Authentic leadership among nursing professionals: knowledge and profile

ABSTRACT Objectives: to identify the knowledge of nursing professionals about leadership models and evaluate the authentic leadership profile among them. Methods: analytical study, conducted between August and December 2015, involving 84 nursing professionals working in a public and tertiary hospital. We used two instruments: Sociodemographic Questionnaire with questions about leadership and the Authentic Leadership Questionnaire. Results: both nurses and nursing technicians were unaware of authentic leadership. Both pointed to communication, planning, and organization as competencies of the leader (n = 58, 95%). Regarding the authentic leadership profile, we observed that the score was “high” among nurses and “low” among technicians. Holding a leadership position and professionally upgrading has positively influenced the highest-profile of authentic leadership. Conclusions: nurses demonstrated to know behavioral leadership, while nursing technicians showed knowledge about situational leadership. Nurses had a high score of authentic leadership behaviors, while nursing technicians had a low score, but we found no significant difference between them. Holding a leadership position and professionally upgrading has positively influenced the highest profile of authentic leadership.

Download Full-text

Effect of Surgical Setting on Hospital-Reported Outcomes for Elective Lumbar Spinal Procedures: Tertiary Versus Community Hospitals

Global Spine Journal ◽

10.1177/2192568219848666 ◽

2019 ◽

Vol 10 (4) ◽

pp. 375-383 ◽

Cited By ~ 1

Author(s):

Tristan B. Weir ◽

Neil Sardesai ◽

Julio J. Jauregui ◽

Ehsan Jazini ◽

Michael J. Sokolow ◽

...

Keyword(s):

Pay For Performance ◽

Linear Regression Analysis ◽

Degenerative Spondylolisthesis ◽

Hospital Costs ◽

Patient Characteristics ◽

Tertiary Hospital ◽

Community Hospitals ◽

Single Level ◽

Significant Difference ◽

Reported Data

Study Design: Retrospective cohort study. Objective: As hospital compensation becomes increasingly dependent on pay-for-performance and bundled payment compensation models, hospitals seek to reduce costs and increase quality. To our knowledge, no reported data compare these measures between hospital settings for elective lumbar procedures. The study compares hospital-reported outcomes and costs for elective lumbar procedures performed at a tertiary hospital (TH) versus community hospitals (CH) within a single health care system. Methods: Retrospective review of a physician-maintained, prospectively collected database consisting of 1 TH and 4 CH for 3 common lumbar surgeries from 2015 to 2016. Patients undergoing primary elective microdiscectomy for disc herniation, laminectomy for spinal stenosis, and laminectomy with fusion for degenerative spondylolisthesis were included. Patients were excluded for traumatic, infectious, or malignant pathology. Comparing hospital settings, outcomes included length of stay (LOS), rates of 30-day readmissions, potentially preventable complications (PPC), and discharge to rehabilitation facility, and hospital costs. Results: A total of 892 patients (n = 217 microdiscectomies, n = 302 laminectomies, and n = 373 laminectomy fusions) were included. The TH served a younger patient population with fewer comorbid conditions and a higher proportion of African Americans. The TH performed more decompressions ( P < .001) per level fused; the CH performed more interbody fusions ( P = .007). Cost of performing microdiscectomy ( P < .001) and laminectomy ( P = .014) was significantly higher at the TH, but there was no significant difference for laminectomy with fusion. In a multivariable stepwise linear regression analysis, the TH was significantly more expensive for single-level microdiscectomy ( P < .001) and laminectomy with single-level fusion ( P < .001), but trended toward significance for laminectomy without fusion ( P = .052). No difference existed for PPC or readmissions rate. Patients undergoing laminectomy without fusion were discharged to a facility more often at the TH ( P = .019). Conclusions: We provide hospital-reported outcomes between a TH and CH. Significant differences in patient characteristics and surgical practices exist between surgical settings. Despite minimal differences in hospital-reported outcomes, the TH was significantly more expensive.

Download Full-text

Predicting mortality in adults with suspected infection in a Rwandan hospital: an evaluation of the adapted MEWS, qSOFA and UVA scores

BMJ Open ◽

10.1136/bmjopen-2020-040361 ◽

2021 ◽

Vol 11 (2) ◽

pp. e040361

Author(s):

Amanda Klinger ◽

Ariel Mueller ◽

Tori Sutherland ◽

Christophe Mpirimbanyi ◽

Elie Nziyomaze ◽

...

Keyword(s):

Decision Making ◽

Quality Improvement ◽

Clinical Decision Making ◽

Clinical Decision ◽

Tertiary Hospital ◽

Early Warning Score ◽

Receiver Operating Curve ◽

Predictive Capacity ◽

Suspected Infection ◽

Significant Difference

RationaleMortality prediction scores are increasingly being evaluated in low and middle income countries (LMICs) for research comparisons, quality improvement and clinical decision-making. The modified early warning score (MEWS), quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA), and Universal Vital Assessment (UVA) score use variables that are feasible to obtain, and have demonstrated potential to predict mortality in LMIC cohorts.ObjectiveTo determine the predictive capacity of adapted MEWS, qSOFA and UVA in a Rwandan hospital.Design, setting, participants and outcome measuresWe prospectively collected data on all adult patients admitted to a tertiary hospital in Rwanda with suspected infection over 7 months. We calculated an adapted MEWS, qSOFA and UVA score for each participant. The predictive capacity of each score was assessed including sensitivity, specificity, positive and negative predictive value, OR, area under the receiver operating curve (AUROC) and performance by underlying risk quartile.ResultsWe screened 19 178 patient days, and enrolled 647 unique patients. Median age was 35 years, and in-hospital mortality was 18.1%. The proportion of data missing for each variable ranged from 0% to 11.7%. The sensitivities and specificities of the scores were: adapted MEWS >4, 50.4% and 74.9%, respectively; qSOFA >2, 24.8% and 90.4%, respectively; and UVA >4, 28.2% and 91.1%, respectively. The scores as continuous variables demonstrated the following AUROCs: adapted MEWS 0.69 (95% CI 0.64 to 0.74), qSOFA 0.65 (95% CI 0.60 to 0.70), and UVA 0.71 (95% CI 0.66 to 0.76); there was no statistically significant difference between the discriminative capacities of the scores.ConclusionThree scores demonstrated a modest ability to predict mortality in a prospective study of inpatients with suspected infection at a Rwandan tertiary hospital. Careful consideration must be given to their adequacy before using them in research comparisons, quality improvement or clinical decision-making.

Download Full-text

Causes of delayed exploration of the acute scrotum in a regional tertiary centre

Journal of Clinical Urology ◽

10.1177/2051415820981196 ◽

2020 ◽

pp. 205141582098119

Author(s):

Benjamin Storey ◽

Nathan Shugg ◽

Alison Blatt

Keyword(s):

Retrospective Review ◽

Testicular Torsion ◽

Tertiary Hospital ◽

Adverse Outcomes ◽

Acute Scrotum ◽

Tertiary Institution ◽

Level Of Evidence ◽

Scrotal Pain ◽

Surgical Exploration ◽

Significant Difference

Background: Testicular torsion is an organ-threatening surgical emergency with a limited timeframe for intervention. Objective: To identify the delays to surgical exploration of patients with an acute scrotum in a tertiary hospital to prevent adverse outcomes associated with this time critical emergency. Methods: A retrospective review of medical records for all patients who underwent scrotal exploration for acute scrotal pain in a tertiary hospital in regional New South Wales between January 2008 to December 2018 was performed. Results: Retrospective review identified 242 patients, of whom 161 had testicular torsion and 56 resultant orchidectomies. No statistically significant difference in pre-hospital delays between paediatric or adult populations was found. The average time from presentation to theatre was 4 h 36 min. Patients who were delayed > 6 h from presentation to surgical exploration had significantly increased rates of orchidectomy. Delays that significantly affected rates of orchidectomy were transfer from peripheral sites, late presentation, misdiagnosis and representation after discharge. Conclusion: The most common reason for delay was diagnostic error with the patient later re-presenting to hospital. Patient transfer from the primary hospital to a tertiary institution and subsequent delayed surgical exploration also contributed to significantly higher rates of orchidectomy. Level of Evidence: 3

Download Full-text

Sonographic Assessment of Renal Volume in Normotensive Pregnant Women and Women With Pregnancy-Induced Hypertension in Enugu Metropolis

Journal of Diagnostic Medical Sonography ◽

10.1177/87564793211021094 ◽

2021 ◽

pp. 875647932110210

Author(s):

Idigo Felicitas Ugochinyere ◽

Nwankwo Sylvia Chiamaka ◽

Abonyi Everistus Obinna ◽

Anakwue Angel-Mary Chukwunyelu ◽

Agbo Julius Amechi

Keyword(s):

Reference Range ◽

Interobserver Variability ◽

Correct Diagnosis ◽

Negative Relationship ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Renal Volume ◽

Cross Sectional ◽

Significant Difference ◽

Induced Hypertension

Objective: Renal volume (RV) assessment during obstetric sonography is rarely considered in our locality. Understanding the changes in RV in both normotensive pregnant (NP) and pregnancy-induced hypertensive (PIH) women is important in making correct diagnosis regarding pregnancy outcome. This study is aimed at determining the RV in NP and PIH women and correlating RV with fetal gestational age (FGA), body mass index (BMI), and parity in NP women. Materials and Methods: This cross-sectional study involved 450 patients recruited at a Tertiary Hospital. A pilot study was done to determine the interobserver variability in RV measurement. RV was calculated using the following formula: L × W × AP × 0.523. Parity, BMI, and blood pressure were documented, while FGA was calculated as an average of FGAs obtained from the measurements of fetal biometric parameters. Results: Mean RV of PIH women was significantly higher than that of NP women ( P < .05). RV shows a positive significant relationship with BMI and FGA, while it shows a negative relationship with parity in NP ( P < .05). Conclusion: Reference range values of RV were generated for clinical use in our locality, while there is statistically significant difference between RV in NP and PIH women.

Download Full-text

Evaluation and Quantification of Cytomorphometry in Conjunction with Visual Examination and Exfoliative Cytology in Early Diagnosis of Oral Premalignant and Malignant Lesions

Acta Cytologica ◽

10.1159/000518582 ◽

2021 ◽

pp. 1-7

Author(s):

Vasudha Singh ◽

Mudita Bhargava ◽

Kachnar Varma ◽

Vatsala Misra ◽

Richa Singh

Keyword(s):

Tertiary Hospital ◽

Accurate Diagnosis ◽

Exfoliative Cytology ◽

Visual Examination ◽

Normal Cytology ◽

Subjective Analysis ◽

Oral Epithelial Dysplasia ◽

Significant Difference ◽

Potentially Malignant ◽

Malignant Lesions

Introduction: Incidence of oral epithelial dysplasia and oral squamous cell carcinoma (SCC) is very high in south Asian countries as compared to western population owing to a greater use of tobacco in these regions. While visual examination and exfoliative cytology are the most common screening and diagnostic modalities at present, it is a subjective analysis. Quantitative analyses such as nuclear size, cell size, and nuclear-to-cytoplasmic ratio may provide an accurate diagnosis and improve reproducibility. The aim of the study was to evaluate the role of morphometry as a diagnostic adjunct to exfoliative cytology and to derive a significant cutoff to identify the population at risk for development of SCC among chronic tobacco users. Material and Methods: This was an outpatient-based prospective study done in a tertiary hospital over a period of 2 years. Hundred and fifty cases with a history of chronic tobacco use for a minimum period of 5 years were evaluated. Visual inspection using acetic acid was done. Oral scrapes were taken for cytological and morphometric analysis followed by incision biopsy for histopathological evaluation, wherever possible. Results: On morphometrical analysis, mean nuclear area and nuclear:cytoplasmic (N:C) ratio increased, while the cytoplasmic area decreased from smears with normal cytology to oral dysplasia to SCC. Analysis of variance and post hoc Tukey’s honest significant difference test showed a statistically significant difference among the 3 groups (p value <0.05). A cutoff value for a significant N:C ratio was calculated as ≥0.08 using Youden’s index with a sensitivity and a specificity of 88% and 94%, respectively. Conclusion: In high-risk cases, morphometry can be a useful adjunct to exfoliative cytology and visual examination for an early and accurate diagnosis and timely intervention in oral potentially malignant and malignant lesions, thereby improving the prognosis.

Download Full-text

Applicability of auriculotherapy in reducing stress and as a coping strategy in nursing professionals

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692012000500021 ◽

2012 ◽

Vol 20 (5) ◽

pp. 980-987 ◽

Cited By ~ 10

Author(s):

Leonice Fumiko Sato Kurebayashi ◽

Juliana Rizzo Gnatta ◽

Talita Pavarini Borges ◽

Maria Júlia Paes da Silva

Keyword(s):

Positive Impact ◽

Control Group ◽

Control Groups ◽

The Third ◽

Stress Symptoms ◽

Significant Difference ◽

Stress Levels ◽

Needle Control ◽

Nursing Professionals ◽

Reducing Stress

AIMS: randomized clinical trial aimed at evaluating the auriculotherapy in reducing stress levels in 75 nursing professionals and analyze the coping domains that have changed after treatment. METHODOLOGY: volunteers were divided into 3 groups (Control, Needles and Seeds) and received eight sessions at Shenmen, Kidney and Brainstem points. The Control Group didn't receive any intervention. RESULTS: ANOVA test showed statistical differences in stress levels for Needle/Control Groups in the third and fourth assessments, according to Stress Symptoms List when compared the three groups in four assessments. For the Inventory of Folkman/Lazarus, a significant difference was obtained for Spacing domain between needle/control. In analysis within the same group, differences were found for Confrontation in fourth assessment between Needle/Control Groups and for Social Support in the third one between Seeds/Control Groups. CONCLUSION: The auriculotherapy decreased stress levels, changed Coping domains after treatment, suggesting that both Auriculotherapy with needles and seeds can produce positive impact to improve strategy Coping in the nursing team. However, more studies are needed to conceive the extent of the technique.

Download Full-text

Study of Maternal and Fetal Outcome among Booked and Unbooked Patients at tertiary Hospital

Birat Journal of Health Sciences ◽

10.3126/bjhs.v5i2.31376 ◽

2020 ◽

Vol 5 (2) ◽

pp. 1027-1030

Author(s):

Shanti Sunuwar Subedi ◽

Rakina Bhansakarya ◽

Sajjan Kumar Sharma

Keyword(s):

Sampling Technique ◽

Secondary Level ◽

Tertiary Hospital ◽

Fetal Outcome ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Spontaneous Vaginal Delivery ◽

Significant Difference ◽

The Difference

Introduction: To evaluate the maternal and perinatal outcome in booked and unbooked cases. Objectives: To assess the maternal and fetal outcomes in unbooked and booked patients. Methodology: This was a cross-sectional comparative study conducted in the Department of Obstetrics and Gynecology from Augustti2019 to January 2020. Using a convenient sampling technique, 204 samples were taken and cross-sectional study was done. Results: There were total 204 cases in this study;102were booked and 102 were unbooked. In this study, 85(83%) of booked cases were educated up to secondary level as compared toti65 (64%) of unbooked cases. There was no significant difference in Apgar score in 1 and 5 minute between booked and unbooked cases. More babies in the unbooked group were transferred to NICU as compared to the booked group and the difference was significant (9.8%vs 1.9%). Greater proportion of booked cases had spontaneous vaginal delivery (81.3% vs 59.8%) and complications like preterm delivery, anemia, preeclampsia/ eclampsia, complicated labor and puerperal sepsis was also less in the booked group. Conclusions: The study showed that unbooked mothers and their newborns had higher chance of having complications.

Download Full-text

Comparing the first and second waves of COVID-19 in a tertiary university hospital in Barcelona

F1000Research ◽

10.12688/f1000research.73988.1 ◽

2021 ◽

Vol 10 ◽

pp. 1197

Author(s):

Yolima Cossio ◽

Marta-Beatriz Aller ◽

Maria José Abadias ◽

Jose-Manuel Domínguez ◽

Maria-Soledad Romea ◽

...

Keyword(s):

Tertiary Hospital ◽

Healthcare Systems ◽

University Hospital ◽

Emergency Rooms ◽

Daily Number ◽

Patient Demographics ◽

Significant Difference ◽

The University ◽

Hospital Wards ◽

Second Wave

Background: Hospitals have constituted the limiting resource of the healthcare systems for the management of the COVID-19 pandemic. As the pandemic progressed, knowledge of the disease improved, and healthcare systems were expected to be more adapted to provide a more efficient response. The objective of this research was to compare the flow of COVID-19 patients in emergency rooms and hospital wards, between the pandemic's first and second waves at the University Hospital of Vall d’Hebron (Barcelona, Spain), and to compare the profiles, severity and mortality of COVID-19 patients between the two waves. Methods: A retrospective observational analysis of COVID-19 patients attending the hospital from February 24 to April 26, 2020 (first wave) and from July 24, 2020, to May 18, 2021 (second wave) was carried out. We analysed the data of the electronic medical records on patient demographics, comorbidity, severity, and mortality. Results: The daily number of COVID-19 patients entering the emergency rooms (ER) dropped by 65% during the second wave compared to the first wave. During the second wave, patients entering the ER were significantly younger (61 against 63 years old p<0.001) and less severely affected (39% against 48% with a triage level of resuscitation or emergency; p<0.001). ER mortality declined during the second wave (1% against 2%; p<0.000). The daily number of hospitalised COVID-19 patients dropped by 75% during the second wave. Those hospitalised during the second wave were more severely affected (20% against 10%; p<0.001) and were referred to the intensive care unit (ICU) more frequently (21% against 15%; p<0.001). Inpatient mortality showed no significant difference between the two waves. Conclusions: Changes in the flow, severity and mortality of COVID-19 patients entering this tertiary hospital during the two waves may reflect a better adaptation of the health care system and the improvement of knowledge on the disease.

Download Full-text

Oocytes with smooth endoplasmic reticulum aggregates do not impact blastocyst euploidy rate

10.21203/rs.3.rs-917473/v1 ◽

2021 ◽

Author(s):

Jian Xu ◽

Li Yang ◽

Zhi-Heng Chen ◽

Min-Na Yin ◽

Juan Chen ◽

...

Keyword(s):

Endoplasmic Reticulum ◽

Smooth Endoplasmic Reticulum ◽

Formation Rate ◽

Tertiary Hospital ◽

Fertilization Rate ◽

Blastocyst Formation ◽

Preimplantation Genetic Testing ◽

Significant Difference ◽

Normal Fertilization ◽

Euploidy Rate

Abstract Objective: To investigate whether the euploidy rate of blastocysts derived from smooth endoplasmic reticulum (SERa) positive cycles and oocytes are impacted.Design: Retrospective cohort study.Setting: A tertiary hospital-based reproductive medicine center.Patient(s): A total of 601 preimplantation genetic testing (PGT) cycles with obtained oocytes in our center between April 2017 and May 2021 were included in the study. Intervention(s): Women＞35 years and PGT cycles with chromosomal structural rearrangements (PGT-SR) were excluded. Embryological and blastocyst ploidy outcomes were compared between SERa+ oocyte, sibling SERa- oocytes and oocytes in SERa- cycles.Main Outcome Measure(s): Embryological outcomes and blastocyst euploidy rate.Results: No significant difference was observed in the normal fertilization rate (82.1 % vs. 77.8 % vs. 83.1 %, respectively, P=0.061), blastocyst formation rate (71.0 % vs. 72.5 % vs. 68.4 %, respectively, P=0.393), good quality blastocyst formation rate (46.4 % vs. 48.3 % vs. 42.6 %, respectively, P=0.198) between the SERa+ oocyte group, sibling SERa- oocyte group and SERa- oocyte group. No significant difference was observed in the euploidy rate (50.0 % vs. 62.5 % vs. 63.3 %, respectively, P=0.324), mosaic rate (12.5 % vs. 9.7 % vs. 13.4 %, respectively, P=0.506) and aneuploidy rate (37.5 % vs. 27.8% vs. 23.2 %, respectively, P=0.137) between the three groups.Conclusion: Our results suggest that the euploidy rate of blastocysts derived from SERa+ cycles and oocytes are not impacted.

Download Full-text

Modelo de Liderança Autêntica: concepção teórica e evidências de validade do Authentic Leadership Questionnaire (ALQ) para o Brasil

Psychologica ◽

10.14195/1647-8606_61-2_1 ◽

2018 ◽

Vol 61 (2) ◽

pp. 7-29

Author(s):

Clarissa Socal Cervo ◽

Jean Carlos Natividade ◽

Lisete Dos Santos Mendes Mónico ◽

Leonor Pais ◽

Nuno Rebelo Dos Santos ◽

...

Keyword(s):

Authentic Leadership ◽

Authentic Leadership Questionnaire

O modelo de Liderança Autêntica destaca-se entre as teorias positivas de liderança. O instrumento mais utilizado para aferir a autenticidade do líder é o Authentic Leadership Questionnaire (ALQ). No Brasil, esta medida encontra-se validada, contudo, é ainda necessário reforçar as suas evidências de validade para este país. O objetivo desta investigação é apresentar evidências adicionais de validade do ALQ para o contexto brasileiro de trabalho. Participaram no estudo profissionais líderes (N = 437) e liderados (N = 1329), de organizações da região sul do país. O ALQ foi aplicado nas versões de auto e heteroavaliação. Análises Fatoriais Confirmatórias indicam a presença dos quatro fatores do modelo de Liderança Autêntica, e há confiabilidade e validade do ALQ para as amostras brasileiras estudadas. A natureza privada das organizações impacta na percepção de autenticidade na liderança, contudo os resultados não confirmam a importância das variáveis sociodemográficas (idade, sexo, escolaridade e renda pessoal) e da dimensão da organização. Discutem-se as limitações do estudo e apresentam-se sugestões para futuras investigações.

Download Full-text