Leadership Staff Research Articles

Stakeholder perspectives around post-TB wellbeing and care in Kenya and Malawi.

There is growing awareness of the burden of post-TB morbidity, and its impact on the lives and livelihoods of TB affected households. However little work has been done to determine how post-TB care might be delivered in a feasible and sustainable way, within existing National TB Programmes (NTPs) and health systems, in low-resource, high TB-burden settings. In this programme of stakeholder engagement around post-TB care, we identified actors with influence and interest in TB care in Kenya and Malawi, including TB-survivors, healthcare providers, policy-makers, researchers and funders, and explored their perspectives on post-TB morbidity and care. Stakeholder mapping was completed to identify actors with interest and influence in TB care services in each country, informed by the study team's local, regional and international networks. Key international TB organisations were included to provide a global perspective. In person or online one-to-one interviews were completed with purposively selected stakeholders. Snowballing was used to expand the network. Data were recorded, transcribed and translated, and a coding frame was derived. Data were coded using NVivo 12 software and were analysed using thematic content analysis. Online workshops were held with stakeholders from Kenya and Malawi to explore areas of uncertainty and validate findings. The importance of holistic care for TB patients, which addresses both TB comorbidities and sequelae, was widely recognised by stakeholders. Key challenges to implementation include uncertainty around the burden of post-TB morbidity, leadership of post-TB services, funding constraints, staff and equipment limitations, and the need for improved integration between national TB and non-communicable disease (NCD) programmes for care provision and oversight. There is a need for local data on the burden and distribution of morbidity, evidence-informed clinical guidelines, and pilot data on models of care. Opportunities to learn from existing HIV-NCD services were emphasised. This work addresses important questions about the practical implementation of post-TB services in two African countries, exploring if, how, where, and for whom these services should be provided, according to a broad range of stakeholders. We have identified strong interest in the provision of holistic care for TB patients in Kenya and Malawi, and key evidence gaps which must be addressed to inform decision making by policy makers, TB programmes, and funders around investment in post-TB services. There is a need for pilot studies of models of integrated TB care, and for cross-learning between countries and from HIV-NCD services.

THE RELATIONSHIP OF LEADERSHIP STYLE, PSYCHOLOGICAL CAPITAL, AND STAFF PERFORMANCE AMONG ACADEMICS HOLDING ADMINISTRATIVE POST IN PUBLIC HIGHER EDUCATION INSTITUTION IN MALAYSIA: BRIEF REVIEW

Staff leadership especially among academics holding administrative post has long been debated in relation to level of performance. Notably, past studied rarely talked about the relationship of leadership styles and psychological capital in boosting the performance in which this study investigated. Through literature review, the leadership style of academic leaders predicts the performance while their psychological capital determines the impact further. Some insights were excavated from articles in various journal related to variables of study particularly among academia which become the context of this study. Full-Range Leadership theory drove the study to further entice the relationship of the variables. In the end, the study manages to gauge explanation why academic leaders’ performance is differently affected by transformational leadership style as compared to transactional leadership style. The effect, however, can be regulated by the psychological capital of the academic leaders while performing their tasks.

Empowerment in action

Working within the early years is dynamic and change driven. The opportunities to embrace change are through empowered staff and responsive leadership, supported with action research.

Improving assessments and follow-up for pediatric emergency department mental health visits

Background: Over the past decade, the number of children presenting to emergency departments (ED) with mental health (MH) concerns has increased substantially. EDs struggle to respond to this increase with approaches that comprehensively address patient needs. The lack of standardized processes to perform risk stratification, assess severity, and ensure access to follow-up care pose barriers to the provision of safe MH care. Our team addressed this gap by introducing an evidence-based care bundle to Alberta’s two pediatric EDs. This report presents the quality improvement (QI) approach used to ensure fidelity of implementation at one of the EDs. This initiative was funded by Alberta Innovates (Partnership for Research and Innovation in the Health System; PRIHS).
 Methods: We used the Model for Improvement to test and implement each bundle element: suicide risk screening (Ask Suicide-Screening Questions [ASQ]) at ED triage; a tool (HEADS-ED) to streamline and standardize MH assessments by ED-based MH nurse); and an urgent, single-session ‘Choice Appointment’ with a MH professional within 96 hours of the ED visit for patients lacking access to appropriate and timely MH follow-up care. The two ED-based bundle elements did not require additional resources or funding and are expected to reduce length of stay. The follow-up clinic option for ED patients without resources is intended to prevent crisis escalation and match patients with supports. Each new practice was introduced sequentially over a 2-week period. For each practice, we identified 1 to 2 improvement aims, developed key driver diagrams, and selected primary outcomes and measures. Each practice was implemented using Plan-Do-Study-Act (PDSA) cycles with initial tests of change starting small and becoming larger as learning accrued from previous cycles. Our QI team included families with lived experience, patient care and unit managers, nurse educators, frontline healthcare providers, content experts, and clinical leaders who supported staff and led change management strategies. A nurse was hired as a QI lead to support execution of PDSA cycles. We developed a sustainability plan which included embedding education regarding new practices in new healthcare staff orientation, having a measurement strategy to ensure that improvement was maintained, and planning for transition of responsibility for these processes to operational and medical leadership. 
 Evaluation Methods: Primary aims included: 80% of targeted patients would receive the ASQ and HEADS-ED and 100% of children eligible for an Urgent, single-session ‘Choice Appointments’ would be offered it within 96 hours. We used clinical data from the electronic health record (Epic/Connect Care) as well as patient experience data collected via parent/caregiver surveys to determine if the aims for each practice were achieved. We included balancing measures to test whether changes in care in one part of the system introduced unintended consequences in other parts. We evaluated results for the primary aims using run charts to rapidly detect change according to established rules for detecting special cause. We discussed the results from each PDSA cycle in the context of existing healthcare resources to support implementation of each element of the bundle.
 Results: Tests of change to introduce suicide risk screening began February 1st, 2021. Performance was measured in weekly intervals. The median initial use of ASQ by triage nurses was with 77% of MH patients (686/901 patients), and over time, improved to 93% (319/350 patients), with special cause (shift) in noted September 2021. Tests of change to introduce the HEADS-ED tool began February 16th, 2021. Initial use of the HEADS-ED by MH nurses was 81% (440/555) and improved to 87% (201/227) with special cause (shift) noted August 2021. Urgent, single-session ‘Choice Appointments’ were offered to all patients who did not have timely and access to urgent follow-up with an existing mental healthcare provider with 89.1% having an appointment booked within 96 hours of the ED visit (139/156).
 Advice and Lessons Learned: Three plans were viewed as crucial to the success of this initiative: 1) a robust strategy to develop proposed changes based on best evidence combined with patient and staff engagement; 2) a comprehensive QI strategy to test, measure, and implement changes; and 3) regular communication and collaboration among ED staff, mental healthcare staff, patients/families, and hospital leadership. There were also lessons learned regarding what could have further enhanced project success: 1) enhanced communication strategies using multiple methods to ensure that project communications reached all stakeholders, including those not regularly present in the ED; 2) hiring the QI lead earlier to begin change management prior to bundle implementation; and 3) outlining a transition plan for clinical data management and bundle monitoring earlier to ease the QI transition to clinical leadership.

Transformational Leadership and Psychological Well-Being of Service-Oriented Staff: Hybrid Data Synthesis Technique.

Leaders play a significant role in organizations and their leadership behaviors can either enhance or undermine the well-being of their employees. This study aimed to meta-analyze the relationship between transformational leadership and well-being in the service industry, and how employees’ gender and service sector moderated the strength of this relationship. This study used a convergent mixed-method approach. PubMed, MEDLINE, Google Scholar, AMED, and Scopus electronic databases were utilized to search for relevant studies. Textual data were analyzed using a text data-mining technique (Leximancer) to determine the relevant themes and concepts. Statistical data were examined through a comprehensive meta-analysis to determine their effect sizes. The qualitative results outline the major themes that emerged: leadership, well-being, and health. The quantitative findings revealed that the perceived well-being of male employees and those working outside of the health-care service sector was positively higher when employees’ leaders showed transformational leadership. In general, the findings from the qualitative and quantitative data converge. The findings confirm the positive relationship between transformational leadership and employee well-being. This study also highlights the applicability of a convergent mixed-method approach as a useful methodological strategy when analyzing both lexical and statistical data.

Using Implementation Science to Promote Integration and Sustainability of Community Health Workers in the HIV Workforce.

Community health worker (CHW) interventions are an evidence-based practice adopted by health care settings to increase retention in care and viral suppression for people living with HIV (PLWH) from racial/ethnic minority communities. However, disparate funding, unclear roles vis a vis other care team members, limited training and promotion opportunities, and a lack of standards for wages and tasks limit the ability to effectively use CHWs as part of the health care team. Guided by the Exploration, Preparation, Implementation, and Sustainment and Reach, Effectiveness, Adoption, Implementation, and Maintenance frameworks, this study describes the key determinants for CHW integration and sustainability at 3 agencies in Shelby County, TN, to improve viral suppression and reduce disparities among rural and urban people living with HIV. Memphis Transitional Grant Area (TGA) which includes 8 rural and urban counties in west Tennessee, Arkansas, and Mississippi. Seventeen key informants were identified using purposeful and snowball sampling techniques, including community and agency leadership staff, frontline staff, and faith leaders. Key determinants of CHW integration include establishing clear and standardized CHW roles within and across organizations, facilitating interorganizational networks, and leveraging funds for livable CHW wages and sustainable positions. Training strategies that strengthen the CHW workforce include content related to trauma-informed care, managing stress, and cultural humility. Several inner and outer settings and innovation and bridging factors affect CHW positions. Data collected will inform the implementation and sustainment of future policies and interventions intended to improve HIV care continuum outcomes and reduce disparities for PLWH.

MANAJEMEN KEPALA SEKOLAH DALAM PENINGKATAN MUTU LULUSAN

The purpose of this study is to analyze the management of school principals in improving the quality of graduates at MTs Pesantren Dairi.The research method used is descriptive qualitative method. Data were collected using interviews, observation, and document studies. The data analysis technique was carried out through data reduction, data presentation and drawing conclusions.The results of the study found that: 1) Planning for improving the quality of madrasas at MTs Pesantren Dairi was carried out by the head of the madrasa through deliberation by involving other madrasa components with the aim of building commitment and responsibility so as to produce performance for leaders, teachers and education staff in terms of achievement and quality of graduates. 2) Organizing resources in improving the quality of graduates at MTs Pesantren Dairi, carried out by dividing the duties of staff, leaders, teachers and education personnel to carry out their respective main tasks and functions so that individual, unit/field and madrasa performance is achieved as expected. 3) The implementation of the graduate quality improvement program runs according to procedures that refer to the goals and graduate standards set by the madrasa management and is realized through three main programs that serve as work guidelines, namely strengthening tahfiz juz 30, developing superior classes, and strengthening student worship. 4) Supervision of improving the quality of graduates at MTs Pesantren Dairi shows that supervision is carried out through supervision, monitoring and evaluation by involving elements of the leadership and staff of the madrasa leadership in this pesantren to ensure the achievement of goals effectively and efficiently.

A Focused Checklist for Constructing Equitable, Diverse, and Inclusive Simulation Experiences

BackgroundFor the past six years, the School of Nursing has engaged in a concerted effort to transform our culture into one that deeply embraces inclusion and equity, not only in building awareness and stating intentions, but in strategic actions that lead to sustainable change. MethodThe School's Inclusion, Diversity, and Excellence Achievement Initiative (IDEA) provides a framework to foster sustainable change in the composition, content and context of our learning environment. To approach equity on a systemic level, faculty and staff leaders participated in the University of Southern California's Equity Institute, an 8-week intensive learning series on advancing racial equity. The training provided authors the groundwork to critically assess the learning experiences offered by their Clinical Simulation Learning Center with a goal to continue to build more diverse, inclusive and equity-minded experiences for students, with special attention to eliminating stereotypes and bias. ResultsA team of 6 faculty collaborated to develop a checklist to critically analyze existing simulation learning experiences, and guide new development of equitable and inclusive clinical simulation learning experiences. An equity and inclusivity checklist was developed. ConclusionsDespite limited literature supporting DEI in nursing student simulation education, there are tools from other interprofessional fields centered on diversity and equity, which may be adapted to meet needs of students. Effectively enhancing DEI within nursing education requires a comprehensive review of all aspects of administrative and educational elements including clinical simulation experiences. Hardwiring equitable and inclusive processes into clinical simulations can be fostered through structured checklists.

Selecting and Implementing a Telementoring Program: Case Studies of Project ECHO

Extension for Community Healthcare Outcomes (Project ECHO) is a telementoring program for health professionals that uses adult learning techniques and interactive video technology to connect distal community providers with specialist and multidisciplinary teams in real-time collaborative sessions. We examine the adoption, implementation, and sustainability of ECHO programs at four academic medical centers through case studies based on structured interviews. The study and its analysis are informed by the Diffusion of Innovation theory and the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. We found that early adopters became aware of ECHO by chance and were persuaded through observations to adopt ECHO. Finding a home for ECHO was an important initial adoption decision. Five context factors influence the implementation of ECHO: Funding, networks, staffing processes, leadership, and individual characteristics of staff. Sustainability requires ongoing funding, which itself may rely on evidence of outcomes. Findings from this study can inform the implementation of Project ECHO at other academic medical centers and extend to decisions to adopt, implement, and sustain similar telementoring programs designed to close the research-practice care gap between communities and academic medical centers.

Using a learning needs assessment to develop infection prevention training for certified nursing assistants

Background: In 2021, the California Department of Public Health Healthcare-Associated Infections Program developed new infection prevention and control (IPC) training for skilled nursing facility (SNF) certified nursing assistants (CNAs), as part of the CDC Project Firstline. CNAs comprise approximately one-third of SNF healthcare personnel (HCP) nationwide; ~50,000 CNAs are employed in California SNFs. Despite making up a large proportion of direct care HCP, CNAs can frequently lack understanding of fundamental IPC practices, including hand hygiene and appropriate personal protective equipment use. We conducted a learning needs assessment for SNF can and leadership to understand and design our program to mecanCNA IPC training needs and preferences. Methods: We distributed the learning needs assessment via SurveyMonkey in English and Spanish with questions regarding current IPC practices and challenges, as well as preferred training delivery methods and posttraining support. We leveraged partnershipscanth CNA-affiliated organizations to engage CNAs throughout California. Results: Of 193 respondents, 80 (41%) were CNAs and 113 (59%) were leadership staff, representing 97 SNFs in 41 local health jurisdictions. Among CNAs, 34 (43%) believed that they had to do workarounds in their IPC practice and 18 (23%) stated that they would benefit from one-on-one question-and-answer sessions with an infection prevention expert. Also, 50 (63%) selected visual learning, 34 selected (43%) in-person learning, and 30 (38%) selected live or online trainings as their preferred learning style and training method. Most CNAs stated that they were most comfortable listening and speaking (73%) and reading (76%) in English only, followed by listening and speaking (16%) and reading (13%) in English and Spanish. For posttraining support, CNAs preferred access to online training materials (75%), digital materials (68%), virtual office hours with IPC educators (53%), and regular webinars (49%). Conclusions: The results of our learning needs assessment confirm the need for accessible IPC training and materials and continued engagement with posttraining support for CNAs. We will continue to provide online training and resources, access to IPC experts including an ‘AskBox’ for CNAs to e-mail IPC questions or request one-on-one support, and monthly office hours. Even though most CNAs are comfortable with training in English only, we will translate curricula into Spanish to support our bilingual Spanish-canaking CNA population. We are developing a tool kit to support SNFs and local health jurisdictions interested in providing their own training using our materials, and we will offer icanerson CNA training. We will use our experience from this process in future learning needs assessments to inform other frontline HCP training, including for SNF environmental services staff.Funding: NoneDisclosures: None

The Contribution of Smallholder Beef Cattle Farming to Household Development in Chipinge Rural District, Zimbabwe

Smallholder beef farming is a critical tool for combating rural poverty. Several less developed countries have promoted smallholder beef farming with twin objectives to encourage rural development and sustainable rural livelihoods. This study was conducted in Chipinge South Rural District, Manicaland Province, Zimbabwe, with the aim of examining the extent to which smallholder beef farming contributes to rural household development. An assessment was made to ascertain the level of household development for the sampled respondents before and after the beef farming project intervention. An embedded mixed method approach, which combines qualitative and quantitative approaches, was used in the study. The research made use of key informant interviews, focus group discussions, questionnaires, observations and project reports in the collection of both quantitative and qualitative research data. A multi-stage sampling technique was adopted in the study and out of a total population of 1740 farm households in Chipinge South, a sample of 174 farm units was selected from all the six farmer groups registered and operating under the Chipinge Livestock Development Trust (CLDT). In addition, 30 key informants were conveniently sampled for interviews among members of the project management, extension staff, and farmer committee leaders. The results from the study showed that smallholder beef farming enhanced the economic status of the smallholders which translated into improved household assets, better education, adoption of new technology, capacity building and improved food security, among others. While the beef farming project yielded notable benefits to rural households in Chipinge South, the project’s ability to foster sustainable rural livelihoods in the long run was negatively affected by, among other factors, limited access to key livelihood capitals. The study recommends that the responsible authorities in Chipinge South Rural District urgently address the challenges threatening the sustainability of the project in order to promote long-term investment in the beef farming sector in the study area.

An Exploration of Change Leadership at Public Higher Education Institutions in Ethiopia

The purpose of this study was to assess the contribution of mid and lower-level academic leaders in bringing about change readiness in the university. To this end, 180 academic staff were sampled from the five colleges and one institute using a stratified random sampling method. Data were collected using a modified form of the organizational change recipients’ beliefs scale and an adapted change attitude assessment scale. The collected data were analyzed using descriptive and inferential statistics using simple linear regression. The analysis of the collected data revealed that change readiness in the university is low and met usually with resistance from the academic staff of the university. Moreover, the relationship between change leadership and change readiness of the academic staff of the university revealed that there is a significant relationship between change leadership and change readiness of the academic staff of the university. Accordingly, the regression coefficient between change leadership and discrepancy, principal support, valence, efficacy, and appropriateness of the change effort was found to be .464, .212, .444, .347, and .202, respectively. Thus, it was recommended that the mid and lower-level leadership of the university as a whole need to work toward improving the change readiness perception of the academic staff of the university. It should also show commitment to the smooth implementation of change tools being implemented in the university and provide adequate material, psychological, training, and other forms of support needed for smooth implementation of change in the universities.

159 Community Engagement (CE) Brokers: Diversity and the Science of CE

OBJECTIVES/GOALS: Since 2013, managers of community engagement (CE) programs across the Clinical and Translational Science Award (CTSA) consortium funded by the National Center for Advancing Translational Sciences (NCATS) have convened monthly to build connections, share knowledge, and enable collaboration. METHODS/STUDY POPULATION: Notable for focus on staff leadership, the CE Brokers group has been central to the ongoing success of CTSA community engagement partnerships and approaches to research. In early 2022, a survey of the 139-member group asked about their roles and responsibilities, the ways the CE Brokers network has contributed to their hubs adoption and development of best practices and innovations, resources and lessons learned, and the creation of opportunities for members to collaboratively conduct and disseminate original research, and research on the science of community engagement. The survey also asked CE Brokers if they or their community partners are part of an underrepresented community. RESULTS/ANTICIPATED RESULTS: These demographic data will be shared, along with analyses of data on growth of the group over time, evolving themes, and a SWOT analysis completed in 2021. DISCUSSION/SIGNIFICANCE: This will provide a platform to explore new avenues for the CE Brokers and their impact within the NCATS CTSA consortium, in line with the evolving direction of the clinical and translational research enterprise.

Addressing the Intersectionality of Race and Disability to Improve Autism Care

“We must do the work that justice and equality calls us to do.”– John Lewis.We write this article to (1) summarize intersectionality, (2) consider implications of intersectionality for Black, Indigenous, people of color (BIPOC) autistic communities, and (3) provide a call to action for disability researchers and organizations to foster and maintain an intersectional lens. The authors, who identify as disabled persons and family members of autistic people, seek to show how intersectionality affects the work of researchers and disability organization leaders.Intersectionality, coined by Kimberlé Crenshaw, describes the complex and multidimensional social phenomenon of double oppression that Black women experience in the United States.1 The term has expanded to include interlocking aspects of identity as it relates to race and disability. To have a Black, Brown, and disabled body in the United States is to be connected to a history saturated in oppressive and discriminatory treatment. The sociohistorical relationship between race and disability perpetuates inequalities that impact Black and Brown disabled people and thus lead to overrepresentation in disability categories associated with more restrictive environments.2 Disparities in the diagnosis and treatment of autism in children in the BIPOC communities has resulted in later identification and higher misdiagnosis rates. Black and Brown children are less likely to be identified for autism spectrum disorder by either a qualified health or educational professional.3,4In 2021, we see the conversation about race and its intersections with disability as overdue, dynamic, and urgent because of a failure to address systemic barriers to progress. We recognize the Civil Rights movement and the Women’s Liberation movement as the inspiration for the Disability Rights movement. These distinct forces served as the foundation for the coalitions that supported the disability community’s 1977 San Francisco Federal Building sit-ins, which led to the enactment of Section 504 regulations.5 With current movements such as “Black Lives Matter” and “Say Her Name” demanding an end of police violence against Black and Brown bodies, we see the cyclical connection to progress as we see these movements growing to include the lives of autistic BIPOC.This is the time for continual improvement through the amelioration of research priorities, system design considerations, and for individual and group education inside and outside our laboratories and organizations. The work is not that of the affected communities alone. Racism and ableism harm all communities. However, the voices, needs, and wants of autistic BIPOC communities must be prioritized as we seek to move forward to create projects and programs that address complex issues associated with race and disability. We must use an intersectional paradigm to acknowledge the sociohistorical roots of race and disability and acknowledge our own contributions in perpetuating systems that have maintained unequal scales by taking the social justice steps need to undo harm in our work. This includes, but is not limited to, disability researchers and organizations elevating the voice of autistic BIPOC, which includes prioritizing funding for self-advocate researchers and leadership staff. This also includes the intentional incorporation and citation of autistic scholars and disabled scholars of color in all program design and research projects. The change will be incremental but will address health inequities and better support individuals and families from our autistic BIPOC communities.

Ransomware Incident Preparations With Ethical Considerations and Command System Framework Proposal

Concerns with cyber-attacks in the form of ransomware are on the mind of many executives and leadership staff in all industries. Inaction is not an option, and approaching the topic with real, honest, and hard discussions will be valuable ahead of such a possible devastating experience. This research note aims to bring thoughtfulness to the topics of ethics in the role of cybersecurity when dealing with ransomware events. Additionally, a proposed set of non-technical recovery preparation tasks are outlined to help organizations bring about cohesiveness and planning for dealing with the real potential of a ransomware event. Constraints from many factors come into focus during preparations for ransomware, and a method to categorize them is detailed. Finally, the use of Incident Command Systems is well known and documented in emergency management, and a proposed model for integrating this process for ransomware episodes is sketched.

An autonomous and active journey to school: a case study of good practice / Uma viagem autônoma e ativa à escola: um estudo de caso de uma boa prática

This report analyses an instance of good practice for autonomous and active school walking in a large city of the Basque Country (Spain). Specifically, this work describes the background and development, methodology and phases, strengths and weaknesses, impact, and future challenges of this project. Various techniques such as life history timelines, personal interviews, documentary analysis, and contrast sessions have been used. The strengths of the project include the real impact on pupils and families in terms of work-life balance, the importance of the inter-institutional collaborative network and the inter-municipal relationship. This has been achieved through a group of town councils, the involvement of the entire school community, the leadership and active participation of the municipal technical staff, and the use of new technological tools for the development of the project.

Using coaching and action learning to support staff leadership development.

During the coronavirus disease 2019 pandemic, nurse leaders and managers have been compelled to prioritise immediate issues in their clinical areas and put aside the professional development of staff. However, leadership development for individuals and teams is essential to ensure nurses feel valued and develop the skills required for team cohesion, problem-solving, decision-making and innovation. Simple and effective approaches to staff leadership development are needed. Two such approaches are coaching and action learning. This article provides an introduction to coaching and action learning as approaches nurse leaders and managers can use to promote leadership development among individual team members and within the team. It describes how coaching and action learning work and their potential benefits and challenges. It explains how the two approaches can be used to underpin effective problem-solving and goal setting, and support nurses in their professional development, the ultimate aim being to deliver safe and effective patient care.

Navigating COVID-19 Educational Challenges: Transitioning an In-Person Mentoring Program to a Virtual Learning Environment.

Nursing professional development practitioners and leadership staff implemented a second Transitional Mentor Education Program. The pilot program was classroom based; however, with pandemic restrictions, a shift to deliver a hybrid mentoring program was needed. Learning needs, clinician well-being, and professional development were addressed. Regardless of the method of educational delivery, the nurses in Phase 2 achieved the same outcomes as the pilot program, including increased clinical confidence, communication, integration of stress reduction strategies, and reflective practice.

Higher Education Study Programme Quality Assessment

Study programme quality assessment provides higher education quality which in its turn is an essential precondition for the successful national economy development. At the moment the society has a lot of discussion about what is higher education quality and how to assess it. The pragmatic approach makes us set criteria for study programme quality assessment. However, before doing that one must understand what higher education quality is. Developing over the years, higher education has created different quality understandings. The different quality understandings form the necessity of different quality assessment approaches. As the foundation of higher education quality assessment to create the methodological basis there are taken higher education quality assessment conceptions distinguished by R. Barnett: objective, subjective and development. Each of the conceptions intends to use different approaches for higher education assessment. The research approbates the usage of The Analytic Hierarchy process (AHP) method to detect the most significant study programme quality criteria and the most suitable way of assessment for them. AHP method is based on expert surveys, which were taken part by two most important interest groups interested in higher education: higher education administrative staff and students. Higher education administrators are represented by Higher Education Council representative, LU heads of administrative departments and leadership staff who are responsible for study quality and programme accreditation. In their turn, students are represented by members of Latvian Student Association, LU student council representatives and students from different LU faculties.

Protocol for scoping review of effective nursing leadership in Africa; Prospect and challenges

Background: Leadership is an essential aspect that contributes to the success of organizations through people who are organized, inspired, encouraged, and assessed to perform up to the standards that have been set. Leaders have the capacity and the talent to develop and shape attitudes toward the completion of objectives through the support they receive from group members. Since nursing, which is widely regarded as a respectable profession, accounts for the vast majority of the healthcare workforce involved in the provision of high-quality care, the nursing staff's leadership is of the utmost importance in reaching and sustaining high care standards. Effective nursing leadership requires the nurse manager to possess strong time management, organizational, and professional abilities to effectively communicate ideas to a team of nurses working in the healthcare institution. As such the nursing leadership is obligated to bring their profession to a level that will have a constructive influence on decision-making on a worldwide scale to fulfil their responsibilities. However, this is complicated by the politics of organizations, the high levels of stress and burnout that contribute to depression, and the fact that the majority of nurse leaders who compete for leadership roles are depressed. This protocol seeks to review available studies on effective nursing leadership and to determine the prospects, challenges, and the way forward in Africa. It will also assess previous work, identify and fill gaps, and add to the body of knowledge, particularly to nursing leadership in Africa. Conclusion: Researchers expect to find studies of effective nursing leadership in Africa that will enhance nurse managers effectively make appropriate decisions to determine the prospects and the challenges of effective nursing leadership to improving health care delivery in Africa. Systematic review registration: review registry 1392 The Objective of review: Effective nursing leadership in Africa; Prospects and Challenge: A scoping review protocol. Research questions: 1. Is there evidence of the prospects for effective nursing leadership in Africa? 2. To date what are the challenges to effective nursing leadership in Africa? 3. What is the way forward to effective nursing leadership in Africa? Purpose of review: Nursing leadership will be better equipped to design leadership practices in the future as these practices will assist nursing leadership to alleviate the problems that hinder successful nursing leadership and exhibit their professionalism and abilities. In addition to this, it will assist registered nurses in examining strategic roles, methods of performance evaluation, and the leadership paradigms that will be used in the future to enhance overall performance in the healthcare industry. Furthermore, the nursing community will benefit from more leadership mentorship as a result of this evaluation, which will help advance professional growth. Systematic review registration: This review was registered with the Research Registry for Systematic Reviews with unique number review registry 1392.