Keepnews, David M; Brewer, Carol S; Kovner, Christine T; Shin, Juh Hyun
Responses of 2369 newly licensed registered nurses from 3 generational cohorts-Baby Boomers, Generation X, and Generation Y-were studied to identify differences in their characteristics, work-related experiences, and attitudes. These responses revealed significant differences among generations in: job satisfaction, organizational commitment, work motivation, work-to-family conflict, family-to-work conflict, distributive justice, promotional opportunities, supervisory support, mentor support, procedural justice, and perceptions of local job opportunities. Health organizations and their leaders need to anticipate intergenerational differences among newly licensed nurses and should provide for supportive working environments that recognize those differences. Orientation and residency programs for newly licensed nurses should be tailored to the varying needs of different generations. Future research should focus on evaluating the effectiveness of orientation and residency programs with regard to different generations so that these programs can be tailored to meet the varying needs of newly licensed nurses at the start of their careers. Copyright 2010 Mosby, Inc. All rights reserved.
Chang, Hyoung Eun; Cho, Sung-Hyun
Purpose: The purpose of this study was to examine the prevalence of workplace violence toward newly licensed nurses and the relationship between workplace violence and job outcomes. Methods: An online survey was conducted of newly licensed registered nurses who had obtained their license in 2012 or 2013 in South Korea and had been working for 5–12 months after first being employed. The sample consisted of 312 nurses working in hospitals or clinics. The Copenhagen Psychosocial Questionnaire...
Banks, Zarata Mann; Bailey, Jessica H.
Despite vast research on newly licensed registered nurses (RNs), we don't know why some newly licensed registered nurses remain in their current jobs and others leave the nursing profession early in their career. Job satisfaction, the most significant factor emerging from the literature, plays a significant role in nurses' decisions to remain in…
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
Chang, Hyoung Eun; Cho, Sung-Hyun
The purpose of this study was to examine the prevalence of workplace violence toward newly licensed nurses and the relationship between workplace violence and job outcomes. An online survey was conducted of newly licensed registered nurses who had obtained their license in 2012 or 2013 in South Korea and had been working for 5-12 months after first being employed. The sample consisted of 312 nurses working in hospitals or clinics. The Copenhagen Psychosocial Questionnaire II was used to measure violence and nurse job outcomes. Multiple linear and logistic regression analyses were conducted to examine the relationship between violence and job outcomes. Verbal abuse was most prevalent (59.6%), followed by threats of violence (36.9%), physical violence (27.6%), bullying (25.6%), and sexual harassment (22.4%). Approximately three quarters of the nurses had experienced at least one type of violence. The main perpetrators were patients and nurse colleagues, although the distribution of perpetrators varied depending on the type of violence. Bullying had a significant relationship with all four job outcomes (job satisfaction, burnout, commitment to the workplace, and intent to leave), while verbal abuse was associated with all job outcomes except for intent to leave. Violence perpetrated by nurse colleagues had a significant relationship with all four job outcomes, while violence by physicians had a significant inverse relationship with job satisfaction. Workplace violence is experienced by a high percentage of newly licensed nurses, and is associated with their job outcomes. Copyright © 2016. Published by Elsevier B.V.
Watkins, Chanell; Hart, Patricia L; Mareno, Nicole
The first year turnover rate for newly licensed registered nurses is roughly 30% and increases to about 57% in the second year (Twibell et al., 2012). An effective preceptorship has been shown to better facilitate the first year transition (Hodges et al., 2008) and increase retention rates (Pine and Tart, 2007). The purpose of this study was to examine the relationships between newly licensed registered nurses' perceived preceptor role effectiveness, psychological empowerment and professional autonomy. A prospective, cross-sectional, descriptive research design was used. Sixty-nine newly licensed registered nurses were recruited and surveyed. Newly licensed registered nurses were found to have moderately high levels of perceived preceptor role effectiveness, psychological empowerment, and professional autonomy. Preceptor role effectiveness had significant, moderately, positive relationships with professional autonomy and psychological empowerment. There was also a significant relationship found between professional autonomy and psychological empowerment. Results show that preceptor role effectiveness is linked to increased professional autonomy and psychological empowerment. Therefore, effective preceptorships are necessary in easing the newly licensed registered nurse's transition to practice. Strategies to ensure effective preceptorships and enhance the NRLN's transition to practice are proposed. Copyright © 2016 Elsevier Ltd. All rights reserved.
Hirsch, Anne M
Current projections for the need for nurses in Washington state are based on an increase in the need for health care, the aging of the population, and the inability of the nursing educational institutions to supply adequate numbers of graduates. Yet many new graduates are providing anecdotal evidence that they cannot find a job in nursing. This study gathered information regarding the employment of newly licensed registered nurses in Washington between May 2009 and August 2010. Questionnaires were administered to a randomly selected sample of 2,200 newly licensed nurses; 532 responses were returned. Nearly 81% reported current employment as a registered nurse and 69.5% reported that they were very or somewhat satisfied with their employment situation. The job search strategies, type of job sought, and factors contributing to their success are reported. Factors contributing to the success of their job search and to job dissatisfaction are explored. Copyright 2011, SLACK Incorporated.
Stimpfel, Amy Witkoski; Brewer, Carol S; Kovner, Christine T
Registered nurses across the globe bear a heavy injury burden. Every shift, nurses are exposed to a variety of hazards that can jeopardize their health, which negatively impacts their ability to provide high-quality patient care. Previous research suggests that inexperienced, or newly licensed nurses, may have an increased risk for certain occupational injuries. However, the current knowledge base is insufficient to fully understand how work hours influence newly licensed nurses' occupational injury, given the significant variation in hospital organization and work characteristics. To describe newly licensed nurses' shift work characteristics and determine the association between shift type and scheduling characteristics and nurse injury, before and after adjusting for individual and combined effects of demographics, external context, organizational context, and work context, following the Organization of Work model. This study is a secondary analysis of a nationally representative survey of newly licensed registered nurses using a cross-sectional design. The analytic sample includes 1744 newly licensed registered nurses from 34 states and the District of Columbia who reported working in a hospital and were within 6-18 months of passing their state licensure exam at the time of survey administration. Descriptive statistics were calculated, followed by bivariate and multivariate Poisson regression models to assess the relationship between shift type and scheduling characteristics and nurse injury. Lastly, full models with the addition of demographics, external context, organizational context, and work context variables were calculated. The majority (79%) of newly licensed nurses worked 12-h shifts, a near majority worked night shift (44%), and over half (61%) worked overtime (mandatory or voluntary) weekly. Nurses working weekly overtime were associated with a 32% [incidence rate ratio (IRR) 1.32, CI 1.07-1.62] increase in the risk of a needle stick and nurses
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.
Bontrager, Sarah; Hart, Patricia L; Mareno, Nicole
Thirteen percent of newly licensed registered nurses (NLRNs) vacate their first job after 1 year, and 37% report that they feel ready to change jobs. Turnover can lead to consistent and detrimental nursing shortages in nursing units, as well as increased costs for health care systems. A descriptive, prospective, cross-sectional design was used to understand how preceptor role effectiveness and group cohesion affect NLRNs' satisfaction and intent to stay. NLRNs reported high levels of perceived preceptor role effectiveness, group cohesion, and job satisfaction, with only moderate levels of intent to stay. Statistically significant relationships were found among preceptor role effectiveness, job satisfaction, and intent to stay, as well as among group cohesion, job satisfaction, and intent to stay. Preceptor role effectiveness and group cohesion are predictors of NLRNs' level of job satisfaction. Job satisfaction is a predictor of NLRNs' intent to stay. Effective preceptors and positive group cohesion are factors that are important to NLRNs' job satisfaction and intent to stay. Copyright 2016, SLACK Incorporated.
Voldbjerg, Siri Lygum; Grønkjaer, Mette; Sørensen, Erik Elgaard
AIM: To advance evidence on newly graduated nurses' use of knowledge sources. BACKGROUND: Clinical decisions need to be evidence-based and understanding the knowledge sources that newly graduated nurses use will inform both education and practice. Qualitative studies on newly graduated nurses' use...... underscoring progression in knowledge use and perception of competence and confidence among newly graduated nurses. CONCLUSION: The transition phase, feeling of confidence and ability to use critical thinking and reflection, has a great impact on knowledge sources incorporated in clinical decisions....... The synthesis accentuates that for use of newly graduated nurses' qualifications and skills in evidence-based practice, clinical practice needs to provide a supportive environment which nurtures critical thinking and questions and articulates use of multiple knowledge sources....
Full Text Available The South African education and training system, through its policy of outcomesbased education and training, has made competency a national priority. In compliance to this national requirement of producing competent learners, the South African Nursing Council ( 1999 B require that the beginner professional nurse practitioners and midwives have the necessary knowledge, skills, attitudes and values which will enable them to render efficient professional service. The health care system also demands competent nurse practitioners to ensure quality in health care. In the light of competency being a national priority and a statutory demand, the research question that emerges is, how competent are the newly qualified registered nurses from a specific nursing college in clinical nursing education? A quantitative, non-experimental contextual design was used to evaluate the competence of newly qualified registered nurses from a specific nursing college. The study was conducted in two phases. The first phase dealt with the development of an instrument together with its manual through the conceptualisation process. The second phase focused on the evaluation of the competency of newly qualified nurses using the instrument based on the steps of the nursing process. A pilot study was conducted to test the feasibility of the items of the instrument. During the evaluation phase, a sample of twenty-six newly qualified nurses was selected by simple random sampling from a target population of thirty-six newly qualified registered nurses. However, six participants withdrew from the study. Data was collected in two general hospitals where the newly qualified registered nurses were working. Observation and questioning were used as data collection techniques in accordance with the developed instrument. Measures were taken to ensure internal validity and reliability of the results. To protect the rights of the participants, the researcher adhered to DENOSA’S (1998
Saber, Deborah A; Anglade, Debbie; Schirle, Lori M
This study explored traditional and accelerated Bachelor of Science nursing students' expectations of nursing work and the workforce. Role transition difficulty is blamed for much of the 15-60% newly licensed registered nurse turnover in their first 3 years of employment. This qualitative study consisted of 14 focus groups (n = 98) to determine Bachelor of Science nursing students' expectations of work as newly licensed registered nurses. Two overriding themes for accelerated and traditional students emerged: stressors and coping strategies. Students believe four stressors will affect their progression into the newly licensed registered nurse role and have developed coping strategies. This study suggests that students have experienced stressors in the clinical environment and anticipate them in the newly licensed registered nurse role. During transition, strategies such as 'fitting in' and 'staying safe' will be employed to ensure work success. Younger generations value a healthy work-life balance and a positive working environment. These nurses will not tolerate positions that do not align with their values. With the aging of citizens in the USA and the predicted nursing shortage, nursing management needs to employ strategies to retain newly licensed registered nurses. © 2015 John Wiley & Sons Ltd.
Danbjørg, Dorthe Boe; Birkelund, Regner
This paper reports the findings from a study of newly qualified nurses and which subjects the nurses regarded as the most important in order to be able to live up to the requirements of clinical practice, and how they experience their potential for developing practical and moral skills, after the decrease in practical training. A qualitative approach guided the research process and the analysis of the data. The data was collected by participant observation and qualitative interviews with four nurses as informants. The conclusions made in this study are based on the statements and the observations of the newly qualified nurses. Our findings are discussed in relation to the Aristotelian concept and other relevant literature. The main message is that the newly qualified nurses did not feel equipped when they finished their training. This could be interpreted as a direct consequence of the decrease in practical training. Our study also underlines that the way nursing theory is perceived and taught is problematic. The interviews revealed that the nurses think that nursing theories should be applied directly in practice. This misunderstanding is probably also applicable to the teachers of the theories. Copyright © 2010 Elsevier Ltd. All rights reserved.
Numminen, Olivia; Leino-Kilpi, Helena; Isoaho, Hannu; Meretoja, Riitta
Nursing practice takes place in a social framework, in which environmental elements and interpersonal relations interact. Ethical climate of the work unit is an important element affecting nurses' professional and ethical practice. Nevertheless, whatever the environmental circumstances, nurses are expected to be professionally competent providing high-quality care ethically and clinically. This study examined newly graduated nurses' perception of the ethical climate of their work environment and its association with their self-assessed professional competence, turnover intentions and job satisfaction. Descriptive, cross-sectional, correlational research design was applied. Participants consisted of 318 newly graduated nurses. Data were collected electronically and analysed statistically. Ethical approval and permissions to use instruments and conduct the study were obtained according to required procedures. Data were rendered anonymous to protect participant confidentiality. Completing the questionnaire was interpreted as consent to participate. Nurses' overall perception of the ethical climate was positive. More positive perceptions related to peers, patients and physicians, and less positive to hospitals and managers. Strong associations were found between perceived ethical climate and self-assessed competence, turnover intentions in terms of changing job, and job satisfaction in terms of quality of care. Nurses at a higher competence level with positive views of job satisfaction and low turnover intentions perceived the climate significantly more positively. Nursing management responsible for and having the power to implement changes should understand their contribution in ethical leadership, as well as the multidimensional nature of nurses' work environment and the interaction between work-related factors in planning developmental measures. Future research should focus on issues in nurse managers' ethical leadership in creating ethical work environments. There
Ekström, Louise; Idvall, Ewa
This paper presents a study that explores how newly qualified registered nurses experience their leadership role in the ward-based nursing care team. A nurse's clinical leadership affects the quality of care provided. Newly qualified nurses experience difficulties during the transition period from student to qualified professional and find it challenging to lead nursing care. Twelve nurses were interviewed and the transcribed texts analysed using qualitative content analysis to assess both manifest and latent content. Five themes were identified: feeling stranded; forming well-functioning teams; learning to lead; having the courage, strength, and desire to lead; and ensuring appropriate care. The findings indicate that many factors limit nurses' leadership but some circumstances are supportive. The leadership prerequisites for newly registered nurses need to improve, emphasizing different ways to create a supportive atmosphere that promotes professional development and job satisfaction. To increase nurse retention and promote quality of care, nurse managers need to clarify expectations and guide and support newly qualified nurses in a planned way. © 2013 John Wiley & Sons Ltd.
Wangensteen, Sigrid; Johansson, Inger S; Björkström, Monica E; Nordström, Gun
wangensteen s., johansson i.s., björkström m.e. & nordström g. (2010) Critical thinking dispositions among newly graduated nurses. Journal of Advanced Nursing66(10), 2170–2181. Aim The aim of the study was to describe critical thinking dispositions among newly graduated nurses in Norway, and to study whether background data had any impact on critical thinking dispositions. Background Competence in critical thinking is one of the expectations of nursing education. Critical thinkers are described as well-informed, inquisitive, open-minded and orderly in complex matters. Critical thinking competence has thus been designated as an outcome for judging the quality of nursing education programmes and for the development of clinical judgement. The ability to think critically is also described as reducing the research–practice gap and fostering evidence-based nursing. Methods A cross-sectional descriptive study was performed. The data were collected between October 2006 and April 2007 using the California Critical Thinking Disposition Inventory. The response rate was 33% (n= 618). Pearson’s chi-square tests were used to analyse the data. Results Nearly 80% of the respondents reported a positive disposition towards critical thinking. The highest mean score was on the Inquisitiveness subscale and the lowest on the Truth-seeking subscale. A statistically significant higher proportion of nurses with high critical thinking scores were found among those older than 30 years, those with university education prior to nursing education, and those working in community health care. Conclusion Nurse leaders and nurse teachers should encourage and nurture critical thinking among newly graduated nurses and nursing students. The low Truth-seeking scores found may be a result of traditional teaching strategies in nursing education and might indicate a need for more student-active learning models. PMID:20384637
Vogelpohl, Darla A; Rice, Susan K; Edwards, Mary Ellen; Bork, Christopher E
This study investigated the bullying experience in the workplace of newly licensed registered nurses (RNs). Preventing newly licensed nurses from leaving the profession is important, especially because there is a nursing shortage. Education of staff and administrators provides recognition of negative behaviors in the workplace. Participants in this research study included 135 newly licensed RN's from 5 nursing schools in Northwestern Ohio licensed in years 2007-2010. Quantitative methods and a descriptive design process included chi-square tests and descriptive statistical methods. Bullying workplace behaviors were identified by participants utilizing the survey tool, the Negative Acts Questionnaire-Revised, and a questionnaire on work relationships and bullies recognized in the workplace. Nursing peers, physicians, or a patient's family were the main sources of bullying, and 29.5% had considered leaving the nursing profession. Education of staff is imperative for providing recognition of negative behaviors in the workplace. Bullying occurs in the workplace and is affecting the new graduates' work performance. Retaining newly graduated nurses is the ultimate goal for maintaining RN's in the workforce. Copyright © 2013 Elsevier Inc. All rights reserved.
Kentucky State Council on Higher Education, Frankfort.
Data on nurses licensed in Kentucky for 1979-1981 are presented, as part of the Kentucky Nursing Education Project. Information is provided on: licensure status, home state/district/county, employment status, employment state/district/county, field of employment in nursing, position, highest educational level attained, age, sex, marital status,…
McCloskey, Rose; Donovan, Cindy; Stewart, Connie; Donovan, Alicia
Calls for improved conditions in nursing homes have pointed to the importance of optimizing the levels and skills of care providers. Understanding the work of care providers will help to determine if staff are being used to their full potential and if opportunities exist for improved efficiencies. To explore the activities of care providers in different nursing homes and to identify if variations exist within and across homes and shifts. A multi-centre cross-sectional observational work flow study was conducted in seven different nursing homes sites in one Canadian province. Data were collected by a research assistant who conducted 368 h of observation. The research assistant collected data by following an identical route in each site and recording observations on staff activities. Findings indicate staff activities vary across roles, sites and shifts. Licensed practical nurses (nursing assistants) have the greatest variation in their role while registered nurses have the least amount of variability. In some sites both registered nurses and licensed practical nurses perform activities that may be safely delegated to others. Care providers spend as much as 53.7% of their time engaged in non-value added activities. There may be opportunities for registered nurses and licensed practical nurses to delegate some of their activities to non-regulated workers. The time care providers spend in non-value activities suggest there may be opportunities to improve efficiencies within the nursing home setting. Copyright © 2015 Elsevier Ltd. All rights reserved.
Voldbjerg, Siri Lygum; Grønkjaer, Mette; Wiechula, Rick
AIMS AND OBJECTIVES: To explore which knowledge sources newly graduated nurses' use in clinical decision-making and why and how they are used. BACKGROUND: In spite of an increased educational focus on skills and competencies within evidence based practice newly graduated nurses' ability to use...... approaches to strengthen the knowledgebase used in clinical decision-making. DESIGN AND METHODS: Ethnographic study using participant-observation and individual semi-structured interviews of nine Danish newly graduated nurses in medical and surgical hospital settings. RESULTS: Newly graduates use...... in clinical decision-making. If newly graduates are to be supported in an articulate and reflective use of a variety of sources, they have to be allocated to experienced nurses who model a reflective, articulate and balanced use of knowledge sources. This article is protected by copyright. All rights reserved....
Kuokkanen, Liisa; Leino-Kilpi, Helena; Numminen, Olivia; Isoaho, Hannu; Flinkman, Mervi; Meretoja, Riitta
Although both nurse empowerment and competence are fundamental concepts of describing newly graduated nurses' professional development and job satisfaction, only few studies exist on the relationship between these concepts. Therefore, the purpose of this study was to determine how newly graduated nurses assess their empowerment and to clarify professional competence compared to other work-related factors. A descriptive, cross-sectional and correlational design was applied. The sample comprised newly graduated nurses (n = 318) in Finland. Empowerment was measured using the 19-item Qualities of an Empowered Nurse scale and the Nurse Competence Scale measured nurses' self-assessed generic competence. In addition to demographic data, the background data included employment sector (public/private), job satisfaction, intent to change/leave job, work schedule (shifts/business hours) and assessments of the quality of care in the workplace. The data were analysed statistically by using Spearman's correlation coefficient as well as the One-Way and Multivariate Analysis of Variance. Cronbach's alpha coefficient was used to estimate the internal consistency. Newly graduated nurses perceived their level of empowerment and competence fairly high. The association between nurse empowerment and professional competence was statistically significant. Other variables correlating positively to empowerment included employment sector, age, job satisfaction, intent to change job, work schedule, and satisfaction with the quality of care in the work unit. The study indicates competence had the strongest effect on newly graduated nurses' empowerment. New graduates need support and career opportunities. In the future, nurses' further education and nurse managers' resources for supporting and empowering nurses should respond to the newly graduated nurses' requisites for attractive and meaningful work.
Voldbjerg, Siri Lygum; Grønkjaer, Mette; Sørensen, Erik Elgaard; Hall, Elisabeth O C
To advance evidence on newly graduated nurses' use of knowledge sources. Clinical decisions need to be evidence-based and understanding the knowledge sources that newly graduated nurses use will inform both education and practice. Qualitative studies on newly graduated nurses' use of knowledge sources are increasing though generated from scattered healthcare contexts. Therefore, a metasynthesis of qualitative research on what knowledge sources new graduates use in decision-making was conducted. Meta-ethnography. Nineteen reports, representing 17 studies, published from 2000-2014 were identified from iterative searches in relevant databases from May 2013-May 2014. Included reports were appraised for quality and Noblit and Hare's meta-ethnography guided the interpretation and synthesis of data. Newly graduated nurses' use of knowledge sources during their first 2-year postgraduation were interpreted in the main theme 'self and others as knowledge sources,' with two subthemes 'doing and following' and 'knowing and doing,' each with several elucidating categories. The metasynthesis revealed a line of argument among the report findings underscoring progression in knowledge use and perception of competence and confidence among newly graduated nurses. The transition phase, feeling of confidence and ability to use critical thinking and reflection, has a great impact on knowledge sources incorporated in clinical decisions. The synthesis accentuates that for use of newly graduated nurses' qualifications and skills in evidence-based practice, clinical practice needs to provide a supportive environment which nurtures critical thinking and questions and articulates use of multiple knowledge sources. © 2016 John Wiley & Sons Ltd.
Full Text Available Healthcare employers often criticize the lack of emotional competency and critical thinking skills demonstrated by newly licensed nurses. The purpose of this study was to evaluate whether emotional intelligence (EI training for nurses improves critical thinking and emotional competence enough to justify including EI in nursing curricula. A meta-analysis was conducted inclusive of EI related nursing abilities and traits such as leadership, health, reflection, ethical behavior, nursing student performance, and job retention/satisfaction. Studies of EI constructs, test instruments, and contrary viewpoints were also examined. The analysis included 395 EI studies of approximately 65,300 participants. All the studies reported a positive correlation with EI ranging from weak to strong with a moderate cumulative effect size of r = 0.3022 across all studies. This study may contribute to positive social change by reducing employers time and cost for training newly licensed nurses, thereby decreasing the overall cost of health care to the public.
Wangensteen, Sigrid; Johansson, Inger S; Björkström, Monica E; Nordström, Gun
The aim of the study was to describe critical thinking dispositions among newly graduated nurses in Norway, and to study whether background data had any impact on critical thinking dispositions. Competence in critical thinking is one of the expectations of nursing education. Critical thinkers are described as well-informed, inquisitive, open-minded and orderly in complex matters. Critical thinking competence has thus been designated as an outcome for judging the quality of nursing education programmes and for the development of clinical judgement. The ability to think critically is also described as reducing the research-practice gap and fostering evidence-based nursing. A cross-sectional descriptive study was performed. The data were collected between October 2006 and April 2007 using the California Critical Thinking Disposition Inventory. The response rate was 33% (n = 618). Pearson's chi-square tests were used to analyse the data. Nearly 80% of the respondents reported a positive disposition towards critical thinking. The highest mean score was on the Inquisitiveness subscale and the lowest on the Truth-seeking subscale. A statistically significant higher proportion of nurses with high critical thinking scores were found among those older than 30 years, those with university education prior to nursing education, and those working in community health care. Nurse leaders and nurse teachers should encourage and nurture critical thinking among newly graduated nurses and nursing students. The low Truth-seeking scores found may be a result of traditional teaching strategies in nursing education and might indicate a need for more student-active learning models. © 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.
Twenty Licensed Practical Nurses (LPN) became Registered Nurses (RN) in a pilot program giving partial academic credit for their LPN training and building on their existing skills. The program revolved around three needs: (1) trained nurses; (2) eliminating the notion that jobs were dead-end; and (3) achieving upward mobility for hospital staff.…
Full Text Available The clinical competence of newly registered nurses relating to the care of individual Clients, depends on their ability to correlate theoretical knowledge learned in the classroom with practice and the development of clinical skills. Its foundation lies in the ability to identify and solve problems that emanate from critical thinking, analytical reasoning and reflective practice. It is clear that the quality of clinical exposure plays a leading role in the development of nursing professionals. Nursing skills alone cannot ensure quality care of clients without the application of theory. Facilitation of this theory to practice therefore remains an essential component of nursing education. This study was aimed at identifying areas of incompetence of newly registered nurses (1998- 2001 in the clinical area by determining the newly registered nurses1 and professional nurses1 perceptions of the competence of the newly registered nurses. A quantitative, non-experimental, descriptive survey was used to collect the data regarding the clinical competence of newly registered nurses (1998-2001.
Dec 28, 2011 ... Full Length Research Paper. Breeding of newly licensed wheat variety Huapei 8 and improved breeding strategy by anther culture ... more efficient in pure line selection rather than the hete- .... Regional and productivity tests showed that Huapei 8 had .... Large-scale production of wheat and triticale double.
South Africa transformed higher education through the enactment of the Higher Education Act (No. 101 of 1997). The researcher identified the need to develop a model for the mentoring of newly-appointed nurse educators in nursing education institutions in South Africa. To develop and describe the model for mentoring newly-appointed nurse educators in nursing education institutions in South Africa. A qualitative and theory-generating design was used (following empirical findings regarding needs analysis) in order to develop the model. The conceptualisation of the framework focused on the context, content, process and the theoretical domains that influenced the model. Ideas from different theories were borrowed from and integrated with the literature and deductive and inductive strategies were applied. The structure of the model is multidimensional and complex in nature (macro, mesoand micro) based on the philosophy of reflective practice, competency-based practice andcritical learning theories. The assumptions are in relation to stakeholders, context, mentoring, outcome, process and dynamic. The stakeholders are the mentor and mentee within an interactive participatory relationship. The mentoring takes place within the process with a sequence of activities such as relationship building, development, engagement, reflective process and assessment. Capacity building and empowerment are outcomes of mentoring driven by motivation. The implication for nurse managers is that the model can be used to develop mentoring programmes for newly-appointed nurse educators.
van Rooyen, Dalena R M; Jordan, Portia J; Ten Ham-Baloyi, Wilma; Caka, Ernestina M
Literature shows that successful transition of newly graduate nurses to professional nurses is imperative but does not always take place, resulting in difficulty in performance, cognizance or behaviour of a role as a nurse, affecting the quality of patient care negatively. No integrative literature review could be found to summarize available guidelines facilitating transition of final year nursing students to professional nurses. An extensive search of the literature by means of an integrative literature review was conducted in 2014 and updated in June 2017, following a five-step process. All relevant studies were subsequently appraised for rigour and quality using the AGREE II tool by two independent reviewers. Eight (n = 8) guidelines on transitions were independently extracted. After thematic analysis was done, three factors to facilitate transition of final year nursing students to professional nurses were found: 1) support for new graduates, 2) the graduate's need for socialization and belonging, and 3) a positive clinical learning environment. The availability and implementation of guidelines on transition of final year nursing students by educational institutions and healthcare facilities could ease the transition from being final year nursing students to becoming professional nurses as well as improve retention of newly qualified professional nurses. Copyright © 2018. Published by Elsevier Ltd.
Numminen, Olivia; Leino-Kilpi, Helena; Isoaho, Hannu; Meretoja, Riitta
To explore newly graduated nurses' occupational commitment and its associations with their self-assessed professional competence and other work-related factors. As a factor affecting nurse turnover, newly graduated nurses' occupational commitment and its associations with work-related factors needs exploring to retain adequate workforce. Nurses' commitment has mainly been studied as organisational commitment, but newly graduated nurses' occupational commitment and its association with work-related factors needs further studying. This study used descriptive, cross-sectional, correlation design. A convenience sample of 318 newly graduated nurses in Finland participated responding to an electronic questionnaire. Statistical software, NCSS version 9, was used in data analysis. Frequencies, percentages, ranges, means and standard deviations summarised the data. Multivariate Analyses of Variance estimated associations between occupational commitment and work-related variables. IBM SPSS Amos version 22 estimated the model fit of Occupational Commitment Scale and Nurse Competence Scale. Newly graduated nurses' occupational commitment was good, affective commitment reaching the highest mean score. There was a significant difference between the nurse groups in favour of nurses at higher competence levels in all subscales except in limited alternatives occupational commitment. Multivariate analyses revealed significant associations between subscales of commitment and competence, turnover intentions, job satisfaction, earlier professional education and work sector, competence counting only through affective dimension. The association between occupational commitment and low turnover intentions and satisfaction with nursing occupation was strong. Higher general competence indicated higher overall occupational commitment. Managers' recognition of the influence of all dimensions of occupational commitment in newly graduated nurses' professional development is important. Follow
Spetz, Joanne; Rickles, Jordan; Chapman, Susan; Ong, Paul M
Most studies of nurse turnover focus on job turnover, which could reflect nurse advancement and thus not be detrimental to the workforce. The authors discuss findings from a study that involved 2 cohorts of graduates from registered nursing and licensed vocational nursing community college programs in California. The duration of employment in the healthcare industry, as well as with specific employers, is tracked, lending a more thorough analysis of nursing job and industry turnover than found in other studies.
de los Ríos-Castillo, José Lauro; Barrios-Santiago, Pedro; Ocampo-Mancilla, Mariano; Avila-Rojas, Teresa Luzeldy
The burnout syndrome (BS) is characterized by emotional fatigue, loss of personal identity and loss of personal realization feelings. BS is frequent among professionals that assist people (health care workers) and among those that have interpersonal contact; the occupational characteristics are among BS contributing factors. The objective was to ascertain BS prevalence among nurses affiliated to the San Luis Potosí General Hospital. A cross-sectional survey was carried out with a groups of nurses who gave their informed consent to participate. The Brief Questionnaire of Burnout version standardized for Mexico was used to collect the information. This version explores the following areas: emotional fatigue, loss of personal identity and personal realization. Also, participants answered three questionnaires about their socio-demographic characteristics, occupational satisfaction, family variables and emotional dysfunction. 70 licensed nurses participated. The BS was common among participants. Some variables related to BS were: age older than 30 years, being female, being married, housekeeping work, absenteeism due to illness, serious depression and occupational dissatisfaction. Nurses working at the emergency room and in critical care services had BS more often. The burnout syndrome has a high prevalence among licensed nurses. Interventions to decrease and to avert BS are needed.
Full Text Available Background: South Africa transformed higher education through the enactment of the Higher Education Act (No. 101 of 1997. The researcher identified the need to develop a model for the mentoring of newly-appointed nurse educators in nursing education institutions in South Africa. Objectives: To develop and describe the model for mentoring newly-appointed nurse educators in nursing education institutions in South Africa. Method: A qualitative and theory-generating design was used (following empirical findings regarding needs analysis in order to develop the model. The conceptualisation of the framework focused on the context, content, process and the theoretical domains that influenced the model. Ideas from different theories were borrowed from and integrated with the literature and deductive and inductive strategies were applied. Results: The structure of the model is multidimensional and complex in nature (macro, mesoand micro based on the philosophy of reflective practice, competency-based practice andcritical learning theories. The assumptions are in relation to stakeholders, context, mentoring, outcome, process and dynamic. The stakeholders are the mentor and mentee within an interactive participatory relationship. The mentoring takes place within the process with a sequence of activities such as relationship building, development, engagement, reflective process and assessment. Capacity building and empowerment are outcomes of mentoring driven by motivation. Conclusion: The implication for nurse managers is that the model can be used to develop mentoring programmes for newly-appointed nurse educators.
Newton, Paul; Chandler, Val; Morris-Thomson, Trish; Sayer, Jane; Burke, Linda
To map current selection and recruitment processes for newly qualified nurses and to explore the advantages and limitations of current selection and recruitment processes. The need to improve current selection and recruitment practices for newly qualified nurses is highlighted in health policy internationally. A cross-sectional, sequential-explanatory mixed-method design with 4 components: (1) Literature review of selection and recruitment of newly qualified nurses; and (2) Literature review of a public sector professions' selection and recruitment processes; (3) Survey mapping existing selection and recruitment processes for newly qualified nurses; and (4) Qualitative study about recruiters' selection and recruitment processes. Literature searches on the selection and recruitment of newly qualified candidates in teaching and nursing (2005-2013) were conducted. Cross-sectional, mixed-method data were collected from thirty-one (n = 31) individuals in health providers in London who had responsibility for the selection and recruitment of newly qualified nurses using a survey instrument. Of these providers who took part, six (n = 6) purposively selected to be interviewed qualitatively. Issues of supply and demand in the workforce, rather than selection and recruitment tools, predominated in the literature reviews. Examples of tools to measure values, attitudes and skills were found in the nursing literature. The mapping exercise found that providers used many selection and recruitment tools, some providers combined tools to streamline process and assure quality of candidates. Most providers had processes which addressed the issue of quality in the selection and recruitment of newly qualified nurses. The 'assessment centre model', which providers were adopting, allowed for multiple levels of assessment and streamlined recruitment. There is a need to validate the efficacy of the selection tools. © 2014 John Wiley & Sons Ltd.
of clinical decisions, based on transparent, articulate and reflective use of knowledge sources. Furthermore, it is implied that nurses are able to retrieve, asses, implement and evaluate research evidence. To meet these requirements, nursing educations around the world have organised curricula to educate...... graduated nurses do not work within a framework of evidence-based practice. The overall aim of this thesis was to explore which knowledge sources newly graduated nurses’ use in their clinical decision-making and why they use them in order to understand why newly graduated nurses use research and components...... within evidence-based practice to a limited extent. The thesis is based on a synthesis of findings from two studies. The aim of the first study was to explore which knowledge sources newly graduated nurses use in clinical decision making as reported within international qualitative research. The purpose...
Full Text Available Abstract Background Falls are common in old age and may have serious consequences. There are many strategies to predict and prevent falls from occurring in long-term care and hospitals. The aim of this study was to describe licensed practical nurse experiences of predicting and preventing further falls when working with patients who had experienced a fall-related fracture. Licensed practical nurses are the main caretakers that work most closely with the patients. Methods A qualitative study of focus groups interviews and field observations was done. 15 licensed practical nurses from a rehabilitation ward and an acute ward in a hospital in northern Sweden were interviewed. Content was analyzed using qualitative content analysis. Results The result of the licensed practical nurse thoughts and experiences about risk of falling and fall prevention work is represented in one theme, “the balancing act”. The theme includes three categories: “the right to decide”, “the constant watch”, and “the ongoing negotiation” as well as nine subcategories. The analysis showed similarities and differences between rehabilitation and acute wards. At both wards it was a core strategy in the licensed practical nurse work to always be ready and to pay attention to patients’ appearance and behavior. At the rehabilitation ward, it was an explicit working task to judge the patients’ risk of falling and to be active to prevent falls. At the acute ward, the words “risk of falling” were not used and fall prevention were not discussed; instead the licensed practical nurses used for example “dizzy and pale”. The results also indicated differences in components that facilitate workplace learning and knowledge transfer. Conclusions Differences between the wards are most probably rooted in organizational differences. When it is expected by the leadership, licensed practical nurses can express patient risk of falling, share their observations with others
This project examines the effects of age, experience, and video-based feedback on the rate and type of safety-relevant events captured on video event : recorders in the vehicles of three groups of newly licensed young drivers: : 1. 14.5- to 15.5-year...
Ivarsson, Bodil; Nilsson, Gunilla
The aim was to describe, from the newly registered nurses' perspective, specific events when using their pedagogical knowledge in their everyday clinical practice. The design was qualitative and the critical incident technique was used. Data was collected via interviews with ten newly registered nurses who graduated from the same University program 10 months earlier and are now employed at a university hospital. Two categories emerged in the analyses. The first category was "Pedagogical methods in theory" with the sub-categories Theory and the application of the course in practice, Knowledge of pedagogy and Information as a professional competence. The second category was "Pedagogical methods in everyday clinical practice" with sub-categories Factual knowledge versus pedagogical knowledge, Information and relatives, Difficulties when giving information, Understanding information received, Pedagogical tools, Collaboration in teams in pedagogical situations, and Time and giving information. By identifying specific events regarding pedagogical methods the findings can be useful for everyone from teachers and health-care managers to nurse students and newly registered nurses, to improve teaching methods in nurse education.
Kudo, Yasushi; Kono, Keiko; Kume, Ryuko; Matsuhashi, Ayako; Tsutsumi, Akizumi
Registered nurses and licensed practical nurses have received professional education, but to enhance their work motivation it is necessary to create work environments in which they can concentrate on their jobs as specialists. One of the methods to develop such work environments is to use nursing assistants effectively. We investigated professional nurses' feelings toward nursing assistants and then examined the associations between those feelings and their work motivation. The analyzed subjects were 2,170 female nurses working in 25 hospitals with from 55 to 458 beds. The average age of the respondents was 38.0 (standard deviation, 10.6 years). Factor analyses extracted four factors of professional nurses' feelings toward nursing assistants: 1. knowledge related to healthcare, 2. nursing assistants' attitudes toward work, 3. human relations, and 4. distinguishing between professional nurses' work and nursing assistants' work. Using multiple linear regression analysis, our results revealed that scores of maintaining a high motivation to work thanks to nursing assistants became lower as the ages of the respondents increased. Scores of maintaining a high motivation to work thanks to nursing assistants became higher as professional nurses gained satisfaction from: knowledge related to healthcare, nursing assistants' attitudes toward work, and human relations. Hospital managers should consider these findings to improve working environments in which professional nurses can feel motivated to work.
Roelen, Corné; van Rhenen, Willem; Schaufeli, Wilmar; van der Klink, Jac; Magerøy, Nils; Moen, Bente; Bjorvatn, Bjørn; Pallesen, Ståle
To investigate whether health-related functioning mediates the effect of psychological job demands on sickness absence in nurses. Nurses face high job demands that can have adverse health effects resulting in sickness absence. Prospective cohort study with 1-year follow-up. Data for 2964 Norwegian nurses were collected in the period 2008-2010. At baseline, psychological job demands were measured with the Demand-Control-Support Questionnaire. Health-related functioning was assessed by the Mental Composite Score and the Physical Composite Score of the SF-12 Health Survey (2nd version). Sickness absence (no = 0, yes = 1) was self-reported at 1-year follow-up. Interaction and mediation analyses were conducted stratified by tenure (6 years) as a registered nurse. A total of 2180 nurses (74%) with complete data were eligible for analysis. A significant three-way interaction between job demands, control and support was found in newly licensed nurses (tenure sickness absence at 1-year follow-up. This association was substantially weakened when Mental Composite Score and Physical Composite Score were introduced as mediator variables, indicating a partial mediation effect that was particularly pronounced in newly licensed nurses. Psychological job demands did not modify the effect of health-related functioning on sickness absence. Both mental and physical health-related functioning mediated between psychological job demands and sickness absence. Nurse managers should pay attention to health-related functioning, because poor health-related functioning may predict sickness absence, especially in newly licensed nurses. © 2013 John Wiley & Sons Ltd.
Halpin, Yvonne; Terry, Louise M; Curzio, Joan
To investigate transition in newly qualified nurses through an exploration of their stressors and stress experiences during their first 12 months postqualifying. Globally, thousands of new nurses qualify annually. They are crucial for the profession and healthcare service delivery. Work-related stress has multiple serious consequences, yet there is a lack of robust, empirical evidence that directly analyses newly qualified nurses and the stress they feel and experience in the workplace. Understanding what causes newly qualified nurses' stress is vital to retaining and nurturing this vital component of the workforce. Longitudinal, explanatory sequential mixed methods, cohort study. At the point of qualification (n = 288), 6 months postqualifying (n = 107) and 12 months postqualifying (n = 86), newly qualified nurses completed the Nursing Stress Scale, with 14 completing a one-to-one interview at 12 months postqualifying. Data were collected from 2010 - 2012. Inferential statistics, "thematic analysis" and "side-by-side comparisons in a discussion" were used for analysis. Workload was consistently the highest reported stressor with inadequate staffing and managing multiple role demands given as explanations. Incivility within the workplace was a noted stressor. Conversely, being part of "a good team" provided a civil, supportive, facilitative work environment. Entering nurse education with previous healthcare experience had a mediating effect on the reported frequency of stressors. Newly qualified nurses encounter multiple work-related stressors over their first 12 months postqualifying, which are intrinsically entwined with their transition. Employing organizations need to be more proactive in managing their workload and addressing workplace incivility. © 2017 John Wiley & Sons Ltd.
Bergen Community Coll., Paramus, NJ.
The Associate Degree Nursing Program at Bergen Community College developed and field tested competency-based instructional modules in a program designed to allow licensed practical nurses to qualify to take the certification examination for registered nurses after a year of study. Thirteen licensed practical nurses were enrolled in the first class…
Evidence-based practice has been introduced internationally as a standard for healthcare delivery to improve the quality of care, thus ensuring safe care and treatment. Evidence-based practice calls for a decision-making that specifically requires nurses to place the patient at the centre...... of clinical decisions, based on transparent, articulate and reflective use of knowledge sources. Furthermore, it is implied that nurses are able to retrieve, asses, implement and evaluate research evidence. To meet these requirements, nursing educations around the world have organised curricula to educate...... and support future nurses, enabling them to work within a framework of evidence-based practice. Recent studies underline that despite curricula interventions, newly graduated nurses’ use of research evidence and components within evidence-based practice is limited. However, it is unclear why the newly...
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.
Nour, Violet; Williams, Anne M
Background Newly graduated nurses often encounter a gap between theory and practice in clinical settings. Although this has been the focus of considerable research, little is known about the learning transition process. Purpose The purpose of this study was to explore the experiences of newly graduated nurses in acute healthcare settings within Canada. This study was conducted to gain a greater understanding of the experiences and challenges faced by graduates. Methods Grounded theory method was utilized with a sample of 14 registered nurses who were employed in acute-care settings. Data were collected using in-depth interviews. Constant comparative analysis was used to analyze data. Results Findings revealed a core category, "Theory Becoming Alive," and four supporting categories: Entry into Practice, Immersion, Committing, and Evolving. Theory Becoming Alive described the process of new graduate nurses' clinical learning experiences as well as the challenges that they encountered in clinical settings after graduating. Conclusions This research provides a greater understanding of learning process of new graduate nurses in Canada. It highlights the importance of providing supportive environments to assist new graduate nurses to develop confidence as independent registered nurses in clinical areas. Future research directions as well as supportive educational strategies are described.
Suresh, Patricia; Matthews, Anne; Coyne, Imelda
To measure and compare the perceived levels of job-related stress and stressors of newly qualified nurses and fourth-year student nurses in the clinical environment and to explore the participants' views on stress and stressors. Stress in the nursing workplace has significant consequences for the person, the patient and the organisation, such as psychological and physical health deterioration and impaired professional practice. To address this problem, stress and stressors need to be measured and identified. This study used a cross-sectional survey design and self-reporting questionnaires to measure and compare levels of stress in both groups. Convenience sampling involved all newly qualified nurses (n = 120) and fourth-year student nurses (n = 128) in Dublin North-East region in Ireland. The instrument used was 'The Nursing Stress Scale' (Gray-Toft & Anderson 1981, Journal of Behavioral Assessment 3, 11-23). Descriptive, qualitative analysis was conducted on an open-ended question. Data were obtained from newly qualified nurses (n = 31) and fourth-year student nurses (n = 40) in six acute hospital sites. Levels of perceived stress and stressors were high in both groups. Themes identified from the responses to the open question by both groups included excessive workload, difficult working relationships and unmet clinical learning needs. Student nurses also reported the combination of academic demands with clinical placement as a major stressor. There was no significant difference between each group. Stress continues to be a problem for nurses in the clinical setting. Excessive workload requires urgent attention by hospital managers in view of widespread retention difficulties. Themes identified could provide a framework for possible interventions for improving the clinical environment for nurses. These results can help stakeholders in nurse education and practice to develop interventions to reduce stress for both groups and to ease the transition from student to
Loes, Chad N; Tobin, Mary B
The shortage of nursing professionals in the United States is unquestionable. This shortage, which is predicted to continue into the foreseeable future, is a particularly salient problem within the nursing profession. This is especially true for long-term care facility administrators who not only are faced with the challenge of increasing numbers of aging residents but also regularly struggle with turnover among more cost-effective nursing staff, such as licensed practical nurses (LPNs). The primary purpose of this study was to examine whether perceived interpersonal conflict influences organizational commitment among LPNs. To accomplish this, we analyzed responses from 1165 LPNs throughout a Midwestern state who were queried on their perceptions of interpersonal conflict and organizational commitment in their work settings. Considering a wide range of potential confounding influences such as age and years working as an LPN, for example, we found that higher perceived interpersonal conflict was associated with significantly lower levels of organizational commitment. The implications of these findings, along with recommendations for nurse administrators to reduce LPN turnover, are discussed in the article.
Lindfors, Kirsi; Meretoja, Riitta; Kaunonen, Marja; Paavilainen, Eija
To identify existing orientation patterns and to find elements that may enhance or impede successful orientation of newly graduated nurses. Preceptors have first-hand information concerning orientation and their opinions should not be forgotten when organisations develop their orientation processes. An open-ended questionnaire was undertaken to collect data from preceptors (n = 172) about the current orientation patterns. Data were analysed by using deductive content analysis and by quantifying the phrases. Communal commitment to the orientation process, strong professional orientation know-how and supportive leadership were the enhancing elements of successful orientation. Complex interpersonal relationship problems during orientation, inadequate orientation resources and the organisation's structural and functional problems were the impeding elements of successful orientation. With the elements of successful orientation we ensure a supportive transition to practice for newly graduate nurses and possibilities to focus on good orientation practices for preceptors. Nurse leaders play an important part in ensuring newly graduated nurses have a safe nursing career starting point and, for preceptors, opportunities to provide orientation that is as good as possible. Supportive leadership, sufficient resources and good interpersonal relationships should be the leading principles during newly graduated nurses' orientation period. © 2017 John Wiley & Sons Ltd.
McGilton, Katherine S; Boscart, Veronique M; Brown, Maryanne; Bowers, Barbara
Turnover of licensed nursing staff in long-term care (LTC) settings (e.g., nursing homes) is a mounting concern and is associated with poor quality of care and low staff morale. Retention and turnover research in LTC have focused primarily on direct care workers (i.e., nurse aides) leaving the issues largely unexplored for licensed nursing staff (i.e., registered nurses and licensed practical nurses). The main objective of this study was to understand factors that influence nurses' intentions to remain employed at their current job. Qualitative descriptive study. Seven nursing homes in Ontario, Canada. A convenience sample of forty-one licensed LTC nurses. Data were collected through focus groups conducted at each of the participating nursing homes. Focus group discussions were transcribed verbatim. Directed content analysis was used to identify and develop themes. Work conditions were a salient element affecting nurses' intention to stay and included impact of regulations on nurse role flexibility and professional judgment, an underfunded system contributing to insufficient resources and staffing, and a lack of supportive leadership. Factors promoting nurses' willingness to stay included the development of meaningful relationships with residents and staff and opportunities for learning and professional development. Nurses also considered personal and life circumstances (e.g., marital status and seniority) when discussing intention to stay. Nurses in this study weighed positive and negative work-related factors as well as personal circumstances to determine their intent to stay. Developing a more individualized approach to address attrition of licensed nurses in LTC may be the most successful strategy for improving retention of highly skilled staff in this sector. Copyright © 2013 Elsevier Ltd. All rights reserved.
McSweeney, K; O'Connor, D W
This research concerns the prevalence and course of depression in newly admitted nursing home residents. We attempted to recruit consecutive admissions into the study, irrespective of cognitive status, enabling a comparison of the prevalence and course of depression experienced by cognitively intact residents and those exhibiting all levels of cognitive impairment. Depression was assessed at one month, three months and six months post-admission. The assessment of mood in this study entailed the conduct of a semi-structured clinical interview, which encompassed DSM-IV criteria and Cornell Scale for Depression in Dementia (CSDD) items. Recruitment difficulties resulted in a sample of 51 newly admitted residents, drawn from six nursing homes located in Victoria, Australia. Of particular interest, throughout the duration of the study, only the cognitively impaired were diagnosed with major depression (MD). One month post-admission, 24% of the sample were diagnosed with MD, and a further 20% evidenced a non-major depressive disorder. At the second and third assessments, MD was observed in 14% and 15% of residents, respectively. For residents who completed all three assessments, there was no appreciable change in the proportion diagnosed with a depressive disorder, nor was there a change in the levels of depressive symptomatology. Although subject to limitations, the current study indicated that clinical depression in nursing home facilities most often occurs in residents who also exhibit pronounced cognitive impairment. These depressions are unlikely to remit spontaneously. Accordingly, care staff and general practitioners must be trained in the identification of depression in dementia, and any interventions implemented in these facilities should be tailored to meet the unique needs of this group.
Mihyun Park, PhD, RN
Conclusion: Relatively dissatisfying job characteristics in nursing work environment that were significant predictors for nurses' job satisfaction should be improved. Newly graduated nurses are at risk for job dissatisfaction. This can result in high turnover rates and can exacerbate the nursing shortage. Efforts to improve the work environment are needed.
To measure and compare the perceived levels of job-related stress and stressors of newly qualified nurses and fourth-year student nurses in the clinical environment and to explore the participants\\' views on stress and stressors.
Full Text Available Recognizing the emotional labour underlying interprofessional collaborations (IPCs could be considered a crucial step towards building a cohesive nursing team. Although IPCs between registered nurses (RNs and licensed practical nurses (LPNs have been linked to quality nursing care, little is known about the emotions experienced by LPNs during their interactions with RNs or those factors that influence IPCs. A questionnaire administered to 309 LPNs found that (1 the professional identity of LPNs has evolved into a that of a unique social group; (2 LPNs define IPC as an interpersonal process of exploring similar or dissimilar assessments of a patient's status with RNs and, together, establishing a course of nursing actions; (3 the primary organizational factor facilitating IPCs is inclusive nursing leadership; (4 the interpersonal factor promoting IPCs is the level of trust RNs extend to LPNs; and (5 an LPN's emotional labour (i.e., internal emotional regulation is most tangible during uncollaborative interactions with RNs.
Missouri Univ., Columbia. Instructional Materials Lab.
This curriculum guide provides materials for a 10-unit intravenous (IV) therapy course for licensed practical nurses. Units contain from one to nine lessons. The first unit provides an introduction and orientation to the course. Subsequent units concern documentation, anatomy and physiology as applied to IV therapy, fundamental aspects of fluid…
Kovner, Christine T; Djukic, Maja; Jun, Jin; Fletcher, Jason; Fatehi, Farida K; Brewer, Carol S
The Institute of Medicine (IOM) report, The Future of Nursing, included recommendations to increase nurse diversity, the percent of nurses obtaining a bachelor's degree, and inter-professional education. The purpose of this paper is to report the progress toward achievement of these recommendations. We used a longitudinal, multi-state data from four cohorts of nurses newly licensed in 2004 to 2005, 2007 to 2008, 2010 to 2011, and 2014 to 2015 to examine and compare the trends. The percentage of males who became licensed increased, from 8.8% in 2004 to 2005 cohort to 13.6% in the 2014 to 2015 cohort. The percentage of white-non-Hispanic nurses who were licensed decreased from 78.9% in 2007 to 2008 to 73.8% in 2014 to 2015. These differences primarily reflect an increase in white-Hispanic nurses. More nurses are obtaining a bachelor's degree as their first professional degree, from 36.6% in 2004 to 2005 cohort to 48.5% in 2014 to 2015 cohort. About 40% of the 2014 to 2015 cohort reported that they learned to work in inter-professional teams. Collegial nurse-physician relations had an upward positive trajectory over time increasing almost 7%. The diversity and education of new nurses have increased, but are short of meeting the IOM recommendations. Copyright © 2017. Published by Elsevier Inc.
Maben, Jill; Latter, Sue; Clark, Jill Macleod
This paper reports the findings from a naturalistic enquiry undertaken in the United Kingdom into the extent to which the ideals and values of the preregistration nursing course are adopted by individual newly educated Registered Nurses. Research in several countries provides consistent evidence of the existence of a theory-practice gap in nursing. Clear disparities have been demonstrated between the best practice ideals and values that are taught and those actually encountered in everyday practice. Nurse education 'Project 2000' reforms in the United Kingdom were designed, in part, to address this issue. Few studies to date have examined the impact of these reforms on newly qualified Registered Nurses' ability to translate theory into practice. A longitudinal study was carried out in three educational institutions in the United Kingdom from 1997 to 2000. Final year nursing students (n = 72) in three colleges of nursing completed questionnaires to elicit views on their ideals and values for practice. In-depth interviews with a purposive subsample of 26 participants (at 4-6 and 11-15 months postqualification) indicated the extent to which these ideals and values were adopted in practice. Interviews were tape-recorded, transcribed, and data were analysed using constant comparison and negative case analysis. Although new nurses emerged from their programmes with a strong set of nursing values, a number of professional and organizational factors effectively sabotaged implementation. Professional sabotage includes obeying covert rules, lack of support and poor nursing role models. Organizational sabotage includes structural and organizational constraints such as time pressures, role constraints, staff shortages and work overload. The disparity between nursing as taught and as practised may have profound implications for the future of the profession both in the United Kingdom and internationally, in terms of morale, job satisfaction and retention. Measures to improve
Ikeda, Mari; Inoue, Katsuya; Kamibeppu, Kiyoko
To investigate the effects of personal and professional variables on career advancement intentions of working Licensed Practical Nurses (LPNs). In Japan, two levels of professional nursing licensures, the LPN and the registered nurse (RN), are likely to be integrated in the future. Therefore, it is important to know the career advancement intentions of LPNs. Questionnaires were sent to a sample of 356 LPNs. Analysis of variance (anova) and discriminative analysis were used. We found that those who had a positive image of LPNs along with a positive image of RNs were identified as showing interest in career advancement. The results of anova showed that age had a negative effect; however, discriminative analysis suggested that age is not as significant compared with other variables. Our results indicate that the 'image of RNs', and 'role-acceptance factors' have an effect on career advancement intentions of LPNs. Our results suggest that Nursing Managers should create a supportive working environment where the LPN would feel encouraged to carry out the nursing role, thereby creating a positive image of nursing in general which would lead to career motivation and pursuing RN status.
Brownie, Sharon M.; Williams, Ged; Barnewall, Kate; Bishaw, Suzanne; Cooper, Jennifer L.; Robb, Walter; Younis, Neima; Kuzemski, Dawn
Graduates of an Abu Dhabi transnational nursing degree struggled with the mandatory national licensing examination. Poor pass rates undermine graduate career futures and impact on the workforce capacity building contributions of the partnering transnational educational providers. This paper describes how the design and delivery of an intensive…
Su Jin Shin
Full Text Available Purpose The purpose of this study was to analyze opinions about the action plan for implementation of clinical performance exam as part of the national nursing licensing examination and presents the expected effects of the performance exam and aspects to consider regarding its implementation. Methods This study used a mixed-methods design. Quantitative data were collected by a questionnaire survey, while qualitative data were collected by focus group interviews with experts. The survey targeted 200 nursing professors and clinical nurses with more than 5 years of work experience, and the focus group interviews were conducted with 28 of professors, clinical instructors, and nurses at hospitals. Results First, nursing professors and clinical specialists agreed that the current written tests have limitations in evaluating examinees’ ability, and that the introduction of a clinical performance exam will yield positive results. Clinical performance exam is necessary to evaluate and improve nurses’ work ability, which means that the implementation of a performance exam is advisable if its credibility and validity can be verified. Second, most respondents chose direct performance exams using simulators or standardized patients as the most suitable format of the test. Conclusion In conclusion, the current national nursing licensing exam is somewhat limited in its ability to identify competent nurses. Thus, the time has come for us to seriously consider the introduction of a performance exam. The prerequisites for successfully implementing clinical performance exam as part of the national nursing licensing exam are a professional training process and forming a consortium to standardize practical training.
This critical analysis of the literature examines the factors and theoretical perspectives contributing to the theory-practice gap for newly qualified nurses within the United Kingdom. This article aspires to inform, guide and promote effective nursing education both academically and practically. A systematic search strategy was conducted to identify relevant literature covering the period of 2000-2014, to include only contemporary theoretical perspectives coinciding with the dearth of contemporary literature post Project 2000. The literature was systematically investigated utilising nursing research databases, the Cumulative Index of Nursing and Allied Health Literature, Allied and Complementary Medicine, the U.S. National Library of Medicine and Internurse. To satisfy the search criteria only articles conducted within the United Kingdom and written in the English language were included. Only literature including nurses and newly qualified nurses were included. To identify relevant literature a series of key words were utilised. Systematic review of the literature revealed that newly qualified nurses feel unprepared for practice, lacking confidence in their own abilities. It was also felt by newly qualified nurses that not enough time was dedicated to the production of clinical skills during their training. The use of preceptorship programmes was found to reduce the transitional stress associated with becoming a qualified nursing practitioner. Despite the increasing research being undertaken in the area of theory-practice gap there is still a need for nursing educators, practice areas and regulatory bodies to invest further in research. The effects of preceptorship and simulation exercises in particular require more research to provide regulatory bodies with enough evidence to make an informed decision as to whether their use should be mandatory. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Mahfouz, Rasha; Alsahli, Haya
The present study aimed at assessing the stress level and coping strategies among students who were newly in Practicing the clinical training in different hospitals, at the Nursing College, Princess Nourah University. The study design was a descriptive analytical one. The study was conducted at the beginning of second semester in the academic year…
The present study examines job-related factors leading to low self-esteem in nurses. The lowering of self-esteem suggests that such nurses had difficulty in fully accepting themselves and their circumstances. Subjects were registered nurses (RN) and licensed practical nurses (LPN) at hospitals, and unemployed registered nurses (UEN) seeking employment. Questionnaires were provided at 53 hospitals and a Nurse Bank in Kanagawa Prefecture. The responses of 552 RN, 146 LPN and 433 UEN were analyzed. Questions were asked about personal life, past or present nursing experience, working conditions, nursing skills, satisfaction with work performance and self-esteem. Factors giving rise to low self-esteem were determined using logistic regression analysis and logistic discriminant analysis. Employment status and qualifications were determined to be the most important factors determining the self-esteem of nurses. The next most important factors were 'a limited number of years of experience (less than five years)' and 'dissatisfaction with discretion and responsibility as a nurse' (P self-esteem for LPN was 4.07 times higher than for UEN, and 2.2 times higher than for RN by logistic regression analysis. LPN are treated as unskilled workers, and thus significant differences were apparent in their performance of certain job tasks. These differences were analyzed using discriminant analysis, and were referred to as follows, 1: Advanced assessment skills, 2: Advanced technical skills, 3: Advanced communication skills, and 4: Nursing plan and documentation (positive discrimination rate was 70.8%). Job dissatisfaction is closely associated with the level of professional training. Continuous education and a feedback system for various levels of nurses are needed.
Numminen, Olivia; Ruoppa, Eija; Leino-Kilpi, Helena; Isoaho, Hannu; Hupli, Maija; Meretoja, Riitta
To explore newly graduated nurses' (NGN) perception of their practice environment and its association with their self-assessed competence, turnover intentions and job satisfaction as work-related factors. The impact of practice environment on nurses' work is important. Positive practice environments are associated with positive organisational, nurse and patient outcomes. How this applies to NGNs needs further exploration. A cross-sectional descriptive correlation design was used. Data were collected with PES-NWI and NCS instruments from 318 Finnish registered nurses, and analysed statistically. Newly graduated nurses' perception of their practice environment was mainly positive. Most positive perceptions related to collegial nurse-physician relations, and the least positive to staffing and resource adequacy. Positive perceptions were also associated with higher professional competence, higher perceptions of quality of care and lower intentions to leave the job or profession. The findings revealed strong and significant associations between practice environment and work-related factors. Practice environment is an important element in supporting NGNs' competence, retention and job satisfaction. Nursing management should pay attention to NGNs' perceptions of their practice environment. Management's ability to create and maintain positive practice environments can foster NGNs' professional development and job satisfaction, and consequently retain them in the workforce. © 2015 John Wiley & Sons Ltd.
VanDenKerkhof, Elizabeth; Sears, Nancy; Edge, Dana S; Tregunno, Deborah; Ginsburg, Liane
Practical nurses have experienced an increasing scope of practice, including an expectation to care for complex patients and function on interdisciplinary teams. Little is known about the degree to which patient safety principles are addressed in practical nursing education. To examine self-reported patient safety competencies of practical nurses. A cross-sectional online survey (July 2014) and face-to-face interviews (June 2015). Ontario, Canada. Survey participants were practical nurses newly registered with the College of Nurses of Ontario between January 2012 and December 2013. Interview participants were faculty and students in a practical nursing program in Ontario. Survey respondents completed the Health Professional Education in Patient Safety Survey online. Self-reported competencies in various patient safety domains were compared between classroom and clinical settings. Faculty members were interviewed about educational preparation of practical nurses and students were interviewed to provide insight into interpretation of survey questions. The survey response rate was 28.4% (n=1104/3883). Mean domain scores indicated a high level of confidence in patient safety competence (Nurses of Ontario >2years and in those who obtained their education outside of Canada. Faculty believed their approach to teaching and learning instilled a deep understanding of the limits to practical nurse autonomous practice. Practical nurses were confident in what they learned about patient safety in their educational programs. The high degree of patient safety competence may be a true reflection of practical nurses understanding of, and comfort with, the limits of their knowledge and, ultimately, the limits of their individual autonomous practice. Further exploration as to whether the questionnaire requires additional modification for use with practical nurse populations is warranted. However, this study provides the first examination of practical nurses' perspectives and
Increasing application and use of information systems and mobile technologies in the healthcare industry require increasing nurse competency in computer use. Computer literacy is defined as basic computer skills, whereas computer competency is defined as the computer skills necessary to accomplish job tasks. Inadequate attention has been paid to computer literacy and computer competency scale validity. This study developed a computer literacy scale with good reliability and validity and investigated the current computer literacy of newly enrolled students to develop computer courses appropriate to students' skill levels and needs. This study referenced Hinkin's process to develop a computer literacy scale. Participants were newly enrolled first-year undergraduate students, with nursing or nursing-related backgrounds, currently attending a course entitled Information Literacy and Internet Applications. Researchers examined reliability and validity using confirmatory factor analysis. The final version of the developed computer literacy scale included six constructs (software, hardware, multimedia, networks, information ethics, and information security) and 22 measurement items. Confirmatory factor analysis showed that the scale possessed good content validity, reliability, convergent validity, and discriminant validity. This study also found that participants earned the highest scores for the network domain and the lowest score for the hardware domain. With increasing use of information technology applications, courses related to hardware topic should be increased to improve nurse problem-solving abilities. This study recommends that emphases on word processing and network-related topics may be reduced in favor of an increased emphasis on database, statistical software, hospital information systems, and information ethics.
Voldbjerg, Siri; Elgaard Sørensen, Erik; Grønkjær, Mette
Clinical-decision-making is of decisive importance to how evidence-based practice is put into practice. Schools of Nursing have a responsibility to teach and train nursing students to make clinical decisions within a frame of evidence-based practice. Clinical decision-making among nurses has been...... explored from numerous angles using a diversity of methodologies. Existing research has mainly focused on promoting and inhibiting factors for implementation of evidence-based practice and incorporation of research evidence in the clinical-decision. Little attention has been given to the nurses' behavior......, including the knowledge that actually informs the newly graduated nurses’ clinical decision. The aim of the study is to combine and synthesize results from qualitative research. Noblit and Hare’s meta-ethnographic approach is used to conduct a metasynthesis of qualitative research that has studied...
Govender, Selverani; Brysiewicz, Petra; Bhengu, Busisiwe
Compulsory community service (CCS) for nurses commenced in South African January 2008 after it was legislated in the new Nursing Act (Act No. 33 of 2005). Nurses completing their registered nurse programme are registered as community nurse practitioners (CNPs) during the CCS period and make up the largest number of health professionals serving CCS. Whilst health institutions have welcomed CNPs as additional resources for the shortage of nursing staff, no structured guidelines have been provided at a regional level as to how these nurses should be utilised or managed during the CCS year. To date, no large-scale study has been conducted on nurses carrying out CCS in order to generalise the findings. To establish the perceptions of newly-qualified nurses carrying out CCS in KwaZulu-Natal, South Africa. A quantitative survey design was used to obtain data from a randomly selected sample of the 2012 cohort of nurses carrying out CCS in KwaZulu-Natal. CNPs have a positive attitude toward CCS and perceive themselves as being well prepared for the year of community service in terms of knowledge, skills and ability to administer nursing care. They identified positive benefits of the year of community service.The concerns raised were limited orientation and support; and a few CNPs experienced problems of acceptance by the nurses with whom they work. It is recommended that all health institutions who receive CNPs develop structured orientation and support for these nurses in order to promote their development, thereby enhancing their benefit to the communities they serve.
Ulbricht, Christine M; Rothschild, Anthony J; Hunnicutt, Jacob N; Lapane, Kate L
The objective of this study is to describe the prevalence of depression and cognitive impairment among newly admitted nursing home residents in the USA and to describe the treatment of depression by level of cognitive impairment. We identified 1,088,619 newly admitted older residents between 2011 and 2013 with an active diagnosis of depression documented on the Minimum Data Set 3.0. The prevalence of receiving psychiatric treatment was estimated by cognitive impairment status and depression symptoms. Binary logistic regression using generalized estimating equations provided adjusted odds ratios and 95% confidence intervals for the association between level of cognitive impairment and receipt of psychiatric treatment, adjusted for clustering of residents within nursing homes and resident characteristics. Twenty-six percent of newly admitted residents had depression; 47% of these residents also had cognitive impairment. Of those who had staff assessments of depression, anhedonia, impaired concentration, psychomotor disturbances, and irritability were more commonly experienced by residents with cognitive impairment than residents without cognitive impairment. Forty-eight percent of all residents with depression did not receive any psychiatric treatment. Approximately one-fifth of residents received a combination of treatment. Residents with severe cognitive impairment were less likely than those with intact cognition to receive psychiatric treatment (adjusted odds ratio = 0.95; 95% confidence interval: 0.93-0.98). Many newly admitted residents with an active diagnosis of depression are untreated, potentially missing an important window to improve symptoms. The extent of comorbid cognitive impairment and depression and lack of treatment suggest opportunities for improved quality of care in this increasingly important healthcare setting. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.
Jones, Cheryl B; Toles, Mark; Knafl, George J; Beeber, Anna S
A more diverse registered nurse (RN) workforce is needed to provide health care in North Carolina (NC) and nationally. Studies describing licensed practical nurse (LPN) career transitions to RNs are lacking. To characterize the occurrence of LPN-to-RN professional transitions; compare key characteristics of LPNs who do and do not make such a transition; and compare key characteristics of LPNs who do transition in the years prior to and following their transition. A retrospective design was conducted using licensure data on LPNs from 2001 to 2013. Cohorts were constructed based on year of graduation. Of 39,398 LPNs in NC between 2001 and 2013, there were 3,161 LPNs (8.0%) who had a LPN-to-RN career transition between 2001 and 2013. LPNs were more likely to transition to RN if they were male; from Asian, American Indian, or other racial groups; held an associate or baccalaureate degree in their last year as an LPN (or their last year in the study if they did not transition); worked in a hospital inpatient setting; worked in the medical-surgical nursing specialty; and were from a rural area. Our findings indicate that the odds of an LPN-to-RN transition were greater if LPNs were: male; from all other racial groups except white; of a younger age at their first LPN licensure; working in a hospital setting; working in the specialty of medical-surgical nursing; employed part-time; or working in a rural setting during the last year as an LPN. This study fills an important gap in our knowledge of LPN-to-RN transitions. Policy efforts are needed to incentivize: LPNs to make a LPN-to-RN transition; educational entities to create and communicate curricular pathways; and employers to support LPNs in making the transition. Copyright © 2017 Elsevier Inc. All rights reserved.
Jinks, Annette M; Bradley, Eleanor
This article presents the findings of a comparative study, which investigated the attitudes of two groups of newly recruited student nurses to gender and nursing stereotypes. The 1992 sample (n=100) was a group of student nurses who were in their second day of studies of a Project 2000 type curriculum. The 2002 sample (n=96) were in their second month of studies of a "Fitness for Practice" curriculum [Fitness for Practice (the 'Peach Report'), UKCC, London, 1999]. Data were collected using a questionnaire, which utilised a Likert scale for measurement of attitudes to statements pertaining to gender and nursing stereotypes. The findings reveal significant differences between the characteristics of the two groups of students. For example, the 2002 group were generally older and had more healthcare experience. However, male representation in the sample groups was similar. The overall high scores and implied propensity towards beliefs in gender and nursing stereotypes in the 1992 study was found not to be the case for the 2002 sample. This is particularly true of most statements related to gender stereotypes, nursing as 'feminine', male nurse stereotyping and issues related to nurses' uniform. However, there is less evidence of changes in attitudes towards female nursing stereotypes with indecision being a general feature of both the 1992 and 2002 responses.
Trépanier, Amélie; Gagnon, Marie-Pierre; Mbemba, Gisèle Irène Claudine; Côté, José; Paré, Guy; Fortin, Jean-Paul; Duplàa, Emmanuel; Courcy, François
To identify factors that influence the initial plan and final decision to choose a rural area as first employment location in final-year nursing students or newly graduated nurses. We conducted a mixed-methods review of the literature, including both published and gray literature, using established criteria. Two reviewers performed data extraction of relevant information independently. We retrieved empirical studies from the following databases: PubMED, Embase, CINAHL (EBSCO), Web of Science (SCI and SSCI), The Cochrane Library, Business Source Premier (EBSCO), ERIC, Proquest and PsychInfo. We also searched for empirical studies in the technical and gray literature and reviewed journals related to rural health. Additionally, we conducted searches in websites such as the Center for Health Workforce Planning and Analysis, as well as Google and Google Scholar search engines. Of the 523 studies thus screened, 15 were included for data extraction. We identified more than 40 factors associated with initial plans and final decision to settle in a rural area among nursing graduates. Only limited literature is currently available on the factors associated with the intention of nursing students or newly graduated nurses of practicing in rural areas and on the relationship between intention and effective behavior. This review highlights the needs for further research in this field. Copyright © 2012 Elsevier Ltd. All rights reserved.
Myers, Dennis R; Rogers, Rob; LeCrone, Harold H; Kelley, Katherine; Scott, Joel H
Career resilience provided a frame for understanding how Licensed Nursing Facility Administrators (LNFAs) sustain role performance and even thrive in stressful skilled nursing facility work environments. Quantitative and qualitative analyses of in-depth interviews with18 LNFAs, averaging 24 years of experience were conducted by a five-member research team. Analysis was informed by evidence-based frameworks for career resilience in the health professions as well as the National Association of Long-Term Care Administrator Boards' (NAB) five domains of competent administrative practice. Findings included six sources of work stressors and six sources of professional satisfaction. Also, participants identified seven strategic principles and 10 administrative practices for addressing major sources of stress. Recommendations are provided for research and evidence-based application of the career resilience perspective to LNFA practice aimed at reducing role abandonment and energizing the delivery of the quality of care that each resident deserves.
Brewer, Carol S; Kovner, Christine T; Djukic, Maja; Fatehi, Farida; Greene, William; Chacko, Thomas P; Yang, Yulin
To examine the effect of transformational leadership on early career nurses' intent to stay, job satisfaction and organizational commitment. Lack of leadership support is one of the top reasons staff nurses leave. Current studies reported mixed results about the impact of transformational leadership on key nurse outcomes. However, little is known whether leadership directly or indirectly affects satisfaction, organizational commitment and intent to stay. This study was a cross-sectional study of nurses who had been licensed for 7·5-8·5 years which was part of a 10-year longitudinal panel design. The analytic sample was 1037 nationally representative newly licensed Registered Nurses. Data were collected from January-March 2013. We used a probit model to model the relationship between transformational leadership and intent to stay, organizational commitment and job satisfaction. Transformational leadership did not have a significant impact on intent to stay and job satisfaction, but significantly associated with organizational commitment. Organizational commitment, job satisfaction, mentor support, promotional opportunities and age were positively associated with intent to stay, while ethnicity, non-local job opportunities and work settings were negatively associated with intent to stay. Transformational leadership had no direct relationship with intent to stay and job satisfaction and had a small direct positive effect on organizational commitment. Transformational leadership has potential to slow attrition and retain nurses by creating a positive work environment that supports nurses. Any improvement in job satisfaction and organizational commitment would positively increase the change in probability for intent to stay. © 2016 John Wiley & Sons Ltd.
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.
Kim, Eun-Young; Yeo, Jung Hee; Park, Hyunjeong; Sin, Kyung Mi; Jones, Cheryl B
Reality shock is a critical representation of the gap between nursing education and clinical practice and it is important to explore the level of reality shock among nurses. However, there is no relevant instrument to assess the level of reality shock in South Korea. The purpose of this is to determine the validity and reliability of the Korean version of the Environmental Reality Shock-Related Issues and Concerns instrument. A cross-sectional study design was used in this study. The data collection was conducted in selected 15 hospitals in South Korea. A convenience sample of 216 newly graduated nurses participated in the study. The Korean version of the Environmental Reality Shock-Related Issues and Concerns instrument was developed through the forward-backward translation technique, and revision based on feedback from expert groups. The internal consistency reliability was assessed using Cronbach's alpha, and the construct validity was determined via exploratory and confirmatory factor analysis. The Korean version of the Environmental Reality Shock-Related Issues and Concerns has reliable internal consistency (Cronbach's alpha=0.91). Exploratory factor analysis revealed five factors including job, relationships, expectations, private life, and performance, which explained 61.92% of variance. The factor loadings ranged from 0.451 to 0.832. The five-factor structure was validated by confirmatory factor analysis (RMR0.9). It was concluded that the Korean version of the Environmental Reality Shock-Related Issues and Concerns instrument has satisfactory construct validity and reliability to measure the reality shock of newly graduated nurses in South Korea. Copyright © 2017 Elsevier Ltd. All rights reserved.
Dong Gi Seo
Full Text Available Purpose The dimensionality of examinations provides empirical evidence of the internal test structure underlying the responses to a set of items. In turn, the internal structure is an important piece of evidence of the validity of an examination. Thus, the aim of this study was to investigate the performance of the DETECT program and to use it to examine the internal structure of the Korean nursing licensing examination. Methods Non-parametric methods of dimensional testing, such as the DETECT program, have been proposed as ways of overcoming the limitations of traditional parametric methods. A non-parametric method (the DETECT program was investigated using simulation data under several conditions and applied to the Korean nursing licensing examination. Results The DETECT program performed well in terms of determining the number of underlying dimensions under several different conditions in the simulated data. Further, the DETECT program correctly revealed the internal structure of the Korean nursing licensing examination, meaning that it detected the proper number of dimensions and appropriately clustered the items within each dimension. Conclusion The DETECT program performed well in detecting the number of dimensions and in assigning items for each dimension. This result implies that the DETECT method can be useful for examining the internal structure of assessments, such as licensing examinations, that possess relatively many domains and content areas.
Law, Bernice Yee-Shui; Chan, Engle Angela
To explore the process of learning to speak up in practice among newly graduated registered nurses. Speaking up is an important aspect of communication to ensure patient safety within a healthcare team. However, nurses have reported being hesitant about speaking up or being unable to be heard, despite adopting various safety tools. A power differential could be a factor in their hesitation to speak up. While a large number of new graduates are employed in the lower rungs of the hospital hierarchy to resolve local and global nursing shortages, the process of their learning to speak up remains under-explored. The narrative concept of experience is addressed through the three-dimensional space of a narrative inquiry. Eighteen new graduates were recruited. Stories of experiences of speaking up emerged naturally during repeated unstructured interviews and ongoing email conversations with three participants. The complex process of learning to speak up is schematically represented. Three interrelated narrative threads were identified: (1) learning to speak up requires more than one-off training and safety tools, (2) mentoring speaking up in the midst of educative and miseducative experiences and (3) making public spaces safe for telling secret stories. Speaking up requires ongoing mentoring to see new possibilities for sustaining professional identities in the midst of miseducative experiences under the potential shaping of the Chinese culture and generational differences. Appreciative inquiry might be a new approach that can be used to promote positive cultural changes to encourage newly graduated registered nurses to learn to speak up to ensure patient safety. Cultivating a safe and open culture of communication and mentoring new graduates to speak up will benefit patient safety now and in the future by helping to retain committed patient advocates who could mentor future generations. © 2015 John Wiley & Sons Ltd.
Cleary, Michelle; Horsfall, Jan; Mannix, Judy; O'Hara-Aarons, Maureen; Jackson, Debra
In this qualitative study, the experiences of a small cohort of registered nurses (RN) during the first 2 years of mental health employment were documented. A total of 13 semistructured interviews were completed from within a specialist mental health setting. Eleven issues were identified: (i) teamwork; (ii) experiential learning; (iii) self-development; (iv) confidence; (v) listening; (vi) rapport; (vii) keen observation; (viii) patience; (ix) empathy; (x) learning from colleagues; and (xi) maintaining a positive approach towards patients. The nurses focused on the here-and-now circumstances, rather than on future plans, or past preparation, and were able to elucidate the qualities and skills that they brought to their clinical work. Participants were most proud of achievements that bridged the personal and professional, such as self-development, working closely with patients to develop rapport, experiential learning, and teamwork. Findings highlight the importance of teamwork to newly-graduated RN entering the mental health environment. It is known that teamwork can convey a sense of belonging and help create an environment in which applied experiential clinical learning can occur. Therefore, it is important that efforts are made to facilitate team building and opportunities for teamwork when new graduates are transitioning into the mental health clinical practice environment. © 2011 The Authors; International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.
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.
Whitehead, Bill; Owen, Patricia; Henshaw, Lorraine; Beddingham, Elaine; Simmons, Maxine
Nurse education in the United Kingdom (UK) has been university based since the mid-1990s but despite careful preparation and assessment of student nurses it has been considered necessary to provide a period of additional support for newly qualified nurses (NQNs) to help them settle into their new role and responsibilities. Preceptorship is the process of supporting NQNs over the transition from student to registered nurse (RN) and it is recognised that this can be a difficult time for NQNs. A systematic review was conducted as part of this project and has been published in an earlier edition of Nurse Education Today (Whitehead et al, 2013). This suggests that preceptorship is a positive and essential experience for NQNs. Lincoln and Guba's Naturalistic Inquiry (1985) was used. A qualitative case study method was developed and consisted of a multi-stage approach including semi-structured interviews with key personnel; documentary analysis of preceptorship material; and focus groups with key actors. Ethical approval was attained for the project. The aim was to interpret the social phenomena and to produce an evidence based tool to improve preceptorship. Findings are grouped under the headings indicated by the research design. In addition a further 11 themes emerged, including: the need for specific time for preceptors and preceptees; formal recognition of the role and a culture of support; selection and preparation of preceptors and the management structure to support preceptorship. The findings indicate that there are a range of factors which are reported to affect the successful transition from student to NQN. Based on these factors recommendations are made for practice and for further research. Practice recommendations: to provide supported preceptorship following the recommendations of the research findings. to concentrate on enhancing preceptorship as preceptorship in any form is better than none. Copyright © 2015 Elsevier Ltd. All rights reserved.
Edwards, Deborah; Hawker, Clare; Carrier, Judith; Rees, Colin
Background: The transition period from student to newly qualified nurse where nurses are adjusting to their new role and consolidating their knowledge and skills can be stressful. It is a time when many newly qualified nurses are left feeling inadequately prepared. A variety of strategies to ease the transition process have been reported, which aim to increase confidence, competence, sense of belonging of new graduates, improve recruitment and retention and reduce turnover costs. To synthesise the best available evidence on the effectiveness of support strategies and interventions aimed for newly qualified nurses. A comprehensive search was undertaken on major electronic databases to identify both published and unpublished studies from 2000 to the present date. Reference lists of retrieved papers were searched and authors contacted. Only quantitative studies published in English language were considered.Methodological quality and data extraction: Two reviewers independently assessed methodological quality and extracted data from the included studies. A third reviewer resolved any disagreements through discussion. The review did not identify comparable Randomised Controlled Trials (RCTs), and as such meta-analysis of the data was not appropriate. The data extracted from the included studies were synthesized into a narrative summary. Thirty three studies were included in the review: RCT (1), Quasi-experimental (3) and observational/descriptive studies (29). Countries of origin were: USA (25), Australia (4), England (2), New Zealand (1) and Thailand (1). Studies were categorised according to the type of programme or support strategy provided: nurse internship/residency programmes (14) and graduate nurse orientation programmes (7), preceptorship (4), simulation (3) and mentoring (2), final year nursing students transition programs (2) and externship (1).Outcomes were categorised as being important to the employer (recruitment, retention, turnover rates, competence
Gerontological nursing (the care of the elderly) as a specialization for registered nurses, licensed practical nurses, and nursing aides is discussed with respect to training and qualifications, employment outlook, and earnings for each group. (JT)
Park, Mihyun; Lee, Ji Yun; Cho, Sung-Hyun
The purposes of this study are to examine differences in job satisfaction among professional groups including nurses, allied hospital professionals, social workers, and elementary school teachers, and to identify specific characteristics of job satisfaction of nurses. The study design was a cross-sectional exploratory study using secondary data analysis with the 2009 Graduates Occupational Mobility Survey. The sample was female new graduates. The differences in job satisfaction among professional groups were analyzed using logistic regression (satisfied vs. not satisfied). Overall, 41.5% of nurses, 50.1% of allied hospital professionals, 58.2% of social workers, and 89% of elementary school teachers were satisfied with their job. Nurses were significantly less satisfied than the other professionals in 5 of the 11 job characteristics and had the lowest odds ratio (OR) when compared with elementary school teachers: work content (OR = 0.197, 95% CI [0.128, 0.304]), physical work environment (OR = 0.353, 95% CI [0.236, 0.529]), working hours (OR = 0.054, 95% CI [0.033, 0.088]), personal growth (OR = 0.242, 95% CI [0.160, 0.366]), and autonomy (OR = 0.188, 95% CI [0.123, 0.288]). Work content, physical work environment, interpersonal relationship, advancement system, and autonomy were significantly associated with the overall job satisfaction of nurses. Relatively dissatisfying job characteristics in nursing work environment that were significant predictors for nurses' job satisfaction should be improved. Newly graduated nurses are at risk for job dissatisfaction. This can result in high turnover rates and can exacerbate the nursing shortage. Efforts to improve the work environment are needed. Copyright © 2012. Published by Elsevier B.V.
Usually newly employed nurses find adjusting to a work setting a challenging experience. Their successful adaptation to their work situation is greatly influenced by the socialisation process inherent in the organisational culture. The newly employed nurse often finds that the norms are unclear, confusing and restrictive.
As newly graduated associate degree nurses (ADN) and baccalaureate degree nurses (BSN) enter into the workforce, they must be equipped to care for a complex patient population; therefore, the purpose of this study was to address the practice expectations and clinical competency of new nurses as perceived by nurse preceptors and nurse managers.…
Full Text Available A newly dead cadaver simulation is practiced on the physical remains of the dead before the onset of rigor mortis. This technique has potential benefits for providing real-life in-situ experience for novice providers in health care practices. Evolving ethical views in health care brings into question some of the ethical aspects associated with newly dead cadaver simulation in terms of justification for practice, autonomy, consent, and the need of disclosure. A clear statement of policies and procedures on newly dead cadaver simulation has yet to be implemented. Although there are benefits and disadvantages to an in-situ cadaver simulation, such practices should not be carried out in secrecy as there is no compelling evidence that suggests such training as imperative. Secrecy in these practices is a violation of honor code of nursing ethics. As health care providers, practitioners are obliged to be ethically honest and trustworthy to their patients. The author explores the ethical aspects of using newly dead cadaver simulation in training novice nursing providers to gain competency in various lifesaving skills, which otherwise cannot be practiced on a living individual. The author explores multiple views on cadaver simulation in relation to ethical theories and practices such as consent and disclosure to family.
Kiljunen, Outi; Välimäki, Tarja; Kankkunen, Päivi; Partanen, Pirjo
People living in care and nursing homes are vulnerable individuals with complex needs; therefore, a wide array of nursing competence is needed to ensure their well-being. When developing the quality of care in these units, it is essential to know what type of competence is required for older people nursing. The aim of this integrative review was to identify the competence needed for older people nursing in licensed practical nurses' and registered nurses' work in care and nursing homes. Integrative literature review. We performed an integrative review using Whittemore and Knafl's method. The CINAHL, MEDLINE, PsycINFO, SocINDEX and Scopus databases were searched for studies published from 2006 to April 2016. We assessed the quality of the studies using Joanna Briggs Institute critical appraisal tools and analysed the data by applying qualitative content analysis. Ten articles were included in the review. Most of the studies focused on registered nurses' work. We identified five competence areas that are needed for older people nursing in registered nurses' work in care and nursing homes: attitudinal and ethical, interactional, evidence-based care, pedagogical, and leadership and development competence. Empirical evidence of competence requirements related to licensed practical nurses' work in these facilities was scarce. The competence required for registered nurses and licensed practical nurses should be clearly identified to support competence management in the care and nursing home context. Well-educated nursing staff are needed in care and nursing homes to provide high-quality care because comprehensive and advanced nurse competence is required to meet the needs of older people. © 2016 John Wiley & Sons Ltd.
Wadson, Kelley; Phillips, Leah Adeline
Although information literacy skills are recognized as important to the curriculum and professional outcomes of two-year nursing programs, there is a lack of research on the information literacy skills and support needed by graduates. To identify the information literacy skills and consequent training and support required of Licensed Practical Nurses (LPNs) in Alberta, Canada. An online survey using a random sample of new graduates (graduated within 5 years) from the registration database of the College of Practical Nurses of Alberta (CLPNA). There was a 43% response rate. Approximately 25-38% of LPNs felt they were only moderately or to a small extent prepared to use evidence effectively in their professional practice. LPNs use the internet and websites most frequently, in contrast to library resources that are used least frequently. Developing lifelong learning skills, using information collaboratively, and locating and retrieving information are areas where LPNs desire more effective or increased training. The results suggest there are significant gaps in the preparedness and ability of LPNs to access and apply research evidence effectively in the workplace. There are several areas in which the training provided by Librarians appears either misaligned or ineffective. © 2018 Health Libraries Group.
Kramer, Marlene; Maguire, Pat; Halfer, Diana; Budin, Wendy C; Hall, Debra S; Goodloe, Lauren; Klaristenfeld, Jessica; Teasley, Susan; Forsey, Lynn; Lemke, Johanna
Residency programs for newly licensed registered nurses (NLRNs) have been strongly advocated by the Institute of Medicine, American Organization of Nurse Executives, and other professional organizations. Their cost-effectiveness as well as their impact on NLRN retention, job and practice satisfaction, improved performance, and reduction in environmental reality shock has been demonstrated. This qualitative study sought answers to the question: what people, components, processes and activities of Nurse Residency Programs (NRPs), and the work environment are instrumental in the transition and integration of NLRNs into the professional practice role and into professional communities? In the course of interviewing 907 nurses-NLRNs, experienced nurses, managers, and educators-practicing on clinical units with confirmed "very healthy work environments" in 20 Magnet hospitals, it became evident that not only did NRPs positively impact the professional socialization of NLRNs, they led to transformative changes in the organization and in the practice of other health care professionals. The organizational transformative changes described by the interviewees are presented for each of the 7 major challenges identified by NLRNs-delegation, prioritization, managing patient care delivery, autonomous decision-making, collaboration with other disciplines, constructive conflict resolution, and utilizing feedback to restore self-confidence. If it can be demonstrated that these transformative changes stimulated by NRPs also lead to improved patient outcomes, NRPs may be the most significant organization transformation instituted by nurse leaders in recent years.
Numminen, Olivia; Leino-Kilpi, Helena; Isoaho, Hannu; Meretoja, Riitta
To study the relationships between newly graduated nurses' (NGNs') perceptions of their professional competence, and individual and organizational work-related factors. A multivariate, quantitative, descriptive, correlation design was applied. Data collection took place in November 2012 with a national convenience sample of 318 NGNs representing all main healthcare settings in Finland. Five instruments measured NGNs' perceptions of their professional competence, occupational commitment, empowerment, practice environment, and its ethical climate, with additional questions on turnover intentions, job satisfaction, and demographics. Descriptive statistics summarized the demographic data, and inferential statistics multivariate path analysis modeling estimated the relationships between the variables. The strongest relationship was found between professional competence and empowerment, competence explaining 20% of the variance of empowerment. The explanatory power of competence regarding practice environment, ethical climate of the work unit, and occupational commitment, and competence's associations with turnover intentions, job satisfaction, and age, were statistically significant but considerably weaker. Higher competence and satisfaction with quality of care were associated with more positive perceptions of practice environment and its ethical climate as well as higher empowerment and occupational commitment. Apart from its association with empowerment, competence seems to be a rather independent factor in relation to the measured work-related factors. Further exploration would deepen the knowledge of this relationship, providing support for planning educational and developmental programs. Research on other individual and organizational factors is warranted to shed light on factors associated with professional competence in providing high-quality and safe care as well as retaining new nurses in the workforce. The study sheds light on the strength and direction of
Foronda, Cynthia L; Alfes, Celeste M; Dev, Parvati; Kleinheksel, A J; Nelson, Douglas A; OʼDonnell, John M; Samosky, Joseph T
Augmented reality and virtual simulation technologies in nursing education are burgeoning. Preliminary evidence suggests that these innovative pedagogical approaches are effective. The aim of this article is to present 6 newly emerged products and systems that may improve nursing education. Technologies may present opportunities to improve teaching efforts, better engage students, and transform nursing education.
Zhang, Yuanyuan; Qian, Yan; Wu, Juemin; Wen, Fule; Zhang, Yaqing
Newly graduated nurses suffer from occupational stress during the transition from school to employment as a result of inadequacy, interpersonal relationships, and the overwhelming workload. Mentoring programs have proved effective in facilitating this transition. To evaluate the effectiveness of a mentoring program on the mentor, mentee, and organization. The Cochrane Library, Medline, Ovid, Elsevier, Embase, CINAHL, CBM, CNKI, and WanFang Data databases were searched to identify relevant publications in English or Chinese up to October 2014. This is a systematic review. This review identified nine potentially eligible studies, and the methodological quality levels of the included studies were all ranked as level B. These studies revealed that the turnover rate can be decreased through a mentoring program. Additionally, mentoring can enhance nursing competency and establish a supportive workforce environment, resulting in positive outcomes. This review reveals that a mentoring program has positive effects on the mentors, mentees, and organizations. A successful mentorship program should include rigorous mentor selection and adequate training. Additionally, potential barriers such as time constraints and scheduling limitations should be taken into consideration during implementation. Copyright © 2015 Elsevier Ltd. All rights reserved.
Sauer, Penny A; McCoy, Thomas P
Workplace bullying has been experienced by 27% to 80% of nurses who have participated in studies. Bullying behaviors negatively impact the health of nurses. This study examined whether nurses' resilience had an impact on the effects of bullying on the nurse's health. This cross-sectional descriptive study surveyed licensed registered nurses in one state. The sample ( N = 345) was predominately female (89%) and Caucasian (84%), with an average age of 46.6 years. In this sample, 40% of nurses were bullied. Higher incidence of bullying was associated with lower physical health scores ( p = .002) and lower mental health scores ( p = .036). Nurses who are bullied at work experience lower physical and mental health, which can decrease the nurses' quality of life and impede their ability to deliver safe, effective patient care.
Full Text Available To test the applicability of item response theory (IRT to the Korean Nurses' Licensing Examination (KNLE, item analysis was performed after testing the unidimensionality and goodness-of-fit. The results were compared with those based on classical test theory. The results of the 330-item KNLE administered to 12,024 examinees in January 2004 were analyzed. Unidimensionality was tested using DETECT and the goodness-of-fit was tested using WINSTEPS for the Rasch model and Bilog-MG for the two-parameter logistic model. Item analysis and ability estimation were done using WINSTEPS. Using DETECT, Dmax ranged from 0.1 to 0.23 for each subject. The mean square value of the infit and outfit values of all items using WINSTEPS ranged from 0.1 to 1.5, except for one item in pediatric nursing, which scored 1.53. Of the 330 items, 218 (42.7% were misfit using the two-parameter logistic model of Bilog-MG. The correlation coefficients between the difficulty parameter using the Rasch model and the difficulty index from classical test theory ranged from 0.9039 to 0.9699. The correlation between the ability parameter using the Rasch model and the total score from classical test theory ranged from 0.9776 to 0.9984. Therefore, the results of the KNLE fit unidimensionality and goodness-of-fit for the Rasch model. The KNLE should be a good sample for analysis according to the IRT Rasch model, so further research using IRT is possible.
Lerner, Nancy B; Johantgen, Meg; Trinkoff, Alison M; Storr, Carla L; Han, Kihye
To examine CNA and licensed nurse (RN+LPN/LVN) turnover in relation to numbers of deficiencies in nursing homes. A secondary data analysis of information from the National Nursing Home Survey (NNHS) and contemporaneous data from the Online Survey, Certification and Reporting (OSCAR) database. Data were linked by facility as the unit of analysis to determine the relationship of CNA and licensed nurse turnover on nursing home deficiencies. The 2004 NNHS used a multistage sampling strategy to generate a final sample of 1174 nursing homes, which represent 16,100 NHs in the United States. This study focused on the 1151 NNHS facilities with complete deficiency data. Turnover was defined as the total CNAs/licensed nurse full-time equivalents (FTEs) who left during the preceding 3 months (full- and part-time) divided by the total FTE. NHs with high turnover were defined as those with rates above the 75th percentile (25.3% for CNA turnover and 17.9% for licensed nurse turnover) versus all other facilities. This study used selected OSCAR deficiencies from the Quality of Care, Quality of Life, and Resident Behavior categories, which are considered to be more closely related to nursing care. We defined NHs with high deficiencies as those with numbers of deficiencies above the 75th percentile versus all others. Using SUDAAN PROC RLOGIST, we included NNHS sampling design effects and examined associations of CNA/licensed nurse turnover with NH deficiencies, adjusting for staffing, skill mix, bed size, and ownership in binomial logistic regression models. High CNA turnover was associated with high numbers of Quality of Care (OR 1.53, 95% CI 1.10-2.13), Resident Behavior (OR 1.42, 95% CI 1.03-1.97) and total selected deficiencies (OR 1.54, 95% CI 1.12-2.12). Licensed nurse turnover was significantly related to Quality of Care deficiencies (OR 2.06, 95% CI 1.50-2.82) and total selected deficiencies (OR 1.71, 95% CI 1.25-2.33). When both CNA turnover and licensed nurse turnover were
Allers, Katharina; Hoffmann, Falk
The proportion of deaths occurring in nursing homes is increasing and end of life hospitalizations in residents are common. This study aimed to obtain the time from nursing home admission to death and the frequency of hospitalizations prior to death among residents with and without dementia. This retrospective cohort study analyzed claims data of 127,227 nursing home residents aged 65 years and older newly admitted to a nursing home between 2010 and 2014. We analyzed hospitalizations during the last year of life and assessed mortality rates per 100 person-years. Factors potentially associated with time to death were analyzed in Cox proportional hazard models. The median time from nursing home admission to death was 777 and 635 days in residents with and without dementia, respectively. Being male, older age and a higher level of care decreased the survival time. Sex and age had a higher influence on survival time in residents with dementia, whereas level of care was found to have a higher influence in residents without dementia. Half of the residents of both groups were hospitalized during the last month and about 37% during the last week before death. Leading causes of hospitalizations were infections (with dementia: 20.6% vs. without dementia: 17.2%) and cardiovascular diseases (with dementia: 16.6% vs. without dementia: 19.0%). A high proportion of residents with and without dementia are hospitalized shortly before death. There should be an open debate about the appropriateness of hospitalizing nursing home residents especially those with dementia near death.
Garee, Denise L.
Ethical decision making of new nurses relies on professional values and moral development obtained during training. This descriptive, comparative study demonstrated the importance values attributed to the items of the Nurses' Professional Values Scale-Revised (Weis & Schank, 2009), by a sample of senior ADN and BSN students from across the…
Kapaale, Chaluza C
Perioperative nursing is faced with a staffing crisis attributed in part to minimal numbers of newly graduated nurses choosing a career in this specialty. This article analyzes and applies the concept of value to explore how to maintain an adequate perioperative nursing workforce; recruit newly graduated nurses; and encourage career professional, nurse educator, and student collaboration to generate meaningful value for perioperative nursing. This analysis revealed that value co-creation for perioperative nursing could lead to newly graduated nurses increasingly choosing perioperative nursing as a career, and enjoying satisfying perioperative nursing careers while providing high-quality patient care. © AORN, Inc, 2018.
H2 was the best selection generation for traits with high heredity ability, and H3 was the best selection for grain traits and yield test. Consequently, we bred and licensed six new wheat varieties derived from anther culture and significantly reduced breeding time to three to five years. Huapei 8 was the newest released wheat ...
MOLINARI, RALPH G.; AND OTHERS
COMPARISON OF THE COMPOSITION, CHARACTERISTICS, AND CURRENT LICENSING PRACTICES OF STATE LICENSING BOARDS FOR EDUCATIONAL ADMINISTRATION WITH LICENSING PROGRAMS FOR SEVEN OTHER PROFESSIONS, (ACCOUNTANCY, ARCHITECTURE, DENTISTRY, ENGINEERING, LAW, MEDICINE, AND NURSING) WAS THE PURPOSE OF THIS NATIONWIDE STUDY. THE RESEARCH PROCEDURES WERE DIVIDED…
Kaltoft, Mette Kjer
All healthcare visions, including that of The TIGER (Technology-Informatics-Guiding-Educational-Reform) Initiative envisage a crucial role for nursing. However, its 7 descriptive pillars do not address the disconnect between Nursing Informatics and Nursing Ethics and their distinct communities......-of-(care)-decision. Increased pressure for translating 'evidence-based' research findings into 'ethically-sound', 'value-based' and 'patient-centered' practice requires rethinking the model implicit in conventional knowledge translation and informatics practice in all disciplines, including nursing. The aim is to aid 'how...... nurses and other health care scientists more clearly identify clinical and other relevant data that can be captured to inform future comparative effectiveness research. 'A prescriptive, theory-based discipline of '(Nursing) Decisionics' expands the Grid for Volunteer Development of TIGER's newly launched...
Jones, Terry; Heui Bae, Sung; Murry, Nicole; Hamilton, Patti
This article describes the evolution of mandated nurse staffing committees in Texas from 2002 to 2009 and presents a study that analyzed nurse staffing trends in Texas using a secondary analysis of hospital staffing data (N = 313 hospitals) from 2000 to 2012 obtained from the American Hospital Association Annual Survey. Nurse staffing patterns based on three staffing variables for registered nurses (RNs), licensed vocational nurses (LVNs), and total licensed nurses were identified: full-time equivalents per 1,000 adjusted patient days, productive hours per adjusted patient day, and RN skill mix. Similar to national trends between 2000 and 2012, most Texas hospitals experienced an increase in RN and total nurse staffing, decrease in LVN staffing, and an increase in RN skill mix. The magnitude of total nurse staffing changes in Texas (5% increase) was smaller than national trends (13.6% increase). Texas's small, rural, government hospitals and those with the highest preregulation staffing levels experienced the least change in staffing between 2000 and 2012: median change of 0 to .13 full-time equivalents per 1,000 adjusted patient days and median change in productive hours per patient day of 0 to .23. The varying effects of staffing committees in different organizational contexts should be considered in future staffing legislative proposals and other policy initiatives. © The Author(s) 2015.
Hall, Linda McGillis; Peterson, Jessica; Sheri, Sheri; Andrews, Gavin; Lalonde, Michelle; Harris, Alexandra; MacDonald-Rencz, Sandra
The internal migration of nurses within Canada has had limited study. This paper reports the results of a survey of registered nurses and licensed practical nurses who had migrated between the provinces and territories in Canada. Factors contributing to internal nurse mobility included seeking full-time work, opportunities for career advancement and flexible scheduling options. Few nurses received incentives to move between the provinces/territories to work. A number of challenges with internal migration are identified, including complexities related to licensing and limitations in available job information. Implications for nursing health human resources policy related to nurse retention in Canada are identified and discussed.
Mack, Deborah S; Hunnicutt, Jacob N; Jesdale, Bill M; Lapane, Kate L
Racial disparities in pain management persist across health care settings and likely extend into nursing homes. No recent studies have evaluated racial disparities in pain management among residents with cancer in nursing homes at time of admission. Using a cross-sectional study design, we compared reported pain and pain management between non-Hispanic White and non-Hispanic Black newly admitted nursing home residents with cancer (n=342,920) using the de-identified Minimum Data Set version 3.0. Pain management strategies included the use of scheduled analgesics, pro re nata analgesics, and non-pharmacological methods. Presence of pain was based on self-report when residents were able, and staff report when unable. Robust Poisson models provided estimates of adjusted prevalence ratios (aPR) and 95% CIs for reported pain and pain management strategies. Among nursing home residents with cancer, ~60% reported pain with non-Hispanic Blacks less likely to have both self-reported pain (aPR [Black versus White]: 0.98, 95% CI: 0.97-0.99) and staff-reported pain (aPR: 0.89, 95% CI: 0.86-0.93) documentation compared with Non-Hispanic Whites. While most residents received some pharmacologic pain management, Blacks were less likely to receive any compared with Whites (Blacks: 66.6%, Whites: 71.1%; aPR: 0.98, 95% CI: 0.97-0.99), consistent with differences in receipt of non-pharmacologic treatments (Blacks: 25.8%, Whites: 34.0%; aPR: 0.98, 95 CI%: 0.96-0.99). Less pain was reported for Black compared with White nursing home residents and White residents subsequently received more frequent pain management at admission. The extent to which unequal reporting and management of pain persists in nursing homes should be further explored.
Faustine K. Nkulu Kalengayi
Full Text Available Background: Screening newly arrived migrants from countries with high burden of communicable diseases of public health significance is part of the Swedish national strategy against the spread of these diseases. However, little is known about its implementation. Objective: This study aimed at exploring caregivers’ experiences in screening newly arrived migrants to generate knowledge that could inform policy and clinical practice. Design: Using an interpretive description framework, we conducted semistructured interviews between November and December 2011 in four Swedish counties, with 15 purposively selected nurses with experience in screening migrants. Data were analyzed using thematic analysis. Results: Participants described a range of challenges including discordant views between migrants and the nurses about medical screening, inconsistencies in rules and practices, and conflicting policies. Participants indicated that sociocultural differences resulted in divergent expectations with migrants viewing the participants as agents of migration authorities. They also expressed concern over being given a new assignment without training and being expected to share responsibilities with staff from other agencies without adequate coordination. Finally, they indicated that existing policies can be confusing and raise ethical issues. All these were compounded by language barriers, making their work environment extremely complex and stressful. Conclusions: These findings illuminate complex challenges that could limit access to, uptake, and delivery of health screening and undermine public health goals, and highlight the need for a multilevel approach. This entails avoiding the conflation of migration with health issues, harmonizing existing policies to make health care services more accessible and acceptable to migrants, and facilitating health professionals’ work in promoting public health, improving interagency collaboration and the skills of all
Goodwin, Miki; Candela, Lori
The aim of this qualitative study was to explore if newly practicing nurses benefited from learning holistic comfort theory during their baccalaureate education, and to provide a conceptual framework to support the transition from school to practice. The study was conducted among graduates of an accelerated baccalaureate nursing program where holistic comfort theory was embedded as a learner-centered philosophy across the curriculum. A phenomenological process using van Manen's qualitative methodology in education involving semi-structured interviews and thematic analysis was used. The nurses recalled what holistic comfort meant to them in school, and described the lived experience of assimilating holistic comfort into their attitudes and behaviors in practice. Themes were established and a conceptual framework was developed to better understand the nurses' lived experiences. Results showed that holistic comfort was experienced as a constructive approach to transcend unavoidable difficulties during the transition from school to practice. Participants described meaningful learning and acquisition of self-strengthening behaviors using holistic comfort theory. Holistic comfort principles were credited for easing nurses into the realities of work and advocating for best patient outcomes. Patient safety and pride in patient care were incidental positive outcomes. The study offers new insights about applying holistic comfort to prepare nurses for the realities of practice. Copyright © 2012 Elsevier Ltd. All rights reserved.
Missen, Karen; McKenna, Lisa; Beauchamp, Alison; Larkins, Jo-Ann
Evidence from the literature and anecdotally from clinical settings suggests that newly graduated nurses are not fully prepared to be independent practitioners in healthcare settings. The aim of this study was to explore perceptions of qualified nurses in relation to the practice readiness of newly registered nursing graduates and determine whether these views differ according to specific demographic characteristics, clinical settings, and geographical locations. A descriptive quantitative design was used. An online survey tool was used to assess how qualified nurses (n=201) in Victoria, Australia, rated newly graduated nurses' abilities on 51 individual clinical skills/competencies in eight key skill areas. A composite score was calculated for each skill area and a comparative analysis was undertaken on the various cohorts of participants according to their demographic and clinical characteristics using one-way ANOVA and post hoc tests. Newly graduated nurses were found to be lacking competence in two key skill areas and were rated as performing adequately in the remaining six skill areas assessed. Significant differences (p≤0.05) in performance were found according to the age of the nurse, number of years registered, the educational setting in which they undertook their nurse education, their role, and the clinical area in which they worked. There were no significant differences according to whether the nurse worked in the private or public healthcare sector. Few differences were found between nurses working in a metropolitan vs. regional/rural healthcare setting. This is the first study to quantify the scale of this problem. Our findings serve as a reference for both nurse education providers and healthcare settings in better preparing nursing graduates to be competent, safe practitioners in all clinical areas. Copyright © 2016 Elsevier Ltd. All rights reserved.
Mikolaitchouk, H.; Bogdan, L.; Steinberg, N.
In the former USSR, unlike most countries, radioactive waste management activities including waste disposal needed no license. But after the USSR breakdown the Ukrainian Parliament -- Verkhovna Rada -- invoked the revised Law on Business activities. According to Article 4 of the Law, in order to treat or to dispose radioactive waste every enterprise has to get a special permission or license. In compliance with the Law, the Cabinet of Ministers by its Ordinance of January 13, 1993, authorized the Ukrainian State Committee for Nuclear and Radiation Safety (UkrSCNRS) to issue special permissions or licenses for waste treatment and disposal. And that requirement was valid not only for future activities but also for existing facilities in operation. Taking into account the undergoing legislative process, SCNRS began to develop its licensing process without waiting for the special nuclear laws to be passed. On the basis of the legislation already in effect, first of all the Law on Enterprises (full responsibility of enterprises for their activities) and Law on Business activities (requirement to have a license for special types of activities), the newly formed national regulatory body had to identify all the enterprises that needed to be licensed, to establish relevant procedures, to develop related regulatory documents, to implement these procedures and documents at operating enterprises, and for each case to make a decision concerning feasibility of issuing a license, period of validity and license conditions
Full Text Available Abstract Background The Longitudinal Analysis of Nursing Education (LANE study was initiated in 2002, with the aim of longitudinally examining a wide variety of individual and work-related variables related to psychological and physical health, as well as rates of employee and occupational turnover, and professional development among nursing students in the process of becoming registered nurses and entering working life. The aim of this paper is to present the LANE study, to estimate representativeness and analyse response rates over time, and also to describe common career pathways and life transitions during the first years of working life. Methods Three Swedish national cohorts of nursing students on university degree programmes were recruited to constitute the cohorts. Of 6138 students who were eligible for participation, a total of 4316 consented to participate and responded at baseline (response rate 70%. The cohorts will be followed prospectively for at least three years of their working life. Results Sociodemographic data in the cohorts were found to be close to population data, as point estimates only differed by 0-3% from population values. Response rates were found to decline somewhat across time, and this decrease was present in all analysed subgroups. During the first year after graduation, nearly all participants had qualified as nurses and had later also held nursing positions. The most common reason for not working was due to maternity leave. About 10% of the cohorts who graduated in 2002 and 2004 intended to leave the profession one year after graduating, and among those who graduated in 2006 the figure was almost twice as high. Intention to leave the profession was more common among young nurses. In the cohort who graduated in 2002, nearly every fifth registered nurse continued to further higher educational training within the health professions. Moreover, in this cohort, about 2% of the participants had left the nursing
Laschinger, Heather K Spence
To describe new graduate nurses' worklife experiences in Ontario hospital settings in the first 2 years of practice and to examine predictors of job and career satisfaction and turnover intentions. With a large cohort of nurses approaching retirement, every effort must be made to ensure that the work environments of new graduate nurses are positive, promoting job satisfaction and commitment to the profession to address the nursing workforce shortage. A cross-sectional analysis of data from a mail survey of new graduate nurses (n=342) in their first and second year of experience was used to address the research objectives. Overall, new graduate nurses were positive about their working conditions and there were few differences between nurses in their first and second years of practice. Structural and personal factors explained significant amounts of variance (31-68%) in both job and career satisfaction and turnover intentions. Empowerment, work engagement and burnout were important significant predictors. Modifiable workplace factors play an important role in influencing new graduates' job and career satisfaction and turnover intentions. Managers can employ strategies to enhance quality work environments that promote retention of new graduates and lessen the nursing workforce shortage. © 2011 Blackwell Publishing Ltd.
Tominaga, Maki T; Miki, Akiko
The early resignation of newly graduated nurses (NGNs) will become a concern in Japan as the need for nurses increases. The aim of this study was to conduct an investigation using the Effort-Reward Imbalance (ERI) questionnaire to examine the effect of stressful experiences in the work environment and over-commitment on NGNs' intention to leave and to identify the factors that were associated with their intention to leave, clarifying the appropriate times at which to conduct interventions to prevent NGNs from leaving advanced-treatment hospitals. Anonymous self-administered questionnaires were distributed to all the NGNs (n = 1364) in 14 advanced-treatment university hospitals. Questionnaires with no missing data were returned by 737 NGNs (54%). For the development of the questionnaire, we designed a framework that consisted of the factors that occur during three stages of the NGNs' transition into the workplace. The questions addressed items for individual attributes, employment and organizational characteristics, the Role Model Scale, the ERI questionnaire, two scale items for health status, and the intention to leave. In order to determine the factors that related to the dependent variables, hierarchical multiple linear regression analyses were carried out. We revealed that effort, subjective health status, role models, and effort were important factors that related to the NGNs' intention to leave, as well as their age and city size. Over-commitment and reward were not significant factors. We also found that three subscales of the Job Readiness Scale independently related to the NGNs' intention to leave. These findings can help employers, supervisors, and senior staff of advanced-treatment university hospitals in Japan to improve their work environment in order to benefit NGNs and aid in their retention. © 2010 The Authors. Japan Journal of Nursing Science © 2010 Japan Academy of Nursing Science.
Wallston, Barbara Strudler; And Others
Examined whether sex-role stereotypes would affect nurses' (N=32) attitudes toward simulations of male and female patients. Emotional style and patients' diagnosis were manipulated. Results showed significant sex-role differences and stereotypical attitudes. Male patients were rated more positively, and were more likely to possess traditional male…
Wheeler, R M; Foster, J W; Hepburn, K W
US healthcare facilities have addressed nursing shortages in part by recruiting internationally educated nurses (IENs), and studies suggest IENs may make up a significant percentage of the nursing workforce in urban hospitals. Despite the economic recession of 2008-2012, international nurse migration is expected to continue. Little is known about IENs in the southeastern USA, and no studies have compared their perspectives to those of their US counterparts. The purpose of this study was to gain a deeper understanding about the experiences of IENs compared to those of US registered nurses (RNs) practising in two urban hospitals in southeastern USA. This study involved two rounds of semi-structured interviews of 82 IENs and US RNs. Interviews focused on themes relating to education, barriers to practice, intent to stay in nursing and IENs' migration experiences. Most IENs interviewed migrated to the USA after 1990 to join their family and do not plan to return to their home countries to practise. Most IENs initially received their Associate Degree in Nursing; many have obtained their Bachelor of Science in Nursing degree. IENs and newly licensed US RNs faced similar barriers when they began practising in the USA, but IENs faced additional challenges adjusting to the attitudes of US patients, the perceived lack of respect for nurses and delivering total patient care. IENs would benefit from orientation regarding the cultural differences in the USA. In other ways, their challenges are similar to those of US RNs; policies regarding education, recruitment and retention could target both groups together. © 2013 The Authors. International Nursing Review © 2013 International Council of Nurses.
Full Text Available Objective: To verify if licensed practical nurses and Nursing technicians working at an Oncology department present burnout syndrome. Methods: Data of 21 licensed practical nurses and Nursing technicians who had worked for, at least, one year at the Oncology department of a large hospital in the city of São Paulo, Brazil, were collected. The burnout inventory developed by Maslach and Jackson was used. Rresults: The studied population presented burnout based on scores in each of its three dimensions: emotional exhaustion, depersonalization and lack of personal accomplishment. As to burnout symptoms, this study showed that 28.6% of the sample presented high scores in “emotional exhaustion”; 28.6% had high scores in “depersonalization” and 19.1% in lack of “personal accomplishment”. Cconclusions: When compared to other studies with nurses, this sample presented greater burnout.
Maíra Aguiar; Nico Stollenwerk; Scott B Halstead
Background With approximately 3 billion people at risk of acquiring the infection, dengue fever is now considered the most important mosquito-borne viral disease in the world, with 390 million dengue infections occurring every year, of which 96 million manifest symptoms with any level of disease severity. Treatment of uncomplicated dengue cases is only supportive and severe dengue cases require hospital intensive care. A vaccine now licensed in several countries and developed by Sanofi Pasteu...
Rubin, Gerald; Balaji, Rengarajan V; Barcikowski, Robert
The aims of this study were: (1) to identify barriers to nurse/nursing aide communication and to discuss and provide solutions to some of these problems through a focus group; and (2) to determine the effectiveness of this focus group on job satisfaction-related outcomes. Numerous studies have attributed problems with nurse staffing and turnover to faulty communication between nursing supervisors and nursing aides. Registered nurses (RNs) (n = 2), licensed practical nurses (LPNs) (n = 10) and nursing aides (n = 19) were interviewed; narrative themes from the interviews were then used to guide focus group discussions. A job satisfaction survey in a pre-test/post-test fashion was used to test the efficacy of the focus group. Qualitative data from the interviews highlighted: (1) anger and condescension in communication; and (2) lack of mentoring, empathy and respect. The job satisfaction survey data showed that the attitudes decreased significantly among participants in the focus group but not in the control group (P communication and collegiality, thereby reducing job turnover in nursing homes.
Jang, Chansu; Um, Kilsup; Choi, Jaedon
KNF is developing a new design methodology on the Non-LOCA analysis for the licensing purpose. The code chosen is the best-estimate transient analysis code RETRAN and the OPR1000 is aimed as a target plant. For this purpose, KNF prepared a simple nodal scheme appropriate to the licensing analyses and developed the designer-friendly analysis tool ASSIST (Automatic Steady-State Initialization and Safety analysis Tool). To check the validity of the newly developed methodology, the single CEA withdrawal and the locked rotor accidents are analyzed by using a new methodology and are compared with current design results. Comparison results show a good agreement and it is concluded that the new design methodology can be applied to the licensing calculations for OPR1000 Non-LOCA
Habeck, M.; Minkov, V.; Griebel, J.; Brix, G.; Epsch, R.; Langer, M.
This publication outlines the 'medical research' licensing procedure as specified in the amendment of the German Radiation Protection Ordinance of November 1, 2011. The general licensing requirements for the use of radiation have not been changed by the amendment. Three so-called use restrictions (i.e., dose limits of 10 mSv and 20 mSv, age limit of 50 years) have been modified. They will only apply to healthy volunteers in the future. In addition, there are considerable simplifications with respect to applications and licensing procedures of the Federal Office for Radiation Protection (Bundesamt fuer Strahlenschutz, BfS) regarding the use of radiation in the newly introduced 'accompanying diagnostics' ('Begleitdiagnostik') case group. The newly established, independent panel of experts at the German Radiological Society (Deutsche Roentgengesellschaft, DRG) may provide essential support to principal investigators, qualified physicians and sponsors for differentiating between 'medical research' and 'health care', the latter not being subject to licensing. An expert statement will be issued by the DRG within four weeks of an inquiry. This consulting service is subject to confidentiality, and is free of charge for inquirers and without any commitment. (orig.)
Newly qualified professional nurses (NQPNs) allocated to community health care services require the use of validated model to practice independently. Validation was done to adapt and assess if the model is understood and could be implemented by NQPNs and mentors employed in community health care services.
Wilmot, Roger D.
The workshop described here was organised to address more general issues regarding regulatory review of SKB's safety assessment and overall review strategy. The objectives of the workshop were: - to learn from other programmes' experiences on planning and review of a license application for a nuclear waste repository, - to offer newly employed SSM staff an opportunity to learn more about selected safety assessment issues, and - to identify and document recommendations and ideas for SSM's further planning of the licensing review
Madsen, Lydia T; Craig, Catherine; Kuban, Deborah
Newly diagnosed patients with prostate cancer have various treatment options, and a multidisciplinary prostate cancer clinic (MPCC) can present all options in a single setting. An MPCC was started in 2004 at the University of Texas M.D. Anderson Cancer Center, and 258 patients with prostate cancer were evaluated in its first year. The clinic expanded in 2006 and an oncology advanced practice nurse (APN) was recruited to address specific objectives. The APN role was used to implement a quality-of-life protocol, provide detailed patient education (including a treatment summary and care plan), and serve as a single point of contact as patients move toward a treatment decision. Formal evaluation of the MPCC showed that patients were satisfied with this approach to the complex decision-making process in prostate cancer.
Quirk, J.F.; Williams, W.A.
Part 50 of Title 10 of the Code of Federal Regulation (CFR) establishes a two-step licensing process by which the U.S. Nuclear Regulatory Committee (NRC) authorizes nuclear reactor plant construction through issuance of a construction permit and authorizes operation by issuance of an operating license. At each stage, the NRC Staff conducts technical reviews and there is potential for public hearings. In 1989, the NRC issued a new, simplified licensing process: Part 52. The purpose of the Part 52 licensing process is to provide a regulatory framework that brings about earlier resolution of licensing issues. Because issues are not resolved early in the Part 50 licensing process, approval of an operating license is not assured until after a significant investment has been made in the plant. Part 52 increases the stability and certainty of the licensing process by providing for the early resolution of safety and environmental issues. The Part 52 licensing process features (1) early site permits, (2) design certification, and (3) combined construction permit and operating licenses. As part of the U.S. Advanced Light Water Reactor (ALWR) Program to revitalize the nuclear option through the integration of government/utility/industry efforts, GE undertook the role of applying for certification for its latest product line, the Advanced Boiling Water Reactor (ABWR), under the U.S. ABWR certification program. The ABWR design is an essentially complete plant. Initial application for design certification was in 1987 under Part 50. GE reapplied in late 1991 under the newly promulgated Part 52. Following seven years of intensive interactions with the NRC and ACRS, GE was awarded the first Final Design Approval (FDA) under Part 52. The Commission initiated rulemaking by publishing the proposed ABWR Certification Rule in the Federal Register in early 1995. Certification is anticipated mid-1996. (J.P.N.)
Morrison-Sandberg, Leslie F.; Kubik, Martha Y.; Johnson, Karen E.
Elementary schools are an optimal setting to provide obesity prevention interventions, yet little is known about the obesity prevention practices of elementary school nurses. The purpose of this study was to gain insight into current obesity-related school nursing practice in elementary schools in Minnesota, opinions regarding school nurse-led…
registered nurses with current licenses were unemployed and that only 3% of the unemployed registered nurses were looking for jobs in the field of...characteristic symptoms involve a re-experiencing of the traumatic event (intrusive recollections of the event, dreams or nightmares) and psychic numbing
It is the position of the National Association of School Nurses (NASN) that every school-age child deserves a school nurse who has a baccalaureate degree in nursing from an accredited college or university and is licensed as a registered nurse through the state board of nursing. These requirements constitute minimal preparation needed to practice at the entry level of school nursing (American Nurses Association [ANA] & NASN, 2011). Additionally, NASN supports state school nurse certification, where required, and promotes national certification of school nurses through the National Board for Certification of School Nurses.
Mentoring is important in the career development of novice and experienced nurses. With the anticipated shortage in nursing, it is important to explore factors such as mentoring that may contribute to career satisfaction and intent to stay in the profession. This study explored the effects of mentoring on career satisfaction and intent to stay in nursing, and the relationship between career satisfaction and intent to stay in nursing. It was conducted through a mailed survey of RNs 55 years or younger currently in practice, education, administration, or research. Career satisfaction was measured through the use of the newly developed Mariani Nursing Career Satisfaction Scale. Findings revealed no statistically significant effect of mentoring on career satisfaction and intent to stay in nursing. There was a statistically significant relationship between career satisfaction and intent to stay in nursing. The majority of nurses reported participating in a mentoring relationship. Although the findings related to mentoring, career satisfaction, and intent to stay were not statistically significant, there was a prevalence of mentoring in nursing, thus suggesting the need for future research to identify outcomes of mentoring. In addition, the study contributed a newly developed instrument to measure the concept of career satisfaction in nursing. PMID:22645673
Mentoring is important in the career development of novice and experienced nurses. With the anticipated shortage in nursing, it is important to explore factors such as mentoring that may contribute to career satisfaction and intent to stay in the profession. This study explored the effects of mentoring on career satisfaction and intent to stay in nursing, and the relationship between career satisfaction and intent to stay in nursing. It was conducted through a mailed survey of RNs 55 years or younger currently in practice, education, administration, or research. Career satisfaction was measured through the use of the newly developed Mariani Nursing Career Satisfaction Scale. Findings revealed no statistically significant effect of mentoring on career satisfaction and intent to stay in nursing. There was a statistically significant relationship between career satisfaction and intent to stay in nursing. The majority of nurses reported participating in a mentoring relationship. Although the findings related to mentoring, career satisfaction, and intent to stay were not statistically significant, there was a prevalence of mentoring in nursing, thus suggesting the need for future research to identify outcomes of mentoring. In addition, the study contributed a newly developed instrument to measure the concept of career satisfaction in nursing.
Norushe, T F; Van Rooyen, D; Strumpher, J
Nursing is a dynamic profession that is subject to rapid changes in health care provision, hence the need for in-service training programmes for nurses. Newly employed registered nurses require in-service training in order to update them regarding the latest developments in nursing practice. The researcher noted that some newly appointed registered nurses were not competent in all aspects relating to their tasks. This could have been due to a knowledge deficit relating to either new developments or of the procedure relating to a specific task. In some institutions newly-appointed registered nurses on probation reported not receiving in-service training for six months or longer, yet they were still expected to perform their tasks efficiently. The objectives of the study were to, firstly, explore and describe the experiences of registered nurses regarding in-service training programmes in their institutions and, secondly, to make recommendations to Nursing Service Managers relating to the development of effective in-service training programmes in their institutions. A qualitative, exploratory, descriptive design was implemented. Data was analysed using Tesch's descriptive approach (in Creswell, 1994:155). Two main themes emerged, namely that registered nurses experienced in-service training programmes as inadequate and reacted negatively towards them. This article focuses on the experiences of registered nurses relating to in-service training programmes, as well as the formulation of guidelines to assist nursing service managers in the development of effective in-service training programmes.
Wilmot, Roger D. (Galson Sciences Limited (United Kingdom))
The workshop described here was organised to address more general issues regarding regulatory review of SKB's safety assessment and overall review strategy. The objectives of the workshop were: - to learn from other programmes' experiences on planning and review of a license application for a nuclear waste repository, - to offer newly employed SSM staff an opportunity to learn more about selected safety assessment issues, and - to identify and document recommendations and ideas for SSM's further planning of the licensing review
和泉, 浩; 菊地, よしこ; IZUMI, Hiroshi; KIKUCHI, Yoshiko
The purpose of this paper is to shed light on the postwar history of unlicensed nurses in Akita Prefecture.After World War n, under the control of GHQ (General Headquarters of the Allied Powers), the Public Health Nurse, Midwife and Nurse Law was enacted in 1948. Since then the professionalization of nurse and the improvement of their social status have been fostered in Japan, by law, educational system, administrative system, professional organization, amelioration of working conditions and ...
Schroyer, Coreena C; Zellers, Rebecca; Abraham, Sam
Recruiting and training 1 newly hired registered nurse can cost thousands of dollars. With a high percentage of these newly hired nurses leaving their first place of employment within their first year, the financial implications may be enormous. It is imperative that health care facilities invest in recruiting and retention programs that retain high-quality nurses. Mentorship programs in retaining and easing the transition to practice for new graduate nurses, re-entry nurses, and nurses new to a specialty area are critical in nurse retention. Discussion in this study includes the effect of implementing a mentor program into the critical care services area of a 325-bed not-for-profit community hospital in northern Indiana. Based on this study, nurses with a mentor were retained at a 25% higher rate than those not mentored. Implementation of a mentor program reduced the training cost to the facility and increased retention and morale.
Nurses have the same rate of substance use disorders (SUDs) as the general public. Management of nurses with SUDs is moving from being punitive, including public license suspension or revocation, to alternative-to-discipline (ATD) programs that focus on early intervention and non-punitive, confidential help, which often involve continued employment. These programs have good retention rates, and nurses who complete them have fewer criminal convictions and are able to retain their nursing licenses and maintain successful careers in nursing. Barriers to nurses receiving care for SUDs include wide variability in ATD programs, inconsistent funding for treatment, and lack of policies and support for nursing students. Recommendations include changes to nurse practice acts to make ATD programs more uniform, provide adequate funding for all nurses and nursing students, and allow nurses to seek and obtain care without disclosing directly to Boards of Nurses. Colleges of nursing should implement policies to encourage early identification and treatment in nursing students, including ATD and dismissal programs. [Journal of Psychosocial Nursing and Mental Health Services, 55(12), 11-14.]. Copyright 2017, SLACK Incorporated.
Siegel, Elena O; Bettega, Kristen; Bakerjian, Debra; Sikma, Suzanne
Nursing homes use team nursing, with minimal RN presence, leaving the majority of direct care to licensed practical/vocational nurses (LPNs/LVNs) and unlicensed assistive personnel (UAP), including medication aides. The current article describes challenges faced by nursing home directors of nursing (DONs) leading and managing a team nursing approach, including consideration of scope of practice, delegation and supervision regulations, and related policy implications. A secondary data analysis was performed of qualitative data from a study to develop and test DON guidelines for delegation in nursing home practice. A convenience sample (N = 29) of current or previous DONs and other nursing home leaders with knowledge and expertise in the DON role participated in in-depth, guided interviews. The findings highlight a core concern to nursing licensure policy and regulation: knowledge and practice gaps related to scope of practice and delegation and supervision among DONs, RNs, and LPNs/LVNs, as well as administrators, and the role of nursing leaders in supporting appropriate delegation practices. The findings offer directions for research and practice in addressing challenges in aligning team nursing practices with regulatory standards as well as the related gaps in knowledge among DONs, administrators, and nursing staff. [Journal of Gerontological Nursing, 44(6), 10-14.]. Copyright 2018, SLACK Incorporated.
Rolince, Patricia; Giesser, Nancy; Greig, Judith; Knittel, Kathleen; Mahowald, Jane F.; McAloney-Madden, Lisa; Schloss, Robert A.
A collaborative group of 25 Northeast Ohio nursing deans/directors has developed an access model to provide new education and career mobility pathways into nursing. Model components describe the routes of licensed practical nurse to registered nurse and registered nurse to bachelor of science in nursing. Cost effectiveness and equity are…
Nilsson, Jan; Johansson, Eva; Egmar, Ann-Charlotte; Florin, Jan; Leksell, Janeth; Lepp, Margret; Lindholm, Christina; Nordström, Gun; Theander, Kersti; Wilde-Larsson, Bodil; Carlsson, Marianne; Gardulf, Ann
To develop and validate a new tool intended for measuring self-reported professional competence among both nurse students prior to graduation and among practicing nurses. The new tool is based on formal competence requirements from the Swedish Board of Health and Welfare, which in turn are based on WHO guidelines. A methodological study including construction of a new scale and evaluation of its psychometric properties. 1086 newly graduated nurse students from 11 universities/university colleges. The analyses resulted in a scale named the NPC (Nurse Professional Competence) Scale, consisting of 88 items and covering eight factors: "Nursing care", "Value-based nursing care", "Medical/technical care", "Teaching/learning and support", "Documentation and information technology", "Legislation in nursing and safety planning", "Leadership in and development of nursing care" and "Education and supervision of staff/students". All factors achieved Cronbach's alpha values greater than 0.70. A second-order exploratory analysis resulted in two main themes: "Patient-related nursing" and "Nursing care organisation and development". In addition, evidence of known-group validity for the NPC Scale was obtained. The NPC Scale, which is based on national and international professional competence requirements for nurses, was comprehensively tested and showed satisfactory psychometrical properties. It can e.g. be used to evaluate the outcomes of nursing education programmes, to assess nurses' professional competences in relation to the needs in healthcare organisations, and to tailor introduction programmes for newly employed nurses. © 2013.
Spence Laschinger, Heather K; Wong, Carol A; Grau, Ashley L
Retaining skilled and engaged nurses is critical during a time of shortage, however growing reports of workplace bullying threaten nurses' health and wellbeing, especially the transition of newly graduated nurses entering the profession. High rates of burnout and turnover among new nurses puts additional strain on limited financial resources in healthcare organizations and can compromise the quality of care provided to patients. The purpose of this study is to test a model linking authentic leadership to new graduate nurses' experiences of workplace bullying and burnout, and subsequently, job satisfaction and intentions to leave their jobs. This study employed a cross-sectional survey design with 342 new graduate nurses (defined as less than two years of practice experience) working in acute care hospitals in Ontario, Canada. Participants completed a questionnaire with measures of authentic leadership, workplace bullying, burnout, job satisfaction and turnover intentions. The model was tested using path analysis techniques within structural equation modeling. The model fit indices suggested that the original hypothesized model did not adequately fit the data (χ(2)=33.59, df=5, p=.000, χ(2)/df=6.72, IFI=.937, CFI=.937, RMSEA=.130), thus an additional theoretically justified direct path from authentic leadership to job satisfaction was added, which improved the fit substantially (χ(2)=5.26, df=4, p=.261, χ(2)/df=1.32, IFI=.997, CFI=.997, RMSEA=.030). Authentic leadership had a negative direct effect on workplace bullying, which in turn had a direct positive effect on emotional exhaustion. Authentic leadership also influenced job satisfaction indirectly through bullying and emotional exhaustion. Authentic leadership, workplace bullying and emotional exhaustion all had significant direct effects on job satisfaction, which in turn, was related to lower turnover intentions. The findings from this study demonstrate the fundamental importance of authentic leadership in
Kurjenluoma, K; Rantanen, A; McCormack, B; Slater, P; Hahtela, N; Suominen, T
This study looks to describe the workplace culture from the viewpoints of stress, job satisfaction and practice environment. Data were collected from nurses (n = 109) using a web-based survey, The Person-Centred Nursing Index, from two purposefully selected hospital districts in Finland. Data were statistically analysed. Nurses described their workplace culture in slightly positive terms. Nurses only occasionally experienced stress (mean = 2.56, SD = 0.55) and were fairly satisfied with their job (mean = 4.75, SD = 0.66) and their practice environment (mean = 4.42, SD = 0.81). Demographic variables such as the nurses' age, length of time in nursing, time at their present hospital, working shifts and their use of patient restriction were more frequently associated with their perceived workplace culture. Older nurses and those with a longer work history in the nursing profession tended to be more satisfied with their workplace culture in psychiatric nursing. Young and/or newly graduated nurses felt more negatively on their workplace culture; this issue should be recognised and addressed with appropriate support and mentoring. Nurses who used restrictive measures were more often less satisfied with their workplace culture. Continuous efforts are needed to reduce the use of coercive measures, which challenge also the managers to support nursing practice to be more person-centred. © 2017 Nordic College of Caring Science.
DePaola, Stephen J.; And Others
Investigated the relationship between death fear, attitudes toward the elderly, and personal anxiety about aging in nursing home employees. Nursing professionals (registered nurses or licensed practical nurses) had lower levels of death concern than nursing assistants, and results also indicated that nursing assistants displayed significantly…
Blackwell, Christopher W.; Kiehl, Ermalynn M.
This study examined registered nurses' overall attitudes and homophobia towards gays and lesbians in the workplace. Homophobia scores, represented by the Attitudes Toward Lesbians and Gay Men (ATLG) Scale, was the dependent variable. Overall homophobia scores were assessed among a randomized stratified sample of registered nurses licensed in the…
Bond, Carol S
This paper reports the findings from a Florence Nightingale Foundation Travel Scholarship undertaken by the author in the spring of 2006. The aim of the visit was to explore nurses' attitudes towards, and experiences of, using computers in their practice, and the requirements that they have to encourage, promote and support them in using ICT. Nurses were found to be using computers mainly for carrying out administrative tasks, such as updating records, rather than as information tools to support evidence based practice, or patient information needs. Nurses discussed the systems they used, the equipment provided, and their skills, or more often their lack of skills. The need for support was a frequent comment, most nurses feeling that it was essential that help was available at the point of need, and that it was provided by someone, preferably a nurse, who understood the work context. Three groups of nurses were identified. Engagers; Worried Willing and Resisters. The report concludes that pre-registration education has a responsibility to seek to ensure that newly qualified nurses enter practice as engagers.
Pachocka, Lucyna Małgorzata; Urbanik, Anna
The treatment of intestinal stoma is often a difficult experience for patients and results in numerous problems in the physical, psychological and social aspects. Therefore, post-operative care of the patient with the newly appointed stoma should be taken by therapeutic team consisting of doctors, nurses, physiotherapists, dieticians, psychologists and social workers. Appropriate nutritional education of patients aims to improve their quality of life and to prevent from unpleasant ailments formed after the operation. The specific type of stoma may decide about certain dietary recommendations. The presented work provides a practical dietary recommendations for patients with newly appointed stoma.
Ehlman, Katie; Wilson, Amy; Dugger, Renee; Eggleston, Brandon; Coudret, Nadine; Mathis, Sherri
Urinary incontinence (UI) poses challenges for nursing home personnel. The authors of this study explored differences in attitude and knowledge about UI among registered nurses, licensed practical nurses, and certified nursing assistants working in skilled nursing homes before and after study interventions.
Hutchison, Billy Eugene
Accelerated transitional nursing programs (ATNPs) designed specifically for licensed vocational nurses (LVNs) to transition to become registered nurses (RNs) are graduating novice nurses who need critical thinking skills to solve patient problems. The health care industry and patient outcomes depend on graduate nurses to be proficient with quality…
The average age of today's nurse is 45. The average age of today's nurse educator is 55. Not only is the mean age of nurses increasing, but the United States is also facing a national nursing shortage crisis--with fewer and fewer nurses both in the field and entering the profession. Massive advertising campaigns highlighting flexible nursing opportunities, increased incentives from health care agencies in need of nurses, and newly created flexible shift opportunities for nurses include strategies aimed at addressing this shortage. Fortunately, nursing education programs are seeing an increase in applicants, and many schools of nursing are filling their slots for new students to capacity. But this problem will not be solved by solely tempting new recruits.
Hicks, Carolyn; Fide, Jane
Nurses working with breast cancer patients (n=119) identified general and cancer-specific continuing education needs; 13 of the 14 cancer-related needs ranked in the top 20. There were no differences between acute care and community nurses. Newly qualified nurses had significantly greater needs. (Contains 44 references.) (SK)
Joseph, Sundari; Juwah, Charles
Constructive alignment theory has been used to underpin the development of curricula in higher education for some time (Biggs and Tang, 2007), however, its use to inform and determine skills curricula in nursing is less well documented. This paper explores the use of constructive alignment theory within a study of undergraduate student nurses undertaking clinical skill acquisition in the final year of a BSc (Hons) Nursing course. Students were followed up as newly qualified nurses (NQN) (n = 58) to ascertain the impact of skill acquisition in this way. Comparisons were made with newly qualified nurses who did not participate in a constructively aligned curriculum. This mixed methods study reported skill identification within the immediate post-registration period and evaluated the constructively aligned curriculum as having positive benefits for NQNs in terms of confidence to practice. This was supported by preceptors' views. The study recommends two process models for nursing skills curriculum development and reports that constructive alignment is a useful theoretical framework for nurse educators. Copyright © 2011 Elsevier Ltd. All rights reserved.
The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.
... midwifery practice, adaptation, organizational culture, health practice culture and interaction with the community they serve. It was recommended that adaptation/adjustment, health and nursing practice culture, development of skills and competencies, improvement of good relationships between NQPNs and community ...
The Nursing and Midwifery Council (NMC) has voiced concern over nurses' poor levels of English and maths after a third of newly qualified nurses failed a basic test set by a hospital as part of anew selection process.
Kwong, Enid W-Y; Lau, Ada T-Y; Lee, Rainbow L-P; Kwan, Rick Y-C
The aim of this study was to evaluate a pressure ulcer prevention programme for nursing homes to ascertain the feasibility of its implementation, impact on care staff and outcomes for pressure ulcer knowledge and skills and pressure ulcer reduction. No pressure ulcer prevention protocol for long-term care settings has been established to date. The first author of this study thus developed a pressure ulcer prevention programme for nursing homes. A quasi-experimental pretest and post-test design was adopted. Forty-one non-licensed care providers and eleven nurses from a government-subsidised nursing home voluntarily participated in the study. Knowledge and skills of the non-licensed care providers were assessed before, immediately after and six weeks after the training course, and pressure ulcer prevalence and incidence were recorded before and during the protocol implementation. At the end of the programme implementation, focus group interviews with the subjects were conducted to explore their views on the programme. A statistically significant improvement in knowledge and skills scores amongst non-licensed care providers was noted. Pressure ulcer prevalence and incidence rates dropped from 9-2·5% and 2·5-0·8%, respectively, after programme implementation. The focus group findings indicated that the programme enhanced the motivation of non-licensed care providers to improve their performance of pressure ulcer prevention care and increased communication and cooperation amongst care staff, but use of the modified Braden scale was considered by nurses to increase their workload. A pressure ulcer prevention programme for nursing homes, which was feasible and acceptable, with positive impact and outcome in a nursing home was empirically developed. The study findings can be employed to modify the programme and its outcomes for an evaluation of effectiveness of the programme through a randomised controlled trial. © 2011 Blackwell Publishing Ltd.
McBride, Karin; Snyder, Eugene R
The field of nursing is in a state of crisis. This crisis has a number of causes: a shortage of registered nurses to fill job vacancies, lack of professional growth opportunities, inability to participate in decision making, and lack of orientation and training for newly graduated nurses. Democratic leadership can result in respect and greater levels of trust among staff in a neonatal intensive care unit.
Fosse, Anette; Ruths, Sabine; Malterud, Kirsti; Schaufel, Margrethe Aase
Doctors often find dialogues about death difficult. In Norway, 45% of deaths take place in nursing homes. Newly qualified medical doctors serve as house officers in nursing homes during internship. Little is known about how nursing homes can become useful sites for learning about end-of-life care. The aim of this study was to explore newly qualified doctors' learning experiences with end-of-life care in nursing homes, especially focusing on dialogues about death. House officers in nursing homes (n = 16) participated in three focus group interviews. Interviews were audiotaped and transcribed verbatim. Data were analysed with systematic text condensation. Lave & Wenger's theory about situated learning was used to support interpretations, focusing on how the newly qualified doctors gained knowledge of end-of-life care through participation in the nursing home's community of practice. Newly qualified doctors explained how nursing home staff's attitudes taught them how calmness and acceptance could be more appropriate than heroic action when death was imminent. Shifting focus from disease treatment to symptom relief was demanding, yet participants comprehended situations where death could even be welcomed. Through challenging dialogues dealing with family members' hope and trust, they learnt how to adjust words and decisions according to family and patient's life story. Interdisciplinary role models helped them balance uncertainty and competence in the intermediate position of being in charge while also needing surveillance. There is a considerable potential for training doctors in EOL care in nursing homes, which can be developed and integrated in medical education. This practice based learning arena offers newly qualified doctors close interaction with patients, relatives and nurses, teaching them to perform difficult dialogues, individualize medical decisions and balance their professional role in an interdisciplinary setting.
Bogner, Hillary R; de Vries, Heather F; Kaye, Elise M; Morales, Knashawn H
Depression is a risk factor for hypertension, and risk of depression is increased substantially in patients with hypertension. Our objective was to examine whether an intervention carried out by Licensed Practical Nurses (LPNs) integrating depression treatment into care for hypertension improved blood pressure control and depressive symptoms. In all, 60 patients ages 41 to 92 years with hypertension and depressive symptoms at a large primary care practice in Philadelphia were randomly assigned to an integrated care intervention carried out by LPNs (n=30) or usual care (n=30). Intervention and control groups did not differ statistically on baseline measures. Outcomes assessed at baseline and 12 weeks included standard laboratory procedures to measure blood pressure control and the Patient Health Questionnaire (PHQ-9) to assess depression. Patients in the integrated care intervention had lower diastolic blood pressure (intervention 74.2 mmHg versus usual care 82.0 mmHg) and fewer depressive symptoms (PHQ-9 mean scores, intervention 2.4 versus usual care 7.1) compared with patients in the usual care group at 12 weeks after adjustment for baseline values. Patients in the integrated care intervention also had lower systolic blood pressure (intervention 130.0 mmHg versus usual care 140.6 mmHg) compared with patients in the usual care group at 12 weeks although the results approached but did not reach conventional levels of statistical significance. Training existing primary care practice office staff will facilitate implementation in real world practices with limited resources and competing demands.
Bogner, Hillary R.; de Vries, Heather F.; Kaye, Elise M.; Morales, Knashawn H.
BACKGROUND AND OBJECTIVES Depression is a risk factor for hypertension, and risk of depression is increased substantially in patients with hypertension. Our objective was to examine whether an intervention carried out by Licensed Practical Nurses (LPNs) integrating depression treatment into care for hypertension improved blood pressure control and depressive symptoms. METHODS In all, 60 patients ages 41 to 92 years with hypertension and depressive symptoms at a large primary care practice in Philadelphia were randomly assigned to an integrated care intervention carried out by LPNs (n=30) or usual care (n=30). Intervention and control groups did not differ statistically on baseline measures. Outcomes assessed at baseline and 12 weeks included standard laboratory procedures to measure blood pressure control and the Patient Health Questionnaire (PHQ-9) to assess depression. RESULTS Patients in the integrated care intervention had lower diastolic blood pressure (intervention 74.2 mmHg versus usual care 82.0 mmHg) and fewer depressive symptoms (PHQ-9 mean scores, intervention 2.4 versus usual care 7.1) compared with patients in the usual care group at 12 weeks after adjustment for baseline values. Patients in the integrated care intervention also had lower systolic blood pressure (intervention 130.0 mmHg versus usual care 140.6 mmHg) compared with patients in the usual care group at 12 weeks although the results approached but did not reach conventional levels of statistical significance. CONCLUSION Training existing primary care practice office staff will facilitate implementation in real world practices with limited resources and competing demands. PMID:23681683
Walker, Margaret J
Long-term care nurses continue to struggle with increasing workloads, fulfilling regulatory requirements and limited staffing resources. One method of impacting the workload is the introduction of the new medication nursing assistant (MNA) role to alleviate the nurse from prolonged time intervals spent administering medications. An early step in MNA role implementation is to evaluate its impact by comparing agencies using the MNA and those not using the role. This article presents findings from a mixed method study examining the efficacy of the MNA role in relationship to job satisfaction and the degree of perceived stress experienced by long-term care nurses. Ninety-one nurses employed at 2 large New Hampshire facilities responded. Findings offer empirical evidence supporting the use of the MNA to reduce job stress and increase satisfaction for licensed nurses. The MNA role is accepted by nurse leaders and viewed as a benefit. Findings also support a correlation between empowerment and decision making in the nursing environment with levels of nurse satisfaction.
Robertson, Ethel M.; Higgins, Leslie; Rozmus, Cathy; Robinson, James P.
Continuing-education participation and job satisfaction of 85 licensed practical nurses and 25 registered nurses in long-term care were compared. There were no differences between full- and part-time staff. Nurses with higher family incomes participated more frequently. Registered nurses participated more and had greater job satisfaction. (SK)
Ewens, Ann; Howkins, Elizabeth; McClure, Lorly
An action research study found that newly qualified community nurses were very positive about their new roles and able to use analytic skills in practice. However, they felt inadequately prepared for work pressures and the pace of activity. (SK)
Dellefield, Mary Ellen; Magnabosco, Jennifer L
Sustaining pressure ulcer prevention (PUP) in nursing homes has been difficult to achieve. Implementation science researchers suggest that identification of individual staff and organizational factors influencing current practices is essential to the development of an effective and customized plan to implement practice changes in a specific setting. A mixed methods approach was used to describe nurses' perceptions of individual and organization-level factors influencing performance of PUP in two Veterans Health Administration (VHA) nursing homes prior to implementation of a national VHA initiative on Hospital Acquired Pressure Ulcers (HAPUs). Individual interviews of 16 nursing staff were conducted. Individual factors influencing practice were a personal sense of responsibility to Veterans and belief in the effectiveness and importance of preventive measures. Organizational factors were existence of cooperative practices between nursing assistants and licensed nurses in assessing risk; teamwork, communication, and a commitment to Veterans' well-being. Integration and reinforcement of such factors in the development and maintenance of customized plans of PUP initiatives is recommended. Published by Mosby, Inc.
The task of developing vocational nursing students' critical thinking abilities is one of the greatest challenges facing nurse educators today. Licensed vocational nurses (LVNs) must be trained to think critically in order to provide safe patient care. Due to the expanded role and functions in the LVN's scope of practice, LVNs are making more…
Nursing programs have embraced distance learning in their curricula, but discussion is ongoing about course assignments and grading criteria to increase examination scores in nursing distance learning courses. Because course examinations are a predictor of success on the postgraduate licensing examination (NCLEX-RN), the purpose of this study was…
Chauke, Motshedisi E; Van Der Wal, Dirk; Botha, Annalie
Literature provides adequate evidence of a poor perception of nursing within the profession, resulting in high rates of attrition of student nurses and newly qualified nurses. The nursing profession, in particular nurse educators, has an ethical and professional responsibility to find innovative strategies to promote the positive image of nursing amongst student nurses. The purpose of the study was to explore the potential of appreciative inquiry (AI) as an intervention teaching strategy to transform student nurses' image of nursing. A quantitative, quasi-experimental, explorative-descriptive design comprising the pretest, appreciative inquiry as intervention, and the post-test was used. Convenience sampling was used to select third and fourth year college and university student nurses in the Gauteng province of South Africa for the pre- and the post-test respectively. Data were collected by means of a questionnaire and analysed by SPSS version 20.0. The pretest results revealed a mix of positive and negative perceptions of the image of nursing amongst student nurses. The negative perceptions of the image of nursing that needed intervention included the working conditions of nurses, and the perception of nursing as a profession that was not respected and appreciated. The post-test results showed a significant and positive change in the student nurses' perception of the image of nursing as a respected and appreciated profession. Although AI resulted in a negative to positive change in some aspects of student nurses' image of nursing, the negative perceptions of the working conditions of nurses remained and became more negative. The positive image of gender in nursing was enhanced following the implementation of AI. Appreciative inquiry demonstrated potential as a teaching strategy to produce a positive nursing image change and positive orientation towards nursing amongst student nurses.
Theander, Kersti; Wilde-Larsson, Bodil; Carlsson, Marianne; Florin, Jan; Gardulf, Ann; Johansson, Eva; Lindholm, Christina; Nordström, Gun; Nilsson, Jan
Nursing competence is of significant importance for patient care. Newly graduated nursing students rate their competence as high. However, the impact of different designs of nursing curricula on nursing students' self-reported nursing competence areas is seldom reported. To compare newly graduated nursing students' self-reported professional competence before and after the implementation of a new nursing curriculum. The study had a descriptive comparative design. Nursing students, who graduated in 2011, having studied according to an older curriculum, were compared with those who graduated in 2014, after a new nursing curriculum with more focus on person-centered nursing had been implemented. A higher education nursing program at a Swedish university. In total, 119 (2011 n=69, 2014 n=50) nursing students responded. Nursing students' self-reported professional competencies were assessed with the Nurse Professional Competence (NPC) scale. There were no significant differences between the two groups of nursing students, who graduated in 2011 and 2014, respectively, with regard to age, sex, education, or work experience. Both groups rated their competencies as very high. Competence in value-based nursing was perceived to be significantly higher after the change in curriculum. The lowest competence, both in 2011 and 2014, was reported in education and supervision of staff and students. Our findings indicate that newly graduated nursing students - both those following the old curriculum and the first batch of students following the new one - perceive that their professional competence is high. Competence in value-based nursing, measured with the NPC scale, was reported higher after the implementation of a new curriculum, reflecting curriculum changes with more focus on person-centered nursing. Copyright © 2015 Elsevier Ltd. All rights reserved.
Liu, L; Coenen, A; Tao, H; Jansen, K R; Jiang, A L
This study aimed to develop a prenatal nursing care catalogue of International Classification for Nursing Practice. As a programme of the International Council of Nurses, International Classification for Nursing Practice aims to support standardized electronic nursing documentation and facilitate collection of comparable nursing data across settings. This initiative enables the study of relationships among nursing diagnoses, nursing interventions and nursing outcomes for best practice, healthcare management decisions, and policy development. The catalogues are usually focused on target populations. Pregnant women are the nursing population addressed in this project. According to the guidelines for catalogue development, three research steps have been adopted: (a) identifying relevant nursing diagnoses, interventions and outcomes; (b) developing a conceptual framework for the catalogue; (c) expert's validation. This project established a prenatal nursing care catalogue with 228 terms in total, including 69 nursing diagnosis, 92 nursing interventions and 67 nursing outcomes, among them, 57 nursing terms were newly developed. All terms in the catalogue were organized by a framework with two main categories, i.e. Expected Changes of Pregnancy and Pregnancy at Risk. Each category had four domains, representing the physical, psychological, behavioral and environmental perspectives of nursing practice. This catalogue can ease the documentation workload among prenatal care nurses, and facilitate storage and retrieval of standardized data for many purposes, such as quality improvement, administration decision-support and researches. The documentations of prenatal care provided data that can be more fluently communicated, compared and evaluated across various healthcare providers and clinic settings. © 2016 International Council of Nurses.
Ketelaar, Sarah M.; Nieuwenhuijsen, Karen; Frings-Dresen, Monique H. W.; Sluiter, Judith K.
To investigate Dutch novice nurses' experiences and needs regarding occupational health support to prevent work-related health problems and to keep them well-functioning. A qualitative interview study was conducted with six nursing students and eight newly qualified nurses. The interviews covered
Garcia, Mayra G; Watt, Jennifer L; Falder-Saeed, Karie; Lewis, Brennan; Patton, Lindsey
Clinical nurse specialists (CNSs) have a unique advanced practice role. This article describes a process useful in establishing a comprehensive orientation and onboarding program for a newly hired CNS. The project team used the National Association of Clinical Nurse Specialists core competencies as a guide to construct a process for effectively onboarding and orienting newly hired CNSs. Standardized documents were created for the orientation process including a competency checklist, needs assessment template, and professional evaluation goals. In addition, other documents were revised to streamline the orientation process. Standardizing the onboarding and orientation process has demonstrated favorable results. As of 2016, 3 CNSs have successfully been oriented and onboarded using the new process. Unique healthcare roles require special focus when onboarding and orienting into a healthcare system. The use of the National Association of Clinical Nurse Specialists core competencies guided the project in establishing a successful orientation and onboarding process for newly hired CNSs.
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.
Mazyck, Donna; Cellucci, Margaret; Largent, Piper
School nurses have influence, and this influence is ignited with school nurse stories. School nurses must tell school staff, leaders, families, and students what they do to help students access their education. School boards, city councils, and legislators need to know the knowledge, skills, and judgment school nurses use daily. NASN understands that school nurses benefit from a "how to" kit and has developed tools to empower school nurses in advocating for their important role in supporting the health and learning of students. This article provides an overview this newly developed electronic toolkit while at the same time reinforcing the power of influence when sharing your stories. © 2015 The Author(s).
Hunt, Selina R; Probst, Janice C; Haddock, Kathlyn S; Moran, Robert; Baker, Samuel L; Anderson, Ruth A; Corazzini, Kirsten
As the American population ages and the proportion of individuals over the age of 65 expands, the demand for high-quality nursing home care will increase. However, nursing workforce instability threatens care quality and sustainability in this sector. Despite increasing attention to nursing home staff turnover, far less is known about registered nurse (RN) retention. In this study, the relationships between retention strategies, employee benefits, features of the practice environment, and RN retention were explored. Further, the utility of Herzberg's two-factor theory of motivation as a framework for nursing home retention studies was evaluated. This study was a secondary analysis of the nationally representative 2004 National Nursing Home Survey. The final sample of 1,174 participating nursing homes were either certified by Medicare or Medicaid or licensed by state agencies. We used a weighted multinomial logistic regression using an incremental approach to model the relationships. Although most nursing homes offered some combination of retention programs, the majority of strategies did not have a significant association with the level of RN retention reported by facilities. Director of nursing tenure and other extrinsic factors had the strongest association with RN retention in adjusted analyses. To improve RN retention, organizations may benefit greatly from stabilizing nursing home leadership, especially the director of nursing position. Second, managers of facilities with poor retention may consider adding career ladders for advancement, awarding attendance, and improving employee benefits. As a behavioral outcome of motivation and satisfaction, retention was not explained as expected using Herzberg's two-factor theory.
Hahtela, Nina; McCormack, Brendan; Paavilainen, Eija; Slater, Paul; Helminen, Mika; Suominen, Tarja
The aim of this study is to explore the relations of workplace culture on nursing-sensitive organizational factors. The need for standardized and valid measures for nursing-sensitive organizational outcomes has already been recognized in the literature. A cross-sectional questionnaire survey of 21 inpatient acute care units in 9 organizations at the municipal primary healthcare level was conducted. Participants included licensed practical nurses, registered nurses, and nurse managers. Workplace culture, especially the overarching factor of stress, correlated with the use of supplemental nursing staff and patients' length of stay. It is essential to find and test workplace-sensitive indicators so that managers will have a wider range of methods to plan and evaluate nursing outcomes.
Jackson, Cerian F; Makin, Selina M; Baker, Gus A
population. This study was rated as low quality. One study assessed a specialist nurse intervention in an adult population. This study was rating as very low quality.We rated one study as having unclear risk of bias and one study as having high risk of bias.The CBI study indicated that this intervention could significantly reduce depressive symptoms in people with subthreshold depressive disorder. However, the study assessing the effectiveness of a nurse intervention found no significant benefit for depressive symptoms,but did find that in individuals with the least knowledge of epilepsy, a nurse intervention could increase their knowledge of epilepsy scores. Meta-analysis was not possible as we identified only two studies and they utilised different interventions and outcome measures.Previous research has highlighted the impact of psychological and neuropsychological difficulties experienced by people with epilepsy and the negative effect this has on their quality of life. The main finding of this review is that there is a paucity of research assessing possible neuropsychological and psychological interventions for adults with newly diagnosed epilepsy.
Brookdale Community Coll., Lincroft, NJ.
A program was developed to facilitate the transition of Licensed Practical Nurses (LPNs) into a program to become registered nurses (RNs) and acquire an associate degree in allied health at Brookdale Community College (New Jersey). A committee of four nursing faculty compared the curriculum of an exemplary practical nursing program with…
Willens, Joyce S; DePascale, Christine; Penny, James
A role delineation study, or job analysis, is a necessary step in the development of a quality credentialing program. The process requires a logical approach and systematic methods to have an examination that is legally defensible. There are three main phases: initial development and evaluation, validation study, and development of test specifications. In the first phase, the content expert panel discussed performance domains that exist in pain management nursing. The six domains developed were: 1) assessment, monitoring, and evaluation of pain; 2) pharmacologic pain management; 3) nonpharmacologic pain management; 4) therapeutic communication and counseling; 5) patient and family teaching; and 6) collaborative and organizational activities. The panel then produced a list of 70 task statements to develop an online survey which was sent to independent reviewers with expertise in pain management nursing. After the panel reviewed the results of the pilot test, it was decided to clarify a few items that did not perform as expected. After the questionnaire was finalized it was distributed to 1,500 pain management nurses. The final yield was 585 usable returns, for a response rate of 39%. Thirty-three percent of the respondents reported a bachelor's degree in nursing as the highest degree awarded. Over 80% indicated that they were certified in pain management. Over 35% reported working in a staff position, 14% as a nurse practitioner, and 13% as a clinical nurse specialist. Part of the questionnaire asked the participants to rate performance expectation, consequence or the likelihood that the newly certified pain management nurse could cause harm, and the frequency of how often that nurse performs in each of the performance domains. The performance expectation was rated from 0 (the newly certified pain management nurse was not at all expected to perform the domain task) to 2 (after 6 months the newly certified pain management nurse would be expected to perform the domain
Cooper, Emily; Spilsbury, Karen; McCaughan, Dorothy; Thompson, Carl; Butterworth, Tony; Hanratty, Barbara
To establish a consensus on the care and professional development needs of registered nurses (RNs) employed by UK care homes. Two-stage, online modified Delphi study. A panel (n = 352) of individuals with experience, expertise or interest in care home nursing: (i) care home nurses and managers; (ii) community healthcare professionals (including general practitioners, geriatricians, specialist and district nurses); and (iii) nurse educators in higher education. RNs employed by nursing homes require particular skills, knowledge, competence and experience to provide high-quality care for older residents. The most important responsibilities for the nursing home nurse were: promoting dignity, personhood and wellbeing, ensuring resident safety and enhancing quality of life. Continuing professional development priorities included personal care, dementia care and managing long-term conditions. The main barrier to professional development was staff shortages. Nursing degree programmes were perceived as inadequately preparing nurses for a nursing home role. Nursing homes could improve by providing supportive learning opportunities for students and fostering challenging and rewarding careers for newly RNs. If nurses employed by nursing homes are not fit for purpose, the consequences for the wider health and social-care system are significant. Nursing homes, the NHS, educational and local authorities need to work together to provide challenging and rewarding career paths for RNs and evaluate them. Without well-trained, motivated staff, a high-quality care sector will remain merely an aspiration.
Ulrich, Beth T; Buerhaus, Peter I; Donelan, Karen; Norman, Linda; Dittus, Robert
To compare how registered nurses view the work environment and the nursing shortage based on the Magnet status of their organizations. The upsurge in organizations pursuing and obtaining Magnet recognition provides increased opportunities to investigate whether and how registered nurses who are employed in Magnet organizations and organizations pursuing Magnet status perceive differences in the nursing shortage, hospitals' responses to the shortage, characteristics of the work environment, and professional relationships. A nationally representative sample of registered nurses licensed to practice in the United States was surveyed. The views of registered nurses who worked in Magnet organizations, organizations in the process of applying for Magnet status, and non-Magnet organizations were analyzed as independent groups. Significant differences were found. Although there is a clear Magnet difference, there are also identifiable differences that occur during the pursuit of Magnet recognition. Many organizations in the process of applying for Magnet status rated higher than Magnet organizations, indicating that there is much to do to maintain the comparative advantages for Magnet hospitals.
Saini, Radha; Saini, Parvesh; Alagh, Preety
Nurses involved in research, whether as a principal investigator, a study coordinator, clinical trials nurse, or as a staff nurse caring for patients who are research subjects have a responsibility to promote the ethical conduct of clinical research. Will a registered nurse be ever able to challenge and infact unearth the unscrupulous medical practices which make poor patients guinea pigs in pharmaceutical company-sponsored clinical trials? Keeping this in view an exploratory study was carried out to assess the knowledge of bioethics among MSc Nursing students studying in recognised Nursing Colleges of North India. 92 percent of MSc nursing students scored below average knowledge regarding bioethics even after studying ethics in MSc (N) 1st year and B.Sc. Nursing degree programme. This research study strongly recommends the Indian Nursing Council-the statutory licensing body of nurses in India to ensure strict compliance of all researches (at masters as well as bachelors level) in nursing education with all the principles and components of bioethics. Need of the hour is to include at least one clinical nurse in the Institutional Ethics Committee in every medical and research institution.
Mukamel, Dana B; Kang, Taewoon; Collier, Eric; Harrington, Charlene
Policy initiatives at the Federal and state level are aimed at increasing staffing in nursing homes. These include direct staffing standards, public reporting, and financial incentives. To examine the impact of California's Medicaid reimbursement for nursing homes which includes incentives directed at staffing. Two-stage limited-information maximum-likelihood regressions were used to model the relationship between staffing [registered nurses (RNs), licensed practical nurses, and certified nursing assistants hours per resident day] and the Medicaid payment rate, accounting for the specific structure of the payment system, endogeneity of payment and case-mix, and controlling for facility and market characteristics. A total of 927 California free-standing nursing homes in 2006. The model included facility characteristics (case-mix, size, ownership, and chain affiliation), market competition and excess demand, labor supply and wages, unemployment, and female employment. The instrumental variable for Medicaid reimbursement was the peer group payment rate for 7 geographical market areas, and the instrumental variables for resident case-mix were the average county revenues for professional therapy establishments and the percent of county population aged 65 and over. Consistent with the rate incentives and rational expectation behavior, expected nursing home reimbursement rates in 2008 were associated with increased RN staffing levels in 2006 but had no relationship with licensed practical nurse and certified nursing assistant staffing. The effect was estimated at 2 minutes per $10 increase in rate. The incentives in the Medicaid system impacted only RN staffing suggesting the need to improve the state's rate setting methodology.
Washington State Board for Community and Technical Colleges, 2017
Though it is still possible to enter the nursing profession with a Licensed Practical Nursing Certificate (LPN) or an Associate's Degree in Nursing (ADN), it is becoming increasingly necessary to get a Bachelor of Science in Nursing (BSN) in order to be assured of continued employment. The Associate in Applied Science-T Nursing Degree prepares…
Simón Melchor, Lucía; Simón Melchor, Alba
Cuts in temporary contracts has had big consequences for newly qualified nurses with regards to finding employment. This cut in contracts has resulted in a doubling in the rate of unemployment in this profession. In the past nurses emigrated to other countries for purposes like knowledge of the language or to extend their training and experience, however today the emigration has become the only way out for many professional nurses. The reputation of nurses in Spain is recognised internationally, with the UK being one of the countries with the largest demand for Spanish nurses. Due to the great amount of job opportunities that are emerging in the UK, nurses need help and guidance in their careers, and also nurses need training in areas such as Professional Body, developing a curriculum, facing an interview etc...
Wang, Kwua-Yun; Chang, Shu-Rong
This article explores the evolution and development of the Taiwanese nursing profession. After introducing the origins of nursing, this article proceeds to introduce nursing during various periods in Taiwan, including the early-Qing Dynasty, foreign missionary nursing, the Japanese Colonial Era, and the Nationalist Chinese Era following World War Two up to the present. The authors then present the current situation in the Taiwanese nursing profession in terms of gender issues, high-technology developments, educational issues, the nursing licensing examination, hiring and training, multiple role functions, and the skill-mix care model. Finally, the authors make recommendations for the further development and improvement of the nursing profession in Taiwan.
Gardner, Diane L.
A longitudinal, repeated-measures descriptive survey used to measure career commitment and its relationship to turnover and work performance in 320 newly employed registered nurses at one hospital found that career commitment is not a stable phenomenon. The direct association between career commitment and turnover and with job performance is weak.…
Mohr, Lynn D; Coke, Lola A
Today's healthcare environment poses diverse and complex patient care challenges and requires a highly qualified and experienced nursing workforce. To mitigate these challenges are graduate nursing roles, each with a different set of competencies and expertise. With the availability of many different graduate nursing roles, both patients and healthcare professionals can be confused in understanding the benefit of each role. To gain the maximum benefit from each role, it is important that healthcare providers and administrators are able to distinguish the uniqueness of each role to best use the role and develop strategies for effective collaboration and interprofessional interaction. The purpose of this article was to define the role, educational preparation, role differences, and practice competencies for the clinical nurse specialist (CNS), nurse practitioner, clinical nurse leader, and nurse educator/staff development educator roles. A second purpose was to provide role clarity and demonstrate the unique value the CNS brings to the healthcare environment. Using evidence and reviewing role competencies established by varying organizations, each role is presented with similarities and differences among the roles discussed. In addition, collaboration among the identified roles was reviewed, and recommendations were provided for the new and practicing CNSs. Although there are some similarities among the graduate nursing roles such as in educational, licensing, and certification requirements, each role must be understood to gain the full role scope and benefit and glean the anticipated outcomes. Healthcare providers must be aware of the differences in graduate nursing roles, especially in comparing the CNS with other roles to avoid confusion that may lead to roles being underused with a limited job scope. The CNS provides a unique set of services at all system outcome levels and is an essential part of the healthcare team especially in the acute care setting.
Kiel, D P; Eichorn, A; Intrator, O; Silliman, R A; Mor, V
The outcomes of elderly, hospitalized patients discharged to nursing homes after hip fracture were examined. For 2624 hip fracture patients admitted to any of 43 proprietary nursing homes between 1984 and 1988, admission assessments were examined in relation to 1-month outcomes. Mean patient age was 82 +/- 7 y; 85% of the sample were female. Within 1 month after discharge, 24% had returned home, 12% had been rehospitalized, 3% had died, and 61% remained in the nursing home. Characteristics significantly associated with morality included disorientation, functional dependency, neurologic diagnoses, and use of cardiac medications, antidepressants, or narcotics. Rehospitalization was significantly associated with age, gender, living with someone, being ambulatory, and functional dependency. Returning home was associated with younger age, living with someone, being ambulatory, and having no disorientation, functional dependency, or psychiatric or neurologic diagnoses, nor any pressure sores. Better-functioning persons and those with social support returned home; physically and cognitively impaired persons and those taking narcotics, cardiac medications, or antidepressants were likely to die; and younger men, those with social support, those with functional dependency, and those who were free of disorientation were more likely to be rehospitalized.
ITER was fortunate to have four countries interested in ITER siting to the point where licensing discussions were initiated. This experience uncovered the challenges of licensing a first of a kind, fusion machine under different licensing regimes and helped prepare the way for the site specific licensing process. These initial steps in licensing ITER have allowed for refining the safety case and provide confidence that the design and safety approach will be licensable. With site-specific licensing underway, the necessary regulatory submissions have been defined and are well on the way to being completed. Of course, there is still work to be done and details to be sorted out. However, the informal international discussions to bring both the proponent and regulatory authority up to a common level of understanding have laid the foundation for a licensing process that should proceed smoothly. This paper provides observations from the perspective of the International Team. (author)
Sun J. Kim
Full Text Available Purpose: Hospital transfer from a skilled nursing facility (SNF is costly, and many are potentially preventable. This study examines: 1 whether functional decline is a predictor of hospital transfer, and 2 the magnitude of relationships between predictors (functional impairment and chronic medical illness and hospital transfer from SNFs. Methods: We used Minimum Data Set (MDS Version 2.0 in the state of Michigan between 2007 and 2009. In total, 196,662 new SNF admissions were observed. Multilevel generalized estimating equations and regression models were performed for each functional and clinical domain while adjusting for demographic variables and change in activities of daily living (ADL. Results: 65% of recently admitted SNF residents experienced functional decline after SNF admission, and 58% were readmitted to a hospital. Residents who needed extensive assistance or were completely dependent in their functional domains had pressure ulcers, deteriorated mood or lower cognitive performance scale scores. These residents experienced higher chances of hospital transfer. However, a deteriorated ADL played a significant role in all multivariate models, indicating that a decline in ADL is a stronger predictor of hospital transfer than other functional or clinical predictors. Conclusion: Although all functional impairments and chronic medical illness can be associated with hospital transfer, functional decline may be the most important predictor of hospital transfer in patients newly admitted to an SNF.
Tei-Tominaga, Maki; Miki, Akiko
This study aimed to examine the factors associated with intentions to leave among newly graduated nurses (NGNs), using a longitudinal design. We distributed self-administered questionnaires (to be returned anonymously) to all the NGNs (n=567) in nine advanced treatment hospitals in Japan on two separate occasions (Time 1 and Time 2, which were approximately 6 months apart). The questionnaire items addressed individual attributes, employment and organizational characteristics, and subjective health, and also included the 22-item Job Content Questionnaire, a scale of intentions to leave, and a novel 21-item job readiness scale. The data from 301 NGNs who had participated in both questionnaire instances was used, and a hierarchical multiple regression analysis was conducted to investigate the factors associated with intentions to leave. The results showed that while psychological distress was a more important predictor of intentions to leave than was cumulative fatigue at Time 1, cumulative fatigue was a more important predictor at Time 2. Among the job stressors, a lack of coworker support consistently led to increased intentions to leave, while a lack of supervisor support had a greater impact on intentions to leave at Time 1. "Being personally suited for nursing work", which was one of the job-readiness subscales, was found to independently and consistently influence intentions to leave. Our study findings revealed the predictors of intentions to leave among NGNs early in their careers in Japan.
Kaltoft, Mette Kjer
All healthcare visions, including that of The TIGER (Technology-Informatics-Guiding-Educational-Reform) Initiative envisage a crucial role for nursing. However, its 7 descriptive pillars do not address the disconnect between Nursing Informatics and Nursing Ethics and their distinct communities in the clinical-disciplinary landscape. Each sees itself as providing decision support by way of information inputs and ethical insights, respectively. Both have reasons - ideological, professional, institutional - for their task construction, but this simultaneously disables each from engaging fully in the point-of-(care)-decision. Increased pressure for translating 'evidence-based' research findings into 'ethically-sound', 'value-based' and 'patient-centered' practice requires rethinking the model implicit in conventional knowledge translation and informatics practice in all disciplines, including nursing. The aim is to aid 'how nurses and other health care scientists more clearly identify clinical and other relevant data that can be captured to inform future comparative effectiveness research. 'A prescriptive, theory-based discipline of '(Nursing) Decisionics' expands the Grid for Volunteer Development of TIGER's newly launched virtual learning environment (VLE). This provides an enhanced TIGER-vision for educational reform to deliver ethically coherent, person-centered care transparently.
Sussman, Jonathan; Bainbridge, Daryl; Whelan, Timothy J; Brazil, Kevin; Parpia, Sameer; Wiernikowski, Jennifer; Schiff, Susan; Rodin, Gary; Sergeant, Myles; Howell, Doris
Better coordination of supportive services during the early phases of cancer care has been proposed to improve the care experience of patients. We conducted a randomized trial to test a community-based nurse-led coordination of care intervention in cancer patients. Surgical practices were cluster randomized to a control group involving usual care practices or a standardized nursing intervention consisting of an in-person supportive care assessment with ongoing support to meet identified needs, including linkage to community services. Newly diagnosed breast and colorectal cancer patients within 7 days of cancer surgery were eligible. The primary outcome was the patient-reported outcome (PRO) of continuity of care (CCCQ) measured at 3 weeks. Secondary outcomes included unmet supportive care needs (SCNS), quality of life (EORTC QLQ-C30), health resource utilization, and level of uncertainty with care trajectory (MUIS) at 3 and/or 8 weeks. A total of 121 breast and 72 colorectal patients were randomized through 28 surgical practices. There was a small improvement in the informational domain of continuity of care (difference 0.29 p = 0.05) and a trend to less emergency room use (15.8 vs 7.1%) (p = 0.07). There were no significant differences between groups on unmet need, quality of life, or uncertainty. We did not find substantial gaps in the PROs measured immediately following surgery for breast and colorectal cancer patients. The results of this study support a more targeted approach based on need and inform future research focused on improving navigation during the initial phases of cancer treatment. ClinicalTrials.gov Identifier: NCT00182234. SONICS-Effectiveness of Specialist Oncology Nursing.
Filipova, Anna A
This study investigates ethical climates in government, nonprofit, and for-profit nursing homes and determines their similarities and differences. Surveys were collected from 656 (21.4%) licensed nurses who worked in 100 skilled nursing facilities in one Midwestern state. Shared law and code and caring ethical climates were identified across the 3 sector nursing homes. Those climates were also polarized. Important implications were drawn for consideration of ethical perceptions of each sector during negotiations and contract management.
Crawley, Rocquel Devonne
The implementation of electronic health records (EHR) by health care organizations has been limited. Despite the broad consensus on the potential benefits of EHRs, health care organizations have been slow to adopt the technology. The purpose of this qualitative phenomenological study was to explore licensed practical and registered nurses'…
Martin-Misener, Ruth; Bryant-Lukosius, Denise; Harbman, Patricia; Donald, Faith; Kaasalainen, Sharon; Carter, Nancy; Kilpatrick, Kelley; DiCenso, Alba
In Canada, education programs for the clinical nurse specialist (CNS) and nurse practitioner (NP) roles began 40 years ago. NP programs are offered in almost all provinces. Education for the CNS role has occurred through graduate nursing programs generically defined as providing preparation for advanced nursing practice. For this paper, we drew on pertinent sections of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing to describe the following: (1) history of advanced practice nursing education in Canada, (2) current status of advanced practice nursing education in Canada, (3) curriculum issues, (4) interprofessional education, (5) resources for education and (6) continuing education. Although national frameworks defining advanced nursing practice and NP competencies provide some direction for education programs, Canada does not have countrywide standards of education for either the NP or CNS role. Inconsistency in the educational requirements for primary healthcare NPs continues to cause significant problems and interferes with inter-jurisdictional licensing portability. For both CNSs and NPs, there can be a mismatch between a generalized education and specialized practice. The value of interprofessional education in facilitating effective teamwork is emphasized. Recommendations for future directions for advanced practice nursing education are offered.
Missen, Karen; McKenna, Lisa; Beauchamp, Alison; Larkins, Jo-Ann
The aim of this study was to explore perceptions of qualified nurses on the abilities of newly registered nursing graduates to perform a variety of clinical skills. Evidence from the literature suggests that undergraduate nursing programmes do not adequately prepare nursing students to be practice-ready on completion of their nursing courses. A descriptive quantitative design was used. Participants were recruited through the Australian Nursing and Midwifery Federation, Victorian branch. A brief explanation of the study and a link to the survey were promoted in their monthly e-newsletter. A total of 245 qualified nurses in the state of Victoria, Australia participated in this study. A survey tool of 51 clinical skills and open-ended questions was used, whereby participants were asked to rate new nursing graduates' abilities using a 5-point Likert scale. Overall participants rated new nursing graduates' abilities for undertaking clinical skills as good or very good in 35·3% of skills, 33·3% were rated as adequate and 31·4% rated as being performed poorly or very poorly. Of concern, essential clinical skills, such as critical thinking and problem solving, working independently and assessment procedures, were found to be poorly executed and affecting new registered nurses graduates' competence. The findings from this study can further serve as a reference for nursing education providers to enhance nursing curricula and work collaboratively with healthcare settings in preparing nurses to be competent, safe practitioners on completion of their studies. Identifying key areas in which new nursing graduates are not yet competent means that educational providers and educators from healthcare settings can focus on these skills in better preparing our nurses to be work ready. © 2016 John Wiley & Sons Ltd.
Kyrkjebø, Jane Mikkelsen; Mekki, Tone Elin; Hanestad, Berit Rokne
The aim of this paper is to describe nursing education in Norway and some essential questions and challenges regarding the undergraduate and newly graduated nurses' competencies and functionally preparedness. The first formal training of nurses in Norway started in Oslo in 1886. Since then the education has changed considerably. As long as society is changing, and nurses are going to meet and adapt to societies needs, the education of nurses will also have to change continuously. The present general plan of nursing education has gone through a long process. The discussions have concerned the content of medical and natural science subjects, the practical part of the training and the relation between theory and practice. There are challenges in nursing education in Norway today. We have seen that recruitment has decreased, and that nurses seek jobs where they are better paid. To increase the accessibility distance and part-time education has been established. The theory-practice gap will always exist. Therefore we should aim to prepare the students to minimize this gap in a way that they can combine training of nursing with training in improvement. The demand of a masters degree to be a nursing teacher has reduced the teachers' ability to keep up their practical skills. The government pays nursing teachers who want to practice as nurses for several months to maintain their salary level during that period. There are many possibilities to improve nursing education in Norway. We are on our way with highly qualified teachers and students, and we still have enough good applicants. The new general plan and new law for universities and university colleges offer great opportunities. However, the shortage of nurses is a great challenge for further quality improvement both in clinical practice and in education.
Altmann, Tanya K
The education of nurses has an influence on patient safety and outcomes, the nursing shortage, the faculty shortage, and nurses' attitudes and actions. This article reports on a dissertation study designed to examine the attitudes of nurses, initially registered with an associate degree or diploma in nursing, toward continuing formal education. Actively licensed registered nurses in the eastern and western United States (n=535) participated. The main finding of this study was that, although nurses held positive attitudes overall, attitudes ranked barely above neutral. The findings suggest that work needs to be done to improve nurses' attitudes toward continuing formal education and research needs to be undertaken to understand what would entice nurses back to school. Implications for nursing practice and education are discussed along with suggestions for future research.
Bowblis, John R; Hyer, Kathryn
To study the effect of minimum nurse staffing requirements on the subsequent employment of nursing home support staff. Nursing home data from the Online Survey Certification and Reporting (OSCAR) System merged with state nurse staffing requirements. Facility-level housekeeping, food service, and activities staff levels are regressed on nurse staffing requirements and other controls using fixed effect panel regression. OSCAR surveys from 1999 to 2004. Increases in state direct care and licensed nurse staffing requirements are associated with decreases in the staffing levels of all types of support staff. Increased nursing home nurse staffing requirements lead to input substitution in the form of reduced support staffing levels. © Health Research and Educational Trust.
Pittman, Patricia; Davis, Catherine; Shaffer, Franklin; Herrera, Carolina-Nicole; Bennett, Cudjoe
To determine whether foreign-educated nurses (FENs) perceived they were treated equitably in the U.S. workplace during the last period of high international recruitment from 2003 to 2007. With experts predicting that isolated nursing shortages could return as soon as 2015, it is important to examine the lessons learned during the last period of high international recruitment in order to anticipate and address problems that may be endemic to such periods. In this baseline study, we asked FENs who were recruited to work in the United States between 2003 and 2007 about their hourly wages; clinical and cultural orientation to the United States; wages, benefits, and shift or unit assignments; and job satisfaction. In 2008, we administered a survey to FENs who were issued VisaScreen certificates by the Commission on Graduates of Foreign Nursing Schools International between 2003 and 2007. We measured four outcomes of interest (hourly wages, job satisfaction, adequacy of orientation, and perceived discrimination) and conducted descriptive and regression analyses to determine if country of education and recruitment model were correlated with the outcomes. We found that 51% of respondents reported receiving insufficient orientation and 40% reported at least one discriminatory practice with regard to wages, benefits, or shift or unit assignments. FENs educated in low-income countries and those recruited by staffing agencies were significantly more likely than other FENs to report that they receive inequitable treatment compared with their U.S. counterparts. These findings raise both practical and ethical concerns that should interest those striving to create positive health care workplace environments and to ensure staff retention. Health care leaders should take steps to ensure that FENs are, and perceive that they are, treated equitably.
This qualitative design study addressed the enhancement of nursing assessment skills through the use of Visual Thinking Strategies and reflection. This study advances understanding of the use of Visual Thinking Strategies and reflection as ways to explore new methods of thinking and observing patient situations relating to health care. Sixty nursing students in a licensed practical nursing program made up the sample of participants who attended an art gallery as part of a class assignment. Participants replied to a survey of interest for participation at the art gallery. Participants reviewed artwork at the gallery and shared observations with the larger group during a post-conference session in a gathering area of the museum at the end of the visit. A reflective exercise on the art gallery experience exhibited further thoughts about the art gallery experience and demonstrated the connections made to clinical practice by the student. The findings of this study support the use of Visual Thinking Strategies and reflection as effective teaching and learning tools for enhancing nursing skills. Copyright © 2017 Elsevier Ltd. All rights reserved.
Harris, Ruth; Ooms, Ann; Grant, Robert; Marshall-Lucette, Sylvie; Chu, Christine Sek Fun; Sayer, Jane; Burke, Linda
Securing employment after qualification is of utmost importance to newly qualified nurses to consolidate knowledge and skills. The factors that influence success in gaining this first post are not known. The study aimed to describe the first post gained after qualification in terms of setting, nature of employment contract and geographical distribution and explore the relationship between a range of factors (including ethnicity) and employment at the point of qualification. An exploratory study using structured questionnaires and secondary analysis of data routinely collected by the universities about students and their progress during their course. The study was conducted in eight universities within a large, multicultural city in the UK as part of the 'Readiness for Work' research programme. Eight hundred and four newly qualified nurses who had successfully completed a diploma or degree from one of the universities; a response rate of 77% representing 49% of all graduating students in the study population. Data were collected by self-completed semi-structured questionnaires administered to students at the time of qualification and at three months post-qualification. Routinely collected data from the universities were also collected. Fifty two percent of participants had been offered a job at the point of qualification (85% of those who had applied and been interviewed). Of these, 99% had been offered a nursing post, 88% in the city studied, 67% in the healthcare setting where they had completed a course placement. 44% felt "confident" and 32% "very confident" about their employment prospects. Predictors of employment success included ethnicity, specialty of nursing and university attended. Predictors of confidence and preparedness for job seeking included ethnicity, nursing specialty, gender and grade of degree. Newly qualified nurses from non-White/British ethnic groups were less likely to get a job and feel confident about and prepared for job seeking. This
This article gives an overview of the process of license renewal for nuclear power plants. It explains what is meant by license renewal, the significance of license renewal, and goes over key elements involved in the process of license renewal. Those key elements are NRC requirements embodied in 10 CFR Part 54 (Reactor Safety) and 10 CFR Part 51 (Environmental Issues). In addition Industry Reports must be developed and reviewed. License renewal is essentially the process of applying for a 20 year extension to the original 40 year operating license granted for the plant. This is a very long term process, which involves a lot of preparation, and compliance with regulatory rules and guidelines. In general it is a process which is expected to begin when plants reach an operating lifetime of 20 years. It has provisions for allowing the public to become involved in the review process
Harrod, Molly; Montoya, Ana; Mody, Lona; McGuirk, Helen; Winter, Suzanne; Chopra, Vineet
To understand the perceived preparedness of frontline nurses (registered nurses (RNs), licensed practical nurses (LPNs)), unit nurse managers, and skilled nursing facility (SNF) administrators in providing care for residents with peripherally inserted central catheters (PICCs) in SNFs. Exploratory, qualitative pilot study. Two community based SNFs. Residents with PICCs, frontline nurses (RNs, LPNs), unit nurse managers, and SNF administrators. Over 36 weeks, 56 residents with PICCs and their nurses were observed and informally interviewed, focusing on PICC care practices and documentation. In addition, baseline PICC data were collected on placement indication (e.g., antimicrobial administration), placement setting (hospital vs SNF), and dwell time. Focus groups were then conducted with frontline nurses and unit nurse managers, and semistructured interviews were conducted with SNF administrators to evaluate perceived preparedness for PICC care. Data were analyzed using a descriptive analysis approach. Variations in documentation were observed during weekly informal interviews and observations. Differences were noted between resident self-reported PICC concerns (quality of life) and those described by frontline nurses. Deficiencies in communication between hospitals and SNFs with respect to device care, date of last dressing change, and PICC removal time were also noted. During focus group sessions, perceived inadequacy of information at the time of care transitions, limited availability of resources to care for PICCs, and gaps in training and education were highlighted as barriers to improving practice and safety. Practices for PICC care in SNFs can be improved. Multimodal strategies that enhance staff education, improve information exchange during care transitions, and increase resource availability in SNFs appear necessary to enhance PICC care and safety. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.
Changes in the 'medical research' licensing procedure under the German Radiation Protection Ordinance; Neuerungen im Genehmigungsverfahren 'Medizinische Forschung' gemaess Roentgen- und Strahlenschutzverordnung
Habeck, M.; Minkov, V.; Griebel, J.; Brix, G. [Bundesamt fuer Strahlenschutz (BfS), Oberschleissheim-Neuherberg (Germany). Fachbereich Strahlenschutz und Gesundheit; Epsch, R.; Langer, M. [Deutsche Roentgengesellschaft e.V. (DRG), Berlin (Germany). Klinische Studienkoordination
This publication outlines the 'medical research' licensing procedure as specified in the amendment of the German Radiation Protection Ordinance of November 1, 2011. The general licensing requirements for the use of radiation have not been changed by the amendment. Three so-called use restrictions (i.e., dose limits of 10 mSv and 20 mSv, age limit of 50 years) have been modified. They will only apply to healthy volunteers in the future. In addition, there are considerable simplifications with respect to applications and licensing procedures of the Federal Office for Radiation Protection (Bundesamt fuer Strahlenschutz, BfS) regarding the use of radiation in the newly introduced 'accompanying diagnostics' ('Begleitdiagnostik') case group. The newly established, independent panel of experts at the German Radiological Society (Deutsche Roentgengesellschaft, DRG) may provide essential support to principal investigators, qualified physicians and sponsors for differentiating between 'medical research' and 'health care', the latter not being subject to licensing. An expert statement will be issued by the DRG within four weeks of an inquiry. This consulting service is subject to confidentiality, and is free of charge for inquirers and without any commitment. (orig.)
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.
Avis, Mark; Mallik, Maggie; Fraser, Diane M
Transition experiences of newly qualified midwives were examined in depth during the third phase of a UK evaluation study of midwifery education. The fitness to practise and the retention of newly qualified nursing and midwifery graduates are pressing concerns for health care managers. The advantages of preceptorship are reported in the literature but the content and timing of schemes remain unclear. A semi-structured diary was kept for up to 6 months by 35 newly qualified midwives in 18 work sites covering all countries in the UK. The preceptor and supervisor of midwives for each newly qualified midwife completed short questionnaires about their preceptee's performance, and a further sub-sample of newly qualified midwives and preceptors participated in a semi-structured interview. Data were analysed to elicit aspects of newly qualified midwives transition experiences. Findings confirm that structured preceptorship schemes are not widely available. Newly qualified midwives primarily obtained transition support from members of the midwifery team. Although perceived as competent, there is no demarcation point in becoming confident to practise as a registered practitioner. Implications for managers include the importance of a supportive culture within clinical teams for successful transition and the introduction of structured preceptorship schemes facilitated by appropriate rotation patterns. © 2012 John Wiley & Sons Ltd.
Draper, Janet; Sparrow, Shelagh; Gallagher, Donna
This paper presents the findings of a Centre for Excellence in Teaching and Learning-funded project exploring the experience of student nurses making the transition from student to qualified nurse. \\ud \\ud The transition from student to staff nurse ‘is a common rite of passage that marks the end of initial educational preparation in the discipline and the beginning of the professional journey as a nurse’ (Nash et al, 2009: 49). However, the extent to which newly qualified staff nurses are abl...
Cruttenden, Kathleen E
This planning study was designed and conducted in a predominantly rural Canadian province to examine the strengths and learning needs of four categories of nursing staff practising in New Brunswick nursing homes. Participants included directors of care, registered nurses, licensed practical nurses, and resident attendants. The nursing homes ranged in size from 38 to 196 beds and were located throughout the province. In health and planning studies, ethnography conveys a coherent statement of peoples' local knowledge as culture-sharing groups (Muecke, 1994). The study derived information from the Nursing Home Act, reports, the literature, key informants, and direct observations of and interviews with participants. Leadership strengths defined the roles for categories of staff and supported the capacity of each category to identify their learning needs. In conclusion, nurses practising in nursing homes can and must take an active role in decision making for their learning.
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.
Kulig, Judith C; Penz, Kelly; Karunanayake, Chandima; MacLeod, Martha L P; Jahner, Sharleen; Andrews, Mary Ellen
Globally, disasters are on the rise. Nurses play a significant role in responding to such events but little is known about rural and remote nurses' experiences. A national cross-sectional survey of regulated nurses (registered nurses, registered psychiatric nurses, licensed practical nurses and nurse practitioners) in rural and remote Canada provided the data (n=2465) for the logistic regression of predictors of assisting with a disaster event within the last five years. The types of disaster events were also examined and open-ended responses were explored to reveal nurses' perspectives. Nurse type, age, region of employment, employment status, number of rural communities worked, distance to advanced referral centre, remote community, personal-professional boundaries, burnout and work engagement were significant factors related to assisting with a disaster event. Open-ended data alluded to the importance of pre-disaster preparation, and the difficulties experienced when personal-professional relationships are impacted during a disaster. Nursing education curricula needs to include information about disasters and the nurse's role. Continuing education opportunities and preparation for nurses should be offered in the workplace. Psychosocial supports to assist rural nurses who attend to disasters in their workplace will help them deal with issues such as the blurring of personal-professional relationships. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.
Nursing schools face the challenge of improving student academic performance and completion rates. The current supply of newly graduated nurses fails to meet the increasing demands of society. In 2009, Cochise College responded by implementing a major change in their curriculum to improve student retention and academic performance. The problem…
Begg, Dorothy J; Langley, John D; Brookland, Rebecca L; Ameratunga, Shanthi; Gulliver, Pauline
The aim of this study was to determine whether pre-licence driving experiences, that is driving before beginning the licensing process, increased or decreased crash risk as a car driver, during the learner or the restricted licence stages of the graduated driver licensing system (GDLS). Study participants were 15-24 year old members of the New Zealand Drivers Study (NZDS) - a prospective cohort study of newly licensed car drivers. The interview stages of the NZDS are linked to, the three licensing stages of the GDLS: learner, restricted and full. Baseline demographic (age, ethnicity, residential location, deprivation), personality (impulsivity, sensation seeking, aggression) and, behavioural data, (including pre-licensed driving behaviour), were obtained at the learner licence interview. Data on distance driven and crashes that occurred at the learner licence and restricted licence stages, were reported at the restricted and full licence interviews, respectively. Crash data were also obtained from police traffic crash report files and this was combined with the self-reported crash data. The analysis of the learner licence stage crashes, when only supervised driving is allowed, was based on the participants who had passed the restricted licence test and undertaken the NZDS, restricted licence interview (n=2358). The analysis of the restricted licence stage crashes, when unsupervised driving is first allowed, was based on those who had passed the full licence test and completed the full licence interview (n=1428). After controlling for a range of demographic, personality, behavioural variables and distance driven, Poisson regression showed that the only pre-licence driving behaviour that showed a consistent relationship with subsequent crashes was on-road car driving which was associated with an increased risk of being the driver in a car crash during the learner licence period. This research showed that pre-licensed driving did not reduce crash risk among learner or
Crigger, Nancy; Barnes, Kristen; Junko, Autumn; Rahal, Sarah; Sheek, Casey
This paper reports on a study conducted to describe family nurse practitioners' perceptions towards and participation in pharmaceutical marketing and to explore the relationships among related variables. The pharmaceutical industry's intense global marketing strategies have resulted in widespread concern in healthcare professionals and professional groups, sectors of the public in many countries, and in the World Health Organization. Research on healthcare providers' participation in pharmaceutical marketing indicates that these relationships are conflicts of interests and compromise healthcare providers' prescribing practices and trust. Nursing, as a discipline, appears to be slow to address the impact of pharmaceutical marketing on nursing practice. Questionnaires about perceptions and participation in pharmaceutical marketing were completed by a random sample of 84 licensed family nurse practitioners in the United States of America in 2007. Family nurse practitioners viewed pharmaceutical company marketing uncritically as educational and beneficial. They also perceived other providers but not themselves as influenced by pharmaceutical marketing. The findings supported those found in previous research with nurses and physicians. Lack of education, participation in marketing and psychological and social responses may impede family nurse practitioners' ability to respond critically and appropriately to marketing strategies and the conflict of interest it creates.
Dunne, Karen; Brereton, Bernadette; Duggan, Vivienne; Campion, Deirdre
Veterinary nurses report an intrinsic desire to work with animals. However, this motivation may be eroded by poor working conditions and low pay, resulting in the exit of experienced veterinary nurses from clinical practice. This study sought to quantify the level of animal-handling experience students possessed at the start of their training and to explore the factors motivating them to enter veterinary nurse training in two Irish third-level institutions. The authors had noted a tendency for veterinary nursing students to possess limited animal-handling skills, despite their obvious motivation to work with animals. The study explores possible reasons for this, as it mirrors previous reports in relation to students of veterinary medicine. First-year veterinary nursing students at Dundalk Institute of Technology and University College Dublin were surveyed and a focus group was held in each institution to explore student motivations for choosing this career and their prior animal-handling experience and workplace exposure. The results show that veterinary nursing students are highly intrinsically motivated to work with and care for animals. The majority had spent time in the veterinary workplace before starting their studies but they had limited animal-handling experience beyond that of family pets, primarily dogs. The study also revealed potential tensions between the veterinary nursing and veterinary medical students at University College Dublin: a hitherto unexposed aspect of the hidden curriculum in this institution. The results of this study highlight the need for ongoing investment in practical animal-handling training for veterinary nursing students.
Practical nurses can provide quality, cost-effective care in an ever-changing health care setting which is faced with a shortage of nurses. A community college system in the southeastern area of the United States began using the Test of Essential Academic Skills (TEAS) V as part of admission criteria for nursing programs. While Assessment…
Mitty, Ethel; Resnick, Barbara; Allen, Josh; Bakerjian, Debra; Hertz, Judith; Gardner, Wendi; Rapp, Mary Pat; Reinhard, Susan; Young, Heather; Mezey, Mathy
Assisted living (AL) residences are residential long-term care settings that provide housing, 24-hour oversight, personal care services, health-related services, or a combination of these on an as-needed basis. Most residents require some assistance with activities of daily living and instrumental activities of daily living, such as medication management. A resident plan of care (ie, service agreement) is developed to address the health and psychosocial needs of the resident. The amount and type of care provided, and the individual who provides that care, vary on the basis of state regulations and what services are provided within the facility. Some states require that an RN hold a leadership position to oversee medication management and other aspects of care within the facility. A licensed practical nurse/licensed vocational nurse can supervise the day-to-day direct care within the facility. The majority of direct care in AL settings is provided by direct care workers (DCWs), including certified nursing assistants or unlicensed providers. The scope of practice of a DCW varies by state and the legal structure within that state. In some states, the DCW is exempt from the nurse practice act, and in some states, the DCW may practice within a specific scope such as being a medication aide. In most states, however, the DCW scope of practice is conscribed, in part, by the delegation of responsibilities (such as medication administration) by a supervising RN. The issue of RN delegation has become the subject of ongoing discussion for AL residents, facilities, and regulators and for the nursing profession. The purpose of this article is to review delegation in AL and to provide recommendations for future practice and research in this area.
Briggs, Susan; Griego, Elizabeth
A program was implemented to expand the curriculum materials within the Licensed Practical Nursing (LPN) Program at Clark County Community College (CCCC) which relate to oral hygiene care for the hospital patient. The instructional materials included a video tape and a written instructional packet which were researched, prepared, and presented by…
Fable, D.; Prah, M.; Vrankic, K.; Lebegner, J.
The purpose of this paper is to provide information about license renewal process, as defined by Nuclear Regulatory Commission (NRC). The Atomic Energy Act and NRC regulations limit commercial power reactor licenses to an initial 40 years but also permit such licenses to be renewed. This original 40-year term for reactor licenses was based on economic and antitrust considerations not on limitations of nuclear technology. Due to this selected time period; however, some structures and components may have been engineered on the basis of an expected 40-year service life. The NRC has established a timely license renewal process and clear requirements codified in 10 CFR Part 51 and 10 CFR Part 54, that are needed to assure safe plant operation for extended plant life. The timely renewal of licenses for an additional 20 years, where appropriate to renew them, may be important to ensuring an adequate energy supply during the first half of the 21st Century. License renewal rests on the determination that currently operating plants continue to maintain adequate levels of safety, and over the plant's life, this level has been enhanced through maintenance of the licensing bases, with appropriate adjustments to address new information from industry operating experience. Additionally, NRC activities have provided ongoing assurance that the licensing bases will continue to provide an acceptable level of safety. This paper provides additional discussion of license renewal costs, as one of key elements in evaluation of license renewal justifiability. Including structure of costs, approximately value and two different approaches, conservative and typical. Current status and position of Nuclear Power Plant Krsko, related to license renewal process, will be briefly presented in this paper. NPP Krsko is designed based on NRC Regulations, so requirements from 10 CFR 51, and 10 CFR 54, are applicable to NPP Krsko, as well. Finally, this paper will give an overview of current status of
Vogelsmeier, Amy A; Scott-Cawiezell, Jill R; Pepper, Ginette A
The purpose of this qualitative descriptive study was to describe medication reconciliation practices in nursing homes with a specific focus on nursing staff involvement in the process. The study was conducted in eight Midwestern nursing homes and included 46 onsite observations of resident transfers to the nursing home. Informal interviews of nursing staff performing medication reconciliation were conducted during each observation. Findings suggest nursing home nursing staff, including both RN and licensed practical nurse (LPN) staff, were primarily responsible for performing medication reconciliation; however, these staff often varied in how they processed resident transfer information to identify medication order discrepancies. Patterns of differences were found related to their perceptions about medication reconciliation, as well as their actions when performing the process. RN staff were more often focused on resident safety and putting the "big picture" together, whereas LPN staff were more often focused on the administrative assignment and "completing the task." Copyright 2011, SLACK Incorporated.
J. Michael Lindsay
Results: 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. Conclusions: 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. This article has been approved for the Medical Library Association’s Independent Reading Program.
Edwards, D.W.; Allen, S.R.
The NUPLEX Licensing Subcommittee was organized to seek a formal license renewal mechanism that institutionalizes the current licensing basis and consequent level of safety of a plant as the legitimate standard for acceptance and approval of an application for extended operation. Along with defining the most workable approach to and scope of review for license renewal, this paper explains the reasons why a regulatory framework is needed by the early 1990s. The initial results of development work on two key issues, licensing criteria and hearing process, are also presented. at this point six potential license renewal criteria have emerged: evaluation of existing monitoring/maintenance programs, revalidation of current licensing basis, conformance to special regulations, evaluation to a safety goal, plant performance history, and environmental assessment. The work on a hearing process has led to the development of two models for future consideration: hybrid legislative and hybrid adjudicatory
Mahendran, Rathi; Lim, Haikel A; Tan, Joyce Y S; Chua, Joanne; Lim, Siew Eng; Ang, Emily N K; Kua, Ee Heok
Cancer patients experience distress and high levels of psychosocial concerns. However, in Asian countries like Singapore, patients are often unwilling to seek support and help from mental healthcare professionals, but, instead, are more willing to confide in nurses. This quasi-experimental study developed and tested the efficacy of a brief nurse-led psychosocial intervention to alleviate these patients' distress, minor psychiatric morbidity, and psychosocial concerns. The semi-structured intervention comprised 20- to 30-minute face-to-face sessions with trained oncology nurses, monthly for 2 months and then bimonthly for 4 months. Patients received psycho-education on symptoms of stress, anxiety, and depression and counseling and were taught behavioral techniques such as deep breathing, progressive muscle relaxation, and positive self-talk. The results of this study found that patients who received the intervention had reduced distress, depression, and anxiety levels and improved quality of life (QOL) at 6 months. Although further research is necessary to explore the efficacy and viability of this intervention, findings support brief nurse-led psycho-educational interventions in Asian settings especially for cancer patients reluctant to seek help from mental health professionals.
Dellefield, Mary Ellen
Human resource practices including supervision and management are associated with organizational performance. Evidence supportive of such an association in nursing homes is found in the results of numerous research studies conducted during the past 17 years. In this article, best practices related to this topic have been culled from descriptive, explanatory, and intervention studies in a range of interdisciplinary research journals published between 1990 and 2007. Identified best practices include implementation of training programs on supervision and management for licensed nurses, certified nursing assistant job enrichment programs, implementation of consistent nursing assignments, and the use of electronic documentation. Organizational barriers and facilitators of these best practices are described. Copyright 2009, SLACK Incorporated.
Ko, Woonhwa; Kiser-Larson, Norma
Oncology nursing is often a source of substantial stress for nurses. Many nurses, particularly novice nurses, have inadequate preparation to care for patients at the end of life and their families. Unless nurses prevent or manage work-related stress by using effective coping strategies, oncology nursing staff will continue to suffer from burnout and compassion fatigue. The purpose of this article is to identify stress levels and stressful factors of nurses working in oncology outpatient units and to explore coping behaviors for work-related stress of oncology staff nurses in outpatient units. A descriptive, cross-sectional design was used to identify stress levels and stressful factors for outpatient oncology nurses, investigate differences in stress levels among nurses' demographic characteristics, and explore coping behaviors of the nurses. Study participants (N = 40) included RNs and licensed practical nurses who completed the Nursing Stress Scale, three open-ended questions, and a demographic questionnaire. The highest sources of stress were workload and patient death and dying. Demographic variables of age and work experience in nursing showed a significant positive relationship to work-related stress scores. The three most frequently used coping behaviors were verbalizing, exercising or relaxing, and taking time for self. Continuing education programs on stress management are highly recommended. Outpatient oncology nurses should be nurtured and supported through tailored interventions at multiple levels to help them find effective coping strategies and develop self-care competencies. Although younger and less experienced nurses had lower mean stress scores than older and more experienced nurses, the continuing education programs and tailored interventions would be helpful for all oncology nursing staff.
The global movement towards free trade and market integration has enabled greater mobility for skilled professionals, including nurses. As of 2015, newly graduated Canadian nurses will enter the register with an exam prepared by the US-based National Council of State Boards of Nursing, making Canadian nurses possibly the most mobile skilled workers in North America. But given the fragmentation of Canada's internal labour market, it is the United States that stands to benefit most from greater nurse mobility.
Erlingmark, Julia; Hedström, Mariann; Lindberg, Magnus
Current trends in renal anaemia management place greater emphasis, and thus increased workload, on the role of the nurse in haemodialysis settings. However, there is little evidence that demonstrates the relationship between nurse staffing and patient outcomes. To describe nurse staffing in haemodialysis settings, its relationship with target levels of renal anaemia management and to describe target level achievement for different ways of organising anaemia management. Cross-sectional audit. Forty (out of 78) haemodialysis centres in Sweden reported quality assurance data. The numbers of bedside registered nurses, licensed nurse assistants and patients undergoing haemodialysis during a predefined morning shift; type of anaemia management and achieved target levels of anaemia management. The mean patient:registered nurse ratio was 2.4 and the mean patient:nurse assistant ratio was 12.8. There were no significant relationships between registered nurse staffing and target level achievement. On average, 45.6% of the patients had haemoglobin within the target levels at centres applying nurse-driven anaemia management, compared with 47.3% at physician-driven centres. These cross-sectional data suggest that renal anaemia outcomes are unrelated to the patient:registered nurse ratio. There is, however, room for improvement in renal anaemia management in the units included in this study, particularly the achievement of target levels of haemoglobin and transferrin saturation. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.
Al Awaisi, Huda; Cooke, Hannah; Pryjmachuk, Steven
Studies have demonstrated that the transition experience of new graduate nurses is complex and frequently negative, leading to dissatisfaction with nursing and increased attrition. Existing studies of new graduate nurses' transition experiences tend to be concerned with the experiences of new graduate nurses in the West. To date, no study has been conducted examining the transition experience in any Middle Eastern country where the cultural context surrounding nursing education and practice is different. To explore the experiences of new graduate nurses during their transition period in the Sultanate of Oman. A qualitative case study utilising an embedded single case design was conducted to investigate the transition experience of new nursing graduates from one university in the Sultanate of Oman. Data were collected from the perspective of new graduate nurses and also from the perspective of other key informants who are key organisational actors such as clinical instructors, managers and preceptors. As is characteristic of case study design, this study employed triangulated methods including individual and focus group interviews, observation and documentary analysis. Data collected were thematically analysed using Microsoft Access. This study showed that nursing is not an attractive choice for Omani students to study and pursue as a future career. During the transition period, new graduate nurses experienced reality shock resulting mainly from a theory-practice gap. They found themselves with limited practical experience but a high level of theoretical knowledge that was difficult to utilise in practice. They experienced many competing priorities in their working environment which resulted in task-orientation and compromised patient care. Many new graduate nurses resented their involvement in basic nursing care, which they believed should not be part of their role as degree nurses. Omani new graduate nurses' transition experiences are complex and highly affected
Barać, Ivana; Prlić, Nada; Plužarić, Jadranka; Farčić, Nikolina; Kovačević, Suzana
The aim of this study was to examine the degree to which it is possible to predict job satisfaction in hospital nurses based on core self-evaluation and the nurses' professional commitment. Psychological constructs of nurses' professional commitment could predict a level of job satisfaction. A cross-sectional design was applied. Data were collected between April 2016 and November 2016 from 584 nurses of the University Hospital Osijek. Core Self-Evaluation Scale (CSES), Job Satisfaction Survey (JSS) and Nurses' professional commitment scale (NPCS) were administrated to the study participants. Confirmatory factor analyses were conducted to test the validity of each questionnaire. Structural equation modeling was used to test the prediction of nurses' professional commitment and core self-evaluation on job satisfaction. Nurses' professional commitment is variable, which functions as a mediator between predictor (CSE) and criterion variable (JS). As a mediator, it explains what the effect is, provided that correlations between all variables are significant. The correlation analyses reveal significant positive correlations between job satisfaction and core self evaluation (r = 0.441, p > 0.001) and also between job satisfaction and nurses' professional commitment (r = 0.464, p > 0.001). Furthermore, core self evaluation significantly and positively correlates with nurses' professional commitment (r = 0.402, p > 0.001). The results showed that nurses' professional commitment mediates the relationship between core self evaluation and job satisfaction. Bootstrap analysis showed that core self evaluation partially mediated the relationship between nurses' professional commitment and job satisfaction ( β = 0.78, p core self evaluation on job satisfaction through nurses' professional commitment was also significant (β = 0.17, p < 0.001**). Nurses who are more committed to their work, regardless of the structure of personality, have greater satisfaction in their work. This
Aguiar, Maíra; Stollenwerk, Nico; Halstead, Scott B
With approximately 3 billion people at risk of acquiring the infection, dengue fever is now considered the most important mosquito-borne viral disease in the world, with 390 million dengue infections occurring every year, of which 96 million manifest symptoms with any level of disease severity. Treatment of uncomplicated dengue cases is only supportive and severe dengue cases require hospital intensive care. A vaccine now licensed in several countries and developed by Sanofi Pasteur (CYD-TDV, named Dengvaxia), was able to protect, in the first 25 months of the two Phase III, 66% of a subset of 9-16 year old participants. However, a significantly lower efficacy (including negative vaccine efficacy) was noted for children younger than 9 years of age. Analysis of year 3 results of phase III trials of Dengvaxia suggest high rates of protection of vaccinated partial dengue immunes but high rates of hospitalizations during breakthrough dengue infections of persons who were vaccinated when seronegative, with vaccine appearing to induce enhancing antibodies (ADE). An age structured model was developed based on Sanofi's recommendation to vaccinate persons age 945 years in dengue endemic countries. The model was used to explore the clinical burden of two vaccination strategies: 1) Vaccinate 4 or 20% of individuals, ages 9-45 years, seropositives and seronegatives, and 2) vaccinate 4 or 20% of individuals, ages 9-45 years, who are dengue immune only. Our results show that vaccinating dengue monotypic immune individuals prevents dengue hospitalizations, but at the same time dengue infections of vaccine-sensitized persons increases hospitalizations. When the vaccine is given only to partial immune individuals, after immunological screening of the population, disease burden decreases considerably.
Full Text Available With approximately 3 billion people at risk of acquiring the infection, dengue fever is now considered the most important mosquito-borne viral disease in the world, with 390 million dengue infections occurring every year, of which 96 million manifest symptoms with any level of disease severity. Treatment of uncomplicated dengue cases is only supportive and severe dengue cases require hospital intensive care. A vaccine now licensed in several countries and developed by Sanofi Pasteur (CYD-TDV, named Dengvaxia, was able to protect, in the first 25 months of the two Phase III, 66% of a subset of 9-16 year old participants. However, a significantly lower efficacy (including negative vaccine efficacy was noted for children younger than 9 years of age.Analysis of year 3 results of phase III trials of Dengvaxia suggest high rates of protection of vaccinated partial dengue immunes but high rates of hospitalizations during breakthrough dengue infections of persons who were vaccinated when seronegative, with vaccine appearing to induce enhancing antibodies (ADE. An age structured model was developed based on Sanofi's recommendation to vaccinate persons age 945 years in dengue endemic countries. The model was used to explore the clinical burden of two vaccination strategies: 1 Vaccinate 4 or 20% of individuals, ages 9-45 years, seropositives and seronegatives, and 2 vaccinate 4 or 20% of individuals, ages 9-45 years, who are dengue immune only.Our results show that vaccinating dengue monotypic immune individuals prevents dengue hospitalizations, but at the same time dengue infections of vaccine-sensitized persons increases hospitalizations. When the vaccine is given only to partial immune individuals, after immunological screening of the population, disease burden decreases considerably.
Full Text Available Many original equipment manufacturers (OEMs face the choice of whether to license an independent remanufacturer (IR to remanufacture their used products. In this paper, we develop closed-loop supply chain models with licensed and unlicensed remanufacturing operations to analyze the competition and cooperation between an OEM and an IR. The OEM sells new products and collects used products through trade-ins, while the IR intercepts the OEM’s cores to produce remanufactured products and sell them in the same market. We derive optimal decisions for each of the two types of firms in licensed and unlicensed remanufacturing scenarios and identify conditions under which the OEM and the IR would be most likely to cooperate with each other in implementing remanufacturing. The results show although it is beneficial for an OEM to license an IR to remanufacture its cores, it is not always necessary for an IR to accept OEM’s authorization. Moreover, we contrast the result for licensed remanufacturing scenario in the decentralized system with that in the centrally coordinated system to quantify potential inefficiency resulting from decentralization of decision making.
Wang, Yuandi; Li-Ying, Jason; Chen, Jin
We explore the landscape of technology licensing among Chinese entities in the period 2000–12, using a unique database on technological licensing from the State Intellectual Property Office of China. We find that: first, among Chinese licensee organizations, firms have dominated in terms...... of the number of licensed technologies; second, the geographical distribution of licensed technologies among the provinces has gradually reached a new quantitative balance; third, utility models are the most popular technologies to be licensed and the majority of technology licensing in China has been between...... Chinese entities, and most transactions have been local within provinces; and finally, Chinese firms have gradually in-licensed newer and newer technologies, but the technologies in-licensed from foreign sources are by no means state-of-the-art. We make several suggestions for innovation policy...
Doe, Patience Fakornam; Oppong, Elizabeth Agyeiwaa; Sarfo, Jacob Owusu
The decreasing performance of student nurses in the professional licensure examinations (LE) in Ghana is a major concern to stakeholders, especially at a time when the nurse-patient ratio stands at 1: 1500. The study sought to determine the effect of students' demographic and academic characteristics on performance in the Registered General…
Flinkman, Mervi; Salanterä, Sanna
To describe why young registered nurses (RNs) had previously left an organisation and why they intend to leave the profession. Currently, many young registered nurses, including those in Finland, are considering leaving their job or have an intention to leave the profession. An in-depth, descriptive approach was adopted. Data were collected in 2012 from interviews with 15 registered nurses (under the age of 30 years). The interviews were semi-structured and analysed using conventional content analysis. The main questions addressed were: 'Why had the young registered nurses left their previous organisation?' and 'Why do young registered nurses have an intention to leave the profession?' The findings centre on three themes: poor nursing practice environments; lack of support, orientation and mentoring, and nursing as a 'second best' or serendipitous career choice. The first years of nursing are particularly stressful for newly-graduated and inexperienced registered nurses. An in-depth, qualitative approach reveals more complex reasons behind the turnover of registered nurses and intention to leave the profession than questionnaire surveys. Young registered nurses need social support from nurse managers and experienced colleagues to successfully transition into nursing practice environments. Adequate orientation and mentoring programmes are needed to facilitate this transition. © 2014 John Wiley & Sons Ltd.
In accordance with the Nuclear Energy Act, the use of nuclear energy constitutes operations subject to license. The licensing process and conditions for granting a license is defined in the legislation. The licenses are applied from and granted by the Government. This paper discusses briefly the licensing process in Finland and also the roles and responsibilities of main stakeholders in licensing. Licensing of a nuclear power plant in Finland has three steps. The first step is the Decision in Principle (DiP). Goal of DiP is to decide whether using nuclear power is for the overall good for the Finnish society. The second step is Construction License (CL) and the goal of CL phase is to determine whether the design of the proposed plant is safe and that the participating organisations are capable of constructing the plant to meet safety goals. The third step is the Operating License (OL) and the goal of the OL phase is to determine whether the plant operates safely and licensee is capable to operate the plant safely. Main stakeholders in the licensing process in Finland are the utility (licensee) interested in using nuclear power in Finland, Ministry of Employment and the Economy (MEE), Government, Parliament, STUK, the municipality siting the plant and the general public. Government grants all licenses, and Parliament has to ratify Government's Decision in Principle. STUK has to assess the safety of the license applications in each step and give statement to the Ministry. Municipality has to agree to site the plant. Both STUK and the municipality have a veto right in the licensing process
Simpson, Michelle R
To examine the factor structure, internal consistency reliability and concurrent-related validity of the Core Nurse Resource Scale. A cross-sectional survey study design was used to obtain a sample of 149 nurses and nursing staff [Registered Nurse (RNs), Licensed Practical Nurse (LPNs) and Certified Nursing Assistant (CNAs)] working in long-term care facilities. Exploratory factor analysis, Cronbach's alpha and bivariate correlations were used to evaluate validity and reliability. Exploratory factor analysis yielded a scale with 18 items on three factors, accounting for 52% of the variance in scores. Internal consistency reliability for the composite and Core Nurse Resource Scale factors ranged from 0.79 to 0.91. The Core Nurse Resource Scale composite scale and subscales correlated positively with a measure of work engagement (r=0.247-0.572). The initial psychometric evaluation of the Core Nurse Resource Scale demonstrates it is a sound measure. Further validity and reliability assessment will need to be explored and assessed among nurses and other nursing staff working in other practice settings. The intent of the Core Nurse Resource Scale is to evaluate the presence of physical, psychological and social resources of the nursing work environment, to identify workplaces at risk for disengaged (low work engagement) nursing staff and to provide useful diagnostic information to healthcare administrators interested in interventions to improve the nursing work environment. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.
Yoo, Byung-kwan; Lin, Tzu-chun; Kim, Minchul; Sasaki, Tomoko; Spetz, Joanne
Registered nurses (RN) who held prior health-related employment in occupations other than licensed practical or vocational nursing (LPN/LVN) are reported to have increased rapidly in the past decades. Researchers examined whether prior health-related employment affects RN workforce supply. A cross-sectional bivariate probit model using the 2008 National Sample Survey of Registered Nurses was esti- mated. Prior health-related employment in relatively lower-wage occupations, such as allied health, clerk, or nursing aide, was positively associated with working s an RN. ~>Prior health-related employ- ment in relatively higher-wage categories, such as a health care manager or LPN/LVN, was positively associated with working full-time as an RN. Policy implications are to promote an expanded career ladder program and a nursing school admission policy that targets non-RN health care workers with an interest in becoming RNs.
Fornés-Vives, Joana; Garcia-Banda, Gloria; Frias-Navarro, Dolores; Rosales-Viladrich, Gerard
The purpose of this study was to examine the dominant stress coping style in nursing students, its relationships with stressful life events and personality traits, and the students' changes during their academic training. A non-experimental two-wave longitudinal design was carried out in 199 nursing students recruited from three Spanish nursing schools. The Stressful Life Events Scale, NEO-FFI, and COPE questionnaire were administered at the beginning (T1) and end (T2) of their nursing studies. Descriptive statistics, Anova(s), NPar tests, and Pearson correlations were carried out. Results show that nursing students' dominant coping style was emotion-focused coping, both at T1 and T2. Highly significant correlations between emotional coping and the neuroticism trait were found. Coping, stress, and personality changed positively during the training program. At T2, the use of problem-focused strategies increased, and participants became more extroverted, agreeable, and conscientious. Coping and personality changes experienced by nursing students throughout their degree program seem to mirror the professional competences needed by future licensed nurses. Copyright © 2015 Elsevier Ltd. All rights reserved.
Angel, Elizabeth; Craven, Rhonda; Denson, Nida
Professional self-concept is a critical driver of job satisfaction. In Australia, as international nursing enrolments rise, nursing is increasingly characterised by a professional body of international nurses who may differ from domestic Australian nurses in their nursing self-concept. At present, no psychometrically sound instrument for assessing nursing self-concept for Australian domestic and international nursing students is available. The purpose of this study was to: (1) develop an instrument (the Nurses' Self-Concept Instrument (NSCI)) to measure the professional self-concept of domestic and international nursing students in Australia, and (2) test the psychometric properties of this newly developed instrument. A literature review was conducted to generate the initial dimension and item pools to measure nurses' professional self-concept (NSCI). Two stakeholders examined the content and face validity of dimensions and items. Analysis was performed on data collected from 253 undergraduate nursing students in a large public university in Sydney, Australia, and consisted of domestic (n=218) and international (n=35) nursing students. Internal reliability was assessed using Cronbach's Alpha. Confirmatory factor analysis (CFA) was used to assess the construct validity of the NSCI. The resulting NSCI consisted of 14 items across four self-concept domains: care, leadership, staff relations, and knowledge. The CFA supported the hypothesised factor structure of the self-concept model. All reliabilities were acceptable for both domestic and international students (ranging from r=.78 to .93). The NSCI was shown to be a valid and reliable tool for assessing Australian domestic and international student nurses' professional self-concept. This instrument may also enable those responsible for recruitment of students into nursing courses to assess students' professional self-concept and implement appropriate strategies to foster the growth of lifelong career development
Murray, Ted A; Pole, David C; Ciarlo, Erica M; Holmes, Shearon
The purpose of this article is to describe a collaborative project designed to recruit and retain students from underrepresented minorities and disadvantaged backgrounds into nursing education. Ethnic minorities remain underrepresented in the nursing workforce in comparison to the general population. The numbers of minorities enrolled in nursing education programs are insufficient to meet the health care workforce diversity needs of the future. High school students were provided with a preprofessional education program to prepare them for admission into a nursing program. Retention strategies were implemented for newly admitted and enrolled nursing education students. Twenty-one high school students enrolled in a nursing education program. The students enrolled in the nursing education program graduated and passed the licensure examination. Early recruitment and multiprong retention programs can be successful in diversifying the registered nurse workforce.
Full Text Available Background: The period of transition from registered nurse to nurse practitioner is often challenging. While adjusting to their autonomous role, nurse practitioners need to create and define a distinct role for themselves within practice contexts that may be unfamiliar, sometimes unwelcoming and inhospitable. During this time of transition, nurses need well developed negotiation skills and personal attributes including resilience, tenacity, fortitude and determination. Purpose of the research: The purpose of the research reported in this paper was to explore the transition experiences of 10 newly endorsed nurse practitioners in Australia during their first year of practice. This paper focuses on power, control and political manoeuvring that negatively impacted the ×³nurse practitioners×³ transition. A qualitative approach using a modified version of Carspecken×³s five stage critical ethnography, informed by focused ethnography, was the methodology selected for this study. Methods included observations of practice, journaling, face to face and phone interviews which were recorded, transcribed and analysed thematically. Results: âThe enemy withinâ emerged as a dominant theme highlighting issues of power, powerlessness and politics dominating the participant×³s experiences. Power struggles amongst nurses, both overt and covert, and the deliberate misuse of power were frequently encountered. Many of the participants felt powerless and ill-prepared to negotiate the challenging situations in which they found themselves. Many lacked the skills needed to address the negative behaviours they experienced. Conclusions: This paper reports on the experiences of 10 newly endorsed nurse practitioners during their transition to the nurse practitioner role. The impact of the political climate at the time of this study had an undeniable influence on many of the participants×³ transition experiences. Competition for the limited numbers of
Full Text Available In the mid 90s, the abundance of various electronic publications exposed libraries to the problems of licensing electronic content. Various licensing principles have been prepared recently to help libraries in the process; it can be said that in general, the knowledge of licensing issues has improved in libraries of all types. Libraries form consortia in order to gain stronger negotiating positions and obtain better conditions.In the article, new licensing principles are presented in more detail, as well as some domestic and foreign experiences with consortia forming.
Full Text Available This article discusses the results of a workshop designed as an action research cycle to ascertain what matters most in the practice of nursing children in South Africa today. The workshop was convened at the University of Cape Town (UCT, in order to guide and direct the newly established post- basic, children’s nursing pathway in the Bachelor of Nursing for Registered nurses [BN(RN] programme. The participants were eight experienced paediatric nurses, currently practising in a variety of settings in the Western Cape. The results show that the participants move from their original task- and procedure - based perspective to a more processive one in which the focus of the learning is relational, emphasising the family and culture of the child.
Irani, Elliane; Hirschman, Karen B; Cacchione, Pamela Z; Bowles, Kathryn H
Despite patients referred to home health having diverse and complex needs, it is unknown how nurses develop personalized visit plans. In this qualitative descriptive study, we interviewed 26 nurses from three agencies about their decision-making process to determine visit intensity and analyzed data using directed content analysis. Following a multifactorial assessment of the patient, nurses relied on their experience and their agency's protocols to develop the personalized visit plan. They revised the plan based on changes in the patient's clinical condition, engagement, and caregiver availability. Findings suggest strategies to improve visit planning and positively influence outcomes of home health patients.
Mathews, Maria; Ryan, Dana
Financial incentives are increasingly offered to recruit nursing personnel to work in underserved communities. The authors describe and compare the characteristics of federal, provincial and territorial financial recruitment incentive programs for registered nurses (RNs), nurse practitioners (NPs), licensed practical nurses (LPNs), registered practical nurses or registered psychiatric nurses. The authors identified incentive programs from government, health ministry and student aid websites and by contacting program officials. Only government-funded recruitment programs providing funding beyond the normal employee wages and benefits and requiring a service commitment were included. The authors excluded programs offered by hospitals, regional or private firms, and programs that rewarded retention. All provinces and territories except QC and NB offer financial recruitment incentive programs for RNs; six provinces (BC, AB, SK, ON, QC and NL) offer programs for NPs, and NL offers a program for LPNs. Programs include student loan forgiveness, tuition forgiveness, education bursaries, signing bonuses and relocation expenses. Programs target trainees, recent graduates and new hires. Funding and service requirements vary by program, and service requirements are not always commensurate with funding levels. This snapshot of government-funded recruitment incentives provides program managers with data to compare and improve nursing workforce recruitment initiatives. Copyright © 2015 Longwoods Publishing.
The goal of the study has been to learn about physicians' and nurses' awareness of the professional activities that are being performed by their colleague in the physician-nurse team. Postal questionnaires were sent out to occupational physicians and nurses in Poland. The analysis includes responses from 232 pairs of physician-nurse teams. The knowledge among occupational professionals about tasks performed by their colleagues in the physician-nurse team seems to be poor. Respondents were asked about who performs tasks from each of 21 groups mentioned in the Occupational Medicine Service Act. In the case of only 3 out of 21 groups of tasks, the rate of non-consistence in answers was lower than 30%. A specified number of professionals performed their tasks on the individual basis. Although in many cases their team colleagues knew about those activities, there was a major proportion of those who had no awareness of such actions. Polish occupational physicians and nurses perform a variety of tasks. Occupational nurses, besides medical role, also play important organizational roles in their units. The cooperation between the two professional groups is, however, slightly disturbed by the deficits in communication. This issue needs to be improved for the betterment of operations within the whole system. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Häggström, Elisabeth; Skovdahl, Kirsti; Fläckman, Birgitta; Kihlgren, Annika L; Kihlgren, Mona
The aim of the study was to investigate, from the narratives of nine enrolled nurses and one nurses' aide directly involved in patient care, the deeper meaning of work satisfaction and dissatisfaction when working with the older people. Both nationally and internationally, there is little research documented regarding the working situation of the enrolled nurses and nurses' aides who make up the majority of care for older people today. With this in mind, it is important to focus on how these occupational groups experience their work with the older residents in municipal care, following a two-year intervention. The study is part of a larger longitudinal study, with a quasi-experimental design within the municipal system of care for older people in Sweden. The investigation was carried out following a two-year intervention, which included: education, support and clinical supervision. The interviews were performed 12 and 24 months after start of the intervention and were analysed with a phenomenological-hermeneutic method inspired by Ricoeur's philosophy. The findings from these narratives illustrated a change compared with the findings from the first interviews, when the nursing home had just opened. There was a shift from a dominance of dissatisfaction with work, to a dominance of work satisfaction and this was expressed in the following themes: experience of a changed perspective, experience of open doors, and experience of closed doors. Each theme emerged from several different subthemes and each subtheme that had been expressed in the caregivers' narratives was interpreted. The study shows that the caregivers' experience of work satisfaction in the workplace exceeded their experience of dissatisfaction and that the intervention, consisting of: education, support, and supervision might have facilitated this positive development where the older residents were prioritized. It also shows that communication and understanding between management and staff had increased
This presentation discusses reactor licensing and includes the legislative basis for licensing, other relevant legislation , the purpose of the Nuclear Safety and Control Act, important regulations, regulatory document, policies, and standards. It also discusses the role of the CNSC, its mandate and safety philosophy
Anderson, Ruth A.; Corazzini, Kirsten N.; McDaniel, Reuben R.
Purpose Turnover in nursing homes is a widespread problem adversely affecting care quality. Using complexity theory, we tested the effect of administrative climate, communication patterns, and the interaction between the two on turnover, controlling for facility context. Design and Methods Perceptions of administrative climate and communication were collected from 3,449 employees in 164 randomly sampled nursing homes, and they were linked to secondary data on facility characteristics, resource allocation, and turnover. We used hierarchical regression to test the hypotheses. Results Climate and communication both affected turnover, but lower turnover was dependent on the interaction between climate and communication. In nursing homes with reward-based administrative climates, higher levels of communication openness and accuracy explained lower turnover of licensed vocational nurses and certified nurse assistants, relative to nursing homes with an ambiguous climate. Adequate staffing and longer tenure of the nursing director were also important predictors of turnover. Implications Although context is important, managers can also influence turnover by addressing climate and communication patterns and by encouraging stable nursing leadership. PMID:15197292
The Atomic Energy Act of 1954, which was amended in 1974 by the Energy Reorganization Act, established the requirement that individuals who had the responsibility of operating the reactors in nuclear power plants must be licensed. Section 107 of the act states ''the Commission shall (1) prescribe uniform conditions for licensing individuals; (2) determine the qualifications of such individuals; and (3) issue licenses to such individuals in such form as the Commission may prescribe.'' The article discusses the types of licenses, the selection and training of individuals, and the administration of the Nuclear Regulatory Commission licensing examinations
The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes
Carrington, Betty Watts; Burst, Helen Varney
Recognized continuously by the US Department of Education since 1982 as a specialized accrediting agency, the American College of Nurse-Midwives' Division of Accreditation (DOA) accredits not only nurse-midwifery education programs at the postbaccalaureate or higher academic level as certificate and graduate programs for registered nurses (RNs), but also precertification programs for professional midwives from other countries who are licensed as RNs in the United States. The DOA also accredits midwifery education programs for non-nurses at the postbaccalaureate or higher academic level as certificate and graduate programs, and precertification programs for professional midwives from other countries. The accreditation process is a voluntary activity involving both nurse-midwifery and/or midwifery education programs and the DOA. Present plans include another expansion of recognition: to become an institutional accreditation agency for independent and proprietary schools and to continue as a programmatic accrediting agency. Since its inception, the accreditation process has been viewed as a positive development in nurse-midwifery education.
Kózka, Maria; Brzostek, Tomasz; Cisek, Maria; Brzyski, Piotr; Przewoźniak, Lucyna; Gabryś, Teresa; Ogarek, Maria; Gajda, Krzysztof; Ksykiewicz-Dorota, Anna
Nurses constitute the major professional group offering constant hospital patients' care. Willingness to recommend their hospital reflects confidence in the offered care, satisfaction and identification with the work place. The aim of the present study has been to investigate which elements of hospital environment and nurse personal related factors predict recommendation of the hospital as a place of care by employed nurses. Cross-sectional, correlation study was, based on 1723 self-reported, anonymous questionnaires of nurses working in 30 acute hospitals. Data was analyzed using the logistic regression model, with general estimation equations. About 25% of nurses were unwilling to recommend their hospital as the place of care. The odds ratio (OR) of the lack of willingness to recommend the hospital was related to assessment of patients' safety (OR = 0.28, 95% confidence interval (CI): 0.18-0.46, p = 0.00), decrease in the quality of patient care during the preceding year (OR = 0.62, 95% CI: 0.41-0.93, p = 0.02), overall work conditions (OR = 0.35, 95% CI: 0.22-0.57, p = 0.00), weak cooperation between nurses and physicians (OR = 0.37, 95% CI: 0.25-0.54, p = 0.00), poor work schedule flexibility (OR = 0.74, 95% CI: 0.55- 0.99, p = 0.04) and educational opportunities (OR = 0.71, 95% CI: 0.54-0.95, p = 0.02) and the level of nurses depersonalization (OR = 1.78, 95% CI: 1.18-1.68, p = 0.00). The hospital manager should consider strategies which improve patients' safety and the staff working conditions. Thanks to that they will also achieve better and more competitive image of the hospital in the local community. Med Pr 2016;67(4):447-454. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Ferreira, Fernanda A.; Ferreira, Flávio
We study the effects of entry of two foreign firms on domestic welfare in the presence of licensing, when the incumbent is technologically superior to the entrants. We consider two different situations: (i) the cost-reducing innovation is licensed to both entrants; (ii) the cost-reducing innovation is licensed to just one of the entrants. We analyse three kind of license: (lump-sum) fixed-fee; (per-unit) royalty; and two-part tariff, that is a combination of a fixed-fee and a royalty. We prove that a two part tariff is never an optimal licensing scheme for the incumbent. Moreover, (i) when the technology is licensed to the two entrants, the optimal contract consists of a licensing with only output royalty; and (ii) when the technology is licensed to just one of the entrants, the optimal contract consists of a licensing with only a fixed-fee.
Perkins, Danielle E K
Newly graduated registered nurses face a barrage of physical and mental challenges in their first few years of practice, especially in the hospital setting. This article explores discrepancies between student nurse practice and professional nursing practice and the challenges that new nurses face in bridging the gap between idealistic theory and realistic practice. The author's subsequent graduate nursing education and continued practice in the field resulted in a personal evolution of practice that elicited a profound sense of appreciation for the field and a desire to share these experiences with other practicing nurses and students.
Sørensen, Tanja; Tingleff, Ellen B; Gildberg, Frederik A
Forensic mental health care is faced with serious problems in the recruitment and retention of newly graduated nurses (NGNs). Research into NGNs' experiences of their transition to and evaluations of transition programs in forensic care is sparse, and more studies are called for. This study aimed to investigate the characteristics of NGNs' experiences and perceptions of their transition into a forensic setting and their evaluations of the introduction period. Three focus group interviews were carried out, involving 13 NGNs, lasting 79.68 minutes on average. They were analyzed using thematic analysis. Results show two main themes: "feeling safe" and "taking on responsibilities." If NGNs felt overburdened with clinical responsibilities during their transition, their feeling of safety reduced. The converse also applied; theThe safer they felt, the greater clinical responsibility they felt capable of handling. The more difficult the NGNs perceived the informal transition, the more unsafe they felt, and the more negatively they perceived the responsibilities placed upon them. Tailored programs designed to support both the informal and formal transitions are recommended, along with preceptorship, theoretical training, and role-based support, such as a shift manager, along with early introduction to conflict management and security measures.
Chu, Wen; Hsu, Li-Ling
There is a paucity of published research on clinical or practical nursing knowledge. The ways that nurses acquire, develop, and maintain emergency room (ER) nursing care skills is a research area, in particular, that deserves further investigation. This study examined clinical setting learning processes to better understand the practical knowledge content of ER nurses. This study used a phenomenological approach and in-depth interviews of 10 nurses. Each participant had at least 3 years of ER experience. Researchers used Moustakas' method to analyze interview data. Findings were checked for credibility, transferability, dependability, and confirmability. The authors identified four major practical knowledge themes for ER professionals. These were (a) basic emergency treatment procedure routines and symptom management; (b) disease mechanisms, pharmacodynamics, and treatment responses; (c) newly identified diseases, updated emergency treatments and techniques, and medical treatment discussions; and (d) identifying nursing values including nursing attitudes and continuing patient care. Participants in this study had experience with the first three themes and successfully combined various types of nursing knowledge in their nursing care duties. Only few participants indicated experience with the fourth theme. Findings clarify that clinical or practical knowledge in ER nurses evolves first from declarative knowledge (e.g., basic emergency treatment routines and operating procedures) to procedural knowledge (e.g., instructions from supervisors, actual practice, and drills) to conditional knowledge (e.g., observation and treatment involving direct interactions with patients). Nurses should combine and apply the various knowledge types in their nursing practice to assess comprehensively each patient's condition and administer effective treatment and service.
... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Continuing accuracy of license application; application for modification of license. 431.73 Section 431.73 Aeronautics and Space COMMERCIAL SPACE... Conditions § 431.73 Continuing accuracy of license application; application for modification of license. (a...
In order to provide for the continuity of the current generation of nuclear power plant operating licenses and at the same time ensure the health and safety of the public, and the quality of the environment, the US Nuclear Regulatory Commission (NRC) established a goal of developing and issuing regulations and regulatory guidance for license renewal in the early 1990s. This paper will discuss some of those activities underway to achieve this goal. More specifically, this paper will discuss the Commission's regulatory philosophy for license renewal and the two major license renewal rule makings currently underway. The first is the development of a new Part 54 to address procedural and technical requirements for license renewal; the second is a revision to existing Part 51 to exclude environmental issues and impacts from consideration during the license renewal process. (author)
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
California Natural Resource Agency — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...
Anna C. van Graan
Full Text Available Higher cognitive skills are essential competencies for nurses joining the technologically and increasingly complex health care environment to provide safe and effective nursing care. Educators and clinical facilitators have recognised that newly qualified nurses do not meet the expectations for entry level clinical judgement and are held accountable for finding adequate learning experiences as preparation for such practice demands. An explorative and descriptive qualitative design was followed in this study to reach an understanding of clinical judgement in the clinical nursing environment from the perspective of professional nurses. Eleven professional nurses (n = 11 working at primary health care clinics, public and private hospitals participated voluntarily. Data was collected by means of the “World Café” method, incorporating a combination of techniques such as interviewing, discussions, drawings, narratives and reflection. The focus was on professional nurses' knowledge of the meaning of clinical judgement and factors influencing the development of clinical judgement in the clinical environment. Qualitative thematic content analysis principles were applied during data analysis. The findings were integrated with the relevant literature to culminate in conclusions that should add to the knowledge base of clinical judgement as an essential skill for improving autonomous and accountable nursing care.
Anna C. van Graan
Full Text Available Higher cognitive skills are essential competencies for nurses joining the technologically and increasingly complex health care environment to provide safe and effective nursing care. Educators and clinical facilitators have recognised that newly qualified nurses do not meet the expectations for entry level clinical judgement and are held accountable for finding adequate learning experiences as preparation for such practice demands. An explorative and descriptive qualitative design was followed in this study to reach an understanding of clinical judgement in the clinical nursing environment from the perspective of professional nurses. Eleven professional nurses (n = 11 working at primary health care clinics, public and private hospitals participated voluntarily. Data was collected by means of the “World Cafe” method, incorporating a combination of techniques such as interviewing, discussions, drawings, narratives and reflection. The focus was on professional nurses' knowledge of the meaning of clinical judgement and factors influencing the development of clinical judgement in the clinical environment. Qualitative thematic content analysis principles were applied during data analysis. The findings were integrated with the relevant literature to culminate in conclusions that should add to the knowledge base of clinical judgement as an essential skill for improving autonomous and accountable nursing care.
City of Jackson, Mississippi — This data displays all business license information for the year of 2015. This information details license classifications and status. This information will updated...
Mertz, Birgitte Goldschmidt; Dunn-Henriksen, Anne Katrine; Kroman, Niels
AIM: Our aim was to determine the feasibility and effectiveness of an individual, nurse-navigator intervention for relieving distress, anxiety, depression and health-related quality of life in women who have been treated for breast cancer (BC) and are experiencing moderate-to-severe psychological...... and the secondary outcomes were anxiety, depression, health-related quality of life and feasibility of the intervention. RESULTS: Women in the intervention group reported significantly greater satisfaction with treatment and rehabilitation and lower levels of distress (mean 2.7 vs. 5.1, p.... 7.8, p = .02) and depression (mean 2.2 vs. 4.4, p = .04) after 12 months compared to the control group. No significant effects were seen on health-related quality of life. CONCLUSIONS: The study shows promising feasibility of the individually tailored nurse-navigation intervention and while...
Williams, Allan F
One objective was to determine teenage licensing rates on a national basis, interest in early licensure, and reasons for delay. A second objective was to learn teenagers' opinions about licensing policies, important in states considering ways to upgrade their current licensing systems. One thousand three hundred eighty-three 15- to 18-year-olds completed an online survey in November 2010. They were drawn from a nationally representative panel of US households recruited using probability-based sampling. The panel included cell phone-only households, and Internet access was provided to those without it. Weighting procedures were applied so that the study population represented the national US population of 15- to 18-year-olds. Most teens said that they were interested in getting a license as soon as legally possible, but many had not started the process. At 16, teens were about equally divided among those who had not started, those in the learner stage, and those with a restricted or full license. At 18, 62 percent had full licenses; 22 percent had not started. For those old enough to start, lack of a car, costs, parent availability, ability to get around without a car, and being busy with other activities were leading reasons for delay. The majority of teens were not in favor of higher licensing ages. Forty-six percent thought the minimum learner age should be 16; 30 percent thought the full license age should be 18 or older. The majority approved of night (78%) and passenger (57%) restrictions, and 85 and 93 percent endorsed cell phone and texting bans, respectively. When these policies were packaged together in a single law that included an age 16 start, night, passenger, cell phone and texting bans, and a full license at age 18, 74 percent of teens were in favor. Teenagers are not as supportive of strong licensing policies as parents of teens, but there is evidence that they will support comprehensive policies likely to lead to further reductions in teen crash
Recent health service legislation, and especially the loss of crown immunity has once again focussed attention on the arrangements for licensing of radiopharmaceuticals. The aim of the article is to describe in general terms the UK licensing system and in particular to provide guidance to those responsible for the supply of radiopharmaceuticals in hospitals. (author)
Efendi, Ferry; Nursalam, N; Kurniati, Anna; Gunawan, Joko
International nurse migration among Association of Southeast Asian Nations (ASEAN) countries has the potential to increase the effectiveness of health services and access for the ASEAN Economic Community. Providing equivalent nursing qualifications and licensure standards and increasing the availability of the nursing workforce has become a challenge for ASEAN members. The purpose of this study is: 1) to comparatively analyze information on nursing licensing examinations (NLE) across ASEAN countries; and 2) to present information on the human resources required for a successful nursing workforce. This study reviews all documents published on the subject within the ASEAN Economic Community. NLE systems exist in all ASEAN Member States (AMSs)s except Brunei, Vietnam, and Lao PDR. Nursing education systems also vary across ASEAN countries. Language as a means of general communication and nursing examinations also differs. The availability of a qualified health workforce at the regional level is above the threshold in some areas. However, at the national level, Indonesia, Myanmar, Cambodia, and Lao PDR fall below the threshold. Professional licensure requirements differ among ASEAN nurses as a part of the process to become a qualified nurse in host and source countries. Mutual Recognition Agreements on nursing services should address the differences in NLE requirements as well as the availability of nurses. © 2018 Wiley Periodicals, Inc.
Spinks, Jean; Chaboyer, Wendy; Bucknall, Tracey; Tobiano, Georgia; Whitty, Jennifer A
Nursing bedside handover in hospital has been identified as an opportunity to involve patients and promote patient-centred care. It is important to consider the preferences of both patients and nurses when implementing bedside handover to maximise the successful uptake of this policy. We outline a study which aims to (1) identify, compare and contrast the preferences for various aspects of handover common to nurses and patients while accounting for other factors, such as the time constraints of nurses that may influence these preferences.; (2) identify opportunities for nurses to better involve patients in bedside handover and (3) identify patient and nurse preferences that may challenge the full implementation of bedside handover in the acute medical setting. We outline the protocol for a discrete choice experiment (DCE) which uses a survey design common to both patients and nurses. We describe the qualitative and pilot work undertaken to design the DCE. We use a D-efficient design which is informed by prior coefficients collected during the pilot phase. We also discuss the face-to-face administration of this survey in a population of acutely unwell, hospitalised patients and describe how data collection challenges have been informed by our pilot phase. Mixed multinomial logit regression analysis will be used to estimate the final results. This study has been approved by a university ethics committee as well as two participating hospital ethics committees. Results will be used within a knowledge translation framework to inform any strategies that can be used by nursing staff to improve the uptake of bedside handover. Results will also be disseminated via peer-reviewed journal articles and will be presented at national and international conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Small Business Administration — Starting a business? Confused about whether you need a business license or permit? Virtually every business needs some form of license or permit to operate legally....
The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes. As appropriate, these standards will be revised periodically to accommodate comments and reflect new information or experience
Snell, V. G.; Takats, F.; Szivos, K.
The SLOWPOKE Energy System (SES-10) is a 10 MW heating reactor that has been developed in Canada. It will be capable of running without a licensed operator in continuous attendance, and will be sited in urban areas. It has forgiving safety characteristics, including transient time-scales of the order of hours. A process called `up-front` licensing has been evolved in Canada to identify, and resolve, regulatory concerns early in the process. Because of the potential market in Hungary for nuclear district heating, a licensing plan has been developed that incorporates Canadian licensing experience, identifies specific Hungarian requirements, and reduces the risk of licensing delays by seeking agreement of all parties at an early stage in the program.
Huntelaar, Mark; Vos, Renate de; Roobol, Lars
Full text: A new license under the nuclear power act is applied for at the Dutch Government for the building of a High Active Repackaging Unit (HAVA-VU in Dutch) at NRG in Petten, The Netherlands. This new building is necessary to comply with our nuclear license to dispose of high active nuclear waste at Petten to the intermediate storage facility (COVRA). In the first part of this paper attention is given to the formal procedure followed by the Government, what type of documents are to be submitted, what time frames are followed, how citizen participation is organized, and as final result a new license. In the second part more detailed information is given about the present license renewal needed for the High Active Repackaging Unit
Noguchi, Norihito; Inoue, Satoshi; Shimanoe, Chisato; Shibayama, Kaoru; Shinchi, Koichi
Background Although nurses play an important role in humanitarian aid and disaster relief (HA/DR), little is known about the nursing activities that are performed in HA/DR. We aimed to clarify the nursing activities performed by Japanese nurses in HA/DR and to examine the factors associated with the frequency of nursing activities. Methods A self-administered questionnaire survey was completed by 147 nurses with HA/DR experience. The survey extracted information on demographic characteristics, past experience (e.g., disaster medical training experience, HA/DR experience), circumstances surrounding their dispatched to HA/DR (e.g., team size, disaster type, post-disaster phase, mission term), and the frequency of nursing activities performed under HA/DR. The frequency of nursing activities was rated on a 5-point Likert scale. Evaluation of nursing activities was conducted based on the “nursing activity score”, which represents the frequency of each nursing activity. Factors related to the nursing activity score were evaluated by multiple logistic regression analysis. Results Nurses were involved in 27 nursing activities in HA/DR, 10 of which were performed frequently. On analysis, factors significantly associated with nursing activity score were nursing license as a registered nurse (OR 7.79, 95% CI 2.95–20.57), two or more experiences with disaster medical training (OR 2.90 95%, CI 1.12–7.49) and a post-disaster phase of three weeks or longer (OR 8.77, 95% CI 2.59–29.67). Conclusions These results will contribute to the design of evidence-based disaster medical training that improves the quality of nursing activities. PMID:26959351
Rajbhandary, Sameer; Basu, Kisalaya
This paper investigates the relationship between the working conditions and illness- and injury-related absenteeism of full-time Registered Nurses (RNs) and Licensed Practical Nurses (LPNs). We used 2005 National Survey of the Work and Health of Nurses, which was designed to be representative of nurses employed in nursing in Canada in the fall of 2005. We estimated Negative Binomial regression models separately for RNs and LPNs with health related absenteeism as the dependent variable. The regressors include working conditions, work settings, and shift type/length along with socio-demographic variables. Depression is a significant determinant of absenteeism for both RNs and LPNs. However, workload and lack of respect are significant determinant of absenteeism for LPNs but not for RNs. Both RNs and LPNs working in other setting (physician offices, private nursing educations, educational institutions, governments and associations) will have less absenteeism than those working in hospitals. For LPNs, those working in long-term facility will also have less absenteeism than those working in hospitals. The length and type of shift also has significant effect on absenteeism. Improving working conditions with a resulting reduction in absenteeism might be an economic way to increase the labour supply of nurses without increasing new admissions or new recruits. Crown Copyright (c) 2010. Published by Elsevier Ireland Ltd. All rights reserved.
Spencer, K.M.; Zeighami, E.A.
This report presents the results of a six-year project that reviewed material licenses that had been terminated during the period from inception of licensing until approximately late-1994. The material licenses covered in the review project were Part 30, byproduct material licenses; Part 40, source material licenses; and Part 70, special nuclear material licenses. This report describes the methodology developed for the project, summarizes the findings of the license file inventory process, and describes the findings of the reviews or evaluations of the license files. The evaluation identified nuclear material use sites that need review of the licensing material or more direct follow-up of some type. The review process also identified licenses authorized to possess sealed sources for which there was incomplete or missing documentation of the fate of the sources
Full Text Available Aim: The objective of the review was the analysis of Czech and foreign literature sources and professional periodicals to obtain a relevant comprehensive overview of validation studies of nursing diagnoses in neonatology. Design: Review. Methods: The selection criterion was studies concerning the validation of nursing diagnoses in neonatology. To obtain data from relevant sources, the licensed professional databases EBSCO, Web of Science and Scopus were utilized. The search criteria were: date of publication - unlimited; academic periodicals - full text; peer-reviewed periodicals; search language - English, Czech and Slovak. Results: A total of 788 studies were found. Only 5 studies were eligible for content analysis, dealing specifically with validation of nursing diagnoses in neonatology. The analysis of the retrieved studies suggests that authors are most often concerned with identifying the defining characteristics of nursing diagnoses applicable to both the mother (parents and the newborn. The diagnoses were validated in the domains Role Relationship; Coping/Stress tolerance; Activity/Rest, and Elimination and Exchange. Diagnoses represented were from the field of dysfunctional physical needs as well as the field of psychosocial and spiritual needs. The diagnoses were as follows: Parental role conflict (00064; Impaired parenting (00056; Grieving (00136; Ineffective breathing pattern (00032; Impaired gas exchange (00030; and Impaired spontaneous ventilation (00033. Conclusion: Validation studies enable effective planning of interventions with measurable results and support clinical nursing practice.
Hoarea, Karen J; Millsc, Jane; Francis, Karen
Graduate nurses in general practice became a feature of New Zealand's health care system in 2008 following an expansion of the New Entrant to Practice Programme. General practice in New Zealand comprises general practitioner business owners who employ nursing and administration staff. Practice nurses are an ageing workforce in New Zealand, it is imperative therefore to attract younger nurses into general practice. This paper reports a section of the findings from a constructivist grounded theory study which examines the use of information by practice nurses in New Zealand. Initially data were collected using the ethnographic technique of observation and field notations in one general practice. Theoretical sensitivity to the value of role models was heightened by this first phase of data collection. A total of eleven practice nurses were interviewed from six general practices. One practice nurse agreed to a second interview; five of the interviewees were new graduate nurses and the other six were experienced practice nurses. The grounded theory constructed from this research was reciprocal role modelling which comprises the following three categories, becoming willing, realising potential and becoming a better practitioner. Graduate nurses and experienced practice nurses enter into a relationship of reciprocal role modelling. Becoming willing, the first core category of this grounded theory features three sub-categories: building respectful relationships, proving yourself and discerning decision making which are reported in this paper. Findings from this study may address the reported phenomenon of 'transition shock' of newly graduated nurses in the work place.
Gobbi, Paola; Castoldi, Maria Grazia; Alagna, Rosa Anna; Brunoldi, Anna; Pari, Chiara; Gallo, Annamaria; Magri, Miriam; Marioni, Lorena; Muttillo, Giovanni; Passoni, Claudia; Torre, Anna La; Rosa, Debora; Carnevale, Franco A
The research question for this study was as follows: Is the Code of Ethics for Nurses in Italy (Code) a valid or useful decision-making instrument for nurses faced with ethical problems in their daily clinical practice? Focus groups were conducted to analyze specific ethical problems through 11 case studies. The analysis was conducted using sections of the Code as well as other relevant documents. Each focus group had a specific theme and nurses participated freely in the discussions according to their respective clinical competencies. The executive administrative committee of the local nursing licensing council provided approval for conducting this project. Measures were taken to protect the confidentiality of consenting participants. The answer to the research question posed for this investigation was predominantly positive. Many sections of the Code were useful for discussion and identifying possible solutions for the ethical problems presented in the 11 cases. We concluded that the Code of Ethics for Nurses in Italy can be a valuable aid in daily practice in most clinical situations that can give rise to ethical problems. © The Author(s) 2016.
Zvika Neeman; Gerhard O. Orosel
We analyze a model of repeated franchise bidding for natural monopoly with contestable licensing - a franchisee halds an (exclusive) license to operate a franchise until another rm offers to pay more for it. In a world where quality is observable but not veri able, the simple regulatory scheme we describe combines market-like incentives with regulatory oversight to generate efficient outcomes.
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
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.
Gyurko, Charlene C
In 2009, the National League for Nursing reported that there are over 3.4 million persons in the United States employed in nursing in the roles of Registered Nurses (RNs) and Advanced Practice Nurses (APRNs). In 2007, the Bureau of Labor Statistics also reported that in 2006, there were over 749,000 Licensed Practical Nurses (LPNs) working in the United States with a projected increase of 14% by 2016. Buerhaus et al, in 2009, stated that between 2016 and 2025, it is estimated that the U.S. will need over 260,000 registered nurses (RNs) Using the conceptual framework of Vroom's expectancy theory on motivation as well as theories addressing student and career development, this paper demonstrates a synthesis of Vroom's model with other educational theories and its application to nursing education, specifically the prediction of motivation to advance one's nursing education. By putting Vroom's theory into a context, Vroom's fairly simple model could help nurse educators predict the factors that make for success in midcareer educational advancement--and even possibly manipulate those factors to increase that success. In today's economy, that practical part seems too good to lose. Copyright © 2010 Elsevier Ltd. All rights reserved.
Gazda, P.A.; Bhatt, P.C.
During the next 10 years, nuclear plant license renewal is expected to become a significant issue. Recent Electric Power Research Institute (EPRI) studies have shown license renewal to be technically and economically feasible. Filing an application for license renewal with the Nuclear Regulatory Commission (NRC) entails verifying that the systems, structures, and components essential for safety will continue to perform their safety functions throughout the license renewal period. This paper discusses the current proposed requirements for this verification and the current industry knowledge regarding age-related degradation of structures. Elements of a license renewal program incorporating NRC requirements and industry knowledge including a schedule are presented. Degradation mechanisms for structural components, their significance to nuclear plant structures, and industry-suggested age-related degradation management options are also reviewed
Thrysøe, Lars; Hounsgaard, Lise; Dohn, Nina Bonderup
of their career. Studies indicate that interaction between NQNs and their colleagues has an important influence of the way in which the NQNs experience their participation in the community of practice. Methodology: Nine NQNs participated in the study. The data collection took place six months after graduating...... for Clinical Practice: NQNs' participation in a COP is influenced by the extent to which they are included in both professional and social interactions and afforded the opportunity to contribute with knowledge and experience from their nursing studies. Furthermore, the study indicates that NQNs' experience...
Darnall, Emily D; Kishi, Aileen; Wiebusch, Pamela
Texas, like many states across the nation, is struggling to position itself to achieve the Institute of Medicine (IOM) recommendations on the future of nursing. This article provides insights into the hurdles faced by Texas in achieving some of the IOM goals, particularly those related to a better educated nursing workforce. Only 9% of actively licensed nurses have pursued higher degrees, putting Texas below the national average. Currently, there is a gap between actual academic mobility and national recommendations to increase the numbers of baccalaureate- and doctorate-prepared nurses by 2020. The purpose of this study was to evaluate the educational pipeline in the state of Texas while suggesting partnerships as a solution to promote academic mobility. This cross-sectional study evaluated the academic mobility of four selected cohorts of nurses who have been in practice for 5 to 20 years. The findings revealed limited academic mobility compared with national benchmarks among all cohorts, regardless of basic degree and length in the profession. Educational pipelines for nurses need to be more dynamic in Texas than current trends reflect. Collaboration and partnerships between academics, clinicians, administrators, employers, and policy makers should be developed to address barriers that are deterring nurses from continuing their education. Copyright © 2011 Elsevier Inc. All rights reserved.
Soderholm, K., E-mail: email@example.com [Fortum Power, Espoo (Finland)
This paper aims to increase the understanding of high level Nuclear Power Plant (NPP) licensing processes in Finland, France, the UK, Canada and the USA. These countries have been selected for this study because of their different licensing processes and recent actions in new NPP construction. After discussing their similarities and differences, suitable features for Small Modular Reactor licensing can be emphasized and suggested. Some of the studied licensing processes have elements that are already quite well suited for application to SMRs, but all of these different national processes can benefit from studying and implementing lessons learned from SMR specific licensing needs. The main SMR features to take into account in licensing are standardization of the design, modularity, mass production and serial construction. Modularity can be divided into two different categories: the first category is simply a single unit facility constructed of independently engineered modules (e.g., construction process for Westinghouse AP-1000 NPP) and the second is a facility structure composed of many reactor modules where modules are manufactured in factories and installed into the facility as needed (e.g., NuScale Power SMR design). Short construction schedules will not be fully benefited from if the long licensing process prolongs the commissioning and approach to full-power operation. The focus area of this study is to better understand the possibility of SMR deployment in small nuclear countries, such as Finland, which currently has four operating NPPs. The licensing process needs to be simple and clear to make SMR deployment feasible from an economical point of view. This paper uses public information and interviews with experts to establish the overview of the different licensing processes and their main steps. A high-level comparison of the licensing steps has been carried out. Certain aspects of the aviation industry licensing process have also been studied and certain
... ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS General Definitions § 596.306 License. Except as otherwise specified, the term license means any license or...
Cabaleiro, Goretti; Moreira, Solon; Reichstein, Toke
The potential for rent dissipation has been argued to be the main cause of firms? licensing out behavior being stifled.However, this aspect has been scarcely studied empirically. We draw on rent dissipation arguments, and hypothesize that firms suffering from the not-invented-here (NIH) syndrome......, firms in competitive product markets, and firms that have incurred substantial sunk cost are associated with lower rates of technology out-licensing. We also posit that sunk costs negatively moderate the relationship between competition in the licensor?s product market, and licensing rate. We test our...
Freed, Gary L; Dunham, Kelly M; Martyn, Kristy; Martin, Jean; Moran, Lauren M; Spera, Laura
The demand for hiring pediatric nurse practitioners (PNPs) is strong. However, the number of newly educated PNPs has remained relatively flat during the past several years. Understanding the rationale and timing for the decision to pursue this profession is essential to having a positive impact on increasing the future workforce. A mail survey of all new PNPs certified between January 2009 and July 2011 (N = 1040) was conducted. The response rate was 79.9%. Nearly half of all respondents (45%, N = 314) reported that they work in outpatient general pediatrics, 26% (N = 184) in outpatient subspecialty pediatrics, and 22% (N = 152) in inpatient settings. More than one third (36%, N = 253) spend most of their time in a private practice. Forty percent (N = 307) reported that they decided to pursue education as an advanced practice nurse while in practice as a registered nurse (RN), and 38% (N = 289) made the decision before pursuing RN education. Efforts to increase the PNP pipeline will need to be directed both to students during their RN education and to creating opportunities for current RNs to pursue advanced practice nurse education that is focused on children. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.
The judicial aspects of nuclear stations licensing are presented. The licensing systems of the United States, Spain, France and Federal Republic of Germany are focused. The decree n 0 60.824 from July 7 sup(th), 1967 and the following legislation which define the systematic and area of competence in nuclear stations licensing are analysed [pt
Hendry, Charles; Walker, Anne
Time is a valuable resource. When nurses experience demands on their services which exceed their available time, then 'rationing' must occur. In clinical practice such rationing requires practitioners to set priorities for care. The aim of this paper is establish what is currently known about priority setting in nursing, including how nurses set priorities and what factors influence this. CINAHL, Medline, ASSIA, and PsychLit databases for the years 1982-2002 were searched, using the terms (clinical decision-making or problem-solving or planning) and (setting priorities or prioriti*). The publications found were used in a selective, descriptive review. Priority setting is an important skill in nursing, and a skill deficit can have serious consequences for patients. Recent studies have suggested that it is a difficult skill for newly qualified nurses to acquire and may not be given sufficient attention in nurse education. Priority setting can be defined as the ordering of nursing problems using notions of urgency and/or importance, in order to establish a preferential order for nursing actions. A number of factors that may impact on priority setting have been identified in the literature. These include: the expertise of the nurse; the patient's condition; the availability of resources; ward organization; philosophies and models of care; the nurse-patient relationship; and the cognitive strategy used by the nurse to set priorities. However, very little empirical work has been conducted in this area. Further study of priority setting in a range of clinical practice settings is necessary. This could inform both practice and education, promote better use of limited resources and maximize patient outcomes.
Motshedisi E. Chauke
Full Text Available Introduction: Literature provides adequate evidence of a poor perception of nursing within the profession, resulting in high rates of attrition of student nurses and newly qualified nurses. The nursing profession, in particular nurse educators, has an ethical and professional responsibility to find innovative strategies to promote the positive image of nursing amongst student nurses. Purpose: The purpose of the study was to explore the potential of appreciative inquiry (AI as an intervention teaching strategy to transform student nurses’ image of nursing. Design: A quantitative, quasi-experimental, explorative-descriptive design comprising the pretest, appreciative inquiry as intervention, and the post-test was used. Methods: Convenience sampling was used to select third and fourthyear college and university student nurses in the Gauteng province of South Africa for the pre- and the post-test respectively. Data were collected by means of a questionnaire and analysed by SPSS version 20.0. Findings: The pretest results revealed a mix of positive and negative perceptions of the image of nursing amongst student nurses. The negative perceptions of the image of nursing that needed intervention included the working conditions of nurses, and the perception of nursing as a profession that was not respected and appreciated. The post-test results showed a significant and positive change in the student nurses’ perception of the image of nursing as a respected and appreciated profession. Although AI resulted in a negative to positive change in some aspects of student nurses’ image of nursing, the negative perceptions of the working conditions of nurses remained and became more negative. The positive image of gender in nursing was enhanced following the implementation of AI. Conclusion: Appreciative inquiry demonstrated potential as a teaching strategy to produce a positive nursing image change and positive orientation towards nursing amongst student
Melrose, Sherri; Miller, Jean; Gordon, Kathryn; Janzen, Katherine J.
This paper presents findings from a qualitative descriptive study that explored the professional socialization experiences of Licensed Practical Nurses (LPNs) who attended an online university to earn a Baccalaureate degree in nursing (BN), a prerequisite to writing the Canadian Registered Nurse (RN) qualifying exam. The project was framed from a constructivist worldview and Haas and Shaffir's theory of legitimation. Participants were 27 nurses in a Post-LPN to BN program who came from across Canada to complete required practicums. Data was collected from digital recordings of four focus groups held in different cities. Transcripts were analyzed for themes and confirmed with participants through member checking. Two overarching themes were identified and are presented to explain how these unique adult learners sought to legitimize their emerging identity as Registered Nurses (RNs). First, Post-LPN to BN students need little, if any, further legitimation to affirm their identities as “nurse.” Second, practicum interactions with instructors and new clinical experiences are key socializing agents. PMID:22548165
Full Text Available This paper presents findings from a qualitative descriptive study that explored the professional socialization experiences of Licensed Practical Nurses (LPNs who attended an online university to earn a Baccalaureate degree in nursing (BN, a prerequisite to writing the Canadian Registered Nurse (RN qualifying exam. The project was framed from a constructivist worldview and Haas and Shaffir’s theory of legitimation. Participants were 27 nurses in a Post-LPN to BN program who came from across Canada to complete required practicums. Data was collected from digital recordings of four focus groups held in different cities. Transcripts were analyzed for themes and confirmed with participants through member checking. Two overarching themes were identified and are presented to explain how these unique adult learners sought to legitimize their emerging identity as Registered Nurses (RNs. First, Post-LPN to BN students need little, if any, further legitimation to affirm their identities as “nurse.” Second, practicum interactions with instructors and new clinical experiences are key socializing agents.
Melrose, Sherri; Miller, Jean; Gordon, Kathryn; Janzen, Katherine J
This paper presents findings from a qualitative descriptive study that explored the professional socialization experiences of Licensed Practical Nurses (LPNs) who attended an online university to earn a Baccalaureate degree in nursing (BN), a prerequisite to writing the Canadian Registered Nurse (RN) qualifying exam. The project was framed from a constructivist worldview and Haas and Shaffir's theory of legitimation. Participants were 27 nurses in a Post-LPN to BN program who came from across Canada to complete required practicums. Data was collected from digital recordings of four focus groups held in different cities. Transcripts were analyzed for themes and confirmed with participants through member checking. Two overarching themes were identified and are presented to explain how these unique adult learners sought to legitimize their emerging identity as Registered Nurses (RNs). First, Post-LPN to BN students need little, if any, further legitimation to affirm their identities as "nurse." Second, practicum interactions with instructors and new clinical experiences are key socializing agents.
Fero, Laura J; Witsberger, Catherine M; Wesmiller, Susan W; Zullo, Thomas G; Hoffman, Leslie A
This paper is a report of a study to identify critical thinking learning needs of new and experienced nurses. Concern for patient safety has grown worldwide as high rates of error and injury continue to be reported. In order to improve patient safety, nurses must be able to recognize changes in patient condition, perform independent nursing interventions, anticipate orders and prioritize. In 2004-2006, a consecutive sample of 2144 newly hired nurses in a university-affiliated healthcare system completed the Performance Based Development System Assessment consisting of 10 videotaped vignettes depicting change in patient status. Results were reported as meeting or not meeting expectations. For nurses not meeting expectations, learning needs were identified in one of six subcategories. Overall, 74.9% met assessment expectations. Learning needs identified for nurses not meeting expectations included initiating independent nursing interventions (97.2%), differentiation of urgency (67%), reporting essential clinical data (65.4%), anticipating relevant medical orders (62.8%), providing relevant rationale to support decisions (62.6%) and problem recognition (57.1%). Controlling for level of preparation, associate (P=0.007) and baccalaureate (Por=10 years experience (P=0.046). Patient safety may be compromised if a nurse cannot provide clinically competent care. Assessments such as the Performance Based Development System can provide information about learning needs and facilitate individualized orientation targeted to increase performance level.
Kaya, Ayla; Boz, İlkay
One of the most important criteria for professionalism is accumulation of knowledge that is usable in professional practice. Nursing models and theories are important elements of accumulating nursing knowledge and have a chance to guarantee the ethical professional practice. In recent years, there has been an increase in the use of models in nursing research and newly created terminology has started to be used in nursing. In this study, a new model, termed as the Professional Values Model, developed by the authors was described. Concepts comprising the conceptual framework of the model and relations between the concepts were explained. It is assumed that awareness about concepts of the model will increase not only the patients' satisfaction with nursing care, but also the nurses' job satisfaction and quality of nursing care. Contemporary literature has been reviewed and synthesized to develop this theoretical paper on the Professional Values Model in nursing. Having high values in nursing increases job satisfaction, which results in the improvement of patient care and satisfaction. Also, individual characteristics are effective in the determination of individual needs, priorities, and values. This relation, proved through research about the Professional Values Model, has been explained. With development of these concepts, individuals' satisfaction with care and nurses' job satisfaction will be enhanced, which will increase the quality of nursing care. Most importantly, nurses can take proper decisions about ethical dilemmas and take ethical action when they take these values into consideration when giving care. The Professional Values Model seems suitable for nurse managers and it is expected that testing will improve it. Implementation of the Professional Values Model by nurse managers may increase motivation of nurses they work with. It is suggested that guidance by the Professional Values Model may help in enhancement of motivation efforts of the nurse managers
Sofarelli, Theresa A; Ricks, Jane H; Anand, Rahul; Hale, Devon C
International travel plays a significant role in the emergence and redistribution of major human diseases. The importance of travel medicine clinics for preventing morbidity and mortality has been increasingly appreciated, although few studies have thus far examined the management and staff training strategies that result in successful travel-clinic operations. Here, we describe an example of travel-clinic operation and management coordinated through the University of Utah School of Medicine, Division of Infectious Diseases. This program, which involves eight separate clinics distributed statewide, functions both to provide patient consult and care services, as well as medical provider training and continuing medical education (CME). Initial training, the use of standardized forms and protocols, routine chart reviews and monthly continuing education meetings are the distinguishing attributes of this program. An Infectious Disease team consisting of one medical doctor (MD) and a physician assistant (PA) act as consultants to travel nurses who comprise the majority of clinic staff. Eight clinics distributed throughout the state of Utah serve approximately 6,000 travelers a year. Pre-travel medical services are provided by 11 nurses, including 10 registered nurses (RNs) and 1 licensed practical nurse (LPN). This trained nursing staff receives continuing travel medical education and participate in the training of new providers. All nurses have completed a full training program and 7 of the 11 (64%) of clinic nursing staff serve more than 10 patients a week. Quality assurance measures show that approximately 0.5% of charts reviewed contain a vaccine or prescription error which require patient notification for correction. Using an initial training program, standardized patient intake forms, vaccine and prescription protocols, preprinted prescriptions, and regular CME, highly trained nurses at travel clinics are able to provide standardized pre-travel care to
The EU-directive on Environmental Impact Assessment (EIA) for certain public and private projects was once again amended in 2014 after controversial discussions, three previous modifications during 1985 and 2010 and an aggregation of all amendments within the EU-EIA-2011/92 directive. This newly released EU-EIA-directive 2014/52/EU (hereinafter RL 2014/52) is published within the EU-official journal EU L 124 p. 1 from 25.04.2014, came into force on 15. May 2014 and has to be adopted into international law until 16.05.2017. The modifications made are also valid, apart from certain exceptions, for licensing procedures (including decommissioning of nuclear power plants) in the field of nuclear energy, as far as they might have possible, significant environmental effects. The European EIA directive's 30th ''anniversary'' on 27.06.2015 raises the question, which substantial changes will come soon along with the newly released EU-EIA law. All in all it seems like if authorities and industry might get along with the newly released EU-EIA regulations. The responsible Federal Ministry for the Environment is already working on a first preliminary draft. It is under consideration if the EIA-regulation should be submitted additionally, beyond required amendments by EU-law, to a general revision. EIA-law remains exciting.
With nearly 2,000 free and open source software (FLOSS) licenses, software license proliferation¿ can be a major headache for software development organizations trying to speed development through software component reuse, as well as companies redistributing software packages as components of their products. Scope is one problem: from the Free Beer license to the GPL family of licenses to platform-specific licenses such as Apache and Eclipse, the number and variety of licenses make it difficu...
Murrells, Trevor; Robinson, Sarah; Griffiths, Peter
Job satisfaction is an important component of nurses' lives that can impact on patient safety, productivity and performance, quality of care, retention and turnover, commitment to the organisation and the profession. Little is known about job satisfaction in early career and how it varies for different groups of nurses. This paper investigates how the components of job satisfaction vary during early career in newly qualified UK nurses. Nurses were sampled using a combined census and multi-stage approach (n = 3962). Data were collected by questionnaire at 6 months, 18 months and 3 years after qualification between 1998 and 2001. Scores were calculated for seven job satisfaction components and a single item that measured satisfaction with pay. Scores were compared longitudinally and between nursing speciality (general, children's, mental health) using a mixed model approach. No single pattern across time emerged. Trends varied by branch and job satisfaction component. Rank order of job satisfaction components, from high to low scores, was very similar for adult and child branch nurses and different for mental health. Nurses were least satisfied with pay and most satisfied with relationships at 6 and 18 months and with resources (adult and child) and relationships (mental health) at 3 years. Trends were typically upwards for adult branch nurses, varied for children's nurses and downwards for mental health nurses. The impact of time on job satisfaction in early career is highly dependent on specialism. Different contexts, settings and organisational settings lead to varying experiences. Future research should focus on understanding the relationships between job characteristics and the components of job satisfaction rather than job satisfaction as a unitary construct. Research that further investigates the benefits of a formal one year preceptorship or probationary period is needed.
Full Text Available Abstract Background Job satisfaction is an important component of nurses' lives that can impact on patient safety, productivity and performance, quality of care, retention and turnover, commitment to the organisation and the profession. Little is known about job satisfaction in early career and how it varies for different groups of nurses. This paper investigates how the components of job satisfaction vary during early career in newly qualified UK nurses. Methods Nurses were sampled using a combined census and multi-stage approach (n = 3962. Data were collected by questionnaire at 6 months, 18 months and 3 years after qualification between 1998 and 2001. Scores were calculated for seven job satisfaction components and a single item that measured satisfaction with pay. Scores were compared longitudinally and between nursing speciality (general, children's, mental health using a mixed model approach. Results No single pattern across time emerged. Trends varied by branch and job satisfaction component. Rank order of job satisfaction components, from high to low scores, was very similar for adult and child branch nurses and different for mental health. Nurses were least satisfied with pay and most satisfied with relationships at 6 and 18 months and with resources (adult and child and relationships (mental health at 3 years. Trends were typically upwards for adult branch nurses, varied for children's nurses and downwards for mental health nurses. Conclusion The impact of time on job satisfaction in early career is highly dependent on specialism. Different contexts, settings and organisational settings lead to varying experiences. Future research should focus on understanding the relationships between job characteristics and the components of job satisfaction rather than job satisfaction as a unitary construct. Research that further investigates the benefits of a formal one year preceptorship or probationary period is needed.
Zomer, T P; VAN DER Maaden, T; VAN Gageldonk-Lafeber, A B; DE Greeff, S C; VAN DER Steen, J T; Verhoef, L
Pneumonia leads to considerable morbidity and mortality in nursing home residents with dementia. We assessed pneumonia incidence based on data from three different studies: (1) real-time national surveillance of healthcare-associated infections in nursing home residents in 2009-2015; (2) a randomized controlled trial in 2012-2015 to assess effects of a practical guideline in nursing home residents with dementia and pneumonia; and (3) a study in 2007-2010 to assess quality of dying in newly admitted nursing home residents with dementia. In national surveillance data, pneumonia incidence was calculated separately for psychogeriatric and somatic beds, as a proxy for residents with and without dementia. Weekly pneumonia incidence was significantly lower per 1000 psychogeriatric beds (3·9; 95% confidence interval (CI) 3·2-4·6) compared with 1000 somatic beds (5·7; 95% CI 5·1-6·3). Annual incidence per 1000 psychogeriatric beds was similar in national surveillance (range 78·9-117·1) and the trial (range 71·0-94·3), and significantly higher in newly admitted dementia residents (range 267·3-363·2). The incidence was highest during the first months after admission when compared with residents with longer stay. In conclusion, follow-up of pneumonia in newly admitted dementia residents may result in higher incidence, possibly due to higher risk in this population.
Wang, Yuandi; Roijakkers, N.; Vanhaverbeke, W.
This paper explores how interfirm variations in their in-licensed technology portfolios influence subsequent innovation performance. Existing studies mainly assume licensed technologies are homogeneously accessible to firms, and a prevailing explanation as to why firms vary in their innovation pe...
Ahmadi, K S; Speedling, E J; Kuhn-Weissman, G
In a previously reported panel study [Speedling et al. (1981). Int. J. Nurs. Stud. 18, 217-225], 180 Registered Nurses, three-quarters new graduates, were given questionnaires at time of hire and a year later. Using the panel study data, relationships among bureaucratic-professional role conception, actual situation and role discrepancy, and importance of job factors, job satisfaction and alienation, as well as age and length of stay at termination for time of hire only, are explored in this follow-up report. Mean bureaucratic actual situation (t = -5.18, P less than 0.001), bureaucratic role discrepancy (t = -2.77, P less than 0.01) and alienation (t = -2.36, P less than 0.05) increased, while professional actual situation (t = 3.39, P less than 0.01) and importance of job factors (t = 2.33, P less than 0.05) decreased during this first year of employment. In correlational analysis, at the time of hiring relationships were found between numerous variables, including: bureaucratic role conception with alienation (r = 0.17, P less than 0.05); bureaucratic actual situation with alienation (r = 0.19, P less than 0.05); professional role conception with alienation (r = -0.20, P less than 0.05) and with job satisfaction (r = -0.35, P less than 0.001); professional actual situation with job satisfaction (r = -0.19, P less than 0.05); and professional role discrepancy with job satisfaction (r = 0.23, P less than 0.01). A year after hiring, many relationships were found, including professional actual situation with job satisfaction (r = 0.26, P less than 0.05) and alienation with job satisfaction (r = -0.33, P less than 0.01). In stepwise regression analysis, age accounted for 8% of the variance in the importance of job factors (P less than 0.05), professional role conception for 28% of the variance in job satisfaction (P less than 0.001) at time of hire. A year after hiring, alienation and job satisfaction accounted for 12% of the variance in each other (P less than 0
Jimenez, M Michelle; Bui, Anthony L; Mantilla, Eduardo; Miranda, J Jaime
Most analyses of gaps in human resources for health (HRH) do not consider training and the transition of graduates into the labour market. This study aims to explore the labour market for Peru's recent medical, nursing, and midwifery graduates as well as their transition into employment in the Ministry of Health's (MOH) system. Data from four different datasets, covering 2007-2013, was used to characterize the patterns of recently trained physicians, nurses, midwives, and postgraduate-trained physicians that enter employment in the MOH system, and scenario analyses were used to describe how this rate of entry needs to adapt in order to fill current HRH shortages. HRH graduates have been increasing from 2007 to 2011, but the proportions that enter employment in the MOH system 2 years later range from 8 to 45% and less than 10% of newly trained medical specialists. Scenario analyses indicate that the gap for physicians and nurses will be met in 2027 and 2024, respectively, while midwives in 2017. However, if the number of HRH graduates entering the MOH system doubles, these gaps could be filled as early as 2020 for physicians and 2019 for nurses. In this latter scenario, the MOH system would still only utilize 56% of newly qualified physicians, 74% of nurses, and 66% of midwives available in the labour market. At 2013 training rates, Peru has the number of physicians, nurses, and midwives it needs to address HRH shortages and meet estimated HRH gaps in the national MOH system during the next decade. However, a significant number of newly qualified health professionals do not work for the MOH system within 2 years of graduation. These analyses highlight the importance of building adequate incentive structures to improve the entry and retention of HRH into the public sector.
Carolina Luiza Bernardes
Full Text Available Objective: To identify the issues occurred with nursing workers through a Health Monitoring System for Nursing Workers (SIMOSTE and to describe the consequences of those problems. Method: This is a quantitative, exploratory and descriptive study realized in a teaching hospital in the west region of the city of São Paulo. Results: From the SIMOSTE, 1.847 occurrences were registered in a six month period. Within the main occurrences, medical licenses, work related accidents with and without removals; psychiatric consultations and psychotherapy were highlighted. Conclusion: The data points out to the need for the development of new health vigilance actions to notify accidents and illness related to work, besides the prevention of issues.
Johansen, Laurie Jo; Stenvig, Thomas; Wey, Howard
We examined the relationships between factors (intention, habit, facilitating conditions, and social, cognitive, and affective factors) and nurses' decisions about influenza vaccinations to understand why some get vaccinated while others do not. In a descriptive correlational design, the Triandis model of interpersonal behavior was used to examine the decision of nurses to receive influenza vaccinations. Participants were a random sample (N=193) of registered nurses in North and South Dakota drawn from the respective state nursing licensing board lists. Instrument construction and mail survey procedures followed Dillman's tailored design method. The response rate exceeded 80%. The findings revealed significant, positive correlations among all model variables. Item analysis showed that false beliefs about influenza disease and vaccinations were prevalent and that there was a wide variation in employer support for nurses getting vaccinated. Educational and social marketing strategies may improve nurse's knowledge about influenza disease and vaccine and increase vaccine uptake. Employers should be encouraged to promote and improve influenza vaccine accessibility in the workplace. Additional study is needed to understand how best to strengthen the influence of intention and habit on the decision of nurses to receive influenza vaccinations. © 2011 Wiley Periodicals, Inc.
Shalala, Donna E
Millions more insured Americans. Increasing numbers of older patients. Higher rates of chronic illness. Fewer providers. How can our healthcare system not only manage these challenges but also improve performance and access to care while containing costs? The answer lies with our nurses. In some parts of the United States, nurses provide the full spectrum of primary and preventive care. They have successfully improved access and quality in rural areas. In other parts, nurses' hands are tied by antiquated laws and regulations that limit their ability to expand access to care. Our system cannot increase access when we have providers who are not allowed to perform to the top of their education, training, and capability. It is time to rethink how we deliver primary and preventive care and redefine the roles of doctors and nurses. This article examines the history of the Institute of Medicine's (IOM) Future of Nursing report (chaired by the author) and the resulting Future of Nursing Campaign for Action, which is working to institute the report's recommendations in all 50 states. The IOM report's recommendations are simple: 1. Remove outdated restrictions on nursing practice. 2. Promote nurse leadership on hospital boards and in all healthcare sectors. 3. Strengthen nurse education and training, and increase the number of nurses with advanced degrees. 4. Increase diversity in the nursing workforce to better reflect the patient population. 5. Improve data reporting and compilation to predict workforce needs. New York, Kentucky, and Minnesota are three recent states to remove barriers pre venting advanced practice registered nurses from practicing at the top of their license. Similar efforts in California, Florida, and Indiana failed initially but are expected to make progress in the near future. The article makes clear how and why the Center to Champion Nursing in America (an initiative of AARP, the AARP Foundation, and the Robert Wood Johnson Foundation) is working to
Kalisch, Beatrice J; Lee, Hyunhwa
This study aimed to explore whether and how staff characteristics, staffing, and scheduling variables are associated with the level of teamwork in nursing staff on acute care hospital patient units. This was a cross-sectional study with a sample of 1,758 nursing staff members from two different hospitals on 38 patient care units who completed the Nursing Teamwork Survey in 2008. This study focused on nursing teams who are stationed on a particular patient care unit (as opposed to visitors to the units). The return rate was 56.9%. The sample was made up of 77.4% nurses (registered nurses and licensed practical nurses), 11.9% assistive personnel, and 7.9% unit secretaries. Teamwork varied by unit and service type, with the highest scores occurring in pediatrics and maternity and the lowest scores on the medical-surgical and emergency units. Staff with less than 6 months of experience, those working 8- or 10-hour shifts (as opposed to 12 hours or a combination of 8 and 12 hours), part-time staff (as opposed to full time), and those working on night shift had higher teamwork scores. The higher teamwork scores were also associated with no or little overtime. The higher perception of the adequacy of staffing and the fewer patients cared for on a previous shift, the higher the teamwork scores. There is a relationship between selected staff characteristics, aspects of work schedules, staffing, and teamwork. Nursing staff want to work where teamwork is high, and perceptions of good staffing lead to higher teamwork. Higher teamwork scores correlated with those who worked less overtime.
The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining licensees and applicants for reactor operator and senior reactor operator licenses at power reactor facilities pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). The Examiner Standards are intended to assist NRC examiners and facility licensees to better understand the initial and requalification examination processes and to ensure the equitable and consistent administration of examinations to all applicants. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator licensing policy changes
Full Text Available The case is presented for a more flexible approach to licensing online library resources. Today's distributed education environment creates pressure for UK higher and further education institutions (HEI/FEIs to form partnerships and to develop educational products and roll them out across the globe. Online library resources are a key component of distributed education and yet existing licensing agreements struggle to keep pace with the increasing range of users and purposes for which they are required. This article describes the process of developing a flexible approach to licensing and proposes a new model licence for online library resources which has the adaptability needed in this new global educational landscape. These ideas have been presented and discussed at various workshops across Eduserv's and JISC Collections' higher education and publisher communities, and further consultation is ongoing.
Dalton, N W [Council for Nuclear Safety, Hennopsmeer, Pretoria (South Africa)
The development of nuclear safety and licensing is briefly reviewed in four stages namely: The Formative Period (1946-1959), The Expansive Period (1960-1969), The Mature Period (1970-1979) and the Apprehensive Period (1980-1989). Particular safety issues in the respective periods are highlighted to indicate the changing emphasis of nuclear licensing over the past thirty years or so. Against this background, nuclear licensing. (author)
The development of nuclear safety and licensing is briefly reviewed in four stages namely: The Formative Period (1946-1959), The Expansive Period (1960-1969), The Mature Period (1970-1979) and the Apprehensive Period (1980-1989). Particular safety issues in the respective periods are highlighted to indicate the changing emphasis of nuclear licensing over the past thirty years or so. Against this background, nuclear licensing. (author)
Teare, Jean; Horne, Maria; Clements, Gill; Mohammed, Mohammed A
To compare and contrast job descriptions for nursing roles in out-of-hours services to obtain a general understanding of what is required for a nurse working in this job. Out-of-hours services provide nursing services to patients either through telephone or face-to-face contact in care centres. Many of these services are newly created giving job opportunities to nurses working in this area. It is vital that nurses know what their role entails but also that patients and other professionals know how out-of-hours nurses function in terms of competence and clinical role. Content analysis of out-of-hours job descriptions. Content analysis of a convenience sample of 16 job descriptions of out-of-hours nurses from five out-of-hours care providers across England was undertaken. The findings were narratively synthesised, supported by tabulation. Key role descriptors were examined in terms of job titles, managerial skills, clinical skills, professional qualifications and previous experience. Content analysis of each out-of-hours job description revealed a lack of consensus in clinical competence and skills required related to job title although there were many similarities in skills across all the roles. This study highlights key differences and some similarities between roles and job titles in out-of-hours nursing but requires a larger study to inform workforce planning. Out-of-hours nursing is a developing area of practice which requires clarity to ensure patient safety and quality care. © 2016 John Wiley & Sons Ltd.
Meesterberends, Esther; Halfens, Ruud J G; Spreeuwenberg, Marieke D; Ambergen, Ton A W; Lohrmann, Christa; Neyens, Jacques C L; Schols, Jos M G A
To investigate whether the incidence of pressure ulcers in nursing homes in the Netherlands and Germany differs and, if so, to identify resident-related risk factors, nursing-related interventions, and structural factors associated with pressure ulcer development in nursing home residents. A prospective multicenter cohort study. Ten nursing homes in the Netherlands and 11 nursing homes in Germany (around Berlin and Brandenburg). A total of 547 newly admitted nursing home residents, of which 240 were Dutch and 307 were German. Residents had an expected length of stay of 12 weeks or longer. Data were collected for each resident over a 12-week period and included resident characteristics (eg, demographics, medical history, Braden scale scores, nutritional factors), pressure ulcer prevention and treatment characteristics, staffing ratios and other structural nursing home characteristics, and outcome (pressure ulcer development during the study). Data were obtained by trained research assistants. A significantly higher pressure ulcer incidence rate was found for the Dutch nursing homes (33.3%) compared with the German nursing homes (14.3%). Six factors that explain the difference in pressure ulcer incidence rates were identified: dementia, analgesics use, the use of transfer aids, repositioning the residents, the availability of a tissue viability nurse on the ward, and regular internal quality controls in the nursing home. The pressure ulcer incidence was significantly higher in Dutch nursing homes than in German nursing homes. Factors related to residents, nursing care and structure explain this difference in incidence rates. Continuous attention to pressure ulcer care is important for all health care settings and countries, but Dutch nursing homes especially should pay more attention to repositioning residents, the necessity and correct use of transfer aids, the necessity of analgesics use, the tasks of the tissue viability nurse, and the performance of regular
Dozier, J.; Lee, S.; Kuo, P.T.
The staff of the NRC has been developing three regulatory guidance documents for license renewal: the Generic Aging Lessons Learned (GALL) report, Standard Review Plan for License Renewal (SRP-LR), and Regulatory Guide (RG) for Standard Format and Content for Applications to Renew Nuclear Power Plant Operating Licenses. These documents are designed to streamline the license renewal review process by providing clear guidance for license renewal applicants and the NRC staff in preparing and reviewing license renewal applications. The GALL report systematically catalogs aging effects on structures and components; identifies the relevant existing plant programs; and evaluates the existing programs against the attributes considered necessary for an aging management program to be acceptable for license renewal. The GALL report also provides guidance for the augmentation of existing plant programs for license renewal. The revised SRP-LR allows an applicant to reference the GALL report to preclude further NRC staff evaluation if the plant's existing programs meet the criteria described in the GALL report. During the review process, the NRC staff will focus primarily on existing programs that should be augmented or new programs developed specifically for license renewal. The Regulatory Guide is expected to endorse the Nuclear Energy Institute (NEI) guideline, NEI 95-10, Revision 2, entitled 'Industry Guideline for Implementing the Requirements of 10 CFR Part 54 - The License Renewal Rule', which provides guidance for preparing a license renewal application. This paper will provide an introduction to the GALL report, SRP-LR, Regulatory Guide, and NEI 95-10 to show how these documents are interrelated and how they will be used to streamline the license renewal review process. This topic will be of interest to domestic power utilities considering license renewal and international ICONE participants seeking state-of-the-art information about license renewal in the United States
Clauss, J.M.; Harrison, D.L.; Pickens, T.A.
Today, 111 nuclear power plants provide over 20 percent of the electrical energy generated in the United States. The operating license of the oldest operating plant will expire in 2003, one-third of the existing operating licenses will expire by 2010 and the newest plant's operating license will expire in 2033. The National Energy Strategy (NES) prepared by the Department of Energy (DOE) assumes that 70 percent of the current operating plants will continue to operate beyond their current license expiration. Power from current operating plants can assist in ensuring an adequate, diverse, and environmentally acceptable energy supply for economic growth and improved U.S. competitiveness. In order to preserve this energy resource, three major tasks must be successfully completed: (1) establishment of regulations, technical standards, and procedures for the preparation and review of License Renewal Applications (LRAs); (2) development of technical criteria and bases for monitoring, refurbishing or replacing plant equipment; and (3) demonstration of the regulatory process by a plant obtaining a renewed license. Since 1986, the DOE has been working with the nuclear industry and the Nuclear Regulatory Commission (NRC) to establish and demonstrate the option to extend the life of a nuclear power plant by renewing the operating license. The Monticello Lead Plant demonstration project was initiated in September 1988, following the Pilot Plant studies. This paper is primarily focused on the status and insights gained from the Northern States Power Company (NSP) Monticello Lead Plant demonstration project. The following information is included: (1) Current Status - Monticello License Renewal Application; (2) Economic Analysis; (3) License Renewal Regulatory Uncertainty Issues; (4) Key Decisions; (5) Management Structure; (6) Technical and Licensing Perspective; (7) NRC Interactions; (8) Summary
Masterson, Abigail; Robb, Elizabeth; Gough, Pippa; Machell, Sue
The enabling compassionate care in practice programme was an innovative development programme for bands 6 and 7 nurses working with older people in all settings. It was commissioned by the Department of Health from the Florence Nightingale Foundation. A total of 117 nurses participated. They included experienced and newly appointed clinical leaders from medicine, surgery, acute specialties, community services, mental health, emergency departments, hospices and care homes. All participants reported increases in their knowledge, understanding and practical application of the 6Cs; courage and confidence to lead; and ability to change practice. Participants also reported feeling reinvigorated and being brought back in touch with why they entered nursing. At the close of the programme most participants had already made small but significant changes in their areas for the benefit of frail older people.
Alameddine, Mohamad; Baumann, Andrea; Onate, Kanecy; Deber, Raisa
One important strategy to address nursing shortages is to tap into the pool of licensed nurses who are not currently working in nursing and induce them to return to the nursing labour market. However, there is a paucity of research examining their likelihood of return to the active labour market. Analyze the career transitions of nurses registered with the College of Nurses Ontario but not working in the province's nursing labour market to determine the proportion of these nurses rejoining the active nursing workforce and examine the variation by inactive sub-category and age group. Quantitative analysis of a linked longitudinal database for all those registered with the College of Nurses of Ontario for the years 1993-2006. Registration records of all 215,687 nurses registered at any time in those years were merged by their unique registration number. Each nurse was placed for each year into an employment category. Two groups of nurses were defined: active (registered, working in nursing in Ontario) and inactive (registered, not working in nursing in Ontario). Inactive nurses were then sub-categorized into five mutually exclusive sub-categories: 'not working and seeking nursing employment', 'working in non-nursing and seeking nursing employment', 'not working and not seeking nursing employment', 'working in non-nursing and not seeking nursing employment' and 'working outside Ontario'. One-year career movements of nurses were tracked by generating 13 year-to-year transition matrixes. In the short-term, inactive nurses seeking a nursing job had the highest average rate of return to the active workforce (27.3-30.8%), though they might become high risk of leaving the profession if they do not find employment in a timely manner. Inactive nurses not seeking nursing employment are a heterogeneous group, and include nurses on leave who are likely to subsequently rejoin the active workforce should appropriate opportunities arise. The proportion of nurses rejoining the
Finotto, Stefano; Carpanoni, Marika; Turroni, Elena Casadei; Camellini, Riccarda; Mecugni, Daniela
For the nature of the Evidence-Based Practice (EBP) and its relevance to nursing, the skills that it requires should be a component in the basic Nursing degree courses. For this reason, the EBP process should be introduced early on in nursing education to develop students' independence and ability to self-learning. the aim of this study is to describe the perception that newly graduated nurses have relative to the benefits of the skills learned during the laboratory's three-year EBP in consideration of the construction of the thesis, the research of evidence and usefulness of the EBP process for the development of their professional career. A descriptive study with a sample of 300 newly graduated nurses from the Degree Course in Nursing of the University of Modena and Reggio Emilia, venue of Reggio Emilia. The data collection instrument was an anonymous questionnaire. It was possible to answer through a 10 Likert scale. The sample considers effective the research of evidence carried out (mean 6, SD 2), related to the problems of patients (mean 7, SD 2); the sample considered the skills acquired during the laboratory's three-year EBP to be useful for career development (mean 7, SD 2). the decision to include the laboratory's three-year EBP in the curriculum of the Nursing degree promotes the development of skills relating to the use of the EBP process, competence that in the literature is indicated as one of the core competencies that all health professionals should develop and maintain throughout their professional career. Copyright © 2013 Elsevier Ltd. All rights reserved.
Aiyub, S; Linh, N N; Tayler-Smith, K; Khogali, M; Bissell, K
Fiji's schools of nursing and government health services, 2001-2010. To report on 1) the number and characteristics of nurses who graduated in Fiji, 2) the proportion of vacant nursing positions in the government health services and 3) attrition among nurses. Descriptive study involving a retrospective record review of Ministry of Health annual reports and nursing registers. Over the period 2001-2010, a total of 1500 nurses graduated, with the overall trend being a gradual increase in newly qualified nurses year on year. Available data from 2007 onwards showed relatively low vacancy rates (range 0.4-2%), with a sharp rise to 15% in 2009. Complete data on nurse attrition were available only from 2007 onwards, with rates of attrition ranging from 4% to 10%; the most common reason for attrition was resignation. While it was unable to directly assess whether Fiji's supply of nursing graduates has been meeting the country's health service demands, this study provides a series of baseline data on Fiji's nurse graduate and nursing workforce. In addition, it identifies some of the challenges and gaps that need to be considered to better assess and address nursing staff shortages.
The Atomic Energy Act and the implementing regulations of the US Nuclear Regulatory Commission (NRC) permit the renewal of nuclear plant operating licenses upon expiration of their 40-year license term. However, the regulatory process by which license renewal may be accomplished and the requirements for the scope and content of renewal applications are yet to be established. On August 29, 1988, the NRC published an Advanced Notice of Proposed Rulemaking regarding the subject of license renewal. This Advanced Notice and the NUREG which it references, NUREG-1317, Regulatory Options for Nuclear Plant License Renewal, provide the most recent regulatory thought on this issue. The basic issue addressed by NUREG-1317 is the definition of an adequate licensing basis for the renewal of a plant license. The report contemplates three alternatives in this regard. This paper discusses each of these three proposals. The NUMARC NUPLEX Working Group endorses a license renewal process based on a plant's current licensing basis along with an evaluation of the pertinent components, systems, and structures affected by age-related degradation. The NUMARC NUPLEX Working group believes that an appropriate scope for NRC review of the license renewal application should focus on those safety-significant structures systems, and components subject to significant age-related degradation that are not subject to existing recognized effective replacement, refurbishment, or inspection programs. The paper also briefly discusses NUMARC's view of the role of the Backfit Rule in the license renewal process
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
Poirier, Brigitte; Blais, Etienne; Faubert, Camille
In keeping with the differential deterrence theory, this article assesses the moderating effect of license type on the relationship between social control and intention to violate road rules. More precisely, the article has two objectives: (1) to assess the effect of license type on intentions to infringe road rules; and (2) to pinpoint mechanisms of social control affecting intentions to violate road rules based on one's type of driver license (a restricted license or a full license). This effect is examined among a sample of 392 young drivers in the province of Quebec, Canada. Drivers taking part in the Graduated Driver Licensing (GDL) program have limited demerit points and there is zero tolerance for drinking-and-driving. Propensity score matching techniques were used to assess the effect of the license type on intentions to violate road rules and on various mechanisms of social control. Regression analyses were then conducted to estimate the moderating effect of license type. Average treatment effects from propensity score matching analyses indicate that respondents with a restricted license have lower levels of intention to infringe road rules. While moral commitment and, to a lesser extent, the perceived risk of arrest are both negatively associated with intentions to violate road rules, the license type moderates the relationship between delinquent peers and intentions to violate road rules. The effect of delinquent peers is reduced among respondents with a restricted driver license. Finally, a diminished capability to resist peer pressure could explain the increased crash risk in months following full licensing. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Abstract Background Job satisfaction is important for nursing home staff and nursing home management, as it is associated with absenteeism, turnover, and quality of care. However, we know little about factors associated with job satisfaction and dissatisfaction for nursing home workers. Methods In this investigation, we use data from 251 caregivers (i.e., Registered Nurses, Licensed Practical Nurses, and Nurse Aides to examine: job satisfaction scores of these caregivers and what characteristics of these caregivers are associated with job satisfaction. The data were collected from two nursing homes over a two and a half year period with five waves of data collection at six-month intervals. The Job Description Index was used to collect job satisfaction data. Results We find that, overall nursing home caregivers are satisfied with the work and coworkers, but are less satisfied with promotional opportunities, superiors, and compensation. From exploratory factor analysis three domains represented the data, pay, management, and work. Nurse aides appear particularly sensitive to the work domain. Of significance, we also find that caregivers who perceived the quality of care to be high have higher job satisfaction on all three domains than those who do not. Conclusion These results may be important in guiding caregiver retention initiatives in nursing homes. The finding for quality may be especially important, and indicates that nursing homes that improve their quality may have a positive impact on job satisfaction of staff, and thereby reduce their turnover rates.
Kadak, Andrew C.
The license by test approach to licensing is a novel method of licensing reactors. It provides an opportunity to deal with innovative non-water reactors in a direct way on a time scale that could permit early certification based on tests of a demonstration reactor. The uncertainties in the design and significant contributors to risk would be identified in the PRA during the design. Deterministic analysis computer codes could be tested on a real reactor. Scaling effects and associated uncertainties would be minimized. License by test is an approach that has sufficient merit to be developed and tested
... Licensing and Corporate Governance § 96.30 State licensing. (a) The agency or person is properly licensed or... person follows applicable State licensing and regulatory requirements in all jurisdictions in which it provides adoption services. (c) If it provides adoption services in a State in which it is not itself...
The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements
The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements
The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements
Strohal, P.; Subasic, D.; Valcic, I.
As the outcomes of the newly introduced safety philosophies, new and more strict safety design requirements for nuclear installation are expected to be introduced. New in-depth defence measures should be incorporated into the design and operation procedure for a nuclear installation, to compensate for potential failures in protection or safety measures. The new requirements will also apply to licensing of NPP's operation as well as to licensing of nuclear sites, especially for radioactive waste disposal sites. This paper intends to give an overview of possible impacts of new internationally agreed basic safety standards with respect to NPP and related technologies. Recently issued new basic safety standards for radiation protection are introducing some new safety principles which may have essential impact on future licensing requirements regarding nuclear power plants and radioactive waste installations. These new standards recognize exposures under normal conditions ('practices') and intervention conditions. The term interventions describes the human activities that seek to reduce the existing radiation exposure or existing likelihood of incurring exposure which is not part of a controlled practice. The other new development in safety standards is the introduction of so called potential exposure based on the experience gained from a number of radiation accidents. This exposure is not expected to be delivered with certainty but it may result from an accident at a source or owing to an event or sequence of events of a probabilistic nature, including equipment failures and operating errors. (author)
Norikoshi, Kensuke; Kobayashi, Toshio; Tabuchi, Keiji
To identify attributes of nurses' workplace social capital in Japan. Much attention has been paid to nurses' workplace social capital to improve the quality of the work environment; however, few studies are available on the attributes of nurses' workplace social capital. Semi-structured interviews were conducted with 32 nurses at seven hospitals. Nurses reported on the attributes of workplace social capital, such as characteristics facilitating individual positive action in an organisation, which were qualitatively analysed using the Kawakita Jiro method. The attributes of nurses' workplace social capital were organised into six groups: affirmation; exchange of appreciation; unrestricted information sharing; ability to trust; access to the strength; and altruistic reciprocity. The attributes of nurses' workplace social capital included a social structure that allowed nurses to make full use of their abilities both vertically and horizontally and were supported by a sense of security. In particular, newly emerged exchange of appreciation and altruistic reciprocity were important for nurses in Japan in building cooperative relationships with others. Managing human relationships, such as exchange of appreciation and altruistic reciprocity, in clinical settings based on nurses' workplace social capital may promote positive emotions in the organisation, positive ideas among staff and cooperative teamwork, which may lead to high-quality patient care. © 2017 John Wiley & Sons Ltd.
The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining licensees and applicants for reactor operator and senior reactor operator licenses at power reactor facilities pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). The Examiner Standards are intended to assist NRC examiners and facility licensees to better understand the initial and requalification examination processes and to ensure the equitable and consistent administration of examinations to all applicants. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator licensing policy changes. Revision 7 was published in January 1993 and became effective in August 1993. Supplement 1 is being issued primarily to implement administrative changes to the requalification examination program resulting from the amendment to 10 CFR 55 that eliminated the requirement for every licensed operator to pass an NRC-conducted requalification examination as a condition for license renewal. The supplement does not substantially alter either the initial or requalification examination processes and will become effective 30 days after its publication is noticed in the Federal Register. The corporate notification letters issued after the effective date will provide facility licensees with at least 90 days notice that the examinations will be administered in accordance with the revised procedures
Ferreira, Fernanda A.
We study the effects of entry of a foreign firm on domestic welfare in the presence of licensing, when the entrant is technologically superior to the incumbent. We show that foreign entry increases domestic welfare for sufficiently large technological differences between the firms under both fixed-fee licensing and royalty licensing.
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false License. 120.20 Section 120.20 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS PURPOSE AND DEFINITIONS § 120.20 License. License means a document bearing the word “license” issued by the Directorate of Defense Trade...
... Software and Computer Software Documentation 227.7203-4 License rights. (a) Grant of license. The... license, under an irrevocable license granted or obtained by the contractor which developed the software... granted to the Government. The scope of a computer software license is generally determined by the source...
Nowrouzi, Behdin; Lightfoot, Nancy; Carter, Lorraine; Larivière, Michel; Rukholm, Ellen; Schinke, Robert; Belanger-Gardner, Diane
The purpose of this mixed methods study was to examine the quality of work life of registered nurses working in obstetrics at 4 hospitals in northeastern Ontario and explore demographic and occupational factors related to nurses' quality of work life (QWL). A stratified random sample of registered nurses (N = 111) selected from the 138 eligible registered nurses (80.4%) of staff in the labor, delivery, recovery, and postpartum areas at the 4 hospitals participated. Logistic regression analyses were used to consider QWL in relation to the following: 1) demographic factors, and 2) stress, employment status and educational attainment. In the logistic regression model, the odds of a higher quality of work life for nurses who were cross trained (nurses who can work across all areas of obstetrical care) were estimated to be 3.82 (odds ratio = 3.82, 95% confidence interval: 1.01-14.5) times the odds of a higher quality of work life for nurses who were not cross trained. This study highlights a relationship between quality of work life and associated factors including location of cross-training among obstetrical nurses in northeastern Ontario. These findings are supported by the qualitative interviews that examine in depth their relationship to QWL. Given the limited number of employment opportunities in the rural and remote regions, it is paramount that employers and employees work closely together in creating positive environments that promote nurses' QWL. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Kim, J. Y.; Cho, J. S.; Min, Y. S.; Nam, J. M.; Jeon, G. P.; Park, S. S.; Jo, J. H.; Song, I. T.
Since 2010 August, PEFP(Proton Engineering Frontier Project)'s Proton Accelerator Research Center has been under construction so far. Generally, in advance of construction startup, many kinds of licenses should be acquired along with the types of construction works. To acquire a license in time, each item should meet the standard by the related regulation, including not only procedural but also content aspect. In the advent of internet era, electronic government system has been adopted in many governmental functions: So is the national construction license acquisition system. Owing to the system, both approval and documentation functions in licensing are integrated in online computer network which provide us simplification in process and easy accessibility to license data. However, aside from these construction licenses, other types of licenses still remain separately managed: Machinery, electric facilities, and so on. Moreover, all the licenses have the priority order and take legal term in processing. So, to avoid any time delay in license acquisition, we organized license hierarchy and found out the priority among them. Thereafter, according to their legal term in approval and acquisition, whole license acquisition schedule was arranged and we completed all the necessary licenses acquisition in time In this study, we summarize the current status of license acquisition on Proton Accelerator Research Center Construction, and manifest how they have been and will be managed systematically
Kim, J. Y.; Cho, J. S.; Min, Y. S.; Nam, J. M.; Jeon, G. P.; Park, S. S.; Jo, J. H.; Song, I. T. [KAERI, Daejeon (Korea, Republic of)
Since 2010 August, PEFP(Proton Engineering Frontier Project)'s Proton Accelerator Research Center has been under construction so far. Generally, in advance of construction startup, many kinds of licenses should be acquired along with the types of construction works. To acquire a license in time, each item should meet the standard by the related regulation, including not only procedural but also content aspect. In the advent of internet era, electronic government system has been adopted in many governmental functions: So is the national construction license acquisition system. Owing to the system, both approval and documentation functions in licensing are integrated in online computer network which provide us simplification in process and easy accessibility to license data. However, aside from these construction licenses, other types of licenses still remain separately managed: Machinery, electric facilities, and so on. Moreover, all the licenses have the priority order and take legal term in processing. So, to avoid any time delay in license acquisition, we organized license hierarchy and found out the priority among them. Thereafter, according to their legal term in approval and acquisition, whole license acquisition schedule was arranged and we completed all the necessary licenses acquisition in time In this study, we summarize the current status of license acquisition on Proton Accelerator Research Center Construction, and manifest how they have been and will be managed systematically.
acquisition. The findings indicate that technology licensing is positively related to the number of inventions produced by the licensee in the years subsequent to the licensing deal. Subsequently, I investigate the moderating effect that organizational slack and myopia have on this main relationship....... The findings also suggest that high levels of Organizational Slack (available financial resources) strengthen the positive effect of licensing on innovation. However, higher levels of Organizational Myopia (the extent to which a firm draws on its own knowledge) can decrease the main effect of licensing....
Järvinen, Tiina; Eklöf, Niina; Salminen, Leena
The aim of this scoping literature review was to identify the factors related to nursing students' readiness to enter working life. The literature search was carried out in autumn 2017 in PubMed and CINAHL databases. The studies selected for this review (n = 17) were analyzed thematically with inductive content analysis. Four subthemes that were combined into two main factors related to nursing students' readiness to enter working life were found. The main factors found were 1) educational factors and 2) personal factors. Educational factors consisted of professional competence and clinical practice, while personal factors consisted of nursing students' background and feelings. Some nursing students tend to feel insecure about entering working life as a newly graduated nurse. This literature review also supports the importance of clinical practice periods in nursing education and for readiness for working life. Nurse education needs to ensure clinical practice periods which support nursing students' professional growth. Further research is needed on how the factors related to nursing students' readiness to enter working life correlate with each other. Particularly, the association between competence, readiness and positive feelings towards graduation needs further investigation. Copyright © 2018 Elsevier Ltd. All rights reserved.
... FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS General Definitions § 596.309 Specific license. The term specific license means any license or...
The Kentucky Department of Vehicle Regulation is exploring the possibility of developing and implementing online : drivers license renewal. The objective of this project was to: 1) evaluate online drivers license and REAL ID renewal : programs ...
For reasons of public acceptance the basis of a licensing system should be laid down in a law, details can be fixed in regulations below the law-level. The competence for licensing nuclear installations should be attributed to one body, which is not a the same time charged with the promotion of nuclear energy. The licensing authority has to be provided with sufficient technical advice, given by experts organized in advisory bodies. Normally a licensing procedure is split into several steps (site approval, construction permit, operation licence), each step can be subdivided. Some general aspects of licensing conditions (personal, technical and financial) as well as of the licensing procedure are outlined. The participation of the public is of particular importance but also involves most intricate problems. The paper concludes with some critical remarks on the role of administrative courts with respect to the licensing of nuclear power plants. (orig.) [de
... FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS General Definitions § 596.305 General license. The term general license means any license or authorization...
Silverman, D.J.; Bauser, M.A.; Baird, R.D.
This report provides a detailed set of proposed criteria and guidance for the preparation of a license application for an assured isolation facility (AIF). The report is intended to provide a detailed planning basis upon which a prospective applicant may begin pre-licensing discussions with the Nuclear Regulatory Commission and initiate development of a license application. The report may also be useful to the NRC or to state regulatory agencies that may be asked to review such an application. Volume 1 of this report provides background information, and describes the licensing approach and methodology. Volume 2 identifies specific information that is recommended for inclusion in a license application
Deane, William H; Fain, James A
With the increased life expectancy, older adults will interact with multiple health care providers to manage acute and chronic conditions. These interactions include nursing students who use various health care settings to meet the clinical practicum requirements of their programs. Nursing faculty are charged with facilitating students' learning throughout the program from basic human needs, to holistic communication, to advanced medical surgical concepts. Despite educating students on holistic communication, there remains a lack of a reliable framework to undertake the task of teaching holistic communication skills. Nursing students preparing to function as licensed practitioners need to develop appropriate knowledge to holistically care for older adults. The purpose of this article is to examine Hildegard Peplau's interpersonal relations theory as a framework to assist nursing students to understand holistic communication skills during their encounters with older adults. Peplau's theory provides nursing a useful set of three interlocking and oftentimes overlapping working phases for nurses' interaction with patients in the form of the nurse-patient relationship. Nursing education could adopt the three phases of Peplau's interpersonal relations theory to educate students on holistically communicating with older adults. © The Author(s) 2015.
Nasa Zata Dina
Full Text Available The number of vehicles on the road has increased drastically in recent years. The license plate is an identity card for a vehicle. It can map to the owner and further information about vehicle. License plate information is useful to help traffic management systems. For example, traffic management systems can check for vehicles moving at speeds not permitted by law and can also be installed in parking areas to se-cure the entrance or exit way for vehicles. License plate recognition algorithms have been proposed by many researchers. License plate recognition requires license plate detection, segmentation, and charac-ters recognition. The algorithm detects the position of a license plate and extracts the characters. Various license plate recognition algorithms have been implemented, and each algorithm has its strengths and weaknesses. In this research, I implement three algorithms for detecting license plates, three algorithms for segmenting license plates, and two algorithms for recognizing license plate characters. I evaluate each of these algorithms on the same two datasets, one from Greece and one from Thailand. For detecting li-cense plates, the best result is obtained by a Haar cascade algorithm. After the best result of license plate detection is obtained, for the segmentation part a Laplacian based method has the highest accuracy. Last, the license plate recognition experiment shows that a neural network has better accuracy than other algo-rithm. I summarize and analyze the overall performance of each method for comparison.
The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis
Sines, John A.
The large nursing home market has several natural characteristics which make it a good applications area for robotics. The environment is already robot accessible and the work functions require large quantities of low skilled services on a daily basis. In the near future, a commercial opportunity for the practical application of robots is emerging in the delivery of housekeeping services in the nursing home environment. The robot systems will assist in food tray delivery, material handling, and security, and will perform activities such as changing a resident's table side drinking water twice a day, and taking out the trash. The housekeeping work functions will generate cost savings of approximately 22,000 per year, at a cost of 6,000 per year. Technical system challenges center around the artificial intelligence required for the robot to map its own location within the facility, to find objects, and to avoid obstacles, and the development of an energy efficient mechanical lifting system. The long engineering and licensing cycles (7 to 12 years) required to bring this type of product to market make it difficult to raise capital for such a venture.
Cuccia, Valeria; Sacramento, Arivaldo M.; Aleixo, Bruna L.; Ferreira, Vinicius V.M.
The licensing process of a waste disposal facility is a complex and demanding undertaking. It proceeds in phases, starting with the site selection and ending many decades later, when the radionuclides decayed and no longer offer possible hazard. That is one of the reasons why the licensing process for the Brazilian repository for low and intermediate level radioactive waste (RBMN Project) is a challenge for all the technicians involved. Besides that, the only national experience associated to this subject arose after a radiological accident in the State of Goias, in 1987. Two different institutions are involved in this licensing process: IBAMA, for environmental licensing, and CNEN, for nuclear licensing. Both of them will evaluate the possible impacts caused by the waste disposal, so it is essential to avoid conflicts and duplications of activities. The RBMN project has different teams for each main activity, and one of them is the Licensing group. This team has been planning the licensing activities for the repository, studying the legal framework and estimating costs and execution time for each step. This paper presents the status of the licensing activities regarding to the RBMN project done by the CNEN staff. (author)
Dumas, Orianne; Varraso, Raphaëlle; Zock, Jan Paul; Henneberger, Paul K; Speizer, Frank E; Wiley, Aleta S; Le Moual, Nicole; Camargo, Carlos A
Nurses are at increased risk of occupational asthma, an observation that may be related to disinfectants exposure. Whether asthma history influences job type or job changes among nurses is unknown. We investigated this issue in a large cohort of nurses. The Nurses' Health Study II is a prospective study of US female nurses enrolled in 1989 (ages 24-44 years). Job status and asthma were assessed in biennial (1989-2011) and asthma-specific questionnaires (1998, 2003). Associations between asthma history at baseline (diagnosis before 1989, n=5311) and job type at baseline were evaluated by multinomial logistic regression. The relations of asthma history and severity during follow-up to subsequent job changes were evaluated by Cox models. The analytic cohort included 98 048 nurses. Compared with nurses in education/administration (likely low disinfectant exposure jobs), women with asthma history at baseline were less often employed in jobs with likely high disinfectant exposure, such as operating rooms (odds ratio 0.73 (95% CI 0.63 to 0.86)) and emergency room/inpatient units (0.89 (0.82 to 0.97)). During a 22-year follow-up, nurses with a baseline history of asthma were more likely to move to jobs with lower exposure to disinfectants (HR 1.13 (1.07 to 1.18)), especially among those with more severe asthma (HR for mild persistent: 1.13; moderate persistent 1.26; severe persistent: 1.50, compared with intermittent asthma, p trend: 0.004). Asthma history was associated with baseline job type and subsequent job changes among nurses. This may partly reflect avoidance of tasks involving disinfectant use, and may introduce bias in cross-sectional studies on disinfectant exposure and asthma in nurses. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Arora, Ashish; Rønde, Thomas; Fosfuri, Andrea
the technology makes licensing decisions—to centralized licensing. The business unit has superior information about licensing opportunities but may not have the appropriate incentives because its rewards depend upon product market performance. If licensing is decentralized, the business unit forgoes valuable...... licensing opportunities since the rewards for licensing are (optimally) weaker than those for product market profits. This distortion is stronger when production-based incentives are more powerful, making centralization more attractive. Growth of technology markets favors centralization and drives higher...
The Department of Energy (DOE) is authorized by the Nuclear Waste Policy Act of 1982 (Act) to site, design, construct, and operate mined geologic repositories for high-level radioactive wastes and is required to obtain licenses from the Nuclear Regulatory Commission (NRC) to achieve that mandate. To this end the DOE has developed a licensing approach which defines program strategies and which will facilitate and ease the licensing process. This paper will discuss the regulatory framework within which the repository program is conducted, the DOE licensing strategy, and the interactions between DOE and NRC in implementing the strategy. A licensing strategy is made necessary by the unique technical nature of the repository. Such a facility has never before been licensed; furthermore, the duration of isolation of waste demanded by the proposed EPA standard will require a degree of reliance on probabilistic performance assessment as proof of compliance that is a first of a kind for any industry. The licensing strategy is also made necessary by the complex interrelationships among the many involved governmental agencies and even within DOE itself, and because these relationships will change with time. Program activities which recognize these relationships are essential for implementing the Act. The guiding principle in this strategy is an overriding commitment to safeguarding public health and safety and to protecting the environment
Grant, S D [Atomic Energy of Canada Ltd., Saskatoon, SK (Canada); Snell, V G [Atomic Energy of Canada Ltd., Mississauga, ON (Canada)
AECL has been pioneering `up-front` licensing of new reactor designs. The CANDU 3 design has been formally reviewed by AECB staff for a number of years. The CANDU 9 design has just started the up-front licensing process. The process gives designers, regulators and potential customers early confidence in the licensability of future plants. (author). 4 refs., 2 tabs.
Grant, S.D.; Snell, V.G.
AECL has been pioneering 'up-front' licensing of new reactor designs. The CANDU 3 design has been formally reviewed by AECB staff for a number of years. The CANDU 9 design has just started the up-front licensing process. The process gives designers, regulators and potential customers early confidence in the licensability of future plants. (author). 4 refs., 2 tabs
The US Nuclear Regulatory Commission (NRC) has developed a series of licensing guidance documents based on the regulatory requirements in Part 60 of Title 10 of the Code of Federal Regulations (10 CFR Part 60). This regulatory systems-based approach to licensing guidance documentation relies on the definition of the high-level waste repository in 10 CFR Part 60. A document which is important for the frame-work it gives to other programmatic licensing guidance is the Draft Regulatory Guide open-quotes Format and Content for the License Application for the High-Level Waste Repositoryclose quotes (FCRG). The FCRG describes a format and content acceptable to NRC for a high-level waste repository license application pursuant to the requirements of 10 CFR Part 60. Other licensing guidance documents will be compatible with the FCRG
Full text: Nuclear plants in the United States are licensed for 40 years, a length specified in the Atomic Energy Act of 1954, which laid out much of the regulatory basis for the commercial nuclear industry. The Act, however, made provision for license renewal. The original 40-year license period was chosen arbitrarily by the U.S. Congress because it was the typical period over which utilities recovered their investment in electricity generating plants. Nuclear plants, however, are subject to a rigorous program of Nuclear Regulatory Commission oversight, maintenance and equipment replacement. In effect, they must be in the same operating condition on the last day of their licenses as they were on the first. As the industry matured, it became apparent that there was no physical limitation on the continued operation of nuclear plants past 40 years. The industry turned its attention toward license renewal. When the issue was first raised, the NRC considered stringent process equivalent to seeking a new operating license for each plant. The complexity, length and cost of the process made it unlikely that many nuclear plants would seek license renewal. The nuclear industry worked successfully with NRC on the application of generic principles to license renewal, however, and in 1995, the NRC issued an efficient, tightly-focused rule that made license renewal a safe, viable option. To extend the operating license for a reactor, a company must demonstrate to the NRC that aging effects will be adequately managed during the renewal terms, thus ensuring equipment functionality. The rule allows licensees to apply for extensions of up to 20 years. The first license renewal application was filed in 1998 by the owner of the two-unit Calvert Cliffs plant. Shortly thereafter, an application was filed for the three-unit Oconee Nuclear Station. The NRC renewed the licenses for all five units in 2000, and since then, five more licenses have been renewed. The NRC has received 37
Goh, Yong-Shian; Lopez, Violeta
This study sought to explore the job satisfaction level of migrant nurses working in a multicultural society and, more specifically, the relationship between their job satisfaction levels, work environment, their intentions to leave and the predictors of their intentions to leave. Nursing shortages have led to the increasing trend of employing migrant nurses, which necessitated studies examining nurses' migration. A cross-sectional, correlational design using a stratified random sample was conducted on 495 migrant nurses working in a tertiary public-funded hospital in Singapore. The results showed that migrant nurses were satisfied with their jobs; with job satisfaction negatively correlated with work environment. Interestingly, pre-existing groups of Chinese migrant nurses did not help newly arrived Chinese migrant nurses to assimilate better. Predictors of migrant nurses' intentions to leave included having supportive nurse managers and nursing practice environment. The presence of a supportive work environment is essential to retain migrant nurses. Health administrators need to empower nursing managers with skills to implement career development plans as part of hospitals' retention strategies for migrant nurses. Information should also be provided during recruitment campaigns to enable migrant nurses to make informed choices. © 2016 John Wiley & Sons Ltd.
Patrick Leonardo Nogueira da Silva
Full Text Available This study aimed to identify the relevance of Service Infection Control in an Intensive Care Unit in the view of licensed practical nurses. This is a qualitative, descriptive, exploratory and research field. We used an interview in which he applied a semi-structured to eleven practical nurses working in intensive care of a hospital foundation. As the understanding of the benefits arising from the Service Infection Control for the industry, contacted that the respondents cited more often by the prevention of infections, was also mentioned as a boon to the maintenance of the organization in the industry, the quality and safety of assistance as other benefits generated by this executor service standards. It is concluded that the nursing staff have a lack of knowledge about the activities undertaken by the service control infections since the actions of the members of the Commission executors encompass a series of regulatory actions.
Full Text Available Abstract Background Nursing professionals have received comprehensive medical education and training. However, whether these medical professionals exhibit positive patient care attitudes and behaviors and thus reduce mortality risks when they themselves are diagnosed with chronic diseases is worth exploring. This study compared the mortality risks of female nurses and general patients with diabetes and elucidated factors that caused this difference. Methods A total of 510,058 female patients newly diagnosed with diabetes between 1998 and 2006 as recorded in the National Health Insurance Research Database were the participants in this study. Nurses with diabetes and general population with diabetes were matched with propensity score method in a 1:10 ratio. The participants were tracked from the date of diagnosis to 2009. The Cox proportional hazards model was utilized to compare the mortality risks in the two groups. Results Nurses were newly diagnosed with diabetes at a younger age compared with the general public (42.01 ± 12.03 y vs. 59.29 ± 13.11 y. Nevertheless, the matching results showed that nurses had lower mortality risks (HR: 0.53, 95 % CI: 0.38–0.74 and nurses with diabetes in the < 35 and 35–44 age groups exhibited significantly lower mortality risks compared with general patients (HR: 0.23 and 0.36. A further analysis indicated that the factors that influenced the mortality risks of nurses with diabetes included age, catastrophic illnesses, and the severity of diabetes complications. Conclusion Nurses with diabetes exhibited lower mortality risks possibly because they had received comprehensive medical education and training, may had more knowledge regarding chronic disease control and change their lifestyles. The results can serve as a reference for developing heath education, and for preventing occupational hazards in nurses.
MacLeod, Martha L P; Stewart, Norma J; Kulig, Judith C; Anguish, Penny; Andrews, Mary Ellen; Banner, Davina; Garraway, Leana; Hanlon, Neil; Karunanayake, Chandima; Kilpatrick, Kelley; Koren, Irene; Kosteniuk, Julie; Martin-Misener, Ruth; Mix, Nadine; Moffitt, Pertice; Olynick, Janna; Penz, Kelly; Sluggett, Larine; Van Pelt, Linda; Wilson, Erin; Zimmer, Lela
In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care. In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions. A cross-sectional survey used a mailed questionnaire with persistent follow-up to achieve a stratified systematic sample of 3822 regulated nurses from all provinces and territories, living outside of the commuting zones of large urban centers and in the north of Canada. Rural workforce characteristics reported here suggest the persistence of key characteristics noted in a previous Canada-wide survey of rural registered nurses (2001-2002), namely the aging of the rural nursing workforce, the growth in baccalaureate education for registered nurses, and increasing casualization. Two thirds of the nurses grew up in a community of under 10 000 people. While nurses' levels of satisfaction with their nursing practice and community are generally high, significant variations were noted by nurse type. Nurses reported coming to rural communities to work for reasons of location, interest in the practice setting, and income, and staying for similar reasons. Important variations were noted by nurse type and region. The proportion of the rural nursing workforce in Canada is continuing to decline in relation to the proportion of the Canadian population in rural and remote
Voyer, Philippe; Cole, Martin G; McCusker, Jane; St-Jacques, Sylvie; Laplante, Johanne
The purpose of this study undertaken in an acute care hospital was to evaluate sensitivity and specificity of the documentation of nurse-reported delirium symptoms in medical charts. This is a descriptive study based on the clinical assessments of a study nurse and nursing notes in the medical charts of 226 delirious older patients newly admitted to an acute care hospital. The results of this prospective validation study indicated that documentation of delirium symptoms is poor. Disorientation, agitation and altered level of consciousness were the three symptoms yielding a higher level of sensitivity, but even so said symptoms were reported in less than a third of the medical charts. Univariate analysis suggested that higher comorbidity level, more severe symptoms of delirium and the use of physical restraints were associated with more valid documentation of delirium symptoms in medical charts. Lastly, this study corroborates results of previous studies, indicating that documentation of delirium symptoms in medical charts can be improved. Future study should target improving nurse documentation of delirium symptoms in medical charts.
Turale, S; Klunklin, A; Chontawan, R
Asia-Pacific nursing education and research is growing but little is known about the nature and development of nursing scholarship in the region. This qualitative study explored the perspectives of 14 leading Thai scholars about the development, facilitators and barriers relating to Thailand's nursing scholarship. In-depth interviews were digitally recorded, and data were subjected to content analysis. Five themes arose: (1) growing together, (2) visionary leadership, (3) external support to grow nurse scholars, (4) developing nursing through research, and (5) barriers to scholarship. A history of visionary nursing leadership was revealed, underpinned by leaders' values of growing nursing together. Resource sharing among universities, and a significant number of scholarships for study abroad were major facilitators of scholarship growth. Barriers to scholarship included high teaching loads, especially for newly graduated faculty; a low rate of research publications; not enough mentorship for research and changes to teaching practice; and a wide range of different agencies providing courses for entry to practice. Scholarship development in Thailand is a role model for a number of South-East Asian countries, with inclusiveness and collaboration to facilitate the growth of nursing education inside and outside of the country as a hallmark of its character. However, against a backdrop of nursing shortages, Thai scholars are challenged, in the future, to produce meaningful research outcomes, including publications of studies; to collaborate with other health professionals; change practices to overcome high teaching loads; and provide the much needed mentorship for young scholars.
Numminen, Olivia; Leino-Kilpi, Helena; Isoaho, Hannu; Meretoja, Riitta
Research on newly graduated nurses' competence development and associated factors is relatively scarce. Data for this longitudinal, descriptive, correlation study were collected during 2012-2014 from 318 Finnish nurses to explore their competence development during the first 3 years after graduation and to estimate the extent to which given work-related factors predicted change in competence. Data were analyzed using NCSS 10 statistical software. Nurses' initially fairly high level of competence showed an increase in the third year, as measured by the Nurse Competence Scale. Empowerment increased minimally, whereas perceptions of practice environment, ethical climate, and occupational commitment decreased. Willingness to leave the profession and dissatisfaction with current job and nursing profession increased. Empowerment, satisfaction with current job and quality of care, time from graduation, and work experience explained 25.6% of the change in competence. Competence development was modest but increasing. Willingness to leave the profession was concerning. Factors enhancing or preventing competence development need further studying and developing proactive interventions. J Contin Educ Nurs. 2017;48(1):29-39. Copyright 2017, SLACK Incorporated.
Storage of spent fuel at Away-From-Reactor (AFR) installations will allow reactors to continue to operate until reprocessing or other fuel disposal means are available. AFR installations must be licensed by the Nuclear Regulatory Commission (NRC). Although wide experience in licensing reactors exists, the licensing of an AFR installation is a relatively new activity. Only one has been licensed to date. This paper delineates the requirements for licensing an AFR installation and projects a licensing schedule. Because the NRC is developing specific AFR requirements, this schedule is based primarily on draft NRC documents. The major documents needed for an AFR license application are similar to those for a reactor. They include: a Safety Analysis Report (SAR), and Environmental Report (ER), safeguards and security plans, decommissioning plans, proposed technical specifications, and others. However, the licensing effort has one major difference in that for AFR installations it will be a one-step effort, with follow-up, rather than the two-step process used for reactors. The projected licensing schedule shows that the elapsed time between filing an application and issuance of a license will be about 32 months, assuming intervention. The legal procedural steps will determine the time schedule and will override considerations of technical complexity. A license could be issued in about 14 months in the absence of intervention
Hahtela, N; Paavilainen, E; McCormack, B; Helminen, M; Slater, P; Suominen, T
This study aimed to describe nurses' perceptions of workplace culture, especially in regard to stress levels, job satisfaction and the practice environment in primary health care. Health care is facing many challenges related to its attractiveness as a place of employment and the maintenance of a sufficient workforce supply. Previous studies report increasing rates of nurse job dissatisfaction and intentions to leave their current positions both in Finland and also globally. Improving workplace culture is thus vital in meeting the challenges related to recruitment and retention. A cross-sectional descriptive design was used to describe nurses' perceptions of workplace culture. Data were collected by questionnaire from 22 units in nine primary healthcare organizations in Finland, and analysed using descriptive and inferential statistics. Most of the respondents indicated that they were not certain whether their workplace culture was either positive or negative. Profession, age and work shift characteristics had an effect on the respondents' perceptions of workplace culture. Younger licensed practical and registered nurses assessed their workplace culture more positively, whereas older registered nurses and those working rotating rosters viewed workplace culture more negatively. The findings suggest that both unit and demographic characteristics affect workplace culture. This survey highlights that a positive workplace culture is one of the key factors in retaining and recruiting nurses, and provides an essential evidence that may be considered by other healthcare organizations. Nurse managers and healthcare leaders need to address workload management and take into account the related variables that affect a unit's workplace culture. © 2015 International Council of Nurses.
Kennerly, Susan; Heggestad, Eric D; Myers, Haley; Yap, Tracey L
An effective workforce performing within the context of a positive cultural environment is central to a healthcare organization's ability to achieve quality outcomes. The Nursing Culture Assessment Tool (NCAT) provides nurses with a valid and reliable tool that captures the general aspects of nursing culture. This study extends earlier work confirming the tool's construct validity and dimensionality by standardizing the scoring approach and establishing norm-referenced scoring. Scoring standardization provides a reliable point of comparison for NCAT users. NCAT assessments support nursing's ability to evaluate nursing culture, use results to shape the culture into one that supports change, and advance nursing's best practices and care outcomes. Registered nurses, licensed practical nurses, and certified nursing assistants from 54 long-term care facilities in Kentucky, Nevada, North Carolina, and Oregon were surveyed. Confirmatory factor analysis yielded six first order factors forming the NCAT's subscales (Expectations, Behaviors, Teamwork, Communication, Satisfaction, Commitment) (Comparative Fit Index 0.93) and a second order factor-The Total Culture Score. Aggregated facility level comparisons of observed group variance with expected random variance using rwg(J) statistics is presented. Normative scores and cumulative rank percentages and how the NCAT can be used in implementing planned change are provided.
This article explores the history and describes the main features of free software licenses and other free licenses in an attempt to shed light on the reasons for their success in promoting individual behaviors converging towards the collective construction of digital commons.
Arora, Ashish; Fosfuri, Andrea; Rønde, Thomas
, we find that interdependency across business units may result in more, not less, decentralization. Furthermore, even though centralization results in less information, centralized licensing deals are larger. Our model conforms to the existing evidence that reports heterogeneity across firms in both......Technology licensing is an important means for companies to extract more value from their intellectual assets. We build a model that helps understand how licensing activity should be organized within large corporations. More specifically, we compare decentralization—where the business unit using...... the technology makes licensing decisions—to centralized licensing. The business unit has superior information about licensing opportunities but may not have the appropriate incentives because its rewards depend on product market performance. If licensing is decentralized, the business unit forgoes valuable...
Simon, Michael; Hausner, Elke; Klaus, Susan F; Dunton, Nancy E
The identification of health services research in databases such as PubMed/Medline is a cumbersome task. This task becomes even more difficult if the field of interest involves the use of diverse methods and data sources, as is the case with nurse staffing research. This type of research investigates the association between nurse staffing parameters and nursing and patient outcomes. A comprehensively developed search strategy may help identify nurse staffing research in PubMed/Medline. A set of relevant references in PubMed/Medline was identified by means of three systematic reviews. This development set was used to detect candidate free-text and MeSH terms. The frequency of these terms was compared to a random sample from PubMed/Medline in order to identify terms specific to nurse staffing research, which were then used to develop a sensitive, precise and balanced search strategy. To determine their precision, the newly developed search strategies were tested against a) the pool of relevant references extracted from the systematic reviews, b) a reference set identified from an electronic journal screening, and c) a sample from PubMed/Medline. Finally, all newly developed strategies were compared to PubMed's Health Services Research Queries (PubMed's HSR Queries). The sensitivities of the newly developed search strategies were almost 100% in all of the three test sets applied; precision ranged from 6.1% to 32.0%. PubMed's HSR queries were less sensitive (83.3% to 88.2%) than the new search strategies. Only minor differences in precision were found (5.0% to 32.0%). As with other literature on health services research, nurse staffing studies are difficult to identify in PubMed/Medline. Depending on the purpose of the search, researchers can choose between high sensitivity and retrieval of a large number of references or high precision, i.e. and an increased risk of missing relevant references, respectively. More standardized terminology (e.g. by consistent use of the
Fowler, Cathrine; Schmied, Virginia; Psaila, Kim; Kruske, Sue; Rossiter, Chris
Australia has a well-established universal child and family health service predominately staffed by specialist/qualified child and family health nurses. Two common and interrelated concerns are the need for nurses to be ready for practice after completing a nursing education program and the means to ensure ongoing nursing competence. To investigate the readiness of CFH nurses to practise after qualification and their continuing engagement with learning. The study used an interpretive descriptive approach. This paper presents data from four questions from a larger survey of child and family health nurses across Australia. 1098 child and family health nurses responded to the survey. Qualitative survey responses from the four education questions were analysed using inductive thematic content analysis. Five significant themes were identified: hands-on experience (student clinical practice/placement); drawing on prior experience; learning on the job; learning (learning over time); and barriers to learning. This paper provides insights into nurses' readiness for practice at the completion of a postgraduate child and family health nursing qualification and their maintenance of competence and specialist knowledge. It highlights: the need for clinical placement to be retained and enhanced; the significant contribution of more experienced child and family health nurses mentoring newly graduated child and family health nurses; the need for minimum education standards; the importance of reviewing education courses in relation to graduates' readiness for child and family health nursing practice; the importance of supporting ongoing professional development; and the removal of barriers to accessing education opportunities. Copyright © 2014 Elsevier Ltd. All rights reserved.
Ismail, Wan Rosmanira; Jenal, Ruzzakiah
The scheduling of nurses is particularly challenging because of the nature of the work which is around the clock. In addition, inefficient duty roster can have an effect on the nurses well being as well as their job satisfaction. In nurse scheduling problem (NSP), nurses are generally allocated to periods of work over a specified time horizon. A typical length of the schedule varies from a few weeks to a month. The schedule will be consistently rebuilt after the specified time period and will result in a time-consuming task for the administrative staff involved. Moreover, the task becomes overwhelming when the staff needs to consider the previous duty rosters in order to maintain the quality of schedules. Therefore, this study suggests the development of a master plan for a nurse duty roster for approximately one year. The master plan starts with the development of a blue print for the nurse duty roster using a 0-1 goal programming technique. The appropriate working period for this blue print is formulated based on the number of night shifts and the number of required nurses for night shift per schedule. Subsequently, the blue print is repeated to complete the annual nurse duty roster. These newly developed procedures were then tested on several data sets. The test results found that the master plan has successfully distributed the annual workload evenly among nurses. In addition, the master plan allows nurses to arrange their career and social activities in advance.
... Licensing Authority will transfer to such other person the historical, nonhistorical or designated license... escrow with the sole condition for return of escrow being that the Licensing Authority determines that... to whom the historical licenses were issued during the quota year in which the sale or conveyance...
Full Text Available This article explores the history and describes the main features of free software licenses and other free licenses in an attempt to shed light on the reasons for their success in promoting individual behaviors converging towards the collective construction of digital commons.
Tong, Myriam; Schwendimann, René; Zúñiga, Franziska
As a category of bullying, mobbing is a form of violence in the workplace that damages the employing organization as well as the targeted employee. In Europe, the overall prevalence of mobbing in healthcare is estimated at 4%. However, few studies have explored mobbing among long-term care workers. This study aims to examine the frequency of mobbing in Swiss nursing homes and its relationships with care workers' (i.e. registered nurse, licensed practical nurse, assistant nurse, nurse aide) health status, job satisfaction, and intention to leave, and to explore the work environment as a contributing factor to mobbing. A cross-sectional, multi-center sub-study of the Swiss Nursing Homes Human Resource Project (SHURP). Nursing homes in Switzerland's three language regions. A total of 162 randomly selected nursing homes with 20 or more beds, including 5311 care workers with various educational levels. Controlling for facility and care worker characteristics, generalized estimation equations were used to assess the relationships between mobbing and care workers' health status, job satisfaction, and intention to leave as well as the association of work environment factors with mobbing. In Swiss nursing homes, 4.6% of surveyed care workers (n=242) reported mobbing experiences in the last 6 months. Compared to untargeted persons, those directly affected by mobbing had higher odds of health complaints (Odds Ratios (OR): 7.81, 95% CI 5.56-10.96) and intention to leave (OR: 5.12, 95% CI 3.81-6.88), and lower odds of high job satisfaction (OR: 0.19, 95% CI 0.14-0.26). Odds of mobbing occurrences increased with declining teamwork and safety climate (OR: 0.41, 95% CI 0.30-0.58), less supportive leadership (OR: 0.42, 95% CI 0.30-0.58), and higher perceived inadequacy of staffing resources (OR: 0.66, 95% CI 0.48-0.92). Mobbing experiences in Swiss nursing homes are relatively rare. Alongside teamwork and safety climate, risk factors are strongly associated with superiors
The licensing of teachers should be modeled against professions similar to teaching rather than professions like medicine and architecture that are vastly different. Applying similar licensing practices can raise the status of teaching. Ignoring these licensing practices will prevent teachers from functioning as professionals. (MD)
Medina Gironzini, E.
In Peru, the Regulation for Ionizing Radiation Sources is applied, which establishes the norms and procedures to follow in the nuclear and radioactive installations of the country in order to assure their correct operation as concerns to the nuclear safety and radiological protection, allowing the emission of the respective licenses. As for the nuclear facilities, this authorization includes the Previous License, the Construction License and the Operation License (provisional and definitive) and for radioactive facilities and equipment generating ionizing radiations: the Construction License and the Operation License. The personnel also require a license that can be an operator license (as for nuclear reactors) or a supervisor license (for nuclear and radioactive facilities). In spite of the above mentioned regulation and its long enforcement period, less than 10% of radioactive facilities in this country are licensed, due to different problems which will be solved in the medium term. (Author)
Locatelli, Giorgio; Mancini, Mauro; Sainati, Tristano; Sallinen, Liisa
The paper deals with the licensing nuclear power plants; it focuses primarily on the licensing process implications into the international nuclear market. Nowadays there are twenty-six countries that are planning to build new nuclear facilities, and thirty-seven where nuclear reactors are proposed; on the other hand, there are mainly ten international reactor vendors. At international level, there are few vendors that have sufficient resources, capabilities and experience to carry out the design and delivering of a nuclear power plant in the international market; On the other hand, the licensing processes are strictly dependent on national law frameworks, and on the nuclear policies. The paper proposes a comparison of six licensing processes (the ones established in Finland, France, Italy, South Korea, USA and UK), and analyzes its main features and implications; the IAEA licensing process is taken as reference point. The objective of the paper is to propose a systemic approach for considering the licensing procedures. The framework proposed enables facilitating the licensing management and inferring the main features of licensing contexts. The paper concludes with a forecast of the nuclear licensing context, especially with respect to the fourth generation of nuclear reactors. (author)
Patient autonomy-with an emphasis on informed consent and the right to refuse treatment-is a cornerstone of modern bioethics. Within discussions about patient autonomy, feminist bioethicists have argued for a relational approach to autonomy. Under a relational framework, we must look beyond the individual moment of choice to include the role relationships and specific contexts can play in supporting or undermining autonomy. Given the day-to-day interactions they have with patients, nurses play a significant role in helping patients understand the nature of their illnesses and make truly informed decisions. However, the skills of expert nurses also support patient autonomy in more subtle ways. Specifically, nurses develop skills of attunement that help them to find subtle ways to support patient autonomy. However, in order to effectively do this, nurses need institutions that support their professional autonomy. In this paper, I look at the ways nurses have been inhibited in their professional autonomy both as a profession and as individual practitioners. I argue that turning our attention to institutions and the role they play in supporting or undermining nurses' autonomy can help promote nurses' professional autonomy and thereby enhance patient autonomy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Laursen, Keld; Reichstein, Toke; Trombini, Giulia
between technology and market forces: if partners are market distant, the likelihood of technology license contractual partnership decreases with partners’ technological distance. Using data on the formation of license partnerships in the global biopharmaceutical industry over the period 1994......This paper investigates the matching of firms on the market for technology. The paper forwards two dimensions along which license formation occurs: technology and product-market. Both sides of the market search for a partner representing potential for high technology synergies to maximize licensing...
This paper deals with the problems of an overseas regulatory agency in licensing a Canadian-supplied nuclear plant which is referenced to a plant in Canada. Firstly, the general problems associated with the use of a reference plant are discussed. This is followed by a discussion of specific problems which arise from the licensing practices in Canada. The paper concludes with recommendations to simplify the task of demonstrating the licensability of an overseas CANDU plant
... 7 Agriculture 1 2010-01-01 2010-01-01 false Globalization of licenses. 6.32 Section 6.32 Agriculture Office of the Secretary of Agriculture IMPORT QUOTAS AND FEES Dairy Tariff-Rate Import Quota Licensing § 6.32 Globalization of licenses. If the Licensing Authority determines that entries of an article...
Enns, Victoria; Currie, Shawn; Wang, JianLi
The prevalence of major depression in Canadian nurses is double the national average for working women. The present study sought to delineate the role of professional autonomy, health care setting, and work environment characteristics as risk factors for depression and absenteeism in female nurses. A cross-sectional, secondary analysis was conducted on a large representative sample of female nurses working in hospitals and other settings across Canada (N = 17,437). Univariate and multivariate analyses were used to test the hypothesis that work environment factors are significant determinants of major depression and absenteeism in female nurses after accounting for other risk factors. Experiencing a major depressive episode in the past 12 months was significantly associated with lower autonomy (odds ratio [OR] = 0.93), higher job strain (OR = 2.2), being a licensed practical nurse (OR = 0.82), and working in a nonhospital setting (OR = 1.5). Higher absenteeism was associated with the same variables as well as having less control over one's work schedule. Efforts to increase autonomy of nurses and reduce job strain may help to address the high prevalence of major depression in this professional group. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.
The goal of this project is to organize and centralize the data about software tools available to CERN employees, as well as provide a system that would simplify the license management process by providing information about the available licenses and their expiry dates. The project development process is consisted of two steps: modeling the products (software tools), product licenses, legal agreements and other data related to these entities in a relational database and developing the front-end user interface so that the user can interact with the database. The result is an ASP.NET MVC web application with interactive views for displaying and managing the data in the underlying database.
Bamonti, Patricia; Conti, Elizabeth; Cavanagh, Casey; Gerolimatos, Lindsay; Gregg, Jeffrey; Goulet, Carol; Pifer, Marisa; Edelstein, Barry
Direct care workers (e.g., certified nursing assistants [CNAs]) employed in long-term care (LTC) are particularly vulnerable to the experience of burnout, yet they have received relatively less research attention compared to Licensed Practical Nurses and Registered Nurses. Within the burnout literature, evidence suggests that the deployment of certain coping strategies influences levels of burnout. The current study examined the extent to which coping (e.g., problem-focused, emotion-focused, and dysfunctional coping) and cognitive emotion regulation strategies (e.g., positive reappraisal) predicted burnout after controlling for covariates (age, sleep duration). Fifty-six CNAs were surveyed at four skilled nursing facilities in the United States. Dysfunctional coping was significantly associated with emotional exhaustion and depersonalization. Among cognitive emotion regulation strategies, positive reappraisal was significantly associated with depersonalization. Shorter sleep duration was associated with significantly greater depersonalization. Findings suggest the need to develop interventions for CNAs aimed at reducing dysfunctional coping strategies and increasing sleep duration.
Nguyen, Van N B; Forbes, Helen; Mohebbi, Mohammadreza; Duke, Maxine
Teaching nursing in clinical environments is considered complex and multi-faceted. Little is known about the role of the clinical nurse educator, specifically the challenges related to transition from clinician, or in some cases, from newly-graduated nurse to that of clinical nurse educator, as occurs in developing countries. Confidence in the clinical educator role has been associated with successful transition and the development of role competence. There is currently no valid and reliable instrument to measure clinical nurse educator confidence. This study was conducted to develop and psychometrically test an instrument to measure perceived confidence among clinical nurse educators. A multi-phase, multi-setting survey design was used. A total of 468 surveys were distributed, and 363 were returned. Data were analyzed using exploratory and confirmatory factor analyses. The instrument was successfully tested and modified in phase 1, and factorial validity was subsequently confirmed in phase 2. There was strong evidence of internal consistency, reliability, content, and convergent validity of the Clinical Nurse Educator Skill Acquisition Assessment instrument. The resulting instrument is applicable in similar contexts due to its rigorous development and validation process. © 2017 The Authors. Nursing & Health Sciences published by John Wiley & Sons Australia, Ltd.
Jakobsson Larsson, Birgitta; Nordin, Karin; Askmark, Håkan; Nygren, Ingela
To prospectively identify different coping strategies among newly diagnosed amyotrophic lateral sclerosis patients and whether they change over time and to determine whether physical function, psychological well-being, age and gender correlated with the use of different coping strategies. Amyotrophic lateral sclerosis is a fatal disease with impact on both physical function and psychological well-being. Different coping strategies are used to manage symptoms and disease progression, but knowledge about coping in newly diagnosed amyotrophic lateral sclerosis patients is scarce. This was a prospective study with a longitudinal and descriptive design. A total of 33 patients were included and evaluation was made at two time points, one to three months and six months after diagnosis. Patients were asked to complete the Motor Neuron Disease Coping Scale and the Hospital Anxiety and Depression Scale. Physical function was estimated using the revised Amyotrophic Lateral Sclerosis Functional Rating Scale. The most commonly used strategies were support and independence. Avoidance/venting and information seeking were seldom used at both time points. The use of information seeking decreased between the two time points. Men did not differ from women, but patients ≤64 years used positive action more often than older patients. Amyotrophic Lateral Sclerosis Functional Rating Scale was positively correlated with positive action at time point 1, but not at time point 2. Patients' psychological well-being was correlated with the use of different coping strategies. Support and independence were the most used coping strategies, and the use of different strategies changed over time. Psychological well-being was correlated with different coping strategies in newly diagnosed amyotrophic lateral sclerosis patients. The knowledge about coping strategies in early stage of the disease may help the nurses to improve and develop the care and support for these patients. © 2014 John Wiley
The Uranium Mill Tailings Remedial Action (UMTRA) Project Office developed a plan to define UMTRA Project licensing program objectives and establish a process enabling the DOE to document completion of remedial actions in compliance with 40 CFR 1 92 and the requirements of the NRC general license. This document supersedes the January 1987 Project Licensing Plan (DOE, 1987). The plan summarizes the legislative and regulatory basis for licensing, identifies participating agencies and their roles and responsibilities, defines key activities and milestones in the licensing process, and details the coordination of these activities. This plan provides an overview of the UMTRA Project from the end of remedial actions through the NRC's acceptance of a disposal site under the general license. The licensing process integrates large phases of the UMTRA Project. Other programmatic UMTRA Project documents listed in Section 6.0 provide supporting information
Carvalho, A.J.M. de.
The need for the adoption of a legal and normative system, defining objectives, pescriptions and the process of nuclear licensing and building of nuclear power plants in Brazil is enphasized. General rules for the development of this system are presented. The Brazilian rules on the matter are discussed. A general view of the German legal system for nuclear power plant licensing and the IAEA recommendations on the subject are finally presented. (A.L.S.L.) [pt
McCrae, N; Askey-Jones, S; Laker, C
Accelerated mental health nurse training attracts talented graduates, many with a psychology degree. Our study shows that such trainees feel incompatible with the nursing culture. Consequently, professional identification is inhibited, and on qualifying these nurses may choose to develop their careers elsewhere. Nurse educators and mentors should pay greater attention to nurturing a positive professional identity in trainees. Alongside their attainment of knowledge and skills, nursing trainees are moulded by a professional culture and inculcated to norms of beliefs and behaviour. The process of professional identification may be inhibited by accelerated nurse training and an influx of psychology graduates potentially using mental health nursing qualification as a springboard to other career opportunities. This study explored facilitators and barriers to professional identification in newly qualified nurses of accelerated postgraduate training. Qualitative interviews were conducted with 10 nurses who had recently completed a postgraduate diploma in mental health nursing at King's College London. Participants identified more with the mental health field than with the broader profession of nursing. They defined their practice in terms of values rather than skills and found difficulty in articulating a distinct role for mental health nursing. Although participants had found experience in training and as a registered practitioner rewarding, they were concerned that nursing may not fulfil their aspirations. Professional identity is likely to be a major factor in satisfaction and retention of nurses. Training and continuing professional development should promote career advancement within clinical nursing practice. © 2014 John Wiley & Sons Ltd.
There is ongoing concern among mental health professionals regarding the recruitment of newly graduated nurses to this specialist nursing area. Many reasons for the problem have been identified, including the perceived inadequate preparation by the tertiary sector, students' prejudices and anxieties about mental illness, a perceived lack of support while undertaking clinical placement, and the quality of the clinical placement itself. This paper describes a collaborative response to these issues undertaken in the Illawarra region of New South Wales, Australia. The implementation of preclinical undergraduate workshops using problem-based learning and role plays were undertaken. Mental health nursing scenarios were developed in association with experienced clinicians to introduce core concepts in a supportive learning environment. Quantitative and qualitative evaluation data were collected immediately following the workshop and again after the students returned to the university following a mental health clinical placement. A further survey of one cohort was undertaken 12 months after initial state registration and the beginning of a career in mental health nursing. Results showed that both students' and clinicians' attitudes to the workshops were consistently positive and indicated that the workshops were beneficial in preparing students for their clinical placement. Importantly, since the implementation of the workshops and other collaborative initiatives, an increasing number of newly graduated nurses from the region are choosing to work in mental health.
Full Text Available In this paper the authors examine statutes that regulate, license, and enforce investigative functions in each US state. After identification and review of Private Investigator licensing requirements, the authors find that very few state statutes explicitly differentiate between Private Investigators and Digital Examiners. After contacting all state agencies the authors present a distinct grouping organizing state approaches to professional Digital Examiner licensing. The authors conclude that states must differentiate between Private Investigator and Digital Examiner licensing requirements and oversight.
Topa, Gabriela; Moriano, Juan A
Horizontal mobbing is a process of systematic and repeated aggression towards a worker by coworkers. Among others, stress has been pointed out as one of the antecedents that favors the onset of horizontal mobbing, whereas group support to the target could act as a buffer. Moreover, the social identity approach emphasizes that group identity is an antecedent of group support. This study explores the interaction of group support and group identity in the explanation of horizontal mobbing in a sample (N = 388) of registered nurses and licensed practical nurses employed at two large hospitals in Madrid and Navarre (Spain). The results show that stress is positively associated to horizontal mobbing, whereas group support and group identity were negative predictors of horizontal mobbing. Furthermore, the combination of low group identity and low group support precipitated HM among nurses. Copyright © 2013 Elsevier Inc. All rights reserved.
The Operating Reactors Licensing Actions Summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors
... DEPARTMENT OF DEFENSE Department of the Army Notice of Intent to License Government-Owned Inventions; Intent to License on a Partially-Exclusive Basis AGENCY: Department of the Army, DoD. ACTION... by the Secretary of the Army. The US Army Edgewood Chemical Biological Center intends to license...
LaMarche, Kimberley; Tullai-McGuinness, Susan
To examine the level of job satisfaction and its association with extrinsic and intrinsic job satisfaction characteristics among Canadian primary healthcare nurse practitioners (NPs). A descriptive correlational design was used to collect data on NPs' job satisfaction and on the factors that influence their job satisfaction. A convenience sample of licensed Canadian NPs was recruited from established provincial associations and special-interest groups. Data about job satisfaction were collected using two valid and reliable instruments, the Misener Nurse Practitioner Job Satisfaction Survey and the Minnesota Satisfaction Questionnaire. Descriptive statistics, Pearson correlation and regression analysis were used to describe the results. The overall job satisfaction for this sample ranged from satisfied to highly satisfied. The elements that had the most influence on overall job satisfaction were the extrinsic category of partnership/collegiality and the intrinsic category of challenge/autonomy. These findings were consistent with Herzberg's Dual Factor Theory of Job Satisfaction. The outcomes of this study will serve as a foundation for designing effective human health resource retention and recruitment strategies that will assist in enhancing the implementation and the successful preservation of the NP's role.
Anna C. van Graan
Full Text Available Reform in the South African healthcare and educational system were characterized by the ideals that the country needs to produce independent, critical thinkers. Nurses need to cope with diversity in a more creative way, defining their role in a complex, uncertain, rapidly changing health care environment. Quality clinical judgement is therefore imperative as an identified characteristic of newly qualified professional nurses. The objective of this study was to explore and describe clinical judgement through various data sources and review of literature to clarify the meaning and promote a common understanding through formulating the characteristics and developing a connotative (theoretical definition of the concept. An explorative, descriptive qualitative design was used to discover the complexity and meaning of the phenomenon. Multiple data sources and search strategies were used, for the time frame 1982—2013. A concept analysis was used to arrive at a theoretical definition of the concept of ‘clinical judgement’ as a complex cognitive skill to evaluate patient needs, adaption of current treatment protocols as well as new treatment strategies, prevention of adverse side effects through being proactive rather than reactive within the clinical nursing environment. The findings emphasized clinical judgement as skill within the clinical nursing environment, thereby improving autonomous and accountable nursing care. These findings will assist nurse leaders and clinical nurse educators in developing a teaching-learning strategy to promote clinical judgement in undergraduate nursing students, thereby contributing to the quality of nursing care.
Craig, John W.; Kuo, P.T.
In preparation for license renewal reviews, the Nuclear Regulatory Commission has recently published for public review and comment a proposed rule for license renewal and a draft Standard Review Plan as well as a draft Regulatory Guide relating to the implementation of the proposed rule. In support of future license renewal applications, the nuclear industry has also submitted 11 industry reports for NRC review and approval. This paper briefly describe how these parallel regulatory and industry activities will be factored into the NRC review process for license renewal. (author)
Walker, Rosalyn M
Nearly all states and provinces have laws mandating licensed healthcare professionals to report to law enforcement suspicions and allegations of the abuse of children, older adults, and disabled persons and all incidents of violence by a deadly weapon. However, a few states in the United States additionally mandate providers to report all injuries resultant from reported or suspected domestic/intimate partner violence. This can present a challenge to forensic nurses seeking to protect patient confidentiality and autonomy. This challenge becomes further compounded when a patient desiring to remain anonymous reports sexual assault by their partner, accompanied by bodily injury. This case report explores one such scenario that occurred in a rural Colorado Emergency Department, the issues this presents to forensic nurses, and possible responses.
McDonald, Ewan W; Boulton, Jessica L; Davis, Jacqueline L
This review examines the current evidence on the effectiveness of digital technologies or e-based learning for enhancing the skills and knowledge of nursing students in nursing assessment. This integrative review identifies themes emerging from e-learning and 'nursing assessment' literature. Literature reviews have been undertaken in relation to digital learning and nursing education, including clinical skills, clinical case studies and the nurse-educator role. Whilst perceptions of digital learning are well covered, a gap in knowledge persists for understanding the effectiveness of e-learning on nursing assessment skills and knowledge. This is important as comprehensive assessment skills and knowledge are a key competency for newly qualified nurses. The MEDLINE, CINAHL, Cochrane Library and ProQuest Nursing and Allied Health Source electronic databases were searched for the period 2006 to 2016. Hand searching in bibliographies was also undertaken. Selection criteria for this review included: FINDINGS: Twenty articles met the selection criteria for this review, and five major themes for e-based learning were identified (a) students become self-evaluators; (b) blend and scaffold learning; (c) measurement of clinical reasoning; (d) mobile technology and Facebook are effective; and (e) training and preparation is vital. Although e-based learning programs provide a flexible teaching method, evidence suggests e-based learning alone does not exceed face-to-face patient simulation. This is particularly the case where nursing assessment learning is not scaffolded. This review demonstrates that e-based learning and traditional teaching methods used in conjunction with each other create a superior learning style. Copyright © 2018 Elsevier Ltd. All rights reserved.
... corporate structure of which licensee is a part, if any. However, the license shall not be assignable or... license upon the policies of the United States Government; (3) The effect of the license upon domestic and... extent of U.S. Government contribution to the development of the invention; (iv) The degree of...
... certified mail, return receipt requested, advising the licensee that if payment is not mailed in accordance.... Where the license at issue is a historical license, this will result, pursuant to § 6.23(b), in the person's loss of historical eligibility for such license. (d) Licensees may elect not to accept certain...
Mazurenko, O; Gupte, G; Shan, G
This study examined the education and work experience of immigrant and American-trained registered nurses from 1988 to 2008. The USA increasingly relies on immigrant nurses to fill a significant nursing shortage. These nurses receive their training overseas, but can obtain licenses to practice in different countries. Although immigrant nurses have been in the USA workforce for several decades, little is known about how their education and work experience compares with USA-trained nurses. Yet much is presumed by policy makers and administrators who perpetuate the stereotype that immigrant nurses are not as qualified. We analysed the National Sample Survey of Registered Nurses datasets from 1988 to 2008 using the Cochran-Armitage trend tests. Our findings showed similar work experience and upward trends in education among both groups of nurses. However, American-trained nurses were more likely to further advance their education, whereas immigrant nurses were more likely to have more work experience and practice in a wider range of healthcare settings. Although we discovered differences between nurses trained in the USA and abroad, we theorize that these differences even out, as education and work experience each have their own distinct caregiving advantages. Immigrant nurses are not less qualified than their American-trained counterparts. However, healthcare providers should encourage them to further pursue their education and certifications. Even though immigrant nurses' education and work experience are comparable with their American counterparts, workforce development policies may be particularly beneficial for this group. © 2014 International Council of Nurses.
Wielenga, Joke M; Tume, Lyvonne N; Latour, Jos M; van den Hoogen, Agnes
This study aimed to identify and prioritise neonatal intensive care nursing research topics across Europe using an e-Delphi technique. An e-Delphi technique with three questionnaire rounds was performed. Qualitative responses of round one were analysed by content analysis and research statements were generated to be ranged on importance on a scale of 1-6 (not important to most important). Neonatal intensive care units (NICUs) in 17 European countries. NICU clinical nurses, managers, educators and researchers (n=75). None. A list of 43 research statements in eight domains. The six highest ranking statements (≥5.0 mean score) were related to prevention and reduction of pain (mean 5.49; SD 1.07), medication errors (mean 5.20; SD 1.13), end-of-life care (mean 5.05; SD 1.18), needs of parents and family (mean 5.04; SD 1.23), implementing evidence into nursing practice (mean 5.02; SD 1.03), and pain assessment (mean 5.02; SD 1.11). The research domains were prioritised and ranked: (1) pain and stress; (2) family centred care; (3) clinical nursing care practices; (4) quality and safety; (5) ethics; (6) respiratory and ventilation; (7) infection and inflammation; and (8) professional issues in neonatal intensive care nursing. The results of this study might support developing a nursing research strategy for the nursing section of the European Society of Paediatric and Neonatal Intensive Care. In addition, this may promote more European researcher collaboratives for neonatal nursing research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
... 25 Indians 1 2010-04-01 2010-04-01 false Marriage licenses. 11.601 Section 11.601 Indians BUREAU... ORDER CODE Domestic Relations § 11.601 Marriage licenses. A marriage license shall be issued by the clerk of the court in the absence of any showing that the proposed marriage would be invalid under any...
Tower, Marion; Chaboyer, Wendy; Green, Quentine; Dyer, Kirsten; Wallis, Marianne
To examine registered nurses' decision-making when documenting care in patients' progress notes. What constitutes effective nursing documentation is supported by available guidelines. However, ineffective documentation continues to be cited as a major cause of adverse events for patients. Decision-making in clinical practice is a complex process. To make an effective decision, the decision-maker must be situationally aware. The concept of situation awareness and its implications for making safe decisions has been examined extensively in air safety and more recently is being applied to health. The study was situated in a naturalistic paradigm. Purposive sampling was used to recruit 17 registered nurses who used think-aloud research methods when making decisions about documenting information in patients' progress notes. Follow-up interviews were conducted to validate interpretations. Data were analysed systematically for evidence of cues that demonstrated situation awareness as nurses made decisions about documentation. Three distinct decision-making scenarios were illuminated from the analysis: the newly admitted patient, the patient whose condition was as expected and the discharging patient. Nurses used mental models for decision-making in documenting in progress notes, and the cues nurses used to direct their assessment of patients' needs demonstrated situation awareness at different levels. Nurses demonstrate situation awareness at different levels in their decision-making processes. While situation awareness is important, it is also important to use an appropriate decision-making framework. Cognitive continuum theory is suggested as a decision-making model that could support situation awareness when nurses made decisions about documenting patient care. Because nurses are key decision-makers, it is imperative that effective decisions are made that translate into safe clinical care. Including situation awareness training, combined with employing cognitive
Full Text Available Abstract Background The theory of planned behaviour states that attitudinal variables (e.g. job satisfaction only have an indirect effect on retention whereas intentions have a direct effect. This study uses secondary data from a longitudinal cohort of newly qualified nurses to test for the direct and indirect effects of job satisfaction (client care, staffing, development, relationships, education, work-life interface, resources, pay and intentions to nurse on working as a nurse during the 3 years after qualification. Methods A national sample (England of newly qualified (1997/98 nurses (n = 3669 were surveyed at 6 months, 18 months and 3 years. ANOVA and MANOVA were used for comparison of mean job satisfaction scores between groups; intentions to nurse (very likely, likely vs. unlikely, very unlikely and unable to say at this stage; working (or not working as a nurse at each time-point. Indirect and direct effects were tested using structural equation and logistic regression models. Results Intentions expressed at 6 months to nurse at 18 months were associated with higher scores on pay and relationships, and intentions at 3 years were associated with higher scores on care, development, relationships, work-life interface, resources, pay respectively. Intentions expressed at 18 months to nurse at 3 years were associated with higher scores on development, relationships, education and work-life interface. Associations with actual nursing were fewer. Those working as a nurse had higher satisfaction scores for development (18 months and relationships (3 years. Regression models found significant associations between the pay and staffing factors and intentions expressed at 6 months to nurse at 18 months, and between pay and intentions to nurse at 3 years. Many of the associations between intentions and working as a nurse were significant. Development was the only job satisfaction factor significantly associated with working as a nurse and just at 18
Hong, Xianpei; Yang, Lijun; Zhang, Huaige; Zhao, Dan
This paper extends the work of Wang (2002) by considering a differentiated Stackelberg model, when the leader firm is an inside innovator and licenses its new technology by three options, that is, fixed-fee licensing, royalty licensing, and two-part tariff licensing. The main contributions and conclusions of this paper are threefold. First of all, this paper derives a very different result from Wang (2002). We show that, with a nondrastic innovation, royalty licensing is always better than fixed-fee licensing for the innovator; with a drastic innovation, royalty licensing is superior to fixed-fee licensing for small values of substitution coefficient d; however when d becomes closer to 1, neither fee nor royalty licensing will occur. Secondly, this paper shows that the innovator is always better off in case of two-part tariff licensing than fixed-fee licensing no matter what the innovation size is. Thirdly, the innovator always prefers to license its nondrastic innovation by means of a two-part tariff instead of licensing by means of a royalty; however, with a drastic innovation, the optimal licensing strategy can be either a two-part tariff or a royalty, depending upon the differentiation of the goods.
Nakata, Yoshifumi; Miyazaki, Satoru
This paper aims to forecast the total number of non-working nursing staff in Japan both overall and in terms of separate age groups for assistant nurses and fully qualified nurses. This also examines policy implications of those forecasts. Although the existence of around 550,000 of non-working nursing staff has been announced, the actual number of non-working nurses is not so clear that we might make errors in making policy to meet nurse workforce demand and supply in Japan. Estimations by integrating various data on the quantitative characteristics of non-working nursing staff were carried out. Considering the length and the type of education or training in referred four nursing positions; registered nurses, assistant nurses, public health nurses and midwives, we first estimated the number of students who completed a full course. And then multiplying by the ratio for gender and age classifications at the time of entry into courses, the number of those who obtained licenses was estimated. The number of non-working nurses was estimated at 100,000 higher than those in 2005 by government. Looking at age group, it is also possible to see a strong reflection of an employment pattern that follows the life cycle of female workers. Further analysis of life cycle effects and cohort effects proved the effect of life cycles even when subtracting the differences between the working behaviours of different generations. Our findings strongly suggest the need to provide an urgent policy that workplace conditions can be created in which a balance between work and family is achievable. Moreover, to empower clinical activity, we also believe there is an urgent need to reexamine the overall career vision for assistant nurses including in terms of compensation. Relevance to clinical practice. Our findings strongly suggests that consideration for work-life balance of nursing staff; particularly, female staff is all the more important to provide a stable quality care.
Tjia, Jennifer; Mazor, Kathleen M; Field, Terry; Meterko, Vanessa; Spenard, Ann; Gurwitz, Jerry H
Clear and complete communication between health care providers is a prerequisite for safe patient management and is a major priority of the Joint Commission's 2008 National Patient Safety Goals. The goal of this study was to describe nurses' perceptions of nurse-physician communication in the long-term care (LTC) setting. Mixed-method study including a self-administered questionnaire and qualitative semistructured telephone interviews of licensed nurses from 26 LTC facilities in Connecticut. The questionnaire measured perceived openness to communication, mutual understanding, language comprehension, frustration, professional respect, nurse preparedness, time burden, and logistical barriers. Qualitative interviews focused on identifying barriers to effective nurse-physician communication that may not have previously been considered and eliciting nurses' recommendations for overcoming those barriers. Three hundred seventy-five nurses completed the questionnaire, and 21 nurses completed qualitative interviews. Nurses identified several barriers to effective nurse-physician communication: lack of physician openness to communication, logistic challenges, lack of professionalism, and language barriers. Feeling hurried by the physician was the most frequent barrier (28%), followed by finding a quiet place to call (25%), and difficulty reaching the physician (21%). In qualitative interviews, there was consensus that nurses needed to be brief and prepared with relevant clinical information when communicating with physicians and that physicians needed to be more open to listening. A combination of nurse and physician behaviors contributes to ineffective communication in the LTC setting. These findings have important implications for patient safety and support the development of structured communication interventions to improve quality of nurse-physician communication.
Skandalis, Dean A.
MPEG LA, LLC offers a joint patent license for the AVC (a/k/a H.264) Standard (ISO/IEC IS 14496-10:2004). Like MPEG LA's other licenses, the AVC Patent Portfolio License is offered for the convenience of the marketplace as an alternative enabling users to access essential intellectual property owned by many patent holders under a single license rather than negotiating licenses with each of them individually. The AVC Patent Portfolio License includes essential patents owned by DAEWOO Electronics Corporation; Electronics and Telecommunications Research Institute (ETRI); France Telecom, societe anonyme; Fujitsu Limited; Hitachi, Ltd.; Koninklijke Philips Electronics N.V.; LG Electronics Inc.; Matsushita Electric Industrial Co., Ltd.; Microsoft Corporation; Mitsubishi Electric Corporation; Robert Bosch GmbH; Samsung Electronics Co., Ltd.; Sedna Patent Services, LLC; Sharp Kabushiki Kaisha; Siemens AG; Sony Corporation; The Trustees of Columbia University in the City of New York; Toshiba Corporation; UB Video Inc.; and Victor Company of Japan, Limited. Another is expected also to join as of August 1, 2006. MPEG LA's objective is to provide worldwide access to as much AVC essential intellectual property as possible for the benefit of AVC users. Therefore, any party that believes it has essential patents is welcome to submit them for evaluation of their essentiality and inclusion in the License if found essential.
Full Text Available This paper extends the work of Wang (2002 by considering a differentiated Stackelberg model, when the leader firm is an inside innovator and licenses its new technology by three options, that is, fixed-fee licensing, royalty licensing, and two-part tariff licensing. The main contributions and conclusions of this paper are threefold. First of all, this paper derives a very different result from Wang (2002. We show that, with a nondrastic innovation, royalty licensing is always better than fixed-fee licensing for the innovator; with a drastic innovation, royalty licensing is superior to fixed-fee licensing for small values of substitution coefficient d; however when d becomes closer to 1, neither fee nor royalty licensing will occur. Secondly, this paper shows that the innovator is always better off in case of two-part tariff licensing than fixed-fee licensing no matter what the innovation size is. Thirdly, the innovator always prefers to license its nondrastic innovation by means of a two-part tariff instead of licensing by means of a royalty; however, with a drastic innovation, the optimal licensing strategy can be either a two-part tariff or a royalty, depending upon the differentiation of the goods.
Davidson, S.L.; Novendstern, E.H.
For the past 15 years, Westinghouse has been actively involved in the development and licensing of fuel designs that contain major advanced features. These designs include the optimized fuel assembly, The VANTAGE 5 fuel assembly, the VANTAGE 5H, and most recently the VANTAGE+ fuel assembly. Each of these designs was supported by extensive experimental data, safety evaluations, and design efforts and required intensive interaction with the US Nuclear Regulatory Commission (NRC) during the review and approval process. This paper presents a description of the licensing approach and how it was utilized by the utilities to facilitate the licensing applications of the advanced fuel designs for their plants. The licensing approach described in this paper has been successfully applied to four major advanced fuel design changes ∼40 plant-specific applications, and >350 cycle-specific reloads in the past 15 years
Lafleur, J.D. Jr.; Hauber, R.D.; Chenier, D.M.
A network of formal and informal bilateral arrangements for the exchange of nuclear safety information is being established by the U.S. Nuclear Regulatory Commission. For developing countries, such arrangements can provide ready access to the extensive, fully documented safety analyses and safety research results that NRC has accumulated. NRC has been receiving foreign visitors at a rate of about 500 per year, largely for discussions of safety and licensing questions related to light water reactors. Exchanges also are taking place on the safety of advanced reactors. A special interest of the NRC is in providing for reciprocal communicaion, at the earliest possible time, of important problems, decisions and other actions on nuclear safety matters. For example, it is essential that a newly-discovered problem in a nuclear reactor be brought immediately to the attention of other governments which are responsible for the safety of similar reactors. Definite progress has been made in the U.S. Freedom of Information Act. Certain exchanges have taken place on this basis. Experience in the establishment and operation of NRC's bilateral exchange arrangements is summarized. A typical exchange with the regulatory authority of country building its first power reactor is described
Prah, M.; Spiler, J.; Vojnovic, D.; Pristavec, M.
The article presents the approach to nuclear licensing in Slovenia. The paper describes, the initialization, internal authorization and review process in the Krsko NPP. The overall process includes preparation, internal independent evaluation, the Krsko Operating Committee and the Krsko Safety Committee review and internal approval. In addition, the continuation of the licensing process is discussed which includes independent evaluation by an authorized institution and a regulatory body approval process. This regulatory body approval process includes official hearing of the licensee, communication with the licensee, and final issuance of a license amendment. The internal evaluation, which follows the methodology of US NRC (defined in 10 CFR 50.59 and NUMARC 125) is described. This concept is partially implemented in domestic legislation.(author)
Thoma, John A.
The proposed 10 CFR Part 54 rule proceduralizes the process for license renewal by identifying both the administrative and technical requirements for a renewal application. To amplify and support this regulation, written guidance has been provided in the form of a draft Regulatory Guide (DG 1009) and a draft Standard Review Plan for License Renewal (NUREG 1299). This guidance is scheduled to be finalized in 1992. Similar guidance will be provided for the proposed revisions to 10 CFR Part 51 concerning the environmental aspects of license renewal. (author)
Lee, Huei Ying; Hsu, Min-Tao; Li, Pei-Ling; Sloan, Rebecca S
To obtain a comprehensive understanding of the transition process of new nurses in Taiwan. Background. The transition period for new nurses can be a daunting and traumatic experience. The large number of newly graduated Taiwanese nurses who resign from their jobs within three months indicates that this process can be complicated. However, the problems associated with the experiences of new nurses have not yet been recognised. We adopted a phenomenological design using focus group interviews. Sixteen new nurses (less than one year working experience) participated in eight weekly group interviews lasting two hours each to grasp their experience of 'being new'. Interview data were analysed according to Sloan's (2002) three moments, and the whole process of analysis followed the suggestions of Agar (1986), which was performed in a close collaboration between researchers until the consensus about the findings could be reached. The overarching pattern of the transition process of new nurses becoming experienced members of the clinical nursing team was revealed as a journey of 'struggling to be an insider'. This phenomenon was characterised by four themes, including (1) 'being new as being weak', (2) 'masking myself', (3) 'internalising the unreasonable' and (4) 'transforming myself to get a position'. While Western culture view abusive indoctrination of new nurses as toxic behaviour, under the Chinese traditions of yield, tolerance and self-oppression, following the power hierarchy and seeking harmony, the transition of new nurses is interpreted differently. Recognition of the journey of 'struggling to be an insider' helps nurse administrators to (1) gain a better understanding of what new nurses encounter in their transition process, (2) help new nurses without harm, (3) improve in-service training programmes and (4) retain future nurses. © 2012 Blackwell Publishing Ltd.
McCreaddie, M; Kuzemski, D; Griffiths, J; Sojka, E M; Fielding, M; Al Yateem, N; Williams, J J
This article identified, critically analysed and synthesized the literature on international nursing and midwifery research capacity building and standards. The United Arab Emirates is heavily dependent up on expatriate nurses. Only 4% of nurses working within the country are Emirati. The nation is therefore committed to developing nurses and nursing as a profession. The United Arab Emirates' Nursing and Midwifery Council was formed in 2009 and initially focused on regulation, education and specialization. This review was undertaken to inform the work of the Council's newly established Scientific Research Sub-Committee. A rapid narrative review was conducted using the Cumulative Index of Nursing and Allied Health Literature database, key words, Boolean operators, parameters and a journal-specific search. An inclusion/exclusion criterion was identified. The search provided 332 articles with 45 included in the final review. The literature on nursing research 'standards' and 'capacity building' is diverse and inconsistent across continents and in approaches. Nursing research has evolved to varying degrees across the globe. Nevertheless, irrespective of the locale, there are similar problems encountered in growing research, for example nursing faculty shortage, lack of collaborative research, funding. There are also specific challenges in the Middle East and North Africa region. The review was constrained by time and access. There are specific challenges for the United Arab Emirates. However, the country is well placed to learn from the experiences of colleagues elsewhere. Time and commitment is required to build the solid foundations necessary to ensure robust, sustained growth. Identifying research capacity as both a process and outcome at the outset may also assist. Further, it may be prudent to consider initiating a Gulf Coast Countries' collaborative approach to building research capacity to harness scare resources and create a larger critical mass. © 2017
Roberts, J.P.; Desell, L.J.; Birch, M.L.; Berkowitz, L.; Bader, J.F.
To provide guidance for the Department of Energy's (DOE) Civilian Radioactive Waste Management Program, the Nuclear Regulatory Commission (NRC) has issued a draft regulatory guide on the Format and Content for the License Application for the High-Level Waste Repository (FCRG). To facilitate the development of the FCRG, NRC suggested that DOE use the draft guide as the basis for preparing an annotated outline for a license application. DOE is doing so using an iterative process called the Annotated Outline Initiative. DOE;s use of the Initiative will assist in achieving the desired incorporation of actual experience in the FCRG, contribute to the development of shared interpretation and understanding of NRC regulations, and provide other important programmatic benefits described in this paper
Simpson, Janis Lee
The purpose of this quantitative research study was to determine the degree to which Licensed Practical Nursing programmatic variables positively correlate with select Tennessee Technology Center institution pass rates on the licensure examination--NCLEX-PNRTM. This study investigated the relationship between the dependent variable of NCLEX-PNRTM…
Palese, Alvisa; Dobrowolska, Beata; Squin, Anna; Lupieri, Giulia; Bulfone, Giampiera; Vecchiato, Sara
Some developed countries have recently changed their role in the context of international recruitment, becoming donors due to socio-economical and political factors such as recessions. This is also the case in Italy, where there has been a flow of immigrant nurses out of the country that has been documented over the past several years. In a short time, it has become a donor country to other developed European countries, such as the United Kingdom. To advance knowledge in the context of human rights conflicts and ethical implications of the decision-making process of nurses who migrate between developed countries, such as from Italy to the United Kingdom, during times of recession. A case study based on the descriptive phenomenological approach was undertaken in 2014. Participants and research context: A total of 26 Italian newly graduated nurses finding a job in the United Kingdom were interviewed via Skype and telephone. Ethical considerations: The Internal Review Board of the University approved the project. In accordance with the descriptive phenomenological approach undertaken, three main themes emerged: (1) escaping from the feeling of being refused/rejected in order to be desired, (2) perceiving themselves respected, as a person and as a nurse, in a growth project and (3) returning if the country changes its strategy regarding nurses. Ethical implications in the context of human rights, such as autonomy of the decision, social justice and reciprocal obligation, non-maleficence and double effect, have been discussed. The call for investing in nurses and nurses' care in developed countries facing recession is urgent. Investing in nurses means respecting individuals and citizens who are at risk of developing health problems during the recession.
Hall, Katherine C; Diffenderfer, Sandy K; Stidham, April; Mullins, Christine M
In the 1990s, dedicated education units transformed undergraduate preceptorships, but graduate preceptorships remain static. The dyadic nurse practitioner preceptorship model supports an environment where faculty, students, and preceptors may overlook nuances that affect the teaching-learning process. This article describes an innovative clinical education model, Student and Preceptor Advancement in a Dedicated Education Site, designed to improve preceptorships for advanced practice nurses. The focus is on adaptations made to facilitate use in advanced practice nursing programs.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Ilić, Ivana M; Arandjelović, Mirjana Ž; Jovanović, Jovica M; Nešić, Milkica M
Psychosocial risks represent a great challenge for safety and health protection at work in Europe. The purpose of this study has been to determine the relationships of psychosocial risks arising from work, stress, personal characteristics and burnout among physicians and nurses in the Emergency Medical Service (EMS). We performed a cross-sectional study based on a questionnaire survey which contained the Copenhagen Psychosocial Questionnaire (COPSOQ) and Copenhagen Burnout Inventory (CBI). A total of 88 physicians and 80 nurses completed the survey. Physicians demonstrated higher emotional (mean (M) ± standard deviation (SD) = 74.57±16.85) and cognitive (M±SD = 75.95±13.74) demands as compared to nurses. Both groups had high sensory demands and responsibilities at work, in spite of the low degree of their autonomy. The meaning of work, commitment to the workplace, and insecurity at work were high for both groups. Among all participants, stressful behavior and reactions were within the limits of low values ( 60). Personal and patient-related burnout was high for both groups, where physicians were significantly affected by work-related burnout. The influence at work, degree of freedom at work, social support, sense of coherence, mental health, and problem-focused coping are negatively related to work-related burnout. Based on personal factors and coping styles, emergency physicians and nurses are representing a self-selective professional group that meets high work demands, great responsibility, strong commitment and insecurity at work. Burnout of physicians and nurses in the EMS tends to be ignored, although it has severe consequences on their mental and general health. Med Pr 2017;68(2):178-178. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Banaszak-Holl, Jane; Castle, Nicholas G; Lin, Michael K; Shrivastwa, Nijika; Spreitzer, Gretchen
We examined how organizational culture in nursing homes affects staff turnover, because culture is a first step to creating satisfactory work environments. Nursing home administrators were asked in 2009 to report on facility culture and staff turnover. We received responses from 419 of 1,056 administrators contacted. Respondents reported the strength of cultural values using scales from a Competing Values Framework and percent of staff leaving annually for Registered Nurse (RN), Licensed Practice Nurse (LPN), and nursing aide (NA) staff. We estimated negative binomial models predicting turnover. Turnover rates are lower than found in past but remain significantly higher among NAs than among RNs or LPNs. Facilities with stronger market values had increased turnover among RNs and LPNs, and among NAs when turnover was adjusted for facilities with few staff. Facilities emphasizing hierarchical internal processes had lower RN turnover. Group and developmental values focusing on staff and innovation only lowered LPN turnover. Finally, effects on NA turnover become insignificant when turnover was adjusted if voluntary turnover was reported. Organizational culture had differential effects on the turnover of RN, LPN, and NA staff that should be addressed in developing culture-change strategies. More flexible organizational culture values were important for LPN staff only, whereas unexpectedly, greater emphasis on rigid internal rules helped facilities retain RNs. Facilities with a stronger focus on customer needs had higher turnover among all staff. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Twisk, D.A.M. Bos, N.M. Shope, J.T. & Kok, G.
Whereas the safety of teens in early licensing countries has been extensively studied, little is known about the safety of pre-license teens in late licensing countries, where these teens also may be at risk. This risk exists because of the combination of a) increasing use of travel modes with a
... License Renewal, Operating License SUA-1341, Uranium One USA, Inc., Willow Creek Uranium In Situ Recovery.... SUA- 1341 to Uranium One USA, Inc. (Uranium One) for its Willow Creek Uranium In Situ Recovery (ISR... Commission License No. SUA-1341 For Uranium One USA, Inc., Irigaray and Christensen Ranch Projects (Willow...
... University of Illinois Advanced TRIGA Reactor, License No. R-115 The U.S. Nuclear Regulatory Commission (NRC) is noticing the termination of Facility Operating License No. R-115, for the University of Illinois... Operating License No. R-115 is terminated. The above referenced documents may be examined, and/or copied for...
The US Congress promulgated a law in 1954, entitled 'Atomic Energy Act'. This Act states that operating licenses for commercial nuclear power plants are limited to a fixed term of 40 years, but they may be renewed for a period not to exceed 20 years. The terms were established mainly for economic considerations, not based on technical limitations. The U.S. Nuclear Regulatory Commission (USNRC) published the license renewal rule, Title 10 of the Code of Federal Regulations, Part 54 (10 CFR Part 54), in December, 1991. The rule has since been amended in May, 1995. The underlying principle of the rule is that the regulatory process is adequate for ensuring safety of operating plants. The regulatory process includes NRC's issuance of Orders, Bulletins, Generic Letters, and Information Notices, as well as a number of special inspections in addition to the continuous oversight and routine inspection activities performed by on-site inspectors. Because of this comprehensive regulatory process, compilation of the current license basis or re-verification of the current licensing basis is not considered necessary for a license renewal review. The USNRC also determined on the basis of the findings of its research programs that active structures and components are well maintained by the existing programs. Therefore, the focus of the license renewal review is on passive, long-lived structures and components and on time-limited ageing analyses. The time-limited ageing analyses are for those structures and components which were originally designed to a 40 year service life
In the US, at-reactor-site dry spent fuel storage in independent spent fuel storage installations (ISFSI) has become the principal option for utilities needing storage capacity outside of the reactor spent fuel pools. Delays in the geologic repository operational date at or beyond 2010, and the increasing uncertainty of the US Department of Energy's (DOE) being able to site and license a Monitored Retrievable Storage (MRS) facility by 1998 make at-reactor-site dry storage of spent nuclear fuel increasingly desirable to utilities and DOE to meet the need for additional spent fuel storage capacity until disposal, in a repository, is available. The past year has been another busy year for dry spent fuel storage licensing. The licensing staff has been reviewing 7 applications and 12 amendment requests, as well as participating in inspection-related activities. The authors have licensed, on a site-specific basis, a variety of dry technologies (cask, module, and vault). By using certified designs, site-specific licensing is no longer required. Another new cask has been certified. They have received one new application for cask certification and two amendments to a certified cask design. As they stand on the brink of receiving multiple applications from DOE for the MPC, they are preparing to meet the needs of this national program. With the range of technical and licensing options available to utilities, the authors believe that utilities can meet their need for additional spent fuel storage capacity for essentially all reactor sites through the next decade
Workplace incivility is a well-documented issue in nursing in the health care setting. It has the potential to cause emotional and physical distress in victims and potentially affects the quality of care provided. The purpose of this study was to critique and summarize the most recent, available evidence related to interventions in assisting nursing staff working in health care settings in managing incivility. This systematic review of literature yielded 10 studies meeting the criteria. The studies were mostly identified as lower quality research. Despite the lower quality of research, the collection of evidence suggests the use of a combination of educational training about workplace incivility, training about effective responses to uncivil workplace behaviors, and active learning activities to practice newly learned communication skills, in assisting nurses in improving their ability to manage incivility in the workplace.
Blanken, Irene; van de Ven, Niels; Zeelenberg, Marcel
Moral licensing refers to the effect that when people initially behave in a moral way, they are later more likely to display behaviors that are immoral, unethical, or otherwise problematic. We provide a state-of-the-art overview of moral licensing by conducting a meta-analysis of 91 studies (7,397 participants) that compare a licensing condition with a control condition. Based on this analysis, the magnitude of the moral licensing effect is estimated to be a Cohen's d of 0.31. We tested potential moderators and found that published studies tend to have larger moral licensing effects than unpublished studies. We found no empirical evidence for other moderators that were theorized to be of importance. The effect size estimate implies that studies require many more participants to draw solid conclusions about moral licensing and its possible moderators. © 2015 by the Society for Personality and Social Psychology, Inc.
Kudo, Yasushi; Kido, Shigeri; Shahzad, Machiko Taruzuka; Shida, Kyoko; Satoh, Toshihiko; Aizawa, Yoshiharu
Proper work environments are important for nurses to feel motivated. We examined the associations between work motivation and job satisfaction among Japanese nurses to improve their motivation. In Japan, relatively small and medium-sized private hospitals play a central role in the healthcare industry. In the present study, the subjects were nurses working in 23 small and medium-sized private hospitals that had 65 to 326 beds. We analyzed 1,116 registered and licensed practical female nurses (average age, 38.3 years; standard deviation, 11.3 years). Many nurses with their specialized nursing skills dedicate themselves to patient care. However, many of these nurses may not be interested in contributing to their hospitals. Nurses may have different opinions regarding dedication to patient care and contribution to their hospitals. Therefore, concerning work motivation, we produced these two different items, "Nurses' dedication to patients" and "Nurses' contribution to their hospitals." We also produced our own original new job satisfaction questionnaire. We found 7 facets of job satisfaction: "Work as specialists," "Workplace safety," "Relationships with superiors," "Work-life balance," "Relationships among nurses," "Communications with physicians," and "Salary." Multiple linear regression analyses show that both "Nurses' dedication to patients" and "Nurses' contribution to their hospitals" were significantly associated with "Work as specialists." Nurses feel their jobs of protecting people's lives and health are valuable. They do not feel motivated only by money. They value the intrinsic nature of their jobs. Creating proper work environments is important for nurses to be able to work as specialists.
Feng, Zhanlian; Grabowski, David C; Intrator, Orna; Zinn, Jacqueline; Mor, Vincent
We examined the impact of state Medicaid payment rates and case-mix reimbursement on direct care staffing levels in US nursing homes. We used a recent time series of national nursing home data from the Online Survey Certification and Reporting system for 1996-2004, merged with annual state Medicaid payment rates and case-mix reimbursement information. A 5-category response measure of total staffing levels was defined according to expert recommended thresholds, and examined in a multinomial logistic regression model. Facility fixed-effects models were estimated separately for Registered Nurse (RN), Licensed Practical Nurse (LPN), and Certified Nurse Aide (CNA) staffing levels measured as average hours per resident day. Higher Medicaid payment rates were associated with increases in total staffing levels to meet a higher recommended threshold. However, these gains in overall staffing were accompanied by a reduction of RN staffing and an increase in both LPN and CNA staffing levels. Under case-mix reimbursement, the likelihood of nursing homes achieving higher recommended staffing thresholds decreased, as did levels of professional staffing. Independent of the effects of state, market, and facility characteristics, there was a significant downward trend in RN staffing and an upward trend in both LPN and CNA staffing. Although overall staffing may increase in response to more generous Medicaid reimbursement, it may not translate into improvements in the skill mix of staff. Adjusting for reimbursement levels and resident acuity, total staffing has not increased after the implementation of case-mix reimbursement.
Smith, Shannon Bright; Alexander, Judith W
The study's purpose was to determine nurses' opinions of sending patients from the hospital to home with home health services. The study occurred in the Charleston, South Carolina, Tricounty area (Berkeley, Charleston, and Dorchester counties). Home health agencies and hospitals were invited to participate. The study used a survey design to gather information on nursing perceptions of current practices and needed changes to improve transition of patients. The population was nurses (licensed practical nurses (LPNs) and registered nurses (RNs)) employed at inpatient hospitals or home health agencies in the area. Thirty-four RNs responded with no LPNs respondents. Agency administrators/chief nursing officers agreed for their agencies to participate and distributed the survey using a Research Electronic Data Capture (REDCap) Internet-based survey tool. Using the survey results and information from a literature review, the study developed a list of propositions, which participating administrators reviewed, for improving transitions to home. Both home health and hospital nurses reported a need to improve the process of sending patients from hospital to home with home health services. This study provides hospitals and home health agencies with propositions to facilitate the establishment of a process to communicate effectively patients care needs and streamline the discharging patients from the hospital to home health care; thus, improving patient transition. Case managers and discharge planners will need interagency collaboration along with evidence-based interventions to transition patients from the hospital to home with home health services with various populations. Direct patient care nurses in both hospital and home health settings should share the same accountability as case managers to ensure successful transitions.
Clapisson, G.A.; Metcalf, P.E.; Mysen, A.
The South African nuclear regulatory authority, the Council for Nuclear Safety (CNS), is beginning the safety review of the Pebble Bed Modular Reactor (PBMR) design under development by the South African National Electrical Utility, Eskom. This paper describes the CNS licensing process, including the establishment of basic licensing criteria, general design criteria, and specific design rules, as well the safety assessment to be conducted in accordance with the established structure. It also summarises the CNS PBMR review project activities, including the overall organisational arrangements, licensing basis, safety and risk assessment, general operating rules and plant design engineering, and pre-operational testing. (author)
The licensing process for nuclear power plants in the USA is currently in two distinct stages: the issuance of a construction permit followed later by the issuance of an operation license. The ''two-step'' process has come under heavy criticism from the U.S. nuclear industry on the grounds that it causes uncertainty and delays and therefore inhibits new commitments to nuclear power plants. In 1989 the NRC published new regulations for the licensing of nuclear power plants which provide for the issuance of early site permits, safety certifications of standard designs, and combined construction permits and operating licences. The new rule was challenged by intervenors representing antinuclear groups who filed a legal challenge seeking to have the rule set aside on the grounds that it violates the Atomic Energy Act which they allege makes two-step licensing mandatory. In November 1990 the US Court of Appeals upheld the NRC's authority to issue combined licenses. An appeal for a rehearing has been filed. The paper analyses the events and the possible consequences of an adverse court decision. It reviews the options open to the NRC and industry if the court decision is upheld. The possibility of congressional action to amend the Atomic Energy Act is discussed. (author)
Meier, Lawrence H.
Intellectual property licensing is an important issue facing all technology companies. Before entering into license agreements a number of issues need to be addressed, including invention ownership, obtaining and identifying licensable subject matter, and developing a licensing strategy. There are a number of important provisions that are included in most intellectual property license agreements. These provisions include definitions, the license grant, consideration, audit rights confidentiality, warranties, indemnification, and limitation of liability. Special licensing considerations exist relative to each type of intellectual property, and when the other party is a foreign company or a university.
... licensing. Licensing Contact: Patrick P. McCue, PhD, (301) 435-5560; [email protected] . Collaborative... Reference No. E-051-2010/0-US-01). Licensing Status: Available for licensing. Licensing Contact: Patrick P... for the brain tumors or brain cancers indentified as gliomas, glioblastomas, or astrocytomas. This...
Mysen, A.; Clapisson, G.A.; Metcalf, P.E.
The CNS is currently reviewing the PBMR conceptual design from a licensibility point of view. The PBMR concept is based on a High Temperature Gas Cooled Reactor - pebble bed reactor type. It is anticipated that the PBMR design will rely on inherent safety characteristics to contain fission products within fuel over the full range of design basis events. This feature combined with the high temperature integrity of the fuel and structural graphite, allows the safe use of a high coolant temperature, which allows consideration of the future development of this reactor for non-electrical applications of nuclear heat for industrial use. The CNS licensing approach requires that the licensing and design basis of the plant should respect prevailing international norms and practices and that a quantitative risk assessment should demonstrate compliance with the CNS fundamental safety standards. The first stage of the licensing process is now ongoing; this is a pre-application phase, which will result in a statement on licensibility being issued. Identification of the specific documentation requirements and information needed is required across every step of the licensing process. Top level regulatory requirements have been established for the PBMR. They include the CNS fundamental safety standard and basic licensing criteria, which describes requirements on licensees of nuclear installations regarding risk assessment and compliance with the safety criteria and define classification of licensing basis events. (author)
...: Voluntary surrender of license. License No.: 12454N. Name: Federation Exports-Imports Inc. Address: 747...: Natco International Transports USA, L.L.C. Address: 12415 SW 136th Avenue, Bay 4, Miami, FL 33186 Date...: Voluntary surrender of license. License No.: 022773F. Name: WLI (USA) Inc. Address: 175-01 Rockaway Blvd...
The lives of the first women doctors in Britain have been well studied by historians, as have the many debates about the right of women to train and practice as doctors. Yet the relationship between these women and their most obvious comparators and competitors-the newly professionalized hospital nurses-has not been explored. This article makes use of a wide range of sources to explore the ways in which the first lady doctors created "clear water" between themselves and the nurses with whom they worked and trained. In doing so, it reveals an identity that may seem at odds with some of the clichés of Victorian femininity, namely that of the intelligent and ambitious lady doctor.
Hansen, Anne B; Stayner, Leslie; Hansen, Johnni; Andersen, Zorana J
Night shift work has been associated with poor sleep, weight gain, metabolic syndrome, which are recognised risk factor for diabetes. However, only a few studies have examined the effect of shift work on diabetes risk. Here, we study the association between shift work and incidence of diabetes in Danish nurses. We used the Danish Nurse Cohort with 28,731 participating female nurses recruited in 1993 (19,898) or 1999 (8833), when self-reported baseline information on diabetes prevalence, lifestyle and working time were collected, and followed them in the Danish Diabetes Register for incidence of diabetes until 2013. Nurses reported whether they worked night, evening, rotating or day shifts. We analysed the association between working time and diabetes incidence using a Cox proportional hazards model adjusted for diabetes risk factors, separately with and without adjustment for body mass index (BMI) which might be an intermediate variable. Of 19,873 nurses who worked and were diabetes-free at recruitment, 837 (4.4%) developed diabetes during 15 years of follow-up. The majority of nurses (62.4%) worked day shifts, 21.8% rotating shift, 10.1% evening and 5.5% night shifts. Compared with nurses who worked day shifts, we found statistically significantly increased risk of diabetes in nurses who worked night (1.58; 1.25 to 1.99) or evening shifts (1.29; 1.04 to 1.59) in the fully adjusted models including BMI. Danish nurses working night and evening shifts have increased risk for diabetes, with the highest risk associated with current night shift work. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Chandiwala, F.; Evans, W.P.
After the NRC issued a revised license renewal rule in May 1995, the nuclear industry focussed on developing generic industry for implementing the rule and testing the guidance through various demonstration programs and work products in conjunction with the NRC. In addition, plant-specific programs also proceeded forward. These activities show that implementation issues continue to exist. Since the issuance of the rule, the NRC has issued a draft standard review plan for license renewal (SRP-LR), working draft, September 1997. Southern Nuclear Operating Company (SNC) has begun development work on a license renewal application for Plant Hatch Units 1 and 2. Plant Hatch Units 1 and 2 are BWR 4, Mark I plants whose operating licenses expire in 2014 and 2018, respectively. The Plant Hatch initiative also involves teaming with other boiling water reactors (BWRs) to develop the license renewal technology within the BWR fleet, and to support Plant Hatch by providing an oversight role for the application process. The teaming effort involved two other utilities, each being assigned to prepare a common report on a mechanical system or a structure. The common report could be presented to the NRC with modifications to suit the individual plants, thereby saving time and money, and hopefully resulting in quicker approval by the NRC. The desired license renewal process end result is a renewed license with up to a 20 year extension (10CFR 54.31(b)). (orig.)
Rural health care facilities are geographically remote, tend to be small, and often possess limited resources. Although newly graduated registered nurses are important to the work force of many rural communities, maintaining a formal preceptorship/mentorship program within a rural hospital may prove difficult as a result of limited resources. Unfortunately, the new graduate may become overwhelmed by the many expectations for clinical practice and the facility can experience high turnover rates of new graduate hires. This article explores the unique traits of the rural hospital and the new graduate nurse as well as the pros and cons of a formal preceptorship program within a rural setting. Constructivist learning theory is used to develop practical teaching strategies that can be used by the preceptor and the new graduate. These strategies are inexpensive, yet effective, and are feasible for even the smallest of facilities. Copyright 2013, SLACK Incorporated.
... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false License to contractor. 1245.108 Section... INTELLECTUAL PROPERTY RIGHTS Patent Waiver Regulations § 1245.108 License to contractor. (a) Each contractor.... The license extends to the contractor's domestic subsidiaries and affiliates, if any, within the...
Chong, C.N.; Ren, Bin; Doumen, J.M.; Etalle, Sandro; Hartel, Pieter H.; Corin, R.J.; Lim, Chae Hoon; Yung, Moti
Content protection mechanisms are intended to enforce the usage rights on the content. These usage rights are carried by a license. Sometimes, a license even carries the key that is used to unlock the protected content. Unfortunately, license protection is difficult, yet it is important for digital
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.
Donoghue, Christopher; Castle, Nicholas G
The purpose of this study was to examine the associations between nursing home administrator (NHA) leadership style and staff turnover. We analyzed primary data from a survey of 2,900 NHAs conducted in 2005. The Online Survey Certification and Reporting database and the Area Resource File were utilized to extract organizational and local economic characteristics of the facilities. A general linear model (GLM) was used to estimate the effects of NHA leadership style, organizational characteristics, and local economic characteristics on nursing home staff turnover for registered nurses (RNs), licensed practical nurses (LPNs), and nurse's aides (NAs). The complete model estimates indicate that NHAs who are consensus managers (leaders who solicit, and act upon, the most input from their staff) are associated with the lowest turnover levels, 7% for RNs, 3% for LPNs, and 44% for NAs. Shareholder managers (leaders who neither solicit input when making a decision nor provide their staffs with relevant information for making decisions on their own) are associated with the highest turnover levels, 32% for RNs, 56% for LPNs, and 168% for NAs. The findings indicate that NHA leadership style is associated with staff turnover, even when the effects of organizational and local economic conditions are held constant. Because leadership strategies are amenable to change, the findings of this study may be used to develop policies for lowering staff turnover.
Wagner, Joan I J; Gregory, David M
To explore registered nurses' (RNs) perspectives about the health care system, management/leadership, patients and spirit at work (SAW). Researchers investigating RNs experiences of reduced job satisfaction and diminishing organisational commitment are looking carefully at spirit at work as a means to foster healthier workplaces. A descriptive, cross-sectional mixed methods design was used to measure and explore the relationships between spirit at work, job satisfaction and organisational commitment. A 2012 postal survey sent by the provincial licensing body to a random sample of 217 surgical and 158 home care registered nurses' in western Canada returned 179 surveys. Seventy-five respondents answered the open-ended survey question. Their responses warrant further content analysis and serve as the foundation of this article. Participants noted that organisational structures and policies, combined with unsupportive leadership, were associated with a reduced sense of community, lack of trust and diminished accountability. Spirit at work was described as sustaining registered nurses' and providing them with hope as they fulfilled their covenant of care with patients. Leadership attention to the advancement of SAW may support the covenant of care between the registered nurses and patient while fostering healthier workplaces. © 2014 John Wiley & Sons Ltd.
Gloudemans, H.; Reynaert, W.; Schalk, R.; Braeken, J.
Background: The aim of this study is to validate a newly developed nurses' self-efficacy sources inventory. We test the validity of a five-dimensional model of sources of self-efficacy, which we contrast with the traditional four-dimensional model based on Bandura’s theoretical
Snell, V.G.; Grant, S.D.
Modern utilities view nuclear power more and more as a commodity - it must compete 'today' with current alternatives to attract their investment. With its long construction times and large capital investment, nuclear plants are vulnerable to delays once they have been committed. There are two related issues. Where the purchaser and the regulator are experienced in CANDU, the thrust is a very practical one: to identify and resolve major licensing risks at a very early stage in the project. Thus for a Canadian project, the designer (AECL) and the prospective purchaser would deal directly with the AECB. However CANDU has also been successfully licensed in other countries, including Korea, Romania, Argentina, India and Pakistan. Each of these countries has its own regulatory agency responsible for licensing the plant. In addition, however, the foreign customer and regulator may seek input from the AECB, up to and including a statement of licensability in Canada; this is not normally needed for a ''repeat'' plant and/or if the customer is experienced in CANDU, but can be requested if the plant configuration has been modified significantly from an already-operating CANDU. It is thus the responsibility of the designer to initiate early discussions with the AECB so the foreign CANDU meets the expectations of its customers
.... (3) A military recreation station license grant. A military recreation station license grant may be... States military recreational premises where the station is situated. The person must not be a... the balance of the license term and the suspension is still in effect, suspended for the balance of...
... performance of the installation work in compliance with the requirements of this part. (3) A license is not required for individuals working as direct employees of a licensed installer or for the company that... and competent performance of all employees working under the licensed installer's supervision and for...
The Non-Power Reactor Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR Part 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes. As appropriate, this standard will be revised periodically to accommodate comments and reflect new information or experience
Hull, A.B.; Hiser, A.L.; Lindo-Talin, S.E.
Based on the Atomic Energy Act, the NRC issues licenses for commercial power reactors to operate for up to 40 years and allows these licenses to be renewed for up to another 20 years. NRC has approved license renewal for well over 50% of U.S. located reactors originally licensed to operate for 40 years. Of these 104 reactors (69 PWRs, 35 BWRs), the NRC has issued renewed licenses for 71 units and is currently reviewing applications for another 15 units. As of May 1, 2012, ten plants at nine sites had entered their 41st year of operation and thus are in their first period of extended operation (PEO). Five more plants will enter the PEO by the end of 2012. One foundation of the license renewal process has been license renewal guidance documents (LRGDs). The U.S. Nuclear Regulatory Commission (NRC) revised key guidance documents used for nuclear power license renewal in 2010 and 2011. These include NUREG-1800, 'Standard Review Plan for Review of License Renewal Applications,' revision 2 (SRP-LR), and NUREG-1801, 'Generic Aging Lessons Learned (GALL) Report,' revision 2 (GALL Report). The guidance documents were updated to reflect lessons learned and operating experience gained since the guidance documents were last issued in 2005. (author)
... DEPARTMENT OF DEFENSE Department of the Army Notice of Intent To License Government-Owned Inventions; Intent To License Exclusively AGENCY: Department of the Army, DoD. ACTION: Notice. SUMMARY: The... Army. The US Army Edgewood Chemical Biological Center and the US Army Research Laboratory intend to...
Chao, Minston; Shih, Chih-Ting; Hsu, Shu-Fen
Most previous studies on the relationship between occupational burnout and the quality of care among nurses have used self-reported data on the quality of care from nurses, thus rendering evaluating the relationship between burnout and the quality of care difficult. Hospitals increasingly hire contract nurses and high turnover rates remain a concern. Little is known about whether nurses' emotional intelligence and demographic factors such as contract status, tenure, and marital status affect the quality of care when burnout occurs. This study investigated the relationship between burnout and patient-rated quality of care and investigated the moderating role of emotional intelligence and demographic variables. Hierarchical moderated regression was used to analyze 98 sets of paired data obtained from nurses and their patients at a teaching hospital in northern Taiwan. The results suggest that occupational burnout has a less unfavorable effect on the quality of care from permanent, married, and senior nurses. Nursing management should pay particular attention to retaining permanent, married, and senior nurses. To ensure a sustainable nursing workforce in the future, newly graduated registered nurses should have access to permanent positions and opportunities for long-term professional development. In addition, married nurses should be provided with flexible work-family arrangements to ensure their satisfaction in the nursing profession. © 2015 Japan Academy of Nursing Science.
Lin, Pei-Chao; Hsieh, Mei-Hui; Chen, Meng-Chin; Yang, Yung-Mei; Lin, Li-Chan
The quality of dementia care in hospitals is typically substandard. Staff members are underprepared for providing care to older people with dementia. The objective of the present study was to examine dementia care knowledge, attitude and behavior regarding self-education about dementia care among nurses working in different wards. This was a descriptive cross-sectional study. The present study was carried out from July 2013 to December 2013. In total, 387 nurses working in different wards were recruited from two hospitals in Taiwan by using convenience sampling. The nurses completed a self-report questionnaire on demographic data, experience and learning behavior, and attitude towards dementia care, and a 16-item questionnaire on dementia care knowledge. Descriptive and inferential statistics were used to analyze the status and differences in dementia care knowledge among nurse in different wards. The average dementia care knowledge score was 10.46 (SD 2.13), with a 66.5% mean accuracy among all nurses. Dementia care knowledge was significantly associated with age, nursing experience, possession of a registered nurse license, holding a bachelor's degree, work unit, training courses and learning behavior towards dementia care. The dementia care knowledge of the emergency room nurses was significantly lower than that of the psychiatric and neurology ward nurses. A significantly lower percentage of emergency room nurses underwent dementia care training and actively searched for information on dementia care, compared with the psychiatric and neurology ward nurses. Hospital nurses show a knowledge gap regarding dementia care, especially emergency room nurses. Providing dementia care training to hospital nurses, particularly emergency room nurses, is crucial for improving the quality of care for patients with dementia. Geriatr Gerontol Int 2018; 18: 276-285. © 2017 Japan Geriatrics Society.
Duffield, Christine; Pallas, Linda O'Brien; Aitken, Leanne M
The desire to care for people, a family history of professional health care work, and security in career choice are documented reasons for entering nursing. Reasons for leaving include workload, unsafe work environments and harassment. The relationship between these factors and the time nurses spend in the profession has not been explored. This paper reports a study with people who have left nursing, to investigate why they became a nurse, how long they stayed in nursing, and their reasons for leaving. A questionnaire was mailed to Registered Nurses currently working outside nursing, seeking respondents' reasons for entering and leaving nursing, and perceptions of the skills gained from nursing and the ease of adjustment to working in a non-nursing environment. Data analysis included descriptive statistics, exploratory and confirmatory factor analysis, correlational analysis and linear and multiple regression analysis. A model incorporating the factors 'altruistic reasons', 'default choice' and 'stepping stone' explained 36.2% of the variance in reasons for becoming a nurse. A model incorporating the factors 'legal and employer', 'external values and beliefs about nursing', 'professional practice', 'work life/home life' and 'contract requirements' explained 55.4% of the variance in reasons for leaving nursing. Forty-eight per cent of the variance in tenure in nursing practice was explained through personal characteristics of nurses (36%), reasons for becoming a nurse (7%) and reasons for leaving (6%). The reasons why nurses entered or left the profession were varied and complex. While personal characteristics accounted for a large component of tenure in nursing, those managing the nursing workforce should consider professional practice issues and the balance between work life and home life.
Murray, Melanie; Sundin, Deborah; Cope, Vicki
To critically appraise available literature and summarise evidence pertaining to the patient safety knowledge and practices of new graduate registered nurses. Responsibility for patient safety should not be limited to the practice of the bedside nurses, rather the responsibility of all in the healthcare system. Previous research identified lapses in safety across the health care, more specifically with new practitioners. Understanding these gaps and what may be employed to counteract them is vital to ensuring patient safety. A focused review of research literature. The review used key terms and Boolean operators across a 5-year time frame in CINAHL, Medline, psycINFO and Google Scholar for research articles pertaining to the area of enquiry. Eighty-four articles met the inclusion criteria, 39 discarded due to irrelevant material and 45 articles were included in the literature review. This review acknowledges that nursing has different stages of knowledge and practice capabilities. A theory-practice gap for new graduate registered nurses exists, and transition to practice is a key learning period setting new nurses on the path to becoming expert practitioners. Within the literature, there was little to no acknowledgement of patient safety knowledge of the newly registered nurse. Issues raised in the 1970s remain a concern for today's new graduate registered nurses. Research has recognised several factors affecting transition from nursing student to new graduate registered nurse. These factors are leaving new practitioners open to potential errors and risking patient safety. Understanding the knowledge of a new graduate registered nurse upon entering clinical practice may assist in organisations providing appropriate clinical and theoretical support to these nurses during their transition. © 2017 John Wiley & Sons Ltd.
... method used to calculate the license fee. All initial license and changed class of license fees must be... research facilities, dealers, exhibitors, retail pet stores, and persons for use as pets, directly or through an auction sale, by the dealer or applicant during his or her preceding business year (calendar or...
Gleim, A.; Winter, G.
The authors examine as potential statements fo fact for licensing so-called compact storage facilities for spent fuel elements Sec. 6 to 9c of the German Atomic Energy Act and Sec. 4 of the German Radiation Protection Ordinance. They find that none of these provisions were applicable to compact stroage facilities. In particular, the storage of spent fuel elements was no storage of nuclear fuels licensable under Sec. 6 of the Atomic Energy Act, because Sec. 6 did not cover spent fuel elements. Also in the other wording of the Atomic Energy Act there was no provision, which could be used as a statement of fact for licensing compact storage facilities. Such facilities could not be licensed and, for that reason, were not permitted. (IVR) [de
Wolfstetter, Elmar; Giebe, Thomas
This paper revisits the licensing of a nonâ€“drastic process innovation by an outside innovator to a Cournot oligopoly. We propose a new mechanism that combines a restrictive license auction with royalty licensing. This mechanism is more profitable than standard license auctions, auctioning royalty contracts, fixedâ€“fee licensing, pure royalty licensing, and two-part tariffs. The key features are that royalty contracts are auctioned and that losers of the auction are granted the option to si...
... DEPARTMENT OF DEFENSE Department of the Army Notice of Intent To License Government-Owned Inventions; Intent To License Exclusively AGENCY: Department of the Army, DoD. ACTION: Notice. SUMMARY: The... McGill telephone: 410-436-8467, [email protected]us.army.mil , U.S. Army Edgewood Chemical Biological Center...
Barbosa, E.A.; Martucci, M. Jr.
The scope of CNEN (Comissao Nacional de Energia Nuclear) is established by standards and procedures, which allow one context where several activities for nuclear licensing are realized by persons, machines and other entities of real world and by software systems. The CNEN objectives for licensing nuclear installations can be specified and they define how the systems are consisted, its nature, and which important elements were considered relevant for its constitution. The behavior, where the software will be operated, was likely defined in this paper through all aspects of its business process, which means from its licensing context. The concepts and definition showed here defined one specifics business domain, through ODP context. The functionalities of nuclear licensing process, the relationship scope and the rules of interaction that contributed for to specify the nuclear licensing process were defined, too. Therefore, the definition of the domain follows the orientation of architecture concepts and allows to implement the reflection model, where, with the auxiliary from IDEF0 (Integration Definition for Function Modeling) diagrams, the interactions between extern domains were mapped
Ketelaar, Sarah M; Nieuwenhuijsen, Karen; Frings-Dresen, Monique H W; Sluiter, Judith K
To investigate Dutch novice nurses' experiences and needs regarding occupational health support to prevent work-related health problems and to keep them well-functioning. A qualitative interview study was conducted with six nursing students and eight newly qualified nurses. The interviews covered three topics: experiences with the link between work and health, received occupational health support, and occupational health support needs. Data were analysed using a grounded theory approach. Participants reported experiences with work-related health problems early in their career and described experiences with how health problems lead to suboptimal work functioning. Occupational health support needs included knowledge and psychosocial support during nursing education, e.g. through paying attention to dealing with shift work, or career counselling. Also, they reported a need for knowledge and psychosocial support at the start of their clinical placement or new job in the hospital, e.g. information from occupational health services or having a mentor. Furthermore, they reported that occupational health support requires a more general place at work through offering knowledge, e.g. tailored advice on proper lifting position; psychosocial support, e.g. positive team atmosphere; and physical support, e.g. suitable preventive measures. Occupational health support for novice nurses is important, since they already experience work-related health problems and suboptimal work functioning due to health problems early in their career and while still in training to be a nurse. Novice nurses should be given more knowledge and support to help them stay healthy and well-functioning in their work. This is a joint responsibility of nurse educators, the employer and occupational health services.
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Prof. Dr. Rene Schalk; dr. Wouter Reynaert; Dr. Johan Braeken; Drs. Henk Gloudemans
Background: The aim of this study is to validate a newly developed nurses' self-efficacy sources inventory. We test the validity of a five-dimensional model of sources of self-efficacy, which we contrast with the traditional four-dimensional model based on Bandura's theoretical concepts. Methods:
Gloudemans, H.; Schalk, R.; Reynaert, W.M.; Braeken, J.
Background: The aim of this study is to validate a newly developed nurses' self-efficacy sources inventory. We test the validity of a five-dimensional model of sources of self-efficacy, which we contrast with the traditional four-dimensional model based on Bandura’s theoretical concepts. Methods:
Dingel-Stewart, Sylvia; LaCoste, Janice
Lacking political stewardship, healthcare in America is shaped primarily by rapidly changing market forces seeking to stem the tide of rising healthcare costs. However, nursing's voice in this process is fragmented and unfocused. Staff nurses' focus and commitment are to quality care rendered at the bedside and in interactions with the patient. With this narrow focus, staff nurses are paralyzed by the constant change and unable to move to a broader, more integrative view of healthcare-one that encompasses quality care, policymaking, and healthcare finance. Using the theory of transformative learning, nurse administrators and managers can influence nurses' frames of reference and expand their view to be more inclusive. Nurses who are successful in this transformation process will emerge with a new view of self-visible and empowered. These newly transformed nurses see themselves more as healthcare engineers than as technicians coordinating care across the continuum, and creating fluid working relationships to prevent the dis-continuum of care of patients falling through the cracks of the current healthcare system.
This paper is a report of a study to examine the relationship between intention to change profession and intention to change employer among newly graduated nurses. Few studies of the worldwide nursing workforce shortage consider the contribution of changing professions to the shortage. Organizational behaviour research has identified that professional commitment and organizational commitment have an important role in organizational turnover and that professional commitment and intention to change professions may have a greater role in organizational turnover than is presently understood. A model of the relationships between affective professional commitment job satisfaction, organizational commitment, intention to change professions and organizational turnover intention was developed through review of the organizational behaviour literature and tested using path analysis. The sample was drawn from all nurses in Queensland, Australia, entering the workforce for the first time in 2005. The model was tested with a final sample size of 131 nurses in the initial period of exposure to the workplace. Affective professional commitment and organizational commitment were statistically significantly related to intention to change professions. Job satisfaction, organizational commitment and intention to change professions were statistically significantly related to intention to change employer. Turnover research in nursing should include intention to change professions as well as intention to change employer. Policies and practices that enhance the development of affective professional commitment prior to exposure to the workplace and support affective professional commitment, job satisfaction and organizational commitment in the workplace are needed to help reduce nurse turnover.
Boyd-Turner, Danni; Bell, Elaine; Russell, Alison
This paper explores how the student placement experience may influence employment choices in the context of paediatric nursing. A qualitative research methodology was used. Data was collected using semi structured interviews at a tertiary teaching hospital. The sample group comprised of six newly qualified nurses who had completed their Bachelor of Nursing less than 12 months before the interview. They had completed at least one clinical placement at the site of data collection in their 2nd or 3rd year of undergraduate nursing studies. The main themes contributing to the student nurse experience within the context of paediatric nursing included the wish to work with children, a job being available, support during clinical placements and assistance with future career planning while on placement. The support experienced by student nurses during their clinical placement was seen to have a very positive influence on their future employment choices. Group de-briefing to support mutual understanding and sharing was seen to be a highly positive aspect of a clinical placement. Also how students were treated by clinical staff was a key factor that influenced future employment choices. Copyright © 2015 Elsevier Ltd. All rights reserved.
Full Text Available An effective workforce performing within the context of a positive cultural environment is central to a healthcare organization’s ability to achieve quality outcomes. The Nursing Culture Assessment Tool (NCAT provides nurses with a valid and reliable tool that captures the general aspects of nursing culture. This study extends earlier work confirming the tool’s construct validity and dimensionality by standardizing the scoring approach and establishing norm-referenced scoring. Scoring standardization provides a reliable point of comparison for NCAT users. NCAT assessments support nursing’s ability to evaluate nursing culture, use results to shape the culture into one that supports change, and advance nursing’s best practices and care outcomes. Registered nurses, licensed practical nurses, and certified nursing assistants from 54 long-term care facilities in Kentucky, Nevada, North Carolina, and Oregon were surveyed. Confirmatory factor analysis yielded six first order factors forming the NCAT’s subscales (Expectations, Behaviors, Teamwork, Communication, Satisfaction, Commitment (Comparative Fit Index 0.93 and a second order factor—The Total Culture Score. Aggregated facility level comparisons of observed group variance with expected random variance using rwg(J statistics is presented. Normative scores and cumulative rank percentages and how the NCAT can be used in implementing planned change are provided.
Description of licensing assistance project for VATESI is presented. In licensing of unit No.1 of INPP VATESI is supported by many western countries. Experts from regulatory bodies or scientific organizations of those countries assist VATESI staff in reviewing documentation presented by INPP. Among bilateral cooperation support is provided by European Commission through Phare programme
Pike, W.J.; O'Reilly, P.D.
This report describes the licensing process (both safety and environmental) that would apply if the Department of Defense (DOD) chooses to obtain licenses from the US Nuclear Regulatory Commission (NRC) for using nuclear energy for power and luminous sources. The specific nuclear energy sources being considered include: small or medium-size nuclear power reactors; radioisotopic thermoelectric generators with 90 Sr or 238 Pu; radioisotopic dynamic electric generators with 90 Sr or 238 Pu; and applications of radioisotopes for luminous sources (lights) with 3 H, 85 Kr, or 147 Pm. The steps of the licensing process are summarized in the following sections, with particular attention given to the schedule and level of effort necessary to support the process
The aim of the study is to establish the main motives for choosing nursing by men in Poland and the results for leaving the profession. Nursing is a profession less frequently chosen by men. On average, one person in ten working in nursing is a man, but in Poland this percentage is especially low, amounting to 1·8%. Qualitative research with a grounded theory approach. Individual semi-structured interviews were used for data collection. The study included 17 licensed male nurses. Data were collected between January 2014-June 2015. The study revealed the most common motives for choosing nursing as declared by men: vocation, interest in medicine, accident and pragmatic motivation. The men for whom hegemonic masculinity constitutes the point of reference more frequently emphasize their interest in medicine and the pragmatic reasons for choosing nursing; they also more frequently try to gain managerial positions and higher income. The most common reason for men leaving the nursing profession was low income. Despite the common stereotype, men also choose nursing because of vocation and/or their willingness to help others, but they more frequently declare that chance was the direct reason for their choice of nursing, which helps reduce the dissonance associated with choosing a non-traditional male career path. Leaving the profession was associated with beliefs about its feminine dimension, but it seems that in Poland low income is a much more important reason for such a decision. © 2016 John Wiley & Sons Ltd.
This paper presents an overview of the licensing process for a Yucca Mountain repository for high-level radioactive waste and spent nuclear fuel. The paper discusses the steps in the licensing proceeding, the roles of the participants, the licensing and hearing requirements contained in the Code of Federal Regulations. A description of the Nuclear Regulatory Commission (NRC) staff acceptance and compliance reviews of the Department of Energy (DOE) application for a construction authorization and a license to receive and possess high-level radioactive waste and spent nuclear fuel is provided. The paper also includes a detailed description of the hearing process
Carelli, Mario D.; Kling, Charles L.; Ritterbusch, Stanley E.
This paper presents the approach to pre-application licensing by the International Reactor Innovative and Secure (IRIS), and advanced, integral reactor design with a thermal power of 1000 MW. The rationale for the pre-application licensing is discussed. Since IRIS technology is based on proven LWR experience, the project will rely on AP600/AP1000 precedent and will focus during the pre-application on long lead and novel items. A discussion of the evolution of the project to significantly reduce licensing issues is provided, followed by a summary of the IRIS safety-by-design which provides a formidable first step in the Defense in Depth approach. The effects of the safety-by-design, as well as of passive systems, on the IRIS safety will be investigated in a proposed testing program that will be reviewed by NRC during the pre-application. Documentation to be provided to NRC is discussed. Early design analyses indicate that the benefits of the IRIS safety-by-design approach are so significant that the basic premise of current emergency planning regulations (i.e., likelihood of core damage) will be reduced to the extent that special emergency response planning beyond the exclusion area boundary may not be needed. How this very significant outcome can be effected through a highly risk-informed licensing is discussed. (author)
Rohatinsky, Noelle K; Jahner, Sharleen
The global shortage of rural healthcare professionals threatens the access these communities have to adequate healthcare resources. Barriers to recruitment and retention of nurses in rural facilities include limited resources, professional development opportunities, and interpersonal ties to the area. Mentorship programs have been used to successfully recruit and retain rural nurses. This study aimed to explore (i) employee perceptions of mentorship in rural healthcare organizations, (ii) the processes involved in creating mentoring relationships in rural healthcare organizations, and (iii) the organizational features supporting and inhibiting mentorship in rural healthcare organizations. This study was conducted in one rural health region in Saskatchewan, Canada. Volunteer participants who were employed at one rural healthcare facility were interviewed. A semi-structured interview guide that focused on exploring and gaining an understanding of participants' perceptions of mentorship in rural communities was employed. Data were analyzed using interpretive description methodology, which places high value on participants' subjective perspective and knowledge of their experience. All seven participants were female and employed as registered nurses or licensed practical nurses. Participants recognized that the rural environment offered unique challenges and opportunities for the transition of nurses new to rural healthcare. Participants believed mentorships facilitated this transition and were vital to the personal and professional success of new employees. Specifically, their insights indicated that this transition was influenced by three factors: rural community influences, organizational influences, and mentorship program influences. Facilitators for mentorships hinged on the close working relationships that facilitated the development of trust. Barriers to mentorship included low staff numbers, limited selection of volunteer mentors, and lack of mentorship
This policy report defines and provides a 50-state review of teacher license reciprocity, explores how state-specific licensing requirements impact the teacher labor market, and includes examples of national and state efforts to facilitate reciprocity.
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.
Lyndon, Audrey; Simpson, Kathleen Rice; Spetz, Joanne
Childbirth is a leading reason for hospital admission in the USA, and most labour care is provided by registered nurses under physician or midwife supervision in a nurse-managed care model. Yet, there are no validated nurse-sensitive quality measures for maternity care. We aimed to engage primary stakeholders of maternity care in identifying the aspects of nursing care during labour and birth they believe influence birth outcomes, and how these aspects of care might be measured. This qualitative study used 15 focus groups to explore perceptions of 73 nurses, 23 new mothers and 9 physicians regarding important aspects of care. Transcripts were analysed thematically. Participants in the final six focus groups were also asked whether or not they thought each of five existing perinatal quality measures were nurse-sensitive. Nurses, new mothers and physicians identified nurses' support of and advocacy for women as important to birth outcomes. Support and advocacy actions included keeping women and their family members informed, being present with women, setting the emotional tone, knowing and advocating for women's wishes and avoiding caesarean birth. Mothers and nurses took technical aspects of care for granted, whereas physicians discussed this more explicitly, noting that nurses were their 'eyes and ears' during labour. Participants endorsed caesarean rates and breastfeeding rates as likely to be nurse-sensitive. Stakeholder values support inclusion of maternity nursing care quality measures related to emotional support and providing information in addition to physical support and clinical aspects of care. Care models that ensure labour nurses have sufficient time and resources to engage in the supportive relationships that women value might contribute to better health outcomes and improved patient experience. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Hull, A.B.; Hiser, A.L.; Lindo-Talin, S.E.
Based on the Atomic Energy Act, the NRC issues licenses for commercial power reactors to operate for up to 40 years and allows these licenses to be renewed for up to another 20 years. NRC has approved license renewal (LR) for well over 50% of U.S. located reactors originally licensed to operate for 40 years. Of these 104 reactors (69 PWRs, 35 BWRs), the NRC has issued renewed licenses for 71 units and is currently reviewing applications for another 15 units. As of May 1, 2012, ten plants at nine sites had entered their 41st year of operation and thus are in their first period of extended operation (PEO). Five more plants will enter the PEO by the end of 2012. One foundation of the license renewal process has been license renewal guidance documents (LRGDs). The U.S. Nuclear Regulatory Commission (NRC) revised key guidance documents used for nuclear power LR in 2010 and 2011. These include NUREG-1800, 'Standard Review Plan for Review of License Renewal Applications,' revision 2 (SRP-LR), and NUREG-1801, 'Generic Aging Lessons Learned (GALL) Report,' revision 2 (GALL Report). The guidance documents were updated to reflect lessons learned and operating experience gained since the guidance documents were last issued in 2005. The reactor LRGDs referenced in this poster can all be accessed at http://www.nrc.gov/reactors/operating/licensing/renewal/guidance.html (author)
&D strategies. On the supply side, the existing literature has been focused on understanding how technology licensing can be used by firms as a mechanism to recover investments in innovative activities and to foster learning opportunities. On the demand side, it has been shown that licensing is an important...... source that firms can tap into to feed their internal needs for innovative knowledge. While several studies have examined technology licensing through the lens of the licensor, research on how firms rely on licensing contracts to acquire knowledge and improve their innovation performance still leaves......Licensing contracts represent one of the most widely used mechanisms to exchange technologies and transfer know-how between firms. Due to the opportunities that licensing creates for firms operating on both sides of the markets for technology, it has increasingly become an integral part of firms’ R...
Present Canadian regulations and anticipated changes to these regulations relevant to the utilization of tritium in fusion facilities and in commercial applications have been reviewed. It is concluded that there are no serious licensing obstacles, but there are a