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1.
Br J Nurs ; 29(1): 28-34, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31917951

RESUMEN

A study was conducted to explore whether fatigue, workload, burnout and the work environment can predict the perceptions of patient safety among critical care nurses in Oman. A cross-sectional predictive design was used. A sample of 270 critical care nurses from the two main hospitals in the country's capital participated, with a response rate of 90%. The negative correlation between fatigue and patient safety culture (r= -0.240) indicates that fatigue has a detrimental effect on nurses' perceptions of safety. There was also a significant relationship between work environment, emotional exhaustion, depersonalisation, personal accomplishment and organisational patient safety culture. Regression analysis showed that fatigue, work environment, emotional exhaustion, depersonalisation and personal accomplishment were predictors for overall patient safety among critical care nurses (R2=0.322, F=6.117, P<0.0001). Working to correct these predictors and identifying other factors that affect the patient safety culture are important for improving and upgrading the patient safety culture in Omani hospitals.


Asunto(s)
Actitud del Personal de Salud , Enfermería de Cuidados Críticos/organización & administración , Personal de Enfermería en Hospital/psicología , Cultura Organizacional , Seguridad del Paciente , Adulto , Agotamiento Profesional/epidemiología , Estudios Transversales , Fatiga/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Personal de Enfermería en Hospital/estadística & datos numéricos , Omán/epidemiología , Carga de Trabajo , Lugar de Trabajo , Adulto Joven
3.
J Nurs Adm ; 50(2): 78-84, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31977944

RESUMEN

OBJECTIVE: To examine factors that influence nurses' perceptions of organizational compassion and their engagement with the organization. BACKGROUND: Despite agreement about the importance of compassionate healthcare, it is difficult for employees to consistently act compassionately when organizational leaders, managers, and systems of care fail to support compassion as a value. METHODS: The study used a cross-sectional design, and quantitative and qualitative data were collected through an online survey of nurses. RESULTS: Higher individual compassion and team compassion were associated with higher perceived organizational compassion, and higher organizational compassion was associated with greater engagement with the hospital. In contrast, high turnover rates and inadequate staffing were associated with lower perceived organizational compassion and lower engagement with one's organization. CONCLUSIONS: Adequate staffing, resource allocation, and practices that contribute to the sense that one is a supported member of a caring team focused on addressing patients' needs build the capacity for compassion within an organization.


Asunto(s)
Actitud del Personal de Salud , Empatía , Personal de Enfermería en Hospital/organización & administración , Personal de Enfermería en Hospital/psicología , Cultura Organizacional , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos
4.
J Nurs Adm ; 50(2): 90-94, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31977946

RESUMEN

As the role of nursing grows in healthcare, the engagement of frontline nurses in evidence-based practice, quality improvement, and research is becoming the expectation and no longer the exception. Clinical nurses are in a unique position to inform and implement scholarly projects. The purpose of this staff development and capacity-building project was to increase the output of scholarly work among frontline nurses through the formalization of nursing inquiry support via designated nursing inquiry project coordinators.


Asunto(s)
Educación Continua en Enfermería/organización & administración , Rol de la Enfermera , Investigación en Enfermería/organización & administración , Personal de Enfermería en Hospital/educación , Personal de Enfermería en Hospital/psicología , Cultura Organizacional , Desarrollo de Personal/organización & administración , Adulto , Actitud del Personal de Salud , Femenino , Humanos , Masculino , Persona de Mediana Edad
5.
J Nurs Adm ; 50(2): 72-77, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31929345

RESUMEN

OBJECTIVE: To examine whether end-of-life care quality is superior in Magnet hospitals, a recognition designating nursing excellence. BACKGROUND: Considerable research shows better patient outcomes in hospitals with excellent nurse work environments, but end-of-life care quality has not been studied in Magnet hospitals. METHODS: An analysis of cross-sectional data was completed using surveys of nurses and hospitals. Multivariate logistic regression models were used to determine the association between Magnet hospitals and measures of end-of-life care quality. RESULTS: Overall, nurses report poor quality of end-of-life care in US hospitals. In Magnet hospitals, nurses were significantly less likely to give their hospital an unfavorable rating on end-of-life care. CONCLUSIONS: Hospital Magnet status may signal better quality in end-of-life care. Administrators looking to improve the quality of end-of-life care may consider improving aspects of nursing that distinguish Magnet hospitals.


Asunto(s)
Hospitales/estadística & datos numéricos , Personal de Enfermería en Hospital/psicología , Personal de Enfermería en Hospital/normas , Calidad de la Atención de Salud/estadística & datos numéricos , Calidad de la Atención de Salud/normas , Cuidado Terminal/psicología , Cuidado Terminal/normas , Adulto , Actitud del Personal de Salud , Estudios Transversales , Femenino , Encuestas de Atención de la Salud , Humanos , Satisfacción en el Trabajo , Masculino , Persona de Mediana Edad , Cultura Organizacional , Cuidado Terminal/estadística & datos numéricos , Estados Unidos
6.
Unfallchirurg ; 123(1): 22-28, 2020 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-31728555

RESUMEN

An error-resistant safety culture can only be achieved through proactive clinical risk management. In April 2019 the Federal Joint Committee once again increased the pressure on hospitals by means of the Quality Promotion and Enforcement Directive (QFD Directive) to take measures within the framework of clinical risk management in order to reduce the error and harm rate and therefore to significantly improve patient safety. In the long term this can only be achieved by positively influencing the safety culture and thus the attitudes and motives of all employees. Clinical risk management should focus on the prevention of so-called sentinel events on the one hand and on the reduction of frequent and avoidable complications on the other hand. This not only improves patient safety but also protects employees from negative consequences. Effective clinical risk management always follows a systemic approach, the 10 fields of action of which are discussed in this article. Large meta-analyses have also confirmed the substantial economic benefit of a clinical risk management.


Asunto(s)
Cultura Organizacional , Seguridad del Paciente , Gestión de Riesgos , Administración de la Seguridad , Humanos
7.
Accid Anal Prev ; 134: 105350, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31715549

RESUMEN

Previous studies have acknowledged the impact of risk perception on safety behavior, but were largely controversial. This study aims to clarify this conflict and the mechanism through which risk perception can have an impact on safety behavior. From the perspective of the dual attribute of the job demand concept in job demands-resources theory, we posit that risk perception can be considered as a job hindrance or a job challenge depending on the context, thereby resulting in a negative or positive impact on safety behavior, respectively. The current research context is the construction industry and the hypotheses were tested using hierarchically nested data collected from 311 workers in 35 workgroups. Risk perception was demonstrated to be a job hindrance exerting a negative impact on safety behavior and safety motivation mediated this effect. In addition, two dimensions of group-level safety climate--supervisor's and coworkers'--were expected to alleviate or even reverse the detrimental effects of hindrance risk perception on safety motivation and on safety behavior via motivation. A moderation model and a first-stage moderated mediation model were established, respectively, for testing the moderating roles of safety climate in the relationship between risk perception and safety motivation, and in the indirect relationship of risk perception with safety behavior via motivation. Surprisingly, contrary to the hypotheses, when supervisor's safety climate changed from a low level to a high level, the impact of risk perception on safety motivation changed from positive to negative, and the negative effect of risk perception on safety behavior via safety motivation was not alleviated but worsened. As expected, for workers in a positive coworkers' safety climate, the negative effect of risk perception on motivation and the indirect negative effect of risk perception on behavior were both reversed to the positive. This indicates that coworkers' safety climate helped to change perceived risk from a job hindrance to a challenge. This research contributes to workplace risk perception and safety behavior research by theoretically viewing risk perception as a dual job hindrance-challenge concept and proposing two competing hypotheses concerning the impact of risk perception on safety behavior. The empirical investigation confirmed the hindrance attribute of risk perception in the construction context. It provides a theoretical framework and empirical evidence for future research to synthesize the conflict risk perception-safety behavior relationship. We also contribute to the literature by pointing out the potential negative role of certain supervisor safety activities such as paternalistic leadership in influencing employee safety.


Asunto(s)
Cultura Organizacional , Administración de la Seguridad/organización & administración , Prevención de Accidentes/métodos , Adulto , Industria de la Construcción/organización & administración , Femenino , Humanos , Masculino , Motivación , Salud Laboral
8.
J Nurs Adm ; 50(1): 9-11, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31809451

RESUMEN

Despite Health Resources and Services Administration projecting a national excess of approximately 300 000 RNs as compared with demand by 2030, continued regional and local shortages have been confirmed. Pockets of chronic nurse shortages for various reasons, continued margin pressures, increased inpatient care complexity, continued RN turnover, and overall RN resilience are prompting chief nurse executives to investigate staffing model innovations. Next-generation staffing models include those that significantly embrace new teams and technology, as well as the philosophy of primary nursing care. Chief nurse executives must carefully analyze all models from the standpoint of organizational, cultural, and professional norms, as well their role in spearheading such efforts.


Asunto(s)
Modelos Organizacionales , Enfermeras Administradoras , Personal de Enfermería en Hospital/organización & administración , Admisión y Programación de Personal , Humanos , Cultura Organizacional
9.
Int J Radiat Oncol Biol Phys ; 106(1): 32-36, 2020 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-31647968

RESUMEN

PURPOSE: Radiation treatment planning (RTP) is a unique skill that requires interdisciplinary collaboration among radiation oncologists (ROs), dosimetrists, and medical physicists (MP) to train and assess residents. With the adoption of competency-based medical education (CBME) in Canada, it is essential residency program curricula focuses on developing competencies in RTP to facilitate entrustment. Our study investigates how radiation oncology team members' perspectives on RTP education align with requirements of the CBME approach, and its implications for improving residency training. METHODS AND MATERIALS: This qualitative research study took place in the Department of Oncology at a midsize academic institution. Through convenience sampling, focus groups were conducted with radiation oncologists (n = 11), dosimetrists (n = 7), medical physicists (n = 7), and residents (n = 7). Thematic design was adopted to analyze the transcripts through open coding resulting in 3 overarching themes. RESULTS: The results identified existing strengths and weaknesses of the residency program and future opportunities to redesign the curriculum and assessment process within a CBME model. Three overarching themes emerged from the analysis: (1) the strengths of RTP in the CBME environment; (2) challenges of RTP in CBME; and (3) opportunities for change. Stakeholders were optimistic CBME will help enrich resident learning with the increased frequency and quality of competency-based assessments. Participants suggested building a library of cases and developing computer-based learning resources to provide a safe environment to develop skills in contouring, dosimetry, and plan evaluation, in accordance with CBME training. CONCLUSIONS: This study identified future opportunities to redesign the RTP curriculum and assessment process within a CBME model. The need for innovative teaching and learning strategies, including case libraries, computer-based learning, and quality assessments, were highlighted in designing an innovative RTP planning curriculum.


Asunto(s)
Competencia Clínica , Educación Basada en Competencias , Internado y Residencia , Oncología por Radiación/educación , Planificación de la Radioterapia Asistida por Computador , Canadá , Competencia Clínica/normas , Educación Basada en Competencias/normas , Grupos Focales , Predicción , Humanos , Internado y Residencia/normas , Cultura Organizacional , Investigación Cualitativa , Oncólogos de Radiación , Oncología por Radiación/normas , Enseñanza/organización & administración , Carga de Trabajo
10.
Epidemiol Psychiatr Sci ; 29: e80, 2019 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-31839026

RESUMEN

AIMS: No instrument has been developed to explicitly assess the professional culture of mental health workers interacting with severely mentally ill people in publicly or privately run mental health care services. Because of theoretical and methodological concerns, we designed a self-administered questionnaire to assess the professional culture of mental health services workers. The study aims to validate this tool, named the Mental Health Professional Culture Inventory (MHPCI). The MHPCI adopts the notion of 'professional culture' as a hybrid construct between the individual and the organisational level that could be directly associated with the professional practices of mental health workers. METHODS: The MHPCI takes into consideration a multidimensional definition of professional culture and a discrete number of psychometrically derived dimensions related to meaningful professional behaviour. The questionnaire was created and developed by a conjoint Italian-Canadian research team with the purpose of obtaining a fully cross-cultural questionnaire and was pretested in a pilot study. Subsequently, a validation survey was conducted in northern Italy and in Canada (Montreal area, Quebec). Data analysis was conducted in different steps designed to maximise the cross-cultural adaptation of the questionnaire through a recursive procedure consisting of performing a principal component analysis (PCA) on the Italian sample (N = 221) and then testing the resulting factorial model on the Canadian sample (N = 237). Reliability was also assessed with a test-retest design. RESULTS: Four dimensions emerged in the PCA and were verified in the confirmatory factor analysis: family involvement, users' sexuality, therapeutic framework and management of aggression risk. All the scales displayed good internal consistency and reliability. CONCLUSIONS: This study suggests the MHPCI could be a valid and reliable instrument to measure the professional behaviour of mental health services workers. The content of the four scales is consistent with the literature on psychosocial rehabilitation, suggesting that the instrument could be used to evaluate staff behaviour regarding four crucial dimensions of mental health care.


Asunto(s)
Actitud del Personal de Salud/etnología , Competencia Cultural , Asistencia Sanitaria Culturalmente Competente , Personal de Salud/psicología , Servicios de Salud Mental/normas , Encuestas y Cuestionarios/normas , Adulto , Canadá , Comparación Transcultural , Humanos , Italia , Salud Mental , Persona de Mediana Edad , Cultura Organizacional , Psicometría , Reproducibilidad de los Resultados
12.
Medicine (Baltimore) ; 98(50): e18352, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31852137

RESUMEN

Improvement in patient safety culture requires constant attention. This study aimed to identify hospital-level elements related to patient safety culture, such as patient safety management systems, activities and work environments.Two questionnaire surveys were administered to hospitals in Japan in 2015 and 2016. The first survey aimed to determine which hospitals would allow their staff to respond to a questionnaire survey. The second survey aimed to measure the patient safety culture in those hospitals. Patient safety culture was assessed using the Hospital Survey on Patient Safety Culture (HSOPS). The relationship of hospital-level patient safety culture with the aforementioned elements in each hospital was analyzed.The response rate to the first survey was 22% (721/3270), and 40 eligible hospitals were selected from the respondents. The second survey was administered to healthcare workers in those 40 hospitals, and the response rate was 94% (3768/4000). The proportion of respondents who had 7 or more days off each month was related to the scores of 7 composites and the Patient Safety Grade of HSOPS. Both the presence of a mission statement describing patient safety and the proportion of respondents who participated in in-house patient safety workshops at least twice annually were related to the scores of 5 composites and the Patient Safety Grade of HSOPS.Our study suggests that the number of days off each month, the presence of a hospital patient safety mission statement, and the participation rate in in-house patient safety workshops might be key factors in creating a good patient safety culture within each hospital.


Asunto(s)
Cultura Organizacional , Seguridad del Paciente , Personal de Hospital/psicología , Administración de la Seguridad , Lugar de Trabajo/psicología , Adulto , Actitud del Personal de Salud , Estudios Transversales , Femenino , Encuestas de Atención de la Salud , Hospitales , Humanos , Japón , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
14.
Hosp Pract (1995) ; 47(5): 241-248, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31682467

RESUMEN

Objectives: One of the current concerns of hospitals is how to become a health promoting hospital (HPH). This qualitative research aimed at exploring the views of members of the medical staff in two Iran hospitals about the defined standards to transform the hospitals into a health promoting one.Methods: The research reported in this paper was a content analysis qualitative study. The license numbered (IR.UMSHA.REC.1395.388) was obtained from the ethics committee of Hamadan Medical Science University. Sampling was carried out through the snowballing method. Also, 55 interviews were conducted with the members of the medical staff. To collect data, the semi-structured interview guide was used based on the standards of HPHs. The framework analysis method was used to analyze the data qualitatively.Results: From three central questions on the basis of the main study question, nine themes were earned. Policies governing the hospitals were in the direction of converting them to health promoting organizations including the creation of a health promoting work environment, empowering personnel and health promoting corporate culture. Also, suggestions to create a HPH included improving management, paying attention to patients and their satisfaction, as well as increasing effective interpersonal relationships in the hospital.Conclusion: The findings showed that it can be a key strategy in this field to use staff's solutions for the existing problems and their opinions on the challenges against establishing the standards for HPHs. People usually accept more comfortable and easy changes in decision-making and implementing processes of which they are involved.


Asunto(s)
Actitud del Personal de Salud , Promoción de la Salud , Cuerpo Médico de Hospitales/psicología , Femenino , Humanos , Entrevistas como Asunto , Irán , Masculino , Cultura Organizacional , Investigación Cualitativa
16.
J Nurs Adm ; 49(11): 569-573, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31651618

RESUMEN

OBJECTIVE: This study aims to examine 1st-line managers' (FLMs') experiences in managing the workplace social environment (WSE). BACKGROUND: FLMs are responsible for the establishment and maintenance of supportive WSE essential for effective teamwork. Poorly managed WSE and dysfunctional teams hold negative implications for patients, teams, and organizations. METHODS: This was a qualitative descriptive study, using content analysis of individual and focus group interviews with FLMs and directors. RESULTS: FLMs play a critical role in the management of the WSE; however, the task is fraught with constraints and challenges including competing demands, lack of support, and insufficient training. Findings explicate how competing demands and communication challenges impede the successful management of the WSE. CONCLUSIONS: Given the importance of a healthy WSE to patient, professional, and organizational outcomes, FLMs need support, training, and resources to assist them in managing the social environment alongside other competing priorities.


Asunto(s)
Actitud del Personal de Salud , Liderazgo , Enfermeras Administradoras/psicología , Cultura Organizacional , Medio Social , Lugar de Trabajo/organización & administración , Lugar de Trabajo/psicología , Adulto , Femenino , Grupos Focales , Humanos , Masculino , Investigación Cualitativa
17.
Aust Vet J ; 97(11): 424-432, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31651999

RESUMEN

Extensive research in the business and organisational literature links teamwork to enhanced productivity and employee job satisfaction. Good teamwork capability is also a highly regarded graduate attribute linked to employability. This study explored desirable teamwork attributes for veterinary technology graduates in Australia, by surveying veterinarians, veterinary technology graduates, veterinary nurses, clients and academics. Respondents highlighted the importance of seven attributes sourced from the cross-disciplinary teamwork literature-'flexibility' (in approach to work), 'agreeableness', being 'cooperative', 'socially sensitive and perceptive', 'conscientiousness', being 'accepting of others' and 'sharing professional values'. The majority in each stakeholder group viewed all attributes important for teamwork concurring with findings in other fields. Few differences were found between and within groups with veterinarians and academics rating 'conscientiousness' higher than others and female clients placing more importance on relational attributes compared to male clients. Thematic analysis of an open-ended item asking the veterinary health care groups, and veterinary academics, to define teamwork generated nine themes centred on: collaboration, goals and outcomes, sharing values, relationships, diversity, communication, task-orientation, personal attributes, and workplace culture. This study illuminates an interprofessional perspective on veterinary teamwork. Results will be useful for veterinary technology, veterinary nursing and veterinary educators when developing a curriculum for interprofessional teamwork to enhance team performance, employability and, ultimately, the quality of veterinary services.


Asunto(s)
Técnicos de Animales/psicología , Conducta Cooperativa , Relaciones Interprofesionales , Cultura Organizacional , Veterinarios/psicología , Adulto , Anciano , Anciano de 80 o más Años , Australia , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Grupo de Atención al Paciente , Participación de los Interesados , Encuestas y Cuestionarios , Medicina Veterinaria , Adulto Joven
19.
J R Soc Med ; 112(10): 428-437, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31609172

RESUMEN

OBJECTIVES: To investigate doctors' intentions to raise a patient safety concern by applying the socio-psychological model 'Theory of Planned Behaviour'. DESIGN: Qualitative semi-structured focus groups and interviews. SETTING: Training venues across England (North West, South East and South West). PARTICIPANTS: Sampling was purposeful to include doctors from differing backgrounds and grades. MAIN OUTCOME MEASURES: Perceptions of raising a patient safety concern. RESULTS: While raising a concern was considered an appropriate professional behaviour, there were multiple barriers to raising a concern, which could be explained by the Theory of Planned Behaviour. Negative attitudes operated due to a fear of the consequences, such as becoming professionally isolated. Disapproval for raising a concern was encountered at an interpersonal and organisational level. Organisational constraints of workload and culture significantly undermined the raising of a concern. Responses about concerns were often side-lined or not taken seriously, leading to demotivation to report. This was reinforced by high-profile cases in the media and the negative treatment of whistle-blowers. While regulator guidance acted as an enabler to justify raising a concern, doctors felt disempowered to raise a concern about people in positions of greater power, and ceased to report concerns due to a perceived lack of action about concerns raised previously. CONCLUSIONS: Intentions to raise a concern were complex and highly contextual. The Theory of Planned Behaviour is a useful model to aid understanding of the factors which influence the decision to raise a concern. Results point to implications for policymakers, including the need to publicise positive stories of whistle-blowers and providing greater support to doctors.


Asunto(s)
Actitud del Personal de Salud , Toma de Decisiones , Intención , Errores Médicos , Seguridad del Paciente , Médicos , Gestión de Riesgos , Inglaterra , Miedo , Femenino , Grupos Focales , Humanos , Masculino , Cultura Organizacional , Profesionalismo , Teoría Psicológica , Investigación Cualitativa , Denuncia de Irregularidades , Carga de Trabajo
20.
Br J Nurs ; 28(16): 1099, 2019 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-31518536

RESUMEN

Sam Foster, Chief Nurse, Oxford University Hospitals, discusses 'compassionate leadership', an approach that aims to allow staff to provide the best care for patients by listening to and acting on staff concerns.


Asunto(s)
Liderazgo , Cultura Organizacional , Medicina Estatal/organización & administración , Inglaterra , Humanos
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