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Abbenbroek, Brett, Christine Duffield, and Doug Elliott. "Selection of an instrument to evaluate the organizational environment of nurses working in intensive care: an integrative review." Journal of Hospital Administration 3, no. 6 (October 31, 2014): 143. http://dx.doi.org/10.5430/jha.v3n6p143.
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Objective: To determine an appropriate survey instrument to evaluate the impact of organizational structures on the work environment of intensive care nurses. Background: Internationally the demand for intensive care is increasing. Solely increasing bed capacity is not sustainable. Large capacity multi-specialty Intensive Care Units are emerging as the preferred organizational model with benefits resulting from optimizing operational synergies and economies of scale. The impact of this organizational transition on intensive care nurses is not well understood. An appropriate survey instrument for intensive care nurses is required. Design: Integrative literature review. Data Sources: CINAHL, PubMed, EMBASE and OVID Nursing databases searched for studies published between 2005 and 2013. Review methods: An integrative review and quality assessment of the studies was undertaken to select nurse outcome measures associated with organizational structures across a range of acute and critical care settings. Congruence between nurse outcome measures and nurse survey instruments tested in the literature was assessed to select instruments for further psychometric evaluation. Results: Thirty-one cross sectional quantitative studies, from fourteen countries, were reviewed. Twenty one nurse outcome measures associated with organizational factors were identified and a total of twenty five survey instruments used in the studies reviewed. Assessment of congruence and psychometric properties determined that a combination of two instruments is required to comprehensively assess the organizational environment of nurses working in intensive care units. Conclusion: The environment of nurses working in intensive care is effectively evaluated with an instrument that combines subscales from the Practice Environment Scale-Nurse Work Index and Maslach’s Burnout Inventory.
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van der Mark, Carmen J. E. M., Hester Vermeulen, Paul H. J. Hendriks, and Catharina J. van Oostveen. "Measuring perceived adequacy of staffing to incorporate nurses’ judgement into hospital capacity management: a scoping review." BMJ Open 11, no. 4 (April 2021): e045245. http://dx.doi.org/10.1136/bmjopen-2020-045245.
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BackgroundMatching demand and supply in nursing work continues to generate debate. Current approaches focus on objective measures, such as nurses per occupied bed or patient classification. However, staff numbers do not tell the whole staffing story. The subjective measure of nurses’ perceived adequacy of staffing (PAS) has the potential to enhance nurse staffing methods in a way that goes beyond traditional workload measurement or workforce planning methods.ObjectivesTo detect outcomes associated with nurses’ PAS and the factors that influence PAS and to review the psychometric properties of instruments used to measure PAS in a hospital setting.Design and methodsA scoping review was performed to identify outcomes associated with PAS, factors influencing PAS and instruments measuring PAS. A search of PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Business Source Complete and Embase databases identified 2609 potentially relevant articles. Data were independently extracted, analysed and synthesised. The quality of studies describing influencing factors or outcomes of PAS and psychometric properties of instruments measuring PAS were assessed following the National Institute for Health and Care Excellence quality appraisal checklist and the COnsensus-based Standards for the selection of health Measurement INstruments guidelines.ResultsSixty-three studies were included, describing 60 outcomes of PAS, 79 factors influencing PAS and 21 instruments measuring PAS. In general, positive PAS was related to positive outcomes for the patient, nurse and organisation, supporting the relevance of PAS as a staffing measure. We identified a variety of factors that influence PAS, including demand for care, nurse supply and organisation of care delivery. Associations between these factors and PAS were inconsistent. The quality of studies investigating the development and evaluation of instruments measuring PAS was moderate.ConclusionsMeasuring the PAS may enhance nurse staffing methods in a hospital setting. Further work is needed to refine and psychometrically evaluate instruments for measuring PAS.
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Manojlovich, Milisa, Cathy L. Antonakos, and David L. Ronis. "Intensive Care Units, Communication Between Nurses and Physicians, and Patients’ Outcomes." American Journal of Critical Care 18, no. 1 (January 1, 2009): 21–30. http://dx.doi.org/10.4037/ajcc2009353.
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Background Various factors in hospitals can adversely affect patients’ outcomes, including faulty communication between nurses and physicians. Whether specific communication elements (timeliness, accuracy, openness, understanding) can influence adverse outcomes is unknown. Objectives To determine the relationships between patients’ outcomes and (1) nurses’ perceptions of elements of communication between nurses and physicians and (2) characteristics of the practice environment. Methods A cross-sectional survey design was used. Information on ventilator-associated pneumonia, bloodstream infection associated with a central catheter, and pressure ulcers was collected from 25 intensive care units in southeastern Michigan. Simultaneously, 462 nurses in those units (response rate, 53.3%) were anonymously surveyed. The Conditions for Work Effectiveness Questionnaire-II and the Practice Environment Scale of the Nursing Work Index were used to measure characteristics of the practice environment. The Intensive Care Unit Nurse-Physician Questionnaire was used to measure communication between nurses and physicians. Statistical tests included correlation and multiple regression. Analyses were conducted at the unit level. Results Unit response rates varied from 6% to 100%. Together, variability in understanding communication and capacity utilization were predictive of 27% of the variance in ventilator-associated pneumonia. Timeliness of communication was inversely related to pressure ulcers (r= −0.38; P=.06), and workplace empowerment and scores on the Acute Physiology and Chronic Health Evaluation III were positive predictors of ventilator-associated pneumonia (R2=0.36; P=.005). Conclusions Not all elements of communication were related to the selected adverse outcomes. The connection between characteristics of the practice environment at the unit level and adverse outcomes remains elusive.
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Naughton, C., I. Ezhova, N. Hayes, and J. Fitzpatrick. "77 Developing and Testing An Education-Career Pathway in Healthcare for Older People (ECHO) to Promote Retention in Early-Career Gerontological Nurses." Age and Ageing 49, Supplement_1 (February 2020): i25—i26. http://dx.doi.org/10.1093/ageing/afz191.02.
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Abstract Background The NHS Long Term Plan (2019) sets specific targets for multidisciplinary services for frail older people over the next ten years. Delivery and sustainability is crucially dependant on the capability and capacity of gerontological nursing. High cost cities such as London experience high staff vacancy rates in acute care older adult services. Aim The study took a regional approach, working with NHS Trusts to develop a multicomponent intervention to increase retention and competencies of early career nurses working in gerontological services. The study examined the acceptability and feasibility of the intervention and tested a quasi-experiential evaluation design. Ethical approval was obtained from the University Ethics committee. Methods A co-design approach with stakeholders, early career nurses, educationalists and nurse managers, produced a multicomponent intervention: education module (masters level), gerontological competency booklet, external clinical learning opportunities, career coaching and mentorship delivered over a six-month period. The evaluation involved a mix-methods pre-post survey and focus group interviews. Results Twenty-nine early career nurses were recruited from five Trusts. The multicomponent intervention was well received, but there were difficulties facilitating external learning opportunities and providing career mentors. The primary outcome was intention to remain in gerontological nursing (measured using a point Likert scale). Pre-post the intervention this remained high (mean score 6 IQR 5-7), p=0.78. There was a significant increase in gerontological knowledge: at baseline the median score was 87 (IQR 81-102) compared to 107 (IQR 98-112) post-intervention, p=0.006. In focus groups participants identified three main mechanism of action for ECHO: building gerontological knowledge and skills; professional identity as older adult nurse; and networking to broaden horizons. Conclusions The study has demonstrated the potential of Trusts to work collaboratively with education providers to deliver a model of career-education pathway that may help attract and retain early career nurses to work in gerontology.
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Bula, Santa, Liana Deklava, Jelena Reste, and Inese Lusena-Ezera. "The presence of violence at work of health care personnel and their work ability." SHS Web of Conferences 51 (2018): 01013. http://dx.doi.org/10.1051/shsconf/20185101013.
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Proportion of health care workers of those who believe that the work in progress threatens their health and safety is higher than the average in other sectors. Workers in health care facilities are especially exposed to violence in the workplace [1]. The aim of the study was the evaluation of the presence of violence at work and determination of its effect on the working ability of health care sector workers. The study included the survey of 132 emergency department employees (doctors, physician assistants, nurses) from Kurzeme Region hospitals (Latvia). Questionnaire of violence in the workplace of the health care sector workers and the work ability index assessment questionnaire were used for the data collection. It was found that medical staff of health care establishments experience mostly verbal abuse (97%), less from physical attacks (36%), and intimidation/bullying (30%). The study found that medical personnel are aware of the changes implemented in the workplace (29%), there has been no change (33%), while the impact of changes implemented by medical staff at the workplace has not been experienced (47%). For personnel who have suffered from violence in the workplace, working capacity is generally lower than for the personnel that has not experienced violence in the workplace.
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Dammiano, Mariella, Sandra Scalorbi, Manuela De Rosa, Domenica Gazineo, and Paolo Chiari. "Comparing the capacity of nurses and nursing students in assessing patient problems during clinical internship: A descriptive comparative study." Journal of Nursing Education and Practice 9, no. 6 (February 28, 2019): 61. http://dx.doi.org/10.5430/jnep.v9n6p61.
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Objective: No studies were found in the literature which compared the capacity of nurses and nursing students to assess patient problems using the clinical cases followed during internship. Therefore, the aim of this study was to formulate a method for comparing these skills in cases followed during a practical clinical internship.Methods: The sample studied was made up of students of the degree course in nursing during their internship and by community nurses, both trained in using assessment. Each student identified a patient and carried out an assessment of the problems according to the functional patterns of M. Gordon; the nurses also simultaneously carried out the same activity without comparing their work with that of the students. A method was formulated for evaluating the correctness of the two evaluations.Results: The results relative to the assessment showed a percentage of correctness of 85.77% for the students and 91.28% for the nurses with a statistically significant difference (p = .027).Conclusions: The results obtained demonstrated that the students in the last year of their degree course in nursing had developed a good capacity of assessment during their internship in clinical practice in the community in line with the capacity of the nurses who taught them.
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Larsson, A., Anders Möller, Ingela Karlsson, Marie Stolz-löfgren, Gösta Pettersson, Eva Berglin William-Olsson, and Peter A. Shapiro. "Toward a Model for Quality Assessment in Heart Transplantation." International Journal of Technology Assessment in Health Care 10, no. 2 (1994): 305–11. http://dx.doi.org/10.1017/s0266462300006267.
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AbstractA model for quality assessment of heart transplantation that combines a scientific method for studying the recipients' quality of life and a basis for a method of clinical work by nurses and other health care professionals is discussed. Besides its use as a research method, this model also may serve as an instrument for documenting patients' biopsychosocial status, including coping capacity, and for evaluating nursing interventions.
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Peter, Eleanor. "Evaluating the impact of nurse practitioner involvement in a pleural procedures clinic." British Journal of Nursing 29, no. 14 (July 23, 2020): 816–20. http://dx.doi.org/10.12968/bjon.2020.29.14.816.
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Background: Pleural disease incidence is increasing and there has been a move towards outpatient management. Pleural clinics have been developed for patients to be assessed and have pleural procedures for diagnostic and symptomatic purposes. Aim: The study aimed to assess the impact of nurse practitioner (NP) involvement in a pleural procedures clinic on clinic capacity, and staff and patient experience. Methods: A mixed-methods service evaluation was completed in a medium-sized general hospital. The number of patients seen in clinic over a 6-month period at the beginning of NP involvement was compared with the number of patients seen 1 year later. Semi-structured interviews of key staff stakeholders were conducted. Findings: Clinic capacity increased from 4.57 to 5.86 patients per list. NP involvement increased access, improved patient care, reduced work burden for other staff and improved educational opportunities. Conclusion: The impact of NP involvement in the pleural clinic was seen as positive and increased clinic capacity. The same model of practice could be considered elsewhere.
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Nwogbe, Olayemi A., and Yacob Haliso. "Continuing Professional Development Assessment of Healthcare Professionals in Public Secondary Hospitals in Lagos State, Nigeria." Information Impact: Journal of Information and Knowledge Management 11, no. 1 (April 30, 2020): 26–39. http://dx.doi.org/10.4314/iijikm.v11i1.3.
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This study investigates the engagement of healthcare professionals in continuing professional development in public secondary hospitals in Lagos State, Nigeria. A survey research design and a multistage sampling technique were adopted for the study. The sample consisted of 356 healthcare professionals (112 physicians, 32 pharmacists and 212 nurses). The data were collected using a self-developed structured questionnaire. The questions were built based on the literature review with modified questions adapted from widely used the questionnaires on hospital survey on patient safety, ambulatory and community pharmacy, nursing safety practices and CPD professional and skill competency and World Health Organization Regional Guidelines for Continuing Medical Education. Healthcare professionals in adult general outpatient departments were only included in the study. Findings revealed that physicians engagement in informal CPD (conferences, seminars, in-service training) is (M = 3.09), and formal CPD (conduct of research, publications or peer journal review) (M = 2.11). Pharmacists engagement in informal CPD is (M = 3.10) and formal CPD (M =1.89), Nurses’ engagement in informal CPD is (M =2.30) and CPD (M = 1.78). These evidence indicates that the respondents tend to lean more on less time-demanding and work-based capacity building approach, than they engaged mostly in informal CPD activities than they engaged in a methodical educational and professional advanced method of capacity building. The study recommends improved Government funding for training, policy improvement on organizational support and working conditions for study leave opportunities, and aligning the metrics of evaluating and scoring CPD engagement with the need assessment gaps in healthcare system in renewing practicing license of healthcare professionals.
Keywords: Capacity building, Healthcare professionals Public healthcare service, Health workers training
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Novak Lauscher, H., E. Stacy, J. Christenson, B. Clifford, F. Flood, D. Horvat, R. Markham, J. Pawlovich, P. Rowe, and K. Ho. "MP34: Evaluation of real-time virtual support for rural emergency care." CJEM 20, S1 (May 2018): S53. http://dx.doi.org/10.1017/cem.2018.188.
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Introduction: In many rural and remote communities in BC, family physicians who are providing excellent primary and emergency care would like to access useful, timely, and collegial support to ensure the highest quality of health services for their patients. We undertook a real-time virtual support project in Robson Valley, located in northern BC, to evaluate the use of digital technologies such as videoconferencing for on demand consultation between family physicians at rural sites and emergency physicians at a regional site. Telehealth consults also occurred between rural sites with nurses at community emergency rooms consulting with local on-call physicians. Our aim was to use telehealth to facilitate timely access to high quality, comprehensive, coordinated team-based care. An evaluation framework, based on the Triple Aim sought to: 1) Identify telehealth use cases and assess impact on patient outcomes, patient and health professional experience, and cost of health care delivery; and 2) Assess the role of relationships among care team members in progressing from uptake to normalization of telehealth into routine usage. Methods: Using a participatory approach, all members of the pilot project were involved in shaping the pilot including the co-development of the evaluation itself. Evaluation was used iteratively throughout implementation for ongoing quality improvement via regular team meetings, sharing and reflecting on findings, and adjusting processes as required. Mixed methods were used including: interviews with family physicians, nurses, and patients at rural sites, and emergency physicians at regional site; review of records such as technology use statistics; and stakeholder focus groups. Results: From November 2016 to July 2017, 26 cases of telehealth use were captured and evaluated. Findings indicate that telehealth has positively impacted care team, patients, and health system. Benefits for care team at the rural sites included confidence in diagnoses through timely access to advice and support, while emergency physicians at the regional site gained deeper understanding of the practice settings of rural colleagues. Nevertheless, telehealth has complicated the emergency department work flow and increased physician workload. Findings demonstrated efficiencies for the health system, including reducing the need for patient transfer. Patients expressed confidence in the physicians and telehealth system; by receiving care closer to home, they experienced personal cost savings. Implementation saw a move away from scheduled telehealth visits to real use of technology for timely access. Conclusion: Evidence of the benefits of telehealth in emergency settings is needed to support stakeholder engagement to address issues of workflow and capacity. This pilot has early indications of significant local impact and will inform the expansion of emergency telehealth in all emergency settings in BC.
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Bashkin, Osnat, Keren Dopelt, Zohar Mor, Lore Leighton, Robert Otok, Mariusz Duplaga, Fiona MacLeod, et al. "The Future Public Health Workforce in a Changing World: A Conceptual Framework for a European–Israeli Knowledge Transfer Project." International Journal of Environmental Research and Public Health 18, no. 17 (September 2, 2021): 9265. http://dx.doi.org/10.3390/ijerph18179265.
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Health services quality and sustainability rely mainly on a qualified workforce. Adequately trained public health personnel protect and promote health, avert health disparities, and allow rapid response to health emergencies. Evaluations of the healthcare workforce typically focus on physicians and nurses in curative medical venues. Few have evaluated public health workforce capacity building or sought to identify gaps between the academic training of public health employees and the needs of the healthcare organizations in which they are employed. This project report describes the conceptual framework of “Sharing European Educational Experience in Public Health for Israel (SEEEPHI): harmonization, employability, leadership, and outreach”—a multinational Erasmus+ Capacity Building in Higher Education funded project. By sharing European educational experience and knowledge, the project aims to enhance professionalism and strengthen leadership aspects of the public health workforce in Israel to meet the needs of employers and the country. The project’s work packages, each jointly led by an Israeli and European institution, include field qualification analysis, mapping public health academic training programs, workforce adaptation, and building leadership capacity. In the era of global health changes, it is crucial to assess the capacity building of a well-qualified and competent workforce that enables providing good health services, reaching out to minorities, preventing health inequalities, and confronting emerging health challenges. We anticipate that the methods developed and the lessons learned within the Israeli context will be adaptable and adoptable by other countries through local and cultural adjustments.
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Maidment, Ian. "MEMORABLE: MEdication Management in Older people: Realist Approaches Based on Literature and Evaluation." British Journal of General Practice 69, suppl 1 (June 2019): bjgp19X703325. http://dx.doi.org/10.3399/bjgp19x703325.
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BackgroundOlder people are major users of medication. As people get age, the balance between benefits and harms for medication changes. Medication management by healthcare practitioners (for example, pharmacists, doctors, and nurses) is designed to help older people take the appropriate medication. Current evidence indicates that medication management is a complex process that is not easy to do well.AimThe aim of MEMORABLE, funded by the NIHR, is to understand how medication management works and how it might be implemented effectively.MethodMEMORABLE uses realism to understand how, why, for whom, and in what circumstances medicines management works. Realism is a theory-driven approach using primary and secondary data to make sense of complex interventions (for example medicines management), where outcomes are context sensitive. This is the first-time worldwide that realism has been used for this long-standing problem. MEMORABLE uses the literature (secondary data) and interviews (primary data). Data will be synthesised across datasets to set out and refine programme theories, about how medication management works, and develop a framework to improve practice.ResultsThree candidate programme theories (older people, informal carers, and practitioners) were identified from the literature and interviews. These programme theories will be explored against a 5-stage medication management process, conceived as a framework for analysis of the data. Emerging mechanisms of interest, burden, capacity, and needs/concerns are being explored.ConclusionMEMORABLE, which ended in December 2018, is using an innovative methodology, applied collaboratively, to develop an outcome-focused, evidence-based framework enhance medication management.
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Flynn, Rachel, and Dawn Hartfield. "An evaluation of a frontline led quality improvement initiative." Leadership in Health Services 29, no. 4 (October 3, 2016): 402–14. http://dx.doi.org/10.1108/lhs-11-2015-0039.
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Purpose The Edmonton Zone, one of five Zones in Alberta Health Services (the health system in the province of Alberta, Canada), established a quality management framework (QMF) as a means to improve the delivery of high quality health care in the spring of 2014. The purpose of this research study was to understand the factors that facilitated or hindered the implementation of a quality improvement (QI) initiative for hand hygiene led by a newly formed frontline unit quality council (UQC), a part of the QMF, based out of the pediatric intensive care unit (PICU) at the Stollery Children’s Hospital in the Edmonton Zone. This research will provide an understanding of the newly established QMF in the Edmonton Zone and the factors needed to foster the ongoing development of frontline UQC that do improvement work as part of their daily routine. Design/methodology/approach Using a qualitative case study research design data were collected using semi-structured open-ended interviews with six key stakeholders (one registered nurse, one physician, one patient case manager, medical director for QI, clinical QI consultant and director of clinical QI) involved in UQC at the PICU. Findings Individual, unit and organizational level factors were identified as influencing the function of the UQC. Leadership and work culture were the key facilitating factors to success and lack of QI training and personnel/dedicated time were perceived barriers to completing the QI initiative. Originality/value The findings from this research illustrate that frontline UQC are able to impact positive sustained change early in their establishment as part of a larger QMF. It is important, however, for the system to foster ongoing development of capacity and capability of these frontline UQC to ensure sustained success of the larger systems change.
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Michaels, Jessica, Dariusz Olszyna, Frank Ng, Cheng Chuan Lee, and Sophia Archuleta. "1326. Inter-Professional Education and Training to Build Capacity Among Healthcare Workers in Singapore." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S405. http://dx.doi.org/10.1093/ofid/ofy210.1159.
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Abstract Background People Living with HIV (PLHIV) in Singapore continue to face stigma and confidentiality concerns in their interactions with Healthcare Workers (HCWs). There is a recognized gap in HIV-related knowledge and lack of training opportunities for HCWs in Singapore, particularly amongst nonphysicians and other HCWs who do not regularly care for PLHIV. The HCW HIV Education Series was conceptualized to address these issues and to improve the HIV-related knowledge, attitudes and practices of HCWs in Singapore. Methods The HCW HIV Education Series is organized by an interprofessional organizing committee. The series is made up of four half day modules which are conducted quarterly. The modules are designed and implemented to cater to as many HCWs as possible. The modules function as a series but can also be run as standalone education sessions. The modules are: HIV Basics, Working with PLHIV, Basic HIV Clinical Care and Advanced HIV Clinical Care. In its pilot year (2016–2017), 334 HCWs, predominantly nurses, pharmacists, and social workers attended the series. The HCWs attended from diverse healthcare settings, including public and private hospitals, nursing homes, faith based and community organizations. Pre- and post-module evaluations were completed by participants. Results Only 5% of Module 1 attendees had previously received training in HIV. Across all four modules, there was a marked improvement in knowledge and confidence pre- and post-training. 95% of attendees across all modules felt that they had gained new skills that would add value to their work. While 97% of attendees of Module 1 planned to attend future modules, the attrition rate between modules was high. Conclusion The HCW HIV Education Series is highly evaluated and well attended. Efforts to maintain and strengthen attendance across all modules is needed, the delivery of the modules over a 2-day period may be an effective way to achieve this. Research into the experiences of PLHIV in healthcare facilities should also be considered. Disclosures All authors: No reported disclosures.
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Chetty, Laran. "Calling on the Client’s Perceptions About the Contributions of Physiotherapists Working in Occupational Health Services." Journal of Patient Experience 7, no. 2 (February 22, 2019): 155–59. http://dx.doi.org/10.1177/2374373519831447.
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Background: Clients are the recipients of occupational health care. To date, little is known about the perceptions of clients about the contribution of physiotherapists working in occupational health services. Gathering this information is imperative to understanding and responding to clients’ needs. Methods: An interpretative qualitative study was undertaken and face-to-face interviews were conducted with clients from 2 occupational health services situated within the National Health Service in the United Kingdom. Data were tape-recorded and transcribed verbatim in full. Data were analyzed using thematic analysis. Results: There were 9 clients interviewed, predominantly comprising secretaries, staff nurses, and care assistants. Thematic analysis revealed 2 main themes: vocational rehabilitation and health promotion. Clients revealed distinct subcomponents of the contribution of physiotherapists in occupational health services such as functional capacity evaluations, job demand analysis, and work-specific rehabilitation. Promoting staff health was another pertinent issue reported by clients. Conclusions: Clients clearly felt that physiotherapists made a contribution to occupational health services. This information lays the groundwork for the development of physiotherapists within occupational health services, which in turn will help clients achieve better care and health outcomes.
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Swain, Swagatika Priyadarsini, Kripalini Patel, Subrata Kumar Palo, Bijaya Mishra, and Sanghamitra Pati. "A conceptual framework on health professionals' engagement towards pharmacovigilance: a qualitative exploration." International Journal of Basic & Clinical Pharmacology 10, no. 9 (August 24, 2021): 1087. http://dx.doi.org/10.18203/2319-2003.ijbcp20213361.
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Background: With the growing reliance on drug therapy in the recent era, the safety of medications is one of the vital parameters for the success of any medicine. Considering this, pharmacovigilance (PV) was developed to provide adequate identification, reporting, evaluation, and understanding of adverse drug reactions (ADR). The objective of this study was to understand the opinion of health care providers on PV, the current reporting mechanisms, identifying the causes for underreporting, and the existing process in clinical practice.Methods: A qualitative study using pretested interview guide was conducted among 20 different cadres of healthcare personnel (doctors, pharmacists, and staff nurses) from various hospitals such as government, private, corporate, and medical college of Odisha state. The data were analysed using a thematic analysis. The meaning units have been identified from the transcript and coded with MAXQDA software (MAXQDA Analytics Pro 2020, VERBI GmbH Berlin).Results: Participants showed a lack of awareness regarding the concept of PV. A cluster of challenges such as lack of ADR monitoring, non-conducive work atmosphere and lack of cooperation between staff, lack of knowledge among the health professionals, and fear of legal liability as major pitfalls causing poor ADR reporting. To enhance the pharmacovigilance practice, participants suggested context-specific strategies such as IEC activities, innovative ideas to improve ADR monitoring, regular monitoring.Conclusions: Capacity building through training, regular monitoring and supervision to strengthen the pharmacovigilance practices is the current need in India.
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Beacon, Angela. "Practice-integrated care teams – learning for a better future." Journal of Integrated Care 23, no. 2 (April 20, 2015): 74–87. http://dx.doi.org/10.1108/jica-01-2015-0005.
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Purpose – The purpose of this paper is to present a case study of one element of the integrated work which has taken place in Central Manchester, the development of multi-disciplinary Practice-Integrated Care Teams (PICT). The paper will show how working together has become a practical reality for members of these teams, and is forming the building blocks for further integration across neighbourhoods. Design/methodology/approach – This paper draws on the author’s experience of working in the PICT project from 2012 to 2014. The report will draw on the evaluation work which took place during the project, and will include reflections from others involved in the project and members of the teams. Findings – The integrated care teams which have been developed in Central Manchester have started to make significant changes to the ways that professionals work together, to the experience that patients have and to the costs of urgent care provision. Whilst there is still a long way to go, there has been significant learning from the PICT. This includes improved patient outcomes and experience. There has been an overall reduction in secondary care activity for patients the teams have been working with, with the largest reduction being in emergency admissions. Alongside this, patient feedback has reinforced the value of this personalised approach and increased overall satisfaction with the care and advice received from health and social care professionals and an improved professional experience. Evaluation has demonstrated that amongst professionals involved in the team there is a strong commitment to the principles of integrated care and that the confidence, skills and capacity of the teams have strengthened since this way of working has been introduced. As monitoring of financial impact continues to develop, cost savings from secondary care, particularly around emergency unplanned care, are encouraging. Originality/value – This paper draws on the recent experience of designing and delivering integrated care across a range of multi-agency, multi-professional partners. The model which has been developed centres around the role of general practice, and has enabled primary care to take a key role in the development of an out-of-hospital integrated care system. This has enabled community professionals such as nurses and social workers to build a much stronger relationship with general practice and enable system linkages which will be essential to the delivery of joined-up health and social care in the future. The project has been accompanied by thorough and ongoing evaluation to support the validity of the learnings which have been reported.
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Moffatt, Fiona, Rob Goodwin, and Paul Hendrick. "Physiotherapy-as-first-point-of-contact-service for patients with musculoskeletal complaints: understanding the challenges of implementation." Primary Health Care Research & Development 19, no. 02 (September 12, 2017): 121–30. http://dx.doi.org/10.1017/s1463423617000615.
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Background Primary care faces unprecedented challenges. A move towards a more comprehensive, multi-disciplinary service delivery model has been proposed as a means with which to secure more sustainable services for the future. One seemingly promising response has been the implementation of physiotherapy self-referral schemes, however there is a significant gap in the literature regarding implementation. Aim This evaluation aimed to explore how the professionals and practice staff involved in the delivery of an in-practice physiotherapy self-referral scheme understood the service, with a focus on perceptions of value, barriers and impact. Design and setting A qualitative evaluation was conducted across two UK city centre practices that had elected to participate in a pilot self-referral scheme offering ‘physiotherapy-as-a-first-point-of-contact’ for patients presenting with a musculoskeletal complaint. Methods Individual and focus group interviews were conducted amongst participating physiotherapists, administration/reception staff, general practitioners (GPs) and one practice nurse (in their capacity as practice partner). Interview data were collected from a total of 14 individuals. Data were analysed using thematic analysis. Results Three key themes were highlighted by this evaluation. First, the imperative of effecting a cultural change – including management of patient expectation with particular reference to the belief that GPs represented the ‘legitimate choice’, re-visioning contemporary primary care as a genuine team approach, and the physiotherapists’ reconceptualisation of their role and practices. Second, the impact of the service on working practice across all stakeholders – specifically re-distribution of work to ‘unburden’ the GP, and the critical role of administration staff. Finally, beliefs regarding the nature and benefits of physiotherapeutic musculoskeletal expertise – fears regarding physiotherapists’ ability to work autonomously or identify ‘red flags’ were unfounded. Conclusion This qualitative evaluation draws on the themes to propose five key lessons which may be significant in predicting the success of implementing physiotherapy self-referral schemes.
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Bjegovich-Weidman, Marija, Jill Kahabka, Amy Bock, Jacob Frick, Helga Kowalski, and Joseph Mirro. "Development by a Large Integrated Health Care System of an Objective Methodology for Evaluation of Medical Oncology Service Sites." Journal of Oncology Practice 8, no. 2 (March 2012): 70. http://dx.doi.org/10.1200/jop.2011.000425.
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Purpose: Aurora Health Care (AHC) is the largest health care system in Wisconsin, with 14 acute care hospitals. In early 2010, a group of 18 medical oncologists became affiliated with AHC. This affiliation added 13 medical oncology infusion clinics to our existing 12 sites. In the era of health care reform and declining reimbursement, we need an objective method and criteria to evaluate our 25 outpatient medical oncology sites. We developed financial, clinical, and strategic tools for the evaluation and management of our cancer subservice lines and outpatient sites. The key to our success has been the direct involvement of stakeholders with a vested interest in the services in the selection of the criteria and evaluation process. Methods: We developed our objective metrics for evaluation based on strategic, financial, operational, and patient experience criteria. Strategic criteria included: population trends, full-time equivalent (FTE) medical oncologists/primary care physicians, FTE radiation oncologists, FTE oncologic surgeons, new annual cases of patients with cancer, and market share trends. Financial criteria per site included: physician work relative value units, staff FTE by type, staff salaries, and profit and loss. Operational criteria included: facility by type (clinic v hospital based), hours of operation, and facility detail (eg, No. of chairs, No. of procedure and examination rooms, square footage). Patient experience criteria included: nursing model primary/nurse navigators, multidisciplinary support at site, Press Ganey (South Bend, IN; health care performance improvement company) results, and employee engagement score. Results: The outcome of our data analysis has resulted in the development of recommendations for AHC senior leadership and geographic market leadership to consider the consolidation of four sites (phase one, four sites; phase two, two sites) and priority strategic sites to address capacity issues that limit growth. The recommendations if implemented would result in significant cost savings, currently being quantified as a result of consolidation and improved efficiency. A reinvestment of these cost savings would be required to address facility expansion and program enhancement to maximize patient-centered expert care consistently across all of our remaining sites of service.
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Matheson, Leonard N., Vert Mooney, Janet E. Grant, Scott Leggett, and Kevin Kenny. "Standardized evaluation of work capacity." Journal of Back and Musculoskeletal Rehabilitation 6, no. 3 (May 1, 1996): 249–64. http://dx.doi.org/10.3233/bmr-1996-6306.
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Hilleshein, Eunice Fabiani, and Liana Lautert. "Work capacity, sociodemographic and work characteristics of nurses at a university hospital." Revista Latino-Americana de Enfermagem 20, no. 3 (June 2012): 520–27. http://dx.doi.org/10.1590/s0104-11692012000300013.
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This cross-sectional study evaluated the work capacity of 195 nurses at a university hospital, from a calculation of sample size with a Confidence Interval (CI) of 95%. The data was collected by means of the Work Capacity Index (WCI) instrument and analyzed by statistical analysis. 94.5% of the sample was made up of women; the average age was of 42.6 years (sd=8.5); 66.5% had partners and 76.7% were educated to post-graduate level. 36.0% worked the night shift; 28.4% the morning shift and 20.8% the afternoon shift. The average score given to work capacity was Good (41.8 points) and there was a significant correlation with pay (p-value<0.05), satisfaction with workplace (p-value=0.001) and feeling valued by the institution (p-value=0.003). The group which carried out family activities showed higher scores in the WCI compared to those who did not (p-value=0.009). The nurses presented differing sociodemographic and work aspects, with a high capacity for work.
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Ohkubo, T., M. Ogasawara, and S. Saito. "An evaluation on work load of nurses." Japanese journal of ergonomics 25, Supplement (1989): 132–33. http://dx.doi.org/10.5100/jje.25.supplement_132.
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Saito, S., and T. Ohkubo. "An evaluation of work load on nurses." Japanese journal of ergonomics 26, Supplement (1990): 178–79. http://dx.doi.org/10.5100/jje.26.supplement_178.
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Monteiro, Maria Silvia, Neusa Maria Costa Alexandre, Daniela Milani, and Fernanda Fujimura. "Work capacity evaluation among nursing aides." Revista da Escola de Enfermagem da USP 45, no. 5 (October 2011): 1177–82. http://dx.doi.org/10.1590/s0080-62342011000500021.
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Work force aging generates the need to develop studied with the purpose to evaluate work capacity. The objective of this study was to analyze the work capacity of the nursing aides of a public health institute. A cross-sectional study was developed on the work capacity of these professionals regarding their demographic, work and lifestyle characteristics (n=241). A univariate logistic regression analysis was performed with inadequate work capacity (score below 37) as the dependent variable. There was an association with age (the eldest), work time at the institution (the oldest), body mass index (obesity) and item 1 of the work capacities index: present work capacity. This information can be used to create preventive measures and restore work capacity.
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Jahn, Warren T., Leanne N. Cupon, and John H. Steinbaugh. "Functional and work capacity evaluation issues." Journal of Chiropractic Medicine 3, no. 1 (December 2004): 1–5. http://dx.doi.org/10.1016/s0899-3467(07)60059-7.
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Negeliskii, Christian, and Liana Lautert. "Occupational stress and work capacity of nurses of a hospital group." Revista Latino-Americana de Enfermagem 19, no. 3 (June 2011): 606–13. http://dx.doi.org/10.1590/s0104-11692011000300021.
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The study aimed to evaluate the relationship between occupational stress and the work capacity index of 368 nurses (82.1% of the population) of a Hospital Group. A questionnaire with socio-occupational questions was used as well as two scales: the Job Stress Scale and the Work Capacity Index. The group of nurses was predominantly female (93.2%), worked in care activities (63.9%), had undertaken at least one Postgraduate course (76%) and were satisfied with the unit where they worked (70.5%). Occupational stress was present in 23.6% of the nurses, of these 15.2% presented High Strain work and 8.4% Passive Work. Social Support exercised a significant positive influence on all groups - exposed or not to occupational stress. Regarding the Work Capacity, this was Moderate (28-36 points) for 51.4% of the nurses and Good (37-43 points) for 47.4%. There was no correlation between stress and work capacity.
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Mitchell, Marion, Benjamin Mackie, Leanne M. Aitken, and Loretta C. McKinnon. "Evaluation of an Australian nursing partnership to improve disaster response capacity." Disaster Prevention and Management 23, no. 5 (October 28, 2014): 524–32. http://dx.doi.org/10.1108/dpm-04-2014-0069.
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Purpose – The purpose of this paper is to evaluate a partnership with specialized nurses from geographically disparate hospitals to provide critical support in national disasters. Design/methodology/approach – The Australian Government established the National Critical Care Trauma Response Centre (NCCTRC) within Royal Darwin Hospital (RDH). A partnership with the Princess Alexandra Hospital (PAH) occurred to support RDH during national disasters. PAH nurses undertook two-week rotations to RDH in readiness for deployment. PAH, NCCTRC and RDH nurses’ perceptions of the efficacy of the nurse rotations were explored in surveys and focus groups. Findings – PAH nurses felt they were well equipped for practice in RDH and the partnership developed professional reciprocity with the PAH nurses feeling respected, valued and part of the RDH team. This finding of adequate preparation and effective integration was consistent with the perceptions of senior staff from the participating organizations. Originality/value – This unique partnership created a well-prepared team to provide support in a national disaster.
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Suaib, Suaib, Syahrul Syahrul, and Takdir Tahir. "Nurses' Quality of Work Life." Journal of Health Science and Prevention 3, no. 3S (December 5, 2019): 63–66. http://dx.doi.org/10.29080/jhsp.v3i3s.292.
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The nurse is a professional who has the ability, responsibility, and authority incarrying out nursing services/care at various levels of nursing services whose lives are fully influenced by the quality of work life (QWL) as a consequence of a dynamic change in the work environment. Therefore in order to increase the capacity of nurses in meeting the quality of health services, it is necessary to research the Quality of Work Life. The purpose of the literature study was to identify the nurses’ quality of work life in supporting the improvement of the quality of health services. The database used in the making of this literature review is Pubmed, Science Diret, and Google Scholar published in 2012-2018. There are 6 articles that meet the criteria with the results showing that the fulfillment of QWL nurses can affect organizational commitment, job satisfaction, and turnover. Fulfillment of nurses’ QWL is important to do, where if the nurses’ QWL is fulfilled, it provides many benefits to the nurse and has a direct impact on the health services provided so that organizational attention is needed because QWL is seen as capable of increasing the participation of workers in the organization. The increase in QWL in the hospital can improve the professionalism of nurses and influence the effectiveness and organization productivity.
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Gardner, Annette L., and Peter Bishop. "Expanding Foresight Evaluation Capacity." World Futures Review 11, no. 4 (August 9, 2019): 287–91. http://dx.doi.org/10.1177/1946756719866271.
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The subject of evaluating foresight work has been around for almost as long as the professional practice itself has, but the field has done little to move closer to a systematic evaluation of its work. This special issue marks the second collection of articles on that project after a special issue of Futures in 2012 (Van Der Duin and Van Der Martin 2012). This issue takes a three-part approach: Part 1: evaluation of foresight in general and evaluation approaches and methods that can support designing an appropriate evaluation; Part 2: evaluation of foresight work in organizations and its impact on long-term thinking and decision-making; and Part 3: evaluation of specific foresight activities—an undergraduate learner foresight experience and a health sector scenario development exercise. The foreword ends with a reflection on the continuing issue of foresight and evaluation.
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Herbin, Mary L. "Work capacity evaluation for occupational hand injuries." Journal of Hand Surgery 12, no. 5 (September 1987): 958–61. http://dx.doi.org/10.1016/s0363-5023(87)80264-2.
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Cabal-Escandón, Victoria-Eugenia. "Developments and Challenges in Advanced Practice Nursing." Revista Colombiana de Enfermería 18, no. 2 (August 31, 2019): e007. http://dx.doi.org/10.18270/rce.v18i2.2663.
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Advanced Practice Nursing (APN) emerged as a response to the need for professionals capable of giving care to patients, thereby improving the quality of healthcare; the results obtained by implementing APNs in healthcare teams confirm that APNs can be implemented in the healthcare of patients of all ages and with varied health situations (1).
Levels of development in APN are very diverse in distinct countries, in the legal aspect as well as in the roles that a nurse with this level of training can fulfill. The International Council of Nurses (ICN) counts around seventy countries as being preoccupied with introducing clear function for APNs (20); nonetheless, literature describes the main progress in this sense occurring in Canada, Australia, Ireland, Finland, the United Kingdom, and the United States, although in the last ten years significant advances have been identifies in Belgium, Germany, Switzerland, Thailand, Singapore, Korea, and Africa (3, 4).
In Latin-American, progress in this initiative is embryonic: the role that a APN can fulfill has not been sufficiently disseminated and the implementation of this strategy has been limited by healthcare policies in many countries or by the opposition to APNs by professionals in other areas who are reacting to misinformation or to fear of usurpation of certain functions by APNs. However, in primary care, APNs have been incorporated into healthcare teams, and research shows positive results for the expansion of coverage and reduction of healthcare costs, in both rural areas and urban centers (1, 5).
Thanks to these advances, in 2000 the ICN supported the creation of the International Nurse Practitioner/Advanced Practice Nursing Network (INP/APNN) with the objective of favoring dialogue, advancing the installation of APNs in the countries, facilitating the interchange of knowledge, determining the limits in the expansion of the role of nurses, and defining the guidelines for the formation of human resources at this level. Likewise, the World Health Organization and the Pan-American Health Organization (PAHO) have worked with universities and nursing associations in Latin America and the Caribbean to, through context analyses, propose implementation of APNs (5).
During August 2018, the 10th Conference of the International Nursing Council convened in Rotterdam with the goal of exploring the role of APNs in the transformation of healthcare (6). With the participation of more than fifty countries, the council established a global panorama of the situation and of the challenges nursing faces as an active participant and agent for achieving universal health coverage. An important conclusion drawn from the event is the recognition given by all participating countries to APNs for allowing significant advancement of strategies for primary healthcare and the achievement of goals related with universal health coverage and sustainable development: the guarantee of a healthy life and the promotion of wellness for everyone at every age (4, 5).
These propositions imply a process and the need for countries to work towards the expansion of nursing roles, which requires the promotion of a collective project that unites different sectors involved in the formation of human talent, on one hand, that the offering of health services on the other. Likewise, administrators of education and health policy along with associations involved in the nursing discipline need to contribute to the analyses of strategies for implementing a sustainable and efficient health system that allows universal access to health (1, 4, 7).
In this context, APNs are understood to have undergone master or doctorate level training that develops scientific knowledge, clinical expertise, leadership, political formation, communicational capacity, and education for the patient, family, and community groups. Therefore, the professional is enabled to take ethical decisions, work autonomously, interact in intra- and interdisciplinary groups, and understand that ANP’s work will be determined by the unique environment, healthcare structure, and legislation of different countries.
In accord with Morán-Peña (8), the International Nursing Council states that APNs are characterized by an autonomous practice that allows the implementation of tools like: valuation, diagnostic reasoning, decision making for the handling of cases, plan development, implementation and evaluation of programs as part of consultation services, and being the first point of contact in the healthcare system. This implies that an ANP will have competencies to participate in the elaboration of public policy as well as on teams dedicated to care for individuals, families, groups, and communities in disease prevention, health promotion, treatment, recuperation, and palliative care (7, 9, 10).
Consequently, working on the implementation of the EPA can possibly lead to transformation of healthcare systems in the clinical area, improvement in the access to primary healthcare, and in the design and development of investigation projects whose results can be applied in practice; in short, it would affect the quality and effectiveness of healthcare at different levels and allow the urgent and much needed evolution of healthcare systems (11).
With this perspective, the fundamental question is whether sufficient political interest exist for the development of APN’s roles, the definition of APN’s limits, the adaption of the existing structure, the establishment of guidelines for educational programs, and the application of expert knowledge, among other aspects, in benefit of health coverage, healthcare quality, and the establishment of a sustainable healthcare system.
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Karlsson, Per-Åke, Elisabeth Beijer, Bengt Eriksson, and Tom Leissner. "Evaluation Workshops for Capacity Building in Welfare Work." Evaluation 14, no. 4 (October 2008): 483–98. http://dx.doi.org/10.1177/1356389008095489.
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Robles, Jane. "The Effect of the Electronic Medical Record on Nurses’ Work." Creative Nursing 15, no. 1 (February 2009): 31–35. http://dx.doi.org/10.1891/1078-4535.15.1.31.
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The electronic medical record (EMR) is a workplace reality for most nurses. Its advantages include a single consolidated record for each person; capacity for data interfaces and alerts; improved interdisciplinary communication; and evidence-based decision support. EMRs can add to work complexity, by forcing better documentation of previously unrecorded data and/or because of poor design. Well-designed and well-implemented computerized provider order entry (CPOE) systems can streamline nurses’ work. Generational differences in acceptance of and facility with EMRs can be addressed through open, healthy communication.
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Zulkosky, Julie, and Ann Harms. "Evidence Based Approach to Capacity Assessment for Hospitalized Patients." CNS Spectrums 26, no. 2 (April 2021): 150. http://dx.doi.org/10.1017/s1092852920002382.
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AbstractMedical decision-making capacity (MDMC) is inherent to the legal and ethical principles of respect for autonomy and is an essential element of informed consent. Qualitative and quantitative evidence to support a final decision of capacity should be the gold standard. General hospital policies and state laws mandate that a licensed provider make the final determination of capacity, but they do not specifically mandate who is responsible for those assessments. When a patient s decisional capacity fluctuates, the role of the nurse in a hospital setting is valuable because they have the most direct contact with the patient. Objective: Determine receptiveness of nursing staff to assessing capacity, to gather feedback on the Aid to Capacity Evaluation (ACE) tool, and to ascertain awareness of capacity by sixty nurses working on progressive care, trauma orthopedic, and medical/surgical units. Method: This project was completed at a Midwestern academic level I trauma center. Nurses on a medical/surgical, orthopedic trauma, and progressive care unit participated. Education about MDMC and the ACE tool were given to nurses verbally and in writing. They were asked to utilize the Aide to Capacity Evaluation (ACE) tool to assess patients whom they believed lacked decision-making capacity. After four weeks the nurses completed an evaluation. Results: Thirty nurses (50%) responded. Over 70% of those respondents used the tool at least once. 63% agreed that the format helped to systematically evaluate a patient and they found it easy to incorporate into practice. Overall, 73% of respondents would welcome more education about capacity. Conclusion: Given a standardized tool in conjunction with proper and continuous education, bedside nurses are in an optimal position to identify mental changes early, alert the provider so steps can be taken to optimize mental capacity, and assist with assessment of capacity with minimal disruption of care. Implementation of a tool such as the ACE can ensure accurate, reliable, and consistent assessments. Furthermore, providers would benefit from the extra time to gather information and complete focused assessments to make a determination of capacity with confidence.
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Soo Hoo, E. Randolph. "Evaluating Return-to-work Ability Using Functional Capacity Evaluation." Physical Medicine and Rehabilitation Clinics of North America 30, no. 3 (August 2019): 541–59. http://dx.doi.org/10.1016/j.pmr.2019.04.002.
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Bautista, John Robert, Sonny Rosenthal, Trisha Tsui-Chuan Lin, and Yin-Leng Theng. "Psychometric evaluation of the Smartphone for Clinical Work Scale to measure nurses’ use of smartphones for work purposes." Journal of the American Medical Informatics Association 25, no. 8 (May 17, 2018): 1018–25. http://dx.doi.org/10.1093/jamia/ocy044.
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Abstract Objective This study reports the development and psychometric evaluation of the Smartphone for Clinical Work Scale (SCWS) to measure nurses’ use of smartphones for work purposes. Methods Items were developed based on literature review and a preliminary study. After expert consultations and pilot testing, a 20-item scale was administered in January-June 2017 to 517 staff nurses from 19 tertiary-level general hospitals in Metro Manila, Philippines. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate construct validity. Structural equation modeling (SEM) was used to test the predictive validity of SCWS on perceived work productivity. Results EFA results show that 15 out of 20 items loaded on five factors: communication with clinicians via call and text, communication with doctors via instant messaging, information seeking, communication with nurses via instant messaging, and communication with patients via call and text. CFA results suggest that the five factors that form SCWS have adequate fit to the data, thus supporting construct validity. SEM results suggest predictive validity since SCWS was positively associated with perceived work productivity. Conclusions The 15-item SCWS showed satisfactory psychometric properties for use in future studies. These studies can focus on identifying factors associated with nurses’ use of smartphones for work purposes.
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Prawira, Agung, Ismail Effendi, and Miskah Afriani. "Work Stress Factors in Innures at the Putri Hijau Kesdam I Bukit Barisan Medan." Journal La Medihealtico 2, no. 2 (February 21, 2021): 1–10. http://dx.doi.org/10.37899/journallamedihealtico.v2i2.309.
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One of the jobs that is prone to stress is a nurse. According to PPNI, 50.9% of Indonesian nurses experience work stress. This study was to determine the factors that influence the stress of nurses at the Putri Hijau Level II Hospital, Medan. The research design used was cross sectional with a population of 152 nurses in this study and the sample used a stratified random sampling technique to 60 nurses. Data analysis using binary logistic regression test. Research shows that there is an effect of workload (p = 0.03) and interpersonal relationship (p = 0.03) on nurses 'work stress, while the variables of gender, tenure, career development and role conflict have no effect on nurses' work stress. Workload and interpersonal relationships in the workplace have the potential to cause work stress for nurses. So it is advisable for the management to adjust the physical and mental workload with the capacity and ability of nurses, and strive for a conducive social environment.
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Sun, Carlos, Praveen Edara, and Zhongyuan Zhu. "Evaluation of Temporary Ramp Metering for Work Zones." Transportation Research Record: Journal of the Transportation Research Board 2337, no. 1 (January 2013): 17–24. http://dx.doi.org/10.3141/2337-03.
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Ramp metering has been successfully implemented in many states to improve traffic operations on freeways. Studies have documented the positive mobility and safety benefits of ramp metering. However, there have been no studies on the use of ramp metering for work zones. This paper reports the results from the first deployment of temporary ramp meters in work zones in the United States. Temporary ramp meters were deployed at seven work zones in Missouri. Safety measures such as driver compliance, merging behavior, speed differentials, lane changing, and braking maneuvers were extracted from video-based field data. Mobility analysis was conducted with a calibrated simulation model, and the total delays were obtained for under capacity, at capacity, and over capacity conditions. This evaluation suggests that temporary ramp meters should be deployed only at work zone locations where there is potential for congestion and turned on only during periods of high congestion. The compliance analysis showed that noncompliance could be a major safety issue in the deployment of temporary ramp meters. The use of a three-section instead of a traditional two-section signal head for ramp metering produced significantly higher compliance rates. Mobility analysis revealed that ramp metering produced delay savings for high traffic volume work zones. For flows below capacity, ramp metering is not recommended because it increases total delays.
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Durand, Marie-José, Patrick Loisel, Stéphane Poitras, Richard Mercier, Susan R. Stock, and Jacques Lemaire. "The Interrater Reliability of a Functional Capacity Evaluation: The Physical Work Performance Evaluation." Journal of Occupational Rehabilitation 14, no. 2 (June 2004): 119–29. http://dx.doi.org/10.1023/b:joor.0000018328.35521.e8.
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Al Kalaldeh, Mahmoud, and Samah Khamis. "The Performance of Emergency Department Nurses Across Sectors in Jordan: An Application of the Work Functioning Model." Research and Theory for Nursing Practice 33, no. 4 (October 30, 2019): 344–56. http://dx.doi.org/10.1891/1541-6577.33.4.344.
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Work functioning is a relatively new conceptual model developed to embrace various aspects surrounding work performance, work participation, and individual capacity. The assessment of work performance (AWP) in nursing has gained inconsistent evidence due to examining it from multidimensional aspects. This study aimed to perform the AWP in nurses working in the emergency departments (EDs) at different healthcare sectors in Jordan. A descriptive, cross-sectional design was used in which ED nurses completed a questionnaire. ED nurses were recruited conveniently from four referral hospitals located in Amman (two government and two private hospitals). The Nursing Work Functioning Questionnaire (NWFQ), in addition to the demographic questionnaire were completed. A total of 179 ED nurses participated in the study (100 government and 79 private nurses). A few differences were found between government and private sector nurses in respect to work functioning domains. Overall, nurses from both sectors reported minimal impairments in their performance represented in seven domains. However, ED nurses from the private sector claimed more frequent work incidences compared to ED nurses from the government sector (p = .043). In addition, associate nurses showed higher avoidance behavior than registered nurses in both sectors (p = .031). Contrary to former studies, this study found minimal discrepancies in work performance between government and private sectors, and employing the work functioning model is useful to gain a thorough understanding of the AWP.
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Dasgupta, Prasanjit. "Work Engagement of Nurses in Private Hospitals." Journal of Health Management 18, no. 4 (November 28, 2016): 555–68. http://dx.doi.org/10.1177/0972063416666160.
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This study examined the impact of organizational, personal, team, job demand factors and mediating effects of team and affective commitments on nurses’ work engagement. Health workers’ work engagement has positive effect on patient satisfaction; nurses constitute a major group among health workers. To find reliability of the instruments pilot study was conducted in three hospitals of Kolkata (India) in which 175 nurses participated. In the main study, 504 nurses from five hospitals in Kolkata participated. Correlation, regression analysis and Sobel test was used to find out the relationships. Perceived organizational support, leader–member exchange, team–member exchange, workplace friendship, all relate positively to work engagement. Nursing role stress negatively relates to work engagement. Team commitment positively mediates the relationship between leader–member exchange, team member exchange and workplace friendship with work engagement. Affective commitment positively mediates the relationship between perceived organizational support and core self-evaluation with work engagement and negatively mediates the relationship between nursing role stress and work engagement. Result of the study shall be helpful for health care managers to devise appropriate strategies for enhancement of work engagement of nurses.
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van de Sand, W. H. "RehaAssessment - A System for Comprehensive Evaluation of Work Related Capacity." Die Rehabilitation 40, no. 5 (October 2001): 304–13. http://dx.doi.org/10.1055/s-2001-17534.
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Butler, Christopher C., Eleri Owen-Jones, Mandy Lau, David Gillespie, Mark Lown, Philip C. Calder, Helen Stanton, et al. "Probiotics to reduce antibiotic administration in care home residents aged 65 years and older: the PRINCESS RCT." Efficacy and Mechanism Evaluation 8, no. 7 (April 2021): 1–128. http://dx.doi.org/10.3310/eme08070.
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Background Care homes are an increasingly important sector of care. Care home residents are particularly vulnerable to infections and are often prescribed antibiotics, driving antibiotic resistance. Probiotics may be a cheap and safe way to reduce antibiotic use. Efficacy and possible mechanisms of action are yet to be rigorously evaluated in this group. Objective The objective was to evaluate efficacy and explore mechanisms of action of a daily oral probiotic combination in reducing antibiotic use and infections in care home residents. Design This was a multicentre, parallel, individually randomised, placebo-controlled, double-blind trial, with qualitative evaluation and mechanistic studies. Setting A total of 310 care home residents were randomised from 23 UK care homes (from December 2016 to May 2018). Participants The participants were care home residents aged ≥ 65 years who were willing and able to give informed consent or, if they lacked capacity to consent, had a consultee to advise about participation on their behalf. Intervention A daily capsule containing an oral probiotic combination of Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp. lactis BB-12 (n = 155) or matched placebo (n = 155) for up to 1 year. Main outcome measures The primary outcome was cumulative systemic antibiotic administration days for all-cause infections. Secondary outcomes included incidence and duration of infections, antibiotic-associated diarrhoea, quality of life, hospitalisations and the detection of resistant Enterobacterales cultured from stool samples (not exclusively). Methods Participants were randomised (1 : 1) to receive capsules containing probiotic or matched placebo. Minimisation was implemented for recruiting care home and care home resident sex. Care home residents were followed up for 12 months with a review by a research nurse at 3 months and at 6–12 months post randomisation. Care home residents, consultees, care home staff and all members of the trial team, including assessors and statisticians, were blinded to group allocation. Results Care home residents who were randomised to probiotic had a mean 12.9 cumulative systemic antibiotic administration days (standard error 1.49 days) (n = 152) and care home residents randomised to placebo had a mean 12.0 cumulative systemic antibiotic administration days (standard error 1.50 days) (n = 153) (adjusted incidence rate ratio = 1.13, 95% confidence interval 0.79 to 1.63; p = 0.495). There was no evidence of any beneficial effects on incidence and duration of infections, antibiotic-associated diarrhoea, quality of life, hospitalisations, the detection of resistant Enterobacterales cultured from stool samples or other secondary outcomes. There was no evidence that this probiotic combination improved blood immune cell numbers, subtypes or responses to seasonal influenza vaccination. Conclusions Care home residents did not benefit from daily consumption of a combination of the probiotics Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp. lactis BB-12 to reduce antibiotic consumption. Limitations Limitations included the following: truncated follow-up of some participants; higher than expected probiotics in stool samples at baseline; fewer events than expected meant that study power may have been lower than anticipated; standard infection-related definitions were not used; and findings are not necessarily generalisable because effects may be strain specific and could vary according to patient population. Future work Future work could involve further rigorous efficacy, mechanisms and effectiveness trials of other probiotics in other population groups and settings regarding antibiotic use and susceptibility to and recovery from infections, in which potential harms should be carefully studied. Trial registration Current Controlled Trials ISRCTN16392920. Funding This project was funded by the Efficacy and Mechanism Evaluation (EME) programme, a MRC and NIHR partnership. This will be published in full in Efficacy and Mechanism Evaluation; Vol. 8, No. 7. See the NIHR Journals Library website for further project information.
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Venkataraman, Vijeta, Trudy Rudge, and Jane Currie. "Hiding in Plain Sight." Witness: The Canadian Journal of Critical Nursing Discourse 3, no. 1 (June 30, 2021): 85–97. http://dx.doi.org/10.25071/2291-5796.73.
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The incidence of Intimate Partner Violence (IPV) in Australia is rising. Women experiencing IPV seek assistance through Emergency Departments (ED). Women exhibit help-seeking behaviours to nurses who work in emergency over medical or allied health professionals. Nurses’ capacity to recognise the need to care for women experiencing IPV is essential. The aim of this study was to explore nurses’ capacity to care for women who have experienced IPV through outlining inhibiting factors that limit care and create a discourse that contributes to addressing these factors. Pre (n=10) and post (n=6) focus groups (FGs) were undertaken with nurses who work in ED. In between the FGs an intervention was applied to prompt change to caring practices. The discourse generated from the FGs was subjected to a Foucauldian discourse analysis from a poststructural feminist perspective. Participants’ capacity to care was found to be based on the values they formed on IPV, as shaped by their post-registration training. The formation of boundaries was fundamental in inhibiting the participants’ capacity to care. Challenging boundaries through educational inquiry into nursing values can be effective in shifting perspectives of IPV. The raising of awareness of IPV in our communities serves as a vital tool in eliciting cultural behaviour change within EDs and within nursing culture.
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Umann, Juliane, Laura de Azevedo Guido, and Eliane da Silva Grazziano. "Presenteeism in hospital nurses." Revista Latino-Americana de Enfermagem 20, no. 1 (February 2012): 159–66. http://dx.doi.org/10.1590/s0104-11692012000100021.
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This quantitative, descriptive, cross-sectional research aimed to determine the estimated productivity of health-related limitations at work in 129 nurses working in direct care delivery to critical and potentially critical patients. Instruments were applied for socio-demographic and functional characterization and for the evaluation of presenteeism (Work Limitations Questionnaire). Statistical Package for the Social Sciences software was used for data analysis. In this study, 75% of nurses obtained a lost productivity index of up to 4.84%. The physical demand domain represented the major limitation for these professionals (25%). Presenteeism was directly correlated to health care, occurrence and number of absences, and indirectly related to work time at the unit. It was concluded that organizational or individual factors influence individuals' productivity, in view of the circumstances involving care delivery to critical and potentially critical patients.
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Aragon, Daleen. "Evaluation of Nursing Work Effort and Perceptions About Blood Glucose Testing in Tight Glycemic Control." American Journal of Critical Care 15, no. 4 (July 1, 2006): 370–77. http://dx.doi.org/10.4037/ajcc2006.15.4.370.
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• Background Tight glycemic control is important in critically ill patients and involves insulin infusions and monitoring of blood glucose levels. Hourly measurements of blood glucose levels and adjustments of intravenous insulin doses require additional work by nurses. • Objectives To evaluate the nursing work incurred with and nursing perceptions about tight glycemic control and blood glucose monitoring. • Methods A variety of intensive care units were studied. Surveys were used to gain information about nurses’ perceptions. Time-in-motion observations were used to determine the time taken to measure blood glucose levels and adjust insulin doses. • Results Nurses thought that tight glycemic control was important and that the work associated with it was substantial. Nurses thought that easier and automated forms of blood glucose monitoring are needed. They preferred using an arterial catheter to obtain blood samples to avoid excessive finger sticks. The total number of blood glucose measurements was 77 954. The mean time taken for hourly blood glucose monitoring and adjustment of insulin doses was 4.72 minutes. The estimated costs of time spent on glycemic control during a 1-year period were $182 488 for nurses’ salaries and $58 500 for supplies. • Conclusions Although most nurses endorse tight glycemic control, the work associated with it is burdensome and costly. Because up to 2 hours might be required for tight glycemic control for a single patient in a 24-hour period, the costs in time and money are high. Easier clinical methods for monitoring blood glucose levels are needed.
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Roscani, Alessandra Nazareth Caine Pereira, and Edinêis de Britto Guirardello. "Attention Demands in the Workplace and the Capacity to Direct Attention of Nurses." Revista Latino-Americana de Enfermagem 18, no. 4 (August 2010): 778–85. http://dx.doi.org/10.1590/s0104-11692010000400017.
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This was a descriptive, correlational study designed to evaluate the capacity to direct attention (CDA) of the nurse and to verify an association between the CDA and attention demand situations. For data collection the instruments used were: the Attentional Function Index and the Directed Attention Demands. The participants were 169 nurses of a teaching hospital in the State of São Paulo. The mean perception of performance or CDA was 60.4 which differed between the variables: unit of work (p=0.013), work hours (p=0.044), presence of health problems (p=0.026) and problems of a psychological nature (p=0.005). There was a negative association between the situations of demand and CDA (r = - 0.294, p<0.0001). It was concluded that nurses showed good CDA, which was related to some professional and demographic variables, and the higher the attentional demands, the lower the CDA.
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Niazkhani, Z., H. van der Sijs, M. Berg, R. Bal, and H. Pirnejad. "Evaluation of the Impact of a CPOE System on Nurse-physician Communication." Methods of Information in Medicine 48, no. 04 (2009): 350–60. http://dx.doi.org/10.3414/me0572.
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Summary Objectives: To assess the impact of a CPOE system on medication-related communication of nurses and physicians. Methods: In six internal medicine wards of an academic medical center, two questionnaires were used to evaluate nurses’ attitudes toward the impact of a paper-based medication system and then a CPOE system on their communication in medication-related-activities (medication work). The questionnaires were analyzed using t-tests, followed by Bonferroni correction. Nine nurses and six physicians in the same wards were interviewed after the implementation to determine how their communication and their work have been impacted by the system. Results: The total response rates were 54% and 52% for pre- and post-implementation questionnaires. It was shown that after im plementation, the legibility and completeness of prescriptions were significantly improved (P < .001) and the administration system had a more intelligible layout (P < .001), with a more reliable overview (P < .001). The analysis of the interviews supported and confirmed the findings of the surveys. Moreover, they showed communication problems that caused difficulties in integrating medication work of nurses into physicians’. To compensate for these, nurses and physicians devised informal interactions and practices (workarounds), which often represented risks for medication errors. Conclusion: The introduction of CPOE system with paper-based medication administration system improved prescription legibility and completeness but introduced many workflow impediments and as a result error-inducing conditions. In order to prevent such an effect, CPOE systems have to support the level of communication which is necessary to integrate the work of nurses and physicians.
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Kasimovskaya, N. A., and V. E. Efremova. "Introducing adaptation program for nursing staff to a new work environment and the work place." Kazan medical journal 95, no. 2 (April 15, 2014): 272–75. http://dx.doi.org/10.17816/kmj2079.
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Aim. To find a scientific rationale and to develop a comprehensive system to adapt nursing staff at federal healthcare facilities. Methods. The following methods were used: direct observation, sociological, expert evaluation, analytical, statistical. The study included 526 nurses, among them 8 were principal chief nurses, 114 - senior nurses of the departments, 328 - ordinary nursing staff, 79 - newly accepted employees who completed the developed adaptation program for nursing staff. Special questionnaires were designed for adaptation program development. The existing system of nursing staff professional development was assessed by processing «Nursing staff adaptation program» documents. Results. A new program of adaptation of new employees to the workplace and professional requirements for a future position was designed while improving nursing staff management, according to the study results. The program includes the use of modern adaptation process methodology and contains teaching materials. The comparative analysis of the answers of executive nursing staff revealed that principal chief nurses admitted the need for the program: 7 (87.5%) out of 8 nurses considered it necessary before it was introduced, 100% of principal chief nurses recognized the importance of adaptation program after it was introduced. Senior nurses admitted the need for introducing the program in 70 (61.4%) of cases, however, after its introduction 108 (94.7%) of respondents confirmed that it was necessity. Conclusion. Adaptation program to a professional environment and new workplace for nursing staff is actual and is a necessary part of preparing the new employees to a professional environment and activities at the new workplace.
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French, Susan E., Rhonda Lenton, Vivienne Walters, and John Eyles. "An Empirical Evaluation of an Expanded Nursing Stress Scale." Journal of Nursing Measurement 8, no. 2 (June 2000): 161–78. http://dx.doi.org/10.1891/1061-3749.8.2.161.
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In the study of work-related stress among nurses, the Nursing Stress Scale (NSS) is the best known and most widely used scale. This article presents an overview of the NSS and its use, and describes the development of an expanded instrument (ENSS) to measure sources and frequency of stress perceived by nurses. Findings are based on a random sample of 2,280 nurses in Ontario working in a wide range of work settings. Pretests for the study indicated that an expanded version of the NSS was necessary in order to adequately measure sources of stress among nurses. The sources of stress comprised nine subscales—death and dying, conflict with physicians, inadequate preparation, problems with peers, problems with supervisors, workload, uncertainty concerning treatment, patients and their families, and discrimination. Confirmatory factor analyses, run on two randomly selected halves of the sample, came close to meeting standard criteria levels. The alpha coefficients of eight of the subscales were .70 or higher, and concurrent and construct validity assessments provided strong support for the expanded NSS.