Literatura académica sobre el tema "Nurse's Role. Nursing Homes Nursing, Supervisory"

Workload in the nursing profession is high, which is associated with poor health. Thus, it is important to get a proper understanding of the working situation and to analyse factors which might be able to mitigate the negative effects of such a high workload. In Germany, many people with serious or life-threatening illnesses are treated in non-specialized palliative care settings such as nursing homes, hospitals and outpatient care. The purpose of the present study was to investigate the buffering role of resources on the relationship between workload and burnout among nurses. A nationwide cross-sectional survey was applied. The questionnaire included parts of the Copenhagen Psychosocial Questionnaire (COPSOQ) (scale ‘quantitative demands’ measuring workload, scale ‘burnout’, various scales to resources), the resilience questionnaire RS-13 and single self-developed questions. Bivariate and moderator analyses were performed. Palliative care aspects, such as the ‘extent of palliative care’, were incorporated to the analyses as covariates. 497 nurses participated. Nurses who reported ‘workplace commitment’, a ‘good working team’ and ‘recognition from supervisor’ conveyed a weaker association between ‘quantitative demands’ and ‘burnout’ than those who did not. On average, nurses spend 20% of their working time with palliative care. Spending more time than this was associated with ‘burnout’. The results of our study imply a buffering role of different resources on burnout. Additionally, the study reveals that the ‘extent of palliative care’ may have an impact on nurse burnout, and should be considered in future studies.

Objectives: to reflect on nurse leadership in a health and nursing work organizational context, as well as to provide material for nurses and nursing students that aim to study and/or improve the exercise of leadership. Methods: a theoretical essay based on a bibliographical narrative review of books, papers, and dissertations; from which three axes of analysis and reflection have been built: searching for a leadership concept, potential development for the exercise of leadership and nurse leadership in the past, present, and future. Results: leadership is an important competence for the nurse in managing the work process and coordinating the activities involving health and nurse care. Thus, the exercise of leadership requires nurses to develop entrepreneurial postures based on the setting of teams, negotiation, power relations share, and exploring human motivation at work. Conclusion: the nurse must be sure of his/her leadership role and try to develop coherently and with a critical view on the reality before different contexts, valuing the multidimensionality of the human being that provides and receives care. Descriptors: leadership; management; nursing, supervisory; nurse's role.

OBJECTIVE To describe the type and frequency of drug-related problems discussed in regular team meetings conducted in 15 Swedish nursing homes and report physician and staff assessments of these interventions and residents' outcomes. DATA SOURCES AND METHODS The data were collected within the context of a controlled trial with the primary aim of exploring the effects of regular team interventions on drug prescribing practices in Swedish nursing homes. In 15 experimental nursing homes, the residents' drug therapy was discussed regularly by a team consisting of a pharmacist, a physician, nurses, undernurses (similar to licensed practical nurses), and nurse's aides. The pharmacist documented problems, made changes, and observed outcomes. Following the intervention period, a questionnaire was sent to the medical staff that contained items regarding perceived outcomes, the intervention's impact on knowledge of drug therapy in the elderly, and attitudes toward the pharmacist's role. RESULTS Unclear indication and problematic choice of drugs were the most common drug-related problems discussed. In 19% of the situations, therapy changes were reported to have had a beneficial effect on the residents' clinical status; in 47% of the situations, staff reported no observable outcome from changes, suggesting that the changes had been appropriate. Finally, medical staff claimed in the follow-up survey that their knowledge about drug therapy had increased; they expressed an overall positive attitude toward this interactive collaboration. CONCLUSIONS Regular interventions conducted by a multidisciplinary team incorporating a pharmacist can effectively improve prescribing practices, increase staff knowledge about appropriate drug therapy in the elderly, and result in improved quality of care for nursing home residents. OBJETIVO: Describir el tipo y frecuencia de problemas relacionados a medicamentos discutidos durante las reuniones de equipo conducidas en 15 casas de convalecencias en Suecia. Reportar las evaluaciones de los médicos y otro personal de estas intervenciones y el resultado en los residentes. FUENTES DE INFORMACIÓN Y MÉTODOS: La información se recopiló dentro del contexto de un estudio controlado con el propósito primario de explorar el efecto de las intervenciones durante reuniones de equipo en las prácticas de prescripción en las casas de convalecencia en Suecia. En 15 casas de convalecencia, regularmente se llevan a cabo discusiones de la terapia de los residentes con la participación de un equipo compuesto por un farmacéutico, un médico, enfermeras, y asistentes de enfermeras. El farmacéutico documenta los problemas, cambios realizados, y resultados observados. Luego del período de intervención, se envió un cuestionario al personal médico que contenía aseveraciones sobre los resultados percibidos, el impacto de la intervención en su conocimiento sobre la farmacoterapia en el paciente de edad avanzada, y sus actitudes hacia el papel del farmacéutico. RESULTADOS: Los problemas relacionados a medicamentos más comunmente identificados y discutidos fueron falta de indicación y selección de fármaco inadecuada. En el 19% de los casos, los cambios en terapia resultaron de beneficio en el estatus clínico del residente; en el 47% de los casos, el personal reportó que no observaron resultados de los cambios, sugiriendo que los cambios fueron apropiados. Finalmente, el personal médico alegó en el cuestionario que sus conocimientos sobre la farmacoterapia en el paciente de edad avanzada aumentó y expresaron tener una actitud positiva hacia esta colaboración interactiva. CONCLUSIONES: Las intervenciones rutinarias conducidas por un equipo multidisciplinario que incorpora un farmacéutico puede efectivamente mejorar las prácticas de prescripción, aumentar el conocimiento del personal médico sobre la farmacoterapia en el paciente de edad avanzada y puede así resultar en una mejoria en la calidad del cuidado que se ofrece en las casas de convalecencia. OBJECTIF: Décrire le genre de problèmes reliés aux médicaments discutés lors des réunions d'équipe régulièrement tenues dans 15 centres d'accueuil Suédois. Rapporter l'évaluation que les médecins et le personnel soignant ont fait des résultats obtenus et du processus d'intervention. REVUE DE LITTÉRATURE ET MÉTHODES: Les données ont été collectées dans le cadre d'une étude contrôlée ayant pour objectif principal d'explorer l'effet d'interventions régulières sur les pratiques de prescription dans des centres d'accueuil Suédois. Dans les 15 centres à l'étude, des discussions concernant la thérapie médicamenteuse des résidents ont été tenues régulièrement par une équipe formée d'un pharmacien, d'un médecin, d'infirmières, de sous-infirmières, et d'aide-infirmières. Le pharmacien documentait les problèmes, les changements effectués, et observait les résultats de l'intervention. Après l'intervention, un questionnaire était envoyé au personnel médical. Ce questionnaire portait sur les résultats perçus, l'impact de l'intervention sur leurs connaissances de la thérapie médicamenteuse chez la personne âgée, et leurs attitudes envers le rôle du pharmacien. RÉSULTATS: Les problèmes les plus fréquemment discutés étaient le choix du médicament et les médicaments ayant une indication incertaine. Dans 19% des cas, les changements thérapeutiques ont eu un effet bénéfique sur l'état clinique du résident. Dans 47% des cas, le personnel n'a rapporté aucun changement à l'état du résident, suggérant ainsi que le changement était approprié. Finalement, le personnel médical reconnaît, par l'entremise du questionnaire, que leurs connaissances sur la thérapie médicamenteuse des personnes âgées se sont accrues et ils ont exprimés une attitude positive envers cette collaboration interactive. CONCLUSIONS Des interventions régulières conduites par une équipe multidiciplinaire incorporant un pharmacien peuvent effectivement améliorer les pratiques de prescription et la connaissance du personnel quant aux médicaments appropriés pour les personnes âgées. Ces interventions permettent ainsi d'améliorer la qualité des soins en centre d'accueuil.

Purpose The aim of this paper is to examine a relevant innovation in terms of how corporate supervisory boards are structured for an effective measure of anti-corruption that concerns a new application of Italian Legislative Decree No. 231/2001 in compliance with the obligations set out by OECD Convention of 17 September 1997 on the fight against corruption. Design/methodology/approach The research hypotheses which lead the study are based on an empirical analysis of 119 nursing homes with the aim of investigating the state-of-the art of this innovative application especially regarding the composition, effectiveness and functioning of the supervisory board in the unique case when this compliance system becomes compulsory. Findings The results show how, even though a certain level of uncertainty and ambiguity have led to great variance in the ways the compliance system is drafted, was possible to identify a positive relation between supervisory board composition and performance – that is the effectiveness of anti-corruption system – and a negative relation between board size and performance. Finally, the results suggest the relevance of supervisory board in fostering knowledge as mediating role. Research limitations/implications The authors believes that future work using inter-temporal modelling could build upon and extend the insights presented here. A second area arises from those contrasts in board characteristics that are present across countries and/or across company’s size, small- and medium-sized enterprises or multinational companies and/or across industrial sectors. Practical implications The authors offers a more nuanced understanding of the linkages between corporate governance and anti-corruption. In particular, the paper suggests that for an effective anti-corruption strategy, larger supervisory board sizes are associated with weaker performance, and a greater external composition is preferable to an internal one. Originality/value The paper depicts a first and relevant step toward the identification of best practices of corporate governance as anti-corruption system, relating to an innovative and unique – to the date – application of a compliance system based on the supervisory board.

Este estudo teve como objetivo geral analisar a dimensão gerencial do processo de trabalho do enfermeiro em um serviço hospitalar de emergência. Trata-se de uma pesquisa qualitativa do tipo estudo de caso com base no referencial teórico dos estudos sobre processo de trabalho em saúde, processo de trabalho gerencial do enfermeiro e gerenciamento do cuidado. Os dados foram coletados entre junho e setembro de 2009, por meio de observação participante e entrevista semi-estruturada com enfermeiros do Serviço de Emergência de um Hospital Universitário do Rio Grande do Sul – RS, Brasil. O material empírico foi analisado segundo a técnica de análise de conteúdo temática, a partir da qual se constituíram quatro categorias: 1) O trabalho dos enfermeiros no cotidiano do serviço de emergência; 2) Atuação dos enfermeiros no gerenciamento do cuidado; 3) Articulação entre os profissionais e trabalho em equipe; e, 4) Desafios no gerenciamento do cuidado e estratégias para superá-los. O trabalho dos enfermeiros no serviço de emergência é constantemente influenciado por situações inesperadas e pela procura por atendimento, que variam em diversidade e complexidade. A dimensão gerencial do trabalho do enfermeiro tem como foco o atendimento às necessidades dos pacientes e contempla a realização e o planejamento do cuidado, a previsão e provisão de recursos para o bom funcionamento da unidade e a liderança, supervisão e capacitação da equipe de enfermagem. Os enfermeiros reconhecem a importância do trabalho em equipe e sua responsabilidade na articulação das ações dos profissionais de saúde. A superlotação e manutenção da qualidade do cuidado são os principais desafios gerenciais dos enfermeiros. As estratégias para superá-los incluem mudanças no fluxo de atendimento dos pacientes e na estrutura física da unidade e a reorganização do sistema de saúde para a atenção às urgências. Esses resultados podem colaborar com o trabalho dos enfermeiros possibilitando que discutam e reflitam sobre suas práticas e avancem na compreensão do gerenciamento do cuidado como instrumento para a melhoria da assistência e das práticas de atenção à saúde nos serviços de emergência.
The purpose of this study was to analyze the managerial dimension of the nurse work in a hospital emergency service. It is a qualitative research approached as a case study based on the theoretical referent of the studies on the working process in health, managerial working process, and care management. The data were collected between June and September 2009 through participant observation and semi-structured interview with nurses of the Emergency Service of a University Hospital of Rio Grande do Sul – RS, Brazil. The empirical material has been analyzed according to theme content analysis, from which four categories had been set: 1) Nurse work in the quotidian of emergency service; 2) Care management; 3) Articulation among professionals and team work; and, 4) Challenges for care management and strategies to overcome them. The work of nurses in emergency services is constantly influenced by unexpected situations and the great search of people to be attended to; which varies in diversity and complexity. The managerial dimension of nurse‟s work focuses in the fulfillment of patients' needs and contemplates the accomplishment and care planning, prevision, provision of resources for the unit; as well as the leadership, supervision, and training of nursing team. Nurses recognize the importance of team work and their responsibility in joining health professional actions. Overcrowding and quality of care are the main challenges nurses face in managing care. The strategies to overcome them include changes in the flow of patients and physical structure of the unit and reorganization of the health system for emergency attention. These results might collaborate with the work of nurses enabling those professionals to discuss and reflect on their practices and advance in the comprehension of care management as a tool for assistance improvement and of the practices in health attention in emergency services.
Este estudio tuvo como objetivo general analizar la dimensión gerencial del proceso de trabajo del enfermero en un servicio hospitalario de emergencia. Se trata de una investigación cualitativa de tipo estudio de caso basada en el marco teórico de los estudios sobre proceso de trabajo en salud, proceso de trabajo gerencial del enfermero y gerenciamiento del cuidado. Se recolectaron los datos entre junio y septiembre de 2009, por medio de observación participante y entrevista semi-estructurada con enfermeros del Servicio de Emergencia de un Hospital Universitario del Rio Grande do Sul – RS, Brasil. Se analizó el material empírico según la técnica del análisis temático de contenido, a partir del cual se establecieron cuatro categorías: 1) El trabajo de los enfermeros en el cotidiano del servicio de emergencia; 2) Atuacción de los enfermeros en lo gerenciamiento del cuidado; 3) Articulación entre los profesionales y trabajo en equipo; y, 4) Retos en el gerenciamiento del cuidado y estrategias para superarlos. El trabajo de los enfermeros en el servicio de emergencia recibe frecuentemente la influencia de situaciones inesperadas y de la gran búsqueda por atención, que varían en diversidad y complejidad. La dimensión gerencial del trabajo del enfermero tiene como foco la atención a las necesidades de los pacientes y comprende la realización y la planificación del cuidado, la previsión y la disposición de recursos para el buen funcionamiento de la unidad y el liderazgo, supervisión y capacitación del equipo de enfermería. Los enfermeros reconocen la importancia del trabajo en equipo y su responsabilidad en la articulación de las acciones de los profesionales de salud. La superpoblación de la unidad y la manutención de la calidad del cuidado son los principales retos de los enfermeros en su gerencia. Las estrategias para transponerlos incluyen cambios en el flujo de atención a los pacientes y en la estructura física de la unidad y la reorganización del sistema de salud para la atención a las urgencias. Esos resultados pueden colaborar con el trabajo de los enfermeros permitiendo que discutan y reflexionen sus prácticas, avanzando en la comprensión de la gerencia del cuidado como una herramienta para la mejora de la asistencia y de las prácticas de atención a la salud en los servicios de emergencia.