RELATION OF HOSPITAL ADMINISTRATORS, NURSING STAFF, AND MEDICAL STAFF

JAMA ◽  
1952 ◽  
Vol 149 (14) ◽  
pp. 1304
Author(s):  
Thomas P. Murdock
Keyword(s):  
Nursing Staff ◽  
Medical Staff ◽  
Hospital Administrators

scholarly journals P13 Optimising paediatric intravenous fluid management plans: a quality improvement project

2020 ◽  
Vol 105 (9) ◽  
pp. e12.2-e13
Author(s):  
Jenny Gray ◽  
Susie Gage
Keyword(s):  
Patient Safety ◽  
Nursing Staff ◽  
Fluid Balance ◽  
Medical Staff ◽  
Fluid Management ◽  
Management Plan ◽  
Intravenous Fluid ◽  
Safety Alert ◽  
Management Plans ◽  
National Patient

IntroductionIntravenous (IV) maintenance fluids are often prescribed post-surgery when enteral routes are contraindicated. Serious consequences have been documented when poor fluid management has occurred, as highlighted in the National Patient Safety Alert (NPSA) 22; reducing the risk of hyponatraemia; when administering IV fluids to children.1 In response to this, the National Institute for Health and Care Excellence (NICE) published their guidance in December 2015 regarding IV fluids in children.2 Based on NICE recommendations, a pan hospital fluid guidance was produced. Within the NICE and hospital’s own guideline it states that there should be a daily fluid management plan documented. It has been well recognised that this daily fluid management plan was not routinely been completed; hence showing non-adherence to our hospital policy and NICE recommendations.AimsPrimary aim was to improve the documentation of the daily fluid management plan; aimed at the medical staff and the secondary aim was to improve the monitoring requirements of IV fluids and documentation of these; largely aimed at the nursing staff.MethodsA simple sticker was designed and attached to continuous sheets for medical notes which had a checklist of monitoring requirements and a section for fluid balance. Additionally, 2 posters were produced; one aimed at medical staff for documenting a fluid management plan and one aimed at the nursing staff with the monitoring requirements. These posters were displayed on the paediatric surgical ward.ResultsA total of 22 patients who were prescribed IV fluids were identified for a baseline measurement, an equal number of patients were compared after the intervention. Neonates and children receiving total parenteral nutrition were excluded from the data collection. There were 41% of daily fluid management plans completed pre intervention and post intervention there were 56% completed; showing a 15% increase in completion. As regards the monitoring indications; there were increases for nursing fluid balance completed from 19% to 46%, blood glucose taken and recorded from 64% to 83% and the daily weight documented from 10% to 49%.ConclusionsThis short QI project shows that implementation of an intervention did improve outcomes across all indications investigated. The results are not as dramatic as first hoped, but this is largely due to the short time scale of 4 weeks to introduce our change and it coincided with the change-over month of junior medical staff. With further education and champions within the medical and nursing teams; further improvement is very much possible, with the main aim in reducing risk and improving patient safety.ReferencesNational Patient Safety Alert: Reducing the risk of hyponatraemia when administering intravenous infusions to neonates 2007. Available at https://www.sps.nhs.uk/articles/npsa-alert-reducing-the-risk-of-hyponatraemia-when-administering-intraveneous-infusions-to-neonates/ [Accessed 12th June 2019]NICE guidance: Intravenous fluid therapy in children and young people in hospital. Available at https://www.nice.org.uk/guidance/ng29 [Accessed 12th June 2019]

scholarly journals P010 Influencing change: impactful communication – paediatric diabetes prescriptions

2019 ◽  
Vol 104 (7) ◽  
pp. e2.13-e2
Author(s):  
Emma Barbour
Keyword(s):  
Nursing Staff ◽  
Medical Staff ◽  
Hospital Pharmacy ◽  
Resistance To Change ◽  
Electronic System ◽  
Diabetic Patients ◽  
List Type ◽  
Newly Diagnosed ◽  
Paediatric Ward ◽  
Discharge Letter

AimThe paediatric wards in two hospital sites within one Trust deal with the supply of newly diagnosed diabetic prescriptions differently and the aim of this project was to have uniformity throughout the Trust with regards the supply of these discharge items, with both hospital pharmacy sites supplying the discharge items. Having completed the Pharmacy Management Clinical Leadership in Pharmacy (CLIP) program I wanted to use new skills learned throughout CLIP to be able to lead on influencing a change of practice on one hospital site and have uniformity across the Trust. I wanted to be able to persuade one site to change their practice of over 20 years and start getting the items dispensed through the hospital pharmacy.MethodsUsing the GROW model I ensured I was clear on what my plan was and that my goals were SMARTER. I had to deal with a number of different professionals and was prepared for some conflict as was expecting resistance to change. I met with the key stakeholders with regards the change. I communicated with medical staff, nursing staff and dispensary manager in the relevant hospital, and used the Colours Model1 to help me with this. The Colours Model is a simple and effective way to analyse our own communication preference and also to understand the preference of others. Knowing this I was then able to flex my communication style accordingly to engage with all parties more effectively. I identified what ‘colour’ I classed each group as and used different styles of communication for each. I also reviewed the records of newly diagnosed diabetic patients discharged from the paediatric ward over a period of one year to determine what discharge letter was given to the patient, and what detail was on it.ResultsOf the patients discharged in 2017, only 44% had a discharge on the relevant electronic system with pharmacy items on it, with just one having all required items. I communicated the following way with the different staff, once I had identified their ‘colour’. Medical staff (GREEN - Amiables, who are task focused and have indirect style). I focused on whole team and explained the benefit for change across interface. Nursing staff (RED - Drivers, who are task focused and have a direct style). I got straight to the point, explained reasons and results. Dispensary manager (BLUE - Analyticals, who are task focused and have an indirect style). I emailed in advance. Got to the point and gave exact details.ConclusionAll Staff agreed to the change in process in the paediatric ward. All discharges for newly diagnosed diabetic children on both sites will be electronically written and dispensed within the hospital pharmacy. The outcome for patient care is a more seamless transition of care between interface. By undertaking the CLIP programme I acquired a number of important skills to enable me to successfully lead this change. I made my voice heard and led with impactful communication.ReferenceCLIP workbook Leading with Impactful Communication Chapter 5 The Colours ModelJanuary 2018.

Authentic leadership and its impact on extra role behaviour of nurses

2017 ◽  
Vol 46 (2) ◽  
pp. 277-296 ◽  
Author(s):  
Nishtha Malik ◽  
Rajib Lochan Dhar
Keyword(s):  
Nursing Staff ◽  
Authentic Leadership ◽  
Mediating Effect ◽  
Content Type ◽  
Hospital Administrators ◽  
Mediating Role ◽  
Relevant Variables ◽  
Service Oriented ◽  
The Relationship

Purpose The purpose of this paper is to examine the relationship between authentic leadership (AL) and employee extra role behaviour (ERB) while determining the mediating effect of psychological capital (PC) and moderating effect of autonomy on that relationship. Design/methodology/approach Data were collected from 42 small- and medium-sized hospitals in the state of Uttarakhand, India. The sample for the study included 520 nurses and their 163 supervisors. Process macro (Hayes) was used to examine the mediating role of PC and the moderating role of autonomy in the relationship between AL and ERB. Findings Results indicate that AL is positively linked to ERB of followers. Further, PC was found to mediate the relationship between AL and ERB while autonomy acted as a moderator between PC and ERB. Practical implications Findings of the study would help hospital managements understand the importance of technical and behavioural training of nursing staff and supervisors. The paper draws the attention of hospital administrators towards the need for formulating policies that are less restrictive and allow for greater autonomy to the nursing staff. Further, this study highlights the importance of an effective leadership approach like AL in service-oriented organizations such as healthcare institutions. Originality/value This study contributes to existing research on AL and ERB by showing that PC and autonomy are important and relevant variables that affect the degree of influence that AL has on employee ERB.

Staff attitudes to a daily otolaryngology ward round

2004 ◽  
Vol 118 (12) ◽  
pp. 963-971 ◽  
Author(s):  
M.-L. Montague ◽  
M.S.W. Lee ◽  
S.S.M. Hussain
Keyword(s):  
Nursing Staff ◽  
Medical Staff ◽  
Learning Experience ◽  
Ward Round ◽  
Educational Opportunities ◽  
Ward Rounds ◽  
Sensitive Issues ◽  
Adequate Communication ◽  
Private Setting ◽  
Structured Questionnaire

This survey investigates the attitudes of medical and nursing staff towards the daily otolaryngology ward rounds in a teaching hospital.Initial, open-ended questionnaires generated themes from which a structured questionnaire was constructed. Respondents indicated on a Likert scale the extent to which they agreed or disagreed with statements concerning their attitudes towards the ward round.Thirty-five members of staff were surveyed. The overall response rate was 74.3 per cent (n = 26). The majority of staff agreed that the ward round was a constructive use of their time and served to promote team spirit. It allowed for adequate communication between medical and nursing staff but there was uncertainty about the provision of adequate patient communication. The nursing staff agreed that the ward round provided a valuable learning experience. There was uncertainty about this among the medical staff. There was agreement in both groups that patients find the ward round to be reassuring. A significant majority of staff expressed concerns over maintenance of patient confidentiality.These findings could be used to inform changes in the departmental ward round structure. Specific attention should be directed to discussing sensitive issues in a more private setting and maximizing educational opportunities for junior medical staff.

scholarly journals Using Trend Extrapolation Model to Predict the Needs of Elderly Care Talents in Beijing Institutions

2021 ◽  
Vol 233 ◽  
pp. 01168
Author(s):  
Aijia Song ◽  
Zhaoqi Peng
Keyword(s):  
Nursing Staff ◽  
Medical Staff ◽  
Population Aging ◽  
Care Service ◽  
Rapid Development ◽  
Elderly Care ◽  
Institutional Care ◽  
The Elderly ◽  
Care Services ◽  
Extrapolation Model

2020-2050 is a period of rapid development of China's population aging, and it is also a critical period for the country to actively respond to population aging. Under the background of the combination of medical care and nursing, institutional elderly care services, as an important branch of the multi-level elderly care service system, have become the main battlefield of the integrated medical and elderly care policy. Therefore, institutional care talents for the aged have also become a key link in improving the quality of life of the elderly population. This paper using trend extrapolation model to predict the needs of elderly care talents in institutions in Beijing, including nursing staff who provide basic living care and professional medical staff who provide services such as rehabilitation, medical treatment, nutrition, and psychological consultation. The results show that, in 2050, the demand for institutional elderly nursing staff in Beijing will exceed 150,000, and the demand for institutional elderly medical staff will reach about 20,000.

scholarly journals The prevalence and stressors of job burnout among medical staff in Liaoning, China: a cross-section study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Youqi Guo ◽  
Shu Hu ◽  
Fei Liang
Keyword(s):  
Regression Analysis ◽  
Medical Staff ◽  
Linear Regression Analysis ◽  
Health Care Service ◽  
Job Burnout ◽  
Liaoning Province ◽  
Subjective Perception ◽  
Hospital Administrators ◽  
Work Tasks ◽  
The Relationship

Abstract Background Sustained attention to the prevalence and associated factors of burnout in China is important for the health care service quality and related reform. In this study, we investigated the prevalence of job burnout among medical staff in Liaoning province, China; performed a survey of subjective perception ranking for the main stressors among respondents; estimated the effect of stresses from work tasks and the relationship with patients on job burnout in order to provide improved strategy and suggestion for hospital administrators. Methods The respondents were from 8 hospitals in 3 cities in Liaoning province, China. Data were collected and analyzed including the following sections: (1) demographic characteristics; (2) work situations; (3) ranking of six stressors; (4) job burnout scale; (5) effort-reward imbalance scale; (6) work violence scale; (7) fear of malpractice scale. A total of 1056 individuals became the study objects. A statistical analysis and hierarchical linear regression analysis were performed to explore the prevalence of burnout and the effects of stressors. Results The prevalence of job burnout was 20.5, and 72.9% of all respondents reported a least one symptom of burnout. The respondents who were male, 30–39 years old, had a master’s degree or high and working hours > 60 h per week, came from obstetrics and gynecology or pediatrics profession prone to job burnout. The relationship with patients and work tasks are the top two ranking stressors in the subjective perception survey. Regression analysis showed that the relationship with patients explained 19.2, 16.8 and 2.0% of variance in burnout subscales EE, DP and PA, respectively and work tasks explained 23.5, 16.0 and 5.24% of variance in burnout subscales EE, DP and PA, respectively. Conclusion The Chinese medical staff had high prevalence of job burnout. Some factors of demographic and work situations were associated with job burnout. The medical staff considered the relationship with patients and work tasks are the two major stressors. These two stressors are also the major indicators associated with job burnout. The hospital administrators should be aware of the risk of burnout. Efforts should be made to ameliorate the status of job burnout.

scholarly journals Understanding age-triggered cognitive assessments of late-career physicians

2019 ◽  
Vol 8 (5) ◽  
pp. 26
Author(s):  
Edward P. Monico ◽  
Valerie M. Allusson ◽  
Arthur Calise ◽  
Valerie R.C. Allusson
Keyword(s):  
Medical Practice ◽  
Medical Staff ◽  
Demographic Data ◽  
The United States ◽  
Disciplinary Action ◽  
Older Individuals ◽  
Hospital Administrators ◽  
Legal Implications ◽  
Practice Of Medicine ◽  
Discrimination In Employment

Late-career physicians now represent a significant part of the physician workforce in the United States. The American Medical Association Council on Medical Education tracks physician demographic data and found that in 1975 there were 50,993 practicing physicians 65 years or older, but by 2013, this number had risen to 241,641 physicians, a 374% increase. The AMA Council also concluded that aging was associated with decreased processing speed, increased difficulty inhibiting irrelevant information, reduced hearing and visual acuity, decreased manual dexterity and visuospatial ability. There is mounting concern that the effects of aging can adversely impact the practice of medicine by late-career physicians. Although results are mixed, studies suggest late-career physicians have a higher rate of disciplinary action, fail to acquire new knowledge and have greater variability in test scores and their patients experience higher mortality rates after complex surgical procedures. Hospital administrators in their efforts to assess cognition of their aging medical staff are limited by the absence of validated metrics when it comes to older individuals with above-average years of education. Also, attempts to curtail medical practice based on age are fraught with legal implications arising from the Americans with Disabilities Act of 1990 and the Age Discrimination in Employment Act of 1967. We examined the issues hospital administrators face when formulating policies regulating the medical practice of late-career physicians. Our review summarizes the state of the literature of late-career physicians, reviews the legal implications of policies regarding age and the practice of medicine and offers our experience in creating a late-career physician policy for a multi-disciplinary medical staff. 

The second victims’ experience and related factors among medical staff

2019 ◽  
Vol 12 (3) ◽  
pp. 134-145 ◽  
Author(s):  
Amjad Mohamadi-Bolbanabad ◽  
Ghobad Moradi ◽  
Bakhtiar Piroozi ◽  
Hossein Safari ◽  
Heshmatollah Asadi ◽  
...  
Keyword(s):  
Medical Errors ◽  
Medical Staff ◽  
Sleep Disturbances ◽  
Physical Symptoms ◽  
Public Hospitals ◽  
Self Report ◽  
Related Factors ◽  
Cross Sectional ◽  
Content Type ◽  
Hospital Administrators

Purpose The purpose of this paper is to determine the second victims’ experience and its related factors among medical staff. Design/methodology/approach This research is a cross-sectional study that was conducted in public hospitals of Sanandaj, west of Iran, in 2017. The sample consisted of 338 medical staff including physicians, nurses and mid-wives. A self-report questionnaire was used for data collection. Descriptive statistics, cross-tabs and χ2 test were used for data analysis using SPSS20. Findings A total of 51.5 percent (n=174) of the medical staff had experienced medical error in the past year, of which 90.2 percent (n=157) had at least one of the symptoms of “second victims.” Tachycardia and sleep disturbances were the most commonly referred physical symptoms with 73 and 51.7 percent, respectively. Also, repetitive/intrusive memories and fear of reputation damage were the most commonly referred psychosocial symptoms with 68.3 and 51.7 percent, respectively. The experience of physical and psychosocial symptoms was different according to the occupational category. In addition, there was a significant association between the experience of physical symptoms with the hospital administrators’ awareness of medical errors and the consequences of medical errors for patients. Practical implications Adoption of coping strategies, including learning from medical errors as well as hospital administrators’ support from second victims, is recommended. It is also suggested that medical staff be informed about the consequences of medical errors as well as physical and psychological symptoms of second victims so that they can ask for help from managers and colleagues when the symptoms occur. Originality/value This study outlines the prevalence, the most psychological and physical symptoms, and the demographic and occupational factors associated with the second victim phenomenon in medical staff. Also, the most important strategies for coping with this phenomenon are prioritized from the perspective of medical staff.

Role of a Nurse on a Psychiatric Consultation Service

1974 ◽  
Vol 19 (5) ◽  
pp. 453-456 ◽  
Author(s):  
Diane Moreau ◽  
Pamela Kahn ◽  
Samarthji Lal
Keyword(s):  
General Hospital ◽  
Nursing Staff ◽  
Medical Staff ◽  
Psychiatric Care ◽  
Psychiatric Nursing ◽  
Psychiatric Nurse ◽  
Psychiatric Consultation ◽  
Consultation Service ◽  
Psychiatric Setting

A psychiatric nurse on a psychiatric consultation service in a general hospital plays both a diagnostic and therapeutic role, and also provides a teaching service to nursing personnel in other departments. This paper focuses on these functions and how they apply in a specific psychiatric setting. The role of the psychiatric nurse also illustrates the use of para-medical staff in the delivery of psychiatric care. The addition of a psychiatric nurse as a regular member of a psychiatric consultation service in a general hospital is of value both for the consultation service and for the non-psychiatric nursing staff.

scholarly journals Letters and Notes in Orthopaedic Surgery

2006 ◽  
Vol 88 (3) ◽  
pp. 292-296 ◽  
Author(s):  
Samantha E Hook ◽  
Gordon C Banister ◽  
Claire Topliss ◽  
Jonathan Webb
Keyword(s):  
General Practitioners ◽  
Nursing Staff ◽  
Medical Staff ◽  
Orthopaedic Surgery ◽  
Hospital Staff ◽  
Essential Information ◽  
Poor Knowledge ◽  
Complete Set ◽  
Letter Format

INTRODUCTION Accurate written communication is essential in orthopaedic surgery. Incomplete and poorly structured letters can lead to poor knowledge of a patient's diagnosis. MATERIALS AND METHODS Structured and traditional letter formats were compared for speed of reading and preference by general practitioners (GPs), consultants, registrars and out-patient nursing staff. In addition, out-patient clinic letters and notes were analysed and compared for speed of reading and ease of assimilating information and content. RESULTS There was overwhelming preference for the structured letter format. This style of letter could be read significantly more quickly with information better assimilated and relevant data included more frequently. However, only 26% of letters generated contained a complete set of information sought by GPs and hospital staff. CONCLUSIONS Structured letters are better in orthopaedics because it is easier to access the contents. The structured format disciplines medical staff to address essential information. Even with a structured format the majority of letters omitted essential information. Training in letter writing is necessary. A structured letter format next to dictating machines might improve the quality of letters generated.

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