Sample records for incident nursing management

  1. Nurses' experiences of managing patient deterioration following a post-registration education programme: A critical incident analysis study. (United States)

    Butler, Clare


    The aim of this study was to explore nurses' experiences assessing and managing deteriorating patients in practice following completion of a relevant post-registration education programme. Recognising the increasing acuity of ward patients, nurses are faced with patients who are at an increased risk of deterioration. Patients who are acutely ill or deteriorating often exhibit periods of physiological deterioration; however there is evidence illustrating that these clinical changes are frequently missed, misinterpreted or mismanaged in practice. In order to prepare nurses to competently assess and manage the deteriorating patient, education as a care initiative is offered to develop the knowledge and skills required. A qualitative study using critical incident analysis was conducted to acquire narrative data from nurses, describing their clinical practice experiences of patient deterioration. Thematic analysis was used to analyse the data. Findings revealed improvements in nurses' abilities to recognise patient deterioration, greater application of the evidence base and an increase in confidence and assertiveness. There was some evidence of applying the knowledge and skills learned, however equally some nurses indicated that they remained ill-prepared to apply the skills in practice. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  2. Incident Information Management Tool

    CERN Document Server

    Pejovic, Vladimir


    Flaws of\tcurrent incident information management at CMS and CERN\tare discussed. A new data\tmodel for future incident database is\tproposed and briefly described. Recently developed draft version of GIS-­‐based tool for incident tracking is presented.

  3. Traffic incident management resource management. (United States)


    The necessity of a multi-disciplinary approach involving law enforcement, fire and rescue, transportation, towing and recovery, and others has been well-recognized and integrated into incident management operations. This same multidisciplinar...

  4. Critical incident stress management. (United States)

    Lim, J J; Childs, J; Gonsalves, K


    Recent studies have indicated implementation of the CISM Program has impacted and reduced the cost of workers' compensation claims for stress related conditions and the number of lost work days (Ott, 1997; Western Management Consultants, 1996). Occupational health professionals need to be ready to develop and implement a comprehensive critical incident stress management process in anticipation of a major event. The ability to organize, lead, or administer critical incident stress debriefings for affected employees is a key role for the occupational health professional. Familiarity with these concepts and the ability to identify a critical incident enhances value to the business by mitigating the stress and impact to the workplace. Critical Incident Stress Management Systems have the potential for decreasing stress and restoring employees to normal life function--a win/win situation for both the employees and the organization.

  5. Information Security Incident Management

    Directory of Open Access Journals (Sweden)

    D. I. Persanov


    Full Text Available The present report highlights the points of information security incident management in an enterprise. Some aspects of the incident and event classification are given. The author presents his view of the process scheme over the monitoring and processing information security events. Also, the report determines a few critical points of the listed process and gives the practical recommendations over its development and optimization.

  6. Patient Safety Incidents and Nursing Workload

    Directory of Open Access Journals (Sweden)

    Katya Cuadros Carlesi

    Full Text Available ABSTRACT Objective: to identify the relationship between the workload of the nursing team and the occurrence of patient safety incidents linked to nursing care in a public hospital in Chile. Method: quantitative, analytical, cross-sectional research through review of medical records. The estimation of workload in Intensive Care Units (ICUs was performed using the Therapeutic Interventions Scoring System (TISS-28 and for the other services, we used the nurse/patient and nursing assistant/patient ratios. Descriptive univariate and multivariate analysis were performed. For the multivariate analysis we used principal component analysis and Pearson correlation. Results: 879 post-discharge clinical records and the workload of 85 nurses and 157 nursing assistants were analyzed. The overall incident rate was 71.1%. It was found a high positive correlation between variables workload (r = 0.9611 to r = 0.9919 and rate of falls (r = 0.8770. The medication error rates, mechanical containment incidents and self-removal of invasive devices were not correlated with the workload. Conclusions: the workload was high in all units except the intermediate care unit. Only the rate of falls was associated with the workload.

  7. Relationship between nursing workloads and patient safety incidents

    Directory of Open Access Journals (Sweden)

    Yuji Nishizaki


    Full Text Available Yuji Nishizaki1, Yasuharu Tokuda2, Ekiko Sato1, Keiko Kato1, Akiko Matsumoto1, Miwako Takekata1, Mineko Terai1, Chitose Watanabe3, Yang Ya Lim1, Sachiko Ohde1, Ryoichi Ishikawa11St. Luke’s International Hospital, Tokyo, Japan; 2Mito Medical Center, University of Tsukuba, Ibaraki, Japan; 3Saitama City Hospital, Saitama, JapanObjective: To evaluate the relationship between nursing workloads and patient safety incidents in inpatient wards of a general hospital.Methods: A retrospective data analysis was conducted involving the internal medicine wards in a teaching hospital in Japan between July 1st and December 31st, 2006. To assess associations between nursing workloads and patient safety incidents, we analyzed the following: the relationships between the level of patients’ dependency and the number of incident reports; and the relationships between the presence of accidental falls and the presence of patients transferred from the intensive care unit to the wards.Results: Fifty-five nurses worked on the wards (105 beds. The total number of incidents was 142 over the 184 days of this study. There was a positive trend between the number of incidents and the total patient dependency score. The presence of accidental falls in the wards was associated with the presence of transfers from the intensive care unit to the wards (odds ratio 3.14, 95% confidence interval: 1.48, 6.65.Conclusion: Greater nursing workloads may be related to the higher number of patient safety incidents in inpatient wards of hospitals. Keywords: risk management, bed control, incident report, patient dependency, nursing care, diagnosis and procedure combination

  8. Incident Management: Process into Practice (United States)

    Isaac, Gayle; Moore, Brian


    Tornados, shootings, fires--these are emergencies that require fast action by school district personnel, but they are not the only incidents that require risk management. The authors have introduced the National Incident Management System (NIMS) and the Incident Command System (ICS) and assured that these systems can help educators plan for and…

  9. Improving freight crash incident management. (United States)


    The objective of this study was to determine the most effective way to mitigate the effect of freight : crash incidents on Louisiana freeways. Candidate incident management strategies were reviewed from : practice in other states and from those publi...

  10. Nurse manager engagement: what it means to nurse managers and staff nurses. (United States)

    Gray, Linda R; Shirey, Maria R


    To describe what nurse manager engagement means to nurse managers and staff nurses by incorporating an organizational dashboard to document engagement outcomes. Retaining engaged nurse managers is crucial for individual performance and organizational outcomes. However, nurse manager engagement is currently underreported in the literature. Existing data from the 2010 Employee Opinion Survey at the Baylor University Medical Center in Dallas, Texas, were used to measure staff engagement among 28 nurse managers and 1497 staff nurses. The data showed a 21% gap between manager and staff nurse engagement levels, with managers showing higher engagement levels than staff. No clear depiction of nurse manager engagement emerged. Consequently, an expanded definition of nurse manager engagement was developed alongside a beginning dashboard of engagement outcomes. The findings have implications for overcoming barriers that affect staff nurse engagement, improving outcomes, and creating definitions of nurse manager engagement.

  11. Nurse managers' challenges in project management. (United States)

    Suhonen, Marjo; Paasivaara, Leena


    To analyse the challenges that nurse managers meet in project management. Project management done by nurse managers has a significant role in the success of projects conducted in work units. The data were collected by open interviews (n = 14). The participants were nurse managers, nurses and public health nurses. Data analysis was carried out using qualitative content analysis. The three main challenges nurse managers faced in project management in health-care work units were: (1) apathetic organization and management, (2) paralysed work community and (3) cooperation between individuals being discouraged. Nurse managers' challenges in project management can be viewed from the perspective of the following paradoxes: (1) keeping up projects-ensuring patient care, (2) enthusiastic management-effective management of daily work and (3) supporting the work of a multiprofessional team-leadership of individual employees. It is important for nurse managers to learn to relate these paradoxes to one another in a positive way. Further research is needed, focusing on nurse managers' ability to promote workplace spirituality, nurse managers' emotional intelligence and their enthusiasm in small projects. © 2011 Blackwell Publishing Ltd.

  12. Job Satisfaction of Nursing Managers


    Petrosova, Liana; Pokhilenko, Irina


    The aim of the study was to research levels of job satisfaction, factors affecting job satisfaction/dissatisfaction, and ways to improve job satisfaction among nursing managers. The purposes of the study were to extend knowledge in the field of healthcare management, to raise awareness about factors that affect job satisfaction in nursing management career, and to provide suggestions regarding how to increase job satisfaction among nursing managers. The method of this study is literature r...

  13. Patient Safety Incidents and Nursing Workload. (United States)

    Carlesi, Katya Cuadros; Padilha, Kátia Grillo; Toffoletto, Maria Cecília; Henriquez-Roldán, Carlos; Juan, Monica Andrea Canales


    to identify the relationship between the workload of the nursing team and the occurrence of patient safety incidents linked to nursing care in a public hospital in Chile. quantitative, analytical, cross-sectional research through review of medical records. The estimation of workload in Intensive Care Units (ICUs) was performed using the Therapeutic Interventions Scoring System (TISS-28) and for the other services, we used the nurse/patient and nursing assistant/patient ratios. Descriptive univariate and multivariate analysis were performed. For the multivariate analysis we used principal component analysis and Pearson correlation. 879 post-discharge clinical records and the workload of 85 nurses and 157 nursing assistants were analyzed. The overall incident rate was 71.1%. It was found a high positive correlation between variables workload (r = 0.9611 to r = 0.9919) and rate of falls (r = 0.8770). The medication error rates, mechanical containment incidents and self-removal of invasive devices were not correlated with the workload. the workload was high in all units except the intermediate care unit. Only the rate of falls was associated with the workload. identificar a relação entre a carga de trabalho da equipe de enfermagem e a ocorrência de incidentes de segurança dos pacientes ligados aos cuidados de enfermagem de um hospital público no Chile. pesquisa transversal analítica quantitativa através de revisão de prontuários médicos. A estimativa da carga de trabalho em Unidade de Terapia Intensiva (UTI) foi realizada utilizando o Índice de Intervenções Terapêuticas-TISS-28 e para os outros serviços, foram utilizados os cocientes enfermeira/paciente e auxiliar de enfermagem/ paciente. Foram feitas análises univariada descritiva e multivariada. Para a análise multivariada utilizou-se análise de componentes principais e correlação de Pearson. foram analisados 879 prontuáriosclínicos de pós-alta e a carga de trabalho de 85 enfermeiros e 157

  14. Information sharing for traffic incident management. (United States)


    Traffic incident management focuses on developing procedures, implementing policies, and deploying technologies to more quickly identify incidents, improve response times, and more effectively and efficiently manage the incident scene. Because so man...

  15. [The art of nursing management]. (United States)

    Lu, Meei-Shiow


    It is often said that management is a science as well as an art. Nursing managers have to master the science of management and make management an art, which is the goal of nursing leadership. The purpose of this paper was to integrate the views of Eastern and Western scholars and propose a combination of science and art in nursing management, to include the following components: the art of management and leadership; the art of to manage or not to manage, the art of leadership, and the art of delegation. The concept of "government by doing nothing that goes against nature," of Taoism, "Zen management," from Buddhism, and "situational leadership" have also been considered in this paper in the hope of providing guidance for nursing management.

  16. Patients' Perceptions of Nurses' Behaviour That Influence Patient Participation in Nursing Care: A Critical Incident Study

    Directory of Open Access Journals (Sweden)

    Inga E. Larsson


    Full Text Available Patient participation is an important basis for nursing care and medical treatment and is a legal right in many Western countries. Studies have established that patients consider participation to be both obvious and important, but there are also findings showing the opposite and patients often prefer a passive recipient role. Knowledge of what may influence patients' participation is thus of great importance. The aim was to identify incidents and nurses' behaviours that influence patients' participation in nursing care based on patients' experiences from inpatient somatic care. The Critical Incident Technique (CIT was employed. Interviews were performed with patients (=17, recruited from somatic inpatient care at an internal medical clinic in West Sweden. This study provided a picture of incidents, nurses' behaviours that stimulate or inhibit patients' participation, and patient reactions on nurses' behaviours. Incidents took place during medical ward round, nursing ward round, information session, nursing documentation, drug administration, and meal.

  17. Critical incidents connected to nurses' leadership in Intensive Care Units. (United States)

    Lima, Elaine Cantarella; Bernardes, Andrea; Baldo, Priscila Lapaz; Maziero, Vanessa Gomes; Camelo, Silvia Helena Henriques; Balsanelli, Alexandre Pazetto


    The goal of this study is to analyze nurses' leadership in intensive care units at hospitals in the state of São Paulo, Brazil, in the face of positive and negative critical incidents. Exploratory, descriptive study, conducted with 24 nurses by using the Critical Incident Technique as a methodological benchmark. Results were grouped into 61 critical incidents distributed into categories. Researchers came to the conclusion that leadership-related situations interfere with IC nurses' behaviors. Among these situations they found: difficulty in the communication process; conflicts in the daily exercise of nurses' activities; people management; and the setting of high quality care targets. Researchers identified a mixed leadership model, leading them to the conclusion that nurses' knowledge and practice of contemporary leadership theories/styles are crucial because they facilitate the communication process, focusing on behavioral aspects and beliefs, in addition to valuing flexibility. This positively impacts the organization's results. Analisar a liderança do enfermeiro em Centros de Terapia Intensiva de hospitais localizados no interior do estado de São Paulo, diante de incidentes críticos positivos e negativos. Estudo exploratório, descritivo, realizado com 24 enfermeiros, que utilizou a Técnica do Incidente Crítico como referencial metodológico. Os resultados foram agrupados em 61 incidentes críticos distribuídos em categorias. Identificou-se que situações relacionadas à liderança interferem no comportamento do enfermeiro de Terapia Intensiva, dentre elas: dificuldade no processo de comunicação, conflitos existentes no dia a dia do exercício profissional, gerenciamento de pessoas e estabelecimento de metas para o alcance da assistência qualificada. Encontrou-se um modelo misto de liderança, o que permite concluir que o conhecimento e a prática dos enfermeiros acerca de teorias/estilos contemporâneos de liderança tornam-se fundamentais, pois

  18. nurse managers ' perspectives

    African Journals Online (AJOL)


    Nov 3, 2010 ... non-nursing jobs which offer better salaries, more job satisfaction and better working hours (Ehlers. 2003:81) further ..... had advantages. Older nurses brought the human touch, while the younger nurses completed tasks expeditiously. Some of the responses that attest to these standpoints are: 'The older ...

  19. Critical incident analysis: nursing a dying man. (United States)

    Ta, L


    When a nursing student cares for a terminally ill person for the first time, that student faces many challenges. Here, a third year student describes and analyses her thoughts, feelings and actions, reflecting on her perceptions of the patient's (Mr A's) needs; the mutual benefits of a close relationship between nurse and patient; and the personal and professional growth which resulted from writing about this challenging experience. The memory of Mr A is an inspirational legacy.

  20. Incidence, Type, Related Factors, and Effect of Workplace Violence on Mental Health Nurses: A Cross-sectional Survey. (United States)

    Yang, Bing Xiang; Stone, Teresa E; Petrini, Marcia A; Morris, Diana L


    Workplace violence and its impact on mental health nurses have yet to be thoroughly explored in China. This study aims to investigate the incidence, type, related factors, and effects of workplace violence on mental health nurses as well as identifying coping strategies. A researcher - designed workplace violence questionnaire and the Maslach Burnout Inventory-General Survey were distributed to nurses at a mental health hospital in Wuhan, China. Most nurses reported a high incidence of workplace violence (94.6%) in the past year ranging from verbal aggression, sexual harassment, to physical attack. The forms of violence significantly correlated with each other (r>0.5, p=0.000). Working on the psychiatric intensive care unit for adult males and being a male nurse placed nurses at significantly higher risk for workplace violence. Providing routine treatment, caring for male patients, and working the night shift increased the risk of sexual harassment. Nurses who believed that workplace violence was preventable experienced a significantly lower incidence of violence. Burnout levels of the mental health nurses were relatively mild, but increased with age, professional title, years of employment and frequency of workplace violence. The incidence of workplace violence among mental health nurses is common, and its frequency is correlated with nurses' level of burnout. Management and clinical nurses should work together on an organization-wide strategy targeting the major identified risk areas to reduce the incidence of workplace violence and minimize its impact on nurses. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. International Nursing: Nurse Managers' Leadership and Management Competencies Assessed by Nursing Personnel in a Finnish Hospital. (United States)

    Lehtonen, Mia-Riitta; Roos, Mervi; Kantanen, Kati; Suominen, Tarja

    The aim of this research was to describe nurse managers' leadership and management competencies (NMLMC) from the perspective of nursing personnel. Nurse managers are responsible for the management of the largest professional group in social and health care. The assessment of NMLMC is needed because of their powerful influence on organizational effectiveness. An electronic survey was conducted among the nursing personnel (n = 166) of 1 Finnish hospital in spring 2016. Nursing personnel assessed their manager using a NMLMC scale consisting of general and special competences. The data were statistically analyzed. Leadership and management competencies were assessed as being quite good by the nursing personnel. The best-assessed area of general competence was professional competence and credibility and the weakest was service initiation and innovation. The best-assessed area of special competence was substance knowledge and the weakest was research and development. The nursing personnel's assessment of their nurse manger's competencies was associated with the personnel's education level, working experience, and with their knowledge of the manager's education. Conclusion was made that nursing personnel highly value professional competence as part of nursing leadership and management. To achieve more appreciation, nurse managers have to demonstrate their education and competence. They must also work in more open and versatile ways with their nursing personnel.

  2. Relationship between nursing workloads and patient safety incidents. (United States)

    Nishizaki, Yuji; Tokuda, Yasuharu; Sato, Ekiko; Kato, Keiko; Matsumoto, Akiko; Takekata, Miwako; Terai, Mineko; Watanabe, Chitose; Lim, Yang Ya; Ohde, Sachiko; Ishikawa, Ryoichi


    To evaluate the relationship between nursing workloads and patient safety incidents in inpatient wards of a general hospital. A retrospective data analysis was conducted involving the internal medicine wards in a teaching hospital in Japan between July 1st and December 31st, 2006. To assess associations between nursing workloads and patient safety incidents, we analyzed the following: the relationships between the level of patients' dependency and the number of incident reports; and the relationships between the presence of accidental falls and the presence of patients transferred from the intensive care unit to the wards. Fifty-five nurses worked on the wards (105 beds). The total number of incidents was 142 over the 184 days of this study. There was a positive trend between the number of incidents and the total patient dependency score. The presence of accidental falls in the wards was associated with the presence of transfers from the intensive care unit to the wards (odds ratio 3.14, 95% confidence interval: 1.48, 6.65). Greater nursing workloads may be related to the higher number of patient safety incidents in inpatient wards of hospitals.

  3. Characteristics that perinatal nurse managers desire in new nurse hires. (United States)

    Falls, Emily; Hensel, Desiree


    Nursing leaders have proposed that nurses must have the Quality and Safety Education for Nurses (QSEN) competencies to work in complex health care systems. Using the QSEN framework, this study explored what characteristics perinatal nurse managers desired most in new nurses. This study used a survey design and a convenience sample of perinatal nurse managers working in Indiana hospitals (N = 46). Managers were more likely to hire nurses with experience, positive references, and excellent attendance. Of the QSEN competencies, managers looked most for teamwork and collaboration, followed by safety and patient-centered care. In addition to the traditional qualities desired in new nurses, the QSEN competencies are gaining importance among perinatal managers. Copyright 2012, SLACK Incorporated.

  4. Information Security Incident Management Practical Aspects

    Directory of Open Access Journals (Sweden)

    A. B. Kostina


    Full Text Available The information security incident management process model (ISIMP is developed; the role of this process in the information security management system is established. Input and output data of the process are determined. Key practical aspects of incident management are determined.

  5. Bronchoaspiration: incidence, consequences and management. (United States)

    Beck-Schimmer, Beatrice; Bonvini, John M


    Aspiration is defined as the inhalation of oropharyngeal or gastric contents into the lower respiratory tract. Upon injury, epithelial cells and alveolar macrophages secrete chemical mediators, attracting and activating neutrophils, which in turn release proteases and reactive oxygen species, degrading the alveolocapillary unit. Aspiration can lead to a range of diseases such as infectious pneumonia, chemical pneumonitis or respiratory distress syndrome with significant morbidity and mortality. It occurs in approximately 3-10 per 10 000 operations with an increased incidence in obstetric and paediatric anaesthesia. Patients are most at risk during induction of anaesthesia and extubation, in particular in emergency situations. The likelihood of significant aspiration can be reduced by fasting, pharmacological intervention and correct anaesthetic management using a rapid sequence induction. Treatment of acid aspiration is by suctioning after witnessed aspiration; antibiotics are indicated in patients with aspiration pneumonia only. Steroids are not proven to improve outcome or reduce mortality. Patients with acute lung injury requiring mechanical ventilation should be ventilated using lung protective strategies with low tidal volumes and low plateau pressure values, attempting to limit peak lung distension and end-expiratory collapse.

  6. 49 CFR 1542.307 - Incident management. (United States)


    ... 49 Transportation 9 2010-10-01 2010-10-01 false Incident management. 1542.307 Section 1542.307 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION... Incident management. (a) Each airport operator must establish procedures to evaluate bomb threats, threats...

  7. Competency of Graduate Nurses as Perceived by Nurse Preceptors and Nurse Managers (United States)

    Wise, Vanessa


    As newly graduated associate degree nurses (ADN) and baccalaureate degree nurses (BSN) enter into the workforce, they must be equipped to care for a complex patient population; therefore, the purpose of this study was to address the practice expectations and clinical competency of new nurses as perceived by nurse preceptors and nurse managers.…

  8. Major incident medical management and support the practical approach at the scene

    CERN Document Server

    Advanced Life Support Group


    Major Incident Medical Management and Support (MIMMS) is the coursebook for the Advanced Life Support Group's internationally taught training for health care professionals responding to major incidents. The practical approach employed in MIMMS has proved an invaluable aid to both civilian and military doctors, nurses and paramedics working in disaster management worldwide.

  9. Comparing nurse managers and nurses' perceptions of nurses' self-leadership during capacity building. (United States)

    Jooste, Karien; Cairns, Lindi


    This paper compares the perceptions of nurse managers and nurses about self-leadership of professional nurses while taking ownership of capacity building during unit management. The Nursing Strategy for South Africa states that the competency of nurses is dependent upon factors that lead to capacity building. A quantitative design was followed by conducting a survey. The target population included nurse managers and professional nurses working at an academic public hospital in the Gauteng Province of South Africa. The findings indicate shortcomings in relation to advising professional nurses about self-direction while taking ownership of their daily pressures and stresses associated with unit management. Professional nurses should develop their confidence by focusing on their self-leadership strengths when managing a unit. Recommendations are made to promote self-leadership while taking ownership of nurses during capacity building of unit management. © 2014 John Wiley & Sons Ltd.

  10. Stroke Management: Nursing Roles


    Maryam Esmaeili


    Introduction: The subacute and long-term assessment and management of patients who have suffered a stroke includes physical therapy and testing to determine the precise etiology of the event so as to prevent recurrence. The acute management differs. Immediate goals include minimizing brain injury, treating medical complications, and moving toward uncovering the pathophysiologic basis of the patient's symptoms. Methods: This is a review paper that report up to date finding with review some...

  11. Relationship between nursing workloads and patient safety incidents


    Nishizaki, Yuji; Tokuda,Yasuharu; Sato,; Kato,; Matsumoto,; Takekata,; Terai,; Watanabe,; Lim,; Ohde,S; Ishikawa,


    Yuji Nishizaki1, Yasuharu Tokuda2, Ekiko Sato1, Keiko Kato1, Akiko Matsumoto1, Miwako Takekata1, Mineko Terai1, Chitose Watanabe3, Yang Ya Lim1, Sachiko Ohde1, Ryoichi Ishikawa11St. Luke’s International Hospital, Tokyo, Japan; 2Mito Medical Center, University of Tsukuba, Ibaraki, Japan; 3Saitama City Hospital, Saitama, JapanObjective: To evaluate the relationship between nursing workloads and patient safety incidents in inpatient wards of a general hospital.Methods: A retrospective ...

  12. Improving patient safety: how and why incidences occur in nursing care

    Directory of Open Access Journals (Sweden)

    Maria Cecilia Toffoletto


    Full Text Available The present investigation was a cross-sectional, quantitative research study analyzing incidents associated with nursing care using a root-cause methodological analysis. The study was conducted in a public hospital intensive care unit (ICU in Santiago de Chile and investigated 18 incidents related to nursing care that occurred from January to March of 2012. The sample was composed of six cases involving medications and the self-removal of therapeutic devices. The contributing factors were related to the tasks and technology, the professional work team, the patients, and the environment. The analysis confirmed that the cases presented with similar contributing factors, thereby indicating that the vulnerable aspects of the system are primarily responsible for the incidence occurrence. We conclude that root-cause analysis facilitates the identification of these vulnerable points. Proactive management in system-error prevention is made possible by recommendations.

  13. Early identification and management of critical incident stress. (United States)

    Caine, Randy M; Ter-Bagdasarian, Levon


    Everyone experiences stress. That stress may be related to work (internal), community (external), or family; it may be cumulative or related to a particular critical incident. The cost related to treating acute stress is staggering, both to individuals and to organizations. Critical care nurses are well educated in the physiological responses to the stress of acute illness. Recognizing the emotional impact of stress and the techniques to manage it in themselves and in those with whom they work is equally as important. CISD is widely advocated as an intervention after critical incidents. Although debriefing in and of itself is effective, a single-session semistructured crisis intervention will not prevent posttraumatic stress; thus, the use of CISD as part of a comprehensive multifaceted approach to the management of acute stress related to a critical incident is recommended.

  14. Conflict management style of Jordanian nurse managers and its relationship to staff nurses' intent to stay. (United States)

    Al-Hamdan, Zaid; Nussera, Hayat; Masa'deh, Rami


    To explore the relationship between conflict management styles used by nurse managers and intent to stay of staff nurses. Nursing shortages require managers to focus on the retention of staff nurses. Understanding the relationship between conflict management styles of nurse managers and intent to stay of staff nurses is one strategy to retain nurses in the workforce. A cross-sectional descriptive quantitative study was carried out in Jordan. The Rahim organization conflict inventory II (ROCI II) was completed by 42 nurse managers and the intent to stay scale was completed by 320 staff nurses from four hospitals in Jordan. The anova analysis was carried out. An integrative style was the first choice for nurse managers and the last choice was a dominating style. The overall level of intent to stay for nurses was moderate. Nurses tend to keep their current job for 2-3 years. There was a negative relationship between the dominating style as a conflict management style and the intent to stay for nurses. The findings of the present study support the claim that leadership practices affect the staff nurses' intent to stay and the quality of care. Nurse managers can improve the intent to stay for staff nurses if they use the appropriate conflict management styles. © 2015 John Wiley & Sons Ltd.

  15. Kentucky's highway incident management strategic plan. (United States)


    Kentucky s Highway Incident Management Strategic Plan consists of a mission statement, 4 goals, 16 objectives, and 49 action strategies. The action strategies are arranged by priority and recommended time frame for implementation. When implemented...

  16. Integrating incident investigation into the management system

    International Nuclear Information System (INIS)

    Peterson, E.E.


    In the last 10 yr, the size and frequency of incidents affecting the communities and environment surrounding chemical processing facilities has increased. The chemical process industry, which has always concerned itself with the safety of its facilities, has responded by committing to stricter standards of operation and management. A critical element of these management practices is the use of a structured incident investigation program. Many facilities have implemented and disciplined themselves to perform good investigation of incidents. However, most of these facilities maintain incident investigation as part of their safety management programs. This allows the process to be disconnected from the management system that deals with the day-to-day business of the facility. The first step of integration is understanding the objectives and functions of the management system into which the integration is to occur. To begin, a common definition of management is needed. Management, for the purposes of this discussion, is defined as the system of activities used to control, coordinate, and improve the flow of work within a facility or organization. This definition refers to several concepts that need further development in order to understand how incident investigation can be integrated into a management system, including (a) flow of work, (b) control, and (c) improvement. Application can be made to the nuclear industry

  17. Knowledge management: organizing nursing care knowledge. (United States)

    Anderson, Jane A; Willson, Pamela


    Almost everything we do in nursing is based on our knowledge. In 1984, Benner (From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Menlo Park, CA: Addison-Wesley; 1984) described nursing knowledge as the culmination of practical experience and evidence from research, which over time becomes the "know-how" of clinical experience. This "know-how" knowledge asset is dynamic and initially develops in the novice critical care nurse, expands within competent and proficient nurses, and is actualized in the expert intensive care nurse. Collectively, practical "know-how" and investigational (evidence-based) knowledge culminate into the "knowledge of caring" that defines the profession of nursing. The purpose of this article is to examine the concept of knowledge management as a framework for identifying, organizing, analyzing, and translating nursing knowledge into daily practice. Knowledge management is described in a model case and implemented in a nursing research project.

  18. Exploring the Influence of Nurse Work Environment and Patient Safety Culture on Attitudes Toward Incident Reporting. (United States)

    Yoo, Moon Sook; Kim, Kyoung Ja


    The aim of this study was to explore the influence of nurse work environments and patient safety culture on attitudes toward incident reporting. Patient safety culture had been known as a factor of incident reporting by nurses. Positive work environment could be an important influencing factor for the safety behavior of nurses. A cross-sectional survey design was used. The structured questionnaire was administered to 191 nurses working at a tertiary university hospital in South Korea. Nurses' perception of work environment and patient safety culture were positively correlated with attitudes toward incident reporting. A regression model with clinical career, work area and nurse work environment, and patient safety culture against attitudes toward incident reporting was statistically significant. The model explained approximately 50.7% of attitudes toward incident reporting. Improving nurses' attitudes toward incident reporting can be achieved with a broad approach that includes improvements in work environment and patient safety culture.

  19. [The emotional labor of nursing: critical incidents and coping strategies]. (United States)

    Zamperini, Adriano; Paoloni, Cristina; Testoni, Ines


    Despite the suggestion to adopt a balanced approach between detachment and involvement, the nurse-patient relationship is always embedded with emotional conflicts. To collect data on how nurses manage the emotional support to patients. The study adopted the theoretical perspective of the emotional work. Fifty-three nurses completed a questionnaire investigating everyday "emotional accidents." The data were analyzed considering the strategies employed to address and resolve them. All nurses exert an emotional work to try to outcome the dissonance between subjective emotions and emotional rules required by the professional role. There are three strategies: normalizing, regressive, transformative. Most of the emotional efforts are aimed at showing emotions in accordance with the role, even if they are dissonant with respect to the subjective feelings (surface acting). Nurses are expected to practice an "emotional neutrality", but their profession continually exposes them to a heavy emotional work that may be at the basis of emotional exhaustion and burnout. Strategies should be adopted to prevent stress and health damages.

  20. Incident Management Organization succession planning stakeholder feedback (United States)

    Anne E. Black


    This report presents complete results of a 2011 stakeholder feedback effort conducted for the National Wildfire Coordination Group (NWCG) Executive Board concerning how best to organize and manage national wildland fire Incident Management Teams in the future to meet the needs of the public, agencies, fire service and Team members. Feedback was collected from 858...

  1. Japanese management. Implications for nursing administration. (United States)

    Smith, H L; Reinow, F D; Reid, R A


    Does Japanese management possess sufficient practical validity to warrant retraining of nursing administrators and their staffs? Can Japanese management really address the complexities of contemporary nursing administration? Before espousing the benefits of Theory Z and implementing quality circles in your hospital, read this analysis of the advantages and disadvantages of Japanese management--the benefits can be substantial but so can the costs!

  2. Nurse managers and the sandwich support model. (United States)

    Chisengantambu, Christine; Robinson, Guy M; Evans, Nina


    To explore the interplay between the work of nurse managers and the support they receive and provide. Support is the cornerstone of management practices and is pivotal in employees feeling committed to an organisation. Support for nurse managers is integral to effective health sector management; its characteristics merit more attention. The experiences of 15 nurse managers in rural health institutions in South Australia were explored using structured interviews, observation and document review. Effective decision making requires adequate support, which influences the perceptions and performance of nurse managers, creating an environment in which they feel appreciated and valued. An ideal support system is proposed, the "sandwich support model," to promote effective functioning and desirable patient outcomes via support "from above" and "from below." The need to support nurse managers effectively is crucial to how they function. The sandwich support model can improve management practices, more effectively assisting nurse managers. Organisations should revisit and strengthen support processes for nurse managers to maximize efficiencies. This paper contributes to understanding the importance of supporting nurse managers, identifying the processes used and the type of support offered. It highlights challenges and issues affecting support practices within the health sector. © 2017 John Wiley & Sons Ltd.

  3. Leadership and management in mental health nursing. (United States)

    Blegen, Nina Elisabeth; Severinsson, Elisabeth


    Mental health nurses are agents of change, and their leadership, management role and characteristics exist at many levels in health care. Previous research presents a picture of mental health nurses as subordinate and passive recipients of the leader's influence and regard leadership and management as distinct from the nurses' practical work. The aim was to provide a synthesis of the studies conducted and to discuss the relationship between nursing leadership and nursing management in the context of mental health nursing. A literature search was conducted using EBSCO-host, Academic Search Premier, Science Direct, CINAHL and PubMed for the period January 1995-July 2010. Leadership and management in the context of mental health nursing are human activities that imply entering into mutual relationships. Mental health nurses' leadership, management and transformational leadership are positively related in terms of effectiveness and nurses' skills. It is important to consider mental health nurses' management as a form of leadership similar to or as a natural consequence of transformational leadership (TL) and that ethical concerns must be constantly prioritized throughout every level of the organization. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  4. Perspectives from nurse managers on informatics competencies. (United States)

    Yang, Li; Cui, Dan; Zhu, Xuemei; Zhao, Qiuli; Xiao, Ningning; Shen, Xiaoying


    Nurse managers are in an excellent position for providing leadership and support within the institutions they serve and are often responsible for accessing information that is vital to the improvement of health facility processes and patients' outcomes. Therefore, competency in informatics is essential. The purposes of this study are to examine current informatics competency levels of nurse managers and to identify the variables that influence these competencies. A questionnaire designed to assess demographic information and nursing informatics competency was completed by 68 nurse managers. Multiple linear regression analysis was conducted to analyze the factors influencing informatics competency. Descriptive analysis of the data revealed that informatics competency of these nurse managers was in the moderate range (77.65 ± 8.14). Multiple linear regression analysis indicated that level of education, nursing administration experience, and informatics education/training were significant factors affecting competency levels. The factors identified in this study can serve as a reference for nurse managers who were wishing to improve their informatics competency, hospital administrators seeking to provide appropriate training, and nursing educators who were making decisions about nursing informatics curricula. These findings suggest that efforts to enhance the informatics competency of nurse managers have marked potential benefits.

  5. University management nurse: a grounded theory


    Kamylla Santos da Cunha; Selma Regina de Andrade; Alacoque Lorenzini Erdmann


    ABSTRACT Objective: to understand the meaning of the university management performed by nurses managers of the nursing undergraduate course of a public university. Method: this is a qualitative research, based on the grounded theory. Data collection took place between May and September 2016, with open interviews, in the scenario of a federal public university. The technique of constant comparative analysis of the data was followed, obtaining a theoretical sample with 19 nurses, in two sampl...

  6. The Influence of Nurse Manager Leadership Style on Staff Nurse Work Engagement. (United States)

    Manning, Jennifer


    Nursing literature supports the importance of an engaged nursing workforce as a means to positively influence performance. Nurse manager leadership style plays a critical role in engaging staff nurses. These relationships have been minimally studied in nurse managers and staff nurses. The aim of this study is to evaluate the influence of nurse manager leadership style factors on staff nurse work engagement. Using a descriptive correlational research design, 441 staff nurses working in 3 acute care hospitals were surveyed. Survey instruments included the Utrecht Work Engagement Scale and the Multifactorial Leadership Questionnaire 5X short form. Transactional and transformational leadership styles in nurse managers positively influenced staff nurse work engagement. Passive-avoidant leadership style in nurse managers negatively influenced staff nurse work engagement. Nurse managers who provide support and communication through transformational and transactional leadership styles can have a positive impact on staff nurse work engagement and ultimately improve organizational outcomes.

  7. IT Security Vulnerability and Incident Response Management

    NARCIS (Netherlands)

    Hafkamp, W.H.M.; Paulus, S.; Pohlman, N.; Reimer, H.


    This paper summarises the results of a Dutch PhD research project on IT security vulnerability and incident response management, which is supervised by the University of Twente in the Netherlands and which is currently in its final stage. Vulnerabilities are ‘failures or weaknesses in computer

  8. [Management of nursing personnel with job security: perceptions of nurses]. (United States)

    Guimarães, Amanda Troca; Vaghetti, Helena Heidtmann; Lunardi Filho, Wilson Danilo; Gomes, Giovana Calcagno


    This study aimed to identify a university hospital nurses' perception on the management of nursing personnel with job security, using data collected from a qualitative research developed with sixteen nurses, in 2010. The data, collected through semi-structured interviews, and analyzed by Thematic Analysis, produced two empirical categories: Security at work versus the impunity afforded by tenure; Job stability and (un)involvement in nursing work. It has been verified that job stability provides security of employment; security spawns impunity, and nurses are reluctant to conduct administrative proceedings. The conclusion are that the security of employment caused by stability can favour the break of hierarchies; impunity leads to the vulgarisation of transgressions by the lack of effective administrative measures toward the solution of problems; and job stability does not ensure the quality of assistance.

  9. Challenges for nurse managers in China. (United States)

    Wong, Frances Kam Yuet


    To critically review the challenges facing nurse leaders in China during healthcare reform. China is now undergoing a major reform aimed at enhancing the accessibility and quality of its healthcare at a level that is affordable to the people. Nurses have a key role to play in this reform. Key documents produced by the government of China were critically reviewed using the strengths, weaknesses, opportunities and threats (SWOT) framework. A number of factors, including the insufficient number of nurses and the medical orientation of the health system, have hindered the development of nursing. However, healthcare reform has created new opportunities for nurses and nursing. This paper reviews the strengths, weaknesses, opportunities and threats faced by nurse managers in China. It identifies barriers but also possibilities for nurse leaders to advance nursing and make nurses visible in this era of transforming healthcare. Many of the issues identified in this review, such as the enhancement of quality and accessibility of care, are important to nurse leaders around the world. However, this article reveals the particular challenges faced by nurse leaders in China, with its unique social and historical background.

  10. Predictors of transformational leadership of nurse managers. (United States)

    Echevarria, Ilia M; Patterson, Barbara J; Krouse, Anne


    The aim of this study was to examine the relationships among education, leadership experience, emotional intelligence and transformational leadership of nurse managers. Nursing leadership research provides limited evidence of predictors of transformational leadership style in nurse managers. A predictive correlational design was used with a sample of nurse managers (n = 148) working in varied health care settings. Data were collected using the Genos Emotional Intelligence Inventory, the Multi-factor Leadership Questionnaire and a demographic questionnaire. Simple linear and multiple regression analyses were used to examine relationships. A statistically significant relationship was found between emotional intelligence and transformational leadership (r = 0.59, P leadership. Nurse managers should be well informed of the predictors of transformational leadership in order to pursue continuing education and development opportunities related to those predictors. The results of this study emphasise the need for emotional intelligence continuing education, leadership development and leader assessment programmes. © 2016 John Wiley & Sons Ltd.

  11. Emotional intelligence (EI) and nursing leadership styles among nurse managers. (United States)

    Tyczkowski, Brenda; Vandenhouten, Christine; Reilly, Janet; Bansal, Gaurav; Kubsch, Sylvia M; Jakkola, Raelynn


    Less than 12.5% of nurses aspire to leadership roles, noting lack of support and stress as major factors in their decision not to pursue this area of practice. Psychological resiliency, described as the ability to properly adapt to stress and adversity, is key to successful nurse managers. Emotional intelligence (EI) is a related concept to resiliency and is another noteworthy predictor of leadership and management success. This study was undertaken to determine the level of and relationship between EI and leadership style of nurse managers employed in Wisconsin and Illinois facilities. A descriptive, exploratory study design was utilized, with a convenience sample of nurse managers working in 6 large Midwestern health systems. Nurse managers were invited to participate in the study by their employer, completing the online consent form and the demographic, Multifactor Leadership Questionnaire (MLQ) Form 5X and the Emotional Quotient Inventory (EQ-i 2.0) surveys. Statistically significant positive relationships were noted between EI and transformational leadership and the outcomes of leadership (extra effort, effectiveness, and satisfaction). No statistically significant relationships were noted between EI and transactional or laissez-faire leadership styles.

  12. [Management of infectious diarrhea in nursing homes]. (United States)

    Ferahta, Nabila; Héquet, Delphine; Bizzozzero, Tosca; Major, Kristof; Petignat, Christiane


    Infectious diarrheas are of great concern in nursing homes and can engender outbreaks. Their importance in terms of morbidity, mortality and health economics justify the implementation of prevention and control measures. Although past studies emphasize the importance of infectious diarrheas occurring during hospitalization, data on nursing homes epidemiology remain scarce. This article is founded on recent data of the literature, on recommendations for the management of infectious diarrheas and for prevention and control of outbreaks in nursing homes.

  13. Evaluating and improving incident management using historical incident data : case studies at Texas transportation management centers. (United States)


    The companion guidebook (0-5485-P2) developed as part of this study provides the procedures and : methodologies for effective use of historical incident data at Texas Transportation Management Centers : (TMCs). This research report documents the resu...

  14. Nursing's role in cancer pain management. (United States)

    Vallerand, April Hazard; Musto, Susan; Polomano, Rosemary C


    Nurses have advanced practice, research, and education in the field of cancer pain management. This paper highlights the contributions nurses have made to pain science and practice through literature published in the past 3 years. Work accomplished by nurses is examined in the areas of pain assessment, pain management, intervention-based research, evidence-based practice, patient education, and palliative care. Nurses serve as advocates for empowering patients to engage in self-management of their pain, and offer education and support to patients and families at their most vulnerable times. Nurse researchers have been at the forefront of work to develop and test new instruments and approaches to measure pain, elucidate pain experiences through quantitative and qualitative methodologies, and gauge the quality of pain care for patients and its impact on their caregivers. This research has uncovered many patient, health care professional, and systemic barriers to effective pain control, and has offered feasible solutions to overcoming these barriers.

  15. Nurse Managers' Leadership Styles in Finland (United States)

    Vesterinen, Soili; Suhonen, Marjo; Isola, Arja; Paasivaara, Leena


    Nurse managers who can observe their own behaviour and its effects on employees can adjust to a better leadership style. The intention of this study was to explore nurses' and supervisors' perceptions of nurse managers' leadership styles. Open-ended interviews were conducted with 11 nurses and 10 superiors. The data were analysed by content analysis. In the study, six leadership styles were identified: visionary, coaching, affiliate, democratic, commanding, and isolating. Job satisfaction and commitment as well as operation and development work, cooperation, and organizational climate in the work unit were the factors, affected by leadership styles. The nurse managers should consider their leadership style from the point of view of employees, situation factors, and goals of the organization. Leadership styles where employees are seen in a participatory role have become more common. PMID:23008767

  16. Nurse managers' leadership styles in Finland. (United States)

    Vesterinen, Soili; Suhonen, Marjo; Isola, Arja; Paasivaara, Leena


    Nurse managers who can observe their own behaviour and its effects on employees can adjust to a better leadership style. The intention of this study was to explore nurses' and supervisors' perceptions of nurse managers' leadership styles. Open-ended interviews were conducted with 11 nurses and 10 superiors. The data were analysed by content analysis. In the study, six leadership styles were identified: visionary, coaching, affiliate, democratic, commanding, and isolating. Job satisfaction and commitment as well as operation and development work, cooperation, and organizational climate in the work unit were the factors, affected by leadership styles. The nurse managers should consider their leadership style from the point of view of employees, situation factors, and goals of the organization. Leadership styles where employees are seen in a participatory role have become more common.

  17. Strategic management and nurses: building foundations. (United States)

    Crossan, Frank


    Effective strategic management is the means by which organizations achieve their desired levels of performance. There is a need to explore and describe the relationship between the profession of nursing and strategic management, with particular reference to nurses' participation in the field of strategy development and implementation. This paper aims to 'set the scene' in relation to such an exploration. The concept of strategic management is discussed and some possible definitions are explored. The need for nurses to be involved in strategic management is then considered, drawing on literature from nursing and general management sources. The overall aim of the paper is to provide a basis for further discussion and to generate ideas for research in the area.

  18. University management nurse: a grounded theory. (United States)

    Cunha, Kamylla Santos da; Andrade, Selma Regina de; Erdmann, Alacoque Lorenzini


    to understand the meaning of the university management performed by nurses managers of the nursing undergraduate course of a public university. this is a qualitative research, based on the grounded theory. Data collection took place between May and September 2016, with open interviews, in the scenario of a federal public university. The technique of constant comparative analysis of the data was followed, obtaining a theoretical sample with 19 nurses, in two sample groups. there were three categories emerged that shaped the phenomenon: Articulating complex collectives through university management for the qualified training of new nurses. The categories included: a) conditions, defined by perceiving the commitment to the collective, previous experiences, and training for health management, as motivations to be a teacher manager; b) actions/interactions, delimited by Knowing and recognizing, in practice, the university management process, limits and possibilities in the coordination of complex collective subjects; and, c) consequences, such as Improving teaching work and taking responsibility for university education. the nurses teaching managers to explain university management as a set of individual and collective actions that, articulated in a complex social environment, promote conditions for the training of critical and reflexive nurses with the demands of society.

  19. University management nurse: a grounded theory

    Directory of Open Access Journals (Sweden)

    Kamylla Santos da Cunha


    Full Text Available ABSTRACT Objective: to understand the meaning of the university management performed by nurses managers of the nursing undergraduate course of a public university. Method: this is a qualitative research, based on the grounded theory. Data collection took place between May and September 2016, with open interviews, in the scenario of a federal public university. The technique of constant comparative analysis of the data was followed, obtaining a theoretical sample with 19 nurses, in two sample groups. Results: there were three categories emerged that shaped the phenomenon: Articulating complex collectives through university management for the qualified training of new nurses. The categories included: a conditions, defined by perceiving the commitment to the collective, previous experiences, and training for health management, as motivations to be a teacher manager; b actions/interactions, delimited by Knowing and recognizing, in practice, the university management process, limits and possibilities in the coordination of complex collective subjects; and, c consequences, such as Improving teaching work and taking responsibility for university education. Conclusion: the nurses teaching managers to explain university management as a set of individual and collective actions that, articulated in a complex social environment, promote conditions for the training of critical and reflexive nurses with the demands of society.


    Directory of Open Access Journals (Sweden)

    Ahsan Ahsan


    Full Text Available Introduction: Model of nursing care based on knowledge management can reduce the incidence of nosocomial infections through the performance of nurses in the prevention of infection. Nursing care based on knowledge management is established from identi fi cation knowledge which is required, prevention performance of nosocomial infections post caesarean section. Nosocomial infections component consists of wound culture result. Method: This study was an observational study with a quasy experimental design. The population were all of nursing staff who working in obstetrics installation and a number of patients who is treated in hospitals A and B post sectio caesarea. Sample is comparised a total population all the nursing staff who worked in obstetrics installation according to criteria of the sample, and most of patients were taken care by nursing staff post caesarean section which is taken by random sampling 15 patients. Data was collected through observation sheets and examination of the wound culture. Data analysis which is used the t test. Result: The result was showed that there was signi fi cant difference in the incidence of nosocomial infection in patients with post sesctio caesarea in hospital before and after nursing care training based on knowledge management (tvalue = 2.316 and p = 0.028 < α = 0.05 level, and the incidence of nosocomial infection was lower after training than before training. Discussion: It can be concluded that training knowledge management based on nursing care effectives to reduce Incidence of Nosocomial Infections in Patients after Sectio Caesarea.

  1. Home Care Nursing Improves Cancer Symptom Management (United States)

    Home care nursing (HCN) improves the management of symptoms in breast and colorectal cancer patients who take the oral chemotherapy drug capecitabine, according to a study published online November 16 in the Journal of Clinical Oncology.

  2. The Nurse Leader Role in Crisis Management. (United States)

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


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

  3. Crisis management systems: staff nurses demand more support from their supervisors. (United States)

    Tzeng, Huey-Ming; Yin, Chang-Yi


    This study illustrates the contributions of the necessity, comprehensiveness, and difference (between necessity and comprehensiveness) levels of crisis management systems to participants' general satisfaction with their working institutions' nursing-related crisis management activities. Crisis management systems include strategic, technical/structural, assessment, public communication, and psychological/cultural aspects. An effective institutional crisis management system might help to decrease the number of incidents related to medical disputes or to prevent a crisis from worsening and becoming disastrous. A cross-sectional survey was administered during a nursing conference held in Taipei, Taiwan, on June 27, 2005. Two hundred ninety questionnaires were distributed, and 121 were retrieved (response rate, 41.7%; nursing administrators and staff). Univariate and multivariate analyses were performed. Ordinal logistic regression analyses show that being a public hospital managed by the government and having more difference on the strategic aspect between the necessity and comprehensiveness levels contribute to lower satisfaction with nursing-related crisis management activities (Nagelkerke R(2) = .441). In addition, staff nurses perceive higher necessity levels on all five aspects compared to nursing administrators. This study provides important insights into how the policies and activities of a medical institution's crisis management system can be prioritized and implemented. It is also important for students in nursing programs and for currently employed nurses to learn how to manage disputes related to nursing practice, so that early resolution can be achieved and crises can be avoided. These results suggest that staff nurses demand more support from their supervisors.

  4. Caring behaviour perceptions from nurses of their first-line nurse managers. (United States)

    Peng, Xiao; Liu, Yilan; Zeng, Qingsong


    Nursing is acknowledged as being the art and science of caring. According to the theory of nursing as caring, all persons are caring but not every behaviour of a person is caring. Caring behaviours in the relationship between first-line nurse managers and Registered Nurses have been studied to a lesser extent than those that exist between patients and nurses. Caring behaviour of first-line nurse managers from the perspective of Registered Nurses is as of yet unknown. Identifying caring behaviours may be useful as a reference for first-line nurse managers caring for nurses in a way that nurses prefer. To explore first-line nurse managers' caring behaviours from the perspective of Registered Nurses in mainland China. Qualitative study, using descriptive phenomenological approach. Fifteen Registered Nurses recruited by purposive sampling method took part in in-depth interviews. Data were analysed according to Colaizzi's technique. Three themes of first-line nurse managers' caring behaviours emerged: promoting professional growth, exhibiting democratic leadership and supporting work-life balance. A better understanding of the first-line nurse managers' caring behaviours is recognised. The three kinds of behaviours have significant meaning to nurse managers. Future research is needed to describe what first-line nurse managers can do to promote nurses' professional growth, increase the influence of democratic leadership, as well as support their work-life balance. © 2015 Nordic College of Caring Science.

  5. The practice and effect of combined duty of administrative management, medical treatment and nursing

    Directory of Open Access Journals (Sweden)

    Min HU


    Full Text Available Objective: To explore the effect of combined duty mode on discovery and control of medical nursing hidden trouble. Method: In order to make sure that patients are in the first place, we should take the mode of combined duty of administrative management, medical treatment and nursing. Results:The incidence of nursing errors and defects reduced, and patients’ satisfaction improved. the differences were statistically significant (P<0.01 or P<0.05.Results: Combined duty can the reduce medical nursing defects, improve the efficiency of quality health care services and the management efficiency.

  6. [Nurses' practices in the nursing and health care management: integrative review]. (United States)

    Santos, José Luís Guedes Dos; Pestana, Aline Lima; Guerrero, Patrícia; Meirelles, Betina Schlindwein Hörner; Erdmann, Alacoque Lorenzini


    This study aimed to highlight and analyze the nurses' practices in care management described in the scientific production in Brazil and internationally, through an integrative review. It was examined articles published between 2005 and 2010, in the LILACS, SciELO, BDENF and CINAHL databases, with the descriptors Management and Administration, in conjunction with Care and Nursing, and the terms Nursing Management and Nursing Care, totaling 27 publications. The management of care performed by nurses is directly related to the search for quality care and better working conditions through actions such as: care realization, human and material resources management, leadership, assistance planning, nursing team training, care coordination and evaluation of nursing actions.

  7. Nurse manager residency program: an innovative leadership succession plan. (United States)

    Watkins, Amy; Wagner, Jennifer; Martin, Christina; Grant, Brandy; Maule, Katrina; Resh, Kimberly; King, Lisa; Eaton, Holly; Fetter, Katrina; King, Stacey L; Thompson, Elizabeth J


    To ensure succession planning within the ranks of nurse managers meet current and projected nursing management needs and organizational goals, we developed and implemented a nurse manager residency program at our hospital. By identifying, supporting, and mentoring clinical experts who express a desire and display an aptitude for nursing leadership, we are graduating individuals who can transition to a nurse manager position with greater ease and competence.

  8. Strategic management of health care information systems: nurse managers' perceptions. (United States)

    Lammintakanen, Johanna; Kivinen, Tuula; Saranto, Kaija; Kinnunen, Juha


    The aim of this study is to describe nurse managers' perceptions of the strategic management of information systems in health care. Lack of strategic thinking is a typical feature in health care and this may also concern information systems. The data for this study was collected by eight focus group interviews including altogether 48 nurse managers from primary and specialised health care. Five main categories described the strategic management of information systems in health care; IT as an emphasis of strategy; lack of strategic management of information systems; the importance of management; problems in privacy protection; and costs of IT. Although IT was emphasised in the strategies of many health care organisations, a typical feature was a lack of strategic management of information systems. This was seen both as an underutilisation of IT opportunities in health care organisations and as increased workload from nurse managers' perspective. Furthermore, the nurse managers reported that implementation of IT strengthened their managerial roles but also required stronger management. In conclusion, strategic management of information systems needs to be strengthened in health care and nurse managers should be more involved in this process.

  9. Leadership styles of nurse managers in a multinational environment. (United States)

    Suliman, Wafika A


    This is a descriptive study conducted at a multinational working environment, where 1500 nurses representing 52 nationalities are employed. The study aimed at exploring the predominant leadership style of nurse managers through self-evaluation and staff nurses' evaluation and the impact of working in a multinational environment on their intention to stay or quit. The value lies in its focus on leadership styles in an environment where national diversity among managers, staff, and patients is very challenging. The study included 31 nurse managers and 118 staff nurses using Bass and Avolio's (1995) Multifactor Leadership Questionnaire. The results showed that nurse managers and staff nurses reported transformational leadership as predominant with significant difference in favor of nurse managers. Participants' nationality and intention to stay or quit affected their perception of transformational leadership as a predominant style. The implications highlight the need for senior nursing management to set effective retention strategies for transformational nurse managers who work at multinational environments.

  10. Best practice of nurse managers in risk management

    Directory of Open Access Journals (Sweden)

    Veridiana Tavares Costa


    Full Text Available OBJECTIVE: to identify the actions, undertaken by nurse managers in a risk management program, considered as best practice. METHOD: a case study undertaken in a private hospital in the south of Brazil. A risk manager and nurse managers working in a risk management program participated in this study. The data was collected between May and September 2011 through analysis of documents, semi-structured interviews and non-participant observation. Based on the triangulation, the data was analyzed through practical measures. RESULTS: educational actions, the critical analysis of the context, and the multiple dimensions of the management were evidenced as best practice. CONCLUSIONS: the broadening of understanding regarding risk management best practice offers further support for nurse managers to achieve excellence in their actions and thus provide safe and quality care.

  11. Nurse manager succession planning: a concept analysis. (United States)

    Titzer, Jennifer L; Shirey, Maria R


    The current nursing leadership pipeline is inadequate and demands strategic succession planning methods. This article provides concept clarification regarding nurse manager succession planning. Attributes common to succession planning include organizational commitment and resource allocation, proactive and visionary leadership approach, and a mentoring and coaching environment. Strategic planning, current and future leadership analysis, high-potential identification, and leadership development are succession planning antecedents. Consequences of succession planning are improved leadership and organizational culture continuity, and increased leadership bench strength. Health care has failed to strategically plan for future leadership. Developing a strong nursing leadership pipeline requires deliberate and strategic succession planning. © 2013 Wiley Periodicals, Inc.

  12. Nurses' knowledge of chronic disease management

    African Journals Online (AJOL)


    Nov 21, 2014 ... Objective: This study's objective was to evaluate the impact of the 'Primary Care 101' chronic disease management ... on management of tuberculosis, human immunodeficiency virus infection, mental health, epilepsy ... Conclusion: The improvements in nurses' knowledge can ensure improved patient.

  13. Nurses involved in whistleblowing incidents: sequelae for their families. (United States)

    Wilkes, Lesley M; Peters, Kath; Weaver, Roslyn; Jackson, Debra


    Nurses involved in whistleblowing often face economic and emotional retaliation, victimization and abuse. Yet for many nurses, one major part of their whistleblowing experience is the negative impact it has on their families. This paper reports findings from a qualitative study pertaining to the effects of whistleblowing on family life from the perspective of the nurses. Using a narrative inquiry approach, fourteen nurses were interviewed who were directly involved in whistleblowing complaints. Data analysis drew out three themes: strained relationships with family members, dislocation of family life, and exposing family to public scrutiny. The harm caused to the nurses involved in a whistleblowing event is not restricted to one party but to all those involved, as the harrowing experience and its consequences are echoed in the family life as well. It is important for organizations to seek strategies that will minimize the harmful effects on nurses' families during whistleblowing events.

  14. Computer incident response and forensics team management conducting a successful incident response

    CERN Document Server

    Johnson, Leighton


    Computer Incident Response and Forensics Team Management provides security professionals with a complete handbook of computer incident response from the perspective of forensics team management. This unique approach teaches readers the concepts and principles they need to conduct a successful incident response investigation, ensuring that proven policies and procedures are established and followed by all team members. Leighton R. Johnson III describes the processes within an incident response event and shows the crucial importance of skillful forensics team management, including when and where the transition to forensics investigation should occur during an incident response event. The book also provides discussions of key incident response components. Provides readers with a complete handbook on computer incident response from the perspective of forensics team management Identify the key steps to completing a successful computer incident response investigation Defines the qualities necessary to become a succ...

  15. Sources, incidence and effects of non?physical workplace violence against nurses in Ghana


    Boafo, Isaac Mensah; Hancock, Peter; Gringart, Eyal


    Abstract Aim To document the incidence, sources and effects of workplace verbal abuse and sexual harassment against Ghanaian nurses. Methods A cross?sectional study was conducted in Ghana from 2013?2014 which surveyed 592 professional nurses and midwives working in public hospitals in Ghana using the health sector violence questionnaire. Results The majority of participants were females (80%). The average age of participants was 31?76?years and the average number of years practising as nurse ...

  16. The incidence risk of type 2 diabetes mellitus in female nurses: a nationwide matched cohort study

    Directory of Open Access Journals (Sweden)

    Hsiu-Ling Huang


    Full Text Available Abstract Background Diabetes is one of the most common chronic illnesses worldwide. This study was to assess whether the incidence risk of type 2 diabetes mellitus between female nurses and female non-nurses. Methods Study data were obtained from the Longitudinal Health Insurance Research Database, and nurses were sampled from the Registry for medical personnel. Nurses and non-nurses with similar traits and health conditions were selected via 1:1 propensity score matching. A total of 111,670 subjects were selected (55,835 nurses and 55,835 non-nurses. Stages of diabetes development were monitored until December 31, 2009. The Cox proportional hazards model was used to discuss risks and influencing factors related to diabetes. Poisson distribution methods were used to examine the incidence rate of diabetes per 1,000 person-years. Results The propensity matching results show that on average, female nurses who were diagnosed with diabetes were younger compared with the non-nurses (46.98 ± 10.80 vs. 48.31 ± 10.43, p <0.05. However, the results of the Cox proportional hazards model show that the nurses showed a lower risk of developing diabetes compared with the non-nurses (Adj. HR = 0.84, 95 % CI: 0.79–0.90. Factors influencing diabetes development risks among the nurses include advanced age and high Charlson Comorbidity Index levels. Conclusion The low degree of diabetes development among the nurses may be attributable to the fact that nurses possess substantial knowledge on health care and on healthy behaviors. The results of this study can be used as a reference to assess occupational risks facing nursing staff, to prevent diabetes development, and to promote health education.

  17. New York integrated incident management system evaluation project final report (United States)


    The Integrated Incident Management System (IIMS) enables incident response personnel to transmit data about an incident to other responders and dispatchers on a real-time basis. When an incident is entered into IIMS, the system uses GPS to identify t...

  18. Assessment of the amount of ability to manage transformation in nursing managers (Head Nurses

    Directory of Open Access Journals (Sweden)

    Asra Ramyad


    Full Text Available Quiescent leadership cannot last long time. When the environment is constant and unchanged, firms will have little mobility Human is subject to organizational changes and numerous factors. Removing the rust from the mirror of the soul of man enhances his development towards his capabilities. Purpose: This study aimed to examine change management capabilities of nurse managers (Head nurses. This research is a descriptive study, which examines the change management capabilities in 50 different supervisors from the perspective of 187 nurses in hospitals under the supervision of head nurses in Qazvin, and it is conducted by Census method. The tools of this research are Bass and Avolio's Transformational leadership questionnaire that its validity and reliability were confirmed. To analyze the data, the software ѕрѕѕ version 22 statistical tests of Pearson, T, Nava, KS, and Chi-square exact was used. The findings showed that, according to the results of t-test, a statistically significant difference was not seen between the scores on all subscales obtained from the questionnaire of management capabilities in change management from nurses, demographic characteristics of nurses. (All p>0/5. However, scores in terms of individual consideration was (p=0/44 and Mental stimulation was (p=0/035 and only statistically significant difference was observed in the education of nurses. Given that nursing managers (supervisors in the field of change management have a poor and average performance, it seems the higher the level of education is for nurse managers, their ability to apply change management is higher. Also supervisors' performance within individual consideration with an error probability equal to 0/012 is at an optimum level and hence was able to win the trust of staff. To advance the goals of excellence in medical care, training the managers towards change, establishing physical and mental health and confidence in them by their involvement, is

  19. The development of an incident event reporting system for nursing students. (United States)

    Chiou, Shwu-Fen; Huang, Ean-Wen; Chuang, Jen-Hsiang


    Incident events may occur when nursing students are present in the clinical setting. Their inexperience and unfamiliarity with clinical practice put them at risk for making mistakes that could potentially harm patients and themselves. However, there are deficiencies with incident event reporting systems, including incomplete data and delayed reports. The purpose of this study was to develop an incident event reporting system for nursing students in clinical settings and evaluate its effectiveness. This study was undertaken in three phases. In the first phase, a literature review and focus groups were used to develop the architecture of the reporting system. In the second phase, the reporting system was implemented. Data from incident events that involved nursing students were collected for a 12-month period. In the third phase, a pre-post trial was undertaken to evaluate the performance of the reporting system. The ASP.NET software and Microsoft Access 2003 were used to create an interactive web-based interface and design a database for the reporting system. Email notifications alerted the nursing student's teacher when an incident event was reported. One year after installing the reporting system, the number of reported incident events increased tenfold. However, the time to report the incident event and the time required to complete the reporting procedures were shorter than before implementation of the reporting system. The incident event reporting system appeared to be effective in more comprehensively reporting the number of incident events and shorten the time required for reporting them compared to traditional written reports.

  20. Cancer patients' experiences of nurses' behaviour and health promotion activities: a critical incident analysis. (United States)

    Björklund, M; Fridlund, B


    Patients with head and neck cancer report several disease- and health-related problems before, during and a long time after completed treatment. Nurses have an important role in educating/supporting these patients about/through the disease and treatment so that they can attain well-being. This study describes the cancer patients' experiences of nurses' behaviour in terms of critical incidents after nurses had given them care to promote health. The study had a qualitative, descriptive design and the method used was the critical incident technique. Twenty-one informants from the Nordic countries diagnosed with head and neck cancer were strategically selected. It was explained to the informants what a critical incident implies before the interviews took place; this was defined as a major event of great importance, an incident, which the informants still remember, due to its great importance for the outcome of their health and well-being. The nurses' behaviour was examined, and critical incidents were involved in 208 cases-150 positive and 58 negative ones-the number of incidents varying between three and 20 per informant. The nurses' health promotion activities or lack of such activities based on the patients' disease, treatment and symptoms, consisted of informing and instructing the patients as well as enabling their participation. Personal consideration and the nurses' cognisance, knowledge, competence, solicitude, demeanour and statements of understanding were found to be important. Continuous health promotion nursing interventions were of considerable value for the majority of this group of cancer patients. Oncology nurses could reconfirm and update the care of head and neck cancer patients by including health promotion activities in individual care plans. By more frequent use of health promotion models, such as the empowerment model, the nurses could identify and focus on those individuals who needed to alter their life-style as well as tailor their approach

  1. Nurses' Psychosocial Barriers to Suicide Risk Management

    Directory of Open Access Journals (Sweden)

    Sharon Valente


    Full Text Available Suicide remains a serious health care problem and a sentinel event tracked by The Joint Commission. Nurses are pivotal in evaluating risk and preventing suicide. Analysis of nurses' barriers to risk management may lead to interventions to improve management of suicidal patients. These data emerged from a random survey of 454 oncology nurses' attitudes, knowledge of suicide, and justifications for euthanasia. Instruments included a vignette of a suicidal patient and a suicide attitude questionnaire. Results. Psychological factors (emotions, unresolved grief, communication, and negative judgments about suicide complicate the nurse's assessment and treatment of suicidal patients. Some nurses (=122 indicated that euthanasia was never justified and 11 were unsure of justifications and evaluated each case on its merits. Justifications for euthanasia included poor symptom control, poor quality of life, incurable illness or permanent disability, terminal illness, and terminal illness with inadequate symptom control or impending death, patient autonomy, and clinical organ death. The nurses indicated some confusion and misconceptions about definitions and examples of euthanasia, assisted suicide, and double effect. Strategies for interdisciplinary clinical intervention are suggested to identify and resolve these psychosocial barriers.

  2. Exploring factors associated with the incidence of sexual harassment of hospital nurses by patients. (United States)

    Hibino, Yuri; Hitomi, Yoshiaki; Kambayashi, Yasuhiro; Nakamura, Hiroyuki


    To identify factors affecting nurse-perceived sexual harassment and specific types of patient sexual behavior experienced by Japanese nurses. Cross-sectional questionnaire study of Japanese hospital nurses. Self-administered questionnaires (N=600) were distributed to Japanese hospital nurses, and 464 were returned (response rate of 77.3%). Two instruments were used: one was for determining sexual harassment by patients, and the other was for determining specific types of patient behavior that had sexual connotations. Registered nurses were at a much higher risk of sexual harassment than were nurse assistants. In addition, registered nurses had a much more positive attitude toward gender equality compared with assistant nurses. A positive attitude toward gender equality mediated by a relatively high education level might be associated with increasing reports of sexual harassment. An increasing incidence of sexual harassment claims among nurses should prompt hospital organizations to take proper action against it. Education on gender equality was thus considered a long-term solution for reducing the sexual harassment of Japanese hospital nurses. Establishing a safer working environment could enable nurses to provide better care for patients and thereby promote the development of good relationships between nurses and patients.

  3. Staff nurse perceptions of nurse manager leadership styles and outcomes. (United States)

    Casida, Jesus; Parker, Jessica


    To explore the correlations of leadership styles of nurse managers (NMs) and outcomes.   Little is known about the linkages among leadership styles [transformational (TFL), transactional (TRL)] of NMs and outcomes [a leader's extra effort (LEE), leadership satisfaction (LS) and effectiveness (LE)] using the full-range leadership theory. Methods  An exploratory correlational design was employed using data from a 2007 study in which staff nurses (n = 278) from four hospitals in the Northeastern US were asked to rate the leadership styles of NMs (n = 37) and outcomes using the Multifactor Leadership Questionnaire Form 5x-Short. Data were analysed using descriptive and inferential statistical methods. TFL leadership has strong correlations to LEE, LS and LE, and was a predictor for leadership outcomes. Conversely, TRL leadership has week correlations to LEE, LS and LE and did not predict leadership outcomes. NMs who frequently display TFL leadership styles will probably achieve goals in a satisfying manner, warranting further research. TFL leadership training should be a basic competency requirement of NMs. Placing successful and effective TFL leaders in nursing units are the professional and moral obligations of nurse executives. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  4. Incident Management in Academic Information System using ITIL Framework (United States)

    Palilingan, V. R.; Batmetan, J. R.


    Incident management is very important in order to ensure the continuity of a system. Information systems require incident management to ensure information systems can provide maximum service according to the service provided. Many of the problems that arise in academic information systems come from incidents that are not properly handled. The objective of this study aims to find the appropriate way of incident management. The incident can be managed so it will not be a big problem. This research uses the ITIL framework to solve incident problems. The technique used in this study is a technique adopted and developed from the service operations section of the ITIL framework. The results of this research found that 84.5% of incidents appearing in academic information systems can be handled quickly and appropriately. 15.5% incidents can be escalated so as to not cause any new problems. The model of incident management applied to make academic information system can run quickly in providing academic service in a good and efficient. The incident management model implemented in this research is able to manage resources appropriately so as to quickly and easily manage incidents.

  5. The incidence of depression and its risk factors in Dutch nursing homes and residential care homes

    NARCIS (Netherlands)

    Boorsma, M.; Joling, K.J.; Dussel, M.; Ribbe, M.W.; Frijters, D.H.M.; van Marwijk, H.W.J.; Nijpels, G.; van Hout, H.P.J.


    Objective: Although it is known that depression is highly prevalent in institutionalized older adults, little is known about its incidence and risk factors in nursing homes and residential care homes. The aim of this study was to investigate and compare the incidence and associated risk factors for

  6. Night shift work and incidence of diabetes in the Danish Nurse Cohort

    DEFF Research Database (Denmark)

    Hansen, Anne B.; Stayner, Leslie; Hansen, Johnni


    OBJECTIVES: Night shift work has been associated with poor sleep, weight gain, metabolic syndrome, which are recognised risk factor for diabetes. However, only a few studies have examined the effect of shift work on diabetes risk. Here, we study the association between shift work and incidence...... of diabetes in Danish nurses. METHODS: We used the Danish Nurse Cohort with 28 731 participating female nurses recruited in 1993 (19 898) or 1999 (8833), when self-reported baseline information on diabetes prevalence, lifestyle and working time were collected, and followed them in the Danish Diabetes Register...... for incidence of diabetes until 2013. Nurses reported whether they worked night, evening, rotating or day shifts. We analysed the association between working time and diabetes incidence using a Cox proportional hazards model adjusted for diabetes risk factors, separately with and without adjustment for body...

  7. Effective classroom teaching methods: a critical incident technique from millennial nursing students' perspective. (United States)

    Robb, Meigan


    Engaging nursing students in the classroom environment positively influences their ability to learn and apply course content to clinical practice. Students are motivated to engage in learning if their learning preferences are being met. The methods nurse educators have used with previous students in the classroom may not address the educational needs of Millennials. This manuscript presents the findings of a pilot study that used the Critical Incident Technique. The purpose of this study was to gain insight into the teaching methods that help the Millennial generation of nursing students feel engaged in the learning process. Students' perceptions of effective instructional approaches are presented in three themes. Implications for nurse educators are discussed.

  8. Nursing approaches in the postoperative pain management

    Directory of Open Access Journals (Sweden)

    Sevilay Yüceer


    Full Text Available Patients frequently experience moderate to severe pain inthe postoperative period. Although the pain managementis an integral and important part of the nursing care, studiessuggest that, nursing management of postoperativepain remains inadequate.Postoperative care nurses are responsible to assess thepatient’s pain, teach the patient strategies to deal with thepain, apply the analgesic treatment plan, monitor the resultsof treatment, educate the patient and the family onpain management and document the pain managementoutcomes. The nurses’ holistic approach to pain managementminimizes the patients’ discomfort caused by pain inthe postoperative period after the surgery. In this article,nurses’ approaches to postoperative pain managementare discussed. J Clin Exp Invest 2011; 2 (4: 474-478

  9. Palliative care nurses' recognition and assessment of patients with delirium symptoms: a qualitative study using critical incident technique. (United States)

    Hosie, Annmarie; Agar, Meera; Lobb, Elizabeth; Davidson, Patricia M; Phillips, Jane


    Delirium is prevalent in palliative care inpatient settings and management is often challenging. Despite nurses' integral patient care role, little is known about palliative care nurses' capacity to recognise, assess and respond to patients' delirium symptoms. To explore the experiences, views and practices of inpatient palliative care nurses in delirium recognition and assessment. 30 nurses from nine Australian specialist palliative care inpatient services. Critical incident technique (CIT) guided a series of semi-structured interviews. Prior to interviews participants were given a vignette of a palliative care inpatient with an unrecognised hypoactive delirium, to prompt their recollection and recounting of a similar clinical incident. Clearly recalled and described incidents were analysed using thematic content analysis. 20 of 30 participants recalled and described 28 relevant delirium incidents. Two themes and six sub-themes provide a general description of participants' experiences, views and practice in delirium recognition and assessment. Participants experience distress related to caring for patients with delirium and express compassion and empathy for delirious patients. Enhancing their delirium knowledge, strengthening collaborative multidisciplinary team relationships and better communication are important supports. Some participants, usually those in advance practice roles, describe more comprehensive assessment capabilities that incorporate clinical expertise with whole person awareness, yet systematic and structured delirium screening and assessment processes and application of the delirium diagnosis criteria are largely missing. Use of ambiguous terminology to describe delirium symptoms contributes to ineffective practice. The findings of this study expands our understanding of how palliative care nurses' capacity to recognise and assess patients' delirium symptoms in the inpatient setting could be strengthened. Copyright © 2014 Elsevier Ltd. All

  10. Managing Food Allergies at School: School Nurses

    Centers for Disease Control (CDC) Podcasts


    This podcast highlights the leadership role of school nurses in the management of food allergies in schools. It also identifies CDC food allergy resources for schools.  Created: 1/20/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/20/2015.

  11. Intensive Care Nursing And Time Management


    ÖZCANLI, Derya; İLGÜN, Seda


    Time is not like other resources, because it can not be bought, sold, stolen, borrowed, stored, saved, multiplied or changed. All it can be done is spent. Time management means the effective use of resources, including time, in such a way that indi- viduals are effective in achieving important personal goals. With the increasing emphasis on efficiency in health care, how a nurse manages her time is an important consideration. Since intensive care nurs- ing is focused on the care and tr...

  12. [Sick leave and nursing personnel management]. (United States)

    Estorce, Thiago Puliesi; Kurcgant, Paulina


    Sick leaves in the nursing team demand immediate managerial actions when health care has quality as a goal. This descriptive-exploratory, quantitative study was performed with the purpose of characterizing that phenomenon in a university hospital between 2003 and 2007. The medical leaves added up to 3,207 leaves and 32,022 days lost. Leaves lasting up to two days accounted for 54% of the total leaves and to 7% of the days lost; leaves of more than 15 days, 5% of the total, and 66% of the lost days. Hence, sick leaves consist of an important tool in nursing personnel management.

  13. Nurse managers' perceptions and experiences regarding staff nurse empowerment: a qualitative study. (United States)

    Van Bogaert, Peter; Peremans, Lieve; de Wit, Marlinde; Van Heusden, Danny; Franck, Erik; Timmermans, Olaf; Havens, Donna S


    To study nurse managers' perceptions and experiences of staff nurse structural empowerment and its impact on the nurse manager leadership role and style. Nurse managers' leadership roles may be viewed as challenging given the complex needs of patients and staff nurses' involvement in both clinical and organizational decision-making processes in interdisciplinary care settings. Qualitative phenomenological study. Individual semi-structured interviews were conducted with 8 medical or surgical nurse managers in a 600-bed Belgian university hospital between December 2013 and June 2014. This hospital was undergoing conversion from a classical hierarchical, departmental structure to a flat, interdisciplinary model. Nurse managers were found to be familiar with the structural empowerment of clinical nurses in the hospital and to hold positive attitudes toward it. They confirmed the positive impact of empowerment on their staff nurses, as evidenced by increased responsibility, autonomy, critical reflection and enhanced communication skills that in turn improved the quality and safety of patient care. Structural empowerment was being supported by several change initiatives at both the unit and hospital levels. Nurse managers' experiences with these initiatives were mixed, however, because of the changing demands with regard to their manager role and leadership style. In addition, pressure was being experienced by both staff nurses and nurse managers as a result of direct patient care priorities, tightly scheduled projects and miscommunication. Nurse managers reported that structural empowerment was having a favorable impact on staff nurses' professional attitudes and the safety and quality of care in their units. However, they also reported that the empowerment process had led to changes in the managers' roles as well as daily practice dilemmas related to the leadership styles needed. Clear organizational goals and dedicated support for both clinical nurses and nursing unit

  14. Learning from Errors: Critical Incident Reporting in Nursing (United States)

    Gartmeier, Martin; Ottl, Eva; Bauer, Johannes; Berberat, Pascal Oliver


    Purpose: The purpose of this paper is to conceptualize error reporting as a strategy for informal workplace learning and investigate nurses' error reporting cost/benefit evaluations and associated behaviors. Design/methodology/approach: A longitudinal survey study was carried out in a hospital setting with two measurements (time 1 [t1]:…

  15. Strategic management: a new dimension of the nurse executive's role. (United States)

    Johnson, L J


    The growth of corporate orientation for health care structures, with a focus on bottom-line management, has radically altered the role of nurse executives. With the organization's emphasis on performance, productivity, and results, successful nurse executives are now integrating the management of the delivery of nursing care with the management of complex corporate structures and relationships. The editor of Executive Development discusses the rapidly changing expectations and demands of the contemporary nurse executive's work. The nurse executive's role can be viewed from many perspectives: its scope, its value, its structure, its content. Content--"What does the nurse executive do that makes a real difference?"--is the focus here.

  16. Development of Kentucky's highway incident management strategic plan. (United States)


    ven though Kentucky has undertaken many initiatives to improve specific aspects of incident management, there has never been a plan that establishes an overall framework for a systematic, statewide, multi-agency effort to improve the management of hi...

  17. Nursing contributions to chronic disease management in primary care. (United States)

    Lukewich, Julia; Edge, Dana S; VanDenKerkhof, Elizabeth; Tranmer, Joan


    As the prevalence of chronic diseases continues to increase, emphasis is being placed on the development of primary care strategies that enhance healthcare delivery. Innovations include interprofessional healthcare teams and chronic disease management strategies. To determine the roles of nurses working in primary care settings in Ontario and the extent to which chronic disease management strategies have been implemented. We conducted a cross-sectional survey of a random sample of primary care nurses, including registered practical nurses, registered nurses, and nurse practitioners, in Ontario between May and July 2011. Nurses in primary care reported engaging in chronic disease management activities but to different extents depending on their regulatory designation (licensure category). Chronic disease management strategy implementation was not uniform across primary care practices where the nurses worked. There is the potential to optimize and standardize the nursing role within primary care and improve the implementation of chronic disease management strategies.

  18. Nurse middle manager ethical dilemmas and moral distress. (United States)

    Ganz, Freda D; Wagner, Nurit; Toren, Orly


    Nurse managers are placed in a unique position within the healthcare system where they greatly impact upon the nursing work environment. Ethical dilemmas and moral distress have been reported for staff nurses but not for nurse middle managers. To describe ethical dilemmas and moral distress among nurse middle managers arising from situations of ethical conflict. The Ethical Dilemmas in Nursing-Middle Manager Questionnaire and a personal characteristics questionnaire were administered to a convenience sample of middle managers from four hospitals in Israel. Middle managers report low to moderate levels of frequency and intensity of ethical dilemmas and moral distress. Highest scores were for administrative dilemmas. Middle managers experience lower levels of ethical dilemmas and moral distress than staff nurses, which are irrespective of their personal characteristics. Interventions should be developed, studied, and then incorporated into institutional frameworks in order to improve this situation. © The Author(s) 2014.

  19. Melanoma in Organ Transplant Recipients: Incidence, Outcomes and Management Considerations

    Directory of Open Access Journals (Sweden)

    Faisal R. Ali


    Full Text Available The incidence of melanoma continues to increase year on year. With better surgical techniques and medical management, greater numbers of organ transplants are being performed annually with much longer graft survival. The authors review our current understanding of the incidence of melanoma amongst organ transplant recipients, outcomes compared to the immunocompetent population, and management strategies in this burgeoning group.

  20. Melanoma in Organ Transplant Recipients: Incidence, Outcomes and Management Considerations

    International Nuclear Information System (INIS)

    Ali, F. R.; Lear, J. T.


    The incidence of melanoma continues to increase year on year. With better surgical techniques and medical management, greater numbers of organ transplants are being performed annually with much longer graft survival. The authors review our current understanding of the incidence of melanoma amongst organ transplant recipients, outcomes compared to the immunocompetent population, and management strategies in this burgeoning group

  1. Pro-active Management of Traffic Incidents Using Novel Technologies

    NARCIS (Netherlands)

    Nitsche, P.; Olstam, J.; Taylor, N.; Reinthaler, M.; Ponweiser, W.; Bernhardsson, V.; Mocanu, I.; Uittenbogaard, J.; Dam, E. van


    This paper presents the results of the assessment phase of the project PRIMA (Pro-Active Incident Management), where the benefits, costs and risks of novel traffic incident management techniques are investigated. The project targets the enhancement of current state-of-the-art measures for handling

  2. Current approaches to managing aggressive incidents among in ...

    African Journals Online (AJOL)

    Background: Aggressive behavior and incidents in psychiatric wards are commonplace and management approaches should be evidencebased. This audit aims to review the management of violent incidents and aggressive behaviour in the acute wards of the Federal Neuropsychiatric Hospital Calabar against the NICE ...

  3. Generational diversity: what nurse managers need to know. (United States)

    Hendricks, Joyce M; Cope, Vicki C


    This article presents a discussion of generational differences and their impact on the nursing workforce and how this impact affects the work environment. The global nursing workforce represents four generations of nurses. This generational diversity frames attitudes, beliefs, work habits and expectations associated with the role of the nurse in the provision of care and in the way the nurse manages their day-to-day activities. An electronic search of MEDLINE, PubMed and Cinahl databases was performed using the words generational diversity, nurse managers and workforce. The search was limited to 2000-2012. Generational differences present challenges to contemporary nurse managers working in a healthcare environment which is complex and dynamic, in terms of managing nurses who think and behave in a different way because of disparate core personal and generational values, namely, the three Cs of communication, commitment and compensation. An acceptance of generational diversity in the workplace allows a richer scope for practice as the experiences and knowledge of each generation in the nursing environment creates an environment of acceptance and harmony facilitating retention of nurses. Acknowledgement of generational characteristics provides the nurse manager with strategies which focus on mentoring and motivation; communication, the increased use of technology and the ethics of nursing, to bridge the gap between generations of nurses and to increase nursing workforce cohesion. © 2012 Blackwell Publishing Ltd.

  4. [Effectiveness of managing styles of nursing management staff]. (United States)

    Stychno, Ewa


    There are many possibilities of the division of the managing styles. In theory one can distinguish two basic styles: directive and integrative. Generalisations describing both styles result in the fact that they do not reflect reality taking place at work. Because of it they cannot be applied in such a form. Therefore, it is necessary to build up the theoretical concept of the managing styles through decreasing their generality and adjusting them to the reality requirements at the same time. For the reality of management Reddin concept seems to be useful. It describes the organizational behaviour of managers. He noticed that the managing style is effective when it fits into the manager's situation whereas it is ineffective in such a situation, when the manager cannot select and adjust the managing techniques to the circumstances of the concrete decision-taking situation. Putting together 3 handling ways: orientation on assignments, orientation on staff, effectiveness, 8 managing can be differentiated. The aim of the paper was an attempt to check what managing styles are used by the nursing management staff working in hospitals. To determine the managing style a questionnaire consisting of 64 statements divided into 8 groups was applied. The examined persons were assigned to distribute 10 points among the statements belonging to each group of tasks which are supposed to specify their solution in the best way. The nursing management staff prefer the styles belonging to the more effective one in which there is a high orientation on staff.

  5. Pilot Testing of the NURSE Stress Management Intervention. (United States)

    Delaney, Colleen; Barrere, Cynthia; Robertson, Sue; Zahourek, Rothlyn; Diaz, Desiree; Lachapelle, Leeanne


    Student nurses experience significant stress during their education, which may contribute to illness and alterations in health, poor academic performance, and program attrition. The aim of this pilot study was to evaluate the feasibility and potential efficacy of an innovative stress management program in two baccalaureate nursing programs in Connecticut, named NURSE (Nurture nurse, Use resources, foster Resilience, Stress and Environment management), that assists nursing students to develop stress management plans. An explanatory sequential mixed-methods design was used to evaluate the effects of the intervention with 40 junior nursing students. Results from this study provide evidence that the NURSE intervention is highly feasible, and support further testing to examine the effect of the intervention in improving stress management in nursing students. © The Author(s) 2015.

  6. Role of Emotional Intelligence in Conflict Management Strategies of Nurses

    Directory of Open Access Journals (Sweden)

    Ceyda Başoğul, MD, RN


    Conclusions: The study determined that nurses' emotional intelligence affects conflict management strategies. To use effective strategies in conflict management, nurses must develop emotional intelligence. Training programs on conflict management and emotional intelligence are needed to improve effective conflict management in healthcare facilities.

  7. A New Model For Understanding Incident Management (United States)


    emergency management agencies and practitioners. Additionally, NEMA seeks to improve and create “ strategic partnerships, innovative programs, and...formulated, and revised administrative responsibilities for emergency management .”33 Several scholarly journals , academic papers, and practitioner articles... management as a profession, David T. Crews states, “In their primary and ‘ strategic ’ roles, emergency managers must analyze the threat to economic

  8. [From classical management to contemporary management: understanding new concepts to empower nursing management]. (United States)

    Spagnol, Carla Aparecida


    This theoretical work aimed to study Hospital Administration, focusing on Nursing Management. The author points out contemporary administration concepts, and leads us to think over how those new models of management (already in use in some institutions known as pioneers on this area) may have influence on the Nursing Management practice inserted on the context. The author concludes that Nursing is going through a transition moment, breaking paradigms, trying to get over Classical Administration beliefs and searching for flexible, humanized and shared ways to manage Nursing Care.

  9. What role can nurse leaders play in reducing the incidence of pressure sores? (United States)

    Wurster, Joan


    Pressure sores have plagued the nursing profession for many years as a major health care problem in terms of a patient's suffering and financial cost. Pressure sores are increasingly common in hospitalized patients in the United States with a 63% increase from 1993 to 2003. The nurse leader is accountable for the occurrence of pressure sores, a nurse-sensitive indicator, by a scorecard which is benchmarked against other facilities. The nurse leader must take a systematic approach in the prevention of pressure sores, with the strategy being consistent and motivating to the staff in order to improve patient outcome. The chief nursing officer, the unit manager, and the bedside nurse must all collaborate to prevent tissue injury in patients at risk for developing pressure sores and to promote wound healing in patients with existing breakdown.

  10. Barriers to Asthma Management for School Nurses: An Integrative Review. (United States)

    Hanley Nadeau, Ellen; Toronto, Coleen E


    Childhood asthma is a growing health concern. Asthma is the most common chronic illness of childhood and a leading cause of emergency room visits, hospitalizations, and school absenteeism. School nurses play a valuable role in asthma management. The purpose of this integrative review is to examine barriers to asthma management for school nurses in the school setting. Findings revealed multiple barriers school nurses encounter in managing asthma. Six themes emerged that included lack of resources and support, insufficient time, communication challenges, limited knowledge, and lack of awareness of school nurses' expertise. Students, parents, primary care physicians, school administration, staff, and school nurses themselves all play a role in constructing barriers to asthma management. There is a need for school nurses and school nurse leaders to focus efforts to develop strategies to overcome barriers to ensure evidence-based, best practice management of asthma in the school setting. © The Author(s) 2015.

  11. Use of electronic information systems in nursing management. (United States)

    Lammintakanen, Johanna; Saranto, Kaija; Kivinen, Tuula


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

  12. The teaching of nursing management in undergraduate: an integrative review

    Directory of Open Access Journals (Sweden)

    Mara Solange Gomes Dellaroza


    Full Text Available The study aims to identify the dynamics of teaching management in nursing degree. It is an integrative literature review with research conducted in the following online database platforms: SciELO, Medline, Lilacs and BDENF. The keywords used in the study were: competency-based education, professional competence, education, nursing, organization and administration, management, nursing, educational assessment, organization of management services, management of professional practice and education. All articles published in the last 10 years which answered the question presented to approach the teaching of nursing management in Brazil, published in any language were included. Those that were not presented in full text were excluded. Of the 1432 studies identified after matching the keywords, only 8 were selected for answering objective of this review. From these results, three related themes emerged: the teaching plans, workload and program content; methodologies of teaching and learning in nursing management; challenges faced in developing the teaching of nursing management.

  13. Is nurse managers' leadership style related to Japanese staff nurses' affective commitment to their hospital? (United States)

    Kodama, Yoshimi; Fukahori, Hiroki; Sato, Kana; Nishida, Tomoko


    To determine if nurse managers' leadership style is related to Japanese staff nurses' affective commitment to their hospital. In Western countries, nurse managers' transformational leadership style has been found to increase staff nurses' affective commitment to their hospital. However, there are few studies examining this relationship in the context of acute care hospitals in Japan. Staff nurses completed measures of their nurse managers' perceived leadership style and factors related to their own affective commitment. The association between affective commitment and perception of leadership style was assessed with multiple logistic regression. Of 736 questionnaires distributed, 579 (78.9%) were returned, and data from 396 (53.8%) fully completed questionnaires were analysed. The intellectual stimulation aspect of transformational leadership positively increased staff nurses' affective commitment (odds ratio: 2.23). Nurse managers' transactional and laissez-faire leadership styles were not related to affective commitment among staff nurses. The intellectual stimulation aspect of transformational leadership may increase the retention of staff nurses through enhanced affective commitment. To increase staff nurses' affective commitment to their hospital, we suggest that hospital administrators equip nurse managers with intellectual stimulation skills. © 2016 John Wiley & Sons Ltd.

  14. Managing home nursing care: visibility, accountability and exclusion. (United States)

    Purkis, M E


    The paper examines managerial practices shaping contemporary home nursing care. Foucault's writings on governmentality are used to appraise managerial and nursing practices understood as exemplars of forms of government of people's health. An ethnographic study of organizational practices shaping contemporary home nursing care reveals that the everyday work of managers involves making particular forms of nursing practice visible. Through careful scripting of these visible forms of practice, managers and nurses together work to exclude the local knowledge of patients and of nurses regarding experiences of living with chronic illness. Recommendations are offered for managers and nurses who seek to develop more autonomous roles for nurses: roles that require the inclusion of people's own knowledge of how they live at home with their chronic illness.

  15. Leadership styles of Finnish nurse managers and factors influencing it. (United States)

    Vesterinen, Soili; Isola, Arja; Paasivaara, Leena


    The purpose of the present study was to explore nurse managers' perceptions of their leadership styles and factors influencing it. It is a challenge for nurse managers to retain nurses in hospitals and to ensure a high quality of care in nursing practice. Leadership style is an important part of leadership. Knowledge concerning nurse managers' resonant and non-resonant leadership styles provides nurse managers with tools to reflect on their own leadership style. Open-ended, tape-recorded interviews were conducted with 13 nurse managers from five Finnish hospitals and two long-term care facilities. The data were analysed using qualitative content analysis. Five categories of leadership style were discerned: visionary, coaching, affiliate, democratic, commanding. Factors that influence leadership style were identified: earlier superiors, values, information, cooperation, employees and education. The results of this study show that Finnish nurse managers use both resonant and non-resonant leadership styles. The findings of this study show that nurse managers use a variety of leadership styles. The study demonstrates the importance of knowledge about leadership styles and factors influencing it among nurse managers providing future leadership and management education.

  16. Sources, incidence and effects of non-physical workplace violence against nurses in Ghana. (United States)

    Boafo, Isaac Mensah; Hancock, Peter; Gringart, Eyal


    To document the incidence, sources and effects of workplace verbal abuse and sexual harassment against Ghanaian nurses. A cross-sectional study was conducted in Ghana from 2013-2014 which surveyed 592 professional nurses and midwives working in public hospitals in Ghana using the health sector violence questionnaire. The majority of participants were females (80%). The average age of participants was 31·76 years and the average number of years practising as nurse was 7·38. Twelve per cent of the participants experienced at least one incident of sexual harassment and 52·2% were exposed to verbal abuse. The majority of perpetrators of sexual harassment were medical doctors (50%). Relatives of patients emerged as the most frequent verbal abusers (45·5%). Chi-square test showed statistically significant associations between gender and workplace violence and between workplace violence and intention to quit the nursing profession. The effects of workplace violence ranged from having disturbing memories about the incident to being 'super alert' and vigilant. Establishing the incidence of workplace violence is a necessary step towards addressing the problem. It is concluded that educational programs must be designed for healthcare workers and the general public to foster awareness of the effects of workplace violence. Clear policies must also be instituted to address the problem.

  17. Leadership styles in nursing management: preferred and perceived. (United States)

    Sellgren, Stina; Ekvall, Göran; Tomson, Göran


    The aim was to explore nursing leadership regarding what nurse managers and subordinates see as important and to explore subordinates' opinions of their nurse manager's performance in reality. Background The manager's style can be fundamental for subordinates' acceptance of change and in motivating them to achieve stated visions and goals and high quality of care. Nurse managers (n=77) and 10 of each included nurse manager's subordinates received a questionnaire to assess 'preferred' leadership behaviour in three dimensions: change, production and employee/relation orientations. The same questionnaire was used to assess subordinates' opinions of their manager's leadership behaviour. There are statistically significant differences in opinions of preferred leadership between managers and subordinates, especially related to production and relation orientation. The subordinates' perception of real leadership behaviour has lower mean values than their preferred leadership behaviour in all three dimensions. Subordinates prefer managers with more clearly expressed leadership behaviour than managers themselves prefer and demonstrate.

  18. An integrative review on conflict management styles among nursing students: Implications for nurse education. (United States)

    Labrague, Leodoro J; McEnroe-Petitte, Denise M


    Nurse education plays a critical role in the achievement of conflict management skills in nursing students. However, a wider perspective on this concept has not been explored. This paper is a report of a review appraising and synthesizing existing empirical studies describing conflict management styles among nursing students. An integrative review method guided this review. Five (5) bibliographic databases (CINAHL, Medline, Psych Info, Embase and SCOPUS) were searched to locate relevant articles. An electronic database search was performed in December 2016 to locate studies published from 2007 onwards. The search words included: 'conflict', 'management resolution', 'management style', 'management strategy', 'nursing', 'student'. Thirteen (13) articles met the inclusion criteria. Nursing students preferred 'constructive/positive conflict management styles' when handling conflicts. However, more studies are needed to identify factors that may affect their choice of styles. Further, this review emphasizes the need for empirical studies to identify appropriate interventions that would effectively enhance nursing students' skills in managing conflicts using rigorous methods. Nursing faculty play a critical role in teaching, training, and modeling constructive conflict resolution styles in nursing students. Simulation scenarios, reflective exercises, and role playing may be useful to facilitate such learning in choosing constructive conflict management styles. Structured training programme on conflict management will assist nursing students develop positive conflict management styles. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Leadership Practices in Hospital Nursing: A Self of Manager Nurses. (United States)

    Silva, Vânea Lúcia Dos Santos; Camelo, Silvia Helena Henriques; Soares, Mirelle Inácio; Resck, Zélia Marilda Rodrigues; Chaves, Lucieli Dias Pedreschi; Santos, Fabiana Cristina Dos; Leal, Laura Andrian


    To assess the frequency of the leadership practices performed by the manager nurses of hospital institutions and their association with the variables of the socioprofessional profile. Cross-sectional, descriptive, correlational study conducted in four hospitals in a city of the state of São Paulo. A sociodemographic questionnaire and the instrument Leadership Practices Inventory were used. Data collection and analysis were based on an exemplary Leadership Practices Model. Eighty-four manager nurses participated in the study. The mean values of the leadership practices used by the nurses were: enable others to act (50.6); encourage the heart (48.2); model the way (46.7); challenge the process (43.3); and inspire a shared vision (43.1). Data analysis also evidenced a correlation between the practice encourage the heart and the variables time of care and employment relationship. The study evidenced the presence of manager nurses exercising moderate leadership, and promoting teamwork, an environment of trust, and a horizontal vision. However, moderate values also reveal managerial aspects to be improved by the leaders by means of organizational strategies and/or tools aimed at best leadership practices. Avaliar a frequência das práticas de liderança executadas pelos enfermeiros gerentes de instituições hospitalares e sua associação às variáveis do perfil socioprofissional. Estudo transversal, descritivo e correlacional, realizado em quatro hospitaisde um município do interior paulista. Utilizou-se de questionário sociodemográfico e do instrumento Leadership Practices Inventory. A coleta e a análise de dados foram fundamentadas em um Modelo de Práticas para Liderança exemplar. Participaram 84 enfermeiros gerentes. As médias das práticas de liderança utilizadas pelos enfermeiros foram: capacitar os outros a agir (50,6), encorajar o coração (48,2), traçar o caminho (46,7), desafiar o processo (43,3) e inspirar uma visão compartilhada (43,1). Na an

  20. [Creativity and innovation: competences on nursing management]. (United States)

    Feldman, Liliane Bauer; Ruthes, Rosa Maria; Cunha, Isabel Cristina Kowal Olm


    This article presents the importance of the creativity and innovation on health services, distinguishing those concepts. Creative behavior is the improvement of an element or known actions: whereas innovation means finding new alternatives. Considering competences like knowledge, skill and attitude--KSA, it is understood that by stimulating creativity and innovation, the performance of the health professional will be optimized. Therefore, creativity and innovation are key elements for improvement and organization, and, more specifically, for Nursing to find alternatives for solving problems related to the occupation as a whole. In this way, this approach brings a strategic tool on the process of management and a differential for the nurse, which by innovating and creating will amaze herself with her potential.

  1. Timing of nurses activities: human resources management

    Directory of Open Access Journals (Sweden)

    Hamid Hosein Poor


    Full Text Available Costs of human resources include a high percentage of hospital’s costs; therefore, determination of number of real and optimal employees needed for organizations is very important. In the meantime, the optimal organization of nurses, as the biggest human resource in health care organizations, is of great importance. The present study aimed to assess the distribution of nurses’ activities in shifts and the results of productivity in human resources management in Imam Khomeini hospital in Shirvan. The present cross-sectional study was conducted in 2016. All nurses, working in three shifts of morning, afternoon, and evening in emergency unit and general units of Imam Khomeini hospital, Shirvan, were enrolled into the study through census methods. The instrument, used in this study, was the checklist of timing activities and patients’ satisfaction from nurses. The statistical software SPSS was used for analysis. Mean age of employees in these two units/wards was 31 years and mean duration of work experience was 5.24 years, The difference was significant between the two wards. necessity of the work, especially in emergency unit, are issues that need more assessment and need to be adjusted. Given the high volume of non-care matters of nursing staff, including writing services, including completing paper records and work with HIS (Hospital Information System, which has been emphasized in several studies, new definition of service and use of artificial intelligence with high efficacy is proposed. The status of the available equipment, availability, and efficiency of digital equipment and hoteling state of wards and hospitals also play an important factor in the distribution of time of nursing care activities. Employment of nurses to perform non-nursing duties, because of the shortage of other classes or lack of their permanent presence and based on Although there were differences in standard time of direct and indirect care in emergency unit and

  2. Using nurse managers' perceptions to guide new graduates toward positive nurse relationships. (United States)

    Moore, Linda Weaver; Sublett, Cynthia; Leahy, Cathy; Bradley, Jennifer M

    One of the greatest challenges new graduates confront when transitioning to practice is establishing positive relationships with experienced nurses. Nursing faculty must prepare graduates for this challenge. However, nursing faculty are often removed from everyday practice and must rely on the perceptions of those entrenched in practice in order to ground teaching endeavors in authenticity. Nurse managers are well positioned to provide knowledgeable insights to nursing faculty regarding nurse relationships. The purpose of this qualitative, descriptive study was to explore nurse managers' perceptions regarding new graduates' relationships with more experienced nurses. Researcher-participant audiotaped interviews were conducted with 13 nurse managers. A content analysis revealed that all participants believed nurse relationships were significant, that factors such as perceived inequities and stressful occurrences triggered poor relationships, that new graduates were often targeted for negative relationships, and that reasons for targeting of new graduates included prolonged dependence on experienced nurses and either over or under confidence of the new graduate. Providing a supportive, protective environment and hiring practices that promote team unity were posed as strategies that could help to prevent targeting of new graduates. Findings provide real-life, practice based information that can underpin nurse educators' teaching regarding nurse relationships and relationship building. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Research nurse manager perceptions about research activities performed by non-nurse clinical research coordinators. (United States)

    Jones, Carolynn Thomas; Hastings, Clare; Wilson, Lynda Law


    There has been limited research to document differences in roles between nurses and non-nurses who assume clinical research coordination and management roles. Several authors have suggested that there is no acknowledged guidance for the licensure requirements for research study coordinators and that some non-nurse research coordinators may be assuming roles that are outside of their legal scopes of practice. There is a need for further research on issues related to the delegation of clinical research activities to non-nurses. This study used nominal group process focus groups to identify perceptions of experienced research nurse managers at an academic health science center in the Southern United States about the clinical research activities that are being performed by non-nurse clinical research coordinators without supervision that they believed should only be performed by a nurse or under the supervision of a nurse. A total of 13 research nurse managers volunteered to be contacted about the study. Of those, 8 participated in two separate nominal group process focus group sessions. The group members initially identified 22 activities that they felt should only be performed by a nurse or under the direct supervision of a nurse. After discussion and clarification of results, activities were combined into 12 categories of clinical research activities that participants believed should only be performed by a nurse or under the direct supervision of a nurse. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Psychological contracts and commitment amongst nurses and nurse managers: a discourse analysis. (United States)

    McCabe, T J; Sambrook, Sally


    Few studies explore the link between the psychological contracts and the commitment of nursing professionals in the healthcare sector, and how perceived breaches of the psychological contract can impact on nurses' commitment levels. This study explores the connections between the psychological contracts and organisational and professional commitment of nurses and nurse managers. Semi-structured interviews were conducted with nurses and nurse managers, to explore the connections between their psychological contracts and organisational and professional commitment. Large acute and small community organisation within the British National Health Service. 28 nurses and 11 nurse managers working within an acute and a community sector organisation - 20 and 19 in each organisation. Participants were selected through a process of purposive sampling, reflecting variations in terms of age, grade, ward and tenure. A discourse analysis was conducted on the qualitative data from the thirty nine semi-structured interviews. Two overall themes emerged, professional and managerial values. Professional values included the sub-themes: professional recognition; immediate work environment - leadership and peer support; professional development and progression. Sub-themes under managerial values included: involvement; general management; resource management. The findings suggest that nurses and nurse managers are governed by relational psychological contracts, underpinned by an affective and to a lesser extent normative commitment towards the nursing profession. They emphasise 'professional values', and professional commitment, as the basis for positive psychological contracts amongst nursing professionals. There was anecdotal evidence of relational psychological contract breach, with decreasing job satisfaction as the outcome of perceived psychological contract breach. Positive psychological contracts and commitment levels amongst nursing professionals can be supported by managers been

  5. The nature of leadership style in nursing management. (United States)

    Azaare, John; Gross, Janet

    The purpose of this study was to explore the nature of leadership styles used by nurse managers, and describe staff nurses' perceptions of leadership styles. Effective leadership among nurse managers has been associated with staff nurse job satisfaction and retention. Twenty staff nurses from two hospitals in Ghana responded to tape-recorded interview questions. Four themes emerged from inductive analysis of the data. Findings suggest that nurse managers employed intimidation and minimal consultation to control their employees. The study further indicated that nurse managers were perceived as 'figure-heads', who are weak and inarticulate at the level of policy planning and implementation. It was therefore concluded that staff nurses in the study site hospitals lack confidence, trust and satisfaction with the current style of leadership. Staff nurses preferred a more proactive, articulate and independent nursing leadership at the top level. It is recommended that effective leadership training be instituted for prospective nurse managers before appointments are made into management and administrative positions.

  6. Sports Related Injuries: Incidence, Management and Prevention


    Stanger, Michael A.


    The incidence of injury related to various sports is reviewed according to sport, area of injury, number of participants and hours per week spent at the sport. Organized sports accounted for fewer injuries than unsupervised recreational activities like tree climbing, skateboarding and running. The knee is the most commonly injured site. Sensitivity to patients' commitment to their sport is necessary: sometimes instead of rest, they can substitute a less hazardous form of exercise. Principles ...

  7. Safer travel, improved economic productivity : incident management systems (United States)


    This brochure gives an overview of how incident management technologies can be used to reduce incident-related congestion and increase road safety. It focuses on the need for interagency cooperation and the benefits that can be derived from the coope...

  8. Wildfire incidence and management in the forest transition zone of ...

    African Journals Online (AJOL)

    A survey was conducted in eight communities in the forest transition zone to assess the perceptions of farmers on farming-related wildfire incidences, specific activities in farming associated with incidence of wildfires and coping measures being used by farmers to manage wildfires. Farmers in the studied settlements hold ...

  9. Nursing unit managers, staff retention and the work environment. (United States)

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


    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

  10. Relationships between core factors of knowledge management in hospital nursing organisations and outcomes of nursing performance. (United States)

    Lee, Eun Ju; Kim, Hong Soon; Kim, Hye Young


    The study was conducted to investigate the levels of implementation of knowledge management and outcomes of nursing performance, to examine the relationships between core knowledge management factors and nursing performance outcomes and to identify core knowledge management factors affecting these outcomes. Effective knowledge management is very important to achieve strong organisational performance. The success or failure of knowledge management depends on how effectively an organisation's members share and use their knowledge. Because knowledge management plays a key role in enhancing nursing performance, identifying the core factors and investigating the level of knowledge management in a given hospital are priorities to ensure a high quality of nursing for patients. The study employed a descriptive research procedure. The study sample consisted of 192 nurses registered in three large healthcare organisations in South Korea. The variables demographic characteristics, implementation of core knowledge management factors and outcomes of nursing performance were examined and analysed in this study. The relationships between the core knowledge management factors and outcomes of nursing performance as well as the factors affecting the performance outcomes were investigated. A knowledge-sharing culture and organisational learning were found to be core factors affecting nursing performance. The study results provide basic data that can be used to formulate effective knowledge management strategies for enhancing nursing performance in hospital nursing organisations. In particular, prioritising the adoption of a knowledge-sharing culture and organisational learning in knowledge management systems might be one method for organisations to more effectively manage their knowledge resources and thus to enhance the outcomes of nursing performance and achieve greater business competitiveness. The study results can contribute to the development of effective and efficient

  11. Defining Incident Management Processes for CSIRTs: A Work in Progress

    National Research Council Canada - National Science Library

    Alberts, Chris; Dorofee, Audrey; Killcrece, Georgia; Ruefle, Robin; Zajicek, Mark


    .... Workflow diagrams and descriptions are provided for each of these processes. One advantage of the model is that it enables examination of incident management processes that cross organizational boundaries, both internally and externally...

  12. Air quality evaluation of Rhode Island's incident management program (United States)


    The objective of this preliminary air quality analysis was to assess the potential air quality benefits associated with the implementation of Providence's Metropolitan portion of Rhode Island's Incident Management Program. Specifically, the air quali...

  13. Nurse staff allocation by nurse patient ratio vs. a computerized nurse dependency management system: a comparative cost analysis of Australian and New Zealand hospitals. (United States)

    Heslop, Liza; Plummer, Virginia


    Coding, costing, and accounting for nursing care requirements in Australian public and private hospitals lacks systematic research. Nurse costing for two nurse staffing allocation methods--nurse patient ratios and a computerized nurse dependency management system--were compared. Retrospective nursing workload management data were obtained from hospital information systems in 21 acute care public and private hospitals in Australia and New Zealand. Descriptive statistics, cost analysis, and cost modeling were conducted for 103,269 shifts of nursing care. The comparison of costs for nursing staff by nurse-patient ratios and by a computerized nurse dependency management system demonstrated differences. The provision of nursing care using the computerized nurse dependency management system was, overall, lower in cost than for nurse-patient ratios.

  14. Neonatal nurses' perceptions of pain management. (United States)

    Collados-Gómez, L; Camacho-Vicente, V; González-Villalba, M; Sanz-Prades, G; Bellón-Vaquerizo, B

    To describe the perceptions of nurses in neonatal units on pain management, meet the educational profile and describe the use of pain assessment tools and non-pharmacological management for treatment. Cross-sectional descriptive multicentre study, developed during the months of February to September 2015, in the neonatology services of three hospitals at the Community of Madrid, Spain. Data collection was performed through an ad hoc questionnaire on paper or electronically using Survey Monkey platform. The sample consisted of 142 professionals, with a response rate of 55%: 47.9% (68) confirmed they had received specific training in pain management; 39.5% (56) stated that pain is regularly assessed in the unit; only 43.6% reported using validated scales, the most used being the Premature Infant Pain Profile (PIPP). As for the non-pharmacological management, swaddling and non-nutritive sucking it is the most used, followed by sucrose. Intravenous cannulation was identified as the most painful procedure. Pain management is in the process of improvement, because of training and because there is little pain assessment using validated scales. The improvement in the use of non-pharmacological management for the relief of pain in minor procedures is noteworthy. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  15. A diabetes management mentor program: outcomes of a clinical nurse specialist initiative to empower staff nurses. (United States)

    Modic, Mary Beth; Canfield, Christina; Kaser, Nancy; Sauvey, Rebecca; Kukla, Aniko


    The purpose of this project was to enhance the knowledge of the bedside nurse in diabetes management. A forum for ongoing support and exploration of clinical problems, along with the distribution of educational tools were the components of this program. Diabetes accounts for 30% of patients admitted to the hospital. It has become more challenging to manage as the treatment choices have increased. There are a number of researchers who have identified nurse and physician knowledge of diabetes management principles as suboptimal. DESCRIPTION OF THE INNOVATION: Staff nurses are educated for a role as a Diabetes Management Mentor and are expected to educate/dialogue with peers monthly, model advocacy and diabetes patient education skills, facilitate referrals for diabetes education, and direct staff to resources for diabetes management. Diabetes Management Mentors feel more confident in their knowledge of diabetes and their ability to resolve clinical issues as they arise. The Diabetes Management Mentor role is another avenue for nurses to refine their clinical knowledge base and acquire skills to share with colleagues while remaining at the bedside. The clinical nurse specialist is expertly prepared to foster the professional development of bedside nurses while simultaneously making a positive impact on disease management. Opportunity for future investigation includes efficacy of teaching tools on diabetes mastery, the effect of clinical nurse specialist mentoring on a select group of bedside nurses, and the Diabetes Management Mentor's impact on prevention of near-miss events.

  16. Information management competencies for practicing nurses and new graduates

    Directory of Open Access Journals (Sweden)

    Corina Saratan


    Full Text Available Nursing informatics skills are required at all levels of nursing practice. Of those basic skills, management of information through the electronic health record (EHR is paramount. Previous research has explored computer literacy of nurses but has not investigated the competencies that relate specifically to information management. The purpose of this research study was to gather practicing nurses’ views of current information management competencies published by the Technology Informatics Guiding Education Reform (TIGER initiative, as they pertain to new graduates. A convenience sample of members from the InspireNet online user group was surveyed. The results suggest that overall, nurses tend to agree with the information management competencies; however, informatics education is most needed for those who have been practicing nursing for longer, rather than for novice nurses.

  17. Changing Incidence, Outcome and Management of Myelomeningocele

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available Pediatric neurosurgeons at Children’s Memorial Hospital, Chicago, review their long-term experience and the evolution of the etiology, diagnosis and management of patients born with myelomeningocele (MM in 1975-1979 and followed for 25 years in a multi-disciplinary spina bifida clinic.

  18. Congenital clinical malaria: Incidence, management and outcome ...

    African Journals Online (AJOL)

    Objective: With paucity of documentation of congenital clinical malaria in the world literature, we therefore aimed to review its rates, presentation, management and out come of this problem in neonates at the Usmanu Danfodiyo University Teaching Hospital, Sokoto. Methodology: This prospective study was carried out in ...

  19. Retaining professional nurses in South Africa: Nurse managers ...

    African Journals Online (AJOL)

    South Africa is experiencing a serious shortage of nurses, which has to be addressed to prevent crises in health care services. Previous studies (Fletcher 2001:324; Oosthuizen 2005:117) found that nurses change their work environment due to dissatisfaction with their job situations. This implies that creating a favourable ...

  20. Identifying nurse managers' essential communication skills: an analysis of nurses' perceptions in Oman. (United States)

    Rouse, Ruby A; Al-Maqbali, Majid


    The aim of the present study was to analyse nurses' perceptions of the communication qualities that are essential for nurse managers to carry out their jobs effectively. An examination of effective communication may help to identify nurse manager behaviours that promote dignity and respect. A paper-and-pencil survey collected open-ended data from 1526 nursing professionals (RNs) representing 22 hospitals in Oman. Qualitative content analysis was conducted first, followed by a quantitative descriptive analysis. The participants reported frustration with nurse managers who seemed overly focused on mistakes. Many participants felt there was little to no appreciation for tasks that were well done. Nurses also disliked being disciplined openly in front of colleagues or patients. The participants stressed that nurse manager feedback should be shared privately and framed in a positive and constructive tone. Active listening, team collaboration and the avoidance of discrimination/favouritism were also emphasised. A supportive and communicative work environment promotes nurses' dignity and respect. Embarrassing nurses in front of other health care professionals may be counterproductive. Instead, the study results suggested privately discussing concerns in a positive, constructive tone is more likely to foster nurse trust and dignity. © 2014 John Wiley & Sons Ltd.

  1. Determinants of nurses' knowledge gap on pain management in Ghana. (United States)

    Aziato, Lydia; Adejumo, Oluyinka


    There are concerns about adequacy of nurses' knowledge and skill in effective pain management since effective pain management promotes early recovery after surgery. This study explores factors that accounted for Ghanaian nurses' inadequate knowledge of postoperative pain management using a focused ethnographic design for data collection at a tertiary teaching hospital in Ghana. Fourteen nurses designated as key informants with different backgrounds as nurse educators and leaders were purposively sampled to participate. Data were collected through in-depth individual interviews; all interviews were conducted in English, audio-taped and transcribed verbatim. The study revealed that nurses' inadequate pain management knowledge might have resulted from curriculum gaps during training; inadequate clinical supervision, study days, and workshops for practising nurses; lack of funding for organising regular workshops; and, negative attitudes of nurses whereby new information learned at workshops was not readily applied in clinical practice. It was concluded that nursing curricula at all levels of training in Ghana should incorporate credit-bearing courses on pain management, and appropriate pain management education programmes should be instituted for practising nurses. Regular monitoring and evaluation of the impact of such education programs is required. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Managers' leadership and critical care nurses' intent to stay. (United States)

    Boyle, D K; Bott, M J; Hansen, H E; Woods, C Q; Taunton, R L


    Cyclical fluctuations in turnover of critical care nurses are a large and complex problem. Managers' leadership characteristics may be a determinant of critical care nurses' intent to stay in the job. To examine the direct and indirect effects of nurse-managers' characteristics of power, influence, and leadership style on critical care nurses' intent to stay in the nurses' employment positions. The sample was 255 staff nurses in intensive care units at 4 urban hospitals. Established instruments with sound reliability and validity were used to assess the predictor, intervening, and outcome variables. Path analysis was used to examine the relationships in a conceptual model of intent to stay. The model explained 52% of the variance in intent to stay, and managers' characteristics were significant at each stage. Managers' position power and influence over work coordination had a direct link to intent to stay; structuring expectations and consideration contributed indirectly through the variables of instrumental communication, autonomy, and group cohesion. Instrumental communication, autonomy, and group cohesion decreased job stress and thus increased job satisfaction. Job satisfaction was directly linked with intent to stay. Inclusion of nurse-managers' characteristics explained more variance in intent to stay than did previous models. Managers with leadership styles that seek and value contributions from staff, promote a climate in which information is shared effectively, promote decision making at the staff nurse level, exert position power, and influence coordination of work to provide a milieu that maintains a stable cadre of nurses.

  3. Barriers to Asthma Management for School Nurses: An Integrative Review (United States)

    Hanley Nadeau, Ellen; Toronto, Coleen E.


    Childhood asthma is a growing health concern. Asthma is the most common chronic illness of childhood and a leading cause of emergency room visits, hospitalizations, and school absenteeism. School nurses play a valuable role in asthma management. The purpose of this integrative review is to examine barriers to asthma management for school nurses in…

  4. Nurse managers and budgeting: professional/bureaucratic conflict? (United States)

    Abernethy, M A; Stoelwinder, J U


    Professional/bureaucratic conflict theory suggests that the extent to which nurse managers use management control systems will depend on whether their goal orientation is to system rather than output or derived goals. This article examines the use of budgeting as a management control strategy, in relation to the goal orientation of nurse managers, in four large teaching hospitals. The goal orientations and use of budgeting by nurse managers is also compared with those of physician managers and other sub-unit managers. The results indicate that nurse managers appear to be developing their goals of professionalization without a diminution of their organizational focus or their orientation towards providing a high standard of patient care.

  5. Challenges of nurses' empowerment in the management of patient aggression: A qualitative study

    Directory of Open Access Journals (Sweden)

    Tahereh Ramezani


    Full Text Available Background: Patients' aggression in the mental care setting is a global health problem with major psychological, physical, and economic consequences; nurse empowerment to manage this aggressive behavior is an important step in psychiatric nursing. The aim of this study was to explore psychiatric nurses' experiences of the challenges of empowerment in the management of patients' aggression. Materials and Methods: This qualitative study was performed among 20 nurses working in a major referral psychiatric center in Iran during 2014–2016. The purposive sampling method was used for selecting the participants. Data were collected through semi-structured interviews, observations, and filed notes. Inductive content analysis was used for data analysis. Results: Three categories and ten subcategories were identified: inefficient organizational policy (limited human resources, mandatory shifts, shortage of protective equipment, lack of motivational sparks; insufficient job growth (failure to implement training programs, insufficient effort for job competence, lack of clinical guidelines; and deficiencies in the organizational culture (inadequate autonomy and authority, lack of the culture of prevention, culture of fault and blame after an incident. Conclusions: Psychiatric nurses were not satisfied with organizational empowering conditions for the management of patients' aggression and reported low levels of access to learning opportunity, receiving support and essential resources that led to unnecessary use of containment measures. Managers must make every effort to create organizational context that make it possible to empower nurses for optimal practice.

  6. Emotional Intelligence of Nurse Managers: An Exploratory Study. (United States)

    Prufeta, Patricia


    The purposes of this study are to determine the level of emotional intelligence (EI) among nurse managers (NMs) in an academic medical center and determine the relationship of EI and demographic variables. Emotional intelligence is a concept that warrants further research in nursing because there is a huge gap in knowledge about nurse leaders' EI. Data were collected from 38 NMs recruited from a large academic medical center in the Northeast. Mean EI scores among NMs were average. Nurse managers with less than 2 years of experience had statistically significant lower "using emotions" branch score and strategic EI. Nurse managers with a masters' degree in nursing scored significantly higher in using emotions branch score than did those with a masters' degree in a related field. Opportunities exist to enhance the EI of NMs.

  7. Intensive Care Unit Nurses' Beliefs About Delirium Assessment and Management. (United States)

    Oosterhouse, Kimberly J; Vincent, Catherine; Foreman, Marquis D; Gruss, Valerie A; Corte, Colleen; Berger, Barbara


    Delirium, the most frequent complication of hospitalized older adults, particularly in intensive care units (ICUs), can result in increased mortality rates and length of stay. Nurses are neither consistently identifying nor managing delirium in these patients. The purpose of this study was to explore ICU nurses' identification of delirium, actions they would take for patients with signs or symptoms of delirium, and beliefs about delirium assessment and management. In this cross-sectional study using qualitative descriptive methods guided by the theory of planned behavior, 30 ICU nurses' responses to patient vignettes depicting different delirium subtypes were explored. Descriptive and content analyses revealed that nurses did not consistently identify delirium; their actions varied in different vignettes. Nurses believed that they needed adequate staffing, balanced workload, interprofessional collaboration, and established policy and protocols to identify and manage delirium successfully. Research is needed to determine if implementing these changes increases recognition and decreases consequences of delirium. ©2016 American Association of Critical-Care Nurses.

  8. Nurse practitioner integration: Qualitative experiences of the change management process. (United States)

    Lowe, Grainne; Plummer, Virginia; Boyd, Leanne


    The aim of this qualitative research was to explore perceptions of organisational change related to the integration of nurse practitioners from key nursing stakeholders. The ongoing delivery of effective and efficient patient services is reliant upon the development and sustainability of nurse practitioner roles. Examination of the factors contributing to the underutilization of nurse practitioner roles is crucial to inform future management policies. A change management theory is used to reveal the complexity involved. Qualitative interviews were undertaken using a purposive sampling strategy of key stakeholders. Thematic analysis was undertaken and key themes were correlated to the theoretical framework. The results confirm the benefits of nurse practitioner roles, but suggest organisational structures and embedded professional cultures present barriers to full role optimization. Complicated policy processes are creating barriers to the integration of nurse practitioner roles. The findings increase understanding of the links between strategic planning, human resource management, professional and organisational cultures, governance and politics in change management. Effective leadership drives the change process through the ability to align key components necessary for success. Sustainability of nurse practitioners relies on recognition of their full potential in the health care team. The results of this study highlight the importance of management and leadership in the promotion of advanced nursing skills and experience to better meet patient outcomes. The findings reinforce the potential of nurse practitioners to deliver patient centred, timely and efficient health care. © 2018 John Wiley & Sons Ltd.

  9. Factors relating to professional self-concept among nurse managers. (United States)

    Kantek, Filiz; Şimşek, Belkıs


    To investigate the self-concept in nurse managers in Turkey and the effects of certain variables on professional self-concept. Professional self-concept plays a significant role in improving certain professional behaviours. Nursing managers have the potential to influence other members of the profession with their attitudes and behaviours. The study was designed as a cross-sectional descriptive study. This study was conducted with 159 nurse managers in nine different hospitals. The study data were collected with a Personal Information Form and Professional Self-concept Nursing Inventory, and the data analysis was accomplished with descriptive statistics, Cronbach's alpha coefficients and Chi-squared Automatic Interaction Detector analyses. The professional self-concept score of nurse managers was 3·33 (SD = 0·308). Professional competence subdimension had the highest scores, while professional satisfaction subdimension had the lowest. The types of hospital were found to be influential on professional self-concept. The types of hospital were reported to influence the professional self-concept of nurses. Nursing managers are visionaries who can potentially influence nursing practices and decisions. Nursing leaders must monitor and administer strategies to improve their professional self-concept. © 2017 John Wiley & Sons Ltd.

  10. Transformational leadership: the development of a model of nursing case management by the army nurse corps. (United States)

    Hocker, Susan M; Trofino, Joan


    Management philosophy and culture of any organization must match the nursing professions' core value of caring. Organizational conflict symptomology includes communication barriers and widely differing values. Employment of accountability based systems and bringing nurses into governance prevents conflict and improves job satisfaction. This article identifies the barriers to case management program development and discusses strategies for its successful implementation. Today's most successful organizations will implement an institution-wide commitment to a culture within which excellence flourishes. Creative staffing models and professional practice partnerships such as nursing case management will be supported and encouraged by executive leadership; they work as a team and will be jointly accountable for positive outcomes The United States Army Nurse Corps has the framework necessary to develop a premiere nursing organization. Case management departments may adopt these techniques to improve working relationships and leadership capacity within their organizations.

  11. Leadership styles in nursing management: implications for staff outcomes

    Directory of Open Access Journals (Sweden)

    James Avoka Asamani


    Full Text Available Introduction: Nursing is a people-centred profession and therefore the issue of leadership is crucial for success. Nurse managers’ leadership styles are believed to be important determinant of nurses’ job satisfaction and retention. In the wake of a global nursing shortage, maldistribution of health workforce, increasing healthcare costs and expanding workload, it has become imperative to examine the role of nurse managers’ leadership styles on their staff outcomes. Using the Path-Goal Leadership theory as an organised framework, this study investigated the leadership styles of nurse managers and how they influence the nursing staff job satisfaction and intentions to stay at their current workplaces.Methods: The study employed a cross-sectional survey design to collect data from a sample of 273 nursing staff in five hospitals in the Eastern Region of Ghana. Descriptive and regression analyses were performed using SPSS version 18.0Results: Nurse managers used different leadership styles depending on the situation, but were more inclined to the supportive leadership style, followed by the achievement-oriented leadership style and participative leadership style. The nursing staff exhibited moderate levels of job satisfaction. The nurse managers’ leadership styles together explained 29% of the variance in the staff job satisfaction. The intention to stay at the current workplace was low (2.64 out of 5 among the nursing staff. More than half (51.7% of the nursing staff intended to leave their current workplaces, and 20% of them were actively seeking the opportunities to leave. The nurse managers’ leadership styles statistically explained 13.3% of the staff intention to stay at their current job position.Conclusions: These findings have enormous implications for nursing practice, management, education, and human resource for health policy that could lead to better staff retention and job satisfaction, and ultimately improve patient care.  

  12. Existential encounters: nurses' descriptions of critical incidents in end-of-life cancer care. (United States)

    Browall, Maria; Henoch, Ingela; Melin-Johansson, Christina; Strang, Susann; Danielson, Ella


    Nurses working with cancer patients in end of life care need to be prepared to encounter patients' psychosocial and spiritual distress. The aim of this study was to describe nurses' experiences of existential situations when caring for patients severely affected by cancer. Nurses (registered and enrolled) from three urban in-patient hospices, an oncology clinic and a surgery clinic and a palliative homecare team were, prior to the start of a training program, invited to write down their experiences of a critical incident (CI), in which existential issues were featured. Eighty-eight CIs were written by 83 nurses. The CIs were analyzed with qualitative content analysis. Two main themes were found: Encounters with existential pain experiences, which concerned facing death and facing losses; and Encountering experiences of hope, which concerned balancing honesty, and desire to live. This study points out that health care professionals need to be aware of patients' feelings of abandonment in exposed situations such as patients' feelings of existential loneliness. That there are some patients that express a desire to die and this makes the nurses feel uncomfortable and difficult to confront these occurrences and its therefore important to listen to patients' stories, regardless of care organization, in order to gain access to patients' inner existential needs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Management and leadership in nursing: an Australian educational perspective. (United States)

    Dignam, Denise; Duffield, Christine; Stasa, Helen; Gray, Joanne; Jackson, Debra; Daly, John


    In this article, we present an Australian perspective on issues influencing management and leadership education in nursing. Nurse leaders and managers work in a context of high pressure, uncertainty and rapid change, and face unprecedented challenges on a daily basis. In the present paper, we reflect on the issues and challenges facing providers of management education for nursing, and consider these challenges in relationship to current trends and imperatives. Collaborative approaches between educational and clinical settings are needed to ensure quality, relevant educational support for managers and leaders, and enhance curriculum integrity. There is a need for contemporaneous and relevant research to inform innovative models of collaborative education. © 2011 Blackwell Publishing Ltd.

  14. The incidence of depression and its risk factors in Dutch nursing homes and residential care homes. (United States)

    Boorsma, Marijke; Joling, Karlijn; Dussel, Martine; Ribbe, Miel; Frijters, Dinnus; van Marwijk, Harm W J; Nijpels, Giel; van Hout, Hein


    Although it is known that depression is highly prevalent in institutionalized older adults, little is known about its incidence and risk factors in nursing homes and residential care homes. The aim of this study was to investigate and compare the incidence and associated risk factors for depression in Dutch nursing homes and residential care homes. Data on depression were extracted from the Vrije Universiteit naturalistic cohort on routine care monitoring with the Minimum Data Set of the Resident Assessment Instrument. A total of 1,324 residents in six nursing homes and 1,723 residents in 23 residential care homes with an average follow-up of 1.2 years. Depression was defined as a clinical diagnosis according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria and the use of antidepressants. Residents with prevalent depression at baseline were excluded. The incidence rate was 13.6 per 100 person years in the nursing homes and 10.2 per 100 person years in the residential care homes. The independent risk factors for in-home depression for residents in nursing homes included dementia (OR: 1.7; 95% CI: 1.02-2.95) and a score of 3 or more on the Depression Rating Scale (odds ratio [OR]: 2.1; 95% confidence interval [CI]: 1.23-3.70). A protective effect was seen on the use of a hearing aid (OR: 0.3; 95% CI: 0.12-0.80). In the residential care homes, being male (OR: 2.1; 95% CI: 1.27-3.30), having cancer (OR: 2.9; 95% CI: 1.64-4.95), and a score of 2 or higher on the Cognitive Performance Scale (OR: 1.5; 95% CI: 1.05-2.22) increased the risk to develop depression. Age greater than 85 years (OR: 0.5; 95% CI: 0.31-0.67) and hearing impairment (OR: 0.8; 95% CI: 0.60-1.00) appeared to be protective. The incidence rate for depression in residents of Dutch nursing homes and residential care homes was high and the associated risk factors found may have important implications for staff. 2012 American Association for Geriatric Psychiatry

  15. Effect of a nurse-implemented sedation protocol on the incidence of ventilator-associated pneumonia. (United States)

    Quenot, Jean-Pierre; Ladoire, Sylvain; Devoucoux, Fabrice; Doise, Jean-Marc; Cailliod, Romain; Cunin, Nicole; Aubé, Hervé; Blettery, Bernard; Charles, Pierre Emmanuel


    To determine whether the use of a nurse-implemented sedation protocol could reduce the incidence of ventilator-associated pneumonia in critically ill patients. Two-phase (before-after), prospective, controlled study. University-affiliated, 11-bed medical intensive care unit. Patients requiring mechanical ventilation for >or=48 hrs and sedative infusion with midazolam or propofol alone. During the control phase, sedatives were adjusted according to the physician's decision. During the protocol phase, sedatives were adjusted according to a protocol developed by a multidisciplinary team including nurses and physicians. The protocol was based on the Cambridge scale, and sedation level was adjusted every 3 hrs by the nurses. Standard practices, including weaning from the ventilator and diagnosis of VAP, were the same during both study phases. A total of 423 patients were enrolled (control group, n = 226; protocol group, n = 197). The incidence of VAP was significantly lower in the protocol group compared with the control group (6% and 15%, respectively, p = .005). By univariate analysis (log-rank test), only use of a nurse-implemented protocol was significantly associated with a decrease of incidence of VAP (p < .01). A nurse-implemented protocol was found to be independently associated with a lower incidence of VAP after adjustment on Simplified Acute Physiology Score II in the multivariate Cox proportional hazards model (hazard rate, 0.81; 95% confidence interval, 0.62-0.95; p = .03). The median duration of mechanical ventilation was significantly shorter in the protocol group (4.2 days; interquartile range, 2.1-9.5) compared with the control group (8 days; interquartile range, 2.2-22.0; p = .001), representing a 52% relative reduction. Extubation failure was more frequently observed in the control group compared with the protocol group (13% and 6%, respectively, p = .01). There was no significant difference in in-hospital mortality (38% vs. 45% in the protocol vs


    Heydari, Abbas; Najar, Ali Vafaee; Bakhshi, Mahmoud


    Nurses are the main users of supplies and equipment applied in the Intensive Care Units (ICUs) which are high-priced and costly. Therefore, understanding ICU nurses' experiences about resource management contributes to the better control of the costs. This study aimed to investigate the culture of nurses' working environment regarding the resource management in the ICUs in Iran. In this study, a focused ethnographic method was used. Twenty-eight informants among ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations as a participant observer was used for data gathering. Data analysis was performed using the methods described by Miles and Huberman (1994). Two main themes describing the culture of ICU nurses regarding resource management included (a) consumption monitoring and auditing, and (b) prudent use. The results revealed that the efforts for resource management are conducted in the conditions of scarcity and uncertainty in supply. ICU nurses had a sense of futurism in the supply and use of resources in the unit and do the planning through taking the rules and guidelines as well as the available resources and their values into account. Improper storage of some supplies and equipment was a reaction to this uncertain condition among nurses. To manage the resources effectively, improvement of supply chain management in hospital seems essential. It is also necessary to hold educational classes in order to enhance the nurses' awareness on effective supply chain and storage of the items in the unit stock.

  17. Financial literacy as an essential element in nursing management practice. (United States)

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


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

  18. Challenges and leadership strategies for managers of nurse practitioners. (United States)

    Reay, Trish; Golden-Biddle, Karen; Germann, Kathy


    The aim of this paper is to report on the findings from our research into the recent introduction of nurse practitioners in Alberta, Canada. Through an organizational research perspective, we identify the critical role of health care managers in developing a sustainable nurse practitioner role. Previous literature has focused on nurse practitioners themselves as the key factor in their integration into the health care system. Although they are qualified and organizationally well placed, managers of nurse practitioners have been overlooked as a critical part of implementation strategies. We interviewed 25 nurse practitioners and seven of their managers. Through our data analysis we identified three major challenges for managers: (1) clarifying the reallocation of tasks; (2) managing altered working relationships within the team; (3) continuing to manage the team in an evolving situation. Associated with these challenges, we propose leadership strategies that managers may find useful as they work through the consequences of introducing the nurse practitioner role. These strategies are: * encourage all team members to sort out 'who does what'; * ensure that task reallocation preserves job motivating properties; * give consideration to how tasks have been allocated when issues identified as 'personal conflict' arise; * pay attention to all perspectives of the working relationships within the team; * facilitate positive relationships between team members; * lead from a 'balcony' perspective; * work with the team to develop goals that are not over focused on the nurse practitioner; * regularly share with other managers the experiences and lessons learned in introducing nurse practitioners. For managers to be most effective, they need to address three challenges that are of a managerial, not clinical, nature. By implementing specific leadership strategies, managers of nurse practitioners can facilitate the introduction of the new role and improve its sustainability in

  19. Management of adult spontaneous spondylodiscitis and its rising incidence. (United States)

    Sur, A; Tsang, K; Brown, M; Tzerakis, N


    Spondylodiscitis refers to the infection of the intervertebral disc and osteomyelitis of the adjacent endplates, and it is uncommon in the developed world. Broad consensus indicates its incidence is on the rise. The aim of this retrospective study was twofold. First, we sought to give an up-to-date incidence estimate by comparing case presentation over two time periods (1995-1999 and 2008-2011). Data from the England and Wales census in 2001 and 2011 were used for incidence estimation. The second part of this study aimed to generate management guidance from data from medical and radiographic records of the 2008-2011 patient cohort. The incidence of adult spontaneous spondylodiscitis in the local region between 2008 and 2011 was 3.67/100,000 per year, representing a 150% increase from the incidence in 1995-1999. Our data demonstrate that methicillin sensitive Staphylococcus aureus remains the most common offending pathogen of spontaneous spondylodiscitis. The mean C-reactive protein (CRP) level remained at >30mg/l after a month of starting antibiotic treatment in both medically and surgically managed groups. Evidence suggests that the incidence of spondylodiscitis is on the rise. A review of our case series has demonstrated the effectiveness of intravenous antibiotic therapy. While no official guidance exists for when to switch from intravenous to oral antibiotics, our study shows that CRP at 1 month is >30mg/l and we recommend 6 weeks of intravenous therapy, followed by 6 further weeks of oral therapy.

  20. Nursing Care Model Based on Knowledge Management in Preventing Nosocomial Infection After Caesarean Section in Hospital

    Directory of Open Access Journals (Sweden)

    Ahsan Ahsan


    Full Text Available Introduction: Nosocomial infection is one indicator of the quality of health services in the community, which also determines the image of health care institutions becauseit was a major cause of morbidityand death rate (mortality in hospital. Nursing care based on knowledge management is established from identification knowledge which is required, prevention performance of nosocomial infections post section caesarea. Nosocomial infections component consists of wound culture result. Method: This study was an observational study with a quasi experimental design. The population was all of nursing staff who working in obstetrics installation in hospitals A and B as much as 46 people. Sample was the total population. Data was collected through questionnaire, observation sheets and examination of the wound culture. Data was analyzed using t test B 1.274 dan p=0.028 Result: The result showed that 1 there was difference in knowledge management implementation before and after training; 2 there was difference in nurse’s performance in preventing nosocomial infection before and after training; 3 there is significant relationship between nurse’s performance in preventing nosocomial infection and infection incidence; 4 there is no significant difference of nursing care impementation on nosocomial incidence. Discussion: In conclusion, the development of nursing care based on knowledge management as a synthesis or induction of findings directed at 1 nurses’ knowledge does not affect the performance of the prevention of nosocomial infections; 2 knowledge management has a positive effect on the performance of the prevention of nosocomial infections; 3 implementation of infection prevention is integrated capabilities between knowledge, skills and attitudes of nurses in implementing performance in care. Keywords: model prevention, nosocomial infections, nursing care, knowledge management, sectio Caesarea

  1. Nursing and Focal Dyscognitive Seizures: A Clinical Update When Managing Risk Using Advanced Nursing Skills. (United States)

    Holland, Christine; Edward, Karen-Leigh; Giandinoto, Jo-Ann


    Focal seizures are divided into simple and dyscognitive, with the latter resulting in the alteration of consciousness. In the ictal and postictal stages, patients may present with confusion, delirium, and psychosis, presenting a risk of safety to themselves and others. This article presents 3 case studies where patients have been admitted for visual and electroencephalographic monitoring. Seizure activity is provoked for the diagnosis and development of a management plan. These cases illustrate the unique nursing implications when caring for patients experiencing focal dyscognitive seizures, highlighting the unique circumstances for the neuroscience nurse regarding risk management, safe administration of radioactive isotopes, detection of subtle seizure manifestation, and use of family as experts in patient-centered care. Through a deliberate onset of seizures, neuroscience nurses are placed in nontypical nursing situations, thus managing risk in unpredictable conditions and displaying advanced and distinctive nursing skills.

  2. Nursing intranet for communication and knowledge management. (United States)

    Teow, Alvin; Lim, Wei Chen; Tan, Lay Geok


    Leveraging on staff's familiarity with the global Internet and the Hospital Information Technology infrastructure, nurses at Singapore General Hospital (SGH) first took the challenge to design and develop an in-house intranet, which serves as a communication network in 1997. This nursing intranet was further enhanced using multi-media technology to develop e-learning modules on nursing specialty, skill-based, and audio slides presentation training. In addition, it also serves as a repository for policies, operational, nursing procedure documents and catalogue of forms, patient instruction pamphlets. Nurses can easily print all these forms and teaching brochures on-line. The nursing intranet offers cost-effective solution for distributing information through virtual network and accessible from over 700 points in SGH, 6 other affiliated medical institutions, and from nurses' homes too.

  3. The impact of nurse managers' leadership styles on ward staff. (United States)

    Saleh, Usama; O'Connor, Tom; Al-Subhi, Hattan; Alkattan, Rana; Al-Harbi, Saad; Patton, Declan


    to explore the nature of leadership styles used by the nursing management team, as perceived by nurses working at the bedside. leadership style is related to job satisfaction, staff retention, costs, and quality of care. The leadership styles of managers can be crucial in the healthcare setting, but very few studies have focused on them. the study employed qualitative methodology, involving 35 nurses working in different specialties of a medical city in Saudi Arabia. Data collection consisted of completing demographic and professional information and a semi-structured interview using open-ended questions. a phenomenologic-hermeneutic approach was used to identify major themes. the findings showed that participants described four types of leadership styles: relational leadership, preferential leadership, communication chain leadership, and ineffectual leadership. the leadership style employed by nurse managers has a major impact on nurses' satisfaction, turnover, and the quality of patient care they deliver.

  4. [Managment in nursing and the administration of third sector organizations]. (United States)

    Ruthes, Rosa Maria; Cunha, Isabel Cristina Kowal Olm


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

  5. Incidence and management of postoperative bile leaks: A ...

    African Journals Online (AJOL)

    Incidence and management of postoperative bile leaks: A prospective cohort analysis of 467 liver resections. A.J. Dell, J.E.J. Krige, E. Jonas, S.R. Thomson, S.J. Beningfield, U.K. Kotze, S.A. Tromp, S. Burmeister, M.M. Bernon, P.C. Bornman ...

  6. Relationship between leadership styles of nurse managers and nurses' job satisfaction in Jimma University Specialized Hospital. (United States)

    Negussie, Nebiat; Demissie, Asresash


    Leadership style of nurse managers plays a significant role in nurses' job satisfaction. However, there is limited literature in areas related to nurses' manager leadership style. The objective of this research was thus to investigate the relationship between leadership style of nurse managers and nurses' job satisfaction in Jimma University Specialized Hospital. The study was conducted at Jimma University Specialized Hospital from January to June 2012 and used a non-experimental correlation design. All full time, non-supervisory nurses with an experience of more than one year in nursing profession were participated in the study. The Multifactor Leadership Questionnaire and Minnesota Satisfaction Questionnaire were used to collect data. Data were entered and analyzed using SPSS version16.0 statistical software. The results were analyzed through descriptive statistics followed by the application of inferential statistics on the variables. Significance level was considered when pquestionnaires were returned out of 186 copies distributed to respondents. The result indicated that nurses can prefer transformational leadership style over transactional leadership style and had moderate-level intrinsic (M=2.72, SD=0.71) but low level of extrinsic job satisfaction (M=1.83, SD=0.68). Furthermore, from transactional leadership, only contingent reward was found to be statically significant and correlated with extrinsic (B=0.45, pleadership style were statistically significant and correlated with both intrinsic and extrinsic job satisfaction. Nurses tended to be more satisfied with the transformational leadership than transactional leadership style. Therefore, nurses' managers should use transformational leadership style in order to increase nurses' job satisfaction.

  7. Behavioral Health Emergencies Managed by School Nurses Working with Adolescents (United States)

    Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy


    Background: As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health…

  8. The Experience of Intense Pain: Nursing Management and Interventions. (United States)

    Kiser-Larson, Norma

    Personal stories of illness give depth to otherwise clinical descriptions of diagnoses. This article offers an autobiographical narrative of complications after total knee replacement surgery. Diagnosis and nursing management of acute compartment syndrome, nociceptive and neuropathic origins of pain, pharmacologic and nursing interventions for pain, the use of prayer in illness, and compassionate caring from a Christian perspective are discussed.

  9. Improvements in disaster planning and directions for nursing management. (United States)

    Danna, Denise; Bernard, Marirose; Jones, John; Mathews, Pamela


    Since Hurricane Katrina, there have been numerous lessons learned and improvements in disaster planning and nursing management. The subsequent Hurricane Gustav allowed nurses and disaster planners to "test the system" and identify improvements that worked and did not. The authors outline those improvements and give direction for change and further improvements.

  10. Factors that influence patient advocacy by pain management nurses: results of the American society for pain management nursing survey. (United States)

    Ware, Laurie Jowers; Bruckenthal, Patricia; Davis, Gail C; O'Conner-Von, Susan K


    What is the meaning of advocacy, and how does it relate to the nurse who wants patients to experience optimum pain management? This question and the lack of empirical data provided the stimulus for the American Society for Pain Management Nursing (ASPMN) Research Committee to explore ASPMN members' beliefs, knowledge, and skills regarding pain management advocacy activities. The specific aim of the study was to determine the educational needs for and barriers of advocacy for nurses working with patients experiencing pain. An ASPMN Advocacy Survey Instrument was developed to gather data about advocacy activities and interventions. The sample consisted of 188 ASPMN nurses (20% of the membership) who responded via the internet. Study findings revealed that the majority of nurse respondents were active in personal advocacy, serving as guardians of the patient. They confronted physicians as necessary and assisted patients to evaluate their pain management. Regarding making the public aware of pain management-related issues (i.e., public awareness advocacy), the respondents were not as active. Respondents were knowledgeable about pain management and best practices/best evidence, with the exceptions of legislative issues and media training. These two areas need support and educational intervention. Additional areas in need of education and training, as identified by respondents, are social and political advocacy interventions. "Lack of time" was identified as the barrier to advocacy experienced by the greatest number of nurses. Copyright © 2011 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  11. Major incident medical management and support: The practical approach at the scene Kevin Mackway-Jones Major Incident Medical Management and Support: The Practical Approach at the Scene Wiley-Blackwell £41.99 196pp 9781405187572 1405187573 [Formula: see text]. (United States)


    ALTHOUGH THIS excellent, informative book is intended primarily to be a manual for the pre-major incident medical management and support course, it would be a useful resource in any emergency department and a useful guide for individual nurses who provide care at major incident scenes.

  12. Leadership styles of nurse managers and registered sickness absence among their nursing staff. (United States)

    Schreuder, Jolanda A H; Roelen, Corné A M; van Zweeden, Nely F; Jongsma, Dianne; van der Klink, Jac J L; Groothoff, Johan W


    Sickness absence leads to understaffing and interferes with nursing efficiency and quality. It has been reported in literature that managerial leadership is associated with self-reported sickness absence in the working population. This study investigated the relationship between managerial leadership and sickness absence in health care by associating nurse managers' leadership styles with registered sickness absence among their nursing staff. The cross-sectional study included 699 nurses working in six wards (staff range = 91-140 employees) of a Dutch somatic hospital employing a total of 1,153 persons. The nurse managers heading the wards were asked to complete the Leadership Effectiveness and Adaptability Description questionnaire for situational leadership. The Leadership Effectiveness and Adaptability Description scores were linked to employer-registered nursing staff sickness absence. High relationship-high task behavior (odds ratio [OR] = 0.76, 95% confidence interval [CI] = 0.65-0.85) and high relationship-low task behavior (OR = 0.37, 95% CI = 0.14 -0.98) were inversely related to the number of short (one to seven consecutive days) episodes of sickness absence among the staff. Low relationship-high task styles (OR = 2.44, 95% CI = 1.14-5.22) as well as low relationship-low task styles (OR = 2.44, 95% CI = 1.26-4.71) were positively associated with the number of short episodes of sickness absence. However, the leadership styles only explained 10% of the variance in short episodes of sickness absence. Leadership styles are associated with registered sickness absence. The nursing staff of relationship-oriented nurse managers has fewer short episodes of sickness absence than the staff of task-oriented managers. Training nurse managers in relational leadership styles may reduce understaffing and improve nursing efficiency and quality.

  13. Canadian hospital nurses' roles in communication and decision-making about goals of care: An interpretive description of critical incidents. (United States)

    Strachan, Patricia H; Kryworuchko, Jennifer; Nouvet, Elysée; Downar, James; You, John J


    Nurses in acute medical units are uniquely positioned to support goals of care communication. Further understanding of nurse and physician perceptions about hospital nurses' actual and possible roles was required to improve goals of care communication. To critically examine nurse and physician perceptions of the nurse's role in communication with seriously ill patients and their families. We focus on the qualitative component of a mixed method study. We employed an interpretive descriptive approach informed by Flanagan's critical incident technique. Participants were recruited from the acute medical units at three tertiary care hospitals in three Canadian provinces. Thirty participants provided interviews (10 from each site): 12 nurses, 9 staff physicians and 9 medical resident physicians. Participants' described "critical incidents" they considered as "excellent" or "poor" or "usual" practice. Interviews, were audiotaped and transcribed. Team-based analysis used constant comparison and triangulation to identify healthcare team members' roles in goals of care communication. We identified two major themes from 120 critical incidents: 1) the ambiguous nature of the nurse's role in formal, physician-led, decision-making communication, and 2) embedded in care serious illness communication. Physicians understood nurses' supportive role in relation to their own communication practices that culminated in decisions about care; nurses' reported their roles were determined by unit routines, physician practices and preferences, and their self-confidence in supporting decision-making. Nurses described their unique role in facilitating informal and spontaneous communication with patients and families that was critical background work to physician-led goals of care communication. Nurses and physicians had different understandings, practices and beliefs about goals of care communication The value of nurses embedded in care work is key to supporting the interprofessional team

  14. What do nurse managers say about nurses' sickness absenteeism? A new perspective. (United States)

    Baydoun, Mohamed; Dumit, Nuhad; Daouk-Öyry, Lina


    To explore nurses' sickness absenteeism from the perspective of nurse managers. Sickness absenteeism among health-care providers, especially nurses, remains a significant problem in an era of challenges to provide high quality care with the required skill mix. This in turn compromises the quality of care and adds to the costs of an organisation. A qualitative descriptive design was used. Data were collected from a governmental academic hospital in Lebanon. In-depth tape-recorded interviews were conducted with a total of 20 nurse managers. Data were analysed through a content analysis approach. Data analysis yielded three domains as follows: work-related, individual and organisational factors that lead to nurses' sickness absenteeism. This study conceptualised nurses' absenteeism from the nurse managers' perspective, and it revealed absence antecedents that are rarely reported elsewhere in the literature. The findings from this study can be utilised to design reform initiatives concerned with nurses' absenteeism and to decrease its negative consequences in terms of quality and cost. © 2015 John Wiley & Sons Ltd.

  15. Prospective Analysis of Nursing Management from the Students Voices

    Directory of Open Access Journals (Sweden)

    Rafael Alejandro Camejo Giménez


    Full Text Available This scientific article was intended to study management in nursing from a prospective analysis, interpret the meanings and meanings that social actors grant to the future of nursing management and unveil the importance of nursing management from prospectivity. The paradigm was interpretative under a qualitative approach, where the phenomenological method based on hermeneutics was applied. We selected 05 students from the first semester of nursing and 05 from the eighth for a total of 10 social actors. As a technique for obtaining the information I used as resources the in-depth interview, notes, photographs and recordings. The following categories emerged from the findings: Service management: training, administration and functions; Prospectivity: profile and futuristic scenario. The emerging categories triangulated and I can say that every bachelor who enters the career must know the functions of nursing. The contribution of the theoretician Michel Godet, among others, was considered. Finally, as a main finding, it was known that most nursing students do not know the future of the career and UCLA in the Deanery under study does not apply prospective management to determine cognitive and mental indicators in future Nursing graduates.

  16. Nurse managers' conceptions of quality management as promoted by peer supervision. (United States)

    Hyrkäs, Kristiina; Koivula, Meeri; Lehti, Kristiina; Paunonen-Ilmonen, Marita


    The aim of the study was to describe nurse managers' conceptions of quality management in their work as promoted by peer supervision. Quality management is one of the topical issues in a nurse manager's demanding and changing work. As first-line managers, they have a key role in quality management which is seen to create the system and environment for high quality services and quality improvement. Despite the official recommendations and definitions of quality management, several published reports have shown that there is no single solution for quality management. Peer supervision or the support provided by it to nursing managers have rarely been a subject of study. This study was carried out at Tampere University Hospital between 1996 and 1998. The peer supervision intervention was organized once a month, 2 hours at a time and in closed supervisor-led groups of nine nurse managers. Data were collected by themed interviews. Fifteen nurse managers participated in the study. The data were analysed using the phenomenographic method. Two main categories were formed of nurse managers' conceptions. The first described supportive and reflective characteristics of peer supervision. This main category was described by horizontal, hierarchical categories of support from peer group and reflection. The second main category described nurse managers' conceptions of individual development of leadership during peer supervision. This main category was also described by three horizontal categories: personal growth, finding psychological resources and internalization of leadership. The finding of this study show that peer supervision benefited nurse managers in quality management through reflection and support. The reflective and supportive characteristics of peer supervision promoted the nurse managers' individual development, but also that of leadership. It can be concluded that peer supervision promotes quality management in nurse managers' work.

  17. Leadership style and patient safety: implications for nurse managers. (United States)

    Merrill, Katreena Collette


    The purpose of this study was to explore the relationship between nurse manager (NM) leadership style and safety climate. Nursing leaders are needed who will change the environment and increase patient safety. Hospital NMs are positioned to impact day-to-day operations. Therefore, it is essential to inform nurse executives regarding the impact of leadership style on patient safety. A descriptive correlational study was conducted in 41 nursing departments across 9 hospitals. The hospital unit safety climate survey and multifactorial leadership questionnaire were completed by 466 staff nurses. Bivariate and regression analyses were conducted to determine how well leadership style predicted safety climate. Transformational leadership style was demonstrated as a positive contributor to safety climate, whereas laissez-faire leadership style was shown to negatively contribute to unit socialization and a culture of blame. Nursing leaders must concentrate on developing transformational leadership skills while also diminishing negative leadership styles.

  18. Safety Incident Management Team Report for NIMLT Case 50796

    LENUS (Irish Health Repository)


    This is a report on the management of a patient safety incident involving BowelScreen and symptomatic colonoscopy services at Wexford General Hospital (WGH). The patient safety incident relates to the work of a Consultant Endoscopist (referred to as Clinician Y) employed by WGH who undertook screening colonoscopies on behalf of the BowelScreen Programme since the commencement of the screening programme in WGH in March 2013. Clinician Y also performed non-screening colonoscopies for the diagnosis of symptomatic patients as part of routine surgical service provision at WGH.\\r\

  19. Specialist palliative care nurses' management of the needs of patients with depression. (United States)

    Hayes, Jessica Elizabeth; Hart, Bethne; Phillips, Jane


    Depression is an important condition to consider if we are to optimise the care outcomes for patients with palliative care needs. Depression has a high incidence in palliative patients, with up to 15% diagnosed with major depression and 37% expressing some form of depressive symptoms ( O'Connor et al, 2010 ). The challenge is to ensure that palliative care patients with depression are identified in a timely manner and that their depression is effectively managed. To examine how Australian specialist inpatient palliative care nurses perceive, assess and respond to depression in a patient case study. This descriptive pilot study is a replication of a United States study by Little et al (2005) , exploring contemporary Australian specialist palliative care nurses' screening, assessment and management of depression in people with a progressive life-limiting illness. A survey titled 'Specialist palliative care nurses managing patients with complex care needs' questioned the nursing assessment, knowledge and clinical care priorities related to a case vignette of a patient demonstrating signs of depression. A total of 33 nurses completed this survey. Less than half (39.4%) of the participants identified depression as a major issue arising from the case vignette. Depression screening tools were not widely known. Functionality assessments measuring activities of daily living were the most recognised and widely used tools by participants. This small sample pilot study demonstrated that specialist palliative care nurses are still not confident in their screening and responding to a patient with depression. The available evidenced based depression screening tools were unfamiliar to these nurses and not widely used which can result in depression remaining undetected and undermanaged. The connections between physical health and mental health need stronger recognition and response within nursing care of palliative patients.

  20. Becoming nursing manager in the nested and complex border of caring and management dimensions

    Directory of Open Access Journals (Sweden)

    Gabriela Marcellino de Melo Lanzoni


    Full Text Available The study aimed to understand the experience of managing medical-surgical inpatient units in a general hospital, highlighting the meaning of being a nursing manager, with the intention to qualify and instrument nurses for caring management practice in this scenario. This is a Grounded Theory research, conducted from August 2010 to August 2012, through interviews with 19 participants from the nursing team, distributed in 3 sampling groups. From the analysis emerged the phenomenon “Becoming a nursing manager in the nested and complex border of caring and management dimension”. To exercise caring management, nurses use management instruments as essential tools, they become capable theoretically and enhances, based on his experience, professional skills and personal characteristics.  We conclude that competency mobilization beyond the clinical aspect is needed; allowing the use of management instruments to make caring viable and to improve relational and interactive processes.

  1. A concept analysis of turnover intention: implications for nursing management. (United States)

    Takase, Miyuki


    This paper provides a review and concept analysis of turnover intention. The aim was to promote Nurse Managers' understanding of the meanings and mechanisms of turnover intention, which could help them counteract nurse turnover. Sixty-six papers published between January 1998 and August 2007 were collected from CINAHL, PubMed, and PsycINFO databases, and were subjected to Rogers' concept analysis. The results showed that turnover intention is a multi-stage process involving the voluntary departure of employees from their current position, and is triggered by negative psychological responses to internal/external job context. These psychological responses evolve into withdrawal cognition and behaviours, and lead to actual turnover. To prevent nurse turnover, Nurse Managers should closely observe the internal and external causes of turnover, and the stage of nurses' turnover intention.

  2. Dental trauma management by New York City school nurses. (United States)

    Choi, David; Badner, Victor M; Yeroshalmi, Farhad; Margulis, Keith S; Dougherty, Nancy J; Kreiner-Litt, Geri


    The purpose of this study was to assess the knowledge and ability of school nurses in NYC to manage and properly treat traumatic dental injuries. A survey questionnaire was sent to 160 randomly selected public schools and 40 randomly selected private schools in New York City. The questionnaire consisted of 24 multipart questions regarding background, personal experience, and knowledge of dental trauma. Seventy-four percent (74%) of the nurses rated their confidence in handling dental trauma in the middle range on a scale from 1 to 10. Sixty-two percent (62%) of nurses knew liquid was the optimal transportation method of an avulsed tooth; however, 52% of participants responded incorrectly that it was not appropriate to replant an avulsed permanent tooth. Ninety percent of nurses surveyed were interested in receiving further education in the management of dental trauma. This survey indicates that a gap of knowledge exists in the ability of school nurses to handle dental trauma.

  3. Stress Management and Coping Strategies among Nurses : A Literature Review


    Iyi, Obiora


    There is obvious need to have the safest working environments and the best quality of health care delivery to patients by nurses working in the hospitals. Effective stress management and coping strategies is one very important step towards this goal. This research aims to identify the major stressors for nurses and the most effective management and coping strategies as contained in literature. This involved excellent review of relevant articles in addition to deductive content analysis of the...

  4. [Job satisfaction of nurses in the clinical management units]. (United States)

    Martínez Lara, Concepción; Praena Fernández, Juan Manuel; Gil García, Eugenia


    Clinical Management Unit (CMU) is currently set in the Andalusian health institutions as the model reference management. This management model aims to make all healthcare professionals a powerful idea: the best performance of health resources is performed to drive clinical practice using the least number of diagnostic and therapeutic resources. The CMU not only aims at saving money, in the Clinical Management Agreement [1] are measured all the dimensions that make up the UGC: research, training, clinical process, the portfolio of services, objectives, financial management and indicators to control and security. The CMU is to transfer more responsibilities to Health Care Professionals, involving them in the management of the Unit. The CMU sets new approaches that directly affect health professionals and presents advantages and disadvantages for the Doctors and the Nurses, involved in achieving excellence in care work. Nurse Practitioners shows expectant before the changes are generated in health institutions and appears a discussion of skills derived from the CMU. Some Nurses believe that the bur, den of care to which they are subjected in public institutions has increased since the onset of the CMU and yet others believe that they are motivated and rewarded for the results obtained with this model of management. In health institutions, some professionals are more motivated than others and this is found in the outcome of health care activity [2]. Given the positive and negative perceptions that arise in the CMU Professional Nurses, it is considered appropriate to focus the objective of this work in the search for factors that influence job satisfaction of nurses in the CMU. There are few studies about the CMU [3] but are absent when linked with nursing, so the pursuit of scientific knowledge related to nursing management model based on Clinical and Quality Care can lead to establish new concepts around the nursing profession, a profession in which major changes are

  5. Implementing a nurse information system in a nurse-managed primary care practice: a process in progress. (United States)

    Wong, S T; Bernick, L A; Portillo, C; Stewart, A; Taylor, D; Duderrstadt, K; Gilliss, C L


    As part of a larger project, a nurse-managed primary care clinic (Valencia Pediatric and Family Practice) sought to implement a nursing information system for the purposes of (1) patient record keeping, (2) capturing advanced practice nursing interventions and outcomes and transforming them into standardized language, (3) project data management, and (4) evaluating advanced practice nursing care thereby improving and standardizing quality of care. This article represents the background information for selection of a data management system and early experiences of implementation.

  6. How staff nurses perceive the impact of nurse managers' leadership style in terms of job satisfaction: a mixed method study. (United States)

    Morsiani, Giuliana; Bagnasco, Annamaria; Sasso, Loredana


    To describe staff nurses' perceptions related to the leadership styles adopted by their nurse managers, identify which leadership style ensured job satisfaction in staff nurses and describe which behaviours nurse managers should change. Empirical literature suggests that leadership styles of nurse managers significantly influence staff satisfaction. However, few studies investigate how staff nurses perceive the leadership styles of their nurse managers, and how these impact upon the staff nurses' job satisfaction. This was a mixed method study, which included the administration of the Multi-factor Leadership Questionnaire and three focus groups. Ward nurse managers mostly adopted a transactional leadership style ('Management by exception active') aimed at monitoring errors and intervening to correct errors and punish, which had a negative impact on staff nurses' levels of job satisfaction. In contrast, the transformational leadership style, which is mostly correlated with satisfaction ('Idealized Influence Attributed', which staff nurses perceived as 'respect', 'caring for others', 'professional development' and 'appreciation'), was rarely practiced by nurse managers. The transformational leadership skills of Italian nurse managers need to be improved through behaviours based on greater respect, caring for others, professional development and appreciation. The present study could also serve as model to improve the leadership style of nurse managers in other countries. The themes of transformational leadership could serve as a guide for nurse managers to help them improve their leadership style, and improve the levels of job satisfaction in staff nurses. Owing to the complexity and the importance of this issue, classroom educational interventions would not be sufficient: it should be dealt as a strategic priority by nursing directors. © 2016 John Wiley & Sons Ltd.

  7. Management and leadership: a dual role in nursing education. (United States)

    Calpin-Davies, Philomena J


    The purpose of this paper is to review the dual concepts of leadership and management in nursing education. It provides a consideration of caring as the end purpose of nursing education and argues that empowered caring makes use of professional academic credentials to form collaborative alliances that influence health care delivery. Inspiring and empowering leadership also transform educational services. In particular the key issues of investing in technology, supporting life long learning and creating a community workplace are addressed. It concludes with the suggestion that the nurse education ought to be led and managed differently.

  8. Quality assurance feedback as a nursing management strategy. (United States)

    Brannon, D; Bucher, J A


    Quality assurance and effective nurse management can be viewed as intersecting goals. Objective feedback derived from quality assurance data is a potentially powerful means of enhancing nurses' performance and job satisfaction. The use of automated information systems to provide such direct feedback offers the additional advantage of recognizing nurses as self-monitoring, self-correcting professionals. The need, opportunity, and challenge involved in meshing quality assurance with human resource management through computer-generated feedback are discussed in the context of the home health care setting.

  9. Nurse manager succession planning: A cost-benefit analysis. (United States)

    Phillips, Tracy; Evans, Jennifer L; Tooley, Stephanie; Shirey, Maria R


    This commentary presents a cost-benefit analysis to advocate for the use of succession planning to mitigate the problems ensuing from nurse manager turnover. An estimated 75% of nurse managers will leave the workforce by 2020. Many benefits are associated with proactively identifying and developing internal candidates. Fewer than 7% of health care organisations have implemented formal leadership succession planning programmes. A cost-benefit analysis of a formal succession-planning programme from one hospital illustrates the benefits of the programme in their organisation and can be replicated easily. Assumptions of nursing manager succession planning cost-benefit analysis are identified and discussed. The succession planning exemplar demonstrates the integration of cost-benefit analysis principles. Comparing the costs of a formal nurse manager succession planning strategy with the status quo results in a positive cost-benefit ratio. The implementation of a formal nurse manager succession planning programme effectively reduces replacement costs and time to transition into the new role. This programme provides an internal pipeline of future leaders who will be more successful than external candidates. Using an actual cost-benefit analysis equips nurse managers with valuable evidence depicting succession planning as a viable business strategy. © 2017 John Wiley & Sons Ltd.

  10. Enhancing nurses' empowerment: the role of supervisors' empowering management practices. (United States)

    Montani, Francesco; Courcy, François; Giorgi, Gabriele; Boilard, Amélie


    This study tests a theoretical model where: (a) nurses' dispositional resistance to change is indirectly negatively related to behavioural empowerment through the mediating role of psychological empowerment; and (b) supervisors' empowering management practices buffer both the negative relationship between dispositional resistance to change and psychological empowerment and the indirect negative relationship between resistance to change and behavioural empowerment via psychological empowerment. Promoting a high level of empowerment among nursing personnel is important to ensure their effectiveness in the context of organizational change. It is thus essential to advance our current understanding of the factors that hamper nurses' psychological and behavioural expressions of empowerment and to clarify supervisor practices that can overcome such barriers. A cross-sectional research design. We collected survey data during 2012 from a sample of 197 nurses from a Canadian hospital undergoing a major organizational change. Results from moderated mediation analyses provided evidence for an indirect negative relationship between dispositional resistance to change and behavioural empowerment through psychological empowerment, and for a moderating (buffering) effect of supervisors' empowering management practices on this mediated relationship. These findings provided support for our hypotheses. Supervisors' empowering management practices represent an important contextual buffer against the negative effects of dispositional resistance to change on nurses' empowerment. Organizations should develop empowering management skills among nurses' supervisors to counteract the detrimental effects of dispositional resistance to change and to sustain an empowered nursing workforce. © 2015 John Wiley & Sons Ltd.

  11. Management support and perceived consumer satisfaction in skilled nursing facilities. (United States)

    Metlen, Scott; Eveleth, Daniel; Bailey, Jeffrey J


    How managers 'manage' employees influences important firm outcomes. Heskett, Sasser, and Schlesinger contend that the level of internal support for service workers will influence consumer satisfaction. This study empirically explores how skilled nursing facility (SNF) managers affect consumer satisfaction by encouraging employee effectiveness and listening to employees to determine how to improve employee effectiveness. We extend previous research by proposing management as a form of internal support and demonstrating its relationship to service process integration, as a distinct form of internal support. The results of our individual-level investigation of 630 nursing assistants from 45 SNFs provide support for our two-part hypothesis. First, active management support and process integration, as elements of internal support, do lead to increased employee satisfaction and employee effectiveness. Second, the increased employee satisfaction and effectiveness was positively related to consumer satisfaction, as evaluated by the service workers. Thus, there is a positive influence of management's internal support of nursing assistants on perceived consumer satisfaction.

  12. Conflict management styles used by nurse managers in the Sultanate of Oman. (United States)

    Al-Hamdan, Zaid; Shukri, Raghda; Anthony, Denis


    The study aimed at investigating the conflict management styles used by nurse managers in the Sultanate of Oman. Conflict is inevitable in daily nursing work. Several styles are used to manage conflict situations. In previous studies conducted in Western countries, avoiding and compromising conflict management styles appear to be the first choices for the nurses. In Arab countries, no study to date has examined the conflict management styles used by nurse managers to compare with the results from studies conducted in Western countries. Survey. A questionnaire was distributed to all nurse managers working in the three-management levels from nine referral hospitals in Sultanate of Oman, 271 were returned, a response rate of 86%. The results were analysed using spss version 16. Nurse managers in Oman used all five conflict management styles, with integrating style as the first choice followed in order by compromising, obliging, dominating and avoiding. These results differ from the results of the studies conducted on nurses in other countries. The results of this study have implications for people who work in the hospitals, whether practitioners or policy makers. Recommendations are offered to improve nurse managers' work environment. Conflict can affect patient care if handled badly. Poorly handled conflict results in lower staff morale and poorer retention, both adversely affect patient care. © 2011 Blackwell Publishing Ltd.

  13. The impact of ED nurse manager leadership style on staff nurse turnover and patient satisfaction in academic health center hospitals. (United States)

    Raup, Glenn H


    Nurse managers with effective leadership skills are an essential component to the solution for ending the nursing shortage. Empirical studies of existing ED nurse manager leadership styles and their impact on key nurse management outcomes such as staff nurse turnover and patient satisfaction have not been performed. The specific aims of this study were to determine what types of leadership styles were used by ED nurse managers in academic health center hospitals and examine their influence on staff nurse turnover and patient satisfaction. ED nurse managers were asked to complete the Multifactor Leadership Questionnaire and a 10-item researcher defined nurse manager role and practice demographics survey. Completed surveys (15 managers and 30 staff nurses) representing 15 out of 98 possible U.S. academic health centers were obtained. Fisher's exact test with 95% confidence intervals were used to analyze the data. The sample percentage of managers who exhibited Transformational leadership styles and demographic findings of nurse manager age, total years experience and length of time in current position matched current reports in the literature. A trend of lower staff nurse turnover with Transformational leadership style compared to non-Trasformational leadership styles was identified. However, the type of leadership style did not appear to have an effect on patient satisfaction. The ED is an ever-changing, highly regulated, critical-care environment. Effective ED nurse manager leadership strategies are vital to maintaining the standards of professional emergency nursing practice to create an environment that can produce management outcomes of decreased staff nurse turnover, thereby enhancing staff nurse retention and potentially impacting patient satisfaction.

  14. Looking ahead to our next generation of nurse leaders: Generation X Nurse Managers. (United States)

    Keys, Yolanda


    The present inquiry identifies elements of professional success, and personal and professional fulfilment as defined by Generation X Nurse Managers. Although work concerning Nurse Manager preparation has been documented, there is a paucity of research specific to the generation of nurses next in line to assume leadership roles. For the purposes of this study, a qualitative approach was used to develop insight regarding Generation X Nurse Managers and their perspectives on professional success, personal and professional fulfilment, and organisational environments that are conducive to loyalty and long-term professional commitment. Findings from this study reinforced those identified in the original study in that inflexible organisational cultures, a lack of opportunities for upward mobility, the need to be available at all times, feeling stereotyped or undervalued can all be barriers to members of Generation X perceptions of professional success and professional and personal fulfilment. Study findings suggest that Generation X Nurse Managers would benefit from initiatives focused on better preparation for the Nurse Manager role, openness to innovative scheduling alternatives and tailored support and feedback. © 2014 John Wiley & Sons Ltd.

  15. Incident alopecia areata and vitiligo in adult women with atopic dermatitis: Nurses' Health Study 2. (United States)

    Drucker, A M; Thompson, J M; Li, W-Q; Cho, E; Li, T; Guttman-Yassky, E; Qureshi, A A


    We aimed to determine the risk of alopecia areata (AA) and vitiligo associated with atopic dermatitis (AD) in a large cohort of US women, the Nurses' Health Study 2. We used logistic regression to calculate age- and multivariate-adjusted odds ratios to determine the risk of incident AA and vitiligo associated with AD diagnosed in or before 2009. A total of 87 406 and 87 447 participants were included in the AA and vitiligo analyses, respectively. A history of AD in 2009 was reported in 11% of participants. There were 147 incident cases of AA and 98 incident cases of vitiligo over 2 years of follow-up. AD was associated with increased risk of developing AA (OR 1.80, 95% CI 1.18-2.76) and vitiligo (OR 2.14, 95% CI 1.29-3.54) in multivariate models. In this study of US women, AD was associated with increased risk of incident vitiligo and AA in adulthood. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Care management in nursing within emergency care units

    Directory of Open Access Journals (Sweden)

    Roberta Juliane Tono de Oliveira


    Full Text Available Objective.Understand the conditions involved in the management of nursing care in emergency care units. Methodology. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Results. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. Conclusion. Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.

  17. Care management in nursing within emergency care units. (United States)

    Tono de Oliveira, Roberta Juliane; Vieira Hermida, Patrícia Madalena; da Silva Copelli, Fernanda Hannah; Guedes Dos Santos, José Luís; Lorenzini Erdmann, Alacoque; Regina de Andrade, Selma


    Understand the conditions involved in the management of nursing care in emergency care units. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.

  18. Fever management practices of neuroscience nurses: what has changed? (United States)

    Rockett, Hannah; Thompson, Hilaire J; Blissitt, Patricia A


    Current evidence shows that fever and hyperthermia are especially detrimental to patients with neurologic injury, leading to higher rates of mortality, greater disability, and longer lengths of stay. Although clinical practice guidelines exist for ischemic stroke, subarachnoid hemorrhage, and traumatic brain injury, they lack specificity in their recommendations for fever management, making it difficult to formulate appropriate protocols for care. Using survey methods, the aims of this study were to (a) describe how nursing practices for fever management in this population have changed over the last several years, (b) assess if institutional protocols and nursing judgment follow published national guidelines for fever management in neuroscience patients, and (c) explore whether nurse or institutional characteristics influence decision making. Compared with the previous survey administered in 2007, there was a small increase (8%) in respondents reporting having an institutional fever protocol specific to neurologic patients. Temperatures to initiate treatment either based on protocols or nurse determination did not change from the previous survey. However, nurses with specialty certification and/or working in settings with institutional awards (e.g., Magnet status or Stroke Center Designation) initiated therapy at a lower temperature. Oral acetaminophen continues to be the primary choice for fever management, followed by ice packs and fans. This study encourages the development of a stepwise approach to neuro-specific protocols for fever management. Furthermore, it shows the continuing need to promote further education and specialty training among nurses and encourage collaboration with physicians to establish best practices.

  19. Does performance management affect nurses' well-being? (United States)

    Decramer, Adelien; Audenaert, Mieke; Van Waeyenberg, Thomas; Claeys, Tine; Claes, Claudia; Vandevelde, Stijn; van Loon, Jos; Crucke, Saskia


    This article focuses on employee performance-management practices in the healthcare sector. We specifically aim to contribute to a better understanding of the impact of employee performance-management practices on affective well-being of nurses in hospitals. Theory suggests that the features of employee-performance management (planning and evaluation of individual performances) predict affective well-being (in this study: job satisfaction and affective commitment). Performance-management planning and evaluation and affective well-being were drawn from a survey of nurses at a Flemish hospital. Separate estimations were performed for different aspects of affective well-being. Performance planning has a negative effect on job satisfaction of nurses. Both vertical alignment and satisfaction with the employee performance-management system increase the affective well-being of nurses; however, the impact of vertical alignment differs for different aspects of affective well-being (i.e. job satisfaction and affective commitment). Performance-management planning and evaluation of nurses are associated with attitudinal outcomes. The results indicate that employee performance-management features have different impacts on different aspects of well-being. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Including information technology project management in the nursing informatics curriculum. (United States)

    Sockolow, Paulina; Bowles, Kathryn H


    Project management is a critical skill for nurse informaticists who are in prominent roles developing and implementing clinical information systems. It should be included in the nursing informatics curriculum, as evidenced by its inclusion in informatics competencies and surveys of important skills for informaticists. The University of Pennsylvania School of Nursing includes project management in two of the four courses in the master's level informatics minor. Course content includes the phases of the project management process; the iterative unified process methodology; and related systems analysis and project management skills. During the introductory course, students learn about the project plan, requirements development, project feasibility, and executive summary documents. In the capstone course, students apply the system development life cycle and project management skills during precepted informatics projects. During this in situ experience, students learn, the preceptors benefit, and the institution better prepares its students for the real world.

  1. Communication and the healthy work environment: nurse managers' perceptions. (United States)

    Hartung, Sheila Q; Miller, Mindi


    A qualitative design was used to decipher the viewpoints of nurse managers about communication trends associated with their leadership roles and unit subcultures. Disruptive behaviors such as poor communication and inadequate teamwork have been associated with patient harm and deficient workplace cultures. However, few studies have focused on nurse managers' perceptions of communication and a healthy workplace. A descriptive qualitative study was conducted using 12 in-depth interviews of 6 nurse managers to better understand communication patterns of managers. Analysis identified 5 themes and 13 subthemes. Workplace processes were identified that either promoted or hindered managers' abilities to set a positive tone and to stay connected to their staff, ensuring effective communication while meeting multiple unit and institutional challenges. Findings can be used to strengthen communication practices, obviate communication disconnects, and ensure a healthy workplace.

  2. Top Nurse-Management Staffing Collapse and Care Quality in Nursing Homes (United States)

    Hunt, Selina R.; Corazzini, Kirsten; Anderson, Ruth A.


    Director of nursing turnover is linked to staff turnover and poor quality of care in nursing homes; however the mechanisms of these relationships are unknown. Using a complexity science framework, we examined how nurse management turnover impacts system capacity to produce high quality care. This study is a longitudinal case analysis of a nursing home (n = 97 staff) with 400% director of nursing turnover during the study time period. Data included 100 interviews, observations and documents collected over 9 months and were analyzed using immersion and content analysis. Turnover events at all staff levels were nonlinear, socially mediated and contributed to dramatic care deficits. Federal mandated, quality assurance mechanisms failed to ensure resident safety. High multilevel turnover should be elevated to a sentinel event for regulators. Suggestions to magnify positive emergence in extreme conditions and to improve quality are provided. PMID:24652943

  3. Sociocultural Factors Influencing Incident Reporting Among Physicians and Nurses: Understanding Frames Underlying Self- and Peer-Reporting Practices. (United States)

    Hewitt, Tanya; Chreim, Samia; Forster, Alan


    Voluntary reporting of incidents is a common approach for improving patient safety. Reporting behaviors may vary because of different frames within and across professions, where frames are templates that individuals hold and that guide interpretation of events. Our objectives were to investigate frames of physicians and nurses who report into a voluntary incident reporting system as well as to understand enablers and inhibitors of self-reporting and peer reporting. This is a qualitative case study-confidential in-depth interviews with physicians and nurses in General Internal Medicine in a Canadian tertiary care hospital. Frames that health care practitioners use in their reporting practices serve as enablers and inhibitors for self-reporting and peer reporting. Frames that inhibit reporting are shared by physicians and nurses, such as the fear of blame frame regarding self-reporting and the tattletale frame regarding peer reporting. These frames are underpinned by a focus on the individual, despite the organizational message of reporting for learning. A learning frame is an enabler to incident reporting. Viewing the objective of voluntary incident reporting as learning allows practitioners to depersonalize incident reporting. The focus becomes preventing recurrence and not the individual reporting or reported on. Physicians and nurses use various frames that bound their views of self and peer incident reporting-further progress should incorporate an understanding of these deep-seated views and beliefs.

  4. Incidence of pneumonia in nursing home residents with dementia in the Netherlands: an estimation based on three differently designed studies. (United States)

    Zomer, T P; VAN DER Maaden, T; VAN Gageldonk-Lafeber, A B; DE Greeff, S C; VAN DER Steen, J T; Verhoef, L


    Pneumonia leads to considerable morbidity and mortality in nursing home residents with dementia. We assessed pneumonia incidence based on data from three different studies: (1) real-time national surveillance of healthcare-associated infections in nursing home residents in 2009-2015; (2) a randomized controlled trial in 2012-2015 to assess effects of a practical guideline in nursing home residents with dementia and pneumonia; and (3) a study in 2007-2010 to assess quality of dying in newly admitted nursing home residents with dementia. In national surveillance data, pneumonia incidence was calculated separately for psychogeriatric and somatic beds, as a proxy for residents with and without dementia. Weekly pneumonia incidence was significantly lower per 1000 psychogeriatric beds (3·9; 95% confidence interval (CI) 3·2-4·6) compared with 1000 somatic beds (5·7; 95% CI 5·1-6·3). Annual incidence per 1000 psychogeriatric beds was similar in national surveillance (range 78·9-117·1) and the trial (range 71·0-94·3), and significantly higher in newly admitted dementia residents (range 267·3-363·2). The incidence was highest during the first months after admission when compared with residents with longer stay. In conclusion, follow-up of pneumonia in newly admitted dementia residents may result in higher incidence, possibly due to higher risk in this population.

  5. Iranian senior nursing managers' experiences and understanding of social capital in the nursing profession. (United States)

    Manoochehri, Houman; Lolaty, Hamideh Azimi; Hassani, Parkhideh; Arbon, Paul; Shorofi, Seyed Afshin


    This study aimed to explore the role of social capital within the context of the nursing profession in Iran, based on the experience and perspectives of senior nursing managers. The study was conducted using the Graneheim and Lundman content analysis method. Using purposive sampling, 26 senior nursing managers from the Ministry of Health and Medical Education, the College of Nursing and Midwifery, the Iranian Nursing Organization, nursing associations and hospitals were selected, who participated in semi-structured in-depth interviews. Content analysis revealed three main themes (social capital deficit, applying multiple strategies, and cultivating social capital) as well as eight categories which included professional remoteness, deficiency in professional potency, deficiency in professional exchanges, accumulation of personal social capital, accumulation of professional social capital, socio-political strategies, psychological-cognitive strategies, and ethical/spiritual strategies. The results show the perceived level of social capital in nursing in Iran, the application of some key strategies, and the principal rewards accrued from active participation in improving the social capital in nursing environment and profession. Efforts should be made to strengthen the social capital and apply key strategies with the aim of achieving personal and professional benefits for nurses, their patients, and co-workers, and for the delivery of healthcare in general. In this respect, the role of senior managers is vital in stimulating collective action within the profession, planning for the development of a culture of participation in healthcare services, helping to develop all fields of the profession, and developing and strengthening intra- and inter-professional exchanges and networking.

  6. Meeting baccalaureate public/community health nursing education competencies in nurse-managed wellness centers. (United States)

    Thompson, Cheryl W; Bucher, Julia A


    The purpose of this article is to describe how community health competencies for baccalaureate nursing education have been met by locating clinical experiences in nurse-managed wellness centers. Such centers are an ideal setting for students to integrate theoretical concepts into clinical practice while building on previous learning. Students are able to develop skills in community health nursing practice at individual, family, and population level. In addition, the practice setting provides other advantages. Clients who represent a vulnerable population group receive valuable health services. Students gain learning opportunities that are broader than community health competencies, and faculty are provided clinical practice, research, and scholarship opportunities. The challenges to year-round sustainability of nurse-managed centers are burdensome; however, the benefits outweigh the difficulty of those challenges. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Exploring Nurse Manager Support of Evidence-Based Practice: Clinical Nurse Perceptions. (United States)

    Caramanica, Laura; Spiva, LeeAnna


    The study identifies what constitutes nurse manager (NM) support and other resources that enable clinical nurses (CNs) to engage in evidence-based practice (EBP). Clinical nurses report that NM support enables them to use EBP but what constitutes NM support is still unclear. Nurse managers, CNs, and EBP mentors received specialized education and use a team approach for EBP. Data were collected preintervention, mid-intervention, and postintervention from observations, interviews, journaling, and surveys. Results demonstrate how NMs can perform their role responsibilities and still engage CNs to develop a spirit of inquiry, seek answers to their clinical questions using EBP, and advance their clinical performance to improve patient outcomes. Four NM supportive behaviors emerged: cultivating a shared EBP vision, ensuring use of EBP, communicating the value of EBP, and providing resources for EBP. Through education and support, NMs describe supportive behaviors necessary for the successful conduction of EBP by CNs.

  8. Clinical management of fever by nurses: doing what works. (United States)

    Thompson, Hilaire J; Kagan, Sarah H


    The specific aims were to (1) define fever from the nurse's perspective; (2) describe fever management decision-making by nurses and (3) describe barriers to evidence-based practice across various settings. Publication of practice guidelines, which address fever management, has not yielded improvements in nursing care. This may be related to differences in ways nurses define and approach fever. The collective case study approach was used to guide the process of data collection and analysis. Data were collected during 2006-7. Transcripts were coded using the constant comparative method until themes were identified. Cross-case comparison was conducted. The nursing process was used as an analytical filter for refinement and presentation of the findings. Nurses across settings defined fever as a (single) elevated temperature that exceeded some established protocol. Regardless of practice setting, interventions chosen by nurses were frequently based on trial and error or individual conventions -'what works'- rather than evidence-based practice. Some nurses' accounts indicated use of interventions that were clearly contraindicated by the literature. Participants working on dedicated neuroscience units articulated specific differences in patient care more than those working on mixed units. By defining a set temperature for intervention, protocols may serve as a barrier to critical clinical judgment. We recommend that protocols be developed in an interdisciplinary manner to foster local adaptation of best practices. This could further best practice by encouraging individual nurses to think of protocols not as a recipe, but rather as a guide when individualizing patient care. There is value of specialty knowledge in narrowing the translational gap, offering institutions evidence for planning and structuring the organization of care. © 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.

  9. Cypriot nurses' knowledge of heart failure self-management principles. (United States)

    Kalogirou, Fotini; Lambrinou, Ekaterini; Middleton, Nicos; Sourtzi, Panayota


    The nurse's role as educator has become very crucial in heart failure management; thus, nurses must be adequately prepared to undertake this task. The main objective of the study was to estimate the level of Cypriot nurses' knowledge on basic heart failure self-care principles. A questionnaire measuring knowledge on heart failure self-care principles was administered among cardiology nurses working in five public urban hospitals of Cyprus. Data were analysed by using descriptive statistics, t-test and analysis of variance for categorical variables (such as gender and working setting) and correlation tests (Pearson's) plus simple linear regression for continuous variables (such as working experience). Participants were 143 nurses. The mean heart failure self-care knowledge score was 13.57/20 (SD 2.33). Gender, hospital and cardiac clinical experience do not significantly affect scoring. Significant difference in the knowledge score was observed among critical care, cardiology and medical unit nurses (f=4.1, p=0.018). Post hoc analysis showed that this significant difference originated from the comparison of critical care nurses with cardiology unit nurses (14.1, SD 2.3 vs. 13.0, SD 2.1 respectively). Correlation and linear regression analyses yielded only weak negative correlation between correct scoring and duration of nursing practice (r=-0.262, p=0.002), with 6% of the total variation in scoring being explained by this relationship. Results are consistent with previous findings and it is thus under question whether cardiology nurses are properly educating their heart failure patients. Consequently, there is an urgent need for nurses to update their knowledge and enhance their educational skills.

  10. Human capital in the nursing management of hospitals

    Directory of Open Access Journals (Sweden)

    Ana Lúcia Arcanjo Oliveira Cordeiro


    Full Text Available Abstract OBJECTIVE To analyze how the components of human capital are used in the nursing management of hospital organizations. METHOD This was an exploratory and qualitative study. Data collection took place between October 2014 and May 2015 using semi-structured interviews. The data were analyzed according to content analysis. RESULTS Twelve nurse managers participated. The components of human capital used by the nurses in personnel management were: during the hiring process, when requiring specialized education in the field and prior professional experience; when retaining talents with promotion strategies; in building capacities of professionals through support and training; and in collective work to construct processes and outcome assessment. CONCLUSION The components of human capital need to be managed strategically with a focus on professional skills and development, with the aim of transforming individual and collective knowledge into new technology.

  11. The nurse manager's role in creating a healthy work environment. (United States)

    Whiley, K


    The role of nurse manager of an acute or critical care unit is one of the most difficult roles in healthcare today. This individual must juggle patient care issues, staff concerns, medical staff relationships, supply inadequacies, and organizational initiatives--and then balance all of this with a personal life. The only way in which any of this is remotely possible is if the patient care unit provides a supportive environment for patients, families, and staff. The nurse manager is a pivotal person in this effort: research repeatedly shows that people don't leave their jobs, they leave their managers. This article describes how the nurse manager of an acute neurosciences unit worked with her staff to define, create, and maintain a work environment in which patient care improved, people enjoyed working, and retention of staff increased.

  12. Rural Nurse Managers' Perspectives into Better Communication Practices. (United States)

    Hartung, Sheila Q; Miller, Mindi


    The aim of this qualitative study was to describe the communication perceptions of nurse managers in rural areas. Prior research in tertiary settings was the impetus for studying viewpoints in other settings. Grounded theory methods were used to collect and analyze interview data with nine managers from regional, critical access hospitals, and home health settings in central Pennsylvania. Nurse Managers associated successful communication with job satisfaction, work efficiency, and employee retention. Circumstances influencing communication involved discussion tones, techniques, resources, and environmental factors. Recommended techniques included regular conversations, diverse messaging, and conferencing huddles to improve information dissemination and workflow in rural settings.

  13. Managing work-related stress in the district nursing workplace. (United States)

    Burke, Michelle


    This article aims to highlight the issue of work-related stress within the district nursing workplace. It will acknowledge how the management of work-related stress has previously been discussed within nursing literature and will consider the emerging relationship between staff working conditions, staff wellbeing and quality of patient care. It will reintroduce the Health and Safety Executive's (HSE's) Management Standards approach to tackling work-related stress, which provides management support to reduce environmental work stressors and encourage enabling work environments and a positive workplace culture.

  14. Medical management of three workers following a radiation exposure incident

    International Nuclear Information System (INIS)

    House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L.


    The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms

  15. Medical management of three workers following a radiation exposure incident

    Energy Technology Data Exchange (ETDEWEB)

    House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L. (Department of Occupational and Environmental Health, St. Michael' s Hospital, Toronto, Ontario (Canada))


    The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms.

  16. Barriers to Asthma Management as Identified by School Nurses (United States)

    Quaranta, Judith E.; Spencer, Gale A.


    Asthma rates are increasing in children. School nurses have opportunities to care for children with asthma but need to overcome barriers impacting their ability to manage asthma in the school setting. This study (a) assessed barriers present in the school setting, (b) determined the impact of barriers on performance of asthma management behaviors,…

  17. Relationship between management styles and nurses' retention at ...

    African Journals Online (AJOL)

    Introduction: Management styles are an essential issue from both theoretical and managerial perspectives. However, success in nursing management is found in being flexible and adaptable to a variety of situations which increase quality of care. One of the best ways to ensure quality of care is to recruit and retain sufficient ...

  18. Obstetric anal sphincter injury: incidence, risk factors, and management. (United States)

    Dudding, Thomas C; Vaizey, Carolynne J; Kamm, Michael A


    Obstetric sphincter damage is the most common cause of fecal incontinence in women. This review aimed to survey the literature, and reach a consensus, on its incidence, risk factors, and management. This systematic review identified relevant studies from the following sources: Medline, Cochrane database, cross referencing from identified articles, conference abstracts and proceedings, and guidelines published by the National Institute of Clinical Excellence (United Kingdom), Royal College of Obstetricians and Gynaecologists (United Kingdom), and American College of Obstetricians and Gynecologists. A total of 451 articles and abstracts were reviewed. There was a wide variation in the reported incidence of anal sphincter muscle injury from childbirth, with the true incidence likely to be approximately 11% of postpartum women. Risk factors for injury included instrumental delivery, prolonged second stage of labor, birth weight greater than 4 kg, fetal occipitoposterior presentation, and episiotomy. First vaginal delivery, induction of labor, epidural anesthesia, early pushing, and active restraint of the fetal head during delivery may be associated with an increased risk of sphincter trauma. The majority of sphincter tears can be identified clinically by a suitably trained clinician. In those with recognized tears at the time of delivery repair should be performed using long-term absorbable sutures. Patients presenting later with fecal incontinence may be managed successfully using antidiarrheal drugs and biofeedback. In those who fail conservative treatment, and who have a substantial sphincter disruption, elective repair may be attempted. The results of primary and elective repair may deteriorate with time. Sacral nerve stimulation may be an appropriate alternative treatment modality. Obstetric anal sphincter damage, and related fecal incontinence, are common. Risk factors for such trauma are well recognized, and should allow for reduction of injury by proactive

  19. Persistent perineal sinus. Incidence, pathogenesis, risk factors, and management

    International Nuclear Information System (INIS)

    Lohsiriwat, V.


    This review discusses the incidence, pathogenesis, risk factors, diagnosis, and therapeutic options for persistent perineal sinus (PPS), defined as a perineal wound that remains unhealed more than 6 months after surgery. The incidence of PPS after surgery for inflammatory bowel disease (IBD) ranges from 3% to 70% and after abdominoperineal resection (APR) for Low rectal cancer, it can be up to 30%. These unhealed wounds are frequently related to perioperative pelvic or perineal sepsis. Crohn's disease (CD) and neoadjuvant radiation therapy are also important risk factors. The management of PPS is based on an understanding of pathogenesis and clinical grounds. The advantages and disadvantages of the current therapeutic approaches, including the topical administration of various drugs, vacuum-assisted closure, and perineal reconstruction with a muscle flap or a myocutaneous flap are also discussed. (author)

  20. Orbital cellulitis in Scotland: current incidence, aetiology, management and outcomes. (United States)

    Murphy, C; Livingstone, I; Foot, B; Murgatroyd, H; MacEwen, C J


    Orbital cellulitis is a potentially blinding and life-threatening condition. There are little published data on the incidence of orbital cellulitis and little is known about the differences between children and adults affected. The purpose of this study was to identify the incidence, aetiology, management and outcome of orbital cellulitis in children and adults in Scotland. This study was a 1-year prospective observational study using the Scottish Ophthalmic Surveillance Unit reporting system among Scottish ophthalmologists. The response rate from ophthalmologists was 66.4%. There were 15 children and 5 adults reported giving an incidence of 1.6 per 100 000 and 0.1 per 100 000 in children and adults, respectively. 47% of children had a preceding upper respiratory tract infection with 87% having radiological evidence of sinus disease. Within the adult group, there was preceding immunosuppression and trauma. Streptococcus (66%) and Haemophilus (46%) species were the most commonly isolated pathogens in children. Respiratory pathogens were less predictable in adults. All patients were treated with intravenous antibiotics. All children with orbital and subperiosteal abscesses had surgery; one adult with orbital abscess did not have surgery. There were two cases of series morbidity: one intracranial spread of infection and one evisceration. The incidence of orbital cellulitis is higher in children than in adults. In children, it commonly follows upper respiratory infection and sinus disease; however, in adults, preceding illness and trauma are more common. Respiratory pathogens are common in affected children. Intravenous antibiotics and surgical treatment of abscesses remain the preferred management. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  1. Developing a decision support system to meet nurse managers' information needs for effective resource management. (United States)

    Ruland, C M


    This article describes the development of a decision support system called CLASSICA, which assists nurse managers in financial management, resource allocation, activity planning, and quality control. CLASSICA integrates information about patient flow and activity, staffing, and the cost of nursing care at the nursing-unit level. The system provides assistance in planning activities, balancing the budget, and identifying barriers to unsatisfactory resource management. In addition, CLASSICA contains forecasting and simulation options to analyze the influence of factors that affect nursing costs. This article describes the system's development process steps to tailor it to the needs of nurse managers and their existing work practices. Nurse managers actively participated in defining their tasks and responsibilities; identified barriers and difficulties in managing these tasks; defined information needs, data input, and output and interface requirements; and identified expected benefits. Clear communication of project goals, strong user involvement, and purposeful benefit planning was used to achieve the goals for CLASSICA: (1) to provide essential information and decision support for effective financial management, resource allocation, activity planning, and staffing; (2) to improve nurse managers' competence in financial management and decision making; (3) to improve cost containment; and (4) to provide a helpful and easy to use tool for decision support.

  2. How nursing leadership and management interventions could facilitate the effective use of ICT by student nurses. (United States)

    Willmer, Marian


    This article makes the case for how evidence-based nursing leadership and management activities could promote, implement and sustain quality patient care by student nurses using Information and Communications Technology. It is on aspects of the findings of a professional doctorate inquiry into Information and Communications Technology use and skills development by student nurses. The 21st century is both an information and knowledge age. Nursing and medical professions are facing the increasing usage of information technology in day-to-day operations with the overall aim of improving the quality of patient care. The quality of the future of the nursing profession is dependent on the calibre of those who are currently socialized to become professional nurses. The new United Kingdom Labour Government, in power since 1997, has placed increasing focus on the effectiveness of the National Health Service and using computers as one way to assist in achieving greater effectiveness. This has implications for nurse education and the future preparation of future nurses to acquire skills in Information and Communications Technology. This is a case study approach using multiple triangulation methodology. This includes: semi-structured interview of six student nurses and four of their mentors; one unstructured meeting with the Research and Development Manager; observational visit to a medical admission ward and a renal unit; one semi-structured meeting with the Information Manager; Review of Documentation - the National Health Service Trust Nursing Strategy; and Review, Application and Development of relevant theory. The overall findings are that student nurses are not using Information and Communications Technology in nursing practice in a structured and systematic way. The reasons for this are very many and very complex but are interrelated. They include strategic resource-based issues, what Jumaa referred to as Time, Human, Equipment, Information, Material and Money resources

  3. Management of response to the polonium-210 incident in London

    International Nuclear Information System (INIS)

    Croft, John; Bailey, Michael; Tattersall, Phil; Morrey, Mary; McColl, Neil; Prosser, Lesley; Maguire, Helen; Fraser, Graham; Gross, Roger


    On the 23 November 2006, Alexander Litvinenko died in London allegedly from poisoning by 210 Po, an alpha particle emitter. The spread of radioactive contamination, arising from the poisoning and the events leading up to it, involved many locations in London. The potential for intakes of 210 Po arising from the contamination posed a public health risk and generated significant public concern. The scale of the event required a multi-agency response, including top level UK Government emergency response management arrangements. The Health Protection Agency (HPA) had a leading role in co-ordinating and managing the public health response. This paper reviews the management of the incident response and the issues involved. The fatal poisoning of Mr Litvinenko with 210 Po, and the associated public health hazard from the spread of contamination to many locations across London, was an unprecedented event. Fortunately, no one else is known to have suffered any acute effects. Results from the programme of individual monitoring showed that whilst more than 100 people had measurable intakes of 210 Po, only 17 had assessed doses in excess of 6 mSv. The highest dose of about 100 mSv gives rise to an increased risk of fatal cancer of about 0.5%, compared with the natural incidence of about 25%. The incident required a co-ordinated and sustained multi-agency emergency response. The Health Protection Agency, as the lead on public health matters played a significant role in this. Whilst inevitably some lessons have been identified, the response is considered to have been very effective and to have benefited from the wide spectrum of experience and expertise developed through normal work, together with the effort put into emergency preparedness and the various emergency response. (author)

  4. [Second victim : Critical incident stress management in clinical medicine]. (United States)

    Schiechtl, B; Hunger, M S; Schwappach, D L; Schmidt, C E; Padosch, S A


    Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second victim of an adverse event. Psychological distress may not only have a long lasting impact on quality of life of the physician or caregiver involved but it may also affect the ability to provide safe patient care in the aftermath of adverse events. A literature review was performed to obtain information on care giver responses to medical errors and to determine possible supportive strategies to mitigate negative consequences of an adverse event on the second victim. An internet search and a search in Medline/Pubmed for scientific studies were conducted using the key words "second victim, "medical error", "critical incident stress management" (CISM) and "critical incident stress reporting system" (CIRS). Sources from academic medical societies and public institutions which offer crisis management programs where analyzed. The data were sorted by main categories and relevance for hospitals. Analysis was carried out using descriptive measures. In disaster medicine and aviation navigation services the implementation of a CISM program is an efficient intervention to help staff to recover after a traumatic event and to return to normal functioning and behavior. Several other concepts for a clinical crisis management plan were identified. The integration of CISM and CISM-related programs in a clinical setting may provide efficient support in an acute crisis and may help the caregiver to deal effectively with future error events and employee safety.

  5. Nurses improve migraine management in primary care

    NARCIS (Netherlands)

    Veenstra, Petra; Kollen, Boudewijn J.; de Jong, Gosse; Baarveld, Frans; van den Berg, J. S. Peter

    Introduction Migraine is a common disorder with a high burden. Adequate treatment results in improvement of quality of life. Migraine patients are mainly treated by general practitioners (GPs), but there is still room for improvement. This study investigated whether primary care nurses could improve

  6. Nurses' knowledge of chronic disease management

    African Journals Online (AJOL)


    Nov 21, 2014 ... Intervention clinic nurses were also surveyed immediately after training and three months post-training. Data were analysed using SPSS version 19 (SPSS Inc., Chicago, IL).Total mean knowledge percentage scores were calculated for each chronic disease. Mean knowledge percentage score changes.

  7. Bring Your Own Device and Nurse Managers' Decision Making. (United States)

    Martinez, Karen; Borycki, Elizabeth; Courtney, Karen L


    The Bring Your Own Device phenomenon is important in the healthcare environment because this trend is changing the workplace in healthcare organizations, such as British Columbia. At present, there is little research that exists in Canada to provide a distinct understanding of the complexities and difficulties unique to this phenomenon within the nursing practice. This study focused on the experiences and perceptions of nurse managers regarding how they make decisions on the use of personal handheld devices in the workplace. Telephone interviews (N = 10) and qualitative descriptive analysis were used. Four major themes emerged: (1) management perspective, (2) opportunities, (3) disadvantages, and (4) solutions. Nurse managers and other executives in healthcare organizations and health information technology departments need to be aware of the practice and organizational implications of the Bring Your Own Device movement.

  8. Integrating medicines management into mental health nursing in UK. (United States)

    Snowden, Austyn


    There is increasing concern that mental health nurses in UK are inadequately trained in medicines management. Recommended solutions entail proposals for further training to improve safety for service users. Although fundamentally important, these organizational approaches lack a conceptual framework to explain how individual practitioners develop competence in medicines management. This is important because applying knowledge of how individuals learn makes strategic interventions more effective. This article presents empirical evidence of how individual mental health nurse prescribers develop competence in prescribing within the context of the therapeutic relationship. It is proposed that these findings can then be extended to inform medicines management training relevant to all mental health nurses, whether prescribers or not. Copyright 2010 Elsevier Inc. All rights reserved.

  9. [Management trends that may lead nursing to new paths]. (United States)

    Magalhães, Ana Maria Müller; Duarte, Erica Rosalba Mallmann


    The changes in the economic and social context have led to the need of new management strategies for organizations. In the area of services, healthcare and nursing organizations have suffered the impact of these changes within their work processes. Our goal was to reflect on the new management trends and how they could influence the nursing work organization in healthcare services and the actions by managing nurses in strategies that meet the challenges of the profession in a changing social context. These new trends have pointed to the emphasis on the development or learning organizations, investment on human capital, inclusion of new knowledge and skills, searching for an open, flexible and participatory administrative practice, based on reason, creativity, sensitivity and intuition.

  10. Experiences of nurse case managers within a central discharge planning role of collaboration between physicians, patients and other healthcare professionals: A sociocultural qualitative study. (United States)

    Thoma, Jorun E; Waite, Marion A


    To gain knowledge of nurse case managers' experiences within the German acute care context of collaboration with patients and physicians in a discharge planning role; further to learn about patients' assignment to the management of the nurse case managers; and explicitly to explore critical incidences of interactions between nurse case managers, patients and healthcare practitioner in discharge planning to understand the factor that contributes to effective collaboration. The defined role of nurse case managers in many contexts is a patient-centred responsibility for a central task of discharge management of patients with complex physical and social needs. Some studies have indicated that the general impact of the role reduces readmission rates. Given the necessity to work interprofessionally to achieve a safe discharge, little is known about how nurse case managers achieve this collaboratively. A qualitative case study within a German teaching hospital of nurse case managers (N = 8). Data were collected through semi-structured interviews prompted by a critical incident technique and rigorously analysed through the lenses of sociocultural theory. Consistent object being worked upon was a safe and effective discharge from hospital with a focus on patient advocacy. Significant themes were a self-value or recognition by others of professional expertise, reciprocal value on the capabilities of others thorough relational expertise and negotiation with patients and an identification of case trajectories. More continuity of nurse case managers' care and management, clarity of role and transparency to peers, physicians and other professionals would be beneficial in ensuring appropriate referral of complex patients to nurse case managers responsibility. Clearer role description and benefit realisation of the nurse case managers could be achieved by interventions that are interprofessional and focus on the tasks that matter from a collaborative perspective. This could lead

  11. Relationship between assertiveness and burnout among nurse managers. (United States)

    Suzuki, Eiko; Saito, Miyuki; Tagaya, Akira; Mihara, Rieko; Maruyama, Akiko; Azuma, Tomomi; Sato, Chifumi


    We aimed to clarify the relationship between assertiveness and burnout among nurse managers at university hospitals. The directors at three university hospitals agreed to cooperate with our study. During a one-month period from May to June 2007, a self-administered questionnaire was distributed to 203 nurse managers (head and sub-head nurses). The Japanese version of the Rathus Assertiveness Schedule (J-RAS) and the Japanese version of the Maslach Burnout Inventory (MBI) were used as scales. Burnout was operationally defined as a total MBI score in the highest tertile. Valid responses were obtained from 172 nurse managers. The mean J-RAS score of the burnout group (-14.3) was significantly lower than that of the non-burnout group (-3.3). Responses about work experience and age showed no significant group difference. Total MBI score was inversely correlated with J-RAS score (R = -0.30, P < 0.01). Multiple logistic regression analyses indicated a decrease in the risk of burnout by 26% (0.74 times) for every 10 point increase in the J-RAS score, and by 60% (0.40 times) for greater satisfaction with own care provision. The results suggest that increasing assertiveness and satisfaction with own care provision contributes to preventing burnout among Japanese nurse managers.

  12. Absence of Nursing Position in the new Health Policies in Iran: A Dialogue with Nursing Scholars and Nursing Managers

    Directory of Open Access Journals (Sweden)

    Ahmad Kalateh Sadati


    Full Text Available Family physician (FP is a suggested model for controlling Iran health system challenges such as non-communicable diseases (NCDs, mental illnesses, and HIV-AIDS besides urbanization, and elderly issues. Although FP is a legal commitment, it faces several obstacles such as lack of infrastructure, diversity of insurances, and unwillingness of senior health policy makers about it.1 As Shiraz University of Medical Sciences (SUMS is a pilot center for implementation of FP model, the First International Conference on Family Physician with participation of Health Policy Research Center (HPRC was conducted successfully on 27th and 28th of December 2015 in Shiraz, Iran. The main goal of this conference was developing the discourse of FP with these major subjects: ‘the philosophy of FP’, ‘FP and medical education’, ‘FP and universal health coverage’, ‘incentive and financial system in FP’, and ‘evaluation of the international, national and provincial experiences in FP’. Despite presenting interesting topics in the conference, the main missing issue was the role of nursing, specifically nursing practitioner (NP, in the conference. Experiences of other countries revealed that NP has an important role in primary health care (PHC,2,3 quality of care,3 diagnosis and treatment4 in healthcare system. Moreover, International Council of Nursing believed that nursing can be effective for universal health coverage and being cost-effective in health care delivery.5 However, none of the nursing scholars and nursing managers actively participated in this conference. With respect to recent great changes in health care system in Iran, problem is not limited to this conference. Absence of community based approaches in nursing is obvious in three major health policies recently approved in Iran; they include establishing FP project in two provinces (Fars and Mazandaran as pilot, making urban community health centers (UCHC or Comprehensive Health Center in

  13. Role of Emotional Intelligence in Conflict Management Strategies of Nurses. (United States)

    Başoğul, Ceyda; Özgür, Gönül


    This study analyzes the emotional intelligence levels and conflict management strategies of nurses and the association between them. This cross-sectional, descriptive study was conducted with 277 nurses in a stratified random sample from a university hospital in Turkey. The data were collected from nurses who gave their informed consent to participate using a personal information form, the Rahim Organizational Conflict Inventory-II and Bar-On's Emotional Quotient Inventory (EQ-I). Data were assessed by descriptive statistics, t tests, and Pearson correlation analyses, using SPSS software. The levels of the nurses' strategies were as follows: avoiding (M = 2.98), dominating (M = 2.76), and obliging (M = 2.71) were medium; compromising (M = 1.99) and integration (M = 1.96) were low. The levels of the emotional intelligence of nurses (mean = 2.75) were medium on a 5-point scale. Integration (r = .168), obliging (r = .25), dominating (r = .18), and compromising (r = .33), which are conflict management strategies, were positively correlated with scores of emotional intelligence, and avoiding (r = -.25) was negatively correlated with scores of emotional intelligence (p emotional intelligence affects conflict management strategies. To use effective strategies in conflict management, nurses must develop emotional intelligence. Training programs on conflict management and emotional intelligence are needed to improve effective conflict management in healthcare facilities. Copyright © 2016. Published by Elsevier B.V.

  14. Program for accident and incident management support, AIMS

    International Nuclear Information System (INIS)

    Putra, M.A.


    A prototype of an advisory computer program is presented which could be used in monitoring and analyzing an ongoing incident in a nuclear power plant. The advisory computer program, called the Accident and Incident Management Support (AIMS), focuses on processing a set of data that is to be transmitted from a nuclear power plant to a national or regional emergency center during an incident. The AIMS program will assess the reactor conditions by processing the measured plant parameters. The applied model of the power plant contains a level of complexity that is comparable with the simplified plant model that the power plant operator uses. A standardized decay heat function and a steam water property library is used in the integral balance equations for mass and energy. A simulation of the station blackout accident of the Borssele plant is used to test the program. The program predicts successively: (1) the time of dryout of the steam generators, (2) the time of saturation of the primary system, and (3) the onset of core uncovery. The coolant system with the actual water levels will be displayed on the screen. (orig./HP)

  15. University management: contributions for nurses who are faculty members and managers

    Directory of Open Access Journals (Sweden)

    Kamylla Santos da Cunha

    Full Text Available ABSTRACT Objective: To comprehend how university management contributes on the performance of nurses who are professors and managers in a public university. Method: Qualitative research anchored on the Grounded Theory. The setting to collect the data was a public university in south Brazil and it happened between May and September of 2016. A total of 19 nurses took part in the study, all of them also faculty members and managers that were divided in two sample groups. Results: Two subcategories were created: the comprehension that university management improves the faculty performance; obtaining a wider view of the university. Final considerations: The contributions of university management for faculty nurses who are managers are mainly on the personal and professional satisfaction through the production and dissemination of knowledge, reflecting positively on the refinement of the teaching competences to train Nurses with knowledge, technical skills and cognitive abilities to answer society’s needs.

  16. Towards Incidence Management in 5G Based on Situational Awareness

    Directory of Open Access Journals (Sweden)

    Lorena Isabel Barona López


    Full Text Available The fifth generation mobile network, or 5G, moves towards bringing solutions to deploying faster networks, with hundreds of thousands of simultaneous connections and massive data transfer. For this purpose, several emerging technologies are implemented, resulting in virtualization and self-organization of most of their components, which raises important challenges related to safety. In order to contribute to their resolution, this paper proposes a novel architecture for incident management on 5G. The approach combines the conventional risk management schemes with the Endsley Situational Awareness model, thus improving effectiveness in different aspects, among them the ability to adapt to complex and dynamical monitoring environments, and countermeasure tracking or the role of context when decision-making. The proposal takes into account all layers for information processing in 5G mobile networks, ranging from infrastructure to the actuators responsible for deploying corrective measures.

  17. Nurse practitioners' perceptions of interprofessional team functioning with implications for nurse managers. (United States)

    Heale, Roberta; Dickieson, Patti; Carter, Lorraine; Wenghofer, Elizabeth F


    To determine the perceptions of nurse practitioners (NPs) about the level of functioning of their interprofessional teams. Interprofessional teams are a global trend, and nurses play leadership roles in their management. Little is known about the impact of specific barriers to team functioning and the role of the nurse manager on team functioning. Ninety-eight NPs at a conference completed the Interprofessional Team Functioning Survey (ITFS). The survey items with the lowest mean scores were related to organisational systems. These items included workplace policies that support interprofessional teamwork, in particular, orientation to the interprofessional team. Items that generated lower mean scores were adequate time to work as a member of the interprofessional team, team dynamics, collaboration among team members and the sharing of responsibility. Organisational and team relational issues can be addressed through organisational management strategies. Nurse managers have an important role in facilitating high functioning interprofessional teams. Strategies for managers to support interprofessional team functioning emerged. These strategies include ensuring that there are appropriate policies, orientation of new members, allocation of time to support interprofessional teamwork, leadership to enhance team collaboration and clear delineation of responsibilities of each member. © 2013 John Wiley & Sons Ltd.

  18. Incidence and Management of Bleeding Complications Following Percutaneous Radiologic Gastrostomy

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    Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)


    Upper gastrointestinal (GI) bleeding is a serious complication that sometimes occurs after percutaneous radiologic gastrostomy (PRG). We evaluated the incidence of bleeding complications after a PRG and its management including transcatheter arterial embolization (TAE). We retrospectively reviewed 574 patients who underwent PRG in our institution between 2000 and 2010. Eight patients (1.4%) had symptoms or signs of upper GI bleeding after PRG. The initial presentation was hematemesis (n = 3), melena (n = 2), hematochezia (n = 2) and bloody drainage through the gastrostomy tube (n = 1). The time interval between PRG placement and detection of bleeding ranged from immediately after to 3 days later (mean: 28 hours). The mean decrease in hemoglobin concentration was 3.69 g/dL (range, 0.9 to 6.8 g/dL). In three patients, bleeding was controlled by transfusion (n = 2) or compression of the gastrostomy site (n = 1). The remaining five patients underwent an angiography because bleeding could not be controlled by transfusion only. In one patient, the bleeding focus was not evident on angiography or endoscopy, and wedge resection including the tube insertion site was performed for hemostasis. The other four patients underwent prophylactic (n = 1) or therapeutic (n = 3) TAEs. In three patients, successful hemostasis was achieved by TAE, whereas the remaining one patient underwent exploration due to persistent bleeding despite TAE. We observed an incidence of upper GI bleeding complicating the PRG of 1.4%. TAE following conservative management appears to be safe and effective for hemostasis.

  19. Nurse managers' work life quality and their participation in knowledge management: a correlational study. (United States)

    Hashemi Dehaghi, Zahra; Sheikhtaheri, Abbas; Dehnavi, Fariba


    The association between quality of work life and participation in knowledge management is unknown. This study aimed to discover the association between quality of work life of nurse managers and their participation in implementing knowledge management. This was a correlational study. All nurse managers (71 people) from 11 hospitals affiliated with the Social Security Organization in Tehran, Iran, were included. They were asked to rate their participation in knowledge management and their quality of work life. Data was gathered by a researcher-made questionnaire (May-June 2012). The questionnaire was validated by content and construct validity approaches. Cronbach's alpha was used to evaluate reliability. Finally, 50 questionnaires were analyzed. The answers were scored and analyzed using mean of scores, T-test, ANOVA (or nonparametric test, if appropriate), Pearson's correlation coefficient and linear regression. Nurse managers' performance to implement knowledge management strategies was moderate. A significant correlation was found between quality of work life of nurse managers and their participation in implementing knowledge management strategies (r = 0.82; P knowledge management and participation of nurse managers in decision making (r = 0.82; P knowledge management.

  20. Knowledge, Attitude, and Performance of Nurses\\' Crisis Management in Natural Disasters in Yazd City

    Directory of Open Access Journals (Sweden)

    Tahere Soltani


    Full Text Available Abstract: Introduction: Natural disasters are considered as events that are beyond human control and usually result in death and different injuries; they also significantly affect public health. The lack of proper sanitation and communal life creates numerous problems. The aim of this study was to determine the knowledge, attitudes, and performance of nurses (since nurses work more than others in disasters in disaster management. Materials & Methods: This was a cross–sectional and descriptive study. The 220 participants of this study were selected by stratified random sampling method. Data was collected by questionnaire taken from similar studies in the field of nursing whose reliability was confirmed by the relevant specialists and its validity was confirmed by Cronbach's alpha (0.83. Data analyses included Spearman test, analysis of different levels of the independent variables (Mann-Whitney, Kruskal-Wallis test or t- test, and comparing means as well as the related data (non-parametric. Results: In this study, the average age of staff was 33.94±6.4 and years of their work experience was 10.5 ±7.14. The nurses' average level of knowledge about crisis management was 13.05±5.24 out of 22.  The mean grade scores of attitude to crisis management was 28.94±3.39 out of 33, further, their function in crisis management was 45.88±6.5 out of 57. Discussion: Due to the increased frequency of occurrence and consequences of the disaster and the special role of health care services before, during, and after the occurrence of such incidents, the results were not suitable. Then, it was concluded that proper preparation is essential for nurses as the largest providers of information and health services to people, so their performance must be measured which is the objective of this study.

  1. [Management of cytostatic drugs by nurses: analysis of preliminary results]. (United States)

    Bilski, Bartosz


    Cytostatic drugs pose a quite specific occupational risk to health care workers. There is a wide range of potential harmful effects, including remote effects, exerted by this group of drugs. In Polish and international regulations, standards of work safety and hygiene concerning these substances are clearly defined. Nevertheless working conditions in Polish health care institutions are now mostly influenced by economic and organizational problems, which may also be reflected in the compliance with the work safety rules. This paper presents a preliminary analysis of subjective assessment of practice with regard to the management of cytostatics reported by nurses, an occupational group mostly exposed to these substances. The study was carried out at hospital departments in the Warmińsko-Mazurskie Voivodship, where exposure of the staff to these drugs was observed. The study covered the whole nursing staff exposed. Completed questionnaires were obtained from 60 nurses, aged +/- 32 years (20-54 years) with job seniority +/- 8 years (2-18), including 58 nurses with secondary education and two university graduates. Undergraduate education did not develop in respondents skills to work with cytostatics. There is a need to increase the involvement of nursing schools, research institutes and teaching hospitals in the improvement of vocational training of nurses working with cytostatic drugs. To this end, all nurses should be covered with the obligatory training how to handle this group of drugs. The respondents reported that they had acquired their knowledge and experience of managing cytostatics in their work and during training organized at workplace. Despite the acquired knowledge and experience the interviewed nurses did not always comply with work safety and hygiene regulations. The problem of exposure to cytostatic drugs in the form of tablets was most frequently neglected. Some of the nurses were additionally exposed to ionizing radiation. Shortage of the nursing

  2. Teaching Pain Management to Student Nurses: A Literature Review

    Directory of Open Access Journals (Sweden)

    Ekatrina Wijayanti


    Full Text Available Purpose: To provide nursing students knowledge of pain prior, during, and post- surgery, recovery and rehabilitation. Methods: Review articles published during 2005 until 2012 that focused on pain assessment and pain management. The databases used in this study were Medline and CINAHL.Results: Postoperative pains need special approach and care. It needs teach patient how to adapt pain, control pain, monitor result of treatment. Conclusion: Nursing students need to learn how to assess pain using appropriate tools for each age level and in patients with special needs. The students also need to learn about pain management including pharmacology and non-pharmacology means and consider pain as the fifth vital sign. As student nurses learn pain assessment, they should be considerate about culture, and different languages that might happen during practical rotations.

  3. Nursing safety management in onco-hematology pediatric wards

    Directory of Open Access Journals (Sweden)

    Marcelle Miranda da Silva


    Full Text Available This study aimed at identifying how safety management is applied by nurses to manage the nursing care, and at analyzing their challenges in onco-hematology pediatric wards. Descriptive and qualitative research, conducted at the Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti, Rio de Janeiro, Brazil, in August 2013. Six nurses were interviewed, and the content analysis was used. The key aspects relate to the importance of training and continuing education, teamwork, with the challenges in the care of hospitalized children and particularities of the disease, and the systematization, use of instruments and protocols. For child safety, the relationship between the administration and support is critical to the quality of care.

  4. [Endomarketing: Essay on possibilities of innovation in nursing management]. (United States)

    Weirich, Claci Fátima; Munari, Denize Bouttelet; Bezerra, Ana Lúcia Queiroz


    This article is aimed at presenting endomarketing as a tool for nurses in the management process, taking into account the current context of changes in the healthcare sector, which also requires the development of skills that are directly related to the introduction of new technologies and ways of work organization. Our reflection leaves some important points to be analyzed by nurses and educators in the search for better ways and alternatives for educating nurses who will have greater professional satisfaction and competence to manage the healthcare services. The big challenge of endomarketing is, therefore, to combine the aims and interests of the internal public with the needs and expectations of the external public in the organization.

  5. Tools assessing nurse manager behaviours and RN job satisfaction: a review of the literature. (United States)

    Feather, Rebecca


    To determine the state of the science in relation to registered nurse (RN) perceptions of nurse manager behaviours that influence registered nurse job satisfaction. Nurse managers have been related by research to the job satisfaction of their staff. However, little is known about how nurses perceive the behaviours of nurse managers as influencing their job satisfaction. A literature search was conducted to identify journal articles that included studies involving instruments of nurse manager behaviours and staff nurse job satisfaction levels. The literature shows a lack of consistency in the definitions of job satisfaction, instrumentation for measurement and conclusions that identify specific management behaviours effective for high levels of job satisfaction of RNs related to staff nurse perceptions. Studies include important aspects of what shapes a healthy work environment for nurses, but no single study identified specific nurse manager behaviours based solely on the perceptions of staff nurses and their job satisfaction. The perceptions of staff nurses are important for hospital administrators and nurse managers in order to know how to improve satisfaction and reduce turnover. Instruments developed based on manager beliefs may not provide data needed to influence a change in management behaviours that results in improved job satisfaction. © 2014 John Wiley & Sons Ltd.

  6. Education of nurse practitioners in academic nurse-managed centers: student perspectives. (United States)

    Tanner, Clare L; Pohl, Joanne; Ward, Sheila; Dontje, Kathy


    Clinical experiences for advanced practice nurses are increasingly a challenge. Finding settings that demonstrate primary care nursing practice in its finest form can be difficult. This article reports on nurse practitioner (NP) student feedback on clinical placements in the academic nurse-managed centers (ANMCs) associated with four Michigan schools or colleges of nursing. Student feedback was solicited over three years through site and preceptor evaluation tools and focus groups. Students were overwhelmingly satisfied with their experience in ANMCs. Being mentored by an NP preceptor in an ANMC was a valuable experience for students. They valued the role modeling of the NP and the quality of their preceptors' instruction. Students stated that the nursing model of care to which they were exposed was congruent with classroom learning. They reported learning to apply an understanding of their patients' economic, social, and cultural situations to treatment decisions and patient-education efforts and learning to understand the role of community-based care. One limitation of ANMCs from the students' perspective was a relatively low volume of patients, particularly in the initial years. However, the benefit of having time to spend with clients and to reflect on clinical practice was also articulated.

  7. Nurses' Role in Managing "The Fit" of Older Adults in Skilled Nursing Facilities. (United States)

    Jones, Jacqueline; Lawrence, Emily; Ladebue, Amy; Leonard, Chelsea; Ayele, Roman; Burke, Robert E


    Post-acute care for older adults often involves transfer to a skilled nursing facility (SNF) following hospital discharge. This transition is often poorly coordinated and leaves older adults at risk for poor health outcomes, but new payment models offer opportunities to align improved care practices with payments. There is a dearth of evidence regarding the role of nursing and its potential to improve hospital to SNF care transitions. Ninety-nine semi-structured interviews were conducted with clinicians, patients, and caregivers from three hospitals and three SNFs. Results indicate a sharp contrast in the roles of hospital nurses-who are often silent partners in post-acute care decision making-and SNF nurses, who take a primary role as managing "the fit" for patients transitioning to a SNF. Nurses are uniquely positioned to make needed changes to culture to adapt to new payment models and improve patient outcomes. [Journal of Gerontological Nursing, 43(12), 11-20.]. Copyright 2017, SLACK Incorporated.

  8. Lessons Learnt from the Improvement of Customer Support Processes: A Case Study on Incident Management (United States)

    Jäntti, Marko

    IT Infrastructure Library (ITIL) is the most widely used IT service management framework that provides guidelines how to create, manage and support IT services. Service support processes, such as incident management and problem management, are among the first ITIL processes that organizations start to implement. However, several challenges may exist in the process implementation. The research question of this study is: which issues are important in establishing an ITIL-based incident management process? The main contribution of this paper is to present lessons learnt from an ITIL-based process improvement project that focused on establishing an incident management process in an IS department of a university hospital. Our results show that key issues in implementing incident management are to 1) define the basic concepts of incident management with concrete examples and 2) define process interfaces between incident management and other support processes.



    Giakoumidakis, Konstantinos; Katzilieri, Christina


    ntroduction: Standardized nursing terminologies (SNT) provide a common language among nurses, contributing to standardized and evidence based nursing care plans Aim: The development of a standardized nursing care plan for the effective management of postoperative mediastinal hemorrhage of cardiac surgery patients Material and Method: The SNT Perioperative Nursing Data Set (PNDS), 3rd edition, was used for a care plan formation, which is consisted of a coding system of nursing diagnoses...

  10. Participatory design of an integrated information system design to support public health nurses and nurse managers. (United States)

    Reeder, Blaine; Hills, Rebecca A; Turner, Anne M; Demiris, George


    The objectives of the study were to use persona-driven and scenario-based design methods to create a conceptual information system design to support public health nursing. We enrolled 19 participants from two local health departments to conduct an information needs assessment, create a conceptual design, and conduct a preliminary design validation. Interviews and thematic analysis were used to characterize information needs and solicit design recommendations from participants. Personas were constructed from participant background information, and scenario-based design was used to create a conceptual information system design. Two focus groups were conducted as a first iteration validation of information needs, personas, and scenarios. Eighty-nine information needs were identified. Two personas and 89 scenarios were created. Public health nurses and nurse managers confirmed the accuracy of information needs, personas, scenarios, and the perceived usefulness of proposed features of the conceptual design. Design artifacts were modified based on focus group results. Persona-driven design and scenario-based design are feasible methods to design for common work activities in different local health departments. Public health nurses and nurse managers should be engaged in the design of systems that support their work. © 2013 Wiley Periodicals, Inc.

  11. Part 1: The influence of personal and situational predictors on nurses' aspirations to management roles: preliminary findings of a national survey of Canadian nurses. (United States)

    Laschinger, Heather K Spence; Wong, Carol A; MacDonald-Rencz, Sandra; Burkoski, Vanessa; Cummings, Greta; D'Amour, Danielle; Grinspun, Doris; Gurnham, Mary-Ellen; Huckstep, Sherri; Leiter, Michael; Perkin, Karen; MacPhee, Maura; Matthews, Sue; O'Brien-Pallas, Linda; Ritchie, Judith; Ruffolo, Maurio; Vincent, Leslie; Wilk, Piotr; Almost, Joan; Purdy, Nancy; Daniels, Frieda; Grau, Ashley


    To examine the influence of personal and situational factors on direct-care nurses' interests in pursuing nursing management roles. Nursing managers are ageing and nurses do not appear to be interested in nursing management roles, raising concerns about a nursing leadership shortage in the next decade. Little research has focused on factors influencing nurses' career aspirations to nursing management roles. A national survey of nurses from nine Canadian provinces was conducted (n = 1241). Multiple regression was used to test a model of personal and situational predictors of nurses' career aspirations to management roles. Twenty-four per cent of nurses expressed interest in pursuing nursing management roles. Personal and situational factors explained 60.2% of nurses' aspirations to management roles. Age, educational preparation, feasibility of further education, leadership self-efficacy, career motivation, and opportunity to motivate others were the strongest predictors of aspirations for management roles. Personal factors were more strongly associated with career aspirations than situational factors. There is a steady decline in interest in management roles with increasing age. Nursing leadership training to develop leadership self-efficacy (particularly for younger nurses) and organizational support for pursuing advanced education may encourage nurses to pursue nursing management roles. © 2012 Blackwell Publishing Ltd.

  12. [Informatics competencies essential to decision making in nursing management]. (United States)

    Jensen, Rodrigo; Guedes, Erika de Souza; Leite, Maria Madalena Januário


    To identify informatics abilities essential to decision making in nursing management. Survey study with specialist nurses in health informatics and management. An electronic questionnaire was built based on the competencies Information Literacy (five categories; 40 abilities) and Information Management (nine categories; 69 abilities) of the TIGER - Technology Informatics Guiding Education Reform - initiative, with the guiding question: Which informatics abilities are essential to decision making in management? Answers were sorted in a Likert scale, ranging from 1 to 5. Rasch analysis was conducted with the software WINSTEPS(®). Results were presented in logits, with cutoff value zero. Thirty-two specialists participated, coming from all regions of Brazil. In the information literacy competency, 18 abilities were considered essential and in Information Management, 38; these were sorted according to their degree of essentiality. It is believed that the incorporation of these abilities in teaching can support the education of nurse managers and contribute to evidence-based practice, incorporation of information and communication technologies in health and information management.

  13. [Nursing management of a refractory cardiac death donor]. (United States)

    Kaufmann, Marion


    The nursing management of a refractory circulatory death donor is a new procedure which forms an integral part of patient care. It comprises technical and organisational aspects, and requires a conceptual, ethical and deontological effort. Copyright © 2016. Published by Elsevier Masson SAS.

  14. Responsibility-Centered Management: A 10-Year Nursing Assessment. (United States)

    McBride, Angela Barron; Neiman, Sandra; Johnson, James


    Describes the implementation of responsibility-centered management, a decentralized model giving deans responsibility for expanding and using resources, at Indiana University's nursing school. Discusses how it led to creation of an information-rich environment, strategic decision making, and a performance-based reward structure. (SK)

  15. The holistic leadership model and the nurse unit manager ...

    African Journals Online (AJOL)

    Effective leadership is arguably one of the most relevant indicators of a profession's advancement or lack thereof. The purpose of this article is to share the authors' personal views on the leadership competencies necessary for the nurse unit manager transitioning into the role for the first time. To identify these leadership ...

  16. Post-operative pain assessment and management among nurses in ...

    African Journals Online (AJOL)

    Millions of surgeries performed on patients are accompanied by some degree of pain. Successful outcome of any surgery is partly dependent on pre-, intra- and post-operative pain assessment and management. Nurses are professionally responsible for pain assessment and administration of analgesia, however, poor pain ...

  17. HIV management by nurse prescribers compared with doctors at a ...

    African Journals Online (AJOL)

    HIV management by nurse prescribers compared with doctors at a paediatric centre in Gaborone, Botswana. ... Task shifting remains a promising strategy to scale up and sustain adult and paediatric ART more effectively, particularly where provider shortages threaten ART rollout. Policies guiding ART services in southern ...

  18. Critical-Thinking Types among Nursing and Management Undergraduates. (United States)

    Thorpe, Karran; Loo, Robert


    The short form of the Watson-Glaser Critical Thinking Appraisal was completed by 233 nursing and 131 management students, yielding four clusters of critical thinking types. Discriminant analysis using cluster membership and subtest scores showed 96% were correctly classified. (Contains 40 references) (SK)

  19. Principal Experiences with Crisis Management Professional Development, Collaboration, and Implementation of the National Incident Management System Phases of Emergency Management (United States)

    Naradko, Anthony M.


    The purpose of this qualitative single-subject case study was to identify the elements critical to crisis management professional development for school principals; the factors influencing the implementation of the National Incident Management System Phases of Emergency Management (2010) for principals; and the necessary elements for fostering…

  20. Global nursing management. Avoiding conflicts of interest. (United States)

    Willers, Lisa


    Traditionally, the healthcare industry has been no stranger to some conflicts of interest. However, as healthcare responds to demands to contain costs and adapts business models that resemble those of the corporate world, new conflicts of interest arise. Nurse executives operating in healthcare systems today must have an understanding of conflicts of interest in order to promptly identify actual as well as potential conflicts. It is imperative that strategies are set in place to prevent or handle conflicts of interest as they occur in order to build trusting relationships with patients, suppliers, and communities.

  1. Personal Information Management for Nurses Returning to School. (United States)

    Bowman, Katherine


    Registered nurses with a diploma or an associate's degree are encouraged to return to school to earn a Bachelor of Science in Nursing degree. Until they return to school, many RNs have little need to regularly write, store, and retrieve work-related papers, but they are expected to complete the majority of assignments using a computer when in the student role. Personal information management (PIM) is a system of organizing and managing electronic information that will reduce computer clutter, while enhancing time use, task management, and productivity. This article introduces three PIM strategies for managing school work. Nesting is the creation of a system of folders to form a hierarchy for storing and retrieving electronic documents. Each folder, subfolder, and document must be given a meaningful unique name. Numbering is used to create different versions of the same paper, while preserving the original document. Copyright 2015, SLACK Incorporated.

  2. The influence of interpersonal relationships on nurse managers' work engagement and proactive work behavior. (United States)

    Warshawsky, Nora E; Havens, Donna S; Knafl, George


    This study tested the effects of interpersonal relationships on nurse managers' work engagement and proactive work behavior. An engaged workforce may help healthcare organizations improve performance. In healthcare, nurse managers are responsible for creating motivating work environments. They also need to be engaged, yet little is known about what influences nurse managers' performance. A self-administered electronic survey was used to collect data from 323 nurse managers working in acute care hospitals. Instruments included the Relational Coordination Scale, Utrecht Work Engagement Scale, and Proactive Work Behavior Scale. Interpersonal relationships with nurse administrators were most predictive of nurse managers' work engagement. Interpersonal relationships with physicians were most predictive of nurse managers' proactive work behavior. Organizational cultures that foster quality interpersonal relationships will support the job performance of nurse managers.

  3. Part 2: Nurses' career aspirations to management roles: qualitative findings from a national study of Canadian nurses. (United States)

    Wong, Carol A; Laschinger, Heather K Spence; MacDonald-Rencz, Sandra; Burkoski, Vanessa; Cummings, Greta; D'Amour, Danielle; Grinspun, Doris; Gurnham, Mary-Ellen; Huckstep, Sherri; Leiter, Michael; Perkin, Karen; MacPhee, Maura; Matthews, Sue; O'Brien-Pallas, Linda; Ritchie, Judith; Ruffolo, Maurio; Vincent, Leslie; Wilk, Piotr; Almost, Joan; Purdy, Nancy; Daniels, Frieda; Grau, Ashley


    Our aim was to investigate direct-care nurses' interests in formal management roles and factors that facilitate their decision-making. Based on a projected shortage of nurses by 2022, the profession could be short of 4200 nurse managers in Canada within the next decade. However, no data are currently available that identify nurses' interests in assuming manager roles. Using focus group methodology, we conducted 18 focus groups with 125 staff nurses and managers in four regions across Canada. Major themes and subthemes influencing nurses' decisions to pursue management roles included personal demographic (education, age, clinical experience and life circumstances), personal disposition (leadership skills, intrinsic rewards and professional commitment) and situation (leadership development opportunities, manager role perceptions and presence of mentors). Although nurses see management roles as positive opportunities, they did not perceive the rewards to be great enough to outweigh their concerns. Findings suggested that organizations need to provide support, leadership development and succession opportunities and to redesign manager roles for optimum success. Leaders need to ensure that they convey positive images of manager roles and actively identify and support staff nurses with leadership potential. © 2012 Blackwell Publishing Ltd.

  4. Do educational outcomes correspond with the requirements of nursing practice: educators' and managers' assessments of novice nurses' professional competence (United States)

    Numminen, Olivia; Laine, Tuija; Isoaho, Hannu; Hupli, Maija; Leino-Kilpi, Helena; Meretoja, Riitta


    Objective This study evaluated weather educational outcomes of nurse education meet the requirements of nursing practice by exploring the correspondence between nurse educators' and nurse managers' assessments of novice nurses' professional competence. The purpose was to find competence areas contributing to the acknowledged practice–theory gap. Design A cross-sectional, comparative design using the Nurse Competence Scale was applied. Subjects The sample comprised nurse educators (n = 86) and nurse managers (n = 141). Methods Descriptive and inferential statistics were used in the data analysis. Main outcome measures Educators assessed novice nurses' competence to a significantly higher level than managers in all competence areas (p competencies related to immediate patient care, commitment to ethical values, maintaining professional skills and nurses' care of the self. The biggest differences were in competencies related to developmental and evaluation tasks, coaching activities, use of evidence-based knowledge and in activities which required mastering a comprehensive view of care situations. However, differences between educators' and managers' assessments were strongly associated with their age and work experience. Active and improved collaboration should be focused on areas in which the differences between educators' and managers' assessments greatly differ in ensuring novice nurses′ fitness for practice. PMID:24512685

  5. Barriers to Seizure Management in Schools: Perceptions of School Nurses. (United States)

    Terry, Debbie; Patel, Anup D; Cohen, Daniel M; Scherzer, Daniel; Kline, Jennifer


    The purpose of this study was to assess school nurses' perceptions of barriers to optimal management of seizures in schools. Eighty-three school nurses completed an electronic survey. Most agreed they felt confident they could identify a seizure (97.6%), give rectal diazepam (83.8%), and handle cluster seizures (67.1%), but fewer were confident they could give intranasal midazolam (63.3%), had specific information about a student's seizures (56.6%), or could swipe a vagus nerve stimulator magnet (47.4%). Nurses were more likely to be available at the time of a seizure in rural (17/20) (85%) versus suburban (21/34) (62%) or urban (8/25) (32%) schools (P = .001). School nurses are comfortable managing seizures in the school setting. However, a specific seizure plan for each child and education on intranasal midazolam and vagus nerve stimulator magnet use are needed. A barrier in urban schools is decreased availability of a nurse to identify seizures and administer treatment. © The Author(s) 2016.

  6. [Delphi study to identify the management skills of nursing executives]. (United States)

    Yañez, M R; Avila, J A; Bermudez, M I; De Miguel, I; Bellver, V; Guilabert, M; Mira, J J


    To determine and update the skills map for the position of Nurse Administrator in hospitals and Primary Care. An observational, descriptive, cross-sectional study based on a Delphi technique was conducted in hospital and Primary Care settings. Two nominal groups with 15 nurses each were used to define the contents of the questionnaire 0 in the Delphi technique. All nurses registered in the professional associations of Alicante, Castellón and Valencia were invited to participate. The results of the Delphi study was submitted to factor analysis to identify the set of skills and, subsequently, compare them with the offer of post-graduate course in colleges and universities during the 2014-15 academic year. Forty-five competences were extracted during the Nominal groups. In total, 705 nurses replied to the first wave in the Delphi Technique, and 394 in the second (response rate of 56%). Factorial analysis grouped the skills chosen into 10 factors: managing people, conflict management, independent learning, ethics, emotional balance, commitment, self-discipline, continuous improvement, critical-thinking, and innovation. Four skills groups identified in this study (emotional balancing, commitment, self-discipline and courage) were not usually included in the post-graduate courses The nurse administrator skills should be related to relational and ethical behaviour. The training offer of the post-graduate courses must be reoriented. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

  7. Care management in nursing within emergency care units


    Roberta Juliane Tono de Oliveira; Patrícia Madalena Vieira Hermida; Fernanda Hannah da Silva Copelli; José Luís Guedes dos Santos; Alacoque Lorenzini Erdmann; Selma Regina de Andrade


    Objective.Understand the conditions involved in the management of nursing care in emergency care units. Methodology. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Results. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency se...

  8. Nurse management skills required at an emergency care unit


    Montezeli, Juliana Helena; Peres, Aida Maris; Bernardino, Elizabeth


    Objective: To identify the management skills needed for this professional at an emergency care unit. Method: An exploratory descriptive qualitative study conducted with eight nurses in which semi-structured interviews with nonparticipating systematic observation were conducted; the data was processed by content analysis. Results: The categories which emerged from the content analysis served as a list of management skills necessary to their work at the emergency care unit: leadership, decision...

  9. Nurse entrepreneurs' attitudes to management, their adoption of the manager's role and managerial assertiveness. (United States)

    Sankelo, Merja; Akerblad, Leena


    This study explores the attitudes of Finnish nurse entrepreneurs to management, their adoption of the manager's role, managerial assertiveness, development and training needs in management and associated factors. The research was conducted as part of a questionnaire survey among 335 entrepreneurs with different educational backgrounds. The sample for the study reported here consisted of those respondents who had a registered nurse degree. The data were analysed using SPSS statistical software. Nurse entrepreneurs took a positive attitude towards management, but there were obvious shortcomings in their adoption of the manager's role. They also showed a lack of managerial assertiveness. Half of the respondents had development needs and one-third had training needs in relation to management. Nurses who are planning to start up in business should have earlier leadership experience and should attend some form of management training. The provision of care and nursing services is increasingly taking place in the private sector. This study contributes to our understanding of the managerial role of nurse entrepreneurs in this new environment.

  10. Using a management perspective to define and measure changes in nursing technology. (United States)

    Alexander, J W; Kroposki, M


    The aims of this paper are to discuss the uses of the concept of technology from the medical science and the management perspectives; to propose a clear definition of nursing technology; and to present a study applying the use of the concept of nursing technology on nursing units. Nurse managers must use management terms correctly and the term technology may be misleading for some. A review of the nursing literature shows varied uses of the concept of technology. Thus a discussion of the dimensions, attributes, consequences, and definitions of nursing technology from the management perspective are given. A longitudinal study to measure the dimensions of nursing technology on nursing units 10 years apart. The findings suggest that the dimensions of nursing technology change over time and support the need for nurse managers to periodically assess nursing technology before making management changes at the level of the nursing unit. This study helps health care providers understand the unique role of nurses as healthcare professionals by identifying and measuring nursing technology on the nursing unit.

  11. Specially trained registered nurses can safely manage epidural analgesia infusion in laboring patients. (United States)

    Charles, Lenore A; Korejwa, Elise; Kent, Donna Curtis; Raniero, Debbie


    To discover evidence for defining the registered nurse's (RN's) role in the management of epidural analgesia in the labor and delivery setting. The Labor Epidural Nurse Safety (LENS) study consisted of two parts. The first part was a 10-year retrospective review of the outcomes of 2,568 laboring women for whom epidural catheters had been placed and verified by an anesthesiologist or certified registered nurse anesthetist, then continuous epidural infusion initiated, and basal rate or patient-controlled epidural analgesia (PCEA) dose increased, if needed, within specified parameters by specially trained labor and delivery RNs. The second part compared the outcomes of the neonates born to the 2,568 women in the first part of the study with neonates born to mothers who received PCEA with a continuous infusion initiated and managed exclusively by anesthesiologists and/or certified registered nurse anesthetists at two control sites. Maternal outcomes were quantified by incidences of clinically significant hypotension and sentinel events, such as respiratory distress, cardio/respiratory distress, loss of consciousness, and seizures. Evidence of neonatal outcomes was collected by comparing Apgar scores. No sentinel events occurred, and there was no increase in maternal hypotensive events in the RN-managed group. There were no statistically significant differences in Apgar scores between the experimental and control groups. Specially trained RNs can safely initiate continuous infusions and increase the basal rate of epidural analgesia infusions or PCEA doses administered to laboring women, after insertion and confirmation of correct catheter placement by a qualified anesthesia provider, without adversely affecting maternal and fetal/neonatal outcomes. Copyright © 2015 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  12. Managing stress in prehospital care: Strategies used by ambulance nurses. (United States)

    Bohström, Dan; Carlström, Eric; Sjöström, Nils


    Ambulance nurses display stress symptoms, resulting from their work with patients in an emergency service. Certain individuals seem, however, to handle longstanding stress better than others and remain in exposed occupations such as ambulance services for many years. This paper examines stress inducing and stress defusing factors among ambulance nurses. A qualitative descriptive design using critical incident technique was used. A total of 123 critical incidents were identified, and a total of 61 strategies dealing with stress were confirmed. In all, 13 sub-categories (seven stress factors and five stress reducing factors) were merged into four categories (two stress categories and two stress reducing categories). The study shows that ambulance nurses in general experience emergency calls as being stressful. Unclear circumstances increase the stress level, with cases involving children and childbirth being especially stressful. Accurate information and assistance from the dispatch centre reduced the stress. Having discussions with colleagues directly after the assignment were particularly stress reducing. Advanced team collaboration with teammates was viewed as effective means to decrease stress, in addition to simple rituals to defuse stress such as taking short breaks during the workday. The study confirmed earlier studies that suggest the benefits of defusing immediately after stress reactions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. [Risk management in the operation room. Results of a pilot project of interdisciplinary "incident reporting"]. (United States)

    Horstmann, R; Hofinger, G; Mäder, M; Gaidzik, P W; Waleczek, H


    Methods for error analysis are suitable to increase patients' safety as well as staff satisfaction and may avoid, in a sense of process control, financial damage to the hospital. The aim of the presented pilot study was to establish and evaluate an incident reporting system as a first step towards a new safety culture. In June 2003 an incident reporting system was introduced in the central surgical suite, in which the surgical and anaesthesiologic departments took part as well medical and nursing staff. Besides conceiving a report form, a "board of confidence" was elected, kick-off meetings were held and a baseline study on the basis of industrial psychological knowledge was initialised. The process of creating confidence is arduous and depends elementarily on sincere cooperation of management staff, especially of the heads of the departments. The exclusive participation of only two medical departments led to conflicts. Therefore, after finishing the pilot study, the system was expanded to the whole surgical suite including all operating departments. In order to increase the motivation for the strictly voluntarily participation, the frequency of regular echoes to the staff was optimised. To achieve high acceptance in the whole staff, the board of confidence needs a clearly defined position within the system of quality management. For the first time in Germany an incident reporting system under participation of several medical departments has been installed. After finishing the pilot project, in future we will be able to evaluate changes caused by this system. Simultaneously an electronic database for reported adverse events and strategies to avoid them are being developed based on similar systems in aviation industry. In near future, the system will be of increasing importance likewise for inpatient units and non-operative departments.

  14. Development of the decision make supporting system on incident management

    International Nuclear Information System (INIS)

    Kasamatsu, Mizuki; Hanada, Satoshi; Noda, Eisuke


    Decision Make Supporting System is designed to support appropriate decision made by top management in the nuclear severe conditions. With crisis response in nuclear power plant (NPP), information entanglement between sites and control centers during intense situations interfere with prompt and accurate decision making. This research started with that kind of background. In order to solve the issue of the information entanglement, Mitsubishi Heavy Industries, Inc. (MHI) carried out the development of the Decision Make Supporting System and the system applies the technology combining the human factors engineering (HFE) and information and communication technology (ICT). During the crisis response, various commands, reactions and communications in a human system need to be managed. Therefore, the combined HFE method including detailed task analysis, user experience (UX), graphic user interface (GUI) and related human-system interface (HSI) design method is applied to the design of the system. These design results systematize the functions that prevent interference with decision-making in the headquarters for incident management. This new solution as a system enhances the safety improvement of the NPP and contributes to develop the skills and abilities of the resources in the NPP. The system has three key features for supporting emergency situations: 'understanding the situation', 'planning the next action', and 'managing resources'. The system helps commanders and responders to grasp the whole situation and allows them to share information in real time to get a whole picture, and the system accumulates the data of the past events in the chronological order to understand correctly how they happened and plan the next action by using a knowledge database that MHI has been developed. If the unexpected event happens which are not in the incident scenario, the system provides support to formulate alternative strategies and measures. With this

  15. Factors that guide nurse managers regarding the staffing of agency nurses in intensive care units at private hospitals in Pretoria

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    Karien Jooste


    Full Text Available Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses. It is unclear how the role players (the nursing agency manager, the nurse manager and the agency nurse perceive the staffing of agency nurses in intensive care units (ICUs. The purpose of this study was to explore and describe the factors that guide nurse managers regarding the staffing of agency nurses in ICUs at private hospitals in Pretoria. A quantitative exploratory and descriptive design was used. A survey by means of a structured questionnaire was carried out. Probability sampling was implemented to obtain a study sample (n = 124. One similar self-administered 5-point scale instrument was completed by the participants. Data was analysed by means of descriptive and inferential statistics. The principles of validity and reliability were adhered to and ethical considerations were also taken into account. The results indicated limitations in the determining of posts, recruitment and advertising, as well as the selection and appointment of agency nurses in ICUs at private hospitals in Pretoria. Recommendations on staffing are made to nurse managers in ICUs.

  16. Leadership style and choice of strategy in conflict management among Israeli nurse managers in general hospitals. (United States)

    Hendel, Tova; Fish, Miri; Galon, Vered


    To identify conflict mode choices of head nurses in general hospitals and examine the relationship between leadership style, choice of strategy in handling conflicts and demographic characteristics. Nurse managers deal with conflicts daily. The choice of conflict management mode is associated with managerial effectiveness. The ability to creatively manage conflict situations, towards constructive outcomes is becoming a standard requirement. Head nurses (N = 60) in five general hospitals in central Israel were surveyed, using a 3-part questionnaire: The Thomas-Kilmann Conflict Mode Instrument, the Multi-factor Leadership Questionnaire, Form 5X-Short (MLQ 5X) and demographic data. Head nurses perceive themselves significantly more as transformational leaders than as transactional leaders. Compromise was found to be the most commonly used conflict management strategy. Approximately half of the nurses surveyed used only one mode in conflict management. Transformational leadership significantly affected the conflict strategy chosen. Head nurses tend to choose a conflict-handling mode which is concerned a form of a Lose-Lose approach. Preparation in conflict management should start from undergraduate education.

  17. Early Detection and Localization of Downhole Incidents in Managed Pressure Drilling

    DEFF Research Database (Denmark)

    Willersrud, Anders; Imsland, Lars; Blanke, Mogens


    Downhole incidents such as kick, lost circulation, pack-off, and hole cleaning issues are important contributors to downtime in drilling. In managed pressure drilling (MPD), operations margins are typically narrower, implying more frequent incidents and more severe consequences. Detection...

  18. The effect of nursing management development program on clinical competency in coronary care unit

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    Ali Akbar Vaezi


    Full Text Available Background: Nurses are the main members in nursing cares and nursing managers can improve their clinical competency by applying better leadership skills. This study carried out to determine the effect of nursing management program on clinical competency of nurses in a coronary care unit (CCU.Methods: A quasi-experimental study was carried out in two educational hospitals in Yazd- Iran. These hospitals were allocated randomly in case and control hospitals. 25 matched nurses were selected by convenience sampling from both case and control hospitals. The clinical competency of nurses was measured by related questioners consisted of two dimensions caring and care management behaviors by self-evaluation and head nurse evaluation in case and control groups. Then, the intervention was implemented in four stages including nurse's development, managers' development, adaptation and supervision period during four months in the case group. After intervention, clinical competency of nurses was measured in both groups.Results: The results showed that before intervention more than 80% of nurses in two groups was in the moderate clinical competency level and they were proficient based on Benner's skill acquisition model. After intervention, nurses' clinical competency improved to higher level in case group but it didn't change in control group (P<0.05. Conclusion: Creating necessary modifications in nursing environments through the management development program by head nurses may improve nurses' clinical competency.

  19. Job satisfaction and perceived autonomy for nurse practitioners working in nurse-managed health centers. (United States)

    Pron, Ann Linguiti


    More primary care providers are needed to deliver health care to Americans living in poverty and those soon to be insured under the Affordable Care Act. Nurse practitioners (NPs) in nurse-managed health centers (NMHCs) are poised to meet this need. This research study examined the characteristics of NPs working in NMHCs and measured job satisfaction and perceived level of autonomy. No studies about job satisfaction or autonomy for NPs working in NMHCs had been previously reported. This descriptive, quantitative study surveyed primary care NPs working in NMHCs that are part of the National Nursing Centers Consortium (NNCC). NP e-mail addresses were obtained from NNCC center directors. Of 198 NPs invited to the electronic survey, 99 completed the Misener Nurse Practitioner Job Satisfaction Scale, demographic questionnaire, questions about perceived autonomy, and whether they would recommend working in an NMHC. Participants came from 16 states and 46 NMHCs. NPs working in NMHCs have job satisfaction, perceive their role as autonomous, and are satisfied with the autonomy they have. NMHCs can provide access to primary health care for many Americans. More NPs may choose employment in NMHCs for job satisfaction and autonomy. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

  20. Nurse managers: Determinants and behaviours in relation to patient and visitor aggression in general hospitals. A qualitative study. (United States)

    Heckemann, Birgit; Peter, Karin A; Halfens, Ruud Jg; Schols, Jos Mga; Kok, Gerjo; Hahn, Sabine


    To explore nurse managers' behaviours, attitudes, perceived social norms, and behavioural control in the prevention and management of patient and visitor aggression in general hospitals. Patient and visitor aggression in general hospitals is a global problem that incurs substantial human suffering and organizational cost. Managers are key persons for creating low-aggression environments, yet their role and behaviours in reducing patient and visitor aggression remains unexplored. A qualitative descriptive study underpinned by the Reasoned Action Approach. Between October 2015-January 2016, we conducted five focus groups and 13 individual interviews with nurse leaders in Switzerland. The semi-structured interviews and focus groups were recorded, transcribed, and analysed in a qualitative content analysis. We identified three main themes: (i) Background factors: "Patient and visitor aggression is perceived through different lenses"; (ii) Determinants and intention: "Good intentions competing with harsh organizational reality"; (iii) Behaviours: "Preventing and managing aggressive behaviour and relentlessly striving to create low-aggression work environments". Addressing patient and visitor aggression is difficult for nurse managers due to a lack of effective communication, organizational feedback loops, protocols, and procedures that connect the situational and organizational management of aggressive incidents. Furthermore, tackling aggression at an organizational level is a major challenge for nurse managers due to scant financial resources and lack of interest. Treating patient and visitor aggression as a business case may increase organizational awareness and interest. Furthermore, clear communication of expectations, needs and resources could optimize support provision for staff. © 2017 John Wiley & Sons Ltd.

  1. Knowledge management, health information technology and nurses' work engagement. (United States)

    Hendriks, Paul H J; Ligthart, Paul E M; Schouteten, Roel L J


    Knowledge management (KM) extends the health information technology (HIT) literature by addressing its impact on creating knowledge by sharing and using the knowledge of health care professionals in hospitals. The aim of the study was to provide insight into how HIT affects nurses' explicit and tacit knowledge of their ongoing work processes and work engagement. Data were collected from 74 nurses in four wards of a Dutch hospital via a paper-and-pencil survey using validated measurement instruments. In a quasiexperimental research design, HIT was introduced in the two experimental wards in contrast to the two control wards. At the time of the HIT introduction, a pretest was administered in all four wards and was followed by a posttest after 3 months. Data were analyzed via partial least squares modeling. Generally, nurses' tacit knowledge (i.e., their insight into and their capacity to make sense of the work processes) appears to be a significant and strong predictor of their work engagement. In contrast, nurses' explicit knowledge (i.e., information feedback about patients and tasks) only indirectly affects work engagement via its effect on tacit knowledge. Its effect on work engagement therefore depends on the mediating role of tacit knowledge. Interestingly, introducing HIT significantly affects only nurses' explicit knowledge, not their tacit knowledge or work engagement. Nurses' tacit and explicit knowledge needs to be systematically distinguished when implementing HIT/KM programs to increase work engagement in the workplace. Tacit knowledge (insight into work processes) appears to be pivotal, whereas efforts aimed only at improving available information will not lead to a higher level of work engagement in nurses' work environments.

  2. Turnover of professional nurses at Mokopane Hospital in the Limpopo Province, South Africa: Experiences of nursing unit managers

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    Mogale L. Mmamma


    Full Text Available Background: 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. Objectives: 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. Method: 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. Results: 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. Conclusion: 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.

  3. An ethical leadership program for nursing unit managers. (United States)

    Jeon, Sang Hee; Park, Mihyun; Choi, Kyungok; Kim, Mi Kyoung


    The aims of this study were to evaluate the effect of an ethical leadership program (ELP) on ethical leadership, organizational citizenship behavior (OCB), and job outcomes of nursing unit managers (UMs) and to examine changes in staff nurses' perception about UMs' EL, OCB, job outcomes, and ethical work environments (EWEs) post-ELP. A quasi-experimental (pre- and post-test design) study conducted six-month intervention (ELP) using self-reported UM survey (n=44), and staff nurses (n=158) were randomly extracted by two steps. The Korean version of Ethical Leadership at Work for UMs' self-ethical leadership, the Ethical Leadership Scale for staff nurses' perceived ethical leadership, a 19-item OCB scale, and six dimensions of the medium-sized Copenhagen Psychosocial Questionnaire II for job outcomes and EWEs were administered at baseline and post-intervention. UMs' ethical leadership scores differed significantly over time in people orientation (p=0.041) and concern for ethical leadership sustainability (p=0.002) adjusting for UM experience duration and nursing unit type. Total mean and level of power-sharing of ethical leadership among UMs with leadership, OCB, job outcomes, and EWEs, significant improvement over time appeared only in EWEs' work influence level (p=0.007). This study provides useful information for clinical ELP development and examining the program's effect on leadership skills and followers' outcomes. Program facilitation relies on practical training methods, participant motivation, and assessment outcome designs by controlling clinical confounding factors. Findings have implications as an attempt for intervention to promote competencies related to ethical leadership of nursing unit managers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Practices and outcomes: pressure ulcer management in nursing facilities. (United States)

    Rapp, Mary Pat; Nelson, Francine; Slomka, Jacquelyn; Persson, Diane; Cron, Stanley G; Bergstrom, Nancy


    The objective of this study was to compare reported pressure ulcer prevention and treatment practices in nursing facilities with high prevalence of pressure ulcers versus nursing facilities with low prevalence of pressure ulcers. A 26-item survey on implementation of nationally accepted standards for pressure ulcer prevention and treatment was mailed to directors of nursing in all 68 nursing facilities in an urban county. There were no statistically significant differences on reported pressure ulcer prevention interventions based on pressure ulcer prevalence. When treating pressure ulcers, respondents of facilities with high prevalence of pressure ulcers reported more frequent pain assessments, more frequent use of low air-loss beds, and daily wound assessments. The study failed to support the hypothesis that nursing facilities with low prevalence of pressure ulcers report using more guideline-recommended pressure ulcer prevention and treatment interventions than facilities with high prevalence of pressure ulcers. Reported adherence to recommended interventions for repositioning and pressure relief measures, moisture management, and attention to nutrition exceeded 60% in all facilities. The disparity between reported interventions and pressure ulcer prevalence rates offers an opportunity for future collaborative quality improvement projects, research, and the need for leadership to develop systems of care to ensure the use of pressure ulcer prevention guidelines.

  5. Use of Balanced Indicators as a Management Tool in Nursing

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    Neidamar Pedrini Arias Fugaça


    Full Text Available Objective: to develop a proposal for a nursing panel of indicators based on the guiding principles of Balanced Scorecard. Method: a single case study that ranked 200 medical records of patients, management reports and protocols, which are capable of generating indicators. Results: we identified 163 variables that resulted in 72 indicators; of these, 32 nursing-related: two financial indicators (patient's average revenue per day and patient's revenue per day by product used; two client indicators (overall satisfaction rate of patient with nursing care and adherence rate to the patient satisfaction survey; 23 process indicators, and five learning and growth indicators (average total hours of training, total of approved nursing professionals in the internal selection process, absenteeism rate, turnover rate and index of performance evaluation. Conclusion: although there is a limit related to the amount of data generated, the methodology of Balanced Scorecard has proved to be flexible and adaptable to incorporate nursing services. It was possible to identify indicators with adherence to more than one area. Internal processes was the area with the higher number of indicators.

  6. Nursing pain management--a qualitative interview study of patients with pain, hospitalized for cancer treatment. (United States)

    Rustøen, Tone; Gaardsrud, Torill; Leegaard, Marit; Wahl, Astrid K


    Pain is a significant symptom in cancer patients. Understanding of patients' experiences in relation to pain management is important in evidence-based nursing in the field of pain. The aim of this study was to explore cancer patients' experiences of nursing pain management during hospitalization for cancer treatment. Eighteen cancer patients participated in the study, all with advanced cancer, including skeleton metastases. The female participants all had breast cancer, and the male participants all had prostate cancer. Data were collected by in-depth interviews, and qualitative description was used to entail low-inference interpretation to reach an understanding of the essence of pain and nursing pain management. Patients found it somewhat difficult to express their expectations of nursing pain management and competencies. However, 1) being present and supportive; 2) giving information and sharing knowledge; 3) taking care of medication; and 4) recognizing the pain emerged as themes in nursing pain management. Although patients believed that nurses were caring persons, they perceived differences between nurses in the ways they handled pain management. Furthermore, some patients experienced a lack of information from nurses in relation to pain management. Although cancer patients' experiences showed the importance of nurses in pain management, it seems that nurses should have a clearer role in cancer pain management in relation to counseling and patient education. The results from this study can increase nurses' awareness of their role in pain management as a first step in improving pain management for patients.

  7. Vacant hospitals and under-employed nurses: a qualitative study of the nursing workforce management situation in Nepal. (United States)

    Adhikari, Radha


    It is vital for all healthcare systems to have a sufficient number of suitably trained health professionals including nurses at all levels of health services to deliver effective healthcare. An ethnographic, qualitative method was chosen for this study, which included open-ended, in-depth interviews with a range of stakeholders including student nurses, qualified nurses, nurse managers and lecturers, and the human resource co-ordinator in the Ministry of Health and Population. Available records and policy documents were also analysed. Study findings suggest that there is a severe mal-distribution of the nursing workforce in rural and urban healthcare centres in Nepal. Although there is an oversupply of newly qualified nurses in hospitals in Kathmandu, the staffing situation outside the valley is undesirable. Additionally, the turnover of junior nursing staff remains high in major urban hospitals. Most qualified nurses aspire to work in developed countries, such as the UK, North America, Australia and New Zealand. Between 2000 and 2008, as many as 3000 nurses have left Nepal for jobs in the developed west. There is no effective management strategy in place to retain a nursing workforce, particularly in rural Nepal. This article concludes by proposing some suggestions for a nursing workforce retention policy to address this critical issue. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  8. Antipsychotic Drug-Induced Somnolence: Incidence, Mechanisms, and Management. (United States)

    Fang, Fang; Sun, Hongwei; Wang, Zuowei; Ren, Ming; Calabrese, Joseph R; Gao, Keming


    Somnolence is a common side effect of antipsychotics. To assess the incidence of this side effect, we performed a MEDLINE search for randomized, double-blinded, placebo- or active-controlled studies of adult patients treated with antipsychotics for schizophrenia, mania, bipolar depression, or bipolar disorder. We extracted rates of somnolence from original publications and pooled them based on the dose of each antipsychotic in the same psychiatric condition, then estimated the absolute risk increase (ARI) and the number needed to harm (NNH) of an antipsychotic relative to placebo or an active comparator in the same psychiatric condition. According to the ARI in acute schizophrenia, bipolar mania, and bipolar depression, antipsychotics can be classified as high somnolence (clozapine), moderate somnolence (olanzapine, perphenazine, quetiapine, risperidone, ziprasidone), and low somnolence (aripiprazole, asenapine, haloperidol, lurasidone, paliperidone, cariprazine). The risk of somnolence with blonanserin, brexpiprazole, chlorpromazine, iloperidone, sertindole, and zotepine needs further investigation. The rates of somnolence were positively correlated to dose and duration for some antipsychotics, but not for others. Many factors, including antipsychotic per se, the method used to measure somnolence, patient population, study design, and dosing schedule, might affect the incidence of antipsychotic-induced somnolence. The mechanisms of antipsychotic-induced somnolence are likely multifactorial, although the blockade of histamine 1 receptors and α1 receptors may play a major role. The management of antipsychotic-induced somnolence should include sleep hygiene education, choosing an antipsychotic with a lower risk for somnolence, starting at a lower dose with a slower titration based on psychiatric diagnoses, adjusting doses when necessary, and minimizing concurrent somnolence-prone agents. Since most cases of somnolence were mild to moderate, allowing tolerance to


    Directory of Open Access Journals (Sweden)

    Aruna Kumari


    Full Text Available INTRODUCTION: Parapharyngeal tumors are rare, comprising approximately 0.5% of all head and neck tumours. Most of them are benign. These tumors present with difficulties in diagnosis - complementary MRI and CT scanning are necessary for diagnosis, and Fine Needle Aspiration Cytology (FNAC is very specific in the histological diagnosis of these tumours. Open biopsy is not advisable due to bleeding, breaching of the capsule and seeding of the tumor. These tumors presents a challenge to the surgeon due to its anatomical complexities. This study deals with the incidence and management of various parapharyngeal tumors. OBJECTIVE OF THE STUDY: This study deals with the incidence of various tumors in the parapharyngeal space in different age and sex groups, role of sophisticated diagnostic modalities like CT, MRI, MR Angio. Colour Doppler along with FNAC and various surgical approaches to this space. This study also deals with intra-operative and post operative complications. In this series, a total of 25 cases has been studied retrospectively in a time period of 2 years from 2012 to 2014, presenting in our ENT and Head and Neck Dept., Gandhi hospital. RESULTS: According to this study, there is male preponderance (52% and highest incidence is seen in 3rd and 5th decade (24% each. Most common presenting symptoms are difficulty in swallowing (36% and swelling either intraoral or in the neck (28%. Least common symptoms being cranial nerve palsy (4%, difficulty in breathing/noisy breathing (4%, nasal regurgitation (4% and hard of hearing (8%. FNAC was done in 21 cases, in which 13 were correlating with the biopsy report. CT scan was required in all cases. MR Angiography was done in 4 cases and colour Doppler in 2 cases. Surgery is the mainstay of the treatment. Most common tumor in PPS is neurogenic (schwannoma/neurofibroma.i.e 44%. Next commonly occurring tumor in our study is of salivary origin-pleomorphic adenoma (24%, paragangliomas (12%. Other less

  10. [Management in nursing: a critical view about the knowledge produced in Brazilian journals (2000-2004)]. (United States)

    Jorge, Maria Salete Bessa; de Freitas, Consuelo Helena Aires; Nóbrega, Maria Fátima Bastos; Queiroz, Maria Veraci Oliveira


    This study aimed at analyzing the scientific production about management in nursing in Brazilian journals through bibliographic research in the period from 2000 to 2004. This bibliographic study considered data bases and libraries during the period of May to July 2005. From the texts submitted to categorization apprehended the following categories: general considerations about management; the formation of nurse in management area; models of management in nursing in practice and management theories used; difficulties in nursing management; suggestions of changes and solutions to be searched. The confronts and reflections pointed out the need of transformation of management in direction to a participative and flexive posture, valuing the human potential.

  11. Occupational Stress and Turnover Intention: Implications for Nursing Management

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    Ali Mohammad Mosadeghrad


    Full Text Available BackgroundThe main purpose of this study was to explore the status of occupational stress among hospital nurses in Isfahan, Iran. It also aimed to examine the relationship between nurses’ occupational stress and their intention to leave the hospital. MethodsThe study employed a cross-sectional research design. A validated questionnaire was used to collect data from 296 nurses. Respondents were asked to rate the intensity of 30 common occupational stressors using a five-point scale. ResultsA third of hospital nurses rated their occupational stress high. The major sources of stress were inadequate pay, inequality at work, too much work, staff shortage, lack of promotion, job insecurity and lack of management support. More than 35% of nurses stated that they are considering leaving the hospital, if they could find another job opportunity. Occupational stress was positively associated with nurses’ turnover intentions. ConclusionHospital managers should develop and apply appropriate policies and strategies to reduce occupational stress and consequently nurses’ turnover intention.

  12. Incidence and Risk Factors of Workplace Violence on Nursing Staffs Caring for Chronic Psychiatric Patients in Taiwan


    Chen, Wen-Ching; Sun, Yu-Hua; Lan, Tsuo-Hung; Chiu, Hsien-Jane


    This one-year follow-up study determined the incidence and risk factors of workplace violence against nursing staff in a psychiatric hospital. The cohort members had a website to report events whenever they came across violence. A total of 971 events were reported. The incidence rates of physical violence, verbal abuse, bullying/mobbing, sexual harassment, and racial harassment were 1.7, 3.7, 0.2, 0.3, and 0 per staff-year, respectively. Young age, female sex, lower education, shorter duratio...

  13. Acceptability and perceived utility of drone technology among emergency medical service responders and incident commanders for mass casualty incident management. (United States)

    Hart, Alexander; Chai, Peter R; Griswold, Matthew K; Lai, Jeffrey T; Boyer, Edward W; Broach, John


    This study seeks to understand the acceptability and perceived utility of unmanned aerial vehicle (UAV) technology to Mass Casualty Incidents (MCI) scene management. Qualitative questionnaires regarding the ease of operation, perceived usefulness, and training time to operate UAVs were administered to Emergency Medical Technicians (n = 15). A Single Urban New England Academic Tertiary Care Medical Center. Front-line emergency medical service (EMS) providers and senior EMS personnel in Incident Commander roles. Data from this pilot study indicate that EMS responders are accepting to deploying and operating UAV technology in a disaster scenario. Additionally, they perceived UAV technology as easy to adopt yet impactful in improving MCI scene management.

  14. [Training student nurses in risk management]. (United States)

    Nombalier, Yannick


    At the heart of the complexity of an organised system, the student must learn to manage situations presenting characteristics of known or potential risk. The trainer integrates it into an approach in which reflexive analysis and objectivity are essential in the professional practice. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. Effectiveness of a nurse-managed protocol to prevent hypoglycemia in hospitalized patients with diabetes. (United States)

    Marelli, Giuseppe; Avanzini, Fausto; Iacuitti, Giuseppe; Planca, Enrico; Frigerio, Ilaria; Busi, Giovanna; Carlino, Liliana; Cortesi, Laura; Roncaglioni, Maria Carla; Riva, Emma


    Hypoglycemia due to inadequate carbohydrate intake is a frequent complication of insulin treatment of diabetic in-patients. Objective. To assess the effectiveness of a nurse-managed protocol to prevent hypoglycemia during subcutaneous insulin treatment. Prospective pre-post-intervention study. In 350 consecutive diabetic in-patients the incidence of hypoglycemia (blood glucose food to integrate incomplete carbohydrate intake in the meal; (2) in case of lack of appetite or repeatedly partial intake of the planned food, prandial insulin administered at the end of the meal to be related to the actual amount of carbohydrates eaten; (3) intravenous infusion of glucose during prolonged fasting. Eighty-four patients in phase A and 266 in phase B received subcutaneous insulin for median periods of, respectively, 7 (Q1-Q3 6-12) and 6 days (Q1-Q3 4-9). Hypoglycemic events declined significantly from 0.34 ± 0.33 per day in phase A to 0.19 ± 0.30 in phase B (P > 0.001). A nurse-managed protocol focusing on carbohydrate intake reduced the incidence of hypoglycemia in patients with diabetes receiving subcutaneous insulin in hospital.

  16. Prostate Cancer in Transgender Women: Incidence, Etiopathogenesis, and Management Challenges. (United States)

    Deebel, Nicholas A; Morin, Jacqueline P; Autorino, Riccardo; Vince, Randy; Grob, Baruch; Hampton, Lance J


    To critically analyze the available evidence regarding the incidence, etiopathogenesis, and management of prostate cancer (CaP) in transgender women. In addition, this article aims to present a recent case report of a transgender woman with a unique presentation at the author's institution. An electronic nonsystematic literature search was performed to identify pertinent studies. PubMed search engine was queried by using the following search terms: "prostate cancer," "male to female transsexual," "transgender patient," "androgen + prostate cancer," "estrogen therapy + prostate cancer," and "health care barrier." In addition, a clinical case managed at our institution was reviewed and critically discussed. Including our case, there have been only 10 documented cases of CaP in transgender women. Additionally, an emerging body of literature has questioned the role of androgens in the development of CaP and suggested that estrogen therapy may not be as protective as initially thought. Therefore, the current evidence suggests that the transgender woman should be screened for CaP the same as a nontransgender men. Barriers to care in the transgender female population include accessing resources, medical knowledge deficits, ethics of transition-related medical care, diagnosing vs pathologizing transgender patients, financial restrictions of the patient, and health system determinants. Although rare, CaP in transgender women has been documented. Both the mechanism and the impact of receiving a bilateral orchiectomy on disease development are unclear. Future study is needed to examine these factors, and to further shape the treatment and screening regimen for these patients. Published by Elsevier Inc.

  17. Policies for managing emergency medical services in mass casualty incidents. (United States)

    Adini, B; Bodas, M; Nilsson, H; Peleg, K


    Diverse decision-making is needed in managing mass casualty incidents (MCIs), by emergency medical services (EMS). The aim of the study was to review consensus among international experts concerning policies of EMS management during MCIs. Applicability of 21 EMS policies was tested through a 2-cycle modified e-Delphi process, in which 38 multi-disciplinary experts from 10 countries participated. Threshold for approving proposed solutions was defined as consensus of >80%. Policies that did not achieve the targeted consensus were reviewed to detect variability according to respondents' origin country. 16 policies were endorsed in the first cycle including collaboration between ambulance service providers; implementing a unified mode of operation; preparing criteria for ground versus aerial evacuation; and, developing support systems for caregivers exposed to violence. An additional policy which proposed that senior EMS officers should not necessarily act as on-site MCI commanders was endorsed in the second cycle. Demographic breakdown of views concerning non-consensual policies revealed differences according to countries of origin. Assigning ambulances to off-duty team members was highly endorsed by experts from Israel and South Africa and strongly rejected by European respondents. Avoiding entry to risk areas until declared safe was endorsed by European, Asian and Oceanic experts, but rejected by Israeli, South African and North American experts. Despite uniqueness of countries and EMS agencies, solutions to most dilemmas were applicable to all organizations, regardless of location or affiliation. Cultural diversity was found concerning readiness to implement military-civilian collaboration in MCIs and a rigid separation between work-leisure responsibilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Examining the structural challenges to communication as experienced by nurse managers in two US hospital settings. (United States)

    Marx, Marcia


    This study examined the structural barriers to communication for first-line nurse managers with their staff nurses. The delivery of quality care depends on effective communication in hospital units. First-line nurse managers are central figures in networks whose responsibility is to communicate information from the senior management to staff nurses. The data were collected using face-to-face interviews with first-line managers at two US hospitals The interviews were transcribed and coded with limited use of the qualitative software atlas Interview questions focused on work experiences of managers with special emphases on communication. Structural barriers that influenced managers' communication included the amount of face-to-face interaction with nurses, the amount of information to communicate, levels of formalization, outreach to all nurses, time constraints and nurses' subcultural networks These factors compromised managers' ability to communicate effectively with nurses. Managers should carefully examine how structure affects communication recognizing that some dynamics of structure cannot be changed but that they can influence others, such as formalization and communication networks. Managers should examine their own positioning within nurses' networks and demonstrate to nurses that their expertise contributes to the collaborative capital upon which nursing practice depends. © 2013 John Wiley & Sons Ltd.

  19. What do cardiovascular nurses know about the hematological management of patients with Eisenmenger syndrome?

    NARCIS (Netherlands)

    Moons, Philip; Fleck, Desiree; Jaarsma, Tiny; Norekval, Tone M.; Smith, Karen; Stromberg, Anna; Thompson, David R.; Budts, Werner


    Aim: We investigated the level of knowledge of hematological management of patients with Eisenmenger syndrome among general cardiovascular nurses and nurses who specialize in congenital heart disease (CHD). Methods: We conducted a survey at two international conferences attended by cardiovascular

  20. A Nurse communication manager reduces the number of non-relevant contacts

    DEFF Research Database (Denmark)

    Wright, Nana; Laursen, Jannie; Rosenberg, Jacob


    Objective The aim of this study was to reduce interruptions in nursing practice by exploring the effects on the number of nonrelevant contacts received by the nursing staff after implementation of a Nurse Communication Manager. Design The study was designed as a pre/post interventional study. All...... contacts to the nursing staff, either by telephone or in person, were registered 14 days before intervention and 14 days after intervention. Setting The study was set in a department of surgery. Subjects The subjects were contacts either in person or by telephone aimed at nurses and nurse assistants...... in the surgical department. Interventions During the daytime a Nurse Communication Manager handled all incoming contacts irrespective of whether they were in person or by telephone. When the Nurse Communication Manager was not available and during the evening, night and weekends, telephone contacts were managed...

  1. Management of change for nurses: lessons from the discipline of organizational studies. (United States)

    Shanley, Chris


    This paper explores the literature on change management from the discipline of organizational studies to provide insights that nurse managers can use in their professional practice. The paper will benefit nurse managers by extending the nursing discourse on change management to include wider theoretical and academic perspectives. Important aspects of change management explored are the roles of power and political behaviour, how much change can be planned and controlled, how to combine top-down and bottom-up approaches to change, the role of emotions in the change management process, a comparison of prescriptive and analytical approaches to understanding change, and the connection between theory and practice in managing change. While nurses can draw much useful information from within the nursing discipline, they can also benefit by exploring other disciplinary areas. In the case of change management, there are many useful lessons nurses can carry over into their professional practice.

  2. Conflict in schools: student nurses' conflict management styles. (United States)

    Kantek, Filiz; Gezer, Nurdan


    Unless conflicts between the students and the instructors can be successfully managed, they will certainly result in negative outcomes for the students. The conflict management styles of the students should be recognized in detail in order to attain positive outcomes in regard to the conflict management styles. The purpose of this study was to examine the conflict management styles used by nursing students in conflict with faculty members and the differences in use of style from the aspect of some variables. This study was conducted with 151 students in a public university nursing school. Data were collected using a personal information form and the Rahim Organizational Conflict Inventory II (ROCI II). The data were analyzed using descriptive statistics, ANOVA, Tukey test, Kruskal Wallis test, Mann-Whitney U test and Cronbach alpha coefficient analyses. The students were found to use integrating (X=3.82) and obliging (X=3.81) styles the most, and dominating style (X=3.02) the least. In addition there were differences determined in management style between classes, frequency of experiencing conflict, and feeling of success in the conflict (pconflict resolution and that the frequency of experiencing conflict and the feeling of success in conflict had an effect on choice of style. It will be helpful to analyze the relationship between the causes of conflict between the student and the instructor in the practice field and the uses of conflict management styles.

  3. Rumor management in nursing systems: role of the psychiatric CNS. (United States)

    Chase, P; Stuart, G W


    RUMOR MANAGEMENT AND control is particularly important in nursing systems during times of change. In this article, a brief history of the study of rumor and the rumor process is given and applied to nursing, systems thinking and the CNS, and three types of rumor are described. Examples are given and strategies and approaches for managing rumor are prescribed. The first approach, used when a final decision about a planned change has not been made, helps avoid "trickle down" and builds trust and empowerment by soliciting and using input from those who will be affected by the proposed change. The intent of the second approach, used when a decision has been finalized or an event has occurred and rumor has preceded an official announcement, is to debrief from the occurrence or transform the decision. The last approach is used to interrupt a pattern of misinformation and to clarify or inform. The nurse leader or manager must stay in the communication loop and refrain from blaming a speculated source in order to correct information.

  4. Perception Of Nursing Middle Managers About The Evidence-Based Management

    Directory of Open Access Journals (Sweden)

    Wilza Carla Spiri


    Full Text Available Objective: to comprehend the experience of nursing middle managers of an accredited public hospital, from São Paulo state, about the evidence-based management. Method: case study and analysis of thematic content in the stages of unity of meaning, condensed meaning unity, interpretation of the underlying meaning, sub-theme and theme. Nine manager nurses participated. The data collection was done through a script with questions that, according to the convenience of the participants, were answered by electronic mail. The data were analyzed in the light of the theoretical reference of the managerial process in nursing and the evidence-based management. Results: six themes were revealed: Evidence-based management and management process; Evidence-based management strengths; Evidence-based management challenges; the leader and the Evidence-based management; Hospital accreditation and evidence-based management and Experiences with the evidence-based management. Conclusion: the scientific knowledge and the experiences in the work are sources of evidences that interfere, positively, in the quality and safety of the patient. Leadership training, planning, team empowerment and involvement are essential for the development of this practice. Strategies need to be discussed and implemented so that the management process is based on evidences.

  5. Relationship between management styles and nursesв€™ retention ...

    African Journals Online (AJOL)

    Magda E. Nassar


    Sep 21, 2011 ... sector. Abstract Introduction: Management styles are an essential issue from both theoretical and man- agerial perspectives. However, success in nursing management is found ... commitment and job satisfaction amongst nurses in manage- ... managers' leadership style to be, the more satisfied they were.

  6. Management practices associated with the incidence rate of clinical mastitis. (United States)

    Barkema, H W; Schukken, Y H; Lam, T J; Beiboer, M L; Benedictus, G; Brand, A


    Risk factors for the incidence rate of clinical mastitis were studied in 274 Dutch dairy herds. Variables that were associated with resistance to disease were the feeding, housing, and milking machine factors. Variables that were associated with exposure were grazing, combined housing of dry cows and heifers, and calving area hygiene. Postmilking teat disinfection in herds with a low bulk milk somatic cell count and years of practicing dry cow therapy were positively associated with the incidence rate of clinical mastitis. Herds with a low bulk milk somatic cell count and in which postmilking teat disinfection was not used had lower incidence rates of clinical mastitis than did other herds. The incidence rate of clinical mastitis caused by Escherichia coli was mostly related to housing conditions, hygiene, and machine milking. The incidence rate of clinical mastitis caused by Staphylococcus aureus was mostly related to factors associated with bulk milk somatic cell count and factors that might be due to cause and effect reversal. A strong positive correlation existed between the incidence rate of clinical mastitis caused by Streptococcus dysgalactiae and the incidence rate of clinical mastitis caused by Staph. aureus. The incidence rate of clinical mastitis caused by Streptococcus dysgalactiae was related to nutrition, milking technique, and machine milking. The incidence rate of clinical mastitis caused by Streptococcus uberis was associated with factors related to housing, nutrition, and machine milking.

  7. Profile of an excellent nurse manager: identifying and developing health care team leaders. (United States)

    Kallas, Kathryn D


    The purpose of this research was to identify the profile of an excellent nurse manager who can lead effective health care teams. Leadership attributes and competencies that characterize an excellent nurse manager and tools to identify them are lacking in the literature but are required to efficiently and effectively address the growing shortage of registered nurses (RNs) in health care team leadership roles and the critical linkage of these roles to patient outcomes. A profile of an excellent nurse manager was developed on the basis of the responses of nurse managers across the United States who had been identified as excellent or competent by chief nurse executive assessment or/and the Nurse Manager Ability, Leadership, and Support of Nurses staff survey to the Kouzes and Posner Leadership Practices Inventory: Self Instrument. Statistically significant distinctions exist between nurse managers who are excellent and those who are competent as assessed by the Five Practices of Exemplary Leadership, which together comprise the profile of an excellent nurse manager. The Kouzes and Posner Leadership Practices Inventory: Self Instrument can be used to identify, recruit, and develop RNs in the nurse manager role as excellent leaders of effective health care teams.

  8. Leadership skills for nursing unit managers to decrease intention to leave

    Directory of Open Access Journals (Sweden)

    Roche MA


    Full Text Available Michael A Roche,1 Christine Duffield,1,2 Sofia Dimitrelis,1 Belinda Frew1 1Centre for Health Services Management, Faculty of Health, University of Technology, Sydney, NSW, 2Clinical Nursing and Midwifery Research Centre, School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia Aim: To examine specific elements of nursing leadership linked to intention to leave, in public acute care hospitals. Background: Nurse turnover is a global issue receiving widespread attention due to prolonged and projected workforce shortages. Nurse management and leadership qualities have been associated with intention to leave and turnover of nurses. The role of the nurse unit managers in the retention of nurses is becoming increasingly important, particularly because of their strong influence on the quality and stability of the work environment. Methods: Data were collected from 62 medical, surgical, and mixed units across eleven public acute care hospitals in three Australian states (September 2008 to August 2010. A total of 1,673 nurses completed a nurse survey that included measures of intention to leave and leadership aspects of the practice environment. Analyses explored specific leadership characteristics that were associated with turnover intent. Results: The role of nursing unit managers was confirmed to be a major factor in nurses’ intention to remain or leave their current workplace. Nurses valued “human” skills more highly than other leadership characteristics, including their manager’s connection with nurses’ concerns, clarity, participation in decisions, and encouragement. Conclusion: Strong leadership qualities in the nursing unit manager have been associated with greater job satisfaction, reduced turnover intention among nursing staff, and improved patient outcomes. Nurse leaders need to be supported in an effort to retain nurses given ongoing workforce issues and to ensure high-quality patient care. Keywords: nurse

  9. Australia's health care reform agenda: implications for the nurses' role in chronic heart failure management. (United States)

    Betihavas, Vasiliki; Newton, Phillip J; Du, Hui Yun; Macdonald, Peter S; Frost, Steven A; Stewart, Simon; Davidson, Patricia M


    The importance of the nursing role in chronic heart failure (CHF) management is increasingly recognised. With the recent release of the National Health and Hospitals Reform Commission (NHHRC) report in Australia, a review of nursing roles in CHF management is timely and appropriate. This paper aims to discuss the implications of the NHHRC report and nursing roles in the context of CHF management in Australia. The electronic databases, Thomson Rheuters Web of Knowledge, Scopus and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), were searched using keywords including; "heart failure", "management", "Australia" and "nursing". In addition policy documents were reviewed including statements and reports from key professional organisations and Government Departments to identify issues impacting on nursing roles in CHF management. There is a growing need for the prevention and control of chronic conditions, such as CHF. This involves an increasing emphasis on specialist cardiovascular nurses in community based settings, both in outreach and inreach health service models. This review has highlighted the need to base nursing roles on evidence based principles and identify the importance of the nursing role in coordinating and managing CHF care in both independent and collaborative practice settings. The importance of the nursing role in early chronic disease symptom recognition and implementing strategies to prevent further deterioration of individuals is crucial to improving health outcomes. Consideration should be given to ensure that evidence based principles are adopted in models of nursing care. Copyright © 2010 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  10. Nurses' adherence to the Kangaroo Care Method: support for nursing care management1 (United States)

    da Silva, Laura Johanson; Leite, Josete Luzia; Scochi, Carmen Gracinda Silvan; da Silva, Leila Rangel; da Silva, Thiago Privado


    OBJECTIVE: construct an explanatory theoretical model about nurses' adherence to the Kangaroo Care Method at the Neonatal Intensive Care Unit, based on the meanings and interactions for care management. METHOD: qualitative research, based on the reference framework of the Grounded Theory. Eight nurses were interviewed at a Neonatal Intensive Care Unit in the city of Rio de Janeiro. The comparative analysis of the data comprised the phases of open, axial and selective coding. A theoretical conditional-causal model was constructed. RESULTS: four main categories emerged that composed the analytic paradigm: Giving one's best to the Kangaroo Method; Working with the complexity of the Kangaroo Method; Finding (de)motivation to apply the Kangaroo Method; and Facing the challenges for the adherence to and application of the Kangaroo Method. CONCLUSIONS: the central phenomenon revealed that each nurse and team professional has a role of multiplying values and practices that may or may not be constructive, potentially influencing the (dis)continuity of the Kangaroo Method at the Neonatal Intensive Care Unit. The findings can be used to outline management strategies that go beyond the courses and training and guarantee the strengthening of the care model. PMID:26155013

  11. Nurses' adherence to the Kangaroo Care Method: support for nursing care management

    Directory of Open Access Journals (Sweden)

    Laura Johanson da Silva


    Full Text Available OBJECTIVE: construct an explanatory theoretical model about nurses' adherence to the Kangaroo Care Method at the Neonatal Intensive Care Unit, based on the meanings and interactions for care management.METHOD: qualitative research, based on the reference framework of the Grounded Theory. Eight nurses were interviewed at a Neonatal Intensive Care Unit in the city of Rio de Janeiro. The comparative analysis of the data comprised the phases of open, axial and selective coding. A theoretical conditional-causal model was constructed.RESULTS: four main categories emerged that composed the analytic paradigm: Giving one's best to the Kangaroo Method; Working with the complexity of the Kangaroo Method; Finding (demotivation to apply the Kangaroo Method; and Facing the challenges for the adherence to and application of the Kangaroo Method.CONCLUSIONS: the central phenomenon revealed that each nurse and team professional has a role of multiplying values and practices that may or may not be constructive, potentially influencing the (discontinuity of the Kangaroo Method at the Neonatal Intensive Care Unit. The findings can be used to outline management strategies that go beyond the courses and training and guarantee the strengthening of the care model.

  12. A profile of the structure and impact of nursing management in Canadian hospitals. (United States)

    Laschinger, Heather K Spence; Wong, Carol A; Ritchie, Judith; D'Amour, Danielle; Vincent, Leslie; Wilk, Piotr; Stassen, Marjorie Armstrong; Matthews, Sue; Saxe-Braithwaite, Marcy; Grinspun, Doris; Shamian, Judith; McCutcheon, Amy; Kerr, Michael; Macdonald-Rencz, Sandra; Oke, Barbara; Denney, Donna; White, Jerry; Almost, Joan


    The purpose of this study was to describe the profile of nursing leadership structures in Canada and to assess relationships among structures, processes and outcomes pertaining to nurse leaders' work. Data were collected from nurse leaders in 28 academic health centres and 38 community hospitals in 10 Canadian provinces (n = 1,164). The results of this study revealed that the current contingent of nursing leaders in Canada see themselves as an empowered and influential group within their organizations. Despite very large spans of control, nurse leaders at all levels were positive about their work life and confident in their ability to provide effective leadership on nursing affairs within their organizations. Structural and process factors significantly affected nurse manager outcomes at all levels. Senior nurse leaders' work-life factors had a significant effect on middle and first-line managers' perceptions of patient care quality in the organization. Nurse leaders averaged 49 years of age highlighting the need for succession planning.

  13. CE: Preeclampsia: Current Approaches to Nursing Management. (United States)

    Anderson, Cindy M; Schmella, Mandy J


    : Preeclampsia, one of four hypertensive disorders of pregnancy, has traditionally been characterized as new-onset hypertension and proteinuria developing after 20 weeks' gestation. It is, however, now understood to be a complex, progressive, multisystem disorder with a highly variable presentation and a number of potentially life-threatening complications. The American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy has refined preeclampsia diagnostic criteria accordingly, and as the disorder's pathogenesis has been more clearly defined, new targets for screening, diagnosis, prevention, and treatment have emerged. This clinical update provides a review of current practice related to preeclampsia risk assessment, prediction, and management. It discusses preeclampsia pathophysiology and points readers to valuable health care resources on the topic.

  14. Nurse managers' insights regarding their role highlight the need for practice changes. (United States)

    Moore, Linda Weaver; Sublett, Cynthia; Leahy, Cathy


    The purpose of this study was to understand the insights of nurse managers regarding the nurse manager role. Nurse managers are vital to the success of healthcare organizations. Vacancy rates of nurse manager positions are on the rise. Recruiting and retaining qualified individuals for these positions requires an understanding of the perceptions of nurse managers regarding the role and the issues embedded in the role. A descriptive, qualitative investigation was conducted. Data were analyzed using content analysis. Although desired, role orientation, mentorship, and a strong foundational knowledge, were often lacking. Personal attributes viewed as important for success in the role included seeking opportunities and intentional self-growth. Lessons learned while in the role included the art of managing role demands and that comfort comes with time. Concerns regarding the preparation for, introduction to, and support in the nurse manager role highlight the need for practice changes. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Incidence, diagnosis and management of eye affections in dogs ...

    African Journals Online (AJOL)

    A retrospective study of ocular affections in dogs was conducted at some selected clinics and hospitals in Southwest Nigeria between 2003 and, 2013 to determine the incidence, pattern of distribution, methods of diagnosis and treatment modalities using descriptive statistical tool. Overall incidence of eye affection in dogs ...

  16. The World Trade Center attack. Helping the helpers: the role of critical incident stress management. (United States)

    Hammond, J; Brooks, J


    Healthcare and prehospital workers involved in disaster response are susceptible to a variety of stress-related psychological and physical sequelae. Critical incident stress management, of which critical incident stress debriefing is a component, can mitigate the response to these stressors. Critical incident stress debriefing is a peer-driven, therapist-guided, structured, group intervention designed to accelerate the recovery of personnel. The attack on the World Trade Center, and the impact it may have on rescue, prehospital, and healthcare workers, should urge us to incorporate critical incident stress management into disaster management plans.

  17. Nursing management and organizational ethics in the intensive care unit. (United States)

    Wlody, Ginger Schafer


    This article describes organizational ethics issues involved in nursing management of an intensive care unit. The intensive care team and medical center management have the dual responsibility to create an ethical environment in which to provide optimum patient care. Addressing organizational ethics is key to creating that ethical environment in the intensive care unit. During the past 15-20 yrs, increasing costs in health care, competitive markets, the effect of high technology, and global business changes have set the stage for business and healthcare organizational conflicts that affect the ethical environment. Studies show that critical care nurses experience moral distress and are affected by the ethical climate of both the intensive care unit and the larger organization. Thus, nursing moral distress may result in problems related to recruitment and retention of staff. Other issues with organizational ethics ramifications that may occur in the intensive care unit include patient safety issues (including those related to disruptive behavior), intensive care unit leadership style, research ethics, allocation of resources, triage, and other economic issues. Current organizational ethics conflicts are discussed, a professional practice model is described, and multidisciplinary recommendations are put forth.

  18. Using a Critical Incident Scenario With Virtual Humans to Assess Educational Needs of Nurses in a Postanesthesia Care Unit. (United States)

    White, Casey; Chuah, Joon; Robb, Andrew; Lok, Benjamin; Lampotang, Samsun; Lizdas, David; Martindale, James; Pi, Guillermo; Wendling, Adam


    During critical incidents, teamwork failures can compromise patient safety. This study provides evidence that virtual humans can be used in simulated critical incidents to assess the learning needs of health professionals, and provide important information that can inform the development of continuing education programs in patient safety. We explored the effectiveness of information transfer during a devolving medical situation between postanesthesia care unit (PACU) nurses and a virtual attending physician. We designed a three-stage scenario: tutorial, patient transfer, and critical incident. We developed 2 checklists to assess information transfer: Critical Patient Information and Interprofessional Communication Skills. All participants were videotaped; 2 raters reviewed all videos and assessed performance using the checklists. Participants (n = 43) who completed all 3 stages scored 62.3% correct on critical patient information transfer and 61.6% correct on interprofessional communication skills. Almost 87% missed a fatal drug error. The checklists measured each item on a 1/0 (done/not) calculation. Additionally, no relationship was found between years of nursing experience and performance on either checklist. The PACU nurses in this study did not consistently share critical information with an attending (virtual) physician during a critical incident, and most missed a fatal dosage error. These findings strongly suggest a crucial need for additional structured team training among practicing health care teams, and they demonstrate the utility of using virtual humans to simulate team members. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  19. Leadership development: an essential ingredient in supporting nursing unit managers

    Directory of Open Access Journals (Sweden)

    Wilson V


    Full Text Available Valerie Wilson,1,2 Sheree Paterson,3 Kelly Kornman1 1Nursing Research and Practice Development Unit, The Children’s Hospital at Westmead, Westmead, NSW, Australia; 2Faculty of Nursing Midwifery Health, The University of Technology, Sydney, Broadway, NSW, Australia; 3Formerly of the Nursing Research and Practice Development Unit, The Children’s Hospital at Westmead, Westmead, NSW, Australia Purpose: The aim of the leadership development program was to enhance participants’ understanding of person-centered leadership in the context of their nursing unit manager (NUM roles. Materials and methods: This article details the results of the NUM leadership development program (LDP. Twenty-one NUMs from an Australian pediatric hospital participated in the 8-month program. The evaluation encompassed a group claims/concerns/issues session, one-on-one interviews, and written feedback. Data were themed using a four-step sequential process. Results: The NUM LDP had a positive impact on the leadership practices of the participants. Six key themes were identified from the evaluation: “forming the group”; “being in the group”; “translating into practice”; “how we see ourselves; how do we want to be seen?”; “positive outcomes for me”; and “positive outcomes for others”. Conclusion: This study showed improvements in the leadership understanding and practice of NUMs who participated in the program. Further research, particularly into the transferability of skills and active participatory aspects of these types of evaluation studies, is required. Keywords: nurse, evaluation, person-centered care, experiential learning

  20. Factors influencing nurse managers' intent to stay or leave: a quantitative analysis. (United States)

    Hewko, Sarah J; Brown, Pamela; Fraser, Kimberly D; Wong, Carol A; Cummings, Greta G


    To identify and report on the relative importance of factors influencing nurse managers' intentions to stay in or leave their current position. Effective nurse managers play an important role in staff nurse retention and in the quality of patient care. The advancing age of nurse managers, multiple job opportunities within nursing and the generally negative perceptions of the manager role can contribute to difficulties in retaining nurse managers. Ninety-five Canadian nurse managers participated in a web survey. Respondents rated the importance of factors related to their intent to leave or stay in their current position for another 2 years. Descriptive, t-test and mancova statistics were used to assess differences between managers intending to stay or leave. For managers intending to leave (n = 28), the most important factors were work overload, inability to ensure quality patient care, insufficient resources, and lack of empowerment and recognition. Managers intending to leave reported significantly lower job satisfaction, perceptions of their supervisor's resonant leadership and higher burnout levels. Organisations wishing to retain existing nurse managers and to attract front-line staff into leadership positions must create and foster an environment that supports nurse managers. © 2014 John Wiley & Sons Ltd.

  1. Acute burns management: placement reflections of a children's nursing student. (United States)

    Smith, Sara; Hunt, Jane


    Reflection can help nurses make sense of their clinical surroundings and understand risks, challenges and opportunities. Learning the art required for reflective practice begins as a student when critical reflection is particularly important during practice placements. A suitable reflective framework is provided by Rolfe et al ( 2011 ). Adopting this framework, this article draws on the placement experiences of a second-year undergraduate children's nursing student in an acute setting, caring for a toddler with 13% partial and full-thickness burns. The decisions made about assessing and monitoring homeostasis, overall fluid and pain management, infection prevention and potential safeguarding concerns are explored. Reflecting on clinical experience provides students with invaluable transferable skills. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  2. Emotional Intelligence and Transformational Leadership in Nurse Managers. (United States)

    Spano-Szekely, Lauraine; Quinn Griffin, Mary T; Clavelle, Joanne; Fitzpatrick, Joyce J


    This study describes the relationship between emotional intelligence (EI) and transformational leadership (TL) in nurse managers (NMs). Effective NM leadership is important as they have direct influence over RN performance and patient outcomes. Research has demonstrated that a TL style generates greater commitment from followers than other leadership styles. EI is 1 potential characteristic of TL. A descriptive exploratory research study was conducted to correlate EI and TL practices of NMs. EI was significantly positively correlated with TL and outcome measures of extra-effort, effectiveness, and satisfaction and significantly negatively correlated with laissez-faire leadership. A positive relationship was found between TL and NMs with advanced education and administrative certification. Nursing administrators should consider EI characteristics when hiring NMs and lead efforts to advance education to align with organization needs for business and strategic essentials necessary for NM effectiveness.

  3. Are nurses prepared to manage cancer pain? A national survey of nurses' knowledge about pain control in Taiwan. (United States)

    Lai, Yeur-Hur; Chen, Mei-Ling; Tsai, Li-Yun; Lo, Li-Hua; Wei, Ling-Ling; Hong, Ming-Ying; Hsiu, Ling-Nu; Hsiao-Sheen, Shu-Tai; Chen, Shu-Ching; Kao, Chin-Chiu; Huang, Tsai-Wei; Chang, Shu-Chen; Chen, Li; Guo, Shu-Liu


    Nurses play a crucial role in cancer pain control, but little is known about how well-prepared nurses are to manage cancer pain in Taiwan. The purpose of this study was to examine the level of knowledge about pain management among Taiwanese nurses with different background characteristics and to determine the predictor(s) of nurses' pain management knowledge. Nurse subjects were recruited by a cross-sectional nationwide survey with stratified sampling from nine hospitals distributed in the four major geographic regions of Taiwan. The Nurses' Knowledge and Attitudes Survey-Taiwanese version (NKAS-T) and a background information form were used to collect the data. Of 1900 surveys distributed, 1797 valid questionnaires (94.5%) were analyzed. The average correct response rate was 50.5%, with rates ranging from 7-86% for each survey question. Results from stepwise regression showed that nurses with higher mean correct answer scores had BS or higher degrees, had received pain education at professional conferences, had more prior hours of pain education, had longer clinical care experiences, and always worked with cancer patients. Nurses who worked in intensive care units, however, had significantly lower mean correct scores. The results strongly suggest an urgent need to strengthen pain education in Taiwan. The results also provide the direction for developing pain education.

  4. [Influence of Nurse Managers' Authentic Leadership on Nurses' Organizational Commitment and Job Satisfaction: Focused on the Mediating Effects of Empowerment]. (United States)

    Choi, Han Gyo; Ahn, Sung Hee


    The aim of this study was to examine the mediating effect of empowerment in the relationship of nurse managers' authentic leadership, with nurses' organizational commitment and job satisfaction. The participants in this study were 273 registered nurses working in five University hospitals located in Seoul and Gyeonggi Province. The measurements included the Authentic Leadership Questionnaire, Condition of Work Effectiveness Questionnaire-II, Organizational Commitment Questionnaire and Korea-Minnesota Satisfaction Questionnaire. Data were analyzed using t-test, ANOVA, Scheffé test, Pearson correlation coefficients, simple and multiple regression techniques with the SPSS 18.0 program. Mediation analysis was performed according to the Baron and Kenny method and Sobel test. There were significant correlations among authentic leadership, empowerment, organizational commitment and job satisfaction. Empowerment showed perfect mediating effects in the relationship between authentic leadership and organizational commitment. It had partial mediating effects in the relationship between authentic leadership and job satisfaction. In this study, nurse managers' authentic leadership had significant influences on nurses organizational commitment and job satisfaction via empowerment. Therefore, to enhance nurses' organizational commitment and job satisfaction, it is necessary to build effective strategies to enhance nurse manager's authentic leadership and to develop empowering education programs for nurses.

  5. Impact of human resource management practices on nursing home performance. (United States)

    Rondeau, K V; Wagar, T H


    Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain 'progressive' or 'high-performance' human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more 'progressive' HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain

  6. Managing change in the nursing handover from traditional to bedside handover - a case study from Mauritius. (United States)

    Kassean, Hemant K; Jagoo, Zaheda B


    The shift handover forms an important part of the communication process that takes place twice within the nurses' working day in the gynaecological ward. This paper addresses the topic of implementing a new system of bedside handover, which puts patients central to the whole process of managing care and also addresses some of the shortcomings of the traditional handover system. A force field analysis in terms of the driving forces had shown that there was dissatisfaction with the traditional method of handover which had led to an increase in the number of critical incidents and complaints from patients, relatives and doctors. The restraining forces identified were a fear of accountability, lack of confidence and that this change would lead to more work. A 3 - step planned change model consisting of unfreezing, moving and refreezing was used to guide us through the change process. Resistance to change was managed by creating a climate of open communication where stakeholders were allowed to voice opinions, share concerns, insights, and ideas thereby actively participating in decision making. An evaluation had shown that this process was successfully implemented to the satisfaction of patients, and staff in general. This successful change should encourage other nurses to become more proactive in identifying areas for change management in order to improve our health care system.

  7. Managers' views on and experiences with moral case deliberation in nursing teams

    NARCIS (Netherlands)

    Weidema, F.C.; Molewijk, A.C.; Kamsteeg, F.; Widdershoven, G.A.M.


    Aims: Providing management insights regarding moral case deliberation (MCD) from the experiential perspective of nursing managers. Background: MCD concerns systematic group-wise reflection on ethical issues. Attention to implementing MCD in health care is increasing, and managers' experiences

  8. Significant differences in nurses' knowledge of basic wound management - implications for treatment. (United States)

    Zarchi, Kian; Latif, Seemab; Haugaard, Vibeke B; Hjalager, Ida R C; Jemec, Gregor B E


    Wounds represent a growing healthcare problem due to an aging population. Nurses play a key role in wound management and their theoretical understanding of basic wound management may be expected to influence the quality of wound therapy fundamentally. In this study, we evaluated the level of knowledge of wound management in 136 Danish nurses working in 3 different settings: advanced wound care clinics, home care and general hospital departments. We found that hospital nurses had less theoretical knowledge than home care nurses and nurses working at advanced wound care clinics. We also found that the length of experience (adjusted for workplace and education) did not have any impact on nurses' knowledge. Nurses' knowledge of clinical investigations was consistently lower than their knowledge of therapy and clinical symptoms. This study provides benchmarking information about the current status of wound management in Denmark and suggests how improvements might be achieved.

  9. The impact on nurses and nurse managers of introducing PEPFAR clinical services in urban government clinics in Uganda

    Directory of Open Access Journals (Sweden)

    Kyegombe Nambusi


    Full Text Available Abstract Background Improving provider performance is central to strengthening health services in developing countries. Because of critical shortages of physicians, many clinics in sub-Saharan Africa are led by nurses. In addition to clinical skills, nurse managers need practical managerial skills and adequate resources to ensure procurement of essential supplies, quality assurance implementation, and productive work environment. Giving nurses more autonomy in their work empowers them in the workplace and has shown to create positive influence on work attitudes and behaviors. The Infectious Disease Institute, an affiliate of Makerere University College of Health Science, in an effort to expand the needed HIV services in the Ugandan capital, established a community-university partnership with the Ministry of Health to implement an innovative model to build capacity in HIV service delivery. This paper evaluates the impact on the nurses from this innovative program to provide more health care in six nurse managed Kampala City Council (KCC Clinics. Methods A mixed method approach was used. The descriptive study collected key informant interviews from the six nurse managers, and administered a questionnaire to 20 staff nurses between September and December 2009. Key themes were manually identified from the interviews, and the questionnaire data were analyzed using SPSS. Results Introducing new HIV services into six KCC clinics was positive for the nurses. They identified the project as successful because of perceived improved environment, increase in useful in-service training, new competence to manage patients and staff, improved physical infrastructure, provision of more direct patient care, motivation to improve the clinic because the project acted on their suggestions, and involvement in role expansion. All of these helped empower the nurses, improving quality of care and increasing job satisfaction. Conclusions This community-university HIV

  10. The impact on nurses and nurse managers of introducing PEPFAR clinical services in urban government clinics in Uganda. (United States)

    Nankumbi, Joyce; Groves, Sara; Leontsini, Elli; Kyegombe, Nambusi; Coutinho, Alex; Manabe, Yuka


    Improving provider performance is central to strengthening health services in developing countries. Because of critical shortages of physicians, many clinics in sub-Saharan Africa are led by nurses. In addition to clinical skills, nurse managers need practical managerial skills and adequate resources to ensure procurement of essential supplies, quality assurance implementation, and productive work environment. Giving nurses more autonomy in their work empowers them in the workplace and has shown to create positive influence on work attitudes and behaviors. The Infectious Disease Institute, an affiliate of Makerere University College of Health Science, in an effort to expand the needed HIV services in the Ugandan capital, established a community-university partnership with the Ministry of Health to implement an innovative model to build capacity in HIV service delivery. This paper evaluates the impact on the nurses from this innovative program to provide more health care in six nurse managed Kampala City Council (KCC) Clinics. A mixed method approach was used. The descriptive study collected key informant interviews from the six nurse managers, and administered a questionnaire to 20 staff nurses between September and December 2009. Key themes were manually identified from the interviews, and the questionnaire data were analyzed using SPSS. Introducing new HIV services into six KCC clinics was positive for the nurses. They identified the project as successful because of perceived improved environment, increase in useful in-service training, new competence to manage patients and staff, improved physical infrastructure, provision of more direct patient care, motivation to improve the clinic because the project acted on their suggestions, and involvement in role expansion. All of these helped empower the nurses, improving quality of care and increasing job satisfaction. This community-university HIV innovative model was successful from the point of view of the nurses

  11. Long-term exposure to fine particulate matter and incidence of diabetes in the Danish Nurse Cohort

    DEFF Research Database (Denmark)

    Hansen, Anne Busch; Ravnskjær, Line; Loft, Steffen


    AIMS/HYPOTHESIS: It has been suggested that air pollution may increase the risk of type 2 diabetes but data on particulate matter with diameter PM2.5) are inconsistent. We examined the association between long-term exposure to PM2.5 and diabetes incidence. METHODS: We used the Danish Nurse...... Cohort with 28,731 female nurses who at recruitment in 1993 or 1999 reported information on diabetes prevalence and risk factors, and obtained data on incidence of diabetes from National Diabetes Register until 2013. We estimated annual mean concentrations of PM2.5, particulate matter with diameter ... diabetes. We detected a significant positive association between PM2.5 and diabetes incidence (hazard ratio; 95% confidence interval: 1.11; 1.02-1.22 per interquartile range of 3.1μg/m(3)), and weaker associations for PM10 (1.06; 0.98-1.14 per 2.8μg/m(3)), NO2 (1.05; 0.99-1.12 per 7.5μg/m(3)), and NOx (1...

  12. Role for a Labor-Management Partnership in Nursing Home Person-Centered Care (United States)

    Leutz, Walter; Bishop, Christine E.; Dodson, Lisa


    Purpose: To investigate how a partnership between labor and management works to change the organization and focus of nursing home frontline work, supporting a transition toward person-centered care (PCC) in participating nursing homes. Design and Methods: Using a participatory research approach, we conducted case studies of 2 nursing homes…

  13. Impact of disease management programs on hospital and community nursing practice. (United States)

    Goldstein, Perry C


    The impact of disease management progrmms on the role of the nursing profession in the evolving U.S. health care system is reviewed. Needed changes in educational and training programs are discussed in relation to demands for changing clinical and administrative skills in nursing with an emphasis on increasing demand for advanced practice nurses.

  14. Indoor fire in a nursing home : evaluation of the medical response to a mass casualty incident based on a standardized protocol

    NARCIS (Netherlands)

    Koning, S. W.; Ellerbroek, P. M.; Leenen, L. P. H.

    This retrospective study reports the outcome of a mass casualty incident (MCI) caused by a fire in a nursing home. Data from the medical charts and registration system of the Major Incident Hospital (MIH) and ambulance service were analyzed. The evaluation reports from the MIH and an independent

  15. [A study of leadership training program demands of first-line nurse managers in university hospitals]. (United States)

    Koh, M S


    There is an important concern regarding the First-line nurse manager's leadership because of the recognition that effectiveness of Leadership in this position results in benefits for the whole health care organization. So knowledge and practice of effective leadership behavior are now more essential to nursing than ever before. First-line Nurse Managers must be effective leaders to meet today's challenge because staff nurse, patient are affected by them. So the purpose of this study was to identify and to analyse the need for Leadership program of First Line nurse managers in university hospitals. There were three major purposes of this study. First, identify First-line nurse managers general characteristic, second, identify their experience of leadership training, third, identify and analysis their demands for leadership training program. The subjects for this study was 167 First-line nurse manager randomly from 18 university hospitals in Korea. The data were collected through questionnaires from Oct. 13th to Nov. 20th, 1997, data was analysed using frequencies and percentages. Especially the steps of analysis of descriptions were as follows: Initial analysis centered on the identification of the demands of first-line nurse managers. Later analysis collapsed the demands into broad categories. From the collect data, 283 demands of first-line nurse managers were identified. These demands were then sorted into 3 broad categories that included: Self development as first-line nurse managers, relationship with others, and practice The result of the study were as follows: 1) Most of nurse managers (79.6%) had leadership training course and had good experience to improve self leadership. 2) Their demands of leadership training course are as follows: First, for self as first-line nurse managers, they want to learn leadership theory, identify their leadership style and then develop their leadership skill. Second, for others as first-line nurse managers, they want to improve

  16. Barriers and enablers to emergency department nurses' management of patients' pain. (United States)

    Pretorius, Annatjie; Searle, Judy; Marshall, Bob


    Pain is the most common reason for presentation to the emergency department (ED). On presentation patients expect rapid pain relief, yet this is often not met. Despite extensive improvements in analgesia medication there are still barriers to nurses' assessment, management, documentation, and reassessment of pain. The aim of this study is to identify barriers, enablers, and current nursing knowledge regarding pain management. Using an anonymous quantitative web-based survey, members of the College of Emergency Nurses New Zealand were invited to complete a questionnaire on pain assessment and management. The questionnaires were analyzed using descriptive statistics. Enablers to ED nurses' improved management of pain were the provision of nurse-initiated analgesic protocols and pain management champions. Common barriers perceived by the respondents were the responsibility of caring for acutely ill patients as well as a patient with pain. Similar barriers to previous research were identified and included lack of time, workload, reluctance of clinicians to prescribe analgesia, and the lack of nursing knowledge regarding opioid administration. Raising awareness that oligoanalgesia exists in the ED is essential. This research suggested that nurses would benefit from ongoing education on the usage of opioids. Nurses' attitude regarding patients' right to expect total pain relief as a consequence of treatment was also an issue. ED nurses, by virtue of their role, are in a unique position to be leaders in pain assessment and pain management. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  17. Nurses' Role in Cardiovascular Risk Assessment and Management in People with Inflammatory Arthritis

    DEFF Research Database (Denmark)

    Primdahl, Jette; Ferreira, Ricardo J O; Garcia-Diaz, Silvia


    INTRODUCTION: Cardiovascular risk (CVR) assessment and management in patients with inflammatory arthritis (IA) is recommended but European nurses' involvement in this role has not been well studied. AIM: The aim of the present study was to explore European nurses' role in assessing and managing CVR...... to the systematic review, we provided case studies from five different countries to illustrate national guidelines and nurses' role regarding CVR assessment and management in patients with IA. RESULTS: Thirty-three articles were included. We found that trained nurses were undertaking CVR assessment and management...

  18. Indoor fire in a nursing home: evaluation of the medical response to a mass casualty incident based on a standardized protocol. (United States)

    Koning, S W; Ellerbroek, P M; Leenen, L P H


    This retrospective study reports the outcome of a mass casualty incident (MCI) caused by a fire in a nursing home. Data from the medical charts and registration system of the Major Incident Hospital (MIH) and ambulance service were analyzed. The evaluation reports from the MIH and an independent research institute were used. The protocol for reports from major accidents and disaster was used to standardize the reporting [Lennquist, in Int J Disaster Med 1(1):79-86, 2003]. The emergency services were quickly at the scene. The different levels of pre-hospital management performed a tight coordination. However, miscommunication led to confusion in the registration and tracking of patients. In total, 49 persons needed medical treatment, 46 were treated in the MIH. Because of (possible) inhalation injury nine patients needed mechanical ventilation and nine patients were hospitalized to exclude delayed onset of pulmonary symptoms. No incident related deaths occurred. The intensive care unit of the MIH was initially understaffed despite the efforts of the automated calling system and switchboard operators. The handwritten registration of incoming staff was incomplete and should be performed digitally. Some staff members were unfamiliar with the MIH procedures. The medical chart appeared too extensive. Miscommunication between chain partners resulted in the delayed sharing of (semi) medical information. The different levels of incident managers performed a tight coordination. The MIH demonstrated its potency to provide emergency care for 46 patients and 9 intubated patients. No deaths or persistent disabilities occurred. Areas of improvement were recognized both in the pre-hospital as the hospital phase.

  19. How coaching can play a key role in the development of nurse managers. (United States)

    Westcott, Liz


    The aim of this study was to explore empirically the role that coaching plays in the development of nurse managers in order to inform further research and policy makers about the potential utility and value of this means of development. There is evidence of the importance of the role of nurse managers who are first line managers of a team of nurses within any health sector. However, there appears to be little understanding of the United Kingdom wide scope of nurse manager development across the United Kingdom and the means to increase its effectiveness. At the same time, it appears that some nurse managers receive coaching to help in their development. This is a mixed methods study, using a pragmatist paradigm. Data was gathered from a quantitative survey and qualitative interviews. This paper is reporting the results of the qualitative interviews only. Twenty-one qualitative interviews were undertaken with nurse managers, coaches and directors of nursing to draw out their own experiences of coaching for nurse managers. Thematic analysis framework was used for data interrogation, identifying new patterns and emerging themes. Themes that emerged from interviews include how nurse managers were introduced to coaching, how they balanced transitions, the role of reflection, the value of relationships and overlaps between clinical supervision, mentoring and coaching. Findings show that following coaching, nurse managers gained increased resilience, confidence and better coping mechanisms. This resulted in perceived improved team management and cohesion and appeared to lead to better quality of care for patients. This study suggests the importance of nurse managers accessing coaching, to enable transformational leadership of their teams of nurses. It suggests also the importance of organisations supporting a coaching culture, to ensure staff satisfaction, motivation and improved quality of patient care. © 2016 John Wiley & Sons Ltd.

  20. Walk the talk: leaders' enacted priority of safety, incident reporting, and error management. (United States)

    Van Dyck, Cathy; Dimitrova, Nicoletta G; de Korne, Dirk F; Hiddema, Frans


    The main goal of the current research was to investigate whether and how leaders in health care organizations can stimulate incident reporting and error management by "walking the safety talk" (enacted priority of safety). Open interviews (N = 26) and a cross-sectional questionnaire (N = 183) were conducted at the Rotterdam Eye Hospital (REH) in The Netherlands. As hypothesized, leaders' enacted priority of safety was positively related to incident reporting and error management, and the relation between leaders' enacted priority of safety and error management was mediated by incident reporting. The interviews yielded rich data on (near) incidents, the leaders' role in (non)reporting, and error management, grounding quantitative findings in concrete case descriptions. We support previous theorizing by providing empirical evidence showing that (1) enacted priority of safety has a stronger relationship with incident reporting than espoused priority of safety and (2) the previously implied positive link between incident reporting and error management indeed exists. Moreover, our findings extend our understanding of behavioral integrity for safety and the mechanisms through which it operates in medical settings. Our findings indicate that for the promotion of incident reporting and error management, active reinforcement of priority of safety by leaders is crucial. Social sciences researchers, health care researchers and health care practitioners can utilize the findings of the current paper in order to help leaders create health care systems characterized by higher incident reporting and more constructive error handling.

  1. [Emotional Leadership: a survey on the emotional skills expressed by nursing management]. (United States)

    Spagnuolo, Antonella; De Santis, Marco; Torretta, Claudia; Filippi, Mauro; Talucci, Carlo


    The emotional leadership applied to nursing management is a new topic in the Italian nursing literature, but of great interest internationally. There is a close correlation between nursing leaders with a well-developed emotional intelligence and nurses working well-being. This study investigates knowledge about the emotional leadership and emotional competence in nursing management. The survey was conducted using a questionnaire devised for the purpose, validated and administered to 130 managers, head nurses and nurses in a hospital in Rome. Analysis of data shows a great interest in the subject. 90% of the sample showed that it is essential for managerial roles, be aware and able to manage their own and others' emotions to generate wellbeing at work. Emotional competencies are considered important just as theoretical, technical and social skills to a effective leadership on nursing. This study is one of the first Italian survey on the importance of the development of emotional intelligence in nursing leadership to improve wellbeing at work. Results of the survey should be confirmed by further studies. The emotional skills could be improved in nursing education programs and used as a yardstick for the nursing managers selection.

  2. Storied experiences of nurse practitioners managing prehypertension in primary care. (United States)

    Hernandez, Johnanna; Anderson, Stoerm


    The purpose of this study was to explore the nurse practitioner (NP) experience with caring for prehypertensive patients. Lifestyle modifications are the primary recommendation for management of prehypertension. Given the historical foundation of health promotion and disease prevention as a fundamental component of NP professional identity, gaining insight into the experience of caring for prehypertensive patients in the current healthcare environment is valuable to the profession, patients, and communities. Therefore, the NP role in health promotion and disease prevention related to prehypertension was explored as well. Narrative inquiry was the chosen methodology to gather narrative accounts of eight NPs caring for prehypertensive patients in primary care. The three-dimensional narrative inquiry space was used to guide the researcher during data analysis. Three themes emerged from the NPs' narratives: realities of practice, ambiguous role identity, and bridging models. Time constraints, financial considerations, and bridging the nursing and medical models while adapting to practice environments were barriers identified as components of the NP experience caring for patients with prehypertension. This study revealed that caring for prehypertensive patients is a complex and multilayered experience. ©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.

  3. A Nurse Communication Manager reduces the number of non‑relevant contacts

    DEFF Research Database (Denmark)

    Wright, Nana Keir; Seested Nielsen, Nina; Lauersen, Jannie


    Objective The aim of this study was to reduce interruptions in nursing practice by exploring the effects on the number of nonrelevant contacts received by the nursing staff after implementation of a Nurse Communication Manager. Design The study was designed as a pre/post interventional study. All...... in the surgical department. Interventions During the daytime a Nurse Communication Manager handled all incoming contacts irrespective of whether they were in person or by telephone. When the Nurse Communication Manager was not available and during the evening, night and weekends, telephone contacts were managed...... 43) to a mean of 18 contacts per day (SD 7), pCommunication Manager (NCM) reduced the number of non-relevant contacts. Reduction of non-relevant contacts is important for nurses in the clinical setting as non-relevant contacts may be perceived...

  4. Nursing as a scientific undertaking and the intersection with science in undergraduate studies: implications for nursing management. (United States)

    Logan, Patricia A; Angel, Lyndall


    To explore the science-nursing tension and impact for nursing students studying bioscience. Several studies have examined why nursing students struggle to be successful in bioscience subjects. Undeveloped science background and theory-practice gaps are noted as contributing factors. A qualitative study explored the science-nursing tension with 100 Australian Registered Nurses using focus groups and a survey. The survey response rate was 85 from 550. Of survey respondents, 88% viewed nursing as an applied science. An emphasis on procedural skills and task busyness undermines theoretical understanding of care and can be a negative influence upon the student bioscience experience. Practicum mentors confident in scientific knowledge enhance the student experience of bioscience by providing opportunities for integration with practice. Competing philosophies that reinforce the science-nursing tension have an impact upon student endeavours yet the nexus created by practice can be used to activate student curiosity and scientific understanding. Nurse managers need to structure the student practicum to encompass scientific theory applied to practice with equal emphasis on task efficiency. This improves student attitudes to learning bioscience and potentially minimizes the impact of the science-nursing tension on student learning. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  5. Additional Cost Because of Pneumonia in Nursing Home Residents: Results From the Incidence of Pneumonia and Related Consequences in Nursing Home Resident Study. (United States)

    Costa, Nadège; Hoogendijk, Emiel O; Mounié, Michael; Bourrel, Robert; Rolland, Yves; Vellas, Bruno; Molinier, Laurent; Cesari, Matteo


    Pneumonia is a frequent condition in older people. Our aim was to examine the total healthcare cost related to pneumonia in nursing home (NH) residents over a 1-year follow-up period. This was a prospective, longitudinal, observational, and multicenter study that was a part of the Incidence of Pneumonia and related Consequences in Nursing Home Resident study. Thirteen NHs located in Languedoc Roussillon and Midi-Pyrénées regions in France were included. Resident in NH, older than 60 years and had a group iso-resource score ranging from 2 to 5. Pneumonia events were characterized according to the Observatoire du Risque Infectieux en Geriatrie criteria. Direct medical and nonmedical costs were assessed from the French health insurance perspective. Healthcare resources was retrospectively gathered from the French Social Health Insurance database and valued using the tariffs reimbursed by the French health insurance. Sociodemographic variables, clinical factors, vaccinations, cognition, depression, functional status, frailty index, as well as group iso-resource score were also recorded. Among the 800 patients initially included in the Incidence of Pneumonia and Related Consequences in Nursing Home Resident study, 345 which were listed in the database of the French Social Health Insurance were included in this economic study. Among them, 64 (18%) experienced at least 1 episode of pneumonia during the 1-year follow-up period. Mean annual total additional cost for a patient who experienced at least 1 episode of pneumonia during the 1 year follow-up period is 2813€. On average, total annual costs increased by 60% to 93% when a patient experienced at least 1 episode of pneumonia. NH-acquired pneumonia has a great impact on total cost of care for NH residents. Our results suggest the potential economic savings that could be achieved if pneumonia could be prevented in NHs. Copyright © 2017. Published by Elsevier Inc.

  6. Promoting leadership and management in Australian general practice nursing: what will it take? (United States)

    Halcomb, Elizabeth J; Davidson, Patricia M; Patterson, Elizabeth


    This paper outlines the current state of Australian practice nursing, describes the context of general practice and establishes the importance of promoting leadership and management in this setting. Australian general practice nurses have emerged as key stakeholders in primary health care. However, their role in leadership and management has been largely invisible. The reasons for this are multifactorial, including the delay to establish a strong professional organization, their negative power relationships with general medical practitioners, limited nursing leadership and poorly defined roles. To date, the impetus for practice nurse growth has been largely external to the nursing profession. Growth has been driven by the increasing burden of chronic disease and workforce shortages. This has further weakened the control of nurse leaders over the development of the specialty. The Australian practice nurse role is at a crossroads. While the practice nurse role is a viable force to improve health outcomes, the growing strength of the practice nurse challenges traditional professional roles and practice patterns. There is an urgent need to develop practice nurse leaders and managers to not only embrace the challenges of Australian general practice from an operational perspective, but also undertake a clinical leadership role. As clinical leaders, these nurses will need to develop a culture that not only optimizes health outcomes but also advances the status of the nursing profession.

  7. Incidence and Risk Factors of Workplace Violence on Nursing Staffs Caring for Chronic Psychiatric Patients in Taiwan

    Directory of Open Access Journals (Sweden)

    Hsien-Jane Chiu


    Full Text Available This one-year follow-up study determined the incidence and risk factors of workplace violence against nursing staff in a psychiatric hospital. The cohort members had a website to report events whenever they came across violence. A total of 971 events were reported. The incidence rates of physical violence, verbal abuse, bullying/mobbing, sexual harassment, and racial harassment were 1.7, 3.7, 0.2, 0.3, and 0 per staff-year, respectively. Young age, female sex, lower education, shorter duration of employment, and high level of anxiety of staff seemed to be the determinants of violence. Pre-placement education should focus on these staff to reduce workplace violence.

  8. Incidence and risk factors of workplace violence on nursing staffs caring for chronic psychiatric patients in taiwan. (United States)

    Chen, Wen-Ching; Sun, Yu-Hua; Lan, Tsuo-Hung; Chiu, Hsien-Jane


    This one-year follow-up study determined the incidence and risk factors of workplace violence against nursing staff in a psychiatric hospital. The cohort members had a website to report events whenever they came across violence. A total of 971 events were reported. The incidence rates of physical violence, verbal abuse, bullying/mobbing, sexual harassment, and racial harassment were 1.7, 3.7, 0.2, 0.3, and 0 per staff-year, respectively. Young age, female sex, lower education, shorter duration of employment, and high level of anxiety of staff seemed to be the determinants of violence. Pre-placement education should focus on these staff to reduce workplace violence.

  9. Essential managerial attributes of the nowadays nursing service manager in the South African context. (United States)

    Jooste, K


    Nursing service managers need certain essential managerial attributes in taking the lead in effective management of the nowadays health care organisations in South Africa. Major changes in restructuring and human resources planning are taking place through transformation of health services and specific managerial attributes are needed in this scenario. Without nursing service managers with the necessary managerial attributes, change in the health care environment will be hampered and planning, organising, directing and control of the delivering of quality care will be negatively influenced. The research problem was addressed in the following question that guided the study: Which essential attributes/characteristics should a nursing service manager possess to run a health care service effectively? It was unclear what the opinions of all level of nurse managers were regarding the necessary managerial attributes the health services manager currently need to run the current health care services effectively. This study aimed at highlighting the necessary attributes of the nowadays nursing service manager in running a health care institution in the current health care environment of South Africa. Purposive sampling was done and forty-five functional, middle and top-level managers registered for a second year degree course in Health Services Management at a South African university participated in the study. The findings indicated important managerial and leadership attributes, which the current nursing service manager should possess. This article will only discuss the important managerial attributes needed. A conceptual framework came to the fore according to which an example of a self-evaluation instrument was compiled for nursing service managers for future use. The results of the data analysis indicated that the nursing service manager should promote good interpersonal relationships with colleagues, subordinates and patients through the attributes of openness, being

  10. Nursing case management in the millennium. Two perspectives. (United States)

    Coile, R C; Matthews, P


    To prepare case managers for the next millennium, Russell Coile, a noted healthcare futurist, and Pamela Matthews, a respected clinician and consultant, participate in a dialogue. Coile takes a broad view of millennial issues, while Matthews responds to those issues with her clinician's perspective. Case management will face challenges and opportunities as a result of internal and external pressures to the healthcare community. These pressures, both near- and far-term, will simultaneously strengthen and tax the case manager's responsibilities. Developments in technology and demands for more and better access to high-quality patient information will require nursing case managers to expand their knowledge of, and influence over, the application of technology and information systems. Case managers will need to participate in advocating, planning, and deploying these systems. Technological challenges will not change case managers' fundamental roles within an organization, but they will strengthen and support those roles by harnessing the information necessary to allow more efficient outcomes, create standards of care, and increase patient satisfaction.

  11. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records. (United States)

    Cashmore, Aaron W; Indig, Devon; Hampton, Stephen E; Hegney, Desley G; Jalaludin, Bin B


    Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71%) was more common than physical abuse (29%). The most (44%) incidents of workplace violence (including both verbal and physical abuse) occurred in adult male prisons, although the most (50%) incidents of physical abuse occurred in a forensic hospital. Most (90%) of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as 'high risk' work duties for verbal abuse and physical abuse, respectively. Most (93%) of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46%) or low (52%) Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury - there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%). Few (6%) victims of verbal abuse sought help from a health professional. Among employees of a large correctional health service, verbal abuse in the workplace was substantially more common than physical abuse. The most incidents of workplace

  12. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records

    Directory of Open Access Journals (Sweden)

    Cashmore Aaron W


    Full Text Available Abstract Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71% was more common than physical abuse (29%. The most (44% incidents of workplace violence (including both verbal and physical abuse occurred in adult male prisons, although the most (50% incidents of physical abuse occurred in a forensic hospital. Most (90% of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93% of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46% or low (52% Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%. Few (6% victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more

  13. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records (United States)


    Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71%) was more common than physical abuse (29%). The most (44%) incidents of workplace violence (including both verbal and physical abuse) occurred in adult male prisons, although the most (50%) incidents of physical abuse occurred in a forensic hospital. Most (90%) of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93%) of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46%) or low (52%) Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%). Few (6%) victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more common than physical

  14. Acute Appendicitis: Incidence and Management in Nigeria | Alatise ...

    African Journals Online (AJOL)

    Appendicitis is the leading cause of surgical emergency admission in most hospital in Nigeria. It accounts for about 15-40% of all emergency surgery done in most centers in the country. All age groups can develop the disease including the fetus in utero, but the incidence is higher in the second and third decade of life.

  15. The Critical Incident Technique in Library and Information Management Research. (United States)

    Fisher, Shelagh; Oulton, Tony


    Focuses on the application of the Critical Incident Technique (CIT) in three studies at the Department of Information and Communications, Manchester Metropolitan University, United Kingdom. Examines staff-development needs as a key element in change in higher education; decision-making practices in small- to medium-size libraries; and development…

  16. Incidence, Pattern and Management of Ovarian Cancer at a Tertiary ...

    African Journals Online (AJOL)

    Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku‑Ozalla 1Department of. Histopathology, University of ... ovarian cancer giving an incidence rate of 1/405 gynecological admissions per year or 0.3% (95% .... not found in the records. Follow up of patients was by clinical examination and.

  17. Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea. (United States)

    Oh, Jinjoo; Oh, Seieun


    The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Copyright © 2017. Published by Elsevier B.V.

  18. An Interprofessional Consensus of Core Competencies for Prelicensure Education in Pain Management: Curriculum Application for Nursing (United States)

    Herr, Keela; St. Marie, Barbara; Gordon, Debra B.; Paice, Judith A.; Watt-Watson, Judy; Stevens, Bonnie J.; Bakerjian, Debra; Young, Heather M.


    Background Ineffective assessment and management of pain is a significant problem. A gap in prelicensure health science program pain content has been identified for the improvement of pain care in the United States. Method Through consensus processes, an expert panel of nurses, who participated in the interdisciplinary development of core competencies in pain management for prelicensure health professional education, developed recommendations to address the gap in nursing curricula. Results Challenges and incentives for implementation of pain competencies in nursing education are discussed, and specific recommendations for how to incorporate the competencies into entry-level nursing curricula are provided. Conclusion Embedding pain management core competencies into prelicensure nursing education is crucial to ensure that nurses have the essential knowledge and skills to effectively manage pain and to serve as a foundation on which clinical practice skills can be later honed. PMID:26057425

  19. Resolving the ethical dilemma of nurse managers over chemically-dependent colleagues. (United States)

    Chiu, W; Wilson, D


    This paper addresses the nurse manager's role regarding chemically-dependent nurses in the workplace. The manager may intervene by: terminating the contract of the impaired colleague; notifying a disciplinary committee; consulting with a counselling committee; or referring the impaired nurse to an employee assistance programme. A dilemma may arise about which of these interventions is ethically the best. The ethical theories relevant to nursing involve ethical relativism, utilitarianism, Kantian ethics, Kohlberg's justice, and Gilligan's ethic of care. Nurse managers first need to understand these theories in order to clarify their own perceptions and attitudes towards chemical dependency, and then satisfactorily resolve this ethical dilemma. Education and social learning are routes to a better understanding of chemical dependency and to broadening the ethical dimensions of nurse managers.

  20. Apprehensions of nurse managers on evidence-based practice

    Directory of Open Access Journals (Sweden)

    Fernanda Carolina Camargo


    Full Text Available Abstract Objective: To analyze the apprehensions of nurse managers in the implementation of the Evidence Based Practice in a Teaching Hospital of Triângulo Mineiro. Method: Qualitative research guided by the Theory of the Diffusion of Innovations. Five workshops were conducted per focal group (n = 18 participants, conducted by hermeneutic-dialectic interactions between August and September/2016. Textual records resulting from each workshop were analyzed by semantic categories. Results: Aspects conditioning to the implementation of the Evidence Based Practice permeate from elements related to the fragmentation of the care network to the necessary expansion of the governability of the nurse managers to put changes into practice in their sectors. Most importantly, timely access to the results of research conducted at the teaching hospital was mentioned as crucial to guide better practices. Final considerations: The approach allowed the recognition of contextual conditions for the implementation of the Evidence-Based Practice, which may coincide with similar scenarios, as well as increase the national scientific production on the subject, which is still scarce.

  1. Role stressors and coping strategies among nurse managers. (United States)

    Udod, Sonia; Cummings, Greta G; Care, W Dean; Jenkins, Megan


    Purpose The purpose of this paper is to share preliminary evidence about nurse managers' (NMs) role stressors and coping strategies in acute health-care facilities in Western Canada. Design/methodology/approach A qualitative exploratory inquiry provides deeper insight into NMs' perceptions of their role stressors, coping strategies and factors and practices in the organizational context that facilitate and hinder their work. A purposeful sample of 17 NMs participated in this study. Data were collected through individual interviews and a focus group interview. Braun and Clarke's (2006) six phase approach to thematic analysis guided data analysis. Findings Evidence demonstrates that individual factors, organizational practices and structures affect NMs stress creating an evolving role with unrealistic expectations, responding to continuous organizational change, a fragmented ability to effectively process decisions because of work overload, shifting organizational priorities and being at risk for stress-related ill health. Practical implications These findings have implications for organizational support, intervention programs that enhance leadership approaches, address individual factors and work processes and redesigning the role in consideration of the role stress and work complexity affecting NMs health. Originality/value It is anticipated that health-care leaders would find these results concerning and inspire them to take action to support NMs to do meaningful work as a way to retain existing managers and attract front line nurses to positions of leadership.

  2. Implications of staff 'churn' for nurse managers, staff, and patients. (United States)

    Duffield, Christine; Roche, Michael; O'Brien-Pallas, Linda; Catling-Paull, Christine


    In this article, the term "churn" is used not only because of the degree of change to staffing, but also because some of the reasons for staff movement are not classified as voluntary turnover. The difficulties for the nurse managing a unit with the degree of "churn" should not be under-estimated. Changes to skill mix and the proportions of full-time, agency, and temporary staff present challenges in providing clinical leadership, scheduling staff, performance management, and supervision. Perhaps more importantly, it is likely that there is an impact on the continuity of care provided in the absence of continuity of staffing. A greater understanding of the human and financial costs and consequences, and a willingness to change established practices at the institutional and ward level, are needed.

  3. Factors influencing intentions to stay and retention of nurse managers: a systematic review. (United States)

    Brown, Pamela; Fraser, Kimberly; Wong, Carol A; Muise, Melanie; Cummings, Greta


    This systematic review aimed to explore factors known to influence intentions to stay and retention of nurse managers in their current position. Retaining staff nurses and recruiting nurses to management positions are well documented; however, there is sparse research examining factors that influence retention of nurse managers. Thirteen studies were identified through a systematic search of the literature. Eligibility criteria included both qualitative and quantitative studies that examined factors related to nurse manager intentions to stay and retention. Quality assessments, data extraction and analysis were completed on all studies included. Twenty-one factors were categorized into three major categories: organizational, role and personal. Job satisfaction, organizational commitment, organizational culture and values, feelings of being valued and lack of time to complete tasks leading to work/life imbalance, were prominent across all categories. These findings suggest that intentions to stay and retention of nurse managers are multifactoral. However, lack of robust literature highlights the need for further research to develop strategies to retain nurse managers. ImplICATIONS FOR NURSE MANAGEMENT: Health-care organizations and senior decision-makers should feel a responsibility to support front-line managers in relation to workload and span of control, and in understanding work/life balance issues faced by managers. © 2012 Blackwell Publishing Ltd.

  4. Inpatient Nursing and Parental Comfort in Managing Pediatric Tracheostomy Care and Emergencies. (United States)

    Pritchett, Cedric V; Foster Rietz, Melissa; Ray, Amrita; Brenner, Michael J; Brown, David


    Tracheostomy is a critical and often life-saving intervention, but associated risks are not negligible. The vulnerability of the pediatric population underlies the importance of caregiver comfort and competence in tracheostomy care. To assess inpatient nursing staff and parental perspectives in managing tracheostomy care. Cross-sectional analysis of survey data from (1) a volunteer sample of inpatient nurses in a tertiary care, freestanding pediatric hospital in the Midwest, assigned to clinical wards that provide care for children with tracheostomy tubes and (2) a consecutive sample of families whose child underwent tracheostomy tube placement at the same institution between March 1 and December 31, 2013. Nurse and parental comfort in managing acute and established tracheostomy tubes. Nursing data were analyzed with attention to years' experience and primary unit of practice. Respondents included 129 of 820 nurses (16% response rate) and family members of 19 of 38 children (50% response rate). When queried about changing established tracheostomies, 59 of 128 nurses (46%) reported being "totally comfortable," including 46 of 82 intensive care unit (ICU) nurses (56%) vs 13 of 46 floor nurses (28%) (P = .002) and 48 of 80 nurses with at least 5 years' experience (60%) vs 12 of 49 less experienced nurses (24%) (P tracheostomy, 61 nurses (47%) described being completely uncomfortable, including 27 of 83 ICU nurses (33%) vs 34 of 46 floor nurses (73%) (P = .006), and 33 of 80 nurses with at least 5 years' experience (41% ) vs 28 of 49 less experienced nurses (57%) (P = .03). Most families felt prepared for discharge (16 of 17 [94%]) and found the health care team accessible (16 of 17 [94%]), although only 5 of 18 families (28%) indicated that tracheostomy teaching was consistent. Nurses' comfort with tracheostomy was higher among nurses with at least 5 years' experience and primary ICU location. Whereas parental comfort with tracheostomy care was high

  5. Processes influencing the development of graduate nurse capabilities in clinical risk management: an Australian study. (United States)

    Johnstone, Megan-Jane; Kanitsaki, Olga


    To explore and describe key processes influencing the development of graduate nurse capabilities in clinical risk management (CRM). This study was undertaken using an exploratory descriptive case study method. Four sample units of analysis were used, notably: 2 cohorts of graduate nurses (n = 11) undertaking a 12-month graduate nurse transition program; key stakeholders (n = 34), that is, nurse unit managers, clinical teachers, preceptors, a quality manager, a librarian, and senior nurse administrators employed by the participating health service; patient outcome data; and pertinent literature. Data strongly suggested that graduate nurse capabilities in CRM were most influenced not by their supposed lack of clinical knowledge and skills but by their lack of corporate knowledge. The failure to provide new graduate nurses with pertinent information on CRM at the beginning of their employment and thereafter at pertinent intervals during the graduate nurse year program aslo hindered the development of their capabilities to manage clinical risk. Management and educational processes pertinent to informing and involving new graduate nurses in a hospital's local CRM program (including information about the organization's local policies and procedures) need to be implemented systematically at the very beginning of a new graduate's employment and thereafter throughout the remainder of the graduate nurse year.


    de Barbieri, Ilaria; Baumann, Jacqueline; Casal, Maria Cruz; Gurevich, Andrey; Pancirova, Jitka; Poulia, Kalliopi-Anna; Riemann, Aase


    Nurses have an important role to play in the management of secondary hyperparathyroidism (SHPT). An online survey conducted by the European Dialysis and Transplant Nurses Association/European Renal Care Association (EDTNA/ERCA) in conjunction with Amgen (Europe) GmbH surveyed nephrology nurses' knowledge of secondary hyperparathyroidism, treatment targets, current treatments, patient adherence and nephrology nurse training education needs. The survey's aim was to establish common practices being used by nurses in the management of secondary hyperparathyroidism and to identify nephrology nurses' training and educational needs in order to improve patient care. Descriptive study. An online survey of multiple choice and closed questions. A sample of nephrology nurses from Spain, Italy, France and the Netherlands. A total of 111 nurses completed the questionnaire (98% response rate, 82% of which were fully completed). Collected data revealed that there were specific aspects of SHPT patient management where nurses lacked confidence, despite the majority of respondents having 15 years nephrology nursing experience. These aspects included explaining the disorder and therapies to patients, managing side effects of drugs and appreciating the significance of controlling biochemical targets. Over 40% of the respondents felt they did not have sufficient training to support patients who were non-compliant. Nursing skills are integral to SHPT patient management as part of the multidisciplinary approach. The nurse's role is particularly important in patient assessment and monitoring, and in the provision of patient education and support, particularly with treatment adherence. Nephrology nurses who are better informed about SHPT and who receive training on practical patient care may improve the care of patients. © 2015 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  7. The relationship among pressure ulcer risk factors, incidence and nursing documentation in hospital-acquired pressure ulcer patients in intensive care units. (United States)

    Li, Dan


    To explore the quality/comprehensiveness of nursing documentation of pressure ulcers and to investigate the relationship between the nursing documentation and the incidence of pressure ulcers in four intensive care units. Pressure ulcer prevention requires consistent assessments and documentation to decrease pressure ulcer incidence. Currently, most research is focused on devices to prevent pressure ulcers. Studies have rarely considered the relationship among pressure ulcer risk factors, incidence and nursing documentation. Thus, a study to investigate this relationship is needed to fill this information gap. A retrospective, comparative, descriptive, correlational study. A convenience sample of 196 intensive care units patients at the selected medical centre comprised the study sample. All medical records of patients admitted to intensive care units between the time periods of September 1, 2011 through September 30, 2012 were audited. Data used in the analysis included 98 pressure ulcer patients and 98 non-pressure ulcer patients. The quality and comprehensiveness of pressure ulcer documentation were measured by the modified European Pressure Ulcer Advisory Panel Pressure Ulcers Assessment Instrument and the Comprehensiveness in Nursing Documentation instrument. The correlations between quality/comprehensiveness of pressure ulcer documentation and incidence of pressure ulcers were not statistically significant. Patients with pressure ulcers had longer length of stay than patients without pressure ulcers stay. There were no statistically significant differences in quality/comprehensiveness scores of pressure ulcer documentation between dayshift and nightshift. This study revealed a lack of quality/comprehensiveness in nursing documentation of pressure ulcers. This study demonstrates that staff nurses often perform poorly on documenting pressure ulcer appearance, staging and treatment. Moreover, nursing documentation of pressure ulcers does not provide a complete

  8. Resilience and Work-life Balance in First-line Nurse Manager


    Kim, Miyoung; Windsor, Carol


    Purpose: The aim of this study was to explore how first-line nurse managers constructed the meaning of resilience and its relationship to work-life balance for nurses in Korea. Methods: Participants were 20 first-line nurse managers working in six university hospitals. Data were collected through in-depth interviews from December 2011 to August 2012, and analyzed using Strauss and Corbin's grounded theory method. Results: Analysis revealed that participants perceived work-life balance a...

  9. Chronic Health Conditions Managed by School Nurses. Position Statement. Revised (United States)

    Morgitan, Judith; Bushmiaer, Margo; DeSisto, Marie C.; Duff, Carolyn; Lambert, C. Patrice; Murphy, M. Kathleen; Roland, Sharon; Selser, Kendra; Wyckoff, Leah; White, Kelly


    It is the position of the National Association of School Nurses that students with chronic health conditions have access to a full-time registered professional school nurse (hereinafter referred to as school nurse). School districts should include school nurse positions in their full-time instructional support personnel to provide health services…

  10. Early Detection and Localization of Downhole Incidents in Managed Pressure Drilling

    DEFF Research Database (Denmark)

    Willersrud, Anders; Imsland, Lars; Blanke, Mogens


    Downhole incidents such as kick, lost circulation, pack-off, and hole cleaning issues are important contributors to downtime in drilling. In managed pressure drilling (MPD), operations margins are typically narrower, implying more frequent incidents and more severe consequences. Detection and han...

  11. Using the Critical Incident Technique for Triangulation and Elaboration of Communication Management Competencies (United States)

    Brunton, Margaret Ann; Jeffrey, Lynn Maud


    This paper presents the findings from research using the critical incident technique to identify the use of key competencies for communication management practitioners. Qualitative data was generated from 202 critical incidents reported by 710 respondents. We also present a brief summary of the quantitative data, which identified two superordinate…

  12. Improving Nursing Communication Skills in an Intensive Care Unit Using Simulation and Nursing Crew Resource Management Strategies: An Implementation Project. (United States)

    Turkelson, Carman; Aebersold, Michelle; Redman, Richard; Tschannen, Dana

    Effective interprofessional communication is critical to patient safety. This pre-/postimplementation project used a multifaceted educational strategy with high-fidelity simulation to introduce evidence-based communication tools, adapted from Nursing Crew Resource Management, to intensive care unit nurses. Results indicated that participants were satisfied with the education, and their perceptions of interprofessional communication and knowledge improved. Teams (n = 16) that used the communication tools during simulation were more likely to identify the problem, initiate key interventions, and have positive outcomes.

  13. Human capital in the nursing management of hospitals. (United States)

    Cordeiro, Ana Lúcia Arcanjo Oliveira; Fernandes, Josicélia Dumêt; Mauricio, Maria Deolinda Antunes Luz Lopes Dias; Silva, Rosana Maria de Oliveira; Barros, Claudia Silva Marinho Antunes de; Romano, Cátia Maria Costa


    To analyze how the components of human capital are used in the nursing management of hospital organizations. This was an exploratory and qualitative study. Data collection took place between October 2014 and May 2015 using semi-structured interviews. The data were analyzed according to content analysis. Twelve nurse managers participated. The components of human capital used by the nurses in personnel management were: during the hiring process, when requiring specialized education in the field and prior professional experience; when retaining talents with promotion strategies; in building capacities of professionals through support and training; and in collective work to construct processes and outcome assessment. The components of human capital need to be managed strategically with a focus on professional skills and development, with the aim of transforming individual and collective knowledge into new technology. Analisar como os componentes do capital humano são utilizados na gestão de enfermeiras em organizações hospitalares. Estudo exploratório, com abordagem qualitativa. A coleta de dados ocorreu de outubro de 2014 a maio de 2015 com a utilização de entrevistas semiestruturadas. Os dados foram analisados segundo a análise de conteúdo. Participaram 12 gestoras de enfermagem. Os componentes do capital humano utilizados pelas enfermeiras na gestão de pessoas foram: no processo admissional ao utilizar como critérios para contratação a exigência de especialização na área e experiência profissional prévia; na manutenção de talentos com estratégias de promoção; na capacitação de profissionais com apoio e treinamento; e no trabalho coletivo para a construção dos processos e avaliação dos resultados. Os componentes do capital humano precisam ser gerenciados estrategicamente com foco nas competências e no desenvolvimento do profissional, visando transformar os conhecimentos individuais e coletivos em novas tecnologias.

  14. Design and implementation of a rule based system for ambulatory nursing data management. (United States)

    Campbell, J R; Stoupa, R; Warren, J J


    In order to effectively organize the use of nursing time during clinic check-in, we designed a forward chaining rule based program for nursing history taking, problem tracking, and documentation. The program consists of a medical logic module trigger engine which identifies relevant rules for nursing history, an interactive question manager for nursing history taking, and a rule generation shell implemented within a specially designed Medical Query Language (MQL) shcema. At clinic check-in, the engine refreshes the rule set for the patient from interaction with the computerized medical record. The interaction driver assists the nurse with tracking of elapsed time, and allows him/her to pursue questions, record data, and create or complete nursing interventions. Nursing question sets and interventions are maintained longitudinally to assure continuity of care. Nursing problems are created on the problem list within the computerized record as the rule system identifies their existence.

  15. Chemotherapy-induced peripheral neuropathy: an algorithm to guide nursing management. (United States)

    Tofthagen, Cindy; Visovsky, Constance M; Hopgood, Rachelle


    Oncology nurses play a critical role in the assessment and management of chemotherapy-induced peripheral neuropathy (CIPN). Baseline and ongoing evaluation of physical function is a critical but often overlooked aspect of assessment of CIPN. The diversity of symptoms and the complexity associated with neuromuscular assessment lead to challenges in evaluation and management of CIPN. To meet this challenge, the authors devised a feasible algorithm to guide oncology nurses in the assessment and management of CIPN using techniques that can easily be implemented in a variety of clinical settings. Managing pain, maintaining safety, and maximizing physical function are the primary goals for nursing management of CIPN.

  16. The (mis)management of migrant nurses in the UK: a sociological study. (United States)

    Adhikari, Radha; Melia, Kath M


    To examine Nepali migrant nurses' professional life in the UK. In the late 1990 s the UK experienced an acute nursing shortage. Within a decade over 1000 Nepali nurses migrated to the UK. A multi-sited ethnographic approach was chosen for this study. Between 2006 and 2009, 21 in-depth interviews with Nepali nurses were conducted in the UK using snowballing sampling. Nepali migrant nurses are highly qualified and experienced in specialised areas such as critical care, management and education. However, these nurses end up working in the long-term care sector, providing personal care for elderly people - an area commonly described by migrant nurses as British Bottom Care (BBC). This means that migrant nurses lack career choices and professional development opportunities, causing them frustration and lack of job satisfaction. International nurse migration is an inevitable part of globalisation in health. Nurse managers and policy makers need to explore ways to make better use of the talents of the migrant workforce. We offer a management strategy to bring policies for the migrant workforce into line with the wider workforce plans by supporting nurses in finding jobs relevant to their expertise and providing career pathways. © 2013 John Wiley & Sons Ltd.

  17. Knowledge and Beliefs about Chronic Non Cancer Pain Management for Family Medicine Group Nurses. (United States)

    Bergeron, Dave A; Bourgault, Patricia; Gallagher, Frances


    To provide effective care for chronic pain sufferers, nurses must have a knowledge of chronic pain management. In Quebec, nurses working in Family Medicine Groups (FMGs) could play a major role in helping patients with chronic noncancer pain (CNCP); however, the extent of their knowledge about CNCP management is unknown. The primary goal of this study was to explore the knowledge and beliefs of FMG nurses about CNCP management. The secondary goal was to explore the obstacles seen by these nurses as preventing them from performing CNCP management. We used a mixed-methods design with quantitative preponderance. Fifty-three FMG nurses answered a self-administered mail-in questionnaire. A rigorous data collection method was used. FMG nurses have suboptimal knowledge about CNCP management. They identify their lack of training and lack of knowledge as major obstacles to conducting pain management interventions. There is a need for pain management training specifically designed around the realities of FMG nursing. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  18. Challenges of Asthma Management for School Nurses in Districts with High Asthma Hospitalization Rates (United States)

    Liberatos, Penny; Leone, Jennifer; Craig, Ann Marie; Frei, Elizabeth Mary; Fuentes, Natalie; Harris, India Marie


    Background: School nurses play a central role in assisting elementary school children in managing their asthma, especially those in higher-risk school districts that are at increased risk of uncontrolled asthma. Study purposes are to (1) identify barriers to asthma management by school nurses in higher-risk school districts; and (2) assess the…

  19. Effect of Time Management Program on Job Satisfaction for Head Nurses (United States)

    Elsabahy, Hanan ELsayed; Sleem, Wafaa Fathi; El Atroush, Hala Gaber


    Background: Time management and job satisfaction all related to each other and greatly affect success of organization. Subjects and Methods: The study aimed to evaluate the efficacy of a designed program of time management on job satisfaction for head nurses. A Quasi-experimental design was used for a total number of head nurses participated. Two…

  20. Top Management Leadership Style and Quality of Care in Nursing Homes (United States)

    Castle, Nicholas G.; Decker, Frederic H.


    Purpose: The purpose of this study was to examine the association of Nursing Home Administrator (NHA) leadership style and Director of Nursing (DON) leadership style with quality of care. Design and Methods: Leaders were categorized into 4 groups: consensus managers, consultative autocrats, shareholder managers, or autocrats. This leadership style…

  1. Nurse managers' preferred and perceived leadership styles: a study at an Italian hospital. (United States)

    Zampieron, Alessandra; Spanio, Daniele; Bernardi, Paola; Milan, Rosalia; Buja, Alessandra


    The aim of this cross-sectional descriptive study was to compare the different leadership styles based on perceptions of nurse managers and their staff. Nurse managers' styles are fundamental to improving subordinates' performance and achieving goals at health-care institutions. This was a cross-sectional study. A questionnaire developed by Ekvall & Arvonen, considering three leadership domains (Change, Production and Employee relations), was administered to all nurse managers and to their subordinates at a city hospital in north-east Italy. The comparison between the leadership styles actually adopted and those preferred by the nurse managers showed that the preferred style always scored higher than the style adopted, the difference reaching statistical significance for Change and Production. The leadership styles preferred by subordinates always scored higher than the styles their nurse managers actually adopted; in the subordinates' opinion, the differences being statistically significant in all three leadership domains. The study showed that nurse managers' expectations in relation to their leadership differ from those of their subordinates. These findings should be borne in mind when selecting and training nurse managers and other personnel, and they should influence the hospital's strategic management of nurses. © 2012 Blackwell Publishing Ltd.

  2. Simulation analysis of route diversion strategies for freeway incident management : final report. (United States)


    The purpose of this project was to investigate whether simulation models could : be used as decision aids for defining traffic diversion strategies for effective : incident management. A methodology was developed for using such a model to : determine...

  3. Logbook: experience of teaching-learning management and management in nursing and health

    Directory of Open Access Journals (Sweden)

    José Luís Guedes dos Santos


    Full Text Available The article aimed at reporting an experience of a group of post-graduate students in teaching on the stage of implementation active teaching-learning methodologies in the discipline of Management in Nursing and Health. The experience happened in three different admission units of a federal hospital in the southern region of the country, in the second semester of 2010. We used a logbook for students to register the journey to deepen the reflections on the experiences of the actions of management. At the end of the internship, the students were asked the logbook so that experiences, feelings, anxieties generated in the course of the journey to knowledge could be identified. The students report that the curricular internship of Management in Nursing and Health is a process of construction that gradually allows to have a sense of what awaits them when they are professionals, thus contributing to a critical and reflective formation.

  4. Implementing a pain management nursing protocol for orthopaedic surgical patients: Results from a PAIN OUT project. (United States)

    Cui, Cui; Wang, Ling-Xiao; Li, Qi; Zaslansky, Ruth; Li, Li


    To investigate the effect of introducing a standardised pain management nursing protocol in orthopaedic patients undergoing surgery. Postoperative pain is a common phenomenon but is still undertreated in hospitalised patients. Nurses' lack of sufficient knowledge and skills about pain management may be a contributing factor to poor outcomes. An interventional, separate sample pre- and post-test. A pain management nursing protocol was introduced and a handbook and training sessions regarding management of postsurgical pain were provided to the nurses on a Joint Orthopaedic ward at a university-affiliated general hospital in Guangzhou, China. Before and after the intervention, nurses' knowledge about pain management and attitudes were assessed, and perioperative management practices and pain-related patient-reported outcomes were evaluated. Sixteen and 15 registered nurses, and 77 and 71 patients participated in the study before and after the intervention, respectively. Nurses' scores related to knowledge and skills increased significantly after the protocol was introduced but were still insufficient with regard to pharmacological-related items. The proportion of patients receiving a combined opioid and nonopioid increased after the intervention. Clinically significant changes were observed in some patient-reported outcomes, such as worst pain since surgery, percentage of time experiencing severe pain, and pain interference with activities out of bed. There were significant changes in nonpharmacological methods administered by nurses to patients or used by patients to relieve pain. Implementation of a pain management nursing protocol combined with education in one surgical ward was associated with nurses' increased knowledge and attitudes regarding pain, a change in some management practices, and improvement in a number of pain-related patient-reported outcomes. It was feasible to develop and implement a standardised pain management nursing protocol and use it in the

  5. Frailty Screening (FRAIL-NH) and Mortality in French Nursing Homes: Results From the Incidence of Pneumonia and Related Consequences in Nursing Home Residents Study. (United States)

    De Silva, Thanuja R; Theou, Olga; Vellas, Bruno; Cesari, Matteo; Visvanathan, Renuka


    To investigate the ability of the fatigue, resistance, ambulation, incontinence or illness, loss of weight, nutritional approach, and help with dressing (FRAIL-NH) tool to predict mortality. The Incidence of Pneumonia and Related Consequences in Nursing Home Residents (INCUR) study database was used. This was an observational cohort study in French nursing homes conducted over 12 months in 2012. A total of 788 residents aged 60 years or older, from 13 randomly selected French nursing homes. FRAIL-NH was generated from the available variables at baseline. FRAIL-NH scores ranged from 0 to 14 and people were categorized as nonfrail (0‒1), frail (2‒5), and most frail (6‒14). Mortality data were obtained from medical charts and confirmed by the nursing home administrative documentation. Mean age of the participants was 86.2 ± 7.5 years, and 74.5% were women. The prevalence of persons with FRAIL-NH score greater than 1 was 88.8%, with 54.2% and 34.6% of residents identified as most frail and frail, respectively. The mean FRAIL-NH score was 6.0 ± 3.4. Women (N = 583) were frailer (6.1 ± 3.4) than men (N = 200, 5.5 ± 3.4; P = .027). Overall, 136 residents died over the 1-year follow-up period. The FRAIL-NH score was a predictor of mortality (adjusted hazard ratios: for frail group 1.15, 95% confidence interval 0.55‒2.41; for most frail group 2.14, 95% confidence interval 1.07‒ 4.27). FRAIL-NH is a predictor of mortality in nursing home residents and the score could assist with guiding appropriate care planning. Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  6. Psychosocial and organizational work environment of nurse managers and self-reported depressive symptoms: Cross-sectional analysis from a cohort of nurse managers

    Directory of Open Access Journals (Sweden)

    Nathalie Nourry


    Full Text Available Objectives: The association between depressive symptoms and psycho‑organisational work environment has been established in the literature. Some studies have evaluated depressive symptoms in healthcare workers, but little research has been carried out among nurse managers. The aim of the study is to evaluate the depressive symptoms prevalence among nurse managers' population and work environment factors. Material and Methods: A descriptive correlational research design was used. Data were collected from 296 nurse managers in five hospitals in the eastern area of France between 2007 and 2008. Health outcomes were evaluated by measuring depressive symptoms (CES-D scale, the exposure data by assessing psycho‑organisational work environment with effort-reward imbalance-model of Siegrist. Multiple logistic regressions were used to describe the strength of the association between depressive symptoms and effort-reward imbalance adjusted for personal and occupational characteristics of the nurse managers. Results: Among the nurse managers, a third had depressive symptoms, and 18% presented an effort-reward imbalance (ratio: ≥ 1. A significant association was found between depressive symptoms and effort-reward imbalance (OR = 10.81, 95% CI: 5.1-23, p < 10-3, and with esteem as a reward (OR = 3.21, 95% CI: 1.6-6.3, p < 10-2. Conclusion: In view of the hierarchical situation of nurse managers and their primary roles in hospitals, it is necessaryto take prevention measures to improve their work environment and health.

  7. A ward without walls? District nurses' perceptions of their workload management priorities and job satisfaction. (United States)

    Stuart, Elaine Haycock; Jarvis, Alison; Daniel, Katie


    To explore district nurses' workload management, job satisfaction and the challenges they face. This paper reports qualitative findings from a qualitative and quantitative study to identify a district nursing perspective on use of time, challenges and work satisfaction. District nursing is under increasing pressure because of the increasing shift to care in the community, early hospital discharge and changes in demography with an ageing population and more people with chronic illnesses. Qualitative. The study took place in one Scottish Health Board and data were collected in February and March 2005. The qualitative approach involved a total of 31 district nurses and senior managers in focus group discussions or individual interviews. Three main themes were identified: (1) the priorities of district nurses and their views on work unrelated to 'hands on' clinical care, (2) aspects of district nursing considered stressful and (3) district nurses' job satisfaction. District nurses and managers agree that caring work with patients is the priority for the service and provides job satisfaction. Many nurses feel overwhelmed by their workload and have little control over the admission of patients to their caseload; they are mainly demand led and therefore reactive care providers. A culture of long hours has developed as district nurses struggle to meet the needs of patients. Feeling devalued lowers satisfaction and Agenda for Change is perceived as de-valuing the skills of community nurses. More clerical support is required so district nurses can deliver care to patients. District nurses can better represent their workload and how it is managed through expressing the nature of assessing risk and caring for patients as opposed to defining patients care needs by medical diagnoses. Extending the hours of the full district nursing service would benefit patients and staff.

  8. Nurses' perception of their manager's leadership style and unit climate: are there generational differences? (United States)

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


    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.

  9. Factors influencing job satisfaction of front line nurse managers: a systematic review. (United States)

    Lee, How; Cummings, Greta G


    The purpose of this study was to systematically review the research literature that examined the determinants of front line nurse managers' job satisfaction. Front line managers are the vital link between senior management and clinical nurses. They influence organizational culture and outcomes for patients and staff so their job satisfaction and ultimately retention is of importance. A review of research articles that examined the determinants of front line nurse managers' job satisfaction was conducted. These managers supervise staff nurses and have direct responsibility for the management of a nursing unit or team in any type of healthcare facility. Fourteen studies were included in the final analysis. Evidence of significant positive relationships were found between span of control, organizational support, empowerment and the job satisfaction of front line nurse managers. The review suggests that job satisfaction of front line managers may be improved by addressing span of control and workload, increasing organizational support from supervisors and empowering managers to participate in decision-making. Healthcare organizations may enhance the recruitment, retention and sustainability of future nursing leadership by addressing the factors that influence job satisfaction of front line managers.

  10. Leadership and management skills of general practice nurses: experience or education? (United States)

    Lau, Rosalind; Cross, Wendy; Moss, Cheryle; Campbell, Annie; De Castro, Magali; Oxley, Victoria


    A key finding of this qualitative exploratory descriptive study into advanced nursing for general practice nurses (Australian setting) revealed that participants viewed leadership and management as best learnt 'apprenticeship' style on the job by years of experience. Participants (48) comprised of general practice nurses, practice managers and general practitioners from metropolitan Melbourne were interviewed. Other findings demonstrated that the participants generally had limited awareness that postgraduate education can assist in the development of leadership and management in advanced nursing practice. The participants lacked clarity about professional competencies and generally did not connect these to leadership and management. Professional bodies need to take the opportunity to promote awareness of the national competency standards. All three groups of participants expressed hopes about the future provision of professional development opportunities and support by the Medicare Local for leadership and management aspirations within advanced practice nursing.

  11. Registered Nurses' Patient Education in Everyday Primary Care Practice: Managers' Discourses. (United States)

    Bergh, Anne-Louise; Friberg, Febe; Persson, Eva; Dahlborg-Lyckhage, Elisabeth


    Nurses' patient education is important for building patients' knowledge, understanding, and preparedness for self-management. The aim of this study was to explore the conditions for nurses' patient education work by focusing on managers' discourses about patient education provided by nurses. In 2012, data were derived from three focus group interviews with primary care managers. Critical discourse analysis was used to analyze the transcribed interviews. The discursive practice comprised a discourse order of economic, medical, organizational, and didactic discourses. The economic discourse was the predominant one to which the organization had to adjust. The medical discourse was self-evident and unquestioned. Managers reorganized patient education routines and structures, generally due to economic constraints. Nurses' pedagogical competence development was unclear, and practice-based experiences of patient education were considered very important, whereas theoretical pedagogical knowledge was considered less important. Managers' support for nurses' practical- and theoretical-based pedagogical competence development needs to be strengthened.

  12. [Institutional demands and care demands in the management of nurses in an emergency unit]. (United States)

    Montezelli, Juliana Helena; Peres, Aida Maris; Bernardino, Elizabeth


    To characterize the registered nurse's management activities in an emergency department. Qualitative research, implemented from February to April 2009 by a semi-structured interview with eight nurses from an emergency department at a university hospital in Curitiba, PR. Brazil. The data was submitted to content analyses. Two categories emerged: Management focused on meeting the institutional demands that emphasizes the Registered Nurses' bureaucratic activities required by the hospital; and Management focused on meeting the nursing care demands that prioritizes the care as the main management activity. The study reached its objective and joined the literature findings that the division between care and management does not match with the registered nurse's performance at an emergency department.

  13. The Development and Psychometric Testing on Psychiatric Nurses of a Nurse Case Management Competence Scale in Taiwan. (United States)

    Chen, Shing-Chia; Lee, Shih-Kai; Rong, Jiin-Ru; Wu, Chien-Chang; Liu, Wen-I


    Case management is a complex process involving multiple activities. It is vital that nurses are competent in all related tasks for case management. A competence scale is a valuable tool for assessing task-related competency. The aims of this study were to examine the reliability and validity of an assessment scale for nurse case management competence and to use this scale to assess the current competency of nurses. A nurse case management competence scale was developed in three stages: (a) selection of assessment items according to standards of practice for case management and literature review, (b) determination of content validity using the Delphi technique with a panel of experts, and (c) psychometric testing of the developed competence scale using a cross-sectional design. Convenience sampling was used to recruit psychiatric nurses at seven psychiatric centers in Taiwan to complete the scale anonymously. An exploratory factor analysis was performed to analyze construct validity. Discriminant validity, internal consistency, and 2-week test-retest reliability were also examined. Two hundred eighty-five psychiatric nurses completed an assessment scale comprising 18 items (originally 25 items). The content validity index reached 0.96 after the Delphi technique was applied twice in the expert panel. Seventy-eight percent of the total variance was explained by two dimension factors: coordination facilitation competence and direct care competence. Participants who had undertaken case management courses had superior case management ability compared with those who had not, indicating that the scale possesses excellent discriminant validity. Cronbach's α and the test-retest results showed excellent reliability. Of the two competence factors, direct care competence (3.03) was better than coordination facilitation competence (2.81). There is a dearth of studies investigating the development and psychometric testing of case management competence scales. The results of this

  14. Childhood constipation: recognition, management and the role of the nurse. (United States)

    Schuster Bruce, James; Schuster Bruce, Catherine; Short, Hayley; Paul, Siba Prosad


    Constipation is a common childhood condition that health professionals will encounter in many different settings. The majority of these cases of childhood constipation are idiopathic in nature. It is considered to exhibit the 'tip of the iceberg' phenomenon as a large number of cases remain undetected due to under-recognition by families, embarrassment regarding the condition, fear of receiving a negative response from health professionals, or parental belief there is actually something more seriously wrong and failure to accept the diagnosis. Prompt evaluation and management is likely to be associated with better outcomes. To ensure this, fast recognition of symptoms, with care taken to exclude any 'red flag' symptoms that could indicate an organic cause and subsequently a different treatment pathway, is essential. Nurses, given their regular contact with families in different settings, are suitably placed to detect these symptoms early and can play a vital role in successful management of the condition. Laxatives are the first line in management of constipation. Polyethylene glycol 3350 is the laxative that evidence-based guidelines from the National Institute for Health and Care Excellence (2010) recommend as the initial pharmacological management. Advice should also be given about supportive measures, including diet and lifestyle changes.

  15. Attitudes, beliefs, and practices of Sri Lankan nurses toward cancer pain management: an ethnographic study. (United States)

    De Silva, Badurakada Sunil Santha; Rolls, Colleen


    Cancer pain is a serious problem that requires specialized nursing knowledge. In the present ethnographic study, we sought to explore the experiences and cancer pain management practices of nurses working at a government hospital in Sri Lanka. Data were collected from October 2007 to January 2008, and were obtained by observing the nurses in a cancer ward, conducting semistructured interviews with 10 participants, and maintaining a research diary. To analyze the data, the data were coded, and an integrative process was implemented to develop categories. The results suggested that Sri Lankan nurses perform poor cancer pain management practices due to a lack of resources, a shortage of nurses, and poor workload allocation within the hospital. Additionally, the nurses are not autonomous, and are required to refer to medical staff for cancer pain management strategies. The nurses work in a task-oriented system that rarely acknowledges cancer patients' pain management needs. This study might improve nursing pain management practices for cancer patients and lead to changes in the curriculum of nursing courses in Sri Lanka. © 2011 Blackwell Publishing Asia Pty Ltd.

  16. Praise matters: the influence of nurse unit managers' praise on nurses' practice, work environment and job satisfaction: a questionnaire study. (United States)

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


    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.

  17. Managers' Compensation in a Mixed Ownership Industry: Evidence from Nursing Homes. (United States)

    Huang, Sean Shenghsiu; Hirth, Richard A; Smith, Dean G


    An extensive literature is devoted to differences between for-profit and non-profit health-care providers' prices, utilization, and quality. Less is known about for-profit and non-profit managers' compensation and its relationship with financial and quality performance. The aim of this study is to examine whether for-profit and non-profit nursing homes place differential weights on financial and quality performance in determining managers' compensation. Using a unique 8-year dataset on Ohio nursing homes, fixed-effect regression models of managers' compensation include financial and quality performance as well as other explanatory variables concerning firm and market characteristics and manager qualifications. Among for-profit nursing homes, compensation of owner-managers and non-owner managers are compared. Compensation of for-profit managers is significantly positively associated with profit margin and return-on-assets, while compensation of non-profit managers does not exhibit any consistent relationship with financial measures. Compensation of neither for-profit nor non-profit managers is significantly related to quality measures. Nursing home size and managers' years of experience are the only consistent determinants of compensation. Owner-managers earn significantly higher compensation than non-owner managers and their compensation is less related to nursing home performance. Finding that home size and experience are strong determinants of compensation, and the association with ownership and financial performance for for-profit nursing homes are as expected. The insignificant relationship between compensation and quality performance is potentially troublesome.

  18. The Impact of Nurses on Neglected Tropical Disease Management. (United States)

    Blood-Siegfried, Jane; Zeantoe, G Clinton; Evans, Lauren J; Bondo, John; Forstner, James R; Wood, Kathryn


    Although Neglected Tropical Diseases (NTDs) are largely endemic in the developing nations of Africa, Asia, and South and Central America, they are reemerging with increasing frequency in developed countries. Their diagnosis, treatment, and control are an increasing public health concern that requires a different awareness by health care providers. Neglected tropical diseases (NTDs) are chronic infectious diseases which disproportionately burden poor, rural, and marginalized populations with significant mortality and high morbidity (disability, disfigurement, impaired childhood growth and cognitive development, increased vulnerability to coinfection) that reinforces their poverty. What can we learn from the nurses in developing countries already battling NTD's that could be useful in the developed world? This article provides an overview of distribution, pathophysiology, symptoms, and management of 13 NTDs, with particular attention to the role of nurses in delivering cost-effective integrated interventions. Case studies of schistosomiasis, Chagas disease, and leishmaniasis address recognition and treatment of infected individuals in developed nations where NTD infection is limited primarily to immigrants and travelers. © 2014 Wiley Periodicals, Inc.

  19. Nurse Manager Behaviors That RNs Perceive to Affect Their Job Satisfaction. (United States)

    Feather, Rebecca A; Ebright, Patricia; Bakas, Tamilyn


    Nurse manager behaviors and job satisfaction are commonly addressed in the literature; however, registered nurse (RN) perceptions of nurse manager behaviors provide a unique perspective that may inform future strategies designed to enhance RN job satisfaction. In this paper, the perceptions of RNs were explored through focus groups to learn the behaviors of nurse managers that most influence RNs' job satisfaction. Five focus groups were conducted through semi-structured interviews of a total of 28 RNs to provide data that were coded through qualitative content analysis for themes. The findings provide nurse managers with data related to the perceptions of RNs and the behaviors of managers that influence job satisfaction. The findings identified two conceptual categories of RN perceptions of nurse manager behaviors: manager behaviors supportive of RNs (communication, respect, and feeling cared for) plus the RNs' perceived disconnect of work issues from the manager's role. Findings support past research in relation to the perceptions of RNs wanting to be respected, included in communication, and the need to feel cared for by nurse managers to have higher levels of job satisfaction. © 2014 Wiley Periodicals, Inc.

  20. Nurse leaders as managers of ethically sustainable caring cultures. (United States)

    Salmela, Susanne; Koskinen, Camilla; Eriksson, Katie


    The aim of this study was to identify the distinctive foundations of the care culture and how nurse leaders (NL) can manage and strengthen these in a quest for ethically sustainable caring cultures. Sustainability presupposes an ethical leadership, a management of the good care and a well-educated staff, but research on NLs as managers of ethically sustainable caring cultures is not available. The study has a quantitative design with elements of a qualitative research approach. Data were collected through a web-based questionnaire sent to staff at eight selected units at a hospital in western Finland during September 2013; the reply rate was 32%. The data material was comprised of opinion questions, the ranking of values and two open-ended questions on lodestars in care and ethical principles in care work. NLs manage a care culture that rests on a solid foundation, where staff are co-creators of an ethically sustainable caring culture that includes good traditions for the praxis of care. NLs as managers are therefore responsible for realizing and passing on ethically sustainable caring cultures and creating prerequisites for staff's growth and development. The basis of good care, patient safety and sustainability is comprised of ethics with a respectful and dignified care that is evidence-based and economically stable. Through their management NLs have a responsibility to nurture and protect the core of caring and create contextual, professional and cultural prerequisites to maintain the core and art of caring as well as care staff's ethical and professional competence. © 2016 John Wiley & Sons Ltd.

  1. Developing students' time management skills in clinical settings: practical considerations for busy nursing staff. (United States)

    Cleary, Michelle; Horsfall, Jan


    In clinical settings, nursing staff often find themselves responsible for students who have varying time management skills. Nurses need to respond sensitively and appropriately, and to teach nursing students how to prioritize and better allocate time. This is important not only for developing students' clinical skills but also for shaping their perceptions about the quality of the placement and their willingness to consider it as a potential work specialty. In this column, some simple, practical strategies that nurses can use to assist students with improving their time management skills are identified. Copyright 2011, SLACK Incorporated.

  2. CE: Nursing Management of Patients with Ehlers-Danlos Syndrome. (United States)

    Anderson, Linda K


    Ehlers-Danlos syndrome (EDS), a hereditary connective tissue disorder, has historically been misunderstood and underdiagnosed by health care providers. Because of the high degree of phenotypic variability, patients are often correctly diagnosed only after years of seemingly unrelated but debilitating injuries and illnesses. Specific genetic mutations have been identified for some, but not all, EDS types; patients presenting with a high index of suspicion should be referred to a geneticist. As awareness and recognition of the syndrome improve, nurses are increasingly likely to care for patients with EDS. This article gives a brief overview of the syndrome and provides guidance on ways to manage symptoms, recognize and prevent serious complications, and improve patients' quality of life.

  3. Shivering management during therapeutic temperature modulation: nurses' perspective. (United States)

    Presciutti, Mary; Bader, Mary Kay; Hepburn, Millie


    Therapeutic temperature modulation, which incorporates mild hypothermia and maintenance of normothermia, is being used to manage patients resuscitated after cardiac arrest. Methods of modulating temperature include intravenous infusion of cold fluids and surface or endovascular cooling. During this therapy, the shiver response is activated as a defense mechanism in response to an altered set-point temperature and causes metabolic and hemodynamic stress for patients. Recognition of shivering according to objective and subjective assessments is vital for early detection of the condition. Once shivering is detected, treatment is imperative to avoid deleterious effects. The Bedside Shivering Assessment Scale can be used to determine the efficacy of interventions intended to blunt thermoregulatory defenses and can provide continual evaluation of patients' responses to the interventions. Nurses' knowledge and understanding of the harmful effects of shivering are important to effect care and prevent injury associated with uncontrolled shivering.

  4. Do personality traits of nurses have an effect on conflict management strategies? (United States)

    Erdenk, Nigar; Altuntaş, Serap


    This research was conducted in a descriptive, correlational and cross-sectional design to determine whether personality traits of nurses have an effect on conflict management strategies. It is known that integration, avoidance and compromise conflict management strategies are the most frequent strategies used among nurses and obligation and domination are the least frequent. However, the reasons behind their strategy choice are not known. It is predicted that one of the reasons is the personality characteristics of the nurses. The study was conducted with the participation of 237 nurses working in three different hospitals. Research data were collected by using the 'Personal Information Form', 'Rahim Organisational Conflict Inventory-II' and 'Five Factor Personality Inventory' between December 2013 and February 2014. Ethical approval and the organisations' approvals were obtained before data collection. The collected data were analysed using frequency and percentage distributions, descriptive statistics, Pearson product-moment correlation analysis, t-test, Cronbach's alpha coefficient and simple linear regression analysis tests. The majority of nurses had conflict especially with patients' relatives several times a month. It was found that the personality traits of nurses were mostly 'conscientiousness' and 'openness' and when they had a conflict, they tended to use 'integration' strategy. It was also found that the personality traits of nurses had an effect on some of the conflict management strategies adopted by them. It was found that the personality traits of nurses had an effect on some conflict management strategies adopted by them. Nurse managers should support nurses who adopt appropriate conflict management strategies and there should be conflict management programmes that can teach appropriate skills to other nurses. © 2017 John Wiley & Sons Ltd.

  5. Nurse manager perspective of staff participation in unit level shared governance. (United States)

    Cox Sullivan, Sheila; Norris, Mitzi R; Brown, Lana M; Scott, Karen J


    To examine the nurse manager perspective surrounding implementation of unit level shared governance in one Veterans Health Administration facility. Nursing shared governance is a formal model allowing nursing staff decision-making input into clinical practice, quality improvement, evidence-based practice and staff professional development. Unit level shared governance is a management process where decision authority is delegated to nursing staff at the unit level. Convenience sampling was used to recruit ten nurse managers who participated in face-to-face semi-structured interviews. Data were analysed using content analysis and constant comparison techniques. Demographic data were described using descriptive statistics. The participants included seven female and three male nurse managers with seven Caucasian and three African American. Participant quotes were clustered to identify sub-themes that were then grouped into four global themes to describe unit level shared governance. The global themes were: (1) motivation, (2) demotivation, (3) recommendations for success, and (4) outcomes. These research findings resonate with previous studies that shared governance may be associated with increased nurse empowerment, self-management, engagement, and satisfaction. These findings reflect the need for nurse managers to promote and recognize staff participation in unit level shared governance. © 2017 John Wiley & Sons Ltd.

  6. Applying an ethical decision-making tool to a nurse management dilemma. (United States)

    Toren, Orly; Wagner, Nurith


    This article considers ethical dilemmas that nurse managers may confront and suggests an ethical decision-making model that could be used as a tool for resolving such dilemmas. The focus of the article is on the question: Can nurse managers choose the ethically right solution in conflicting situations when nurses' rights collide with patients' rights to quality care in a world of cost-effective and economic constraint? Managers' responsibility is to ensure and facilitate a safe and ethical working environment in which nurses are able to give quality care to their patients. In nursing it is frequently declared that managers' main obligations are to patients' needs and their rights to receive quality care. However, managers' ethical responsibilities are not only to patients but also to the nurses working in their institution. This article describes a real (but disguised) situation from an Israeli health care context to illustrate the dilemmas that may arise. The question is posed of whether nurse managers can maintain patients' and nurses' rights and, at the same time, fulfill their obligation to the conflicting demands of the organization. The article also offers a way to solve conflict by using an ethical decision-making model.

  7. How transformational leadership appears in action with adverse events? A study for Finnish nurse manager. (United States)

    Liukka, Mari; Hupli, Markku; Turunen, Hannele


    The aim of this study was to determine whether elements of transformational leadership are present in nursing managers' actions following adverse events. Transformational leadership exerts a positive influence on organisational culture and patient safety. Eleven nursing managers were interviewed individually using a semi-structured format. Data were analysed using inductive content analysis. Four themes emerged relating to nursing managers' actions following adverse events: patient-centredness as a principle for common action, courage to reform operational models to prevent future adverse events, nursing staff's encouragement of open and blame-free discussion, and challenge to recognize adverse events. Nursing managers must understand their responsibilities and the importance of making it clear to staff that patient-centredness should be evident in all health care actions. Nursing managers must also recognize the need to ensure that staff treat patients' interests as the top priority. If an adverse event occurs, the situation should be discussed with the nursing staff and any unique aspects of the event must be accounted for. Nursing managers must have the skill to motivate and empower staff to find new ways to work, to prevent adverse events and to promote patient safety. © 2017 John Wiley & Sons Ltd.

  8. Professional Values, Job Satisfaction, and Intent to Leave Among Nursing Managers. (United States)

    Kantek, Filiz; Kaya, Ayla


    The professional values that are typically attributed to nursing managers influence the behaviors of staff nurses as well as of nursing managers. Therefore, the efficient planning and implementation of nursing services require that nursing managers raise their awareness of professional nursing values. This study aims to investigate the correlations between professional values, job satisfaction, and intent to leave the job and the institution. This descriptive and cross-sectional study was conducted on 216 nursing managers in nine different hospitals in Turkey. The data were collected using a personal information form, Nursing Professional Values Scale, Minnesota Job Satisfaction Questionnaire, and scales on intent to leave the job and the institution. Results indicate a positive correlation between the professional values of nurses and their job satisfaction and suggest a negative correlation between professional values and intent to leave the job and the institution. Furthermore, agency was found to be a determinant of job satisfaction. Strong professional values were found to increase job satisfaction and decrease the intent to leave the job and the institution.

  9. Incidence and management of biliary leakage after hepaticojejunostomy

    NARCIS (Netherlands)

    de Castro, Steve M. M.; Kuhlmann, Koert F. D.; Busch, Olivier R. C.; van Delden, Otto M.; Laméris, Johan S.; van Gulik, Thomas M.; Obertop, Hugo; Gouma, Dirk J.


    This study analyzes the change in the management of biliary leakage after hepaticojejunostomy. Between 1993 and 2003 all patients (n = 1033) were studied with a hepaticojejunostomv as part of a pancreatoduodenectomy (n = 486), proximal bile duct resection (without liver resection) (n = 35), and

  10. Predictors of nurse manager stress: a dominance analysis of potential work environment stressors. (United States)

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


    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.

  11. The effect of manager exclusion on nurse turnover intention and care quality. (United States)

    Cottingham, Marci D; Erickson, Rebecca J; Diefendorff, James M; Bromley, Gail


    Little is known about how exclusionary practices (i.e., ignored, ostracized) by managers differ across demographics and influence nursing outcomes. This study examines whether managerial exclusion varies by generation, race, and gender, and the extent to which these variables, in turn, relate to turnover intention and perceived patient care among a sample of 747 nurses working in hospitals in a midwestern health system. Exclusion did not differ across most demographic groups, though men reported less exclusion than women. Younger nurses of the Millennial generation, those feeling excluded, and those with fewer years of experience reported lower quality patient care. Managerial exclusion, being a nurse of color, and less experience were associated with stronger intentions to leave. Nursing leaders should attend to factors that may contribute to racial minorities seeking other jobs, diminish younger nurses' ability to provide high-quality care, and minimize practices that might lead nurses to feel excluded.

  12. [The development and impacts of professional nursing in senior care and senior business management: the perspective of a U.S.-based nurse entrepreneur]. (United States)

    Chang, Theresa


    The three main parts of this article include (1) the process of transition from a clinical nurse to a nurse entrepreneur, (2) senior care business management and social responsibility and (3) the development of senior care business in the future as well as the chances for nursing development. The article analyzes the development of gerontology nursing careers in the United States and Taiwan and the role professional nurses can play in ageing societies. A prospective plan for collaboration between gerontology nurses and long-term care health professionals in the United States and Taiwan concludes the article.

  13. Knowledge and power necessary to reconstruct nursing after management changes at a teaching hospital. (United States)

    Bernardino, Elizabeth; Felli, Vanda Elisa Andres


    This study was carried out at a teaching hospital in Southern Brazil, which adopted a management model that provoked the dismantling of the nursing service and the disbandment of nursing professionals. Its general goal was to promote changes that would be implemented in the re-organization of nursing work. It is a case study with a historical-dialectic approach, whose data were collected in March and April 2005 through the focal group technique. The study subjects were eight nurses, two technicians and two nursing auxiliaries. Data were analyzed through thematic content analysis. Results evidenced that the greatest challenges nursing faced at this hospital were: to construct a new identity, carry out teamwork while maintaining its professional identity, acquire visibility in the institution, change care and expand management.

  14. 76 FR 61371 - All-Hazard Position Task Books for Type 3 Incident Management Teams (United States)


    ...). 11. Division/Group Supervisor. 12. Unit Leader. 13. Strike Team/Task Force Leader. 14. Technical... Teams AGENCY: Federal Emergency Management Agency; DHS. ACTION: Notice of availability; request for comments. SUMMARY: The All-Hazard Position Task Books for Type 3 Incident Management Teams were developed...

  15. Empowerment in nurse leader groups in middle management: a quantitative comparative investigation. (United States)

    Spencer, Caroline; McLaren, Susan


    The aim was to investigate structural empowerment in nurse leaders in middle management positions. Objectives were to determine levels of empowerment of nurse leaders and to compare levels of empowerment between nurse leader groups. Access to formal and informal power, opportunity, resources, information and support are determinants of structural empowerment. Empowerment of nurse leaders in middle management positions is vital given their roles in enabling nursing teams to deliver high-quality care, benefitting both patient and workforce outcomes. Quantitative component of a mixed methods study using survey principles. The Conditions of Work Effectiveness Questionnaire II was distributed to the total population (n = 517) of nurse leaders in an NHS Foundation Trust in England. Nurse leader groups comprised unit leaders (sisters, matrons) and senior staff nurses. Quantitative data entered on spss v 17/18, were analysed using descriptive and inferential statistics. Overall, the unit response rate was 44·1% (n = 228). Levels of total and global empowerment were moderate and moderate to high respectively. Groups did not differ significantly on these parameters or on five elements of total empowerment, but significantly higher scores were found for unit leaders' access to information. Significantly higher scores were found for senior staff nurses on selected aspects of informal power and access to resources, but scores were significantly lower than unit leaders for components of support. A moderately empowered population of nurse leaders differed in relation to access to information, aspects of support, resources and informal power, reflecting differences in roles, spheres of responsibility, hierarchical position and the constraints on empowerment imposed on unit leaders by financial and resource pressures. Empowerment of nurse leaders in middle management is vital in enabling nursing teams to deliver high-quality care. Roles, spheres of responsibility, hierarchical

  16. [Preclinical and intrahospital management of mass casualties and terrorist incidents]. (United States)

    Franke, A; Bieler, D; Friemert, B; Kollig, E; Flohe, S


    Due to the recent terrorist attacks in Paris, Brussels, Ansbach, Munich, Berlin and more recently Manchester and London, terrorism is realized as a present threat to our society and social life, as well as a challenge for the health care system. Without fueling anxiety, there is a need for sensitization to this subject and to familiarize all concerned with the special kind of terrorist attack-related injuries, the operational priorities and tactics and the individual basic principles of preclinical and hospital care. There is a need to adapt the known established medical structure for a conventional mass casualty situation to the special requirements that are raised by this new kind of terrorist threat to our social life. It is the aim of this article, from a surgical point of view, to depict the tactics and challenges of preclinical care of the special kind of terrorist attack-related injuries from the site of the incident, via the advanced medical post or casualty collecting point, to the triage point at the hospital. The special needs of medical care and organizational aspects of the primary treatment in the hospital are highlighted and possible decisional options and different approaches are discussed.

  17. Essential managerial attributes of the nowadays nursing service manager in the South African context

    Directory of Open Access Journals (Sweden)

    K Jooste


    Full Text Available Nursing service managers need certain essential managerialattributes in taking the lead in effective management ofthe nowadays health care organisations in South Africa.Major changes in restructuring and human resources planningare taking place through transformation of health servicesand specific managerial attributes are needed in thisscenario. Without nursing service managers with the necessarymanagerial attributes, change in the health care environmentwill be hampered and planning, organising, directingand control of the delivering of quality care will benegatively influenced.

  18. First-line nurse leaders' health-care change management initiatives. (United States)

    Macphee, Maura; Suryaprakash, Nitya


    To examine nurse leaders' change management projects within British Columbia, Canada. British Columbia Nursing Leadership Institute 2007-10 attendees worked on year-long change management initiatives/projects of importance to their respective health-care institutions. Most leaders were in first-line positions with initiatives. Constant change is a global reality. Change management, a universal competency, must be included in leadership development programmes. © 2011 Blackwell Publishing Ltd.

  19. The role of practical wisdom in nurse manager practice: why experience matters. (United States)

    Cathcart, Eloise Balasco; Greenspan, Miriam


    To illustrate through the interpretation of one representative nurse manager's narrative how the methodology of practice articulation gives language to the ways practical wisdom develops in leadership practice and facilitates learning. Patricia Benner's corpus of research has demonstrated that reflection on clinical narratives comes closer than other pedagogical methods to replicating and enhancing the experiential learning required for the development of practical wisdom. Using Benner's methodology of practice articulation, 91 nurse managers wrote and read to a peer group a narrative of their lived experience in the role. The groups interpreted the narratives to extract the skilled knowledge and ethics embedded in the practice of the nurse manager authors. One narrative was chosen for this paper because it is a particularly clear exemplar of how practical wisdom develops in nurse manager practice. Articulating and reflecting on experiential learning led to an understanding of how practical wisdom developed in one nurse manager's practice. Interpretation of the narrative of one nurse manager illustrated how reflection on a complex ethical dilemma was a source of character development for the individual and the peer group. Describing and interpreting how practical wisdom develops for individual nurse managers can be a source of learning for the narrative author and other role incumbents who need to make sound decisions and take prudent action in ethically challenging situations. © 2013 John Wiley & Sons Ltd.

  20. Leadership styles of nurse managers in ethical dilemmas: Reasons and consequences. (United States)

    Zydziunaite, Vilma; Suominen, Tarja


    Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (N = 278) were nurse managers. The data were analysed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients,' relatives' and nurse managers' needs. Nurse managers exhibited leadership styles oriented to maintenance, focussing more on the 'doing the job' than on managing the decision-making in ethical dilemmas.


    Zydziunaite, V; Suominen, T


    Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. Purpose: To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. Methods: The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (n=278) were nurse managers. The data were analyzed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. Results: The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients', relatives' and nurse managers' needs. Conclusions: Nurse managers exhibited leadership styles oriented to maintenance, focusing more on the "doing the job" than on managing the decision-making in ethical dilemmas.

  2. Role delineation study for the American Society for Pain Management Nursing. (United States)

    Willens, Joyce S; DePascale, Christine; Penny, James


    A role delineation study, or job analysis, is a necessary step in the development of a quality credentialing program. The process requires a logical approach and systematic methods to have an examination that is legally defensible. There are three main phases: initial development and evaluation, validation study, and development of test specifications. In the first phase, the content expert panel discussed performance domains that exist in pain management nursing. The six domains developed were: 1) assessment, monitoring, and evaluation of pain; 2) pharmacologic pain management; 3) nonpharmacologic pain management; 4) therapeutic communication and counseling; 5) patient and family teaching; and 6) collaborative and organizational activities. The panel then produced a list of 70 task statements to develop an online survey which was sent to independent reviewers with expertise in pain management nursing. After the panel reviewed the results of the pilot test, it was decided to clarify a few items that did not perform as expected. After the questionnaire was finalized it was distributed to 1,500 pain management nurses. The final yield was 585 usable returns, for a response rate of 39%. Thirty-three percent of the respondents reported a bachelor's degree in nursing as the highest degree awarded. Over 80% indicated that they were certified in pain management. Over 35% reported working in a staff position, 14% as a nurse practitioner, and 13% as a clinical nurse specialist. Part of the questionnaire asked the participants to rate performance expectation, consequence or the likelihood that the newly certified pain management nurse could cause harm, and the frequency of how often that nurse performs in each of the performance domains. The performance expectation was rated from 0 (the newly certified pain management nurse was not at all expected to perform the domain task) to 2 (after 6 months the newly certified pain management nurse would be expected to perform the domain

  3. Practice nurse involvement in primary care depression management: an observational cost-effectiveness analysis


    Gray, Jodi; Haji Ali Afzali, Hossein; Beilby, Justin; Holton, Christine; Banham, David; Karnon, Jonathan


    Background Most evidence on the effect of collaborative care for depression is derived in the selective environment of randomised controlled trials. In collaborative care, practice nurses may act as case managers. The Primary Care Services Improvement Project (PCSIP) aimed to assess the cost-effectiveness of alternative models of practice nurse involvement in a real world Australian setting. Previous analyses have demonstrated the value of high level practice nurse involvement in the manageme...

  4. Home care nurses' knowledge of evidence-based education topics for management of heart failure. (United States)

    Delaney, Colleen; Apostolidis, Beka; Lachapelle, Leeanne; Fortinsky, Richard


    We primarily sought to evaluate home care nurses' knowledge of evidence-based education topics in managing heart failure (HF). Moreover, we wanted to determine if differences were evident in nurses' knowledge based on education and work experience, and to identify home care nurses' specific educational needs. A cross-sectional survey design was used. Home care nurses (n = 94) were recruited from 4 home care agencies. A previously published 20-item HF knowledge questionnaire was administered to participants, and an open-ended question determined participants' need for further HF-related education. Home care nurses' scores demonstrated a 78.9% knowledge level in overall HF education principles. The mean HF knowledge score was 15.78 (SD, ±1.69) out of a possible 20 points. Nurses scored lowest on knowledge related to asymptomatic hypotension (24.5% answered correctly), daily weight monitoring (26.6% answered correctly), and transient dizziness (30.9% answered correctly). Nurses requested further information on all HF topics addressed in the survey as well as on psychosocial issues, research evidence, and more information from other healthcare providers. Our findings suggest that home care nurses may not be sufficiently knowledgeable in evidence-based education topics for managing HF. The results help confirm the need to develop educational programs for home care nurses in managing HF, which may lead to improved quality of patient education. Further research is needed to address specific deficits in the knowledge of home care nurses, and to determine if HF educational programs for nurses would enhance and sustain nurses' knowledge of HF management education. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Serving two (or more) masters: accomplishing autonomous nursing practice in chronic disease management. (United States)

    Kimpson, Sally; Purkis, Mary E


    The concept of professional autonomy has figured prominently in literature that addresses nursing's project of professionalization. Nursing's capacity to determine the nature and scope of its practice is related in important ways to the location of practice. Within highly structured environments such as acute-care hospitals, nurses' professional autonomy has frequently been contested yet is often implicated by nursing's elite as a necessary condition in the construction of quality work environments. Professional concerns and management practices related to retaining experienced nurses to support sustainability in healthcare delivery systems' impact on the ability of nurses to practice autonomously. Our paper focuses on the emerging field of practice of chronic disease management. We describe the complex relationships negotiated by a nurse in a theoretically autonomous practice setting as she seeks to fulfil both the requirements of a research protocol designed by physician experts representing the specialty of renal medicine, and her professional obligations to respond to the expressed needs of patients with early-stage renal disease. We utilize a case study approach to explore particular contemporary concerns that nurses in practice confront as they attempt to accomplish professional relationships with patients central to achieving prescribed medical outcomes where nursing practice, as an element of the achievement of those outcomes, is constituted as absent or unacknowledged by the medical researchers leading the project. Implications for nursing's discourses on the professional project of autonomy will be discussed. © 2011 Blackwell Publishing Ltd.

  6. Enhancing the nurses' role in healthcare delivery through strategic management: recognizing its importance or not? (United States)

    Carney, Marie


    To determine the importance of strategy in nursing management and to establish if strategic management has entered the lexicon of nurses' vocabulary. Developing and managing strategy is a critical success factor for health care managers. It remains unclear if nurse managers view strategy development as their role. A review of scholarly International nursing and management literature, available through CINAHL and PUBMED Data Bases was undertaken. The titles of 1063 articles, published between 1997 and 2007 were examined in order to determine the profile of strategy in those titles. Documentary analysis was undertaken on a random sample of 250 of those articles and on the full text of a further 100. Less than 10% of journal titles contained the word strategy. What was presented as strategy was in the majority of cases describing policy, administration or management. Little formal strategy theory was evident. The nursing profession does not appear to have adopted the terms strategy or strategic management to any great extent. Nurse Managers could play a greater role in enhancing healthcare delivery if an understanding of, and acceptance of the importance of strategy in health care delivery was promoted.

  7. Nurse-Managed Clinics: Barriers and Benefits Toward Financial Sustainability when Integrating Primay Care and Mental Health. (United States)

    Ely, Linda T


    Nurse-managed, integrated clinics offer access, affordability, and quality to the health care environment. The integration of mental health and primary care is a holistic, comprehensive model that addresses the complicated needs of those with mental illness. As nurses increase their education in leadership, financial management, and business, there is a correlating increase in the number of nurse-managed clinics. More research is needed to determine the financial structures that benefit sustainability of nurse-managed, integrated clinics. However, in an integrated review of the literature between 2000 and 2012, the data indicate nurse-managed health centers receive less federal financial support than the medically modeled federally qualified health center.

  8. Self-management-support in dementia care: A mixed methods study among nursing staff. (United States)

    Verkaik, Renate; van Antwerpen-Hoogenraad, Paulien; de Veer, Anke; Francke, Anneke; Huis In Het Veld, Judith


    Background Self-management in patients and family caregivers confronted with dementia is not self-evident. Self-management skills may be limited because of the progressive cognitive decline of the patient and because family caregivers are often also very aged. Self-management support by nursing staff is therefore of paramount importance. Objectives To gain insight into how nursing staff perceive their self-management support tasks, and how they put them into practice. Research questions are: 'What are the opinions and experiences of Dutch nursing staff working in home care or residential elderly care regarding self-management support for people with dementia and their family caregivers?' and 'Do nursing staff feel sufficiently trained and skilled for self-management support?'. Methods A mixed methods approach was used, combining cross-sectional quantitative survey data from 206 Dutch nursing professionals with qualitative interviews among 12 nursing staff working in home care or residential elderly care in The Netherlands. Results Nursing staff working in home care experienced self-management support of people with dementia as a part of their job and as an attractive task. They consider 'helping people with dementia to maintain control over their lives by involving them in decisions in daily care' the essence of self-management support. Nursing staff saw family caregivers as their main partners in providing self-management support to the patient. They were less aware that family caregivers themselves might also need self-management support. Nursing staff often felt insufficiently trained to give adequate self-management support. RN's and CNA's did not differ in their opinions, experiences and training needs. Conclusions Nursing staff in home care do consider self-management support an important and attractive task in dementia care. Their skills for providing self-management support to patients with dementia and family caregivers need improvement. Recommendations

  9. The management of care: a social and legal function of chilean nursing

    Directory of Open Access Journals (Sweden)

    Paula Ceballos-Vásquez


    Full Text Available Introduction: The objective of this article is to reflect on the implication of the concept of management of nursing, making Latin-American countries that have incorporated the management of care aware of its norms and the chilean experience and the legal aspects that regulate the management of care are specifically presented.Development: To achieve this objective, a bibliographic revision of diverse mainstream magazines, texts and laws related to administration and Management of Care was carried out.Initially, the concept of management is analyzed with the purpose of comprehending why the nursing integrate it in its field of performance. To visualize later how some of the countries of Latin-America have incorporated it in their legal frameworks of management of Care care of nursing, and subsequently the experience of the Chilean chilean nursing with regard to the Management management of Care care is analyzed extensively.Conclusions: As final considerations it is indicated that the Management management of Care care is part of the social function of the nurses, for the daily work they are to perform incorporating the management, it would provide managing competencies and would permit the autonomous caretaking to these professionals. 

  10. Strategic directions for developing the Australian general practice nurse role in cardiovascular disease management. (United States)

    Halcomb, Elizabeth J; Davidson, Patricia M; Yallop, Julie; Griffiths, Rhonda; Daly, John


    Practice nursing is an integral component of British and New Zealand primary care, but in Australia it remains an emerging specialty. Despite an increased focus on the Australian practice nurse role, there has been limited strategic role development, particularly relating to national health priority areas. This paper reports the third stage of a Project exploring the Australian practice nurse role in the management of cardiovascular disease (CVD). This stage involved a consensus development conference, undertaken to identify strategic, priority recommendations for practice nurse role development. 1. Practice nurses have an important role in developing systems and processes for CVD management; 2. A change in the culture of general practice is necessary to promote acceptance of nurse-led CVD management; 3. Future research needs to evaluate specific models of care, incorporating outcome measures sensitive to nursing interventions; 4. Considerable challenges exist in conducting research in general practice; and 5. Changes in funding models are necessary for widespread practice nurse role development. The shifting of funding models provides evidence to support interdisciplinary practice in Australian general practice. The time is ripe, therefore, to engage in prospective and strategic planning to inform development of the practice nurse role.

  11. Developing a Web-Based Nursing Practice and Research Information Management System: A Pilot Study. (United States)

    Choi, Jeeyae; Lapp, Cathi; Hagle, Mary E


    Many hospital information systems have been developed and implemented to collect clinical data from the bedside and have used the information to improve patient care. Because of a growing awareness that the use of clinical information improves quality of care and patient outcomes, measuring tools (electronic and paper based) have been developed, but most of them require multiple steps of data collection and analysis. This necessitated the development of a Web-based Nursing Practice and Research Information Management System that processes clinical nursing data to measure nurses' delivery of care and its impact on patient outcomes and provides useful information to clinicians, administrators, researchers, and policy makers at the point of care. This pilot study developed a computer algorithm based on a falls prevention protocol and programmed the prototype Web-based Nursing Practice and Research Information Management System. It successfully measured performance of nursing care delivered and its impact on patient outcomes successfully using clinical nursing data from the study site. Although Nursing Practice and Research Information Management System was tested with small data sets, results of study revealed that it has the potential to measure nurses' delivery of care and its impact on patient outcomes, while pinpointing components of nursing process in need of improvement.

  12. The emotional labour of nursing -- Defining and managing emotions in nursing work. (United States)

    Gray, Benjamin


    Emotions in health organisations tend to remain tacit and in need of clarification. Often, emotions are made invisible in nursing and reduced to part and parcel of 'women's work' in the domestic sphere. Smith (1992) applied the notion of emotional labour to the study of student nursing, concluding that further research was required. This means investigating what is often seen as a tacit and uncodified skill. A follow-up qualitative study was conducted over a period of twelve months to re-examine the role of the emotional labour of nursing. Data were collected primarily from 16 in-depth and semi-structured interviews with nurses. Key themes elicited at interviews touch upon diverse topics in the emotional labour of nursing. In particular, this article will address nurse definitions of emotional labour; the routine aspects of emotional labour in nursing; traditional and modern images of nursing; and gender and professional barriers that involve emotional labour in health work. This is important in improving nurse training and best practice; investigating clinical settings of nurses' emotional labour; looking at changing techniques of patient consultation; and beginning to explore the potential therapeutic value of emotional labour.

  13. [Computers in nursing: development of free software application with care and management]. (United States)

    dos Santos, Sérgio Ribeiro


    This study aimed at developing an information system in nursing with the implementation of nursing care and management of the service. The SisEnf--Information System in Nursing--is a free software module that comprises the care of nursing: history, clinical examination and care plan; the management module consists of: service shifts, personnel management, hospital indicators and other elements. The system was implemented at the Medical Clinic of the Lauro Wanderley University Hospital, at Universidade Federal da Paraiba. In view of the need to bring user and developer closer, in addition to the constant change of functional requirements during the interactive process, the method of unified process was used. The SisEnf was developed on a WEB platform and using free software. Hence, the work developed aimed at assisting in the working process of nursing, which will now have the opportunity to incorporate information technology in their work routine.

  14. Development of a Traffic Management Decision Support Tool for Freeway Incident Traffic Management (FITM) Plan Deployment (United States)


    Traffic incidents have long been recognized as the main contributor to congestion in highway networks. Thus, contending with non-recurrent congestion has been a priority task for most highway agencies over the past decades. Under most incident scenar...

  15. Mobbing in the workplace by peers and managers: mobbing experienced by nurses working in healthcare facilities in Turkey and its effect on nurses. (United States)

    Yildirim, Aytolan; Yildirim, Dilek


    This research was conducted as a descriptive and cross-sectional study with the purpose of determining the mobbing experienced by nurses who work in healthcare facilities in Turkey, its emotional, social and physiological effects on the nurses and the actions that the individuals take to escape from the mobbing. The term 'mobbing', which includes workplace terrorizing, pressure, frightening, belittling and psycho-terror, is defined as the presence of systematic, directed, unethical communication and antagonistic behaviour by one or more individuals. These actions that occur frequently and continue for a long time are the most serious and effective causes of workplace stress. The person who is the target of the mobbing is left without help, without protection and alone in the workplace. Individuals who are exposed to psychological abuse experience physiological, psychological and social problems that are related to high levels of stress and anxiety. The research participants were 505 nurses of whom 325 (64%) worked in public and 180 (36%) in private hospitals. All of the participants were female. A questionnaire developed by the researchers in the light of information in the literature was used for data collection and had four sections including the participants' demographic characteristics and questions asking about mobbing behaviours, reaction to mobbing incidents and actions taken to escape from the mobbing. The data were collected between October and December 2005 by giving an envelope to the participants and then collecting the responses in the closed envelope. The overwhelming majority (86.5%) of the nurses participating in the research reported facing mobbing behaviour in the workplace in the last 12 months. The nurses working at private hospitals faced statistically significantly more mobbing behaviours than those at public hospitals (pmobbing behaviours gave various physiological, emotional and social reactions to these incidents. The most common behaviours

  16. Control systems, personnel policies and management initiatives to limit pollution incidents

    International Nuclear Information System (INIS)

    Martin, B.F.


    After the regulatory requirements are met, an important collateral step in the continuing Hazardous Waste/Environmental Management cycle of activities is to minimize the possibility of a pollution incident, spill, contamination, mislabeling, mishandling or exposure, since this minimizes a major contingent liability of the company. Human failure accounts for 88% of accidents, 10% occur from mechanical failure and only 2% are unpreventable force majeure. This implies that fully 98% of all accidents can be prevented or minimized. Good engineering, production, management and educational practices can be formulated to minimize the occurrence and effects of accidental pollution incidents. Hazardous Material/Environmental Management tends to focus on technical and regulatory objectives, a reactionary mode caused in part by the rapidly changing regulatory environment and the need to continually adapt to these changes. Management functions such as personnel management and situational management get shortchanged in research and in practice. What is needed is a system that incorporates change readily, adapts personnel to change easily and mobilizes all the human resources of a company in meeting environmental and regulatory goals in the same way other goals of the company are met. Feedback Loop/Control System concepts have been applied to management practice in the popular Management By Objectives School as well as other schools of management practice. An Environmental Management program is proposed which incorporates feedback loop/ control systems to facilitate operations and training objectives and requirements. By incorporating Environmental and Hazardous Waste goals with other management goals in a system involving all levels of management and workers on the same team, the proposed system will reduce the probability of accidental pollution incidents and thus the contingent liability of a spill or other incident

  17. The protection of radioactive nuclide and nursing management in DSA room

    International Nuclear Information System (INIS)

    Zhang Guimin


    Objective: To discuss the protection of radioactive nuclide and nursing management in DSA room. Methods: The clinical state of the protection of radioactive 131 I nuclide and nursing management in DSA room was retrospectively summarized. Results: The standard management for the protection of radioactive nuclide in DSA room was established. The main management schemas included the management of personnel, the management of professional skills and, specialty, the management of radioactive drugs and abandoned odds and ends, preoperative health education, etc. Conclusion: The standard management can ensure that the patients get a good radionuclide therapy in DSA room, and, at the same time, the working environment can be effectively protected and the professional nursing staff can be well trained. (authors)

  18. Nursing management, religion and spirituality: a bibliometric review, a research agenda and implications for practice. (United States)

    Cullen, John G


    This article aims to contribute to the growing field of spirituality and nursing management by analysing bibliographic data on peer-reviewed research in the field. Articles on spirituality and nursing management often claim that these fields have grown over the past two decades. This article gathers empirical evidence to test these claims. Bibliometric data on peer-reviewed research articles on nursing, nursing management, spirituality and religion in the Social Sciences Citation Index were analysed to ascertain general trends in publication and citation. The data support claims that research activity and interest in both spirituality and religion in the field of nursing have grown steeply over recent years, and continue to accelerate. The research identified spirituality as a beneficial variable in management, training and/or care scenarios. Critical studies of nursing management spiritual initiatives could add considerably to the growing body of research and theory in this field. It is essential that nurse managers be equipped to foster not only a broader understanding of the variety of faith traditions found in a multi-cultural society, but also to develop an understanding of the ways in which individuals engage in spiritual practice outside traditional religious settings. © 2015 John Wiley & Sons Ltd.

  19. Clinical nursing leaders', team members' and service managers' experiences of implementing evidence at a local level. (United States)

    Kitson, Alison; Silverston, Heidi; Wiechula, Rick; Zeitz, Kathryn; Marcoionni, Danni; Page, Tammy


    To describe the experiences of 14 clinical nursing leaders introducing a knowledge translation (KT) project into one metropolitan acute care hospital in South Australia. The study also explored team members' and service managers' experiences. KT strategies assume that local (nursing) clinical leaders have the capacity and capability to champion innovation combining positional leadership roles (ward leader) with a project lead role. There is limited evidence to support these assumptions. Semi-structured interviews of clinical nursing leaders and managers were undertaken at month 4 and 12 of the project. Data were also collected from the interdisciplinary team members (n = 28). Clinical nursing leaders identified risks and anxieties associated with taking on an additional leadership role, whereas managers acknowledged the multiple pressures on the system and the need for local level innovation. Team members generally reported positive experiences. With support, clinical nursing leaders can effectively embrace KT project leadership roles that complement their positional leadership roles. Clinical nursing leaders' experiences differed from nursing and medical managers' experiences.   Managers need to be more attuned to the personal risks local leaders experience, providing support for leaders to experiment and innovate. Managers need to integrate local priorities with broader system wide agendas. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  20. A systematic review of factors influencing knowledge management and the nurse leaders' role. (United States)

    Lunden, Anne; Teräs, Marianne; Kvist, Tarja; Häggman-Laitila, Arja


    To describe factors facilitating or inhibiting the development of registered nurses' competency and nurse leader's role in knowledge management. Nurses' competency directly influences patient safety and the quality and effectiveness of patient care. Challenges of nurse leaders in knowledge management include acquiring, assessing and utilising current knowledge and assessing and enhancing competency. A systematic search was conducted in PubMed, CINAHL, SCOPUS and ERIC databases in April 2015. The search identified 18 relevant research articles published between 2009 and 2015. The quality of the studies was appraised in accordance with study designs. Knowledge management is facilitated by an organisation culture that supports learning, sharing of information and learning together. Leader commitment and competency were factors related to leadership facilitating knowledge management. Nurse leaders need evidence-based interventions to support shared learning and to create infrastructures that facilitate competence development. Future research is especially needed to evaluate connections between knowledge management and patient outcomes. The results of this review can be utilised in enhancing factors to facilitate knowledge management in clinical practice and identifying nurse leaders' role in strengthening nurses' competency. © 2017 John Wiley & Sons Ltd.

  1. Exploring barriers to pain management in newborn intensive care units: a pilot survey of NICU nurses. (United States)

    Byrd, Patricia J; Gonzales, Irene; Parsons, Virgil


    To explore barriers that NICU nurses face when attempting to optimally manage newborn pain. Ninety California NICU nurses with current membership in the National Association of Neonatal Nurses (NANN) voluntarily participated. A descriptive survey study. A researcher-developed survey consisting of 37 questions was mailed to 300 NICU nurses; 102 were returned and 90 were usable. Probability sampling from a listing of California registered nurses with current membership in the NANN was used to obtain the study's sampling frame. Less than half of the nurses felt that newborn pain is well managed within the NICUs where they are employed. Barriers identified related to physicians' pain management practices, lack of evidence-based pain management protocols, nurses' and physicians' resistance to change practice, infant pain assessment tools, and inadequate staff training regarding pain assessment and management. A knowledge-practice gap still exists within newborn pain management. Increased caregiver education remains a necessity, but strategies that address resistance to change practice within healthcare settings must also be considered.

  2. Air Force Critical Incident Stress Management outreach with Pentagon staff after the terrorist attack. (United States)

    Rowan, Anderson B


    This article describes the Critical Incident Stress Management outreach to Pentagon staff conducted after the terrorist attack by a team of Air Force mental health and chaplain personnel. Also discussed are lessons learned from the author's experience while leading the mental health component and working in a larger tri-service outreach. Finally, the observed impacts of the outreach effort are examined along with recommendations for future postcritical incident outreach efforts.

  3. Peripartum cardiomyopathy: definition, incidence, etiopathogenesis, diagnosis, and management. (United States)

    Garg, Jalaj; Palaniswamy, Chandrasekar; Lanier, Gregg M


    Peripartum cardiomyopathy (PPCM) is a serious pregnancy-associated disorder of unknown etiology. The precise cellular and molecular mechanisms underlying PPCM are unclear. A heightened awareness among health care providers can result in early diagnosis of heart failure in late pregnancy and the early postpartum period. Though the symptoms of dyspnea and fatigue can result from normal physiologic changes during pregnancy, an electrocardiogram and brain natriuretic peptide level should be obtained in these patients, in addition to baseline laboratory tests such as a complete blood count, and basic metabolic and hepatic function panels. If the electrocardiogram and brain natriuretic peptide level are abnormal, an echocardiogram should be obtained. The role of endomyocardial biopsy for the diagnosis of PPCM is controversial. Patients should be started on diuretics if volume overloaded, and beta-blockers (preferably metoprolol) if no contraindications exist; angiotensin-converting enzyme inhibitors and angiotensin receptor blockers should be avoided during pregnancy or lactation. There are no standard, universally accepted guidelines for the management of PPCM. Although experimental therapies like bromocriptine, pentoxifylline and immunoglobulins have shown promising results, large double-blind randomized trials are essential to confirm the results of smaller studies. In patients with persistent severe left ventricular (LV) dysfunction, advanced therapies like mechanical circulatory support and heart transplantation should be considered. Owing to recent data demonstrating deterioration of LV systolic function after initial recovery, it is essential to maintain long-term follow up of these patients regardless of initial recovery of LV function. We present a comprehensive review of the literature etiopathogenesis, diagnosis, and management of PPCM.

  4. Conflict management style, supportive work environments and the experience of work stress in emergency nurses. (United States)

    Johansen, Mary L; Cadmus, Edna


    To examine the conflict management style that emergency department (ED) nurses use to resolve conflict and to determine whether their style of managing conflict and a supportive work environment affects their experience of work stress. Conflict is a common stressor that is encountered as nurses strive to achieve patient satisfaction goals while delivering quality care. How a nurse perceives support may impact work stress levels and how they deal with conflict. A correlational design examined the relationship between supportive work environment, and conflict management style and work stress in a sample of 222 ED nurses using the expanded nurse work stress scale; the survey of perceived organisational support; and the Rahim organisational conflict inventory-II. Twenty seven percent of nurses reported elevated levels of work stress. A supportive work environment and avoidant conflict management style were significant predictors of work stress. Findings suggest that ED nurses' perception of a supportive work environment and their approach to resolving conflict may be related to their experience of work stress. Providing opportunities for ED nurses in skills training in constructive conflict resolution may help to reduce work stress and to improve the quality of patient care. © 2015 John Wiley & Sons Ltd.

  5. Nursing Satisfaction with Medication Care by Using Neonatal Electronic Medication Management Systems

    Directory of Open Access Journals (Sweden)

    Mahboobeh Namnabati


    Conclusion: Electronic medication management system has more practical advantages than other similar systems. This system helps the nurses to identify and prevent many medication errors and save time in drug care documentation. Therefore, this system is a big step towards satisfaction with nursing medication care.

  6. Nurse adoption of continuous patient monitoring on acute post-surgical units: managing technology implementation. (United States)

    Jeskey, Mary; Card, Elizabeth; Nelson, Donna; Mercaldo, Nathaniel D; Sanders, Neal; Higgins, Michael S; Shi, Yaping; Michaels, Damon; Miller, Anne


    To report an exploratory action-research process used during the implementation of continuous patient monitoring in acute post-surgical nursing units. Substantial US Federal funding has been committed to implementing new health care technology, but failure to manage implementation processes may limit successful adoption and the realisation of proposed benefits. Effective approaches for managing barriers to new technology implementation are needed. Continuous patient monitoring was implemented in three of 13 medical/surgical units. An exploratory action-feedback approach, using time-series nurse surveys, was used to identify barriers and develop and evaluate responses. Post-hoc interviews and document analysis were used to describe the change implementation process. Significant differences were identified in night- and dayshift nurses' perceptions of technology benefits. Research nurses' facilitated the change process by evolving 'clinical nurse implementation specialist' expertise. Health information technology (HIT)-related patient outcomes are mediated through nurses' acting on new information but HIT designed for critical care may not transfer to acute care settings. Exploratory action-feedback approaches can assist nurse managers in assessing and mitigating the real-world effects of HIT implementations. It is strongly recommended that nurse managers identify stakeholders and develop comprehensive plans for monitoring the effects of HIT in their units. © 2011 Blackwell Publishing Ltd.

  7. Using the Health Belief Model to Understand School Nurse Asthma Management (United States)

    Quaranta, Judith E.; Spencer, Gale A.


    Ten million children in the United States have asthma. Since children are in school about 6 hr a day, school nurses are positioned to intervene and influence asthma outcomes. A descriptive correlational study was designed to investigate performance of school nurses' asthma management behaviors in relationship to asthma knowledge, asthma attitude,…

  8. Leadership in blended care : on daily work and habitus of nurse middle managers in hospitals

    NARCIS (Netherlands)

    Pieterbas Lalleman


    A Magnet-related program has been recently adopted in the Netherlands. Support for staff nurses from nurse middle managers (NMMs) is a key component of such a program. A Bourdieusian ethnographic organizational case study in four hospitals in the Netherlands and the United States (Magnet,

  9. Management of inpatient aggression in forensic mental health nursing : the application of the Early Recognition Method

    NARCIS (Netherlands)

    Fluttert, F.A.J.


    Management of Inpatient Aggression in Forensic Mental Health Nursing. The application of the Early Recognition Method. Forensic mental health nurses take care of forensic patients convicted for an offense for which they were assessed not to be fully accountable due to their psychiatric disorder. For

  10. Iranian staff nurses' views of their productivity and management factors improving and impeding it: a qualitative study. (United States)

    Dehghan Nayeri, Nahid; Nazari, Ali Akbar; Salsali, Mahvash; Ahmadi, Fazlollah; Adib Hajbaghery, Mohsen


    As the biggest proportion of hospital personnel, Iranian nurses have a major role in providing quality care to patients. Nursing managers and nurses no longer feel that nurses' work is valued and they are concerned about their productivity. Nurses' views about productivity and management factors affecting it have been identified as the most important aspects affecting productivity. Thus, this study assesses productivity from the nurse's view. A grounded theory approach was used for this research. Purposive sampling and semistructured interviews were used. The data were analyzed using constant comparative analysis. Most participants felt that the qualitative nature (effectiveness) of productivity is very important. Also, participants indicated that management is the most important factor that can promote or impede their productivity. They suggested that managers' performance and their skill level are the factors influencing productivity. Effective management can improve nurses' productivity and the quality of care that nurses provide.

  11. Nurse Managers’ Work Life Quality and Their Participation in Knowledge Management: A Correlational Study (United States)

    Hashemi Dehaghi, Zahra; Sheikhtaheri, Abbas; Dehnavi, Fariba


    Background: The association between quality of work life and participation in knowledge management is unknown. Objectives: This study aimed to discover the association between quality of work life of nurse managers and their participation in implementing knowledge management. Materials and Methods: This was a correlational study. All nurse managers (71 people) from 11 hospitals affiliated with the Social Security Organization in Tehran, Iran, were included. They were asked to rate their participation in knowledge management and their quality of work life. Data was gathered by a researcher-made questionnaire (May-June 2012). The questionnaire was validated by content and construct validity approaches. Cronbach’s alpha was used to evaluate reliability. Finally, 50 questionnaires were analyzed. The answers were scored and analyzed using mean of scores, T-test, ANOVA (or nonparametric test, if appropriate), Pearson’s correlation coefficient and linear regression. Results: Nurse managers’ performance to implement knowledge management strategies was moderate. A significant correlation was found between quality of work life of nurse managers and their participation in implementing knowledge management strategies (r = 0.82; P knowledge management and participation of nurse managers in decision making (r = 0.82; P knowledge management. PMID:25763267

  12. The effect of a daily application of a 0.05% chlorhexidine oral rinse solution on the incidence of aspiration pneumonia in nursing home residents: a multicenter study.

    NARCIS (Netherlands)

    Hollaar, V.R.Y.; Putten, G.J. van der; Maarel-Wierink, C.D. van der; Bronkhorst, E.M.; Swart, B.J.M. de; Creugers, N.H.J.


    BACKGROUND: Dysphagia and potential respiratory pathogens in the oral biofilm are risk factors for aspiration pneumonia in nursing home residents. The aim of the study was to examine if the daily application of 0.05% chlorhexidine oral rinse solution is effective in reducing the incidence of

  13. Conflict management styles among Iranian critical care nursing staff: a cross-sectional study. (United States)

    Ahanchian, Mohammad Reza; Emami Zeydi, Amir; Armat, Mohammad Reza


    Conflict among nurses has been recognized as an extremely important issue within health care settings throughout the world. Identifying the conflict management style would be a key strategy for conflict management. The aim of this study was to evaluate the prevalence of conflict management styles and its related factors among Iranian critical care nursing staff. In a descriptive cross-sectional study, a total of 149 critical care nurses who worked in the critical care units of 4 teaching hospitals in Sari (Iran) were evaluated. A 2-part self-reported questionnaire including personal information and Rahim Organizational Conflict Inventory II was used for data collection. Although Iranian critical care nurses used all 5 conflict management styles to manage conflict with their peers, the collaborating style was the most prevalent conflict management style used by them, followed by compromising, accommodating, avoiding, and competing. Male gender was a predictor for both compromising and competing styles, whereas position and shift time were significant predictors for compromising and competing styles, respectively. Based on the results of this study, nurse managers need to take these factors into account in designing programs to help nurses constructively manage unavoidable conflicts in health care setting.

  14. Variation in nurse self-reported practice of managing chest tubes: A cross-sectional study. (United States)

    Lu, Cui; Jin, Ying-Hui; Gao, Weijie; Shi, Yue-Xian; Xia, Xinhua; Sun, Wen-Xi; Tang, Qi; Wang, Yunyun; Li, Ge; Si, Jinhua


    To reveal nurses' self-reported practice of managing chest tubes and to define decision-makers for these practices. No consensus exists regarding ideal chest-tube management strategy, and there are wide variations of practice based on local policies and individual preferences, rather than standardised evidence-based protocols. This article describes a cross-sectional study. Questionnaires were emailed to 31 hospitals in Tianjin, and the sample consisted of 296 clinical nurses whose work included nursing management of chest drains. The questionnaire, which was prepared by the authors of this research, consisted of three sections, including a total of 22 questions that asked for demographic information, answers regarding nursing management that reflected the practice they actually performed and who the decision-makers were regarding eight chest-drain management procedures. McNemar's test was used to analyse the data. The results indicated that most respondents thought that it was necessary to manipulate chest tubes to remove clots impeding unobstructed drainage (91.2%). Most respondents indicated that dressings would be changed when the dressing was dysfunctional. At the same time, more than half of respondents approved of changing dressings routinely, and the frequency of changing dressings varied. When drainage was employed for pleural effusion and for a pneumothorax, 64.6% and 94.5% of respondents, respectively, considered that underwater seal-drainage bottles should be changed routinely, and the frequency of changing bottles both varied. The results indicated that nurses were the primary decision-makers in the replacement of chest tubes, manipulation of chest tubes and monitoring of drainage fluid. There was considerable variation in respondents' self-reported clinical nursing practice regarding management of chest drains. The rationale on which respondents' practices were based also varied greatly. This study indicated that nurses were the primary decision

  15. Managing shoreline assessment data during the Lake Wabamun incident

    Energy Technology Data Exchange (ETDEWEB)

    Lamarche, A. [Environmental Performance and Decision Support, Montreal, PQ (Canada); Martin, V. [Eastern Canada Response Corp. Ltd., Vercheres, PQ (Canada)


    A freight train derailed near the shore of Lake Wabamun near Edmonton in August 2003, spilling about 750 m{sup 3} of heavy Bunker C oil on the lakeshore. The nature and extent of oiling was assessed over a period of 3 consecutive summers using a variety of techniques. Surface oiling along the shore was evaluated using the Shoreline Cleanup Assessment Team (SCAT) approach, with some modifications to consider local conditions. Oiling conditions of the submerged tar ball oil in the shallow near shore waters was evaluated in the summer of 2006. Several computerized functions were developed in order to provide reports and maps of the submerged oil conditions, so that the treatment team could remove most of the oil before the next reed growing season. The location of all observations were recorded using GPS. Lake Wabamun includes the following along its shores: industry which uses the lake water for cooling purposes; a provincial park; a First-nations reservation; and private residences. Since all survey data was made available to the general public, it had to be detailed and easy to understand. This paper described how some of the data management issues were addressed within the framework of the shoreline assessment organization. 6 refs., 3 tabs., 13 figs.

  16. University management: contributions for nurses who are faculty members and managers. (United States)

    Cunha, Kamylla Santos da; Kahl, Carolina; Koerich, Cintia; Santos, José Luís Guedes Dos; Lanzoni, Gabriela Marcellino de Melo; Erdmann, Alacoque Lorenzini


    To comprehend how university management contributes on the performance of nurses who are professors and managers in a public university. Qualitative research anchored on the Grounded Theory. The setting to collect the data was a public university in south Brazil and it happened between May and September of 2016. A total of 19 nurses took part in the study, all of them also faculty members and managers that were divided in two sample groups. Two subcategories were created: the comprehension that university management improves the faculty performance; obtaining a wider view of the university. The contributions of university management for faculty nurses who are managers are mainly on the personal and professional satisfaction through the production and dissemination of knowledge, reflecting positively on the refinement of the teaching competences to train Nurses with knowledge, technical skills and cognitive abilities to answer society's needs. Compreender como a gestão universitária contribui na atuação de enfermeiros docentes gestores de uma universidade pública. Pesquisa qualitativa ancorada na Teoria Fundamentada nos Dados. O cenário de coleta de dados foi uma universidade pública do sul do Brasil e ocorreu entre maio e setembro de 2016. Participaram do estudo 19 enfermeiros docentes gestores divididos em dois grupos amostrais. Elucidam duas subcategorias: compreender que a gestão universitária aperfeiçoa a atuação docente; obter uma visão ampliada da universidade. As contribuições da gestão universitária para os enfermeiros docentes gestores encontram-se especialmente na satisfação profissional e pessoal através da produção e disseminação do conhecimento, repercutindo de forma positiva no aperfeiçoamento de competências docentes para a formação de Enfermeiros com conhecimentos, habilidades e aptidões técnicas e cognitivas para atender às necessidades da sociedade.

  17. Negotiating futility, managing emotions: nursing the transition to palliative care. (United States)

    Broom, Alex; Kirby, Emma; Good, Phillip; Wootton, Julia; Yates, Patsy; Hardy, Janet


    Nurses play a pivotal role in caring for patients during the transition from life-prolonging care to palliative care. This is an area of nursing prone to emotional difficulty, interpersonal complexity, and interprofessional conflict. It is situated within complex social dynamics, including those related to establishing and accepting futility and reconciling the desire to maintain hope. Here, drawing on interviews with 20 Australian nurses, we unpack their accounts of nursing the transition to palliative care, focusing on the purpose of nursing at the point of transition; accounts of communication and strategies for representing palliative care; emotional engagement and burden; and key interprofessional challenges. We argue that in caring for patients approaching the end of life, nurses occupy precarious interpersonal and interprofessional spaces that involve a negotiated order around sentimental work, providing them with both capital (privileged access) and burden (emotional suffering) within their day-to-day work. © The Author(s) 2014.

  18. The business management preceptorship within the nurse practitioner program. (United States)

    Wing, D M


    Changes in health care reimbursement practices have affected the way in which primary health care is provided. To be successful, nurse practitioners must have a proficient understanding of basic business functions, including accounting, finance, economics, marketing, and reimbursement practices. Yet, many graduates of nurse practitioner programs are not adequately prepared to make fundamental business decisions. Therefore, it is essential that nurse practitioner faculty provide learning experiences on primary practice business. Because the preceptor experience is an integral aspect of nurse practitioner education, a business preceptorship provides students with pragmatic knowledge of the clinical practice within a business framework. The University of Indianapolis School of Nursing offers a nurse practitioner business preceptorship. The implementation, challenges, and positive outcomes of the course are discussed in this article.

  19. Stress and ways of coping among nurse managers: An integrative review. (United States)

    Labrague, Leodoro J; McEnroe-Petitte, Denise M; Leocadio, Michael C; Van Bogaert, Peter; Cummings, Greta G


    To appraise and synthesise empirical studies examining sources of occupational stress and ways of coping utilised by nurse managers when dealing with stress. The Nurse Manager's role is challenging yet draining and stressful and has adverse consequences on an individual's overall health and well-being, patients' outcomes and organisational productivity. Considerable research has been carried out; however, an updated and broader perspective on this critical organisational issue has not been performed. An integrative review. Five databases (Cumulative Index to Nursing and Allied Health Literature, SCOPUS, PubMed, PsychINFO and MEDLINE) were searched to identify relevant articles. Search terms and MeSH terms included: "charge nurse," "coping," "coping strategy," "coping style," "psychological adaptation," "psychological stress," "stressors," "nurse manager" and "unit manager." Twenty-two articles were included in this review. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. Four themes were identified: moderate stress levels, common sources of stress, ways of coping and the impact of nurses' characteristics on stress. Nurse managers experienced moderate levels of stress mainly from heavy workloads, lack of resources and financial responsibilities. Enhancing social support and promoting job control were seen as important in reducing work stress and its related consequences. Additional studies using a more rigorous method and a larger sample size preferably in multicultural settings would shed more light on this topic. Hospital and nurse administrators play an important role in promoting supportive structures for daily professional practice for nurse managers through staffing, organisational resources, support services, leadership and stress management training. © 2017 John Wiley & Sons Ltd.

  20. Nurse management of hypertension in rural western Kenya: implementation research to optimize delivery. (United States)

    Vedanthan, Rajesh; Kamano, Jemima H; Horowitz, Carol R; Ascheim, Deborah; Velazquez, Eric J; Kimaiyo, Sylvester; Fuster, Valentin


    Hypertension is the leading global risk factor for mortality. Hypertension treatment and control rates are low worldwide, and insufficient human resource capacity is among the contributing factors. Thus, a critical component of hypertension management is to develop novel and effective solutions to the human resources challenge. One potential solution is task redistribution and nurse management of hypertension in these settings. The aim of this study is to investigate whether nurses can effectively reduce blood pressure in hypertensive patients in rural western Kenya and, by extension, throughout sub-Saharan Africa. An initial phase of qualitative inquiry will assess facilitators and barriers of nurse management of hypertension. In addition, we will perform usability and feasibility testing of a novel, electronic tablet-based integrated decision-support and record-keeping tool for the nurses. An impact evaluation of a pilot program for nurse-based management of hypertension will be performed. Finally, a needs-based workforce estimation model will be used to estimate the nurse workforce requirements for stable, long-term treatment of hypertension throughout western Kenya. The primary outcome measure of the impact evaluation will be the change in systolic blood pressure of hypertensive individuals assigned to nurse-based management after 1 year of follow-up. The workforce estimation modeling output will be the full-time equivalents of nurses. This study will provide evidence regarding the effectiveness of strategies to optimize task redistribution and nurse-based management of hypertension that can be applicable to noncommunicable disease management in low- and middle-income countries. Copyright © 2014 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

  1. The effectiveness of risk management program on pediatric nurses' medication error. (United States)

    Dehghan-Nayeri, Nahid; Bayat, Fariba; Salehi, Tahmineh; Faghihzadeh, Soghrat


    Medication therapy is one of the most complex and high-risk clinical processes that nurses deal with. Medication error is the most common type of error that brings about damage and death to patients, especially pediatric ones. However, these errors are preventable. Identifying and preventing undesirable events leading to medication errors are the main risk management activities. The aim of this study was to investigate the effectiveness of a risk management program on the pediatric nurses' medication error rate. This study is a quasi-experimental one with a comparison group. In this study, 200 nurses were recruited from two main pediatric hospitals in Tehran. In the experimental hospital, we applied the risk management program for a period of 6 months. Nurses of the control hospital did the hospital routine schedule. A pre- and post-test was performed to measure the frequency of the medication error events. SPSS software, t-test, and regression analysis were used for data analysis. After the intervention, the medication error rate of nurses at the experimental hospital was significantly lower (P error-reporting rate was higher (P medical environment, applying the quality-control programs such as risk management can effectively prevent the occurrence of the hospital undesirable events. Nursing mangers can reduce the medication error rate by applying risk management programs. However, this program cannot succeed without nurses' cooperation.

  2. The influence of leadership practices and empowerment on Canadian nurse manager outcomes. (United States)

    Spence Laschinger, Heather K; Wong, Carol A; Grau, Ashley L; Read, Emily A; Pineau Stam, Lisa M


    To examine the influence of senior nurse leadership practices on middle and first-line nurse managers' experiences of empowerment and organizational support and ultimately on their perceptions of patient care quality and turnover intentions. Empowering leadership has played an important role in staff nurse retention but there is limited research to explain the mechanisms by which leadership influences nurse managers' turnover intentions. This study was a secondary analysis of data collected using non-experimental, predictive mailed survey design. Data from 231 middle and 788 first-line Canadian acute care managers was used to test the hypothesized model using path analysis in each group. The results showed an adequate fit of the hypothesized model in both groups but with an added path between leadership practices and support in the middle line group. Transformational leadership practices of senior nurses empower middle- and first-line nurse managers, leading to increased perceptions of organizational support, quality care and decreased intent to leave. Empowered nurse managers at all levels who feel supported by their organizations are more likely to stay in their roles, remain committed to achieving quality patient care and act as influential role models for potential future leaders. © 2011 Blackwell Publishing Ltd.

  3. Managerial competence of first-line nurse managers: A concept analysis. (United States)

    Gunawan, Joko; Aungsuroch, Yupin


    A variety of terms are used interchangeably to define managerial competence of first-line nurse managers. This has resulted in a degree of ambiguity in the way managerial competence is described. The aim of this concept analysis is to clarify what is meant by managerial competence of first-line nurse managers internationally, what attributes signify it, and what its antecedents and consequences are. The Walker and Avant concept analysis approach was applied. The attributes of managerial competence include developing self, planning, organizing, leading, managing legal and ethical issues, and delivering health care. Antecedents to managerial competence include internal and external factors. Consequences include nurse performances, nurse and patient outcomes, intention to stay of nurses, and nurse and patient satisfaction. This analysis helps first-line nurse managers to understand the concept and determine where the responsibility lies in establishing a definition of managerial competence. It is recommended that middle and top managers should be aware of the internal and external factors as antecedents of the concept. Further research is needed to illuminate the attributes of managerial competence in relation to antecedents and the potential effect upon the consequences, and the need to establish managerial competence evaluation. © 2017 John Wiley & Sons Australia, Ltd.

  4. Building leadership capacity in advanced nurse practitioners - the role of organisational management. (United States)

    Elliott, Naomi


    To highlight the organisation-level management's role in building leadership capacity in advanced nurse practitioners and the need for appropriate supports to increase their becoming leaders. Little is published about the role of organisation-level management in building leadership capacity and in developing the next generation of nurse leaders. In times of economic constraint, organisations need to focus their efforts on targeted leadership initiatives. Advanced nurse practitioners are ideally positioned to act as leaders both within and beyond the health care organisation. From the available research evidence, several support structures and mechanisms are identified as enablers for advanced nurse practitioners to enact their leadership role. Health care organisations need to include building leadership capacity as a priority in their strategic plan and take action to build-up the level of advanced nurse practitioner leadership. Nurse executives have a vital role in influencing the organisation's strategic plan and making a business case for prioritising leadership capacity building within advanced nurse practitioners. A challenge for nurse executives faced with competing service and leadership development demands, involves strategic decision-making regarding whether the advanced nurse practitioner's role is limited to service delivery or its potential in leading health care reforms is realised. © 2016 John Wiley & Sons Ltd.

  5. Can nurse teachers manage student incivility by guided democracy? A grounded theory study. (United States)

    Rad, Mostafa; Karimi Moonaghi, Hossein; Ildarabadi, Eshagh


    Managing incivility in academic settings is among the basic concerns and challenges of most educational systems, including nursing education. Incivility management cannot be considered devoid of disruptive behaviors. However, incivility management is a complexphenomenon upon which few studies are conducted. The present study aims at discovering teachers and students' experiences regarding incivility and developing an approach to manage nursing students' incivility. The present study was conducted based on the qualitative research design of the grounded theory methodology. This study was conducted at schools of nursing in academic settings in Iran. Study participants in the present study include nurse teachers (N=20) and nursing students (N=9). In-depth semi-structured interviews were conducted using theoretical and purposive sampling. Constant comparative analysis was used for data analysis. The results include four main categories; (1) deterioration of learning; (2) dominant individual and organisational culture; (3) guided democracy; and (4) movement toward professionalism. Guided democracy is recognised as the main basic psychosocial process for incivility management. Incivility management is pursued to help learners develop professional performance. As indicated by the results of the present study, guided democracy is an effective strategy for incivility management in nursing education. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. From conflict to collaboration? Contrasts and convergence in the development of nursing and management theory. (United States)

    Hewison, Alistair; Stanton, Angela


    This is the first of two papers which examine the development of theory in the occupations of management and nursing, in order to determine where the similarities and differences lie. The need for the Health Service to be effectively managed was a prominent feature of UK health policy in the 1980s and early 1990s and accounts of the introduction of 'management methods' into health care tend to focus on the conflict between management and nursing. More recently, however, the policy emphasis has shifted towards collaborative and co-operative approaches to the provision of health care. An examination of the development of nursing is conducted as the first step in identifying areas of contrast and convergence in the development of nursing and managerial ideologies. In the second paper a similar approach is taken to the history of management. Nursing has been subject to a succession of ideologies aimed at advancing practice, however, many of these approaches have been accepted in an uncritical way. In the second paper the similarities in the development of management thought are examined and the implications this has for nursing management explored.

  7. Attributes for effective nurse management within the health services of Western Australia, Singapore and Tanzania. (United States)

    Boldy, Duncan; Della, Phillip; Michael, Rene; Jones, Mark; Gower, Shelley


    To identify the perceptions of nurse managers in Western Australia, Singapore and Tanzania regarding desirable attributes for effective management of their health services, and to identify and discuss the implications for health-management education provided by Australian universities. Nurse managers completed a questionnaire covering four key dimensions: personality characteristics, knowledge and learning, skills, and beliefs and values. Each of 75 items were rated as to their effect on management effectiveness, according to a 5-point Likert scale. Skills were considered the most important for management effectiveness by each group. Tanzanian respondents rated knowledge and learning almost as highly, and significantly higher than Western Australian respondents. They also rated personality characteristics and beliefs and values significantly higher than Western Australian respondents. No significant differences were found between Singapore and Western Australia. Participants desired a different relative mix of attributes in their nurse managers, with Western Australian respondents most likely to indicate that transformational leadership contributed most to managerial effectiveness. Tanzanian nurse managers were most likely to advocate transactional leadership, whereas Singaporean nurse managers' views were located somewhere between. Given that these perceptions are valid, the content and curricula of management-development courses need to be cognisant of the cultural backgrounds of participants. WHAT IS KNOWN ABOUT THE TOPIC? Views differ as to the extent to which the criteria for management effectiveness are broadly universal or contingent on culture. This applies to the area of nurse management as it does to healthcare management in general. WHAT DOES THIS PAPER ADD? It is demonstrated that each of the three quite different countries or states considered identified a distinctive combination of attributes as desirable, with the nurse managers of Western Australia

  8. EP&R Standards Project Report: Technical Review of National Incident Management Standards

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.


    The importance and necessity for a fully developed and implemented National Incident Management System (NIMS) has been demonstrated in recent years by the impact of national events such as Hurricane Katrina in 2005. Throughout the history of emergency response to major disasters, especially when multiple response organizations are involved, there have been systemic problems in the consistency and uniformity of response operations. Identifying national standards that support the development and implementation of NIMS is key to helping solve these systemic problems. The NIMS seeks to provide uniformity and consistency for incident management by using common terminology and protocols that will enable responders to coordinate their efforts to ensure an efficient response.

  9. Trends in the job market of nurses in the view of managers. (United States)

    Oliveira, Jonas Sâmi Albuquerque de; Pires, Denise Elvira Pires de; Alvarez, Ângela Maria; Sena, Roseni Rosângela de; Medeiros, Soraya Maria de; Andrade, Selma Regina de


    to identify and interpret the main trends of the labor market for nurses in Rio Grande do Norte, based on the opinion of managers of training institutions and employers. Data were collected through interviews with key informants, organized using Atlas.ti software resources and examined under the thematic content review. the study showed six trends in the labor market of nurses: availability of professionals to the market; worsening working conditions with precariousness; indication for insertion in employment; unemployment for nurses; shortage of nurses; and the existence of a cooperative of nursing professionals. the current scenario of growth in the number of registered nurses without the expansion of the job supply has remained, unemployment tends to increase and work conditions will worsen.

  10. Management of resources in nursing: beyond leadership. Our will to be and do

    Directory of Open Access Journals (Sweden)

    Delby Antonio Cano Serna


    Full Text Available This article reflects upon the reach of the contribution from nursing in the management and development of public policies for adequate assignment of resources that facilitate better healthcare in the Colombian population.

  11. [Nursing care management in hospital settings: the building of a construct]. (United States)

    Christovam, Barbara Pompeu; Porto, Isaura Setenta; de Oliveira, Denise Cristina


    The objective of this study was to build and present a theoretical definition of the concept of nursing care management in hospital settings, based on specific literature. We chose to use Concept Analysis strategies for building concepts, the rules of Archeological Analysis for forming concepts, and Lexical Analysis as the theoretical-methodological framework. The operationalization of the strategies and rules for forming the concept permitted the construction of the concept of nursing care in hospital settings. The constructed concept presented, by its nature, the capacity to form a dialectic integration of the aspects relative to the knowing-doing of care and management. The theoretical definition of the concept of Nursing Care Management in Hospital Settings assigned meaning to the term, in the initial context of the construction of a theory of Nursing Care Management in Health Services.

  12. Design and validation of a questionnaire on nursing competence in the notification of medication incidents. (United States)

    Salcedo-Diego, Isabel; de Andrés-Gimeno, Begoña; Ruiz-Antorán, Belén; Layunta, Rocío; Serrano-Gallardo, Pilar

    To design and perform a face and content validation of a questionnaire to measure the competence of hospital RN to report medication incidents. Content and face questionnaire validation descriptive study. A review of the literature was performed for the creation of ítems. A panel of six experts assessed the relevance of the inclusion of each ítem in the questionnaire by calculating the position index; ítems with position index >0.70 were selected. The questionnaire was piloted by 59 RN. Finally, a meeting was convened with experts, in order to reduce the length of the piloted questionnaire through review, discussion and decision by consensus on each item. From the literature review, a battery of 151 ítems grouped into three elements of competence: attitudes, knowledge and skills was created. 52.9% (n=80) of the ítems received a position index > 0.70. The response rate in the pilot study was 40.65%. The median time to complete the questionnaire was 23:35minutes. After reduction by the experts, the final questionnaire comprised 45 ítems grouped into 32 questions. The NORMA questionnaire, designed to explore the competence of hospital RN to report medication incidents, has adequate face and content validity and is easy to administer, enabling its institutional implementation. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  13. The skills gap in nursing management in South Africa: a sectoral analysis: a research paper. (United States)

    Pillay, Rubin


    To identify competencies important for effective nursing management and to assess managers' proficiency therein. A lack of management capacity has been identified as the key stumbling block to health delivery in South Africa. Despite nursing managers being central to overcoming the challenges facing health care, there has been a paucity of research that empirically evaluates their skill levels. A survey was conducted among 171 senior nursing managers in South Africa using a self-administered questionnaire. Public sector managers assessed themselves as being relatively less competent than private sector managers. The largest skill gaps for public sector managers were for 'ethico-legal', 'task-related' and 'controlling' skills whereas those for private sector managers were for 'ethico-legal', 'health-related ' and 'task-related' skills. This research confirmed the lack of management capacity within the health sector and identified areas in which the skills deficit was most significant for both the public and private sectors. These findings reflect the needs of nursing managers and will be useful in the conceptualization, design and delivery of health management programmes aimed at enhancing management and leadership capacity in the health sector in South Africa.

  14. Nursing Management Minimum Data Set: Cost-Effective Tool To Demonstrate the Value of Nurse Staffing in the Big Data Science Era. (United States)

    Pruinelli, Lisiane; Delaney, Connie W; Garciannie, Amy; Caspers, Barbara; Westra, Bonnie L


    There is a growing body of evidence of the relationship of nurse staffing to patient, nurse, and financial outcomes. With the advent of big data science and developing big data analytics in nursing, data science with the reuse of big data is emerging as a timely and cost-effective approach to demonstrate nursing value. The Nursing Management Minimum Date Set (NMMDS) provides standard administrative data elements, definitions, and codes to measure the context where care is delivered and, consequently, the value of nursing. The integration of the NMMDS elements in the current health system provides evidence for nursing leaders to measure and manage decisions, leading to better patient, staffing, and financial outcomes. It also enables the reuse of data for clinical scholarship and research.

  15. Nurses Knowledge Regarding Risk Factors And Management Of Stroke At Rajshahi Medical College Hospital Bangladesh

    Directory of Open Access Journals (Sweden)

    Nahid Uz Zaman


    Full Text Available The study was carried out with a view to assess the nurses knowledge regarding the risk factors and management of stroke following a cross type descriptive study. Nurses having academic qualification were S.S.C 32 and H.S.C 68. Nurses having professional qualification were Diploma in Nursing amp Midwifery 50 because this degree was compulsory and basic for all. During the data collection there were also 42 B.Sc. in Nursing and 8 MPHM.Sc. among those respondents. Length of Service of the respondents nurses were 6 1 to 10 years followed by 24 58 amp 12 were in the 11 to 20 years 21 to 30 years and 31 to 40 years. The Nurses were given correct answer about 74 knowledge regarding stroke 50 types of stroke 82 controllable risk factor of stroke 76 uncontrollable risk factor of stroke 85 positioning needed for patients and 86 management of stroke. Considering the above discussion it was obviously clear that the Senior Staff Nurses SSN were much conscious regarding the risk factors and management of stroke working at Rajshahi Medical College Hospital RMCH.

  16. Two incidents that changed quality management in the Australian livestock export industry

    Directory of Open Access Journals (Sweden)

    Peter R. Stinson


    Full Text Available Quality assurance in Australia's livestock export industry arose from a need to address animal welfare concerns. It was initially instigated by industry in the form of an accreditation scheme which contained standards, auditing requirements and training requirements. Two major incidents in long haul shipping of livestock demonstrated that risk management in the industry cannot be achieved through compliance with standards alone. A thorough investigation of the first incident recommended the introduction of formal risk management to complement a standards regime. This approach is applicable to the management of major risks, such as heat stress and disease. It is also especially suited to commercial risks, such as the rejection of cargo and where voyage or market specific treatments are needed and depend upon the expertise of the exporter. However, before these recommendations on risk management could be fully implemented, a significant public incident occurred which altered the direction of quality assurance in industry. The Australian response was to transfer authority to government regulators with a tightening of standards. This focuses on the need to ensure ownership of quality assurance programmes by the exporter. Formal risk management has been a casualty of the second incident and, unfortunately, has not been introduced.

  17. Adherence of Pain Assessment to the German National Standard for Pain Management in 12 Nursing Homes

    Directory of Open Access Journals (Sweden)

    Jürgen Osterbrink


    Full Text Available BACKGROUND: Pain is very common among nursing home residents. The assessment of pain is a prerequisite for effective multiprofessional pain management. Within the framework of the German health services research project, ‘Action Alliance Pain-Free City Muenster’, the authors investigated pain assessment adherence according to the German national Expert Standard for Pain Management in Nursing, which is a general standard applicable to all chronic/acute pain-affected persons and highly recommended for practice.

  18. The process of implementing an ISO 9001 quality management system in a school of nursing. (United States)

    Lett, M


    This paper documents the process undertaken during the establishment of an ISO 9000 series quality management system by a School of Nursing. Further discussion centres around the reasons why an ISO quality management system was implemented, the lessons learnt during the process and the benefits that accreditation has brought to the School of Nursing. The lessons learnt during the process could be of help to other organisations wishing to achieve a similar accreditation status.

  19. Self-efficacy, coping with stress and goal-orientation in nurse managers


    Melek Kalkan; Hatice Odacı; Hatice Epli Koç


    The purpose of this study was to investigate the correlation between self-efficacy, coping with stress, and goal-orientation in nurse managers. The results indicated that the self-efficacy scores were significantly correlated with learning goal-orientation (r=.37, p.05) was not significant. This study showed a positive meaningful relationship between nurse managers' self-efficacy levels and learning goal orientation and performance-proving orientation. The study provided information related t...

  20. A 'new' psychological contract for nurses: some management implications. (United States)

    Cavanagh, S J


    Changes within the health services are raising a number of employment issues for nurses. The idea that a professional qualification and a job will lead to security of employment and career development is rapidly changing. These assumptions, the 'old' psychological contract, is giving way to new expectations from employers and employees; the emergence of a 'new' psychological contract. A psychological contract is an implicit agreement between employer and employee that each party will treat the other fairly. Such contracts are maintained by virtue of all parties wanting to seek agreement on issues where possible and to maintain trust. While such a contract is not a legally binding agreement it is nonetheless a binding understanding between people. Changes to this psychological contract can have important implications for individuals and their employer in terms of work and organizational commitment. This paper will discuss some of the issues surrounding psychological contracts and the impact of violating them. It will also discuss, from a management perspective, how psychological contracts develop between employer and employee, and how to form a 'new' psychological contract based upon mutual benefit and shared values.

  1. Critical Incident Stress Management (CISM) in complex systems: cultural adaptation and safety impacts in healthcare. (United States)

    Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim


    In complex systems, such as hospitals or air traffic control operations, critical incidents (CIs) are unavoidable. These incidents can not only become critical for victims but also for professionals working at the "sharp end" who may have to deal with critical incident stress (CIS) reactions that may be severe and impede emotional, physical, cognitive and social functioning. These CIS reactions may occur not only under exceptional conditions but also during every-day work and become an important safety issue. In contrast to air traffic management (ATM) operations in Europe, which have readily adopted critical incident stress management (CISM), most hospitals have not yet implemented comprehensive peer support programs. This survey was conducted in 2010 at the only European general hospital setting which implemented CISM program since 2004. The aim of the article is to describe possible contribution of CISM in hospital settings framed from the perspective of organizational safety and individual health for healthcare professionals. Findings affirm that daily work related incidents also can become critical for healthcare professionals. Program efficiency appears to be influenced by the professional culture, as well as organizational structure and policies. Overall, findings demonstrate that the adaptation of the CISM program in general hospitals takes time but, once established, it may serve as a mechanism for changing professional culture, thereby permitting the framing of even small incidents or near misses as an opportunity to provide valuable feedback to the system. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Pilot study for evidence-based nursing management: improving the levels of job satisfaction, organizational commitment, and intent to leave among nurses in Turkey. (United States)

    Arslan Yurumezoglu, Havva; Kocaman, Gulseren


    Because of the nursing shortage problem, an important goal for nurse managers is preventing nurses from leaving the organization. This study analyzed the effect of evidence-based nursing management practices on nurses' levels of job satisfaction, organizational commitment, and intent to leave using the Promoting Action Research Implementation in Health Service framework as a guide. This study employed a single-group, quasi-experimental, pretest-post-test design with repeated measures. Data were collected using the Minnesota Job Satisfaction Questionnaire and the Organizational Commitment Scale. The study was conducted at a 127-bed private, accredited hospital. The sample was composed of 58 nurses who participated in all three measurements. Data analysis was conducted using repeated-measures anova and the Cochrane Q-test. An improvement was observed in the nurses' intrinsic, extrinsic, and total satisfaction levels, and in the degree of normative commitment. Nurse managers stated that they benefited from this study. In order to find effective and long-lasting solutions to the nursing shortage problem, evidence-based recommendations should be used in nursing management. © 2012 Blackwell Publishing Asia Pty Ltd.

  3. Scoping study into wound management nurse practitioner models of practice. (United States)

    Gibb, Michelle A; Edwards, Helen E; Gardner, Glenn E


    The primary objective of this research was to investigate wound management nurse practitioner (WMNP) models of service for the purposes of identifying parameters of practice and how patient outcomes are measured. A scoping study was conducted with all authorised WMNPs in Australia from October to December 2012 using survey methodology. A questionnaire was developed to obtain data on the role and practice parameters of authorised WMNPs in Australia. The tool comprised seven sections and included a total of 59 questions. The questionnaire was distributed to all members of the WMNP Online Peer Review Group, to which it was anticipated the majority of WMNPs belonged. Twenty-one WMNPs responded (response rate 87%), with the results based on a subset of respondents who stated that, at the time of the questionnaire, they were employed as a WMNP, therefore yielding a response rate of 71% (n=15). Most respondents (93%; n=14) were employed in the public sector, with an average of 64 occasions of service per month. The typical length of a new case consultation was 60 min, with 32 min for follow ups. The most frequently performed activity was wound photography (83%; n=12), patient, family or carer education (75%; n=12), Doppler ankle-brachial pressure index assessment (58%; n=12), conservative sharp wound debridement (58%; n=12) and counselling (50%; n=12). The most routinely prescribed medications were local anaesthetics (25%; n=12) and oral antibiotics (25%; n=12). Data were routinely collected by 91% of respondents on service-related and wound-related parameters to monitor patient outcomes, to justify and improve health services provided. This study yielded important baseline information on this professional group, including data on patient problems managed, the types of interventions implemented, the resources used to accomplish outcomes and how outcomes are measured.

  4. [The Effectiveness of a Strategy for the Flexible Management of Nursing Human Resources: A Pilot Study]. (United States)

    Huang, Chung-I; Lu, Meei-Shiow


    The flexibility of a hospital's nursing-related human resource management policies affects the working willingness and retention of nurses. To explore the effectiveness of a flexible nursing-related human resource management strategy. This quasi-experimental research used a one group pretest-posttest design. Supervisors at participating hospitals attended the "Application of Flexible Nursing Human Resources Management Strategies" workshop, which introduced the related measures and assessed nurses' pretest satisfaction. After these measures were implemented at the participating hospitals, implementation-related problems were investigated and appropriate consultation was provided. The posttest was implemented after the end of the project. Data were collected from nurses at the participating hospitals who had served in their present hospital for more than three months. The participating hospitals were all nationally certified healthcare providers, including 13 medical centers, 17 regional hospitals, and 3 district hospitals. A total of nurses 2,810 nurses took the pretest and 2,437 took the posttest. The research instruments included the "Satisfaction with working conditions and system flexibility" scale and the "Flexible nursing human resource management strategies". The effectiveness of the implemented strategy was assessed using independent samples t-test and variance analysis. The result of implementing the flexible strategies shows that the total mean of pretest satisfaction (Likert 5 scores) was 3.47 (SD = 0.65), and the posttest satisfaction was 3.52 (SD = 0.65), with significant statistical differences in task, numerical, divisional, and leading flexibility. Due to the good implementation effectiveness, the authors strongly suggest that all of the participating hospitals continue to apply this strategic model to move toward a more flexible nursing system and work.

  5. A comparison of prescribing and non-prescribing nurses in the management of people with diabetes. (United States)

    Courtenay, Molly; Carey, Nicola; Gage, Heather; Stenner, Karen; Williams, Peter


    The aim of this study were to compare nurse prescribers and non-prescribers managing people with diabetes in general practice regarding: (a) patient characteristics; (b) activities and processes of care; (c) patient outcomes (self-management, clinical indicators, satisfaction) and (d) resource implications and costs. Over 28,000 nurses in the UK can prescribe the same medicines as doctors provided that it is in their level of experience and competence. Over 30%, mostly in general practice, prescribe medicines for patients with diabetes. A comparative case study. Nurses managing care of people with Type 2 diabetes were recruited in twelve general practices in England; six could prescribe, six could not. Patients, recruited by nurses, were followed up for 6 months (2011-2012). The patient sample comprised 131 in prescriber sites, 83 in non-prescriber sites. Patients of prescribers had been diagnosed and cared for by the nurse longer than those of non-prescribers. There were no differences in reported self-care activities or HbA1c test results between the patients of prescribers and non-prescribers. Mean HbA1c decreased significantly in both groups over 6 months. Patients of prescribers were more satisfied. Consultation duration was longer for prescribers (by average of 7·7 minutes). Non-prescribing nurses sought support from other healthcare professionals more frequently. Most prescribing nurses were on a higher salary band than non-prescribers. Clinical outcomes of patients managed by prescribing and non-prescribing diabetes nurses are similar. Prescribing nurses had longer relationships with their patients and longer consultations, possibly contributing to higher satisfaction with care. Employment costs of prescribing nurses are potentially higher. © 2015 John Wiley & Sons Ltd.

  6. Managing health worker migration: a qualitative study of the Philippine response to nurse brain drain

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    Dimaya Roland M


    Full Text Available Abstract Background The emigration of skilled nurses from the Philippines is an ongoing phenomenon that has impacted the quality and quantity of the nursing workforce, while strengthening the domestic economy through remittances. This study examines how the development of brain drain-responsive policies is driven by the effects of nurse migration and how such efforts aim to achieve mind-shifts among nurses, governing and regulatory bodies, and public and private institutions in the Philippines and worldwide. Methods Interviews and focus group discussions were conducted to elicit exploratory perspectives on the policy response to nurse brain drain. Interviews with key informants from the nursing, labour and immigration sectors explored key themes behind the development of policies and programmes that respond to nurse migration. Focus group discussions were held with practising nurses to understand policy recipients’ perspectives on nurse migration and policy. Results Using the qualitative data, a thematic framework was created to conceptualize participants’ perceptions of how nurse migration has driven the policy development process. The framework demonstrates that policymakers have recognised the complexity of the brain drain phenomenon and are crafting dynamic policies and programmes that work to shift domestic and global mindsets on nurse training, employment and recruitment. Conclusions Development of responsive policy to Filipino nurse brain drain offers a glimpse into a domestic response to an increasingly prominent global issue. As a major source of professionals migrating abroad for employment, the Philippines has formalised efforts to manage nurse migration. Accordingly, the Philippine paradigm, summarised by the thematic framework presented in this paper, may act as an example for other countries that are experiencing similar shifts in healthcare worker employment due to migration.

  7. The Holistic Leadership Model and the Nurse Unit Manager ...

    African Journals Online (AJOL)

    promoting unit teamwork, collaboration, and successful interdisciplinary communication. In Africa, it has been ... role by clarifying their purpose and promoting teamwork collaboration. On a global scale, nurse leaders may ... More specific to Rwanda, the importance of innovation in nursing leadership cannot be overlooked.

  8. Leadership development needs of managers who supervise foreign nurses. (United States)

    Sherman, Rose O


    This concept paper seeks to outline evidenced-based findings about the current experiences, best practices and leadership development needs of nurse leaders who work with foreign nurses. A qualitative approach was used to collect data for this project. A convenience sample of ten nursing leaders from different geographic areas in the USA was telephone interviewed to obtain information for this project. Recommendations are made about the type of educational programming that leaders who receive foreign nurses in their work environments will need to facilitate a successful transition. The legal, ethical and human resource issues that surround the international recruitment of nurses have received widespread coverage in the media and nursing literature. Although organizations which do foreign recruitment invest significant resources, little has been written about the challenges in the transition of foreign nurses into healthcare practice environments outside their countries of origin. The literature suggests that the successful transition of foreign nurses into the healthcare environment of another country requires supportive leadership but this does not always occur.