ISSN:0002-0443    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0002-0443    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

ObjectivesThe authors determine the importance that patients, nurses, and nurse managers place on aspects of care and measure nurses' care values based on their perceptions of their patients and nurse manager care values and their desire to meet these care expectations.BackgroundThe literature has documented gaps in how nurses and patients define quality and value specific care aspects, but little is known about the situation in the current continuous quality improvement and patient-centered care environment, which emphasizes a customer focus. Misunderstanding patients' values and expectations may impede service improvement. Information about any existing gaps could help managers begin to devise patient satisfaction improvement strategies.MethodTwo thousand fifty-one medical-surgical patients, 1264 staff members, and 97 nurse managers from 17 randomly selected hospitals participated in study activities related to selected aspects of patient care. Trained interviewers surveyed patients by telephone within 26 days of discharge using a pretested instrument. Staff members and managers completed a coordinated written tool. Descriptive and correlational statistics were used in individual and unit-level analyses.ResultsStaff members perceive correctly that patients value differently various aspects of care but do not agree with their managers on patients' values of aspects of care. Unit staff members' and managers' beliefs regarding patients' care values did not match those of their patients (-14 to 0.11 and -0.01 to 0.06 zero order correlations, respectively).ConclusionsA unit's errors in defining patients' values may be self-reinforcing. Strategies to reorient personnel, including adoption of those suggested by the diffusion of innovation literature, may help bridge the gap and change practice.

ISSN:0002-0443    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

ObjectiveThe authors explore levels of occupational stress (burnout) and organizational commitment (intent to stay), their inter-relationships, and their relationships to personal and organizational factors in nurse administrators.BackgroundAlthough the concepts of burnout and turnover have been studied and reported for staff nurses, relatively few such studies exist in relation to nurse administrators.MethodsConsequently, theMaslach Burnout Inventory,theOrganizational Commitment Questionnaire,and a personal data sheet were completed by respondents to a mailed survey representing 65.6% of the membership of the state's nurse executive organization and 58.2% of the state's hospitals (N = 78).ResultsScores indicate that half the respondents experience low levels of burnout whereas a third have high levels of burnout. Commitment scores were high for most nurse executives and were correlated inversely with burnout scale scores (depersonalization, personal accomplishment, emotional exhaustion), with the amount or phase of burnout, and with non-nursing management experience. Those with few opportunities to meet with colleagues scored higher on emotional exhaustion and lower on personal accomplishment scales. Intent to stay (high commitment scores) was related positively to perceived organizational support and to religiosity.ConclusionsFindings are consistent with those reported in other studies; however, the administrative role may require unique approaches to avoid or correct organizational stress. The role of social support, the determination of organizational/individual fit, and the adaptation of traditional organizational development techniques to the administrative role are discussed and proposed as areas for further study.

ISSN:0002-0443    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

ObjectiveThe author developed and tested a model formulated to determine what combination of organizational, leadership, and personal characteristics maximize the prediction of registered nurse empowerment in an acute care hospital.BackgroundRecent innovations in patient care delivery and nursing governance are more successful with an empowered nursing staff. However, the contexts for empowerment and management practices that foster empowerment are poorly understood. Previous empowerment studies suggest that personal characteristics such as age, experience, and education are related to empowerment. Additionally, specific leadership practices and organizational cultures have been shown to foster empowerment.MethodsRegistered nurses (N = 113) who were employed in an academic health center participated in the study. Participants completed measures of organizational culture, connective leadership, empowerment, and a demographic questionnaire designed to elicit the personal characteristics included in the model.ResultsRegression analysis identified constructive organizational culture and connective leadership as positive predictors of empowerment, whereas defensive culture was a negative predictor. The three variables combined to explain 45% of the variance in empowerment (P< 0.001). Personal characteristics were not significant predictors, but education and position level were significantly related to connective leadership (P< 0.01).ConclusionsThe Registered Nurse Empowerment Model can serve as a framework for identifying and targeting areas requiring organizational change. The quantitative measures for organizational culture, connective leadership, and empowerment provide practical assessment and evaluation tools for data-based change. Education programs for nurses at all levels should address the behaviors and strategies that promote constructive cultures and connective leadership, minimize defensive cultures, and thus, foster empowerment of nursing staff.

ISSN:0002-0443    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

ObjectiveThis study extends knowledge of how nurses' careers interact with their personal lives and professional development.BackgroundExtant research suggests that nurses' career patterns are unstable or unplanned. However, these images may be a reflection of the models that are applied. Such models are overwhelmingly normative and do not reflect the actual life experience of nurses.MethodsA series of interviews explored how nurses make changes in their lives. Questions focused on the stimulus for change and the resources used, problems associated with changes, and the effects of changes on the nurses themselves and others.ResultsThe results show that nurses' careers, professional development, and personal lives are interconnected.ConclusionsThe concept of interconnectedness reflects the confluence of events or people and their contemplation and integration by the nurses into their lives and relationships. The results contradict normative admonitions about career planning and have implications for the development of theories on nursing careers and for nurse managers.

ISSN:0002-0443    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

ObjectiveEvaluating the practice environment is essential to determine if the practice environment is conducive to the delivery of quality patient care. The Practice Environment Project (PEP) was created to provide a framework for current and ongoing evaluation of the practice environment.BackgroundMajor changes in the delivery of patient care services have focused attention on the evaluation of the effectiveness of these changes. The extent and type of change may vary throughout an institution. The identification of core variables to assess the effectiveness of these changes sets the framework for ongoing evaluation of new unit-based models for delivery of services.MethodsIn part 1, quantitative data were collected from nursing staff members (job satisfaction, collaboration with physicians, autonomy), physicians (quality of nursing care, collaboration with nurses), and patients (satisfaction with nursing care). In part 2, focus groups were held with nursing personnel to discuss factors that affected the provision of services. Unit-based action plans were developed to manage barriers to the delivery of services.ResultsPatients and physicians reported a high degree of satisfaction with patient care. Physicians reported a higher level of collaboration with nurses than that reported by nurses. Nurses reported a high degree of autonomy in practice; however, in other areas of job satisfaction (development and recognition), they suggested areas for improvement.ConclusionsThe PEP created a mechanism to evaluate the current state-of-the-practice environment by identifying core elements for evaluation of work redesign. It also provided a framework for managing barriers that disrupted the delivery of patient care services.

ISSN:0002-0443    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0002-0443    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

ObjectiveThe objective of the study was to measure the effect of an enhanced professional practice model on perception of work groups and nurse leaders.BackgroundPrevious studies of staff nurse perception of work environment and nurse leaders were used to guide development of the professional practice model and the selection of variables. Implementation of the model was expected to result in more favorable perceptions of the work group and a desire for facilitative leadership style.MethodsA quasi-experimental design was used to compare change over time in five hospitals—an urban medical center, two community hospitals, and two rural hospitals.FindingsIntroduction of the model resulted in more favorable perceptions about the work group and a desire for a more facilitative nurse leader.ConclusionChange in perception of work group and leader rather than job satisfaction may be an early indication of favorable outcome of planned change. Changes in nurse satisfaction may be a late outcome, which may be the reason findings from previous studies are mixed.

ISSN:0002-0443    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0002-0443    

出版商:OVID    

年代:1996

数据来源: OVID