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Sample records for nurse-managed poc inr

  1. Performance evaluation of the microINR® point-of-care INR-testing system.

    Science.gov (United States)

    Joubert, J; van Zyl, M C; Raubenheimer, J

    2018-04-01

    Point-of-care International Normalised Ratio (INR) testing is used frequently. We evaluated the microINR ® POC system for accuracy, precision and measurement repeatability, and investigated instrument and test chip variability and error rates. Venous blood INRs of 210 patients on warfarin were obtained with Thromborel ® S on the Sysmex CS-2100i ® analyser and compared with capillary blood microINR ® values. Precision was assessed using control materials. Measurement repeatability was calculated on 51 duplicate finger-prick INRs. Triplicate finger-prick INRs using three different instruments (30 patients) and three different test chip lots (29 patients) were used to evaluate instrument and test chip variability. Linear regression analysis of microINR ® and Sysmex CS2100i ® values showed a correlation coefficient of 0.96 (P < .0001) and a positive proportional bias of 4.4%. Dosage concordance was 93.8% and clinical agreement 95.7%. All acceptance criteria based on ISO standard 17593:2007 system accuracy requirements were met. Control material coefficients of variation (CV) varied from 6.2% to 16.7%. The capillary blood measurement repeatability CV was 7.5%. No significant instrument (P = .93) or test chip (P = .81) variability was found, and the error rate was low (2.8%). The microINR ® instrument is accurate and precise for monitoring warfarin therapy. © 2017 John Wiley & Sons Ltd.

  2. Identification of nursing management diagnoses.

    Science.gov (United States)

    Morrison, R S

    1997-02-01

    Theories from nursing and management provide frameworks for enhancing effectiveness of nursing management practice. The concept nursing management diagnosis has been developed by integrating nursing diagnosis and organizational diagnosis as a basis for nurse manager decision-making. Method triangulation was used to identify problems of managing nursing units, to validate those problems for relevancy to practice, to generate nursing management diagnoses, and to validate the diagnoses. Diagnoses were validated according to a definition of nursing management diagnosis provided. Of the 72 nursing management diagnoses identified, 66 were validated at a 70% level of agreement by nurse managers participating in the study.

  3. The reliability of point-of-care prothrombin time testing. A comparison of CoaguChek S and XS INR measurements with hospital laboratory monitoring.

    LENUS (Irish Health Repository)

    Ryan, F

    2010-02-01

    The development of point-of-care (POC) testing devices enables patients to test their own international normalized ratio (INR) at home. However, previous studies have shown that when compared with clinical laboratory values, statistically significant differences may occur between the two methods of INR measurement. The aim of this study was to evaluate the accuracy of the CoaguChek S and XS POC meters relative to clinical laboratory measurements. As part of a randomized, crossover patient self-testing (PST) study at Cork University Hospital, patients were randomized to 6 months PST or 6 months routine care by the anticoagulation management service. During the PST arm of the study, patients measured their INR at home using the CoaguChek S or XS POC meter. External quality control was performed at enrollment, 2 months and 4 months by comparing the POC measured INR with the laboratory determined value. One hundred and fifty-one patients provided 673 paired samples. Good correlation was shown between the two methods of determination (r = 0.91), however, statistically significant differences did occur. A Bland-Altman plot illustrated good agreement of INR values between 2.0 and 3.5 INR units but there was increasing disagreement as the INR rose above 3.5. Eighty-seven per cent of all dual measurements were within the recommended 0.5 INR units of each other. This study adds to the growing evidence that POC testing is a reliable and safe alternative to hospital laboratory monitoring but highlights the importance of external quality control when these devices are used for monitoring oral anticoagulation.

  4. Critical thinking in nurse managers.

    Science.gov (United States)

    Zori, Susan; Morrison, Barbara

    2009-01-01

    Formal education and support is needed for nurse managers to effectively function in their role in the current health care environment. Many nurse managers assume their positions based on expertise in a clinical role with little expertise in managerial and leadership skills. Operating as a manager and leader requires ongoing development of critical thinking skills and the inclination to use those skills. Critical thinking can have a powerful influence on the decision making and problem solving that nurse managers are faced with on a daily basis. The skills that typify critical thinking include analysis, evaluation, inference, and deductive and inductive reasoning. It is intuitive that nurse managers require both the skills and the dispositions of critical thinking to be successful in this pivotal role at a time of transformation in health care. Incorporating critical thinking into education and support programs for the nurse manager is necessary to position the nurse manager for success.

  5. Validation of nursing management diagnoses.

    Science.gov (United States)

    Morrison, R S

    1995-01-01

    Nursing management diagnosis based on nursing and management science, merges "nursing diagnosis" and "organizational diagnosis". Nursing management diagnosis is a judgment about nursing organizational problems. The diagnoses provide a basis for nurse manager interventions to achieve outcomes for which a nurse manager is accountable. A nursing organizational problem is a discrepancy between what should be happening and what is actually happening that prevents the goals of nursing from being accomplished. The purpose of this study was to validate 73 nursing management diagnoses identified previously in 1992: 71 of the 72 diagnoses were considered valid by at least 70% of 136 participants. Diagnoses considered to have high priority for future research and development were identified by summing the mean scores for perceived frequency of occurrence and level of disruption. Further development of nursing management diagnoses and testing of their effectiveness in enhancing decision making is recommended.

  6. Job Satisfaction of Nursing Managers

    OpenAIRE

    Petrosova, Liana; Pokhilenko, Irina

    2015-01-01

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

  7. Status of neutron complex of INR RAS

    Energy Technology Data Exchange (ETDEWEB)

    Grachev, M I; Koptelov, E A; Kravchuk, L V; Matveev, V A; Perekrestenko, A D; Sidorkin, S F [Institute for Nuclear Research of Russian Academy of Sciences, Prospekt, Moscow (Russian Federation); Stavissky, Y Y

    2001-03-01

    The neutron complex of INR RAS consists of two sources of neutrons, beam stop, lead slowing down spectrometer and solid state spectrometers. The description of objects and their condition, the program of planned researches, co-operation with other institutes of the Moscow Region, progress reached for last two years are introduced in the article. (author)

  8. Status of neutron complex of INR RAS

    International Nuclear Information System (INIS)

    Grachev, M.I.; Koptelov, E.A.; Kravchuk, L.V.; Matveev, V.A.; Perekrestenko, A.D.; Sidorkin, S.F.; Stavissky, Y.Y.

    2001-01-01

    The neutron complex of INR RAS consists of two sources of neutrons, beam stop, lead slowing down spectrometer and solid state spectrometers. The description of objects and their condition, the program of planned researches, co-operation with other institutes of the Moscow Region, progress reached for last two years are introduced in the article. (author)

  9. Nurse manager engagement: what it means to nurse managers and staff nurses.

    Science.gov (United States)

    Gray, Linda R; Shirey, Maria R

    2013-01-01

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

  10. Writing business communications. Are nurse managers prepared?

    Science.gov (United States)

    Spears, L A

    1997-12-01

    Based on interviews, this study indicates that writing business communications is a key task for nurse managers, affecting their professional success and power. However, most of the nurse managers interviewed felt they needed more education in business communications. Several ways of bringing this training to nursing students and practicing managers are suggested.

  11. Nurse managers' challenges in project management.

    Science.gov (United States)

    Suhonen, Marjo; Paasivaara, Leena

    2011-11-01

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

  12. Can job sharing work for nurse managers?

    Science.gov (United States)

    Dubourg, Laurence; Ahmling, Janette A; Bujas, Lenka

    2006-02-01

    Addressing employer reluctance to employ nurse managers in a job-sharing capacity, the aim of this paper is to explore job sharing among nurse managers. The literature highlighted potential fragmentation of leadership, breakdown of communication and higher costs as issues, with the retention of experienced highly motivated managers identified as an advantage. A staff survey explored whether the job-sharing arrangement trialled in a day surgery setting by two nurse managers was successful compared with similar roles held by full-time managers. This paper suggests that nurse managers can successfully job share. Overall, this paper recommends that employers consider a job-sharing arrangement when they wish to retain experienced nurse managers, and highlights aspects that can enhance a successful outcome.

  13. NCAR 2009+2010 and VII POC Weather Data

    Data.gov (United States)

    Department of Transportation — The first major set of trials conducted at the Michigan Test Bed was the Proof of Concept (POC) trials during 2008. The POC trials featured fifty-two RSEs within 45...

  14. Predictors of transformational leadership of nurse managers.

    Science.gov (United States)

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

    2017-04-01

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

  15. Succession planning for RNs: implementing a nurse management internship.

    Science.gov (United States)

    Wendler, M Cecilia; Olson-Sitki, Kristi; Prater, Marsha

    2009-01-01

    The nursing shortage affects all levels, including the pivotal role of nurse managers, who may find themselves functioning in a complex, stressful work environment. In this increasingly difficult milieu, succession planning for nurse manager turnover is imperative. The authors describe an evidence-based, theoretically driven nurse management internship that allows staff nurses to explore the nurse manager role.

  16. INR calibration of Owren-type prothrombin time based on the relationship between PT% and INR utilizing normal plasma samples.

    Science.gov (United States)

    Lindahl, Tomas L; Egberg, Nils; Hillarp, Andreas; Ødegaard, Ole R; Edlund, Bror; Svensson, Jan; Sandset, Per M; Rånby, Mats

    2004-06-01

    Prothrombin time (PT) is clinically important and is used to monitor oral anticoagulant therapy. To obtain PT results in international normalized ratio (INR), the current standardization procedure is complex and involves reference reagents. The PT of diluted plasma samples can be determined with a combined thromboplastin (the Owren-type procedure), but not necessarily with a plain thromboplastin (the Quick-type procedure). Owren-type PT procedures can therefore, as an alternative to the INR calibration, be calibrated with diluted normal plasma to give PT results in percent of normal PT activity (PT%). The present study explored if a plasma-based calibration of an Owren-type PT procedure can be used to obtain results in INR. The approach was to establish a relationship between PT% and INR by multi-center analysis of 365 samples from healthy individuals and patients on warfarin treatment. INR values were obtained by manual Quick-type reference procedure and PT% values by various automated Owren-type procedures. A relationship INR = (1/PT% + 0.018)/0.028 was found. A calibration procedure, based on the relationship, was investigated. Calibrators were the median PT of 21 normal plasma at dilutions representing 100%, 50%, 25%, 12.5% and 6.25% of normal PT activity. These were assigned INR values of 1.00, 1.36, 2.07, 3.05 and 6.36. Calibration of various Owren-type assays was repeatedly performed by 5 expert laboratories during 3 consecutive years. The INR values of certain lyophilised or frozen control plasmas were determined. The frozen control plasmas had externally assigned INR values according to WHO guide-lines. Within the laboratory, CV was typically below 3%. No appreciable difference among the results of the different laboratories or the three assay occasions was found. Externally assigned and INR values were essentially identical to those found. These and other results indicated that the calibration procedure was reproducible, precise and accurate. Thus, an

  17. Future preparation of occupational health nurse managers.

    Science.gov (United States)

    Scalzi, C C; Wilson, D L; Ebert, R

    1991-03-01

    This article presents the results of a national survey of job activities of corporate level occupational health nurse managers. The survey was designed to identify the relative amount of time spent and importance attributed to specific areas of their current job. In general this sample tended to have more management experience and educational preparation than previously cited studies: over 50% had completed a graduate degree. The scores for importance and time spent were highly correlated. That is, occupational health corporate nurse managers seemed to allocate their time to job responsibilities they considered most important. Management activities related to policy, practice standards, quality assurance, staff development, and systems for client care delivery appear to represent the core responsibilities of occupational health nursing management. Curriculum recommendations for management positions in occupational health include: health policy, program planning, and evaluation; business strategy; applications of management information systems; quality assurance; and marketing.

  18. Nurse managers' leadership styles in Finland.

    Science.gov (United States)

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

    2012-01-01

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

  19. Nurse Managers' Leadership Styles in Finland

    Science.gov (United States)

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

    2012-01-01

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

  20. LEPI - INR Pitesti. Achievements and prospects

    International Nuclear Information System (INIS)

    Gentea, Cristian; Parvan, Marcel; Tuturici, Ioan Liviu

    2002-01-01

    The Post-Irradiation Examination Laboratory, LEPI, of the Institute for Nuclear Research at Pitesti, Romania was designed and realized in the period 1977 - 1984. It is devoted to the nuclear activities of reception, manipulation, storing, processing, and examination of the radiation sources of high intensities, particularly irradiated nuclear materials and spent nuclear fuels. These materials result from the irradiation process taking place in the INR materials testing reactors and/or from the Cernavoda NPP. The examination implies nondestructive and destructive testing, followed by mechanical or chemical processing and allows physico-chemical and mechanical characterization, information needed to determine the behavior and operational performance in normal a hypothetically accidental operation conditions. The laboratory is provided with a set of hot chambers, transfer and examination cells suitable for working high activities, up to 1 MCi (37 PBq). The transfer cell is equipped with to working stations while the examinations cell has seven working stations. Each working station is equipped with a SOVIS window, a pair of HWM-A100 remote manipulators and several ducts for int/ext connections. The underpressurized inner air is filtered by a double battery of absolute serial filters with a 99.9% retaining efficiency for radioactive air sols with particles of sizes larger then 0.3 μm. The post irradiation examination comprises the following operations: transport; reception; visual inspection; dimensional control; high resolution gamma spectrometry; inflammable element marking; mounting and processing of the samples, mechanical testing to stretching; ceramographic and/or metallographic analysis by optical microscopy; radiochemical analysis, collecting, conditioning and intermediate storage of the process waste (residuals from spent fuel or irradiate materials); collecting, sorting and conditioning of the technological wastes (decontaminations materials, maintenance

  1. Nurse managers: the ties that bind.

    Science.gov (United States)

    Simons, Sherri Lee

    2003-01-01

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

  2. Nurse manager engagement: a concept analysis.

    Science.gov (United States)

    Gray, Linda R

    2012-01-01

    This concept analysis examines the visibility of nurse manager engagement in the healthcare work environment. The term employee engagement was derived from studies of morale or the willingness of a group to accomplish objectives in the 1920s. "Following World War II group morale scores were used as predictors of speed, quality, and militancy by US Army researchers. The goal was to identify star, or high performers. A term was needed to describe emotional attachment of an individual to the organization, fellow associates, and the job" ("Employee engagement origins," 2010, p. 1). The CINAHL, MEDLINE, ABI INFORM, PsycINFO, and Ovid databases and the Internet were searched for the period of 2005-2010 for literature published in English with a focus on peer-reviewed journals from disciplines of health sciences, health administration, business, and psychology. The Walker and Avant method was used for this analysis. The experience of the author as a current and previous nurse manager was also used for this analysis. Nurse manager engagement was assumed to be present based indirectly on empirical referents and consequences, such as low or high vacancy rates for staff nurses. Further research is needed to explore the identity of the nurse serving in the role of manager/leader who is able to demonstrate the skills and talents necessary to visibly demonstrate engagement and facilitate a culture of engaged nurse managers. © 2012 Wiley Periodicals, Inc.

  3. Mitigating the Impact of Nurse Manager Large Spans of Control.

    Science.gov (United States)

    Simpson, Brenda Baird; Dearmon, Valorie; Graves, Rebecca

    Nurse managers are instrumental in achievement of organizational and unit performance goals. Greater spans of control for managers are associated with decreased satisfaction and performance. An interprofessional team measured one organization's nurse manager span of control, providing administrative assistant support and transformational leadership development to nurse managers with the largest spans of control. Nurse manager satisfaction and transformational leadership competency significantly improved following the implementation of large span of control mitigation strategies.

  4. Nurse manager residency program: an innovative leadership succession plan.

    Science.gov (United States)

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

    2014-01-01

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

  5. Leadership styles, roles, and relationships for the nurse manager.

    Science.gov (United States)

    Musholt, K S

    1996-12-01

    This article explores the nurse manager's relationships to physicians, staff, administration, patient and family, other department heads, and peers. Included in the discussion are the expectations of the nurse manager by these other disciplines and examples of some of the situations discussed. Throughout the article are descriptions of leadership styles that are necessary for a nurse manager to accomplish his or her pivotal role.

  6. Using subcontractors: the experience of IRSN and INRS

    International Nuclear Information System (INIS)

    Jeffroy, Francois; Hery, Michel

    2014-01-01

    This article discusses the current status and assessment of risks and opportunities associated with subcontracting in nuclear installations as perceived and addressed by the IRSN (Institut de Radioprotection et de Surete Nucleaire) and the INRS (Institut National de Recherche et de Securite). A first part recalls how these issues have been addressed since the 1990's. The author notices that subcontracting is associated with different terminologies for the IRSN and the INRS. In the next part, the author discusses the debate about subcontracting. He outlines that the organisation of the client must be examined, notably with respect to safety, to the way ability and traceability of subcontractor activities are considered and addressed. He comments the relationships between the client and its subcontractors. He briefly comments how the IRSN and the INRS address differently these issues related to subcontracting

  7. Professional development needs of nurse managers.

    Science.gov (United States)

    Miltner, Rebecca S; Jukkala, Angela; Dawson, Martha A; Patrician, Patricia A

    2015-06-01

    Nurse managers have a key role in creating positive work environments where safe, high-quality care is consistently provided. This requires a broad range of skills to be successful within today's complex health care environment; however, managers are frequently selected based on their clinical expertise and are offered little formal preparation for this leadership role. We conducted three focus groups with 20 nurse managers to understand their professional development needs. Transcripts were analyzed using conventional content analysis. Three themes emerged: Managing Versus Leading, Gaining a Voice, and Garnering Support. Managers focused on daily tasks, such as matching staffing to patient needs. However, the data suggested gaps in foundational management skills, such as understanding organizational behavior, use of data to make decisions, and refined problem-solving skills. Professional development activities focusing on higher level leadership competencies could assist managers to be more successful in this challenging, but critical, role. Copyright 2015, SLACK Incorporated.

  8. Leadership styles of nurse managers in a multinational environment.

    Science.gov (United States)

    Suliman, Wafika A

    2009-01-01

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

  9. Nurse manager succession planning: a concept analysis.

    Science.gov (United States)

    Titzer, Jennifer L; Shirey, Maria R

    2013-01-01

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

  10. Implications of online learning for nurse managers.

    Science.gov (United States)

    McCarthy, Jillian

    2014-10-30

    Online learning for nurses is growing in popularity, with programmes ranging from mandatory update training to part-time master's degrees. E-learning, as it is known, offers flexibility in access to learning, study time and learning styles. In busy clinical areas, where guidance is provided on minimum nurse staffing levels, e-learning provides solutions for managers who wish to encourage professional development while maintaining adequate nursing cover. Caution must be taken, however, when choosing e-learning programmes, as quality and efficacy differ across the range. This article highlights the properties of good e-learning pedagogy to prepare nurse managers for successful assessment of these programmes.

  11. Use of electronic information systems in nursing management.

    Science.gov (United States)

    Lammintakanen, Johanna; Saranto, Kaija; Kivinen, Tuula

    2010-05-01

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

  12. Nurse manager job satisfaction and intent to leave

    Science.gov (United States)

    Warshawsky, Nora E.; Havens, Donna S.

    2015-01-01

    Background The nurse manager role is critical to staff nurse retention and often the portal to senior nursing leadership, yet little is known about nurse managers' job satisfaction and career plans. The purpose of this study was to describe nurse managers' job satisfaction and intent to leave. Methods An electronic survey was used to collect data from 291 nurse managers working in U.S. hospitals. Findings Seventy percent were satisfied or very satisfied with their jobs and 68% were either likely or very likely to recommend nursing management as a career choice. Seventy-two percent of these nurse managers were also planning to leave their positions in the next five years. The four most common reasons reported for intent to leave included burnout, career change, retirement, and promotion. Burnout was the most common reason cited by the entire sample but the fourth most common reason for leaving cited by those nurse managers who were planning to leave and also satisfied or very satisfied with their positions. Conclusions Recommendations for nursing leaders include evaluating the workload of nurse managers, providing career counseling, and developing succession plans. Additional research is needed to understand the determinants and consequences of nurse manager job satisfaction, intent to leave, and turnover. PMID:24689156

  13. Derived release limits for airborne effluents at TRIGA - INR Reactor

    International Nuclear Information System (INIS)

    Toma, A.; Dulama, C.; Hirica, O.; Mihai, S.; Oprea, I.

    2008-01-01

    Beginning from fulfilling the purposes of dose limitation system recommended by ICRP, and now accepted in radiation protection, this paper presents an environmental transfer model to calculate derived release limits for airborne and gaseous radioactive effluents at TRIGA-INR, 14 MW Steady State Reactor, in function on INR-Pitesti site. The methodology consists in determination of the principal exposure pathways for different groups of population and dose calculations for each radionuclide. The characterization of radionuclides transfer to environment was made using the compartmental model. The parameter transfer concept was used to describe the distribution of radionuclides between the different compartments. Atmospheric dispersion was very carefully treated, because it is the primary mechanism of the transfer of radionuclides in the environment and it determines all exposure pathways. Calculation of the atmospheric dispersion was made using ORION-II computer code based on the Gaussian plume model which takes account of site's specific climate and relief conditions. Default values recommended by literature were used to calculate some of the parameters when specific site values were not available. After identification of all transfer parameters which characterize the most important exposure pathways, the release rate corresponding to the individual dose rate limit was calculated. This maximum release rate is the derived release limit for each radionuclide and source. In the paper, the derived release limits are calculated for noble gases, radioiodine and other airborne particulate radionuclides, which can be released on the TRIGA-INR reactor stack, and are important to radiation protection. (authors)

  14. Human error theory: relevance to nurse management.

    Science.gov (United States)

    Armitage, Gerry

    2009-03-01

    Describe, discuss and critically appraise human error theory and consider its relevance for nurse managers. Healthcare errors are a persistent threat to patient safety. Effective risk management and clinical governance depends on understanding the nature of error. This paper draws upon a wide literature from published works, largely from the field of cognitive psychology and human factors. Although the content of this paper is pertinent to any healthcare professional; it is written primarily for nurse managers. Error is inevitable. Causation is often attributed to individuals, yet causation in complex environments such as healthcare is predominantly multi-factorial. Individual performance is affected by the tendency to develop prepacked solutions and attention deficits, which can in turn be related to local conditions and systems or latent failures. Blame is often inappropriate. Defences should be constructed in the light of these considerations and to promote error wisdom and organizational resilience. Managing and learning from error is seen as a priority in the British National Health Service (NHS), this can be better achieved with an understanding of the roots, nature and consequences of error. Such an understanding can provide a helpful framework for a range of risk management activities.

  15. Leadership styles of Finnish nurse managers and factors influencing it.

    Science.gov (United States)

    Vesterinen, Soili; Isola, Arja; Paasivaara, Leena

    2009-05-01

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

  16. Frontline nurse managers' confidence and self-efficacy.

    Science.gov (United States)

    Van Dyk, Jennifer; Siedlecki, Sandra L; Fitzpatrick, Joyce J

    2016-05-01

    This study was focused on determining relationships between confidence levels and self-efficacy among nurse managers. Frontline nurse managers have a pivotal role in delivering high-quality patient care while managing the associated costs and resources. The competency and skill of nurse managers affect every aspect of patient care and staff well-being as nurse managers are largely responsible for creating work environments in which clinical nurses are able to provide high-quality, patient-centred, holistic care. A descriptive, correlational survey design was used; 85 nurse managers participated. Years in a formal leadership role and confidence scores were found to be significant predictors of self-efficacy scores. Experience as a nurse manager is an important component of confidence and self-efficacy. There is a need to develop educational programmes for nurse managers to enhance their self-confidence and self-efficacy, and to maintain experienced nurse managers in the role. © 2016 John Wiley & Sons Ltd.

  17. The prothrombin time/international normalised ratio (PT/INR) line: derivation of local INR with commercial thromboplastins and coagulometers – two independent studies

    DEFF Research Database (Denmark)

    Poller, Leon; Ibrahim, S.; Keown, M.

    2011-01-01

    reagents, and from 7.0% to 2.6% with rabbit reagents. In the second study, deviation was reduced from 11.2% to 0.4% with human reagents by both local ISI calibration and the PT/INR Line. With rabbit reagents, 10.4% deviation was reduced to 1.1% with both procedures; 4.9% deviation was reduced to 0.5......Background: The WHO scheme for prothrombin time (PT) standardization has been limited in application, because of its difficulties in implementation, particularly the need for mandatory manual PT testing and for local provision of thromboplastin international reference preparations (IRP). Methods...... thromboplastins and coagulometers. INRs were compared with manual certified values with thromboplastin IRP from expert centres and in the second study also with INRs from local ISI calibrations. Results: In the first study with the PT/INR Line, 8.7% deviation from certified INRs was reduced to 1.1% with human...

  18. Vitamin K antagonist use: evidence of the difficulty of achieving and maintaining target INR range and subsequent consequences

    OpenAIRE

    Schein, Jeff R.; White, C. Michael; Nelson, Winnie W.; Kluger, Jeffrey; Mearns, Elizabeth S.; Coleman, Craig I.

    2016-01-01

    Vitamin K antagonists (VKAs) are effective oral anticoagulants that are titrated to a narrow therapeutic international normalized ratio (INR) range. We reviewed published literature assessing the impact of INR stability - getting into and staying in target INR range - on outcomes including thrombotic events, major bleeding, and treatment costs, as well as key factors that impact INR stability. A time in therapeutic range (TTR) of ?65?% is commonly accepted as the definition of INR stability. ...

  19. Patient-Specific Tailored Intervention Improves INR Time in Therapeutic Range and INR Variability in Heart Failure Patients.

    Science.gov (United States)

    Gotsman, Israel; Ezra, Orly; Hirsh Raccah, Bruria; Admon, Dan; Lotan, Chaim; Dekeyser Ganz, Freda

    2017-08-01

    Many patients with heart failure need anticoagulants, including warfarin. Good control is particularly challenging in heart failure patients, with range, thereby increasing the risk of complications. This study aimed to evaluate the effect of a patient-specific tailored intervention on anticoagulation control in patients with heart failure. Patients with heart failure taking warfarin therapy (n = 145) were randomized to either standard care or a 1-time intervention assessing potential risk factors for lability of INR, in which they received patient-specific instructions. Time in therapeutic range (TTR) using Rosendaal's linear model was assessed 3 months before and after the intervention. The patient-tailored intervention significantly increased anticoagulation control. The median TTR levels before intervention were suboptimal in the interventional and control groups (53% vs 45%, P = .14). After intervention the median TTR increased significantly in the interventional group compared with the control group (80% [interquartile range, 62%-93%] vs 44% [29%-61%], P <.0001). The intervention resulted in a significant improvement in the interventional group before versus after intervention (53% vs 80%, P <.0001) but not in the control group (45% vs 44%, P = .95). The percentage of patients with a TTR ≥60%, considered therapeutic, was substantially higher in the interventional group: 79% versus 25% (P <.0001). The INR variability (standard deviation of each patient's INR measurements) decreased significantly in the interventional group, from 0.53 to 0.32 (P <.0001) after intervention but not in the control group. Patient-specific tailored intervention significantly improves anticoagulation therapy in patients with heart failure. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Nurse manager succession planning: synthesis of the evidence.

    Science.gov (United States)

    Titzer, Jennifer; Phillips, Tracy; Tooley, Stephanie; Hall, Norma; Shirey, Maria

    2013-10-01

    The literature supporting nurse manager succession planning is reviewed and synthesised to discover best practice for identifying and developing future nurse managers. Healthcare succession planning practices are lacking. Nurse managers are historically selected based on clinical skills and lack formal leadership preparation. A systematic literature search appraises and summarises the current literature supporting nurse manager succession planning. Multiple reviewers were used to increase the reliability and validity of article selection and analysis. New nurse managers require months to adapt to their positions. Deliberate nurse manager succession planning should be integrated in the organisation's strategic plan and provide a proactive method for identifying and developing potential leaders. Organisations that identify and develop internal human capital can improve role transition, reduce nurse manager turnover rates and decrease replacement costs. Despite the clear benefits of succession planning, studies show that resource allocation for proactive, deliberate development of current and future nurse leaders is lacking. Additionally, systematic evaluation of succession planning is limited. Deliberate succession planning efforts and appropriate resource allocation require strategic planning and evaluation methods. Detailed evaluation methods demonstrating a positive return on investment utilising a cost-benefit analysis and empirical outcomes are necessary. © 2013 John Wiley & Sons Ltd.

  1. Nuclear fuel manufacturing. Current activities and prospects at INR Pitesti

    International Nuclear Information System (INIS)

    Horhoianu, Grigore

    2001-01-01

    Development of the CANDU nuclear fuel is currently conducted world wide onto two principal directions: - increasing the service span of the current type of fuel and improving the efficiency of burnup in reactor; - reducing the costs of fuel manufacturing by improving the design and manufacturing technologies in condition of increasing fuel performance. In parallel, a research program, RAAN, is undergoing, concerning the development of advanced CANDU type fuels (SEU, RU, DUPIC, Th), aiming at reducing the overall costs per fuel cycle. In the INR TRIGA reactor a large number of experimental fuel elements manufactured in INR were irradiated under different conditions specific to the CANDU reactor operation. Post irradiation investigations both destructive and non-destructive were carried out in the hot cells at INR Pitesti. The experimental results were used in order to optimize and evaluate the fuel project, to check the fuel manufacturing technologies as well as to certify the computational codes. The local thermo-mechanical analyses by final element methods, modelling the SCC phenomenon, probabilistic evaluation of performance parameters of the fuel, constitute new directions in the modelling and developing computational code. The developed codes were submitted to a thorough validation process to comply with the quality assurance. The excellent results obtained in INR were confirmed by participation in the FUMEX International Exercises of computer code intercomparison, organized by IAEA Vienna. Progress was also recorded in establishing the behaviour of fuel elements failed during reactor operation and the effect their maintenance in the reactor core could have upon the power reactor operation. A system-expert variant was worked out able for a short term analysis of the decisions referring to removing the failing element at Cernavoda NPP. As advanced CANDU fuel is concerned, until now preliminary variants for a fuel bundle with 43 elements containing slightly

  2. The Automatic Radiation Control System Of The Inr Linear Accelerator (troitsk).

    CERN Document Server

    Grachev, M I; Kuptsov, S I; Peleshko, V N; Shishkin, K I; Shmelev, M O; Skorkin, V M

    2004-01-01

    The radiation monitor system (RMS) at accelerator INR is a part of radiation safety system of experimental complex INR. RMS is intended for continuous monitoring of radiation field behind biological protection of linear accelerator INR with the personnel dose control and alarm purposes. Three-level system RMS consists of the operator computer, microprocessor data acquisition modules and networks of UDBN-02R neutron detectors and BDRC-01P photon detectors, located inside and behind biological protection of the accelerator (fig. 1).

  3. Challenges for nurse managers in China.

    Science.gov (United States)

    Wong, Frances Kam Yuet

    2010-07-01

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

  4. Leadership styles in nursing management: preferred and perceived.

    Science.gov (United States)

    Sellgren, Stina; Ekvall, Göran; Tomson, Göran

    2006-07-01

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

  5. Nurse managers and budgeting: professional/bureaucratic conflict?

    Science.gov (United States)

    Abernethy, M A; Stoelwinder, J U

    1988-01-01

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

  6. Break-even analysis in a nurse-managed center.

    Science.gov (United States)

    McBryde-Foster, Merry J

    2005-01-01

    The concept of break-even analysis as a financial assessment tool is defined and demonstrated in evaluation of a proposed nurse-managed center. The advantages of using break-even analysis during proposal development are explored.

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

    African Journals Online (AJOL)

    Retaining professional nurses in South Africa: Nurse managers' perspectives. ... This implies that creating a favourable environment in the workplace situation ... Unsafe working environments and a lack of resources threaten the safety and ...

  8. Management and leadership: analysis of nurse manager's knowledge.

    Science.gov (United States)

    Lourenço, Maria Regina; Shinyashiki, Gilberto Tadeu; Trevizan, Maria Auxiliadora

    2005-01-01

    Nurses have assumed management positions in many health institutions. To properly accomplish the demands of this role, it is important that they be competent in both management and leadership. For appropriate performance, knowledge of management and supervision styles is a priority. Therefore, the goal of this investigation is to identify the nurse manager's knowledge regarding management and leadership. A structured questionnaire containing twenty-seven questions was applied to twelve Brazilian nurse managers of primary care center called "Family Basic Health Units". Data analysis suggested that the nurse manager lower knowledge in management and leadership is related to visionary leadership, management and leadership conceptual differences, leader's behavior, and situational leadership. And, nurse manager greater knowledge is related to power; team work, and coherence between values and attitudes.

  9. Implementing a Nurse Manager Profile to Improve Unit Performance.

    Science.gov (United States)

    Krugman, Mary E; Sanders, Carolyn L

    2016-06-01

    Nurse managers face significant pressures in the rapidly changing healthcare environment. Staying current with multiple sources of data, including reports that detail institutional and unit performance outcomes, is particularly challenging. A Nurse Manager Customized Profile was developed at a western academic hospital to provide a 1-page visual of pertinent data to help managers and director supervisors focus coaching to improve unit performance. Use of the Decisional Involvement Scale provided new insights into measuring manager performance.

  10. Eleven years of net network research activity - inr contributions

    International Nuclear Information System (INIS)

    Deaconu, V.; Ionita, I.; Meleg, T.; Deaconu, M.; Truta, C.; Oncioiu, G.

    2013-01-01

    The European Network on Neutron Techniques Standardization for Structural Integrity (NeT) was established in 2002, grouping institutions from industry, research and academic media. Coordinated by the European Commission.s Joint Research Centre, the main mission of this network is to develop experimental and numerical techniques and standards for the reliable characterisation of residual stresses in structural welds. Each problem is tackled by creating a dedicated Task Group which manages measurement and modelling round robin studies and undertakes a thorough analysis and interpretation of the results. Over forty institutions are active NeT partners, their specific involvement and contributions being summarised in this paper. The Institute for Nuclear Research Pitesti (INR) is one of NeT founders and its contribution is related to numerical modelling, specimen analysis, material characterisation, data analysis or SANS support. This is also emphasised throughout this paper, together with the specific NeT research topics presentation. (authors)

  11. Negative workplace behaviours: an ethical dilemma for nurse managers.

    Science.gov (United States)

    Lindy, Cheryl; Schaefer, Florence

    2010-04-01

    To discover nurse managers' perception of negative workplace behaviours (bullying) encountered by staff on their unit. Background Negative workplace behaviour is a worldwide phenomenon happening in all types of work settings. Absent from the literature were studies specific to the nurse managers' perception on this topic. A phenomenological qualitative research methodology was used to gain insight into the perceptions of nurse managers about negative workplace behaviours that they have observed or addressed. Nurse Managers described their perceptions of, and experiences pertaining to, instances of negative workplace behaviour. Six themes emerged from the data analysis: 'that's just how she is', 'they just take it', 'a lot of things going on', 'old baggage', 'three sides to a story' and 'a management perspective'. Nurse Managers had observed, experienced and/or had received reports of negative workplace behaviours. While some felt comfortable addressing the behaviour, others experienced ethical dilemmas when trying to treat all fairly. The results of the present study provide guidance for nurse managers to address negative workplace behaviours occurring on their units.

  12. Development and Testing of the Nurse Manager EBP Competency Scale.

    Science.gov (United States)

    Shuman, Clayton J; Ploutz-Snyder, Robert J; Titler, Marita G

    2018-02-01

    The purpose of this study was to develop and evaluate the validity and reliability of an instrument to measure nurse manager competencies regarding evidence-based practice (EBP). The Nurse Manager EBP Competency Scale consists of 16 items for respondents to indicate their perceived level of competency on a 0 to 3 Likert-type scale. Content validity was demonstrated through expert panel review and pilot testing. Principal axis factoring and Cronbach's alpha evaluated construct validity and internal consistency reliability, respectively. Eighty-three nurse managers completed the scale. Exploratory factor analysis resulted in a 16-item scale with two subscales, EBP Knowledge ( n = 6 items, α = .90) and EBP Activity ( n = 10 items, α = .94). Cronbach's alpha for the entire scale was .95. The Nurse Manager EBP Competency Scale is a brief measure of nurse manager EBP competency with evidence of validity and reliability. The scale can enhance our understanding in future studies regarding how nurse manager EBP competency affects implementation.

  13. Nurse manager succession planning: A cost-benefit analysis.

    Science.gov (United States)

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

    2018-03-01

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

  14. Waste processing practices at waste management department from INR

    International Nuclear Information System (INIS)

    Bujoreanu, D.; Bujoreanu, L.

    2010-01-01

    The Institute for Nuclear Research Pitesti (INR), subsidiary of the Romanian Authority for Nuclear Activities has its own Radioactive Waste Treatment Plant (STDR). The object of activity of STDR within the INR Pitesti is to treat and condition radioactive waste resulted from the nuclear facility. Also, it will must prepare and manage the decommissioning projects of its own facilities and to upgrade the facilities for the management of the radioactive waste resulting from other decommissioning activities. In according with the National Nuclear Program and the Governmental order no. 11/2003, the Institute for Nuclear Research is the main support for implementation of the methods and technologies for conditioning and disposal of radioactive waste generated by the decommissioning of nuclear facilities. The classes and criteria of classification for radioactive waste generated in operation and decommissioning in Romania are established in compliance with the classification recommended by IAEA and generally valid in EU countries. The general classification takes into consideration the disposal requirements to isolate the radioactive waste from environment. In Romania, waste minimization is considered by Order No. 56/2004 of CNCAN President for approval of Fundamental regulations on the safe management of radioactive waste. According to this regulation, the generation of radioactive waste is to be kept to the minimum practicable level in terms of both its activity and volume through appropriate design measures, facility operation and decommissioning practices. In order to meet this requirement, the operator must ensure: - selection and control of materials; - recycling and reuse of materials, including clearance of materials; - implementing adequate operating procedures, including those referring to the physical, chemical and radiological characterization of the waste and sorting of different type of materials. (orig.)

  15. The nature of leadership style in nursing management.

    Science.gov (United States)

    Azaare, John; Gross, Janet

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

  16. Factors relating to professional self-concept among nurse managers.

    Science.gov (United States)

    Kantek, Filiz; Şimşek, Belkıs

    2017-12-01

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

  17. Strategic management of health care information systems: nurse managers' perceptions.

    Science.gov (United States)

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

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mara Solange Gomes Dellaroza

    2015-03-01

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

  19. The nurse manager's role in creating a healthy work environment.

    Science.gov (United States)

    Whiley, K

    2001-08-01

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

  20. Emotional intelligence (EI) and nursing leadership styles among nurse managers.

    Science.gov (United States)

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

    2015-01-01

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

  1. [Nursing management of a refractory cardiac death donor].

    Science.gov (United States)

    Kaufmann, Marion

    2016-09-01

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

  2. Generational diversity: what nurse managers need to know.

    Science.gov (United States)

    Hendricks, Joyce M; Cope, Vicki C

    2013-03-01

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

  3. Relationship between assertiveness and burnout among nurse managers.

    Science.gov (United States)

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

    2009-12-01

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

  4. Ethical issues in patient safety: Implications for nursing management.

    Science.gov (United States)

    Kangasniemi, Mari; Vaismoradi, Mojtaba; Jasper, Melanie; Turunen, Hannele

    2013-12-01

    The purpose of this article is to discuss the ethical issues impacting the phenomenon of patient safety and to present implications for nursing management. Previous knowledge of this perspective is fragmented. In this discussion, the main drivers are identified and formulated in 'the ethical imperative' of patient safety. Underlying values and principles are considered, with the aim of increasing their visibility for nurse managers' decision-making. The contradictory nature of individual and utilitarian safety is identified as a challenge in nurse management practice, together with the context of shared responsibility and identification of future challenges. As a conclusion, nurse managers play a strategic role in patient safety. Their role is to incorporate ethical values of patient safety into decision-making at all levels in an organization, and also to encourage clinical nurses to consider values in the provision of care to patients. Patient safety that is sensitive to ethics provides sustainable practice where the humanity and dignity of all stakeholders are respected.

  5. The Experience of Intense Pain: Nursing Management and Interventions.

    Science.gov (United States)

    Kiser-Larson, Norma

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

  6. INR Recent Contributions to Thorium-Based Fuel Using in CANDU Reactors

    International Nuclear Information System (INIS)

    Prodea, I.; Mărgeanu, C. A.; Rizoiu, A.; Olteanu, G.

    2014-01-01

    The paper summarizes INR Pitesti contributions and latest developments to the Thorium-based fuel (TF) using in present CANDU nuclear reactors. Earlier studies performed in INR Pitesti revealed the CANDU design potential to use Recovered Uranium (RU) and Slightly Enriched Uranium (SEU) as alternative fuels in PHWRs. In this paper, we performed both lattice and CANDU core calculations using TF, revealing the main neutron physics parameters of interest: k-infinity, coolant void reactivity (CVR), channel and bundle power distributions over a CANDU 6 reactor core similar to that of Cernavoda, Unit 1. We modelled the so called Once Through Thorium (OTT) fuel cycle, using the 3D finite-differences DIREN code, developed in INR. The INR flexible SEU-43 bundle design was the candidate for TF carrying. Preliminary analysis regarding TF burning in CANDU reactors has been performed using the finite differences 3D code DIREN. TFs showed safety features improvement regarding lower CVRs in the case of fresh fuel use. Improvements added to the INR ELESIMTORIU- 1 computer code give the possibility to fairly simulate irradiation experiments in INR TRIGA research reactor. Efforts are still needed in order to get better accuracy and agreement of simulations to the experimental results. (author)

  7. Implication of POC/234Th ratios in oceanic particulate matter. An approach to particle aggregation

    International Nuclear Information System (INIS)

    Hirose, Katumi

    2003-01-01

    234 Th has been widely applied as a tracer of particulate organic carbon (POC) fluxes in the upper ocean. Fundamental to this approach is the determination of 234 Th fluxes from water column measurements of the 234 Th- 238 U disequilibria, and the conversion of 234 Th flux to POC export, using the measured POC/ 234 Th ratio on particles. As such, POC/ 234 Th ratios are one of the most critical factors in quantifying the carbon export flux in ocean interior when using this approach. However, the POC/ 234 Th ratios show significant temporal and spatial variations, but cannot be predicted at this time. therefore, it is important to elucidate factors controlling the variations of the POC/ 234 Th ratios. To achieve this purpose, we should understand the chemical interactions between POC and 234 Th. In the open ocean, POC/ 234 Th ratios have been determined together with other oceanographic parameters. We examined here the relationship between POC/ 234 Th and primary production. The POC/ 234 Th ratios were linearly related to logarithmic values of primary production. Taken into account the complexation between surface ligand on particulate organic matter (POM) and 234 Th, a complexation model suggests that the size of particles adsorbing 234 Th is related to primary production; in the equatorial Pacific, the size of particles adsorbing 234 Th apparently decreases with increasing primary production, whereas opposite phenomenon occurs in the North Atlantic. Since the POC/ 234 Th ratios were determined in filtered particulate matter, this finding suggests that aggregation of small particles would be dominant in the equatorial Pacific, which can be explained by a chemical aggregation model. (author)

  8. Nurse manager cognitive decision-making amidst stress and work complexity.

    Science.gov (United States)

    Shirey, Maria R; Ebright, Patricia R; McDaniel, Anna M

    2013-01-01

      The present study provides insight into nurse manager cognitive decision-making amidst stress and work complexity.   Little is known about nurse manager decision-making amidst stress and work complexity. Because nurse manager decisions have the potential to impact patient care quality and safety, understanding their decision-making processes is useful for designing supportive interventions.   This qualitative descriptive study interviewed 21 nurse managers from three hospitals to answer the research question: What decision-making processes do nurse managers utilize to address stressful situations in their nurse manager role? Face-to-face interviews incorporating components of the Critical Decision Method illuminated expert-novice practice differences. Content analysis identified one major theme and three sub-themes.   The present study produced a cognitive model that guides nurse manager decision-making related to stressful situations. Experience in the role, organizational context and situation factors influenced nurse manager cognitive decision-making processes.   Study findings suggest that chronic exposure to stress and work complexity negatively affects nurse manager health and their decision-making processes potentially threatening individual, patient and organizational outcomes.   Cognitive decision-making varies based on nurse manager experience and these differences have coaching and mentoring implications. This present study contributes a current understanding of nurse manager decision-making amidst stress and work complexity. © 2012 Blackwell Publishing Ltd.

  9. The impact of nurse managers' leadership styles on ward staff.

    Science.gov (United States)

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

    2018-02-22

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

  10. Bring Your Own Device and Nurse Managers' Decision Making.

    Science.gov (United States)

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

    2017-02-01

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

  11. A nurse manager succession planning model with associated empirical outcomes.

    Science.gov (United States)

    Titzer, Jennifer L; Shirey, Maria R; Hauck, Sheila

    2014-01-01

    Perceptions of leadership and management competency after a formal nurse manager succession planning program were evaluated. A lack of strategic workforce planning and development of a leadership pipeline contributes to a predicted nurse manager shortage. To meet the anticipated needs for future leadership, evidence-based action is critical. A quasi-experimental mixed-methods, 1-group pretest/posttest research design was used. Nurses working in an acute care hospital were recruited for the study and selected using an objective evaluative process. Participant perceptions regarding their leadership and management competencies significantly increased after the leadership program. Program evaluations confirmed that participants found the program beneficial. One year after program completion, 100% of the program participants have been retained at the organization and 73% had transitioned to leadership roles. Succession planning and leadership development serve as beneficial and strategic mechanisms for identifying and developing high-potential individuals for leadership positions, contributing toward the future nursing leadership pipeline.

  12. Characteristics that perinatal nurse managers desire in new nurse hires.

    Science.gov (United States)

    Falls, Emily; Hensel, Desiree

    2012-04-01

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

  13. Multispectral remote-sensing algorithms for particulate organic carbon (POC): The Gulf of Mexico

    OpenAIRE

    Son, Young Baek; Gardner, Wilford D.; Mishonov, Alexey V.; Richardson, Mary Jo

    2009-01-01

    To greatly increase the spatial and temporal resolution for studying carbon dynamics in the marine environment, we have developed remote-sensing algorithms for particulate organic carbon (POC) by matching in situ POC measurements in the Gulf of Mexico with matching SeaWiFS remote-sensing reflectance. Data on total particulate matter (PM) as well as POC collected during nine cruises in spring, summer and early winter from 1997-2000 as part of the Northeastern Gulf of Mexico (NEGOM) study were ...

  14. INR targets and site-level anticoagulation control: results from the Veterans AffaiRs Study to Improve Anticoagulation (VARIA).

    Science.gov (United States)

    Rose, A J; Berlowitz, D R; Miller, D R; Hylek, E M; Ozonoff, A; Zhao, S; Reisman, J I; Ash, A S

    2012-04-01

    Not all clinicians target the same International Normalized Ratio (INR) for patients with a guideline-recommended target range of 2-3. A patient's mean INR value suggests the INR that was actually targeted. We hypothesized that sites would vary by mean INR, and that sites of care with mean values nearest to 2.5 would achieve better anticoagulation control, as measured by per cent time in therapeutic range (TTR). To examine variations among sites in mean INR and the relationship with anticoagulation control in an integrated system of care. We studied 103,897 patients receiving oral anticoagulation with an expected INR target between 2 and 3 at 100 Veterans Health Administration (VA) sites from 1 October 2006 to 30 September 2008. Key site-level variables were: proportion near 2.5 (that is, percentage of patients with mean INR between 2.3 and 2.7) and mean risk-adjusted TTR. Site mean INR ranged from 2.22 to 2.89; proportion near 2.5, from 30 to 64%. Sites' proportions of patients near 2.5, below 2.3 and above 2.7 were consistent from year to year. A 10 percentage point increase in the proportion near 2.5 predicted a 3.8 percentage point increase in risk-adjusted TTR (P < 0.001). Proportion of patients with mean INR near 2.5 is a site-level 'signature' of care and an implicit measure of targeted INR. This proportion varies by site and is strongly associated with site-level TTR. Our study suggests that sites wishing to improve TTR, and thereby improve patient outcomes, should avoid the explicit or implicit pursuit of non-standard INR targets. © 2012 International Society on Thrombosis and Haemostasis.

  15. The Influence of Nurse Manager Leadership Style on Staff Nurse Work Engagement.

    Science.gov (United States)

    Manning, Jennifer

    2016-09-01

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

  16. Vitamin K antagonist use: evidence of the difficulty of achieving and maintaining target INR range and subsequent consequences.

    Science.gov (United States)

    Schein, Jeff R; White, C Michael; Nelson, Winnie W; Kluger, Jeffrey; Mearns, Elizabeth S; Coleman, Craig I

    2016-01-01

    Vitamin K antagonists (VKAs) are effective oral anticoagulants that are titrated to a narrow therapeutic international normalized ratio (INR) range. We reviewed published literature assessing the impact of INR stability - getting into and staying in target INR range - on outcomes including thrombotic events, major bleeding, and treatment costs, as well as key factors that impact INR stability. A time in therapeutic range (TTR) of ≥65 % is commonly accepted as the definition of INR stability. In the real-world setting, this is seldom achieved with standard-of-care management, thus increasing the patients' risks of thrombotic or major bleeding events. There are many factors associated with poor INR control. Being treated in community settings, newly initiated on a VKA, younger in age, or nonadherent to therapy, as well as having polymorphisms of CYP2C9 or VKORC1, or multiple physical or mental co-morbid disease states have been associated with lower TTR. Clinical prediction tools are available, though they can only explain <10 % of the variance behind poor INR control. Clinicians caring for patients who require anticoagulation are encouraged to intensify diligence in INR management when using VKAs and to consider appropriate use of newer anticoagulants as a therapeutic option.

  17. Health Professionals Facing Burnout: What Do We Know about Nursing Managers?

    OpenAIRE

    Heeb, Jean-Luc; Haberey-Knuessi, Véronique

    2014-01-01

    Objective. To address the degree of burnout in nursing managers in hospitals of Western Switzerland, including comparison with medical managers, and its relationship with personal, work-related, and organizational characteristics. Methods. Statistical analysis of the scores of the Maslach Burnout Inventory-Human Services Survey from 257 nursing managers who answered a standardized electronic questionnaire. Results. Nursing managers showed a low degree of burnout, which was similar to that of ...

  18. Critical thinking of nurse managers related to staff RNs' perceptions of the practice environment.

    Science.gov (United States)

    Zori, Susan; Nosek, Laura J; Musil, Carol M

    2010-09-01

    BACKGROUND INFORMATION AND SIGNIFICANCE: Critical thinking (CT) skills and the inclination to engage in critical thinking are essential for nurse managers to function as transformational leaders capable of influencing staff to align with organizational goals. In an extensive literature review, numerous studies were found examining the concept of CT in students and no studies were found exploring CT in nurse managers. Identifying the attributes, such as CT, that lead to success in the nurse manager role is useful when preparing nurse managers to lead effectively in the current healthcare climate. Is there a difference between nurse managers' CT dispositions and their respective staff nurses' perceptions of the practice environment? A convenience sample of 12 nurse managers and a random sample of 132 of their respective staff registered nurses (RNs) participated in this descriptive study. CT in nurse managers was measured by the California Critical Thinking Disposition Inventory (CCTDI). Staff RNs' perceptions of the practice environment were measured by the Practice Environment Scale (PES). The research question was answered using a t test. Significant (p thinking confidence, and significant differences (p thinking dispositions of nurse managers and their respective staff RNs' perceptions of the practice environment. Nurse managers with stronger CT dispositions may be better able to create positive practice environments that are conducive to job satisfaction and thus the retention of staff RNs. Inclusion of strategies to support the development and use of CT in nurse managers is recommended. CT and other leadership attributes and skills including emotional and social intelligence and management of change through an appreciative inquiry process may provide opportunities to improve leadership effectiveness in nurse managers. Enhancing critical thinking skills and dispositions of nurse managers may help to create positive work environments for staff RNs. Staff RNs who

  19. The state of the art of the tacit knowledge transfer and preservation in INR

    International Nuclear Information System (INIS)

    Balaceanu, V.; Constantin, M.; Apostol, M.

    2008-01-01

    This paper intends to highlight the stringency that the nuclear knowledge, mainly the tacit one, must be transferred and preserved and, also, the appropriate methods and tools to perform it should be identified, selected and developed. The paper shows a detailed analysis of the state of the nuclear knowledge in INR. The starting point in this work were two investigations: a questionnaire-based investigation regarding the motivations of the INR retiring experts for knowledge transfer and preservation and an IAEA general questionnaire applied in INR. The necessity of a such analysis is motivated by the fact that in the next 5-10 years many experienced researchers should be retired and the INR staff must very quickly find the best methods and tools for an optimal transfer and preservation of the knowledge, mainly the tacit one because this is embedded in experts' minds. One of the most important conclusion of this analysis is that a short-medium term strategy must be developed, regarding the knowledge management. (authors)

  20. Participation of INR to the research project initiated by the CANDU Owners Group - Canada

    International Nuclear Information System (INIS)

    Roth, Maria; Ciocanescu, Marin; Gheorghiu, C-tin; Ohai, Dumitru; Visinescu, Doru; Ionescu, Silviu; Man, Ion; Pitigoi, Vasile; Anghel, Dumitru; Uta, Octavian

    2004-01-01

    Having in view the participation of the INR's Nuclear Materials and Corrosion Departments together with Chalk River Laboratories, AECL, and other nine well known institutes, to the Research Project coordinated by the International Atomic Energy Agency - Vienna and the results obtained as well, the CANDU Owners Group (COG) - Canada has proposed an economical contract to INR - Pitesti, called the DHC Project. The goal of this project was the investigation of the slow cracking in the hydration state (Delayed Hydride Cracking phenomenon) of the pressure tubes in CANDU reactors. There were determined, in specific conditions, the DHC rate, V DHC , and threshold factor of triggering the phenomenon K HI (the factor of stress intensity in the crack) occurring in un-irradiated Zr-2.5%Nb alloy. Further extensions of the project to irradiated alloys of the pressure tubes used in CANDU reactors, provided by the Canadian partner, are planned. This paper gives an overview covering the contributions of the INR's departments to the contract provisions for the current year as concluded with COG - Canada. It is described the design and execution activity of a device for processing the samples subject to testing, the mounting of the measuring chain, developing of a system for monitoring the testing parameters, the acquisition and automated processing of experimental data up to constituting the final report. The testing report was appreciated by the COG and recognized as demonstrating the INR's capability to fulfil the tasks of the DHC Project and so opened the way to further cooperation

  1. INR TRIGA Research Reactors: A Neutron Source for Radioisotopes and Materials Investigation

    International Nuclear Information System (INIS)

    Barbos, D.; Ciocanescu, M.; Paunoiu, C.; Bucsa, A.F.

    2013-01-01

    At the INR there are 2 high intensity neutron sources. These sources are in fact the two nuclear TRIGA reactors: TRIGA SSR 14 MW and TRIGA ACPR. TRIGA stationary reactor is provided with several in-core irradiation channels. Other several out-of-core irradiation channels are located in the vertical channels in the beryllium reflector blocks. The maximum value of the thermal neutron flux (E 14 cm -2 s -1 and of fast neutron flux (E>1 MeV) is 6.89×10 13 cm -2 s -1 . For neutron activation analysis both reactors are used and k0-NAA method has been implemented. At INR Pitesti a prompt gamma ray neutron activation analysis devices has been designed, manufactured ant put into operation. For nuclear materials properties investigation neutron radiography methods was developed in INR. For these purposes two neutron radiography devices were manufacture, one of them underwater and other one dry. The neutron beams are used for investigation of materials properties and components produced or under development for applications in the energy sector (fission and fusion). At TRIGA 14 MW reactor a neutron difractormeter and a SANS devices are available for material residual stress and texture measurements. TRIGA 14 MW reactor is used for medical and industrial radioisotopes production ( 131 I, 125 I, 192 Ir, etc) and a method for 99 Mo- 99 Tc production from fission is under developing. At INR Pitesti several special programmes for new types of nuclear fuel behavior characterization are under development. (author)

  2. Quality assurance feedback as a nursing management strategy.

    Science.gov (United States)

    Brannon, D; Bucher, J A

    1989-01-01

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

  3. The effect of nurse manager turnover on patient fall and pressure ulcer rates.

    Science.gov (United States)

    Warshawsky, Nora; Rayens, Mary Kay; Stefaniak, Karen; Rahman, Rana

    2013-07-01

    The purpose of this study was to explore the effects of nurse manager turnover on the occurrence of adverse events. Nurse managers create professional nurse practice environments to support the provision of quality patient outcomes. Inconsistent findings were reported in the literature testing the relationship between nurse managers and patient outcomes. All prior studies assumed stable nursing management. A longitudinal quasi-experimental study of 23 nursing units in two hospitals was used to determine whether unit characteristics, including nurse manager turnover, have an effect on patient falls or pressure ulcers. Statistical analyses included repeated measures and hierarchical modelling. Patients in medical/surgical units experienced more falls than in intensive care units (F1,11 = 15.9, P = 0.002). Patients in units with a nurse manager turnover [odds ratio: 3.16; 95% confidence interval: 1.49-6.70] and intensive care units (odds ratio: 2.70; 95% confidence interval: 1.33-5.49) were more likely to develop pressure ulcers. Nurse manager turnover and intensive care unit status were associated with more pressure ulcers. Medical/surgical unit status was associated with more falls. The study was limited by a small sample size. Nurse manager turnover may negatively impact patient outcomes. Stable nursing management, strategic interim management and long-term succession planning may reduce adverse patient events. © 2013 John Wiley & Sons Ltd.

  4. [Effectiveness of managing styles of nursing management staff].

    Science.gov (United States)

    Stychno, Ewa

    2002-01-01

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

  5. Apprehensions of nurse managers on evidence-based practice

    Directory of Open Access Journals (Sweden)

    Fernanda Carolina Camargo

    2017-12-01

    Full Text Available Abstract Objective: To analyze the apprehensions of nurse managers in the implementation of the Evidence Based Practice in a Teaching Hospital of Triângulo Mineiro. Method: Qualitative research guided by the Theory of the Diffusion of Innovations. Five workshops were conducted per focal group (n = 18 participants, conducted by hermeneutic-dialectic interactions between August and September/2016. Textual records resulting from each workshop were analyzed by semantic categories. Results: Aspects conditioning to the implementation of the Evidence Based Practice permeate from elements related to the fragmentation of the care network to the necessary expansion of the governability of the nurse managers to put changes into practice in their sectors. Most importantly, timely access to the results of research conducted at the teaching hospital was mentioned as crucial to guide better practices. Final considerations: The approach allowed the recognition of contextual conditions for the implementation of the Evidence-Based Practice, which may coincide with similar scenarios, as well as increase the national scientific production on the subject, which is still scarce.

  6. Prospective Analysis of Nursing Management from the Students Voices

    Directory of Open Access Journals (Sweden)

    Rafael Alejandro Camejo Giménez

    2017-08-01

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

  7. Oxadiazole-carbazole polymer (POC)-Ir(ppy)3 tunable emitting composites

    Science.gov (United States)

    Bruno, Annalisa; Borriello, Carmela; Di Luccio, Tiziana; Sessa, Lucia; Concilio, Simona; Haque, Saif A.; Minarini, Carla

    2017-04-01

    POC polymer is an oxadiazole-carbazole copolymer we have previously synthetized and established as light emitting material in Organic Light Emitting Devices (OLEDs), although POC quantum yield emission efficiency and color purity still need to be enhanced. On the other hand, tris[2-phenylpyridinato-C2,N]iridium(III) (Ir(ppy)3) complexes, namely Ir(ppy)3 are among the brightest luminophores employed in green light emitting devices. Our aim, in this work, is to take advantage of Ir(ppy)3 bright emission by combining the Ir complex with blue emitting POC to obtain tunable light emitting composites over a wide range of the visible spectrum. Here we have investigated the optical proprieties POC based nanocomposites with different concentrations of Ir(ppy)3, ranging from 1 to 10 wt%. Both spectral and time resolved fluorescence measurements show an efficient energy transfer from the polymer to the dopants, resulting in white-emitting composites. The most intense and stable emission has been found when POC was doped with about 5 wt% concentration of Ir(ppy)3.

  8. Caring behaviour perceptions from nurses of their first-line nurse managers.

    Science.gov (United States)

    Peng, Xiao; Liu, Yilan; Zeng, Qingsong

    2015-12-01

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

  9. The provision and utilisation of casemix and demographic data by nursing managers in seven hospitals.

    Science.gov (United States)

    Blay, Nicole; Donoghue, Judith

    2003-01-01

    The role of the nursing manager has evolved from clinician and bed manager to one with greater accountability for evidence based practice, benchmarking and more recently, budget liability. Casemix data are widely believed to be a means of providing essential information for effective decision making and financial management but have not been widely utilised by nursing managers (Diers & Bozzo, 1999). This paper will report the results of a survey of nursing managers in seven hospitals within a metropolitan area health service. The hospitals include tertiary referral hospitals, specialist public hospitals and an affiliated public hospital for aged care and rehabilitation services. The survey sought to establish what casemix and related data were provided to nurse managers, who provided these data and how supplied data were utilised by the nurse managers. Results demonstrated that the majority of nursing managers surveyed received minimal (if any) casemix and/or demographic data on a routine basis. Some were provided with data in response to specific requests. The information that was provided varied both within and across hospitals, and no consistent methods of data distribution were available. Few nursing managers believed that the information provided aided their decision-making processes partly due to the minimalist nature of provided data while some nursing managers demonstrated a lack of understanding of the potential benefit of casemix data as a resource to support management decision making.

  10. Profile of an excellent nurse manager: identifying and developing health care team leaders.

    Science.gov (United States)

    Kallas, Kathryn D

    2014-01-01

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

  11. The making of a nurse manager: the role of experiential learning in leadership development.

    Science.gov (United States)

    Cathcart, Eloise Balasco; Greenspan, Miriam; Quin, Matthew

    2010-05-01

    To articulate the experientially acquired knowledge, skill and ethics embedded in nurse manager practice and describe the ways in which they were developed. The role of the nurse manager is usually described in lists of competencies, talents and traits which fail to capture the experience-based judgment and practical knowledge in this pivotal organizational role. Using Benner's methodology of practice articulation, 32 nurse managers wrote and interpreted first person narratives of their practice. The experience level of the group ranged from new nurse managers to those with more than 10 years' role tenure. The seminars were facilitated by a seasoned nurse executive and nurse manager with expertise in narrative interpretation. Interpretation of the paradigm case of one nurse manager suggests that complex leadership challenges can be a source of significant experiential learning for the individual and for the group. CONCLUSIONS; Articulating and reflecting on experiential learning elucidates the skilled knowledge and judgment embedded in nurse manager practice which cannot be accessed in any other way. Articulating the practical knowledge which is necessary for effective nurse manager practice can hasten the development of role incumbents.

  12. Factors that facilitate registered nurses in their first-line nurse manager role.

    Science.gov (United States)

    Cziraki, Karen; McKey, Colleen; Peachey, Gladys; Baxter, Pamela; Flaherty, Brenda

    2014-11-01

    To determine the factors that attract and retain Registered Nurses in the first-line nurse manager role. The first-line nurse manger role is pivotal in health-care organisations. National demographics suggest that Canada will face a first-line nurse manager shortage because of retirement in the next decade. Determination of factors that attract and retain Registered Nurses will assist organisations and policy makers to employ strategies to address this shortage. The study used an exploratory, descriptive qualitative approach, consisting of semi-structured individual interviews with 11 Registered Nurses in first-line nurse manager roles. The findings revealed a discrepancy between the factors that attract and retain Registered Nurses in the first-line nurse manager role, underscored the importance of the mentor role and confirmed the challenges encountered by first-line nurse managers practicing in the current health-care environment. The first-line nurse manager role has been under studied. Further research is warranted to understand which strategies are most effective in supporting first-line nurse managers. Strategies to support nurses in the first-line nurse manager role are discussed for the individual, programme, organisation and health-care system/policy levels. © 2013 John Wiley & Sons Ltd.

  13. Psychosocial and organizational work environment of nurse managers and self-reported depressive symptoms: Cross-sectional analysis from a cohort of nurse managers

    Directory of Open Access Journals (Sweden)

    Nathalie Nourry

    2014-04-01

    Full Text Available Objectives: The association between depressive symptoms and psycho‑organisational work environment has been established in the literature. Some studies have evaluated depressive symptoms in healthcare workers, but little research has been carried out among nurse managers. The aim of the study is to evaluate the depressive symptoms prevalence among nurse managers' population and work environment factors. Material and Methods: A descriptive correlational research design was used. Data were collected from 296 nurse managers in five hospitals in the eastern area of France between 2007 and 2008. Health outcomes were evaluated by measuring depressive symptoms (CES-D scale, the exposure data by assessing psycho‑organisational work environment with effort-reward imbalance-model of Siegrist. Multiple logistic regressions were used to describe the strength of the association between depressive symptoms and effort-reward imbalance adjusted for personal and occupational characteristics of the nurse managers. Results: Among the nurse managers, a third had depressive symptoms, and 18% presented an effort-reward imbalance (ratio: ≥ 1. A significant association was found between depressive symptoms and effort-reward imbalance (OR = 10.81, 95% CI: 5.1-23, p < 10-3, and with esteem as a reward (OR = 3.21, 95% CI: 1.6-6.3, p < 10-2. Conclusion: In view of the hierarchical situation of nurse managers and their primary roles in hospitals, it is necessaryto take prevention measures to improve their work environment and health.

  14. Inaccuracy of INR measurements and suggestions for improved WHO guidelines for calibration of reference preparations – a statistical study

    DEFF Research Database (Denmark)

    Attermann, Jørn

    2003-01-01

    Numerous empirical studies show that the accuracy of international normalized ratio (INR) measurements is unsatisfactory and worse than generally expected. We demonstrate that a plausible reason for this large inaccuracy is a conventional calibration procedure of reference preparations with (i...... procedure also results in serious overestimation of the accuracy of INR measurements, thus leading to a false sense of security in oral anticoagulant therapy. In an example with data from WHO guidelines, we show that the systematic overprediction of INR (which is believed to be 0) may be as large as 5...

  15. Public expertise and crisis management: the contributions of the INRS and IRSN

    International Nuclear Information System (INIS)

    Supervil, Sylvie; Vaxelaire, Stephane

    2015-01-01

    The authors present and comment the main assets of the INRS (Institut national de recherche et de securite) and IRSN Institut de Radioprotection et de Surete Nucleaire), their common and specific concerns in the field of crisis management. The INRS possesses a diversity of abilities and professions (engineering, medicine, toxicology, ergonomics, etc.), resources adapted to the field of intervention of actors (work health services, local prevention services), the ability to intervene from the upstream knowledge of hazards to the proposition of solutions, the structures and availability to assist and support public authorities, and some practice outside a crisis context. On its side, the IRSN is a largely acknowledged expert, and participated to the elaboration of the national plan for the response to a major radiological or nuclear accident

  16. Effect of olanzapine treatment on INR of a patient receiving warfarin therapy

    Directory of Open Access Journals (Sweden)

    Derya Arslan

    2016-06-01

    Full Text Available Olanzapine is an atypical antipsychotic drug, commonly used in the management of psychotic symptoms in patients with schizoprenia and bipolar affective disorder. Deep venous thrombosis is a manifestation of venous thromboembolism. It is very well known that use of antipsychotic drugs increase the risk of thrombosis in a patient with schizophrenia. It has been reported in many studies the effects of olanzapine on thrombosis but there isn't any report about the effect of olanzapine on international normalized ratio (INR. in the medical literature. In this paper, a patient with schizophrenia and also family history of deep venous thrombosis who emerged deep venous thrombosis after being started on olanzapine treatment and effect of olanzapine treatment on INR has been reported. [Cukurova Med J 2016; 41(2.000: 370-373

  17. Novel POC1A mutation in primordial dwarfism reveals new insights for centriole biogenesis.

    Science.gov (United States)

    Koparir, Asuman; Karatas, Omer F; Yuceturk, Betul; Yuksel, Bayram; Bayrak, Ali O; Gerdan, Omer F; Sagiroglu, Mahmut S; Gezdirici, Alper; Kirimtay, Koray; Selcuk, Ece; Karabay, Arzu; Creighton, Chad J; Yuksel, Adnan; Ozen, Mustafa

    2015-10-01

    POC1A encodes a WD repeat protein localizing to centrioles and spindle poles and is associated with short stature, onychodysplasia, facial dysmorphism and hypotrichosis (SOFT) syndrome. These main features are related to the defect in cell proliferation of chondrocytes in growth plate. In the current study, we aimed at identifying the molecular basis of two patients with primordial dwarfism (PD) in a single family through utilization of whole-exome sequencing. A novel homozygous p.T120A missense mutation was detected in POC1A in both patients, a known causative gene of SOFT syndrome, and confirmed using Sanger sequencing. To test the pathogenicity of the detected mutation, primary fibroblast cultures obtained from the patients and a control individual were used. For evaluating the global gene expression profile of cells carrying p.T120A mutation in POC1A, we performed the gene expression array and compared their expression profiles to those of control fibroblast cells. The gene expression array analysis showed that 4800 transcript probes were significantly deregulated in cells with p.T120A mutation in comparison to the control. GO term association results showed that deregulated genes are mostly involved in the extracellular matrix and cytoskeleton. Furthermore, the p.T120A missense mutation in POC1A caused the formation of abnormal mitotic spindle structure, including supernumerary centrosomes, and changes in POC1A were accompanied by alterations in another centrosome-associated WD repeat protein p80-katanin. As a result, we identified a novel mutation in POC1A of patients with PD and showed that this mutation causes the formation of multiple numbers of centrioles and multipolar spindles with abnormal chromosome arrangement. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Precision of INR measured with a patient operated whole blood coagulometer

    DEFF Research Database (Denmark)

    Attermann, Jørn; Andersen, Niels Trolle; Korsgaard, Helle

    2003-01-01

    INTRODUCTION: The objective of the present study was to evaluate the precision of a portable whole blood coagulometer (CoaguChek S) in the hands of self-managing patients on oral anticoagulant therapy (OAT). MATERIALS AND METHODS: Fifteen patients on self-managed OAT performed measurements of INR...... and between patients was 15.0% and 14.7%, respectively. CONCLUSION: The precision of CoaguChek S is satisfactory....

  19. Implications of staff 'churn' for nurse managers, staff, and patients.

    Science.gov (United States)

    Duffield, Christine; Roche, Michael; O'Brien-Pallas, Linda; Catling-Paull, Christine

    2009-01-01

    In this article, the term "churn" is used not only because of the degree of change to staffing, but also because some of the reasons for staff movement are not classified as voluntary turnover. The difficulties for the nurse managing a unit with the degree of "churn" should not be under-estimated. Changes to skill mix and the proportions of full-time, agency, and temporary staff present challenges in providing clinical leadership, scheduling staff, performance management, and supervision. Perhaps more importantly, it is likely that there is an impact on the continuity of care provided in the absence of continuity of staffing. A greater understanding of the human and financial costs and consequences, and a willingness to change established practices at the institutional and ward level, are needed.

  20. Leadership style and patient safety: implications for nurse managers.

    Science.gov (United States)

    Merrill, Katreena Collette

    2015-06-01

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

  1. Emotional Intelligence and Transformational Leadership in Nurse Managers.

    Science.gov (United States)

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

    2016-02-01

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

  2. The professional profile of UFBA nursing management graduate students.

    Science.gov (United States)

    Paiva, Mirian Santos; Coelho, Edméia de Almeida Cardoso; Nascimento, Enilda Rosendo do; Melo, Cristina Maria Meira de; Fernandes, Josicelia Dumêt; Santos, Ninalva de Andrade

    2011-12-01

    The objective of the present study was to analyze the professional profile of the nursing graduate students of Federal University of Bahia, more specifically of the nursing management area. This descriptive, exploratory study was performed using documental research. The data was collected from the graduates' curriculum on the Lattes Platform and from the graduate program documents, using a form. The study population consisted of graduates enrolled under the line of research The Organization and Evaluation of Health Care Systems, who developed dissertations/theses addressing Nursing/Health Management. The data were stored using Microsoft Excel, and then transferred to the STATA 9.0 statistical software. Results showed that most graduates are women, originally from the State of Bahia, and had completed the course between 2000 and 2011; faculty of public institutions who continued involved in academic work after completing the course. These results point at the program as an academic environment committed to preparing researchers.

  3. The nurse manager: job satisfaction, the nursing shortage and retention.

    Science.gov (United States)

    Andrews, Diane Randall; Dziegielewski, Sophia F

    2005-07-01

    A critical shortage of registered nurses exists in the United States and this shortage is expected to worsen. It is predicted that unless this issue is resolved, the demand for nursing services will exceed the supply by nearly 30% in 2020. Extensive analysis of this pending crisis has resulted in numerous recommendations to improve both recruitment and retention. The purpose of this article is to clearly outline the issues contributing to this problem, and to provide the nurse manager with information regarding specific influences on job satisfaction as it relates to job turnover and employee retention. To accomplish this, an analysis of the literature using both national and international sources is used to formulate the lessons learned as well as strategies and future courses of action designed to address this shortage.

  4. Learning in the workplace: the role of Nurse Managers.

    Science.gov (United States)

    Yen, Margaret; Trede, Franziska; Patterson, Carmel

    2016-06-01

    Objective This research explores Nurse Managers' (NMs') influence on workplace learning. The facilitation of staff learning has implications for the role of NMs, who are responsible for the quality and safety of patient care. However, this aspect of their work is implicit and there is limited research in the area. Methods This paper discusses the findings from one hospital as part of a broader philosophical hermeneutic study conducted in two public hospitals over a 20-month timeframe. NMs participated in interviews, a period of observation, follow-up interviews and a focus group. Transcribed data was thematically analysed. Eraut's 'Two triangle theory of workplace learning' was used to interpret participants' accounts of how they facilitated workplace learning. Findings The analysis found that NMs worked to positively influence staff performance through learning in three domains: orientating new staff, assessing staff performance and managing underperformance. Conclusions This study purports that NMs influence workplace learning in ways that are seldom recognised. A more conscious understanding of the impact of their role can enable NMs to more purposefully influence workplace learning. Such understanding also has implications for the professional preparation of NMs for their role in the context of workplace learning, facilitating learning for change and enabling the advancement of quality and safety in healthcare. What is known about the topic? Studies exploring the influence of Nurse Managers in workplace learning have been limited to their role in the facilitation of formal learning. There is a paucity of research that examines their role in influencing informal learning. What does this paper add? The findings of this study draw on Eraut's 'Two triangle theory of workplace learning' to further define the interdependent relationship between management and educational practices. What are the implications for practitioners? NMs' awareness and deliberate use of

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

    Directory of Open Access Journals (Sweden)

    James Avoka Asamani

    2016-03-01

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

  6. Requirements for Successful Adoption of a Glucose Measurement System Into a Hospital POC Program.

    Science.gov (United States)

    Füzéry, Anna K; Cembrowski, George S

    2016-07-01

    Widespread and successful implementation of any glucose measurement system in a hospital point-of-care (POC) program requires a number of features in addition to accurate and reliable analytical performance. Such features include, but are not limited to, a system's glucose-hematocrit dependence, durability, information technology capabilities, and battery capacity and battery life. While the study of Ottiger et al in this issue supports the analytical accuracy and reliability of Bayer's CONTOUR XT® blood glucose monitoring system, the suitability of other features of this system for a hospital POC program remains to be established. © 2016 Diabetes Technology Society.

  7. Determination of a safe INR for joint injections in patients taking warfarin.

    Science.gov (United States)

    Bashir, M A; Ray, R; Sarda, P; Li, S; Corbett, S

    2015-11-01

    With an increase in life expectancy in 'developed' countries, the number of elderly patients receiving joint injections for arthritis is increasing. There are legitimate concerns about an increased risk of thromboembolism if anticoagulation is stopped or reversed for such an injection. Despite being a common dilemma, the literature on this issue is scarce. We undertook 2,084 joint injections of the knee and shoulder in 1,714 patients between August 2008 and December 2013. Within this cohort, we noted 41 patients who were taking warfarin and followed them immediately after joint injection in the clinic or radiology department, looking carefully for complications. Then, we sought clinical follow-up, correspondence, and imaging evidence for 4 weeks, looking for complications from these joint injections. We recorded International Normalised Ratio (INR) values before injection. No complications were associated with the procedure after any joint injection. The radiologists who undertook ultrasound-guided injections to shoulders re-scanned the joints looking for haemarthroses: they found none. A similar outcome was noted clinically after injections in the outpatient setting. With a mean INR of 2.77 (range, 1.7-5.5) and a maximum INR within this group of 5.5, joint injections to the shoulder and knee can be undertaken safely in primary or secondary care settings despite the patient taking warfarin.

  8. Irradiation tests on PHWR type fuel elements in TRIGA research reactor of INR Pitesti

    Energy Technology Data Exchange (ETDEWEB)

    Horhoianu, Grigore [Institute for Nuclear Research, Pitesti (Romania). Nuclear Fuel Engineering Lab.; Sorescu, Ion [Institute for Nuclear Research, Pitesti (Romania). TRIGA Reactor Loop Facility; Parvan, Marcel [Institute for Nuclear Research, Pitesti (Romania). Hot Cells Lab.

    2012-12-15

    Nine PHWR type fuel elements with reduced length were irradiated in loop A of the TRIGA Research Reactor of INR Pitesti. The primary objective of the test was to determine the performance of nuclear fuel fabricated at INR Pitesti at high linear powers in pressurized water conditions. Six fuel elements were irradiated with a ramp power history, achieving a maximum power of 45 kW/m during pre-ramp and of 64 kW/m in the ramp. The maximum discharge burnup was of 216 MWh/kgU. Another three fuel elements with reduced length were irradiated with declining power history. At the beginning of irradiation the fuel elements achieved a maximum linear power of 66 kW/m. The maximum fuel power was about 1.3 times the maximum expected in PHWR. The maximum discharge burnup was 205 MWh/kgU. The elements were destructively examined in the hot cells of INR Pitesti. Temperature-sensitive parameters such as UO{sub 2} grain growth, fission-gas release and sheath deformations were examined. The tests proved the feasibility of irradiating PHWR type fuel elements at linear powers up to 66 kW/m under pressurized water conditions and demonstrated the possibility of more flexible operation of this fuel in power reactors. This paper presents the results of the investigation. (orig.)

  9. Use of an INR-style bunch-length detector in the Fermilab Linac

    International Nuclear Information System (INIS)

    McCrory, E.S.; Schmidt, C.W.; Feschenko, A.V.

    1993-01-01

    Device to accurately measure the phase extent of a linac beam is being developed for use in the Fermilab 400 MeV Linac Upgrade. Prototypes have been and are being tested. We have attempted to improve the original design from the Institute for Nuclear Research in Moscow (INR) to increase the resolution for adequate operation at 805 MHz. The device incorporating a new arrangement of lens and deflector, reported previously, cannot achieve the desired resolution. This paper describes the operation and the strengths and weaknesses of the three types of bunch-length detectors (BLDs) and the measurements made at this time. The differences among these devices is delineated by the relative position of the rf deflector and the electrostatic einsel lens, as follows: INR--Lens before deflector; Fermilab--Lens after deflector; H- beam; and FNAL/INR--Lens and deflector combined. To satisfy the goals of commissioning the new linac, a resolution of about 5 picoseconds (1 degree at 805 MHz) is desired

  10. Diagnostic and Therapeutic Yield of Endoscopy in Patients with Elevated INR and Gastrointestinal Bleeding.

    Science.gov (United States)

    Peloquin, Joanna M; Seraj, Siamak M; King, Lindsay Y; Campbell, Emily J; Ananthakrishnan, Ashwin N; Richter, James M

    2016-06-01

    Gastrointestinal bleeding is a well-known risk of systemic anticoagulation. However, bleeding in the setting of supratherapeutic anticoagulation may have a milder natural history than unprovoked bleeding. It is a common clinical gestalt that endoscopy is common, but bleeding source identification or intervention is uncommon, yet few data exist to inform this clinical impression. Consequently, we sought to examine our institutional experience with gastrointestinal bleeding in the setting of supratherapeutic international normalized ratio (INR) with the aim of identifying predictors of endoscopically identifiable lesions, interventions, and outcomes. A retrospective review was conducted at a tertiary referral academic medical center to identify patients presenting with gastrointestinal bleeding in the setting of warfarin and a supratherapeutic INR (>3.5) who underwent an endoscopic procedure. Relevant clinical covariates, endoscopic findings, need for intervention, and outcomes were collected by review of the medical record. Logistic regression adjusting for potential confounders identified predictors of endoscopically significant lesions as well as intervention and outcomes. A total of 134 patients with INR 3.5 or greater (mean 5.5, range 3.5-17.1) presented with symptoms of gastrointestinal bleeding, most commonly as melena or symptomatic anemia. Antiplatelet agents were used by 54% of patients, and 60% of patients were on concomitant acid suppression on admission. Procedures included esophagogastroduodenoscopy (upper endoscopy; EGD) (n = 128), colonoscopy (n = 73), and video capsule endoscopy (n = 32). Active bleeding at first EGD or colonoscopy was found in only 19 patients (18%), with endoscopic intervention in only 26 patients (25%). At a critical threshold of INR 7.5 at presentation, the likelihood of finding an endoscopically significant lesion fell to therapy (odds ratio [OR] 2.59; 95% confidence interval [CI], 1.13-5.94), timing of EGD within 12 hours of

  11. A highly conserved Poc1 protein characterized in embryos of the hydrozoan Clytia hemisphaerica: localization and functional studies.

    Directory of Open Access Journals (Sweden)

    Cécile Fourrage

    Full Text Available Poc1 (Protein of Centriole 1 proteins are highly conserved WD40 domain-containing centriole components, well characterized in the alga Chlamydomonas, the ciliated protazoan Tetrahymena, the insect Drosophila and in vertebrate cells including Xenopus and zebrafish embryos. Functions and localizations related to the centriole and ciliary axoneme have been demonstrated for Poc1 in a range of species. The vertebrate Poc1 protein has also been reported to show an additional association with mitochondria, including enrichment in the specialized "germ plasm" region of Xenopus oocytes. We have identified and characterized a highly conserved Poc1 protein in the cnidarian Clytia hemisphaerica. Clytia Poc1 mRNA was found to be strongly expressed in eggs and early embryos, showing a punctate perinuclear localization in young oocytes. Fluorescence-tagged Poc1 proteins expressed in developing embryos showed strong localization to centrioles, including basal bodies. Anti-human Poc1 antibodies decorated mitochondria in Clytia, as reported in human cells, but failed to recognise endogenous or fluorescent-tagged Clytia Poc1. Injection of specific morpholino oligonucleotides into Clytia eggs prior to fertilization to repress Poc1 mRNA translation interfered with cell division from the blastula stage, likely corresponding to when neosynthesis normally takes over from maternally supplied protein. Cell cycle lengthening and arrest were observed, phenotypes consistent with an impaired centriolar biogenesis or function. The specificity of the defects could be demonstrated by injection of synthetic Poc1 mRNA, which restored normal development. We conclude that in Clytia embryos, Poc1 has an essentially centriolar localization and function.

  12. Nurse managers' preferred and perceived leadership styles: a study at an Italian hospital.

    Science.gov (United States)

    Zampieron, Alessandra; Spanio, Daniele; Bernardi, Paola; Milan, Rosalia; Buja, Alessandra

    2013-04-01

    The aim of this cross-sectional descriptive study was to compare the different leadership styles based on perceptions of nurse managers and their staff. Nurse managers' styles are fundamental to improving subordinates' performance and achieving goals at health-care institutions. This was a cross-sectional study. A questionnaire developed by Ekvall & Arvonen, considering three leadership domains (Change, Production and Employee relations), was administered to all nurse managers and to their subordinates at a city hospital in north-east Italy. The comparison between the leadership styles actually adopted and those preferred by the nurse managers showed that the preferred style always scored higher than the style adopted, the difference reaching statistical significance for Change and Production. The leadership styles preferred by subordinates always scored higher than the styles their nurse managers actually adopted; in the subordinates' opinion, the differences being statistically significant in all three leadership domains. The study showed that nurse managers' expectations in relation to their leadership differ from those of their subordinates. These findings should be borne in mind when selecting and training nurse managers and other personnel, and they should influence the hospital's strategic management of nurses. © 2012 Blackwell Publishing Ltd.

  13. Factors influencing nurse managers' intent to stay or leave: a quantitative analysis.

    Science.gov (United States)

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

    2015-11-01

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

  14. The role of practical wisdom in nurse manager practice: why experience matters.

    Science.gov (United States)

    Cathcart, Eloise Balasco; Greenspan, Miriam

    2013-10-01

    To illustrate through the interpretation of one representative nurse manager's narrative how the methodology of practice articulation gives language to the ways practical wisdom develops in leadership practice and facilitates learning. Patricia Benner's corpus of research has demonstrated that reflection on clinical narratives comes closer than other pedagogical methods to replicating and enhancing the experiential learning required for the development of practical wisdom. Using Benner's methodology of practice articulation, 91 nurse managers wrote and read to a peer group a narrative of their lived experience in the role. The groups interpreted the narratives to extract the skilled knowledge and ethics embedded in the practice of the nurse manager authors. One narrative was chosen for this paper because it is a particularly clear exemplar of how practical wisdom develops in nurse manager practice. Articulating and reflecting on experiential learning led to an understanding of how practical wisdom developed in one nurse manager's practice. Interpretation of the narrative of one nurse manager illustrated how reflection on a complex ethical dilemma was a source of character development for the individual and the peer group. Describing and interpreting how practical wisdom develops for individual nurse managers can be a source of learning for the narrative author and other role incumbents who need to make sound decisions and take prudent action in ethically challenging situations. © 2013 John Wiley & Sons Ltd.

  15. Diurnal and seasonal DOC and POC variability in the land-locked sea

    Directory of Open Access Journals (Sweden)

    Beata Szymczycha

    2017-07-01

    Full Text Available Organic matter is a minor yet important component of the marine environment. The aim of this study was to investigate the diurnal and seasonal changes in dissolved and particulate organic carbon (DOC and POC, respectively. Thus, DOC and POC as well as chlorophyll a (Chl a, δ13C, NO3−, NO2−, NH4+, PO43−, salinity, pH, and temperature were regularly measured in samples collected for 24 h (2-h resolution in the Gdańsk Deep (54°44.730′N, 19°08.531′E at three water depths (1, 10, and 40 m during sampling campaigns in 2011 (May, 2014 (May, and 2015 (January, March, May, July, September, November. Seasonal variations in DOC and POC followed the seasonality of Chl a (proportional trend and nutrients (reverse trend concentrations. Diurnal oscillations were detected in six out of the eight measurement series. The strongest diurnal variability in both POC and DOC occurred in May 2011 and March 2015, when phytoplankton activity was highest (high Chl a. The surprisingly low δ13C values (range: −28‰ to −24‰ measured over the course of the study revealed the gaps in our knowledge of the isotopic characteristics of terrestrial- vs. marine-derived particulate organic matter.

  16. How coaching can play a key role in the development of nurse managers.

    Science.gov (United States)

    Westcott, Liz

    2016-09-01

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

  17. Emotional intelligence in nurse management and nurse job satisfaction and retention: a scoping review protocol.

    Science.gov (United States)

    Phillips, Jacqueline; Harris, Janet

    2017-11-01

    The objective of this review is to map what is known about emotional intelligence (EI) in relation to staff job satisfaction and retention in nursing, and the tools that are used to measure EI in this context. The primary question of this review is: What is known about nurse managers' EI as it relates to staff job satisfaction and retention in nursing?Sub-question 1: What tools are being used to measure nurse managers' EI and what theoretical frameworks are they based on?Sub-question 2: What gaps exist in the research related to nurse managers' EI as it relates to staff job satisfaction and retention in nursing?

  18. Human capital in the nursing management of hospitals.

    Science.gov (United States)

    Cordeiro, Ana Lúcia Arcanjo Oliveira; Fernandes, Josicélia Dumêt; Mauricio, Maria Deolinda Antunes Luz Lopes Dias; Silva, Rosana Maria de Oliveira; Barros, Claudia Silva Marinho Antunes de; Romano, Cátia Maria Costa

    2017-08-17

    To analyze how the components of human capital are used in the nursing management of hospital organizations. This was an exploratory and qualitative study. Data collection took place between October 2014 and May 2015 using semi-structured interviews. The data were analyzed according to content analysis. Twelve nurse managers participated. The components of human capital used by the nurses in personnel management were: during the hiring process, when requiring specialized education in the field and prior professional experience; when retaining talents with promotion strategies; in building capacities of professionals through support and training; and in collective work to construct processes and outcome assessment. The components of human capital need to be managed strategically with a focus on professional skills and development, with the aim of transforming individual and collective knowledge into new technology. Analisar como os componentes do capital humano são utilizados na gestão de enfermeiras em organizações hospitalares. Estudo exploratório, com abordagem qualitativa. A coleta de dados ocorreu de outubro de 2014 a maio de 2015 com a utilização de entrevistas semiestruturadas. Os dados foram analisados segundo a análise de conteúdo. Participaram 12 gestoras de enfermagem. Os componentes do capital humano utilizados pelas enfermeiras na gestão de pessoas foram: no processo admissional ao utilizar como critérios para contratação a exigência de especialização na área e experiência profissional prévia; na manutenção de talentos com estratégias de promoção; na capacitação de profissionais com apoio e treinamento; e no trabalho coletivo para a construção dos processos e avaliação dos resultados. Os componentes do capital humano precisam ser gerenciados estrategicamente com foco nas competências e no desenvolvimento do profissional, visando transformar os conhecimentos individuais e coletivos em novas tecnologias.

  19. Staff nurse perceptions of nurse manager leadership styles and outcomes.

    Science.gov (United States)

    Casida, Jesus; Parker, Jessica

    2011-05-01

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

  20. Nursing management and organizational ethics in the intensive care unit.

    Science.gov (United States)

    Wlody, Ginger Schafer

    2007-02-01

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

  1. Feasibility of using the Omaha System to represent public health nurse manager interventions.

    Science.gov (United States)

    Monsen, Karen A; Newsom, Eric T

    2011-01-01

    To test the feasibility of representing public health nurse (PHN) manager interventions using a recognized standardized nursing terminology. A nurse manager in a Midwest local public health agency documented nurse manager interventions using the Omaha System for 5 months. ANALYTIC STRATEGY: The data were analyzed and the results were compared with the results from a parallel analysis of existing PHN intervention data. Interventions for 79 "clients" (projects, teams, or individuals) captured 76% of recorded work hours, and addressed 43% of Omaha System problems. Most problems were addressed at the "community" level (87.1%) versus the "individual" level (12.9%). Nursing practice differed between the 2 knowledge domains of public health family home visiting nursing and public health nursing management. Standardized nursing terminologies have the potential to represent, describe, and quantify nurse manager interventions for future evaluation and research. © 2011 Wiley Periodicals, Inc.

  2. Retrofitting the instrumentation and control system of primary cooling circuit from TRIGA INR 14 MW reactor

    International Nuclear Information System (INIS)

    Preda, M.; Ciocanescu, M.; Ana, E. M.; Cristea, D.

    2008-01-01

    Activities of retrofitting the instrumentation and control system from TRIGA INR primary cooling circuit consists in replacement of actual system for: - parameter measurement; - safety; - reactor external scramming; - protection, command and supply for electrical elements of the system. This retrofitting project is designed to ensure the necessary features of reactor external safety and for technological parameter measurement. The new safety system of main cooling circuit is completely separated from its operating system and is arranged in a panel assembly in reactor control room. The operating system has the following features: - data acquisition; - parameter value and state of command elements displaying; - command elements on hierarchical levels; - operator information through visual and acoustic alarm. (authors)

  3. Nurse managers' perceptions and experiences regarding staff nurse empowerment: a qualitative study.

    Science.gov (United States)

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

    2015-01-01

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

  4. Resilience and Work-life Balance in First-line Nurse Manager

    OpenAIRE

    Kim, Miyoung; Windsor, Carol

    2015-01-01

    Purpose: The aim of this study was to explore how first-line nurse managers constructed the meaning of resilience and its relationship to work-life balance for nurses in Korea. Methods: Participants were 20 first-line nurse managers working in six university hospitals. Data were collected through in-depth interviews from December 2011 to August 2012, and analyzed using Strauss and Corbin's grounded theory method. Results: Analysis revealed that participants perceived work-life balance a...

  5. Predictors of nurse manager stress: a dominance analysis of potential work environment stressors.

    Science.gov (United States)

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

    2013-11-01

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

  6. Using Cognitive Work Analysis to fit decision support tools to nurse managers' work flow.

    Science.gov (United States)

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

    2011-10-01

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

  7. How transformational leadership appears in action with adverse events? A study for Finnish nurse manager.

    Science.gov (United States)

    Liukka, Mari; Hupli, Markku; Turunen, Hannele

    2017-12-26

    The aim of this study was to determine whether elements of transformational leadership are present in nursing managers' actions following adverse events. Transformational leadership exerts a positive influence on organisational culture and patient safety. Eleven nursing managers were interviewed individually using a semi-structured format. Data were analysed using inductive content analysis. Four themes emerged relating to nursing managers' actions following adverse events: patient-centredness as a principle for common action, courage to reform operational models to prevent future adverse events, nursing staff's encouragement of open and blame-free discussion, and challenge to recognize adverse events. Nursing managers must understand their responsibilities and the importance of making it clear to staff that patient-centredness should be evident in all health care actions. Nursing managers must also recognize the need to ensure that staff treat patients' interests as the top priority. If an adverse event occurs, the situation should be discussed with the nursing staff and any unique aspects of the event must be accounted for. Nursing managers must have the skill to motivate and empower staff to find new ways to work, to prevent adverse events and to promote patient safety. © 2017 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    McCallin, A M; Frankson, C

    2010-04-01

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

  9. COMPETENCIES OF NURSE MANAGERS IN SLOVENIA: A QUALITATIVE AND QUANTITATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Karmen Erjavec

    2017-05-01

    Full Text Available Aim: The aim of the study is to identify nurse managers’ competencies in Slovenia regarding various healthcare organisations, public and private healthcare sectors, and management levels, as well as the reasons for their differences. Design: The study was based on quantitative and qualitative research. Methods: An online survey was conducted among 297 nurse managers in Slovenia, and in-depth interviews with 12 nurse managers were carried out. Results: Managers who worked in nursing homes were significantly more likely to perceive themselves as being more competent in leadership (p = 0.001 and financial management (p = 0.004 than their colleagues. Managers who had higher management positions were significantly more likely to perceive themselves as being more competent in financial management than their colleagues in lower management positions (p = 0.002. Nurse managers in the private sector perceived themselves to be significantly more competent in financial management (p = 0.0001. The reasons for nurse managers’ differences in proficiency levels are the degree of job security, and degree of autonomy and support in the healthcare team. Conclusion: The study identified inadequate nurse manager competencies, and reflected the needs of nurse managers for designing and providing health management programmes aimed at enhancing management capacity in the health sector in Slovenia. Keywords: management, competencies, skills, nurse managers, Slovenia, in-depth interviews, healthcare organisations, management level.

  10. Factors influencing intentions to stay and retention of nurse managers: a systematic review.

    Science.gov (United States)

    Brown, Pamela; Fraser, Kimberly; Wong, Carol A; Muise, Melanie; Cummings, Greta

    2013-04-01

    This systematic review aimed to explore factors known to influence intentions to stay and retention of nurse managers in their current position. Retaining staff nurses and recruiting nurses to management positions are well documented; however, there is sparse research examining factors that influence retention of nurse managers. Thirteen studies were identified through a systematic search of the literature. Eligibility criteria included both qualitative and quantitative studies that examined factors related to nurse manager intentions to stay and retention. Quality assessments, data extraction and analysis were completed on all studies included. Twenty-one factors were categorized into three major categories: organizational, role and personal. Job satisfaction, organizational commitment, organizational culture and values, feelings of being valued and lack of time to complete tasks leading to work/life imbalance, were prominent across all categories. These findings suggest that intentions to stay and retention of nurse managers are multifactoral. However, lack of robust literature highlights the need for further research to develop strategies to retain nurse managers. ImplICATIONS FOR NURSE MANAGEMENT: Health-care organizations and senior decision-makers should feel a responsibility to support front-line managers in relation to workload and span of control, and in understanding work/life balance issues faced by managers. © 2012 Blackwell Publishing Ltd.

  11. Nurse managers' experiences in continuous quality improvement in resource-poor healthcare settings.

    Science.gov (United States)

    Kakyo, Tracy Alexis; Xiao, Lily Dongxia

    2017-06-01

    Ensuring safe and quality care for patients in hospitals is an important part of a nurse manager's role. Continuous quality improvement has been identified as one approach that leads to the delivery of quality care services to patients and is widely used by nurse managers to improve patient care. Nurse managers' experiences in initiating continuous quality improvement activities in resource-poor healthcare settings remain largely unknown. Research evidence is highly demanded in these settings to address disease burden and evidence-based practice. This interpretive qualitative study was conducted to gain an understanding of nurse managers' Continuous Quality Improvement experiences in rural hospitals in Uganda. Nurse managers in rural healthcare settings used their role to prioritize quality improvement activities, monitor the Continuous Quality Improvement process, and utilize in-service education to support continuous quality improvement. The nurse managers in our sample encountered a number of barriers during the implementation of Continuous Quality Improvement, including: limited patient participation, lack of materials, and limited human resources. Efforts to address the challenges faced through good governance and leadership development require more attention. © 2017 John Wiley & Sons Australia, Ltd.

  12. REASONS AND CONSEQUENCES OF APPLIED LEADERSHIP STYLES IN ETHICAL DILEMMAS WHEN NURSE MANAGERS MAKE DECISIONS.

    Science.gov (United States)

    Zydziunaite, V; Suominen, T

    2014-09-21

    Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. Purpose: To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. Methods: The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (n=278) were nurse managers. The data were analyzed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. Results: The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients', relatives' and nurse managers' needs. Conclusions: Nurse managers exhibited leadership styles oriented to maintenance, focusing more on the "doing the job" than on managing the decision-making in ethical dilemmas.

  13. Leadership styles of nurse managers in ethical dilemmas: Reasons and consequences.

    Science.gov (United States)

    Zydziunaite, Vilma; Suominen, Tarja

    2014-01-01

    Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (N = 278) were nurse managers. The data were analysed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients,' relatives' and nurse managers' needs. Nurse managers exhibited leadership styles oriented to maintenance, focussing more on the 'doing the job' than on managing the decision-making in ethical dilemmas.

  14. Tools assessing nurse manager behaviours and RN job satisfaction: a review of the literature.

    Science.gov (United States)

    Feather, Rebecca

    2015-09-01

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

  15. Nurse Manager Behaviors That RNs Perceive to Affect Their Job Satisfaction.

    Science.gov (United States)

    Feather, Rebecca A; Ebright, Patricia; Bakas, Tamilyn

    2015-01-01

    Nurse manager behaviors and job satisfaction are commonly addressed in the literature; however, registered nurse (RN) perceptions of nurse manager behaviors provide a unique perspective that may inform future strategies designed to enhance RN job satisfaction. In this paper, the perceptions of RNs were explored through focus groups to learn the behaviors of nurse managers that most influence RNs' job satisfaction. Five focus groups were conducted through semi-structured interviews of a total of 28 RNs to provide data that were coded through qualitative content analysis for themes. The findings provide nurse managers with data related to the perceptions of RNs and the behaviors of managers that influence job satisfaction. The findings identified two conceptual categories of RN perceptions of nurse manager behaviors: manager behaviors supportive of RNs (communication, respect, and feeling cared for) plus the RNs' perceived disconnect of work issues from the manager's role. Findings support past research in relation to the perceptions of RNs wanting to be respected, included in communication, and the need to feel cared for by nurse managers to have higher levels of job satisfaction. © 2014 Wiley Periodicals, Inc.

  16. Guidelines for certification of International Normalized Ratio (INR) for vitamin K antagonists monitoring according to the EN ISO 22870 standards.

    Science.gov (United States)

    Brionne-François, Marie; Bauters, Anne; Mouton, Christine; Voisin, Sophie; Flaujac, Claire; Le Querrec, Agnès; Lasne, Dominique

    2018-06-01

    Point of care testing (POCT) must comply with regulatory requirements according to standard EN ISO 22870, which identify biologists as responsible for POCT. INR for vitamin K antagonists (VKAs) monitoring is a test frequently performed in haemostasis laboratories. Bedside INR is useful in emergency room, in particular in case of VKAs overdosage but also for specific populations of patients like paediatrics or geriatrics. INR POCT devices are widely used at home by the patients for self-testing, but their use in the hospital by the clinical staff for bedside measurement is growing, with devices which now comply with standard for POCT accreditation for hospital use. The majority of point of care devices for INR monitoring has shown a good precision and accuracy with results similar to those obtained in laboratory. With the aim to help the multidisciplinary groups for POCT supervision, the medical departments and the biologists to be in accordance with the standard, we present the guidelines of the GFHT (Groupe français d'étude sur l'hémostase et la thrombose, subcommittee "CEC et biologie délocalisée") for the certification of POCT INR. These guidelines are based on the SFBC guidelines for the certification of POCT and on the analysis of the literature to ascertain the justification of clinical need and assess the analytical performance of main analysers used in France, as well as on a survey conducted with biologists.

  17. The use of vitamin K supplementation to achieve INR stability: a systematic review and meta-analysis.

    Science.gov (United States)

    Kramps, Melissa; Flanagan, Abigail; Smaldone, Arlene

    2013-10-01

    Systematically review and quantitatively synthesize evidence on use of oral vitamin K supplementation in reducing international normalized ratio (INR) variability. PubMed, The Cochrane Library, PsycINFO, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Turning Research Into Practice (TRIP), Web of Science were searched for studies meeting predetermined inclusion/exclusion criteria. Five studies meeting criteria (three randomized trials, one quasi-experimental pre-post study, one retrospective case series) were appraised for quality and data synthesized by two reviewers. Pooled effect size of time in INR therapeutic range (TTR) was estimated using random effects meta-analysis. Pooled effect size representing data from four studies (678 subjects) was 0.31, 95% confidence interval 0.03-0.59 (Cochran Q = 7.1; p = .07; I(2) = 57.8) and favored vitamin K supplementation. Given wide variability among individual studies, there is not enough evidence to advise for or against the routine use of vitamin K supplementation to achieve INR stability. However, evidence does suggest that it may be of some benefit for some patients with INR instability. There is insufficient evidence to support routine supplementation with vitamin K in patients on chronic anticoagulation therapy but select patients, particularly those with persistent INR instability despite known adherence to regimen and no dietary or drug-drug interactions, may benefit from the intervention. Future research is warranted. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

  18. The environmental radioactivity data analysis at the inr platform in the post-chernobyl period

    International Nuclear Information System (INIS)

    Tudor, G.; Valeca, M.; Iordache, R.

    2016-01-01

    As a result of the Chernobyl accident, large quantities of radioactive substances were released into the atmosphere and were transported long distances, covering virtually the whole Europe, including Romania. This paper presents the analysis of the environment radioactivity data around the INR site, in the post-Chernobyl period in different types of samples. The purpose of this study was to evaluate the evolution of Chernobyl originated radionuclides concentration in Mioveni-Pitesti area. The selected indicator was Cs-137, which was monitored on a regular basis. From the post-Chernobyl annual reports, were collected the average values for Cs-137 activity in environmental samples. The concentration was determined for eleven sampling locations (soil and vegetation samples) distributed on 10 km distance around INR site, and the determination was made using gamma spectrometry. The data reveals significant variations of the Cs-137 activity. These variations may be generated by various disturbances that detach material from the soil and air, therefore allowing the substance to travel long distances from its origin. (authors)

  19. hPOC5 is a centrin-binding protein required for assembly of full-length centrioles.

    Science.gov (United States)

    Azimzadeh, Juliette; Hergert, Polla; Delouvée, Annie; Euteneuer, Ursula; Formstecher, Etienne; Khodjakov, Alexey; Bornens, Michel

    2009-04-06

    Centrin has been shown to be involved in centrosome biogenesis in a variety of eukaryotes. In this study, we characterize hPOC5, a conserved centrin-binding protein that contains Sfi1p-like repeats. hPOC5 is localized, like centrin, in the distal portion of human centrioles. hPOC5 recruitment to procentrioles occurs during G2/M, a process that continues up to the full maturation of the centriole during the next cell cycle and is correlated with hyperphosphorylation of the protein. In the absence of hPOC5, RPE1 cells arrest in G1 phase, whereas HeLa cells show an extended S phase followed by cell death. We show that hPOC5 is not required for the initiation of procentriole assembly but is essential for building the distal half of centrioles. Interestingly, the hPOC5 family reveals an evolutionary divergence between vertebrates and organisms like Drosophila melanogaster or Caenorhabditis elegans, in which the loss of hPOC5 may correlate with the conspicuous differences in centriolar structure.

  20. Requirements for Successful Adoption of a Glucose Measurement System Into a Hospital POC Program

    OpenAIRE

    F?z?ry, Anna K.; Cembrowski, George S.

    2016-01-01

    Widespread and successful implementation of any glucose measurement system in a hospital point-of-care (POC) program requires a number of features in addition to accurate and reliable analytical performance. Such features include, but are not limited to, a system?s glucose-hematocrit dependence, durability, information technology capabilities, and battery capacity and battery life. While the study of Ottiger et al in this issue supports the analytical accuracy and reliability of Bayer?s CONTO...

  1. Effectiveness of nursing management information systems: a systematic review.

    Science.gov (United States)

    Choi, Mona; Yang, You Lee; Lee, Sun-Mi

    2014-10-01

    The purpose of this study was to review evaluation studies of nursing management information systems (NMISs) and their outcome measures to examine system effectiveness. For the systematic review, a literature search of the PubMed, CINAHL, Embase, and Cochrane Library databases was conducted to retrieve original articles published between 1970 and 2014. Medical Subject Headings (MeSH) terms included informatics, medical informatics, nursing informatics, medical informatics application, and management information systems for information systems and evaluation studies and nursing evaluation research for evaluation research. Additionally, manag(*) and admin(*), and nurs(*) were combined. Title, abstract, and full-text reviews were completed by two reviewers. And then, year, author, type of management system, study purpose, study design, data source, system users, study subjects, and outcomes were extracted from the selected articles. The quality and risk of bias of the studies that were finally selected were assessed with the Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS) criteria. Out of the 2,257 retrieved articles, a total of six articles were selected. These included two scheduling programs, two nursing cost-related programs, and two patient care management programs. For the outcome measurements, usefulness, time saving, satisfaction, cost, attitude, usability, data quality/completeness/accuracy, and personnel work patterns were included. User satisfaction, time saving, and usefulness mostly showed positive findings. The study results suggest that NMISs were effective in time saving and useful in nursing care. Because there was a lack of quality in the reviewed studies, well-designed research, such as randomized controlled trials, should be conducted to more objectively evaluate the effectiveness of NMISs.

  2. POC1A truncation mutation causes a ciliopathy in humans characterized by primordial dwarfism.

    Science.gov (United States)

    Shaheen, Ranad; Faqeih, Eissa; Shamseldin, Hanan E; Noche, Ramil R; Sunker, Asma; Alshammari, Muneera J; Al-Sheddi, Tarfa; Adly, Nouran; Al-Dosari, Mohammed S; Megason, Sean G; Al-Husain, Muneera; Al-Mohanna, Futwan; Alkuraya, Fowzan S

    2012-08-10

    Primordial dwarfism (PD) is a phenotype characterized by profound growth retardation that is prenatal in onset. Significant strides have been made in the last few years toward improved understanding of the molecular underpinning of the limited growth that characterizes the embryonic and postnatal development of PD individuals. These include impaired mitotic mechanics, abnormal IGF2 expression, perturbed DNA-damage response, defective spliceosomal machinery, and abnormal replication licensing. In three families affected by a distinct form of PD, we identified a founder truncating mutation in POC1A. This gene is one of two vertebrate paralogs of POC1, which encodes one of the most abundant proteins in the Chlamydomonas centriole proteome. Cells derived from the index individual have abnormal mitotic mechanics with multipolar spindles, in addition to clearly impaired ciliogenesis. siRNA knockdown of POC1A in fibroblast cells recapitulates this ciliogenesis defect. Our findings highlight a human ciliopathy syndrome caused by deficiency of a major centriolar protein. Copyright © 2012 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

  3. Upper ocean carbon flux determined by the 234Th approach and sediment traps using size-fractionated POC and 234Th data from the Golf of Mexico

    International Nuclear Information System (INIS)

    Hung, Chin-Chang; Roberts, Kimberly A.; Santschi, Peter H.; Guo, Laodong

    2004-01-01

    Size-fractionated particulate 234 Th and particulate organic carbon (POC) fluxes were measured in the Gulf of Mexico during 2000 and 2001 in order to obtain a better estimation of upper ocean organic carbon export out of the euphotic zone within cold core and warm core rings, and to assess the relative merit of sediment trap and POC/ 234 Th methods. In 2000, the flux of POC measured by sediment traps at 120 m ranged from 60 to 148 mg C m -2 d -1 , while 234 Th-derived POC fluxes in large particles (>53 μm) varied from 18 to 61 mg C m -2 d -1 using the ratio of POC/ 234 Th at 120 m, and from 51 to 163 mg C m -2 d -1 using an average ratio of POC/ 234 Th for the upper 120 m water column. In 2001, the fluxes of POC measured by traps deployed at 120 m water depth ranged from 39 to 48 mg C m -2 d -1 , while the 234 Th-derived POC fluxes in large particles (>53 μm) varied from 7 to 37 mg C m -2 d -1 using a ratio of POC/ 234 Th at 120 m, and from 37 to 45 mg C m -2 d -1 using an average ratio of POC/ 234 Th within the 0-120 m interval. The results show that POC fluxes estimated by the 234 Th method using the average ratio of POC/ 234 Th within the euphotic zone are similar to those measured by sediment traps. Furthermore, the results demonstrate that the variability in POC export fluxes estimated by the 234 Th/ 238 U disequilibrium approach is strongly related to the ratio of POC/ 234 Th that is taken, and for which we have independent evidence that it may be controlled by the chemical composition of the suspended particles. The results also reveal that using POC/ 234 Th ratios in small particles may result in an estimate of the POC export flux that is considerably higher than when using POC/ 234 Th ratios in large particles (>53 μm). The POC flux calculated from ratios in large particles is, however, more comparable to the POC flux determined directly by sediment traps, but both of these estimates are much lower than that determined by using the POC/ 234 Th ratios in

  4. The changing training needs of clinical nurse managers: exploring issues for continuing professional development.

    Science.gov (United States)

    Gould, D; Kelly, D; Goldstone, L; Maidwell, A

    2001-04-01

    To identify areas where clinical nurse managers perceived that they would benefit from further training and to make recommendations for planning future programmes to meet their needs. The effectiveness of the clinical nurse manager has traditionally been associated with maintaining standards of care. Continuing professional development (CPD) is essential to ensure this important group feel adequately prepared to perform their role and has been recognized as an important factor in maintaining job satisfaction and reducing wasteful staff turnover. A review of the literature indicated that since the 1980s the CPD needs of clinical nurse managers have tended to be overlooked despite increasing complexity of the tasks expected of them. Thus it appeared that a fresh study to address these needs would be justified and should take into account sources of work-related stress and variables relating to job satisfaction. The study involved clinical nurse managers employed in all four acute hospital National Health Service (NHS) trusts where training needs were served by a major inner city educational consortium. Data collection proceeded in two stages. Initially interviews were undertaken with a random sample of 15 clinical nurse managers to provide in-depth, qualitative data. This information was used to develop a survey questionnaire distributed to the remaining 182 clinical nurse managers in each of the trusts. Data from the interviews indicated that clinical nurse managers appeared to feel clinically competent but generally experienced lack of confidence when dealing with a range of issues, in particular; human resources, managing budgets, deputizing for senior colleagues across the trust ('acting up') and using information technology in everyday practice. Response rate to the survey was good (65%). The results corroborated the interview findings, indicating a need for updating in the same wide range of topics. There were few differences in training needs across all four

  5. Assessing Clinical Laboratory Quality: A College of American Pathologists Q-Probes Study of Prothrombin Time INR Structures, Processes, and Outcomes in 98 Laboratories.

    Science.gov (United States)

    Howanitz, Peter J; Darcy, Theresa P; Meier, Frederick A; Bashleben, Christine P

    2015-09-01

    The anticoagulant warfarin has been identified as the second most frequent drug responsible for serious, disabling, and fatal adverse drug events in the United States, and its effect on blood coagulation is monitored by the laboratory test called international normalized ratio (INR). To determine the presence of INR policies and procedures, INR practices, and completeness and timeliness of reporting critical INR results in participants' clinical laboratories. Participants reviewed their INR policies and procedure requirements, identified their practices by using a questionnaire, and studied completeness of documentation and timeliness of reporting critical value INR results for outpatients and emergency department patients. In 98 participating institutions, the 5 required policies and procedures were in place in 93% to 99% of clinical laboratories. Fifteen options for the allowable variations among duplicate results from different analyzers, 12 different timeliness goals for reporting critical values, and 18 unique critical value limits were used by participants. All required documentation elements were present in 94.8% of 192 reviewed INR validation reports. Critical value INR results were reported within the time frame established by the laboratory for 93.4% of 2604 results, but 1.0% of results were not reported. Although the median laboratories successfully communicated all critical results within their established time frames and had all the required validation elements based in their 2 most recent INR calculations, those participants at the lowest 10th percentile were successful in 80.0% and 85.7% of these requirements, respectively. Significant opportunities exist for adherence to INR procedural requirements and for practice patterns and timeliness goals for INR critical results' reporting.

  6. Conflict management style of Jordanian nurse managers and its relationship to staff nurses' intent to stay.

    Science.gov (United States)

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

    2016-03-01

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

  7. Conflict management styles used by nurse managers in the Sultanate of Oman.

    Science.gov (United States)

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

    2011-02-01

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

  8. Factors contributing to managerial competence of first-line nurse managers: A systematic review.

    Science.gov (United States)

    Gunawan, Joko; Aungsuroch, Yupin; Fisher, Mary L

    2018-02-01

    To determine the factors contributing to managerial competence of first-line nurse managers. Understanding factors affecting managerial competence of nurse managers remains important to increase the performance of organizations; however, there is sparse research examining factors that influence managerial competence of first-line nurse managers. Systematic review. The search strategy was conducted from April to July 2017 that included 6 electronic databases: Science Direct, PROQUEST Dissertations and Theses, MEDLINE, CINAHL, EMBASE, and Google Scholar for the years 2000 to 2017 with full text in English. Quantitative and qualitative research papers that examined relationships among managerial competence and antecedent factors were included. Quality assessment, data extractions, and analysis were completed on all included studies. Content analysis was used to categorize factors into themes. Eighteen influencing factors were examined and categorized into 3 themes-organizational factors, characteristics and personality traits of individual managers, and role factors. Findings suggest that managerial competence of first-line nurse managers is multifactorial. Further research is needed to develop strategies to develop managerial competence of first-line nurse managers. © 2017 John Wiley & Sons Australia, Ltd.

  9. Is nurse managers' leadership style related to Japanese staff nurses' affective commitment to their hospital?

    Science.gov (United States)

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

    2016-10-01

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

  10. Health Professionals Facing Burnout: What Do We Know about Nursing Managers?

    Science.gov (United States)

    Heeb, Jean-Luc; Haberey-Knuessi, Véronique

    2014-01-01

    Objective. To address the degree of burnout in nursing managers in hospitals of Western Switzerland, including comparison with medical managers, and its relationship with personal, work-related, and organizational characteristics. Methods. Statistical analysis of the scores of the Maslach Burnout Inventory-Human Services Survey from 257 nursing managers who answered a standardized electronic questionnaire. Results. Nursing managers showed a low degree of burnout, which was similar to that of medical managers. Most of them had a low level of emotional exhaustion and a low level of depersonalization, while personal accomplishment was contrasted. Only 2.3% had a high degree of burnout. These findings challenge the hypothesis of high stress being associated with high burnout, as nursing managers can be supposed to have a highly demanding job due to their intermediary position within the hospital hierarchy. Variations of burnout by personal, work-related, and organizational characteristics mainly concerned emotional exhaustion. Conclusion. Though nursing managers face a highly demanding job, they may benefit from resources (including coping strategies and empowerment) which help counterbalance job stress. Unequal distribution of resources may play a central role when facing burnout.

  11. Health Professionals Facing Burnout: What Do We Know about Nursing Managers?

    Directory of Open Access Journals (Sweden)

    Jean-Luc Heeb

    2014-01-01

    Full Text Available Objective. To address the degree of burnout in nursing managers in hospitals of Western Switzerland, including comparison with medical managers, and its relationship with personal, work-related, and organizational characteristics. Methods. Statistical analysis of the scores of the Maslach Burnout Inventory-Human Services Survey from 257 nursing managers who answered a standardized electronic questionnaire. Results. Nursing managers showed a low degree of burnout, which was similar to that of medical managers. Most of them had a low level of emotional exhaustion and a low level of depersonalization, while personal accomplishment was contrasted. Only 2.3% had a high degree of burnout. These findings challenge the hypothesis of high stress being associated with high burnout, as nursing managers can be supposed to have a highly demanding job due to their intermediary position within the hospital hierarchy. Variations of burnout by personal, work-related, and organizational characteristics mainly concerned emotional exhaustion. Conclusion. Though nursing managers face a highly demanding job, they may benefit from resources (including coping strategies and empowerment which help counterbalance job stress. Unequal distribution of resources may play a central role when facing burnout.

  12. Nurse managers' work life quality and their participation in knowledge management: a correlational study.

    Science.gov (United States)

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

    2015-01-01

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

  13. Nurse managers' perception of night-shift napping: A cross-sectional survey.

    Science.gov (United States)

    Dalky, Heyam F; Raeda, AbuAlRub F; Esraa, Aldalqamouni A

    2017-10-04

    Night-shift work often results in sleep deprivation, and this in turn results in fatigue that jeopardizes both nurse and patient safety. Napping is considered a viable deterrent to fatigue, yet hospital administration has been slow to adopt napping. To identify nurse managers' knowledge and approval of napping practices for nurses on night shifts. Nurse managers at nine Jordanian hospitals (n = 129) were surveyed using an Arabic version of a questionnaire previously used in a Canadian study. Descriptive statistics were used to describe results, and a one-way ANOVA was used to determine if relationships existed among nurse manager's approval of napping and nurse demographic characteristics. The majority of nurse managers (61%) knew nurses were napping during breaks. However, the managers reported there was no written policy for napping. A majority thought there were more benefits to napping than drawbacks. Some 55% of nurse managers recognized fatigue as a cause of errors or incidents regarding patient safety, and 40% perceived fatigue to be a factor in staff injuries. This study supports an urgent need for shared responsibility among nursing administration, and bedside nurses to develop evidence-based programs to counteract the effects of nurse fatigue. © 2017 Wiley Periodicals, Inc.

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

    Science.gov (United States)

    Keys, Yolanda

    2014-01-01

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

  15. Conflict coaching training for nurse managers: a case study of a two-hospital health system.

    Science.gov (United States)

    Brinkert, Ross

    2011-01-01

    This study evaluated the application of the Comprehensive Conflict Coaching model in a hospital environment. Conflict coaching involves a coach working with a client to improve the client's conflict understanding, interaction strategies and/or interaction skills. The training of nurse managers as conflict coaches is an innovative continuing education programme that partially addresses conflict-related concerns in nursing. Twenty nurse managers trained as conflict coaches and each coached a supervisee. Qualitative data were gathered from nurse managers, supervisees and senior nursing leaders over an 8-month period and organized using standard programme evaluation themes. Benefits included supervisor conflict coaching competency and enhanced conflict communication competency for nurse managers and supervisees facing specific conflict situations. Challenges included the management of programme tensions. Additional benefits and challenges are discussed, along with study limitations. Conflict coaching was a practical and effective means of developing the conflict communication competencies of nurse managers and supervisees. Additional research is needed. Conflict is common in nursing. Conflict coaching is a new conflict communication and supervision intervention that demonstrates initial promise. Conflict coaching seems to work best when supported by a positive conflict culture and integrated with other conflict intervention processes. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.

  16. Inre och yttre motivation till träning : en kvalitativ studie bland regebundet aktiva kvinnor

    OpenAIRE

    Jonsson, Johanna

    2015-01-01

    Bakgrund: Regelbunden träning är viktig för både fysiskt och psykisktvälbefinnande. För att bibehålla en regelbundenhet i träningen krävs det ettengagemang och en motivation. En person kan motiveras av både inre ochyttre faktorer beroende på personens intresse. Trots att människor tenderaratt vara mer stillasittande, tycks intresset för träning och hälsa öka. Inteminst syns detta på sociala medier, där bilder och inlägg medträningsbudskap förmedlas frekvent. Syfte: Studiens syfte är att under...

  17. Resolving the ethical dilemma of nurse managers over chemically-dependent colleagues.

    Science.gov (United States)

    Chiu, W; Wilson, D

    1996-12-01

    This paper addresses the nurse manager's role regarding chemically-dependent nurses in the workplace. The manager may intervene by: terminating the contract of the impaired colleague; notifying a disciplinary committee; consulting with a counselling committee; or referring the impaired nurse to an employee assistance programme. A dilemma may arise about which of these interventions is ethically the best. The ethical theories relevant to nursing involve ethical relativism, utilitarianism, Kantian ethics, Kohlberg's justice, and Gilligan's ethic of care. Nurse managers first need to understand these theories in order to clarify their own perceptions and attitudes towards chemical dependency, and then satisfactorily resolve this ethical dilemma. Education and social learning are routes to a better understanding of chemical dependency and to broadening the ethical dimensions of nurse managers.

  18. A Phenomenological Study of Nurse Manager Interventions Related to Workplace Bullying.

    Science.gov (United States)

    Skarbek, Anita J; Johnson, Sandra; Dawson, Christina M

    2015-10-01

    The aim of this study was to acquire nurse managers' perspectives as to the scope of workplace bullying, which interventions were deemed as effective and ineffective, and what environmental characteristics cultivated a healthy, caring work environment. Research has linked workplace bullying among RNs to medical errors, unsafe hospital environments, and negative patient outcomes. Limited research had been conducted with nurse managers to discern their perspectives. Six nurse managers from hospital settings participated in in-depth, semistructured interviews. Ray's theory of bureaucratic caring guided the study. These themes emerged: (a) awareness, (b) scope of the problem, (c) quality of performance, and (d) healthy, caring environment. Findings indicated mandated antibullying programs were not as effective as individual manager interventions. Systems must be in place to hold individuals accountable for their behavior. Communication, collective support, and teamwork are essential to create environments that lead to the delivery of safe, optimum patient care.

  19. Nurse manager perceptions of role satisfaction and retention at an academic medical center.

    Science.gov (United States)

    Zwink, Jennifer E; Dzialo, Maureen; Fink, Regina M; Oman, Kathleen S; Shiskowsky, Kaycee; Waite, Kathi; DeVine, Deborah; Sanders, Carolyn L; Le-Lazar, Jamie T T

    2013-03-01

    The aim of this study was to explore the perceptions of inpatient acute care nurse managers (NM) employed at an academic Magnet® hospital about factors that influence NM retention, including current work environment, satisfaction, work-life balance, sucssful NM traits, and personal development and educational needs. Nurse managers are challenged with increased workloads impacting their ability to implement all role components. A qualitative descriptive study design used focus group methodology to explore perceptions of the NM role. Nurse managers identified staff recognition, support, peer relationships, collaboration, and ability to make positive change as factors influencing their decision to remain in the role. Burnout factors included workload issues, work-life imbalance, and difficulty sustaining positive relationships. Traits supporting success were communication, resiliency, integrity, and a visionary outlook. Suggestions for NM development and education were identified. Findings can be used to improve NM satisfaction, work-life balance, recruitment, retention, and succession planning.

  20. INR participation in the IAEA research project investigating the influence of hydrogen absorption on zirconium alloy behavior

    International Nuclear Information System (INIS)

    Roth, Maria; Radu, Vasile; Dobrea, Dumitru; Pitigoi, Vasile

    2003-01-01

    The paper summarizes the results obtained at INR Pitesti from its participation in the research project coordinated by IAEA Vienna in cooperation with Chalk River and AECL Canada, titled 'Hydrogen and Hydride Induced Degradation of the Mechanical and Physical Properties of Zirconium-based Alloys'. Evidenced is the contribution of INR Pitesti in the works of this project as well as the benefits of this participation for Romania as owner of CANDU type reactor. In the frame this project new results concerning the propagation rate of DHC type cracks in pressure tubes in CANDU reactors were obtained. The same method used to investigate the DHC project was adapted for determination of other quantities of interest related to structural integrity of the materials. The methodology was applied for testing the pressure tubes in Cernavoda NPP Unit 1. The contribution of INR team to statistical processing of data obtained in all the laboratories participating in this project is also highlighted. Opportunity afforded by IAEA to INR Pitesti to bring its contribution to the development of this project of international cooperation together with other well-known institutions and the support from RAAN are acknowledged. These opened ways for other fruitful international cooperation

  1. [Knockdown of InR gene in ventral nephrocytes promotes resistance to toxic stress in Drosophila melanogaster females].

    Science.gov (United States)

    Andreenkova, O V; Karpova, E K; Menshanov, P N; Rauschenbach, I Yu

    2015-02-01

    Hemolymph filtration in insects is performed by nephrocytes, additional cells of the circulatory system that are not connected to Malpighian vessels. Drosophila has two types of nephrocytes: the ventral ("garland"), which are situated around the connection site of the esophagus and proventriculus, and the pericardial, which are localized around the heart. In this study, we examined the role of the of insulin-like receptor (InR)gene in regulation of the function of ventral nephrocytes (VNC) in D. melanogaster females. Immunofluorescent analysis of female VNC with anti-InR antibodies revealed for the first time that the InR gene is expressed in VNC cells. To determine whether a change in the level of InR expression has an effect on VNC function in Drosophila females, we implemented an antisense suppressor of the InR gene, together with a driver that is expressed specifically in VNC. VNC function was evaluated by survival of the females exposed to toxic stress (treatment with AgNO3). This study has shown for the first time that suppression of InR expression in VNC leads to a rise in the survival of flies under conditions of toxic stress.

  2. [From classical management to contemporary management: understanding new concepts to empower nursing management].

    Science.gov (United States)

    Spagnol, Carla Aparecida

    2002-01-01

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

  3. Nurse managers' strategies for feeling less drained by their work: an action research and reflection project for developing emotional intelligence.

    Science.gov (United States)

    Taylor, Bev; Roberts, Sue; Smyth, Therese; Tulloch, Moira

    2015-10-01

    To raise nurse managers' critical awareness of practice problems; uncover practice constraints and improve work effectiveness. Nurse management requires skills and knowledge, underscored by emotional intelligence. The research improved participants' practice and personal insights. Purposive sampling targeted nurse managers interested in improving their practice. Three experienced female nurse managers met fortnightly in a group, for 1 hour, for 10 meetings. The methods included: writing and sharing de-identified journal reflections; critically analysing practice stories; identifying a thematic concern; generating action strategies; and instituting and revising the action plan. Phase One resulted in the identification of the issue of 'being drained by the intensity of nurse managers' work'. The participants adopted five strategies: debriefing problematic situations; deflecting multiple requests; diffusing issues; naming dysfunctional behaviours; and regrouping. In Phase Two, participants implemented and revised the action plan strategies, which resulted in them feeling less drained by their work. Strategies can lessen nurse managers' sense of personal depletion. However, strategies cannot guarantee success every time because the emotional intelligence is integral to nurse management. Action research and reflection assist nurse managers to improve their practice and develop their emotional intelligence. © 2014 John Wiley & Sons Ltd.

  4. Transcriptional repressor role of PocR on the 1,3-propanediol biosynthetic pathway by Lactobacillus panis PM1.

    Science.gov (United States)

    Kang, Tae Sun; Korber, Darren R; Tanaka, Takuji

    2014-06-01

    The regulatory role of a transcriptional regulator (PocR) in the 1,3-propanediol biosynthetic pathway of Lactobacillus panis PM1 contributes to the optimization of 1,3-propanediol production by this strain, which potentially will lead to 1,3-propanediol manufacturing efficiencies. Lactobacillus panis PM1 can utilize a 1,3-propanediol (1,3-PDO) biosynthetic pathway, consisting of diol dehydratase (PduCDE) and 1,3-PDO dehydrogenase, as a NADH recycling system, to survive under various environmental conditions. In this study, we identified a key transcriptional repressor (PocR) which was annotated as a transcriptional factor of AraC family as part of the 1,3-PDO biosynthetic pathway of L. panis PM1. The over-expression of the PocR gene resulted in the significant repression (81 %) of pduC (PduCDE large subunit) transcription, and subsequently, the decreased activity of PduCDE by 22 %. As a result of the regulation of PduCDE, production of both 3-hydroxypropionaldehyde and 1,3-PDO in the PocR over-expressing strain were significantly decreased by 40 % relative to the control strain. These results clearly demonstrate the transcriptional repressor role of PocR in the 1,3-PDO biosynthetic pathway.

  5. Relationship between leadership styles of nurse managers and nurses' job satisfaction in Jimma University Specialized Hospital.

    Science.gov (United States)

    Negussie, Nebiat; Demissie, Asresash

    2013-03-01

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

  6. Nurse-Managed Clinics: A Blueprint for Success Using the Covey Framework.

    Science.gov (United States)

    Starck, Patricia L.; And Others

    1995-01-01

    Describes the process from inception to successful operation of a university-based, nurse-managed clinic, based on Covey's seven habits of highly effective people. Includes information on the planning process, financing, political strategies for gaining approval, and ongoing development of services. (JOW)

  7. Relaxation training methods for nurse managers in Hong Kong: a controlled study.

    Science.gov (United States)

    Yung, Paul M B; Fung, Man Yi; Chan, Tony M F; Lau, Bernard W K

    2004-12-01

    Nurse managers are under increased stress because of excessive workloads and hospitals' restructuring which is affecting their work tasks. High levels of stress could affect their mental health. Yet, few stress management training programmes are provided for this population. The purpose of this study was to apply stretch-release relaxation and cognitive relaxation training to enhance the mental health for nurse managers. A total of 65 nurse managers in Hong Kong were randomly assigned to stretch-release relaxation (n = 17), cognitive relaxation (n = 18), and a test control group (n = 35). Mental health status was assessed using the Chinese version of State-Trait Anxiety Inventory and the Chinese version of the General Health Questionnaire. Participants were assessed at the pretreatment session, the fourth posttreatment session, and at the 1-month follow-up session. The results revealed both the stretch-release and cognitive relaxation training enhanced mental health in nurse managers in Hong Kong. The application of relaxation training in enhancing mental health status for nurses and health professionals is discussed.

  8. The skills gap in nursing management in South Africa: a sectoral analysis: a research paper.

    Science.gov (United States)

    Pillay, Rubin

    2010-03-01

    To identify competencies important for effective nursing management and to assess managers' proficiency therein. A lack of management capacity has been identified as the key stumbling block to health delivery in South Africa. Despite nursing managers being central to overcoming the challenges facing health care, there has been a paucity of research that empirically evaluates their skill levels. A survey was conducted among 171 senior nursing managers in South Africa using a self-administered questionnaire. Public sector managers assessed themselves as being relatively less competent than private sector managers. The largest skill gaps for public sector managers were for 'ethico-legal', 'task-related' and 'controlling' skills whereas those for private sector managers were for 'ethico-legal', 'health-related ' and 'task-related' skills. This research confirmed the lack of management capacity within the health sector and identified areas in which the skills deficit was most significant for both the public and private sectors. These findings reflect the needs of nursing managers and will be useful in the conceptualization, design and delivery of health management programmes aimed at enhancing management and leadership capacity in the health sector in South Africa.

  9. Developing a decision support system to meet nurse managers' information needs for effective resource management.

    Science.gov (United States)

    Ruland, C M

    2001-01-01

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

  10. The influence of leadership practices and empowerment on Canadian nurse manager outcomes.

    Science.gov (United States)

    Spence Laschinger, Heather K; Wong, Carol A; Grau, Ashley L; Read, Emily A; Pineau Stam, Lisa M

    2012-10-01

    To examine the influence of senior nurse leadership practices on middle and first-line nurse managers' experiences of empowerment and organizational support and ultimately on their perceptions of patient care quality and turnover intentions. Empowering leadership has played an important role in staff nurse retention but there is limited research to explain the mechanisms by which leadership influences nurse managers' turnover intentions. This study was a secondary analysis of data collected using non-experimental, predictive mailed survey design. Data from 231 middle and 788 first-line Canadian acute care managers was used to test the hypothesized model using path analysis in each group. The results showed an adequate fit of the hypothesized model in both groups but with an added path between leadership practices and support in the middle line group. Transformational leadership practices of senior nurses empower middle- and first-line nurse managers, leading to increased perceptions of organizational support, quality care and decreased intent to leave. Empowered nurse managers at all levels who feel supported by their organizations are more likely to stay in their roles, remain committed to achieving quality patient care and act as influential role models for potential future leaders. © 2011 Blackwell Publishing Ltd.

  11. Professional Values, Job Satisfaction, and Intent to Leave Among Nursing Managers.

    Science.gov (United States)

    Kantek, Filiz; Kaya, Ayla

    2017-08-01

    The professional values that are typically attributed to nursing managers influence the behaviors of staff nurses as well as of nursing managers. Therefore, the efficient planning and implementation of nursing services require that nursing managers raise their awareness of professional nursing values. This study aims to investigate the correlations between professional values, job satisfaction, and intent to leave the job and the institution. This descriptive and cross-sectional study was conducted on 216 nursing managers in nine different hospitals in Turkey. The data were collected using a personal information form, Nursing Professional Values Scale, Minnesota Job Satisfaction Questionnaire, and scales on intent to leave the job and the institution. Results indicate a positive correlation between the professional values of nurses and their job satisfaction and suggest a negative correlation between professional values and intent to leave the job and the institution. Furthermore, agency was found to be a determinant of job satisfaction. Strong professional values were found to increase job satisfaction and decrease the intent to leave the job and the institution.

  12. Competency of Graduate Nurses as Perceived by Nurse Preceptors and Nurse Managers

    Science.gov (United States)

    Wise, Vanessa

    2013-01-01

    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.…

  13. Nurse manager perspective of staff participation in unit level shared governance.

    Science.gov (United States)

    Cox Sullivan, Sheila; Norris, Mitzi R; Brown, Lana M; Scott, Karen J

    2017-11-01

    To examine the nurse manager perspective surrounding implementation of unit level shared governance in one Veterans Health Administration facility. Nursing shared governance is a formal model allowing nursing staff decision-making input into clinical practice, quality improvement, evidence-based practice and staff professional development. Unit level shared governance is a management process where decision authority is delegated to nursing staff at the unit level. Convenience sampling was used to recruit ten nurse managers who participated in face-to-face semi-structured interviews. Data were analysed using content analysis and constant comparison techniques. Demographic data were described using descriptive statistics. The participants included seven female and three male nurse managers with seven Caucasian and three African American. Participant quotes were clustered to identify sub-themes that were then grouped into four global themes to describe unit level shared governance. The global themes were: (1) motivation, (2) demotivation, (3) recommendations for success, and (4) outcomes. These research findings resonate with previous studies that shared governance may be associated with increased nurse empowerment, self-management, engagement, and satisfaction. These findings reflect the need for nurse managers to promote and recognize staff participation in unit level shared governance. © 2017 John Wiley & Sons Ltd.

  14. Comparison of local International Sensitivity Index calibration and 'Direct INR' methods in correction of locally reported International Normalized Ratios: an international study. On behalf of the European Action of Anticoagulation

    DEFF Research Database (Denmark)

    Poller, L; Keown, M; Ibrahim, S

    2007-01-01

    collaborative study at 77 centers has compared local INR correction using the two alternative methods recommended in the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis guidelines: local ISI calibration and 'Direct INR'. METHODS: Success of INR correction...

  15. Stress and ways of coping among nurse managers: An integrative review.

    Science.gov (United States)

    Labrague, Leodoro J; McEnroe-Petitte, Denise M; Leocadio, Michael C; Van Bogaert, Peter; Cummings, Greta G

    2018-04-01

    To appraise and synthesise empirical studies examining sources of occupational stress and ways of coping utilised by nurse managers when dealing with stress. The Nurse Manager's role is challenging yet draining and stressful and has adverse consequences on an individual's overall health and well-being, patients' outcomes and organisational productivity. Considerable research has been carried out; however, an updated and broader perspective on this critical organisational issue has not been performed. An integrative review. Five databases (Cumulative Index to Nursing and Allied Health Literature, SCOPUS, PubMed, PsychINFO and MEDLINE) were searched to identify relevant articles. Search terms and MeSH terms included: "charge nurse," "coping," "coping strategy," "coping style," "psychological adaptation," "psychological stress," "stressors," "nurse manager" and "unit manager." Twenty-two articles were included in this review. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. Four themes were identified: moderate stress levels, common sources of stress, ways of coping and the impact of nurses' characteristics on stress. Nurse managers experienced moderate levels of stress mainly from heavy workloads, lack of resources and financial responsibilities. Enhancing social support and promoting job control were seen as important in reducing work stress and its related consequences. Additional studies using a more rigorous method and a larger sample size preferably in multicultural settings would shed more light on this topic. Hospital and nurse administrators play an important role in promoting supportive structures for daily professional practice for nurse managers through staffing, organisational resources, support services, leadership and stress management training. © 2017 John Wiley & Sons Ltd.

  16. Two novel POC1A mutations in the primordial dwarfism, SOFT syndrome: Clinical homogeneity but also unreported malformations.

    Science.gov (United States)

    Barraza-García, Jimena; Iván Rivera-Pedroza, Carlos; Salamanca, Luis; Belinchón, Alberta; López-González, Vanesa; Sentchordi-Montané, Lucía; del Pozo, Ángela; Santos-Simarro, Fernando; Campos-Barros, Ángel; Lapunzina, Pablo; Guillén-Navarro, Encarna; González-Casado, Isabel; García-Miñaur, Sixto; Heath, Karen E

    2016-01-01

    Primordial dwarfism encompasses rare conditions characterized by severe intrauterine growth retardation and growth deficiency throughout life. Recently, three POC1A mutations have been reported in six families with the primordial dwarfism, SOFT syndrome (Short stature, Onychodysplasia, Facial dysmorphism, and hypoTrichosis). Using a custom-designed Next-generation sequencing skeletal dysplasia panel, we have identified two novel homozygous POC1A mutations in two individuals with primordial dwarfism. The severe growth retardation and the facial profiles are strikingly similar between our patients and those described previously. However, one of our patients was diagnosed with severe foramen magnum stenosis and subglottic tracheal stenosis, malformations not previously associated with this syndrome. Our findings confirm that POC1A mutations cause SOFT syndrome and that mutations in this gene should be considered in patients with severe pre- and postnatal short stature, symmetric shortening of long bones, triangular facies, sparse hair and short, thickened distal phalanges. © 2015 Wiley Periodicals, Inc.

  17. A review of the clinical utility of INR to monitor and guide administration of prothrombin complex concentrate to orally anticoagulated patients

    DEFF Research Database (Denmark)

    Sølbeck, Sacha; Ostrowski, Sisse R; Johansson, Pär I

    2012-01-01

    the initiation steps of the haemostatic process. The objective of the present review was to reassess the evidence for using INR as a tool to guide administration of prothrombin complex concentrates (PCC) to OAC patients. A Medline and Cochrane database search was conducted using the following keywords...... value to aim for when reversing OAC was found. In three of the studies it was reported that patients reaching their target INR continued to bleed, whereas three studies reviewed reported good haemostatic response also in patients that did not reach their target INR. The present review found limited...

  18. Source and flux of POC in two subtropical karstic tributaries with contrasting land use practice in the Yangtze River Basin

    International Nuclear Information System (INIS)

    Tao, F.-X.; Liu, C.-Q.; Li, S.-L.

    2009-01-01

    Elemental (C/N ratio) and C isotope composition (δ 13 C) of particulate organic C (POC) and organic C content (OC) of total suspended solids (TSS) were determined for two subtropical karstic tributaries of the Yangtze River, the Wujiang (the eighth largest tributary) and Yuanjiang (the third largest tributary). For the latter, two headwaters, the karstic Wuyanghe and non-karstic Qingshuijiang were studied. The Wujiang catchment is subject to intensive land use, has low forest coverage and high soil erosion rate. The δ 13 C of POC covered a range from -30.6 per mille to -24.9 per mille, from -27.6 per mille to -24.7 per mille , and from -26.2 per mille to -23.3 per mille at the low-water stage, while at the high-water stage varied in a span between -28.6 per mille and -24.4 per mille , between -27.7 per mille and -24.5 per mille, and between -27.6 per mille and -24.2 per mille for the Wujiang, Wuyanghe, and Qingshuijiang, respectively. The combined application of C isotopes, C/N ratio, OC, and TSS analyses indicated that catchment soil was the predominant source of POC for the Wujiang while for the Wuyanghe and Qingshuijiang, in-stream processes supplied the main part of POC in winter and summer. A significant increase in δ 13 C value (1.4 per mille ) of POC was found in the Wujiang during summer, and was attributed to the enhanced soil erosion of the dry arable uplands close to the riverbanks of the main channel. Based on a conservative estimate, POC fluxes were 3.123 x 10 10 , 0.084 x 10 10 , and 0.372 x 10 10 g a -1 while export rates of POC were 466, 129, and 218 mg m -2 a -1 for the Wujiang, Wuyanghe, and Qingshuijiang, respectively. The POC export rate for the karstic Wujiang, with intensive land use, was 2-3 higher than that of the karstic Wuyanghe or of the non-karstic Qingshuijiang where soil erosion was minor. Such high values imply rapid degradation of related karstic ecosystems impacted by intensive land use activities, and pose a potential threat to

  19. The use of upconverting phosphors in point-of-care (POC) testing

    Science.gov (United States)

    Tanke, Hans J.; Zuiderwijk, Michel; Wiesmeijer, Karien C.; Breedveld, Robert N.; Abrams, William R.; de Dood, Claudia J.; Tjon Kon Fat, Elisa M.; Corstjens, Paul L. A. M.

    2014-03-01

    Point-of-care (POC) testing is increasingly applied as a cost effective alternative to many diagnostic tests. Key in POC testing is to create sufficient assay sensitivity with relatively low cost reagents and equipment. For this purpose we have employed a unique reporter, upconverting phosphor (UCP) particles, in combination with lateral flow (LF) assays. UCPs, submicron ceramic particles doped with rare earth ions (lanthanides), convert infrared to visible light and do not suffer from autofluorescence which limits conventional fluorescence based assays. Low cost handheld readers and microfluidics were evaluated in various applications. Designed assays are well suited for applications outside diagnostic laboratories, in resource poor settings, and can even be used by patients at home. Using two distinctly different UCP-LF assay formats, we focussed on assays for infectious diseases based on the detection of pathogen-specific antibodies and/or antigens including nucleic acids to demonstrate active infection with HIV. Only minor adaptation of the standard UCP-LF assay format is needed to render the format suitable for applications involving low affinity capture antibodies (e.g. in the detection of neurotoxin, botulism), capture of small molecules (e.g. detection of melatonin, a key hormone in chronopharmacology) or the use of dry UCP reagents (e.g. detection of protein based fruit-ripening markers, of economic interest in agriculture). Finally, we anticipate on developments in healthcare (personalized medicine) by discussing the potential of one of the UCP-LF assay formats to measure serum trough levels of immunodrugs (e.g. infliximab or adalimumab) in patients treated for inflammatory bowel disease and rheumatoid arthritis.

  20. Impact of INR monitoring, reversal agent use, heparin bridging, and anticoagulant interruption on rebleeding and thromboembolism in acute gastrointestinal bleeding.

    Directory of Open Access Journals (Sweden)

    Naoyoshi Nagata

    Full Text Available Anticoagulant management of acute gastrointestinal bleeding (GIB during the pre-endoscopic period has not been fully addressed in American, European, or Asian guidelines. This study sought to evaluate the risks of rebleeding and thromboembolism in anticoagulated patients with acute GIB.Baseline, endoscopy, and outcome data were reviewed for 314 patients with acute GIB: 157 anticoagulant users and 157 age-, sex-, and important risk-matched non-users. Data were also compared between direct oral anticoagulants (DOACs and warfarin users.Between anticoagulant users and non-users, of whom 70% underwent early endoscopy, no endoscopy-related adverse events or significant differences were found in the rate of endoscopic therapy need, transfusion need, rebleeding, or thromboembolism. Rebleeding was associated with shock, comorbidities, low platelet count and albumin level, and low-dose aspirin use but not HAS-BLED score, any endoscopic results, heparin bridge, or international normalized ratio (INR ≥ 2.5. Risks for thromboembolism were INR ≥ 2.5, difference in onset and pre-endoscopic INR, reversal agent use, and anticoagulant interruption but not CHA2DS2-VASc score, any endoscopic results, or heparin bridge. In patients without reversal agent use, heparin bridge, or anticoagulant interruption, there was only one rebleeding event and no thromboembolic events. Warfarin users had a significantly higher transfusion need than DOACs users.Endoscopy appears to be safe for anticoagulant users with acute GIB compared with non-users. Patient background factors were associated with rebleeding, whereas anticoagulant management factors (e.g. INR correction, reversal agent use, and drug interruption were associated with thromboembolism. Early intervention without reversal agent use, heparin bridge, or anticoagulant interruption may be warranted for acute GIB.

  1. How staff nurses perceive the impact of nurse managers' leadership style in terms of job satisfaction: a mixed method study.

    Science.gov (United States)

    Morsiani, Giuliana; Bagnasco, Annamaria; Sasso, Loredana

    2017-03-01

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

  2. Status of the development of RU-43 fuel at INR Pitesti

    International Nuclear Information System (INIS)

    Horhoianu, G.

    2008-01-01

    More than 50000 fuel bundles containing natural uranium fuel have been irradiated in the CANDU-6 reactors of Cernavoda-Romania NPP, with a very low defect rate, to a core-average discharge burnup of 170-190 Mwh/kgU. Recovered uranium (RU) is a by-product of many light-water reactor (LWR) fuel recycling programs. After fission products and plutonium (Pu) have been removed from spent LWR fuel, RU is left. A fissile content in the RU of 0.9 to 1.1% makes it impossible for reuse in an LWR without re-enrichment, but CANDU reactors have a sufficiently high neutron economy to use RU as fuel. RU from spent LWR fuel can be considered as a lower cost source of enrichment at the optimal enrichment level for CANDU fuel pellets. In Europe the feedstock of RU is approaching thousands tones and would provide sufficient fuel for hundreds CANDU-6 reactors years of operation. The use of RU fuel offers significant benefits to CANDU reactor operators. RU fuels improves fuel cycle economics by increasing the fuel burnup, which enables large cost reductions in fuel consumption and in spent fuel disposal. RU fuel offers enhanced operating margins that can be applied to increase reactor power. These benefits can be realized using existing fuel production technologies and practices, and with almost negligible changes to fuel receipt and handling procedures at the reactor. The application of RU fuel could be an important element in Cernavoda NPP. For this reason the Institute for Nuclear Research (INR), Pitesti has started a research programme aiming to develop a new fuel bundle RU-43 for extended burnup operation. The most relevant calculations performed on this fuel bundle design version are presented. Also, the stages of an experimental program aiming to verify the operating performance are briefly described in this paper. (orig.)

  3. The Active Metabolite of Warfarin (3'-Hydroxywarfarin) and Correlation with INR, Warfarin and Drug Weekly Dosage in Patients under Oral Anticoagulant Therapy: A Pharmacogenetics Study.

    Science.gov (United States)

    Gemmati, Donato; Burini, Francesco; Talarico, Anna; Fabbri, Matteo; Bertocco, Cesare; Vigliano, Marco; Moratelli, Stefano; Cuneo, Antonio; Serino, Maria Luisa; Avato, Francesco Maria; Tisato, Veronica; Gaudio, Rosa Maria

    2016-01-01

    Warfarin oral anticoagulant therapy (OAT) requires regular and frequent drug adjustment monitored by INR. Interindividual variability, drug and diet interferences, and genetics (VKORC1 and CYP2C9) make the maintenance/reaching of stable INR a not so easy task. HPLC assessment of warfarin/enantiomers was suggested as a valid monitoring-tool along with INR, but definite results are still lacking. We evaluated possible correlations between INR, warfarin/3'-hydroxywarfarin, and drug weekly dosage aimed at searching novel alternatives to OAT monitoring. VKORC1/CYP2C9 pharmacogenetics investigation was performed to account for the known influence on warfarin homeostasis. 133 OAT patients were recruited and assessed for warfarin/3'-hydroxywarfarin serum levels (HPLC), INR, and VKORC1 and CYP2C9 genotypes. A subgroup of 52 patients were monitored in detail (5 consecutive controls; c0-c4) till the target INR was reached. Correlation analyses were performed in both groups. In the whole OAT group both warfarin and 3'-hydroxywarfarin correlate with INR at comparable degree (r2 = 0.0388 and 0.0362 respectively). Conversely, warfarin weekly dosage better correlates with warfarin than with 3'-hydroxywarfarin (r2 = 0.0975 and r2 = 0.0381 respectively), but considering together warfarin plus 3'-hydroxywarfarin the correlation strongly increased (r2 = 0.1114; ppharmacogenetics studies confirmed that patients carrying the VKORC1 variant-allele required lower warfarin maintenance dosage and that the combination of VKORC1 and CYP2C9 yielded a warfarin responsive index (WRI) inversely related to the number variant alleles. Our results overall suggest that 3'-hydroxywarfarin monitoring could be of great advantage in INR monitoring respect to classical warfarin assessment showing significant contribution also in multivariate analysis. Therefore, additional active metabolites should be recognized and investigated as novel useful indicators.

  4. Post Cyclone (PoC) : An innovative way to reduce the emission of fines from industrial cyclones

    NARCIS (Netherlands)

    Ray - Bhowmick, Madhumita; Luning, P.E.; Hoffmann, A.C; Plomp, A.; Beumer, M.I.L.

    A novel approach for reducing the emission of industrial-scale cyclones of particles smaller than 10 mu m is presented. Utilizing the strong swirl already present in the vortex finder of a conventional cyclone, the escaped dust from the cyclone is collected in a so-called ''Post Cyclone'' (PoC),

  5. Comparing nurse managers and nurses' perceptions of nurses' self-leadership during capacity building.

    Science.gov (United States)

    Jooste, Karien; Cairns, Lindi

    2014-05-01

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

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

    Science.gov (United States)

    Thompson, Cheryl W; Bucher, Julia A

    2013-01-01

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

  7. Educational gaps and solutions for early-career nurse managers' education and participation in quality improvement.

    Science.gov (United States)

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

    2015-04-01

    The objective of this study was to examine early-career frontline nurse managers' (FLNMs') reported educational preparedness and participation in quality improvement (QI). Frontline nurse managers are vitally important for leading QI. However, it is not well known if they have adequate knowledge and skills to lead this important function. We examined cross-sectional survey data from 42 FLNMs using descriptive statistics. About 30% of FLNMs reported being very prepared across 12 measured QI skills by schools or employers and 35% reported participating in a specific clinical effort to improve patient care on their unit more than once a month. More than 50% reported having good organizational support for QI, but only about 30% reported being rewarded for their contributions to QI. Our study highlights opportunities for development in QI for FLNMs and offers some solutions for nurse executives that can bridge the educational gaps.

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

    Directory of Open Access Journals (Sweden)

    Gabriela Marcellino de Melo Lanzoni

    2015-06-01

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

  9. The protection of radioactive nuclide and nursing management in DSA room

    International Nuclear Information System (INIS)

    Zhang Guimin

    2009-01-01

    Objective: To discuss the protection of radioactive nuclide and nursing management in DSA room. Methods: The clinical state of the protection of radioactive 131 I nuclide and nursing management in DSA room was retrospectively summarized. Results: The standard management for the protection of radioactive nuclide in DSA room was established. The main management schemas included the management of personnel, the management of professional skills and, specialty, the management of radioactive drugs and abandoned odds and ends, preoperative health education, etc. Conclusion: The standard management can ensure that the patients get a good radionuclide therapy in DSA room, and, at the same time, the working environment can be effectively protected and the professional nursing staff can be well trained. (authors)

  10. Participation of the nurse manager in the process of hospital accreditation

    Directory of Open Access Journals (Sweden)

    Andréia Guerra Siman

    Full Text Available This study's aim was to understand the role of nurse managers in the process of hospital accreditation. This qualitative case study was conducted in a large private hospital in Belo Horizonte, MG, Brazil. Five nurse managers were interviewed using a semi-structured script from April to May, 2011 and content analysis was used to interpret the data. Results show the strategic position of this professional, his/her managerial skills and participation in the implementation and maintenance of accreditation, and the importance of care management. Nurses have played managerial roles with greater autonomy, connecting inter-sector care, which contrasts with the curative model, and have established partnerships with different social and institutional segments, adopting standards for teamwork. Managerial, healthcare, and educational work is performed from a procedural and indivisible perspective.

  11. Exploring Nurse Manager Support of Evidence-Based Practice: Clinical Nurse Perceptions.

    Science.gov (United States)

    Caramanica, Laura; Spiva, LeeAnna

    2018-05-01

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

  12. Integrating the nursing management minimum data set into the logical observation identifier names and codes system.

    Science.gov (United States)

    Subramanian, Amarnath; Westra, Bonnie; Matney, Susan; Wilson, Patricia S; Delaney, Connie W; Huff, Stan; Huff, Stanley M; Huber, Diane

    2008-11-06

    This poster describes the process used to integrate the Nursing Management Minimum Data Set (NMMDS), an instrument to measure the nursing context of care, into the Logical Observation Identifier Names and Codes (LOINC) system to facilitate contextualization of quality measures. Integration of the first three of 18 elements resulted in 48 new codes including five panels. The LOINC Clinical Committee has approved the presented mapping for their next release.

  13. Psychological contracts and commitment amongst nurses and nurse managers: a discourse analysis.

    Science.gov (United States)

    McCabe, T J; Sambrook, Sally

    2013-07-01

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

  14. Nursing Management Visionary Leader 2006: North Carolina chief nurse officer earns journal's annual leadership award.

    Science.gov (United States)

    Wessman, Joan

    2007-01-01

    The following manuscript is the winning Visionary Leader 2006 entry submitted to Nursing Management by the staff of Moses Cone Health System, Greensboro, N.C., in recognition of Joan Wessman, chief nurse officer at the organization. Joan was formally recognized for her achievements during the opening ceremony of Congress 2006, October 15, in Philadelphia, Pa., during which she received the award, sponsored this year by B.E. Smith.

  15. Leadership styles of nurse managers and registered sickness absence among their nursing staff.

    Science.gov (United States)

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

    2011-01-01

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

  16. "Hit the ground running": perspectives of new nurses and nurse managers on role transition and integration of new graduates.

    Science.gov (United States)

    Chernomas, Wanda M; Care, W Dean; McKenzie, Jo-Ann Lapointe; Guse, Lorna; Currie, Jan

    2010-01-01

    The workplace for new graduates must be a constructive learning environment to facilitate their development. Nurse managers need new graduates who can "hit the ground running." Conflict between the needs of new nurses and the realities of the workplace often creates role confusion and tension in new graduates and threatens employers' ability to retain them. As part of a larger study that examined the effectiveness of a new strategy on new nurse retention and workplace integration, we conducted focus groups with new nurses and nurse managers. This paper discusses the perspectives of new nurses on their role transition from graduates to practising professionals and the perspectives of nurse managers on the workplace integration of new nurses. The thematic findings integrate new nurses' perspectives on their needs during role transition with the perspectives of nurse managers in meeting those needs. The discussion includes strategies to facilitate successful transition and integration of new nurses into the workplace within the context of recruitment and retention.

  17. Sources and fate of organic (DOC, POC, CDOM) and inorganic (DIC) carbon in a mangrove dominated estuary (French Guiana)

    Science.gov (United States)

    Ray, R.; Michaud, E.; Vantrepotte, V.; Aller, R. C.; Morvan, S.; Thouzeau, G.

    2016-12-01

    We studied the mangrove dominated Sinnamary estuarine system in French Guiana during the dry and wet seasons in 2015 to examine the sources, transport and fate of surface water DOC, POC and DIC along the salinity gradient and the effect of tidal fluctuations on carbon dynamics. Elemental ratios, stable isotopes and optical properties (absorption) were applied as proxies to delineate the sources and molecular structure of the organic carbon. Results showed that during the wet season there were significant net inputs of POC and DOC along the salinity gradient from mangroves and enhanced surface runoff. Time series performed during the dry season at a station in channel water adjacent to mangroves revealed mangrove-derived export and exchanges of DOC and POC during the ebb and marine algae import during the flood. DOC was the dominant form of carbon in both seasons with DOC:POC ratios typically between 13 and 40. Both δ13DOC and CDOM descriptors (e.g., S275-295 and a*412) confirmed mangrove litter leaching to be the primary contributor of high molecular weight dissolved organic matter in the wet season which was replaced by marine phytoplanktonic OC during transport offshore in the dry season. CDOM aromaticity is lower in the dry season as mangrove inputs decrease. POC showed similar trends as DOC, with maximum contributions of terrestrial litter in the river and mixing zone, and in situ production dominant in the marine zone. The entire estuary is heterotrophic, exhibiting high pCO2 (837-5575µatm) and oxygen undersaturation (59-86%) in both seasons, and substantial CO2 emission fluxes (278-3671mmol m-2 d-1). Intense local remineralization and laterally transported CO2 originating from mangrove benthic respiration could account for the water column pCO2 enrichment during low tide and night time. Keywords: Organic carbon, stable isotopes, CDOM, pCO2, mangrove, French Guiana

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

    Science.gov (United States)

    Marx, Marcia

    2014-11-01

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

  19. Applying an ethical decision-making tool to a nurse management dilemma.

    Science.gov (United States)

    Toren, Orly; Wagner, Nurith

    2010-05-01

    This article considers ethical dilemmas that nurse managers may confront and suggests an ethical decision-making model that could be used as a tool for resolving such dilemmas. The focus of the article is on the question: Can nurse managers choose the ethically right solution in conflicting situations when nurses' rights collide with patients' rights to quality care in a world of cost-effective and economic constraint? Managers' responsibility is to ensure and facilitate a safe and ethical working environment in which nurses are able to give quality care to their patients. In nursing it is frequently declared that managers' main obligations are to patients' needs and their rights to receive quality care. However, managers' ethical responsibilities are not only to patients but also to the nurses working in their institution. This article describes a real (but disguised) situation from an Israeli health care context to illustrate the dilemmas that may arise. The question is posed of whether nurse managers can maintain patients' and nurses' rights and, at the same time, fulfill their obligation to the conflicting demands of the organization. The article also offers a way to solve conflict by using an ethical decision-making model.

  20. Resilience and work-life balance in first-line nurse manager.

    Science.gov (United States)

    Kim, Miyoung; Windsor, Carol

    2015-03-01

    The aim of this study was to explore how first-line nurse managers constructed the meaning of resilience and its relationship to work-life balance for nurses in Korea. Participants were 20 first-line nurse managers working in six university hospitals. Data were collected through in-depth interviews from December 2011 to August 2012, and analyzed using Strauss and Corbin's grounded theory method. Analysis revealed that participants perceived work-life balance and resilience to be shaped by dynamic, reflective processes. The features consisting resilience included "positive thinking", "flexibility", "assuming responsibility", and "separating work and life". This perception of resilience has the potential to facilitate a shift in focus from negative to positive experiences, from rigidity to flexibility, from task-centered to person-centered thinking, and from the organization to life. Recognizing the importance of work-life balance in producing and sustaining resilience in first-line nurse managers could increase retention in the Korean nursing workforce. Copyright © 2015. Published by Elsevier B.V.

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

    Science.gov (United States)

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

    2014-01-01

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

  2. Factors influencing job satisfaction of front line nurse managers: a systematic review.

    Science.gov (United States)

    Lee, How; Cummings, Greta G

    2008-10-01

    The purpose of this study was to systematically review the research literature that examined the determinants of front line nurse managers' job satisfaction. Front line managers are the vital link between senior management and clinical nurses. They influence organizational culture and outcomes for patients and staff so their job satisfaction and ultimately retention is of importance. A review of research articles that examined the determinants of front line nurse managers' job satisfaction was conducted. These managers supervise staff nurses and have direct responsibility for the management of a nursing unit or team in any type of healthcare facility. Fourteen studies were included in the final analysis. Evidence of significant positive relationships were found between span of control, organizational support, empowerment and the job satisfaction of front line nurse managers. The review suggests that job satisfaction of front line managers may be improved by addressing span of control and workload, increasing organizational support from supervisors and empowering managers to participate in decision-making. Healthcare organizations may enhance the recruitment, retention and sustainability of future nursing leadership by addressing the factors that influence job satisfaction of front line managers.

  3. Using nurse managers' perceptions to guide new graduates toward positive nurse relationships.

    Science.gov (United States)

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

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

  4. Managerial competence of first-line nurse managers: A concept analysis.

    Science.gov (United States)

    Gunawan, Joko; Aungsuroch, Yupin

    2017-02-01

    A variety of terms are used interchangeably to define managerial competence of first-line nurse managers. This has resulted in a degree of ambiguity in the way managerial competence is described. The aim of this concept analysis is to clarify what is meant by managerial competence of first-line nurse managers internationally, what attributes signify it, and what its antecedents and consequences are. The Walker and Avant concept analysis approach was applied. The attributes of managerial competence include developing self, planning, organizing, leading, managing legal and ethical issues, and delivering health care. Antecedents to managerial competence include internal and external factors. Consequences include nurse performances, nurse and patient outcomes, intention to stay of nurses, and nurse and patient satisfaction. This analysis helps first-line nurse managers to understand the concept and determine where the responsibility lies in establishing a definition of managerial competence. It is recommended that middle and top managers should be aware of the internal and external factors as antecedents of the concept. Further research is needed to illuminate the attributes of managerial competence in relation to antecedents and the potential effect upon the consequences, and the need to establish managerial competence evaluation. © 2017 John Wiley & Sons Australia, Ltd.

  5. The effectiveness of educational supervisors from the viewpoints of nurse managers and clinical nurses

    Directory of Open Access Journals (Sweden)

    M Khodayarian

    2012-09-01

    Full Text Available Introduction: The educational supervisors should attempt to plan and implement nurses’ development programs according to the principles of educational process. The present study was conducted to assess the effectiveness of educational supervisors from the viewpoints of clinical nurses and nurse managers in 2007. Methods : 97 clinical nurses and 33 nurse managers in educational hospitals of Yazd participated in this cross sectional study. The questionnaire including 56 items related to expected professional competencies of educational supervisor was prepared and its validity and reliability was confirmed. Overall Cronbach’s alpha was 0.97 ranging from 0.77 to 0.96 for different dimensions which indicated internal consistency of the questionnaire. Results: The results showed 42.3% of nurses considered the function of their hospital as effective, 52.6% as ineffective, and 5.2% as relatively effective. One hundred percent of metrons considered the function of educational supervisors as effective. All the educational supervisors considered their function effective. The study samples reported that all the listed criteria were important in the effectiveness of educational supervisors’ function. Conclusion: In order to improve the effectiveness of educational supervisors’ function their management and leadership competencies should be developed. Competency-based approach is suggested in preparing educational supervisors for implementing the educational process from the problem solving skills. This will help nurse managers to make their work environments a learning and educational institute.

  6. The skills gap in nursing management in the South African public health sector.

    Science.gov (United States)

    Pillay, Rubin

    2011-01-01

    Nurse managers are central to health delivery in South Africa. However, there is a paucity of research that analyzes their competence to successfully discharge their managerial role. To identify the competencies perceived to be important for effective nursing management in the South African public sector and the managers' self-assessed proficiency in these. A cross-sectional survey using a self-administered questionnaire. 215 senior nursing managers at South African public sector hospitals. Respondents rated the level of importance that 51 proposed competencies had in their job and indicated their proficiency in each. Public sector managers ranked controlling as the most important competency, followed by leading, organizing, and self-management. Health/clinical skills, planning, and legal/ethical competencies were ranked as being relatively less important. They assessed themselves as being most competent in self-management, followed by planning, controlling, leading, and specific health skills. The competency gap was the largest for legal/ethical issues, organizing, and controlling. The competency gap for planning and self-management was relatively smaller. This research confirms that there is a lack of management capacity within the public health sector and also identifies the areas in which the lack of knowledge or skills is most significant. © 2011 Wiley Periodicals, Inc.

  7. What do nurse managers say about nurses' sickness absenteeism? A new perspective.

    Science.gov (United States)

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

    2016-01-01

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

  8. The impact of ED nurse manager leadership style on staff nurse turnover and patient satisfaction in academic health center hospitals.

    Science.gov (United States)

    Raup, Glenn H

    2008-10-01

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

  9. On-site emergency intervention plan for nuclear accident situation at INR-Pitesti TRIGA reactor

    International Nuclear Information System (INIS)

    Oprea, I.; Margenu, S.; Preda, M.

    2001-01-01

    evaluate alternative countermeasure strategies in the various stage of an accident. In this way, we have developed at INC Pitesti a computer code namely DOZIM which is presented. The structure of the emergency intervention plan, as objectives, general features and procedures is given. Each year there is organized at INR Pitesti an emergency intervention exercise for a nuclear accident situation at the TRIGA reactor. The main objective of such an exercise is to test the response capability in a nuclear accident situation for all the institutions and organizations from all levels as well as to test the implementation of specific procedures

  10. Stroke unit Nurse Managers' views of individual and organizational factors liable to influence evidence-based practice: A survey.

    Science.gov (United States)

    Drury, Peta; McInnes, Elizabeth; Hardy, Jennifer; Dale, Simeon; Middleton, Sandy

    2016-04-01

    The uptake of evidence into practice may be impeded or facilitated by individual and organizational factors within the local context. This study investigated Nurse Managers of New South Wales, Australia, stroke units (n = 19) in their views on: leadership ability (measured by the Leadership Practices Inventory), organizational learning (measured by the Organizational Learning Survey), attitudes and beliefs towards evidence-based practice (EBP) and readiness for change. Overall Nurse Managers reported high-level leadership skills and a culture of learning. Nurse Managers' attitude towards EBP was positive, although nursing colleague's attitudes were perceived as less positive. Nurse Managers agreed that implementing evidence in practice places additional demands on staff; and almost half (n = 9, 47%) reported that resources were not available for evidence implementation. The findings indicate that key persons responsible for evidence implementation are not allocated sufficient time to coordinate and implement guidelines into practice. The findings suggest that barriers to evidence uptake, including insufficient resources and time constraints, identified by Nurse Managers in this study are not likely to be unique to stroke units. Furthermore, Nurse Managers may be unable to address these organizational barriers (i.e. lack of resources) and thus provide all the components necessary to implement EBP. © 2015 John Wiley & Sons Australia, Ltd.

  11. A fast method to emulate an iterative POCS image reconstruction algorithm.

    Science.gov (United States)

    Zeng, Gengsheng L

    2017-10-01

    Iterative image reconstruction algorithms are commonly used to optimize an objective function, especially when the objective function is nonquadratic. Generally speaking, the iterative algorithms are computationally inefficient. This paper presents a fast algorithm that has one backprojection and no forward projection. This paper derives a new method to solve an optimization problem. The nonquadratic constraint, for example, an edge-preserving denoising constraint is implemented as a nonlinear filter. The algorithm is derived based on the POCS (projections onto projections onto convex sets) approach. A windowed FBP (filtered backprojection) algorithm enforces the data fidelity. An iterative procedure, divided into segments, enforces edge-enhancement denoising. Each segment performs nonlinear filtering. The derived iterative algorithm is computationally efficient. It contains only one backprojection and no forward projection. Low-dose CT data are used for algorithm feasibility studies. The nonlinearity is implemented as an edge-enhancing noise-smoothing filter. The patient studies results demonstrate its effectiveness in processing low-dose x ray CT data. This fast algorithm can be used to replace many iterative algorithms. © 2017 American Association of Physicists in Medicine.

  12. The INR program in 2000-2005 period for developing the national technical support of the nuclear power

    International Nuclear Information System (INIS)

    Gheorghiu, C.

    2001-01-01

    The INR - Pitesti is largely implied in implementing the tasks of high complexity stipulated by the Emergency Directive of the Romanian Government No. 144/30.09.1999 meant to ensure the national technical support for the nuclear power field as well as the development of presupposed international cooperation. The Strategic Program of the Autonomous Authority for Nuclear Activities (RAAN) stipulates the main activities to be carried-out in the period 2000-2005 and beyond, in the frame of 18 specific programs. These programs approaches high priority world wide issues targeting major objectives like efficient operation of NPPs ensuring the design service life, creating conditions for extension of operation duration increasing the safety standard of personnel, of population as well as reducing the impact of nuclear power upon the environmental. Also, the program approaches functionally the problem of safety management of the radioactive waste resulting from nuclear facility operation. Achieving these major objective as well as of those specific laid down in the Strategic Program requires continual supply with material and human resources, refurbishment of material background of INR in its research and development activities as well as a consistent integration of the INR staff of researchers within the international scientific community. Implementing the annual programs included in the Strategic Program will ensure also fulfilment of the international arrangements of our country as well as the realization of the agreements concluded by the Ministry of Industry and Resources and RAAN with analogous authorities from abroad (AECL - Canada, DOE - USA, etc.). This document has the following content: 1. Legislative support and the mission of the program; 2. Program's strategic objectives; 3. General technical objectives of the programs. 4. Financing; 5. Providing and training human resources; 6. Investments for research and development; 7. International cooperation; 8

  13. Gene polymorphisms and the risk of warfarin-induced bleeding complications at therapeutic international normalized ratio (INR)

    Energy Technology Data Exchange (ETDEWEB)

    Pourgholi, Leyla [Department of Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, P.O. Box 1411713138, Tehran (Iran, Islamic Republic of); Department of Pharmacology & Toxicology, School of Pharmacy, Kerman University of Medical Sciences, P.O. Box 7616911319, Kerman (Iran, Islamic Republic of); Goodarzynejad, Hamidreza [Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, P.O. Box 1411713138, Tehran (Iran, Islamic Republic of); Mandegary, Ali [Department of Pharmacology & Toxicology, School of Pharmacy, Kerman University of Medical Sciences, P.O. Box 7616911319, Kerman (Iran, Islamic Republic of); Gastroenterology and Hepatology Research Center, Afzalipour' s Hospital, Imam Highway, P.O. Box 7616913911, Kerman (Iran, Islamic Republic of); Ziaee, Shayan [Department of Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, P.O. Box 1411713138, Tehran (Iran, Islamic Republic of); Talasaz, Azita Hajhosseini [Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, P.O. Box 1411713138, Tehran (Iran, Islamic Republic of); Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences (Iran, Islamic Republic of); Jalali, Arash [Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, P.O. Box 1411713138, Tehran (Iran, Islamic Republic of); Boroumand, Mohammadali, E-mail: maboroumand@yahoo.com [Department of Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, P.O. Box 1411713138, Tehran (Iran, Islamic Republic of)

    2016-10-15

    Background: Bleeding episodes commonly occur in patients on warfarin treatment even in those within therapeutic range of international normalized ratio (INR). The objective of this study was to investigate the effects of the 8 examined polymorphisms on the risk of bleeding complications in a sample of Iranian patients. Methods: A total of 552 warfarin treated patients who maintained on a target INR level of 2.0–3.5 for at least three consecutive intervals were enrolled from those attended our anticoagulation clinics. Ninety-two bleeding events were observed in 87 patients. The presences of the examined polymorphisms were analyzed using polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP). Results: Patients with the T allele in NQO1*2 (CT or TT genotypes) had a higher risk of bleeding than patients with the CC genotype (adjusted OR: 2.25, 95% CI: 1.37 to 3.70, P = 0.001). Those who were carriers of CYP2C9 one-variant haplotypes (*1/*2 or *1/*3) were also found to be associated with the higher risk of bleeding events. Compared to reference group (*1/*1), the odds of bleeding increased for carriers of one variant allele (*1/*2 or *1/*3) (adjusted OR: 1.75, 95% CI: 1.03 to 2.97, P = 0.039). Variant VKORC1, Factor VII, and EPHX1 genotypes were not significantly associated with the risk of bleeding events. Conclusion: The SNP C609T within NQO1 and haplotypes of CYP2C9 (1*2 or 1*3) are independently associated to bleeding complications of warfarin at normal INR. Further studies are required to confirm such associations in diverse racial and ethnic populations. - Highlights: • NQO1 C609T variant is associated with warfarin induced bleeding at therapeutic INR. • Haplotypes of CYP2C9 (1*2 or 1*3) are also associated with bleeding events. • VKORC1, Factor VII, and EPHX1 genotypes were not associated with bleeding risk.

  14. Management of radioactive waste at INR-technical support for processing of radioactive waste from nuclear facilities

    International Nuclear Information System (INIS)

    Bujoreanu, D.; Popescu, I.V.; Bujoreanu, L.

    2009-01-01

    The Institute for nuclear research (INR) subsidiary of the Romanian authority for nuclear activities has its own radwaste treatment plant (STDR). STDR is supposed to treat and condition radioactive waste from the nuclear fuel facility, the TRIGA reactor, post irradiation examination laboratories and other research laboratories of NRI. The main steps of waste processing are: pretreatment (collection, characterization, segregation, decontamination)., treatment (waste volume reduction, radionuclide removal, compositional change), conditioning (immobilization and containerization), interim storage of the packages in compliance with safety requirements for the protection of human health and environmental protection, transport of the packages containing radioactive waste, disposal.

  15. Gene polymorphisms and the risk of warfarin-induced bleeding complications at therapeutic international normalized ratio (INR)

    International Nuclear Information System (INIS)

    Pourgholi, Leyla; Goodarzynejad, Hamidreza; Mandegary, Ali; Ziaee, Shayan; Talasaz, Azita Hajhosseini; Jalali, Arash; Boroumand, Mohammadali

    2016-01-01

    Background: Bleeding episodes commonly occur in patients on warfarin treatment even in those within therapeutic range of international normalized ratio (INR). The objective of this study was to investigate the effects of the 8 examined polymorphisms on the risk of bleeding complications in a sample of Iranian patients. Methods: A total of 552 warfarin treated patients who maintained on a target INR level of 2.0–3.5 for at least three consecutive intervals were enrolled from those attended our anticoagulation clinics. Ninety-two bleeding events were observed in 87 patients. The presences of the examined polymorphisms were analyzed using polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP). Results: Patients with the T allele in NQO1*2 (CT or TT genotypes) had a higher risk of bleeding than patients with the CC genotype (adjusted OR: 2.25, 95% CI: 1.37 to 3.70, P = 0.001). Those who were carriers of CYP2C9 one-variant haplotypes (*1/*2 or *1/*3) were also found to be associated with the higher risk of bleeding events. Compared to reference group (*1/*1), the odds of bleeding increased for carriers of one variant allele (*1/*2 or *1/*3) (adjusted OR: 1.75, 95% CI: 1.03 to 2.97, P = 0.039). Variant VKORC1, Factor VII, and EPHX1 genotypes were not significantly associated with the risk of bleeding events. Conclusion: The SNP C609T within NQO1 and haplotypes of CYP2C9 (1*2 or 1*3) are independently associated to bleeding complications of warfarin at normal INR. Further studies are required to confirm such associations in diverse racial and ethnic populations. - Highlights: • NQO1 C609T variant is associated with warfarin induced bleeding at therapeutic INR. • Haplotypes of CYP2C9 (1*2 or 1*3) are also associated with bleeding events. • VKORC1, Factor VII, and EPHX1 genotypes were not associated with bleeding risk.

  16. Adaptive patch-based POCS approach for super resolution reconstruction of 4D-CT lung data

    International Nuclear Information System (INIS)

    Wang, Tingting; Cao, Lei; Yang, Wei; Feng, Qianjin; Chen, Wufan; Zhang, Yu

    2015-01-01

    Image enhancement of lung four-dimensional computed tomography (4D-CT) data is highly important because image resolution remains a crucial point in lung cancer radiotherapy. In this paper, we proposed a method for lung 4D-CT super resolution (SR) by using an adaptive-patch-based projection onto convex sets (POCS) approach, which is in contrast with the global POCS SR algorithm, to recover fine details with lesser artifacts in images. The main contribution of this patch-based approach is that the interfering local structure from other phases can be rejected by employing a similar patch adaptive selection strategy. The effectiveness of our approach is demonstrated through experiments on simulated images and real lung 4D-CT datasets. A comparison with previously published SR reconstruction methods highlights the favorable characteristics of the proposed method. (paper)

  17. The Active Metabolite of Warfarin (3'-Hydroxywarfarin) and Correlation with INR, Warfarin and Drug Weekly Dosage in Patients under Oral Anticoagulant Therapy: A Pharmacogenetics Study

    Science.gov (United States)

    Talarico, Anna; Fabbri, Matteo; Bertocco, Cesare; Vigliano, Marco; Moratelli, Stefano; Cuneo, Antonio; Serino, Maria Luisa; Avato, Francesco Maria

    2016-01-01

    Objectives Warfarin oral anticoagulant therapy (OAT) requires regular and frequent drug adjustment monitored by INR. Interindividual variability, drug and diet interferences, and genetics (VKORC1 and CYP2C9) make the maintenance/reaching of stable INR a not so easy task. HPLC assessment of warfarin/enantiomers was suggested as a valid monitoring-tool along with INR, but definite results are still lacking. We evaluated possible correlations between INR, warfarin/3’-hydroxywarfarin, and drug weekly dosage aimed at searching novel alternatives to OAT monitoring. VKORC1/CYP2C9 pharmacogenetics investigation was performed to account for the known influence on warfarin homeostasis. Methods 133 OAT patients were recruited and assessed for warfarin/3’-hydroxywarfarin serum levels (HPLC), INR, and VKORC1 and CYP2C9 genotypes. A subgroup of 52 patients were monitored in detail (5 consecutive controls; c0-c4) till the target INR was reached. Correlation analyses were performed in both groups Results In the whole OAT group both warfarin and 3’-hydroxywarfarin correlate with INR at comparable degree (r2 = 0.0388 and 0.0362 respectively). Conversely, warfarin weekly dosage better correlates with warfarin than with 3’-hydroxywarfarin (r2 = 0.0975 and r2 = 0.0381 respectively), but considering together warfarin plus 3’-hydroxywarfarin the correlation strongly increased (r2 = 0.1114; pwarfarin (r2 = 0.2157 and r2 = 0.0549; p = 0.0005 and p = 0.0944 respectively) seeming less affected by drug adjustments in the subgroup of 52 patients who started OAT. The multivariate analyses aimed at estimating the true contribution of 3’-hydroxywarfarin on INR value ascribed it the unique significant value (p = 0.0021) in spite of warfarin who lost association. The pharmacogenetics studies confirmed that patients carrying the VKORC1 variant-allele required lower warfarin maintenance dosage and that the combination of VKORC1 and CYP2C9 yielded a warfarin responsive index (WRI

  18. Carbon cycling and POC turnover in the mesopelagic zone of the ocean: Insights from a simple model

    Science.gov (United States)

    Anderson, Thomas R.; Tang, Kam W.

    2010-08-01

    Carbon budgets of the mesopelagic zone are poorly constrained, highlighting our lack of understanding of the biota that inhabit this environment and their role in the cycling and sequestering of carbon in the deep ocean. A simple food web model of the mesopelagic zone is presented that traces the turnover of particulate organic carbon (POC), supplied as sinking detritus, through to its respiration by the biota via three pathways: colonization and solubilization of detritus by attached bacteria, production of free-living bacteria following losses of solubilization products during particle degradation, and consumption by detritivorous zooplankton. The relative consumption of detritus by attached bacteria was initially specified as 76%, with the remaining 24% by detritivores. Highlighting an asymmetry between consumption and respiration, the resulting predicted share of total respiration due to bacteria was 84.7%, with detritivores accounting for just 6.6% (with 6.5% and 2.2% by bacterivores and higher zooplankton, respectively). Bacteria thus dominated respiration and thereby acted as the principal sink for POC supplied to the mesopelagic zone, whereas zooplankton mainly recycled carbon back to the base of the food web as detritus or dissolved organic carbon rather than respiring it to CO 2. Estimates of respiration are therefore not necessarily a reliable indicator of the relative roles of bacteria and zooplankton in consuming and processing POC in the mesopelagic zone of the ocean. The work highlighted a number of major unknowns, including how little we know in general about the dynamics and metabolic budgets of bacteria and zooplankton that inhabit the mesopelagic zone and, specifically, the degree to which the solubilized products of enzymatic hydrolysis of POC by attached bacteria are lost to the surrounding water, the magnitude and factors responsible for bacterial growth efficiency, the role of microbes in the nutrition of detritivores, and the recycling

  19. WE-G-207-02: Full Sequential Projection Onto Convex Sets (FS-POCS) for X-Ray CT Reconstruction

    International Nuclear Information System (INIS)

    Liu, L; Han, Y; Jin, M

    2015-01-01

    Purpose: To develop an iterative reconstruction method for X-ray CT, in which the reconstruction can quickly converge to the desired solution with much reduced projection views. Methods: The reconstruction is formulated as a convex feasibility problem, i.e. the solution is an intersection of three convex sets: 1) data fidelity (DF) set – the L2 norm of the difference of observed projections and those from the reconstructed image is no greater than an error bound; 2) non-negativity of image voxels (NN) set; and 3) piecewise constant (PC) set - the total variation (TV) of the reconstructed image is no greater than an upper bound. The solution can be found by applying projection onto convex sets (POCS) sequentially for these three convex sets. Specifically, the algebraic reconstruction technique and setting negative voxels as zero are used for projection onto the DF and NN sets, respectively, while the projection onto the PC set is achieved by solving a standard Rudin, Osher, and Fatemi (ROF) model. The proposed method is named as full sequential POCS (FS-POCS), which is tested using the Shepp-Logan phantom and the Catphan600 phantom and compared with two similar algorithms, TV-POCS and CP-TV. Results: Using the Shepp-Logan phantom, the root mean square error (RMSE) of reconstructed images changing along with the number of iterations is used as the convergence measurement. In general, FS- POCS converges faster than TV-POCS and CP-TV, especially with fewer projection views. FS-POCS can also achieve accurate reconstruction of cone-beam CT of the Catphan600 phantom using only 54 views, comparable to that of FDK using 364 views. Conclusion: We developed an efficient iterative reconstruction for sparse-view CT using full sequential POCS. The simulation and physical phantom data demonstrated the computational efficiency and effectiveness of FS-POCS

  20. The role of research programs and commercial contracts for increase of economic competitiveness and development at INR Pitesti

    International Nuclear Information System (INIS)

    Petra, Nicoleta Mihaela; Ionila, Maria; Datcu, Mirela; Balan, Iosif Bogdan; Cretu, Ileana

    2008-01-01

    In the period in which globalization is increasing, one of the strategic objectives of the institute is to focus on those activities which help developing of services, products and technologies, applicable in nuclear industry, environment protection and medicine. One way to sustain INR activity is the technological transfer which ensures availability of research results by carrying out of R and D contracts in priority areas and of contracts with economical agents for the supply of services, products, technologies, such as: - Materials irradiation for medicine, industry and research; - Neutron Activation Analysis (NAA) and prompt gamma spectrometry for Cernavoda NPP - Unit 1; - Control and testing: non-destructive examination, functional tests of samples and equipment from Cernavoda NPP - Unit 1; - Characterization, conditioning and treatment of radioactive wastes for NPP- Cernavoda, Unit 1, Nuclear Fuel Plant (FCN) - Pitesti; - Measurement of isotopes concentration in environmental samples; -Corrosion experiments in static autoclaves and experiments regarding microbial corrosion for NPP Cernavoda Unit 1 and FCN Pitesti; - Nuclear consultancy for Cernavoda NPP - Unit 1 and Unit 2; - Stainless steel casks for radwaste; - Containers for heavy water; - Training and practice for students at the Universities of Pitesti, Bucuresti, Brasov. The paper presents the main areas where the results obtained in R and D programs can be applied, their implementation can be done, and the status of contracts and their importance for INR Pitesti and Romanian society development, as well. (authors)

  1. [A sudden rise in INR due to combination of Tribulus terrestris, Avena sativa, and Panax ginseng (Clavis Panax)].

    Science.gov (United States)

    Turfan, Murat; Tasal, Abdurrahman; Ergun, Fatih; Ergelen, Mehmet

    2012-04-01

    Warfarin sodium is an antithrombin agent used in patients with prosthetic valve and atrial fibrillation. However, there are many factors that can change the effectiveness of the drug. Today, herbal mixtures promoted through targeted print and visual media can lead to sudden activity changes in patients using warfarin. In this case report we will present two cases with a sudden rise in INR due to using combination of Tribulus terrestris, Avena sativa and Panax ginseng (Panax Clavis). Two patients who used warfarin due to a history of aortic valve replacement (case 1) and atrial fibrillation (case 2) were admitted to the hospital due very high levels of INR detected during routine follow-up. Both patients had used an herbal medicine called ''Panax'' during the last month. The patients gave no indication regarding a change in diet or the use of another agent that might interact with warfarin. In cases where active bleeding could not be determinated, we terminated the use of the drug and re-evaluated dosage of warfarin before finally discharging the patient.

  2. Determinants of job satisfaction for novice nurse managers employed in hospitals.

    Science.gov (United States)

    Djukic, Maja; Jun, Jin; Kovner, Christine; Brewer, Carol; Fletcher, Jason

    Numbering close to 300,000 nurse managers represent the largest segment of the health care management workforce. Their effectiveness is, in part, influenced by their job satisfaction. We examined factors associated with job satisfaction of novice frontline nurse managers. We used a cross-sectional, correlational survey design. The sample consisted of responders to the fifth wave of a multiyear study of new nurses in 2013 (N = 1,392; response rate of 69%) who reported working as managers (n = 209). The parent study sample consisted of registered nurses who were licensed for the first time by exam 6-18 months prior in 1 of 51 selected metropolitan statistical areas and 9 rural areas across 34 U.S. states and the District of Columbia. We examined bivariate correlations between job satisfaction and 31 personal and structural variables. All variables significantly related to job satisfaction in bivariate analysis were included in a multivariate linear regression model. In addition, we tested the interaction effects of procedural justice and negative affectivity, autonomy, and organizational constraints on job satisfaction. The Cronbach's alphas for all multi-item scales ranged from .74 to .96. In the multivariate analysis, negative affectivity (β = -.169; p = .006) and procedural justice (β = .210; p = .016) were significantly correlated with job satisfaction. The combination of predictors in the model accounted for half of the variability in job satisfaction ratings (R = .51, adjusted R = .47; p <. 001). Health care executives who want to cultivate an effective novice frontline nurse manager workforce can best ensure their satisfaction by creating an organization with strong procedural justice. This could be achieved by involving managers in decision-making processes and ensuring transparency about how decisions that affect nursing are made.

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

    Directory of Open Access Journals (Sweden)

    Asra Ramyad

    2016-05-01

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

  4. Strategic performance in hospitals: the use of the balanced scorecard by nurse managers.

    Science.gov (United States)

    Naranjo-Gil, David

    2009-01-01

    The competitive and dynamic health care sector has spurred hospitals into delivering greater flexibility and quality of services while cutting the hospital cost at the same time. However, hospitals differ in the extent to which they achieve these strategic goals. This article explores the use of a new management tool-the balanced scorecard-which facilitates managers to meet multiple strategic goals. It also analyzes how nurse managers use the balanced scorecard in an interactive or diagnostic way and its subsequent effect on strategic goal achievement (cost reduction and flexibility). It also examines how "balanced" is the balanced scorecard in terms of financial versus nonfinancial measures. Data were collected from a mail survey sent to 218 nurse managers in Spanish public hospitals. A satisfactory response rate was achieved, with 114 (52.29%) useful answered questionnaires. The results show that younger, more tenured, and clinically trained nurse managers would be more likely to use the balanced scorecard in an interactive way. Conversely, older, less tenured, and administratively trained managers would use it diagnostically. The results also indicate that the balanced scorecard facilitates the cost reduction and flexibility in hospitals only when it is used interactively. This article provides evidence that not only the technical design of the balanced scorecard matters, but also an appropriate use of the balanced scorecard is paramount for achievement of multiple strategic goals. An effective use of the balanced scorecard requires managers to actively stimulate dialogue and agreement among hospital's staff about desirable financial and nonfinancial performance measures in alignment with multiple strategic goals.

  5. Challenges faced in rural hospitals: the experiences of nurse managers in Uganda.

    Science.gov (United States)

    Kakyo, T A; Xiao, L D

    2018-04-19

    The aim of this study was to understand nurse ward managers perceived challenges in the rural healthcare setting in Uganda. The health workforce, essential medicines and equipment and political unrest are the main factors affecting the international community in addressing the hefty disease burden in World Health Organization African regions. Nurse ward managers have an important role to play to mitigate these factors in health facilities in these regions through leadership, supervision and support for staff. This study utilized interpretive phenomenology based on Gadamer's hermeneutical principles. Eleven nurse managers from two rural public hospitals in Uganda were interviewed. Those with more than a 2-year experience in their management role were invited to participate in the study. Nurse managers pointed out four major challenges with staffing, while they worked in the rural healthcare settings. These are summarized into themes: 'Numbers do matter'; 'I cannot access them when I need them at work'; 'Challenges in dealing with negative attitudes'; and 'Questioning own ability to manage health services'. Health facilities in rural areas face extremely low staff-to-patient ratio, a high level of workload, lack of essential medicines and equipment, low salaries and delayed payment for staff. Nurse managers demonstrated situation-based performance to minimize the impact of these challenges on the quality and safety of patient care, but they had less influence on policy and resource development. It is imperative to mobilize education for nurse ward managers to enable them to improve leadership, management skills and to have a greater impact on policy and resource development. © 2018 International Council of Nurses.

  6. An evaluation of the competencies of primary health care clinic nursing managers in two South African provinces.

    Science.gov (United States)

    Munyewende, Pascalia O; Levin, Jonathan; Rispel, Laetitia C

    2016-01-01

    Managerial competencies to enhance individual and organisational performance have gained currency in global efforts to strengthen health systems. Competent managers are essential in the implementation of primary health care (PHC) reforms that aim to achieve universal health coverage. To evaluate the competencies of PHC clinic nursing managers in two South African provinces. A cross-sectional study was conducted in two South African provinces. Using stratified random sampling, 111 PHC clinic nursing managers were selected. All supervisors ( n =104) and subordinate nurses ( n =383) were invited to participate in the survey on the day of data collection. Following informed consent, the nursing managers, their supervisors, and subordinate nurses completed a 40-item, 360-degree competency assessment questionnaire, with six domains: communication, leadership and management, staff management, financial management, planning and priority setting, and problem-solving. Standard deviations, medians, and inter-quartile ranges (IQRs) were computed separately for PHC nursing managers, supervisors, and subordinate nurses for competencies in the six domains. The Tinsley and Weiss index was used to assess agreement between each of the three possible pairs of raters. A 95.4% response rate was obtained, with 105 nursing managers in Gauteng and Free State completing the questionnaires. There was a lack of agreement about nursing managers' competencies among the three groups of raters. Overall, clinic nursing managers rated themselves high on the five domains of communication (8.6), leadership and management (8.67), staff management (8.75), planning and priority setting (8.6), and problem-solving (8.83). The exception was financial management with a median score of 7.94 (IQR 6.33-9.11). Compared to the PHC clinic managers, the supervisors and subordinate nurses gave PHC nursing managers lower ratings on all six competency domains, with the lowest rating for financial management

  7. [A discussion of nursing management philosophy in the light of Mo-tzu's concept of love without distinction].

    Science.gov (United States)

    Hsiao, Hung-En

    2005-10-01

    When one mentions the word, "management," people all too easily conclude that one is referring to the question of how to create profit for a business enterprise. This is because, in business, that is indeed the precise purpose of management. So what should the aim of management be in nursing? That is to say, how does the function of management apply to the nursing profession? It is not difficult to understand that behind the implementation of any practice is a key thought or guiding principle. To investigate the central idea or key thought about nursing management requires research into the philosophy of nursing management. The writer believes that the teaching of Mo-tzu, who advocated love without distinction, in ancient (pre-Chin) China, is the fundamental idea of nursing management, because that philosophy emphasizes impartial love of every person. It does not stress investigations of different levels of abstract theories; but simply calls for the practical application of the idea. The goal of nursing management is to care about patients impartially and strengthen nursing care. The aim of nursing care is completely different from that of business enterprises. We can also say that it is precisely because nursing means taking care of sick people, that the goal of nursing management is to care about achieving the recovery of body, mind, and spirit of a patient. The management of nursing, therefore, and the goal of nursing are united harmoniously into one in nursing care.

  8. Nurse managers' decision-making in daily unit operation in peri-operative settings: a cross-sectional descriptive study.

    Science.gov (United States)

    Siirala, Eriikka; Peltonen, Laura-Maria; Lundgrén-Laine, Heljä; Salanterä, Sanna; Junttila, Kristiina

    2016-09-01

    To describe the tactical and the operational decisions made by nurse managers when managing the daily unit operation in peri-operative settings. Management is challenging as situations change rapidly and decisions are constantly made. Understanding decision-making in this complex environment helps to develop decision support systems to support nurse managers' operative and tactical decision-making. Descriptive cross-sectional design. Data were collected from 20 nurse managers with the think-aloud method during the busiest working hours and analysed using thematic content analysis. Nurse managers made over 700 decisions; either ad hoc (n = 289), near future (n = 268) or long-term (n = 187) by nature. Decisions were often made simultaneously with many interruptions. Ad hoc decisions covered staff allocation, ensuring adequate staff, rescheduling surgical procedures, confirmation tangible resources and following-up the daily unit operation. Decisions in the near future were: planning of surgical procedures and tangible resources, and planning staff allocation. Long-term decisions were: human recourses, nursing development, supplies and equipment, and finances in the unit. Decision-making was vulnerable to interruptions, which sometimes complicated the managing tasks. The results can be used when planning decision support systems and when defining the nurse managers' tasks in peri-operative settings. © 2016 John Wiley & Sons Ltd.

  9. When caretaking competes with care giving: a qualitative study of full-time working mothers who are nurse managers.

    Science.gov (United States)

    Firmin, Michael W; Bailey, Megan

    2008-10-01

    The purpose of this study was to explore the motivations and stresses associated with full-time working mothers who practice as nurse managers. Full-time work outside the home for mothers has been recognized as a circumstance which may present certain benefits and risks to family life. Nursing management is recognized as a high-stress occupation, which may be filled by mothers who work full time. Little is known about the specific needs and stresses of full-time nurse managers who are caring for children at home. In-depth interviews were conducted with 13 mothers who worked as nurse managers. Participants expressed challenges in several areas including balancing/separating work and home, self-imposed advancement inhibitions, and constant giving. Challenges were offset by assets, which included complimentary roles, health insurance, added income, and professional and personal fulfilment. Participants 'wanted it all', including the conveniences of part-time employment and the benefits of full-time employment. Full-time nurse managers with children at home experience unique tensions which characterize their work and home environments. Employers may assist nurses by adopting flexible scheduling, educational and child-care support and assistance in negotiating work and home roles.

  10. The international normalized ratio (INR as seen in a population of patients with atrial fibrillation and cerebral infarction undergoing long-term treatment with vitamin K antagonists

    Directory of Open Access Journals (Sweden)

    Szczepańska-Szerej Anna

    2015-12-01

    Full Text Available It is estimated that nearly 20% of all cerebral infarctions in the total population are the result of a complication of atrial fibrillation (AF. While oral anticoagulation with vitamin K antagonists (AVKs substantially reduces this risk, this requires regular monitoring of the international normalized ratio (INR in order to achieve therapeutic levels (2,0-3,0. The aim of this study was to evaluate a group at high risk of cerebral infarction, among patients with AF undergoing long-term treatment with VKAs, taking into account the significance of therapeutic INR values. The analysed group consisted of 90 acute ischaemic stroke patients with paroxysmal or chronic “non-valvular” AF, receiving treatment with VKAs. As a result of the study, therapeutic INR values (≥ 2 were seen in thirty-five of these individuals (38,8%, while 55 (61,2% showed non-therapeutic INR values. Moreover, there were no differences in demographics, vascular risk factors, biochemical and morphological blood parameters, mean CHA2DS2-VASc score and TOAST classification between either of the two groups. Furthermore, no additional factor that would increase their risk of cerebral infarction during the adequate treatment with VKAs was found. However, patients with non-therapeutic INR values had a statistically significantly higher frequency of concomitant moderate pathology of the bicuspid valve, p<0.05. Hence, a lack of proper control of INR can proved to be particularly dangerous for this subgroup of patients. Hence, this is a group with an elevated risk of cerebral infarction and therefore requires special oversight of VKA treatment or NOA treatment.

  11. Mechanical, Permeability, and Degradation Properties of 3D Designed Poly(1,8 Octanediol-co-Citrate)(POC) Scaffolds for Soft Tissue Engineering

    Science.gov (United States)

    Jeong, Claire G.; Hollister, Scott J.

    2015-01-01

    Poly(1,8-octanediol-co-citric acid) (POC) is a synthetic biodegradable elastomer that can be processed into 3D scaffolds for tissue engineering. We investigated the effect of designed porosity on the mechanical properties, permeability and degradation profiles of the POC scaffolds. For mechanical properties, scaffold compressive data was fit to a 1D nonlinear elastic model and solid tensile data was fit to a Neohookean incompressible nonlinear elastic model. Chondrocytes were seeded on scaffolds to assess the biocompatibility of POC. Increased porosity was associated with increased degradation rate, increased permeability, and decreased mechanical stiffness which also became less nonlinear. Scaffold characterization in this paper will provide design guidance for POC scaffolds to meet the mechanical and biological parameters needed for engineering soft tissues such as cartilage. PMID:20091910

  12. Frequency of different disorders requiring warfarin therapy and its outcome in terms of dosage and inr value in pakistani population

    International Nuclear Information System (INIS)

    Qayyum, A.; Najmi, M.H.

    2014-01-01

    To determine the frequency of different disorders requiring warfarin therapy and to see the target INR and warfarin dose requirement in Pakistani population. Study Design:Descriptive study. Setting and Duration of Study: The study was carried out at Armed Forces Institut e of Cardiology (AFIC) Rawalpindi, Military Hospital Rawalpindi and National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan from October 2010 to March 2012. Patients and Methods: Stable patients taking warfarin therapy were recruited after detailed medical history, physical examination and laboratory tests. The demographic and clinical data of individuals were entered in a pre-structured proforma. Patients suffering from hepatic and renal disease, any co-morbid disease or taking any concurrent medication or diet which would have affected warfarin therapy, were excluded. Data was analyzed using PSS version 20.0. Results: A total of 607 stable patients fulfilling the eligibility criteria, participated in the study. There were 297 (48.9%) male and 310 (51.1%) female patients. The mean age was 37.93 +- 12.23 years (range 18-65 years). The most common indication for warfarin therapy was valvular heart diseases (93.4%) followed by atrial fibrillation (2.3%) whereas other indications for warfarin use are less commonly seen in our study population. Patients had mean international normalized ratio (INR) value of 2.3 +9- 0.8 (range 1.5-3.5). Mean daily dose of warfarin calculated in 607 patients was 5.62 and 1.98 mg with the range of 0.36-15 g whereas mean weekly dose was 39.36 +- 13.8 mg with the range of 2.5-105 mg. Conclusion: In Pakistani population the most common indications for warfarin use are valvular heart diseases followed by atrial fibrillation. The mean INR values were within recommended range of 2-3. The mean daily dose observed in long-term therapy is comparable to the empirical dose of 5 mg routinely started in clinical practice. (author)

  13. Role stress among first-line nurse managers and registered nurses - a comparative study.

    Science.gov (United States)

    Johansson, Gunilla; Sandahl, Christer; Hasson, Dan

    2013-04-01

    Studies show that first-line nurse managers (F-LNMs) experience high psychological job demands and inadequate managerial guidance. The purpose of this study was to investigate whether F-LNMs have higher stress levels and show more signs of stress-related ill health than registered nurses (RNs). The aim of this study was to examine possible differences in self-rated health between F-LNMs and RNs on various psychosocial factors (e.g. job demand, job control and managerial support). Data were collected at a university hospital in Sweden. Sixty-four F-LNMs and 908 RNs filled in a web-based questionnaire. Both F-LNMs and RNs reported having good health. Approximately 10-15% of the F-LNMs and RNs showed signs of being at risk for stress-related ill health. Statistically significant differences (Mann-Whitney U-test) were found in the distribution between the F-LNMs and the RNs on three indices of job control, job demand and managerial support. Our findings suggest that F-LNMs were able to cope with high-demand job situations because of relatively high control over work. The implication for nursing management shows the needs for a work environment for both F-LNMs and RNs that includes high job control and good managerial support. © 2011 Blackwell Publishing Ltd.

  14. Research nurse manager perceptions about research activities performed by non-nurse clinical research coordinators.

    Science.gov (United States)

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

    2015-01-01

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

  15. Barriers and facilitators of care for diverse patients: Nurse leader perspectives and nurse manager implications.

    Science.gov (United States)

    Ogbolu, Yolanda; Scrandis, Debra A; Fitzpatrick, Grace

    2018-01-01

    To examine chief nurse executives' perspectives on: (1) the provision of culturally and linguistically appropriate services in hospitals and (2) to identify barriers and facilitators associated with the implementation of culturally and linguistically appropriate services. Hospitals continue to face challenges providing care to diverse patients. The uptake of standards related to culturally and linguistically appropriate services into clinical practice is sluggish, despite potential benefits, including reducing health disparities, patient errors, readmissions and improving patient experiences. A qualitative study with chief nurse executives from one eastern United States (US). Data were analysed using content analysis. Seven themes emerged: (1) lack of awareness of resources for health care organisations; (2) constrained cultural competency training; (3) suboptimal resources (cost and time); (4) mutual understanding; (5) limited workplace diversity; (6) community outreach programmes; and (7) the management of unvoiced patient expectations. As the American population diversifies, providing culturally and linguistically appropriate services remains a priority for nurse leaders. Being aware and utilizing the resources, policies and best practices available for the implementation of culturally and linguistically appropriate services can assist nursing managers in reaching their goals of providing high quality care to diverse populations. Nurse managers are key in aligning the unit's resources with organisational goals related to the provision of culturally and linguistically appropriate services by providing the operational leadership to eliminate barriers and to enhance the uptake of best practices related to culturally and linguistically appropriate services. © 2017 John Wiley & Sons Ltd.

  16. How nursing managers respond to intraprofessional aggression: novel strategies to an ongoing challenge.

    Science.gov (United States)

    St-Pierre, Isabelle

    2012-01-01

    Nursing managers are identified as playing a central role in workplace aggression management. In effect, employees' decisions to report unacceptable behavior is said to be directly influenced by how a manager will respond to their claims. Using principles from critical nursing ethnography, data were collected from interviews, organizational documents, and observation of physical environment. Twenty-three semistructured interviews were conducted in both a university-affiliated psychiatric hospital and a community hospital located in a large metropolitan city in Ontario. The study aimed at broadening the understanding of how nurse managers respond to intraprofessional and interprofessional workplace aggression. Several strategies were described by managers including coaching individuals so they feel capable of addressing the issue themselves, acting as mediator to allow both sides to openly and respectfully talk about the issue, and disciplining employees whose actions warrant harsh consequences. As part of the study, managers reported that dealing with workplace aggression could be difficult and time consuming and admitted that they sometimes came to doubt their abilities to be able to positively resolve such a widespread problem. Conclusions drawn from the study suggest that aggression management is not solely the responsibility of managers but must involve several actors including the aggressive individual, peers, human resources department, and unions.

  17. Nurse practitioners' perceptions of interprofessional team functioning with implications for nurse managers.

    Science.gov (United States)

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

    2014-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Ali Akbar Vaezi

    2011-03-01

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

  19. The nursing human resource planning best practice toolkit: creating a best practice resource for nursing managers.

    Science.gov (United States)

    Vincent, Leslie; Beduz, Mary Agnes

    2010-05-01

    Evidence of acute nursing shortages in urban hospitals has been surfacing since 2000. Further, new graduate nurses account for more than 50% of total nurse turnover in some hospitals and between 35% and 60% of new graduates change workplace during the first year. Critical to organizational success, first line nurse managers must have the knowledge and skills to ensure the accurate projection of nursing resource requirements and to develop proactive recruitment and retention programs that are effective, promote positive nursing socialization, and provide early exposure to the clinical setting. The Nursing Human Resource Planning Best Practice Toolkit project supported the creation of a network of teaching and community hospitals to develop a best practice toolkit in nursing human resource planning targeted at first line nursing managers. The toolkit includes the development of a framework including the conceptual building blocks of planning tools, manager interventions, retention and recruitment and professional practice models. The development of the toolkit involved conducting a review of the literature for best practices in nursing human resource planning, using a mixed method approach to data collection including a survey and extensive interviews of managers and completing a comprehensive scan of human resource practices in the participating organizations. This paper will provide an overview of the process used to develop the toolkit, a description of the toolkit contents and a reflection on the outcomes of the project.

  20. Improving diabetic foot care in a nurse-managed safety-net clinic.

    Science.gov (United States)

    Peterson, Joann M; Virden, Mary D

    2013-05-01

    This article is a description of the development and implementation of a Comprehensive Diabetic Foot Care Program and assessment tool in an academically affiliated nurse-managed, multidisciplinary, safety-net clinic. The assessment tool parallels parameters identified in the Task Force Foot Care Interest Group of the American Diabetes Association's report published in 2008, "Comprehensive Foot Examination and Risk Assessment." Review of literature, Silver City Health Center's (SCHC) 2009 Annual Report, retrospective chart review. Since the full implementation of SCHC's Comprehensive Diabetic Foot Care Program, there have been no hospitalizations of clinic patients for foot-related complications. The development of the Comprehensive Diabetic Foot Assessment tool and the implementation of the Comprehensive Diabetic Foot Care Program have resulted in positive outcomes for the patients in a nurse-managed safety-net clinic. This article demonstrates that quality healthcare services can successfully be developed and implemented in a safety-net clinic setting. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

  1. Through the Eyes of Nurse Managers in Long-Term Care: Identifying Perceived Competencies and Skills.

    Science.gov (United States)

    Dever, Kathleen H

    2018-05-01

    Nurse managers (NMs) in long-term care supervise health care services for individuals with high acuity levels and numerous comorbidities. There is minimal research identifying NMs' skills and competencies as unit leaders within the long-term care environment. The current mixed-methods study identified NMs' leadership skills and competencies. Nineteen NMs with ≥5 years' long-term care management experience completed the Nurse Manager Inventory Tool and were individually interviewed. They rated their clinical skills at the competent level and their financial/strategic management skills at the novice level. All other skill categories, including leadership reflective practice, diversity, human resource leadership/management, relationship management, performance improvement, and problem solving, were rated at a competent level. Emergent interview qualitative themes included their visibility on the unit, trial and error learning, a sense of "aloneness" due to the absence of other RNs, NM position being a tough job, need for peer support, role modeling, and importance of supporting the resident through their "final journey." [Journal of Gerontological Nursing, 44(5), 32-38.]. Copyright 2018, SLACK Incorporated.

  2. Beyond Magnet® Designation: Perspectives From Nurse Managers on Factors of Sustainability and High-Performance Programming.

    Science.gov (United States)

    Hayden, Margaret A; Wolf, Gail A; Zedreck-Gonzalez, Judith F

    2016-10-01

    The aim of this study was to identify patterns of high-performing behaviors and nurse manager perceptions of the factors of Magnet® sustainability at a multidesignated Magnet organization. The Magnet program recognizes exemplary professional nursing practice and is challenging to achieve and sustain. Only 10% (n = 42) of Magnet hospitals sustained designation for 12 years or longer. This study explored the perspectives of Magnet nurse managers regarding high-performing teams and the sustainability of Magnet designation. A qualitative study of nurse managers was conducted at 1 multidesignated Magnet organization (n = 13). Interview responses were analyzed using pattern recognition of Magnet model domains and characteristics of high-performing teams and then related to factors of Magnet sustainability. Transformational leadership is both an essential factor for sustainability and a potential barrier to sustainability of Magnet designation. Transformational nursing leaders lead high-performing teams and should be in place at all levels as an essential factor in sustaining Magnet redesignation.

  3. Abundance, stable isotopic composition, and export fluxes of DOC, POC, and DIC from the Lower Mississippi River during 2006–2008

    Science.gov (United States)

    Cai, Yihua; Guo, Laodong; Wang, Xuri; Aiken, George R.

    2015-01-01

    Sources, abundance, isotopic compositions, and export fluxes of dissolved inorganic carbon (DIC), dissolved and colloidal organic carbon (DOC and COC), and particulate organic carbon (POC), and their response to hydrologic regimes were examined through monthly sampling from the Lower Mississippi River during 2006–2008. DIC was the most abundant carbon species, followed by POC and DOC. Concentration and δ13C of DIC decreased with increasing river discharge, while those of DOC remained fairly stable. COC comprised 61 ± 3% of the bulk DOC with similar δ13C abundances but higher percentages of hydrophobic organic acids than DOC, suggesting its aromatic and diagenetically younger status. POC showed peak concentrations during medium flooding events and at the rising limb of large flooding events. While δ13C-POC increased, δ15N of particulate nitrogen decreased with increasing discharge. Overall, the differences in δ13C between DOC or DIC and POC show an inverse correlation with river discharge. The higher input of soil organic matter and respired CO2 during wet seasons was likely the main driver for the convergence of δ13C between DIC and DOC or POC, whereas enhanced in situ primary production and respiration during dry seasons might be responsible for their isotopic divergence. Carbon export fluxes from the Mississippi River were estimated to be 13.6 Tg C yr−1 for DIC, 1.88 Tg C yr−1 for DOC, and 2.30 Tg C yr−1 for POC during 2006–2008. The discharge-normalized DIC yield decreased during wet seasons, while those of POC and DOC increased and remained constant, respectively, implying variable responses in carbon export to the increasing discharge.

  4. An evaluation of the competencies of primary health care clinic nursing managers in two South African provinces

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    Pascalia O. Munyewende

    2016-12-01

    Full Text Available Background: Managerial competencies to enhance individual and organisational performance have gained currency in global efforts to strengthen health systems. Competent managers are essential in the implementation of primary health care (PHC reforms that aim to achieve universal health coverage. Objective: To evaluate the competencies of PHC clinic nursing managers in two South African provinces. Design: A cross-sectional study was conducted in two South African provinces. Using stratified random sampling, 111 PHC clinic nursing managers were selected. All supervisors (n=104 and subordinate nurses (n=383 were invited to participate in the survey on the day of data collection. Following informed consent, the nursing managers, their supervisors, and subordinate nurses completed a 40-item, 360-degree competency assessment questionnaire, with six domains: communication, leadership and management, staff management, financial management, planning and priority setting, and problem-solving. Standard deviations, medians, and inter-quartile ranges (IQRs were computed separately for PHC nursing managers, supervisors, and subordinate nurses for competencies in the six domains. The Tinsley and Weiss index was used to assess agreement between each of the three possible pairs of raters. Results: A 95.4% response rate was obtained, with 105 nursing managers in Gauteng and Free State completing the questionnaires. There was a lack of agreement about nursing managers’ competencies among the three groups of raters. Overall, clinic nursing managers rated themselves high on the five domains of communication (8.6, leadership and management (8.67, staff management (8.75, planning and priority setting (8.6, and problem-solving (8.83. The exception was financial management with a median score of 7.94 (IQR 6.33–9.11. Compared to the PHC clinic managers, the supervisors and subordinate nurses gave PHC nursing managers lower ratings on all six competency domains, with

  5. Warfarin dose and INR related to genotypes of CYP2C9 and VKORC1 in patients with myocardial infarction

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    Seljeflot Ingebjørg

    2008-06-01

    Full Text Available Abstract Background Warfarin treatment has a narrow therapeutic range, requiring meticulous monitoring and dosage titration. Individual dosage requirement has recently partly been explained by genetic variation of the warfarin metabolizing enzyme CYP2C9 and the Vitamin K-activating enzyme VKORC1. In the WARIS-II study, comparing three different antithrombotic regimens after myocardial infarction, warfarin treatment reduced thrombotic events, but was associated with more frequent bleeding than use of acetylsalisylic acid (ASA alone. Aims The primary aim of the present study was to investigate the relation between genotypes of CYP2C9 and VKORC1 and warfarin maintenance dose in myocardial infarction. The secondary aim was to relate the genotypes to international normalized ratio (INR. Methods Genotyping was performed in 212 myocardial infarction patients from the WARIS-II study by robotic isolation of DNA from EDTA whole blood (MagNa Pure LC before PCR amplification (LightCycler and melting point analysis. Results The 420 C>T substitution of CYP2C9*2, the 1075 A>C substitution of CYP2C9*3 and the 1173 C>T substitution of VKORC1 had minor allele frequencies of, 11.3%, 5.7% and 36.6% respectively. Warfarin weekly dose varied between 17 mg and 74 mg among the patients. INR did not vary between genotypes. Warfarin dosage requirement was significantly associated with CYP2C9 and VKORC1 genotypes, treatment group and age. The VKORC1 genotype contributed 24.5% to the interindividual variation in warfarin dosage, whereas the combined CYP2C9 genotypes were only responsible for 7.2% of the dose variation. Conclusion CYP2C9 and VKORC1 genotype frequencies in myocardial infarction patients appear similar to other patient groups and have similar impact on warfarin maintenance dose.

  6. Nurse managers' perceptions related to their leadership styles, knowledge, and skills in these areas-a viewpoint: case of health centre wards in Finland.

    Science.gov (United States)

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

    2013-01-01

    The purpose of this study was to explore nurse managers' perceptions related to their leadership styles, knowledge, and their skills in these areas in health centre wards in Finland. The data were collected from nurse managers (n = 252) in health centre hospitals in Finland using a structured questionnaire (response rate 63%). Six leadership styles-visionary, coaching, affiliate, democratic, commanding, and isolating-were reflected on. Almost all respondents in every age group considered four leadership styles-visionary, coaching, affiliate, and democratic-to be very important or important. Nurse managers estimated their knowledge and skills in leadership styles to be essentially fairly sufficient or sufficient. Nurse managers' abilities to reflect, understand, and, if necessary, change their leadership style influence the work unit's success and employees' job satisfaction. Nurse managers, especially new nurse managers, need more theoretic, evidence-based education to cope with these expectations and to develop their professional abilities. Together with universities, health care organizations should start planning nurse manager education programmes that focus on strategic issues, leadership, job satisfaction, challenging situations in leadership, change management, work unit management (e.g., economy, efficiency, and resources), and how the nurse managers consider their own wellbeing.

  7. Nurse Managers' Perceptions Related to Their Leadership Styles, Knowledge, and Skills in These Areas—A Viewpoint: Case of Health Centre Wards in Finland

    Science.gov (United States)

    Suhonen, Marjo; Isola, Arja; Paasivaara, Leena; Laukkala, Helena

    2013-01-01

    The purpose of this study was to explore nurse managers' perceptions related to their leadership styles, knowledge, and their skills in these areas in health centre wards in Finland. The data were collected from nurse managers (n = 252) in health centre hospitals in Finland using a structured questionnaire (response rate 63%). Six leadership styles—visionary, coaching, affiliate, democratic, commanding, and isolating—were reflected on. Almost all respondents in every age group considered four leadership styles—visionary, coaching, affiliate, and democratic—to be very important or important. Nurse managers estimated their knowledge and skills in leadership styles to be essentially fairly sufficient or sufficient. Nurse managers' abilities to reflect, understand, and, if necessary, change their leadership style influence the work unit's success and employees' job satisfaction. Nurse managers, especially new nurse managers, need more theoretic, evidence-based education to cope with these expectations and to develop their professional abilities. Together with universities, health care organizations should start planning nurse manager education programmes that focus on strategic issues, leadership, job satisfaction, challenging situations in leadership, change management, work unit management (e.g., economy, efficiency, and resources), and how the nurse managers consider their own wellbeing. PMID:23691356

  8. POC-SCALE TESTING OF A DRY TRIBOELECTROSTATIC SEPARATOR FOR FINE COAL CLEANING

    Energy Technology Data Exchange (ETDEWEB)

    R.H. Yoon; G.H. Luttrell; E.S. Yan; A.D. Walters

    2001-04-30

    suffer from low throughput capacities and high maintenance requirements. In general, surface area-based separators (e.g., shaking tables, magnetic drum separator, electrodynamic separator, etc.) have lower throughput capacities than volume-based separators (e.g., flotation cell, dense-medium bath, cyclones, etc.) by an order of magnitude. Furthermore, the electrodes of the laboratory unit need to be cleaned frequently, creating a high maintenance requirement if it is scaled-up to a commercial unit. The bench-scale continuous TES unit developed at NETL, on the other hand, separates positively and negatively charged particles by splitting the gaseous stream containing these particles in an electric field by means of a flow splitter, so that the oppositely charged particles can be directed into different compartments. This device is fundamentally different from the laboratory unit in that the former is a surface area-based separator, while the latter is a volume-based separator. The bench-scale unit is referred to as an entrained flow separator by the in-house researchers at NETL. Thus, the entrained flow TES unit is a significant improvement over the laboratory unit with regard to throughput capacity. In the present work, the entrained flow separator concept will be utilized for developing a proof-of concept (POC) separator that can be scaled-up to commercial size units. To accomplish this, it is necessary to develop a bench-scale separator that can achieve high Btu recoveries while maintaining the high degree of separation efficiencies. It is the objective of the present investigation to develop an efficient separator by studying the mechanisms of triboelectrification and investigating better ways of separating the charged particles. An important criterion for developing efficient separators is that they not only provide high separation efficiencies but also have high throughput capacities, which are essential ingredients for successful commercialization.

  9. TRial of an Educational intervention on patients' knowledge of Atrial fibrillation and anticoagulant therapy, INR control, and outcome of Treatment with warfarin (TREAT

    Directory of Open Access Journals (Sweden)

    Pattison Helen M

    2010-05-01

    Full Text Available Abstract Background Atrial fibrillation (AF patients with a high risk of stroke are recommended anticoagulation with warfarin. However, the benefit of warfarin is dependent upon time spent within the target therapeutic range (TTR of their international normalised ratio (INR (2.0 to 3.0. AF patients possess limited knowledge of their disease and warfarin treatment and this can impact on INR control. Education can improve patients' understanding of warfarin therapy and factors which affect INR control. Methods/Design Randomised controlled trial of an intensive educational intervention will consist of group sessions (between 2-8 patients containing standardised information about the risks and benefits associated with OAC therapy, lifestyle interactions and the importance of monitoring and control of their International Normalised Ratio (INR. Information will be presented within an 'expert-patient' focussed DVD, revised educational booklet and patient worksheets. 200 warfarin-naïve patients who are eligible for warfarin will be randomised to either the intervention or usual care groups. All patients must have ECG-documented AF and be eligible for warfarin (according to the NICE AF guidelines. Exclusion criteria include: aged Discussion More data is needed on the clinical benefit of educational intervention with AF patients receiving warfarin. Trial registration ISRCTN93952605

  10. Paradigms and nursing management, analysis of the current organizational structure in a large hospital.

    Science.gov (United States)

    Wilson, D

    1992-01-01

    Hospitals developed over the period of time when positivism become a predominant world view. Positivism was founded by four Western trends: preponderance of hierarchy and autocracy, popularization of bureaucracy, extensive application of a machine orientation to work and predominance of "scientific" inquiry. Organizational theory developed largely from quantitative research findings arising from a positivistic world view. A case study, analyzing a current nursing organizational structure at one large hospital, is presented. Nursing management was found to be based upon the positivistic paradigm. The predominance of a machine orientation, and an autocratic and bureaucratic structure are evidence of this. A change to shared governance had been attempted, indicating a shift to a more modern organizational structure based on a different paradigm. The article concludes by emphasizing that managers are largely responsible for facilitating change; change that will meet internal human resource needs and the cost-effectiveness crises of hospitals today through more effective use of human resources.

  11. A profile of the structure and impact of nursing management in Canadian hospitals.

    Science.gov (United States)

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

    2008-01-01

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

  12. Development of an online nursing management course: successful experience between Brazil and Portugal.

    Science.gov (United States)

    Tronchin, Daisy Maria Rizatto; Peres, Heloisa Helena Ciqueto; Lima, Antônio Fernandes Costa; Alavarce, Débora Cristina; Prata, Ana Paula; Santos, Margarida Reis; Aroldi, Juscilynne Barros da Costa

    2015-12-01

    Objective To describe the experience of planning and developing online refresher courses in nursing management for nurses in the contexts of Brazil and Portugal. Method The instructional design was based on meaningful learning theory, andragogy, and dialectical methodology, so it valued interaction between the actors, emphasizing the scenarios of practice and applying the concepts covered. The course structure is divided into nine theoretical units, four case studies, and an essay exam. Results The course was positively evaluated by the participants, who reported opportunities for acquisition of new knowledge, interaction and exchange of experiences, motivation to study the topics, and self-learning. Conclusion It is expected that description of this experience will stimulate proposals for new courses and programs in distance education modalities, improving the processes of teaching and learning so as to give support to future analyses of their impact on the development and enhancement of management skills in nursing.

  13. A Critical Perspective on Relations between Staff Nurses and their Nurse Manager: Advancing Nurse Empowerment Theory.

    Science.gov (United States)

    Udod, Sonia; Racine, Louise

    2014-12-01

    This study considers empowerment in nurse-manager relations by examining how conflict is handled on both sides and how the critical social perspective has influenced these relations. The authors use inductive analysis of empirical data to explain how (1) nursing work is organized, structured, and circumscribed by centrally determined policies and practices that downplay nurses' professional judgement about patient care; (2) power is held over nurses in their relationship with their manager; and (3) nurses' response to power is to engage in strategies of resistance. The authors illustrate how power influences relations between staff nurses and managers and provide a critical analysis of the strategies of resistance that result in personal, relational, and critical empowerment among staff nurses. Through resistance, staff nurses engage in alternative discourses to counteract the prevailing neoliberal organizational and managerial discourses of efficiency and cost-effectiveness. Copyright© by Ingram School of Nursing, McGill University.

  14. The effects of leadership competencies and quality of work on the perceived readiness for organizational change among nurse managers.

    Science.gov (United States)

    Al-Hussami, Mahmoud; Hamad, Sawsan; Darawad, Muhammad; Maharmeh, Mahmoud

    2017-10-02

    Purpose This paper aims to set a leadership guidance program that can promote nurses' knowledge of leadership and, at the same time, to enhance their leadership competencies and quality of work to promote their readiness for change in healthcare organizations. Design/methodology/approach A pre-experimental, one-group pretest-posttest design was utilized. Out of 90 invited to participate in this study, 61 nurses were accepted to participate. Findings The statistical analyses suggested several significant differences between pre- and in-service nurse managers about leadership competencies, quality of work and readiness for change. Yet, findings from the background characteristics were not found to be significant and had no effects on the perceived readiness for change. Research limitations/implications The present study highlights the importance of leadership competencies and quality of work that healthcare policymakers identify for the success of organizational change efforts. Practical implications Healthcare policymakers, including directors of nursing, should focus on applications that increase leadership competencies and overall satisfaction of the nurse managers to support the changes in hospitals and supporting learning organization. Hence, they should establish policies that decrease the possible negative impact of planned change efforts. Originality/value Competent nurse managers enhance their readiness for change, which in turn helps nurses in constructive change processes. A leadership guidance program should be set for nurse managers. This study has important implications for hospital administrators and directors of nursing.

  15. Impacts of erosion and restoration on POC flux and pollutant mobilisation in the peatlands of the Peak District National Park, UK

    Science.gov (United States)

    Shuttleworth, E. L.; Evans, M. G.; Rothwell, J. J.; Hutchinson, S. M.

    2012-04-01

    Peatlands represent major carbon stores. However, much of the UK's blanket peat is significantly degraded and actively eroding which significantly impacts carbon storage through the physical export of particulate organic carbon (POC). The stability of peatlands is therefore important for the preservation this carbon store and the restoration of the eroded peat of the Peak District, southern Pennines, UK has been a major conservation concern for several decades. The near-surface layer of these blanket peats is severely contaminated with high concentrations of atmospherically deposited lead - a legacy of Britain's Industrial Revolution. Recently there has been growing interest in the mobilisation of this heavy metal which has been shown to be associated with POC. However, little is known about the source and quality of sediment still entering the fluvial system in revegetated catchments. Understanding the physical process dynamics relating to revegetation and sediment flux is required in order to assess the efficacy of peatland restoration operations in reducing POC and lead release. Three sites have been studied in the Bleaklow area of the Peak District; each representing different surface conditions: (i) actively eroding, (ii) recently revegetated and, (iii) intact. The contaminated nature of the near surface peat distinguishes POC mobilised from the peat surface from that eroded from gully walls. This has allowed a fingerprinting approach to be adopted as a means of characterising and identifying the sources of sediment entering the fluvial system. A survey of surface lead concentrations at each site was conducted and other catchment sources were identified and their relative contribution to the suspended load assessed. POC fluxes are greatly reduced following restoration to levels comparable to intact sites. Lead flux is also significantly reduced but surface condition makes little difference to the quality of the sediment, i.e. the concentration of lead

  16. Implementing case-based teaching strategies in a decentralised nursing management programme in South Africa

    Directory of Open Access Journals (Sweden)

    Zethu Nkosi

    2013-11-01

    Full Text Available Background: Case-based education has a long history in the disciplines of education, business, law and the health professions. Research suggests that students who learn via a case-based method have advanced critical thinking skills and a greater ability for application of knowledge in practice. In medical education, case-based methodology is widely used to facilitate knowledge transfer from theoretical knowledge to application in patient care. Nursing education has also adopted case-based methodology to enhance learner outcomes and critical thinking.Objectives: The objectives of the study was to describe a decentralised nursing management education programme located in Durban, South Africa and describe the perceptions of nursing faculty facilitators regarding implementation of this teaching method.Method: Data was collected through the use of one-on-one interviews and also focus groups amongst the fifteen facilitators who were using a case-based curriculum to teach the programme content. The average facilitator was female, between 41 and 50 years of age, working part-time, educated with a baccalaureate degree, working as a professional nurse for between 11 and 20 years; slightly more than half had worked as a facilitator for three or more years.Results: The facilitators identified themes related to the student learners, the learning environment, and strengths and challenges of using facilitation to teach the content through cases. Decentralised nursing management educational programmes can meet the needs of nurses who are located in remote areas which are characterised by poor transportation patterns and limited resources and have great need for quality healthcare services.Conclusion: Nursing faculty facilitators need knowledgeable and accessible contact with centrally based full-time nursing faculty in order to promote high quality educational programmes.

  17. Implementing case-based teaching strategies in a decentralised nursing management programme in South Africa

    Directory of Open Access Journals (Sweden)

    Zethu Nkosi

    2013-11-01

    Full Text Available Background: Case-based education has a long history in the disciplines of education, business, law and the health professions. Research suggests that students who learn via acase-based method have advanced critical thinking skills and a greater ability for application of knowledge in practice. In medical education, case-based methodology is widely used to facilitate knowledge transfer from theoretical knowledge to application in patient care. Nursing education has also adopted case-based methodology to enhance learner outcomes and critical thinking. Objectives: The objectives of the study was to describe a decentralised nursing management education programme located in Durban, South Africa and describe the perceptions of nursing faculty facilitators regarding implementation of this teaching method. Method: Data was collected through the use of one-on-one interviews and also focus groups amongst the fifteen facilitators who were using a case-based curriculum to teach the programme content. The average facilitator was female, between 41 and 50 years of age,working part-time, educated with a baccalaureate degree, working as a professional nurse for between 11 and 20 years; slightly more than half had worked as a facilitator for three or more years. Results: The facilitators identified themes related to the student learners, the learning environment, and strengths and challenges of using facilitation to teach the content through cases. Decentralised nursing management educational programmes can meet the needs of nurses who are located in remote areas which are characterised by poor transportation patterns and limited resources and have great need for quality healthcare services. Conclusion: Nursing faculty facilitators need knowledgeable and accessible contact with centrally based full-time nursing faculty in order to promote high quality educational programmes.

  18. Using diaries to explore the work experiences of primary health care nursing managers in two South African provinces

    Directory of Open Access Journals (Sweden)

    Pascalia O. Munyewende

    2014-12-01

    Full Text Available Background: South Africa is on the brink of another wave of major health system reforms that underscore the centrality of primary health care (PHC. Nursing managers will play a critical role in these reforms. Objective: The aim of the study was to explore the work experiences of PHC clinic nursing managers through the use of reflective diaries, a method hitherto under-utilised in health systems research in low- and middle-income countries. Design: During 2012, a sub-set of 22 PHC nursing managers was selected randomly from a larger nurses’ survey in two South African provinces. After informed consent, participants were requested to keep individual diaries for a period of 6 weeks, using a clear set of diary entry guidelines. Reminders consisted of weekly short message service reminders and telephone calls. Diary entries were analysed using thematic content analysis. A diary feedback meeting was held with all the participants to validate the findings. Results: Fifteen diaries were received, representing a 68% response rate. The majority of respondents (14/15 were female, each with between 5 and 15 years of nursing experience. Most participants made their diary entries at home. Diaries proved to be cathartic for individual nursing managers. Although inter-related and not mutually exclusive, the main themes that emerged from the diary analysis were health system deficiencies; human resource challenges; unsupportive management environment; leadership and governance; and the emotional impact of clinic management. Conclusions: Diaries are an innovative method of capturing the work experiences of managers at the PHC level, as they allow for confidentiality and anonymity, often not possible with other qualitative research methods. The expressed concerns of nursing managers must be addressed to ensure the success of South Africa's health sector reforms, particularly at the PHC level.

  19. Laboratory and field evaluation of the Partec CyFlow miniPOC for absolute and relative CD4 T-cell enumeration.

    Directory of Open Access Journals (Sweden)

    Djibril Wade

    Full Text Available A new CD4 point-of-care instrument, the CyFlow miniPOC, which provides absolute and percentage CD4 T-cells, used for screening and monitoring of HIV-infected patients in resource-limited settings, was introduced recently. We assessed the performance of this novel instrument in a reference laboratory and in a field setting in Senegal.A total of 321 blood samples were obtained from 297 adults and 24 children, all HIV-patients attending university hospitals in Dakar, or health centers in Ziguinchor. Samples were analyzed in parallel on CyFlow miniPOC, FACSCount CD4 and FACSCalibur to assess CyFlow miniPOC precision and accuracy.At the reference lab, CyFlow miniPOC, compared to FACSCalibur, showed an absolute mean bias of -12.6 cells/mm3 and a corresponding relative mean bias of -2.3% for absolute CD4 counts. For CD4 percentages, the absolute mean bias was -0.1%. Compared to FACSCount CD4, the absolute and relative mean biases were -31.2 cells/mm3 and -4.7%, respectively, for CD4 counts, whereas the absolute mean bias for CD4 percentages was 1.3%. The CyFlow miniPOC was able to classify HIV-patients eligible for ART with a sensitivity of ≥ 95% at the different ART-initiation thresholds (200, 350 and 500 CD4 cells/mm3. In the field lab, the room temperature ranged from 30 to 35°C during the working hours. At those temperatures, the CyFlow miniPOC, compared to FACSCount CD4, had an absolute and relative mean bias of 7.6 cells/mm3 and 2.8%, respectively, for absolute CD4 counts, and an absolute mean bias of 0.4% for CD4 percentages. The CyFlow miniPOC showed sensitivity equal or greater than 94%.The CyFlow miniPOC showed high agreement with FACSCalibur and FACSCount CD4. The CyFlow miniPOC provides both reliable absolute CD4 counts and CD4 percentages even under the field conditions, and is suitable for monitoring HIV-infected patients in resource-limited settings.

  20. POC CD4 Testing Improves Linkage to HIV Care and Timeliness of ART Initiation in a Public Health Approach: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Lara Vojnov

    Full Text Available CD4 cell count is an important test in HIV programs for baseline risk assessment, monitoring of ART where viral load is not available, and, in many settings, antiretroviral therapy (ART initiation decisions. However, access to CD4 testing is limited, in part due to the centralized conventional laboratory network. Point of care (POC CD4 testing has the potential to address some of the challenges of centralized CD4 testing and delays in delivery of timely testing and ART initiation. We conducted a systematic review and meta-analysis to identify the extent to which POC improves linkages to HIV care and timeliness of ART initiation.We searched two databases and four conference sites between January 2005 and April 2015 for studies reporting test turnaround times, proportion of results returned, and retention associated with the use of point-of-care CD4. Random effects models were used to estimate pooled risk ratios, pooled proportions, and 95% confidence intervals.We identified 30 eligible studies, most of which were completed in Africa. Test turnaround times were reduced with the use of POC CD4. The time from HIV diagnosis to CD4 test was reduced from 10.5 days with conventional laboratory-based testing to 0.1 days with POC CD4 testing. Retention along several steps of the treatment initiation cascade was significantly higher with POC CD4 testing, notably from HIV testing to CD4 testing, receipt of results, and pre-CD4 test retention (all p<0.001. Furthermore, retention between CD4 testing and ART initiation increased with POC CD4 testing compared to conventional laboratory-based testing (p = 0.01. We also carried out a non-systematic review of the literature observing that POC CD4 increased the projected life expectancy, was cost-effective, and acceptable.POC CD4 technologies reduce the time and increase patient retention along the testing and treatment cascade compared to conventional laboratory-based testing. POC CD4 is, therefore, a useful tool

  1. A Nursing Management Model to Increase Medication Adherence and Nutritional Status of Patients with Pulmonary TB

    Directory of Open Access Journals (Sweden)

    Eka Mishbahatul Mar’ah Has

    2015-04-01

    Full Text Available Introduction: High dropout rate, inadequate treatment, and resistance to medication, still become an obstacle in the treatment of pulmonary TB. Pulmonary TB patient care management at home can be done actively through telenursing. N-SMSI (Ners-Short Message Service Intervention is one of community nursing intervention, in which community nurses send short messages to remind patients to take medication and nutrition. The aim of this study was to analyze the effect of nursing management model N-SMSI to increased medication adherence and nutritional status of patients with pulmonary TB. Method: This study was used prospective design. The populations were new pulmonary TB patient at intensive phase, at Puskesmas Pegirian Surabaya. Samples were taken by purposive sampling technique; consist of 30 people, divided into treatment and control groups. The independent variable was N-SMSI. The dependent variables were medication adherence collected by using questionnaire and nutritional status by using measurement of body weight (kg. The data were then analyzed by using Wilcoxon Signed Rank Test, Mann Whitney, and Independent t-test with α ≤ 0.05 Result: The results of wilcoxon signed rank test had showed difference in the nutritional status of the treatment group before and after intervention, with p = 0.001. It’s similar with the control group, with p = 0.002. Mann whitney test results had showed no signifi cant difference in nutritional status between treatment and control group, as indicated by the value of p=0.589. While independent t-test had showed difference in compliance between treatment and control group, with p=0.031. Conslusion: N-SMSI can improve medication adherence of patient with Pulmonary TB. This model can be developed by nurse as alternative methods to improve medication adherence in patients with Pulmonary TB. Further research should modify nursing management model which can improve the nutritional status of patient with Pulmonary

  2. Comparisons between POC and zooplankton swimmer flux from sediment traps in the subarctic and subtropical North Pacific

    Science.gov (United States)

    Yokoi, Naoya; Abe, Yoshiyuki; Kitamura, Minoru; Honda, Makio C.; Yamaguchi, Atsushi

    2018-03-01

    Seasonal changes in zooplankton swimmer (ZS) abundance, biomass and community structure were evaluated based on samples collected by moored sediment traps at a depth of 200 m in the subarctic (SA) and subtropical (ST) western North Pacific. Based on these samples, we made comparisons on two topics: 1) latitudinal (subarctic vs. subtropical) changes in ZS abundance, biomass and community and 2) quantitative differences between the ZS and particle organic carbon (POC) fluxes based on data from moored or drifting sediment traps. The results showed that the ZS flux was greater in the SA (annual mean: 311 ind. m-2 day-1 or 258 mg C m-2 day-1) than in the ST (135 ind. m-2 day-1 or 38 mg C m-2 day-1). The peak ZS flux was observed from July-August in the SA and from April-May in the ST. The dominant taxa were Copepoda and Chaetognatha in the SA and Ostracoda and Mollusca in the ST. These latitudinal differences are likely related to the dominance of large-sized Copepoda in the SA, regional differences in the timing of the spring phytoplankton bloom, and the magnitude and size structure of primary producers. The percent composition of ZS to the total C flux (= ZS+POC flux) varied by region: 85-95% in the SA and 47-75% in the ST. These differences between the ZS composition and the total C flux are most likely caused by the dominance of large-sized Copepoda (Neocalanus spp. and Eucalanus bungii) in the SA.

  3. Den inre och yttre självkänslans betydelse för tendensen att bruka self-handicapping

    OpenAIRE

    Ottosson, Olivia

    2008-01-01

    Självkänsla är något vi ständigt bär med oss och den inverkar på vårt agerande samt våra val i livet. Johnson (2003) delar in självkänslan i två delar den inre och yttre, vilka kan kombineras till fyra personligheter. Forskning har visat att självkänslan samvarierar med tendensen till att bruka self-handicapping. Self-handicapping innebär att människan skapar hinder för sig själv påhittade eller verkliga. Etthundrasju studenter fyllde i en enkät bestående av 58 påståenden, vilken mätte inre, ...

  4. Image Navigation and Registration (INR) Performance Assessment Tool Set (IPATS) for the GOES-R Advanced Baseline Imager and Geostationary Lightning Mapper

    Science.gov (United States)

    DeLuccia, Frank J.; Houchin, Scott; Porter, Brian C.; Graybill, Justin; Haas, Evan; Johnson, Patrick D.; Isaacson, Peter J.; Reth, Alan D.

    2016-01-01

    The GOES-R Flight Project has developed an Image Navigation and Registration (INR) Performance Assessment Tool Set (IPATS) for measuring Advanced Baseline Imager (ABI) and Geostationary Lightning Mapper (GLM) INR performance metrics in the post-launch period for performance evaluation and long term monitoring. For ABI, these metrics are the 3-sigma errors in navigation (NAV), channel-to-channel registration (CCR), frame-to-frame registration (FFR), swath-to-swath registration (SSR), and within frame registration (WIFR) for the Level 1B image products. For GLM, the single metric of interest is the 3-sigma error in the navigation of background images (GLM NAV) used by the system to navigate lightning strikes. 3-sigma errors are estimates of the 99.73rd percentile of the errors accumulated over a 24 hour data collection period. IPATS utilizes a modular algorithmic design to allow user selection of data processing sequences optimized for generation of each INR metric. This novel modular approach minimizes duplication of common processing elements, thereby maximizing code efficiency and speed. Fast processing is essential given the large number of sub-image registrations required to generate INR metrics for the many images produced over a 24 hour evaluation period. Another aspect of the IPATS design that vastly reduces execution time is the off-line propagation of Landsat based truth images to the fixed grid coordinates system for each of the three GOES-R satellite locations, operational East and West and initial checkout locations. This paper describes the algorithmic design and implementation of IPATS and provides preliminary test results.

  5. Developing a leadership laboratory for nurse managers based on lived experiences: a participatory action research model for leadership development.

    Science.gov (United States)

    Mackoff, Barbara L; Glassman, Kimberly; Budin, Wendy

    2013-09-01

    The aim of the pilot study was to design an innovative model of leadership development, Leadership Laboratory (LL), grounded in the lived experiences and peer best practices of 43 cross-disciplinary nurse managers. The Institute of Medicine/Robert Wood Johnson Foundation study, The Future of Nursing, reinforces the need to prepare nurses for leadership positions. A 1-year participatory action research study was designed to develop 3 LLs involving nurse managers as participants, co-creators, and evaluators of the unique learning format. Analysis of qualitative and quantitative data revealed consistent and significantly positive results in leadership skill areas in all 3 LLs. Participants identified elements that distinguished LLs from traditional seminars and trainings sessions, including opportunities to gain from peer-to peer consultation, strategies, and support. Participants in the 1-year pilot demonstrated significant learning based on postsession and postproject assessments of the LLs. Data also described the unique attributes of a peer-driven approach to leadership development.

  6. Practicability of patient self-testing of oral anticoagulant therapy by the international normalized ratio (INR) using a portable whole blood monitor. A pilot investigation.

    Science.gov (United States)

    Hasenkam, J M; Knudsen, L; Kimose, H H; Grønnesby, H; Attermann, J; Andersen, N T; Pilegaard, H K

    1997-01-01

    The prophylactic efficacy of long-term oral anticoagulant treatment (OAT) has been demonstrated in a number of clinical conditions with increased tendency to thromboembolism, and the number of individuals subjected to OAT in the industrialised world has increased substantially in recent years. Since this therapy requires considerable resources from both the health care system and the patients, the feasibility of patients' self-monitoring and self-management of OAT has been investigated (1,2,3). The anticipated advantages of this approach include improved convenience and compliance for the patient, who may increase his apprehension for managing the treatment. In addition, self-testing allows for more frequent control compared to the conventional out-patient approach. Importantly, a prerequisite for conceiving a safe and operational concept for patient self-management (PSM) is the availability of a portable INR monitoring system with an accuracy, precision, reproducibility, and long-term reliability comparable to standard coagulometric equipment. The purpose of the present study was to evaluate the feasibility of a commercially available INR-monitor. CoaguChek, for patient self-testing, through a step-wise investigation of the performance characteristics of the equipment in the laboratory, in command of the patient, and during self-testing and self-adjustment of treatment at home. Laboratory INR values were used as reference.

  7. Job satisfaction and perceived autonomy for nurse practitioners working in nurse-managed health centers.

    Science.gov (United States)

    Pron, Ann Linguiti

    2013-04-01

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

  8. Improving clinical handover in a paediatric ward: implications for nursing management.

    Science.gov (United States)

    Mannix, Trudi; Parry, Yvonne; Roderick, Allison

    2017-04-01

    To describe how nursing staff in a paediatric ward improved the conduct of clinical handover, using a practise development approach. ISBAR (Identify, Situation, Background, Assessment and Recommendation) is a mnemonic tool to aid the safe transfer of patient information in clinical handover. The nurses identified the need to improve the use of ISBAR, and other issues related to handover that could compromise patient safety and constrain family-centred care. Sixty-one percent of nurses on the ward contributed to issue identification and the design of the educational material, including a set of written and video resources and incorporating the role of a handover coach. Staff performance was evaluated before and after access to the resources using self-administered Likert scales, observation and a focus group. After the intervention, there was a stronger relationship between the participants' understanding of ISBAR and their application of it in handover. Further, there were statistically significant increases in improved handover practises, including family inclusion and safety checks. A practise development approach is useful in the provision of education to guide clinical performance in patient handover. Nurse managers can use this approach to empower their staff to make positive changes to practise. © 2017 John Wiley & Sons Ltd.

  9. Education of nurse practitioners in academic nurse-managed centers: student perspectives.

    Science.gov (United States)

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

    2003-01-01

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

  10. Nurse consultants 10 years on: an insight to the role for nurse managers.

    Science.gov (United States)

    Mullen, Chris; Gavin-Daley, Ann; Kilgannon, Helen; Swift, Juliette

    2011-09-01

    To evaluate the Non-Medical Consultant role in the North West of England. The objective was to identify the current number of Non-Medical Consultants, what they do and the impact of the role in practice. The Non-Medical Consultant role for nursing and midwifery was introduced in the UK in 2000 to provide better outcomes for patients by improving service and quality; strengthening clinical leadership; and providing a new career opportunity to help retain experienced and expert professionals in practice. A combined qualitative and quantitative design was adopted. This included desktop review of previous studies, a survey questionnaire to current consultants, focus group meetings with Non-Medical Consultants, sponsors and champions. The role is effective, flexible, responsive and outward facing both internal to the organization and externally on a local, regional and national basis. A key challenge for the Non-Medical Consultants was organizational understanding of the role. The small size of the Non-Medical Consultant workforce can limit individual organizations experience of establishing and supporting the role. Effective Non-Medical Consultants lead, drive and support quality improvement, increased productivity and service effectiveness. Other impacts include sharing and promoting best practice with colleagues, income generation and financial savings through service redesign and/or staff skill mix changes. Managerial issues identified may assist Nurse Managers seeking to introduce new consultant roles and/or support, and retain existing consultants to reach their full potential. 2011 Blackwell Publishing Ltd.

  11. [Empowering leadership style among health care workers. A study on the nurse manager].

    Science.gov (United States)

    Bobbio, A; Manganelli Rattazzi, A M; Muraro, M

    2007-01-01

    The aim of the study is to supply a contribution to the validity analysis of the Empowering Leadership Questionnaire (ELQ) in the Italian context. The ELQ has been developed in order to measure empowering leadership style in organizational contexts and, in the present work, has been administered to a group of health care workers in order to evaluate the Nurse Manager's leadership style. Three hundred and eleven individuals from an important Local Health Unit of the Veneto Region participated in the study, filling out a self-administered structured questionnaires. Correlations between ELQ, task-oriented, relationship-oriented and transformational leadership stile are addressed. Moreover, the relationships between ELQ, organizational commitment, job burnout, turnover intentions and job satisfaction are analyzed. Exploratory, confirmatory, reliability analyses and path analyses techniques are applied. Results support the main results obtained by the authors of the scale. In addition, with regards to ELQ predictive validity, the selected dependent variables (turnover intentions and job satisfaction) are significantly influenced by some of the ELQ dimensions, via the mediation of affective commitment and job burnout, supporting the value of the ELQ measures in the healthcare context.

  12. Can I relate? A review and guide for nurse managers in leading generations.

    Science.gov (United States)

    Christensen, Scott S; Wilson, Barbara L; Edelman, Linda S

    2018-01-30

    The purpose of this review is to help the nurse leader develop an understanding of the five generations currently in the health care workforce by providing defining characteristics, general behaviours, and strategies for the nurse manager to employ for each generational cohort. Generations are groups of people born during the same 15-20 year time period who share similar experiences before adulthood, which shape long-term behaviours. Key descriptors and characteristics are provided. The current generational cohorts in the health care workforce are Traditionalists (born between 1922 and 1945), baby boomers (born between 1946 and 1964), Generation X (born between 1965 and 1979), millennials (born between 1980 and 1995), and Generation Z (born after 1995). Health care teams often comprise members of three or more generations. Intergenerational differences in team members can result in challenges; however, different perspectives provided by multiple generations can be used advantageously to strengthen the team's efficiency and outcomes. There are strengths in each generation. Key differences can be harnessed to build stronger teams through comprehensive communication strategies, customized reward systems, and workplace flexibility. Examples are provided for each area. Managers can use intergenerational differences to create a rich environment that bridges generational differences and fosters workforce cohesion. © 2018 John Wiley & Sons Ltd.

  13. Leadership style and choice of strategy in conflict management among Israeli nurse managers in general hospitals.

    Science.gov (United States)

    Hendel, Tova; Fish, Miri; Galon, Vered

    2005-03-01

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

  14. Evaluation of Time Management Behaviors and Its Related Factors in the Senior Nurse Managers, Kermanshah-Iran

    OpenAIRE

    Ziapour, Arash; Khatony, Alireza; Jafari, Faranak; Kianipour, Neda

    2015-01-01

    Background and Objective: Time management is an extensive concept that is associated with promoting the performance of managers. The present study was carried out to investigate the time management behaviors along with its related factors among senior nurse mangers. Materials and Methods: In this descriptive-analytical study, 180 senior nurse managers were selected using census method. The instrument for data collection was a standard time behavior questionnaire. Data were analyzed by descrip...

  15. Nurse managers' experience with ethical issues in six government hospitals in Malaysia: a cross-sectional study.

    Science.gov (United States)

    Musa, Maizura binti; Harun-Or-Rashid, M D; Sakamoto, Junichi

    2011-11-16

    Nurse managers have the burden of experiencing frequent ethical issues related to both their managerial and nursing care duties, according to previous international studies. However, no such study was published in Malaysia. The purpose of this study was to explore nurse managers' experience with ethical issues in six government hospitals in Malaysia including learning about the way they dealt with the issues. A cross-sectional study was conducted in August-September, 2010 involving 417 (69.2%) of total 603 nurse managers in the six Malaysian government hospitals. Data were collected using three-part self-administered questionnaire. Part I was regarding participants' demographics. Part II was about the frequency and areas of management where ethical issues were experienced, and scoring of the importance of 11 pre-identified ethical issues. Part III asked how they dealt with ethical issues in general; ways to deal with the 11 pre-identified ethical issues, and perceived stress level. Data were analyzed using descriptive statistics, cross-tabulations and Pearson's Chi-square. A total of 397 (95.2%) participants experienced ethical issues and 47.2% experienced them on weekly to daily basis. Experiencing ethical issues were not associated with areas of practice. Top area of management where ethical issues were encountered was "staff management", but "patient care" related ethical issues were rated as most important. Majority would "discuss with other nurses" in dealing generally with the issues. For pre-identified ethical issues regarding "patient care", "discuss with doctors" was preferred. Only 18.1% referred issues to "ethics committees" and 53.0% to the code of ethics. Nurse managers, regardless of their areas of practice, frequently experienced ethical issues. For dealing with these, team-approach needs to be emphasized. Proper understanding of the code of ethics is needed to provide basis for reasoning.

  16. Characteristics of the nurse manager's recognition behavior and its relation to sense of coherence of staff nurses in Japan.

    Science.gov (United States)

    Miyata, Chiharu; Arai, Hidenori; Suga, Sawako

    2015-01-01

    The recognition behaviors strongly influence the job satisfaction of staff nurses and an extremely important factor for the prevention of burnout and the promotion of retention. Additionally, among internal factors that may affect worker's mental health, a sense of coherence (SOC) is an important concept from the view of the salutogenic theory and stress recognition style. Individual's SOC increases in relation to recognition behavior. However, in Japan, few studies have examined the effect of recognition behaviors on the SOC of staff nurses. The purpose of this study was to investigate how staff nurses perceive recognition behaviors of the nurse manager and to determine the relationship between recognition behaviors and the staff nurses' SOC. This quantitative, cross-sectional study involved 10 hospitals in Japan. A total of 1425 nurses completed the questionnaire. As a result, the perceptions of nurse manager's recognition behaviors by staff nurses were evaluated by presentation and report, individual value and the transfer of responsibility, and professional development. The median score of staff nurse SOC-13 was 50 (IQR; 45-55). Significant differences in SOC scores were found in marital status, age, years of experience, and mental and physical health condition. In conclusion, recognition behaviors by the nurse manager can improve staff nurse's SOC and effectively support the mental health of the staff nurse.

  17. Evaluation of time management behaviors and its related factors in the senior nurse managers, Kermanshah-Iran.

    Science.gov (United States)

    Ziapour, Arash; Khatony, Alireza; Jafari, Faranak; Kianipour, Neda

    2015-01-21

    Time management is an extensive concept that is associated with promoting the performance of managers. The present study was carried out to investigate the time management behaviors along with its related factors among senior nurse mangers. In this descriptive-analytical study, 180 senior nurse managers were selected using census method. The instrument for data collection was a standard time behavior questionnaire. Data were analyzed by descriptive and analytical statistics. The findings showed that among the dimensions of time management behaviors, setting objectives and prioritization, and mechanics of time management dimensions obtained the highest and lowest frequency, respectively. Comparison of the mean scores of time management behaviors indicated a significant difference in the gender (p<0.05), age (p<0.001), education (p=0.015), job experience (p<0.001), managerial experience (p<0.001) and management rank management (p<0.029). On the whole, senior nurse managers enjoyed a favorable time management skill. Given the importance of time management behaviors, it seems that teaching these behaviors more seriously through regular educational programs can effectively promote the performance of senior nurse managers.

  18. [Influence of Nurse Managers' Authentic Leadership on Nurses' Organizational Commitment and Job Satisfaction: Focused on the Mediating Effects of Empowerment].

    Science.gov (United States)

    Choi, Han Gyo; Ahn, Sung Hee

    2016-02-01

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

  19. Nurse managers: Determinants and behaviours in relation to patient and visitor aggression in general hospitals. A qualitative study.

    Science.gov (United States)

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

    2017-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Karien Jooste

    2013-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Karien Jooste

    2013-01-01

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

  2. Functional identification in Lactobacillus reuteri of a PocR-like transcription factor regulating glycerol utilization and vitamin B12 synthesis

    Directory of Open Access Journals (Sweden)

    Saulnier Delphine MA

    2011-07-01

    Full Text Available Abstract Background Lactobacillus reuteri harbors the genes responsible for glycerol utilization and vitamin B12 synthesis within a genetic island phylogenetically related to gamma-Proteobacteria. Within this island, resides a gene (lreu_1750 that based on its genomic context has been suggested to encode the regulatory protein PocR and presumably control the expression of the neighboring loci. However, this functional assignment is not fully supported by sequence homology, and hitherto, completely lacks experimental confirmation. Results In this contribution, we have overexpressed and inactivated the gene encoding the putative PocR in L. reuteri. The comparison of these strains provided metabolic and transcriptional evidence that this regulatory protein controls the expression of the operons encoding glycerol utilization and vitamin B12 synthesis. Conclusions We provide clear experimental evidence for assigning Lreu_1750 as PocR in Lactobacillus reuteri. Our genome-wide transcriptional analysis further identifies the loci contained in the PocR regulon. The findings reported here could be used to improve the production-yield of vitamin B12, 1,3-propanediol and reuterin, all industrially relevant compounds.

  3. Spatial distribution and mobility of organic carbon (POC and DOC) in a coastal Mediterranean environment (Saronikos Gulf, Greece) during 2007-2009 period.

    Science.gov (United States)

    Evangeliou, Nikolaos; Florou, Heleny

    2013-08-01

    Particulate (POC) and dissolved organic carbon (DOC) is an important parameter for the pollution assessment of coastal marine systems, especially those affected by anthropogenic, domestic, and industrial activities. In the present paper, a similar marine system (Saronikos Gulf) located in the west-central Aegean Sea (eastern Mediterranean Sea) was examined, in terms of the temporal and spatial distribution of organic carbon (POC and DOC), with respect to marine sources and pathways. POC was maximum in winter in the Saronikos Gulf, due to the bloom of phytoplankton, whereas in the Elefsis Bay (located in the north side of the Saronikos Gulf) in summer, since phytoplankton grazes in the Bay in the end of summer (except for winter). Approximately 60 % of the bulk DOC of the water column was estimated as non-refractory (labile and semi-labile), due to the major anthropogenic, domestic, and industrial effects of the region and the shallow depths. The spatial distribution of POC and DOC mainly affects the northeastern section of the Gulf, since that region has been accepted major organic discharges for a long time period, in connection to the relatively long renewal times of its waters.

  4. Integrating patient reported outcomes with clinical cancer registry data: a feasibility study of the electronic Patient-Reported Outcomes From Cancer Survivors (ePOCS) system.

    Science.gov (United States)

    Ashley, Laura; Jones, Helen; Thomas, James; Newsham, Alex; Downing, Amy; Morris, Eva; Brown, Julia; Velikova, Galina; Forman, David; Wright, Penny

    2013-10-25

    Routine measurement of Patient Reported Outcomes (PROs) linked with clinical data across the patient pathway is increasingly important for informing future care planning. The innovative electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system was developed to integrate PROs, collected online at specified post-diagnostic time-points, with clinical and treatment data in cancer registries. This study tested the technical and clinical feasibility of ePOCS by running the system with a sample of potentially curable breast, colorectal, and prostate cancer patients in their first 15 months post diagnosis. Patients completed questionnaires comprising multiple Patient Reported Outcome Measures (PROMs) via ePOCS within 6 months (T1), and at 9 (T2) and 15 (T3) months, post diagnosis. Feasibility outcomes included system informatics performance, patient recruitment, retention, representativeness and questionnaire completion (response rate), patient feedback, and administration burden involved in running the system. ePOCS ran efficiently with few technical problems. Patient participation was 55.21% (636/1152) overall, although varied by approach mode, and was considerably higher among patients approached face-to-face (61.4%, 490/798) than by telephone (48.8%, 21/43) or letter (41.0%, 125/305). Older and less affluent patients were less likely to join (both Pplanning and for targeting service provision.

  5. 14C as a tool for evaluating riverine POC sources and erosion of the Zhujiang (Pearl River) drainage basin, South China

    International Nuclear Information System (INIS)

    Wei Xiuguo; Yi Weixi; Shen Chengde; Yechieli, Yoseph; Li Ningli; Ding Ping; Wang Ning; Liu Kexin

    2010-01-01

    Radiocarbon can serve as a powerful tool for identifying sources of organic carbon and evaluating the erosion intensity in river drainage basins. In this paper we present 14 C-AMS measurements of particulate organic carbon (POC) collected from the three major tributaries of the Zhujiang (Pearl River) system: the Xijiang (Western River), Beijiang (Northern River) and Dongjiang (Eastern River) rivers. Furthermore, we discuss the distribution of POC 14 C apparent ages and the related watersheds erosion of these rivers. Results yield Δ 14 C values of -425 per mille to -65 per mille which indicate that the 14 C apparent ages of suspended POC in the entire area are in the range of 540-4445 years. The POC apparent ages from Xijiang are mostly between 2000 and 4000 years, while in Dongjiang they mostly range from 540 to 1010 years. These 14 C apparent ages indicate that the watershed erosion of the Xijiang is more severe than that of the Dongjiang. This is in agreement with other data showing deeper erosion in Xijiang due to human activities.

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

    Directory of Open Access Journals (Sweden)

    Kyegombe Nambusi

    2011-03-01

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

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

    Science.gov (United States)

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

    2011-03-09

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

  8. PT and INR Test

    Science.gov (United States)

    ... Plasma Free Metanephrines Platelet Count Platelet Function Tests Pleural Fluid Analysis PML-RARA Porphyrin Tests Potassium Prealbumin ... and vitamin K (either in a multivitamin or liquid nutrition supplement) may decrease PT. Certain foods, such ...

  9. Ultra-High Gradient Channeling Acceleration in Nanostructures: Design/Progress of Proof-of-Concept (POC) Experiments

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Young Min [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Northern Illinois Univ., DeKalb, IL (United States). Northern Illinois Center for Accelerator & Detector Development; Green, A. [Northern Illinois Univ., DeKalb, IL (United States). Northern Illinois Center for Accelerator & Detector Development; Lumpkin, A. H. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Thurman-Keup, R. M. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Shiltsev, V. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Zhang, X. [Shanhai Inst. of Optics and Fine Mechanics, Shanghai (China); Farinella, D. M. [Univ. of California, Irvine, CA (United States); Taborek, P. [Univ. of California, Irvine, CA (United States); Tajima, T. [Univ. of California, Irvine, CA (United States); Wheeler, J. A. [Univ. of Michigan, Ann Arbor, MI (United States). Center for Ultrafast Optical Science and FOCUS Center; Ecole Polytechnique, CNRS, Palaiseau (France). Lab. d' Optique Appliquee; Mourou, G. [Univ. of Michigan, Ann Arbor, MI (United States). Center for Ultrafast Optical Science and FOCUS Center; Ecole Polytechnique, CNRS, Palaiseau (France). Lab. d' Optique Appliquee

    2016-09-16

    A short bunch of relativistic particles or a short-pulse laser perturbs the density state of conduction electrons in a solid crystal and excites wakefields along atomic lattices in a crystal. Under a coupling condition the wakes, if excited, can accelerate channeling particles with TeV/m acceleration gradients in principle since the density of charge carriers (conduction electrons) in solids n0 = ~ 1020 – 1023 cm-3 is significantly higher than what can be obtained in gaseous plasma. Nanostructures have some advantages over crystals for channeling applications of high power beams. The dechanneling rate can be reduced and the beam acceptance increased by the large size of the channels. For beam-driven acceleration, a bunch length with a sufficient charge density would need to be in the range of the plasma wavelength to properly excite plasma wakefields, and channeled particle acceleration with the wakefields must occur before the ions in the lattices move beyond the restoring threshold. In the case of the excitation by short laser pulses, the dephasing length is appreciably increased with the larger channel, which enables channeled particles to gain sufficient amounts of energy. This paper describes simulation analyses on beam- and laser (X-ray)-driven accelerations in effective nanotube models obtained from Vsim and EPOCH codes. Experimental setups to detect wakefields are also outlined with accelerator facilities at Fermilab and NIU. In the FAST facility, the electron beamline was successfully commissioned at 50 MeV and it is being upgraded toward higher energies for electron accelerator R&D. The 50 MeV injector beamline of the facility is used for X-ray crystal-channeling radiation with a diamond target. It has been proposed to utilize the same diamond crystal for a channeling acceleration POC test. Another POC experiment is also designed for the NIU accelerator lab with time-resolved electron diffraction. Recently, a

  10. Specialist palliative care nurses' management of the needs of patients with depression.

    Science.gov (United States)

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

    2017-06-02

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

  11. Study of relationship between the organizational structure and market orientation from the viewpoint of nurse managers.

    Science.gov (United States)

    Bahadori, Mohammadkarim; Yaghoubi, Maryam; Javadi, Marzieh; Rahimi, Zahreh Agha

    2015-01-01

    Considering globalization of health care and quality improvement trend to respond to competition and customer orientation, attention to organizational structure and its relationship with market orientation is essential. Therefore, this study reviews the relationship between organizational structure and market orientation in selected hospitals of Isfahan (Iran). This study was a descriptive survey. The study population comprised nurse managers from selected hospitals (n = 80). Data collection tools were two questionnaires (market orientation questionnaire and organizational structure) that the validity and reliability were confirmed (r = 0.83 for market orientation questionnaire and r = 0.87 for organizational structure). SPSS (Ver. 16) software was used for the analyses. The mean score of organizational structure was 65.4 (11.2) and total mean of market orientation was 51.14 (17.6). All aspects of the organizational structure (Organization Centralization, Formalization in Organization, and Organization Complication) and market orientation (responding to competition, accountability, customer satisfaction, intelligent organization)-except by responding to clients with Formalization in Organization-as well as all aspects of the Systemic attitude (the system of internal coordination and communication systems_ and market orientation (responding to competition, accountability, customer satisfaction, intelligent organization), there was a meaningful relationship (P organizational structure and can lead managers' view to the analysis and recognizing elements of success and achievement to goals. With increasing competition in markets, globalization of health services, and presence in international markets and more attention to patients' satisfaction, hospitals need to understand and use of market orientation in order to promote quality and services in the health care system.

  12. Organizational intellectual capital and the role of the nurse manager: A proposed conceptual model.

    Science.gov (United States)

    Gilbert, Jason H; Von Ah, Diane; Broome, Marion E

    Nurse managers must leverage both the human capital and social capital of the teams they lead in order to produce quality outcomes. Little is known about the relationship between human capital and social capital and how these concepts may work together to produce organizational outcomes through leadership of nurses. The purpose of this article was to explore the concepts of human capital and social capital as they relate to nursing leadership in health care organizations. Specific aims included (a) to synthesize the literature related to human capital and social capital in leadership, (b) to refine the conceptual definitions of human capital and social capital with associated conceptual antecedents and consequences, and (c) to propose a synthesized conceptual model guiding further empirical research of social capital and human capital in nursing leadership. A systematic integrative review of leadership literature using criteria informed by Whittemore and Knafl (2005) was completed. CINAHL Plus with Full Text, Academic Search Premier, Business Source Premier, Health Business FullTEXT, MEDLINE, and PsychINFO databases were searched for the years 1995 to 2016 using terms "human capital," "social capital," and "management." Analysis of conceptual definitions, theoretical and conceptual models, antecedents and consequences, propositions or hypotheses, and empirical support for 37 articles fitting review criteria resulted in the synthesis of the proposed Gilbert Conceptual Model of Organizational Intellectual Capital. The Gilbert Conceptual Model of Organizational Intellectual Capital advances the propositions of human capital theory and social capital theory and is the first model to conceptualize the direct and moderating effects that nurse leaders have on the human capital and social capital of the teams they lead. This model provides a framework for further empirical study and may have implications for practice, organizational policy, and education related to nursing

  13. Calcium-binding capacity of centrin2 is required for linear POC5 assembly but not for nucleotide excision repair.

    Directory of Open Access Journals (Sweden)

    Tiago J Dantas

    Full Text Available Centrosomes, the principal microtubule-organising centres in animal cells, contain centrins, small, conserved calcium-binding proteins unique to eukaryotes. Centrin2 binds to xeroderma pigmentosum group C protein (XPC, stabilising it, and its presence slightly increases nucleotide excision repair (NER activity in vitro. In previous work, we deleted all three centrin isoforms present in chicken DT40 cells and observed delayed repair of UV-induced DNA lesions, but no centrosome abnormalities. Here, we explore how centrin2 controls NER. In the centrin null cells, we expressed centrin2 mutants that cannot bind calcium or that lack sites for phosphorylation by regulatory kinases. Expression of any of these mutants restored the UV sensitivity of centrin null cells to normal as effectively as expression of wild-type centrin. However, calcium-binding-deficient and T118A mutants showed greatly compromised localisation to centrosomes. XPC recruitment to laser-induced UV-like lesions was only slightly slower in centrin-deficient cells than in controls, and levels of XPC and its partner HRAD23B were unaffected by centrin deficiency. Interestingly, we found that overexpression of the centrin interactor POC5 leads to the assembly of linear, centrin-dependent structures that recruit other centrosomal proteins such as PCM-1 and NEDD1. Together, these observations suggest that assembly of centrins into complex structures requires calcium binding capacity, but that such assembly is not required for centrin activity in NER.

  14. Positive practice environments influence job satisfaction of primary health care clinic nursing managers in two South African provinces

    Science.gov (United States)

    2014-01-01

    Background Nurses constitute the majority of the health workforce in South Africa and they play a major role in providing primary health care (PHC) services. Job satisfaction influences nurse retention and successful implementation of health system reforms. This study was conducted in light of renewed government commitment to reforms at the PHC level, and to contribute to the development of solutions to the challenges faced by the South African nursing workforce. The objective of the study was to determine overall job satisfaction of PHC clinic nursing managers and the predictors of their job satisfaction in two South African provinces. Methods During 2012, a cross-sectional study was conducted in two South African provinces. Stratified random sampling was used to survey a total of 111 nursing managers working in PHC clinics. These managers completed a pre-tested Measure of Job Satisfaction questionnaire with subscales on personal satisfaction, workload, professional support, training, pay, career prospects and standards of care. Mean scores were used to measure overall job satisfaction and various subscales. Predictors of job satisfaction were determined through multiple logistic regression analysis. Results A total of 108 nursing managers completed the survey representing a 97% response rate. The mean age of respondents was 49 years (SD = 7.9) and the majority of them (92%) were female. Seventy-six percent had a PHC clinical training qualification. Overall mean job satisfaction scores were 142.80 (SD = 24.3) and 143.41 (SD = 25.6) for Gauteng and Free State provinces respectively out of a maximum possible score of 215. Predictors of job satisfaction were: working in a clinic of choice (RRR = 3.10 (95% CI: 1.11 to 8.62, P = 0.030)), being tired at work (RRR = 0.19 (95% CI: 0.08 to 0.50, P = 0.001)) and experience of verbal abuse (RRR = 0.18 (95% CI: 0.06 to 0.55, P = 0.001). Conclusion Allowing nurses greater choice of clinic

  15. Positive practice environments influence job satisfaction of primary health care clinic nursing managers in two South African provinces.

    Science.gov (United States)

    Munyewende, Pascalia Ozida; Rispel, Laetitia Charmaine; Chirwa, Tobias

    2014-05-15

    Nurses constitute the majority of the health workforce in South Africa and they play a major role in providing primary health care (PHC) services. Job satisfaction influences nurse retention and successful implementation of health system reforms. This study was conducted in light of renewed government commitment to reforms at the PHC level, and to contribute to the development of solutions to the challenges faced by the South African nursing workforce. The objective of the study was to determine overall job satisfaction of PHC clinic nursing managers and the predictors of their job satisfaction in two South African provinces. During 2012, a cross-sectional study was conducted in two South African provinces. Stratified random sampling was used to survey a total of 111 nursing managers working in PHC clinics. These managers completed a pre-tested Measure of Job Satisfaction questionnaire with subscales on personal satisfaction, workload, professional support, training, pay, career prospects and standards of care. Mean scores were used to measure overall job satisfaction and various subscales. Predictors of job satisfaction were determined through multiple logistic regression analysis. A total of 108 nursing managers completed the survey representing a 97% response rate. The mean age of respondents was 49 years (SD = 7.9) and the majority of them (92%) were female. Seventy-six percent had a PHC clinical training qualification. Overall mean job satisfaction scores were 142.80 (SD = 24.3) and 143.41 (SD = 25.6) for Gauteng and Free State provinces respectively out of a maximum possible score of 215. Predictors of job satisfaction were: working in a clinic of choice (RRR = 3.10 (95% CI: 1.11 to 8.62, P = 0.030)), being tired at work (RRR = 0.19 (95% CI: 0.08 to 0.50, P = 0.001)) and experience of verbal abuse (RRR = 0.18 (95% CI: 0.06 to 0.55, P = 0.001). Allowing nurses greater choice of clinic to work in, the prevention of violence

  16. White light-emitting nanocomposites based on an oxadiazole–carbazole copolymer (POC) and InP/ZnS quantum dots

    Energy Technology Data Exchange (ETDEWEB)

    Bruno, Annalisa, E-mail: annalisa.bruno@enea.it; Borriello, Carmela, E-mail: carmela.borriello@enea.it; Di Luccio, Tiziana, E-mail: tiziana.diluccio@enea.it; Nenna, Giuseppe [Centro Ricerche Portici, ENEA, UTTP NANO (Italy); Sessa, Lucia [University of Salerno, Department of Pharmacy (Italy); Concilio, Simona [University of Salerno, Department of Industrial Engineering (Italy); Haque, Saif A. [Imperial College London, Chemistry Department (United Kingdom); Minarini, Carla [Centro Ricerche Portici, ENEA, UTTP NANO (Italy)

    2013-11-15

    In this work, we studied energetic and optical proprieties of a polyester-containing oxadiazole and carbazole units that we will indicate as POC. This polymer is characterized by high photoluminescence activity in the blue region of the visible spectrum, making it suitable for the development of efficient white-emitting organic light emission devices. Moreover, POC polymer has been combined with two red emitters InP/ZnS quantum dots (QDs) to obtain nanocomposites with wide emission spectra. The two types of QDs have different absorption wavelengths: 570 nm [InP/ZnS(570)] and 627 nm [InP/ZnS(627)] and were inserted in the polymer at different concentrations. The optical properties of the nanocomposites have been investigated and compared to the ones of the pure polymer. Both spectral and time resolved fluorescence measurements show an efficient energy transfer from the polymer to QDs, resulting in white-emitting nanocomposites.

  17. White light-emitting nanocomposites based on an oxadiazole-carbazole copolymer (POC) and InP/ZnS quantum dots

    Science.gov (United States)

    Bruno, Annalisa; Borriello, Carmela; Di Luccio, Tiziana; Nenna, Giuseppe; Sessa, Lucia; Concilio, Simona; Haque, Saif A.; Minarini, Carla

    2013-11-01

    In this work, we studied energetic and optical proprieties of a polyester-containing oxadiazole and carbazole units that we will indicate as POC. This polymer is characterized by high photoluminescence activity in the blue region of the visible spectrum, making it suitable for the development of efficient white-emitting organic light emission devices. Moreover, POC polymer has been combined with two red emitters InP/ZnS quantum dots (QDs) to obtain nanocomposites with wide emission spectra. The two types of QDs have different absorption wavelengths: 570 nm [InP/ZnS(570)] and 627 nm [InP/ZnS(627)] and were inserted in the polymer at different concentrations. The optical properties of the nanocomposites have been investigated and compared to the ones of the pure polymer. Both spectral and time resolved fluorescence measurements show an efficient energy transfer from the polymer to QDs, resulting in white-emitting nanocomposites.

  18. Pengaruh Pemberian Urea, Tsp, Kcl Dan Pupuk Organik Cair (Poc) Kulit Pisang Terhadap Pertumbuhan Dan Produksi Tanaman Cabai Merah Keriting (Capsicum Annum L.)

    OpenAIRE

    adrian, Edo; Yetti, Husna

    2017-01-01

    This research to determine the interaction of inorganic fertilizer (Urea, TSP, KCl)and banana peelliquid organic fertilizer (POC) to find the best results on the growth and yield of red pepper (Capsicum annuum L.).This study was conducted for four months (March-June, 2016), the Experimental Station, Faculty of Agriculture, University of Riau Pekanbaru,using a completely randomized design (CRD) factorial,consists of two factors and three replications.The results were analyzed by analysis of va...

  19. Non-vitamin K antagonist oral anticoagulants compared with warfarin at different levels of INR control in atrial fibrillation: A meta-analysis of randomized trials.

    Science.gov (United States)

    Carmo, João; Ferreira, Jorge; Costa, Francisco; Carmo, Pedro; Cavaco, Diogo; Carvalho, Salomé; Morgado, Francisco; Adragão, Pedro; Mendes, Miguel

    2017-10-01

    The efficacy and safety of warfarin for stroke prevention in atrial fibrillation (AF) depend on the time in the therapeutic range (TTR) with an international normalised ratio (INR) of 2.0-3.0. This meta-analysis focused the relative efficacy and safety of non-VKA oral anticoagulants (NOAC) compared with warfarin at different thresholds of centre's TTR (cTTR). We searched PubMed, Embase, CENTRAL and websites of regulatory agencies, limiting searches to randomized phase 3 trials. Primary outcomes were stroke or systemic embolism (SSE) and major or non-major clinically relevant (NMCR) bleeding. We used a random-effects model to pool effect on outcomes according to different thresholds of cTTR. Four TTR sub-studies with a total of 71,222 patients were included. The benefit of NOAC in reducing SSE compared with warfarin was significantly higher in patients at cTTRwarfarin in patients at all sub-groups (0.67, 0.54-0.83 for patients at cTTRwarfarin for stroke prevention is lost above a cTTR threshold of approximately 70%, but the relative safety appears to be less modified by the centre-based quality of INR control. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. The evaluation of the compatibility of electronic patient record (EPR) system with nurses' management needs in a developing country.

    Science.gov (United States)

    Kahouei, Mehdi; Zadeh, Jamileh Mahdi; Roghani, Panoe Seyed

    2015-04-01

    In a developing country like Iran, wasting economic resources has a number of negative consequences. Therefore, it is crucial that problems of introducing new electronic systems be identified and addressed early to avoid failure of the programs. The purpose of this study was to evaluate head nurses' and supervisors' perceptions about the efficiency of the electronic patient record (EPR) system and its impact on nursing management tasks in order to provide useful recommendations. This descriptive study was performed in teaching hospitals affiliated to Semnan University of Medical Sciences, Iran. An anonymous self-administered questionnaire was developed. Head nurses and supervisors were included in this study. It was found that the EPR system was immature and was not proportionate to the operational level. Moreover, few head nurses and supervisors agreed on the benefits of the EPR system on the performance of their duties such as planning, organizing, budgeting, and coordinating. It is concluded that in addition to the technical improvements, the social and cultural factors should be considered to improve the acceptability of electronic systems through social marketing in the different aspects of nursing management. It is essential that health information technology managers emphasize on training head nurses and supervisors to design technology corresponding to their needs rather than to accept poorly designed technology. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. POCT PT INR - Is it adequate for patient care? A comparison of the Roche Coaguchek XS vs. Stago Star vs. Siemens BCS in patients routinely seen in an anticoagulation clinic.

    Science.gov (United States)

    Baker, Wendy S; Albright, Kathleen J; Berman, Megan; Spratt, Heidi; Mann, Peggy A; Unabia, Jaime; Petersen, John R

    2017-09-01

    In this study we examined the difference in patient INR values as measured by the POCT CoaguChek XS device and central laboratory Stago Evolution and Siemens BCS XP analyzers. This study composed of 100 warfarin therapy patients and 20 coagulation normal subjects, showed that the difference between the POCT and clinical laboratory values increased with increasing INR and was exacerbated by the use of different thromboplastin reagents by the POCT and central lab. The CoaguChek XS and on-site Stago analyzers which used human recombinant (ISI=1.01) and rabbit brain thromboplastin (ISI=1.25), respectively, showed reasonable agreement for INR5.0 with the Stago Evolution prevented adverse treatment events for the warfarin therapy patients in the six months preceding and following this investigation. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Evaluation and optimization of the Circulating Cathodic Antigen (POC-CCA) cassette test for detecting Schistosoma mansoni infection by using image analysis in school children in Mwanza Region, Tanzania

    DEFF Research Database (Denmark)

    Partal, Miriam Casacuberta; Kinunghi, Safari; Vennervald, Birgitte J

    2016-01-01

    of Lake Victoria in Mwanza Region, Tanzania, and to optimize the reading of the POC-CCA test lines by using a computer software image analysis. Initially, a pilot study in 106 school children indicated that time of urine collection did not have an impact on CCA results as 84.9% (90) had identical scores...... POC-CCAs were compared to six Kato-Katz smears (75.0% vs. 42.6%; p reading of the POC-CCA, a Software...... tool (Image Studio Lite®) was used to read and quantify the colour (expressed as pixels) of the test line on all positive tests, showing a positive correlation between number of pixels and the visually scored intensities and between number of pixels and egg counts. In conclusion, the POC-CCA assay...

  3. Pilot study for evidence-based nursing management: improving the levels of job satisfaction, organizational commitment, and intent to leave among nurses in Turkey.

    Science.gov (United States)

    Arslan Yurumezoglu, Havva; Kocaman, Gulseren

    2012-06-01

    Because of the nursing shortage problem, an important goal for nurse managers is preventing nurses from leaving the organization. This study analyzed the effect of evidence-based nursing management practices on nurses' levels of job satisfaction, organizational commitment, and intent to leave using the Promoting Action Research Implementation in Health Service framework as a guide. This study employed a single-group, quasi-experimental, pretest-post-test design with repeated measures. Data were collected using the Minnesota Job Satisfaction Questionnaire and the Organizational Commitment Scale. The study was conducted at a 127-bed private, accredited hospital. The sample was composed of 58 nurses who participated in all three measurements. Data analysis was conducted using repeated-measures anova and the Cochrane Q-test. An improvement was observed in the nurses' intrinsic, extrinsic, and total satisfaction levels, and in the degree of normative commitment. Nurse managers stated that they benefited from this study. In order to find effective and long-lasting solutions to the nursing shortage problem, evidence-based recommendations should be used in nursing management. © 2012 Blackwell Publishing Asia Pty Ltd.

  4. Going beyond "two-getherness": Nurse managers' experiences of working together in a leadership model where more than two share the same chair.

    Science.gov (United States)

    Döös, Marianne; Vinell, Helene; von Knorring, Mia

    2017-12-01

    To explore nurse manager experiences of working in leadership constellations where more than two managers share leadership, and to compare this multilateral sharing form to what is known about experiences of working in joint leadership in pairs. A qualitative design based on semi-structured interviews with nurse managers in two multilaterally shared leadership constellations at two intensive care units at an emergency hospital in Sweden. Data were analysed using a thematic and comparative approach. The comparative analysis identified four aspects that differ decisively from the positive picture in the literature on joint pair leadership: the perception of mandate with reduced decision-making power and reduced access to forums, the way of working with a strict division of tasks and a rotating schedule, a need to cope with the increasing number of internal relations and a feeling of doubt concerning trust. Shared leadership between nurse managers has gone from being a tight collaboration based on a feeling of "two-getherness", to being an organisational solution multilateral in character. In this transformation, a weakening of leadership qualities has occurred. Further research is necessary on how this new organisational solution impacts the nurse managers, their staff and the care provided in healthcare organisations generally. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Analysis of in-R12 CHF data: influence of hydraulic diameter and heating length; test of Weisman boiling crisis model

    International Nuclear Information System (INIS)

    Czop, V.; Herer, C.; Souyri, A.; Garnier, J.

    1993-09-01

    In order to progress on the comprehensive modelling of the boiling crisis phenomenon, Electricite de France (EDF), Commissariat a l'Energie Atomique (CEA) and FRAMATOME have set up experimental programs involving in-R12 tests: the EDF APHRODITE program and the CEA-EDF-FRAMATOME DEBORA program. The first phase in these programs aims to acquire critical heat flux (CHF) data banks, within large thermal-hydraulic parameter ranges, both in cylindrical and annular configurations, and with different hydraulic diameters and heating lengths. Actually, three data banks have been considered in the analysis, all of them concerning in-R12 round tube tests: - the APHRODITE data bank, obtained at EDF with a 13 mn inside diameter, - the DEBORA data bank, obtained at CEA with a 19.2 mm inside diameter, - the KRISTA data bank, obtained at KfK with a 8 mm inside diameter. The analysis was conducted using CHF correlations and with the help of an advanced mathematical tool using pseudo-cubic thin plate type Spline functions. Two conclusions were drawn: -no influence of the heating length on our CHF results, - the influence of the diameter on the CHF cannot be simply expressed by an exponential function of this parameter, as thermal-hydraulic parameters also have an influence. Some calculations with Weisman and Pei theoretical boiling crisis model have been compared to experimental values: fairly good agreement was obtained, but further study must focus on improving the modelling of the influence of pressure and mass velocity. (authors). 12 figs., 4 tabs., 21 refs

  6. Field Observations of Changes in SST, Chlorophyll and POC Flux in the Southern East China Sea Before and After the Passage of Typhoon Jangmi

    Directory of Open Access Journals (Sweden)

    Yung-Yen Shih

    2013-01-01

    Full Text Available Severe tropical storms play an important role in triggering phytoplankton blooms, yet direct field observation of evidence of the effects of a typhoon is very rare. Sea surface temperature (SST, nitrate concentration, chlorophyll a (chl a concentration, and particulate organic carbon (POC flux were measured before and shortly after Typhoon Jangmi which affected the southern East China Sea (SECS on September 28 ~ 29, 2008. In situ SST (27.5 ~ 28.0°C on September 19 ~ 21, decreased to ~24.0°C (October 3 ~ 6 in the SECS 4 ~ 7 days after the passage of Typhoon Jangmi. In situ nitrate and chl a concentrations 7-days (on October 6 after the passage of Jangmi were 1.9 μM and 1.61 mg m-3, respectively, much higher than those (nitrate: 0.3 μM and chl a: 0.73 mg m-3 concentrations before the typhoon (September 21. The enhanced chl a concentration is thus caused by a nutrient supply via vertical mixing or upwelling in the euphotic zone. The POC flux 7-days after Jangmi¡¦s passage was 552 ± 28 mg-C m-2 d-1, a ~2.5-fold increases before the typhoon (224 ± 33 mg-C m-2 d-1, on September 21. Our results suggest that typhoons indeed can stimulate efficient POC export out of the euphotic zone, while it is still poorly understood with regard to the total effects of a typhoon on nutrient dynamics and detailed carbon sequestration due to sampling difficulty. Therefore, successional sea-going observations ought to be conducted in the affected area after the passage of typhoons.

  7. RNI Point-of-care test (POCT: esperança ou ilusão? Point-of-care test (POCT INR: hope or illusion?

    Directory of Open Access Journals (Sweden)

    Luci Maria Sant'Ana Dusse

    2012-06-01

    , INR point-of-care test (POCT INR, is the main test of this new proposal. This test has great potential benefit in situations where the quick INR results influences clinical decision making, as in acute ischemic stroke, before surgical procedures and during cardiac surgery. The INR POCT has the potential to be used for self-monitoring of oral anticoagulation in patients under anticoagulant therapy. However, the precision and accuracy of INR POCT still need to be enhanced to increase effectiveness and efficiency of the test. Additionally, the RDC / ANVISA Number 302 makes clear that the POCT testing must be supervised by the technical manager of the Clinical Laboratory in the pre-analytical, analytical and post-analytical. In practice, the Clinical Laboratory does not participate in the implementation of POCT testing or release of the results. Clinicians have high expectation with the incorporation of INR POCT in clinical practice, despite the limitations of this method. These professionals are willing to train the patient to perform the test, but are not legally responsible for the quality of it and are not prepared for the maintenance of equipment. The definition of who is in charge for the test must be one to ensure the quality control.

  8. Improvement of POC-CCA Interpretation by Using Lyophilization of Urine from Patients with Schistosoma mansoni Low Worm Burden: Towards an Elimination of Doubts about the Concept of Trace.

    Directory of Open Access Journals (Sweden)

    Paulo Marcos Zech Coelho

    2016-06-01

    Full Text Available Accurate diagnostic techniques for schistosomiasis are essential for prevalence determination and identification of positive patients. A point-of-care test for detecting schistosome circulating cathodic antigen (POC-CCA has been evaluated for its accuracy in different endemic regions. This reagent strip/dipstick based assay has showed high sensitivity for individuals with high or moderate worm burden, but the interpretation of light infections is less clear, especially for trace readings.We introduced a urine lyophilization step to the POC-CCA assay to improve its sensitivity and clarify the interpretation of traces. We evaluated POC-CCA sensitivity and specificity within individuals with low parasite burdens in a Brazilian endemic area where a high number of traces were detected. Patients that were positive for other helminths were also evaluated for cross reactions. In all cases, a combined parasitological diagnosis using Kato-Katz (24 slides and Saline Gradient (1 g of feces were used as reference. At baseline, diagnosis by POC-CCA (1-2 cassettes showed 6% sensitivity, inaccurately predicting a low prevalence of Schistosoma mansoni infections (2 POC-CCA positives/32 egg positives. After urine lyophilization, the sensitivity was increased significantly (p < 0.05. Prevalence rates changed from 2% to 32% (27 POC-CCA positives/32 egg positives, equivalent to parasitological techniques. Most of the trace readings changed to positive after lyophilization while some negatives turned into traces. Cross reaction analysis confirmed the specificity of POC-CCA.Trace readings cannot be primarily defined as positive or negative cases. It is critical to verify case-by-case by concentrating urine 10 fold by lyophilization for the diagnosis. Following lyophilization, persistent trace readings should be read as negatives. No trained technician is needed and cost is restricted to the cost of a lyophilizer and the electricity to run it.

  9. Direct comparison of {sup 210}Po, {sup 234}Th and POC particle-size distributions and export fluxes at the Bermuda Atlantic Time-series Study (BATS) site

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, Gillian, E-mail: gstewart@qc.cuny.ed [Queens College, CUNY Flushing, NY 11367 (United States); Moran, S. Bradley, E-mail: moran@gso.uri.ed [Graduate School of Oceanography, URI Narragansett, RI 02882 (United States); Lomas, Michael W., E-mail: Michael.Lomas@bios.ed [Bermuda Institute for Ocean Sciences, St. George' s, GE01 (Bermuda); Kelly, Roger P., E-mail: rokelly@gso.uri.ed [Graduate School of Oceanography, URI Narragansett, RI 02882 (United States)

    2011-05-15

    Particle-reactive, naturally occurring radionuclides are useful tracers of the sinking flux of organic matter from the surface to the deep ocean. Since the Joint Global Ocean Flux Study (JGOFS) began in 1987, the disequilibrium between {sup 234}Th and its parent {sup 238}U has become widely used as a technique to measure particle export fluxes from surface ocean waters. Another radionuclide pair, {sup 210}Po and {sup 210}Pb, can be used for the same purpose but has not been as widely adopted due to difficulty with accurately constraining the {sup 210}Po/{sup 210}Pb radiochemical balance in the ocean and because of the more time-consuming radiochemical procedures. Direct comparison of particle flux estimated in different ocean regions using these short-lived radionuclides is important in evaluating their utility and accuracy as tracers of particle flux. In this paper, we present paired {sup 234}Th/{sup 238}U and {sup 210}Po/{sup 210}Pb data from oligotrophic surface waters of the subtropical Northwest Atlantic and discuss their advantages and limitations. Vertical profiles of total and particle size-fractionated {sup 210}Po and {sup 234}Th activities, together with particulate organic carbon (POC) concentrations, were measured during three seasons at the Bermuda Atlantic Time-series Study (BATS) site. Both {sup 210}Po and {sup 234}Th reasonably predict sinking POC flux caught in sediment traps, and each tracer provides unique information about the magnitude and efficiency of the ocean's biological pump.

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

    Directory of Open Access Journals (Sweden)

    Ahmad Kalateh Sadati

    2016-10-01

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

  11. Emotions at work: what is the link to patient and staff safety? Implications for nurse managers in the NHS.

    Science.gov (United States)

    Smith, Pam; Pearson, Pauline H; Ross, Fiona

    2009-03-01

    This paper sets the discussion of emotions at work within the modern NHS and the current prioritisation of creating a safety culture within the service. The paper focuses on the work of students, frontline nurses and their managers drawing on recent studies of patient safety in the curriculum, and governance and incentives in the care of patients with complex long term conditions. The primary research featured in the paper combined a case study design with focus groups, interviews and observation. In the patient safety research the importance of physical and emotional safety emerged as a key finding both for users and professionals. In the governance and incentives research, risk emerged as a key concern for managers, frontline workers and users. The recognition of emotions and the importance of emotional labour at an individual and organizational level managed by emotionally intelligent leaders played an important role in promoting worker and patient safety and reducing workplace risk. Nurse managers need to be aware of the emotional complexities of their organizations in order to set up systems to support the emotional wellbeing of professionals and users which in turn ensures safety and reduces risk.

  12. Nursing as a scientific undertaking and the intersection with science in undergraduate studies: implications for nursing management.

    Science.gov (United States)

    Logan, Patricia A; Angel, Lyndall

    2011-04-01

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

  13. Exploring the role of the nurse manager in supporting point-of-care nurses' adoption of electronic health records: protocol for a qualitative research study.

    Science.gov (United States)

    Strudwick, Gillian; Booth, Richard G; Bjarnadottir, Ragnhildur I; Collins, Sarah; Srivastava, Rani

    2017-10-12

    An increasing number of electronic health record (EHR) systems have been implemented in clinical practice environments where nurses work. Findings from previous studies have found that a number of intended benefits of the technology have not yet been realised to date, partially due to poor system adoption among health professionals such as nurses. Previous studies have suggested that nurse managers can support the effective adoption and use of the technology by nurses. However, no known studies have identified what role nurse managers have in supporting technology adoption, nor the specific strategies that managers can employ to support their staff. Therefore, the purpose of this research is to better understand the role of the nurse manager in point-of-care nurses' use of EHRs, and to identify strategies that may be effective in supporting clinical adoption. This study will use a qualitative descriptive design. Interviews with both nurse managers and point-of-care nursing staff will be conducted in a Canadian mental health and addiction healthcare organisation where an EHR has been implemented. A semistructured interview guide will be used, and interviews will be audio recorded. Transcripts will be analysed using a directed content analysis technique. Strategies to ensure the trustworthiness of the data analysis procedure and findings will be employed. Ethical approval for this study has been obtained. Dissemination strategies may include a paper submission to a peer-reviewed journal, a conference submission and meetings to share findings with the study site leadership team. Findings from this research will be used to inform a future study which aims to assess levels of competencies and perform a psychometric analysis of the Nursing Informatics Competency Assessment for the Nurse Leader instrument in a Canadian context. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is

  14. Relationship between general safety requirements and safety culture in the improvement of safe operation of I.N.R. TRIGA reactor facilities

    International Nuclear Information System (INIS)

    Ciocanescu, M.; Preda, M.; Chiritescu, M.; Dumitru, M.

    1996-01-01

    Acquiring of the basic principles of ''safety culture'' by a large number of profesionals in the nuclear field drew the attention of the decision factors in the INR managerial structure, who decided to promote certain practical actions at each level in order to improve nuclear safety. Starting from the ''Republican Standards for Nuclear Safety'' issued by CSEN in 1975, where general safety criteria are defined for nuclear reactors and NPPs, the specialists at the TRIGA reactor originated and implemented a coherent and secure system to ensure nuclear safety over all steps of nuclear activities: research, conception, execution, commissioning and operation. This system has been continuosly corrected so that now it is completely integrated in a modern safety system. The paper presents the way in which a modern system for nuclear safety at the TRIGA reactor has been implemented and developed, in accordance to specific criteria and requirements imposed by related National Regulations and with the principles of safety culture. Starting from the definition of specific responsabilities, there are presented the internal stipulations and practical actions at all levels in order to enhance nuclear safety. (orig.)

  15. Opposing Post-transcriptional Control of InR by FMRP and LIN-28 Adjusts Stem Cell-Based Tissue Growth

    Directory of Open Access Journals (Sweden)

    Arthur Luhur

    2017-12-01

    Full Text Available Summary: Although the intrinsic mechanisms that control whether stem cells divide symmetrically or asymmetrically underlie tissue growth and homeostasis, they remain poorly defined. We report that the RNA-binding protein fragile X mental retardation protein (FMRP limits the symmetric division, and resulting expansion, of the stem cell population during adaptive intestinal growth in Drosophila. The elevated insulin sensitivity that FMRP-deficient progenitor cells display contributes to their accelerated expansion, which is suppressed by the depletion of insulin-signaling components. This FMRP activity is mediated solely via a second conserved RNA-binding protein, LIN-28, known to boost insulin signaling in stem cells. Via LIN-28, FMRP controls progenitor cell behavior by post-transcriptionally repressing the level of insulin receptor (InR. This study identifies the stem cell-based mechanism by which FMRP controls tissue adaptation, and it raises the possibility that defective adaptive growth underlies the accelerated growth, gastrointestinal, and other symptoms that affect fragile X syndrome patients. : Luhur et al. report that FMRP acts via LIN-28 in progenitor cells to dampen the adaptive expansion of intestinal tissue in the fruit fly, raising the possibility that defective LIN28-mediated adaptive growth underlies some of the symptoms that affect fragile X syndrome patients. Keywords: FMRP, fmr1, LIN-28, insulin receptor, IIS, adaptive growth, tissue resizing, intestinal stem cell, insulin sensitivity

  16. [Validation of the Polish version of The Authentic Leadership Questionnaire for the of evaluation purpose of nursing management staff in national hospital wards].

    Science.gov (United States)

    Sierpińska, Lidia

    2013-09-01

    The Authentic Leadership Questionnaire (ALQ) is a standardized research instrument for the evaluation of individual elements of leader's conduct which contribute to the authentic leadership. The application of this questionnaire in Polish conditions required to carry out the validation process. The aim of the study was to evaluate of validity and reliability of the Polish version of the American research instrument for the needs of evaluation of authenticity of leadership of the nursing management in Polish hospitals. The study covered 286 nurses (143 head nurses and 143 of their subordinates) employed in 45 hospitals in Poland. Theoretical validity of the instrument was evaluated using Fisher's transformation (r-Person correlation coefficient), while the criterion validity of the ALQ was evaluated using rho-Spearman correlation coefficient and the BOHIPSZO questionnaire. The reliability of the ALQ was assessed by means of the Cronbach-alpha coefficient. The ALQ questionnaire applied for the evaluation of authenticity of leadership of the nursing management in Polish hospital wards shows an acceptable theoretical and criterion validity and reliability (Cronbach-alpha coefficient 0.80). The Polish version of the ALQ is valid and reliable, and may be applied in studies concerning the evaluation of authenticity of leadership of the nursing management in Polish hospital wards.

  17. THE PROS AND CONS OF THE RELATIONSHIP BETWEEN PERSONALITY AND LEADERSHIP OR MANAGERIAL BEHAVIOR OF NURSING MANAGER

    Directory of Open Access Journals (Sweden)

    Joko Gunawan

    2016-10-01

    Full Text Available Dear Editor, “Complex role in complex times” that is what nurse managers have as the one on the most key roles in the hospital.1 They are not just about managing staff schedules, but also need to have a vision and able to inspire them.2 Thus, competent nurse managers are needed. Research suggests that employees and employers are looking for similar characteristics or personality traits in their leaders. Personality trait refers to the dimensions of individual differences in tendencies to show consistent patterns of thoughts, feelings and actions.3 Personality trait seems able to explain why a person acts the way he/she does when in a leadership position. Research aggregated the results of 222 correlations contained in 73 studies of personality and leadership performance by involving 25,000 managers from every level in organizations across every industry sector.4 There were four of the five dimensions of the big five personality were significantly correlated with leadership emergence and effectiveness with adjustment / emotional stability as the best predictor, and agreeableness as the weakest predictor.4 Scholars who believe in data, these findings definitively indicate that personality predicts leadership behaviors across all organizational levels and industry sectors, and does so more powerfully than any known alternative.5 Personality traits relate to leader behaviors to a greater extent and less ambiguously than earlier reviews had suggested.6 However, although there are clear evidences in examining the relationship between personality and leadership or managerial behavior, it is also important that there are cons about the degree to which personality is related to managerial or leadership behavior Literature indicates that personality traits cannot be concluded to determine leadership with some considerations: (1 it is impossible to find one specific personality trait that characterizes leaders and (2 it is impossible to isolate a

  18. Balancing professional and personal satisfaction of nurse managers: current and future perspectives in a changing health care system.

    Science.gov (United States)

    Thorpe, Karran; Loo, Robert

    2003-09-01

    The objectives of this research were to explore and describe emerging new roles of First-Line Nurse Managers (F-LNMs i.e. individuals who oversee the daily operations of nursing units, regardless of their titles) in one Canadian province, identify their requisite knowledge, skills, competencies, and determine the training and development needs of these managers. F-LNMs, recognized as key players in health care systems, face major challenges (e.g. continuing organizational change, lack of resources) daily. These challenges affect their ability to achieve quality work experiences for their staff members and quality of nursing care for their patients and for themselves. The research design entails a triangulation of investigators (nursing and management), methods (interviews and a Delphi Study), samples (interviews with 26 F-LNMs and a Delphi Study with 62 panelists), and data (qualitative and quantitative). Institutions were randomly selected and then F-LNMs were randomly selected to participate in personal interviews and the remaining F-LNMs, along with nominated senior administrators, were invited to participate in the Delphi Study. Key findings relate to role changes (e.g. job enlargement and emphasis on efficiency), challenges (e.g. staffing and retention, frustrations), and recommendations for administrators (e.g. provide resources, training and development) and educators (e.g. link education to organizational needs). Ultimately, organizational changes and challenges affect how F-LNMs perceive their future professional (e.g. providing quality of patient care) and personal (e.g. high quality of life) satisfaction levels. This research suggests that the role of F-LNMs continues to evolve, consistent with the changing health care system. F-LNMs face challenges that compromise performance of their functions as they believe their work should be completed. To enhance satisfaction in their roles, F-LNMs express a desire for balance in their professional and personal

  19. An evaluation of patient self-testing competency of prothrombin time for managing anticoagulation: pre-randomization results of VA Cooperative Study #481--The Home INR Study (THINRS).

    Science.gov (United States)

    Dolor, Rowena J; Ruybalid, R Lynne; Uyeda, Lauren; Edson, Robert G; Phibbs, Ciaran; Vertrees, Julia E; Shih, Mei-Chiung; Jacobson, Alan K; Matchar, David B

    2010-10-01

    Prior studies suggest patient self-testing (PST) of prothrombin time (PT) can improve the quality of anticoagulation (AC) and reduce complications (e.g., bleeding and thromboembolic events). "The Home INR Study" (THINRS) compared AC management with frequent PST using a home monitoring device to high-quality AC management (HQACM) with clinic-based monitoring on major health outcomes. A key clinical and policy question is whether and which patients can successfully use such devices. We report the results of Part 1 of THINRS in which patients and caregivers were evaluated for their ability to perform PST. Study-eligible patients (n = 3643) were trained to use the home monitoring device and evaluated after 2-4 weeks for PST competency. Information about demographics, medical history, warfarin use, medications, plus measures of numeracy, literacy, cognition, dexterity, and satisfaction with AC were collected. Approximately 80% (2931 of 3643) of patients trained on PST demonstrated competency; of these, 8% (238) required caregiver assistance. Testers who were not competent to perform PST had higher numbers of practice attempts, higher cuvette wastage, and were less able to perform a fingerstick or obtain blood for the cuvette in a timely fashion. Factors associated with failure to pass PST training included increased age, previous stroke history, poor cognition, and poor manual dexterity. A majority of patients were able to perform PST. Successful home monitoring of PT with a PST device required adequate levels of cognition and manual dexterity. Training a caregiver modestly increased the proportion of patients who can perform PST.

  20. Radiation technologies at INR NASU

    International Nuclear Information System (INIS)

    Vishnevs'kij, Yi.M.; Sakhno, V.Yi.; Tomchaj, S.P.

    2011-01-01

    The results of Institute for Nuclear Research of National Academy of Sciences of Ukraine in the development and use of nuclear and radiation technologies applied for a number of scientific, technical and technological projects in the framework of state budget themes, research programs, innovation and scientific and technological national and international programs and projects are presented.

  1. Nurse manager and student nurse perceptions of the use of personal smartphones or tablets and the adjunct applications, as an educational tool in clinical settings.

    Science.gov (United States)

    McNally, George; Frey, Rosemary; Crossan, Michael

    2017-03-01

    Personally owned handheld referencing technology such as smartphones or tablets, and the adjunct applications (apps) that can be used on them, are becoming a part of everyday life for the New Zealand population. In common with the population at large, student nurses have embraced this technology since the advent of the Apple iPhone in 2010. Little is known internationally or in New Zealand about the way student nurses may apply personally owned handheld referencing technology to their education process. The perceptions of New Zealand nurse managers, toward personally owned handheld referencing technology, could not be located. Using a qualitative descriptive methodology, semi structured interviews were conducted with New Zealand student nurses (n = 13), and nurse managers (n = 5) about their perceptions of use of personally owned handheld referencing technology as an educational tool in clinical settings. A thematic analysis was conducted on the resulting text. Student nurses said they wanted to use their own handheld referencing technology to support clinical decisions. Nurse managers perceived the use of personally owned handheld referencing technology as unprofessional, and do not trust younger cohorts of student nurses to act ethically when using this technology. This research supports historical research findings from the student perspective about the usefulness of older hand held referencing devices to augment clinical decisions. However, due to perceptions held by nurse mangers regarding professional behaviour, safety and the perceived institutional costs of managing personally owned handheld referencing technology, the practice may remain problematic in the studied setting. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. nurse managers ' perspectives

    African Journals Online (AJOL)

    2010-11-03

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

  3. Investigating the relationship between emotional displays of nursing managers and the performance of nursing staff (Case study: Dr. Shariati Hospital, Tehran

    Directory of Open Access Journals (Sweden)

    Zahra Riahi Paghaleh

    2016-07-01

    Full Text Available Emotional display is the management and proper expression of correct emotions consistent with organizational and profession rules. One of the factors affecting the occupational performance is the skills of the managers in control and effective use of excitement. The present study was conducted to determine the relationship between nursing managers' emotional display and the performance of nursing staff. The study population consisted of all managers and nursing staff of Shariati Hospital, Tehran in 2015 who were selected using census method. The instruments were Dindorf et al. emotional display questionnaire and Paterson's job performance questionnaire whose validity and reliability were confirmed. Data were analyzed with Spearman correlation Coefficient, independent t-test, and ANOVA using SPSS software. "Real-emotion display" of nursing managers had a significant correlation with nursing staff performance (P=0.02, r=0.203. But "superficial and deep display of emotions" of the managers did not. There were no significant correlations between emotional display with age and work experience in managers and between job performance with marital status, gender, and age and work experience in nursing staff (P>0.05. The results showed that design and mplementation of training courses about emotional display are necessary in managers in order to improve the job performance of nursing staff.

  4. The Relationship Between and Factors Influencing Staff Nurses' Perceptions of Nurse Manager Caring and Exposure to Workplace Bullying in Multiple Healthcare Settings.

    Science.gov (United States)

    Olender, Lynda

    2017-10-01

    The aim of this study was to examine the relationship between, and factors influencing, staff nurse perceptions of nurse manager caring (NMC) and the perceived exposure to workplace bullying (WPB) in multiple healthcare settings. Workplace bullying is commonplace, increasing, and detrimental to the health and availability of our nursing workforce. Positive relationships between a nurse manager (NM) and staff increase staff satisfaction and reduce turnover. Still unknown, however, is whether a caring relationship between manager and staff can reduce staff nurse perception of exposure to WPB. On the basis of Watson's theory that caring is reciprocal in nature, a descriptive correlational design was used to assess 156 staff nurses' self-report of NMC and their exposure to negative acts using the Caring Factor Survey-Caring of the Manager and the Negative Acts Questionnaire-Revised instruments. There is a significant inverse relationship between NMC and exposure to WPB in the nursing workplace. Gender, work environment, and a high workload influenced these findings. This study highlights the importance of caring leadership to reduce exposure to negative behaviors. The data lend support to the idea of educating NMs regarding the application of caring behaviors to support staff at the point of care.

  5. The research status on transformational leadership in nursing management%变革型领导理论在护理管理领域的研究现状

    Institute of Scientific and Technical Information of China (English)

    王娜; 丁焱

    2012-01-01

    This paper reviewed the concepts, structure model and measurement of transformational leadership, summarized the research status of transformational leadership in nursing management both at home and abroad, and pointed out the existing problems while nursing managers applying this leadership theory, and then put forward some suggestions from the perspective of nursing management.%文章从概念、结构和测量方面对变革型领导理论进行概述,归纳了变革型领导理论在护理管理领域的研究现状,指出了护理管理者在运用该领导理论时所存在的问题,并在此基础上提出相应的建议.

  6. [No role for oral anticoagulants (target INR: 2.0-3.0) after transient ischaemic attack or cerebral infarction of arterial origin; the 'European/Australasian stroke prevention in reversible ischaemia trial' (ESPRIT)].

    Science.gov (United States)

    De Schryver, E L L M; Halkes, P H A

    2008-02-23

    The 'European/Australasian stroke prevention in reversible ischaemia trial' (ESPRIT) aimed to determine whether oral anticoagulation of moderate intensity (target international normalised ratio (INR): 2.0-3.0) is more effective than acetylsalicylic acid in preventing future vascular events in patients with transient ischaemic attack (TIA) or minor stroke of arterial origin. International, multicentre randomised clinical trial. Patients were randomised within 6 months of TIA or minor stroke of arterial origin to oral anticoagulants (target INR: 2.0-3.0; n = 536) or acetylsalicylic acid (30-325 mg daily; n = 532). The primary endpoint was a composite of vascular death, non-fatal stroke, non-fatal myocardial infarction or major bleeding complications. In a post hoc analysis, the efficacy of anticoagulants was compared with that of the combination of acetylsalicylic acid and dipyridamole (200 mg twice daily), a third arm of ESPRIT. Treatment was unblinded, but auditing of endpoints was blinded. Data were analysed on an intent-to-treat basis. The comparison of anticoagulants and acetylsalicylic acid was stopped prematurely because the combination of acetylsalicylic acid and dipyridamole was found to be more effective than acetylsalicylic acid alone. The mean duration of follow-up was 4.6 years (SD: 2.2). The mean INR was 2.57 (SD: 0.86; nearly 70% of the time within target range). The primary endpoint occurred in 99 patients (19%) in the anticoagulation group and 98 patients (18%) in the acetylsalicylic acid group (hazard ratio: 1.02; 95% CI: 0.77-1.35). The hazard ratio was 0.73 (95% CI: 0.52-1.01) for ischaemic events and 2.56 (95% CI: 1.48-4.43) for major bleeding complications. The hazard ratio for the primary outcome event comparing anticoagulants with the combination of acetylsalicylic acid and dipyridamole was 1.31 (95% CI: 0.98-1.75). Oral anticoagulants (target INR: 2.0-3.0) were not more effective than acetylsalicylic acid in the secondary prevention of

  7. Ressocialização do enfermeiro gerente Resocialización del enfermero gerente Resocialization of the nurse manager

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Trevizan

    2011-07-01

    la Teoría U en la actividad gerencial del enfermero, resocializándolo por medio de comportamientos y actitudes focalizados en el sentir, el presenciar y el concretizar.This is a theoretical study aimed at contributing to understanding of the professional and organizational resocialization process of the nurse manager. Thus, we report the premises of the U Theory in order to contribute to the development of human resources in Nursing. U Theory presents values for nursing managerial work characterized by the acts of feeling, living and concretizing. Based on four studies in the Brazilian Nursing literature about the nursing role over three decades, we noted a consolidation of organizational values based on classical management models, emphasizing the mechanical view of humans which does not match with an understanding of health services as social entities. In this context, we conclude that it is possible to include the premises of U Theory in nurses’ management activities, resocializing them in terms of behaviors and attitudes based on feeling, living and concretizing.

  8. Nursing Management Minimum Data Set: Cost-Effective Tool To Demonstrate the Value of Nurse Staffing in the Big Data Science Era.

    Science.gov (United States)

    Pruinelli, Lisiane; Delaney, Connie W; Garciannie, Amy; Caspers, Barbara; Westra, Bonnie L

    2016-01-01

    There is a growing body of evidence of the relationship of nurse staffing to patient, nurse, and financial outcomes. With the advent of big data science and developing big data analytics in nursing, data science with the reuse of big data is emerging as a timely and cost-effective approach to demonstrate nursing value. The Nursing Management Minimum Date Set (NMMDS) provides standard administrative data elements, definitions, and codes to measure the context where care is delivered and, consequently, the value of nursing. The integration of the NMMDS elements in the current health system provides evidence for nursing leaders to measure and manage decisions, leading to better patient, staffing, and financial outcomes. It also enables the reuse of data for clinical scholarship and research.

  9. Relationship between Leadership Style and Personality Type in Three Levels of Nursing Managers in Iran-Esfahan Medical University Hospitals In 2015

    Directory of Open Access Journals (Sweden)

    Zahra Akbari

    2016-05-01

    Full Text Available Proper leadership style helps proper functioning of nurses who are the most frequent experts in hospitals and improves quality of their work. One of the important factors affecting nurses` performance is the behaviors of managers toward them which is due to their personality type. The purpose of this study was to study the relationship between personality type and leadership style of nursing managers in Iran-Esfahan medical university hospitals in 2015. Present study is descriptive correlation type. The research community are 150 nursing managers of three levels, Matron, Supervisor and head nurse, from hospitals belonging to Esfahan medical university. Data collection was done by a 3-part questionnaire consisting of demographic information, McCurry and Costa 5-factor personality questionnaire and Renesis Likert questionnaire for determining leadership style. Data were analyzed using SPSS software ver. 22 in two level, descriptive and inferential. The average scores of dominant responsible personality among the first, second and third level were 36.33±5.12, 39.59±5.51 and 36.50±6.75, respectively and a verage scores of dominant organization oriented leadership style were 12.56±1.88, 11.03±4.54 and 12.30±4.40. Hospitals like other organizations require modern leadership styles instead of conventional one. Although organizationoriented leadership has been beneficial to achieve organizational objectives in short term, but in the long term it decreases productivity and job satisfaction because of lack of proper attention to the staff. Thus, applying humanoriented leadership, specially combined leadership will have much better results. Responsible personality is useful for the organization and increases productivity but it seems that in health care department in which interaction with humans is crucial, flexible or extroverted personality is more beneficial.

  10. Nurse management of 'same day' consultation for patients with minor illnesses: results of an extended programme in primary care in Catalonia.

    Science.gov (United States)

    Fabrellas, Núria; Vidal, Angel; Amat, Gemma; Lejardi, Yolanda; del Puig Deulofeu, Maria; Buendia, Carmen

    2011-08-01

    This paper is a report of a study to assess the feasibility and efficacy of a programme of nurse management for patients requesting same day consultation for minor illnesses in primary care. The efficacy of such programmes has been demonstrated in randomized studies but there is little information on these programmes in highly populated areas. Patients seeking same day consultation for one of 23 preselected minor illnesses (16 for adults, 7 for paediatric patients) from March 2009 to April 2010 were seen by trained nurses who followed predefined algorithms. If signs of alarm were detected, patients were referred to a general practitioner. A total of 629,568 consultations were performed, 575,189 in adults and 54,379 in paediatric patients. Case resolution was achieved in 61.8% of adult and 75.6% of paediatric patients. In adults, the highest resolution rates (>90%) were obtained for burns, skin injury and emergency contraception, and the lowest for lower urinary symptoms (46.7%), sore throat (45.7%), pink eye (45.5%) and upper respiratory symptoms (41.4%). In paediatric patients, the highest resolution rates (>90%) were obtained for stomach cramps and burns and the lowest for cough (36.2%). A return to consultation during a 7-day period for the same reason as the first consultation was low, 4% for adults and 2.4% for paediatric patients. An extended programme of nurse management for same day consultation of patients with minor illnesses showed an acceptably high rate of resolution and low rate of return to consultation. The application of such programmes in extensive areas is feasible and effective. © 2011 Blackwell Publishing Ltd.

  11. Feasibility test of a UK-scalable electronic system for regular collection of patient-reported outcome measures and linkage with clinical cancer registry data: The electronic Patient-reported Outcomes from Cancer Survivors (ePOCS system

    Directory of Open Access Journals (Sweden)

    Velikova Galina

    2011-10-01

    Full Text Available Abstract Background Cancer survivors can face significant physical and psychosocial challenges; there is a need to identify and predict which survivors experience what sorts of difficulties. As highlighted in the UK National Cancer Survivorship Initiative, routine post-diagnostic collection of patient reported outcome measures (PROMs is required; to be most informative, PROMs must be linked and analysed with patients' diagnostic and treatment information. We have designed and built a potentially cost-efficient UK-scalable electronic system for collecting PROMs via the internet, at regular post-diagnostic time-points, for linking these data with patients' clinical data in cancer registries, and for electronically managing the associated patient monitoring and communications; the electronic Patient-reported Outcomes from Cancer Survivors (ePOCS system. This study aims to test the feasibility of the ePOCS system, by running it for 2 years in two Yorkshire NHS Trusts, and using the Northern and Yorkshire Cancer Registry and Information Service. Methods/Design Non-metastatic breast, colorectal and prostate cancer patients (largest survivor groups, within 6 months post-diagnosis, will be recruited from hospitals in the Yorkshire Cancer Network. Participants will be asked to complete PROMS, assessing a range of health-related quality-of-life outcomes, at three time-points up to 15 months post-diagnosis, and subsequently to provide opinion on the ePOCS system via a feedback questionnaire. Feasibility will be examined primarily in terms of patient recruitment and retention rates, the representativeness of participating patients, the quantity and quality of collected PROMs data, patients' feedback, the success and reliability of the underpinning informatics, and the system running costs. If sufficient data are generated during system testing, these will be analysed to assess the health-related quality-of-life outcomes reported by patients, and to explore

  12. Nature and sources of suspended particulate organic matter in a tropical estuary during the monsoon and pre-monsoon: Insights from stable isotopes (delta 13C POC, delta 15 N TPN) and carbohydrate signature compounds

    Digital Repository Service at National Institute of Oceanography (India)

    Khodse, V.B.; Bhosle, N.B.

    zooplankton, and then known aliquots (0.25 to 1.5 L) were filtered through pre-combusted (450 °C, 4h) 47 mm GF/F filter papers (0.7 µm, Whatman) for the measurements of suspended particulate matter (SPM), particulate organic carbon (POC), δ13CPOC, δ15NTPN... analysis. 2.3. Determination of bulk parameters and stable isotopes GF/F (0.7 µm, 47 mm) filter containing particulate matter was washed with UV-Milli-Q- water to remove salt and the filter was dried at 40 °C for 24 h. Filter was cooled and weighed...

  13. Comparison of the CoaguChek XS handheld coagulation analyzer and conventional laboratory methods measuring international normalised ratio (INR) values during the time to therapeutic range after mechanical valve surgery.

    Science.gov (United States)

    Bardakci, Hasmet; Altıntaş, Garip; Çiçek, Omer Faruk; Kervan, Umit; Yilmaz, Sevinc; Kaplan, Sadi; Birincioglu, Cemal Levent

    2013-05-01

    To compare the international normalised ratio (INR) value of patients evaluated using the CoaguChek XS versus conventional laboratory methods, in the period after open-heart surgery for mechanical valve replacement until a therapeutic range is achieved using vitamin K antagonists (VKA) together with low molecular weight heparin (LMWH). One hundred and five patients undergoing open-heart surgery for mechanical valve replacement were enrolled. Blood samples were collected from patients before surgery, and on the second and fifth postoperative days, simultaneously for both the point of care device and conventional laboratory techniques. Patients were administered VKA together with LMWH at therapeutic doses (enoxaparin 100 IU/kg twice daily) subcutaneously, until an effective range was achieved on approximately the fifth day after surgery. The mean INR values using the CoaguChek XS preoperatively and on the second and fifth days postoperatively were 1.20 (SD ± 0.09), 1.82 (SD ± 0.45), and 2.55 (SD ± 0.55), respectively. Corresponding results obtained using conventional laboratory techniques were 1.18 (SD ± 0.1), 1.81 (SD ± 0.43), and 2.51 (SD ± 0.58). The correlation coefficient was r = 0.77 preoperatively, r = 0.981 on postoperative day 2, and r = 0.983 on postoperative day 5. Results using the CoaguChek XS Handheld Coagulation Analyzer correlated strongly with conventional laboratory methods, in the bridging period between open-heart surgery for mechanical valve replacement and the achievement of a therapeutic range on warfarin and LMWH. © 2013 Wiley Periodicals, Inc.

  14. The relationship between work engagement and psychological distress of hospital nurses and the perceived communication behaviors of their nurse managers: A cross-sectional survey.

    Science.gov (United States)

    Kunie, Keiko; Kawakami, Norito; Shimazu, Akihito; Yonekura, Yuki; Miyamoto, Yuki

    2017-06-01

    Communication between nurse managers and nurses is important for mental health of hospital nurses. The aim of the present study was to investigate the relationship between managers' communication behaviors toward nurses, and work engagement and psychological distress among hospital nurses using a multilevel model. The present study was a cross-sectional questionnaire survey. The participants were nurses working at three hospitals in Japan. A total of 906 nurses from 38 units participated in the present study. The units with small staff sizes and participants with missing entries in the questionnaire were excluded. The data for 789 nurses from 36 questionnaire survey units were analyzed. A survey using a self-administered questionnaire was conducted. The questionnaire asked staff nurses about communication behaviors of their immediate manager and their own levels of work engagement, psychological distress, and other covariates. Three types of manager communication behaviors (i.e., direction-giving, empathetic, and meaning-making language) were assessed using the Motivating Language scale; and the scores of the respondents were averaged for each unit to calculate unit-level scores. Work engagement and psychological distress were measured using the Utrecht Work Engagement Scale and the K6 scale, respectively. The association of communication behaviors by unit-level managers with work engagement and psychological distress among nurses was analyzed using two-level hierarchical linear modeling. The unit-level scores for all three of the manager communication behaviors were significantly and positively associated with work engagement among nurses (pwork environment. The individual levels of all three of the manager communication behaviors were also significantly and positively associated with work engagement (p0.05). Motivating language by unit-level managers might be positively associated with work engagement among hospital nurses, which is mediated through the better

  15. The Relationship Between the Managerial Skills and Results of “Performance Evaluation “Tool Among Nursing Managers in Teaching Hospitals of Iran University of Medical Science

    Science.gov (United States)

    Isfahani, Haleh Mousavi; Aryankhesal, Aidin; Haghani, Hamid

    2015-01-01

    Performance of different organizations, such as hospitals is mainly influenced by their managers’ performance. Nursing managers have an important role in hospital performance and their managerial skills can improve the quality of the services. Hence, the present study was conducted in order to assess the relationship between the managerial skills and the results of their performance evaluation in Teaching Hospitals of Iran University of Medical Science in 2013. The research used the cross sectional method in 2013. It was done by distributing a managerial skills assessment questionnaire, with close-ended questions in 5 choice Likert scale, among 181 managers and head nurses of hospitals of Iran university of Medical Sciences; among which 131 answered the questions. Another data collection tools was a forms to record evaluation marks from the personnel records. We used Pearson and Spearman correlation tests and SPSS for analysis and description (frequency, mean and standard deviation). Results showed that the managerial skills of the nursing mangers were fair (2.57 out of 5) and the results of the performance evaluation were in a good condition (98.44). The mangers’ evaluation results and the managerial skills scores were not in a meaningful correlation (r=0.047 np=0.856). The research showed no correlation between different domains of managerial skills and the performance evaluation marks: decision making skills (r=0.074 and p=0.399), leadership (correlation coefficient 0.028 and p=0.654), motivation (correlation coefficient 0.118 and p=0.163), communication (correlation coefficient 0.116 and p=0.122), systematic thinking (correlation coefficient 0.028 and p=0.828), time management (correlation coefficient 0.077 and p=0.401) and strategic thinking (correlation coefficient 0.041 and p=0.756). Lack of any correlation and relation between managers’ managerial skills and their performance evaluation results shows need to a fundamental revision at managers

  16. Survey ofAn Investigation of the Relationship between Emotional Labor and Job Satisfaction among the Executives and Nursing Managers of the Teaching Hospitals Affiliated to Isfahan University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Mahmood Keyvanara

    2015-09-01

    Full Text Available Introduction and Purpose: Due to vast and varied nature of their work, managers need to operate in a wide range of emotions. In addition, managers must be able to determine when to show certain emotions. This shows the important role of emotional labor in management positions which can in turn affect the managers' job satisfaction. Therefore the current study aims to investigate the relationship between emotional labor and job satisfaction among executives and nursing managers of educational hospitals of Isfahan University of Medical Sciences.   Methods: This is a descriptive, correlation study using field survey method. The study population consisted of executives and nursing managers of educational hospitals of Isfahan University of Medical Sciences. The sample size of 250 people was selected using census method. Data collection was carried out using a translated version of a questionnaire whose validity and reliability were approved (&alpha=0/81. The questionnaires were distributed among the study population and the resulting data was analyzed using descriptive and analytical statistics with the help of SPSS18 software.   Results: The rate of emotional labor among the executive and nursing management of the selected hospitals was average while the job satisfaction, deep interaction and genuine emotions were reported to be above average and the rate of surface interaction was lower than average. The results showed that there is a direct and significant statistical relationship between the genuine emotions dimension of emotional labor and job satisfaction (P<0/05. However there was no statistically significant relationship between the other dimensions of emotional labor (surface interaction and deep interaction and job satisfaction of the managers.   Conclusions: It can be concluded that, like in general population, the closer the emotional labor of the managers is to what they really feel (genuine emotions the greater their job satisfaction.

  17. The relationship between the managerial skills and results of "performance evaluation "tool among nursing managers in teaching hospitals of Iran University of Medical Science.

    Science.gov (United States)

    Isfahani, Haleh Mousavi; Aryankhesal, Aidin; Haghani, Hamid

    2014-09-25

    Performance of different organizations, such as hospitals is mainly influenced by their managers' performance. Nursing managers have an important role in hospital performance and their managerial skills can improve the quality of the services. Hence, the present study was conducted in order to assess the relationship between the managerial skills and the results of their performance evaluation in Teaching Hospitals of Iran University of Medical Science in 2013. The research used the cross sectional method in 2013. It was done by distributing a managerial skills assessment questionnaire, with close-ended questions in 5 choice Likert scale, among 181 managers and head nurses of hospitals of Iran university of Medical Sciences; among which 131 answered the questions. Another data collection tools was a forms to record evaluation marks from the personnel records. We used Pearson and Spearman correlation tests and SPSS for analysis and description (frequency, mean and standard deviation). Results showed that the managerial skills of the nursing mangers were fair (2.57 out of 5) and the results of the performance evaluation were in a good condition (98.44). The mangers' evaluation results and the managerial skills scores were not in a meaningful correlation (r=0.047 np=0.856). The research showed no correlation between different domains of managerial skills and the performance evaluation marks: decision making skills (r=0.074 and p=0.399), leadership (correlation coefficient 0.028 and p=0.654), motivation (correlation coefficient 0.118 and p=0.163), communication  (correlation coefficient 0.116 and p=0.122), systematic thinking  (correlation coefficient 0.028 and p=0.828), time management (correlation coefficient 0.077 and p=0.401) and strategic thinking  (correlation coefficient 0.041 and p=0.756). Lack of any correlation and relation between managers' managerial skills and their performance evaluation results shows need to a fundamental revision at managers

  18. Acolhimento: tecnologia leve nos processos gerenciais do enfermeiro Acogimiento: tecnología leve en los procesos gerenciales del enfermero Welcoming: soft technology in nurse's management processes

    Directory of Open Access Journals (Sweden)

    Flávia Raquel Rossi

    2005-06-01

    Full Text Available O estudo teve por objetivo identificar a utilização das tecnologias leves nos processos gerenciais do enfermeiro e a sua interferência na produção do cuidado. Constituiu-se em um estudo de caso de abordagem qualitativa, cujos sujeitos da pesquisa foram enfermeiros de um setor de internação de um hospital geral localizado em um município do interior do Rio Grande do Sul. Os dados foram coletados através da observação livre do trabalho do enfermeiro. Nos processos gerenciais do enfermeiro identificou-se a utilização de tecnologias leves, entre elas o acolhimento, assim como alguns fatores que o configuram, sendo possível afirmar que ao utilizar essa tecnologia o enfermeiro produz e promove a humanização do cuidado.El objetivo de este estudio fué la utilización de tecnologías leves en los procesos gerenciales del enfermería e su interferencia al producir lo cuidado. Se constituye en un estudio de caso de abordaje cualitativa e los sujetos de investigación eran enfermeros de un sector de internación de un hospital general localizado en una ciudad del Río Grande do Sul. Los datos fueron colectados a través de la libre observación de sus trabajos. En los procesos gerenciales del enfermero, se identifico el uso de tecnologías leves, entre ellas, el acogimiento, así como algunos factores que lo configuran, siendo posible afirmar que al utilizar esa tecnología, el enfermero produce e promociona la humanización del cuidado.This study aimed the identification of the use of soft technologies in nursing management processes and their interference in care production. It was constituted in a case study case of quality feature and the research subjects were nurses of a public hospital located in a city of Rio Grande do Sul. Data were collected by means of free observation of the nurses' job. In their managing processes, it was identified the use of soft technologies, among them the welcoming, as well as some factors that present it

  19. Event Registration System for INR Linac

    International Nuclear Information System (INIS)

    Grekhov, O.V.; Drugakov, A.N.; Kiselev, Yu.V.

    2006-01-01

    The software of the Event registration system for the linear accelerators is described. This system allows receiving of the information on changes of operating modes of the accelerator and supervising of hundreds of key parameters of various systems of the accelerator. The Event registration system consists of the source and listeners of events. The sources of events are subroutines built in existing ACS Linac. The listeners of events are software Supervisor and Client ERS. They are used for warning the operator about change controlled parameter of the accelerator

  20. Inr training programme in nuclear research

    International Nuclear Information System (INIS)

    Cretu, I.; Ionila, M.; Gyongyosi, E.; Dragan, E.; Petra, M.

    2013-01-01

    The field of scientific research goes through rapid changes to which organizations must dinamically and efficiently adapt, which leads to the need to develop a continuous learning process that should be the basis for a long-term operational performance. Thus, human resource management systems and continuous learning should be perfectly correlated/alligned with the organizational strategy and knowledge. The research institutes through the nature of their activity are constantly undergoing a transformation process by exploring new research areas which presumes ensuring competent human resources who have to continuously learn and improve. The «learning organization » concept represents a metaphor rooted in the search of a strategy for promoting the personal development of the individual within an organization through a continuous transformation. Learning is associated with the idea of continuous transformation based on the individual and organizational development. Within « learning organizations » the human development strategy occupies a central role in management strategies. It was learned that organizations which perform excellently depend on the employees committment, especially in the budget constraints environment. For this, the human resources have to be used at maximum capacity but this is possible only with an increased committment of the employee towards the organization. The purpose of this paper is to present the basic training programme for the new employees which is part of the training strategy which carry out activities in the nuclear field of SCN Pitesti. With the majority of the research personnel aged between 45 and 60 years old there is the risk of loosing the knowledge gained in this domain. The expertise gained by experienced experts in the institute nationally and internationally can be exploited through the knowledge transfer to the new employees by organizing training programmes. The knowledge transfer between generations is one of the main challenges of the nuclear field in the near future. Thus, starting 2011 every year lecturers from the institute present in an organized environment seminars focused on key areas of activity: reactor and nuclear materials, nuclear power plants and operating nuclear installations, nuclear security, nuclear security culture, radioactive waste, radiation protection, environment, quality, safety and work health, quality culture, emergency preparedness, prevention and protection, information technology, intellectual property protection, physical protection and protection of classified information, international cooperation, technological transfer, the economic-financial system in the scientific research domain, legislations, regulations, standardization. This paper presents the main results achieved through the general training programme for the nuclear activities conducted within SCN and the conclusions drawn from this type of training. (authors)

  1. Quality of management of oral anticoagulation as assessed by time in therapeutic INR range in elderly and younger patients with low mean years of formal education: a prospective cohort study.

    Science.gov (United States)

    Costa, Gustavo Lamego de Barros; Ferreira, Diana Carvalho; Valacio, Reginaldo Aparecido; Vieira Moreira, Maria da Consolação

    2011-05-01

    despite the overwhelming evidence of its effectiveness, oral anticoagulation continues to be underused in the elderly, presumably due to physicians' misconceptions when estimating bleeding risk and ability to comply with treatment. to investigate the quality of anticoagulation control among deprived elderly and younger patients. prospective observational study. a public anticoagulation clinic in a developing country. all adult patients on intended long-term (>90 days) oral anticoagulation. We studied 171 patients (79 elderly and 92 non-elderly) with a mean follow-up of 273 ± 84.9 days. the main outcome measure was the quality of anticoagulation management as measured by the time in therapeutic (TTR) international normalised ratio (INR) range. Elderly patients (≥60 years) were compared with younger patients with respect to the educational level and co-morbidities. the mean number of years of formal education was 4.37 ± 3.2 years. The mean TTR was 62.50 ± 17.9% in non-elderly and 62.10 ± 16.6% in elderly (P = 0.862) subjects, despite the higher prevalence of co-morbidities in the latter group: heart failure (46.3 versus 28.6%, P = 0.042), diabetes mellitus (22.8 versus 8.7%, P = 0.011), renal failure (estimated glomerular filtration rate educational levels (3.42 ± 2.5 versus 5.55 ± 3.4 years of formal education, P < 0.001) and higher rates of cognitive impairment (34.0 versus 13.1%, P = 0.004), but a similar mean TTR (62.46 ± 16.1 versus 63.02 ± 17.8%, P = 0.856). The oldest (≥75 years) patients did as well as those aged ≤50 years (mean TTR: 62.54 ± 16.0 versus 62.23 ± 16.4%, respectively, P = 0.98). good-quality management of oral anticoagulation is achievable in deprived populations attending an anticoagulation clinic. Elderly patients may experience similar quality of anticoagulation despite having higher levels of co-morbidities and polypharmacy. These results add evidence to the safety of such therapeutic interventions in the elderly.

  2. Management and leadership: analysis of nurse manager's knowledge Gestión y liderazgo: análisis del conocimiento de enfermeros gerentes Gerenciamento e liderança: análise do conhecimento dos enfermeiros gerentes

    Directory of Open Access Journals (Sweden)

    Maria Regina Lourenço

    2005-08-01

    Full Text Available Nurses have assumed management positions in many health institutions. To properly accomplish the demands of this role, it is important that they be competent in both management and leadership. For appropriate performance, knowledge of management and supervision styles is a priority. Therefore, the goal of this investigation is to identify the nurse manager's knowledge regarding management and leadership. A structured questionnaire containing twenty-seven questions was applied to twelve Brazilian nurse managers of primary care center called "Family Basic Health Units". Data analysis suggested that the nurse manager lower knowledge in management and leadership is related to visionary leadership, management and leadership conceptual differences, leader's behavior, and situational leadership. And, nurse manager greater knowledge is related to power; team work, and coherence between values and attitudes.Los enfermeros han asumido cargos gerenciales en diversas instituciones de salud. Para que ejerzan su cargo de forma adecuada, deben desarrollar competencias de gestión y liderazgo. Eso requiere conocimiento. La finalidad de esta investigación fue identificar el conocimiento de los enfermeros/gerentes sobre gestión y liderazgo. Aplicamos un cuestionario estructurado con veintisiete cuestiones a doce enfermeros/gerentes de las Unidades Básicas de Salud y de Unidades de Salud de la Familia. El análisis de los datos mostró que los enfermeros/gerentes poseían menos conocimientos respecto a liderazgo visionario; diferencias conceptuales de gestión y liderazgo; comportamiento del líder y liderazgo situacional. Los mayores conocimientos estaban relacionados con el poder; trabajo en equipo y coherencia entre valores y actitudes.Os enfermeiros têm assumido cargos gerenciais em diversas instituições de saúde. Para que exerçam o cargo de forma adequada é necessário que desenvolvam competências de gerenciamento e liderança. Para o

  3. The Success of Self-Testing for Anticoagulation Therapy

    Directory of Open Access Journals (Sweden)

    Cetin Songur

    2013-10-01

    Full Text Available Aim: The optimal therapeutic range for INR of the patient who were on warfarin therapy is narrow. There are various methods of INR monitoring to adjust the appropriate dosage of warfarin therapy. This study aims to test the reliability of POC (Point of care devices used for INR(International normalized ratio monitoring. Material and Method: Forty six  patients who were on warfarin therapy for any reasons were enrolled for this study. Their INR  were divided into 3 groups according to their laboratory INR results. Grup 1 had INR results lower than 2, group 2 had INR levels of 2 to 3.5, group 3 had INR levels of higher than 3.5 INR of the patients were remeasured with the POC device.  Results: The ages of the patients were between 24 to 84. Twenty six patients were male and 20 were female. The mean INR level of laboratory measurements was 1.26 in group 1 whereas it was 1.45 for POC device measurements. There were not statistically significant difference between two devices for group 1 (p=0.15. In group 2 the mean INR levels were measured by laboratory instrument and POC device were 2.74 and 3.51 respectively (p=0,01. In group 3 mean INR levels were measured by laboratory instrument and POC device were 4.27 and 5.25 respectively (p=0.01. Discussion: We suppose it is rational to adjust warfarin dosage by specialists using laboratory results in order to prevent hemorrhagic and thromboembolic complications.

  4. A teoria da complexidade no cotidiano da chefia de enfermagem La teoría de la complejidad en el cotidiano de la jefatura de enfermería Complexity theory in the daily experience of the nurse manager

    Directory of Open Access Journals (Sweden)

    Vania Marta Pradebon

    2011-01-01

    últiples los eventos que desaniman y hacen que los enfermeros evadan el cargo de jefe de la UTIP.OBJECTIVE: To reveal the perceptions that members of the nursing staff of the Pediatric Intensive Care Unit (PICU have about the leadership of the nurse manager of the unit, using the approach of the paradigm of complexity. METHODS: A qualitative study. Data collection occurred in a university hospital with a group of 11 professional nurses, in six meetings with focus groups, held in 2001. RESULTS: After the content analysis, categories emerged that link the tangle of relationships and interconnections in multiple dimensions. CONCLUSION: The nursing staff, and especially the nurse managers, need to recognize the complexity of the nursing role due to uncertainty, instability, insecurity, lack of logic, contradiction, ambiguity, change, randomness, and indetermination, which fights against order, objectivity, and certainty - in particular when multiple events discourage nurses and cause them to avoid the nurse manager.

  5. Clarice Della Torre Ferrarini: o depoimento de uma pioneira da administração em enfermagem no Brasil Clarice Della Torre Ferrarini: the testimony of a pioneer in nursing management in Brazil

    Directory of Open Access Journals (Sweden)

    Maria Cristina Sanna

    2003-12-01

    Full Text Available O presente depoimento, construído a partir de entrevistas realizadas nos anos de 1996 e 1997 com a enfermeira Clarice Della Torre Ferrarini, por ocasião da coleta de dados para a tese de doutoramento intitulada História de Enfermeiras gerentes: subsídios para a compreensão de um modelo-referência de organização de serviços de enfermagem no período de 1950 a 1980, é apresentado após ter sido submetido aos processos de transcrição, validação e autorização. O processo é descrito e exemplificado, e o produto apresentado evidencia a trajetória da entrevistada, desde a escolha da profissão até o desempenho de vários papéis profissionais de liderança no cenário da administração em enfermagem, em cinqüenta anos de vida profissional vinculada a instituições como o Hospital das Clínicas de São Paulo, o Ministério da Saúde e a Associação Brasileira de Enfermagem, entre outras.This testimony is drawn from interviews conducted with the nurse Clarice Della Torre Ferrarini in 1996 and 1997 as part of data collection for the doctoral dissertation entitled History of nurse managers: subsidies for an understanding of a reference model on the organization of nursing services from 1950 through 1980 (História de Enfermeiras gerentes: subsídios para a compreensão de um modelo-referência de organização de serviços de enfermagem no período de 1950 a 1980. The article describes and exemplifies the process of transcription, validation, and authorization to which these interviews were submitted. The product reveals the interviewee's trajectory from the time she chose her profession through her performance of a series of leadership roles within the realm of nursing management, covering a career of fifty years at institutions such as São Paulo's Hospital das Clínicas, the Brazilian Ministry of Health, and the Brazilian Nursing Association, among others.

  6. 护士长管理理论培训课程需求调查及其引发的思考%The thoughts from the survey of head nurses' management theory training needs

    Institute of Scientific and Technical Information of China (English)

    张含凤; 李秋洁; 孔繁莹

    2012-01-01

    Objective: To explore the training needs and provide the scientific basis of management theory course for the head nurses. Methods: Using the Delphi method to investigate the head nurses' training needs about management theory course. Results: Nursing management theory course have 5 categories and 23 statements ,and the 5 categories includes management theories, leadership theories, learning theories .incentive theories, and the related theories, among which the management theories are the most needed course, but the learning theories are the least needed course and the motivation theories are controversial course. Conclusion: The coordination degree of experts is higher, thus, this results can be the reference for the following nursing management theory training for the head nurses. At the same time, the different results between this study and the previous researches will enlighten us to examine the importance and necessity of the head nurses' theory training.%目的:探讨护士长对管理理论课程的培训需求,为下一步护士长理论培训提供科学依据.方法:采用德尔菲法就护士长对管理理论课程的培训需求进行两轮函询.结果:管理理论课程包括管理理论、领导理论、学习理论、激励理论、相关理论等5个一级指标和23个二级指标,其中管理理论和学习理论分别是护士长最需要和最不需要培训的理论,而激励理论是最受争议的内容.结论:专家对确定的护士长管理理论课程的协调程度较高,可为以后的护士长理论培训提供参考.需要进一步审视护士长理论培训的重要性和必要性.

  7. Analysis of in-R12 CHF data: influence of hydraulic diameter and heating length; test of Weisman boiling crisis model; Analyse de donnees de flux critique en R12: influence du diametre hydraulique et de la longueur chauffante; test du modele de Weisman

    Energy Technology Data Exchange (ETDEWEB)

    Czop, V; Herer, C; Souyri, A; Garnier, J

    1993-09-01

    In order to progress on the comprehensive modelling of the boiling crisis phenomenon, Electricite de France (EDF), Commissariat a l`Energie Atomique (CEA) and FRAMATOME have set up experimental programs involving in-R12 tests: the EDF APHRODITE program and the CEA-EDF-FRAMATOME DEBORA program. The first phase in these programs aims to acquire critical heat flux (CHF) data banks, within large thermal-hydraulic parameter ranges, both in cylindrical and annular configurations, and with different hydraulic diameters and heating lengths. Actually, three data banks have been considered in the analysis, all of them concerning in-R12 round tube tests: - the APHRODITE data bank, obtained at EDF with a 13 mn inside diameter, - the DEBORA data bank, obtained at CEA with a 19.2 mm inside diameter, - the KRISTA data bank, obtained at KfK with a 8 mm inside diameter. The analysis was conducted using CHF correlations and with the help of an advanced mathematical tool using pseudo-cubic thin plate type Spline functions. Two conclusions were drawn: -no influence of the heating length on our CHF results, - the influence of the diameter on the CHF cannot be simply expressed by an exponential function of this parameter, as thermal-hydraulic parameters also have an influence. Some calculations with Weisman and Pei theoretical boiling crisis model have been compared to experimental values: fairly good agreement was obtained, but further study must focus on improving the modelling of the influence of pressure and mass velocity. (authors). 12 figs., 4 tabs., 21 refs.

  8. The significance of sense of coherence for the perceptions of task characteristics and stress during interruptions amongst a sample of public health nurses in Hong Kong: implications for nursing management.

    Science.gov (United States)

    Shiu, A T

    1998-08-01

    The study aimed to investigate the significance of sense of coherence (SOC) for the perceptions of task characteristics and for stress perceptions during interruptions of public health nurses (PHNs) with children in Hong Kong. The research design employed the experience sampling method. Convenience sampling was used to recruit 20 subjects. During stage one of the study a watch was worn that gave a signal at six random times each day for seven days to complete an experience sampling diary. PHNs on average responded to 34 signals (80%) to complete the diaries which collected data on work and family juggling, task characteristics, and their effects on mood states. At stage two respondents completed the SOC scale which measured confidence in life as comprehensible, manageable, and meaningful. Two major findings provide the focus for this paper. First, results indicate that there was positive correlation between SOC and perceived task characteristics. Second, results reveal that when interruptions occurred, PHNs with high SOC had higher positive affect and lower negative affect than PHNs with low SOC. These results suggest that SOC as a salutogenic model helps PHNs to cope with the family and work juggling as well as the occupational stress. Implications for nursing management on strengthening SOC of PHNs are discussed.

  9. Construction of a new model of job engagement, psychological empowerment and perceived work environment among Chinese registered nurses at four large university hospitals: implications for nurse managers seeking to enhance nursing retention and quality of care.

    Science.gov (United States)

    Fan, Yuying; Zheng, Qiulan; Liu, Shiqing; Li, Qiujie

    2016-07-01

    To explore the relationships among perceived work environment, psychological empowerment and job engagement of clinical nurses in Harbin, China. Previous studies have focused on organisational factors or nurses' personal characteristics contributing to job engagement. Limited studies have examined the effects of perceived work environment and psychological empowerment on job engagement among Chinese nurses. A cross-sectional quantitative survey with 923 registered nurses at four large university hospitals in China was carried out. Research instruments included the Chinese versions of the perceived nurse work environment scale, the psychological empowerment scale and the job engagement scale. The relationships of the variables were tested using structural equation modelling. Structural equation modelling revealed a good fit of the model, χ(2) /df = 4.46, GFI = 0.936, CFI = 0.957. Perceived work environment was a significant positive direct predictor of psychological empowerment and job engagement. Psychological empowerment was a significant positive direct contributor to job engagement and had a mediating effect on the relationship between perceived work environment and job engagement. Perceived work environment may result in increased job engagement by facilitating the development of psychological empowerment. For nurse managers wishing to increase nurse engagement and to achieve effective management, both perceived work environment and psychological empowerment are factors that need to be well controlled in the process of nurse administration. © 2016 John Wiley & Sons Ltd.

  10. Traços identitários da enfermeira-gerente em hospitais privados de Belo Horizonte, Brasil The nurse manager's identity features in private hospitals of Belo Horizonte, Brazil

    Directory of Open Access Journals (Sweden)

    Maria José Menezes Brito

    2008-06-01

    Full Text Available Com o propósito de compreender aspectos subjetivos do trabalho da enfermeira-gerente, buscou-se, por meio deste estudo, analisar os traços identitários da enfermeira-gerente no contexto de instituições hospitalares a partir do questionamento fundamentado na apresentação que os sujeitos fazem de si mesmos. Trata-se de um estudo de caso, com abordagem qualitativa, do qual participaram nove enfermeiras-gerente que atuam em quatro instituições hospitalares privadas de médio e grande porte, no município de Belo Horizonte. Os traços identitários foram organizados de acordo com os planos profissional, organizacional e individual, os quais abrangem: preservação e reforço de identidade social da enfermeira, a trajetória profissional como uma evolução da prática da assistência para o exercício da gerência, valorização da experiência prática e permanência em atividades ligadas à prestação da assistência direta ao paciente; identificação com a organização; e questões relativas à vida privada e auto-imagem positiva expressa pelas gerentes. O estudo permitiu a identificação de traços marcantes de um grupo profissional específico, evidenciando a influência das questões de gênero, das relações de poder e da cultura na identidade social dos sujeitos pesquisados.Aiming to understand subjective aspects of the work of nurse managers, this study analyzed their identity features in the context of hospital institutions. These were obtained through a questioning based on the introduction that the subjects make of themselves. It is a case study carried out according to the qualitative approach, in which nine nurse managers participated. They worked at four large- and medium-sized private hospitals in the city of Belo Horizonte. The identity features were organized in accordance with the professional, institutional and individual planes, which encompass: the preservation and reinforcement of the nurse's social identity

  11. Global nursing management. Avoiding conflicts of interest.

    Science.gov (United States)

    Willers, Lisa

    2004-01-01

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

  12. The glass ceiling in nursing management.

    Science.gov (United States)

    Crawford, D I

    1993-01-01

    Women managers in business and health care have experienced discrimination related to advancement in management. Nurse executives must understand the strategies to overcome the barriers, the "glass ceiling," as well as implications for future practice. Women executives need an organized blueprint and the tools to dismantle the glass ceiling and overcome the political and discriminatory barriers to success.

  13. Does access to a colorectal cancer screening website and/or a nurse-managed telephone help line provided to patients by their family physician increase fecal occult blood test uptake?: A pragmatic cluster randomized controlled trial study protocol

    Directory of Open Access Journals (Sweden)

    Clouston Kathleen

    2012-05-01

    Full Text Available Abstract Background Fecal occult blood test screening in Canada is sub-optimal. Family physicians play a central role in screening and are limited by the time constraints of clinical practice. Patients face multiple barriers that further reduce completion rates. Tools that support family physicians in providing their patients with colorectal cancer information and that support uptake may prove useful. The primary objective of the study is to evaluate the efficacy of a patient decision aid (nurse-managed telephone support line and/or colorectal cancer screening website distributed by community-based family physicians, in improving colorectal cancer screening rates. Secondary objectives include evaluation of (disincentives to patient FOBT uptake and internet use among 50 to 74 year old males and females for health-related questions. Challenges faced by family physicians in engaging in collaborative partnerships with primary healthcare researchers will be documented. Methods/design A pragmatic, two-arm, randomized cluster controlled trial conducted in 22 community-based family practice clinics (36 clusters with 76 fee-for-service family physicians in Winnipeg, Manitoba, Canada. Each physician will enroll 30 patients attending their periodic health examination and at average risk for colorectal cancer. All physicians will follow their standard clinical practice for screening. Intervention group physicians will provide a fridge magnet to each patient that contains information facilitating access to the study-specific colorectal cancer screening decision aids (telephone help-line and website. The primary endpoint is patient fecal occult blood test completion rate after four months (intention to treat model. Multi-level analysis will include clinic, physician and patient level variables. Patient Personal Health Identification Numbers will be collected from those providing consent to facilitate analysis of repeat screening behavior. Secondary outcome

  14. Processo de trabalho do gerente de enfermagem em unidade hospitalar - uma visão dos enfermeiros Proceso de trabajo del gerente en el oficio de enfermeros en unidad hospitalar - una visión de los enfermeros Working process of nursing management at a hospital unit - the nurses' approach

    Directory of Open Access Journals (Sweden)

    Viviane Francisco Sanches

    2006-08-01

    Full Text Available Nesta pesquisa delimitamos como objeto de estudo a visão do enfermeiro quanto ao processo de trabalho do gerente de enfermagem. Temos como objetivos: conhecer o conceito dos enfermeiros sobre gerência em enfermagem, identificar a compreensão dos enfermeiros quanto ao processo de trabalho da gerência de enfermagem; e verificar qual a importância atribuída ao trabalho do gerente de enfermagem. Como referencial, utilizaram-se teorias administrativas, conceitos de gerência. Sua abordagem é qualitativa, do tipo estudo de caso, realizada em um Hospital Universitário no município de Niterói, RJ. Foi utilizado como instrumento de coleta de dados um questionário com perguntas abertas, respondido por 10 enfermeiras. Os resultados mostram enfermeiras com conhecimento básico sobre gerência e o processo de trabalho do gerente visto como muito complicado.En esta pesquisa delimitamos como objeto de estudio la visión del enfermero cuanto al proceso de trabajo del gerente. Teniendo como objetivos: conocer el concepto de los enfermeros cuanto a la gerencia, identificar la comprensión de los enfermeros cuanto al proceso de trabajo de la gerencia; verificar la importancia atribuida al trabajo del gerente. Como referencial, han sido utilizadas teorías administrativas y conceptos de gerencia. Su abordaje es cualitativo, del tipo estudio de caso, realizada en un hospital universitario en el municipio de Niteroi, RJ. Ha sido utilizado como instrumento de colecta de dados un cuestionario con preguntas abiertas, respondido por diez enfermeras. Los resultados muestran enfermeras con conocimiento básico sobre gerencia y el proceso de trabajo del gerente visto como muy difícil.In this resesarch we have delimited as object of study the nurse approach as working process of the nursing manager. It had as objectives: to know the nurses concept as to nursing management, to identify the nurses understanding as to working process of nursing management; to check

  15. Effect of situational leadership theory training on head nurses' leadership style in nursing management%情境领导理论培训对护士长护理管理领导风格的影响

    Institute of Scientific and Technical Information of China (English)

    刘祚燕; 倪碧玉; 胡秀英

    2017-01-01

    Objective To evaluate the effect of situational leadership theory training on head nurses' leadership style in nursing management,and summarize the application methods of situational leadership theory.Methods In December 2013,by means of convenience cluster sampling method,154 head nurses of West China Hospital of Sichuan University were selected for a Leadership Style Self-rating Questionnaire survey,of whom 84 attended the situational leadership theory training one month ago.The questionnaire score was compared between the trained head nurses (the trained group) and the non-trained ones (the non-trained group).Results A total of 154 questionnaires were issued,and 109 valid ones were recovered,in whom 72 were trained by the situational leadership theory while the other 37 were not.The average scores of head nurses' flexibility and efficacy in the trained group (22.35±5.12 and 55.67±7.59) were higher than those in the non-trained group (19.03±4.05 and 50.95±5.30),and the proportions of head nurses with high flexibility and high efficacy in the trained group (61.1% and 31.9%) were higher than those in the non-trained group (32.4% and 8.1%),and the differences above were statistically significant (P<0.05).Conclusions The training of the situational leadership theory can improve the application of theory to clinical nursing management and promote the head nurses' flexibility and efficacy to accelerate their work enthusiasm and personal improvement.It can also promote team cohesion and sense of accomplishment by creating a positive team atmosphere to make the efficient usage of limited human resources.%目的 观察情境领导理论培训对护士长护理管理领导风格的影响,并总结情境领导理论在护理管理中的应用方法.方法 2013年11月四川大学华西医院154名护士长中有84名护士长参加了情境领导理论培训.2013年12月即培训1个月后,以领导风格自我问卷为调查工具,采用便利

  16. Power cycling experiments in INR-TRIGA-SSR Reactor

    International Nuclear Information System (INIS)

    Dumitru, M.

    2008-01-01

    The in-reactor experimental program started this summer with some power cycling experiments to provide date on fuel behaviour under abnormal reactor operating conditions. The paper describes the irradiation device, its operational features and an original 'under-flux' movement system. Also, there are presented main data of irradiation device (pressure, flow, temperature, construction), in-pile section, location, sample, instrumentation, experimental sequences and operating data of Interest for the experimenters. (author)

  17. MODIST_L3m_CU_POC_4km

    Data.gov (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  18. MODIST_L3m_MC_POC_9km

    Data.gov (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  19. MODISA_L3m_SCSU_POC_4km

    Data.gov (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  20. MODIST_L3b_8D_POC

    Data.gov (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  1. MODIST_L3b_SNSP_POC

    Data.gov (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  2. From Inhumanitarian Non-intervention to Protection of Civilians (POC)

    DEFF Research Database (Denmark)

    Mandrup, Thomas

    2017-01-01

    From its birth in 2002, the African Union has developed into an important continental conflict management tool. However, the continental body has also come to realise that it is more often than not confronted with a militarily strategic asymmetric opponent, requiring a different mandate and milit...... is the consequence of the increased use of force to stop conflict, and what results might this have for the future mandates of UN PSO operation?...

  3. O conflito como realidade e desafio cultural no exercício da gerência do enfermeiro El conflicto como realidad y desafío cultural, en el ejercício de la gerencia del enfermero Conflict as a reality and a cultural challenge in the practice of nurses' management

    Directory of Open Access Journals (Sweden)

    Adelina Giacomelli Prochnow

    2007-12-01

    resultados de este estudio apuntan para la importancia de la cultura organizacional en el ejercicio de la gerencia en la enfermería delante de las inseguridades laborables, en la complejidad del ambiente hospitalario.The practice of nurses' management is permeated by conflicts that can be interpreted through culture references. The objective of this study is to denote cultural specificities, analyzed according to Geertz's Cultural Interpretative Theory, that are expressed as conflicts in the scope of nurses' management at a University Hospital. The results denoted the incorporation of ideological elements and mechanisms of control and power, whose origin can be seen in the way in which the work is organized. The application of policies based on the profession's very values was observed. Practices highlight a cultural construction that elucidates some understandings regarding cognitive, social and behavioral processes, because they organize the interpretations and the answers to the events of nurses' practices in management. The results of this study point out the importance of organizational culture in the practice of Nursing management in the face of labor uncertainties in the complexity of a hospital environment.

  4. El conflicto en la gerencia de enfermería: un análisis de la producción científica brasileña The conflict in nurses management practice: An analysis of scientific production brazilian

    Directory of Open Access Journals (Sweden)

    Soeli Teresinha Guerra

    2010-09-01

    Full Text Available Este artículo tuvo como objetivos identificar y analizar la producción científica de la enfermería brasileña sobre los conflictos, destacando las investigaciones acerca de los conflictos en la gerencia de enfermería. Se trata de una investigación bibliográfica de los resúmenes de las tesis de maestría y doctorado compiladas por el Centro de Investigaciones en Enfermería de la Asociación Brasilera de Enfermería. Se encontraron 145 estudios con la palabra conflicto (en la búsqueda, se utilizó la palabra en portugués: conflito en su título o en el cuerpo del resumen. Se utilizó el análisis de contenido para clasificar los trabajos en tres universos sociales que demuestran la presencia de conflictos en el trabajo de enfermería: uno relacionado con la enseñanza; otro, con el equipo de asistencia; y, el último, con la comunidad usuaria. Trece estudios abordaban el tema conflicto en la gerencia de enfermería. Se propone una reflexión sobre el fenómeno del conflicto con la finalidad de interpretarlo en el ejercicio gerencial del enfermero.This study aimed to identify and analyze the scientific production's Brazilian Nursing about conflicts in nursing, including among the publications that was searched the conflict in nurse's management practice. This is a bibliographical review of the theses and dissertations' abstracts compiled by the Studies and Research in Nursing Center of the Brazilian Nursing Association. One hundred forty-five studies were localized with the word conflict in the abstract's title or body. The content analysis was used to classify the works into three social universes that reveal the presence of conflict in nursing work: one related to education, another patient care team and the last, to the user community. Thirteen studies boarded the conflicts in the nurse's management exercise. It proposes a reflection on the phenomenon of conflict with finalidea to interpret it in the management practice of nurses.

  5. Inclusão da competência interpessoal na formação do enfermeiro como gestor Inclusión de la competencia interpersonal en la formación del enfermero geston Inclusion of interpersonal competence in the formation of the nurse manager

    Directory of Open Access Journals (Sweden)

    Denize Bouttelet Munari

    2004-08-01

    Full Text Available Este artigo se propõe a apresentar reflexões sobre a necessidade de incluir o desenvolvimento da competência interpessoal no processo de formação do enfermeiro gestor. Destaca as tendências da gestão contemporânea e a importância da construção de relacionamentos interpessoais como base para as ações do gestor. A inclusão da competência interpessoal, nesse sentido, pode influenciar na transformação da prática gerencial do enfermeiro e na formação de um líder que consiga avaliar e dimensionar os problemas de modo global e exercer o seu papel com segurança e transparência.El artículo presenta reflexiones sobre la necesidad para incluir el desarrollo de la capacidad interpersonal en el proceso de la formación de la enfermera de manejo. Destaca que la construcción de las relaciones interpersonales es recomendable a las buenas acciones de un encargado, ocurriendo con la interacción de la gente, pudiendo influenciar en la transformación de la práctica gerencial de este profesional y en la formación de un líder que obtenga para evaluar y dimensionar los problemas de la manera global y ejercer su papel con seguridad y transparencia.This article presents reflections about the necessity to include the development of interpersonal competence in the process of the nurse manager formation. It points up a trend of contemporary management and the importance of the construction of interpersonal relationships as base for the actions of a manager. The inclusion of interpersonal competence in this way can influence in the transformation of the nurse manager practice and in the formation of a leader who can evaluate and measure the problems in a global way and perform her/his role with security and transparency.

  6. O significado de competência para o docente de administração em enfermagem El significado de competencia para el docente de administración en enfermería The meaning of competence for nursing management faculty members

    Directory of Open Access Journals (Sweden)

    Miriam Aparecida Nimtz

    2006-09-01

    ítica de desarrollo de recursos humanos que privilegie el proceso de capacitación docente, ofreciendo oportunidades concretas para que el desarrollo docente impulse transformaciones rumbo a una educación emancipadora.This study is aimed at identifying and analyzing the perceptions of professors who work on Nursing Management disciplines regarding the meaning of faculty competence at the undergraduate level. The objective is to suggest interventions that favor proposals for capacity building for the teaching of management that are compatible with teaching norms and with the current Curriculum Guidelines. In order to do so, the content analysis method was applied in twelve discourses of Nursing Management professors who teach in private institutions in the Greater São Paulo area between August and October of 2002. The meaning and perceptions reported were categorized, and the authors recommend a policy of human resources development that offers concrete opportunities that faculty development will lead to changes toward an emancipating education.

  7. CE: Nursing Management of Patients with Ehlers-Danlos Syndrome.

    Science.gov (United States)

    Anderson, Linda K

    2015-07-01

    Ehlers-Danlos syndrome (EDS), a hereditary connective tissue disorder, has historically been misunderstood and underdiagnosed by health care providers. Because of the high degree of phenotypic variability, patients are often correctly diagnosed only after years of seemingly unrelated but debilitating injuries and illnesses. Specific genetic mutations have been identified for some, but not all, EDS types; patients presenting with a high index of suspicion should be referred to a geneticist. As awareness and recognition of the syndrome improve, nurses are increasingly likely to care for patients with EDS. This article gives a brief overview of the syndrome and provides guidance on ways to manage symptoms, recognize and prevent serious complications, and improve patients' quality of life.

  8. Financial literacy as an essential element in nursing management practice.

    Science.gov (United States)

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

    2013-01-01

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

  9. NURSE MANAGEMENT SKILLS REQUIRED AT AN EMERGENCY CARE UNIT

    Directory of Open Access Journals (Sweden)

    Juliana Helena Montezeli

    2013-05-01

    Full Text Available Objetivo: identificar as competências gerenciais necessárias a este profissional em um pronto-socorro. Metodologia: estudo qualitativo descritivo-exploratório realizado com oito enfermeiros em que se conjugou entrevista semi-estruturada com observação sistemática não participante; os dados foram tratados pela análise de conteúdo. Resultados: as categorias emersas da análise de conteúdo permitiram elencar como competências gerenciais necessárias para sua atuação no pronto-socorro: liderança, tomada de decisão, comunicação, administração do tempo e trabalho em equipe. Conclusão: as competências gerenciais possuem dialogicidade entre si e são mobilizadas de maneira hologramática na atuação do enfermeiro em um cenário que valoriza sobremaneira o aspecto técnico como elemento fundamental para uma prática produtivista.

  10. Nursing management of reflex anoxic seizures in children.

    Science.gov (United States)

    Patel, Neal; Kerr-Liddell, Rowan; Challis, Louise; Paul, Siba Prosad

    2017-04-13

    Children who present with transient loss of consciousness (T-LOC) are often first seen in emergency departments (EDs). Reflex anoxic seizure (RAS), vasovagal syncope and prolonged respiratory apnoea are benign, syncopal events that can be generally managed by explanation and reassurance. RAS is a short, paroxysmal, self-reverting episode of asystole that is triggered by pain, fear or anxiety and is caused by increased vagal response. It is an important differential diagnosis in pre-school age children who present with T-LOC, but is often underdiagnosed and can sometimes be misdiagnosed as epilepsy. Nurses working in EDs are among the first healthcare professionals to see children in acute settings and should therefore be aware of RAS, the presenting features and management options. This article discusses the epidemiology, pathophysiology and management of RAS, includes an illustrative case study and discusses the role of ED nurses.

  11. Nurse management skills required at an emergency care unit

    OpenAIRE

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

    2013-01-01

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

  12. [Endomarketing: Essay on possibilities of innovation in nursing management].

    Science.gov (United States)

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

    2004-01-01

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

  13. The systems psychodynamic leadership coaching experiences of nursing managers

    Directory of Open Access Journals (Sweden)

    Frans Cilliers

    2010-07-01

    Opsomming Die meestal liniêre en meganistiese aard van die verpleegbestuursrol is vinnig besig om na ’n meer dinamiese en sistemiese rol te verander. Die verandering behels taak- en mensbestuur binne 'n steeds veranderende organisasie-identiteit, waar 'n verskeidenheid rolle opgeneem word, die self en ander in 'n komplekse matrikssisteem bemagtig word, en waartydens bewuste en onbewuste sielkundige grense in en tussen botsende sisteme bestuur word. Die doel van hierdie studie was om die sisteem-psigodinamiese leerervaringe van verpleegbestuurders tydens leierskapafrigting te beskryf. Die afrigtingstaak was om leergeleenthede aan die individuele leier beskikbaar te stel vir die ontwikkeling van insig in bewuste en onbewuste leierskapsdinamika in terme van angs, taak, rol, outoriteit, grense en identiteit. 'n Kwalitatiewe navorsingsontwerp is gebruik. Ses verpleegbestuurders het tien leierskapafrigtingsessies oor tien weke bygewoon. Veldnotas en besinnende opstelle is deur middel van sisteem-psigodinamiese gespreksanalise ontleed. Die bevindinge dui op duidelikheid oor en bemagtiging in hulle primêre taak en normatiewe rol; angs en ontmagtiging in hulle ervarings- en fenomenale rolle; angs in grenshandhawing wat verband hou met magsmisbruik deur andere; en die voortdurende ondersoek en integrasie van leierskapsrolidentiteit. Deelnemers se leerervarings is na aanleiding van kriteria vir organisasieleer geëvalueer, waarna die algemene hipotese geformuleer is.

  14. Liderança e comunicação no cenário da gestão em enfermagem Liderazgo y comunicación en el escenario de la gestión en enfermería Leadership and communication in the scenery of nursing management

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Trevizan

    1998-12-01

    Full Text Available Tecendo considerações a respeito de comunicação e liderança, as autoras examinam o papel do líder como foco de recepção e transmissão de informação, fundamentadas na classificação de Mintzberg, em relação a seus papéis informativos, ou seja, o líder atuando como monitor, como disseminador e como porta-voz. Contextualizando esta abordagem para o cenário da gestão em enfermagem, as autoras enfocam a dimensão do papel do enfermeiro-líder como elemento essencial de comunicação nos sistemas de organização da assistência de enfermagem.Tejiendo consideraciones sobre comunicación y liderazgo, las autoras examinan el papel del líder como foco de recepción y transmisión de información, basadas en la clasificación de Mintzberg, en relación a sus papeles informativos, o sea, el líder actuando como monitor, como diseminador y como portavoz. Contextualizando este abordaje para el escenario de la gestión en enfermería, las autoras enfocan la dimensión del papel del enfermero-líder como elemento esencial de comunicación en los sistemas de organización de la asistencia de enfermería.Considering communication and leadership, authors examine the role of the leader as a focus of reception and transmission of information, based on the classification of Mintzberg related to their informative roles, such as the leader acting as monitor, disseminator and spokesman. Contextualizing this approach in the scenery of nursing management, authors study the dimension of nurses-leaders role as an essential element of communication in the systems of organization of nursing care.

  15. Uso de videoconferência para discussão de temas sobre gestão de enfermagem em hospitais universitários Uso de videoconferencia para discusión de temas sobre la gestión de enfermería en hospitales universitarios Using videoconferencing to discuss themes of nursing management in university hospitals

    Directory of Open Access Journals (Sweden)

    Maria Elisabete Salvador

    2010-10-01

    Full Text Available O presente estudo relata a experiência da criação de um projeto baseado em tecnologia de videoconferência para discussão de temas relacionados à gestão de enfermagem em hospitais universitários do País. Descreve a Rede Universitária de Telemedicina do Ministério da Ciência e Tecnologia em parceria com o Ministério da Educação, como autores de projetos que subsidiam infraestrutura para a realização de videoconferências, com vistas a oferecer intercâmbio de experiências relevantes entre os hospitais de ensino. Profissionais da Diretoria de Enfermagem do Hospital São Paulo vêm utilizando recursos de telemedicina a cerca de 2 anos, a fim de discutir aspectos administrativos, humanos e técnicos da enfermagem hospitalar. Esta iniciativa vem apresentando bons resultados em relação à participação e assiduidade dos enfermeiros usuários.O presente estudio relata la experiencia de la creación de un proyecto basado en tecnología de videoconferencia, con la finalidad posibilitar la discusión de temas relacionados con la gestión de enfermería en hospitales universitarios del país. El estudio describe la Red Universitaria de Telemedicina del Ministerio de Ciencia y Tecnología en sociedad con el Ministerio de la Educación, que son los autores de proyectos que subsidian la infraestructura para la realización de videoconferencias, con el objetivo de ofrecer intercambio de experiencias relevantes entre los hospitales de enseñanza. Los profesionales de la Dirección de Enfermería del Hospital Sao Paulo vienen utilizando recursos de telemedicina desde hace 2 años, con la finalidad de discutir aspectos administrativos, humanos y técnicos de la enfermería hospitalaria. Esta iniciativa viene presentando buenos resultados en relación a la participación y asiduidad de los enfermeros usuarios.This study reports the experience of creating a project based on videoconferencing technology to discuss topics related to nursing

  16. ESTUDO BIBLIOGRÁFICO DE PUBLICAÇÕES SOBRE A ATIVIDADE ADMINISTRATIVA DA ENFERMAGEM EM SAÚDE MENTAL ESTUDIO BIBLIOGRÁFICO DE PUBLICACIONES SOBRE LA ACTIVIDAD ADMINISTRATIVA DE ENFERMERIA EN SALUD MENTAL BIBLIOGRAPHIC STUDY ON PUBLICATIONS CONCERNING NURSING MANAGEMENT ACTIVITIES IN MENTAL HEALTH SERVICES

    Directory of Open Access Journals (Sweden)

    Neide Marina Feijó Bertoncello

    2001-09-01

    Full Text Available 0bjetivando estudar a atividade administrativa do enfermeiro em saúde mental enquanto um instrumento do processo de trabalho, realizamos um estudo bibliográfico de publicações de enfermagem sobre esta temática no período de 1988 a 1997. Através da leitura e análise crítica de 8 artigos e 19 dissertações e teses selecionadas, identificamos as principais características dessa prática, quais sejam: os enfermeiros são os responsáveis pela equipe e assistência de enfermagem, obedecendo à lógica determinada pela instituição; suas ações não são planejadas, coordenadas e avaliadas; as atividades administrativas utilizam a maior parte de seu tempo de trabalho e o cuidado direto de enfermagem é realizado pela equipe auxiliar de enfermagem, sendo que nos serviços extra--hospitalares os atendimentos diretos e grupais são mais freqüentes.Buscando estudiar la actividad administrativa del enfermero en salud mental como un instrumento del proceso de trabajo, realizamos un estudio bibliográfico de las publicaciones de enfermería sobre ésta temática en la fecha de 1988 a 1997. A través de la lectura y el análisis crítico de 8 artículos y 19 disertaciones y tesis seleccionadas, identificamos las principales características de esa práctica, son estas: los enfermeros son los responsables por el equipo y asistencia de enfermería, obedeciendo a la lógica determinada por la institución; sus acciones no son planeadas, coordinadas y evaluadas; las actividades administrativas utilizan la mayor parte de su tiempo de trabajo y el cuidado directo de enfermería es realizado por el equipo auxiliar de enfermería. En los servicios extra-hospitalarios la atención directa y grupal es más frecuente.Aiming at studying the mental health nurse's management activity as an instrument in the work process, a bibliographic study on nursing publications from 1988 to 1997 which concerned that topic was carried out. By reading and critically

  17. Eventos adversos: análise de um instrumento de notificação utilizado no gerenciamento de enfermagem Eventos adversos: análisis de un instrumento de notificación utilizado en la administración de enfermería Adverse events: analysis of a notification instrument used in nursing management

    Directory of Open Access Journals (Sweden)

    Miriam Cristina Marques da Silva de Paiva

    2010-06-01

    úmero creciente de registros. Los eventos adversos más frecuentes fueron aquellos relacionados con la medicación, caídas, catéteres, sondas/drenajes e integridad de la piel. La practicidad del instrumento viabilizó su utilización también por parte de los auxiliares y técnicos de enfermería. El análisis sistematizado y el seguimiento de los eventos adversos asociados a los recursos de comunicación se mostraron fundamentales para la seguridad del paciente.The nursing management board of a tertiary university hospital located in Central-South São Paulo state implemented an Adverse Events Notification Instrument in January 2004 aiming at patient safety and at establishing a means of communication between the team and the administration board. The aim of this study was to analyze the use of the referred communication instrument and identify the frequency, type, nature and period of the incident/adverse events. A descriptive data analysis was performed on 826 instruments completed between January 2004 and June 2006. There was compliance to using the instrument. There was predominance of notifications regarding health care services, although there was an increase in reports on administrative issues in the referred period. The most frequent adverse events concerned medications, falls, catheters, probes and drains, and skin integrity. The practicality of the instrument made it feasible for use among nursing aides and technicians. Systematic analysis and follow-up of the adverse events associated with this means of communication appeared as fundamental issues for patient safety.

  18. Determination of the natural Uranium in the ecosystems around the site of INR-Pitesti

    International Nuclear Information System (INIS)

    Horhoianu, V.; Todoran, A.; Valeca, M.; Hirica, O.

    2002-01-01

    Natural radioactivity, a basic component of the environment, is determined by the presence in soil, atmosphere, water, vegetation, live elements and humans of radioactive matter of terrestrial origin, naturally existing from the very beginning. To all these, extra-terrestrial cosmic radiation must be added. Human exposure to terrestrial radiation is due to radionuclides present in the earth crust or to those transferred from atmosphere or hydrosphere. An abundance of radionuclides present in the crust are radioactive. Their lifetime is shorter or equal to the estimated age of the earth crust and, consequently, they are presumed to represent a primordial inventory. Uranium and thorium in natural state decay in three different series, the first ones being the radionuclides 2 38U , 2 35U and 2 32T h. The population exposure to radiation must take into account both natural and artificial radiation

  19. Derived release limits for airborne effluents at TRIGA-INR reactor

    International Nuclear Information System (INIS)

    Oprea, I.; Toma, A.; Dulama, C.; Hirica, O.; Mihai, S.; Ana, E.

    2001-01-01

    The deleterious effects of radiation are classified as stochastic and deterministic. There is a finite probability for the occurrence of stochastic effects even at small doses. As the dose is increased, the frequency of such stochastic events increases, but in the absence of other modifying factors, the severity of the resulting changes is not expected to increase. In contrast to these, in case of deterministic effects, the number of killed cells reaches a detection level which constitutes a threshold, the magnitude of which will depend on the chosen injury level. Due to the proportionality between dose and probability and stochastic effects the doses are additive. The probability of individual harmful effects or risk is proportional to effective dose: H E = Σ T w T H T where H T is the equivalent dose in tissue or organ T and w T is the weighting factor for tissue T. ICRP recommended the committed effective dose E (τ) as the effective dose integrated over the time interval τ. If not specified, values of 50 years for adults and 17 years for children are used. Radionuclides in airborne and liquid effluents can result in radiation exposure of man via a number of routes or 'pathways' in the environment. Some pathways, such as ingestion of food, result in internal exposures; others, as for instance, in case of radioactive cloud, result in external exposures. However, the total exposure of an individual via all significant pathways from an source of contaminated effluents, must be taken into account to ensure that the regulatory dose limits are not exceeded. The methodology consists of, first, determining for each radionuclide released from each source the most important pathways with regard to radiation exposure of individuals in various localised groups. The following step is calculation of the maximum release rate (Q M ) corresponding to the individual dose-rate limits for each pathways. Then, for each exposed group, the Q M - values are summed in such a way as to determine the maximum permissible release rate (Q M ) for the radionuclide from the particular source. Finally, the smallest Q M values are identified. The minimum value of Q M will be the Derived Release Limits (DRL) for that radionuclide and source. The exposed group for which the minimum applies is the 'critical group'. The DRL then represents an upper limit to the rate of release of a radionuclide from a single source. Description are given for the following environmental transfer pathways: - Immersion, i.e., external exposure while being immersed in a cloud of radioactive noble gases from airborne effluents; - Standing on contaminated ground; - Inhalation; - Vegetable ingestion; - Milk ingestion; - Meat ingestion. As an example, DRL assessment for inhalation pathway is presented. Using a mathematical model, DRLs were calculated for significant radionuclides in gaseous emissions of the TRIGA reactor. For every radionuclide, organ doses were calculated for every contamination pathway as well as external doses for both skin an whole body

  20. Description of INR-Pitesti own strategy for on site radioactive solid waste storage concepts

    International Nuclear Information System (INIS)

    Tuturici, I.L.; Toma, V.; Bujoreanu, D.; Prava, M.

    1993-01-01

    The Post Irradiation Examination Laboratory (PIEL) produces and will produce the majority of institute's alpha-contaminated solid radioactive waste, generated by the process of examination of irradiated CANDU-600 type nuclear fuel. The wastes will be divided into three categories: low-level, medium-level, and high-level general process trash (LLGPT, MLGPT, and HLGPT). The paper describes the strategy adopted for immobilization, conditioning and on-site long-term storage of these wastes. The proposed strategy is based on the best experience acquired by other nuclear centers, confronted with same problems. (Author)

  1. Study concerning the erection within the precincts of INR Pitesti of TRIGA prototype nuclear heating plant

    International Nuclear Information System (INIS)

    Ciocanescu, M.; Ionescu, M.; Constantin, L.

    1993-01-01

    This paper presents the problems of nuclear plant energy production as heating source for industrial processes and urban district heating. The study is based on the TRIGA concept due to some of its advantages in comparison with other concepts. The system solutions for a prototype implementation and the aspects of the economical and financial efficiency are outlined. The conclusion is drawn that the TRIGA 53 MWt-reactor is suitable to meet the heating needs of urban and industrial heating systems in this country

  2. The results obtained by INR-Pitesti to an international in-situ intercomparison exercise

    International Nuclear Information System (INIS)

    Dobrin, Relu; Dulama, Cristian; Toma, Alexandru

    2008-01-01

    Full text: The determination of soil contamination, dose rate measurements and in-situ gamma spectrometry are well established and widely used measurement procedures, especially after large scale nuclear incidents. To support decision makers and first responders with a more comprehensive and accurate overview immediately after a large scale nuclear or radiological emergency, as releases from a nuclear power plant or a terrorist attack with a dirty bomb, a fast and clear presentation of measurement data is indispensable. In 2007, the Austrian Research Centers GmbH - ARC (Seibersdorf) in cooperation with IAEA and the Austrian NBC Defense School organized an international measurement campaign, 'In-Situ Intercomparison Scenario' ISIS 2007, with the focus on In-Situ Gamma Spectrometry and Dose Rate Measurements in Emergency Situations. 56 teams from 25 countries, worldwide, took part to this exercise. The only Romanian team was 'CROWN'. The CROWN Laboratory is part of the Radiation Protection Laboratory of the Institute for Nuclear Research - Pitesti, certified for characterization of radioactive wastes and nuclear materials. The paper presents results obtained during different tasks of the exercise: 'Dose rate mapping'; 'Localization - Drive by'; 'Simulation of a contamination'; 'Identification Shielded; 'Identification/Quantification'; 'Buried sources; 'Environmental measurement'. (authors)

  3. Measurement Uncertainty Analysis of an Accelerometer Calibration Using a POC Electromagnetic Launcher

    Energy Technology Data Exchange (ETDEWEB)

    Timpson, Erik J.; Engel, T. G.

    2012-06-12

    A pulse forming network (PFN), helical electromagnetic launcher (HEML), command module (CM), and calibration table (CT) were built and evaluated for the combined ability to calibrate an accelerometer. The PFN has a maximum stored nergy of 19.25 kJ bank and is fired by a silicon controlled rectifier (SCR), with appropriate safety precautions. The HEML is constructed out of G-10 fiberglass reinforced epoxy and is designed to accelerate a mass of 600 grams to a velocity of 10 meters per second. The CM is microcontroller-based running Arduino Software. The CM has a keypad input and 7 segment outputs of the PFN voltage and desired charging voltage. After entering a desired PFN voltage, the CM controls the charging of the PFN. When the two voltages are equal it sends a pulse to the SCR to fire the PFN and in turn, the HEML. The HEML projectile’s tip hits a target that is held by the CT. The CT consists of a table to hold the PFN and HEML, a vacuum chuck, air bearing, velocimeter and catch pot. The target is held with the vacuum chuck awaiting impact. After impact, the air bearing allows the target to fall freely so that the velocimeter can accurately read. A known acceleration is determined from the known change in velocity of the target. Thus, if an accelerometer was attached to the target, the measured value can be compared to the known value.

  4. Complete Pentalogy of Cantrell (POC) with Phocomelia and Other Associated Rare Anomalies.

    Science.gov (United States)

    Jagtap, Sunil V; Shukla, Dhirajkumar B; Jain, Akash; Jagtap, Swati S

    2014-05-01

    We are reporting a rare case of Complete Pentalogy of Cantrell (CPOC) with phocomelia and other associated anomalies such as encephalocoele, craniofacial defects, limb defects and a flexion deformity, with club foot in right lower limb. Antenatal ultrasonography done in a 20 year old primigravida revealed multiple thoraco-abdominal and CNS anomalies in a foetus with an average gestational age of 18.2 weeks. Foetal autopsy done following termination of the pregnancy revealed a combination of defects, based on which the diagnosis of Complete Pentalogy of Cantrell with associated anomalies was given. To the best of our knowledge, this is the first case of Complete Pentalogy of Cantrell with phocomelia which has been seen in the world.

  5. Reduced Transfusion During OLT by POC Coagulation Management and TEG Functional Fibrinogen: A Retrospective Observational Study.

    Science.gov (United States)

    De Pietri, Lesley; Ragusa, Francesca; Deleuterio, Annalisa; Begliomini, Bruno; Serra, Valentina

    2016-01-01

    Patients undergoing orthotopic liver transplantation are at high risk of bleeding complications. Several Authors have shown that thromboelastography (TEG)-based coagulation management and the administration of fibrinogen concentrate reduce the need for blood transfusion. We conducted a single-center, retrospective cohort observational study (Modena Polyclinic, Italy) on 386 consecutive patients undergoing liver transplantation. We assessed the impact on resource consumption and patient survival after the introduction of a new TEG-based transfusion algorithm, requiring also the introduction of the fibrinogen functional thromboelastography test and a maximum amplitude of functional fibrinogen thromboelastography transfusion cutoff (7 mm) to direct in administering fibrinogen (2012-2014, n = 118) compared with a purely TEG-based algorithm previously used (2005-2011, n = 268). After 2012, there was a significant decrease in the use of homologous blood (1502 ± 1376 vs 794 ± 717 mL, P < 0.001), fresh frozen plasma (537 ± 798 vs 98 ± 375 mL, P < 0.001), and platelets (158 ± 280 vs 75 ± 148 mL, P < 0.005), whereas the use of fibrinogen increased (0.1 ± 0.5 vs 1.4 ± 1.8 g, P < 0.001). There were no significant differences in 30-day and 6-month survival between the 2 groups. The implementation of a new coagulation management method featuring the addition of the fibrinogen functional thromboelastography test to the TEG test according to an algorithm which provides for the administration of fibrinogen has helped in reducing the need for transfusion in patients undergoing liver transplantation with no impact on their survival.

  6. SeaWiFS_L3b_8D_POC

    Data.gov (United States)

    National Aeronautics and Space Administration — The SeaWiFS instrument was launched by Orbital Sciences Corporation on the OrbView-2 (a.k.a. SeaStar) satellite in August 1997, and collected data from September...

  7. Multi-hybrid instrumentations with smartphones and smartpads for innovative in-field and POC diagnostics

    Science.gov (United States)

    Hofmann, Dietrich; Dittrich, Paul-Gerald; Gärtner, Claudia; Klemm, Richard

    2013-03-01

    Aim of the paper is the orientation of research and development on a completely new approach to innovative in-field and point of care diagnostics in industry, biology and medicine. Central functional modules are smartphones and/or smart pads supplemented by additional hardware apps and software apps. Specific examples are given for numerous practical applications concerning optodigital instrumentations. The methodical classification distinguishes between different levels for combination of hardware apps (hwapps) and software apps (swapps) with smartphones and/or smartpads. These methods are fundamental enablers for the transformation from stationary conventional laboratory diagnostics into mobile innovative in-field and point of care diagnostics. The innovative approach opens so far untapped enormous markets due to the convenience, reliability and affordability of smartphone and/or smartpad instruments. A highly visible advantage of smartphones and/or smartpads is the huge number of their distribution, their worldwide connectivity via cloud services and the experienced capability of their users for practical operations.

  8. Privatization in Latvia : Drawing to a Close / Janis Pocs, Ugis Poes

    Index Scriptorium Estoniae

    Pocs, Janis

    2000-01-01

    Erastamine Lätis: eesmärgid, protsess ja järeldused. Diagrammid: era- ja riigisektor; tööhõive era- ja riigisektoris; ettevõtete erastamine erinevates valdkondades nii era- kui riigisektoris; korterite erastamine; maa erastamine

  9. POC-scale testing of an advanced fine coal dewatering equipment/technique

    Energy Technology Data Exchange (ETDEWEB)

    Groppo, J.G.; Parekh, B.K. [Univ. of Kentucky, Lexington, KY (United States); Rawls, P. [Department of Energy, Pittsburgh, PA (United States)

    1995-11-01

    Froth flotation technique is an effective and efficient process for recovering of ultra-fine (minus 74 {mu}m) clean coal. Economical dewatering of an ultra-fine clean coal product to a 20 percent level moisture will be an important step in successful implementation of the advanced cleaning processes. This project is a step in the Department of Energy`s program to show that ultra-clean coal could be effectively dewatered to 20 percent or lower moisture using either conventional or advanced dewatering techniques. As the contract title suggests, the main focus of the program is on proof-of-concept testing of a dewatering technique for a fine clean coal product. The coal industry is reluctant to use the advanced fine coal recovery technology due to the non-availability of an economical dewatering process. in fact, in a recent survey conducted by U.S. DOE and Battelle, dewatering of fine clean coal was identified as the number one priority for the coal industry. This project will attempt to demonstrate an efficient and economic fine clean coal slurry dewatering process.

  10. POC-scale testing of a dry triboelectrostatic separator for fine coal cleaning

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, R.H.; Luttrell, G.H.; Adel, G.T. [Virginia Polytechnic Institute and State Univ., Blacksburg, VA (United States)

    1995-11-01

    Numerous advanced coal cleaning processes have been developed in recent years that are capable of substantially reducing both the ash and sulfur contents of run-of-mine coals. The extent of cleaning depends on the liberation characteristics of the coal, which generally improve with reducing particle size. however, since most of the advanced technologies are wet processes, the clean coal product must be dewatered before it can be transported and burned in conventional boilers. This additional treatment step significantly increases the processing cost and makes the industrial applicability of these advanced technologies much less attractive. In order to avoid problems associated with fine coal dewatering, researchers at the Pittsburgh Energy Technology Center (PETC) developed a novel triboelectrostatic separation (TES) process that can remove mineral matter from dry coal. In this technique, finely pulverized coal is brought into contact with a material (such as copper) having a work function intermediate to that of the carbonaceous material and associated mineral matter. Carbonaceous particles having a relatively low work function become positively charged, while particles of mineral matter having significantly higher work functions become negatively charged. once the particles become selectively charged, a separation can be achieved by passing the particle stream through an electrically charged field. Details related to the triboelectrostatic charging phenomenon have been discussed elsewhere (Inculet, 1984).

  11. Design of point-of-care (POC) microfluidic medical diagnostic devices

    Science.gov (United States)

    Leary, James F.

    2018-02-01

    Design of inexpensive and portable hand-held microfluidic flow/image cytometry devices for initial medical diagnostics at the point of initial patient contact by emergency medical personnel in the field requires careful design in terms of power/weight requirements to allow for realistic portability as a hand-held, point-of-care medical diagnostics device. True portability also requires small micro-pumps for high-throughput capability. Weight/power requirements dictate use of super-bright LEDs and very small silicon photodiodes or nanophotonic sensors that can be powered by batteries. Signal-to-noise characteristics can be greatly improved by appropriately pulsing the LED excitation sources and sampling and subtracting noise in between excitation pulses. The requirements for basic computing, imaging, GPS and basic telecommunications can be simultaneously met by use of smartphone technologies, which become part of the overall device. Software for a user-interface system, limited real-time computing, real-time imaging, and offline data analysis can be accomplished through multi-platform software development systems that are well-suited to a variety of currently available cellphone technologies which already contain all of these capabilities. Microfluidic cytometry requires judicious use of small sample volumes and appropriate statistical sampling by microfluidic cytometry or imaging for adequate statistical significance to permit real-time (typically medical decisions for patients at the physician's office or real-time decision making in the field. One or two drops of blood obtained by pin-prick should be able to provide statistically meaningful results for use in making real-time medical decisions without the need for blood fractionation, which is not realistic in the field.

  12. PoC, LGBTQ, and gender: The intersectionality of America Chavez.

    Science.gov (United States)

    Jiménez, Laura M

    2018-05-04

    The Life and Times of America Chavez was a comic book series eventually published in trade form. Written by Gabby Rivera, queer Latinx young adult literature author, this iteration of Marvel Comic's Miss America (America Chavez) possesses an awareness and authenticity of Latinx culture and lesbian identity that was nothing less than revolutionary. Joe Quinones's artwork, rich in color, spirit, and pride, underscored the need for Latinx voices (both visual and verbal) to tell our stories. In this essay, I provide both a scholarly view of AMERICA as a superhero tale and illuminate the experience of reading her as a Latina lesbian.

  13. Vertical Distributions of Coccolithophores, PIC, POC, Biogenic Silica, and Chlorophyll a Throughout the Global Ocean.

    Science.gov (United States)

    Balch, William M; Bowler, Bruce C; Drapeau, David T; Lubelczyk, Laura C; Lyczkowski, Emily

    2018-01-01

    Coccolithophores are a critical component of global biogeochemistry, export fluxes, and seawater optical properties. We derive globally significant relationships to estimate integrated coccolithophore and coccolith concentrations as well as integrated concentrations of particulate inorganic carbon (PIC) from their respective surface concentration. We also examine surface versus integral relationships for other biogeochemical variables contributed by all phytoplankton (e.g., chlorophyll a and particulate organic carbon) or diatoms (biogenic silica). Integrals are calculated using both 100 m integrals and euphotic zone integrals (depth of 1% surface photosynthetically available radiation). Surface concentrations are parameterized in either volumetric units (e.g., m -3 ) or values integrated over the top optical depth. Various relationships between surface concentrations and integrated values demonstrate that when surface concentrations are above a specific threshold, the vertical distribution of the property is biased to the surface layer, and when surface concentrations are below a specific threshold, the vertical distributions of the properties are biased to subsurface maxima. Results also show a highly predictable decrease in explained-variance as vertical distributions become more vertically heterogeneous. These relationships have fundamental utility for extrapolating surface ocean color remote sensing measurements to 100 m depth or to the base of the euphotic zone, well beyond the depths of detection for passive ocean color remote sensors. Greatest integrated concentrations of PIC, coccoliths, and coccolithophores are found when there is moderate stratification at the base of the euphotic zone.

  14. IFPE/EFE-RO, Experimental Fuel Elements RO89 and RO51 in TRIGA 14 MW Reactor (INR-Pitesti)

    International Nuclear Information System (INIS)

    Paraschiv, Marius; Turnbull, J.A.

    2002-01-01

    Description of program or function: Romanian irradiation tests concerned with Candu type fuel elements behavior and with the limits of the design parameters. A particular feature of the Candu fuel project is the small plenum (void volume) added for relaxation of the fission gases, which are inherently released during the fuel irradiation. Two irradiation tests in the C2 device from the TRIGA 14 MW reactor were performed between the years 1985-1987. The tests were done to evaluate the effect of the fuel density on the time-evolution of the fission gas pressure. Experimental fuel elements were adequately instrumented with pressure transducers to follow the fission gas pressure changes during fuel irradiation. The first irradiation test was conducted on the fuel element coded No.89 whose main characteristics were the nominal values of the main fuel design parameters. The second one was conducted on the fuel element coded No.51. Because of the axial flux asymmetry inside the TRIGA reactor core, the experimental elements are shorter in length than the Candu fuel design. The irradiation tests consisted in evaluation of the time-evolution of the internal pressure from two experimental fuel elements having the main design characteristics as the Romanian Candu type fuel element design and to follow the dependence of the internal pressure of the fission gas on the fuel density

  15. Out-of-range INR values and outcomes among new warfarin patients with non-valvular atrial fibrillation.

    Science.gov (United States)

    Nelson, Winnie W; Wang, Li; Baser, Onur; Damaraju, Chandrasekharrao V; Schein, Jeffrey R

    2015-02-01

    Although efficacious in stroke prevention in non-valvular atrial fibrillation, many warfarin patients are sub-optimally managed. To evaluate the association of international normalized ratio control and clinical outcomes among new warfarin patients with non-valvular atrial fibrillation. Adult non-valvular atrial fibrillation patients (≥18 years) initiating warfarin treatment were selected from the US Veterans Health Administration dataset between 10/2007 and 9/2012. Valid international normalized ratio values were examined from the warfarin initiation date through the earlier of the first clinical outcome, end of warfarin exposure or death. Each patient contributed multiple in-range and out-of-range time periods. The relative risk ratios of clinical outcomes associated with international normalized ratio control were estimated. 34,346 patients were included for analysis. During the warfarin exposure period, the incidence of events per 100 person-years was highest when patients had international normalized ratio 3, patients had significantly increased risk of major bleeding (relative risk ratio: 1.5; 95 % confidence interval 1.2-2.0). In a Veterans Health Administration non-valvular atrial fibrillation population, exposure to out-of-range international normalized ratio values was associated with significantly increased risk of adverse clinical outcomes.

  16. A novel prothrombin time method to measure all non-vitamin K-dependent oral anticoagulants (NOACs)

    Science.gov (United States)

    Lindahl, Tomas L.; Arbring, Kerstin; Wallstedt, Maria; Rånby, Mats

    2017-01-01

    Background There is a clinical need for point-of-care (POC) methods for non-vitamin K-dependent oral anticoagulants (NOACs). We modified a routine POC procedure: Zafena’s Simple Simon™ PT-INR, a room-temperature, wet-chemistry prothrombin time method of the Owren-type. Methods To either increase or decrease NOAC interference, two assay variants were devised by replacing the standard 10 µL end-to-end capillary used to add the citrated plasma sample to 200 µL of prothrombin time (PT) reagent by either a 20 µL or a 5 µL capillary. All assay variants were calibrated to show correct PT results in plasma samples from healthy and warfarin-treated persons. Results For plasmas spiked with dabigatran, apixaban, or rivaroxaban, the 20 µL variant showed markedly higher PT results than the 5 µL. The effects were even more pronounced at room temperature than at +37 °C. In plasmas from patients treated with NOACs (n = 30 for each) there was a strong correlation between the PT results and the concentration of NOACs as determined by the central hospital laboratory. For the 20 µL variant the PT response of linear correlation coefficient averaged 0.90. The PT range was INR 1.1–2.1 for dabigatran and apixaban, and INR 1.1–5.0 for rivaroxaban. Using an INR ratio between the 20 µL and 5 µL variants (PTr20/5) made the NOAC assay more robust and independent of the patient sample INR value in the absence of NOAC. Detection limits were 80 µg/L for apixaban, 60 µg/L for dabigatran, and 20 µg/L for rivaroxaban. Conclusions A wet-chemistry POC PT procedure was modified to measure the concentrations of three NOACs using a single reagent. PMID:28891412

  17. Boundary spanning by nurse managers: effects of managers' characteristics and scope of responsibility on teamwork.

    Science.gov (United States)

    Meyer, Raquel M; O'Brien-Pallas, Linda; Doran, Diane; Streiner, David; Ferguson-Paré, Mary; Duffield, Christine

    2014-06-01

    Increasing role complexity has intensified the work of managers in supporting healthcare teams. This study examined the influence of front-line managers' characteristics and scope of responsibility on teamwork. Scope of responsibility considers the breadth of the manager's role. A descriptive, correlational design was used to collect cross-sectional survey and administrative data in four acute care hospitals. A convenience sample of 754 staff completed the Relational Coordination Scale as a measure of teamwork that focuses on the quality of communication and relationships. Nurses (73.9%), allied health professionals (14.7%) and unregulated staff (11.7%) worked in 54 clinical areas, clustered under 30 front-line managers. Data were analyzed using hierarchical linear modelling. Leadership practices, clinical support roles and compressed operational hours had positive effects on teamwork. Numbers of non-direct report staff and areas assigned had negative effects on teamwork. Teamwork did not vary by span, managerial experience, worked hours, occupational diversity or proportion of full-time employees. Large, acute care teaching hospitals can enable managers to foster teamwork by enhancing managers' leadership practices, redesigning the flow or reporting structure for non-direct reports, optimizing managerial hours relative to operational hours, allocating clinical support roles, reducing number of areas assigned and, potentially, introducing co-manager models. Copyright © 2014 Longwoods Publishing.

  18. Helping or hindering: the role of nurse managers in the transfer of practice development learning.

    Science.gov (United States)

    Currie, Kay; Tolson, Debbie; Booth, Jo

    2007-09-01

    This paper reports selected findings from a recent PhD study exploring how graduates from a BSc Specialist Nursing programme, with an NMC-approved Specialist Practitioner Qualification, engage in practice development during their subsequent careers. The UKCC (1998) defines specialist practice as requiring higher levels of judgement, discretion and decision-making, with leadership in clinical practice development forming a core dimension of this level of practice. However, there is little evidence in the published literature that describes or evaluates the practice development role of graduate specialist practitioners. This study applied a modified Glaserian approach to grounded theory methods. A preliminary descriptive survey questionnaire was posted to all graduates from the programme, response rate of 45% (n=102). From these respondents, theoretical sampling decisions directed the selection of 20 participants for interview, permitting data saturation. The grounded theory generated by this study discovered a basic social process labelled 'making a difference', whereby graduate specialist practitioners are increasingly able to impact in developing patient care at a strategic level by coming to own the identity of an expert practitioner (Currie, 2006). Contextual factors strongly influence the practitioner journey, with organizational position and other people presenting enabling or blocking conditions. The line manager plays a crucial role in helping or hindering graduate specialist practitioners to transfer their learning to the clinical setting and become active in practice development. Recommendations to enhance managerial support for the practice development role of graduate specialist practitioners are proposed. ADDING TO CURRENT KNOWLEDGE: This work adds to currently limited knowledge of the graduate specialist practitioners' role in the leadership of clinical practice development. In addition, the findings emphasize the potential influence of the workplace environment by analyzing organizational factors in the specific context of the graduate specialist practitioner attempting to develop practice.

  19. Teaching quality improvement to the next generation of nurses: what nurse managers can do to help.

    Science.gov (United States)

    Odell, Ellen

    2011-12-01

    Engaging staff in performance improvement and patient safety initiatives is no easy task. It is not just time that is involved but there is also a definite repertoire of knowledge, skills, and attitudes required. This article describes a win-win venture that assists healthcare agencies in improving current quality improvement activities while actively teaching and vetting students in the process. Nursing students enter the workforce with an appreciation and working knowledge of quality improvement, and agencies gain assistance with their programs and outcomes.

  20. Psychological approaches for the nursing management of chronic pain: part 2.

    Science.gov (United States)

    Richardson, Clifford; Adams, Nicola; Poole, Helen

    2006-09-01

    The aim of this article was to present the ways that nurses can integrate psychological approaches into their management of chronic pain conditions using a biopsychosocial framework. Communication, the importance of the patient-practitioner interaction, the role of education and provision of information, reassurance and reduction of anxiety and the use of coping strategies training in the management of chronic pain are reviewed alongside the key skills of nursing. This is the second part of a two-part article. Part 1 was a discussion of psychosocial factors associated with chronic pain conditions and the psychological approaches used in the management of these conditions. It is identified that key nursing skills often equate to the requirements of the psychological approaches, therefore specific techniques from a cognitive-behavioural framework can be readily applied, integrated and used by nurses in the management of chronic pain conditions. Commonly utilized nursing skills are similar to those required for cognitive-behavioural therapy. It is reasonable to assume therefore that nurses can and should be involved in effectively managing the psychological aspects associated with chronic pain conditions.

  1. Social justice considerations in neonatal care for nurse managers and executives.

    Science.gov (United States)

    Yoder, Linda; Walden, Marlene; Verklan, M Terese

    2010-01-01

    This article presents the struggle between social justice and market justice within the current health care system, specifically issues affecting neonatal care. Community benefit is described and discussed as an aspect of social justice demonstrated by hospitals. The federal and state Children's Health Insurance Program also is discussed in relation to social justice and health care costs. Implications for managers and executives overseeing neonatal care are presented in relation to the economic and social issues.

  2. The motivations to nurse: an exploration of factors amongst undergraduate students, registered nurses and nurse managers.

    Science.gov (United States)

    Newton, Jennifer M; Kelly, Cherene M; Kremser, Anne K; Jolly, Brian; Billett, Stephen

    2009-04-01

    To identify what motivates individuals to engage in a nursing career. Recruitment and retention of nurses is a worldwide concern that is associated with several compounding factors, primarily the high attrition of its new graduates and an ageing workforce. Given these factors, it is necessary to understand why individuals choose to nurse, what keeps them engaged in nursing, and in what ways healthcare systems can support career development and retention. This paper presents initial interview data from a longitudinal multi method study with 29 undergraduate student nurses, 25 registered nurses (RNs), six Nurse Unit Managers (NUMs) and four Directors of Nursing (DoNs) from four hospitals across a healthcare organization in Australia. Thematic analysis yielded four key themes that were common to all participants: (1) a desire to help, (2) caring, (3) sense of achievement and (4) self-validation. These themes represented individuals' motivation to enter nursing and sustain them in their careers as either nurses or managers. Managers need to be cognisant of nurses underlying values and motivators in addressing recruitment and retention issues. Strategies need to be considered at both unit and organizational levels to ensure that the 'desire to care' does not become lost.

  3. Conflict management styles of Asian and Asian American nurses: implications for the nurse manager.

    Science.gov (United States)

    Xu, Yu; Davidhizar, Ruth

    2004-01-01

    Foreign nurses and American nurses who are culturally diverse make up an increasing number of the US nursing workforce. Of foreign nurses, Asians constitute the largest number. Conflict is an inevitable aspect of human relations in health care settings. Nurses and other health team members with diverse cultural background bring to the workplace different conflict behaviors that directly impact the outcomes of conflicts. It is essential for health care team members and managers to be cognizant of different conflict behaviors as well as different conflict management styles so that strategies can be designed to build a culturally diverse health care team that is able to effectively achieve group and organizational objectives.

  4. Consensus achievement of leadership, organisational and individual factors that influence safety climate: Implications for nursing management.

    Science.gov (United States)

    Fischer, Shelly A; Jones, Jacqueline; Verran, Joyce A

    2018-01-01

    To validate a framework of factors that influence the relationship of transformational leadership and safety climate, and to enable testing of safety chain factors by generating hypotheses regarding their mediating and moderating effects. Understanding the patient safety chain and mechanisms by which leaders affect a strong climate of safety is essential to transformational leadership practice, education, and research. A systematic review of leadership and safety literature was used to develop an organising framework of factors proposed to influence the climate of safety. A panel of 25 international experts in leadership and safety engaged a three-round modified Delphi study with Likert-scored surveys. Eighty per cent of participating experts from six countries were retained to the final survey round. Consensus (>66% agreement) was achieved on 40 factors believed to influence safety climate in the acute care setting. Consensus regarding specific factors that play important roles in an organisation's climate of safety can be reached. Generally, the demonstration of leadership commitment to safety is key to cultivating a culture of patient safety. Transformational nurse leaders should consider and employ all three categories of factors in daily leadership activities and decision-making to drive a strong climate of patient safety. © 2017 John Wiley & Sons Ltd.

  5. Napping during breaks on night shift: critical care nurse managers' perceptions.

    Science.gov (United States)

    Edwards, Marie P; McMillan, Diana E; Fallis, Wendy M

    2013-01-01

    Fatigue associated with shiftwork can threaten the safety and health of nurses and the patients in their care. Napping during night shift breaks has been shown to be an effective strategy to decrease fatigue and enhance performance in a variety of work environments, but appears to have mixed support within health care. The purpose of this study was to explore critical care unit managers'perceptions of and experiences with their nursing staff's napping practices on night shift, including their perceptions of the benefits and barriers to napping/not napping in terms of patient safety and nurses'personal health and safety. A survey design was used. Forty-seven Canadian critical care unit managers who were members of the Canadian Association of Critical Care Nurses responded to the web-based survey. Data analysis involved calculation of frequencies and percentages for demographic data, use of the Friedman rank test for comparison of managers' perceptions, and content analysis for responses to open-ended questions. The findings of this study offer valuable insights into the complexities and conflicts perceived by managers with respect to napping on night shift breaks by nursing staff Staff and patient health and safety issues, work and break expectations and experiences, and strengths and deficits related to organizational napping resources and policy are considerations that will be instrumental in the development of effective napping strategies and guidelines.

  6. Confidence and clinical judgement in community nurses managing venous leg ulceration - A judgement analysis.

    Science.gov (United States)

    Adderley, Una J; Thompson, Carl

    2017-11-01

    The variation in the management of venous leg ulceration in the UK is partly attributable to an uncertain clinical environment but the quality of judgements is influenced by the how well nurses' confidence and accuracy are aligned. To assess UK community nurses' confidence in the accuracy of their diagnostic judgements and treatment choices when managing venous leg ulceration. Judgement Analysis. UK community and primary care nursing services. 18 community non-specialist nurses working in district (home) nursing teams and general practitioner services and 18 community tissue viability specialist nurses. Using judgement analysis methods, 18 community non-specialist nurses and 18 community tissue viability specialist nurses made diagnoses and treatment judgements about compression therapy for 110 clinical scenarios and indicated their confidence for each judgement. An expert panel made consensus judgements for the same scenarios and these judgements were used as a standard against which to compare the participants. Confidence analysis was used to assess the nurses' confidence about their diagnostic judgements and treatment choices. Despite being very experienced, both non-specialist nurses' and specialist tissue viability nurses' levels of confidence were not well calibrated with their levels of accuracy. The results of this study are important as errors resulting from both over and under-confidence at the diagnostic phase of management may influence treatment choices, and thus increase the chances of treatment error. Copyright © 2017 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  7. Nursing management of sensory overload in psychiatry – Theoretical densification and modification of the framework model

    Science.gov (United States)

    Scheydt, Stefan; Needham, Ian; Behrens, Johann

    2017-01-01

    Background: Within the scope of the research project on the subjects of sensory overload and stimulus regulation, a theoretical framework model of the nursing care of patients with sensory overload in psychiatry was developed. In a second step, this theoretical model should now be theoretically compressed and, if necessary, modified. Aim: Empirical verification as well as modification, enhancement and theoretical densification of the framework model of nursing care of patients with sensory overload in psychiatry. Method: Analysis of 8 expert interviews by summarizing and structuring content analysis methods based on Meuser and Nagel (2009) as well as Mayring (2010). Results: The developed framework model (Scheydt et al., 2016b) could be empirically verified, theoretically densificated and extended by one category (perception modulation). Thus, four categories of nursing care of patients with sensory overload can be described in inpatient psychiatry: removal from stimuli, modulation of environmental factors, perceptual modulation as well as help somebody to help him- or herself / coping support. Conclusions: Based on the methodological approach, a relatively well-saturated, credible conceptualization of a theoretical model for the description of the nursing care of patients with sensory overload in stationary psychiatry could be worked out. In further steps, these measures have to be further developed, implemented and evaluated regarding to their efficacy.

  8. Leadership styles of nurse managers and registered sickness absence among their nursing staff

    NARCIS (Netherlands)

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

    2011-01-01

    Background: Sickness absence leads to understaffing and interferes with nursing efficiency and quality. It has been reported in literature that managerial leadership is associated with self-reported sickness absence in the working population. Purposes: This study investigated the relationship

  9. Norms and nurse management of conflicts: keys to understanding nurse-physician collaboration.

    Science.gov (United States)

    Keenan, G M; Cooke, R; Hillis, S L

    1998-02-01

    In this cross-sectional study, registered nurses from 36 emergency rooms completed an abridged version of the Organizational Culture Inventory (Cooke & Lafferty, 1989) and responded to nine hypothetical conflict vignettes. Stepwise regressions were performed with nurse conflict style intentions as dependent variables and 10 independent variable (three sets of norms, five measures of conflict styles expected to be used by the physician, gender, and education). Nurses' expectations for physicians to collaborate and strong constructive and aggressive norms were found to explain a moderate amount of variance (32%) in nurses' intentions to collaborate in conflicts conducive to nurse-physician collaboration. The findings of this study provide support for the proposed theoretical framework and can be used to design interventions that promote nurse-physician collaboration.

  10. Nursing management of sensory overload in psychiatry – development of a theoretical framework model

    Science.gov (United States)

    Scheydt, Stefan; Needham, Ian; Nielsen, Gunnar H; Behrens, Johann

    2016-09-01

    Background: The concept of “removal from stimuli” has already been examined by a Delphi-Study. However, some knowledge gaps remained open, which have now been further investigated. Aim: Examination of the concept “management of sensory overload in inpatient psychiatry” including its sub-concepts and specific measures. Method: Analysis of qualitative data about “removal from stimuli” by content analysis according to Mayring. Results: A theoretical description and definition of the concept could be achieved. In addition, sub-concepts (removal from stimuli, modulation of environmental factors, help somebody to help him-/herself) could be identified, theoretical defined and complemented by possible specific measures. Conclusions: The conceptual descriptions provide a further step to raise awareness of professionals in the subject area. Furthermore, we created a theoretical basis for further empirical studies.

  11. A review of research and nursing management of mental health problems in pregnancy and motherhood

    Directory of Open Access Journals (Sweden)

    Jarosinski JM

    2016-01-01

    Full Text Available Judith M Jarosinski,1 Jane A Fox21Nursing Department, Henson School of Science, Salisbury University, Salisbury, MD, 2School of Nursing, College of Health and Human Services, University of North Carolina Wilmington, Wilmington, NC, USAAbstract: In this article, the authors explore the risks pregnant women experience due to mental illness and intimate partner violence (IPV and discuss the nursing role involved in the management of their care. For many women, pregnancy is a time of hopeful anticipation, yet for others, pregnancy reflects a new or an ongoing struggle with mental illness. The sequelae of untreated mental illness can be as severe as infanticide, maternal suicide, lack of maternal attachment, and inability to parent. Newborns whose mothers misuse alcohol and drugs are at risk of fetal alcohol spectrum disorders and neonatal addiction syndrome. Women who live with IPV risk their physical and mental well-being as well as the safety of their newborn. Implications for practice include the use of assessment tools early and during the treatment trajectory; otherwise, mental illness and IPV in pregnancy would go undetected/untreated. Identifying postpartum depression early is key toward providing timely care for both the mother and infant; yet, few obstetric practices use a depression assessment tool such as the Edinburgh Postnatal Depression Scale. During the initial intake assessment, the Edinburgh Postnatal Depression Scale can provide the means of early treatment through targeted assessment. Further implications include specialized services for substance-misusing pregnant women whose issues are different and separate from those of men, integration of services to address their multifaceted needs, and educating nurses to the reality of comorbidity as the norm rather than the rare occurrence, with a truly holistic approach that diminishes stigma. Keywords: intimate partner violence, mental illness, pregnancy, serious mental illness, Women Abuse Screening Tool, depression, domestic violence, family violence, HITS

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

    Science.gov (United States)

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

    2015-01-01

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

  13. AN OVERVIEW OF NURSES' MANAGEMENT OF SECONDARY HYPERPARATHYROIDISM: HOW IS EUROPE DOING?

    Science.gov (United States)

    de Barbieri, Ilaria; Baumann, Jacqueline; Casal, Maria Cruz; Gurevich, Andrey; Pancirova, Jitka; Poulia, Kalliopi-Anna; Riemann, Aase

    2015-09-01

    Nurses have an important role to play in the management of secondary hyperparathyroidism (SHPT). An online survey conducted by the European Dialysis and Transplant Nurses Association/European Renal Care Association (EDTNA/ERCA) in conjunction with Amgen (Europe) GmbH surveyed nephrology nurses' knowledge of secondary hyperparathyroidism, treatment targets, current treatments, patient adherence and nephrology nurse training education needs. The survey's aim was to establish common practices being used by nurses in the management of secondary hyperparathyroidism and to identify nephrology nurses' training and educational needs in order to improve patient care. Descriptive study. An online survey of multiple choice and closed questions. A sample of nephrology nurses from Spain, Italy, France and the Netherlands. A total of 111 nurses completed the questionnaire (98% response rate, 82% of which were fully completed). Collected data revealed that there were specific aspects of SHPT patient management where nurses lacked confidence, despite the majority of respondents having 15 years nephrology nursing experience. These aspects included explaining the disorder and therapies to patients, managing side effects of drugs and appreciating the significance of controlling biochemical targets. Over 40% of the respondents felt they did not have sufficient training to support patients who were non-compliant. Nursing skills are integral to SHPT patient management as part of the multidisciplinary approach. The nurse's role is particularly important in patient assessment and monitoring, and in the provision of patient education and support, particularly with treatment adherence. Nephrology nurses who are better informed about SHPT and who receive training on practical patient care may improve the care of patients. © 2015 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  14. 78 FR 73553 - Prospective Grant of Exclusive License: Development of Cripto-1 Point of Care (POC) Tests and...

    Science.gov (United States)

    2013-12-06

    ... contemplated exclusive license should be directed to: Eggerton Campbell, Ph.D. Licensing and Patenting Manager... colon, pancreas, stomach, gallbladder, breast, lung, endometrium and cervix. Current methodologies of...

  15. Hydrothermal Fe cycling and deep ocean organic carbon scavenging: Model-based evidence for significant POC supply to seafloor sediments

    Digital Repository Service at National Institute of Oceanography (India)

    German, C.R.; Legendre, L.L.; Sander, S.G.;; Niquil, N.; Luther-III, G.W.; LokaBharathi, P.A.; Han, X.; LeBris, N.

    by more than ~10% over background values, what the model does indicate is that scavenging of carbon in association with Fe-rich hydrothermal plume particles should play a significant role in the delivery of particulate organic carbon to deep ocean...

  16. A POC Clinical Trial for PTSD with a First-In-Class Vasopressin 1a Receptor Antagonist

    Science.gov (United States)

    2017-10-01

    clinical benefit of SRX246 for the treatment of anger, irritability, and aggression; major depression ; disturbed sleep; and quality of life that...safety and tolerability of SRX246 (160 mg PO BID) and ii) clinical benefit of SRX246 for the treatment of major depression , anger, irritability, and...colleagues. Changes that had a significant impact on expenditures Nothing to Report Significant changes in use or care of human subjects, vertebrate

  17. Point-of-care coagulation monitoring: first clinical experience using a paper-based lateral flow diagnostic device.

    Science.gov (United States)

    Hegener, Michael A; Li, Hua; Han, Daewoo; Steckl, Andrew J; Pauletti, Giovanni M

    2017-09-01

    Vitamin K antagonists such as warfarin are the most widely used class of oral anticoagulants. Due to a narrow therapeutic window, patients on warfarin require regular monitoring. Self-testing using point-of-care (POC) diagnostic devices is available, but cost makes this monitoring method beyond reach for many. The main objective of this research was to assess the clinical utility of a low-cost, paper-based lateral flow POC diagnostic device developed for anticoagulation monitoring without the need for a separate electronic reader. Custom-fabricated lateral flow assay (LFA) test strips comprised of a glass fiber sample pad, a nitrocellulose analytical membrane, a cellulose wicking pad, and a plastic backing card were assembled in a plastic cassette. Healthy volunteers and patients on warfarin therapy were recruited for this prospective study. For each participant, a whole blood sample was collected via fingerstick to determine: (1) international normalized ratio (INR) using the CoaguChek® XS coagulometer, (2) hematocrit by centrifugation, and (3) red blood cell (RBC) travel distance on the experimental LFA device after 240 s using digital image analysis. RBC travel distance measured on the LFA device using blood samples obtained from warfarin patients positively correlated with increasing INR value and the LFA device had the capability to statistically distinguish between healthy volunteer INR values and those for patients groups with INR ≥ 2.6. From these data, it is predicted that this low-cost, paper-based LFA device can have clinical utility for identifying anticoagulated patients taking vitamin K antagonists who are outside of the desired therapeutic efficacy window.

  18. Effects of a nurse-managed program on hepatitis A and B vaccine completion among homeless adults.

    Science.gov (United States)

    Nyamathi, Adeline; Liu, Yihang; Marfisee, Mary; Shoptaw, Steven; Gregerson, Paul; Saab, Sammy; Leake, Barbara; Tyler, Darlene; Gelberg, Lillian

    2009-01-01

    Hepatitis B virus (HBV) infection constitutes a major health problem for homeless persons. Ability to complete an HBV vaccination series is complicated by the need to prioritize competing needs, such as addiction issues, safe places to sleep, and food, over health concerns. The objectives of this study were to evaluate the effectiveness of a nurse-case-managed intervention compared with that of two standard programs on completion of the combined hepatitis A virus (HAV) and HBV vaccine series among homeless adults and to assess sociodemographic factors and risk behaviors related to the vaccine completion. A randomized, three-group, prospective, quasi-experimental design was conducted with 865 homeless adults residing in homeless shelters, drug rehabilitation sites, and outdoor areas in the Skid Row area of Los Angeles. The programs included (a) nurse-case-managed sessions plus targeted hepatitis education, incentives, and tracking (NCMIT); (b) standard targeted hepatitis education plus incentives and tracking (SIT); and (c) standard targeted hepatitis education and incentives only (SI). Sixty-eight percent of the NCMIT participants completed the three-series vaccine at 6 months, compared with 61% of SIT participants and 54% of SI participants. NCMIT participants had almost 2 times greater odds of completing vaccination than those of participants in the SI program. Completers were more likely to be older, to be female, to report fair or poor health, and not to have participated in a self-help drug treatment program. Newly homeless White adults were significantly less likely than were African Americans to complete the vaccine series. The use of vaccination programs incorporating nurse case management and tracking is critical in supporting adherence to completion of a 6-month HAV/HBV vaccine. The finding that White homeless persons were the least likely to complete the vaccine series suggests that programs tailored to address their unique cultural issues are needed.

  19. The nursing management of diarrhoea and constipation before and after the implementation of a bowel management protocol.

    Science.gov (United States)

    McKenna, S; Wallis, M; Brannelly, A; Cawood, J

    2001-02-01

    Intensive care unit (ICU) patients frequently suffer problems associated with both diarrhoea and constipation. Strategies to optimise the management of these conditions need to focus on improving the communication between staff and ensuring effective treatment is implemented. The team involved in this study developed a Bowel Management Protocol (BMP). The effect of this BMP on the documentation of assessment and management of diarrhoea and constipation was evaluated using a quasi-experimental research design. Data were collected via a retrospective audit of medical records. Two groups of patient records were randomly sampled. The records of 60 patients who were admitted to ICU in the 6 months before the introduction of the BMP were accessed together with the records of 60 patients admitted in the 6 months following the introduction of the BMP. Data were collected regarding patient demographics and the assessment and management of bowel function before and after BMP introduction. The results indicated that a BMP improved documentation of the assessment of bowel function. In addition, there was an improvement in the documentation of nursing intervention in the presence of constipation and diarrhoea. These results have to be interpreted with caution because, despite random sampling over two 6 month periods, there were statistically significant differences in age, length of stay, method of feeding and medical diagnosis between the two groups. Further research into the effectiveness of using a BMP is recommended.

  20. How Do Nurses Manage Their Occupational Exposure to Cytotoxic Drugs? A Descriptive Survey in Chemotherapy Settings, Shiraz, Iran

    Directory of Open Access Journals (Sweden)

    M Momeni

    2013-04-01

    Full Text Available Occupational exposure to cytotoxic drugs is a global concern. We conducted this cross-sectional study in 2012 to describe the adverse effects experienced by nurses working in one of chemotherapy facilities affiliated to Shiraz University of Medical Sciences, Shiraz, southern Iran, and their proper use of personal protective equipment and educational programs. The frequency of side effects reported by participants was noticeably high. Approximately, 60% of the nurses used all personal protective equipment. There were air conditioner ventilation systems in all facilities, but they were not standard. Clinics did not have any dedicated room. Lack of adequate training was noticeable among all participants. We concluded that establishment of safety regulations, health care workers safety surveillance systems as well as continuous training for nurses are of paramount importance.

  1. Veno-occlusive disease nurse management: development of a dynamic monitoring tool by the GITMO nursing group.

    Science.gov (United States)

    Botti, Stefano; Orlando, Laura; Gargiulo, Gianpaolo; Cecco, Valentina De; Banfi, Marina; Duranti, Lorenzo; Samarani, Emanuela; Netti, Maria Giovanna; Deiana, Marco; Galuppini, Vera; Pignatelli, Adriana Concetta; Ceresoli, Rosanna; Vedovetto, Alessio; Rostagno, Elena; Bambaci, Marilena; Dellaversana, Cristina; Luminari, Stefano; Bonifazi, Francesca

    2016-01-01

    Veno-occlusive disease (VOD) is a complication arising from the toxicity of conditioning regimens that have a significant impact on the survival of patients who undergo stem cell transplantation. There are several known risk factors for developing VOD and their assessment before the start of conditioning regimens could improve the quality of care. Equally important are early identification of signs and symptoms ascribable to VOD, rapid diagnosis, and timely adjustment of support therapy and treatment. Nurses have a fundamental role at the stages of assessment and monitoring for signs and symptoms; therefore, they should have documented skills and training. The literature defines nurses' areas of competence in managing VOD, but in the actual clinical practice, this is not so clear. Moreover, there is an intrinsic difficulty in managing VOD due to its rapid and often dramatic evolution, together with a lack of care tools to guide nurses. Through a complex evidence-based process, the Gruppo Italiano per il Trapianto di Midollo Osseo (GITMO), cellule staminali emopoietiche e terapia cellulare nursing board has developed an operational flowchart and a dynamic monitoring tool applicable to haematopoietic stem cell transplantation patients, whether they develop this complication or not.

  2. Spontaneous growth of whiskers on RE-bearing intermetallic compounds of Sn-RE, In-RE, and Pb-RE

    Energy Technology Data Exchange (ETDEWEB)

    Liu Meng [Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Science, 72 Wenhua Road, Shenyang 110016 (China); Xian Aiping, E-mail: ap.xian@imr.ac.c [Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Science, 72 Wenhua Road, Shenyang 110016 (China)

    2009-11-03

    A phenomenon of the whiskers growth on the bulk rare earth (RE)-intermetallic compounds of NdSn{sub 3}, NdIn{sub 3}, and LaPb{sub 3} is reported. The whiskers formed spontaneously on all of the RE-intermetallic compounds after exposed to room ambience (21-28 deg. C/20-56% RH, relative humidity) for several days. Among the samples, the propensity of whisker growth for NdSn{sub 3} is the strongest, on which the tin whiskers were flourishing and covered all of the surfaces after exposed to room ambience for 22 days; while LaPb{sub 3} is the secondary and NdIn{sub 3} is the last one. Observed by SEM, the whiskers were exhibited as different morphology, size, and number density. The XRD analysis confirms the existence of RE(OH){sub 3} after whiskers formed, also, the weight gain curve of the samples exposed to room ambience supports that a spontaneous chemical reaction of the RE-intermetallic compounds with water in room ambience takes place. In discussion, it is proposed that the fresh metal atoms released by the chemical reaction could be causative to result in nucleation and spontaneous growth of the whiskers, while the anisotropy of crystal structure could be a reason to understand the difference of the whisker growth behaviors between Sn and Pb.

  3. Spontaneous growth of whiskers on RE-bearing intermetallic compounds of Sn-RE, In-RE, and Pb-RE

    International Nuclear Information System (INIS)

    Liu Meng; Xian Aiping

    2009-01-01

    A phenomenon of the whiskers growth on the bulk rare earth (RE)-intermetallic compounds of NdSn 3 , NdIn 3 , and LaPb 3 is reported. The whiskers formed spontaneously on all of the RE-intermetallic compounds after exposed to room ambience (21-28 deg. C/20-56% RH, relative humidity) for several days. Among the samples, the propensity of whisker growth for NdSn 3 is the strongest, on which the tin whiskers were flourishing and covered all of the surfaces after exposed to room ambience for 22 days; while LaPb 3 is the secondary and NdIn 3 is the last one. Observed by SEM, the whiskers were exhibited as different morphology, size, and number density. The XRD analysis confirms the existence of RE(OH) 3 after whiskers formed, also, the weight gain curve of the samples exposed to room ambience supports that a spontaneous chemical reaction of the RE-intermetallic compounds with water in room ambience takes place. In discussion, it is proposed that the fresh metal atoms released by the chemical reaction could be causative to result in nucleation and spontaneous growth of the whiskers, while the anisotropy of crystal structure could be a reason to understand the difference of the whisker growth behaviors between Sn and Pb.

  4. Non-Destructive Assessment of Concrete Structures Reliability and Limits of Single and Combined Techniques State-of-the-Art Report of the RILEM Technical Committee 207-INR

    CERN Document Server

    2012-01-01

    This book gives information on non destructive techniques for assessment of concrete structures. It synthesizes the best of international knowledge about what techniques can be used for assessing material properties (strength) and structural properties (geometry, defects...). It describes how the techniques can be used so as to answer a series of usual questions, highlighting their capabilities and limits, and providing advices for a better use of techniques. It also focuses on possible combinations of techniques so as to improve the assessment. It is based on many illustrative examples and give in each case references to standards and guidelines.

  5. Distribution of POC, PON and particulate Al, Cd, Cr, Cu, Pb, Ti, Zn and δ13C in the English Channel and adjacent areas

    International Nuclear Information System (INIS)

    Dauby, P.; Frankignoulle, M.; Gobert, S.; Bouquegneau, J.M.

    1994-01-01

    A study of the spatial distribution of the total suspended matter and of its elemental composition (C, N and trace metals) has been performed in the English Channel. The Celtic Sea, and the Southern Bight of the North Sea in June and October 1991. South-west to north-east gradients of suspended matter mass and of lithogenic components (Ti an Al) linked to riverine inputs and to depth shallowing, are observed; organic carbon and nitrogen display an opposite distribution pattern and reach a maximum in the Biscay oceanic waters. Cu, Pb and Zn concentrations are highest near industrialized areas and large estuaries, showing the importance of river inputs. In contrast, Cd, Cu and Cr concentrations are markedly elevated in organic-rich suspended matter from waters in which suspended matter loadings are low, suggesting a significant biological uptake. Finally, 13 C/ 12 C analyses reveal the relative importance of coastal or continental inputs in the north-eastern Channel and in the North Sea. (authors). 56 refs., 12 figs., 3 tabs

  6. Designing a Smart Car Parking System (PoC Prototype Utilizing CCTV Nodes: A vision of an IoT parking system via UCD process

    Directory of Open Access Journals (Sweden)

    Muftah Fraifer

    2017-06-01

    Full Text Available Using smart parking systems has become very important, and particularly so for metropolitan areas, because of the benefits for drivers in many aspects, such as time, frustration, stress, and anger, in addition to the increased consumption of fuel while searching for a vacant parking space. This paper proposes a review of recent advances in sensing and communication technology concerning smart parking systems. It includes a brief study of the selected topics and provides an implementation process of those selected systems. Moreover, this work proposes a design approach for a smart car parking system prototype based on utilizing CCTVs (nodes, it is also illustrates the algorithms used for computer vision detection through simulation and real environments, as the system has been deployed in both these environments. Furthermore, the system has been tested and evaluated by stakeholders via a user-centred design process by applying a qualitative research; the promising results demonstrate the effectiveness of our prototype. Finally, this paper discusses the benefits of engaging the stakeholders to develop the prototype.

  7. Functional identification in Lactobacillus reuteri of a PocR-like transcription factor regulating glycerol utilization and vitamin B12 synthesis.

    NARCIS (Netherlands)

    Santos, F.; Spinler, J.K.; Saulnier, D.M.; Molenaar, D.; Teusink, B.; de Vos, W.M.; Versalovic, J.; Hugenholtz, J.

    2011-01-01

    BACKGROUND: Lactobacillus reuteri harbors the genes responsible for glycerol utilization and vitamin B12 synthesis within a genetic island phylogenetically related to gamma-Proteobacteria. Within this island, resides a gene (lreu_1750) that based on its genomic context has been suggested to encode

  8. Functional identification in Lactobacillus reuteri of a PocR-like transcription factor regulating glycerol utilization and vitamin B12 synthesis

    NARCIS (Netherlands)

    Santos, dos F.; Molenaar, D.; Teusink, B.; Vos, de W.M.

    2011-01-01

    BACKGROUND: Lactobacillus reuteri harbors the genes responsible for glycerol utilization and vitamin B12 synthesis within a genetic island phylogenetically related to gamma-Proteobacteria. Within this island, resides a gene (lreu_1750) that based on its genomic context has been suggested to encode

  9. Factors associated with initial treatment and survival for clinically localized prostate cancer: results from the CDC-NPCR Patterns of Care Study (PoC1)

    International Nuclear Information System (INIS)

    Schymura, Maria J; Kahn, Amy R; German, Robert R; Hsieh, Mei-Chin; Cress, Rosemary D; Finch, Jack L; Fulton, John P; Shen, Tiefu; Stuckart, Erik

    2010-01-01

    Despite the large number of men diagnosed with localized prostate cancer, there is as yet no consensus concerning appropriate treatment. The purpose of this study was to describe the initial treatment patterns for localized prostate cancer in a population-based sample and to determine the clinical and patient characteristics associated with initial treatment and overall survival. The analysis included 3,300 patients from seven states, diagnosed with clinically localized prostate cancer in 1997. We examined the association of sociodemographic and clinical characteristics with four treatment options: radical prostatectomy, radiation therapy, hormone therapy, and watchful waiting. Diagnostic and treatment information was abstracted from medical records. Socioeconomic measures were derived from the 2000 Census based on the patient's residence at time of diagnosis. Vital status through December 31, 2002, was obtained from medical records and linkages to state vital statistics files and the National Death Index. Multiple logistic regression analysis and Cox proportional hazards models identified factors associated with initial treatment and overall survival, respectively. Patients with clinically localized prostate cancer received the following treatments: radical prostatectomy (39.7%), radiation therapy (31.4%), hormone therapy (10.3%), or watchful waiting (18.6%). After multivariable adjustment, the following variables were associated with conservative treatment (hormone therapy or watchful waiting): older age, black race, being unmarried, having public insurance, having non-screen detected cancer, having normal digital rectal exam results, PSA values above 20, low Gleason score (2-4), comorbidity, and state of residence. Among patients receiving definitive treatment (radical prostatectomy or radiation therapy), older age, being unmarried, PSA values above 10, unknown Gleason score, state of residence, as well as black race in patients under 60 years of age, were associated with receipt of radiation therapy. Overall survival was related to younger age, being married, Gleason score under 8, radical prostatectomy, and state of residence. Comorbidity was only associated with risk of death within the first three years of diagnosis. In the absence of clear-cut evidence favoring one treatment modality over another, it is important to understand the factors that inform treatment selection. Since state of residence was a significant predictor of both treatment as well as overall survival, true regional differences probably exist in how physicians and patients select treatment options. Factors affecting treatment choice and treatment effectiveness need to be further explored in future population-based studies

  10. Factors associated with initial treatment and survival for clinically localized prostate cancer: results from the CDC-NPCR Patterns of Care Study (PoC1

    Directory of Open Access Journals (Sweden)

    Fulton John P

    2010-04-01

    Full Text Available Abstract Background Despite the large number of men diagnosed with localized prostate cancer, there is as yet no consensus concerning appropriate treatment. The purpose of this study was to describe the initial treatment patterns for localized prostate cancer in a population-based sample and to determine the clinical and patient characteristics associated with initial treatment and overall survival. Methods The analysis included 3,300 patients from seven states, diagnosed with clinically localized prostate cancer in 1997. We examined the association of sociodemographic and clinical characteristics with four treatment options: radical prostatectomy, radiation therapy, hormone therapy, and watchful waiting. Diagnostic and treatment information was abstracted from medical records. Socioeconomic measures were derived from the 2000 Census based on the patient's residence at time of diagnosis. Vital status through December 31, 2002, was obtained from medical records and linkages to state vital statistics files and the National Death Index. Multiple logistic regression analysis and Cox proportional hazards models identified factors associated with initial treatment and overall survival, respectively. Results Patients with clinically localized prostate cancer received the following treatments: radical prostatectomy (39.7%, radiation therapy (31.4%, hormone therapy (10.3%, or watchful waiting (18.6%. After multivariable adjustment, the following variables were associated with conservative treatment (hormone therapy or watchful waiting: older age, black race, being unmarried, having public insurance, having non-screen detected cancer, having normal digital rectal exam results, PSA values above 20, low Gleason score (2-4, comorbidity, and state of residence. Among patients receiving definitive treatment (radical prostatectomy or radiation therapy, older age, being unmarried, PSA values above 10, unknown Gleason score, state of residence, as well as black race in patients under 60 years of age, were associated with receipt of radiation therapy. Overall survival was related to younger age, being married, Gleason score under 8, radical prostatectomy, and state of residence. Comorbidity was only associated with risk of death within the first three years of diagnosis. Conclusions In the absence of clear-cut evidence favoring one treatment modality over another, it is important to understand the factors that inform treatment selection. Since state of residence was a significant predictor of both treatment as well as overall survival, true regional differences probably exist in how physicians and patients select treatment options. Factors affecting treatment choice and treatment effectiveness need to be further explored in future population-based studies.

  11. Com podem aplicar les TIC a la biblioteca? Què podem fer amb pocs recursos i una mica d'imaginació?

    OpenAIRE

    Carnerero Gámiz, Francesc; Yoldi, Àlex; Clavero Campos, Javier

    2007-01-01

    En aquest article s'exposa l'experiència desenvolupada pels bibliotecaris responsables de la creació i el manteniment del web de la Biblioteca del campus del Baix Llobregat. Els bibliotecaris han dissenyat i desenvolupat aplicacions que permeten als usuaris i al personal de la Biblioteca d'interactuar i de comunicar-se, creant d'una manera conjunta un espai útil i convertint d'aquesta manera el web en l'eina principal de comunicació de la Biblioteca. Aquestes tres aplicacions són: un sistema ...

  12. Distribution of particulate organic carbon in the central Bay of Bengal

    Digital Repository Service at National Institute of Oceanography (India)

    Nandakumar, K.; Venkat, K.; Bhosle, N.B.

    litre at 2000 m. The POC decreased with increasing water depth at all the stations. Deep water concentrations of POC were higher than those reported from other oceanic waters. Distribution of POC was not influenced by water masses. The POC...

  13. Changes in leadership styles as a function of a four-day leadership training institute for nurse managers: a perspective on continuing education program evaluation.

    Science.gov (United States)

    Wolf, M S

    1996-01-01

    This study measured changes in knowledge acquisition and application of the Hersey and Blanchard model of leadership styles and leadership style adaptability among 144 registered nurses who participated in a four-day management institute. A pre- and post-institute administration of the LEAD-Self instrument was conducted. Although the findings demonstrated a significant change in the participants' leadership styles, the data revealed that outcomes were not as positive as had been assumed based on participants' self-reports. The discussion of findings reveals the complexity and the necessity of measuring learning outcomes for continuing education program improvement.

  14. [Quality Manager 2.0 in hospitals: A practical guidance for executive managers, medical directors, senior consultants, nurse managers and practicing quality managers].

    Science.gov (United States)

    Pilz, Stefan; Hülsmann, Sylvia; Michallik, Stefan; Rimbach-Schurig, Monika; Schollmeier, Margarita; Sommerhoff, Benedikt; Weßling, Adelheid

    2013-01-01

    Aiming at the development of perspectives and recommendations for modern quality management in health services the GQMG conducted a study on the role and self-conception of quality managers in hospitals. It seems obvious that the effectiveness of quality management clearly depends on the executive board's skilful installation of quality management, their support of quality managers and, particularly in larger-sized institutions on the coordination of staff units and cross-sectional functions.(As supplied by author). Copyright © 2013. Published by Elsevier GmbH.

  15. Usability and feasibility of a tablet-based Decision-Support and Integrated Record-keeping (DESIRE) tool in the nurse management of hypertension in rural western Kenya.

    Science.gov (United States)

    Vedanthan, Rajesh; Blank, Evan; Tuikong, Nelly; Kamano, Jemima; Misoi, Lawrence; Tulienge, Deborah; Hutchinson, Claire; Ascheim, Deborah D; Kimaiyo, Sylvester; Fuster, Valentin; Were, Martin C

    2015-03-01

    Mobile health (mHealth) applications have recently proliferated, especially in low- and middle-income countries, complementing task-redistribution strategies with clinical decision support. Relatively few studies address usability and feasibility issues that may impact success or failure of implementation, and few have been conducted for non-communicable diseases such as hypertension. To conduct iterative usability and feasibility testing of a tablet-based Decision Support and Integrated Record-keeping (DESIRE) tool, a technology intended to assist rural clinicians taking care of hypertension patients at the community level in a resource-limited setting in western Kenya. Usability testing consisted of "think aloud" exercises and "mock patient encounters" with five nurses, as well as one focus group discussion. Feasibility testing consisted of semi-structured interviews of five nurses and two members of the implementation team, and one focus group discussion with nurses. Content analysis was performed using both deductive codes and significant inductive codes. Critical incidents were identified and ranked according to severity. A cause-of-error analysis was used to develop corresponding design change suggestions. Fifty-seven critical incidents were identified in usability testing, 21 of which were unique. The cause-of-error analysis yielded 23 design change suggestions. Feasibility themes included barriers to implementation along both human and technical axes, facilitators to implementation, provider issues, patient issues and feature requests. This participatory, iterative human-centered design process revealed previously unaddressed usability and feasibility issues affecting the implementation of the DESIRE tool in western Kenya. In addition to well-known technical issues, we highlight the importance of human factors that can impact implementation of mHealth interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. International normalized ratio stability in warfarin-experienced patients with nonvalvular atrial fibrillation.

    Science.gov (United States)

    Nelson, Winnie W; Desai, Sunita; Damaraju, Chandrasekharrao V; Lu, Lang; Fields, Larry E; Wildgoose, Peter; Schein, Jeffery R

    2015-06-01

    Maintaining stable levels of anticoagulation using warfarin therapy is challenging. Few studies have examined the stability of the international normalized ratio (INR) in patients with nonvalvular atrial fibrillation (NVAF) who have had ≥6 months' exposure to warfarin anticoagulation for stroke prevention. Our objective was to describe INR control in NVAF patients who had been receiving warfarin for at least 6 months. Using retrospective patient data from the CoagClinic™ database, we analyzed data from NVAF patients treated with warfarin to assess the quality of INR control and possible predictors of poor INR control. Time within, above, and below the recommended INR range (2.0-3.0) was calculated for patients who had received warfarin for ≥6 months and had three or more INR values. The analysis also assessed INR patterns and resource utilization of patients with an INR >4.0. Logistic regression models were used to determine factors associated with poor INR control. Patients (n = 9433) had an average of 1.6 measurements per 30 days. Mean follow-up time was 544 days. Approximately 39% of INR values were out of range, with 23% of INR values being 3.0. Mean percent time with INR in therapeutic range was 67%; INR 3.0 was 14%. Patients with more than one reading of INR >4.0 (~39%) required an average of one more visit and took 3 weeks to return to an in-range INR. Male sex and age >75 years were predictive of better INR control, whereas a history of heart failure or diabetes were predictive of out-of-range INR values. However, patient characteristics did not predict the likelihood of INR >4.0. Out-of-range INR values remain frequent in patients with NVAF treated with warfarin. Exposure to high INR values was common, resulting in increased resource utilization.

  17. Comparison of International Normalized Ratio Measurement between CoaguChek XS Plus and STA-R Coagulation Analyzers

    Directory of Open Access Journals (Sweden)

    Mina Hur

    2013-01-01

    Full Text Available Background. Point-of-care testing (POCT coagulometers are increasingly being used in the hospital setting. We investigated whether the prothrombin time international normalized ratio (INR results by CoaguChek XS Plus (Roche Diagnostics GmbH, Mannheim, Germany can be used reliably without being confirmed with the INR results by STA-R system (Diagnostica Stago S.A.S, Asnières sur Seine, France. Methods. A total of 118 INR measurements by CoaguChek XS Plus and STA-R were compared using Passing/Bablok regression analysis and Bland-Altman plot. Agreement of the INR measurements was further assessed in relation to dosing decision. Results. The correlation of INR measurements between CoaguChek XS Plus and STA-R was excellent (correlation coefficient = 0.964. The mean difference tended to increase as INR results increased and was 0.25 INR in the therapeutic range (2.0-3.0 INR. The overall agreement was fair to good (kappa = 0.679, and 21/118 (17.8% INR measurements showed a difference in dosing decision. Conclusion. The positive bias of CoaguChek XS Plus may be obvious even in the therapeutic INR range, and dosing decision based on the CoaguChek XS Plus INR results would be different from that based on the STA-R results. The INR measurements by POCT coagulometers still need to be confirmed with the laboratory INR measurements.

  18. Criatividade e inovação: competências na gestão de enfermagem Creatividad y innovación: competencias en la gerencia de enfermería Creativity and innovation: competences on nursing management

    Directory of Open Access Journals (Sweden)

    Liliane Bauer Feldman

    2008-04-01

    Full Text Available O presente artigo apresenta a importância da criatividade e da inovação nos serviços de saúde, distinguindo esses conceitos. Comportamento criativo é o aprimoramento de um elemento ou ação conhecidos, enquanto inovação significa encontrar novas alternativas. Considerando-se as competências, ou seja, conhecimento, habilidade e atitude - CHA, compreende-se que, estimulando-se a criatividade e a inovação, a atuação do profissional de saúde será otimizada. A criatividade e a inovação são, portanto, elementos-chave para o aprimoramento organizacional e para que, especificamente, a Enfermagem encontre alternativas para solucionar problemas no âmbito profissional. Dessa forma, esta abordagem traz uma ferramenta estratégica no processo de gestão e um diferencial para o enfermeiro o qual, ao criar ou inovar, se surpreenderá com seu potencial.El presente artículo presenta la importancia de la creatividad y de la innovación en los servicios de salud, distinguiendo estos conceptos. Comportamiento creativo es el mejoramiento de un elemento o acción conocidos, siendo que innovación significa encontrar nuevas alternativas. Llevando en consideración las competencias, o sea el conocimiento, la habilidad y la actitud - CHA, se comprende que, sé estimulando la creatividad y la innovación, la actuación del profesional de salud va ser optimizada. La creatividad y la innovación son, por tanto, elementos-clave para la mejora, organización y para que, específicamente, la Enfermería encuentre alternativas para solucionar los problemas en el campo que la profesión envuelve. De esta forma, este abordaje trae una herramienta estratégica en el proceso de gerencia y un diferencial para el enfermero el cual, al criar o innovar, se sorprenderá con su potencial.This article presents the importance of the creativity and innovation on health services, distinguishing those concepts. Creative behavior is the improvement of an element or known actions; whereas innovation means finding new alternatives. Considering competences like knowledge, skill and attitude - KSA, it is understood that by stimulating creativity and innovation, the performance of the health professional will be optimized. Therefore, creativity and innovation are key elements for improvement and organization, and, more specifically, for Nursing to find alternatives for solving problems related to the occupation as a whole. In this way, this approach brings a strategic tool on the process of management and a differential for the nurse, which by innovating and creating will amaze herself with her potential.

  19. 先天性大疱表皮松解症患儿的创面护理管理%Wound nursing management of children with congenital epidermolysis bullosa

    Institute of Scientific and Technical Information of China (English)

    任平; 陈劼; 张玉侠

    2016-01-01

    It reviewed the research status quo of wound care of children with congenital epidermolysis bullosa (EB),based on epidermolysis bullosa“wound bed preparation”(WBP)from the wound management steps inclu-ding the effective cleaning of the wound,the reasonable choice of wet dressing and the prevention of complica-tions and so on.The wet dressings and matters needing attention suitable for the different types of EB patients were not the same,it thought that drug and non drug intervention methods of pain and itching management were nursing important points.%以大疱表皮松解症“创面床准备”为基础,从创面管理步骤包括有效清洁创面病灶、合理选用湿性敷料以及预防并发症等方面综述了先天性大疱表皮松解症患儿的创面护理管理研究现状,不同类型的大疱表皮松解症患儿适用的湿性敷料和注意事项各不相同,认为药物和非药物干预方法的疼痛、瘙痒管理也是护理的重点。

  20. Does participating in a clinical trial affect subsequent nursing management? Post-trial care for participants recruited to the INTACT pressure ulcer prevention trial: A follow-up study.

    Science.gov (United States)

    Webster, Joan; Bucknall, Tracey; Wallis, Marianne; McInnes, Elizabeth; Roberts, Shelley; Chaboyer, Wendy

    2017-06-01

    Participation in a clinical trial is believed to benefit patients but little is known about the post-trial effects on routine hospital-based care. To describe (1) hospital-based, pressure ulcer care-processes after patients were discharged from a pressure ulcer prevention, cluster randomised controlled trial; and (2) to investigate if the trial intervention had any impact on subsequent hospital-based care. We conducted a retrospective analysis of 133 trial participants who developed a pressure ulcer during the clinical trial. We compared outcomes and care processes between participants who received the pressure ulcer prevention intervention and those in the usual care, control group. We also compared care processes according to the pressure ulcer stage. A repositioning schedule was reported for 19 (14.3%) patients; 33 (24.8%) had a dressing applied to the pressure ulcer; 17 (12.8) patients were assessed by a wound care team; and 20 (15.0%) were seen by an occupational therapist. Patients in the trial's intervention group were more likely to have the presence of a pressure ulcer documented in their chart (odds ratio (OR) 8.18, 95% confidence intervals (CI) 3.64-18.36); to be referred to an occupational therapist OR 0.92 (95% CI 0.07; 0.54); to receive a pressure relieving device OR 0.31 (95% CI 0.14; 0.69); or a pressure relieving mattress OR 0.44 (95% CI 0.20; 0.96). Participants with Stage 2 or unstageable ulcers were more likely than others to have dressings applied to their wounds (p=pressure ulcer status and care is poor. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Prothrombin time (PT)

    Science.gov (United States)

    PT; Pro-time; Anticoagulant-prothrombin time; Clotting time: protime; INR; International normalized ratio ... PT is measured in seconds. Most of the time, results are given as what is called INR ( ...

  2. Quality of anticoagulation therapy in neurological patients in a tertiary care hospital in north India

    Directory of Open Access Journals (Sweden)

    Prabhat Singh

    2016-01-01

    Interpretation & conclusions: It may be concluded that stable therapeutic INR is difficult to maintain in neurological patients. Optimal modification of diet, drug and dose of oral anticoagulant may help in stabilization of INR.

  3. Influence of kidney function on risk of supratherapeutic international normalized ratio-related hemorrhage in warfarin users: a prospective cohort study

    Science.gov (United States)

    Background: Anticoagulation management is difficult in chronic kidney disease, with frequent supratherapeutic international normalized ratios (INRs >/= 4) increasing hemorrhagic risk. We evaluated whether the interaction of INR and lower estimated glomerular filtration rate (eGFR) increases hemorrha...

  4. Proceedings – Mathematical Sciences | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    Spectral and Inverse Spectral Theory. Guest Editors: Peter D. Hislop and M. Krishna. pp 597-854 Volume 104 1994 INR 100 USD 30. Spectral and Inverse Spectral Theory. pp 304 Volume 104 1994 INR 100 USD 30. K. G. Ramanathan Memorial Issue. pp 328 Volume 97 1987 INR 100 USD 30. Srinivasan Ramanujan Birth ...

  5. Patterns of international normalized ratio values among new warfarin patients with nonvalvular atrial fibrillation.

    Science.gov (United States)

    Nelson, Winnie W; Milentijevic, Dejan; Wang, Li; Baser, Onur; Damaraju, C V; Schein, Jeffrey R

    2016-12-01

    Limited information exists regarding the relationship between international normalized ratio (INR) control/stability and the discontinuation of warfarin therapy among patients with nonvalvular atrial fibrillation (NVAF). This study evaluated the association between INR stabilization and warfarin discontinuation and assessed INR patterns before and after INR stabilization among patients (≥18 years) with NVAF who newly initiated warfarin (Veterans Health Administration datasets; October 1, 2007 through September 30, 2012). Achievement of INR stabilization (≥3 consecutive in-range therapeutic INR measurements ≥7 days apart) was examined from warfarin initiation through the end of warfarin exposure. Proportion of time in therapeutic range during warfarin exposure was calculated (Rosendaal method) and categorized as at least 60% or less than 60%. Among 34 346 patients, 49.4% achieved INR stabilization (mean time to stabilization, 98 days). Approximately 40% of INR values were out-of-range, even after achieving stabilization. During 30 days following an INR 4.0 or higher, patients had more INR testing than the overall mean (2.51 vs. 1.67 tests). Warfarin discontinuation was 4.2 times more likely among patients without INR stabilization versus those with INR stabilization (P < 0.00001). Patients with poor INR control (time in therapeutic range <60%) were 1.76 times more likely to discontinue warfarin within 1 year (P < 0.0001). INR stabilization is a better predictor of warfarin discontinuation than poor INR control. Improved approaches are necessary to maintain appropriate anticoagulation levels among patients with NVAF.

  6. Relationship between leadership styles of Nurese managers and ...

    African Journals Online (AJOL)

    BACKGROUND: Leadership style of nurse managers plays a significant role in nurses' job satisfaction. However, there is limited literature in areas related to nurses' manager leadership style. The objective of this research was thus to investigate the relationship between leadership style of nurse managers and nurses' job ...

  7. Short term variations in particulate matter in Mahi river estuary

    Digital Repository Service at National Institute of Oceanography (India)

    Bhosle, N.B.; Rokade, M.A.; Zingde, M.D.

    The particulate matter (PM) collected from Mahi River Estuary was analysed for organic carbon (POC), nitrogen (PON), and chlorophyll a (Chl a). The concentration of PM, POC, PON and Chl a showed short term variations. Average surface concentration...

  8. 75 FR 38504 - Meetings of the Naval Research Advisory Committee

    Science.gov (United States)

    2010-07-02

    ...-553-2726 via your embassy to: SPAWARSYSCEN San Diego, CODE 20352 (PL-TS), POC: Jackie Olson, 854... JPAS to SPAWARS; UIC number 660015 or fax it to 619-553-2726. POC is Ms. Jackie Olson, Office 85400...

  9. Journal of Earth System Science | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    POC) in the Northeastern Gulf of Mexico · Young Baek Son Wilford D Gardner Alexey V Mishonov Mary Jo Richardson · More Details Abstract Fulltext PDF. Hydrographic data, including particulate organic carbon (POC) from the Northeastern ...

  10. Satellite observation of particulate organic carbon dynamics in ...

    Science.gov (United States)

    Particulate organic carbon (POC) plays an important role in coastal carbon cycling and the formation of hypoxia. Yet, coastal POC dynamics are often poorly understood due to a lack of long-term POC observations and the complexity of coastal hydrodynamic and biogeochemical processes that influence POC sources and sinks. Using field observations and satellite ocean color products, we developed a nw multiple regression algorithm to estimate POC on the Louisiana Continental Shelf (LCS) from satellite observations. The algorithm had reliable performance with mean relative error (MRE) of ?40% and root mean square error (RMSE) of ?50% for MODIS and SeaWiFS images for POC ranging between ?80 and ?1200 mg m23, and showed similar performance for a large estuary (Mobile Bay). Substantial spatiotemporal variability in the satellite-derived POC was observed on the LCS, with high POC found on the inner shelf (satellite data with carefully developed algorithms can greatly increase

  11. Variation pattern of particulate organic carbon and nitrogen in oceans and inland waters

    Science.gov (United States)

    Huang, Changchun; Jiang, Quanliang; Yao, Ling; Yang, Hao; Lin, Chen; Huang, Tao; Zhu, A.-Xing; Zhang, Yimin

    2018-03-01

    We examined the relationship between, and variations in, particulate organic carbon (POC) and particulate organic nitrogen (PON) based on previously acquired ocean and inland water data. The latitudinal dependency of POC / PON is significant between 20 and 90° N but weak in low-latitude areas and in the Southern Hemisphere. The mean values of POC / PON in the Southern Hemisphere and Northern Hemisphere were 7.40 ± 3.83 and 7.80 ± 3.92, respectively. High values of POC / PON appeared between 80-90 (12.2 ± 7.5) and 70-80° N (9.4 ± 6.4), while relatively low POC / PON was found from 20 (6.6 ± 2.8) to 40° N (6.7 ± 2.7). The latitudinal variation of POC / PON in the Northern Hemisphere is much stronger than in the Southern Hemisphere due to the influence of more terrestrial organic matter. Higher POC and PON could be expected in coastal waters. POC / PON growth ranged from 6.89 ± 2.38 to 7.59 ± 4.22 in the Northern Hemisphere, with an increasing rate of 0.0024 km from the coastal to open ocean. Variations of POC / PON in lake water also showed a similar latitude-variation tendency of POC / PON with ocean water but were significantly regulated by the lakes' morphology, trophic state and climate. Small lakes and high-latitude lakes prefer relatively high POC / PON, and large lakes and low-latitude lakes tend to prefer low POC / PON. The coupling relationship between POC and PON in oceans is much stronger than in inland waters. Variations in POC, PON and POC / PON in inland waters should receive more attention due to the implications of these values for the global carbon and nitrogen cycles and the indeterminacy of the relationship between POC and PON.

  12. Point-of-Care Ultrasound: A Trend in Health Care.

    Science.gov (United States)

    Buerger, Anita M; Clark, Kevin R

    2017-11-01

    To discuss the current and growing use of point-of-care (POC) ultrasound in the management and care of patients. Several electronic research databases were searched to find articles that emphasized the use of POC ultrasound by health care providers who manage and treat critically ill or injured patients. Thirty-five relevant peer-reviewed journal articles were selected for this literature review. Common themes identified in the literature included the use of POC ultrasound in emergency medicine, military medicine, and remote care; comparison of POC ultrasound to other medical imaging modalities; investigation of the education and training required for nonimaging health care professionals who perform POC ultrasound in their practices; and discussion of the financial implications and limitations of POC ultrasound. POC ultrasound provides clinicians with real-time information to better manage and treat critically ill or injured patients in emergency medicine, military medicine, and remote care. In addition to providing immediate bedside diagnostic information, use of POC ultrasound has increased because of concerns regarding radiation protection. Finally, the expansion of POC ultrasound to other specialty areas requires nonimaging health care professionals to perform bedside ultrasound examinations and interpret the resulting images. Because POC ultrasound is user-dependent, adequate training is essential for all who perform and interpret the examinations. Research involving POC ultrasound will continue as innovations and confidence in ultrasound applications advance. Future research should continue to examine the broad use of POC ultrasound in patient care and management. ©2017 American Society of Radiologic Technologists.

  13. Origin and biochemical cycling of particulate nitrogen in the Mandovi estuary

    Digital Repository Service at National Institute of Oceanography (India)

    Fernandes, L

    for particulate organic carbon (POC) and particulate organic nitrogen (PON), delta sup(13) C sub(POC), total hydrolysable amino acid enantiomers (L- and D- amino acids) concentration and composition. Delta sup(13)C sub(POC) values were depleted (-32 to -25 ppt...

  14. Effect of Coating Palm Oil Clinker Aggregate on the Engineering Properties of Normal Grade Concrete

    Directory of Open Access Journals (Sweden)

    Fuad Abutaha

    2017-10-01

    Full Text Available Palm oil clinker (POC is a waste material generated in large quantities from the palm oil industry. POC, when crushed, possesses the potential to serve as an aggregate for concrete production. Experimental investigation on the engineering properties of concrete incorporating POC as aggregate and filler material was carried out in this study. POC was partially and fully used to replace natural coarse aggregate. The volumetric replacements used were 0%, 20%, 40%, 60%, 80%, and 100%. POC, being highly porous, negatively affected the fresh and hardened concrete properties. Therefore, the particle-packing (PP method was adopted to measure the surface and inner voids of POC coarse aggregate in the mixtures at different substitution levels. In order to enhance the engineering properties of the POC concrete, palm oil clinker powder (POCP was used as a filler material to fill up and coat the surface voids of POC coarse, while the rest of the mix constituents were left as the same. Fresh and hardened properties of the POC concrete with and without coating were determined, and the results were compared with the control concrete. The results revealed that coating the surface voids of POC coarse with POCP significantly improved the engineering properties as well as the durability performance of the POC concrete. Furthermore, using POC as an aggregate and filler material may reduce the continuous exploitation of aggregates from primary sources. Also, this approach offers an environmental friendly solution to the ongoing waste problems associated with palm oil waste material.

  15. Distribution of particulate organic matter in the Bay of Bengal

    Digital Repository Service at National Institute of Oceanography (India)

    Rao, V.C.; Rao, T.S.S.

    At greater depths (300m), POC concentrations increased and were similar (145 to 542 mu gl-1) to those observed at surface Deep water POC maximum was embedded within the oxygen minimum layer and was also associated with high phosphate-phosphorus The POC...

  16. Satellite observation of particulate organic carbon dynamics on the Louisiana continental shelf

    Science.gov (United States)

    Particulate organic carbon (POC) plays an important role in coastal carbon cycling and the formation of hypoxia. Yet, coastal POC dynamics are often poorly understood due to a lack of long-term POC observations and the complexity of coastal hydrodynamic and biogeochemical process...

  17. Poor anticoagulation control in patients taking warfarin at a tertiary and districtlevel prothrombin clinic in Cape Town South Africa

    Directory of Open Access Journals (Sweden)

    I Ebrahim

    2018-05-01

    Full Text Available Background. Warfarin is the most commonly used anticoagulant for both primary and secondary prevention of thromboembolism. For anticoagulation efficacy, the international normalised ratio (INR needs to be within the therapeutic range for at least 65% of time on warfarin.Objectives. To describe INR control in patients on long-term warfarin and identified predictors of good INR control at two dedicated warfarin follow-up clinics in Cape Town, South Africa (SA.Methods. We reviewed clinical records of patients in care at the INR clinics at Mitchell’s Plain Community Health Centre and Groote Schuur Hospital. We included patients who had been on warfarin therapy for at least 27 months and excluded patients with <6 months of INR monitoring data or a >70-day gap between INR tests in the calculation period, and if >25% of follow-up time was at an alternative site. The time in therapeutic range (TTR over 180 days using the Rosendaal method was calculated, and we categorised INR control as good if the TTR was ≥65%. We constructed a multivariate logistic regression model to identify associations with good INR control.Results. We included 363 patients, with a median age of 55 years (interquartile range (IQR 44 - 64, of whom 65.6% were women. The most common indications for warfarin were valvular heart disease (45.7% and atrial fibrillation (25.1%. The mean TTR was 47%, with only 91/363 patients having good INR control. In a multivariate model adjusted for age, sex, clinic and target INR, patients aged ≥55 years were more likely to have good INR control than younger patients (adjusted odds ratio 1.69, 95% confidence interval 1.03 - 2.79. Poorly controlled patients had more frequent INR monitoring than those with good INR control, with a median of 8 INRs (IQR 6 - 10 v. 6 INRs (IQR 5 - 8 in the 180-day period (p<0.0001.Conclusions. Only 25.1% of patients in our study achieved good INR control, despite regular INR monitoring. There is an

  18. Fluxes of particulate organic carbon in the East China Sea in summer

    Directory of Open Access Journals (Sweden)

    C.-C. Hung

    2013-10-01

    Full Text Available To understand carbon cycling in marginal seas better, particulate organic carbon (POC concentrations, POC fluxes and primary production (PP were measured in the East China Sea (ECS in summer 2007. Higher concentrations of POC were observed in the inner shelf, and lower POC values were found in the outer shelf. Similar to POC concentrations, elevated uncorrected POC fluxes (720–7300 mg C m−2 d−1 were found in the inner shelf, and lower POC fluxes (80–150 mg C m−2 d−1 were in the outer shelf, respectively. PP values (~ 340–3380 mg C m−2 d−1 had analogous distribution patterns to POC fluxes, while some of PP values were significantly lower than POC fluxes, suggesting that contributions of resuspended particles to POC fluxes need to be appropriately corrected. A vertical mixing model was used to correct effects of bottom sediment resuspension, and the lowest and highest corrected POC fluxes were in the outer shelf (58 ± 33 mg C m−2 d−1 and the inner shelf (785 ± 438 mg C m−2 d−1, respectively. The corrected POC fluxes (486 to 785 mg C m−2 d−1 in the inner shelf could be the minimum value because we could not exactly distinguish the effect of POC flux from Changjiang influence with turbid waters. The results suggest that 27–93% of the POC flux in the ECS might be from the contribution of resuspension of bottom sediments rather than from the actual biogenic carbon sinking flux. While the vertical mixing model is not a perfect model to solve sediment resuspension because it ignores biological degradation of sinking particles, Changjiang plume (or terrestrial inputs and lateral transport, it makes significant progress in both correcting the resuspension problem and in assessing a reasonable quantitative estimate of POC flux in a marginal sea.

  19. Comparison of outcomes among patients randomized to warfarin therapy according to anticoagulant control: results from SPORTIF III and V

    DEFF Research Database (Denmark)

    White, Harvey D; Gruber, Michael; Feyzi, Jan

    2007-01-01

    BACKGROUND: Warfarin sodium reduces stroke risk in patients with atrial fibrillation, but international normalized ratio (INR) monitoring is required. Target INRs are frequently not achieved, and the risk of death, bleeding, myocardial infarction (MI), and stroke or systemic embolism event (SEE......) may be related to INR control. METHODS: We analyzed the relationship between INR control and the rates of death, bleeding, MI, and stroke or SEE among 3587 patients with atrial fibrillation randomized to receive warfarin treatment in the SPORTIF (Stroke Prevention Using an Oral Thrombin Inhibitor...... control group (1.69% and 1.58%, respectively) (Pwarfarin, the risks of death...

  20. Contribution of rivaroxaban to the international normalized ratio when switching to warfarin for anticoagulation as determined by simulation studies.

    Science.gov (United States)

    Siegmund, Hans-Ulrich; Burghaus, Rolf; Kubitza, Dagmar; Coboeken, Katrin

    2015-06-01

    This study evaluated the influence of rivaroxaban 20 mg once daily on international normalized ratio (INR) during the co-administration period when switching from rivaroxaban to warfarin. We developed a calibrated coagulation model that was qualified with phase I clinical data. Prothrombin time and INR values were simulated by use of phospholipid concentrations that matched Neoplastin Plus® and Innovin® reagents. To simulate the combined effects of rivaroxaban and warfarin on INR during switching, warfarin initiation was simulated by adjusting the magnitude of the warfarin effect to reach the desired target INRs over the course of 21 days. The warfarin effect values (obtained every 6 h) and the desired rivaroxaban plasma concentrations were used. Nomograms were generated from rivaroxaban induced increases in INR. The simulation had good prediction quality. Rivaroxaban induced increases in the total INR from the warfarin attributed INR were seen, which increased with rivaroxaban plasma concentration. When the warfarin only INR was 2.0-3.0, the INR contribution of rivaroxaban with Neoplastin Plus® was 0.5-1.2, decreasing to 0.3-0.6 with Innovin® at median trough rivaroxaban plasma concentrations (38 μg l(-1) ). The data indicate that measuring warfarin induced changes in INR are best performed at trough rivaroxaban concentrations (24 h after rivaroxaban dosing) during the co-administration period when switching from rivaroxaban to warfarin. Furthermore, Innovin® is preferable to Neoplastin Plus® because of its substantially lower sensitivity to rivaroxaban, thereby reducing the influence of rivaroxaban on the measured INR. © 2014 The British Pharmacological Society.

  1. Population Impact of Drug Interactions with Warfarin: A Real-World Data Approach.

    Science.gov (United States)

    Martín-Pérez, Mar; Gaist, David; de Abajo, Francisco J; Rodríguez, Luis A García

    2018-03-01

     To investigate the population impact of previously reported interactions between warfarin and other drugs on international normalized ratio (INR) levels.  Using The Health Improvement Network (THIN), a United Kingdom primary care database, a cohort of warfarin users between 2005 and 2013 ( N  = 121,962) was followed until the first qualifying prescription for the potential interacting drugs was evaluated. Sixteen sub-cohorts, one for each study drug, and a control sub-cohort of warfarin were ascertained. Short-term changes in INR levels were assessed by comparing INR values measured before and after initiation of the interacting drug with paired Student's t -test. We also evaluated the proportion of patients with INR values outside the therapeutic range (INR: 2-3).  Miconazole use was associated with the highest mean increase in INR (+3.35), followed by amiodarone (+1.28), fluconazole (+0.79), metronidazole (+0.75) and nystatin (+0.65). After subtracting the natural INR variation observed in the control sub-cohort, supra-therapeutic levels (INR > 3) were found in 53.2% (miconazole), 45.5% (amiodarone), 23.3% (metronidazole), 23.2% (fluconazole) and 17.6% (nystatin) of patients initiating treatment with these drugs. Carbamazepine use was associated with a mean INR decrease of -0.63 and infra-therapeutic levels (INR < 2) were observed in 46.2% of patients initiating carbamazepine. For all other drugs, the change was small to moderate, in absolute INR units (+0.23 to +0.55) and in the proportion of patients with INR levels out of therapeutic range (<16%).  Clinically potentially important interactions were observed in several study drugs. The majority of them, although confirmed, had little impact after adjusting for standard INR variability in the general population of warfarin users. Schattauer GmbH Stuttgart.

  2. Factors associated with failure to correct the international normalised ratio following fresh frozen plasma administration among patients treated for warfarin-related major bleeding. An analysis of electronic health records.

    Science.gov (United States)

    Menzin, J; White, L A; Friedman, M; Nichols, C; Menzin, J; Hoesche, J; Bergman, G E; Jones, C

    2012-04-01

    This study assessed the frequency and factors associated with failure to correct international normalised ratio (INR) in patients administered fresh frozen plasma (FFP) for warfarin-related major bleeding. This retrospective database analysis used electronic health records from an integrated health system. Patients who received FFP between 01/01/2004 and 01/31/2010, and who met the following criteria were selected: major haemorrhage diagnosis the day before to the day after initial FFP administration; INR ≥2 on the day before or the day of FFP and another INR result available; warfarin prescription within 90 days. INR correction (defined as INR ≤1.3) was evaluated at the last available test up to one day following FFP. A total of 414 patients met selection criteria (mean age 75 years, 53% male, mean Charlson score 2.5). Patients presented with gastrointestinal bleeding (58%), intracranial haemorrhage (38%) and other bleed types (4%). The INR of 67% of patients remained uncorrected at the last available test up to one day following receipt of FFP. In logistic regression analysis, the INR of patients who were older, those with a Charlson score of 4 or greater, and those with non-ICH bleeds (odds ratio vs. intracranial bleeding 0.48; 95% confidence interval 0.31-0.76) were more likely to remain uncorrected within one day following FFP administration. In an alternative definition of correction, (INR ≤1.5), 39% of patients' INRs remained uncorrected. For a substantial proportion of patients, the INRs remain inadequately or uncorrected following FFP administration, with estimates varying depending on the INR threshold used.

  3. Evaluating Diagnostic Point-of-Care Tests in Resource-Limited Settings

    Science.gov (United States)

    Drain, Paul K; Hyle, Emily P; Noubary, Farzad; Freedberg, Kenneth A; Wilson, Douglas; Bishai, William; Rodriguez, William; Bassett, Ingrid V

    2014-01-01

    Diagnostic point-of-care (POC) testing is intended to minimize the time to obtain a test result, thereby allowing clinicians and patients to make an expeditious clinical decision. As POC tests expand into resource-limited settings (RLS), the benefits must outweigh the costs. To optimize POC testing in RLS, diagnostic POC tests need rigorous evaluations focused on relevant clinical outcomes and operational costs, which differ from evaluations of conventional diagnostic tests. Here, we reviewed published studies on POC testing in RLS, and found no clearly defined metric for the clinical utility of POC testing. Therefore, we propose a framework for evaluating POC tests, and suggest and define the term “test efficacy” to describe a diagnostic test’s capacity to support a clinical decision within its operational context. We also proposed revised criteria for an ideal diagnostic POC test in resource-limited settings. Through systematic evaluations, comparisons between centralized diagnostic testing and novel POC technologies can be more formalized, and health officials can better determine which POC technologies represent valuable additions to their clinical programs. PMID:24332389

  4. Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management.

    Science.gov (United States)

    Kuupiel, Desmond; Bawontuo, Vitalis; Mashamba-Thompson, Tivani P

    2017-11-29

    Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs) and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings.

  5. Implementation of Point-of-Care Diagnostics in Rural Primary Healthcare Clinics in South Africa: Perspectives of Key Stakeholders.

    Science.gov (United States)

    Mashamba-Thompson, Tivani P; Jama, Ngcwalisa A; Sartorius, Benn; Drain, Paul K; Thompson, Rowan M

    2017-01-08

    Key stakeholders' involvement is crucial to the sustainability of quality point-of-care (POC) diagnostics services in low-and-middle income countries. The aim of this study was to explore key stakeholder perceptions on the implementation of POC diagnostics in rural primary healthcare (PHC) clinics in South Africa. We conducted a qualitative study encompassing in-depth interviews with multiple key stakeholders of POC diagnostic services for rural and resource-limited PHC clinics. Interviews were digitally recorded and transcribed verbatim prior to thematic content analysis. Thematic content analysis was conducted using themes guided by the World Health Organisation (WHO) quality-ASSURED (Affordable, Sensitive, Specific, User friendly, Rapid and to enable treatment at first visit and Robust, Equipment free and Delivered to those who need it) criteria for POC diagnostic services in resource-limited settings. 11 key stakeholders participated in the study. All stakeholders perceived the main advantage of POC diagnostics as enabling access to healthcare for rural patients. Stakeholders perceived the current POC diagnostic services to have an ability to meet patients' needs, but recommended further improvement of the following areas: research on cost-effectiveness; improved quality management systems; development of affordable POC diagnostic and clinic-based monitoring and evaluation. Key stakeholders of POC diagnostics in rural PHC clinics in South Africa highlighted the need to assess affordability and ensure quality assurance of current services before adopting new POC diagnostics and scaling up current POC diagnostics.

  6. Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management

    Directory of Open Access Journals (Sweden)

    Desmond Kuupiel

    2017-11-01

    Full Text Available Access to point-of-care (POC diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings.

  7. Implementation of Point-of-Care Diagnostics in Rural Primary Healthcare Clinics in South Africa: Perspectives of Key Stakeholders

    Directory of Open Access Journals (Sweden)

    Tivani P. Mashamba-Thompson

    2017-01-01

    Full Text Available Introduction: Key stakeholders’ involvement is crucial to the sustainability of quality point-of-care (POC diagnostics services in low-and-middle income countries. The aim of this study was to explore key stakeholder perceptions on the implementation of POC diagnostics in rural primary healthcare (PHC clinics in South Africa. Method: We conducted a qualitative study encompassing in-depth interviews with multiple key stakeholders of POC diagnostic services for rural and resource-limited PHC clinics. Interviews were digitally recorded and transcribed verbatim prior to thematic content analysis. Thematic content analysis was conducted using themes guided by the World Health Organisation (WHO quality-ASSURED (Affordable, Sensitive, Specific, User friendly, Rapid and to enable treatment at first visit and Robust, Equipment free and Delivered to those who need it criteria for POC diagnostic services in resource-limited settings. Results: 11 key stakeholders participated in the study. All stakeholders perceived the main advantage of POC diagnostics as enabling access to healthcare for rural patients. Stakeholders perceived the current POC diagnostic services to have an ability to meet patients’ needs, but recommended further improvement of the following areas: research on cost-effectiveness; improved quality management systems; development of affordable POC diagnostic and clinic-based monitoring and evaluation. Conclusions: Key stakeholders of POC diagnostics in rural PHC clinics in South Africa highlighted the need to assess affordability and ensure quality assurance of current services before adopting new POC diagnostics and scaling up current POC diagnostics.

  8. Expectativas de gerentes e assessores de enfermagem quanto ao estilo gerencial do diretor executivo de um hospital de ensino Expectativas de gerentes y asesores de enfermería referente al estilo gerencial del director eyecutivo de un hospital escuela The managerial style of an executive director of a university hospital: perceptions and expectations of nursing managers and assistants

    Directory of Open Access Journals (Sweden)

    Lúcia Marinilza Beccaria

    2000-04-01

    Full Text Available Este estudo focalizou as expectativas de 13 enfermeiros de um hospital de ensino, quanto ao estilo gerencial do diretor executivo. Utilizou-se o Grid Gerencial de BLAKE & MOUTON (1987, como referencial teórico e aplicou-se um questionário baseado no Instrumento Grid & Liderança em enfermagem, de TREVIZAN (1993. Os resultados evidenciaram que o estilo mais esperado corresponde, no Grid Gerencial, à "gerência em equipe", ou 9.9. O segundo estilo desejado foi a "gerência do homem organizacional, "ou 5.5. Concluiu-se que, para esses enfermeiros, existem expectativas significativas relacionadas à gerência que invista em valores como confiança, respeito, comprometimento, empenho pessoal e trabalho em equipe para o alcance dos objetivos organizacionais.Este estudio enfocó las expectativas de 13 enfermeros del hospital escuela, con relación al estilo directivo del director ejecutivo. El "grid" gerencial de BLAKE & MOUTON (1987, fue usado como referencial teórico y una encuesta se aplicó basada en el Instrumento Grid & Liderazgo en enfermería, de TREVIZAN (1993. Los resultados evidenciaron el estilo más esperado fue "la gerencia en equipo", o 9.9. EL segundo estilo fue la "gerencia organizacional del hombre," o 5.5. Se concluye que, para esos enfermeros existen expectativas significativas relacionadas con la dirección que invierte en valores como confianza, respeto, compromiso, empeño personal y trabajo en equipo para el alcance del objetivos organizacionales.The present study focussed the expectations of 13 nurses from a University hospital regarding to the executive director's managerial style. The Managerial Grid of BLAKE & MOUTON (1987 was used as a theoretical reference and a questionnaire was applied based on the Grid & Leadership in Nursing Instrument elaborated by TREVIZAN (1993. Results evidenced that the most expected style corresponds, considering the Managerial Grid, to "team management", or 9.9. The second style was the "management of a men organization", or 5.5. Authors concluded that there are important expectations for these nurses related to a management that enhances values such as trust, respect, commitment, personal investment and team work in order to achieve the organization goals.

  9. De um novo paradigma na gestão dos enfermeiros: a espiritualidade no local de trabalho Hacia un nuevo paradigma en la gestión de los enfermeros - la espiritualidad en el local de trabajo A new paradigm in nurses management - spirituality in the workplace

    Directory of Open Access Journals (Sweden)

    Sílvia Caldeira

    2011-03-01

    Full Text Available Contexto: A espiritualidade no local de trabalho é um tema emergente na área da gestão de recursos humanos, porém, com uma evidente escassez em enfermagem. Os enfermeiros trabalham em ambientes que favorecem a vivência espiritual e, também por isso, deverão ser cuidados pelos seus gestores como seres espirituais. Objectivos: Explorar e compreender a percepção dos enfermeiros acerca da espiritualidade no local de trabalho. Método: Aplicou-se um questionário contendo uma escala de avaliação da espiritualidade no local de trabalho (Rego, Cunha e Souto, 2007a. A amostra foi constituída por 40 enfermeiros a frequentar o curso de complemento de formação. Resultados: A espiritualidade no local de trabalho é percepcionada como “moderada” nas dimensões: sentido de comunidade na equipa, alinhamento do indivíduo com os valores da organização, alegria no trabalho e oportunidades para a vida interior, sendo “alta” na dimensão relacionada com “o sentido de préstimo à comunidade”. Conclusões: Embora de natureza exploratória, este estudo permitiu conhecer que este fenómeno é percebido pelos enfermeiros e, como tal, deverá ser atendido pelos gestores. A liderança espiritual poderá trazer mais criatividade, compromisso, comunicação e adopção de comportamentos éticos às equipas de enfermagem. Este estudo é um contributo para a continuação da investigação nesta área.Contexto: La espiritualidad en el lugar de trabajo es un tema emergente en la gestión de los recursos humanos, pero con una evidente escasez en la enfermería. Los enfermeros trabajan en ambientes que promueven la experiencia espiritual y debían también ser atendidos por sus directivos como seres espirituales. Objetivos: Explorar y comprender las percepciones de los enfermeros sobre la espiritualidad en el lugar de trabajo. Método: Se aplicó un cuestionario con una escala de evaluación de la espiritualidad en el lugar de trabajo (Rego, Cunha e Souto, 2007a. La muestra fue constituida por enfermeros que estaban asistiendo al curso de formación complementario. Resultados: La espiritualidad en el lugar de trabajo se percibe como “moderada” en el sentido de comunidad en el equipo, identificación con los valores organizacionales, la felicidad en el trabajo y las oportunidades de vida interior, y fue “alta” en la dimensión relacionada con el sentido de utilidad para la sociedad. Conclusiones: Aunque exploratorio, las conclusiones expresan que este fenómeno es percibido por las enfermeras y como tal debe ser atendido por los administradores. Liderazgo espiritual puede traer más creatividad, comunicación, compromiso y adopción de un comportamiento ético a los equipos de enfermería. Este estudio es una contribución a la investigación en este ámbito.Context: Spirituality at work is an emerging issue in human resource management, but with an obvious absence in nursing. Nurses provide care in particular environments that give rise to spiritual experience, and as spiritual beings they must be cared for by their managers. Objectives: To explore and understand nurses’ perceptions about spirituality in the workplace. Method: Data were collected by a questionnaire including a spirituality at work scale (Rego, Cunha e Souto, 2007a. The sample consisted of 40 nurses attending the complementary training course. Results: Spirituality at work is perceived as “moderate” in 4 dimensions of the scale, and “high” in dimension related to “sense of contribution to the community”, aligning the individual with the values of the organization, joy in the work and opportunities for the interior life, and as “high” on the dimension related to ‘the feeling of being needed by the community”.Conclusions: Although this is exploratory research, the conclusions show that spirituality at work is understood by nurses and should be attended to by managers. Spiritual leadership can bring more creativity, commitment, communication and ethical behavior to nursing teams. This study is a contribution towards further research in this area.

  10. Endomarketing: ensaio sobre possibilidades de inovação na gestão em enfermagem Endomarketing: ensayo sobre posibilidades de innovación en la gestión en enfermería Endomarketing: essay on possibilities of innovation in Nursing management

    Directory of Open Access Journals (Sweden)

    Claci Fátima Weirich

    2004-12-01

    Full Text Available Este artigo tem como objetivo apresentar o endomarketing como ferramenta para o enfermeiro no processo de gestão, tendo em vista o contexto atual de mudanças no setor saúde, que exige também o desenvolvimento de habilidades que estão diretamente relacionadas à introdução de novas tecnologias e formas de organização do trabalho. Nossa reflexão deixa alguns pontos importantes a serem analisados por enfermeiros e educadores, na busca de melhores caminhos e alternativas para a formação de enfermeiros com maior satisfação profissional, com competência para gerenciar serviços de saúde. O grande desafio do endomarketing é, portanto, conciliar os objetivos e interesses do público interno com as necessidades e expectativas do público externo da organização.Este artículo tiene como objetivo presentar el endomarketing como una herramienta para el enfermero en el proceso de gestión, tomando en consideración el actual contexto de cambios que existe en el sector de salud, y que además exige el desarrollo de habilidades, las cuales están directamente relacionadas con la introducción de nuevas tecnologías y formas de organización del trabajo. Nuestra reflexión deja algunos puntos importantes para ser analizados por enfermeros y educadores, en la búsqueda de mejores caminos y mejores alternativas para la formación de enfermeros con más satisfacción profesional y con competencia para gerenciar servicios de salud. El gran desafío del endomarketing es, por lo tanto, conciliar los objetivos e intereses del público interno con las necesidades y expectativas del público externo de la organización.This article is aimed at presenting endomarketing as a tool for nurses in the management process, taking into account the current context of changes in the healthcare sector, which also requires the development of skills that are directly related to the introduction of new technologies and ways of work organization. Our reflection leaves some important points to be analyzed by nurses and educators in the search for better ways and alternatives for educating nurses who will have greater professional satisfaction and competence to manage the healthcare services. The big challenge of endomarketing is, therefore, to combine the aims and interests of the internal public with the needs and expectations of the external public in the organization.

  11. Planning documents: a business planning strategy.

    Science.gov (United States)

    Kaehrle, P A

    2000-06-01

    Strategic planning and business plan development are essential nursing management skills in today's competitive, fast paced, continually changing health care environment. Even in times of great uncertainty, nurse managers need to plan and forecast for the future. A well-written business plan allows nurse managers to communicate their expertise and proactively contribute to the programmatic decisions and changes occurring within their patient population or service area. This article presents the use of planning documents as a practical, strategic business planning strategy. Although the model addresses orthopedic services specifically, nurse managers can gain an understanding and working knowledge of planning concepts that can be applied to all patient populations.

  12. GETDB: 104236 [GETDB

    Lifescience Database Archive (English)

    Full Text Available : 104236 InR E2f 2552 3 FlyBase Insertion: P{GawB}NP2552 Rebalanced. Genotype: w[*]; P{Gaw} / TM6B. NP line....04236 Related Genes InR E2f Original Number 2552 Chr. 3 Comments FlyBase Insertion: P{GawB}NP2552 Rebalanced

  13. Validation of the CoaguChek XS international normalised ratio point ...

    African Journals Online (AJOL)

    laboratory automated coagulation analysers up to INR values of. 3.0. ... To evaluate the clinical utility of the CoaguChek XS for monitoring of patients on standard warfarin therapy (INR 2 - 3) as well .... quality control system with satisfactory.

  14. Failure mode and effect analysis experimental reliability determination for the CANDU reactor equipment

    International Nuclear Information System (INIS)

    Vieru, G.

    1996-01-01

    This paper describes the experimental tests performed in order to prove the reliability parameters for certain equipment manufactured in INR Pitesti, for NPP Cernavoda. The tests were provided by Technical Specifications and test procedures. A comparison, referring to the reliability parameters, between Canadian equipment and INR manufactured equipment ones is also given. The results of tests and conclusions are shown. (author)

  15. Fixed Versus Variable Dosing of Prothrombin Complex Concentrate in Vitamin K Antagonist-Related Intracranial Hemorrhage : A Retrospective Analysis

    NARCIS (Netherlands)

    Abdoellakhan, Rahat Amadkhan; Miah, Ishita Parveen; Khorsand, Nakisa; Meijer, Karina; Jellema, Korne

    Millions of patients receive vitamin K antagonist (VKA) therapy worldwide. Annually 0.2-1 % of all VKA users develops an intracranial hemorrhage (ICH). Prothrombin complex concentrate (PCC) is administered to restore the INR In a before and after design, we compared successful achievement of an INR

  16. Monitoring Oral Anticoagulant Therapy: Measuring Coagulant Activity

    DEFF Research Database (Denmark)

    Attermann, Jorn

    substudy we investigated the fundamental assumptions of the INR system. We found that the data from the comparison of three thromboplastin preparations (CRM 149S, Nycotest and Hepato Quick) were consistent with these assumptions and concluded that the INR system is valid for these thromboplastins...

  17. Sadhana | Indian Academy of Sciences

    Indian Academy of Science