(1) Background: Healthcare workers experienced rising burnout rates during and after the COVID-19 pandemic. A practice-academic collaboration between health services researchers and the surgical ...services program of a Canadian tertiary-care urban hospital was used to develop, implement and evaluate a potential burnout intervention, the Synergy tool. (2) Methods: Using participatory action research methods, this project involved four key phases: (I) an environmental scan and a baseline survey assessment, (II), a workshop, (III) Synergy tool implementation and (IV) a staffing plan workshop. A follow-up survey to evaluate the impact of Synergy tool use on healthcare worker burnout will be completed in 2023. (3) Results: A baseline survey assessment indicated high to severe levels of personal and work-related burnout prior to project initiation. During the project phases, there was high staff engagement with Synergy tool use to create patient care needs profiles and staffing recommendations. (4) Conclusions: As in previous research with the Synergy tool, this patient needs assessment approach is an efficient and effective way to engage direct care providers in identifying and scoring acuity and dependency needs for their specific patient populations. The Synergy tool approach to assessing patient needs holds promise as a means to engage direct care providers and to give them greater control over their practice-potentially serving as a buffer against burnout.
OBJECTIVESThis study evaluated the psychometric properties of the Korean-language version of the Hospital Survey on Patient Safety Culture (HSOPSC) among Korean nurses.
METHODSWe analyzed secondary ...data from 801 direct care nurses working at a tertiary, private, nonprofit, teaching hospital in South Korea. Descriptive statistics, internal consistency coefficients, and intercorrelations were calculated. The latent factor structure of the HSOPSC was examined using exploratory structural equation modeling techniques, which account for the noncontinuous nature of ordinal data.
RESULTSAlthough a majority of subscales showed acceptable to good internal consistency, 4 dimensions (staffing, overall perceptions of patient safety, organizational learning–continuous improvement, and nonpunitive response to errors) had reliability levels less than 0.6. The HSOPSC items loaded somewhat diffusely on 3 subscalesstaffing, teamwork across units, and organizational learning–continuous improvement. Correlations between the 12 HSOPSC factors indicated discriminant validity. Convergent validity was supported by correlations between the 12 subscales and a single-item outcome variable, namely, patient safety grade. Several items did not load well on their respective subscales, but most items fit the underlying theoretical model implied by the HSOPSC, resulting in an acceptable model fit (confirmatory fit index = 0.985, root mean square error of approximation = 0.034, weighted root mean square residual = 0.54).
CONCLUSIONSDespite the acceptable model fit of the Korean version of HSOPSC, the psychometric properties of this instrument require further investigation to ensure it is an effective tool to measure patient safety culture and identify areas for improvement in the Korean health care system.
Psychological Competence Havaei, Farinaz; Dahinten, V. Susan; MacPhee, Maura
The Journal of nursing administration
44, Issue:
5
Journal Article
Peer reviewed
OBJECTIVE:The aim of this study was to examine the effects of specific cognitions or aspects of psychological empowerment on 5 major aspects of leader empowering behaviors.
BACKGROUND:Leader ...empowering behaviors are linked to important employee outcomes such as work effectiveness. Psychologically empowered leaders are known to use more empowering behaviors in their practice. There is limited research examining what aspects of psychological empowerment are most associated with different aspects of leader empowering behaviors.
METHODS:Data from a sample of 103 frontline and midlevel nurse leaders were analyzed after they participated in a leadership development program.
RESULTS:Psychological competence was the strongest predictor of the total score for leader empowering behaviors and 4 of 5 subscale scores, and meaning was the 2nd strongest predictor. Autonomy was not a significant predictor.
CONCLUSION:Psychological empowerment, particularly in the form of psychological competence, is an important leader characteristic and should be a focus of leadership development strategies.
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BFBNIB, CMK, NMLJ, NUK, PNG, UL, UM, UPUK
Aim
The purpose of this study was to examine the main and interaction effects of perceived organisational support, span of control and leadership rank on novice nurse leaders’ organisational ...commitment.
Background
As nurse leaders’ organisational commitment is eroded at times of healthcare restructuring, it is important to study factors associated with organisational commitment.
Methods
Cross‐sectional data from 69 novice nurse leaders, collected via mailed surveys at two time points, were analysed using hierarchical regression.
Results
The findings supported our hypotheses about the positive effect of perceived organisational support, the positive effect of leadership rank and the negative effect of span of control on novice nurse leaders’ organisational commitment. In addition, perceived organisational support was shown to moderate the negative effect of span of control on novice nurse leaders’ organisational commitment at time 2.
Conclusion
Organisational strategies aimed at supporting nurse leaders, and attention to span of control, are required to enhance the organisational commitment of novice nurse leaders.
Implications for nursing management
Nurse leaders with a wide span of control, in particular those with little leadership experience, need to adopt leadership strategies that maximise their effectiveness, such as organising smaller work groups or teams within their wide span of control.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Background: In British Columbia, the Nursing Policy Secretariat of the Ministry of Health recently issued a series of priority nursing recommendations, including team-based care delivery models.
Aim: ...This paper will describe the data collection and analysis phase of a quality improvement initiative focused on care delivery redesign within three healthcare organizations. The focus of the care delivery redesign was a transition from total nursing care to team-based nursing care.
Methods: Our leadership-academic partnership used the Canadian Nurses Association's "Staff Mix Decision-Making Framework for Quality Nursing Care" to guide data collection and analysis on patient, nurse and organizational factors. Data were collected by nurse-led project teams using a patient needs assessment tool, surveys of nurses' scope of practice and teamwork and an environmental profile tool with nurse demographics and unit/facility-level characteristics.
Results: Findings from one organization's pediatric medicine and surgery units are presented in this paper.
Conclusion: Quality improvement data provide multiple opportunities for proactive human resource planning and professional development. Resources and examples are provided to guide others' redesign efforts.
The main purpose of this paper is to examine the psychometric properties of the original five-point CWEQ II using Item Response Theory (IRT) methods, followed by an examination of the revised ...three-point CWEQ II. (1) Background: The psychometric properties of the CWEQ II have not been previously assessed using more robust techniques such as IRT. (2) Methods: This is a secondary analysis of baseline data from 1067 staff nurses whose leaders had attended a leadership development program. Data were analyzed using a polytomous IRT model. (3) Results: The two versions of CWEQ II fit the SE data equally as each had only one poor-fitting item. For the five-point CWEQ II, discriminant ability was poor for a majority of the items; one item demonstrated a disordinal step difficulty parameter; and item reliability was supported for a relatively wider range of SE levels. The discriminant ability and reliability of items for the three-point CWEQ II was better than those of the five-point CWEQ II, but for a narrower range of SE levels; and the disordinal step difficulty parameter was resolved. (4) Conclusion: The appropriate use of each version of the scale depends on the conditions of the work setting targeted.
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CEKLJ, IZUM, KILJ, NUK, ODKLJ, PILJ, SAZU, UL, UM, UPUK
Aims: This study examined the effect of various components of a model of nursing care delivery, the mode of nursing care delivery and nursing skill mix on (a) quality of nursing care (i.e., nurse ...reported quality of nursing care and nursing tasks left undone), (b) patient adverse events, and (c) nurse outcomes (i.e., job satisfaction and emotional exhaustion) after controlling for nurse demographic characteristics, work environment and workload factors. This study also explores the moderating effects of mode of nursing care delivery and skill mix on the relationship between workload factors and the five outcome variables. ;
Background: Research into redesigning care delivery has typically focused on only one care delivery component at a time (e.g., skill mix). There exists little research focusing on both components, and controlling for one factor while the other is investigated to determine quality of nursing care delivery and nurse and patient outcomes. ;
Method: This cross-sectional exploratory correlational survey study drew upon secondary data from 416 direct care registered nurses (RNs) from medical-surgical settings.;
Results: Nurses working in a team-based mode of care delivery reported a greater number of nursing tasks left undone compared to those working in a total patient care mode of delivery. Nurses working in a skill mix with licensed practical nurses (LPNs) reported a higher frequency of patient adverse events compared to those working in a skill mix without LPNs. Two moderating effects were found. At higher levels of acuity, nurses in a team-based mode of care delivery reported a higher frequency of patient adverse events than did nurses in a total patient care mode of delivery. At higher levels of acuity, nurses working in a skill mix with LPNs reported lower levels of emotional exhaustion than nurses in a skill mix without LPNs.;
Conclusion: Models of nursing care delivery components influenced quality and safety outcomes. ;
Implications: To be effective, a team-based mode of care delivery requires collaborative teamwork. Policy makers, administrators and healthcare providers should work together to clarify and optimize the scopes of practice for RNs and LPNs.
Applied Science, Faculty of
Nursing, School of
Graduate
The aim of this paper is to enhance readers' understanding of research design strategies, past and present, for studying nursing workloads. Future research directions are also discussed. Nursing ...workloads are associated with nurse burnout and turnover. During our current global nursing shortage, researchers must identify ways to mitigate nurses' heavy workloads. Relevant, prior nursing workload research is presented with brief descriptions of designs, methods and findings. To illustrate the current complexity of nurses' work environments and the myriad factors that influence nurses' workloads, this paper features the ongoing nursing workload research of two Canadian research teams with different methodological approaches. These two teams are employing current research innovations, such as human factors multi-systems frameworks, design thinking, simulation modeling and integrated knowledge translation. With respect to future research implications, the teams are melding methods and tools to promote a more sophisticated way of understanding the complex linkages between patient needs, systems design and the management of nurses' workloads. Keywords: nursing workloads, nurses' work environments, synergy tool, patient needs assessment, human factors, simulation modeling
Context: To slow the spread of COVID-19 within the Canadian long-term residential care (LTRC) sector, a series of pandemic management strategies were introduced, including restricted visitation and ...single site employment. These strategies were enacted to prevent and control infection, resulting in unknown impact on direct care staff and staff capacity to deliver quality care or service. Objective: To explore staff reports of outcomes associated with LTRC pandemic management strategies, particularly their impact on LTRC staff mental health, work behaviours and quality of care or service provision. Method: This was a case study using mixed methods including a longitudinal survey and interviews with staff from one LTRC site in British Columbia. Survey data from 68 staff who participated in both survey times were analyzed using regressions with relative weight analysis. Semi-structured interviews were conducted with 26 LTRC staff and analyzed using content analysis. Findings: Survey data demonstrated that staff perceived the sick time policy and staffing levels as the most inadequate pandemic management strategies. Survey data also showed the visitation policy, the sick time policy and the single site employment policy were most significantly associated with negative outcomes to staff mental health, work behaviours and quality of care or service delivery. Qualitative data suggested connections between these policies and inadequate staffing levels and heavy workloads. Limitations: The study design along with the low response rate and the small sample size limits the generalizability of the findings to other settings. Implications: The development and implementation of pandemic management strategies must be informed by and give consideration to working conditions of LTRC staff including long standing systemic issues such as staffing shortages and heavy workloads.
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