Thesis (M.S.)--University of Wisconsin--Madison, 1982. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 129-135).

Thesis (M.S.)--University of Wisconsin-Madison, 1989. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 52-54).

<p>En kvantitativ studie genomfördes som en mindre kartläggning på några orter i Skaraborg. Det framkom i studien att kontinuiteten av vårdpersonal vid behandling av bensår varierar. Kartläggningen genomfördes under en månads tid inom både primärvård och kommuners hemsjukvård. En grupp patienter hade få omläggare medan en annan grupp hade många som lade om bensåret. Nästan alla patienter med bensår i kommunens hemsjukvård hade en patientansvarig sjuksköterska. Av dessa hade en tredjedel träffat sin sjuksköterska under den kartlagda månaden. I primärvården hade drygt hälften av patienterna med bensår en patientansvarig sjuksköterska och majoriteten av dem hade träffat sin patientansvariga sjuksköterska under innevarande månad. Kommunens patienter blev huvudsakligen omlagda av undersköterskor medan primärvårdens patienter blev omlagda av distriktssköterskor och sjuksköterskor.</p> / <p>A quantitative study has been done, carrying out through a small survey in some places in thecounty of Skaraborg. During a month the survey was done in both the primary care and also inthe community care. It was found that the continuity of staff was varying. One sample ofpatients had few nursing staff taking care of the patient’s leg ulcer while another sample ofpatients had many care givers. Almost all patients in the community care had a nurse who wasresponsible for the patient’s leg ulcer. A third of the patients in the community had met theresponsible nurse during the month. At the primary care more than a half of the patients had anurse who was responsible for the patient’s leg ulcer and a majority of them had seen the nurseduring the month. The patients in the community for the most had been taken care of by theassistant nurse who had changed the bandage of the leg ulcer while in primary care, the patientshad been taken care of by a nurse or a district nurse.</p>

Aims: The aims of this thesis were focused on the social climate of inpatient forensic mental health settings. Firstly, the study reviewed the literature of qualitative studies of staff and patient experiences of social climate. Secondly, the utility of a case study methodology to examine innovations to practice in forensic mental health settings are discussed. Thirdly, a longitudinal case study aimed to examine the impact of a Mentalization based treatment (MBT) training and case consultation intervention on the functioning of a low secure ward. Method: A systematic review and qualitative synthesis of social climate in forensic mental health settings was completed using the ‘best-fit’ framework approach. Secondly, a critical analysis of case study methodology was presented based on key decision points. A longitudinal ward case study with staff (n=37) and patient (n=7) participants examined the impact of staff MBT training and MBT based case consultation sessions. MBT based case consultation sessions ran on the ward over an eight month period. Data was collected through a range of methods including questionnaires, semi-structured interviews, ward observations and routinely reported data. The case study data was tested through a pattern matching approach with reference to rival explanations. Results: The systematic review identified 20 papers that met the inclusion criteria. The framework synthesis identified 22 themes related to social climate, which were organised in a conceptual model. Ten themes were seen to represent the experience of social climate. Consideration of the applicability of the case study method to forensic settings found the method to be feasible and acceptable to staff though a limitation is that outcomes are tentative and open to rival explanations. Positive impacts of the training and case consultation intervention included an increase in enthusiasm for working with patients with a personality disorder diagnosis and evidence of some increased team cohesion. The main rival explanation identified was the impact of changes to the composition of the staff and patient group. Conclusions: The systematic review findings highlight that current quantitative measures of social climate may not fully represent the construct. The conceptual model developed allows for generation of potential interventions to improve social climate. In the case study, staff reported positive perspectives of both MBT training and the case consultation sessions. The intervention did not appear to impact on patient motivation, though patients reported positive changes in staff behaviour. The case study method was seen as applicable to forensic mental health settings and provided interpretable data useful for analytical generalisations, and clinically in considering innovations to practice.

A área de enfermagem tem vivenciado algumas problemáticas relativas a recursos humanos, entre elas: escassez de enfermeiros, insatisfação no trabalho e alta rotatividade nos serviços.Este estudo descritivo teve como objetivos: descrever a distribuição das diferentes categorias de trabalhadores de enfermagem segundo variáveis demográficas e de inserção no emprego na rede hospitalar do município de Uberaba-Minas Gerais; mensurar e descrever a rotatividade desses trabalhadores. O estudo foi realizado em 11 hospitais, sendo um público, seis privados e quatro filantrópicos. A população constituiu-se de todos os enfermeiros, técnicos e auxiliares de enfermagem que, no período de 1º de janeiro a 31 de dezembro de 2003, antiveram vínculo empregatício nos hospitais estudados. As variáveis demográficas estudadas foram: sexo e idade; aquelas de inserção no emprego: regime de contrato, jornada semanal, tempo de trabalho e rendimento médio. A rotatividade foi verificada aplicando-se indicadores globais: taxas de admissão (TA) e de desligamento (TD), taxa líquida de substituição (TLS), permanência média no emprego (em anos); e específicos: tempo mediano de trabalho dos demitentes (em meses) e curva de sobrevivência no emprego. Os dados foram coletados mês a mês, em fontes secundárias originárias do cadastro de empregados e folha de pagamento. Durante o ano de 2003 estiveram empregados na rede hospitalar 1.368 trabalhadores de enfermagem, sendo 805 auxiliares de enfermagem, 417 técnicos de enfermagem e 146 enfermeiros. Essa força de trabalho era composta, majoritariamente, por mulheres (81,8%), com idade mediana de 38 anos, a maioria cumprindo jornada de trabalho semanal de 36 horas, sob contrato celetista. Nos hospitais privados e filantrópicos os trabalhadores eram mais jovens que no público; 70% dos técnicos de enfermagem, 60% dos auxiliares de enfermagem e 50% dos enfermeiros tinham menos de cinco anos no emprego atual. Os enfermeiros apresentaram média de rendimentos de 5|-10 SM e os técnicos e auxiliares de enfermagem, de 2|-5 SM. Nos hospitais estudados ocorreram 327 admissões e 276 demissões. As taxas de admissão dos trabalhadores (31%) foram superiores às de desligamento (26,1%). Os hospitais privados apresentam as maiores TA (44,3%) e TD (42,1%). A TLS dos trabalhadores foi de 24,3%. O maior nível de TLS situou-se nos hospitais privados (30,7%). O quadro de trabalhadores da rede hospitalar seria totalmente renovado em 3,6 anos; nos hospitais privados, isso ocorreria em 2,4 anos enquanto no público, em 5,3 anos. Todos os enfermeiros seriam substituídos em 4,7 anos e os técnicos e auxiliares de enfermagem em, aproximadamente, 3,5 anos. A mediana de tempo de trabalho dos 276 trabalhadores que saíram do emprego foi de 19 meses; para os demitentes do hospital público, esse tempo foi de 37 meses; nos hospitais privados, de 13 meses, cerca de um ano; pelas curvas de sobrevivência no emprego dos demitentes, identificou-se maior estabilidade e, por conseqüência, menor rotatividade para o grupo de trabalhadores do hospital público. De modo geral, a rotatividade nos hospitais estudados pode ser considerada elevada. Os resultados do estudo trazem contribuições importantes, tanto à direção dos hospitais e serviços de enfermagem, como ao gestor local com vistas ao gerenciamento de recursos humanos em enfermagem no município. / The Nursing area has been facing some difficulties regarding the human resource aspects like nurse scarceness, work dissatisfaction, high turnover rate. The present report aims to describe the allocation of the different Nursing working categories according to demographic variables and working admittance in the hospital network staff of Uberaba - Minas Gerais; to evaluate and portray the turnover of these professionals. The study had embraced eleven hospitals, including a public one, six privates and four philanthropics. The large sample is composed by every Nurse, Technician and Nurse Assistant that had employment relationships with the hospitals aforementioned, in the period of January, 1st to December, 31st of 2003. The demographic variables analyzed were: gender and age; regarding the working admittance: labor agreement, weekly working journey, average income. The turnover was evaluated using global indexes: admission (TA) and dislodgment (TD) rate, liquid replacement rate (TLS), stayers mean service (by years); and specifics: leavers mean service (months), and survival of leavers curve. The data were acquired monthly, using secondary sources, derived from Employees Official Register and Payroll. During 2003, the hospital network engaged 1368 Nursing employees, including 805 nursing assistants, 417 nursing technicians and 146 nurses. This working power was compounded mostly by women (81,8%), with ages varying from 38 years, the majority with 36 hours weekly work journey, under usual rules agreement. The workers are younger in the private and philanthropic hospitals than in the public ones; 70% of nursing technicians, 60% of nursing assistants and 50% of nurses have been less than 5 years in the present work. The nurses have average income of 5 to 10 minimum salaries and the nursing auxiliaries and technicians have 2-5 minimum salaries. In the aforementioned studied hospitals occurred 327 admissions 276 resignations. The admission rate (31%) was higher than the resignation rate (26,1%). The private hospitals presented the biggest TA (44,3%) and TD (42,1%). The TLS was 24,3%. The TLS highest rate is on the private hospitals (30,7%). The entire employee staff would be completed renewed on 3,6 years; in the private hospitals this situation would happen in 2,4 years, while the public would take 5,3 years. All the nurses would be replaced in 4,7 years and the nursing assistants and technicians in 3,5 years. The median service of the 276 workers who left the job were 19 months; for the leavers of the public hospital this time were of 37 months; in the private hospitals, 13 months, approximately a year; by the survival leavers curve could be identified a higher work stability rate, therefore lower turnover rate in the public hospitals. In general, the turnover in the studied hospitals can be considered high. When the issue is the management of human resources in nursing, the results of the study bring important contributions, as much to the hospitals’ direction and nursing services, as to the local manager in town.

Abstract Elderly people, because of the frail health condition and consequent problems, have in most cases substantial difficulties living at home. Despite the need for widened nursing home custody, the field of quality institutional elderly care in Slovenia in the past did not undergo comprehensive research. The purpose of this two-part study was to investigate the quality of institutional elderly care and elderly care offered in Slovenian nursing homes. Additional purpose was to evaluate nursing staff members about their willingness, knowledge, skills and importance to meet residents’ physical and psychosocial nursing care needs. Also, a part of this research was bound for recognition of maltreatment and nursing staff members’ well-being. The qualitative and quantitative research methods were used. The quality of institutional elderly care and elderly care offered were researched by interviewing the parties involved in elderly care, residents, relatives and nursing staff members (N=48). The data for quantitative research was collected by surveying nursing staff by using a structured questionnaire (N=148). All data have been collected in three public and one private nursing home located in two major cities of Ljubljana and Maribor. Collected data was examined by content analysis method and statistical analysis, to corroborate findings across data sets, reducing the impact of potential biases that can exist in a single study. Triangulation was used to approach to data analysis to synthesize data from multiple sources. Main categories of quality institutional elderly were formulated as attentive care, optimal custody and holistic approach. The most important issue of quality institutional elderly care was formulated as meeting needs on time. Nursing staff members were found to be better skilled in meeting physical than psychosocial needs of residents. Maltreatment was recognised as neglect of care due to postponed duties or hastiness in nursing interventions resulting in discomfort of residents. Factors in connection to quality of institutional elderly care were expressed as quality of nursing care, friendly relationship, meaningful activities, pleasant dwelling environment and versatile assistance. The obtained findings were presented in form of proposals to improve quality of institutional elderly care in Slovenian nursing homes, and could be used to develop institutional elderly care and improve dwelling. In addition many specific terms have been extracted during the analysis process that may contribute to development of gerontological nursing care rationale in Slovenia.

This descriptive study was designed to further the exploration of job satisfaction among hospital-employed nurses by using an established theoretical formulation of job satisfaction called the Job Characteristics Model (Hackman & Oldham, 1976) and a standardized tool called the Job Diagnostic Survey (Hackman & Oldham, 1980) to identify and measure job design variables and job satisfaction. Specific study questions guided investigation into perceptions of job characteristics and satisfactions among nurses, the relationship between job design variables and job satisfaction, and the relationship between selected nurse characteristics and job satisfaction. The study was conducted at three geographically dispersed acute care hospitals in British Columbia. A convenience sample of 96 full-time employed registered nurses completed a Nurse Characteristics Questionnaire and a Job Diagnostic Survey. Data were analyzed and compared to normative data using descriptive statistics. Sample data were further analyzed using Pearson's correlation coefficient and the chi-square test of association. Overall, nurses perceived their jobs to be rich in terms of importance, skill variety, and human interaction; but poor in terms of autonomy and the ability to complete a whole and identifiable piece of work. Significant relationships were identified between specific job design variables and job satisfaction. Compared to other professionals, nurses were less satisfied with the autonomy and motivating potential of their job. There was little evidence to support an association between nurse characteristics and job satisfaction. / Applied Science, Faculty of / Nursing, School of / Graduate

The purpose of this study was to explore Zohar’s Multi-Climate Framework for Occupational Safety to determine the effects of staff nurse perceptions of safety priorities in their organization (safety climate) and their work ownership climate (Magnet Hospital designation) on safety citizenship behaviors viewed as in role or extra role. Safety citizenship behaviors are described as behaviors that go beyond the job description to ensure safety. Participants from a convenience sample of three Magnet designated community hospitals in New England completed three scales (Zohar’s Safety Climate Questionnaire, Essentials of Magnetism II and the Safety Citizenship Role Definitions Scale) representing the study variables via an online survey platform. Multivariate analysis of covariance informed the results. Findings include a positive unadjusted relationship between safety climate and work ownership climate (rs=.492, pF (1, 86) = 8.4, p=.005, N=92), controlling for work ownership climate and hospital. Implications include support for a continued focus on better understanding the importance of a positive nursing work environment, a characteristic shared by Magnet designated hospitals, on the presence of safety citizenship behaviors in the acute care environment. A professional work environment should be considered as an important factor in reducing errors in the acute care setting.

No description available.

As a facility that offers an important service to its users, a hospital can be considered as a production unit ; a unit that provides health-care service. Therefore, a range of factors that facilitate this service (i.e. healthcare) need to be considered when speaking of improving the productivity in a hospital ward. Evidence suggests that one of the main factors that affect the productivity level of a hospital ward is how the design of the hospital deals with access and circulation of the people inside the ward (e.g. Joseph and Ulrich, 2007). A productivity-oriented circulation system will need to improve staff performance; enhance patients safety, privacy and rate of recovery; minimise the risk of cross-infection; reduce the delay time of external service delivery; create a more welcoming environment for visitors; and reduce the evacuation time in emergency situations. Thus, the need to design ward layouts that benefit from the most effective circulation system cannot be over-emphasised. The study presented in this thesis focused on finding a method for identifying different systems of access and people circulation in hospital wards and how they could affect nursing staff productivity. The study comprised five main phases. The first phase involved a literature review of existing healthcare environments to identify different types of access and people circulation requirements. In the second phase, data on nursing staff s movements were collected from a case study. The third phase focused on categorising and modelling the existing approaches and layout design systems. Phase four provided a comparative study of different categories of people circulation designs and contrasted their advantages and disadvantages to improve access and people circulation. In the fifth and final phase, the study concluded with proposing guidelines for choosing between different layout options in the design of new hospital wards or the refurbishment of the existing ones. Findings of the study included: further empirical and analytical support for the impact of the ward design on nursing staff s performance; a ranking of the suitability of different design layouts for minimising staff s unnecessary walking in wards similar to the case study; the importance of considering different staff members needs in such analyses; and a ranking of the criticality of different routes within a ward.