Organizational configuration of hospitals succeeding in attracting and retaining nurses

Organizational configuration of hospitals succeeding in attracting and retaining nurses. This paper contrasts structural and managerial characteristics of low- and high-turnover hospitals, and describes the organizational configuration of attractive hospitals. In countries facing nurse shortages and turnover, some hospitals succeed in recruiting and retaining nurses. In Magnet Hospitals, managerial practices and environmental characteristics increase nurses\u2019 job satisfaction and their commitment to the organization, which in turn decreases nurse turnover. Such an approach suggests that organizations are best understood as clusters of interconnected structures and practices, i.e. organizational configurations rather than entities whose components can be understood in isolation. From a sample of 12 hospitals whose nurse turnover was studied for 1 year, structural and organizational features of hospitals in the first and fourth quartiles, i.e. attractive (turnover11\uc68%) were contrasted. A questionnaire, including perceptions of health-related factors, job demands, stressors, work schedules, organizational climate, and work adjustments antecedent to turnover, was received from 401 nurses working in attractive hospitals (response rate - 53\uc68%) and 774 nurses in conventional hospitals (response rate \ubc 54\uc65%). Structural characteristics did not differentiate attractive and conventional hospitals, but employee perceptions towards the organization differed strikingly. Differences were observed for risk exposure, emotional demands, role ambiguity and conflicts, work-family conflicts, effort-reward imbalance and the meaning of work, all in favour of attractive hospitals (P < 0.01). Relationships with nursing management, work ability and satisfaction with working time, handover shifts and schedules were also better in attractive hospitals (P < 0.001). Job satisfaction and commitment were higher in attractive hospitals, whereas burnout and intention to leave were lower (P < 0.001). Organizational characteristics are key factors in nurse attraction and retention. Nurses face difficulties in their work situations, but some hospitals are perceived as healthy organizations. The concept of attractive institutions could serve as a catalyst for improvement in nurses\u2019 work environments in Europe

Interactions entre qualité et facteurs humains dans les soins. Facteurs liés à la crainte des erreurs parmi les infirmiers

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Traditional beliefs, illness and health among the Motuan people of Papua New Guinea

BACKGROUND: Recent research suggests that violence in health care is increasing and that it strongly influences the recruitment and retention of nurses as well as sick leave and burnout levels. AIMS: To identify the prevalence of violence in nursing and to provide a basis for appropriate interventions. METHODS: Nurses from 10 European countries answered to a questionnaire and to a follow-up assessment. Stepwise adjusted multiple logistic regression was used to assess the association between frequency of violence, factors related to teamwork and other work-related factors and outcomes, such as burnout, intention to leave nursing and intention to change institution. RESULTS: A total of 39,894 nurses responded to the baseline questionnaire (51% response rate). After adjustment for age, gender and other risk factors, quality of teamwork appeared to be a major factor with odds ratio (OR) 1.35 (1.24-1.48) for medium quality and 1.52 (1.33-1.74) for low quality. Uncertainty regarding patients' treatments was linked with violence, with a clear gradient (OR 1.59, 1.47-1.72 for medium uncertainty and 2.13, 1.88-2.41 for high uncertainty). Working only night shift was at high risk (OR 2.17, 1.76-2.67). High levels of time pressure and physical load were associated with violence OR 1.45 (1.24-1.69) and 1.84 (1.66-2.04), respectively. High and medium frequency of violence was associated with higher levels of burnout, intent to leave nursing and intent to change institution. A 1-year follow-up assessment indicated stability in the relationships between outcomes. CONCLUSION: This study supports efforts aimed at improving teamwork-related factors as they are associated with a decrease in violence against nurses

The impact of social work environment, teamwork characteristics, burnout, and personal factors upon intent to leave among European nurses

Contains fulltext : 138775.pdf (publisher's version ) (Closed access)- Objectives -Europe's nursing shortage calls for more effective ways to recruit and retain nurses. This contribution aims to clarify whether and how social work environment, teamwork characteristics, burnout, and personal factors are associated with nurses' intent to leave (ITL). - Methods - Our sample comprises 28,561 hospital-based nurses from 10 European countries. Different occupational levels have been taken into account: qualified registered nurses (n = 18,594), specialized nurses (n = 3957), head nurses (n = 3256), and nursing aides and ancillary staff (n = 2754). - Results - Our outcomes indicate that ITL is quite prevalent across Europe, although we have found some differences across the countries depending on working conditions and economic situation. Quality of teamwork, interpersonal relationships, career development possibilities, uncertainty regarding treatment, and influence at work are associated with nurses' decision to leave the profession across Europe, notwithstanding some country-specific outcomes. A serious lack of quality of teamwork seems to be associated with a 5-fold risk of ITL in 7 countries. As far as personal factors are concerned, our data support the hypothesized importance of work–family conflicts, satisfaction with pay, and burnout. A high burnout score seems to be associated with 3 times the risk of ITL in 5 countries. - Conclusions - To prevent premature leaving, it is important to expand nurses' expertise, to improve working processes through collaboration and multidisciplinary teamwork, and to develop team training approaches and ward design facilitating teamwork.12 p

Factors associated with violence against healthcare workers : results of the European Presst-Next study

The respective roles of medical specialties and work organization on violent events against healthcare workers (HCW) in different countries was examined. Using the results of the Presst-Next study, we analyzed data from 27134 HCW in 7 European countries. Multivariate logistic analyses were conducted with SPSS 12 software. After adjustment for age, gender and other occupational risk factors, the factors indicating insufficient team work were highly associated with an increased risk of violent events. Dissatisfaction with shift change (OR=1.35; 95%CI 1.23-1.47), uncertainty about treatment (OR=1.57; 95%CI 1 .44-1.71), and frequent interruptions (OR=2.04; 95%CI 1.81-2.31) were linked to violent events, up to twice the number among HCW reporting better team work. Contradictory orders, dissatisfaction with psychological support, and harassment by superiors were all significantly associated with increased reporting of frequent violent events. We observed a positive gradient between violent events and job demand (time pressure) (OR=1.25 for an intermediate score and OR=1.55 for a high score, compared with a low score). Loneliness at work, certain work schedules, and physical load increased the risk. Nurses' aides were exposed to violent events more often (OR=1.57; 95%CI 1.38-1.79) than head nurses. Older HCW and those with more experience were less exposed. The highest risks were associated with working in psychiatric (OR=4.89; 95%CI 3.82-6.25) and emergency (OR=2.68; 95%CI 2.10-3.44) departments, compared with home care and day care. The excess risk was an additional 30% in geriatrics and long-stay departments. Significantly less risk was observed in pediatrics, obstetrics and gynecology departments (OR=0.70; 95%CI 0.56-0.88). Team building requires time, and shift change is a key period. This time is far from nonproductive. Rather, its effective use reduces treatment errors, enhances quality of care, and reduces the frequency of violent events. It is crucial in every department

Interactions entre qualit\ue9 et facteurs humains dans les soins: facteurs lies \ue0 la crainte des erreurs parmi les infermiers

L\u2019analyse de la crainte des erreurs parmi 28 517 infirmiers et infirmiers sp\ue9cialis\ue9s europ\ue9ens a montr\ue9 que la formation continue de quelques jours par an ne peut suffire. La comp\ue9tence acquise par la sp\ue9cialisation et l\u2019enrichissement continu au sein d\u2019une \ue9quipe stable avec des temps d\u2019\ue9changes sont d\ue9terminants pour r\ue9duire l\u2019anxi\ue9t\ue9 concernant les aspects techniques et relationnels des soins. Les interruptions sont alors moindres et la pression temporelle r\ue9duite, permettant ainsi une meilleure prise en charge du patient

Promotion of work ability among French health care workers: value of the work ability index

The French HCWs who have been studied belong to the French sample of European NEXT Study. This sample consists of 55 public and private institutions in five regions. WAI has been calculated on 4306 subjects out of 5376 because of missing data. More than a third have a moderate or a poor index (29.4% and 5.2%, respectively). Half (50.6%) of the sample have a good index and only 14.9%, an excellent one. The WAI decreases with age: 19.4% of the "less than 30", 14.6% of the 30-44 years old and 12.3% of the 45 + have an excellent WAI. But, the rate of decrease depends definitely on job demands and especially on physical load. The multivariate analysis showed that in France as well as in the other countries, work demand, uncertainty about treatments, low support from colleagues, and dissatisfaction with psychological support had high odds ratios for a low WAI. Dissatisfaction with physical working conditions and the necessity to maintain uncomfortable postures were the second group of factors with a strong influence on a low WAI. The absence of time for sports or leisure remained strongly linked with a low WAI after an adjustment to the other risk factors. The WAI enables the workplace physician to summarize data which the hospital can use to further its thinking about how to manage jobs and skills

Nurses'work schedules, work content, and well-being in seven European countries: comparative study within the NEXT project

Recent technological developments (e.g. PET) have given us insight into the brain mechanisms of cognitive processes, i.a. attention. The attention system has a basis of neural networks with a different location for separate subsystems i.e. orienting, detective-executive and vigilance attention networks. Their complex interplay is responsible for the proper functioning of attention governing all cognitive processes from perception to decision making and execution. Driving a vehicle imposes especially high demands on the attention system. Variable road conditions might expose this system to entirely different demands. Monotonous driving on a highway and intense town traffic are typical examples. Additionally the time of day factor complicates the issue. The visual field undergoes specific changes as result of attention functioning. Stressful situations resulting in domination of the executive attention subsystem may cause narrowing of the visual field (tunnel vision). This in turn may lead to danger due to our omitting important information appearing in the peripheral part of the visual field. The examples presented below allow us to conclude that driving a car exposes the attention system to tasks surpassing its capabilities, are phylogenetically adjusted to the natural speed of changes in natural environment conditions. The scale and importance of the problem make it one of the most important challenges for contemporary ergonomics