Suchergebnisse

This study investigated the relationships between seven workload factors and patient and nurse outcomes. (1) Background: Health systems researchers are beginning to address nurses' workload demands at different unit, job and task levels; and the types of administrative interventions needed for specific workload demands. (2) Methods: This was a cross-sectional correlational study of 472 acute care nurses from British Columbia, Canada. The workload factors included nurse reports of unit-level RN staffing levels and patient acuity and patient dependency; job-level nurse perceptions of heavy workloads, nursing tasks left undone and compromised standards; and task-level interruptions to work flow. Patient outcomes were nurse-reported frequencies of medication errors, patient falls and urinary tract infections; and nurse outcomes were emotional exhaustion and job satisfaction. (3) Results: Job-level perceptions of heavy workloads and task-level interruptions had significant direct effects on patient and nurse outcomes. Tasks left undone mediated the relationships between heavy workloads and nurse and patient outcomes; and between interruptions and nurse and patient outcomes. Compromised professional nursing standards mediated the relationships between heavy workloads and nurse outcomes; and between interruptions and nurse outcomes. (4) Conclusion: Administrators should work collaboratively with nurses to identify work environment strategies that ameliorate workload demands at different levels.

A collaborative project between an academic healthcare faculty and a professional development director resulted in the design, delivery and evaluation of an inter-professional collaborative leadership workshop with ongoing leadership development activities. The workshop attendees were five inter-professional teams from one large, urban cancer care center in Taipei, Taiwan. The workshop included didactic instruction complemented with team discussions and interactive exercises. Continued practice was encouraged, such as appreciative inquiry exercises and rotated team leadership. Evaluation involved the use of a cross-culturally validated collaborative practice tool and follow-up interviews and focus groups. Although the formal workshop was a 1-day session, continued organizational support and systematic approaches to collaborative leadership practice in clinical settings were necessary components for transfer of learning from the workshop to real life. This paper will include an overview of the foundational leadership concepts covered in the workshop. The instructional strategies, evaluation methods and outcomes will be discussed. The limitations and strengths of this collaborative leadership project will be provided, as well as future plans for a collaborative leadership development program.

Background: Evidence-based clinical care delivery begins with comprehensive assessments of patients' priority needs. A Canadian health sciences corporation conducted a quality improvement initiative to enhance clinical care delivery, beginning with one acute care site. A real-time staffing tool, the synergy tool, was used by direct care providers and leadership to design and implement patient-centered care delivery. The synergy tool is the patient characteristics component of the Synergy Model™, developed by an expert panel of nurses in the 1990s. Since then, the tool has been effectively used to assess a variety of patient populations on eight important characteristics, informing real-time staffing decisions. Methods: Plan-Do-Study Act cycles were managed by department-based project teams with assistance from business analytics and a quality/safety officer. Results: Initial findings demonstrate reductions in nurse missed breaks, improved workload management, and significant increases in staff engagement. Conclusions: The synergy tool is an easy-to-use tool that can be used to highlight priority care needs for individual patients or specific patient populations. The tool informs real-time staffing decisions, ensuring a better fit between patient needs and nurse staffing assignments. Although this initiative began with nurses, project work is expanding to include inter-professional teams.