Perceived Readiness for Hospital Discharge in Adult Medical-Surgical Patients

Purpose: The purpose of the study was to identify predictors and outcomes of adult medical-surgical patients\u27 perceptions of their readiness for hospital discharge. Design: A correlational, prospective, longitudinal design with path analyses was used to explore relationships among transition theory-related variables. Setting: Midwestern tertiary medical center. Sample: 147 adult medical-surgical patients. Methods: Predictor variables included patient characteristics, hospitalization factors, and nursing practices that were measured prior to hospital discharge using a study enrollment form, the Quality of Discharge Teaching Scale, and the Care Coordination Scale. Discharge readiness was measured using the Readiness for Hospital Discharge Scale administered within 4 hours prior to discharge. Outcomes were measured 3 weeks postdischarge with the Post-Discharge Coping Difficulty Scale and self-reported utilization of health services. Findings: Living alone, discharge teaching (amount of content received and nurses\u27 skill in teaching delivery), and care coordination explained 51% of readiness for discharge score variance. Patient age and discharge readiness explained 16% of variance in postdischarge coping difficulty. Greater readiness for discharge was predictive of fewer readmissions. Conclusions: Quality of the delivery of discharge teaching was the strongest predictor of discharge readiness. Study results provided support for Meleis\u27 transitions theory as a useful model for conceptualizing and investigating the discharge transition. Implications for Practice: The study results have implications for the CNS role in patient and staff education, system building for the postdischarge transition, and measurement of clinical care outcomes

An Investigation into the Indicators of a Successful Total Force Association

The Air Force, since adopting and subsequently developing the Total Force concept in the early 1970s, has not thoroughly outlined clear objectives by which the progress toward and realization of this strategic vision should be defined and measured. Without clear definition, direction, and method of evaluation, the ability to credibly claim any subsequent successes or failures in the pursuit of this vision become vulnerable to challenge. Indeed, the mere claim that a single, clear vision exists may be challenged. The Total Force concepts degree of success has, on multiple occasions through its history, been critiqued with the most recent instance occurring with the National Commission on the Structure of the Air Forces report, delivered to the President and Congress, specifying 42 recommended improvements. The relatively brief history of the Total Force concept has led to a gap in knowledge with respect to this topic. While the SecAF and CSAF have employed language implicitly claiming successful integration of the Total Force and all the stated benefits thereof, these benefits as well as the key success factors for attaining them at the tactical level have yet to be quantified. Therefore, through the semi-structured interviewing of tactical level Total Force leaders, this research provides an assessment of the perceived local Total Force Association health, highlights strategic and tactical level communication and perception disconnects with regards to the Total Force concept, and provides the Headquarters Air Force Total Force Continuum office an actionable listing of tactical level obstacles and concerns as well as a collection of best practices and innovative solutions

On Becoming a Strategic Partner: The Role of Human Resources in Gaining Competitive Advantage

Although managers cite human resources as a firm\u27s most important asset, many organizational decisions do not reflect this belief. This paper uses the VRIO (value, rareness, imitability, and organization) framework to examine the role that the Human Resource (HR) function plays in developing a sustainable competitive advantage. We discuss why some popularly cited sources of sustainable competitive advantage are not, and what aspects of a firm\u27s human resources can provide a source of sustainable competitive advantage. We also examine the role of the HR executive as a strategic partner in developing and maintaining competitive advantage within the firm

Predicting attrition of new Student Affairs professionals through perceptions of work-related quality of life, synergistic supervision, and executive servant leadership

Abstract New professional attrition in Student Affairs has been established as a concern for the field (Bender, 1980; Lorden, 1998; Renn & Hodges, 2007; Marshall, Gardner, Hughes, & Lowery, 2016). The debilitating impacts on university finances, productivity, organizational stability, team disruption, and innovation as a result of this problem creates urgency for the field to understand its predictors. The current study reviewed the impact of new professionals’ work-related quality of life, their perception of the use of synergistic supervision by their direct supervisors, and their perception of the use of executive servant leadership by divisional leaders as potential predictors of attrition. Using logistic regression, several models were examined to determine the isolated influence of each of these study variables and the cumulative impact. Counter to hypotheses, the perceptions of style in both the supervisor and divisional leaders were not statistically significant. As hypothesized, the predictive value of work-related quality of life for new professionals proved to be significant, demonstrating that as new professionals increase in their level of work-related quality of life, the odds of them intending to leave the field decrease. The factors of work-related quality of life were further explored for their predictive value. New professionals’ job and career satisfaction and their general well-being were important predictors with both demonstrating that as they increased, the odds of new professionals intending to leave the field decreased. Control at work was a significant predictor as well with increases in the perceived level of control leading to increases in the odds of new professionals intending to leave Student Affairs. These findings provide insight on new professional attrition for Student Affairs supervisors, divisional leaders, and national organizations. Recommendations for Student Affairs leadership and suggestions for further research are discussed

How Supervisors Influence Performance: A Multilevel Study of Coaching and Group Management in Technology-Mediated Services

This multilevel study examines the role of supervisors in improving employee performance through the use of coaching and group management practices. It examines the individual and synergistic effects of these management practices. The research subjects are call center agents in highly standardized jobs, and the organizational context is one in which calls, or task assignments, are randomly distributed via automated technology, providing a quasi-experimental approach in a real-world context. Results show that the amount of coaching that an employee received each month predicted objective performance improvements over time. Moreover, workers exhibited higher performance where their supervisor emphasized group assignments and group incentives and where technology was more automated. Finally, the positive relationship between coaching and performance was stronger where supervisors made greater use of group incentives, where technology was less automated, and where technological changes were less frequent. Implications and potential limitations of the present study are discussed

Seshat: The Global History Databank

The vast amount of knowledge about past human societies has not been systematically organized and, therefore, remains inaccessible for empirically testing theories about cultural evolution and historical dynamics. For example, what evolutionary mechanisms were involved in the transition from the small-scale, uncentralized societies, in which humans lived 10,000 years ago, to the large-scale societies with an extensive division of labor, great differentials in wealth and power, and elaborate governance structures of today? Why do modern states sometimes fail to meet the basic needs of their populations? Why do economies decline, or fail to grow? In this article, we describe the structure and uses of a massive databank of historical and archaeological information, Seshat: The Global History Databank. The data that we are currently entering in Seshat will allow us and others to test theories explaining how modern societies evolved from ancestral ones, and why modern societies vary so much in their capacity to satisfy their members’ basic human needsPeer reviewedFinal Published versio

Epidemiology of Island and Mainland Populations: How Does Culture Influence Health Risk Factors Of Non-Communicable, Chronic, and Metabolic Diseases?

Non-communicable diseases (NCDs), including chronic and metabolic diseases, are responsible for 74% of global mortality and are strongly influenced by health risk factors. Geographical differences in NCDs have been identified in several countries but have not been completely explained through cultural factors, specifically island and mainland cultures. This study aimed to develop an epidemiological framework for determining diseases with the highest mortality for further investigation regarding different health risk factors rooted in a specific population’s cultural foundations. Preliminary findings indicated diabetes type II (D2) and CKD caused by hypertension and D2 to have the highest risk factor and mortality percentage in both island and mainland populations. Further analysis indicated the potential for each population’s culture as a harmful influence regarding non-communicable, chronic, and metabolic diseases. The study suggests family-based educational programs implemented in each population’s respective healthcare systems to manage and prevent the heavy disease burden of diabetes type II and chronic kidney disease