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Weatherford, Barbara H. "Patient Safety: A Multi-Climate Approach to the Nursing Work Environment: A Dissertation". eScholarship@UMMS, 2011. https://escholarship.umassmed.edu/gsn_diss/20.
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The purpose of this study was to explore Zohar’s Multi-Climate Framework for Occupational Safety to determine the effects of staff nurse perceptions of safety priorities in their organization (safety climate) and their work ownership climate (Magnet Hospital designation) on safety citizenship behaviors viewed as in role or extra role. Safety citizenship behaviors are described as behaviors that go beyond the job description to ensure safety. Participants from a convenience sample of three Magnet designated community hospitals in New England completed three scales (Zohar’s Safety Climate Questionnaire, Essentials of Magnetism II and the Safety Citizenship Role Definitions Scale) representing the study variables via an online survey platform. Multivariate analysis of covariance informed the results. Findings include a positive unadjusted relationship between safety climate and work ownership climate (rs=.492, pF (1, 86) = 8.4, p=.005, N=92), controlling for work ownership climate and hospital. Implications include support for a continued focus on better understanding the importance of a positive nursing work environment, a characteristic shared by Magnet designated hospitals, on the presence of safety citizenship behaviors in the acute care environment. A professional work environment should be considered as an important factor in reducing errors in the acute care setting.
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Craig, Beverly F. "Climate and research productivity of collegiate nursing faculty: implications for educational and administrative interventions". Diss., Virginia Polytechnic Institute and State University, 1985. http://hdl.handle.net/10919/54747.
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The purposes of this study were to (a) explore the relationship between the nursing faculty member's perception of the climate for research and the research productivity of nursing faculty members; and (b) identify educational and administrative interventions possessing the potential for increasing research productivity.
The questionnaire consisted of a modification of Likert’s Profile of Organizational Characteristics Form S, perceptions of the influence of organizational climate on research productivity, several aspects of institutional support, job-related data, and research productivity for the period June 1980-May 1983.
Data were analyzed using Pearson's product-moment correlation coefficient. Descriptive statistics were compared for types of institutional support.
Research productivity ranged from 0-40 research publications and presentations in the 3 year period. Twenty-five percent of the faculty produced 80 percent of the research. Almost half of the respondents did no research for the period studied.
Organizational climate ranged from System 1 (Exploitative-Authoritative System) to System 4 (Participative Group) with the predominate climate being System 3 (Consultative System). Although faculty perceived components of organizational climate as affecting their research productivity, the finding revealed only a low positive correlation (.173, p <.05) between organizational climate and research productivity.
The relationships (p <.05) between two other measures of climate (number of current facilitators and number of additional research knowledge needs) and research productivity were low (.252, -.162 respectively). No relationship was found between other climate measures (number of facilitators needing change and number of types of research training faculty desired) and research productivity.
Faculty indicated that primarily monetary-related facilitators and rewards for research were most frequently available and that time-related and knowledge and skill-related facilitators were least frequently available. High producers had some of the same needs as other producers, e.g., workload policy providing time for research. Other needs, particularly knowledge and skill needs, differed by productivity level.
Two interventions were suggested: (a) a workload policy with time for research, and (b) educational interventions for faculty with various productivity levels.Ed. D.
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O'Brien, Roxanne Louise. "Keeping patients safe: The relationship between patient safety climate and patient outcomes". Diss., Search in ProQuest Dissertations & Theses. UC Only, 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3378501.
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Mosser, Nancy Rowland. "A study of the relationship between the perceived leadership style of nursing chairpersons and the organizational climate in baccalaureate nursing programs". Morgantown, W. Va. : [West Virginia University Libraries], 2000. http://etd.wvu.edu/templates/showETD.cfm?recnum=1291.
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Thesis (Ed. D.)--West Virginia University, 2000.Title from document title page. Document formatted into pages; contains viii, 115 p. Vita. Includes abstract. Includes bibliographical references (p. 83-96).
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Campbell, Quincy McKenzie. "Patterns Of Asthma Exacerbation Related To Climate And Weather In The Northeast Kingdom Of Vermont". ScholarWorks @ UVM, 2016. http://scholarworks.uvm.edu/graddis/428.
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Asthma is a chronic respiratory disease characterized by long- and short-term inflammation and bronchospasm susceptible to multiple triggers that affects patients across the lifespan. Asthma management is a primary care priority in Vermont, where there continues to be an above-average prevalence of asthma among both children and adults as compared to other states. However, many of Vermont's children and especially adults with asthma are not participating in regular check-ups for asthma management that would best prevent exacerbation of asthma symptoms. Several climate and weather elements including, but not limited to, extreme temperatures and particulate matter are known asthma triggers. Vermont's high per capita use of old woodstoves, pockets of poverty and cold winters are all factors that might collide to adversely impact residents' asthma. Insights into how climate and weather might be related to peak periods of acute asthma exacerbation (AAE) among individuals living in the rural Northeast Kingdom of Vermont (NEK) could provide valuable, regionally focused public health information to primary care providers on the front lines of asthma management.
The objective of this research was to examine the potential relationship between the climate and weather of the NEK and visits for asthma exacerbation in the primary care setting. The research began with a retrospective chart review including visits to five different clinic sites in the NEK between 2009-2014 with the ICD-9 code for asthma exacerbation (493.xx) as the primary diagnosis. When visits were individually validated as an AAE, the clinic site, date of visit, and the patients' age and sex were documented. These validated visits were then analyzed against weather and climate data including temperature and air quality. Results suggest that while diurnal shifts and air quality do not show a strong relationship with AAEs in this area, colder days do appear to correlate to when patients visit primary care clinics in the NEK for AAEs.
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Boyle, Kathleen Black. "Nurse-physician collaborative communication and safety climate /". Connect to full text via ProQuest. Limited to UCD Anschutz Medical Campus, 2007.
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Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2007.Typescript. Includes bibliographical references (leaves 93-101). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;
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Jay, Rita A. "Relationship of organizational work climate to nurse turnover in operating room settings". Thesis, Capella University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3724927.
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Organizational work climates in healthcare organizations were described in the literature using a social framework of structured interactions, defined roles, and behavioral responses between team members of physicians and nurses. It was hypothesized that the characteristics of physician-nurse collaboration, physician dominance, and nurse autonomy in socially complex work settings have relationships to turnover intent in nurses who work in operating room settings. In an era of nursing shortages the challenge of nurse retention and the evidence of challenging work climate become even more critical for healthcare organizations. This research study examined a gap in knowledge regarding the extent to which aspects of organizational work climate predict nurse turnover in operating room work settings. A quantitative correlational study using three work climate characteristics of physician-nurse collaboration, physician dominance, and nurse autonomy was conducted using the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (Hojat & Herman, 1985, Developing an Instrument to Measure Attitudes toward Nurses: Preliminary Psychometric Findings) and the Anticipated Turnover Scale (Hinshaw & Atwood, 1983, Nursing Staff Turnover, Stress, and Satisfaction: Models, Measures, and Management). Responses from 322 Operating Room staff nurses who were members of a national professional nursing organization were examined in the analyses. The study concluded that the independent variables of collaboration, dominance, and autonomy were not significant in predicting turnover among nurses in the operating room setting.
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Porter, Rebecca Blanche. "Nurse managers' moral distress in the context of the hospital ethical climate". Diss., University of Iowa, 2010. https://ir.uiowa.edu/etd/2758.
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Moral distress is a negative emotional and somatic response to external constraints on moral action. The constraints are typically identified as a component of the work environment, called the ethical climate. Moral distress is identified as a primary reason for job attrition by up to one-quarter of registered nurses who leave their jobs. One strategy suggested to staff nurses who experience moral distress is to consult their Nurse Manager (NM). However, the moral distress of NMs who are employed in acute care hospitals is poorly understood. The purpose of this qualitative study was to examine NMs' perceptions of the external constraints on moral agency, specifically the hospital ethical climate, which leads to their experience of moral distress and how attributes of the ethical climate facilitated or impeded resolution of their moral distress. Semi-structured, audio-recorded telephone interviews were conducted with 17 NMs from across United States. An interpretive description design using an iterative process between data collection and data analysis was used. Data were analyzed through descriptive coding and thematic analysis.
The participants in this study were 15 women and 2 men with a mean age of 46.4 years. The mean length of time in their current positions was slightly less than 5 years. Of the 17 hospitals represented, 6 were affiliated with a university and 4 had a religious affiliation. Fifteen of 17 NMs described situations in which the implicit and explicit values of the hospital were incongruent with their personal moral values and professional ethics. Common themes describing factors contributing to moral distress were administrative policies, negative communication patterns and relationships with physicians, issues related to staff nurses, issues related to patients and families, and multiple competing job obligations. Respondents described strategies to navigate through their moral distress. The strategies included taking a positive perspective, seeking the advice of NM colleagues, reliance on a positive relationship with a supervisor, and talking it through with family members. For 5 of the 15 NMs who experienced moral distress, their final strategy included plans to resign from their positions. Issues within the ethical climate of the hospital that were perceived to contribute to the development of moral distress among this cohort of NMs differed from those reported for staff nurses. Further examination of strategies used by NMs to improve the ethical climate may yield insights into effective ways to address moral distress for this population.
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Turner, Gordon Neil. "Organisational climate and standards of nursing care : the administration of depot neuroleptic drugs to psychiatric out-patients". Thesis, University of Edinburgh, 1994. http://hdl.handle.net/1842/21576.
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The findings showed that nurses placed the greatest emphasis on issues related to drug injection techniques while the wider concerns of long term depot medication therapy, including monitoring drug side-effects and assessing general health and social well-being, were generally given a lower priority. Significant differences existed between the four Managerial Sectors of the main study area in terms of both the standards of nursing care observed and the Organisational Climates reported by nurses. The highest standards of care were found to exist in a Managerial Sector where nurses dealt with significantly smaller numbers of patients and where they had access to more comprehensive information. The relationship between Climate and standards of care was also found to be significant. Where there was a greater emphasis on innovation, standards of nursing care, and aspects of organisational structure, higher standards of nursing care were observed. The findings reveal important practical and theoretical concerns pertinent to the different standards of nursing care observed. The findings suggest that certain organisational characteristics appear to facilitate the delivery of a higher standard of nursing care. The utility of adopting an organisational approach in exploring nursing care issues is discussed. Recommendations for changes to the existing arrangements for depot drug administration within the study area are suggested.
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Hellwig, Sharon Donahue. "The relationship between climate and nurses work satisfaction in two types of hospitals /". Access Digital Full Text version, 1995. http://pocketknowledge.tc.columbia.edu/home.php/bybib/11790489.
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Thesis (Ed.D.)--Teachers College, Columbia University, 1995.Includes tables. Typescript; issued also on microfilm. Sponsor: Keville Frederickson. Dissertation Committee: Elizabeth Tucker. Includes bibliographical references (leaves 77-83).
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Candeias, Zélia Cristina Godinho Torres. "O Absentismo dos Enfermeiros do Agrupamento de Centros de Saúde Arrábida". Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Ciências Empresariais, 2018. http://hdl.handle.net/10400.26/25616.
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Dissertação de Mestrado em Gestão Estratégica de Recursos HumanosEste estudo tem como tema “O Absentismo dos enfermeiros do Agrupamento de Centros de Saúde Arrábida ” sendo a pergunta de partida “Quais os principais fatores que levam ao absentismo dos profissionais de enfermagem?” O objetivo é analisar o absentismo dos profissionais de Enfermagem no ACeSA, para identificar os principais fatores que levam ao absentismo. Especificamente pretende-se: Identificar os tipos de absentismo dos profissionais de enfermagem; Identificar as variáveis sociodemográficas dos profissionais de enfermagem; Identificar a relação entre as variáveis sociodemográficas dos profissionais de enfermagem e o absentismo; Identificar a relação entre a satisfação no trabalho e o absentismo nos profissionais de enfermagem; Identificar a relação entre o clima organizacional e o absentismo nos profissionais de enfermagem; Identificar a relação entre o burnout e o absentismo. A metodologia tem como base o inquérito por questionário a aplicar aos enfermeiros do ACeSA. Os questionários validados foram 76 sendo 96% dos respondentes do sexo feminino; a média etária é de 46,4 anos; 67.1% têm mais de 20 anos de profissão. Referem ter restrições de saúde 44,7%, em média faltaram 16,21 dias em 2017. Quanto à satisfação com o trabalho, clima organizacional e Burnout não se evidencia relação com o absentismo.
This study has as its theme "The Absenteeism of Nurses of the Grouping of Arrábida Health Centers". The question is "What are the main factors that lead to absenteeism in nursing professionals?" The objective is to analyze the absenteeism of nursing professionals in ACeSA, to identify the main factors that lead to absenteeism. Specifically, we intend to: Identify the types of absenteeism of nursing professionals; To identify the sociodemographic variables of nursing professionals; To identify the relationship between sociodemographic variables of nursing professionals and absenteeism; To identify the relationship between job satisfaction and absenteeism in nursing professionals; To identify the relationship between organizational climate and absenteeism in nursing professionals; Identify the relationship between burnout and absenteeism. The methodology is based on the questionnaire survey to be applied to ACeSA nurses. The validated questionnaires were 76 being 96% of the female respondents; the mean age is 46.4 years; 67.1% have more than 20 years of profession. They reported having health restrictions of 44.7%; on average, there were 16.21 days in 2017. Regarding satisfaction with work, organizational climate and Burnout, there is no evidence of absenteeism.
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Doyle, Patrick. "Social climate and staff based interventions in forensic mental health settings : a research portfolio". Thesis, University of Edinburgh, 2017. http://hdl.handle.net/1842/26016.
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Aims: The aims of this thesis were focused on the social climate of inpatient forensic mental health settings. Firstly, the study reviewed the literature of qualitative studies of staff and patient experiences of social climate. Secondly, the utility of a case study methodology to examine innovations to practice in forensic mental health settings are discussed. Thirdly, a longitudinal case study aimed to examine the impact of a Mentalization based treatment (MBT) training and case consultation intervention on the functioning of a low secure ward. Method: A systematic review and qualitative synthesis of social climate in forensic mental health settings was completed using the ‘best-fit’ framework approach. Secondly, a critical analysis of case study methodology was presented based on key decision points. A longitudinal ward case study with staff (n=37) and patient (n=7) participants examined the impact of staff MBT training and MBT based case consultation sessions. MBT based case consultation sessions ran on the ward over an eight month period. Data was collected through a range of methods including questionnaires, semi-structured interviews, ward observations and routinely reported data. The case study data was tested through a pattern matching approach with reference to rival explanations. Results: The systematic review identified 20 papers that met the inclusion criteria. The framework synthesis identified 22 themes related to social climate, which were organised in a conceptual model. Ten themes were seen to represent the experience of social climate. Consideration of the applicability of the case study method to forensic settings found the method to be feasible and acceptable to staff though a limitation is that outcomes are tentative and open to rival explanations. Positive impacts of the training and case consultation intervention included an increase in enthusiasm for working with patients with a personality disorder diagnosis and evidence of some increased team cohesion. The main rival explanation identified was the impact of changes to the composition of the staff and patient group. Conclusions: The systematic review findings highlight that current quantitative measures of social climate may not fully represent the construct. The conceptual model developed allows for generation of potential interventions to improve social climate. In the case study, staff reported positive perspectives of both MBT training and the case consultation sessions. The intervention did not appear to impact on patient motivation, though patients reported positive changes in staff behaviour. The case study method was seen as applicable to forensic mental health settings and provided interpretable data useful for analytical generalisations, and clinically in considering innovations to practice.
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Zimmerman, Melissa M. "Leadership Practices of Supervisory Employees: An Exploration of Current Practices at a Southeastern Veterans Affairs Medical Center". Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etd/3149.
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As the nation’s healthcare system moves through the 21st century, unprecedented changes are occurring on both a local and global stage. Healthcare organizations are faced with creating and implementing leadership strategies to enhance the overall patient experience. When coupled with the need to ensure increased nurse job satisfaction, improved cost-effectiveness and healthy organizational cultures with fiscally sound budgets, improvement work has led efforts to ensure effective leadership techniques are used across an agency.
This task may be viewed as commonplace for some organizations, while others may perceive this process as a complete paradigm shift from historical practices related to leadership style, behaviors and performance. A successful transition during this time of unprecedented change may depend on an organization’s ability to accept and implement the tenets of transformational leadership. Empirical research illustrates that transformational leadership empowers staff, increases job satisfaction and facilitates cost-effectiveness while constructing an environment conducive to the development of a supportive organizational culture.
In an effort to ascertain the current state of leadership at a southeastern Veterans Affair Medical Center, this research study explored the self-reporting leadership practices of all supervisory staff employed at the facility. As a means of measurement, the Leadership Practices Inventory (LPI) was coupled by demographic questionnaire developed by the researcher. Both measurement tools were used to collect the data.
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Yang, Liu-Qin. "Aggression And Its Consequences In Nursing: A More Complete Story By Adding Its Social Context". [Tampa, Fla.] : University of South Florida, 2009. http://digital.lib.usf.edu/?e14.2926.
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Siemon, Mark. "The impact of state certification of community health workers on team climate among registered nurses in the United States". Thesis, The University of New Mexico, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3630354.
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A number of states have adopted certification programs for community health workers (CHWs) to increase oversight, allow for direct funding, and improve recognition of CHWs as members of the health care team. More states are considering CHW certification programs to increase the use of CHWs by health care organizations with the hopes of improving health outcomes and decreasing health disparities. There has been little research into the impact of state CHW certification on the adoption and dissemination of CHWs into the existing health care system. This study examined the impact of state CHW certification on the perceptions of team climate among registered nurses (RNs) who work with CHWs in states with and without CHW certification programs. Team climate is defined as the perceptions of team members on how they work together, share a single vision, are open to new ideas, and if they feel safe and supported by other team members. This study recruited RNs using an online purposeful sampling method to compare the perceptions of team climate using the Team Climate Inventory (TCI) short-form. The study found no significant differences in the overall mean TCI score or TCI subscale scores between RNs who work in states with CHW certification programs (n = 81) and those who work in states without CHW certification programs (n = 115). There was a significant difference in one survey question on the RNs views of whether state certification of CHW improved the ability of their health care team to deliver quality care. Further analysis of the results using multiple regression found few significant predictors of overall TCI and TCI subscale scores among the independent variables used in the regression models. Registered nurses are the largest part of the professional health care workforce, and their ability to collaborate and work with CHWs is critical to the integration of CHWs into existing health care organizations. More research on the impact of state certification of CHW and the factors that influence the adoption of innovative health care delivery methods is needed to meet the national goal of eliminating health disparities and improving health in minority and underserved populations.
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Clark, Olga L. "COMPLIANCE WITH SAFETY PRACTICES AMONG NURSES: EXPLORING THE LINK BETWEEN ORGANIZATIONAL SAFETY CLIMATE, ROLE DEFINITIONS, AND SAFE WORK PRACTICES". Connect to this title online, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=bgsu1143231038.
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GORMLEY, DENISE KOLESAR. "ORGANIZATIONAL CLIMATE, ROLE AMBIGUITY, ROLE CONFLICT AND NURSE FACULTY WORK ROLE BALANCE: INFLUENCE ON ORGANIZATIONAL COMMITMENT AND TURNOVER INTENTION". University of Cincinnati / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1131630993.
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Thunberg, Elin y Madeleine Kastlund. "När sjuksköterskan hindras från att göra rätt : En litteraturöversikt om moralisk stress hos sjuksköterskan". Thesis, Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-6659.
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Bakgrund: Moralisk stress är ett begrepp som först kom att definieras av Jameton (1984) och anses uppstå när sjuksköterskor inte kan handla i enlighet med det de anser vara det rätta på grund av organisatoriska eller institutionella barriärer. Den legitimerade sjuksköterskan ansvarar för ett stort kunskaps- och arbetsområde som ska präglas av ett etiskt förhållningssätt och en personcentrerad vård. En inre konflikt uppstår när sjuksköterskan hindras att arbeta utifrån de rådande värdena, vilket ger upphov till känslor av moralisk stress. En större kunskap och förståelse inom problemområdet är nödvändig för att åstadkomma framtida förbättringar. Syfte: Syftet var att belysa moralisk stress hos sjuksköterskan. Metod: För att uppnå syftet har en litteraturöversikt genomförts. Sökningar efter relevanta artiklar i enlighet med den engelska översättningen av moralisk stress utfördes. Artiklar med kvalitativa och kvantitativa ansatser har använts. Resultat: Ur analysen urskildes tre olika huvudkategorier: bakomliggande orsaker till moralisk stress, konsekvenser av moralisk stress och strategier för hantering av moralisk stress. Diskussion: I resultatdiskussionen diskuteras moralisk stress hos sjuksköterskor utifrån Jean Watsons teori om mänsklig omsorg samt andra relevanta artiklar. Uppkomsten av moralisk stress hos sjuksköterskor diskuteras ur olika perspektiv. Skillnader i miljö och ledningens betydande roll avseende sjuksköterskors känslor av moralisk stress diskuteras vidare. Konsekvenser av moralisk stress hos sjuksköterskor diskuteras med betoning på patientsäkerhet och bemötandet av patienter. Medvetenheten kring moralisk stress hos sjuksköterskor behöver bli större. Ett fokus på moralisk stress hos sjuksköterskor kan med fördel lyftas redan under sjuksköterskeutbildningen.Background: Moral stress is a term that was first defined by Jameton (1984) and is considered to occur when individuals are unable to act in accordance with what they consider to be right due to organizational or institutional barriers. The registered nurse is responsible for a large area of knowledge and work that needs to be characterized by an ethical approach and person-centered care. An internal conflict occurs when the nurse is prevented from working on the basis of these values, which causes feelings of moral stress. A greater knowledge and understanding of the problem area is necessary to achieve future improvements. Aim: The aim was to illustrate moral stress among the nurse. Method: To achieve this goal, a literature review has been conducted. Searches for relevant articles in accordance with the English translation of moral stress were performed. The databases Cinahl, PsycINFO and PubMed were used. Articles with qualitative and quantitative approaches have been used. Results: The analysis revealed three different main categories: underlying causes for moral stress, consequences of moral stress and strategies for managing moral stress. Discussion: In the result, moral stress is discussed among nurses based on Jean Watson's theory of human care and other relevant articles. The appearance of moral stress in nurses is discussed from different perspectives. Differences in the environment and management's significant role regarding nurses' feelings of moral stress are discussed further. The consequences of moral stress in nurses are discussed with emphasis on patient safety and the encounter of patients. Awareness about moral stress in nurses needs to be greater. A focus on moral stress in nurses should be emphasized during nursing education.
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Phillips, Janet Martha. "Clinical educators' adoption of socioculturally-based teaching strategies". Thesis, Connect to resource online, 2009. http://hdl.handle.net/1805/1902.
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Thesis (Ph.D.)--Indiana University, 2009.Title from screen (viewed on August 28, 2009). School of Nursing, Indiana University-Purdue University Indianapolis (IUPUI). Advisor(s): Pamela Ironside, Anna McDaniel. Includes vita. Includes bibliographical references (leaves 177-197).
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Elkins, Sharon Patricia. "Continuing professional nursing education and the relationship of learner motivation, the nature of the change, the social system of the organizational climate, and the educational offering : a reliability study". Virtual Press, 1998. http://liblink.bsu.edu/uhtbin/catkey/1115730.
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Dr. Ronald Cervero (1985) identified learner motivation, the nature of the change, the social system of the organizational climate, and the educational program as factors affecting the application of learning to professional practice. A repeated measures research design was used to measure stability over time of instruments developed to measure variables in Cervero's model. Participants, N=27) graduate students, completed the instruments, "New Ideas and You" which measures learner's motivation to change, "The Nature of Change" which measures the learner's perception of the proposed change, and "Organizational Climate of the Social System" which measures the learner's perception of the social system's affect on the implementation of change. Staff nurses (N=27) completed the instrument "Continuing Education Offering Evaluation" which measures the learner's perception of the educational offering. Participants then completed the instruments again in three weeks. Procedures for the protection of human subjects were followed. The test-retest reliability coefficients were: "New Ideas and You," r=.72 L)-.01; "The Nature of Change," r.84 p=.01; "Organizational Climate of the Social System," r.83 p=.01; "Continuing Education Offering Evaluation," r.91 p=.01. The significance of this study was the initial establishment of stability over time of instruments developed to measure specific factors that affect the application of newly gained knowledge to nursing practice. Establishing reliability coefficients of instruments to measure the variables in Cervero's model is a step forward in the investigation of the larger question, "Does continuing education change practice?"School of Nursing
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Almeida, Mirian Cristina dos Santos. "Correlação entre clima organizacional, satisfação no trabalho e burnout em trabalhadores de enfermagem". Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-24092018-163120/.
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Introdução: A síndrome de burnout, caracterizada por níveis elevados de exaustão emocional e despersonalização e reduzida realização profissional, tem sido grande causa de adoecimento psíquico nos trabalhadores de enfermagem, com sério impacto na qualidade dos serviços e segurança do paciente. Objetivos: Analisar a correlação entre clima organizacional, satisfação no trabalho e burnout nos trabalhadores de enfermagem do litoral norte de São Paulo e propor estratégias para promoção de clima organizacional favorável e da satisfação no trabalho. Método: Estudo transversal, correlacional, com abordagem quantitativa, realizado em 2015/2016, com trabalhadores de enfermagem de estabelecimentos de saúde públicos/filantrópicos do Litoral Norte de São Paulo. Seguiram-se todos os princípios éticos da legislação vigente. Para coleta de dados, foram utilizados o Questionário de Caracterização Sociodemográfica e Profissional, a Escala de Clima Organizacional para Organizações de Saúde, o Questionário de Satisfação no Trabalho - S20/23 e o Maslach Burnout Inventory. Foi realizada análise descritiva e analítica dos dados, por meio de frequências relativas, absoluta, média, desvio padrão, mínimo e máximo, bem como testes de associação e correlação entre as variáveis, adotando-se intervalo de confiança de 95%. Resultados: Dos 534 trabalhadores de enfermagem participantes do estudo, 90,45% são mulheres, 62,92% declarou estado conjugal estável e a maioria (92,5%) contribui financeiramente com sustento da família. Possuem idade média de 37,69 anos, renda pessoal mensal média de R$ 2.136,72 (dp=1.283,00) e tempo médio de formação profissional de 10,29 anos. Quanto ao cargo, identificou-se 72,28% de auxiliares/técnicos de enfermagem, seguido de enfermeiros assistenciais (21,35%); 52,24% atuam na atenção hospitalar e 42,51% na atenção básica à saúde. Considerando a média dos escores, o Clima Organizacional foi avaliado como regular ( =3,32), tendo o fator Remuneração apresentado menor média ( =2,16). Verificou-se que os trabalhadores apresentam níveis médios de Satisfação no Trabalho ( =3,4), sendo o menor índice de satisfação atribuído à Satisfação com Ambiente Físico de Trabalho ( =3,27). Quanto à Síndrome de Burnout, observaram-se níveis moderados de Exaustão Emocional ( =1,67), baixos de Despersonalização ( =0,86) e elevados de Realização Profissional ( =2,94). Ao correlacionar os construtos foram identificados correlação positiva forte entre Satisfação no Trabalho e Clima Organizacional (r=0,673); correlação negativa moderada entre Exaustão Emocional e Clima Organizacional (r=-0,408); correlação negativa moderada entre Exaustão Emocional e Satisfação no Trabalho (r=-0,457); e correlação negativa moderada entre Despersonalização e Satisfação no Trabalho (r=-0,319). Apresentaram resultados estatisticamente significativos na associação com pelo menos um dos fatores dos construtos as variáveis sociodemográficas e ocupacionais sexo, estado conjugal, possuir filhos, nível de escolaridade, realização de atividade física/ lazer, possuir dependentes que presta cuidados, local de trabalho, cargo e regime de trabalho. As sugestões para promoção do clima organizacional e da satisfação no trabalho estão relacionadas ao fortalecimento da gestão por meio de investimento em Políticas de Recursos Humanos, Políticas de Saúde do Trabalhador, Instrumentalização para Gestão Participativa e Planejamento. Conclusão: Ao correlacionar os construtos foram identificados correlação positiva forte entre Satisfação no Trabalho e Clima Organizacional; correlação negativa moderada entre Exaustão Emocional e Clima Organizacional; correlação negativa moderada entre Exaustão Emocional e Satisfação no Trabalho; e correlação negativa moderada entre Despersonalização e Satisfação no Trabalho. O fortalecimento da gestão, por meio da utilização de ferramentas gerenciais, foi proposto como estratégia para promoção do clima organizacional favorável e da satisfação no trabalho.Introduction: Characterized by high levels of emotional exhaustion, depersonalization and decreased professional achievement, Burnout syndrome has been a great cause of psychic illness in nursing workers, with a serious impact on the quality of services and on the patient safety. Objectives: To analyze the correlation among organizational climate, job satisfaction and Burnout among nursing workers from the northern shore of São Paulo and to propose strategies to promote a favorable organizational climate as well as job satisfaction. Method: This is a cross- sectional and correlational study, with a quantitative approach, which was performed in 2015/2016, with nursing workers from public/philanthropic health facilities in the Northern Shore of São Paulo. We have followed all the ethical principles of the current legislation. In order to collect data, we used the Sociodemographic and Professional Characterization Questionnaire, the Organizational Climate Scale for Health Organizations, the Job Satisfaction Questionnaire S20/23 and the Maslach Burnout Inventory. We performed an analytical and descriptive analysis of the data by means of relative and absolute frequencies, average, standard deviation, minimum and maximum, in addition to tests of association and correlation among variables, adopting a 95% confidence interval. Results: Of the 534 nursing workers who took part in this study, 90.45% are women, 62.92% declared a stable marital status, and most of them (92.5%) have financially contributed to the family livelihood. They have an average age of 37.69 years, an average monthly personal income of R$ 2.136,72 (sd=1.283,00) and an average professional training time of 10.29 years. Regarding the position held, we identified 72.28% of nursing assistants/technicians, followed by health care nurses (21.35%); 52.24% work in hospital care and 42.51% in primary health care. Taking into account the average scores, the Organizational Climate was rated as regular ( =3.32), where the factor of Remuneration showed the lowest average ( =2.16). We found that workers unveil average levels of Job Satisfaction ( =3.4), where the lowest index of satisfaction was attributed to the Satisfaction with Physical Work Environment ( =3.27). With regard to Burnout syndrome, we noted moderate levels of Emotional Exhaustion ( =1.67), low levels of Depersonalization ( =0.86) and high levels of Professional Achievement ( =2.94). When correlating the constructs, we identified strong positive correlation between Job Satisfaction and Organizational Climate (r=0.673); moderate negative correlation between Emotional Exhaustion and Organizational Climate (r=-0.408); moderate negative correlation between Emotional Exhaustion and Job Satisfaction (r=-0.457); and moderate negative correlation between Depersonalization and Job Satisfaction (r =-0.319). The sociodemographic and occupational variables of gender, marital status, having children, schooling level, physical or leisure activity, having dependent people for providing care, work place, position, and work regime showed statistically significant results in the association with at least one of the factors of the constructs. The suggestions for promoting organizational climate and job satisfaction are related to the strengthening of management through investment in Human Resources Policies, Workers Health Policies, Instrumentation for Participatory Management and Planning. Conclusion: When correlating the constructs, we identified strong positive correlation between Job Satisfaction and Organizational Climate; moderate negative correlation between Emotional Exhaustion and Organizational Climate; moderate negative correlation between Emotional Exhaustion and Job Satisfaction; and moderate negative correlation between Depersonalization and Job Satisfaction. The strengthening of management by means of the use of management tools was proposed as a strategy to promote a favorable organizational climate and job satisfaction.
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Frostenson, Brolund Charlotta y Draper Sarah Pedersen. "Miljö- och klimatmässigt hållbara arbetssätt inom omvårdnad : – en litteraturöversikt". Thesis, Högskolan Dalarna, Omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:du-29568.
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Bakgrund . Miljö- och klimatförändringar till följd av skadliga utsläpp är ett allvarligt hot mot den globala hälsan. Hälso- och sjukvårdens främsta uppgift är att främja hälsa men verksamheten själv orsakar skadliga utsläpp. Omvårdnad står i direkt samband med utsläppsrelaterade områden i arbetets brukande av material och energi. Sjuksköterskor utgör Hälso- och sjukvårdens största yrkesgrupp och professionen innefattar främjandet av hälsa samt kunskapen om förbättringsarbete. Därför spelar sjuksköterskor en nyckelroll i att mildra de skadliga utsläppen orsakade av hälso- och sjukvården. Syfte . Att sammanställa kunskap om områden och arbetssätt för sjuksköterskor att bedriva miljö- och klimatmässigt hållbar omvårdnad i det dagliga kliniska arbetet. Metod . Litteraturöversikt i form av en metasyntes. Resultat . Sexton studier var inkluderade som visar tre huvudområden där omvårdnad kan bedrivas mer klimatmässigt hållbart, vilka är: (1) mathantering; (2) avfallshantering och (3) nyttjandet av resurser. Utbildning och behovet av fortbildning av personal genomsyrade studierna. Minskade mängder växthusgasutsläpp, ekonomiska besparingar samt en mer personcentrerad vård sågs vara följder av att klimatmässigt förbättra omvårdnaden. Slutsats . Omvårdnad kan bedrivas mer miljö- och klimatmässigt hållbart utan att inskränka vårdkvalitén för patienten. Genom att kommunicera och samarbeta med patienter och kollegor, samla in data, reducera användandet av el och vatten samt bidra till klimatmässiga förbättringar av verksamheten kan sjuksköterskor minska matsvinn, avfallshantera korrekt och använda resurser effektivt. Detta leder till en mer miljö- och klimatmässigt hållbar omvårdnad.Background . Environmental and climate changes caused by harmful emissions seriously threaten global health. Health care’s main function is to promote health but it contributes to harmful emissions itself. Nursing is directly connected to areas that causes emissions - the usage of materials and energy. Nurses are the largest group of healthcare staff and the profession includes promoting health and work towards improvement of health care. Therefore nurses play key roles in mitigating health care’s harmful emissions. Aim . To compile knowledge of areas and working methods for nurses to conduct environmental and climate sustainable nursing care in their daily clinical work. Method . A literature review in the form metasynthesis. Results . Sixteen studies were included which shows the areas where nursing can be performed in a more climate sustainable way. These are (1) food handling; (2) waste management and (3) the usage of resources. Education and further practical training is prerequisite improvements in order to achieve climate sustainable nursing. The outcomes are decreased greenhouse emissions and a more cost-effective and patientcentered healthcare. Conclusion . The nursing practice can become more environmental and climate sustainable without affecting the quality of patient care. By communicating and cooperating with patients and colleagues as well as collecting data, reducing the usage of energy and water, contributing to workplace improvements and advocating for environmental and climate sustainable nursing; improvements such as decreased food waste, correct waste handling and a more effective usage of resources can be achieved.
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Chaves, Jaqueline Alves. "Equipe de enfermagem: análise do clima organizacional no centro cirúrgico do Hospital Universitário Getúlio Vargas". Universidade Federal do Amazonas, 2012. http://tede.ufam.edu.br/handle/tede/3591.
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Previous issue date: 2012-02-14Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
The quality of the organizational environment increasingly influence the behavior of employees in the institutions, thus interfering in performance, expanding the potential of people and results. The objective of this research is to understand what factors are conducive to a good organizational climate within the nursing team of the surgical center at a university hospital in view of this, we seek to have the views of nurses, technicians and nursing assistants in total of 37 professionals, about the ten dimensions considered relevant to a healthy organizational environment. The theoretical findings found on the subject were used to develop a questionnaire, self-administered, containing 60 closed questions and distributed in ten dimensions. The quantitative analyzes were developed from the SPSS software according to the rules of the instrument. In short, we intend to observe the opinion of the servers about the current situation and desired situation. The results showed that the servers are not satisfied with the dimensions of safety and working conditions, indicated that the training is limited, moreover, there is no recognition when the job is well done, however there is satisfaction concerning the salary received. According to these conditions, it is possible to understand and specify measures that allow a good organizational climate.
A qualidade do ambiente organizacional influencia cada vez mais o comportamento dos colaboradores nas Instituições, interferindo, assim, na performance, na ampliação do potencial das pessoas e nos resultados. O objetivo desta pesquisa consistiu em conhecer quais são os fatores favoráveis a um bom Clima Organizacional na equipe de enfermagem do centro cirúrgico de um hospital universitário. Em vista disso, buscou-se obter a opinião dos enfermeiros, técnicos e auxiliares de enfermagem num total de 37 profissionais, a respeito das dez dimensões consideradas relevantes a um ambiente organizacional saudável. Os achados teóricos encontrados a respeito do tema foram aplicados no desenvolvimento de um questionário, autoadministrado, contendo 60 questões fechadas e distribuídas em dez dimensões. As análises foram quantitativas, desenvolvidas a partir do software SPSS de acordo com as normas do instrumento. Em suma, pretendeu-se observar a opinião dos servidores acerca da situação vigente e situação desejada. Os resultados demonstraram que os servidores não estão satisfeitos com as dimensões: segurança e condições do trabalho, indicaram que os treinamentos são escassos, além disso, não existe reconhecimento quando o trabalho é bem feito, todavia existe satisfação em relação ao salário recebido. Desta forma, tornou-se possível compreender e indicar medidas que viabilizem um bom Clima Organizacional.
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Santiago, Thaiana Helena Roma. "Cultura organizacional para segurança do paciente em terapia intensiva: comparação de dois instrumentos Hospital Survey on Patient Safety Culture (HSOPSC) e Safety Attitudes Questionnaire (SAQ)". Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-17042015-130803/.
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Introdução: A segurança do paciente tornou-se uma preocupação formal em diversos sistemas de saúde no mundo nas últimas décadas. Em 2004 a Organização Mundial da Saúde (OMS) propõe a Aliança para segurança do paciente e aponta a avaliação da cultura de segurança nas instituições de saúde como um dos aspectos chave para esse processo. Método: pesquisa transversal de abordagem quantitativa, realizada em um hospital de ensino no interior do estado de são Paulo entre os meses de março e abril de 2014. A população de estudo foi composta por todos os profissionais que faziam parte da escala de trabalho das unidades de terapia intensiva (UTI) adulto, pediátrica e neonatal e não se enquadravam no critério de exclusão (menos de 6 meses na unidade). Foram aplicados dois instrumentos para avaliação da cultura e clima de segurança do paciente, o Hospital Survey on Patient Safety (HSOPSC) e o Safety Attitudes Questionnaire (SAQ), e um instrumento para levantamento das informações sociodemográficas e profissionais. Para a análise de dados utilizou-se o teste de confiabilidade das escalas pelo Alfa de Cronbach. Foi verificada a presença de associações das escalas com variáveis de estudo pelo qui-quadrado de Pearson ou teste exato de Fischer nas variáveis qualitativas, a ANOVA para as variáveis quantitativas. A presença de correlação entre os instrumentos SAQ e HPSOPSC foi verificada pelo teste de correlação de Pearson. Resultado: os dados sociodemográficos quanto a sexo e idade e cargo foram homogêneos nas três UTI. A UTI Neonatal possuía profissionais com mais tempo de trabalho na unidade e na especialidade quando comparada as demais unidades. Ambas as escalas apresentaram boa confiabilidade pelo alfa de Cronbach, 0,853 para o SAQ e 0,889 para o HSPOSC. Na análise dos domínios do SAQ, observou-se pontuação 62 para as Condições de Trabalho e para Percepções da Gerência, enquanto para o HSPOSC a dimensão Resposta não punitiva aos erros obteve o menor percentual de repostas positivas (29,6%), e as dimensões Abertura da comunicação e Retorno da comunicação e das informações sobre o erro uma proporção de neutros maior de 30%. A nota total de segurança do paciente pelo HSPOSC foi de 85% (somados ótima e muito boa). Analisando-se o comportamento das UTIs através de cada escala, a UTI Neonatal apresentou maior satisfação no trabalho do que as demais UTIs. A UTI Adulto apresentou menores pontuações em cada domínio quando comparada com as demais e para os domínios do HSPOSC somente o domínio Abertura de comunicação obteve uma proporção de respostas positivas discretamente superior às demais UTIs. A correlação entre as escalas através da correlação de Pearson foi de força moderada (coeficiente de Pearson de 0,656). As respostas abertas evidenciaram que as mudanças ocorridas no hospital em decorrência dos processos de acreditação, contribuíram para a melhor percepção dos profissionais sobre a segurança do paciente. Conclusões: há diferenças de percepções quanto a segurança do paciente entre as UTIs dentro de um mesmo hospital, o que corrobora com a existência de microculturas locais. As escalas de avaliação de clima/ cultura de segurança do paciente parecem medir fenômenos semelhantes.Introduction: Patient safety has become a formal concern in several health systems in the world, in the last decades. In 2004 the World Health Organization (WHO) proposes the Alliance for patient safety and aims safety culture evaluation in healthcare institutions as one of the key aspects to this process. Method: Cross-sectional quantitative research approach, performed in a teaching hospital in São Paulo State between the months of March and April 2014. The study population was composed of all the professional who were part of the work schedule of intensive care unit (ICU) adult, pediatric and neonatal and did not fit the exclusion criteria (less than six months in the unit). Two instruments for assessing the culture environment and patient safety, the Hospital Survey on Patient Safety (HSOPSC) the Safety Attitudes Questionnaire (SAQ), and an instrument for survey of demographic and professional information were applied. For data analysis, the test of reliability of the scales by Cronbachs alpha was used. The presence of associations of scales with study variables was checked by Pearsons chi-square test or Fishers exact test in the qualitative variables, the ANOVA for quantitative variables. The presence of correlation between the SAQ and the HPSOPSC instruments was tested by Pearson correlation test. Result: sociodemographic data regarding gender and age and position were homogenous in the three ICUs. Professional of the Neonatal ICU had worked longer time in this unit and specialty when compared to other units. Both scales showed good reliability by Cronbachs alpha, 0.853 for SAQ and 0.889 for HSPOSC. In the analysis of the SAQ domains, it was observed score 62 for Working Conditions and Perceptions of Management, while for HSPOSC dimension Non-punitive Response to Error had the lowest percentage of positive responses (29.6%), the dimension Open Communication and Return of Communication and Information on the Error a proportion of neutral responses more than 30%. The total score of patient safety by HSPOSC was 85% (summed up great and very good). Analyzing the behavior of ICUs through each scale, Neonatal ICU had higher job satisfaction than the other ICUs. Adult ICU had lower scores in each domain compared to other domains and for HSPOSC only the area Open Communication obtained the proportion of positive responses slightly superior to the other ICUs. The correlation between the scales through Pearson correlation was of moderate strength (Pearson correlation coefficient of 0.656). The open responses showed that changes in hospital as a result of accreditation processes, contributed to a better perception of professionals about patient safety. Conclusions: There are differences in perceptions of patient safety among ICUs within the same hospital, which corroborates the existence of local microcultures. Rating scales of climate/culture of patient safety seems to measure similar phenomena.
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Teixeira, Geraldo Magella [UNIFESP]. "Programa Educativo na prevenção de LER/DORT: uma avaliação com Técnicos de Enfermagem". Universidade Federal de São Paulo (UNIFESP), 2011. http://repositorio.unifesp.br/handle/11600/9984.
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Previous issue date: 2011-06-29A educação em saúde é um campo multifacetado, para o qual concorrem inúmeras concepções, das áreas tanto da educação, quanto da saúde, as quais espelham diferentes compreensões do mundo, demarcadas por distintas posições político-filosóficas sobre o homem e a sociedade. Sua prática na saúde ocupacional favorece e potencializa a adaptação harmônica do indivíduo ao meio laboral e potencializa as relações com os outros, com o espaço e o tempo, elementos indispensáveis para o sucesso no autogerenciamento na prevenção das LER/DORTs. Esta pesquisa procurou compreender, juntamente com um grupo de técnicos de enfermagem que trabalham em Hospital Público do Nordeste do Brasil, o significado da questão LER/DORT, sobretudo nos aspectos preventivos e ainda propor e avaliar um recurso educativo na prevenção de LER/DORT para estes profissionais, erigido a partir das necessidades e da interação com os sujeitos. Para a realização desta pesquisa optou-se pela metodologia analítico-descritiva, assumindo a complementaridade das abordagens qualitativas e quantitativas. Esta pesquisa compreendeu duas etapas distintas. O primeiro momento correspondeu ao caminho metodológico proposto que objetivava conhecer os sujeitos da investigação e elaborar um programa educativo que potencialmente desencadeia-se na transformação de suas práticas; nessa etapa foram utilizadas as técnicas da observação etnográfica e grupo focal. A segunda etapa da pesquisa correspondeu ao caminho metodológico proposto que objetivava avaliar as mudanças induzidas pelo programa educativo elaborado, especificamente em relação às diferentes dimensões de qualidade de vida como a percepção álgica; nesta etapa foram utilizados os instrumentos Questionário Nórdico (QNSO) e Questionário de Qualidade de Vida (SF 36). Participaram 70 técnicos de enfermagem e esses foram divididos, aleatoriamente, em dois subgrupos; os primeiros trinta e cinco sujeitos participantes da primeira etapa e os restantes participaram da segunda etapa. Foi possível compreender que os Técnicos de Enfermagem possuem, mesmo que intuitivamente, saberes sobre a questão LER/DORT e são capazes de contribuir positivamente no construto de recurso. Após a participação no programa educativo foi possível observar que o recurso construído a partir da fala dos participantes é capaz de interferir positivamente na qualidade de vida e na percepção da sintomatologia álgica. A utilização de Práticas Educativas em Saúde na ambiência laboral com técnicos de enfermagem sobre este tema mostra-se como uma estratégia a ser valorizada na prevenção das LER/DORTs.
Health education is a multifaceted field for which many competing conceptions, both areas of education, and health, reflecting different understandings of the world, framed by distinct political-philosophical views on man and society. Its practice in occupational health promotes and enhances the harmonious adaptation of the individual in the work environment and enhances relationships with others with space and time, essential elements for success in self-management in the prevention of RSI. This research sought to understand, along with a group of practical nurses who work in Public Hospitals of Northeast Brazil, the meaning of the issue RSI, especially in the preventive aspects and also propose and evaluate an educational resource in the prevention of RSI for these professionals, built from the needs and interaction with the participants. For this research, we opted for a descriptive-analytic methodology, assuming the complementarity of qualitative and quantitative approaches. This research was composed for two distinct stages. The first stage corresponded to the proposed methodological approach that aimed to know the subjects of research and develop an educational program that potentially triggers on the transformation of their practices, this step was used the techniques of ethnographic observation and focus groups. The second stage of the study corresponded to the proposed methodological approach that aimed to evaluate the changes induced by the educational program developed specifically in relation to different dimensions of quality of life as a painful perception, this stage were used tools Nordic Questionnaire (QNSO) and Questionnaire Quality of Life (SF 36).Participated 70 nursing technicians and these were divided randomly into two subgroups: the first thirty-five subjects in the first stage and the other participated in the second step. It was possible to understand that nursing technicians have, although intuitively, knowledge on the issue RSI and are able to positively contribute to the construct of resource. After participating in the educational program was possible to observe that the action constructed from the speech of the participants is able to positively affect the quality of life and perception of pain symptoms. The use of health education in the ambience with nursing technicians working about this theme shows up as a strategy to be valued in the prevention of RSI.
TEDE
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Almutairi, Adel Faza. "A case study examination of the influence of cultural diversity in the multicultural nursing workforce on the quality of care and patient safety in a Saudi Arabian hospital". Thesis, Queensland University of Technology, 2012. https://eprints.qut.edu.au/51580/1/Adel_Almutairi_Thesis.pdf.
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The purpose of the study:
The purpose of this study is to investigate the influence of cultural diversity, in a multicultural nursing workforce, on the quality and safety of patient care and the work environment at King Abdul-Aziz Medical City, Riyadh region.
Study background:
Due to global migration and workforce mobility, to varying degrees, cultural diversity exists in most health services around the world, particularly occurring where the health care workforce is multicultural or where the domestic population comprises minority groups from different cultures speaking different languages. Further complexities occur when countries have a multicultural workforce which is different from the population for whom they care, in addition to the workers being from culturally diverse countries and with different languages. In Saudi Arabia the health system is mainly staffed by expatriate nurses who comprise 67.7% of the total number of nurses.
Study design:
This research utilised a case study design which incorporated multiple methods including survey, qualitative interviews and document review.
Methods:
The participant nurses were selected for the survey via a population sampling strategy; 319 nurses returned their completed Safety Climate Survey questionnaires. Descriptive and inferential statistics (Kruskal–Wallis test) were used to analyse survey data. For the qualitative component of the study, a purposive sampling strategy was used; 24 nurses were interviewed using a semi-structured interview technique. The documentary review included KAMC-R policy documents that met the inclusion criteria using a predetermined data abstraction instrument. Content analysis was used to analyse the policy documents data.
Results:
The data revealed the nurses‘ perceptions of the clinical climate in this multicultural environment is that it was unsafe, with a mean score of 3.9 out of 5. No significant difference was detected between the age groups or years of experience of the nurses and the perception of safety climate in this context; the study did reveal a statistically significant difference between the cultural background categories and the perception of safety climate. The qualitative phase indicated that the nurses within this environment were struggling to achieve cultural competence; consequently, they were having difficulties in meeting the patients‘ cultural and spiritual needs as well as maintaining a high standard of care. The results also indicated that nurses were disempowered in this context. Importantly, there was inadequate support by the organisation to manage the cultural diversity issue and to protect patients from any associated risks, as demonstrated by the policy documents and supported by the nurses‘ experiences. The study also illustrated the limitations of the conceptual framework of cultural competence when tested in this multicultural workforce context. Therefore, this study generated amendments to the model that is suitable to be used in the context of a multicultural nursing workforce.
Conclusion:
The multicultural nature of this nursing work environment is inherently risky due to the conflicts that arise from the different cultural norms, beliefs, behaviours and languages. Further, there was uncertainty within the multicultural nursing workforce about the clinical and cultural safety of the patient care environment and about the cultural safety of the nursing workforce. The findings of the study contribute important new knowledge to the area of patient and nurse safety in a multicultural environment and contribute theoretical development to the field of cultural competence. Specifically, the findings will inform policy and practice related to patient care in the context of cultural diversity.
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Fernandes, Liva Gurgel Guerra. "Clima e cultura de seguran?a do paciente em uma maternidade escola: percep??o dos profissionais de enfermagem em terapia intensiva". Universidade Federal do Rio Grande do Norte, 2014. http://repositorio.ufrn.br:8080/jspui/handle/123456789/14822.
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Previous issue date: 2014-04-04Since the publication of the report "To Err is Human" by the Institute of Medicine (IOM) , which estimated that between 44.000 to 98.000 Americans die annually as a result of errors in health care, patient safety spent gaining prominence, emerging studies assess the safety culture by measuring the safety climate. In this context, the aim of this study was to identify safety culture perceived by nursing professionals working in the intensive care unit of a maternity school in Natal/RN through the Security Attitudes Questionnaire (SAQ). This was a descriptive study, cross-sectional and quantitative approach undertaken in the Intensive Care Unit Maternal and Neonatal a maternity school in Natal/RN. The project was submitted to and approved by Brazil Platform Zip/UFRN under number 309 540 and CAAE 16489713.7.0000.5537. It was used to collect data two instruments: a questionnaire in order to collect socio-demographic data of the subjects and the Question?rio Atitudes de Seguran?a , a cultural adaptation to Portuguese of the instrument of the World Health Organization titled Safety Attitudes Questionnaire - (SAQ ) Short Form 2006. The collected data were analyzed quantitatively by the organization in electronic databases in Microsoft Excel 2010 spreadsheet and exported to statistical software for free access to be coded, tabulated and analyzed using descriptive statistics. The study included a total of 50 nurses, 31 and 19 of the NICU Maternal ICU, predominantly female, mean age 35 years, median time of 10 years training and working in maternity, mostly, less than 05 anos. As a result, two articles were produced. The first refers to the first two domains of the instrument entitled "climate of teamwork" and "climate security" . The scores of the two areas were slightly higher in Maternal ICU compared to the NICU, but no sector has reached the ideal minimum score of 75: in the first domain Maternal ICU had an average of 74.77, with medians of 75 and 100, while Neonatal ICU reached an average of 69.61 with median also 75 and 100, while the second field means were 69.35 and 66.01 for Maternal and Neonatal ICUs respectively, with a median of 100 in the two sectors. The second article relates to the field "Perception Management Unit and Hospital", which 9 assessed the perception of management units and motherhood by professionals. In general, the items of the domain in question also obtained scores below the ideal minimum: 63.68 to 51.02 and maternal ICU for neonatal, featuring a clear separation between the management and the professionals who work in direct care. These findings indicate a warning sign for the institution and point to the need to implement actions aimed at patient safety
A partir da publica??o do relat?rio Errar ? Humano pelo Institute of Medicine (IOM), o qual estimou que entre 44.000 e 98.000 americanos morrem anualmente em decorr?ncia de erros da assist?ncia ? sa?de, a seguran?a do paciente passou ganhar destaque, surgindo estudos que avaliam a cultura de seguran?a atrav?s da mensura??o do clima de seguran?a. Nesse contexto, o objetivo deste estudo foi identificar a cultura de seguran?a percebida pelos profissionais de enfermagem que atuam nas unidades de terapia intensiva de uma maternidade-escola em Natal/RN, atrav?s do Question?rio Atitudes de Seguran?a (SAQ). Tratou-se de um estudo do tipo descritivo, transversal, com abordagem quantitativa, realizado nas Unidades de Terapia Intensiva Materna e Neonatal de uma maternidade-escola na cidade de Natal/RN. O projeto foi submetido ? Plataforma Brasil e aprovado pelo CEP/UFRN sob o n?mero 309.540 e CAAE 16489713.7.0000.5537. Utilizaram-se para a coleta de dados dois instrumentos: um question?rio com a finalidade de coletar dados sociodemogr?ficos dos sujeitos e o Question?rio Atitudes de Seguran?a, uma adapta??o transcultural para a l?ngua portuguesa do instrumento da Organiza??o Mundial da Sa?de intitulado Safety Attitudes Questionnaire (SAQ) Short Form 2006. Os dados coletados foram analisados quantitativamente atrav?s da organiza??o em banco de dados eletr?nico no Microsoft Excel 2010 e exportados para planilha do SPSS (Statistical Package for the social sciences) vers?o 2.0 para serem codificados, tabulados, e analisados mediante estat?stica descritiva. Participaram do estudo 50 profissionais de enfermagem, sendo 31 da UTI Neonatal e 19 da UTI Materna, predominantemente do sexo feminino, com idade m?dia de 35 anos, tempo de forma??o m?dio de 10 anos e que trabalhavam na maternidade, em sua maioria, havia menos de 5 anos. Como resultado, foram produzidos dois artigos. O primeiro refere-se aos dois primeiros dom?nios do instrumento, intitulados Clima de trabalho em equipe e Clima de seguran?a . Os escores dos dois dom?nios foram ligeiramente mais elevados na UTI Materna se comparada ? UTI Neonatal, por?m nenhum setor atingiu o escore m?nimo ideal de 75: 7 no primeiro dom?nio a UTI Materna obteve m?dia de 74,77, com medianas de 75 e 100, e a UTI Neonatal atingiu m?dia de 69,61 com medianas tamb?m de 75 e 100; enquanto que no segundo dom?nio as m?dias foram de 69,35 e 66,01 para as UTIs Materna e Neonatal respectivamente, com mediana de 100 nos dois setores. O segundo artigo diz respeito ao dom?nio Percep??o da Ger?ncia da Unidade e do Hospital , que avaliou a percep??o da ger?ncia das unidades e da maternidade por parte dos profissionais. Em geral, os itens do dom?nio em quest?o tamb?m obtiveram escores aqu?m do m?nimo ideal: 63,68 para a UTI Materna e 51,02 para a Neonatal, caracterizando um evidente distanciamento entre a gest?o e os profissionais que atuavam na assist?ncia direta. Tais achados indicam um sinal de alerta para a institui??o e apontam para a necessidade de implementar a??es que visem a seguran?a do paciente
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Araújo, Sonia Teixeira de. "Doenças emergentes e condições de trabalho de enfermagem: um estudo de caso durante a pandemia de H1N1 no Rio de Janeiro". Universidade do Estado do Rio de Janeiro, 2011. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=2549.
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Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorAs doenças infecto-parasitárias, ainda hoje, em pleno século XXI são responsáveis por uma quantidade generosa de morbidade e mortalidade no Brasil e no mundo. Muitas delas são amplamente influenciadas pelas mudanças climáticas que estão ocorrendo em todo o planeta fazendo com que sua incidência e distribuição geográfica aumentem. A dengue é considerada a principal doença reemergente nos países tropicais e subtropicais. A malária tem forte incidência nos países ao sul do deserto do Saara na África, ocorrendo também em vários países da América do Sul que possuem parte da região Amazônica em seu território. Várias doenças voltam a assolar a população de vários locais como as leishmanioses, a Doença de Lyme, erlichioses entre outras. Em março de 2009 começam a ocorrer os primeiros casos de uma nova doença inicialmente denominada Influenza suína, a qual, levou alguns indivíduos a óbito em Oaxaca, uma cidade mexicana localizada a 400 quilômetros da capital. Rapidamente, a doença se espalhou pelo país e posteriormente, no começo do mês de abril de 2009 já, existiam relatos de casos em vários países. O objetivo geral desta pesquisa é verificar em que medida o cuidado de enfermagem realizado expressou um maior ou menor grau de controle do enfermeiro sobre seu trabalho, apontando para os potenciais riscos (biológicos) de adoecimento e impactos negativos na saúde deste trabalhador. O presente estudo foi desenvolvido por meio de uma abordagem quantitativa com desenho longitudinal e observacional, delineamento de pesquisa não experimental e caráter descritivo. Foi feita a análise observacional nas tendas quanto a sua infraestrutura e posteriormente foi passado um questionário aos enfermeiros pautado em questões sobre o risco biológico que estes estavam sendo submetidos. Faz-se necessário que a cultura do improviso acabe e comece a se pensar em uma nova realidade: as doenças transmissíveis são uma realidade, elas existem e há de ser feito um adequamento de tudo que esteja ligado à área de saúde pensando em um novo contexto. É imperioso que tanto as autoridades como os profissionais revejam e reflitam sobre o que aconteceu, para que os erros do passado possam ficar para trás e não se repitam.
Infectious-parasitic diseases, up to the present, in XXI century are responsible for a high morbidity and mortality rate in Brazil as well as overseas. Many of them are widely influenced by climatic modifications that have been occuring all over the planet leading to an increase in their incidence and geographical distribution. Dengue is considered the main reemerging disease in tropical and subtropical countries. Malaria has strong incidence in countries that are in the south of Sahara desert in Africa, also occuring in many countries of South America that have part of their territory in Amazon region. A great deal of diseases have been frightening the population once again in many places, as leishmanioses, Lyme Disease, erlichioses, for instance. In March, 2009 the first cases of a new disease initially termed Influenza swine started to appear, leading some subjects to death in Oaxaca, a mexican city localized 400 kilometers far from the capital. Rapidly ,the disease had spread all over the country and later, in the beginning of April , 2009 there were some related cases in several countries. The overall aim of this study is to verify to what extent the nursing care that is carried out has expressed a higher or lower degree of control from the part of the nurse about his/her job, pointing at potential risks (biological) of illnesses and negative impacts into the worker health status. This study was developed by means of quantitative approach with longitudinal and observational design, a non experimental research and descriptive features. An observational analysis was carried out at the tents for their infra-structure and after this, a questionnaire was applied to the nurses based on matters as the biological risk they were being exposed. It is necessary that the improvisation culture comes to an end and a new reality come true : transmissible diseases are a reality, they exist and adjustments in relation to everything that is linked to health have to be achieved in order to envision a new context. It is essential that both authorities and professionals reflect and reconsider on the events from the past so as to old mistakes can be left behind and do not repeat again.
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Lundström, Mats. "Våld - utmaning och utmattning : vårdares utsatthet och upplevelser i samband med våld i gruppbostäder för personer med utvecklingsstörning". Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-780.
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ABSTRACT This thesis aims to explore the prevalence of violence towards caregivers working in group home for people with learning disabilities, as well as the influence of work climate and personality on the caregivers’ experiences of strain and exposure to violence. The thesis comprises four studies conducted among caregivers working in group homes for people with learning disabilities in one urban district in Sweden. Study I includes data regarding caregivers’ exposure to violence and their demographics. In study II and III data were collected by instruments for measuring caregivers’ personalities and experiences of the work climate as well as emotional reactions, strain, and experiences of burnout. Data were also collected by 50 narrative interviews with 44 caregivers reporting exposure to violence. In order to illuminate caregivers’ experiences of being exposed to violence, the interviews were transcribed and interpreted using qualitative content analysis. The results showed that 31% of the caregivers (n=120) had been exposed to violence during the preceding year, with physical violence being the most common type. Weak relationships were found between reported exposure to violence and caregivers’ age and education (I). Among those in studies II and III who completed all instruments (n=112), 45 caregivers (40%) reported exposure to violence. A significant difference in age was found between exposed and not exposed caregivers. In the total sample of studies II and III, 30% (n=41) of the caregivers were at risk of developing burnout. The relationship between exposure to violence and the caregivers’ experiences of the work climate (CCQ) showed that “debates” was the only factor that on average was significantly higher among caregivers reporting violence from the residents. The caregivers’ emotional reactions, strain, and work climate factors explained 35% of the variance in burnout scores (II). No significant relationships were found between the caregivers’ personalities (TCI and RSES) and their exposure to violence. Personality dimensions explained 32% of the variance of the caregivers’ experiences of burnout. The results did not show a significant relationship between a caregiver’s personality and exposure to violence. However, those exposed to violence reported more emotional exhaustion than those not exposed (III). Caregivers exposed to violence reported feelings of powerlessness, insufficiency, anger and violence was very seldom followed by support from the managers at the group homes (I). Interviews show that caregivers’ experiences are about “falling apart” and “keeping it together”. Falling apart involves fear, powerlessness, sadness, anger, and timelessness, while keeping it together involves joy, respect, self-reflection, and habituation. Destructive experiences are balanced by a more constructive view of the situation by keeping the situation, and the caregivers themselves, together. The findings show that exposure to violence occurs frequently and a large proportion of the exposed caregivers are at risk for burnout. It was not possible to confirm the relationships between the caregivers’ personality, experiences of the work climate, and exposure to violence but partly to emotional reactions, strain and burnout. The findings of the four studies are discussed in relation to how it is to live and work in an environment where violence is of frequent occurrence.SAMMANFATTNING Avhandlingens övergripande syfte är att undersöka förekomst av våld mot vårdare som arbetar i gruppbostäder för personer med utvecklingsstörning samt arbetsklimatets och personlighetens betydelse för upplevelser av påfrestning och utsatthet för våld bland vårdare. Avhandlingen omfattar fyra delstudier utförda bland vårdare som arbetar i gruppbostäder för personer med utvecklingsstörning. I delstudie I insamlades data om vårdares utsatthet för våld och information om vårdarnas bakgrund med hjälp av en enkät. I delstudierna II och III ombads vårdarna att fylla i instrument som skattade deras personlighet, upplevelser av arbetsklimat, emotionella reaktioner, upplevelse av påfrestning samt upplevelse av utbränning. I syfte att belysa vårdares upplevelser av att vara utsatt för våld genomfördes 50 narrativa intervjuer med 44 vårdare. Intervjuerna transkriberades och tolkades med hjälp av kvalitativ innehållsanalys. Resultaten visar att 31% av vårdarna (n=120) hade varit utsatt för våld under det föregående året och fysiskt våld var den vanligaste typen av våld. Alla kategorier av vårdare var utsatta för våld och emotionella reaktioner var vanligt förekommande. Svaga samband framkom mellan rapporterad utsatthet för våld och vårdares ålder och utbildning (I). Bland vårdare i studie II och III som besvarat alla instrument (n=112), rapporterade 45 vårdare (40%) att de utsatts för våld. En signifikant skillnad avseende ålder framkom mellan de som rapporterat våld respektive inte rapporterat våld. Bland de svarande var 30% (n=41) av vårdarna i en riskzon för utbränning (burnout). Sambanden mellan utsatthet för våld och vårdares upplevelser av arbetsklimat (CCQ) visade att ’debates’ var den enda faktorn som var genomsnittligt högre bland de som rapporterat våld från vårdtagare. Vårdarnas emotionella reaktioner (ERNC) påfrestningsfaktorer (SNC) och arbetsklimatfaktorerna förklarade 35% av variansen i utbrändhetsvärden (II). Inget signifikant samband framkom mellan vårdares personlighet (TCI och RSES) och utsatthet för våld. Personlighetsdimensionerna förklarade 32% av variansen i vårdarnas upplevelse av utbränning (III). Resultaten visade inget signifikant samband mellan vårdares personlighet och utsatthet för våld men de som blivit utsatta för våld rapporterade mer emotionell utmattning än inte utsatta vårdare (III). Vårdare utsatta för våld rapporterade upplevelser av maktlöshet, otillräcklighet och vrede i samband med våld. De rapporterade också att utsatthet för våld mycket sällan följdes av stöd från arbetsledare (I). Resultat från intervjuer med vårdare utsatta för våld indikerar att deras upplevelser av våld handlar om att “falla i bitar” och att “hålla ihop”. Falla i bitar innebär upplevelser av rädsla, maktlöshet, sorgsenhet, vrede och tidlöshet medan hålla ihop innebär glädje, respekt, självreflektion och tillvänjning. Destruktiva upplevelser balanseras genom en konstruktiv syn på situationen och vårdarna strävar efter att upprätthålla respekten för den boende som person och att hålla ihop situationen och sig själva (IV). Resultaten visar att våld förekommer ofta och att en stor proportion av utsatta vårdare löper risk för utbränning. Det var inte möjligt att bekräfta samband mellan utsatthet för våld och vårdares personlighet, upplevelse av arbetsklimat, emotionella reaktioner, påfrestning samt utbränning. Resultaten diskuteras i relation till hur det är att leva och arbeta i en miljö där våld ofta förekommer.
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Zadvinskis, Inga Mirdza. "An Exploration of Contributing Factors to Patient Safety and Adverse Events". The Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1437409566.
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Claëson, Matilda y Ida Hedberg. "Personen framför allt : personcentrerad vård i högteknologisk hjärtsjukvård". Thesis, Sophiahemmet Högskola, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-4089.
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Miljöbegreppet har i modern omvårdnadsforskning fått en allt bredare och djupare dimensiondär människan i sin miljö betraktas ur ett holistiskt perspektiv. Personcentrerad vård är ettarbetssätt där man utgår från patienten som person som inte kan reduceras till enbart sinsjukdom. Att som vårdgivare vara medveten om den fysiska miljön, personers handlingar ochhur den organisatoriska filosofin är uppbyggd skapar en större möjlighet att kunna arbetapersoncentrerat. Personcentrering är det som patienten upplever, medan personcentrerad vårdär arbetssättet som genererar patientens upplevelse av personcentrering. Personcentreratklimat är den miljö där personcentrerad vård sker. De förhållanden som formas mellanpatienten, vårdpersonal, närstående och teknik liksom miljöns atmosfär, omgivning ochomvärld, är avgörande för om patienten kommer att uppleva miljön som vårdande eller ickevårdande. Syftet med studien var att undersöka och beskriva förekomst av personcentrerad vård blandpersoner som vårdats i en högteknologisk vårdmiljö i samband med hjärtkirurgi ochhjärtsvikt. Metoden var en icke-experimentell tvärsnittsstudie som genomfördes inom högteknologiskahjärtsjukvård. Datainsamlingen utfördes med hjälp av två patientrapporterade mått: BeingTaken Seriously Questionnaire - Patient version (BTSQ-P) och Person-Centered ClimateQuestionnaire - Patient version (PCQ-P). Resultatet visade att patienterna upplevde att vården var personcentrerad utifrån att bli tagenpå allvar och att den innefattade ett personcentrerat klimat. Regressionsanalysen visade att ettsäkert klimat är den viktigaste komponenten för känslan av att bli tagen på allvar. Slutsatsen var att högteknologisk hjärtsjukvård inte enbart genererar goda medicinska resultatutan också kan bidra till personcentrerad vård. Vidare drar vi lärdom av studiens resultat medkunskapen om att ett säkert klimat är den viktigaste faktorn inom det personcentreradeklimatet, för patientens upplevelse av personcentrering.In modern nursing research, the concept of the environment has acquired an ever broader anddeeper dimension where people in their environment are viewed from a holistic perspective.Person-centered care is a way of working that is based on the patient as a person who cannotbe reduced to his or her illness alone. As a caregiver, being aware of the physicalenvironment, people's actions and how the organizational philosophy is structured creates agreater opportunity to be able to work person-centered. Person-centeredness is what thepatient experiences, while person-centered care is the way of working that generates thepatient's experience of person-centeredness. Person-centered climate is the environment inwhich person-centered care takes place. The relationships that are formed between the patient,care staff, relatives and technology, as well as the environment's atmosphere, surroundingsand settings, are decisive for whether the patient will experience the environment as caring oruncaring. The aim of the study was to investigate the prevalence of person-centered care amongstpeople who have been cared for in a high-tech care environment in connection with heartsurgery and heart failure. The method was a non-experimental cross-sectional study conducted in high-tech cardiaccare. Data collection was performed using two patient-reported measures: Being TakenSeriously Questionnaire - Patient version (BTSQ-P) and Person-Centered ClimateQuestionnaire - Patient version (PCQ-P). The results showed that the patients felt that the care was person-centered based on beingtaken seriously and that it included a person-centered climate. The regression analysis showedthat a safe climate is the most important component for the feeling of being taken seriously. The conclusion was that high-tech cardiac care not only generates good medical results butcan also contribute to person-centered care. Furthermore, we learn from the study results withthe knowledge that a safe climate is the most important factor in the person-centered climate,for the patient's experience of person-centering.
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From, Ingrid. "Health and quality of care from older peoples' and formal caregivers' perspective". Doctoral thesis, Karlstads universitet, Avdelningen för omvårdnad, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:du-15765.
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Aim: The overall aim of this thesis was to gain a deeper understanding of older people's view of health and care while dependent on community care. Furthermore to describe and compare formal caregivers' perceptions of quality of care, working conditions, competence, general health, and factors associated with quality of care from the caregivers' perspective. Method: Qualitative interviews were conducted with 19 older people in community care who were asked to describe what health and ill health((I), good and bad care meant for them (II). Data were analyzed using content analysis (I) and a phenomenological analysis (II). The formal caregivers; 70 nursing assistants (NAs) 163 enrolled nurses (ENs) and 198 registered nurses (RNs), answered a questionnaire consisting of five instruments: quality of care from the patient's perspective modified to formal caregivers, creative climate questionnaire, stress of conscience, health index, sense of coherence and items on education and competence (III). Statistical analyses were performed containing descriptive statistics, and comparisons between the occupational groups were made using Kruskal-Wallis ANOVA, Mann-Whitney U-test and Pearson's Chi-square test (III). Pearson's product moment correlation analysis and multiple regression analysis were performed studying the associations between organizational climate, stress of conscience, competence, general health and sense of coherence with quality of care (IV). Results: The older people's health and well-being were related to their own ability to adapt to and compensate for their disabilities and was described as negative and positive poles of autonomy vs. dependence, togetherness vs. being an onlooker, security vs. insecurity and tranquility vs. disturbance (I). The meaning of good care (II) was that the formal caregivers respected the older people as unique individuals, having the opportunity to live their lives as usual and receiving a safe and secure care. Good care could be experienced when the formal caregivers had adequate knowledge and competence in caring for older people, adequate time and continuity in the care organization (II). Formal caregivers reported higher perceived quality of care in the dimensions medical-technical competence and physical-technical conditions than in identity-oriented approach and socio-cultural atmosphere (III). In the organizational climate three of the dimensions were close to the value of a creative climate and in seven near a stagnant climate. The formal caregivers reported low rate of stress of conscience. The RNs reported to a higher degree than the NAs/ENs a need to gain more knowledge, but the NAs and the ENs more often received training during working hours. The RNs reported lower emotional well-being than the NAs/ENs (III). The formal caregivers' occupation, organizational climate and stress of conscience were associated with perceived quality of care (IV). Implications: The formal caregivers should have an awareness of the importance of kindness and respect, supporting the older people to retain control over their lives. The nursing managers should employ highly competent and adequate numbers of skilled formal caregivers, organize formal caregivers having round the clock continuity. Improvements of organizational climate and stress of conscience are of importance for good quality of care.
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Agreli, Heloise Lima Fernandes. "Prática interprofissional colaborativa e clima do trabalho em equipe na Atenção Primária à Saúde". Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-27062017-165741/.
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Introdução: Nas organizações de saúde, a Prática Interprofissional Colaborativa (PIC) e Clima do Trabalho em Equipe (CTE) são essenciais para promoção do cuidado integrado e melhoria na qualidade da assistência em saúde. Entretanto, a implementação da PIC tem se mostrado um desafio, com lacuna de conhecimentos relacionados a sua operacionalização no âmbito do Sistema Único de Saúde (SUS). Assim como a PIC, o CTE preocupa-se com aspectos relacionais e organizacionais do trabalho interprofissional. Poucas investigações têm explorado a relação entre PIC e CTE. Este estudo considera as implicações do CTE para a PIC, destaca as ligações teóricas e empíricas entre os dois, e sugere como o CTE pode ter um papel na compreensão e operacionalização da PIC. Objetivo geral: Analisar a PIC em equipes de Atenção Primária à Saúde (APS) com diferentes perfis de CTE. Método: estudo de método misto sequencial explanatório (quantitativo-qualitativo) realizado em 18 equipes da Estratégia Saúde da Família (ESF), em município da região metropolitana de São Paulo. Na fase 1 (quantitativa), o CTE foi avaliado com a aplicação da Escala de Clima do Trabalho em equipe (ECTE) em 18 equipes da ESF (N=144). Para análise dos dados utilizou-se estatística descritiva, análise de agrupamentos (método Ward) e análise bivariada (t student). Na fase 2 (qualitativa), realizou-se estudo de caso múltiplo com entrevistas em profundidade com membros das equipes (N=24) que apresentaram escores contrastantes na ECTE. Na coleta e análise dos achados qualitativos foram utilizadas técnicas da teoria fundamentada em dados. Os resultados das fases 1 e 2 foram integrados. Resultados: Na fase 1 foram identificados dois agrupamentos de equipes: (A) com maiores e (B) de menores escores na ECTE. As diferenças entre os grupos foram estatisticamente significativas em todos os fatores da escala: participação na equipe (p<0,001), apoio para ideias novas (p=0,002), objetivos da equipe (p=0,001) e orientação para as tarefas (p=0,015). Achados da fase 2 corroboram os achados da fase 1, sendo as equipes do agrupamento A aquelas que apresentaram características relacionais e processuais mais favoráveis ao CTE e também à PIC. A análise interpretativa permitiu a identificação de duas modalidades contingenciais e dinâmicas de colaboração: 1) colaboração em equipe e 2) colaboração intersetorial, em rede e com a comunidade. Em torno das modalidades identificadas foi proposto um modelo da PIC. O modelo descreve as condições em que a PIC ocorre, as formas como se apresenta e suas consequências na organização da assistência à saúde. Conclusões: A análise do CTE mostrou-se capaz de prover insights sobre a PIC nas equipes. O modelo proposto apresenta conhecimentos que contribuem para compreensão e operacionalização da PIC. Os resultados sugerem que embora o clima de equipe tenha um papel importante na construção da colaboração, a compreensão da PIC no âmbito do SUS requer a consideração de elementos pertinentes à inovação no trabalho interprofissional e da própria forma de organização da APS e das Redes de Atenção à Saúde.Background: In health care organizations, Interprofessional Collaborative Practice (ICP) and Team Climate (TC) are essential means to promote integrated care and improve health care quality. However, implementing ICP presents a series of challenges, and there is a lack of knowledge of how to operationalize this approach within the Brazilian Health Care System (SUS). Like Interprofessional Collaborative Practice, Team Climate is concerned with the effectiveness of relational and organisational aspects of interprofessional work. Few studies have explored the relationship between these two concepts or the role that Team Climate might play in establishing the operational conditions needed for Interprofessional Collaborative Practice. This study considers the implications of Team Climate for Interprofessional Practice, highlights the theoretical and empirical links between the two, and suggests how Team Climate may have a role in understanding and operationalising Interprofessional Collaborative Practice more effectively. Aim: To analyse ICP in Primary Health Care (PHC) teams with different TC. Methods: This is a mixed methods sequential explanatory study (quantitative-qualitative) conducted with 18 primary care teams from the Family Health Strategy (FHS), in the metropolitan region of São Paulo. In Stage 1 (quantitative), Team Climate was assessed using the Team Climate Inventory (TCI) in all 18 teams (144 participants in total). Data from the TCI were analysed using descriptive statistics, cluster analysis (Wards method) and bivariate analysis (Student t). In Stage 2, which used a multiple qualitative case study approach, data were collected through in-depth interviews with members (N=24) from teams with contrasting scores on the TCI. Grounded theory techniques were employed to analyse the qualitative data. Findings from both stages of the research were then compared and considered together. Results: Two different clusters of teams were identified in Stage 1: (A) teams with the highest mean scores; and (B), teams with the lowest mean scores on the TCI. Differences between cluster A and B were statistically significant for all TCI factors: participative safety (p <0.001), support for new ideas (p = 0.002), team goals (p = 0.001) and task orientation (p=0.015). Findings from Stage 2 reinforced quantitative findings from Stage 1. Teams from cluster A demonstrated more positive relational and processual characteristics to support TC and ICP. Interpretative analysis revealed two dynamic and contingent modalities of collaboration: 1) team collaboration; and 2) collaboration between different health and social sectors, within a healthcare network, and with the community. A framework for Interprofessional Collaborative Practice in primary health care was developed, based on these modalities of collaboration, and describing the conditions, modalities and health care consequences of ICP. Conclusions: Analysis of Team Climate provided insights into ICP in healthcare teams. The proposed framework provides fresh insights into the understanding and operationalization of ICP, and suggests that although Team Climate is important in establishing collaboration, the understanding of ICP within SUS also requires consideration of a range of other factors, including innovation in interprofessional work and the organizational structure of PHC and Health Care Networks.
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Castilho, Dayse Edwiges Carvalho. "Clima de segurança do paciente em um hospital de urgências". Universidade Federal de Goiás, 2018. http://repositorio.bc.ufg.br/tede/handle/tede/8372.
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Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG
INTRODUCTION: The patient's safety climate refers to the perception and attitudes of professionals regarding patient safety at a given moment in the organizational history. The measurement of the safety climate makes it possible to diagnose the predominant culture, which influences the health professionals' safe behaviors and, consequently, the care results. OBJECTIVE: To analyze the patient safety climate of an emergency hospital from the perspective of nursing professionals. METHODOLOGY: An analytical cross-sectional study carried out with the nursing team of an emergency hospital in Goiás, through the application of the Safety Attitudes Questionnaire - Short Form 2006, validated and adapted transculturally into the Portuguese language. The instrument has two parts, one consisting of five items referring to sex, position, time in the specialty and main activity; and the other, with 36 items, encompassing six domains: teamwork climate, safety climate, job satisfaction, perception of stress, perception of unit and hospital management, working conditions. In order to complement socio-demographic and labor information of the professionals, a second instrument was applied. The analysis was descriptive, simple frequency, central tendency and dispersion. Bivariate and multivariate analyzes were performed to verify factors associated with the domains. Study approved by the Research Ethics Committee, CAAE: 49279115.4.0000.5078. RESULTS: The study was attended by 177 nursing professionals, with 72.9% of nursing technicians and auxiliaries and 27.1% of nurses. The population was predominantly female (85.9%) and young adult, with a mean age of 39.5 years (SD: 6.7), 52.0% with a formal relationship and 48.0% with a statutory relationship. Of the total number of participants, 17.0% had moderate / high intention to leave the workplace and 8.5% had moderate / high intention to leave nursing. The analysis of the patient safety climate among nursing professionals was unfavorable (66,7; SD:14,5), except for the satisfaction domain at work, which presented a positive mean of 78.8. There was a correlation between all domains, demonstrating that teamwork, safety climate, job satisfaction, working conditions and management perception are factors that correlate. The perception of stress was associated with the perception of hospital and unit management. A negative association between the general safety situation and the Medical and Surgical Clinic (β = -11,07; p = 0,001) and the Emergency Room (β = -11,30; p < 0,001), night shift (β = -5,60; p = 0,005) and intention to leave nursing (β = -8,27; p = 0,018) were observed. However, being CLT (β = -7.00, p = 0.008) improved the overall patient safety climate. CONCLUSION: The study highlights the need for improved patient safety climate and the factors that may influence it negatively as: work in first aid or in medical and surgical units, working night shift and have intention to leave nursing. These data contribute to the management of health services, pointing issues that can be worked in order to improve the quality of care and patient safety climate.
INTRODUÇÃO: O clima de segurança do paciente refere-se à percepção e às atitudes de profissionais em relação à segurança do paciente, em um determinado momento da história organizacional. A mensuração do clima de segurança possibilita diagnosticar a cultura predominante, a qual influencia os comportamentos seguros dos profissionais de saúde e, consequentemente, os resultados assistenciais. OBJETIVO: Analisar o clima de segurança do paciente de um hospital de urgências sob a perspectiva dos profissionais de enfermagem. METODOLOGIA: Estudo transversal analítico realizado com a equipe de enfermagem de um hospital de urgências de Goiás, por meio da aplicação do instrumento Safety Attitudes Questionnaire - Short Form 2006, validado e adaptado transculturalmente para a língua portuguesa. O instrumento possui duas partes, sendo uma composta por cinco itens referentes a sexo, cargo, tempo na especialidade e atuação principal; e a outra, com 36 itens, englobando seis domínios: clima de trabalho em equipe, clima de segurança, satisfação no trabalho, percepção do estresse, percepção da gerência da unidade e do hospital, condições de trabalho. Para complementação de informações sócio demográficas e laborais dos profissionais foi aplicado um segundo instrumento. A análise foi descritiva, de frequência simples, tendência central e de dispersão. Análises bivariadas e multivariável foram realizadas para verificar fatores associados aos domínios. Estudo aprovado pelo Comitê de Ética Pesquisa, CAAE: 49279115.4.0000.5078. RESULTADOS: Participaram do estudo 177 profissionais de enfermagem, sendo 72,9% técnicos e auxiliares em enfermagem e 27,1% enfermeiros. A população é predominante feminina (85,9%) e adulta jovem, com média de idade de 39,5 anos (DP: 6,7), sendo 52,0% com vínculo celetista e 48,0% estatutário. Do total de participantes, 17,0% possuía a intenção moderada/alta de deixar o local de trabalho e 8,5% intenção moderada/alta de sair da enfermagem. A análise do clima de segurança do paciente entre os profissionais de enfermagem se revelou desfavorável (66,7; DP:14,5), exceto para o domínio satisfação no trabalho, que apresentou média positiva de 78,8. Houve correlação entre todos os domínios, demonstrando que o trabalho em equipe, o clima de segurança, a satisfação no trabalho, as condições de trabalho e a percepção da gerência são fatores que se correlacionam. A percepção do estresse se associou a percepção da gerência do hospital e da unidade. Observou-se associação negativa entre clima de segurança geral e atuar na Clínica Médica e Cirúrgica (β = -11,07; p = 0,001) ou Pronto Socorro (β = -11,30; p < 0,001), turno de trabalho noturno (β = -5,60; p = 0,005) e intenção de sair da enfermagem (β = -8,27; p = 0,018). Contudo, ser celetista (β = -7,00; p = 0,008) melhorou o clima de segurança do paciente geral. CONCLUSÃO: O estudo evidencia a necessidade de melhoria do clima de segurança do paciente e dos fatores que podem influenciá-lo negativamente como: atuar em pronto socorro ou em unidades de clínica médica e cirúrgica, trabalhar em turno noturno e possuir intenção de sair da enfermagem. Estes dados contribuem com a gestão dos serviços de saúde, apontando questões que podem ser trabalhadas em prol da melhoria da qualidade da assistência e do clima de segurança do paciente.
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Souza, Letícia Silva de. "Clima organizacional e ocorrência de acidentes com materiais perfurocortantes num hospital público do Estado de São Paulo". Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/22/22134/tde-28032017-153644/.
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Atualmente, a avaliação do clima organizacional tem sido considerada importante ferramenta de gestão nas instituições de saúde. O objetivo deste estudo foi avaliar o clima organizacional e a sua relação com a ocorrência de acidentes de trabalho com material perfurocortante entre os profissionais de enfermagem em um hospital público de média complexidade do interior do Estado de São Paulo. Trata-se de um estudo de abordagem quantitativa, descritivo e transversal. Para a coleta de dados, foi utilizada a versão validada e adaptada para o contexto brasileiro do Safety Attitudes Questionnaire (SAQ) - Short Form, denominada Questionário de Atitudes de Segurança - QAS. Por meio do QAS foi possível avaliar a percepção dos trabalhadores acerca do clima de trabalho em equipe, clima de segurança, satisfação profissional, percepção do estresse, ações da gerência quanto às questões de segurança e as condições de trabalho. As respostas foram dadas por meio da escala Likert de cinco pontos e o processamento e a análise dos dados foram realizados com o auxílio do programa Statistical Package for Social Science (SPSS), versão 17.0. Para relacionar o clima organizacional com a ocorrência de acidentes de trabalho, inicialmente, foi realizado levantamento junto ao Serviço Especializado de Medicina e Segurança do Trabalho - SESMT dos registros de acidentes de trabalho ocorridos no período 2008-2014 e foram identificados os trabalhadores de enfermagem vítimas desses acidentes. Após este levantamento, foram constituídos dois grupos: Grupo 1 - profissionais de enfermagem que sofreram acidentes de trabalho envolvendo perfurocortantes; Grupo 2 - profissionais de enfermagem que não sofreram acidente de trabalho com perfurocortantes. A análise dos dados foi realizada por meio de estatística descritiva com testes de comparação entre as variáveis dos grupos. A amostra do estudo foi constituída por 116 participantes, técnicos de enfermagem e enfermeiros atuantes em unidades de internação hospitalar, sendo o Grupo 1 composto por 21 participantes e o Grupo 2 composto por 95 participantes. Predominaram participantes do sexo feminino, técnicos de enfermagem e profissionais com cinco a 10 anos de atuação na instituição. A percepção dos participantes quanto ao clima organizacional foi considerada desfavorável; no entanto, foi considerada satisfação no trabalho pela maioria dos participantes. Os resultados não indicaram relação direta entre o clima organizacional e a ocorrência de acidentes com perfurocortante, mas foi possível observar que o grupo que não sofreu acidentes apresentou maior satisfação no trabalho. Considera-se que este estudo permitiu ampliar o conhecimento acerca da percepção de profissionais de enfermagem sobre o clima organizacional, contribuindo para a discussão sobre formas de melhoria da assistência segura, de redução de eventos adversos e sobre a qualidade da assistência de enfermagemRecently, evaluation of organizational climate has been considered an important management tool in health institutions. The aim of this study was to evaluate the organizational climate and its relationship with the occurrence of accidents with needlestick materials among nursing professionals in a public hospital of medium complexity in the state of São Paulo. It is a study of quantitative, descriptive and cross-sectoral approach. The instrument Safety Attitudes Questionnaire (SAQ) was used - Short Form, 2006, validated and adapted version for the Portuguese language (Safety Attitudes Questionnaire - QAS). Through the areas of QAS was possible to assess attitudes about the working environment in staff, safety climate, job satisfaction, perceived stress, management actions regarding safety issues and working conditions. The answers were given by Likert scale of five points, processing and data analysis was performed with the aid of the Statistical Package for Social Sciences (SPSS) version 17.0. To relate the organizational climate with the occurrence of accidents with sharps survey was carried out by the Specialized Service of Medicine and Safety - SESMT with records of work accidents in the period 2008-2014 and workers were identified nursing victims of these accidents. Constituted two groups: Group 1 - nursing professionals who were victims of work accidents involving sharps; Group 2 - nursing professionals who did not undergo occupational accidents with needlestick during the study period. After conformal groups, the data analysis was performed using descriptive statistics with correlation tests between the variables of the groups in order to analyze possible relationship between accidents and the adoption of safety measures by the professional. The study sample consisted of 116 participants, nursing technicians and nurses working in hospital units. Group 1 consisted of 21 participants and Group 2 consists of 95 participants. Predominated female participants, nursing technicians and professionals with five to 10 years of experience in this institution. The perception of the participants about the organizational climate was considered unfavorable, however it was observed that job satisfaction was evidenced by most of the participants, demonstrating how they feel during the exercise of the profession in this institution. On the relationship between organizational climate and the occurrence of accidents with needlestick materials, the results indicated no direct relationship between organizational climate and the occurrence of such accidents, however it was observed that the group that did not suffer sharps injuries was the group that presented greater job satisfaction. Thus, this study promotes the opportunity to meet the professionals\' perception of the organizational climate and can contribute to improvement of safe care, reduce adverse events and improve the quality of patient care
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Hsieh, Pei-Jung y 謝佩蓉. "A Case Study of Nursing Schools’ Organizational Climate". Thesis, 2004. http://ndltd.ncl.edu.tw/handle/80437889355088354124.
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碩士國立台北護理學院
醫護教育研究所
92
This research uses two methods─the survey and focus group. The main purposes of this case study are to explore the perceptions of organizational climate of the faculty, staff and students at National Taipei College of Nursing, and also to compare the variation in their perception based on the difference in background. Census was used for the faculty and staff and stratified random sampling was used for the students. 77 effective samples (57.9%) were returned by the faculty, 40 (76.9%) by the staff and 654 (99.2%) by the students. The student version of the assessment was first tested on 81 students and then tested for credibility with Cronbach . The assessments were distributed by the researcher to offices and classrooms. Then, the data was analyzed by the methods of descriptive statistics, one-way ANOVA or Kruskal-Wallis Test, and t-test or Mann-Whitney Test. The study found that the type of organizational climate perception for each group is as follows: familiarity for the faculty, autonomy for the staff, and close for the students. The perceptions of organization climate are more positive for two groups: male faculty with a more advance degree in non-nursing departments, and female students who are older, married and studying in non-nursing departments at the downtown campus. However, there is no significant variation for staff from different backgrounds. Therefore, based on these findings, we suggest that the college reduce work load for the nursing department faculty, whose educational background are master or bachelor degree. Besides, to promote satisfaction of school work and social-needs for the nursing department students. In addition, the organization climate investigation will be carried out by the Research and Development Center regularly.
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Wu, Chia-Chun y 吳佳純. "A Study on Nursing Shortage in Taiwan: From Organizational-Climate Perspective". Thesis, 2014. http://ndltd.ncl.edu.tw/handle/r6973p.
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碩士國立中山大學
企業管理學系研究所
102
People in Taiwan are experiencing severe problem of Nursing Shortage, this research discussed the problem via an organizational-climate perspective and tried to find the way out. Organizational-climate is an organizational level variable, and it affects employee’s behaviors and attitude. Through visiting 9 hospitals and surveying 205 nurses, result turned out that Human-relation climate and Rational-goal climate are positive predictors to job satisfaction and work engagement. For job satisfaction, the most predictable aspects are welfare and involvement, and for work engagement are welfare and effort. Apparently welfare is the most powerful aspect. To conclude, hospitals which facing Nursing shortage could start form human resource management, formulating policies or executing practice that caring and valuing employee. After that their job satisfaction and work engagement will increase, and we can expect the decrease of their intention to quit.
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Nelson, Shanelle. "Organizational Climate and Hospital Infection Preventionists". Thesis, 2013. https://doi.org/10.7916/D8NP2BN7.
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Healthcare associated infections (HAI) continue to be a significant patient safety problem. Researchers have found that nurses; perception of organizational climate is associated with patient outcomes. However, given the increased prevalence of HAI, an examination of multiple organizational factors within the healthcare organization particularly amongst infection prevention and control staff is warranted. The purpose of this study was to gain a knowledge base on the issue of HAI in acute care hospitals and the role organizational climate plays in improving clinician;s performance and ultimately decreasing HAI rates. Guided by the integrative model of organizational climate and safety conceptual framework the specific aims were to: 1) systematically review published evidence examining relationships between organizational climate, adherence to infection prevention and control processes and HAI rates in hospital settings; 2) assess the psychometric properties of an organizational climate measure, the Leading a Culture of Quality (LCQ) scale, in a national sample of Infection Preventionists (IPs); and 3) identify setting characteristics that predict a more positive perception of organizational climate by the IP and measured by the LCQ revised, using a national sample. Ten studies, mostly cross sectional design, were included in the systematic review. There was evidence that positive perceptions of organizational climate as perceived by nurses and/or an intervention aimed at improving organizational climate are associated with decreased HAI rates and adherence to evidence based guidelines. The exploratory factor analysis on the LCQ identified a four factor solution explaining 59.65% of the total variance. The Cronbach's alpha of the new subscales ranged from .74 to .90 and .93 for the final composite LCQ, the LCQ revised. The subscales are: Psychological Safety, Organizational Leadership and Work Environment, HAI Prevention/Communication and Vision/Perspective of Organization. In a sample of 1,013 IPs, relationships were found between the structural characteristics examined and organizational climate. IPs who worked in hospitals that share or pool infection prevention resources with a larger facility perceived the climate more positively among 2 subscales (Psychological Safety β = 0.113, p-value = 0.006; HAI Prevention/Communication β = 0.129, p-value = 0.005) and the overall climate (β = 0.085, p-value = 0.027). IPs in hospitals with an Infection Control Director position in the Infection Control department perceived the organizational climate more positively among 3 subscales (Psychological Safety β = 0.120, p-value = 0.005; Organizational Leadership β = 0.198, p-value = 0.000; HAI Prevention/Communication β = 0.159 , p-value = 0.001) and the overall climate (β = 0.152, p-value = 0.000). IPs working in hospitals located in a rural area as compared to urban perceived organizational climate more negatively on all 4 subscales (Psychological Safety β = -0.123, p-value = 0.001; Organizational Leadership and Work Environment β = -0.099, p-value = 0.029; HAI Prevention/Communication β = -0.168, p-value = 0.002; Vision/Perspective of Organization β = -0.179, p-value = 0.000) and the overall climate (β = -0.124, p-value = 0.001). Also, IPs working in hospitals located in a suburban area as compared to urban perceived organizational climate more negatively among HAI Prevention/Communication (β = -0.111, p-value = 0.039). These findings suggest the need for additional support and organizational resources for the infection prevention and control department. As the issue of patient safety continues to progress, particularly around HAI, concerns of how to improve organizational systems to enable implementation and adherence to safety processes should be a priority on the research agenda. This is the first study to evaluate associations between structural characteristics of the hospital setting and organizational climate via the IP perspective using a large national sample. Future research should focus on other structural variables such as IP staffing. Also, further analyses on organizational climate and outcomes such as clinician adherence to evidence based practices and HAI rates should be conducted.
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"Role conception, ethical decision-making and learning climate among nursing students in Hong Kong". Chinese University of Hong Kong, 1994. http://library.cuhk.edu.hk/record=b5887272.
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by Yung Ha-ping, Hilary.Questionnaire also in Chinese.
Thesis (M.Phil.)--Chinese University of Hong Kong, 1994.
Includes bibliographical references (leaves 92-101).
ACKNOWLEDGEMENTS
ABSTRACT --- p.ii
LIST OF TABLES --- p.vii
LIST OF FIGURES --- p.viii
CHAPTER
Chapter 1. --- INTRODUCTION --- p.1
Bacground of the Study --- p.1
Significance of the Study --- p.4
Purpose of the Study --- p.5
Chapter 2. --- REVIEW OF LITERATURE AND THEORETICAL FRAMEWORK
Role Conception
Role --- p.6
Role Conception --- p.7
Nursing Role Conception --- p.8
Role Discrepancy --- p.9
Change of Role Conception --- p.10
Socilaisation and Role Conception --- p.11
Socialisation of Baccalaureate Degree Students --- p.12
Socialisation of Hospital-based Certificate Students --- p.13
Nursing and Ethics --- p.14
Ethical Dilemma --- p.15
Code of Ethics --- p.16
Moral Development --- p.17
Moral Reasoning and Moral Behaviour --- p.18
Decision-making Framework --- p.20
Ethical Decision-making in Nursing --- p.21
Ethical Decision-making and Work Environment --- p.23
Ethical Decision-making and Role Conception --- p.24
Ethical Decision-making and Education --- p.25
Learning Climate
Concept of Organizational Climate --- p.26
Organizational Climate and Leadership --- p.28
Ward Learning Climate --- p.28
Ward Teaching and Learning --- p.30
Role of Ward Staff and School Tutor in Ward Teaching --- p.31
Role of ward Sister in Ward Teaching --- p.32
"Relationship among Role Conception, Ethical Decision- Making and Ward Learning Climate" --- p.34
Chapter 3. --- RESEARCH METHODOLOGY
Design of the Study --- p.38
Hypotheses --- p.38
Definitions --- p.39
Subjects --- p.40
Procedure --- p.42
Instruments --- p.42
Analysis Design --- p.50
Chapter 4. --- RESULTS
Demographic Characteristics --- p.52
Differences in Role Conception Types --- p.53
Differences in Discrepancy Role Conception --- p.60
Differences in Ethical Decision-making --- p.63
Differences in Perception of Ward Learning Climate --- p.66
"Relationship among Ethical Decision-making, Role Conception and Learning Climate" --- p.69
Chapter 5. --- DISCUSSION
Differences in Professional Role Conception --- p.75
Differences in Bureaucratic Role Conception --- p.79
Differences in Service Role Conception --- p.80
Differences in Ethical Decision-making --- p.81
Differences in Perception of Ward Learning Climate --- p.83
"Relationship among Ethical Decision-making, Role Conception and Learning Climate" --- p.84
Limitations --- p.87
Chapter 6. --- "CONCLUSION, IMPLICATIONS AND RECOMMENDATIONS"
Conclusion --- p.88
Implications and Recommendations --- p.89
Suggestions for Further Research --- p.90
REFERENCES --- p.91
APPENDICES
Chapter I. --- Code for Nurses --- p.102
Chapter II. --- Letter of Request for Approval --- p.103
Chapter III. --- Questionnaire Instruction --- p.104
Chapter IV. --- Letter to Students --- p.105
Chapter V. --- Consent Form --- p.106
Chapter VI. --- Demographic Data --- p.107
Chapter VII. --- Nursing Role Conception Inventory --- p.108
Chapter VIII(A). --- Opinion About Nursing (Role Conception Questionnaire) --- p.110
Chapter VIII(B). --- Opinion About Nursing - Chinese Version --- p.115
Chapter IX(A). --- Judgment About Nursing Decision (JAND) (Ethical Decision-making Qusetionnaire) --- p.118
Chapter IX(B). --- Judgment About Nursing Decision (JAND) -Chinese Version --- p.125
Chapter X. --- Ward Learning Climate Indicators --- p.132
Chapter XI(A). --- Ward Learning Climate Questionnaire --- p.135
Chapter XI(B). --- Ward Learning Climate Questionnaire -Chinese Version --- p.138
Chapter XII. --- Narrative Responses --- p.140
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Lin, Yu Li y 林幼麗. "The effect of Leadership style and Team Climate on Nursing team performance". Thesis, 2008. http://ndltd.ncl.edu.tw/handle/65876458469483791974.
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碩士長庚大學
醫務管理學研究所
96
High quality leadership and good team climate are significant factors for team’s successful performance, but long-term management improvement requires good performance evaluation tools to establish feedback system. This research aims to examine how leadership style and team climate contribute to nursing team’s performance as evaluated by the application of Balanced-Scorecard (BSC) system. A total of 144 medium-level nursing supervisors from a healthcare center was recruited and surveyed with questionnaires. The instrument used in this study included Multifactor Leadership Questionnaire (MLQ5X) and Team Climate Inventory (TCI). In regard to performance evaluation, a total of 16 indicators were retrieved from the center’s archives in terms of BSC’s four dimensions, namely Business Process, Learning and Innovation, Customer Relationship, and Finance. The results suggested that some indicators of the Business Process dimension and the Customer Relationship dimension significantly correlated with dimensions of team climate and transformational and transactional leadership respectively (r=0.21-0.38, all r<0.05). Indicators within the Learning and Innovation dimension and were significantly correlated with factors of transformational and transactional leadership (r =0.18-0.24，all p<0.05). The indicator in the Finance dimension was correlated with factors of transactional leadership（r=-0.18, p<0.05）. The implication of the results for nursing leaders and supervisors will be discussed.
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Liu, Chieh ju y 劉潔儒. "Correlations among Chinese Medicine Nursing Learning Experiences, Organizational Climate, Job Satisfaction and Job Performance". Thesis, 2011. http://ndltd.ncl.edu.tw/handle/40812436814304956007.
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碩士國立臺北護理健康大學
中西醫結合護理研究所
99
The aim of this study is to improve the quality of current Traditional Chinese Medicine (TCM) nursing care by exploring the correlations among Traditional Chinese Medicine (TCM) learning experience, organizational climate, job satisfaction and job performance. A cross-sectional study was designed and conducted by a questionnaire survey. The study objectives include TCM nurses who work at TCM clinics and wards in hospitals. A total of 108 questionnaires were issued, including four invalid questionnaires and 104 effective questionnaires. The questionnaire has five parts: first, the basic demographics including gender, age, service units of TCM care, periods of service, educational level and locus of control personality. Second, the learning experiences of TCM nursing including the educational experience and the studied numbers of curriculum subjects in TCM nursing. Third, organizational climate. Fourth, the job performance including the nursing competences and achievements and the last, job satisfaction. Data analysis was conducted by SPSS 18.0, the parameters included frequency, percentage, mean, standard deviation, independent t-test, one-way ANOVA, Kruskal-Wallis one-way analysis of variance by ranks, Mann-Whitney U-test. And decision trees were constructed to predict the impact factors on job performance and job satisfaction of TCM nursing staff. The results revealed: 1. Nurses with institute degree have significant differences in TCM competences comparing to others. 2 Comparing to others, the nurses who had both school education and on-job training experiences have significant differences in TCM nursing competences (p<0.01), and have significant difference in external satisfaction (p<0.05). 3. The total number of curriculum subjects studied in TCM nursing, the organization climate and the periods of service are the important factors of TCM nursing competences and job satisfaction. 4. And TCM nursing competences and job satisfaction are important factors of the results of the work. In conclusion, it is our suggestions that we should take the TCM nursing subjects into current nursing education at school as an essential learning course to promote the prevelence of TCM nursing education and to help clinical nurses to develop the concept of combined Chinese and Western medical care and apply to daily patient care. The directors of medical organizations should provide supportive organizational climate, better clinical learning environment and opportunities in professional development and improve the competences of clinical nurses in TCM nursing and promote job satisfaction to achieve better job performance.
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Kao, Yu Yi y 高有怡. "The effect of leadership style of nursing supervisor and team climate on leadership effectiveness". Thesis, 2008. http://ndltd.ncl.edu.tw/handle/73932153714896555869.
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碩士長庚大學
醫務管理學研究所
96
Nursing staffs play an important role for patient care. The operation requires team work with strong leadership to ensure healthcare quality. The research aims to examine how leadership styles of nursing supervisors influence team climate and leadership effectiveness. A total of 144 medium-level nursing supervisors from a healthcare center was recruited and surveyed with questionnaires. The instrument used in this study included Multifactor Leadership Questionnaire (MLQ5X) and Team Climate Inventory (TCI). The results showed that transformational and transactional leadership were significantly and positively correlated with four dimensions of team climate, while passive avoidant one showed significantly negative correlations. The result of path analysis suggested that transformational leadership has greater positive effects (β=0.44~0.50, p<0.001) on the dependent variables of team climate: participative safety, support for innovation, vision and task orientation. The application of independent two sample t-test revealed that nurses with high transformational leadership scores generates significantly more positive effects upon team climate and leadership effectiveness. According to this study, nursing supervisors need to adopt transformational leadership in order to establish effective team to carry out organizational missions.
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Cassie, Kimberly McClure. "The effects of nursing home organizational culture and climate on employee and resident outcomes". 2009. http://etd.utk.edu/2009/Spring2009Dissertations/CassieKimberlyMcClure.pdf.
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Jung, Huang Yen y 黃嬿蓉. "Investigation of relationship between transformational leadership and team climate on innovative nursing team performance". Thesis, 2011. http://ndltd.ncl.edu.tw/handle/86888877322074300328.
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碩士長庚大學
管理學院碩士學位學程在職專班醫務管理組
99
Quality assurance of medical care is brought about by effective team leadership and management. The leadership style has been shown to be a key factor related to the generation and performance of team innovation. This study hypothesized that the leadership style acts as the antecedent variable for team innovation, and this relationship is mediated or moderated by team climate such as support for innovation and vision. Structured questionnaires were sent to the entry level nursing staffs. A total of 275 nurses were surveyed which resulted in 261 valid data. Statistical analyses included correlation analysis, regression analysis, and structural equation modeling. The results indicated that transformational leadership is positively related to team innovation, and only teams with a high altitude of team vision may result in constant generation of team innovation. In addition, the relationship between transformational leadership and perceived innovation is mediated by team climate of support for innovation. The results suggested that the major force driving team innovation was resulted from a high degree of attention paid to a shared goal and vision amongst all team members. The results have important implications for team innovation management model in healthcare settings, especially for nursing teams. Key word: Transformational Leadership, Team Climate, Team Innovation, Nursing Team
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(9788096), Kerrie Coleman. "A descriptive study on: The impact of climate and comfort on patient's compliance with compression therapy". Thesis, 2003. https://figshare.com/articles/thesis/A_descriptive_study_on_The_impact_of_climate_and_comfort_on_patient_s_compliance_with_compression_therapy/19352483.
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Leg ulcers are a common problem especially amongst the elderly, with incidence rates of 3.3/1000 in Australia (Baker, Stacey, Jopp-McKay, Hoskin & Thompson 1991 p.864). The persistence and recurrence of venous ulcers presents a management challenge to the patient and the health care team (Chase, Melloni & Savage 1997). It is important therefore that treatment offered should be based on rigorous research, and that also in general this type of research should facilitate understanding of how venous leg ulcers, and their treatments, impact on people's lives (Walshe 1995).
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Boyd, Jr Donald Richard. "Investigating and Measuring Certified Registered Nurse Anesthetist Organizational Climate". Thesis, 2017. https://doi.org/10.7916/D8445S76.
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Approximately 40,000 certified registered nurse anesthetists (CRNAs) are included in the anesthesia workforce in the United States. They provide a critical portion of anesthesia care throughout the country often practicing in rural and underserved areas of America. CRNAs are educated and trained to provide high-quality, cost-effective care for patients. Policy makers and health care organizations consistently call for policies to enable these providers to deliver care to the full extent of their education and training. The National Academy of Medicine (former Institute of Medicine) recommends in their seminal report, The Future of Nursing: Leading Change, Advancing Health, that CRNAs practice to their full potential as full partners with physicians. In order to promote CRNA ability to practice to the full extent of their training and education and assure that patients have access to safe anesthesia services, both policy and organizational influences on their care provision and should be taken into account.
Whereas focus has been paid to policy restrictions and their influence on CRNA care, little is known about organizational influences on CRNA care or organizational structures that are present in the employment settings of CRNAs. Organizational climate, which is employees’ perceptions of and experience with organizational structures within their employment settings, has been studied in healthcare settings. Studying organizational climate in healthcare settings is important because research concludes that organizational climate of healthcare settings impacts providers and patients. Registered nurse (RN) organizational climate has been well studied, and researchers identified that important aspects of RN organizational climate include autonomy, control over practice, teamwork, and collaborative relationships with physicians and staff. When RN organizational climate is favorable, job satisfaction and nurse retention improve, and patients receive high-quality care. Researchers have also studied nurse practitioner (NP) organizational climate and have identified climate characteristics that enable NPs to function to their full capacity, while promoting job retention, decreasing costs, and improving access to care.
Whereas evidence is clear that organizational climate is an important concept to study within healthcare organizations, little is known about CRNA organizational climate or how it impacts CRNA outcomes or patient outcomes, nor do we know how to measure organizational climate and further asses it. Therefore, this dissertation investigates CRNA organizational climate and adapts a tool to measure CRNA organizational climate. In Chapter 1, a background on CRNA contributions to anesthesia care in the United States is presented. In addition, challenges and restrictions affecting CRNA practice are discussed, and studying the concept of CRNA organizational climate is introduced. The theoretical and empirical underpinnings guiding the dissertation are presented, and the three aims of the dissertation are stated. In Chapter 2, aim one of the dissertation is addressed. Aim one of the dissertation is achieved by systematically reviewing and synthesizing evidence regarding CRNA working conditions and outcomes. This evidence lays the foundation for studying CRNA organizational climate. In Chapter 3, aim two of the dissertation is addressed. This aim is achieved by selecting an instrument to adapt to measure CRNA organizational climate. In this chapter, the processes of content validity testing and reliability testing of the Certified Registered Nurse Anesthetist Organizational Climate Questionnaire (CRNA-OCQ), the adapted instrument to measure CRNA organizational climate, are presented. In Chapter 4, aim three of the dissertation is addressed. This aim is achieved by the further psychometric testing of the CRNA-OCQ, which is presented in this chapter. In this chapter, the CRNA-OCQ is refined and finalized through conducting exploratory factor analysis. In addition, the internal consistency reliability of CRNA-OCQ subscales is assessed. In Chapter 5, results from the three included studies are discussed and synthesized. In addition, practice, policy, and research recommendations are presented. Lastly, the strengths and limitations of the dissertation are discussed before the conclusion.
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Squires, Mae Ellen. "The Influence of Perceived Fairness and Relational Leadership on Nursing Safety Climate and Work Environment". Thesis, 2010. http://hdl.handle.net/1807/26385.
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Canadian statistics on patient safety in acute care hospitals are alarming. Hospital safety concerns are not isolated to patient safety. Occupational safety is also important. With increasing shortages of nurses, stress in the work place is growing. Nurses report high levels of absenteeism of 14.5 days per year. The importance of a just and fair culture and the role of nurse leaders have been emphasized in safety literature. Although deemed important, studies of nurse leaders and patient outcomes are limited. The influence of interactional justice in the workplace on nurse and patient safety has not been studied.
The purpose of this study was to test and refine a model developed from the literature which explains the impact of perceived interactional justice, relational leadership, and quality of nurse manager – clinical nurse relationships on the nursing work environment and ultimately patient and nurse safety outcomes.
The model was tested on a random sample of 266 Ontario acute care registered nurses. Findings indicated the model reasonably fit the observed data, however could benefit from further refinement. The addition of 2 pathways (span of control to nurses’ intent to leave and number of medication errors to nurse emotional exhaustion) and trimming of the insignificant paths improved the overall model fit.
The resulting model indicates that resonant leadership style and interactional justice improves the quality of nurse leader-nurse relationships which in turn improves quality of the nurses’ work environment and safety climate. A positive safety climate led to a decrease in the number medication errors and nurses’ intentions to leave their unit. A higher quality work environment predicted lower nurse emotional exhaustion. Additionally, higher numbers of medication errors led to an increase in nurse emotional exhaustion. This suggests that distress may be associated with making a medication error or fear of consequences. As well, larger manager spans were associated with less nurse intent to leave. As the span increased, the number of support personnel also increased. Contrary to other research findings, this result suggests that supportive personnel may mitigate the effect of large manager spans of control on nurses’ intent to leave their units.
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Chen, Ya-Ping y 陳雅萍. "A Study of the Relationship between Organization Justice, Team Work Climate, and Safety Climate: An Exemplar from a Nursing Department of a Regional Teaching Hospital". Thesis, 2019. http://ndltd.ncl.edu.tw/handle/nybb5s.
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HUANG, SHOU-CHIH y 黄守智. "A Study of the Organizational Climate, Satisfaction of Nursing Work, and Intention to Stay for Hemodialysis Nurse". Thesis, 2018. http://ndltd.ncl.edu.tw/handle/jv84vd.
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碩士東南科技大學
工業管理研究所
107
Social pattern as the population ages, food safety problems, chronic diseases and improper use of drugs by people, that causes poor kidney function and renal lesions. National Health Insurance Administration Ministry of Health and Welfare (2016) indicates that there are about 60,000 to 70,000 people who have hemodialysis in Taiwan. The incidence and prevalence of hemodialysis are high, showing the importance of nursing manpower. The literature review found that the turnover rate of clinical nursing staff in Taiwan has been increasing year by year, and it is worth further exploration of its influencing factors. This study used exploratory research methods to conduct questionnaires and interviews with hemodialysis nurse, and then performed descriptive statistics, reliability verification, factor analysis, variance analysis, Pearson correlation analysis, regression analysis with SPSS 22 statistical software, and comparison of questionnaires and interviews. In this study, the nursing staff of the small hemodialysis institution was used as a research sample. The convenience sampling and snowball sampling were used. A total of 45 people were interviewed. The reliability α values of the independent variable and the dependent variable are both greater than 0.7. The research shows, in variance analysis, the sub-dimensions of Organizational Climate and Satisfaction of Nursing Work, are no significant difference to Intention to Stay. Basic personnel attributes are no significant difference in variance analysis of Organizational Climate, Satisfaction of Nursing Work, and Intention to Stay. In Pearson correlation analysis, Organizational Climate, Satisfaction of Nursing Work, and Intention to Stay are positive correlation. In regression analysis, R2 explanatory power is 13.5%. Finally, in the qualitative interview, the results of the interviewee's description and statistical analysis did not find any significant difference.
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Moore, Linda E. "The relationship between organizational climate, personality and performance of nursing staff and patient outcomes on long-term care units". 1997. https://scholarworks.umass.edu/dissertations/AAI9809374.
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The purpose of the study is to present a different perspective from which to evaluate two patient outcomes--infection and pressure ulcer. Past research has looked at the relationship of various medical treatments and/or nursing interventions to these outcomes. This descriptive exploratory study uses a cross-sectional design to investigate the variables being studied. In this study personality type and the performance of nursing staff and the organizational climate on long term care wards is examined in relationship to patient outcomes (infection and pressure ulcer rates). A questionnaire was completed by two hundred and seventy-six nursing employees who worked on 25 long term care wards at three medical centers. The Myers Briggs Type Inventory was used to measure personality. The Ward Environment Scale was used to measure organizational climate. Of the sixteen possible personality types, four types occurred with the greatest frequency. Collectively, these four types accounted for 60% of the staff participating in this study. Of the four bipolar personality dimensions, only extroversion/introversion had a significant effect on patient outcomes. Two of the organizational climate subscales were significantly related to patient outcomes--peer cohesion and task orientation. Six organizational climate dimensions were significantly related to performance ratings. Several organizational climate dimensions were also related to personality. Surprisingly, although both personality and organization climate related to performance and patient outcomes, no significant correlations were identified between staff performance ratings and patient outcomes. This raises several questions about the relationship between staff performance and patient outcomes for future studies. This study supports the belief that organizational climate influences the work site and is a factor worthy of management's attention. Implications for nursing management and nursing are discussed, Several recommendations for future research are offered including longitudinal studies to identify the effects of organizational climate and personality on and patient outcomes over time. The use of personality types to enhance team building and communications, and reduce turnover rates among nurses is also discussed.