Factors surgical team members perceive influence choices of wearing or not wearing personal protective equipment during operative /invasive procedures

Exposure to certain bloodborne pathogens can prematurely end a person’s life. Healthcare workers (HCWs), especially those who are members of surgical teams, are at increased risk of exposure to these pathogens. The proper use of personal protective equipment (PPE) during operative/invasive procedures reduces that risk. Despite this, some HCWs fail to consistently use PPE as required by federal regulation, accrediting agencies, hospital policy, and professional association standards. The purpose of this mixed methods survey study was to (a) examine factors surgical team members perceive influence choices of wearing or not wearing PPE during operative/invasive procedures and (b) determine what would influence consistent use of PPE by surgical team members. Using an ex post facto, non-experimental design, the memberships of five professional associations whose members comprise surgical teams were invited to complete a mixed methods survey study. The primary research question for the study was: What differences (perceptual and demographic) exist between surgical team members that influence their choices of wearing or not wearing PPE during operative/invasive procedures? Four principal differences were found between surgical team members. Functional (i.e., profession or role based) differences exist between the groups. Age and experience (i.e., time in profession) differences exist among members of the groups. Finally, being a nurse anesthetist influences the use of risk assessment to determine the level of PPE to use. Four common themes emerged across all groups informing the two study purposes. Those themes were: availability, education, leadership, and performance. Subsidiary research questions examined the influence of previous accidental exposure to blood or body fluids, federal regulations, hospital policy and procedure, leaders’ attitudes, and patients’ needs on the use of PPE. Each of these was found to strongly influence surgical team members and their use of PPE during operative/invasive procedures. Implications based on the findings affect organizational policy, purchasing and distribution decisions, curriculum design and instruction, leader behavior, and finally partnership with PPE manufacturers. Surgical team members must balance their innate need to care for patients with their need to protect themselves. Results of this study will help team members, leaders, and educators achieve this balance.

Factors Surgical Team Members Perceive Influence Choices of Wearing or not Wearing Personal Protective Equipment During Operative/Invasive Procedures

Exposure to certain bloodborne pathogens can prematurely end a person’s life. Healthcare workers (HCWs), especially those who are members of surgical teams, are at increased risk of exposure to these pathogens. The proper use of personal protective equipment (PPE) during operative/invasive procedures reduces that risk. Despite this, some HCWs fail to consistently use PPE as required by federal regulation, accrediting agencies, hospital policy, and professional association standards. The purpose of this mixed methods survey study was to (a) examine factors surgical team members perceive influence choices of wearing or not wearing PPE during operative/invasive procedures and (b) determine what would influence consistent use of PPE by surgical team members. Using an ex post facto, non-experimental design, the memberships of five professional associations whose members comprise surgical teams were invited to complete a mixed methods survey study. The primary research question for the study was: What differences (perceptual and demographic) exist between surgical team members that influence their choices of wearing or not wearing PPE during operative/invasive procedures? Four principal differences were found between surgical team members. Functional (i.e., profession or role based) differences exist between the groups. Age and experience (i.e., time in profession) differences exist among members of the groups. Finally, being a nurse anesthetist influences the use of risk assessment to determine the level of PPE to use. Four common themes emerged across all groups informing the two study purposes. Those themes were: availability, education, leadership, and performance. Subsidiary research questions examined the influence of previous accidental exposure to blood or body fluids, federal regulations, hospital policy and procedure, leaders’ attitudes, and patients’ needs on the use of PPE. Each of these was found to strongly influence surgical team members and their use of PPE during operative/invasive procedures. Implications based on the findings affect organizational policy, purchasing and distribution decisions, curriculum design and instruction, leader behavior, and finally partnership with PPE manufacturers. Surgical team members must balance their innate need to care for patients with their need to protect themselves. Results of this study will help team members, leaders, and educators achieve this balance.

Managing conflict in user-oriented development environments: Effects on information systems success

Today, many organizations are turning to new approaches to building and maintaining information systems (I/S) to cope with a highly competitive business environment. Current anecdotal evidence indicates that the approaches being used improve the effectiveness of software development by encouraging active user participation throughout the development process. Unfortunately, very little is known about how the use of such approaches enhances the ability of team members to develop I/S that are responsive to changing business conditions.^ Drawing from predominant theories of organizational conflict, this study develops and tests a model of conflict among members of a development team. The model proposes that development approaches provide the relevant context conditioning the management and resolution of conflict in software development which, in turn, are crucial for the success of the development process.^ Empirical testing of the model was conducted using data collected through a combination of interviews with I/S executives and surveys of team members and business users at nine organizations. Results of path analysis provide support for the model's main prediction that integrative conflict management and distributive conflict management can contribute to I/S success by influencing differently the manifestation and resolution of conflict in software development. Further, analyses of variance indicate that object-oriented development, when compared to rapid and structured development, appears to produce the lowest levels of conflict management, conflict resolution, and I/S success.^ The proposed model and findings suggest academic implications for understanding the effects of different conflict management behaviors on software development outcomes, and practical implications for better managing the software development process, especially in user-oriented development environments. ^

Team diversity and leadership: Tests of model of process and direct effects

A model was tested to examine relationships among leadership behaviors, team diversity, and team process measures with team performance and satisfaction at both the team and leader-member levels of analysis. Relationships between leadership behavior and team demographic and cognitive diversity were hypothesized to have both direct effects on organizational outcomes as well as indirect effects through team processes. Leader member differences were investigated to determine the effects of leader-member diversity leader-member exchange quality, individual effectiveness and satisfaction.^ Leadership had little direct effect on team performance, but several strong positive indirect effects through team processes. Demographic Diversity had no impact on team processes, directly impacted only one performance measure, and moderated the leadership to team process relationship.^ Cognitive Diversity had a number of direct and indirect effects on team performance, the net effects uniformly positive, and did not moderate the leadership to team process relationship.^ In sum, the team model suggests a complex combination of leadership behaviors positively impacting team processes, demographic diversity having little impact on team process or performance, cognitive diversity having a positive net impact impact, and team processes having mixed effects on team outcomes.^ At the leader-member level, leadership behaviors were a strong predictor of Leader-Member Exchange (LMX) quality. Leader-member demographic and cognitive dissimilarity were each predictors of LMX quality, but failed to moderate the leader behavior to LMX quality relationship. LMX quality was strongly and positively related to self reported effectiveness and satisfaction.^ The study makes several contributions to the literature. First, it explicitly links leadership and team diversity. Second, demographic and cognitive diversity are conceptualized as distinct and multi-faceted constructs. Third, a methodology for creating an index of categorical demographic and interval cognitive measures is provided so that diversity can be measured in a holistic conjoint fashion. Fourth, the study simultaneously investigates the impact of diversity at the team and leader-member levels of analyses. Fifth, insights into the moderating impact of different forms of team diversity on the leadership to team process relationship are provided. Sixth, this study incorporates a wide range of objective and independent measures to provide a 360$\sp\circ$ assessment of team performance. ^

Team Primacy Concept-based employee evaluation and job performance

This qualitative case study explored how employees learn from Team Primacy Concept (TPC)-based employee evaluation and how they apply the knowledge in their job performance. Kolb's experiential learning model (1974) served as a conceptual framework for the study to reveal the process of how employees learn from TPC evaluation, namely, how they experience, reflect, conceptualize and act on performance feedback. TPC based evaluation is a form of multirater evaluation that consists of three components: self-feedback, supervisor's feedback, and peer feedback. The distinctive characteristic of TPC based evaluation is the team evaluation component during which the employee's professional performance is discussed by one's peers in a face-to-face team setting, while other forms of multirater evaluation are usually conducted in a confidential and anonymous manner.^ Case study formed the methodological framework. The case was the Southeastern Virginia (SEVA) region of the Institute for Family Centered Services, and the participants were eight employees of the SEVA region. Findings showed that the evaluation process was anxiety producing for employees, especially the process of peer evaluation in a team setting. Preparation was found to be an important phase of TPC evaluation. Overall, the positive feedback delivered in a team setting made team members feel acknowledged. The study participants felt that honesty in providing feedback and openness to hearing challenges were significant prerequisites to the TPC evaluation process. Further, in the planning phase, employees strove to develop goals for themselves that were meaningful. Also, the catalyst for feedback implementation appeared to stem from one's accountability to self and to the client or community. Generally, the participants identified a number of performance improvement goals that they attained during their employment with IFCS, which were supported by their developmental plans.^ In conclusion, the study identified the process by which employees learned from TPC-based employee evaluation and the ways in which they used the knowledge to improve their job performance. Specifically, the study examined how participants felt and what they thought about TPC-based feedback, in what ways they reflected and made meaning of the feedback, and how they used the feedback to improve their job performance.^