906 resultados para Nurse Leaders


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Being an academic in universities today is characterised by change and increasing complexity in response to a multitude of factors impacting on the university sector. Among the consequences of such changes are that many academics, and academic leaders in particular, are subjected to both increasing stress and scrutiny in many of the decisions they make. Some of these decisions require critical choices that involve contestation of values (including personal, professional, institutional, and community), resulting in ethical dilemmas for the decisionmakers. This article reports on an exploratory study into ethical dilemmas faced by middle-level academic leaders, drawing on the results of an on-line survey distributed to relevant academics in three universities in Australia. Here, middle-level academic leaders are defined as those holding course coordination roles, locating them between senior university staff and other academics on the one hand, and students on the other hand. As a consequence, these diverse groups of staff and students potentially have an array of conflicting interests in, and expectations on, middle-level academics’ decision-making processes. The findings of the study are clear: ethical dilemmas are evident, and commonly so, for many middle-level academic leaders. While exploratory in nature, the findings of this study suggest that much more attention to ethics and ethical dilemmas is needed in our universities.

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Defining the difference between successful and mediocre leaders is a quest that has attracted many renowned scholars, drawing vast amounts of research effort. Yet while there are excellent theoretical explanations of what leaders should do: exhibit transformational behaviours, demonstrate authenticity, build productive relationships with followers and so on; there is still a scarcity of empirically-based research advising practicing leaders how to do these things. This study seeks to provide guidance about the fine-grained processes that effective leaders use on a daily basis to undertake the core process of all leadership activity; influencing followers. Using a grounded research approach, this study employs qualitative methods to capture the detail of effective leader behaviour and the micro-level influence processes that leaders use to create effective follower outcomes. Conducted in the health services industry with medical and allied health leaders, the study sought to answer the question: What influence methods might effective, contemporary leaders be using? The study builds on existing influence research, seeking to extend and update the typology of 11 influence tactics originally developed by Yukl and others, and which has been static since the late 1990s. Eight new influence tactics were identified, offering practicing leaders a powerful suite of potential strategies and representing a significant contribution to the field. Further research is recommended to confirm the identified influence constructs and test the generalisability of these findings to broader leader populations in health organisations and other knowledge-based organisations.

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The purpose of this paper is to bring leadership context into sharper focus and to suggest there are strong constraints on public leaders’ discretion to lead in ways consistent with NPM or NPL. Much of the existing public leadership research focuses on the individual leader and tends to give little attention to the influence of context. This lack of focus on leader context adversely affects our ability to build public leadership capacity. We draw on prior research to establish that (1) there are strong contextual constraints on public leaders’ capacity to lead in ways consistent with NPL, (2) public leaders are subject to contradictory messages and for the most part these contradictions are unacknowledged and unresolved, the impact of which is confusion and informal power-politics, (3) the task of leader transition from traditional leadership to new public leadership is very much underestimated and requires a new way to think about leadership development. On the basis of this analysis, we argue that public leaders find themselves between a rock and a hard place.

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This paper reports safety leaders’ perceptions of safety culture in one of Australasia’s largest construction organisations. A modified Delphi method was used including two rounds of data collection. The first round involved 41 semi-structured interviews with safety leaders within the organisation. The second round involved an online quantitative perception survey, with the same sample, aimed at confirming the key themes identified in the interviews. Participants included Senior Executives, Corporate Managers, Project Managers, Safety Managers and Site Supervisors. Interview data was analysed using qualitative thematic analysis, and the survey data was analysed using descriptive statistics. Leaders’ definitions and descriptions of safety culture were primarily action-oriented and some confusion was evident due to the sometimes implicit nature of culture in organisations. Leadership was identified as a key factor for positive safety culture in the organisation, and there was an emphasis on leaders demonstrating commitment to safety, and being visible to the project-based workforce. Barriers to safety culture improvement were also identified, including the subcontractor management issues, pace of change, and reporting requirements. The survey data provided a quantitative confirmation of the interview themes, with some minor discrepancies. The findings highlight that safety culture is a complex construct, which is difficult to define, even for experts in the organisation. Findings on the key factors indicated consistency with the current literature; however the perceptions of barriers to safety culture offer a new understanding in to how safety culture operates in practice.

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Aims and Objectives To examine relationships between socio-demographic factors and job satisfaction and to identify if these factors predict job satisfaction levels in an Australian registered nurses. Background Reports indicate that in Australia there are 30,000 qualified nurses no longer working in the healthcare and that current nursing shortages vary as a result of certain socio-demographic variables including type of nurse, geographic, location, sector, service and organisation. Furthermore it has been revealed that there is not only a real shortage but also a pseudo-shortage (i.e. either there are not enough nurses are available, or not enough are willing to work under existing workplace conditions). International studies have found significant relationships exist between some socio-demographic factors and job satisfaction in registered nurses however there is limited information available on relationships between socio-demographic factors and job satisfaction in nurses in the Australian context. Design A cross sectional survey was undertaken of Australian registered nurses. Methods Two thousand Australian registered nurses who were members of an industrial and professional organisation were sent the questionnaire in 2008. They were stratified and randomised according to gender. Six hundred and thirty-nine registered nurses responded. Descriptive analyses, correlation analyses, one- way ANOVA tests, simple linear regression and multivariable analyses were conducted to examine further if any relationships existed between the variables. Results The majority of respondents showed positive job satisfaction scores. An ANOVA found significant positive relationships existed between job satisfaction, specialty area, health sector and Australian states. Multivariable analyses found relationships existed between specialty area, health sector, and job satisfaction. Conclusions The variables specialty area and health sector were found to be significantly associated with job satisfaction. The different specialty areas and health sectors in relation to job satisfaction should be investigated further. Clinical Relevance The study results have provided new knowledge for policy makers, organisational and nursing leaders of the socio-demographic variables that may affect job satisfaction in registered nurses in the Australian context.

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Introduction: Delirium is a serious issue associated with high morbidity and mortality in older hospitalised people. Early recognition enables diagnosis and treatment of underlying cause/s, which can lead to improved patient outcomes. However, research shows knowledge and accurate nurse recognition of delirium and is poor and lack of education appears to be a key issue related to this problem. Thus, the purpose of this randomised controlled trial (RCT) was to evaluate, in a sample of registered nurses, the usability and effectiveness of a web-based learning site, designed using constructivist learning principles, to improve acute care nurse knowledge and recognition of delirium. Prior to undertaking the RCT preliminary phases involving; validation of vignettes, video-taping five of the validated vignettes, website development and pilot testing were completed. Methods: The cluster RCT involved consenting registered nurse participants (N = 175) from twelve clinical areas within three acute health care facilities in Queensland, Australia. Data were collected through a variety of measures and instruments. Primary outcomes were improved ability of nurses to recognise delirium using written validated vignettes and improved knowledge of delirium using a delirium knowledge questionnaire. The secondary outcomes were aimed at determining nurse satisfaction and usability of the website. Primary outcome measures were taken at baseline (T1), directly after the intervention (T2) and two months later (T3). The secondary outcomes were measured at T2 by participants in the intervention group. Following baseline data collection remaining participants were assigned to either the intervention (n=75) or control (n=72) group. Participants in the intervention group were given access to the learning intervention while the control group continued to work in their clinical area and at that time, did not receive access to the learning intervention. Data from the primary outcome measures were examined in mixed model analyses. Results: Overall, the effect of the online learning intervention over time comparing the intervention group and the control group were positive. The intervention groups‘ scores were higher and the change over time results were statistically significant [T3 and T1 (t=3.78 p=<0.001) and T2 and T1 baseline (t=5.83 p=<0.001)]. Statistically significant improvements were also seen for delirium recognition when comparing T2 and T1 results (t=2.58 p=0.012) between the control and intervention group but not for changes in delirium recognition scores between the two groups from T3 and T1 (t=1.80 p=0.074). The majority of the participants rated the website highly on the visual, functional and content elements. Additionally, nearly 80% of the participants liked the overall website features and there were self-reported improvements in delirium knowledge and recognition by the registered nurses in the intervention group. Discussion: Findings from this study support the concept that online learning is an effective and satisfying method of information delivery. Embedded within a constructivist learning environment the site produced a high level of satisfaction and usability for the registered nurse end-users. Additionally, the results showed that the website significantly improved delirium knowledge & recognition scores and the improvement in delirium knowledge was retained at a two month follow-up. Given the strong effect of the intervention the online delirium intervention should be utilised as a way of providing information to registered nurses. It is envisaged that this knowledge would lead to improved recognition of delirium as well as improvement in patient outcomes however; translation of this knowledge attainment into clinical practice was outside the scope of this study. A critical next step is demonstrating the effect of the intervention in changing clinical behaviour, and improving patient health outcomes.

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Although the multiple economic, environmental and social challenges threatening the viability of rural and regional communities in Australia are well-known, little research has explored how community leaders conceptualise the impact and opportunities associated with economic diversification from agriculture into alternative industries, such as tourism and mining. This qualitative research, utilising the Darling Downs in Queensland as a case study, documents how 28 local community leaders have experienced this economic diversification process. The findings reveal that local community leaders have a deep understanding about the opportunities and challenges presented by diversification, articulating a clear vision about how to achieve the best possible future for their region. Despite excitement about growth, there were concerns about preserving heritage, the increased pressure on local infrastructure and an ageing population. By documenting local leader’s insights, these findings may help inform planning for rural and regional communities and facilitate management of the exciting yet challenging process of growth and diversification

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