Scoping review protocol examining charge nurse skills: requirement for the development of training

INTRODUCTION

The charge nurse (CN) holds a position in clinical-administrative management and is essential for improving the quality and safety of care in healthcare institutions. The position requires five essential skills: leadership; interpersonal communication; clinical-administrative caring; problem solving; and knowledge and understanding of the work environment. The scientific literature has not widely examined the importance of providing these skills as part of initial training, nor when CNs begin their duties. This study aims to fill this gap through an exhaustive review of the literature with the aim of developing standardised training for the CN when they start in their position.

METHODS AND ANALYSIS

A scoping review using the Joanna Briggs Institute framework will be conducted. The CINAHL, MEDLINE, Science Direct and Cairn, databases as well as grey literature from ProQuest dissertations and thesis global database, Google Scholar and the website of the Order of Nurses of Quebec will be queried using keywords. Relevant literature in French and English, published between 2000 and 2022 will be retained. The CN is the target population. Outcomes address at least one of the five CN skills, describe how they are operationalised and what their impact is on the organisation of work and quality of care. This analysis will identify essential and relevant elements for the development of standardised, up-to-date and appropriate training for the position of CN.

ETHICS AND DISSEMINATION

Ethical approval is not required, as data does not include individual patient data. The results will be published in peer-reviewed journals, presented at conferences and presented to nursing managers and directors.

SCOPING REVIEW REGISTRATION

Research Registry ID: researchregistry7030.

Associations between lean maturity in primary care and musculoskeletal complaints among staff: a longitudinal study

OBJECTIVE

This study had two aims: (1) to determine the prevalence of musculoskeletal complaints among staff in primary care and (2) to determine to what extent lean maturity of the primary care unit can predict musculoskeletal complaints 1 year later.

DESIGN

Descriptive, correlational and longitudinal design.

SETTING

Primary care units in mid-Sweden.

PARTICIPANTS

In 2015, staff members responded to a web survey addressing lean maturity and musculoskeletal complaints. The survey was completed by 481 staff members (response rate 46%) at 48 units; 260 staff members at 46 units also completed the survey in 2016.

OUTCOME MEASURES

Associations with musculoskeletal complaints were determined both for lean maturity in total and for four Lean domains entered separately in a multivariate model, that is, philosophy, processes, people and partners, and problem solving.

RESULTS

The shoulders (12-month prevalence: 58%), neck (54%) and low back (50%) were the most common sites of 12-month retrospective musculoskeletal complaints at baseline. Shoulders, neck and low back also showed the most complaints for the preceding 7 days (37%, 33% and 25%, respectively). The prevalence of complaints was similar at the 1-year follow-up. Total lean maturity in 2015 was not associated with musculoskeletal complaints, neither cross-sectionally nor 1 year later, for shoulders (1 year β: -0.002, 95% CI -0.03 to 0.02), neck (β: 0.006, 95% CI -0.01 to 0.03), low back (β: 0.004, 95% CI -0.02 to 0.03) and upper back (β: 0.002, 95% CI -0.02 to 0.02).

CONCLUSION

The prevalence of musculoskeletal complaints among primary care staff was high and did not change within a year. The extent of lean maturity at the care unit was not associated with complaints among staff, neither in cross-sectional analyses nor in a 1-year predictive analysis.

Determining the key performance indicators of human resource management of military hospital managers; a TOPSIS study

BACKGROUND

Proper human resource management in military health centers leads to long-term development and improved health-care quality. As a result, the purpose of this research is to identify the key performance indicators of human resource management for military hospital managers, and the unique indicators of military hospitals were obtained.

METHODS

This cross-sectional study was performed by the TOPSIS method in the fall of 2021. This study used a checklist consisting of 20 performance indicators of human resource management, which were scored by 20 senior military hospital managers based on two criteria: "importance" and "measurability in military hospitals". The Shannon entropy method was used to weight the indicators, and the BT-TOPSIS Solver software was used to analyze and prioritize them.

RESULTS

Among the 20 indicators in human resource management, the staff satisfaction index in military hospitals, the competitiveness rate of salaries in military hospitals relative to the national sector, the number of permanent staff in military hospitals, and the percentage of contract labor costs in military hospitals have the highest coefficient, respectively.

CONCLUSIONS

The importance of human resource management and organizational performance is due to their influence on each other. As a result, human resource management should pay special attention to the professional and personal development of human resources, as this has an impact on the performance of the organization in the long run. In light of the sensitive nature of human resource management and its crucial role in achieving any organization's strategic goals, selecting appropriate indicators is essential. The Department of Military Health requires indicators unique to the military sector to assess the human resource management of the military hospital, since according to the existing circumstances, the indicators of the military sector and those of the civilian sector are different.

Proactive career management for female health professionals: a scoping review protocol

INTRODUCTION

Many women in frontline healthcare positions face work demands that are incompatible with their needs and aspirations, resulting in poorer work satisfaction and engagement, and greater probability of leaving their jobs. Proactive career management is associated with elevated well-being and career success but may not be accessible to female health professionals who encounter social, cultural and structural barriers. The complex and diverse nature of proactive career management and absence of a comprehensive review on the topic necessitates a synthesis of extant literature. This study aims to identify (i) proactive career management behaviours and activities among female health professionals and (ii) outcomes of proactive career management initiatives. This study will contribute to a larger study on encouraging proactive career management behaviours among Singapore female health professionals.

METHODS AND ANALYSES

Scoping review is used as our method of evidence synthesis to provide a comprehensive overview of all available constructs and markers of interest. This study started in January 2022. Original research, reviews, short reports, letters, methodologies and case studies relevant to our objectives will be examined with guidance from Arksey and O'Malley's framework. The literature contained in scientific databases and grey literature sources will be thoroughly searched. Two independent reviewers will screen citations for eligibility and extract data from the included articles. Extracted data will be narratively synthesised by two independent reviewers using Braun and Clarke's six steps of thematic analysis. We will observe the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews standards in reporting the results. An advisory panel will provide insights on the applicability of the results to negate confirmation bias.

ETHICS AND DISSEMINATION

Ethics clearance is not required. Dissemination plans include peer-reviewed journal publication and conference presentations.

REGISTRATION DETAILS

This review was registered on open science framework (Registration DOI: https://doi.org/10.17605/OSF.IO/2SY8V).

A mixed-methods evaluation of unconscious racial bias training for NHS senior practitioners to improve the experiences of racially minoritised students

OBJECTIVE

The degree awarding gap indicates that racially minoritised higher education students receive lower degree classifications relative to their white peers. While the reasons for this are complex, research suggests that educator and practitioner attitudes and behaviour towards racially minoritised students are a significant contributing factor. This preregistered study evaluates the effectiveness of unconscious racial bias training (URBT) to enhance National Health Service senior practitioner's recognition of how racial inequalities negatively impact racially minoritised students.

DESIGN

A mixed-methods study with a pretest and post-test design was conducted in the higher education and healthcare practice environment.

METHODS

Forty-nine NHS senior practitioners completed a 4-hour URBT workshop with activities focusing on activating stereotypes, exploring differences between unconscious and implicit bias, discussing the development of bias, and reflecting on student experiences of prejudice, harassment and discrimination. They completed pre- and post- quantitative measures that assessed the effectiveness of URBT and changes in racial competency, awareness and perceptions of unconscious racial bias. Qualitative measures explored the usefulness and perceived applications of URBT, and a 1-month follow-up assessed further how it had been applied within practice.

RESULTS

Participants reported positive evaluations of URBT, higher perceived racial competency, awareness and perceptions of racial bias (ps<0.001, dz>0.35). After 1 month, key themes from qualitative responses suggested that participants had increased self-awareness and were exploring how to set up mentoring and working groups, change recruitment and progression processes, and diversify the taught curriculum.

CONCLUSIONS

URBT may be one effective strategy to enhance awareness and encourage reflections of racial bias. We discuss how reducing racial inequalities requires a multifaceted approach that affords upfront conversations about systemic racism, implements effective initiatives, policies and procedures, and engages in continuous evaluation.

Remote work and the COVID-19 pandemic: An artificial intelligence-based topic modeling and a future agenda

As remote work has become more common than ever throughout the COVID-19 pandemic, it has drawn special attention from scholars. However, the outcome has been significantly sporadic and fragmented. In our systematic review, we use artificial intelligence-based machine learning tools to examine the relevant extant literature in terms of its dominant topics, diversity, and dynamics. Our results identify-eight research themes: (1) Effect on employees at a personal level, (2) Effect on employees' careers, (3) Family life and gender roles, (4) Health, well-being, and safety, (5) Labor market dynamics, (6) Economic implications, (7) Remote work management, (8) Organizational remote work strategies. With further content analysis, we structure the sporadic research into three overarching categories. Finally, for each category, we offer a detailed agenda for further research.

Impact of intrawork rest breaks on doctors' performance and well-being: systematic review

OBJECTIVES

To summarise evidence on intrawork breaks and their associated effect on doctors' well-being and/or performance at work.

DESIGN

Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement guidelines DATA SOURCES: Embase, PubMed, Web of Science (Core Collection) and PsychINFO were systematically searched on 6 June 2021.

ELIGIBILITY CRITERIA

No restrictions were placed on language, study design or date of publication.

DATA EXTRACTION AND ANALYSIS

Methodological quality was appraised using Cochrane's Risk of Bias (ROB-2), Cochrane's Risk of Bias in Non-randomised Studies (ROBINS-I), and the Johanna Briggs Institute (JBI) checklists for cross-sectional, cohort and qualitative studies. Quantitative synthesis was not undertaken due to substantial heterogeneity of design and outcomes. Results are presented narratively.

RESULTS

Database searches returned 10 557 results and searches of other sources returned two additional records. Thirty-two papers were included in the systematic review, comprised of 29 unique studies, participants and topics and 3 follow-up studies. A variety of well-being and performance outcome measures were used. Overall, findings indicate that intrawork breaks improved some measures of well-being and/or work performance. However, methodological quality was judged to be low with a high risk of bias in most included studies.

DISCUSSION

Using existing evidence, it is not possible to conclude with confidence whether intrawork breaks improve well-being and/or work performance in doctors. There is much inconsistency regarding how breaks are defined, measured and the outcomes used to assess effectiveness. Future research should seek to: (a) define and standardise the measurement of breaks, (b) use valid, reliable outcome measures to evaluate their impact on well-being and performance and (c) minimise the risk of bias in studies where possible.

PROSPERO REGISTRATION NUMBER

CRD42020156924; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=156924.

Understanding the trends, and drivers of emigration, migration intention and non-migration of health workers from low-income and middle-income countries: protocol for a systematic review

INTRODUCTION

The WHO estimates a shortage of 18 million health workers (HWs) by 2030, primarily in low-income and middle-income countries (LMICs). The perennial out-migration of HWs from LMICs, often to higher-income countries, further exacerbates the shortage. We propose a systematic review to understand the determinants of HWs out-migration, intention to migrate and non-migration from LMICs.

METHODS AND ANALYSIS

This protocol was designed in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols guideline for the development and reporting of systematic review protocols. We will include English and French language primary studies (quantitative or qualitative) focused on any category of HWs; from any LMICs; assessed migration or intention to migrate; and reported any determinant of migration. A three-step search strategy that involves a search of one electronic database to refine the preliminary strategy, a full search of all included databases and reference list search of included full-text papers for additional articles will be employed. We will search Ovid MEDLINE, EMBASE, CINAHL, Global Health and Web of Science from inception to August 2022. The retrieved titles will be imported to EndNote and deduplicated. Two reviewers will independently screen all titles and abstract for eligibility using Rayyan. Risk of bias of the individual studies will be determined using the National Institute of Health study quality assessment tools for quantitative studies and the 10-item Critical Appraisal Skills Programme checklists for qualitative studies. The results will be presented in the form of narrative synthesis using a descriptive approach ETHICS AND DISSEMINATION: We will not seek ethical approval from an institutional review board, as this is a systematic review. At completion, we will submit the report of this review to a peer-reviewed journal for publication. Key findings will be presented at local and international conferences.

PROSPERO REGISTRATION NUMBER

CRD42022334283.

Effective machine learning, Meta-heuristic algorithms and multi-criteria decision making to minimizing human resource turnover

Employee turnover is one of the most important issues in human resource management, which is a combination of soft and hard skills. This makes it difficult for managers to make decisions. In order to make better decisions, this article has been devoted to identifying factors affecting employee turnover using feature selection approaches such as Recursive Feature Elimination algorithm and Mutual Information and Meta-heuristic algorithms such as Gray Wolf Optimizer and Genetic Algorithm. The use of Multi-Criteria Decision-Making techniques is one of the other approaches used to identify the factors affecting the employee turnover in this article. Our expert has used the Best-Worst Method to evaluate each of these variables. In order to check the performance of each of the above methods and to identify the most significant factors on employee turnover, the results are used in some machine learning algorithms to check their accuracy in predicting the employee turnover. These three methods have been implemented on the human resources dataset of a company and the results show that the factors identified by the Mutual Information algorithm can show better results in predicting the employee turnover. Also, the results confirm that managers need a support tool to make decisions because the possibility of making mistakes in their decisions is high. This approach can be used as a decision support tool by managers and help managers and organizations to have a correct insight into the departure of their employees and adopt policies to retain and optimize their employees.

How sustainable human resources management helps in the evaluation and planning of employee loyalty and retention: Can social capital make a difference?

Researchers establish that the current challenges of human resources management to attract and retain talent are based on fostering and increasing the participation of relationships with employees and sustainably managing the organization and teams. The objective of this article is to evaluate the effect that sustainable human resource management has on social capital, and employee retention and loyalty programs. The information required to carry out the empirical analysis was obtained from an online survey to Spanish universities. Data processing was conducted by using the PLS-SEM technique. The results obtained show that social sustainability actions influence the social capital perceived by employees significantly and that social capital influences their loyalty and retention significantly. However, we found that social sustainability actions influence employee loyalty and retention significantly and positively only when it mediates between social capital. This research contributes to the management of organizations and suggests human capital managers to have a greater relational management of human resources in the connection, involvement and transparency of their social sustainability actions in order to achieve greater loyalty and retention ratios, better performance of the organization and, in general, a greater benefit for society.

Complications with hot, cold and altitude environments in disaster management

INTRODUCTION

Disaster management is the process of preparing, responding and recovering to an emergency whether that be natural or man-made. It is a time-consuming, resource-heavy process with the aim of reducing the risk of certain events and, where not possible, reducing the impact of said disaster, ensuring that the risks have been identified and appropriate rescue and recovery plan is in place.

METHODS

We carried out a thorough literature search on the complications of hot, cold and altitude environments in disaster management and distilled the learnings into this article.

RESULTS

The incidence of disasters of natural, man-made and complex origin is likely to continue increasing as global temperatures continue to rise.

CONCLUSION

Disaster management in the extreme environments of hot, cold and high altitude is fraught with unique challenges, especially around the physiological response of rescuers, resource constraints and logistics. Recognising these challenges is an important aspect of planning and preparation for disaster management in these environments.

Administration approaches of nursing assistants in hospitals: a scoping review

OBJECTIVES

The administration of nursing assistants (NAs) is closely associated with patient outcomes, but studies evaluating intrahospital administration of NAs are limited. This study aimed to identify existing literature on intrahospital NAs' administration approaches.

DESIGN

Scoping review.

DATA SOURCES

PubMed, Embase, CINAHL, Scopus, ProQuest, CNKI, APA PsycInfo, Wanfang Med, SinoMed, Ovid Emcare, NICE, AHRQ, CADTH, JBI EBP and Cochrane DSR were searched for articles published between January 2011 and March 2022.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Qualitative, quantitative or mixed-method studies and evidence syntheses that evaluate administration approaches, models and appraisal tools of intrahospital NAs were included.

DATA EXTRACTION AND SYNTHESIS

Two independent reviewers conducted search, data selection and data extraction according to Joanna Briggs Institute guidance and methodology for scoping review. The quality of included studies was assessed using Mixed Methods Appraisal Tool or AMSTAR V.2. Data were synthesised using narrative methods and frequency effect size analysis.

RESULTS

Thirty-six studies were eligible, with acceptable quality. We identified 1 administration model, 9 administration methods, 15 educational programmes and 7 appraisal tools from the included studies. The frequency effect size analysis yielded 15 topics of the main focus at four levels, suggesting that included articles were mainly (33%) focused on the competency of NAs, and the lectures were the most (80%) used strategy in quality improvement projects. Evidence from the studies was of low-to-moderate quality, indicating huge gaps between evidence-based research and management practice.

CONCLUSIONS

Practical intrahospital administration approaches were revealed, and fifteen primarily focused topics were identified. We should explore this area more thoroughly using structured frameworks and standardised methodology. This scoping review will help managers find more effective ways to improve the quality of care. Researchers may focus more on evidence-based practice in NA administration using the 15 topics as a breakthrough.

Quality of working life of medical doctors and associated risk factors: a cross-sectional survey in public hospitals in China

OBJECTIVES

To assess the quality of working life (QWL) of medical doctors and associated risk factors.

SETTING AND PARTICIPANTS

A cross-sectional questionnaire survey of 2915 medical doctors from 48 hospitals was conducted in China.

METHODS

The QWL-7-32 scale was adopted to assess seven domains of QWL: physical health, mental health, job and career satisfaction, work passion and initiative, professional pride, professional competence, and balance between work and family.

PRIMARY AND SECONDARY OUTCOME MEASURES

Data were analysed using SPSS V.19.0. Analysis of variance tests and multivariate linear regression analyses were performed to identify the sociodemographic characteristics and job factors associated with overall QWL and its seven subdomain scores.

RESULTS

On average, the respondents reported an overall QWL score of 92.51 (SD=17.74) of a possible 160. Over 35% of respondents reported more than 60 hours of weekly working time; 59.9% experienced night sleep deprivation frequently; 16.6% encountered workplace violence frequently. The multivariate regression models revealed that the eastern region (β≤-2.887 for non-eastern regions, p<0.001), shorter working hours (β≤-2.638 for over 40 hours a week, p<0.01), less frequent night sleep deprivation (β≤-5.366 for sometimes or frequent, p<0.001), higher income (β≥2.795 for lower income, p<0.001) and less frequent encounters of workplace violence (β≤-9.267 for sometimes or frequent, p<0.001) were significant predictors of higher QWL. Night sleep deprivation and workplace violence were common predictors (p<0.05) for all seven domains of QWL.

CONCLUSION

The low QWL of medical doctors working in public hospitals in China is evident, which is associated with high workloads, low rewards and workplace violence. There are also significant regional differences in the QWL of medical doctors, with the eastern developed region featuring better QWL. Public hospitals in China are facing serious challenges in occupational health and safety, which needs to be addressed through a systems approach.

Perceived job demands: a qualitative study of workplace stress in the Iranian healthcare workers (HCWs)

OBJECTIVES

Work-related stress is a common risk factor among healthcare workers (HCWs). In Iran, the healthcare system has undergone extensive changes to develop services. Organisational change has led to the creation of new working conditions for HCWs. The purpose of this study is to identify job demands that health workers perceive as stressors.

DESIGN

As a qualitative study, semistructured interviews, a focus group, and related data were analysed both inductively and deductively with reference to the job demand component based on the job demands-resources model and MAXQDA.

SETTING

This investigation was conducted in 18 primary healthcare centres in Qazvin, Iran.

PARTICIPANT

Twenty-one female HCWs with at least 6 months of work experience and an average age of 34.4 years.

RESULTS

The participants identified six key elements as the stressful job demands including organisation's supervisory function, role characteristics, workload, job insecurity, client service challenges and perceived job content.

CONCLUSIONS

After organisational changes and development, HCWs were faced with role changes and increased workload. In addition, organisational supervision in terms of quantity and quality and lack of job security intensified the pressures. These factors led to the high level of stress among employees who dealt with people and those who perceived their job content as unfavourable. Perhaps teaching stress control skills and organisational support interventions can be useful to reduce and control stress among HCWs.

Less than full-time training (LTFT), is this the new norm? A cross-sectional study using a UK-wide online survey to evaluate trainees' views and intentions for LTFT

OBJECTIVES

Interest in less than full-time training (LTFT) is growing among doctors in training. LTFT applications have previously been limited to fulfilment of specific criteria such as childcare or health reasons, but Health Education for England (HEE) has recently completed a pilot into LTFT for a third category: lifestyle choice. This was recognised as an opportunity to canvas trainee perspectives and intentions on LTFT and implications for workforce planning.

DESIGN

A cross-sectional study of UK trainees via an online questionnaire.

SETTING/PARTICIPANTS

The survey was distributed via email to trainees in all specialities and stages of training across the UK. The survey focused on three key themes: experiences of current LTFT trainees, perspectives of trainees considering LTFT in the future and experience of working with LTFT colleagues.

RESULTS

Responses were received from 783 trainees across the UK, with most responses received from physician trainees (76%). Current LTFT trainees represented one-third of respondents. Of those not currently working LTFT, 75% expressed an intention to do so in future with lifestyle being the most common reason. Almost half of this group were concerned about the impact on their training. Stigma, reduced training opportunities, prolonged training and the application process were commonly cited barriers. These difficulties were experienced by several current LTFT trainees, 32% of whom described a negative impact on their training. Almost two-thirds (62%) of respondents stated they wish to work LTFT as a consultant.

CONCLUSION

Systems must adapt to increase access to LTFT training to promote trainee well-being and retention. Progress is being made and we suggest HEE's category three pilot be rolled out across the UK as a priority. Workforce planning needs to consider the substantial rise in popularity of LTFT among trainees to offset any shortfalls in the present and future workforce.

Lean, agile, resilient, and green human resource management: the impact on organizational innovation and organizational performance

There are four paradigms of lean, agile, resilient, and green (LARG) which can promote human resource culture to create novel ideas and increase performance in organizations. This study aims to conceptualize, develop, and validate four lean, agile, resilient, and green paradigms in human resource management (HRM) context and investigates how different LARG HRM elements can affect organizational innovation and performance. In this way, a conceptual model for investigating the LARG concept in HRM is proposed. A new tool to measure lean, agile, resilient, and green indicators in service industry has been developed. Using convenience sampling method, an online survey questionnaire is managed to collect data from 102 service sector organizations, including banking and financial services, transportation, hotel, telecom, and insurance, having more than 50 employees in Iran. The collected data are analyzed by partial least squares-structural equation modeling (PLS-SEM). The results indicate that the LARG HRM significantly and positively influences organizational performance. In addition, the LARG HRM indirectly affects organizational performance through organizational innovation. The findings also showed that employee's ability to perform several different jobs from the lean paradigm, paying attention to employee's ideas in decision-making from the agile paradigm, increasing the ability of staff to change rules in different situations from the resilient paradigm, and having employees with a full understanding of environmental policies from the green paradigm, is the most effective elements among the LARG paradigms factors. This study provides valuable insights into recognizing the most effective LARG elements and factors for implementing the LARG HRM in organizations and how it contributes to enhancing organizational performance and organizational innovation in order to achieve competitive advantage.

Mediation role of work motivation and job satisfaction between work-related basic need satisfaction and work engagement among doctors in China: a cross-sectional study

OBJECTIVES

This study aims to examine the association of work-related basic need satisfaction (W-BNS) with doctors' work engagement and explore the mediating role of work motivation and job satisfaction between the two variables.

DESIGN

This was a cross-sectional study.

SETTING

The study was conducted in four public grade A tertiary hospitals in China.

PARTICIPANTS

A total of 1000 doctors were invited to participate; 849 doctors completed questionnaires validly.

PRIMARY AND SECONDARY OUTCOME MEASURES

Questionnaires were administered online and offline to collect data, consisting of six parts: social demographic characteristics, work-related characteristics, and scales related to W-BNS, work motivation, job satisfaction and work engagement. One-way analysis of variance, Pearson correlation analysis were performed using SPSS, and mediation analysis was carried out via PROCESS macro.

RESULTS

Our research showed that W-BNS, work motivation, job satisfaction and work engagement were positively correlated. Work engagement was significantly predicted by W-BNS (β＝0.15, p<0.001) through motivation at work (β＝0.23, p<0.001) and job satisfaction (β＝0.44, p<0.001), respectively. Compared with work motivation, the mediating effect of job satisfaction was stronger (95% CI -0.22 to -0.06).

CONCLUSION

The findings suggest that job satisfaction and work motivation may be important pathways through which doctors' W-BNS may influence their work engagement. In order to maintain and promote doctors' work engagement, hospital administrators should consider strengthening the internal motivation of doctors and improving their job satisfaction.

Relationship between job satisfaction, burnout syndrome and depressive symptoms in physicians: a cross-sectional study based on the employment demand-control model using structural equation modelling

OBJECTIVE

To evaluate the relationship between job satisfaction, burnout syndrome (BS) and depressive symptoms (DS) based on the job demand-control framework model on a nationally representative sample of physicians working in the Peruvian Health System.

SETTING

We carried out a secondary data analysis of the National Survey of Satisfaction of Users in Health 2016 in Peru.

PRIMARY AND SECONDARY OUTCOME MEASURES

Our study assessed the development of the predictive model and had two parts: (1) to evaluate the association among the variables based on the job demand-control framework, and (2) to assess the proposed model acceptability using the structural equation modelling approach to estimate goodness-of-fit indices (GOFIs).

PARTICIPANTS

We excluded physicians older than 65 years, who did not report income levels or who had missing data related to the workplace. Thus, we analysed 2100 participants.

RESULTS

The prevalence of DS was 3.3%. Physicians' work-related illnesses had more probability to result in DS (prevalence ratio=2.23). DS was moderately related to BS dimensions (r>0.50); nevertheless, the relationships between DS and the three job satisfaction scales were weak (r<0.30). The first predictive model based on the variables, DS, BS and job satisfaction, had low GOFIs (comparative fit index (CFI)=0.883; root mean square error of approximation (RMSEA)=0.125). In a second evaluation, we used models with correlated errors obtaining optimal GOFIs (CFI=0.974; RMSEA=0.060).

CONCLUSIONS

Our study identified a stable model to explain the relationship between job satisfaction, BS and DS among physicians. The results are consistent with the job demand-control framework. They could be applied to decision-making in occupational contexts in Latin American low/middle-income countries.

Influence of HRM on CSR and performance of upscale hotels in developed and developing countries

The researchers showed their increased interest in linking human resource management (HRM) and corporate social responsibility (CSR) practices in recent studies. HRM is a critical factor in how CSR should be enacted, developed, and understood at a broader level to achieve organizational benefits. Hence, it is evident that current studies are asking for more studies on HRM-CSR nexus, and we argue that such a relationship is necessary and relevant. Probing more in this research stream, the current research investigates the impact of HRM and CSR on sustainable performance. More specifically, this study explores how 3-star, 4-star, and 5-star hotels achieve sustainable performance through HRM and CSR in the hospitality industry of the UK, Italy, and Pakistan. A stratified random sampling technique was used to select the hotels by collecting hotel details from Chambers of the Commerce United Kingdom, Italian Government Statistics, and Pakistan Hotel Associations for the UK, Italy, and Pakistan. Through a highly structured survey questionnaire, the data were collected from 438 UK, 520 Italian, and 354 Pakistani hotels. The results confirm the HRM-CSR-sustainable performance nexus in the hospitality industries of three countries. They show that HRM impact on CSR and sustainable performance is relatively stronger in five-star hotels followed by three-star and then four-star hotels. These results supported the resource-based view theory by providing strong evidence that HRM and CSR are essential resources for achieving sustainable performance and competitive advantage.

Burnout and coping strategies among nurses in Malaysia: a national-level cross-sectional study

OBJECTIVE

This national-level study aimed to determine the prevalence and risk factors of burnout, as well as the coping strategies among nurses in the Ministry of Health (MOH) Malaysia.

DESIGN

Using a complex sampling design, a two-stage stratified cluster sampling was performed to recruit MOH nurses between August and November 2019.

SETTING AND PARTICIPANTS

A total of 2428 nurses from 32 hospitals and 28 district health offices answered the questionnaires based on Maslach Burnout Inventory for Human Services and Brief COPE. Complex sampling analysis was applied.

OUTCOME MEASURES

The outcome of interest was the prevalence of burnout and its three domains of emotional exhaustion (EE), depersonalisation (DP) and low personal accomplishment. ORs using 95% CIs were calculated. Significant factors at the univariate level were entered into the multivariate logistic regression to identify independent predictors of burnout.

RESULTS

One in four (24.4%) nurses experienced burnout. Younger, single, and childless nurses had a higher prevalence of burnout. Shift working nurses were 1.6 times more likely to develop burnout. Those who performed >6 night shifts per month were 1.5 times more predisposed to burnout (95% CI 1.01 to 2.36; p<0.05). While encountering traumatic events at work led to 4.2 times (95% CI 2.31, 7.63; p<0.05) higher risk of burnout, those who received post-traumatic psychological support were better protected. The use of dysfunctional coping strategies was detrimental as it was positively correlated with EE and DP.

CONCLUSION

Addressing modifiable stressors of burnout at individual and institutional levels identified in this study can be potentially beneficial in reducing burnout and its undesirable effects among nurses. Interventions that promote positive coping strategies should be implemented. Organisational-driven efforts must target the improvement of work schedules for nurses and the establishment of a structured debriefing service for post-trauma counselling.

Why do ambulance employees (not) seek organisational help for mental health support? A mixed-methods systematic review protocol of organisational support available and barriers/facilitators to uptake

INTRODUCTION

The COVID-19 pandemic is exacerbating a wide range of symptoms of poor mental health among emergency medical service (EMS) ambulance populations. Evidence suggests that using organisational support can improve employee outcomes and in turn, patient outcomes. Understanding why EMS staff do and do not use support services is therefore critical to improving uptake, ensuring equitable access, and potentially influencing workforce well-being, organisational sustainability and patient care delivery. This systematic review aims to identify what support is available and any perceived barriers and facilitators to accessing and utilising organisational support.

METHODS AND ANALYSIS

Searches performed between 18 February 2022 and 23 February 2022 will be used to identify studies that report barriers and facilitators to EMS employee support among all government/state commissioned EMS ambulance systems. Electronic databases, AMED, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, EMBASE, EMCARE, HMIC, Medline and PsycINFO will be searched. All relevant English-language studies of adult employees of government/state commissioned EMS ambulance organisations published since December 2004 will be screened and relevant data extracted by two independent reviewers. A third reviewer will resolve any disagreements.The primary outcome is the identification of perceived barriers or facilitators to EMS staff using organisational support for mental health. The secondary outcome is the identification of supportive interventions offered through or by ambulance trusts. Study selection will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the methodological quality of included studies will be appraised by administering rating checklists. A narrative synthesis will be conducted to report qualitative and quantitative data and will include population characteristics, methodological approach and information about barriers and facilitators.

ETHICS AND DISSEMINATION

Ethical approval is not required because only available published data will be analysed. Findings will be disseminated through peer-reviewed publication and conference presentation.

PROSPERO REGISTRATION NUMBER

CRD42022299650.

Key learnings from an outcome and embedded process evaluation of a direct to beneficiary mobile health intervention among marginalised women in rural Bihar, India

INTRODUCTION

Mobile Vaani was implemented as a pilot programme across six blocks of Nalanda district in Bihar state, India to increase knowledge of rural women who were members of self-help groups on proper nutrition for pregnant or lactating mothers and infants, family planning and diarrhoea management. Conveners of self-help group meetings, community mobilisers, introduced women to the intervention by giving them access to interactive voice response informational and motivational content. A mixed methods outcome and embedded process evaluation was commissioned to assess the reach and impact of Mobile Vaani.

METHODS

The outcome evaluation, conducted from January 2017 to November 2018, used a quasi-experimental pre-post design with a sample of 4800 married women aged 15-49 from self-help group households, who had a live birth in the past 24 months. Surveys with community mobilisers followed by meeting observations (n=116), in-depth interviews (n=180) with self-help group members and secondary analyses of system generated data were conducted to assess exposure and perceptions of the intervention.

RESULTS

From the outcome evaluation, 23% of women interviewed had heard about Mobile Vaani. Women in the intervention arm had significantly higher knowledge than women in the comparison arm for two of seven focus outcomes: knowledge of how to make child's food nutrient and energy dense (treatment-on-treated: 18.8% (95% CI 0.4% to 37.2%, p<0.045)) and awareness of at least two modern spacing family planning methods (treatment-on-treated: 17.6% (95% CI 4.7% to 30.5%, p<0.008)). Women with any awareness of Mobile Vaani were happy with the programme and appreciated the ability to call in and listen to the content.

CONCLUSION

Low population awareness and programme exposure are underpinned by broader population level barriers to mobile phone access and use among women and missed opportunities by the programme to improve targeting and programme promotion. Further research is needed to assess programmatic linkages with changes in health practices.

Impacts of economic inequality on healthcare worker safety at the onset of the COVID-19 pandemic: cross-sectional analysis of a global survey

OBJECTIVES

To assess the extent to which protection of healthcare workers (HCWs) as COVID-19 emerged was associated with economic inequality among and within countries.

DESIGN

Cross-sectional analysis of associations of perceptions of workplace risk acceptability and mitigation measure adequacy with indicators of respondents' respective country's economic income level (World Bank assessment) and degree of within-country inequality (Gini index).

SETTING

A global self-administered online survey.

PARTICIPANTS

4977 HCWs and healthcare delivery stakeholders from 161 countries responded to health and safety risk questions and a subset of 4076 (81.2%) answered mitigation measure questions. The majority (65%) of study participants were female.

RESULTS

While the levels of risk being experienced at the pandemic's onset were consistently deemed as unacceptable across all groupings, participants from countries with less income inequality were somewhat less likely to report unacceptable levels of risk to HCWs regarding both workplace environment (OR=0.92, p=0.012) and workplace organisational factors (OR=0.93, p=0.017) compared with counterparts in more unequal national settings. In contrast, considerable variation existed in the degree to which mitigation measures were considered adequate. Adjusting for other influences through a logistic regression analysis, respondents from lower middle-income and low-income countries were comparatively much more likely to assess both occupational health and safety (OR=10.91, p≤0.001) and infection prevention and control (IPC) (OR=6.61, p=0.001) protection measures as inadequate, despite much higher COVID-19 rates in wealthier countries at the time of the survey. Greater within-country income inequality was also associated with perceptions of less adequate IPC measures (OR=0.94, p=0.025). These associations remained significant when accounting for country-level differences in occupational and gender composition of respondents, including specifically when only female care providers, our study's largest and most at-risk subpopulation, were examined.

CONCLUSIONS

Economic inequality threatens resilience of health systems that rely on health workers working safely to provide needed care during emerging pandemics.

Assessment of core teaching competency of health professional educators in Ethiopia: an institution-based cross-sectional study

OBJECTIVES

Understanding the competency of educators is key to informing faculty development, recruitment and performance monitoring. This study aimed to assess the core teaching competency of nursing, midwifery and biomedical educators, and associated factors in Ethiopia.

DESIGN

An institution-based cross-sectional study was conducted in January 2020 using structured tools adapted from the WHO's nurse and midwifery educator competency frameworks.

SETTING

Two health science colleges and nine student practice sites in Ethiopia.

PARTICIPANTS

All classroom instructors and clinical preceptors of nursing, midwifery and biomedical technician training programmes, and all the graduating class students.

MEASURES

Overall teaching competency scores, teaching domain competency scores, competency gaps and performance gaps of educators were outcome measures. Past training on teaching skills courses, teaching experiences and sociodemographic characteristics of educators are associated factors.

RESULTS

Most educators were not trained in teaching methods (82%). The teaching competency scores of classroom instructors and clinical preceptors were 61.1% and 52.5%, respectively. Competency gaps were found in using active learning methods, performance assessment, feedback and digital learning. Professional background of classroom instructors had a significant and strong association with their competency score (p=0.004; V=0.507). Age and teaching experience of clinical preceptors had significant associations with their competency score (p=0.023 and p=0.007, respectively) and had strong associations (V=0.280 and 0.323, respectively). Sex of students and their perceptions of how well the educators give education resources had a significant and strong association (p<0.001; V = 0.429).

CONCLUSIONS

Nursing, midwifery and biomedical educators lacked the competency to undertake important teaching roles, which could contribute to the low quality of education. More attention should be given to strengthening faculty development.

Maternity service reconfigurations for intrapartum and postnatal midwifery staffing shortages: modelling of low-risk births in England

INTRODUCTION

Choice of birth setting is important and it is valuable to know how reconfiguring available settings may affect midwifery staffing needs. COVID-19-related health system pressures have meant restriction of community births. We aimed to model the potential of service reconfigurations to offset midwifery staffing shortages.

METHODS

We adapted the Birthrate Plus method to develop a tool that models the effects on intrapartum and postnatal midwifery staffing requirements of changing service configurations for low-risk births. We tested our tool on two hypothetical model trusts with different baseline configurations of hospital and community low-risk birth services, representing those most common in England, and applied it to scenarios with midwifery staffing shortages of 15%, 25% and 35%. In scenarios with midwifery staffing shortages above 15%, we modelled restricting community births in line with professional guidance on COVID-19 service reconfiguration. For shortages of 15%, we modelled expanding community births per the target of the Maternity Transformation programme.

RESULTS

Expanding community births with 15% shortages required 0.0 and 0.1 whole-time equivalent more midwives in our respective trusts compared with baseline, representing 0% and 0.1% of overall staffing requirements net of shortages. Restricting home births with 25% shortages reduced midwifery staffing need by 0.1 midwives (-0.1% of staffing) and 0.3 midwives (-0.3%). Suspending community births with 35% shortages meant changes of -0.3 midwives (-0.3%) and -0.5 midwives (-0.5%) in the two trusts. Sensitivity analysis showed that our results were robust even under extreme assumptions.

CONCLUSION

Our model found that reconfiguring maternity services in response to shortages has a negligible effect on intrapartum and postnatal midwifery staffing needs. Given this, with lower degrees of shortage, managers can consider increasing community birth options where there is demand. In situations of severe shortage, reconfiguration cannot recoup the shortage and managers must decide how to modify service arrangements.