Ten steps to transform ideas into product innovations: An interdisciplinary collaboration between nursing and engineering.

AIMS: To describe the development process of a device from the conception of the idea to the first contact with the commercial environment, and to demonstrate its practical application through an interdisciplinary collaboration between nursing and engineering for the design of a protective device for peripheral venous catheters. BACKGROUND: Nurses are key agents for identifying unresolved needs or problems related to nursing care. To address these needs, creative ideation processes are often triggered among nurses to seek technological answers to these challenges. RESULTS: The ten steps to develop a device are presented: (1) detecting an unsatisfied clinical need; (2) searching for preexisting marketed products; (3) searching for patents; (4) maintaining confidentiality throughout the process; (5) obtaining institutional support; (6) forming a multidisciplinary team; (7) developing the idea; (8) applying for a patent; (9) building the prototype; (10) marketing the device. This methodology was applied to design a protective device for peripheral venous catheters in hospitalized patients. CONCLUSIONS: Nurses can play a key role in the promotion of healthcare innovation in their field to improve procedures, thanks to their direct contact with patients, and by providing their insight on devices that can enhance patient care. The successful interdisciplinary collaboration between nurses and engineers can provide a response to relevant clinical problems such as the manipulation or removal of peripheral venous catheters. IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: A hospital policy is required to encourage the participation of nurses in innovative actions. Furthermore, it is important to support nurse leaders who can play a pivotal role in incorporating creativity into work environments and empowering other nurses to innovatively address clinical issues. NO PATIENT OR PUBLIC CONTRIBUTION: This article describes the process for developing a health device.

Effects of workplace incivility and workload on nurses' work attitude: The mediating effect of burnout.

AIM: The study's aim was to examine how workplace incivility and workload influence nurses' work attitudes (turnover intention, job satisfaction, and organizational commitment) using the stress-strain-outcome framework. BACKGROUND: There is a lack of comprehensive research on the combined effects of workplace incivility and workload on nurses' work attitudes. INTRODUCTION: Two workplace stressors, incivility and workload, were hypothesized to lead to burnout, which in turn influences nurses' work attitudes. METHODS: A cross-sectional, descriptive correlational study was conducted. Survey data were collected from 1,255 direct care nurses with a minimum of 6 months' nursing experiences in 34 general hospitals across Korea. Structural equation modeling was used to test the hypothesized model. This study is reported using the STROBE checklist. RESULTS: As hypothesized, both workplace incivility and workload increased burnout. Heightened burnout correlated with increased turnover intention, lowered job satisfaction, and reduced organizational commitment. While workplace incivility impacted these outcomes both directly and indirectly via its effect on burnout, workload influenced the outcomes solely through burnout. CONCLUSION: The study's findings are based on one, nonrandomized sample of nurses working at South Korean hospitals. Despite such study limitations, the study findings support the adverse impact of two workplace stressors on burnout and nurses' work attitudes. IMPLICATIONS FOR NURSING: Evidence-informed interventions for both workplace stressors include training programs, clear policy guidelines, open communication channels, and supportive work environments. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Zero tolerance and equity, diversity and inclusivity policies to promote workplace civility must be enforced. Workload needs to be patient-centered, ensuring a "fit" between patient needs and nurse staffing.

Health Service Managers' Digital Competencies: A Conceptual Framework.

Health service managers play a crucial role in managing and leading in the digital health environment. Development of the health management workforce that is ready to lead and manage digital health transformation requires partnerships across sectors, in not only developing workforce competence but also in developing supportive mechanisms that can translate competencies into practice. A framework presenting a systematic approach in enabling the development of a competent health management workforce in the digital health era has recently been published. The purpose of this paper is to explore and discuss the application of the framework in the Australian context, informed by the findings of a PhD research project that uses an empirically validated four-step approach to confirm the health service management workforce development needs in the digital health context. The PhD project has already confirmed: 1) the paucity of Australian Health Informatics Competency Framework (AHICF) competencies being included in Australian health service management postgraduate program curricula; 2) five key strategies that contribute to developing health management workforce competency and capacity; and 3) seven key factors that enable health management workforce development in the digital health context. Further understanding of the barriers and enablers for health service managers to develop capability and manage in the digital health environment, and the factors that influence digital health policy and practice will be developed, by critically analysing findings from focus group discussions with health managers and semi-structured interviews with digital health leaders, to be completed by May 2023.

Child health nurses in Solomon Islands, piloting the 'Bachelor of nursing: Child health'.

AIM: In 2016, the Solomon Islands National University developed and implemented the country's first nursing specialisation in child health, the Bachelor of Nursing: Child Health. This qualitative study aimed to explore the experiences of the first cohort of students (n = 14) during this course in order to evaluate the programme. BACKGROUND: The Bachelor of Nursing: Child Health was implemented in 2016 to develop nurses' knowledge and skills in child health and improve child health outcomes and so on. DESIGN: The qualitative evaluation study used an exploratory, descriptive design. METHODS: The 14 nurses who constituted the first cohort of students were selected as study participants. Individual semi-structured interviews were conducted between August and December 2018. Thematic analysis was undertaken following the Braun and Clarke six-phase process to generate themes and sub-themes from the data. The Consolidated Criteria for Reporting Qualitative Research checklist guided the reporting of the study. RESULTS: Interviews revealed important feedback about the course, including areas to strengthen and avenues to improve it in the future. Four themes emerged: learning during the Bachelor of Nursing: Child Health, support during the course, challenges experienced during the course and suggested course improvements in the future. The study found that theoretical sessions combined with practical and interactive activities were most effective in learning both theoretical concepts and their related clinical applications and skills. Although support was generally available during the course, participants emphasised their responsibility to take the lead in their learning and seek support when required. The lack of mentoring combined with logistical difficulties were perceived as barriers to learning. Participant recommendations support further development of the child health nursing specialisation, with specific strengthening in areas such as teaching and mentoring, logistics, course curriculum and human and material resources. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Given the potential benefits of increasing nurses' knowledge and skills in child health and paediatric care on reducing neonatal and child mortality and morbidity, ongoing support for the implementation of this course in Solomon Islands and more broadly across the Pacific region is recommended. The provision of such support is a local, regional and a global responsibility. Indeed, Sustainable Development Goal 3c calls for a substantial increase in health financing and in the recruitment, development, training and retention of the health workforce in low- and middle-income countries. CONCLUSIONS: Results of the evaluation demonstrate the positive aspects of the course in relation to content and curriculum delivery strategies as well as identifying areas where further refinement and strengthening is required.

A pioneer in the management of Australian psychiatric services: Dr Richard Greenup (1803-1866).

OBJECTIVES: To provide a brief biography of Dr Richard Greenup and to explore the legacy he has left to one of Australia's longest operating psychiatric services. METHODS: This history was obtained by consulting staff working within Cumberland Hospital, New South Wales and by examining primary and secondary sources. RESULTS: Greenup was the second surgeon superintendent of 'The Parramatta Lunatic Asylum' from 1852 until 1866 when he was fatally stabbed with a pair of scissors by a patient. Greenup was involved in establishing The University of Sydney and advocated for expanded and improved services for people diagnosed with mental disorders. CONCLUSIONS: Greenup recognised the needs of the mentally ill and sought to address similar social and demographic determinants of health to those that we face today. The challenges he faced, and his tragic end remind us of the importance of delivering patient-centred care whilst being mindful of associated risks.

Child health nursing in the Solomon Islands: A qualitative evaluation of the impact of the 'Bachelor of nursing - Child health'.

AIM: To explore graduates' perceptions of the impact on nursing practice of a new postgraduate course in child health, developed and implemented in the Solomon Islands in 2016. BACKGROUND: The Bachelor of Nursing - Child Health was implemented in 2016 to develop nurses' knowledge and skills in child health and paediatric care with the intent to improve national child health outcomes. DESIGN: A qualitative exploratory, descriptive design was used to evaluate the impact of the Bachelor of Nursing - Child Health on graduates' nursing practice. METHODS: Fourteen nurses who graduated from the first cohort of students enrolled in the child health course were purposively selected to participate. Participants engaged in individual semi-structured interviews, conducted between August and December 2018. A thematic analysis was undertaken following Braun and Clarke's six-phase process. RESULTS: Findings from the study demonstrate positive impacts of the course on graduates' nursing practice. These include a perceived enhanced quality of care through their commitment to evidence-based practice, the ability to contribute to capacity building of colleagues, the reinforcement of provincial public health programmes and expanded participation in managerial activities. Following graduation, most alumni took on senior roles and greater responsibilities, felt more confident in managing unwell children, felt there was better access to and quality of child health care at the community and broader country levels and felt recognised by colleagues and communities. Some graduates faced resistance from colleagues to change practice and felt that despite being given greater responsibilities, nursing levels and salaries remained unchanged. This reflected a potential lack of recognition from hospital or provincial managers, the Nursing Council as the regulatory body for the nursing profession, and the Ministry of Health and Medical Services. A lack of human and material resources also impacted quality of care. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Findings from this study underline the need for the Solomon Islands National University, the Nursing Council, the Public Service and the Ministry of Health and Medical Services to concord and delineate formal accreditation standards for child health nurses. Overall, collaborative efforts and commitments at local, regional and global levels are required to support child health nurses in their ability and ambition to improve national child health outcomes. CONCLUSIONS: Findings from this study demonstrate positive impacts of the course on graduates' nursing practice. The impact of increasing nurses' knowledge and skills on national child health outcomes could be significant. Ongoing implementation and recognition of this course in the Solomon Islands, as well as more broadly across the Pacific region, are recommended.

Migration of nurses and doctors: pull factors to work in Saudi Arabia.

BACKGROUND: Although Saudi Arabia is a common destination to which nurses and doctors migrate, few studies have explored the pull factors attracting them to work in the Middle East and Saudi Arabia. This qualitative study explores the pull factors drawing nurses and doctors to work in Saudi Arabian hospitals. METHODS: The study utilized a qualitative approach with focus groups. The participants included 83 doctors and nurses at two government hospitals. RESULTS: Five themes (rewards, job entry requirements, religion, influence of family and friends, and changing work environments) were identified based on the 10 focus group sessions. CONCLUSION: Moving forward, health managers should proactively plan the state of healthcare as the need for migrant healthcare workers changes.

Analysis of the effect of patients' health status on efficiency: Application of data envelopment analysis in healthcare.

The effective and efficient operation of public healthcare systems is more and more important as a consequence of the increasing amount of money spent on their operation. For this reason, accurate and science-based efficiency information is needed for managers and healthcare policy makers. The evaluation of the efficiency in this sector is particularly difficult because several measures and indicators are used. Data envelopment analysis (DEA) can provide aggregate and overall measures of efficiency. The purpose of this paper is the examination of the efficiency of in-patient rehabilitation units curing musculoskeletal disorders in Hungary. The research presented focuses on rehabilitation units which attend to patients recovering from stroke or other acquired brain injuries. Output-oriented, slack-based DEA models are applied for the evaluation of in-patient rehabilitation units using data of a national survey. The novelty of the method presented is the consideration of the change in patients' functional status when efficiency is evaluated using DEA.

Leadership During a Pandemic: A Lexical Analysis.

To manage pandemics, like COVID-19, leadership can enable health services to weather the storm. Yet there is limited clarity on how leadership manifested and was discussed in the literature during COVID-19. This can have considerable public health implications given the importance of leadership in the health sector. This article addresses this missed opportunity by examining the literature on leadership during a pandemic. Following a systematic search of nine academic databases in May 2021, 1,747 publications were screened. Following this, a lexical analysis of the results section was conducted, sourced from a corpus of publications across myriad journals. The results found a prevalence of references to "leader" as a sole actor, risking the perpetuation of a view that critical decisions emanate from a singular source. Moreover, "leadership" was a concept disconnected from the fray of frontline workers, patients, and teams. This suggests a strong need for more diverse vocabularies and conceptions that reflect the "messiness" of leadership as it takes shape in relation to the challenges and uncertainties of COVID-19. There is a considerable opportunity to advance scholarship on leadership via further empirical studies that help to clarify different approaches to lead teams and organizations during a pandemic.

Preoperative anxiety after face-to-face patient assessment versus preanaesthesia telemedicine (PANTEM) in adults: a randomised clinical trial.

Preanaesthesia consultation is performed to assess and optimise patient-specific risk factors before surgery, to inform patients about anaesthesia techniques and to obtain consent. Aside from face-to-face visits, telephone consultation is increasingly being used clinically. Concentration on the content and avoidance of confounding factors could lead to improved patient preparation. We hypothesised that patients receiving a telemedical intervention have less anxiety. Patients scheduled for elective surgery were randomised into two groups according to the consultation performed face-to-face (FTF) or via telephone (TEL). Before consultation (< 48 h) and 1-2 h prior to surgery, both groups had to fill in the State-Trait Anxiety Inventory (STAI). A total of 271 patients were randomised and 130 were analysed. There were no significant intergroup differences in mean state anxiety (STAI-S) before and after the intervention. Patients' positive feedback on telemedical consultation urges future studies on its effect on satisfaction and quality of life.

Home and expatriate nurses' perceptions of job satisfaction: Qualitative findings.

AIM: This paper is part of a larger doctoral study that investigated the impact of nationality on the job satisfaction of nurses and their intentions to leave Saudi Arabian government hospitals. The paper aims to gain an understanding of the impact of expatriate status on nurses' perceptions, by comparing the factors that influence job satisfaction among Saudi nurses to those that affect nurses recruited from other countries. BACKGROUND: Job satisfaction is a known predictor of nurse retention. Although there is a broad understanding of the factors that affect job satisfaction, little is known about how these vary between home and expatriate nurses working in countries which rely on a multicultural migrant workforce. METHODS: A descriptive qualitative approach was taken, in which 26 semi-structured interviews were conducted with nurses selected from different nationalities, all of whom were working in Saudi Arabian hospitals. Eight participants were Saudi Arabian, six Filipino, four Indian, four South African, two Jordanian and two Malaysian. FINDINGS: Five themes were identified that differentiated the perceptions of expatriates regarding their job satisfaction from those of the home nurses: separation from family, language and communication, fairness of remuneration, moving into the future and professionalism. CONCLUSION: Focusing on the enhancement of job satisfaction experienced by expatriate nurses can result in a healthier work environment and greater retention of these nurses. IMPLICATIONS FOR NURSING AND NURSING POLICY: To enhance nurse retention, policy makers in countries with migrant nurses should address their socio-economic needs. This includes providing both greater access to their dependent family members, and language lessons and cultural orientation to reduce linguistic and cultural challenges.

Characteristics and implications of curriculum for PHD students of health service management in the world / 中华医学教育探索杂志

Five universities with health policy and management ranked top level worldwide, including Harvard University, John Hopkins University, Stanford University, University of North Carolina at Chapel Hill and National University of Singapore were selected in our study. From above universities, we found that the curriculum of PHD students was focused on research concentration, methodology courses, and numerous elective courses. Hence, in China, the curriculum of PHD students should be improved with emphasis on course studying, management courses and highlighting curriculum content according to research area to enhance the quality of doctoral education.

Avaliação do impacto da pandemia do Covid-19 na saúde bucal para usuários do SUS / Evaluation of the impact of the COVID-19 Pandemic on oral health for SUS users

As condições da saúde bucal podem afetar a alimentação, a interação social, o desempenho intelectual, a comunicação, alterações psicológicas, enfim trazem grandes alterações na qualidade de vida do indivíduo. Ao avaliar as experiências subjetivas relacionadas com o impacto dessas com as condições de saúde bucal é possível recolher informações que podem auxiliar na melhoria do indivíduo. Assim, o objetivo desse trabalho foi investigar o impacto da Pandemia do Covid-19 e qual foi o seu impacto nessas condições, o OHIP-14 foi o questionário utilizado em conjunto com as variáveis sociodemográficas e socioeconômicas. O questionário foi aplicado a população que utilizou o serviço público de Odontologia na cidade de São José dos Campos/SP durante o período de pandemia do Covid-19. O serviço eletivo de atendimento odontológico foi diretamente afetado pelas restrições de atendimento decorrente do risco de contágio e da grande exposição do profissional de Odontologia ao vírus, SARS-Cov2, com isso o serviço de assistência odontológica sofreu grandes interrupções e limitações. O impacto da pandemia Covid-19 na pesquisa foi interpretado na análise das respostas do OHIP14 nas variáveis: Prevalência, a qual mede a porcentagem de indivíduos que relataram pelo menos uma resposta de grande impacto, "repetidamente" ou "sempre"; Extensão, que considera a média no número de respostas de maior impacto do mesmo indivíduo; e por último a Gravidade, que é a soma numérica da pontuação das respostas. Após a análise desses dados, os valores relevantes encontrados foram de 67,30% para Prevalência geral da amostra e 19,40 para Gravidade, maior ainda quando avaliado somente o público feminino (prevalência 67,30% e Gravidade 21,24). Quando observamos os dados da grandeza que reflete o Impacto Psicológico causado, temos um alto valor de Prevalência de 58,33% e gravidade 12,18, comparado a 37,5% para Dor/Desconforto e de 14,58 para limitação funcional. Atenção também para o impacto causado pela pandemia do Covid-19 na qualidade de vida dos indivíduos estudados, valores altos para Gravidade (12,18) no que tange somente o impacto psicológico. Ainda nesse contexto de um modelo biopsicossocial serão necessários estudos constantes para melhor elucidar seu impacto e para apontar algum aprendizado para futuros surtos globais, além da avaliação qualitativa dos serviços públicos prestados. Não podemos deixar de salientar a relevância dos questionários e estudos qualitativos que, junto aos quantitativos, colaboram na formação de políticas públicas de saúde, por meio de índices obtidos nesses estudos que oferecem ferramentas importantes para gestores no desenvolvimento de melhores serviços à população. (AU)

Oral health conditions can affect food, social interaction, intellectual performance, communication, psychological changes, in short, they bring great changes in the individual's quality of life. By evaluating subjective experiences related to their impact on oral health conditions, it is possible to collect information that can help improve the individual. Thus, the objective of this work was to investigate the impact of the Covid19 Pandemic and what was its impact under these conditions, the OHIP-14 was the questionnaire used in conjunction with the sociodemographic and socioeconomic variables. The questionnaire was applied to the population that used the public dental service in the city of São José dos Campos/SP during the Covid-19 pandemic period. The elective dental care service was directly affected by the service restrictions resulting from the risk of contagion and the great exposure of the dental professional to the virus, SARS-Cov2, with this the dental care service suffered major interruptions and limitations. The impact of the Covid-19 pandemic on the survey was interpreted in the analysis of OHIP14 responses in the variables: Prevalence, which measures the percentage of individuals who reported at least one high-impact response, "repeatedly" or "always"; Extension, which considers the average of the number of responses with the greatest impact from the same individual; and finally the Severity, which is the numerical sum of the response scores. After analyzing these data, the relevant values found were 67.30% for the overall prevalence of the sample and 19.40 for Severity, even higher when evaluating only the female audience (67.30% prevalence and 21.24 severity). When we look at the data of the magnitude that reflects the Psychological Impact caused, we have a high Prevalence value of 58.33% and severity of 12.18, compared to 37.5% for Pain/Discomfort and 14.58 for functional limitation. Attention should also be paid to the impact caused by the Covid-19 pandemic on the quality of life of the individuals studied, high values for Severity (12.18) regarding only the psychological impact. Still in this context of a biopsychosocial model, constant studies will be needed to better elucidate its impact and to point out some learning for future global outbreaks, in addition to the qualitative evaluation of the public services provided. We cannot fail to emphasize the relevance of questionnaires and qualitative studies that, together with quantitative ones, collaborate in the formation of public health policies, through indices obtained in these studies that offer important tools for managers in the development of better services to the population. (AU)

Factors supporting career pathway development amongst advanced practice nurses in Thailand: A cross-sectional survey.

BACKGROUND: Thailand has recently reformed its health care system and this change has contributed to the rapidly increasing need for skilled and experienced specialist nurses and in 2003 a new Advanced Practice Nursing role was formally introduced. While Advanced Practice Nursing is now accepted as a clinical career option, there is little understanding of the factors conducive to successful career development. This study offers the first examination of factors associated with successful career progression for Advanced Practice Nurses in Thailand. OBJECTIVES: 1. To provide a description of the Advanced Practice Nurse population in Thailand, as represented by a purposive stratified national sample. 2. To examine the factors influencing successful career pathway development of Advanced Practice Nurses in Thailand. 3. To examine the factors which influence the extent to which Advanced Practice Nurses in Thailand engage in evidence-based practice and research. DESIGN: National cross-sectional survey. SETTING: Thailand. PARTICIPANTS: 333 currently practicing Advanced Practice Nurses. METHODS: A national cross-sectional survey was conducted in Thailand in order to identify and examine key influencing factors on the successful development of Advanced Practice Nurses. The research tool was a specifically designed questionnaire in the Thai language, informed by international academic literature on the development of the Advanced Practice Nurse role, validated and piloted with 30 Advanced Practice Nurses to assess its reliability using Cronbach's alpha. The data were analysed in SPSS (version 21). Initial parametric testing was done using the Kolmogorov-Smirnov test and Pearson's correlation analysis was performed to examine the relationship between the independent variables (those measuring demographic and support factors) and the dependent variables (measuring career pathway development). RESULTS: A response rate of 90% was achieved. A lack of clear progression routes in the Advanced Practice Nurse structure was identified along with inconsistent patterns of working including variation in the number of days per week (range: 1-5 days) that nurses dedicated to the Advanced Practice Nurse role and the amount of autonomy achieved in this role. The study highlighted a lack of research productivity in and production of outputs (59% had never published) and given the expectation of Advanced Practice Nurses to both produce and utilise research evidence, this constitutes a significant gap in current practice. Other factors reported as important for career pathway development of Advanced Practice Nurses related to the environment, peer networks, institutional (hospitals) and external (government and the Thai Nursing Council) support. CONCLUSIONS: Our study offers insights for national and local policymakers and highlights the need to firmly establish, standardised career pathways in Advanced Practice Nursing to support career progression and the implementation of evidence into practice. These findings also have implications for clinical departments which have a responsibility to ensure they provide an enabling environment for Advanced Practice Nurses to fully carry out their roles. Tweetable abstract: Our study reports findings from a first national survey in Thailand investigating the factors which support career development in Advanced Practice Nurses.

A Call for Leadership and Management Competency Development for Directors of Medical Services-Evidence from the Chinese Public Hospital System.

Background: A competent medical leadership and management workforce is key to the effectiveness and efficiency of health service provision and to leading and managing the health system reform agenda in China. However, the traditional recruitment and promotion approach of relying on clinical performance and seniority provides limited incentive for competency development and improvement. Methods: A three-component survey including the use of a validated management competency assessment tool was conducted with Directors of Medical Services (n = 143) and Deputy Directors of Medical Services (n = 152) from three categories of hospital in Jinan, Shandong Province, China. Results: The survey identified the inadequacy of formal and informal management training received by hospital medical leaders before commencing their management positions and confirms that the low self-perceived competency level across two medical management level and three hospitals was beyond acceptable. The study also indicates that the informal and formal education provided to Chinese medical leaders have not been effective in developing the required management competencies. Conclusions: The study suggests two system level approaches (health and higher education systems) and one organization level approach to formulate overall medical leadership and management workforce development strategies to encourages continuous management competency development and self-improvement among clinical leaders in China.

The association between nationality and nurse job satisfaction in Saudi Arabian hospitals.

BACKGROUND: Job satisfaction is important for increasing nurse retention rates. However, there is little research examining whether there is an association between nationality and job satisfaction among nurses. AIM: To examine whether there is an association between nationality and nurse job satisfaction. METHODS/DESIGN: A cross-sectional survey design was utilized, and 743 nurses from three major government hospitals in Saudi Arabia participated in the survey. Job satisfaction was measured using McCloskey/Mueller Satisfaction Scale. Data were collected between May 2014 and February 2015. RESULTS: Compared with Saudi nurses, expatriate nurses had overall lower job satisfaction after controlling for other predictors. While expatriates were less satisfied than Saudi nurses about extrinsic rewards and family-work balance, however, Saudi nurses were less satisfied than expatriate nurses about their professional opportunities, praise and recognition, and co-worker relationships. CONCLUSION: For some subscales, Saudi nurses were more satisfied than expatriate nurses, while for other subscales, the opposite was true. Nationality should be included in job satisfaction studies in countries with migrant workforces, as nationality-based differences may have been present but masked in earlier international studies by aggregating satisfaction across national groups. IMPLICATIONS FOR NURSING & HEALTH POLICY: Policy makers in Saudi Arabia and other countries with migrant nursing workforces should have effective induction programmes that help newly employed nurses - migrant and local - clearly understand their jobs, roles and responsibilities. Policy makers must have sufficient evidence to modify the reward system to ensure fairness and equality for all.

The health of the nursing workforce. A survey of National Nurse Associations.

AIM: This investigation explored the extent to which nurses' own health is a priority for global National Nursing Associations. BACKGROUND: There is a growing body of evidence linking staff health and well-being and key dimensions of service quality, including patient safety, patient experience and the effectiveness of patient care. INTRODUCTION: The International Council of Nurses is a federation of more than 130 National Nurses Associations, representing more than 20 million nurses worldwide. Representatives from these Associations attended a Congress in Singapore in 2019 at which a survey was conducted. METHODS: A convenience sample of 37 leaders of National Nurse Associations from 33 countries and 61 nurse representatives took part in a survey. RESULTS: The majority of nurse leaders and participants believed that nurses' own health should be a priority to be addressed, principally because a healthy nurse is better able to provide good patient care. All of the examples offered about how these Associations address nurses' own health were about actions to prompt individual health behaviour change. DISCUSSION: The National Nurses Associations did not have a common terminology to talk about nurses' own health. Taking care of one's own health was included as part of the professional role and most nurse leaders thought that working conditions contributed to ill health. CONCLUSIONS: There is widespread agreement that nurses' own health matters but for most National Nurses Associations it is not a current priority. IMPLICATIONS FOR NURSING POLICY: Going forward nurse health and wellbeing should be a core principle for health services and professional associations, and additional research is needed that demonstrates if improving working environments contributes to nurse retention and recruitment.

Management of bed availability in intensive care in the context of hospitalization by court order / Gestão da disponibilidade de leitos na terapia intensiva no contexto da internação por ordem judicial / Gestión de disponibilidad de camas en terapia intensiva en el contexto de internación por orden judicial

Abstract Objective: to identify, from the nurse perspective, situations that interfere with the availability of beds in the intensive care unit in the context of hospitalization by court order. Method: qualitative exploratory, analytical research carried out with 42 nurses working in adult intensive care. The selection took place by non-probabilistic snowball sampling. Data collected by interview and analyzed using the Discursive Textual Analysis technique. Results: three categories were analyzed, entitled deficiency of physical structure and human resources; Lack of clear policies and criteria for patient admission and inadequate discharge from the intensive care unit. In situations of hospitalization by court order, there is a change in the criteria for the allocation of intensive care beds, due to the credibility of professionals, threats of medico-legal processes by family members and judicial imposition on institutions and health professionals. Conclusion: nurses defend the needs of the patients, too, with actions that can positively impact the availability of intensive care beds and adequate care infrastructure.

Resumo Objetivo: identificar, a partir da perspectiva de enfermeiros, situações que interferem na disponibilidade de leitos em unidade de terapia intensiva no contexto de internação por ordem judicial. Método: pesquisa qualitativa exploratória, analítica, realizada com 42 enfermeiros atuantes em terapia intensiva adulto. A seleção aconteceu por amostragem não probabilística, do tipo bola de neve. Dados coletados por entrevista e analisados pela técnica de Análise Textual Discursiva. Resultados: analisaram-se três categorias, intituladas deficiência de estrutura física e de recursos humanos; falta de políticas e critérios claros para admissão de paciente e alta inadequada da unidade de terapia intensiva. Nas situações de internação por ordem judicial há alteração nos critérios de alocação de leito de terapia intensiva, mediante a credibilidade dos profissionais, ameaças de processos médico-legais por parte de familiares e imposição judicial às instituições e aos profissionais de saúde. Conclusão: enfermeiros defendem as necessidades dos pacientes, também, com ações que possam impactar positivamente na disponibilidade de leitos de terapia intensiva e de infraestrutura adequada de atendimento.

Resumo Objetivo: identificar, desde la perspectiva de los enfermeros, situaciones que interfieren en la disponibilidad de camas en unidad de terapia intensiva en contexto de internación por orden judicial. Método: investigación cualitativa exploratoria, analítica realizada con 42 enfermeros que prestan servicios en terapia intensiva de adultos. La selección se realizó por muestreo no probabilístico de bola de nieve. Recolección de datos por medio de entrevistas y análisis mediante la Técnica de Análisis de Texto Discursivo. Resultados: se analizaron 3 categorías a saber: deficiencia de infraestructura y de recursos humanos; falta de políticas y criterios claros para admisión de pacientes y alta inadecuada en unidades de terapia intensiva. En situaciones de internación por orden judicial, se advierten alteraciones respecto de los criterios de asignación de camas de terapia intensiva, mediante la credibilidad de los profesionales, amenazas de interposición de acciones médico-legales por parte de los familiares e imposiciones judiciales a instituciones y a profesionales de la salud. Conclusión: los enfermeros abogan por las necesidades de los pacientes mediante acciones que puedan impactar de manera positiva en la disponibilidad de lechos de terapia intensiva y de una infraestructura adecuada de atención.

Trajectories of Rehabilitation across Complex Environments (TRaCE): design and baseline characteristics for a prospective cohort study on spinal cord injury and acquired brain injury.

PURPOSE: Trajectories of Rehabilitation across Complex Environments (TRaCE), a consented prospective cohort study, addresses a critical need to better understand access to the healthcare system after acute treatment and specialist inpatient rehabilitation for acquired disability. It is expected that this study will produce new knowledge on access to healthcare through the linkage of administrative, survey, and spatial datasets on the one cohort. This paper outlines the study design and baseline characteristics of the cohort. METHODS: The TRaCE cohort is comprised of 165 inpatients who are currently being followed up for 12 months after discharge from specialist rehabilitation for acquired brain injury (ABI) and spinal cord injury (SCI). This project combines a data linkage framework on health service use with a prospective survey on psychosocial wellbeing, geographical information systems to examine spatial accessibility to services, and qualitative interviews with a sub-cohort on experiences of service access. CONCLUSION: Ultimately, TRaCE will have strong translational impact on strategies for more targeted interventions to improve the healthcare system and support individuals with acquired disabilities in the long-term.