Jenis Intervensi dalam Meningkatkan Kepuasan Kerja Perawat

This study aims to determine the types of interventions that can increase the job satisfaction of nurses in hospitals through an article review approach. The research method used is scoping review through databases namely Pubmed, ScienceDirect, Scopus, SpringerLink, and Garuda Portal. The results of the study show that 15 interventions articles that can increase nurse job satisfaction include organizational culture, organizational commitment, implementation of nurse welfare programs, work professionalism, clinical supervision, implementation of sharia behavior in nursing services, scheduling management, leadership, democratic leadership, transformational leadership, style transformational leadership, organizational climate, application of the team method, application of the professional nursing practice model (MPKP), leadership style, and structural empowerment. In conclusion, this type of intervention is proven to increase the nurses job satisfaction.   Keywords: Intervention, Job Satisfaction, Nurs

Contextual Influences and Strategies for Dissemination and Implementation in Mental Health

Implementation science has emerged to bridge the gap between research and practice. A number of conceptual frameworks have been developed to advance implementation research and illuminate the contextual influences that can facilitate or impede the implementation of evidence-based practices. Contextual factors that may be important in the dissemination and implementation of evidence-based practice may occur at the system-, organizational-, and provider-levels. System-level barriers may include external policies, incentives, and peer pressure. Organizational-level factors that are important in implementation include organizational culture and climate and implementation climate. At the individual provider-level, barriers may occur around provider attitudes, knowledge, and self-efficacy. Finally, additional barriers such as client-level that can be used to overcome contextual barriers when attempting to implement evidence-based practices into new settings. Several exemplar implementation strategies are discussed, including the Availability, Responsiveness, and Continuity intervention, Community Development Team model, and Interagency Collaborative Team Model

Is organizational justice climate at the workplace associated with individual-level quality of care and organizational affective commitment?:A multi-level, cross-sectional study on dentistry in Sweden

Purpose The aim of this study is to investigate whether organizational justice climate at the workplace level is associated with individual staff members’ perceptions of carequality and affective commitment to the workplace.Methods The study adopts a cross-sectional multi-level design. Data were collected using an electronic survey and a response rate of 75% was obtained. Organizational justice climate and affective commitment to the workplace were measured by items from Copenhagen Psychosocial Questionnaire and quality of care by three self-developed items. Non-managerial staff working at dental clinics with at least five respondents (n = 900 from 68 units) was included in analyses. A set of Level-2 random intercept models were built to predict individual-level organizational affective commitment and perceived quality of care from unit-level organizational justice climate, controlling for potential confoundingby group size, gender, age, and occupation.Results The results of the empty model showed substantial between-unit variation for both affective commitment (ICC-1 = 0.17) and quality of care (ICC-1 = 0.12). The overall results showed that the shared perception of organizational justice climate at the clinical unit level was significantly associated with perceived quality of care and affective commitment to the organization (p < 0.001).Conclusions Organizational justice climate at work unit level explained all variation in affective commitment among dental clinics and was associated with both the individualstaff members’ affective commitment and perceived quality of care. These findings suggest a potential for that addressing organizational justice climate may be a way to promote quality of care and enhancing affective commitment. However, longitudinal studies are needed to support causality in the examined relationships. Intervention research is also recommended to probe the effectiveness of actions increasingunit-level organizational justice climate and test their impact on quality of care and affective commitment

An Integrated Model of Organizational Culture and Climate: A Case Study in Obstetrics Practice in Ontario

The goal of this study was to determine whether a training intervention would be sufficient to produce a cultural change. A comprehensive review of literature on culture and climate indicated that these separately studied constructs could be integrated; thus, an integrated model of culture and climate, and the associated theory, was developed. Three studies were conducted within the obstetrics practice in Ontario, Canada. The specific training intervention used in this study was the MOREOB program (Managing Obstetric Risks Efficiently), which was a proprietary program developed by the Salus Global Corporation, Canada. This program sought to improve safety culture in the field of obstetrics through a strategic approach to knowledge-building and team-training. Over the past decade, more than 300 hospitals across Canada have implemented this program. However, the impact of this program on the culture of respective obstetrics units had not been evaluated. The sample for this research consisted of 68 hospitals from Ontario that had implemented the MORE-OB program. Overall, this study used a mixed-methods approach, consisting of both quantitative and qualitative analyses, and explored five research questions and two hypotheses. The study was structured in terms of three sub-studies: Study#1 focused on quantitative assessment of knowledge gained through the training intervention, changes in clinical outcomes, and changes in the patient safety climate; Study #2 focused on qualitative assessment aimed at analyzing interview narratives and artifacts to develop a deeper understanding of how various external influences as well as internal factors and the MORE-OB training may have shaped the organizational culture at the subject hospitals. Study #3 took a longitudinal approach and presented an integrated analysis of culture and climate at two subject hospitals. Ultimately, the three studies arrived at the following conclusions: 1. Contemporary environmental factors such as economics, geo-social conditions, legal requirements, and professional coalitions played a vital role in influencing organizational values as well operationalizing them. By asking the study participants how external environmental factors might have influenced their organizational culture, the researcher was able to map the role played by the changing external conditions in shifting the participants’ unquestioned assumptions. 2. Leadership’s role in shaping organizational culture was not limited to imprinting of his/her personal values on the organization. First, key influencers outside the organization raised awareness about critical issues, questioned the norms, and presented ideas and test-cases about best practices that could be used to solve the issues. Next, formal leaders within the organization interpreted these external signals in the context of local conditions and engaged internal mechanisms to revise or reinforce corresponding organizational values. Internal key influencers, on the other hand, took the signal from their formal leaders and developed group-level standards of practice, enforced those standards, and served as role models. 3. Three levels of shared experiences were noted: (a) experiences resulting from external influences (e.g., the experiences resulting from placing one subject hospital under supervisory control); (b) experiences resulting from internal implementation mechanism (e.g., the use of the Lean methodology across one of the subject hospitals); and (c) experiences resulting from the MOREOB program as a training intervention aimed at improving the patient safety culture in obstetrics. 4. A 2x2 matrix of internal versus external and formal versus informal feedback mechanisms was noted. External mechanisms, whether formal or informal, were aligned with external influence factors. For example, overall transparency regarding every hospital’s clinical performance provided means to compare hospital performance across peers and enabled patients to choose their care providers based on quality of care metrics. Since patient volume was linked with financial health of the hospital, the benchmarked performance measures received significant attention from senior management. Thus, the study of feedback mechanisms revealed how such mechanisms could work in concert with external factors and have substantial impact on the organizational culture. 5. There was a positive influence of training on participants’ knowledge, clinical outcomes, and safety climate factors. Additionally, the training was aligned with shared organizational values. However, it was evident from the low-to-moderate relationship between improvements in clinical knowledge (the focus of the training intervention) and the safety climate improvements that training alone was not sufficient to cause a climatic or cultural change. Results of the qualitative analysis were helpful in understanding the influence of MOREOB training on shared values, practices, leadership commitment, and use of feedback mechanisms. Thus, while training may improve the organizational climate, its impact on culture is dependent on its alignment with shared organizational values, leadership commitment, and appropriate use of feedback mechanisms (including alignment of incentives). The emergent model of culture and climate was revised to better represent the various mechanisms that influence organizational culture and climate. As a macro-level integrative model, it presents an alternate perspective compared to other models that generally tend to focus on specific elements like values or leadership. Future studies should consider different domains and different planned interventions in order to test the transferability of the proposed integrated model of culture and climate

The Psychosocial Work Environment, Employee Mental Health and Organizational Interventions: Improving Research and Practice by Taking a Multilevel Approach

Although there have been several calls for incorporating multiple levels of analysis in employee health and wellbeing research, studies examining the interplay between individual, workgroup, organizational and broader societal factors in relation to employee mental health outcomes remain an exception rather than the norm. At the same time, organizational intervention research and practice also tends to be limited by a single-level focus, omitting potentially important influences at multiple levels of analysis. The aims of this conceptual paper are to help progress our understanding of work-related determinants of employee mental health by: (i) providing a rationale for routine multilevel assessment of the psychosocial work environment; (ii) discussing how a multilevel perspective can improve related organizational interventions and (iii) highlighting key theoretical and methodological considerations relevant to these aims. We present five recommendations for future research, relating to using appropriate multilevel research designs, justifying group level constructs, developing group-level measures, expanding investigations to the organizational level, and developing multilevel approaches to intervention design, implementation and evaluation

Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

Abstract Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. Conclusion The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings.http://deepblue.lib.umich.edu/bitstream/2027.42/78272/1/1748-5908-4-50.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/2/1748-5908-4-50-S1.PDFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/3/1748-5908-4-50-S3.PDFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/4/1748-5908-4-50-S4.PDFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/5/1748-5908-4-50.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/6/1748-5908-4-50-S2.PDFPeer Reviewe

Mixed-method study of a conceptual model of evidence-based intervention sustainment across multiple public-sector service settings.

BackgroundThis study examines sustainment of an EBI implemented in 11 United States service systems across two states, and delivered in 87 counties. The aims are to 1) determine the impact of state and county policies and contracting on EBI provision and sustainment; 2) investigate the role of public, private, and academic relationships and collaboration in long-term EBI sustainment; 3) assess organizational and provider factors that affect EBI reach/penetration, fidelity, and organizational sustainment climate; and 4) integrate findings through a collaborative process involving the investigative team, consultants, and system and community-based organization (CBO) stakeholders in order to further develop and refine a conceptual model of sustainment to guide future research and provide a resource for service systems to prepare for sustainment as the ultimate goal of the implementation process.MethodsA mixed-method prospective and retrospective design will be used. Semi-structured individual and group interviews will be used to collect information regarding influences on EBI sustainment including policies, attitudes, and practices; organizational factors and external policies affecting model implementation; involvement of or collaboration with other stakeholders; and outer- and inner-contextual supports that facilitate ongoing EBI sustainment. Document review (e.g., legislation, executive orders, regulations, monitoring data, annual reports, agendas and meeting minutes) will be used to examine the roles of state, county, and local policies in EBI sustainment. Quantitative measures will be collected via administrative data and web surveys to assess EBI reach/penetration, staff turnover, EBI model fidelity, organizational culture and climate, work attitudes, implementation leadership, sustainment climate, attitudes toward EBIs, program sustainment, and level of institutionalization. Hierarchical linear modeling will be used for quantitative analyses. Qualitative analyses will be tailored to each of the qualitative methods (e.g., document review, interviews). Qualitative and quantitative approaches will be integrated through an inclusive process that values stakeholder perspectives.DiscussionThe study of sustainment is critical to capitalizing on and benefiting from the time and fiscal investments in EBI implementation. Sustainment is also critical to realizing broad public health impact of EBI implementation. The present study takes a comprehensive mixed-method approach to understanding sustainment and refining a conceptual model of sustainment

The organizational social context of mental health services and clinician attitudes toward evidence-based practice: a United States national study.

UnlabelledABSTBACKGROUND: Evidence-based practices have not been routinely adopted in community mental health organizations despite the support of scientific evidence and in some cases even legislative or regulatory action. We examined the association of clinician attitudes toward evidence-based practice with organizational culture, climate, and other characteristics in a nationally representative sample of mental health organizations in the United States.MethodsIn-person, group-administered surveys were conducted with a sample of 1,112 mental health service providers in a nationwide sample of 100 mental health service institutions in 26 states in the United States. The study examines these associations with a two-level Hierarchical Linear Modeling (HLM) analysis of responses to the Evidence-Based Practice Attitude Scale (EBPAS) at the individual clinician level as a function of the Organizational Social Context (OSC) measure at the organizational level, controlling for other organization and clinician characteristics.ResultsWe found that more proficient organizational cultures and more engaged and less stressful organizational climates were associated with positive clinician attitudes toward adopting evidence-based practice.ConclusionsThe findings suggest that organizational intervention strategies for improving the organizational social context of mental health services may contribute to the success of evidence-based practice dissemination and implementation efforts by influencing clinician attitudes