Staff Deal Research Articles

Putting patients first: when home-based care staff prioritise loyalty to patients above the system and themselves. An ethnographic study

BackgroundThe growing number of older people worldwide poses challenges for health policy, particularly in the Global North, where policymakers increasingly expect seniors to live and receive care at home. However, healthcare professionals, particularly in home-based care, face dilemmas between adhering to care ideals and meeting external demands. Although they strive to uphold ethical care standards, they must deal with patients’ needs, cooperation with colleagues and management guidelines. Home-based care is an essential part of healthcare services in Norway, but staff struggle with high patient numbers and time management. This article focuses on how staff deal with ethical challenges related to contextual and organisational constraints.MethodsAn ethnographic fieldwork in three municipalities in South-East Norway. The first author conducted three to four months of participant observation in each municipality. In addition, she conducted in-depth interviews with key informants in two municipalities and a focus group interview with seven home-based care workers in one municipality. The data was analysed by using a reflexive thematic analysis.ResultsStaff in home-based care are frequently more loyal to the patient than to the system and to their own needs. To provide good care, all informants disregarded the patient’s formal decision, i.e. they provided more care than the formalised decision stipulated. To prioritise beneficence to patients, informants also disregarded some of the rules applicable in home-based care. In addition, staff accepted risks to their own safety and health to provide care in the patient’s home.ConclusionThe loyalty of home-based care staff to their patients can go beyond their loyalty to the rules of the system and even their own safety. This commitment might be attributed to a sense of doing meaningful work, to providing relationship-based and individualised care, and to strong moral courage. However, the staff’s emphasis on flexibility and individualised care also brings challenges related to unclear boundaries related to patient care.

Traditional Bulletin Board: Benefits and Drawbacks

In institutions and organizations where posting, moving, and removing notices requires human work, manual notice boards are a typical sight. In our daily lives, communication is crucial. One method of communication is to post information and announcements. Generally, when someone wants everyone to know essential information in a corporate setting, a recreational setting, a school setting, or the community at large, they use notes and display them in various locations. Announcements, ads, and critical information have traditionally been sent on fixed sheets that are adhered to a backing. This requires a lot of time, energy, and fatigue. Furthermore, because some staff members assume that no new information is uploaded, vital information is frequently overlooked. With this, it turns into one of the main issues that Lemery Senior High School's staff, parents, instructors, and students deal with. Paper is used for presentation on traditional bulletin boards, and because sustainability is being promoted, it is obvious that using paper that is only meant to be used once is extremely wasteful. LED bulletin boards are not only more practical and efficient than traditional ones, but they are also better for the environment.

Don't stop me now: A qualitative study of how Brazilian dancers and staff perceive injury and its prevention

ObjectiveTo investigate how Brazilian dancers and dance staff perceive and deal with injury and its prevention in professional and non-professional contexts. DesignQualitative study. SettingSemi-structured interviews conducted using an online platform. ParticipantsThirteen participants (8 women, 5 men) from four different dance styles (classical ballet, jazz, contemporary and urban): 6 dancers, 6 staff and 1 classified as both. Main outcome measuresInterviews were recorded, transcribed and analyzed based on Grounded Theory principles using comparative data analysis. ResultsThe main themes and findings were: 1) Injury definition: Injury was defined and classified based on pain, structural damage and consequent limitations and restrictions. 2) Dealing with injury: Dancers' fear of having to stop dancing justifies different behaviours facing injury. 3) Injury factors: Overload and many personal and environmental factors were perceived as related to injury. 4) Injury prevention: it is linked with physical preparation and additional measures and influenced by communication, trust, experience, time, access to preventive programs, dancers’ personalities and environmental factors. Responsibility for injury prevention should be shared by all stakeholders. ConclusionsTo improve injury prevention, we need to acknowledge the dancers’ drive to keep dancing, consider the multiple factors that influence their behaviours, and develop education and self-efficacy to help them make better decisions to reduce the risk of injury.

Rudeness and civility in health care

Rudeness and civility in health care

Formal Caregivers in Intellectual Disability Facilities

IntroductionCaring for individuals with intellectual disabilities is a passionate, but challenging profession. Whether working in residential homes or in occupational facilities, its staff deals with the ordinary issues of teamwork, but also with these clients behavioral comorbidities. It often includes self-harming and aggression towards others – namely towards the staff itself. This is particularly relevant since a high turnover of staff implies the loss of people who are familiar with the needs and specificities of those clients. The quality of care provided may also be affected.ObjectivesTo investigate whether, or not, formal caregivers are at greater risk of occupational health issues, and what their main determinants are.MethodsResearch in Medline for intellectual disability caregivers. Only the relevant articles, published in English, were considered.ResultsAmong formal caregivers of people with intellectual disabilities, job dissatisfaction and job strain were found to be especially relevant and were associated to the following variables:• Younger workers or those with less professional experience• Personality and individual maladaptive coping strategies• Poor organizational support• Conflicting, ambiguous, or overloaded professional roles• Unclear work tasksThe incidence of Burnout Syndrome was also described as relevant among these workers and was associated not only to aggression towards the worker, but also to the fear of aggression.ConclusionsCaring for people with intellectual disabilities, in a residential or in an occupational context, implies heavy emotional and physical demands and a high prevalence of job dissatisfaction, Job Strain and Burnout Syndrome. In addition to the high risks to the quality of life and health of caregivers, there are consequences for the quality of the care that is provided. For this reason, guaranteeing proper work conditions should be considered part of the Social Institutions main goals. Yet, we lack specific, controlled studies that properly evaluate what measures could indeed help institutions to prevent occupational (and mental) health distress among their staff.Disclosure of InterestNone Declared

Team Immediate Meet tool to help intensive care staff: Staff perception of an updated version and preliminary feedback following implementation.

Intensive Care Unit staff deal with potentially traumatic cases throughout their careers. We designed and implemented a 'Team Immediate Meet' (TIM) tool, a communication aid designed to facilitate a two-minute 'hot debrief' after a critical event, provide the team with information about the normal reaction to such an event and signpost staff to strategies to help support their colleagues (and themselves). We describe our TIM tool awareness campaign, quality improvement project and subsequent feedback from staff who reported that the tool would be useful for navigating the aftermath of potentially traumatic events and could be transferable to other ICUs.

Psychological assessment of paramedical staff working in covid-19 ward

In a densely populated country like India, the COVID-19 pandemic poses a major concern in front of the already overworked healthcare workers. Paramedical staff deals with patients of COVID-19 throughout their stay in the hospital and hence these workers are susceptible to the psychological changes followed by this stressful exposure. If these symptoms are dealt with in a professional manner and if they receive proper care then their work efficiency will improve immensely. A cross-sectional study was carried out in 65 consecutively selected paramedical staff including 50 nurses and 15 attendants. They were interviewed telephonically after taking their informed consent. Data was collected using semi-structured proforma, Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D). Statistical analysis was done using mean, chi square test. Statistically significant difference was found between married and unmarried participants in total Ham-A score (mean score 7.75 in married and 3.85 in unmarried, P=0.0008); insomnia early in the night (28.57% in married and 61.36% in unmarried, P=0.033); anxiety psychic (76.19% in unmarried and 84.09% in married; P=0.004); anxiety somatic (61.9% in unmarried and 84.09% in married, P= 0.012); Somatic symptoms gastrointestinal (19.05% in unmarried and 61.36% in married, P=0.006); general somatic symptoms (28.57% in unmarried and 68.18% in married, P=0.006); HAM-D total score (mean score 2.90 in unmarried and 6.06 in married, P=0.0003). 1. Paramedical staff working in COVID-19 wards are susceptible for psychological symptoms; 2. Anxious mood was the most common symptom reported.

Awareness of Mental Health Challenges and its Implications for Job Performance among Library Staff at the Workplace: A Qualitative Study

Mental health is one of the neglected aspects at the workplace during planning and policy formulation that, in turn, affects job performance. This study, aimed to investigate awareness of mental health challenges among library staff at the Institute of Finance Management (IFM), Tanzania and their implications for job performance. Using a pragmatic qualitative research approach, the study conducted four FGDs coupled with interviews to collect data from library staff and heads of department and the head of the library. The resultant data was subjected to content relational analysis and findings were organised thematically. Findings revealed that most of the library staff had low awareness of mental health challenges such as depression, anxiety, stress and addictive behaviours but were familiar with symptoms such as extreme sadness, lack of will to do anything and constant fear. Stigma, lack of education and professional counsellors at the workplace and lack of management support emerged as major hindrances to maintaining a positive mental health. Availability of counsellors to help staff deal with life’s challenges and navigate through personal problems; provision of education to reduce social stigma and honest conversations regarding mental health challenges were recommended as prerequisite for better mental health of library staff.

“The success of the journal”: Personal networks in early 19th-century publishing

Tools like Zoom and Slack helped to facilitate regular work during the self-quarantine period of the pandemic. However, stress was increasing among staff. The informal, everyday interactions among colleagues was missing, including the stress relief those informal interactions provided. A small group of Dartmouth College Library staff were inspired to explore a different avenue to help staff deal with stress and offered a Listening Forum. The goal was to actively listen to each speaker, not to respond with ideas, suggestions, or other forms of dialogue. It proved to be a special gift for participants.

The gift of compassion: A Listening Forum at Dartmouth College Library

Tools like Zoom and Slack helped to facilitate regular work during the self-quarantine period of the pandemic. However, stress was increasing among staff. The informal, everyday interactions among colleagues was missing, including the stress relief those informal interactions provided. A small group of Dartmouth College Library staff were inspired to explore a different avenue to help staff deal with stress and offered a Listening Forum. The goal was to actively listen to each speaker, not to respond with ideas, suggestions, or other forms of dialogue. It proved to be a special gift for participants.

Psychological First Aid Well-Being Support Rounds for Frontline Healthcare Workers During COVID-19.

Background and Objective: Frontline healthcare workers face unprecedented stress from the current SARS COV-2 (COVID-19) pandemic. Hospital systems need to develop support programs to help frontline staff deal with this stress. The purpose of this article is to describe a support program for front line healthcare workers.Methods: In this community case report, we describe a well-being support rounding program that was developed to deliver Psychological First Aid (PFA) to frontline healthcare workers in a large urban medical center to maintain their sense of psychological well-being and self-efficacy. A team of clinicians from the department of psychiatry, who were trained on the Johns Hopkins RAPID model (Reflective Listening, Assessment, Prioritization, Intervention, and Disposition) to provide PFA, were deployed throughout the hospital. These clinicians carried out daily well-being rounds from April to June during the peak of the pandemic.Results: Approximately 20% of the frontline staff members were going through an acute crisis and benefited from PFA. Anxiety, anger, exhaustion, economic worry, job insecurity, dehumanized interactions with patients due to Personal Protective Equipment (PPE), and stress of taking care of sick and dying patients without their families present, were the main themes identified by the staff. The deployed team used active listening, mindfulness, validation, reframing and other cognitive interventions to support staff.Conclusions: Our experience suggests that frontline staff are willing to engage with in-person, on-site support programs. Fostering resilience and self-efficacy through PFA is a useful model to provide emotional support to frontline healthcare workers during health crises.

COVID-19 and Dialysis Patients: Unsolved Problems in Early 2021.

COVID-19 and Dialysis Patients: Unsolved Problems in Early 2021.

The classroom as a space of welcome: exploration of the current challenges of teaching Spanish for refugees (El aula como espacio de acogida: exploración de los desafíos actuales sobre la enseñanza de español para personas refugiadas)

ABSTRACT The scant examination and dearth of academic and didactic contributions in Spain of teaching–learning Spanish for refugees is a clear shortcoming which should begin to be rectified within the next few years given the increasing presence of applicants and beneficiaries of international protection (henceforth ABIP) in our country. Given this dearth, and based on our experience as teachers with this student group, this study aims to offer several particularly illustrative examples of this phenomenon of structural divergence in language learning, in particular in relation to the crises of meaning that refugees deploy on traditional didactic materials, which reveal profound imbalances and shortcomings when faced with unprecedented pedagogical expectations. Here, it is also worth noting that a class of this kind — as a locus of (re)inscription of meanings — takes on additional functions not included in common pedagogical practice which stem from a profoundly novel educational context. To conclude, we seek to outline several reflections and recommendations which can stimulate proposed practices to help teachers, volunteers or technical staff deal with this contemporary social, political and educational challenge.

Interactional strategies for progressing through quizzes in dementia settings

People with early-to-mid stage dementia frequently attend groups that provide opportunities for socialising and engaging in group activities, such as quizzes. This article uses conversation analysis to investigate the interactional strategies that the staff use to initiate and keep these quizzes ‘on track’, and what they orient to as impediments and facilitators of quiz progression. Specifically, we outline how staff deal with incorrect or ‘non-answers’, and what happens when players have their own goals or ‘projects’ that do not align with staff members’ orientations to the overarching activity completion. We reflect on the tensions that arise between doing interactional work to progress through the quiz, and how that goal can conflict with attending to the needs or wishes expressed by the person living with dementia, potentially resulting in threats to the ‘face’ of the quiz players. Data are taken from a corpus of 10 quizzes recorded in 4 different group settings in England.

Degree of Nurses’ Compliance to the Guidelines of Occupational Exposure to Pathogenic Micro-organisms; A Review of Literature

Biological infectious hazards are the main factors which nursing staff deal with. It is fundamental rule, nurses to apply the guidelines of occupational exposure to pathogenic micro-organisms. The aim of this review was to examine the current literature on the degree of nurses’ compliance to the guidelines of occupational according to exposure to pathogenic micro-organisms. A review of literature was conducted on the Medline / PubMed, Cochrane, Scopus, and Google Scholar databases from 2000 to 2018. The keywords used in the bibliography search were, health care professionals, nurses’ attitudes, occupational exposure, and safety guidelines. The inclusion criteria were: a) studies that were directly related to the topic, and b) studies in English and Greek language, published in peer-reviewed journals. The search strategy revealed 1287 studies, 1260 excluded. Finally 27 studies were included. Nurses' compliance to the guidelines of occupational exposure to pathogenic microorganisms is described as unsatisfactory, and an emergency situation has been shown to be the major obstacle to follow the guidelines. It is necessary to understand the factors which contribute to nurse’s noncompliance. The results show that there is a need to propose measures that will positively affect the nurses’ performance. Keywords: Health care professionals; Nurses’ attitudes; Occupational exposure; Safety guidelines.

How Korean Psychiatric Staff Deal with Religious and Spiritual Issues of Patients: What Is Professional?

In contrast to other secularized countries, religious and spiritual needs and/or aspects of patient-centred-care are hardly studied in South Korea, even less in the context of psychiatry and psychotherapies. This study investigates religious and spiritual values of Korean psychiatric staff, and their experiences as well as considerations regarding their patients’ religious and spiritual aspects in clinical settings. In 2015, we surveyed psychiatric staff in Daegu and suburban areas using Korean versions of the Duke Religion Index and a questionnaire on Religion and Spirituality in Medicine: Physicians’ Perspectives by F. Curlin. Six clinics participated in our research. A total of 328 questionnaires were distributed. Ultimately, 270 fully completed questionnaires were analysed (return rate: 82.3%). Regarding religious and spiritual values, Korean psychiatric staff does not differ considerably from the average of the Korean population. However, there are significant moderate correlations between their own religious and spiritual attitudes, and their consideration as well as behaviors related to religious and spiritual aspects of their patients. In addition, there is evidence of an unconscious bias which influences treatment. These results call for more professional attention and self-reflective training.

Equipping Nurses and Care Staff to Manage Mealtime Difficulties in People With Dementia: A Systematic Scoping Review of Training Needs and Interventions.

Purpose Mealtime difficulties are prevalent in dementia, posing major challenges to people with dementia (PWD), carers, and clinical services. Speech-language pathologists have a recognized role in providing training to carers of PWD who have mealtime difficulties. The aims of this study are (a) to identify the training needs of nurses and care staff with regard to managing mealtime difficulties in PWD, (b) to describe existing training interventions on this topic, and (c) to investigate the extent to which these interventions are relevant to the needs of nurses and care staff. Method A systematic search was carried out to identify studies relevant to the aims of the review. Data were extracted and then synthesized using thematic analysis and a synthesis matrix. Study quality was appraised using a validated appraisal tool. Results Various themes were identified in relation to the training needs of nurses and other care staff who manage mealtime difficulties in PWD. These were as follows: person-centered care; dealing with uncertainty; strategies, skills, and knowledge; and creating the right environment. Existing training interventions were described and compared against the training needs. The review found some correspondence between interventions and staff needs, but also some gaps. Conclusions Training interventions on this topic should be more systematically developed and better reported to facilitate effective implementation. Evidence to date indicates that training should do more to help staff deal with uncertainty. Further research assessing the benefits of speech-language pathologists' involvement in the development of training interventions is recommended because of this profession's specialist skills and knowledge with regard to both dysphagia and communication.

A qualitative study of urban hospital transitional care

This study is part of a mixed methods evaluation of a large urban medical center transitional care practice (NMG-TC). The NMG-TC provides integrated physical and behavioral health care for high need patients referred from the hospital emergency department or inpatient units and who lack a usual source of primary care. The study was designed for internal quality improvement and sought to evaluate staff perceptions of successful transitions for their medically and socially complex patients, and alternatively, the obstacles most likely to negatively impact patient outcomes. All 16 NMG-TC patient care staff were interviewed in a collaborative effort to produce empowered testimony that might go beyond expected clinical narratives. The interview schedule included questions on risk stratification, integrated mental health care, provider to provider handoffs, and how staff deal with key social determinates of patients’ health. The constant comparative method was used to deductively derive themes reflecting key domains of transitional care practice. Seven themes emerged: i) the need to quickly assess patient complexity; ii) emphasizing caring for major mental health and substance use issues; iii) obstacles to care for uninsured, often undocumented patients; iv) the intractability of homelessness; v) expertise in advancing patients’ health literacy, engagement and activation; vi) fragmented handoffs from hospital care and vii) to primary care in the community. Respondent stories emphasized methods of nurturing patients’ self-efficacy in a very challenging urban health environment. Findings will be used to conceptualize pragmatic, potentially high-impact transitional care quality improvement initiatives capable of better addressing frequent hospital use.

营改增环境下房地产企业增值税筹划方法研究

针对房地产开发企业会计长期从事营业税核算操作而短期内很难适应“营改增”政策环境的客观实际，结合国家营改增政策中相关对房地产行业增值税计税方法等规定内容，采用实地调查法、对比分析法和经验判断法等，提炼出营改增后房开业掌握增值税筹划方法的重要性，系统地探讨了纳税筹划的六种重要技术方法，以指导房开业税务会计在日常涉税业务核算处理工作中恰当应用，积极为企业创造税收利益。 The accounting staff in real estate development enterprise is long engaged in business tax ac-counting operations, but it is difficult to adapt to the objective reality of the reform that replaces the business tax with VAT in the short term. In order to guide real estate enterprises tax accounting staff deal with daily enterprise tax-related business correctly and maintain the tax benefits of enterprises actively, this paper combines with the related content of the methods of VAT in the reform that replaces the business tax with VAT to extract the importance of the VAT planning methods for real estate enterprises after the reform to replace the business tax with VAT, and systematically discuss the six important technical methods of tax planning by field investigation method, comparative analysis method and empirical judgment method.

Identifying and Evaluating the Criteria's Affecting of Customer ExperienceUsing Fuzzy Dematel Approach (Case Study: Branches of Bank Melli in Tehran)

Customer experience is one of the most important factors that maintains the customer for banks and turns him into a loyal customer in the competitive marketplace conditions. This concept includes any type of interaction, feelings, perceptions, reactions, thoughts and other related cases from customers about the organization especially in the circumstance of service organization. In this study, 7 factors were identified as key determinants or constructs in the customer experience that according to the methodology of use the technique of fuzzy dematel, the most influential factor is the diversity of services and facilities provided in the bank. Other affecting factors include staff and managers of banks dealing with customers and quickness and easiness of using the bank's services. The factors that are affected are the communication system with the customers in the bank, services environment in bank and advertising as well as the bank's reputation. According to the results, the most influential factor in the customer experience of the bank services is in fact the diversity of services and facilities provided by the bank and how the bank directors and staff deal with customers indicating that for customers the main services of bank and how the staff deal with them is very important and these two factors should be focused to increase better experience of customers.