To see the other types of publications on this topic, follow the link: Personnel management Hospitals.
Dissertations / Theses on the topic 'Personnel management Hospitals'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Personnel management Hospitals.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Roberts, Angela K. "Factors involved in management decision-making : a study of Indiana hospital public relations directors' perceptions." Virtual Press, 1995. http://liblink.bsu.edu/uhtbin/catkey/941717.
Full textAbstract:
This study of Indiana hospital public relations professionals investigated factors predicting a person's participation in management decision-making. A telephone survey was conducted of professionals directing public relations activities in Indiana hospitals, yielding 55 usable responses.Each respondent was asked the likelihood he or she would be called on by top hospital management to help solve hospital problems, and the likelihood that his or her advice would be seriously considered when making major decisions about programs or policies. Each of the seven questions was answered using a Likert-type scale, with values assigned from 1.0 (highly unlikely) to 5.0 (highly likely). Values were averaged for a total "influence" score.A stepwise multiple regression measured the relationship between influence scores and eight variables: age, gender, salary, department size, education, manager score, technician score, and use of research and evaluation. Only the manager score, research score, and department size were found to be related to influence.Department of Journalism
2
DeMartini, Mikaela. "Exploring Self Care Programs in Hospitals." Thesis, Mills College, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13426861.
Full textAbstract:
Self care is more than a requirement for life. Working in a high stress hospital environment lends itself to having many personal and professional stressors that go beyond medical professionals job requirements. The purpose of this study was to explore how hospitals support medical staff through self care programs. Data was collected through semi-structured interviews of five medical professionals who work in various specialties. Results of this study indicated that self care was represented in various unstructured formats. Additionally, this study demonstrates the need for more support in the medical field to allow for more opportunities for self care to take place. Furthermore, this analysis of self care explains the importance of this practice to be implemented by medical professionals as it helps to reduce the high rates of burnout and compassion fatigue.
3
Fransson, Sellgren Stina. "Nursing management at a Swedish University hospital : leadership and staff turnover /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-330-6/.
Full text
4
Hodges, Nancy Davis. "Impact of Goal-setting on Motivation as Affected by the Joint Influence of the Attributional Dimensions of Causality, Stability, and Control." PDXScholar, 1994. https://pdxscholar.library.pdx.edu/open_access_etds/4859.
Full textAbstract:
A systematic, empirical study conducted in eight hospital operating rooms found that employees often select opportunity-dependent goals. These goals are self-set or chosen by the individual, but the opportunity to perform the goal chosen is dependent on others. For example, "learn to circulate on total joint surgeries" is a self-set, opportunity-dependent goal. The individual must be assigned to that job. It was found that when this type of goal is chosen and the individual is not given the opportunity to perform it, the individual attributes the failure to external causes. This failed opportunity-goal type was significantly related to lower motivation, whereas failed self-dependent goals (for example, "become more proficient on the computer") were related to higher motivation. It was found that the joint influence of the attributional dimensions of causality, stability, and control were affecting these differences for the two types of failed goal groups.
5
Spagnol, Carla Aparecida. "A trama de conflitos vivenciada pela equipe de enfermagem no contexto da instituição hospitalar : como explicitar seus nos?" [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312132.
Full textAbstract:
Orientador: Solange L'AbbateTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-09T01:40:40Z (GMT). No. of bitstreams: 1 Spagnol_CarlaAparecida_D.pdf: 6634502 bytes, checksum: 47034f29257b951227f80406fc8f54c2 (MD5) Previous issue date: 2006
Resumo: Nessa pesquisa, investiguei os conflitos vivenciados pela equipe de enfermagem do Hospital das Clínicas-UFMG, motivada pelo fato de o enfermeiro desempenhar atividade de gerência nos serviços de saúde e freqüentemente lidar com relações conflituosas. Os objetivos delineados foram: conhecer as diferentes percepções de conflito dos enfermeiros; identificar aqueles mais comuns e os principais fatores que geram esses conflitos; compreender como o enfermeiro lida com os conflitos no trabalho; levantar facilidades e dificuldades para lidar com os conflitos e propor aos enfermeiros a construção coletiva de um dispositivo socioanalítico, a ser utilizado como espaço de análise e reflexão da prática profissional, focalizando o objeto de estudo. Por se tratar de um fenômeno processual, optei pela abordagem qualitativa, desenvolvendo uma pesquisa-intervenção em duas fases. Na primeira, realizei uma pesquisa exploratória, com o objetivo de me aproximar dos sujeitos e do objeto de estudo, utilizando um questionário, que foi aplicado, em setembro de 2003, a cento e cinco enfermeiros (105), sendo que desses, trinta e sete (37), o devolveram. Na segunda, utilizei a perspectiva da socioanálise, para construir um dispositivo, visando a criação de um espaço que permitisse à pesquisadora e às pesquisadas realizarem, conjuntamente, análises e reflexões acerca da prática profissional, focalizando situações de conflito vivenciadas no trabalho. Foram realizados cinco encontros nos meses de setembro e outubro de 2005, com duração de duas horas cada, onde participaram seis enfermeiras que, no questionário, responderam afirmativamente quanto à sua continuidade no estudo. Nessa fase, as integrantes ao elaborarem a demanda de análise do grupo, expressaram vários motivos para participarem dessa investigação, dentre eles destaco suas implicações com a pesquisadora. Para as enfermeiras conflito é: diferença de pensamentos e de posições, coisa que incomoda e algo estressante. Apresentam uma visão bipolar desse fenômeno, pois, a princípio, são percebidos como negativos, mas dependendo do ângulo que se olha também o consideram como positivo, isso se forem discutidos com todos os envolvidos e conduzidos adequadamente. Identifiquei os seguintes tipos de conflitos: intrapessoal, interpessoal, intergrupal, de poder e de interesse. As principais causas que geram esses conflitos são: duplicidade de vínculo empregatício; deficiências na estrutura organizacional e no modelo de gerência implantado; escassez de recursos; centralização do trabalho; hierarquia; autoritarismo; imaturidade; escalas de serviço; falta de respeito e compromisso profissional, trazendo conseqüências para as relações interpessoais e para a assistência prestada. As enfermeiras lidam com situações de conflito, de forma racional, apresentando desejo de fuga, ao realizarem ações imediatistas, a fim de contornarem ou amenizarem a situação, assumindo que não são preparadas para conduzirem questões problemáticas ligadas ao comportamento e relacionamento interpessoal. Sendo assim, em determinadas situações, solicitam ajuda aos psicólogos da Diretoria de Recursos Humanos do hospital. O próprio dispostivo socioanalítico se constituiu em um analisador, permitindo explicitar instituídos e instituintes, implicações e transversalidades, presentes na organização hospital que é atravessada pelas 'instituições enfermagem e medicina¿. Diante das avaliações positivas relacionadas aos encontros grupais, sugiro desenvolvermos outros trabalhos tendo o dispositivo socioanalítico como um espaço coletivo de análise e reflexão das relações e práticas profissionais
Abstract: In this research, I investigated the conflicts experienced by a nursing team at the Federal University of Minas Gerais Hospital, motivated by the fact that nurses manage health care and frequently face conflict situations. The aims of this research were: to learn about nurses different perceptions regarding conflict; to identify the most common conflicts and the main factors that generate these conflicts; to understand how nurses manage conflicts at work; to find out motivations and difficulties to manage conflicts and propose to nurses a collective construction of a socio-analytical instrument to be used as a space for analysis and reflection of professional practice, focusing on the study object. As it is a process phenomenon, I used a qualitative approach, developing an intervention research in two phases. In the first phase, I developed an exploratory research with the purpose to get closer to the subjects and study object, using a questionnaire that was applied in September 2003 to 105 nurses. Among them, 37 responded and sent it back. In the second phase, I used the socio-analysis perspective to build an instrument, aiming at creating a space that would allow the researcher and research to be developed as well as analyses and reflections regarding professional practice, focusing on conflict situations experienced at work. Five meetings happened in September and October 2005, of two hours each, with the participation of six nurses that manifested in the questionnaire their intention to continue the study. In this phase, the members of the group expressed their motivations to participate in the study, emphasized its implications regarding the researcher. According to these nurses, conflict is a difference of thoughts and positions, something that may impair the relationship. They present a bipolar view of this phenomenon as at first they are perceived as negative, but depending on the way they are seen they can be considered positive, if they are discussed with all the persons involved and managed adequately. The following types of conflict were identified: intrapersonal, interpersonal, intergroup, of power and of interest. The main causes that generate these conflicts are: work in more than one place, problems regarding the organizational structure and management, lack of resources, work centralization, hierarchy, authoritarianism, immaturity, work shifts, lack of respect and professional commitment that influence interpersonal relations and the care provided. Nurses manage conflict situations in a rational way, presenting their desire to run away when they implement immediate actions, in order to minimize the situation, assuming that they are not prepared to conduct problems related to behaviors and interpersonal relationships. Therefore, in some situations they ask for help to psychologists from the Hospital Human Resources Division. The socio-analytical instrument was a means to analyze it, enabling them to expose the situations, implications and transversal intersections that are present at the hospital organization that is crossed by other institutions such as ¿nursing and medicine¿. Considering the positive evaluation of the group meetings, I suggest the development of other works based on socio-analytical instruments as a collective space for the analysis and reflection of relationships and professional practices
Doutorado
Saude Coletiva
Doutor em Saude Coletiva
6
Mdindela, Sindiswa Victoria. "Staff turnover at selected government hospitals." Thesis, Nelson Mandela Metropolitan University, 2009. http://hdl.handle.net/10948/1191.
Full textAbstract:
The purpose of this study was to identify factors that impact on staff turnover and strategies that organisations can use to curtail staff turnover. To achieve this goal the following procedure was followed. An overview of theories related to staff turnover was conducted to identify what staff turnover is. Also the consequences of staff turnover, the classification and measurement of staff turnover and the broad theoretical explanation of staff turnover were investigated. The current brain drain experienced in the medical field was explored. A literature study was also conducted focusing on individual, job, organisational and environmental factors that influence staff turnover and strategies that managers can utilise to reduce staff turnover. Interviews were conducted with the chief executive officer and one doctor at Hewu hospital. Interviews were also conducted among senior nurses. An empirical study was undertaken to determine individual, job, organisational and environmental factors that impacted on staff turnover among doctors and nurses at Bisho and Hewu Hospitals. The strategies that were utilised at these hospitals to retain doctors and nurses were also investigated. Suggestions were made for addressing factors that could impact on staff turnover among doctors and nurses and strategies that could be utilised to retain staff. These strategies include: Getting people off to a good start, Create a great environment with bosses whom people respect, Share information, Give people as much autonomy as they can handle and Challenge people to stretch. iii Staff turnover is an issue that many South African organisations are currently facing and an issue that is especially affecting the medical field. Various factors, especially job and organisational factors, are not adequately addressed and these could lead to a high rate of staff turnover. It is clear that organisations should have a human resource strategic plan in order for them to effectively select, retain, train and develop employees. Health Care organisation could use the strategies identified in this study as a mechanism to benchmark how well they manage staff turnover. It is therefore important that the management of hospitals should strive to identify the underlying causes of labour turnover in their organisations and formulate strategies to address the problem.
7
Griffiths, Debra. "Agreeing on a way forward management of patient refusal of treatment decisions in Victorian hospitals /." full-text, 2008. http://eprints.vu.edu.au/2036/1/griffiths_debra_thesis.pdf.
Full textAbstract:
The purpose of this study is to investigate and develop a substantive theory, of the processes adopted by nurses and medical practitioners when patients with serious illness refuse medical treatment. The study seeks to identify the main constraints confronting nurses and medical practitioners and to explain the key factors that moderate the processes of dealing with refusal decisions. Using a grounded theory method, a sample of 18 nurses and 6 medical practitioners from two public hospitals in Melbourne were interviewed. In addition, observations and documentary evidence were utilised. The basic social psychological problem shared by nurses and medical practitioners is conceptualized as Competing Perspectives: Encountering Refusal of Treatment, which reflects the diverse perceptions and beliefs that confront participants when patients decide to forgo therapy. In utilizing the grounded theory method of analysis, it is recognised that participants deal with this problem through a basic social psychological process conceptualized as Endeavouring to Understand Refusal: Agreeing on a Way Forward. This core variable represents the manner in which participants, to varying extents, deal with the situations they face and it incorporates the various influences which moderate their activities. Endeavouring to Understand Refusal: Agreeing on a Way Forward comprises a series of three transitions. The first involves a struggle for participants to come to terms with, or even recognize that patients are rejecting treatment. The second transition illustrates the varied responses of participants as they interact with patients, relatives and each other, in order to clarify and validate decisions made during episodes of care. The third transition reflects the degree to which patients and family members are incorporated into treatment decisions, and highlights a shift in emphasis, from a focus on the disease state, to the patient as a person with individualistic thoughts and wishes. The remaining social processes evident in the study consist of four categories. The first, Seeking Clarification, embodies exploration undertaken by participants and their recognition that treatment is actually being refused. The second category, Responding to Patients and Families, demonstrates the level of expertise of participants communicating, and their ability to encourage reciprocity in the professional-patient relationship. The third category, Advocating, highlights the extent and manner in which patient and family wishes are promoted to members of the treating team. The fourth category, Influencing, reveals the ability of participants to utilize a degree of authority or power in order to shape particular outcomes. The findings also indicate that over arching the core variable and categories are various contextual determinants that moderate the way nurses and medical practitioners deal with patient refusal of treatment. These determinants are categorized into three main influences: The Context of Work, describes the of the environment and organisational factors pertinent to public hospitals; Beliefs and Behaviours, illustrates the perceptions of, and values held, by four key groups involved in decisions, namely, nurses, medical practitioners, patients, and family members; and Legal and Ethical Frameworks, examines the existing principles that support or guide professional practice in situations where patients with serious illness refuse medical treatment.
8
Anthonie, Ramona F. G. "The experiences of critical nurses regarding staffing management in critical care units in private hospitals of the Cape Metropole." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71776.
Full textAbstract:
Thesis (MCurr)--Stellenbosch University, 2012.ENGLISH ABSTRACT: Nurse managers are responsible to staff different hospital units and departments with sufficient, trained and experienced personnel. Most critical care units in the private healthcare in South Africa are staffed below maximum workload levels and additional staff is supplemented when needed. Current staffing management strategies comprises the application of the patient acuity score, the utilisation of contracted agency staff and ward staff who assist occasionally in the critical care unit (CCU). The aim of the study was to explore the experiences of critical care nurses regarding staffing management within critical care units in private health care institutions in the Western Cape. The following objectives were set to: - explore the experiences of CCNs regarding staffing management strategies such as o the patient acuity score o the employment of ad hoc agency staff and o the utilization of ward staff A descriptive design with a qualitative approach was applied. A sample size of n=15 was drawn from a total population of N=377, using purposive sampling technique. A pilot-test was also completed. The trustworthiness of this study was assured with the use of Lincoln and Guba’s criteria of credibility, transferability, dependability and confirmability. All ethical principles were met. The findings of the study demonstrated that nurses perceive the workload in critical care units as heavy. The utilisation of the acuity score does not really assist in relieving the workload as managers tend not to consider the staffing requirements as predicted by the acuity score due to budget constraints. The enrolled nurses who assist occasionally in the critical care unit require supervision as well as ongoing development to ensure safe and quality patient care. Yet agency nurses were perceived as either extraordinary good or incompetent.
AFRIKAANSE OPSOMMING: Verpleegbestuurders het die verantwoordelik om verskillende hospitaaleenhede en departemente met voldoende opgeleide en ervare personeel te voorsien. Die meeste kritieke sorgeenhede in Suid-Afrika word met minder as dan die maksimum werkladingsvlak beman en addisionele personeel word aangevul wanneer nodig. Huidige personeelbestuurstrategieë behels die toepassing van die pasiënt akuïteit telling, die gebruik van ingekontrakteerde agentskap-personeel en saalpersoneel wat per geleentheid in die kritiekesorgeenheid help. Die doel van die studie was om die ervaringe van kritieke-sorgverpleegsters ten opsigte van personeel bestuur binne die kritiekesorgeenhede in die privaat gesondheidsorginstellings in die Weskaap, te ondersoek. Die volgende doelwitte is gestel: - Om die ervaringe van kritieke-sorgverpleegsters aangaande personeelbestuur-strategieë te ondersoek, soos: o die pasiënt akuïteit telling o die gebruik van agentskapverpleegpersoneel en o die gebruik van saal personeel, te ondersoek ’n Beskrywende kwalitatiewe studie is toegepas. ’n Steekproef van n=15 is uit ’n totale populasie van N=377 getrek deur die doelgerigte steekproeftegniek te gebruik. ’n Loodstoetsing van die semi-gestruktureerde vraelys is ook gedoen. Die betroubaarheid van hierdie studie was verseker deur van Lincoln en Guba se kriteria vir geloofwaardigheid, oordraagbaarheid, betroubaarheid en bevestigbaarheid gebruik te maak. Daar is aan alle etiese vereistes voldoen. Die bevindings van die studie toon dat die verpleegpersoneel die werklading in die kritiekesorgeenheid as veeleisend ervaar. Die aanwending van die pasiënt akuïteit-telling dra nie werklik by tot verligting van die werklading nie, aangesien bestuurders weens begrotingsbeperkings neig om nie die personeelbenodigdhede soos deur die akuïteit-telling voorspel in ag neem nie. Die ingeskrewe verpleegsters wat per geleentheid in die kritieke-sorgeenheid hulp verleen, benodig toesig asook volgehoue ontwikkeling ten einde veilige en kwaliteit pasiëntsorg te verseker. Die agentskapverpleegpersoneel is egter as baie bekwaam of onbevoeg beskou.
9
Haines, Fiona Imelda. "Error management in nursing amongst registered nurses working in a tertiary hospital in Saudi Arabia." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/80226.
Full textAbstract:
Thesis (MCurr)--Stellenbosch University, 2013.ENGLISH ABSTRACT: Healthcare organizations have implemented numerous safety initiatives to address errors due to the impact on the patient, families, healthcare provider and the organization as highlighted in the Institute of Medicine report. However, error identification, reporting and management remain a challenge. Nurses have been identified as the healthcare provider with the greatest potential for errors. Supportive work environments are needed to provide optimal care to the nurse who makes an error; which may be minor to severe repercussions. The patient is identified as the first victim and the nurse who makes the error as the second victim. How nurse errors are reported, managed and disclosed is dependent on the response of leaders and peers which may be in a shame and blame or just culture approach. The aim of the study was to assess error management in nursing amongst registered nurses working in a tertiary hospital in Saudi Arabia. The objectives were to identify the occurrence of nursing related errors, determine the current process of reporting nursing errors, describe the management of nursing errors and explore the factors impacting on the management of nursing errors. The research methodology for this study was a descriptive, quantitative approach which is applicable when exploring the unknown. Ethical approval was obtained from the Ethics Board, University of Stellenbosch and the Institutional Review Board, King Faisal Specialist Hospital and Research Centre (General Organization) -Jeddah (KFSH&RC-J). The population was registered nurses working in KFSH&RC-J and assigned to the job descriptions of Staff Nurse 1&2, Clinical Nurse Coordinators and Assistant/Head nurses. Sample was selected using proportional allocation for nationality and simple random selection for nursing specialty; 215 RNs from these three groups. Data was collected using a questionnaire developed by the researcher and analysis completed using SPSS and regression analysis to identify factors which influences the reporting and management of errors. Data was presented in the form of frequency tables and graphs using the EXCEL program to analyze the data. The main findings of the study; there was significant difference in nurse leaders and professional nurses ability to identify nursing errors; questioning of the practice of peers, views of a non-punitive environment and the ability to differentiate between error and negligence. The nurse executive was positively associated with the average positive responses received. RNs of Middle Eastern nationality and the Adult nursing division were found to be slightly more negative in their perceptions about error reporting and management than other respondents. Improvements are needed in the processes of error reporting and management which include education; leadership development, underreporting of errors, feedback and communication, nurse manager support and disclosure of errors. Recommendations are the implementation of the Just Culture principles within the organization and leadership development to address error reporting and management. The need to develop a national database for error reporting in Saudi Arabia is recommended. Nursing errors occurred in one tertiary hospital in Saudi Arabia and an on-line system is available to report errors. However, nurses do not report errors as they fear being blamed and shamed. The process of error management within the organization has not been clearly defined.
AFRIKAANSE OPSOMMING: Gesondheidsorganisasies het talle veiligheids inisiatiewe geïmplementeer om foute aan te spreek weens die invloed wat dit het op die pasiënt, families, die gesondheidsverskaffer en die organisasie soos uitgelig in die Mediese Verslag van die Instituut. Nietemin, die identifisering van foute, verslaggewing en bestuur bly ’n uitdaging. Verpleegsters is geïdentifiseer as die gesondheidsverskaffers wat oor die grootste potensiaal beskik om foute te begaan. Ondersteunende werkomgewings word benodig om optimale sorg aan die verpleegster te verskaf wat ’n fout van ’n mindere aard tot die met ernstige gevolge begaan. Die pasiënt word geïdentifiseer as die eerste slagoffer en die verpleegster wat die fout begaan as die tweede slagoffer. Die manier hoedat verpleegfoute gerapporteer, bestuur en openbaar gemaak word, is afhanklik van die reaksies van leiers en portuurgroepe wat ’n skaamte- en blameerbenadering of “just culture”-benadering kan wees. Die doel van die studie was om die hantering van verpleegfoute tussen geregistreerde vepleegkundiges wat in n tersiêre hospital in Saudi werk te ondersoek. Die doelwitte is om die voorkoms van verpleegverwante foute te identifiseer, die huidige proses van verslaggewing van verpleegfoute te bepaal, die bestuur van verpleegfoute te beskryf en die faktore te ondersoek wat ’n impak het op die bestuur van verpleegfoute. Die navorsingsmetodologie vir hierdie studie is ’n beskrywende, kwantitatiewe benadering wat van toepassing is wanneer die onbekende ondersoek word. Etiese goedkeuring is verkry van die Etiese Raad aan die Universiteit Stellenbosch en die Institusionele Beoordelingsraad, King Faisal Specialist Hospitaal en Navorsingssentrum (Algemene Organisasie) – Jeddah (KFSH & RC-J). Die teikengroep is geregistreerde verpleegsters wat werk in KFSH & RC-J aan wie die posbeskrywing van stafverpleegster 1 & 2 toegeken is, Kliniese Verpleegkoördineerders en Assistent/Hoofverpleegsters. Die steekproef is geselekteer deur gebruik te maak van proporsionele toekenning vir nasionaliteit en ’n eenvoudige ewekansige steekproef vir verpleegspesialiteit; 215 geregistreerde verpleegsters van hierdie drie groepe. Data is gekollekteer deur gebruik te maak van ’n vraelys wat deur die navorser ontwikkel is en die analise is voltooi deur gebruik te maak van SPSS en regressie-analise om faktore te identifiseer wat verslaggewing en bestuur van foute beïnvloed. Data is aangebied in die vorm van frekwensie-tabelle en grafieke deur gebruik te maak van die EXCEL-program om die data te analiseer. Die vernaamste bevindinge van die studie is dat daar beduidende verskille tussen verpleegleiers en professionele verpleegsters se vermoë is om verpleegfoute te identifiseer; bevraagtekening van die praktyke van portuurgroepe; beskouinge van nie-strafgerigte omgewing en die vermoë om te onderskei tussen foute en nalatigheid. Die verpleegeksekuteur is positief geassosieer met die gemiddelde positiewe response wat ontvang is. Geregistreerde verpleegsters van Midde-Oostelike nasionaliteit en die Volwasse Verpleegafdeling is gevind om effens meer negatief te wees in hulle persepsies van fouteverslaggewing en bestuur, as ander respondente. Verbeterings is nodig in die prosesse van verslaggewing van foute en bestuur daarvan wat opvoeding daarvan insluit; leierskapontwikkeling, onderverslaggewing van foute, terugvoer en kommunikasie, ondersteuning van verpleegbestuur en bekendmaking van foute. Aanbevelings is die implementering van die “Just”-kultuur beginsels binne die organisasie en leierskap ontwikkeling om die verslag van foute en bestuur aan te spreek. Die behoefte om ’n nasionale databasis te ontwikkel vir die verslag van foute in Saoedi-Arabië word aanbeveel. Verpleegfoute het in een tersiêre hospitaal in Saoedi-Arabië plaasgevind en ’n aanlyn sisteem is beskikbaar gestel om foute te rapporteer. Nietemin, verpleegsters rapporteer nie foute nie, want hulle vrees om geblameer te word en beskaamd te staan. Hierdie proses van foutebestuur binne die organisasie is nog nie duidelik gedefinieer nie.
10
Bush, Mary Ann. "Applying adult education principles in an interpersonal management skills training program for hospital operations managers." CSUSB ScholarWorks, 1993. https://scholarworks.lib.csusb.edu/etd-project/704.
Full text
11
George, Janet C. "Nurses' perceived autonomy in a shared governance setting." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1036188.
Full textAbstract:
The basic philosophy of shared governance includes the right for staff nurses to practice in an environment that allows participation in the decision making process at all levels of the organization. Autonomy and responsibility support shared governance. The purpose of this study was to examine nurses’ perceptions of autonomy in a well established shared governance setting. The Neuman Systems Model served as the theoretical framework.A convenience sample of 83 (42%) staff nurses at Saint Joseph’s Hospital of Atlanta, Georgia completed the Schutzenhofer Professional Nursing Autonomy Scale. Three open ended questions were included in the questionnaire to further explore staff nurses’ perceptions of the professional practice environment. Demographic data were also collected.Findings in this study revealed no significant correlations between selected demographic variables and autonomy. More than between selected demographic variables and autonomy. More than half (65.1%) ranked in the higher level of professional autonomy, 34.9% (29) ranked in the mid level and none in the lower level. Qualitative data revealed that nurses working in a well established shared governance setting perceived control over the nursing care of patients and appreciated and the ability to make decisions regarding patient care. Respondents overwhelmingly indicated that nurses should be compensated for participation in governance activities.Conclusions from this study were that implementation of professional practice models such as shared governance improve nurses’ perceptions of autonomy and create an atmosphere in which nurses can practice the art of nursing while clearly articulating a vision for the future. Consistent and appropriate decision making by nurses facilitates the interdisciplinary plan of care and encourages trusting relationships among professional disciplines.Nurse managers are in an ideal position to create a vision by designing structures that promote staff involvement. Managers must build formal recognition programs into shared governance systems and provide nurses with the time to attend meetings. Today’s nursing leaders must be ready to create a vision, facilitate change, mentor, nurture, coach and advise staff.School of Nursing
12
Toni, Gladys Nosisana. "Accelerated staff turnover among professional nurses at a district hospital." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/620.
Full textAbstract:
The study emanated from the researcher’s experience and involvement in clinical nursing and nursing management. The researcher noted how heavy losses of recruited professional nurses might have had an influence on the quality of service delivery. It is a costly and time-consuming task to recruit enough nurses into the profession and retention of staff is especially difficult. There had been a significant increase in the number of professional nurses leaving the district hospitals either to primary health care service, private hospitals or other countries. Before the commencement of the study the turnover rate at the district hospital where the study was conducted, almost doubled the accepted norm, which was ten percent of the staff. For those reasons the researcher decided to conduct a study named, “Accelerated staff turnover among professional nurses at a district hospital.” The constant heavy losses of qualified nurses from the profession constitute one of the serious challenges for nursing managers. The researcher wanted answers to the following question: “What were your experiences of your job as a professional nurse at the district hospital?” The objectives of the study were: · to explore and describe factors leading to high staff turnover of professional nurses at a district hospital · to develop guidelines to help retain professional nurses. The design of this study, which was conducted in one of the district hospitals in the Makana Local Service Area in the Eastern Cape, is qualitative, descriptive and contextual. Informed permission for conducting the research was obtained from relevant authorities and participants were asked to sign a consent form before the researcher proceeded with the study. Participants that met the selection criteria were selected by means of purposive sampling. Data was obtained by means of semi-structured telephonic interviews that were audio-taped and later transcribed verbatim. To ensure trustworthiness of the study, the researcher applied the four strategies as proposed by Lincoln and Guba (De Vos, 2002:351) namely, credibility, transferability, dependability and confirmability. Collected data was analysed according to the descriptive method proposed by Tesch (in Creswell, 1994:154). The services of an independent coder, who was provided with transcripts and a protocol to guide data analysis, were utilised. A consensus meeting was held between the researcher and the independent coder to discuss the identified themes and sub-themes. Following the data analysis, a literature control was undertaken to highlight the similarities to and differences in comparison between this and previous studies. Four major themes and sub-themes were identified through analysis.
13
Rautenbach, Leontine. "The relationship between organisational citizenship behaviour, workplace trust and workplace well-being in public and private hospitals in the Eastern Cape province of South Africa." Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/5984.
Full textAbstract:
Globally, there is a shortage of professional nurses, which compromises the rendering of Health Care performance worldwide. South Africa has the added challenge of a dual Health Care system where there is a large disparity in financial resources, service levels and workload between private and public hospitals, which leads to public hospitals in rural areas failing to attract and retain professional nurses. The purpose of this study is to determine the relationships between three variables from the Positive Organisational Scholarship paradigm namely Workplace Trust, Organisational Citizenship Behaviour and Workplace Well-being which is researched amongst professional nurses in the private and public sectors in both the rural and urban areas in two districts in the Eastern Cape Province. The ultimate aim of the study is to propose interventions of how hospitals can improve the work environment in order to attract and to retain professional nurses. It is also anticipated that the results of the research will contribute to the body of research about Positive Organisational Scholarship (POS). The Workplace Trust Survey (WTS), Organisational Citizenship Level Scale (OCLS) and the Workplace Well-being Questionnaire (WWQ) were integrated into a single selfadministered questionnaire to measure the existence of the variables. The questionnaire also included questions relating to demographic factors. In order to confirm the reliability of the measuring instruments, an Exploratory Analysis was done, a Scree test was applied and a Principal Axis Factor Analysis was conducted. Finally, an Item-reliability Analysis on each factor was administered. The WTS and WWQ revealed sound factorial validity and was considered to be compatible with a South African sample, but the OCLS indicated poor construct validity. Relationships between the variables were analysed by applying a Pearson Productmoment Correlation Analysis in SPSS. T-tests, Analysis of Variance (ANOVA) and the Tukey HSD test was utilized to determine the potential influence of demographic characteristics on the variables. Several interesting relationships between variables and sub-variables were identified. The study concludes with proposed interventions needed to retain professional nurses in hospitals. The limitations of the study as well as recommendations for further research is briefly noted.
14
Stofile, Phakama Phumla Bernadette. "Exploring the effects of the psychological contract on organisational commitment and employee engagement in a restructured organisational environment: the case of selected hospitals in the Eastern Cape province." Thesis, University of Fort Hare, 2015. http://hdl.handle.net/10353/1984.
Full textAbstract:
This study investigated the impact of organisation restructuring on the psychological contract and the effects on employee engagement and organisational commitment. The study focused on employees from selected health care institutions. The sample consisted of 156 employees from the selected health care institutions. Results indicated positive relationships between employee engagement, psychological contract and organisational commitment. The researcher recommended a better understanding of the manner in which individuals interpret various inducements where would clearer prescriptions be provided. Therefore, employers were advised to be aware of employees’ values and attempt to address them as they are important
15
Vos, Porsha. "Learner nurses experiences regarding clinical supervision at private hospitals in East London in the Eastern Cape." Thesis, University of Fort Hare, 2013. http://hdl.handle.net/10353/d1006824.
Full textAbstract:
The purpose of this study was to explore and to describe experiences of learner nurses regarding clinical supervision at private hospitals in East London in the Eastern Cape. These were Life Healthcare hospitals. A qualitative, contextual approach was used and the exploratory, descriptive design was seen as most appropriate in this study. The subjects were the learner nurses in the Bridging Course Programme leading to registration as a General Nurse. The research questions were: How did you as a learner nurse, doing the Bridging Course, experience clinical supervision at Life Healthcare hospitals? A pilot study was conducted in a clinical setting involving respondents with similar characteristics to the study population. Fourteen participants were selected for this study by using a purposive, non-probability sampling method. Data were collected by means of individual interviews during which participants were able to describe their experiences during clinical supervision; data were collected until data saturation was reached.During data analysis, the researcher used the process of bracketing and remained neutral, setting aside previous knowledge and beliefs about the phenomenon under investigation. The researcher listened to the audiotapes used for data collection several times until she was completely satisfied with the interpretation of the verbatim data. Transcriptions were made within three days of the interview. The research was done in an ethically reflective manner and the researcher ensured the trustworthiness of the study at all times. The researcher allowed the participants freedom to conduct their lives as autonomous agents, without external The purpose of this study was to explore and to describe experiences of learner nurses regarding clinical supervision at private hospitals in East London in the Eastern Cape. These were Life Healthcare hospitals. A qualitative, contextual approach was used and the exploratory, descriptive design was seen as most appropriate in this study. The subjects were the learner nurses in the Bridging Course Programme leading to registration as a General Nurse. The research questions were: How did you as a learner nurse, doing the Bridging Course, experience clinical supervision at Life Healthcare hospitals? A pilot study was conducted in a clinical setting involving respondents with similar characteristics to the study population. Fourteen participants were selected for this study by using a purposive, non-probability sampling method. Data were collected by means of individual interviews during which participants were able to describe their experiences during clinical supervision; data were collected until data saturation was reached.During data analysis, the researcher used the process of bracketing and remained neutral, setting aside previous knowledge and beliefs about the phenomenon under investigation. The researcher listened to the audiotapes used for data collection several times until she was completely satisfied with the interpretation of the verbatim data. Transcriptions were made within three days of the interview. The research was done in an ethically reflective manner and the researcher ensured the trustworthiness of the study at all times. The researcher allowed the participants freedom to conduct their lives as autonomous agents, without external control, coercion or exploitation. The following findings were evident: Three main themes emerged from data analyses. These comprised inadequate clinical supervision, satisfactory clinical supervision and suggestions and inputs regarding clinical supervision. Detailed discussions about the findings in relation to earlier studies were conducted. Recommendations to improve clinical supervision were made in order to improve the experiences of learner nurses during training. The findings of the research will be made available through the University of Fort Hare library and the Life College of Learning. Furthermore the information of this study will be shared with colleagues and will be published in an accredited nursing journal such as Curationis as well as other journals.control, coercion or exploitation. The following findings were evident: Three main themes emerged from data analyses. These comprised inadequate clinical supervision, satisfactory clinical supervision and suggestions and inputs regarding clinical supervision. Detailed discussions about the findings in relation to earlier studies were conducted. Recommendations to improve clinical supervision were made in order to improve the experiences of learner nurses during training. The findings of the research will be made available through the University of Fort Hare library and the Life College of Learning. Furthermore the information of this study will be shared with colleagues and will be published in an accredited nursing journal such as Curationis as well as other journals.
16
Kriel, Dora Jenice. "Perceptions of nurses with regard to staffing in the operating rooms of a private hospital." Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/18014.
Full textAbstract:
Despite a number of research studies showing the correlation between higher nurse staffing levels and improved outcomes, RCN members continues to report lower nurse-to-patient ratios than what research results suggests (RCN, 2011:1). This reflected a general concern within the nursing profession. The operating room requires appropriate staffing which is critical to the safety of surgical patients and quality of patient care. The research study was motivated by the researcher’s own experiences while working in an OR in a private hospital where continuous discussions were held with management about the shortage of skilled staff; and where a shortage of OR nurses resulted in the use of Central Sterilizing Department (CSD) staff to do OR duties. The objective of the study was to explore and describe the perceptions of nurses regarding staffing in the operating rooms of a private hospital in the Nelson Mandela Bay Health District. The researcher used qualitative methods and designs to explore and described the perception of nurses regarding staffing in the operating room (OR) of a private hospital in the Nelson Mandela Bay Health District. The research population of the study included all the nurses working in the OR of a private hospital. The total number of 20 OR nurses was individually interviewed by means of semi-structured interviews. Three main themes emerged that includes nurses ‘perceptions with regard to the implications of inadequate staffing in the OR; nurses experiences towards top management with regard to staffing in the OR and recommendations from participants to improve staffing in the OR. Research findings concluded that nurses have a perception that shortage of OR nurses causes lack of communication, physical, emotional and psychological strain. They also perceived OR nurses to work under unrealistic conditions and to receive added responsibilities due to staff shortages, which affect the overall delivery of quality patient care. Comments included failure of management to attend to staff complaints and the perception of high staff turnover due to a lack of recognition and acknowledgement of overworked staff.
17
Makong, Makahlolo. "Retention strategies for doctors and nurses in Lesotho : an implementation framework." Thesis, Cape Peninsula University of Technology, 2017. http://hdl.handle.net/20.500.11838/2559.
Full textAbstract:
Thesis (MTech (Business Administration))--Cape Peninsula University of Technology, 2017.This paper reviews retention strategies for Lesotho’s doctors and nurses and presented an implementation framework to support and promote staff retention. . Based on the increasing necessity to retain doctors and nurses, the implementation framework becomes an essential element of retention strategy. A qualitative and quantitative research design technique using a self-managed questionnaire and interviews was adopted to gather data. The 120 doctors and nurses make up a sample. The information was statistically analysed using SPSS and grounded theory. Results identified that the current implementation strategy has failed to increase the retention rate of doctors and nurses. It is hoped that the implementation framework presented in this paper would help to achieve increased retention rate for doctors and nurses.
18
Bekwa, Noluvuyo Margaret. "Assessing reasons for non-compliance to the requirements of the Employment Equity Act no. 55 of 1998 : case study of the dietetics department within Tygerberg Hospital." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/85573.
Full textAbstract:
Thesis (MPA)--Stellenbosch University, 2013.ENGLISH ABSTRACT: The relevance of employment equity has been widely debated. This study is of the view that affirmative action is the core factor in realising compliance to and implementation of employment equity. The study was aimed at investigating why Tygerberg Hospital has not complied with the implementation of the Employment Equity Act (EEA) No 55 of 1998 specifically with regards to the field of Dietetics. Research questions have been formulated, relying on literature which includes guiding legislation and policies. Recruitment and selection processes applicable to the dietetic department were analysed and linked with the consulted literature. Role of transformation in transforming the institution was part of the study to ascertain the scope of transformation in managing diversity within Tygerberg Hospital. A combination of data collection tools was used in the study, including interviews and questionnaires to better understand the underlying reasons of non-compliance. The fundamental findings of the study showed that even though policies and legislation had been formulated, there are underlying issues to be addressed by the institution, such as language barriers and personal perceptions of the institution which could subsequently be improved through effective diversity management strategies. It is recommended that the institution will have to come up with a short-term, measurable plan to ensure compliance such as an institutional employment equity plan, appointment of a transformational officer who will focus on managing the institutional diversity management, and an internal capacity building unit to carry out institutional training and development as opposed to the current system. To ensure monitoring and evaluation compliance on employment equity, it is recommended that the responsibility be linked to the performance plan of the senior managers as well as the line manager of the dietetic department. By so doing failure to comply will result in a poor performance assessment outcome of the delegated authority, compliance enforced through departmental disciplinary procedures.
AFRIKAANSE OPSOMMING: Die toepaslikheid van billike indiensneming is al wyd gedebatteer. Hierdie studie is die mening toegedaan dat regstellende aksie die kern faktor is om nakoming van en die implementering van billike indiensneming te bereik. Die studie was daarop gemik om ondersoek in te stel waarom Tygerberg Hospitaal nie voldoen het aan die implementering van die Indiensneming Gelykheids Wet No 55 van 1998 nie, spesifiek met betrekking tot die veld van Dieetkunde. Vrae in die navorsing was geformuleer, gebasseer op literature wat rigtinggewende wetgewing en beleid insluit. Werwing en seleksie prosesse van toepassing in die Dieetkunde Departement was ontleed en gekoppel aan die toepaslike literatuur. Die rol van transformasie in die transformering van die inrigting het deel uitgemaak van die studie om die omvang van transformasie te bepaal, rakende die bestuur van diversiteit binne Tygerberg Hospitaal. ‘n Kombinasie van data versameling metodes was in die studie gebruik. Dit het onderhoude en vraelyste ingesluit om die onderliggende redes vir nie-nakoming te verstaan. Die fundamentele bevindinge van die studie het getoon dat ongeag die feit dat beleid en wetgewing geformuleer was, daar onderliggende aspekte was wat by die inrigting aangespreek moet word, soos taal-hindernisse en persoonlike persepsie oor die inrigting en wat gevolglik verbeter kan word by wyse van ‘n effektiewe uiteenlopende bestuursstrategie. Dit word aanbeveel dat die inrigting navore moet kom met ‘n kort-termyn en meetbare plan ter versekering van ‘n institusionele billikheidsindiensneming plan, die indiensneming van ‘n Transformasie Beampte wat sal fokus op bestuur van die inrigting se diversiteit en ‘n interne eenheid om die vermoë van die inrigting se opleiding en ontwikkeling uit te voer in teenstelling met die huidige sisteem. Om monitoring en evaluasie van billike indiensneming te verseker, word dit aanbeveel dat dié verantwoordelikheid gekoppel word aan die werkverrigtingsplan van Senior Bestuurders asook dié van Lynbestuurders van die Dieetkundige Departement. Mislukking om hieraan te voldoen sal lei tot ‘n swak werkverrigting evaluering resultaat van die aangewese outoriteit. Voldoening hieraan sal afgedwing moet word deur departementele dissiplinêre prosedures.
19
McIntosh, Jane. "An investigation into the effect of a staffing strategy on patient care in a selected hospital in Kwazulu-Natal." Thesis, Link to the online version, 2008. http://hdl.handle.net/10019/874.
Full text
20
Feng, Feifei. "Hospital nurses' attitudes to work : a case study of a Chinese hospital." Thesis, University of Wolverhampton, 2018. http://hdl.handle.net/2436/622069.
Full textAbstract:
The aim of this study is to explore what the relevant factors of nurses' attitudes to and at work are. These include the separate but related hypotheses - the nature of the profession and changes in terms of management and training; the nature of the work situation including contracts and pay determination; and the nature of work relations as they impinge on nurse status including relations with co-workers and patients. All of which can be understood and compared with other workers in terms of both labour process and industrial relations as Goldthorpe (1968) did in the study of car workers. In the context of the contemporary Chinese social and political economy, the research also evaluates the roles of the government and how it affects nurses' attitudes to the profession. It is grounded in a case study of 330 nurses in a Chinese public sector hospital, using questionnaires, interviews, and documentary evidence on government policies and hospital practices. The findings suggest that nurses at the case study hospital are frequently put under pressure due to the high number of patients they are expected to care for. This was caused by insufficient government funding for public sector hospitals, and the pressure to improve overall efficiency within the health service. The use of different types of employment contracts for nurses has caused strong resentment among nurses because it fails to award 'equal pay for equal work'. In addition, the current system used in many Chinese hospitals for nurse education, recruitment, training and development, and pay have not helped establish realistic expectations of nursing or rewarded nurses for the work they do effectively.
21
Fylan, Gwynn Elizabeth Margaret Mary. "Medicines management after hospital discharge : patients' personal and professional networks." Thesis, University of Bradford, 2015. http://hdl.handle.net/10454/14465.
Full textAbstract:
Improving the safety of medicines management when people leave hospital is an international priority. There is evidence that poor co-ordination of medicines between providers can cause preventable harm to patients, yet there is insufficient evidence of the structure and function of the medicines management system that patients experience. This research used a mixed-methods social network analysis to determine the structure, content and function of that system as experienced by patients. Patients’ networks comprised a range of loosely connected healthcare professionals in different organisations and informal, personal contacts. Networks performed multiple functions, including health condition management, and orienting patients concerning their medicines. Some patients experienced safety incidents as a function of their networks. Staff discharging patients from hospital were also observed. Contributory factors that were found to risk the safety of patients’ discharge with medicines included active failures, individual factors and local working conditions. System defences involving staff and patients were also observed. The study identified how patients often co-ordinated a system that lacked personalisation and there is a need to provide more consistent support for patients’ self-management of medicines after they leave hospital. This could be achieved through interventions that include patients’ informal contacts in supporting their medicines use, enhancing their resilience to preventable harm, and developing and testing the role of a ‘medicines key worker’ in safely managing the transfer of care. The role of GP practices in co-ordinating the involvement of multiple professionals in patient polypharmacy needs to be further explored.
22
Fylan, Beth. "Medicines Management after Hospital Discharge: Patients’ Personal and Professional Networks." Thesis, University of Bradford, 2015. http://hdl.handle.net/10454/14465.
Full textAbstract:
Improving the safety of medicines management when people leave hospital is an international priority. There is evidence that poor co-ordination of medicines between providers can cause preventable harm to patients, yet there is insufficient evidence of the structure and function of the medicines management system that patients experience. This research used a mixed-methods social network analysis to determine the structure, content and function of that system as experienced by patients. Patients’ networks comprised a range of loosely connected healthcare professionals in different organisations and informal, personal contacts. Networks performed multiple functions, including health condition management, and orienting patients concerning their medicines. Some patients experienced safety incidents as a function of their networks. Staff discharging patients from hospital were also observed. Contributory factors that were found to risk the safety of patients’ discharge with medicines included active failures, individual factors and local working conditions. System defences involving staff and patients were also observed. The study identified how patients often co-ordinated a system that lacked personalisation and there is a need to provide more consistent support for patients’ self-management of medicines after they leave hospital. This could be achieved through interventions that include patients’ informal contacts in supporting their medicines use, enhancing their resilience to preventable harm, and developing and testing the role of a ‘medicines key worker’ in safely managing the transfer of care. The role of GP practices in co-ordinating the involvement of multiple professionals in patient polypharmacy needs to be further explored.University of Bradford studentship
23
Mitchell, James S. "Management spiritual retreats formulating and implementing a spirituality for health care /." Theological Research Exchange Network (TREN), 1991. http://www.tren.com.
Full text
24
Onaga, Chukwuka Moses. "The impact of job redesign on employee job outcomes: the case of the implementation of a private-public partnership model at a hospital." Thesis, Rhodes University, 2015. http://hdl.handle.net/10962/d1017521.
Full textAbstract:
It has been widely reported that despite high health expenditure and a myriad of policies in place, South Africa’s health outcomes are worse than those in many lower income countries. The adverse health outcomes are even more pronounced in a rural province such as the Eastern Cape Province. Consequently, the Eastern Cape Department of Health (ECDOH) had turned to Private Public Partnerships (PPP) with the hope of mitigating some of the challenges beleaguering the health system in the province. This study evaluated the impact of the implementation of one of the PPP models at an Eastern Cape Hospital on key employee job outcomes. This is crucial as there had not yet, been this type of scientific assessment of the impact of the PPP model since the inception of the PPP about half a decade ago. Theoretical guidance of the study was provided by the Job Characteristics Theory (JCT) of Oldham and Hackman (1975), which predicted that changes in five core characteristics of a job will affect three critical psychological states which will in turn impact on key employee job outcomes. Uniquely, this study veered away from the traditional quantitative approach to the application of the JCT but rather adopted a qualitative case study approach. There is historical evidence that cross cultural validation of a theory in a new setting (a South African PPP hospital in this instance) benefits from an initial qualitative study. Data collection and analysis were guided by the JCT. Primary data collection was by semi-structured, face to face, one on one interviews. The analyses of the data specifically employed pattern matching and explanation building techniques, all underpinned by the JCT. Validity of interview data was strongly contributed to by available relevant case study documents. This study found that indeed, the implementation of this PPP model brought about changes in all five (JCT) core job characteristics of clinical staff, but to varying degrees in the three unique shared service areas. Interestingly, the three psychological states were found to have been impacted upon by changes in the JCT core job characteristics but also by factors related to the context of the job, such as quality of supervision and co-worker relationship. In contrast to the predictions of the JCT, this study also found that the key job outcomes were impacted directly by such contextual factors as the recent availability of specialists and staff shortages, among others. It also emerged that the PPP implementation has directly evoked a perception of inequity and breach of psychological contract among clinical staff working at the shared service areas. Among the three shared areas, the accident and emergency unit was discovered to have had the worst overall impact. Due to the importance of contextual factors at this PPP setting, key recommendations were directed towards improved management of the jobs. It is also recommended that a follow-up quantitative study be commissioned to further explore the main themes that emerged from this study. This research report is presented in three sections. Section 1 is the evaluative report itself, structured as an academic paper. Section 2 expands on the literature that was briefly reviewed in Section 1 while Section 3 outlines, in greater details, the research methods followed during the conduct of the research and the justifications thereof.
25
Mac, Gabhann Kevin. "Managing ethno-cultural differences in healthcare service delivery in hospital settings : the Irish experience." Phd thesis, Université de Strasbourg, 2012. http://tel.archives-ouvertes.fr/tel-00983562.
Full textAbstract:
Europe in the 21st century is a continent of cultural and ethnic diversity. Recent enlargement of the European Union to 27 states, constant flows of free trade and the migration of people have resulted in an increasingly diverse Europe. National health systems face the challenge of accommodating the cultural diversity of healthcare providers and service users. The Irish health system is an example of a national health system which has attempted to implement adequate planning and delivery of care and support services, encompassing the needs of minority ethnic communities (MECs) in a new and rapidly changing multicultural Ireland.This research focuses on the challenges of recent multiculturalism in Ireland and describes the Irish health sector's process in the construction of the Whole Organisation Approach (WOA) as the framework for Irish hospitals to respond to the management of diversity and the provision of culturally sensitive healthcare service delivery to members of MECs.The aim of the research is to investigate how six hospitals have implemented the Whole Organisation Approach as recommended in the Irish Health Services Executive's National Intercultural Health Strategy 2007-2012. Research findings indicate to what extent the Irish strategy has been implemented in each hospital and outline factors that promote and impede successful implementation at a hospital level and analyses how each of the three strands, i.e. organisational ethos, workplace environment and service elements necessary to support intercultural training, of the WOA have been implemented across the 6 hospitals.
26
John, Koodathinal John. "A Biblical model for personnel development and conflict resolution in an organised ministry." Online full text .pdf document, available to Fuller patrons only, 2002. http://www.tren.com.
Full text
27
Shum, Wai-man, and 沈慧文. "Assessing the effectiveness of the human resources management for nursing staff of the Hospital Authority in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B46759773.
Full text
28
Barros, Dione Bezerra de. "CompreensÃes e escolhas de um grupo de gerentes de um hospital de alta complexidade sobre estratÃgias de melhoria da gestÃo." Universidade Federal do CearÃ, 2010. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=7603.
Full textAbstract:
O alto nÃvel de complexidade da gestÃo hospitalar exige muita criatividade por parte dos gestores e gerentes para identificar estratÃgias que conduzam aos resultados desejados e que faÃam frente aos inÃmeros desafios que surgem e se renovam no cotidiano das instituiÃÃes. As estratÃgias da gestÃo hospitalar sÃo diretamente influenciadas pelo contexto onde a organizaÃÃo està inserida. As gerÃncias dos serviÃos nÃo podem ignorar os fatores sÃciopolÃticos que definem o rumo das suas atividades, mas veem-se questionadas acerca do seu preparo tÃcnico-gerencial para encontrar caminhos para as dificuldades urgentes.
Este estudo teve como objetivo analisar os discursos dos gerentes de serviÃos acerca das estratÃgias para a melhoria da gestÃo, em um hospital de alta complexidade do CearÃ. Trata-se de uma pesquisa avaliativa, utilizando a abordagem qualitativa, realizada com seis gerentes de serviÃos do Hospital Dr. Carlos Alberto Studart Gomes, Fortaleza, CearÃ, no perÃodo de 3 de maio a 30 de junho de 2010. Foram realizadas entrevistas individuais, gravadas, com transcriÃÃo das narrativas, com a posterior anÃlise de conteÃdo. Os participantes selecionados foram gerentes com experiÃncia de, no mÃnimo, dois anos na funÃÃo. Foram definidas as seguintes unidades de significaÃÃo: estratÃgias de gestÃo hospitalar; motivaÃÃo para escolha das estratÃgias de gestÃo hospitalar; aspectos dificultadores da gestÃo hospitalar e aspectos facilitadores da gestÃo hospitalar. Os gestores revelaram que as escolhas acerca das estratÃgias para melhoria da gestÃo hospitalar variam em funÃÃo da sua formaÃÃo e das experiÃncias vividas, tanto na vida pessoal, como profissional. Destacaram como relevantes as estratÃgias relacionadas à gestÃo de pessoas, uso de indicadores, exercÃcio da lideranÃa e interaÃÃo dos processos, todas orientadoras do Modelo de ExcelÃncia em GestÃo PÃblica (MEGP). PÃde-se apreender que o gerente precisa ser qualificado para trabalhar a intersubjetividade nos grupos, caso contrÃrio, nÃo terà sucesso com as estratÃgias que adota, podendo ter dificuldades com a resoluÃÃo de problemas, inclusive por processos de comunicaÃÃo falhos que distanciam pessoas e metas organizacionais. Considera-se indispensÃvel um maior investimento na formaÃÃo teÃrico-prÃtica dos gerentes para enfrentar o grande desafio da gestÃo hospitalar.The high complexity level of hospital management requires a great deal of creativity on the part of hospital managers and administrators so as to identify strategies leading to the expected outcomes which also face up to the countless challenges renewedly arising in the institutionsâ daily routine. Hospital management strategies are directly influenced by the context where the organization belongs. Services management cannot ignore sociopolitical factors which determine their activities directions, but they find themselves being questioned about their techno-managerial readiness for finding ways to solve the difficulties which may arise. This study aims at analyzing what services managers say regarding strategies for enhancing management in a high complexity hospital in CearÃ. It is an evaluative research, which used quality approach, and was carried out among six services managers of Hospital Dr. Carlos Alberto Studart Gomes, Fortaleza, CearÃ, from May 3rd to June 30th, 2010. Recorded individual interviews were held, with narrative transcriptions and later content analyses. The selected participants were managers with at least a 2-year experience in the position. The following units of meaning have been set: hospital management strategies; motivation for hospital management strategies choices; hindering aspects in hospital management; and facilitating aspects in hospital management. The managers reported that choices regarding the strategies for the enhancement of the hospital management vary due to their educational background and what they have experienced both personally and professionally. They highlighted as being relevant the strategies related to people management, the use of indicators, leadership practice, and the interaction of processes, all of them guidelines for the Public Management Excellence Model (in Portuguese, Modelo de ExcelÃncia em GestÃo PÃblica â MEGP). We could infer that the manager needs to be skilled to work the intersubjectivity within the groups, otherwise he/she will not be successful in the strategies he/she adopted, which may cause him/her difficulties while resolving situations, including faulty communicational processes that keep people away from the organizational targets. We regard as indispensable greater investment in the managersâ theoretical and practice formation for facing the huge challenge of hospital management.
29
Harmse, Magda Susanna. "Physicians' perspectives on personal health records: a descriptive study." Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/6876.
Full textAbstract:
A Personal Health Record (PHR) is an electronic record of a patient’s health-related information that is managed by the patient. The patient can give access to other parties, such as healthcare providers and family members, as they see fit. These parties can use the information in emergency situations, in order to help improve the patient’s healthcare. PHRs have an important role to play in ensuring that a patient’s complete health history is available to his healthcare providers at the point of care. This is especially true in South Africa, where the majority of healthcare organizations still rely on paper-based methods of record-keeping. Research indicates that physicians play an important role in encouraging the adoption of PHRs amongst patients. Whilst various studies have focused on the perceptions of South African citizens towards PHRs, to date no research has focused on the perceptions of South African physicians. Considering the importance of physicians in encouraging the adoption of PHRs, the problem being addressed by this research project thus relates to the lack of information relating to the perceptions of South African physicians of PHRs. Physicians with private practices at private hospitals in Port Elizabeth, South Africa were surveyed in order to determine their perceptions towards PHRs. Results indicate perceptions regarding benefits to the physician and the patient, as well as concerns to the physician and the patient. The levels of trust in various potential PHR providers and the potential uses of a PHR for the physician were also explored. The results of the survey were compared with the results of relevant international literature in order to describe the perceptions of physicians towards PHRs.
30
Wood, Benjamin R. "Workplace violence in the emergency healthcare setting balancing the needs of behavioral patients-in-crisis with the personal safety of hospital staff /." Online version, 2009. http://www.uwstout.edu/lib/thesis/2009/2009woodb.pdf.
Full text
31
Leung, Chiu-fai Charles, and 梁超輝. "A study of the transformation of domestic services in the Hong Kong Hospital Authority." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31965933.
Full text
32
Crawford, H., and Jean Croce Hemphill. "Bridging the Gap in Care Transitions by Implementing an Electronic Homeless Resource Toolkit for Case Management Personnel: Hospital to Community." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7574.
Full text
33
Van, Dyk Anneline Lynette. "Die bepaling van standaarde vir die eenheidsbestuurder in geselekteerde hospitale." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51692.
Full textAbstract:
Thesis (MCur)--Stellenbosch University, 2000.ENGLISH ABSTRACT: The traditional management practice of the unit manager has changed dramatically in the past decade. She is responsible to supply nursing services in an environment which is characterized by smaller operational budgets, rapid developments and changes in every sphere. The researcher has identified deficiencies in the management process of the unit manager. This led to the evaluation of the management activities of the unit manager in a selected group of hospitals. A quantitative, non-experimental, descriptive approach was followed with a questionnaire survey as research design. Standards were set and the management activities were evaluated against these standards. The main findings were: • The unit manager was not 100% involved in her comprehensive management task • The unit manager did not have the necessary training to empower her to manage effectively. The researcher recommends that the unit manager should be empowered by inservice education programmes but should also follow the formal management programmes at a recognized tertiary education institution. Keywords: Unit management / Standard formulation
AFRIKAANSE OPSOMMING: Die tradisionele bestuurspraktyk van die eenheidsbestuurder het oor die afgelope dekade dramaties verander. Sy is verantwoordelik vir die verskaffing van verpleegdienste in 'n omgewing wat gekenmerk word deur kleiner operasionele begrotings, vinnige vooruitgang en veranderinge op alle gebiede, Die navorser het leemtes in die bestuursproses van die eenheidsbestuurder geïdentifiseer. Dit het gelei tot die evaluering van die bestuursaktiwiteite van die eenheidsbestuurder in 'n geselekteerde groep hospitale. 'n Kwantitatiewe, nie-eksperimentele beskrywende navorsingsbenadering is gebruik met 'n vraelysopname as navorsingsontwerp. Standaarde is gestel waarteen die bestuursaktiwiteite geëvalueer is. Die belangrikste bevindinge was dat: • Die eenheidsbestuurder nie 100% betrokke was by haar omvangryke bestuurstaak nie • Die eenheidsbestuurder nie oor die nodige opleiding beskik wat haar bemagtig om hierdie bestuurstaak effektief te verrig nie. Die navorser beveel aan dat die eenheidsbestuurder bemagtig moet word deur middel van indiensopleidingsprogramme maar ook deur formele bestuursopleiding aan 'n erkende tersiêre opvoedkundige intansie moet te volg. Sleutelwoorde: Eenheidsbestuur/standaard formulering
34
Balabanian, Yvete Carvalho Chaves 1965. "Rotatividade dos profissionais de enfermagem de um hospital universitário público." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/283889.
Full textAbstract:
Orientador: Maria Inês MonteiroDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Enfermagem
Made available in DSpace on 2018-08-25T17:34:14Z (GMT). No. of bitstreams: 1 Balabanian_YveteCarvalhoChaves_M.pdf: 2175763 bytes, checksum: c4a6dbb48d4e4cf4dc66c5c63b120739 (MD5) Previous issue date: 2014
Resumo: A rotatividade de profissionais de enfermagem é impactante para a qualidade e segurança da assistência prestada aos usuários, para o desgaste dos profissionais envolvidos na educação permanente, assim como para o dispêndio de valores para custear os processos demissionais e admissionais nas instituições empregadoras. A reposição do profissional depende de processos de seleção e contratação que demandam tempo para a sua admissão, período em que a equipe fica sobrecarregada pela sua ausência ou pela presença temporária de outro trabalhador não capacitado para as atividades específicas da unidade de trabalho. Portanto, é relevante para a gestão hospitalar o estudo do mecanismo que leva os profissionais a buscarem a troca de emprego nas instituições de saúde, os motivos e a análise dos índices da rotatividade, podendo elucidar as circunstâncias, as consequências e propor possíveis intervenções da administração da instituição para a retenção de trabalhadores, para que a assistência de enfermagem seja realizada por profissionais competentes, experientes, que visem à qualidade da assistência de forma humanizada. O presente estudo realizou a análise dos fatores relacionados à rotatividade dos trabalhadores de enfermagem, durante quatro anos, mediante as informações de um instrumento de coleta de dados do Departamento de Enfermagem de um hospital universitário público do interior do Estado de São Paulo, que foram preenchidos pelos próprios profissionais na vigência dos trâmites do processo demissional do trabalho. A amostra foi de 223 sujeitos, a maioria era técnicos de enfermagem, a mediana do tempo de permanência foi de um ano e meio, a mediana da idade dos profissionais foi 31,4 anos, 62 relataram algum problema de saúde durante a permanência do contrato com o hospital e o vínculo empregatício teve relevância nas demissões. Os motivos da rotatividade dos profissionais são multifatoriais e influenciados pelos aspectos econômicos, sociais e políticos, que se inter-relacionam em um panorama dinâmico. Os profissionais demissionários apresentaram pouco tempo de permanência no hospital, indicando que o trabalhador com menor tempo de trabalho apresenta maior facilidade de desvincular e procurar oportunidades no mercado de trabalho. O vínculo contratual demonstrou ser um fator significante para a rotatividade dos profissionais de enfermagem, com reflexo na satisfação com o salário e benefícios. Diminuir as diferenças nas condições de trabalho que geram insatisfação, como vínculos de trabalho diferentes para profissionais que exercem a mesma função e realizam as mesmas atividades é fundamental para o decréscimo da taxa de rotatividade
Abstract: The nursing professional turnover is impactful in the user assistance service quality and security, depletion of energy by the professional involved in permanent education and expenditure of amounts for cover resignation processes and hiring processes in employing institutions. The professional reposition depends of selection and hiring processes that demands time for the effective professional hiring, period in which the team is overloaded by the lack of professional or by the temporary presence of a non-trained member for specific activities of the work unit. Therefore, the study of the mechanism that leads the workers to change jobs in health institutions, their motives and turnover rate are relevant for the hospital management. This knowledge can clarify the circumstances and consequences and propose management interventions for the retention of professionals who are competent, experienced and able to provide high-quality and humanized assistance. This study accomplished the analysis of nursing employee turnover factors through the information of a collecting data instrument from the Nursing Department in a public university hospital in the state of São Paulo, which were answered by the professionals themselves in the validity of the dismissal procedures work process for a period of four years. The sample consisted of 223 subjects, most were nursing technicians, the median length of stay was a year and a half, the median age was 31.4 years of professional, 62 reported some health problem during the stay of the contract with the hospital and the employment relationship had relevance in employment layoffs. The grounds for the personnel turnover are multifactorial and affected by economic, social and political aspects, which are interrelated in a dynamic landscape. Retiring professionals showed little time spend in the hospital, indicating that professionals with less time on the job are more likely to disassociate and seek opportunities in the labor market. The contractual obligation demonstrated being a significant factor for the nursing employee turnover, reflecting in the satisfaction on the salary and benefits. In order to lessen the turnover rate, it is fundamental to diminish the differences between the working conditions that generates dissatisfaction, such as different working binding for professionals that are in the same position and do the same activities
Mestrado
Enfermagem e Trabalho
Mestra em Ciências da Saúde
35
Nakagawa, Yoshiaki. "A New Accounting System for Financial Balance Based on Personnel Cost and New Indicators for Management Efficiency in a Hospital." Kyoto University, 2010. http://hdl.handle.net/2433/120573.
Full text
36
Oswald, Sharon. "A retrospective case note analysis of the recognition and management of deteriorating patients prior to critical care admission." Thesis, University of Stirling, 2017. http://hdl.handle.net/1893/27289.
Full textAbstract:
This study explores the use of early warning scores (EWS) in deteriorating patients. These are widely used tools to measure vital signs and highlight abnormal physiology in acutely unwell patients. Measurements of the process in the management of the deteriorating patient includes time to first assessment of such patients. The level of clinician involved in the subsequent management is also investigated to determine whether escalation of care was appropriate. This work is a retrospective case note analysis of the recognition and management of deteriorating patients prior to critical care admission. Research Questions 1. What violations in the optimum process are associated with sub-optimal recognition and management of deteriorating patients and delayed critical care admission in patients triggering early warning scores in acute care wards? 2. Are there independent variables which can predict the delay in the recognition and management of deteriorating patients and subsequent critical care admission? Methods The literature was reviewed to determine the optimum process of recognition and management of deteriorating patients in acute care wards. A data collection tool was then specifically designed and locally validated to extract objective data from the case records. A sample of 157 patients admitted to critical care from acute wards over a 6 month period were included in the study. The case records were then retrospectively reviewed and information was extracted using the data collection tool. Results The accuracy and frequency of early warning scores were measured and findings demonstrated that 59% of Early Warning Scores (EWS) were miscalculated. The most frequent of those miscalculated were the intermediate scores (4 or 5) (error rate - 52%) followed by the higher scores (6 or more) (error rate - 32%). The least frequently miscalculated were the lower scores (0 -3) (error rate 15%). Descriptive data from the sample such as age, ward, diagnosis, time of hospital admission, time and day of transfer / EWS triggering were included. From the total case records reviewed, 110 patients had abnormal Early Warning Scores (4 or more) and were included in the inferential data analysis. The independent variables related to the processes objectively measurable in the recognition and management of deteriorating patients were included. After descriptive analysis the independent variables were cross-tabulated with the dependent variable using Pearson chi-square. The dependent variable was identified from the literature. This was whether time from triggering an abnormal EWS to critical care admission was delayed more than 6 hours. The subsequent predictor variables were then entered in to a binary logistic regression model for statistical analysis using SPSS version 21 software. Binominal Logistic Regression Analysis identified three significant variables predicting delay of the recognition and management of deteriorating patients. • Frequency of EWS measurement not increased appropriately • Length of stay prior to critical care admission 12-36 hours • If no consultant review during 6 hours of abnormal EWS Implications for Future Practice This study highlights areas of risk in the detection of patients’ clinical deterioration in acute wards. These findings should guide quality improvement to prevent unnecessary morbidity and mortality. As a key area of patient risk included the lack of frequency and accuracy of EWS measurements, staff education is required to ensure staff are given the appropriate knowledge to understand the use of the tool. Regular review of the frequency of measurement is also required as this was statistically significant in the delay to critical care admission. The high risk time from admission of 12-36 hours needs further investigation. This study also highlights the need for senior decision makers to be involved in the care of deteriorating patients to improve outcomes.
37
Hillman, Ken School of Medicine UNSW. "CONCEPTUALISATION, DEVELOPMENT AND IMPLEMENTATION OF THE MEDICAL EMERGENCY TEAM (MET) AS A SYSTEM OF MANAGEMENT TO IMPROVE OUTCOMES FOR SERIOUSLY ILL PATIENTS." Awarded by:University of New South Wales. School of Medicine, 2006. http://handle.unsw.edu.au/1959.4/30408.
Full textAbstract:
This thesis covers research around the Medical Emergency Team (MET) system, describing its development, evaluation and other related research that evolved as a result of the MET concept. The basic problem that prompted development of the MET system was related to the inadequate care given to the seriously ill in acute hospitals. This thesis contains background research on some of the reasons why a MET system may be useful, including the limited skills and knowledge of medical training and the sort of acute problems encountered in a hospital at night. Research then describes how the MET system works, including published data on when and how often the team is called, the type of patient the team is called to, the interventions performed by the team, and the outcome of patients on whom a MET was called. At the same time research was being performed around outcome indicators used to measure the effectiveness of the MET system, resulting in the use of cardiac arrests, deaths and unanticipated admission to the Intensive Care Unit (ICU) as common end-points for research in this area. Further research demonstrated that potentially preventable antecedents were common before serious illness The thesis then concentrates on how effective the MET system was in reducing death and serious adverse events. The first study compared a hospital where a MET system had been implemented to two control hospitals and found there was a reduction in admissions to the ICU but after adjustment, not for deaths and cardiac arrests. The second study used a cluster randomised methodology, enrolling 23 hospitals across Australia, comparing the three end-points described above. The study found no difference between both groups. It did highlight some interesting areas around the importance of effective implementation in determining the effectiveness of systems in health. Other publications have described the importance of developing effective ways of caring for the seriously ill outside traditional areas such as ICUs. The MET system, or variations on it, is now implemented in many hospitals in Australia and around the world and there have been two international MET conferences held in North America and international guidelines on the MET concept established.
38
Kobuse, Hiroe. "Visualizing variations in organizational safety culture across an inter-hospital multifaceted workforce." 京都大学 (Kyoto University), 2016. http://hdl.handle.net/2433/215217.
Full text
39
Rossetti, Ana Cristina. "Carga de trabalho de profissionais de enfermagem em pronto socorro: proposta metodológica." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-18012011-084203/.
Full textAbstract:
O objetivo deste estudo foi propor uma metodologia para identificar carga de trabalho de enfermagem em Pronto Socorro Geral. Trata-se de estudo descritivo exploratório, do tipo estudo de caso, realizado em um Hospital Geral, de atenção secundária que integra o Sistema Único de Saúde, com gestão por Organização Social, localizado no município de São Paulo. Os dados foram coletados de junho a agosto de 2010 por meio de instrumentos específicos. Para identificar a carga de trabalho das áreas em que houve atendimento para avaliação da gravidade e realização de procedimentos, como: Sala de choque, Sala de sutura e Sala de medicação/procedimentos de pacientes adultos e pediátricos, os dados foram coletados por meio de planilhas para registrar o tempo disponibilizado pela enfermagem para os pacientes. Nas áreas em que o paciente permaneceu em observação ou aguardando internação, como: Sala de emergência e Observações de pacientes adultos e pediátricos, utilizaram-se instrumentos reconhecidos na literatura. Para calcular a carga de trabalho da Sala de emergência, utilizou-se o Nursing Activities Score, considerando que essa área é similar a uma Unidade de Terapia Intensiva. Para as Observações de pacientes adultos e pediátricos foi utilizada a categoria de cuidado e o Sistema de Classificação de Pacientes específicos para unidades de internação de pacientes adultos e pediátricos. Pela característica da coleta de dados, obtiveram-se amostras distintas em cada área do PS. O tempo médio de assistência de enfermagem por paciente foi encontrado e a carga média diária de trabalho de cada área foi calculada por meio de equações e apresentada em horas e na relação entre enfermagem-paciente nas áreas em que o paciente permaneceu em observação ou aguardando internação. Na Triagem de classificação de risco, por tratar-se de consultórios que funcionam ininterruptamente, a carga diária de trabalho foi de 48 horas (1:1 consultório). Nas demais áreas, a carga média diária de trabalho encontrada foi: na Sala de choque, 27,8; na Sala de emergência, 170,7 (1:1,2); na Observação de pacientes adultos, 293,6 (1:3,5); na Observação de pacientes pediátricos, 108,7 (1:2,1); na Sala de medicação/procedimentos de pacientes adultos, 169,0; na Sala de medicação/procedimentos de pacientes pediátricos,63,8; e na Sala de sutura, 8,7. Os instrumentos utilizados para coleta de dados mostraram-se adequados, no entanto, os utilizados na Sala de choque e Sala de medicação e procedimentos de pacientes pediátricos não contemplaram a assistência por mais de um profissional de enfermagem para um paciente. Com este estudo, foi possível propor uma metodologia para identificação da carga de trabalho em Pronto Socorro geral e assim subsidiar o dimensionamento de profissionais de enfermagem.The aim of this study is to suggest a methodology to identify nursing workload in General Emergency Room (ER). This is an exploratory and descriptive study, case study type, carried out in General Public Hospital located in the city of São Paulo for secondary care, managed by social organization. Data was collected from June to August 2010 using specific instruments to identify workload of areas that have assistance to assess severity and procedures performed at shockroom, suture room and medication/procedure room for adults and pediatric patients. All data was registered in plans including length of time required to nursing assist patients. In areas that patients were at observation and waiting for hospital admission, such as: emergency room and outpatient observation room for adults and pediatric patients we used well-known instruments in the literature. To measure workload in emergency room the Nursing Activities Score was used, because this area is similar to an Intensive Care Unit. For adults and pediatrics patients observation, the category of care and patient classification system specific for hospital admission units were used. Given the characteristics of data collected, different samples were obtained in each area of ER. The mean time of nursing care and mean daily workload were found, and both were calculated using equations and presented in hours and nurse-patient ratio in the area that patients were kept at observation or waiting for hospital admission. In triage rooms, which function continuously, daily workload was 48 hours (1:1 triage room). In other areas, the mean daily workload was 27.8 in the shockroom, 170.7 (1:1.2) in the emergency room, 293.6 (1:3.5) in the outpatient observation room for pediatric patients, 108.7 (1:2.1) in the medication/procedure room for adults patients, 63.8 in the medication/procedure room for pediatric patients and 8.7 in the suture room. The instruments for data collection were adequate, however, those used in shockroom and medication/procedure room for pediatric patients did not provide care delivered by more than one nurse practitioner for a single patient. This study enables to propose a methodology to identify workload in general emergency room and helps to sizing the nursing professional.
40
Mora, Cintia Teixeira Rossato. "Gestão do trabalho nos hospitais da 9ª região de saúde do Paraná." Universidade Estadual do Oeste do Parana, 2015. http://tede.unioeste.br:8080/tede/handle/tede/657.
Full textAbstract:
Made available in DSpace on 2017-07-10T14:17:13Z (GMT). No. of bitstreams: 1
DissertacaoCintiaFinal.pdf: 1517804 bytes, checksum: fd57c5897b91994bcdbb803fd0388323 (MD5)
Previous issue date: 2015-07-02This study is characterized as a documentary and field research. It has as an objective to analyze the work management in hospitals of the 9th of Paraná Health Region, moreover, it tried to identify characteristics of the hospital network and health professionals in the technical and professional level. The first part of the research took place through the data collection in the National Health Facilities Register in April 2014, hospitals in the region were identified, as well as all health professionals who work in these units. Among the main results, in the 13 hospitals, 84.62% (11) were private and 61.54% (8) were small. It was identified 2,307 working occupations, from which 57.91% (1,336) were of higher education; 77.42% (1786) located in Foz do Iguaçu (health regional headquarters); 69.27% (1598) of the linkages work were classified as poor; 23.50% (376) had more than one occupation. Regarding the second step, the field research was carried out through semi-structured questionnaire filled out by the own researcher in meetings from November 2014 to February 2015, in the workplace of the subjects. It was interviewed 116 health professionals, from which 52.59% (61) were of a higher level and 47.41% (55) technical level, with specific training in health. The questions addressed socio-demographic aspects, training, work management (order of entry, type of relationship, career plans, jobs and salaries, program evaluation and other forms of performance assessment, progression and career promotion, payment bonuses and incentives) continuing education and political participation of the interviewed. Among the results it stood out: average age of 38.20 ± 14.73 years; female 72.41% (84); residents in Foz do Iguaçu 70.69% (82); belonging to the nurse staff 60.34% (70). The selection process was the primary form of entrance (56.43%), most of the bonds were protected, both in technical (95.84%) as the top-level (60.30%). The medical professional is the one with most unprotected bonds (100%), more than one job (84.61%) and higher salaries. Regarding the other aspects of the analyzed work management, it was identified in the professional responses the performance evaluation (25.71%), progression and career promotion (34.28%), bonus payments (13.57%) and incentive payments (29.29%). Lifelong learning occured sporadically in only 50% of cases, predominantly technical level (40%). As a conclusion it is noted that there is a hospital network of small institutions, from private nature, with a number of beds both general or complementary below recommended, divided workforce between doctors and nursing staff and lack of plan career, jobs and salaries in hospitals. It is recommended a greater regulation of the government in labor management in hospitals, regardless the ownership being public or private, since all are active in providing health services, which are considered by the Federal Constitution as a public relevance
O presente estudo caracterizou-se como uma pesquisa documental e de campo. Teve por objetivo analisar a gestão do trabalho nos hospitais da 9ª Região de Saúde do Paraná, além disso, buscou identificar características da rede hospitalar e dos profissionais de saúde do nível técnico e superior. A primeira parte da pesquisa realizou-se através da coleta de dados no Cadastro Nacional de Estabelecimentos de Saúde, em abril de 2014, foram identificados os hospitais da região, bem como todos os profissionais de saúde que atuam nestas unidades. Entre os principais resultados tem-se que nos 13 hospitais 84,62% (11) eram privados e 61,54% (8) de pequeno porte. Identificaram-se 2.307 ocupações de trabalho, destas 57,91% (1.336) eram de nível superior; 77,42% (1.786) localizados em Foz do Iguaçu (sede da regional de saúde); 69,27% (1.598) dos vínculos de trabalho classificaram-se como precários; 23,50% (376) apresentavam mais que uma ocupação. Em relação à segunda etapa, a pesquisa de campo, ocorreu por meio de questionário semiestruturado preenchido pelo próprio pesquisador em encontro presencial no período de novembro de 2014 a fevereiro de 2015, no local de trabalho dos sujeitos. Foram entrevistados 116 profissionais de saúde, sendo 52,59% (61) de nível superior e 47,41% (55) de nível técnico, com formação específica em saúde. As questões abordaram aspectos sócio-demográficos, de formação, gestão do trabalho (forma de ingresso, tipo de vínculo, plano de carreira, cargos e salários, programa de avaliação e outras formas de avaliação de desempenho, progressão e promoção na carreira, pagamentos de gratificações e incentivos) educação permanente e participação política dos entrevistados. Entre os resultados destacam-se: idade média de 38,20±14,73 anos; gênero feminino 72,41% (84); residentes em Foz do Iguaçu 70,69% (82); pertencentes ao pessoal de enfermagem 60,34% (70). O processo seletivo foi a principal forma de ingresso (56,43%), a maioria dos vínculos eram protegidos, tanto no nível técnico (95,84%) como no nível superior (60,30%). O profissional médico é o que apresentou mais vínculos desprotegidos (100%), mais de um vínculo empregatício (84,61%) e maiores remunerações. Em relação aos demais aspectos da gestão do trabalho analisados, identificou-se nas respostas dos profissionais a avaliação de desempenho (25,71%), progressão e promoção na carreira (34,28%), pagamentos de gratificações (13,57%) e pagamentos de incentivos (29,29%). A educação permanente ocorria de maneira esporádica em apenas 50% dos casos, com predomínio para o nível técnico (40%). Como conclusão salienta-se a existência de uma rede hospitalar composta por instituições de pequeno porte, de natureza privada, número de leitos tanto gerais como complementares abaixo do preconizado, força de trabalho dividida entre profissionais médicos e da equipe de 8 enfermagem e ausência de Plano de Carreira, Cargos e Salários nos hospitais. Recomenda-se uma maior regulação do Estado na gestão do trabalho nos hospitais, independente da titularidade ser pública ou privada, uma vez que todos atuam na prestação de serviços de saúde, os quais são considerados pela Constituição Federal como de relevância pública.
41
Borges, Jackeline Lemes. "Satisfação profissional de enfermeiros de um hospital da rede pública de Goiânia." Universidade Federal de Goiás, 2013. http://repositorio.bc.ufg.br/tede/handle/tede/4236.
Full textAbstract:
Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2015-03-04T13:48:17Z
No. of bitstreams: 2
Dissertação - Jackeline Lemes Borges - 2013.pdf: 1174696 bytes, checksum: e86915750de79cb73b4cdfb8ffc8ef35 (MD5)
license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-03-05T11:49:26Z (GMT) No. of bitstreams: 2 Dissertação - Jackeline Lemes Borges - 2013.pdf: 1174696 bytes, checksum: e86915750de79cb73b4cdfb8ffc8ef35 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)
Made available in DSpace on 2015-03-05T11:49:26Z (GMT). No. of bitstreams: 2 Dissertação - Jackeline Lemes Borges - 2013.pdf: 1174696 bytes, checksum: e86915750de79cb73b4cdfb8ffc8ef35 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-12-10
This is an exploratory descriptive cross-sectional study with a quantitative approach , conducted with 47 nurses in a public hospital in Goiânia . The instrument used was a questionnaire Index of Work Satisfaction of Stamps (1997), translated, adapted and validated for Portuguese by Lino (1999). The questionnaire is self-administered and self-explanatory, composed of paired comparisons that allow the identification of the importance of each component to job satisfaction and attitude scale, Likert, which helps identify job satisfaction perceived by the subjects as to the components Autonomy, Interaction, Professional Status, Organizational policies, Pay and Task Requirements. Data were analyzed using SPSS version 18.0. To assess the internal consistency Cronbach's alpha was used. Most of the nurses interviewed were women, married, with some specialization, with less than five years on the job , with more than one employment and effective. The component considered most important to the job satisfaction of nurses was the Pay and least Autonomy. The Professional Status was identified as the one that most influenced the satisfaction regarding their current job, and compensation as the least satisfaction. Index of Work Satisfaction among nurses was 9.77 and the Professional Status showed the highest real level of satisfaction, followed by Interaction, Organizational policies, Autonomy, Task Requirements and Pay. It can be considered that the high level of satisfaction with the professional status of nurses showed motivation to the perception of the importance and recognition of their work by the same category and own patients. The adoption of an instrument, from what was used in this study could be extended to the whole multidisciplinary team, is an alternative to the monitoring of this indicator in public health institutions in Goiânia, contributing to decision making by hospital managers in search of improved quality of care .
Estudo descritivo exploratório com delineamento transversal, de abordagem quantitativa, realizado com 47 enfermeiros de um hospital da rede pública de Goiânia. O instrumento utilizado foi o questionário do Índice de Satisfação Profissional de Stamps (1997), traduzido, adaptado e validado para a língua portuguesa por Lino (1999). O questionário é auto-aplicável e auto-explicativo, composto por comparações pareadas que permitem a identificação da importância de cada componente para a satisfação profissional e uma escala de atitudes, do tipo Likert, que possibilita identificar a satisfação profissional percebida pelos sujeitos quanto aos componentes Autonomia, Interação, Status profissional, Normas organizacionais, Remuneração e Requisitos do Trabalho. Os dados foram analisados no programa SPSS versão 18.0. Para avaliar a consistência interna foi utilizado o alfa de Cronbach. Dos enfermeiros entrevistados a maioria eram mulheres, casadas, com alguma especialização, com menos de cinco anos de trabalho na instituição, com mais de um vínculo empregatício e efetivo. O componente considerado mais importante para a satisfação profissional dos enfermeiros foi a Remuneração, e o menos importante a Autonomia. O Status Profissional foi identificado como aquele que mais influenciava na satisfação quanto ao seu trabalho atual, e a Remuneração como o de menor satisfação. O índice de Satisfação Profissional entre os enfermeiros foi de 9,77 e o Status Profissional foi o que apresentou maior nível real de satisfação, seguido da Interação, Normas Organizacionais, Autonomia, Requisitos do Trabalho e Remuneração. Pode-se considerar que o alto índice de satisfação com o Status profissional evidenciou motivação do enfermeiro com a percepção da importância seu trabalho e reconhecimento do mesmo pela própria categoria e pacientes. A adoção de um instrumento, a partir do que foi utilizado neste estudo, podendo se estender a toda a equipe multiprofissional, é uma alternativa para o acompanhamento desse indicador nas instituições de saúde pública de Goiânia, podendo contribuir para a tomada de decisão pelos gestores hospitalares, em busca de melhoria da qualidade da assistência.
42
Ruiz, Paula Buck de Oliveira. "Custo da rotatividade da equipe de enfermagem em hospital de ensino." Faculdade de Medicina de São José do Rio Preto, 2014. http://hdl.handle.net/tede/316.
Full textAbstract:
Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2017-02-08T12:59:51Z
No. of bitstreams: 1
paulabuckdeoliveiraruiz_dissert.pdf: 1095981 bytes, checksum: 359255681fb82a18f8d15fb82f928411 (MD5)Made available in DSpace on 2017-02-08T12:59:51Z (GMT). No. of bitstreams: 1 paulabuckdeoliveiraruiz_dissert.pdf: 1095981 bytes, checksum: 359255681fb82a18f8d15fb82f928411 (MD5) Previous issue date: 2014-11-28
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
Introduction: The staff turnover is determined by the output of employees or exchanges of staff the organization and constitutes a poorly explored subject and subdued by the institutions, but it begins to take relevant due to the economic consequences. The management of this indicator may benefit the intellectual capital, the environment, the institution's image and cost control. Aims: Identify the types and reasons of dismissals of professionals and calculate the rate and cost of staff turnover. Methods: Study was exploratory, descriptive, and manner of case study, conducted in teaching hospital southeastern Brazil, in the period May-November 2013. The data were obtained through interviews shutdown provided by human resources in the period 2009-2012. For the calculation of the turnover was used the equation proposed by the Hospital Quality Commitment. For the measurement of cost, the collection was prospective (May-August 2013). and was used the Methodology of Calculation of Cost of Turnover in Nursing. The pre and post contract processes were mapped and the direct costs of labor were analyzed Results: There were 522 dismissal, the average of terminations was 76.3 (dp 97,3), personal reason was the predominant cause of shutdowns - 35.9%, mainly for nursing assistants. The average turnover rate/year was 9.4% nurses, 35.7 % and 11.2 % technical assistants. The total cost of turnover, during the period of 2013 May and August was R$314,605.62 and the average was R$2.759,69, and the cost of employees was R$8.279,09 (average turnover rate of 0.98%). The costs of pre-employment totaled R$101.004,60, and the vague process consumed – 29.5%, and the costs of post-employment totaled R$213.601,02, aimed mainly at subprocess decreased productivity – 63.6%. The cost of turnover/employee avarage R$2.221,42 to R$3.073,23 and the cost of dismissal/employee was R$8.279,09, from R$5.553,56 to R$16.811,75. Conclusion: This research showed a historical series regarding turnover and reasons for dismissals, as well as the financial impact of employees/off cost which represented three times the average salary of the nursing staff. These findings instrumentalize manager for improvement in reducing costs of these proceedings and directed will retain intellectual capital policies.
Introdução: A rotatividade de pessoal é determinada pela entrada e saída de colaboradores do quadro de pessoal da instituição e constitui um tema ainda pouco explorado e subestimado pelas instituições, mas que começa a tomar relevância em virtude das consequências econômicas. A gestão desse indicador poderá beneficiar o capital intelectual, o ambiente, a imagem da instituição e o controle dos gastos. Objetivos: Identificar os tipos e motivos dos desligamentos da equipe de enfermagem; Calcular a taxa e o custo de rotatividade desses profissionais. Métodos: Pesquisa quantitativa, exploratória, descritiva na modalidade de estudo de caso, realizada em hospital de ensino de capacidade extra na região sudeste do Brasil. Os dados foram obtidos por meio da entrevista de desligamento disponibilizado pelos recursos humanos no período de 2009 a 2012. Para o cálculo da rotatividade foi adotada a equação proposta pelo Compromisso com a Qualidade Hospitalar. A mensuração do custo da rotatividade da equipe de enfermagem foi prospectiva (maio a novembro de 2013) mediante a aplicação da Metodologia do Cálculo de Custo de Rotatividade na Enfermagem. Foram mapeados os processos de pré e pós-contratação e analisados os custos diretos da mão de obra. Resultados: Houve 522 desligados, com média anual de 76,3 (dp 97,3), o motivo pessoal foi a causa predominante dos desligamentos - 35,9%, principalmente para auxiliares de enfermagem. A taxa média de rotatividade foi de 9,4% enfermeiros, 35,7% técnicos e 11,2% auxiliares. A mensuração do custo total da rotatividade da equipe de enfermagem, no período de maio a agosto de 2013 foi de R$314.605,62, média rotatividade/colaborador de R$2.759,69 e o custo desligamento/colaborador R$8.279,09 (taxa média de rotatividade de 0,98%). Os custos decorrentes da pré-contratação totalizaram R$101.004,60, sendo que o subprocesso vagas consumiu - 29,5% e os pós-contratação totalizaram R$213.601,02, destinados principalmente ao subprocesso diminuição da produtividade - 63,6%. Conclusão: A presente pesquisa mostrou uma série histórica em relação à taxa de rotatividade e motivos de desligamentos, bem como, o impacto financeiro do custo desligamento/colaborador que representou três vezes o salário médio da equipe de enfermagem. Estes achados instrumentalizam o gestor para melhorias na redução de custos desses processos e de políticas direcionadas à retenção de capital intelectual.
43
Machado, Bruna Parnov. "LIDERANÇA DE ENFERMEIROS-GERENTES NO CONTEXTO HOSPITALAR." Universidade Federal de Santa Maria, 2013. http://repositorio.ufsm.br/handle/1/7371.
Full textAbstract:
Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorMore than find the importance of the presence of active leaders in the hospital nursing context, we sought torescue the meanings attributed by nurses who experience the position of manager in nurse and that have their actionspermeated by possibilities for leadership development. View of this the research conducted object was the nurse manager leadership that act at the University Hospital in the countryside of Rio Grande do Sul. For this, was elaborated the guiding question: how the manager nurse exercises the leadership in a hospital context? Were outlined that objectives: to analyzes the leadership of University Hospital nurse managers, to describe the experiences related to leadership in nurses managementevery day and to elaborate a representative theoretical matrix of nurse managers experiences´ in relation to leadership. It is about a descriptive and qualitative research which scenario was the Santa Maria University Hospital (HUSM), Rio Grande do Sul. The participants were nurse managers and the data were collected in April and May 2012, using semi-structured interviews.The analysis had been started concomitant with the data collect, with theuse of Grounded Theory (GT), theoretical support of Symbolic Interactionism and others leadership studies.Were followed the ethical principles of Resolution No. 196/96 of the National Health Council, which regulates research involving humans.That way, the audio data´swere transcripts and coded according to the order: open coding, axial code and selective coding.The results originated the thematic categories: realizing a nurse manager, looking for meanings to the process of leading and being leader, experiencing the service reality, confronting management challenges, establishing interpersonal relationships and seeking improvements to the service.The interconnection of these, through the analysis with the paradigmatic model has made emerge a theoretical matrix, composed by the central phenomenon following:experiencing nursing management in a hospital context: meanings to leadership. Finally, it was possible identified that the nurse manager realizes the importance of their actions at the managerial dimension and seeks to achieve their objectivesthrough attitudes that approaches a participative leadership model.Thus, should be paid attention with regard the need to awaken a look that valuates interpersonal relationships and the development of the human potential inhealthcare organizations.
Mais do que constatar a importância da presença de líderes ativos no contexto da enfermagem hospitalar, buscou-se resgatar os significados dos enfermeiros que vivenciam a posição de gerentes em enfermagem e que possuem suas ações permeadas de possibilidades relativas ao desenvolvimento de liderança. Em vista disso, o objeto da pesquisa realizada foi a liderança de enfermeiros-gerentes que atuam em um Hospital Universitário do interior do Rio Grande do Sul. Para isso, elaborou-se a questão norteadora: como o enfermeiro-gerente exerce a liderança no contexto hospitalar? Foram traçados como objetivos: analisar a liderança de enfermeiros-gerentes de um Hospital Universitário, descrever as vivências relacionadas à liderança no cotidiano gerencial dos enfermeiros e elaborar uma matriz teórica representativa da experiência dos enfermeiros-gerentes em relação à liderança. Trata-se de uma pesquisa descritiva e qualitativa cujo cenário foi o Hospital Universitário de Santa Maria (HUSM), Rio Grande do Sul. Os sujeitos foram enfermeiros-gerentes, e os dados foram coletados em abril e maio de 2012, por meio de entrevistas semiestruturadas. A análise foi iniciada concomitante à coleta, com a utilização da Teoria Fundamentada nos Dados (TFD) e o respaldo teórico do Interacionismo Simbólico e estudos sobre liderança. Foram seguidos os princípios éticos da Resolução nº 196/96 do Conselho Nacional de Saúde que regulamenta a pesquisa envolvendo seres humanos. Dessa forma, os dados em áudio foram transcritos e codificados de acordo com a ordem: codificação aberta, codificação axial e codificação seletiva. Os resultados obtidos originaram as categorias temáticas: percebendo-se enfermeiro- gerente, buscando significados para o processo de liderar e ser líder, vivenciando a realidade do serviço, enfrentando desafios gerenciais, estabelecendo relações interpessoais e buscando melhorias para o serviço. A interconexão dessas, por meio da análise junto ao Modelo Paradigmático, fez emergir uma matriz teórica, composta pelo seguinte fenômeno central: vivenciando a gerência de enfermagem no contexto hospitalar: significações para a liderança. Por fim, foi possível identificar que o enfermeiro- gerente percebe a importância de suas ações na dimensão gerencial e busca atingir seus objetivos por meio de atitudes que se aproximam de um modelo de liderança participativa. Assim, deve-se atentar no que se refere à necessidade de despertar um olhar voltado para a valorização das relações interpessoais e ao desenvolvimento do potencial humano nas organizações de saúde.
44
Capellini, Verusca Kelly. "Exposição, avaliação e manejo da dor aguda do recém-nascido em unidades neonatais de um hospital estadual." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/22/22133/tde-16012013-113033/.
Full textAbstract:
Os recém-nascidos internados em unidades neonatais são expostos a inúmeros procedimentos potencialmente dolorosos durante sua hospitalização, e há desconhecimento de tal exposição e das práticas para o manejo da dor, na maioria dos serviços brasileiros de referência neonatal. Este estudo descritivo exploratório foi realizado em três etapas, com os objetivos de avaliar o conhecimento e as práticas dos profissionais de saúde que atuam em unidades neonatais de um hospital estadual do interior paulista quanto à avaliação e ao manejo da dor no recém-nascido (etapa 1), identificar os registros de avaliação da dor e de intervenções farmacológicas e não farmacológicas para o alívio da dor, feitos pelos profissionais em prontuários neonatais nesse hospital (etapa 2) e dimensionar a exposição dos neonatos a procedimentos de dor aguda, durante os primeiros sete dias de internação nessas unidades neonatais (etapa 3). Os 15 médicos, 8 enfermeiras e 34 auxiliares de enfermagem preencheram um questionário contendo dados relacionados ao conhecimento e às práticas de avaliação e manejo da dor neonatal. Na etapa 2, foi feito um estudo retrospectivo em fonte secundária, utilizando dados dos prontuários de 115 recém-nascidos internados nas unidades de cuidados intensivos e intermediários neonatais do hospital, no período de 12 meses. Na etapa 3, foi realizado registro à beira do leito de todos os eventos potencialmente dolorosos a que os recém-nascidos foram submetidos, durante a primeira semana de internação nessas unidades, no período de setembro a dezembro de 2011. Constatou-se que apenas uma auxiliar de enfermagem acredita que o neonato não sente dor. Todas as enfermeiras e a grande maioria dos médicos e auxiliares de enfermagem afirmaram que avaliam a dor no recém-nascido, tendo como parâmetros de avaliação mais frequentes o choro e a mímica facial; os parâmetros fisiológicos, especialmente o aumento da frequência cardíaca, foram os mais mencionados pelos médicos. Nenhum dos profissionais de saúde conhecia escalas para a avaliação de dor no recém-nascido. Entre as medidas não farmacológicas para o alívio da dor neonatal, citadas pelos profissionais de saúde, predominou o uso da glicose com ou sem a sucção não nutritiva, enquanto as medicações mais referidas como adequadas para o alívio da dor neonatal foram o fentanil e o paracetamol. Os registros sobre a avaliação e as intervenções para o alívio da dor neonatal constavam apenas nas prescrições médicas e nos diagnósticos, prescrições e anotações de enfermagem. Os recém-nascidos participantes da etapa 3 foram submetidos a 1.316 procedimentos potencialmente dolorosos, durante a primeira semana de internação; a média foi de 5,9 ± 4,7 procedimentos por dia, variando de 9,4 ± 6,2 no primeiro dia a 3,8 ± 3,2 procedimentos no sétimo dia de internação. Os procedimentos dolorosos mais frequentes foram as punções de calcâneo e venosa. Concluiu-se que há desconhecimento dos profissionais de saúde e sub-registro sobre a avaliação e o manejo adequados da dor aguda no recém- nascido e que os neonatos são submetidos a inúmeros procedimentos potencialmente dolorosos, durante sua hospitalização. Recomenda-se a capacitação profissional e a elaboração de protocolos de cuidado para a avaliação adequada e o tratamento efetivo da dor, nessas unidades neonatais.The neonates hospitalized in neonates\' unities are exposed to a countless potentially painful procedures during hospitalization and there is no knowledge of this exposure and the practices to handling this pain in most cases of Brazilian neonates referring. This descriptive exploratory study was made in three stages, in purpose to evaluate the knowledge and the practices of the health professionals who work in neonates\' unities of a state hospital in the São Paulo interior that concerns to evaluation and handling of pain in neonates (stage 1), identify the evaluation records of pain and pharmacologic and non-pharmacologic interventions for pain relief done by the professionals in neonates\' records in this hospital (stage 2) and dimensioning the exposure of the neonates to acute pain procedures during the first seven days of hospitalization in these unities (stage 3). The 15 physicians, 8 nurses and 34 nursing assistants filled a questionnaire related to knowledge and practices of evaluation and handling of neonate pain. On stage 2 was made a retrospective study in secondary sources using data from records of 115 hospitalized neonates in intermediary and intensive and care unities in 12 months. On stage 3 was made a record on the bedside of all the potentially painful events that the neonates underwent during the first week of hospitalization from September to December of 2011. When It comes to believing that the neonates don\'t feel any pain, just one nursing assistant believed that. All the nurses and the most part of physicians asserted that they evaluate the pain taking into consideration the weeping and facial expressions; the physiologic parameters, like heart rate increasing, were mentioned specially by the physicians. None of the professionals knew the scale of evaluation of a pain in neonates. Among the mentioned non- pharmacologic procedures, the glucose use with or without non- nutritive suction, while the most mentioned adequate medicine were fentanyl and paracetamol. In the records about evaluation and intervention for pain relief were present only medical prescriptions and in diagnosis, prescriptions and nursing notes. The participating neonates from stage 3 were submitted to 1,316 potentially painful procedures during the first week of hospitalization; the mean was 5.9 ± 4.7 procedures per day, varying from 9.4 ± 6.2 in the first day to 3.8 ± 3.2 procedures in the seventh day of hospitalization. The more frequent painful procedures were calcaneus and venous puncture. We concluded that there is ignorance by the health professionals and under-register about the evaluation and handling of acute pain in neonates and that the neonates are submitted to a countless potentially painful procedures during their hospitalization. We recommend the professional capacitation and elaboration of care protocols for the evaluation and effective treatment of pain in these neonates\' unities.
45
Gangloff, Florence. "Contribution à l'étude du contrôle organisationnel dans les organisations professionnelles : discours croisés des acteurs face à la mise en oeuvre du nouveau management public à l'hôpital." Thesis, Montpellier 1, 2010. http://www.theses.fr/2010MON10051.
Full textAbstract:
Dans le cadre des systèmes de santé, la réalité de la crise est très largement admise. Les solutions proposées prennent alors forme au travers d’initiatives spécifiques des pouvoirs publics. L’ensemble des réformes véhiculées par les différents gouvernements ont une influence sur les acteurs de santé. Cette thèse a pour objectif de mettre en évidence les discours des différents acteurs des centres hospitaliers. La question centrale est ainsi formulée : quelles sont les représentations des différents acteurs face à la mise en oeuvre du nouveau management public à l’hôpital ? Le cadre théorique proposé pour cette analyse prend appui sur le lien entre contrôle et discours dans les organisations, d’une part. Et, d’autre part, il fait appel au nouveau management public et au développement de l’obligation de rendre compte pour les acteurs. Cette étude se base sur une démarche méthodologique qualitative centrée sur des données textuelles issues d’entretiens réalisés en France et en Italie. Pour cela, elle mobilise des outils d’analyse de discours. Les résultats de l’étude montre que de représentations communes existent entre les acteurs de la même catégorie professionnelle (médical, infirmière et administrative). Ces représentations sont toutefois divergentes lorsque celles-ci sont mises en parallèle. Deux catégories d’acteurs, les responsables de pôle et les cadres de santé, émergent de l’étude pour leur capacité à gérer deux dimensions fondamentales : le management et le soinWithin the framework of the health care systems, the reality of the crisis is widely admitted. The solutions are shaped through specific initiatives of public authorities. The health care reforms conveyed by the various governments have an influence upon the actors of the health care sector. The goal of this thesis is to bring to light the discourses of the various actors of medium hospitals. The central question is : what are the representations of the various actors during theimplementation of the new public management in the hospital ? The theoretical framework for this analysis lies on the link between control and discourses in organizations, on one hand. And, on the other hand, it highlights the new public management and to the development of the accountability for the actors. This study is based on a qualitative methodological approach focused on textual data stemming from interviews in France and in Italy. For that purpose, we choose tools for the analysis of discourse. The results of the study show that common representations remain between the actors of the same professional category (medical, nursing and administrative). These representations are however different from one category to another. Two categories of actors, responsible of pole and nursing managers, are revealed by the study for their ability to manage two fundamental dimensions : management and care
46
Rivière, Audrey. "Tensions de rôle et stratégies d'ajustement chez les cadres de santé : une étude empirique à l'hôpital public." Thesis, Montpellier 2, 2014. http://www.theses.fr/2014MON20104/document.
Full textAbstract:
Depuis ces trois dernières décennies, la modernisation du secteur hospitalier implique un nouveau mode d'organisation de l'activité et une nouvelle répartition des pouvoirs à l'hôpital. De nouveaux modes de management ont été transposés du secteur privé pour perfectionner et moderniser l'action du secteur public. Cependant, les objectifs de ces deux secteurs ne sont pas les mêmes : satisfaction de l'intérêt général pour l'un et rentabilité pour l'autre. Cette différence peut être enrichissante (exemples : émulation liée à la compétition, réalisation d'économies substantielles), mais aussi source de résistances et de stress. Cette nouvelle gestion publique déstabilise les différents acteurs des établissements qui doivent, à la fois, répondre aux grands principes du service public et à des logiques économiques de performance. Dans un tel contexte, des tensions de rôle peuvent-elles se développer chez le personnel soignant ? Ce travail de recherche s'intéresse tout particulièrement aux différentes stratégies d'ajustement utilisées par les cadres de santé, pour faire face aux tensions de rôle qui pourraient se développer. Les changements vécus suite à la mise en place du Nouveau Management Public dans les hôpitaux ont modifié le rôle et les fonctions des cadres de santé qui sont désormais à l'interface entre une culture du soin et une culture gestionnaire. Cette recherche est basée sur une étude exploratoire menée auprès de 15 cadres de santé dans un CHRU et sur une enquête confirmatoire réalisée auprès de 445 cadres de santé répartis dans 39 établissements hospitaliers publics français. Les résultats révèlent que les cadres de santé se trouvent dans une position délicate qui suscite différents types de tensions de rôle quotidiennes. Des stratégies d'ajustement utilisées par les cadres de santé pour faire face à ces tensions de rôle ont également été identifiéesOver the past three decades, the modernization of the hospital sector has given rise to a new way of organizing the activity and a new distribution of power in hospitals. New management methods have been transposed from the private sector with the aim to improve and modernize the public sector action. However, the objectives of these two sectors are not the same: satisfaction of the public interest for one of them and profitability for the other one. This difference can be beneficial (emulation in link with competition, substantial savings), but also a source of resistance and stress. This new public management destabilizes the different hospital actors who must respond, in the same time, to the principles of public service and to the economic logics of performance. In this context, role stresses can they develop for caregivers? This research is particularly concerned with the different strategies used by the healthcare managers to cope with this kind of potential role stresses. Different changes implemented with the new public management in hospitals, have modified the role and functions of healthcare managers who are henceforth at the interface between a culture of care and a management culture. This research comprises an exploratory study conducted among 15 French healthcare managers in a public hospital and a confirmatory survey conducted among 445 French healthcare managers in 39 public hospitals. The results show that the healthcare managers are in a delicate position that raises different type of daily role stresses. Strategies used by healthcare managers to cope with these role stresses have been also identified
47
Carroll, Gretchen Kay. "AN EXAMINATION OF THE RELATIONSHIP BETWEEN PERSONALITY TYPE, SELF PERCEPTION ACCURACY AND TRANSFORMATIONAL LEADERSHIP PRACTICES OF FEMALE HOSPITAL LEADERS." Bowling Green State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1288189512.
Full text
48
Derros, Ellie. "L'hôpital malade de l'absentéisme santé : évaluation socio-économique des congés "maladie" non ordinaires chez les personnels non médicaux dans trois établissements publics d'Auvergne." Thesis, Clermont-Ferrand 1, 2012. http://www.theses.fr/2012CLF10395/document.
Full textAbstract:
La présente étude s’attache à l’absentéisme long pour raison de santé chez les personnels hospitaliers non médicaux. Deux types de congé non ordinaire sont visés : les C.L.M. et C.L.D. Ceux-Ci constituent en effet un enjeu de gestion par les désorganisations et les coûts, principalement cachés, qu’ils suscitent. Ces derniers représentent également un enjeu de santé sociale (voire publique), en raison de la morbidité qu’ils expriment.Afin de les caractériser et de les mesurer, ce travail s’inspire de l’approche socioéconomique des organisations (I.S.E.O.R., Lyon). On s’efforce notamment de procéder à un diagnostic pluriel (social, organisationnel et financier). L’ambition est triple. Il s’agit 1) de faire prendre conscience de l’ampleur des préjudices (effet miroir pour la direction) ; 2) de contribuer au développement d’un référentiel théorique et pratique (évaluation élargie des absences) ; 3) d’encourager la promotion d’un présentéisme-Qualité (préconisations de type R.H.). Les diverses investigations se font sur trois hôpitaux régionaux publics (Auvergne) de taille volontairement différente (C.H.U., C.H. et H.L.). Les résultats laissent à chaque fois apparaître des profils, des fonctionnements, des dépenses et des vécus assez alarmants. Ils témoignent d’une défaillance au niveau des ressources humaines (organisationnelle et managériale). Ces retours négatifs attestent par ailleurs d’une possibilité d’extension de l’analyse de type socio-Économique (application aux interruptions prolongées en structures de soins). Ils autorisent enfin à dégager quelques pistes d’intervention, tantôt transversales(proximité dans les procédures), tantôt spécifiques (particularités de la structure)The present study focuses on the long absenteeism for health reason at non medicalhospital staff. Two types of non ordinary sick leave are aimed : the C.L.M. and C.L.D. (rulingson salary insurance). Those indeed constitute a challenge of management by thedisorganizations and the costs, mainly hidden, which they cause. They represent also a stakein social health, because of the morbidity they express.In order to characterize and measure them, this work takes as a starting point theorganizations socio-Economic approach (I.S.E.O.R., Lyon). We particularly try to carry out aplural diagnosis (social, organizational and financial). The ambition is threefold. It acts 1) tomake become aware of the scale of the damages (mirror effect for the direction); 2) tocontribute to the development of a theoretical and practical reference frame (widenedevaluation of the absences); 3) to contribute to the promotion of good and really presenteeim(human resources recommendations).The various investigations are done on three publicregional hospitals of voluntarily different size (C.H.U., C.H., H.L. – in the center of France).Each time the results let appear alarming profiles, operations, spending and lived. They giveevidence to a failure in organisational and managerial human resources. These negativereturns also attest an extension possibility of the socio-Economics’ analysis (to the extendedsickness absences in structures of care). They finally allows to identify some tracks ofintervention, sometimes transverse (proximity in the procedures), sometimes specific(peculiarities of the structure)
49
Heus, Kamel. "Gestion des plannings infirmiers : application des techniques de programmation par contraintes." Université Joseph Fourier (Grenoble), 1996. http://www.theses.fr/1996GRE10071.
Full textAbstract:
Le problème d'établissement de plannings de travail, bien que n'étant pas spécifique au milieu hospitalier, est l'un des problèmes les plus difficiles et les plus délicats rencontre par tout service de soinsLa diversité des contraintes à satisfaire fait de la génération des plannings une tâche complexe qui inclut une phase importante de négociation et de calcul combinatoire. Décrits et explores par des techniques de recherche opérationnelle et d'intelligence artificielles, ces problèmes suscitent un intérêt nouveau en raison de l'émergence de nouvelles techniques de programmation et du développement du nouveaux modèles d'organisation de travail
Nous présentons dans le cadre de ce travail une nouvelle approche de résolution du problème de plannings infirmiers basée sur les techniques de programmation par contraintes (PPC). La formulation du problème comme un CSP permet une gestion transparente des contraintes et des affectations journalières des infirmiers, facilitant ainsi l'interactivité avec l'utilisateur et la prise en compte des vœux individuels, permettant par conséquent un management plus participatif des plannings
L'association de la programmation orientée objet avec la ppc facilite la maintenance du programme chaque fois qu'il est nécessaire d'ajouter, modifier ou supprimer des objets, règles ou contraintes
Afin de limiter la recherche de solutions dans un espace plus restreint, nous proposons deux méthodes de réduction de la complexité du problème, l'une basée sur l'élimination des valeurs permutables et l'autre sur la décomposition du problème en deux sous-problèmes
50
Martin, Mark Anthony. "Servant Leadership Characteristics and Empathic Care: Developing a Culture of Empathy in the Healthcare Setting." Antioch University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1572254537330104.
Full text