scholarly journals Exploratory study of staff perceptions of shift safety in the critical care unit and routinely available data on workforce, patient and organisational factors

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e034101
Author(s):  
Clare Leon-Villapalos ◽  
Mary Wells ◽  
Stephen Brett
Keyword(s):  
Critical Care ◽  
Work Environment ◽  
Exploratory Study ◽  
Routine Data ◽  
Care Staff ◽  
Staff Perceptions ◽  
Large Teaching Hospital ◽  
Level 3 ◽  
Perceptions Of Safety ◽  
Organisational Factors

ObjectivesTo explore bedside professional reported (BPR) perceptions of safety in intensive care staff and the relationships between BPR safety, staffing, patient and work environment characteristics.DesignAn exploratory study of self-recorded staff perceptions of shift safety and routinely collected data.SettingA large teaching hospital comprising 70 critical care beds.ParticipantsAll clinical staff working in adult critical care.InterventionsStaff recorded whether their shift felt ‘safe, unsafe or very unsafe’ for 29 consecutive days. We explored these perceptions and relationships between them and routine data on staffing, patient and environmental characteristics.Outcome measuresRelationships between BPR safety and staffing, patient and work environment characteristics.Results2836 BPR scores were recorded over 29 consecutive days (response rate 57.7%). Perceptions of safety varied between staff, including within the same shift. There was no correlation between perceptions of safety and two measures of staffing: care hours per patient day (r=0.13 p=0.108) and Safecare Allocate (r=−0.19 p=0.013). We found a significant, positive relationship between perceptions of safety and the percentage of level 3 (most severely ill) patients (r=0.32, p=0.0001). There was a significant inverse relationship between perceptions of safety and the percentage of level 1 patients on a shift (r=−0.42, p<0.0001). Perceptions of safety correlated negatively with increased numbers of patients (r=−0.44, p=0.0006) and higher percentage of patients located side rooms (r=0.63, p<0.0001). We found a significant relationship between perceptions of safety and the percentage of staff with a specialist critical care course (r=0.42. p=0.0001).ConclusionExisting staffing models, which are primarily influenced by staff-to-patient ratios, may not be sensitive to patient need. Other factors may be important drivers of staff perceptions of safety and should be explored further.

Compassion Fatigue and the Healthy Work Environment

2017 ◽  
Vol 28 (4) ◽  
pp. 351-358 ◽  
Author(s):  
Lesly Kelly ◽  
Michael Todd
Keyword(s):  
Critical Care ◽  
Work Environment ◽  
Compassion Fatigue ◽  
American Association ◽  
Medical Center ◽  
Academic Medical Center ◽  
Compassion Satisfaction ◽  
Critical Care Nurses ◽  
Healthy Work Environment ◽  
Healthy Work

Background:Burnout is a concern for critical care nurses in high-intensity environments. Studies have highlighted the importance of a healthy work environment in promoting optimal nurse and patient outcomes, but research examining the relationship between a healthy work environment and burnout is limited.Objective:To examine how healthy work environment components relate to compassion fatigue (eg, burnout, secondary trauma) and compassion satisfaction.Methods:Nurses (n = 105) in 3 intensive care units at an academic medical center completed a survey including the Professional Quality of Life and the American Association of Critical-Care Nurses’ Healthy Work Environment standards.Results:Regression models using each Healthy Work Environment component to predict each outcome, adjusting for background variables, showed that the 5 Healthy Work Environment components predicted burnout and that meaningful recognition and authentic leadership predicted compassion satisfaction.Conclusions:Findings on associations between healthy work environment standards and burnout suggest the potential importance of implementing the American Association of Critical-Care Nurses’ Healthy Work Environment standards as a mechanism for decreasing burnout.

scholarly journals The side effects of service changes: exploring the longitudinal impact of participation in a randomised controlled trial (DOORWAYS) on staff perceptions of barriers to change

2019 ◽  
Author(s):  
Caroline Laker ◽  
Matteo Cella ◽  
Felicity Callard ◽  
Til Wykes
Keyword(s):  
Mental Health ◽  
Controlled Trial ◽  
Occupational Status ◽  
Intervention Group ◽  
Direct Care ◽  
Care Staff ◽  
Control Group ◽  
Staff Perceptions ◽  
Barriers To Change ◽  
Randomised Controlled

Abstract Background Staff and service users have expressed concerns that service improvements in U.K. mental health wards have been slow or transient. It is possible that certain changes are positive for some (e.g. service users), but negative for others (e.g. staff), which may affect implementation success. In this study, we explore whether a programme of change to improve the therapeutic milieu on mental health wards influenced staff perceptions of barriers to change, 12 months after implementation. Method A cluster randomised controlled trial called DOORWAYS was conducted on eight inner-city U.K. acute mental health wards. Randomisation was achieved using a list randomly generated by a computer. A psychologist trained ward staff (mainly nurses) to deliver evidence-based groups and supported their initial implementation. The impact of these changes was measured over 12 months (when 4 wards were randomised), according to nurses’ perceptions of barriers to change (VOCALISE), using unstructured multivariate linear regression models. This innovative analysis method allows maximum use of data in randomised controlled trials with reduced sample sizes due to substantial drop out rates. The contextual influences of occupational status (staff) and of workplace setting (ward) were also considered. Results Staff who participated in the intervention had significantly worse perceptions of barriers to change at follow up. The perceptions of staff in the control group did not change over time. In both groups (N=120), direct care staff had more negative perceptions of barriers to change, and perceptions varied according to ward. Across time, direct care staff in the intervention group became more negative than those in the control group. Conclusion Participation in this program of change, worsened staff perceptions of barriers to change. In addition, occupational status (being from the direct care group) had a negative effect on perceptions of barriers to change, an effect that continued across time and was worse in the intervention group. Those providing direct care should be offered extra support when changes are introduced and through the implementation process. More effort should be placed around reducing the perceived burden of innovation for staff in mental health wards.

scholarly journals Stomatheraphy: influences and repercussions on the professional career

2020 ◽  
Author(s):  
Lais Del Moro Cespedes Wojastyk ◽  
Maria Angela Boccara de Paula ◽  
Merielen Neves Brajão Prado
Keyword(s):  
Work Environment ◽  
Exploratory Study ◽  
Sao Paulo ◽  
Nursing School ◽  
Quantitative Approach ◽  
Job Market ◽  
Professional Career ◽  
Management Positions ◽  
The Subject ◽  
The University

Objective: To analyze the influences and repercussions of enterostomal therapy on the career of nurses. Methods: Descriptive, exploratory study with quantitative approach, conducted in 2014. The sample consisted of 29 nurses graduated from the Nursing School of the University of São Paulo and the University of Taubaté. The data were collected through a questionnaire and analyzed by SPHINXR software. The results were discussed in the light of the literature on the subject. Results: The continuity of the studies provided the nurse a career with promotions, management positions or even a career redirection. The work environment influenced the achievement of the specialty (21/79%). The participants worked in several types of institutions and their positions were diverse, thus presenting options for those who want to pursue a career in the area. Conclusion: The job market, as well as the environment in which the nurse is inserted, most of the time plays a defining role when the subject is the choice of a specialization.

Review of Regional Workplace Development Cases

2012 ◽  
pp. 79-95
Author(s):  
Arto Reiman ◽  
Seppo Väyrynen
Keyword(s):  
Work Environment ◽  
Industrial Development ◽  
Manufacturing Industry ◽  
Assessment Tool ◽  
Social Systems ◽  
Self Assessment ◽  
Life Challenges ◽  
Northern Areas ◽  
Workplace Development ◽  
Organisational Factors

The labour-intensive manufacturing industry faces many working-life challenges in the rural, sparsely populated northern areas of Finland at both operational and strategic levels. These challenges vary, being in interaction with both technical and social systems and their combinations. In this paper, the authors review and evaluate needs, actions and results carried out to improve work and productivity in three regional industrial development cases. The actions discussed in this paper, such as work environment management, change management in general and the sociotechnical approach, are essential for the success of enterprises. Using the results of this research as a basis for developing design knowledge, two guidelines for strategic management purposes are proposed. These guidelines implement sociotechnical aspects into the work environment and its management, and recognise that it is important to focus on human and organisational factors in addition to technical end environmental aspects. A proposal for a specific, unique self-assessment tool for evaluating the level of the quality of the work environment in SMEs is also suggested.

Prolonged mechanical ventilation and delayed weaning

2019 ◽  
pp. 243-258
Author(s):  
Patrick B. Murphy ◽  
Nicholas Hart
Keyword(s):  
Critical Care ◽  
Critical Care Unit ◽  
Prolonged Mechanical Ventilation ◽  
Daily Practice ◽  
Care Staff ◽  
Standard Textbook ◽  
Long Term Ventilation ◽  
Learning Points

This chapter is centred on a case study on long-term ventilation and weaning. This topic is one of the key challenging areas in critical care medicine and one that all intensive care staff will encounter. The chapter is based on a detailed case history, ensuring clinical relevance, together with relevant images, making this easily relatable to daily practice in the critical care unit. The chapter is punctuated by evidence-based, up-to-date learning points, which highlight key information for the reader. Throughout the chapter, a topic expert provides contextual advice and commentary, adding practical expertise to the standard textbook approach and reinforcing key messages.

Acute pancreatitis and renal replacement therapy

2019 ◽  
pp. 179-190
Author(s):  
Clinton Lobo ◽  
Kim Gupta ◽  
Matt Thomas
Keyword(s):  
Critical Care ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critical Care Unit ◽  
Daily Practice ◽  
Care Staff ◽  
Evidence Based ◽  
Standard Textbook ◽  
Learning Points

This chapter is centred on a case study on pancreatitis and renal replacement therapy. This topic is one of the key challenging areas in critical care medicine and one that all intensive care staff will encounter. The chapter is based on a detailed case history, ensuring clinical relevance, together with relevant images, making this easily relatable to daily practice in the critical care unit. The chapter is punctuated by evidence-based, up-to-date learning points, which highlight key information for the reader. Throughout the chapter, a topic expert provides contextual advice and commentary, adding practical expertise to the standard textbook approach and reinforcing key messages.

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