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Crevacore C, Coventry L, Duffield C, Jacob E. Factors impacting nursing assistants to accept a delegation in the acute care settings: A mixed method study. J Clin Nurs 2024; 33:2153-2164. [PMID: 38556781 DOI: 10.1111/jocn.17127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 04/02/2024]
Abstract
AIMS To investigate the experience of nursing assistants being delegated nursing tasks by registered nurses. DESIGN Mixed method explanatory sequential design. METHODS A total of 79 nursing assistants working in an acute hospital in Australia completed surveys that aimed to identify their experience of working with nurses and the activities they were delegated. The survey data were analysed using descriptive statistics. Interviews with 11 nursing assistants were conducted and analysed using Braun and Clarke's thematic analysis. Results were triangulated to provide a richer understanding of the phenomena. RESULTS Most nursing assistants felt supported completing delegated care activities. However, there was confusion around their scope of practice, some felt overworked and believed that they did not have the right to refuse a delegation. Factors impacting the nursing assistant's decision to accept a delegation included the attitude of the nurses, wanting to be part of the team and the culture of the ward. Nursing assistants who were studying to be nurses felt more supported than those who were not. CONCLUSIONS Delegation is a two-way relationship and both parties need to be cognisant of their roles and responsibilities to ensure safe and effective nursing care is provided. Incorrectly accepting or refusing delegated activities may impact patient safety. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Highlights the need for implementing strategies to support safe delegation practices between the registered and unregulated workforce to promote patient safety. IMPACT Describes the experiences of nursing assistants working in the acute care environment when accepting delegated care from nurses. Reports a range of factors that inhibit or facilitate effective delegation practices between nurses and nursing assistants. Provides evidence to support the need for stronger education and policy development regarding delegation practices between nurses and unregulated staff. REPORTING METHOD Complied with the APA Style JARS-MIXED reporting criteria for mixed method research. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Carol Crevacore
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
- Centre for Research in Aged Care, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Linda Coventry
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
- Centre for Research in Aged Care, Edith Cowan University, Joondalup, Western Australia, Australia
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Christine Duffield
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Elisabeth Jacob
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
- Australian Catholic University, Fitzroy, Victoria, Australia
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Peisah C, Sheppard A, Benbow SM, Loughran-Fowlds A, Grayson S, Gunton JE, Kataria A, Lai R, Lele K, Quadrio C, Wright D, McLean L. Operationalising the Family-Friendly Medical Workplace and the Development of FAM-MED, a Family-Friendly Self-Audit Tool for Medical Systems: A Delphi Consensus. Healthcare (Basel) 2023; 11:1679. [PMID: 37372796 DOI: 10.3390/healthcare11121679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/02/2023] [Accepted: 06/04/2023] [Indexed: 06/29/2023] Open
Abstract
Globally, the call for Family-Friendly (FF) workplaces is loud and clear. However, this call is inaudible in medical workplaces, despite both well-established benefits of FF workplaces across businesses and well-known effects of work-family conflict on the well-being and practice of doctors. We aimed to use the Delphi consensus methodology to: (i) operationalise the Family-Friendly medical workplace and (ii) develop a Family-Friendly Self-Audit tool for medical workplaces. The expert medical Delphi panel was deliberatively recruited to capture a breadth of professional, personal, and academic expertise, diversity of age (35-81), life stage, family contexts and lived experience of dual commitments to work and family, and diversity of work settings and positions. Results reflected the inclusive and dynamic nature of the doctor's family and the need to adopt a family life cycle approach to FF medical workplaces. Key processes for implementation include holding firms to zero discrimination; flexibility and openness to dialogue and feedback; and a mutual commitment between the doctor and the department lead to best meet the doctor's individualised needs while still ensuring optimal patient care and team support and cohesion. We hypothesise that the Department Head may be the key to implementation but recognise the workforce constraints to realising these aspirational systemic shifts. It is time we acknowledge that doctors have families, to narrow the gap between identifying as a partner, mother, father, daughter, son, grandparent, and identifying as a doctor. We affirm the right to be both good doctors and good family members.
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Affiliation(s)
- Carmelle Peisah
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Discipline of Psychiatry and Mental Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | | | - Susan Mary Benbow
- Centre for Ageing and Mental Health, Faculty of Health and Social Care, University of Chester, Chester CH1 4BJ, UK
| | | | | | - Jenny E Gunton
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Westmead Hospital, Sydney, NSW 2145, Australia
- Westmead Institute for Medical Research, Sydney, NSW 2145, Australia
| | - Anuradha Kataria
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Rosalyn Lai
- Discipline of Psychiatry and Mental Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Royal North Shore Hospital, Sydney, NSW 2065, Australia
| | - Kiran Lele
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Carolyn Quadrio
- Discipline of Psychiatry and Mental Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Danette Wright
- Blacktown Hospital, Sydney, NSW 2148, Australia
- School of Medicine, Western Sydney University, Sydney, NSW 2751, Australia
| | - Loyola McLean
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Westmead Psychotherapy Programme for Complex Traumatic Disorders, Cumberland Hospital, Sydney, NSW 2145, Australia
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Overcoming Obstacles to Develop High-Performance Teams Involving Physician in Health Care Organizations. Healthcare (Basel) 2021; 9:healthcare9091136. [PMID: 34574910 PMCID: PMC8469144 DOI: 10.3390/healthcare9091136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 11/16/2022] Open
Abstract
Many health care organizations struggle and often do not succeed to be high-performance organizations that are not only efficient and effective but also enjoyable places to work. This review focuses on the physician and organizational roles in limiting achievement of a high-performance team in health care organizations. Ten dimensions were constructed and a number of competencies and metrics were highlighted to overcome the failures to: (i) Ensure that the goals, purpose, mission and vision are clearly defined; (ii) establish a supportive organizational structure that encourages high performance of teams; (iii) ensure outstanding physician leadership, performance, goal attainment; and (iv) recognize that medical team leaders are vulnerable to the abuses of personal power or may create a culture of intimidation/fear and a toxic work culture; (v) select a good team and team members—team members who like to work in teams or are willing and able to learn how to work in a team and ensure a well-balanced team composition; (vi) establish optimal team composition, individual roles and dynamics, and clear roles for members of the team; (vii) establish psychological safe environment for team members; (viii) address and resolve interpersonal conflicts in teams; (xi) ensure good health and well-being of the medical staff; (x) ensure physician engagement with the organization. Addressing each of these dimensions with the specific solutions outlined should overcome the constraints to achieving high-performance teams for physicians in health care organizations.
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Raykova EL, Semerjieva MA, Yordanov GY, Cherkezov TD. Dysfunctional Effects of a Conflict in a Healthcare Organization / Дисфункциональный Аспект Конфликта В Организации Здравоохранения. Folia Med (Plovdiv) 2015; 57:133-7. [DOI: 10.1515/folmed-2015-0032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 12/18/2014] [Indexed: 11/15/2022] Open
Abstract
AbstractConflicts in healthcare settings are quite common events because of the continuous changes and transformations today’s healthcare organizations are undergoing and the vigorous interaction between the medical professionals working in them. AIM: To survey the opinions of medical professionals about the possible destructive effects of conflicts on them in the workplace. MATERIALS AND METHODS: We conducted a direct individual survey of 279 medical employees at four general hospitals. We used a set of questions that reflect the negative effects and consequences of conflict on healthcare professionals as direct or indirect participants. All data were analysed using the descriptive statistics and non-parametric analysis at a significance level for the null hypothesis of p < 0.05. RESULTS: Workplace conflicts contribute a lot to the stress, psychological tension and emotional exhaustion medical professionals are exposed to. The confrontation the conflict brings the participants into acts as a catalyst of the conflict and enhances the manifestation of hostile actions. A conflict generates a situation which has an impact on the behaviour of all participants involved in it giving rise to emotional states such as anger, aggression and reproaches. The destructive consequences resulting from a conflict are seen in the reduced work satisfaction and demotivation to perform the work activity. The contradictions that arise as a result affect negatively the team cooperation and obstruct the collaborative efforts in solving the problems in the healthcare setting. CONCLUSION: A conflict in a healthcare setting exerts a considerable destructive effect on an employee, therefore it requires prompt identification and effective intervention to minimise its unfavourable outcomes.
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Cox KB. The new Intragroup Conflict Scale: testing and psychometric properties. J Nurs Meas 2014; 22:59-76. [PMID: 24851664 DOI: 10.1891/1061-3749.22.1.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE The importance of healthy work environments has received attention. Health care organizations are plagued with conflict which is detrimental to work environments. Thus, conflict must be studied. The purpose of this article is to describe the testing of a measure of conflict. METHODS A survey was used to evaluate the psychometric properties. The sample consisted of 430 nurses at an academic medical center. RESULTS Using principal component analysis (PCA) with varimax rotation, a six-factor solution (30 items) that explained 74.3% of variance emerged. Coefficient alpha ranged from .95 to .81. Correlations with existing scales supported construct validity (r = -.32(-)-.58). CONCLUSIONS The results are encouraging. Use of the scale may provide insight into the impact of conflict on patient, staff, and organizational outcomes.
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