Structural and psychological empowerment of students obtaining continuing leadership education in Finland:a national survey

Abstract Background: In nursing, empowerment may be deemed one’s potential to gain power, achieve goals and promote one’s skills to advance positive changes in the working environment, or decentralization of authority. Empowerment is associated with nurse’’ and nurse leaders’ satisfaction, performance and organizational commitment, as well as burnout, emotional exhaustion and intentions to leave the profession. Research on nurse empowerment in relation to continuing education is sparse. Objectives: This study describes the structural and psychological empowerment levels of students beginning a collaboratively implemented continuing leadership education program. Design: Cross-sectional electronic survey. Settings: National, continuing nursing leadership education program (37 ECT) organized by five universities that provide masters level education to nurse leaders in Finland. Participants: Students (N = 85) working at nine healthcare organizations across the service system as current or prospective nurse leaders and enrolled in the continuing leadership education program. Methods: The Conditions of Work Effectiveness Questionnaire and the Work Empowerment Questionnaire were each used to measure structural and psychological empowerment, respectively. The data were collected between October 2019 and February 2020. Results: A total of 69 students participated (response rate 81%). Moderate levels of both structural and psychological empowerment were observed. In structural empowerment, the strongest dimension was access to opportunity (4.1, SD 0.7), whereas access to support was the weakest (2.7, SD 0.7). The strongest psychological empowerment dimension was verbal empowerment (8.5, SD 1.9) and the weakest was outcome empowerment (7.0, SD 1.6). Conclusions: Nurses and nurse leaders seem to lack the status and power required to impact their organizations, possibly causing them to apply for nursing leadership education. Nurse leaders should be given opportunities for continuing leadership education to improve empowerment and, as a result, staff outcomes

Hoitotyön johtamisen tehtävänkuvat ja johtamisosaaminen jatkuvan oppimisen opintokokonaisuuteen osallistuvilla opiskelijoilla

Tiivistelmä Tulevaisuuden muutokset sote-alalla edellyttävät hoitotyön johtajilta uudistuvaa ja vahvaa johtamisosaamista sekä jatkuvaa oppimista. Tutkimuksen tarkoituksena oli kuvata hoitotyön johtamisen jatkuvan oppimisen opintokokonaisuudessa opiskelevien tehtävänkuvia sekä johtamisosaamista. Tutkimukseen osallistui hoitotyön johtajina toimivia tai tulevaisuudessa hoitotyön johtamistehtäviin suuntaavia hoitotyöntekijöitä (N=69). Aineisto kerättiin kyselyllä 10/2019–02/2020 ja analysoitiin tilastollisesti. Enemmistö vastaajista oli naisia ja toimi hoitotyön johtotehtävissä. Tehtävänkuvissa painottuivat henkilöstövoimavarojen suunnittelu ja johtaminen. Vähemmän niissä ilmeni strategista johtamista ja toiminnan kehittämistä, talouden johtamista sekä yhteistyötä ulkoisten sidosryhmien kanssa. Johtamisosaamisessa painottuivat hoitotyö ja sen kehittäminen sekä viestintä ja yhteistyö. Johtamisosaaminen arvioitiin heikoimmiksi talouden johtamiseen sekä palveluiden suunnitteluun ja markkinointiin liittyen. Jatkuvan oppimisen kehittämistyössä tulisi huomioida talouden johtamiseen, palvelujen suunnitteluun ja markkinointiin sekä strategiseen kumppanuuteen liittyviä teemoja. Jatkuvan oppimisen tulisi olla joustavaa sekä opiskelijoiden lähtökohtia ja aiempaa ammatillista osaamista tukevaa.Abstract Work descriptions and leadership skills of students participating in continuing education in the social- and healthcare sector The future changes in social- and health care require renewing and strong leadership skills as well as continuous learning from the health care leaders. The aim of this study was to describe the work descriptions and leadership skills of students’ participating in continuing education. Participating students (n=69) worked as leaders in health care sector or aimed to become a leader in the future. The data was collected by a questionnaire between 10/2019 and 02/2020 and analyzed statistically. Majority of the participants were women and worked as a nursing leader. The planning and management of human resources were emphasized in the participants’ work descriptions. The strategic leadership as well as development of the operations, financial management and collaboration with the external stakeholders had lower emphasis in participants work descriptions. Strongest leadership skills were reported in clinical care and its development as well as communication and collaboration. Participants considered their skills to be weakest in financial management. Further weakness was reported by participants in service planning and marketing. Based on the results, the content of future leadership educations should include themes of financial management and strategical change management in collaboration with external stakeholders

Heme oxygenase-1 repeat polymorphism in septic acute kidney injury

Abstract Acute kidney injury (AKI) is a syndrome that frequently affects the critically ill. Recently, an increased number of dinucleotide repeats in the HMOX1 gene were reported to associate with development of AKI in cardiac surgery. We aimed to test the replicability of this finding in a Finnish cohort of critically ill septic patients. This multicenter study was part of the national FINNAKI study. We genotyped 300 patients with severe AKI (KDIGO 2 or 3) and 353 controls without AKI (KDIGO 0) for the guanine–thymine (GTn) repeat in the promoter region of the HMOX1 gene. The allele calling was based on the number of repeats, the cut off being 27 repeats in the S–L (short to long) classification, and 27 and 34 repeats for the S–M–L₂ (short to medium to very long) classification. The plasma concentrations of heme oxygenase-1 (HO-1) enzyme were measured on admission. The allele distribution in our patients was similar to that published previously, with peaks at 23 and 30 repeats. The S-allele increases AKI risk. An adjusted OR was 1.30 for each S-allele in an additive genetic model (95% CI 1.01–1.66; p = 0.041). Alleles with a repeat number greater than 34 were significantly associated with lower HO-1 concentration (p<0.001). In septic patients, we report an association between a short repeat in HMOX1 and AKI risk