公立医院临床护士薪酬分配对人力资源管理的影响

目的调查珠海市公立医院临床护士薪酬分配情况,探讨其对护理人力资源管理的影响,为制定护理人力资源发展规划提供科学的决策依据。方法采用整群抽样的方法,了解珠海市A、B、C、D、E共5家公立医院临床护士薪酬分配情况,进一步对A及B医院进行实证分析。结果在调研的5家医院中,A、C、D、E医院固定编制护士薪酬明显比合同制护士高(P<0.05),而B医院固定编制护士薪酬与合同制护士差别无统计学意义(P>0.05)。进一步对A及B医院进行实证分析发现,临床护士的年龄、学历、职称分布不平衡,以合同编制护士更加明显;A医院护士流失率明显大于B医院(P<0.05)。结论珠海市公立医院合同制与固定编制护士执行不同的薪酬制度,薪酬水平存在差异,而这种差异导致合同制护士年龄、学历、职称分布不平衡,流失率高,影响了护理人力资源的管理。     

公立医院改革对护士离职的影响探讨

目的了解深化公立医院改革对护士离职的影响。方法分析某公立医院在深化医院改革前、后5年间157名离职护士的情况。结果 10年间合同制护士的离职率高于事业编护士(P0.01)。但深化医院改革前、后护士总的离职率比较差异无统计学意义(P0.05),而合同制护士离职率在深化医院改革后较之前有所下降(P0.05)。深化医院改革后护士离职去往私立医院的比例增高(P0.01)。结论深化公立医院改革提出让医疗、护理人才合理与有序流动,但并不会由此造成公立医院护理人才的大量流失。     

公立医院非编制护士工作倦怠、组织支持感与离职倾向的关系研究

[目的]探讨公立医院非编制护士工作倦怠、组织支持感与离职倾向的关系,改善非编制护士身心健康,提高公立医院护理队伍稳定性。[方法]应用工作倦怠量表(MBI-GS)、组织支持感量表与离职倾向量表,对四川某市6家三级公立医院550名非编制护士进行问卷调查,采用SPSS 19. 0进行描述性分析、因子分析、pearson相关分析,采用AMOS21. 0建立3个变量的结构方程模型。[结果]公立医院非编制护士工作倦怠得分为(2. 48±1. 08)分,组织支持感得分为(2. 80±1. 04)分,离职倾向得分为(2. 42±1. 03)分;工作倦怠及其3个维度与组织支持感呈负相关(P 0. 01),与离职倾向呈正相关(P 0. 01),组织支持感与离职倾向呈负相关(P 0. 01);组织支持感在工作倦怠与离职倾向的关系间起部分中介作用。[结论]公立医院非编制护士工作倦怠普遍存在,组织支持感处于较低水平;公立医院管理者可以通过提高非编制护士的组织支持感降低离职倾向。     

基于公立医院资源整合视角下护理文化建设实践与成效△

目的：探讨资源整合视角下公立医院整合过程中护理文化建设现状，为医院管理者在改善和促进护理文化建设等方面提供参考依据。方法：医院成立护理文化建设组，从物质、行为、制度和精神文化方面加强护理文化建设，选取无锡市某公立医院的1 300名护士为研究对象，对其一般资料、工作价值观和组织文化进行问卷调查，并统计分析2021年、2022年医院护士离职情况和思想动态反馈条数、参加护理活动积极性等情况。结果：实施护理文化建设后，护士的组织文化总均分为（90.47±18.82）分、工作价值观总均分（181.83±33.50）；均高于实施前（P < 0.05）；2022年离职人数较2021年明显下降、思想动态反馈条数下降、参加各类活动积极性明显提升。结论：基于资源整合视角的护理文化建设对提升医院整合过程中护士的组织文化和工作价值观有重要意义，有助医院营造良好的护理文化环境，增强组织凝聚力。     

门诊预检分诊护士标准化服务管理模式探索

目的探索某大型综合三甲医院门诊护士中实施标准化服务护理模式对患者就诊体验及护理质量的影响。方法对医院各种规章进行解析细化指标,制定科室严格规章制度,将患者就诊各种流程及护理人员各班次各诊区工作流程和注意事项、健康宣教内容、门诊标准化服务用语等制定成《预检分诊护士工作手册》,在门诊护士中进行培训和标准化护理管理,督查标准采用医院门诊患者满意度调查表、医院各种护理质量评分标准。结果实施后门诊感染管理、预检分诊工作质量、健康教育工作质量、护理质量综合评分均有提高(P0. 05);不良事件发生率下降(P0. 05);患者满意度提升(P0. 05)。结论对门诊护士实施标准化服务护理模式培训和护理管理,能有效提高门诊护士的综合素质和服务能力,护患纠纷和不良事件减少,患者满意度明显提高。     

公立医院岗位管理及相关问题探讨

落实岗位管理制度是公立医院改革人事管理制度的重要举措,是激活公立医院高质量发展的动力。文章结合某公立医院实施岗位管理的工作实践,本文结合某公立医院实施岗位管理的工作实践,对医院岗位管理中存在的岗位管理配套制度不完善、岗位结构比例不合理、岗位分析不深入、岗位晋升渠道窄、聘用难等问题进行探讨,为深化公立医院人事制度改革提出解决对策。     

公立医院社会化用工的风险及对策研究

公立医院后勤制度改革是医改的重要组成部分,后勤服务的终极目标是让“患者满意、医院满意、临床满意、后勤职工满意”,落实到具体工作中,就是规范管理、提质增效。社会化用工是后勤管理中的一项重要的工作内容,是实现公立医院医、教、研健康发展的有力保障。本文通过对目前公立医院普遍采用的业务外包及劳务派遣两种用工形式可能存在的风险进行剖析,并就可以采取的应对措施进行了探讨。     

眼科护士工作压力现况调查

目的 了解眼科护士的工作压力现况及其来源,并提出应对措施.方法 采用横断面调查法对某眼科医院60名在职护理人员进行问卷调查.结果 54人(90.0％)觉得工作压力大;42人(70.0％)在工作和生活的时间分配方面感到不合理;25人(41.7％)为护理过多患者忙得焦头烂额;30人(50.0％)对薪资不满意.工作中的困惑主要体现于协调难度大、护患关系、医护关系及与上级的关系不好处理;工作压力对护士影响作用包括情绪不好、降低工作效率、失眠、影响家庭生活;目前护士缓解压力的应对方式是向家人或朋友倾诉、自己默默承受.结论 针对眼科医院护理职业的工作压力来源,采取应对措施减轻工作压力负荷,促进护理人员身心健康,从而提高护理质量.     

深圳市龙华新区公立医院护士工作满意度调查分析

目的:了解龙华新区公立医院护士工作满意度现状并分析影响因素.方法:采用问卷调查法对深圳市龙华新区两家公立医院的1084名护士进行调查.使用SPSS13.0对数据进行统计分析.结果:护士总体工作满意度得分为(95.30±13.93)分.比较各维度的平均分,其中对人际关系的满意程度得分最高,对工作回报的满意程度得分最低;在人口学统计变量中,不同性别、婚姻状况对护士工作满意度的总分影响没有统计学意义.但是在不同年龄、收入、学历、职称、用工性质、工作年限上存在差异,P＜0.05,差异具有统计学意义.结论:龙华新区公立医院的护士工作满意度有待于提高.医院管理者在改善工作条件和建立公平合理的薪酬机制时,要充分考虑科室、学历、编制和收入等重要因素的影响.     

新加坡医院管理经验与启示

通过学习交流,对新加坡的医疗保障体系、医疗服务体系、公立医院法人治理模式、全面质量管理与评价认证、医生培训及准入制度、护士培养与护理管理体系、"以病人为中心"的人性化服务等有了更深层次的认识;并提出,应结合我国国情,在培养全民健康意识、完善公立医院法人治理结构、严格医疗法治监管、崇尚精细化管理等方面进行借鉴,以提升我国医院质量管理水平。     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Hydrazine inhalation hepatotoxicity

Abstract Hydrazine is a hazardous chemical commonly used as a reactant in rocket and jet fuel cells. Animal studies have demonstrated hepatic changes after hydrazine inhalation. Human case reports of hydrazine inhalation hepatotoxicity are rare. We report a case of mild hepatotoxicity following brief hydrazine vapour inhalation in a healthy young man, which resolved completely on expectant management.     

Fitness standards in airline staff

Employers have a legal duty to manage safety and to meet this duty it is necessary to control risks arising from pre-existing medical conditions. Such conditions can be identified at the time of job placement, but there is little published information about the approach to fitness standards by most airlines. This review is therefore limited to the practice of one major airline. It is illustrated by reference to various occupations within the airline, with the associated rationale.