Perceptions Of Organizational Factors Research Articles

60 NICU Manager’s Perception of High Unit Activity and Its Association with Patient Care in the Neonatal Intensive Care Unit

Abstract Background Each year, 15,000 critically ill neonates require specialized care that is offered in only 32 tertiary neonatal intensive care units (NICUs) in Canada. Previous studies have shown associations between nurse-to-patient ratios and higher bed occupancy with patient outcomes. Objective To explore neonatal managers’ perceptions of organizational factors in Canadian NICUs. Methods This was a web-based cross-sectional survey, consisting of 20 questions pertaining to the determinants of resource allocation, the ascertainment of high occupancy state, as well as the different challenges and mitigation strategies implemented during periods of high unit strain. The survey was designed following the CHERRIES guidelines and was critically reviewed through a two-round validation process prior to deployment. It was sent by e-mail to the unit managers of all Canadian Level-3 NICUs between August and November 2022. They were invited to respond based on their unit’s practices in 2021. The analysis was conducted using descriptive statistics, where units were dichotomized by size (small unit ˂36 beds, large unit ≥36 beds). Results A total of 24 unit managers (75%) completed the survey. Most respondents relied exclusively on clinical judgment to estimate the total number of nurses required per shift (33%) and the individual nurse-to-patient ratios (67%) as opposed to nursing workload assessment tools (8% and 21%, respectively). The response for the proportion of nursing shifts perceived as adequately staffed was: 0% for 100% adequately staffed, 37% for ˃80% adequately staffed, and 27% for 60%-80% adequately staffed. The response for the proportion of nursing shifts perceived as understaffed to the point of being unsafe for patient care was: 17% for no understaffed, 52% for ˂20% understaffed, and 9% for 20%-40% understaffed. The most common organizational challenges were personnel recruitment and unit occupancy (each reported as being a major issue by 38% of respondents). Although most (75%) respondents believed that high occupancy, especially when exceeding 90%, likely increases the risk of adverse patient outcomes, they revealed implementing mitigation strategies to reduce occupancy only when it exceeded 95%. At that point, the most common strategies implemented were to call for additional voluntary nurses, implement voluntary nursing overtime, and accelerate patient transfer. Conclusion Although Canadian NICUs form a very heterogeneous group, managers shared similar perspectives in terms of staffing and occupancy challenges. This emphasizes the need for collaborative NICU person-power resource management practices to improve neonatal intensive care service organization.

Faktor-faktor yang Mempengaruhi Niat Melapor Insiden Keselamatan Pasien

Data indicate low patient safety incident report (PSI) at the X hospital (0.22%) when compared to theoretical prediction which is 10% of hospital admission. The PSI report is one of quality control method to prevent the incident recurrence. This study identify that the intention to report PSI is influenced by individual factors i.e. age, gender, working period, position, education level, employment status as well as organizational factors i.e. knowledge, patient safety culture, reporting system and response of the report. This study aimed to identify the role of individual and organizational factors on the intention to report PSI in all cases severity level (mild, moderate or severe). A structured questionnaire developed form previous research were distributed to 283 respondents (184 medical staff and 99 non-medical staff). A logistic regression analysis was performed to test the hypothesis. The level of respondents’ perceptions of organizational factors are moderate, including knowledge of PSI report, patient safety culture, reporting system and response of the report. About 39.92% of the respondents did not know how to report the PSI. The majority of respondents tend to report all PSI, either mild, moderate or severe cases. Individual and organizational factors simultaneously did not predict the intention to report PSI. Partially only organizational factors i.e. knowledge, patient safety culture and manager response to the report significantly predict the intention to report moderate case PSI (α <0.05). Organizational factors play a role in building a reporting culture, therefore the hospital need to put more effort in improving the staff knowledge, safety culture and provide adequate response to PSI report.

The influence of organizational factors on patient safety: Examining successful handoffs in health care.

Although patient handoffs have been extensively studied, they continue to be problematic. Studies have shown poor handoffs are associated with increased costs, morbidity, and mortality. No prior research compared perceptions of management and clinical staff regarding handoffs. Our aims were (a) to determine whether perceptions of organizational factors that can influence patient safety are positively associated with perceptions of successful patient handoffs, (b) to identify organizational factors that have the greatest influence on perceptions of successful handoffs, and (c) to determine whether associations between perceptions of these factors and successful handoffs differ for management and clinical staff. A total of 515,637 respondents from 1,052 hospitals completed the Hospital Survey on Patient Safety Culture that assessed perceptions about organizational factors that influence patient safety. Using weighted least squares multiple regression, we tested seven organizational factors as predictors of successful handoffs. We fit three separate models using data collected from (a) all staff, (b) management only, and (c) clinical staff only. We found that perceived teamwork across units was the most significant predictor of perceived successful handoffs. Perceptions of staffing and management support for safety were also significantly associated with perceived successful handoffs for both management and clinical staff. For management respondents, perceptions of organizational learning or continuous improvement had a significant positive association with perceived successful handoffs, whereas the association was negative for clinical staff. Perceived communication openness had a significant association only among clinical staff. Hospitals should prioritize teamwork across units and strive to improve communication across the organization in efforts to improve handoffs. In addition, hospitals should ensure sufficient staffing and management support for patient safety. Different perceptions between management and clinical staff with respect to the importance of organizational learning are noteworthy and merit additional study.

Exploring Individual and Organizational Factors Contributing to Compassion Satisfaction, Secondary Traumatic Stress, and Burnout in Domestic Violence Service Providers

Research on workplace wellness often neglects the role of organizational factors in preventing negative effects and promoting positive outcomes for service providers. Using a person–environment fit model, which highlights compatibility between an individual worker’s characteristics and his or her work environment, we examine key risk and protective factors that might contribute to the well-being of domestic violence services providers. Service providers working in domestic violence agencies completed a Web-based survey measuring their perceptions of organizational factors (e.g., workload, control, reward, community, fairness, organizational values) and outcome variables of provider burnout, secondary traumatic stress, and compassion satisfaction. Individual–organizational mismatch emerges as a significant risk factor for burnout and secondary traumatic stress, both of which are negative outcomes associated with less manageable workloads. Secondary traumatic stress is also associated with providers’ feelin...

Exploring Nurses' Perceptions of Organizational Factors of Collaborative Relationships

Collaborative relationships are influenced by the context of the organization in which health professionals work. There is limited knowledge concerning the influence that organizational factors have on this process. A descriptive study design using semistructured interviews was used to explore nurses' perceptions of the organizational factors that influence the development of collaborative relationships in health care teams. Eight nurses from a university-affiliated teaching hospital in Montreal participated in this study. Nurses described a variety of experiences where effective collaboration took place. One common theme emerged from the participants: Being Available for Collaboration. Nurses perceived that 2 particular organizational factors-time and workday scheduling-influenced the development of collaborative relationships. This study supports the need for health care managers to promote and invest in alternative means of communication technology and to structure clinical care environments to help promote the development of collaborative relationships within health care teams.

Professionals' Perspectives on Organizational Factors That Support or Hinder the Successful Implementation of Family-Centered Practice

This article presents findings from an exploratory, qualitative study whose objective was to identify professionals' perceptions of organizational factors that support or hinder the implementation of family-centered practice (FCP). Two disability services organizations in Manitoba, Canada, were selected as the research sites. In 2002, all staff were invited to participate in qualitative interviews and focus groups, resulting in 36 people responding (front-line service coordinators, supervisors, and key informants). The analysis identified factors related to the organization's culture and climate (such as caseload size and activity, supervision, and training), policy limitations, and collateral services, as negatively affecting the ability to successfully implement FCP. The findings suggest that organizations should develop and maintain organizational cultures and climates necessary to support, implement and sustain FCP to positively impact service quality and outcomes.

Nursing Satisfaction and Job Enrichment in Turkey

Survey research was conducted with the aim of better understanding nurses' perceptions of organizational factors which relate to their job satisfaction and motivation in Turkey. Nurses (N = 290) who were employed at a training and research hospital, part of the Turkish Republic Ministry of Health, were included. The questionnaire used was developed for this study based on Hackman and Oldman's job enrichment theory. The results showed that only one third of the nurse leaders and one in five of the staff nurses reported being satisfied with their job. The participants saw the five core job dimensions of Hackman and Oldman's work design model: skill variety, task identity, task significance, autonomy, and feedback as important for nurses. Nursing was described by the participants as hard and challenging, but they also found it meaningful and said that it gave them the opportunity to use their skills and abilities.

Human and organizational factors in offshore safety

The role of human and organizational factors in predicting accidents and incidents has become of major interest to the UK offshore oil and gas industry. Some of these factors had been measured in an earlier study focusing on the role of risk perception in determining accident involvement. The current study sought to extend the methodology by focusing on perceptions of organizational factors that could have an impact on safety. A self-report questionnaire was developed and distributed to 11 installations operating on the UK Continental Shelf. A total of 722 were returned (33% response rate) from a representative sample of the offshore workforce on these installations. The study investigated the underlying structure and content of offshore employees' attitudes to safety, feelings of safety and satisfaction with safety measures. Correlations and step-wise regression analysis were used to test the relationships between measures. The results suggest that 'unsafe' behaviour is the 'best' predictor of accidents/near misses as measured by self-report data and that unsafe behaviour is, in turn, driven by perceptions of pressure for production.