Servant leadership behaviour of head nurse assessment and its linkage with nurse work engagement in China.

AIM: To assess the servant leadership behaviour of head nurse and its linkage with nurse work engagement in China. DESIGN: A cross-sectional study. METHODS: A anonymous investigation with the stratified cluster randomized sampling of nurse was conducted in Hunan Province of China in December 2020. We administered the Perceived Head Nurse Service Leadership Behaviour Scale and the Chinese version of Utrecht work engagement scale to survey, and analyse its relationships by multiple linear regression. RESULTS: A number of 890 nurses participated in this study. The average score of the perceived servant leadership of head nurse reported by nurses was 78.90 ± 14.04, which was at a medium level. Among its six dimensions, the dimension of promote nurse development scored highest (16.04 ± 2.84), while the dimension of dedication scored lowest (11.39 ± 2.46). Official nurses reported higher perceived servant leadership scores of head nurses than those who were employed and temporary nurses (b = 1.727, 95% CI: 0.054-3.400); nurses in tertiary hospitals reported higher perceived servant leadership scores of head nurses than nurses in primary and secondary hospitals (b = 2.703, 95% CI: 0.305-5.100); and lower perceived servant leadership scores were associated with nurses' job overtime (b = -4.935, 95% CI: -6.891 to -2.978). Nurses' perceived servant leadership of head nurses were positively associated with nurses' work engagement (r = 0.336, p < .05). Multiple linear regression analysis indicated that the perceived servant leadership of head nurse affected nurses' work engagement strongly (b = 0.585, 95% CI: 0.479-0.691). CONCLUSION: The servant leadership behaviour of head nurse in China was at the medium level, which was positively associated with nurses' work engagement. Further research should improve the power of the servant leadership behaviour of head nurse by integrating additional training, policies and support. IMPACT: It is time to consider the servant leadership behaviour of head nurses and its linkage with nurses' work engagement in China seriously, and address the policies, guidelines, curriculum, and practice culture. PATIENT OR PUBLIC CONTRIBUTION: The study was conducted to explore the situation of servant leadership behaviour of head nurses and its linkage with nurses' work engagement in China, which did not include input from the public or the intended participants.

Involvement of Jordanian Head Nurses' in Health Policy Development: A Cross-Sectional Study.

BACKGROUND: Despite the importance of involving nurses in health policy, nurse's involvement faces many challenges. Literature showed that there is a low level of nurses' and nurse leaders' involvement in health policy development. AIM: The aims of this study were to examine (a) the level of Jordanian head nurses' involvement in health policy development and their perceived benefits and barriers; (b) the relationships between level of knowledge, competence, and interest in health policy and the level of involvement in health policy development; and (c) the relationship between the level of self-efficacy (efficacy expectation and outcome expectation) and the level of involvement in health policy development. METHODS: A cross-sectional descriptive correlational study design was adopted in this study. A convenience sampling of 250 participants from hospitals affiliated to three health sectors in Jordan (private, governmental, and university) were recruited to complete a self-administered questionnaire. Descriptive statistics and Pearson correlation coefficient were used to answer the study questions. RESULTS: The results revealed a moderate level of involvement of head nurses in the policy development. The most frequent cited political activity was "providing written reports, consultations, research." "Lack of time" was the most perceived barrier, while "improving the health of the public" was the most perceived benefit. Workshops or sessions at conferences is the most indicated source of knowledge. Participants had an excellent level of skills with positive relationships between the competence and both of the levels of professional and personal involvement in health policy. Participants reported a low level of confidence in performing political activities as well as the impact of such activities on health outcomes. Positive relationship was indicated between self-efficacy and the levels of professional and personal involvement in political activities.Implications: Health policies affect nurses and their practice. Overcoming the barriers and enhancing the levels of head nurses' knowledge and competence regarding health policies can help activating their roles in health policy development process. This will help in activating nurses' role in health policy development, which in turn will have a positive impact on health outcomes.

Psychometric Testing of a Structured Assessment Instrument for Non-technical Skills (NANTS-no) for Use in Clinical Supervision of Student Nurse Anesthetists.

BACKGROUND: This study evaluated psychometric properties of a structured behavioral assessment instrument, Nurse Anaesthetists' Non-Technical Skills-Norway (NANTS-no). It estimated whether reliable assessments of nontechnical skills (NTS) could be made after taking part in a workshop. An additional objective was to evaluate the instrument's acceptability and usability. METHODS: An explorative design was used. Nurse anesthetists (n = 46) involved in clinical supervision attended a 6-hour workshop on NTS, then rated NTS in video-recorded simulated scenarios and completed a questionnaire. RESULTS: High reliability and dependability were estimated in this setting. Participants regarded the instrument as useful for clinical supervision of student nurse anesthetists (SNAs). CONCLUSIONS: Findings suggest that NANTS-no may be reliable for performing clinical assessments of SNAs and encouraging critical reflection. However, further research is needed to explore its use in clinical settings.

A Multicentre Study of Nursing Leadership in Andalusian Hospitals from a Gender-based Perspective

ABSTRACT Introduction: Leadership is the ability to guide subordinates in a direction or decision so that they can perform a task or achieve a goal that leaves them feeling empowered and accomplished. Leaders are capable of producing changes and at the same time, they inspire others to do the same. This research analysed gender-based differences and dimensions of nursing leadership styles in 18 hospitals in Andalusia, a region of southern Spain. Methods: The sample population of the study comprised 335 subjects, who were middle managers in 18 public regional hospitals in Andalusia. The instrument used to measure different leadership styles was the Multifactor Leadership Questionnaire (MLQ 5X-Short form), which is composed of 45 items. Results: The study showed that the most predominant leadership style was transactional leadership with a mean value of M = 4.22 (standard deviation [SD] = 0.42) followed by transformational leadership with a mean value of M = 3.97 (SD 0.45). Of the three styles analysed, transactional leadership had the highest statistical median for both male and female subjects. From a gender-based perspective, transformational leadership showed statistically significant differences (p < 0.01) between men and women. This was true for leadership styles as well as for the dimensions that define each style. Conclusion: The most frequent leadership style in middle nursing management in Andalusian hospitals was transactional leadership. In regard to the three leadership styles as well as their dimensions, the female subjects obtained the highest scores. This means that from a gender-based perspective, female nursing managers had better performance levels than their male counterparts in the regional hospital system in Andalusia.

Liderança coaching na enfermagem e sua influência na satisfação profissional e segurança do paciente / Liderazgo coaching en la enfermería y su influencia sobre la satisfacción profesional y seguridad del paciente / Nursing coaching leadership and its influence on job satisfaction and patient safety

RESUMO Objetivo Comparar a percepção dos técnicos de enfermagem com a autopercepção do enfermeiro sobre o exercício da sua Liderança coaching e verificar a influência desse modelo de liderança no clima de segurança e na satisfação da equipe. Método Estudo correlacional, realizado com 85 enfermeiros e 85 técnicos de enfermagem, utilizando o Questionário de Autopercepção do Enfermeiro no Exercício da Liderança, o Questionário de Percepção do Técnico e Auxiliar de Enfermagem no Exercício da Liderança e as subescalas Clima de segurança e Satisfação no trabalho. As relações entre as respostas dos profissionais foram avaliadas pelo teste de Mann Whitney e coeficiente de Spearman. Resultados Os enfermeiros alcançaram maiores médias nas quatro dimensões da Liderança coaching, sendo que, em três, as diferenças foram significantes (p < 0,05). As dimensões da Liderança coaching obtiveram correlações positivas e significantes com as subescalas Clima de segurança e Satisfação, sendo a maioria de moderada magnitude. Conclusão A autopercepção dos enfermeiros, com relação ao exercício da liderança, foi mais positiva do que a avaliação dos técnicos. Quanto mais o enfermeiro exercer as dimensões da Liderança coaching, melhores serão o clima de segurança e a satisfação da equipe.

RESUMEN Objetivo Comparar la percepción de los técnicos de enfermería con la autopercepción del enfermero sobre la práctica de su Liderazgo coaching y verificar la influencia de ese modelo de liderazgo en el clima de seguridad y en la satisfacción del equipo. Método Estudio correlacional, realizado con 85 enfermeros y 85 técnicos de enfermería que utilizaron el Cuestionario de Autopercepción del Enfermero en la Práctica del Liderazgo, el Cuestionario de Percepción del Técnico y Auxiliar de Enfermería en la Práctica del Liderazgo y las subescalas clima de seguridad y Satisfacción en el trabajo. Las relaciones entre las respuestas de los profesionales fueron evaluadas por el test de Mann Whitney y coeficiente de Spearman. Resultados Los enfermeros alcanzaron mejores medias en las cuatro dimensiones del Liderazgo coaching, siendo que, en tres, las diferencias fueron significativas (p < 0,05). Las dimensiones del Liderazgo coaching obtuvieron correlaciones positivas y significativas con las subescalas Clima de seguridad y satisfacción, siendo la mayoría de moderada magnitud. Conclusión La autopercepción de los enfermeros, con relación a la práctica del liderazgo, fue más positiva que la evaluación de los técnicos. A la medida que el enfermero ejerce más las dimensiones de Liderazgo coaching, mejores serán el clima de seguridad y la satisfacción del equipo.

ABSTRACT Objective To compare the nursing technicians' perception with the nurses' self-perception of the exercise of nurses' coaching leadership and to check the influence of this leadership model on the safety climate and on the team's satisfaction. Method This is a correlational study, carried out with 85 nurses and 85 nursing technicians, using the Questionnaire on the Nurse's Self-Perception of Leadership Exercise, the Questionnaire on Nursing Technicians' and Assistants' Perception of Leadership Exercise, and the subscales Safety climate and Satisfaction at Work. The relations among the professionals' responses were assessed using the Mann Whitney test and Spearman's coefficient. Results Nurses achieved higher means in the four dimensions of coaching Leadership, and in three, the differences were significant (p < 0.05). The dimensions of Coaching Leadership obtained positive and significant correlations with the subscales Safety Climate and Satisfaction, the majority being of moderate magnitude. Conclusion Nurses' self-perception regarding the exercise of leadership was more positive than the technicians' assessment. The more the nurse exercises the dimensions of Coaching Leadership, the better the team's safety climate and satisfaction.

Una mirada fenomenológica social al cotidiano de la gestión de la enfermera jefa de servicio / A Phenomenological Approach to the Daily Management Practice in the Head Nurse of the Service

Introducción: La inquietud surge como enfermera asistencial, percibiendo el trabajo diario de la enfermera jefa de servicio como sobrecargado y estresante. Está relacionado al quehacer cotidiano de la enfermera jefa, un área poco investigada. Objetivo: Comprender el cotidiano de la gestión de la enfermera jefa de servicio. Métodos: El abordaje teórico metodológico fue la fenomenología social de Alfred Schütz. El escenario, el Hospital Central de la Fuerza Aérea del Perú en el año 2018 a 2019. La muestra, conformada por diez enfermeras jefes de servicio, seleccionadas mediante saturación de discursos, utilizándose como técnica de recolección de datos la entrevista fenomenológica, como instrumento una guía de entrevista y para el análisis de los datos se utilizó el análisis temático. Resultados: Se generaron 2 categorías: "Asumiendo la responsabilidad y el liderazgo en la gestión del cotidiano de un servicio de Enfermería" y "Compartiendo intersubjetividades al interactuar con otros semejantes en el mundo de vida cotidiano". Conclusiones: La enfermera jefa de servicio en la gestión de su cotidiano tiene muy arraigado el sentido de responsabilidad atribuido al cargo, interactúa no solo con el equipo de enfermería, sino también con médicos y autoridades militares, encuentra muchas veces dificultades en hacerles entender las necesidades del servicio, sin embargo, en el cotidiano maneja estas intersubjetividades mediante su acervo de conocimientos(AU)

Introduction: The concern arises in the practice as a nurse, perceiving the daily work of the head nurse of the service as overloaded and stressful. It is associated with the daily work of the head nurse, an area little investigated. Objective: To understand the daily practice of the head nurse of the service. Methods: The theoretical-methodological approach was Alfred Schütz's social phenomenology. The setting was the Central Hospital of the Peruvian Air Force in the year 2018 to 2019. The sample was made up of ten service chief nurses, selected through saturation of speeches, using the phenomenological interview as a data collection technique; as an instrument, an interview guide was used and thematic analysis was used for data analysis. Results: Two categories were generated: "Assuming responsibility and leadership in the daily practice of a nursing service" and "Sharing intersubjectivities when interacting with other peers in the world of daily practice". Conclusions: The head nurse of the service, in the management of her daily practice, has a deep-rooted sense of responsibility attributed to the position. She interacts not only with the nursing team, but also with doctors and military authorities, often coming across difficulties in making them understand their needs. However, in everyday practice, the head nurse handles these intersubjectivities through her or his wealth of knowledge(AU)

Gerenciamento de enfermagem em sala de vacina: desafios e potencialidades / Nursing management in the vaccine room: challenges and potentialities / Gerencia de enfermería en sala de vacuna: retos y potencialidades

Objetivo: analisar o gerenciamento de enfermagem em sala de vacina, com ênfase na supervisão, em um município de médio porte de Minas Gerais, Brasil. Método: estudo descritivo, de abordagem qualitativa, tipo estudo de caso único. Os dados foram organizados e analisados por meio da Análise de Conteúdo modalidade temático-categorial. Resultados: os achados foram organizados em duas categorias analíticas: "Fatores intervenientes no gerenciamento em sala de vacina", abordando desafios para supervisão, necessidade de um instrumento que padronize essa atividade, falta de organização do processo de trabalho e sobrecarga de funções. A segunda categoria: "Potencialidades para o gerenciamento na sala de vacina" aponta como fatores potencializadores a organização do tempo e agenda do enfermeiro e a necessidade de um instrumento que sistematize as atividades de supervisão. Considerações finais: a maioria dos enfermeiros compreendem a importância da supervisão, como ferramenta do gerenciamento, mas não a realizam de forma sistemática.

Objective: to analyze nursing management in the vaccine room, with emphasis on supervision, in a medium-sized city of Minas Gerais, Brazil. Method: a descriptive, qualitative, unique case study. The data were organized and analyzed through theme/category-based content analysis. Results: the findings were organized into two analytical categories: "Intervening factors in the management of the vaccine room", addressing the challenges for supervision, the need for an instrument to standardize this activity, lack of work process organization and overloading of functions. The second category: "Potentialities for the management in the vaccine room" points out as potentiating factors the organization of the nurse's time and agenda and the need for an instrument that systematizes the supervision activities. Final Remarks: Most nurses understand the importance of supervision as a management tool, but do not perform it systematically.

Objetivo: analizar la gerencia de enfermería en sala de vacuna, con énfasis en supervisión, en un municipio de tamaño mediano en Minas Gerais, Brasil. Método: estudio descriptivo, cualitativo, tipo estudio de caso único. Los datos fueron organizados y analizados a través de modalidad temática y categoría de Análisis de Contenido. Resultados: los hallazgos se organizaron en dos categorías analíticas: "Factores que intervienen en la gerencia en sala de vacuna", que abordan desafíos de la supervisión, necesidad de instrumento para estandarizar esta actividad, falta de organización del trabajo y sobrecarga de funciones. La segunda categoría: "Potencialidades para gerencia en sala de vacuna" señala factores potenciadores en organización del tiempo y agenda de la enfermera y la necesidad de un instrumento que sistematice las actividades de supervisión. Consideraciones finales: la mayoría de las enfermeras entienden la importancia de la supervisión como una herramienta de gestión, pero no realizan de manera sistemática.

Managerial competencies of head nurses: a model and assessment tool.

Head nurses' performance plays an important role in the successful operation of hospitals. Identification and prioritisation of managerial competencies required for these supervisors and evaluation of their performance on this basis are necessary. This study aimed to provide a valid tool for assessing managerial competencies of hospital department head nurses. First, through literature review, Delphi technique and expert panel, a competency model was developed. Then using the analytic hierarchy process, competencies were weighted and prioritised. Finally, based on the model, an instrument was designed to measure the competencies of head nurses. Validity and reliability of the instrument was also checked. The proposed framework included 27 competencies categorised by four main managerial tasks: planning, organising, leadership and control. Findings revealed that the highest priority was given to strategic thinking (0.1221) and the lowest priority was given to evidence-based decision making (0.007). Based on impact score and content validity ratio results, the content validity of all questions has been proved. Furthermore through the use of a content validity index, 11 questions were omitted or modified. The study presents a valid and comprehensive model for assessing managerial competencies of hospital department head nurses in order to take an important step towards improving their performance.

Charge nurse facilitated clinical debriefing in the emergency department.

ABSTRACTThis paper describes the development and implementation of the INFO (immediate, not for personal assessment, fast facilitated feedback, and opportunity to ask questions) clinical debriefing process. INFO enabled charge nurses to facilitate a group debriefing after critical events across three adult emergency departments (EDs) in Calgary, Alberta. Prior to implementation at our institutions, ED critical event debriefing was a highly variable event. Post-implementation, INFO critical event debriefings have become part of our ED culture, take place regularly in our EDs (254 documented debriefings between March 2016 and September 2017), with recommendations arising from these debriefings being introduced into clinical practice. The INFO clinical debriefing process addresses two significant barriers to regular ED clinical debriefing: a lack of trained facilitators and the focus on physician-led debriefings. Our experience shows that a nurse-facilitated debriefing is feasible, can be successfully implemented in diverse EDs, and can be performed by relatively inexperienced debriefers. A structured approach means that debriefings are more likely to take place and become a routine part of improving team management of high stakes or unexpected clinical events.

Representações de supervisão na perspectiva dos enfermeiros coordenadores de um hospital de ensino / Representaciones de supervisión en la perspectiva de enfermeros coordinadores de un hospital de enseñanza / Nursing supervision from the perspective of nurse coordinators of a teaching hospital

Objetivo compreender a percepção dos Coordenadores de Áreas Assistenciais de Enfermagem sobre a supervisão de enfermagem realizada pelos enfermeiros assistenciais no contexto hospitalar. Método estudo de abordagem qualitativa, fundamentado na Teoria das Representações Sociais. Foram entrevistados 16 coordenadores de enfermagem de um hospital de ensino. Os dados foram analisados pelo método Conteúdo Qualitativo-Temático. Emergiram três categorias empíricas: Supervisão de Enfermagem: Ferramenta Gerencial que Qualifica o Cuidado, Imbricamento entre Administrar e Cuidar e Supervisionar: Reflexo do Processo Formativo e Contexto Institucional. Resultados a significação dada pelo grupo social dos coordenadores sobre a supervisão de enfermagem praticada revela uma prática gerencial de controle e pouco educativa, porém com impacto positivo para a qualidade assistencial. Conclusão a percepção dos Coordenadores de Áreas Assistenciais de Enfermagem sobre a supervisão de enfermagem revelou deficiências na implementação atribuídas às lacunas da formação, às demandas excessivas no trabalho e à falta de capacitação em relação à prática da supervisão.

Objetivo comprender la percepción de Coordinadores de Áreas Asistenciales de Enfermería sobre supervisión de enfermería por enfermeros asistenciales en el contexto hospitalario. Método estudio cualitativo, basado en la Teoría de las Representaciones Sociales. Se entrevistaron a 16 coordinadores de enfermería de hospital de enseñanza. Datos analizados por el método Contenido Cualitativo-Temático. Emergieron tres categorías empíricas: Supervisión de Enfermería: Herramienta Gerencial que Qualifica la Atención, Imbricamiento entre Administrar y Cuidar y Supervisionar: Reflejo del Proceso Formativo y Contexto Institucional. Resultados la significación del grupo social de coordinadores sobre supervisión de enfermería practicada revela práctica gerencial de control y poco educativa, pero con impacto positivo para calidad asistencial. Conclusión la percepción de Coordinadores de Áreas Asistenciales de Enfermería sobre supervisión de enfermería reveló deficiencias en la implementación atribuidas a las lagunas de la formación, a las demandas excesivas en el trabajo y falta de capacitación en relación a la práctica de supervisión.

Objective to report the opinions of nurse coordinators on supervisory activities performed by nursing assistants in the hospital setting. Method a qualitative study based on the theory of social representations. Sixteen nursing coordinators from a teaching hospital were interviewed. The data were analyzed using qualitative thematic content analysis. Nursing supervision was divided into three categories: 1. a management tool that qualifies care, 2. an activity that interconnects nursing management and health care practice, and 3. a reflection of the formative process and the institutional context. Results the opinions of nursing coordinators indicate that nursing supervision is a managerial practice based primarily on the exercise of authority but not on supervision training. However, this practice has a positive impact on the quality of care. Conclusion the opinions of nursing coordinators about nursing supervision revealed deficiencies related to educational gaps, excessive work demands, and lack of supervision training.

Claims to the benefits of clinical supervision: A critique of the policy development process and outcomes in New South Wales, Australia.

The historical development of clinical supervision has been variously interpreted in the international literature. Creditable evidence has accumulated, particularly over the past two decades, to show that clinical supervision has a positive demonstrable effect on supervisees. However, comparatively little research evidence has entered the public domain on any effect that clinical supervision might have on other nominated outcomes. In Australia, developments in clinical supervision were recently prompted by initiatives at national and state levels. Since 2010, lead agencies for these have sought feedback from professional bodies and organizations on a number of inter-related draft policy documents. The present article tracked changes over time between the draft and final versions of these documents in New South Wales, and reviewed the original sources of literature cited within them. The strength of evidence upon which the final published versions were reportedly predicated was scrutinized. Upon examination, claims to the wider benefits of clinical supervision were found to be unconvincingly supported, not least because the examples selected by the agencies from the international literature and cited in their respective documents were either silent, parsimonious, or contradictory. Many claims remain at the level of folklore/hypothetical propositions, therefore, and stay worthy of rigorous empirical testing and faithful public reporting. Such investigations have been acknowledged as notoriously difficult to conduct. The present article identified noteworthy examples in the contemporary literature that signpost robust ways forward for empirical outcomes-orientated research, the findings from which might strengthen the evidence base of future policy documents.

Counting the cost of healthcare reform.

Fiscal cost containment is an inherent component of any nurse manager's job, regardless of practice setting.

Avaliação das atividades de supervisão nos Programas de provimento de médicos na Bahia

O Programa de Valorização da Atenção Básica (PROVAB) foi criado em 2011 com o objetivo de minimizar a má distribuição de médicos no território nacional e a aposta do governo seguiu com a criação do Programa Mais Médicos (PMM) em 2013. O PROVAB e PMM propõem, para além de ofertar provimento de profissionais para atuação na AB, uma oferta pedagógica, em que uma das frentes é a supervisão. A supervisão médica ocorre com visitas uma vez ao mês, in loco e têm como objetivo acompanhar e apoiar, de forma permanente e longitudinal, o médico participante do programa. O supervisor deve se utilizar de dispositivos para o suporte necessário e singular aos médicos participantes do Projeto, a fim de fortalecer competências para o desenvolvimento de ações na Atenção Básica. Este trabalho tem como objetivo principal avaliar a atividade de supervisão aos médicos dos programas de provimento médico do governo federal na perspectiva da integralidade. Trata-se de uma pesquisa qualitativa e a técnica empregada para a coleta de dados foi a realização de entrevistas abertas com médicos vinculados aos programas e supervisores, na Bahia. Utilizou-se como técnica a análise temática e os dados obtidos foram organizados em dois núcleos de sentido, quatro temas e sete categorias. Os resultados evidenciaram, como potencialidades, contribuições na qualificação do cuidado integral, na organização processo de trabalho e a função de apoiador da prática de supervisão aos médicos. Algumas foram as dificuldades apresentadas no processo de supervisão. Uma delas em relação ao formato, frequência das visitas de supervisão e organização local da supervisão do PMM. Outro achado deste trabalho foi a importância de pensar onde os pés pisam, referindo-se à necessidade da experiência na APS para a prática da supervisão...

he Program of Basic Care Valorization (Programa de Valorização da Atenção Básica, PROVAB) was created in 2011 to minimize the bad distribution of doctors in the country, and the government improved on this initiative with the Mais Médicos Program (PMM) in 2013. PROVAB and PMM claims to aim to not only provide professionals for Basic Care, but also focus on supervision. Medical supervision happens with monthly visits in loco focusing on monitoring and supporting, permanently and longitudinally, the professional who is a part of the program. The supervisor must grant the kind singular support the doctors in the programs need in order to strengthen their ability to develop actions in Basic Care. This research aims to evaluate the supervision of the doctors in these staff provision programs of the federal government focusing on wholeness. It is a qualitative research and data was collected through open interviews with doctors who participate in these programs as well as with supervisors in the state of Bahia. Thematic analysis was used and the data obtained was organized in two unities of meaning, four themes, and seven categories. Results show as potentialities contributions to qualifying integral care and to organizing the work process as well as supportive practices in medical supervision.

A supervisão do enfermeiro no trabalho do agente comunitário de saúde: uma revisão integrativa

Objetivou-se conhecer as fragilidades e potencialidades na supervisão de enfermagem dos agentes comunitários de saúde. Trata-se de uma revisão integrativa, que segue as cinco etapas propostas por Cooper: formulação do problema, coleta de dados, avaliação dos dados, análise e interpretação dos dados e apresentação dos resultados. Fizeram parte da amostra deste estudo seis artigos, que respondiam a questão norteadora. Dentre as fragilidades pode-se citar a ausência de supervisão dos enfermeiros devido à demanda de atividades gerenciais e assistenciais ou mesmo por férias; e nas relações de fiscalização e cobrança por produção. Quanto às potencialidades destaca-se o papel do enfermeiro como profissional de referência e o que orienta as atividades dos agentes comunitários de saúde; a supervisão deve ser vista de forma mais educativa. Há poucos estudos que abordam esta temática, por isso, sugere-se a realização de outros sobre supervisão de enfermagem, pensando na qualificação do trabalho.

Exploring Organizational Barriers to Strengthening Clinical Supervision of Psychiatric Nursing Staff: A Longitudinal Controlled Intervention Study.

This article reports findings from a longitudinal controlled intervention study of 115 psychiatric nursing staff. The twofold objective of the study was: (a) To test whether the intervention could increase clinical supervision participation and effectiveness of existing supervision practices, and (b) To explore organizational constraints to implementation of these strengthened practices. Questionnaire responses and registration of participation in clinical supervision were registered prior and subsequent to the intervention consisting of an action learning oriented reflection on staff's existing clinical supervision practices. Major organizational changes in the intervention group during the study period obstructed the implementation of strengthened clinical supervision practices, but offered an opportunity for studying the influences of organizational constraints. The main findings were that a) diminishing experience of social support from colleagues was associated with reduced participation in clinical supervision, while b) additional quantitative demands were associated with staff reporting difficulties finding time for supervision. This probably explained a negative development in the experienced effectiveness of supervision. It is concluded that organizational support is an imperative for implementation of clinical supervision.

Prática gerencial na estratégia saúde da família / Management practice in the family health strategy

Analisamos práticas gerenciais realizadas em Unidades de Saúde da Família. Realizamos entrevistas com 54 profissionais destes serviços e processamos os dados segundo referencial da Análise de Conteúdo (Temático Categorial). Identificamos 3 categorias analíticas: a) Conhecimentos e significados sobre a gerência; b) Práticas gerenciais assistemáticas e; c) Desenvolvimento de habilidades gerenciais. Identificamos que é preciso melhor definição do papel dos atores envolvidos no gerenciamento das Unidades, visto que os profissionais demonstram desentendimento em relação à execução de tais práticas...

We analyze management practices developed in the Family Health Units. We conducted interviews with 54 professionals working in this service and process the data according to reference to the thematic content analysis. We identified three analytical categories: a) Knowledge and meanings of management; b) unsystematic and management practices; c) management training. We identified that we need define in a better way the role of the actors involved in the management of the units, since the professionals demonstrate disagreement regarding the implementation of such practices...

Analizamos las prácticas de gestión en las unidades de Estrategia de Salud de la Familia. Entrevistamos a 54 profesionales de estos servicios y procesar los datos de acuerdo para hacer referencia ai Análisis de Contenido (temática categórica) Se identificaron tres categorías de análisis: a) Conocimiento y significados de la gestión; b) las prácticas no sistemáticas y de gestión; c) Desarrollo de habilidades directivas. Identificamos que tenemos que definir mejor el papel de los actores involucrados en la gestión de las unidades, ya que los profesionales demuestran el desacuerdo con respecto a la implementación de este tipo de prácticas...

AWHONN Position Statement. The Role of Unlicensed Assistive Personnel (Nursing Assistive Personnel) in the Care of Women and Newborns.

The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) recognizes that unlicensed assistive personnel (UAP) also known as nursing assistive personnel (NAP) can function as supportive members of the health care team under the direction of the professional registered nurse (AWHONN, 2010). The professional registered nurse is ultimately responsible for the coordination and delivery of nursing care to women and newborns.

How nurse managers in Japanese hospital wards manage patient violence toward their staff.

AIM: This study explores nurse managers' experiences in dealing with patient/family violence toward their staff. BACKGROUND: Studies and guidelines have emphasised the responsibility of nurse managers to manage violence directed at their staff. Although studies on nursing staff have highlighted the ineffectiveness of strategies used by nurse managers, few have explored their perspectives on dealing with violence. METHODS: This qualitative study adopted a grounded theory approach to explore the experiences of 26 Japanese nurse managers. RESULTS: The nurse managers made decisions using internalised ethical values, which included maintaining organisational functioning, keeping staff safe, advocating for the patient/family and avoiding moral transgressions. They resolved internal conflicts among their ethical values by repeating a holistic assessment and simultaneous approach consisting of damage control and dialogue. They facilitated the involved persons' understanding, acceptance and sensemaking of the incident, which contributed to a resolution of the internal conflicts among their ethical values. CONCLUSIONS: Nurse managers adhere to their ethical values when dealing with patient violence toward nurses. Their ethical decision-making process should be acknowledged as an effective strategy to manage violence. IMPLICATIONS FOR NURSING MANAGEMENT: Organisational strategies that support and incorporate managers' ethical decision-making are needed to prevent and manage violence toward nurses.

The object of your affection: how commitment, leadership and justice influence workplace behaviours in health care.

AIM: This paper describes the development of a coherent framework that develops nursing knowledge and guides research in workplace behaviours, work performance, and the factors that influence behaviours and performance. BACKGROUND: Work performance is dependent upon behaviours that are related to one's commitment towards their workplace and leadership interactions. The influence of these concepts on work outcomes has been established in disparate studies, but their precedence in terms of influencing workers' behaviours, is not well understood. METHODS: A scientific realism approach is applied, where theory and current research in the field of organisational behaviour and work motivation are drawn upon to identify validated constructs and explain their relationships. DISCUSSION: An augmented framework is produced, incorporating concepts of relevance to work motivation and work attitudes. Propositions, predicated on research evidence, are offered. Conclusions A novel comprehensive framework is developed, extending the range of behaviours important to workers and the organisation. IMPLICATIONS FOR NURSING MANAGEMENT: Focusing on targets for which nurses are affectively committed can prove useful to managers. The developed framework can be informative to managers by increasing awareness of the relationships between concepts, such that they are mindful of these constructs while interacting with staff.