Inadequate Management Support Research Articles

Implementasi Kurikulum Merdeka di Pendidikan Anak Usia Dini (PAUD): Tinjauan Kritis dari Perspektif Guru

The Implementation of the Merdeka Curriculum in Early Childhood Education (ECE) presents unique challenges and opportunities in improving the quality of early childhood education in Indonesia. This article analyzes teachers' perspectives on the implementation of the Merdeka Curriculum, focusing on understanding, implementation, and impact of the curriculum. Through questionnaires and critical analysis, findings indicate that most teachers have a sufficient understanding of the Merdeka Curriculum, although there is still a need for better training and support. Implementation challenges include resource limitations, inadequate management support, and the expansion of new learning approaches. Nevertheless, the Merdeka Curriculum has had a positive impact on children's motivation to learn and parental involvement in education. In conclusion, with a collective commitment to improving the quality of PAUD education, the Merdeka Curriculum has great potential to provide innovation and optimal benefits for the development of children in Indonesia.

Why are Turkish nurses migrating? A mixed-methods study.

This study aimed to identify the factors influencing nurses' migration patterns in Turkey. The flow of nurse migration from developing countries to developed countries is steadily increasing. As a result, countries that are sources of migration tend to develop domestic inequities with respect to the population's ability to access health services. In particular, fragile economic conditions and the pandemic triggered the migration of nurses from Turkey, a developing country. This study employed a mixed-method explanatory sequential design and was conducted in Turkey between April and November 2022. The decision to migrate was the focus of both the quantitative aspect, involving 237 participants, and the qualitative aspect, with 20 participants. Quantitative data were gathered through a questionnaire, and qualitative data were obtained using open-ended questions during in-depth individual interviews. We followed the Strengthening the Reporting of Observational Studies in Epidemiology checklist in the quantitative phase and the Consolidated Criteria for Reporting Qualitative Research checklist in the qualitative phase. Descriptive statistics and thematic analyses were used to analyze the data. In the quantitative stage of the study, nurses' reasons for deciding to migrate were identified as economic conditions, working conditions, society's outlook on the profession, political factors, and professional growth opportunities. In the qualitative stage, four major themes influencing nurse migration patterns emerged: devaluation and poor collegiality in nursing; inadequate management support; negative work environment; and health, social, and economic policies. The results of the study showed that the three factors most influential in the decision to migrate were economic issues, a negative work environment, and political climate. In developing countries, there is an urgent need for nurse administrators and health workforce decision-makers to create healthy working conditions and manage resources efficiently, focusing on improving nurses' economic situations while developing appropriate nationwide and international strategies.

The Push and Pull Factors in the Retention of Health Workers in a District in Ghana

Aim: To assess the push and pull factors associated with the retention of health workers in a district in Ghana.
 Study Design: This study was an analytical cross-sectional study using quantitative methods in the collection of data.
 Place and Duration of Study: Komenda-Edina-Eguafo-Abirem District of the Central Region of Ghana in October 2022.
 Methodology: A structured self-administered questionnaire was used to obtain data from 282 health workers who were consecutively selected from various health facilities in the study. The data collected was cleaned and analyzed using the statistical software STATA version 15. Descriptive statistics were presented in tables and graphs. A Chi-square test and multiple logistic regression analysis were used to assess the association between dependent and independent variables. The significance of association was set at P<0.05 at a 95% confidence interval. 
 Results: Overall, 22.0% of the health workers intended to stay at their current organization. Logistic regression analysis predicted that age more than 35 years (AOR: 3.4, CI: 1.025 -11.283, P = .046) and sex - females (AOR: 0.56, CI: 0.016 - 0.223, P = .001) were significantly associated with retention. Institutional factors like lack of supervision of work (AOR: 0.508, CI: 0.176 – 1.472, P = .021), lack of in-service training (AOR:0.045, CI: 0.010 - 0.193, P = .001), inadequate management support (AOR: 0.288, CI: 0.109 – 0.764, P = .012), and poor career progression (AOR: 0.472, CI: 0.019 - 1.873, P = .028) significantly reduced the likelihood of staying. Community factors like the absence of family (AOR: 0.138, CI: 0.051 – 0.376, P = .001) and the absence of alternative jobs (AOR: 0.051, CI: 0.006 – 0.459, P = .008) also negatively predicted retention. 
 Conclusion: Only a small proportion of health workers in the district intended to stay. Factors related to retention were predominantly organizational like career progression, management support, and incentives.

Occupational health and safety practices and associated factors among workers in Ethiopia’s Metehara and Wonji sugar industries: a convergent parallel mixed design

IntroductionInformation regarding workers’ practices concerning safety measures in Ethiopia’s sugar industries is inadequate.ObjectivesTo assess occupational health and safety practices and associated factors among workers in Ethiopia’s Metehara and Wonji sugar...

Professional nurses’ challenges regarding drug supply management in the primary health care clinics

Drug Supply Management (DSM) is the core responsibility of pharmacists and pharmacist assistants however in practice South Africa has a huge shortage of pharmacists. In order to deal with excessive shortage of pharmacy personnel, the DSM responsibilities were handed over to professional nurses through strategies such as task shifting which were introduced as an alternative method to improve access to health care services especially in the Primary Health Care (PHC) clinics.The purpose of the study was to explore the challenges experienced by professional nurses regarding the implementation of the drug supply management standard operating procedure in the primary health care setting of the City of Ekurhuleni. The study was conducted in primary health care clinics in the City of Ekurhuleni. MethodAn exploratory contextual qualitative research design was followed. The study population included all professional nurses working in the City of Ekurhuleni. Purposive sampling was used to select a sample of professional nurses with at least two years’ experience. Semi-structured interviews were conducted. Data analysis was conducted and using qualitative content analysis. ResultsThe study identified the following challenges: non-adherence to the standard operating procedure for drug supply management, human resources challenges, inadequate management support and compromised patient care. ConclusionThe suggested recommendations from the study will promote adherence to the standard operation procedure regarding drug supply management outcomes.

Performance of quality improvement teams and associated factors in selected regional referral hospitals in Tanzania: a cross-sectional study.

Introductionquality improvement teams facilitate improvement in the performance of the health facilities and simultaneously improving the quality of health services. There is scanty information on the factors associated with performance of quality improvement teams. This study aimed to assess the perceptions of members of the quality improvement teams on the factors influencing the performance of quality improvement teams in regional referral hospitals in Tanzania.Methodsa cross-sectional study was conducted in four regional referral hospitals in Tanzania. We used self-administered questionnaires to collect data from 61 members of quality improvement teams. Descriptive statistics were used to assess the perceived factors influencing team performance. Bivariate and multivariate logistic regression was used to test the association between perceptions of the team members and factors associated with team performance.Resultsthe overall mean perception score on team performance was high at 27.51 ± 4.62. Five factors namely: training (83.6%); communication (75.1%); team cohesiveness (71.5%); clarity of roles and responsibility (70.2%); team size and composition (65.5%); and self-assessment and learning (56.2%) were considered as the main drivers of team performance. Inadequate management support obtained the lowest score (36.1%). Multivariable regression analysis established a significant association between training, communication, clarity of roles and responsibilities, team size and composition, self-assessment and learning, management support and team performance.Conclusioninadequate management support to the team was found to be a barrier to team performance. Managerial interventions should focus on provision of coaching and mentoring to the team while addressing resource challenges affecting the team performance.

Challenges for Nurses in Providing Patient-Centered Care in Rural Primary Health Care Clinics in Nigeria

Globally, patient-centered care has become the focus of the healthcare system. It is imperative to note that during a global pandemic crisis, patient-centered care principles seek to empower partnering approaches in Primary Health Care (PHC), and have recently gained prominence in nursing practice and applied nursing research. However, nurses are faced with challenges in achieving the desired results in the PHC system. Thus, the study aimed to explore the factors that influence PCC utilization in the PHC facilities in Nigeria. A qualitative exploratory-descriptive design was used for this study. Data collection was conducted with the nurses from PHC facilities through individual interviews. Data saturation was achieved with 35 participants from 30 PHC facilities in Osun State, Nigeria, using a purposive sampling technique. All interviews were audio-recorded, later transcribed verbatim, and analyzed using the thematic analysis approach. NVivo 12 software was used for data management. The results from this study were categorized into two factors: Organizational factors and individual factors. Six themes that emerged from the study include inadequate management support, insufficient opportunities for further training, work overload and time constraints, health personnel readiness to use PCC, dearth enthusiasm for change, and poor nurses’ Accountability. The study shows that nurses encountered diverse challenges in providing patient-centered care. To improve the quality of healthcare delivery in the PHC facilities, there is a need to reinforce adequate management support, education, continued training, and the internal motivation of nurses to achieve transformative health outcomes in the community.

Barriers to Knowledge Management Practices, Interprofessional Collaboration and Information Technology Application in Federal Tertiary Hospitals in Nigeria

Effective dissemination of knowledge among healthcare professionals using information and telecommunication technology has been identified as an important tools to improve qaulity service delivery. This study provide succinct explanation of the constraints of using information technology in the management of knowledge among diverse healthcare professionals in federal tertiary hospitals in Nigeria. The study specifically focus on factors militating against the effective use of information technology application to manage knowledge to promote interprofessional collaboration for improved quality service deleivery. Cross-sectional data were collected from 479 healthcare workers across the federal tertiary hospitals in Nigeria. Using the Relative Importance Index (RII), the results show that inadequate ICT infrastructure (R = 0.79), inadequate technical support (R = 0.78), ICT illiteracy (R = 0.77), inadequate management support (R= 0.76), behavioural and personal characteristics (R = 0.72), among others are the major barriers militating against interprofessional collaboration and knowledge management in federal tertiary hospitals in Nigeria. Majority of the respondents also perceived lack of time and interaction among healthcare workers, poor verbal communication, level of experience, organisational structure and hierarchy, difference in education and gender as parts of the sociocultural factors inhibiting effective management of knowledge and interprofessional collaboration among healthcare workers. The study concludes that provision of basic information and communication technology facility to healthcare workers is paramount to enhance knowledge sharing and interprofessional collaboration to improve quality health service delivery. Adequate funding, provision of medical infrastructure and basic amenities, healthcare workers eduction and orientation towards the benefits of interprofessional collaboration using the IT application are suggested as ways to improve quality healthcare services in tertiary hospiatls.

User-provider experiences of the implementation of KidzAlive-driven child-friendly spaces in KwaZulu-Natal, South Africa

BackgroundKidzAlive is a child-centred intervention aimed at improving the quality of HIV care for children in South Africa. Through this intervention, 10 child-friendly spaces were created in 10 primary healthcare centres (PHCs) in KwaZulu-Natal to enhance child-centred HIV care. However, the user-provider experiences of these child-friendly spaces in these facilities have not been explored. This paper addresses this gap.MethodsWe conducted qualitative interviews with children (n = 30), their primary caregivers (PCGs) (n = 30), and KidzAlive trained healthcare workers (HCWs) (n = 20) using and providing child-friendly spaces, respectively. Data were generated, using a semi-structured interview guide printed in both English and IsiZulu. The interviews were audio-recorded transcribed and translated to English by a research team member competent in both languages. Data were imported to NVivo 10 for thematic analysis. The COREQ checklist was used to ensure that the study adheres to quality standards for reporting qualitative research.ResultsChild-friendly spaces contributed to the centredness of care for children in PHCs. This was evidenced by the increased involvement and participation of children, increased PCGs’ participation in the care of their children and a positive transformation of the PHC to a therapeutic environment for children. Several barriers impeding the success of child-friendly spaces were reported including space challenges; clashing health facility priorities; inadequate management support; inadequate training on how to maximise the child-friendly spaces and lastly the inappropriateness of existing child-friendly spaces for much older children.ConclusionChild-friendly spaces promote HIV positive children’s right to participation and agency in accessing care. However, more rigorous quantitative evaluation is required to determine their impact on children’s HIV-related health outcomes.

Stress and coping strategies among nurse managers

Background: The role of Nurse Managers (NMs) is dynamic, multifaceted and complex thus, exposing NMs to high levels of work-related stress which seriously impact general wellbeing, and organizational outcomes.Methods: A quantitative cross-sectional approach was employed to examine the phenomenon of stress among NMs in 38 selected hospitals. Census approach was used to collect data from 267 NMs. Descriptive and inferential statistics were performed to describe the sample and established the predictors of stress.Results: The main causes of stress among NMs are a shortage of staff (94.4%), poor working conditions (91.8%), inadequate management support (89.9%) and heavy workload (89.15%). NMs experienced all the types of stress (psychological, emotional and physical). The major stress coping mechanisms are time management (91.8%), effective communication (91%) and delegation of duties (89.5%) while excessive eating (18.4%) is the least strategy used. Sociodemographic characteristics together explained 6.4% of stress among NMs [R2 = .064, F(6,241) = 2.676, p = .016].Conclusions: Senior managers of hospitals should create a favourable working environment for nurses and the appointment of NMs should be based on experience and competence. Implication for Nursing Practice: Stress among healthcare managers especially, NMs is very common. This current study has extensively proven that stress among NMs affects their general health as well as patient safety and quality of care. Training on stress management should be organized regularly for hospital staff particularly, NMs to enable them to cope better with stress.

From strategy to action: a qualitative study on salient factors influencing knowledge transfer in project-based experiential learning in healthcare organisations in Kenya

ObjectivesKnowledge transfer is recognised as a key determinant of organisational competitiveness. Existing literature on the transfer of knowledge and skills imply diminutive return on investment in training and development due...

The Barriers and Challenges Faced by Private Sector Higher Education Institutions (HEIs) in Promoting Sustainable Development: A Qualitative Inquiry in Pakistan

Private sector higher education institutions (HEIs) play a significant rolein advancement of sustainability. In Pakistan still this concept is in stageof infancy and has received little research attention. Moreover, HEIs inprivate sector are facing a lot of barriers and challenges in itsimplementation. In this backdrop, the purpose of this exploratory study isto determine the roles, barriers and challenges for development ofsustainable private sector HEIs in Punjab using semi-structuredinterviews form 11 faculty members working in private sector HEIs inPunjab, thematic analysis was carried out using NVivo 12. In general, allthe participants agreed that private sector HEIs are the knowledgecreating institutes and they can actively promote the sustainabledevelopment in Pakistan through faculty training and active involvementof all the stakeholders and action oriented research. Major barriers werefound to be lack of finance, poor research culture, faculty incompetencyand inadequate management support. It is suggested that HEIs must usethe resources in an optimal manner and develop appropriate class roomenvironment, effective curriculum, right technology usage, solutionbased research and well developed infrastructure to generate theinnovative solutions for sustainable development.

Why do organisational change programmes fail?

Many organisations have found it difficult to implement organisational change successfully. This paper using a systematic and meta-analysis review of the literature published between 1980 and 2011 explored the major reasons for organisational change failure. Unsuccessful change programmes were attributed to insufficient education and training, employees’ apathy, inadequate management support, poor leadership, inappropriate organisational culture, inadequate resources, poor communication, inappropriate planning, insufficient customer focus, and lack of a monitoring and measurement system. Change-programme implementation and its impact depend on the ability of managers to adopt and adapt the change programme principles in their organisations. A well-designed, wisely adapted and well-implemented change programme helps managers achieve desired results. Identification of those factors that contribute to change success or failure enables change leaders to develop effective strategies for enhancing the chances of achieving desired outcomes.

Factors That Affect Staff Morale in Tertiary Hospitals in Malawi: A Case Study of Kamuzu Central Hospital

Staff morale is low among medical and nursing staff in Malawi’s health facilities. This leads to voluntary attrition or unfavorable survival strategies among members of staff. This study sought to determine critical factors that affected staff morale at Kamuzu Central Hospital (KCH). This was a case study research design. Quantitative data were collected through structured questionnaires filled in by doctors, registered nurses and clinical officers. Qualitative data were collected through focus group discussions with the same cadres. An in-depth interview was done with one human resource officer. Key factors that affected staff morale at KCH were: inadequate resources for work, poor compensation, heavy workload, inadequate performance management, lack of career development and lack of training opportunities. Nurses further complained of inadequate management support. Thirty-one percent of the respondents were very dissatisfied with their jobs and 57% were intending to leave within 12 months. Job satisfaction was associated with management responsiveness (p-value 0.009).

Assessment of patient safety culture in Palestinian public hospitals

To assess the prevalent patient safety culture in Palestinian public hospitals. A cross-sectional design, Arabic translated version of the Hospital Survey on Patient Safety Culture was used. All the 11 general public hospitals in the West Bank. A total of 1460 clinical and non-clinical hospital staff. No. Twelve patient safety culture composites and 2 outcome variables (patient safety grade and events reported in the past year) were measured. Most of the participants were nurses and physicians (69.2%) with direct contact with patients (92%), mainly employed in medical/surgical units (55.1%). The patient safety composites with the highest positive scores were teamwork within units (71%), organizational learning and continuous improvement (62%) and supervisor/manager expectations and actions promoting patient safety (56%). The composites with the lowest scores were non-punitive response to error (17%), frequency of events reported (35%), communication openness (36%), hospital management support for patient safety (37%) and staffing (38%). Although 53.2% of the respondents did not report any event in the past year, 63.5% rated patient safety level as 'excellent/very good'. Significant differences in patient safety scores and outcome variables were found between hospitals of different size and in relation to staff positions and work hours. This study highlights the existence of a punitive and blame culture, under-reporting of events, lack of communication openness and inadequate management support that are key challenges for patient safe hospital care. The baseline survey results are valuable for designing and implementing the patient safety program and for measuring future progress.