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Wang Q, Chen T, Lang X, Feng D, Liu Y, Zhang K, Huang J, Liu S, Sheng X, Huang S. When and how does the practice environment most benefit the job outcomes of newly graduated nurses? J Adv Nurs 2024; 80:339-349. [PMID: 37449572 DOI: 10.1111/jan.15783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 06/02/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Providing a favourable practice environment has been regarded as an essential to improve the job outcomes of newly graduated nurses (NGNs). However, little is known about how and when NGNs can best utilize their practice environment to produce optimal job outcomes. AIM The aim of this study, which is based on the Conservation of Resources Theory and the Social Cognitive Model of Career Self-Management, is to investigate whether NGNs who have a higher level of personal growth initiative are more likely to benefit from their practice environment and achieve better job outcomes by increasing their occupational self-efficacy. DESIGN A cross-sectional study. METHODS From 1 September 2022, to 30 September 2022, 279 NGNs from five Chinese state-owned hospitals were recruited for this study. The participants completed measures of practice environment, personal growth initiative, occupational self-efficacy, job stress, job satisfaction, turnover intention and quality of care. A descriptive analysis and a moderated mediation model were computed. Reporting adhered to the STROBE statement. RESULTS The influence of the practice environment on job outcomes was significantly mediated by occupational self-efficacy, with personal growth initiative acting as a moderator of this mediation effect. CONCLUSIONS NGNs who exhibited a higher degree of personal growth initiative were more likely to derive benefits from their practice environment and attain positive job outcomes by enhancing their occupational self-efficacy. To boost NGNs' occupational self-efficacy and achieve optimal job outcomes, hospital administrators may not only provide a supportive practice environment for them but also conduct interventions that promote their personal growth initiative. NO PATIENT OR PUBLIC CONTRIBUTION This study was designed to examine the psychosocial factors associated with NGNs' job outcomes. The study was not conducted using suggestions from the patient groups or the public. IMPACTS Our findings indicate that favourable practise contexts may not always benefit the nursing job outcome if NGNs do not exhibit a high level of personal growth initiative and produce increased occupational self-efficacy. Therefore, hospital administrators should consider implementing an intervention to improve the personal growth initiative of NGNs so that they can take full advantage of the practice environment and gain resources at work to create optimal job outcomes.
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Affiliation(s)
- Quan Wang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ting Chen
- The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Xiaorong Lang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Danni Feng
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuchen Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Kexin Zhang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jingjing Huang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shiya Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaoxuan Sheng
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sufang Huang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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McLeod KE, Buxton JA, Martin RE. "A different sense of what we do here, who we are and what we deliver": Provider perspectives on the effects of a change in governance of healthcare services in correctional facilities in British Columbia. Health Serv Manage Res 2023:9514848231218626. [PMID: 38018489 DOI: 10.1177/09514848231218626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
In 2017, British Columbia (BC) transferred responsibility for healthcare services in provincial correctional facilities from the Ministry of Public Safety and Solicitor General to the Ministry of Health. This study explored how healthcare leadership perceived the impact of the transfer on services, work-life, and job satisfaction. We conducted one-on-one interviews (n = 8) with healthcare managers and medical and administrative leadership within Correctional Health Services. Using the Two-Factor theory of job satisfaction as a framework, we applied Interpretive Description methodology to analyse interview data. Participants identified changes to four areas of the working environment: (1) staffing, equipment, and resources (2) systems of supervision and support (3) standards, policies, and quality improvement and (4) culture and orientation. These changes predominantly affected motivational factors of job satisfaction and were described as enriching the roles of managers and staff. Participants described improved autonomy and recognition of providers, increased quality of services delivered, and a shift toward patient-centred care. The perspectives of healthcare leaders provide new insight into the potential impact of transferring healthcare services in custody to a public healthcare system. Discussion of changes and their affects also provide practical learning for jurisdictions seeking to improve healthcare under a variety of governance and service-delivery models.
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Affiliation(s)
- Katherine E McLeod
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Jane A Buxton
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - Ruth Elwood Martin
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
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Herrera J, De Las Heras-Rosas C, Veiga PM. Editorial: Healthcare management: challenges for improving performance and quality of patient services. Front Psychol 2023; 14:1272083. [PMID: 37799516 PMCID: PMC10549929 DOI: 10.3389/fpsyg.2023.1272083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/11/2023] [Indexed: 10/07/2023] Open
Affiliation(s)
- Juan Herrera
- Department of Economics and Business Administration, Faculty of Economics and Business Administration, University of Malaga, Málaga, Spain
| | - Carlos De Las Heras-Rosas
- Department of Economics and Business Administration, Faculty of Economics and Business Administration, University of Malaga, Málaga, Spain
| | - Pedro Mota Veiga
- NECE - Research Center for Business Sciences, University of Beira Interior, Covilhã, Portugal
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Imam A, Obiesie S, Aluvaala J, Maina M, Gathara D, English M. Missed nursing care in acute care hospital settings in low-middle income countries: a systematic review protocol. Wellcome Open Res 2022; 6:359. [PMID: 35495089 PMCID: PMC9020529 DOI: 10.12688/wellcomeopenres.17431.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Missed nursing care (care left undone or task incompletion) is viewed as an important early predictor of adverse patient care outcomes and is a useful indicator to determine the quality of patient care. Available systematic reviews on missed nursing care are based mainly on primary studies from developed countries, and there is limited evidence on missed nursing care from low-middle income countries (LMICs). We propose conducting a systematic review to identify the magnitude of missed nursing care and document factors and reasons associated with this phenomenon in LMIC settings. Methods and analysis: This protocol was developed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P). We will conduct literature searching across the Ovid Medline, Embase and EBSCO Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, from inception to 2021. Two independent reviewers will conduct searches and data abstraction, and discordance will be handled by discussion between both parties. The risk of bias of the individual studies will be determined using the Newcastle-Ottawa Scale (NOS). Ethics and dissemination: Ethical permission is not required for this review as we will make use of already published data. We aim to publish the findings of our review in peer-reviewed journals PROSPERO registration number: CRD42021286897 (27 th October 2021).
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Affiliation(s)
- Abdulazeez Imam
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UK
| | | | - Jalemba Aluvaala
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Paediatrics, University of Nairobi, Nairobi, Kenya
| | - Michuki Maina
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - David Gathara
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- MARCH Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Mike English
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UK
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
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Imam A, Obiesie S, Aluvaala J, Maina M, Gathara D, English M. Missed nursing care in acute care hospital settings in low-middle income countries: a systematic review protocol. Wellcome Open Res 2021; 6:359. [PMID: 35495089 PMCID: PMC9020529 DOI: 10.12688/wellcomeopenres.17431.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 02/15/2024] Open
Abstract
Background: Missed nursing care (care left undone or task incompletion) is viewed as an important early predictor of adverse patient care outcomes and is a useful indicator to determine the quality of patient care. Available systematic reviews on missed nursing care are based mainly on primary studies from developed countries, and there is limited evidence on missed nursing care from low-middle income countries (LMICs). We propose conducting a systematic review to identify the magnitude of missed nursing care and document factors and reasons associated with this phenomenon in LMIC settings. Methods and analysis: This protocol was developed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P). We will conduct literature searching across the Ovid Medline, Embase and EBSCO Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, from inception to 2021. Two independent reviewers will conduct searches and data abstraction, and discordance will be handled by discussion between both parties. The risk of bias of the individual studies will be determined using the Newcastle-Ottawa Scale (NOS). Ethics and dissemination: Ethical permission is not required for this review as we will make use of already published data. We aim to publish the findings of our review in peer-reviewed journals PROSPERO registration number: CRD42021286897 (27 th October 2021).
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Affiliation(s)
- Abdulazeez Imam
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UK
| | | | - Jalemba Aluvaala
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Paediatrics, University of Nairobi, Nairobi, Kenya
| | - Michuki Maina
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - David Gathara
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- MARCH Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Mike English
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UK
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
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Schmalz O, Jacob C, Ammann J, Liss B, Iivanainen S, Kammermann M, Koivunen J, Klein A, Popescu RA. Digital Monitoring and Management of Patients With Advanced or Metastatic Non-Small Cell Lung Cancer Treated With Cancer Immunotherapy and Its Impact on Quality of Clinical Care: Interview and Survey Study Among Health Care Professionals and Patients. J Med Internet Res 2020; 22:e18655. [PMID: 33346738 PMCID: PMC7781800 DOI: 10.2196/18655] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/01/2020] [Accepted: 11/02/2020] [Indexed: 02/06/2023] Open
Abstract
Background Cancer immunotherapy (CIT), as a monotherapy or in combination with chemotherapy, has been shown to extend overall survival in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC). However, patients experience treatment-related symptoms that they are required to recall between hospital visits. Digital patient monitoring and management (DPMM) tools may improve clinical practice by allowing real-time symptom reporting. Objective This proof-of-concept pilot study assessed patient and health care professional (HCP) adoption of our DPMM tool, which was designed specifically for patients with advanced or metastatic NSCLC treated with CIT, and the tool’s impact on clinical care. Methods Four advisory boards were assembled in order to co-develop a drug- and indication-specific CIT (CIT+) module, based on a generic CIT DPMM tool from Kaiku Health, Helsinki, Finland. A total of 45 patients treated with second-line single-agent CIT (ie, atezolizumab or otherwise) for advanced or metastatic NSCLC, as well as HCPs, whose exact number was decided by the clinics, were recruited from 10 clinics in Germany, Finland, and Switzerland between February and May 2019. All clinics were provided with the Kaiku Health generic CIT DPMM tool, including our CIT+ module. Data on user experience, overall satisfaction, and impact of the tool on clinical practice were collected using anonymized surveys—answers ranged from 1 (low agreement) to 5 (high agreement)—and HCP interviews; surveys and interviews consisted of closed-ended Likert scales and open-ended questions, respectively. The first survey was conducted after 2 months of DPMM use, and a second survey and HCP interviews were conducted at study end (ie, after ≥3 months of DPMM use); only a subgroup of HCPs from each clinic responded to the surveys and interviews. Survey data were analyzed quantitatively; interviews were recorded, transcribed verbatim, and translated into English, where applicable, for coding and qualitative thematic analysis. Results Among interim survey respondents (N=51: 13 [25%] nurses, 11 [22%] physicians, and 27 [53%] patients), mean rankings of the tool’s seven usability attributes ranged from 3.2 to 4.4 (nurses), 3.7 to 4.5 (physicians), and 3.7 to 4.2 (patients). At the end-of-study survey (N=48: 19 [40%] nurses, 8 [17%] physicians, and 21 [44%] patients), most respondents agreed that the tool facilitated more efficient and focused discussions between patients and HCPs (nurses and patients: mean rating 4.2, SD 0.8; physicians: mean rating 4.4, SD 0.8) and allowed HCPs to tailor discussions with patients (mean rating 4.35, SD 0.65). The standalone tool was well integrated into HCP daily clinical workflow (mean rating 3.80, SD 0.75), enabled workflow optimization between physicians and nurses (mean rating 3.75, SD 0.80), and saved time by decreasing phone consultations (mean rating 3.75, SD 1.00) and patient visits (mean rating 3.45, SD 1.20). Workload was the most common challenge of tool use among respondents (12/19, 63%). Conclusions Our results demonstrate high user satisfaction and acceptance of DPMM tools by HCPs and patients, and highlight the improvements to clinical care in patients with advanced or metastatic NSCLC treated with CIT monotherapy. However, further integration of the tool into the clinical information technology data flow is required. Future studies or registries using our DPMM tool may provide insights into significant effects on patient quality of life or health-economic benefits.
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Affiliation(s)
- Oliver Schmalz
- Department of Haematology, Oncology and Palliative Care, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
| | - Christine Jacob
- The Faculty of Business and Law, Anglia Ruskin University, Cambridge, United Kingdom.,School of Business, University of Applied Sciences Northwestern Switzerland, Brugg, Switzerland
| | - Johannes Ammann
- Medical Affairs (Personalised Healthcare and Patient Access), F Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Blasius Liss
- Department of Haematology, Oncology and Palliative Care, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
| | - Sanna Iivanainen
- Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | | | - Jussi Koivunen
- Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Alexander Klein
- Medical Affairs (Personalised Healthcare and Patient Access), F Hoffmann-La Roche Ltd, Basel, Switzerland
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Andersen IA, Kleiven OT, Kyte L, Pettersen MAS. Quality of care and job satisfaction in a Hospital Trust before and after The Coordination Reform in Norway. Nurs Open 2020; 7:1707-1714. [PMID: 33072354 PMCID: PMC7544862 DOI: 10.1002/nop2.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 11/13/2022] Open
Abstract
Aims To study the impact of organizational changes on the quality of health services and on health professionals' job satisfaction in specialist health services. Design A repeated cross‐sectional study, including 5 years before (2007) and 5 years after (2017) the introduction of The Coordination Reform in Norway. Methods Nurses and auxiliary nurses working in medical wards at three hospitals evaluated the quality of health services and various aspects of their working conditions, using questionnaires: Quality of Patient Care and the Job Satisfaction Scale. Results In 2017, nurses and auxiliary nurses had longer work experience compared with 2007. Nurses and auxiliary nurses also worked full hours. There was no significant change over time in total Quality of Patient Care score or in any of the sub‐scores. There was no significant change in total Job Satisfaction Scale score over time, but there was a significant decline in the sub‐score for physical working conditions.
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Affiliation(s)
- Irene Aasen Andersen
- Faculty of Health Studies Western Norway University of Applied Sciences Førde Norway
| | - Ole T Kleiven
- Faculty of Health Studies Western Norway University of Applied Sciences Førde Norway
| | - Lars Kyte
- Faculty of Health Studies Western Norway University of Applied Sciences Førde Norway
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Tozzi VD, Pacileo G, Ferrara L. Evaluating the appropriateness of elective surgery: The case of spinal fusion (arthrodesis). Health Serv Manage Res 2020; 34:167-177. [PMID: 32910680 DOI: 10.1177/0951484820952331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Appropriateness is an essential element of quality of care. Several methods and tools have been developed to measure the appropriateness of care, however, none of these could be used to systematically support providers in keeping the appropriateness under control. Our study aimed to develop a framework to evaluate the appropriateness of care that took into account four dimensions of appropriateness: clinical dimension, equity, service delivery model, outcome. METHODS We employed mixed-method approaches. These included a retrospective analysis of administrative data collected from Kinetika Sardinia (Italy) and a qualitative analysis of stakeholders' experiences and perspectives aimed at supporting data collection, identification of improvement actions and definition of performance indicators. We used arthrodesis as a paradigmatic example of potentially inappropriate elective surgery. RESULTS We collected data from 2,584 patients that underwent arthrodesis between January 1, 2010 and April 30, 2015. Based on the analysis and the exchanges with professionals, we identified 11 improvement actions. Monitoring and evaluation actions were finally conducted for 171 patients that underwent spinal fusion during the first semester of 2016 in order to assess if the improvement actions identified were put into practice and acquired desirable outcomes. CONCLUSIONS Our work provides a definition of appropriateness that goes beyond the clinical perspective and includes other perspectives (equity, service delivery and outcome); develops a framework and an approach that can be a valid help to systematically assess the appropriateness of elective surgery, adopt improvement actions, and monitor their impact; discusses what are the competencies necessary for measuring the appropriateness.
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Affiliation(s)
- Valeria D Tozzi
- Centre for Research on Health and Social Care, Bocconi University, Italy; SDA Bocconi, School of Management, Government Health and Not for profit Division, Milan, Italy
| | - Guglielmo Pacileo
- Centre for Research on Health and Social Care, Bocconi University, Italy; SDA Bocconi, School of Management, Government Health and Not for profit Division, Milan, Italy.,Local Health Authority Alessandria, Milano, Italy
| | - Lucia Ferrara
- Centre for Research on Health and Social Care, Bocconi University, Italy; SDA Bocconi, School of Management, Government Health and Not for profit Division, Milan, Italy
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Falguera CC, De Los Santos JAA, Galabay JR, Firmo CN, Tsaras K, Rosales RA, Mirafuentes EC, Labrague LJ. Relationship between nurse practice environment and work outcomes: A survey study in the Philippines. Int J Nurs Pract 2020; 27:e12873. [PMID: 32677223 DOI: 10.1111/ijn.12873] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 06/01/2020] [Accepted: 06/11/2020] [Indexed: 01/10/2023]
Abstract
AIMS Challenges in the nurse practice environment greatly affect nurse work outcomes. This study investigated the relationship between nurse practice environment and work outcomes in the Philippines. METHODS This cross-sectional survey involved 549 hospital nurses in the Philippines in 2018. The nurse practice environment was measured using the Practice Environment Scale of the Nursing Work Index (PES-NWI). Four self-report scales were used to measure work outcomes: job satisfaction, job burnout, job stress and nurse-assessed quality of care. Multiple linear regression analysis was used to analyse the data. RESULTS Significant relationships were found between nurse and organizational characteristics and nurse practice environment. Further, multivariate regression analysis revealed that the nurse practice environment had a significant and positive relationship with perceived quality of care and a significant and negative relationship with job burnout and job stress. CONCLUSION A favourable work environment significantly reduced job burnout and job stress and improved the quality of patient care. With considerable migration abroad, a favourable nurse practice environment may engage a better nurse workforce in the country and subsequently reduce migration. Managers must focus on developing good nurse practice environments that will improve professional work outcomes and quality patient care.
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Affiliation(s)
- Charlie C Falguera
- School of Health Sciences, University of the Philippines Manila, Manila, Philippines
| | | | - Jolo R Galabay
- College of Nursing, Isabela State University - Ilagan Campus, Iligan City, Philippines
| | - Carmen N Firmo
- School of Health Sciences, University of the Philippines Manila, Manila, Philippines
| | - Konstantinos Tsaras
- Nursing Department, Technological Educational Institute of Thessaly, Larrisa, Greece
| | - Rheajane A Rosales
- College of Nursing, Samar State University, Catbalogan City, Philippines
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10
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Sulaiman CFC, Henn P, Smith S, O'Tuathaigh CMP. Burnout syndrome among non-consultant hospital doctors in Ireland: relationship with self-reported patient care. Int J Qual Health Care 2018; 29:679-684. [PMID: 28992145 DOI: 10.1093/intqhc/mzx087] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 07/03/2017] [Indexed: 11/15/2022] Open
Abstract
Objective Intensive workload and limited training opportunities for Irish non-consultant hospital doctors (NCHDs) has a negative effect on their health and well-being, and can result in burnout. Burnout affects physician performance and can lead to medical errors. This study examined the prevalence of burnout syndrome among Irish NCHDs and its association with self-reported medical error and poor quality of patient care. Methods A cross-sectional quantitative survey-based design. Setting All teaching hospitals affiliated with University College Cork. Participants NCHDs of all grades and specialties. Intervention(s) The following instruments were completed by all participants: Maslach Burnout Inventory-Human Service Survey (MBI-HSS), assessing three categories of burnout syndrome: Emotional exhaustion (EE), Personal Achievement (PA) and Depersonalization (DP); questions related to self-reported medical errors/poor patient care quality and socio-demographic information. Main outcome measure(s) Self-reported measures of burnout and poor quality of patient care. Results Prevalence of burnout among physicians (n = 265) was 26.4%. There was a significant gender difference for EE and DP, but none for PA. A positive weak correlation was observed between EE and DP with medical error or poor patient care. A negative association was reported between PA and medical error and reduced quality of patient care. Conclusions Burnout is prevalent among NCHDs in Ireland. Burnout syndrome is associated with self-reported medical error and quality of care in this sample population. Measures need to be taken to address this issue, with a view to protecting health of NCHDs and maintaining quality of patient care.
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Affiliation(s)
- Che Fatehah Che Sulaiman
- School of Medicine, Brookfield Health Sciences Complex, University College Cork, College Road, Cork T12 AK54, Ireland
| | - Patrick Henn
- School of Medicine, Brookfield Health Sciences Complex, University College Cork, College Road, Cork T12 AK54, Ireland
| | - Simon Smith
- School of Medicine, Brookfield Health Sciences Complex, University College Cork, College Road, Cork T12 AK54, Ireland
| | - Colm M P O'Tuathaigh
- School of Medicine, Brookfield Health Sciences Complex, University College Cork, College Road, Cork T12 AK54, Ireland
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Khatri N, Gupta V, Varma A. The Relationship Between HR Capabilities and Quality of Patient Care: The Mediating Role of Proactive Work Behaviors. Hum Resour Manage 2016; 56:673-691. [PMID: 28808354 DOI: 10.1002/hrm.21794] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Based on theoretical frameworks of resource-based theory, dynamic capabilities, and behavioral perspective on human resource management, we developed a multidimensional construct of human resource (HR) capabilities and tested its relationship with quality of patient care using a national sample of U.S. hospitals. The data on HR capabilities were collected from senior managers (421 individuals nested in 279 hospitals) representing both the administrative and clinical sides of the hospitals. The data on quality of patient care were gathered from two unique sources - patients of 207 hospitals who reported the data via the Hospital Consumer Assessment of Healthcare Providers and Systems Survey and 421 senior managers of 279 hospitals. Our analyses using structural equation modeling suggests that the positive relationship of HR capabilities with quality of patient care is mediated by proactive behaviors of health care workers. Implications of the study findings for research and practice are discussed.
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Affiliation(s)
- Naresh Khatri
- Associate Professor, Health Management & Informatics, CE729 Clinical Support & Education Building, University of Missouri, Columbia, MO 65212
| | - Vishal Gupta
- Assistant Professor, Organizational Behavior, Indian Institute of Management Ahmedabad, Vastrapur, Ahmedabad 380015, India
| | - Arup Varma
- Professor, Loyola University Chicago, Quinlan School of Business, 820 N Michigan Ave, Chicago, IL 60611 USA
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Nejati A, Rodiek S, Shepley M. The implications of high-quality staff break areas for nurses' health, performance, job satisfaction and retention. J Nurs Manag 2015; 24:512-23. [PMID: 26667389 DOI: 10.1111/jonm.12351] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2015] [Indexed: 11/29/2022]
Abstract
AIM The main study objective was to explore policy and design factors contributing to nurses' perception of how well-designed staff break areas can play an important beneficial role in relation to their overall job satisfaction, retention, performance and job-related health concerns. BACKGROUND Nurses are extremely valuable to the healthcare industry; however, today's nursing profession is challenged by nurses' fatigue and its negative consequences on nurses' health and the quality of patient care they provide. METHODS Preliminary interviews were conducted with 10 nurses who worked as consultants in the healthcare design and construction industry. Based on findings, an online survey was developed and distributed to over 10 000 members of the Academy of Medical-Surgical Nurses in the United States. RESULTS The majority of nurses viewed high-quality break spaces as 'fairly' or 'very' important in terms of their potential to positively influence staff, patient and facility outcomes. Stress, rest breaks and the quality of break areas were some of the significant factors contributing to their perception. CONCLUSION/IMPLICATIONS FOR NURSING MANAGEMENT The results of this empirical study support the conclusion that improvements in healthcare facility policies regarding staff breaks, as well as the creation of better-designed break areas, can be of significant benefit for nurses and the patients that they serve.
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Affiliation(s)
- Adeleh Nejati
- Center for Health Systems & Design, College of Architecture, Texas A&M University, College Station, TX, USA
| | - Susan Rodiek
- Center for Health Systems & Design, College of Architecture, Texas A&M University, College Station, TX, USA
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Abstract
BACKGROUND Medical group practices are central to many of the proposals for health care reform, but little is known about the relationship between practice-level characteristics and the quality and cost of care. METHODS Practice characteristics from a 2009 national survey of 211 group practices were linked to Medicare claims data for beneficiaries attributed to the practices. Multivariate regression was used to examine the relationship between practice characteristics and claims-computable measures of screening and monitoring, avoidable utilization, risk-adjusted per-beneficiary per-year (PBPY) costs, and the practice's net revenue. RESULTS Several characteristics of group practices are predictive of screening and monitoring measures. Those measures, in turn, are predictive of lower values of avoidable utilization measures that contribute to higher PBPY costs. The effects of group practice characteristics on avoidable utilization, cost, and practice net revenue appear to work primarily through improved screening and monitoring. CONCLUSIONS Practice characteristics influence costs indirectly through a set of statistically significant relationships among screening and monitoring measures and avoidable utilization. However, these relationships are not the only pathways connecting practice characteristics to cost and those additional pathways contain substantial "noise" adding uncertainty to the estimated direct effects. Some of the attributes thought to be important characteristics of accountable care organizations and medical homes appear to be associated with lower quality and no improvement in cost.
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Affiliation(s)
- John Kralewski
- Medica Research InstituteCW105, 401 Carlson Parkway, Minnetonka, MN 55305
| | - Bryan Dowd
- Division of Health Policy and Management, University of MinnesotaMinneapolis, MN
| | - David Knutson
- Division of Health Policy and Management, University of MinnesotaMinneapolis, MN
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14
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Abstract
The range of mental health rehabilitation (MHR) available to children and adolescents with mental health disorders differs internationally. While MHR programs have been already implemented for this target group in Germany, in Austria such services are still in the planning phase. With regard to the quality assurance of potential MHR programs, however, ongoing evaluation approaches are needed already in the course of program design. This review focuses on indicators and measurement methods used in MHR program evaluations. Through a systematic literature search, we identified six studies providing information on five evaluation indicators (clinical symptoms, quality of life, functionality, rehabilitation progress, and rehabilitation satisfaction). By measuring these endpoints, the studies included mainly reported on instruments that had been used throughout different indication groups ("generic tools"). In addition to children and adolescents with mental-health disorders, the parents were usually also included in the evaluations. Thus, the self-assessments of the children and adolescents (e.g., regarding the development of behavioral problems and strengths) were complemented by external assessments. Most evaluation studies included several subsequent time-points of measurement ("longitudinal studies"). The indicators may play a central role in future evaluation projects, since their range of topics provides comprehensive insights into rehabilitation results. However, with regard to the measurement methods, the psychometric quality criteria require proper reviews and consideration.
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Affiliation(s)
- Roman Winkler
- Ludwig Boltzmann Institut für Health Technology Assessment, Wien
| | - Brigitte Piso
- Ludwig Boltzmann Institut für Health Technology Assessment, Wien
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