1. |
- Friberg, Febe, 1950, et al.
(author)
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Nurses’ patient-education work : conditional factors - an integrative review.
- 2012
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In: Journal of Nursing Management. - : Wiley-Blackwell Publishing Ltd.. - 0966-0429 .- 1365-2834 .- 1365-263X. ; 20:2, s. 170-186
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Journal article (peer-reviewed)abstract
- AIM: The aim of this review was to identify conditional factors for nurses' patient-education work and to identify foundational aspects of significance when designing studies on this patient-education work. BACKGROUND: A few reviews of nurses patient education work exist, published up to 30 years ago, spawning interest in performing a review of more recent studies. EVALUATION: A search of CINAHL, MEDLINE and ERIC was made for articles dating from 1998 to 2011. Thirty-two articles were selected and an integrative review was performed. KEY ISSUES: Conditional factors were identified and beliefs and knowledge, environment, organization, interdisciplinary cooperation, collegial teamwork and patient education activities. A model was developed to describe foundational aspects of significance when designing studies. CONCLUSIONS: The conditional factors are to be seen as either enabling or hindering the accomplishment of evidence-based patient education and the level of person centredness, patient safe care and ethics - something that has to be considered when designing studies. IMPLICATIONS FOR NURSING MANAGEMENT: More detailed studies are required to clarify the nature of patient education work and to create realistic conditions that enable the role to be fulfilled in everyday work. Such knowledge is of significance for nursing management in developing supportive activities for nurses.
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2. |
- Bergh, Anne-Louise, et al.
(author)
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Registered nurses' perceptions of conditions for patient education - focusing on organisational, environmental and professional cooperation aspects
- 2012
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 20:6, s. 758-770
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Journal article (peer-reviewed)abstract
- Aim To describe nurses' perceptions of conditions for patient education, focusing on organisational, environmental and professional cooperation aspects, and to determine any differences between primary, municipal and hospital care. Background Although patient education is an important part of daily nursing practice, the conditions for this work are unclear and require clarification. Method A stratified random sample of 701 (83%) nurses working in primary, municipal and hospital care completed a 60-item questionnaire. The study is part of a larger project. The study items relating to organisation, environment and professional cooperation were analysed using descriptive statistics, non-parametric tests and content analysis. Results Conditions for patient education differ. Nurses in primary care had better conditions and more managerial support, for example in the allocation of undisturbed time. Conclusions Conditions related to organisation, environment and cooperation need to be developed further. In this process, managerial support is important, and nurses must ask for better conditions in order to carry through patient education. Implications for nursing management Managerial support for the development of visible patient education routines (e.g. allocation of time, place and guidelines) is required. One recommendation is to designate a person to oversee educational work.
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3. |
- Dychawy-Rosner, I, et al.
(author)
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Direct care staff's need for support in their perceived work role in day activities units
- 2000
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In: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 8:1, s. 39-48
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Journal article (peer-reviewed)abstract
- AIMS: This study sets out to investigate direct care staff's views of their need for support, supervision, and training in their practice in day care settings when supporting daily occupations among developmentally disabled persons. BACKGROUND: The first line staff are considered as having a prominent role in the successful delivery of service. METHODS: Three municipalities, one urban and two rural areas in southern Sweden, were chosen for the study. The studied population n = 81 consisted of 94.1% of all staff employed in day activities units supporting the clients' daily occupations or community-integrated, sheltered work employment. The data were collected by means of a questionnaire. FINDINGS: This material identified the staff's perceived work role, and their needs for support, supervision, and training in the areas of communication, environment adaptation, individual activation and training methods, with regard to learning disabilities and special needs. CONCLUSIONS: Care managers should focus upon preparation of staff support programmes to improve the quality and efficiency in this area of care.
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4. |
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5. |
- Ivarsson, Bodil, et al.
(author)
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Patient reactions to cancelled or postponed heart operations.
- 2002
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In: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 10:2, s. 75-81
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Journal article (peer-reviewed)abstract
- Objectives The aim was to survey the rate and cause of cancellations of planned cardiac operations at a Swedish clinic during 1999, and to study how the patients were affected. Design Questionnaires were distributed to 74 patients who had their operations cancelled. Their mood after discharge was measured with The Hospital Anxiety and Depression scale. Ninety-three patients, who were operated on without postponement, served as controls. Results Sixty-one percent of the patients in the cancellation group reacted negatively, especially if the reason for cancellation was organizational (P = 0.03). The women in the cancellation group had a significantly higher degree of depression than men (P = 0.01) and both women (P = 0.02) and men (P = 0.003) in the control group. Most of the patients, however, were satisfied with the nursing staff's reception and information. Conclusions The patients reacted negatively to the cancellation, especially if it had organizational reasons. Women subjected to cancellation had a significantly higher degree of depression than other patients. To be avoided, organizational and medical problems must be identified in time. One way to do this is to introduce a preadmission nurse clinic.
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6. |
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7. |
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8. |
- Levenstam, Anna-Karin, et al.
(author)
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Changes in patients' need of nursing care reflected in the Zebra system.
- 2002
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In: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 10:4, s. 191-199
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Journal article (peer-reviewed)abstract
- During 1995-97, many head nurses stated that they had perceived an increase in patients' need of nursing care. A questionnaire was designed to determine the reasons for this. The purpose of the investigation was to answer two questions, 'What were the reasons for head nurses perception of an increase in patients need of nursing care from 1995 to May 1997?' and, 'Does patient classification in the Zebra system reflect the underlying changes in patients' need of nursing care? The results show that there are several reasons behind changes in the patients need of nursing care. The main reasons are a decreased general level of health among patients and that treatments are more time-consuming. After comparing statistics concerning patient classification with the answers received from the questionnaire, a good level of agreement could be seen in these.
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9. |
- Lindholm, M, et al.
(author)
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Management from four different perspectives
- 1999
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In: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 7:2, s. 101-111
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Journal article (peer-reviewed)abstract
- AIM: This study intended to illuminate nursing management in a developing organization from the perspectives of nurse managers, chief physicians, hospital directors and politicians. BACKGROUND: Increased responsibility in a changing health care system makes it important that nurses occupy advantageous positions so that they may safeguard and facilitate the development of their core area. METHODS: Open-ended taped interviews were conducted with 15 nurse managers, 11 chief physicians, three hospital directors and three politicians from three Swedish cities. FINDINGS: The main theme found was power and three dependent themes were identified as; power within activities, being in power and freedom to act. CONCLUSION: The four professional groups related their opinion of nursing management to the needs and interests of their own group. Acceptance or nonacceptance between the groups was discussed in terms of the concept of knowledge, which was interpreted as being a more acceptable topic for discussion than the phenomenon of power.
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10. |
- Nilsson, Petra, 1980-, et al.
(author)
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How to make a workplace health promotion questionnaire process applicable, meaningful, and sustainable
- 2011
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In: Journal of Nursing Management. - : Wiley-Blackwell. - 0966-0429 .- 1365-2834. ; 19:7, s. 906-914
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Journal article (peer-reviewed)abstract
- Background In workplace health promotion, a questionnaire could be of great use. Unfortunately, fatigue regarding answering questionnaires has recently become greater than before. An action research approach could be a possible way of increasing employee participation.Aim This study reports an attempt to explore key aspects for participation in, and commitment to, a workplace health promotion questionnaire process.Method The study was conducted at two wards in a Swedish hospital. Data was collected during an action research process. Data were analysed with regard to a framework of questions.Findings The three key aspects for participation in, and commitment to, a workplace health promotion questionnaire process were: an applicable questionnaire, a meaningful questionnaire process and a continuous and sustainable questionnaire process. A structure is presented as practical advice to managers, describing how such a process could be established to be applicable, meaningful and sustainable.Conclusion This study has identified key aspects and prerequisites for questionnaire processes. The prerequisites – share decision-making, involve a core group and follow a structure – are discussed and proposed for managers and workgroups to consider in further workplace health promotion questionnaire processes.Implications for nursing management The key aspects and prerequisites presented could provide a stimulating standpoint or advice, useful for planning and accomplishing workplace questionnaire processes.
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11. |
- Nilsson, Petra, et al.
(author)
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How to make a workplace health promotion questionnaire process applicable, meaningful, and sustainable
- 2011
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In: Journal of Nursing Management. - : Wiley-Blackwell Publishing Ltd. - 0966-0429 .- 1365-2834. ; 19:7, s. 906-914
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Journal article (peer-reviewed)abstract
- Background In workplace health promotion, a questionnaire could be of great use. Unfortunately, fatigue regarding answering questionnaires has recently become greater than before. An action research approach could be a possible way of increasing employee participation. Aim This study reports an attempt to explore key aspects for participation in, and commitment to, a workplace health promotion questionnaire process. Method The study was conducted at two wards in a Swedish hospital. Data was collected during an action research process. Data were analysed with regard to a framework of questions. Findings The three key aspects for participation in, and commitment to, a workplace health promotion questionnaire process were: an applicable questionnaire, a meaningful questionnaire process and a continuous and sustainable questionnaire process. A structure is presented as practical advice to managers, describing how such a process could be established to be applicable, meaningful and sustainable. Conclusion This study has identified key aspects and prerequisites for questionnaire processes. The prerequisites – share decision-making, involve a core group and follow a structure – are discussed and proposed for managers and workgroups to consider in further workplace health promotion questionnaire processes. Implications for nursing management The key aspects and prerequisites presented could provide a stimulating standpoint or advice, useful for planning and accomplishing workplace questionnaire processes.
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12. |
- Nylinder, Pia, 1973-
(author)
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Perception of budgetary control : a study of differences across managers in Swedish public primary healthcare related to professional background and sex
- 2011
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In: Journal of Nursing Management. - : Wiley-Blackwell. - 0966-0429 .- 1365-2834. ; 19:5, s. 664-672
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Journal article (peer-reviewed)abstract
- Background The composition of managers in Swedish public primary care centres has changed since the mid-1990s, favouring nurses and female managers. In parallel, health-care professionals have become more involved in the management structure and many have experienced an increased demand for cost containment. There is limited empirical evidence about how managers with different professional backgrounds perceive tight budgetary control.Aim To examine whether perceptions of tight budgetary control across managers in Swedish public primary care are related to personal characteristics such as professional background and sex.Method A questionnaire measuring perception of tight budgetary control was administered to all (636) identified managers in Swedish public primary care centres (response rate was 59%). Differences between groups were analysed through logistic regression and factor analysis.Results Nurses and other non-physicians perceived the budgetary control to be tighter than did physicians and female physicians perceived the budgetary control to be tighter than did male physicians.Conclusions and implications for nursing management Results suggest that nurses were more committed to the budgetary control system and county council objectives than physicians. The impact of these differences are uncertain, however, nurses’ capacity to influence primary care services may be more limited compared with physicians because of their lower professional status.
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13. |
- Athlin, Elsy, 1945-, et al.
(author)
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A model for a national clinical final examination in the Swedish bachelor programme in nursing
- 2012
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In: Journal of Nursing Management. - Oxford : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 20:1, s. 90-101
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Journal article (peer-reviewed)abstract
- Aim To describe the development and evaluation of a model for a national clinical final examination in the bachelor nursing education.Background After the transfer of nursing education to the academy, concerns have been raised among nurses, nurse leaders, lecturers and researchers about the nursing students clinical competence at the entrance to professional life.Methods During 2003 to 2005, a collaborative project was carried out between four universities and adjunctive health-care areas supplying clinical placements in Sweden. A two-part examination was agreed upon comprising a written theoretical test and a bedside test. An assessment tool for the bedside test was created. Nursing students, nurses and clinical lecturers participated voluntarily in the evaluation.Results The model was highly appreciated, and its relevance, usability, and validity were considered quite good for the assessment of nursing students clinical competence at the final stage of their education. Several deficiencies were revealed, which led to further development of the model.Conclusions and implications for nursing management The development and first evaluation of the model proved encouraging for further use, but it needs further evaluation. Involvement of nursing managers is necessary in order to satisfy new demands on competence and staffing of clinical nurses.
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14. |
- Abdelrazek, Fathya, et al.
(author)
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Leadership and management skills of first-line managers of elderly care and their work environment
- 2010
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 18:6, s. 736-745
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Journal article (peer-reviewed)abstract
- Aim To study the leadership and management skills of first-line managers (FLMs) of elderly care and their work environment in Egypt and Sweden. Background FLMs in Egypt and Sweden are directly responsible for staff and quality of care. However, FLMs in Sweden, in elderly care, have smaller units/organizations to manage than do their colleagues in Egypt. Furthermore, family care of the elderly has been the norm in Egypt, but in recent years institutional care has increased, whereas in Sweden, residential living homes have existed for a longer period. Methods A convenience sample of FLMs, 49 from Egypt and 49 from Sweden, answered a questionnaire measuring leadership and management skills, structural and psychological empowerment, job satisfaction and psychosomatic health. Results In both countries, FLMs' perceptions of their leadership and management skills and psychological empowerment were quite high, whereas scores for job satisfaction and psychosomatic health were lower. FLMs had higher values in several factors/study variables in Egypt compared with in Sweden. Conclusion and implications The work environment, both in Egypt and Sweden, needs to be improved to increase FLMs' job satisfaction and decrease stress. The cultural differences and levels of management have an effect on the differences between the two countries.
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15. |
- Alnes, Rigmor Einang, et al.
(author)
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The influence of the learning climate on learning outcomes from Marte Meo counselling in dementia care
- 2013
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In: Journal of Nursing Management. - : Wiley-Blackwell. - 0966-0429 .- 1365-2834. ; 21:1, s. 130-140
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Journal article (peer-reviewed)abstract
- AIM: To identify factors that affected the learning outcomes from Marte Meo counselling (MMC).BACKGROUND: Although MMC has shown promising results regarding learning outcomes for staff working in dementia-specific care units, the outcomes differ.METHOD: Twelve individual interviews and four focus group interviews with staff who had participated in MMC were analysed through a qualitative content analysis.RESULTS: The learning climate has considerable significance for the experienced benefit of MMC and indicate that this learning climate depends on three conditions: establishing a common understanding of the content and form of MMC, ensuring staff's willingness to participate and the opportunity to do so, and securing an arena in the unit for discussion and interactions.CONCLUSION: Learning outcomes from MMC in dementia-specific care units appear to depend on the learning climate in the unit. Implication for nursing management The learning climate needs attention from the nursing management when establishing Marte Meo intervention in nursing homes. The learning climate can be facilitated through building common understandings in the units regarding why and how this intervention should take place, and by ensuring clarity in the relationship between the intervention and the organization's objectives.
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16. |
- Antonsson, Helen, et al.
(author)
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First-line managers’ experiences of alternative modes of funding in elderly care in Sweden
- 2012
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 20:6, s. 737-747
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Journal article (peer-reviewed)abstract
- Aim: The aim of this study was to describe first-line managers’ experiences of alternative modes of funding elderly care in two communities in western Sweden. Background: A growing elderly population demands alternative modes of funding elderly care for better outcomes for patients and better efficiency as it is publicly funded through taxation. Methods: The study comprised a total of eight semi-structured interviews with first-line managers working within elderly care. The interviews were analysed using manifest qualitative content analysis. Respect for the individuals was a main concern in the study. Results: One category, quality improvement, and four subcategories freedom of choice, organisational structure, quality awareness and market forces effects were identified to describe first-line managers’ experiences of the operation of elderly care. Conclusions: Quality improvement was an important factor to deal with when elderly care was operated in different organisational perspectives, either private or public. The first-line manager is a key person for developing a learning organisation that encourages both staff, clients and their relatives to improve the organisation. Moreover, person-centred care strengthens the client’s role in the organisation, which is in line with the government’s goal for the quality improvement of elderly care. However, further research is needed on how quality improvement could be developed when different caregivers operate in the same market in order to improve care from the elderly perspective.Implications for nursing management: This study highlights alternative modes of funding elderly care. The economical perspectives should not dominate without taking care of quality improvement when the operation of elderly care is planned and implemented. Strategies such as a learning organisational structure built on person-centred care could create quality improvement in elderly care.
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17. |
- Arman, Rebecka, 1976, et al.
(author)
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What health care managers do : Applying Mintzberg’s structured observation method
- 2009
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 17:6, s. 718-729
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Journal article (peer-reviewed)abstract
- Aim The aim of the present study was to explore and describe what characterizes first-and second-line health care managers' use of time. Background Many Swedish health care managers experience difficulties managing their time. Methods Structured and unstructured observations were used. Ten first-and second-line managers in different health care settings were studied in detail from 3.5 and 4 days each. Duration and frequency of different types of work activities were analysed. Results The individual variation was considerable. The managers' days consisted to a large degree of short activities (<9 minutes). On average, nearly half of the managers' time was spent in meetings. Most of the managers' time was spent with subordinates and <1% was spent alone with their superiors. Sixteen per cent of their time was spent on administration and only a small fraction on explicit strategic work. Conclusions The individual variations in time use patterns suggest the possibility of interventions to support changes in time use patterns. Implications for nursing management A reliable description of what managers do paves the way for analyses of what they should do to be effective.
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18. |
- Arvidsson, Barbro, et al.
(author)
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Factors influencing nurse supervisor competence : a critical incident analysis study
- 2005
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In: Journal of Nursing Management. - Oxford : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 13:3, s. 231-7
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Journal article (peer-reviewed)abstract
- The aim of the study was to identify factors related to critical incidents that influence the competence of nurse supervisors. Nurse supervisors require considerable competence in order to help supervisees to reflect on their clinical work and to interpret the needs of the patient. A qualitative approach involving the critical incident technique was used. Critical incidents were collected by means of self-reports from 25 nurse supervisors. Two main areas emerged: a professional and a personal stance. The professional stance described the nurse supervisors’ awareness of the importance of creating a secure learning environment and facilitating reflection. The supervisors structured the material and created awareness of fundamental nursing values. The second main area, personal stance, described the nurse supervisors’ behaviour when they gave the participating nurses the opportunity to work through the experiences gained in the daily provision of nursing care. Although they experienced lack of self-assurance during the supervision session, they also expressed security regarding their own performance as nurse supervisors. Nurse supervisors need to include more nursing theory and focus on the nursing process as well as being aware of their own shortcomings and resources. One way for the supervisior to scrutinize his/her actions is to discuss and examine them with a more experienced nurse supervisor colleague.
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19. |
- Arvidsson, Barbro, et al.
(author)
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Process-oriented group supervision implemented during nursing education : nurses’ conceptions 1 year after their nursing degree
- 2008
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In: Journal of Nursing Management. - Oxford : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 16:7, s. 868-875
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Journal article (peer-reviewed)abstract
- AIM: To describe the variation in how nurses conceive process-oriented group supervision, implemented during nursing education, 1 year after their nursing degree. BACKGROUND: Process-oriented group supervision can be an effective support system for helping nursing students and nurses to reflect on their activities. METHODS: A descriptive qualitative design was chosen for the study. Conceptions were collected through interviews with 18 strategically selected Swedish nurses in 2005. RESULTS: Three descriptive categories comprising seven conceptions were emerged. Supportive actions comprised: a sense of security, belonging and encouragement. Learning actions involved: sharing and reflecting while developmental actions described: enabling professional identity and facilitating personal development. CONCLUSIONS: Process-oriented group supervision has a lasting influence on nurses' development. The possibility to reflect over new stances during nursing education was a prerequisite for the provision of high-quality care. Process-oriented group supervision can make an important contribution to nursing education. IMPLICATIONS: for Nursing Management Process-oriented group supervision provides nurses with the strength to achieve resilience to stress in their work. It may lead to autonomy as well as clarity in the nurse's professional function. This indicates the need for nurse managers to organize reflective group supervision as an integral part of the nurse's work.
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20. |
- Arvidsson, Barbro, 1945-, et al.
(author)
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Psychiatric nurses' conceptions of how a group supervision programme in nursing care influences their professional competence : a 4-year follow-up study
- 2001
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In: Journal of Nursing Management. - Chichester, United Kingdom : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 9:3, s. 161-171
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Journal article (peer-reviewed)abstract
- AIM: The aim of the study was to describe, after 4 years, psychiatric nurses' conceptions of how a 2-year group supervision programme within nursing care had influenced their professional competence.BACKGROUND: The intention of group supervision in nursing care is to understand nurses' experiences within real care settings and to structure these in a professional and personal context.METHODS: Ten psychiatric nurses participated in a 2-year group supervision programme. They were interviewed 4 years after the group supervision was ended. Data were analysed according to the phenomenographic method.FINDINGS: Six description categories emerged: a feeling of job satisfaction; gaining knowledge and competence; gaining a sense of security in nursing situations; a feeling of personal development; realizing the value of supervision; and a sense of professional solidarity.CONCLUSIONS: The findings of the 4-year follow-up showed that a group supervision programme in nursing care had lasting influences on the psychiatric nurses' professional competence in the form of a pronounced professional identity and an integrated nursing care perspective. Group supervision contributes to maintaining the strength and energy needed to carry on working, which makes continuing supervision necessary.IMPLICATIONS: An important research implication could be to investigate the type of knowledge that ought to be developed within group supervision in nursing care.© 2001 Blackwell Science Ltd.
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21. |
- Arvidsson, Barbro, 1945-, et al.
(author)
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Psychiatric nurses' conceptions of how group supervision in nursing care influences their professional competence
- 2000
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In: Journal of Nursing Management. - Oxford : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 8:3, s. 175-185
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Journal article (peer-reviewed)abstract
- AIM: The aim of the study was to describe, after 1 and 2 years respectively, psychiatric nurses' conceptions of how group supervision within nursing care influenced their professional competence.BACKGROUND: The intention of group supervision in nursing care is to understand nurses' experiences within real care settings and to structure these in a professional and personal context.THE STUDY: Ten psychiatric nurses participated in the group supervision. They were interviewed on two occasions: after 1 and 2 years, respectively.FINDINGS: The data analysis was influenced by the phenomenographic approach and provided four description categories: a feeling of job satisfaction; acquiring knowledge and competence; gaining a sense of security in nursing situations; and a feeling of personal development.CONCLUSIONS: In supervision, practice and theory are integrated, resulting in enhanced nursing competence among the participants. Supervision should be an integrated part of nursing work and regarded as a means of quality assurance. A long-term follow-up could give valuable proof that group supervision in nursing care has a lasting effect on nurses' professional competence.
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22. |
- Bégat, Ingrid, 1942-, et al.
(author)
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Australian nurse supervisors' styles and their perceptions of ethical dilemmas within health care
- 2003
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 11:1, s. 6-14
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Journal article (peer-reviewed)abstract
- AIM: To examine clinical nurse supervisors' styles, in terms of models, organization, focus on supervision and theories used in supervision, as well as their perceptions of ethical dilemmas within health care. BACKGROUND: The importance of clinical supervision in clinical practice has been reported. However, literature dealing with its implementation is rare. METHODS: This study is a descriptive-correlational study. Data were collected by means of a questionnaire from two groups of nurse supervisors randomly selected from a university (n = 55) and a hospital (n = 31). Data were analysed using descriptive and inferential statistics. RESULTS: The models most frequently used were 'case-oriented' and 'decision-making oriented'. The nurse supervision was reported as being organized on a one-to-one basis. The focus of supervision was on 'patient problems' and 'cooperation in team'. The theory most commonly used was the theory of reflection. The supervisors' perceptions of moral dilemmas were related to 'decision making' and actions impacting on quality of care resulting from their supervisor styles. CONCLUSION: By correlating the supervisors' styles and their perceptions of ethical dilemmas, we conclude that it is important to contribute to further research on supervisors' styles in order to ensure successful supervision.
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23. |
- Bégat, Ingrid, 1942-, et al.
(author)
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Nurses' satisfaction with their work environment and the outcomes of clinical nursing supervision on nurses' experiences of well-being -- a Norwegian study.
- 2005
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 13:3, s. 221-30
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Journal article (peer-reviewed)abstract
- BACKGROUND: Various studies have demonstrated that nursing is stressful and that the incidence of occupational stress-related burnout in the profession is high. AIM: This descriptive-correlational study examined nurses' satisfaction with their psychosocial work environment, their moral sensitivity and differences in outcomes of clinical nursing supervision in relation to nurses' well-being by systematically comparing supervised and unsupervised nurses. METHODS: Nurses were selected from two hospitals (n = 71). Data collection was by means of questionnaires and analysed by descriptive and inferential statistics. RESULTS: The nurses' satisfaction with their psychosocial work environment was reflected in six factors: 'job stress and anxiety', 'relationship with colleagues', 'collaboration and good communication', 'job motivation', 'work demands' and 'professional development'. The nurses' perceptions of moral sensitivity comprised seven factors: 'grounds for actions', 'ethical conflicts', 'values in care', 'independence patient-oriented care', 'the desire to provide high-quality care' and 'the desire to provide high-quality care creates ethical dilemmas'. Nurses well-being were reflected in four factors 'physical symptom and anxiety', 'feelings of not being in control', 'engagement and motivation' and 'eye strain sleep disturbance'. The moral sensitivity 'ethical conflicts' were found to have mild negative correlations with psychosocial work environment 'job stress and anxiety professional development' and with 'total score' psychosocial work, moral sensitivity factor 'independence were correlated with psychosocial work factor 'relationships with colleagues' and 'total score', moral sensitivity were mildly correlated with 'collaboration and good communication and had a negative correlation to psychosocial work factor 'work demands'. In addition, significant correlations were found between the nurses' well-being profile and demographic variables, between 'engagement and motivation' and 'absence due to illness' and between 'time allocation for tasks', 'physical symptoms and anxiety' and 'age'. Mild significant differences were found between nurses attending and not attending group supervision and between 'physical symptoms and anxiety' and 'feelings of not being in control'. CONCLUSIONS: We conclude that ethical conflicts in nursing are a source of job-related stress and anxiety. The outcome of supporting nurses by clinical nursing supervision may have a positive influence on their perceptions of well-being. clinical nursing supervision have a positive effect on nurses physical symptoms and their feeling of anxiety as well as having a sense of being in control of the situation. We also conclude that psychosocial work have an influence on nurses experience of having or not having control and their engagement and motivation.
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24. |
- Berg, Agneta, et al.
(author)
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Dementia care nurses experiences of systematic clinical group supervision and supervised individually planned nursing care
- 2000
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In: Journal of Nursing Management. - 0966-0429 .- 1365-2834. ; 8:6, s. 357-368
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Journal article (peer-reviewed)abstract
- AimTo reveal 13 nurses' experiences of systematic clinical group supervision and supervised individually planned nursing care, while working with people suffering from severe dementia.BackgroundClinical supervision is a major issue in nursing, however empirical knowledge of the subject is limited. Nurse's narrations about their experiences may extend the knowledge available and serve as a basis for creating models of support systems for nurses in their care provision.MethodsOpen-ended interviews were performed and the text was analysed through content analysis. A questionnaire was used to evaluate the views of the effects of clinical supervision.FindingsTwo main themes were found. Confirmed uniqueness included two sub-themes: confirming the nurses as a person and as a professional and confirming the patient as a unique human being. Consolidated sense of community included three sub-themes: closer relationship between the nurses, changed organization of nursing care and improved individualizing in routines of nursing care. The questionnaire result showed improvements in co-operation and in providing professional nursing care and personal development.ConclusionInterventions to improve working conditions for the nurses and care quality for the patients may well focus the core process, i.e. feedback and support for the nurse–patient interaction and person-orientated nursing care, taking into account the constellation and conditions of the group.
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25. |
- Berglund, Mia, et al.
(author)
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Reflect and learn together - when two supervisors interact in the learning support process of nurse education
- 2012
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In: Journal of Nursing Management. - : Wiley-Blackwell. - 0966-0429 .- 1365-2834. ; 20:2, s. 152-158
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Journal article (peer-reviewed)abstract
- Aim To describe the importance of supervisors working together in supporting the learning process of nurse students through reflective caring science supervision.Background A supervision model has been developed in order to meet the need for interweaving theory and practice. The model is characterized by learning reflection in caring science. A unique aspect of the present project was that the student groups were led by a teacher and a nurse.Method Data were collected through interviews with the supervisors. The analysis was performed with a phenomenological approach.Results The results showed that theory and practice can be made more tangible and interwoven by using two supervisors in a dual supervision. The essential structure is built on the constituents ‘Reflection as Learning Support’, ‘Interweaving Caring Science with the Patient’s Narrative’, ‘The Student as a Learning Subject’ and ‘The Learning Environment of Supervision’.Conclusion The study concludes that supervision in pairs provides unique possibilities for interweaving and developing theory and practice.Implications for nursing management The supervision model offers unique opportunities for cooperation, for the development of theory and practice and for the development of the professional roll of nurses and teachers.
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26. |
- Boström, Barbro, et al.
(author)
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Pain and health-related quality of life among cancer patients in final stage of life : a comparison between two palliative care teams
- 2003
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In: Journal of Nursing Management. - Chichester, West Sussex : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 11:3, s. 189-196
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Journal article (peer-reviewed)abstract
- A two-centred descriptive study was performed in order to describe and compare pain and health-related quality of life (HRQOL) among cancer patients, in their final stage of life. The patients were cared for by either a nurse-led palliative care team I (PCT I) or a physician-led palliative care team II (PCT II). Forty-six consecutive, stratified patients (PCT I, n = 21 and PCT II, n = 25) participated. The medical outcomes study short form 36 (SF-36) was used for evaluating HRQOL and the Pain-O-Meter for assessing pain. Patients' pain intensity, pain quality and HRQOL showed no significant difference between the two groups PCT I and PCT II. The patients from PCT I had significantly longer survival time (P = 0.017) than those from PCT II. The different composition of the teams being led by nurses or physicians is worth further research; both from the patient's and staff's viewpoint, there may also be cost-benefits worth examining.
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27. |
- Boström, Barbro, et al.
(author)
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Survey of post-operative patients' pain management
- 1997
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In: Journal of Nursing Management. - : Blackwell Publishing Ltd.. - 0966-0429 .- 1365-2834. ; 5:6, s. 341-349
-
Journal article (peer-reviewed)abstract
- Although effective pain treatment is available for both cancer-related pain and acute post-operative pain, many patients suffer unnecessarily. The aim of this study was to evaluate post-operative patients' pain management. A descriptive survey study was conducted in a 460-bed acute hospital in the southwestern part of Sweden. One hundred post-operative inpatients, on their second post-operative day, took part in the study. They were consecutively selected from six surgical wards. Data were collected using an interview questionnaire designed by the American Pain Society and analysed by descriptive and inferential statistics. At the time of the interview, 29 of the patients reported moderate to severe pain. Regarding the patients' worst pain experienced during the last 24 h, 79 of them reported moderate to very severe pain. Significant correlations were found between reported poor pain relief after pain medication and high intensity of pain both within the last 24 h and at the time of the interview. Eighty-three patients were satisfied with the way nurses treated their pain, while 64 patients were satisfied with the way physicians treated their pain. However, the higher the pain intensity experienced by the patients the less satisfied they were. The fact that patients do not know what kinds of relief are available may be one reason for the patients expressing satisfaction despite being in pain, another that the patients judge the kindness of the staff rather than their way of treating the pain. The field of pain management is rapidly changing requiring professional knowledge and experience in order to ensure pain management of good quality.
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28. |
- Bystedt, Maria, 1955-, et al.
(author)
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Delegation within municipal healthcare
- 2011
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 19:4, s. 534-541
-
Journal article (peer-reviewed)abstract
- Aim To describe how registered nurses (RNs) perceive delegation to unlicensed personnel (UP) in a municipal healthcare context in Sweden. Background Within municipal health care RNs often delegate tasks to UP. The latter have practical training, but lack formal competence. Method Twelve RNs were interviewed and the material was analysed using a phenomenographic approach. Results Owing to a shortage of RNs, delegation is seen as a prerequisite for a functioning organization. This necessity also involves a number of perceived contradictions in three areas: (1) the work situation of RNs - facilitation and relief vs. lack of control, powerlessness, vagueness regarding responsibility, and resignation; (2) the relationship with unlicensed personnel - stimulation, possibility for mentoring, use of UP competence and the creation of fairness vs. questioning UP competence; and (3) The patients - increase in continuity, quicker treatment, and increased security vs. insecurity (with respect to, for example, the handling of medicine). Conclusion Registered nurses perceptions of delegation within municipal healthcare involve their own work situation, the UP and the patients. Implications for nursing management Registered nurses who delegate to UP must be given time for mentoring such that the nursing care is safe care of high quality.
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29. |
- Cronqvist, Agneta, et al.
(author)
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A theoretical argumentation on the consequences of moral stress.
- 2007
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 15:4, s. 458-65
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Intensive care units are characterized by heavy workloads, increasing work complexity and ethical concerns related to life-and-death decisions. In the present study, it is assumed that there is a relationship between moral stress, support and competence for nurses in intensive care units. AIM: To analyse and describe the theoretical relationship between moral stress and support on the one hand and competence on the other, in the context of intensive care. METHOD: A form of qualitative secondary analysis based on the findings from three original studies. In the analytic process a theory on professional competence was used. FINDINGS: The findings suggest that imbalance due to moral stress between different competences hinders the development of collectively shared caring competence. CONCLUSIONS: Moral stress cannot be totally eliminated in the intensive care unit. But moral stress is not only a problem. It can also become a driving force to stimulate competence.
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30. |
- Dackert, Ingrid
(author)
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The impact of team climate for innovation on well-being and stress in elderly care
- 2010
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In: Journal of Nursing Management. - : John Wiley & Sons. - 0966-0429 .- 1365-2834. ; 18:3, s. 302-310
-
Journal article (peer-reviewed)abstract
- The impact of team climate for innovation on well-being and stress in elderly care Aims To investigate the impact of team climate in providing support for innovation on well-being and stress and to explore whether well-being is a mediating variable between team climate and negative stress. Background The well-being of the nursing staff needs to be improved in elderly care as well as the quality of the care. Team work may be a way of addressing both needs. Method A questionnaire was completed by auxiliary nurses and nurses' aides (n = 329) within elderly care in Sweden. Structural equation modelling was used to test the relationships among team climate, well-being and stress. Results The perceived team climate has a significant positive correlation with well-being and a significant negative correlation with stress reactions. The structural equation modelling suggested that well-being is a mediating variable between team climate and stress. Conclusion A better team climate providing support for innovation may increase well-being and decrease stress reactions among nursing staff. Implications for nursing management: Interventions that improve the team climate and provide support for innovation may increase the possibilities for growth and self-actualization of the employees that, in turn, make them more qualified to deal with stress.
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31. |
- Dellve, Lotta, 1965, et al.
(author)
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Managing complex workplace stress in health care organisations: Leaders' perceived legitimacy conflicts
- 2009
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In: International Journal of Nursing Management. - : Wiley-Blackwell Publishing Ltd.. - 0966-0429 .- 1365-2834. ; 17:8, s. 931-941
-
Journal article (peer-reviewed)abstract
- Aim To conceptualize how health care leaders’ strategies to increase their influence in their psychosocial work environment are experienced and handled, and may be supported. Background The complex nature of the psychosocial work environment with increased stress creates significant challenges for leaders in today’s health care organizations. Method Interviews with health care leaders (n = 39) were analysed in accordance with constructivist grounded theory. Results Compound identities, loyalty commitments and professional interests shape conditions for leaders’ influence. Strategies to achieve legitimacy were either to retain clinical skills and a strong occupational identity or to take a full leadership role. Ethical stress was experienced when organizational procedural or consequential legitimacy norms were in conflict with the leaders’ own values. Leadership support through socializing processes and strategic support structures may be complementary or counteractive. Conclusions Support programmes need to have a clear message related to decision-making processes and should facilitate communication between top management, human resource departments and subordinate leaders. Ethical stress from conflicting legitimacy principles may be moderated by clear policies for decision-making processes, strengthened sound networks and improved communication. Implications for nursing management Supportive programmes should include: (1) sequential and strategic systems for introducing new leaders and mentoring; (2) reflective dialogue and feedback; (3) team development; and (4) decision-making policies and processes.
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32. |
- Edvardsson, David, et al.
(author)
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Construction and psychometric evaluation of the Swedish language person-centred climate questionnaire : staff version
- 2009
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 17:7, s. 790-795
-
Journal article (peer-reviewed)abstract
- AIM: The aim of the study was to construct and evaluate psychometric properties of the Swedish language Person-centred Climate Questionnaire - staff version. BACKGROUND: Person-centred care is often quoted but ill defined, and the literature warrants the development of valid and reliable measurement tools. METHODS: During 2006, a questionnaire was constructed and distributed to a sample of Swedish hospital staff (n = 600). Questionnaire data was subjected to item analysis and reduction. Psychometrical properties of the questionnaire were evaluated. RESULTS: The 14-item Person-centred Climate Questionnaire showed satisfactory psychometric properties. Measures of validity were good, internal consistency was high, Cronbach's alpha was satisfactory for the total scale (0.88) and test-retest reliability was adequate. CONCLUSION: The results indicate that the staff Person-centred Climate Questionnaire is a valid and reliable tool for assessing staff perceptions of the person centredness of hospital environments. IMPLICATIONS FOR NURSING MANAGEMENT: This instrument makes it possible to study the degree of person-centredness in relation to different organizational systems, environments, staff groups and managerial styles. In addition, staff variables such as turnover rates, health outcomes and efficacy can be related to staff perceived person centredness of the organization.
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33. |
- Edvardsson, David, et al.
(author)
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Predictors of job strain in residential dementia care nursing staff
- 2009
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 17:1, s. 59-65
-
Journal article (peer-reviewed)abstract
- AIM: To identify predictors of job strain in residential nursing care staff working with people with dementia. BACKGROUND: It is well known that nursing staff experience high levels of stress, but less is known about how to predict job strain. METHODS: The job strain of nursing care staff (n = 344) within residential dementia care settings was assessed. Standard linear regression analysis was used to explore predictors of job strain. RESULT: Data from the study shows that nursing staff in residential dementia care have a demanding job and experience high levels of strain. The linear regression model with four predictor variables explained 19% of the variability in job strain scores. Perceived caring climate of the unit, staff education level, possibilities to have discussions of difficulties and ethics at work and staff age, had a statistically significant association with job strain. CONCLUSIONS: The caring climate, staff education, reflective practice and staff age can be used as screening variables when predicting job strain. IMPLICATIONS FOR NURSING MANAGEMENT: These predictors can assist managers and directors to identify targeted strategies for supervision and support of nursing staff to secure their well-being, and by that securing the quality of care provided to residents.
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34. |
- Edvardsson, David, et al.
(author)
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Psychometric evaluation of the English language person-centred climate questionnaire : staff version
- 2010
-
In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 18:1, s. 54-60
-
Journal article (peer-reviewed)abstract
- The 14-item questionnaire showed high reliability as Cronbach's alpha was satisfactory for the total scale (0.89), and for the four subscales: 0.87, 0.79, 0.82 and 0.69. Test-retest reliability were evaluated in a subsample of 40 staff and resulted in P-values >0.05 between mean scores of the PCQ-S at test and retest, r-values between 0.6 and 0.9, and a two-way mixed effects model, single measures intra-class correlations of 0.75 with a confidence interval of 0.58-0.86. Validity of the scale needs further evaluation. CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT: The English PCQ-S makes possible studies of associations between person-centredness and different organizational systems, environments, staff characteristics and health and managerial styles. However, scale validity needs further evaluation.
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35. |
- Edvardsson, David, et al.
(author)
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The person-centred care of older people with cognitive impairmentin acute care scale (POPAC)
- 2013
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 21:1, s. 79-86
-
Journal article (peer-reviewed)abstract
- Aim: To construct and evaluate psychometric properties of the person-centred care of older people with cognitive impairment in acute care settings (POPAC) scale.Background: Older people with cognitive impairment are admitted frequently to acute care, with needs not always met through standard practice. Best practice models have been suggested, but few assessment scales exist.Methods: Psychometric evaluation using statistical estimates of validity and reliability based on an Australian sample of acute care nursing staff (n = 212).Results: The final 15-item questionnaire consists of three subscales, using cognitive assessments and care interventions, using evidence and cognitive expertise and individualizing care. Estimates of validity and reliability were highly satisfactory.Conclusion: The POPAC scale makes a valuable contribution by providing valid and reliable measures of the extent to which acute nursing staff report using best practice care processes to identify and consider cognitive impairment and to employ nursing interventions to meet the needs associated with old age and cognitive impairment.Implications for nursing management: The POPAC scale is short, easy to administer and not time consuming to complete, but still provides clinically relevant information. It can be used as a conceptual fundament in developing best practice nursing care in the acute clinical setting, as well as for nursing research.
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36. |
- Eklund, Anna Josse, 1968-, et al.
(author)
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Swedish registered nurses’ and nurse managers’ attitudes towards patient advocacy in community care of older patients
- 2013
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In: Journal of Nursing Management. - : Wiley-Blackwell. - 0966-0429 .- 1365-2834. ; 21:5, s. 753-761
-
Journal article (peer-reviewed)abstract
- Aim To describe and compare registered nurses’ (RNs) and nurse managers’ (NMs) attitudes towards patient advocacy in the community care of older patients.Background RNs may act as patients’ advocates in the care of older patients. NMs should support patient advocacy in order to make the best care available to patients.Method A modified Attitudes towards Patient Advocacy Scale was used to collect data from 207 RNs and 23 NMs in the Swedish community care of older patients. The response rate was 52%. Descriptive and inferential statistics were used.Results Both RNs and NMs showed positive attitudes towards patient advocacy. They were more positive towards patient advocacy for patients unable to help themselves than for competent patients.Conclusions This study showed that RNs and NMs did not differ in their attitudes towards patient advocacy. This result is consistent with the idea of giving the neediest and vulnerable patients greater care.Implications for Nursing Management It is important for NMs to clarify their own and RNs attitudes towards patient advocacy as disparities may affect cooperation between the groups. Any effects on cooperation may, by extension, affect the quality of care.
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37. |
- Engström, Maria, et al.
(author)
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Caregivers' job satisfaction and empowerment before and after an intervention focused on caregiver empowerment
- 2010
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 18:1, s. 14-23
-
Journal article (peer-reviewed)abstract
- Aims: To evaluate a training programme aimed at strengthening caregivers' self-esteem and empowering them, and also to study correlations between psychological empowerment and job satisfaction.Background: Structural and psychological empowerment have received increased attention in nursing management, yet few intervention studies on this topic, based on theoretical assumptions, have been conducted in elderly care.Method: Data on self-assessed psychological empowerment and job satisfaction were collected in an intervention (n = 14) and a comparison group (n = 32), before and after the intervention.Results: When compared over time in the respective groups, there were significant improvements in the intervention group regarding the factor criticism (job satisfaction scale). There were no statistically significant differences in the comparison group. Total empowerment and all factors of empowerment correlated positively with total job satisfaction. Six out of eight factors of job satisfaction correlated positively with total empowerment.Conclusions: Caregivers' perception of criticism can improve through an intervention aimed at strengthening their self-esteem and empowering them.Implications for nursing management: Intervention focused on psychological empowerment and especially caregivers' communication skills seems to be beneficial for caregivers. Recommendations are to increase the programme's length and scope and to include all staff at the unit. However, these recommendations need to be studied further.
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38. |
- Engström, Maria, et al.
(author)
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Staff members' perceptions of a ICT support package in dementia care during the process of implementation
- 2009
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 17:7, s. 781-789
-
Journal article (peer-reviewed)abstract
- AIM The aim of the present study was to describe staff members' perceptions of an information and communication technology (ICT) support package during the process of implementation. BACKGROUND ICT in dementia care will likely increase in the future. The diffusion of new innovations can be better understood through diffusion research. METHODS Fourteen staff members in dementia care were interviewed, in groups, once before the new ICT, twice during its implementation and once after. Data were analysed using qualitative content analyses. The ICT included monitors/alarms: passage alarms, fall detectors, sensor-activated night-time illumination of the lavatory, and communication technology: Internet communication and additional computers. RESULTS The results showed two themes 'Moving from fear of losing control to perceived increase in control and security' and 'Struggling with insufficient/deficient systems'. CONCLUSIONS Staff perceptions of ICT were diverse and changed during the implementation. Benefits were more pronounced than disadvantages, and improvements were described both in care and in staff job situation. IMPLICATIONS FOR NURSING MANAGEMENT Functioning and use of ICT may relate to design as well as by application and the surrounding structure, and the whole system: the organizational structure, the employers and the new product needs to be taken into consideration when implementing new technology.
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39. |
- Engström, Maria, 1966-, et al.
(author)
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Working life and stress symptoms among caregivers in elderly care with formal and no formal competence
- 2011
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 19:6, s. 732-741
-
Journal article (peer-reviewed)abstract
- Working life and stress symptoms among caregivers in elderly care with formal and no formal competence Aim The aim of the present study was to describe and compare caregivers with formal and no formal competence on job satisfaction, psychosomatic health, structural and psychological empowerment and perceptions of care quality. A further aim was to study relationships among study variables. Methods A convenience sample of 572 caregivers in elderly care participated. Results Caregivers with no formal competence perceived higher workload, more communication obstacles, less competence, poorer sleep and more stress symptoms than did their colleagues. Linear regression analyses revealed that the factor self-determination was an explanatory variable of stress levels among caregivers with no formal competence, and self-determination and impact among caregivers with formal competence. Linear regression analysis revealed that different dimensions in structural and psychological empowerment explained the variance in staff job satisfaction, perceived stress symptoms and quality of care. Conclusions No formal competence seems to be a risk factor for psychosomatic health problems. Implications for nursing management Managers need to have a strategic plan for how to create a working environment for caregivers with no formal competence. Caregivers' self-determination seems to be important for stress symptoms. Meaning, self-determination, impact and opportunities appear to be important for job satisfaction and competence, opportunities, resources and formal power for quality of care.
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40. |
- Ericson-Lidman, Eva, et al.
(author)
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Meanings of being a supervisor for care providers suffering from burnout : from initial signs to recuperation
- 2009
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 17:3, s. 366-375
-
Journal article (peer-reviewed)abstract
- To illuminate meanings of being a supervisor for care providers suffering from burnout: from initial signs to recuperation. Background Supervisors in health care, i.e. supervisors with first-line responsibilities for a work unit, are exposed to heavy demands, especially in times of downsizing and restructuring of the healthcare system. When care providers show signs of developing burnout, these demands are even greater. Methods Interviews with 12 supervisors in health care were interpreted using a phenomenological-hermeneutic method. Results Being a supervisor when someone in the work team shows signs of burnout means struggling to help them to continue working. In this predicament and being responsible for the unit, the supervisors are torn between focusing on relations and on production. When the care provider reports sick, they are left with feelings of hopelessness and self-blame. Conclusions and implications for nursing management Supervisors face almost unmanageable strain, caught between conflicting demands. It seems important that supervisors are offered opportunities to share their feelings about this predicament as well as gaining increased knowledge about burnout. This is important if the supervisors are to give proper support, but it will also help to turn supervisory failure into development and to protect the health of the supervisors.
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41. |
- Eriksson, Susanne, et al.
(author)
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Supervisor experiences of supervising nursing staff in the care of older people
- 2008
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 16:7, s. 876-882
-
Journal article (peer-reviewed)abstract
- Aim To describe supervisors’ experiences of supervising nursing staff who care for older people in order to develop an understanding of the opportunities and limitations involved in supervision. Background Little is known of what group supervision of nursing staff means for the supervisor, particularly in regards to care of the old. Methods A reflective life-world research approach, based upon phenomenological epistemonology was used. Two supervisors with 2 years experience of supervising nursing staff caring for older people were interviewed. Conclusions Results point to the need for support for supervisors in order to enable them to develop their supervisory abilities and skills. Implications for nursing management Support is of crucial importance for both the ability to supervise and the quality of supervision.
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42. |
- Fagerström, Lisbeth
(author)
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Evidence-based human resource management : a study of nurse leaders' resource allocation
- 2009
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In: Journal of Nursing Management. - : Wiley-Blackwell. - 0966-0429 .- 1365-2834. ; 17:4, s. 415-425
-
Journal article (peer-reviewed)abstract
- Aims The aims were to illustrate how the RAFAELA system can be used to facilitate evidence-based human resource management.Background The theoretical framework of the RAFAELA system is based on a holistic view of humankind and a view of leadership founded on human resource management.Methods Nine wards from three central hospitals in Finland participated in the study. The data, stemming from 2006–2007, were taken from the critical indicators (ward-related and nursing intensity information) for national benchmarking used in the RAFAELA system. The data were analysed descriptively.Results The daily nursing resources per classified patient ratio is a more specific method of measurement than the nurse-to-patient ratio. For four wards, the nursing intensity per nurse surpassed the optimal level 34% to 62.2% of days. Resource allocation was clearly improved in that a better balance between patients' care needs and available nursing resources was maintained.Conclusions The RAFAELA system provides a rational, systematic and objective foundation for evidence-based human resource management.Implications for nursing management Data from a systematic use of the RAFAELA system offer objective facts and motives for evidence-based decision making in human resource management, and will therefore enhance the nurse leaders' evidence and scientific based way of working.
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43. |
- Fagerström, Lisbeth, et al.
(author)
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Leading change : a challenge for leaders in Nordic health care
- 2010
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In: Journal of Nursing Management. - : Blackwell Publishing Ltd.. - 1365-2834 .- 0966-0429. ; 18:5, s. 613-617
-
Journal article (peer-reviewed)abstract
- Aims: The aim of the present study was to describe personnel's attitudes to change processes between a regional hospital and the primary health care centre as well as investigate these results with regards to theories pertaining to change and leading change. Background: Leadership has three crucial dimensions: focusing on personnel, results/key processes and the ethical base of activities. Methods: A survey was conducted in 2003 using a comprehensive questionnaire. The total sample consisted of the personnel (n = 899) at the two organizations (answering rate was 68.8%). The data were analysed descriptively. Results: Approximately two-thirds of the respondents understood why the merger was occurring. Only one-third expressed that they had received sufficient information regarding the merger. In total 67% felt that the merger would create conflict while approximately one-fourth expressed uncertainty. Despite such negative responses, approximately two-thirds felt there were advantages to the merger. Significant differences were seen between the groups. Conclusions: In times of change personnel expect leaders to focus on dialogue with their personnel and to anchor the vision of the change process amongst the personnel. Implications for nursing management: By identifying the 'prison of thought' and creating an atmosphere where reflection and discussion are valued the nurse leader can help prevent resistance to change.
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44. |
- Frilund, Marianne, et al.
(author)
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Managing the optimal workload by the PAONCIL method : a challange for nursing leadership in care of older people
- 2009
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In: Journal of Nursing Management. - : Wiley-Blackwell. - 0966-0429 .- 1365-2834. ; 17:4, s. 426-434
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Journal article (peer-reviewed)abstract
- Aim The aim of the study was to test the ability of the professional assessment of optimal nursing care intensity level (PAONCIL)-method to establish the optimal nursing intensity (NI) per care giver within the care of older people by testing whether the method's prerequisites for hospital settings can be fulfilled within the care of older people as well.Background The PAONCIL method is included in the RAFAELA system as a method for calculating personnel resources based on NI.Method The PAONCIL assessments were collected through questionnaires (n = 3512). The data was analysed by simple linear regression analysis.Results It can be stated that the prerequisites for the PAONCIL method were fulfilled and that the optimal NI-level could be determined on seven participating units.Discussion It can be stated that the RAFAELA system is a useful system for measuring NI within the care of older people, but additional research is needed, especially within the home care setting.Conclusion Although an instrument never provides a complete overview of the patient's care needs and need satisfaction, it provides information about the daily situation as well as gives guidelines for long-term strategic planning.
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45. |
- Fröjd, Camilla, et al.
(author)
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Patient information and participation still in need of improvement : evaluation of patients' perceptions of quality of care
- 2011
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 19:2, s. 226-236
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Journal article (peer-reviewed)abstract
- Aims:To identify areas in need of quality improvement by investigating inpatients' perceptions of quality of care, and to identify differences in perceptions of care related to patient gender, age and type of admission.Background:Nursing managers play an important role in the development of high-quality care.Methods:Quality of care was assessed using the Quality from the Patients' Perspective (QPP). In all, 2734 inpatients at a Swedish university hospital completed the QPP.Results:Inadequate quality was identified for 15 out of 24 items, e.g. information given on treatment and examination results, opportunities to participate in decisions related to care and information on self-care. Patients with emergency admissions reported lower scores for quality of information and doctors' care than did patients with planned admissions.Conclusion:Results from the present survey identified areas in need of quality improvement and differences in perceived care quality between patients. Quality of care must be developed in close collaboration with other healthcare professionals; in this respect, nursing managers could play an important role.Implications for nursing management:Nursing managers could play a more active part in measuring quality of care, and in using results from such measurements to develop and improve quality of care.
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46. |
- Furåker, Carina, 1946
(author)
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Registered nurses’ views about their professional role
- 2008
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In: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 16:8, s. 933-941
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Journal article (peer-reviewed)abstract
- Aim The aim is to study Registered Nurses’ opinions and reflections about their work tasks, competence and organization in acute hospital care. Background The definition of the role of nurses has changed over time and it is often discussed whether Registered Nurses have a professional status or not. Method A qualitative research design was used. Data were derived from written reflections on diaries and from focus group interviews. Results All respondents had difficulties in identifying the essence of their work. It can be argued that being ‘a spider in the web’ is an important aspect of the nursing profession. Conclusion Registered Nurses tend to regard their professional role as vague. Managers must be considered key persons in defining the professional role of Registered Nurses. Implications for nursing management This study contributes to an understanding of the managers’ and the importance of nursing education in Registered Nurses professional development.
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47. |
- Galan Perroca, Marcia, 1956-, et al.
(author)
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Utilization of patient classification systems in Swedish hospitals and the degree of satisfaction among nursing staff
- 2007
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 15:5, s. 472-480
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Journal article (peer-reviewed)abstract
- Background Although patient classification tools have been used in Sweden since the 1980s, few studies have examined how they are utilized and monitored. Aim This paper investigates the patient classification systems implemented in hospitals in the country as well as the level of satisfaction of nurses with the implemented instrument. Method A postal survey method was used in which a total of 128 questionnaires were sent to nurse managers. Twenty-three hospitals were identified with patient classification systems currently in operation. Results and conclusion The Zebra and Beakta systems are the most commonly used instruments. Nurse managers appear to be satisfied with the patient classification systems in use on their wards as a whole except for their inability to measure the quality of care provided, the time spent to use the instruments and the fact that the administration do not estimate nursing staff requirements using the system.
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48. |
- Gunningberg, Lena, et al.
(author)
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Nurse Managers prerequisite for nursing development: a survey on pressure ulcers and contextual factors in hospital organizations
- 2010
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In: JOURNAL OF NURSING MANAGEMENT. - : Blackwell Publishing Ltd. - 0966-0429 .- 1365-2834. ; 18:6, s. 757-766
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Journal article (peer-reviewed)abstract
- Aim To describe and compare pressure ulcer prevalence in two county councils and concurrently explore Nurse Managers perspective of contextual factors in a hospital organization. Background Despite good knowledge about risk factors and prevention of pressure ulcers, the prevalence of pressure ulcers remains high. Nurse Managers have a key role in implementing evidence-based practice. Methods The present study included five hospitals in two Swedish county councils: county council A (non-university setting) and county council B (university setting). A pressure ulcer prevalence study was conducted according to the methodology developed by the European Pressure Ulcer Advisory Panel. The Nurse Managers answered a (27-item) questionnaire on contextual factors. Results County council B had significantly less pressure ulcers grade (2-4) (7.7%) than county council A (11.3%). The Nurse Managers assessed only two out of the 27 general contextual items significantly differently. Some significant differences were observed in ward organization. Conclusions In county council B, the Nurse Managers seemed more aware of prevention strategies compared with Nurse Managers in county council A. The Nurse Managers should take more responsibility to develop the prerequisite for quality improvement in nursing. Implication for nursing management Nursing outcomes (e. g. pressure ulcers) should be incorporated into national quality registries for benchmarking and Nurse Managers competence in evidence-based practice and research methodology increased.
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49. |
- Gustafsson, Christine, 1967-, et al.
(author)
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Supportive leadership in Swedish community night nursing
- 2010
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In: Journal of Nursing Management. - : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 18:7, s. 822-831
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Journal article (peer-reviewed)abstract
- Aim The aim of the present study was to examine the support night nurses’ give to staff in community night nursing.Background Studies have shown that support given to staff is one of night registered nurses’ (RNs’) experiences of the meaning of caring. This support, that community RNs display for staff in night-time care, is sparsely described.Methods All community night-duty nurses in a medium-sized municipal in Sweden participated in the present study. Thematic content analysis was used to analyse data from observations.Results The support given by RNs to staff is described using three themes: (1) a conditional supporting stance, (2) preparing propitious conditions for caring and (3) confidence in the abilities of individual staff members and adaptation to their individual needs. The results reveal that RNs consider support to staff in terms of nursing leadership.Conclusions Out of ‘concern for the staff’ the RNs try to be there for them, which corresponds to nursing leadership. Such concern also arises from the RNs’ awareness that by giving support to staff this affects the staffs’ caring for older people.Implications for nursing management The current municipal social care organization of community nursing of older people in which RNs have extensive responsibilities with insufficient control, is a working condition with a risk for decreased quality of care and a high risk for work-related stress syndrome.The aim of the present study was to examine the support night nurses give to staff in community night nursing. Studies have shown that support given to staff is one of night registered nurses (RNs) experiences of the meaning of caring. This support, that community RNs display for staff in night-time care, is sparsely described.All community night-duty nurses in a medium-sized municipal in Sweden participated in the present study. Thematic content analysis was used to analyse data from observations. The support given by RNs to staff is described using three themes: (1) a conditional supporting stance, (2) preparing propitious conditions for caring and (3) confidence in the abilities of individual staff members and adaptation to their individual needs. The results reveal that RNs consider support to staff in terms of nursing leadership.Conclusions Out of concern for the staff the RNs try to be there for them, which corresponds to nursing leadership. Such concern also arises from the RNs awareness that by giving support to staff this affects the staffs caring for older people. Implications for nursing management The current municipal social care organization of community nursing of older people in which RNs have extensive responsibilities with insufficient control, is a working condition with a risk for decreased quality of care and a high risk for work-related stress syndrome.
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- Hallberg, Ingalill R., et al.
(author)
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Satisfaction with nursing care and work during a year of clinical supervision and individualized care : Comparison between two wards for the care of severely demented patients
- 1993
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 1:6, s. 297-307
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Journal article (peer-reviewed)abstract
- An intervention study was set up to explore the effects of the implementation of planned individualized care and regular systematic clinical supervision regarding nurses' degree of satisfaction with nursing care and work. All nurses on two similar wards caring for severely demented patients participated as experimental ward (EW) (n= 19) and control ward (CW) (n=20). Data were collected before intervention and at 6 months and 12 months during intervention, by means of a questionnaire developed in Sweden which assesses aspects of satisfaction with nursing care and work. Analysis was performed by means of principal component analysis, Wilcoxon rank sum test and Friedman two-way ANOVA. The baseline data showed no significant differences in the responses from the nurses on the two wards; they were found to be more satisfied than dissatisfied with their job although recognition from management was poor. During the intervention, the experimental ward nurses' experience of praise, professional growth, autonomy and quality of care, as well as their feeling of co-operation with colleagues and comfort improved significantly, while no changes occurred on the control ward. The quality of the written documentation on patients' needs and care improved significantly, and the experimental ward nurses also rejected significantly more strongly that their knowledge about patients and work was unsatisfactory. Their improved satisfaction with nursing care and work was believed to be related to the support they received in cognitive and emotional coping, the possibility of reflective learning and the change in management style associated with intervention.
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