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The drive to reform the public health care system became a common feature of Australia's political and economic landscape from the early 1980s. Health care reform in Australia has been underpinned by New Public Management (NPM) which was promoted as providing more transparent policy and empowering managers to manage service delivery. However, these claims are a fallacy and nursing and nursing care have been affected adversely and severely. General (generic) management structures have replaced established nursing management structures and the distance between politics (politicians) and health service managers has narrowed to the extent that there is now an unprecedented level of political interference in the daily management of health services, in direct contrast to the tenets of NPM. This article reports on the 'reformed' health care environment as experienced by nurse managers. They reported that their ability to manage nursing services and provide professional and clinical leadership has been seriously diminished, as has their work satisfaction, motivation and commitment. They also report uncertainty about their future as well as the future of nursing itself.

Background To identify barriers to participation in a primary oral health care programme aimed at preventing early childhood caries, as perceived by nurses. Methods Of a total of 140 randomly selected nurses employed in 40 government health centres in Lima, 123 completed a pre-tested questionnaire. Background variables were districts' 'socio-economic status' (SES) and 'years of experience'. Factor analysis was performed. ANOVA was applied for testing the influence of the background variables on the barrier factors. Chi-square test was applied to test for differences between single item barriers and the background variables. The Likert-scale (1–4) was used. Results There was no statistical significant effect of 'SES' or of 'years of experience' of nurses on any of the 7 barrier factors, nor on the 11 single item barrier factors. The highest mean score (3.81) was obtained for the barrier factor 'importance of oral health', followed by 'perceived responsibility' (3.44). The lowest mean score was (1.70) for 'knowledge on caries prevention'. Conclusions Nurses consider oral health very important and are willing to participate actively in programmes aimed at reducing Early Childhood Caries, provided that they will be trained well and that the director and dentists of the health centre give their consent.

This book is intended to be a tool for personnel working in the field of public nutrition or related areas. Such personnel may be public nutritionists, community dieticians, physicians, nurses, mid-level managers and planners and managers in government and private institutions with responsibility for or interested in public nutrition, and relevant others who are not mentioned here. The personnel of non-governmental and international organisations and university departments concerned with health and nutrition may also find it useful. The book may not be considered as a textbook on basic issues in nutrition or research methodology. It is assumed that the people who will use the book already have fundamental skills in these areas. The approach suggested reflects the author's viewpoint on public nutrition. The editor has drawn for the first publication of the book, and his own experiences, that of other people working in public nutrition, various theories in nutrition and health planning, education, social marketing, business planning and leadership, and managers by objectives. The World Health Organisation should also be thanked for allowing using the second issue of the book, Planning and Managing Community Nutrition Work, as a point of departure for this issue.

IntroductionNurse home visiting (NHV) is designed to redress child and maternal health inequities, but long-term evaluation is hampered by sample attrition. Evaluation using administrative data has the potential to overcome attrition through provision of a more complete outcome profile. Australia's "right@home" trial is the only long-running evaluation of NHV designed for a population with universal healthcare.
ObjectivesTo investigate the effects of the NHV program on children's health and development outcomes and service use, compared with usual care (comparator), using linked administrative data at school transition.
MethodsA screening survey identified pregnant women experiencing adversity from antenatal clinics across two states (Victoria, Tasmania). 722 were randomized: 363 to the right@home program (25 visits promoting parenting and home learning environment) and 359 to usual care. At children's first birthdays, 198/237 (83.5) Tasmanian and 420/485 (86.6) Victorian parents consented to data linkage with the Tasmanian Kindergarten Development Check (KDC, 4 years) and Victorian School Entrant Health Questionnaire (SEHQ, 5-6 years), respectively. Jurisdictional differences meant measures could not be harmonized, and variables varied in their interpretability. Following best-practice methods for managing missing data, outcomes were compared between groups (intention-to-treat) using regression models adjusted for stratification factors, baseline variables, and nurse/site cluster.
ResultsLinked data were obtained for n = 134/237 (56.5) Tasmanian and n = 252/485 (52.0) Victorian children. These children had substantially higher prevalence of negative life events and poorer health and development outcomes, and used similar or more services than children state-wide. Compared with usual care, the NHV program increased KDC achievement and SEHQ health service use. There was less evidence for program impacts on SEHQ outcomes.
ConclusionsBenefits of NHV were evident at school transition for child development outcomes and service use. This adds further evidence for NHV being an important component of universal health services that deliver support responsive to families' needs.
RegistrationISRCTN89962120

This paper presents a sociological approach to coffee consumption as a performance management strategy in work contexts, particularly in professions with intense work rhythms and highly responsive demands. Focusing on the daily work of three professional groups (nurses, police officers, and journalists), we analyze the social expression of coffee and how it is mobilized to deal with sleep problems, fatigue, concentration, or stress. For this purpose, three intertwined dimensions are explored: (1) the nature of these professionals' work and the pressures for certain forms and levels of performance; (2) sleep problems as both a result of those work characteristics and a constraint on performance; and (3) the role of coffee in managing professional imperatives. The use of coffee appears as a legitimate practice in everyday working routines, due to its socializing markers, whereas additional benefits are attributed to the pharmacological properties of caffeine, given the perceived improvement in performance. The empirical data derive from a study carried out in Portugal on the use of medicines and food supplements for performance management, following a mixed methods approach. In particular, data from a questionnaire survey in a sample of 539 workers and information collected through seven focus groups with a total of 33 participants were used.

BackgroundImprovement of the quality of maternal and child health care remains a focus in India. Working with the Government of Bihar, CARE-India facilitated a comprehensive set of quality of care improvement initiatives. PRONTO's simulation and team-training was incorporated into the large-scale Apatkaleen Matritva evam Navjat Tatparta (AMANAT)nurse-mentoring program of the Government of Bihar supported by CARE-India to improve maternal and child health outcomes. Along-with the AMANAT program, the PRONTO components provided training on nontechnical and technical competencies for managing a variety of obstetric and neonatal conditions, as a team. This study assessed the effectiveness of nurse-mentoring including simulations on intrapartum and newborn care practices in 320 basic emergency obstetric and neonatal care (BEmONC) facilities.MethodsDeliveries were observed to obtain specific information on evidence-based practice (EBP) indicators before and after the intervention. Intrapartum and newborn care composite scores - were calculated using those EBP indicators. A web-based routine monitoring system provided total training days, weeks and days/week of training and counts of simulation and teamwork-communication activities. Multilevel linear regression was used to examine the exposure-outcome associations.ResultsThe final analysis included 668 normal spontaneous vaginal deliveries (NSVDs) from 289 public health facilities in Bihar. Facility-level intrapartum and newborn scores improved by 37 and 26-percentage points, respectively, from baseline to endline. Compared to the bottom one-third facilities that performed fewest NSVD simulations, the top one-third had 6 (95% confidence interval (CI) = 1-12) percentage points higher intrapartum score. Similar comparison using maternal complication simulations yielded 7 (95% CI = 1-12) percentage point higher scores. The highest newborn scores were observed in the middle one-third of facilities relative to the bottom one-third that did the fewest NSVD simulations (5, 95% CI: 1-10).ConclusionsFindings suggest significant overall improvement in intrapartum and newborn care practices after the AMANAT nurse-mentoring program in public sector BEmONC facilities. Simulation and team-training likely contributed towards the overall improvement, especially for intrapartum care.Study registrationClinicalTrials.gov number NCT02726230.

Health-related behaviours in children can be influenced by parental support programmes. The aim of this study was to explore barriers to and facilitators for the implementation of a parental support programme to promote physical activity and healthy dietary habits in a school context. We explored the views and experiences of 17 coordinating school nurses, non-coordinating school nurses, and school principals. We based the interview guide on the Consolidated Framework for Implementation Research. We held four focus group discussions with coordinating and non-coordinating school nurses, and conducted three individual interviews with school principals. We analysed data inductively using qualitative content analysis. We identified "Creating commitment in an overburdened work situation" as an overarching theme, emphasising the high workload in schools and the importance of creating commitment, by giving support to and including staff in the implementation process. We also identified barriers to and facilitators of implementation within four categories: (1) community and organisational factors, (2) a matter of priority, (3) implementation support, and (4) implementation process. When implementing a parental support programme to promote physical activity and healthy dietary habits for 5- to 7-year-old children in the school context, it is important to create commitment among school staff and school nurses. The implementation can be facilitated by political support and additional funding, external guidance, use of pre-existing resources, integration of the programme into school routines, a clearly structured manual, and appointment of a multidisciplinary team. The results of this study should provide useful guidance for the implementation of similar health promotion interventions in the school context.

Health-related behaviours in children can be influenced by parental support programmes. The aim of this study was to explore barriers to and facilitators for the implementation of a parental support programme to promote physical activity and healthy dietary habits in a school context. We explored the views and experiences of 17 coordinating school nurses, non-coordinating school nurses, and school principals. We based the interview guide on the Consolidated Framework for Implementation Research. We held four focus group discussions with coordinating and non-coordinating school nurses, and conducted three individual interviews with school principals. We analysed data inductively using qualitative content analysis. We identified "Creating commitment in an overburdened work situation" as an overarching theme, emphasising the high workload in schools and the importance of creating commitment, by giving support to and including staff in the implementation process. We also identified barriers to and facilitators of implementation within four categories: (1) community and organisational factors, (2) a matter of priority, (3) implementation support, and (4) implementation process. When implementing a parental support programme to promote physical activity and healthy dietary habits for 5- to 7-year-old children in the school context, it is important to create commitment among school staff and school nurses. The implementation can be facilitated by political support and additional funding, external guidance, use of pre-existing resources, integration of the programme into school routines, a clearly structured manual, and appointment of a multidisciplinary team. The results of this study should provide useful guidance for the implementation of similar health promotion interventions in the school context.

Successive evaluations of French Military hospitals by the Court of Auditors point out a sub-activity that generates a deficit. The French Military Health Care Service acknowledged these points but considers that military activities (in particular participation in External Operation), may explain, at least partly, the deficit and sub-activity mentioned by the Court of Auditors.This practical question feeds the theoretical reflection conducted in this thesis. A detailed description of external operations shows that they can be considered as soft projects. These projects are characterized by the progressive determination of their goals: that are not completely known when the project starts. The literature questions adequacy of project management standards to soft projects and the following research question emerges: what is the role of stakeholders' engagement and planning flexibility in soft projects management?The thesis is based on an intervention research. A simulation is built to objectify external operations management in military hospitals. It highlights the impact of external operations on care production and consequently on hospitals 'deficit. Two analyses are conducted to understand the causes of this impact. First, an analysis of the current planning process of external operations suggests that renewing planning methods can be necessary to offer a flexible planning based on cooperation. Second, the simulation reveals the important role of physicians and nurses' commitment in managing external operations. This commitment, driven by strong relationships between project stakeholders, positively influences external operations' outcomes.These observations allow theoretical progress on management tools for soft projects.Two concepts seem particularly suited to soft projects' constraints: interactive planning developed in companies facing high uncertainties and relational contracting described by law and economics scholars. Interactive planning brings both flexibility and cooperation that appear decisive to ...

Background: Non-pharmacological methods have unique advantages to relieving pain that medications do not have such as giving the patients a more active role in managing their pain. There are many types of non-pharmacological methods that vary amongst heat/cold, distraction, massage and relaxation. Nurses must have a great knowledge of non pharmacological methods to practice them effectively. In addition, nurses' own attitudes greatly affect the way they treat a patient's pain. Objective: To assess nurses' knowledge, attitudes and practice of non-pharmacological pain management therapies and techniques when caring for patients in selected governmental health care settings in West Gojjam zone, Amhara regional state, Ethiopia. Method: Cross-sectional study design was used. Data was collected from March 2014 to April 2014 by using a structured open and closed ended questionnaire. Source population of the study was nurses who work at governmental health care institutions in West Gojjam. In this study, sample size was 583 nurses from randomly selected woredas. To assess the relationship of factors and non-pharmacological pain management odds ratio, bivariate and multivariate regression analysis were performed. Results: The results show non pharmacologic pain management practices were at an unsatisfactory level. The most barriers to applied non-pharmacological pain management were lack of time, patient unwieldiness and lack of equipment. There was a positive relationship between age, educational level, years of experience, and attendance on training courses with practice and positive relationship between knowledge and attitude with practice of the nursing staff regarding non-pharmacological methods. Conclusion: In this cross-sectional study, socio demographic factors, knowledge, attitude contributing to nurses' non-pharmacological practice were analyzed. , socio demographic factors, knowledge and attitude were found significantly associated with nurses' practice. Recommendation: This study recommended that efforts to improve application of non drug interventions should focus on innovative educational strategies, using problem solving to secure support, and development and testing of new delivery methods that require less time from busy staff nurses. Key words: pain, non-pharmacological, nurses, knowledge, attitude, practice

AbstractAs the largest public health crisis within a century, the COVID‐19 pandemic has caused long‐term disruption in the support systems of people with intellectual and developmental disabilities (IDD) across the globe. The purpose of this study was to investigate challenges and ameliorative strategies to supporting the basic care needs of people with IDD 1 year into the pandemic, as experienced by nurses who specialize in IDD nursing. We surveyed a convenience sample of 369 nurses from across North America, Europe, and Australasia using a 52‐item online questionnaire. Descriptive statistics were used to rank the greatest challenges and the degree of support available to nurses, and manifest content analysis was used to analyze open‐ended responses related to ongoing challenges and ameliorative strategies. Results of descriptive analyses revealed consistent findings across global regions in terms of the challenges faced by nurses; the greatest challenges related to supporting or enabling socialization with family/friends, ensuring adequate day programming or educational services, identifying/planning alternative entertainment activities, ensuring adequate staffing of familiar support workers and caregivers, and managing challenging behaviors related to change in daily routine and activities. Nurses described a considerable degree of support offered by their organizations in terms of flexibility in scheduling related to family obligations and paid time off for COVID‐19‐related isolation and quarantine. Content analysis of open‐ended survey responses revealed numerous challenges related to: (1) client socialization, meaningful activity, and mental/behavioral health; (2) interpreting, keeping up with, and helping others to understand COVID‐19 guidelines; (3) access to, quality of, and continuity of care; and (4) COVID‐19 fatigue and the influence of time. Overall, our study highlights ongoing issues with access to care and support, exacerbated by the pandemic, and the importance of having meaningful activity and socialization for overall well‐being of people with IDD during a long‐term public health crisis.

The objective of this study was to explore and describe the experiences of health care providers managing sexual assault victims in the emergency unit of a community hospital in the Nkangala district in the Mpumalanga Province. A qualitative, phenomenological design was applied. Purposeful sampling was used to select participants from health care providers who were working in the emergency unit and had managed more than four sexual assault victims. Data were collected by means of individual interviews and analysed according to the Tesch method of data analysis by the researcher and the independent co-coder. Main categories, subcategories and themes were identified. Participants expressed their emotions, challenges and police attitudes and behaviours as well as inconsistencies in guidelines and needs identification. It was recommended that members of the multidisciplinary team engage in community activities and that the community participate in matters pertaining to sexual assault. Government should develop clear guidelines that are applicable to rural and urban South Africa. Health care sciences should aim to train more forensic nurses. All relevant departments should work together to alleviate the complications caused by sexual assault incidents. ; Die doel van hierdie studie was om die ervaringe van gesondheidsorgverskaffers wat slagoffers van seksuele aanranding in die ongevalle-eenheid van 'n gemeenskapshospitaal in die Nkangala-distrik in die provinsie van Mpumalanga hanteer, te verken en te beskryf. 'n Kwalitatiewe fenomenologiese ontwerp is toegepas. Doelbewuste steekproefneming is gebruik om deelnemers te selekteer uit die groep gesondheidsorgverskaffers wat in die ongevalle-eenheid werksaam was en meer as vier slagoffers van seksuele aanranding hanteer het. Data is by wyse van individuele onderhoude ingesamel en volgens die Tesch-metode van data-analise deur die navorser en die onafhanklike medekodeerder geanaliseer. Hoofkategorieë, subkategorieë en temas is geïdentifiseer. Deelnemers het uitdrukking ...

Introduction: Birth asphyxia is failure to initiate and sustain breathing immediately after birth. According to world health organization (WHO), it is the third major cause of neonatal death after infections and Preterm births in developing countries, accounts for an estimated 23% of the annual 4 million neonatal deaths. The nurses require a high level of knowledge in managing birth asphyxia that occurs in newborn and assessment skills to practice it in NICU and labour ward to prevent further complications in the newborn. This will enable quality care which increase likelihood of newborns survival and promote optimal quality care. Objective: To assess knowledge, attitude and practice of nurses working in NICU and labour ward toward management of birth asphyxia in governmental hospitals Addis Ababa, Ethiopia. Methodology: Institutional based Cross sectional study was conducted to assess the knowledge, attitude and practice of staff nurses working in NICU and labour ward toward management of birth asphyxia at governmental hospital in Addis Ababa from February-March, 2017. Systematic random sampling technique wasutilized to select study subjects and to determine sample size a single proportion formula was used. According to this formula the sample size of the study was 168. Pretest was done and data entered into Epi-info version (3.5.1) statistical software package then exported to SPSS software package version 21 for further analysis.Result was presented by text, table, pie chart and histogram. Result:Of the total 163, 108 (66.3%)of the respondents have knowledge of birth asphyxia management.Nurses and midwives whogot training were 2.6 times {AOR=2.6; 95% CI (1.02- 6.63)} more likely to have knowledge of birth asphyxia compared to those didn't get training. In relation to practice profession was significantly associated with practice for birth asphyxia management, nurses were 4.7 times {(AOR=4.71; CI (1.306, 16.988)} more likely to practice compared to those midwives. Conclusion and Recommendation: The study revealed about sixty six percent of nurses and midwives have knowledge of birth asphyxia management. More than half of them have good practice and positive attitude towards the management of birth asphyxia. Training should be considered to increase knowledge of nurses and midwives on management of birth asphyxia. Keywords: Birth asphyxia, knowledge, attitude, practice, NICU, labour ward, nurses, midwives

Overall aim: To describe the essence of autonomy and participation for older people in care, and how to promote this in care for them. Method: A descriptive design with a phenomenological approach. Sixteen older people (I) and 13 registered nurses (II) participated in individual face-to-face interviews (I and II). Twelve case/care managers and supervisors participated in a focus group interview, they were grouped by profession, case managers, first line managers and local authority senior medicine advisors, four in each group and interviewed once (III and IV). The data analyses were guided by Giorgi's descriptive phenomenological method (I and II) and the systematic text condensation by Malterud (III and IV). Findings: The informants were in agreement that maintaining older people's health and wellbeing promote autonomy and participation, and supportive relationships are relevant (I–IV). Older people focused on everyday life experiences they made by choice and managing on their own, as strengthening self-esteem and self-identity (I). The registered nurses focused on caring for frail older people and their need for acknowledgement in everyday care. They noted that of providing choices as enable older people to have joyful everyday life experiences (II). The managers and supervisors focused on informed consent, and legislation, and offered solutions to securing a meaningful everyday life by caring for older people's wishes and needs. They also spoke of the risk the severe consequences could result from older people's decision-making and their health conditions (III). Relatives were respected as a resource and attended to in everyday care for older people but the focus was the older person in their present life situation and their individual rights (IV). Conclusion: Promoting to autonomy and participation for older people were maintained health and wellbeing, and the possibility to manage on their own terms. Informed consent, shared decision-making, supportive relationships and acknowledgement of relatives in the life-changing situations were ways to promote autonomy and participation. To promote autonomy and participation in care for older people is also to provide for choices that are meaningful to the older person at end of life in a joyful and permissive atmosphere.

Cover -- Title -- Copyright -- Contents -- Contributors -- Foreword -- Preface -- Reference -- Acknowledgments -- Share: Nursing Deans on Leading: Lessons for Novice and Aspiring Deans and Directors -- Section I: Dimensions of the Nursing Dean/Director Role -- Chapter 1: Searching for a Dean/Director Position -- Introduction -- Dean/Director or Not?Change or Not? -- Searching for a Dean/Director Position -- What Do You Want in a Dean/Director Position? -- Interim Dean -- Next Steps -- Conclusion -- Resources -- Chapter 2: Stepping Into a Dean/Director Position -- Introduction -- Background -- Arrival Phase -- Honeymoon Phase -- Launch Phase -- Challenges/Opportunities -- Managing Expectations -- Work-Life Balance, or Not? -- Crisis Management -- Self-Care -- Conclusion -- Resources -- References -- Chapter 3: Day-to-Day Deaning -- Introduction -- Organization of Dean/Director Activities -- The Dean/Director's Calendar -- Changing Priorities -- Checking in with the Budget Officer -- Email -- Teaching -- Hiring New Faculty -- Firing Faculty and Staff -- Student Services -- Delegation: Who, What, When -- Recognition and Awards -- Conclusion -- Resources -- References -- Chapter 4: Deaning in a For-Profit Environment -- Introduction -- The For-Profit Sector -- Look-Alikes, Act-Alikes -- What's the Same? -- Traits for Successful Deaning in the For-Profit Sector -- Growth and Scaling -- Understanding Compensation -- Measures of Success -- Managing Up and to the Side -- Compliance and Scrutiny -- Conclusion -- References -- Chapter 5: Interim Deaning -- Introduction -- In the Beginning… -- Leading in a Time of Change -- Considering the First Step -- The First Step -- The Philanthropic Challenge -- New Steps on the Horizon -- Maintaining Personal Career Balance -- The Last Step: Stepping in a New Way on the Staircase -- Conclusion -- References.