Do Australian public and nonprofit nurses cope with administrative stressors?

The nursing profession in Australia and other OECD countries such as the USA and the UK, have focused on ways to recruit and retain nurses (e.g., Bartram, Joiner, & Stanton, 2004). Research has shown that the most common factors impacting negatively on retention include sources of nursing stress such as workload and work environment. While the literature has shown that nursing staff encounter these stressors, studies do not examine the effects of stress caused by an increasing degree of administrative demand placed on nurses, caused by the new public management (NPM) reform in public and nonprofit (PNP) health care organizations. At best, some studies have alluded to some aspects of administrative related stressors (vis-a-vis nursing related stressors such as death, sickness, etc), but they have not been examined in any detail. Similarly, extant research has not examined how nurses cope with these administrative stressors. These will be the main aims of the present study.

Negative change and job outcomes : the impact of subjective fit in public sector health care organization

There is an ongoing level of organizational-wide change (such as empowerment and downsizing) occurring within the Australian health care sector. However, there is a paucity of empirical evidence on how public and nonprofit sector nurses cope with these organizational-wide change initiatives and their consequences on individual and work outcomes. This will be the primary aim of the current paper. To this end, a path model is developed base on an integration of existing theoretical perspectives on occupational stress, change management, and person-organizational fit. Data were collected from 252 public and not-for-profit sector nurses. The path analysis suggests that public and nonprofit nurses experience positive and negative change initiatives. Negative change initiatives resulted in an increase in the level of administrative-related stressors. Nurses with more congruent values report less experience with administrative stressors. As nurses experienced more administrative stressors, they tend to report more job dissatisfaction. Nurses whose values were more congruent during organizational change reported higher level of psychological wellbeing. Nurses who were had higher level of psychological wellbeing were found to have higher job satisfaction, which subsequently led to a higher level of organizational commitment.

Nonprofit Boards in Australia: A Distinctive Governance Appoach

This article reports the findings into patterns of governance on nonprofit boards in Australia. The research surveys 118 boards, upon which serve a total of 1405 directors. The findings indicate that nonprofit boards can mimic some aspects of a shareholder approach to governance. But nonprofit boards, in the main, indicate priorities and activities of a stakeholder approach to governance. The features of `isomorphism' that arise largely stem from legislative requirements in corporate governance. Generally, nonprofit directors are influenced by agenda and motivations that can be differentiated from the influences upon director activity in the corporate sector. The study indicates that nonprofit boards prize knowledge and loyalty to the sector when considering board composition. The survey suggests nonprofits ``compensate'' for the demands placed upon them about fiduciary duty and due diligence responsibilities with the diverse intellectual expertise of non-executive directors. Nonprofit boards possess greater diversity than boards in the corporate sector; they include more women as directors than corporate boards and they include a greater proportion of directors from minority groups. While strategic issues feature significantly as a task of the nonprofit board, they distinguish themselves from their corporate counterparts by engaging in operational management. The findings indicate that, in the main, directors on nonprofit boards deliberate and operate in ways distinctive from their corporate counterparts. Such findings offer a contribution to the reform of Corporations Law in other countries and the likely consequence on boards outside the corporate sector.

The Impact of Experiential Learning in Enhancing Palliative Care Knowledge and Skills among Nurses

Nurses working in community settings are increasingly required to care for people with chronic, life limiting conditions. Innovative educational programs are required to ensure nurses are equipped to deal with this challenging area of practice. The Program of Experience in the Palliative Approach (PEPA) started in 2003 as an initiative of the Australian Government, Department of Health and Ageing. The overall aim of PEPA is to improve the quality, availability and access to palliative care for people who are dying, and their families, by improving the skills and expertise of health practitioners, and enhancing collaboration between primary and specialist palliative care services. PEPA provides nurses with an opportunity to develop knowledge and skills in the palliative approach to care through funded clinical workforce placements or workshops.

Compliance in peritoneal dialysis : a qualitative study of renal nurses

End-stage renal failure is a life-threatening condition, often treated with home-based peritoneal dialysis (PD). PD is a demanding regimen, and the patients who practise it must make numerous lifestyle changes and learn complicated biomedical techniques. In our experience, the renal nurses who provide mostPDeducation frequently express concerns that patient compliance with their teaching is poor. These concerns are mirrored in the renal literature. It has been argued that the perceived failure of health professionals to improve compliance rates with PD regimens is because ‘compliance’ itself has never been adequately conceptualized or defined; thus, it is difficult to operationalize and quantify. This paper examines how a group of Australian renal nurses construct patient compliance with PD therapy. These empirical data illuminate how PD compliance operates in one practice setting; how it is characterized by multiple and often competing energies; and how ultimately it might be pointless to try to tame ‘compliance’ through rigid definitions and measurement, or to rigidly enforce it in PD patients. The energies involved are too fractious and might be better spent, as many of the more experienced nurses in this study argue, in augmenting the energies that do work well together to improve patient outcomes.

An exploration of knowledge management and intellectual capital in a nonprofit organisation context

In recent years, practitioners and researchers alike have turned their attention to knowledge management (KM) in order to increase organisational performance (OP). As a result, many different approaches and strategies have been investigated and suggested for how knowledge should be managed to make organisations more effective and efficient. However, most research has been undertaken in the for-profit sector, with only a few studies focusing on the benefits nonprofit organisations might gain by managing knowledge. This study broadly investigates the impact of knowledge management on the organisational performance of nonprofit organisations. Organisational performance can be evaluated through either financial or non-financial measurements. In order to evaluate knowledge management and organisational performance, non-financial measurements are argued to be more suitable given that knowledge is an intangible asset which often cannot be expressed through financial indicators. Non-financial measurement concepts of performance such as the balanced scorecard or the concept of Intellectual Capital (IC) are well accepted and used within the for-profit and nonprofit sectors to evaluate organisational performance. This study utilised the concept of IC as the method to evaluate KM and OP in the context of nonprofit organisations due to the close link between KM and IC: Indeed, KM is concerned with managing the KM processes of creating, storing, sharing and applying knowledge and the organisational KM infrastructure such as organisational culture or organisational structure to support these processes. On the other hand, IC measures the knowledge stocks in different ontological levels: at the individual level (human capital), at the group level (relational capital) and at the organisational level (structural capital). In other words, IC measures the value of the knowledge which has been managed through KM. As KM encompasses the different KM processes and the KM infrastructure facilitating these processes, previous research has investigated the relationship between KM infrastructure and KM processes. Organisational culture, organisational structure and the level of IT support have been identified as the main factors of the KM infrastructure influencing the KM processes of creating, storing, sharing and applying knowledge. Other research has focused on the link between KM and OP or organisational effectiveness. Based on existing literature, a theoretical model was developed to enable the investigation of the relation between KM (encompassing KM infrastructure and KM processes) and IC. The model assumes an association between KM infrastructure and KM processes, as well as an association between KM processes and the various levels of IC (human capital, structural capital and relational capital). As a result, five research questions (RQ) with respect to the various factors of the KM infrastructure as well as with respect to the relationship between KM infrastructure and IC were raised and included into the research model: RQ 1 Do nonprofit organisations which have a Hierarchy culture have a stronger IT support than nonprofit organisations which have an Adhocracy culture? RQ 2 Do nonprofit organisations which have a centralised organisational structure have a stronger IT support than nonprofit organisations which have decentralised organisational structure? RQ 3 Do nonprofit organisations which have a stronger IT support have a higher value of Human Capital than nonprofit organisations which have a less strong IT support? RQ 4 Do nonprofit organisations which have a stronger IT support have a higher value of Structural Capital than nonprofit organisations which have a less strong IT support? RQ 5 Do nonprofit organisations which have a stronger IT support have a higher value of Relational Capital than nonprofit organisations which have a less strong IT support? In order to investigate the research questions, measurements for IC were developed which were linked to the main KM processes. The final KM/IC model contained four items for evaluating human capital, five items for evaluating structural capital and four items for evaluating relational capital. The research questions were investigated through empirical research using a case study approach with the focus on two nonprofit organisations providing trade promotions services through local offices worldwide. Data for the investigation of the assumptions were collected via qualitative as well as quantitative research methods. The qualitative study included interviews with representatives of the two participating organisations as well as in-depth document research. The purpose of the qualitative study was to investigate the factors of the KM infrastructure (organisational culture, organisational structure, IT support) of the organisations and how these factors were related to each other. On the other hand, the quantitative study was carried out through an online-survey amongst staff of the various local offices. The purpose of the quantitative study was to investigate which impact the level of IT support, as the main instrument of the KM infrastructure, had on IC. Overall several key themes were found as a result of the study: • Knowledge Management and Intellectual Capital were complementary with each other, which should be expressed through measurements of IC based on KM processes. • The various factors of the KM infrastructure (organisational culture, organisational structure and level of IT support) are interdependent. • IT was a primary instrument through which the different KM processes (creating, storing, sharing and applying knowledge) were performed. • A high level of IT support was evident when participants reported higher level of IC (human capital, structural capital and relational capital). The study supported previous research in the field of KM and replicated the findings from other case studies in this area. The study also contributed to theory by placing the KM research within the nonprofit context and analysing the linkage between KM and IC. From the managerial perspective, the findings gave clear indications that would allow interested parties, such as nonprofit managers or consultants to understand more about the implications of KM on OP and to use this knowledge for implementing efficient and effective KM strategies within their organisations.

Evaluation of contextual influences on the medication administration practice of paediatric nurses

Aim. This paper is a report of a study conducted to explore the impact of preidentified contextual themes (related to work environment and socialization) on nursing medication practice. Background. Medication administration is a complex aspect of paediatric nursing and an important component of day-to-day nursing practice. Many attempts are being made to improve patient safety, but many errors remain. Identifying and understanding factors that influence medication administration errors are of utmost importance. Method. A cross-sectional survey was conducted with a sample of 278 paediatric nurses from the emergency department, intensive care unit and medical and surgical wards of an Australian tertiary paediatric hospital in 2004. The response rate was 67%. Result. Contextual influences were important in determining how closely medication policy was followed. Completed questionnaires were returned by 185 nurses (67%). Younger nurses aged <34 years thought that their medication administration practice could be influenced by the person with whom they checked the drugs (P = 0·001), and that there were daily circumstances when it was acceptable not to adhere strictly to medication policy (P < 0·001), including choosing between following policy and acting in the best interests of the child (P = 0·002). Senior nurses agreed that senior staff dictate acceptable levels of medication policy adherence through role modelling (P = 0·01). Less experienced nurses reported greater confidence with computer literacy (P < 0·001). Conclusions. Organizations need to employ multidisciplinary education programmes to promote universal understanding of, and adherence to, medication policies. Skill mix should be closely monitored to ensure adequate support for new and junior staff.