Dissertations / Theses on the topic 'Nursing services – Administration'
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Babst, Terrill Anne. "Trauma nursing care :a workload model." Thesis, Cape Technikon, 2000. http://hdl.handle.net/20.500.11838/1015.
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Thesis (MTech (Business Administration))--Cape Technikon, Cape Town, 2000The current rationalisation of health care in the Western Cape may result in a decrease in the number of patients attending the Trauma Unit at Groote Schuur Hospital (GSH), one of the two large tertiary care hospitals in the Western Cape. This in turn may result in cuts in staff allocations to this unit. The nursing staff need to be proactive in preventing potential cuts which may compromise the services that they offer. Current statistics collected by nursing managers in the trauma unit at GSH provide an indication of the volume of work handled, but do not necessarily capture the intensity of that work. The purpose of this research project will determine the extent to which nursing care required by patients attending the trauma unit at GSH has increased and to establish appropriate staff workload scheduling. The existing classification systems available for assessing patient acuity levels are no longer suitable as they use patient numbers to describe workload. By using a classification system specifically developed for the use by nurse managers in high care units (trauma units), the appropriate staffing norms based on the acuity level of patients can be determined. Finally, this research project will determine a suitable model for measuring the intensity of workload specific to a trauma unit environment for the effective and efficient allocation of staff.
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DeLorey, Robin. "Nursing and the computerized age." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=30790.
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This thesis provides the rationale for the necessity of a redefining of the holistic back into nursing after the consequences of technological restructuring. This study revealed that the impact of modern technology-based, prescriptive changes on professional nursing practice in Canada has resulted in an increasing alienation of labour for nurses, including direct interference with patient-based nursing care, authority, necessity for broader knowledge systems, stability and fragility in job security. The implications of this examination have demonstrated that this shift has not been the result of mechanical technologies alone, but the science-based management philosophies and communicative nature of technologies as well.This project has verified that more importantly than the advancing technological shift itself the danger for professional nursing has been in what these systems are actively replacing. Namely, prescriptive technologies work to establish a managerial or 'expert' presence and authority within the practice of nursing serving to change professional understandings for nurses as well as to decrease value in the judgement and holistic care skills of registered nurses.
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Peoples, Paula Beth. "Pay-per-visit for Home Health Agency nurses." CSUSB ScholarWorks, 1997. https://scholarworks.lib.csusb.edu/etd-project/1410.
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George, Janet C. "Nurses' perceived autonomy in a shared governance setting." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1036188.
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The basic philosophy of shared governance includes the right for staff nurses to practice in an environment that allows participation in the decision making process at all levels of the organization. Autonomy and responsibility support shared governance. The purpose of this study was to examine nurses’ perceptions of autonomy in a well established shared governance setting. The Neuman Systems Model served as the theoretical framework.A convenience sample of 83 (42%) staff nurses at Saint Joseph’s Hospital of Atlanta, Georgia completed the Schutzenhofer Professional Nursing Autonomy Scale. Three open ended questions were included in the questionnaire to further explore staff nurses’ perceptions of the professional practice environment. Demographic data were also collected.Findings in this study revealed no significant correlations between selected demographic variables and autonomy. More than between selected demographic variables and autonomy. More than half (65.1%) ranked in the higher level of professional autonomy, 34.9% (29) ranked in the mid level and none in the lower level. Qualitative data revealed that nurses working in a well established shared governance setting perceived control over the nursing care of patients and appreciated and the ability to make decisions regarding patient care. Respondents overwhelmingly indicated that nurses should be compensated for participation in governance activities.Conclusions from this study were that implementation of professional practice models such as shared governance improve nurses’ perceptions of autonomy and create an atmosphere in which nurses can practice the art of nursing while clearly articulating a vision for the future. Consistent and appropriate decision making by nurses facilitates the interdisciplinary plan of care and encourages trusting relationships among professional disciplines.Nurse managers are in an ideal position to create a vision by designing structures that promote staff involvement. Managers must build formal recognition programs into shared governance systems and provide nurses with the time to attend meetings. Today’s nursing leaders must be ready to create a vision, facilitate change, mentor, nurture, coach and advise staff.School of Nursing
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Chirwa, Maureen L. "Management skills of middle-level nurse managers in Malawi." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1996. https://ro.ecu.edu.au/theses/952.
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Much has been written about the problems facing nurse managers in different countries including Malawi, yet the literature is sparse in relation to information about their perception of required management skills. There is enough evidence that nurse managers face many problems. These problems stem from different sources including organizational, economic, social or political changes. All changes within and outside the health care system affect nursing and its management. Nurse managers require relevant management skills to make valuable decisions and promote quality care, and enable them to motivate staff. Further, management skills will enable nurse managers to actively participate in policy making and financial management. In this way autonomy over nursing services can be maintained. This study took place in Malawi and explored tasks that Malawian middle-level nurse managers carry out, problems that they experience in carrying out their work, and their perceptions of management skills required in carrying out their work. Middle-level nurse managers in Malawi are known as matron and senior sisters. A two staged random sampling of 42 hospitals and 20 middle-level nurse managers was used. The hospitals included government and non-government hospitals known as CHAM (Christian Hospitals Association of Malawi). Data was collected using an interview schedule based on a conceptual framework adopted from King's Goal Attainment Theory. Field notes were taken alongside taped interviews, and administrative documents such as job descriptions were collected to provide complementary data. All interviews were transcribed and thematic analysis was used to analyze data. Results of the analysis demonstrated that middle level nurse managers in Malawi experience enormous problems in carrying out their work. Such problems included shortage of staff (especially registered nurses), and lack of adequate managerial knowledge of nurse managers themselves in policy making, financial management, and the setting and monitoring of nursing standards. In addition, results have indicated an increased amount of stress in the nursing profession in Malawi. Consequently, results have shown that middle-level nurse managers require management skills in resource management, setting nursing standards and financial management skills. Information obtained from this study will provide nurse managers with knowledge of the management skills they require to be more effective. The information will also be relevant for professional (management) development, as it would be used by policy makers to design management education curricula for nurses contemplating management careers or reviewing current management programs in nursing schools. In addition, the knowledge gained wi1l form a basis for future research.
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Green, Cheryl. "Supports and Services Helpful to Working Adult Nursing Students." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5712.
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The United States has experienced historically low graduation rates in public and private 2-year, degree-granting institutions. Many of these institutions are community colleges, which account for 60% of all student enrollment. This study was conducted to explore supports and services that may be helpful to working adult students over the age of 25 enrolled in a 2-year associate degree nursing program in a community college. Tinto's interactionalist theory of student persistence and retention and constructivist theory were the conceptual frameworks for this qualitative case study. The two guiding questions were focused on the types of support that would be helpful for degree completion and service improvements that would most effectively assist students to graduate. Data were collected using semistructured interviews and observations with 10 participants who volunteered from a bound system. Requirement for participation included being over the age of 25 and enrolled in the 2-year associate degree nursing program. Data were analyzed using a phenomenological reduction process and cross-sectional analysis to identify convergent and divergent themes in the data. The findings of this study highlight 5 overarching themes as described by the participants: support system, barriers to education, effect of work, engagement in school services, and recommendations for college improvement. The findings of this study could be helpful to administrators and policy makers in developing supports and services that promote retention and degree completion of students in the 2-year associate degree nursing programs. Completion of a 2-year associate-degree nursing program promotes financial viability and meets the workforce needs of the community.
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Hector, Dawn. "A retrospective analysis of nursing documentation in the intensive care units of an academic hospital in the Western Cape." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/4096.
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Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: Critical care nursing is the specialty within nursing that deals with an individual's response to life-threatening problems. These life threatening problems require continuous in-depth assessment and intense therapeutic measures and interventions. The level of nursing care is intense and the amount of documentation is enormous in the intensive care unit. Failure to document any aspects, may threaten the continuity of care and patient safety. Furthermore, it may result in negligence that may result in litigation. The purpose of this study was to retrospectively analyse nursing documentation in the intensive care units of an academic hospital in the Western Cape. The objectives set for this study were to determine whether the documentation of the: • assessment of the patients were adequate; • diagnoses were based on the assessment; • nursing care plans were based on the diagnoses; • nursing care plans were implemented and • nursing care plan shows evidence of continuous evaluation A retrospective exploratory- descriptive research design with a quantitative approach was applied to audit objectively the status of nursing documentation of patients who were admitted to the ICU’s of an academic hospital in the Western Cape in the first 48 hours of admission. Ethical approval was obtained from the University of Stellenbosch and consent from the Chief Executive Officer of the academic hospital to conduct the research in the hospital under study. The research population (N) was the documentation (files) of patients admitted in the ICU’s between 1 July 2008 and 31 December 2008. A stratified sample was drawn consisting of 151 files. The researcher collected the data personally utilising a pretested audit instrument. The reliability and validity was assured through experts in nursing science and intensive care nursing, a statistician and a research methodologist. A pilot study was conducted to pretest the instrument and the feasibility of the study. Modifications to the instrument were done based on suggestions from the experts and findings of the pilot study. Data analysis included statistical associations between variables using the Chi-square test on a 95% confidence level. Data is presented in the form of figures, tables and frequencies. The findings of the study show that the nursing documentation in the intensive unit is inadequate with the following total mean scores: • Assessment 62.6% • Nursing diagnosis 53.1% • Nursing care plans 37.1% • Implementation 72.6% • Evaluation 40.5%. In conclusion nursing documentation of patients admitted to an ICU is inadequate during the first 48 hours of admission. Poor documentation threatens the safety of patients and demands urgent improvement. Recommendations to improve the documentation include nursing practice supervision, quality improvement programmes, in-service training, evidence based practice and further research.
AFRIKAANSE OPSOMMING: Kritieke-sorg verpleging is die spesialiteit in verpleging wat betrekking het op die individu se reaksie.op lewensgevaarlike probleme.Hierdie lewensgevaarlike probleme benodig deurlopend deeglike beraming en intense terapeutiese benaderings en intervensies. In die intensiewesorg eenheid is die vlak van verpleegsorg baie intens en die dokumentasie hoeveelheid is enorm. Versuim om enige aspekte van sorg deeglik en akkuraat te dokumenteer, kan die deurlopendheid van sorg sowel as die veiligheid van die pasient bedreig. Verder kan dit tot regsstappe lei as gevolg van nalatigheid. Die doel van hierdie studie was om ‘n retrospektiewe analise van verpleeg dokumentasie in die intensiewe sorgeenhede van ‘n akademiese hospitaal in die Wes Kaap te doen. Die doelwitte van hierdie studie was om vas te stel of die dokumentasie van die: • beraming van die pasiênt voldoende gedoen is • verpleegdiagnose gebaseer is op die beraming • verpleegsorgplan gebaseer is op die diagnose • implementering van die verpleegsorgplan en • verpleegsorgplan bewyse toon. van deurlopende evaluasie ‘n Retrospektiewe eksploratiewe-beskrywende navorsingsontwerp met ‘n kwantitatiewe benadering is toegepas ten einde die status van verpleegdokumentasie van pasiente wat toegalaat is tot die intensiewesorg eenhede van ‘n akademiese hospitaal in die Wes Kaap in die eerste 48 uur na toelating te bepaal. Etiese goedkeuring is verkry van die Universiteit van Stellenbosch asook vanaf die Hoof Uitvoerende Beampte van die akademiese hospitaal om die navorsing daar uit te voer. Die navorsings populasie (N) was die dokumentasie (lêers) van die pasiente wat opgeneem is in die intensiewesorg eenheid tussen 1 Julie 2008 en 31 Desember 2008. ‘n Gestratifieerde steekproef is getrek bestaande uit 151 lêers. Die navorser het die data persoonlik kollekteer deur gebruik te maak van ‘n voortoets oudit instrument. Die betroubaarheid en geldigheid is verseker deur kundiges in verpleegkunde en intensiewesorg verpleging, asook ‘n statistikus en ‘n navorsingsmetodoloog. ‘n Loodstudie is gedoen om die instrument vooraf te toets en om die uitvoerbaarheid van die navorsing te bepaal. Veranderinge is aangebring op grond van die voorstelle van die kundiges sowel as die bevindinge van die loodstudie. Data analise het ingesluit die statistiese assosiasies tussen veranderlikes deur gebruik te maak van die Chi-kwadraat toets tot ‘n 95% sekerheidsvlak. Data is aangebied in die vorm van figure, tabelle en frekwensies. Die bevindinge van die studie wys dat die verpleegdokumentasie in die intensiewesorg eenheid is onvoldoende met die volgende gemiddelde telling: • Beraming 62.6% • Verpleegdiagnose 53.1% • Verpleegsorgplanne 37.1% • Implementering 72.6% • Evaluering 40.5% Ten slotte, verpleegdokumentasie van pasiënte wat tot die intensiewesorg eenheid toegelaat is, is onvoldoende gedurende die eerste 48 uur van toelating. Swak dokumentasie bedreig die veiligheid van pasiënte en verg dringende verbetering. Aanbevelings om die dokumentasie te verbeter sluit in toesig oor verpleegpraktyke kwaliteit verbeteringsprogramme, indiensopleiding, bewysgebaseerde praktyke en verdere navorsing.
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Allen, Susan. "Creating an integrated nursing team within primary healthcare : an action enquiry approach." Thesis, University of Leicester, 2005. http://hdl.handle.net/2381/27841.
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This thesis is based on a journey towards developing team working within a primary healthcare setting which enabled the NHS agenda for primary care service delivery to keep pace with the government modernisation agenda. (Department of Health, 1997). Initially the focus was on the development of an integrated nursing team which enabled all disciplines of nurses to work towards a patient focussed healthcare service, but it soon became evident that all staff involved in delivering the primary healthcare service were essential to the process and developments of the enquiry if the objective was to be achieved. An action enquiry approach based on collaborative and participative action research (Carr and Kemmis, 1986; Lincoln and Guba, 1989; Cayer, 1997) was discussed and was the prime method of enabling changes to occur in the healthcare practice. This is represented by the interrelated four main cycles of enquiry that have emerged from the data, and discussed in this thesis. Key to the success of the developments was an understanding of team working and leadership as it applied within a healthcare setting and also the underlying dynamics, which are evident when different professional groups from different traditions and knowledge base work together. (Schon, 1983) This was explored within the context of a systems approach to organisational development and through reflective dialogue along the principles advocated for creating a learning organisation. (Senge, 1990) This thesis will demonstrate how confidence developed in myself and the practitioners, especially those from marginalised groups, and how the wider healthcare system made an impact on the developments within the practice. The area of leadership will be discussed from multiple perspectives and recognition that as a concept all stakeholders had a poor understanding of leadership. The key finding from this study identifies the need for a holistic approach to manage and sustain change, and indeed everyday productive working relationships. This especially identifies the importance of giving attention to the preparation of future healthcare workers, the appropriateness of organisational structures in which services are delivered and support structures available to those in team leadership positions.
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Loyd, Roylin F. "Mentoring potential of oncology nurses." Virtual Press, 1995. http://liblink.bsu.edu/uhtbin/catkey/941369.
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Nurses in management and clinical positions in all areas of the country are experiencing role changes due to restructuring within the health care industry. Nurses have an opportunity to embrace and enhance these changes as the trend toward Patient Focused Care continues which entails a restructuring of care delivery at all levels.Oncology nurses are specifically encouraged by the Oncology Nursing Society to mentor other nurses. The purpose of this study was to examine the concept of mentoring as related to oncology nurses who have experienced role changes due to redesigns in the health care delivery systems. The theoretical framework used in this study was Benner's "From Novice to Expert."A convenience sample of 88 oncology nurses were surveyed. The Darling Measuring Mentoring Potential Scale (MMP), a demographic questionnaire, and a cover letter were mailed. Respondent confidentiality was maintained and the procedures for protection of human subjects were followed. A descriptive correlational design was used. The research questions were analyzed using Pearson's correlation coefficient and multiple regression analysis. Means and standard deviation of mentoring characteristics were also obtained on the clustered scores. Findings of the study indicated a small, but significant difference between levels of education, role changes and mentoring potential. Levels of education and role changes accounted for 15% of the differences in mentoring potential scores. However, the mean scores for both the clustered basic and supporting mentoring characteristics were below the suggested scores as suggested for a substantial mentoring relationship.Conclusions from the study were that the concept of mentoring is still not prevalent among oncology nurses and does not play an important role in the professional lives of the respondents. The concept of mentoring needs to be formally addressed in nursing education as well as in hospital staff education and leadership programs. There needs to be continuing research regarding the concept of mentoring within the nursing profession in order to promote the benefits of this concept so that nurses may join with those in other professions to enjoy the products of mentoring.School of Nursing
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Jones, Andrea. "From matrons to managers : the role of political influence in the development of nursing in Wales c1948-c1998." Thesis, Swansea University, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.589757.
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Lin, Chun-Chieh. "Nursing Home Organizational Characteristics and Utilization of Cancer-Related Medical Services." VCU Scholars Compass, 2010. https://scholarscompass.vcu.edu/etd/2043.
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Cancer is the second leading cause of death in the U.S and is more common among the elderly. Since frailty and other age related conditions put the elderly at risk for nursing home care, nursing homes may be the site of care and death for many elderly cancer patients. However, there is a large gap in knowledge concerning cancer treatment of elderly nursing home residents. Since residents rely heavily on their nursing facilities, nursing homes might influence them in their treatment decisions. After controlling for resident and nursing home market characteristics, this study applies Andersen’s Behavioral Model to examine whether nursing home organizational characteristics (nurse staffing level, nursing skill mix, and quality deficiencies) are related to the use of cancer-related medical services for treatment (oncologist visits, cancer-directed surgery, chemotherapy or radiation therapy), and palliative care (pain medication and hospice services) among 1,183 Medicaid and Medicare insured residents of nursing homes in Michigan from 1996-2000. Using data from the Medicare claim file, Medicaid claim file, Michigan tumor registry, Area Resource File, Michigan Medicaid Nursing Home Cost Report, and Online Survey, Certification and Reporting (OSCAR), the study used logistic regression to predict the utilization of cancer-related medical services. The results generally did not support the hypotheses. Nursing staffing level and nursing skill mix did not predict any cancer-related medical service utilization. Cancer care may be more associated with patient characteristics, such as age, which are usually taken into consideration when physicians suggest treatments, than nursing home organizational characteristics. However, relative to residents of nursing homes with the highest quartile of quality deficiencies, residents of nursing homes in the lowest quartile of quality deficiencies had a decreased likelihood of utilizing hospice care (OR=.509; 95%CI=.325 to .796; p=.003). Residents in high quality nursing homes may want to stay in the same place and not transfer to another facility for hospice care while residents in poor quality nursing homes may be motivated to use hospice care. Even though this study did not successfully find that higher nurse staffing level, nursing skill mix, quality of care are associated with greater opportunity of utilizing cancer-related medical services, this study was successful in laying out an empirically sound base framework to analyze this association. Future research can incorporate other states or nationwide data to re-examine this relationship using this study as a base model.
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Ryan, Marilyn E. "Relationships among entry level preparation, experience, and leadership effectiveness styles of head nurses." Virtual Press, 1986. http://liblink.bsu.edu/uhtbin/catkey/450104.
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Nurses are being promoted to head nurse positions without adequate preparation in leadership and management. One reason this problem exists is because nursing managers are being selected from different levels of basic nursing education programs. Only baccalaureate education has a curriculum designed to develop professional nurse leaders.The purpose of the study was to determine the relationship of leadership effectiveness styles of head nurses drawn from a stratified random sample of hospitals in the state of Indiana, to type of basic nursing education program, and experience in a head nurse position.Data were collected from 204 out of 343 head nurses practicing in hospitals in the state of Indiana accredited by the Joint Commission on Accreditation. A Leader Effectiveness and Adaptability Description Instrument measuring four styles of leadership effectiveness as formalized by Hersey and Blanchard, and a Demographic Data Sheet were utilized for data collection.Decisions about three null hypotheses were made at the 0.05 level by use of step-wise multiple regression analysis, and chi square procedures.Major findings include:1. The magnitude and/or direction of the relationship between entry-level preparation and leadership effectiveness styles of head nurses did not vary with years of experience in a head nurse position.2. There was no significant relationship between entry-level preparation and leadership effectiveness when experience was controlled.3. There was no significant relationship between experience and leadership effectiveness when entry-level preparation was controlled.4. Other data concerning major and alternate styles utilized by head nurses, and the number of style used were reported. The predominant major style of head nurses was High Task/ High Relationship. The predominant alternate style was Low Task/High Relationship...5. Head nurses used all four styles.6. All effectiveness style scores for head nurses were in the effective range.Conclusions1. Leadership effectiveness styles of head nurses do not depend on entry-level preparation and experience.2. Leadership effectiveness styles of head nurses do not depend on the type of basic nursing education program with experience controlled.3. Leadership effectiveness styles of head nurses do not depend on years of experience with entry-level controlled. 4. Head nurses predominantly use two styles of leadership: High Task/High Relationship, and Low Task/Low Relationship.5. Head nurses are able to vary leadership styles to meet the needs of the situation.6. Head nurses have effective styles.
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Crouse, Marlene. "Satisfaction and importance of job communication and interpersonal relationships among nurses and first-line supervisors." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1036195.
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Job-communication satisfaction and its importance to nursing staff and first-line supervisors is important because people in complex health care delivery systems tend to dehumanize communication (Duldt, 1989, 1990b). The purpose of the study is to determine the level of satisfaction first-line supervisors and staff nurses have of job-communication and interpersonal relationships, and the degree of importance staff members and first-line supervisors place on job-communication and interpersonal relationships within a mid-sized acute care facility in an urban area. The theoretical framework is Duldt's Humanistic Nursing Communication Theory (Hersey & Duldt, 1989).The population was all staff nurses and first-line supervisors employed in inpatient services at a midwest hospital. The sample was comprised of about 231 registered nurses and 61% first-line supervisors who volunteered to answer the Job-Communication Satisfaction Importance Questionnaire (JCSI). The JCSI was developed by B. W. Duldt (1990) based on the work of Downs, Hazen, and Thiry as cited in Duldt (1990a). The procedures for the protection of human subjects were followed.Findings revealed that supervisors and staff nurses were satisfied with aspects of job-communication. Supervisors and staff nurses rated six of the eight topics on the JCSI as important aspects of job-communication. Aspects of job-communication and interpersonal relationships were important to supervisors and staff nurses in the facility studied.The conclusions from the study were: (a) satisfaction with job-communication and interpersonal relationships can be improved, (b) aspects of job-communication and interpersonal relationships identified in the study were important to supervisors and staff nurses. Nursing supervisors are in key positions to influence job -communication satisfaction. Organizations undergoing rapid changes need to develop and maintain communication which is satisfactory to human beings working in the organization.School of Nursing
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Van, der Heever Mariana. "An ideal leadership style for unit managers in intensive care units of private health care institutions." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/4058.
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Thesis (MCur (Nursing Science))--University of Stellenbosch, 2009.ENGLISH ABSTRACT: The work environment in critical care units in South Africa is hampered by a profound shortage of nurses, heavy workloads, conflict, high levels of stress, lack of motivation and dissatisfaction among the staff. The task of managing a C.C.U. has therefore become a challenge. It is important that unit managers apply a leadership style that matches these challenges. The aim of this study was to investigate the ideal style of leadership. The objectives set for the study were to identify the ideal leadership style required in the following areas: administrative functions education functions patient care research An explorative, descriptive research design was applied, with a quantitative approach to determine the ideal leadership style for unit managers in critical care units of private health care institutions. The research sample consisted of all nurses working permanently in eleven private hospitals in the Cape Metropolitan area. A questionnaire consisting of predominantly closed questions was used for the collection of data, which was collected by the researcher in person. Ethical approval was obtained from the Committee of Human Science Research at Stellenbosch University. Permission to conduct the research was obtained from the institutions and informed consent from the participants. A pilot study was conducted to test the questionnaire at a private hospital which did not form part of the study. A 10% sample of the relevant staff, namely 27 participants were involved in this study. The validity and reliability was assured through the pilot study and the use of a statistician as well as experts in nursing and a research methodologist. Data was tabulated and presented in histograms and frequencies. Statistical significant associations were drawn between variables, using the Chi-square test. The Spearman rank (rho) order correlation was used to show the strength of the relationship between two continuous variables. Findings of the study show that participatory leadership style and transformational leadership approach were valued in all four (4) of the objectives. Emphasis was placed on consultation prior to any decisions. Nurses requested an opportunity to give feedback on a regular basis regarding the unit managers conduct (Chi-square test p = 0.025). They also agreed that unit managers should apply the necessary rules and procedures (Chi-square test p = 0.016). A huge request was made for integrity, trust, impartiality, openness, approachability and particularly honesty. The nurses also maintained that the nurse manager’s behaviour should be congruent. Furthermore, the results indicate that nurses would like to be empowered by: being involved in the scheduling of off-duties taking the lead in climate meetings being granted opportunities (to all categories of nurses) to attend managerial meetings. N = 41 (48.2%) of nurses admitted that unit managers would instruct them to cope with insufficient staffing pertaining to ventilated patients, putting them under severe strain and at risk legally. N = 39 (47%) of nurses admitted that unit managers only consider qualifications and experience in the delegation of tasks if the workload in the unit justifies it. Safe patient care is not always a priority. N = 99 (96%) of nurses agreed that autocratic behaviour relating to task delegation exists. Recommendations included the application of transformational leadership and participatory management. The aim to create a healthier, more favourable work environment for critical care nurses will hopefully be attained through applying the ideal leadership style and leadership approach.
AFRIKAANSE OPSOMMING: Die werksverrigtinge in kritieke sorgeenhede in Suid-Afrika word deur ‘n ernstige tekort aan verpleegsters, hoë werklading, konflik, spanning, min motivering en baie ontevredenheid onder verpleeglui gekortwiek. Die leiding en bestuur van ‘n kritieke sorgeenheid is dus nie ‘n maklike taak nie. Dit is dus belangrik dat eenheidsbestuurders ‘n leierskapstyl aan die dag lê wat dié uitdagings doeltreffend aanspreek. Die doel van die studie is dus om ondersoek in te stel na die wenslike leierskapstyl vir kritieke sorgeenhede. Die doelwitte daargestel is dus om die ideale leierskapstyl in elk van die volgende funksies te bepaal: administrasie opleiding pasiënte-sorg navorsing Die ideale leierskapstyl vir eenheidbestuurders in kritieke sorgeenhede in privaathospitale is bepaal deur ‘n kwantitatiewe benadering met ‘n beskrywende ontwerp toe te pas. Die populasie het alle kritieke sorg verpleeglui ( permanent werksaam by een van elf privaathospitale in die Kaapse Metropool) ingesluit. Instrumentasie het ‘n vraelys behels (met oorwegend geslote vrae) en data is persoonlik deur die navorser ingevorder. Etiese toestemming is vanaf die Etiese Komitee van die Mediese Fakulteit te Universiteit Stellenbosch verkry asook die hoofde van die verskillende privaathospitale waar navorsing plaasgevind het. Ingeligte toestemming is ook van elkeen van die deelnemers verkry. Ten einde die vraelys te toets, is ‘n loodstudie by ‘n privaathospitaal ( wat nie by die studie ingesluit was nie) gedoen. Die loodstudie het N = 27 (10%) van die totale populasie behels. Die betroubaarheid en geldigheid van die studie is deur die loodstudie, die gebruik van ‘n statistikus, verpleegdeskundiges en die navorser-metodoloog versterk. Data is getabuleer en in histogramme en frekwensies voorgestel. Deur die Chi-square- toets te gebruik, is statisties betekenisvolle assosiasies tussen veranderlikes bepaal. Ten einde sterkte van verhoudings tussen twee opeenvolgende veranderlikes te bepaal, is die Spearman rangordekorrelasie (rho) aangewend. Die bevindings van die studie het getoon dat ‘n deelnemende bestuurstyl en transformasie-leierskapbenadering die mees aangewese keuse vir al vier doelwitte is. Die toepassing van veral ‘n deelnemende besluitnemingsproses het groot voorrang geniet, Verpleegkundiges wil daarbenewens ook op ‘n gereelde basis geleentheid hê om terugvoering oor die leierskapgedrag van die eenheidsbestuurder te gee (Chi-square toets p = 0.025). Ook verlang die deelnemers dat eenheidsbestuurders nie reëls en regulasies moet verontagsaam nie (Chi-square toets p = 0.016). ‘n Ernstige versoek is gerig ten opsigte van integriteit met pertinente verwysing na eerlikheid, vertroue, onpartydigheid, deursigtigheid, toeganklikheid en dat die leier se woorde en dade moet ooreenstem. Die resultate het verder getoon dat verpleegsters graag bemagtig wil word deur: betrokkenheid in die skedulering van afdienste, leiding in klimaatsvergaderings te wil neem, geleentheid te hê om bestuurvergaderings by te woon (alle kategorieë van verpleegkundiges).. N = 39 (48.2%) van verpleegkundiges het erken dat hulle gedwonge personeeltekorte ten opsigte van geventileerde pasiënte ervaar en dus aan mediese geregtelike risiko’s en onnodige druk blootgestel word. N 39 (47%) van verpleegkundiges het erken dat eenheidsbestuuders kwalifikasies en ondervinding slegs in ag neem indien die werklading in die eenheid dit toelaat..Veilige pasiëntesorg kry dus nie altyd voorkeur nie. N = 99 (96%) van verpleegkundiges het erken dat outokratiese gedrag ( wat met werkstoewysing verband hou) wel voorkom. ‘n Transformasie leierskapsbenadering en deelnemende bestuurstyl is dus aanbeveel. Die hoop word dus uitgespreek dat deur aan die verpleegkundiges se versoeke ten opsigte van die ideale bestuursbenadering en bestuurstyl te voldoen, die werksatmosfeer binne kritieke sorgeenhede toenemend gesonder en dus aangenamer sal word.
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Chrisinger, Laura. "Policies and practices associated with medication administration in Ohio public elementary schools." Connect to this title online, 2004. http://hdl.handle.net/1811/180.
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Thesis (Honors)--Ohio State University, 2004.Title from first page of PDF file. Document formatted into pages; contains 24 p.; also includes graphics (some col.). Available online via Ohio State University's Knowledge Bank. Includes bibliographical references (p. 20-21). Available online via Ohio State University's Knowledge Bank.
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Brule, Joyel J. "Application at the bedside: Moving from knowing how to knowing why in nursing." ScholarWorks, 2008. http://scholarworks.waldenu.edu/dissertations/617.
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The nursing field is beginning to emerge as a profession with curricula that emphasis nursing as a discipline distinguished from a medically dominated paradigm. This changing focus places emphasis on professional competence upon graduation and entry into practice to foster fitness for purpose within an environment of continuously changing expectations of the nurse by society. Despite a growing body of research on transition into practice, a gap exists as to when this transition occurs and how this finding may influence educational preparation of nurses. This qualitative, exploratory study examined nurses' perceptions of their transformation from novice to professional practitioner by examining a pivotal moment in their practice that affected their self-reported professional competence, Twenty-five nurses who had worked in a hospital setting between 2 and 5 years were interviewed. The primary research question sought to address whether a common thread became apparent after conducting interviews that may have implications for nurse educators to enhance or change their curriculum. Analysis of the interviews was conducted utilizing a constructivist approach. The data collected were analyzed using ATLAS.ti, Using participants' words that described people, settings, themes and ideas that appeared in the data, coding was done acknowledging that some codes were based on the research questions and the initial review of the data. A common theme emerged from analysis that respondents felt that what they were taught in school was not valid in real life. Nurse educators need to re-envision their social responsibility and interrogate the traditional principles that have guided the curricula to prepare and train nurses' for the holistic welfare of all individuals in society. This is necessary to meet the needs of a changing social structure within the nursing profession and society as a whole.
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Hess, Edward Alan. "The impact of diabetes nurse care managers in outlying medical offices on quality of care: An empirical investigation." CSUSB ScholarWorks, 2001. https://scholarworks.lib.csusb.edu/etd-project/1744.
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The objective of this study is to evaluate the impact of the Diabetes Nurse Care Manager on an at-risk diabetic population using a Primary Group Visit Model in Outlying Medical Offices within the Kaiser-Permanente Health Care System upon the process and outcome of care in this population.
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Mazur, Lukasz Maciej. "The study of errors, expectations and skills for medication delivery systems improvement." Thesis, Montana State University, 2008. http://etd.lib.montana.edu/etd/2008/mazur/MazurL0508.pdf.
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Medication errors occurring in hospitals are a growing national concern. The enormous gaps in knowledge related to medication errors are often seen as major reasons for increased patient safety risks and increased waste in the hospital setting. However, little research effort in industrial and management engineering has been devoted specifically to medication delivery systems to improve or optimize their operations in terms of patient safety and systems efficiency and productivity. As a result, the current literature does not offer integrated solutions to overcome the workflow and management difficulties with medication delivery. Therefore, a better understanding of workflow and management sources of medication errors is needed to help support decisions about investing in strategies to reduce medication errors. Using qualitative and quantitative research methods the work reported in this dissertation makes several contributions to the existing body of knowledge. First, using healthcare professionals' perceptions of medication delivery system, a set of simple and logical workflow design rules are proposed. If properly implemented, the proposed rules are capable of eliminating the unnecessary variations in the process of medication delivery which cause medication errors and waste. Second, a theoretical model of 'expectations' for effective management of medication error reporting, analysis and improvement is provided. The practical implication of this theoretical model extends to effective management strategies that can increase feelings of competence and help create a culture that values improvement efforts. Third, eight propositions for effective use of a systems engineering method (in this research the "Map-to-Improve" (M2I) method) for medication delivery improvement are offered. Finally, a set of skills needed for future healthcare professionals to effectively use systems engineering methods is provided. The proposed insights into these areas can result in improved pedagogy for professional development of healthcare professionals. The practical implication extends to the development of better methods for healthcare systems analysis. In summary, the author of this research work hopes that the findings and discussions will help healthcare organizations to achieve satisfactory improvement in medication delivery.
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Curtis, Kathleen Anne Public Health & Community Medicine Faculty of Medicine UNSW. "Trauma nursing case management: impact on patient outcomes." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/33367.
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Aim The purpose of the study was to formally identify trauma care delivery problems at the study institution, implement a solution in the form of trauma case management (TCM), and measure the effect of TCM on staff satisfaction, clinical coding accuracy and patient outcomes, using practice-specific outcome variables such as in-hospital complication rates, length of stay, resource use and allied health service intervention rates. This research also aimed to make a unique contribution to the international trauma literature by addressing the lack of any evidence specifically measuring the impact of trauma case management intervention. Methods St George Hospital is a 600 bed urban Teaching Hospital of the University of NSW. It is a designated Trauma Centre, seeing around 200 severely injured patients and around 2500 injury admissions per year. A series of focus groups and a staff satisfaction survey identified perceived problems associated with trauma care, and a trauma case management program was implemented. A preliminary study was conducted with positive results and funding was obtained to provide TCM seven days a week to all trauma patient admissions. A larger clinical trial was conducted and data from 754 patients were collected over fourteen months after TCM was introduced at the study hospital. These data were compared with 777 matched patients from the previous 14 months as a control group. An audit was conducted on trauma patient clinical coding using the daily progress record kept by the trauma case manager. The data were analysed with SPSS. The statistical tests used were Mann-Whitney U, chi-squared (2) logistic regression and generalised linear models. Results Focus groups and the staff satisfaction survey identified communication and coordination as the main problems associated with trauma care delivery. Following the initial implementation of the program, staff support for TCM was overwhelming. TCM greatly improved the rate of and time to Allied Health intervention (p<0.0001). Results demonstrated a decrease in the occurrence of deep vein thrombosis (p<0.038), coagulopathy (p=0.041) and respiratory failure. A reduced hospital length of stay (LOS), particularly in the paediatric (p<0.05) and 45 - 64 years age group was noted. There were 6621 fewer pathology tests performed (p<0.0001) and the total number of bed days was 483 days less than predicted from the control group. Many hospital clinical coding errors and omissions were highlighted by the TCM record comparison. The use of TCM records resulted in Twenty eight percent of recoded records having their Australian national diagnostic related group (AN-DRG) changed, which resulted in the identification over $39,000 in unidentified funding. Conclusion TCM improves staff satisfaction, communication and clinical coding accuracy. The introduction of TCM improved the efficiency and effectiveness of trauma patient care in our institution. This initiative demonstrates that TCM results in improvements to quality of care, trauma patient morbidity, financial performance and resource use. This research makes an important and original contribution to the international trauma literature by providing the results of a clinical trial formally measuring the impact of trauma nursing case management intervention.
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Haglund, Kristina. "Patient and Staff Perceptions of Medication Administration and Locked Entrance Doors at Psychiatric Wards." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-6133.
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Talley, Carla E. "A case example of nursing leadership : I don't look good until they look good." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1020141.
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Rapid and chaotic changes in health care have created a need for a new type of nursing leadership. Many leadership theories have been studied and adopted by nursing. However, historical approaches to leadership will not help nurses thrive in the current health care arena.The purpose of this study was to describe a case example of nursing leadership using a topical life history of one exceptional nurse leader. The topical life history describes two representative periods in an exemplary nurse leader's life to fully describe an insider's perspective of leadership. This definition, which includes the participant's interactions with her self, others, and her environment during two significant periods during her life, will be used as the initial case for the future collection of multiple case examples in an effort to develop a definition of nursing leadership.Nursing leadership was defined, based on the interpretation of interview transcripts, as: Hard work, vision, communication, coaching/facilitating, strong values, proactivity, and charisma. Findings support various leadership theories and identified two core categories previously poorly defined in nursing leadership literature: Hard work and street smarts. Implications for nursing research, education, and practice have been identified. Recommendations for use of this study as a case example to stimulate classroom discussion have been made. Additional recommendations for further research in the areas of hard work and street smarts have also been made.School of Nursing
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Beymer, Toni M. "The tenure of directors of nursing in rural acute care hospitals." Virtual Press, 1995. http://liblink.bsu.edu/uhtbin/catkey/935945.
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Rural health care has been affected by health care changes. Twenty-seven percent of the U.S. population live in rural areas (Adams, 1993; Weinert & Long, 1991). The purpose of this study was to examine the tenure of rural Directors of Nursing (DONs) in the DON position, to examine the tenure of rural DONs in the organization, and to profile the personal system of the DON in a rural hospital. The significance of the study was that little is known about rural DONs.The Neuman Systems Model (Neuman, 1989) provided the theoretical. framework for the study using the personal system level. The sample included all rural acute care DONs in one midwestern state. The Assessment of DON Tenure Questionnaire (Rowles, 1992) was the instrument used to collect data. Thirty-three questionnaires were mailed to rural acute careDONs with a return rate of 100%.Rural DONs were found to have a longer tenure in the DON position than the tenure data in the nursing literature. Tenure in the organization was also found to be longer. The typical DON was found to be female, married, with children,45 years old, with a BSN in nursing. The rural DONS were found to be slightly dissatisfied with the job.The return rate of questionnaires demonstrated the rural DONs interest in nursing education, practice and research. The research implication called for further investigation into the tenure measure of rural DONs in other geographic location along with urban DONs tenure measure for comparative analysis. Rural DONs have limited education opportunities based on geographic location. Continuing education programs in nursing administration and practice that are accessible in the rural setting via TVs or computers would be beneficial.School of Nursing
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Andrews, Sheila Bernadette. "Skilled nursing facility based rehabilitation outcomes of the geriatric stroke patient." CSUSB ScholarWorks, 1995. https://scholarworks.lib.csusb.edu/etd-project/1000.
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Peregrina, Michael. "Lost in transition : a study of the leadership practices of nursing unit managers." Thesis, View thesis, 2009. http://handle.uws.edu.au:8081/1959.7/45489.
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Leadership has become an important aspect of management practice in the changing health care environment. As health care organisations restructure to meet the demands for accessible, efficient, safe and affordable health care, nurses in management roles are under constant pressure to develop new skills and strategies to meet the challenges that accompany system change. The role of Nursing Unit Manager (NUM), being a frontline management position, is well placed to effect the changes now being asked of health care organisations. Nursing Unit Managers are expected to have management and leadership skills in order to function effectively in their roles and in responding to the challenges that emerge as a consequence of health care systems reform. This study explores the self-reported leadership practices of Nursing Unit Managers (NUMs), examines their leadership strengths from the perspectives of their staff and the impact of their leadership practices on workplace outcomes such as sense of empowerment and job satisfaction of staff. In addition, the study examines the leadership development needs of Nursing Unit Managers. Leadership and employee’s job satisfaction and empowerment are important elements in organisational performance. The relationship of these constructs is still not well understood. Moreover little is known about the influence of NUMs leadership practices on employee outcomes in Australia. Thus, this descriptive, exploratory study was used to explore the self-reported leadership practices of NUMs and describe the relationship of leadership practices to workplace outcomes in a tertiary referral hospital. The study sought to build knowledge and understanding of the leadership practices of NUMs including their impact on the work environment and staff. The study also investigated the barriers and facilitators for NUM leadership role enactment. Role theory was utilised as the theoretical framework for this study. Data generated from the Leadership Practices Inventory, Job in General Scale, and Conditions of Workplace Effectiveness- II Instrument were utilised in this study. Data analyses included the use of Statistical Package for Social Sciences (SPSS). The findings showed that the use of leadership behaviours and employee outcomes were positively correlated. The findings from this study support the importance of NUM leadership and its potential influence in staff job satisfaction and empowerment. The findings reaffirm the need for organisation to provide a mechanism to help nursing unit managers become effective nursing leaders. Commitment should be made to design and implement management training and leadership development programs that focus on effective and facilitative leadership styles such as a transformational style of leadership. Nursing Unit Managers continue to struggle with their role because to date the role of the NUM is not clearly defined. Recommendations from the findings can contribute to clarifying the role of NUM and the development of a professional leadership development model, which could foster development of leadership practices within the Australian context.
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Stubbings, Elizabeth. "Understanding the Contribution of Situation Awareness to Decision Making by Medical/Surgical Nurses for Pressure Injury Prevention in Nursing Practice." Thesis, Griffith University, 2015. http://hdl.handle.net/10072/366247.
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Situation awareness (SA) has been developed in occupations other than nursing to improve decision making (DM) for optimal performance and outcomes. There are some studies exploring the use of situation awareness by nurses in simulated settings but few have examined SA in clinical practice. Because of this paucity of evidence nurses’ use of situation awareness in practice is not fully understood.
Studies examining decision making by nurses have indicated that clinical decisions arising from a lack of awareness of patient needs in busy, complex clinical environments can compromise care. In ward environments, compromised care often results in the omission of ‘basic’ nursing interventions which may include pressure injury prevention. This thesis explored the use of situation awareness by nurses in medical/surgical wards as the precursor to decision making and the influences on situation awareness whilst making pressure injury prevention decisions in practice.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Griffith Health
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Vannatter, Beverly J. "Perceptions of staff nurse autonomy and management characteristics in shared governance systems and traditional organizational systems." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1036192.
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The purpose of this study was to determine if shared governance systems result in an increased perception of autonomy for staff nurses. The population for this study included all registered nurses providing inpatient care at two mid-sized community hospitals in the Midwest, who were not identified as supervisors, managers or executives. The convenience sample was obtained from those completing and returning a distributed survey. The sample was 146 staff nurses from each organization. Only responses from nurses with more than one year experience at the current facility were included in the study. , One hospital had a shared governance system in place. The other hospital had a traditional organizational system.The theoretical framework for the study was the Neuman Systems Model (1989). Staff nurse autonomy was measured by the Nursing Activity Scale (Schutzenhofer, 1987). Management characteristics were measured by the Profile of Organizational Characteristics (Liken, 1978). Also administered was a brief demographic data questionnaire (Schutzenhofer & Musser, 1994).Each hospital provided the researcher with access to participant mailboxes of those registered nurses providing inpatient care and not in management or executive roles Surveys were placed in each mailbox, and drop boxes were made available in unit classrooms in one hospital, and in nursing administration in the other hospital. A reminder notice was placed in each participant mailbox one week after initial survey distribution. Drop boxes were retrieved by the researcher one week following the reminder notice distribution. Study participants were informed about the study by cover letter and invited to participate. Participation was strictly voluntary. Data was available only to the investigator and only group data were reported without reference to individual participants. Participant responses were completely anonymous. Questionnaires were printed on two different colors of paper in order to distinguish between hospitals. No code numbers or other identifying marks were placed on any of the questionnaires. The study provided information on which to base management decisions regarding nursing governance arrangements.School of Nursing
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Abenojarj, John Paul Tuanqui. "Leadership among Directors of Social Services at Rehabilitative Healthcare Chains." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3736.
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Rehabilitation and healthcare centers (RHCs) provide ongoing care to the elderly and chronically ill. To maximize the quality of this care, RHC staff must be properly trained to respond to patient care crises and communicate across departments. Although researchers have studied the leadership styles, strategies, and interactions of facility administrators and nursing directors, there is a substantial gap in the literature on the leadership styles and strategies employed by directors of social services (DSSs). The aim of this phenomenological study was to address this gap in the research by exploring how DSSs influenced leadership policies, prepared subordinates for crisis intervention and management, perceived that social workers influenced decision-making in patient care, and believed that communication amongst RHC staff about patient care could be improved. The conceptual framework for this study was based on 3 leadership model constructs: the multilevel leadership model construct, the situational leadership model construct, and the complex adaptive leadership model construct. Participants included a purposive sample of 10 DSSs working in large, corporate RHCs in Virginia. Data were collected via in-person, semistructured interviews consisting of open-ended questions. Data were analyzed via Hycner's phenomenological approach. Findings from this investigation helped clarify roles and responsibilities of DSSs, thereby improving the leadership they provide to subordinate social workers. Findings may be used to improve communication across professionals within RHCs and emphasize the important role that social workers should play in patient care decisions.
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Caster, Marcus Ellis. "Strategies to Improve Customer Care Services in Urgent Care Businesses." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6979.
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Healthcare industry owners who have unsatisfactory customer care services may experience a financial risk and create dissatisfied patients. The purpose of this case study was to explore customer care strategies that managers of urgent care businesses used to improve customer care services and patient satisfaction. The target population consisted of 1 urgent care manager from 3 separate urgent care clinics with the highest customer satisfaction ratings in Alabama. The urgent care managers were knowledgeable about effective customer care strategies that improved customer care services and patient satisfaction. Customer loyalty theory with emphases on customer behavior, customer attitude, repeat patronage, and loyalty was the conceptual framework for the study. Semistructured interviews and patient survey forms were the data sources. Data were analyzed using thematic analysis which identified similar codes, patterns, and themes. The 3 primary themes that emerged from thematic analysis were patient-focused care, social media outreach, and employee engagement. The implications of this study for positive social change include the potential to enhance the quality of healthcare experiences, which may empower individuals to seek medical care. The patients might become trusting of healthcare providers and become collaborators in responding to medical care requests by medical staff to improve their quality of life.
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Miles, Mary Alice, and n/a. "A critical analysis of the relationships between nursing, medicine and the government in New Zealand 1984-2001." University of Otago. Faculty of Education, 2006. http://adt.otago.ac.nz./public/adt-NZDU20061024.145605.
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This thesis concerns an investigation of the tripartite arrangements between the government, the nursing and the medical sectors in New Zealand over the period 1984 to 2001 with a particular focus on primary health care. The start point is the commencement of the health reforms instituted by the Fourth New Zealand Labour Government of 1984. The thesis falls within a framework of critical inquiry, specifically, the methodology of depth hermeneutics (Thompson, 1990), a development of critical theory.
The effects of political and economic policies and the methodologies of neo-liberal market reform are examined together with the concept of collaboration as an ideological symbolic form, typical of enterprise culture.
The limitations of economic models such as public choice theory, agency theory and managerialism are examined from the point of view of government strategies and their effects on the relationships between the nursing and medical professions.
The influence of American health care policies and their partial introduction into primary health care in New Zealand is traversed in some detail, together with the experiences of health reform in several other countries.
Post election 1999, the thesis considers the effect of change of political direction consequent upon the election of a Labour Coalition government and concludes that the removal of the neo-liberal ethic by Labour may terminate entrepreneurial opportunities in the nursing profession. The thesis considers the effects of a change to Third Way political direction on national health care policy and on the medical and nursing professions. The data is derived from various texts and transcripts of interviews with 12 health professionals and health commentators.
The histories and current relationships between the nursing and medical professions are examined in relation to their claims to be scientific discourses and it is argued that the issue of lack of recognition as a scientific discourse is at the root of nursing�s perceived inferiority to medicine. This is further expanded in a discussion at the end of the thesis where the structure of the two professions is compared and critiqued. A conclusion is drawn that a potential for action exists to remedy the deficient structure of nursing. The thesis argues that this is the major issue which maintains nursing in the primary sector in a perceived position of inferiority to medicine.
The thesis also concludes that the role of government in this triangular relationship is one of manipulation to bring about necessary fundamental change in the delivery of health services at the lowest possible cost without materially strengthening the autonomy of the nursing or the medical professions.
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Hilton, Paula Evangeline. "The influence of verbal abuse on intention to leave an organization among registered nurses." CSUSB ScholarWorks, 1989. https://scholarworks.lib.csusb.edu/etd-project/548.
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Egan, Julia. "Exploring the relationship between leadership, leadership behaviours and organisational culture." Thesis, University of Dundee, 2010. https://discovery.dundee.ac.uk/en/studentTheses/688a2b1d-651b-4fff-931a-c7049b6f50c4.
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This thesis explores the theme of leadership in the NHS, specifically focusing on nursing. Leadership has become an important area in recent years, particularly in relatiion to improving efficiency, effectiveness and quality of services. As nurses provide 80% of care in the NHS, their role is pivotal in achieving any change. Despite the importance placed on leadership in the NHS, literature shows little is known about perceptions of leadership, how leaders function or what importance staff place on the culture and context in which they work. This study is based on the findings of 28 qualitative interviews with leaders in two health boards in Scotland. Through the presentation of informants' perceptions, beliefs and collective accounts, the study illustrates how staff view leadership in the NHS and provides some significant results. Firstly, it proposes that leadership is comprised of two elements; one relating to individuals and one relating to how individuals function in organisations. Secondly, it indicates three models of leadership are particularly relevant and how these differ according to role and hierarchy. Thirdly, it reveals leadership and management as disticnct components. In nursing a number of complexities make these roles challenging, and the culture and context of health borads influence how these fundtion in practice. Finally, this research concludes that staff value a clear set of characteristics, styles and behaviours not related to vision and change but which centre on character, values, integrity and engagement. The study has considerable impolication for emerging work on leadership in the NHS and for the future development of leadership roles in nursing.
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Wilkinson, Joyce E. "Managing to implement evidence-based practice? : an exploration and explanation of the roles of nurse managers in evidence-based practice implementation." Thesis, St Andrews, 2008. http://hdl.handle.net/10023/560.
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Edgar, Linda. "The relationship between the characteristics of nursing care delivery systems and work-motivation, satisfaction, and intent to leave." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp02/NQ36974.pdf.
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Burns, Diane Sutton. "A financial analysis of a Southern California Coalition of Visiting Nurse Associations." CSUSB ScholarWorks, 1994. https://scholarworks.lib.csusb.edu/etd-project/922.
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White, Jill Fredryce. "The commodification of caring : a search for understanding of the impact of the New Zealand health reforms on nursing practice and the nursing profession : a journey of the heart /." Title page, table of contents and abstract only, 2004. http://web4.library.adelaide.edu.au/theses/09PH/09phw5822.pdf.
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Pereira, Maria Valéria [UNESP]. "Compreensão de processo de trabalho gerenciar em enfermagem pelos enfermeiros de um hospital estadual." Universidade Estadual Paulista (UNESP), 2012. http://hdl.handle.net/11449/96439.
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pereira_mv_me_botfm.pdf: 593804 bytes, checksum: cbf185f88477b6d064aa8a03d6f9159e (MD5)O presente estudo teve como objetivo compreender o significado para os Enfermeiros sobre o processo gerenciar em enfermagem e quais elementos indispensáveis para a tomada de decisão gerencial em um Hospital Estadual do Estado de São Paulo. Para essa finalidade, optou-se por uma abordagem qualitativa, na vertente da fenomenologia, pois contempla a compreensão e a interpretação do sentido, considerando os sujeitos como seres histórico-culturais que produzem as transformações por meio do processo de trabalho gerencial. A saturação teórica se configurou, por meio da análise de vinte e duas entrevistas, sendo os sujeitos enfermeiros de unidades assistenciais e supervisores de unidades de serviço. As entrevistas foram áudio-gravadas, transcritas e mantidas com preservação da identidade do sujeito para que não pudessem interferir nos resultados propostos. Utilizamos as seguintes questões norteadoras: Qual o conhecimento sobre o processo gerenciar em enfermagem? Quais os elementos fundamentais para tomada de decisão? Após as transcrições, os depoimentos foram analisados individualmente resgatando os temas: Processo gerenciar e os recursos humanos; Processo gerenciar como meio para o processo assistir/cuidar; Processo gerenciar e os recursos materiais; Processo gerenciar e a tomada de decisão; Processo gerenciar e a dimensão técnico–científica; Processo gerenciar e a dimensão ético-política. A análise dos temas apresentados visou à reflexão sobre o fenômeno a partir das convergências, divergências e idiossincrasias o que possibilitou compreender o mundo-vida dos sujeitos do estudo que possuem um olhar próprio sobre o fenômeno. Neste sentido, desvelamos que o processo gerencial é considerado importante e com ações voltadas para a busca de qualificação da assistência assim como...
This study aimed to understand the meaning for nurses of the managerial process in nursing and which are the indispensable components to decision-making in a State Hospital of the State of São Paulo. For this purpose, we choose a qualitative approach, on phenomenology. The phenomenology contemplates the understanding and interpretation of the meaning, considering the subject as an historical and cultural transformations that produce through of the managerial process of the work. The theoretical saturation has occurred with the analysis of twenty-two interviews of the subjects of nursing care units and supervisors of units of service. The interviews were audio-recorded, transcribed and maintained with preservation of the identity of the subject. We use the following questions: What knowledge about the managerial process in nursing? What are the key elements in decision-making? After the transcription, the reports were analyzed individually and the themes revealed were: Managerial process of the human resources; Managerial process as important to nursing care; Managerial process in material resources; Decision-making process; Scientific and technical dimension of the managerial process, Ethical-political dimension of the managerial process. The analysis of the issues presented aimed to reflect on the phenomenon through the convergence, divergence and idiosyncrasies. Revealing the managerial process is considered important to develop actions, search for care with quality, recognize the role of practical nurses, and comprehend the managerial perspective. Some aspects are inherent in managerial processes. These aspects correspond to the understanding of the staff and the tools required for care classification; preparation of work schedules; absenteeism; turnover; positioning in face of... (Complete abstract click electronic access below)
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Pereira, Maria Valéria. "Compreensão de processo de trabalho gerenciar em enfermagem pelos enfermeiros de um hospital estadual /." Botucatu : [s.n.], 2012. http://hdl.handle.net/11449/96439.
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Orientador: Wilza Carla SpiriBanca: Marta Maria Melleiro
Banca: Ilda Godoy
Resumo: O presente estudo teve como objetivo compreender o significado para os Enfermeiros sobre o processo gerenciar em enfermagem e quais elementos indispensáveis para a tomada de decisão gerencial em um Hospital Estadual do Estado de São Paulo. Para essa finalidade, optou-se por uma abordagem qualitativa, na vertente da fenomenologia, pois contempla a compreensão e a interpretação do sentido, considerando os sujeitos como seres histórico-culturais que produzem as transformações por meio do processo de trabalho gerencial. A saturação teórica se configurou, por meio da análise de vinte e duas entrevistas, sendo os sujeitos enfermeiros de unidades assistenciais e supervisores de unidades de serviço. As entrevistas foram áudio-gravadas, transcritas e mantidas com preservação da identidade do sujeito para que não pudessem interferir nos resultados propostos. Utilizamos as seguintes questões norteadoras: Qual o conhecimento sobre o processo gerenciar em enfermagem? Quais os elementos fundamentais para tomada de decisão? Após as transcrições, os depoimentos foram analisados individualmente resgatando os temas: Processo gerenciar e os recursos humanos; Processo gerenciar como meio para o processo assistir/cuidar; Processo gerenciar e os recursos materiais; Processo gerenciar e a tomada de decisão; Processo gerenciar e a dimensão técnico-científica; Processo gerenciar e a dimensão ético-política. A análise dos temas apresentados visou à reflexão sobre o fenômeno a partir das convergências, divergências e idiossincrasias o que possibilitou compreender o mundo-vida dos sujeitos do estudo que possuem um olhar próprio sobre o fenômeno. Neste sentido, desvelamos que o processo gerencial é considerado importante e com ações voltadas para a busca de qualificação da assistência assim como... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: This study aimed to understand the meaning for nurses of the managerial process in nursing and which are the indispensable components to decision-making in a State Hospital of the State of São Paulo. For this purpose, we choose a qualitative approach, on phenomenology. The phenomenology contemplates the understanding and interpretation of the meaning, considering the subject as an historical and cultural transformations that produce through of the managerial process of the work. The theoretical saturation has occurred with the analysis of twenty-two interviews of the subjects of nursing care units and supervisors of units of service. The interviews were audio-recorded, transcribed and maintained with preservation of the identity of the subject. We use the following questions: What knowledge about the managerial process in nursing? What are the key elements in decision-making? After the transcription, the reports were analyzed individually and the themes revealed were: Managerial process of the human resources; Managerial process as important to nursing care; Managerial process in material resources; Decision-making process; Scientific and technical dimension of the managerial process, Ethical-political dimension of the managerial process. The analysis of the issues presented aimed to reflect on the phenomenon through the convergence, divergence and idiosyncrasies. Revealing the managerial process is considered important to develop actions, search for care with quality, recognize the role of practical nurses, and comprehend the managerial perspective. Some aspects are inherent in managerial processes. These aspects correspond to the understanding of the staff and the tools required for care classification; preparation of work schedules; absenteeism; turnover; positioning in face of... (Complete abstract click electronic access below)
Mestre
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Mensah, Gwendolyn Patience. "Best practice guideline for the nursing management of women with gestational diabetes mellitus in military health institutions in Ghana." Thesis, Nelson Mandela University, 2017. http://hdl.handle.net/10948/14036.
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Pregnancy is a normal physiological process for the majority of women. These women, their families and significant others normally expect a successful period of pregnancy, labour, delivery and arrival of a normal and healthy baby. However, some of these pregnant women may develop Gestational Diabetes Mellitus (GDM) during this period and if not managed properly, the mother and the foetus in utero are affected in a negative way: there is a likelihood of the mother and baby developing Type 2 Diabetes in the future and also, other risks such as preterm labour, and foetal macrosomia. In order to prevent such occurrences, I set out to develop a best practice guideline for the nursing management of GDM in military health institutions in Ghana in order to help enhance nursing care. The design for this research was qualitative, explorative, descriptive and contextual in nature. The research is organised in three phases: Phase one deals with the data analysis and discussion of the interviews with professional nurses and midwives and women with a history of GDM. The data collected from the interviews were transcribed, analysed and extracted with Tesch’s eight steps of coding used for the coding. The services of an independent coder were employed to assist with the coding process which led to the formulation of key themes. Semi-structured individual interviews provided a means of exploring the perceptions of professional nurses and midwives on the nursing management of GDM: in addition, women with a history of GDM were interviewed so as to elicit their views on the management they had experienced from professional nurses and midwives before and after being diagnosed with GDM. The trustworthiness of the study was ensured by conforming to Lincoln and Guba’s framework of credibility, transferability, dependability, confirmability and authenticity. An independent coder assisted with the coding process. Phase two deals with the Integrative literature review of available evidence-based clinical practice guidelines for the nursing management of GDM. Evidence-based clinical practice guidelines were searched and appraised with assistance from an independent appraiser and themes were then formulated. In Phase three, the themes from Phase one and Phase two were integrated for the development of a draft best practice guideline for the nursing management of GDM in military health institutions in Ghana. The draft guideline was given to an expert panel of reviewers for their comments and recommendations. These were considered in the development of the final best practice guideline for the nursing management of GDM.
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Jantjies, Leigh-Anne Rene. "The experiences of professional nurses regarding the management of health services rendered to tuberculosis patients." Thesis, Nelson Mandela Metropolitan University, 2011. http://hdl.handle.net/10948/1399.
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The World Health Organisation (WHO) declared tuberculosis (TB) a global emergency, and this infectious disease remains a health threat by being the leading cause of death amongst adults (Naidoo, Dick & Cooper, 2008:55). In 2005, South Africa was ranked seventh in the world for having the highest TB rate and the lowest TB success rate in the world. As a professional nurse involved in the tuberculosis programme at a clinic in the Nelson Mandela Bay Municipality at local government level for approximately three years, the researcher observed that the morale of professional nurses who provide TB services appeared to be low. They also appeared to be frustrated because they feel that they are not winning the battle with regard to the TB epidemic in their communities irrespective of their efforts to try and curb the spread of the disease. The extent of the workload per person also appeared to add to the low morale and frustration of the professional nurses rendering TB health services because they feel that they are unable to manage everything. The objectives of the study were therefore to explore and describe how professional nurses experienced the management of health services being rendered to TB patients in Sub district B of the Nelson Mandela Bay Municipality (NMBM) in order to make recommendations that could be used by the district manager to address the research findings. The research study was based on a qualitative, explorative, descriptive and contextual research design. The research population consisted of all professional nurses who worked in the TB services of Sub district B. Non-probability, purposive sampling was used to select the participants for the study. Seven in-depth and three follow-up interviews were conducted before data saturation was achieved. The data gathered during the interview process by the researcher were transcribed and coded by an independent coder using Tech’s model for data analysis. Ethical considerations were adhered to throughout the research study. The aspect of trustworthiness according to Guba’s model was implemented in the research study and included credibility, applicability, consistency and neutrality. iii One theme, two sub themes and categories were identified relating to the diverse experiences expressed by the participants relating to the management of health services being rendered to TB patients. The experiences expressed by the professional nurses included both negative and positive experiences. The negative experiences expressed by the participants were for example, a lack of resources as hampering adequate service delivery, a concern regarding the number of staff contracting TB due to a lack of infection control measures, a difference in conditions of service between the two local authorities and the DOTS supporters as being a threat to patient confidentiality. The positive experiences expressed by the participants included experiences relating to job satisfaction in rendering TB health services, the DOTS supporters as being supportive to the staff, the TB meetings serving as an appropriate platform for problem solving and the audits conducted by managers as being remedial. The study concludes with recommendations made with regard to the areas of nursing practice, education and research.
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Hayes-Burrell, Ingrid Monique. "Financing School-Based Health Centers: Sustaining Business Operational Services." ScholarWorks, 2015. http://scholarworks.waldenu.edu/dissertations/1684.
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Walden University
College of Management and Technology
This is to certify that the doctoral study by
Ingrid Hayes-Burrell
has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.
Review Committee
Dr. Ify Diala, Committee Chairperson, Doctor of Business Administration Faculty
Dr. Anne Davis, Committee Member, Doctor of Business Administration Faculty
Dr. Yvette Ghormley, University Reviewer, Doctor of Business Administration Faculty
Chief Academic Officer
Eric Riedel, Ph.D.
Walden University
2015
â??
School-based health centers (SBHCs) have faced challenges in securing adequate funding for operations and developing sound business systems for billing and reimbursement. Specifically, administrators often lack strategies to develop and sustain funding levels to support appropriate resources for business operations. The focus of this descriptive study was to explore best practice strategies to develop and sustain funding through the experiences of SBHC administrators. The conceptual framework included Elkington's sustainability theory, which posits that corporate social responsibility, stakeholder involvement, and citizenship improve manager's effect on the business system. Twenty full-time SBHC administrators working in separate locations throughout the state of Maryland participated in semistructured telephone interviews. The van Kaam process was used to cluster descriptive experiences in data analysis that resulted in the development of thematic strategies for implementing best practices relevant to developing and sustaining funding for SBHC business operations. Major themes provided by the participants were interagency communications, creating marketing plans, and disparities in the allocation of funding for programs and professional staff. Findings indicated SBHC administrators continue to face challenges in developing and sustaining adequate funding for operations in the state of Maryland. Suggestions for future research include how administrators can develop marketing plans and explore long-range funding for SBHC services. The findings in this study may contribute to positive social change by demonstrating to officials in the Maryland State Department of Education the significance of SBHCs, and the need to increase mental health services.
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Ucar, Bulent. "The Effectiveness of Religion-Affiliated Nonprofit Organizations in Social Services: A Survey Study of Nursing Homes in Virginia." VCU Scholars Compass, 2011. http://scholarscompass.vcu.edu/etd/2640.
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The primary purpose of this study is to determine whether being a church affiliated nursing home influences performance. Performance is measured based on criterion put in place by the Center for Medicare and Medicaid Services (CMS). The secondary purpose is, regardless of ownership type - religiously affiliated or secular- to investigate if more religiously involved nursing homes perform better than their less religiously involved counterparts. These two purposes are hypothesized with six different hypotheses each of which are tested by utilizing OLS regression analysis. This study extensively discusses the arguments surrounding the Charitable Choice Initiative, which allowed faith-based organizations (FBOs) to compete for federal and state grants and funds without altering their religious beliefs or practices while setting up a partnership with government in delivering social services. The subject has been part of serious debates among policy makers, practitioners and scholars after President George W. Bush's creation of the White House Office of Faith-Based and Community Initiatives in 2001. This study applied self regulation theory, which is originally an individual level theory, to organizations by using metaphors, as many newly developing fields of studies have done. The self regulation theory is tested through analyzing secondary data sets that are provided by CMS and through a religiosity survey data set that this researcher collected from 218 out of 287 CMS certified nursing homes in Virginia. The relationship between religious involvements of nursing homes and their patient outcomes and health inspection outcomes are tested. The statistical analyses supported only one hypothesis out of six. Since most of the hypotheses are not supported by the findings, the theory used to explain the role of religious motivation in performance of organizations requires further testing through additional rigorous studies.
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Moss, Rita J. "The relationship of staff nurse job satisfaction and head nurse management style." Virtual Press, 1994. http://liblink.bsu.edu/uhtbin/catkey/935941.
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America's health care industry is in a state of crisis. Nursing administrators are in the position to facilitate change in institutions. One aspect of nursing which has remained constant is high turnover rates. The high turnover rates have been linked to job dissatisfaction. One method of reducing turnover is to provide greater job satisfaction to staff nurses. Job satisfaction has been connected with management style (Lucas, 1991; Price & Mueller, 1981; Volk & Lucas, 1991).This study described the impact of head nurse management style on staff nurse job satisfaction. Likert's (1967) System 4 management theory was utilized as the framework in the study. All staff nurses and head nurses from three Central Indiana hospitals were given the opportunity to participate in the study. Participants completed two questionnaires, one from Price and Mueller's (1981) work on turnover to determine job satisfaction and one from Likert and Likert's (1976) work to determine management style.Data analysis was conducted to describe any variations between staff nurse experience of head nurse management style and staff nurse job satisfaction. Differences between head nurse and staff nurse description of management style were also examined. There were no identified risks as participation was voluntary and did not affect the employment status of any individual.Results of the study demonstrated agreement with previous research findings. When management style is closer to participative (system 4), greater job satisfaction is expressed. Recommendations are to provide management training and training in communication and self-awareness for head nurses, and to form unit based committees designed to achieve greater staff input in decisions affecting the unit functioning.Benefits of the study include identification of the management style which leads to improved staff nurse job satisfaction. Equipping nurse administrators with information regarding desirable management style to employ for staff nurses to experience greater job satisfaction, and training present managers in that management style are also possible benefits from the study.School of Nursing
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Hillier, Fleur Jane School of Public Health & community medicine Centre for Clinical Governance Research in Health UNSW. "Managing creative and health production processes : issues, similarities and differences." Awarded by:University of New South Wales. School of Public Health and community medicine. Centre for Clinical Governance Research in Health, 2005. http://handle.unsw.edu.au/1959.4/22281.
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In this thesis I am concerned to examine the management behaviours and predilections of managers across the two settings of health and theatre considered to be divergent. To do this I explore and map methods, similarities and differences managers employ to ???manage??? workers across the industries. I also deconstruct creativity and its manifestations in both managerial behaviours and environmental contexts and map the complexity issues that managers face in different settings. Further, I explore the extent to which management activity is contextual to the identity of participant organisational aims and processes and examine the level of calculated chaos experienced by managers across the settings. Central to this approach is the utilisation of multi-method design incorporating interview, micro-ethnography, auto-ethnography and a RAND expert panel to assist with interpretation of the results. Core findings include high degrees of similarity in the roles and functions and support systems utilised by managers across the settings despite substantial differences in environmental contexts and organisational aims and processes. Differences were identified in the areas of: levels of chaos, interactions, purposes, and environmental characteristics. To account for these differences I apprehended seven metafactors grounded in the data sets. These seven metafactors can be found in each setting but emerge in different ways. The metafactors that I apprehend are order versus disorder; creativity; experimentation and change; risk; reflection; trust and respect; and time and pressure. While I discuss these seven metafactors as separate factors in reality they are fundamentally inter-related. Suggestions for future research are included.
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Coelho, Mônica Franco. "Caracterização dos atendimentos de urgência clínica em um hospital de ensino." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-07102009-143905/.
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Os serviços de urgência/emergência apresentam-se como uma das portas de entrada do Sistema Único de Saúde (SUS), têm por objetivo atender de forma imediata indivíduos com risco iminente de vida. Nos últimos anos, a demanda por atendimento nestes serviços tem aumentado, dificultando a organização do trabalho e o acesso aos pacientes que realmente necessitam, comprometendo a qualidade do trabalho da equipe de saúde. As mudanças no perfil de morbi-mortalidade por doenças crônicas não transmissíveis trazem repercussão para o atendimento às urgências/emergências hospitalares. Este estudo teve por objetivo caracterizar os atendimentos clínicos de adultos segundo aspectos demográficos, organizacionais e de diagnóstico médico de alta em um Serviço de Urgência de um Hospital de Ensino do interior de São Paulo, no ano de 2007. Trata-se de uma pesquisa com desenho metodológico quantitativo, do tipo descritivo e transversal, utilizando dados secundários, obtidos através de um banco de dados do próprio hospital, os quais foram analisados segundo a estatística descritiva, apresentados na forma de freqüência e porcentagens, discutidos a partir de referencial teórico de reorganização do atendimento a urgências/emergências clínicas na perspectiva do SUS. No período ocorreram 5285 atendimentos clínicos que se caracterizaram em sua maior parte por usuários do sexo masculino (54,1%), com escolaridade de ensino fundamental (73,9%), na faixa etária de 18 à 59 anos (62,8%), procedentes do município de Ribeirão Preto (63,7%). No que se refere ao diagnóstico mais freqüente encontramos a hipertensão essencial (primária), correspondendo a 4,9% do total de atendimentos realizados. Quanto as variáveis organizacionais que o mês com maior número de atendimentos clínicos foi janeiro, 10%, enquanto o mês de novembro teve o menor número de atendimentos clínicos (7,3%), o dia da semana que apresentou maior demanda foi a segunda-feira (16%); quanto a variável horário de entrada do paciente no serviço, das 12 às 24h obtivemos um porcentual de 67,1% do total de atendimentos clínicos. O principal motivo de saída após atendimento foi a internação hospitalar e o tempo de permanência na unidade predominante foi inferior a seis horas. A caracterização dos atendimentos clínicos do serviço de urgência/emergência fornece subsídios para a organização do trabalho na unidade de estudo e no próprio hospital.Emergency services are one of the entrances of the Unified Health System (SUS). They aim to delivery immediate care to people at eminent risk of death. The demand for care in these services has increased in the last years. This makes the organization of the work and the access of patients who really need care more difficult, compromising the quality of the health team work. Changes in the profile of morbimortality by nontransmissible chronic diseases reflect on the care provided in hospital emergency services. This quantitative, descriptive, cross-sectional study aimed to characterize the adult clinical care delivered in an Emergency Service in a Teaching Hospital in the interior of the state of São Paulo, in 2007. Secondary data, obtained in the hospital database, were used to characterize care according to demographic and organizational aspects and the discharge medical diagnosis. Data were analyzed using descriptive statistics and presented as frequency and percentage. Data are discussed through the theoretical framework of the reorganization of clinical emergency care in the perspective of SUS. During the analyzed period, 5285 clinical care sessions were delivered, most clients were men (54.1%), with primary educational level (73.9%), between 18 and 59 years of age (62.8%), and lived in the city of Ribeirão Preto (63.7%). The most frequent diagnosis observed was essential high blood pressure (primary), corresponding to 4.9% of the total care sessions delivered. Regarding the organizational variables, it was found that January was the month with the highest number of care sessions (10%), while November had the lowest (7.3%). Monday was the day of the week that presented highest demand (16%); the peak time of patient\'s entrance to emergency service was between 12 am and 12 pm, with 67.1% of the total clinical care sessions. The main reason of exit after the care session was hospitalization, and the prevailing length of stay at the service was less than six hours. The characterization of the clinical care delivered at the emergency service supports the organization of the work in the service under study and in the hospital itself.
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Morin, Sheila Kenny. "Certified nursing assistants' satisfaction with education and training programs in long-term care facilities: A Massachusetts study." CSUSB ScholarWorks, 1994. https://scholarworks.lib.csusb.edu/etd-project/946.
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Alcusky, Matthew. "Anticoagulant Use, Safety and Effectiveness for Ischemic Stroke Prevention in Nursing Home Residents with Atrial Fibrillation." eScholarship@UMMS, 2019. https://escholarship.umassmed.edu/gsbs_diss/1034.
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Background
Fewer than one-third of nursing home residents with atrial fibrillation were treated with the only available oral anticoagulant, warfarin, historically. Management of atrial fibrillation has transformed in recent years with the approval of 4 direct-acting oral anticoagulants (DOACs) since 2010.
Methods
Using the national Minimum Data Set 3.0 linked to Medicare Part A and D claims, we first described contemporary (2011-2016) warfarin and DOAC utilization in the nursing home population (Aim 1). In Aim 2, we linked residents to nursing home and county level data to study associations between resident, facility, county, and state characteristics and anticoagulant treatment. Using a new-user active comparator design, we then compared the incidence of safety (i.e., bleeding), effectiveness (i.e., ischemic stroke), and mortality outcomes between residents initiating DOACs versus warfarin (Aim 3).
Results
The proportion of residents with atrial fibrillation receiving treatment increased from 42.3% in 2011 to 47.8% as of December 31, 2016, at which time 48.2% of treated residents received DOACs. Demographic and clinical characteristics of residents using DOACs and warfarin were similar in 2016. Half of the 8,734 DOAC users received standard dosages and most were treated with apixaban (54.4%) or rivaroxaban (35.8%) in 2016.
Compared with warfarin, bleeding rates were lower and ischemic stroke rates were higher for apixaban users. Ischemic stroke and bleeding rates for dabigatran and rivaroxaban were comparable to warfarin. Mortality rates were lower versus warfarin for each DOAC.
Conclusions
In nursing homes, DOACs are being used commonly and with equal or greater benefit than warfarin.
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Strömberg, Helén. "Sjukvårdens industrialisering : mellan curing och caring - sjuksköterskearbetets omvandling." Umeå: Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-257.
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Peters, Candice Marie. "A comparison of the levels of patient staffing ratios and staffing mix to the number of patient falls in an acute care setting." CSUSB ScholarWorks, 1997. https://scholarworks.lib.csusb.edu/etd-project/1314.
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Manona, Wellman Wela. "Causative factors of turnover among public sector registered nurses." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51645.
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Thesis (MPA)--Stellenbosch University, 2000.Full text to be digitised and attached to bibliographic record.
ENGLISH ABSTRACT: Managing human resources is crucial to the efficient and effective delivery of quality health care. However, turnover of nurses constitutes a major factor in the shortages of staff which are being experienced by the nursing profession in the Republic of South Africa. Shortages of trained nurses with experience, particularly in public sector hospitals, have adverse effects on the provision of efficient and effective quality health care to the consumers of this service. The aim of the study was to provide an understanding of and insight into those inherent problems in the health sector that propel nurses to leave public sector institutions. The overall objective was to investigate and identify some of the factors which exercised an influence on the turnover of registered nurses in public sector hospitals, so as to be able to provide suggestions to hospital managers on the more effective management of human resources, in order to retain nursing personnel. Theresearch was based on a model of nursing turnover which regarded voluntary withdrawal as a process in which feelings of satisfaction with pay, on the one hand, and the opportunity of obtaining alternative jobs in the labour market, on the other, were proposed as the primary causative factors of turnover behaviour. In addition the propositions, made in literature reviewed, that age, tenure, kinship responsibility, general training, education, professionalism, marital status, lintent to stay', job satisfaction, routinization, job autonomy and responsibility, instrumental communication, promotional opportunity, integration, supervisory relationships, distributive justice, work-load, and local kin acted as predictors of turnover, were also investigated. The research was conducted with a sample of 123 nurses in one hospital, Groote Schuur, situated in the Western Cape Province of the Republic of South Africa. The sample included registered nurses, senior professional (registered) nurses, and chief professional (registered) nurses. The data was gathered from respondents by means of a selfadministered questionnaire. In addition, data was gathered by means of semi-structured, open-ended discussions with nursing management. The hypothesised interactions between variables influencing nursing turnover were explored by means of basic statistics, which made it possible to assess the effects of both independent and dependent variables. The results of data analysis provided some support for the proposition contained in the hypothesis. The determinants whose increase produced a greater degree of turnover were firstly, the many jobs available outside the hospital and secondly, professionalism. The determinants whose increase resulted in reductions in turnover were "intent to stay" (which the researcher views as a dimension of commitment), the existence of local kin (kinship responsibilities), participation in making job-related decisions (job autonomy), the receipt of sufficient work-related information (instrumental communication and good supervisory relationships), and tenure. The determinants whose decreaseresulted in increased turnover werepromotional opportunities, distributive justice, pay satisfaction, job satisfaction, integration, opportunity for self-development,age and tenure. Turnover of nurses has serious ramifications for employers, patients, and the nursing profession itself. Effective management of employee turnover is of critical importance to health care providers, employees, and patients. Better control of turnover can improve the quality of patient care, reduce labour costs, and improve employee morale.
AFRIKAANSE OPSOMMING: Die bestuur van menslike hulpbronne is die deurslaggewende omstandigheid ten einde die lewering van effektiewe en doeltreffende gesondheidsorg van gehalte. Nietemin, dra die omset van verpleegkundiges grotendeels by tot die personeeltekort wat tans deur die verpleegprofessie in Suid-Afrika ondervind word. Die tekort aan ervare, opgeleide verpleegkundiges, veral in die openbare sektor staatshospitale, het 'n nadelige uitwerking op die voorsiening van effektiewe en doeltreffende gesondheidsorg van gehalte aan die verbruikers van hierdie diens. Die doelwit van die studie was om 'n begrip te ontwikkel vir, en 'n insig te probeer kry in, daardie inherente probleme binne die gesondheidsektor wat verpleegkundiges dryf om die staatsinstellings te verlaat. Die oorkoepelende doel was die ondersoek en identifikasie van sommige faktore wat die omset van geregistreerde verpleegkundiges in staatshospitale beïnvloed. Die doel hiervan was om voorstelle aan hospitaal bestuurders te kan voorsien ten opsigte van die meer doeltreffende bestuur van menslike hulpbronne, in die strewe na behoud van verpleegpersoneel. Die navorsing is gebaseer op 'n model van verpleegomset wat vrywillige onttrekking as 'n proses beskou het waar gevoelens van salaristevredenheid, aan die een kant, en geleentheid tot alternatiewe betrekkings in die arbeidsmark, aan die ander, as die primêre veroorsakende faktore van omset-gedrag voorgestel is. Daarbenewens is die stellings vanuit die literatuurstudie dat die volgende dien as voorspellers van omset ook ondersoek: ouderdom, ampstermyn of dienstyd, verantwoordelikheid teenoor familie, algemene opleiding, opvoeding, professionalisme, huwelikstatus, 'voorneme om te bly', werksbevrediging, roetine, selfbestuur en verantwoordelikheid in die werksomgewing, bevorderlike kommunikasie, bevorderingsgeleenthede, integrasie, toesighoudende verhoudings, toedelende gereg, werkslading en plaaslike naasbestaandes. Die navorsing is uitgevoer met gebruik van 'n monster van 123 verpleegkundiges van een hospital, die Groote Schuur Hospital, geleë in die Wes-KaapProvinsie van die Republiek van Suid Afrika. Die monster het geregistreerde verpleegkundiges, senior geregistreerde verpleegkundiges en hoof geregistreerde verpleegkundiges ingesluit. Die data is verkry van respondente deur middel van 'n self-toegediende vraelys. Daarbenewens is data versamel deur half-gestruktureerde, niegeslote besprekings met van die verpleegbestuur. Die interaksie tussen veranderlikes ten opsigte van verpleegomset wat veronderstel is, is ondersoek deur middel van basiese statistiek, dus kon die uitwerking van afhanklike en onafhanklike veranderlikes bepaal word. Die uitslae van data-ontleding het wel ondersteuning verleen aan die voorstelling soos uiteengesit in die hipotese. Die determinante wie se toename 'n toename in die omsetkoers tot gevolg gehad het was, eerstens, meer werksgeleenthede buite die hospitaal en, tweedens, professionalisme. Die determinante wie se toename tot 'n vermindering in omset bygedra het was 'voorneme om te bly' (wat die navorser as binne die omvang van toewyding beskou), deelname aan werksverwante besluitneming (werks outonomie), die ontvangs van genoegsame werksverwante inligting (bevorderlike kommunikasie en goeie toesighoudende verhoudings), en ampsduur (dienstyd). Die determinante wat tot 'n vermindering in omset lei is bevorderingsgeleenthede, toedelende gereg, salaris bevrediging, geleenthede tot self-ontwikkeling, ouderdom en ampsduur. Die omset van verpleegkundiges het verreikende gevolge vir werkgewers, pasiënte en die verpleegsberoep self. Doeltreffende bestuur van werknemer-omsetis van kritiese belang vir gesondheidsorg voorsieners, werknemers en pasiënte. Die meer effektiewe beheer van omset kan die kwaliteit van pasiëntesorg verbeter, arbeidsonkoste verminder en die moraal van werknemers verbeter.
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Drummond-Huth, Barbara. "The Effect of Leadership Skill-Building on Nurse Leader Behaviors." UNF Digital Commons, 2009. http://digitalcommons.unf.edu/etd/311.
Full textAbstract:
Patient outcome data are an important factor in healthcare. Reports by the Institute of Medicine between 1999 and 2001, as well as recent research by Linda Aiken and her colleagues have added more emphasis to measures that can be taken to improve patient outcomes. Because of the role they play in healthcare facilities, nurse leaders are in a position to take the lead in improving patient outcomes. There is evidence to suggest that nurse leaders' transformational leadership behaviors are associated with positive patient outcomes.
The purpose of this project was to identify the effect of transformational leadership skill-building training on nurse leaders' behavior in the acute care setting. The project included assessments of nine nurse leaders by those nurses which are supervised by the nurse leaders. The results indicated the nurse leaders' behavior score of 3.1 was in the transformational range (3.0-3.75.)
Transformational leadership skill-building training followed the assessment process. A post training evaluation by the previous assessors followed the training. The distribution of the transformational leadership behavior scores did not change following the training.