Factors influencing nurse manager retention, intent to stay or leave and turnover: A systematic review update.

AIMS: To understand factors influencing nurse manager retention or intention to leave, develop a preliminary theoretical model and identify strategies and interventions for workforce planning. DESIGN: Systematic review update of literature with integrated design of mixed research synthesis. METHODS: We included peer-reviewed articles examining factors influencing retention or intention to leave for front-line, middle or patient care nurse managers. Authors independently screened articles for inclusion and assessed included articles for quality. We adhered to a convergent synthesis approach. DATA SOURCES: Nine databases included MEDLINE, EMBASE, PsychINFO, CINAHL Plus with Full Text, ERIC, Health Source Nursing/Academic Edition, Scopus, ProQuest Dissertations and Theses and LILACS in January 2023. RESULTS: Thirty-five studies published between 1990 and 2022, 22 quantitative and 13 qualitative or mixed methods, were included. 155 factors influencing nurse manager retention, intention to stay, or turnover were reported. Job satisfaction was most frequently examined (n = 7), followed by factors such as empowerment (n = 3), decision-making (n = 3) and resilience (n = 2). We developed a preliminary theoretical model demonstrating staff relations and leadership, organizational and job characteristics, socio-demographics, personal characteristics, well-being and nurse manager relationship with work influence managers' intention to stay or to leave. CONCLUSIONS: Nurse managers who were empowered, satisfied with their work, received constructive feedback and found meaning in their roles showed greater intent to stay. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurse administrators can ensure managers are provided with authority to make decisions that promote autonomy. Work cultures that allow for regular meaningful constructive feedback from staff and leaders may contribute to nurse managers feeling valued. IMPACT: Understanding factors that influence job retention or intention to leave may help nurse managers and their supervisors identify areas for strategy and intervention design to ensure sustainability of this workforce. REPORTING METHOD: PRISMA 2020 Guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Authentic leadership, organizational culture and the effects of hospital quality management practices on quality of care and patient satisfaction.

AIM: To examine the influence of hospital culture and authentic leadership on the effects of quality improvement practices on patient satisfaction. BACKGROUND: Nurses in formal leadership roles shape and are shaped by organizational culture to achieve high performance standards to influence quality of care. DESIGN: Using structural equation modelling, we tested a model on quality improvement practices across three participant groups that differed based on authentic leadership and hospital culture. METHODS: We used survey data from a cross-sectional study conducted in 2015 measuring nurse. Managers' perceptions of authentic leadership, implementation of quality improvement, and organizational culture in Canadian hospitals. RESULTS: 226 nurse managers participated. Our model estimations fit for the high-relational group and mixed group. Our model explained 50.7% and 39.5% variance in our outcome variable of patient satisfaction for the high-relational group and mixed group, respectively. Our model failed to fit the low-relational group. CONCLUSION: Authentic leadership and developmental/group hospital cultures improve quality management practices, quality of care and patient satisfaction. In organizations with low authentic leadership and hierarchical/rational cultures, strategies should target increasing authentic leadership and shifting to developmental cultures. Organizations with high authentic leadership and/or developmental/group cultures should target employee engagement, autonomy and teamwork. IMPACT: We examined how different combinations of authentic leadership and hospital culture influence the effects of quality management practices on quality improvement and patient satisfaction. Findings demonstrate that having both high authentic leadership and developmental or group hospital cultures are essential for quality improvement practices to enhance the quality of care and patient satisfaction. These organizations would benefit the most from systemic programs aimed at standardizing quality management practices as they have the culture and leadership to support these practices. For hospitals with hierarchical/rational cultures and/or low authentic leadership, enhancing hospital culture and leadership through leadership training and accreditation programs is critically needed. PATIENT OR PUBLIC CONTRIBUTION: The College and Association of Registered Nurses of Alberta contributed to this study by facilitating data collection and supporting the conduct of the study through messaging to its members.

Interprofessional education in Brazilian nursing undergraduate course syllabi.

The objective of this study was to analyze aspects related to interprofessional education in healthcare through the assessment of the syllabi of undergraduate nursing programs in Brazil. An observational, descriptive study was conducted in two phases. The first phase involved identification of programs, and the second phase involved documental analysis of the syllabi through a script created for this purpose. One thousand two hundred and twenty nursing undergraduate programs were identified; 229 were included in the sample for the document analysis. In 2.6% of the programs, the term "interprofessional" was identified in the purpose of the programs. Seventeen percent of the programs valued interprofessional education, and 8% assessed interprofessional learning. Recognizing (9.2%) and respecting (6.6%) the attributes and roles of different professionals were the least identified interprofessional values in the syllabi. Interprofessional education was not institutionalized/stated in the documents, even though the documents indicated use of interprofessional relationships in training scenarios, especially in primary care, and in activities not included in the formal curriculum.

Whey Protein Supplementation Is Superior to Leucine-Matched Collagen Peptides to Increase Muscle Thickness During a 10-Week Resistance Training Program in Untrained Young Adults.

The purpose of this study was to investigate the effects of supplementation of whey protein (WP) versus leucine-matched collagen peptides (CP) on muscle thickness MT and performance after a resistance training (RT) program in young adults. Twenty-two healthy untrained participants were randomly assigned to either a WP (n = 11) or leucine-matched CP (n = 11) group and then submitted to a supervised 10-week RT program (3 days/week). The groups were supplemented with an equivalent amount of WP (35 g, containing 3.0 g of leucine) and CP (35 g, containing 1.0 g of leucine and 2.0 g of free leucine) during the intervention period (after each workout and in the evening on nontraining days). MT of the vastus lateralis and biceps brachii, isokinetic peak torque and mean power output of the elbow flexors, and peak power output of the lower body were assessed before and after the RT program. The WP group experienced a greater (interaction, p < .05) increase in the vastus lateralis (effect size, WP = 0.68 vs. CP = 0.38; % Δ, WP = 8.4 ± 2.5 vs. CP = 5.6 ± 2.6%) and biceps brachii muscle thickness (effect size, WP = 0.61 vs. CP = 0.35; % , WP = 10.1 ± 3.8 vs. CP = 6.0 ± 3.2%), with a similar increase in muscle performance (peak torque, mean power output, and peak power output) between groups (time p < .05). Supplementation with WP was superior to leucine content-matched CP supplementation in increasing muscle size, but not strength and power, after a 10-week RT program in young adults.

What drives WEEE recycling? A comparative study concerning legislation, collection and recycling.

Waste electrical and electronic equipment (WEEE) has been rising worldwide, and its improper management incurs in economic losses and environmental damage. To provide a better understanding of the forces that drive the management of WEEE, economic and political roles are discussed by comparing the WEEE recycling system of Brazil and Australia. Additional insights about the recycling systems were gathered from interviews with recyclers of both countries (in-loco visits and online/phone surveys). Previous studies show that both countries act as first stage recyclers, dismantling WEEE to ship their valuable components for international recyclers (such as printed circuit boards) while keeping less valuable material (such as polymeric and ferrous pieces). Australia has defined the responsibilities of most agents involved in the WEEE management and recycling setup, while Brazil inadvertently has left the system to be defined through free market regulation. As Brazil recently signed a reverse logistic agreement, there is an important opportunity to channel WEEE into formal routes and implement improvements in the entire recycling system (some suggestions are provided). Australian recyclers were found more organised in their disassembly lines, and some characteristics of the Australian model can be adapted for the Brazilian benefit. In conclusion, economic factors will drive first stage recycling (where labour wages are a small fraction of the total costs) and international downstream recycling, while a political framework is necessary to establish a comprehensive collection system, first stage recycling (where wages are representative) and domestic downstream recycling, given these are generally non-profitable activities in the short term.

The use of BCAA to decrease delayed-onset muscle soreness after a single bout of exercise: a systematic review and meta-analysis.

Branched-chain amino acids (BCAA) are used as a recovery method after exercise-induced muscle damage (EIMD). Although data suggest that BCAA may alleviate the delayed-onset muscle soreness (DOMS) evoked by EIMD, there is no consensus about the most effective supplementation protocol. To investigate the effects of BCAA on DOMS after a single exercise session that caused EIMD, a systematic review and meta-analysis were conducted on the effectiveness of BCAA supplementation to reduce DOMS symptoms in healthy subjects after a single session of EIMD. Randomized clinical trials (RCT) were searched in Medline, Cochrane Library, Science Direct, SciELO, LILACS, SciVerse Scopus, Springer Link journals, Wiley Online Library, and Scholar Google, until May 2021. Ten RCTs were included in the systematic review and nine in the meta-analysis. Seven studies demonstrated that BCAA reduced DOMS after 24 to 72 h. BCAA doses of up to 255 mg/kg/day, or in trained subjects, for mild to moderate EIMD, could blunt DOMS symptoms. However, high variability between studies due to training status, different doses, time of treatment, and severity of EIMD do not allow us to conclude whether BCAA supplementation is efficient in untrained subjects, applied acutely or during a period of pre to post days of EIMD, and at higher doses (> 255 mg/kg/day). The overall effects of BCAA on DOMS after a single session of exercise were considered useful for improving muscle recovery by reducing DOMS in trained subjects, at low doses, in mild to moderate EIMD, and should not be administered only after the EIMD protocol.

Atenolol removal by nanofiltration: a case-specific mass transfer correlation.

Concentration polarization is a phenomenon inherent to membrane separation operations and as a precursor of membrane fouling is frequently related to the decrease in the performance of these operations. In the present work, a case-specific mass transfer correlation was developed to assess the concentration polarization when nanofiltration, in different operating conditions, was applied to treat a pharmaceutical wastewater containing atenolol. NF runs with two membranes, two atenolol concentrations and three feed circulating velocities were conducted, and the corresponding experimental mass transfer coefficients were determined using film theory to describe the concentration polarization phenomenon. Higher velocities led to higher mass transfer coefficients and, consequently, lower concentration polarization. These mass transfer coefficients were correlated with the circulating velocity (Re), the solute diffusivity (Sc) and the membrane permeability (LP +) (the membrane is a permeable interface with effect on the concentration profiles developed from the interface towards the bulk feed), yielding the following correlation Sh = 1.98 × 104Re0.5Sc0.33LP +0.32. The good agreement between the calculated and the experimental results makes this correlation a valuable tool for water practitioners to predict and control the concentration polarization during atenolol-rich wastewater treatment by nanofiltration, thereby increasing its productivity and selectivity.

Wine lees from the 1st and 2nd rackings: valuable by-products.

Phenolic compounds of the first and second racking wine lees, including anthocyanins, were qualitatively and quantitatively analyzed by HPLC-DAD-MS. Wine lees from both rackings displayed similar chromatographic profiles. Therefore, it was impossible to differentiate the qualitative results regarding phenolic compounds. On the other hand, those from the second racking presented, on average, concentration of polyphenols twice as high. While the ones from the first racking displayed ca. 1600 mg phenolic compounds and 400 mg anthocyanins per kg of dry matter, those from the second racking have shown ca. 3300 mg phenolic compounds and 700 mg anthocyanins per kg of dry matter. These outcomes indicate that, although the wine lees from the first racking can be employed as a resource for phenolic compounds recovery, those from the second racking are more appropriate for this purpose.

Use of instruments to evaluate leadership in nursing and health services. / A utilização de instrumentos para avaliação da liderança nos serviços de saúde e enfermagem.

OBJECTIVE: To identify the available scientific evidence about the use of instruments for the evaluation of leadership in health and nursing services and verify the use of leadership styles/models/theories in the construction of these tools. METHOD: Integrative literature review of indexed studies in the LILACS, PUBMED, CINAHL and EMBASE databases from 2006 to 2016. RESULTS: Thirty-eight articles were analyzed, exhibiting 19 leadership evaluation tools; the most used were the Multifactor Leadership Questionnaire, the Global Transformational Leadership Scale, the Leadership Practices Inventory, the Servant Leadership Questionnaire, the Servant Leadership Survey and the Authentic Leadership Questionnaire. CONCLUSIONS: The literature search allowed to identify the main theories/styles/models of contemporary leadership and analyze their use in the design of leadership evaluation tools, with the transformational, situational, servant and authentic leadership categories standing out as the most prominent. To a lesser extent, the quantum, charismatic and clinical leadership types were evidenced.

Care and management actions developed in the Supervised Curricular Internship: perceptions by involved actors.

OBJECTIVE: To assess the Supervised Curricular Internship of the Nursing undergraduate course of two higher education institutions in the state of São Paulo based on specific skills described in the Brazilian National Curriculum Guidelines regarding preparation to the development of nursing care and management actions from the perceptions of professors, undergraduate students, and alumni. METHOD: Descriptive study in which a questionnaire was applied to 59 undergraduate students, 111 alumni, and 27 professors of a Nursing undergraduate course involved in the Supervised Curricular Internship in the analyzed institutions. RESULTS: The perceptions of the actors involved in the development of management and care actions were positive, although part of the alumni pointed out that the Supervised Curricular Internship does not allow the students to: develop all the activities performed by the nursing team; work towards comprehensive health care; professional technical confidence; and interfere with the work dynamics. CONCLUSION: In the perception of those involved, the Supervised Curricular Internship is seen as positive and important in the training of students, as it introduces students into the professional reality of nurses. However, this discipline still needs structural changes, particularly in the perception of the alumni.

Translation to Brazilian Portuguese and cultural adaptation of a questionnaire addressing high-alert medications. / Tradução para português do Brasil e adaptação cultural de um questionário sobre medicamentos potencialmente perigosos.

OBJECTIVE: To describe the translation into Portuguese and cultural adaptation of a Questionnaire addressing High-Alert Medications to the Brazilian context. METHODS: Methodological study comprising the translation from Chinese to Brazilian Portuguese, synthesis of translations, back translation, panel of experts, and pretest to obtain the final version of the questionnaire. RESULTS:

Development of a virtual learning environment for cardiorespiratory arrest training.

OBJECTIVE: To develop a Virtual Learning Environment (VLE) aiming at the training of nursing team workers and emergency vehicle drivers in Basic Life Support (BLS) to attend Cardiorespiratory arrest, and to evaluate the quality of its contents among specialists in the area of Emergency and Urgent care. METHOD: Applied research of technological development. The methodology used was based on the Instructional Design Model (ADDIE), which structures the teaching-learning planning in different stages (analysis, design, development, implementation and evaluation). The VLE was composed of texts elaborated from bibliographic research, links, edited video from a simulation scenario in the laboratory and questions to evaluate the fixation of the content, organized in modules. RESULTS: After its development, it was evaluated as adequate to satisfy the needs of the target public, by eight expert judges, which was made available for electronic access. CONCLUSION: The VLE has potential as a tool for training and qualification in BLS, as it can be easily integrated with other pedagogical approaches and strategies with active methodologies. OBJETIVO: Desenvolver um Ambiente Virtual de Aprendizagem (AVA) visando à capacitação de trabalhadores da equipe de enfermagem e condutores de veículo de emergência em Suporte Básico de Vida (SBV) no atendimento à Parada Cardiorrespiratória, e avaliar a qualidade do seu conteúdo junto a especialistas na área de Urgência e Emergência. MÉTODO: Pesquisa aplicada, de produção tecnológica. A metodologia utilizada foi baseada no Modelo de Design Instrucional (ADDIE), que estrutura o planejamento de ensino-aprendizagem em estágios distintos (analysis, design, development, implementation and evaluation). O AVA foi composto por textos elaborados a partir de pesquisa bibliográfica, links, vídeo construído a partir de um cenário de simulação em laboratório e questões para avaliar a fixação do conteúdo, organizados em módulos. RESULTADOS: Após a sua construção, foi avaliado como adequado para satisfazer às necessidades do público-alvo, por oito juízes especialistas, sendo disponibilizado para acesso eletrônico. CONCLUSÃO: O AVA tem potencial como ferramenta para formação e capacitação em SBV porser facilmente integrado a outras abordagens pedagógicas e estratégias com metodologias ativas.

Implementation of a participatory management model: analysis from a political perspective.

AIM: To analyse experiences of managers and nursing staff in the implementation of participatory management, specifically processes of decision-making, communication and power in a Canadian hospital. BACKGROUND: Implementing a Participatory Management Model involves change because it is focused on the needs of patients and encourages decentralisation of power and shared decisions. METHODS: The study design is qualitative using observational sessions and content analysis for data analysis. We used Bolman and Deal's four-frame theoretical framework to interpret our findings. RESULTS: Participatory management led to advances in care, because it allowed for more dialogue and shared decision making. However, the biggest challenge has been that all major changes are still being decided centrally by the provincial executive board. CONCLUSIONS: Managers and directors are facing difficulties related to this change process, such as the resistance to change by some employees and limited input to decision-making affecting their areas of responsibility; however, they and their teams are working to utilise the values and principles underlying participatory management in their daily work practices. IMPLICATIONS FOR NURSING MANAGEMENT: Innovative management models encourage accountability, increased motivation and satisfaction of nursing staff, and improve the quality of care.

[Patient safety management from the perspective of nurses]. / Gerenciamento da segurança do paciente sob a ótica dos enfermeiros.

OBJECTIVE: To evaluate the actions of patient safety management developed in hospitals, from the perspective of nurses. METHOD: This is a cross-sectional, descriptive study of the survey type. Participants were seven hospitals, in which seven nurse managers and 49 sector coordinator nurses (n = 56) answered the instrument prepared by the author. RESULTS: The results showed that 100% of hospitals have an adverse event reporting system, 71.4% have a Risk Management Committee and 80% have discussions about the events. There is agreement that these discussions lead to favorable changes for patient safety in the surveyed institutions. The employees' fear of punishment for their faults, and the underreporting of events were the aspects of greatest weakness found. CONCLUSION: The institutions should develop organizational policies focused on stimulating event notification and on the implementation of measures directed to a non-punitive organizational culture.

Membrane Separation Processes in Wastewater and Water Purification, Volume II.

Water is a crucial natural resource, essential for the development of a range of human activities, from agricultural and industrial to domestic; therefore, its availability is associated with a region or country's economic growth [...].

Lean and/or Six Sigma for process optimization in the perioperative period: an integrative review.

OBJECTIVE: To analyze the evidence on the influence of Lean and/or Six Sigma for process optimization in the perioperative period. METHODS: Integrative review carried out in the MEDLINE (PubMed), Web of Science, EMBASE, CINAHL, Scopus and LILACS databases on the use of Lean and/or Six Sigma to optimize perioperative processes. The studies included were analyzed in three thematic categories: flow of surgical patients, work process and length of stay. RESULTS: The final sample consisted of ten studies, which covered all operative periods. Lean and/or Six Sigma make a significant contribution to optimizing perioperative processes. FINAL CONSIDERATIONS: Lean and/or Six Sigma optimize perioperative processes to maximize the achievement of system stability indicators, making it possible to identify potential problems in order to recognize them and propose solutions that can enable the institution of patient-centered care.

Challenging the status quo through nursing entrepreneurship education: A scoping review.

BACKGROUND: Entrepreneurship education is commonly incorporated into areas beyond nursing. However, advocating for curricular changes is necessary in a generation that seeks new learning styles and has different preferences and needs. Entrepreneurship has been identified as a valuable subject to be incorporated into nursing education, as it aligns with the foundational principles of Nursing as a science. AIM: To examine the state of knowledge regarding the entrepreneurship education of undergraduate nursing students. DESIGN: A scoping review was conducted following JBI and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. METHODS: The searches were performed on July 19th, 2023, in MEDLINE via PubMed; ISI Web of Science; EBSCOhost CINAHL; Embase; Scopus; BVShost LILACS; and ProQuest. Grey literature was searched on Google Scholar. Records examining the entrepreneurship education of nursing students were included. RESULTS: The searches resulted in 17 records, 15 of which were from databases and two of which were identified via other methods. Although entrepreneurship education has increased over the years, the incorporation of diverse teaching modalities as a transformative and innovative educational strategy is still not a reality for many undergraduate nursing students worldwide. The findings highlight that entrepreneurship education is incorporated theoretically into mandatory courses with curricular components related to administration and health services management. CONCLUSIONS: Entrepreneurship education can pivot nursing education and drive change in educational strategy while maintaining the fundamentals of nursing education. With entrepreneurship education, nursing students envision professional identity values, such as leadership, critical thinking, and political development. When understanding their political role, nursing students can exercise leadership to think critically outside the box and challenge the status quo.

Ultrafiltration and Nanofiltration for the Removal of Pharmaceutically Active Compounds from Water: The Effect of Operating Pressure on Electrostatic Solute-Membrane Interactions.

The present work investigates nanofiltration (NF) and ultrafiltration (UF) for the removal of three widely used pharmaceutically active compounds (PhACs), namely atenolol, sulfamethoxazole, and rosuvastatin. Four membranes, two polyamide NF membranes (NF90 and NF270) and two polyethersulfone UF membranes (XT and ST), were evaluated in terms of productivity (permeate flux) and selectivity (rejection of PhACs) at pressures from 2 to 8 bar. Although the UF membranes have a much higher molecular weight cut-off (1000 and 10,000 Da), when compared to the molecular weight of the PhACs (253-482 Da), moderate rejections were observed. For UF, rejections were dependent on the molecular weight and charge of the PhACs, membrane molecular weight cut-off (MWCO), and operating pressure, demonstrating that electrostatic interactions play an important role in the removal of PhACs, especially at low operating pressures. On the other hand, both NF membranes displayed high rejections for all PhACs studied (75-98%). Hence, considering the optimal operating conditions, the NF270 membrane (MWCO = 400 Da) presented the best performance, achieving permeate fluxes of about 100 kg h-1 m-2 and rejections above 80% at a pressure of 8 bar, that is, a productivity of about twice that of the NF90 membrane (MWCO = 200 Da). Therefore, NF270 was the most suitable membrane for this application, although the tight UF membranes under low operating pressures displayed satisfactory results.

Applying Lean Healthcare in the hospitalization and patient discharge process: an integrative review.

OBJECTIVES: to identify scientific evidence regarding the use of Lean Healthcare approach in the hospitalization and patient discharge process. METHODS: this is an Integrative Review conducted in the PubMed, LILACS, SCOPUS, CINAHL, Web of Science, and Embase databases. RESULTS: out of 904 records identified, three were included in this review. The studies demonstrated that when applied to discharge planning, the Lean philosophy brings favorable results, promoting improvements in the communication process, as well as assisting in workflow organization, with a reduction in length of stay and improvement in the quality of care. FINAL CONSIDERATIONS: although the Lean methodology presents positive results, it is considered that the application of the philosophy in healthcare institutions is still not sustainable, as it is often restricted to specific departments or services. Thus, to maximize the success of implementation, the Lean philosophy needs to be incorporated into the organizational culture, representing the greatest challenge.

Relationship between leadership coaching and nurses' resilience in hospital environments.

OBJECTIVE: To analyze the relationship between leadership coaching and nurses' resilience in hospital environments. METHOD: This is a cross-sectional study, carried out with nurses, nursing assistants and technicians. Nurses answered the Nurse Self-Perception Questionnaire in Leadership Exercise Questionnaire (QUAPEEL) and the Connor-Davidson Scale for Brazil-25 (CD-RISC-25BRASIL). Nursing technicians/assistants answered the Nursing Technician and Assistant Perception in Leadership Exercise Questionnaire (QUEPTAEEL). Student's t test and Pearson's correlation were used (p ≤ 0.05). RESULTS: There was a statistically significant difference between nurses' self-perception and nursing technicians/assistants' hetero-perception in coaching leadership exercise for the total score (p = 0.002) and in the "Give and receive feedback" (p < 0.001), "Delegate power and exert influence" (p < 0.001) and "Support the team so that the organizational results are reached" (p = 0.020) domains. There was a statistically significant correlation between all the Nurse Self-Perception Questionnaire in Leadership Exercise Questionnaire Coaching and Resilience domains. CONCLUSION: Resilience was positively related to nurses' self-perception of coaching leadership.