Nursing management (Harrow, London, England : 1994)最新文献

This article presents a simple conceptual road map for implementing a just culture in healthcare settings. The concept of just culture was developed as one of five fundamental elements of a safety culture by psychology professor James Reason in 1997. A just culture requires an unbiased method of judging human error and is designed to develop organisational trust so that adverse medical events (errors) are reported and corrected before they combine with other errors to cause injury or death. To implement a just culture properly so as to increase organisational safety, practitioners must understand its role in enabling the error reporting needed to develop a safety culture. This article reviews these foundational concepts and explores the human causes of errors that a just culture addresses, the psychological importance of a just culture in enabling error reporting and how to implement a just culture in organisations.

The need for hospital-wide solutions to improve patient flow is broadly recognised. Bed management nurses are integral to patient flow processes, and recognition of their strengths and skills is crucial in implementing effective solutions, yet there is limited research describing their role. This article details a systematic review of the literature on bed management nurses. Six themes were identified: complexity in a context of scarcity; dealing with external pressures and conflicting priorities; need for multiple decision-making strategies; uncertainty; need for training; and unrecognised yet important work. The findings could assist nurse managers and hospital leaders to promote communication, teamwork and coordination between hospital staff and bed management nurses.

Background: Nurse retention is a significant issue worldwide, with many nurses planning to leave the profession. Therefore, it is crucial that healthcare organisations and senior leaders identify effective strategies for retaining their employees, who are their most valuable assets.

Aim: To explore strategies to reduce the voluntary turnover of front-line nurses from the perspective of senior healthcare leaders.

Method: This study used a case study design and a qualitative approach. Semi-structured interviews were conducted with six senior leaders in one US hospital and documents from the organisation's website were reviewed to gain information on the retention strategies used.

Findings: Three themes were identified from the data: job satisfaction, financial compensation and effective communication. Retention strategies used by the senior leaders included a points competition to support recognition of nurses' work, a stoplight strategy and reports, sign-on bonuses, preceptor incentives, tuition reimbursements, staff shout-out boards and stay interviews.

Conclusion: Effective communication, respect, competitive financial compensation, benefits and proper recognition are among the main strategies that senior leaders can use to retain nurses. Shared governance is also important in empowering nurses and subsequently improving retention.

One of the many consequences of the coronavirus disease 2019 (COVID-19) pandemic is that the psychological well-being of nurses and other healthcare staff has received greater attention. The Supporting Our Staff (SOS) service, set up in 2017 at Northampton General Hospital NHS Trust, provides psychological peer support to staff using the Trauma Risk Management (TRiM) model. TRiM is a psychological risk assessment and peer support model designed to mitigate the risks associated with exposure to traumatic events. It was initially developed and used in the UK armed forces but has started to be used in healthcare organisations. This article describes the development and expansion of the SOS service, the implementation of the TRiM model by the SOS team, and the significant part the service has played in the trust's response to the increased psychological support needs of its staff during the COVID-19 pandemic.

Background: Ventilator-associated pneumonia is the most frequent infection seen in intensive care units. Of those patients with an endotracheal tube, many will develop ventilator-associated pneumonia within 48 hours of being mechanically ventilated. There are many issues related to mechanical ventilation including costs, patient outcomes and the amount of suffering patients experience during the process.

Aim: To determine the relationship between development of ventilator-associated pneumonia and patient outcomes and costs, including length of stay on mechanical ventilation, in intensive care units (ICU) and in hospital, and mortality rates and to compare results between ventilator-associated pneumonia and non-ventilator-associated pneumonia groups.

Method: Cross-sectional, observational design. A convenience sample of 151 patients on mechanical ventilation (101 with ventilator-associated pneumonia and 50 with non-ventilator-associated pneumonia) were recruited from ICUs in two public hospitals in Jordan. APACHE-II scores, SOFA scores and clinical pulmonary infection scores (CPIS) were assessed.

Results: The incidence rate of ventilator-associated pneumonia was 50.9/1000 mechanical ventilation days and the cumulative incidence rate was 66.9% among patients on mechanical ventilation. The mean score of hospital length of stay and CPIS was significantly higher in the ventilator-associated pneumonia than the non-ventilator-associated pneumonia group. Higher disease severity and higher organ failure scores increase the risk of mortality in patients with ventilator-associated pneumonia.

Conclusion: A high ventilator-associated pneumonia incidence rate is associated with increased mechanical ventilation, ICU and hospital length of stays, higher mortality and attributed costs. There is a need for continuing education and training for ICU staff to reduce ventilator-associated pneumonia incidence in ICUs.

India reported its index case of coronavirus disease 2019 (COVID-19) in January 2020 and since then there has been an alarming rise in cases. In response to the worsening pandemic and the challenge presented by COVID-19 for hospitals in the public sector, the Government of India asked the country's private hospitals to reserve a percentage of their beds for COVID-19 patients. This article describes how nursing services at the Christian Medical College, Vellore - an unaided, not-for-profit quaternary care teaching hospital in Tamil Nadu, India - addressed various challenges to ensure a sustained, high-quality nursing care response to increased patient load. The main challenges included changing COVID-19 policies, ensuring the hospital was prepared to care for COVID-19 patients, and ensuring the availability of nurses. The article demonstrates how proactive planning, empowered involvement of nursing leaders and collaborative efforts resulted in deployment and training of 1,400 nurses, and ensured coordinated care for more than 10,000 patients with COVID-19.

Background: Organisational justice refers to the extent to which employees perceive workplace procedures, interactions, and outcomes to be fair in nature. Previous research has found that organisational justice has been associated with an employee's commitment to their organisation, job satisfaction, and intention to leave their role. Organisational justice has also been linked to organisational citizenship behaviours, and the likelihood of these behaviours being demonstrated by employees.

Aim: To investigate staff nurses' perceptions of organisational justice and job satisfaction and its relationship to their levels of organisational citizenship behaviour.

Method: Perceived levels of organisational justice, job satisfaction, and levels of organisational citizenship behaviour were evaluated among 175 nurses working in two hospitals in Egypt. Analysis was undertaken to ascertain whether a correlation existed between organisational justice or job satisfaction and levels of organisational citizenship behaviour.

Results: The majority of nurses in this study were found to perceive moderate levels of organisational justice. Organisational justice was positively correlated with levels of organisational citizenship behaviour, as was job satisfaction.

Conclusion: This study found that nurses in two hospitals in Egypt perceived moderate levels of organisational justice in their place of work. Nurse managers should pay extra attention to strategies that promote organisational justice among nurses.

Background: Suboptimal medicines management due to inadequate knowledge can cause risks to patient safety and affect the quality of care and patient outcomes.

Aim: To examine the effect of an educational programme on nurses' knowledge of medicines management.

Method: A pre and post-design was used to evaluate the effectiveness of an educational medicines management programme. Data were collected from nurses before and after programme participation from September 2016 to June 2018. A total of 99 nurses received a multiple-choice questionnaire before and after the programme to assess for changes in their knowledge. Any changes in test performance following the medicines management programme were quantified and tested using McNemar's test and the generalised estimating equation for binary outcomes. The Chi-square test was used to analyse group differences.

Results: The nurses' scores were significantly improved after the medicines management programme on questions regarding documentation, observation, aseptic technique and pharmacology half-life. There was a significant improvement on one of the five questions relating to medicine calculation when converting doses from milligrams to grams.

Conclusion: A mandatory hospital medicines management programme had some effect on increasing nurses' knowledge. However, it also was also found that the programme content could have been improved, particularly regarding nurses' responsibilities for medicines management at patient discharge and documentation when undertaking generic substitution.

Background: The effectiveness and stability of a healthcare organisation's workforce, including nurse managers, can be negatively affected by many factors, including illness, retirement and low levels of retention. One way of mitigating these effects is through succession planning, which can be defined as a strategy to employ the appropriate number and quality of people in key positions such as management to account for factors such as turnover, which can cause instability in a workforce. Many healthcare organisations understand the importance of having trained individuals who are ready to be promoted into leadership and managerial roles vacated by those who leave or are promoted into other positions. However, few formal education programmes specifically target the leadership development of nurses and their potential to progress into more complex leadership positions.

Aim: To assess the effect of nurse managers' knowledge of succession planning on leadership practices and organisational resilience.

Methods: A quasi-experimental research design was applied using a test conducted before and after sessions on knowledge of succession planning, with a group of 60 nurse managers working at a Saudi university hospital. Each nurse manager attended the sessions. Study variables were measured using structured questionnaires before and after attendance.

Results: The results showed significant improvement after the sessions. Improvements were noted in knowledge of succession planning, leadership and succession planning practices, and organisational resilience.

Conclusion: This study demonstrated that providing sessions on succession planning resulted in improvements in nurse managers' knowledge of succession planning, demonstration of succession planning practices, and demonstration of leadership practices.

People manage many aspects of their lives online through digital devices such as smartphones. However, the ability for people to manage their healthcare digitally has not yet been fully realised. Patient portals are secure online links that offer patients convenient and constant access to their personal health records. Evidence has suggested that patient portals can enhance patients' engagement in their own care and support them to manage any long-term conditions. This article describes the introduction of a patient portal at Cambridge University Hospitals NHS Foundation Trust. The article outlines the process of implementation and discusses the lessons learned, which may be of value to other organisations.