Factors associated with evidence-based practice among registered nurses in Sweden : a national cross-sectional study

Background: Evidence-based practice (EBP) is emphasized to increase the quality of care and patient safety. EBP is often described as a process consisting of distinct activities including, formulating questions, searching for information, compiling the appraised information, implementing evidence, and evaluating the resulting practice. To increase registered nurses' (RNs') practice of EBP, variables associated with such activities need to be explored. The aim of the study was to examine individual and organizational factors associated with EBP activities among RNs 2 years post graduation. Methods: A cross-sectional design based on a national sample of RNs was used. Data were collected in 2007 from a cohort of RNs, included in the Swedish Longitudinal Analyses of Nursing Education/Employment study. The sample consisted of 1256 RNs (response rate 76%). Of these 987 RNs worked in healthcare at the time of the data collection. Data was self-reported and collected through annual postal surveys. EBP activities were measured using six single items along with instruments measuring individual and work-related variables. Data were analyzed using logistic regression models. Results: Associated factors were identified for all six EBP activities. Capability beliefs regarding EBP was a significant factor for all six activities (OR = 2.6 - 7.3). Working in the care of older people was associated with a high extent of practicing four activities (OR = 1.7 - 2.2). Supportive leadership and high collective efficacy were associated with practicing three activities (OR = 1.4 - 2.0). Conclusions: To be successful in enhancing EBP among newly graduated RNs, strategies need to incorporate both individually and organizationally directed factors.

Teacher’s leadership in web-based language courses in Dalarna University, Sweden

The purpose of this presentation is to discuss how teacher’s leadership can be used as a teaching method in web based language education. The environments that offer online courses provide a wide field for discussion on the contact between teacher and student. My intention is to contribute to the debate on teacher leadership in online courses. In my earlier studies on leadership, I have explored how some religious leaders affected different social movements in Brazil during the military dictatorship (1964-1985). Pruth (2004) by examining the three kinds of legitimacy described by Max Weber I aimed at seeing and analyzing how religious leaders used different teaching methods to explain their messages to ordinary citizens. Thus my research showed how educational leadership is a way to get people to reach their goals. I became interested in the subject teacher’s leadership whenI participated in a survey of the teaching methods of language courses in Dalarna University which is funded by the NGL Center of Dalarna University. In  this project, we have made interviews with the teachers, undertaken the course plans (in the language department at Dalarna University) and categorized the learning outcomes. A questionnaire was constructed based on the learning outcomes and then either sent out remotely to teachers or completed face to face through interviews. The answers provided to the questionnaires enabled the  project to identify many differences in how language teachers interact with their students but  also, the way of giving feedback, motivating and helping students, types of class activities and materials used. This made me aware of how teachers use their leadership or not in their teaching. My focus is to look at the relationship between teachers and students as an important part of the development and quality of online courses. The teacher's performance on campus is different from online courses. I want to understand how the contact between teachers and students in online courses develop and look at how students can make use of this contact and what influence the teacher's leadership has on the ability for the students to achieve the goals of their course

Managerial leadership for research use in nursing and allied health care professions : a narrative synthesis protocol

BACKGROUND: Nurses and allied health care professionals (physiotherapists, occupational therapists, speech and language pathologists, dietitians) form more than half of the clinical health care workforce and play a central role in health service delivery. There is a potential to improve the quality of health care if these professionals routinely use research evidence to guide their clinical practice. However, the use of research evidence remains unpredictable and inconsistent. Leadership is consistently described in implementation research as critical to enhancing research use by health care professionals. However, this important literature has not yet been synthesized and there is a lack of clarity on what constitutes effective leadership for research use, or what kinds of intervention effectively develop leadership for the purpose of enabling and enhancing research use in clinical practice. We propose to synthesize the evidence on leadership behaviours amongst front line and senior managers that are associated with research evidence by nurses and allied health care professionals, and then determine the effectiveness of interventions that promote these behaviours.Methods/design: Using an integrated knowledge translation approach that supports a partnership between researchers and knowledge users throughout the research process, we will follow principles of knowledge synthesis using a systematic method to synthesize different types of evidence involving: searching the literature, study selection, data extraction and quality assessment, and analysis. A narrative synthesis will be conducted to explore relationships within and across studies and meta-analysis will be performed if sufficient homogeneity exists across studies employing experimental randomized control trial designs. DISCUSSION: With the engagement of knowledge users in leadership and practice, we will synthesize the research from a broad range of disciplines to understand the key elements of leadership that supports and enables research use by health care practitioners, and how to develop leadership for the purpose of enhancing research use in clinical practice.

The Key Role of the School Principal’s Leadership in the Schooling of Newly Arrived Immigrant Pupils in Sweden : Experiences from an Interactive Action Research Project

When newly immigrated children and young people begin school in Sweden, certain challengesarise. These may result from weak Swedish-language skills and different schooling backgrounds,as well as organizational and pedagogical limitations in the schools. This generates demands onschool leaders to lead and develop the organization and teachers competences to meet these pupils’needs. This situation was behind the initiation of the project “New Immigrants and Learning—Competence Development for Teachers and School Principals.” The project ran in schools infour Swedish municipalities, its aim was to develop leadership, organizational and pedagogicalskills that would facilitate the schooling and integration of newly arrived pupils. This article aimsto describe and discuss a Participant Action Research (PAR) based on a think tank and researchcircles, drawing special attention to the role of the school leaders. It will also examine whether theresearch circles and the project overall served to develop educational and intercultural leadership,organizational conditions, collegial learning, pedagogical methods and competence in terms ofschooling for this pupil group.

Do inspections of schools influence head teachers’ leadership?

This paper seeks to describe and discuss the impact of inspections of schools in Sweden. It outlines the political context, based on New Public Management (NPM) theory, according to what role the Schools Inspectorate is supposed to play in order to govern and control. Attention is also devoted, referring an on-going case study, to how inspections influence head teachers and their leadership in their everyday work.   Reports from the Schools inspectorate are public. This forces both politicians and head teachers to take measures. In this case, the head teachers perceived that the inspection reports confirmed what they already knew, but it also gave them an alibi and a tool to push their teachers to take part in everyday school development work. During the first year after the inspection the head teachers mainly strived to adjust formal deficiencies in local steering documents. However, some of the deviations reported from the Schools inspectorate are regarding pedagogical problems that are complicated and difficult to handle. As interventions in many cases will show up much later the results are, for example as increased goal fulfilment, in this case, still an open question. Nevertheless, it seems obvious that the Schools Inspectorate must be seen as a result of the governing philosophy that denotes New Public Management NPM).

Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings

Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.

Knowledge translation in Uganda : a qualitative study of Ugandan midwives' and managers' perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework

BACKGROUND: A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful translation of knowledge into practice is the influence of organizational context. A theoretical framework highlighting this process is Promoting Action on Research Implementation in Health Services (PARIHS). However, research linked to this framework has almost exclusively been conducted in high-income countries. Therefore, the objective of this study was to examine the perceived relevance of the subelements of the organizational context cornerstone of the PARIHS framework, and also whether other factors in the organizational context were perceived to influence KT in a specific low-income setting. METHODS: This qualitative study was conducted in a district of Uganda, where focus group discussions and semi-structured interviews were conducted with midwives (n = 18) and managers (n = 5) within the catchment area of the general hospital. The interview guide was developed based on the context sub-elements in the PARIHS framework (receptive context, culture, leadership, and evaluation). Interviews were transcribed verbatim, followed by directed content analysis of the data. RESULTS: The sub-elements of organizational context in the PARIHS framework--i.e., receptive context, culture, leadership, and evaluation--also appear to be relevant in a low-income setting like Uganda, but there are additional factors to consider. Access to resources, commitment and informal payment, and community involvement were all perceived to play important roles for successful KT. CONCLUSIONS: In further development of the context assessment tool, assessing factors for successful implementation of evidence in low-income settings--resources, community involvement, and commitment and informal payment--should be considered for inclusion. For low-income settings, resources are of significant importance, and might be considered as a separate subelement of the PARIHS framework as a whole.

Future Students, Future Revenues: Thriving in a Decade of Demographic Decline:

Over the past decade, universities were able to grow revenue primarily by growing enrollment and increasing net tuition per student. But demographic and economic changes will make it increasingly difficult for all but a handful of institutions to grow tuition revenue at historic rates. Despite rising access rates, demographic projections suggest that the number of high school graduates will decline over the coming decade, leading to a dramatic drop-off in the overall rate of enrollment growth. The traditional population of 18- to 22-year-olds will remain a majority at most institutions, but enrollment growth will come primarily from other student segments. Populations such as community college transfers, international undergraduates, professional master’s students, and adult degree completers offer the best opportunities to grow enrollment and tuition revenue. Serving them well requires significant investments, new organizational models, and cultural change on campus. This can be done in a financially sustainable way—fulfilling the university’s mission to serve a diverse range of students while providing financial resources to support the core. This brief analyzes the forces that will shape higher education over the next decade and highlights the strategies and competencies that colleges and universities will need to be successful.

Optimizing the Performance Evaluation Process for Non-Academic Staff

If conducted poorly and without support from all employee levels, performance management programs at institutions may devolve into annual evaluations that represent a staff burden rather than an ongoing career development opportunity. This brief analyzes the key components of successful performance evaluation systems for non-academic staff, incorporating insights from employers outside of the higher education sector as well. It examines the importance of midyear check-in meetings; employee goal-setting; simplified rating scales on evaluation forms; and core staff competencies that reflect institutional priorities. It also describes how institutions communicate modifications to the evaluation system and offers recommendations for the implementation of process change.

Elementos que intervêm no desdobramento do plano estratégico : estudo em instituição de ensino superior

O presente trabalho foi estruturado a partir de um estudo qualitativo baseado na experiência de planejamento estratégico em uma universidade. Teve por objetivo identificar as variáveis que intervêm na implementação daquele processo com a utilização da metodologia de desdobramento de diretrizes. O estudo qualitativo realizado adotou procedimentos que incluíram pesquisa individual com representantes dos segmentos da universidade. Os entrevistados representam os responsáveis pelas finalidades de planejamento, de supervisão geral e setorial, de execução do ensino, bem como de apoio técnico e assessoria. Os principais procedimentos adotados no desenvolvimento da pesquisa foram descrição, análise e interpretação. O planejamento estratégico, usualmente descrito como processo integrante da gestão empresarial, é apresentado como um recurso que capacita a instituição de ensino superior a atuar com eficiência e eficácia e a reagir com rapidez às demandas do seu entorno social. O desdobramento das diretrizes é mostrado como uma ferramenta que pode ser aplicada no detalhamento do plano estratégico, assim que as linhas de ação anuais estejam definidas. Resultaram do estudo a confirmação de que professores e funcionários necessitam de incentivo para atuar nesse processo e que fatores como liderança e comprometimento com resultados, esforço para o compartilhamento do propósito comum, motivação dos envolvidos e acompanhamento dos processos são essenciais para a implementação, com sucesso, do plano estratégico.

Avaliação de empresas por fluxo de caixa descontado: o impacto dos ativos intangíveis no valor da empresa

Ao mesmo tempo que os ativos intangíveis têm sido amplamente discutidos e apresentados como condutores de sucesso, ainda são poucas as reflexões sobre a influência destes ativos no valor das empresas. Este trabalho surge portanto com o objetivo de identificar uma maneira de se contemplar os ativos intangíveis no valor de uma empresa, quando a mesma é avaliada pelo método de Fluxo de Caixa Descontado. A partir desta metodologia foram analisadas como os intangíveis marca, reputação, redes e alianças estratégicas, tecnologias e processos, capital humano, capital intelectual, inovação, adaptabilidade, cultura organizacional, liderança, responsabilidade socioambiental, e comunicação e transparência podem impactar o valor da empresa, e como eles relacionam-se entre si.

Um caso de aprendizagem organizacional: exame conceitual e de aplicabilidade no contexto público

This research has a practice-oriented focus on the concept of Organizational Learning. The basic approach is a learning organization perspective, and some references to the concepts and concerns of organizational learning were included whenever necessary and proper. Organizational Learning is researched mainly from a management techniques and strategy point of view, with a smaller emphasis on the innovation and accumulation of technological capabilities and theoretical research points of view. A broad approach has been used, based mainly on the study of a successful case using action research in a private telecommunication company operating nationwide in Brazil. This study involved a small group, as it is common with pilot groups for learning organizations. The main purpose of this research is to provide a broad and updated survey about the idea of Organizational Learning. Results presented in the related literature are compared with findings from the field, and that literature is cited throughout the text. The interactions of Organizational Learning with the Brazilian context and with the public administration context are analyzed; important data, ranging from the historical origins and bases of the concept, to details of the activities in a real life learning organization, are shown. Some essential aspects, that should be considered or used when applying this type of management, are analyzed. The action research has shown a close proximity between Organizational Learning and a phenomenological perspective, servant leadership, and managerial model, respectively in the fields of philosophical approach, leadership, and management models.

Análise da integração do balanced scorecard com o Prêmio Nacional da Qualidade : o caso da Dana (Modelo Dana Quality Leadership Process)

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European business schools and global leadership: an examination of the admission criteria of the european master in management programs ranked by the Financial Times 2010

O aumento de empresas que operam internacionalmente requer o desenvolvimento de líderes mundiais para colocar as estratégias em prática. Embora este processo de desenvolvimento é importante para o mundo corporativo, muitos futuros executivos são graduados de escolas de administração de empresas que estão intimamente ligados ao mundo de negócios e, portanto, desempenhão um papel importante no processo. Esta pesquisa examina se os programas europeus “Master in Management” classificado pelo Financial Times em 2010 selecionam aqueles candidatos que são mais adequados para o desenvolvimento de liderança global. Portanto, três anteriores meta-estudos são sintetizados para produzir um perfil de competências classificadas de um líder global. Então, informações sobre os critérios de admissão dos programas de mestrado são coletadas e comparadas com este perfil. Os resultados mostram que seis competências são medidas por mais da metade dos programas: proficiência em Inglês, capacidade analítica (racionamento lógico e quantitativo), capacidade de comunicação, conhecimento do negócio global, determinação para alcançar, motivação e capacidade interpessoal. Além disso, as habilidades operacionais requerentes pelos líderes globais não são significativas no processo de admissão e o foco é sobre as habilidades analíticas. Comparação dos resultados com o perfil anteriormente desenvolvido abrangente indica que uma quantidade significativa de programas pode subestimar o significado de habilidades pessoais e características para o desenvolvimento de líderes globais.

A Comissão Executiva do Plano da Lavoura Cacaueira (CEPLAC): um caso de desenvolvimento institucional

Esta monografia é um estudo de desenvolvimento institucional que proporciona conhecer como uma organização da administração pública brasileira, criada com um fim especifico e transitório, sobreviveu, se transformou, criou raizes, expandiu sua área de influência e tornou-se uma instituição relativamente bem sucedida. Trata-se da Comissão Executiva do Plano da Lavoura Cacaueira - CEPLAC, órgão autônomo vinculado ao Ministério da Agricultura, criado na década de cinqüenta pelo Governo Federal, como solução de emergência para o apoio financeiro aos produtores de cacau do sul da Bahia, numa das maiores crises da economia cacaueira. O autor valeu-se, para sua dissertação, do quadro conceitual formulado por Milton J. Esman e Hans C. Blaise, da Inter-University Research Program in Institution Building. Este é um modelo que parte da premissa de que as instituições são sistema abertos e, como tal, mantêm padrões de relações e intercâmbio com o meio-ambiente em que operam. Importam energia do ambiente (inputs on entradas) e processam tais energias, transformando-as em produtos (outputs ou saldas) desejados e valorizados pelo ambiente. Dentro deste quadro, têm-se três elementos básicos: a organização; as transações; e o meio-ambiente. O trabalho foi dividido em cinco capítulos. No primeiro o autor discorreu sobre o tema e sua importância, objetivos do estudo, metodologia utilizada e o conteúdo da monografia. No segundo, fez uma discussão em torno do que é desenvolvimento institucional, sua evolução como estratégia de desenvolvimento; procedeu à revisão de literatura e descreveu o modelo que serviu de guia à pesquisa. Aí, registrou disfunções, limitações e restrições ao modelo de Esman e Blaise, e/ou aos efeitos da institucionalização, apontados por alguns estudiosos. No terceiro capítulo narrou os antecedentes, origem e evolução da CEPLAC, oportunidade em que identificou três fases da organização; no quarto, mostrou a CEPLAC através do modelo de desenvolvimento institucional, quando a organização foi analisada em função de suas variáveis institucionais (Liderança, Doutrina, Programa, Estrutura I nterna e Recursos), suas t ra n sações com o ambiente e suas variáveis institucionais-ambientais ou simplesmente elos institucionais. Finalmente, no qu into cap(tulo, alinhou as conclusões. A pesquisa objetivou atender aos questionamentos estabelecidos em cinco tópicos que buscavam investigar o seguinte: se houve um planejamento prévio, consciente e deliberado no sentido de transformar a CEPLAC de um órgão transitório, com atividade financeira, para uma instituição técnico-cientl'fica como é hoje. Em caso negativo, o que tornou isso poss(vel? Discorrer sobre a forma pela qual seu quadro dirigente foi estruturado e reuniu recursos, bem como que influências contribuíram para moldar seus programas; constatar como o quadro dirigente da CEPLAC manteve-se estável em um per(odo de mudanças no panorama político brasileiro; e especular sobre o futuro da institu ição. Entre outras coisas, o autor conclu iu que duas variáveis contribu iram particu larmente, de forma decisiva, para a sobrevivência, autonomia e desenvolvimento da instituição, com a obtenção de resultados valorizados pela sua clientela: 1) a existência de uma liderança institucional que soube definir o papel e a missão da CEPLAC, mantendo sua integridade ao longo do tempo; e, 2) a garantia de um fluxo sistemático de recursos financeiros através da contribuição cambial retirada das exportações de cacau. Além disso, constatou que três fatores foram importantes para sua estabilidade: o pleno enquadramento da instituição na filosofia modernizadora contida no bojo dos governos pós-54; a relevância de seus elos institucionais; e o reconhecimento da cl ientela e de setores governamentais importantes pela sua participação na evolução havida na economia cacaueira, de uma situação de crise para resultados satisfatórios.