Evaluation of the Status of Organizational Culture among Hospital Staff in Iran: A Systematic Review and Meta-Analysis.

organizational culture in health care organizations to improve staff performance and quality of care. This study was conducted as a systematic review meta-analysis. The required data was searched in the databases and search engines between 2000 and 2019. CMA: 2 software was used to perform the meta-analysis. A total of 16 studies were selected for Meta-Analysis. The mean score of organizational culture of hospital staff evaluated by Denison tool was 3.063 and the mean score of organizational culture of hospital staff evaluated by Robbins tool was 2.527. It is essential for hospital managers to create a healthy and creative environment.

Clinical nonlicensed personnel in U.S. hospitals: Job trends from 2010 to 2015.

BACKGROUND: Despite the large numbers in health care industry, little is known about the clinical nonlicensed personnel (CNLP) in U.S. hospitals and how their staffing has changed over time. PURPOSE: The purpose of this analysis is to better understand the conformation and recent trends in CNLP staffing in U.S. hospitals from 2010 to 2015. METHODS: Using Premier's OperationsAdvisor database, we examined trends in staffing of 25 CNLP jobs and graduate nurses (GNs) in U.S. hospitals and by hospital units, including medical-surgical units, outpatient units, and emergency departments, from 2010 to 2015, based on their skill levels. We measured CNLP and graduate nurse staffing using the average number of full-time equivalents (FTEs) in each hospital. We performed statistical analysis to compare the changes in the number of FTEs between 2010 and 2015. DISCUSSION: Over the 6-year period from 2010 to 2015, we observed declining trends in the average number of high-skill and middle-skill CNLP FTEs by 22% and 7%, respectively, and increases in the average number of low-skill and graduate nurse FTEs by 38% and 117%, respectively. This skill mix shift appears to be most pronounced in emergency departments. CONCLUSION: Changes in staffing levels and the skill mix of the hospital workforce warrant further study to understand both the reasons behind the observed changes and their effects on health outcomes. Although labor efficiency is an important goal, it is also critically important to assess whether reductions and/or the skill mix shifts among support staff impact nurse workload and, by extension, patient safety.

Actigraph measures of sleep among female hospital employees working day or alternating day and night shifts.

Sleep disturbance is common among shift workers, and may be an important factor in the effect of shift work on chronic disease development. In this cross-sectional study, we described sleep patterns of 294 female hospital workers (142 alternating day-night shift workers, 152 day workers) and determined associations between shift work and sleep duration. Rest-activity cycles were recorded with the ActiGraph GT3X+ for 1 week. Analyses were stratified by chronotype of shift workers. Using all study days to calculate average sleep duration, shift workers slept approximately 13 min less than day workers during main sleep periods, while 24-h sleep duration did not differ between day workers and shift workers. Results from age-adjusted models demonstrated that all shift workers, regardless of chronotype, slept 20-30 min less than day workers on day shifts during main and total sleep. Early and intermediate chronotypes working night shifts slept between 114 and 125 min less than day workers, both with regard to the main sleep episode and 24-h sleep duration, while the difference was less pronounced among late chronotypes. When sleep duration on free days was compared between shift workers and day workers, only shift workers with late chronotypes slept less, by approximately 50 min, than day workers during main sleep. Results from this study demonstrate how an alternating day-night shift work schedule impacts sleep negatively among female hospital workers, and the importance of considering chronotype in sleep research among shift workers.

Short Text Messages (SMS) as an Additional Tool for Notifying Medical Staff in Case of a Hospital Mass Casualty Incident.

OBJECTIVE: The aim of the study was to verify the effectiveness of short text messages (short message service, or SMS) as an additional notification tool in case of fire or a mass casualty incident in a hospital. METHODS: A total of 2242 SMS text messages were sent to 59 hospital workers divided into 3 groups (n=21, n=19, n=19). Messages were sent from a Samsung GT-S8500 Wave cell phone and Orange Poland was chosen as the telecommunication provider. During a 3-month trial period, messages were sent between 3:35 PM and midnight with no regular pattern. Employees were asked to respond by telling how much time it would take them to reach the hospital in case of a mass casualty incident. RESULTS: The mean reaction time (SMS reply) was 36.41 minutes. The mean declared time of arrival to the hospital was 100.5 minutes. After excluding 10% of extreme values for declared arrival time, the mean arrival time was estimated as 38.35 minutes. CONCLUSIONS: Short text messages (SMS) can be considered an additional tool for notifying medical staff in case of a mass casualty incident.

Improving unit performance with a staff-driven peer review process.

PURPOSE: A staff-driven peer review process was developed and implemented to determine if it would improve the perception of the quality of nursing care delivered and unit performance. CONCLUSIONS: Perceived quality of care, as measured on the National Database of Nursing Quality Indicators Survey, improved by the second year after all nurses had completed the process. The unit performance improvement indicators showed improvement in the first year after implementation, with further improvements noted the second year. PRACTICE IMPLICATION: This project demonstrated that staff nurses could and would autonomously improve practice and unit performance based on unit data.

False alarms give hospital staff practice in managing Ebola care.

Most London hospitals have dealt with at least one patent with suspected Ebola virus in the past month, a leading infection control nurse has claimed.

RCN announces innovative plan to tackle discrimination against staff.

Black and minority ethnic (BME) nurses have been trained to sit on staff disciplinary panels at three NHS trusts in Birmingham to challenge discrimination, as part of a groundbreaking RCN project.

Organizational interventions in response to duty hour reforms.

BACKGROUND: Changes in resident duty hours in Europe and North America have had a major impact on the internal organizational dynamics of health care organizations. This paper examines, and assesses the impact of, organizational interventions that were a direct response to these duty hour reforms. METHODS: The academic literature was searched through the SCOPUS database using the search terms "resident duty hours" and "European Working Time Directive," together with terms related to organizational factors. The search was limited to English-language literature published between January 2003 and January 2012. Studies were included if they reported an organizational intervention and measured an organizational outcome. RESULTS: Twenty-five articles were included from the United States (n=18), the United Kingdom (n=5), Hong Kong (n=1), and Australia (n=1). They all described single-site projects; the majority used post-intervention surveys (n=15) and audit techniques (n=4). The studies assessed organizational measures, including relationships among staff, work satisfaction, continuity of care, workflow, compliance, workload, and cost. Interventions included using new technologies to improve handovers and communications, changing staff mixes, and introducing new shift structures, all of which had varying effects on the organizational measures listed previously. CONCLUSIONS: Little research has assessed the organizational impact of duty hour reforms; however, the literature reviewed demonstrates that many organizations are using new technologies, new personnel, and revised and innovative shift structures to compensate for reduced resident coverage and to decrease the risk of limited continuity of care. Future research in this area should focus on both micro (e.g., use of technology, shift changes, staff mix) and macro (e.g., culture, leadership support) organizational aspects to aid in our understanding of how best to respond to these duty hour reforms.

[Temporal evolution of tobacco consumption among health care workers in a Catalonian hospital, Spain]. / Evolución del consumo de tabaco en trabajadores de un hospital de Cataluña.

BACKGROUND: In terms of tobacco consumption, health workers have been considered as reference group, however smoking prevalence in this group is higher than in general population. This study aimed to estimate the prevalence of tobacco consumption among workers of a health institution in Catalonia during a period of 10 years (2001-2011), and to describe their characteristics. METHODS: The questionnaire on tobacco consumption prevalence was validated, and was administered in 2001, 2004, 2008 and 2011. A random sampling was carried out in two acute care institutions. The characteristics of the study sample and the differences between smokers were analyzed using the chi-square test for linear trend. A logistic regression model was performed including all the surveys. RESULTS: The smoking prevalence among health care workers for 2001, 2004, 2008 and 2011, was 30.00%, 34.42%, 36.21% and 29.42%, respectively. Women had the highest consumption prevalence (33,40%). Tobacco smoking decreased in medical staff, from 25.97% in 2001, to 18.88% in 2011 (p=0.005), and in nurses from 35,15% in 2001 to 25.61% in 2011 (p=0.007), but not among the administrative staff. CONCLUSION: Overall and for the first time, smoking prevalence in health workers begins to decrease. However, it does not decrease in the same way among all types of healthcare workers and the prevalence remains high when compared with the population prevalence. This consumption reduction coincides with the measures introduced by the program after the legislative changes.

Industrial relations conflict in Irish hospitals: a review of Labour Court cases.

PURPOSE: The purpose of this paper is to explore the nature of industrial relations (IR), and IR conflict in the Irish healthcare sector. DESIGN/METHODOLOGY/APPROACH: The paper is based on a thematic analysis of Labour Court cases concerning hospitals over a ten-year period. FINDINGS: The findings of the paper indicate that the nature of IR conflict is changing in healthcare. The paper suggests that alternative manifestations of IR conflict evident in the Irish healthcare sector include: absenteeism as a form of temporary exit; and resistance. The key groups in the sector are discussed in the context of their contrasting disputes. The themes which characterise negotiations are identified as precedent, procedure and partnership. RESEARCH LIMITATIONS/IMPLICATIONS: The research was conducted in the healthcare sector, and thus its transferability is limited. Caution is also required as the research pertains to one national setting, which despite sharing some structural similarities with other health and IR systems, is a unique context. The paper highlights the importance of recognising IR conflict in its various forms. It is further suggested that managing the process of IR conflict may be significant in furthering change agendas. ORIGINALITY/VALUE: The value of the paper centres on the investigation of alternative manifestations of IR conflict in the healthcare sector.

Securing your hospital in a family and friends environment.

How does the healthcare security professional protect patients, staff and visitors from harm in the face of a Family and Friends philosophy espoused by many hospitals, a philosophy marked by less restrictive visiting hours, free movement throughout the facility, extended dining hours in the cafeterias and a general feeling of openness? How are security professionals expected to deal with an increase in threats of violence in such a restriction-free environment? In this article the author proposes a number of ways to secure a facility under such challenging circumstances.

Do smoke-free environment policies reduce smoking on hospital grounds? Evaluation of a smoke-free health service policy at two Sydney hospitals.

OBJECTIVE: To evaluate the compliance of hospital staff, inpatients and visitors with Sydney South West Area Health Service's Smoke-free Environment Policy. METHODS: Six sites were observed at two Sydney hospitals 2 weeks before implementation of the policy and at 2 weeks, 6 months, 12 months, 18 months and 2 years after implementation. RESULTS: There was an overall significant 36% (P≤0.05) reduction in observed smoking incidents on hospital grounds 2 years after implementation. Two years after implementation, observed smoking incidents reduced by 44% (P≤0.05) in staff, 37% (P≤0.05) in visitors and remained unchanged among inpatients. CONCLUSIONS AND IMPLICATIONS: The Smoke-free Environment Policy was effective in reducing visitors and staff observed smoking on hospital grounds, but had little effect on inpatients' smoking. Identifying strategies to effectively manage nicotine addiction and promote cessation amongst hospital inpatients remains a key priority.

Access.

Reform will boost health care coverage by adding 30 million previously uninsured people to the insurance rolls. At first glance, that would seem like a boon for hospitals, but the consequences won't be nearly as cut and dried as you might expect.