Dargahi, H; Alirezaie, S; Shaham, G
Organizational Citizenship Behavior (OCB) is defined as "individual behavior that is discretionary, not directly or explicitly recognized by the formal reward system, and that in the aggregate, promotes the effective functioning of organization". OCB, enhance job satisfaction among nursing employees. According to several findings, nurses' OCB have a positive and significant influence on job satisfaction. This research is aimed to study OCB among Iranian nurses. A cross-sectional, descriptive and analytical study was conducted among 510 nurses working in 15 teaching hospitals in Tehran, Iran to be selected by stratified random sampling. The respondents were asked to complete Netemeyer's organizational citizenship behavior questionnaire that encompassed four dimensions of OCB including Sportsmanship, Civil Virtue, Conscientiousness, Altruism and selected each item of OCB dimensions and identified their attitudes about OCB items were observed in hospitals of Tehran. The data was analyzed by T-test, ANOVA and Pearson statistical methods. The results of this research showed that most of the nurses who studied in this study, had OCB behaviors. Also, we found that there was significant correlation between Iranian nurses' marriage status, qualifications and gender with sportsmanship, altruism and civic virtue. This research demonstrates the existence of OCB among Iranian nurses that are essential in developing patient - oriented behavior. The results can be used to develop further nursing management strategies for enhancement of OCB. Finally, the present study indicates new possibilities for future researches such as analysis and comparison of OCB between different hospitals and how nursing policy-makers can enhance these behaviors in Iranian hospitals.
Memarian, R; Ahmadi, F; Vaismoradi, M
Although greater emphasis has been placed on leadership skills in nursing management in the last decade, the concepts are often confused or used erroneously by Iranian nurses. At the same time we have observed that wide variations in nurses' clinical practice appeared to be related to the presence or absence of leadership skills among senior nurses. To begin to identify the concepts used for expressing leadership in nursing within the Iranian cultural context. A qualitative approach was adopted using content analysis of semi-structured interviews carried out with 10 nurse managers from hospitals in Teheran. The data were analysed using the constant comparative method. Fifty-five primary codes were identified from the respondents' experiences and from these three main themes were abstracted for describing the leadership concept. These were 'personality traits', 'being a model', and 'being a spiritual guide for the nursing profession'. Implementing the culture of patient safety and dignity needs leadership. From Iranian nurse managers' perspectives a leader as a spiritual guide should empower nurses spiritually; it means he/she has a vision for nursing; has clear and explicit objectives; and has a commitment to nursing. Nurses who are confident about the underlying concepts of leadership in their culture can help to adapt nursing to an ever-changing healthcare environment.
Varaei, Shokoh; Vaismoradi, Mojtaba; Jasper, Melanie; Faghihzadeh, Soghrat
The purpose of this study was to describe the perspectives of Iranian nurses regarding factors influencing nursing image. Nursing image is closely tied to the nurse's role and identity, influencing clinical performance, job satisfaction and quality of care. Images of nursing and nurses are closely linked to the cultural context in which nursing is practised, hence, this study explores how Iranian nurses perceive the factors that influence their own image. A descriptive study using a survey design was conducted with 220 baccalaureate qualified nurses working in four teaching hospitals in an urban area of Iran. A Nursing Image Questionnaire was used and analysed using descriptive and inferential statistics. In the domains of 'characteristics required for entry to work', 'social role characteristics of nursing' and 'prestige, economic and social status, and self image' the nurses had negative images. 'Reward' and 'opportunity for creativity and originality' were factors that least influenced choosing nursing as a career. The presence of a nurse in the family and working in the hospital had the greatest impact on the establishment of nurses' nursing image. Improving the nursing profession's prestige and social position as well as providing the opportunity for creativity and originality in nursing practice will change the self-image of Iranian nurses, facilitating effective and lasting changes in nursing's image. Nurse managers are well-placed to influence nurses' perceptions of nursing's image. Given the finding that thinking about leaving a job positively correlates with holding a negative nursing image, nurse managers need to consider how they can work effectively with their staff to enhance morale and nurses' experience of their job. © 2012 Blackwell Publishing Ltd.
Ghiyasvandian, Shahrzad; Adera Gebra, Addis
Nursing is a stressful job that could create physical and psychological disorders. Many studies presented information on stress, effects of coping strategies, and job satisfaction of nurses within health setting. We aimed to identify and describe nursing stresses, coping strategies and job satisfaction of Iranian nurses who are working or worked in different wards. In this review, we studied peer-reviewed journal articles on the field of stress, coping strategies and job satisfaction in nursing practice, especially Iranian nurses, which were published between 2000 and 2013. In this regard, we searched databases of PubMed, Elsevier, Google, BMJ, PMC, and MEDLINE. The majority of the studies (60%) had analyzed the effect of coping strategies, experiences and perception of job-related stresses in Iranian nurses working in hospitals. In some of the reviewed studies (60%), the majority of the samples enrolled Iranian nurses. Forty percent of studies selected a maximum sample size of 565 (44%) participants in 2011. Nursing stress scale employed at 30% of the studies was the most commonly used strategy. This reviewed studies also revealed a combined measurement (60% of studies), based on categorical stress measurement, effects of coping strategies, and job satisfaction methods. Three studies explored the relationship between job stress and job satisfaction. For instance, the majority (74.4%) of nurses reported job satisfaction. Effect of coping strategies and job satisfaction on Iranian nurses is a well-accepted issue and has important positive outcomes on several areas of health discipline.
Anoosheh, M; Zarkhah, S; Faghihzadeh, S; Vaismoradi, M
Providing effective communication with patients is an essential aspect of nursing care. Understanding the barriers that inhibit nurse-patient communication can provide an opportunity to eliminate them. To investigate nurse-patient and environment-related communication barriers perceived by patients and nurses in Iranian nursing. A descriptive survey was carried out in three randomly selected educational hospitals in a large urban city in Iran. Data were collected by questionnaire; the study sample consisted of 61 patients and 75 nurses. Participants were asked to rate the importance of each communication barriers item. Finally, data were analysed using descriptive statistics, and to compare the perceived importance of communication barriers between patients and nurses, item means were calculated and the t-test for independent samples was applied. Similarities and differences between the two groups were identified. According to nurses' views, 'heavy nursing workload', 'hard nursing tasks' and 'lack of welfare facilities for nurses' were the main communication barriers. From patients' views, 'unfamiliarity of nurses with dialect', 'having contagious diseases' and 'sex differences between nurses and patients' were determined as the main communication barriers. The shared communication barriers were 'age difference', 'social class difference' and 'having contagious diseases'. It can be concluded that nursing managers and healthcare system planners should focus on eliminating or modifying the barriers stated by the two groups, particularly the shared ones. It is suggested that understanding the cultural aspects of nurse-patient communication barriers in various contexts can help nurses. The study relied on self-report by a limited sample of nurses and patients. The responses should now be tested by a larger sample and then by empirical research into actual practice in order to test whether the nurses' and patients' perceived ideas of communication barriers are
Full Text Available Background Job burnout, defined as a syndrome derived from prolonged exposure to stressors at work, is often observed in health care workers. Shift work and job satisfaction are considered two of the occupational risks for burnout in nurses. Nurses have stress and health complaints. In addition, nurses are likely to job burnout. Objectives The current study aimed to determine the prevalence of job burnout and its association with work schedules and job satisfaction among Iranian nurses in a public hospital. Methods This cross-sectional study was conducted in one of the largest Iranian public hospitals among 362 nurses (response rate: 80.44% in Tehran, Iran. The Maslach burnout inventory (MBI-22 and demographic factors questionnaire were used in the present study. The relationship between job burnout with work schedules and job satisfaction was investigated with multiple logistic regression analysis. Results The mean age and work experience of the participants were 36.14 ± 8.59 and 15.23 ±9.30 years, respectively. The result indicated a relatively high prevalence of burnout (particularly, personal accomplishment among the study population. In general, 64.4% of participants reported low personal accomplishment level. The nurses engaged in shift work reported higher levels of emotional exhaustion (odds ratio (OR = 1.02, 95% confidence interval (CI = 1.006 - 1.041, P-value = 0.008; there was no relationship between work schedules with depersonalization and personal accomplishment. The result showed significant relationship between job satisfaction and emotional exhaustion (OR = 0.945, 95% CI = 0.928 - 0.963, P-value < 0.001 and personal accomplishment (OR = 1.003, 95% CI = 1.014 - 1.058, P-value = 0.001. Conclusions The current study revealed that the Iranian nurses are exposed to a considerable risk of personal accomplishment. Also, job burnout is in association with shift working and low job satisfaction level. In this regard, working pressure
Mahmoudirad, Gholamhossein; Ahmadi, Fazlollah; Vanaki, Zohreh; Hajizadeh, Ebrahim
The purpose of this study was to explore the assertiveness process in Iranian nursing leaders. A qualitative design based on the grounded theory approach was used to collect and analyze the assertiveness experiences of 12 nurse managers working in four hospitals in Iran. Purposeful and theoretical sampling methods were employed for the data collection and selection of the participants, and semistructured interviews were held. During the data analysis, 17 categories emerged and these were categorized into three themes: "task generation", "assertiveness behavior", and "executive agents". From the participants' experiences, assertiveness theory emerged as being fundamental to the development of a schematic model describing nursing leadership behaviors. From another aspect, religious beliefs also played a fundamental role in Iranian nursing leadership assertiveness. It was concluded that bringing a change in the current support from top managers and improving self-learning are required in order to enhance the assertiveness of the nursing leaders in Iran.
Conclusions: Iranian nurses, regardless of their religious sects, reported negative attitude towards many aspects of DNR orders. It may be possible to change the attitude of Iranian nurses towards DNR through education.
Full Text Available Quantum organizations are referred where stakeholders know how to access the infinite potential of the quantum field. Viewing healthcare organizations from perspective of quantum theory suggest new approaches into management techniques for effective and efficient delivery of healthcare services. This research is aimed to determine the quantum skills, quantum leadership characteristics and functions of Tehran University of Medical Sciences hospitals' nursing administrators. A cross-sectional, descriptive and analytical study was conducted among 25 nursing administrators of Tehran University of Medical Sciences (TUMS hospitals, Tehran, Iran. The research tool for data collection was a self-constructed questionnaire that measured the quantum skills, quantum leadership characteristics and functions of TUMS hospitals' nursing administrators. The validity of questionnaire was confirmed by 5 management science experts and its reliability was performed by using test-retest method yielded a Cronbach's alpha coefficient of 0.90. Data were collected and analyzed by SPSS software and t-test statistical methods. The results of this research showed that all respondents had desired quantum skills (75.71±5.98, quantum leadership characteristics (82.01±6.77, and quantum leadership functions (78.57±6.28 and total quantum leadership (78.76±4.50. Also, passing management training courses of the respondents was significantly correlated with their quantum leadership. Iranian healthcare organizations require quantum leadership that provides an important resource to advance Iranian nursing leadership to the organizational excellence. We hope Iranian hospitals' nursing leaders who have quantum skills potentially, present a highly developed sense of self and the ability to improve nursing care outcomes in these hospitals.
Full Text Available Abstract Background This paper identifies the views of Iranian clinical nurses regarding the utilization of nursing research in practice. There is a need to understand what restricts Iranian clinical nurses to use research findings. The aim of this study was to identify practicing nurses' view of aspects which they perceived constrain them from research utilization that summarizes and uses research findings to address a nursing practice problem. Methods Data were collected during 6 months by means of face-to face interviews follow by one focus group. Analysis was undertaken using a qualitative content analysis. Results Findings disclosed some key themes perceived by nurses to restrict them to use research findings: level of support require to be research active, to be research minded, the extent of nurses knowledge and skills about research and research utilization, level of educational preparation relating to using research, administration and executive challenges in clinical setting, and theory-practice gap. Conclusion This study identifies constraints that require to be overcome for clinical nurses to actively get involved in research utilization. In this study nurses were generally interested to use research findings. However they felt restricted because of lack of time, lack of peer and manager support and limited knowledge and skills of the research process. This study also confirms that research utilization and the change to research nursing practice are complex issues which require both organizational and educational efforts.
Jahani, Simin; Abedi, Heidarali; Elahi, Nasrin; Fallahi-Khoshknab, Masoud
To respond efficiently to the increasing and new needs of people in health issues, it is necessary for nurses to develop their knowledge from hospital to society and to be equipped to play entrepreneur role in different levels of care. The present study was conducted to describe Iranian entrepreneur nurses' perceived barriers to entrepreneurship, in order to identify the existing barriers. This is a qualitative study in which Graneheim and Lundman's content analysis method was employed. Thirteen entrepreneur nurses were chosen purposively, and data were gathered by unstructured interviews. As a result of the data analysis, five major themes were extracted: Traditional nursing structure, legal limitations, traditional attitudes of governmental managers, unprofessional behaviors of colleagues, and immoral business. The findings of the present study show that Iranian nurses are confronted with various problems and barriers to enter entrepreneur nursing and keep going in this area. By focusing on such barriers and applying appropriate changes, policymakers and planners in health can facilitate nurses entering into this activity.
Ghorbani, Raheb; Soleimani, Mohsen; Zeinali, Mohammad-Reza; Davaji, Mohammad
The aim of this study is to describe the attitudes of Iranian nurses and students on barriers and facilitators to patient education. In this descriptive quantitative study, 103 nurses and 84 nursing students in two teaching hospitals in an urban area of Iran responded to a questionnaire investigating their attitudes on patient education. Results showed that all nurses and the majority (87.3%) of the students mentioned that they performed patient education. Moreover, 95% and 63.3% of the nurses and students respectively accepted that patient education was one of their roles. The nurses stated that heavy workload, inadequate time and lack of educational facilities were main barriers to patient education. The students believed that lack of knowledge, lack of communication skills and heavy workload were main barriers to patient education from their perspectives. While Iranian nurses and nursing students had positive attitudes towards patient education, it could not guarantee the implementation of patient education. Therefore, the clarification of patient education activities and development of a patient education team with the support of healthcare settings' administrators can facilitate the process of patient education in the Iranian healthcare settings. Copyright © 2014 Elsevier Ltd. All rights reserved.
Vagharseyyedin, Seyyed Abolfazl; Vanaki, Zohreh; Mohammadi, Eesa
The purpose of this qualitative study was to describe the experiences of Iranian nurses concerning their quality of work life. A purposive sample of nurses (n = 14) was recruited from two university hospitals. The data were collected through unstructured interviews and were analyzed by using qualitative content analysis. The results indicated that the participants discerned their quality of work life by assessing how favorable were their working conditions, the level of fulfilment of their personal needs, and the impact of their working conditions on their private life and their social life. Three main themes were identified: quality of work life, as experienced from a personal perspective; quality of work life, as experienced from a sociocultural perspective; and quality of work life, as experienced from an organizational-professional perspective. The results of the present study will help Iranian nurse administrators to adopt effective strategies in order to improve nurses' quality of work life. Future research can broaden the scope of the current results and offer a more comprehensive understanding of nurses' quality of work life. © 2011 Blackwell Publishing Asia Pty Ltd.
Mehraban, Marzieh Adel; Hassanpour, Marzieh; Yazdannik, Ahmadreza; Ajami, Sima
Over the years, the concept technology has modified, especially from the viewpoint of the development of scientific knowledge as well as the philosophical and artistic aspects. However, the concept of technology in nursing are still poorly understood. Only small qualitative studies, especially in Iran, have investigated this phenomenon and they just are about information technology. The aim of this study is to gain a better understanding of the concept of technology in the view of Iranian nurses. This study was qualitative explorative study which was done with a purposeful sampling of 23 nurses (staffs, supervisors and chief nurse managers) working in Isfahan hospitals. Unstructured interviews were including 13 individual interviews and 2 focused-group interviews. In addition to this, filed notes and memos were used in data collection. After this data transcribing was done and then conventional content analysis was used for data coding and classification. The results showed that there are various definitions for technology among nurses. In the view of nurses, technology means using new equipment, computers, information technology, etc). Data analysis revealed that nurses understand technology up to three main concepts: Change, Equipment and Knowledge. In deep overview on categories, we found that the most important concept about technology in nursing perspective is equipment. Therefore, it is necessary to develop deep understanding about the possible concepts technology among nurses. We suppose that technology concepts must be defined separately in all disciplines.
Malekian, Morteza; Ghiyasvandian, Sharzad; Cheraghi, Mohammad Ali; Hassanzadeh, Akbar
Clinical nurses are in need of being able to adapt to the ever-changing environment of clinical settings. The prerequisite for their successful adaptation is to be lifelong learners. An approach for making nurses lifelong learners is self-directed learning. This study was undertaken to evaluate a group of Iranian clinical nurses' readiness for self-directed learning and its relationship with some of their personal characteristics. This cross-sectional descriptive study was conducted in 2014. A random sample of 314 nurses working in three hospitals affiliated to Isfahan Social Security Organization, Isfahan, Iran, was recruited to complete the Fisher's Self-directed Learning Readiness Scale. In total, 279 nurses filled the scale completely. The mean of their readiness for self-directed learning was 162.50±14.11 (120-196). The correlation of self-directed learning readiness with age, gender, marital status, and university degree was not statistically significant. Most nurses had great readiness for self-directed learning. Accordingly, nursing policy-makers need to develop strategies for promoting their self-directed learning. Moreover, innovative teaching methods such as problem solving and problem-based learning should be employed to prepare nurses for effectively managing the complexities of their ever-changing work environment.
Full Text Available Healthcare workers suffer from work-related or occupational stress. This can lead to severe distress, burnout or physical illness, and finally to decrease quality of work life and services provision. Nurses must be aware of retential stressors, because they add to the cumulative effect of other stressful events. Holmes and Rahe both found a relationship between life change unit as stressors and health changes. This research reported here aims to measure the life change units as stressors among Iranian Hospitals Nurses by LCU rating. A cross - sectional, descriptive and analytical study was conducted among 389 nurses working in 15 teaching hospitals in Tehran, Iran. The respondents were asked to select each of 54 events that cause stress ranked in order of their life change units developed by Holmes and Rahe as stress scale. Before beginning the main study, the reliability and coincidental validity was performed. All data were analyzed using SPSS for windows version 18, t-test, Anova statistical methods. Approximately, half of the nurses associated major mortgage, foreclosure of mortgage or loan. More than 50% of the Iranian nurses had 150-300 and more than 300 LCU rating which had the chance to expose to extremely serious risk to health.Iranian hospitals nurses suffer from stress that caused by Life Change Units organizational factors such as change in the financial state, change in the work environment and major mortgage. We recommend to Iranian nursing policy-makers to choose strategies to help nurses cope effectively with workplace stressors. Nursing managers and / or nursing management should develop strategies to address and improve the quality of working conditions for nurses in the hospitals. Providing educational and career prospects can contribute to decrease nurses occupational stress level, the maintaining their work ability.
Adib-Hajbaghery, Mohsen; Zehtabchi, Samira; Fini, Ismail Azizi
The holistic approach views the human as a bio-psycho-socio-spiritual being. Evidence suggests that among these dimensions, the spiritual one is largely ignored in healthcare settings. This study aimed to evaluate Iranian nurses' perceived professional competence in spiritual care, the relationship between perceived competence and nurses' personal characteristics, and barriers to provide spiritual care. A cross-sectional study was conducted in the year 2014. Participants and research context: The study population consisted of nurses working in teaching hospitals in Kashan city. Using a stratified, systematic random method, 250 samples were selected from a total of 1400 nurses. An indigenous instrument was used to assess the nurses' competencies in spiritual care. Ethical considerations: A research ethics committee approved the study. All the participants were briefed on the study aims, were assured of the confidentiality of their personal information, and signed a written informed consent. Among a total of 250 nurses, 239 answered the questionnaire completely, and in total, 23%, 51%, and 26% had poor, moderate, and favorable competence in spiritual care, respectively. No significant differences were found between the mean competence scores of spiritual care in terms of gender, marital status, employment status, and level of qualification. Significant difference was found between nurses' overall score of competence in spiritual care and receiving training on spiritual care, nurses' position, and the ward they worked in. Confirming the findings of the international literature, this study puts light on the situation of nurses' perceived competence and barriers to providing spiritual care in Iran as an eastern and Islamic context. Three-quarters of the nurses had moderate or unfavorable competence in spiritual care. Due to the crucial role of spiritual care in quality of care and patient satisfaction, nurses should be trained and supported to provide spiritual care.
Conclusions: The findings of the present study show that Iranian nurses are confronted with various problems and barriers to enter entrepreneur nursing and keep going in this area. By focusing on such barriers and applying appropriate changes, policymakers and planners in health can facilitate nurses entering into this activity.
Nurses are at risk for symptoms of compassion fatigue (CF) and burnout (BO). Social support plays an important role in predicting CF and BO. This study was performed to determine the prevalence of the symptoms of CF and BO and the role of perceived social support in predicting these symptoms in Iranian nurses. Using a correlational descriptive survey research design, we selected 173 participants among the nurses working in public hospitals of Malayer, Iran. Professional Quality of Life (CF and BO subscales) and Multidimensional Scale of Perceived Social Support (MSPSS) were used for collecting the data. The obtained results indicated that the prevalence of CF and BO symptoms was 45.3% and 15.03%, respectively, in Iranian nurses. Social support (significant other, family, and friends) was negatively correlated to BO (P nurses. Based on the obtained results, some nurses (especially emergency nurses) are at risk for CF and BO and social support negatively correlated to CF and BO in Iranian nurses. It is necessary to develop support systems for nurses who are at risk for CF and BO.
Ghiyasvandian, Shahrzad; Adera Gebra, Addis
Context: Nursing is a stressful job that could create physical and psychological disorders. Many studies presented information on stress, effects of coping strategies, and job satisfaction of nurses within health setting. We aimed to identify and describe nursing stresses, coping strategies and job satisfaction of Iranian nurses who are working or worked in different wards. Evidence Acquisition: In this review, we studied peer-reviewed journal articles on the field of stress, coping strategie...
Haghighathoseini, Atefehsadat; Bobarshad, Hossein; Saghafi, Fatehmeh; Rezaei, Mohammad Sadegh; Bagherzadeh, Nader
Nowadays developing smart and fast services for patients and transforming hospitals to modern hospitals is considered a necessity. Living in the world inundated with information systems, designing services based on information technology entails a suitable architecture framework. This paper aims to present a localized enterprise architecture framework for the Iranian university hospital. Using two dimensions of implementation and having appropriate characteristics, the best 17 enterprises frameworks were chosen. As part of this effort, five criteria were selected according to experts' inputs. According to these criteria, five frameworks which had the highest rank were chosen. Then 44 general characteristics were extracted from the existing 17 frameworks after careful studying. Then a questionnaire was written accordingly to distinguish the necessity of those characteristics using expert's opinions and Delphi method. The result showed eight important criteria. In the next step, using AHP method, TOGAF was chosen regarding having appropriate characteristics and the ability to be implemented among reference formats. In the next step, enterprise architecture framework was designed by TOGAF in a conceptual model and its layers. For determining architecture framework parts, a questionnaire with 145 questions was written based on literature review and expert's opinions. The results showed during localization of TOGAF for Iran, 111 of 145 parts were chosen and certified to be used in the hospital. The results showed that TOGAF could be suitable for use in the hospital. So, a localized Hospital Enterprise Architecture Modelling is developed by customizing TOGAF for an Iranian hospital at eight levels and 11 parts. This new model could be used to be performed in other Iranian hospitals. Copyright © 2018 Elsevier B.V. All rights reserved.
Zali, Mahnaz; Hassankhani, Hadi; Powers, Kelly A; Dadashzadeh, Abbas; Rajaei Ghafouri, Rouzbeh
Family presence during resuscitation (FPDR) has advantages for the patients' family member to be present at the bedside. However, FPDR is not regularly practiced by nurses, especially in low to middle income countries. The purpose of this study was to determine Iranian nurses' and family members' attitudes towards FPDR. In a descriptive study, data was collected from the random sample of 178 nurses and 136 family members in four hospitals located in Iran. A 27-item questionnaire was used to collect data on attitudes towards FPDR, and descriptive and correlational analyses were conducted. Of family members, particularly the women, 57.2% (n=78) felt it is their right to experience FPDR and that it has many advantages for the family; including the ability to see that everything was done and worry less. However, 62.5% (n=111) of the nurses disagreed with an adult implementation of FPDR. Nurses perceived FPDR to have many disadvantages. Family members becoming distressed and interfering with the patient which may prolong the resuscitation effort. Nurses with prior education on FPDR were more willing to implement it. FPDR was desired by the majority of family members. To meet their needs, it is important to improve Iranian nurses' views about the advantages of the implementation of FPDR. Education on FPDR is recommended to improve Iranian nurses' views about the advantages of the implementation of FPDR. Copyright © 2017 Elsevier Ltd. All rights reserved.
Toode, Kristi; Routasalo, Pirkko; Helminen, Mika; Suominen, Tarja
The knowledge surrounding nurses' work motivation is currently insufficient, and previous studies have rarely taken into account the role of many influential background factors. This study investigates the motivation of Estonian nurses in hospitals, and how individual and organisational background factors influence their motivation to work. The study is quantitative and cross-sectional. An electronically self-reported questionnaire was used for data collection. The sample comprised of 201 Registered Nurses working in various hospital settings in Estonia. Data were analysed using descriptive statistics, two-sample Wilcoxon rank-sum (Mann-Whitney) test, Kruskal-Wallis equality-of-populations rank test and Spearman's correlation. Both extrinsic and intrinsic motivations were noted among hospital nurses. Nurses were moderately externally motivated (M = 3.63, SD = 0.89) and intrinsically strongly motivated (M = 4.98, SD = 1.03). A nurses' age and the duration of service were positively correlated with one particular area of extrinsic work motivation, namely introjected regulation (p extrinsic motivation (p = 0.016) and intrinsic work motivation (p = 0.004). The findings expand current knowledge of nurses' work motivation by describing the amount and orientation of work motivation among hospital nurses and highlighting background factors which should be taken into account in order to sustain and increase their intrinsic work motivation. The instrument used in the study can be an effective tool for nurse managers to determine a nurse's reasons to work and to choose a proper motivational strategy. Further research and testing of the instrument in different countries and in different contexts of nursing is however required. © 2014 Nordic College of Caring Science.
Ravari, Ali; Bazargan-Hejazi, Shahrzad; Ebadi, Abbas; Mirzaei, Tayebeh; Oshvandi, Khodayar
This study aimed to describe the effect of nursing profession work-related values on job satisfaction among a sample of Iranian nurses. We used in-depth interviews with 30 nurses who worked in university-affiliated and public hospitals in Tehran, Iran. The results of thematic analysis of interviews are reported in four themes to present the participants' articulations in linking their work-related values to job satisfaction. The themes consist of values that "encourage tolerance," "enhance inner harmony," "reflect traditional commitment," "enhance unity," and are "centered around altruism and spiritual values." The most satisfied participants considered nursing a divine profession and a tool by which they could gain spiritual pleasure and satisfaction. Our findings highlight the potential role of nursing work-related values in reducing dissatisfaction with one's job. For the nursing profession, this may have implications in reducing job instability and turnover.
Jafaragaee, Fateme; Parvizy, Soroor; Mehrdad, Neda; Rafii, Forough
Aim: Professional commitment has been widely discussed during the last decade. There is no comprehensive definition about “professional commitment in Iranian nurses.” Hence, this study was conducted with the aim of analyzing the concept of professional commitment in Iranian nurses. Materials and Methods: Hybrid model was used in three phases. Firstly, in the theoretical phase, data were retrieved from the CINHAl, MEDLINE, PubMed, OVID, Google scholar, and SID databases. The literature search used the keywords “professional commitment” and “nursing.” The final sample included 27 papers published in English between 2001 and 2011.Secondly, in the fieldwork phase, deep interviews with five clinical nurses were carried out, and thirdly, in the final analytical phase, the obtained data from theoretical and fieldwork phases were combined and a comprehensive analysis was conducted. Results: Loyalty and tendency to remain in the profession and responsibility to the professional issues were extracted in theoretical phase. Commitment to promote caring abilities, satisfying of being a nurse, and belonging to the nursing profession were obtained in fieldwork phase. Finally, two main themes including “commitment to offering the best nursing care” and “commitment to promotion of the nursing profession” were extracted. Conclusion: Nursing is a humanistic profession; it has some particular characteristics due to the profession’s nature. In this paper, a definition composed of two main dimensions of professional commitment in nursing has been introduced. PMID:23922592
Faseleh-Jahromi, Mohsen; Moattari, Marzieh; Peyrovi, Hamid
Social responsibility is intertwined with nursing; however, perceptions of Iranian nurses about social responsibility has not been explored yet. This study, as part of a larger qualitative grounded theory approach study, aims to explore Iranian nurses' perception of social responsibility. The study participants included 10 nurses with different job levels. The study data were generated through semi-structured interviews. The participants were selected through purposeful sampling approach, which was then followed by theoretical sampling until reaching the point of data saturation. All the interviews were recorded, transcribed, and analyzed through constant comparative analysis. Positive human characteristics, professional competencies, professional values, solution-focused nursing care, and deployment of professional performance are five categories obtained from the study. The participants believed socially responsible nurses to have positive personality characteristics as well as the necessary skills to do their duties accurately. Such nurses also respect the values, observe the professional principles, and take major steps toward promotion and deployment of the nursing profession in the society.
Full Text Available Nursing is one of the stressful jobs that affect nurse's well-being. The aim of this study was to assess the relationship between spiritual intelligence, hardiness and well-being among Iranian nurses.Samples of this cross- sectional study selected by Randomized stratified sampling, 125 nurses who have been working in different wards of Bushehr university hospitals. Data were collected using spiritual intelligence, hardiness, well-being and demographic characteristics questionnaires. Correlation, t-test, ANOVA, Tukey and regression analysis were applied.The results revealed a significant relationship between spiritual intelligence and hardiness, spiritual intelligence and well-being, Hardiness and well-being. It also showed that among the demographic characteristics (age, gender, working ward, marital status, job experiences, and education working ward significantly correlated with spiritual intelligence.Improvement of spiritual intelligence and reinforcement of hardiness could help increase the well-being of nurses.
Ghiyasvandian, Shahrzad; Bolourchifard, Fariba; Parsa Yekta, Zohreh
The nurse teachers tried to have a complete understanding of the educational contents, to transfer knowledge to nursing students better, and to facilitate the process of education. The purpose of this study was to explore the lived experiences of Iranian nursing students regarding the characteristics of academic nurse teachers. In this hermeneutic phenomenological study, data were collected via in-depth, semi-structured interviews with 12 Iranian nursing students and the audio-taped and transcribed interviews analyzed according to Van Manen´s method. The main theme emerged during data analysis, was "humanistic approach to nursing education". The theme was extracted from 2 sub-themes including 'ethical necessities' and 'effective interaction'. The findings present greater understanding of humanistic approach to nursing education.
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.
Ghiyasvandian, Shahrzad; Malekian, Morteza; Cheraghi, Mohammad Ali
Clinical nurses need lifelong learning skills for responding to the rapid changes of clinical settings. One of the best strategies for lifelong learning is self-directed learning. The aim of this study was to explore Iranian clinical nurses' activities for self-directed learning. In this qualitative study, 23 semi-structured personal interviews were conducted with nineteen clinical nurses working in all four hospitals affiliated to Isfahan Social Security Organization, Isfahan, Iran. Study data were analyzed by using the content analysis approach. The study was conducted from June 2013 to October 2014. Study participants' activities for self-directed learning fell into two main categories of striving for knowledge acquisition and striving for skill development. The main theme of the study was 'Revising personal performance based on intellectual-experiential activities'. Study findings suggest that Iranian clinical nurses continually revise their personal performance by performing self-directed intellectual and experiential activities to acquire expertise. The process of acquiring expertise is a linear process which includes two key steps of knowledge acquisition and knowledge development. In order to acquire and advance their knowledge, nurses perform mental learning activities such as sensory perception, self-evaluation, and suspended judgment step-by-step. Moreover, they develop their skills through doing activities like apprenticeship, masterly performance, and self-regulation. The absolute prerequisite to expertise acquisition is that a nurse needs to follow these two steps in a sequential manner.
Gorji, Hassan Abolghasem; Etemadi, Manal; Hoseini, Fatemeh
Researchers believe that there are social exchanges between the employers and employees, because the employees would be interested in their organization and trust it based on how the organization values them and their welfare, comfort, and security. This belief is known as perceived organizational support that makes employees consider themselves as a part of their organization and have a commitment to it. The literature review is very limited in both variables in Iran and thus few studies also report the perceived organizational support and job involvement at the lower levels in our country. This research aimed at studying the levels of perceived organizational support and job involvement, relationship between this two, and the demographic factors relationship with both of them. This research was a descriptive analytical study conducted in 2012. The population included 123 emergency nurses in General Hospitals of Qom. Data were collected through Perceived Organizational Support and Job Involvement Questionnaires and analyzed using SPSS software, descriptive statistics and Spearman correlation and Chi-square test. Both mean scores for perceived organizational support and job involvement were in average level, 146/12 and 35/38, respectively. There was a significant relationship between perceived organizational support and age, education, tenure, organizational position, and job shift. There was also a significant relationship between job involvement and age and education and finally between perceived organizational support and job involvement (P = 0/029). The high correlation between perceived organizational support and job involvement indicates that the improvement of perceived organizational support are necessary through motivating the employees, showing interest in them, paying attention to them, respecting them, and providing development opportunity in the organization. These should be always considered by managers to improve job involvement.
Hassankhani, Hadi; Hasanzadeh, Firooz; Powers, Kelly A; Dadash Zadeh, Abbas; Rajaie, Rouzbeh
Emergency nurses play an important role in the care of critically ill and injured patients, and their competency to perform clinical skills is vital to safe and effective patient care. The aim of this study was to evaluate the frequency of clinical skills performed and perceived competency levels among Iranian emergency nurses. In addition, attitudes toward expanding the professional roles of Iranian emergency nurses were also assessed. In this descriptive correlational study, 319 emergency nurses from 30 hospitals in northwest Iran participated. Data were collected using a self-report questionnaire. Descriptive statistics and Pearson's correlation coefficient were used to present the findings. Overall competency of the emergency nurses was 73.31 ± 14.2, indicating a good level of perceived competence. The clinical skills most frequently performed were in the domains of organizational and workload competencies (3.43 ± 0.76), diagnostic function (3.25 ± 0.82), and the helping role (3.17 ± 0.83). A higher level of perceived competence was found for skills within these domains. Less frequently, participants performed skills within the domains of effective management of rapidly changing situations (2.70 ± 0.94) and administering and monitoring therapeutic interventions (2.60 ± 0.97); a lower perceived level of competence was noted for these clinical skills. There was a significant correlation between frequency of performing clinical skills and perceived competency level (r = 0.651, P skills. This has implications for nurse managers and educators who may consider offering more frequent experiential and educational opportunities to emergency nurses. Expansion of nurses' roles could also result in increased experience in clinical skills and higher levels of competency. Research is needed to investigate nurses' clinical competence using direct and observed measures. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
Ravari, Ali; Bazargan, Mohsen; Vanaki, Zohre; Mirzaei, Tayebe
The influence of self-expectation, social interaction, and organisational situation on job satisfaction among nurses is examined. Understanding determinants and correlates of job satisfaction are important factors that help to reduce the problem of nurse attrition. Utilizing the Hybrid Model of concept development, job satisfaction was examined in three phases: (1) the theoretical phase, a working definition and the dimensions of job satisfaction were established; (2) the fieldwork phase, a qualitative semi-structured interview was employed to capture participants' perceptions of the concept; and (3) the analytical phase, the experiences of nurses were evaluated using the conceptual model. The results indicate that personal beliefs, rather than social interaction or organisational situation, constitute the core of job satisfaction. Despite the variety of dissatisfaction factors rooted in social interaction and organisational situation, participants achieved the highest job satisfaction when trusting in self-value systems and the spiritual value of their job objectives. Intervention is needed to increase organisational and professional support for nurses. However, highlighting the sacred and spiritual value of the nursing profession, which is rooted in religious values and culture, provides additional reinforcement for enhancing the job satisfaction among this segment of health care providers. © 2011 Blackwell Publishing Ltd.
Imanipour, Masoomeh; Karim, Zahra; Bahrani, Naser
Given the issue of caring critically ill patients, nurses are involved in the process of breaking bad news in critical care units, while little research has been conducted on this challenging issue. The purpose of this study was to determine the role, perspective and knowledge of Iranian critical care nurses regarding breaking bad news. This descriptive study was conducted on a sample of 160 nurses working in critical care units of hospitals affiliated to Tehran University of Medical Sciences. Stratified and quota sampling methods were used. The data collection tool was a four-part questionnaire with validity and reliability confirmed via content validity and test-retest, respectively. The study showed that most critical care nurses were involved in breaking bad news, with different roles. The majority of participants (91.2%) had a positive attitude towards involvement of nurses in breaking bad news. In this study, 78.8% of nurses had moderate knowledge about how to break bad news, and only a few had good level of knowledge (16.2%). According to the findings, while critical care nurses took different roles in the process of breaking bad news and they had positive attitude towards participation in this process, yet their knowledge about this process was inadequate. Thus, designing educational programmes to enhance critical care nurses' knowledge and skills in this area seems necessary. Copyright © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
Background: There is increasing global evidence that today’s work environment results in a higher risk of adverse health among nursing staff than among many other professions. Since nurses constitute the largest group in the healthcare workforce and have a crucial role in providing care services, their impaired health might have an adverse effect on the quality of healthcare. The overall aim of this thesis was to explore work-related health and associated factors. A further aim was to describ...
Konjin, Z Naghavi; Shokoohi, Y; Zarei, F; Rahimzadeh, M; Sarsangi, V
Workplace safety has been a concern of workers and managers for decades. Measuring safety climate is crucial in improving safety performance. It is also a method of benchmarking safety perception. To develop and validate a psychometrics scale for measuring nurses' safety climate. Literature review, subject matter experts and nurse's judgment were used in items developing. Content validity and reliability for new tool were tested by content validity index (CVI) and test-retest analysis, respectively. Exploratory factor analysis (EFA) with varimax rotation was used to improve the interpretation of latent factors. A 40-item scale in 6 factors was developed, which could explain 55% of the observed variance. The 6 factors included employees' involvement in safety and management support, compliance with safety rules, safety training and accessibility to personal protective equipment, hindrance to safe work, safety communication and job pressure, and individual risk perception. The proposed scale can be used in identifying the needed areas to implement interventions in safety climate of nurses.
Full Text Available Around the world there is a growing consensus that students' rights must be protected, regardless of race, creed, color, sex, religion, and socioeconomic status. One of these rights is the educational equity. However, little is known about these phenomena in nursing education. The aim of this study was to explore the educational equity from the perspective of nursing students. A qualitative study was conducted. Thus, we purposefully recruited for in-depth interviews 13 nursing students (8 female and 5 male. All interviews were transcribed verbatim and analyzed by thematic analysis approach to identify categories and themes. Four main themes emerged from the data: Fair Educational Opportunity, fair evaluation, attempts to combat discrimination, and employing qualified teachers. It is argued that educational equity should be developed in higher education. Principles of equity and students' rights may form the most basic rationale for all formal and informal efforts to extend the right of equal access to education.
Ebrahimi, Hossein; Sadeghian, Efat; Seyedfatemi, Naeimeh; Mohammadi, Eesa; Crowley, Maureen
Consideration of patient autonomy is an essential element in individualized, patient-centered, ethical care. Internal and external factors associated with patient autonomy are related to culture and it is not clear what they are in Iran. The aim of this study was to explore contextual factors affecting the autonomy of patients in Iranian hospitals. This was a qualitative study using conventional content analysis methods. Thirty-four participants (23 patients, 9 nurses, and 2 doctors) from three Iranian teaching hospitals, selected using purposive sampling, participated in semi-structured interviews. Unstructured observation and filed notes were other methods for data collection. The data were subjected to qualitative content analysis and analyzed using the MAXQDA-10 software. Five categories and sixteen subcategories were identified. The five main categories related to patient autonomy were: Intrapersonal factors, physical health status, supportive family and friends, communication style, and organizational constraints. In summary, this study uncovered contextual factors that the care team, managers, and planners in the health field should target in order to improve patient autonomy in Iranian hospitals.
Ebrahimi, Hossein; Sadeghian, Efat; Seyedfatemi, Naeimeh; Mohammadi, Eesa; Crowley, Maureen
Background: Consideration of patient autonomy is an essential element in individualized, patient-centered, ethical care. Internal and external factors associated with patient autonomy are related to culture and it is not clear what they are in Iran. The aim of this study was to explore contextual factors affecting the autonomy of patients in Iranian hospitals. Materials and Methods: This was a qualitative study using conventional content analysis methods. Thirty-four participants (23 patients, 9 nurses, and 2 doctors) from three Iranian teaching hospitals, selected using purposive sampling, participated in semi-structured interviews. Unstructured observation and filed notes were other methods for data collection. The data were subjected to qualitative content analysis and analyzed using the MAXQDA-10 software. Results: Five categories and sixteen subcategories were identified. The five main categories related to patient autonomy were: Intrapersonal factors, physical health status, supportive family and friends, communication style, and organizational constraints. Conclusions: In summary, this study uncovered contextual factors that the care team, managers, and planners in the health field should target in order to improve patient autonomy in Iranian hospitals. PMID:27186203
Shaffer, F A; Preziosi, P
The health care marketplace is becoming increasingly competitive. The hospital has a built-in marketing force with the nursing department, because nurses are in constant, direct contact with the customer. Nursing must identify the case mix profile of the community and focus the hospital product lines to meet community needs. The nursing department should decentralize, change, measure, and innovate the staff mix needed to operationalize these product lines. The development of nursing practice standards for the case mix will help to identify the staff mix needed and create systems to efficiently manage the product lines. Nursing management must become aware of cross-subsidization and downward skill substitution of nursing personnel. Nursing information systems must generate quality reports that invoke cost consciousness on the part of nursing staff. Quality assurance programs must become unit based and complete with frequent audits to correlate length of stay with nursing quality. Correlations must be determined between nursing productivity and case mix to determine the hospital's niche in the marketplace. The transformation of health care into a competitive business industry has created many opportunities for nursing. The health care industry's incentives for efficiency along with the decreasing demand for inpatient hospital services will be the forces driving health care toward a competitive marketplace. The hospital's nursing department should be strategically positioned to become accountable for increasing market share and enhancing quality patient outcomes. The focus has shifted from the theoretical to the tactical, which is a step in the right direction, particularly for nursing. Nursing, if strategically positioned, will not only thrive but will also excel in this chaotic environment by capturing the opportunities and being innovative.
Z Naghavi Konjin
Full Text Available Background: Workplace safety has been a concern of workers and managers for decades. Measuring safety climate is crucial in improving safety performance. It is also a method of benchmarking safety perception. Objective: To develop and validate a psychometrics scale for measuring nurses' safety climate. Methods: Literature review, subject matter experts and nurse's judgment were used in items developing. Content validity and reliability for new tool were tested by content validity index (CVI and test-retest analysis, respectively. Exploratory factor analysis (EFA with varimax rotation was used to improve the interpretation of latent factors. Results: A 40-item scale in 6 factors was developed, which could explain 55% of the observed variance. The 6 factors included employees' involvement in safety and management support, compliance with safety rules, safety training and accessibility to personal protective equipment, hindrance to safe work, safety communication and job pressure, and individual risk perception. Conclusion: The proposed scale can be used in identifying the needed areas to implement interventions in safety climate of nurses.
Asgar Aghaei Hashjin
Full Text Available OBJECTIVE: To examine the extent of implementation for patient safety (PS and patient-centeredness (PC strategies and their association with hospital characteristics (type, ownership, teaching status, annual evaluation grade in Iran. METHODS: A cross-sectional study through an adapted version of the MARQuIS questionnaire, eliciting information from hospital and nursing managers in 84 Iranian hospitals on the implementation of PS and PC strategies in 2009-2010. RESULTS: The majority of hospitals reported to have implemented 84% of the PS and 72% of the PC strategies. In general, implementation of PS strategies was unrelated to the type of hospital, with the exception of health promotion reports, which were more common in the Social Security Organization (SSO, and MRSA testing, which was reported more often in nonprofit hospitals. MRSA testing was also more common among teaching hospitals compared to non-teaching hospitals. The higher grade hospitals reported PS strategies significantly more frequently than lower grade hospitals. Overall, there was no significant difference in the reported implementation of PC strategies across general and specialized hospitals; except for the provision of information in different languages and recording of patient's diet which were reported significantly more often by general than specialized hospitals. Moreover, patient hotel services were more common in private compared to public hospitals. CONCLUSIONS: Despite substantial reporting of PS and PC strategies, there is still room for strengthening standard setting on safety, patient services and patient-centered information strategies in Iranian hospitals. To assure effective implementation of PS and PC strategies, enforcing standards, creating a PS and PC culture, increasing organizational responsiveness, and partnering with patients and their families need more attention.
Aghaei Hashjin, Asgar; Kringos, Dionne S; Manoochehri, Jila; Ravaghi, Hamid; Klazinga, Niek S
To examine the extent of implementation for patient safety (PS) and patient-centeredness (PC) strategies and their association with hospital characteristics (type, ownership, teaching status, annual evaluation grade) in Iran. A cross-sectional study through an adapted version of the MARQuIS questionnaire, eliciting information from hospital and nursing managers in 84 Iranian hospitals on the implementation of PS and PC strategies in 2009-2010. The majority of hospitals reported to have implemented 84% of the PS and 72% of the PC strategies. In general, implementation of PS strategies was unrelated to the type of hospital, with the exception of health promotion reports, which were more common in the Social Security Organization (SSO), and MRSA testing, which was reported more often in nonprofit hospitals. MRSA testing was also more common among teaching hospitals compared to non-teaching hospitals. The higher grade hospitals reported PS strategies significantly more frequently than lower grade hospitals. Overall, there was no significant difference in the reported implementation of PC strategies across general and specialized hospitals; except for the provision of information in different languages and recording of patient's diet which were reported significantly more often by general than specialized hospitals. Moreover, patient hotel services were more common in private compared to public hospitals. Despite substantial reporting of PS and PC strategies, there is still room for strengthening standard setting on safety, patient services and patient-centered information strategies in Iranian hospitals. To assure effective implementation of PS and PC strategies, enforcing standards, creating a PS and PC culture, increasing organizational responsiveness, and partnering with patients and their families need more attention.
Aghaei Hashjin, Asgar; Kringos, Dionne S.; Manoochehri, Jila; Ravaghi, Hamid; Klazinga, Niek S.
Objective To examine the extent of implementation for patient safety (PS) and patient-centeredness (PC) strategies and their association with hospital characteristics (type, ownership, teaching status, annual evaluation grade) in Iran. Methods A cross-sectional study through an adapted version of the MARQuIS questionnaire, eliciting information from hospital and nursing managers in 84 Iranian hospitals on the implementation of PS and PC strategies in 2009–2010. Results The majority of hospitals reported to have implemented 84% of the PS and 72% of the PC strategies. In general, implementation of PS strategies was unrelated to the type of hospital, with the exception of health promotion reports, which were more common in the Social Security Organization (SSO), and MRSA testing, which was reported more often in nonprofit hospitals. MRSA testing was also more common among teaching hospitals compared to non-teaching hospitals. The higher grade hospitals reported PS strategies significantly more frequently than lower grade hospitals. Overall, there was no significant difference in the reported implementation of PC strategies across general and specialized hospitals; except for the provision of information in different languages and recording of patient’s diet which were reported significantly more often by general than specialized hospitals. Moreover, patient hotel services were more common in private compared to public hospitals. Conclusions Despite substantial reporting of PS and PC strategies, there is still room for strengthening standard setting on safety, patient services and patient-centered information strategies in Iranian hospitals. To assure effective implementation of PS and PC strategies, enforcing standards, creating a PS and PC culture, increasing organizational responsiveness, and partnering with patients and their families need more attention. PMID:25268797
Cheraghi, Mohammad Ali; Ghiyasvandian, Shahrzad; Aarabi, Akram
Presence of nurses in policy making will result improvement of nursing practice, and increase qualification of patients' care, but still few nurses are involved in policy debates and health reforms and their status in policy making for nursing is not clear. The aim of this study was to elucidate Iranian nurses' status in policy making for nursing in health system. This is a qualitative study. Using purposive sampling 22 participants were interviewed to gain deep understanding from the phenomenon of status of nurses in policy making. Of these 2 were not nurses but the members of Iran's council for health policy making. Data were analyzed by employing conventional content analysis. Nurses' status in policy making declared base on the implications of three main themes including "the policy making framework", "perceived status of nurses in policy making", and "the manner of nurses' participation in policy making". The conclusion of the present study is that Policy making for nursing is a subcategory of Iran's macro health policies. What made the status of nurses more efficient in policy making for nursing was their practice and rate of participation in the appointed positions and the society. Results of this study represented major points of weakness in nursing policies and some recommendations for modifications.
Full Text Available Background. Despite decades of research and the availability of effective analgesic approaches, many children continue to experience moderate-to-severe pain after hospitalization. Greater research efforts are needed to identify the factors that facilitate effective pain management. The aim of this study was to explore the perceptions of Iranian nurses on facilitators of pain management in children. Materials and Methods. This qualitative study collected the data profoundly through unstructured interviews with 19 nurses in Amirkola Children’s Hospital in Babol and Children’s Medical Center in Tehran, during 2013-2014. Purposeful sampling and analysis of the data were conducted using conventional qualitative content analysis. Results. Four themes were extracted through data analysis: mother and child participation in diagnosis and pain relief, the timely presence of medical staff and parents, proper communication, and training and supportive role of nurses. Conclusion. Mother and child participation in the report and diagnosis of pain and nonpharmacological interventions for pain by the mother, the timely presence of medical team at the patient’s bedside, and proper interaction along with the training and supportive role of a nurse enhanced the optimal pain management in hospitalized children.
Full Text Available Context Over the past decade the number of accidents and disasters has been growing around the world. In addition to damaging communities and infrastructures, unexpected disasters also affect service providers. This study aimed to evaluate the readiness of hospitals when confronted with unexpected disasters. Evidence Acquisition The present study was a simple review article, which was conducted via searching different sites, such as: Web of Science, Scopus, Science Direct and PubMed, using different key words such as: Disasters, Crisis, Hospital and preparedness. The relationship between the articles found in relation to our subject was investigated through the title and abstract of articles. The relationship between the articles, which were found in relation to our subject, was investigated through the title and abstract of the articles. Our search included papers published during the period between 2007 and 2015 and we only considered studies that measured the preparedness of hospitals in critical conditions. Among the 30 articles, which were found, 17 were excluded from the study due to lack of relevant data. Hence, 15 papers, which were of proper design and robust data analysis, were included in the current study. Results Hospital preparedness in disaster was evaluated in three dimensions: structural, non-structural factors and vulnerability management performance. A total of readiness of hospitals in three dimensions was mediocre. Conclusions Overall, the results derived from these studies indicated that hospital safety levels in most of the surveyed hospitals were moderate. Although the situation in hospitals is not critical, there is a need to plan and take appropriate measures to improve the safety level of the hospitals.
Khorasgani, Sahar Rabani; Moghtadaie, Leila
The present study aimed at Investigating the knowledge and attitude of Nursing Students towards Iranian Traditional Medicine in universities of Tehran in 2012-2013. 300 students of nursing studying at different universities in Tehran participated in this descriptive, cross-sectional study. The data was collected through a standard questionnaire with an acceptable validity and reliability. The questionnaire was made of five sections including demographic, general knowledge of the Iranian traditional medicine, general attitude towards it, resources of the Iranian traditional medicine and the barriers to it. The results revealed that general knowledge of the students about Iranian traditional medicine and complementary medicine is low. The attitude of the students towards including Iranian traditional medicine and complementary medicine in their curriculum is positive. General attitude of students towards Iranian traditional medicine is positive too. The majority of the participants had not passed any course on Iranian traditional medicine. There was no relationship between participants’ attitude towards Iranian traditional medicine and the number of semesters they had passed. Considering the participants’ positive attitude and their low level of knowledge, it seems necessary for the university policy makers to provide nursing students with different training courses on Iranian traditional medicine and complementary medicine in order to increase their knowledge. PMID:25363119
Full Text Available Background: To respond to the growing and emerging needs of the people in the health sector, the nurses need to develop their working domain from the hospitals to the community and be prepared to provide entrepreneurial roles at different care levels. Thus, to discover how to identify entrepreneurial opportunities in the field of nursing entrepreneurship, a study was conducted with the aim of describing the experiences of Iranian entrepreneurs on the identification of proper opportunities in entrepreneurship. Materials and Methods: This study was a qualitative research in which the Graneheim and Lundman's content analysis was used to collect and analyze the data. Thirteen entrepreneurial nurses were purposefully selected, and the data were collected by unstructured interviews. Results: As a result of data analysis, three main themes were obtained including the resources for opportunity identification and opportunity assessment and identification of proper opportunities. Conclusion: The findings indicate how to identify entrepreneurial opportunities in the field of health by entrepreneurial nurses which is the first step in the entrepreneurial process. Therefore, the findings of this study can be used to educate nurses who are interested in entering the field of nursing entrepreneurship.
Ajoudani, Fardin; Baghaei, Rahim; Lotfi, Mojgan
Moral distress and workplace bullying are important issues in the nursing workplace that appear to affect nurse's burnout. To investigate the relationship between moral distress and burnout in Iranian nurses, as mediated by their perceptions of workplace bullying. Ethical considerations: The research was approved by the committee of ethics in research of the Urmia University of Medical Sciences. This is a correlation study using a cross-sectional design with anonymous questionnaires as study instruments (i.e. Moral Distress Scale-Revised, Maslach Burnout Inventory and The Negative Acts Questionnaire-Revised). Data were collected from 278 nurses from five teaching hospitals in Urmia, the capital of Western Azerbaijan, northwest of Iran. Structural equation modeling and bootstrapping procedures were employed to recognize the mediating role of their perceptions of workplace bullying. The mean score of moral distress, burnout, and the Negative Acts Questionnaire-Revised Scale among the participants were 91.02 ± 35.26, 79.9 ± 18.27, and 45.4 ± 15.39, respectively. The results confirmed our hypothesized model. All the latent variables of study were significantly correlated in the predicted directions. The moral distress and bullying were significant predictors of burnout. Perception of bullying partially mediated the relationship between moral distress and burnout. The mediating role of the bullying suggests that moral distress increases burnout, directly and indirectly. Nursing administrators should be conscious of the role of moral distress and bullying in the nursing workplace in increasing burnout.
Discrimination is a situation in which individuals receive unequal social benefits in return for equal roles they play. They react to such a situation in different ways. This study aims at identifying the strategies used by Iranian nurses to overcome professional discrimination. This qualitative study was conducted with the participation of 23 nurses who worked in hospitals in the cities of Tehran, Tabriz, and Ilam. They were selected based on purposive sampling. Data were collected using deep and unstructured interviews in a period of time between May 2013 and June 2014. Interviews were simultaneously analyzed using conventional content analysis method after being transcribed. Ethical consideration: This study was approved by the Regional Committee of Medical Research Ethics. Also, voluntary participation, anonymity, and confidentiality were considered. "Presenting a positive image of oneself," "objection," and "expectation" were three themes extracted through data analysis. Organizational discrimination puts nurses under stress and pressure. Nurses react to unfair behavior in different ways. These reactions are harmful to an organization and lead to negative consequences. Professional discrimination has made nurses adopt strategies which would lead to such consequences, which in turn influences their performance as nurses.
Vahid Zamanzadeh, PhD
Conclusion: Iranian nurses who care for HSCT patients experience a range of positive and negative emotions. Establishing appropriate support systems for nurses might help mediate the negative aspects of emotional labour. thereby improving nursing work life and ultimately the quality of patient care.
KHALVATI, MALIHEH; FEKRAZAD, HOSSEIN; RAFATJAH, MARYAM; OSTADHASHEMI, LEILA; KHANKEH, HAMID REZA
Introduction: Identity is formed through our understanding of ourselves and what others perceive of our actions and how we do things. Formation of professional identity includes development, advancement and socialization through social learning of specific knowledge and skills obtained within the context of professional roles, new attitudes and values. Methods: This qualitative study used content analysis approach to explain the professionalization process of 22 social workers working in 14 public hospitals in Tehran based on their experiences. The data were collected through semi-structured interviews, observation and writing in the field. Results: Eleven categories and three themes of entry into the profession, identity formation, and identity ownership were extracted out of data analysis. Revealing the process, barriers and facilitators of professionalization of hospital social workers was the results of this study. Conclusion: Certain individual characteristics were factors for the tendency of participants to choose this profession. The participants' understanding of their profession was formed, when studying in the university through learning relevant knowledge, skills, views and professional expectations. Achieving a single identity and professional pride and self-esteem are achievements of identity ownership. PMID:29344524
Soleimani, Mohammad Ali; Sharif, Saeed Pahlevan; Yaghoobzadeh, Ameneh; Sheikhi, Mohammad Reza; Panarello, Bianca; Win, Ma Thin Mar
Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues. This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to study the determinant factors of moral distress and spiritual well-being in nurses. A cross-sectional, correlational design was employed to collect data from 193 nurses using the Spiritual Well-Being Scale and the Moral Distress Scale-Revised. This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. Mean scores of spiritual well-being and moral distress were 94.73 ± 15.89 and 109.56 ± 58.70, respectively. There was no significant correlation between spiritual well-being and moral distress (r = -.053, p = .462). Marital status and job satisfaction were found to be independent predictors of spiritual well-being. However, gender and educational levels were found to be independent predictors for moral distress. Age, working in rotation shifts, and a tendency to leave the current job also became significant after adjusting other factors for moral distress. This study could not support the relationship between spiritual well-being and moral distress. However, the results showed that moral distress is related to many elements including individual ideals and differences as well as organizational factors. Informing nurses about moral distress and its consequences, establishing periodic consultations, and making some organizational arrangement may play an important role in the identification and management of moral distress and
Borhani, Fariba; Abbaszadeh, Abbas; Mohamadi, Elham; Ghasemi, Erfan; Hoseinabad-Farahani, Mohammad Javad
Moral sensitivity is the foremost prerequisite to ethical performance; a review of literature shows that nurses are sometimes not sensitive enough for a variety of reasons. Moral distress is a frequent phenomenon in nursing, which may result in paradoxes in care, dealing with patients and rendering high-quality care. This may, in turn, hinder the meeting of care objectives, thus affecting social healthcare standards. The present research was conducted to determine the relationship between moral sensitivity and moral distress of nurses in intensive care units. This study is a descriptive-correlation research. Lutzen's moral sensitivity questionnaire and Corley Moral Distress Questionnaire were used to gather data. Participants and research context: A total of 153 qualified nurses working in the hospitals affiliated to Shahid Beheshti University of Medical Sciences were selected for this study. Subjects were selected by census method. Ethical considerations: After explaining the objectives of the study, all the participants completed and signed the written consent form. To conduct the study, permission was obtained from the selected hospitals. Nurses' average moral sensitivity grade was 68.6 ± 7.8, which shows a moderate level of moral sensitivity. On the other hand, nurses also experienced a moderate level of moral distress (44.8 ± 16.6). Moreover, there was no meaningful statistical relationship between moral sensitivity and moral distress (p = 0.26). Although the nurses' moral sensitivity and moral distress were expected to be high in the intensive care units, it was moderate. This finding is consistent with the results of some studies and contradicts with others. As moral sensitivity is a crucial factor in care, it is suggested that necessary training be provided to develop moral sensitivity in nurses in education and practical environments. Furthermore, removing factors that contribute to moral distress may help decrease it in nurses.
Tahamtan, Iman; Bagheri, Zeinab; Janani, Payman; Majidi, Somayye; Ghasemi, Elham; Negarandeh, Reza
Background: Little is known about the features of Iranian nursing journals, specifically the subject areas used in articles, study designs, sampling methods, international collaboration of Iranian nursing scholars, specialty and academic rank of authors, and the most frequently contributing academic institutions in articles. Objectives: The aim of this study was to analyze the content of the articles published in Iranian scientific nursing journals. Materials and Methods: Quantitative content analysis was implemented to study Iranian nursing journals, which were approved by the commission for accreditation and improvement of Iranian medical journals in 2011. Thus, 763 articles from six journals, published from 2009 through 2011, were investigated. Data were extracted from the abstracts and when necessary, from the full-text of articles by visiting the websites of these journals. Descriptive statistics were used to analyze the data. Results: The main subjects of published articles in Iranian scientific nursing journals were consecutively renal dialysis (n = 21), intensive care unit (n = 16), nursing education (n = 15), patient satisfaction (n = 13), quality of life (n = 12), health education (n = 11), patient education (n = 11), pain (n = 10), and education (n = 9). The majority of authors had nursing and midwifery specialty (52.59%) followed by epidemiology/biostatistics specialty (7.72%). Isfahan, Tehran, Shahid Beheshti, Iran, Baqiyatallah, and Urmia universities of medical sciences had consecutively the largest number of publications in the studied journals. Only three papers (0.39%) were published by the international collaboration. Conclusions: Iranian nursing journals should publish special issues in the neglected subject areas. These journals should encourage authors to publish research evidence with higher quality. PMID:25741512
Tahamtan, Iman; Bagheri, Zeinab; Janani, Payman; Majidi, Somayye; Ghasemi, Elham; Negarandeh, Reza
Little is known about the features of Iranian nursing journals, specifically the subject areas used in articles, study designs, sampling methods, international collaboration of Iranian nursing scholars, specialty and academic rank of authors, and the most frequently contributing academic institutions in articles. The aim of this study was to analyze the content of the articles published in Iranian scientific nursing journals. Quantitative content analysis was implemented to study Iranian nursing journals, which were approved by the commission for accreditation and improvement of Iranian medical journals in 2011. Thus, 763 articles from six journals, published from 2009 through 2011, were investigated. Data were extracted from the abstracts and when necessary, from the full-text of articles by visiting the websites of these journals. Descriptive statistics were used to analyze the data. The main subjects of published articles in Iranian scientific nursing journals were consecutively renal dialysis (n = 21), intensive care unit (n = 16), nursing education (n = 15), patient satisfaction (n = 13), quality of life (n = 12), health education (n = 11), patient education (n = 11), pain (n = 10), and education (n = 9). The majority of authors had nursing and midwifery specialty (52.59%) followed by epidemiology/biostatistics specialty (7.72%). Isfahan, Tehran, Shahid Beheshti, Iran, Baqiyatallah, and Urmia universities of medical sciences had consecutively the largest number of publications in the studied journals. Only three papers (0.39%) were published by the international collaboration. Iranian nursing journals should publish special issues in the neglected subject areas. These journals should encourage authors to publish research evidence with higher quality.
Discovery and analysis of care meanings, expressions, and practices of Iranian Immigrants in New South Wales, Australia was the focus of this ethnonursing qualitative research. The purpose of the study was to systematically discover, describe and analyse the values, beliefs, and practices of Iranian immigrants in New South Wales, Australia. The aim of the investigation was to discover transcultural nursing knowledge to guide nurses and health professionals to provide culturally congruent nursing and health care to Iranians. Leininger's theory of Culture Care Diversity and Universality (Leininger, 1991) was used as the conceptual framework for the study. It was predicted that care meanings and expressions of Iranian immigrants would be influenced by their worldview, social structure features, language, and cultural values rooted in their long ethnohistorical past and reflected in their lifeways in Australia. Using the ethnonursing qualitative research method, key and general informants were purposefully selected among Iranian immigrants residing in New South Wales. Three care themes supported by a number of universal and some diverse patterns were identified for Iranian immigrants. The three themes were: (1) Care meant family and kinship ties (hambastegie) as expressed in daily lifeways and interactions with family, friends, and community; (2) Care as expressed in carrying out traditional urban gender roles (role-zan-o-mard) (Azadie zan) as well as in fulfilling emerging new role responsibilities related to equality for female Iranian immigrants; and (3) Care as preservation of Iranian identity (inhamoni, hamonandi) as expressed in traditional cultural events and health care practices. Leininger's (1991) three modes of actions and decisions were used to develop appropriate and culturally meaningful nursing care actions and decisions which were in harmony with the cultural beliefs of Iranian immigrants.
Full Text Available In recent years, particular attention has been paid to nursing students’ therapeutic communication (TC with patients, due to a strong emphasis on patient-centered education in the Iranian healthcare reform. However, various studies have highlighted the poor communication of future nurses. Therefore, researchers have used qualitative methodology to shed light on the antecedents and consequences of nursing students’ TC and promote it. We carried out a conventional content analysis using semistructured interviews with a purposefully selected sample of 18 participants, including nursing instructors, students, and patients in hospitals affiliated to Tehran University of Medical Sciences. “Communication readiness,” “predisposing factors,” and “continuity of care” were identified as the three major themes. “Communication readiness” consisted of “physical readiness,” “academic readiness,” and “developmental readiness.” “Predisposing factors” included “contextual factors” and “educational condition.” “Continuity of care” included “patient satisfaction” and “improving nursing student’s motivation to communicate with patients.” “Communication readiness” and “predisposing factors” constitute the antecedents of nursing student’s TC with patients, and “continuity of care” is considered as its consequence. More attention needs to be paid by the regulators to TC instruction in both theoretical and clinical educational curriculum. Furthermore, all nurses must be informed about the importance of TC in promoting patient outcomes and quality of care.
Jafaraghaee, Fateme; Mehrdad, Neda; Parvizy, Soroor
Dissatisfaction and tending to leave are some of the major nursing problems around the world. Professional commitment is a key factor in attracting and keeping the nurses in their profession. Commitment is a cultural dependent variable. Some organizational and socio-cultural factors are counted as the drivers of professional commitment. This study aimed to explore factors influencing the professional commitment in Iranian nurses. A qualitative content analysis was used to obtain rich data. We performed 21 in-depth face-to-face semi-structured interviews. The sampling was based on the maximum variation with the staff nurses and managers in 5 university affiliated hospitals. Constant comparative method used for data analysis. TWO MAIN CATEGORIES WERE EMERGED: "Challenging with different feelings" and "Managers' role". Challenging with different feelings had two subcategories: "Burnout" and "sense of valuing". The other theme was composed of three subcategories: "Gratitude or punishment climate", "manager's view of caring" and "knowledge-based vs. routine-based nursing". Findings revealed the burnout as a common sense in nurses. They also sensed being valued because of having a chance to help others. Impediments in the health care system such as work overload and having more concern in the benefits of organization rather than patient's care and wellbeing lead to a sense of humiliation and frustration. Congruence between the managers and nurses' perceived values of the profession would be a main driver to the professional commitment. Making a sense of support and gratitude, valuing the care and promoting the knowledge-based practice were among the other important factors for making the professional commitment.
Valizadeh, Leila; Zamanzadeh, Vahid; Habibzadeh, Hosein; Alilu, Leyla; Shakibi, Ali
Due to the high clinical challenges, differences in coping strategies, and high workload in nurses, there is a need to develop strategies to keep them in the profession. The aim of the present study was to explore the Iranian nurses' coping strategies to deal with intention to leave. A qualitative content analysis was used to obtain rich data. We performed 13 in-depth face-to-face semi-structured interviews with nurses working in hospitals affiliated to Tabriz and Urmia Universities of Medical Sciences in Iran, selected through purposive sampling. Constant comparative method was used for data analysis. Three categories and eleven subcategories emerged during data analysis. The extracted categories and sub-categories consisted of (I) Self-empowerment (practical knowledge increase, responsibility, finding identification of the nurse, balancing work and life, seek support and humanitarian interests), (II) Self-controlling (tolerance, avoidance, the routine-based performance), and (III) Pursuing opportunities for advancement and promotion (community development, planning for higher education). Nurses make attempts to individually manage problems and stressors perceived from bedside that have led them to leave the bedside; these efforts have been effective in some cases but sometimes they are ineffective due to discontinuous training and relative competence in terms of how to manage and deal with problems. It is suggested that nurses should learn strategies scientifically to meet the challenges of bedside. Through enabling and supporting behaviors and creating opportunities for growth and professional development, nursery managers can help nurses to stay and achieve improvement of the quality of cares.
Reza Pourmirza Kalhori
Full Text Available Background: The aim of this study was to compare the cardiopulmonary resuscitation (CPR knowledge of hospital nurses and emergency medical personnel in Kermanshah, Iran. Materials and Methods: This descriptive cross-sectional study was conducted on 330 hospital nurses and 159 emergency medical personnel working in educational hospitals and emergency medical centers in Kermanshah. Data were collected using a validated and reliable (r = 0.74 researcher-made questionnaire consisting of a demographic characteristics questionnaire and the 2010 CPR knowledge questionnaire. Results: Based on the most recent CPR guidelines, the knowledge of 19.5%, 78.6%, and 1.9% of the emergency medical staff was excellent, good, and moderate, respectively. None of the participants had poor knowledge. In addition, the knowledge of 20.2%, 65.4%, 14%, and 0.4% of the nurses in this study was excellent, good, moderate, and poor, respectively. There was no significant difference in CPR knowledge between hospital nurses and emergency medical staff. Moreover, no significant association was found between CPR knowledge and gender, age, work experience, field of study, previous occupation, and advanced resuscitation courses. However, CPR knowledge of individuals with training in basic CPR courses was higher than participants without training in these courses (P < 0.05. Conclusions: Based on the findings of this study, CPR knowledge among Iranian nurses and emergency medical personnel was in an acceptable range. Nevertheless, it is strongly recommended that nurses and emergency staff receive training according to the most recent CPR guidelines.
Imani, Behzad; Kermanshahi, Sima Mohamad Khan; Vanaki, Zohreh; Kazemnejad Lili, Anoshiravan
The aim of this study was to explore Iranian hospital nurses' lived experiences of intelligent resilience. Nurses do high levels of emotional work when fulfilling patients' and their family members' complex needs. Intelligent resilience can alleviate nurses' stress and enhance their endurance. This study was based on the Husserlian descriptive phenomenology. A purposive sample of ten hospital nurses was drawn from hospitals affiliated with Hamadan University of Medical Sciences, Hamadan, Iran. In-depth semi-structured interviews were held to collect data. The seven-step data analysis approach proposed by Colaizzi was used for the data analysis. In this study, the adherence to consolidated criteria for reporting qualitative guidelines has been followed. The participating hospital nurses' lived experiences of intelligent resilience came into four main themes of patience and wisdom, reverence, situational self-control, and appealing to religiosity. Each of the four main themes included two subthemes which were having peace and wise quietness, reverence for the patients, physicians and nurses, distancing themselves from stressful situations and displacing staff who cause stress, and the nurse's trust in God as well as the patient and his family's trust in God, respectively. Nurses with intelligent resilience are able to bring peace, reverence for others, and situational self-control to stressors thereby providing higher quality of care to their patients. Nurses work in unstable and stressful conditions. The findings of this study provide better understanding about the concept of nurses' intelligent resilience and its indicators and attributes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Heydari, Abbas; Emami Zeydi, Amir
Research utilization (RU), is an important strategy to promote the quality of patient care. The aim of this study was to present a comprehensive literature review describing barriers and facilitators of RU among Iranian nurses. Literature review was undertaken using the international databases including Pub Med/Medline, Scopus, Science Direct, and Google Scholar. Also, Persian electronic databases such as Magiran, SID and Iran Medex were searched up to May 2014. The search was limited to articles in the English and Persian languages that evaluate the barriers or facilitators of RU among Iranian nurses. A total of 11 articles were in the final dataset. The most important barriers to RU among Iranian nurses were related to the organization factors such as inadequate facilities; insufficient time on the job, lack of authority, physician cooperation, and administrative support. The most frequent facilitators of RU were education in enhancing nurses knowledge and skills in research evaluation, support from knowledgeable nursing colleagues and nursing faculty in the clinical setting, access to an expert committee for clinical appraisal, improving skills in English language and searching for articles, sufficient economic resources to carry out research, and having access to more facilities such as internet. Iranian nurses encounter with the same difficulties as to other countries regarding RU; while setting related barriers were the predominant obstacles to RU among them. Therefore, health managers are expected to plan appropriate strategies to smooth the progress of RU by nurses in their practice.
Valizadeh, Leila; Zamanzadeh, Vahid; Habibzadeh, Hosein; Alilu, Leyla; Shakibi, Ali
Background: Due to the high clinical challenges, differences in coping strategies, and high workload in nurses, there is a need to develop strategies to keep them in the profession. The aim of the present study was to explore the Iranian nurses’ coping strategies to deal with intention to leave. Methods: A qualitative content analysis was used to obtain rich data. We performed 13 in-depth face-to-face semi-structured interviews with nurses working in hospitals affiliated to Tabriz and Urmia Universities of Medical Sciences in Iran, selected through purposive sampling. Constant comparative method was used for data analysis. Results: Three categories and eleven subcategories emerged during data analysis. The extracted categories and sub-categories consisted of (I) Self-empowerment (practical knowledge increase, responsibility, finding identification of the nurse, balancing work and life, seek support and humanitarian interests), (II) Self-controlling (tolerance, avoidance, the routine-based performance), and (III) Pursuing opportunities for advancement and promotion (community development, planning for higher education). Conclusion: Nurses make attempts to individually manage problems and stressors perceived from bedside that have led them to leave the bedside; these efforts have been effective in some cases but sometimes they are ineffective due to discontinuous training and relative competence in terms of how to manage and deal with problems. It is suggested that nurses should learn strategies scientifically to meet the challenges of bedside. Through enabling and supporting behaviors and creating opportunities for growth and professional development, nursery managers can help nurses to stay and achieve improvement of the quality of cares. PMID:26448959
Full Text Available Background: Continuous change in the complex health care environments is a major challenge for administrative managers. This study aimed to design a change model to facilitate change implementation in the Iranian hospitals. Methods: This is a descriptive and comparative study. The data were collected through library search and in-depth interview with 15 hospital managers. Nine well-established change theories developed by Lewin, Action Research, Kotter, Ackerman- Anderson and Anderson, Prosci , Kilman, Beer, Continuum, and Gelicher were compared. Common denominators of the theories were identified and tabulated. Experienced hospital managers’ suggestions about social factors were acquired. The initial model was designed and validated using the Delphi Technique. Results: The majority of the selected change models emphasize the significance of social factors in change implementation such as effective communication, organizational climate and culture, and leadership. The results from the interviews indicate that low readiness to change, lack of confidence (or trust for change, and autocratic leadership style ,and poor communication could hinder the change process. Conclusion: Based on the model developed in the study, effective communication, readiness of employees, and a contingency leadership/management combined could lead to successful implementation of change in the hospital.
Shokoohi, Shahrzad; Hossein Emami, Amir; Mohammadi, Aeen; Ahmadi, Soleiman; Mojtahedzadeh, Rita
Students' perceptions of the educational environment are an important construct in assessing and enhancing the quality of medical training programs. Reliable and valid measurement, however, can be problematic - especially as instruments developed and tested in one culture are translated for use in another. This study sought to explore the psychometric properties of the Postgraduate Hospital Educational Environment Measure (PHEEM) for use in an Iranian hospital training setting. We translated the instrument into Persian and ensured its content validity by back translation and expert review prior to administering it to 127 residents of Urmia University of Medical Science. Overall internal consistency of the translated measure was good (a=0.94). Principal components analysis revealed five factors accounting for 52.8% of the variance. The Persian version of the PHEEM appears to be a reliable and potentially valid instrument for use in Iranian medical schools and may find favor in evaluating the educational environments of residency programs nationwide.
Neishabouri, M; Ahmadi, F; Kazemnejad, A
To explore Iranian nursing students' transition to professional identity. Professional identity is an important outcome of nursing education that has not been fully explored in the Iranian nursing education system. Professional identity is a significant factor influencing the development of nursing education and practice. The transition of nursing students to professional identity is the main concern of nursing education and fundamental prerequisite for policymaking and planning in the field of nursing education. This was a qualitative content analysis study. In-depth unstructured interviews were held with 35 Iranian bachelor's degree nursing students recruited through purposive sampling. The interviews were transcribed verbatim and analysed using content analysis. The data analysis led to the development of four themes and 15 categories: 'satisfaction with professional practice (attending clinical settings and communicating with patients, the feeling of being beneficial)'; 'personal development (growing interest in nursing, feeling competent in helping others, changing character and attitude shift towards patients)'; 'professional development (realizing the importance of nursing knowledge, appreciating professional roles, a changing their understanding of nursing and the meaning it)'; and 'attaining professional commitment (a tendency to present oneself as a nurse, attempting to change oneself, other students and the public image of nursing)'. Development of professional identity is a continual process of transition. The greatest transition occurred in the last year of the programme. Nursing students experienced transition to PI through gaining satisfaction with professional practice, undergoing personal and professional development and developing a professional commitment. Educational policymakers can use our findings for developing strategies that facilitate and support nursing students' transition to professional identity. © 2016 International Council of
Abdolrahimi, Mahbobeh; Ghiyasvandian, Shahrzad; Zakerimoghadam, Masoumeh; Ebadi, Abbas
In recent years, particular attention has been paid to nursing students’ therapeutic communication (TC) with patients, due to a strong emphasis on patient-centered education in the Iranian healthcare reform. However, various studies have highlighted the poor communication of future nurses. Therefore, researchers have used qualitative methodology to shed light on the antecedents and consequences of nursing students’ TC and promote it. We carried out a conventional content analysis using semist...
Estiri, Mehrdad; Nargesian, Abbas; Dastpish, Farinaz; Sharifi, Seyed Mahdi
The role of nurses in providing high quality healthcare to patients is so important that creating a desirable working environment to enhance their overall performance is unavoidable. This paper aimed to explore the impact of psychological capital on mental health by investigating the mediating effects of job burnout on this relationship. The data used in this research was obtained via a survey conducted among selected Iranian nurses in public hospitals. In total, 450 questionnaires were distributed and 384 were completed and returned. Collected data was analysed using Structural Equation Modelling (SEM). Findings showed that there is a significant relationship between psychological capital, job burnout and mental health; also, there is a significant negative relationship between psychological capital and job burnout, and a significant positive relationship between psychological capital and mental health. The results have several important practical implications for human resource management in Iranian public hospitals. According to the results of this study, reducing job burnout is an important factor in enhancing psychological capital and can positively enhance nurses' mental health.
Lagerström, Monica; Josephson, Malin; Arsalani, Narges; Fallahi-Khoshknab, Masoud
The study reported here explored Iranian nurses' experience of managing work and family roles. Grounded theory method guided the data collection and data analysis from both individual and focus group interviews. Five categories emerged: family role, working conditions, seeking support, perceiving dissatisfaction, and perceiving threats to health. The core concept that emerged was striving for balance between family and work demands. In the work-family role the Iranian nurses faced significant pressures, and they mostly relied on their own capabilities to create balance, often neglecting their own needs. This resulted in perceived dissatisfaction and health threats.
Aliakbari, Fatemeh; Bahrami, Masoud; Aein, Fereshteh; Khankeh, Hamidreza
Today disasters are a part of many people's lives. Iran has a long history of disaster events and nurses are one of the most significant groups within the Iranian disaster relief operations, providing immediate and long-term care for those affected by the disaster. However, the technical competence of Iranian nurses and their training for this work has received little attention. This article presents the results of a study that aims to explore this context. A qualitative study was conducted using in-depth interviews to collect data from 30 nurses, who were deliberately selected from the health centers affiliated to the Isfahan University of Medical Sciences. Themes were identified using the conventional qualitative content analysis. The trustworthiness of the study was supported by considering the auditability, neutrality, consistency, and transferability. The study lasted from 2011 to 2012. Data analysis undertaken for the qualitative study resulted in the identification of five main themes, which included: (1) Management competences, (2) ethical and legal competences, (3) team working, and (4) personal abilities and the specific technical competences presented in this report. This report presents an overview of the nursing technical capabilities required for Iranian nurses during disaster relief. It is argued that additional competencies are required for nurses who care in high-risk situations, including disasters. Nurses need to prepare themselves more effectively to be responsible and effective in nursing care.
Messerly, Sally; King, Michalene A; Hughes, Suzanne
A Faith Community Nurse (FCN) Program was initiated by a Magnet hospital and developed through collaboration between hospital departments and a university nurse educator. This article describes the program's development and activities that offer FCNs networking, free continuing education, and are an extension of the hospital's mission and values.
Nouri, Jamileh Mokhtari; Ebadi, Abbas; Alhani, Fatemeh; Rejeh, Nahid
One of the key strategies in students? learning is being affected by models. Understanding the role-modeling process in education will help to make greater use of this training strategy. The aim of this grounded theory study was to explore Iranian nursing students and instructors? experiences about role modeling process. Data was analyzed by Glaserian?s Grounded Theory methodology through semi-structured interviews with 7 faculty members, 2 nursing students; the three focus group discussions ...
Full Text Available Introduction: Despite the current shortage of nurses, it is important to know the reasons nurses want to leave the clinical setting. The purpose of this study was to explore the experiences of nurses who intend to leave clinical nursing. Methods: In a qualitative content analysis study, data obtained from 13 in-depth face-to-face semi-structured interviews with nurses working in hospitals affiliated to the Tabriz and Urmia University of Medical Sciences in Iran, selected through purposive sampling. A conventional content analysis was used for data analysis. Results: Four categories and eleven subcategories emerged during data analysis. The extracted categories and sub categories consisted of (I Entry routes into nursing (implicitly entry, targeted entry, (II Defects in dignity (lack of professional vision toward the nurses, social status of nurses, (III Work in non-ideal working environment (lack of support, discrimination, conflict, lack of opportunities for advancement, and (IV Dissatisfaction with working conditions (heavy workload, lack of power, unusual working hours. Conclusion: The findings of this qualitative study reflect professional turnover as a complex, ongoing, multidimensional process. By identifying the factors responsible, it could be possible to retain nurses in the field.
Manijeh Yazdanshenas Ghazwin
Full Text Available Objective: The determinants of satisfaction of life (SWL are poorly described among Iranian employed nurses. This study aimed to assess the effect of various factors including age, gender, marital status, depression, anxiety and stress on SWL among Iranian nurses.Method: Employed nurses in three teaching hospitals were invited to participate in this study. Ninety-four nurses (65 women and 29 men participated in this study. Depression, anxiety, stress scale (DASS-21 was used to measure the related variables. Satisfaction with Life Scale (SWLS was used to assess SWL. Multivariate analysis was utilized to examine the relationship between multiple variables. Results: A noticeable proportion of Iranian employed nurses were either dissatisfied or extremely dissatisfied with life (45%. Severe depression was related to lower scores of SWLS (P: 0.001, r = -0.32. The similar outcomes were detected between anxiety and stress scales, and SWLS (P: 0.023, r = -0.23 and P: 0.008, r = -0.27 for anxiety and stress, respectively. Although females were more vulnerable to depression (P: 0.010 and stress (P: 0.013, the overall effect of gender on SWL was insignificant (0.41. Satisfactions with financial power and work environment were associated with higher scores of SWLS (P: 0.030 and 0.042, respectively. Marital status was not related to severity of depression, anxiety, stress and SWLS (P: 0.39, 0.38, 0.80, and 0.61, respectively. Conclusion: This study revealed that poor satisfaction with financial status and work environment, depression, anxiety and stress are the major determinants of satisfaction with life among Iranian employed nurses.
Ali Banagozar Mohammadi
Full Text Available Background: Organophosphorus (OP poisonings, a common source of pesticide poisoning, are an important cause of morbidity and mortality in the developing countries. Combination therapy with atropine and oxime is a common practice in the management of OP poisoning. However, the additive benefit of using pralidoxime in addition to atropine remains controversial. Due to inappropriate and widespread use of this relatively expensive and low available antidote, we aimed to evaluate its usage in an Iranian teaching hospital. Methods: Medical files of patients with pesticide poisoning who had been admitted to the poisoning ward between September 2013 and September 2014 were reviewed. Patients with definite diagnosis of OPs poisoning were selected to evaluate rational use of pralidoxime in their treatment regimen. Data were collected using a checklist containing demographic, clinical, and para clinical characteristics, as well as the type of pesticide poisoning. Appropriateness of the pralidoxime therapy was determined based on clinical practice guideline and endorsed by an attending medical toxicologist. Results: 68.8% of patients had been poisoned with insecticides, 27.1% with aluminum phosphide, 2.1% with herbicides, and 2% with rodenticides, respectively. OPs were responsible for 43.8% of all poisoning. All patients with OPs poisoning received pralidoxime after they had been admitted to emergency department, while only 55% of them were eligible to receive pralidoxime. Moreover, pralidoxime had been administered for 59% of patients with non-OPs poisoning, which all of them were clinically inappropriate. Conclusion: The use of pralidoxime in the northwest of Iran is not appropriate and thus, it is highly recommended that a patient-tailored treatment guideline be provided and implemented regionally.
Full Text Available Background: Students’ perceptions of the educational environment are an important construct in assessing and enhancing the quality of medical training programs. Reliable and valid measurement, however, can be problematic – especially as instruments developed and tested in one culture are translated for use in another. Materials and method: This study sought to explore the psychometric properties of the Postgraduate Hospital Educational Environment Measure (PHEEM for use in an Iranian hospital training setting. We translated the instrument into Persian and ensured its content validity by back translation and expert review prior to administering it to 127 residents of Urmia University of Medical Science. Results: Overall internal consistency of the translated measure was good (a=0.94. Principal components analysis revealed five factors accounting for 52.8% of the variance. Conclusion: The Persian version of the PHEEM appears to be a reliable and potentially valid instrument for use in Iranian medical schools and may find favor in evaluating the educational environments of residency programs nationwide.
Sørensen, Erik Elgaard; Olsen, Ida Østrup; Tewes, Marianne
BACKGROUND: In recent years, perioperative nursing has received ongoing attention as part of an interprofessional collaboration. Perioperative nursing is constantly faced with new challenges and opportunities that necessitate continual updates of nursing knowledge and technical skills. In light...... of the longstanding relationship between nursing and technology, it is interesting that few studies with this focus have been performed. Therefore, our research question was: What is the content of perioperative nursing and how do nurses facilitate the interaction between nursing care and technology in highly...... specialized operating rooms in public university hospitals? METHODS: An ethnography involving participant observations and interviews was conducted during a 9-month study period. The participants comprised 24 nurses from 9 different operating wards at 2 university hospitals in different regions of Denmark...
Esmaeilpour-Bandboni, Mohammad; Vaismoradi, Mojtaba; Salsali, Mahvash; Snelgrove, Sherrill; Sheldon, Lisa Kennedy
Nurse-physician professional communication affects the effectiveness and performance of the health care team and the quality of care delivered to the patient. This study aimed to explore the perspectives and experiences of physicians on nurse-physician professional communication in an urban area of Iran. Semistructured interviews were conducted with 15 physicians selected using a purposive sampling method. Physicians from different medical specialties were chosen from 4 teaching hospitals in an urban area of Iran. The data were analyzed with content analysis and themes developed. Three themes developed during data analysis: "seeking the formal methods of communication to ensure patient care," "nurses' professional attributes for professional communication," and "patients' health conditions as the mediators of professional communication." Nurses need to be informed of the perspectives and experiences of physicians on professional communication. Our findings can improve nurses' understandings of professional communication that could inform the development of educational and training programs for nurses and physicians. There is a need to incorporate communication courses during degree education and design interprofessional training regarding communication in clinical settings to improve teamwork and patient care. Open discussions between nurses and physicians, training sessions about how to improve their knowledge about barriers to and facilitators of effective professional communication, and key terms and phrases commonly used in patient care are suggested.
Motamed-Jahromi, Mohadeseh; Abbaszadeh, Abbas; Borhani, Fariba; Zaher, Homa
Patient advocacy is an inherent component of professional nursing ethics; in other words, nurses' enough knowledge would be essential to gain a positive attitude towards nursing advocacy. Using a descriptive-analytic design, this study aimed to assess the correlation between nurses' perception and attitudes towards patient advocacy, amongst 385 nurses in Kerman, Iran; hence, a three-part questionnaire was applied: part I, a demographic data sheet, part II, attitude measuring instrument, and part III, perception measuring instrument in nursing advocacy. The results implied that fairly positive attitudes and perception were found amongst the participants, and nurses' attitudes, in general, were positively correlated to their perception toward nursing advocacy. This means that with an improvement in perception, the attitude would also improve. In addition to our findings, it seems that these nurses needed more advocacy educational programs and support from responsible employers.
Full Text Available Background: Burnout has its focus on exhaustion and it includes persistent response to long-lasting job-related stressful events. It has a special relevance in health care area in which staff is under constant psychological, emotional, and physical stress. The results of several studies on burnout prevalence among Iranian nurses indicate its high incidence. Therefore, more accurate researches are required for better preventive interventions, and to do so, a reliable validated scale is required. One of the suitable and new tools for the measurement of burnout is Copenhagen Burnout Inventory (CBI. This study aimed to translate and investigate psychometric properties of CBI in Iranian nurses. Materials and Methods: In this methodological study, after the translation process, face and content validities via qualitative and quantitative methods was done. Content validation ratio, scale-level content validated index, item-level content validity index were measured. Then, construct validity was determined through factor analysis. Furthermore, internal consistency reliability and stability were assessed. The questionnaire was sent to 450 nurses who were randomly selected via quota sampling. Results: Face and content validity were acceptable. After translation and cultural adaptation process, exploratory factor analysis suggested a new model based on four factors and fit indices validated this model via confirmatory factor analysis. Internal consistency and stability of CBI were affirmed for each subscale separately. Conclusions: The four-factor Persian version of the CBI proved to enjoy acceptable psychometric properties. It can be applied to evaluate burnout in Iranian nurses or other health care providers.
Lin, Frances; St John, Winsome; McVeigh, Carol
The aim of this study was to examine the level of burnout and factors that contribute to burnout in hospital nurses in the People's Republic of China. While burnout among hospital nurses has been widely researched in western countries, little research has investigated burnout among hospital nurses in China. A translated version of the Maslach Burnout Inventory-Human Services Survey was used to measure burnout in 249 randomly selected nurses from various wards of a large teaching hospital in Beijing, China. Questionnaire packs were sent to the hospital wards where selected nurses worked. One hundred and twenty-eight nurses returned the completed questionnaire. The response rate was 51%. The results showed moderate levels of Emotional Exhaustion and Personal Accomplishment, and low levels of Depersonalization. Age, years of experience and professional title had a significant positive relationship with Emotional Exhaustion and Personal Accomplishment. Older, married nurses with more personal responsibilities and in a more senior position experienced higher levels of Emotional Exhaustion. The findings suggest that burnout is a significant issue for nurses in China. The results of this study indicate that working environment factors such as relationships with coworkers and managers may contribute to or mitigate burnout. There is a need to address personal and professional support, life-work balance, personal accomplishment and educational programmes to reduce burnout in nurses working in China.
Najafi, Fereshteh; Fallahi-Khoshknab, Masoud; Ahmadi, Fazlollah; Dalvandi, Asghar; Rahgozar, Mehdi
Workplace violence against nurses is a challenging problem in both developed and developing countries. Because the concept of violence bears some cultural load, nurses' understanding is region-specific. This study explores Iranian nurses' perceptions of workplace violence. Using qualitative content analysis, 22 registered nurses underwent unstructured, in-depth interviews. The main themes of threats to human dignity and professional reputation emerged, plus four categories: physical violence, psychological violence, honor insults, and ethnic-religious insults. The term "honor insults," as a unique finding, was used instead of "sexual harassment." These findings may help to redefine workplace violence based on cultural background, design strategies for supporting nurses, and prevent and manage such violence. © 2016 John Wiley & Sons Australia, Ltd.
Full Text Available Health care managers realize that job satisfaction impacts on nursing staff retention. This study examined the job satisfaction of nursing staff (N = 109 at a government hospital. Just more than half of the respondents were generally satisfied. Feelings that nursing is worthwhile and satisfying, and financial stability at the hospital could promote staff retention. Specific intrinsic - (promotion, and extrinsic factors (routinization, working conditions, pay, interaction with supervisors, and organizational support could impact negatively on retention. Management should use these findings as a basis for staff consultation, developmental strategies, and interventions. Future research on other nursing populations is recommended.
Fackler, Carol A; Chambers, Angelina N; Bourbonniere, Meg
The purpose of this study was to explore hospital nurses' lived experience of power. A hermeneutic phenomenological approach informed by Merleau-Ponty's philosophy of the phenomenology of perception was used to further an understanding of nurses' embodiment of power. Fourteen hospital clinical nurses employed in intensive care units and on medical floors in two major medical centers in the northeastern United States participated in 1-hr semistructured interviews about their lived experience of power. A hermeneutic analytic approach and reflexive (cultural) bracketing produced three relational themes of power: (a) knowing my patients and speaking up for them; (b) working to build relationships that benefit patients; and (c) identifying my powerful self. Hospital clinical nurses develop a sense of power. Nurses believe power develops through acquisition of knowledge, experience, and self-confidence; this process is enhanced by exposure to good mentors. Nurses use their power to build relationships and advocate for patients. They consciously use power to improve patient care. Nurses' voices need to be heard and acknowledged. To do this in the clinical setting and beyond, hospital nurses must invite themselves or find ways to be invited into the authoritative discourse of hospital organizations. Nurses use their power to advocate for positive outcomes for patients and families. The satisfaction that comes from these positive relationships may improve nurses' perceptions of their work environment. Nurses' understanding and use of sociopolitical knowing needs further study, so that nurses may understand how to participate in current and future debates and decisions about our changing healthcare delivery systems and services. © 2015 Sigma Theta Tau International.
Full Text Available The current industrialized world and ever advancing technology has changed human life by a significant increase in the level of stress and anxiety. Nurses are among those professionals who experience an overwhelming level of stress, anxiety and depression due to work overload and subsequent burnout. The nature of nursing profession for a vulnerable human character increases the possibility of emotional setbacks. Hence, this study was designed to explore and identify the prevalence of anxiety, stress and depression among the Iranian nurses and investigate how these variables relate to personal characteristics and influence the quality of patient care. Using a correlational descriptive design and random cluster method, 242 nurses who worked at different hospital wards in Tabriz, Iran were assessed for anxiety, stress and depression, while their personal characteristics were identified. Data were collected by using a standard questionnaire for stress, anxiety and depression (DASS-21 and later analyzed by SPSS (ver.17.Results showed that Iranian nurses suffered from a moderate level of anxiety, stress and depression and gender influenced these variable rates (p<0.05. Hospital ward type had a relation with stress level (p<0.05, being interested in nursing had an inverse relation to anxiety, stress and depression (p<0.05, while the education level positively related to depression rate among nurses (p<0.05. Type of work at different shifts influenced stress (p<0.05 and marital status reduced depression among nurses (p<0.05. Prevalence of stress and anxiety among the Iranian nurses were at a significant level with susceptibility to experience psychological disorders and provide lower quality of patient care. Findings of this study can alarm the Iranian authorities in healthcare systems to adopt a new policy and improve the current state of health for nurses and patients.
Nobahar, Monir; Ahmadi, Fazlollah; Alhani, Fatemah; Khoshknab, Masood Fallahi
According to recent studies, the level of international interest in bridge employment, as return to work after retirement, has been growing. This study aimed to explore the experiences of retired nurses in Iran with regard to making a decision about whether or not to seek bridge employment. A qualitative study using a content analysis approach was conducted in an urban area of Iran. Semi-structured interviews were held with 20 Iranian male and female retired nurses chosen using purposive sampling. During the data analysis, two main themes were identified as the participants' thoughts supporting the decision of seeking bridge employment. The first theme was entitled motivational factors with categories of ``serving the society,'' ``maintaining and promoting health,'' ``tendency toward flexible work,'' and ``maintaining the role and activity.'' The second theme was entitled forcing factors with categories of ``ardent desire to work (pluralistic ignorance)'' and ``financial need.' ' While some Iranian retired nurses were not motivated to seek work for health reasons, most preferred to return to work after retirement. They were motivated to seek bridge employment out of a desire to serve the society, to promote their own physical and mental health, to continue to use their expertise and maintain the worker role, and because of financial needs and perceived societal expectations. Nurses seeking employment later in life tended to look for job flexibility and less stressful work. Therefore, the management of bridge employment by healthcare system authorities can be useful in making use of the invaluable experiences of retired nurses.
Barra, Daniela Couto Carvalho; Waterkemper, Roberta; Kempfer, Silvana Silveira; Carraro, Telma Elisa; Radünz, Vera
Qualitative research whose purpose was to reflect and argue about the relationship between hospitality, care and nursing according to experiences of PhD students. The research was developed from theoretic and practical meeting carried through by disciplines "the care in Nursing and Health" of PhD nursing Program at Santa Catarina Federal University. Its chosen theoretical frame of Hospitality perspective while nursing care. Data were collected applying a semi-structured questionnaire at ten doctoral students. The analysis of the data was carried through under the perspective of the content analysis according to Bardin. Hospitality it is imperative for the individuals adaptation in the hospital context or any area where it is looking for health care.
Van Schingen, Édith; Ladegaillerie, Geneviève; Lefebvre, Hélène; Challier, Marie-Pierre; Rothan-Tondeur, Monique
For several decades, hospitals have been faced with the voluntary departures of nurses. In parallel to this external mobility, internal mobility is also on the rise and is not always initiated by the nurse. This new mode of management has repercussions for professionals, patients as well as for the quality of care. Copyright © 2015. Published by Elsevier Masson SAS.
Salehi, Asiyeh; Javanbakht, Mahnaz; Ezzatababdi, Mohammad Ranjbar
Health care professions including nursing are ranked among the most stressful jobs. The harmful aspects of this stress can affect the nurses, their families, patients, and health care services. The purpose of this study was to investigate the most important stressors among nurses. This quantitative cross-sectional study was conducted among 225 nurses in Yazd, and data were analyzed with SPSS software. Findings showed that 73.4% of nurses had faced severe stress in the preceding 2 years, and workplace stressors were the most significant factors compared with other sources of stress (mean score of 4.62 on a 7-point Likert scale). Heavy workload (mean: 5.76), insufficient salary (5.67), discrimination (5.56), high expectations (5.48), high degree of responsibility for patients (5.48), and physical atmosphere at the workplace (5.25) were the most important workplace stressors. The results also indicated a significant relationship between the percentage of nurses facing stress in the workplace and gender (P = .037), the type of ward (P = .003), the type of employment (P = .050) and also work experience (P = .020). Findings indicate the necessity of improving the work environment for nurses such as changes in physical work conditions, better salaries and terms of employment, educational programs for stress reduction, and coping techniques.
Azizpour, Yosra; Delpisheh, Ali; Montazeri, Zahra; Sayehmiri, Kourosh
Low back pain (LBP) as a musculoskeletal disorder is one of the most common occupational injuries in nurses but there isn't any valid measure of the prevalence of LBP in Iranian nursing. In order to increase the power and improve the estimates of the prevalence of LBP in Iranian nurses, a comprehensive meta-analysis was carried out. A summary measure of all studies conducted in this field was found and distributions of LBP were evaluated based on different variables. Inclusion criteria included articles with prevalence of LBP in Iranian nurses, who had at least six months of work experience without any trauma, injuries to spine, or any underlying disease. The keywords"prevalence, low back pain, nurses", and "Iran" were used as part of this search. Databases such as Pubmed, Web of Science, Science direct, Scopus, IranMedex, Irandoc, Magiran, SID, CIVILICA, IMEMR and Google scholar were searched up to and including 15 June 2016. For data extraction a form was designed that included the following variables: Author names, province, sample size, age, gender, marital status, work experience, body mass index, job type, smoking status, work schedule, year of publication, type of standard questionnaire, prevalence of LBP, studies' quality score and climate classifications. Data analysis was carried out using fixed and random effects model. Heterogeneity between studies was assessed by using the I 2 and Q tests. In all 1250 articles were identified and 22 articles with 9347 participants met the inclusion criteria for meta-analyses after filtering. The prevalence of low back pain during their working life and during the last year, was estimated at 63% (95% Confidence Interval (CI): 57.4-68.5) and 61.2% (95% CI: 55.7-66.7) respectively. The prevalence rate of this disorder was 58.7% (95% CI: 35.8-81.7) and 60.4% (95% CI: 52.2-68.6) among men and women respectively. Furthermore, prevalence's of LBP were 59.5% in wards nurses, 50.3% in operating room technicians, and 39.4% in
Full Text Available Background: Ethical care is a core value in nursing. Pediatric nurses are in direct and continuous contact with children and their parents. They manage their lives and health. As part of the pediatric nurses' daily work, ethical issues play an important role in making decisions, are important to make decisions, and this capability is only achieved by ethical practice. This study aimed to explore the factors facilitating the learning of ethical practice among Iranian pediatric nurses. Materials and Methods: This study is a conventional qualitative content analysis based on the Graneheim and Lundman method. It was conducted through semi-structured interviews with two focus groups, incorporating 28 nurses working in pediatric wards. Unstructured observation and field notes were other methods of data collection. Purposive sampling continued until data saturation was ensured. All interviews were tape recorded and transcribed in verbatim. Results: Three main categories and 12 subcategories emerged from this study. The facilitating factors include (1 individual competencies (knowledge, experience, emotional intelligence, and loving children, (2 ethical imprinting (responsibility, reflection, empathy, and ethical beliefs, and (3 an environment that nurtures moral values (organizational, spiritual, family, and cultural environments as facilitating factors. Conclusions: The promotion of nurses' competencies, ethical virtues, and imprinting, as well as improvement of the quality of nursing care must be the top priority of the health team. Undoubtedly, the success of the health care system is not possible without ensuring that pediatric nurses learn ethical practices.
Mokhtari Nouri, Jamileh; Ebadi, Abbas; Alhani, Fatemeh; Rejeh, Nahid
One of the key strategies in students' learning is being affected by models. Understanding the role-modeling process in education will help to make greater use of this training strategy. The aim of this grounded theory study was to explore Iranian nursing students and instructors' experiences about role modeling process. Data was analyzed by Glaserian's Grounded Theory methodology through semi-structured interviews with 7 faculty members, 2 nursing students; the three focus group discussions with 20 nursing students based on purposive and theoretical sampling was done for explaining role modeling process from four nursing faculties in Tehran. Through basic coding, an effort to comprehensive growth and excellence was made with the basic social process consisting the core category and through selective coding three phases were identified as: realizing and exposure to inadequate human and professional growth, facilitating human and professional growth and evolution. The role modeling process is taking place unconscious, involuntary, dynamic and with positive progressive process in order to facilitate overall growth in nursing student. Accordingly, the design and implementation of the designed model can be used to make this unconscious to conscious, active and voluntarily processes a process to help education administrators of nursing colleges and supra organization to prevent threats to human and professional in nursing students' education and promote nursing students' growth.
Full Text Available Context: Due to expansion of chronic diseases and increase of health care costs, there is a need for planning and delivering hospice care for patients in their final stages of life in Iran. The aim of the present study is to investigate the knowledge and attitudes of nurses about delivering hospice care for End of Life (EOL patients. Materials and Methods: This cross-sectional study was conducted in 2012 with a sample size of 200 nurses that were selected by convenient (available sampling. The data collection instrument was a self-administered questionnaire whose validity was approved by experts′ opinions and its reliability was approved by test-retest method. Results : Among all participants of this study, 87% were female. The mean age of nurses was 32.00 ± 6.72. From all respondents 62% stated that they have no knowledge about hospice care and 80% declared that need for hospice care is increasing. Most of the participants felt that, appropriate services are not presented to patients in the final stages of their lives. About 80% believed that hospice care leads to reduction of health care costs, improvement of physical, mental and social health of patients and finally improvement of the quality of health care services. There was a significant relationship between age, employment history and level of education of nurses and their attitude and knowledge about how this service is provided. Conclusion : In view of the increase in chronic illnesses and the costs of caring, the need for provision of hospice care is felt more and more every day. However the awareness level of nurses about these services is low. Therefore the need for including these issues in nursing curriculum and holding scientific courses and seminars in this field is needed.
Prosen, Mirko; Piskar, Franka
To test the psychometric properties of the McCloskey-Mueller Satisfaction Scale and to assess which of the McCloskey-Mueller Satisfaction Scale dimensionalities have a considerable impact on job satisfaction of nursing employees in three public Slovenian hospitals. Job satisfaction of nurses is linked to productivity, turnover, absenteeism and patient outcomes. Little is known about the factors contributing to job satisfaction among Slovenian hospital nurses. Understanding the contributing factors could help nurse managers to take appropriate measures. A cross-sectional survey study was used to obtain a sample of 169 registered nursing assistants and 74 registered nurses working in three public hospitals in Slovenia, from which data was obtained using the McCloskey-Mueller Satisfaction Scale. Dimensionality was tested using exploratory factor analysis. A seven-factor structure of 29 items was obtained, which accounted for 54.3% of the total variance in job satisfaction, and was internally consistent (Cronbach's alpha coefficient of the instrument was 0.78). The first factor 'Satisfaction with Interaction Opportunities', which is a component of the social rewards dimension in the McCloskey-Mueller Satisfaction Scale, explained 30.6% of the variation. The registered nursing assistants' job dissatisfaction was higher than that of the registered nurses. Both were mostly dissatisfied with professional opportunities. Using the factor analysis, a seven-factor structure was found instead of the originally introduced eight-factor model, which suggests a need for further redevelopment of the McCloskey-Mueller Satisfaction Scale. The results suggest that operational management needs to revitalize the work environment by ensuring proactive leadership and allowing participation in the decision-making process, while health-care organisations need to support the professional development of registered nursing assistants and registered nurses in order to achieve sustainable effects
Vaismoradi, Mojtaba; Salsali, Mahvash; Ahmadi, Fazlollah
The purpose of the present study was to explore the perspectives of Iranian male nursing students regarding the role of nursing education in developing a professional identity. A qualitative design, based on the content analysis approach, was used to collect the data and analyze the perspectives of 14 Iranian male nursing students who were chosen by using a purposive sampling strategy. After the selection of the participants, semistructured interviews were held in order to collect the data. During the data analysis, three main themes emerged: "reality-expectation incompatibility", "being supported by the educational system", and "nursing image rectification". The second theme consisted of two categories: "feeling trusted" and "being defended". This study will be useful to nurse educators and administrators in relation to what constitutes nursing students' professional identity within the Iranian culture and context and how nursing education can play an effective role in developing their professional identity in order to devise strategies to attract male students to the nursing profession and promote their retention after graduation. © 2010 The Authors. Japan Journal of Nursing Science © 2010 Japan Academy of Nursing Science.
Soroush, Ali; Shamsi, Mohammadbagher; Izadi, Neda; Heydarpour, Behzad; Samadzadeh, Soheila; Shahmohammadi, Afshar
Considering the importance of musculoskeletal disorders (MSDs) as one of the health consequences of job stress among nurses and significant contradictions in prevalence in different parts of the body, this study was carried out to determine the prevalence of MSDs among Iranian nurses. All published studies from June 2000 until June 2015 were considered in reliable databases such as PubMed, Google Scholar, Google search, Scopus, ScienceDirect, and Persian databases such as SID, Iran Medex, and Magiran. These studies, after quality control, were entered into meta-analysis using the random effects model, a total of 41 papers were assessed between 2004 and 2015. The prevalence rate of these disorders was 60.98%, 47.76%, 46.53%, 44.64%, 42.8%, 36.8%, 24.61%, and 17.5%, respectively, obtained for the back, neck, knees, upper back, ankles, shoulders, hands, hips, thighs, and elbows. Prevalence of MSDs will lead to high costs of medical, absenteeism from work, or even unemployment. Due to high prevalence of these disorders among Iranian nurses, providing effective training in the field of ergonomics and undergoing appropriate exercises are necessary to control it.
Babamohamadi, Hassan; Ahmadpanah, Mahsa-Sadat; Ghorbani, Raheb
Addressing spiritual needs is taken into account as an integral part of holistic health care and also an important component of nursing practice. The aim of present study is to evaluate attitudes toward spirituality and spiritual care among nurses and nursing students at Semnan University of Medical Sciences in Iran. In this cross-sectional study, all nurses (n = 180) working in the teaching hospitals affiliated to Semnan University of Medical Sciences as well as senior nursing students (n = 50) selected by the census method. Finally, 168 individuals meeting the inclusion criteria were evaluated as the study sample. The data collection instrument was the Spirituality and Spiritual Care Rating Scale. The mean and standard deviation scores of attitudes toward spirituality and spiritual care among nurses and nursing students were 59 ± 10.9, and the scores obtained by the majority of study population (64.3%) ranged between 32 and 62 which were at a moderate and relatively desirable level. Nurses and nursing students working in aforementioned hospitals reported positive attitudes to spirituality and spiritual care. Given the importance of spiritual care and also the moderate level of spirituality and spiritual care among nurses and nursing students in this study, institutionalization of the concept of spirituality, provision of an appropriate context to deliver such care, and also implementation of interventions in order to improve spiritual care along with other nursing skills were assumed of utmost importance.
Amini, Kourosh; Negarandeh, Reza; Ramezani-Badr, Farhad; Moosaeifard, Mahdi; Fallah, Ramezan
This study aimed to determine the autonomy level of nurses in hospitals affiliated to Zanjan University of Medical Sciences, Iran. In this descriptive cross-sectional study, 252 subjects were recruited using systematic random sampling method. The data were collected using questionnaire including Dempster Practice Behavior Scale. For data analysis, descriptive statistics and to compare the overall score and its subscales according to the demographic variables, t-test and analysis of variance test were used. The nurses in this study had medium professional autonomy. Statistical tests showed significant differences in the research sample according to age, gender, work experience, working position and place of work. The results of this study revealed that most of the nurses who participated in the study compared with western societies have lower professional autonomy. More studies are needed to determine the factors related to this difference and how we can promote Iranian nurses' autonomy. © 2013 Wiley Publishing Asia Pty Ltd.
Sadeghifar, Jamil; Tofighi, Shahram; Roshani, Mohamad; Toulideh, Zahra; Mohsenpour, Seyedramezan; Jafari, Mehdi
To assess the implementation and evaluation phases of strategic plans in selected hospitals. We conducted a cross-sectional study of implementation and evaluation of strategic plan in 24 hospitals in 2015, using a questionnaire which consisted of two separate sections for strategic implementation and strategic evaluation. Data were analyzed with SPSS version 18. Nearly one-third of hospitals claimed that they allocate their budget based on priorities and strategic goals. However, it turned out that although goals had been set, no formal announcements had been made. Most of the hospitals stated that they used measures when evaluating the plan. For hospital staff, clarifying the hospital's priorities was the most important advantage of a strategic plan. There is no clear definition for strategic management in Iranian hospitals, which results in chaotic implementation and control of strategic planning.
Full Text Available Abstract Background College students are prone to stress due to the transitional nature of college life. High levels of stress are believed to affect students' health and academic functions. If the stress is not dealt with effectively, feelings of loneliness, nervousness, sleeplessness and worrying may result. Effective coping strategies facilitate the return to a balanced state, reducing the negative effects of stress. Methods This descriptive cross-sectional study was performed to determine sources of stress and coping strategies in nursing students studying at the Iran Faculty of Nursing & Midwifery. All undergraduate nursing students enrolled in years 1-4 during academic year 2004-2005 were included in this study, with a total of 366 questionnaires fully completed by the students. The Student Stress Survey and the Adolescent Coping Orientation for Problem Experiences Inventory (ACOPE were used for data collection. Results Most students reported "finding new friends" (76.2%, "working with people they did not know" (63.4% as interpersonal sources of stress, "new responsibilities" (72.1%, "started college" (65.8% as intrapersonal sources of stress more than others. The most frequent academic source of stress was "increased class workload" (66.9% and the most frequent environmental sources of stress were being "placed in unfamiliar situations" (64.2% and "waiting in long lines" (60.4%. Interpersonal and environmental sources of stress were reported more frequently than intrapersonal and academic sources. Mean interpersonal (P=0.04 and environmental (P=0.04 sources of stress were significantly greater in first year than in fourth year students. Among coping strategies in 12 areas, the family problem solving strategies, "trying to reason with parents and compromise" (73% and "going along with family rules" (68% were used "often or always" by most students. To cope with engaging in demanding activity, students often or always used "trying to figure
Pouralizadeh, Moluk; Khankeh, Hamidreza; Ebadi, Abbas; Dalvandi, Asghar
Clinical judgment is necessary for clinical decision making and enhancing it in nursing students improves health care quality. Since clinical judgment is an interactive phenomenon and dependent on context and culture, it can be affected by many different factors. To understand the experiences of Iranian nursing students and teachers about the factors influencing nursing students' clinical judgment. A qualitative study was conducted using a directed content analysis approach. In this study, purposive sampling and semi-structured interviews were applied with seven nursing students, six faculty member teachers and four clinical instructors from Guilan University of Medical Sciences, Gilan, Iran. The factors influencing nursing students' clinical judgment consisted of five main categories including thoughtful behaviour, professional ethics, use of evidence based care, the context of learning environment and individual and professional features of clinical teachers. Relying on the results of this research, teachers can create an appropriate educational condition and a safe psychological atmosphere, use instructional strategies strengthening deep thought processes, applying professional ethics and scientific evidence and principles to establish clinical judgment in nursing students.
Rafii, Forough; Nasrabadi, Alireza Nikbakht; Forooshani, Zahra Sadat Dibaji
The professional satisfaction of staff is one of the most challenging organizational concepts that can enhance the efficiency level of organizations. In a similar vein, the professional satisfaction of nurses is of considerable importance, in that, professional dissatisfaction among nurses could result in emotional detachment, depression, anger, evasion from work, and inefficacy and would negatively impact the organization's work rate. The aim of this study was to understand Iranian nurses' experiences of the concept of professional satisfaction. This was a qualitative study conducted with a targeted sampling of 10 nurses (4 men and 6 women) in 2015. The data were collected through conducting in-depth interviews, and textual data were analyzed subsequently using the Qualitative Content Analysis (QCA) method. The findings of this study pointed to "fair conduct," which was comprised of three sub-categories, i.e., expectation of fairness in social-professional settings, expectation of fairness in receiving professional benefits, and expectation of fairness in the area of professional interactions. There are various ups and downs in nursing due to the challenging nature of the profession, from the initial education at the university until retirement. According to the findings of this study, a lack of fairness in social-professional settings, a lack of fairness in receiving professional benefits, and a lack of fairness in the area of professional interactions were among the factors that have great impacts on the degree of professional dissatisfaction among nurses.
Full Text Available Context: Kangaroo Mother Care (KMC is a supportive technique that beings at the neonatal period and is one of the skin-to-skin contact methods of holding neonate by mother. This method has an important role in exclusive breastfeeding and thermal care of neonates. This study aimed to investigate the application of KMC and evaluate the effect of this technique in different neonatal outcomes, particularly in Iranian neonates. Moreover, this review can be a tool for formative evaluation for this newly introduced treatment intervention in Iran. Evidence Acquisition: This review was conducted in national and international databases concerning experience with KMC on term and preterm neonates admitted in Iranian hospitals from 2006 to 2014. The measured outcomes included physiologic, psychologic, and clinical effects of this practice on newborn infants. Results: In this study, 42 Persian and English language papers were reviewed and finally 26 articles were selected. Various effects of KMC on different factors such as analgesia; physiological effects, breastfeeding, icterus, length of hospitalization, infection, psychologic effects, and weight gain were found. Conclusions: The results showed that as a simple and suitable strategy for increasing the health status of the mothers and newborns, KMC had an important role in improvement of neonatal outcomes in neonatal wards of Iranian hospitals in recent ten years. Therefore, promoting this technique in all neonatal wards of the country can promote health status of this population.
Full Text Available Background: There has been conflicting data on whether Nursing Magnet Hospitals (NMH provide better care. Methods: NMH in the Southwest USA (Arizona, California, Colorado, Hawaii, Nevada, and New Mexico were compared to hospitals not designated as NMH using the Centers for Medicare and Medicaid (CMS hospital compare star designation. Results: NMH had higher star ratings than non-NMH hospitals (3.34 + 0.78 vs. 2.86 + 0.83, p<0.001. The hospitals were mostly large, urban non-critical access hospitals. Academic medical centers made up a disproportionately large portion of the NMH. Conclusions: Although NMH had higher hospital ratings, the data may favor non-critical access academic medical centers which are known to have better outcomes.
Full Text Available In the past three decades, organizational commitment has been of interest to researchers as one of the organizational attitudes. The aim of this study was to investigate the relationship of emotional intelligence and personality traits with organizational commitment among Iranian nurses. A total of 280 nurses were selected by multistage random sampling. Study tools included emotional intelligence inventory, Neo personality inventory and organizational commitment inventory. Results showed the positive and significant relationship of emotional intelligence and its dimensions (self-expression, self-regard, independence, social responsibility, problem solving, stress tolerance, impulse control, and optimism with organizational commitment. Also, organizational commitment showed a positive and significant relationship with extroversion and conscientiousness. Moreover, components of self-expression, problem solving and stress tolerance in emotional intelligence are able to predict organizational commitment. Thus, these results indicate the importance of emotional intelligence and personality traits in organizational commitment.
SEYED ALI ENJOO
Full Text Available Introduction: The application of organizational ethics in hospitals is one of the novel ways to improve medical ethics. Nowadays achieving efficient and sufficient ethical hospital indicators seems to be inevitable. In this connection, the present study aims to determine the best indicators in hospital accreditation. Methods: 69 indicators in 11 fields to evaluate hospital ethics were achieved through a five-step qualitative and quantitative study including literature review, expert focus group, Likert scale survey, 3 rounded Delphi, and content validity measurement. Expert focus group meeting was conducted, employing Nominal Group Technique (NGT. After running NGT, a three rounded Delphi and parallel to Delphi and a Likert scale survey were performed to obtain objective indicators for each domain. The experts were all healthcare professionals who were also medical ethics researchers, teachers, or Ph.D students. Content validity measurements were computed, using the viewpoints of two different expert groups, some ethicists, and some health care professionals (n=46. Results: After conducting NGT, Delphi, Likert survey, 11 main domains were listed including: Informed consent, Medical confidentiality, Physician-patient economic relations, Ethics consultation policy in the hospital, Ethical charter of hospital, Breaking bad medical news protocol, Respect for the patients’ rights, Clinical ethics committee, Spiritual and palliative care unit programs in the hospitals, Healthcare professionals’ communication skills, and Equitable access to the healthcare. Also 71 objective indicators for these 11 domains were listed in 11 tables with 5 to 8 indicators per table. Content Validity Ratio (CVR measurements were done and 69 indicators were highlighted. Conclusion: The domains listed in this study seem to be the most important ones for evaluating hospital ethics programs and services. Healthcare organizations’ accreditation and ranking are crucial for
Zarei, Asghar; Arab, Mohammad; Froushani, Abbas Rahimi; Rashidian, Arash; Ghazi Tabatabaei, S Mahmoud
Highly competitive market in the private hospital industry has caused increasing pressure on them to provide services with higher quality. The aim of this study was to determine the different dimensions of the service quality in the private hospitals of Iran and evaluating the service quality from the patients' perspective. A cross-sectional study was conducted between October and November 2010 in Tehran, Iran. The study sample was composed of 983 patients randomly selected from 8 private general hospitals. The study questionnaire was the SERVQUAL questionnaire, consisting of 21 items in service quality dimensions. The result of factor analysis revealed 3 factors, explaining 69% of the total variance. The total mean score of patients' expectation and perception was 4.91(SD = 0.2) and 4.02(SD = 0.6), respectively. The highest expectation and perception related to the tangibles dimension and the lowest expectation and perception related to the empathy dimension. The differences between perception and expectation were significant (p SERVQUAL is a valid, reliable, and flexible instrument to monitor and measure the quality of the services in private hospitals of Iran. Our findings clarified the importance of creating a strong relationship between patients and the hospital practitioners/personnel and the need for hospital staff to be responsive, credible, and empathetic when dealing with patients.
Nurses frequently care for patients who have stomas. A common complication is sore peristomal skin (skin around the stoma). The study aim was to answer the research question: what is the current nursing practice for peristomal skin problems among UK stoma specialist nurses? The question was explored through investigation of descriptions, treatments and opinions of peristomal skin problems. Results were examined to ascertain if practice reflects the literature and if care was evidence-based. A questionnaire was posted in September 2009 to the stoma care nurses in all UK NHS hospitals (n=596). The proportion of completed or partially completed questionnaires was 15% (89 of 596). Most of the responding nurses held a stoma-related qualification (86%), a degree (55%) and had specialised in stoma care for over 5 years (67%). Respondents used erythema to describe sore skin (80%). Stoma powder (98%) and convex appliances (98%) were the most commonly used treatments. The most common cause of sore skin was appliance leakage (61%). The study population was deemed suitably qualified and experienced to answer the research question. Many responses were reflected in the literature (predominantly opinion articles), reflecting a degree of reliability and validity. It could be concluded that stoma specialist nurses can accurately assess and use stoma accessories to treat sore skin, but due to the paucity of research, the care cannot be defined as evidence-based. More research is needed to determine universally accepted definitions and treatments for sore peristomal skin.
Snelson, Donna Ayers
Today the multidimensional global shortage of nurses is negatively impacting the work environment of hospital nurses and causing, in a cyclical fashion, decreasing work satisfaction, increasing nurse turnover, and decreasing patient outcomes. While strategies aimed at causation of the nursing shortage must be addressed, to support nursing until…
Zeynab Sedoughi; Masoumeh Sadeghi; Sedigheh Khodabaneh Shahraki; Seyed Hossein Saberi Anari; Mohammadreza Amiresmaili
Background: Work and family are the source of tranquility and if the balance between these two is not provided, pleasure, happiness and peace of human being would be lost, which will cause unreturnable loss for him. Regarding the importance of nurses’ role in health system, the present study aimed to study the relation of work-family balance and quality of life of nurses working at selected Iranian teaching hospitals. Methods: Present study is a cross sectional, descriptive-analytical study w...
Maroufi, Sh Sadigh; Gharavi, Mj; Behnam, M; Samadikuchaksaraei, A
Nitrous oxide (N(2)O) is the oldest anesthetic in routine clinical use and its occupational exposure is under regulation by many countries. As studies are lacking to demonstrate the status of nitrous oxide levels in operating and recovery rooms of Iranian hospitals, we aimed to study its level in teaching hospitals of Tehran University of Medical Sciences. During a 6-month period, we have measured the shift-long time weighted average concentration of N(2)O in 43 operating and 12 recovery rooms of teaching hospitals of Tehran University of Medical Sciences. The results show that the level of nitrous oxide in all hospitals is higher than the limits set by different countries and anesthetists are at higher risk of exposure. In addition, it was shown that installation of air ventilation could reduce not only the overall exposure level, but also the level of exposure of anesthetists in comparison with other personnel. The high nitrous oxide level in Iranian hospitals necessitates improvement of waste gas evacuation systems and regular monitoring to bring the concentration of this gas into the safe level.
Rogers, Bonnie; Buckheit, Kathleen; Ostendorf, Judith
This study describes workplace conditions, the environment, and activities that may contribute to musculoskeletal injuries among nurses, as well as identifies solutions to decrease these risks and improve work-related conditions. The study used a mixed-methods design. Participants included nurses and stakeholders from five hospitals. Several focus groups were held with nurses, walk-throughs of clinical units were conducted, and stakeholder interviews with key occupational health and safety personnel were conducted in each of the five hospitals, as well as with representatives from the American Nurses Association, Veterans Health Administration hospital, and National Institute for Occupational Safety and Health. Several key contributing factors, including the physical environment (e.g., layout and organization of work stations), work organization and culture (e.g., heavy workload, inadequate staffing, lack of education), and work activities (e.g., manual lifting of patients, lack of assistive devices), were identified. Recommendations included the need for a multifaceted and comprehensive approach to developing a sound ergonomics program. Copyright 2013, SLACK Incorporated.
Abdolrahimi, Mahbobeh; Ghiyasvandian, Shahrzad; Zakerimoghadam, Masoumeh; Ebadi, Abbas
Background: Health communication (HC) is considered an important task of nurses to provide high quality and holistic care as well as to improve patient health. The nursing student–patient HC is an abstract concept and needs to be clarified. Therefore, this study was conducted to increase the knowledge about nursing students' HC with patients by considering various participants' viewpoints. Materials and Methods: In this conventional qualitative content analysis, 18 semi-structured interviews were conducted with six nursing students, six nursing instructors, and six patients in educational hospitals affiliated to the University of Medical Sciences. Credibility, confirmability, dependability, and transferability were established to validate the trustworthiness of the data. The process of data collection and analysis lasted 9 months. Results: After data analysis, two categories were generated: (A) “junior nursing student–patient communication,” with two subcategories of “performing social communication with patients” and “failure to build therapeutic relationships with patients,” and (B) “senior nursing student–patient communication” with two subcategories of “establishing effective communication with patients” and “performing one-way communication with patients.” Conclusions: More attention should be paid to improve HC through shifting towards student-centered approaches in nursing curriculum. Further, role model nurses and clinical educators should guide nursing students for institutionalizing HC in future nurses. PMID:29628962
Full Text Available Background: Health communication (HC is considered an important task of nurses to provide high quality and holistic care as well as to improve patient health. The nursing student–patient HC is an abstract concept and needs to be clarified. Therefore, this study was conducted to increase the knowledge about nursing students' HC with patients by considering various participants' viewpoints. Materials and Methods: In this conventional qualitative content analysis, 18 semi-structured interviews were conducted with six nursing students, six nursing instructors, and six patients in educational hospitals affiliated to the University of Medical Sciences. Credibility, confirmability, dependability, and transferability were established to validate the trustworthiness of the data. The process of data collection and analysis lasted 9 months. Results: After data analysis, two categories were generated: (A “junior nursing student–patient communication,” with two subcategories of “performing social communication with patients” and “failure to build therapeutic relationships with patients,” and (B “senior nursing student–patient communication” with two subcategories of “establishing effective communication with patients” and “performing one-way communication with patients.” Conclusions: More attention should be paid to improve HC through shifting towards student-centered approaches in nursing curriculum. Further, role model nurses and clinical educators should guide nursing students for institutionalizing HC in future nurses.
Abdolrahimi, Mahbobeh; Ghiyasvandian, Shahrzad; Zakerimoghadam, Masoumeh; Ebadi, Abbas
Health communication (HC) is considered an important task of nurses to provide high quality and holistic care as well as to improve patient health. The nursing student-patient HC is an abstract concept and needs to be clarified. Therefore, this study was conducted to increase the knowledge about nursing students' HC with patients by considering various participants' viewpoints. In this conventional qualitative content analysis, 18 semi-structured interviews were conducted with six nursing students, six nursing instructors, and six patients in educational hospitals affiliated to the University of Medical Sciences. Credibility, confirmability, dependability, and transferability were established to validate the trustworthiness of the data. The process of data collection and analysis lasted 9 months. After data analysis, two categories were generated: (A) "junior nursing student-patient communication," with two subcategories of "performing social communication with patients" and "failure to build therapeutic relationships with patients," and (B) "senior nursing student-patient communication" with two subcategories of "establishing effective communication with patients" and "performing one-way communication with patients." More attention should be paid to improve HC through shifting towards student-centered approaches in nursing curriculum. Further, role model nurses and clinical educators should guide nursing students for institutionalizing HC in future nurses.
Vânea Lúcia dos Santos Silva
Full Text Available Abstract OBJECTIVE 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. METHOD 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. RESULTS 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. Conclusion 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.
Full Text Available Because unpleasant hospital odors affect the nursing environment, we investigated nurses' perceptions of the odors of various hospital settings: hospital rooms, nurse stations, and human waste disposal rooms to discard the urine, stools and diapers. A questionnaire based on the Japanese Ministry of the Environment's guidelines on odor index regulation was used to assess nurses' perceptions of odor intensity, comfort, tolerability, and description in the aforementioned settings. Questionnaires were distributed to nursing department directors at three Japanese hospitals, who then disseminated the questionnaires to nursing staff. Of the 1,151 questionnaires distributed, 496 nurses participated. Human waste disposal rooms had greater odor intensity and were perceived as more uncomfortable than the other settings. Unpleasant odors in disposal rooms, hospital rooms, and nurse stations were rated as slightly intolerable in comparison. Hospital and disposal rooms were mainly described as having a “pungent odor such as of urine and stool.” In contrast, nurse stations were described as having other unpleasant odors, such as chemical, human-body-related, or sewage-like odors. Given that nurses spend much of their time in hospital rooms and nurse stations, odor management in these two settings would likely improve nurses' working conditions at hospitals. Improving odors at nurse stations is feasible. Such improvements could have indirect effects on nurse turnover and burnout.
Miyahira, Akiko; Tada, Kazuko; Ishima, Masatoshi; Nagao, Hidenori; Miyamoto, Tadashi; Nakagawa, Yoshiaki; Takemura, Tadamasa
Hospital administration is very important and many hospitals carry out activity-based costing under comprehensive medicine. However, nursing cost is unclear, because nursing practice is expanding both quantitatively and qualitatively and it is difficult to grasp all nursing practices, and nursing cost is calculated in many cases comprehensively. On the other hand, a nursing information system (NIS) is implemented in many hospitals in Japan and we are beginning to get nursing practical data. In this paper, we propose a nursing cost accounting model and we simulate a cost by nursing contribution using NIS data.
Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S.
Background: Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods: A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results: The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability (92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external auditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood bank services (83%) reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%). There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals than in governmental hospitals. Conclusion: There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits) can be improved. Both the effectiveness of QA
Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S
Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability (92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external auditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood bank services (83%) reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%). There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals than in governmental hospitals. There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits) can be improved. Both the effectiveness of QA strategies in practice, and the application of
Asgar Aghaei Hashjin
Full Text Available Background Iran has a widespread diagnostics and clinical support services (DCSS network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%, pharmacopoeia availability (92%, equipment calibration (87% and identifying responsibilities (86%. Least reported was external auditing of the DCSS (57%. The clinical chemistry and microbiology laboratories (84%, pharmacies, blood bank services (83% reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%. There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO and private-for-profit hospitals than in governmental hospitals. Conclusion There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits can be improved. Both the effectiveness of QA
Amir Reza Salehmoghaddam
Full Text Available Background: Revising the medical education programs to meet the needs of society has become both a necessity and an important priority due to the considerable increase of population, changing patterns of diseases, and new health priorities. While this necessity has been highlighted in Iran’s Fifth Development Plan as well as its National 2025 Vision Plan, the determinants of social accountability have not been explained yet. This study aimed to develop determinants of social accountability in the Iranian Nursing and Midwifery Schools. Methods: This classic Delphi study included thirty experts in Nursing and Midwifery Education, Research and Services selected based on purposive sampling and three rounds of Delphi technique and conducted in Nursing and Midwifery School of Mashhad University of Medical Sciences. The primary data were collected using an initial structured questionnaire prepared through extensive review of literature. SPSS 11.5 software was used to analyze the data. The interquartile deviation and percentage of agreement were also used to study the consensus of opinion by experts. Results: Finding obtained from the rounds of Delphi resulted in selecting 69 determinants out of the initial pool of 128 primary determinants of social accountability. The items were selected based on experts’ consensus and categorized under three main activities of Nursing and Midwifery School, namely education, research, and service. Conclusion: Social accountability determinants were explained by 69 items for Schools of Nursing and Midwifery in Iran. The proposed determinants can be used by managers and authorities of Nursing and Midwifery School, policy makers, and evaluating institutions associated with them to ensure realizing social accountability goals.
This qualitative study explores how Catholicism influenced nursing in Catholic hospitals and how nurses met the religious needs of Catholic patients in the 1950s and early 1960s. Six nurses were interviewed who graduated from Catholic schools of nursing between 1952 and 1965 and worked in Catholic hospitals. Results indicate that nursing care was inexorably entwined with meeting the religious needs of Catholic patients. Religious practices were predictable and largely linked to the Holy Sacraments.
Bahreini, Masoud; Moattari, Marzieh; Shahamat, Shohreh; Dobaradaran, Sina; Ravanipour, Mariam
The aim of the study was to determine the effect of a portfolio-based professional development program on nurses' competence in a university hospital in Iran. A pre-test/post-test, controlled, quasi-experimental design was used. From the university hospital's 18 general wards, four wards were randomly selected. Two wards were randomly allocated as the experimental group (35 subjects) and two wards as the control group (38 subjects). Nurses in the experimental group participated in a 12-month portfolio-based professional development program and nurses in the control group participated in the routine professional development programs of their wards. The data were collected by the Nurse Competence Scale and were analyzed using descriptive statistics and independent and paired t-tests. After intervention, the average nurses' competence in the experimental group increased significantly (P professional portfolio is an effective tool for improving nurses' competence. The professional portfolios help nurses update their knowledge, skills, and competence towards their full role as nurses. © 2012 Wiley Publishing Asia Pty Ltd.
Tarciane da Silva Monteiro
Full Text Available Background and Objective: The hospital-acquired infection (HAI is defined as a serious public health problem, resulting in increased morbidity and mortality. The role of nursing staff on this issue is essential in ensuring solving and quality care, minimizing damages that may arise as a result of the care offered to patients. From this discussion, this study aimed to understand the vision of the nursing team professionals about HAI. Method: This is a qualitative, descriptive study. The data collection was performed using a semi-structured interview. We used the Bardin Content Analysis. Results: The categories that emerged were: Definition of HAI; Implemented prevention measures; Difficulties in controlling the HAI, and coping strategies. The study found a clear understanding of what is a HAI for nurses, however, for practical nurses that understanding appeared wrongly. Hand washing and the use of PPE were the main measures mentioned in prevention. The low uptake of the above measures and the problems of working in teams were listed challenges. Conclusion: Therefore, lifelong learning is an important instrument to promote changes in practice. It is essential that HIC act with professionals raising their awareness about the importance of play in the prevention and control of potential complications, ensuring the safety and quality of care directed to the patient. KEYWORDS: Cross Infection. Nursing. Qualitative research.
Buerhaus, Peter I
The imposition of mandatory hospital nurse staffing ratios is among the more visible public policy initiatives affecting the nursing profession. Although the practice is intended to address problems in hospital nurse staffing and quality of patient care, this commentary argues that staffing ratios will lead to negative consequences for nurses involving the equity, efficiency, and costs of producing nursing care in hospitals. Rather than spend time and effort attempting to regulate nurse staffing, this commentary offers alternatives strategies that are directed at fixing the problems that motivate the advocates of staffing ratios.
The paper presents findings from a study examining violence in nursing. A combined ethno-phenomenology was identified as the most appropriate approach. Ethnography is to understand the culture of nursing that permits violence to occur within the profession. Phenomenology is to explore and capture nurse-on-nurse experiences of violence. The population is all nurses registered with the South African Nursing Council. The research participants are nurses employed in eight public hospitals in Cape Town during 2005. METHOD OF DATA COLLECTION: The first stage of data collection was the distributions of confidential questionnaires to nurses employed in eight hospitals and willing to participate in the study. Responses to close-ended questions were analyzed using Microsoft Excel. Responses to open-ended questions were grouped per question. The qualitative data were then compared for similarities and differences in information provided. Six levels of violence exist among nurses. The highest forms of violence among nurses occurred at the psychological level, with the least at the physical level of interaction. The other four levels of violence among nurses were vertical, horizontal, covert, and overt. All categories of nurses in the study had resorted to one or more levels of violence against other nurses during their nursing career. Professional nurses and senior nurse managers were identified as the main category of nurses that frequently resort to mistreating other nurses. However, auxiliary nurses were identified as the main perpetrators of physical violence against other nurses.
Vanaki, Zohreh; Vagharseyyedin, Seyyed Abolfazl
Employee commitment to the organization is a crucial issue in today's health-care market. In Iran, few studies have sought to evaluate the factors that contribute to forms of commitment. The aim of this study was to investigate the relationship between nurses' organizational commitment, work environment conditions, and life satisfaction. A cross-sectional design was utilized. Questionnaires were distributed to all the staff nurses who had permanent employment (with at least 2 years of experience in nursing) in the five hospitals affiliated to Birjand Medical Sciences University. Two hundred and fifty participants returned completed questionnaires. Most were female and married. The correlation of the total scores of nurses' affective organizational commitment and work environment conditions indicated a significant and positive relationship. Also, a statistically significant relationship was found between affective organizational commitment and life satisfaction. The implementation of a comprehensive program to improve the work conditions and life satisfaction of nurses could enhance their organizational commitment.
Full Text Available Background: program evaluation is an integral and expected component in the development of any healthcare program. It helps decision-makers to base their decisions on facts. Objective: This paper analyzes the effect of accreditation on three indicators related to patient safety and hospital care quality in ICU wards of an Iranian teaching hospital. Methods: This interventional study was accomplished based on executive management and scientific methods such as plan-do-check-act (PDCA cycle and audit to improve quality and safety. We used data reported from ICU wards of the hospital to analyze the effect of accreditation on the three selected indicators. (SPSS version 22.00 was used for the statistical analysis. Results: In total, 6997 patients were analyzed. The accreditation interventions appeared to be effective at reducing pressure ulcer incidence average (from an average of 6.8 percent to 4.1 percent (p=0.045. The accreditation also. The average stay of the patients during the study also positively changed from an average of 1.58 days to 10.13 days (1.45 improvements(p=0.0303. In relation to hospital acquired infection but, unexpectedly, its effect on hospital was negative, then it considerably increased and rose from 1.5 percent to 8.1 percent (p=0.001. However this increasing was due to enhanced infection incident report system. Conclusion: hospital accreditation has presented ample opportunity a significant positive effect on hospitals.
Maboko, D R
This study was aimed at describing nursing leadership in an academic hospital in Gauteng, South Africa. Nurse managers' leadership styles affect nurses' attitudes, behaviour and work performance. However, little is known about how nurses experience nurse leadership and what leadership styles are found in academic hospitals in Gauteng. The study was based on Maxwell's framework of leadership (relationships, equipping, leadership and attitude). A qualitative design was used in order to describe the experiences of registered nurses and nurse managers. The population of the study was all registered nurses and nurse managers of the hospital in which the study was conducted. In phase one of the study, a discussion group with 35 registered nurses using the nominal group technique was held to respond to the following statement: 'Please explain how you have experienced leadership by nurse managers in this hospital'. In phase two of the study, five nurse managers were interviewed individually, using a semi-structured interview guide. Some nurse managers were practising autocratic leadership in this hospital. he nurse managers need to be taught about contemporary leadership styles such as transformational leadership and visionary leadership and also about supervision, role modelling and caring. © 2011 Blackwell Publishing Ltd.
Mahnaz Shoghi, MSN
Conclusion: The findings showed a noticeable trend of a rising number of assaults against nurses. The findings of this study may help hospital staff and nurses to avoid, reduce and control violence and abuse.
Jee-In Hwang, PhD
Conclusions: Teamwork was rated as moderate and was positively associated with nurses' error reporting performance. Hospital executives and nurse managers should make substantial efforts to enhance teamwork, which will contribute to encouraging the reporting of errors and improving patient safety.
Jahangir, Fridoon; Shokrpour, Nasrin
To measure the relationship between job satisfaction and the 3 components of organizational commitment. Most of the research conducted in the West has shown a positive relationship between organizational commitment and job satisfaction of nurses; however, the relationship between the components of organizational commitment and job satisfaction is not well established in Iranian samples. This study aimed to investigate the level of organizational commitment and job satisfaction of the hospital nurses in Iran and the interrelationship between the 3 components of commitment and job satisfaction among them. Using the organizational commitment questionnaire developed by Meyer et al (J Appl Psychol. 1993;78:538-551), the 3 components of commitment were measured through a descriptive correlational design. Seven hundred eighty-six licensed nurses working in 12 hospitals participated in the study. One hundred ninety-eight of 220 returned questionnaires were identified as appropriate for the analysis. Affective commitment was positively related to job satisfaction, normative commitment, and experience in nursing, but it was negatively related to continuance commitment. Continuance commitment was negatively related to job satisfaction and affective commitment. Normative commitment was positively related to job satisfaction and affective commitment. The 3 components of commitment are variously related to job satisfaction. Nursing managers should pay attention to different components of commitment variously to promote the appropriate type of commitment needed for specific situation in which they work.
Hope, A; Kelleher, C C; O'Connor, M
Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.
Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends\\/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern\\/worry in caring for AIDS patients than qualified nurses.
Abdollahi, Abbas; Talib, Mansor Abu; Yaacob, Siti Nor; Ismail, Zanariah
Nursing is a stressful occupation, even when compared with other health professions; therefore, it is necessary to advance our knowledge about the protective factors that can help reduce stress among nurses. The present study sought to investigate the associations among problem-solving skills and hardiness with perceived stress in nurses. The participants, 252 nurses from six private hospitals in Tehran, completed the Personal Views Survey, the Perceived Stress Scale, and the Problem-Solving Inventory. Structural Equation Modeling (SEM) was used to analyse the data and answer the research hypotheses. As expected, greater hardiness was associated with low levels of perceived stress, and nurses low in perceived stress were more likely to be considered approachable, have a style that relied on their own sense of internal personal control, and demonstrate effective problem-solving confidence. These findings reinforce the importance of hardiness and problem-solving skills as protective factors against perceived stress among nurses, and could be important in training future nurses so that hardiness ability and problem-solving skills can be imparted, allowing nurses to have more ability to control their perceived stress.
Emamzadeh Ghasemi, Hormat Sadat; Rafii, Forough; Farahani, Mansoureh A; Mohammadi, Nooreddin
It is imperative to understand the factor that influence teaching competency. Therefore, it is necessary to study those that have an impact on the process of acquiring teaching competency. Competent nurse teachers have an important role in the achievement of nursing students and improving the quality of nursing education. However, few researches have focused specifically on the process of acquiring teaching competency in nurse teachers and its related factors. This study as a part of more extensive research aims to explore the factors influencing acquisition of teaching competency by Iranian nurse teachers. Grounded theory was chosen as the method. Eleven teachers from three nursing schools in Tehran were recruited. Data was generated by semi structured interviews during May 2011 to March 2013 and was analyzed through using constant comparison. Three main categories were emerged including "individual characteristics" (spirituality, professional interest, ethical conducts, knowledge expansion and reflective practice), "organizational factors" (management of educational systems, solidarity culture, student characteristics) and "socio-cultural factors" (social situations, and public definition of nursing). Nurse teachers who deal peacefully with the nursing profession and colleagues are responsible and committed to acquiring teaching competency. A suitable organization in nursing educational systems that is structured and ordered also encourages a peaceful approach by nurse teachers.
Chen, Yongyi; Liu, Jingshi; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan
This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients' expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient satisfaction was significantly affected by quality perception and patient expectation. Patient satisfaction and patient loyalty was also affected by disease pressure. Hospital brand was positively correlated with patient satisfaction and patient loyalty, negatively correlated with patient complaint. Patient satisfaction was positively correlated with patient loyalty, patient complaints, and quality perception, and negatively correlated with disease pressure and patient expectation. The satisfaction model on nursing service in hospitalized tumor patients fits well. By this model, the quality of hospital nursing care may be improved.
Full Text Available Introduction: The nursing profession in South Africa has lost skilled nurses due to intense international recruitment drives. The public hospital in this study has also failed to recruit and retain skilled nurses. The shortage of skilled nurses has led to deterioration in patient nursing care. The aim of this study: The aim of this study was to describe the level of job satisfaction among nurses in a public hospital. The methodology: A quantitative, descriptive survey was conducted. The data were collected using the Minnesota Satisfaction Questionnaire. The sample included nurses working in a specific public hospital. Results: Generally all the nurses experienced low satisfaction (42% with the motivational aspects of their job, such as motivation, responsibility, opportunity for creativity and innovation, independence, and recognition. Nurses also experienced very low levels of satisfaction (22% with the hygiene aspects of their job, namely, relationships in the workplace, supervisors’ decision-making skills, supervision, working conditions, policies, job security, and salaries. Conclusions: Health services need to be made aware of the high level of dissatisfaction of nurses. The hospital struggles to keep nurses in their posts, and could benefit from taking note of the results of this study. The findings indicate some of the aspects which need to be considered in a human resource planning strategy for nurses. The hospital and nursing management needs to rethink nurses’ salaries, supervision methods and relationships, and also how the Department of Health policies are implemented.
M.Cur. It is explicit that the change in the South African government since 1994 accompanied by the transformation of nursing services with its new policies and practices is inevitable, and poses challenges for the nursing service managers in Gauteng hospitals. The transformation of nursing services can be a difficult process creating a period of fear, uncertainty, stress and role ambiguity for the nursing service managers. The transformation has been so extensive that the nursing service ...
Ida Torunn Bjørk; Glenys A. Hamilton
This study analyzed nurses' perceptions of clinical decision making (CDM) in their clinical practice and compared differences in decision making related to nurse demographic and contextual variables. A cross-sectional survey was carried out with 2095 nurses in four hospitals in Norway. A 24-item Nursing Decision Making Instrument based on cognitive continuum theory was used to explore how nurses perceived their CDM when meeting an elective patient for the first time. Data were analyzed with d...
Melo, M R; Fávero, N; Trevizan, M A; Hayashida, M
The objective of the present study was to investigate hospital administrator's expectations about the administrative role played by nurses, utilizing functions proposed by the Neoclassical Theory of Administration: planning, organization, direction, and control as theoretical references. An instrument established in TREVIZAN (1989) was applied to 11 hospital administrators. The results showed they expect the four functions to be done by nurses. Therefore, the interaction between nurses and hospital administrators is critical to improve the patient's assistance.
Nurses are loyal to their patients and coworkers. They often put the needs of others before their own and sometimes even before the needs of their families. This concern for others can cause conflicts that manifest as stress. Of the more than 2 million nurses in the United States, more than 62% work in hospitals. Hospitals are known to be both rewarding and stressful places to work. Like most workers, nurses face the challenge of balancing demands and achievements of work with those in their private lives. Hospital leaders can facilitate improved work-life balance (WLB) for hospital nurses by using tools already in place. Equally important, nurses can use their knowledge and resources to nurse the nurse within, which can greatly improve their experience of WLB, independent of the demands of their work environment. © 2015 The Author(s).
Shang, Jingjing; You, Liming; Ma, Chenjuan; Altares, Danielle; Sloane, Douglas M; Aiken, Linda H
Ongoing economic and health system reforms in China have transformed nurse employment in Chinese hospitals. Employment of 'bianzhi' nurses, a type of position with state-guaranteed lifetime employment that has been customary since 1949, is decreasing while there is an increase in the contract-based nurse employment with limited job security and reduced benefits. The consequences of inequities between the two types of nurses in terms of wages and job-related benefits are unknown. This study examined current rates of contract-based nurse employment and the effects of the new nurse contract employment strategy on nurse and patient outcomes in Chinese hospitals. This cross-sectional study used geographically representative survey data collected from 2008 to 2010 from 181 hospitals in six provinces, two municipalities, and one autonomous region in China. Logistic regression models were used to estimate the association between contract-based nurse utilization, dissatisfaction among contract-based nurses, nurse intentions to leave their positions, and patient satisfaction, controlling for nurse, patient, and hospital characteristics. Hospital-level utilization of contract-based nurses varies greatly from 0 to 91%, with an average of 51%. Contract-based nurses were significantly more dissatisfied with their remuneration and benefits than 'bianzhi' nurses who have more job security (P benefits were more likely to intend to leave their current positions (P benefits among contract-based nurses were rated lower and less likely to be recommended by patients (P benefits between contract-based nurses and 'bianzhi' nurses may adversely affect both nurse and patient satisfaction in hospitals. Our study provides empirical support for the 'equal pay for equal work' policy emphasized by the China Ministry of Health's recent regulations, and calls for efforts in Chinese hospitals to eliminate the disparities between 'bianzhi' and contract-based nurses.
Pop, Rodica S
Nursing philosophy is the foundation of nurse practitioner (NP) training. However, NP practice is based on the medical care model. Thus, the necessity of mediating between these two approaches is often problematic for new NPs who are transitioning into their new roles. Mentoring has been used successfully to facilitate role transition and role understanding for nurses, NPs, and physicians. However, mentoring has been rarely studied in NPs. The purpose of this study was to develop a theory of mentoring for new NPs in a hospital setting. Grounded theory methodology was used. The sampling approach was initially purposive and was then shifted to theoretical to ensure the collection of meaningful data. Semistructuredinterviews were recorded and transcribed into Word documents for analysis. The three-phase analysis developed by Corbin and Strauss was initiated after the second interview. Sixteen participants (eight mentors and eight mentees) were interviewed between February and June 2011. The core category that emerged from the data was "defining self," and the main categories were forming the relationship, developing the relationship, and mentoring outcomes. A well-designed formal mentoring program may greatly improve the transition of NPs into a new role. The theory generated by the data from these study participants provides clearly defined categories that may be operationally defined and utilized to develop evaluation tools for mentoring programs.
Hamzehgardeshi, Zeinab; Shahhosseini, Zohreh
Continuing education is one of the modern strategies to maintain and elevate knowledge and professional skills of nurses which in turn elevate the health status of society. Since several factors affect nurses' participation in continuing education, it's essential to know promoters and obstacles in this issue and plan accordingly. In this cross-sectional study, 361 Iranian nurses who were recruited by convenience sampling method completed an anonymous, self-administered questionnaire from October 2012 to April 2013. Topics covered the participants' attitudes towards facilitators and barriers of their participation in continuing education. Mean and standard deviation of participants ' age were 37.14±7.58 years and 93.94% were female. The maximum score of facilitators and barriers to nurses' participation in continuing education were related to "Update my knowledge" and "Work commitments" respectively. The results showed among Iranian nurses, the mean score of personal and structural barriers was significantly higher than the mean score of interpersonal ones (F=2122.66, peducation programs by enforcement of facilitators and reducing barriers focusing on the personal and structural barriers.
Nantsupawat, Apiradee; Srisuphan, Wichit; Kunaviktikul, Wipada; Wichaikhum, Orn-Anong; Aungsuroch, Yupin; Aiken, Linda H
To determine the impact of nurse work environment and staffing on nurse outcomes, including job satisfaction and burnout, and on quality of nursing care. Secondary data analysis of the 2007 Thai Nurse Survey. The sample consisted of 5,247 nurses who provided direct care for patients across 39 public hospitals in Thailand. Multivariate logistic regression was used to estimate the impact of nurse work environment and staffing on nurse outcomes and quality of care. Nurses cared for an average of 10 patients each. Forty-one percent of nurses had a high burnout score as measured by the Maslach Burnout Inventory; 28% of nurses were dissatisfied with their job; and 27% rated quality of nursing care as fair or poor. At the hospital level, after controlling for nurse characteristics (age, years in unit), the addition of each patient to a nurse's workload was associated with a 2% increase in the odds on nurses reporting high emotional exhaustion (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.00-1.03; p work environments were about 30% less likely to report fair to poor care quality (OR 0.69; 95% CI 0.48-0.98; p work environments. The addition of each patient to a nurse's workload was associated with a 4% increase in the odds on nurses reporting quality of nursing care as fair or poor (OR 1.04; 95% CI 1.02-1.05; p work environments and nurse staffing in Thai hospitals holds promise for reducing nurse burnout, thus improving nurse retention at the hospital bedside as well as potentially improving the quality of care. Nurses should work with management and policymakers to achieve safe staffing levels and good work environments in hospitals throughout the world. © 2011 Sigma Theta Tau International.
Qolipour, Mohammad; Torabipour, Amin; Khiavi, Farzad Faraji; Malehi, Amal Saki
Assessing service quality is one of the basic requirements to develop the medical tourism industry. There is no valid and reliable tool to measure service quality of medical tourism. This study aimed to determine the reliability and validity of a Persian version of medical tourism service quality questionnaire for Iranian hospitals. To validate the medical tourism service quality questionnaire (MTSQQ), a cross-sectional study was conducted on 250 Iraqi patients referred to hospitals in Ahvaz (Iran) from 2015. To design a questionnaire and determine its content validity, the Delphi Technique (3 rounds) with the participation of 20 medical tourism experts was used. Construct validity of the questionnaire was assessed through exploratory and confirmatory factor analysis. Reliability was assessed using Cronbach's alpha coefficient. Data were analyzed by Excel 2007, SPSS version18, and Lisrel l8.0 software. The content validity of the questionnaire with CVI=0.775 was confirmed. According to exploratory factor analysis, the MTSQQ included 31 items and 8 dimensions (tangibility, reliability, responsiveness, assurance, empathy, exchange and travel facilities, technical and infrastructure facilities and safety and security). Construct validity of the questionnaire was confirmed, based on the goodness of fit quantities of model (RMSEA=0.032, CFI= 0.98, GFI=0.88). Cronbach's alpha coefficient was 0.837 and 0.919 for expectation and perception questionnaire. The results of the study showed that the medical tourism SERVQUAL questionnaire with 31 items and 8 dimensions was a valid and reliable tool to measure service quality of medical tourism in Iranian hospitals.
Mamishi, S; Mahmoudi, S; Bahador, A; Matini, H; Movahedi, Z; Sadeghi, R H; Pourakbari, B
The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals has been changed in recent years due to the arrival of community-associated MRSA (CA-MRSA) strains into healthcare settings. The aim of this study is to investigate the distribution of staphylococcal cassette chromosome mec (SCCmec) type V as well as SCCmec IV subtypes, which have been associated with community-acquired infection among healthcare-associated MRSA (HA-MRSA) isolates. Antimicrobial susceptibility, SCCmec type, spa type and the presence of Panton-Valentine leukocidin (PVL) genes were determined for all HA-MRSA isolates in an Iranian referral hospital. In this study of 48 HA-MRSA isolates, 13 (27%), three (6.2%), five (10.4%) and one (2%) belonged to SCCmec subtypes IVa, IVb, IVc and IVd, respectively. Only two isolates (4.2%) belonged to SCCmec types V Notably, one isolate was found to harbour concurrent SCCmec subtypes IVb and IVd. MRSA containing SCCmec subtype IVb, IVc and IVd as well as type V isolates were all susceptible to chloramphenicol, clindamycin and rifampicin, while the sensitivity to these antibiotics was lower among MRSA containing SCCmec subtype IVa. The most frequently observed spa ttype was t037, accounting for 88% (22/25). Three other spa type was t002, t1816 and t4478. Large reservoirs of MRSA containing type IV subtypes and type V now exist in patients in this Iranian hospital. Therefore, effective infection control management in order to control the spread of CA-MRSA is highly recommended.
Tjoflåt, Ingrid; Karlsen, Bjørg; Saetre Hansen, Britt
To describe how Norwegian expatriate nurses engaged in humanitarian assignments overseas experience working with the local nurses promoting nursing care in the hospital ward. Western countries have a long tradition of providing nurses with expert knowledge in nursing care for humanitarian projects and international work overseas. Studies from humanitarian mission revealed that health workers rarely acknowledge or use the local knowledge. However, there is a lack of studies highlighting expatriate nurses' experiences working with local nurses to promote nursing care in the hospital ward. This study applies a descriptive explorative qualitative design. The data were collected in 2013 by means of seven semi-structured interviews and analysed using qualitative content analysis. The data analyses revealed three themes related to the expatriate nurses' experiences of working with the local nurses to promote nursing care in the hospital ward: (1) Breaking the code, (2) Colliding worlds and (3) Challenges in sharing knowledge. The findings reflect different challenges when working with the local nurses. Findings indicate valuable knowledge gained about local nursing care and the local health and educational system. They also demonstrate challenges for the expatriate nurses related to the local nursing standard in the wards and using the local nurses' experiences and knowledge when working together. The findings can inform nurses, humanitarian organisations and institutions working overseas regarding the recruitment and the preparation of nurses who want to work cross- culturally or in humanitarian missions overseas. © 2016 John Wiley & Sons Ltd.
Liu, Ke; You, Li-Ming; Chen, Shao-Xian; Hao, Yuan-Tao; Zhu, Xiao-Wen; Zhang, Li-Feng; Aiken, Linda H
This study examines the relationship between hospital work environments and job satisfaction, job-related burnout and intention to leave among nurses in Guangdong province, China. The nursing shortage is an urgent global problem and also of concern in China. Studies in Western countries have shown that better work environments are associated with higher nurse satisfaction and lower burnout, thereby improving retention and lowering turnover rates. However, there is little research on the relationship between nurse work environments and nurse outcomes in China. This is a cross-sectional study. Survey data were collected from 1104 bedside nurses in 89 medical, surgical and intensive care units in 21 hospitals across the Guangdong province in China. Stratified convenience sampling was used to select hospitals, and systematic sampling was used to select units. All staff nurses working on participating units were surveyed. The China Hospital Nurse Survey, including the Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory, was employed to collect data from nurses. Statistical significance level was set at 0·05. Thirty-seven per cent of the nurses experienced high burnout, and 54% were dissatisfied with their jobs. Improving nurses' work environments from poor to better was associated with a 50% decrease in job dissatisfaction and a 33% decrease in job-related burnout among nurses. Burnout and job dissatisfaction are high among hospital nurses in Guangdong province, China. Better work environments for nurses were associated with decreased job dissatisfaction and job-related burnout, which may successfully address the nursing shortage in China. The findings of this study indicate that improving work environments is essential to deal with the nursing shortage; the findings provide motivation for nurse managers and policy makers to improve work environments of hospital nurses in China. © 2012 Blackwell Publishing Ltd.
Yu, Hsing-Yi; Tang, Fu-In; Chen, I-Ju; Yin, Teresa J C; Chen, Chu-Chieh; Yu, Shu
To investigate inactive nurses' human capital, intention to return to hospital nursing and incentives for returning. Few studies have discussed the loss of human capital with regard to inactive nurses and how to attract them to return to clinical work. Systematic random sampling was used, with 328 subjects completing the mailed questionnaires, resulting in a response rate of 25.4%. Inactive nurses not only had moderate to high human capital (average years of nursing experience was 10.29, with moderate to high levels of nursing professional commitment and nursing competence) and were young. Forty-three percent of subjects reported intending to return to hospital nursing. Sufficient nurse staffing, greater safety in the working environment, and re-entry preparation programmes were incentives for returning. Recruiting inactive nurses back to hospital work is vital and feasible as inactive nurses had a moderate to high degree of human capital. The most feasible way is offering reasonable working conditions, in particular, providing sufficient staffing, a safe working environment and re-entry preparation programmes. The findings confirm the human capital of inactive nurses and provide concrete directions for nursing managers to follow when recruiting inactive nurses to hospital nursing. © 2015 John Wiley & Sons Ltd.
Kheirollahi, Hooshang; Matin, Behzad Karami; Mahboubi, Mohammad; Alavijeh, Mehdi Mirzaei
This article developed an approached model of congestion, based on relaxed combination of inputs, in stochastic data envelopment analysis (SDEA) with chance constrained programming approaches. Classic data envelopment analysis models with deterministic data have been used by many authors to identify congestion and estimate its levels; however, data envelopment analysis with stochastic data were rarely used to identify congestion. This article used chance constrained programming approaches to replace stochastic models with "deterministic equivalents". This substitution leads us to non-linear problems that should be solved. Finally, the proposed method based on relaxed combination of inputs was used to identify congestion input in six Iranian hospital with one input and two outputs in the period of 2009 to 2012.
Sadeghian, Afsaneh; Damghanian, Maryam; Shariati, Mohammad
Current study determined the overall incidence, common causes as well as main predictors of this final diagnosis among neonates admitted to a rural district hospital in Iran. This study was conducted on 699 neonates who were candidate for admission to the NICU. Study population was categorized in the case group, including patients exposed to final diagnosis of neonatal seizures and the control group without this diagnosis. Neonatal seizure was reported as final diagnosis in 25 (3.6%) of neonates. The most frequent discharge diagnosis in the seizure group was neonatal sepsis and in the non-seizure group was respiratory problems. No significant difference was found in early fatality rate between neonates with and without seizures (8.0% vs. 10.1%). Only gestational age <38 week had a relationship with the appearance of neonatal seizure. Low gestational age has a crucial role for predicting appearance of seizure in Iranian neonates.
Ferdinand C. Mukumbang
Full Text Available Background: Teaching hospitals are medical institutes at which most nursing education institutions provide their students with practical nursing experience. Although the focus of care is the patient, attention is sometimes focused more on the nursing students rather than on the patients who are undergoing care at the hands of both the nursing professionals and students. However, proper nursing care should also take into account the experiences of patients during the care process in the health facility.Objectives: The study had three objectives: to describe the experiences of patients nursed by student nurses in a teaching hospital in the Western Cape; to identify patterns in the experiences of patients receiving patient care from student nurses; and to analyse aspects of the experiences that may need further attention for the training of student nurses.Method: A descriptive phenomenological approach was used to explore the experiences of patients nursed by student nurses. Participant selection took place purposively from different wards of the identified teaching hospital, and thematic saturation was achieved at 10 participants. The data were collected through in-depth interviews and analysed using thematic content analysis.Results: Three main themes were discovered after data analysis: methods of identification of student nurses by patients; positive perceptions of student nurses by patients; and negative perceptions of student nurses by patients.Conclusion: The findings will inform the clinical supervisors and educational institutions of aspects of the nursing training of student nurses that need improvement and those that require enforcement.
Stordeur, Sabine; D'Hoore, William
This paper contrasts structural and managerial characteristics of low- and high-turnover hospitals, and describes the organizational configuration of attractive hospitals. In countries facing nurse shortages and turnover, some hospitals succeed in recruiting and retaining nurses. In Magnet Hospitals, managerial practices and environmental characteristics increase nurses' job satisfaction and their commitment to the organization, which in turn decreases nurse turnover. Such an approach suggests that organizations are best understood as clusters of interconnected structures and practices, i.e. organizational configurations rather than entities whose components can be understood in isolation. From a sample of 12 hospitals whose nurse turnover was studied for 1 year, structural and organizational features of hospitals in the first and fourth quartiles, i.e. attractive (turnover 11.8%) were contrasted. A questionnaire, including perceptions of health-related factors, job demands, stressors, work schedules, organizational climate, and work adjustments antecedent to turnover, was received from 401 nurses working in attractive hospitals (response rate = 53.8%) and 774 nurses in conventional hospitals (response rate = 54.5%). Structural characteristics did not differentiate attractive and conventional hospitals, but employee perceptions towards the organization differed strikingly. Differences were observed for risk exposure, emotional demands, role ambiguity and conflicts, work-family conflicts, effort-reward imbalance and the meaning of work, all in favour of attractive hospitals (P satisfaction with working time, handover shifts and schedules were also better in attractive hospitals (P Job satisfaction and commitment were higher in attractive hospitals, whereas burnout and intention to leave were lower (P retention. Nurses face difficulties in their work situations, but some hospitals are perceived as healthy organizations. The concept of attractive institutions could
Kim, Yunmi; You, Sunju; Kim, Jinhyun
This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014. Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression. An increase of one newly licensed nurse per 100 beds in general units had significantly lower odds of improving staffing grades (grades 6~0 vs. 7) (odds ratio=0.95, p=.005). The supply of newly licensed nurses increased by 32% from 2009 to 2014, and proportion of hospitals whose staffing grade had improved, not changed, and worsened was 19.1%, 70.1%, and 10.8% respectively. Compared to 2009, the supply variation of newly licensed nurses in 2014 was not significantly related to the increased odds of improving staffing grades in the region (OR=1.02, p=.870). To achieve a balance in the regional supply and demand for hospital nurses, compliance with nurse staffing legislation and revisions in the nursing fee differentiation policy are needed. Rather than relying on increasing nurse supply, retention policies for new graduate nurses are required to build and sustain competent nurse workforce in the future. © 2017 Korean Society of Nursing Science
Heydari, Abbas; Yaghoubinia, Fariba; Roudsari, Robab Latifnejad
The student-educator relationship in nursing is very important to the success of teaching and learning. The perceptions of students and educators of this relationship affect its success. Therefore, it is necessary to better understand this relationship. The purpose of the current study was to explore Iranian nursing students' and educators' perceptions of student-educator relationship in clinical nursing education. In this conventional content analysis study, eight Bachelor of Nursing students and 10 clinical nursing educators from nursing and midwifery school in Mashhad (Iran) participated. Purposive sampling was used to select participants. Data were gathered using semistructured interviews. To analyze data, a conventional content analysis approach was used to identify meaning units and their condensation and to make codes and create categories : Results showed that the multidimensional nature of the student-educator relationship in clinical nursing education consists of (a) dimensions related to the educator, (b) dimensions related to the student, and (c) dimensions of relationship quality. Each of these categories is composed of codes that showed the perception of participants about the nature of relationship. On the basis of the unique features and attributes regarding relationship perceptions in clinical nursing education identified among the participants of this study, students and educators in Iran should pay greater attention to establishing the relationship as it relates to these attributes.
McHugh, Matthew D; Berez, Julie; Small, Dylan S
The Affordable Care Act's Hospital Readmissions Reduction Program (HRRP) penalizes hospitals based on excess readmission rates among Medicare beneficiaries. The aim of the program is to reduce readmissions while aligning hospitals' financial incentives with payers' and patients' quality goals. Many evidence-based interventions that reduce readmissions, such as discharge preparation, care coordination, and patient education, are grounded in the fundamentals of basic nursing care. Yet inadequate staffing can hinder nurses' efforts to carry out these processes of care. We estimated the effect that nurse staffing had on the likelihood that a hospital was penalized under the HRRP. Hospitals with higher nurse staffing had 25 percent lower odds of being penalized compared to otherwise similar hospitals with lower staffing. Investment in nursing is a potential system-level intervention to reduce readmissions that policy makers and hospital administrators should consider in the new regulatory environment as they examine the quality of care delivered to US hospital patients.
Full Text Available Background and Objectives: Nurses in their daily practice need acceptable level of ethical development. There is few literature about ethical development of Iranian nurses. The aims of present study are to determine the level ethical development in nurses and its related factors.Methods: This descriptive-correlational study conducted in 2010. The study sample consisted of 269 nurses working in three training-treatment hospitals affiliated to Tabriz University of Medical Sciences. These nurses selected by census sampling method. For assessing the ethical development of nurses, nursing dilemma test was used. This questionnaire was designed based on Kohlbergs’ theory of ethical development and assessed ethical development in pre-convetional, conventional and post-convetional levels. The data analysis was done by descriptive and inferential statistics. Results: Forty four nurses (16.3% were in pre-conventional level, 86 nurses (31.8% were in conventional level, 116 nurses (43.1% were in post-conventional level, and 23 nurses (8.5% were in clinical consideration level. There was negative significant correlation between ethical development of nurses with their job experience. Conclusion: In spite of this fact that near half of nurses are at postconventional level, but still a significant number of them are at lower levels of ethical development. These findings indicate that nursing managers should pay more attention to ethical development of nurses.
Kebede, Mihiretu; Endris, Yesuf; Zegeye, Desalegn Tegabu
Even though nursing care documentation is an important part of nursing practice, it is commonly left undone. The objective of this study was to assess nursing care documentation practice and the associated factors among nurses who are working at the University of Gondar Hospital. An institution-based cross-sectional study was conducted among 220 nurses working at the University of Gondar Hospital inpatient wards from March 20 to April 30, 2014. Data were collected using a structured and pre-tested self-administered questionnaire. Data were entered into Epi Info version 7 and analyzed with SPSS version 20. Descriptive statistics, bivariate, and multivariate logistic regression analyses were carried out. Two hundred and six nurses returned the questionnaire. Good nursing care documentation practice among nurses was 37.4%. A low nurse-to-patient ratio AOR = 2.15 (95%CI [1.155, 4.020]), in-service training on standard nursing process AOR = 2.6 (95%CI[1.326, 5.052]), good knowledge AOR = 2.156(95% CI [1.092, 4.254]), and good attitude toward nursing care documentation AOR = 2.22 (95% CI [1.105, 4.471] were significantly associated with nursing care documentation practice. Most of the nursing care provided remains undocumented. Nurse-to-patient ratio, in-service training, knowledge, and attitude of nurses toward nursing care documentation were factors associated with nursing care documentation practice.
Al-Majid, Sadeeka; Al-Majed, Hashmiya; Rakovski, Cyril S; Otten, Rebecca A
Although many psychiatric hospital nurses in Bahrain attend at least one continuing nursing education (CNE) activity per year, many others do not. This study explored these nurses' perceptions of CNE and factors that promote or hinder participation in CNE activities. A descriptive design was used to gather data from a convenience sample of 200 nurses working at the psychiatric hospital in Bahrain. Nurses believed that CNE improved the quality of patient care and patient outcomes, increased nurses' knowledge and skills, and kept them current with advances in nursing. Participation in CNE was hindered by unavailability of CNE activities related to psychiatric nursing. The majority of nurses had positive perceptions of CNE. Their participation was hindered by unavailability of CNE activities related to psychiatric nursing. Those responsible for planning continuing education in Bahrain should consider these findings when planning future CNE activities. Copyright 2012, SLACK Incorporated.
Smith, Jessica G; Morin, Karen H; Lake, Eileen T
To determine whether nurse coworker incivility is associated with the nurse work environment, defined as organisational characteristics that promote nurse autonomy. Workplace incivility can negatively affect nurses, hospitals and patients. Plentiful evidence documents that nurses working in better nurse work environments have improved job and health outcomes. There is minimal knowledge about how nurse coworker incivility relates to the United States nurse work environment. Quantitative, cross-sectional. Data were collected through online surveys of registered nurses in a southwestern United States health system. The survey content included the National Quality Forum-endorsed Practice Environment Scale of the Nursing Work Index and the Workplace Incivility Scale. Data analyses were descriptive and correlational. Mean levels of incivility were low in this sample of 233 staff nurses. Incivility occurred 'sporadically' (mean = 0.58; range 0.00-5.29). The nurse work environment was rated highly (mean = 3.10; range of 1.00-4.00). The nurse work environment was significantly inversely associated with coworker incivility. The nurse manager qualities were the principal factor of the nurse work environment associated with incivility. Supportive nurse managers reduce coworker incivility. Nurse managers can shape nurse work environments to prevent nurse incivility. © 2017 John Wiley & Sons Ltd.
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.
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
El-Jardali, Fadi; Merhi, Mirvat; Jamal, Diana; Dumit, Nuhad; Mouro, Gladys
Assess nurse retention challenges and strategies as perceived by nursing directors in Lebanese hospitals. The Kampala Health Workforce Declaration stressed the importance of retaining an effective, responsive and equitably distributed health workforce, particularly nurses. Little is known about nurse retention challenges and strategies in Lebanon. Nursing directors of 76 hospitals participated and were sent a two-page survey on perceived retention challenges and hospital-based retention strategies. Retention challenges included unsatisfactory salary, unsuitable shifts and working hours, as well as better opportunities in other areas within or outside Lebanon. Retention strategies included implementing financial rewards and benefits, a salary scale, staff development, praise and improving work environment. Nursing directors did not address all perceived challenges in their strategies. To better manage the nursing workforce, nursing directors should regularly measure and monitor nurse turnover rates and also their causes and predictors. Nursing directors should develop, implement and evaluate retention strategies. More information is needed on the management and leadership capacities of nursing directors in addition to their span of control. Nursing directors are facing challenges in retaining their nurses. If these problems are not addressed, Lebanon will continue to lose competent and skilled nurses.
Louise Passos Vigolvino Macêdo
Full Text Available Objective: Investigate the understanding of nurses who work at a teaching hospital, in relation to NCS and the nursing process; ascertain facilities/difficulties related to the applicability of the nursing process in that service; and verify the opinions of those professionals for the improvement and/or effectiveness of the nursing process at the hospitalization units of the hospital. Method: Exploratory, descriptive study, with a qualitative approach. The sample consisted of 42 nurses who answered a questionnaire. The empirical material was analyzed and categorized based on the content analysis technique and discussed in the light of the literature. Results: From the participants' discourses, two categories of analysis emerged: 1 understanding of NCS as a tool to organize the Nursing work process and improve the quality of care; and 2 applicability of the nursing process at the various hospitalization units of the institution. Conclusion: The implementation and applicability of that method depend on not only the knowledge and motivation of the nursing professionals, but also on a strategic planning involving management and staff, from the recognition of their importance in order to obtain adherence and effective operationalization in practice. Descriptors: Nursing; Nursing Process; Professional Practice.
Tirgari, Batool; Mirshekari, Leili; Forouzi, Mansooreh Azzizadeh
Pressure injuries are the third most expensive condition after cancer and cardiovascular disease. Nurses are responsible for the direct and continuous care, treatment, and prevention of pressure injuries. To achieve optimal quality care, nursing knowledge and attitudes must be based on the best scientific evidence. This study aimed to examine the knowledge and attitudes of nurses working in intensive care units of hospitals affiliated with Zahedan Medical Sciences University regarding the prevention of pressure injuries. This was a descriptive analytic study involving 89 critical care nurses. Data analysis was conducted using a 3-part questionnaire: demographic data, knowledge, and attitudes of intensive care nurses toward the prevention of pressure injuries. Collected data were analyzed with SPSS version 19 (IBM, Armonk, New York), using descriptive and inferential statistics (such as Pearson correlation coefficient, independent t test, and analysis of variance). The results showed that the mean ± SD score of pressure injury knowledge was 0.44 ± 0.12, and the attitude of participants toward pressure injury prevention was 2.69 ± 0.47. Scores varied widely; "nutrition" showed the highest mean score (0.71 ± 0.45), but "etiology and development" (0.42 ± 0.21) and "classification and observation" (0.42 ± 0.24) showed the lowest mean scores. Of the different aspects of attitudes toward pressure injury prevention, "the impact of pressure injuries" showed the highest mean score (2.95 ± 0.56), and "confidence in the effectiveness of prevention" showed the lowest mean score (2.56 ± 0.46). A statistically significant relationship was observed between pressure injury knowledge and attitudes toward pressure injury prevention (P < .001). Pressure injury prevention is one of many nursing care priorities and is a key indicator of the quality of nursing care. In order to achieve optimal quality care in this area, nurse managers and other administrators should make efforts
Toode, K; Routasalo, P; Helminen, M; Suominen, T
This study looks to describe the relationships between hospital nurses' individual priorities, internal psychological states and their work motivation. Connections between hospital nurses' work-related needs, values and work motivation are essential for providing safe and high quality health care. However, there is insufficient empirical knowledge concerning these connections for the practice development. A cross-sectional empirical research study was undertaken. A total of 201 registered nurses from all types of Estonian hospitals filled out an electronic self-reported questionnaire. Descriptive statistics, Mann-Whitney, Kruskal-Wallis and Spearman's correlation were used for data analysis. In individual priorities, higher order needs strength were negatively correlated with age and duration of service. Regarding nurses' internal psychological states, central hospital nurses had less sense of meaningfulness of work. Nurses' individual priorities (i.e. their higher order needs strength and shared values with the organization) correlated with their work motivation. Their internal psychological states (i.e. their experienced meaningfulness of work, experienced responsibility for work outcomes and their knowledge of results) correlated with intrinsic work motivation. Nurses who prioritize their higher order needs are more motivated to work. The more their own values are compatible with those of the organization, the more intrinsically motivated they are likely to be. Nurses' individual achievements, autonomy and training are key factors which influence their motivation to work. The small sample size and low response rate of the study limit the direct transferability of the findings to the wider nurse population, so further research is needed. This study highlights the need and importance to support nurses' professional development and self-determination, in order to develop and retain motivated nurses. It also indicates a need to value both nurses and nursing in
Khater, W A; Akhu-Zaheya, L M; Al-Mahasneh, S I; Khater, R
Patients' safety culture is a key aspect in determining healthcare organizations' ability to address and reduce risks of patients. Nurses play a major role in patients' safety because they are accountable for direct and continuous patient care. There is little known information about patients' safety culture in Jordanian hospitals, particularly from the perspective of healthcare providers. The study aimed to assess patient safety culture in Jordanian hospitals from nurses' perspective. A cross-sectional, descriptive design was utilized. A total number of 658 nurses participated in the current study. Data were collected using an Arabic version of the hospital survey of patients' safety culture. Teamwork within unit dimensions had a high positive response, and was perceived by nurses to be the only strong suit in Jordanian hospitals. Areas that required improvement, as perceived by nurses, are as follows: communication openness, staffing, handoff and transition, non-punitive responses to errors, and teamwork across units. Regression analysis revealed factors, from nurses' perspectives, that influenced patients' safety culture in Jordanian hospital. Factors included age, total years of experience, working in university hospitals, utilizing evidence-based practice and working in hospitals that consider patient safety to be a priority. Participants in this study were limited to nurses. Therefore, there is a need to assess patient safety culture from other healthcare providers' perspectives. Moreover, the use of a self-reported questionnaire introduced the social desirability biases. The current study provides insight into how nurses perceive patient safety culture. Results of this study have revealed that there is a need to replace the traditional culture of shame/blame with a non-punitive culture. Study results implied that improving patient safety culture requires a fundamental transformation of nurses' work environment. New policies to improve collaboration between
This thesis "Nurse as a support of long-term hospitalized senior" is divided into a theoretical and an empirical part. It deals with the issue of long-term hospitalization of seniors at the aftercare department, especially with the nurses' support to seniors and their interrelationships. Three main goals were appointed. It was examined how the seniors perceive nurses who takes care of them. Then in which areas nurses are supportive and which techniques they try to use to be a support for seni...
Full Text Available Despite extensive research on stress among hospital nurses, the important effects of support and stress on care quality are not yet well established. Similar to other jobs, nurses face stress in their routine working day. The relationship between occupational stress, social support and factors relating to each of them, among Iranian nurses are attempted to correlate. This cross-sectional analytical-descriptive study was carried out in 2013 in Zanjan province where 248 nurses filled the given questionnaires including Demographic data, Work Factors, Nursing Stress Scale, and Social Integration Scale. Data were analyzed using SPSS 16.00. In our study, we found that the stress and social support were significantly correlated. Our findings revealed a significant relation between social supports and occupational stress in nurses. Conclusively, support from supervisors and coworkers can help control nurses’ stress. In addition, both social support and occupational stress are related to three major components: job satisfaction, job security and others' attitude towards nursing. Therefore, creating a positive attitude towards nursing in society, and a suitable working environment for them is a way to increase their efficiency.
Dawson, Angela J; Stasa, Helen; Roche, Michael A; Homer, Caroline S E; Duffield, Christine
This study aimed to reveal nurses' experiences and perceptions of turnover in Australian hospitals and identify strategies to improve retention, performance and job satisfaction. Nursing turnover is a serious issue that can compromise patient safety, increase health care costs and impact on staff morale. A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. Key factors affecting nursing turnover were limited career opportunities; poor support; a lack of recognition; and negative staff attitudes. The nursing working environment is characterised by inappropriate skill-mix and inadequate patient-staff ratios; a lack of overseas qualified nurses with appropriate skills; low involvement in decision-making processes; and increased patient demands. These issues impacted upon heavy workloads and stress levels with nurses feeling undervalued and disempowered. Nurses described supportive strategies: improving performance appraisals, responsive preceptorship and flexible employment options. Nursing turnover is influenced by the experiences of nurses. Positive steps can be made towards improving workplace conditions and ensuring nurse retention. Improving performance management and work design are strategies that nurse managers could harness to reduce turnover.
Abedini, Roghayeh; Soltanzadeh, Ahmad; Faghih, Mohammad Amin; Mohammadi, Heidar; Kamalinia, Mojtaba; Mohraz, Majid Habibi; Arassi, Maziyar; Veyseh, Peyman Piran; Aghaei, Hamed; Hosseini, Seyed Younes
Shift-work, which is an ergonomics issue in workplaces, can negatively affect workers. The security personnel of medical centers in Iran have multiple responsibilities and consequently are exposed to such unwanted situations as observing patients, disputing with patient's attendants, unwanted shift schedules, and being away from family for long periods. This study assessed health problems of Iranian hospital security personnel (shift-worker personnel) using the Survey of Shift-workers (SOS) questionnaire (Persian version). This cross-sectional study was conducted in seven medical centers (4 hospitals and 3 clinics). A total of 416 workers were surveyed: shift-workers (exposed group) (n=209) and non-shift-workers (unexposed group) (n=207). The prevalence of adverse health effects was higher in shift-workers than day-workers. The level of education and mean Body Mass Index (BMI) in shift-workers were significantly higher compared with day-workers. The prevalence of gastrointestinal disorders, cardiovascular and psychological problems were also significantly higher in shift-workers compared with day-workers. Overall, the prevalence of health problems among the security personnel of medical centers was high. Hence, it is recommended that personnel be put under periodic monitoring and receive medical counseling and treatment if there is any disorder.
Klomstad, Kristin; Pedersen, Reidar; Førde, Reidun; Romøren, Maria
Many of the elderly in nursing homes are very ill and have a reduced quality of life. Life expectancy is often hard to predict. Decisions about life-prolonging treatment should be based on a professional assessment of the patient's best interest, assessment of capacity to consent, and on the patient's own wishes. The purpose of this study was to investigate and compare how these types of decisions were made in nursing homes and in hospital wards. Using a questionnaire, we studied the decision-making process for 299 nursing home patients who were treated for dehydration using intravenous fluids, or for bacterial infections using intravenous antibiotics. We compared the 215 (72%) patients treated in nursing homes to the 84 (28%) nursing home patients treated in the hospital. The patients' capacity to consent was considered prior to treatment in 197 (92%) of the patients treated in nursing homes and 56 (67%) of the patients treated in hospitals (p nursing homes than in hospital (90% vs. 52%). Next of kin and other health personnel were also more rarely involved when the nursing home patient was treated in hospital. Whether advance care planning had been carried out, was more often unknown in the hospital (69% vs. 17% in nursing homes). Hospital doctors expressed more doubt about the decision to admit the patient to the hospital than about the treatment itself. This study indicates a potential for improvement in decision-making processes in general, and in particular when nursing home patients are treated in a hospital ward. The findings corroborate that nursing home patients should be treated locally if adequate health care and treatment is available. The communication between the different levels of health care when hospitalization is necessary, must be better. ClinicalTrials.gov NCT01023763 (12/1/09) [The registration was delayed one month after study onset due to practical reasons].
Liu, Ying; Aungsuroch, Yupin
To propose a hypothesized theoretical model and apply it to examine the structural relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care. Improving quality nursing care is a first consideration in nursing management globally. A better understanding of factors influencing quality nursing care can help hospital administrators implement effective programmes to improve quality of services. Although certain bivariate correlations have been found between selected factors and quality nursing care in different study models, no studies have examined the relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care in a more comprehensive theoretical model. A cross-sectional survey. The questionnaires were collected from 510 Chinese nurses in four Chinese tertiary hospitals in January 2015. The validity and internal consistency reliability of research instruments were evaluated. Structural equation modelling was used to test a theoretical model. The findings revealed that the data supported the theoretical model. Work environment had a large total effect size on quality nursing care. Burnout largely and directly influenced quality nursing care, which was followed by work environment and patient-to-nurse ratio. Job satisfaction indirectly affected quality nursing care through burnout. This study shows how work environment past burnout and job satisfaction influences quality nursing care. Apart from nurses' work conditions of work environment and patient-to-nurse ratio, hospital administrators should pay more attention to nurse outcomes of job satisfaction and burnout when designing intervention programmes to improve quality nursing care. © 2017 John Wiley & Sons Ltd.
Freixas Sala, Núria; Monistrol Ruano, Olga; Espuñes Vendrell, Jordi; Sallés Creus, Montserrat; Gallardo González, Mónica; Ramón Cantón, Carme; Bueno Domínguez, María José; Llinas Vidal, Montserrat; Campo Osaba, María Antonia
This study aims to describe the implementation of the patient safety (PS) programs in catalan hospitals and to analyze the level of nursing involvement. Multicenter cross-sectional study. To obtain the data two questionnaires were developed; one addressed to the hospital direction and another to the nurse executive in PS. The survey was distributed during 2013 to the 65 acute care hospitals in Catalonia. The questionnaire was answered by 43 nursing directors and 40 nurse executive in PS. 93% of the hospitals responded that they had a PS Program and 81.4% used a specific scoreboard with PS indicators. The referent of the hospital in PS was a nurse in 55.8% of the centres. 92.5% had a system of notification of adverse effects with an annual average of 190.3 notifications. In 86% of the centres had a nurse involved in the PS program but only in the 16% of the centres the nurse dedication was at full-time. The nurse respondents evaluate the degree of implementation of the PBS program with a note of approved and they propound as improvement increase the staff dedicated to the PS and specific academic training in PS. The degree of implementation of programs for patient safety is high in Catalan acute hospitals, while the organizational structure is highly diverse. In more than half of the hospitals the PS referent was a nurse, confirming the nurse involvement in the PS programs. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.
Al-Kandari, Fatimah; Thomas, Deepa
Unfinished care has a strong relationship with quality of nursing care. Most issues related to tasks incompletion arise from staffing and workload. This study was conducted to assess the workload of nurses, the nursing activities (tasks) nurses commonly performed on medical and surgical wards, elements of nursing care activities left incomplete by nurses during a shift, factors contributing to task incompletion and the relationship between staffing, demographic variables and task incompletion. Exploratory survey using a self-administered questionnaire developed from IHOC survey, USA. All full time registered nurses working on the general medical and surgical wards of five government general hospitals in Kuwait. Research assistants distributed and collected back the questionnaires. Four working days were given to participants to complete and return the questionnaires. A total of 820 questionnaires were distributed and 95% were returned. Descriptive and inferential analysis using SPSS-11. The five most frequently performed nursing activities were: administration of medications, assessing patient condition, preparing/updating nursing care plans, close patient monitoring and client health teaching. The most common nursing activities nurses were unable to complete were: comfort talk with patient and family, adequate documentation of nursing care, oral hygiene, routine catheter care and starting or changing IV fluid on time. Tasks were more complete when the nurse-patient load was less than 5. Nurses' age and educational background influenced task completion while nurses' gender had no influence on it. Increased patient loads, resulting in increased frequency of nursing tasks and non-nursing tasks, were positively correlated to incompletion of nursing activities during the shift. Emphasis should be given to maintaining the optimum nurse-patient load and decreasing the non-nursing workload of nurses to enhance the quality of nursing care.
Gu, Xiuzhu; Andersen, Henning Boje; Madsen, Marlene Dyrløv
Staff perceptions of risks associated with patient handoffs were investigated in a survey of nurses in 6 Japanese hospitals. A total of 1462 valid responses were collected from nurses with an overall response rate of 74%. Respondents are moderately satisfied with the transfer of information and r...... and responsibility during handoffs. However, the handoff system was identified as immature. Hospital, work setting, and work experience affected nurses' views of handoff quality. Strategies for improving patient handoffs in Japan are proposed.......Staff perceptions of risks associated with patient handoffs were investigated in a survey of nurses in 6 Japanese hospitals. A total of 1462 valid responses were collected from nurses with an overall response rate of 74%. Respondents are moderately satisfied with the transfer of information...
Kadivar, Maliheh; Mosayebi, Ziba; Asghari, Fariba; Zarrini, Pari
The challenging nature of neonatal medicine today is intensified by modern advances in intensive care and treatment of sicker neonates. These developments have caused numerous ethical issues and conflicts in ethical decision-making. The present study surveyed the challenges and dilemmas from the viewpoint of the neonatal intensive care personnel in the teaching hospitals of Tehran University of Medical Sciences (TUMS) in the capital of Iran. In this comparative cross-sectional study conducted between March 2013 and February 2014, the physicians' and nurses' perceptions of the ethical issues in neonatal intensive care units were compared. The physicians and nurses of the study hospitals were requested to complete a 36-item questionnaire after initial accommodations. The study samples consisted of 284 physicians (36%) and nurses (64%). Content validity and internal consistency calculations were used to examine the psychometric properties of the questionnaire. Data were analyzed by Pearson's correlation, t-test, ANOVA, and linear regression using SPSS v. 22. Respecting patients' rights and interactions with parents were perceived as the most challenging aspects of neonatal care. There were significant differences between sexes in the domains of the perceived challenges. According to the linear regression model, the perceived score would be reduced 0.33 per each year on the job. The results of our study showed that the most challenging issues were related to patients' rights, interactions with parents, communication and cooperation, and end of life considerations respectively. It can be concluded, therefore, that more attention should be paid to these issues in educational programs and ethics committees of hospitals.
Palmer-Morales, Yusvisaret; Prince-Vélez, Roberto; Searcy-Bernal, Roberto; Compean-Saucedo, Bertha
To determine the prevalence of burnout syndrome in nursing staff in 2 different second level hospitals in the city of Mexicali, Baja California, Mexico. A cross-sectional study was conducted in all nursing staff (n = 698) in 2 second level hospitals (the Gynecology, Pediatrics and Family Medicine Hospital No. 31 and the General Specialist Hospital No. 30 in Mexicali). A stratified random sample was obtained from the 698 nurses, with a sample size of 184 nurses from each hospital. The Maslach Burn-out Inventory and a general questionnaire on demographic factors were used. Statistical analysis consisted of descriptive statistics and analysis of proportions using the chi-squared test. A total of 368 nurses were studied, of whom 345 (93.75%) were women. The mean age was 41.21 SD (standard deviation) = 6.59 years. The mean length of service was 15.87 (SD = 6.12) years. In both hospitals, the prevalence of burnout syndrome was 6.79% (25). Previous publications on burn-out have included studies performed in Mexico and in nurses in the emergency department of a tertiary hospital in Barcelona, as well as in other health care professionals. In comparison with these studies, the prevalence of burn-out observed in the present study was significantly lower.
Dubois, Carl-Ardy; D'Amour, Danielle; Tchouaket, Eric; Rivard, Michèle; Clarke, Sean; Blais, Régis
Over the last decades, converging forces in hospital care, including cost-containment policies, rising healthcare demands and nursing shortages, have driven the search for new operational models of nursing care delivery that maximize the use of available nursing resources while ensuring safe, high-quality care. Little is known, however, about the distinctive features of these emergent nursing care models. This article contributes to filling this gap by presenting a theoretically and empirically grounded taxonomy of nursing care organization models in the context of acute care units in Quebec and comparing their distinctive features. This study was based on a survey of 22 medical units in 11 acute care facilities in Quebec. Data collection methods included questionnaire, interviews, focus groups and administrative data census. The analytical procedures consisted of first generating unit profiles based on qualitative and quantitative data collected at the unit level, then applying hierarchical cluster analysis to the units' profile data. The study identified four models of nursing care organization: two professional models that draw mainly on registered nurses as professionals to deliver nursing services and reflect stronger support to nurses' professional practice, and two functional models that draw more significantly on licensed practical nurses (LPNs) and assistive staff (orderlies) to deliver nursing services and are characterized by registered nurses' perceptions that the practice environment is less supportive of their professional work. This study showed that medical units in acute care hospitals exhibit diverse staff mixes, patterns of skill use, work environment design, and support for innovation. The four models reflect not only distinct approaches to dealing with the numerous constraints in the nursing care environment, but also different degrees of approximations to an "ideal" nursing professional practice model described by some leaders in the
Peyrovi, Hamid; Parsa-Yekta, Zohreh; Vosoughi, Mohammad Bagher; Fathyian, Nasrollah; Ghadirian, Fataneh
The extensive nature of the Iraq-Iran war converted to a human tragedy with large casualties; it has affected nursing discipline dramatically. To analyse the history of the wartime experience of Iranian nurses in Iran-Iraq War. The current study was conducted with oral history. The study sample consisted of 13 Iranian nurses who served in the war zones during the wartime. Purposive and snowball sampling were used to recruit the participants. During the face-to-face interviews, participants were asked to describe their experience in the war zones during the war years. Data collection and analysis took place from April to August 2013, when saturation was reached. All interviews were tape recorded and transcribed and then analysed with thematic content analysis. Finally, five themes and 18 subthemes emerged from data analysis of significant statements from 17 interviews. The five emerged themes included (1) 'From margin to centre', (2) 'Development of referral care', (3) 'Personal and professional growth and development', (4) 'The emerging pillar of culture in war nursing' and (5) 'Threats to nursing at the war'. Nursing in Iran at wartime has a difficult path to development. There are powerful implications for clinical practice. It is recommended to continue collection, archiving and analysing the wartime experiences of Iranian nurses.
This article presents the findings from a phenomenological study that explored the understandings of Australian hospital-based nurse educators' experiences of their role. Purposive sampling resulted in 11 nurse educators from four large metropolitan hospitals within an Australian jurisdiction. The participants were asked how they understand their role and translate that understanding into practice. Thematic analysis identified four themes representative of nurse educators' understanding of their role: Becoming an Educator, Capability Building, Panacea, and Tension. A coherent picture emerged from subthemes highlighting that nurse educators were undervalued and value is added. Being undervalued and value adding are translated into nurse educator practice as resilience, being educationally literate, investing, and having a presence. This article identifies a gap in knowledge related to understanding the nurse educator role and informs recruitment and subsequent retention of nurses into nurse educator roles at a time when the nursing workforce in Australia and internationally is about to experience a major shortfall. Findings are specific to the Australian context and are not necessarily generalizable to other hospital jurisdictions. J Contin Educ Nurs. 2018;49(6):274-281. Copyright 2018, SLACK Incorporated.
Wagner, J-D; Bezuidenhout, M C; Roos, J H
This study aimed to establish and describe the level of communication satisfaction that professional nurses experience in selected public hospitals in the City of Johannesburg, South Africa. The success of any organisation depends on the effectiveness of its communication systems and the interaction between staff members. Data were collected by means of questionnaires, based on the Communication Satisfaction Questionnaire (CSQ), from a sample of 265 professional nurses from different categories, chosen using a disproportionate random stratified sampling method. The results indicated poor personal feedback between nurse managers (operational managers) and professional nurses, as well as dissatisfaction among nurse managers and professional nurses with regard to informal communication channels. A lack of information pertaining to policies, change, financial standing and achievements of hospitals was identified. Nurse managers should play a leadership role in bringing staff of different departments together by creating interactive communication forums for the sharing of ideas. The results emphasise the need for nurse managers to improve communication satisfaction at all levels of the hospital services in order to enhance staff satisfaction and create a positive working environment for staff members. © 2014 The Authors. Journal of Nursing Management Published by John wiley & Sons Ltd.
Saqer, Tahani J; AbuAlRub, Raeda F
To (i) identify the types and reasons for missed nursing care among Jordanian hospital nurses; (ii) identify predictors of missed nursing care based on study variables; and (iii) examine the relationship between nurses' confidence in delegation and missed nursing care. Missed nursing care is a global concern for nurses and nurse administrators. Investigating the relation between the confidence in delegation and missed nursing care might help in designing strategies that enable nurses to minimise missed care and enhance quality of services. A correlational research design was used for this study. A convenience sample of 362 hospital nurses completed the missed nursing care survey, and confidence and intent to delegate scale. The results of the study revealed that ambulating and feeding patients on time, doing mouth care and attending interdisciplinary care conferences were the most frequent types of missed care. The mean score for missed nursing care was (2.78) on a scale from 1-5. The most prevalent reasons for missed care were "labour resources, followed by material resources, and then communication". Around 45% of the variation in the perceived level of "missed nursing care" was explained by background variables and perceived reasons for missed nursing. However, the relationship between confidence in delegation and missed care was insignificant. The results of this study add to the body of international literature on most prevalent types and reasons for missed nursing care in a different cultural context. Highlighting most prevalent reasons for missed nursing care could help nurse administrators in designing responsive strategies to eliminate or reduces such reasons. © 2018 John Wiley & Sons Ltd.
Jee-In Hwang, PhD; Jeonghoon Ahn, PhD
Purpose: To examine levels of teamwork and its relationships with clinical error reporting among Korean hospital nurses. Methods: The study employed a cross-sectional survey design. We distributed a questionnaire to 674 nurses in two teaching hospitals in Korea. The questionnaire included items on teamwork and the reporting of clinical errors. We measured teamwork using the Teamwork Perceptions Questionnaire, which has five subscales including team structure, leadership, situation monitori...
Broom, Alex; Broom, Jennifer; Kirby, Emma; Scambler, Graham
We are likely moving rapidly toward a post-antibiotic era, as a result of escalating antimicrobial resistance, rapidly declining antibiotic production and profligate overuse. Hitherto research has almost exclusively focused on doctors' prescribing, with nurses' roles in antibiotic use remaining virtually invisible. Drawing on interviews with 30 nurses, we focus on nurses as brokers of doctors' antibiotic decisions, nursing capacity to challenge doctors' decisions, and, "back stage" strategies for circumnavigating organizational constraints. We argue that nurses occupy an essential and conscious position as brokers within the hospital; a subject position that is not neutral, facilitates (short-term) cohesion, and involves the pursuit of particular (preferred) nursing outcomes. Illustrating how authority can be diffuse, mediated by institutionalized praxis, and how professionals evade attempts to govern their practice, we challenge the reification of physician prescribing power, arguing that it may work against the utilization of nurses as important stakeholders in the future of antibiotics.
Full Text Available Introduction: Nurse–physician inter-professional relationship is an important issue in health care system that can affect job satisfaction and patient care quality. The present study explores the major issues of nurse–physician inter-professional relationships in Iran. Materials and Methods: In this in-depth qualitative content analysis study conducted in 2014, 12 participants (5 physicians and 7 nurses were recruited from two educational hospitals. The data were collected from deep, open, and unstructured interviews, and analyzed based on content analysis. Results: The participants in this study included 12 individuals, 6 females and 6 males, with the age ranging 27–48 years and tenure ranging 4–17 years. Four themes were identified, namely, divergent attitudes, uneven distribution of power, mutual trust destructors, and prudence imposed on nurses. Conclusions: The results revealed some major inter-professional issues and challenges in nurse–physician relationships, some of which are context-specific whereas others should be regarded as universal. It is through a deep knowledge of these issues that nurses and physicians can establish better collaborative inter-professional relationships.
Full Text Available Objective: Our world is rapidly becoming a global community, which creates a need to further understand the universal phenomena of death and professional caring for dying persons. This study thus was conducted to describe the meaning of nurses′ experiences of caring for dying people in the cultural contexts of Iran and Sweden. Materials and Methods: Using a phenomenological approach, phenomenon of caring for dying people was studied. Eight registered nurses who were working in oncology units in Tehran, Iran and eight registered nurses working in hospital and home care in North part of Sweden were interviewed. The interviews were analyzed using the principles of phenomenological hermeneutics. Results: The findings were formulated based on two themes included: (1 "Sharing space and time to be lost", and (2 "Caring is a learning process. Conclusions: The results showed that being with dying people raise an ethical demand that calls for personal and professional response, regardless of sex, culture or context. The physical and organizational context must be supportive and enable nurses to stand up to the demands of close relationships. Specific units and teamwork across various personnel seem to be a solution that is missing in Iran.
Yolanda Raquel Lapeña-Moñux
Full Text Available Abstract Objective: this paper explores the experiences of registered nurses working with Spanish nursing students within the hospital. Methods: a qualitative phenomenological approach was followed. Purposeful sampling was employed. Twenty-one registered nurses, from a public hospital located in Spain, were included in the study. Data were collected by means of unstructured and semi-structured interviews and were analysed using Giorgi's proposal. The Consolidated Criteria for Reporting Qualitative Research were followed. Results: three main themes described the experience of registered nurses: "The nurse's relationship with nursing students"; most nurses emphasized the importance of the first contact with students and they considered students' attitude to be key. "Defining the role of the student in clinical practice"; it is necessary to unify the nurse's role and interventions to avoid misleading students and establish priorities in clinical practice. "Building bridges between clinical settings and the University"; the need to establish a common ground and connection between the university and hospital clinical settings was emphasized. Nurses felt that the training program should also be designed by the clinical settings themselves. Conclusions: understanding the meaning of nursing students with registered nurses might gain a deeper insight into their expectations.
Chen, Kuan-Ling; Tsai, Yun-Fang; Shao, Jung-Hua; Shyu, Yea-Ing
The hospital-based scholarship is a relatively recent incentive used by hospitals to recruit new nursing graduates. Few studies have explored the impact of these scholarship programs on hospital recruitment. To explore the perspectives and expectations of new nursing graduates on the application of a hospital-based scholarship for nursing students. This study used a qualitative research approach. Purposive sampling was used to recruit 20 new nursing graduates from one university in northern Taiwan in 2013. Content analysis was applied to analyze the data. Two themes were identified by participants who had applied for a hospital-based scholarship: "aspire to be a nursing-scholarship recipient and work towards this aspiration" and "look forward to receiving a nursing-scholarship and imagine possible features of the future life." One theme was identified by participants who had not applied for a hospital-based scholarship: "agree with the policy of hospital-based scholarship but resist the restrictions on their life." Although both groups agreed that the scholarship program helped relieve financial stresses, participants who had applied for the scholarship tended to hold positive and aggressive attitudes towards the nursing scholarship. Conversely, participants who had not applied for the scholarship did so due to the perceived conflicts between the scholarship and their career plans. It is recommended to consider providing career-planning assistance to new graduates and to arrange that students who sign a scholarship contract have their clinical practice in their working unit in order to improve adaptation.
ibrahim, Restu; Andriani, Melan
This study performed on mother child hospital Eria Bunda Pekanbaru. This study destination to determine how the variables influence and leadership training simultaneously and partially on the performance of nurses on mother child hospital Eria Bunda Pekanbaru. As for the population in the study was the nurses who work on mother child hospital Eria Bunda Pekanbaru which amounts to 69 people. Analysis of the data used is descriptive analysis, as it also uses namely Quantitative Analysis using m...
Full Text Available Background: Work and family are the source of tranquility and if the balance between these two is not provided, pleasure, happiness and peace of human being would be lost, which will cause unreturnable loss for him. Regarding the importance of nurses’ role in health system, the present study aimed to study the relation of work-family balance and quality of life of nurses working at selected Iranian teaching hospitals. Methods: Present study is a cross sectional, descriptive-analytical study which was carried out on 306 nurses working at three teaching hospitals of Iran. The sampling method was stratified sampling and questionnaire was the data collection instrument. Data analysis was carried out using inferential statistics through SPSS Ver18. Findings: nurses spent more time to work than family and they had more satisfaction of their family life than their work. This suggests the imbalance of nurses in two dimension of time balance and satisfaction balance, which has resulted a decrease in quality of life of studied nurses. Nurse’s involvement in work and life as the third component of work-life balance concept, was balanced and it did not indicate significant correlation with quality of life. Nurses experiencing less work-family conflict and more stress in their life, had higher level of quality of life. Conclusion: Nurses will be more exposed to the negative outcomes of work-life imbalance than other groups of employees, so paying attention to managing the demands of work and family aimed at improving the nurses’ quality of life, has specific importance. Hence, designing a plan which defines main components of work-family balance among various groups of hospital staff including nurses, should be put at the top agenda of Iran’s health system policy makers.
Marcinowicz, Ludmiła; Abramowicz, Paweł; Zarzycka, Danuta; Abramowicz, Magdalena; Konstantynowicz, Jerzy
A qualitative descriptive design using an interview guide approach was adopted to investigate the patient-nurse relationship and paediatric ward amenities from the perspective of parents and hospitalised children in Poland. The study included 26 parents or caregivers of hospitalised children (between 13 months and 15 years old) and 22 children (from 10 to 16 years old). Qualitative content analysis was used to analyse the recorded verbal data. Data from patients' transcripts were coded and classified in terms of topics on the patient-nurse relationship and hospital care. We identified five main topics. 1. Nurse qualities; 2. Nurse verbal behaviour; 3. Nurse tone of voice and non-verbal behaviour; 4. Hospital amenities; 5. Parents' expectations towards nurses. Our study contributes to increased understanding of parents' and children's experiences of paediatric hospital care. © The Author(s) 2014.
Anzai, Eriko; Douglas, Clint; Bonner, Ann
The purpose of this study was to describe Japanese hospital nurses' perceptions of the nursing practice environment and examine its association with nurse-reported ability to provide quality nursing care, quality of patient care, and ward morale. A cross-sectional survey design was used including 223 nurses working in 12 acute inpatient wards in a large Japanese teaching hospital. Nurses rated their work environment favorably overall using the Japanese version of the Practice Environment Scale of the Nursing Work Index. Subscale scores indicated high perceptions of physician relations and quality of nursing management, but lower scores for staffing and resources. Ward nurse managers generally rated the practice environment more positively than staff nurses except for staffing and resources. Regression analyses found the practice environment was a significant predictor of quality of patient care and ward morale, whereas perceived ability to provide quality nursing care was most strongly associated with years of clinical experience. These findings support interventions to improve the nursing practice environment, particularly staffing and resource adequacy, to enhance quality of care and ward morale in Japan. © 2013 Wiley Publishing Asia Pty Ltd.
Danan, Jane-Laure; Giraud-Rochon, François
The publication of the decree relating to the code of ethics for nurses means that the State is producing a text for all nursing professionals, whatever their sector or their mode of practice. However, faced with the standardisation of nursing procedures, the production of a new standard by a government is not a neutral issue. On the one hand, it could constitute a reinforcement of the professional credibility of this corporation; on the other this text becomes enforceable on all nurses and employers. Within a territory hospital group, this reflection must form part of nursing and managerial practices and the relationships with the hospital administration. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Background Over the last decades, converging forces in hospital care, including cost-containment policies, rising healthcare demands and nursing shortages, have driven the search for new operational models of nursing care delivery that maximize the use of available nursing resources while ensuring safe, high-quality care. Little is known, however, about the distinctive features of these emergent nursing care models. This article contributes to filling this gap by presenting a theoretically and empirically grounded taxonomy of nursing care organization models in the context of acute care units in Quebec and comparing their distinctive features. Methods This study was based on a survey of 22 medical units in 11 acute care facilities in Quebec. Data collection methods included questionnaire, interviews, focus groups and administrative data census. The analytical procedures consisted of first generating unit profiles based on qualitative and quantitative data collected at the unit level, then applying hierarchical cluster analysis to the units’ profile data. Results The study identified four models of nursing care organization: two professional models that draw mainly on registered nurses as professionals to deliver nursing services and reflect stronger support to nurses’ professional practice, and two functional models that draw more significantly on licensed practical nurses (LPNs) and assistive staff (orderlies) to deliver nursing services and are characterized by registered nurses’ perceptions that the practice environment is less supportive of their professional work. Conclusions This study showed that medical units in acute care hospitals exhibit diverse staff mixes, patterns of skill use, work environment design, and support for innovation. The four models reflect not only distinct approaches to dealing with the numerous constraints in the nursing care environment, but also different degrees of approximations to an “ideal” nursing professional practice
Brandi, C L; Naito, A
Nursing administration research is scarce in Japan during a time when health care is rapidly reforming and baccalaureate and graduate nursing programmes are rapidly developing. Additionally, nursing administration content relies heavily on Western and non-nursing theories, some of which have been criticized for male bias. The purpose of this article is to present key findings from a qualitative study that explored the perspectives or viewpoints of 16 Japanese senior female nurse administrators in hospitals in order to learn what was happening in their working situations and how they were managing. This feminist study used dimensional analysis strategies for data collection and analysis. Semi-structured, tape-recorded interviews were conducted by both researchers in Japanese, transcribed into Japanese, and translated into English. The resulting explanatory matrix portrayed a story of 16 nurse administrators, most of whom were able successfully to enact a management role in a context of role ambiguity that was congruent with their relational values and beliefs. Important conditions influencing value-based role enactment included organization mission and purpose, organization structure, nurse-doctor relationships, participant-supervisor relationships, and personal attributes. Many participants were able to overcome barriers in these categories using strategies of tempered radicalism and consequently made positive organizational changes. Advanced formal education, better organizational support, and a raised consciousness among nurses that views nurses and midwives as equal partners with other professionals will enable Japanese nurse administrators to help advance patient-centred care and nursing development and empowerment.
Full Text Available Background: According to the recent studies, violence in health care is growing and it excessively affects the retention and recruitment of nurses. It also affects burnout levels and sick leave. Aims: To determine the physical and verbal abuse violence prevalence against nurses in Al-Medina hospitals. Methods: This a descriptive cross sectional study which was conducted in three community hospitals in Saudi Arabia in 2011 using a random sample of 288 nurses. Results: The prevalence of physical violence among the population of the study was 26%. Verbal abuse prevalence was 23.3%. Patients/clients were the major perpetrators of the violence (76.0% followed by patient’s family member(s (24.0%. Whereas 92.0% mentioned that the violence action was preventable. Gender was correlated significantly with verbal abuse violence. Conclusion: Our study manifested that the prevalence of physical violence and verbal abuse among nurses at Al-Medina hospitals was high.
Luís Felipe Pissaia
Full Text Available Justification and objective: This study has the objective check the use of Information and Communication Technologies (ICT in care processes of nursing through the methodology of Systematization of Nursing Assistance (SNA in a hospital in the interior of Rio Grande do Sul, Brasil. Methods: Descriptive and exploratory study with a qualitative approach carried out six nurses of a hospital service. Results: The lack of knowledge about the importance of ICT, the deficit in the provision of continuing education to professionals and cultural prejudice to new working methods were list as existing weaknesses. Contributions are relate to organizing and planning your activities, as well as an effective personnel management based on the principles of comprehensive care provided to the client. Conclusion: This study demonstrated that ICT help in the implementation of processes and implementation of SNA, promoting new models of work to nurses and encouraging compliance by the hospitals.
Abo Ali, Ehab A; Saied, Shimaa M; Elsabagh, Hala M; Zayed, Hanaa A
Sexual harassment against nurses is a major workplace problem causing adverse psychological effects and may affect the occupational performance of the nurses. This study aimed to assess the magnitude of this problem, and its characteristics and consequences among the nursing staff in Tanta University Hospitals, Gharbeia Governorate, Egypt. A descriptive cross-sectional study was carried out on 430 nurses at Tanta University Hospitals using a semistructured, self-administered questionnaire to collect the data concerning the exposure and characteristics of harassment situations. A representative sample of the nurses was taken randomly from the emergency, medical and surgical departments. Overall, 70.2% of the studied nurses were ever exposed to sexual harassment at the workplace; 43.7% of the harassed nurses were working in both day and night shifts. Staring in a suggestive manner emerged as the most common form of harassment, followed by hearing sexual words and comments or jokes (70.9, 58.6 and 57.3%, respectively). The relatives of the patients were the most common perpetrators, followed by the hospital staff other than the doctors (61.9, 45.4%, respectively). During the harassment situation, astonishment and shock were the most frequent responses in 65.2% of the harassed nurses, while after its occurrence 38.4% ignored the situation. About 95% of the harassed nurses were left with psychological effects, mostly in the form of disappointment and depression (76.5 and 67.9%, respectively). The prevalence of sexual harassment among nurses at the workplace was high with relation to certain occupational factors, and it led to marked psychological effects on the victims. Hence, protective legislations and measures should be taken by the hospital management for prevention of this problem in the future.
Full Text Available When suicide occurs, it is regarded as an adverse event. Often, little attention is given to the nurses who cared for the patients prior to the adverse event. Instead the affected nurses are expected to write statements and incident reports about the adverse event. The aim was to explore the experiences of nurses who cared for patients who successfully committed suicide whilst admitted at a specific general hospital in Gauteng Province, South Africa. A qualitative exploratory research was conducted. Data were collected through in-depth interviews with a purposive sample of six nurses and content analysis was done. Nurses experienced feelings of shock; blame and condemnation; inadequacy and feared reprisal. This study suggests a basis for development of support strategies to assist the nurses to deal with their emotions following experience of adverse events.
Ferdinand C. Mukumbang
Objectives: The study had three objectives: to describe the experiences of patients nursed by student nurses in a teaching hospital in the Western Cape; to identify patterns in the experiences of patients receiving patient care from student nurses; and to analyse aspects of the experiences that may need further attention for the training of student nurses. Method: A descriptive phenomenological approach was used to explore the experiences of patients nursed by student nurses. Participant selection took place purposively from different wards of the identified teaching hospital, and thematic saturation was achieved at 10 participants. The data were collected through in-depth interviews and analysed using thematic content analysis. Results: Three main themes were discovered after data analysis: methods of identification of student nurses by patients; positive perceptions of student nurses by patients; and negative perceptions of student nurses by patients. Conclusion: The findings will inform the clinical supervisors and educational institutions of aspects of the nursing training of student nurses that need improvement and those that require enforcement.
Rutledge, Dana N; Retrosi, Tina; Ostrowski, Gary
The study purpose was to report medication error reporting barriers among hospital nurses, and to determine validity and reliability of an existing medication error reporting barriers questionnaire. Hospital medication errors typically occur between ordering of a medication to its receipt by the patient with subsequent staff monitoring. To decrease medication errors, factors surrounding medication errors must be understood; this requires reporting by employees. Under-reporting can compromise patient safety by disabling improvement efforts. This 2017 descriptive study was part of a larger workforce engagement study at a faith-based Magnet ® -accredited community hospital in California (United States). Registered nurses (~1,000) were invited to participate in the online survey via email. Reported here are sample demographics (n = 357) and responses to the 20-item medication error reporting barriers questionnaire. Using factor analysis, four factors that accounted for 67.5% of the variance were extracted. These factors (subscales) were labelled Fear, Cultural Barriers, Lack of Knowledge/Feedback and Practical/Utility Barriers; each demonstrated excellent internal consistency. The medication error reporting barriers questionnaire, originally developed in long-term care, demonstrated good validity and excellent reliability among hospital nurses. Substantial proportions of American hospital nurses (11%-48%) considered specific factors as likely reporting barriers. Average scores on most barrier items were categorised "somewhat unlikely." The highest six included two barriers concerning the time-consuming nature of medication error reporting and four related to nurses' fear of repercussions. Hospitals need to determine the presence of perceived barriers among nurses using questionnaires such as the medication error reporting barriers and work to encourage better reporting. Barriers to medication error reporting make it less likely that nurses will report medication
Rahimaghaee, Flora; Nayeri, Nahid Dehghan; Mohammadi, Eesa; Salavati, Shahram
Background: Professional development is reiterated in the new definition of modern organizations as a serious undertaking of organizations. This article aims to present and describe a prescriptive model to increase the quality of professional development of Iranian nurses within an organization-based framework. Materials and Methods: This article is an outcome of the results of a study based on grounded theory describing how Iranian nurses develop. The present study adopted purposive sampling and the initial participants were experienced clinical nurses. Then, the study continued by theoretical sampling. The present study involved 21 participants. Data were mainly collected through interviews. Analysis began with open coding and continued with axial coding and selective coding. Trustworthiness was ensured by applying Lincoln and Guba criteria such as credibility, dependability, and conformability. Based on the data gathered in the study and a thorough review of related literature, a prescriptive model has been designed by use of the methodology of Walker and Avant (2005). Results: In this model, the first main component is a three-part structure: Reformation to establish a value-assigning structure, a position for human resource management, and a job redesigning. The second component is certain of opportunities for organization-oriented development. These strategies are as follows: Raising the sensitivity of the organization toward development, goal setting and planning the development of human resources, and improving management practices. Conclusions: Through this model, clinical nurses’ professional development can transform the profession from an individual, randomized activity into more planned and systematized services. This model can lead to a better quality of care. PMID:26457100
Kutney-Lee, Ann; Wu, Evan S; Sloane, Douglas M; Aiken, Linda H
One strategy proposed to alleviate nursing shortages is the promotion of organizational efforts that will improve nurse recruitment and retention. Cross-sectional studies have shown that the quality of the nurse work environment is associated with nurse outcomes related to retention, but there have been very few longitudinal studies undertaken to examine this relationship. To demonstrate how rates of burnout, intention to leave, and job dissatisfaction changed in a panel of hospitals over time, and to explore whether these outcomes were associated with changes in nurse work environments. A retrospective, two-stage panel design was chosen for this study. Survey data collected from large random samples of registered nurses employed in Pennsylvania hospitals in 1999 and 2006 were used to derive hospital-level rates of burnout, intention to leave current position, and job dissatisfaction, and to classify the quality of nurses' work environments at both points in time. A two-period difference model was used to estimate the dependence of changes in rates of nurse burnout, intention to leave, and job dissatisfaction on changes in nurse work environments between 1999 and 2006 in 137 hospitals, accounting for concurrent changes in nurse staffing levels. In general, nurse outcomes improved between 1999 and 2006, with fewer nurses reporting burnout, intention to leave, and job dissatisfaction in 2006 as compared to 1999. Our difference models showed that improvements in work environment had a strong negative association with changes in rates of burnout (β=-6.42%, pjob dissatisfaction (β=-8.00%, pburnout, intention to leave current position, and job dissatisfaction. Copyright © 2012 Elsevier Ltd. All rights reserved.
Alkorashy, Hanan A Ezzat; Al Moalad, Fawziah Bakheet
Violence against nurses is a major challenge for healthcare administrators. It is gaining more attention because it has a negative impact on nurses, the quality of health care and health organization. Common types of violence include physical harassment, sexual abuse, aggression, mobbing and bullying. Patients, their relatives and co-workers are considered the main perpetrators. To determine the prevalence rate of workplace violence against nursing professionals in a university hospital in Riyadh, Saudi Arabia, most frequent type and perpetrators as well as the contributing factors. This quantitative cross-sectional study adapted a survey questionnaire from the Massachusetts Nurses Association Survey on Workplace Violence/Abuse to collect data from a quota sample of 370 nursing personnel. Almost half of the participants had experienced violence in the professional setting during the 12 months prior to the study. The majority of subjects perceived workplace violence as verbal abuse. Nearly all nursing professionals identified patients as the leading cause. Slightly more than half mentioned understaffing, misunderstandings, long waits for service and lack of staff training and policies for preventing crisis as contributing factors. The prevalence rate is extremely high among nurses in the targeted Saudi university hospital. Saudi health as well as university hospitals' administration and policy makers should adopt and introduce a 'zero tolerance policy', set standards and develop practical measures for preventing the incidence and for controlling the prevalence of violence against nurses. Besides, healthcare organizations, particularly hospitals, can fulfil their obligations to provide both staff and patients with more secure environment. Further research on the topic is needed. © 2016 International Council of Nurses.
Full Text Available We aimed to determine the effect of training of new guideline on Pressure ulcer (PU prevention in the intensive care units (ICUs. PU is the third costly disorder with high mortality and morbidity. Thus reduction of PU incidence is very important and effective step for health systems. PU is one of the most common medical conditions, occurring in both hospital and community settings, in all age groups, but mostly among the elderly, the immobile, and patients with severe acute and chronic illnesses or neurological deficits. This semi-experimental study was conducted on high-risk patients with a Norton scale score of 16, while they had daily care for PU prevention. Patients were randomly divided into two equal groups of intervention and control patients in each. The control group was assessed with routine care o PU prevention in the first three months of the study. Then the nurses were trained with the new guideline and after that the data were collected again in the second three months period. The data were analyzed through the SPSS statistical software (version 13. results showed that new guideline training program was associated with decreased risk of PU. Education of the new guideline on PU is an effective way to decrease the rate of PU in (ICUs. Training the new care guideline of the PU prevention for the involved nurses probably can reduce the incidence rate of pressure ulcer.
Mari Skancke Bjerknes
Full Text Available The transition from student to working nurse has long been recognized as challenging. This paper presents the findings of research into the opportunities and limitations encountered by newly qualified nurses when taking on the nursing role. The study had an ethnographic design. Observation, interviews, and document analysis were used to gain insight into nurses' daily work from the perspective of recently graduated nurses. Thirteen nurses were monitored closely during their first year in a hospital setting in Norway. These new nurses generally entered the field with empathy for their patients, enthusiasm for the profession, and readiness to learn more about being a good nurse. However, their more experienced colleagues seemed to neither respect nor nurture this attitude. The new nurses experienced heavier responsibilities than expected, fragmentation of patient care, and stressful interactions with colleagues. The lack of a supportive work environment and role models increased the new nurses' experience of overwhelming responsibility in their daily work situations. The nurses learned to cope the hard way, despite the organizational culture, not because of it. Adjusting the profession's expectations of new nurses, and offering good role models and more comprehensive support programmes, would markedly ease the transition for new nurses.
Sabouni, Farah; Mahmoudi, Shima; Bahador, Abbas; Pourakbari, Babak; Sadeghi, Reihaneh Hosseinpour; Ashtiani, Mohammad Taghi Haghi; Nikmanesh, Bahram; Mamishi, Setareh
The clinical importance of Staphylococcus aureus (S. aureus) is attributed to notable virulence factors, surface proteins, toxins, and enzymes as well as the rapid development of drug resistance. The aim of this study was to compare the occurrence of virulence factors produced by S. aureus strains isolated from children in an Iranian referral children's hospital. The presence of genes encoding for the enterotoxins A (sea), B (seb), C (sec), D (sed), TSST-1 (tsst), exfoliative toxin A (eta), and exfoliative toxin B (etb) were detected by Multiplex polymerase chain reaction (PCR) using specific primers. In addition, the standardized Kirby-Bauer disc-diffusion method was performed on Mueller-Hinton agar. In total, 133 S. aureus isolates were obtained from different patients. Of these S. aureus isolates, 64 (48%) were methicillin-resistant S. aureus (MRSA), and all of these tested positive for the mecA gene. Regarding the classical enterotoxin genes, sea gene (40.6%) was the most prevalent followed by seb (19.6%), tsst (12.8%), eta (11.3%), etb (9%), sed (4.5%), and sec (3%). Among methicillin-susceptible S. aureus (MSSA) isolates, seb and tsst were the more prevalent toxins in comparison with MRSA isolates (p 0.05). In our study enterotoxin A was produced by 40.6% of the isolates (48% from MRSA and 33% from MSSA isolates) which was higher than in previous reports. According to our results, strict hygiene and preventative measures during food processing are highly recommended.
Hsu, Ming-Yi; Kernohan, George
This paper is a report of a study describing the quality of working life of nurses in Taiwan. The purpose of the study was to gather data on which to base a questionnaire to be used in further research. Nurses often complain of overwork and underpay. Problems persist with nurses' job satisfaction, stress, organizational commitment and intent to leave. 'Quality of working life' is a system of analysing how people experience work: it relates to job satisfaction, intent to leave, turnover rate, personality and work stress. However, reliable information on hospital nurses' quality of working life is limited. A descriptive study was carried out with a convenience sample. A total of 16 focus groups in one medical centre and five regional hospitals informed a quality of working life framework. Each group had three to five participants who were Registered Nurses in medical or surgical wards with at least 2 years' nursing experience, and who held a position below assistant nurse manager. The data were collected in 2000. A total of 56 nurses' quality of working life categories were identified and fitted into six dimensions: socio-economic relevance, demography, organizational aspects, work aspects, human relation aspects and self-actualization. In this paper, we focus on issues emphasized by focus group participants. These were managing shift work within the demands of family life; accommodation; support resources; and nurses' clinical ladder system and salary system. Further research is needed with other groups of nurses in a wider variety of settings in order to examine strengths and weaknesses in the total healthcare work environment and to develop appropriate strategies for nurses' quality of working life.
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 pleadership 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.
Full Text Available Abstract Tuberculosis (TB is considered an occupational disease among health-care workers (HCWs. Direct contact with TB patients leads to an increased risk to become latently infected by Mycobacterium tuberculosis. The objective of this study is to estimate the prevalence of latent M. tuberculosis minfection among nursing professionals of a hospital in Rio Grande do Sul, Brazil, assessed by tuberculin skin test (TST. From November 2009 to May 2010, latent M. tuberculosis infection was assessed by TST in 55 nursing professionals. Epidemiological information was collected using a standardized questionnaire. A positive TST result (> or = 10 mm was observed in 47.3% of the HCWs tested. There was no significant difference in TST positivity when duration of employment or professional category (technician or nurse was evaluated. The results of this work reinforce the need for control measures to prevent latent M. tuberculosis infection among nursing professionals at the hospital where the study was conducted.
Matt, Susan B
Since enactment of the Americans with Disabilities Act of 1990, U.S. employers have been mandated to provide reasonable accommodation for employees with disabilities. Nurses with disabilities have described their experiences, reflecting occurrences that might be noncompliant with these mandates. There is little information available regarding the work experience of nurses with disabilities practicing in hospitals. How these workers view their work world and how they perceive the way others within that environment think of them and their contributions to patient care is important because these individuals must be included as equal participants in a profession that relies on teamwork to function effectively. An exploratory study was conducted to gain a context-based understanding of the lived experiences of hospital-employed nurses with disabilities. Grounded theory methodology was used to uncover themes and to identify factors comprising "disability climate"; such factors might inform the future development of workplace policies supportive of all nurses.
García-Juárez, María del Rosario; López-Alonso, Sergio R; Moreno-Verdugo, Ana; Guerra-González, Sara; Fernández-Corchero, Juana; Márquez-Borrego, M José; Orozco-Cózar, M José; Ramos-Bosquet, Gádor
To determine the level of implementation of an inpatient personalized nursing care model in four hospitals of the Andalusian Health Service, and to determine if there is an association between this model and the perception of trust in the nurse by the patient. An observational cross-sectional study included the patients discharged during a period of 12 months from hospital wards that used the Inpatient Personalized Nursing Care Model of the Andalusian Health Service (based on Primary Nursing Model). The level of implemention was evaluated using the Nursing Care Personalized Index (IPC), made by «patient report» methodology, and the nurse-patient trust relationship was evaluated at the same time as the IPC. Statistical analysis included descriptive data analysis, Chi-squared test, and bivariate and multivariate logistic regression, with and without stratifying by hospitals wards. A total of 817 patient were included. The implementation of the inpatient personalized nursing care model varied between 61 and 79%. The IPC values showed a strong association with the nurse-patient trust relationship, and that for each point increase in the IPC score, the probability of a nurse-patient trust relationship increased between 50 and 130% (0.120.58). The implementation of a personalized nursing care model in the wards studied was higher in the surgicals wards and at regular level in medical wards. Furthermore, the influence of the inpatient personalized nursing care model on the nurse-patient trust relationship has been demonstrated using the IPC model. This trust is the main component for the establishment of a therapeutic relationship. Copyright © 2013 Elsevier España, S.L. All rights reserved.
Aronson, Keith R
This study assessed the job satisfaction of nurses who work in private psychiatric hospitals. In 1998 and 1999 an anonymous employee satisfaction survey was completed by all 3,024 employees of 39 for-profit psychiatric hospitals owned by the same hospital corporation. Of this total, 546 were registered nurses (RNs). Generally RNs reported fair levels of satisfaction. They reported high levels of pride in their hospitals but low levels of satisfaction with the parent company. Differences in satisfaction were noted as a function of work shift, supervisory role, work setting, and tenure. RNs were less satisfied than employees in all other hospital job classifications. RNs' low level of satisfaction relative to other positions is concerning.
Emam, Sanaa Abdel-aziz; Nabawy, Zeinab Mohamed; Mohamed, Azzaa Hassan; Sbeira, Walaa Hashem
Work climate is indicative of how well the organization is realizing its full potential. An accurate assessment of work climate can identify the unnecessary obstacles to nurses interfering with their best performance. The present study aims to assess nurses' work climate at Alexandria Main University Hospital. The study sample included all nurses (N=400) who were working in inpatient medical and surgical units at the Alexandria Main University Hospital who were available at the time of data collection. A structured questionnaire was developed to assess nurses' perceptions regarding the dimensions of work climate. Data was collected by individual interview using the structured questionnaire. Results indicated that the highest percentages of nurses in medical and surgical units perceived that their work climate is characterized by good way of performance management, feeling of responsibility, warmth and supportive relationships, quality of communication, morale, organizational clarity and feeling of identity and belongness to the hospital. Nurses perceived that they are lacking work climate conducive to conflict resolution, participation in decision making, opportunity for training and development, fair rewards and recognition, calculated risks, sufficient resources, effective leadership and teamwork. There were no significant difference between nurses perceptions in medical and surgical units regarding all dimensions of work climate. The highest percentage of nurses in all units were satisfied only with the feeling of responsibility, way of performance management, and quality of communication. Conflict and identity were perceived as the most important areas that need improvement in the hospital. Based on the results recommendations were given to enhance work climate through designing compensation and recognition systems, and negotiate their requirements and accomplishment based on established standards and outcomes measures. Also, encouragement of and planning for
Griffin, Ruth A; Polit, Denise F; Byrne, Mary W
The purpose of this study was to examine whether nurses' recommendations for managing children's pain were influenced by stereotypes based on children's personal attributes. Three vignettes, in which hospitalized children's sex, race, and attractiveness were experimentally manipulated, were mailed to a national random sample of 700 pediatric nurses; 334 nurses responded. Responses to vignette questions indicated little evidence of stereotyping. Nurses perceived similar levels of pain and recommended similar pain treatments, regardless of sex, race, and attractiveness. Nurses, on average, perceived children's pain at levels consistent with the children's self-reports and recommended assertive analgesic and non-pharmacologic pain management strategies. The results appear consistent with prevailing views on providing adequate pain treatment for children.
Ana Dulce Amorim Santos Soares
Full Text Available The objective was to analyze the scientific collection on nursing care with the skin of hospitalized newborns. In order to reach the objective, an integrative review was conducted. The search for primary studies was performed in the databases LILACS, MEDLINE, BDENF and PUBMED. The included studies (n=10 were grouped into thematic categories: risk factors for skin lesions in hospitalized newborns and their consequences; and nursing care to promote the integrity of the skin of hospitalized newborns. The main care identified were lubrication with emollient agents, use of hydrocolloids and transparent film, changes in decubitus, hygiene techniques, phototherapy and invasive procedures. The results of the review offer guidance for the conduction of researches that investigate interventions that are more effective in the prevention and treatment of skin injuries and their consequences. Key words: Nursing Care, Newborn, Skin.
Peltokoski, J; Vehviläinen-Julkunen, K; Miettinen, M
This study aimed to describe the research on registered nurses' orientation processes in specialized hospital settings in order to illustrate directions for future research. The complex healthcare environment and the impact of nursing shortage and turnover make the hospital orientation process imperative. There is a growing recognition regarding research interests to meet the needs for evidence-based, effective and economically sound hospital orientation strategies. An integrative literature review was performed on publications from the period 2000 to 2013 included in the CINAHL and PubMed databases. English-language studies were included. Themes guiding the analysis were definition of the hospital orientation process, research topics, data collection and instruments and research evidence. Narrative synthesis was used. Eleven papers met the inclusion criteria. The conceptualization of orientation process reflected the complexity of the phenomenon. Less attention has been paid to designs to establish correlations or relationships between selected variables and hospital orientation process. The outcomes of hospital orientation programmes were limited primarily to retention and job satisfaction. The research evidence therefore cannot be evaluated as strong. The lack of an evidence-based approach makes it difficult to develop a comprehensive orientation process. Further research should explore interventions that will enhance the quality of hospital orientation practices to improve nurses' retention and job satisfaction. To provide a comprehensive hospital orientation process, hospital administrators have to put in place human resource development strategies along with practice implications and research efforts. Comprehensive hospital orientation benefits and outcomes should be visible to policy makers. © 2016 International Council of Nurses.
Ruzafa-Martínez, María; Madrigal-Torres, Manuel; Velandrino-Nicolás, Antonio; López-Iborra, Lidón
To evaluate work satisfaction among Spanish nurses employed by English hospitals, as well as the influence of several social and work-related variables associated with satisfaction. We performed a cross-sectional study. All Spanish nurses (n=360) with a contract with any English hospital in April 2003 were included in the study. The self-administered and validated Font Roja work satisfaction questionnaire was used. The response rate was 78.6%. Overall work satisfaction among Spanish nurses was medium. The dimensions with higher work satisfaction were relationships with colleagues and superiors. The dimensions showing lowest work satisfaction were job satisfaction and professional competence. Statistically significant and positive associations were obtained between level of English, professional grade, shift pattern, working in the intensive care unit or accident and emergency department, time worked in English hospitals and degree of work satisfaction. Employers of Spanish nurses should try to increase job satisfaction and professional competence among these workers. Incentivation and professional promotion systems might help achieve this aim. Employers could also try to improve Spanish nurses' English level before contracts are signed and pay special attention to their needs during the first working year. Spanish nurses job satisfaction would also increase if they were allowed to choose their working shift and the unit or ward where they are going to work.
Research purpose: The purpose of this study was to investigate individual determinants of voluntary turnover to identify a risk-group profile. Motivation for the study: Nursing employers should have a clearer understanding of the dynamics around nurses’ turnover behaviour and embark on strategies to retain their talent. Research design, approach and method: A survey measuring voluntary turnover was conducted among 262 professional and assistant nurses in three selected hospitals in Gauteng province using the McCarthy, Tyrrell and Cronin (2002 instrument. Pearson’s chi square with Yates’s continuity correction tested the relationship among the variables presented in a contingency table, in other words the risk group and each of the individual determinants. Main findings: Discontent with salaries was the major determinant of the nurses’ resignation. Organisational causes were nursing practices, the work environment, physical-emotional costs and employment opportunities after resignation. Practical/managerial implications: Hospital management could indeed establish a good rapport with nursing staff while facilitating respectful and ethical conduct by doctors towards nursing staff. Putting into place effective labour practices and business strategies could improve job satisfaction in the workplace. Contribution/value-add: This study contributed to a greater understanding of the personal and organisational determinants of the turnover of nurses in South African hospitals.
Lu, Hong; Barriball, K Louise; Zhang, Xian; While, Alison E
The current nursing shortage and high turnover is of great concern in many countries because of its impact upon the efficiency and effectiveness of any healthcare delivery system. Recruitment and retention of nurses are persistent problems associated with job satisfaction. To update review paper published in 2005. This paper analyses 100 papers relating to job satisfaction among hospital nurses derived from systematic searches of seven databases covering English and Chinese language publications 1966-2011 (updating the original paper with 46 additional studies published 2004-2011). Despite varying levels of job satisfaction across studies, sources and effects of job satisfaction were similar. Hospital nurse job satisfaction is closely related to working conditions and the organizational environment, job stress, role conflict and ambiguity, role perception and role content, organizational and professional commitment. More research is required to understand the relative importance of the many identified factors relating to job satisfaction of hospital nurses. It is argued that the absence of a robust causal model reflecting moderators or moderator is undermining the development of interventions to improve nurse retention. Copyright © 2011 Elsevier Ltd. All rights reserved.
Ünsal Atan, S; Baysan Arabaci, L; Sirin, A; Isler, A; Donmez, S; Unsal Guler, M; Oflaz, U; Yalcinkaya Ozdemir, G; Yazar Tasbasi, F
This research was conducted to analyse the violence experienced by nurses employed at six university hospitals. A descriptive and cross-sectional study was conducted. The research sample consisted of 441 nurses who worked in the emergency, intensive care and psychiatry units of six university hospitals in Turkey between June 2008 and June 2009 and who voluntarily agreed to participate. It was found that 60.8% of the nurses were subjected to verbal violence and/or physical violence from patients, visitors or health staff. Of the nurses who were subjected to workplace violence, 42.9% stated that their experience of verbal and/or physical violence had a negative impact on their physical and/or psychological health, and 42.9% stated that their work performance was negatively affected. Of these nurses, 1.8% stated that they received professional help, 13.6% stated that a report was made and 9.5% stated that they contacted the hospital police in some way. According to the findings of this research, similar to the situation worldwide, nurses in Turkey are subjected to verbal and/or physical violence from patients, visitors and health staff. © 2012 John Wiley & Sons Ltd.
Goldman, R L; Bates, D P; Bradbury, M; Breaux, D K; Caron, M; Gerardo, C; Copoulos, S; Hansen, L L; Oien, S M; Semones, C
The current nursing shortage problem as defined in this article, is the result of a supply and demand imbalance. The demand for nurses is growing at a faster rate than the supply. If strategies are not implemented to correct this imbalance the demand for nurses will continue to surpass the supply, negatively affecting access to and delivery of quality patient care. Factors contributing to the increased demand for nurses and the dwindling supply must be examined if solutions to the problem are to be found and implemented. Factors contributing to the growing demand for nurses include the decreasing use of ancillary personnel by hospitals in an effort to tighten their budgets; the impact of Medicare's prospective payment system on hospital lengths of stay; the increase in patient acuity with advances in medical technology; and alternative health care opportunities pulling nurses away from the hospital setting. The supply of RNs is shrinking in relation to demand because of low retention rates; declining nursing school enrollment; non-competitive wages; poor working conditions; alternative career opportunities for women; and the lack of power and support within the nursing profession. An active marketing approach that relies on this assessment of contributing factors has been formulated in an attempt to resolve the problem and meet the increasing demand. Recommendations have been made and ranked in the order of their priority and pros and cons established for each. The strategies developed have been divided into four basic marketing categories of product, price, place, and promotion. If the problem is to be resolved these strategies must be marketed to hospitals, their administrators, nurses, other allied health professionals, third party payors, educators, and the general public. The nursing profession itself must find the unity and strength within its own group of professionals to build political and economic powers to enhance their product. Nursing is at a crossroad
Kurnat-Thoma, Emma; El-Banna, Majeda; Oakcrum, Monica; Tyroler, Jill
To examine nurses' health-promoting lifestyle behaviors, describe their self-reported engagement in employee wellness program benefit options, and explore relationships between nurse demographic factors, health characteristics and lifestyle behaviors. Nurses adopting unhealthy lifestyle behaviors are at significantly higher risk for developing a number of chronic diseases and are at increased susceptibility to exhaustion, job dissatisfaction and turnover. Strengthening professional nurses' abilities to engage in healthy lifestyle behaviors could serve as a valuable tool in combating negative workplace stress, promote improved work-life balance and personal well-being, and help retain qualified health-care providers. In a 187-bed community hospital in the Washington D.C. metropolitan area, we conducted an IRB-approved exploratory descriptive study. We examined 127 nurses' demographic characteristics, self-reported employer wellness program use, and measured their healthy lifestyle behaviors using the 52-item Health-Promoting Lifestyle Profile-II (HPLP-II) survey instrument. Nurse demographic and HPLP-II scores were analyzed in SPSS v20.0. Inferential univariate statistical testing examined relationships between nurse demographic factors, health and job characteristics, and HPLP-II score outcomes. Nurses over 40years old were more likely to report participation in hospital wellness program options. Statistically significant age differences were identified in total HPLP-II score (p=0.005), and two subscale scores-spiritual growth (p=0.002) and interpersonal relations (p=0.000). Post-hoc testing identified nurse participants 40-49years old and ≥50years old experienced slightly lower total HPLP-II score, subscale scores in comparison to younger colleagues. Nurses ≥40years old may benefit from additional employer support and guidance to promote and maintain healthy lifestyles, personal well-being, and positive interpersonal relationships. Copyright © 2017 Elsevier
Lindsay, J Michael; Oelschlegel, Sandy; Earl, Martha
The author investigated the educational needs of nurses in an American Nurses Credentialing Center Magnet hospital to determine topics of interest, instruction time and delivery preferences, and interest in a research information skills certificate provided by the library. A 9-question survey was distributed to 1,500 nursing staff of the hospital through email. Surveys were completed by 865 respondents, which represented a response rate of 58%. The majority of respondents were registered nurses, licensed practical nurses, and paramedics (81%), and day-shift workers (65%). For education topics, nursing staff placed the highest priority on finding health-related mobile apps for professionals and developing evidence-based research skills. For mode of delivery, respondents expressed a preference for unit-based in-service, computer-based tutorials, and hands-on computer training. Most (70%) respondents expressed an interest in participating in a research information skills certificate program. Our survey results reveal an avenue for reinvigorating and updating the library's educational program to match the needs of nursing staff and may offer valuable insight for other libraries seeking to do the same.
Vallés, S; Valdavida, E; Menéndez, C; Natal, C
To evaluate the short-term impact of chronic illness in hospital units and to establish a method that allows nursing workloads to be adapted according to the care needs of patients. A descriptive study of the evolution of workloads of nursing staff associated with the care needs of patients between 1 July 2014 and 30 June 2016, in a county hospital. The care needs of the patients were assessed daily using an adaptation of the Montesinos scheme. The estimated times of nursing care and auxiliary nursing required by the patients, based on their level of dependence for time distribution, were based on the standards and recommendations of the Ministry of Health, Social Services and Equality. During the study period, there was a change in the patient care needs, with no increase in activity, which resulted in an increase in the nursing staffing needs of 1,396 theoretical hours per year. This increase implies an increase in the workforce of 5 nurses in the second period. In the study period, the needs for direct nursing care increased by 7%, this increase is not related to the increase in activity, but to the level of dependency of the patients with chronic diseases. This increase occurred in both medical and surgical units. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.
Utriainen, Kati; Ala-Mursula, Leena; Kyngäs, Helvi
To develop a theoretical model of hospital nurses' wellbeing at work. The concept of wellbeing at work is presented without an exact definition and without considering different contents. A model was developed in a deductive manner and empirical data collected from nurses (n = 233) working in a university hospital. Explorative factor analysis was used. The main concepts were: patients' experience of high-quality care; assistance and support among nurses; nurses' togetherness and cooperation; fluent practical organisation of work; challenging and meaningful work; freedom to express diverse feelings in the work community; well-conducted everyday nursing; status related to the work itself; fair and supportive leadership; opportunities for professional development; fluent communication with other professionals; and being together with other nurses in an informal way. Themes included: collegial relationships; enhancing high-quality patient care; supportive and fair leadership; challenging, meaningful and well organised work; and opportunities for professional development. Object-dependent wellbeing was supported. Managers should focus on strengthening the positive aspect of wellbeing at work, focusing on providing fluently organised work practices, fair and supportive leadership and togetherness while allowing nurses to implement their own ideas and promote the experience of meaningfulness. © 2014 John Wiley & Sons Ltd.
Hagos, Fisseha; Alemseged, Fessehaye; Balcha, Fikadu; Berhe, Semarya; Aregay, Alemseged
Background. Nursing process is considered as appropriate method to explain the nursing essence, its scientific bases, technologies and humanist assumptions that encourage critical thinking and creativity, and permits solving problems in professional practice. Objective. To assess the application of nursing process and it's affecting factors in Mekelle Zone Hospitals. Methods. A cross sectional design employing quantitative and qualitative methods was conducted in Mekelle zone hospitals March 2011. Qualitative data was collected from14 head nurses of six hospitals and quantitative was collected from 200 nurses selected by simple random sampling technique from the six hospitals proportional to their size. SPSS version 16.1 and thematic analysis was used for quantitative and qualitative data respectively. Results. Majority 180 (90%) of the respondents have poor knowledge and 99.5% of the respondents have a positive attitude towards the nursing process. All of the respondents said that they did not use the nursing process during provision of care to their patients at the time of the study. Majority (75%) of the respondent said that the nurse to patient ratio was not optimal to apply the nursing process. Conclusion and Recommendation. The nursing process is not yet applied in all of the six hospitals. The finding revealed that the knowledge of nurses on the nursing process is not adequate to put it in to practice and high patient nurse ratio affects its application. The studied hospitals should consider the application of the nursing process critically by motivating nurses and monitor and evaluate its progress. PMID:24649360
Cicchitti, Chiara; Cannizzaro, Giorgia; Rosi, Fabrizio; Maccaroni, Roberto; Menditto, Vincenzo G
Burnout syndrome (BOS) associated with stress has been documented in health care professionals in many specialties. The emergency department and the pre-hospital healthcare services are highly stressful environments. Little is known about the BOS in critical care nursing staff. The objective of the study is to compare the incidence of BOS and its three domains, namely, emotional exhaustion, depersonalization and reduced professional accomplishment, in two cohorts of critical care nurses: a pre-hospital and a hospital emergency service. A survey using a questionnaire (the Maslach Burnout Inventory-General Survey, MBI-GS), among nurses of two Italian emergency services has been performed: a hospital emergency service (HES, Emergency Department or "Pronto Soccorso") and a pre-hospital emergency service (PHES, territorial healthcare service or "Centrale Operativa 118"). All 60 nurses surveyed (82% female) filled the questionnaires. BOS-related symptoms have been identified in at least 50% of the nurses in the HES: 50% suffered a medium-high emotional exhaustion, 75% had a medium-high depersonalization and 92.5% had a medium-high reduced professional accomplishment. Among the PEHS nurses, BOS-related symptoms have been identified in at least 60% of the respondents: 60% had a medium-high emotional exhaustion, 70% had a medium-high depersonalization and 95% had a medium-high reduced professional accomplishment. Moreover, the likelihood that a nurse has a severe BOS, that is at least one degree of high burnout or ≥2 degrees of medium burnout, is significantly higher in the group of the PHES than in the HES (90% vs 60%, p nursing staff had a severe BOS. The incidence of BOS appeared to be similar among PHES and HES nurses with a higher trend for the former. Further interventional studies are needed to investigate the determinants of BOS among critical care nurses and the potentially preventive strategies.
Suzuki, Kenshu; Ohida, Takashi; Kaneita, Yoshitaka; Yokoyama, Eise; Uchiyama, Makoto
This paper reports a study to determine the prevalence of excessive daytime sleepiness and sleep habits among hospital nurses and to analyse associations between excessive daytime sleepiness and different types of medical error. It has been reported that sleep disorders, and the tiredness and sleepiness brought about by sleep disorders may be associated with occupational accidents. However, to our knowledge, there has so far been no report on associations between sleep disorders, excessive daytime sleepiness in particular, and occupational accidents among hospital nurses. The study was a cross-sectional study targeting 4407 nurses working in eight large general hospitals in Japan. An anonymous self-administered questionnaire was used to investigate their sleep patterns and experience of occupational accidents. The data were collected in 2003. The prevalence of excessive daytime sleepiness among hospital nurses in the present study was 26.0%. A statistically significant relationship was observed between having or not having occupational accidents during the past 12 months and excessive daytime sleepiness. Multiple logistic regression analyses on factors leading to occupational accidents during the past 12 months showed statistically significant associations between (1) drug administration errors and (2) shift work and age, between (1) incorrect operation of medical equipment and (2) excessive daytime sleepiness and age, and between needlestick injuries and age. Excessive daytime sleepiness is an important occupational health issue in hospital nurses. It is possible that occupational policies and health promotion measures, such as a provision of sleep hygiene advice and social support at worksites, would be effective in preventing occupational accidents among hospital nurses.
Choo, Janet; Johnston, Linda; Manias, Elizabeth
This study examined registered nurses' overall compliance with accepted medication administration procedures, and explored the distractions they faced during medication administration at two acute care hospitals in Singapore. A total of 140 registered nurses, 70 from each hospital, participated in the study. At both hospitals, nurses were distracted by personnel, such as physicians, radiographers, patients not under their care, and telephone calls, during medication rounds. Deviations from accepted medication procedures were observed. At one hospital, the use of a vest during medication administration alone was not effective in avoiding distractions during medication administration. Environmental factors and distractions can impact on the safe administration of medications, because they not only impair nurses' level of concentration, but also add to their work pressure. Attention should be placed on eliminating distractions through the use of appropriate strategies. Strategies that could be considered include the conduct of education sessions with health professionals and patients about the importance of not interrupting nurses while they are administering medications, and changes in work design. © 2013 Wiley Publishing Asia Pty Ltd.
Zapka, Jane M; Lemon, Stephenie C; Magner, Robert P; Hale, Janet
The purpose of this study was to (i) describe the weight, weight-related perceptions and lifestyle behaviours of hospital-based nurses, and (ii) explore the relationship of demographic, health, weight and job characteristics with lifestyle behaviours. The obesity epidemic is widely documented. Worksite initiatives have been advocated. Nurses represent an important part of the hospital workforce and serve as role models when caring for patients. A sample of 194 nurses from six hospitals participated in anthropometric measurements and self-administered surveys. The majority of nurses were overweight and obese, and some were not actively involved in weight management behaviours. Self-reported health, diet and physical activity behaviours were low, although variable by gender, age and shift. Reports of co-worker norms supported low levels of healthy behaviours. Findings reinforce the need to address the hospital environment and culture as well as individual behaviours for obesity control. Nurse managers have an opportunity to consider interventions that promote a climate favourable to improved health habits by facilitating and supporting healthy lifestyle choices (nutrition and physical activity) and environmental changes. Such efforts have the potential to increase productivity and morale and decrease work-related disabilities and improve quality of life.
Witt, Flemming; Nielsen, Jørn Flohr
The employee empowerment literature promises better organizational performance as well as more motivated and satisfied employees. However, this literature often neglects the specific context of public services in general, or the health care sector, hospitals, and nursing in particular. Nurses...... in Danish public hospitals work in a unique situation that makes the uncritical transfer of empowerment interventions intended to redesign their work difficult or even unfeasible. Analysis from an institutional perspective of the ongoing power struggle between agens of change at several levels in the Danish...
Brown, Diane Storer; Wolosin, Robert
Public demand for safer care has catapulted the healthcare industry's efforts to understand relationships between patient safety and hospital performance. This study explored linkages between staff perceptions of safety culture (SC) and ongoing measures of hospital nursing unit-based structures, care processes, and adverse patient outcomes. Relationships between nursing-sensitive measures of hospital performance and SC were explored at the unit-level from 9 California hospitals and 37 nursing units. SC perceptions were measured 6 months prior to collection of nursing metrics and relationships between the two sets of data were explored using correlational and regression analyses. Significant relationships were found with reported falls and process measures for fall prevention. Multiple associations were identified with SC and the structure of care delivery: skill mix, staff turnover, and workload intensity demonstrated significant relationships with SC, explaining 22-45% of the variance. SC was an important factor to understand in the quest to advance safe patient care. These findings have affordability and care quality implications for hospital leadership. When senior leaders prioritized a safety culture, patient outcomes may have improved with less staff turnover and more productivity. A business case could be made for investing in patient safety systems to provide reliably safe care. © 2013 National Association for Healthcare Quality.
Narges Arsalani, RN, MSc
Conclusion: The findings show that the adapted questionnaire has an acceptable conceptual structure and provides reliable information from the nursing profession. Consequently, the questionnaire is applicable to work situation studies among nurses and other health care workers.
: The Baby-Friendly Hospital Initiative (BFHI) is a program developed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) to promote breastfeeding in hospitals and birthing facilities worldwide. Since the program was launched in 1991, breastfeeding initiation, duration, and exclusivity have increased globally, a trend largely attributed to changes in hospital policies and practices brought about by the BFHI. This article provides an overview of these practices and policies, the institutional benefits of achieving BFHI certification, and the process through which health care facilities can do so. All nurses-whether they work in maternity care or another nursing specialty in a hospital, ambulatory, or community setting-can play a role in promoting societal health through their support of long-term breastfeeding as recommended by the WHO and UNICEF.
Van den Heede, Koen; Florquin, Mieke; Bruyneel, Luk; Aiken, Linda; Diya, Luwis; Lesaffre, Emmanuel; Sermeus, Walter
The realization of an organizational context that succeeds to retain nurses within their job is one of the most effective strategies of dealing with nursing shortages. First, to examine the impact of nursing practice environments, nurse staffing and nurse education on nurse reported intention to leave the hospital. Second, to provide understanding of which best practices in the organization of nursing care are being implemented to provide sound practice environments and to retain nurses. 3186 bedside nurses of 272 randomly selected nursing units in 56 Belgian acute hospitals were surveyed. A GEE logistic regression analysis was used to estimate the impact of organization of nursing care on nurse reported intention to leave controlling for differences in region (Walloon, Flanders, and Brussels), hospital characteristics (technology level, teaching status, and size) and nurse characteristics (experience, gender, and age). For the second objective, in-depth semi-structured interviews with the chief nursing officers of the three high and three low performing hospitals on reported intention to leave were held. 29.5% of Belgian nurses have an intention-to-leave the hospital. Patient-to-nurse staffing ratios and nurse work environments are significantly (pflat organization structure with a participative management style, structured education programs and career opportunities for nurses. This study, together with the international body of evidence, suggests that investing in improved nursing work environments is a key strategy to retain nurses. Copyright © 2011 Elsevier Ltd. All rights reserved.
Gunnarsdóttir, Sigrún; Clarke, Sean P; Rafferty, Anne Marie; Nutbeam, Don
To investigate aspects of nurses' work environments linked with job outcomes and assessments of quality of care in an Icelandic hospital. Prior research suggests that poor working environments in hospitals significantly hinder retention of nurses and high quality patient care. On the other hand, hospitals with high retention rates (such as Magnet hospitals) show supportive management, professional autonomy, good inter-professional relations and nurse job satisfaction, reduced nurse burnout and improved quality of patient care. Cross-sectional survey of 695 nurses at Landspitali University Hospital, Reykjavík. Nurses' work environments were measured using the nursing work index-revised (NWI-R) and examined as predictors of job satisfaction, the Maslach burnout inventory (MBI) and nurse-assessed quality of patient care using linear and logistic regression approaches. An Icelandic adaptation of the NWI-R showed a five-factor structure similar to that of Lake (2002). After controlling for nurses' personal characteristics, job satisfaction, emotional exhaustion and nurse rated quality of care were found to be independently associated with perceptions of support from unit-level managers, staffing adequacy, and nurse-doctor relations. The NWI-R measures elements of hospital nurses' work environments that predict job outcomes and nurses' ratings of the quality of patient care in Iceland. Efforts to improve and maintain nurses' relations with nurse managers and doctors, as well as their perceptions of staffing adequacy, will likely improve nurse job satisfaction and employee retention, and may improve the quality of patient care.
Full Text Available Common problems of Thai nurses are low quality of life, working long hours, and a high turnover rate. The workload imbalance among nurses also worsens the turnover rate. With careful schedule planning, nurses do not have to work in consecutive shifts and can rest more. We interviewed and collected data from an emergency department at a hospital administered by a Thai university, related to objectives and constraints of monthly nurse scheduling, and actual monthly schedules. A multi-objective mathematical model was developed using the open source “OpenSolver” software in MS-Excel for nurse schedulers to freely use. We tested the model using actual data collected from the department and found that the schedules created by the model tended to provide more balanced workloads and more days off compared to the schedules created manually by a real scheduler. The model also suggested an easy policy to increase the number of nurses for future expansion.
Sasaki, Megumi; Kitaoka-Higashiguchi, Kazuyo; Morikawa, Yuko; Nakagawa, Hideaki
The purpose of this study was to examine the relationship between stress coping and burnout in Japanese hospital nurses. Findings on effective stress management training are required in order to reduce nurse's stress and prevent it from becoming chronic. The study included 1291 nurses who completed the General Coping Questionnaire and the Japanese version of the Maslach Burnout Inventory-General Survey. The data were analysed using structural equation modelling. In women, a frequent use of cognitive reinterpretation predicted low exhaustion and cynicism and high professional efficacy. In men, a frequent use of problem solving predicted low cynicism and high professional efficacy. Although for women, a frequent use of problem solving predicted high professional efficacy that was similar to men, there was also a concurrent high exhaustion. These findings suggested that enhancement of cognitive coping skills for women and problem-solving skills for men could contribute to a reduction of burnout in nurses. Our findings suggested that effective intervention strategies in order to prevent hospital nurse's stress from becoming chronic might be different between men and women. This difference should be taken into account in nursing management.
Lorber, Mateja; Skela Savič, Brigita
Aim To determine the level of job satisfaction of nursing professionals in Slovenian hospitals and factors influencing job satisfaction in nursing. Methods The study included 4 hospitals selected from the hospital list comprising 26 hospitals in Slovenia. The employees of these hospitals represent 29.8% and 509 employees included in the study represent 6% of all employees in nursing in Slovenian hospitals. One structured survey questionnaire was administered to the lea...
Carter, Mary W
To examine variations in hospitalization rates among nursing home residents associated with discretionary hospitalization practices. Quarterly Medicaid case-mix reimbursement data from the state of Massachusetts served as the core data source for this study, which was linked with data from the Medicare Provider Analysis and Review file (MEDPAR) to specify hospitalization status, nursing facility attribute data from the state of Massachusetts to specify facility-level organizational and structural attributes, and data from the Area Resource File (ARF) to specify area market-level attributes. Data spans three years (1991-1993) to produce a longitudinal analytical file containing 72,319 person-quarter-level observations. Two-step, multivariate logistic regression models were estimated for highly discretionary hospitalizations versus those containing less discretion, and low discretionary hospitalizations versus those containing greater amounts of physician discretion. Findings indicate that facility case-mix levels and area hospital bed supply levels contribute to variations in hospitalization rates among nursing home residents. Highly discretionary hospitalizations appear to be most sensitive to patient diagnoses best described as chronic, ambulatory care sensitive conditions. Findings suggest that defining hospitalizations simply in terms of whether an event occurs versus otherwise may obscure valuable information regarding the contribution of various risk factors to highly discretionary versus low discretionary hospitalization rates.
Gardner, Jane K; Thomas-Hawkins, Charlotte; Fogg, Louis; Latham, Carolyn E
While the nephrology nursing shortage persists despite the continued growth of the population of individuals with Stage 5 chronic kidney disease, there is a paucity of empirical data regarding nephrology nurses' perceptions of their work environments. Moreover, there are no studies that have examined the relationship of work environment attributes to patient and nurse outcomes in dialysis settings. The purpose of this study was to examine the relationships between staff nurses' perceptions of dialysis work environments, nurses' intentions to leave their current jobs, nurse turnover, patient satisfaction, and patient hospitalization rates. A descriptive, correlational design was used. Nurse level and facility level data were obtained. The sample for nurse-level data consisted of 199 registered nurses in staff nurse roles in 56 dialysis facilities of a national dialysis company. The sample for facility-level analysis consisted of 46 dialysis facilities, and nurse-level data were aggregated for facility-level analysis. The Practice Environment Scale-Nursing Work Index (PES-NWI) was used to measure nurses' perceptions of the dialysis work environment. Nurses' intention to leave their jobs and facility-level turnover rates were the nurse outcomes examined in this study. Facility-level patient satisfaction and hospitalization rates were the patient outcomes examined. Correlation coefficients were computed to measure the relationships between study variables, and independent t-tests were performed to examine subgroup differences in work environment perceptions. Overall, nurses rated the work environment somewhat favorably. Nurses who expressed intention to leave their jobs rated the work environment more negatively compared to nurses who intended to stay. Significant correlations were found between nurses' perceptions of the dialysis work environment, nurses' intention to leave their jobs, nurse turnover rates, and patient hospitalizations. Study findings suggest that
Full Text Available Introduction: People in various professions may face discrimination. In the nursing field, discrimination among nurses in the workplace, regardless of race, gender or religion have not been studied; a problem that leads to a reduction in the quality of nursing care and nurse turnover. Discovery of the concerns of nurses about inter-professional collaboration is the purpose of this study. Methods: The present study is conducted by using a qualitative content analysis. The data collection process included 22 unstructured and in-depth interviews with nurses between April 2012 and February 2013 in the medical teaching centers of Iran. A purposive sampling method was used. All interviews were recorded, typed, and analyzed simultaneously. Results: The category obtained from explaining nurses' experiences of inter-professional collaboration was "discrimination" that included two subcategories, namely (1 lack of perspective towards equality in authorities, and (2 professional respect and value deficit.Conclusion: Nurses' experiences are indicating their perception of discrimination that influences the collaboration between nurses, which should be taken into account by managers. The findings of the present study help to managers about decision making on how to deal with staff and can be helpful in preventing nurse turnover and providing better services by nurses.
Valizadeh, Leila; Zamanzadeh, Vahid; Irajpour, Alireza; Shohani, Masoumeh
People in various professions may face discrimination. In the nursing field, discrimination among nurses in the workplace, regardless of race, gender or religion have not been studied; a problem that leads to a reduction in the quality of nursing care and nurse turnover. Discovery of the concerns of nurses about inter-professional collaboration is the purpose of this study. The present study is conducted by using a qualitative content analysis. The data collection process included 22 unstructured and in-depth interviews with nurses between April 2012 and February 2013 in the medical teaching centers of Iran. A purposive sampling method was used. All interviews were recorded, typed, and analyzed simultaneously. The category obtained from explaining nurses' experiences of inter-professional collaboration was "discrimination" that included two subcategories, namely (1) lack of perspective towards equality in authorities, and (2) professional respect and value deficit. Nurses' experiences are indicating their perception of discrimination that influences the collaboration between nurses, which should be taken into account by managers. The findings of the present study help to managers about decision making on how to deal with staff and can be helpful in preventing nurse turnover and providing better services by nurses.
Corsano, Paola; Majorano, Marinella; Vignola, Valentina; Cardinale, Elisa; Izzi, Giancarlo; Nuzzo, Maria Josè
This article reports an explorative study which aims to investigate hospitalized children's views of their relationships with nurses and doctors. Twenty-seven school-aged children and adolescents from 6 to 15 years old in the paediatric haematology and oncology ward of an Italian hospital participated in the study. Each participant was asked to draw him or herself with a doctor or nurse from the ward while they were doing something. The drawings were analysed using Pictorial Assessment of Interpersonal Relationships (PAIR) and a qualitative analysis. The results showed that the participants viewed their relationships with health professionals positively, in particular with the nurses. This relationship was perceived as close, intimate, cohesive and without conflict. In some cases it became an emotional bond. Finally, this relationship helped the patients to cope with painful and uncomfortable medical procedures, which gradually became familiar and accepted. The clinical implications of this study are discussed.
Karatza, Christine; Zyga, Sofia; Tziaferi, Styliani; Prezerakos, Panagiotis
In this quantitative, cross-sectional study, the authors identified the impact of workplace bullying on nursing staff employed at select Greek public hospitals. They conducted the study using the Negative Acts Questionnaire with a convenience sample of 841 participants employed by five Greek hospitals in the 1st Regional Health Authority of Attica. One third of the respondents reported having been psychologically harassed at work in the past 6 months. According to the results, the impact workplace bullying has on nursing staff varies depending on the existence of a supportive familial or friend environment and if nurses parent children. These findings demonstrate the value of family and friend support when coping with workplace bullying.
Seylani, Khatereh; Negarandeh, Reza; Mohammadi, Easa
Nursing education is both formal and informal. Formal education represents only a small part of all the learning involved; and many students learn more effectively through informal processes. There is little information about nursing student informal education and how it affects their character and practice. This qualitative study explores undergraduate nursing student perceptions of informal learning during nursing studies. Data were gathered through semi-structured interviews with a sample of undergraduate nursing students (n = 14). Strauss and Corbin's constant comparison analysis approach was used for data analysis. The categories that emerged included personal maturity and emotional development, social development, closeness to God, alterations in value systems, and ethical and professional commitment. Findings reveal that nursing education could take advantage of informal learning opportunities to develop students' nontechnical skills and produce more competent students. Implications for nursing education are discussed.
van Hees, B.C.
The aim of the studies described in this thesis was to analyze some aspects of ciprofloxacin use and clinical and (molecular) epidemiology of ciprofloxacin resistance in different settings, both within hospitals (chapter 3,4 and 6), community and nursing homes (chapter 2 and 5). With its broad
Gordon, Pamela Ann
Purpose Although extensive research exists regarding job satisfaction, many previous studies used a more restrictive, quantitative methodology. The purpose of this qualitative study is to capture the perceptions of hospital nurses within generational cohorts regarding their work satisfaction. Design/methodology/approach A preliminary qualitative, phenomenological study design explored hospital nurses' work satisfaction within generational cohorts - Baby Boomers (1946-1964), Generation X (1965-1980) and Millennials (1981-2000). A South Florida hospital provided the venue for the research. In all, 15 full-time staff nurses, segmented into generational cohorts, participated in personal interviews to determine themes related to seven established factors of work satisfaction: pay, autonomy, task requirements, administration, doctor-nurse relationship, interaction and professional status. Findings An analysis of the transcribed interviews confirmed the importance of the seven factors of job satisfaction. Similarities and differences between the generational cohorts related to a combination of stages of life and generational attributes. Practical implications The results of any qualitative research relate only to the specific venue studied and are not generalizable. However, the information gleaned from this study is transferable and other organizations are encouraged to conduct their own research and compare the results. Originality/value This study is unique, as the seven factors from an extensively used and highly respected quantitative research instrument were applied as the basis for this qualitative inquiry into generational cohort job satisfaction in a hospital setting.
Vincent E. Omorogbe, Vivian O. Omuemu, Alphonsus R. Isara ... practice of injection safety by nurses in mission hospitals in Benin City, Nigeria. Materials and Methods: A descriptive cross-sectional study was carried out. .... alternatives, reuse of injection equipment, self ... health facilities in rendering healthcare services.
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
Fox, Mary T; Sidani, Souraya; Butler, Jeffrey I; Tregunno, Deborah
Background Cultivating hospital environments that support older people's care is a national priority. Evidence on geriatric nursing practice environments, obtained from studies of registered nurses (RNs) in American teaching hospitals, may have limited applicability to Canada, where RNs and registered practical nurses (RPNs) care for older people in predominantly nonteaching hospitals. Purpose This study describes nurses' perceptions of the overall quality of care for older people and the geriatric nursing practice environment (geriatric resources, interprofessional collaboration, and organizational value of older people's care) and examines if these perceptions differ by professional designation and hospital teaching status. Methods A cross-sectional survey, using Dillman's tailored design, that included Geriatric Institutional Assessment Profile subscales, was completed by 2005 Ontario RNs and registered practical nurses to assess their perceptions of the quality of care and geriatric nursing practice environment. Results Scores on the Geriatric Institutional Assessment Profile subscales averaged slightly above the midpoint except for geriatric resources which was slightly below. Registered practical nurses rated the quality of care and geriatric nursing practice environment higher than RNs; no significant differences were found by hospital teaching status. Conclusions Nurses' perceptions of older people's care and the geriatric nursing practice environment differ by professional designation but not hospital teaching status. Teaching and nonteaching hospitals should both be targeted for geriatric nursing practice environment improvement initiatives.
Ida Torunn Bjørk
Full Text Available This study analyzed nurses' perceptions of clinical decision making (CDM in their clinical practice and compared differences in decision making related to nurse demographic and contextual variables. A cross-sectional survey was carried out with 2095 nurses in four hospitals in Norway. A 24-item Nursing Decision Making Instrument based on cognitive continuum theory was used to explore how nurses perceived their CDM when meeting an elective patient for the first time. Data were analyzed with descriptive frequencies, t-tests, Chi-Square test, and linear regression. Nurses' decision making was categorized into analytic-systematic, intuitive-interpretive, and quasi-rational models of CDM. Most nurses reported the use of quasi-rational models during CDM thereby supporting the tenet that cognition most often includes properties of both analysis and intuition. Increased use of intuitive-interpretive models of CDM was associated with years in present job, further education, male gender, higher age, and working in predominantly surgical units.
García, I García; Castillo, R F; Santa-Bárbara, E S
Researchers study climate to gain an understanding of the psychological environment of organizations, especially in healthcare institutions. Climate is considered to be the set of recurring patterns of individual and group behaviour in an organization. There is evidence confirming a relationship between ethical climate within organizations and job satisfaction. The aim of this study is to describe organizational climate for nursing personnel in public and private hospitals and to confirm the relationships among the climate variables of such hospitals. A correlational study was carried out to measure the organizational climate of one public hospital and two private hospitals in Granada. The Work Environment Scale was used for data collection. The Work Environment Scale includes 10 scales, ranging from 0 to 9, which were used to evaluate social, demographic and organizational climate variables. In this study, 386 subjects were surveyed in three hospitals. A total of 87% of the participants were female and 16% were male. Most participants were nurses (65.6%), followed by nursing aides (20%), and technicians (14.4%). The results obtained reflected different patterns of organizational climate formation, based on hospital type (i.e. public or private) within the Spanish context. Most of the dimensions were below the midpoint of the scale. In conclusion, in public hospitals, there is a greater specialization and the organizational climate is more salient than in the private hospitals. In addition, in the public hospitals, the characteristics of the human resources and their management can have a significant impact on the perception of the climate, which gives greater importance to the organizational climate as decisive of the ethical climate. © The Author(s) 2013.
Ramezanli, Somayeh; Badiyepeymaie Jahromi, Zohreh
As a major factor in patient-centered care, patient education has a great impact on the quality of care provided by nurses; however, clinical nurses' performance with regard to patient education is not satisfactory. This study is an attempt to investigate barriers and facilitators in patient education from nurses' point of view. 122 nurses at Jahrom University of Medical Sciences participated in this descriptive-cross sectional study. Sampling was based on the census method. The questionnaire used to collect data included questions about nurses' demography, barriers (10 questions), and facilitators (10 questions) in patient education. The questionnaire was designed to be completed independently. To analyze the data, the researchers used descriptive statistics, including frequency, mean and standard deviation. The highest scores related to barriers to patient education were: nurses' insufficient knowledge, patients' physical and emotional unpreparedness, and lack of a proper environment for education. The most important facilitators, on the other hand, were: enhancement of instructing nurses' knowledge and skills, motivating nurses, and a step-by-step approach to patient education. It is important that nurses be prepared and motivated to train their patients. By satisfactory patient education on the part of nurses, patients will be more willing to cooperate in the treatment process.
Phelan, Cynthia H; Schumacher, Sandra; Roiland, Rachel; Royer, Heather; Roberts, Tonya
Evidence is the bedrock of nursing practice, and nursing research is the key source for this evidence. In this article, we draw distinctions between the use and the conduct of nursing research and provide a perspective for how the conduct of nursing research in a Veterans Administration hospital can build an organization's capacity for nursing research.
Mahmoodishan, Gholamreza; Alhani, Fatemeh; Ahmadi, Fazlollah; Kazemnejad, Anoshirvan
The purpose of the present study was to explore nurses' perception about spirituality and spiritual care. A qualitative content analysis approach was conducted on 20 registered nurses interviewed using unstructured strategy in 2009. Three themes emerged from the data analysis: 1) "meaning and purpose of work and life" including 'spiritualistic view to profession', 'commitment and professional responsibility', and 'positive attitude'; 2) "religious attitude" including 'God approval', 'spiritual reward', 'taking advice', 'inner belief in the Supreme Being', 'faith-based interactions and altruism'; 3) "transcendence-seeking" including 'need for respect' and 'personal-professional transcendence'. Therefore, the spirituality produces maintenance, harmony and balance in nurses in relation to God. Spiritual care focuses on respecting patients, friendly and sympathetic interactions, sharing in rituals and strengthening patients and nurses' inner energy. This type of spirituality gives a positive perspective to life and profession, peaceful interactions, a harmonious state of mind, and acts as a motivator among nurses to promote nursing care and spirituality.
Guimarães, Celma Martins; de Andrade, Ilidiana Miranda
The Hospital de Caridade São Pedro de Alcântara was created in the City of Goiás, being the first hospital institution implanted in the state. The work purposes to understand the historical-social context in which the "São Pedro" was implanted, looking for information about the structure and operation, especially what concerns to the nursing. The used approach was the dialectics. The results demonstrated the existence of ten nursing workers and that those were separate to patients' attendance according to gender. The work delivered by the male workers was better remunerated than the one delivered by female workers. The hospital and their servants, gradually, were assuming the responsibility for the ordering and cleanliness of the physical spaces, workers, prisioners, burials, etc. The work was arduous and badly paid.
Dale, C; Rae, M; Tarbuck, P
In August 1992 a damning report was published on the mental health services provided at Ashworth Special Hospital in Merseyside. It described a brutalising and damaging regime in which nurses were singled out for the strongest criticism. In November 1994 the Health Advisory Service (HAS), which has a watchdog role, spent three weeks at Ashworth reviewing developments in the wake of the inquiry report. The HAS report, published last March, praised the hospital for undergoing tremendous change and recovery. Areas of exemplary practice were evident and major dehumanising practices had been eliminated. This paper attempts to analyse some of the difficulties confronting nurses at the hospital during the years of change between the public inquiry and the HAS visit, and identifies recent major achievements and areas for further work.
Blanca-Gutiérrez, Joaquín Jesús; Jiménez-Díaz, María del Carmen; Escalera-Franco, Luis Felipe
To select and summarize the interventions that have proved effective in reducing absenteeism among hospital nurses. A scoping review was conducted through a literature search using Medline, Web of Science, Cinahl, Embase, Lilacs, Cuiden and Cochrane Library Plus databases. Of a total of 361 articles extracted, 15 were finally selected for this review. The implementation of multifaceted support or physical training programs can produce positive results in terms of reducing absenteeism among hospital nurses. Cognitive-behavioral type interventions require studies with larger samples to provide conclusive results. Establishing more flexible working shifts may also reduce absenteeism rates, although again studies with larger samples are needed. Programs aimed at managing change developed by nurses themselves, participatory management of professional relations, the support provided by supervisors who are opposed to hierarchical leadership styles, and wage supplements that reward the lack of absence can also reduce these types of indicators. Absenteeism can be considered as a final result and a consequence of the level of job satisfaction. The effectiveness of interventions to reduce absenteeism among hospital nurses will no doubt largely depend on the ability of these interventions to increase the job satisfaction of these workers. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.
Demir, Defne; Rodwell, John
To test a full model of the antecedents to and consequences of various forms of workplace aggression, considering psychosocial factors, for hospital nursing staff. Cross-sectional survey design. Two hundred and seven nurses and midwives working across wards within a medium to large Australian hospital completed the survey. The survey response rate was 26.9%. High frequencies of nurses reported exposure to workplace bullying and internal and external emotional abuse violence types. In terms of antecedents, bullying was linked to high negative affectivity (NA), as well as low supervisor support and coworker support. Internal emotional abuse was associated with low levels of these support variables, as well as high outside work support and low job control. External threat of assault was related to high job demands and NA. In terms of consequences, bullying and verbal sexual harassment were linked to increased psychological distress levels. Bullying and internal emotional abuse were related to lowered organizational commitment. Changes in job satisfaction were not found for any of the workplace aggression types. NA was a significant covariate for all analyses examining consequences of aggression. Different combinations of work conditions (job demands-resources) and individual levels of NA predicted certain types of aggression. Further, nurse perceptions of psychological distress and organizational commitment were affected by exposure to several types of aggression, even after controlling for NA as a potential perceptual bias. This study therefore extends previous research on workplace bullying as a stressor to other types of workplace aggression for nurses. The findings highlight factors that are important in considering effective prevention and intervention of workplace aggression among nursing staff, particularly those working in hospital settings. © 2012 Sigma Theta Tau International.
Hwang, Jee-In; Ahn, Jeonghoon
To examine levels of teamwork and its relationships with clinical error reporting among Korean hospital nurses. The study employed a cross-sectional survey design. We distributed a questionnaire to 674 nurses in two teaching hospitals in Korea. The questionnaire included items on teamwork and the reporting of clinical errors. We measured teamwork using the Teamwork Perceptions Questionnaire, which has five subscales including team structure, leadership, situation monitoring, mutual support, and communication. Using logistic regression analysis, we determined the relationships between teamwork and error reporting. The response rate was 85.5%. The mean score of teamwork was 3.5 out of 5. At the subscale level, mutual support was rated highest, while leadership was rated lowest. Of the participating nurses, 522 responded that they had experienced at least one clinical error in the last 6 months. Among those, only 53.0% responded that they always or usually reported clinical errors to their managers and/or the patient safety department. Teamwork was significantly associated with better error reporting. Specifically, nurses with a higher team communication score were more likely to report clinical errors to their managers and the patient safety department (odds ratio = 1.82, 95% confidence intervals [1.05, 3.14]). Teamwork was rated as moderate and was positively associated with nurses' error reporting performance. Hospital executives and nurse managers should make substantial efforts to enhance teamwork, which will contribute to encouraging the reporting of errors and improving patient safety. Copyright © 2015. Published by Elsevier B.V.
Barak, Farzaneh; Falahi, Ebrahim; Keshteli, Ammar Hassanzadeh; Yazdannik, Ahmadreza; Esmaillzadeh, Ahmad
Limited observational studies have considered habitual consumption of the general population to examine the relationship between the Dietary Approaches to Stop Hypertension (DASH) diet and obesity. The aim of the present study was to investigate adherence to the DASH diet in relation to general and central obesity among female nurses in Isfahan, Iran. Cross-sectional study carried out among 293 female nurses aged >30 years who were selected by a multistage, cluster random sampling method. Usual dietary intakes were assessed using a validated FFQ. We constructed the DASH score based on foods and nutrients emphasized or minimized in the DASH diet, focusing on eight components: high intake of fruits, vegetables, nuts and legumes, low-fat dairy products and whole grains and low intakes of sodium, sweetened beverages, and red and processed meats. General and abdominal obesity were defined as BMI ≥ 25 kg/m2 and waist circumference ≥ 88 cm, respectively. Isfahan, Iran. Female nurses (n 293) aged >30 years. Increased adherence to the DASH diet was associated with older age (Pobesity between extreme quartiles of the DASH diet score. After adjustment for age, energy intake and other confounding factors, DASH diet score was not significantly associated with obesity. However, with further controlling for other dietary factors, those in the highest quartile of DASH diet score were 71 % less likely to have general obesity compared with those in the lowest quartile. In addition, following a DASH diet was inversely associated with central obesity after adjustment for potential confounders (OR=0.37; 95 % CI 0.14, 0.96). We found that adherence to the DASH diet was inversely related to central obesity among Iranian adult females. This association remained significant even after adjustment for potential confounders.
Kato, Hirosato; Ito, Yukie; Yoshida, Aki; Mizuno, Shizue; Ogoshi, Kumiko; Imamura, Tomoaki
The resignation rate of nurses working in hospitals is extremely high. This study aims to identify both the factors related to the resignation of nurses and the empowerment factors supporting their job retention. In 2011 we conducted a Web-based questionnaire survey of nurses with less than 10 years of working experience. There were 25 survey items including the following reasons for choosing the current employment position, intention of continuing work, sense of fulfillment and the presence or absence of problems in the current workplace. In addition, nurses who previously had resigned were asked why they left their last workplace. The reasons why they chose the current workplace were markedly different between the not-resigned (A group) and previously resigned (B group) nurses. As a result of cluster analysis, the reasons for resignation were classified into six clusters; "overwork", "burnout", "bad atmosphere", "work life balance factors", "working conditions" and "marriage". In this study, it is shown that there is a positive correlation between the sense of fulfillment at work and the intention to do research work. It is suggested that encouragement of nurses to undertake research work is one of the empowerment factors supporting their job retention.
Motamed-Jahromi, Mohadeseh; Leila Dehghani, Seyedeh
A thesis is an important part of nursing graduate students' education, which is also their first systematic and scientific attempt to learn the ABCs of research. Articles derived from theses are important for the dissemination of science and the improvement of nursing as a field. Therefore, it is the goal of the present research is to analyze the different aspects of nursing MSc theses and the number of published articles derived from them. This was a descriptive research carried out on 145 nursing MSc theses defended in Razi Faculty of Nursing and Midwifery in Kerman between 1990 and 2010. All of the extracted data were put into an Excel file (2007 version) followed by a data analysis. The results of this study were then presented via the use of descriptive statistics and figures. The research findings showed that most of the theses used a descriptive or analytical-descriptive method, and 42% of them had patients as their participants. They were usually delivered on the subject of health care, and only 58 articles were extracted from the whole 145 theses. The process of writing nursing MSc theses and thesis research articles is improving gradually. However, there is a growing need for empirical and semi-empirical research to bridge the gap between theory and practice, which is also a major concern among nurses.
Tekindal, Benian; Tekindal, Mustafa Agah; Pinar, Gul; Ozturk, Filiz; Alan, Sumeyra
One of the biggest problems of work life today is burnout. With burnout, satisfaction of clients and service givers reduces. In this study, burnout levels of nurses working in the internal, surgical and intensive care units of a university hospital and the unmet needs of the patients' relatives related to nursing care were investigated. In the study, 225 nurses and 222 relatives of patients constituted the sample group of this study. Three separate forms were used in the study, namely, Nurse and Patient Relative Identification Form, the Maslach Burnout Inventory and the Nursing Services Satisfaction Inventory. In the study, burnout levels of the nurses were found to be high. Conditions like younger ages, scarcity of experience in the profession, lower levels of education, having chosen the profession and the unit they work in not willingly and working in environments like intensive care increase the burnout and as a result, expectations of the relatives of patients from nursing care are not fully met. Some suggestions have been made to make some regulations to prevent the burnout of nurses and to increase the satisfaction of relatives. © 2012 Blackwell Publishing Asia Pty Ltd.
Inoue, T; Karima, R; Harada, K
The aim of this study was to examine how hospital patient-safety procedures affect the job satisfaction of hospital nurses. Additionally, we investigated the association between perceived autonomy and hospital patient-safety procedures and job satisfaction. Recently, measures for patient safety have been recognized as an essential requirement in hospitals. Hospital patient-safety procedures may enhance the job satisfaction of nurses by improving the quality of their work. However, such procedures may also decrease their job satisfaction by imposing excessive stress on nurses because they cannot make mistakes. The participants included 537 nurses at 10 private hospitals in Japan (The surveys were collected from March to July 2012). Factors related to hospital patient-safety procedures were demonstrated using factor analysis, and the associations between these factors and nurses' self-perceived autonomy and job satisfaction were examined using structural equation modelling. Five factors regarding hospital patient-safety procedures were extracted. Additionally, structural equation modelling revealed statistically significant associations between these factors and the nurses' self-perceived autonomy and job satisfaction. The findings showed that nurses' perceived autonomy of the workplace enhanced their job satisfaction and that their perceptions of hospital patient-safety procedures promoted their job satisfaction. However, some styles of chief nurses' leadership regarding patient safety restrict nurses' independent and autonomous decision-making and actions, resulting in a lowering of job satisfaction. This study demonstrated that hospital patient-safety procedures have ambiguous effects on nurses' job satisfaction. In particular, chief nurses' leadership relating to patient safety can have a positive or negative effect on nurses' job satisfaction. The findings indicated that hospital managers should demonstrate positive attitudes to improve patient safety for
Fickley, Sharon K; Mishler, Ray R; Black, Amelia S; DeGuzman, Pam B
The purpose of this research is to explore donors' perspectives on support of nursing excellence in a community hospital. Philanthropic support is rapidly becoming critical to support nursing excellence in hospitals, including continuing education, nursing research, and professional development. However, no research has examined the experience of private donors who support nursing programs in community hospitals. Structured interviews were conducted with individuals with a history of providing significant financial support (gifts >$50 000) targeted specifically for nursing in a 176- bed community hospital in the southeastern United States. Analysis was performed using descriptive content analysis. Four themes emerged that centered around making a difference, helping nurses meet new challenges, an existing foundation of service, and valuing excellent nursing care received. This research provides specific information that nursing administrators can use when seeking philanthropic gifts to support nursing excellence programs in US community hospitals.
Shah, Faraaz; Burack, Orah; Boockvar, Kenneth S
To identify perceived barriers to communication between hospital and nursing home at the time of patient transfer and examine associations between perceived barriers and hospital and nursing home characteristics. Mailed survey. Medicare- or Medicaid-certified nursing homes in New York State. Nursing home administrators, with input from other nursing home staff. Respondents rated the importance as a barrier to hospital-nursing home communication of (1) hospital providers' attitude, time, effort, training, payment, and familiarity with nursing home patients; (2) unplanned and off-hours transfers; (3) HIPAA privacy regulations; and (4) lost or failed information transmission. Associations were determined between barriers and the following organizational characteristics: (1) hospital-nursing home affiliations, pharmacy or laboratory agreements, cross-site staff visits, and cross-site physician care; (2) hospital size, teaching status, and frequency of geriatrics specialty care; (3) nursing home size, location, type, staffing, and Medicare quality indicators; and (4) hospital-to-nursing home communication, consistency of hospital care with health care goals, and communication quality improvement efforts. Of 647 questionnaires sent, 229 were returned (35.4%). The most frequently reported perceived barriers to communication were sudden or unplanned transfers (44.4%), transfers that occur at night or on the weekend (41.4%), and hospital providers' lack of effort (51.0%), lack of familiarity with patients (45.0%), and lack of time (43.5%). Increased hospital size, teaching hospitals, and urban nursing home location were associated with greater perceived importance of these barriers, and cross-site staff visits and hospital provision of laboratory and pharmacy services to the nursing home were associated with lower perceived importance of these barriers. Hospital and nursing home characteristics and interorganizational relationships were associated with nursing home
Shirazi, Mandana; Emami, Amir Hossein; Mirmoosavi, Seyed Jamal; Alavinia, Seyed Mohammad; Zamanian, Hadi; Fathollahbeigi, Faezeh; Masiello, Italo
To assess the effects of a workshop on supportive leadership behaviour (SLB) on the performance of head nurses, using a randomized controlled trial design. The effect of transformational leadership on SLB in nursing management is emphasised. A total of 110 head nurses working at university hospitals were included randomly in two control and intervention groups. The head nurses in the intervention group participated in supportive leadership training, but the control group did not. Performance in supportive leadership was assessed with a validated instrument, which six subordinates used to assess their head nurse (n = 731). There was a significant difference in SLB scores from baseline to the 3 month follow-up (P leadership behaviour, particularly the interactive multifaceted training, improved the leadership performance of the head nurses who participated in this study. Health policy decision makers should apply SLB, which is a significant leadership style, to improve the outcomes in other groups of health-care management, such as physicians. Future studies are needed to investigate the effects of such workshops in longer periods of follow up. © 2015 John Wiley & Sons Ltd.
Dalila Felipe Bitencourt
Full Text Available Qualitative research using the case study, it’s order to understand the vision of nurses in a hospital in the southern of Santa Catarina/SC about their experience as leaders of nursing team. Participants were ten nurses working in this role. Data collection was performed in the hospital, between the months of May and June 2012, using the technique of semi-structured interview, based on the guiding question of the study. The analysis of data was performed qualitative and comprised the organization, classification and final analysis. The results show that most nurses do not feel prepared to exercise a leading role, which derives, in most cases, the lack of academic preparation, institutional issues and the reasons inherent in early stage, especially insecurity. The professionals working in other categories of nursing at the same institution need to learn to position themselves against the new post, especially in dealing with colleagues who are now under his leadership. While most have expressed difficulties in the process of transition between academia and professional life were identified that professionals are clear about the roles, skills and abilities necessary for leadership. It is also noted that nurses feel that in some situations they cannot exercise their leadership in the way they consider most appropriate.
Dalila Felipe Bitencourt
Full Text Available Qualitative research using the case study, it’s order to understand the vision of nurses in a hospital in the southern of Santa Catarina/SC about their experience as leaders of nursing team. Participants were ten nurses working in this role. Data collection was performed in the hospital, between the months of May and June 2012, using the technique of semi-structured interview, based on the guiding question of the study. The analysis of data was performed qualitative and comprised the organization, classification and final analysis. The results show that most nurses do not feel prepared to exercise a leading role, which derives, in most cases, the lack of academic preparation, institutional issues and the reasons inherent in early stage, especially insecurity. The professionals working in other categories of nursing at the same institution need to learn to position themselves against the new post, especially in dealing with colleagues who are now under his leadership. While most have expressed difficulties in the process of transition between academia and professional life were identified that professionals are clear about the roles, skills and abilities necessary for leadership. It is also noted that nurses feel that in some situations they cannot exercise their leadership in the way they consider most appropriate.
Rodríguez, Gabriel; Angélica-Muñoz, Luz; Hoga, Luiza Akiko Komura
to explore the cultural experiences of nurses who immigrated to Chile. The study's theoretical framework was the Purnell Model for Cultural Competence. Leininger's Observation-Participation-Reflection method was developed at two hospitals in the city of Santiago, and ethnographic interviews were held with 15 immigrant nurses. among Purnell's 12 domains, the following were identified: Overview/heritage, Communication, Workforce issues, Family roles and organization, Biocultural ecology and Health-care practices. The difficulties were related to the language and its semantic meaning, the new responsibilities and the difficult relationship with colleagues. "In search of better horizons - the decision to immigrate", "Gaining confidence and establishing a support network - employability and professional performance" and "Seeking for people's acceptance - professional adaptation in a new cultural scenario" are cultural themes that represent their experiences. the competence to offer cultural care demands the development of public policies and continuing education programs at health institutions, specifically focused on immigrant nurses.
Chiarella, Mary; Roydhouse, Jessica K
Health workforce planning is a priority for Australian governments at both state and federal levels. Nursing shortages are a significant problem and addressing these shortages is likely to be a component of any workforce plan. This paper looks at the case of hospital nursing and argues that casemix, workforce and management instability inhibit workforce planning for hospital nursing. These issues are related and any efforts to objectively plan the hospital nursing workforce must seek to address them in order to succeed.
Lehrman, S; Shore, K K
Using 1985 and 1988 American Hospital Association data, this study examines 1,523 hospitals nationwide and concludes that hospitals' ownership of skilled nursing facilities helps minimize the transaction costs associated with post-acute patient transfers while productively using empty hospital beds. Unfortunately, such ownership creates complex cost, quality, and accessibility trade-offs in terms of the skilled nursing care provided.
Kaya, Sidika; Bilgin Demir, İpek; Karsavuran, Seda; Ürek, Duygu; İlgün, Gülnur
This study shows the rates of violence experienced by doctors and nurses and their ensuing responses including reporting rates and any effects experienced because of the violence. The Survey for Investigating the Violence on Medical Employees was administered to 254 doctors and nurses. Data were analyzed using chi-square and logistic regression analysis. Of the participants, 74.4% had been exposed to some form of violence. Most of the participants, 87.3%, experienced verbal violence; 12.2% experienced physical violence; and 0.5% experienced sexual violence. Logistic regression analysis indicated that married doctors and nurses are at risk of experiencing violence 0.5 times greater when compared with unmarried or widowed doctors and nurses (p = 0.026). The experience of violence differs by hospital type (p = 0.038) and years working in the healthcare industry (p = 0.042). Differences were also found regarding exposure to violence between doctors and nurses in terms of time of day (p = 0.031) and the work being performed (p violence (50.8%) was the healthcare system. Verbal response was the most frequent reaction to violence (24.4%), with loss of occupational performance (58.2%) being the most cited negative outcome. Approximately 9.3% of the victims reported the violence to judicial authorities. A lengthy judicial proceeding was chosen as the most significant hindrance to reporting the violence (45.8%). This study reveals the effects of violence and reporting rates at two hospitals in Turkey, and it implies that underreporting of violence is an important issue. Therefore, hospital management should take measures to increase reporting and take necessary actions when violence is reported.
Kazemi, Alireza; Ellenius, Johan; Tofighi, Shahram; Salehi, Aref; Eghbalian, Fatemeh; Fors, Uno G
In recent years, the theory that on-line clinical decision support systems can improve patients' safety among hospitalised individuals has gained greater acceptance. However, the feasibility of implementing such a system in a middle or low-income country has rarely been studied. Understanding the current prescription process and a proper needs assessment of prescribers can act as the key to successful implementation. The aim of this study was to explore physicians' opinions on the current prescription process, and the expected benefits and perceived obstacles to employ Computerised Physician Order Entry in an Iranian teaching hospital. Initially, the interview guideline was developed through focus group discussions with eight experts. Then semi-structured interviews were held with 19 prescribers. After verbatim transcription, inductive thematic analysis was performed on empirical data. Forty hours of on-looker observations were performed in different wards to explore the current prescription process. The current prescription process was identified as a physician-centred, top-down, model, where prescribers were found to mostly rely on their memories as well as being overconfident. Some errors may occur during different paper-based registrations, transcriptions and transfers. Physician opinions on Computerised Physician Order Entry were categorised into expected benefits and perceived obstacles. Confidentiality issues, reduction of medication errors and educational benefits were identified as three themes in the expected benefits category. High cost, social and cultural barriers, data entry time and problems with technical support emerged as four themes in the perceived obstacles category. The current prescription process has a high possibility of medication errors. Although there are different barriers confronting the implementation and continuation of Computerised Physician Order Entry in Iranian hospitals, physicians have a willingness to use them if these systems
The purpose of this survey was to evaluate the implementation of the nursing process at three randomly selected governmental hospitals found in Amhara Region North West Ethiopia. From the total 338 reviewed documents, 264 (78.1%) have a nursing process format attached with the patient's profile/file, 107 (31.7%) had no nursing diagnosis, 185 (54.7%) of nurses stated their plan of care based on priority, 173 (51.2%) of nurses did not document their interventions based on plan and 179 (53.0%) of nurses did not evaluate their interventions. The overall implementation of nursing process among Felege Hiwot Referal hospital, Debretabor general hospital and Finoteselam general hospitals were 49.12, 68.18, and 69.42% respectively. Nursing professionals shall improve documentation required in implementing the nursing process. Nursing managers (matron, ward heads) shall supervise the overall implementation of nursing process. Hospital nursing services managers (matrons) shall arrange and facilitate case presentations by the nursing staffs which focus on documentation and updates on nursing process. Hospitals need to establish and support nursing process coordinating staff in their institution.
This article showcases the realities and challenges of teamwork in American hospitals based on the in situ comparison with France. Drawing on observation of nurse-physician interactions in hospitals in the two nations, this article highlights a troubling conflict between teamwork rhetoric and realities on the ward. Although the use of informatics systems such as electronic health records is supposed to increase cooperation, the observations presented here show that on the contrary, it inhibits communication that is becoming mainly virtual. While the nursing profession is more developed and provides stronger education in the United States, this story highlights the challenges in creating a shared environment of work and suggests the importance of balancing professional autonomy and effective teamwork. Copyright © 2017 by Duke University Press.
Jahanpour, Faezeh; Azodi, Parviz; Azodi, Farzan; Khansir, Ali Akbar
Clinical training is an integral part of nursing education; however, some studies have shown that it is not always efficient. This study aimed to find out the factors that can impede nursing students' clinical learning. In this qualitative study, data were collected via reflective journal writing. Purposeful sampling was used, and 12 senior nursing students were recruited to the study. The data were analyzed using a content analysis method. Three main categories were derived, including inappropriate communication, ineffective role models, and theory-practice gaps. Students perceived that inappropriate communication between instructors, staff members, and students had the greatest impact on student learning. The competence of clinical instructors and staff is an important factor affecting students' training. The clinical learning environment does not always integrate theory and practice together. Nursing students did not experience effective clinical learning. Having expert instructors and supportive communication are important factors in creating a clinical learning environment.
Hanifi, Nasrin; Parvizy, Soroor; Joolaee, Soodabeh
This study explored how nursing students can be kept motivated throughout their clinical education. Motivation is a key issue in nursing clinical education for student retention. The study was conducted using grounded theory methods, which are appropriate when studying process in a social context. Sixteen students and four instructors, who were purposefully selected, participated in semistructured interviews. Data were analyzed using the constant comparative method. Students' motivational journey occurred in three steps: (i) social condition; (ii) encountering the clinical education challenges; and (iii) looking for an escape from nursing, or simply tolerating nursing. Struggling with professional identity emerged as the core variable. Iran's social context and many other conditions in the clinical education setting affect students' motivation. Identifying motivational process might assist educational authorities in offering solutions to promote motivation among students. © 2013 Wiley Publishing Asia Pty Ltd.
Full Text Available Abstract Background Nurses are expected to empower their clients, but they cannot do so if they themselves feel powerless. They must become empowered before they can empower others. Some researchers have emphasized that understanding the concept of power is an important prerequisite of any empowerment program. While many authors have tried to define the concept of power, there is no comprehensive definition. This paper is an attempt to clarify the concept of power in nursing. It also would present a model describing the factors affecting nurse empowerment. Methods We chose the grounded-theory approach for analysis of the participants' experiences and their viewpoints regarding the concept of professional power in nursing. Semi-structured interviews and participant observation methods were used to gather the data. Forty-four participants were interviewed and 12 sessions of observation were carried out. The constant comparative analysis method was used. Results Six main themes emerged from the data: "Application of knowledge and skills", "Having authority", "Being self-confident", "Unification and solidarity", "Being supported" and "Organizational culture and structure". According to the participants, nurses' power is influenced by these six variables. A theoretical model was designed to represent the interrelationships between these six variables. Conclusions Nurses' power depends on gaining and applying professional knowledge and skills. Delegating authority and enhancing self-confidence of the nurses also help them to apply their knowledge in practice. Unification of the nurses and their mutual support play the key roles in development of their collective power and provide a base for better working conditions, professional independence and self-regulation.
Adib Hagbaghery, Mohsen; Salsali, Mahvash; Ahmadi, Fazlollah
BACKGROUND: Nurses are expected to empower their clients, but they cannot do so if they themselves feel powerless. They must become empowered before they can empower others. Some researchers have emphasized that understanding the concept of power is an important prerequisite of any empowerment program. While many authors have tried to define the concept of power, there is no comprehensive definition. This paper is an attempt to clarify the concept of power in nursing. It also would present a model describing the factors affecting nurse empowerment. METHODS: We chose the grounded-theory approach for analysis of the participants' experiences and their viewpoints regarding the concept of professional power in nursing. Semi-structured interviews and participant observation methods were used to gather the data. Forty-four participants were interviewed and 12 sessions of observation were carried out. The constant comparative analysis method was used. RESULTS: Six main themes emerged from the data: "Application of knowledge and skills", "Having authority", "Being self-confident", "Unification and solidarity", "Being supported" and "Organizational culture and structure". According to the participants, nurses' power is influenced by these six variables. A theoretical model was designed to represent the interrelationships between these six variables. CONCLUSIONS: Nurses' power depends on gaining and applying professional knowledge and skills. Delegating authority and enhancing self-confidence of the nurses also help them to apply their knowledge in practice. Unification of the nurses and their mutual support play the key roles in development of their collective power and provide a base for better working conditions, professional independence and self-regulation.
Godoy, Pere; Domínguez, Angela; Alvarez, Josep; Camps, Neus; Barrabeig, Irene; Bartolomé, Rosa; Sala, María Rosa; Ferre, Dolors; Pañella, Helena; Torres, Joan; Minguell, Sofía; Alsedà, Miquel; Pumares, Analía
The low infectious dose and multiple transmission routes favour the appearance of norovirus outbreaks. The objective of this study was to compare the incidence of norovirus outbreaks in hospitals and nursing homes in Catalonia. A descriptive study of norovirus outbreaks between 15/10/2004 and 30/10/2005 was carried out. An epidemiological survey was completed for each outbreak. Norovirus in clinical samples was determined by PCR techniques. The incidence in each centre and the annual incidence of outbreaks by centre were calculated. Differences were calculated using the chi-square test and the Student's t test, taking a p value of > 0.05 as significant. Seventeen outbreaks (6 in hospitals and 11 in nursing homes) were detected. The global attack rate was 33.4% (652/1951) and was slightly higher in nursing homes (35.2%) than in hospitals (31.4%). A total of 94.1% (16/17) of outbreaks were caused by person-to-person transmission and only 5.9% (1/17) by foods. The mean number of days between the first and last case was 11.4 (SD = 6.9). The mean duration of symptoms was 2.39 days (SD=1.6), and was higher hospitals, 2.63 (SD=1.7), than in nursing homes, 1.97 (SD=1.7) (p < 0.0001). Norovirus is responsible for a large number of outbreaks due to person-to-person transmission. Control should be standardized to reduce the number and duration of outbreaks.
Maria Helena Palucci Marziale; Maria Lúcia Carmo Cruz Robazzi
Goals: To identify factors associated with occupational accidents caused by piercing and cutting instruments and to identify the consequences of these accidents.Methods: Descriptive field research. Data were obtained through semi-structured interviews with nurses who suffered accidents during one year in four hospitals at São Paulo State - Brazil. Results: factors associated with accidents were: work overload, poor quality material, inadequate disposal materials, professional negligence, clie...
Askarian, Mehrdad; Ghoreishi, Mahboobeh; Akbari Haghighinejad, Hourvash; Palenik, Charles John; Ghodsi, Maryam
Proper reporting of medical errors helps healthcare providers learn from adverse incidents and improve patient safety. A well-designed and functioning confidential reporting system is an essential component to this process. There are many error reporting methods; however, web-based systems are often preferred because they can provide; comprehensive and more easily analyzed information. This study addresses the use of a web-based error reporting system. This interventional study involved the application of an in-house designed "voluntary web-based medical error reporting system." The system has been used since July 2014 in Nemazee Hospital, Shiraz University of Medical Sciences. The rate and severity of errors reported during the year prior and a year after system launch were compared. The slope of the error report trend line was steep during the first 12 months (B = 105.727, P = 0.00). However, it slowed following launch of the web-based reporting system and was no longer statistically significant (B = 15.27, P = 0.81) by the end of the second year. Most recorded errors were no-harm laboratory types and were due to inattention. Usually, they were reported by nurses and other permanent employees. Most reported errors occurred during morning shifts. Using a standardized web-based error reporting system can be beneficial. This study reports on the performance of an in-house designed reporting system, which appeared to properly detect and analyze medical errors. The system also generated follow-up reports in a timely and accurate manner. Detection of near-miss errors could play a significant role in identifying areas of system defects.
Ruiz, Paula Buck de Oliveira; Perroca, Marcia Galan; Jericó, Marli de Carvalho
To map the sub processes related to turnover of nursing staff and to investigate and measure the nursing turnover cost. This is a descriptive-exploratory study, classified as case study, conducted in a teaching hospital in the southeastern, Brazil, in the period from May to November 2013. The population was composed by the nursing staff, using Nursing Turnover Cost Calculation Methodology. The total cost of turnover was R$314.605,62, and ranged from R$2.221,42 to R$3.073,23 per employee. The costs of pre-hire totaled R$101.004,60 (32,1%), and the hiring process consumed R$92.743,60 (91.8%) The costs of post-hire totaled R$213.601,02 (67,9%), for the sub process decreased productivity, R$199.982,40 (93.6%). The study identified the importance of managing the cost of staff turnover and the financial impact of the cost of the employee termination, which represented three times the average salary of the nursing staff.
Jang, R; Karwowski, W; Quesada, P M; Rodrick, D; Sherehiy, B; Cronin, S N; Layer, J K
A field study was conducted to investigate spinal kinematics and loading in the nursing profession using objective and subjective measurements of selected nursing tasks observed in a hospital setting. Spinal loading was estimated using trunk motion dynamics measured by the lumbar motion monitor (LMM) and lower back compressive and shear forces were estimated using the three-dimensional (3D) Static Strength Prediction Program. Subjective measures included the rate of perceived physical effort and the perceived risk of low back pain. A multiple logistic regression model, reported in the literature for predicting low back injury based on defined risk groups, was tested. The study results concluded that the major risk factors for low back injury in nurses were the weight of patients handled, trunk moment, and trunk axial rotation. The activities that required long time exposure to awkward postures were perceived by nurses as a high physical effort. This study also concluded that self-reported perceived exertion could be used as a tool to identify nursing activities with a high risk of low-back injury.
Hospitals must adapt to the rapidly changing environment of risk by changing the health behavior of their population. There is only one way to do this efficiently and at scale; send a nurse home with every patient at the time of discharge. That nurse can ensure adherence to medication and slowly, over time, transform personal behavior to evidence based levels ... basically taking their medication as prescribed, changing eating habits, increasing exercise, getting people to throw away their cigarettes, teaching them how to cope, improving their sleep and reducing their stress. But, this approach will require a nurse to basically "live" with the patient for prolonged periods of time, as bad health behaviors are quick to start but slow to change or end. The rapid developments in artificial intelligence and natural language understanding paired with cloud based computing and integrated with a variety of data sources has led to a new marketplace comprised of cognitive technologies that can emulate even the most creative, knowledgeable and effective nurse. Termed the Virtual Health Assistant, your patients can literally talk to these agents using normal conversational language. The possibility to send a nurse home with each patient to maintain adherence and prevent readmissions has arrived. The technology is available. Who will step forward to reap the rewards first?
Kubota, Kazumi; Shimazu, Akihito; Kawakami, Norito; Takahashi, Masaya; Nakata, Akinori; Schaufeli, Wilmar B
The present study examined the association between workaholism, the tendency to work excessively hard in a compulsive fashion, and sleep problems among Japanese nurses. A cross-sectional survey was conducted among 600 nurses from 2 university hospitals in Japan using a self-reported questionnaire on workaholism, sleep, job-related variables (i.e., job demands, job control, and worksite support), and demographic variables. A total of 394 nurses returned the questionnaire (response rate=65.7%) and complete data from 312 female nurses were used for analyses (final coverage rate=52.0%). Workaholics, as measured using the Japanese version of the Dutch Workaholism Scale, were defined as those having high scores on both the "work excessively" and "work compulsively" subscales. Logistic regression analyses revealed that workaholics had higher risks for sleep problems in terms of subjective sleep insufficiency, excessive daytime sleepiness at work, difficulty awakening in the morning, and feeling tired when waking up in the morning (odds ratios [OR] of 4.40, 3.18, 3.48, and 4.61, respectively, p<0.05). These remained significant even after adjusting for demographic and job-related variables (OR 3.41, 5.36, 2.56, and 2.77, respectively). However, no significant associations were found between workaholism and insomnia symptoms. These results suggest that workaholic nurses had higher risks for impaired awakening, insufficient sleep, and workplace sleepiness.
Mahani, Tshifularo Olga; Akinsola, Henry Abayomi; Mabunda, Jabu; Oni, Helen Tosin
Work-related violence is a common problem worldwide. In South Africa, the Medical Research Council conducted a study on workplace violence in the health care industry and reported that most respondents had experienced it in different forms. This study aimed to identify the types and causes of workplace violence toward nurses in Thulamela hospitals, Vhembe district. The study employed a quantitative approach using a cross-sectional design. The target population was all nurses working in one regional and two district hospitals in the municipality. The sample consisted of 100 randomly selected participants from each hospital giving a total sample size of 300. Prior to the data collection, an ethical clearance and written informed consent were obtained from each participant. Data were collected using a self-administered questionnaire. Analysis was done using SPSS Version 20.0. The study revealed that 85% of the respondents (255) had experienced workplace violence in the last 12 months with a range of 95% for threats to 60% for bullying. Regarding the gender of the perpetrators, females (71%) were the main perpetrators. This study concludes that workplace violence is a major occupational health issue in the district, most especially among the psychiatric nurses.
Alameddine, Mohamad; Baumann, Andrea; Laporte, Audrey; O'Brien-Pallas, Linda; Levinton, Carey; Onate, Kanecy; Deber, Raisa
This paper is a report of an analysis of the career trajectories of nurses 1 year after leaving hospitals. Although hospitals are traditionally the largest employers of nurses, technological advances and budgetary constraints have resulted in many countries in relative shrinkage of the hospital sector and a shift of care (and jobs) into home/community settings. It has been often assumed that nurses displaced from hospitals will move to work in the other workplaces, especially the community sector. Employment patterns were tracked by examining a longitudinal database of all 201,463 nurses registered with the College of Nurses Ontario (Canada) between 1993 and 2004. Focusing on the employment categories Active (Working in nursing), Eligible-Seeking nursing employment or Dropout from the nursing labour market, year-to-year transition matrixes were generated by sector and sub-sector of employment, nurse type, age group and work status. For every nurse practising nursing in any non-hospital job or in the community a year after leaving hospitals, an average of 1.3 and four nurses, respectively, dropped out of Ontario's labour market. The proportion of nurses leaving hospitals transitioning to the Dropout category ranged from 63.3% (1994-95) to 38.6% (2001-02). The proportion dropping out of Ontario's market was higher for Registered Practical Nurses (compared to Registered Nurses), increased with age and decreased with degree of casualization in nurses' jobs. Downsizing hospitals without attention to the potentially negative impact on the nursing workforce can lead to retention difficulties and adversely affects the overall supply of nurses.
Alavi, Azam; Zargham-Boroujeni, Ali; Yousefy, Alireza; Bahrami, Masoud
Self-efficacy is the most influential among factors affecting nurses' performance. Yet, understanding of the constituent elements of the caring self-efficacy concept was not considered. This study was to introduce altruism as one of the main aspects of caring self-efficacy in pediatric nurses. This is part of a larger study on the concept of caring self-efficacy conducted with qualitative content analysis approach in Iran. Participants included 27 clinical pediatric nurses and instructors, selected purposively. Data were collected using semi-structured interviews and analyzed using conventional content analysis method. Theme "altruism" as one of the main themes extracted from the analysis of the interviews in this study. This theme includes two main categories of "humanistic care" and "caring attitude." This paper introduces altruism as one of the values aspects of caring self-efficacy in pediatric nurses. Efficient nurse with features Humanistic care, through the provision of maternal care and family-centered care and caring attitudes resulting from religious beliefs and loving children to care for the children.
McHugh, John P; Foster, Andrew; Mor, Vincent; Shield, Renée R; Trivedi, Amal N; Wetle, Terrie; Zinn, Jacqueline S; Tyler, Denise A
Establishing preferred provider networks of skilled nursing facilities (SNFs) is one approach hospital administrators are using to reduce excess thirty-day readmissions and avoid Medicare penalties or to reduce beneficiaries' costs as part of value-based payment models. However, hospitals are also required to provide patients at discharge with a list of Medicare-eligible providers and cannot explicitly restrict patient choice. This requirement complicates the development of a SNF network. Furthermore, there is little evidence about the effectiveness of network development in reducing readmission rates. We used a concurrent mixed-methods approach, combining Medicare claims data for the period 2009-13 with qualitative data gathered from interviews during site visits to hospitals in eight US markets in March-October 2015, to examine changes in rehospitalization rates and differences in practices between hospitals that did and did not develop formal SNF networks. Four hospitals had developed formal SNF networks as part of their care management efforts. These hospitals saw a relative reduction from 2009 to 2013 in readmission rates for patients discharged to SNFs that was 4.5 percentage points greater than the reduction for hospitals without formal networks. Interviews revealed that those with networks expanded existing relationships with SNFs, effectively managed patient data, and exercised a looser interpretation of patient choice. Project HOPE—The People-to-People Health Foundation, Inc.
Sheward, Louisa; Hunt, Jennifer; Hagen, Suzanne; Macleod, Margaret; Ball, Jane
To explore the relationship between nurse outcomes (dissatisfaction and emotional exhaustion) and nurse workload, nurse characteristics and hospital variables. Concern about the impact of restructuring of nurse staffing, and reports of nurse shortages, on nurse and patient outcomes led to the research being reported on in this article. A questionnaire survey of registered nurses in Scotland and England. A questionnaire survey of the hospitals in which these nurses worked. Respondents in the two countries were similar in terms of demographic, work and employment characteristics. Significant relationships were found using the combined English and Scottish data between nurse patient ratios and (1) emotional exhaustion and (2) dissatisfaction with current job reported by nurses. Increasing numbers of patients to nurses was associated with increasing risk of emotional exhaustion and dissatisfaction with current job.
Zhang, Li-feng; You, Li-ming; Liu, Ke; Zheng, Jing; Fang, Jin-bo; Lu, Min-min; Lv, Ai-li; Ma, Wei-guang; Wang, Jian; Wang, Shu-hong; Wu, Xue; Zhu, Xiao-wen; Bu, Xiu-qing
The purpose of this study was to describe nurse burnout, job satisfaction, and intention to leave, and to explore the relationship of work environment to nurse outcomes in a sample of 9,698 nurses from 181 hospitals in China. Nurses reported moderate levels of emotional exhaustion and depersonalization, and high levels of reduced personal accomplishment. Nearly one fifth of the nurses reported high levels of burnout on all three dimensions. Forty-five percent of the nurses were dissatisfied with their current job; these nurses were most dissatisfied with their salary. Five percent of nurses reported intention to leave. Nurses reporting mixed and good work environments were less likely to report high burnout, job dissatisfaction, and intention to leave compared with those in poor work environments. The results suggest that high burnout and low job satisfaction are prominent problems for Chinese nurses, and improving work environment might be an effective strategy for better nurse outcomes in Chinese hospitals. PMID:24345617
Bloom, J R; Alexander, J A; Nuchols, B A
The objective of this exploratory study was to assess the effects of four nurse staffing patterns on the efficiency of patient care delivery in the hospital: registered nurses (RNs) from temporary agencies; part-time career RNs; RN rich skill mix; and organizationally experienced RNs. Using Transaction Cost Analysis, four regression models were specified to consider the effect of these staffing plans on personnel and benefit costs and on non-personnel operating costs. A number of additional variables were also included in the models to control for the effect of other organization and environmental determinants of hospital costs. Use of career part-time RNs and experienced staff reduced both personnel and benefit costs, as well as total non-personnel operating costs, while the use of temporary agencies for RNs increased non-personnel operating costs. An RN rich skill mix was not related to either measure of hospital costs. These findings provide partial support of the theory. Implications of our findings for future research on hospital management are discussed.
M Mozafari; G Azami; M Lotfizadeh Dehkordi; S Aazami
Background: Several instruments have so far been developed in English language to measure the level of work-family conflict and further validation is required for non-English speakers. Objective: To test factorial structure and construct validity of the Persian version of work-family conflict scale among Iranian nurse. Methods: This study was conducted among 456 Iranian nurses working at public hospitals in 17 provinces from March 2015 to September 2015. We used a self-administrated q...
Taghinezhad, Fakhredin; Safavi, Mahboobe; Raiesifar, Afsaneh; Yahyavi, Sayed Hossein
Organizational citizenship behavior (OCB) improves efficiency and employees' participation and generally provides a good ambiance. This study was conducted to determine the role of job satisfaction (JS), organizational commitment (OC) and procedural justice (PJ) in explaining OCB among nurses working in fifteen educational-treatment centers in Tehran-Iran, to provide guidelines for health care managers' further understanding of how to encourage citizenship behavior among nurses. In this multi-center descriptive-correlational study 373 nurses were evaluated through a Multi-stage cluster sampling method after obtaining approval from the Ethics Committee of Islamic Azad University, Tehran Medical Branch and Tehran University of Medical Sciences Research Deputy. Nurses who signed the informed consent and holding a bachelor or master degree, having a minimum one year of job experience and not having organizational management position during the questionnaire distribution were included in the study. In order to collect data, Demographic questionnaire, Podsakoff et al. (Leadersh Q 1(2):107-142, 1990) OCB questionnaire, OC questionnaire, Aelterman et al. (Educ Stud 33(3):285-297, 2007) JS questionnaire and PJ questionnaire were used. These questionnaires were translated into Persian and content validity was confirmed by an expert group; their reliability was calculated by the internal consistency Cronbach alpha coefficient and it was satisfied. Data were analyzed by descriptive statistics, Comparative mean tests, correlation coefficient and multiple-regression in the SPSS software version 11. The general mean and all five aspects of OCB that ranked higher than 3 were evaluated in a "quite desired" state. The mean for perceived procedural justice, the general mean for JS and the mean of general grade for OC from the nurses' was in "quite desired" state. Finding from multiple regression indicated that OC and PJ exhibit about 19 % of OCB variance totally which is
Welton, John M
The objective of the study was to better understand how hospitals use different types of RNs, LPNs, and nurse aides in proprietary (for-profit), nonprofit, and government-owned hospitals and to estimate the wages, cost, and intensity of nursing care using a national data set. This is a cross-sectional observational study of 3,129 acute care hospitals in all 50 states and District of Columbia using data from the 2008 Occupational Mix Survey administered by the Centers for Medicare &Medicaid Services (CMS). Nursing skill mix, hours, and labor costs were combined with other CMS hospital descriptive data, including type of hospital ownership, urban or rural location, hospital beds, and case-mix index. RN labor costs make up 25.5% of all hospital expenditures annually, and all nursing labor costs represent 30.1%, which is nearly a quarter trillion dollars ($216.7 billion) per year for inpatient nursing care. On average, proprietary hospitals employ 1.3 RNs per bed and 1.9 nursing personnel per bed in urban hospitals compared with 1.7 RNs per bed and 2.3 nursing personnel per bed for nonprofit and government-owned hospitals (P G .05). States with higher ratios of RN compared with LPN licenses used fewer LPNs in the inpatient setting. The findings from this study can be helpful in comparing nursing care across different types of hospitals, ownership, and geographic locations and used as a benchmark for future nursing workforce needs and costs.
Bormann, Lorraine; Abrahamson, Kathleen
Nurse managers leadership behaviors influence the job satisfaction of staff nurses. Transformational leadership is 1 of the 5 components associated with the Magnet Recognition Program®. The aim of this study was to examine the relationship between staff nurse perception of nurse manager leadership behavior and staff nurse job satisfaction in a hospital on the Magnet® journey and the influence of nurse manager leadership style on staff nurse job satisfaction. A descriptive, correlational design using a self-report survey with convenience sampling was used for this quantitative research study. Staff nurses completed the Multifactor Leadership Questionnaire 5X Short Form, the Abridged Job Descriptive Index survey, and a demographic questionnaire. Pearson correlations and regression analyses were completed to explore the relationship and influence of nurse manager leadership style on staff nurse job satisfaction. Transformational and transactional leadership styles of nurse managers were positively related to staff nurse overall job satisfaction and satisfaction with opportunity for promotion. Passive-avoidant leadership style of nurse managers was negatively related to staff nurse satisfaction with work, promotion, supervision, and coworker. Satisfaction with nurse manager leadership was a positive influence on overall nurse job satisfaction when separately controlling for the influence of each leadership style. Transformational and transactional leadership styles should be taught and encouraged among nurse managers to positively influence the job satisfaction of staff nurses.
Sonett van Wyk
Conclusion: The research findings support the value and continuation of utilising the pre-hospital clinical learning environment for placing post-basic emergency nursing students when enrolled in the emergency nursing programme.
Minnick, Ann F; Mion, Lorraine C; Johnson, Mary E; Catrambone, Cathy
To describe (1) the extent to which acute and intensive care units use the elements of nursing models (team, functional, primary, total patient care, patient-focused care, case management) and (2) the deployment of non-unit-based personnel resources. The lack of current data-based behavioral descriptions of the extent to which elements of nursing models are implemented makes it difficult to determine how work models may influence outcomes. Nurse managers of 56 intensive care units and 80 acute care adult units from 40 randomly selected US hospitals participated in a structured interview regarding (1) day-shift use of patient assignment behaviors associated with nursing models and (2) the availability and consistency of assignment of non-unit-based support personnel. No model was implemented fully. Almost all intensive care units reported similar assignment behaviors except in the consistency of patient assignment. Non-intensive care units demonstrated wide variation in assignment patterns. Patterns differed intra-institutionally. There were large differences in the availability and deployment of non-unit-based supportive resources. Administrators must recognize the differences in work models within their institutions as a part of any quality improvement effort. Attempts to test new work models must be rigorous in the measurement of their implementation.
Hinno, S; Partanen, P; Vehviläinen-Julkunen, K
In several European countries, the availability of qualified nurses is insufficient to meet current healthcare requirements. Nurses are highly dissatisfied with the rising demands of the healthcare environment and increasingly considering leaving their jobs. The study aims to investigate the relationships between the characteristics of hospital nurses' work environment and the quality of care provided, and furthermore to examine Dutch nurses' career plans. A cross-sectional, questionnaire survey of registered nurses (n = 334) working in the academic and district hospitals was conducted in 2005/2006. Previously validated questionnaires translated into the participants' language were used. Factor and regression analysis were used for data analysis. Overall, nurses rated their work environment rather favourably. Five work environment characteristics were identified: support for professional development, adequate staffing, nursing competence, supportive management and teamwork. Significant relationships were found between nurses' perceptions of their work environment characteristics and quality of care provided and nurses' career plans. When work environment characteristics were evaluated to be better, nurse-assessed quality of care also increased and intentions to leave current job decreased linearly. Study findings suggest that nurses' perceptions of their work environment are important for nurse outcomes in hospital settings. Further research is needed to explore the predictive ability of the work environment for nurse, patient and organizational outcomes in hospitals. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.
Su, Shu-Fen; Jenkins, Mary; Liu, Po-Erh
This paper explores the leadership style of hospital managers. Leadership has been widely studied in nursing from the perspective of nurses' psychological strain caused by nursing leadership. There is, however, little contained in the Western and Eastern literatures on the leadership style of hospital managers and certainly no study has explored managers' leadership style in Taiwanese hospitals from the nurses' stance. Grounded theory. A sample of 28 nurses from seven teaching hospitals in Taiwan, Republic of China was selected through theoretical sampling. A multi-step analytic procedure based on the grounded theory approach was used to analyse the qualitative data. The Chinese culture was found to affect the leadership style of Taiwanese hospital managers. They had extreme power and led nurses in a hierarchical manner. Nurse managers followed the autocratic leadership style of their hospital managers. The main category found in this study was thus hierarchical leadership. The Confucian principles of authoritarianism and obedience were found to be part of the Taiwanese hospitals' organisational cultures and strongly impacted on the managers' leadership style. Hospital managers' treatment of doctors and nurses was dependent on their social rankings. Nurses' lowly ranking fed into these enculturated managerial tendencies of using power and obedience thus increasing psychological strain on nurses. Managers of the hospitals demonstrate power and misuse obedience through their leadership style, resulting in deterioration of nurses' work environment. Nurses' managers are not given enough power by the hospitals in Taiwan. Subsequently, nurses feel themselves the lowest and most powerless subordinates. This study reveals that the Chinese cultural burdens are embedded in the leadership of Taiwanese hospitals. These findings enhance the knowledge of leadership and add to the understanding of managerial attitudes in Chinese hospitals located worldwide. © 2011 Blackwell
Conclusion: The hospital sources for the Aspergillus clinical isolates included air condition and walls. RAPD-PCR analysis can play a trivial role to find the hospital sources of Aspergillus clinical isolates.
Janati, Ali; Sadeghi-Bazargani, Homayoun; Hasanpoor, Edris; Sokhanvar, Mobin; HaghGoshyie, Elaheh; Salehi, Abdollah
Hospital emergency management is a continuous process that requires monolithic integration of planning and response attempts with local and national schemes. The aim of the current study is to evaluate emergency response by hospitals against potential disasters in Tabriz, north-west Iran. A cross-sectional study was conducted in the city of Tabriz, in Iran, in 2016. The study population included all hospitals in Tabriz. A total of 18 hospitals were assessed. The hospital emergency response checklist was used to collect data. Tool components included command and control, communication, safety and security, triage, surge capacity, continuity of essential services, human resources, logistics and supply management, and post-disaster recovery. Data entry and analysis were carried out using SPSS software (version 20). The results showed that the emergency response rate of hospitals was 54.26% in Tabriz. The lowest response rates were for Shafaa hospital (18.89%) and the highest response rates were for Razi Hospital (91.67%). The components of hospital emergency response were assessed to be between 48.07% (surge capacity) and 58.95% (communication). On the basis of the World Health Organization checklist, the emergency response rate for hospitals in Tabriz was only 54.26%. Therefore, hospital emergency responses against disasters have to be improved and must be made to reach 100%. It is essential to design a comprehensive framework for hospital emergency response. (Disaster Med Public Health Preparedness. 2018;12:166-171).
A library class was designed and offered to new nurses from the Neonatal Intensive Care Unit at the Children's Hospital of Michigan between 2003 and 2005. The class was intended to increase their knowledge of quality health information resources and to assist them with their smooth transition to a new health care organization. The goal of the library training class was to develop the nurses' awareness and knowledge of the library services and online resources on the organization Intranet and to improve their skills in finding reliable information related to patient care, patient parent education, and research. An evaluation study was conducted to assess the effectiveness of the library class. Although the findings demonstrated strengths of the library class, they also revealed some areas for improvement. The data gathered resulted in a number of recommendations regarding library instruction design and evaluation.
Mohajjel-Aghdam, Alireza; Hassankhani, Hadi; Zamanzadeh, Vahid; Khameneh, Saied; Moghaddam, Sara
Nursing profession requires knowledge of ethics to guide performance. The nature of this profession necessitates ethical care more than routine care. Today, worldwide definition of professional ethic code has been done based on human and ethical issues in the communication between nurse and patient. To improve all dimensions of nursing, we need to respect ethic codes. The aim of this study is to assess knowledge and performance about nursing ethic codes from nurses' and patients' perspective. A descriptive study Conducted upon 345 nurses and 500 inpatients in six teaching hospitals of Tabriz, 2012. To investigate nurses' knowledge and performance, data were collected by using structured questionnaires. Statistical analysis was done using descriptive and analytic statistics, independent t-test and ANOVA and Pearson correlation coefficient, in SPSS13. Most of the nurses were female, married, educated at BS degree and 86.4% of them were aware of Ethic codes also 91.9% of nurses and 41.8% of patients represented nurses respect ethic codes. Nurses' and patients' perspective about ethic codes differed significantly. Significant relationship was found between nurses' knowledge of ethic codes and job satisfaction and complaint of ethical performance. According to the results, consideration to teaching ethic codes in nursing curriculum for student and continuous education for staff is proposed, on the other hand recognizing failures of the health system, optimizing nursing care, attempt to inform patients about Nursing ethic codes, promote patient rights and achieve patient satisfaction can minimize the differences between the two perspectives.
This paper examines possible implications of the US 'magnet hospital' concept for the UK nursing labour market. Magnet hospitals have been researched in the US and have been demonstrated to exhibit lower nurse turnover and higher levels of reported job satisfaction than other hospitals. Key characteristics include a decentralized organizational structure, a commitment to flexible working hours, an emphasis on professional autonomy and development, and systematic communication between management and staff. The paper examines the labour market characteristics of UK nurses and US nurses and finds many similarities. Detailed case studies of employment practice in 10 US hospitals and 10 Scottish hospitals are reported, with specific attention to remuneration practice, methods of organizing nursing care, establishment-setting and flexible hours. The paper concludes that there are features of the magnet hospital concept which are of relevance and applicable to the UK nursing labour market, but that piecemeal importation of ideas is unlikely to be beneficial.
Alving, Berit Elisabeth; Christensen, Janne Buck; Thrysøe, Lars
The purpose of this literature review is to provide an overview of the information retrieval behaviour of clinical nurses, in terms of the use of databases and other information resources and their frequency of use. Systematic searches carried out in five databases and handsearching were used to identify the studies from 2010 to 2016, with a populations, exposures and outcomes (PEO) search strategy, focusing on the question: In which databases or other information resources do hospital nurses search for evidence based information, and how often? Of 5272 titles retrieved based on the search strategy, only nine studies fulfilled the criteria for inclusion. The studies are from the United States, Canada, Taiwan and Nigeria. The results show that hospital nurses' primary choice of source for evidence based information is Google and peers, while bibliographic databases such as PubMed are secondary choices. Data on frequency are only included in four of the studies, and data are heterogenous. The reasons for choosing Google and peers are primarily lack of time; lack of information; lack of retrieval skills; or lack of training in database searching. Only a few studies are published on clinical nurses' retrieval behaviours, and more studies are needed from Europe and Australia. © 2018 Health Libraries Group.
Henning-Smith, Carrie; Almanza, Jennifer; Kozhimannil, Katy B
To describe the maternity care nurse staffing in rural U.S. hospitals and identify key challenges and opportunities in maintaining an adequate nursing workforce. Cross-sectional survey study. Maternity care units within rural hospitals in nine U.S. states. Maternity care unit managers. We calculated descriptive statistics to characterize the rural maternity care nursing workforce by hospital birth volume and nursing staff model. We used simple content analysis to analyze responses to open-ended questions and identified themes related to challenges and opportunities for maternity care nursing in rural hospitals. Of the 263 hospitals, 51% were low volume (maternity care nurses. They did, however, identify significant challenges related to recruiting nurses, maintaining adequate staffing during times of census variability, orienting and training nurses, and retaining experienced nurses. Rural maternity care unit managers recognize the importance of nursing and have varied staffing needs. Policy implementation and programmatic support to ameliorate challenges may help ensure that an adequate nursing staff can be maintained, even in small-volume rural hospitals. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.
Ogata, Yasuko; Nagano, Midori; Fukuda, Takashi; Hashimoto, Michio
The purpose of this study was to examine how the nursing practice environment affects job retention and the turnover rate among hospital nurses. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was applied to investigate the nurse working environment from the viewpoint of hospital nurses in Japan. Methods A postal mail survey was conducted using the PES-NWI questionnaire targeting 2,211 nurses who were working at 91 wards in 5 hospitals situated in the Tokyo metropolitan area from February to March in 2008. In the questionnaire, hospital nurses were asked about characteristics such as sex, age and work experience as a nurse, whether they would work at the same hospital in the next year, the 31 items of the PES-NWI and job satisfaction. Nurse managers were asked to provide staff numbers to calculate the turnover rate of each ward. Logistic regression analyses were carried out, with "intention to retain or leave the workplace next year" as the dependent variable, with composite and 5 sub-scale scores of the PES-NWI and nurse characteristics as independent variables. Correlation coefficients were calculated to investigate the relationship between nurse turnover rates and nursing practice environments. A total of 1,067 full-time nurses (48.3%) from 5 hospitals responded. Almost all of them were men (95.9%), with an average age of 29.2 years old. They had an average of 7.0 years total work experience in hospitals and 5.8 years of experience at their current hospital. Cronbach's alpha coefficients were 0.75 for composite of the PES-NWI, and 0.77-0.85 for the sub-scales. All correlation coefficients between PES-NWI and job satisfaction were significant (P Leadership, and Support of Nurses" and "Staffing and Resource Adequacy" among the 5 sub-scales correlated with the intention of nurses to stay on (P < 0.05). The means for turnover rate were 10.4% for nurses and 17.6% for newly hired nurses. These rates were significantly correlated to the composite and
Albaladejo, Romana; Villanueva, Rosa; Ortega, Paloma; Astasio, P; Calle, M E; Domínguez, V
The term "burnout" is related to a situation arising increasingly more often among the professionals performing their duties by way of a long-term, direct, people-to-people relationship, which includes all healthcare professionals. This study is aimed at determining the prevalence of the Burnout syndrome and of the three components involved therein (emotional exhaustion, impersonalization and lack of personal fulfillment) among the nursing staff at the "Hospital Clínico Universitario San Carlos" in Madrid and the relationship thereof to certain socio-demographic, job-related and institutional factors. A cross-sectional study was conducted among the professionals assigned to the nursing staff at the above-mentioned hospital. The variables involved were gathered by means of a questionnaire prepared by those conducting this study. The Burnout syndrome was measured by means of the Maslach Burnout Inventory, in the validated Spanish version thereof. The nursing staff is more impersonalized (p=0.004) and less fulfilled (p=0.036) than the nursing assistant/technician group. When the results of the four scales by units were analyzed, burnout was found to be greater among the nursing staff assigned to oncology and emergency care units (p=0.001), the impersonalization in the emergency rooms (p=0.007), and Burnout is once again greater in the oncology and emergency units (p=0.000). Those professionals who answered that there was little recognition of their nursing care scored worst regarding Burnout and the three aspects thereof (p =0.000). The lower the degree of on-the-job satisfaction, the higher the scores on the four scales (p=0.000). The conclusion which may be drawn from this study is that the profile of a person affected by Burnout is that of a professional with on-the-job experience who nevertheless considers very little recognition to be given to their caregiving and a high degree of dissatisfaction with the way in which their workplaces are managed.
Quinn, Barbara; Baker, Dian L; Cohen, Shannon; Stewart, Jennifer L; Lima, Christine A; Parise, Carol
Nonventilator hospital-acquired pneumonia (NV-HAP) is an underreported and unstudied disease, with potential for measurable outcomes, fiscal savings, and improvement in quality of life. The purpose of our study was to (a) identify the incidence of NV-HAP in a convenience sample of U.S. hospitals and (b) determine the effectiveness of reliably delivered basic oral nursing care in reducing NV-HAP. A descriptive, quasi-experimental study using retrospective comparative outcomes to determine (a) the incidence of NV-HAP and (b) the effectiveness of enhanced basic oral nursing care versus usual care to prevent NV-HAP after introduction of a basic oral nursing care initiative. We used the International Statistical Classification of Diseases and Related Problems (ICD-9) codes for pneumonia not present on admission and verified NV-HAP diagnosis using the U.S. Centers for Disease Control and Prevention diagnostic criteria. We completed an evidence-based gap analysis and designed a site-specific oral care initiative designed to reduce NV-HAP. The intervention process was guided by the Influencer Model (see Figure) and participatory action research. We found a substantial amount of unreported NV-HAP. After we initiated our oral care protocols, the rate of NV-HAP per 100 patient days decreased from 0.49 to 0.3 (38.8%). The overall number of cases of NV-HAP was reduced by 37% during the 12-month intervention period. The avoidance of NV-HAP cases resulted in an estimated 8 lives saved, $1.72 million cost avoided, and 500 extra hospital days averted. The extra cost for therapeutic oral care equipment was $117,600 during the 12-month intervention period. Cost savings resulting from avoided NV-HAP was $1.72 million. Return on investment for the organization was $1.6 million in avoided costs. NV-HAP should be elevated to the same level of concern, attention, and effort as prevention of ventilator-associated pneumonia in hospitals. Nursing needs to lead the way in the design and
Mmamma, Mogale L; Mothiba, Tebogo M; Nancy, Malema R
Staff turnover of professional nurses remains a concern for public and private hospitals management because it has an impact on the morale of nurses and it may also lead to poor patient care. The objectives of this study were to explore and describe the experiences of nursing unit managers with regard to the turnover of professional nurses who were under their supervision. A qualitative, explorative, descriptive research design was used to determine the experiences of nursing unit managers related to the turnover of professional nurses. Data collection was done by using semi-structured one-to-one interviews with professional nurses .Two groups of participants were interviewed: Those working day duty (n = 9) and those working night duty (n = 3) who were at work on the anticipated days for data collection. The findings revealed that every unit was experiencing a shortage of professional nurses, which caused other nurses to work overtime with an inevitable increase in workload. That led to tiredness, conflict amongst professional nurses, job dissatisfaction, and absenteeism which compromised nursing care. This resulted in patient dissatisfaction and sometimes led to deaths that could have been prevented. It is recommended that staff turnover should be addressed by the hospital top management implementing several strategies. For example, top management could ensure that staff members work in a healthy environment with resources that they need during the provision of care, address the effects of the staff turnover, support the staff members and refrain from putting pressure on nursing unit managers whilst they are attending to problems.
Everhart, Damian; Neff, Donna; Al-Amin, Mona; Nogle, June; Weech-Maldonado, Robert
Hospitals facing financial uncertainty have sought to reduce nurse staffing as a way to increase profitability. However, nurse staffing has been found to be important in terms of quality of patient care and nursing-related outcomes. Nurse staffing can provide a competitive advantage to hospitals and as a result of better financial performance, particularly in more competitive markets. In this study, we build on the Resource-Based View of the Firm to determine the effect of nurse staffing on total profit margin in more competitive and less competitive hospital markets in Florida. By combining a Florida statewide nursing survey with the American Hospital Association Annual Survey and the Area Resource File, three separate multivariate linear regression models were conducted to determine the effect of nurse staffing on financial performance while accounting for market competitiveness. The analysis was limited to acute care hospitals. Nurse staffing levels had a positive association with financial performance (β = 3.3, p = .02) in competitive hospital markets, but no significant association was found in less competitive hospital markets. Hospitals in more competitive hospital markets should reconsider reducing nursing staff, as these cost-cutting measures may be inefficient and negatively affect financial performance.
Everhart, Damian; Neff, Donna; Al-Amin, Mona; Nogle, June; Weech-Maldonado, Robert
Background Hospitals facing financial uncertainty have sought to reduce nurse staffing as a way to increase profitability. However, nurse staffing has been found to be important in terms of quality of patient care and nursing related outcomes. Nurse staffing can provide a competitive advantage to hospitals and as a result better financial performance, particularly in more competitive markets Purpose In this study we build on the Resource-Based View of the Firm to determine the effect of nurse staffing on total profit margin in more competitive and less competitive hospital markets in Florida. Methodology/Approach By combining a Florida statewide nursing survey with the American Hospital Association Annual Survey and the Area Resource File, three separate multivariate linear regression models were conducted to determine the effect of nurse staffing on financial performance while accounting for market competitiveness. The analysis was limited to acute care hospitals. Findings Nurse staffing levels had a positive association with financial performance (β=3.3; p=0.02) in competitive hospital markets, but no significant association was found in less competitive hospital markets. Practice Implications Hospitals in more competitive hospital markets should reconsider reducing nursing staff, as these cost cutting measures may be inefficient and negatively affect financial performance. PMID:22543824
Rafat Mohebbi Far
Full Text Available OBJECTIVE: The purpose of this study was to determine the rate and causes of wastage of blood and blood products (packed red cells, plasma, platelets, and cryoprecipitate in Qazvin hospitals. METHODS: The study was conducted in all hospitals in Qazvin, including 5 teaching hospitals, 2 social welfare hospitals, 3 private hospitals, 1 charity hospital, and 1 military hospital. This descriptive study was based on available data from hospital blood banks in the province of Qazvin. The research instrument was a 2-part questionnaire. The first part was related to demographic characteristics of hospitals and the second part elicited information about blood and blood component wastage. The collected data were then analyzed using descriptive statistic methods and SPSS 11.5. RESULTS: Blood wastage may occur for a number of reasons, including time expiry, wasted imports, blood medically or surgically ordered but not used, stock time expired, hemolysis, or miscellaneous reasons. Data indicated that approximately 77.9% of wasted pack cell units were wasted for the reason of time expiry. Pack cell wastage in hospitals is reported to range from 1.93% to 30.7%. Wastage at all hospitals averaged 9.8% among 30.913 issued blood products. Overall blood and blood product (packed red cells, plasma, platelets, and cryoprecipitate wastage was 3048 units and average total wastage per participant hospital for all blood groups was 254 units per year. CONCLUSION: Blood transfusion is an essential part of patient care. The blood transfusion system has made significant advancements in areas such as donor management, storage of blood, cross-matching, rational use of blood, and distribution. In order to improve the standards of blood banks and the blood transfusion services in Iran, comprehensive standards have been formulated to ensure better quality control in collection, storage, testing, and distribution of blood and its components for the identified major factors
Paez, Kathryn; Schur, Claudia; Zhao, Lan; Lucado, Jennifer
This study assessed the perceptions and actions of rural hospital nurse executives with regard to patient safety and quality improvement (QI). A national sample of rural hospital nurse executives (n = 300) completed a survey measuring 4 domains related to patient safety and QI: (a) patient "Safety Culture," (b) adequacy of QI "Resources," (c) "Barriers" related to QI, and (d) "Nurse Leader Engagement" in activities supporting QI. Perceptions of Safety Culture were strong but 47% of the Resources needed to carry out QI were inadequate, 29% of Barriers were moderate to major, and 25% of Nurse Leader Engagement activities were performed infrequently. Nurse Leader Engagement in quality-related activities was less frequent among nurses in isolated and small rural town hospitals compared with large rural city hospitals. To further QI, rural nurse executives may need to use their communications and actions to raise the visibility of QI.
Issel, L Michele; Lurie, Christine Fitzpatrick; Bekemeier, Betty
The labor market perspective focuses on supply and demand for registered nurses (RNs) as employees. This perspective contrasts with beliefs in the public health sector that RNs working in local health departments (LHD) as public health nurses (PHNs) accept lower wages because of factors other than market demand. This study sought to describe the extent to which hourly wages of RNs working in LHDs are competitive with hospital RN wages within the same county market. A repeated measures survey design was used in collecting 2010 and 2014 data. The unit of analysis was the county, as an RN labor market for LHDs and hospitals. Survey questions captured factors common in human resources benefits and wage packages, such as differential pay, hourly rate pay based on years of experience, components of benefit packages (eg, sick and vacation leave), and reimbursement for education. Within each county, the LHD and all hospitals constituted a "market," yielding a potential 12 markets in our study sample. Human resources representatives from each of the 12 LHDs and from all hospitals within those 12 counties were invited to participate. We conducted comparisons with survey data using t test of mean differences on mean RN wages across years of experience. On average, LHDs paid significantly less than hospitals in their markets, at all levels of RN experience, and this gap increased with RN experience in the sample markets. Salary compression was evident in 2010 and worsened for PHNs in 2014, when compared with hospital RNs. In 2014, 100% of the sample LHDs offered reimbursements for continuing education for PHNs compared with 89% of hospitals providing this benefit. This study contributes to our understanding of the human resources challenges faced by LHDs and provides evidence elucidating resources issues that need to be addressed in order to improve recruitment and retention of PHNs.
Hinno, Saima; Partanen, Pirjo; Vehviläinen-Julkunen, Katri; Aaviksoo, Ain
The aim of the present study was to examine Estonian nurses' thinking with regard to how they perceive their autonomy, control over practice, teamwork and organizational support in regional, central and general hospitals. BACKGROUND; Despite the well-documented fact that there is a need to improve nurses' working environments in hospitals to promote safe patient care, in Europe broader studies on this topic have not received priority thus far. A nationally representative stratified random sample of 478 acute care hospital nurses was surveyed using the Nursing Work Index-Revised (NWI-R) instrument in 2005/2006. Nurses perceived their autonomy, control over practice and organizational support remarkably lower than nurse-physician relationships. Age and tenure were highly related to the nurses' perceptions. The Estonian nurses' ambivalent perceptions of the organizational attributes reflected the effects ascribed to hospital reforms. There is an urgent need for nurse managers to be particularly alert and attentive with regard to nurses who have been practising the profession for more than a decade. Support for their practice should be provided with the long-term goal of assuring the retention of those experienced nurses. Continuous monitoring of nurses' perceptions should be used systematically as a tool for staffing decisions at the hospital level.
Ofi, Bola; Sowunmi, Olanrewaju
The descriptive study was conducted to determine the extent of utilization of the nursing process for documentation of nursing care in three selected hospitals, Ibadan, Nigeria. One hundred fifty nurses and 115 discharged clients' records were selected from the hospitals. Questionnaires and checklists were used to collect data. Utilization of nursing process for care was 100%, 73.6% and 34.8% in the three hospitals. Nurses encountered difficulties in history taking, formulation of nursing diagnoses, objectives, nursing orders and evaluation. Most nurses disagreed or were undecided with the use of authorized abbreviations and symbols (34.3%, 40.3% and 69.5%), recording errors that occurred during care (37.1%, 56.1% and 52.2%) and inclusion of change in clients' condition (54.3%, 56.1% and 73.8%). Most nurses appreciated the significance of documentation. Lack of time, knowledge and need for extensive writing are the major barriers against documentation. Seventy-seven point four per cent of the 115 clients' records from one hospital showed evidence of documentation, no evidence from the other two. Study findings have implications for continuing professional education, practice and supervision. © 2012 Blackwell Publishing Asia Pty Ltd.
Cremer, Sven; Doelling, Kris; Lundberg, Cody L.; McNair, Mike; Shin, Jeongsik; Popa, Dan
In this paper we report on analysis toward identifying design requirements for an Adaptive Robotic Nursing Assistant (ARNA). Specifically, the paper focuses on application requirements for ARNA, envisioned as a mobile assistive robot that can navigate hospital environments to perform chores in roles such as patient sitter and patient walker. The role of a sitter is primarily related to patient observation from a distance, and fetching objects at the patient's request, while a walker provides physical assistance for ambulation and rehabilitation. The robot will be expected to not only understand nurse and patient intent but also close the decision loop by automating several routine tasks. As a result, the robot will be equipped with sensors such as distributed pressure sensitive skins, 3D range sensors, and so on. Modular sensor and actuator hardware configured in the form of several multi-degree-of-freedom manipulators, and a mobile base are expected to be deployed in reconfigurable platforms for physical assistance tasks. Furthermore, adaptive human-machine interfaces are expected to play a key role, as they directly impact the ability of robots to assist nurses in a dynamic and unstructured environment. This paper discusses required tasks for the ARNA robot, as well as sensors and software infrastructure to carry out those tasks in the aspects of technical resource availability, gaps, and needed experimental studies.
Juliana da Costa Fernandes
Full Text Available OBJECTIVE: to analyse the differences between genders in the description in the professional, domestic and total work hours and assess its association with health-related behaviour among nurses. METHODS: this is a transversal study carried out in 18 different public hospitals in the municipality of Rio de Janeiro. The data collection procedure was based on questionnaires. All nurses working with assistance were considered eligible (n=2,279. RESULTS: men and women showed significant differences in relation to working hours. The female group showed longer domestic and total work hours when compared to the group of men. In contrast, the number of hours spent on professional work was higher among men. For the women, both the professional hours and total work hours were often associated with excessive consumption of fried food and also coffee, lack of physical exercise and also the greater occurrence of overweight and obesity. CONCLUSION: both the professional hours and the domestic work hours need to be taken into account in studies about health, self-care and also the care provided within the context of nursing workers, particularly among women. The results add weight to the need for actions for health promotion in this occupational group and the importance of assessing the impact of long working hours on the health of workers.
Full Text Available OBJECTIVE: to explore the cultural experiences of nurses who immigrated to Chile. The study´s theoretical framework was the Purnell Model for Cultural Competence.METHOD: Leininger's Observation-Participation-Reflection method was developed at two hospitals in the city of Santiago, and ethnographic interviews were held with 15 immigrant nurses.RESULTS: among Purnell's 12 domains, the following were identified: Overview/heritage, Communication, Workforce issues, Family roles and organization, Biocultural ecology and Health-care practices. The difficulties were related to the language and its semantic meaning, the new responsibilities and the difficult relationship with colleagues. "In search of better horizons - the decision to immigrate", "Gaining confidence and establishing a support network - employability and professional performance" and "Seeking for people´s acceptance - professional adaptation in a new cultural scenario" are cultural themes that represent their experiences.CONCLUSIONS: the competence to offer cultural care demands the development of public policies and continuing education programs at health institutions, specifically focused on immigrant nurses.
Fernandes, Juliana da Costa; Portela, Luciana Fernandes; Rotenberg, Lúcia; Griep, Rosane Harter
To analyse the differences between genders in the description in the professional, domestic and total work hours and assess its association with health-related behaviour among nurses. This is a transversal study carried out in 18 different public hospitals in the municipality of Rio de Janeiro. The data collection procedure was based on questionnaires. All nurses working with assistance were considered eligible (n=2,279). Men and women showed significant differences in relation to working hours. The female group showed longer domestic and total work hours when compared to the group of men. In contrast, the number of hours spent on professional work was higher among men. For the women, both the professional hours and total work hours were often associated with excessive consumption of fried food and also coffee, lack of physical exercise and also the greater occurrence of overweight and obesity. Both the professional hours and the domestic work hours need to be taken into account in studies about health, self-care and also the care provided within the context of nursing workers, particularly among women. The results add weight to the need for actions for health promotion in this occupational group and the importance of assessing the impact of long working hours on the health of workers.
Qi, Yun-Ke; Xiang, Yu-Tao; An, Feng-Rong; Wang, Jing; Zeng, Jiao-Ying; Ungvari, Gabor S; Newhouse, Robin; Yu, Doris S F; Lai, Kelly Y C; Ding, Yan-Ming; Yu, Liuyang; Zhang, Xiang-Yang; Chiu, Helen F K
Little is known about the level of work-related stress in nurses in China.This study compared the level of work-related stress between female nurses working in psychiatric and general hospitals in China. A descriptive comparative cross-sectional design was used.A consecutive sample of nurses from two psychiatric hospitals (N = 297) and a medical unit (N = 408) of a general hospital completed a written survey including socio-demographic data and a measure of work-related stress (Nurse Stress Inventory). Compared to the nurses working in the general hospital, those working in the psychiatric setting had a higher level of stress in the domains of working environment and resources (p working experience, and working in psychiatric hospitals were associated with high work-related stress (b = .2, p work-related stress, specific stress management workshops and effective staff supportive initiatives for Chinese nurses are warranted.
Macedo, Isabela Fornerolli de; Souza, Tania Vignuda de; Oliveira, Isabel Cristina Dos Santos; Cibreiros, Sylvia Alves; Morais, Rita de Cássia Melão de; Vieira, Rosana Fidelis Coelho
to describe nursing team care and discuss the nursing team's conception of companion families of hospitalized children. The study was based on the theoretical framework of Collière's theory of nursing care identity. this was a qualitative study with 14 members of a nursing team, conducted through an unstructured group interview. Thematic data analysis was employed. habitual and repair care was delegated to families, regardless of the child's clinical condition. the team's official discourse about the families of hospitalized children, as recommended by the literature, refers to the family's alterity and participation in care provision, with sights on discharge and defending family participation as beneficial to children. In practice, however, the nursing staff makes concessions about the presence of chaperoning families and delegates care. descrever os cuidados da equipe de enfermagem e discutir as concepções da equipe de enfermagem frente à família acompanhante da criança hospitalizada. O referencial teórico está vinculado à identidade do cuidado de enfermagem de Collière. Estudo qualitativo com quatorze membros da equipe de enfermagem, utilizando a técnica de entrevista não diretiva em grupo. Foi realizada análise temática dos dados. os cuidados habituais e de reparação prestados à criança estão sendo delegados à família, independentemente da situação clínica da criança. o discurso oficial da equipe de enfermagem frente à família acompanhante da criança hospitalizada, preconizado pela literatura, refere-se à alteridade e à participação da família nos cuidados à criança, prevendo sua alta e justificando a participação como benéfica para a criança. Em contrapartida, na prática, a enfermagem faz concessões sobre a permanência da família e delega os cuidados.
Seldon, Lisa E; McDonough, Kelly; Turner, Barbara; Simmons, Leigh Ann
The aim of this study is to evaluate the effectiveness of a hospital-based pneumonia nurse navigator program. This study used a retrospective, formative evaluation. Data of patients admitted from January 2012 through December 2014 to a large community hospital with a primary or secondary diagnosis of pneumonia, excluding aspiration pneumonia, were used. Data included patient demographics, diagnoses, insurance coverage, core measures, average length of stay (ALOS), disposition, readmission rate, financial outcomes, and patient barriers to care were collected. Descriptive statistics and parametric testing were used to analyze data. Core measure performance was sustained at the 90th percentile 2 years after the implementation of the navigator program. The ALOS did not decrease to established benchmarks; however, the SD for ALOS decreased by nearly half after implementation of the navigator program, suggesting the program decreased the number and length of extended stays. Charges per case decreased by 21% from 2012 to 2014. Variable costs decreased by 4% over a 2-year period, which increased net profit per case by 5%. Average readmission payments increased by 8% from 2012 to 2014, and the net revenue per case increased by 8.3%. The pneumonia nurse navigator program may improve core measures, reduce ALOS, and increase net revenue. Future evaluations are necessary to substantiate these findings and optimize the cost and quality performance of navigator programs.
Kutney-Lee, Ann; Stimpfel, Amy Witkoski; Sloane, Douglas M.; Cimiotti, Jeannie P.; Quinn, Lisa W.; Aiken, Linda H.
Background Research has documented an association between Magnet hospitals and better outcomes for nurses and patients. However, little longitudinal evidence exists to support a causal link between Magnet recognition and outcomes. Objective To compare changes over time in surgical patient outcomes, nurse-reported quality, and nurse outcomes in a sample of hospitals that attained Magnet recognition between 1999 and 2007 with hospitals that remained non-Magnet. Research Design Retrospective, two-stage panel design using four secondary data sources. Subjects 136 Pennsylvania hospitals (11 “emerging” Magnets and 125 non-Magnets) Measures American Nurses Credentialing Center Magnet recognition; risk-adjusted rates of surgical 30-day mortality and failure-to-rescue, nurse-reported quality measures, and nurse outcomes; the Practice Environment Scale of the Nursing Work Index Methods Fixed effects difference models were used to compare changes in outcomes between emerging Magnet hospitals and hospitals that remained non-Magnet. Results Emerging Magnet hospitals demonstrated markedly greater improvements in their work environments than other hospitals. On average, the changes in 30-day surgical mortality and failure-to-rescue rates over the study period were more pronounced in emerging Magnet hospitals than in non-Magnet hospitals, by 2.4 fewer deaths per 1000 patients (pMagnet hospitals and non-Magnet hospitals were observed in nurse-reported quality of care and nurse outcomes. Conclusions In general, Magnet recognition is associated with significant improvements over time in the quality of the work environment, and in patient and nurse outcomes that exceed those of non-Magnet hospitals. PMID:25906016
Lopes, M J
This essay intends to discuss recent transformation both to hospital work and nursing work specifically. Analysis privilege inter and intra relations with multidisciplinary teams which is constituted of practices on the therapeutic process present in hospital space-time.
Full Text Available Background: The hospital anxiety and depression scale (HADS is a common screening tool designed to measure the level of anxiety and depression in different factor structures and has been extensively used in non-psychiatric populations and individuals experiencing fertility problems. Objective: The aims of this study were to evaluate the factor structure, item analyses, and internal consistency of HADS in Iranian infertile patients. Materials and Methods: This cross-sectional study included 651 infertile patients (248 men and 403 women referred to a referral infertility Center in Tehran, Iran between January 2014 and January 2015. Confirmatory factor analysis was used to determine the underlying factor structure of the HADS among one, two, and threefactor models. Several goodness of fit indices were utilized such as comparative, normed and goodness of fit indices, Akaike information criterion, and the root mean squared error of approximation. In addition to HADS, the Satisfaction with Life Scale questionnaires as well as demographic and clinical information were administered to all patients. Results: The goodness of fit indices through CFAs exposed that three and onefactor model provided the best and worst fit to the total, male and female datasets compared to the other factor structure models for the infertile patients. The Cronbach’s alpha for anxiety and depression subscales were 0.866 and 0.753 respectively. The HADS subscales significantly correlated with SWLS, indicating an acceptable convergent validity. Conclusion: The HADS was found to be a three-factor structure screening instrument in the field of infertility.
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.
Souza, Norma Valéria Dantas de Oliveira; Gonçalves, Francisco Gleidson de Azevedo; Pires, Ariane da Silva; David, Helena Maria Scherlowski Leal
To describe and analyze the influence of the neoliberal economic and political model on the nursing hospital work process and organization. Qualitative descriptive research, having as its scenery a university hospital. The subjects were 34 nursing workers. The data collection took place from March to July 2013, through semi-structured interview. The data treatment technique used was content analysis, which brought up the following category: working conditions precariousness and its consequences to the hospital work process and organization in the neoliberal context. The consequences of neoliberalism on hospital work process and organization were highlighted, being observed physical structure, human resources and material inadequacies that harms the assistance quality. In addition to wage decrease that cause the need of second jobs and work overload. There is a significant influence of the neoliberal model on hospital work, resulting on working conditions precariousness. Descrever e analisar a influência do modelo econômico e político neoliberal na organização e no processo de trabalho hospitalar de enfermagem. Pesquisa qualitativa e descritiva, tendo como cenário um hospital universitário. Os participantes foram 34 trabalhadores de enfermagem. A coleta ocorreu de março a julho de 2013, por meio de entrevista semiestruturada. A técnica de tratamento dos dados foi a análise de conteúdo, que fez emergir a seguinte categoria: precarização das condições laborais e suas repercussões para organização e processo de trabalho hospitalar no contexto neoliberal. Evidenciaram-se repercussões do neoliberalismo na organização e no processo de trabalho hospitalar, verificando-se inadequações na estrutura física, nos recursos humanos e materiais, que afetavam a qualidade da assistência. Além de perdas salariais que levam à necessidade de outros empregos e sobrecarga de trabalho. Há forte influência do modelo neoliberal no trabalho hospitalar, resultando
Bahrami, Mohammad Amin; Montazeralfaraj, Razieh; Gazar, Saeed Hashemi; Tafti, Arefeh Dehghani
Organizational citizenship behavior just referred to a set of discretionary workplace behaviors that exceed one's job requirements. The main objective of this study was to determine the relationship between organizational perceived justice and organizational citizenship behavior. This cross-sectional study was done in Shahid Sadoughi Hospital in Yazd, Iran in 2013. A total of 100 hospital employees contributed in the study. The required data was gathered using 2 valid questionnaires, including the Moorman & Niehoff organizational perceived justice questionnaire and the McKinsey organizational citizenship behavior questionnaire. Data were analyzed using SPSS version 16. Descriptive statistics, Chi square, and Pearson's correlation coefficient were used for data analysis. There was a significant positive relationship between organizational perceived justice and organizational citizenship behavior among the studied hospital's employees (P ≤ 0.05, R = 0.33). This study confirmed that any policy that leads to better organizational justice perception will contribute in better organizational citizenship behavior which will increase the hospital's productivity.
Full Text Available Background: Managers in the hospital should have enough managerial skill to be coordinated with the complex environment. Defining a competency framework assessment for hospital man-agement will help to establish core competencies for hospital managers. The aim of this study was to develop concrete and suitable performance assessment criteria using expert's view.Methods: In this qualitative study in total, 20 professionals participated in the interview and Fo-cus Group Discussions (FGD. Two of informants were interviewed and 18 professionals par-ticipants in three focus group discussions. Discussions and interviews were well planned, the FGD environments were suitable and after interviews completion the notes were checked with participant for completeness. Thematic analysis method was used for the analysis of qualitative data.Results: Findings from 3 FGDs and 2 semi structured interviews done with 20 professionals were categorized accordance to themes. The findings were classified in 7 major and 41 sub themes. The major themes include competency related to planning, organization and staff per-formance management, leadership, information management, and clinical governance and per-formance indicators.Conclusion: All participants had hospital administration experience; so their explanation impor-tant in identifying the criteria and developing hospital managers’ performance assessment tool. In addition to professional perspectives and studies done in other countries, in order to design this kind of tools, it is necessary to adopt the obtained findings to the local hospital conditions.
Tzeng, Wen-Chii; Lin, Chiou-Fen; Lin, Lih-Ying; Lu, Meei-Shiow; Chiang, Li-Chi
In the context of professional nursing, the concept of job satisfaction includes the degree to which a nurse is satisfied with the nursing profession, his/her personal adaptation to this profession, and his/her current working environment. No validated scale that addresses the job satisfaction of nurses working in hospitals currently exists in Taiwan. To develop a reliable and validated scale for measuring the job satisfaction of hospital nurses in Taiwan. A three-phase, cross-sectional study design was used. First, a literature review and expert focus group discussion were conducted to develop the initial scale items. Second, experts were invited to validate the content of the draft scale. Finally, convenience sampling was used to recruit 427 hospital nurses from 6 hospitals. These nurses completed the scale and the results were analyzed using item analysis, factor analysis, and internal consistency analysis. The 31-item Taiwanese hospital nurse job satisfaction scale developed in the present study addresses 5 factors, including supportive working environment, professional autonomy and growth, interpersonal interaction and collaboration, leadership style, and nursing workload. The overall Cronbach's α was .96. The results indicate that the developed scale provides good reliability and validity. This study confirms the validity and reliability of the developed scale. It may be used to measure the job satisfaction of nurses working in hospitals.
Xiao, Lily Dongxia; Shen, Jun; Wu, Haifeng; Ding, Fu; He, Xizhen; Zhu, Yueping
A lack of knowledge in registered nurses about geriatric conditions is one of the major factors that contribute to these conditions being overlooked in hospitalized older people. In China, an innovative geriatric continuing nursing education program aimed at developing registered nurses' understanding of the complex care needs of hospitalized…
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.
Mª Dolores Poyatos Ruiz
Full Text Available The social needs and requests change constantly, so that health care is evolving to a more focused on the users, in order to meet users´ needs and expectations of those who are going to get our assistance. Aim: We have developed a research to evaluate the quality of the assistance received by the patientst in their first encounter in the hospital external consulting rooms of traumathology at Santa Bárbara Hospital, letting us know about the patient´s satisfaction after the consulting has finished. Material and method: A transverse descriptive study on the traumathology consulting room of Santa Bárbara Hospital in Puertollano was developed for two months. The research is formed by the patients who attend this consulting room for their first time. A self made multiple choice questionnaire, which was designe by experts, and patients were asked to answer it once their first consulting at traumathology service had finished. Results: 95.6% of the patients considered as good or very good the nursing kindness (confidence/reliabitity when seeing them; 93.5% of them considered as good or very good the information given to them and 90.6% of them considered as good or very good the medical explanations they got. We also noticed a significant statistical difference among nursing kindness (confidence/reliabitity, enough consultation time and explanations received, with regard to the variant high resolution. Conclusions: The study reveals that more than 90% of the interviewed people considered as good or very good the clinical assistance and service given. The research has allowed us to know the areas that we can work on and improve.
de Bie, J.; Cuperus-Bosma, J.M.; van der Jagt, M.A.; Gevers, J.K.M.; van der Wal, G.
Occurrence of problems with, refusals of orders and contemplated refusals of orders for risky procedures by nurses in Dutch hospitals and views on the safety of performance was studied using postal questionnaires (600 physicians and 3200 nurses, response 60-71%). Of the respondents, 11-30%
Oyira, Emilia James; Ella, R. E.; Chukwudi, Usochukwu Easter; Paulina, Akpan Idiok
Objectives: The main purpose of this study was to determine knowledge practice and outcome of quality nursing care among nurses in University of Calabar Teaching Hospital (UCTH). Three research questions and one hypothesis were formulated to guide this study. Literature related to the variables under study was reviewed according to the research…
Brown, Robin; Wey, Howard; Foland, Kay
The purpose of this study was to examine relationships between change fatigue, resilience, and job satisfaction among novice and seasoned hospital staff nurses. Health care is typified by change. Frequent and vast changes in acute care hospitals can take a toll on nurses and cause change fatigue, which has been largely overlooked and under-researched. A descriptive correlational design was employed with 521 hospital staff nurses in one midwestern state. Participants completed three online surveys: (a) Change Fatigue Scale, (b) Connor-Davidson Resilience Scale, and (c) McCloskey/Mueller Satisfaction Scale. In a multiple regression model, job satisfaction had a statistically significant negative association with change fatigue (p job satisfaction among hospital nursing staff being negatively influenced by change fatigue and positively influenced by resilience, although reverse causal connections are also possible. Change fatigue may be increased by larger hospital size (number of beds), and resilience may be increased by higher educational level of hospital staff nurses. The study advanced the nursing knowledge on change fatigue, resilience, and job satisfaction of staff nurses working in acute care hospitals. Engaging in strategies aimed at preventing change fatigue in nursing staff can enhance workplace environments, job satisfaction, and retention of nurses. © 2018 Sigma Theta Tau International.
International evidence reveals that hospital nurses have not been able to incorporate health promotion effectively into the framework of their care. This can be attributed to unclear conceptualizing of the barriers and facilitators to the role of nurses in health promotion. An integrative review was carried out to develop a conceptual model to assist hospital nurses in Jordan to understand how health promotion activities can be developed. Factors affecting the involvement of nurses in health promotion - ranging from limited knowledge about health promotion to the social image of nursing - can be structured into three levels: the micro (individual), meso (organizational) and macro (population). By understanding the interplay of factors between and within the levels, nurses and other health professionals can draw on the individual, social and organizational factors that influence nurses' role in health promotion. The proposed model can be considered as a springboard for developing health promotion activities related to hospitals in other Muslim-majority contexts.
Silber, Jeffrey H; Rosenbaum, Paul R; McHugh, Matthew D; Ludwig, Justin M; Smith, Herbert L; Niknam, Bijan A; Even-Shoshan, Orit; Fleisher, Lee A; Kelz, Rachel R; Aiken, Linda H
The literature suggests that hospitals with better nursing work environments provide better quality of care. Less is known about value (cost vs quality). To test whether hospitals with better nursing work environments displayed better value than those with worse nursing environments and to determine patient risk groups associated with the greatest value. A retrospective matched-cohort design, comparing the outcomes and cost of patients at focal hospitals recognized nationally as having good nurse working environments and nurse-to-bed ratios of 1 or greater with patients at control group hospitals without such recognition and with nurse-to-bed ratios less than 1. This study included 25 752 elderly Medicare general surgery patients treated at focal hospitals and 62 882 patients treated at control hospitals during 2004-2006 in Illinois, New York, and Texas. The study was conducted between January 1, 2004, and November 30, 2006; this analysis was conducted from April to August 2015. Focal vs control hospitals (better vs worse nursing environment). Thirty-day mortality and costs reflecting resource utilization. This study was conducted at 35 focal hospitals (mean nurse-to-bed ratio, 1.51) and 293 control hospitals (mean nurse-to-bed ratio, 0.69). Focal hospitals were larger and more teaching and technology intensive than control hospitals. Thirty-day mortality in focal hospitals was 4.8% vs 5.8% in control hospitals (P value in the focal group. For the focal vs control hospitals, the greatest mortality benefit (17.3% vs 19.9%; P risk quintile, with a nonsignificant cost difference of $941 per patient ($53 701 vs $52 760; P = .25). The greatest difference in value between focal and control hospitals appeared in patients in the second-highest risk quintile, with mortality of 4.2% vs 5.8% (P value (lower mortality with similar costs) compared with hospitals without nursing environment recognition and with below-average staffing, especially for higher
Ahmadian, Leila; Dorosti, Nafise; Khajouei, Reza; Gohari, Sadrieh Hajesmaeel
Hospital Information Systems (HIS) are used for easy access to information, improvement of documentation and reducing errors. Nonetheless, using these systems is faced with some barriers and obstacles. This study identifies the challenges and the obstacles of using these systems in the academic and non-academic hospitals in Kerman. This is a cross-sectional study which was carried out in 2015. The statistical population in this study consisted of the nurses who had been working in the academic and non-academic hospitals in Kerman. A questionnaire consisting of two sections was used. The first section consisted of the demographic information of the participants and the second section comprised 34 questions about the challenges of HIS use. Data were analyzed by the descriptive and statistical analysis (t-test, and ANOVA) using SPSS 19 software. The most common and important challenges in the academic hospitals were about human environment factors, particularly "negative attitude of society toward using HIS". In the non-academic hospitals, the most common and important challenges were related to human factors, and among them, "no incentive to use system" was the main factor. The results of the t-test method revealed that there was a significant relationship between gender and the mean score of challenges related to the organizational environment category in the academic hospitals and between familiarity with HIS and mean score of human environment factors (pinformation systems are the factors related to the human environment and the human factors. The results of this study can bring a good perspective to the policy makers and the managers regarding obstacles of using HISs from the nurses' perspective, so that they can solve their problems and can successfully implement these systems.
Persoon, Anke; Bakker, Franka C.; van der Wal-Huisman, Hanneke; Rikkert, Marcel G. M. Olde
ObjectivesTo develop a questionnaire, the Geriatric In-hospital Nursing Care Questionnaire (GerINCQ), to measure, in an integrated way, the care that older adults receive in the hospital and nurses' attitudes toward and perceptions about caring for older adults. DesignQuestionnaire development.
Purpose: To assess the culture of safety among nurses in a tertiary teaching hospital in Saudi Arabia. Methods: A cross-sectional survey was conducted in King Khaled University Hospital in Riyadh, Saudi Arabia. A random sample of 492 nurses was included in the survey using a pre-validated instrument, Safety Attitudes ...
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.
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.
Ng'ang'a, Njoki; Byrne, Mary W; Anh Ngo, Toan
Abstract Background Nurses in Vietnam, as is typical of many low-income countries, are hampered from impacting health outcomes by low occupational status, overcrowded hospitals and few career development opportunities. In order to understand the current practice environment encountered by nurses in Vietnam in the most realistic way, we listened to the voices of nurses currently performing nursing roles in Vietnam. Purpose The purpose of this study was to explore the emic (insider) perspectives on cultural meaning applied by nurses at a northern Vietnamese women�s hospital to influence professional practice and interpret experience. Design A micro-ethnography approach was used. Methods Seven nurses and one vice-Dean of a school of nursing were interviewed. Data collection consisted of open-ended interviews, participant observation and journal recordings. Spradley�s (1979, 1980) Development Research Sequence was used to guide data collection and analysis. Results/Findings Five themes emerged. These were the big number of patients is a burden for nurses; nurses do not, cannot make their own decisions (but they can and do); my feeling depends on doctor's feeling; nurses learn more from doctor; and just a few nurses can attend the [Vietnamese Nurses Association] meeting. Conclusion The experiences described by the nurses and the vice-Dean of a nursing school reflect the challenges of practicing nursing in one Vietnamese hospital and the resourcefulness of nurses in overcoming those challenges. Recurrent themes highlight the need to better position nurses in Vietnam to advance towards full expression of the professional nursing role.
Aiken, Linda H; Clarke, Sean P; Sloane, Douglas M; Lake, Eileen T; Cheney, Timothy
The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education. Staffing and education have well-documented associations with patient outcomes, but evidence on the effect of care environments on outcomes has been more limited. Data from 10,184 nurses and 232,342 surgical patients in 168 Pennsylvania hospitals were analyzed. Care environments were measured using the practice environment scales of the Nursing Work Index. Outcomes included nurse job satisfaction, burnout, intent to leave, and reports of quality of care, as well as mortality and failure to rescue in patients. Nurses reported more positive job experiences and fewer concerns with care quality, and patients had significantly lower risks of death and failure to rescue in hospitals with better care environments. Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care.
Nyirenda, Maloni; Mukwato, Patricia
Job satisfaction is a major determinant of performance at the workplace. Studies have shown that job dissatisfaction can intensify emotional exhaustion, and this can influence nurses to perceive their work as tiresome and repetitive, leading to frustration and discouragement. The purpose of this study was to investigate the relationship between job satisfaction and attitude towards nursing care at Mzuzu Central Hospital in Mzuzu, Malawi. This was a descriptive correlational study. Eighty-nine nurses were selected using simple random sampling. A self-administered questionnaire was used to collect data. Data were analysed using Stata (version 12). Frequencies, means, and standard deviations were used to summarise sociodemographic data and also to determine job satisfaction and attitudes towards nursing care among the participants. Independent t-tests were used to determine if differences in professional qualifications, job title, work experience, or the clinical setting in which the nurses worked were associated with differences in job satisfaction and attitude. Pearson's product-moment correlation was used to determine the relationship between job satisfaction and attitude in the study sample. The nurses who participated in this study generally had positive attitudes towards nursing care and were moderately satisfied with their jobs. There was a significant variation in attitude depending on the amount of time a nurse worked at a particular post (P = 0.0308), as well as the amount of time a nurse had worked at the hospital (P = 0.0012). There was a significant positive relationship between job satisfaction and attitude (r = 0.226, P = 0.033). The nurses in the study sample were moderately satisified with their work and generally had positive attitudes towards nursing care. There was a positive correlation between attitude towards nursing care and job satisfaction. Addressing factors which dissatisfy nurses can promote nurses' attitudes and likely improve performance
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.
Aiken, Linda H; Sloane, Douglas M; Bruyneel, Luk; Van den Heede, Koen; Griffiths, Peter; Busse, Reinhard; Diomidous, Marianna; Kinnunen, Juha; Kózka, Maria; Lesaffre, Emmanuel; McHugh, Matthew D; Moreno-Casbas, M T; Rafferty, Anne Marie; Schwendimann, Rene; Scott, P Anne; Tishelman, Carol; van Achterberg, Theo; Sermeus, Walter
Austerity measures and health-system redesign to minimise hospital expenditures risk adversely affecting patient outcomes. The RN4CAST study was designed to inform decision making about nursing, one of the largest components of hospital operating expenses. We aimed to assess whether differences in patient to nurse ratios and nurses' educational qualifications in nine of the 12 RN4CAST countries with similar patient discharge data were associated with variation in hospital mortality after common surgical procedures. For this observational study, we obtained discharge data for 422,730 patients aged 50 years or older who underwent common surgeries in 300 hospitals in nine European countries. Administrative data were coded with a standard protocol (variants of the ninth or tenth versions of the International Classification of Diseases) to estimate 30 day in-hospital mortality by use of risk adjustment measures including age, sex, admission type, 43 dummy variables suggesting surgery type, and 17 dummy variables suggesting comorbidities present at admission. Surveys of 26,516 nurses practising in study hospitals were used to measure nurse staffing and nurse education. We used generalised estimating equations to assess the effects of nursing factors on the likelihood of surgical patients dying within 30 days of admission, before and after adjusting for other hospital and patient characteristics. An increase in a nurses' workload by one patient increased the likelihood of an inpatient dying within 30 days of admission by 7% (odds ratio 1·068, 95% CI 1·031-1·106), and every 10% increase in bachelor's degree nurses was associated with a decrease in this likelihood by 7% (0·929, 0·886-0·973). These associations imply that patients in hospitals in which 60% of nurses had bachelor's degrees and nurses cared for an average of six patients would have almost 30% lower mortality than patients in hospitals in which only 30% of nurses had bachelor's degrees and nurses cared
Sheeja. C. V; K. Reddemma.
Introduction: Satisfaction of the nurses are key component in delivering inviolable health care in the country. Multiple factors are responsible for nurses? job satisfaction. Satisfied nurses are able to provide quality nursing care for their patients. Staff Nurses? Job satisfaction are influenced by extrinsic and intrinsic factors. The staff nurses attitude towards their job can be measured through the job satisfaction scale. This study has been undertaken in an attempt to explore and descri...
Prothero, M M; Marshall, E S; Fosbinder, D M
This project was part of a collaborative model for nursing staff development and student education. Personal values and work satisfaction of 49 staff nurses working on three hospital units were compared. One of the units employed differentiated practice. Results revealed high similarity in personal values among all nurses. Work satisfaction was significantly higher among nurses working on the unit employing differentiated practice. The importance of assessing personal values of nurses emerged as an important aspect of staff development, and differentiated practice appeared to be related to staff nurse satisfaction.
Isfandyari-Moghaddam, Alireza; Sedehi, Maryam; Dehghani, Mozhdeh; Nemati-Anaraki, Leila; Hasanzadeh-Dizaji, Elaheh
Purpose: The purpose of this paper is to compare the attitude of the managers of libraries located at Iran, Tehran and Shahid Beheshti Medical Sciences Universities' training hospitals, on the status of information technology (IT) in the mentioned libraries. Design/methodology/approach: This study employed a researcher-made questionnaire. The…
Aghaei Hashjin, Asgar; Kringos, Dionne S.; Manoochehri, Jila; Ravaghi, Hamid; Klazinga, Niek S.
To examine the extent of implementation for patient safety (PS) and patient-centeredness (PC) strategies and their association with hospital characteristics (type, ownership, teaching status, annual evaluation grade) in Iran. A cross-sectional study through an adapted version of the MARQuIS
Conclusions: Nurses who experienced inpatient suicide became stressed. Effective interventions must be implemented to improve the coping mechanisms of nurses against the negative consequences of inpatient suicide. The findings of this study will allow administrators to gain insight into the impacts of inpatient suicides on nurses in general hospitals. Such information can be used to develop effective strategies and provide individual support and ongoing education. Consequently, nurses will acquire suicide prevention skills and help patients achieve swift recovery.
Sperhac, A M; Goodwin, L D
As nurses gain more experience, they often question the basis of nursing practice and want to find the most current and accepted methods of providing nursing care. Attending seminars, conferences, and continuing education programs is often difficult because of financial and staffing constraints. The authors describe the design and implementation of two funded programs--the Prince Scholars and Sabbatical Programs--that support continuing nursing education in a pediatric tertiary hospital.
Oluwatosin Olu-Abiodun; Olumide Abiodun
Introduction: Effective nursing leadership engenders staff retention, job satisfaction, commitment, work unit climate and client satisfaction with nursing services. This study assessed the perception of transformational leadership among nurses working in general hospitals in Nigeria. Materials and methods: A cross-sectional study was conducted among 176 nurses in Ogun State, Nigeria. The independent student t-test was used to test the relationship between respondents’ characteristics and l...
Cummings, Greta G; Midodzi, William K; Wong, Carol A; Estabrooks, Carole A
Nursing work environment characteristics, in particular nurse and physician staffing, have been linked to patient outcomes (adverse events and patient mortality). Researchers have stressed the need for nursing leadership to advance change in healthcare organizations to create safer practice environments for patients. The relationship between styles of nursing leadership in hospitals and patient outcomes has not been well examined. The purpose of this study was to examine the contribution of hospital nursing leadership styles to 30-day mortality after controlling for patient demographics, comorbidities, and hospital factors. Ninety acute care hospitals in Alberta, Canada, were categorized into five styles of nursing leadership: high resonant, moderately resonant, mixed, moderately dissonant, and high dissonant. In the secondary analysis, existing data from three sources (nurses, patients, and institutions) were used to test a hypothesis that the styles of nursing leadership at the hospital level contribute to patient mortality rates. Thirty-day mortality was 7.8% in the study sample of 21,570 medical patients; rates varied across hospital categories: high resonant (5.2%), moderately resonant (7.4%), mixed (8.1%), moderately dissonant (8.8%), and high dissonant (4.3%). After controlling for patient demographics, comorbidities, and institutional and hospital nursing characteristics, nursing leadership styles explained 5.1% of 72.2% of total variance in mortality across hospitals, and high-resonant leadership was related significantly to lower mortality. Hospital nursing leadership styles may contribute to 30-day mortality of patients. This relationship may be moderated by homogeneity of leadership styles, clarity of communication among leaders and healthcare providers, and work environment characteristics.
Lindqvist, Rikard; Smeds Alenius, Lisa; Griffiths, Peter; Runesdotter, Sara; Tishelman, Carol
To investigate whether hospital characteristics not readily susceptible to change (i.e. hospital size, university status, and geographic location) are associated with specific self-reported nurse outcomes. Research often focuses on factors within hospitals (e.g. work environment), which are susceptible to change, rather than on structural factors in their own right. However, numerous assumptions exist about the role of structural factors that may lead to a sense of pessimism and undermine efforts at constructive change. Data was derived from survey questions on assessments of work environment and satisfaction, intention to leave, quality of care and burnout (measured by the Maslach Burnout Inventory), from a population-based sample of 11 000 registered nurses in Sweden. Mixed model regressions were used for analysis. Registered nurses in small hospitals were slightly more likely to rank their working environment and quality of nursing care better than others. For example 23% of staff in small hospitals were very satisfied with the work environment compared with 20% in medium-sized hospitals and 21% in large hospitals. Registered nurses in urban areas, who intended to leave their job, were more likely to seek work in another hospital (38% vs. 32%). While some structural factors were related to nurse-reported outcomes in this large sample, the associations were small or of questionable importance. The influence of structural factors such as hospital size on nurse-reported outcomes is small and unlikely to negate efforts to improve work environment. © 2013 John Wiley & Sons Ltd.
Ebrahimi, Hossein; Hosseinzadeh, Rahele; Tefreshi, Mansoreh Zaghari; Hosseinzadeh, Sadaf
Effective time management is considered important for managers for achieving the goals in an organization. Head nurses can improve their efficiency and performance with effective use of time. There has always been a lot of disagreement in understanding time management behaviors of head nurses; therefore, the present study was conducted with an aim to compare the understanding of head nurses and staff nurses of the time management behaviors of head nurses employed in Social Security Hospitals in Tehran, Iran in 2011. This was a comparative descriptive study in which 85 head nurses were selected through census and 170 staff nurses were also selected through simple random sampling method from hospitals covered by the Social Security. Data collection was done through a standard inventory with high validity and reliability, which consisted of two parts: Socio-demographic characteristics and time management inventory. The obtained data were analyzed by descriptive and inferential statistics through SPSS software version 13. Mean score of time management in head nurses' viewpoint was 143.22 (±18.66) and in staff nurses' viewpoint was 136.04 (±21.45). There was a significant correlation between the mean scores of head nurses' time management and some of their socio-demographic characteristics such as gender, clinical experience, passing a time management course, and book reading (P < 0.05). There was a significant correlation between the mean scores of staff nurses' time management and their clinical working experience, education, using time management approach, and type of hospital (P < 0.05). The majority of head nurses (52.9%) believed that their time management was in a high level; besides, most of the staff nurses also (40%) believed that time management of their head nurses was high. However, there was a significant difference between the perceptions of both groups on using Mann-Whitney test (P < 0.05). With regard to the importance of time management and its vital
Eskandari, Fereidoun; Siahkali, Soheila Rabie; Shoghli, Alireza; Pazargadi, Mehrnoosh; Tafreshi, Mansoreh Zaghari
The demanding nature of nursing work environments signals longstanding and growing concerns about nurses' health and job satisfaction and the provision of quality care. Specifically in health care settings, nurse leaders play an essential role in creating supportive work environments to avert these negative trends and increase nurse job satisfaction. The purpose of this study was to examine the relationship between structural empowerment and organizational commitment of nurses. 491 nurses working in Zanjan hospitals participated in this descriptive-correlational study in 2010. Tools for data collection were Meyer and Allen's organizational commitment questionnaire and "Conditions for Work Effectiveness Questionnaire-II" (CWEQ-II). Data was analyzed by SPSS16. The statistical tests such as variance analysis, t-test, pearson correlation coefficient and linear regression were used for data analysis. According to the findings, the perception of nurses working in hospitals on "Structural Empowerment" was moderate (15.98±3.29). Nurses believed "opportunity" as the most important element in structural empowerment with the score of 3.18 ±0.79. Nurses working in non-academic hospitals and in non-teaching hospitals had higher organizational commitment than others. There was a significant relationship between structural empowerment and organizational commitment. Generally, structural empowerment (relatively strong) correlates with nurses' organizational commitment. We concluded that a high structural empowerment increases the organizational commitment of nurses.
This study was set in an acute Irish health care setting and aimed to explore the activity of the clinical nurse specialist (CNS) in this setting. Quantitative methodology, using a valid and reliable questionnaire, provided descriptive statistics that gave accurate data on the total population of CNSs in the health care setting. The study was set in an acute-care 750-bed hospital that had 25 CNSs in practice. The sample consisted of all 25 CNSs who are the total population of CNSs working in the acute health care institution. The findings show the CNS to be active in the roles of researcher, educator, communicator, change agent, leader, and clinical specialist, but the level of activity varies between different roles. There is variety in the activity of CNSs in the various roles and to what extent they enact the role. The findings merit further study on CNS role activity and possible variables that influence role activity.
Juliana Yukari Takahashi Onishi
Full Text Available ABSTRACT Objective: To understand technical nursing students' meaning of interacting with family members of hospitalized children. Method: Symbolic Interactionism was used as the theoretical framework and Qualitative Content Analysis was the methodological procedure. A total of eight graduates from an institution situated in the city of Osasco, Sao Paulo state, participated in this study. Data were collected through semi-structured interviews. Results: A total of five representative themes were revealed: Dealing with difficult situations with family members; Perceiving oneself to be unprepared to interact with family members; Family members being a helpful tool; Developing strategies to obtain a good interaction with family members; and Teachers being facilitators of the interaction with family members. Final considerations: To be acquainted with this experience has led to the understanding of the need to include the theme of family care in the curriculum of the Technical Nursing Course. Additionally, the present study contributed to reflections on the importance of such knowledge for this population and to the development of future studies, as this theme has been scarcely explored in the literature.
Onishi, Juliana Yukari Takahashi; Ribeiro, Circéa Amália; Silva, Maria Cristina Ferreira Carlos Rodrigues da; Borba, Regina Issuzu Hirooka de
To understand technical nursing students' meaning of interacting with family members of hospitalized children. Symbolic Interactionism was used as the theoretical framework and Qualitative Content Analysis was the methodological procedure. A total of eight graduates from an institution situated in the city of Osasco, Sao Paulo state, participated in this study. Data were collected through semi-structured interviews. A total of five representative themes were revealed: Dealing with difficult situations with family members; Perceiving oneself to be unprepared to interact with family members; Family members being a helpful tool; Developing strategies to obtain a good interaction with family members; and Teachers being facilitators of the interaction with family members. To be acquainted with this experience has led to the understanding of the need to include the theme of family care in the curriculum of the Technical Nursing Course. Additionally, the present study contributed to reflections on the importance of such knowledge for this population and to the development of future studies, as this theme has been scarcely explored in the literature.
CLASSIFICATION OF IRANIAN NURSES ACCORDING TO THEIR MENTAL HEALTH OUTCOMES USING GHQ-12 QUESTIONNAIRE: A COMPARISON BETWEEN LATENT CLASS ANALYSIS AND K-MEANS CLUSTERING WITH TRADITIONAL SCORING METHOD.
Jamali, Jamshid; Ayatollahi, Seyyed Mohammad Taghi
Nurses constitute the most providers of health care systems. Their mental health can affect the quality of services and patients' satisfaction. General Health Questionnaire (GHQ-12) is a general screening tool used to detect mental disorders. Scoring method and determining thresholds for this questionnaire are debatable and the cut-off points can vary from sample to sample. This study was conducted to estimate the prevalence of mental disorders among Iranian nurses using GHQ-12 and also compare Latent Class Analysis (LCA) and K-means clustering with traditional scoring method. A cross-sectional study was carried out in Fars and Bushehr provinces of southern Iran in 2014. Participants were 771 Iranian nurses, who filled out the GHQ-12 questionnaire. Traditional scoring method, LCA and K-means were used to estimate the prevalence of mental disorder among Iranian nurses. Cohen's kappa statistic was applied to assess the agreement between the LCA and K-means with traditional scoring method of GHQ-12. The nurses with mental disorder by scoring method, LCA and K-mean were 36.3% (n=280), 32.2% (n=248), and 26.5% (n=204), respectively. LCA and logistic regression revealed that the prevalence of mental disorder in females was significantly higher than males. Mental disorder in nurses was in a medium level compared to other people living in Iran. There was a little difference between prevalence of mental disorder estimated by scoring method, K-means and LCA. According to the advantages of LCA than K-means and different results in scoring method, we suggest LCA for classification of Iranian nurses according to their mental health outcomes using GHQ-12 questionnaire.
Poell, Rob F; Van der Krogt, Ferd J
A relatively new theoretical concept is proposed in this paper, namely, the individual learning path. Learning paths are created by individual employees and comprise a set of learning-relevant activities that are both coherent as a whole and meaningful to them. To explore the empirical basis of this theoretical concept. A qualitative study involving semi-structured interviews. Two academic medical centers (university hospitals) and two general hospitals in the Netherlands. A total of 89 nurses were involved in the study. Semi-structured interviews were analyzed qualitatively; cluster analysis was then performed on quantified data from the interviews. Four types of learning path emerged, namely, the formal-external, self-directed, social-emotional, and information-oriented learning paths. The relatively new theoretical concept of an individual learning path can be observed in practice and a number of different learning-path types can be distinguished. Nurses were found to create their own learning paths, that is, select a theme that is relevant primarily to themselves, conduct a variety of learning activities around this theme, participate in social contexts that might help them, and mobilize learning facilities provided by their organization. These activities go way beyond the notion of employees as self-directed learners merely in a didactic sense (establishing learning goals, choosing the right learning activities for these goals, evaluating to what extent their goals have been met as a result). The findings can be interpreted as evidence of employees acting strategically when it comes to their professional development. Providers of continuing professional education/development need to take this into account. Copyright © 2013 Elsevier Ltd. All rights reserved.
Full Text Available Background Considering the advancement of technology and application of various appliances in the workplace, one of the most significant current discussions in the industrial and nonindustrialized workplaces is thermal comfort. Hospital staff have a special status because of the diversity of people employed in hospitals and their crucial roles. Objectives The present study aimed at investigating the staffs’ thermal comfort in a hospital in Esfahan. Methods In this cross-sectional study, Al Zahra hospital staff working in the underground floor were recruited. The sampling method was census, and 161 staff participated in the study. Data were collected by mental assessment using a questionnaire and physical measurement using wet bulb globe temperature (WBGT machine in the summer of 2015. The predicted mean vote (PMV and predicted percentage dissatisfied (PPD were determined based on mental assessment or individual feeling of the staff about thermal comfort. Data management and analyses were performed using SPSS 23. Results The results of the data analysis revealed that kitchen, laundry, and sterilization sectors had higher temperature than other units. Moreover, the results demonstrated that the offices of educational sectors and educational classes had a standard level of thermal comfort according to ASHRAE (American society of heating, refrigerating and air-conditioning engineers Standard 55. The investigations of physical and mental PMV in every unit showed that the total index of these 2 values was 1.2 and 1.39, respectively. Conclusions Based on the results, the units located at the underground floor needed proper design and access to natural ventilation and enough air flow to provide optimum thermal comfort based on international standards.
Full Text Available Introduction: Nursing profession requires knowledge of ethics to guide performance. The nature of this profession necessitates ethical care more than routine care. Today, worldwide definition of professional ethic code has been done based on human and ethical issues in the communication between nurse and patient. To improve all dimensions of nursing, we need to respect ethic codes. The aim of this study is to assess knowledge and performance about nursing ethic codes from nurses' and patients' perspective.Methods: A cross-sectional comparative study Conducted upon 345 nurses and 500 inpatients in six teaching hospitals of Tabriz, 2012. To investigate nurses' knowledge and performance, data were collected by using structured questionnaires. Statistical analysis was done using descriptive and analytic statistics, independent t-test and ANOVA and Pearson correlation coefficient, in SPSS13.Results: Most of the nurses were female, married, educated at BS degree and 86.4% of them were aware of Ethic codes also 91.9% of nurses and 41.8% of patients represented nurses respect ethic codes. Nurses' and patients' perspective about ethic codes differed significantly. Significant relationship was found between nurses' knowledge of ethic codes and job satisfaction and complaint of ethical performance. Conclusion: According to the results, consideration to teaching ethic codes in nursing curriculum for student and continuous education for staff is proposed, on the other hand recognizing failures of the health system, optimizing nursing care, attempt to inform patients about Nursing ethic codes, promote patient rights and achieve patient satisfaction can minimize the differences between the two perspectives.
Rezaei, Satar; Matin, Behzad Karami; Moradi, Khalil; Bijan, Behroz; Fallahi, Masoud; Shokati, Behnam; Saeidi, Hamid
The main mission of hospitals in any health system is to deliver high quality healthcare for patients and meet their needs and expectations. The aim of the current study was to assess the quality of the service of educational hospitals affiliated with Kermanshah University of Medical Sciences in 2015, from the perspective of patients. In this cross-sectional study, the perspectives of 400 patients were assessed about the quality of the services provided by educational hospitals in Kermanshah (western Iran) in 2015. The quality was assessed by the SERVQUAL questionnaire with five dimensions, i.e., tangibility, reliability, responsiveness, assurance, and empathy. In addition, the Wilcoxon test and the Kruskal-Wallis test were used to explore any association between the dependent variable and explanatory variables. The data were analyzed using Stata V.12 software. There were negative gaps in all five dimensions. The highest and lowest gaps in the mean score were found in the assurance (-0.88) and responsiveness (-0.56) dimensions. The patients ranked responsiveness as the most important dimension of the quality of healthcare. There were gaps between the patients' perceptions and their expectation about the five dimensions that were studied based on the SERVQUAL model. Also, it is recommended that improving the quality of healthcare is possible by various policies, such as good responsiveness, access to health workers, and delivering healthcare in less time.
Rezaei, Satar; Matin, Behzad Karami; Moradi, Khalil; Bijan, Behroz; Fallahi, Masoud; Shokati, Behnam; Saeidi, Hamid
Introduction The main mission of hospitals in any health system is to deliver high quality healthcare for patients and meet their needs and expectations. The aim of the current study was to assess the quality of the service of educational hospitals affiliated with Kermanshah University of Medical Sciences in 2015, from the perspective of patients. Methods In this cross-sectional study, the perspectives of 400 patients were assessed about the quality of the services provided by educational hospitals in Kermanshah (western Iran) in 2015. The quality was assessed by the SERVQUAL questionnaire with five dimensions, i.e., tangibility, reliability, responsiveness, assurance, and empathy. In addition, the Wilcoxon test and the Kruskal-Wallis test were used to explore any association between the dependent variable and explanatory variables. The data were analyzed using Stata V.12 software. Results There were negative gaps in all five dimensions. The highest and lowest gaps in the mean score were found in the assurance (−0.88) and responsiveness (−0.56) dimensions. The patients ranked responsiveness as the most important dimension of the quality of healthcare. Conclusion There were gaps between the patients’ perceptions and their expectation about the five dimensions that were studied based on the SERVQUAL model. Also, it is recommended that improving the quality of healthcare is possible by various policies, such as good responsiveness, access to health workers, and delivering healthcare in less time. PMID:27123218
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.
Buffington, Annsley; Zwink, Jennifer; Fink, Regina; Devine, Deborah; Sanders, Carolyn
: The aim of this study was to examine the factors affecting the retention of registered nurses (RNs) and validate the revised Casey-Fink Nurse Retention Survey (2009). : Creating an organizational culture of retention may reduce nurse turnover. Focusing on why nurses leave and identifying factors why nurses stay are essential. : A descriptive survey design gathered data from RNs with 1 or more years of experience providing direct patient care and employed in inpatient/ambulatory settings in an acute care, academic, Magnet hospital. : There were no statistically significant relationships between nurse respondents' perceptions of work environment/support/encouragement and age or years of experience. However, there were significant differences between inpatient and ambulatory nurse responses in several key areas including job satisfaction, mentorship, and educational support. Overall, nurses reported feeling a lack of support and recognition from managers. Results provide evidence to support improved strategies to foster nurse retention.
van Bruchem-van de Scheur, G G; van der Arend, Arie J G; Huijer Abu-Saad, Huda; van Wijmen, Frans C B; Spreeuwenberg, Cor; Ter Meulen, Ruud H J
To report a study on the role of nurses in euthanasia and physician-assisted suicide in hospitals, conducted as part of a wider study on the role of nurses in medical end-of-life decisions. Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician-assisted suicide gave the Dutch Minister for Health reason to commission a study on the role of nurses in medical end-of-life decisions in hospitals, homecare and nursing homes. A questionnaire was sent in 2003 to 692 nurses employed in 73 hospital locations. The response suitable for analysis was from 532 (76.9%) nurses. Data were quantitatively analysed using spss version 11.5 for Windows. In almost half of the cases (45.1%), the nurse was the first with whom patients discussed their request for euthanasia or physician-assisted suicide. Consultations between physicians and nurses quite often took place (78.8%). In several cases (15.4%), nurses themselves administered the euthanatics with or without a physician. It is not self-evident that hospitals have guidelines concerning euthanasia/physician-assisted suicide. In the decision-making process, the consultation between the physician and the nurse needs improvement. In administering the euthanatics, physicians should take responsibility and should not leave these actions to nurses. Guidelines may play an important role to improve the collaboration between physicians and nurses and to prevent procedural, ethical and legal misunderstandings. Nurses in clinical practice are often closely involved in the last stage of a person's life. Consequently, they are often confronted with caring for patients requesting euthanasia or physician-assisted suicide. The results provide relevant information and may help nurses in defining their role in euthanasia and physician-assisted suicide, especially in case these practices should become legalised.
Kudo, Yasushi; Kido, Shigeri; Shahzad, Machiko Taruzuka; Yoshimura, Emiko; Shibuya, Akitaka; Aizawa, Yoshiharu
Nursing assistants can work without a professional certification to help registered nurses and licensed practical nurses. Nursing assistants engage in various tasks, e.g., washing laundry, cleaning up, and clerk tasks regarding nursing. Enhancing work motivation among nursing assistants is essential for every hospital, because when nursing assistants do their jobs well, it allows registered nurses and licensed practical nurses to complete their own specialized jobs. We examined the predictors significantly associated with nursing assistants' work motivation. For those predictors, we produced items to examine job satisfaction. Those items are classified into intrinsic and extrinsic facets. The subjects for this study were Japanese nursing assistants working in 26 hospitals with 62-376 beds (4 public and 22 private hospitals). A total of 516 nursing assistants were analyzed, with the average age and standard deviation of 42.7 ± 12.9 years; the age of 456 female subjects was 43.8 ± 12.7 years and that of 60 male subjects was 34.3 ± 11.0 years. Our results show that "work motivation" is significantly associated with "free time to do one's own things," "nursing assistants as important partners on the job," "feeling helpful to patients," "participating in decision making," and "job-skill improvement." Free time to do one's own things is an extrinsic item. Hospital administrators must monitor the workload and their quality of life among nursing assistants. All the other significant items are intrinsic. Nursing assistants are not only motivated by money. They highly value the intrinsic nature and experience of their jobs.
Konuk Şener, Dilek; Karaca, Aysel
This study attempted to identify the mutual expectations of mothers whose children were hospitalized in the pediatric department of a university hospital and nurses who provided care. A descriptive phenomenological design has been used in this study. Data were obtained through tape-recorded semi-structured interviews. This study was conducted at a pediatric clinic, at a university hospital in a small city in Turkey. Participants comprised five nurses working in the children's clinic and 24 mothers who accompanied their children to the hospital. The six major themes that emerged were mothers' feelings and thoughts about the hospital experience, mothers' expectations for attention and support during hospitalization, mothers' expectations for invasive procedures, issues regarding physical comfort and hospital infrastructure, nurses' feelings and thoughts about working in the pediatric clinic, and nurses' expectations of the mothers. Mothers expected nurses to provide physical support including medication administration, and installing/applying IV and nebulizer treatments; and emotional support in terms of having a friendly, rather than critical attitude, and being approachable and receptive of mothers' questions and anxieties. Nurses stated that they were aware of these expectations but needed mothers to be understanding and tolerant, considering their difficult working conditions. Children's hospitalization is a stressful experience for parents. Open and therapeutic communication and relationships between parents and nurses contribute to improving the quality of care provided to children and their families. Copyright © 2017 Elsevier Inc. All rights reserved.
Soh, Sze-Ee; Morello, Renata; Rifat, Sheral; Brand, Caroline; Barker, Anna
Objectives The aim of the present study was to explore nurse perceptions of safety climate in acute Australian hospitals. Methods Participants included 420 nurses who have worked on 24 acute wards from six Australian hospitals. The Safety Attitudes Questionnaire (SAQ) Short Form was used to quantify nurse perceptions of safety climate and benchmarked against international data. Generalised linear mixed models were used to explore factors that may influence safety climate. Results On average, 53.5% of nurses held positive attitudes towards job satisfaction followed by teamwork climate (50.5%). There was variability in SAQ domain scores across hospitals. The safety climate and perceptions of hospital management domains also varied across wards within a hospital. Nurses who had worked longer at a hospital were more likely to have poorer perceptions of hospital management (β=-5.2; P=0.014). Overall, nurse perceptions of safety climate appeared higher than international data. Conclusions The perceptions of nurses working in acute Victorian and New South Wales hospitals varied between hospitals as well as across wards within each hospital. This highlights the importance of surveying all hospital wards and examining the results at the ward level when implementing strategies to improve patient safety and the culture of safety in organisations. What is known about the topic? Prior studies in American nursing samples have shown that hospitals with higher levels of safety climate have a lower relative incidence of preventable patient complications and adverse events. Developing a culture of safety in hospitals may be useful in targeting efforts to improve patient safety. What does this paper add? This paper has shown that the perceptions of safety climate among nurses working in acute Australian hospitals varied between hospitals and across wards within a hospital. Only half the nurses also reported positive attitudes towards job satisfaction and teamwork climate. What are
Yoon, Jungmin; Kim, Miyoung; Shin, Juhhyun
Effective delegation improves job satisfaction, responsibility, productivity and development. The ageing population demands more nurses in long-term-care hospitals. Delegation and leadership promote cooperation among nursing staff. However, little research describes nursing delegation and leadership style. We investigated the relationship between registered nurses' delegation confidence and leadership in Korean long-term-care hospitals. Our descriptive correlational design sampled 199 registered nurses from 13 long-term-care hospitals in Korea. Instruments were the Confidence and Intent to Delegate Scale and Multifactor Leadership Questionnaire. Confidence in delegation significantly aligned with current-unit clinical experience, length of total clinical-nursing experience, delegation-training experience and leadership. Transformational leadership was the most statistically significant factor influencing delegation confidence. When effective delegation integrates with efficient leadership, staff can deliver optimal care to long-term-care patients. © 2016 John Wiley & Sons Ltd.
Gifford, Blair D; Zammuto, Raymond F; Goodman, Eric A
Turnover rates for hospital nurses have been increasing in recent years, which is partially a result of increasing pressure on nurses from higher productivity expectations in a managed care environment. Improving nurse retention is a difficult challenge to managers since the bureaucratic cultural norm of hospitals, with its hierarchical structures, rules, and regulations, and heavy emphasis on measurement of outcomes and costs, may not be the culture most conducive to enhancing nurses' job satisfaction and commitment. Accordingly, this study investigates the relationships between unit organizational culture and several important job-related variables for nurse retention in the labor and delivery units of seven hospitals. Data analysis shows that unit organizational culture does affect nurses' quality of work life factors and that human relations cultural values are positively related to organizational commitment, job involvement, empowerment, and job satisfaction, and negatively related to intent to turnover. These findings suggest that although increasing recruitment of nurses and improved compensation and benefits strategies may offset hospital nurse shortages in the short term, improving quality of work life may be a more practical and long-term approach to improving hospital nurse retention.
Chien, Wai-Tong; Yick, Sin-Yin
Nurses' job satisfaction and job stress are important issues regarding their turnovers. While there are some recent descriptive studies on job satisfaction in public hospitals, very limited research was found on this topic in private hospital setting. It is worth to examine the job satisfaction of nurses and its correlates in such a specific hospital context in Hong Kong, by which the findings can be compared with those in public hospitals, and across countries. To investigate nurses' job satisfaction, job stress and intention to quit of nurses in a private hospital, and the correlates of the nurses' job satisfaction. A cross-sectional, descriptive survey study was conducted. By using stratified random sampling in terms of nature of wards/units and working ranks, 139 full-time nurses who were working in the 400-bed private hospital for at least 6 months and provided direct nursing care were recruited in this study. Data were collected by employing a set of self-administered structured questionnaires, consisting of the Index of Work Satisfaction (job satisfaction), Anxiety-Stress Questionnaire (job stress), Michigan Organizational Assessment Questionnaire (intention to quit), and socio-demographic data. With a response rate of 74.3%, the results of the 139 respondents showed that the nurses in the private hospital had an overall moderate level of satisfaction with their work and rated the professional status as the highest satisfied domain. The nurses also reported moderate levels of job stress and intention to quit. The nurses' job satisfaction was negatively correlated with their job stress and intention to quit; whereas, the nurses' job stress was positively correlated with their intention to quit. The nurses with older in age and more post-registration experience and/or working experience in the private hospital indicated a higher level of job satisfaction, particularly with 'Pay' and 'Autonomy'. The findings suggest that the nurses in the private hospital are
Aguilar-Escobar, Víctor G.
Full Text Available Literature on healthcare supply chain management has shown that the kanban system can provide significant benefits. However, very few benefits have been empirically demonstrated and the extent of each remains unknown. This study aims to measure nurses’ satisfaction with kanban systems in logistics of medical consumables and assesses possible advantages and differences among user groups through an anonymous survey at Hospital Universitario Virgen Macarena of Seville, Spain. Treatment of responses included an exploratory factor analysis, and a CAPTCA analysis. The results showed a high level of satisfaction for each aspect of the kanban system. Moreover, it highlighted the differences of opinion between groups of individuals according to workplace, nursing units, job category, seniority, age and kanban training. The exploratory factor analysis revealed that two factors underlie the collected assessments: the inherent advantages of a kanban system, and the logistics system performance as a whole. Thus, hospital managers should promote the implementation of kanban systems, since it increases nurses’ satisfaction and provides significant benefits.
Blay, Nicole; Donoghue, Judith
The role of the nursing manager has evolved from clinician and bed manager to one with greater accountability for evidence based practice, benchmarking and more recently, budget liability. Casemix data are widely believed to be a means of providing essential information for effective decision making and financial management but have not been widely utilised by nursing managers (Diers & Bozzo, 1999). This paper will report the results of a survey of nursing managers in seven hospitals within a metropolitan area health service. The hospitals include tertiary referral hospitals, specialist public hospitals and an affiliated public hospital for aged care and rehabilitation services. The survey sought to establish what casemix and related data were provided to nurse managers, who provided these data and how supplied data were utilised by the nurse managers. Results demonstrated that the majority of nursing managers surveyed received minimal (if any) casemix and/or demographic data on a routine basis. Some were provided with data in response to specific requests. The information that was provided varied both within and across hospitals, and no consistent methods of data distribution were available. Few nursing managers believed that the information provided aided their decision-making processes partly due to the minimalist nature of provided data while some nursing managers demonstrated a lack of understanding of the potential benefit of casemix data as a resource to support management decision making.
Hayes, Bronwyn; Bonner, Ann; Pryor, Julie
To explore and discuss from recent literature the common factors contributing to nurse job satisfaction in the acute hospital setting. Nursing dissatisfaction is linked to high rates of nurses leaving the profession, poor morale, poor patient outcomes and increased financial expenditure. Understanding factors that contribute to job satisfaction could increase nurse retention. A literature search from January 2004 to March 2009 was conducted using the keywords nursing, (dis)satisfaction, job (dis)satisfaction to identify factors contributing to satisfaction for nurses working in acute hospital settings. This review identified 44 factors in three clusters (intra-, inter- and extra-personal). Job satisfaction for nurses in acute hospitals can be influenced by a combination of any or all of these factors. Important factors included coping strategies, autonomy, co-worker interaction, direct patient care, organizational policies, resource adequacy and educational opportunities. Research suggests that job satisfaction is a complex and multifactorial phenomenon. Collaboration between individual nurses, their managers and others is crucial to increase nursing satisfaction with their job. Recognition and regular reviewing by nurse managers of factors that contribute to job satisfaction for nurses working in acute care areas is pivotal to the retention of valued staff. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
Gurtner, Caroline; Spirig, Rebecca; Staudacher, Diana; Huber, Evelyn
Patient-related complexity in nursing care - Collective case studies in the acute care hospital Abstract. Patient-related complexity of nursing is defined by the three characteristics "instability", "uncertainty", and "variability". Complexity increased in the past years, due to reduced hospital length of stay and a growing number of patients with chronic and multiple diseases. We investigated the phenomenon of patient-related complexity from the point of view of nurses and clinical nurse specialists in an acute care hospital. In the context of a collective case study design, nurses and clinical nurse specialists assessed the complexity of nursing situations with a questionnaire. Subsequently, we interviewed nurses and clinical nurse specialists about their evaluation of patient-related complexity. In a within-case-analysis we summarized data inductively to create case narratives. By means of a cross-case-analysis we compared the cases with regard to deductively derived characteristics. The four cases exemplarily showed that the degree of complexity depends on the controllability and predictability of clinical problems. Additionally, complexity increases or decreases, according to patients' individual resources. Complex patient situations demand professional expertise, experience, communicative competencies and the ability for reflection. Beginner nurses would benefit from support and advice by experienced nurses to develop these skills.
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.
Jahani, Simin; Abedi, Heidarali; Elahi, Nasrin; Fallahi-Khoshknab, Masoud
Background: To respond efficiently to the increasing and new needs of people in health issues, it is necessary for nurses to develop their knowledge from hospital to society and to be equipped to play entrepreneur role in different levels of care. The present study was conducted to describe Iranian entrepreneur nurses’ perceived barriers to entrepreneurship, in order to identify the existing barriers. Materials and Methods: This is a qualitative study in which Graneheim and Lundman's content analysis method was employed. Thirteen entrepreneur nurses were chosen purposively, and data were gathered by unstructured interviews. Results: As a result of the data analysis, five major themes were extracted: Traditional nursing structure, legal limitations, traditional attitudes of governmental managers, unprofessional behaviors of colleagues, and immoral business. Conclusions: The findings of the present study show that Iranian nurses are confronted with various problems and barriers to enter entrepreneur nursing and keep going in this area. By focusing on such barriers and applying appropriate changes, policymakers and planners in health can facilitate nurses entering into this activity. PMID:26985222
Sabouri Kashani Ahmad
Full Text Available Abstract Background Abdominal surgical site infections are among the most common complications of inpatient admissions and have serious consequences for outcomes and costs. Different risk factors may be involved, including age, sex, nutrition and immunity, prophylactic antibiotics, operation type and duration, type of shaving, and secondary infections. This study aimed to determine the risk factors affecting abdominal surgical site infections and their incidence at Imam Khomeini, a major referral teaching hospital in Iran. Methods Patients (n = 802 who had undergone abdominal surgery were studied and the relationships among variables were analyzed by Student's t and Chi-square tests. The subjects were followed for 30 days and by a 20-item questionnaire. Data were collected through pre- and post-operative examinations and telephone follow-ups. Results Of the 802 patients, 139 suffered from SSI (17.4%. In 40.8% of the cases, the wound was dirty infected. The average age for the patients was 46.7 years. The operations were elective in 75.7% of the cases and 24.7% were urgent. The average duration of the operation was 2.24 hours, the average duration of pre-operative hospital stay 4.31 days and the average length of (pre- and post-operation hospital stay 11.2 days. Three quarters of the cases were shaved 12 hours before the operation. The increased operation time, increased bed stay, electivity of the operation, septicity of the wound, type of incision, the administration of prophylactic antibiotic, type of operation, background disease, and the increased time lapse between shaving and operation all significantly associated with SSI with a p-value less than 0.001. Conclusion In view of the high rate of SSI reported here (17.4% compared with the 14% quoted in literature, this study suggests that by reducing the average operation time to less than 2 hours, the average preoperative stay to 4 days and the overall stay to less than 11 days, and
Sving, Eva; Gunningberg, Lena; Högman, Marieann; Mamhidir, Anna-Greta
To describe how registered nurses perform, document and reflect on pressure ulcer prevention in a specific nurse-patient care situation, as well as generally, on hospital wards. Registered nurses should provide safe and qualified pressure ulcer prevention, but pressure ulcers remain a problem. Compliance with evidence-based guidelines impedes pressure ulcer formation. A descriptive design with a multimethods approach. Nine registered nurses at three wards and hospitals participated. The registered nurses were observed in a specific nurse-patient care situation with patients at risk for pressure ulcers. Interviews followed and patients' records were reviewed. Quantitative and qualitative data analysis methods were used. Pressure ulcer prevention performed by the registered nurses was dependent on the cultural care, which ranged from planned to unplanned prevention. Diversity was found in compliance with evidence-based guidelines across the wards. Although all patients involved were at risk and the nurses described pressure ulcer prevention as basic care, the nurses' attention to prevention was lacking. Few prevention activities and no structured risk assessments using risk assessment tools were observed, and few care plans were identified. The lack of attention was explained by registered nurses' trust in assistant nurses' knowledge, and prevention was seen as an assistant nurse task. Registered nurses paid little attention to pressure ulcer prevention among patients at risk. The planned and unplanned care structures affected the prevention. The nurses trusted and largely delegated their responsibility to the assistant nurses. Evidence-based pressure ulcer prevention is fundamental to patient safety. Care quality is created in situations where patients and care providers meet. How registered nurses work with pressure ulcer prevention, their role and communication, particularly with assistant nurses, should be of major concern to them as well as to healthcare
Thomas, D; Borchert, M; Brockhaus, N; Jäschke, L; Schmitz, G; Wasem, J
Decreasing staff numbers compounded by an increasing number of cases is regarded as main challenge in German hospital nursing. These input reductions accompanied by output extensions imply that hospital nursing services have had to achieve a continuous productivity growth in the recent years. Appropriately targeted productivity enhancements require approved and effective methods for productivity acquisition and measurement. However, there is a lack of suitable productivity measurement instruments for hospital nursing services. This deficit is addressed in the present study by the development of an integrated productivity model for hospital nursing services. Conceptually, qualitative as well as quantitative aspects of nursing services productivity are equally taken into consideration. Based on systematic literature reviews different conceptual frameworks of service productivity and the current state of research in hospital nursing services productivity were analysed. On this basis nursing sensitive inputs, processes and outputs were identified and integrated into a productivity model. As an adequate framework for a hospital nursing services productivity model the conceptual approach by Grönroos/Ojasalo was identified. The basic structure of this model was adapted stepwise to our study purpose by integrating theoretical and empirical findings from the research fields of service productivity, nursing productivity as well as national and international nursing research. Special challenges existed concerning the identification of relevant influencing factors as well as the representation of nursing sensitive outputs. The final result is an integrated productivity model, which can be used as an adequate framework for further research in hospital nursing productivity. Research on hospital nursing services productivity is rare, especially in Germany. The conceptual framework developed in this study builds on established knowledge in service productivity research. The
Full Text Available Background It is believed that healthcare staff play an important role in minimizing complications related to urethral catheterization. The purpose of this study was to determine whether or not healthcare staff complied with the standards for urethral catheterization. Methods This study was conducted in Imam Reza teaching hospital, Tabriz, Iran, from July to September 2013. A total of 109 catheterized patients were selected randomly from surgical and medical wards and intensive care units (ICUs. A questionnaire was completed by healthcare staff for each patient to assess quality of care provided for catheter insertion, while catheter in situ, draining and changing catheter bags. Items of the questionnaire were obtained from guidelines for the prevention of infection. Data analysis was performed with SPSS 16. Results The mean age of the patients was 50.54 ± 22.13. Of the 109 patients, 56.88% were admitted to ICUs. The mean duration of catheter use was 15.86 days. Among the 25 patients who had a urinalysis test documented in their hospital records, 11 were positive for urinary tract infection (UTI. The lowest rate of hand-washing was reported before bag drainage (49.52%. The closed drainage catheter system was not available at all. Among the cases who had a daily genital area cleansing, in 27.63% cases, the patients or their family members performed the washing. In 66.35% of cases, multiple-use lubricant gel was applied; single-use gel was not available. The rate of documentation for bag change was 79%. Conclusion The majority of the guideline statements was adhered to; however, some essential issues, such as hand hygiene were neglected. And some patients were catheterized routinely without proper indication. Limiting catheter use to mandatory situations and encouraging compliance with guidelines are recommended.
Lee, Mi Aie; Kim, Eunjeong
This study was performed to investigate the relationship among reciprocity, emotional labor, nursing service quality and intent to leave, and to identify factors influencing nursing service quality and intent to leave. This study was a cross-sectional survey. Participants were 300 nurses working at five general hospitals in two provincial cities in Gyeongsang Province, Korea. From May 1 to June 30, 2014, data were collected using structured questionnaires and analyzed with SPSS/PC ver 20.0 programs. There were relationships between reciprocity and nursing service quality, and intent to leave, and between emotional labor and intent to leave. Participants' general characteristics, reciprocity and emotional labor explained 48.4% of variance in nursing service quality and participants' general characteristics and these two independent variables explained 31.9% of intent to leave. These findings indicate that from the perception of hospital nurses, reciprocity and emotional labor are both very important factors to improve the quality of nursing service and decrease the intent to leave. So nursing managers should try to develop various personnel management programs focused on human emotions, and create a mutual respectable organizational culture and work environment.
Shahsavari Isfahani, Sara; Hosseini, Mohammad Ali; Fallahi Khoshknab, Masood; Peyrovi, Hamid; Khanke, Hamid Reza
Recently, global nursing experts have been aggressively encouraging nurses to pursue creativity and innovation in nursing to improve nursing outcomes. Nurses' creativity plays a significant role in health and well-being. In most health systems across the world, nurses provide up to 80% of the primary health care; therefore, they are critically positioned to provide creative solutions for current and future global health challenges. The purpose of this study was to explore Iranian nurses' perceptions and experiences toward the expression of creativity in clinical settings and the outcomes of their creativity for health care organizations. A qualitative approach using content analysis was adopted. Data were collected through in-depth semistructured interviews with 14 nurses who were involved in the creative process in educational hospitals affiliated to Jahrom and Tehran Universities of Medical Sciences in Iran. Four themes emerged from the data analysis, including a) Improvement in quality of patient care, b) Improvement in nurses' quality of work, personal and social life, c) Promotion of organization, and d) Unpleasant outcomes. The findings indicated that nurses' creativity in health care organizations can lead to major changes of nursing practice, improvement of care and organizational performance. Therefore, policymakers, nurse educators, nursing and hospital managers should provide a nurturing environment that is conducive to creative thinking, giving the nurses opportunity for flexibility, creativity, support for change, and risk taking.
Attitudes of Registered and Licensed Practical Nurses About the Importance of Families in Surgical Hospital Units: Findings From the Landspitali University Hospital Family Nursing Implementation Project.
Blöndal, Katrin; Zoëga, Sigridur; Hafsteinsdottir, Jorunn E; Olafsdottir, Olof Asdis; Thorvardardottir, Audur B; Hafsteinsdottir, Sigrun A; Sveinsdóttir, Herdis
The purpose of this study was to examine attitudes of registered nurses and licensed practical nurses about the importance of the family in surgical hospital units before (T1) and after (T2) implementation of a Family Systems Nursing educational intervention based on the Calgary Family Assessment and Intervention Models. This study was part of the Landspitali University Hospital Family Nursing Implementation Project and used a nonrandomized, quasi-experimental design with nonequivalent group before and after and without a control group. There were 181 participants at T1 and 130 at T2. No difference was found in nurses' attitudes as measured by the Families Importance in Nursing Care-Nurses' Attitudes (FINC-NA) questionnaire, before and after the educational intervention. Attitudes toward families were favorable at both times. Analysis of demographic variables showed that age, work experience, and workplace (inpatient vs. outpatient units) had an effect on the nurses' attitudes toward families. The influence of work experience on attitudes toward family care warrants further exploration. © The Author(s) 2014.
Sonmez, Betul; Yildirim, Aytolan
The aim was to determine the opinions of nurse managers about career planning and development for nurses in hospitals. Career planning and development are defined as an important and necessary tool in the development of nurses as professionals and in retaining nurses in a facility. A descriptive survey. The research population comprised nurse managers in 200+ bed hospitals on the European side of Istanbul province (n = 668). The entire population was targeted and 373 nurse managers were included in the study (55.8% return rate). Data were collected with a 32-item survey form that had three sections to determine the nurse managers' demographic characteristics, the career development practices at the facility where they worked, the nurse managers' responsibilities for career development and their expected competencies and recommendations. The findings of this study suggest that the most common technique used for nurses for career development was education programs, the career development practices of private hospitals were more developed than public hospitals and the nurse managers' perceptions about career development were different according to their management level, age group and educational level (p career development practices identified and the nurse managers did not have agreement on the subject of career development. Hospitals which provide opportunity for horizontal and vertical promotion and have clear development policies will be successful hospitals which are preferred by high quality nurses. This study draws attention to the importance of career planning in nursing and the need for nurse managers to take an active role in career planning and development.
Buus, Niels; Angel, Sanne; Traynor, Michael
Group-based clinical supervision is commonly offered as a stress-reducing intervention in psychiatric settings, but nurses often feel ambivalent about participating. This study aimed at exploring psychiatric nurses' experiences of participating in groupbased supervision and identifying psychosocial...... reasons for their ambivalence. Semi-structured interviews were conducted with 22 psychiatric nurses at a Danish university hospital. The results indicated that participation in clinical supervision was difficult for the nurses because of an uncomfortable exposure to the professional community. The sense...... of exposure was caused by the particular interactional organisation during the sessions, which brought to light pre-existing but covert conflicts among the nurses....
Full Text Available Background and objectives: Emotional intelligence contributes to the success in leadership, especially among nursing managers. This study sought to determine the relationship between the components of emotional intelligence and transformational-transactional leadership style among the heads of nursing education departments of Iranian medical universities.Methods: This cross-sectional study used convenience sampling to select the managers of 68 nursing education departments from the country’s universities of medical sciences. Data were collected using the Bar-On Emotional Quotient Inventory and Bass’s Multifactor Leadership Questionnaire. Data analysis was performed with Pearson’s correlation coefficient, analysis of variance, and Student’s test in SPSS version 16.0.Results: There was a direct, positive correlation between emotional intelligence and leadership style (P < 0.05 r = 0.36. The components of problem solving, happiness, independence, self-actualization, emotional self-awareness, interpersonal relationship, optimism, and accountability showed significant correlations with all leadership styles. However, impulse control was not significantly correlation with any of the leadership styles.Conclusion: Considering the significant positive correlation between the components of emotional intelligence and leadership styles, training about emotional intelligence and its components and reinforcing the components of emotional intelligence can be beneficial to presenting leadership styles and thus more successful management.
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.
McTiernan, K; McDonald, N
Burnout negatively impacts the delivery of mental health services. Psychiatric nurses face stressors that are distinct from other nursing specialities. The research was conducted in Ireland and captured a relatively large sample of respondents. The results compared the stressors, coping strategies and burnout levels between hospital and community-based psychiatric nurses. Occupational stress can negatively impact on the well-being of psychiatric nurses, which in turn can lead to poor client care. There is a dearth of published research conducted in Ireland that examines stress within the discipline. A between-groups study, undertaken in February 2011, investigated stressors, burnout and coping strategies between hospital and community-based psychiatric nurses in a Dublin region. Sixty-nine participants (8 males and 61 females), aged between 18 to 60 years voluntarily completed the Mental Health Professional Stress Scale, the Maslach Burnout Inventory and the PsychNurse Methods of Coping Scale. The findings revealed that nurses were operating in a moderately stressful environment. Stressors focused on organizational issues as opposed to client issues. The main stressors identified were lack of resources, workload and organizational structures/processes. Both groups reported average levels of emotional exhaustion, low levels of depersonalization and average levels of personal accomplishment. A Mann-Whitney U-test and Independent Samples t-test found significant differences between hospital and community-based nurses regarding depersonalization and personal accomplishment, respectively. Hospital nurses reported higher depersonalization scores, and community nurses had a greater sense of personal accomplishment. The personal accomplishment scores of hospital nurses were below mental health professional norms. No significant differences emerged regarding coping strategies. Avoidant coping strategies were favoured by both groups. It is recommended that interventions
Koivunen, Marita; Välimäki, Maritta; Hätönen, Heli
Nursing professionals have long recognized the importance to practice of research and the value of research evidence. Nurses still do not use research findings in practice. The purpose of this paper was to describe nurses' skills in using literature databases and the Internet in psychiatric hospitals and associations of nurses' gender, age, and job position with their information retrieval skills. The study was carried out in 2004 among nursing staff (N=183) on nine acute psychiatric wards in two psychiatric hospitals in Finland (n=180, response rate 98%). The Finnish version of the European Computer Driving Licence test (ECDL) was used as a data collection instrument. The study showed that there were clear deficits in information retrieval skills among nurses working in psychiatric hospitals. Thus, nurses' competence does not support the realization of evidence-based practice in the hospitals. Therefore, it is important to increase nurses' information retrieval skills by tailoring continuing education modules. It would be also advisable to develop centralized systems for the internal dissemination of research findings for the use of nursing staff.
Brewer, Carol S; Kovner, Christine T; Greene, William; Tukov-Shuser, Magdalene; Djukic, Maja
This paper is a report of a study of factors that affect turnover of newly licensed registered nurses in United States hospitals. There is a large body of research related to nursing retention; however, there is little information specific to newly licensed registered nurse turnover. Incidence rates of turnover among new nurses are unknown because most turnover data are not from nationally representative samples of nurses. This study used a longitudinal panel design to obtain data from 1653 registered nurses who were recently licensed by examination for the first time. We mailed surveys to a nationally representative sample of hospital registered nurses 1 year apart. The analytic sample consisted of 1653 nurses who responded to both survey mailings in January of 2006 and 2007. Full-time employment and more sprains and strains (including back injuries) result in more turnover. Higher intent to stay and hours of voluntary overtime and more than one job for pay reduces turnover. When we omitted intent to stay from the probit model, less job satisfaction and organizational commitment led to more turnover, confirming their importance to turnover. Magnet Recognition Award(®) hospitals and several other work attributes had no effect on turnover. Turnover problems are complex, which means that there is no one solution to decreasing turnover. Multiple points of intervention exist. One specific approach that may improve turnover rates is hospital policies that reduce strains and sprains. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.
Bendiane, M K; Bouhnik, A-D; Galinier, A; Favre, R; Obadia, Y; Peretti-Watel, P
Hospital nurses are frequently the first care givers to receive a patient's request for euthanasia or physician-assisted suicide (PAS). In France, there is no consensus over which medical practices should be considered euthanasia, and this lack of consensus blurred the debate about euthanasia and PAS legalisation. This study aimed to investigate French hospital nurses' opinions towards both legalisations, including personal conceptions of euthanasia and working conditions and organisation. A phone survey conducted among a random national sample of 1502 French hospital nurses. We studied factors associated with opinions towards euthanasia and PAS, including contextual factors related to hospital units with random-effects logistic models. Overall, 48% of nurses supported legalisation of euthanasia and 29%, of PAS. Religiosity, training in pallative care/pain management and feeling competent in end-of-life care were negatively correlated with support for legalisation of both euthanasia and PAS, while nurses working at night were more prone to support legalisation of both. The support for legalisation of euthanasia and PAS was also weaker in pain treatment/palliative care and intensive care units, and it was stronger in units not benefiting from interventions of charity/religious workers and in units with more nurses. Many French hospital nurses uphold the legalisation of euthanasia and PAS, but these nurses may be the least likely to perform what proponents of legalisation call "good" euthanasia. Improving professional knowledge of palliative care could improve the management of end-of-life situations and help to clarify the debate over euthanasia.
Anna E. van den Heever
Full Text Available Facilitation of a therapeutic relationship is an essential skill in nursing, particularly in mental-health care. Nurses and care workers in private general hospitals are exposed to the emotional effects of physical illness as well as the increase in admission of patients with mental-health needs. Poor nurse-patient relationships have been reported by patients and in the media. The researchers experienced incidents of apparent misunderstandings during nurse-patient interactions whilst working in private general hospitals. No studies have been done regarding how nurses and care workers perceive a therapeutic relationship with patients in terms of the patients’ emotional and mental-health needs. A quantitative, contextual and deductive study was conducted in three private general hospitals in Gauteng, South Africa with a purposive sample of 154 nurses and 30 care workers. Based on the concepts of a therapeutic relationship, empathy, positive regard, genuineness, concreteness and self-exploration, nurses and care workers’ perceptions of facilitating a therapeutic relationship were self-assessed using five-point scales in a questionnaire. Data were analysed using descriptive statistics and non-parametric statistical techniques. Specific hypotheses were tested to identify whether statistically-significant differences existed between the perceptions of two or more groups of nurses and care workers. Results showed a general insensitivity and lack of awareness and reflection on the part of nurses and care workers with regard to the patients’ emotional needs. When categories of nurses were compared, no statistically-significant differences were found between the perceptions of the various groups tested. There is a need for self-awareness, continued interpersonal skills training and supervision of nurses and care workers. A large percentage of the participants were younger than 40 years, subprofessional, with less than 10 years’ experience as
Toole, Cheryl A; DeGrazia, Michele; Connor, Jean Anne; Gauvreau, Kimberlee; Kuzdeba, Hillary Bishop; Hickey, Patricia A
Neonatal intensive care units (NICUs) located in freestanding children's hospitals may exhibit significant variation in nursing and organizational characteristics, which can serve as opportunities for collaboration to understand optimal staffing models and linkages to patient outcomes. Adopting methods used by Hickey et al in pediatric cardiovascular critical care, the purpose of this study was to provide a foundational description of the nursing and organizational characteristics for NICUs located in freestanding children's hospitals in the United States. Clinical nurse leaders in NICUs located in freestanding children's hospitals were invited to participate in an electronic cross-sectional survey. Descriptive analyses were used to summarize nursing and organizational characteristics. The response rate was 30% (13/43), with 69.2% of NICUs classified as level III/IV and 30.8% classified as level II/III. Licensed bed capacity varied significantly (range, 24-167), as did the proportion of full-time equivalent nurses (range, 71.78-252.3). Approximately three-quarters of staff nurses held baccalaureate degrees or higher. A quarter of nurses had 16 or more years (26.3%) of experience, and 36.9% of nurses had 11 or more years of nursing experience. Nearly one-third (29.2%) had 5 or less years of total nursing experience. Few nurses (10.6%) held neonatal specialty certification. All units had nurse educators, national and unit-based quality metrics, and procedural checklists. This study identified (1) variation in staffing models signaling an opportunity for collaboration, (2) the need to establish ongoing processes for sites to participate in future collaborative efforts, and (3) survey modifications necessary to ensure a more comprehensive understanding of nursing and organizational characteristics in freestanding children's hospital NICUs.
Stab, Nicole; Hacker, Winfried
The main goal of the study was to apply and analyse a moderated participatory small-group procedure with registered nurses, which aims at the development and implementation of measures to improve work organisation in hospital wards and nursing units. Participation in job redesign is an essential prerequisite of the successful implementation of improvement measures in nursing. The study was carried out in a public hospital of maximum care in Germany. We selected 25 wards with the most critical reported exhaustion and general health and applied a series of moderated small-group sessions in which the registered nurses jointly identified deficits in their work organisation, developed improvement measures, and then implemented and assessed them. Registered nurses of 22 wards actively took part in the small-group procedure. All nursing units jointly identified organisational deficits, developed possible improvement measures, and implemented them. The nursing teams then evaluated the implemented measures which were already assessable at the end of our research period; nearly all (99.0%) showed improvements, while 69.4% actually attained the desired goals. Participatory small-group activities may be successfully applied in hospital nursing in order to improve work organisation. Participatory assessment and redesign of nurses' work organisation should be integrated into regular team meetings. The nursing management should actively support the implementation process. © 2018 John Wiley & Sons Ltd.
Weng, Rhay-Hung; Huang, Ching-Yuan; Lin, Tzu-En
Recently, many hospitals have been enthusiastically encouraging nurses to pursue nursing innovation to improve health care quality and increase nursing productivity by proposing innovative training methods, products, services, care skills, and care methods. This study tried to explore the cross-level impact of market orientation on nursing innovation. In our study, 3 to 7 nurses and 1 manager were selected from each nursing team to act as respondents. The questionnaire survey began after the managers of each nursing team and the nurses had been anonymously coded and paired up in Taiwan in 2009-2010. A total of 808 valid questionnaires were collected, including 172 valid teams. Hierarchical linear modeling was used for the analysis. Nursing innovation is the sum of knowledge creation, innovation behavior, and innovation diffusion displayed by the nurses during nursing care. The level of knowledge creation, as perceived by the nurses, was the highest, whereas the level of innovation diffusion was the lowest. Results of hierarchical linear modeling showed that only competitor orientation yielded a significant positive influence on knowledge creation, innovation behavior, or innovation diffusion. The r values were 0.53, 0.49, and 0.61, respectively. Customer orientation and interfunctional coordination did not have significant effects on nursing innovation. Hospital nurses exhibited better performance in knowledge creation than in innovation behavior and diffusion. Only competitor orientation had a significantly positive and cross-level influence on nursing innovation. However, competitor orientation was observed to be the lowest dimension of market orientation, which indicates that this factor should be the focus when improving nursing innovations in the future. Therefore, managers should continually understand the strategies, advantages, and methods of their competitors.
Akter, N; Akkadechanunt, T; Chontawan, R; Klunklin, A
This study examined the level of quality of work life and predictability of years of education, monthly income, years of experience, job stress, organizational commitment and work environment on quality of work life among nurses in tertiary-level hospitals in the People's Republic of Bangladesh. There is an acute shortage of nurses worldwide including Bangladesh. Quality of work life is important for quality of patient care and nurse retention. Nurses in Bangladesh are fighting to provide quality care for emerging health problems for the achievement of sustainable development goals. We collected data from 288 randomly selected registered nurses, from six tertiary-level hospitals. All nurses were requested to fill questionnaire consisted of Demographic Data Sheet, Quality of Nursing Work Life Survey, Expanded Nursing Stress Scale, Questionnaire of Organizational Commitment and Practice Environment Scale of the Nursing Work Index. Data were analysed by descriptive statistics and multiple regression. The quality of work life as perceived by nurses in Bangladesh was at moderate level. Monthly income was found as the best predictor followed by work environment, organizational commitment and job stress. A higher monthly income helps nurses to fulfil their personal needs; positive work environment helps to provide quality care to the patients. Quality of work life and predictors measured by self-report only may not reflect the original picture of the quality of work life among nurses. Findings provide information for nursing and health policymakers to develop policies to improve quality of work life among nurses that can contribute to quality of nursing care. This includes the working environment, commitment to the organization and measures to reduce job stress. © 2017 International Council of Nurses.
Banks, D; Parker, E; Wendel, J
Rising post-acute care expenditures for Medicare transfer patients and increasing vertical integration between hospitals and nursing facilities raise questions about the links between payment system structure, the incentive for vertical integration and the impact on efficiency. In the United States, policy-makers are responding to these concerns by initiating prospective payments to nursing facilities, and are exploring the bundling of payments to hospitals. This paper develops a static profit-maximization model of the strategic interaction between the transferring hospital and a receiving nursing facility. This model suggests that the post-1984 system of prospective payment for hospital care, coupled with nursing facility payments that reimburse for services performed, induces inefficient under-provision of hospital services and encourages vertical integration. It further indicates that the extension of prospective payment to nursing facilities will not eliminate the incentive to vertically integrate, and will not result in efficient production unless such integration takes place. Bundling prospective payments for hospitals and nursing facilities will neither remove the incentive for vertical integration nor induce production efficiency without such vertical integration. However, bundled payment will induce efficient production, with or without vertical integration, if nursing facilities are reimbursed for services performed. Copyright 2001 John Wiley & Sons, Ltd.
Montour, Amy; Baumann, Andrea; Blythe, Jennifer; Hunsberger, Mabel
The nursing literature includes descriptions of rural nursing workforces in Canada, the United States of America and Australia. However, inconsistent definitions of rural demography, diverse employment conditions and health care system reorganization make comparisons of these data difficult. In 2007, the Ministry of Health and Long-term Care in Ontario, Canada, transferred responsibility for decision-making and funding to 14 regional governing bodies known as Local Health Integration Networks (LHINs). Little is known about rural-urban variations in the nursing workforces in the LHINs because existing data repositories do not describe them. This study investigated the influence of demographic characteristics, provincial policies, organizational changes and emerging practice challenges on nursing work in a geographically unique rural region. The purpose was to describe the nature of nursing work from the perspective of rural nurse executives and frontline nurses. The study was conducted in 7 small rural and community hospitals in the Hamilton Niagara Haldimand Brant LHIN. Data collection occurred between August and November 2007. A qualitative descriptive study design was chosen to facilitate exploration of nursing in the rural setting. Study participants were identified through purposive snowball sampling. All nurses, nurse managers and nurse executives currently employed in the 7 study hospitals were eligible to participate. Data collection included the use of questionnaires and semi-structured interviews. Memos were also created to describe the relevance and applicability of concepts, categories and properties emerging from the data. Themes were compared across interviews to determine relevance and value. Twenty-one nurses from 7 different hospitals participated. The nurses reflect the aging trend in the provincial and regional workforces of Ontario. All study participants anticipate a substantial increase in retirements during the next decade, which will alter
Ebrahimi, Hossein; Hosseinzadeh, Rahele; Tefreshi, Mansoreh Zaghari; Hosseinzadeh, Sadaf
Background: Effective time management is considered important for managers for achieving the goals in an organization. Head nurses can improve their efficiency and performance with effective use of time. There has always been a lot of disagreement in understanding time management behaviors of head nurses; therefore, the present study was conducted with an aim to compare the understanding of head nurses and staff nurses of the time management behaviors of head nurses employed in Social Security Hospitals in Tehran, Iran in 2011. Materials and Methods: This was a comparative descriptive study in which 85 head nurses were selected through census and 170 staff nurses were also selected through simple random sampling method from hospitals covered by the Social Security. Data collection was done through a standard inventory with high validity and reliability, which consisted of two parts: Socio-demographic characteristics and time management inventory. The obtained data were analyzed by descriptive and inferential statistics through SPSS software version 13. Results: Mean score of time management in head nurses’ viewpoint was 143.22 (±18.66) and in staff nurses’ viewpoint was 136.04 (±21.45). There was a significant correlation between the mean scores of head nurses’ time management and some of their socio-demographic characteristics such as gender, clinical experience, passing a time management course, and book reading (P nurses’ time management and their clinical working experience, education, using time management approach, and type of hospital (P nurses (52.9%) believed that their time management was in a high level; besides, most of the staff nurses also (40%) believed that time management of their head nurses was high. However, there was a significant difference between the perceptions of both groups on using Mann–Whitney test (P nursing care for clients, and also the fact that head nurses believed more in their time management behaviors, they are
Jennifer L. Embree
Full Text Available Background/Significance of Problem. Nurse-to-nurse lateral violence (NNLV has been internationally reported for greater than two decades and results in new nurse turnover and serious negative outcomes. Clinical Question/Project Objective. Will NNLV and cognitive rehearsal (CR education result in a decrease in perceived nurse-to-nurse lateral violence in a critical access hospital (CAH? The scope of this project was to determine perceived extent and increase awareness of NNLV through an educational project about NNLV and CR. Clinical Appraisal of Literature/Best Evidence. Trends of NNLV were assessed through an extensive literature review from Health Source, CINAHL, ProQuest Health, and Medical Complete. An educational forum about NNLV with CR was advocated for newly licensed nurses and current nurses (potential perpetrators of NNLV with the goal of liberation of oppressed individuals. Integration into Practice/Discussion of Results. An interventional study with one group and pre-/postintervention was used to determine NNLV and CR education on perceived levels of lateral violence. Evidence-based measurement occurred through use of the Nurse Workplace Scale and the Silencing the Self-Work Scale. Outcomes were analyzed quantitatively through independent t-tests. Awareness of NNLV was increased. Evaluation of Evidence-Based Practice/Implications. Organizations must learn to eliminate NNLV. With increased levels of awareness of NNLV, nurses requested additional assistance in dealing with inappropriate behavior.
Chi-square results of the respondents profile and satisfaction with communication of nursing care provision by sex was significant (p< 0.0076). The study recommended among others, that nurses' acquisition of relevant communication skills will be helpful in interactions between nurses and the patients during the period of ...
Background. A global shortage of registered nurses (RNs) has been reported internationally, and confirmed in South Africa by the National Audit of Critical Care services. Critical care nurses (CCNs) especially are in great demand and short supply. Purpose. The purpose of this study was to quantify the nursing workforce ...
Aboshaiqah, Ahmad E; Hamadi, Hanadi Y; Salem, Olfat A; Zakari, Nazik M A
To examine the differences in work engagement among nurses in Saudi Arabia and its relationship with personal characteristics across different hospital affiliations. Quality care requires an adequate supply of engaged nurses who are dedicated, energised and absorbed in their work. In the nursing profession, work engagement is of considerable importance, owing to the shortage of nurses and the continuing reduction in healthcare costs. An analytic comparative cross-sectional design was used. Eight hospitals from three provinces and different affiliation types participated in the study. The Utrecht work engagement scale (UWES) was used to measure 980 nurses' work engagement. The findings indicate that nurses' total engagement scores were closer to the higher end of the Likert scale. The findings indicate generally high levels of work engagement, particularly regarding the element of dedication. Furthermore, the study shows significant differences in nurses' engagement among the various work settings and in nurses' age and experience. A number of nurses' personal characteristics have independent influences on their work engagement. Nurse leaders should acknowledge that a statement of professional nursing scope of practice is a necessity to encourage and fulfil engagement. © 2016 John Wiley & Sons Ltd.
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.
Zhang, Li-Feng; You, Li-Ming; Liu, Ke; Zheng, Jing; Fang, Jin-Bo; Lu, Min-Min; Lv, Ai-Li; Ma, Wei-Guang; Wang, Jian; Wang, Shu-Hong; Wu, Xue; Zhu, Xiao-Wen; Bu, Xiu-Qing
The purpose of this study was to describe nurse burnout, job satisfaction, and intention to leave and to explore the relationship of work environment to nursing outcomes in a sample of 9,698 nurses from 181 hospitals in China. Nurses reported moderate levels of emotional exhaustion and depersonalization and high levels of reduced personal accomplishment. Nearly one-fifth of the nurses reported high levels of burnout on all three dimensions. Forty-five percent of the nurses were dissatisfied with their current job; these nurses were most dissatisfied with their salary. Five percent of nurses reported an intention to leave. Nurses reporting mixed and good work environments were less likely to report high burnout, job dissatisfaction, and intention to leave compared with those in poor work environments. The results suggest that high burnout and low job satisfaction are prominent problems for Chinese nurses, and improving work environment might be an effective strategy for better nursing outcomes in Chinese hospitals. Copyright © 2014 Elsevier Inc. All rights reserved.
Nomura, Aline Tsuma Gaedke; Pruinelli, Lisiane; da Silva, Marcos Barragan; Lucena, Amália de Fátima; Almeida, Miriam de Abreu
Hospital accreditation is a strategy for the pursuit of quality of care and safety for patients and professionals. Targeted educational interventions could help support this process. This study aimed to evaluate the quality of electronic nursing records during the hospital accreditation process. A retrospective study comparing 112 nursing records during the hospital accreditation process was conducted. Educational interventions were implemented, and records were evaluated preintervention and postintervention. Mann-Whitney and χ tests were used for data analysis. Results showed that there was a significant improvement in the nursing documentation quality postintervention. When comparing records preintervention and postintervention, results showed a statistically significant difference (P educational interventions performed by nurses led to a positive change that improved nursing documentation and, consequently, better care practices.
Alves, Débora Cristina Ignácio; Evora, Yolanda Dora Martinez
This qualitative work was developed according to Bardin's method of content analysis. It aimed at finding out the perceptions of nurses that are members of a Hospital Infection Control Commission about ethical issues that are inherent to their professional practice as well as understanding the clinical nurses opinion regarding the professional practice of the nurses that are members of the Hospital Infection Control Commission, considering the ethical aspects. In order to achieve an ethical, efficient and effective professional practice, there is a need for governmental changes and professional recognition through autonomy, respect and exclusivity in the Service of Hospital Infection Control, as well as improvements regarding information, the care provided to the patient and professional secret. The predominance of bureaucratic activities and team work were mentioned by the clinical nurses as differentiating factors of the activities performed by nurses that are members of the Commission.
Australia has a long history of patient level costing initiated when casemix funding was implemented in several states in the early 1990s. Australia includes, to some extent, hospital payment based on nursing intensity adopted within casemix funding policy and the Diagnostic Related Group system. Costing of hospital nursing services in Australia has not changed significantly in the last few decades despite widespread introduction of casemix funding policy at the state level. Recent Commonwealth of Australia National Health Reform presents change to the management of the delivery of health care including health-care costing. There is agreement for all Australian jurisdictions to progress to casemix-based activity funding. Within this context, nurse costing infrastructure presents contemporary issues and challenges. An assessment is made of the progress of costing nursing services within casemix funding models in Australian hospitals. Valid and reliable Australian-refined nursing service weights might overcome present cost deficiencies and limitations. © 2012 Blackwell Publishing Asia Pty Ltd.
Penney, Wendy; Poulter, Nola; Cole, Clare; Wellard, Sally
Nurses worldwide are expected to take a leading role in caring for older people. Considerable literature dedicated to the range and application of assessment skills used by nurses vary. There is limited knowledge of registered nurses' (RNs) views of their assessment of older adults. The aim of this project was to explore RNs current perceptions of nursing assessment, and the core skills they identified as necessary. A qualitative descriptive design study was conducted in three inpatient units in one regional hospital in Victoria. Date were collected through participant observation of RNs (n = 13) followed by 1:1 semi-structured interviews. Data were analysed thematically. This research has illuminated that an ill-defined repertoire of skills was used by RNs when assessing older persons. Skills identified appeared to be based on years of personal-professional experience. Differences were noted between the descriptions nurses gave and what was observed during interactions with older persons.
Barlem, Jamila Geri Tomaschewski; Lunardi, Valéria Lerch; Barlem, Edison Luiz Devos; Ramos, Aline Marcelino; Figueira, Aline Belletti; Fornari, Nerizane Cerutti
Analyzing beliefs and actions of nurses in exercising patient advocacy in a hospital context. A quantitative cross-sectional exploratory and descriptive study, conducted with 153 nurses from two hospitals in southern Brazil, one public and one philanthropic, by applying Protective Nursing Advocacy Scale - Brazilian version. Data were analyzed using descriptive statistics and analysis of variance. Nurses believe they are advocating for patients in their workplaces, and agree that they should advocate, especially when vulnerable patients need their protection. Personal values and professional skills have been identified as major sources of support for the practice of advocacy. Nurses do not disagree nor agree that advocating for patients in their working environments can bring them negative consequences. It is necessary to recognize how the characteristics of public and private institutions have helped or not helped in exercising patient advocacy by nurses.
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.