RESUMO
BACKGROUND: In recent years, an increasing number of care procedures previously under the physician's authority have been placed in the hands of registered nurses. The purpose of this study was to examine the attitudes of nurses towards expanding nurses' authority and the relationships between these attitudes and job satisfaction facets, professional characteristics, and demographics. METHOD: A cross-sectional study was conducted between 2010 and 2011 in three major medical centers in Israel. Participants included 833 nurses working in 89 departments. Attitudes toward the expansion of nurses' authority were assessed by self-report questionnaire, as well as job satisfaction facets including perception of professional autonomy, nurse-physician working relations, workload and burnout, perceptions of quality of care, and nursing staff satisfaction at work. RESULTS: Nurses reported positive attitudes toward the expansion of nurses' authority and moderate attitudes for interpretation of diagnostic tests in selected situations. The results of multivariate regression analyses demonstrate that the nurses' satisfaction from professional autonomy and work relations were the most influential factors in explaining their attitudes toward the expansion of nurses' authority. In addition, professionally young nurses tend to be more positive regarding changes in nurses' authority. CONCLUSIONS: In the Israeli reality of a nurse's shortage, we are witnessing professional transitions toward expansion of the scope of nurses' accountability and decision-making authority. The current research contributes to our understanding of attitudes toward the expansion of nurses' authority among the nursing staffs. The findings indicate the necessity of redefining the scope of nursing practice within the current professional context.
RESUMO
BACKGROUND: Online learning is growing rapidly worldwide, especially in the health related sectors such as medicine and nursing. Our trial wished to measure the objective (i.e. final exam results, courseware usage patterns) and subjective (satisfaction) efficiency of online vs. face-to-face learning in a prospective, controlled trial, a first of its kind in Israel. MATERIALS AND METHODS: The trial tested a blended online course, teaching introduction to clinical nephrology. The course was filmed and edited into a learning platform to fit computer based learning. 90 nursing students, from 4 bachelor's nursing programs in Israel participated in the study. The intervention group included 32 students who studied using the online course, accompanied by 3 frontal meetings dealing with technical and content issues. The reference group included 58 students from 3 nursing programs, studying in a traditional face-to-face course. RESULTS: The final exam results were significantly higher in the intervention group compared with the reference group (9.6 ± 2.57 vs. 8.4 ± 2.72; p<0.05). Student satisfaction was very high in the intervention group: 97% thought the course was well organized, 100% thought the teacher taught clearly and consistently, 90% thought the teacher encouraged self-thinking,100% thought the teacher used clarifying examples, 91% thought the teaching aids helped the learning process and 97% thought the teaching method contributed to the learning process. The average usage of the online course was 4:10h vs. 14 academic hours (10:30 h) in the traditional course. The daily usage habits of the courseware were also followed, indicating that most learning took place between 12 PM and 1 AM, peaking between 5 PM and 7 PM, and dipping between 3 AM and 10 AM. CONCLUSIONS: The online course had higher efficiency compared to the traditional face-to-face course. The subjective feedback of the intervention group proves high satisfaction with online learning.
