四川省公立医院药房经营管理现状调查之四——运营管理与文化建设

目的 了解四川省公立医院药房运营管理和文化建设现状,为提高公立医院药房管理水平提供证据与建议。 方法 依据运营管理和文化建设的理论和研究方法,设计调查问卷,调查74 家公立医院药房的管理者及骨干306 人对公立医院药房运营管理水平和文化建设的认识。采用率和构成比进行统计学描述。 结果 ① 超过70% 的被调查者认为员工的服务意识和质量意识一般;约70% 的被调查者认为相互间配合较好、职责较明确。②近60% 的被调查者认为公立医院药房员工的效率成本意识一般。③ 近50% 的被调查者认为存在不能及时获得信息及沟通不充分现象。④ 约50% 的被调查者认为服务流程不合理,需要优化。⑤ 60% 的被调查者认为文化建设对科室发展有一定作用;超过70% 的被调查者认为现有管理制度较健全,但偶尔有违反制度现象。 结论 公立医院药房运营管理有待完善,科室文化尚未发挥应有的作用。     

四川省公立医院经营管理现状调查之三——人力资源管理

目的了解四川省公立医院药房人力资源管理现状,为提高公立医院药房管理水平提供证据与建议。方法依据人力资源管理理论和研究方法,自行设计问卷调查表,调查74家公立医院药房的管理者及骨干共306人对公立医院药房人力资源管理的认识。采用百分率和构成比进行统计描述。结果被调查者中56％认为公立医院药房员工素质较高;近73％认为公立医院药房人际关系较好,45％喜欢并有能力做好工作;近75％认为应改进现有的绩效考核措施;约63％认为学习培训内容与本职工作关系不大;约63％认为个人才能在目前岗位有些方面没有发挥。结论应改变公立医院药房人力资源管理现状,进一步提高员工素质和工作能力;强化激励机制;有针对性地开展学习与培训;做好员工的职业生涯设计。     

四川省公立医院药房经营管理现状调查之一——对经营管理的认识

目的了解四川省公立医院药房经营管理现状,为提高公立医院药房经营管理水平和公立医院体制改革提供证据与建议。方法依据企业诊断原理和方法,设计公立医院药房经营管理调查问卷,调查74家公立医院药房306名管理者及骨干的经营管理理念。结果①被调查者70%以上对战略定位、品牌及经营发展方向理解和知晓度较好,创新意识、风险意识较强,并对风险和竞争因素有较深理解,对药房经营方向的认识较符合经营管理理念。②60%的被调查者认为公立医院药房缺乏市场竞争意识、危机感及明确的经营管理计划;较少主动适应市场变化,开拓市场,提供新的服务内容;敬业精神、创新能力不尽如人意;对外部环境变化不敏感;竞争优势不突出。③52%的被调查者对公立医院药房的前途充满希望。结论四川公立医院药房亟待加强管理理念的教育与更新,以及管理模式的改进与创新。     

北京市某三级甲等医院护理人员科研现状的调查

目的对护理人员的科研现状进行调查及分析。方法采用自设问卷对780名北京市某三级甲等医院护理人员进行调查,问卷内容包括一般情况、科研现状、相关态度、科研目的、激励措施及科研能力提高途径。结果13．8％的护理人员在近5年内以第一作者发表过护理论文,32．1％参与护理科研。27．8％的护理人员参加护理学术会议,23．6％参加过护理科研培训班。护理人员对护理科研的态度较为积极,77．0％的护理人员认为缺乏科研相关知识技能,70．3％的护理人员从事护理科研的主要目的是晋升职称;69．4％认为总结临床经验;65．1％认为解决临床问题。激励措施和提高科研能力的途径包括组织科研培训班、参加护理学术会议、组织科研讲座等。结论护理人员目前的科研现状不容乐观,需针对各学历、职称等不同层次的护理人员进行相应的科研培训,本研究结果可为提高护理人员科研能力及护理管理者相关决策提供依据。     

护理部领导力在提升护士长执行力中的作用

领导力是领导者在特定的情境中吸引和影响被领导者与利益相关者并持续实现群体或组织目标的能力[1],是决定领导者领导行为的内在力量,是实现群体或组织目标,确保领导过程顺畅运行的动力。护理部必须具备前瞻力、影响力、决断力、感召力、控制力五项领导力。近几年,我院护理部就如何加强护理部领导力,提高护士长执行力进行了探索,     

安徽省873名中医院护士长变革型领导力影响因素分析

目的 了解安徽省内中医院护士长变革型领导力现状,并分析其影响因素,为提高护士长管理效能提供参考依据。方法 采用便利抽样法,选取安徽省内56所中医院873名护士长作为调查对象,使用一般资料调查表、护士长变革型领导力自评量表、护士长核心能力评估量表进行调查。采用多重线性回归分析护士长变革型领导力的影响因素。结果 中医院护士长变革型领导力得分为（109.43±12.40）分,多重线性回归分析结果显示：医院等级、护理管理能力、人际关系能力、护理科研能力及护理教育能力进入回归方程（P<0.001）,共解释总变异的53.0%。结论 中医院护士长变革型领导力处于中上水平。中医院护士长护理管理能力、人际关系能力、护理科研能力、护理教育能力及所在医院等级是变革型领导力的影响因素。建议中医医院管理者重视对护士长核心能力的培养,促进护士长变革型领导行为,并采取有效措施对变革型领导力的提升效果进行评价、追踪,提高护理质量。     

导师制在提高新护士长“五力”中的应用

目的：探讨导师制在新护士长“追随力、领导力、影响力、执行力和平衡力”五力能力提高中的应用效果。方法将2013年7月竞聘的12名护士长随机分为2组,对照组按照常规模式进行培训;实验组采取导师制跟踪培训。培训时间均为2013年7月5日～9月6日。结果实验组在“五力”能力的掌握、运用与提高及护士、医生、医技与后勤总人员、患者的满意度方面均高于对照组（P＜0．05）。结论导师制在新护士长“五力”能力提高中能促进领导力与执行力的提高,扩大影响力的辐射面,提高追随力的忠实度,遇事冷静的平衡力,从而有效提高工作效果。     

注册护士核心能力与一般自我效能感的相关性研究

目的了解护士执行力及各维度与一般自我效能感的相关性。方法对667名护士进行面对面问卷调查,采用注册护士核心能力量表测定护士核心执行力,采用一般自我效能感量表（GSES）测定护士的自我效能,并且分析二者的相关性。结果护士自我效能感与护士核心能力总分及评判性思维、临床护理、领导能力、专业发展均呈正相关。结论护士的自我效能在不同方面影响着护士的核心执行力,应提高护士的自我效能感以提高护士的护士执行力。     

云南省本科护生领导能力现状分析

[目的]了解云南省本科护生领导能力现状及其影响因素,为本科护生领导能力的培养提供科学依据。[方法]采用领导力自评工具对云南省2所高校进入临床毕业实习及见习的154名护理本科生进行问卷调查。[结果]本科护生总体领导能力得分为(128.80±29.37)分,领导能力呈现中等水平;是否为独子、不同性别、不同家庭背景护生的领导能力得分比较,差异无统计学意义(均P0.05);不同实习时间护生的领导能力得分比较,差异有统计学意义(P0.05),实习时间与领导能力得分呈正相关(P0.05)。[结论]云南省本科护生领导力总体处于中等水平,低于国外水平,需要进一步培养及提升。     

护士长领导风格、护士工作满意度对工作绩效的影响

目的 描述护士感知的护士长领导风格、护士工作满意度和工作绩效现状,分析护士长领导风格、护士工作满意度对工作绩效的影响.方法 采用问卷调查法,对北京市某三级甲等综合医院415名临床科室护士进行调查.结果 护士长领导风格、护士工作满意度与工作绩效呈正性相关;控制一般资料影响后,护士长领导风格对工作绩效的解释增加了27.4％;护士工作满意度对工作绩效的解释增加了11.8％.结论 改变临床护士长管理风格,提高护士工作满意度均可增加科室护士工作绩效,从而增强医院的综合竞争力.     

Management vs symbolic leadership and hospitals in transition—a Swedish example

Aim To describe, analyse and interpret symbolic leadership in Swedish public hospitals.
Background Swedish hospitals are undergoing major structural changes. Hospitals are amalgamated in order to increase productivity and accessibility and reduce health care costs.
Method In-depth interviews have been performed with 54 politicians, senior civil servants, medical directors and trade union representatives at nine hospitals. The interviews have been analysed and interpreted following a grounded theory approach.
Findings The results show that leadership is manifested in two dimensions—management and symbolic leadership. The management dimension comprises general leadership aspects like planning, regulation and control. In the symbolic leadership dimension, the leader acts as a guide, inspirer and visionary. Leaders consider they are acting in two large arenas: a public arena and a hospital arena. In the public arena their professional competence is thought to be most important and in the hospital arena their social competence.
Conclusions Structural changes in Swedish hospitals have forced the actors to come out into the public arena, where they increasingly meet the media and have to defend budget cut-backs. This reduces their manoeuvring space in the hospital arena. When leaders work as a team, and make full use of their symbolic role, this helps to promote the process of transition. Symbolic leadership has a potential to increase the role repertory for not least the head nurse.     

Leadership: a new perspective

AIM: This overview article aimed at outlining the image of an effective future-orientated nurse leader in the health care context through a pragmatic approach. The future nurse leaders on different levels in health care institutions is challenged in the current health care environment of culturally diverse countries, such as South Africa. This article should make all nursing leaders more aware of their important role in taking the lead in challenges faced in the current health service environment. BACKGROUND: Leaders have the essentials of authority, power and influence to lead followers to their goals. The use of these essentials has changes from the past, to the present and into the future health care environment. Different changes and challenges are facing nurse leaders and they need to implement an effective leadership style in a complex health care environment. EVALUATION: This overview article focuses on key elements of an effective future leader using a conceptual framework as departure, incorporating relevant literature. It analyses and evaluates the efficiency of past and present roles of authority, power and influence in leadership and summarizes a new perspective of a future nurse leader. Solutions and future actions are indicated for the future role of the nurse leader. KEY ISSUES: The past, present and future leadership setting, role of authority, power and influence in leadership, components of the arch of leadership and solutions to effective leadership in a future dimension is all domains that is presented with the intention of motivating future nurse leaders. CONCLUSION: It was identified that a different kind of leader should emerge to lead in a new way, different from those leadership styles that we have known in the past. The 21st century is a new timeframe and different timeframes demand different leadership approaches.     

Patient safety culture: the nursing unit leader's role

Discussions about a culture of patient safety abound, yet nurse leaders continue to struggle to achieve such a culture in today's complex and fast-paced healthcare environment. In this article the authors discuss the concept of a patient safety culture, present a fictional scenario describing what happened in a hospital that lacked a culture of patient safety, and explain what should have happened in the above scenario. This discussion is offered within a framework consisting of seven driving factors of patient safety. These factors include leadership, evidence-based practice, teamwork, communication, and a learning, just, and patient-centered culture. Throughout, an emphasis is placed on leadership at the unit level. Nurse managers will find practical examples illustrating how leaders can help their teams establish a culture that offers the patient quality care in a safe environment.     

Nurse executive transformational leadership found in participative organizations

OBJECTIVE: The study examined a national sample of 396 randomly selected hospital nurse executives to explore transformational leadership, stage of power, and organizational climate. BACKGROUND: Results from a few nurse executive studies have found nurse executives were transformational leaders. As executives were more transformational, they achieved better staff satisfaction and higher work group effectiveness. This study integrates Bass' transformational leadership model with Hagberg's power stage theory and Likert's organizational climate theory. METHODS: Nurse executives (396) and staff reporting to them (1,115) rated the nurse executives' leadership style, staff extra effort, staff satisfaction, and work group effectiveness using Bass and Avolio's Multifactor Leadership Questionnaire. Executives' bosses (360) rated executive work group effectiveness. Executives completed Hagberg's Personal Power Profile and ranked their organizational climate using Likert's Profile of Organizational Characteristics. RESULTS: Nurse executives used transformational leadership fairly often; achieved fairly satisfied staff levels; were very effective according to bosses; were most likely at stage 3 (power by achievement) or stage 4 (power by reflection); and rated their hospital as a Likert System 3 Consultative Organization. Staff satisfaction and work group effectiveness decreased as nurse executives were more transactional. Higher transformational scores tended to occur with higher educational degrees and within more participative organizations. CONCLUSIONS: Transformational qualities can be enhanced by further education, by achieving higher power stages, and by being within more participative organizations.     

Emergent leadership among tenants with psychiatric disabilities living in supported housing

The overall aim of this study was to explore the experiences of people with psychiatric disabilities living as tenants in independent, supported apartments for the first time. Supported housing provides an alternative to structured, custodial housing models, such as foster homes, or board‐and‐care homes, for clients in public mental health systems. This article reports findings on how leadership emerged among tenants after making the transition from custodial to supported housing. Semi‐structured interviews were conducted with tenants (n = 24) and included questions on their housing history, current living situation, relationships with staff, participation, and understanding or experience of leadership. Interviews were transcribed verbatim, codes generated, and a thematic analysis conducted using a constructivist approach. The findings revealed an understanding and appreciation of leadership among tenants, who identified six pathways to leadership in their housing as a response to unmet tenant needs. Most tenant leaders emerged outside of formal authority or power structures. Supported housing provides a unique social setting and empowering community where the potential of persons with psychiatric disabilities to assume leadership may be realized and further developed. Mental health professionals working in community housing networks are well placed to harness these face‐to‐face tenant communities, and their natural leaders, as an additional tool in promoting tenant recovery, mutual help, neighbourhood integration, and the broader exercise of citizenship.     

Nurse executive transformational leadership and organizational commitment

OBJECTIVE: To investigate the relationship between nurse executive leadership and organizational commitment among nurses in acute care hospitals. BACKGROUND: A key challenge for organizations is to maximize the contributions of all workers by cultivating their commitment. Nurse leaders are in a position to influence organizational commitment among nurses. METHODS: The theoretical constructs underlying this study are the transformational leadership theory and the Etzioni's organizational theory. A cross-sectional, field survey of nurse executives, nurse managers, and staff nurses was conducted to assess nurse executive transformational and transactional leadership and their relationship to organizational commitment. Hypotheses were tested using correlational analysis, and univariate statistics were used to describe the sample. RESULTS: An inverse relationship between nurse executive transformational and transactional leadership and alienative (highly negative) organizational commitment was statistically significant. A positive association was demonstrated between nurse executive leadership and nurse manager leadership. CONCLUSIONS: This study supports the effect of nurse executive leadership on nurse manager leadership and on organizational commitment among nurses despite role distance. To the extent that transformational leadership is present, alienative organizational commitment is reduced. This relationship shows the importance of nurse executive leadership in organizational involvement among nurses in the dynamic context of contemporary hospital settings.     

What constitutes successful nurse leadership?: A qualitative approach utilizing Kanter's theory of organizational behavior

What constitutes successful leadership in today's healthcare environment and what are the principal components of an organization that supports the role of the nurse leader? To answer these questions, 16 nurse leaders from four acute care hospitals were interviewed for their perception of leadership traits that are effective in the inpatient hospital setting and types of organizational infrastructures that create conditions for job effectiveness. Kanter's theory of organizational behavior provided the conceptual framework for this study. Leadership effectiveness is linked to having access to opportunity, resources, information, and formal and informal power in the work setting. Nurse leaders with access to these structures are empowered and successful, which leads to enhanced worth and overall organizational achievement. Also, strong central beliefs and business astuteness are considered vital attributes in today's economically oriented environment.