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Letsie, Thandiwe Marethabile. "Transforming South African Public Hospitals Through Intrapreneurship Practice: Views of Unit Nurse Managers Regarding Their Potential Contribution." Global Journal of Health Science 11, no. 12 (October 29, 2019): 198. http://dx.doi.org/10.5539/gjhs.v11n12p198.
Повний текст джерелаАнотація:
The insurmountable challenges confronting public hospitals globally jeopardize envisaged quality. South Africa health care system faces a number of challenges calling for strategic business approaches embodied through intrapreneurship practice. As a foreign concept in nursing, intrapreneurship is least understood. Views of unit nurse managers concerning their potential contribution towards improving services at public hospitals are least understood. A qualitative, descriptive and explorative study done through focus groups shed light. Data analysed through Tesch approach culminated in rich verbatim. The participants’ shared the following views concerning their intrapreneurial contribution; ability to take–risk in bureaucratic public hospitals; they associate the initiative with creativity and novelty through leading transformative projects in teams, the business leaders are knowledgeable, and share ideas internally or outside. The remarkable paradigm shift in nursing adopting business strategies has a significant impact on outcome of nursing care. The proposed recommendations adding significant value, transform health care policy, practice, education. On-going capacity development for the nurses in clinical practice is a necessary quality improvement initiative.
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Hyland, Declan, and Mohammed Uddin. "A survey of the level of knowledge and understanding of members of the inpatient team on the role of the physician associate on the general adult psychiatric wards." BJPsych Open 7, S1 (June 2021): S140. http://dx.doi.org/10.1192/bjo.2021.398.
Повний текст джерелаАнотація:
AimsPhysician Associates (PAs) are healthcare professionals with a general medical education background, having completed a two-year postgraduate degree. Whilst the number of PAs employed in healthcare trusts continues to increase, the number working in mental health settings remains small.Mersey Care NHS Foundation Trust employed two PAs two years ago. In August 2019, a third PA was recruited to work at Clock View Hospital, a general adult inpatient unit.This survey aims to establish what level of understanding different members of the inpatient teams across the inpatient wards have of the tasks PAs are permitted to undertake and those they are not.MethodA survey was designed, listing 37 tasks, e.g. completing an admission clerking. For each task, the participant was asked whether a PA is allowed to complete it or not, with three options provided – “can carry out the task”, “cannot carry out the task” and “do not know.” A score of + 1 was awarded if the correct answer was provided, –1 for an incorrect answer and 0 if the respondent didn't know. The highest possible score for a completed survey was + 37 points; the lowest possible score was –37 points.A sample of survey respondents was identified from the three general adult inpatient wards at Clock View Hospital and the Psychiatric Intensive Care Unit (PICU), comprising: senior doctors, junior trainees, Ward Manager, Deputy Ward Manager, Band 5 nurse and Assistant Practitioner.ResultTwenty-four members of staff completed the survey – 3 senior doctors, 4 junior trainees, 4 Ward Managers, 4 Deputy Ward Managers, 5 Band 5 nurses and 4 Assistant Practitioners. The respondents were distributed equally across the three general adult wards and the PICU. The highest survey score was 36 out of 37 (a Consultant); the lowest was 18 (a junior trainee). The lowest mean score was variable across the different grades of staff, with Consultants scoring highest at 29 and Assistant Practitioners and Ward Managers both scoring lowest at 25. There was little variability in mean score (only 2 points) across the three wards and PICU.ConclusionThe results from this survey demonstrate that different members of the inpatient team have a good understanding of what tasks PAs are and are not permitted to. There is still a need to provide further education to inpatient staff to ensure they utilise the PA at Clock View Hospital appropriately and that the PA is able to develop his skill set.
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Casida, Jesus M., Patrick C. Crane, Tara L. Walker, and Lisa M. Wargo. "Elaboration of Leadership and Culture in High-Performing Nursing Units of Hospitals as Perceived by Staff Nurses." Research and Theory for Nursing Practice 26, no. 4 (2012): 241–61. http://dx.doi.org/10.1891/1541-6577.26.4.241.
Повний текст джерелаАнотація:
The leadership–culture phenomenon, a known explanatory construct for organizational performance, is understudied in nursing. Building on our previous work, we further addressed this knowledge gap through explorations of demographics and hospital variables which may have a significant influence on staff nurses’ (SNs) perceptions of their nurse managers’ (NMs) leadership and nursing unit culture. Furthermore, we explored the extent to which the NMs’ leadership predicted specific cultures which typify nursing unit effectiveness. Using dissertation data provided by 278 SNs, we found that SNs educated at the baccalaureate level or higher had favorable perceptions of their nursing unit performance and viewed their NMs’ leadership differently than the SNs with diploma or associate degrees. The frequent portrayals of transformational (TFL) leadership behaviors (e.g., visionary) by the NMs were paramount in shaping culture traits which exemplify high performance outcomes. TFL leaders were more likely to shape unit cultures which are flexible and adaptive to the environmental challenges within and outside the nursing unit. Thus, the type of NMs’ leadership and unit culture may provide an added value in explaining the performance level in patient care units which consequently affects the overall hospital/organizational outcomes. Implications for research and leadership practices are presented.
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Hyland, Declan, and Mohammed Uddin. "An analysis of the views of different members of the inpatient team on the role of the physician associate on the general adult psychiatric wards." BJPsych Open 7, S1 (June 2021): S140—S141. http://dx.doi.org/10.1192/bjo.2021.399.
Повний текст джерелаАнотація:
AimsPhysician Associates (PAs) are healthcare professionals who have a general medical education background, having completed a two-year postgraduate degree. Whilst the number of PAs employed in healthcare trusts continues to increase, the number working in mental health settings remains small.Mersey Care NHS Foundation Trust employed two PAs two years ago. In August 2019, a third PA was recruited to work at Clock View Hospital, a general adult inpatient unit.This analysis aimed to establish the views of different members of the team across the three general adult wards and the Psychiatric Care Unit (PICU) at Clock View Hospital on the role of the PA.MethodA sample of members of staff was identified from across the three general adult inpatient wards at and the PICU, comprising: senior doctors (Consultants and Specialty Doctor), junior trainees (Core Trainee and Foundation Trainees), Ward Manager, Deputy Ward Manager, Band 5 nurse and Assistant Practitioner. Each member of staff was asked to answer the question “On a scale of 1 to 10 (with “1” being completely unhappy, “10” being completely happy), how happy are you to have a PA working on your ward?” Each staff member was then asked to provide comments on their views on the role of the PA.ResultTwenty-three members of staff participated – 3 x senior doctors, 4 x junior trainees, 4 Ward Managers, 4 Deputy Ward Managers, 4 x Band 5 nurses and 4 x Assistant Practitioners. The respondents were distributed equally across the three general adult wards and the PICU. All 23 members of staff provided a score of 10 out 10 to the question about how happy they were to have a PA working on the ward. Many of the staff members provided some very positive comments on their respective views about the role of the PA at Clock View Hospital. No negative comments were provided by any members of staff.ConclusionIt is clear from the large sample of members of staff of different grade at Clock View Hospital that were surveyed that the PA has been a warmly received and welcome addition to the inpatient team and that the PA is viewed as having become an important and valued member of the inpatient team. This provides a strong argument for both Mersey Care NHS Foundation Trust, and other mental health trusts across the U.K., to consider employing more PAs to work in their inpatient units.
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Van, Johnson, Alicia Mangram, Christopher Mitchell, Manuel Lorenzo, Dot Howard, and Ernest Dunn. "Is There a Benefit to Multidisciplinary Rounds in an Open Trauma Intensive Care Unit regarding Ventilator-Associated Pneumonia?" American Surgeon 75, no. 12 (December 2009): 1171–74. http://dx.doi.org/10.1177/000313480907501204.
Повний текст джерелаАнотація:
Multidisciplinary rounds (MDRs) have been instituted for patient care since June 2005. Before June 2005, all care was provided by individual practitioners. MDRs include the surgical intensivist, surgical resident, patient's nurse, case manager, pharmacist, chaplain, nutritionist, and respiratory therapist. Our study examined the effect of MDRs on ventilator-associated pneumonia in trauma patients in open intensive care units (ICUs). Group 1 included patients from June 2003 to May 2005 before the implementation of MDRs, and Group 2 included patients after the institution of MDRs from June 2005 to May 2007. In Group 1, there were 83 ventilator-associated pneumonias (VAPs) during 2414 ventilator days. In Group 2, there were 49 VAPs during 2094 ventilator days. The ratio of VAPs per thousand ventilator days decreased from 34.4 to 23.4 between the two groups ( P = 0.04). When comparing trauma patients in our open ICU with similar mean Injury Severity Score and mean Abbreviated Injury Score for chest and for head and neck, implementing MDRs significantly decreased our incidence of VAP.
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Anderson, Tamika, Michelle Flood, Susan Kelley, Lea Ann Pugh, Renato Casabar, Mamta Sharma, and Rebecca Battjes. "Quality Improvement Measures to Reduce Central-Line–Associated Bloodstream Infections (CLABSIs) in a Neonatal Intensive Care Unit (NICU)." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s362—s363. http://dx.doi.org/10.1017/ice.2020.987.
Повний текст джерелаАнотація:
Background: Central-line–associated bloodstream infections (CLABSIs) are a significant contributor to morbidity and mortality for neonates; they also increased healthcare costs and duration of hospitalization. This population is susceptible to infections because of their undeveloped immune systems, and they require intravenous access until they can tolerate enteral feedings, which for extremely premature infants can take several weeks (if not months) to achieve. Our hospital is a regional-referral teaching hospital with 772 licensed beds. The neonatal intensive care unit (NICU) is a level 3, 35-bed unit where the most critically ill neonates receive care. After a sustained 3-year period of zero CLABSIs, we identified 10 infections between September 2016 through April 2018. Methods: A multidisciplinary team known as the neonatal infection prevention team (NIPT) was reinstated. This team included members from nursing and infection prevention (IP) and from NICU Shared Governance, as well as a neonatal nurse practitioner (NNP) and a neonatologist to review these CLABSIs. Evidence-based practices, policies, and procedures were implemented to help reduce CLABSIs. Nurse educators provided education and training. The infection prevention team reinstated and modified the central-line maintenance and insertion tools to document compliance and to identify any gaps in care. Nurses were expected to document line maintenance once per shift (a.m. and p.m.). All CLABSIs were entered into the CDC NHSN and the hospital’s safety event reporting system, which required follow-up by a clinical manager. The infection prevention team monitored NHSN standardized infection ratios (SIRs) monthly. The SIR is the number of observed events divided by the number predicted (calculated based on national aggregate data). Results: The highest reported quarterly SIR was 1.423, which occurred in the third quarter of 2018 (Fig. 1). Overall compliance with line maintenance protocols was 86% on the morning shift and 89% on the afternoon shift. With implementation of an evidence-based bundle, the NICU had a rolling 12-month SIR of 0.00 as of October 2019. Conclusions: Multidisciplinary team development, implementation of evidence-based bundle elements, and education on catheter care contributed to the long-term success in decreasing CLABSI rates in our NICU. Although this implementation achieved a zero CLABSI rate, we experienced some barriers, including compliance issues with staff not completing the audit tools, staff turnover, and high patient census.Funding: NoneDisclosures: None
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Sillero, Amalia, and Adelaida Zabalegui. "Organizational Factors and Burnout of Perioperative Nurses." Clinical Practice & Epidemiology in Mental Health 14, no. 1 (May 31, 2018): 132–42. http://dx.doi.org/10.2174/1745017901814010132.
Повний текст джерелаАнотація:
Background: Knowing the organizational factors that predict burnout in perioperative nurses is paramount for improving the care of patients and promoting nurses’ psychosocial well-being and health. Objective: To determine the influence of organizational factors of the perioperative nurse's work environment on the three burnout dimensions: emotional exhaustion, despersonalization, and personal accomplishment. Method: A cross-sectional study was conducted among 136 nurses in a perioperative care unit at a university hospital in Barcelona, Spain. Data were collected using a demographic data form, and the Spanish versions of the Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory. Results: Findings showed emotional exhaustion in 43% (56) of nurses, depersonalization in 21% (28), and reduced personal accomplisment in 53% (69). The degree of general burnout was moderate. The work environment was considered unfavourable as only one factor of five was favourable (Nursing foundations of quality care). Multiple regression analyses showed three organizational factors were associated with all three dimensions of burnout: “Nurse manager ability, leadership, and support of nurses”; “Staffing and resources adequacy”; and “Nursing foundations of quality care”. Conclusions: In this study three organizational factors played a significant role in predicting burnout among perioperative nurses. We recommend hospital management implement policies to improve these organizational factors. Promoting positive leadership styles, providing necessary resources, and creating a positive climate in the work environment could increase psychosocial wellbeing and decrease burnout among perioperative nurses.
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Dean, Tania D., Wendy Cross, and Ian Munro. "An Exploration of the Perspectives of Associate Nurse Unit Managers Regarding the Implementation of Smoke-free Policies in Adult Mental Health Inpatient Units." Issues in Mental Health Nursing 39, no. 4 (February 13, 2018): 328–36. http://dx.doi.org/10.1080/01612840.2017.1413461.
Повний текст джерела
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Ip, Katie, Leah M. Shayer, susan m. lerner, Leona Kim-Schluger, and Jang Moon. "806. Decreasing Central Line-associated Bloodstream Infections Through Quality Improvement Initiative on a High Acuity Transplant Unit." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S446. http://dx.doi.org/10.1093/ofid/ofaa439.996.
Повний текст джерелаАнотація:
Abstract Background Central line-associated blood stream infections (CLABSI) have a significant impact on mortality, morbidity and length of stay. Data collected by the Infection Prevention Department revealed progressive increases in the rate of CLABSI on an Abdominal Transplant Unit. Recognizing a drift from best practice, front line staff, the IP team and vascular access specialists, collaborated to identify opportunities for improving care of patients with vascular access devices. Methods An increase in CLABSI rate was observed on the Abdominal Transplant Unit beginning in 2016. An initiative began in 2017 to evaluate whether CLABSI rate reduction was sustainable for at least 1 year and to identify key determinants of this sustainability. Interventions were aimed at infection prevention best practices, care standardization, and team-based monitoring. Interventions included (1) re-education on CLABSI reduction, (2) two RN dressing changes to validate practice during central line dressing change, (3) blood draws from central lines (during non-emergent situations) had to be approved by nurse manager, physician lead and transplant quality physician, (4) CLABSI prevention nurses were chosen as designated phlebotomists for patients with prior approval, (5) daily line review was performed to address line days, indication of line (remove latent lines) and plan of care (transition to permanent access) and this information was shared with the unit physician lead and transplant quality team. Assuring compliance with audits and timely feedback with clinician accountability were vital with compliance with best practices. Results Conclusion During the intervention, CLABSI infection rates dropped from 4.825 to 1.533 in 1,000 CVC days. The sustainability plan for this program is to continue line audits, assessing line necessity and review the effectiveness of the initiatives, review all new CLABSI data with staff and implement new changes as necessary. Joint, ongoing multidisciplinary collaboration is essential to reduce CLABSIs and optimize quality in a challenging, high-acuity patient population. Disclosures All Authors: No reported disclosures
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Hihnala, Susanna, Lilja Kettunen, Marjo Suhonen, and Hanna Tiirinki. "The Finnish healthcare services lean management." Leadership in Health Services 31, no. 1 (February 5, 2018): 17–32. http://dx.doi.org/10.1108/lhs-03-2017-0020.
Повний текст джерелаАнотація:
Purpose The purpose of this paper is to discuss health services managers’ experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers’ work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments. Design/methodology/approach These data were collected through a number of thematic interviews. The participants were nurse managers (n = 7) and medical managers (n = 7) who applied Lean management in their work at the University Hospital in the Northern Ostrobothnia Health Care District. The data were analysed with a qualitative content analysis. Findings A common set of values in specialized health-care services, development of activities and challenges for management in the use of the Lean manager development model to improve personal management skills. Practical implications Managers in specialized health-care services can develop and systematically manage with the help of the Lean method. This emphasizes assumptions, from the point of view of management, about systems development when the organization uses the Lean method. The research outcomes originate from specialized health-care settings in Finland in which the Lean method and its associated management principles have been implemented and applied to the delivery of health care. Originality/value The study shows that the research results and in-depth knowledge on Lean method principles can be applied to health-care management and development processes. The research also describes health services managers’ experiences of using the Lean method. In the future, these results can be used to improve Lean management skills, identify personal professional competencies and develop skills required in development processes. Also, the research findings can be used in the training of health services managers in the health-care industry worldwide and to help them survive the pressure to change repeatedly.
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Tonne, Heidi, Theresa Woodrum, and Michael Romano. "Transforming a unit’s culture to improve clinical outcomes." Journal of Clinical Oncology 34, no. 7_suppl (March 1, 2016): 243. http://dx.doi.org/10.1200/jco.2016.34.7_suppl.243.
Повний текст джерелаАнотація:
243 Background: Leadership identified an unhealthy work environment existed in our Oncology Hematology Special Care Unit (OHSCU). This was evidenced by increased turnover, low National Database of Nursing Quality Indicators (NDNQI), and nurse sensitive quality indicator scores. In the fall of 2014 changes were made to the unit with a goal of creating within the unit a culture of clinical excellence, engagement, professionalism, accountability, and improve staff satisfaction. Methods: Leadership met to define the future state of the unit and develop a vision statement. The Quality Manager met with our Unit based Council (UBC) to review data, discuss shared accountability between leadership, and staff and the impact each individual can have on culture and clinical outcomes. Organizational Development facilitated staff focus groups without unit leadership present. Questions asked included: What behaviors would you like to see more or less of? What is your role in supporting change? Focus group results were shared with staff, and guided the development of an OHSCU Guidelines for Professional Behavior. Leadership met with lead staff nurses to discuss their willingness to embrace cultural change and unit vision. Leads completed the Crucial Conversations Class to help them provide immediate, direct, and specific feedback to staff. Leadership met with each staff member to review the guidelines and discuss their commitment to support change. The unit vision was incorporated in all written and verbal communication with staff. Changes in leadership behaviors included increased leadership presence on nights and weekends, daily rounding with patients and staff, and increased amount of positive feedback. Results: Fall injury scores were decreased from 1.55 to 0.25 per 1,000 patient days, target of 0.72. OHSCU has had no catheter associated urinary tract infections (CAUTI) or pressure ulcers in the last 17 months. Patient satisfaction scores have consistently improved over the last nine months. Response of hospital staff scores have increased from 53.6 to 70.9 and currently 90% of patients rate the hospital as a 9 or 10. Conclusions: Through focused efforts and thoughtful actions, it is possible to change the culture of a unit and have a positive impact on quality metrics.
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Jain, Hanish, Elizabeth Hartigan, Joseph Tschopp, Paul Suits, and Kristopher Paolino. "Catheter-Associated Urinary Tract Infections (CAUTIs) Reduction: A Multidisciplinary Approach." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s154. http://dx.doi.org/10.1017/ice.2020.674.
Повний текст джерелаАнотація:
Background: CAUTIs remain one of the most common hospital-acquired infections (HAIs) accounting for prolonged hospital stay and increased healthcare costs. According to the NHSN, the standardized infection ratio (SIR) at our institution was 1.6 compared to national average of 0.84 in 2018. We highlight the interventions implemented in our institution to prevent CAUTIs. These interventions have shown a reduction in the rate of CAUTIs, the SIR, Foley catheter days, and institutional cost. Methods: In addition to standard CAUTI prevention practices, we hypothesized that we could decrease CAUTIs through the daily implementation of specific practices. We developed a comprehensive interdisciplinary team which included the staff or charge registered nurse (RN), the unit manager, an infection preventionist, an advanced practice registered nurse (APRN), a pharmacist with an antimicrobial focus, and a physician from the infectious disease department who would conduct daily rounds on different units in the institution for education and assessment of catheter indications. A detailed review and analysis of the urine culture orders for patients with a Foley catheter was performed. A nurse-driven Foley catheter removal protocol before urine culture collection was initiated. We implemented a Foley catheter bundle that has guidelines for Foley insertion, best practice competency, and urinary catheter best practice algorithm and advocated alternative use of male or female external catheter. We educated physicians about ordering a reflexive urine analysis test followed by urine culture instead of testing either individually after removal of a Foley catheter. Lastly, we performed a root-cause analysis on all reported CAUTIs. These policies were implemented in a 435-bed tertiary-care center in November 2018, and we present data from 1-year before and after the interventions. Results: At our institution, we had 71 CAUTIs, with an SIR of 1.6, a standardized utilization ratio (SUR) of 0.92, 27,621 Foley days, and institutional cost of $979,303 compared to 40 CAUTIs with an SIR of 1, an SUR of 0.88, 24,193 Foley days, and institutional cost $537,927 after implementing our interventions. Conclusions: CAUTIs can be reduced by implementing specific measures that include infection control team rounds, nurse-driven protocol, and the use of Foley catheter bundles. Measures should be undertaken to prioritize these practices as part of a protocol. We advocate further studies to evaluate these measures. Education programs for healthcare professionals concerning CAUTIs and its complications can be implemented to carry out the prevention methods efficiently.Funding: NoneDisclosures: None
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Marra, Alexandre R., Cláudia D'Arco, Bruno de Arruda Bravim, Marinês Dalla Valle Martino, Luci Correa, Cláudia Vallone Silva, Luiz Carlos R. Lamblet, et al. "Controlled Trial Measuring the Effect of a Feedback Intervention on Hand Hygiene Compliance in a Step-Down Unit." Infection Control & Hospital Epidemiology 29, no. 8 (August 2008): 730–35. http://dx.doi.org/10.1086/590122.
Повний текст джерелаАнотація:
Objective.To evaluate hand hygiene compliance in 2 adult step-down units (SDUs).Design.A 6-month (from March to September 2007), controlled trial comparing 2 SDUs, one with a feedback intervention program (ie, the intervention unit) and one without (ie, the control unit).Setting.Two 20-bed SDUs at a tertiary care private hospital.Methods.Hand hygiene episodes were measured by electronic recording devices and periodic observational surveys. In the intervention unit, feedback was provided by the SDU nurse manager, who explained twice a week to the healthcare workers the goals and targets for the process measures.Results.A total of 117,579 hand hygiene episodes were recorded in the intervention unit, and a total of 110,718 were recorded in the control unit (P= .63). There was no significant difference in the amount of chlorhexidine used in the intervention and control units (34.0 vs 26.7 L per 1,000 patient-days;P= .36) or the amount of alcohol gel used (72.5 vs 70.7 L per 1,000 patient-days;P= .93). However, in both units, healthcare workers used alcohol gel more frequently than chlorhexidine (143.2 vs 60.7 L per 1,000 patient-days;P< .001). Nosocomial infection rates in the intervention and control units, respectively, were as follows: for bloodstream infection, 3.5 and 0.79 infections per 1,000 catheter-days (P= .18); for urinary tract infection, 15.8 and 15.7 infections per 1,000 catheter-days (P= .99); and for tracheostomy-associated pneumonia, 10.7 and 5.1 infections per 1,000 device-days (P= . 13). There were no cases of infection with vancomycin-resistant enterococci and only a single case of infection with methicillin-resistantStaphylococcus aureus(in the control unit).Conclusions.The feedback intervention regarding hand hygiene had no significant effect on the rate of compliance. Other measures must be used to increase and sustain the rate of hand hygiene compliance.
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Paolucci, Helen, Benjamin Nutter, and Nancy M. Albert. "RN Knowledge of Vascular Access Devices Management." Journal of the Association for Vascular Access 16, no. 4 (December 1, 2011): 221–25. http://dx.doi.org/10.2309/java.16-4-4.
Повний текст джерелаАнотація:
Abstract Purpose: To explore the level of RNs knowledge of managing vascular access devices (VADs)- peripherally inserted central catheters (PICCs) and midline catheters, and to determine if nurse characteristics are associated with knowledge level. Background: Education of nursing staff about VAD management can improve quality of care and assure standards of practice are maintained. Review of Literature: Minimal research is available on nurses' knowledge of managing VAD catheters. Methods: Nurses working on a colo-rectal unit who frequently manage VADs in a large tertiary-care medical center voluntarily completed one anonymous, validated, 10-item survey of VAD management themes. Analysis included descriptive and correlational statistics. Results: Of 36 nurses, (97% female, 53% full time), mean VAD knowledge score was 8.1 ± 1.4 (81% mean sum score). Perceived general level of comfort in flushing PICCs (r=.35, P=0.04), using Alteplase with PICCs (r=.36, P=0.03) and changing dressings (r=.38; P=0.03) were associated with higher knowledge scores. Of 10 items, 4 resulted in scores below 80%: how fast a Midline can be used after insertion, first step in managing a PICC upon admission, steps in dealing with a withdrawal occlusion, and steps post interventional radiology PICC insertion; however, nurse characteristics were not associated with scores above or below 80%. Conclusions: Nurses working in the colo-rectal unit that frequently treat patients with VADs were generally knowledgeable about their management. Perceived nurse comfort in flushing a PICC, using Alteplase, and changing dressings were associated with higher knowledge. Implications for Practice: Nurses' impressions of comfort with VAD management should be regularly assessed by nurse managers to assure optimal knowledge.
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Patarru', Fitriyanti, Basilius Yosepfus Weu, Febrina Secsaria Handini, and Heryyanoor Heryyanoor. "The Role of the Nurse Unit Manager Function on Nursing Work Performance: A Systematic Review." Jurnal Ners 14, no. 3 (January 5, 2020): 231. http://dx.doi.org/10.20473/jn.v14i3.17108.
Повний текст джерелаАнотація:
Introduction: The role of Nurse Unit Manager is to improve the nurses’ performance in the context of their professional services. This role consists of planning, organizing, actuating and controlling. The aim of this systematic review was to determine the influence of the nurse unit manager’s management functions related to the nurses’ performance.Methods: The literature search was conducted in the PubMed, Scopus, ProQuest, Science Direct and SAGE databases with the keywords ‘head nurses’, ‘management function’ and ‘nurse performance’. The articles were reviewed using the inclusion criteria, which was that the title and abstract was in accordance with the desired topic, that the article aimed to analyze the influence of the nurse unit manager’s management functions related to the nurses’ performance and that it was explained in English. The exclusion criteria were that the title, abstract and purpose of the article was not in accordance with the topic of focus. The search identified 15 relevant journals from the 276.303 articles published between 2014 and 2019.Results: The results indicate a significant relationship exists between the role of the nurse unit manager and nursing work performance.Conclusion: To improve the management function of the nurse unit manager, it is necessary to conduct training for the nurse unit manager to allow them to better understand the functions and role of the nurse unit manager.
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Bray, KA. "Planning at the unit level." Critical Care Nurse 9, no. 6 (July 1, 1989): 21–24. http://dx.doi.org/10.4037/ccn1989.9.6.21.
Повний текст джерелаАнотація:
In recent years, management responsibilities at the unit level have expanded considerably. In this evolution of the nurse-manager role, the importance of the planning process in the overall productivity and success of the unit has gained widespread acceptance. To meet the challenges of today's health care climate, the nurse manager and the unit staff must have a clear understanding of what our business is, what it should be, and finally, depending on the plans developed, what it will be.
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Rahayu, Prastiwi Puji, Budi Anna Keliat, and Yossie Susanti Eka Putri. "HUBUNGAN KEMAMPUAN KARU DAN KATIM DALAM PENERAPAN MPKP JIWA DENGAN HASIL ASUHAN KEPERAWATAN PADA PASIEN HALUSINASI." Jurnal Keperawatan Jiwa 5, no. 1 (February 6, 2019): 1. http://dx.doi.org/10.26714/jkj.5.1.2017.1-9.
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Karu dan katim, di MPKP adalah manajer lini pertama yang secara langsung menangani pasien. Tujuan penelitian ini adalah untuk menentukan hubungan antara kemampuan karu dan katim dalam menerapkan MPKP dengan asuhan keperawatan pasien halusinasi. Desain penelitian menggunakan cross-sectional. Pengumpulan data dengan kuesioner dan wawancara. Data dianalisis menggunakan korelasi Pearson. Responden terdiri dari 18 karu dan katim, 35 pasien dengan halusinasi dan 15 keluarga. Hasil penelitian menunjukkan kemampuan karu dan katim dalam pendekatan manajemen dan pemberian layanan rawat inap mempunyai hubungan yang signifikan dengan pengurangan tanda dan gejala pasien (nilai p <0,05). Kemampuan karu dan katim dalam asuhan keperawatan pasien mempunyai hubungan yang signifikan dengan peningkatan kemampuan pasien (nilai p <0,05). Hasil studi ini direkomendasikan sebagai dasar untuk meningkatkan MPKP. Kata kunci: MPKP, karu, katim, halusinasi CORRELATION BETWEEN NURSE UNIT MANAGER AND TEAM LEADER CAPABILITY IN IMPLEMENTING PNPM WITH NURSING CARE OUTCOMES OF PATIENT WITH HALLUCINATION ABSTRACTNurse unit managerand team leader, in PNP Mare thefirstline managerswhodeal directlywith patients. Theaim of the study was todetermine the relationof theabilityof the nurse unit manager and team leader in implementing PNPMwithnursing careoutcomes of patient withhallucinations. Design of the research was usedcross-sectional. The collection of data by questionnaires and interviews. Data were analyzedusingPearson’s correlation. Respondents consisted of 18 nurse unit manager and team leader, 35 patients with hallucinations and 15 families. The result showedthe abilityof the nurse unit manager and team leader in management approachandpatient care delivery significant relationship with reduction signs and symptoms ofthe patients(p value<0.05). The abilityof the nurse unit manager and team leader in patient care delivery significant relationship with increase in the ability ofpatients(p value<0.05). Results ofthe studyis recommendedas a basisforimprovingthePNPM. Keywords: PNPM, nurse lead manager, team leader, hallucination
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Iswati, Iswati. "PERSEPSI PERAWAT TENTANG PENJAMINAN MUTU KESELAMATAN PASIEN OLEH KEPALA RUANGAN." Adi Husada Nursing Journal 2, no. 1 (August 9, 2016): 75. http://dx.doi.org/10.37036/ahnj.v2i1.37.
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ABSTRAK Penerapan tindakan keselamatan pasien membuat pasien bebas dari cidera yang tidak seharusnya terjadi, namun masih didapatkan adanya insiden keselamatan pasien yang dilakukan perawat akibat kurangnya penerapan penjaminan mutu keselamatan pasien oleh kepala ruangan. Penelitian ini bertujuan untuk mengetahui karakteristik dan persepsi perawat tentang penjaminan mutu keselamatan pasien oleh kepala ruangan di Rumah Sakit. Jenis penelitian ini adalah deskriptif, dengan populasi dan sampel 30 perawat, menggunakan total sampling. Variabel penelitian yaitu persepsi perawat tentang penjaminan mutu keselamatan pasien. Skala data yang digunakan ordinal. Data diperoleh melalui kuesioner serta dianalisis secara deskriptif. Penerapan penjaminan mutu keselamatan pasien oleh kepala ruangan dipersepsikan dalam kategori baik (93.4%) oleh perawat. Persepsi perawat tentang penjaminan mutu keselamatan pasien oleh kepala ruangan dipengaruhi oleh faktor struktural, fungsional, personal, situasional. Namun masih diperlukan peningkatan mutu dan sosialisasi tentang penjaminan mutu oleh kepala ruangan yang lebih intensif agar perawat dapat lebih terlibat dalam upaya penjaminan mutu keselamatan pasien.Kata kunci: Penjaminan mutu, keselamatan pasien, kepala ruang, persepsiABSTRACTIntroduction: Application of patient safety measures to make the patient free from injuries that are not supposed to happen, but still found the incident nurse performed patient safety due to the lack of implementation of quality assurance of the safety of the patient by the nurse unit manager. This study aims to determine the characteristics and perceptions of nurses about patient safety quality assurance by the nurse unit manager. Methods: The study was descriptive, with a population and a sample of 30 nurses, using total sampling. Variable research that the perception of nurses about patient safety quality assurance. Data used ordinal scale. Data obtained through questionnaires and analyzed descriptively. Result: The application of quality assurance of the safety of the patient by the nurse unit manager is perceived in either category (93.4%) by nurses. Discussion: Perception of nurses about patient safety quality assurance by the nurse unit manager influenced by the structural, functional, personal, situational. But the nurse unit manager is still needed to improve the quality and dissemination of quality assurance more intensive for nurses to be involved in the quality assurance of patient safety.
Keywords: quality assurance, patient safety, the nurse unit manager, perception
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Krugman, Mary E., and Carolyn L. Sanders. "Implementing a Nurse Manager Profile to Improve Unit Performance." JONA: The Journal of Nursing Administration 46, no. 6 (June 2016): 345–51. http://dx.doi.org/10.1097/nna.0000000000000355.
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Gunderson, Laurie, and Carole Kenner. "Case Management in the Neonatal Intensive Care Unit." AACN Advanced Critical Care 3, no. 4 (November 1, 1992): 769–76. http://dx.doi.org/10.4037/15597768-1992-4005.
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This article will provide the reader with an overview of the concept of case management as it is used by the neonatal nurse practitioner in a neonatal intensive care unit. The role of the neonatal nurse practitioner as a case manager will be compared and contrasted to the roles of the primary nurse and staff nurse. The collaborative role with physicians will be described. Future directions for neonatal case management also will be addressed
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Medeiros, Marky. "Nurse manager succession planning for unit health and well-being." Nursing Management 53, no. 6 (June 2022): 41–43. http://dx.doi.org/10.1097/01.numa.0000831436.38442.a8.
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Grubaugh, Martha L., and Linda Flynn. "Relationships Among Nurse Manager Leadership Skills, Conflict Management, and Unit Teamwork." JONA: The Journal of Nursing Administration 48, no. 7/8 (2018): 383–88. http://dx.doi.org/10.1097/nna.0000000000000633.
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Cox Sullivan, Sheila, Mitzi R. Norris, Lana M. Brown, and Karen J. Scott. "Nurse manager perspective of staff participation in unit level shared governance." Journal of Nursing Management 25, no. 8 (August 30, 2017): 624–31. http://dx.doi.org/10.1111/jonm.12500.
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Choi, Pin-Pin, Wai-Man Lee, Suet-Shan Wong, and Mei-Ha Tiu. "Competencies of Nurse Managers as Predictors of Staff Nurses’ Job Satisfaction and Turnover Intention." International Journal of Environmental Research and Public Health 19, no. 18 (September 12, 2022): 11461. http://dx.doi.org/10.3390/ijerph191811461.
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Nurse managers have played an integral role in stabilizing the nursing work environment and workforce in the face of the COVID-19 pandemic, yet the competencies required for such a feat are largely unknown. This study was conducted during the pandemic to identify the specific domains of nurse manager competencies that associate with nurse outcomes. A cross-sectional survey was conducted on a convenience sample of 698 staff nurses to measure the perceived competence of their nurse managers and their job satisfaction and turnover intention levels. The overall perceived nurse manager competency level in our sample was 3.15 out of 5 (SD = 0.859). The findings indicated that 34.3% of nurses were dissatisfied with their current jobs, and 36.3% of nurses were considering leaving their current workplace. Regression analyses identified “Team Communication and Collaboration” (β = 0.289; p = 0.002), “Staff Advocacy and Development” (β = 0.229; p = 0.019), and “Quality Monitoring and Pursuance” (β = 0.213; p = 0.031) as significant predictors of staff nurses’ job satisfaction and “Staff Advocacy and Development” (β = −0.347; p < 0.000) and “Team Communication and Collaboration” (β = −0.243; p = 0.012) as significant predictors of nurses’ turnover intention. The findings of the study have implications for the future recruitment, training, and performance evaluation of nurse managers.
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Setiawan, Setiawan, Dewi Elizadiani Suza, and Farida Linda Sari Siregar. "Nurse Manager Competency Model in a Teaching Hospital." Jurnal Ners 16, no. 1 (April 30, 2021): 81. http://dx.doi.org/10.20473/jn.v16i1.26032.
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Introduction: Nurse managers in carrying out their duties must have a variety of competencies, one of which is managerial competencies. A model of competency for nurse managers will assist them in shaping their roles as managers in a teaching hospital. This study aims to develop the managerial competency model for nurse managers at the teaching hospital.Methods: The research design used in this study was action research. This research was conducted with 20 nurse managers who work at inpatient wards of the teaching hospital. Participants were selected by purposive sampling approach and have accepted to participate in the research. The data were obtained by using interview through focus groups discussions. The content analysis method was employed for analyzing the data. Results: This study found six domains of managerial competencies of nurse managers: 1) provision of patient care (assignment methods, clinical excellence, collaborators, patient safety, evidence-based practice), 2) resource management (personnel management, information and technology management, equipment management, supplies management), 3) leadership (commitment, conflict resolution, negotiator, role model, professional mentor, initiator, motivator), 4) self and staff development (effective communication skills, interpersonal relationship skills, tridharma function of nurses), 5) customer and service orientation (team builder, customer service, quality improvement), and 6) function of preceptorships (basic teaching skills, clinical skills). These 24 fundamental competencies are rooted in caring foundation.Conclusion: Nurse managers in teaching hospitals should possess a set of managerial competencies to perform their optimal roles in order to achieve the unit goals. This model will provide comprehensive and solid ways for nurse managers to improve their performance. Therefore, the set of nurse manager competencies needs to be standardized across the setting.
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Silva, Claudia Maria Lima, Jocilene da Silva Paiva, Edmara Chaves Costa, Terezinha Almeida Queiroz, Samara dos Reis Nepomuceno, Alanna Elcher Elias Pereira, Hévila Ferreira Gomes Medeiros Braga, et al. "Difficulties faced by the nurse manager in the primary health care unit." Research, Society and Development 11, no. 4 (March 16, 2022): e18911427248. http://dx.doi.org/10.33448/rsd-v11i4.27248.
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Objective: to present, from the scientific literature, the main difficulties faced by nurses in the management of the primary health care unit. Methodology: this is a narrative literature review carried out in SCIELO and LILACS data sources. The search took place in September 2021. The keywords used were “Nursing”, “Primary Health Care” and “Health Management”. The total of studies revealed in both data sources was 139 studies. After reading and analyzing the researched theoretical framework, 42 selected manuscripts were reached. However, after exhaustive reading of these articles, only nine (21.5%) manuscripts were included in the sample of the present research because they answered the guiding question of the study. Results: the sample of articles in the present study consisted of nine scientific articles. The difficulties most present in the routine and that make the work of this professional more difficult are lack of incentive and qualification and training courses, reduced professional staff, scarce human resources, work overload, lack of financial resources, lack of support from part of public management, and inadequate physical structures. Final Considerations: the difficulties faced by these professionals become a major challenge in the exercise of this profession, culminating directly in a precarious and unsafe quality of care for the patient.
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McElroy, Mary Jo, and Susan Campbell. "Case Management with the Nurse Manager in the Role of Case Manager in an Interventional Cardiology Unit." AACN Advanced Critical Care 3, no. 4 (November 1, 1992): 749–60. http://dx.doi.org/10.4037/15597768-1992-4003.
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Varying external and internal factors are motivating changes in how physicians and nurses deliver patient care within health-care institutions. A care delivery system that has received increasing attention in the literature is case management. This chapter describes how a community hospital implemented case management for patients undergoing percutaneous coronary angioplasty and cardiac catheterization while developing the new role of clinical manager to serve in the role of case manager. The process for planning and implementing such a role change is discussed, and initial evaluative data are presented
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Meadow, William, David Mendez, John Lantos, Robert Hipps, and Michele Ostrowski. "What Is the Legal `Standard of Medical Care' When There Is No Standard Medical Care? A Survey of the Use of Home Apnea Monitoring by Neonatology Fellowship Training Programs in the United States." Pediatrics 89, no. 6 (June 1, 1992): 1083–88. http://dx.doi.org/10.1542/peds.89.6.1083.
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In treating a patient, a doctor is obliged to use the skill and care that is ordinarily used by reasonably well-qualified doctors in similar cases. In addition, the only way in which a juror may decide whether the defendant used the skill and care which the law required of him or her is from evidence presented by doctors called as expert witnesses (cf Illinois Pattern Jury Instructions). However, what should be done if expert opinions differ concerning the care that is "ordinarily used"? Home apnea monitoring (HAM) is prescribed at times for graduates of neonatal intensive care units despite the fact that indications for its use are not well established and efficacy is completely unknown. The authors attempted to determine standards for HAM as it is currently practiced in neonatology training programs. The primary teaching hospital for each of the 99 neonatology training programs in the United States was identified. Both the medical director (MD) and a neonatal intensive care unit nurse manager (RN) were asked about the use of HAM in their own nursery for four clinical vignettes. Each vignette depicted a 1000-g birth weight infant, currently 7 weeks old and ready for discharge. In three vignettes, the infant had demonstrated no apnea, mild apnea (resolved by 2 weeks of age), or moderate apnea (requiring theophylline therapy at discharge) during the hospital course. In the fourth vignette, the infant had no apnea but was to be discharged home with supplemental oxygen. For 67 of 99 training programs, paired responses of RN managers and MD directors were obtained. For infants with no apnea or mild apnea, approximately 85% of RN/MD pairs agreed that HAM would not be used at their institution, 2% would use HAM, and 12% responded that they might use HAM depending on individual circumstances. In contrast, for the premature infant with moderate apnea, there was much less agreement. Sixteen percent of RN/MD pairs responded that HAM would not be used, 39% would use HAM, and 19% might. Remarkably, for this vignette 25% of the RN/MD responses disagreed on the practice of HAM at their own center. Similarly, for the infant with home oxygen, 15% of RN/MD responses agreed that HAM would not be used, 49% answered that HAM would be used, 10% were uncertain, and 25% disagreed on the use of HAM at their own center. It is concluded that (1) for premature infants with no or mild apnea, HAM is currently prescribed by a minority of fellowship-associated neonatology programs, and (2) no obvious consensus exists for HAM in the context of moderate apnea or home oxygen therapy. For many infants, there is no "standard care" for HAM in the neonatology community at this time. "Expert" opinions of the legal "standard of care" for HAM should reflect this fact.
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Sharit, Joseph, Lorgia McCane, Deborah M. Thevenin, and Paul Barach. "Examining Issues in Communicating Patient Care Information Across Shifts in a Critical Care Setting." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 49, no. 11 (September 2005): 1062–66. http://dx.doi.org/10.1177/154193120504901113.
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This study addresses issues associated with sign-out reports occurring during shift changes in the pediatric intensive care unit of a large metropolitan hospital. The issues include the need for organizing our knowledge concerning the types of errors that providers are susceptible to during the sign-out process, the roles of personality, experience, and cultural factors, particularly as they may affect the incoming provider's inquisitiveness, and the potential impact on patient care of various different methods of performing sign-outs. We observed eight outgoing nurses and four residents who gave sign-out reports, and conducted eight semi-structured interviews with nurses, residents, nurse managers, and attending physicians. The results revealed important and intricate relationships among many of the variables that were investigated and suggested a number of interventions that might improve the sign-out process. Overall, our data on shift change sign-outs in an acute care setting confirmed the resiliency of health care providers and their capability for managing patient care under extremely demanding conditions.
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Sigit S, Achmad, Budi Anna Keliat, and Rr Tutik Sri Hariyati. "Fungsi Pengarahan Kepala Ruang dan Ketua Tim Meningkatkan Kepuasan Kerja Perawat Pelaksana." Jurnal Keperawatan Indonesia 14, no. 2 (July 24, 2011): 83–88. http://dx.doi.org/10.7454/jki.v14i2.313.
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AbstrakPenelitian ini bertujuan mengetahui pengaruh fungsi pengarahan kepala ruang dan ketua tim terhadap kepuasan kerja perawatpelaksana di unit rawat inap. Metode penelitian adalah quasi experiment dengan desain pre-post test design with controlgroup. Data diambil sebelum dan sesudah dilaksanakan pelatihan, bimbingan dan pendampingan fungsi pengarahan (operan,pre conference, post conference, iklim motivasi, supervisi dan delegasi) pada kepala ruang dan ketua tim. Sampel penelitiandiperoleh secara purposive sampling, terdiri dari 35 perawat pelaksana sebagai kelompok intervensi dan 40 perawat pelaksanasebagai kelompok kontrol. Instrumen untuk mengukur kepuasan kerja menggunakan Minnesota Satisfaction Questionnaireberjumlah 36 pernyataan. Hasil penelitian didapatkan kepuasan kerja perawat pelaksana yang mendapat pengarahan dari kepalaruang dan ketua tim yang sudah memperoleh pelatihan, bimbingan dan pendampingan meningkat lebih tinggi secara bermaknadibandingkan dengan kepuasan kerja perawat pelaksana yang mendapat pengarahan dari kepala ruang dan ketua tim yang tidakdilatih fungsi pengarahan (p= 0,000; = 0,005). Fungsi pengarahan bila dilaksanakan secara konsisten oleh kepala ruang danketua tim, berpeluang meningkatkan kepuasan kerja sebesar 67,40% dan diperkirakan mampu meningkatkan nilai kepuasanperawat pelaksana sebesar 16.746 poin setelah dikontrol jenis kelamin. Rumah sakit dapat mengupayakan dan meningkatkankondisi kepuasan kerja perawat pelaksana secara berkelanjutan dengan mengimplementasikan fungsi pengarahan agar dapatmemberikan asuhan keperawatan berkualitas tinggi.Kata Kunci: kepala ruang, kepuasan kerja, ketua tim, pengarahan, perawat pelaksanaAbstractThe aim of this study was to investigate the influence of directing function of nurse unit manager and team leader to the nursejob contentment among staff nurses. The research method was a quasi experiment, pre-post test with control group design.The data gathered before and after the directing function (hand over, pre conference, post conference, motivational climate,supervision and delegation) had trained and guided to the nurse unit manager and team leader. The samples were 75respondents, determined by purposive sampling. They were 35 nurse staffs (experimental group) and the others (controlgroup). The instrument was a questionnaire consisted 36 of Likert scale statements adopted from Minnesota SatisfactionQuestionnaire. The result showed that the level of nurse job satisfaction in the experimental group increased higher significantlythan the control group (p= 0.000; = 0.005). Putting the directing function into action consistently in the daily nursingpractice improved the probability of the nurse job satisfaction level about 67.40% and enhanced it around 16.746 point. Theday-to-day maintaining their job satisfaction level should be done through directing function so that they will deliver highqualitynursing care.Keywords: directing, job satisfaction, nurse team leader, nurse unit manager, staff nurse
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Chang, Hyoung Eun, and Sung-Hyun Cho. "The Influence of Social Support on the Relationship between Emotional Demands and Health of Hospital Nurses: A Cross-Sectional Study." Healthcare 9, no. 2 (January 22, 2021): 115. http://dx.doi.org/10.3390/healthcare9020115.
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Social support reduces the negative results of emotional labor. A more detailed analysis should be performed to facilitate adequate social support for nurses. Therefore, this study was conducted to examine the relationships among nurses’ emotional demands, social support, and health. A cross-sectional survey was conducted at two tertiary hospitals in South Korea. A sample of 117 nurses from eight units participated. Between-group differences in the main variables were analyzed using the t-test or Mann–Whitney test, and analysis of variance or the Kruskal–Wallis test. Nurses were classified into eight groups according to emotional demands and type of social support, and the effects of social support were analyzed based on mean scores. Greater social support from colleagues was associated with better health on all measures. However, greater social support from supervisors was associated with a higher incidence of burnout, stress, and sleeping troubles. Nurses’ high emotional demands must be managed actively by hospitals to maintain and promote their health. Providing appropriate social support with consideration of the nurse’s unit experience would help decrease the effects of emotional demands. Enhancing social support from nursing colleagues is a powerful way to manage the negative effects of nurses’ emotional demands.
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Lageson, Catherine. "Quality Focus of the First Line Nurse Manager and Relationship to Unit Outcomes." Journal of Nursing Care Quality 19, no. 4 (October 2004): 336–42. http://dx.doi.org/10.1097/00001786-200410000-00009.
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Lee Simons, Sherri. "Nurse Managers: The Ties That Bind." Neonatal Network 22, no. 5 (January 2003): 69–71. http://dx.doi.org/10.1891/0730-0832.22.5.69.
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The job of managing people, whether a team, a unit, or an entire department, is a challenging one at best. Couple that with larger staffs, shrinking budgets and a burgeoning nursing shortage, and the challenge becomes even greater. This new column is intended to offer some insights into the complex world of the nurse manager. Combining humor with years of management experience, our column editor will delve into a variety of issues facing nurse managers. As with all of our columns, your suggestions and questions are welcome. Please feel free to e-mail the journal, and your thoughts will be forwarded to Ms. Simons.
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Stuedahl, Marit, Sidsel Vold, Pål Klepstad, and Siv Karlsson Stafseth. "Interrater reliability of Nursing Activities Score among Intensive Care Unit health professionals." Revista da Escola de Enfermagem da USP 49, spe (December 2015): 117–22. http://dx.doi.org/10.1590/s0080-623420150000700017.
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ABSTRACT Objective To analyze the interrater reliability of NAS among critical care nurses and managers in an ICU. Method This was a methodological study performed in an adult, general ICU in Norway. In a random selection of patients, the NAS was scored on 101 patients by three raters: a critical care nurse, an ICU physician and a nurse manager. Interrater reliability was analyzed by agreement between groups and kappa statistics. Results The mean NAS were 88.4 (SD=16.2) and 88.7 (SD=24.5) respectively for the critical care nurses and nurse managers. A lower mean of 83.7 (SD=21.1) was found for physicians. The 18 medical interventions showed higher agreement between critical care nurses and physicians (85.6%), than between critical care nurses and nurse managers (78.7). In the five nursing activities the Kappa-coefficients were low for all activities in all compared groups. Conclusion The study indicated a satisfactory agreement of nursing workload between critical care nurses and managers.
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Rapunzelle Sunshine V. Baban and Bella P. Magnaye. "Patient Safety in Selected Healthcare Facilities in Caraga Region: An Aiken Model Approach." International Journal of Research in Pharmaceutical Sciences 11, SPL4 (December 24, 2020): 538–51. http://dx.doi.org/10.26452/ijrps.v11ispl4.3895.
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This study aimed to determine the nursing organizational factors and patient safety in selected healthcare facilities in the Philippines. It utilized quantitative approach of research specifically descriptive correlational research design. The inclusion criteria of the entire population were composed mainly of 455 nurses employed among the five selected healthcare facilities in Caraga Region, Philippines within a period of 1 year and above offering inpatient and outpatient healthcare services. Results revealed that there was a positive response on organizational factors such as nursing foundations for quality care, nurse participation in hospital affairs, nurse manager leadership, ability and support and collegial nurse-physician relationships. Patient Safety with regards to supervisor/manager, wok area/unit, frequency of events reported, and communications, patient safety grade, hospital and number of events reported were positively performed and practiced. The patient safety practices were directly affected by the organizational factors being tested.
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Ofei, Adelaide M. A., and Yennuten Paarima. "Perception of nurse managers’ care coordination practices among nurses at the unit level." International Journal of Care Coordination 24, no. 1 (March 2021): 17–27. http://dx.doi.org/10.1177/2053434521999978.
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Introduction Nursing practice demands coordination of activities within and across units to enable quality delivery of healthcare services. Nurse managers are best positioned to ensure effective care coordination at the operational level in the hospitals. The purpose of this study was to examine the care coordination practices of nurse managers at the unit level. Methods A quantitative exploratory descriptive approach using a cross-sectional survey design was used to collect data from 522 nurses in 19 hospitals in the Greater Accra region of Ghana. Descriptive and regression analyses were performed to describe the sample and to predict the behaviour of nurse managers. The systems model was used as a conceptual framework for the survey. Data collection was from October 2015 to March 2016. Results The response rate for collection of data was 95.7%. Nurse managers exhibited an acceptable level of care coordination practices. Nurse managers’ characteristics together predicted the care coordination practices at the unit (R2=0.111, p < 0.001). The unit, unit workload, experience as a nurse manager, and work duration with nurses were the significant predictors in the regression model. Discussion Care coordination is needed at the unit level to prevent conflict, overlapping, and constant interdepartmental friction which enables nurses to take a broad overview of coordinated care instead of myopic observation and reflection in the unit. Nurse managers are best positioned to coordinate care due to their vast professional knowledge and experience. Effective communication, good interpersonal relationship, and good listening skills are essential coordination practices critical to the efficiency of the unit.
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Patton, JA, and M. Funk. "Survey of use of ST-segment monitoring in patients with acute coronary syndromes." American Journal of Critical Care 10, no. 1 (January 1, 2001): 23–32. http://dx.doi.org/10.4037/ajcc2001.10.1.23.
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BACKGROUND: Although effective for assessing ongoing myocardial ischemia, ST-segment monitoring may be underused. OBJECTIVES: To determine the proportion of cardiac units in the United States that use ST-segment monitoring, hospital and unit characteristics associated with its use, how units use such monitoring with respect to research recommendations, if units that use ST-segment monitoring find it clinically useful and easy to use, and why some units are not using this type of monitoring. METHODS: A survey on ST-segment monitoring was mailed to a random sample of 500 cardiac nurse managers and clinical nurse specialists. RESULTS: Of the final 192 respondents, 104 (54.2%) reported that they were using ST-segment monitoring. Monitor brand was the only characteristic associated with use of this monitoring (P = .03). On units that used ST-segment monitoring, patients were monitored if they had myocardial infarction (81%), unstable angina (79.6%), or possible myocardial infarction (78.6%) and after percutaneous transluminal coronary angioplasty (47.6%). Leads were chosen according to unit protocol (60.2%) and 12-lead electrocardiographic findings (48.5%); leads II (95.0%) and V1 (75.2%) were used most often. The majority of units that use ST-segment monitoring agreed that it is clinically useful (83%) and easy to use (56%). Among the units not using ST-segment monitoring, the most common reason was that physicians were not interested (27.1%). CONCLUSIONS: ST-segment monitoring is not routinely used; when it is, research recommendations are often not followed. Increased awareness is needed among cardiac nurses and physicians of the clinical usefulness and proper use of ST-segment monitoring.
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Bonometti, Stefano. "Start a community of practice through Action Learning: nurse manager to support the changing care practices." EDUCATION SCIENCES AND SOCIETY, no. 2 (December 2016): 71–78. http://dx.doi.org/10.3280/ess2-2016oa3938.
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This paper is part of the current of study defined as workplace studies which have the intent to focus the relationship between learning processes, communities of practice and organisational change processes. The field of intervention is the health field, in relation to nurse manager roles, focusing attention on problem solving and communication skills among Operating Unit (OU) manager and the repercussions on working practices. The study/intervention is triggered by some key questions emerging from the organisational requirements in care contexts, such as: how to reshape coordination roles that are traditionally centred on executive management towards a proactive function that is motivating for the nursing team? How is it possible to promote a community of practice between managers, consolidating the sense of company belonging? How to design a managerial role such as nurse manager according to organisation by processes and not just by tasks?The answers to these questions involve two plans of action; one of a training and advisory nature, the second centred on the logic of research.
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Alqahtani, Naji, Kyeung M. Oh, Panagiota Kitsantas, Margaret Rodan, Adnan Innab, Saeed Asiri, Ali Kerari, Fayez Bin Hayyan, Mohammad Alharbi, and Ghareeb Bahari. "Organizational Factors Associated with Evidence-Based Practice Knowledge, Attitudes, and Implementation among Nurses in Saudi Arabia." International Journal of Environmental Research and Public Health 19, no. 14 (July 9, 2022): 8407. http://dx.doi.org/10.3390/ijerph19148407.
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Evidence-based practice (EBP) is crucial in keeping nurses aware of the current knowledge and improving clinical decision-making. The integration of nurses’ EBP competencies and organizational support has been suggested to create an effective arena in implementing EBP. The purpose of the study was to examine organizational factors influencing nurses’ EBP knowledge, attitudes, and implementation and identify staff nurses’ perceptions of EBP nursing leadership and hospital supports in Saudi Arabia. Data were collected from a convenience sample of staff nurses (N = 227) working in four hospitals using a cross-sectional, correlational descriptive design. Level of education (p < 0.05), EBP training (p < 0.05), unit type (ICU (p < 0.001) and ER (p < 0.01)), perceived nursing leadership (p < 0.001), and work environment (p < 0.05) supports were found significantly associated with nurses’ knowledge. Magnet recognition (p < 0.01) and knowledge (p < 0.001) had significant influence on nurses’ attitudes. Unit type (ER) (p < 0.05), knowledge (p < 0.001), and attitudes (p < 0.001) were associated with implementation. Encouragement to attend EBP trainings from nursing leadership was perceived by most nurses (51.1%). Nurses reported their hospitals support EBP through training (68.2%). Findings support the need for healthcare systems to create a culture that facilitates EBP implementation to enhance nurses’ EBP competencies and improve patients’ outcomes. Nursing managers may consider preparing nurses through education.
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Dewi, Yulis Setiya, Arina Qona'ah, Hidayat Arifin, Rifky Pradipta, and Lizy Sonia Benjamin. "Preventive Bacterial Translocation and Control of Ventilator-Associated Pneumonia: A Qualitative Study." Jurnal Keperawatan Padjadjaran 10, no. 3 (December 31, 2022): 206–15. http://dx.doi.org/10.24198/jkp.v10i3.2195.
Повний текст джерелаАнотація:
Background: Bacterial translocation is one cause of ventilator-associated pneumonia among patients treated in the Intensive Care Unit. The study aimed to observe critical nurses information about bacterial translocation prevention and ventilator-associated control in clinical settings. Methods: A qualitative phenomenology design was undertaken from July to September 2021. We recruited 40 critical nurses in government and educational hospitals in Surabaya, Indonesia. The in-depth online interview was conducted during the interview process and analysed using Colaizzi’s technique. Results: We emerged five themes that consist of 1) limited of nurse’s competence, 2) unsupported work environment, 3) barrier of human resource management, 4) work motivation, and 5) development of bacterial translocation preventive tools. Conclusion: Prevention of bacterial translocation is needed by developing tools and accessible by nurses. Whereases, the capacity and ability need to be developed by training. Nurses and Hospital Managers consider putting the attention of evidence-based tools in clinical settings.
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Saputri, Ekawati, Syahrir A. Pasinringi, and Julianus Ake. "THE RELATIONSHIP BETWEEN CAREER LADDER AND NURSES JOB SATISFACTION AT A HOSPITAL." Jurnal Administrasi Kesehatan Indonesia 9, no. 1 (April 22, 2021): 55. http://dx.doi.org/10.20473/jaki.v9i1.2021.55-66.
Повний текст джерелаАнотація:
Background: Career ladder is given to nurses to encourage and maintain professional development and practice of nursing. Career ladder has an impact on raising clinical levels, promotion opportunities, competency complexity, rewards and recognition. In this study, the career ladder has started by mapping and conducting, credentials and competency assessment at the levels of pre Nurse Clinicians, Nurse Clinicians Level I and Nurse Clinicians Level II. Almost half of the nurses were dissatisfied (47.2%) with their career development.Aims: This study was to analyzed the relationship between the career ladder and nurses’ job satisfaction.Methods: This study was a quantitative correlational study with a cross-sectional approach. There were 108 nurses as samples selected using consecutive sampling techniques. These respondent who met the inclusion criteria came from Inpatient Room, (i.e VVIP, VIP, Class I, Class 2/3, Ophthalmology Inpatient), Polyclinic, Chemotherapy Unit, NICU (Neonatal Intensive Care Unit), ICU (Intensive Care Unit), Hemodialysis, Emergency room and COT (Centra Operation Theater). Data were analyzed using the Spearman test.Results: There was a significant relationship between career ladder (p=0.000) and nurse’ job satisfaction. The nurse were satisfied with her career development related to implementation of career ladder. Besides, career ladder allowed to be promoted as the heads of the rooms. Rewards and recognition of nurses’ competencies through job promotion affected nurses’ satisfaction.Conclusion: Career ladder affects nurse satisfaction. Nurses can advance their careers through a career promotion, competencies, rewards and recognition from other health professionals. Support from nurse manager is needed as a form of mentoring and evaluation of nurse performance in the career ladder. Keywords: career ladder, job satisfaction, nurses
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Tan, Poh-choo, and Zaki Morad. "Training of Peritoneal Dialysis Nurses." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 23, no. 2_suppl (December 2003): 206–9. http://dx.doi.org/10.1177/089686080302302s43.
Повний текст джерелаАнотація:
Clinical disciplines in which the nurse plays as preeminent a role in total patient care as in peritoneal dialysis (PD) are few. The PD nurse is readily identified by the patient as the principal source of advice on day-to-day aspects of treatment, as a resource manager for supplies of PD disposables and fluids, and as a general counselor for all kinds of advice, including diet, rehabilitation, and medication, among others. The PD nurse is thus the key individual in the PD unit, and most activities involve and revolve around the nursing staff. It is therefore not surprising that most nephrologists pay considerable attention to the selection of PD nurses, particularly in long-term PD programs such as continuous ambulatory peritoneal dialysis (CAPD). The appointment of a PD nurse depends on finding an individual with the right attributes, broad general experience, and appropriate training.
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de Mendonca, Ben, Kirsty Wield, Angela Boudreau, Simron Singh, Matthew C. Cheung, and Sherrol Palmer. "Optimizing patient scheduling for ambulatory chemotherapy." Journal of Clinical Oncology 31, no. 31_suppl (November 1, 2013): 199. http://dx.doi.org/10.1200/jco.2013.31.31_suppl.199.
Повний текст джерелаАнотація:
199 Background: The Odette Cancer Centre (OCC) manages more than 24,000 chemotherapy visits annually. The delivery process is complex and patients have significant wait times for treatment. The OCC was faced with improving this process with no data infrastructure to support continuous quality improvement. Methods: An electronic scheduling manager, Chemotherapy Appointment Reservation Manager (CHARM) was built in house to improve scheduling logic and optimize bed and chair utilization. The chemotherapy unit has recently undergone renovations to change the staff-to-patient ratio and chair distribution. At baseline, a nurse is assigned to 4 chairs in a “pod” without adjustment for patient and chemotherapy intensity variation. An interprofessional team participated in a Kaizen event to create a Value Stream Map of the scheduling process. Scheduling logic considerations were identified to better match nursing and chair resources to patient appointment times. An analysis was performed to evaluate the distribution of patients throughout the chemotherapy unit by time of day, and day of week to identify opportunities to align the schedule with nursing and pharmacy resources. Results: The mean number of patients seen per day was 85 with a range of 65 to 105. 80% of patients are scheduled before 11:30 (the unit operations 08:30 to 18:00). The mean number of patients assigned to a pod was 8 with a range of 3 to 15. Unit performance on days of >95 patients was observed to be poorest. Load levelling techniques were established to reduce the range of patients booked per day throughout the week. New considerations for scheduling are: maximum 12 patients per nurse per pod per day, maximum 3 new patients per nurse per pod per day, maximum 10 clinical trials per day, and maximum 50% of patients scheduled before 11:30 per day. Conclusions: Matching the patient schedule to the nursing and pharmacy resources of the unit is critical to efficient and safe chemotherapy delivery. A Plan-Do-Study-Act is scheduled for September 2013 to implement the scheduling changes and evaluate the impact of the new logic on unit operations. Further work to improve the delivery process and pharmacy medication processing is ongoing.
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Vesterinen, Soili, Marjo Suhonen, Arja Isola, Leena Paasivaara, and Helena Laukkala. "Nurse Managers' Perceptions Related to Their Leadership Styles, Knowledge, and Skills in These Areas—A Viewpoint: Case of Health Centre Wards in Finland." ISRN Nursing 2013 (April 3, 2013): 1–8. http://dx.doi.org/10.1155/2013/951456.
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The purpose of this study was to explore nurse managers’ perceptions related to their leadership styles, knowledge, and their skills in these areas in health centre wards in Finland. The data were collected from nurse managers (n=252) in health centre hospitals in Finland using a structured questionnaire (response rate 63%). Six leadership styles—visionary, coaching, affiliate, democratic, commanding, and isolating—were reflected on. Almost all respondents in every age group considered four leadership styles—visionary, coaching, affiliate, and democratic—to be very important or important. Nurse managers estimated their knowledge and skills in leadership styles to be essentially fairly sufficient or sufficient. Nurse managers’ abilities to reflect, understand, and, if necessary, change their leadership style influence the work unit’s success and employees’ job satisfaction. Nurse managers, especially new nurse managers, need more theoretic, evidence-based education to cope with these expectations and to develop their professional abilities. Together with universities, health care organizations should start planning nurse manager education programmes that focus on strategic issues, leadership, job satisfaction, challenging situations in leadership, change management, work unit management (e.g., economy, efficiency, and resources), and how the nurse managers consider their own wellbeing.
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Doas, Michelle Dellaria. "Working on a designated COVID-19 unit: Exploring nurse perceptions and experiences." Journal of Nursing Education and Practice 11, no. 11 (July 15, 2021): 41. http://dx.doi.org/10.5430/jnep.v11n11p41.
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Objective: The COVID-19 global pandemic has had a distressing effect on clinical nursing units, creating unique challenges for the nursing profession. These unprecedented challenges included constant fear of the unknown, major disruptions to daily routines, the need to adapt to the realities of new safety protocols, the need for continuous donning and doffing of PPE, and an alarming increase in patient acuity and death. Rapid increases in COVID-19 hospital admissions prompted hospital administrators to designate specific medical-surgical nursing units as covid units. As a result, nurses faced the real possibility of bringing the virus home to their loved ones and possibly contracting a deadly disease. To understand the impact of COVID-19, a study was conducted to assess nurses’ perceptions, morale, emotions, current knowledge and susceptibility to developing compassion fatigue.Methods: Content analysis was used to identify registered nurses’ perceptions and experiences while providing nursing care during the COVID-19 pandemic. Additionally, data was collected to assess participants’ emotional and physical well-being, knowledge and susceptibility to developing compassion fatigue.Results: Nurses’ qualitative responses were categorized into seven themes. Additionally, compassion fatigue knowledge and susceptibility responses were analyzed.Conclusions: Associated feedback, including narrations, provided a framework to assist nurses with accessing resources to manage stressors, combat compassion fatigue symptoms, promote resiliency, and increase communication skills.
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Cardin, Suzette, Sandra Kane, and Kathleen Koch. "Use of Patient Care Extenders in Critical Care Nursing." AACN Advanced Critical Care 3, no. 4 (November 1, 1992): 789–96. http://dx.doi.org/10.4037/15597768-1992-4007.
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This article explores the implementation and use of patient care extenders in two critical care units. Experimentation and diversity in changing the care-delivery system were the forces motivating the management team to redesign the existing nursing care-delivery system. The impetuses for the change process were the use of the role of the registered nurse and cost containment. Two case studies will illustrate from a practical perspective how the change occurred. Although the same nurse manager was responsible administratively for the two units, the patient care extender models were implemented differently. This was based on the conviction that each unit is unique with regard to patients and staff needs. The first case study occurred in an 18-bed cardiac telemetry unit in which the patient extender care model was integrated with direct patient care activities of the unit. In the second case study, which occurred in a ten-bed cardiac care unit, the patient care extender was integrated with indirect patient care activities. The approach to this article is practical, and it is intended for units that may be dealing with these issues in these changing times in health care
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Abbenbroek, Brett, Christine Duffield, and Doug Elliott. "Intensive care unit organisation and nurse outcomes: A cross-sectional study of traditional and “hot-floor” structures." Journal of Hospital Administration 6, no. 3 (June 1, 2017): 67. http://dx.doi.org/10.5430/jha.v6n3p67.
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Aim: To explore the relationship between the practice environment and nurse outcomes in two Intensive Care Unit (ICU) models.Background: Internationally the demand for intensive care is increasing. A large capacity multi-specialty integrated critical care service, the “hot-floor”, is emerging as the preferred organisational model. Benefits include resource consolidation and improved utilisation, operational synergies, operational flexibility and demand management. A large clinical workforce with commensurate frontline management, education and support positions are required. The association between these factors, within the ICU hot-floor work environment, and nurse outcomes is not known.Methods: Registered nurses (RNs) working in two ICUs, one a hot-floor model and one traditional ICU, completed a structured questionnaire. Nurse perceptions of work-life and organisational factors, and dimensions of burnout were examined using the Practice Environment Scale-Nursing Work Index (PES-NWI) and Maslach’s Burnout Inventory (MBI).Results: Units matched on service level characteristics, training accreditation, patient casemix, operational and clinical care processes. Nurses in had similar demographic characteristics, professional attributes and experience. Workforce structures were also similar though the hot-floor had relatively less dedicated resources for frontline nurse management and clinical education positions. Hot-floor nurses worked more paid overtime and were redeployed less frequently to external wards. Nurse manager leadership and support was less effective, and nurses expressed lower personal accomplishment.Conclusions: Improved demand management achieved through greater operational flexibility is a key driver for the hot-floor model. Planning for enhanced organisational effectiveness requires corresponding improvements in the work environment to optimise nurse retention to ensure organisational sustainability.
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Swito, Ikar, Andi Indahwaty Sidin, and Rini Rachmawaty. "Factors related to the implementation of Evidenced-based practice (EBP) of nursing staffing levels in Hospitals: A Literature Review." Journal of Asian Multicultural Research for Medical and Health Science Study 2, no. 1 (February 9, 2021): 60–68. http://dx.doi.org/10.47616/jamrmhss.v2i1.88.
Повний текст джерелаАнотація:
The implementation of Evidenced-based practice (EBP) was one of the factors in increasing the quality of health services as an ideal problem-solving approach. The ability of nurses to appliance EBP was influenced by many factors, not only on individual nurses consisting by the support of unit leader and colleague. The purpose of this study was to determine the factors associated with the implementation of EBP at the care room level establishing on the support of coworkers and nursing managers. This writing used a literature review study, from several databases namely PubMed, ProQuest, Google Scholar, and ScienceDirect with a limitation of the last 5 years. 17 journals met the inclusion criteria and the results of a literature review study show: eight journals conclude that the support of colleagues and authority in changing practices affects the implementation of EBP, 13 journals concluded the role of managerial nurses affects the implementation of EBP consisting of leadership support and mentorship including the lack of knowledge and skills of nursing leaders regarding EBP. Data from the collected and identified literature study clearly showed that EBP knowledge and skills of nursing leaders related to EBP are important factors in increasing the implementation of EBP but co-worker factors can be a supporter and also an obstacle to the implementation of EBP if it is not well managed.
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Maguire, Denise. "Leadership for Dummies." Neonatal Network 20, no. 8 (December 2001): 61–62. http://dx.doi.org/10.1891/0730-0832.20.8.61.
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OUR CATCHY TITLE ASIDE, LET’S BE clear: Leadership is not for dummies. Although leadership skills are different from those needed to care for critically ill newborns in the neonatal intensive care unit, the job of managing nurses is just as hard as the job of nursing, if not more so. Leadership in the NICU focuses less on technical and patient care skills than on social skills such as coaching and supervising learned from experience in dealing with people.1 As a manager, the nurse leader takes on priorities and goals that are different from the priorities and goals of the nursing staff. Instead of using their sharp assessment skills to avoid fluid overload, for instance, managers must use their assessment skills to recognize nursing skills in candidates they meet once in a 30-minute interview. Instead of prioritizing nursing care interventions for her own two-patient assignment, the manager prioritizes staffing patterns based on the skills needed by the entire patient population. Whereas staff members use every resource available to meet patient needs, nurse managers must allocate resources to keep within a tight budget. Strong fiscal skills have become extremely important for today’s manager.2 But rarely do new managers have the formal training in financial skills needed to manage a budget. Managers must also be keenly aware of the relationships among staff, physicians, and other support staff, and they must continually work at keeping the environment productive for staff. They must know what motivates the NICU staff to achieve the goals of the unit. Perhaps the most difficult task that managers have is conveying and making operational the administrative goals in a clinical setting that is intense, detail oriented, and entirely focused on the work of patient care. At every promotion, interpersonal skills become more important and technical skills become less important.1 No, leadership is certainly not for dummies.
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Rusca Putra, Kuswantoro, Heriandi Sutadi, Setyowati Setyowati, and Rr Tutik Sri Hayati. "The effect of caring work environment model on nurses’ burnout in general hospitals." International Journal of Public Health Science (IJPHS) 10, no. 3 (September 1, 2021): 537. http://dx.doi.org/10.11591/ijphs.v10i3.20800.
Повний текст джерелаАнотація:
Nurses belong to a profession that carries a high risk of burnout. This condition will have an impact on the performance and quality of nursing services. Efforts should be made to minimize burnout for nurses. Management of the nurses' work environment is one that should be done by the nurse manager. This study aimed to identify the effect of the implementation of a caring work environment by the head of the care unit on nurse burnout. This study used a quasi-experimental design with a pre- and post-test with control group approach. Respondent of this study was 170 nurses who were divided into intervention and control groups. The intervention group consisted of nurses within the Caring Work Environment Model as applied by the head of the units. The control group included nurses working in the environment commonly applied in accordance with hospital policies in the inpatient unit. Burnout measurements on nurses applied preand post- intervention. Data analysis was performed using the Mann Whitney<br />test. This research showed a decrease in emotional fatigue and depersonalization scores, and an increase in nurse personal accomplishment, (p<0.001) after the implementation of the nurse's caring work environment model by the head of care unit in the intervention group. Within the control group, only personal accomplishment showed increased scores, (p=0.034). Reduction in burnout symptoms in nurses can be facilitated through the implementation of a caring work environment by the head of the care unit.