Initier une démarche d’analyse de la performance des services infirmiers

Rapport de stage présenté à la Faculté des Sciences infirmières en vue de l’obtention du grade de maîtrise en Administration des services infirmiers, option stage

Transfert de connaissances sur les interventions infirmières pour la prévention du suicide auprès des gens vivant avec un trouble concomitant de santé mentale et de toxicomanie

Travail dirigé présenté à la Faculté des études supérieures en vue de l'obtention du grade de Maître ès (M. Sc.) en sciences infirmières

Responsabilidade social das organizações e satisfação no trabalho: estudo num call center

A presente dissertação tem como objectivo estudar a percepção dos colaboradores a respeito da Responsabilidade Social da Organização exercida pela organização onde trabalham e a relação desta com a Satisfação no Trabalho. Cento e sete colaboradores de um call center responderam a um questionário que incluía as escalas de Percepção de Responsabilidade Social, Satisfação no Trabalho e a escala de Call Center construída para este estudo. As hipóteses são, duas, verificar se quando maior a percepção de práticas socialmente responsáveis nas diferentes dimensões (colaboradores, ambiente e comunidade e económica) maior a satisfação com o trabalho e se as condições de trabalho na organização apresentarem níveis elevados, maior a Satisfação no Trabalho. Dos resultados obtidos, concluiu-se uma associação positiva entre as três dimensões da Responsabilidade Social com a Satisfação no Trabalho, em particular uma associação mais elevada com a dimensão Percepção da Responsabilidade Social - Ambiente e Comunidade. Destaca-se também que a Satisfação no Trabalho está mais associada com a percepção do reconhecimento profissional do que com as condições de trabalho no call center.

A influência do comprometimento organizacional na satisfação no trabalho em voluntariado

Este trabalho tem como principal objetivo estudar a relação entre o comprometimento organizacional e a satisfação no trabalho em voluntários pertencentes a diferentes organizações de terceiro sector da zona da Grande Lisboa. A amostra em estudo é constituída por 121 voluntários, com idades compreendidas entre os 12 e os 63 anos, de ambos os géneros e com habilitações literárias desde o 4ª ano ao ensino superior. No que concerne à metodologia, é utilizado um questionário que mede o comprometimento organizacional, elaborado por Allen e Meyer (1997) e um inventário sobre a satisfação global com trabalho proposto por Hackman e Oldham (1975). Na análise dos dados utilizou-se o programa estatístico SPSS. Os resultados obtidos confirmam a existência de uma relação entre o comprometimento organizacional e a satisfação global com o trabalho. De entre as dimensões do comprometimento organizacional, aquela que possui um melhor poder preditivo sobre a satisfação global com o trabalho é o comprometimento afetivo, sendo que quanto maior este último maior a satisfação com o trabalho. As implicações teóricas destes resultados são abordadas e discutidas.

Egenvård vid typ 2 diabetesur ett sjuksköterske- och patientperspektiv

Syftet med litteraturstudien var att kartlägga sjuksköterskans och patientens syn på egenvård vid typ två diabetes. Studien genomfördes som en systematisk litteraturstudie. Materialsökningen har skett via facklitteratur, Internet samt databaserna Blackwell Synergy, EBSCO HOST, Elin@Dalarna och Ovid. Sökorden var diabetes, education, empowerment, management, nurse, nursing, patient, satisfaction, selfcare. Totalt användes 31 referenser till studien varav 16 empiriska artiklar låg till grund för resultatet. Artiklarna granskades med hjälp av Forsberg & Wengströms modifierade granskningsmall. Av resultatet framkom att sjuksköterskorna och patienterna önskade att de hade mer tid för att tillgodose patientens önskemål. Sjuksköterskorna hindrades av tidsbristen och det påverkade patienterna, vilket ledde till att patienterna inte kunde utveckla sig i hanteringen av sin egenvård. Patienterna önskade även att tillgängligheten av sjuksköterskor fanns kontinuerligt så att de kunde få svar på sina frågor och funderingar kring sin egenvård. Mer ansvar borde läggas på en sjuksköterska som arbetade självständig med diabetespatienter då detta tenderade till att patienterna fick empowerment och ökad kunskap om sin egenvård. Patienterna hade erfarenhet av olika utbildningar som ledde till att deras egenvård förbättrades. Sjuksköterskorna önskade sig mer utbildning som kunde hjälpa patienterna till en god egenvård.

Den fysiska och psykosociala arbetsmiljön samt arbetstillfredsställelse hos egenföretagande tandhygienister i Sverige : en deskriptiv tvärsnittstudie

Syftet med denna studie var att beskriva svenska egenföretagande tandhygienisters (EfTH) arbetsförhållanden för att studera om där fanns samband mellan fysisk och psykosocial arbetsmiljö och arbetstillfredsställelse i gruppen. Samliga tandhygienister i Sveriges tandhygienistförenings sektion för egna företagare (n = 179) inbjöds att deltaga i studien vilken gjordes med hjälp av ett frågeformulär grundat på en förkortad version av the General Nordic Questionnaire for Psychological and Social Factors at Work, QPSNordic 34+. Sextiofem procent (n=108) svarade på enkäten. Resultaten visade att äldre tandhygienister och de som hade fler än 19 yrkesår upplevde högre grad av arbetsskicklighet, var säkrare i sin yrkesroll och kände sig mindre stressade än yngre. Stress var relaterat till fler än trettio arbetstimmar per vecka. Alla frågor i skalorna om arbetstillfredsställelse, arbetsglädje och arbetsstolthet skattades högt och allra högst frågan om arbetsstolthet. Frågor i skalorna om kontroll i arbetet visade på hög kontroll av arbetstakt, pauser och påverkan av beslut i det egna arbetet. Ett statistiskt signifikant samband kunde påvisas mellan kontroll av arbetstakt, påverkansmöjligheter, positiv feedback från patienter och arbetstillfredsställelse. Det fanns också statistiskt signifikanta samband mellan kontroll av arbetstakt, positiv feedback från tandläkare för arbetsresultat, positiv feedback från patienter samt att få tillhöra en (arbets)grupp och arbetsglädje. En slutsats från denna studie är att det förefaller finnas ett samband mellan EfTH:s arbetsförhållanden och hög arbetstillfredsställelse.

How employees remain happy: explaining a paradox

This paper draws on subjective quality of life theory to explain findings from three studies of quality of work life. The studies were conducted with 346 regional process workers, metropolitan employment officers and nurses, The results support the adoption of the theory of homeostasis as an explanation for findings on subjective wellbeing at work surveys. This research goes some way in explaining the paradox that perceived job and work satisfaction remain stable over time, while working conditions may vary widely

People management issues in a third sector health care organisation: preliminary findings

Objective – To use inductive convergent interviewing to generate the perceived critical people management issues of the day as perceived by staff. This was used as preliminary to longitudinal ongoing survey in a third sector health care organisation.

Design – Convergent interviewing is a qualitative technique that addresses research topics that lack theoretical underpinning and is an inductive, flexible, evolving research instrument. The key issues converged after six rounds of interviews as well as a further round to ensure that all of the common people management issues had been generated.

Setting - There is very little in the way of tested models of predictors of employee behaviour in third sector organisations in the Australian health care industry. This study investigates a range of facilities and positions, in various hospitals and aged care facilities within the one third sector health care organisation.

Subjects – The study proposed twenty seven extensive interviews over a range of facilities and positions. Twenty one interviewees participated in the final convergent process.

Conclusions - Critical issues included: workload across occupational groups, internal management support, adequate training, the appropriate skill mix in staff, physical risk in work, satisfaction, as well as other issues. These issues confirm the proposition of sector-ness in health organisations that are multi-dimensional rather than uni-dimensional.

Changes in higher education and valuing the job : the views of accounting academics in Australia

In a previous article (Bellamy et al., 2003), the authors reported on survey research that investigated reasons why academics from business disciplines enter and remain in academia, and the conditions they deem necessary to creating ideal work satisfaction. For both entering and remaining, as well as in achieving ideal work satisfaction, the most important factors were found to be autonomy and flexibility, with teaching and research the next most important factors. In a subsequent analysis of the data, reported in this article, the authors identify and explore significant differences between accounting academics and other business academics in the relative importance placed on these key factors. The findings may be used to inform policy makers and university administrators of the importance of discipline differences when identifying key factors for recruitment and retention of accounting academics specifically, and business academics generally.

Residents' perspectives on urinary incontinence : a review of literature

Background: Individuals in residential aged care facilities experience urinary incontinence more than any other single population. Despite these factors, the impact of the condition on their quality of life, their perspectives of living with the condition, and their preferences for care have received little research attention.

Aim: To provide a descriptive overview of research about; the impact of urinary incontinence on residents’ quality of life; residents’ perspectives of having urinary incontinence; and their preferences for continence care’.

Design: A descriptive review of literature.

Method: A broad search was undertaken for qualitative and quantitative research that evaluated residents’ quality of life related to urinary incontinence; their perspectives on having urinary incontinence, and their preferences for managing it. Data were displayed in tabular format, summarized, and described.

Results: Ten studies were identified and reviewed (six qualitative and four quantitative). They reveal many residents’ value having independent bowel and bladder function, but believe that incontinence in inevitable and intractable. Some adopt self management strategies, however considerable barriers hinder their ability to maintain continence and manage incontinence. Residents often have low expectations, and hence decline further evaluation and treatment. Some express satisfaction with continence care even if this care is not consistent with their preferences. Little is known about how cognitively impaired residents perceive their condition. However some individuals with cognitive impairment respond with acute anxiety when carers’ attempt to provide continence care.

Conclusion: Residents’ perspectives on incontinence and preferences for continence care relate to low expectations for improvement. Such misconceptions should be addressed and residents and their family members should be given a range of options from which to choose. As urinary incontinence impacts on residents’ quality of life, it is also important that continence care is delivered in a participative and sensitive way.

Nurses report a healthy culture: Results of the Practice Environment Scale (Australia) in an Australian hospital seeking Magnet recognition

The Magnet Recognition Program requires evidence that the nursing practice environment supports staff to provide optimal care, access professional development opportunities and participate in hospital affairs. This research aimed to assess clinical nurses’ work environment at a leading private hospital in Sydney, Australia using a version of the Practice Environment Scale of the Nursing Work Index modified for the Australian context. Our results were comparable to Magnet hospitals for two subscales and significantly higher than Magnet results for the remaining three subscales and the composite scale. This was especially pleasing in relation to the hospital's preparation for Magnet recognition. Hospitals across Australasia might find administration of the Practice Environment Scale (modified for use in the Australian context) a useful exercise both as a stimulus to preparation and an indicator of readiness for Magnet recognition.

Exploring nurses' reactions to a novel technology to support acute health care delivery

AIMS AND OBJECTIVES: To explore nurses' reactions to new novel technology for acute health care. BACKGROUND: Past failures of technology developers to deliver products that meet nurses' needs have led to resistance and reluctance in the technology adoption process. Thus, involving nurses in a collaborative process from early conceptualisation serves to inform design reflective upon current clinical practice, facilitating the cementing of 'vision' and expectations of the technology. DESIGN: An exploratory descriptive design to capture nurses' immediate impressions. METHODS: Four focus groups (52 nurses from medical and surgical wards at two hospitals in Australia; one private and one public). RESULTS: Nursing reactions towards the new technology illustrated a variance in barrier and enabler comments across multiple domains of the Theoretical Domains Framework. Most challenging for nurses were the perceived threat to their clinical skill, and the potential capability of the novel technology to capture their clinical workflow. Enabling reactions included visions that this could help integrate care between departments; help management and support of nursing processes; and coordinating their patients care between clinicians. Nurses' reactions differed across hospital sites, influenced by their experiences of using technology. For example, Site 1 nurses reported wide variability in their distribution of barrier and enabling comments and nurses at Site 2, where technology was prevalent, reported mostly positive responses. CONCLUSION: This early involvement offered nursing input and facilitated understanding of the potential capabilities of novel technology to support nursing work, particularly the characteristics seen as potentially beneficial (enabling technology) and those conflicting (barrier technology) with the delivery of both safe and effective patient care. RELEVANCE TO CLINICAL PRACTICE: Collaborative involvement of nurses from the early conceptualisation of technology development brings benefits that increase the likelihood of successful use of a tool intended to support the delivery of safe and efficient patient care.

Reliability and validity of the Alberta context tool (ACT) with professional nurses: Findings from a multi-study analysis

Although organizational context is central to evidence-based practice, underdeveloped measurement hindersitsassessment. The Alberta Context Tool, comprised of 59 items that tap10 modifiable contextual concepts, was developed to address this gap. The purpose of this study to examine the reliability and validity of scores obtained when the Alberta Context Tool is completed by professional nurses across different healthcare settings. Five separate studies (N = 2361 nurses across different care settings) comprised the study sample. Reliability and validity were assessed. Cronbach's alpha exceeded 0.70 for9/10 Alberta Context Tool concepts. Item-total correlations exceeded acceptable standards for 56/59items. Confirmatory Factor Analysescoordinated acceptably with the Alberta Context Tool's proposed latent structure. The mean values for each Alberta Context Tool concept increased from low to high levels of research utilization(as hypothesized) further supporting its validity. This study provides robust evidence forreliability and validity of scores obtained with the Alberta Context Tool when administered to professional nurses.

Investigating the efficacy of an intelligent operation planning and support tool for acute healthcare contexts

Nurses are the largest group of healthcare professionals in hospitals providing 24-hour care to patients. Hence, nurses are pivotal in coordinating and communicating patient care information in the complex network of healthcare professionals, services and other care processes. Yet, despite nurses' central role in health care delivery, intelligent systems have historically rarely been designed around nurses' operational needs. This could explain the poor integration of technologies into nursing work processes and consequent rejection by nursing professionals. The complex nature of acute care delivery in hospitals and the frequently interrupted patterns of nursing work suggest that nurses require flexible intelligent systems that can support and adapt to their variable workflow patterns. This study is designed to explore nurses' initial reactions to a new intelligent operational planning and support tool (IOPST) for acute healthcare. The following reports on the first stage of a longitudinal project to use an innovative approach involving nurses in the development of the IOPST; from conceptualization to implementation.

Trabalhador de enfermagem: de anjo de branco a profissional

O estudo, fundamentado nas premissas teóricas sobre relações de trabalho, em especial de algumas variáveis que integram a categoria microssocial - organização do trabalho e condições de trabalho - aliadas às contribuições da Escola Dejouriana, que analisa os temas do prazer e do sofrimento vinculados ao trabalho, procura desvendar o processo de desgaste/prazer no trabalho dentro de um hospital universitário, trazido através do discurso dos trabalhadores de enfermagem ali atuantes, buscando captar suas realizações, dificuldades, alegrias, tramas e defesas, angústias, contradições, a luta pelo poder, as vivências subjetivas, os silêncios. A presente pesquisa de caráter exploratório, por meio de um roteiro com questões fechadas e entrevistas semi-estruturadas, envolvendo trinta e seis profissionais, representantes das categorias enfermeiro, técnico de enfermagem e auxiliar de enfermagem visou apreender a realidade laboral do Hospital Universitário de Juiz de Fora, tentando delinear os contextos de trabalho vividos como positivo ou negativos, denunciando pontos na convergência trabalhador-contexto de trabalho, a partir dos quais as mudanças devam ser impulsionadas, para que se possa criar novas.estratégias, dirimir conflitos e ampliar as possibilidades de auto-realização e prazer no trabalho. As categorias de análise definidas no estudo possibilitaram uma reflexão sobre os desafios e problemas que surgem da relação trabalhador/trabalho/instituição. O conhecimento dos fatores implicados na gênese do desgaste/prazer no trabalho de enfermagem abre espaço para que estes sejam gerenciados pelos trabalhadores em proveito de sua saúde e qualidade de vida. Em suma, temos que a trajetória da enfermagem de anjo de branco a profissional tem sido marcada por preconceitos, desgaste, sofrimento e luta por espaço laboral. Abandonando a posição de saber periférico e vulnerável, assistimos atualmente o esforço dos trabalhadores de enfermagem para a construção de uma nova imagem que contempla estratégias de revalorização do estatuto profissional, controle da formação, das carreiras e dos conteúdos do trabalho para que se tornem agentes privilegiados e ativos na melhoria das condições de saúde da comunidade e propulsoras de novas idéias para o avanço da gestão nas organizações hospitalares.