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Koivunen K, Kaakinen P, Päätalo K, Mattila O, Oikarinen A, Jansson M, Mikkonen K, Pölkki T, Meriläinen M, Kääriäinen M, Holopainen A, Tuomikoski AM, Kanste O. Frontline nurse leaders' competences in evidence-based healthcare: A scoping review. J Adv Nurs 2024; 80:1314-1334. [PMID: 38041585 DOI: 10.1111/jan.15920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 09/11/2023] [Accepted: 10/17/2023] [Indexed: 12/03/2023]
Abstract
AIM To identify evidence on frontline nurse leaders' competences in evidence-based healthcare (EBHC) and the instruments measuring these competences. DESIGN A scoping review. DATA SOURCES The search was conducted in June 2021 and complemented in June 2022. The CINAHL, ProQuest, Medline (Ovid), Scopus, Web of Science databases and MedNar along with the Finnish database Medic were searched. REVIEW METHOD The scoping review was conducted in accordance with the Joanna Briggs institute methodology for scoping reviews. Titles, abstracts and full-text versions were screened independently by two reviewers according to the inclusion criteria. Deductive-inductive content analysis was used to synthesize data. RESULTS A total of 3211 articles published between 1997 and 2022 were screened, which resulted in the inclusion of 16 articles. Although frontline nurse leaders had a positive attitude towards EBHC, they had a lack of implementing EBHC competence into practice. Part of the instruments were used in the studies, and only one focused especially on leaders. None of instruments systematically covered all segments of EBHC. CONCLUSION There is a limited understanding of frontline nurse leaders' competence in EBHC. It is important to understand the importance of EBHC in healthcare and invest in the development of its competence at all levels of leaders. Frontline nurse leaders' support is essential for direct care nurses to use EBHC to ensure the quality of care and benefits to patients. Leaders must enhance their own EBHC competence to become role models for direct care nurses. It is also essential to develop valid and reliable instruments to measure leaders' competence covering all EBHC segments. The results can be utilized in the assessment and development of frontline nurse leaders' EBHC competence by planning and producing education and other competence development methods.
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Affiliation(s)
- Kirsi Koivunen
- University of Applied Sciences, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
| | - Pirjo Kaakinen
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Kati Päätalo
- University of Applied Sciences, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
| | - Outi Mattila
- Lapland University of Applied Sciences, Rovaniemi, Finland
| | - Anne Oikarinen
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Miia Jansson
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Kristina Mikkonen
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Tarja Pölkki
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Merja Meriläinen
- Wellbeing Services County of North Ostrobothnia, Oulu University Hospital, Medical Research Centre (MRC), Oulu, Finland
| | - Maria Kääriäinen
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Arja Holopainen
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Nursing Research Foundation, Helsinki, Finland
| | - Anna-Maria Tuomikoski
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Wellbeing Services County of North Ostrobothnia, Oulu University Hospital, Medical Research Centre (MRC), Oulu, Finland
| | - Outi Kanste
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Teixeira AC, Nogueira A, Barbieri-Figueiredo MDC. Professional empowerment and evidence-based nursing: A mixed-method systematic review. J Clin Nurs 2022. [PMID: 36039039 DOI: 10.1111/jocn.16507] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To review, synthesise and integrate primary research on the relationship between professional empowerment and evidence-based practice (EBP) in nursing. BACKGROUND Professional empowerment research exposes an association between empowerment and positive work behaviours and attitudes. Empowerment is associated with nurses' productivity, autonomy and resources. However, implementing evidence into practice is not easy due to barriers to EBP, namely organisational and cultural. Research demonstrating the relationship between professional empowerment and EBP will provide direction for future interventions aimed at the development of an effective healthcare sector. DESIGN A mixed-methods systematic review, according to the Joanna Briggs Institute approach, with results reported according to PRISMA. The associated checklist for systematic reviews was also used. METHOD The electronic databases searched for relevant studies included: Medline, Cumulative Nursing and Allied Health Literature (CINAHL), JBI Database of Systematic Reviews and Implementation Reports, and The Cochrane Library; thesis and dissertation databases; and Web pages of reference organisations and Scientific Events programs. Quality assessments, data extraction and analysis were completed on all included studies, according JBI. Thematic analysis was used to synthesise the data. RESULTS We identified 477 studies. After removing duplicates and reviewing title and abstract following the inclusion and exclusion criteria, 26 papers were evaluated for eligibility. The review included 9 articles. The literature was categorised into three themes: (a) organisational and leadership characteristics, (b) individual characteristics, and (c) outcomes/consequences. CONCLUSION This review highlights the importance of empowering environments in EBP. A relationship was evident between leadership, organisation, empowerment, individual characteristics and the use and implementation of evidence, resulting in tangible and measurable gains. However, more robust studies are needed. This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42018086414).
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Affiliation(s)
- Abílio Cardoso Teixeira
- ICBAS: School of Medicine and Biomedical Sciences - University of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Porto, Portugal.,Santa Maria Health School, Porto, Portugal
| | - Assunção Nogueira
- Sousa Valley Health School, Gandra, Portugal.,Institute for Research and Advanced Training in Health Sciences and Technologies, Porto, Portugal
| | - Maria do Céu Barbieri-Figueiredo
- ICBAS: School of Medicine and Biomedical Sciences - University of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Porto, Portugal.,Huelva University - Departamento de Enfermeria, Huelva, Spain
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3
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Lundin K, Silén M, Strömberg A, Engström M, Skytt B. Staff structural empowerment-Observations of first-line managers and interviews with managers and staff. J Nurs Manag 2021; 30:403-412. [PMID: 34783103 DOI: 10.1111/jonm.13513] [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: 02/17/2021] [Revised: 10/11/2021] [Accepted: 11/03/2021] [Indexed: 12/01/2022]
Abstract
AIM The aim was to study how first-line managers act to make structural empowerment accessible for nursing staff and furthermore to relate these observations to the manager's and their nursing staff's descriptions regarding the staff's access to empowering structures. BACKGROUND Staff access to empowering structures has been linked to positive workplace outcomes. Managers play an important role in providing the conditions for structural empowerment. METHOD Five first-line managers were observed for two workdays. Managers and staff (n = 13) were thereafter interviewed. Field notes and interviews were analysed using directed content analysis. RESULTS The managers displayed intentional actions that could enable their staff access to empowering structures. Managers and staff described the importance of staff's access to empowering structures. CONCLUSION Staff who perceive to have access to structural empowerment have managers who are present and available. Unanimity among managers and staff existed in regard to the importance of staff having access to structural empowerment. The managers work continually and intentionally, doing many things at the same time, to provide the staff access to empowering structures. IMPLICATIONS FOR NURSING MANAGEMENT The study shows the importance of promoting managers' awareness of staff's access to structural empowerment and maximizing managers' presence and availability to their staff.
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Affiliation(s)
- Karin Lundin
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Marit Silén
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Annika Strömberg
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Maria Engström
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Bernice Skytt
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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'Stolen Time'-Delivering Nursing at the Bottom of a Hierarchy: An Ethnographic Study of Barriers and Facilitators for Evidence-Based Nursing for Patients with Community-Acquired Pneumonia. Healthcare (Basel) 2021; 9:healthcare9111524. [PMID: 34828571 PMCID: PMC8620708 DOI: 10.3390/healthcare9111524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 10/27/2021] [Accepted: 11/01/2021] [Indexed: 11/20/2022] Open
Abstract
The research has reported a high prevalence of low-quality and missed care for patients with community-acquired pneumonia (CAP). Optimised nursing treatment and care will benefit CAP patients. The aim of this study was to describe the barriers and facilitators influencing registered nurses’ (RNs’) adherence to evidence-based guideline (EBG) recommendations for nursing care (NC) for older patients admitted with CAP. Semi-structured focus group interviews (n = 2), field observations (n = 14), and individual follow-up interviews (n = 10) were conducted in three medical units and analysed by a qualitative content analysis. We found a main theme: ‘‘stolen time’—delivering nursing at the bottom of a hierarchy’, and three themes: (1) ‘under the dominance of stronger paradigms’, (2) ‘the loss of professional identity’, and (3) ‘the power of leadership’. These themes, each comprising two to three subthemes, illustrated that RNs’ adherence to EBG recommendations was strongly influenced by the individual RN’s professionalism and professional identity; contextual barriers, including the interdisciplinary team, organisational structure, culture, and evaluation of the NC; and the nurse manager’s leadership skills. This study identified central factors that may help RNs to understand the underlying dynamics in a healthcare setting hindering and facilitating the performance of NC and make them better equipped for changing practices.
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Cardoso Teixeira A, Nogueira A, Nunes JR, Teixeira L, do Céu Barbieri-Figueiredo M. Professional empowerment among Portuguese nursing staff: A correlational study. J Nurs Manag 2021; 29:1120-1129. [PMID: 33426759 DOI: 10.1111/jonm.13250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/03/2021] [Accepted: 01/05/2021] [Indexed: 11/30/2022]
Abstract
AIM To identify the level of professional empowerment in hospital nurses and describe the relationship between sociodemographic variables and professional empowerment. BACKGROUND Professional empowerment is positively related to work effectiveness, job satisfaction and organisational and professional commitment. METHOD Data on professional empowerment were collected by surveying 365 nurses in a Portuguese hospital, with the Portuguese versions of 'Conditions of Work Effectiveness Questionnaire-II' and the 'Psychological Empowerment Instrument'. RESULTS Overall, psychological empowerment scored 66.2 (standard deviation = 8.9, with 'meaning' scoring highest and 'impact' scoring lowest), whereas structural empowerment scored 18.6 (standard deviation = 3.3, with 'opportunity' and 'informal power' scoring highest and 'resources' scoring lowest). The factor 'age' correlated positively with 'self-determination', 'impact' and 'psychological empowerment', as well as with 'informal power', 'resources' and 'structural empowerment'. Lastly, 'competence' correlated negatively with 'formal power', 'information' and 'structural empowerment'. CONCLUSION There is a relationship between demographic variables and empowerment, and between structural and psychological empowerment. IMPLICATIONS FOR NURSING MANAGEMENT Professional empowerment is related to organisational results, so it is important to reinforce and optimize organisational structures. Empowerment can be achieved with access to structures that promote empowerment, particularly resources.
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Affiliation(s)
- Abílio Cardoso Teixeira
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal.,Escola Superior de Saúde de Santa Maria, Porto, Portugal
| | - Assunção Nogueira
- Escola Superior de Saúde de Vale do Sousa, Gandra, Portugal.,Institute for Research and Advanced Training in Health Sciences and Technologies, Gandra, Portugal
| | | | - Laetitia Teixeira
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal
| | - Maria do Céu Barbieri-Figueiredo
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal.,Escola Superior de Enfermagem do Porto, Porto, Portugal
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Engström M, Högberg H, Strömberg A, Hagerman H, Skytt B. Staff Working Life and Older Persons' Satisfaction With Care: A Multilevel, Correlational Design. J Nurs Care Qual 2021; 36:E7-E13. [PMID: 32079960 DOI: 10.1097/ncq.0000000000000463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The importance of staff working life for staff well-being has been demonstrated in several studies; less research has focused on staff working life and older persons' satisfaction with care. PURPOSE The study aim was to study relationships between 1) staff assessments of their structural conditions/empowerment in elderly care, psychological empowerment, and job satisfaction and (2) older persons' satisfaction with care. METHODS A multilevel, cross-sectional, and correlational design was applied using questionnaire data on working life (1021 staff members) and unit-level data (40 elderly care units) on older persons' satisfaction with care. RESULTS Statistically significant relationships were found between all 3 working life variables and older persons' satisfaction with care. Furthermore, the results revealed an indirect/mediating effect of job satisfaction between structural empowerment and satisfaction with care, but not for psychological empowerment. CONCLUSIONS Staff structural empowerment, psychological empowerment, and job satisfaction are linked to older persons' satisfaction with care.
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Affiliation(s)
- Maria Engström
- Faculty of Health and Occupational Studies, Department of Caring Science, University of Gävle, Sweden (Drs Engström, Högberg, Strömberg, Hagerman, and Skytt); Department of Public Health and Caring Sciences, Uppsala University, Sweden (Drs Engström and Skytt); and Nursing Department, Medicine and Health College, Lishui University, China (Dr Engström)
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7
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Roviralta-Vilella M, Moreno-Poyato AR, Rodríguez-Nogueira Ó, Duran-Jordà X, Roldán-Merino JF. Relationship between the nursing practice environment and the therapeutic relationship in acute mental health units: A cross-sectional study. Int J Ment Health Nurs 2019; 28:1338-1346. [PMID: 31609540 DOI: 10.1111/inm.12648] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/29/2019] [Accepted: 08/06/2019] [Indexed: 02/03/2023]
Abstract
The therapeutic relationship constitutes the central axis of mental health nursing. The clinical practice environment has been empirically related to the quality of care. However, the relationship between the two constructs is unknown in the setting of mental health units. We aimed to examine whether the practice environment and nurses' characteristics influence the therapeutic relationship in mental health units. Through a cross-sectional design, data were collected via an online form completed by nurses in 18 mental health units. Linear regression was used to examine the relationship between the clinical practice environment and the therapeutic relationship. Questionnaires were completed by 198 participants. The mean age was 33.8 (SD 9.1) years, 71.7% were women, and only 20.2% had a specialist qualification in mental health. The therapeutic relationship was better when there was a more favourable practice environment (B: 3.111; 95% CI: 1.46-4.75). The most influential environment-related factor was the nursing foundations for quality of care (B: 2.124; 95% CI: 0.17-4.07). The factors associated with a high-quality therapeutic relationship were a more favourable practice environment and the presence of more foundations for quality nursing care, coupled with higher academic attainment and longer nursing experience. Institutions should take into account the importance of the nursing practice environment in mental health units. Aspects related to the quality of nursing foundations, such as training, the use of nursing language and taxonomy, and the existence of a common nursing philosophy, are influential for a high-quality therapeutic relationship.
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Affiliation(s)
| | - Antonio R Moreno-Poyato
- Escola Superior d'Infermeria del Mar, Parc de Salut Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Óscar Rodríguez-Nogueira
- Nursing and Physical Therapy Department, Health Sciences School, Universidad de León, Ponferrada León, Spain
| | | | - Juan F Roldán-Merino
- Campus Docent Sant Joan de Déu Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain
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Silén M, Skytt B, Engström M. Relationships between structural and psychological empowerment, mediated by person-centred processes and thriving for nursing home staff. Geriatr Nurs 2019; 40:67-71. [DOI: 10.1016/j.gerinurse.2018.06.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/18/2018] [Accepted: 06/22/2018] [Indexed: 12/22/2022]
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Bianchi M, Bagnasco A, Bressan V, Barisone M, Timmins F, Rossi S, Pellegrini R, Aleo G, Sasso L. A review of the role of nurse leadership in promoting and sustaining evidence-based practice. J Nurs Manag 2018; 26:918-932. [DOI: 10.1111/jonm.12638] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Monica Bianchi
- Department of Business Economics, Health and Social Care; University of Applied Science and Arts of Southern Switzerland; Manno Switzerland
| | | | - Valentina Bressan
- Department of Otolaryngology / Head and Neck Surgery; University Hospital Santa Maria della Misericordia; Udine Italy
| | | | - Fiona Timmins
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
| | - Silvia Rossi
- Department of Health Sciences; University of Genoa; Genoa Italy
| | | | - Giuseppe Aleo
- Department of Health Sciences; University of Genoa; Genoa Italy
| | - Loredana Sasso
- Department of Health Sciences; University of Genoa; Genoa Italy
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Eriksson E, Engström M. Internationally educated nurses’ descriptions of their access to structural empowerment while working in another country's health care context. J Nurs Manag 2018. [DOI: 10.1111/jonm.12617] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Elisabet Eriksson
- Department of Health and Caring Sciences; University of Gävle; Gävle Sweden
| | - Maria Engström
- Department of Health and Caring Sciences; University of Gävle; Gävle Sweden
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11
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Knight M, Bolton P, Kopeski L. Providing Physical Care to Persons With Serious Mental Illness: Attitudes, Confidence, Barriers and Psychological Empowerment. Arch Psychiatr Nurs 2017; 31:447-453. [PMID: 28927507 DOI: 10.1016/j.apnu.2017.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/21/2017] [Accepted: 07/07/2017] [Indexed: 10/19/2022]
Abstract
The prevalence of metabolic syndrome (MetS) in people with serious mental illness (SMI) has been well documented in the mental health literature. Despite the adoption of various guidelines for monitoring risk factors for diabetes and cardiovascular risk in this population, limited translation has occurred in actual practice (Hermes, Sernyak, & Rosenheck, 2013). The Institute of Medicine (IoM) (2009) has noted a lag time in the application of knowledge within clinical settings. Evidence-based practice was deemed as a means of improving healthcare outcomes through the use of science supported standards of care. Evidence-based practice (EBP) is a process to guide clinical decision making that involves the clinician's experience, well documented research findings, and the patient's values and choices (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996). The IoM has established that by the year 2020, 90% of clinical decisions should be based upon current and scientifically based information (IoM, 2009). Psychiatric-mental health nurses are challenged to utilize EBP for clients with MetS in assessing their health status and discussing the findings, educating them about their current risk and life style modifications to mitigate risk, and finally, partnering with them to maximize health and quality of life.
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Affiliation(s)
- Margaret Knight
- School of Nursing, University of Massachusetts Lowell, Lowell, MA, United States.
| | - Paula Bolton
- Psychiatric Neurotherapeutics Program, McLean Hospital, Belmont, MA, United States
| | - Lynne Kopeski
- Behavioral Health Partial Hospital Program, McLean Hospital, Belmont, MA, United States
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12
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Bjorkman A, Engstrom M, Olsson A, Wahlberg AC. Identified obstacles and prerequisites in telenurses' work environment - a modified Delphi study. BMC Health Serv Res 2017; 17:357. [PMID: 28521743 PMCID: PMC5437518 DOI: 10.1186/s12913-017-2296-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 05/05/2017] [Indexed: 11/29/2022] Open
Abstract
Background Telenursing is an expanding part of healthcare, staffed with registered nurses whose work environment is typical of a call centre. Work-related stress has been shown to be a major problem in nurses’ work environments and of importance to the outcome of care, patient safety, nurse job satisfaction and burnout. Today, however, we have a limited understanding of and knowledge about the work environment for telenurses. The aim of the present study is to explore and reach consensus on perceived important obstacles and prerequisites in telenurses’ work environment. Methods A modified Delphi design, using qualitative as well as quantitative data sequentially through three phases, was taken. Data were initially collected via semi-structured interviews (Phase I) and later using a web survey (Phase II-III) between March 2015 and March 2016. Results The findings present a consensus view of telenurses’ experiences of important obstacles and prerequisites in their work environment. Central to the findings are the aspects of telenurses having a demanding work, cognitive fatigue and having no opportunity for recovery during the work shift was ranked as important obstacles. Highly ranked prerequisites for managing were being able to focus on one caller at a time, working in a calm and pleasant environment and having technical support 24/7. Conclusions Managers need to enable telenurses to experience control in their work, provided with possibilities to control their work and to recover during work; shortening work time could improve their work environment. Limited possibilities to perform work might contribute to feelings of stress and inability to perform work.
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Affiliation(s)
- Annica Bjorkman
- Faculty of Health and Occupational Studies, Caring Science University of Gavle, Gavle, Sweden. .,Department of Public Health and Caring Sciences, Uppsala University, Health Services Research, Uppsala, Sweden.
| | - Maria Engstrom
- Faculty of Health and Occupational Studies, Caring Science University of Gavle, Gavle, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Health Services Research, Uppsala, Sweden.,Nursing Department, Medicine and Health College, Lishui University, Lishui, People's Republic of China
| | - Annakarin Olsson
- Faculty of Health and Occupational Studies, Caring Science University of Gavle, Gavle, Sweden
| | - Anna Carin Wahlberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Van Bogaert P, Peremans L, de Wit M, Van Heusden D, Franck E, Timmermans O, Havens DS. Nurse managers' perceptions and experiences regarding staff nurse empowerment: a qualitative study. Front Psychol 2015; 6:1585. [PMID: 26528228 PMCID: PMC4604254 DOI: 10.3389/fpsyg.2015.01585] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 09/30/2015] [Indexed: 11/13/2022] Open
Abstract
Aim: To study nurse managers' perceptions and experiences of staff nurse structural empowerment and its impact on the nurse manager leadership role and style. Background: Nurse managers' leadership roles may be viewed as challenging given the complex needs of patients and staff nurses' involvement in both clinical and organizational decision-making processes in interdisciplinary care settings. Design: Qualitative phenomenological study. Methods: Individual semi-structured interviews were conducted with 8 medical or surgical nurse managers in a 600-bed Belgian university hospital between December 2013 and June 2014. This hospital was undergoing conversion from a classical hierarchical, departmental structure to a flat, interdisciplinary model. Results: Nurse managers were found to be familiar with the structural empowerment of clinical nurses in the hospital and to hold positive attitudes toward it. They confirmed the positive impact of empowerment on their staff nurses, as evidenced by increased responsibility, autonomy, critical reflection and enhanced communication skills that in turn improved the quality and safety of patient care. Structural empowerment was being supported by several change initiatives at both the unit and hospital levels. Nurse managers' experiences with these initiatives were mixed, however, because of the changing demands with regard to their manager role and leadership style. In addition, pressure was being experienced by both staff nurses and nurse managers as a result of direct patient care priorities, tightly scheduled projects and miscommunication. Conclusion: Nurse managers reported that structural empowerment was having a favorable impact on staff nurses' professional attitudes and the safety and quality of care in their units. However, they also reported that the empowerment process had led to changes in the managers' roles as well as daily practice dilemmas related to the leadership styles needed. Clear organizational goals and dedicated support for both clinical nurses and nursing unit managers are imperative to maintaining an empowering practice environment which can ensure the best care and healthy, engaged staff.
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Affiliation(s)
- Peter Van Bogaert
- Division of Nursing and Midwifery Sciences, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp Antwerp, Belgium ; Department of Nursing, Antwerp University Hospital Antwerp, Belgium
| | - Lieve Peremans
- Division of Nursing and Midwifery Sciences, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp Antwerp, Belgium
| | - Marlinde de Wit
- Division of Nursing and Midwifery Sciences, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp Antwerp, Belgium ; Department of Nursing, Antwerp University Hospital Antwerp, Belgium
| | - Danny Van Heusden
- Division of Nursing and Midwifery Sciences, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp Antwerp, Belgium ; Department of Nursing, Antwerp University Hospital Antwerp, Belgium
| | - Erik Franck
- Division of Nursing and Midwifery Sciences, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp Antwerp, Belgium ; Department of Health Care, Karel de Grote University College Antwerp Antwerp, Belgium
| | - Olaf Timmermans
- Division of Nursing and Midwifery Sciences, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp Antwerp, Belgium ; Academia for Welfare and Health, HZ University of Applied Sciences Vlissingen Vlissingen, Netherlands
| | - Donna S Havens
- School of Nursing, The University of North Carolina at Chapel Hill Chapel Hill, NC, USA
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Nilsson A, Engström M. E-assessment and an e-training program among elderly care staff lacking formal competence: results of a mixed-methods intervention study. BMC Health Serv Res 2015; 15:189. [PMID: 25943436 PMCID: PMC4438631 DOI: 10.1186/s12913-015-0843-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 04/24/2015] [Indexed: 11/16/2022] Open
Abstract
Background Among staff working in elderly care, a considerable proportion lack formal competence for their work. Lack of formal competence, in turn, has been linked to higher staff ratings of stress symptoms, sleep disturbances and workload. Objectives: 1) To describe the strengths and weaknesses of an e-assessment and subsequent e-training program used among elderly care staff who lack formal competence and 2) to study the effects of an e-training program on staff members’ working life (quality of care and psychological and structural empowerment) and well-being (job satisfaction and psychosomatic health). The hypothesis was that staff who had completed the e-assessment and the e-training program would rate greater improvements in working life and well-being than would staff who had only participated in the e-assessments. Methods An intervention study with a mixed-methods approach using quantitative (2010–2011) and qualitative data (2011) was conducted in Swedish elderly care. Participants included a total of 41 staff members. To describe the strengths and weaknesses of the e-assessment and the e-training program, qualitative data were gathered using semi-structured interviews together with a study-specific questionnaire. To study the effects of the intervention, quantitative data were collected using questionnaires on: job satisfaction, psychosomatic health, psychological empowerment, structural empowerment and quality of care in an intervention and a comparison group. Results Staff who completed the e-assessments and the e-training program primarily experienced strengths associated with this approach. The results were also in line with our hypotheses: Staff who completed the e-assessment and the e-training program rated improvements in their working life and well-being. Conclusion Use of the e-assessments and e-training program employed in the present study could be one way to support elderly care staff who lack formal education by increasing their competence; increased competence, in turn, could improve their self-confidence, working life, and well-being.
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Affiliation(s)
- Annika Nilsson
- Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden. .,Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
| | - Maria Engström
- Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden. .,Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
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