ISSN:0002-0443    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0002-0443    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0002-0443    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0002-0443    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0002-0443    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Objective:The authors describe factors associated with job strain for various job titles in the acute care hospital using the Karasek Job Strain Model, discuss the reliability and validity of the Job Content Questionnaire, and discuss use of the model to enhance the work environment.Background:The Karasek Job Strain Model has been used to describe many occupations in the United States and other countries. Some research indicates that occupations that arouse stress hormones are those in which employees have little job control or must complete psychologically demanding tasks, such as those under time pressure, and these positions can be described as high-strain jobs.Method:This descriptive correlation study was conducted at five tertiary care hospitals on the West Coast. A purposive volunteer sample of staff members working at least 20 hours per week in the adult medical-surgical and specialty nursing units was recruited.Results:Mean scores for each of the nursing units and the overall mean scores for the staff in the initial analysis fell into the Active Work quadrant of the Karasek Job Strain Model. When nursing job titles were analyzed, registered nurses had significantly higher Decision Latitude scores than did nurse assistants (P< 0.001) and clerical staff (P< 0.001), but there were no significant differences for Psychological Demands.Conclusions:Working with nurse assistants to appropriately increase decision latitude related to their work has the potential to enhance the work environment by reducing job strain and improving staff health and morale.

ISSN:0002-0443    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Objective:The authors explore the relation between leadership style and empowerment and its effect on job satisfaction among the nursing staff of a regional medical center.Background:Several empirical studies on transformational leadership found that transformational leadership behaviors were positively related to work team success and leadership effectiveness. Transformational leadership processes have also been suggested to enhance followers' work-oriented values and shape the self-efficacies of followers. Employee empowerment may be influenced by the perception that the organization cares about its employees' well-being and that their work is valued. Empowering nurses may increase job satisfaction and improve patient care. Leadership style and empowerment influence job satisfaction among workers.Methods:All nursing department staff were invited to complete a self-report questionnaire with no identifying information. Leadership style was measured using Bass's Multifactor Leadership Questionnaire, empowerment was measured with items from Spreitzer's Psychological Empowerment instrument, and job satisfaction was measured by Warr, Cook, and Wall's job satisfaction questionnaire.Results:Both transformational and transactional leadership were positively related to job satisfaction, as was empowerment. Differences in the contributions of empowerment and leadership style in predicting job satisfaction for licensed and unlicensed workers was evident.Conclusion:Designing interventions that allow for the relative influence of leadership style as well as empowerment on varying classifications of nursing personnel may be a more effective strategy and have a greater effect on staff attitudes and behaviors.

ISSN:0002-0443    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Objective:Increasingly, professional nurses will be required to function in practice settings other than acute care, yet little is known about how nurses perceive the skill sets required to practice in these nonacute care settings. This study explores nurses' perceptions and needs concerning the transition from acute to home care and community-based healthcare facilities.Background:Because the healthcare reform environment of the 1990s mandates changes in the ways hospitals and hospital nurses care for patients, many nurses in acute care settings anticipate that their roles will include or perhaps shift completely to practice in the home and other community-based settings. How professional nurses perceive the skills required to practice in these nonacute care settings may well influence their willingness to accept work redesign initiatives and voluntary employment transitions that involve working outside the hospital setting.Methods:Based on focus groups and the literature, a three-part 56-item questionnaire was developed as the study instrument to assess skill needs and concerns related to functioning in the acute, home, and community-based settings. A total of 879 nurses representing various specialties in healthcare institutions in the Philadelphia and five-county surrounding areas participated.Results:Test retest for the study instrument was 0.87 for a 2-week period, and alpha coefficients ranged from 0.90 to 0.94. Multivariate analyses revealed that proficiency on certain skill items in the acute care setting predicted feelings of proficiency in home and community-based settings. Based on regression and discriminant function analyses, top predictors and differentiators of proficiency in the nonacute care settings were wound care and dressing, knowledge of community resources, diabetic education, patient and family advocacy, communication with third-party payers, and neonatal care.Conclusions:Some nurses, such as those working in critical care, perceive themselves as being able to function proficiently in a wide variety of care settings-acute, home, and community based. Furthermore, certain acute care skills were identified as top differentiators of proficiency in nonhospital settings, thus providing direction for nursing administrators and academic institutions. In addition, the tool developed for the study can serve as a self-assessment for individual nurses.

ISSN:0002-0443    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Objective:The goal of this study was to develop a method to scientifically create and validate a coordinated care path for use within any hospital setting.Background:In an attempt to reduce the costs associated with high-volume and high-risk diagnosis, attention was focused on reducing patients' length of stay in the hospital. A method to reduce length of stay use a coordinated care path. A path is a guideline used to manage the clinical care of selected patients. The literature is relatively silent regarding studies that have scientifically validated the use of these paths.Methods:This project used a content validity method to validate the care path. Using current research findings, best practice standards both locally and nationally, a transdisciplinary team developed practice guidelines that included sequencing, timing of interventions, and expected patient outcomes. The path was rated by local and national experts using a four-point rating scale. Using Lynn's proportion of experts table computations, the validity of the path and each of its components was determined.Results:Of 161 items on the care path, 10 were not validated. The experts validated the instrument as a whole. Of the 161 items, 151 were validated. This is an instrument validation rate of 0.94. No additional changes or modifications to the path were suggested by the experts. The transdisciplinary team addressed the nonvalidated items. This method can be used to develop other coordinated paths for other diagnostic groups.

ISSN:0002-0443    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Objective:This article describes one medical center's experience in using research to plan for nursing staff integration after hospital acquisition.Background:Resistance to new policies, procedures, and standards; passive acceptance of new leadership; limited support for management plans; and failure to integrate with new nursing units are common staff reactions after acquisitions. Little has been written regarding which key staff variables to assess after acquisitions and how to use this data to plan for change. Structural contingency and attribution theory were used to guide leadership staff's assessment of acquired staff attributes to determine their congruence with concepts valued by the acquiring organization.Methods:Qualitative and quantitative data were collected using a survey method. All 141 registered nurses and licensed practical nurses of the acquired medical center received a mailed survey. Sixty-six completed surveys were returned through the U.S. mail. No identifying information was placed on the survey to assure anonymity.Results:The survey results described nurses' perceptions of the advantages, concerns, and suggestions for a smooth transition after acquisition. In addition, the results clarified that nurses in the newly acquired hospital preferred a shared governance structure (congruent with the acquiring medical center's values) and the nurses' perceived professional nursing autonomy was similar to that of nurses who worked at the acquiring medical center.Conclusions:By sharing the findings, both staffs were sensitized to the similarities among the staff as well as to their differences. Transition strategies were planned to capitalize on this knowledge. This process may be useful for other nurse executives to replicate as they guide their organizations through similar transitions.

ISSN:0002-0443    

出版商:OVID    

年代:1997

数据来源: OVID