Individual and organizational predictors of allied healthcare providers' job satisfaction in residential long-term care

Background

Job satisfaction is a predictor of intention to stay and turnover among allied healthcare providers. However, there is limited research examining job satisfaction among allied health professionals, specifically in residential long-term care (LTC) settings. The purpose of this study was to identify factors (demographic, individual, and organizational) that predict job satisfaction among allied healthcare providers in residential LTC.

Methods

We conducted a secondary analysis of data from Phase 2 of the Translating Research in Elder Care program. A total of 334 allied healthcare providers from 77 residential LTC in three Western Canadian provinces were included in the analysis. Generalized estimating equation modeling was used to assess demographics, individual, and organizational context predictors of allied healthcare providers’ job satisfaction. We measured job satisfaction using the Michigan Organizational Assessment Questionnaire Job Satisfaction Subscale.

Results

Both individual and organizational context variables predicted job satisfaction among allied healthcare providers employed in LTC. Demographic variables did not predict job satisfaction. At the individual level, burnout (cynicism) (β = −.113, p = .001) and the competence subscale of psychological empowerment (β = −.224, p = < .001), were predictive of lower job satisfaction levels while higher scores on the meaning (β = .232, p = .001), self-determination (β = .128, p = .005), and impact (β = .10, p = .014) subscales of psychological empowerment predicted higher job satisfaction. Organizational context variables that predicted job satisfaction included: social capital (β = .158, p = .012), organizational slack-time (β = .096, p = .029), and adequate orientation (β = .088, p = .005).

Conclusions

This study suggests that individual allied healthcare provider and organizational context features are both predictive of allied healthcare provider job satisfaction in residential LTC settings. Unlike demographics and structural characteristics of LTC facilities, all variables identified as important to allied healthcare providers’ job satisfaction in this study are potentially modifiable, and therefore amenable to intervention.

Electronic supplementary material

The online version of this article (10.1186/s12913-018-3307-3) contains supplementary material, which is available to authorized users.

The use of psychiatry-focused simulation in undergraduate nursing education: A systematic search and review

Evidence on the use of simulation to teach psychiatry and mental health (including addiction) content is emerging, yet no summary of the implementation processes or associated outcomes exists. The aim of this study was to systematically search and review empirical literature on the use of psychiatry-focused simulation in undergraduate nursing education. Objectives were to (i) assess the methodological quality of existing evidence on the use of simulation to teach mental health content to undergraduate nursing students, (ii) describe the operationalization of the simulations, and (iii) summarize the associated quantitative and qualitative outcomes. We conducted online database (MEDLINE, Embase, ERIC, CINAHL, PsycINFO from January 2004 to October 2015) and grey literature searches. Thirty-two simulation studies were identified describing and evaluating six types of simulations (standardized patients, audio simulations, high-fidelity simulators, virtual world, multimodal, and tabletop). Overall, 2724 participants were included in the studies. Studies reflected a limited number of intervention designs, and outcomes were evaluated with qualitative and quantitative methods incorporating a variety of tools. Results indicated that simulation was effective in reducing student anxiety and improving their knowledge, empathy, communication, and confidence. The summarized qualitative findings all supported the benefit of simulation; however, more research is needed to assess the comparative effectiveness of the types of simulations. Recommendations from the findings include the development of guidelines for educators to deliver each simulation component (briefing, active simulation, debriefing). Finally, consensus around appropriate training of facilitators is needed, as is consistent and agreed upon simulation terminology.

[An interprofessional simulation: an exploration of the experiences of nursing students.]

BACKGROUND

the literature suggests that simulation is an effective strategy to meet the learning needs of nursing students. Traditionally, simulation learning for nursing students takes place at nursing schools ; at a distance from the clinical setting, patients, and the interprofessional team.

AIM

the objective of this pilot project is to explore the experiences of Francophone nursing students following their participation in an interprofessional simulation in a hospital setting during their third year clinical placements.

METHOD

a case study using Yin's (2003) approach was used to explore this phenomenon through focus groups and individual interviews.

RESULTS

thirteen people participated in three simulation sessions that each included two scenarios. Content analysis of the focus groups revealed four themes : 1) the need for a realistic, but safe environment ; 2) simulation helps to build self-confidence ; 3) simulation improves knowledge of the role of the nurse ; and 4) simulation improves knowledge of teamwork. Two themes emerged from individual interviews : 1) the knowledge and skills acquired during the simulation were retained over time ; and 2) perceptions of the effects on the quality and safety of patient care.

CONCLUSION

the use of simulation could be effective for the development of knowledge of nursing role, teamwork, and self-confidence.

The use of non-slip socks to prevent falls among hospitalized older adults: A literature review

Falls among hospitalized older adults are a growing concern. Hospitals are using non-slip socks as an alternative footwear to help prevent falls, however there is limited evidence to support their use. The aim of this article is to review the literature on the effectiveness of non-slip socks to determine if there is sufficient evidence to support their use in the prevention of falls among hospitalized older adults. A comprehensive literature search was conducted using Medline, CINAHL, Scopus, PubMed and the Cochrane Library. Six studies were included in this review. The results suggested that there is inconclusive evident to support the use of non-slip socks to prevent falls among hospitalized older adults. Non-slip socks do not possess the properties of adequate footwear and have the potential to spread infection. The patient's personal footwear from home is the safest footwear option while admitted into hospital.

People are failing! Something needs to be done: Canadian students' experience with the NCLEX-RN

BACKGROUND

Canada's nurse regulators adopted the NCLEX as the entry-to-practice licensing exam for Canada's registered nurses effective January 2015. It is important to determine whether any issues from this change emerged for nursing students in preparing for and taking this new exam.

OBJECTIVES

To explore the experiences of Canadian graduate student nurses who were the first to write the NCLEX examination for entry to practice in Canada, determine whether any issues with implementation were identified and how these could be addressed.

DESIGN

A qualitative study.

METHODS

Thematic analysis of semi-structured interview data obtained through interviews with 202 graduate Canadian nursing students was the methodology employed in this study.

RESULTS

The predominant theme that emerged from the interview data was policy related issues that students identified with preparing for and taking the NCLEX. Sub-themes included: a) temporary test centre concerns, b) perceptions of American context and content on the exam, c) lack of French language resources and translation issues, d) the limited number of opportunities to write the exam, e) communication and engagement with regulators, f) financial costs incurred and g) reputational costs for the Canadian nursing profession.

CONCLUSIONS

The experiences of study participants with NCLEX implementation in Canada were less than positive. This is of critical importance given the pass rates for first-time NCLEX writers in Canada were reported as 69.7%, substantially lower than pass rates on the previous Canadian entry-to-practice exam.

Preceptor characteristics and the socialization outcomes of new graduate nurses during a preceptorship programme

AIM

The purpose of this study was to explore the relationships between preceptor characteristics (emotional intelligence, personality and cognitive intelligence) and new graduate nurse socialization outcomes regarding turnover intent, job satisfaction, role conflict and ambiguity during a preceptorship programme. To date, no studies have explored these relationships.

DESIGN

A cross-sectional and multi-site design with purposeful sampling.

METHODS

Dyads of preceptors and new nurses were recruited at the end of their preceptorship programme. Pearson's correlational analysis was used to examine the relationships.

RESULTS

A sample of 41 preceptors and 44 new graduate nurses participated in this study, making 38 dyads with complete data. The preceptor personality traits of openness, conscientiousness and emotional stability were significantly related to new graduate nurses who reported greater turnover intent, job dissatisfaction, role conflict and ambiguity. No significant relationships were noted between preceptor EI and IQ and the outcome of new graduate nurses.

Stemming the flow of Canadian nurse migration to the US

The migration of nurses from Canada to the United States has occurred for decades, although substantial increases have been noted since the 1990s. A survey of 4,295 Canadian-educated nurses in the US identified that this trend in mobility is largely unchanged. Almost half the nurses in this study migrated to the US in search of full-time work, often after unsuccessfully seeking employment here in Canada prior to leaving. Incentives to migrate were provided, although the opportunity for full-time work was often perceived as an incentive to move. While some intent to return is apparent, this is unlikely to occur given the levels of satisfaction with work and the high value attributed to Canadian nurses by US employers. Policy makers and nurse leaders are urged to use these data to formulate strategies aimed at retaining Canada's nurses in this country.

LPN perspectives of factors that affect nurse mobility in Canada

Although the licensed practical nurse (LPN) workforce represents an ever-growing and valuable human resource, very little is known about reasons for practical nurse mobility. The purpose of this study was to describe LPN perspectives regarding motives for inter-provincial/territorial (P/T) movement in Canada. Participants included 200 LPNs from nine P/T, and data were analyzed using a qualitative descriptive approach. Three primary themes were identified regarding motivators for LPN migration, including (a) scope of practice, (b) education and advancement opportunities and (c) professional respect and recognition. Although current economic forces have a strong influence on nurse mobility, these findings emphasize that there are other equally important factors influencing LPNs to move between jurisdictions. As such, policy makers, administrators and researchers should further explore and address these themes in order to strengthen Canada's nursing workforce.

Mapping nurse mobility in Canada with GIS: career movements from two Canadian provinces

Recent years have witnessed the publication of a growing number of studies of nursing which, from a disciplinary perspective, are geographical in their orientation. Conceptually, while the emphasis in much of this research has been focused at the micro scale on the dynamics between nursing and "place," curiously there has been scant attention to geometrical "space," and the basic yet important locational and distributive features of nursing at the macro scale. Noting this gap in the literature, the authors of this paper used a Geographical Information System (GIS) to map the movement of 199 nurses from two Canadian provinces where they were educated - Manitoba and Newfoundland - to the provinces where they currently live and work. While the findings show that nurses who move tend to move to nearby provinces, more generally they illustrate the effectiveness of GIS for managing data and representing findings from workforce studies.

Factors that influence career decisions in Canada's nurses

Understanding the experiences of nurses who have moved between the provinces and territories (P/T) in Canada for work provides insight into the role of professional socialization in career decision-making. This paper analyzes some of the qualitative data arising from a survey of nurses from across Canada. The findings provide insight into nurses' professional socialization and demonstrate that early perceptions and expectations of nursing practice can influence future career decisions such as mobility and intent to remain. Participants described how "caring" and direct patient contact were central to their choice of nursing and career satisfaction. As the data reveal, nursing is also regarded as a career that enables mobility to accommodate both family considerations and professional development opportunities. The findings highlight the need for professional socialization strategies and supports that motivate Canadian nurses to continue practising within the profession and the country.

I was never recruited: challenges in cross-Canada nurse mobility

The internal migration of nurses within Canada has had limited study. This paper reports the results of a survey of registered nurses and licensed practical nurses who had migrated between the provinces and territories in Canada. Factors contributing to internal nurse mobility included seeking full-time work, opportunities for career advancement and flexible scheduling options. Few nurses received incentives to move between the provinces/territories to work. A number of challenges with internal migration are identified, including complexities related to licensing and limitations in available job information. Implications for nursing health human resources policy related to nurse retention in Canada are identified and discussed.

Support and access for nursing continuing education in Canadian work environments

The purpose of this study was to explore how educational opportunities may affect nurses' decision to move within Canada. Thematic analysis of qualitative data obtained from 35 registered nurses and 35 licensed practical nurses highlighted educational opportunities available in Canada and how these influence nurses' decision to move across the country for work. The results indicate that Canadian nurses value continued learning but face several barriers while trying to further their education. Two main themes emerged: support for and access to continuing education. Canadian nurses perceive a lack of support, both financially and in the form of scheduling, for engaging in continuing education. Additionally, the lack of access to accredited continuing education programs was reported. The findings and implications of this study are examined within the context of nurse mobility.

Isozyme Variation among 40 Frankia Strains

Forty Frankia strains belonging to the Alnus and Elaeagnus host specificity groups and isolated from various plant species from different geographical areas were characterized by the electrophoretic separation of isozymes of eight enzymes. All the enzyme systems that were investigated showed large variation. Diaphorases and esterases gave multiple band patterns and confirmed the identification of specific Frankia strains. Less variability was observed with enzymes such as phosphoglucose isomerase, leucine aminopeptidase, and malate dehydrogenase, which allowed for the delineation of larger groups of Frankia strains. Cluster analysis, based on the pair-wise similarity coefficients calculated between strains, delineated three large, dissimilar groups of Frankia strains, although each of these groups contained a large amount of heterogeneity. However, numerous Frankia strains, mainly from the Alnus host specificity group, demonstrated a perfect homology for all the enzymes tested.

A Systematic Approach to Improve Lipids in Coronary Artery Disease Patients Participating in a Cardiac Rehabilitation Program

PURPOSE

To determine the effectiveness of an intervention, directed toward the primary care physician (PCP), to improve the number of patients treated to low-density lipoprotein cholesterol (LDL-C) goal in a cardiac rehabilitation (CR) population.

METHODS

A pre-post intervention cohort comparison using data collected from participants in a CR program with LDL-C > or =100 mg/dL at entry. The control cohort participated in CR between 1/00 and 10/02, 41.5% (n = 178) had an entry LDL-C > or =100 mg/dL. The intervention cohort participated in CR between 10/03 and 1/05, 26.4% (n = 67) had an entry LDL-C > or =100 mg/dL. The intervention group had identical treatment as the control group as well as the following: each participant with an LDL-C > or =100 mg/dL in the intervention cohort had an entry letter sent to his or her cardiologist and PCP from the programs Cardiology Medical Director, detailing the lipid goals and therapeutic options. In addition, monthly faxes on progress toward lipid goals were sent to the PCP.

RESULTS

The control cohort was less likely to achieve LDL-C goal compared with the intervention cohort (43% vs 67%, respectively; P = .001). A patient was also less likely to have a lipid medication change during CR in the control group compared with the intervention group (29% vs 42%, respectively; P = .05).

CONCLUSION

Use of systematic reminders directed at the PCP during CR can substantially increase the percentage of patients achieving nationally recognized LDL-C goals.

Decision making for nurse staffing: Canadian perspectives

The effectiveness of methods for determining nurse staffing is unknown. Despite a great deal of interest in Canada, efforts conducted to date indicate that there is a lack of consensus on nurse staffing decision-making processes. This study explored nurse staffing decision-making processes, supports in place for nurses, nursing workload being experienced, and perceptions of nursing care and outcomes in Canada. Substantial information was provided from participants about the nurse staffing decision-making methods currently employed in Canada including frameworks for nurse staffing, nurse-to-patient ratios, workload measurement systems, and "gut" instinct. A number of key themes emerged from the study that can form the basis for policy and practice changes related to determining appropriate workload for nursing in Canada. These include the use of (a) staffing principles and frameworks, (b) nursing workload measurement systems, (c) nurse-to-patient ratios, and (d) the need for uptake of evidence related to nurse staffing.