ISSN:0002-0443    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0002-0443    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0002-0443    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Objectives:The authors describe factors that facilitate positive changes in dementia care as perceived by long-term care employees.Background:Creating positive changes in dementia care is a complex undertaking involving multiple variables. The perspectives of long-term care employees may provide important insight and direction for a successful change process.Methods:A convenience sample of 181 long-term care employees utilized a q-sort methodology to provide data for this descriptive study. Results were analyzed using rankings and Spearman's rho correlation coefficient.Results:The facility factors most often cited as important for making positive changes in dementia care involved teamwork, administrative support, staff attitude, and knowledge. There was little congruence between facility factors identified as ideal for providing dementia care and those identified as actually evident at the subjects place of employment. Personal characteristics that were identified as most important for facilitating positive changes in dementia care include genuinely liking people with dementia, being flexible, kindness, calmness, and having a positive attitude. The correlations between ideal and real personal factors were higher than for the facility factors.Conclusions:This study supports the idea that the fundamental tenets of good leadership-communication, involvement, and empowerment-are foundational for real change in dementia care to be attained and sustained.

ISSN:0002-0443    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Objective:A salaried Differentiated Pay Structure (DPS) model based on the work of Dr. Virginia Cleland was tested on two units. The project objectives were to: 1) create a budget-neutral compensation distinction for different competencies and educational levels; 2) evaluate the effect of the new salaried model on unit costs and pay; 3) determine the effect of the DPS model on job satisfaction, organizational commitment, and anticipated turnover; and 4) assess the impact of professional commitment, professional practice climate, perception of staffing adequacy, and dispositional optimism on job satisfaction, organizational commitment, and anticipated turnover.Background:Although there has been long-standing interest in salaried models and reward methodologies, there is a dearth of systematic research associated with specific compensation models.Methods:A quasi-experimental, non-equivalent control group design was used to examine the effects of the DPS model.Results:Findings demonstrated that nurses were paid more under the DPS model, and that they were paid for more hours than they actually worked (N = 68). No difference in job satisfaction was found between experimental and control groups. For all nurses (N = 232) dispositional optimism was associated with all job satisfaction subscales except pay. Organizational commitment, professional commitment, professional practice climate, and staffing adequacy were also correlated with job satisfaction, perceptions of care quality and anticipated turnover. Older nurses who had worked longer in nursing, and who had more tenure were less satisfied with their coworkers and care quality.Conclusion:Further longitudinal research with larger experimental samples is required in order to fully understand the effects of the DPS model in nursing.

ISSN:0002-0443    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0002-0443    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Objective:This study examined the relationship of the organizational variables of structure, technology, and environment with job satisfaction among public health nurses in a southeastern state.Background:There is little research on the characteristics of the work environment that influence nurses to remain in the public health work setting. Prior research in this setting has focused on the negative aspects of the nursing positions. These aspects of least desirability for the public health nurse provide only a partial view of job satisfaction. To decide and plan specific strategies, the nurse administrator must have valid and useful information about the positive aspects of job satisfaction of public health nurses.Methods:The researchers distributed a questionnaire to all licensed nursing personnel employed by a state public health department. Data collection consisted of four tools: 1) structure instrument; 2) technology instrument; 3) environmental uncertainty instrument; and 4) McCloskey-Mueller Job Satisfaction Scale (MMSS). The sample of 838 public health nurses (response rate of 50.6%) included representation from all 13 districts and the central office of the public health department.Results:Significant relationships were found between job satisfaction and the demographic variables of nurse category (registered nurse and licensed practical nurse) and years of experience with the public health department. The critical variable for predicting job satisfaction in this group of public health nurses was organizational structure (vertical participation, horizontal participation, and formalization). Dimensions of structures accounted for 41% of the variance in job satisfaction. Structure remained the critical predictor of job satisfaction, although the findings do not suggest a conclusive model. The three dimensions of technology (instability, variability, and uncertainty) and environmental uncertainty assumed significance only in concert with each other or with the dimensions of structure.Conclusions:This study contributes to nursing management theory by examining the relationship of organizational structure, technology, and environmental uncertainty with job satisfaction in public health nurses. This research also has implications for nurse administrators in public health for creating more flexible work environments and facilitating staff involvement in decision making.

ISSN:0002-0443    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Objective:As the healthcare system restructures, changes are being made that appear to influence nurses' jobs and satisfaction, yet little is known about effects on job characteristics and related outcomes. The authors present findings from a research project designed to identify links between specific aspects of hospital staff nurse (SN) practice and perceived job characteristics and psychological states, thought to have motivational consequences.Background:The Job Characteristics Model (JCM) is the dominant paradigm in contemporary job design theory and research. Although generally well-supported, the JCM has limitations that constrain its usefulness: first, the Job Diagnostic Survey used to assess perceived characteristics does not indicate the specific aspects of activities that lead to these perceptions, and second, the JCM, based primarily on manufacturing research, does not include interpersonal job characteristics that seem important in human service jobs.Methods:Two studies were conducted using a similar methodology. Focus groups of SNs were held to identify links between specific activities and characteristics and sources of satisfaction in SNs' job content. The Staff Nurse Job Characteristics Index (SNJCI) was developed to assess the presence of certain elements and activities in a nurse's job. An initial sample of 63 and a second sample of 146 SNs from Medical/Surgical and Coronary Care units completed the SNJCI, the JDS, and a demographic form through a mail survey.Results:Internal consistency reliabilities (Cronbach's alpha) for eight of the nine SNJCI scales were acceptable. Correlation analysis indicates that job characteristics are meaningfully related to psychological states and job satisfaction. Findings support the hypothesis that specific aspects of SNs' jobs are reliably related to characteristics.Conclusions:Aspects of SNs' jobs important to their satisfaction include continuity in nurse-patient relationships, authority to initiate independent nursing actions, individual accountability for clinical outcomes, and regular performance feedback from managers.

ISSN:0002-0443    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Objective:The purpose of this study was to describe relationships among adverse patient occurrences aggregated at the unit level of measurement. Relationships between adverse occurrences and a patient acuity measure were also described.Background:Adverse patient occurrence data have been traditionally a major indicator of quality care in hospitals; however, few studies have examined relationships among these indicators or the usefulness of these indicators for assessing the quality of nursing care.Methods:A correlational design was used to examine and describe patterns of relationships among inpatient units in a tertiary care hospital. The results demonstrated positive correlations between medication error rates and patient falls; these adverse occurrences correlated negatively with pressure ulcers, infections, patient complaints, and death. Pressure ulcers, infections, patient complaints and death intercorrelated positively and also related positively to patient acuity levels.Results:An examination of these same rates for a subset of units with similar patient acuity levels revealed that most of the interrelationships among the entire set of adverse occurrence indicators were positive. When patient acuity was taken into account, these adverse outcomes appeared to indicate some common underlying characteristic of the units, such as quality of nursing care.Conclusions:This study suggests a relationship between the adverse occurrences that were correlated (pressure ulcers, patient complaints, infection, and death) and the severity of patient illness. Medication error rates and patient fall rates were not correlated with patient acuity and are more likely to indicate quality of nursing care across all types of units.

ISSN:0002-0443    

出版商:OVID    

年代:1998

数据来源: OVID