Linking the Practice Environment to Nurses' Job Satisfaction Through Nurse-Physician Communication

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74776/1/j.1547-5069.2005.00063.x.pd

Systematic Review of Medicine-Related Problems in Adult Patients with Atrial Fibrillation on Direct Oral Anticoagulants

New oral anticoagulant agents continue to emerge on the market and their safety requires assessment to provide evidence of their suitability for clinical use. There-fore, we searched standard databases to summarize the English language literature on medicine-related problems (MRPs) of direct oral anticoagulants DOACs (dabigtran, rivaroxban, apixban, and edoxban) in the treatment of adults with atri-al fibrillation. Electronic databases including Medline, Embase, International Pharmaceutical Abstract (IPA), Scopus, CINAHL, the Web of Science and Cochrane were searched from 2008 through 2016 for original articles. Studies pub-lished in English reporting MRPs of DOACs in adult patients with AF were in-cluded. Seventeen studies were identified using standardized protocols, and two reviewers serially abstracted data from each article. Most articles were inconclusive on major safety end points including major bleeding. Data on major safety end points were combined with efficacy. Most studies inconsistently reported adverse drug reactions and not adverse events or medication error, and no definitions were consistent across studies. Some harmful drug effects were not assessed in studies and may have been overlooked. Little evidence is provided on MRPs of DOACs in patients with AF and, therefore, further studies are needed to establish the safety of DOACs in real-life clinical practice

Role development in health care assistants: the impact of education on practice

Rationale Health care provision has moved towards an approach to patient care that challenges the traditional role boundaries of health care workers. In nursing this has resulted in the delegation of 'nursing care' to health care assistants (HCAs). This study sought to evaluate the impact of a HCA Development Programme on care delivery. Secondly, it sought to understand the preparedness of HCAs to undertake the programme and the new roles set for them. Methodology The research method was a qualitative, inductive approach. For part one, data were gathered using a 360-degree approach. Semi-structured interviews were conducted with four HCAs, eight of each of their colleagues and four patients. For part two, 12 HCAs were interviewed. Data were analysed following the principles of thematic analysis. Findings The findings for part one showed positive changes to the HCAs' role, which included skill and knowledge development, increased confidence and initiative and a more holistic approach to care. A range of personal and contextual factors including relationships, hierarchy, staffing, experience, responsibility, patient dependency, attitudes and values affected the development of their role. The HCAs in part two voiced positive and negative views of their role development. Of the 12 HCAs interviewed, eight were prepared to attend the programme, two were undecided, and two were reluctant to attend. Conclusions The findings indicated that while the HCA Development Programme positively influenced the role of the HCA, there was a need to invest more into preparation for the restructuring of roles

Education as a determinant of career retention and job satisfaction among registered nurses

Purpose: To compare job satisfaction and career retention in two cohorts of RNs, those whose highest degrees were the associate degree (AD) or the bachelor\u27s degree (BS) in nursing. Design: Survey. Methods: Instruments included a career satisfaction scale and questions based on the ongoing U.S. Health and Retirement Survey. Three-thousand nurses in the U.S. state of Vermont were surveyed with a resulting response rate of 56.7%. Of these respondents, 878 RNs fit the study criteria. Findings: BS RNs started their nursing careers earlier, were employed longer, had held more positions, and in the largest age cohort (age 40-54), ivere more likely to have been in their current positions at least 10 years. BS RNs scored significantly higher in job satisfaction related to: (a) opportunity for autonomy and growth, (b) job stress and physical demands, and (c) job and organizational security. AD and BS nurses were not significantly different in their satisfaction with supervision; career, continuing education, and promotion opportunities; or pay and benefits. Conclusions: These findings indicate support of bachelor\u27s level education for individual and social return on investment, and they show that AD education might have unintended consequences. Implications for the nursing shortage and educational policy are discussed. ©2005 Sigma Theta Tau International