The impact of person-centred care on job productivity, job satisfaction and organisational commitment among employees in long-term care facilities.

AIM AND OBJECTIVES: This study aimed to explore the effects of person-centred care on their job productivity, job satisfaction and organisational commitment among employees in long-term care facilities. BACKGROUND: Person-centred care has been regarded as the best caregiving model for long-term care facilities. Few studies tested the impact of person-centred care on employee performance. DESIGN: A cross-sectional study was employed. METHODS: This study sent 373 samples with self-report questionnaires to the employees of sixteen long-term care facilities in Taiwan. A total of 366 valid samples were collected. A 33-item person-centred care questionnaire with Likert-scale responses was developed to assess the extent of person-centred care. We adopted hierarchical multiple regression analysis to test the impact of person-centred care on employee performance. We adopted the STROBE guidelines. RESULTS: Friendly environment level and personalised care, respectively, scored the highest with a mean of 4.19 among five dimensions of person-centred care. Personalised care, residents' self-realisation and relationships, and organisational support had significant positive correlations with job productivity. Friendly environment level and organisational support had significant correlations with job satisfaction. Friendly environment level, residents' self-realisation and relationships, and organisational support had significant correlations with organisational commitment. CONCLUSION: Person-centred care has beneficial impact on job satisfaction, job productivity and organisational commitment of employees in long-term care facilities. RELEVANCE TO CLINICAL PRACTICE: Person-centred care appears to be a crucial factor of employee performance in long-term care facilities. The five-dimensional person-centred care questionnaire in this study can serve as an important management tool for improving the effectiveness of person-centred care.

Increased Long-Term Risks of Occupational Diseases in Homecare Nurses: A Nationwide Population-Based Retrospective Cohort Study.

Background: The work of homecare nurses is different from that of general hospital nurses; therefore, it is necessary to understand the risks of occupational diseases in homecare nurses. Materials and Methods: In this retrospective cohort research conducted from 2000 to 2013, nursing staff comprised the sample obtained from the National Health Insurance Research Database. Nursing staff were subgrouped according to practice site into homecare, medical center, regional hospital, and local community hospital nurses. The control group included 4,108 subjects. Results: The risk of severe kidney disease was higher in homecare nurses than in medical center nurses (hazard ratio [HR]: 7.3, 95% confidence interval [CI]: 2.45-21.78) and regional hospital nurses (HR: 3.30, 95% CI: 1.37-7.96). The risk of severe liver disease was higher in homecare nurses than in medical center nurses (HR: 1.92, 95% CI: 1.10-3.35) and regional hospital nurses (HR: 2.06, 95% CI: 1.17-3.62). Conclusions: The prevalence of occupational diseases was higher in homecare nurses than in noncaregivers. The correlation between different practice environments and disease prevalence rates revealed that various types of nurses can be ranked in the following order based on the prevalence of the aforementioned diseases: homecare nurses > local community hospital nurses > regional hospital nurses > medical center nurses.

Developing and testing the patient-centred innovation questionnaire for hospital nurses.

AIMS: Develop the patient-centred innovation questionnaire for hospital nurses and establish its validity and reliability. BACKGROUND: Patient-centred care has been adopted by health care managers in their efforts to improve health care quality. It is regarded as a core concept for developing innovation. METHODS: A cross-sectional study was employed to collect data from hospital nurses in Taiwan. This study was divided into two stages: pilot study and main study. In the main study, 596 valid responses were collected. This study adopted reliability analysis, exploratory factor analysis, confirmatory factor analysis and selected nurse innovation scale as a criterion to test criterion-related validity. RESULTS: Five-dimension patient-centred innovation questionnaire was proposed: access and practicability, co-ordination and communication, sharing power and responsibility, care continuity, family and person focus. Each dimension demonstrated a reliability of 0.89-0.98. All dimensions had acceptable convergent and discriminate validity. The patient-centred innovation questionnaire and nurse innovation scale exhibited a significantly positive correlation. CONCLUSIONS: Patient-centred innovation questionnaire not only had a good theoretical basis but also had sufficient reliability and construct validity, and criterion-related validity. IMPLICATIONS FOR NURSING MANAGEMENT: Patient-centred innovation questionnaire could give a measure for evaluating the implementation of patient-centred care and could be used as a management tool during the process of nurse innovation.

Factors influencing medical staff's intentions to implement family-witnessed cardiopulmonary resuscitation: A cross-sectional, multihospital survey.

BACKGROUND: In Taiwan, the current status of family-witnessed resuscitation (FWR) and the factors associated with behavioural intentions to implement FWR have not been systematically examined using representative medical staff. AIM: We explored predictive factors for behavioural intentions to implement FWR among medical staff using constructs from the theory of planned behaviour. METHODS: A survey of 1605 medical staff from five hospitals in southern Taiwan was conducted. Data were collected using a researcher-made questionnaire containing theory of planned behaviour constructs and demographic items. The dependent variable was intention to implement FWR, and the independent variables were three theory of planned behaviour constructs (attitudes, subjective norms, and perceived behavioural control) and the demographic characteristics. A generalized estimating equation was used to identify factors associated with the behavioural intentions. RESULTS: In total, 1122 valid questionnaires revealed that only 3.7% of participants advocated FWR policies. The construct scores for intention to implement FWR were 2.96 (on a five-point Likert scale), and the theory of planned behaviour constructs that significantly predicted intention to implement FWR were positive attitudes and subjective norms ( p<0.001). Classification of hospitals ( p=0.018) and restrictive provisions for FWR ( p=0.004) were additional significant predictors of intention to implement FWR. Moreover, medical staff employed at regional hospitals demonstrated higher intentions, positive attitudes and subjective norms than did those employed at the medical centre. CONCLUSION: According to the findings of this study, it may be desirable for administrators to prioritize the implementation of the FWR policy in regional hospitals. We recommend affording the factors of positive attitudes and subjective norms high priority to improve the medical staff's behavioural intentions of FWR practice.

Can nurse innovation improve customer perception of service quality and experience?

AIMS AND OBJECTIVES: This study aimed to clarify how nurse innovation is related to customer perception of medical service quality and experience. BACKGROUND: Recently, many hospitals have put much emphasis upon the development of nurse innovation. DESIGN: A cross-sectional study was employed. METHODS: This study adopted questionnaire survey method with nurses and customers of the inpatient wards from three Taiwanese hospitals as the research subjects. After pairing, there were 294 valid questionnaires. Hierarchical regression analysis was utilised to test the possible impact of nurse innovation on medical service quality and experience. RESULTS: In terms of the dimensions of nurse innovation, 'innovation behaviour' ranked the highest (3·24), followed by knowledge creation and innovation diffusion; in terms of the degree of the medical service quality, 'reliability' ranked the highest (4·35). As for the degree of the medical service experience, 'feel experience' ranked the highest (4·44). All dimensions of nurse innovation have no significant effects on medical service quality and experience. CONCLUSION: Of these three dimensions of nurse innovation, the level of innovation behaviour was perceived by the nurses as the highest. The study found that nurse innovation has no significant effects on customer perception of service quality and experience. RELEVANCE TO CLINICAL PRACTICE: Hospitals shall provide sufficient resources and budget for fostering innovation development and encourage their nurses to develop nursing innovation for patents. The education and training courses on 'patient-centred' shall be enhanced among hospital nurses. Healthcare managers shall also explore the difficulties about innovation diffusion and find the solutions for nurses.