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1.
Rev Saude Publica ; 55: 56, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34495253

RESUMO

OBJECTIVE: Evaluating safety culture in the perception of professionals working in public hospitals of the Unified Health System (SUS) of Distrito Federal, Brazil, three years after the implementation of the National Patient Safety Program (PNSP). METHODS: Analytical cross-sectional study conducted in eleven public hospitals using the Safety Attitudes Questionnaire (SAQ) in electronic format. Stratified sampling was estimated according to the proportion of the total number of professionals in each hospital, as well as the representativeness of each professional group. The results of the total score and domains equal to or greater than 75 were considered positive. Descriptive and inferential analyses of professional groups and hospitals were carried out. RESULTS: 909 professionals participated. The total score by professional group was negative (62.5 to 69.5) and the domains differed statistically in all cases. The eleven hospitals had a negative total score (61.5 to 68.6). The domains to attain positive performance were job satisfaction, stress recognition and teamwork climate. The lowest results were in working conditions and management perception domains, for which none of the hospitals had an average above 75. Differences were also found for domain means across hospitals, except in management perception. DISCUSSION: Three years after the implementation of PNSP, the safety culture in eleven hospitals evaluated was weak, although the domains of job satisfaction, stress recognition and teamwork climate had positive results. The results can contribute to decision-making by managers, as safety culture is an essential element in the implementation of patient safety policy.


Assuntos
Atitude do Pessoal de Saúde , Cultura Organizacional , Brasil , Estudos Transversais , Hospitais Públicos , Humanos , Satisfação no Emprego , Segurança do Paciente , Percepção , Gestão da Segurança , Inquéritos e Questionários
2.
Artigo em Russo | MEDLINE | ID: mdl-34486849

RESUMO

The organizational (corporate) culture is relevant to beliefs and values existing in the organization during long time and also to behavior practices of personnel effecting attitude to work and interpersonal communications. The healthy corporate culture promotes development of positive reputation of physicians, trust and loyalty of patients and medical personnel. It also supports higher compliance to therapy, culture of treatment and forms corresponding behavior of patient (increasing of preventive activities). The purpose of study is to consider opportunities of organizational culture of medical institutions in promoting loyalty of personnel and decreasing of stuff turnover.


Assuntos
Cultura Organizacional , Lealdade ao Trabalho , Atitude do Pessoal de Saúde , Humanos , Satisfação no Emprego , Reorganização de Recursos Humanos
3.
BMC Health Serv Res ; 21(1): 842, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34416894

RESUMO

BACKGROUND: A stronger safety climate in nursing homes may reduce avoidable adverse events. Yet efforts to strengthen safety climate may fail if nursing homes are not ready to change. To inform improvement efforts, we examined the link between organizational readiness to change and safety climate. METHODS: Seven safety climate domains and organizational readiness to change were measured with validated Community Living Center/CLC Employee Survey of Attitudes about Resident Safety and Organizational Readiness to Change Assessment. Safety climate domains comprised of safety priorities, supervisor commitment to safety, senior management commitment to safety, safety attitudes, environmental safety, coworker interactions around safety, and global rating of CLC. We specified models with and without readiness to change to explain CLC- and person-level variance in safety climate domains. RESULTS: One thousand three hundred ninety seven workers (frontline staff and managers) responded from 56 US Veterans Health Administration CLCs located throughout the US. Adding readiness to change reduced baseline CLC-level variance of outcomes (2.3-9.3%) by > 70% for interpersonal domains (co-workers, supervisors, and senior management). Readiness to change explained person-level variance of every safety climate domain (P < 0.05), especially for interpersonal domains. CONCLUSIONS: Organizational readiness to change predicted safety climate. Safety climate initiatives that address readiness to change among frontline staff and managers may be more likely to succeed and eventually increase resident safety.


Assuntos
Casas de Saúde , Cultura Organizacional , Humanos , Gestão da Segurança , Instituições de Cuidados Especializados de Enfermagem , Inquéritos e Questionários
4.
J Nurs Adm ; 51(7-8): 401-408, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34405979

RESUMO

OBJECTIVE: The aim of this study was to reduce the turnover of new RNs (NRNs) completing a 1-year nurse residency program. BACKGROUND: Businesses use touchpoints to retain both internal and external customers, yet no evidence was found in retaining NRNs. Touchpoints, distinct points in the company-customer experience, play a vital role in the customer's experience with the company. Employees are one of a company's many customer types. METHODS: This quality-improvement project implemented touchpoints to improve NRN retention rates. RESULTS: Retention rates and job-satisfaction scores were significantly higher among the touchpoint-intervention cohort compared with the nonintervention cohort. Implementation costs were far less than those associated with NRN turnover. CONCLUSIONS: Touchpoints are a practical management approach for NRN retention.


Assuntos
Satisfação no Emprego , Recursos Humanos de Enfermagem no Hospital/psicologia , Cultura Organizacional , Reorganização de Recursos Humanos/estatística & dados numéricos , Humanos
5.
Artigo em Inglês | MEDLINE | ID: mdl-34444314

RESUMO

We conceptualize that safety culture (SC) has a positive impact on employee's safety performance by reducing their psychosocial hazards. A higher level of safety culture environment reduces psychosocial hazards by improving employee's performance toward safety concerns. The purpose of this study was to evaluate how psychosocial hazard mediates the relationship between safety culture and safety performance. Data were collected from 380 production employees in three states of Malaysia from the upstream oil and gas sector. Structural equation modeling was implemented to test the suggested hypotheses. The proposed model was evaluated using structural equation modeling. A stratified sampling with a Likert 5-point scale was used to distribute the questionnaires. Furthermore, the proposed model was tested using the simulation of the structural equation and partial. According to our findings, all hypotheses were significant. A review of prior studies was used to select the items of the dimension for the data collection. Safety culture was assessed with psychosocial hazard to determine its direct and indirect impact on safety performance. Results suggest that to enhance safety performance (leading and lagging), psychosocial concerns in the workplace environments should be taken into consideration by employees. In addition, the findings showed that the psychosocial hazard fully mediates the relationship between safety culture and safety performance.


Assuntos
Gestão da Segurança , Local de Trabalho , Malásia , Cultura Organizacional , Inquéritos e Questionários
6.
BMJ Open ; 11(8): e048036, 2021 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-34376449

RESUMO

OBJECTIVES: This study adopted a process view of organisational learning to investigate the barriers to effective organisational learning from medical errors. METHODS: Qualitative data were collected from 40 clinicians in high and low performing hospitals. The fit between the organisational learning process and socio-technical factors was investigated systematically from a pre-reporting stage to reporting and post-reporting stages. RESULTS: The analysis uncovered that the major stumbling blocks to active learning lie largely in the post-reporting stages and that they are rooted in social rather than technical issues. Although the experience of the higher-performing hospital provides valuable pointers in terms of creating more trusting environment and using the potential of small failures towards ways in which the organisational learning process in the lower hospital might be improved, due to lack of local mangers' proactive engagement in integrating changes into practice the active learning takes place in neither of the hospitals. CONCLUSIONS: To ensure that the change solutions are firmly incorporated into the culture and routine practice of the hospital, we need to focus on fostering an organisational culture that encourages positive cooperation and mutual interactions between local managers and frontline clinicians. This process will lead to double-loop learning and an increase in system safety.


Assuntos
Atenção à Saúde , Cultura Organizacional , Hospitais , Humanos , Erros Médicos/prevenção & controle , Organizações
7.
BMJ Open ; 11(8): e045377, 2021 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-34385231

RESUMO

OBJECTIVES: Measuring staff perspectives on patient safety culture (PSC) can identify areas of concern that, if addressed, could lead to improvements in healthcare. To date, there is no validated measure to assess PSC that has been tested and adapted for use in Bosnia and Herzegovina (BiH). This research addresses the gap in the evidence through the psychometric assessment of the Agency for Healthcare Research and Quality's: 'Hospital Survey on Patient Safety Culture' (HSOPSC), to determine its suitability for the health system in BiH. SETTING: Nine hospitals. PARTICIPANTS: Healthcare professionals (n=1429); nurse (n=823), doctors (n=328), other clinical personnel (n=111), non-clinical personnel (n=60), other (n=64), no response (n=43). PRIMARY AND SECONDARY OUTCOME MEASURES: A translated version of HSOPSC was used to conduct psychometric evaluation including exploratory factor analysis and confirmatory factor analysis (CFA). Comparison between the original HSOPSC and the newly adapted 'Hospital Survey on Patient Safety Culture for Bosnia and Herzegovina' (HSOPSC-BiH) was carried out. RESULTS: Compared with the original survey, which has 12 factors (42 items), the adapted survey consisted of 9 factors (29 items). The following factors from the original survey were not included in their original form: Communication Openness, Feedback and Communications about error, Overall Perceptions of Patient Safety and Organisational learning-Continuous Improvement. The results of the CFA for HSOPSC-BiH showed a better model fit compared with the original HSOPSC. The absolute and relative fit indices showed excellent model adjustment. CONCLUSIONS: The BiH version of Hospital Survey on Patient Safety Culture demonstrated satisfactory psychometric properties, with acceptable to good internal consistency and construct validity. Therefore, we recommend the HSOPSC-BiH as a basis for assessing PSC in BiH. This survey could provide insight into patient safety concerns in BiH so that strategies to overcome these issues could be formulated and implemented.


Assuntos
Cultura Organizacional , Gestão da Segurança , Atitude do Pessoal de Saúde , Bósnia e Herzegóvina , Pesquisa sobre Serviços de Saúde , Hospitais , Humanos , Segurança do Paciente , Psicometria , Inquéritos e Questionários
8.
Work ; 69(4): 1317-1342, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34366313

RESUMO

BACKGROUND: Organizational readiness for change measures were reviewed to develop an assessment tool for guiding implementation of an occupational safety and health program based on Total Worker Health (TWH) principles. Considerable conceptual ambiguity in the theoretical and empirical peer-reviewed literature was revealed. OBJECTIVE: Develop and validate an assessment tool that organizations can use to prepare for implementation of a participatory TWH program. METHODS: Inclusion criteria identified 29 relevant publications. Analysis revealed eight key organizational characteristics and predictors of successful organizational change. A conceptual framework was created that subject matter experts used to generate prospective survey items. Items were revised after pretesting with 10 cognitive interviews with upper-level management and pilot-tested in five healthcare organizations. Reliability of the domain subscales were tested based on Cronbach's α. RESULTS: The Organizational Readiness Tool (ORT) showed adequate psychometric properties and specificity in these eight domains: 1) Current safety/health/well-being programs; 2) Current organizational approaches to safety/health/well-being; 3) Resources available for safety/health/well-being; 4) Resources and readiness for change initiatives to improve safety/health/well-being; 5) Resources and readiness for use of teams in programmatic initiatives; 6) Teamwork; 7) Resources and readiness for employee participation; and 8) Management communication about safety/health/well-being. Acceptable ranges of internal consistency statistics for the domain subscales were observed. CONCLUSIONS: A conceptual model of organizational readiness for change guided development of the Organizational Readiness Tool (ORT), a survey instrument designed to provide actionable guidance for implementing a participatory TWH program. Initial internal consistency was demonstrated following administration at multiple organizations prior to implementation of a participatory Total Worker Health® program.


Assuntos
Saúde do Trabalhador , Humanos , Cultura Organizacional , Inovação Organizacional , Estudos Prospectivos , Psicometria , Reprodutibilidade dos Testes
10.
Front Health Serv Manage ; 38(1): 4-13, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34431813

RESUMO

SUMMARY: Across the healthcare landscape, the COVID-19 pandemic has been incredibly challenging. It also has been a catalyst for change. It has ignited a redesign of the US health system and presented opportunities in areas such as caregiver and patient communication, digital practice, telehealth and virtual care, and more. Notably, the pandemic also has shined a new light on caregiver well-being. As executive leaders of Cleveland Clinic's Caregiver Office, our top priority throughout the pandemic has been to support our caregivers professionally and personally-to help them be their best for themselves and for their fellow caregivers, our patients, our organization, and our communities. Today, Cleveland Clinic is realizing the profound impact of many of the strategies put in place during the pandemic and seeing how COVID-19 accelerated our organization's unified vision for caregiver well-being. This article offers insight into Cleveland Clinic's commitment to caregiver well-being, highlights actions we undertook during the pandemic, shares the resulting lessons we learned, and showcases how those lessons are shaping our future caregiver well-being strategy.


Assuntos
Instituições de Assistência Ambulatorial/organização & administração , COVID-19 , Cuidadores/normas , Atenção à Saúde/organização & administração , Pessoal de Saúde/normas , Saúde Holística , Guias de Prática Clínica como Assunto , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ohio , Cultura Organizacional , Objetivos Organizacionais , Pandemias , SARS-CoV-2
11.
Front Health Serv Manage ; 38(1): 14-19, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34431814

RESUMO

SUMMARY: Enhancing employee well-being and creating a distinct employee experience are crucial to the success of Atrium Health. Our strategies for listening, well-being, and experience have always been deep-rooted in our culture, and the COVID-19 pandemic brought extraordinary opportunities to refresh those strategies as we carried out our mission during a time of uncertainty, crisis, and disruption to our everyday lives. From the start of the pandemic, we have deliberately anticipated the needs of our employees to provide support when they need it most. As the pandemic eases, we continue to make relevant and timely resources available to increase resilience and overall well-being. Our efforts have evolved to support our heroes-including our nonclinical workers-and to better position Atrium Health for future challenges that come our way. Although we are constantly changing, our primary focus remains the same. Employee well-being and experience are a significant part of who we are and an essential element of the care we all provide at Atrium Health.


Assuntos
Atitude do Pessoal de Saúde , COVID-19/psicologia , COVID-19/terapia , Atenção à Saúde/organização & administração , Instalações de Saúde , Pessoal de Saúde/psicologia , Cultura Organizacional , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , North Carolina , Pandemias , SARS-CoV-2
12.
Front Health Serv Manage ; 38(1): 39-44, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34431818

RESUMO

SUMMARY: Well-being, engagement, and burnout among clinicians are interconnected, and the common denominator is energy. Decades of research show that employees' energy is a decisive factor in achieving organizational outcomes. Knowing this, healthcare leaders can create well-being programs with measurable outcomes that make a positive impact on the bottom line. Just as important, leaders can avoid wasting money on fruitless efforts. How can clinician well-being be incorporated in organizational culture and strategic and operational plans? What are the special challenges to achieving clinician well-being? What key leadership actions promote and protect the well-being of clinicians? Which approaches are most effective during a crisis such as the COVID-19 pandemic? This article addresses those questions by presenting the rationale and methodology behind well-being programs that also address engagement and burnout so that clinicians can succeed in times of crisis and beyond.


Assuntos
Atitude do Pessoal de Saúde , Esgotamento Profissional/psicologia , COVID-19/terapia , Atenção à Saúde/organização & administração , Pessoal de Saúde/psicologia , Promoção da Saúde/organização & administração , Engajamento no Trabalho , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cultura Organizacional , Objetivos Organizacionais , Pandemias , SARS-CoV-2
13.
Acad Med ; 96(9): 1276-1281, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34432665

RESUMO

The clinical learning environment (CLE) encompasses the learner's personal characteristics and experiences, social relationships, organizational culture, and the institution's physical and virtual infrastructure. During the COVID-19 pandemic, all 4 of these parts of the CLE have undergone a massive and rapid disruption. Personal and social communications have been limited to virtual interactions or shifted to unfamiliar clinical spaces because of redeployment. Rapid changes to the organizational culture required prompt adaptations from learners and educators in their complex organizational systems yet caused increased confusion and anxiety among them. A traditional reliance on a physical infrastructure for classical educational practices in the CLE was challenged when all institutions had to undergo a major transition to a virtual learning environment. However, disruptions spurred exciting innovations in the CLE. An entire cohort of physicians and learners underwent swift adjustments in their personal and professional development and identity as they rose to meet the clinical and educational challenges they faced due to COVID-19. Social networks and collaborations were expanded beyond traditional institutional walls and previously held international boundaries within multiple specialties. Specific aspects of the organizational and educational culture, including epidemiology, public health, and medical ethics, were brought to the forefront in health professions education, while the physical learning environment underwent a rapid transition to a virtual learning space. As health professions education continues in the era of COVID-19 and into a new era, educators must take advantage of these dynamic systems to identify additional gaps and implement meaningful change. In this article, health professions educators and learners from multiple institutions and specialties discuss the gaps and weaknesses exposed, opportunities revealed, and strategies developed for optimizing the CLE in the post-COVID-19 world.


Assuntos
COVID-19/prevenção & controle , Educação à Distância/métodos , Educação Médica/métodos , Aprendizagem , Distanciamento Físico , Estudantes de Medicina/psicologia , Comportamento Cooperativo , Educação à Distância/organização & administração , Educação Médica/organização & administração , Humanos , Práticas Interdisciplinares , Cultura Organizacional , Meio Social , Rede Social , Estados Unidos
14.
J Appl Psychol ; 106(7): 951-964, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34383511

RESUMO

Our theoretically driven cluster-randomized cohort control study sought to understand how psychosocial safety climate (PSC)-a climate to protect worker psychological health-could be built in different organizational change scenarios. We drew on event system theory to characterize change (planned vs. shock) as an event (observable, bounded in time and space, nonroutine) to understand how events connect and impact organizational behavior and features (e.g., job design, PSC). Event 1 was an 8-month planned intervention involving training middle managers to enact PSC in work units and reduce job stressors. Event 2 was the shock COVID-19 pandemic which occurred midintervention (at 4 months). Three waves (T1, 0 months; T2, 4 months; T3, 8 months) of data were collected from experimental (295T1, 224T2, 119T3) and control (236T1, 138T2, 83T3) employees across 22 work groups. Multilevel analysis showed in Event 1 (T1T2) a significant Group × Time effect where PSC (particularly management priority) significantly increased in the experimental versus control group. Under Event 2 (T2T3), PSC was maintained at higher levels in the experimental versus control group but both groups reported significantly increased PSC communication and commitment. Results suggest that middle management training increases PSC within 4 months. Event 2, COVID-19 was shocking and its novelty, disruption, criticality, and timing in Australian industrial history enabled a strong top management response, positively affecting the control group. PSC may be sustained and built in times of shock with top management will, the application of PSC principles, and a top-level pro-psychological health agenda. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
COVID-19 , Saúde Mental , Saúde do Trabalhador , Cultura Organizacional , Pandemias , Adulto , Idoso , Austrália/epidemiologia , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-34360039

RESUMO

Studies have demonstrated associations between safety culture and patient safety based on the perceptions of healthcare professionals, but limited attention has been given to the perceptions of nurses. Moreover, most studies have used regression modeling, an approach that limits researchers' ability to identify the most important predictors of patient safety due to intercorrelations among predictors in the model. Therefore, the purpose of this study was to examine the effects of seven dimensions of safety culture on nurse-rated patient safety and identify the relative importance of these dimensions for predicting patient safety. This correlational study used data from the Agency for Healthcare Research and Quality's 2018 Hospital Survey on Patient Safety Culture. Data from 13,031 nurses working in surgical areas of 443 hospitals in the United States were examined using logistic regression and dominance analysis. Staffing adequacy was the strongest predictor of patient safety, followed by hospital management support for patient safety and organizational learning/continuous improvement. However, dominance analysis showed that hospital management support for patient safety was the most important predictor rather than staffing adequacy. Nurse managers and hospital administrators should role model a culture of safety and demonstrate their valuing of patient safety by providing sufficient resources, listening to and valuing staff suggestions regarding patient safety, and providing feedback about organizational changes to improve patient safety.


Assuntos
Administração Hospitalar , Enfermeiras Administradoras , Atitude do Pessoal de Saúde , Estudos Transversais , Humanos , Cultura Organizacional , Segurança do Paciente , Gestão da Segurança , Inquéritos e Questionários , Estados Unidos
16.
Rev Bras Enferm ; 74(6): e20201315, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34431940

RESUMO

OBJECTIVES: to describe, from literature, the characteristics of patient safety culture in Brazilian hospitals that applied the Hospital Survey on Patient Safety Culture. METHODS: this is a scoping review. A search was performed in the databases LILACS, PubMed, SciELO, CINAHL, Web of Science, Scopus and in the CAPES Dissertations and Theses Database in September and October 2020. RESULTS: thirty-six studies were identified. Nine studies identified strengthened areas such as: "teamwork within the units", "expectations of supervisor/boss and actions promoting safety", "organizational learning", "support of hospital management for patient safety" and "frequency of report of events". As a critical area, the dimension "non-punitive response to error" was evidenced in 30 of 36 studies. CONCLUSIONS: the identification of areas of strength and critical areas of safety culture is relevant to encourage improvement of patient safety problems in an institution.


Assuntos
Administração Hospitalar , Segurança do Paciente , Hospitais , Humanos , Cultura Organizacional , Gestão da Segurança
17.
Worldviews Evid Based Nurs ; 18(4): 243-250, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34288388

RESUMO

BACKGROUND: Evidence-based practice (EBP) is a problem-solving approach to clinical decision making that leads to a higher quality and safety of health care. Three valid and reliable scales that measure EBP attributes, including the EBP Beliefs Scale, the EBP Implementation Scale, and the Organizational Culture and Readiness Scale for System-Wide Integration of EBP, are widely used but require approximately 5 min each to complete. Shorter valid and reliable versions of these scales could offer the benefit of less time for completion, thereby decreasing participant burden. AIM: The aim of this study was to determine the psychometric properties of the three shortened EBP scales, adapted from the longer versions. METHODS: This study used a descriptive survey design with 498 nurses who completed the three original EBP scales along with a shortened version of each scale. Exploratory factor analysis was conducted with principal components extracted to examine the factor structure of each EBP measure for the three shortened EBP scales. Item intercorrelations and the Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO) were used to confirm the validity of using factor analysis. Reliability of each scale using Cronbach's α was examined. Convergent validity of the three shortened EBP scales was assessed by correlating each shortened scale with its longer scale. RESULTS: Factor analysis supported the construct validity of each of the three shortened scales, as all item intercorrelations were greater than 0.40, and KMO values were 0.62 to 0.74. The shortened scales Cronbach alphas were 0.81 for the EBP Beliefs Scale, 0.89 for the EBP Implementation Scale, and 0.87 for the EBP Culture and Readiness Scale. The three shortened EBP scales had acceptable convergent validity (r = 0.42-.072) for the correlations between the shortened and longer scales. LINKING EVIDENCE TO ACTION: The three shortened EBP scales, which are valid and reliable, can be used as an alternative to the longer three scales to decrease participant burden when conducting program evaluations, research, or organizational assessments.


Assuntos
Atitude do Pessoal de Saúde , Enfermagem Baseada em Evidências/normas , Recursos Humanos de Enfermagem no Hospital/psicologia , Cultura Organizacional , Psicometria/normas , Inquéritos e Questionários/normas , Adulto , Estudos Transversais , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ohio , Reprodutibilidade dos Testes
18.
Worldviews Evid Based Nurs ; 18(4): 272-281, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34309169

RESUMO

BACKGROUND: The Advancing Research and Clinical practice through close Collaboration (ARCC© ) Model is a system-wide framework for implementing and sustaining evidence-based practice (EBP) in hospitals and healthcare systems. The model involves assessing organizational culture and readiness for EBP in addition to the development of a critical mass of EBP mentors who work with point-of-care clinicians to facilitate the implementation of evidence-based care. Determining how the various components of the ARCC© Model relate to one another is important for understanding how EBP culture and mentorship impact EBP implementation, nurses' job satisfaction, and intent to stay. AIMS: The current study aimed to test a model that could explain the relationships and direct pathways among eight key variables in the ARCC© Model: (1) EBP culture, (2) mentorship, (3) knowledge, (4) beliefs, (5) competency, (6) implementation, (7) nurses' job satisfaction, and (8) intent to stay. METHODS: Structural equation modeling was used to test relationships among the variables in the ARCC© Model with data obtained from an earlier cross-sectional descriptive study with 2,344 nurses from 19 hospitals and healthcare systems across the United States. RESULTS: The final structural equation model found that EBP culture and mentorship were key variables that positively impacted EBP knowledge, beliefs, competency, implementation, job satisfaction, and intent to stay among nurses. LINKING EVIDENCE TO ACTION: As described in the ARCC© Model, establishing a strong sustainable EBP culture along with a critical mass of EBP mentors is crucial for the development of EBP competency and consistent implementation of evidence-based care by nurses. A strong EBP culture along with EBP mentorship also can result in higher job satisfaction and intent to stay. Implementation of the ARCC© Model is a key strategy in assisting systems to reach health care's Quadruple Aim.


Assuntos
Enfermagem Baseada em Evidências/organização & administração , Satisfação no Emprego , Mentores , Recursos Humanos de Enfermagem no Hospital/psicologia , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Cultura Organizacional , Reorganização de Recursos Humanos/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Enfermagem , Inquéritos e Questionários
19.
Nephrol Nurs J ; 48(3): 253-259, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34286936

RESUMO

This study examines the association between burnout and organizational commitment in nephrology nurses working in hemodialysis. A cross-sectional study of all nurses working in a hospital hemodialysis unit was conducted. Low to medium level of burnout and a high level of organizational commitment were documented. A significant negative correlation was found between burnout and organizational commitment. Burnout was significantly higher among nurses who had made a career shift in the past, and lower levels of burnout were documented among married nurses. In a multivariate analysis, lower levels of burnout and a higher number of children were significantly associated with higher organizational commitment. Burnout is a negative independent predictor for organizational commitment. Inter ventions focused on reducing burnout among nurses should be implemented to improve organizational commitment.


Assuntos
Esgotamento Profissional , Nefrologia , Enfermeiras e Enfermeiros , Criança , Estudos Transversais , Humanos , Satisfação no Emprego , Cultura Organizacional , Inquéritos e Questionários
20.
Artigo em Inglês | MEDLINE | ID: mdl-34281036

RESUMO

A large university in Queensland, Australia with a diverse staff and student community introduced a campus wide smoke-free policy in 2016. The purpose of this enquiry was to understand attitudes about a new smoke-free policy, its potential impact and the shift in social norms and organizational culture to inform the next phase of implementation. An electronic survey was distributed to all staff and students approximately 12 weeks after the smoke-free policy was implemented. The survey consisted of multiple-choice questions about demographics, smoking behaviour, attitudes towards smoking and tobacco control, awareness of the smoke-free policy, and attitudes towards the effect of a completely smoke-free campus on quality of life, learning and enrolment. The survey was completed by 641 university staff and students. Respondents reported seeking out (80.4%) and socialising in smoke-free environments (86.6%) and supported smoke-free buildings (96.1%), indoor areas (91.6%), and outdoor areas (79%). The results revealed overwhelming support for a completely smoke-free campus (83%) and minority support for designated smoking areas (31%). Overall, respondents reflected positively towards a campus wide smoke-free policy. These findings suggest Queensland's early adoption of tobacco control laws influenced the social environment, de-normalised smoking, changed behaviour, preference for smoke-free environments and shifted social norms. These findings provide convincing evidence for organisational change and suggest health promotion policy makers should progress the implementation of smoke-free policies nationally across the higher education sector.


Assuntos
Política Antifumo , Poluição por Fumaça de Tabaco , Atitude Frente a Saúde , Austrália , Promoção da Saúde , Humanos , Cultura Organizacional , Qualidade de Vida , Queensland , Prevenção do Hábito de Fumar , Normas Sociais , Estudantes , Universidades
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