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

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)

Validation of a questionnaire on patient satisfaction with the dispensing service in community pharmacies

Este trabajo fue presentado en forma de póster en el XVII Congreso Farmacéutico Argentino, celebrado en Carlos Paz (Provincia de Córdoba) en octubre de 2006.Objetivo: Analizar la validez y fiabilidad de un cuestionario de satisfacción de pacientes con el servicio de dispensación en las farmacias comunitarias argentinas. Diseño: Descriptivo, de corte transversal. Emplazamiento: Farmacias comunitarias de Argentina que voluntariamente aceptaron participar en el estudio. Participantes: Todos los pacientes o sus cuidadores que concurrieron a las farmacias durante el período de estudio (marzo y abril de 2006) y que supieran leer y escribir. Mediciones principales: Puntuaciones de la escala de satisfacción del cuestionario. Resultados: Participaron 27 farmacias, pertenecientes a 6 provincias de Argentina. Se consiguieron 473 cuestionarios, con un porcentaje de respuesta del 72,4%. El análisis factorial reveló un único componente que explicaba el 54,8% de la varianza total. Se obtuvo un coeficiente alfa de Cronbach de 0,90 y la correlación de Pearson entre cada uno de los ítems y la puntuación total de la escala mostró que todos los ítems están correlacionados entre sí (p < 0,01). Los pacientes expresaron comentarios adicionales en 124 cuestionarios (26,2%) que se relacionaron con la calidad de la atención recibida y con otros aspectos, tales como agradecimiento, coste de los medicamentos, insuficiente stock y amabilidad. Conclusiones: El cuestionario mostró evidencias de la validez de contenido, validez como estructura interna, validez relacionada con otras variables y fiabilidad para valorar la satisfacción de los pacientes con el servicio de dispensación en las farmacias comunitarias argentinas.Objective: To analyze the validity and reliability of a patient satisfaction questionnaire about drug dispensing in Argentine community pharmacies. Design: Descriptive, cross-sectional study. Setting: Community pharmacies of Argentina that voluntarily agreed to take part in the study. Participants: All patients or their careers who attended the pharmacies during the period of the study (March and April, 2006) and knew how to read and write. Main measurements: Scores on the satisfaction scale of the questionnaire. Results: Twenty-seven pharmacies from 6 provinces of Argentina took part; 473 questionnaires were obtained with a 72.4% response rate. Factorial analysis revealed one single component that explained 54.8% of total variance. A 0.90 Cronbach's alpha coefficient was obtained and Pearson's correlation between each of the items and the total score on the scale showed that all items correlated with each other (P<.01). Patients expressed additional comments in 124 questionnaires (26.2%). These concerned the quality of care received and other aspects, such as gratitude, cost of medicines, insufficient stock, and friendliness. Conclusions: The questionnaire, in showing evidence of content validity, validity as internal structure, validity related to other variables, and reliability, could assess patient satisfaction with the drug dispensing service in the community pharmacies of Argentina

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

Stress and eustress in nursing students

Aim. This paper is a report of a study to identify experiences that led to both distress and eustress and to make recommendations to help students cope with course demands.Background. Much of the research on stress in nursing students is quantitative in focus and all draws on their experience of distress, with little attempt to understand experiences of eustress.Method. A series of focus groups were carried out with a volunteer sample of final year nursing students (n = 16) in the United Kingdom in 2007. The data were thematically analysed.Findings. The themes identified were clinical experience, support, learning and teaching experience and course structure. There were experiences within each that were perceived as sources of distress and eustress. Many of the sources of distress concur with earlier findings but they are more likely to be experienced and commented on because the demands of present-day programmes and the profile of many nursing students mean that more effort is invested in meeting educational demands. The experiential learning and patient-care opportunity that placements provided was an important source of eustress.Conclusion. Students who coped well drew on effective support networks and adopted a positive, optimistic perspective towards programme issues. Effective educators did not offer more time than those perceived as less effective but seemed more effective at tuning into students' concerns, showing more empathy and offering clearer guidance.</p

Instrumento de medida de carga de trabalho dos profissionais de Saúde na Atenção Primária: desenvolvimento e validação

RESUMO Objetivo Propor e validar um instrumento que contemple as intervenções/atividades realizadas pela equipe de saúde da família, como referência para o planejamento da força de trabalho. Método Pesquisa metodológica desenvolvida nas etapas: construção do instrumento; validação de conteúdo e teste piloto, em três unidades, localizadas na região sudeste do Brasil. Resultados Foram validadas 39 intervenções em um único instrumento de medida de carga de trabalho para médico, cirurgião-dentista, técnico/auxiliar de saúde bucal, enfermeiro, técnico/auxiliar de enfermagem e agente comunitário de saúde. No teste piloto, o instrumento contemplou 100% das intervenções observadas, atingindo 93,7% de concordância entre os observadores. Conclusão O instrumento proposto, inédito na sua configuração, subsidia o planejamento da força de trabalho em atenção primária