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Compassion Fatigue and Burnout: What Managers Should Know. 同情疲劳和倦怠:管理者应该知道的。
Q2 Nursing Pub Date : 2020-10-01 DOI: 10.1097/HCM.0000000000000306
Lise Anne Slatten, Kerry David Carson, Paula Phillips Carson

Most health care employees experience and are bolstered by compassion satisfaction as they deal with patients in need. However, the more empathetic a health care provider is, the more likely he or she will experience compassion fatigue. Compassion fatigue is a negative syndrome that occurs when dealing with the traumatic experiences of patients, and examples of symptoms include intrusive thoughts, sleeping problems, and depression. Compassion fatigue is different from burnout. Compassion fatigue is a rapidly occurring disorder for primary health care workers who work with suffering patients, whereas burnout, a larger construct, is a slowly progressing disorder for employees who typically are working in burdensome organizational environments. Managers can mitigate problems associated with compassion fatigue with a number of interventions including patient reassignments, formal mentoring programs, employee training, and a compassionate organizational culture. With burnout, health care managers will want to focus primarily on chronic organizational problems.

大多数医护人员在处理有需要的病人时都会体验到同情的满足感,并受到这种满足感的支持。然而,一个医疗保健提供者越有同情心,他或她就越有可能经历同情疲劳。同情疲劳是一种消极综合症,发生在处理病人的创伤经历时,症状的例子包括侵入性思想、睡眠问题和抑郁。同情疲劳不同于倦怠。同情疲劳是一种快速发生的疾病,主要发生在治疗病人的初级卫生保健工作者身上,而倦怠则是一种更大的结构,是一种缓慢发展的疾病,主要发生在工作在繁重的组织环境中的员工身上。管理者可以通过一些干预措施来缓解与同情疲劳相关的问题,包括病人重新分配、正式的指导计划、员工培训和富有同情心的组织文化。随着职业倦怠,卫生保健经理将主要关注慢性组织问题。
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引用次数: 11
Leader Communication Styles and Organizational Health. 领导沟通风格与组织健康。
Q2 Nursing Pub Date : 2020-10-01 DOI: 10.1097/HCM.0000000000000305
Joel M Hicks
Communication is perhaps one of the greatest challenges facing managers and leaders today. Clearly articulating ideas and expectations to employees is vital to the productivity and the longevity of an organization. Furthermore, the style in which the communication is delivered has an influence on the satisfaction levels of employees. Research has discovered that there are many different styles in which a leader may communicate with employees. Research has provided several methods that aid in determining which style is the most appropriate for any given circumstance. Research has demonstrated how appropriate and effective communication is used to promote organizational health. Furthermore, research has demonstrated how inappropriate communication may decrease employee satisfaction. Finally, research has provided methods to aid in improving communication styles and delivery.
沟通可能是当今管理者和领导者面临的最大挑战之一。清晰地表达员工的想法和期望对组织的生产力和寿命至关重要。此外,沟通的方式对员工的满意度也有影响。研究发现,领导者与员工沟通的方式有很多种。研究提供了几种方法来帮助确定哪种风格最适合任何给定的环境。研究已经证明了适当和有效的沟通是如何用来促进组织健康的。此外,研究表明,不恰当的沟通可能会降低员工的满意度。最后,研究提供了帮助改善沟通风格和表达的方法。
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引用次数: 17
Letter from the Publisher. 出版商的来信。
Q2 Nursing Pub Date : 2020-10-01 DOI: 10.1097/HCM.0000000000000308
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引用次数: 0
An Analysis of Restructuring Orientation to Enhance Nurse Retention. 提高护士保留率的重组取向分析。
Q2 Nursing Pub Date : 2020-10-01 DOI: 10.1097/HCM.0000000000000303
Joan M Kiel

The nursing shortage has received much media attention; however, something that contributes to it-nurse turnover-has not received the same attention. Facilities spend time and money to train new employees only to have them leave within a few months. Staff morale, money, time, and quality of care are all affected by nurse turnover. The fact that it often occurs so soon after one takes a position makes it pertinent to look at the process of transition into the new position, namely, the orientation program. This article examines the turnover statistics, costs, rationale, and orientation programs that have proven positive results. It is hoped that the findings can assist health care facilities to replicate successful orientation programs and reduce nurse turnover.

护士短缺受到了媒体的广泛关注;然而,导致护士流失的因素却没有得到同样的重视。工厂花费时间和金钱培训新员工,结果他们在几个月内就离开了。员工士气、金钱、时间和护理质量都受到护士离职的影响。事实上,它经常发生在一个人接受一个职位后不久,这使得我们有必要研究一下向新职位过渡的过程,即入职培训计划。这篇文章考察了已经证明有积极效果的离职统计、成本、基本原理和定向计划。希望研究结果可以帮助医疗机构复制成功的培训计划,减少护士的流失率。
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引用次数: 4
Ethical Issues and the Electronic Health Record. 伦理问题和电子健康记录。
Q2 Nursing Pub Date : 2020-10-01 DOI: 10.1097/HCM.0000000000000302
Elizabeth J Layman

Ethical issues related to electronic health records (EHRs) confront health personnel. Electronic health records create conflict among several ethical principals. Electronic health records may represent beneficence because they are alleged to increase access to health care, improve the quality of care and health, and decrease costs. Research, however, has not consistently demonstrated access for disadvantaged persons, the accuracy of EHRs, their positive effects on productivity, nor decreased costs. Should beneficence be universally acknowledged, conflicts exist with other ethical principles. Autonomy is jeopardized when patients' health data are shared or linked without the patients' knowledge. Fidelity is breached by the exposure of thousands of patients' health data through mistakes or theft. Lack of confidence in the security of health data may induce patients to conceal sensitive information. As a consequence, their treatment may be compromised. Justice is breached when persons, because of their socioeconomic class or age, do not have equal access to health information resources and public health services. Health personnel, leaders, and policy makers should discuss the ethical implications of EHRs before the occurrence of conflicts among the ethical principles. Recommendations to guide health personnel, leaders, and policy makers are provided.

与电子健康记录(EHRs)相关的伦理问题是卫生人员面临的问题。电子健康记录在几个伦理原则之间产生了冲突。电子健康记录可能是有益的,因为据称它们增加了获得保健的机会,提高了保健和健康的质量,并降低了成本。然而,研究并没有始终如一地证明弱势群体的获取,电子病历的准确性,它们对生产力的积极影响,也没有降低成本。如果慈善得到普遍承认,就会与其他伦理原则产生冲突。当患者的健康数据在患者不知情的情况下被共享或链接时,自主权就会受到损害。由于错误或盗窃,数千名患者的健康数据暴露,这破坏了保真度。对健康数据的安全性缺乏信心可能导致患者隐瞒敏感信息。因此,他们的治疗可能会受到损害。当人们由于其社会经济阶层或年龄而不能平等获得卫生信息资源和公共卫生服务时,就违反了正义。卫生人员、领导和政策制定者应在伦理原则发生冲突之前讨论电子病历的伦理含义。提出了指导卫生人员、领导人和决策者的建议。
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引用次数: 1
Health Care Leader Competencies and the Relevance of Emotional Intelligence. 医疗保健领导者的能力和情商的相关性。
Q2 Nursing Pub Date : 2020-10-01 DOI: 10.1097/HCM.0000000000000307
Twila Weiszbrod

As health care leader competencies continue to be refined and emphasized in health care administration educational programs, the "soft skills" of emotional intelligence have often been implied, but not included explicitly. The purpose of this study was to better understand what relationship, if any, could be identified between health care leader competencies and emotional intelligence. A quantitative correlational method of study was used, utilizing self-assessments and 360-degree assessments of both constructs. There were 43 valid participants in the study, representing the various types of health care delivery systems. Correlational analysis suggested there was a positive relationship; for each unit of increase in emotional intelligence, there was a 0.6 increase in overall health care leadership competence. This study did not suggest causation, but instead suggested that including the study and development of emotional intelligence in health care administration programs could have a positive impact on the degree of leader competence in graduates. Some curricula suggestions were provided, and further study was recommended.

随着医疗保健领导者的能力在医疗保健管理教育项目中不断得到完善和强调,情商的“软技能”经常被暗示,但没有明确包括在内。本研究的目的是为了更好地理解医疗保健领导者能力和情商之间的关系,如果有的话。采用定量相关研究方法,利用自我评估和两个构念的360度评估。本研究共有43名有效参与者,代表了不同类型的卫生保健提供系统。相关分析表明存在正相关关系;情绪智力每增加一个单位,整体医疗保健领导能力就会增加0.6个单位。本研究并未提出两者之间的因果关系,但认为在医疗管理课程中加入情绪智力的学习与发展对毕业生的领导能力有正向影响。对课程设置提出了建议,并提出了进一步研究的建议。
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引用次数: 0
Building an Ethical Organizational Culture. 建立诚信的组织文化。
Q2 Nursing Pub Date : 2020-10-01 DOI: 10.1097/HCM.0000000000000304
William A Nelson, Emily Taylor, Thom Walsh

The success of a health care institution-as defined by delivering high-quality, high-value care, positive patient outcomes, and financial solvency-is inextricably tied to the culture within that organization. The ability to achieve and sustain alignment between its mission, values, and everyday practices defines a positive organizational culture. An institution that has a diminished organizational culture, reflected in the failure to consistently align management and clinical decisions and practices with its mission and values, will struggle. The presence of misalignment or of ethics gaps affects the quality of care being delivered, the morale of the staff, and the organization's image in the community. Transforming an organizational culture will provide a foundation for success and a framework for daily ethics-grounded operations in any organization. However, building an ethics-grounded organization is a challenging process requiring strong organization leadership and planning. Using a case study, the authors provide a multiyear, continuous step-by-step strategy consisting of identifying ethics culture gaps, establishing an ethics taskforce, clarifying and prioritizing the problems, developing strategy for change, implementing the strategy, and evaluating outcomes. This process will assist organizations in aligning its actions with its mission and values, to find success on all fronts.

医疗保健机构的成功——通过提供高质量、高价值的护理、积极的患者治疗结果和财务偿付能力来定义——与组织内部的文化密不可分。实现和维持其使命、价值观和日常实践之间的一致性的能力定义了积极的组织文化。一个组织文化下降的机构,反映在未能始终如一地将管理、临床决策和实践与其使命和价值观结合起来,将会挣扎。不协调或道德差距的存在会影响所提供护理的质量、员工的士气和组织在社区中的形象。转变组织文化将为成功提供基础,并为任何组织的日常道德运作提供框架。然而,建立一个以道德为基础的组织是一个具有挑战性的过程,需要强有力的组织领导和计划。通过一个案例研究,作者提供了一个多年的、连续的逐步战略,包括识别道德文化差距、建立道德工作组、澄清问题并确定问题的优先级、制定变革战略、实施战略和评估结果。这个过程将帮助组织将其行动与其使命和价值观相一致,从而在所有方面取得成功。
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引用次数: 0
Fall Prevention Conceptual Framework. 预防跌倒概念框架。
Q2 Nursing Pub Date : 2020-10-01 DOI: 10.1097/HCM.0000000000000300
Sam Abraham

Falls can have lasting psychological and physical consequences, particularly fractures and slow- healing processes, and patients may also lose confidence in walking. Injuries from falls lead to functional decline, institutionalization, higher health care costs, and decreased quality of life. The process related to the problem of patient falls in the hospital, using the nursing model developed by the theorist, Ida Jean Orlando, is explained in this article. The useful tool that provides guidance to marketers in this endeavor is Maslow's hierarchy of needs. During acute illness, individuals are greatly in need of satisfying their physiological needs. If these needs are not met, patients leave the hospital lacking a positive experience. Initial fall risk assessment is critical to plan intervention and individualize care plan. Interventions depend on the severity of fall risk factors.

跌倒会造成持久的心理和生理后果,特别是骨折和愈合缓慢,患者也可能失去走路的信心。跌倒造成的伤害导致功能下降、住院、更高的医疗费用和生活质量下降。本文使用理论家Ida Jean Orlando开发的护理模型,解释了与医院患者跌倒问题相关的过程。马斯洛的需求层次理论是为市场营销人员提供指导的有用工具。在急性疾病期间,个体非常需要满足自己的生理需求。如果这些需求没有得到满足,患者离开医院时就会缺乏积极的体验。初步的跌倒风险评估是制定干预措施和个性化护理计划的关键。干预措施取决于跌倒危险因素的严重程度。
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引用次数: 0
DECIDE: A Decision-Making Model for More Effective Decision Making by Health Care Managers. 决策:医疗保健管理人员更有效决策的决策模型。
Q2 Nursing Pub Date : 2020-07-01 DOI: 10.1097/HCM.0000000000000299
Kristina L Guo

The purpose of this article is to describe a step-by-step process for decision making, and a model is developed to aid health care managers in making more quality decisions, which ultimately determines the success of organizations. The DECIDE model is the acronym of 6 particular activities needed in the decision-making process: (1) D = define the problem, (2) E = establish the criteria, (3) C = consider all the alternatives, (4) I = identify the best alternative, (5) D = develop and implement a plan of action, and (6) E = evaluate and monitor the solution and feedback when necessary. The DECIDE model is intended as a resource for health care managers when applying the crucial components of decision making, and it enables managers to improve their decision-making skills, which leads to more effective decisions.

本文的目的是描述一个逐步决策的过程,并开发了一个模型来帮助医疗保健管理人员做出更有质量的决策,这最终决定了组织的成功。decision模型是决策过程中需要的6个特定活动的缩写:(1)D =定义问题,(2)E =建立标准,(3)C =考虑所有备选方案,(4)I =确定最佳备选方案,(5)D =制定和实施行动计划,(6)E =评估和监控解决方案并在必要时提供反馈。在应用决策的关键组成部分时,decision模型旨在作为卫生保健管理人员的资源,它使管理人员能够提高决策技能,从而做出更有效的决策。
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引用次数: 3
Enhancing Communication to Improve Patient Safety and to Increase Patient Satisfaction. 加强沟通,改善患者安全,提高患者满意度。
Q2 Nursing Pub Date : 2020-07-01 DOI: 10.1097/HCM.0000000000000298
Audrey M Burgener

With the continuous rise of sentinel and adverse events due to ineffective communication, it is time for health care organizations to start implementing a focus on enhancing effective communication in which will, in turn, improve patient safety and experience, boosting the bottom line. This article identifies and discusses different communication protocols that can be used to enhance the consistency of more efficient and effective communication within a health care organization to overall improve patient care and patient satisfaction. The rising importance of patient satisfaction and Hospital Consumer Assessment of Healthcare Providers and Systems scores required by the Centers for Medicare and Medicaid Services are causing a shift in how hospitals evaluate and manage their health care organizations today. Following the situation-background-assessment-recommendation and acknowledge-introduce-duration-explain-thank protocols, as well as proper and effective training and educational programs, enhances more effective communication in health care organizations which improves patient safety and increases patient satisfaction.

由于无效沟通导致的哨兵事件和不良事件不断增加,现在是卫生保健组织开始关注加强有效沟通的时候了,这反过来又会改善患者的安全和体验,提高底线。本文确定并讨论了不同的通信协议,这些协议可用于增强医疗保健组织内更高效和有效通信的一致性,从而全面改善患者护理和患者满意度。根据医疗保险和医疗补助服务中心的要求,患者满意度和医院消费者对医疗保健提供者和系统评分的重要性日益提高,这导致了医院评估和管理其医疗保健机构的方式发生了转变。遵循情况-背景-评估-建议和确认-介绍-持续-解释-感谢协议,以及适当和有效的培训和教育计划,可以增强医疗保健组织中更有效的沟通,从而改善患者安全和提高患者满意度。
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引用次数: 12
期刊
Health Care Manager
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