Staff Nurse Perceptions of the Magnet Journey: Implications for Nurse Leaders

Purpose: The purpose of this qualitative study\u27was to develop a broader understanding of organizational changes that occur during the time leading up to the American Nurses Credentialing Center\u27s Magnet designation. The specific aims of this study were to compile a rich description of the phenomenon \u27Magnet Journey\u27 in a group of registered nurses in clinical settings who provide direct patient care with regards to: the factors that influence quality of care the factors that influence cultural transformation the factors that influence interdisciplinary collaboration Methods: Focus groups were conducted at recently designated Magnet hospitals in Southern California. Participants were consented, asked to complete a demographic form and their responses to a series of questions about the Magnet Journey were digitally recorded. Data were transcribed and reviewed, coded, and themed by the research team. Results: Subjects were registered nurses who had been employed in a staff nurse position during the 2-3 years prior to Magnet designation. The 58 subjects represented all work areas, specialties, and sites within the hospitals. Key themes emerged consistent with components of the Magnet model and examples include: transformational leadership \u27exemplary relationships with the Chief Nursing Officer and direct supervisor; structural empowerment\u27 participation in councils and access to professional development activities; exemplary professional practice \u27enhanced interdisciplinary relationships and autonomy; and new knowledge, innovations, and improvements\u27 new research and innovative practice. Overall staff nurses emphasized the positive impact of Magnet designation on all stakeholders. A surprising finding was staff nurse concern about what occurred during the post-designation period, describing a \u27slippage\u27 of the practice and environmental supports and interactions. Conclusion: Results from this study offer guidance for nurses leading the Magnet Journey (Chief Nursing Officers, Magnet Project Directors, advanced practice nurses, managers, and staff nurses) about maintaining nurse engagement in the post designation period

A Model of Registered Nurse Intent to Stay in Southern California Childrens\u27 Hospitals

The purpose of this study was to examine the interrelationships of professional image, organizational climate or domains thereof, professional commitment, organizational commitment, position satisfaction, and the influence of these variables on intent to stay employed. The path analytic model of intent to stay was temporally ordered and proposed that professional image and organizational climate affect intent to stay through professional commitment, organizational commitment, and position satisfaction. Subjects (n = 232) were both male and female registered nurses who worked per diem, part-time, or full-time on all shifts. They held clinical positions, delivered direct care, and had been employed in one of three Southern California Childrens\u27 Hospitals for a minimum of 6 months. Professional image had inadequate predictive validity with the outcome variable, intent to stay, and was deleted from the model. The predictor variables explained 16% of the variance in intent to stay. Position satisfaction had 57% explained variance, with 34% variance explained for organizational commitment and less than 1% for professional commitment. Organizational commitment was the strongest predictor of intent to stay. Post hoc analysis for hospital differences revealed that predictor variables accounted for 16% of explained variance in intent to stay for Hospital 1, 23% for Hospital 2, and 21% for Hospital 3. Content analysis of qualitative data regarding reasons to stay validated findings from quantitative measures

Challenges relating to the inter-facility transport of high acuity paediatric cases

Abstract: Introduction: The motivation for this study came from anecdotal reports and observations that there was a potential need for improvement to the systems that support inter-facility transfers of high acuity paediatric cases between referring and receiving facilities in Johannesburg, South Africa. In this exploratory study, we formally document and describe challenges being experienced by members of the healthcare team in facilitating the interfacility transport of high acuity paediatric cases. Methods: A qualitative, explorative design was applied, making use of interviews with purposefully-identified role players involved in paediatric transportation and care. Verbatim transcripts from audio recorded interviews underwent content analysis to allow for the identification of common categories. Results: Participants described a number of challenges, which included time delays, lack of qualified ambulance personnel, poor communication between role players, and lack of appropriate equipment. Discussion: There are significant challenges experienced by members of the healthcare team with regard to interfacility transport of high acuity paediatric and neonatal cases in Johannesburg, South Africa. Whilst we acknowledge the African context and resource constrained setting, health systems managers need to explore the feasibility of establishing dedicated and suitably resourced retrieval teams who specialise in the transfer of high acuity paediatric and neonatal patients in order to improve quality of care and overall patient outcomes in this population

Excellence in Clinical Practice [Complete issue - digital origin : Fourth quarter 2002, vol. 3, 4]

Publishing History: Nursing Excellence published yearly in 1998 and 1999. The publication became Excellence in the first quarter 2000. It transitioned to Excellence in Nursing Education, Excellence in Nursing Administration, and Excellence in Clinical Practice in the second quarter 2000 with volume 1, number 2. Excellence in Nursing Education transitioned to Excellence in Nursing Education & Research in the first quarter 2002. Publishing Frequency: Yearly 1998, 1999; Quarterly 2000 - 2004. Format: Print 1999 - third quarter 2002; Online fourth quarter 2002 - first quarter 2004. Ceased publishing in 2004. Select features in this issue: A partnership model of nursing education to prepare critical care nurses, by Diane M. Billings, Pamela Jeffries, Connie J. Rowles, Cynthia Stone and Linda Urde

A description of work processes used by clinical nurse specialists (CNS) to improve patient outcomes

This study identified processes used by CNs working in different settings to improve clinical outcomes. Findings demonstrated that CNS practice is situational and contextual; processes used to gain trust, solve problems, and communicate with other disciplines, when done well, are highly effective and often invisible

Stressors in nurses working in Intensive Care Units

This is a descriptive cross-sectional study. The sample consisted of 235 nurses from two intensive care units in Porto (Portugal). The purpose of this study was to identify stressors for nurses working in intensive care units. The data was collected using the following: i) a questionnaire (for socio-demographic variables, physical aspects of work and variables related to the work context; ii) Interpersonal Work Relations Scale; iii) Nurse Stress Index. Nurses in the early phase of their career have higher stress levels ( = 81). An inadequate physical work structure leads to higher stress levels (X = 83). The worse the interpersonal relations are, the higher stress levels nurses feel (Spearman correlation coefficient =-0.331). Nurses who have a bad relationship with their work superiors view the dimension "Support and Organizational Involvement" as a stressor (Student's t test, pSe trata de un estudio de tipo descriptivo y transversal, en total la muestra fue constituida con 235 enfermeros pertenecientes a dos unidades de terapia intensiva de la ciudad del Porto (Portugal), con el objetivo de conocer algunos factores generadores de estrés de enfermeros que trabajan en unidades de terapia intensiva. En la recolección de datos se utilizó: 1) un cuestionario de auto llenado (para las variables sociodemográficas, para los aspectos físicos del servicio y para las variables relacionadas con el contexto de trabajo); 2) la Escala de las Relaciones Interpersonales en el Trabajo; y 3) la Nurse Stress Índex. Se identificó que los enfermeros en inicio de carrera tiene niveles de estrés más elevados ( o = 81); que una estructura física inadecuada conduce a niveles de estrés más elevados (X=83); que cuanto peor es la relación interpersonal, mayores son los niveles de estrés (Coeficiente de correlación de Spearman =-0,331); que los enfermeros que establecen una mala relación con los jefes perciben la dimensión "Apoyo y envolvimiento organizacional" como fuente generadora de estrés (t-Student, pTrata-se de estudo do tipo descritivo e transversal, englobando amostra com 235 enfermeiros, pertencentes a duas unidades de terapia intensiva da cidade do Porto, Portugal, e teve como objetivo conhecer alguns fatores geradores de estresse em enfermeiros que trabalham em unidades de terapia intensiva. Na recolha de dados, utilizou-se: i) questionário de autopreenchimento (para as variáveis sociodemográficas, para os aspectos físicos do serviço e para as variáveis relacionadas ao contexto de trabalho); ii) a escala das relações interpessoais no trabalho e iii) a nurse stress index. Pelos resultados, observa-se que enfermeiros, em início de carreira, têm níveis de estresse mais elevados ( ou = 81); estrutura física não adequada conduz a níveis de estresse mais elevados (X=83); quanto pior é a relação interpessoal maiores são os níveis de estresse (coeficiente de correlação de Spearman=-0,331). Os enfermeiros que estabelecem má relação com as chefias percepcionam a dimensão apoio e envolvimento organizacional como fonte geradora de estresse (teste t de Student, p<0,001)

Hospital services for ill patients in the middle-belt geopolitical zone, Nigeria: Patient’s waiting time and level of satisfaction

An important parameter in the assessment of quality healthcare lies on patient satisfaction. Despite concerted efforts to improve health care services, patient satisfaction couple with the quality of hospital care at disposal remains a significant challenge in Nigeria. The purpose of the study was to determine the perception on factors associated with prolonged waiting time and patient satisfaction at the outpatient department of Ibrahim Badamasi Babangida Specialist Hospital in Nigeria. A mixed method research was utilised. Questionnaire was administered on 95 outpatients along with a focus group discussion (FGD) was held with 8 participants. Statistical analysis was utilized to determine the association between dependent and independent variables. Data from focus group discussion was analysed with NVivo 10. The overall hospital satisfaction was found to be 75.8% among the study population. There was a significant inverse relationship between the level of satisfaction with the doctor and (employment status, and educational level) and direct relationship with (appointment status and type of visits). In FDG, the result shows that patients were satisfied with the neatness of the hospital, doctor’s professionalism and patient-doctor relationship. Dissatisfaction was with extended patient waiting time and the small size infrastructure of the hospital, inefficient handling of patient files by nurse aids and thoroughness of the physicians. The results showed that majority of the patients were dissatisfied with the waiting time for consultation in the hospital. In other words, consultation time positively correlated with the level of patient satisfaction. To improve the overall patient satisfaction the waiting time for consultation should be reduced significantly