...com/ijns Engagement at work: A review of the literature Michelle R. Simpson * Center on Age and Community, College of Nursing, Cunningham Hall, 1921 East Hartford Avenue, University of Wisconsin-Milwaukee, Milwaukee, WI 53201-0413, United States Received 26 March 2008; received in revised form 20 May 2008; accepted 22 May 2008 Abstract Objectives: Engagement at work has emerged as a potentially important employee performance and organizational management topic, however, the definition and measurement of engagement at work, and more specifically, nurse engagement, is poorly understood. The objective of this paper is to examine the current state of knowledge about engagement at work through a review of the literature. This review highlights the four lines of engagement research and focuses on the determinants and consequences of engagement at work. Methodological issues, as identified in the current research, and recommendations for future nurse-based engagement research are provided. Design: A systematic review of the business, organizational psychology, and health sciences and health administration literature about engagement at work (1990–2007) was performed. Data sources: The electronic databases for Health Sciences and Health Administration (CINAHL, MEDLINE), Business (ABI INFORM), and Psychology (PsycINFO) were systematically searched. Review methods: Due to the limited amount of research that has examined engagement among the nursing workforce, published research that included...
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...VOICE FOR NURSING Work Engagement, Moral Distress, Education Level, and Critical Reflective Practice in Intensive Care Nurses nuf_237 256..268 Lisa A. Lawrence, PhD, RN Lisa A. Lawrence, PhD, RN, Instructional Faculty, Nursing Department, Pima Community College, Tucson, AZ Keywords Critical reflective practice, education level, moral distress, registered nurse, work engagement Correspondence Lisa A. Lawrence, PhD, RN, Nursing Department, Pima Community College, Tucson, AZ E-mail: llawrence@pima.edu AIM. The purpose of this study was to examine how nurses’ moral distress, education level, and critical reflective practice (CRP) related to their work engagement. The study is relevant to nursing, given registered nurse (RN) documented experiences of job-related distress and work dissatisfaction, and the nursing shortage crisis. A better understanding of factors that may enhance RN work engagement is needed. METHODS. A non-experimental, descriptive, correlational design was used to examine the relationships among four variables: moral distress, education level, CRP, and work engagement. The sample included 28 intensive care unit RNs from three separate ICUs in a 355-bed Southwest magnet-designated hospital. RESULTS. There was a positive direct relationship between CRP and work engagement, a negative direct relationship between moral distress and work engagement, and CRP and moral distress, together, explained 47% of the variance in work engagement. Additionally, in the neonatal...
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...(Vioral, 2011). Even after students enter nursing programs, 13% of newly license register nurse change their bedside job after one year and 37% of nurses report a desire to change jobs after one year (Vioral, 2011). These are alarming rates most shift our focus to ensuring we keep our nurses engage and satisfied with their job. What I was able to gather from my research was not a bit surprising as to why nurses are not satisfied with their jobs. These reasons consist of stress related to understaffing and the high acuity, lack of support from the leaders, salary, scheduling problems, an unfriendly or negative environment and the lack of professional growth. I do not about you all but these are not new words to my ears. I have been listening to the same tune for more than 25 years. As a leader it is very frustrating working with HR recruiting department and the engagement crew to keep our nurses engage and at bedside. Fostering a culture of genuine support by nursing administration and educators is one the first step an organization has to take in order to initiate their journey to developing an environment of engage nurses (Vioral, 2011). In my hospital we are currently using Avatar employee engagement survey and base on the results we are going to have our hands full building our employee engagement plan of action. The questions on the survey that score the lowest were related to nurses’ salary, lack of support from supervisor and...
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...The Importance and Implications of Evidence Based Practice-Research Patricia Davis Immaculata University The Importance and Implications of Evidence Based Practice-Research Evidence based practice is a way of providing health care that is guided by incorporating current knowledge and clinical expertise. This research and resource information corrects clinical problems, application of quality interventions, and evaluates the outcomes for further improvements in the future. Evidence based practice is an approach that improves the impact of nursing, psychology and social work. It gives research the cause and effect that gives validity to the information. The purpose of evidence based practice is ensuring that patients receive the best quality care and keep nurses, nursing care, and knowledge up to date. The American Nurses Association (ANA) recognizes the importance of evidence based practice (EBP), and that it incorporates the registered nurse to integrate, participate in the formulation, and contribute to the knowledge of research to improve healthcare outcomes (ANA, 2010). Evidence based research results in favorable patient outcomes across various geographic locations. The impetus for evidence-based practice comes from decisions of efficacy, and healthcare facility pressures for cost containment. Evidence practice stresses changes in the education of students, more practice-relevant research, and closer working relationships between clinicians and researchers...
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...Research Critique Part 1 Alisa Rogers Grand Canyon University Introduction to Nursing Research NRS 433V June Helbig July 28, 2013 Research Critique Part 1 Children are vulnerable in the pediatric intensive care unit (PICU) and experience pain when not needed. The nurses and physicians lack of knowledge about how critical illness affects the signs and symptoms of children’s pain Problem Statement The clinical problem eluded that there is little known in the pediatric intensive care (PICU) settings of the nurses knowledge of pain in critically ill children. It is known that the knowledge of pain and quality of care given for pain alleviation is relevant. Not much is known regarding the nurses clinical learning patterns. Nurses used judgments in measuring pain in a variety of ways and it was found that their clinical judgments came from different levels of understanding and diverse aspects of pain. These assumptions lead to the aim of the study: to elucidate patterns in clinical knowledge development and unfold the role of the nurse as facilitator in relation to pain management in the PICU. (Mattsson, Forsner, Castren, Bolander Laksov, & Arman, 2012, p. 109) It is known that working in a PICU that nurses rely on each other and what they perceive as pain in a child may not be actual pain. Overtime clinical knowledge is developed with different encounters with patients and their families. The nurses need to focus more on their individual learning practices to...
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...Nurse Educator Nurse Educator Vol. 34, No. 5, pp. 209-213 Copyright ! 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Wikis and Blogs Tools for Online Interaction Jane S. Grassley, PhD, RN Robin Bartoletti, MS Online education requires nursing faculty to learn teaching strategies that encourage students’ interaction with the course content, their peers, the faculty, and the technology. The Web 2.0 technologies of wikis and blogs can help faculty direct online learning activities that encourage peer support, collaboration, and dialogue. The authors discuss these tools and how they were used to engage students in a nursing research course. ince the mid-1990s, increasing numbers of people have come to rely on the Internet as a convenient source of information and education. In nursing, the growing need for convenient and nontraditional learning strategies fostered a proliferation of Web-based nursing education programs. Since teaching online requires faculty to use strategies that differ from those used in face-to-face classrooms, nurse researchers have investigated characteristics of online education environments that facilitate students’ engagement with learning.1-3 Thurmond concluded,3(p237) ‘‘Good teaching practices are deeply rooted in the concept of interaction.’’ MancusoMurphy4(p257) identified interaction among faculty and students as ‘‘the core element of an effective online environment.’’ Researchers determined that peer support, collaboration, and...
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...Technology in patient management has become progressively complex, altering how nursing care is provided. Before technology became a major tool in patient care, nurses depended greatly on their senses of touch, sight, hearing, and smell to monitor patient health status and to identify variations. “Over time, the nurses’ unaided senses were replaced with technology designed to detect physical changes in patient conditions. Consider the case of pulse oxymetry. Before its widespread use, nurses relied on subtle changes in mental status and skin color to detect early changes in oxygen saturation, and they used arterial blood gasses to confirm their suspicions. Now pulse oxymetry allows nurses to identify decreased oxygenation before clinical symptoms appear, and thus more promptly diagnose and treat underlying causes,” (Powell-Cope, G., et al. (n.d.). No one would deny that technology has had a significant impact on the healthcare industry. From new testing techniques to surgical equipment, today's medicine is very different from that of just 10 years ago. And now, with the explosion of the Internet and other digital communications, a wealth of health-related information is more accessible to patients than ever. Patients seek information immediately and often research both disease and cure on their own. In many cases, this results in better-informed patients and makes it possible for them to take greater responsibility for their healthcare. But in other cases, when patients access...
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...Staffing Day to Day The American Nursing Association defines staffing as matching the registered nurse expertise with the needs of patients requiring nursing care services. There are many influences and factors that go into determining the staffing level. There are two different ways of staffing: centralized and decentralized. Centralized staffing is when there is one department responsible for all the units, float staff and on-call staff. Decentralized staffing is when unit leaders or charge nurses, managers, or directors determine the level of staff needed before and during the shift. Staffing nurses is typically set in a 24-48hr window, whereas scheduling can be a month out (Mensik, 2014). In addition to the two different ways of staffing, there are three different models that staffing...
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...interpersonal communication skills and maintenance of therapeutic relationships with patients may enhance the role of the nurse in working collaboratively with the patient towards their personal recovery? A nurse- patient relationship is a key aspect of recovery (Castledine, G. 2004). The approach aims to support nurse-patient relationships by providing an empathetic, trusting and respectful engagement between the nurse and the patient, thus enabling them to feel satisfied and confident in the care they are receiving. Hildgard Pepleau (1988) developed a theory in which nurse-patient relationships were considered extremely important to nursing practise. She believed that relationships are thought to be based around the interactions between the nurse and the patient, as well as the discussion of the thoughts and feelings they were experiencing, enabling the patient to experience better health. When nurse-patient relationships are not developed, there cannot be patient and family satisfaction. It could also enable the patient to receive care that may not particularly be suited to their individual needs and preferences (Castledine, G. 2004). David Stonehouse (2011) states that conflict could easily arise when the patient doesn’t have a say in the care they are receiving, causing friction between themselves and the nurse. This could easily result in the nurse not treating the patient in a dignified manner and not facilitating autonomy, meaning they may experience neglect which...
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... Eligibility Requirements: Compliance with all federal laws and regulations administered by the United States OSHRC, EEOC, HHS, DOL, and NLRB as they relate to registered nurses in the workplace (Ponte, 2008) These include health and safety, antidiscrimination, and labor management laws The Appraisal Process: Application Witten Documentation Site Visit Commission Vote Transformational Leadership Structural Empowerment Exemplary Professional Practice New Knowledge, Innovations, and Improvements New Direction: Focus on Outcomes Outcome Sources of Evidence Nurse-sensitive Indicators Clinical Indicators Planning Advocacy and Influence Visibility, Accessibility, and Communication Professional Engagement Commitment to Professional Development Teaching and Role Development Commitment to Community Involvement Recognition of Nursing Professional Practice Model Care Delivery System(s) Staffing, Scheduling, and Budgeting Processes Interdisciplinary Care Accountability, Competence, and Autonomy Ethics, Privacy, and Confidentiality Diversity and Workplace Advocacy Culture of Safety Quality Care Monitoring and Improvement Research Evidence-based Practice Innovation Would you want to work in a Magnet hospital? How would the organization benefit...
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...father started the clinic in Pueblo in the 1980’s and slowly opened satellite clinics in Colorado Springs, Canon City, La Junta and Alamosa. Currently has one other physician, and a physician assistant working with him, with a support staff of roughly 30 employees. The support staff includes two receptionists, two insurance clerks, one transcriptionist, one marketing paid intern and approximately 20 nurses. The market segment that this clinic caters to is lower-middle class, and middle class patients from the blue-collar town of Pueblo, CO. Most of these patients have Medicaid insurance. Patients come in as walk-ins many times without any prior appointments. Sometimes wait times can be longer than usual if many patients walk in at the same times, particularly during pollen season and flu season. When bottlenecks occur this precipitates many disagreements between receptionists and intake nurses. I’ve had various roles at this organization since the age of nine. At first I was helping at the front of office helping patients check in, then I slowly graduated to the position of a nurse and now, as I just graduated...
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...Nurse Manager: Benchmarking Productivity Benchmarking is a process which compares the performance characteristics of an organization and to enable each individual to improve their own performance. There are a couple of purposes for benchmarking. One of its purposes is to find the most valuable way to practice and apply it which will result in a better performance in the organization. Another purpose for benchmarking is looking for ways for employees to improve in the delivery of service. For example managers in the health care have many responsibilities; one is the variable expense of the cost center. Health care managers have to make sure to maintain the right levels of productivity which is a huge challenge in the management process. This process requires a lot of research and help from others regarding the standards of the department. A good way to figure out benchmarking is to look at different organization and compare and contrast the organizations success by getting data that will help improve the organization. Most of the times the help of outside consultants will help provide data needed for the health care manager to implement new and effective strategies to assist and make it for the productivity of the employees (HFMA, 2008). There are a couple of productivity standards, which will help the organization. One thing is to develop certain standard, where standards are needed based on performances in the past, which some these have problems with the amount of information...
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...Benchmarking Productivity in Nursing is Useful Benchmarking is a quality improvement tool that determines who the best is, who sets the standard, and what the standard is. There are two main purposes for benchmarking. The first is to identify best practices to be applied in measuring and improving performance in an organization. The second purpose is to seek ways to improve the delivery of service through the efficient use of staff. For health care managers who are responsible for a variable expense cost center or department, maintaining appropriate levels of productivity is one of the greatest and ongoing challenges of the management process and requires constant research and advice regarding relevant productivity standards. Comparing one’s departmental operations with other successful operations of another organization is a useful source of benchmarking data and many health care managers depend on associates or outside consultants to provide data to assist in implementing new and effective strategies to improve staff productivity. There are three sources of productivity standards. The first source is internally developed historical standards where standards are based on past performances but do not provide information about relative efficiency. The second source is engineered standards where internal staff or outside consultants conduct a study of the work environment and define normal standards of productivity. The third source is a comparative group standard...
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...between a nurse with a two year degree (AD) and one with a 4 year degree (BSN). The clinical and technical expertise of the AD and the BS nurses at the bedside are indistinguishable. There are noticeable differences for the nurses in administrative, managerial and educational positions. The competencies of the AD nurse versus BS nurse will be discussed in the following paragraphs (Moore, 2009). There have been discussions for years over the education required for professional (registered) nursing practice. The National Council of State Board of Nursing (NCSBN) is the organization that sets the standards determining what is required to license registered nurses and practical nurses. This test is called the NCSBN Nursing Licensure Examination for Registered Nurses (NCLEX-RN). By using computerized based information, it measures the candidate’s knowledge and skills (Friberg, 2011). The educational requirements are different for each program of study. The AD Nursing program is generally considered a two-year degree from a community college. It is based upon the associate degree requirements focused on clinical and technical skills used to provide direct care to patients and their families. Most programs have guidelines which require prerequisites and test. It can take three years to complete based on liberal art’s requirements. The programs are structured with little variation or modification from standards of care practiced in nursing school. The AD nurse is more...
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...The Population health issue I have selected is Obesity. It is a serious health problem. Poor dietary habits and physical inactivity are among the factors that lead to obesity. About 70% of American adults are obese or overweight. In 2005, unhealthy diet was responsible for about 350,000 deaths in the United States (Knickman & Kovner, 2015). Our health status is mainly determined by how we live our daily lives. How we interact with the environment in which we live also support our abilities to live healthy and prosperous lives. Our engagement in physical activity helps to maintain healthy bones, muscles, joints, and weight. Our engagements with our physical environment associate with the promotion of feelings of well-being. It reduces feelings of anxiety and depression. Thus, the five population health determinants are; access to health care, individual behavior, social environment, physical environment and genetics (Knickman & Kovner, 2015). The concept of social determinants often denotes how income, education, access, housing and other factors contribute to our wellbeing. Knickman & Kovner (2015) defined social determinant as “The circumstances in which people are born, grow up, live, work and age, and the system in place to address an illness in turn shaped by larger forces, including economic, social policies and politics.” (Knickman & Kovner, p376, 2015). Public Policy influences these social determinants. For instance, the government health system contributes immensely...
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