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Saladino C, Favez L, Serdaly C, Ausserhofer D, De Geest S, Zúñiga F. Characteristics and Activities of Nurses in Expanded Roles Employed in Swiss Nursing Homes: A Cross-Sectional Study. Int J Older People Nurs 2024; 19:e12631. [PMID: 38989647 DOI: 10.1111/opn.12631] [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: 03/22/2023] [Revised: 04/29/2024] [Accepted: 06/22/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND As the number of nursing home residents with multiple healthcare needs grows, the demand for nursing expertise increases. The implementation of new care models involving nurses with expanded roles is crucial for ensuring quality care in nursing homes. OBJECTIVES To investigate the characteristics and activities of nurses employed in nursing homes in expanded roles and the factors associated with variation in the activities performed. METHODS This multicentre cross-sectional survey in Switzerland collected data from a convenience sample of 118 nursing homes between September 2018 and October 2019. From a subsample of 62 nursing homes, we analysed the characteristics and activities of 104 nurses in expanded roles. Associations between the activities performed and the educational background of the nurses in expanded roles, their direct supervisors' positions and the presence of physicians in the nursing homes were examined. RESULTS Most Registered Nurses in expanded roles were diploma educated (48%), with fewer having a bachelor's (35%) or master's degree (17%). Overall, direct clinical practice and guidance and coaching activities were conducted monthly to weekly; consultation, evidence-based practice, collaboration and ethical decision-making activities were conducted monthly. We saw variations where a higher educational background was associated with more frequent evidence-based practice activities (z = 3.47, p < 0.001), and if direct supervisors were ward managers, nurses in expanded roles worked more frequently below their scope of practice (z = 4.10, p < 0.001). CONCLUSION This is the first study to use Hamric's integrative Advanced Practice Nursing model to examine the activities of nurses in expanded roles in nursing homes. We found considerable variation in their activities, where nursing homes seem to adapt their roles to their educational background and the local context. IMPLICATIONS FOR PRACTICE Our findings show the importance of clarifying role expectations for Registered Nurses in expanded roles, allowing them to practice at the top of the licence to meet residents' complex healthcare needs.
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Affiliation(s)
- Christian Saladino
- Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland
- Alterszentrum am Bachgraben, Allschwil, Switzerland
| | - Lauriane Favez
- Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland
- School of Engineering and Management Vaud, HES-SO University of Applied Sciences and Arts Western Switerland, Delémont, Switzerland
| | | | - Dietmar Ausserhofer
- Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland
- Claudiana Research, College of Health Care-Professions Claudiana, Bozen, Italy
| | - Sabina De Geest
- Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland
- Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Franziska Zúñiga
- Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland
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Jubinville M, Tchouaket EN, Longpré C. Scoping review protocol examining charge nurse skills: requirement for the development of training. BMJ Open 2023; 13:e067307. [PMID: 36822804 PMCID: PMC9950913 DOI: 10.1136/bmjopen-2022-067307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
INTRODUCTION The charge nurse (CN) holds a position in clinical-administrative management and is essential for improving the quality and safety of care in healthcare institutions. The position requires five essential skills: leadership; interpersonal communication; clinical-administrative caring; problem solving; and knowledge and understanding of the work environment. The scientific literature has not widely examined the importance of providing these skills as part of initial training, nor when CNs begin their duties. This study aims to fill this gap through an exhaustive review of the literature with the aim of developing standardised training for the CN when they start in their position. METHODS AND ANALYSIS A scoping review using the Joanna Briggs Institute framework will be conducted. The CINAHL, MEDLINE, Science Direct and Cairn, databases as well as grey literature from ProQuest dissertations and thesis global database, Google Scholar and the website of the Order of Nurses of Quebec will be queried using keywords. Relevant literature in French and English, published between 2000 and 2022 will be retained. The CN is the target population. Outcomes address at least one of the five CN skills, describe how they are operationalised and what their impact is on the organisation of work and quality of care. This analysis will identify essential and relevant elements for the development of standardised, up-to-date and appropriate training for the position of CN. ETHICS AND DISSEMINATION Ethical approval is not required, as data does not include individual patient data. The results will be published in peer-reviewed journals, presented at conferences and presented to nursing managers and directors. SCOPING REVIEW REGISTRATION Research Registry ID: researchregistry7030.
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Affiliation(s)
- Maripier Jubinville
- Département des Sciences infirmières, Université du Québec en Outaouais - Campus de Saint-Jérôme, Saint-Jérôme, Quebec, Canada
| | - Eric Nguemeleu Tchouaket
- Département des Sciences infirmières, Université du Québec en Outaouais - Campus de Saint-Jérôme, Saint-Jérôme, Quebec, Canada
| | - Caroline Longpré
- Département des Sciences infirmières, Université du Québec en Outaouais - Campus de Saint-Jérôme, Saint-Jérôme, Quebec, Canada
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Nurmeksela A, Mikkonen S, Kinnunen J, Kvist T. Validation of the Nurse Managers' Work Content Questionnaire and Factors-A Structural Equation Modeling Study. J Nurs Res 2022; 30:e245. [PMID: 36301852 DOI: 10.1097/jnr.0000000000000526] [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] Open
Abstract
BACKGROUND The responsibilities of nurse managers are diverse and occasionally inadequately organized. Moreover, the role of nurse manager often lacks a clear job description. Few methodologies for evaluating the content of nurse managers' work exist. PURPOSE This study was designed to validate the Nurse Managers' Work Content Questionnaire (NMWCQ) instrument and to analyze the relationships between NMWCQ factors and background variables using structural equation modeling. METHODS A multicenter descriptive and cross-sectional study design was used. The NMWCQ, which includes 87 items across 13 components, was developed based on a comprehensive literature review and pilot study. The questionnaire was sent to all of the nurse managers ( N = 756) employed at eight Finnish hospitals in 2019. Exploratory and confirmatory factor analyses were used to psychometrically test and validate the NMWCQ, whereas Cronbach's alpha values were calculated to explore the internal consistency of the instrument. Structural equation modeling was applied to detect the relationships between the constructed factor structure and the background variables. RESULTS Two hundred seven nurse managers participated in this study. The final solution for the NMWCQ included 75 items across 12 factors. The NMWCQ factors were as follows: responsibility for new employees, daily management, human resource management, decision making, clinical nursing, development, planning of processes, collaboration, ensuring knowledge, evidence-based management, ensuring care quality, and financial management. The items showed factor loadings that were either positive or negative, with values ranging from .314 to .846. The Cronbach's alpha values for the factors ranged between .605 and .851. All of the covariances and relationships between background variables and factors were found to be significant ( p ≤ .05). The structural equation modeling showed acceptable index results (incremental fit index = .954, comparative fit index = .951, and root mean square error of approximation = .048). CONCLUSIONS The NMWCQ version assessed in this study shows a more robust structure than the previously published pilot version. Psychometric testing showed the NMWCQ as suitable for describing the diverse work requirements of nurse managers and may offer a framework for concretizing the job description of nurse managers.
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Affiliation(s)
- Anu Nurmeksela
- PhD, RN, Lecturer, Department of Nursing Science, Faculty of Health Sciences, University of Eastern, Finland
| | - Santtu Mikkonen
- PhD, Senior Researcher and Statistician, Department of Applied Physics, and Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio Campus, Finland
| | - Juha Kinnunen
- PhD, Director, Health Care District, Central Finland Central Hospital, Finland
| | - Tarja Kvist
- PhD, RN, Professor and Head, Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland
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Abstract
Role transition from clinical nurse to charge nurse can be challenging. The purpose of this quasi-experiment was to evaluate a charge nurse orientation and development program, designed to increase nurses' confidence regarding this role. Patients' response to care as a result of this program was also assessed. It appears that nurse confidence regarding this transition improves following a formal intervention. Regarding patient satisfaction, charge nurse visits to patients increased as well.
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Nurmeksela A, Mikkonen S, Kinnunen J, Kvist T. Relationships between nurse managers' work activities, nurses' job satisfaction, patient satisfaction, and medication errors at the unit level: a correlational study. BMC Health Serv Res 2021; 21:296. [PMID: 33794875 PMCID: PMC8017674 DOI: 10.1186/s12913-021-06288-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 03/17/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Nurse managers play a critical role in enhancing nursing and patient outcomes. The work of nurse managers, who can be described as middle-managers at health care organizations, is complex and changes on a daily basis. Only a few studies have clarified how nurse managers divide their time across various work activities. This study aimed to describe the relationships between nurse managers' work activities, nurses' job satisfaction, patient satisfaction, and medication errors at the hospital unit level. METHODS A cross-sectional and correlational study design was used. The data were collected from nurse managers (n = 29), nursing staff (n = 306), and patients (n = 651) from 28 units across three Finnish acute care hospitals between April and November 2017. In addition, data concerning medication errors (n = 468) over one calendar year (2017) were acquired from the hospitals' incident reporting register. Analysis of covariance (ANCOVA) was used to estimate relationships between data from subareas of Nurse Managers' Work Content Questionnaire, Kuopio University Hospital Job Satisfaction Scale, and Revised Humane Caring Scale, along with medication error reports. A significance level of 95% was applied when estimating the covariances between variables. Unstandardized regression coefficients (B) were used to explain the relationships between variables. RESULTS Multiple relationships between nurse managers' work activities, nurses' job satisfaction, patient satisfaction, and medication errors were identified. Nurse managers' work activities had both positive and negative relationships on the other studied variables. The Requiring factors of work (p < .001) subarea of nurses' job satisfaction, total patient satisfaction (p < .001), and medication errors (p < .001) were identified as the variables most significantly affected by other factors. CONCLUSIONS The findings suggest that nurse managers should focus on improving nursing practices by managing and organizing nurses' work in a way that makes their employees feel supported, motivated and secure. Furthermore, nurse managers should adopt a leadership style that emphasizes safe and patient-centered care. The results also suggest that the administration of today's health care organizations should actively evaluate nurse managers' share of work activities to ensure that their daily work is in line with the organizational goals.
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Affiliation(s)
- Anu Nurmeksela
- Faculty of Health Sciences, Department of Nursing Science, University Teacher, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Santtu Mikkonen
- Department of Applied Physics and Department of Environmental and Biological Sciences, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Juha Kinnunen
- Central Finland Central Hospital, Keskussairaalantie 19, 40620 Jyväskylä, Finland
| | - Tarja Kvist
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, 70211 Kuopio, Finland
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Shimazaki K, Ota K, Niimi Y. Developing a self-checklist of staff development behavior for associate nurse unit managers using the Delphi method. Nurs Health Sci 2020; 23:195-207. [PMID: 33295081 DOI: 10.1111/nhs.12798] [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: 11/18/2019] [Revised: 11/12/2020] [Accepted: 11/25/2020] [Indexed: 11/26/2022]
Abstract
The most significant influence on nurses' professional growth is through work under direct guidance in clinical settings. Associate nurse unit managers perform direct patient care with the staff, as well as assist management work of nurse unit managers. They can be excellent role models for the staff. We examined their behaviors that help promote staff development, aimed to identify effective behaviors, and created a self-checklist to evaluate them. We created 53 items to assess staff development behaviors, which were evaluated via a Delphi survey with 252 experts and a questionnaire survey with 124 associate nurse unit managers in Japan to evaluate whether the created item was appropriate. The results of the Delphi survey showed an agreement rate of over 90%, and associate nurse unit managers showed an acceptance rate of 82.6-99.2% for 40 of 53 items. Consequently, we created 40-item self-checklist of staff development behaviors for associate nurse unit managers with adequate validity. This checklist would be helpful for them to promote staff development while working in clinical settings and would contribute to enhancing the quality of nursing.
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Affiliation(s)
- Kazuyo Shimazaki
- Department of Nursing, College of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Katsumasa Ota
- Opening Preparation Office of Numazu Human Care Department, Toho University, Numazu, Japan
| | - Yukari Niimi
- Department of Nursing Faculty of Health and Science, Nagoya Women's University, Nagoya, Japan
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Morton D, Topper K, Bowers C, Jardien-Baboo S, Nyangeni T, Mabitja M. Job satisfaction of nurses working in public hospitals: perceptions of nurse unit managers in South Africa. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:1024-1029. [PMID: 32972221 DOI: 10.12968/bjon.2020.29.17.1024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Job satisfaction among nurses often determines whether they choose to remain in the profession or in the facility where they work. AIM The study sought to explore and describe the job satisfaction of registered nurses in South Africa through the lens of their nurse unit managers. METHODS A qualitative, exploratory, descriptive design was undertaken. Fourteen unit managers were interviewed and Tesch's method of data analysis was used. FINDINGS Four themes emerged: 'staff shortages lead to nurses feeling overwhelmed and frustrated', 'nurses' work performance is undermined by limited resources and poor infrastructure', 'discontent among nurses with regard to poor top level and human resource management' and 'despite challenges, nurses experience rare moments of job satisfaction'. CONCLUSION Unit managers need to find ways to enhance existing elements of job satisfaction by emphasising the nurse-patient relationship and teamwork among their staff in order to improve the overall job satisfaction of staff.
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Affiliation(s)
- David Morton
- Senior Lecturer, Department of Nursing Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Kegan Topper
- Professional Psychologist, Private Practice, South Africa
| | - Candice Bowers
- Lecturer, Department of Nursing Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Sihaam Jardien-Baboo
- Senior Lecturer, Department of Nursing Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Thando Nyangeni
- Deputy Head, Lilitha College of Nursing, Port Elizabeth Campus, South Africa
| | - Moeta Mabitja
- Lecturer, Department of Nursing Science, University of Pretoria, South Africa
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Atwal A, Phillip M, Moorley C. Senior nurses' perceptions of junior nurses' incident reporting: A qualitative study. J Nurs Manag 2020; 28:1215-1222. [PMID: 32492230 DOI: 10.1111/jonm.13063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/18/2020] [Accepted: 05/25/2020] [Indexed: 11/28/2022]
Abstract
AIM To develop an understanding of senior nurses' ranking and perceptions of incident reporting by junior nurses. BACKGROUND Nurses must be encouraged to report incidents to nursing management. It is important to ascertain how senior nurses perceive their concerns, as it is crucial to ensuring that patient safety is managed. METHOD Qualitative study. Four focus groups explored senior nurses' perceptions of risks identified by nurses from a live incident reporting database. Data were analysed using framework analysis. RESULTS Five themes emerged demonstrating the differences in opinions in relation to the classification of events by senior and non-senior nurses. Senior nurses held the view that some junior nurses use incident reporting to 'vent frustration.' CONCLUSION There is a mismatch between senior nurses' and junior nurses' perceptions of safety incidents. Nurses need to develop the writing style and use language that red flags incidents when reporting incidents. Senior nurses need to create a positive culture where risk from incident reporting is used to improve patient safety and subsequently a positive work environment. Implications for Nursing Management Our research identified the need for joint training to promote a shared understanding among nurses as to how incident report should be completed to promote patient safety.
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Affiliation(s)
- Anita Atwal
- School of Health and Social Care, London South Bank University, London, UK
| | - Miriam Phillip
- Imperial College HealthCare NHS Trust, St Marys Hospital, London, UK
| | - Calvin Moorley
- School of Health and Social Care/Adult Nursing and Midwifery Studies, London South Bank University, London, UK
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Koesnell A, Bester P, Niesing C. Conflict pressure cooker: Nurse managers' conflict management experiences in a diverse South African workplace. Health SA 2019; 24:1128. [PMID: 31934423 PMCID: PMC6917426 DOI: 10.4102/hsag.v24i0.1128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 09/05/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Nurse managers are central to conflict management and a healthy work environment. South Africa is one of the most diverse countries globally and workplace diversity is a reality in healthcare organisations. There is a gap in academic literature on conflict management by nurse managers in diverse workplaces in South Africa. AIM This research aims to understand nurse managers' experiences of conflict management within a diverse South African workplace (military hospital) in order to facilitate a healthy work environment. SETTING The context was a diverse, medical military organisation servicing all nine South African provinces. This military hospital employed staff of varying nationalities, catering to military and private patients, and functioned within a strict hierarchical structure. METHODS Purposive sampling was used. Thirteen unstructured, individual interviews were conducted based on a qualitative, phenomenological design. The interviews were followed by content analysis and five main themes emerged as a result. RESULTS A hierarchical, diverse organisational culture complicates conflict management. The ranking structure, resource shortages, intergenerational dynamics, poor communication and distrust cause conflict. Nurse managers experience conflict daily and are central to conflict management. As such, they have certain personal characteristics and display specific conflict management skills. Conflict management skills can be taught, but this requires an intra- to interpersonal process. A major challenge for the nursing profession today is the younger nurses who seem less passionate and nurse managers who are under more pressure than before. CONCLUSION A medical military organisation presents an organisational culture that combined with diversity is predisposed to conflict, which endangers the work environment. Yet, both conflict and workplace diversity can, when managed correctly, enrich a healthcare organisation. Nurses and nurse managers will benefit from reflective conflict management training as an intra- to interpersonal process.
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Affiliation(s)
- Angela Koesnell
- Africa Unit for Transdisciplinary Health Research (AUTHeR), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Petra Bester
- Africa Unit for Transdisciplinary Health Research (AUTHeR), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Christi Niesing
- Africa Unit for Transdisciplinary Health Research (AUTHeR), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Nurmeksela A, Kinnunen J, Kvist T. Nurse managers' work content: development of the questionnaire and results of the pilot study. Scand J Caring Sci 2019; 34:839-851. [PMID: 31750557 DOI: 10.1111/scs.12796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 10/29/2019] [Indexed: 11/29/2022]
Abstract
AIM To develop the Nurse Managers' Work Content Questionnaire (NMWCQ) and to describe nurse managers' work content. BACKGROUND Restructuring within health care has expanded the nurse manager's role to include organisational, patient and staff demands. METHODS The pilot study employed a cross-sectional study design. Based on a literature review, the NMWCQ with 102 items was developed and pretested for this study. Data were collected in 2017 from three Finnish acute care central hospitals that provide specialised health care. A total of 61 nurse managers participated, which represents a response rate of 59%. Principal component analysis was used to test the construct validity of the instrument. Cronbach's alpha values were used to analyse the internal consistency of the instrument. In addition, descriptive and nonparametric analysis was used. RESULTS Ultimately, 13 components with 87 items were identified in the questionnaire. The construct validity and internal consistency of the questionnaire were at acceptable levels. Cronbach's alpha rates of the components were 0.554 - 0.890. The most frequently performed daily work of nurse managers was in the component of organising, and the most infrequently performed daily work was in the component of clinical nursing. CONCLUSIONS The study shows that the Nurse Managers' Work Content Questionnaire (NMWCQ) is suitable for measuring the current content of nurse managers' work. However, the questionnaire is new and needs additional testing such as confirmatory factor analysis with larger amounts of data.
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Affiliation(s)
- Anu Nurmeksela
- Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Jyväskylä, Finland
| | - Juha Kinnunen
- Central Finland Central Hospital, University of Eastern Finland, Jyväskylä, Finland
| | - Tarja Kvist
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Andronico J, Getting C, Hughes CH, Ciccolini K. Developing and Standardizing an Orientation for Outpatient Charge Nurses. J Contin Educ Nurs 2019; 50:517-521. [DOI: 10.3928/00220124-20191015-08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 07/17/2019] [Indexed: 11/20/2022]
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El Haddad M, Wilkinson G, Thompson L, Faithfull‐Byrne A, Moss C. Perceptions of the impact of introducing administrative support for nurse unit managers: A qualitative evaluation. J Nurs Manag 2019; 27:1700-1711. [DOI: 10.1111/jonm.12860] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 08/23/2019] [Accepted: 08/29/2019] [Indexed: 11/30/2022]
Affiliation(s)
- May El Haddad
- School of Nursing, Midwifery and Paramedicine University of the Sunshine Coast Maroochydore DC Qld Australia
- Sunshine Coast Hospital and Health Service Sunshine Coast MC Qld Australia
| | - Graham Wilkinson
- School of Nursing, Midwifery and Paramedicine University of the Sunshine Coast Maroochydore DC Qld Australia
- Sunshine Coast Hospital and Health Service Sunshine Coast MC Qld Australia
| | - Lorraine Thompson
- Sunshine Coast Hospital and Health Service Sunshine Coast MC Qld Australia
| | - Annette Faithfull‐Byrne
- School of Nursing, Midwifery and Paramedicine University of the Sunshine Coast Maroochydore DC Qld Australia
- Sunshine Coast Hospital and Health Service Sunshine Coast MC Qld Australia
| | - Cheryle Moss
- Nursing and Midwifery Monash University Melbourne Vic. Australia
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Duffield C, Gardner G, Doubrovsky A, Wise S. Manager, clinician or both? Nurse managers' engagement in clinical care activities. J Nurs Manag 2019; 27:1538-1545. [PMID: 31419364 DOI: 10.1111/jonm.12841] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 08/08/2019] [Accepted: 08/13/2019] [Indexed: 10/26/2022]
Abstract
AIM To explore the extent of Australian nurse managers' engagement in clinical care activities. BACKGROUND Hybrid nurse manager roles lack clarity in the optimal balance between the clinical and other activities, resulting in stress and challenges in recruiting and retaining nurse managers. METHODS In a national survey using the Advanced Practice Role Delineation tool, Australian nurses self-assessed their level of engagement in activities across five domains of nursing practice. The subset sample analysed comprised 2,758 registered nurses, 390 clinical (front-line) nurse managers and 43 organisational (middle) nurse managers. Median domain scores were compared with non-parametric tests of difference. RESULTS Clinical nurse managers were in a hybrid role, reporting high levels of engagement across the domains. Lower scores observed for organisational nurse managers highlight the shift to strategy-focussed activities that occurs as nurses up the management hierarchy. CONCLUSIONS By indicating their engagement in the clinical care domain, respondents demonstrated that clinically focused activities were not entirely lost from either front-line or middle-management roles. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers equipped with clinical and management skills, and allowed time to remain engage in clinical care activities are critical for patient-centred and cost-effective care in today's complex health care environments.
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Affiliation(s)
- Christine Duffield
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.,School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia
| | - Glenn Gardner
- Gardner & Gardner Academic Consulting Pty. Ltd., Brisbane, Qld, Australia.,School of Nursing, Queensland University of Technology, Brisbane, Qld, Australia
| | - Anna Doubrovsky
- School of Nursing, Queensland University of Technology, Brisbane, Qld, Australia
| | - Sarah Wise
- Centre for Health Economics Research and Evaluation, Faculty of Business, University of Technology Sydney, Sydney, NSW, Australia
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Mianda S, Voce AS. Enablers and barriers to clinical leadership in the labour ward of district hospitals in KwaZulu-Natal, South Africa. BMJ LEADER 2019. [DOI: 10.1136/leader-2018-000130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Introduction and backgroundLike many health systems in low-income and middle-income countries, the South African health system has failed to decrease both maternal and perinatal mortality significantly, especially in district hospitals. Inappropriately trained healthcare providers and poor clinical leadership are repeatedly linked to healthcare providers’ preventable factors contributing to most maternal and perinatal deaths. Clinical skills of healthcare providers have been largely addressed, while clinical leadership remained neglected. One strategy implemented recently to support clinical leadership is the introduction of District Clinical Specialist Teams (DCSTs). Clinical leadership in the labour ward of district hospitals in KwaZulu-Natal (KZN) is conceptualised as an emergent phenomenon arising from dynamic interactions in the labour ward and the broader health system, converging to attain optimal patient care.AimTo evaluate the enablers and barriers to clinical leadership in the labour ward of district hospitals.MethodIterative data collection and analysis, following the Corbin and Strauss grounded theory approach, was applied. In-depth interviews were carried out with the midwifery members of the DCSTs in KZN. The emergent enablers and barriers to clinical leadership were presented and discussed at a workshop with broader midwifery representation, leading to a final classification of enablers and barriers to clinical leadership.Results and conclusionEnablers and barriers to clinical leadership arise as a result of emergent dynamic interactions within the labour ward and the broader health system, located at policy, organisational, team and individual healthcare provider levels, with the policy context as the overriding factor framing the implementation of clinical leadership.
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Sawin KJ, Montgomery KE, Dupree CY, Haase JE, Phillips CR, Hendricks-Ferguson VL. Oncology Nurse Managers' Perceptions of Palliative Care and End-of-Life Communication. J Pediatr Oncol Nurs 2019; 36:178-190. [PMID: 30939966 DOI: 10.1177/1043454219835448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The purpose of this study was to describe pediatric oncology nurse managers' (NMs) perspectives of palliative care/end-of-life (PC/EOL) communication. The study, guided by group-as-a-whole theory and empirical phenomenology, was part of a larger, multisite study aimed at understanding pediatric oncology nurses' experiences of PC/EOL communication. Nurses were assigned to focus groups based on length or type of experience (i.e., nurses with <1, 2-5, or >5 years' work experience and NMs). Eleven NMs from three Midwestern pediatric hospitals with large oncology programs participated in one focus group. The participants' mean years of experience was 15.8 in nursing and 12 in pediatric oncology; 90% had a BSN or higher degree; all had supervisory responsibilities. The authors identified 2,912 meaning statements, which were then analyzed using Colaizzi's method. Findings include NMs' overall experience of "Fostering a Caring Climate," which includes three core themes: (1) Imprint of Initial Grief Experiences and Emotions; (2) Constant Vigilance: Assessing and Optimizing Family-Centered Care; and (3) Promoting a Competent, Thoughtful, and Caring Workforce. Findings indicate that pediatric oncology NMs draw on their own PC/EOL experiences and their nursing management knowledge to address the PC/EOL care learning needs of nursing staff and patient/family needs. NMs need additional resources to support nursing staff's PC/EOL communication training, including specific training in undergraduate and graduate nursing programs and national and hospital-based training programs.
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Affiliation(s)
- Kathleen J Sawin
- 1 Children's Hospital of Wisconsin, Milwaukee, WI, USA.,2 University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Abstract
INTRODUCTION Leadership development has been studied extensively in many of the larger countries around the world, but there has been very limited research on nursing leadership development within small island countries. PURPOSE Explorative semistructured interviews underpinned by a phenomenological philosophy were conducted to seek understanding of the meaning attributed to the nursing leadership development within the Maltese culture. METHOD Six nurse leaders from administration, advanced practice, and academic backgrounds participated in semistructured interviews. Thematic data analysis was conducted with a focus on the competencies of nurse leadership within the context of authentic leadership theory. RESULTS Themes moved from a general discussion of the wider cultural setting (Cultural Integration) to a more focused observation of practical factors that contribute to leadership growth (Developing as a Leader), to a personal reflection on their own experiences and journeys (Self-Reflection in Leadership). Indeed, 15 subthemes supported the broad themes addressed in the present study, providing additional context and detail. DISCUSSION Nurse leadership strategies identified during this study may be effective in similar small island cultures.
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Al Sabei SD, Ross AM, Lee CS. Factors influencing nurses’ willingness to lead. J Nurs Manag 2018; 27:278-285. [DOI: 10.1111/jonm.12698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 06/25/2018] [Accepted: 07/21/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Sulaiman D. Al Sabei
- Department of Fundamentals and Nursing Administration; Sultan Qaboos University College of Nursing; Muscat Sultanate of Oman
| | - Amy M. Ross
- Oregon Health and Science University School of Nursing; Portland Oregon
| | - Christopher S. Lee
- Boston College William F. Connell School of Nursing; Chestnut Hill Massachusetts
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Affiliation(s)
- Liesel Delamater
- Liesel Delamater is the director of nursing practice at IU Health North Hospital in Carmel, Ind., and Norma Hall is the dean of nursing at the University of Indianapolis (Ind.)
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