Suchergebnisse

Ferry Efendi,1,2 Joni Haryanto,1,2 Retno Indarwati,1,2 Heri Kuswanto,3 Elida Ulfiana,1,2 Eka Mishbahatul Mar'ah Has,1,2 Mei-Chan Chong4 1Department of Advanced Nursing Care, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia; 2Community Health, Geriatric and Family Nursing Research Group, Universitas Airlangga, Surabaya, Indonesia; 3Department of Statistics, Institut Teknologi Sepuluh Nopember (ITS), Surabaya, Indonesia; 4Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, MalaysiaCorrespondence: Ferry Efendi Email ferry-e@fkp.unair.ac.idBackground: The Indonesian policymakers need to respond to the current challenges, particularly the excess of nurses and the increased demand for nurses in the global market.Objective: This study aimed to present the perception of policymakers and stakeholders on the management of overseas migration of Indonesian nurses.Methods: This study is a descriptive qualitative design where data were collected through structured interviews with key stakeholders representing the Indonesian government, namely the Ministry of Health (MOH), the Ministry of Labour (MOL), Ministry of Education (MOE) and the Indonesian Migrant Workers Protection Agency (BP2MI). The in-depth interviews involved participants who were responsible for managing Indonesian nurses' migration. The qualitative data were analyzed thematically using a content analysis approach.Results: The issues involving nurses' migration policy are quite complex and sectoral. Themes emerging from this study include the move towards global market orientation, addressing challenges on international nurse migration, strengthening coordination among stakeholders and making the most of opportunities. All the themes reflect that the country should work hard to achieve the balance between quantity and quality of nursing resources for the international market.Conclusion: As regulator and executor of Indonesian nurse migration, various government policies have responded to the low number of Indonesian nurses' migration overseas, emphasizing the three cycles of migration: pre-migration, migration and post-migration. The preparation of resources, regulations and placements for Indonesian nurses abroad open the opportunity to the international nursing labour market. Hence, the policies need to be strengthened from upstream to downstream to make Indonesian nurses more competitive and adaptive in global market.Keywords: health worker, Indonesian nurses, migration, workforce, active labour market policies, global jobs

Norwegian municipal health care has large public service offerings, funded by tax revenues; however, the current Norwegian welfare model is not perceived as sustainable and future-oriented. First-line nurse managers in Norwegian municipal health care are challenged by changes due to major political and government-initiated reforms requiring expanded utilization of home nursing. The aim of this theoretical study was to describe challenges the first-line nurse managers in a Nordic welfare country have encountered on the basis of government-initiated reforms and to describe strategies to maintain their responsibilities in nursing care. First-line nurse managers' competence, clinical presence, and support from superiors were identified as prerequisites to maintain sight of the patients in leadership when reforms are implemented. The strategies first-line nurse managers in Norwegian municipal health care use to implement multiple reforms, regulations, and new acts require solid competencies in nursing, leadership, and administration. Competence in nursing enables focus on the patient while leading the staff. Supports from superiors and formal leadership networks are described as prerequisites for managing the challenges posed by change and to persist in leadership positions. ; publishedVersion

Norwegian municipal health care has large public service offerings, funded by tax revenues; however, the current Norwegian welfare model is not perceived as sustainable and future-oriented. First-line nurse managers in Norwegian municipal health care are challenged by changes due to major political and government-initiated reforms requiring expanded utilization of home nursing. The aim of this theoretical study was to describe challenges the first-line nurse managers in a Nordic welfare country have encountered on the basis of government-initiated reforms and to describe strategies to maintain their responsibilities in nursing care. First-line nurse managers' competence, clinical presence, and support from superiors were identified as prerequisites to maintain sight of the patients in leadership when reforms are implemented. The strategies first-line nurse managers in Norwegian municipal health care use to implement multiple reforms, regulations, and new acts require solid competencies in nursing, leadership, and administration. Competence in nursing enables focus on the patient while leading the staff. Supports from superiors and formal leadership networks are described as prerequisites for managing the challenges posed by change and to persist in leadership positions. ; publishedVersion

Norwegian municipal health care has large public service offerings, funded by tax revenues; however, the current Norwegian welfare model is not perceived as sustainable and future-oriented. First-line nurse managers in Norwegian municipal health care are challenged by changes due to major political and government-initiated reforms requiring expanded utilization of home nursing. The aim of this theoretical study was to describe challenges the first-line nurse managers in a Nordic welfare country have encountered on the basis of government-initiated reforms and to describe strategies to maintain their responsibilities in nursing care. First-line nurse managers' competence, clinical presence, and support from superiors were identified as prerequisites to maintain sight of the patients in leadership when reforms are implemented. The strategies first-line nurse managers in Norwegian municipal health care use to implement multiple reforms, regulations, and new acts require solid competencies in nursing, leadership, and administration. Competence in nursing enables focus on the patient while leading the staff. Supports from superiors and formal leadership networks are described as prerequisites for managing the challenges posed by change and to persist in leadership positions. ; publishedVersion ; Paid Open Access

Objective: Currently, health literacy is a hot topic worldwide. It is important for all age groups, for every individual and for society as a whole. Health literacy refers to the ability to obtain, understand and use information related to health and healthcare. The aim of the study was to identify problems related to health literacy that patients encounter in the context of their own healthcare and at the same time clarify the views of nurses on the education and health literacy of older patients. Design: Qualitative research using the technique of semi-structured interviews. Participants: Interviews were conducted with 10 senior healthcare workers (9 women, 1 man) from four healthcare facilities in the Czech Republic and Slovakia. The average age of the participants was 48 years (SD = 6.65, median 47, range 38 – 60). Methods: The method of content analysis was used to analyze the obtained data. The obtained data were processed based on the analysis using open and thematic coding and categorization. Results and conclusion: Barriers and strategies used by patients in managing their health were identified. These barriers and strategies were grouped into three themes and nine categories. Health literacy screening in a clinical care environment would not only be a beneficial tool in the care of elderly patients. Healthcare managers and senior healthcare workers should develop strategies to create environments and resources supportive of health literacy interventions.

Many conversations involve sending or receiving "bad news." These conversations are often dreaded, poorly executed, or avoided altogether. Ways need to be found to make them less difficult and more productive. We explored these issues through three methodologically diverse studies. Study 1 comprised in-depth interviews with 24 nurse managers. Interviews shed light on the characteristics of difficult conversations and strategies for making them less awkward and more successful. Study 2 was a survey investigating relationships between six dimensions of supportive communication and participant satisfaction with a difficult superior-subordinate conversation. Study 3 experimentally manipulated two supportive communication behaviors, plus a third variable, face-work. Together, these studies show that successful outcomes from difficult workplace conversations require the parties to balance task and relational goals, with the latter particularly dependent on acts of empathy and face-giving.

During times of disaster, hospitals play an integral role within the healthcare system by providing essential medical care to their communities. Any incident that causes loss of infrastructure or patient surge, such as a natural disaster, terrorist act, or chemical, biological, radiological, nuclear, or explosive hazard, often requires a competent response and recovery effort of nurses. This descriptive study aimed to assess the disaster risk reduction and management of government hospital nurses on the components of disaster prevention and mitigation, disaster preparedness, disaster response, and disaster rehabilitation and recovery. The one hundred respondents were randomly selected from the five government hospitals in the province of Zambales, Philippines. The researchers employed various data gathering procedures such as interview and the use of questionnaire. Data were statistically treated using frequency, weighted mean, percentage and ANOVA. The researchers found out that the disaster risk reduction and management by government hospital nurses was frequently practiced. Moreover, it revealed that disaster risk reduction and management has a significant difference on the respondent's education, training and work experiences. Healthcare systems need to ensure that all healthcare staff including nurses are ready for disaster occurrences. Regardless of the variation of demographic profiles, nurses should know the scope of their responsibility and role in responding to, managing and recovering from disasters impacts.

Key Foundations of Successful Quality Project Planning, Implementation, Evaluation, and Management : An Overview / James L. Harris and Bettina Riley -- Quality Improvement Projects and Quality Improvement Research : Advancing Translational Science / Linda Roussel -- Implementation Science, Team Science, and Translational Science : The Value for Projects / Clista Clanton and Linda Roussel -- Forming and Managing a Synergistic Interprofessional Improvement Team -- Making the Case for a Project : Organizational and Needs Assessment / Carolyn Thomas Jones and Linda Roussel -- Using Findings from Organizational Analysis and Clinical Needs Assessment to Frame Improvement Projects and Implementation /Linda Roussel and Shea Polancich -- Literature Synthesis and Organizational Alignment to Project Interventions and Implementation / Catherine Dearman and Lolita Chappel-Aiken -- Building the Improvement Project Budget : Quantifying the Cost and Quality Equation / Patricia L. Thomas and James L. Harris -- Developing Metrics That Support Project Plans, Interventions, and Programs / Patricia L. Thomas -- The Institutional Review Board Process / Catherine Dearman, Dionne Roberts, and Lolita Chappel-Aiken -- Big Data and Information Systems : Understanding the Value for Improvement Projects / James L. Harris, Todd Harlan, and Lonnie K. Williams -- Developing Metrics That Support Project Plans, Interventions, and Programs / Patricia L. Thomas and Michael Bleich -- Innovation, Diffusion, and Dissemination of Improvement Outcomes / James L. Harris and Catherine Dearman.

The dissertation "The Ethics of Bilateral Labor Agreement for Global Nurses - Perspectives from the Philippines" is written in the research area of applied ethics and examines ethical aspects of labor migration in the specific area of healthcare, with the Philippines as an example. The central questions for the dissertation are the ethical issues of nurse migration in the Philippine context. These ethical concerns give rise to how the responsibility for such migration governance should be understood and designed. More specifically, the issue of responsibility is discussed in relation to the Philippine Government, and its counterpart foreign governments, for their use of the bilateral labor agreement (BLA) as a policy measure to manage the migration of nurses. The thesis draws on from empirical studies of Filipino nurses' massive emigration and how this mobility affects individuals and the Philippine society. Historical description of the emergence of healthcare professionals as export products in the Philippines is also consulted. The country's colonial history is described, and its relevance to today's migration pattern is analyzed. Based upon the empirical data on past and present Filipino health worker emigration, identified ethical implications are examined. Among these are the rights of individuals and the division of responsibilities between origin and destination countries in order to address the ethical implications the BLAs give rise to. In the theoretical part of the work, key elements from John Rawls' theories of justice (1971, 1993, 2001) are used to identify conditions of a crafting public policy that, ideally, should be met in agreement with the members of a liberal society. Thereafter, the ideal model of a BLA is constructed based on the main principles of justice. The model is used to examine the extent to which, if at all, the existing BLAs between the Philippines and countries like Japan and Germany can be considered as ethically defensible instruments for managing the emigration of nurses. Finally, a discussion on how such agreements should be designed to be ethically defensible is offered. ; Avhandlingen "The Ethics of Bilateral Labor Agreement for Global Nurses – Perspectives from the Philippines " är författad inom forskningsområdet tillämpad etik och undersöker etiska aspekter av kompetensmigration inom det specifika området vård och omsorg, med Filippinerna som ett exempel. De mest centrala frågorna för avhandlingen är vilka etiska frågor som kompetensmigration inom området vård och omsorg i en Filippinsk kontext ger upphov till liksom hur ansvaret för sådan migration bör förstås och utformas. Mer konkret diskuteras ansvarsfrågan i relation till den Filippinska statens bruk av bilaterala avtal avseende Filippinska sjuksköterskor. Studien tar sin utgångspunkt i empiriska studier av massutvandringen av Filippinska sjuksköterskor och hur denna mobilitet påverkar enskilda individer liksom det Filippinska samhället. Den deskriptiva delen rymmer även en historisk beskrivning av framväxten av "vårdpersonal som en exportprodukt" i Filippinerna. Landets koloniala historia skildras och relevansen därav för dagens migrationsflöde analyseras. Ur den inledande empiri-fokuserade delen extraheras ett antal frågor av etisk karaktär. Dessa rör primärt de rättigheter och skyldigheter liksom ansvar och ansvarsfördelning för de identifierade etiska implikationerna av rådande kompetensmigration. I en teoretisk, analytisk del av arbetet, används centrala element ur John Rawls teorier om rättvisa (1971, 1993, 2001) för att identifiera villkor som, idealt, bör vara uppfyllda i avtal som rör medborgare. Därefter tillämpas den ideala modellen på rådande bilaterala avtal gällande arbetskraftsutvandring inom vårdsektorn. Modellen och används för att undersöka i vilken grad, om alls, som de befintliga bilaterala avtalen som Filippinerna har utverkat med länder som Japan och Tyskland kan anses vara etiskt försvarbara instrument för att kontrollera flödet av arbetskraft inom vårdsektorn. Avslutningsvis diskuteras hur sådana avtal skulle behöva utformas för att vara etiskt försvarbara.

ABSTRACTObjectivesTo examine the oral health knowledge and practices of pediatric nurses who coordinate healthcare services for special needs children and to identify those factors that influenced their perceived effectiveness in managing their patients' oral health needs.MethodsSelf‐reported data were collected from 376 nurses employed at Children's Medical Services who responded to an online survey. Likert scale scores were used to specifically assess the nurses' perceived effectiveness in addressing the oral health needs of special needs children.ResultsCharacteristics significantly associated with special needs pediatric nurses who described themselves as "effective or very effective" included: the self‐perception of being very knowledgeable about basic oral health, receiving four or more hours of continuing education training, and securing dental appointments for the majority of their pediatric special needs patients with minimal waiting times.ConclusionFindings reveal that oral health knowledge significantly influenced nurses' perceived effectiveness in addressing the oral health needs of special needs children, as well as their ability to secure timely dental appointments. These results support the need to incorporate oral health education into nursing curricula and expand upon the dental workforce available and willing to treat disabled patients.

The equitable distribution of work among the nurses and health assistants is essential to maintaining the optimum quality of patient care, staff contentedness, and effectiveness of the different health facilities. Unequal distribution of tasks affects the level of emotionally and physically burned-out nurses who lack job satisfaction and provide substandard services. At the same time, the health assistants are overtrained, yet their skills are underemployed. Dependence on gender and other factors to assign certain tasks results in disadvantages for the healthcare professionals in addition to negatively affecting patient care with worse prognosis and potential for mistakes. The gaps reveal that while nurses perform clinical and administrative work and have little face-to-face time with the patient, health assistants are locked into non-clinical work despite their capabilities. The following critical review assesses the current status of workload issues and key findings regarding its influence on health care and workforce concerns. Thus, reviewing the recent research defines the major issues like role conflict and enrichment, lack of effective policies, and organizational resistance to change. The review also points out that there is a need for developing substantial system improvements to improve the textual roles, such as there should be proper demarcation of roles, training that increases the competencies of Health assistants, as well as the incorporation of technology inventions such as task management systems, among others. Such interventions can enhance the fairness of workload distribution, decrease staff turnover, and enhance resource management, promoting efficiency and teamwork. Resolution of these problems is crucial to maintaining high standards of patient care and promoting healthcare employees' welfare, therefore establishing international collaboration as urgent in managing healthcare professionals' workloads.

Family caregivers of patients with moderate-to-severe traumatic brain injury (TBI) regularly visit the patient during the hospital stay and are involved in their care. As impairments caused by the TBI often preclude the patient from stating preferences for visitors, family caregivers often make decisions about visitors on the patient's behalf during the hospital stay. However, limited literature investigates this process. The purpose of this study was to describe family caregivers' experience of visitors while the patient with moderate-to-severe TBI is hospitalized. Authors used grounded theory to conduct 24 interviews with 16 family caregivers. Findings showed family caregivers manage welcome and unwelcome visitors throughout the hospital stay to protect the patient's physical and emotional safety and to conserve their own energy. Staff had limited involvement in management of unwelcome visitors. These findings have practice implications for educating hospital staff about providing family nursing and assisting families to manage unwelcome visitors and about policy implications for improving hospital visiting policies.

This article discusses the relationship between the demands on nurses' professional performance and adherence to the use of medicines and supplements for their management. This approach allows us to analyze the transformations of nursing work and how nurses use various natural and pharmaceutical resources to cope with the pressures they face in their professional activities. To understand the interconnection between the transformations in nursing work and what we refer to here as the process of pharmaceuticalisation of work contexts, we use the results of a sociological mixed methods study on the use of medicines and food supplements for managing professional performance. The results show some of the main pressure factors in nursing work and how the increase in professional pressure substantially affects performance-related medicine use, as these become more frequent when nurses perceive their work as more intense, demanding, and exposed to risks.

Developmental delay in very young children is trending upward. Maternal depressive symptoms are known to negatively impact child development and may also impact family management of the child's condition. Research on family management guided this second phase of a sequential mixed methods study. The purpose of this study was to explore mothers' perceptions of family management of their children's developmental delays. Mothers of very young children who received early intervention services were interviewed. A team-based content analysis approach revealed key findings: (a) views of the child that were not holistic, (b) condition management ability was informed by what the mother thought her child needed, (c) views of condition impact were related to adapting to possible child outcomes and experiences of isolation, and (d) parental/caregiver mutuality was impaired by conflict. Understanding perceptions of family management and influence of depressive symptoms in this context is essential to extend assessment and intervention.

Abstract Background Sweden introduced a school-based human papillomavirus (HPV) vaccination programme in 2012, and school nurses are responsible for managing the vaccinations. The aim of the present study was to investigate the attitudes and experiences of school nurses regarding the school-based HPV vaccination programme 1 year after its implementation. Methods Data were collected using a web-based questionnaire in the spring of 2013, and 83.1% (851/1024) of nurses responded. Results There were strong associations between the nurses' education about the HPV vaccine and their perceived knowledge about the vaccine and a favourable attitude towards vaccination (both p < 0.001). School nurses who received a high level of education were more likely to have a positive attitude to HPV vaccination compared with nurses with little education about HPV vaccination (adjusted odds ratio [OR] = 9.8; 95% confidence interval [CI]: 3.797–25.132). Nurses with high perceived knowledge were more likely to have a positive attitude compared with those with a low level of perceived knowledge (OR = 2.5; 95% CI: 1.299–4.955). If financial support from the government was used to fund an additional school nurse, nurses were more likely to have a positive attitude than if the financial support was not used to cover the extra expenses incurred by the HPV vaccination (OR = 2.1; 95% CI: 1.051–4.010). The majority, 648 (76.1%), had been contacted by parents with questions about the vaccine, mostly related to adverse effects. In addition, 570 (66.9%) stated that they had experienced difficulties with the vaccinations, and 337 (59.1%) of these considered the task to be time-consuming. Conclusions A high level of education and perceived good knowledge about HPV are associated with a positive attitude of school nurses to the HPV vaccination programme. Thus, nurses require adequate knowledge, education, skills and time to address the questions and concerns of parents, as well as providing information about HPV. Strategic financial support is required because HPV vaccination is a complex and time-consuming task.