need, is well established: however, there is little evidence about its effectiveness for older people in acute hospital settings. We report on a collaborative arts in health programme on an acute medical ward for older people. The qualitative study used collaborative enquiry underpinned by a constructivist approach to evaluate an arts programme that involved participatory art-making activities, customised music, song and illustration work, and enlivening the unit environment. Data sources included observation of art activities, semi-structured interviews with patients and family members, and focus groups with staff. Data were transcribed and thematically analysed using a line by line approach. The programme had positive impacts for the environment, patients, families and staff. The environment exhibited changes as a result of programme outputs; patients and families were engaged and enjoyed activities that aided recovery from illness; and staff also enjoyed activities and importantly learnt new ways of working with patients. An acute care arts in health programme is a carefully nuanced programme where the skills of the arts health worker are critical to success. Utilising such skill, continued focus on person-centeredness and openness to creativity demonstrated positive impacts for patients, families, staff and the ward environment. This study affirms the contribution of an arts in health program for older persons in an acute care setting in challenging the dominance of a task based medical model and emphasising person-centred care and outcomes. © 2018 John Wiley & Sons Ltd.
Measuring the nursing work environment: translation and psychometric evaluation of the Essentials of Magnetism.

PubMed

de Brouwer, B J M; Kaljouw, M J; Kramer, M; Schmalenberg, C; van Achterberg, T

2014-03-01

Translate the Essentials of Magnetism II© (EOMII; Dutch Nurses' Association, Utrecht, The Netherlands) and assess its psychometric properties in a culture different from its origin. The EOMII, developed in the USA, measures the extent to which organizations/units provide healthy, productive and satisfying work environments. As many healthcare organizations are facing difficulties in attracting and retaining staff nurses, the EOMII provides the opportunity to assess the health and effectiveness of work environments. A three-phased (respectively N = 13, N = 74 and N = 2542) combined descriptive and correlational design was undertaken for translation and evaluation validity and psychometric qualities of the EOMII for Dutch hospitals (December 2009-January 2010). We performed forward-backward translation, face and content validation via cross-sectional survey research, and semi-structured interviews on relevance, clarity, and recognizability of instruments' items. Psychometric testing included principal component analysis using varimax rotation, item-total statistics, and reliability in terms of internal consistency (Cronbach's α) for the total scale and its subscales. Face validity was confirmed. Items were recognizable, relevant and clear. Confirmatory factor analysis indicated that five of eight subscales formed clear factors. Three original subscales contained two factors. Item-total correlations ranged from 0.43 to 0.83. One item correlated weakly (0.24) with its subscale. Cronbach's α for the entire scale was 0.92 and ranged from 0.58 to 0.92 for eight subscales. Dutch-translated EOMII (D-EOMII) demonstrated acceptable reliability and validity for assessing hospital staff nurses' work environment. The D-EOMII can be useful and effective in identifying areas in which change is needed for a hospital to pursue an excellent work environment that attracts and retains well-qualified nurses. © 2013 International Council of Nurses.
Microorganisms in Confined Habitats: Microbial Monitoring and Control of Intensive Care Units, Operating Rooms, Cleanrooms and the International Space Station

PubMed Central

Mora, Maximilian; Mahnert, Alexander; Koskinen, Kaisa; Pausan, Manuela R.; Oberauner-Wappis, Lisa; Krause, Robert; Perras, Alexandra K.; Gorkiewicz, Gregor; Berg, Gabriele; Moissl-Eichinger, Christine

2016-01-01

Indoor environments, where people spend most of their time, are characterized by a specific microbial community, the indoor microbiome. Most indoor environments are connected to the natural environment by high ventilation, but some habitats are more confined: intensive care units, operating rooms, cleanrooms and the international space station (ISS) are extraordinary living and working areas for humans, with a limited exchange with the environment. The purposes for confinement are different: a patient has to be protected from infections (intensive care unit, operating room), product quality has to be assured (cleanrooms), or confinement is necessary due to extreme, health-threatening outer conditions, as on the ISS. The ISS represents the most secluded man-made habitat, constantly inhabited by humans since November 2000 – and, inevitably, also by microorganisms. All of these man-made confined habitats need to be microbiologically monitored and controlled, by e.g., microbial cleaning and disinfection. However, these measures apply constant selective pressures, which support microbes with resistance capacities against antibiotics or chemical and physical stresses and thus facilitate the rise of survival specialists and multi-resistant strains. In this article, we summarize the available data on the microbiome of aforementioned confined habitats. By comparing the different operating, maintenance and monitoring procedures as well as microbial communities therein, we emphasize the importance to properly understand the effects of confinement on the microbial diversity, the possible risks represented by some of these microorganisms and by the evolution of (antibiotic) resistances in such environments – and the need to reassess the current hygiene standards. PMID:27790191

Microorganisms in Confined Habitats: Microbial Monitoring and Control of Intensive Care Units, Operating Rooms, Cleanrooms and the International Space Station.

PubMed

Mora, Maximilian; Mahnert, Alexander; Koskinen, Kaisa; Pausan, Manuela R; Oberauner-Wappis, Lisa; Krause, Robert; Perras, Alexandra K; Gorkiewicz, Gregor; Berg, Gabriele; Moissl-Eichinger, Christine

2016-01-01

Indoor environments, where people spend most of their time, are characterized by a specific microbial community, the indoor microbiome. Most indoor environments are connected to the natural environment by high ventilation, but some habitats are more confined: intensive care units, operating rooms, cleanrooms and the international space station (ISS) are extraordinary living and working areas for humans, with a limited exchange with the environment. The purposes for confinement are different: a patient has to be protected from infections (intensive care unit, operating room), product quality has to be assured (cleanrooms), or confinement is necessary due to extreme, health-threatening outer conditions, as on the ISS. The ISS represents the most secluded man-made habitat, constantly inhabited by humans since November 2000 - and, inevitably, also by microorganisms. All of these man-made confined habitats need to be microbiologically monitored and controlled, by e.g., microbial cleaning and disinfection. However, these measures apply constant selective pressures, which support microbes with resistance capacities against antibiotics or chemical and physical stresses and thus facilitate the rise of survival specialists and multi-resistant strains. In this article, we summarize the available data on the microbiome of aforementioned confined habitats. By comparing the different operating, maintenance and monitoring procedures as well as microbial communities therein, we emphasize the importance to properly understand the effects of confinement on the microbial diversity, the possible risks represented by some of these microorganisms and by the evolution of (antibiotic) resistances in such environments - and the need to reassess the current hygiene standards.
A Knowledge-Based Approach to Automatic Detection of Equipment Alarm Sounds in a Neonatal Intensive Care Unit Environment.

PubMed

Raboshchuk, Ganna; Nadeu, Climent; Jancovic, Peter; Lilja, Alex Peiro; Kokuer, Munevver; Munoz Mahamud, Blanca; Riverola De Veciana, Ana

2018-01-01

A large number of alarm sounds triggered by biomedical equipment occur frequently in the noisy environment of a neonatal intensive care unit (NICU) and play a key role in providing healthcare. In this paper, our work on the development of an automatic system for detection of acoustic alarms in that difficult environment is presented. Such automatic detection system is needed for the investigation of how a preterm infant reacts to auditory stimuli of the NICU environment and for an improved real-time patient monitoring. The approach presented in this paper consists of using the available knowledge about each alarm class in the design of the detection system. The information about the frequency structure is used in the feature extraction stage, and the time structure knowledge is incorporated at the post-processing stage. Several alternative methods are compared for feature extraction, modeling, and post-processing. The detection performance is evaluated with real data recorded in the NICU of the hospital, and by using both frame-level and period-level metrics. The experimental results show that the inclusion of both spectral and temporal information allows to improve the baseline detection performance by more than 60%.
A Knowledge-Based Approach to Automatic Detection of Equipment Alarm Sounds in a Neonatal Intensive Care Unit Environment

PubMed Central

Nadeu, Climent; Jančovič, Peter; Lilja, Alex Peiró; Köküer, Münevver; Muñoz Mahamud, Blanca; Riverola De Veciana, Ana

2018-01-01

A large number of alarm sounds triggered by biomedical equipment occur frequently in the noisy environment of a neonatal intensive care unit (NICU) and play a key role in providing healthcare. In this paper, our work on the development of an automatic system for detection of acoustic alarms in that difficult environment is presented. Such automatic detection system is needed for the investigation of how a preterm infant reacts to auditory stimuli of the NICU environment and for an improved real-time patient monitoring. The approach presented in this paper consists of using the available knowledge about each alarm class in the design of the detection system. The information about the frequency structure is used in the feature extraction stage, and the time structure knowledge is incorporated at the post-processing stage. Several alternative methods are compared for feature extraction, modeling, and post-processing. The detection performance is evaluated with real data recorded in the NICU of the hospital, and by using both frame-level and period-level metrics. The experimental results show that the inclusion of both spectral and temporal information allows to improve the baseline detection performance by more than 60%. PMID:29404227
[Health promotion: a relevant concept for a management and organizational dynamics tool in the restructuring of a geriatric hospital].

PubMed

Chatot-Henry, Didier; Chatot-Henry, Carole; Courcier, Dominique

2014-01-01

The financial difficulties encountered by Martinique hospitals has led to restructuring of the territory's medical project with the merger of three healthcare facilities. These new constraints impacting the work environment with organizational consequences in services. A management experiment was attempted in a geriatric day care hospital based on the use of health promotion concepts. After an overview of the unit's activity based on the perceptions of staff, patients and private physicians, a one-day research-action structural seminar was organized. Group dynamics, unit functioning, shared values, success factors, and improvement strategies were discussed. This seminar resulted in the development of a business model based on five values (respect, professionalism, cohesion, empathy, communication). Three operational working groups were established to implement the conclusions of the seminar in the unit. This experiment focused on an alternative approach to the management of small health care services by the use of health promotion.
Notes on critical care-review of seminal management and leadership papers in the United Kingdom.

PubMed

Coombs, Maureen

2009-06-01

Review of recent critical care provision reveals substantial changes in clinical unit operating, and policy drivers influencing international critical care delivery. Practitioners who have worked in healthcare environments over this time, will have witnessed substantial shifts in healthcare policy, changes in professional body guidance and greater service evaluation have impacted on critical care management and leadership. This paper offers a personal perspective on seminal management and leadership papers published in the critical care literature over the past decade. Presenting a range of national and international work that utilise diverse approaches, ten key papers are highlighted that have impacted in the United Kingdom setting. Through this, the influence of the modernisation agenda, the increasing significance of outcome studies, and the need for flexible, interdependent practice emerges. A key message to surface from this paper is the need for all in critical care to engage with, and understand the wider implications of management and leadership change for critical care delivery.
Environmental issues and work: women with multiple chemical sensitivities.

PubMed

Lipson, Juliene G; Doiron, Nathalie

2006-08-01

Multiple chemical sensitivities (MCS) is an acquired condition in which exposure to low levels of chemicals causes symptoms in multiple organ systems. Some 12%-16% of the U.S. population has some level of chemical sensitivity, 80% of whom are women. Attempts to reduce chemical exposures leads to enormous life difficulties at home, school, and workplace. We base our article on an ethnographic study of MCS in the United States and Canada. We describe here themes related to work issues in terms of a general trajectory of becoming sick from work exposures, coping with toxic physical environments and dealing with coworkers and, when unable to continue working, applying for workers' compensation, or disability status, or both.
Patient-centered care, nurse work environment and implicit rationing of nursing care in Swiss acute care hospitals: A cross-sectional multi-center study.

PubMed

Bachnick, Stefanie; Ausserhofer, Dietmar; Baernholdt, Marianne; Simon, Michael

2018-05-01

Patient-centered care is a key element of high-quality healthcare and determined by individual, structural and process factors. Patient-centered care is associated with improved patient-reported, clinical and economic outcomes. However, while hospital-level characteristics influence patient-centered care, little evidence is available on the association of patient-centered care with characteristic such as the nurse work environment or implicit rationing of nursing care. The aim of this study was to describe patient-centered care in Swiss acute care hospitals and to explore the associations with nurse work environment factors and implicit rationing of nursing care. This is a sub-study of the cross-sectional multi-center "Matching Registered Nurse Services with Changing Care Demands" study. We included 123 units in 23 acute care hospitals from all three of Switzerland's language regions. The sample consisted of 2073 patients, hospitalized for at least 24 h and ≥18 years of age. From the same hospital units, 1810 registered nurses working in direct patient care were also included. Patients' perceptions of patient-centered care were assessed using four items from the Generic Short Patient Experiences Questionnaire. Nurses completed questionnaires assessing perceived staffing and resource adequacy, adjusted staffing, leadership ability and level of implicit rationing of nursing care. We applied a Generalized Linear Mixed Models for analysis including individual-level patient and nurse data aggregated to the unit level. Patients reported high levels of patient-centered care: 90% easily understood nurses, 91% felt the treatment and care were adapted for their situation, 82% received sufficient information, and 70% felt involved in treatment and care decisions. Higher staffing and resource adequacy was associated with higher levels of patient-centered care, e.g., sufficient information (β 0.638 [95%-CI: 0.30-0.98]). Higher leadership ratings were associated with sufficient information (β 0.403 [95%-CI: 0.03-0.77) and adapted treatment and care (β 0.462 [95%-CI: 0.04-0.88]). Furthermore, higher levels of implicit rationing of nursing care were associated with lower levels of patient-centered care, e.g., adapted treatment and care (β -0.912 [95%-CI: -1.50-0.33]). Our study shows a negative association between implicit rationing of nursing care and patient-centered care: i.e.the lower the level of implicit rationing of nursing care, the better patients understood nurses, felt sufficiently informed and recognized that they were receiving highly individualized treatment. To improve patient-centered care, the nurse work environment and the level of implicit rationing of nursing care should be taken into consideration. Copyright © 2017 Elsevier Ltd. All rights reserved.
A lightweight ambient air-cooling unit for use in hazardous environments.

PubMed

Chen, Y T; Constable, S H; Bomalaski, S H

1997-01-01

Recent research demonstrated (a) the effectiveness of intermittent conditioned air cooling during rest breaks to significantly reduce cumulative heat storage and (b) that longer work sessions were possible for individuals wearing chemical defense ensembles. To further advance this concept, a strategy for implementing continuous air cooling was conceived; ambient air cooling was added during work cycles and conditioned air cooling was delivered during rest periods. A compact battery-powered beltpack cooling unit (3.9 kg) designed and made at the U.S. Air Force Armstrong Laboratory was used to deliver 5.7 L/sec filtered ambient air during work cycles: 4.7 L/sec to the body and 1 L/sec to the face. Five experimental cycles were conducted in a thermally controlled chamber under warm conditions (32 degrees C, 40% relative humidity) with (1) no cooling-intermittent work, (2) intermittent cooling, (3) continuous cooling during intermittent exercise, and (4) no cooling-continuous work and (5) ambient air cooling during continuous exercise. Intermittent, conditioned, and continuous air cooling resulted in significant reductions in rectal temperature, mean skin temperature, and heart rate as compared with the no-cooling trials. The continuous air-cooling trial significantly improved thermal comfort and sweat evaporation. Results suggest that ambient air delivered during work cycles by a lightweight portable unit (in conjunction with conditioned air delivered during rest periods), can definitely improve personal comfort, reduce skin temperature, and decrease the cumulative fatigue common to repeated work/rest cycles in selected military and industrial applications in which individuals work in chemical defense ensembles.
Occupational stress and job satisfaction of healthcare staff in rehabilitation units.

PubMed

Fiabane, Elena; Giorgi, Ines; Musian, D; Sguazzin, Cinzia; Argentero, P

2012-01-01

Occupational stress and job dissatisfaction are recognized risk factors for healthcare professionals and can lead to a decrease in work performance and in the quality of care offered, and to poorer health of workers. Research in the rehabilitation care setting is very limited and needs to be explored. To investigate occupational stress, job satisfaction and their relationships with organizational factors among healthcare staff in rehabilitation units. A cross-sectional study of healthcare staff working in two rehabilitation units was conducted. They were sent two self-administered questionnaires, the Occupational Stress Indicator (OSI) and the Areas of Work life Scale (AWS), in order to assess occupational stress and job satisfaction. One-way ANOVA was used to explore work stress among two groups of workers, characterized by high and low job satisfaction levels. Stepwise multiple linear regression analysis was conducted to assess the association between job satisfaction and organizational risk factors. A total of 90 questionnaires were returned (response rate 53%). The main sources of stress were unfairness, conflict between personal and organizational values, lack of reward and workload Workers with low job satisfaction significantly scored higher in work-related stress in regard to various aspects of work, and in lower job control. Regression analysis showed that the most important predictors of job satisfaction were fairness and workload. The results of this study showed that job dissatisfaction is strongly associated with work stress and certain organizational risk factors. This study suggests the importance of focusing on the psychosocial factors in the work environment and job satisfaction in order to improve the well-being of rehabilitation healthcare staff.
Teaching Rational Number Addition Using Video Games: The Effects of Instructional Variation. CRESST Report 808

ERIC Educational Resources Information Center

Vendlinski, Terry P.; Chung, Greg K. W. K.; Binning, Kevin R.; Buschang, Rebecca E.

2011-01-01

Understanding the meaning of rational numbers and how to perform mathematical operations with those numbers seems to be a perennial problem in the United States for both adults and children. Based on previous work, we hypothesized that giving students more time to practice using rational numbers in an environment that enticed them to apply their…
Formative Postgraduate Assessment: A Comparative Case Study Using a University in the USA and One in South Africa

ERIC Educational Resources Information Center

Friedrich-Nel, Hesta; Mac Kinnon, Joyce

2015-01-01

The purpose of this study was to investigate formative postgraduate assessment from an international perspective while acknowledging the two countries' differing cultures and environments. Using a case study approach, data were collected from research supervisors of postgraduate work at a university in the United States (USA) and a university in…
Prevention of unorganized emissions of ammonia in installations of dewaxing of oils

NASA Astrophysics Data System (ADS)

Rehovskaya, E. O.; Nagibina, I. Yu; Ivanov, A. Yu

2018-01-01

The problem of lack of automation devices in oil dewaxing units is considered in this work. As a result, fugitive ammonia emissions that exceed the maximum permissible concentration, which adversely affect the health of personnel and the environment, can occur in the atmospheric air. The device and the operating principle of the automatic air separator are shown.
Specifications of a Simulation Model for a Local Area Network Design in Support of a Stock Point Logistics Integrated Communication Environment (SPLICE).

DTIC Science & Technology

1983-06-01

constrained at each step. Use of dis- crete simulation can be a powerful tool in this process if its role is carefully planned. The gross behavior of the...by projecting: - the arrival of units of work at SPLICE processing facilities (workload analysis) . - the amount of processing resources comsumed in
Applying UNESCO Guidelines on Mobile Learning in the South African Context: Creating an Enabling Environment through Policy

ERIC Educational Resources Information Center

Aluko, Ruth

2017-01-01

Mobile broadband penetration is growing rapidly in Africa, and it offers vast opportunities for mobile learning. Together with its possibilities is the danger of overlooking standards related to its use. The United Nations Educational, Scientific and Cultural Organisation (UNESCO) has initiated work in this area focusing on African and Middle East…
Apprenticeship: A Partnership 5. A Learning Activities Package for Women in Apprenticeship.

ERIC Educational Resources Information Center

Fairfax County Public Schools, Falls Church, VA. Office of Adult and Community Education.

This learning activity package is designed to help women prepare for the environment they may find while working in a trade. After completing this package, women should have a realistic idea about how well prepared they are to deal with job conditions that tend to be a problem for tradeswomen. Five units address the following topics: (1)…
Electronic Combat Hardware-in-the-Loop Testing in an Open Air Environment

DTIC Science & Technology

1994-09-01

APQ- 126 (F-111) Gun Dish Squat Eye ANAWG-9 (F-14) Grill Pan Straight Flush I-Hawk Hawk Screech Sun Visor Head Light Tall King High Fix Team Work High...the required delay to the IF, the SPCs contain a Teledyne Microwave Bulk Acoustic Wave (BAW) delay line as well as a Coherent Variable Delay Unit
Operational Assessment of Tools for Accelerating Leader Development (ALD): Volume 1, Capstone Report

DTIC Science & Technology

2009-06-01

in units and user juries provided feedback on the tools. The pressures of the operational environment seriously limited the time available to work...following functions: account set-up, user authentication, learning management , usage monitoring, problem reporting, assessment data collection, data...especially sources of data) represented—demonstration/assessment manager , operations manager , Web site experts, users (target audience), data collectors
1988 Revisions to the 1978 National Fire-Danger Rating System

Treesearch

Robert E. Burgan

1988-01-01

The 1978 National Fire-Danger Rating System does not work well in the humid environment of the Eastern United States. System modifications to correct problems and their operational impact on System users are described. A new set of 20 fuel models is defined and compared graphically with the 1978 fuel models. Technical documentation of System changes is provided.
Asian American and Pacific Islander Students and the Institutions that Serve Them

ERIC Educational Resources Information Center

Teranishi, Robert T.

2012-01-01

As the global work environment continues to evolve, the United States needs to increase its human capital in order remain economically competitive. Whether the nation can meet the demands of the global economy and maintain its standing as a global leader will be tied inextricably to its ability to increase the proportion of Americans with advanced…
Estimating and preventing hospital internal turnover of newly licensed nurses: A panel survey.

PubMed

Kovner, Christine T; Djukic, Maja; Fatehi, Faridaben K; Fletcher, Jason; Jun, Jin; Brewer, Carol; Chacko, Thomas

2016-08-01

Registered nurse job turnover is an ongoing problem in the USA resulting in significant financial costs to both organizations and society. Most research has focused on organizational turnover with few studies about internal or unit-level turnover. Turnover of new nurses in hospitals has particular importance as almost 80% of new nurses work in hospitals and have higher turnover rates when compared to experienced nurses. This paper focuses on new nurses' unit-level turnover rates in hospitals. The purpose of this study is to: (1) identify factors that predict new nurses staying in the same units, positions, and job titles to inform unit-level retention strategies, and (2) examine the changes in work environment perceptions over time between nurses who remain in the same unit, position, and title to those who changed unit, position and/or title. A panel survey design was used to analyze changes over time. Participants were newly licensed registered nurses who were licensed for the first time between August 1st, 2004 and July 31st, 2005. The nurses came from metropolitan statistical areas or rural areas that were nested to reflect a nationally representative USA sample (58% response rate). The analytic sample for this study was 1335. Data were collected in January 2006 and 2007 following the Dillman total design approach. All potential respondents received paper surveys and non-responders received repeated mailings. Using multinomial regression the five variables with the largest effects on unit retention were (1) variety (positive), (2) having another job for pay (negative), (3) first basic degree (having a bachelors or higher degree increased the probability of staying), (4) negative affectivity (positive), and (5) job satisfaction (positive). Nurses who changed unit, and/or position, and/or title reported more positive change scores on a variety of work attitudes. Almost 30% of new nurses working in hospitals leave their unit, and/or position, and/or title during their first year of work. Our results point to the variables on which managers can focus to improve unit-level retention of new nurses. Although participants were from a nationally representative sample of nurses who were newly licensed in 2004-2005, with the geographical shifts in the USA population in the last 10 years the sample may not be geographically representative of new nurses who graduated in 2015. Copyright © 2016. Published by Elsevier Ltd.

Perceived workplace mistreatment: Case of Latina hotel housekeepers.

PubMed

Hsieh, Yu-Chin Jerrie; Sönmez, Sevil; Apostolopoulos, Yorghos; Lemke, Michael Kenneth

2017-01-01

Latina hotel housekeepers' social class, gender, race/ethnicity, nationality, and United States immigration status render them particularly vulnerable to workplace mistreatment. We sought to reveal the array of policy- and interpersonal-related mistreatment experienced by Latina hotel housekeepers in the southeastern United States employed at 75 local hotels which included 4-star, 3-star, 2-star, and 1-star properties. This ethnographic study involved 27 in-depth interviews with Latina hotel housekeepers. Using semi-structured in-depth interview guides, participants were interviewed until collected data reached saturation. Data were coded to explore themes and relationships for the housekeepers' work environments, and thick descriptions of these environments were developed. Participants ranged in work experience from 1 to 15 years, with all but one unable to reach full-time status, and were paid between $7.25 and $8.00 per hour. Policy-related phenomena, such as low pay, lack of paid sick leave or overtime, and absence of appropriate cleaning tools or protective equipment were all perceived as forms of mistreatment by Latina hotel housekeepers. Interpersonal mistreatment in the form of supervisor favoritism, unfair work assignments, biased allocation of cleaning supplies, disrespect, and verbal abuse due to ethnicity was also perceived. Latina hotel housekeepers endure mistreatment that impacts their psychosocial and physical occupational health. We provide recommendations to minimize workplace mistreatment and improve well-being of Latina hotel housekeepers.
[Medical cooperation on the internet].

PubMed

Meier, N; Lenzen, H; Renger, B C

1998-01-01

Post-1999, the economically united EEC will pose new challenges to European business, industry and citizen. It is a key objective that in the domain of European "infostructure" these problems are challenged and overcome, and that "advanced communications technologies and services" (ACTS) become the cement which binds the Community together. Within ACTS, 130 different projects are building new services. The consortium Emerald develops a telemedicine platform, setting up teleworking with teleconference, computer supported co-operative work (cscw, joint editing), demonstration and teleteaching for radiology, cardiology, nuclear medicine and radio surgery working environments.
Neighborhood characteristics and mental health among African Americans and whites living in a racially integrated urban community.

PubMed

Gary, Tiffany L; Stark, Sarah A; LaVeist, Thomas A

2007-06-01

Aspects of the environment in which one lives are increasingly being recognized as major contributors to health, yet few empirical studies have focused on mental health. Therefore, we sought to determine if neighborhood characteristics were associated with mental health outcomes among 1408 African-American (59.3%) and white (40.7%) adults living in a socio-economically homogeneous, racially integrated, urban community in Baltimore, MD. Among African Americans and whites, the perception of severe problems in the community was associated with higher levels of stress (approximately 1.8 units higher), anxiety (approximately 1.8 units higher), and depression (OR= approximately 2.0) compared to those who perceived no or few problems (all p<0.05). Community cohesion, the perception that people generally work together, was associated with better mental health among whites only. These findings give further insight into the complex environment of inner-city communities.
HIPP lead to self-health: healthy infection prevention practices in intensive care units.

PubMed

Grota, Patti G; Meinzen, Sarah; Burleson-Rine, Penny

2009-01-01

Healthy infection prevention practices (HIPP) include hand hygiene, respiratory etiquette, environmental cleanliness, and use of personal protective equipment. These healthy practices are most used to protect individuals against exposure to bacterial and viral infections in the workplace, as well as in the home. Most often these infection prevention behaviors in critical care units are promoted to protect the patient from healthcare-associated infections. Yet, these practices are just as important to the health of the critical care nurse. Self-health in the workplace is essential to creating a healthy workplace environment, which is the goal of many intensive care units today. The benefits of creating a healthy work environment are improvement of patient/nurse satisfaction and nurse retention. HIPP reduce the risk of the critical care nurse's exposure to microbial pathogens such as methicillin-resistant Staphylococcus aureus and influenza. Pathogens that cause infections may contaminate the hands, the clothing, equipment, and blood, putting the nurse at risk for unhealthy hands, unhealthy flora, and unhealthy blood. The intensive care nurse is encouraged to embrace HIPP to nurture self, as well as protect the patient.
A Piezoelectric Passive Wireless Sensor for Monitoring Strain

NASA Technical Reports Server (NTRS)

Zou, Xiyue; Ferri, Paul N.; Hogan, Ben; Mazzeo, Aaron D.; Hull. Patrick V.

2017-01-01

Interest in passive wireless sensing has grown over the past few decades to meet demands in structural health monitoring.(Deivasigamani et al., 2013; Wilson and Juarez, 2014) This work describes a passive wireless sensor for monitoring strain, which does not have an embedded battery or chip. Without an embedded battery, the passive wireless sensor has the potential to maintain its functionality over long periods in remote/harsh environments. This work also focuses on monitoring small strain (less than 1000 micro-?). The wireless sensing system includes a reader unit, a coil-like transponder, and a sensing unit. It operates in the Megahertz (MHz) frequency range, which allows for a few centimeters of separation between the reader and sensing unit during measurements. The sensing unit is a strain-sensitive piezoelectric resonator that maximizes the energy efficiency at the resonance frequency, so it converts nanoscale mechanical variations to detectable differences in electrical signal. In response to an external loading, the piezoelectric sensor breaks from its original electromechanical equilibrium, and the resonant frequency shifts as the system reaches a new balanced equilibrium. In this work, the fixture of the sensing unit is a small, sticker-like package that converts the surface strain of a test material to measurable shifts in resonant frequencies. Furthermore, electromechanical modeling provides a lumped-parameter model of the system to describe and predict the measured wireless signals of the sensor. Detailed characterization demonstrates how this wireless sensor has resolution comparable to that of conventional wired strain sensors for monitoring small strain.
Effects of learning climate and registered nurse staffing on medication errors.

PubMed

Chang, Yunkyung; Mark, Barbara

2011-01-01

Despite increasing recognition of the significance of learning from errors, little is known about how learning climate contributes to error reduction. The purpose of this study was to investigate whether learning climate moderates the relationship between error-producing conditions and medication errors. A cross-sectional descriptive study was done using data from 279 nursing units in 146 randomly selected hospitals in the United States. Error-producing conditions included work environment factors (work dynamics and nurse mix), team factors (communication with physicians and nurses' expertise), personal factors (nurses' education and experience), patient factors (age, health status, and previous hospitalization), and medication-related support services. Poisson models with random effects were used with the nursing unit as the unit of analysis. A significant negative relationship was found between learning climate and medication errors. It also moderated the relationship between nurse mix and medication errors: When learning climate was negative, having more registered nurses was associated with fewer medication errors. However, no relationship was found between nurse mix and medication errors at either positive or average levels of learning climate. Learning climate did not moderate the relationship between work dynamics and medication errors. The way nurse mix affects medication errors depends on the level of learning climate. Nursing units with fewer registered nurses and frequent medication errors should examine their learning climate. Future research should be focused on the role of learning climate as related to the relationships between nurse mix and medication errors.
Building a healthy work environment: a nursing resource team perspective.

PubMed

Vaughan, Leslie; Slinger, Trisha

2013-01-01

Leadership and staff from the London Health Sciences Centre (LHSC) Nursing Resource Team (NRT), including members of their Continuous Quality Improvement (CQI) Council, attended the first Southern Ontario Nursing Resource Team Conference (SONRTC), held March 2012 in Toronto. The SONRTC highlighted healthy work environments (HWEs), noting vast differences among the province's various organizations. Conversely, CQI Council members anecdotally acknowledged similar inconsistencies in HWEs across the various inpatient departments at LHSC. In fact, the mobility of the NRT role allows these nurses to make an unbiased observation about the culture, behaviours and practices of specific units as well as cross-reference departments regarding HWEs. Studies have documented that HWEs have a direct impact on the quality of patient care. Furthermore, the literature supports a relationship between HWEs and nurse job satisfaction. Based on this heightened awareness, the NRT CQI Council aimed to investigate HWEs at LHSC. The American Association of Critical Care Nurses (AACN) Standards for Establishing and Sustaining Healthy Work Environments was adapted in developing a survey for measuring HWEs based on the perceptions of NRT staff. Each of the departments was evaluated in terms of the following indicators: skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition and authentic leadership (AACN 2005). Ultimately, the Building a Healthy Work Environment: A Nursing Resource Team Perspective survey was employed with NRT nurses at LHSC, and data was collected for use by leadership and staff for creating HWE strategies aimed at improving the quality of patient care.
Methods of sampling airborne fungi in working environments of waste treatment facilities.

PubMed

Černá, Kristýna; Wittlingerová, Zdeňka; Zimová, Magdaléna; Janovský, Zdeněk

2016-01-01

The objective of the present study was to evaluate and compare the efficiency of a filter based sampling method and a high volume sampling method for sampling airborne culturable fungi present in waste sorting facilities. Membrane filters method was compared with surface air system method. The selected sampling methods were modified and tested in 2 plastic waste sorting facilities. The total number of colony-forming units (CFU)/m3 of airborne fungi was dependent on the type of sampling device, on the time of sampling, which was carried out every hour from the beginning of the work shift, and on the type of cultivation medium (p < 0.001). Detected concentrations of airborne fungi ranged 2×102-1.7×106 CFU/m3 when using the membrane filters (MF) method, and 3×102-6.4×104 CFU/m3 when using the surface air system (SAS) method. Both methods showed comparable sensitivity to the fluctuations of the concentrations of airborne fungi during the work shifts. The SAS method is adequate for a fast indicative determination of concentration of airborne fungi. The MF method is suitable for thorough assessment of working environment contamination by airborne fungi. Therefore we recommend the MF method for the implementation of a uniform standard methodology of airborne fungi sampling in working environments of waste treatment facilities. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Impact of organizational policies and practices on workplace injuries in a hospital setting.

PubMed

Tveito, T H; Sembajwe, G; Boden, L I; Dennerlein, J T; Wagner, G R; Kenwood, C; Stoddard, A M; Reme, S E; Hopcia, K; Hashimoto, D; Shaw, W S; Sorensen, G

2014-08-01

This study aimed to assess relationships between perceptions of organizational practices and policies (OPP), social support, and injury rates among workers in hospital units. A total of 1230 hospital workers provided survey data on OPP, job flexibility, and social support. Demographic data and unit injury rates were collected from the hospitals' administrative databases. Injury rates were lower in units where workers reported higher OPP scores and high social support. These relationships were mainly observed among registered nurses. Registered nurses perceived coworker support and OPP as less satisfactory than patient care associates (PCAs). Nevertheless, because of the low number of PCAs at each unit, results for the PCAs are preliminary and should be further researched in future studies with larger sample sizes. Employers aiming to reduce injuries in hospitals could focus on good OPP and supportive work environment.
The effect of transforming care at the bedside initiative on healthcare teams' work environments.

PubMed

Lavoie-Tremblay, Mélanie; O'Conner, Patricia; Harripaul, Anastasia; Biron, Alain; Ritchie, Judith; Lavigne, Genevieve L; Baillargeon, Sophie; Ringer, Justin; Macgibbon, Brenda; Taylor-Ducharme, Sharon; Sourdif, Jacynthe

2014-02-01

Different initiatives have been implemented in healthcare organizations to improve efficiency, such as transforming care at the bedside (TCAB). However, there are important gaps in understanding the effect of TCAB on healthcare teams' work environments. The specific aim of the study is to describe findings regarding the TCAB initiative effects on healthcare teams' work environments. A pretest and posttest study design was used for this study. The TCAB initiative was implemented in fall 2010 in a university health center in Montreal, Canada. The sample consisted of healthcare workers from four different care units. Statistically significant improvement was observed with the communicating specific information subscale from the measure of processes of care variable, and a significant difference was found between the support from colleagues variable, which was higher at baseline than postprogram. The differences for psychological demand, decisional latitude, and effort-reward were not significant. TCAB is an intervention that allows healthcare teams to implement change to improve patients' and families' outcomes. Ongoing energy should focus on how to improve communication among all members of the team and ensure their support. © 2013 Sigma Theta Tau International.
Moral mindfulness: The ethical concerns of healthcare professionals working in a psychiatric intensive care unit.

PubMed

Salzmann-Erikson, Martin

2018-06-22

Healthcare professionals working on inpatient wards face the externalizing or challenging behaviour of the patients who are admitted. Ethical values and principles in psychiatric nursing have been reported to be important when approaching patients during the most acute phase of deterioration in their mental health. Hence, the aim of this study was to discover and describe staff members' ethical and moral concerns about their work as healthcare professionals in a psychiatric intensive care unit. The study has a qualitative descriptive design and makes use of Framework Analysis. Registered nurses and psychiatric aides in a psychiatric intensive care unit in Sweden were observed during ethical reflection meetings. Four to six staff attended the 90-min meetings. The data comprise observations from six meetings, which provided 94 pages of text. The results demonstrate that the work was described as being both motivating and exhausting. The staff faced ethical concerns in their daily work, as patients often demonstrated challenging behaviours. Three themes were identified as follows: (i) concerns about the staff impacting on patients' experience of care, (ii) concerns about establishing a safe working environment, and (iii) concerns about becoming unprofessional due to expectations and a high workload. Ethical concerns included simultaneously taking into account both the patients' dignity and safety aspects, while also being exposed to high workloads. These elements of work are theorized as influencing complex psychiatric nursing. If we are to bring these influential factors to light in the workplace, advanced nursing practice must be grounded in moral mindfulness. © 2018 Australian College of Mental Health Nurses Inc.
National Center for Nuclear Security - NCNS

ScienceCinema

None

2018-01-16

As the United States embarks on a new era of nuclear arms control, the tools for treaty verification must be accurate and reliable, and must work at stand-off distances. The National Center for Nuclear Security, or NCNS, at the Nevada National Security Site, is poised to become the proving ground for these technologies. The center is a unique test bed for non-proliferation and arms control treaty verification technologies. The NNSS is an ideal location for these kinds of activities because of its multiple environments; its cadre of experienced nuclear personnel, and the artifacts of atmospheric and underground nuclear weapons explosions. The NCNS will provide future treaty negotiators with solid data on verification and inspection regimes and a realistic environment in which future treaty verification specialists can be trained. Work on warhead monitoring at the NCNS will also support future arms reduction treaties.
Health and safety in the dental clinic - Hygiene regulations for use of elemental mercury in the protection of rights, safety and well-being of the patients, workers and the environment.

PubMed

Ngim, Chunhan; Ngim, Allister Daquan

2013-12-01

The rules governing the use of metallic mercury, a toxic and hazardous chemical, is in most jurisdictions identical to widely accepted standards and practices for handling the same chemical in industry for the protection of humans and their work environment. There cannot be exceptions solely for the practitioner dentists and their patients. Any workplace must be safe for both workers and visitors. The latter being dental patients waiting in the dentist's work environment. We reviewed the literature for toxic health effects of elemental mercury upon humans and present information about the Minimata Convention convened by the United Nations Environment Programme. A study conducted among dentists in Singapore and their personal work environment almost 30 years ago contributed to the workplace standard for elemental mercury, which was reduced, and is still currently enforced as a global standard. We recommend that dentists, with a large alternative battery of restorative materials today, make selection of a restorative material a more seriously considered choice, and not to make use of amalgam without the proper use of personal protective equipment for themselves (members of the dental operating team) and their patients, (amalgam traps and judicious monitoring of their workplace air quality). Mercury is ubiquitous in our presence due to human activities; any reduction in the dentists' workplace contributes to a global reduction. © 2013 Published by Elsevier (Singapore) Pte Ltd.
Development of student's skills of 3D modeling of assembly units

NASA Astrophysics Data System (ADS)

Chepur, P. V.; Boshhenko, T. V.

2018-03-01

The paper presents data on the influence of additives of the pre-treated aluminium oxide powder on the structure of cast lead-tin-based bronzes. The article demonstrates that modern, advanced from the point of view of automation, methods in designing products are the basis for the successful implementation of any production task. The advantages of product presentation in the form of an assembly consisting of 3D models of its details are described. The extreme importance of high-quality preparation of students of engineering specialties for work in computer-aided design programs such as AutoCAD, Compass 3D, Inventer|, Solid Edge, Solid Works, Revit, ANSYS is considered. It is established that one of the most effective forms of increasing the level of computer graphic preparation of students are academic competitions and contests on modeling and prototyping products. The stages of creation of assembly unit models in the AutoCad and Compass 3D software suits generally accepted both in design in a business environment and during training of specialists are considered. The developed 3D models of assembly units are presented in the course of preparation for academic competitions (called Academic Olympics in Russia) of students of the 2nd-5th years of study and the first year students of the master's program in engineering. The conclusions and recommendations on the development of the direction of three-dimensional design in the environment of higher education are given.
The United States Army Medical Department Journal. October-December 2011

DTIC Science & Technology

2011-12-01

flowsheet with documentation of continuous fluid resuscitation decreased morbidity and mortality from burn wounds.6 Compartment syndrome ALARACT (all...Army action) memo mandated a high index of suspicion for compartment syndrome and a standardized approach to guide providers in the evaluation and...supervisors and staff concerning scheduling in order to foster a positive work environment, avoid burnout , increase morale, lower absenteeism, and
Localization of Acoustic Transients in Shallow Water Environments

DTIC Science & Technology

1992-12-01

effect of the source signal uncertainty (in localizer performance . The localization process consists of two parts. First, a time domain propagation...for public release; distribution is unlimited 4. PERFORMING ORGANIZATION REPORT NUMBER(S) 5. MONITORING ORGANIZATION REPORT NUMBER(S) E OF PERFORMING ...SOURCE OF FUNDING NUMBERS PROGRAM PROJECT TASK WORK UNIT ELEMENT NO. NO. NO. ACCESSION NO. 11. TITLE (Include Security Classification) LOCALIZATION OF
A Simulation Environment for Aerodynamic Analysis and Design of Flapping Wing Micro Air Vehicles

DTIC Science & Technology

2010-01-01

parametric study involving numerous configurations with multiple flight conditions must be conducted in order to determine the potential "best design...virilis Honey Bee : Apis mellifica Bumble Bee : Bombus terrestris Hummingbird: Archi lochus colubris Hawkmoth: Manduca Sexta Hummingbird...Sf. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) B.PERFORMING ORGANIZATION REPORT NUMBER Streamline Numerics , Inc. SNI-CR
What Works: Building Natural Science Communities. Resources for Reform. Strengthening Undergraduate Science and Mathematics. A Report of Project Kaleidoscope. Volume Two.

ERIC Educational Resources Information Center

Narum, Jeanne L., Ed.

The purpose of Project Kaleidoscope is to be a catalyst for action to encourage a national environment for reform in undergraduate education in science and mathematics in the United States. This report, the second of two volumes, presents ideas from Project Kaleidoscope that involve changing undergraduate science and mathematics education through…
Developmental Characteristics of Young Dual Language Learners: Implications for Policy and Practice in Infant and Toddler Care

ERIC Educational Resources Information Center

Castro, Dina C.; Espinosa, Linda M.

2014-01-01

This article discusses the current knowledge on the developmental characteristics and contexts of care for infants and toddlers who are growing up in bilingual environments at home and in their early care settings in the united States. The authors highlight relevant findings from the work of the Center of Early Care and Education Research-Dual…
EUREKA (European Research Coordination Agency) Program Update to March 1988

DTIC Science & Technology

1988-07-12

fibers for polymer matrix composites. Environment Membranes for Ultra- Microfiltration Denmark, France 34.90/72 5/A UF/MF module/membrane systems for...Germany 7.00/120 140/A Restoration Sweden, Denmark, France, United Development of not now available industrial products and tech- Kingdom, Greece...Netherlands, nologies as well as craft skills for conservation and restoration Portugal, Turkey, CEC work. Establishment of technical standards and

A bill to designate the Federal building located at 118 South Mill Street, Fergus Falls, Minnesota, as the Edward J. Devitt United States Courthouse.

THOMAS, 113th Congress

Sen. Klobuchar, Amy [D-MN

2013-04-11

Senate - 04/11/2013 Read twice and referred to the Committee on Environment and Public Works. (All Actions) Notes: For further action, see H.R.2251, which became Public Law 113-60 on 12/20/2013. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Dehydration and Rehydration

DTIC Science & Technology

2012-01-01

ELEMENT NUMBER 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ...ability to perform .84 This chapter presents an overview of topics surrounding hydration, dehydration, and rehydration. The terms euhydration, hypohydration...environments, or illness, inability to maintain fluid balance can seriously jeopardize health and the ability to perform .84 This chapter presents an overview
Opportunities and Challenges of Working with Gifted and Talented Students in an Urban Context: A University-Based Intervention Program

ERIC Educational Resources Information Center

Casey, Ronald; Smith, Carole Portman; Koshy, Valsa

2011-01-01

The United Kingdom (UK) Labor Government launched three major policy initiatives in the past three decades. First was the introduction of gifted and talented education with a special focus on the identification of and provision for inner-city students whose gifts and talents lie submerged in most cases due to their environment of social and…
Implementation Fest: The Last Decade

DTIC Science & Technology

2010-08-01

architectures New Learning Technologies  Simulations, games, and virtual world  Mobile systems  Performance support, S1000D tech manuals  Intelligent...Darwars Ambush (ECS) Gator 6 (Will Interactive) Games Today 22 VBS2 Enhanced Learning Environment using Creative Technology – Bilateral Negotiations...5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Advanced Decision Learning (ADL),1901 N. Beauregard Street Suite 600
Conceptions of Software Development by Project Managers: A Study of Managing the Outsourced Development of Software Applications for United States Federal Government Agencies

ERIC Educational Resources Information Center

Eisen, Daniel

2013-01-01

This study explores how project managers, working for private federal IT contractors, experience and understand managing the development of software applications for U.S. federal government agencies. Very little is known about how they manage their projects in this challenging environment. Software development is a complex task and only grows in…
Discrepancies in assessing home care workers' working conditions in a Norwegian home care service: differing views of stakeholders at three organizational levels.

PubMed

Andersen, Gunn Robstad; Westgaard, Rolf H

2015-07-25

The present study is a follow-up study of factors contributing to an undesirable quality of work environment and sick leave rate in the home care services in a Norwegian municipality. The underlying assumption is that organizational discrepancies in the perceptions and appraisals of significant factors and processes in an organization have detrimental effects on the management of the organization and on work environment conditions. Thus, the study aim is to explore potential organizational discrepancies in the appraisals of factors relating to home care workers' working conditions. The study, using a mixed-methods design, comprised six home care units. It included survey responses of home care workers (80 respondents, response rate 54 %) and qualitative descriptions of stakeholders' appraisals of organizational issues gathered through semi-structured interviews (33 interviews with stakeholders at three organizational levels). Employees at different organizational levels in the home care services expressed divergent appraisals of factors related to the working conditions of home care workers, including impact of organizational measures (i.e. time pressure, work tasks, a new work program, organizational changes, budget model, budget allocation and coping strategies). Survey responses supported interview descriptions by home care workers. Results suggest that organizational discrepancy serve as an important barrier to a sustainable, well-functioning organization in general and to quality-enhancing changes to work procedures in particular. It is recommended to improve communication channels and facilitate the exchange of information across levels to ensure a common understanding of matters significant to the organization of the home care services and to the work environment of home care workers. The prevalence and impact of organizational discrepancy should be included in organization research, particularly when exploring explanatory factors of an unhealthy organization.
Nurses' sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts

PubMed Central

Gómez-García, Teresa; Ruzafa-Martínez, María; Fuentelsaz-Gallego, Carmen; Madrid, Juan Antonio; Rol, Maria Angeles; Martínez-Madrid, María José; Moreno-Casbas, Teresa

2016-01-01

Objective The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. Methods This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. Results 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). Conclusions Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The most common nursing care omissions reported were related to nursing care plans. For the Global Sleep Quality score, difference were found between day and night shift workers. PMID:27496241
Empowerment in the interpersonal field: discourses of acute mental health nurses.

PubMed

Lloyd, M

2007-08-01

Social policy greatly influences the working environment of mental health nurses but in practice can be difficult to translate. Empowerment of service users is one area that is constantly significant in policy, locally and nationally, yet quite difficult to define in practice. This ethnomethodological study explored the practice of 10 mental health nurses working in an acute admissions unit. Through semi-structured interviews, the nurses were asked to discuss the taken-for-granted methods of empowerment with individual service users, their families and with work colleagues. The results were thematically analysed and compared with international findings, which reflected an awareness among mental health nurses of empowering practice in four areas. These were: Working with mental illness, Making connections, Responsibility and Teamworking.
Decreased Stress Levels in Nurses: A Benefit of Quiet Time.

PubMed

Riemer, Heather C; Mates, Joanna; Ryan, Linda; Schleder, Bonnie J

2015-09-01

The benefits of quiet time, a therapeutic method of improving the health care environment, have been evaluated in patients, but only a few studies have examined the effects of quiet time on intensive care nurses. To evaluate the effects of implementing quiet time in a medical-surgical intensive care unit on levels of light, noise, and nurses' stress. Quiet time consisted of turning down the unit lights for a designated time. Levels of light, noise, and nurses' stress were measured. Nurses' stress levels were measured by using a 100-point visual analog scale; unit noise, by using a digital sound level meter (model 407736, Extech Instruments); and unit light, by using an illumination light meter (model 615, Huygen Corporation). Measurements were obtained 30 minutes before and 30 minutes, 1 hour, and 2 hours after implementation of quiet time. Analysis of variance and comparisons of means indicated that both light levels and nurses' stress levels were significantly decreased after quiet time (both P < .001). Noise levels were also decreased after quiet time, but the decrease was not significant (P = .08). Use of quiet time resulted in decreased light levels and decreased stress levels among nurses. Quiet time is an easily performed energy-saving intervention to promote a healthy work environment. ©2015 American Association of Critical-Care Nurses.
Nurses' views of shared leadership in ICU: a case study.

PubMed

Rosengren, Kristina; Bondas, Terese; Nordholm, Lena; Nordström, Gun

2010-08-01

New management models develop; one of them is shared leadership where two nurse managers share tasks and responsibility for a unit. The overall aim of this study was to describe the view of the staff about shared leadership at an ICU in Sweden and to study if there were any differences in perceptions between staff groups. This unit had changed the management organisation from single leadership (one nurse manager) to shared leadership (two nurse managers). Sixty-four (79%) registered nurses and assistant nurses responded to a 72 item questionnaire measuring social and organisational factors at work, especially leadership and shared leadership. The results showed that staff reported positive views in relation to the dimensions 'Organisational culture', 'Social interactions', 'Work satisfaction', 'Leadership', 'Shared leadership' and 'Work motives'. Registered nurses reported more positive views than assistant nurses in relation to the dimensions: 'Organisational culture', 'Social interactions', 'Work satisfaction' and 'Leadership'. Further, females had more positive views than males on the dimension 'Social interactions'. Staff described that shared leadership positively influenced the work in terms of confidence. In conclusion, staff reported positive views of work and the model shared leadership in the investigated ICU. One implication is that nurse managers have to be conscious of different health professionals in the unit and it is important to offer a good working environment for all staff. However, more research is needed within the area of shared leadership. A future research project could be to add a qualitative research question about how work and shared leadership affects different health professionals in the day to day practice both at the managerial as well as the team level to improve health care. Copyright 2010 Elsevier Ltd. All rights reserved.
Barriers to work-life balance for hospital nurses.

PubMed

Mullen, Kathleen

2015-03-01

Nurses are loyal to their patients and coworkers. They often put the needs of others before their own and sometimes even before the needs of their families. This concern for others can cause conflicts that manifest as stress. Of the more than 2 million nurses in the United States, more than 62% work in hospitals. Hospitals are known to be both rewarding and stressful places to work. Like most workers, nurses face the challenge of balancing demands and achievements of work with those in their private lives. Hospital leaders can facilitate improved work-life balance (WLB) for hospital nurses by using tools already in place. Equally important, nurses can use their knowledge and resources to nurse the nurse within, which can greatly improve their experience of WLB, independent of the demands of their work environment. © 2015 The Author(s).
Worksite Food and Physical Activity Environments and Wellness Supports Reported by Employed Adults in the United States, 2013.

PubMed

Onufrak, Stephen J; Watson, Kathleen B; Kimmons, Joel; Pan, Liping; Khan, Laura Kettel; Lee-Kwan, Seung Hee; Park, Sohyun

2018-01-01

To examine the workplace food and physical activity (PA) environments and wellness culture reported by employed United States adults, overall and by employer size. Cross-sectional study using web-based survey on wellness policies and environmental supports for healthy eating and PA. Worksites in the United States. A total of 2101 adults employed outside the home. Survey items were based on the Centers for Disease Control and Prevention Worksite Health ScoreCard and Checklist of Health Promotion Environments and included the availability and promotion of healthy food items, nutrition education, promotion of breast-feeding, availability of PA amenities and programs, facility discounts, time for PA, stairwell signage, health promotion programs, and health risk assessments. Descriptive statistics were used to examine the prevalence of worksite environmental and facility supports by employer size (<100 or ≥100 employees). Chi-square tests were used to examine the differences by employer size. Among employed respondents with workplace food or drink vending machines, approximately 35% indicated the availability of healthy items. Regarding PA, 30.9% of respondents reported that their employer provided opportunities to be physically active and 17.6% reported worksite exercise facilities. Wellness programs were reported by 53.2% working for large employers, compared to 18.1% for smaller employers. Employee reports suggested that workplace supports for healthy eating, PA, and wellness were limited and were less common among smaller employers.
Land management decisions in a carbonatic geo-environment

NASA Astrophysics Data System (ADS)

Siska, P.; Hung, I.-K.

2017-10-01

Land is the uppermost territorial unit of the earth’s surface that is quasi-homogeneous in its physical, natural, and also anthropogenic properties. The fundamental component of land is lithosphere. The focus of this work is on a carbonatic geo-environment that is dominantly characterized by Mesozoic rock complexes, significant chemical weathering, and a set of landforms that are unique to this type of a geological structures. In general, optimal land management is a composite of land sharing and land sparing practices; however, in order to answer the question: ‘What is a parcel of land best suited for?’ often requires well-organized spatial data. In this work, we have focused on developing a model that would evaluate the suitability of a carbonatic geo-environment for land management practices. Due to the potential hazards of some sinkhole infested areas, the risk of natural hazards must be first evaluated. In addition, the level of hazards depends on population pressure and the intensity of human impact on this particular environment. In this research, we have applied the principles of geostatistics to evaluate the probabilities for sinkhole hazards as well as fuzzy logic to evaluate the suitability of land sharing and land sparing management.
Influence of the Nursing Practice Environment on Job Satisfaction and Turnover Intention

PubMed Central

Lee, Sang-Yi; Kim, Chul-Woung; Kang, Jeong-Hee; Yoon, Tae-Ho; Kim, Cheoul Sin

2014-01-01

Objectives: To examine whether the nursing practice environment at the hospital-level affects the job satisfaction and turnover intention of hospital nurses. Methods: Among the 11 731 nurses who participated in the Korea Health and Medical Workers’ Union’s educational program, 5654 responded to our survey. Data from 3096 nurses working in 185 general inpatient wards at 60 hospitals were analyzed using multilevel logistic regression modeling. Results: Having a standardized nursing process (odds ratio [OR], 4.21; p<0.001), adequate nurse staffing (OR, 4.21; p<0.01), and good doctor-nurse relationship (OR, 4.15; p<0.01), which are hospital-level variables based on the Korean General Inpatients Unit Nursing Work Index (KGU-NWI), were significantly related to nurses’ job satisfaction. However, no hospital-level variable from the KGU-NWI was significantly related to nurses’ turnover intention. Conclusions: Favorable nursing practice environments are associated with job satisfaction among nurses. In particular, having a standardized nursing process, adequate nurse staffing, and good doctor-nurse relationship were found to positively influence nurses’ job satisfaction. However, the nursing practice environment was not related to nurses’ turnover intention. PMID:25284197
Characterizing noise and perceived work environment in a neurological intensive care unit.

PubMed

Ryherd, Erica E; Waye, Kerstin Persson; Ljungkvist, Linda

2008-02-01

The hospital sound environment is complex. Alarms, medical equipment, activities, and ventilation generate noise that may present occupational problems as well as hinder recovery among patients. In this study, sound measurements and occupant evaluations were conducted in a neurological intensive care unit. Staff completed questionnaires regarding psychological and physiological reactions to the sound environment. A-weighted equivalent, minimum, and maximum (L(Aeq),L(AFMin),L(AFMax)) and C-weighted peak (L(CPeak)) sound pressure levels were measured over five days at patient and staff locations. Acoustical descriptors that may be explored further were investigated, including level distributions, restorative periods, and spectral content. Measurements near the patients showed average L(Aeq) values of 53-58 dB. The mean length of restorative periods (L(Aeq) below 50 dB for more than 5 min) was 9 and 13 min for day and night, respectively. Ninety percent of the time, the L(AFMax) levels exceeded 50 dB and L(CPeak) exceeded 70 dB. Dosimeters worn by the staff revealed higher noise levels. Personnel perceived the noise as contributing to stress symptoms. Compared to the majority of previous studies, this study provides a more thorough description of intensive care noise and aids in understanding how the sound environment may be disruptive to occupants.
Individual psychological therapy in an acute inpatient setting: Service user and psychologist perspectives.

PubMed

Small, Catherine; Pistrang, Nancy; Huddy, Vyv; Williams, Claire

2018-01-18

The acute inpatient setting poses potential challenges to delivering one-to-one psychological therapy; however, there is little research on the experiences of both receiving and delivering therapies in this environment. This qualitative study aimed to explore service users' and psychologists' experiences of undertaking individual therapy in acute inpatient units. It focused on the relationship between service users and psychologists, what service users found helpful or unhelpful, and how psychologists attempted to overcome any challenges in delivering therapy. The study used a qualitative, interview-based design. Eight service users and the six psychologists they worked with were recruited from four acute inpatient wards. They participated in individual semi-structured interviews eliciting their perspectives on the therapy. Service users' and psychologists' transcripts were analysed together using Braun and Clarke's (2006, Qualitative Research in Psychology, 3, 77) method of thematic analysis. The accounts highlighted the importance of forming a 'human' relationship - particularly within the context of the inpatient environment - as a basis for therapeutic work. Psychological therapy provided valued opportunities for meaning-making. To overcome the challenges of acute mental health crisis and environmental constraints, psychologists needed to work flexibly and creatively; the therapeutic work also extended to the wider context of the inpatient unit, in efforts to promote a shared understanding of service users' difficulties. Therapeutic relationships between service users and clinicians need to be promoted more broadly within acute inpatient care. Psychological formulation can help both service users and ward staff in understanding crisis and working collaboratively. Practice-based evidence is needed to demonstrate the effectiveness of adapted psychological therapy models. Developing 'human' relationships at all levels of acute inpatient care continues to be an important challenge for clinical practice. Due to the distress of individuals and the constraints of the acute inpatient environment, psychologists need to be flexible and adaptable in delivering individual therapy. Making meaning and psychological formulation can give service users a sense of hope and empowerment, and can contribute to a shared understanding within the ward team of service users' difficulties. © 2018 The British Psychological Society.
Development of a Hospital-based Massage Therapy Course at an Academic Medical Center.

PubMed

Dion, Liza J; Cutshall, Susanne M; Rodgers, Nancy J; Hauschulz, Jennifer L; Dreyer, Nikol E; Thomley, Barbara S; Bauer, Brent

2015-03-01

Massage therapy is offered increasingly in US medical facilities. Although the United States has many massage schools, their education differs, along with licensure and standards. As massage therapy in hospitals expands and proves its value, massage therapists need increased training and skills in working with patients who have various complex medical concerns, to provide safe and effective treatment. These services for hospitalized patients can impact patient experience substantially and provide additional treatment options for pain and anxiety, among other symptoms. The present article summarizes the initial development and description of a hospital-based massage therapy course at a Midwest medical center. A hospital-based massage therapy course was developed on the basis of clinical experience and knowledge from massage therapists working in the complex medical environment. This massage therapy course had three components in its educational experience: online learning, classroom study, and a 25-hr shadowing experience. The in-classroom study portion included an entire day in the simulation center. The hospital-based massage therapy course addressed the educational needs of therapists transitioning to work with interdisciplinary medical teams and with patients who have complicated medical conditions. Feedback from students in the course indicated key learning opportunities and additional content that are needed to address the knowledge and skills necessary when providing massage therapy in a complex medical environment. The complexity of care in medical settings is increasing while the length of hospital stay is decreasing. For this reason, massage provided in the hospital requires more specialized training to work in these environments. This course provides an example initial step in how to address some of the educational needs of therapists who are transitioning to working in the complex medical environment.
Development of a Hospital-based Massage Therapy Course at an Academic Medical Center

PubMed Central

Dion, Liza J.; Cutshall, Susanne M.; Rodgers, Nancy J.; Hauschulz, Jennifer L.; Dreyer, Nikol E.; Thomley, Barbara S.; Bauer, Brent

2015-01-01

Background: Massage therapy is offered increasingly in US medical facilities. Although the United States has many massage schools, their education differs, along with licensure and standards. As massage therapy in hospitals expands and proves its value, massage therapists need increased training and skills in working with patients who have various complex medical concerns, to provide safe and effective treatment. These services for hospitalized patients can impact patient experience substantially and provide additional treatment options for pain and anxiety, among other symptoms. The present article summarizes the initial development and description of a hospital-based massage therapy course at a Midwest medical center. Methods: A hospital-based massage therapy course was developed on the basis of clinical experience and knowledge from massage therapists working in the complex medical environment. This massage therapy course had three components in its educational experience: online learning, classroom study, and a 25-hr shadowing experience. The in-classroom study portion included an entire day in the simulation center. Results: The hospital-based massage therapy course addressed the educational needs of therapists transitioning to work with interdisciplinary medical teams and with patients who have complicated medical conditions. Feedback from students in the course indicated key learning opportunities and additional content that are needed to address the knowledge and skills necessary when providing massage therapy in a complex medical environment. Conclusions: The complexity of care in medical settings is increasing while the length of hospital stay is decreasing. For this reason, massage provided in the hospital requires more specialized training to work in these environments. This course provides an example initial step in how to address some of the educational needs of therapists who are transitioning to working in the complex medical environment. PMID:25780472
CASH--an innovative approach to sustainable OSH improvement at workplace.

PubMed

Pingle, S; Shanbhag, S

2006-01-01

Occupational health department of a large private enterprise located in India launched Project CASH--Change Agents for Safety and Health, at manufacturing units of the enterprise to bring about a positive change in work environment and improvement in work practices to reduce occupational health risk. Multidisciplinary teams of change agents were constituted and were given intensive training inputs. Reduction in exposure to noise, dust and heat stress were identified as specific objectives after a baseline survey of the work environment. Occupational safety and health knowledge and training was imparted to all field personnel to improve their work practices and attitudes. The focus of the actions was on engineering control measures and process engineering changes necessary for workplace improvement. Noise levels were reduced by an average of more than 9dBA in most of the top ten high noise locations. Out of two locations identified for dust exposure, one was fully eliminated and dust levels at other location were significantly reduced. Heat stress was reduced in all three identified locations with an average reduction of more than 3 degrees C in WBGT levels. Thus, final evaluation of workplace environments revealed significant reduction in exposure to all identified agents, viz noise, dust and heat fulfilling the project objectives. Educating and empowering the team led to reduction of occupational health risks in the work environment. There was positive attitudinal and behavioural change in safety and occupational health awareness & practices among employees. The monetary savings resulting from improvements far outweighed the investments. Success of this pilot project was followed up with further similar projects and their number has grown in geometric proportion for the last three years indicating the sustainability of the project.
ThedaCare's business performance system: sustaining continuous daily improvement through hospital management in a lean environment.

PubMed

Barnas, Kim

2011-09-01

For 2003-2008, ThedaCare, a community health system in Wisconsin, achieved significant improvements in quality and the elimination of waste through the development of an improvement system, which included Value Stream analysis, rapid improvement events, and projects applied to specific processes. However, to meet its continuous daily improvement goals, particularly the goal of increasing productivity by 10% annually, ThedaCare needed to change the way its managers and leaders (in its hospital division) conduct and manage their daily work. Accordingly, it developed its Business Performance System (BPS) to achieve and sustain continuous daily improvement. BUILDING THE BPS: ThedaCare devised a multipart pilot project, consisting of "learning to see" and then, "problem solving." On completion of the 15-week alpha phase (6 units) in July 2009, the BPS was spread to the beta pilot (12 units; September 2009-January 2010) and then to cohort 3 (10 units; September 2010-January 2011). Each alpha unit improved performance on (1) the key driver metric of increasing productivity from 2008 to year-end 2009 (by 1%-11%) and (2) its respective safety/ quality drivers over the respective 2008 baselines. For 2010, improvements across the alpha, beta, and cohort 3 units were found for 11 of the 14 safety/quality drivers-85% of the 11 customer satisfaction drivers, 83% of 6 people engagement drivers; and 48% of 23 financial stewardship drivers. The tools developed for the BPS have enabled teams to see, prioritize, and pursue continuous daily improvement opportunities. Unit leaders now have a structured management reporting system to reduce variation in their management styles. Leaders all now follow leadership standard work, and their daily work is now consistently aligned with the hospital and system strategy.

Evaluation of the built environment: staff and family satisfaction pre- and post-occupancy of the Children's Hospital.

PubMed

Kotzer, Anne Marie; Zacharakis, Susan Koch; Raynolds, Mary; Buenning, Fred

2011-01-01

To evaluate and compare the impact of an existing and newly built hospital environment on family and staff satisfaction related to light, noise, temperature, aesthetics, and amenities, as well as safety, security, and privacy. The United States is engaged in an unprecedented healthcare building boom driven by the need to replace aging facilities, understand the impact of the built environment on quality and safety, incorporate rapidly emerging technologies, and enhance patient- and family-centered care. More importantly, there is heightened attention to creating optimal physical environments to achieve the best possible outcomes for patients, families, and staff. Using a pre-post descriptive survey design, all nursing, social work, therapy staff, and families on selected inpatient units were invited to participate. A demographic form and Family and Staff Satisfaction Surveys were developed and administered pre- and post-occupancy of the new facility. Pre/post mean scores for staff satisfaction improved on all survey subscales with statistically significant improvement (p < .05) in most areas. The most improvement was seen with layout of the patient room, natural light, storage and writing surfaces, and comfort and appeal. Family satisfaction demonstrated statistically significant improvement on all subscales (p ≤ .01), especially for natural light, quiet space, parking, and the child's room as a healing environment. Families and staff reported greater satisfaction with the newly built hospital environment compared to the old facility. Study results will help guide future architectural design decisions, attract and retain staff at a world-class facility, and create the most effective healing environments.
A Self-Referenced Optical Intensity Sensor Network Using POFBGs for Biomedical Applications

PubMed Central

Moraleda, Alberto Tapetado; Montero, David Sánchez; Webb, David J.; García, Carmen Vázquez

2014-01-01

This work bridges the gap between the remote interrogation of multiple optical sensors and the advantages of using inherently biocompatible low-cost polymer optical fiber (POF)-based photonic sensing. A novel hybrid sensor network combining both silica fiber Bragg gratings (FBG) and polymer FBGs (POFBG) is analyzed. The topology is compatible with WDM networks so multiple remote sensors can be addressed providing high scalability. A central monitoring unit with virtual data processing is implemented, which could be remotely located up to units of km away. The feasibility of the proposed solution for potential medical environments and biomedical applications is shown. PMID:25615736
77 FR 39319 - Suggestions for Environmental Cooperation Pursuant to the United States-Korea Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-02

...The Department invites the public, including NGOs, educational institutions, private sector enterprises and other interested persons, to submit written comments or suggestions regarding items for inclusion in the first Work Program for implementing the United States--Korea Environmental Cooperation Agreement, which entered into force on March 15, 2012. We encourage submitters to refer to: (1) The U.S.--Korea Environmental Cooperation Agreement; (2) Chapter 20 (Environment) of the U.S.--Korea Free Trade Agreement; and (3) the Environmental Review of the U.S.--Korea Free Trade Agreement. These documents are available at: http:// www.state.gov/e/oes/env/trade/c49687.htm.
A self-referenced optical intensity sensor network using POFBGs for biomedical applications.

PubMed

Tapetado Moraleda, Alberto; Sánchez Montero, David; Webb, David J; Vázquez García, Carmen

2014-12-12

This work bridges the gap between the remote interrogation of multiple optical sensors and the advantages of using inherently biocompatible low-cost polymer optical fiber (POF)-based photonic sensing. A novel hybrid sensor network combining both silica fiber Bragg gratings (FBG) and polymer FBGs (POFBG) is analyzed. The topology is compatible with WDM networks so multiple remote sensors can be addressed providing high scalability. A central monitoring unit with virtual data processing is implemented, which could be remotely located up to units of km away. The feasibility of the proposed solution for potential medical environments and biomedical applications is shown.
Caring for burn patients at the United States Institute of Surgical Research: the nurses' multifaceted roles.

PubMed

Serio-Melvin, Maria; Yoder, Linda H; Gaylord, Kathryn M

2010-06-01

Nursing plays a critical role in the comprehensive burn care delivered at the US Army Institute of Surgical Research, otherwise known as the US Army's Burn Center serving the Department of Defense. This center serves as a model for burn units nationally and internationally. It also provides a challenging and innovative work environment for military and civilian nurses. Nurses in the Burn Center contribute to innovations in acute, rehabilitative, and psychological care for patients with burns. This article provides an overview of the complex nursing care provided to burn patients treated at the Burn Center. Copyright (c) 2010 Elsevier Inc. All rights reserved.
When work happens in the house: perceptions of how residential care staff choose to spend work time in transitional living units for people with brain injury.

PubMed

Chapparo, Christine; Shepherd, Belinda

2010-01-01

This naturalistic study explored the influence of various contextual factors on the decision making of residential care staff (RCS) who worked and lived with clients with brain injury in transitional living environments. The findings reported here arose from the results of a larger study that investigated the multiple contextual, personal, professional and theoretical influences on RCS decision making. Eleven residential care staff who were employed in brain injury transitional living units in Sydney, Australia participated. Qualitative data were derived from interviews, participant observation and reviews of videotaped staff and client interactions with the residential care staff. The RCS identified time and organisational motivators as major influences on daily decision making at work. They described how decisions were made by them about how to prioritise time at work from two personal perspectives, that of 'hospital person' and ;house person', adopted relative to contextual influences at the time. Residential care staff who are in close personal contact with clients for long periods of time make decisions about their work that is largely based on their personal notions of running a house'. Further research is required to describe the emergent phenomenon of staff 'house' behaviour.
Factors Influencing Active Family Engagement in Care Among Critical Care Nurses.

PubMed

Hetland, Breanna; Hickman, Ronald; McAndrew, Natalie; Daly, Barbara

2017-01-01

Critical care nurses are vital to promoting family engagement in the intensive care unit. However, nurses have varying perceptions about how much family members should be involved. The Questionnaire on Factors That Influence Family Engagement was given to a national sample of 433 critical care nurses. This correlational study explored the impact of nurse and organizational characteristics on barriers and facilitators to family engagement. Study results indicate that (1) nurses were most likely to invite family caregivers to provide simple daily care; (2) age, degree earned, critical care experience, hospital location, unit type, and staffing ratios influenced the scores; and (3) nursing work-flow partially mediated the relationships between the intensive care unit environment and nurses' attitudes and between patient acuity and nurses' attitudes. These results help inform nursing leaders on ways to promote nurse support of active family engagement in the intensive care unit. ©2017 American Association of Critical-Care Nurses.
Dedicated Education Unit: an innovative clinical partner education model.

PubMed

Moscato, Susan Randles; Miller, Judith; Logsdon, Karen; Weinberg, Stephen; Chorpenning, Lori

2007-01-01

This article describes the implementation and evaluation of the Dedicated Education Unit (DEU) as an innovative model of clinical nursing education. A partnership of nurse executives, staff nurses and faculty transformed patient care units into environments of support for nursing students and staff nurses while continuing the critical work of providing quality care to acutely ill adults. Various methods were used to obtain formative data during the implementation of this model in which staff nurses assumed the role of nursing instructors. Results showed high student and nurse satisfaction and a marked increase in clinical capacity that allowed for increased enrollment. This article reports on a 3-year project to operationalize the DEU concept with 6 nursing units in 3 hospitals. The development of staff nurses as clinical instructors, best practices to teach and evaluate critical thinking in students, and the mix of student learners continue as focus areas.
A GIS based model for active transportation in the built environment

NASA Astrophysics Data System (ADS)

Addison, Veronica Marie Medina

Obesity and physical inactivity have been major risk factors associated with morbidity and mortality in the United States. Recently, obesity and physical inactivity have been on the rise. Determining connections between this trend and the environment could lead to a built environment that is conducive to healthy, active people. In my previous research, I have studied the built environment and its connection to health. For my dissertation, I build on this fundamental work by incorporating energy, specifically by studying the built environment and its connection to energy expenditures. This research models the built environment and combines this with human energy expenditure information in order to provide a planning tool that allows an individual to actively address health issues, particularly obesity. This research focuses on the design and development of an internet based model that enables individuals to understand their own energy expenditures in relation to their environment. The model will work to find the energy consumed by an individual in their navigation through campus. This is accomplished by using Geographic Information Systems (GIS) to model the campus and using it as the basis for calculating energy expended through active transportation. Using GIS to create the model allows for the incorporation of built environment factors such as elevation and energy expenditures in relation to physical exertion rate. This research will contribute to the long-term solution to the obesity epidemic by creating healthy communities through smart growth and sustainable design. This research provides users with a tool to use in their current environment for their personal and community well being.
Swedish nurses' experiences of caring for dying people: a holistic approach.

PubMed

Iranmanesh, Sedigheh; Häggström, Terttu; Axelsson, Karin; Sävenstedt, Stefan

2009-01-01

Most people need to be cared for at the end of their lives by professionals. This study aimed to elucidate the meaning of nurses' experiences of caring for dying persons at home and in a special unit in a hospital. Four registered nurses working in private homes and 4 registered nurses working in a specific unit in a hospital setting were interviewed. The study was planned and carried out with a phenomenological hermeneutic approach. A naive reading guided a structural analysis, which resulted in 3 main themes: meeting patients and family members as unique persons, learning in a challenging environment, and gaining personal strength. The interpreted comprehensive understanding conveyed a meaning that caring for families with a member awaiting the end of life created a situation where the presence of an inevitable death demanded nurses to create close relationships with each unique person involved.
Projects for increasing job satisfaction and creating a healthy work environment.

PubMed

Brunges, Michele; Foley-Brinza, Christine

2014-12-01

Workplace culture is one of the biggest factors driving employee commitment and engagement. Multiple studies have shown that hospitals will perform better over time if employees are committed to their jobs and engaged in what they do. By creating and implementing multiple projects during a three-year period, a team at the University of Florida Health Shands Hospital, Gainesville, increased job satisfaction. Projects included ensuring meal breaks were offered, creating a serenity area, developing the patient ambassador role, actively addressing bullying and unprofessional behavior, assigning a student mentee to work with staff members on culture change, offering regular fun activities, redesigning the unit, reorganizing schedules to reduce stress, implementing education and training initiatives, establishing a Unit Practice Council, and implementing reward and recognition programs. Survey results and anecdotal evidence suggest that these projects combined to increase employee satisfaction and employee retention rates. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.
What implies the good work for registered nurses in municipal elderly care in Sweden?

PubMed

Josefsson, Karin; Aling, Jenny; Östin, Britt-Louise

2011-08-01

The aim was to describe registered nurses' perceptions of what the good work implies to them in municipal elderly care. A descriptive design and a structured questionnaire specifically designed for this study were used. Sixty housing units for older people and 213 nurses participated, with a response rate of 62%. The good work included the following aspects: intellectually stimulating without guilt feelings; freedom and independence with the possibility to influence; having appreciative and pleasant fellow workers and a fair and understanding manager; a good physical and risk-free environment; work security and a steady income with the possibility of improving salary through work effort; work effort should be beneficial to others; innovative thinking and initiative should be highly valued; and pride in work without compromising personal values. Employers must take this into consideration to retain those nurses already employed and recruit nurses to municipal elderly care.
Workplace democracy and worker health: strategies for implementation.

PubMed

Deutsch, S

1988-01-01

A large body of literature documents that increased worker participation leads to improvements in the working environment. This article identifies the Swedish and Norwegian sources of some of this research and notes the link with social policy, namely, legislative reform in those countries. In contrast, the United States has resisted legislative solutions, but that may be changing. New strategies to democratize the workplace are a result of global economic competition, desire to reduce job stress and compensation costs, and more successful application of new technologies at work. These are examined and some conclusions are drawn about next stages in the reform efforts.
Networking to Improve Nutrition Policy Research.

PubMed

Kim, Sonia A; Blanck, Heidi M; Cradock, Angie; Gortmaker, Steven

2015-09-10

Effective nutrition and obesity policies that improve the food environments in which Americans live, work, and play can have positive effects on the quality of human diets. The Centers for Disease Control and Prevention's (CDC's) Nutrition and Obesity Policy Research and Evaluation Network (NOPREN) conducts transdisciplinary practice-based policy research and evaluation to foster understanding of the effectiveness of nutrition policies. The articles in this special collection bring to light a set of policies that are being used across the United States. They add to the larger picture of policies that can work together over time to improve diet and health.
Assessment of long-term work attendance within human service organisations.

PubMed

Dellve, Lotta; Eriksson, Jesper; Vilhelmsson, Rebecka

2007-01-01

Terms and theories of work attendance vary according to their use and focus. This paper analyzes long-term work attendance in relation to social, psychosocial, and health-related factors. Register-based and questionnaire-based data covering 3,804 human service organisation workers over a three-year period were analyzed at individual and work-unit level. The results showed positive relationships between work attendance and male gender, high income, work commitment, job satisfaction, and having positive feelings towards work. High work attendance combined with work commitment, stress, or pain did not show any negative long-term effects upon short-term or long-term sick leave. Instead, work attendance seemed to be more associated with stable patterns of behaviour. Register-based measures of work attendance (at most 4-7 days of sick leave per worker per year) may be a useful tool in managing psychosocial work environment and related behaviour, but their inability to encompass information regarding individual health and disease must be borne in mind.
Compatibility of Space Nuclear Power Plant Materials in an Inert He/Xe Working Gas Containing Reactive Impurities

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

MM Hall

2006-01-31

A major materials selection and qualification issue identified in the Space Materials Plan is the potential for creating materials compatibility problems by combining dissimilar reactor core, Brayton Unit and other power conversion plant materials in a recirculating, inert He/Xe gas loop containing reactive impurity gases. Reported here are results of equilibrium thermochemical analyses that address the compatibility of space nuclear power plant (SNPP) materials in high temperature impure He gas environments. These studies provide early information regarding the constraints that exist for SNPP materials selection and provide guidance for establishing test objectives and environments for SNPP materials qualification testing.
Connections: Ocean Environments. Unit Grade 5.

ERIC Educational Resources Information Center

Ney, Catherine R.

Ocean Environments for Grade 5 is a 12-week interdisciplinary ocean environmental unit designed for teachers to use with their students. The unit emphasizes investigation and understanding of our ocean environments, including their geological, physical, and biological characteristics. It also stresses awareness of public policy decisions related…
Cost Accounting in the Automated Manufacturing Environment

DTIC Science & Technology

1988-06-01

1 NAVAL POSTGRADUATE SCHOOL M terey, California 0 DTIC II ELECTE R AD%$° NO 0,19880 -- THESIS COST ACCOUNTING IN THE AUTOMATED MANUFACTURING...PROJECT TASK WORK UNIT ELEMENT NO. NO NO ACCESSION NO 11. TITLE (Include Security Classification) E COST ACCOUNTING IN THE AUTOMATED MANUFACTURING...GROUP ’" Cost Accounting ; Product Costing ; Automated Manufacturing; CAD/CAM- CIM 19 ABSTRACT (Continue on reverse if necessary and identify by blo
Battle Staff Training and Synchronization in Light Infantry Battalions and Task Forces

DTIC Science & Technology

1991-12-01

Institute for the Behavioral and Social Sciences Fort Benning Field Unit (ARI-Benning) joined the Training Research Laboratory’s Determinants of Effective ...and unforgiving. The effective management and manipulation of stressors in a continuous operations environment, along with an efficient and consistent...an organizational effectiveness model grounded in the General Systems Theory model. An extensive body of work was reviewed, but two authors stand out
Training Maintenance Troops: A Study of Factors Affecting Airman Performance in a Learning Environment

DTIC Science & Technology

2009-09-01

DANIEL R. WALKER, Colonel, USAF Work Unit Manager Chief, Warfighter Readiness Research Division... management to put additional resources towards this type of learning. Since the majority of the students are kinesthetic, the leaders should spend more...to the waiter or ask friends to recommend choices. c. Choose from the descriptions in the menu. d. Look at what others are eating or look at pictures

The Impact of Leadership Styles and Knowledge Sharing on Police Officers' Willingness to Exert Extra Effort to Provide Better Security: A Study in the Riot Unit of the Turkish National Police

ERIC Educational Resources Information Center

Tombul, Fatih

2011-01-01

The motivation for this study is to understand the factors affecting police officers' willingness to exert extra effort for providing better service through knowledge sharing in different working environments such as riots. Since managers' leadership styles may be important factors affecting subordinates' willingness to exert extra effort, this…
Mock Code: A Code Blue Scenario Requested by and Developed for Registered Nurses

PubMed Central

Rideout, Janice; Pritchett-Kelly, Sherry; McDonald, Melissa; Mullins-Richards, Paula; Dubrowski, Adam

2016-01-01

The use of simulation in medical training is quickly becoming more common, with applications in emergency, surgical, and nursing education. Recently, registered nurses working in surgical inpatient units requested a mock code simulation to practice skills, improve knowledge, and build self-confidence in a safe and controlled environment. A simulation scenario using a high-fidelity mannequin was developed and will be discussed herein. PMID:28123919
Testimony of E. Ramona Trovato, Deputy Assistant Administrator, Office of Environmental Information, U.S. Environmental Protection Agency before the Committee on Environment and Public Works, United States Senate.

ERIC Educational Resources Information Center

2002

This testimony provides an overview of health and environmental issues in U.S. schools and describes efforts by the Environmental Protection Agency (EPA), in concert with other federal agencies, to help schools address environmental issues. These include the Clear Skies Initiative, Indoor Air Quality Tools for Schools, High Performance Schools,…
To amend title 23, United States Code, with respect to the operation of vehicles on certain Wisconsin highways, and for other purposes.

THOMAS, 113th Congress

Rep. Petri, Thomas E. [R-WI-6

2013-06-13

Senate - 07/23/2013 Received in the Senate and Read twice and referred to the Committee on Environment and Public Works. (All Actions) Notes: For further action, see H.R.83, which became Public Law 113-235 on 12/16/2014. Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:
Astronauts Thomas D. Akers and Kathryn C. Thornton during WETF training

NASA Image and Video Library

1993-03-05

S93-30238 (5 Mar 1993) --- Wearing training versions of Space Shuttle Extravehicular Mobility Units (EMU), astronauts Thomas D. Akers (red stripe) and Kathryn C. Thornton use the spacious pool of the Johnson Space Center's (JSC) Weightless Environment Training Facility (WET-F) to rehearse for the Hubble Space Telescope (HST) repair mission. They are working with a full scale mockup of a solar array fixture.
The Costs and Risks of Maturing Technologies, Traditionally vs. Evolutionary Approaches

DTIC Science & Technology

2008-04-23

Acquiring Combat Capability via Public-Private Partnerships (PPPs) Knowledge Value Added (KVA) + Real Options (RO) Applied to Shipyard Planning Processes...NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Tennenbaum Institute...a candid environment where high-ranking Department of Defense (DoD) officials, industry officials, accomplished faculty and military students are
An Approach to Forward Presence in a Resource-Constrained Environment

DTIC Science & Technology

2013-03-01

working quietly to coordinate cooperation between Indonesia, Malaysia , and Singapore , who were historically distrustful of each other. Through...freedom of action. Non-state actors will likely seek to capitalize on these weakening and corrupt failing states as potential safe havens. The low...11 Figure 1. 2011 Defense Spending: United States vs . 16 Next Leading Spenders44 Department of Defense can feel like it is hard pressed for
Client-centered design of residential addiction and mental health care facilities: staff perceptions of their work environment.

PubMed

Novotná, Gabriela; Urbanoski, Karen A; Rush, Brian R

2011-11-01

In this article we discuss the findings from a series of focus groups conducted as part of a 3-year, mixed-method evaluation of clinical programs in a large mental health and substance use treatment facility in Canada. We examined the perceptions of clinical personnel on the physical design of new treatment units and the impact on service delivery and the work environment. The new physical design appeared to support client recovery and reduce stigma; however, it brought certain challenges. Participants reported a compromised ability to monitor clients, a lack of designated therapeutic spaces, and insufficient workspace for staff. They also thought that physical design positively facilitated communication and therapeutic relationships among clinicians and clients, and increased team cohesion. We suggest that, from these findings, new avenues for research on achieving the important balance between client and staff needs in health facility design can be explored.
Long Duration Sorbent Testbed

NASA Technical Reports Server (NTRS)

Howard, David F.; Knox, James C.; Long, David A.; Miller, Lee; Cmaric, Gregory; Thomas, John

2016-01-01

The Long Duration Sorbent Testbed (LDST) is a flight experiment demonstration designed to expose current and future candidate carbon dioxide removal system sorbents to an actual crewed space cabin environment to assess and compare sorption working capacity degradation resulting from long term operation. An analysis of sorbent materials returned to Earth after approximately one year of operation in the International Space Station's (ISS) Carbon Dioxide Removal Assembly (CDRA) indicated as much as a 70% loss of working capacity of the silica gel desiccant material at the extreme system inlet location, with a gradient of capacity loss down the bed. The primary science objective is to assess the degradation of potential sorbents for exploration class missions and ISS upgrades when operated in a true crewed space cabin environment. A secondary objective is to compare degradation of flight test to a ground test unit with contaminant dosing to determine applicability of ground testing.
Breastfeeding and employment: an assessment of employer attitudes.

PubMed

Libbus, M Kay; Bullock, Linda F C

2002-08-01

Both research and anecdotal reports suggest that maternal employment is associated with failure to initiate breastfeeding and early breastfeeding attrition. The objective of this study was to describe the experience with and attitudes toward breastfeeding of a sample of employers in a small Midwestern city in the United States. Based on an analysis of 85 mail-out questionnaires, we found that less than half of the employers had personal experience with breastfeeding. A large percentage of the sample, however, indicated that they would be willing to facilitate women who wished to breastfeed or express milk in the workplace. However, these employers also stated that they saw little value to their business of supporting breastfeeding in the work environment. Thus, enhancement of breastfeeding opportunity in the work environment may come as a result of public and employer education but, more likely, will require some type of directive from official sources.
The development of a program analysis environment for Ada

NASA Technical Reports Server (NTRS)

Brown, David B.; Carlisle, Homer W.; Chang, Kai-Hsiung; Cross, James H.; Deason, William H.; Haga, Kevin D.; Huggins, John R.; Keleher, William R. A.; Starke, Benjamin B.; Weyrich, Orville R.

1989-01-01

A unit level, Ada software module testing system, called Query Utility Environment for Software Testing of Ada (QUEST/Ada), is described. The project calls for the design and development of a prototype system. QUEST/Ada design began with a definition of the overall system structure and a description of component dependencies. The project team was divided into three groups to resolve the preliminary designs of the parser/scanner: the test data generator, and the test coverage analyzer. The Phase 1 report is a working document from which the system documentation will evolve. It provides history, a guide to report sections, a literature review, the definition of the system structure and high level interfaces, descriptions of the prototype scope, the three major components, and the plan for the remainder of the project. The appendices include specifications, statistics, two papers derived from the current research, a preliminary users' manual, and the proposal and work plan for Phase 2.
Family and Work Influences on Stress, Anxiety and Depression Among Bisexual Latino Men in the New York City Metropolitan Area.

PubMed

Muñoz-Laboy, Miguel; Ripkin, Alexandra; Garcia, Jonathan; Severson, Nicolette

2015-12-01

The empirical exploration of mental health problems among bisexual Latino men is scarce. Bisexual men experience stress because of their non-conforming sexuality from multiple-sources. In this study we focus on the family and work environments. We conducted a mixed-methods study to examine the impacts of these social environments among behavioral bisexual Latino men in New York City (N = 142). Using the Brief Symptom Inventory we measured stress, depression, and anxiety, and used specific scales to measure familial and work social environmental stress factors. We also measured four cultural factors to assess their potential influence on our hypothesized stressors. To test our hypothesis we used linear regression with stress, depression and anxiety as the primary outcome variables. Our results indicated that bisexual Latino men experienced negative mental health outcomes due to pressures in their familial and work environments. Stress was the strongest predictor of anxiety and depression among the men in the study. After taking stress into account, familial factors were stronger predictors of negative mental health outcomes than work factors. Cultural factors such as acculturation and length of living in the United States were not associated with negative mental health outcomes in our sample. Our findings suggest the importance of addressing stress, anxiety and depression among behaviorally bisexual men, and suggest that addressing family-based stressors is critical for this population. This research should inform future studies addressing this underserved population and provide mental health providers with a foundation for working with bisexual Latino men.
Mental distress among Liberian medical staff working at the China Ebola Treatment Unit: a cross sectional study.

PubMed

Li, Li; Wan, Changli; Ding, Ru; Liu, Yi; Chen, Jue; Wu, Zonggui; Liang, Chun; He, Zhiqing; Li, Chengzhong

2015-09-26

Ebola virus outbreak in West Africa not only triggered a grave public health crisis, but also exerted and induced huge mental distress on medical staff, which would negatively influence epidemic control and social rebuilt furthermore. We chose the local medical staff working at the China Ebola Treatment Unit (ETU) to explore the severity of potential mental distress and involved potential causes. A descriptive study using the Symptom Check List 90 - Revised (SCL90-R) questionnaire to assess psychological health status was conducted among 52 Liberian medical staff. Global indices, including Global Severity Index (GSI), Positive Symptom Total (PST) and Positive Symptom Distress Index (PSDI), and nine subscales based on 90 inquiry items were compared among gender, work duty and other subgroups. Data were analyzed using Graphpad Prism and SPSS software. Mental distress among participants was not very serious; only PSDI, paranoid ideation and interpersonal sensitivity numerically increased relative to changes in other categories. While male medics and those responsible for cleaning and disinfection showed significant increases in scores for psychological dimensions, such as obsessive-compulsive, anxiety, phobic anxiety, interpersonal sensitivity, paranoid ideation and positive symptom total. Data of this study implies that the psychological health status of medical staff within the special social environment of an Ebola treatment unit should warrant more attention.
Study of the Paleogene carbonate sequence in Campeche and Yucatan, southern Mexico

NASA Astrophysics Data System (ADS)

García Avendaño, A.; Fucugauchi, J. U.

2013-05-01

The relief in the northeastern sector of Yucatan Peninsula is marked in several features, like the Campeche-Hecelchakan fault that indicates a scarp where the carbonate factory was produced from the different processes of eustatic variation throughout all extensions of the shelf. The Campeche scarp is one of the major structures of the peninsula. In this work we present preliminary results of the study on the Paleogene carbonate sequence (stratigraphic age derived from previous works) along a regional transect from the town of Champoton Campeche till Maxcanu town and into nearby Sierra of Ticul in Yucatan state, Mexico. Along this route we carried field work to measure geologic columns and sampled outcrops for petrographic analysis, selected based in litofacies settings in two units Champoton-Maxcanu (CH-CM) and Ticul Sierra (TS), CH-CM unit is formed by interbedded clay, shale, limestone and marl of different thickness, in addition to the content of various bioclasts. ST unit is comprised mostly of collapse breccias. This paper presents the microfacies analysis, directed to highlight changes in lithological horizons within the sequence. The study of carbonates in this study area contributes to the interpretation of the Yucatan geomorphology and development of the carbonate platform, for which the karst topography indicates a gradual subaerial exposure environment. .
Accounting for health-care outcomes: implications for intensive care unit practice and performance.

PubMed

Sorensen, Roslyn; Iedema, Rick

2010-08-01

The aim of this study was to understand the environment of health care, and how clinicians and managers respond in terms of performance accountability. A qualitative method was used in a tertiary metropolitan teaching intensive care unit (ICU) in Sydney, Australia, including interviews with 15 clinical managers and focus groups with 29 nurses of differing experience. The study found that a managerial focus on abstract goals, such as budgets detracted from managing the core business of clinical work. Fractures were evident within clinical units, between clinical units and between clinical and managerial domains. These fractures reinforced the status quo where seemingly unconnected patient care activities were undertaken by loosely connected individual clinicians with personalized concepts of accountability. Managers must conceptualize health services as an interconnected entity within which self-directed teams negotiate and agree objectives, collect and review performance data and define collective practice. Organically developing regimens of care within and across specialist clinical units, such as in ICUs, directly impact upon health service performance and accountability.
An Adaptive Priority Tuning System for Optimized Local CPU Scheduling using BOINC Clients

NASA Astrophysics Data System (ADS)

Mnaouer, Adel B.; Ragoonath, Colin

2010-11-01

Volunteer Computing (VC) is a Distributed Computing model which utilizes idle CPU cycles from computing resources donated by volunteers who are connected through the Internet to form a very large-scale, loosely coupled High Performance Computing environment. Distributed Volunteer Computing environments such as the BOINC framework is concerned mainly with the efficient scheduling of the available resources to the applications which require them. The BOINC framework thus contains a number of scheduling policies/algorithms both on the server-side and on the client which work together to maximize the available resources and to provide a degree of QoS in an environment which is highly volatile. This paper focuses on the BOINC client and introduces an adaptive priority tuning client side middleware application which improves the execution times of Work Units (WUs) while maintaining an acceptable Maximum Response Time (MRT) for the end user. We have conducted extensive experimentation of the proposed system and the results show clear speedup of BOINC applications using our optimized middleware as opposed to running using the original BOINC client.
Experienced pediatric nurses' perceptions of work-related stressors on general medical and surgical units: A qualitative study.

PubMed

De Almeida Vicente, Alexandra; Shadvar, Sanaz; Lepage, Stephanie; Rennick, Janet E

2016-08-01

Experienced pediatric nurses caring for increasingly sick and vulnerable children on medical and surgical units may be at particular risk for work-related stress. In view of their positive impact on quality of care, and the fact that they are particularly difficult to retain, it is imperative to understand the work-related stressors these nurses encounter in order to develop effective organizational interventions to minimize stressors and promote retention. To explore experienced pediatric nurses' perceptions of work-related stressors in medical and surgical units. Qualitative descriptive design with semi-structured interviews. Medical and surgical units at a quaternary care pediatric hospital in Montreal, Canada. Nurses recognized as experienced by the nursing leadership team as reflected by having been 'in charge' of the unit, or having trained junior staff, and who had been practicing full-time for three years or more on a general medical or surgical pediatric unit were eligible to participate. Purposive sampling was used, and nurses recruited until data saturation was reached (n=12). There were no refusals to participate. Semi-structured interviews were conducted between August and December 2013. Nurses described a strong sense of responsibility for providing excellent patient care, and identified stressor that negatively impacted their ability to do so. Stressors are reflected in three themes: (1) "The kids are getting sicker and sicker": Difficulty ensuring excellent patient care to an increasingly vulnerable population, (2) Feeling powerless to provide quality care, and (3) Being a "Jack-of-all-trades": Struggling with competing demands. Experienced pediatric nurses felt powerless to provide quality care to an increasingly acute and vulnerable population. Dealing with multiple and diverse responsibilities, and limited resources and support, were important stressors. Nurse Managers and educators could mitigate stressors and improve retention of experienced pediatric nurses by offering targeted continuing education to those newly responsible for additional roles, and building supportive working environments that encourage collaboration and empower experienced nurses. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.
Significant factors for work attractiveness and how these differ from the current work situation among operating department nurses.

PubMed

Björn, Catrine; Lindberg, Magnus; Rissén, Dag

2016-01-01

The aim was to examine significant factors for work attractiveness and how these differ from the current work situation among operating department nurses. A second objective was to examine the associations between age, gender, length of employment, work engagement, work ability, self-rated health indicators and attractiveness of the current work situation. The attractiveness of work is rarely taken into account in research on nurse retention. To expand this knowledge, it is relevant to examine factors that make work attractive and their associations with related concepts. Correlational, cross-sectional survey using a convenience sample. Questionnaires were answered by 147 nurses in four operating departments in Sweden. Correlation and regression analyses were conducted. The nurses rated the significance of all factors of work attractiveness higher than they rated those factors in their current work situation; salary, organisation and physical work environment had the largest differences. The most significant attractive factors were relationships, leadership and status. A statistically significant positive correlation between work engagement and attractive work was found. In the multiple regression model, the independent variables work engagement and older age significantly predicted work attractiveness. Several factors should be considered in the effort to increase work attractiveness in operating departments and thereby to encourage nurse retention. Positive aspects of work seem to unite work engagement and attractive work, while work ability and self-rated health indicators are other important dimensions in nurse retention. The great discrepancies between the significance of attractive factors and the current work situation in salary, organisation and physical work environment suggest ways in which work attractiveness may be increased. To discover exactly what needs to be improved may require a deeper look into the construct of the examined factors. © 2015 John Wiley & Sons Ltd.
Integrating Quantitative Reasoning into STEM Courses Using an Energy and Environment Context

NASA Astrophysics Data System (ADS)

Myers, J. D.; Lyford, M. E.; Mayes, R. L.

2010-12-01

Many secondary and post-secondary science classes do not integrate math into their curriculum, while math classes commonly teach concepts without meaningful context. Consequently, students lack basic quantitative skills and the ability to apply them in real-world contexts. For the past three years, a Wyoming Department of Education funded Math Science Partnership at the University of Wyoming (UW) has brought together middle and high school science and math teachers to model how math and science can be taught together in a meaningful way. The UW QR-STEM project emphasizes the importance of Quantitative Reasoning (QR) to student success in Science, Technology, Engineering and Mathematics (STEM). To provide a social context, QR-STEM has focused on energy and the environment. In particular, the project has examined how QR and STEM concepts play critical roles in many of the current global challenges of energy and environment. During four 3-day workshops each summer and over several virtual and short face-to-face meetings during the academic year, UW and community college science and math faculty work with math and science teachers from middle and high schools across the state to improve QR instruction in math and science classes. During the summer workshops, faculty from chemistry, physics, earth sciences, biology and math lead sessions to: 1) improve the basic science content knowledge of teachers; 2) improve teacher understanding of math and statistical concepts, 3) model how QR can be taught by engaging teachers in sessions that integrate math and science in an energy and environment context; and 4) focus curricula using Understanding by Design to identify enduring understandings on which to center instructional strategies and assessment. In addition to presenting content, faculty work with teachers as they develop classroom lessons and larger units to be implemented during the school year. Teachers form interdisciplinary groups which often consist of math and science teachers from the same school or district. By jointly developing units focused on energy and environment, math and science curricula can be coordinated during the school year. During development, teams present their curricular ideas for peer-review. Throughout the school year, teachers implement their units and collect pre-post data on student learning. Ultimately, science teachers integrate math into their science courses, and math teachers integrate science content in their math courses. Following implementation, participants share their experiences with their peers and faculty. Of central interest during these presentations are: 1) How did the QR-STEM experience change teacher practices in the classroom?; and 2) How did the modification of their teaching practices impact student learning and their ability to successfully master QR? The UW QR-STEM has worked with Wyoming science and math teachers from across the state over the three year grant period.
Low Back Pain Prevalence and Related Workplace Psychosocial Risk Factors: A Study Using Data From the 2010 National Health Interview Survey.

PubMed

Yang, Haiou; Haldeman, Scott; Lu, Ming-Lun; Baker, Dean

2016-09-01

The objectives of this study were to estimate prevalence of low back pain, to investigate associations between low back pain and a set of emerging workplace risk factors, and to identify worker groups with an increased vulnerability for low back pain in the United States. The data used for this cross-sectional study came from the 2010 National Health Interview Survey, which was designed to collect data on health conditions and related risk factors from the US civilian population. The variance estimation method was used to compute weighted data for prevalence of low back pain. Multivariable logistic regression analyses stratified by sex and age were performed to determine the odds ratios (ORs) and the 95% confidence interval (CI) for low back pain. The examined work-related psychosocial risk factors included work-family imbalance, exposure to a hostile work environment, and job insecurity. Work hours, occupation, and other work organizational factors (nonstandard work arrangements and alternative shifts) were also examined. The prevalence of self-reported low back pain in the previous 3 months among workers in the United States was 25.7% in 2010. Female or older workers were at increased risk of experiencing low back pain. We found significant associations between low back pain and a set of psychosocial factors, including work-family imbalance (OR 1.27, CI 1.15-1.41), exposure to hostile work (OR 1.39, CI 1.25-1.55), and job insecurity (OR 1.44, CI 1.24-1.67), while controlling for demographic characteristics and other health-related factors. Older workers who had nonstandard work arrangements were more likely to report low back pain. Women who worked 41 to 45 hours per week and younger workers who worked >60 hours per week had an increased risk for low back pain. Workers from several occupation groups, including male health care practitioners, female and younger health care support workers, and female farming, fishing, and forestry workers, had an increased risk of low back pain. This study linked low back pain to work-family imbalance, exposure to a hostile work environment, job insecurity, long work hours, and certain occupation groups. These factors should be considered by employers, policymakers, and health care practitioners who are concerned about the impact of low back pain in workers. Copyright © 2016. Published by Elsevier Inc.

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