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Su Y, Zhao L, Yu J, Chen X, Tan E, Liu H, Xie X, Liu F. Burnout among care workers in long-term care institutions: a systematic review and meta-analysis protocol. BMJ Open 2024; 14:e084900. [PMID: 39025823 PMCID: PMC11261695 DOI: 10.1136/bmjopen-2024-084900] [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: 01/31/2024] [Accepted: 05/17/2024] [Indexed: 07/20/2024] Open
Abstract
INTRODUCTION Care workers play a fundamental role in delivering care services in long-term care institutions. Burnout has been found to have a negative impact on care recipients and organisations providing care. Little is known about the key factors associated with care workers' burnout. This systematic review aims to explore the prevalence, severity and correlates of burnout among care workers before and during COVID-19 pandemic. METHODS AND ANALYSIS A five-stage framework outlined by Whittemore and Knafl will be used. The following databases will be used to identify relevant literature, including Medline (PubMed), EMBASE, Cochrane library, PsycINFO, CINAHL, Scopus and Web of Science. RevMan will be used to assist the meta-analysis. Heterogeneity of the included studies will be tested using the I 2 test. ETHICS AND DISSEMINATION No ethics approval is required as this study only involves secondary data analysis. The findings will be published in peer-reviewed journals and presented at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42024499178.
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Affiliation(s)
- Yinhua Su
- School of Nursing, University of South China, Hengyang, Hunan, People's Republic of China
| | - Ling Zhao
- School of Nursing, University of South China, Hengyang, Hunan, People's Republic of China
| | - Juping Yu
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Xia Chen
- School of Nursing, University of South China, Hengyang, Hunan, People's Republic of China
| | - E Tan
- School of Nursing, University of South China, Hengyang, Hunan, People's Republic of China
| | - Hui Liu
- School of Nursing, University of South China, Hengyang, Hunan, People's Republic of China
| | - Xiaoping Xie
- First Affiliated Hospital of University of South China, Hengyang, Hunan, People's Republic of China
| | - Fen Liu
- First Affiliated Hospital of University of South China, Hengyang, Hunan, People's Republic of China
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Coroneos-Shannon DL, Lancaster R. Improving the Recruitment and Retention of Unlicensed Assistive Personnel: A Quality Improvement Initiative. J Nurses Prof Dev 2024; 40:208-213. [PMID: 38949972 DOI: 10.1097/nnd.0000000000001059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
With increasing demands for unlicensed assistive personnel, strategies for optimizing recruitment and retention are paramount. The purpose of this quality improvement project was to increase the recruitment and retention of unlicensed assistive personnel in a nonprofit healthcare organization. Initiatives included expanding academic affiliations enhancing pipeline, developing a tailored onboarding program, and introducing a clinical ladder. Results indicate increases in numbers of academic affiliations and hiring, with unlicensed assistive personnel turnover rates below national averages.
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Schneider M, Good S, Dowd M, Feil D. How to help nursing assistants feel valued. Nursing 2023; 53:49-52. [PMID: 37734021 DOI: 10.1097/01.nurse.0000977560.44177.f3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Affiliation(s)
- Melissa Schneider
- At Wellspan York Hospital in York County, Pa., Melissa Schneider is a clinical nurse educator, Sandy Good is an NP, Megan Dowd is a clinical nurse, and Danielle Feil is a nurse manager
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Cottrell C, Adlesic M, Albert N. Factors associated with retention of nurse assistants in a hospital setting: A qualitative study. Nurs Manag (Harrow) 2023; 54:38-44. [PMID: 36998185 DOI: 10.1097/01.numa.0000921900.52255.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Affiliation(s)
- Constance Cottrell
- Constance Cottrell is a nurse scientist in the Cleveland Clinic's Office of Nursing Research and Innovation in Cleveland, Ohio. Melanie Adlesic is an assistant nurse manager on the observation unit at Cleveland Clinic South Pointe Hospital in Warrensville Heights, Ohio. Nancy Albert is the associate CNO for the Cleveland Clinic's Office of Nursing Research and Innovation, within the Zielony Nursing Institute; a clinical nurse specialist in Cleveland Clinic's George M. and Linda H. Kaufman Center for Heart Failure Treatment and Recovery in the Heart, Vascular & Thoracic Institute; and consultative staff in the Lerner Research Institute in Cleveland, Ohio
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Saiki M, Takemura Y, Kunie K. Relationship between Unit-Level Nurses' Expectations from Nursing Assistant Roles and Individual Nursing Assistants' Information-Sharing Behaviors: A Multilevel Mediation Analysis. Asian Nurs Res (Korean Soc Nurs Sci) 2023; 17:1-7. [PMID: 36481418 DOI: 10.1016/j.anr.2022.11.003] [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: 01/27/2022] [Revised: 11/24/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE This study aimed to investigate the relationship between the expectations of unit-level nurses from nursing assistants (NAs), frequency of individual NAs' information-sharing behaviors with nurses, and the effect of NAs' self-perceived roles on this relationship. NAs provide patient care along with nurses, and their information-sharing behaviors with nurses may be influenced by the expectations of the nurses. METHODS Nurses and NAs from 104 integrated community care (sub- and postacute) units were included in this Japanese cross-sectional study conducted from July to September 2018. Nurses' expectations from NAs and the NAs' self-perceived roles and information-sharing frequency were measured. Multilevel mediation analysis was performed for NAs' information-sharing behaviors, such as expressing, asking, providing linguistic responses, and providing feedback. RESULTS Unit-level nurses' expectations from NAs were associated with the frequency of NAs' asking and responding behaviors with nurses (p < .05), mediated by the NAs' self-perceived roles. The frequency of NAs' expressing behaviors and feedback were also associated with their self-perceived roles (p < .001). CONCLUSIONS High expectations of unit-level nurses from NAs led to better perception by NAs of their roles and led to better information-sharing behaviors. Educating nurses on NAs' roles may improve information-sharing between nurses and NAs that leads to safe and appropriate care to patients.
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Affiliation(s)
- Masatoshi Saiki
- Department of Advanced Clinical Nursing, Frontier Clinical Nursing, Graduate School of Nursing, Chiba University, Japan; Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Japan.
| | - Yukie Takemura
- Nursing Department, The University of Tokyo Hospital, Japan
| | - Keiko Kunie
- Department of Nursing Administration, School of Nursing, Tokyo Women's Medical University, Japan; Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Japan
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Zeng BT, Jin Y, Cheng SD, Ding YM, Du JW. Administration approaches of nursing assistants in hospitals: a scoping review. BMJ Open 2022; 12:e063100. [PMID: 36428023 PMCID: PMC9703314 DOI: 10.1136/bmjopen-2022-063100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
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.
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Affiliation(s)
- Ben-Tuo Zeng
- School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yinghui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Shu-Dong Cheng
- Nursing Department, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Yan-Ming Ding
- Nursing Department, Peking University First Hospital, Beijing, China
| | - Ji-Wei Du
- Nursing Department, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
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Engaging Rehabilitation Technicians Through a Career Ladder During a Pandemic. Rehabil Nurs 2022; 47:43-49. [DOI: 10.1097/rnj.0000000000000361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kennedy KA, Abbott KM, Bowblis JR. The One-Two Punch of High Wages and Empowerment on CNA Retention. J Appl Gerontol 2021; 41:312-321. [PMID: 34340584 DOI: 10.1177/07334648211035659] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The objective of this study was to examine the relationship between high wages and empowerment practices on certified nursing assistant (CNA) retention, necessary for providing high-quality care for nursing home (NH) residents. METHODS Measures of provider-level CNA empowerment and wages from the 2015 Ohio Biennial Survey were used to estimate two regression models on retention (n = 719), one without and one with an interaction term of high wages and high empowerment. RESULTS Only in the context of the interacted model were NHs that provided both high wages and high empowerment associated with a 7.09 percentage-point improvement in the CNA retention rate (p = .0003). Individually, high wages and a high empowerment score were not statistically significant in either regression model. DISCUSSION Retaining CNAs in NH communities requires a combination of empowerment practices (e.g., involving CNAs in decision-making about hiring other staff) and high hourly wages.
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Campbell AR, Kennerly S, Swanson M, Forbes T, Scott ES. Manager's influence on the registered nurse and nursing assistant relational quality and patient safety culture. J Nurs Manag 2021; 29:2423-2432. [PMID: 34272913 DOI: 10.1111/jonm.13426] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/20/2021] [Accepted: 07/15/2021] [Indexed: 11/28/2022]
Abstract
AIMS The purpose of this study is to describe the perceptions of relational quality of the registered nurse and nursing assistant and examine how their view of the manager's influence impacts overall patient safety culture of a unit. BACKGROUND The primary delivery of nursing care within acute care systems uses teams of registered nurses and nursing assistants. METHODS A cross-sectional secondary analysis of data collected in the spring of 2018 using the Agency for Healthcare and Quality Hospital Survey of Patient Safety Culture and a seven-item questionnaire measuring relational quality was conducted. The sample included 1,152 responses. RESULTS The manager influenced overall perceptions of safety regardless of the relational quality between the registered nurse and nursing assistant. CONCLUSIONS This study found manager behaviours that promote patient safety and also influence overall perceptions of patient safety culture regardless of the relational quality between the registered nurse and nursing assistant. IMPLICATIONS FOR NURSING MANAGEMENT Positive registered nurse and nursing assistant relational quality amplifies perceptions of patient safety culture, yet it is the manager's behaviours regarding safety that make the stronger contribution in building a culture of safety.
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Affiliation(s)
| | - Susan Kennerly
- Department of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Melvin Swanson
- Department of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Thompson Forbes
- Department of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Elaine S Scott
- Department of Nursing, East Carolina University, Greenville, North Carolina, USA
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Saiki M, Takemura Y, Kunie K. Nursing assistants' desired roles, perceptions of nurses' expectations and effect on team participation: A cross-sectional study. J Nurs Manag 2021; 29:1046-1053. [PMID: 33393152 DOI: 10.1111/jonm.13242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/08/2020] [Accepted: 12/30/2020] [Indexed: 01/05/2023]
Abstract
AIMS To examine the gap between nursing assistants' desired roles and their perceptions of nurses' expectations, and the relationship between these perceptions and nursing assistants' nursing team participation. BACKGROUND Nursing assistants' role perceptions may be related to their participation in nursing teams. METHODS We performed a secondary analysis of questionnaire data from 1,316 nursing assistants in Japan. RESULTS Participants rated their desired roles higher than their perceptions of nurses' expectations of them. Where perceptions of nurses' expectations were higher, higher desired role scores were associated with greater nursing team participation. Where perceptions of nurses' expectations were lower, the desired role score was not associated with team participation. CONCLUSIONS Nursing assistants perceive their roles as higher and inclusive of more duties than what nurses have expected of them. When perceptions of nurse expectations were high, they performed at a higher level. When perceptions of nurse expectations were low, they performed at a lower level, despite their desire to do more. IMPLICATIONS FOR NURSING MANAGEMENT It may be useful for nurses and nursing assistants to jointly reflect on and promote awareness of nursing assistants' functional roles in the ward. This would promote nursing assistant team participation and optimize their scope of practice.
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Affiliation(s)
- Masatoshi Saiki
- Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukie Takemura
- Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keiko Kunie
- Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Nursing Administration, School of Nursing, Tokyo Women's Medical University, Tokyo, Japan
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Cheng TJ, Hsu YM, Tsai TH, Chen MY, Tsay SF, Shieh SH. Factors Affecting the Competence of Nursing Assistants in Taiwan Long-Term Care Institutions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249413. [PMID: 33334015 PMCID: PMC7765356 DOI: 10.3390/ijerph17249413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/03/2020] [Accepted: 12/10/2020] [Indexed: 11/16/2022]
Abstract
With the increasing number of people with disabilities caused by an aging global population, the need for long-term care is gradually increasing. Nursing assistants (NAs) are the primary providers of direct care services to older adults with disabilities, whose knowledge, skills, and beliefs affect the quality of care provided. This study aimed to investigate the influential factors affecting NAs’ current competences. A total of 255 NAs’ valid questionnaires were collected from 20 long-term care institutions in Taiwan through convenience sampling. The questionnaire comprised dimensions of demographics and care competence. The study results indicated that NAs had the greatest care competence in the domain of recognition of patient rights (4.64 ± 0.54 points). The multiple regression indicated that age, religion, job category, disability care experience, the receiving of performance bonuses, and the receiving of year-end bonuses significantly affected the level of care competence (p < 0.05). With the aforementioned findings, the results of this study serve as references for the government in employing long-term care NAs and developing management policies. Training programs for NAs should be developed to improve the quality of care provided to older adults with disabilities.
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Affiliation(s)
- Tsai-Jung Cheng
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (T.-J.C.); (T.-H.T.); (S.-F.T.)
| | - Yi-Min Hsu
- Department of Public Health, China Medical University, Taichung 40402, Taiwan;
- Department of Nursing, China Medical University Hospital, Taichung 40402, Taiwan
| | - Tung-Han Tsai
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (T.-J.C.); (T.-H.T.); (S.-F.T.)
| | - Ming-Yu Chen
- Taichung Hospital attached Nursing Home, Head Nurse Ministry of Health and Welfare, Taichung 40343, Taiwan;
| | - Shwu-Feng Tsay
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (T.-J.C.); (T.-H.T.); (S.-F.T.)
- Department of Nursing and Health Care, Ministry of Health and Welfare, Taipei 11558, Taiwan
| | - Shwn-Huey Shieh
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (T.-J.C.); (T.-H.T.); (S.-F.T.)
- Department of Nursing, China Medical University Hospital, Taichung 40402, Taiwan
- Department of Nursing, Asia University, Taichung 41354, Taiwan
- Correspondence:
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Saiki M, Kunie K, Takemura Y, Takehara K, Ichikawa N. Relationship between nurses' perceptions of nursing assistant roles and information‐sharing behaviors: A cross‐sectional study. Nurs Health Sci 2020; 22:706-713. [DOI: 10.1111/nhs.12717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Masatoshi Saiki
- Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Keiko Kunie
- Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Yukie Takemura
- Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Kimie Takehara
- Department of Nursing, School of Health Sciences Graduate School of Medicine, Nagoya University Nagoya Japan
| | - Naoko Ichikawa
- Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine The University of Tokyo Tokyo Japan
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Affiliation(s)
- Cindy L. Munro
- Cindy L. Munro is coeditor in chief of the American Journal of Critical Care. She is dean and professor, School of Nursing and Health Studies, University of Miami, Coral Gables, Florida
| | - Aluko A. Hope
- Aluko A. Hope is coeditor in chief of the American Journal of Critical Care. He is an associate professor at Albert Einstein College of Medicine and an intensivist and assistant bioethics consultant at Montefiore Medical Center, both in New York City
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