1
|
Connelly DM, Hay ME, Guitar NA, Prentice K. Bridging Educational Grant in Nursing (BEGIN) students' intentions for retention in long-term, home and community care: A survey protocol. BMJ Open 2024; 14:e084744. [PMID: 38760048 PMCID: PMC11103233 DOI: 10.1136/bmjopen-2024-084744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 05/02/2024] [Indexed: 05/19/2024] Open
Abstract
INTRODUCTION Retention of nurses in long-term care (LTC) and home and community care (HCC) settings is a growing concern. Previous evidence underscores factors which contribute to nurses' intentions for retention in these sectors. However, perspectives of nursing students preparing to enter the workforce, and their intentions for short-term and long-term retention, remain unknown. This study aims to explore relationships between short-term and long-term intentions for retention with psychological empowerment, work engagement, career commitment, burnout, prosocial motivation, self-care and personal resilience among students enrolled in nursing educational bridging programs supported by the Bridging Educational Grant in Nursing (BEGIN) program in Ontario, Canada. METHODS AND ANALYSIS This cross-sectional design study will use an open online survey to investigate perspectives of current nursing students enrolled in educational bridging programs on factors relating to psychological empowerment, work engagement, career commitment, resilience, burnout, prosocial motivation, self-care and intentions for retention. Additionally, the survey will collect demographic information, including age, gender, ethnicity, citizenship, income, family status, nursing role, and years of employment and/or education. Open-ended questions will elicit participants' perspectives on financial considerations for career planning and other factors impacting intentions for retention. Descriptive data will be presented for contextualisation of participants' demographic characteristics to enhance generalisability of the cohort. Descriptive statistics will be used to summarise participants' scores on various assessment measures, as well as their short-term and long-term intentions for retention in LTC and HCC after completion of BEGIN. A Pearson's product moment r correlation will determine relationships between intentions for retention and other measures, and linear regression will determine whether any potential correlations can be explained by regression. ETHICS AND DISSEMINATION This research protocol received ethical approval from a research-intensive university research ethics board (#123211). Findings will be disseminated to nursing knowledge users in LTC and HCC through publications, conferences, social media and newsletters.
Collapse
Affiliation(s)
- Denise M Connelly
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Melissa Erin Hay
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Nicole Ann Guitar
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Kristin Prentice
- School of Physical Therapy, Western University, London, Ontario, Canada
| |
Collapse
|
2
|
Developing a nurse practitioner to work in residential aged care: A qualitative evaluative study. Collegian 2023. [DOI: 10.1016/j.colegn.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
|
3
|
Min D, Cho E, Kim GS, Lee KH, Yoon JY, Kim HJ, Choi MH. Factors associated with retention intention of Registered Nurses in Korean nursing homes. Int Nurs Rev 2022; 69:459-469. [PMID: 35413132 PMCID: PMC9790496 DOI: 10.1111/inr.12754] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/08/2022] [Indexed: 12/30/2022]
Abstract
AIM To identify the factors associated with retention intention among Registered Nurses in South Korean nursing homes. BACKGROUND Although nurses are not mandatory personnel, Korean nursing homes employ Registered Nurses. INTRODUCTION Determining the factors related to Registered Nurses' retention intention is important for their job stability and ensure provision of quality care. METHODS This mixed-methods study employed a sequential explanatory design. A self-reported questionnaire survey was conducted between May 1 and July 3, 2019, with 155 Registered Nurses providing direct care from 37 nursing homes. In-depth qualitative interviews were conducted with 10 participants from August 1 to September 30, 2019. Data were analyzed using multilevel analysis for quantitative study and thematic analysis for qualitative study. RESULTS The participants' average age was 48.48 years. Personal factors related to retention intention were Registered Nurses' role, educational level, and job satisfaction. Institutional factors were ownership, number of beds, and working environment. The qualitative study revealed five themes: "Satisfaction with meaningful relationships," "Potential for professional growth," "Nursing service accompanied by emotional labor," "Poor working environments in nursing homes," and "Unprotected nursing expertise." DISCUSSION A nursing home's work environment is related to the Registered Nurses' retention intention. Most Registered Nurses in Korea received low wages, lacked access to career management programs, and experienced emotional labor. CONCLUSION This study highlighted the personal and institutional factors related to retention intention among Registered Nurses in South Korean nursing homes. IMPLICATIONS FOR NURSING AND NURSING POLICY A law that designates Registered Nurses as an essential nursing home workforce is required. Further, nursing homes should increase the number of Registered Nurses to improve working conditions and thereby job satisfaction. It is also necessary to foster a working environment that facilitates professional development opportunities and job clarity.
Collapse
Affiliation(s)
- Deulle Min
- Department of NursingCollege of MedicineWonkwang UniversityIksanRepublic of Korea
| | - Eunhee Cho
- Mo‐Im Kim Nursing Research InstituteYonsei University College of NursingSeoulRepublic of Korea
| | - Gwang Suk Kim
- Mo‐Im Kim Nursing Research InstituteYonsei University College of NursingSeoulRepublic of Korea
| | - Kyung Hee Lee
- Mo‐Im Kim Nursing Research InstituteYonsei University College of NursingSeoulRepublic of Korea
| | - Ju Young Yoon
- College of Nursing and Research Institute of Nursing ScienceSeoul National UniversitySeoulRepublic of Korea
| | - Hyun Joo Kim
- Yonhee Seniors Nursing HomeSeoulRepublic of Korea
| | - Moon Hee Choi
- Korea Social Science Data Archive at Asia Center Seoul National UniversitySeoulRepublic of Korea
| |
Collapse
|
4
|
Quach ED, Kazis LE, Zhao S, McDannold SE, Clark VA, Hartmann CW. Relationship Between Work Experience and Safety Climate in Veterans Affairs Nursing Homes Nationwide. J Patient Saf 2021; 17:e1609-e1615. [PMID: 32701621 DOI: 10.1097/pts.0000000000000712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Staff values and beliefs about resident safety (safety climate) represent one potential driver of nursing home safety. Staff with more work experience (length of service) may possess richer knowledge of resident safety for strengthening safety climate. We investigated the association of length of service with safety climate in the U.S. Department of Veterans Affairs nursing homes or Community Living Centers (CLCs). METHODS Fifty-six of 134 CLCs participated in 2017 and then 2018 in the previously validated CLC Employee Survey of Attitudes about Resident Safety, which comprised 7 safety climate domains and employee characteristics. We conducted 2 cross-sectional analyses of length of service on each safety climate domain, controlling for occupation, shift, work hours, and clustering by VA hospital, service network, and geographic region, in mixed random-effect regression models. RESULTS A total of 1397 and 1645 staff participated in the survey (26% and 28% response rates) at round 1 and 2, respectively. At each round participants working greater than 6 months were less positive than those working less than 6 months about supervisor commitment to safety, coworker interactions around safety, and CLC global ratings. CONCLUSIONS Differences in work experience contributed to incongruence in perceptions about supervisors, coworkers, and the facility. Workers with more experience may have higher perceived job aptitude and thus higher expectations of supervisory recognition and more criticisms of coworkers. Pairing experienced workers with newer ones may narrow the knowledge gap and increase collaboration. Huddles, team meetings, and organizational initiatives represent opportunities to recognize and leverage experienced workers' accumulated safety knowledge.
Collapse
Affiliation(s)
| | | | - Shibei Zhao
- From the Center for Healthcare Organization and Implementation Research
| | - Sarah E McDannold
- From the Center for Healthcare Organization and Implementation Research
| | - Valerie A Clark
- From the Center for Healthcare Organization and Implementation Research
| | | |
Collapse
|
5
|
Lee JY, Shin JH. Why Do They Stay? Intention to Stay among Registered Nurses in Nursing Homes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228485. [PMID: 33207741 PMCID: PMC7697843 DOI: 10.3390/ijerph17228485] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/09/2020] [Accepted: 11/14/2020] [Indexed: 11/29/2022]
Abstract
Purpose: The purpose of this study was to examine the factors associated with nursing home (NH) registered nurses’ (RNs’) intention to stay in their workplace. Methods: A cross-sectional questionnaire survey was used in this study. Organizational NH data were acquired from the administrators of 56 NHs. Individual RN data were acquired from 189 RNs in 56 NHs across Korea. The questionnaire assessed RNs’ intention to stay in their workplace as well as potential associated factors, including individual and organizational factors. Multilevel regression analysis was used to determine which factors explain RNs’ intention to stay in their workplace. Findings: NH RNs’ intention to stay was positively associated with RNs’ years of experience in NHs, career promotion opportunities, and perceptions of NH resident safety culture. At the organizational level, no factors were found to significantly relate to the intention to stay of NH RNs. Conclusions: Although this study found that organizational factors have no statistically significant relationship with RNs’ intention to stay, organizational support must precede changes in individual factors that have significant relationships. Clinical Relevance: Organizational (NH) and individual (RN) efforts must be made to enhance RNs’ intention to stay because individual factors can change after implementing efforts such as providing educational programs, promotional opportunities, and forming a positive resident safety culture at an organizational level.
Collapse
|
6
|
Siegel EO, Young HM. Assuring Quality in Nursing Homes: The Black Box of Administrative and Clinical Leadership—A Scoping Review. THE GERONTOLOGIST 2020; 61:e147-e162. [DOI: 10.1093/geront/gnaa175] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Indexed: 01/18/2023] Open
Abstract
Abstract
Background and Objectives
Licensed nursing home administrators (NHA) and directors of nursing (DON) are responsible for nursing home quality and assuring optimal performance and job satisfaction/retention of their nursing home workforce. NHA/DON-focused studies have generated important foundational knowledge over the last three decades; yet, targeted research is needed to understand and apply the complexities of the black box of this top management team. This scoping review identifies, reviews, synthesizes, and maps the topical areas of research in NHA/DON positions in U.S. nursing homes.
Research Design and Methods
We conducted searches of 5 databases, yielding 3,479 records; screening/review yielded 88 unique records. We used thematic analysis to code the primary foci of the studies and the variables associated with the concepts of interest.
Results
Most papers (n = 40) focused on role characteristics, 23 examined approaches to management and leadership, 24 focused on perceptions about the role, and the remaining 12 examined role structure. The role-related themes linked to outcomes (n = 42), processes (n = 27), and structures (n = 30).
Discussion and Implications
We highlight important gaps for future research and offer a call to action for research, policy, practice, and education collaborations to accelerate the rate of research and translate the findings into best practices for NHA/DON to lead and manage the nursing home workforce and build capacity to ensure person-centered, high-quality care. Based on foundational descriptive studies, it is time to use what is known to design and implement interventions that enhance the capacity of NHA/DON to improve the structures, processes, and outcomes of nursing homes.
Collapse
Affiliation(s)
- Elena O Siegel
- Betty Irene Moore School of Nursing, University California, Davis, Sacramento, USA
| | - Heather M Young
- Betty Irene Moore School of Nursing, University California, Davis, Sacramento, USA
| |
Collapse
|
7
|
Zúñiga F, Chu CH, Boscart V, Fagertun A, Gea-Sánchez M, Meyer J, Spilsbury K, Devi R, Haunch K, Zheng N, McGilton KS. Recommended Common Data Elements for International Research in Long-Term Care Homes: Exploring the Workforce and Staffing Concepts of Staff Retention and Turnover. Gerontol Geriatr Med 2019; 5:2333721419844344. [PMID: 31192274 PMCID: PMC6540698 DOI: 10.1177/2333721419844344] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 03/26/2019] [Indexed: 11/21/2022] Open
Abstract
The aim of this review is to develop a common data element for the concept of staff retention and turnover within the domain of workforce and staffing. This domain is one of four core domains identified by the WE-THRIVE (Worldwide Elements to Harmonize Research in Long-Term Care Living Environments) group in an effort to establish an international, person-centered long-term care research infrastructure. A rapid review identified different measurement methods to assess either turnover or retention at facility level or intention to leave or stay at the individual staff level. The selection of a recommended measurement was guided by the WE-THRIVE group’s focus on capacity rather than deficits, the expected availability of internationally comparable data, and the goal to provide a short, ecologically viable measurement. We therefore recommend to measure staff’s intention to stay with a single item, at the individual staff level. This element, we argue, is an indicator of staff stability, which is important for reduced organizational cost and improved productivity, positive work environment, and better resident–staff relationships and quality of care.
Collapse
Affiliation(s)
| | | | - Veronique Boscart
- Conestoga College, Kitchener, Ontario, Canada.,Toronto Rehabilitation Institute, Ontario, Canada
| | - Anette Fagertun
- Centre for Care Research west, Western Norway University of Applied Sciences, Bergen, Norway
| | | | | | | | | | | | - Nancy Zheng
- University of Toronto, Ontario, Canada.,Toronto Rehabilitation Institute, Ontario, Canada
| | | |
Collapse
|
8
|
Deng S, Yang N, Li S, Wang W, Yan H, Li H. Doctors' Job Satisfaction and Its Relationships With Doctor-Patient Relationship and Work-Family Conflict in China: A Structural Equation Modeling. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2019; 55:46958018790831. [PMID: 30371128 PMCID: PMC6207965 DOI: 10.1177/0046958018790831] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The objective of this study was to evaluate the relationship of doctors’ job satisfaction with doctor-patient relationship and work-family conflict in China. The data came from a cross-sectional survey in Hubei province, which was part of China’s Fifth National Health Services Survey conducted in 2013. The survey in Hubei covered 54 secondary and tertiary general hospitals distributed in 20 counties. Of the 1080 questionnaires, 908 were included into our analysis. After surviving from reliability and validity tests, structural equation modeling was applied for further analysis with SPSS 20.0 and Mplus 7.0. The results showed that the average score of job satisfaction is 19.61 out of 30 points, indicating a relatively low level of doctors’ job satisfaction in Hubei province. Work-family conflict was found to have negative impact on doctors’ job satisfaction, and good doctor-patient relationship was found to have positive impact on their job satisfaction. Therefore, hospital administrators and policy makers should make effort to design and implement strategies that focus on meliorating doctor-patient relationship and balancing doctors’ work and family life to further improve their job satisfaction.
Collapse
Affiliation(s)
- Shumin Deng
- 1 School of Health Sciences, Wuhan University, China
| | - Ningxi Yang
- 1 School of Health Sciences, Wuhan University, China
| | - Shiyue Li
- 1 School of Health Sciences, Wuhan University, China
| | - Wei Wang
- 1 School of Health Sciences, Wuhan University, China
| | - Hong Yan
- 1 School of Health Sciences, Wuhan University, China
| | - Hao Li
- 1 School of Health Sciences, Wuhan University, China.,2 Belt and Road Health Research Institute, Wuhan University, China
| |
Collapse
|
9
|
van de Klundert J, van Dongen- van den Broek J, Yesuf EM, Vreugdenhil J, Yimer SM. 'We are planning to leave, all of us'-a realist study of mechanisms explaining healthcare employee turnover in rural Ethiopia. HUMAN RESOURCES FOR HEALTH 2018; 16:37. [PMID: 30103747 PMCID: PMC6090584 DOI: 10.1186/s12960-018-0301-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/16/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND We study healthcare employees' turnover intentions in the Afar National Regional State of Ethiopia. This rural region is experiencing the globally felt crisis in human resources, which is inhibiting its ability to meet health-related sustainable development goals. METHODS Realist case study which combines literature study and qualitative analysis of interview and focus group discussion data, following a realist case study protocol. RESULTS A large majority of employees has turnover intentions. Building on Herzberg's two-factor theory, person-environment fit theory, as well as recent sub-Saharan evidence, analysis of the collected data yields four turnover mechanisms: (1) lack of social and personal opportunities in the region, (2) dissonance between management logic and professional logic, (3) standards of service operations are hard to accept, and (4) lack of financial improvement opportunities. CONCLUSIONS While the first and fourth mechanisms may be out of reach for local (human resource) management interventions, the second and third mechanisms proposed to explain health workforce turnover appear to be amenable to local (human resource) management interventions to strengthen healthcare. These mechanisms are likely to play a role in other remote sub-Saharan regions as well.
Collapse
Affiliation(s)
- Joris van de Klundert
- Erasmus School for Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Prince Mohammad Bin Salman College, King Abdullah Economic City, Saudi Arabia
| | - Judith van Dongen- van den Broek
- Erasmus School for Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Transvorm, Tilburg, The Netherlands
| | - Ebrahim Mohammed Yesuf
- Department of Public Health, College of Health Science, Samara University, Semera, Ethiopia
| | - Jasmijn Vreugdenhil
- Erasmus School for Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Saeid Mohammed Yimer
- Department of Management, College of Business and Economics, Samara University, Semera, Ethiopia
| |
Collapse
|
10
|
Dever KH. Through the Eyes of Nurse Managers in Long-Term Care: Identifying Perceived Competencies and Skills. J Gerontol Nurs 2018; 44:32-38. [PMID: 29596711 DOI: 10.3928/00989134-20180322-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 02/04/2018] [Indexed: 11/20/2022]
Abstract
Nurse managers (NMs) in long-term care supervise health care services for individuals with high acuity levels and numerous comorbidities. There is minimal research identifying NMs' skills and competencies as unit leaders within the long-term care environment. The current mixed-methods study identified NMs' leadership skills and competencies. Nineteen NMs with ≥5 years' long-term care management experience completed the Nurse Manager Inventory Tool and were individually interviewed. They rated their clinical skills at the competent level and their financial/strategic management skills at the novice level. All other skill categories, including leadership reflective practice, diversity, human resource leadership/management, relationship management, performance improvement, and problem solving, were rated at a competent level. Emergent interview qualitative themes included their visibility on the unit, trial and error learning, a sense of "aloneness" due to the absence of other RNs, NM position being a tough job, need for peer support, role modeling, and importance of supporting the resident through their "final journey." [Journal of Gerontological Nursing, 44(5), 32-38.].
Collapse
|
11
|
Elliott KEJ, Rodwell J, Martin AJ. Aged care nurses’ job control influence satisfaction and mental health. J Nurs Manag 2017; 25:558-568. [DOI: 10.1111/jonm.12493] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Kate-Ellen J. Elliott
- Wicking Dementia Research and Education Centre; Faculty of Health; University of Tasmania; Hobart Tasmania Australia
| | - John Rodwell
- Swinburne Business School; Swinburne University; Hawthorn Victoria Australia
| | - Angela J. Martin
- Tasmanian School of Business & Economics; University of Tasmania; Hobart Tasmania Australia
| |
Collapse
|
12
|
Nolet K, Roberts T, Gilmore-Bykovskyi A, Roiland R, Gullickson C, Ryther B, Bowers BJ. Preparing tomorrow's nursing home nurses: the wisconsin long term care clinical scholars program. GERONTOLOGY & GERIATRICS EDUCATION 2014; 36:396-415. [PMID: 25162659 PMCID: PMC4344414 DOI: 10.1080/02701960.2014.954040] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Preparing future nurses to care for the growing population of older adults has become a national priority. The demand for long term care services is expected to double between 2000 and 2040, yet the field remains stigmatized as an undesirable place for highly skilled nurses to work. Recent efforts to increase student preparation in geriatrics have been shown to improve student attitudes toward working with older adults and increase knowledge, but long term care settings remain unattractive to students. This article reports on the development, implementation, and evaluation of The Wisconsin Long Term Care Clinical Scholars Program, a nursing home internship for baccalaureate nursing students. The program couples a paid nursing home work experience with an evidence-based long term care nursing curriculum. The program increased student preparation and interest in working both with older adults and in nursing homes, while increasing the capacity of nursing homes to provide a positive student experience.
Collapse
Affiliation(s)
- Kim Nolet
- a School of Nursing , University of Wisconsin-Madison , Madison , Wisconsin , USA
| | | | | | | | | | | | | |
Collapse
|
13
|
Ersek M, Jablonski A. A mixed-methods approach to investigating the adoption of evidence-based pain practices in nursing homes. J Gerontol Nurs 2014; 40:52-60. [PMID: 24640959 DOI: 10.3928/00989134-20140311-01] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 12/18/2013] [Indexed: 11/20/2022]
Abstract
This mixed methods study examined perceived facilitators and obstacles to adopting evidence-based pain management protocols vis-a-vis documented practice changes that were measured using a chart audit tool. This analysis used data from a subgroup of four nursing homes that participated in a clinical trial. Focus group interviews with staff yielded qualitative data about perceived factors that affected their willingness and ability to use the protocols. Chart audits determined whether pain assessment and management practices changed over time in light of these reported facilitators and barriers. Reported facilitators included administrative support, staff consistency, and policy and procedure changes. Barriers were staff attitudes, regulatory issues, and provider mistrust of nurses' judgment. Overall, staff reported improvements in pain practices. These reports were corroborated by modest but significant increases in adherence to recommended practices. Change in clinical practice is complex and requires attention to both structural and process aspects of care.
Collapse
|