Nurse managers' challenges in project management

suhonen m. & paasivaara l . (2011) Journal of Nursing Management 19, 1028–1036
Nurse managers’ challenges in project management Aim To analyse the challenges that nurse managers meet in project management. Background Project management done by nurse managers has a significant role in the success of projects conducted in work units. Methods The data were collected by open interviews (n = 14). The participants were nurse managers, nurses and public health nurses. Data analysis was carried out using qualitative content analysis. Results The three main challenges nurse managers faced in project management in health-care work units were: (1) apathetic organization and management, (2) paralysed work community and (3) cooperation between individuals being discouraged. Conclusions Nurse managers’ challenges in project management can be viewed from the perspective of the following paradoxes: (1) keeping up projects–ensuring patient care, (2) enthusiastic management–effective management of daily work and (3) supporting the work of a multiprofessional team–leadership of individual employees. Implications for nursing management It is important for nurse managers to learn to relate these paradoxes to one another in a positive way. Further research is needed, focusing on nurse managers’ ability to promote workplace spirituality, nurse managers’ emotional intelligence and their enthusiasm in small projects.     

柔性化管理在护理质量督导中的应用

目的探讨柔性化管理在护理质量督导中的应用效果。方法更新护理质量督导理念,在护理质量标准的制订、一级质量控制人员的培训、护理质量检查结果反馈方式等方面,采用柔性化管理的护理督导模式,对全院护理质量进行柔性化督导管理。结果护理质量各项评价指标(除核心制度提问和特级、一级护理)和护理综合满意度均提高(P<0.01)。结论柔性化管理适应现代护理质量督导的特点,满足了新形势下患者需求的变化和护理服务内涵的更新,有利于护理质量的提高。     

Nurse managers' professional networks,psychosocial resources and self-rated health

BACKGROUND: Nurse managers act under constant pressure to develop strategies in response to professional challenges within a changing and restructured health care system. When such environmental stress is present, they need access to sufficient psychosocial recourse. AIM: The study aimed to investigate whether nurse managers' professional networks, psychosocial work conditions, job support, social network and support were associated with self-rated health, sick-leave and salary. METHODS: From a total of 268 Swedish nurse managers, active in management positions, 205 (77%) agreed to participate in the study by answering a self-report questionnaire. Cronbach's alpha was used to calculate internal consistency. Odds ratios were used to estimate the bivariate association between self-rated health and psychosocial resources. RESULTS: Nurse managers exposed to high job demands had significantly increased odds for low self-rated health. It was also found that low level of support from professional network, job support, social network and social support outside work displayed increased odds for low self-rated health, independently of age, gender and education. There were additive (but no synergistic) effects found for job demand in combination with professional networks, job support and emotional support and in relation to self-rated health. CONCLUSION: The study showed that nurse managers exposed to high job demands had elevated odds for low self-rated health, regardless of level of psychosocial resources within or outside work. Two-thirds of the nurse managers who were affiliated to professional networks did not consider this a supporting factor in their management work. Those with low job support had increased odds for sick-leave compared with those with high support. No significant associations were found between psychosocial characteristics and salary.     

The effects of clinical supervision on the quality of care: examining the results of team supervision

AIM(S) OF THE STUDY: This study is part of a larger research project (1995-1998) aiming at quality improvement by means of clinical supervision (CS). The purpose of the study is to ascertain the conceptions of five ward teams having CS of its effects on the quality of care. BACKGROUND: The quality of nursing care has been debated since at least the 1980s. An extensive literature and research reports describe a variety of interventions and methods to improve the quality of care. One of the interventions is CS. However, the amount of empirical research exploring the effects of CS especially on the quality of care is limited. METHOD: Data were collected using group interviews and analysed using the method of phenomenography. FINDINGS: The following categories describing the conceptions related to CS and to the quality of care emerged: knowledge, change and 'I and we as providers of quality'. Conceptions of the effects varied between and within the teams and sometimes contradicted each other. The importance of knowledge was underlined on three of the five wards. The patient's point of view emerged only on one ward. CONCLUSIONS: It can be concluded that CS has effects on the quality of care and it can be considered a quality improving intervention in nursing practice. However, the knowledge of the different conceptions produced in this study also gives proof that team supervision is a challenge for supervisors.     

Nurse Dose as a Concept

PURPOSE: To describe the concept of Nurse Dose. METHODS: The concept of nurse dose has been identified from decades of clinical research as a concept essential in the delivery of safe and high quality health care. The components of nurse dose were conceptualized through review of the literature from nursing, medicine, and health services research. FINDINGS: Nurse dose is conceptualized as having three equally essential components: dose, nurse, and host and host response. Dose in the macro view includes the number of nurses per patient or per population in cities, states, regions, or countries. Dose in a micro view includes the amount of nurse time and the number of contacts. The nurse component consists of the education, expertise, and experience of the nurse. Host is represented by an organization and its characteristics (culture, autonomy, practice control) in a macro view and by the patient and characteristics (beliefs, values, culture) in a micro view. Host response includes response to the autonomy and acceptability of the nurse. CONCLUSIONS: Greater nurse dose has been associated with decreases in patient mortality, morbidity, and healthcare costs.     

血标本质量管理的方法与效果

目的 提高临床血标本质量.方法 通过制订采血操作流程、护士系统培训及跟踪管理的方法,提高血标本质量.结果 降低了检验科对血标本的拒收率,差异具有统计学意义(P＜0.01).结论 通过对血标本的质量管理可以提高血标本的质量.     

Nursing peer review: the manager's role

george v. & haag-heitman b. (2011) Journal of Nursing Management 19 , 254–259
Nursing peer review: the manager’s role Aim This article explains the unique role of nurse managers in facilitating nursing peer review and clarifies the issues of ownership about peer review processes and performance evaluations. Background The authors’ review of the literature and experiences as organizational consultants, found no examples of principled peer review using the authoritative American Nurses Association (ANA) Guidelines for Peer Review. Evaluation The foundation for the work includes the author’s recently published book, which includes a literature review, research on nursing peer review along with the ANA Guidelines for Peer Review. Key issues The distinction between the role of the manager in peer review and the role of the manager related to the annual performance evaluation is identified. The authors’ contemporary model of peer review is used to explore development of peer review for managers and practicing nurses. Conclusions Key behaviours for nurse managers in facilitating peer review processes within a professional practice model are presented. Implications for nursing management Peer review is an essential and often missing element of practice needed to achieve sustainable quality and safety nursing outcomes. Guidelines and principles for development are presented.     

Clinical supervision as a model for clinical leadership

Clinical leadership and clinical supervision are topical areas of nursing development. A project was established to facilitate the growth of leadership ability with a group of ward sisters through individual clinical supervision. The work revealed that ward managers struggled to fulfil their leadership roles largely because of embodied ways of relating within a prevailing organizational culture that constrained them. The paper also reflects on the impact of supervision to develop leadership practice.     

采用同伴教育对体质量超重职业人群进行健康管理的研究

目的探索对体质量超重职业人群的有效健康管理方法。方法选取99名体重指数≥25的功能社区的在职人员为研究对象,分为观察组和对照组,采用同样的授课随访及管理方法。观察组采用同伴教育方法,分别进行为期6个月的饮食和运动干预,观察两组人群体质量指数、腰围、每日有效运动总量、时间和次数的变化。结果观察组的体重指数、腰围均低于对照组（P〈0．01）,每日有效运动量、有效总量比、有效运动时间和次数均高于对照组（P〈0．01）。结论对体质量超重的职业人群进行饮食、运动管理,可以使每日有效运动量增加,降低体重指数、腰围;而采用同伴教育形式可以使运动效果更好。     

Nurse practitioner prescribing practice in Australia: Confidence in aspects of medication management

The findings of the 2010 national survey of nurse practitioner (NP) prescribing in Australia related to confidence in prescribing are reported. A significant correlation between years endorsed as a NP and prescribing confidence was found. NPs in Australia were significantly more confident in the prescribing aspects of commencing a new medication than adjusting or ceasing a medication prescribed by others. These findings are discussed in relation to promotion of the quality use of medicines and identification of potential strategies to promote the ongoing positive evolution of NP practice in Australia.     

Towards a competency-based framework for nursing management education

Defining a competency-based model for nursing management development will help to establish core competencies for nursing managers which will not only strengthen their practice and provide further learning and development opportunities, but will also provide the basis to focus training and professional development efforts. This paper identifies the competencies important for effective nursing management in the public and private health sectors. A total of 420 senior nursing managers in South Africa were surveyed using a self-administered questionnaire. Respondents had to rate the importance of 51 competency items as it pertains to effective nursing management. Self-management, controlling, health/clinical, organizing, people management, planning and ethical/legal competencies were found the most valuable for optimal nursing management. These findings reflect the reality of the nursing management milieu and will be useful in the design and delivery of management development programmes aimed at enhancing nursing management capacity.