Working Environment For Staff Research Articles

Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.

Central line-associated bloodstream infections (CLABSIs) are a common and costly quality problem, and their prevention is a national priority. A decade ago, researchers identified an evidence-based bundle of practices that reduce CLABSIs. Compliance with this bundle remains low in many hospitals. The aim of this study was to assess whether differences in core aspects of work environments-workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%-100% of the time in intensive care units (ICUs). A cross-sectional study of hospital medical-surgical ICUs in the United States was done. Data on work environment and bundle compliance were obtained from the Prevention of Nosocomial Infections and Cost-Effectiveness Refined Survey completed in 2011 by infection prevention directors, and data on ICU and hospital characteristics were obtained from the National Healthcare Safety Network. Factor and multilevel regression analyses were conducted. Reasonable workload and prioritization of quality were positively associated with maximal CLABSI bundle compliance. High-quality relationships, although a significant predictor when evaluated apart from workload and prioritization of quality, had no significant effect after accounting for these two factors. Aspects of the staff work environment are associated with maximal CLABSI bundle compliance in ICUs. Our results suggest that hospitals can foster improvement in ensuring maximal CLABSI bundle compliance-a crucial precursor to reducing CLABSI infection rates-by establishing reasonable workloads and prioritizing quality.

Engagement, empowerment, and job satisfaction before implementing an academic model of shared governance

AimBaseline information was obtained from a School of Nursing faculty and staff about perceptions of job satisfaction, empowerment, and engagement in the workplace before the introduction of an integrated faculty and staff shared governance system. BackgroundGovernance structure in schools of nursing has the potential to enhance or impose constraints on the work environment for faculty, staff, and stakeholders. Research methodsDesign. A cross-sectional quantitative descriptive design.Sample. Full-time faculty and staff (n = 69) employed in a public school of nursing in a health sciences center.Instrumentation. Four well-established instruments were selected to address key aspects of empowerment, engagement, and job satisfaction.Procedures. Data were collected using an online, anonymous survey.Analyses. Descriptive statistics, t-tests, and Pearson correlation analyses were used. ResultsFaculty and staff perceptions of job satisfaction and engagement in the workplace before the introduction of a new model of shared governance are presented. Statistical differences were found between faculty and staff responses on the overall or total scales and select subscales, and group patterns of relationships differed. ConclusionsWe provided a description of the first shared governance structure derived from the perspective of shared governance as defined and operationalized in Magnet Hospital health care systems and includes administrators, faculty, and staff in decision-making councils. As academia embarks on this change in governance structure from hierarchical to a more flattened approach findings support examining levels of work engagement, structural and psychological empowerment, and job satisfaction as key monitors of the work environment.

Prevalence of Workplace Violence Against Chinese Nurses and Its Association with Mental Health: A Cross-sectional Survey

The aim of this study to investigate the prevalence of workplace violence (WPV) in nurses in hospitals in China, and its influence on nurses' mental health. A cross-sectional, anonymous survey was conducted with 886 nurses (effective response rate: 87.46%) from Heilongjiang Province of China. Findings revealed that 595 of the 886 participating nurses (67.2%) were exposed to different levels of WPV. Further, WPV was correlated positively with nurses' anxiety (r=0.256, P<0.01) and depression (r=0.131, P<0.01) levels. In addition, this survey demonstrated that service years (r=0.263, P<0.01) played a moderating role in the relationship between WPV and anxiety, and gender (r=0.135, P<0.01) played a moderating role in the association between WPV and depression. WPV is an extensive problem in the work setting of nurses and it poses a major threat to Chinese nurses. Chinese nurses encounter hospital workplace violence frequently, and WPV has a considerably negative impact on the mental health and well-being of the nurses. It is critical to establish a more secure working environment for Chinese nursing staff to minimize the health threats caused by the negative outcomes associated with WPV, such as symptoms caused by anxiety and depression. This study also confirmed that new nurses and female nurses were more likely to be affected by WPV. Thus, addressing WPV should be one of the top concerns for both the government and the society.

Empirical advances with text mining of electronic health records

BackgroundKorian is a private group specializing in medical accommodations for elderly and dependent people. A professional data warehouse (DWH) established in 2010 hosts all of the residents’ data. Inside this information system (IS), clinical narratives (CNs) were used only by medical staff as a residents’ care linking tool.The objective of this study was to show that, through qualitative and quantitative textual analysis of a relatively small physiotherapy and well-defined CN sample, it was possible to build a physiotherapy corpus and, through this process, generate a new body of knowledge by adding relevant information to describe the residents’ care and lives.MethodsMeaningful words were extracted through Standard Query Language (SQL) with the LIKE function and wildcards to perform pattern matching, followed by text mining and a word cloud using R® packages. Another step involved principal components and multiple correspondence analyses, plus clustering on the same residents’ sample as well as on other health data using a health model measuring the residents’ care level needs.ResultsBy combining these techniques, physiotherapy treatments could be characterized by a list of constructed keywords, and the residents’ health characteristics were built. Feeding defects or health outlier groups could be detected, physiotherapy residents’ data and their health data were matched, and differences in health situations showed qualitative and quantitative differences in physiotherapy narratives.ConclusionsThis textual experiment using a textual process in two stages showed that text mining and data mining techniques provide convenient tools to improve residents’ health and quality of care by adding new, simple, useable data to the electronic health record (EHR). When used with a normalized physiotherapy problem list, text mining through information extraction (IE), named entity recognition (NER) and data mining (DM) can provide a real advantage to describe health care, adding new medical material and helping to integrate the EHR system into the health staff work environment.

Piloting the FAO Gender and Rural Advisory Services Assessment Tool in Bangladesh Component: Enabling Environment

This discussion paper carefully reviewed different policies and strategies of the government of Bangladesh in line with the Gender and Rural Advisory Services Assessment Tool of FAO. The review shows that there is important political commitment but this is often not accompanied by concrete action. The government policies are found to be extensive but existing documents reported slower progress on implementation. While the government has successfully passed policies that do include passages on gender, {e.g. the National Agriculture Policy, New Agriculture Extension Policy, Rural Development Policy, National Women Development Policy, Poverty Reduction Strategy Papers I&II, Seventh Five Year Plan and Two-Year plan (Government’s Plan during 1978-1980)}, there is an implementation gap of these policies. Also, coordination among different departments falls short. None of the policy frameworks have a specific implementation strategy that distinctly addresses gender issues in RAS. For instance, as per CEDAW agreement, the county submits regular report on the progress made in eliminating discrimination against women. However, reservations on articles 2 and 16 pertaining to marriage, divorce and inheritance remain in force. Article 2 (relating to “Obligations to Eliminate Discrimination”) is in direct contradiction to Religious Personal Law, which allows members of different faiths to practice marriage, divorce, alimony custody and guardianship in accordance with the religious faith and article 16 (“Equity in Marriage and Family Law”). Withdrawal of existing reservation on Article 2 and Article 16(1)c was considered and the Law Commission (LC) was requested to review the merit of the reservation and to provide appropriate recommendations. The LC recommended government to withdraw her reservation from Article 2 and Article 16.1(c) of CEDAW. However, Bangladesh shall apply the provisions of these articles in compatibility and harmony with her Constitution and existing laws. The Government is considering the LC recommendation with concern about the potential movements by the Islamic fundamentalist groups are against the withdrawal of the reservations (CEDAW, 2015). Hence, lifting reservation on Article 2 and 16 is a commitment of the GoB to CEDAW is yet to be fulfilled. Although two significant policies (National Women Development Policy 2011, New Agriculture Extension Policy 2015) create provisions to improve access to productive resource, services and income generating activities for women, these are yet to be implemented due to execution problems. For example, the use of a top-down approach, over-dependence on training and visit approach, limited front line human resources, limited policy guidelines and absence of proper feedback mechanism, lack of ICT use, inadequate training centers, lack of coordination and integration in different departments and ministries, and limited number of female RAS advisors, etc. hinder implementation. Despite some favorable policies and strategies, at present RAS is not gender sensitive due to substantial gaps in implementation of policies and lack of proper monitoring. The lack of gender responsive working environment for extension service staff including inadequate facilities of child care, transport, accommodation, occupational health and safety are some of the reasons that discourage women to pursue a career in RAS. Furthermore, education, research and extension links remain weak, hence the extension system fails to come up with solution that could well improve the gender sensitivity of RAS (SAIC, 2006). Therefore, beside policy supports, coordinated and integrated efforts among education, research, and extension organizations could play substantial role to attain gender sensitive rural advisory services in Bangladesh.

Transition from an open-plan to a two-cot neonatal intensive care unit: a participatory action research approach.

To facilitate staff transition from an open-plan to a two-cot neonatal intensive care unit design. In 2012, an Australian regional neonatal intensive care unit transitioned from an open-plan to a two-cot neonatal intensive care unit design. Research has reported single- and small-room neonatal intensive care unit design may negatively impact on the distances nurses walk, reducing the time they spend providing direct neonatal care. Studies have also reported nurses feel isolated and need additional support and education in such neonatal intensive care units. Staff highlighted their concerns regarding the impact of the new design on workflow and clinical practice. A participatory action research approach. A participatory action group titled the Change and Networking Group collaborated with staff over a four-year period (2009-2013) to facilitate the transition. The Change and Networking Group used a collaborative, cyclical process of planning, gathering data, taking action and reviewing the results to plan the next action. Data sources included meeting and workshop minutes, newsletters, feedback boards, subgroup reports and a staff satisfaction survey. The study findings include a description of (1) how the participatory action research cycles were used by the Change and Networking Group: providing examples of projects and strategies undertaken; and (2) evaluations of participatory action research methodology and Group by neonatal intensive care unit staff and Change and Networking members. This study has described the benefits of using participatory action research to facilitate staff transition from an open-plan to a two-cot neonatal intensive care unit design. Participatory action research methodology enabled the inclusion of staff to find solutions to design and clinical practice questions. Future research is required to assess the long-term effect of neonatal intensive care unit design on staff workload, maintaining and supporting a skilled workforce as well as the impact of a new neonatal intensive care unit design on the neonatal intensive care unit culture. A supportive work environment for staff is critical in providing high-quality health care.

Violence at work in prison establishments: a preliminary study

Purpose The purpose of this paper is to present a preliminary study exploring the perception of prison officers in England and Wales regarding violence in their workplace. Design/methodology/approach Data were gathered through questionnaires administered to 152 of Her Majesty’s Prison establishments throughout England and Wales, ranging from high secure to open prisons where officers are affiliated to the Prison Officers Association. In total, 45 officers responded, seven from women’s prisons and the remainder from male adult and youth prisons. In addition, descriptive data from the Ministry of Justice statistical data set on incidents of violence are incorporated where possible. Findings Results indicated that violence, both prisoner on staff and prisoner-to-prisoner, is a major concern among prison officers, across all prison categories. The prison officers who took part considered there to be an absence of what they perceived to be serious measures to prevent and manage violence. Officers view the prison disciplinary system as ineffective, with reluctance for external charges to be considered against prisoners committing acts of violence within the prison. Research limitations/implications The research is limited by a lack of external measures being obtained (e.g. observation of aggressive incidents) and the fact that the participants were self-selecting, with only a small proportion of respondents. However, it suggests a need for more detailed research into prison violence, one that integrates the views of prison staff as well as prisoners, with the former lacking in the research base to date. It also indicates a need for more focussed action from management, staff representatives and reform lobbies to explore collectively how to prevent violence in prison. Only by adopting a multidisciplinary and multifaceted approach can a comprehensive attempt at management be achieved. Practical implications Prison violence has a negative impact on correctional settings and their mission to provide a safe working environment for staff and safe environment for prisoners. Consequently, a focussed management approach on the problem is required, one that captures the view of a range of staff and prisoners. Prisoner’s violent conduct, whether assault on staff or peers, constitutes further criminal conduct. This has to be addressed through formal processes such as prison reports, police charges and potential prosecution. The latter has been under-applied. Determining the barriers to pursuing police charges and possible prosecution would be valuable to pursue. Violence against staff needs to be more thoroughly understood and not considered solely as an occupational hazard, but as a means of safe-guarding both staff and prisoners. Originality/value This study is the first that has sought to incorporate prison workforce perception on the problem of escalating levels of prison violence, using a sample from a wide set of prison environments.

Perceptions of patient-centred care at public hospitals in Nelson Mandela Bay

In South Africa, the quality of health care is directly related to the concept of patient-centred care and the enactment of the Batho Pele Principles and the Patients' Rights Charter. Reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with many patients being treated in condemned hospitals which lacked piped water, electricity and essential medical equipment. Receiving quality care, and principally patient-centred care, in the face of such challenges is unlikely and consequently leads to the following question: “Are patients receiving patient-centred care in public hospitals?”A qualitative, explorative, descriptive and contextual study was conducted to explore and describe the perceptions of professional nurses regarding patient-centred care in public hospitals in Nelson Mandela Bay. Semi-structured interviews were conducted with a total of 40 purposively selected professional nurses working in public hospitals in Nelson Mandela Bay, Eastern Cape Province. Interviews were analysed according to the method described by Tesch in Creswell (2009:192).Professional nurses perceive patient-centred care as an awareness of the importance of the patient's culture, involving the patient's family, incorporating values of love and respect, optimal communication in all facets of patient care and accountability to the patient. Factors which enable patient-centred care were a positive work environment for staff, nursing manager's demonstrating exemplary professional leadership, continuous in service education for staff and collaborative teamwork within the interdisciplinary team. Barriers to patient-centred care were a lack of adequate resources, increased administrative work due to fear of litigation and unprofessional behaviour of nursing staff.

Perceptions of patient-centred care at public hospitals in Nelson Mandela Bay

In South Africa, the quality of health care is directly related to the concept of patient-centred care and the enactment of the Batho Pele Principles and the Patients' Rights Charter. Reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with many patients being treated in condemned hospitals which lacked piped water, electricity and essential medical equipment. Receiving quality care, and principally patient-centred care, in the face of such challenges is unlikely and consequently leads to the following question: “Are patients receiving patient-centred care in public hospitals?”A qualitative, explorative, descriptive and contextual study was conducted to explore and describe the perceptions of professional nurses regarding patient-centred care in public hospitals in Nelson Mandela Bay. Semi-structured interviews were conducted with a total of 40 purposively selected professional nurses working in public hospitals in Nelson Mandela Bay, Eastern Cape Province. Interviews were analysed according to the method described by Tesch in Creswell (2009:192).Professional nurses perceive patient-centred care as an awareness of the importance of the patient's culture, involving the patient's family, incorporating values of love and respect, optimal communication in all facets of patient care and accountability to the patient. Factors which enable patient-centred care were a positive work environment for staff, nursing manager's demonstrating exemplary professional leadership, continuous in-service education for staff and collaborative teamwork within the interdisciplinary team. Barriers to patient-centred care were a lack of adequate resources, increased administrative work due to fear of litigation and unprofessional behaviour of nursing staff.Although the professional nurses had clear perceptions of patient centred care, there are barriers to rendering patient-centred care under the prevailing conditions, which posed a challenge.

장애인 공동생활가정 종사자의 업무환경이 직무만족에 미치는 영향

장애인 공동생활가정 종사자의 업무환경이 직무만족에 미치는 영향

How Staff Work Environment Differences Shape Variation in Central Line Bundle Compliance in ICUs

Preventing central line-associated bloodstream infections (CLABSIs), a common and costly quality problem, is a national priority. Researchers have identified an evidence-based bundle of practices that reduce CLABSI yet hospital compliance with this bundle remains low. The purpose of this study is to assess whether differences in work environment -workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance i.e., compliance 95-100% of the time in intensive-care units (ICUs). We conducted a cross-sectional study of U.S. hospital ICUs. Work environment and bundle compliance data were obtained from the 2011 Prevention of Nosocomial Infections & Cost Effectiveness Refined Survey completed by infection prevention directors, and ICU and hospital characteristics data from the National Healthcare Safety Network. Factor and multi-level regression analyses were conducted. Reasonable workload and prioritization of quality were found to be positively associated with maximal CLABSI bundle compliance. High-quality relationships had no significant effect after accounting for reasonable workload and prioritization of quality. Results suggest aspects of the staff work environment are associated with maximal CLABSI bundle compliance in ICUs. Hospitals could foster improvement in ensuring maximal CLABSI bundle compliance-a precursor to reducing CLABSI rates-by establishing reasonable workloads and prioritizing quality.

Campus Delft: History, policy framework and development of the TU Delft campus

The Delft University of Technology is adapting its campus to the challenges it faces in a rapidly-changing academic context. The original monofunctional greenfield area is being transformed into a high-quality urban campus. The campus needs to provide a sustainable learning and working environment for staff, students and visitors. This article outlines the historical background of the campus, the aims for its future development set out in the university’s policy framework, and the actions that stem from this.

Too few staff, too many patients: a qualitative study of the impact on obstetric care providers and on quality of care in Malawi.

BackgroundShortages of staff have a significant and negative impact on maternal outcomes in low-income countries, but the impact on obstetric care providers in these contexts is less well documented. Despite the government of Malawi’s efforts to increase the number of human resources for health, maternal mortality rates remain persistently high. Health workers’ perceptions of insufficient staff or time to carry out their work can predict key variables concerning motivation and attrition, while the resulting sub-standard care and poor attitudes towards women dissuade women from facility-based delivery. Understanding the situation from the health worker perspective can inform policy options that may contribute to a better working environment for staff and improved quality of care for Malawi’s women.MethodsA qualitative research design, using critical incident interviews, was used to generate a deep and textured understanding of participants’ experiences. Eligible participants had performed at least one of the emergency obstetric care signal functions a in the previous three months and had experienced a demotivating critical incident within the same timeframe. Data were analysed using NVivo software.ResultsEighty-four interviews were conducted. Concerns about staff shortages and workload were key factors for over 40% of staff who stated their intention to leave their current post and for nearly two-thirds of the remaining health workers who were interviewed. The main themes emerging were: too few staff, too many patients; lack of clinical officers/doctors; inadequate obstetric skills; undermining performance and professionalism; and physical and psychological consequences for staff. Underlying factors were inflexible scheduling and staff allocations that made it impossible to deliver quality care.ConclusionThis study revealed the difficult circumstances under which maternity staff are operating and the professional and emotional toll this exacts. Systems failures and inadequate human resource management are key contributors to the gaps in provision of obstetric care and need to be addressed. Thoughtful strategies that match supply to demand, coupled with targeted efforts to support health workers, are necessary to mitigate the effects of working in this context and to improve the quality of obstetric care for women in Malawi.

Re-skilling for the digital humanities: measuring skills, engagement, and learning

Purpose – The purpose of this paper is to describe an assessment design for the Developing Librarian training program. The Developing Librarian training program created by and for librarians and professional staff in the Humanities and History division is a two-year training program to acquire new skills and methodologies to support the digital humanities. The program is based on the assumption that learning must happen in context; therefore the training is project based with all participants engaged in building a digital humanities research site as a team. This approach enables participants to learn about new tools in a sustained manner that parallels the way humanities researchers are likely to use them. Design/methodology/approach – In order to measure the success of achieving this goal, program designers defined three objectives: learn tools and methods that support the emerging research needs and trends in the humanities; create a more interesting and engaging work environment for librarians and professional staff; and engage effectively with the humanities research community across the University. Three methods/instruments were: Explicit Self-Reflections to assess what participants learned in each training unit; the Utrecht Work Engagement Scale to measure how participants feel about their work before and after the training program; and the Skill Set, Knowledge and Attitude Assessment to be administered at completion to measure the effectiveness of the training program as a whole. Findings – At the time of writing, the Developing Librarian Project is mid-way to completion, and implementation of the assessment plan is ongoing. Based on these self-reports, there is evidence that the training program has been effective, and participants have been successful in meeting most of the learning objectives identified in the units completed. While self-assessment of knowledge and skills may have its limitations, this technique is proving adequate and efficient for achieving the program’s goals. This method encourages experimentation and establishes failure as an important aspect of the learning process. Research limitations/implications – An assessment approach such as this does not measure the impact of training and development on digital humanities research, but initiates a valuable process, highlighting skills gaps at the individual, and organizational levels. These data are important for identifying and implementing appropriate training opportunities for librarians supporting emergent research activities and for understanding what skills and professional preparation are needed for new staff recruited into the organization. Originality/value – A successful training program should be benchmarked, evaluated in a substantive and systematic way, and improved continuously. A formal assessment plan, directly tied to clearly articulated objectives, helps assure that such a program is effectively evaluated, iteratively developed, and successfully implemented. The Developing Librarian Project provides a useful model of how an academic library can leverage assessment and evaluation processes to identify skills gaps and training needs and generate actionable data for improving staff learning.

Resident-to-resident physical aggression leading to injury in nursing homes: a systematic review.

resident-to-resident aggression (RRA) is an understudied form of elder abuse in nursing homes. the purpose of this systematic review was to examine the published research on the frequency, nature, contributing factors and outcomes of RRA in nursing homes. in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, this review examined all original, peer-reviewed research published in English, French, German, Italian or Spanish between 1st January 1949 and 31st December 2013 describing incidents of RRA in nursing homes. The following information was extracted for analysis: study and population characteristics; main findings (including prevalence, predisposing factors, triggers, nature of incidents, outcomes and interventions). eighteen studies were identified, 12 quantitative and 6 qualitative. The frequency of RRA ranged from 1 to 122 incidents, with insufficient information across the studies to calculate prevalence. RRA commonly occurred between exhibitors with higher levels of cognitive awareness and physical functionality and a history of aggressive behaviours, and female targets who were cognitively impaired with a history of behavioural issues including wandering. RRA most commonly took place in the afternoon in communal settings, was often triggered by communication issues and invasion of space, or was unprovoked. Limited information exists on organisational factors contributing to RRA and the outcomes for targets of aggression. we must continue to grow our knowledge base on the nature and circumstances of RRA to prevent harm to an increasing vulnerable population of nursing home residents and ensure a safe working environment for staff.

William Pickles Lecture 2014: Cum Scientia Caritas - compassion with knowledge.

I take caritas to mean compassion; we could also consider it to mean charity, one of the three theological virtues. Through compassion, I would like to consider the virtues and values by which we live and practise. Events would have us believe that somehow in the NHS compassion has been lost. I suggest that it is not but that it needs to be supported. There are numerous reports of where compassion has been lacking in health care, with many recommendations for action. The Health Service Ombudsman commented that ‘these accounts present a picture of NHS provision that is failing to respond to the needs of older people with care and compassion’.1 To this we must sadly add the events at Mid Staffordshire as outlined by Robert Francis QC.2 Consider the patient narratives found within the Francis reports3 and Julie Bailey’s book4 through the lens of compassionate care. The inquiry found that the culture of the trust was not conducive to providing good care for patients or providing a supportive working environment for staff; problems included bullying and low morale. To which we could add many other cases: Winterbourne View, NHS Lanarkshire, Vale of Leven, Princess of Wales, Abertawe Bro Morgannwg, and so on. When the Mid Staffordshire scandal broke it was asked, ‘How could clinicians pass on by on the other side of the ward?’ But can we all honestly say that we would have been the ward equivalent of the Good Samaritan? As professionals we must be the Samaritans; we must stand up for what is right. Do doctors lack compassion? I am not convinced that they do, but an accumulation of factors creates an environment in which compassionate care is overwhelmed. ### Re-disorganisation The NHS exists in a constant state of flux with energy being invested …

"Together at school"--a school-based intervention program to promote socio-emotional skills and mental health in children: study protocol for a cluster randomized controlled trial.

BackgroundSchools provide a natural context to promote children’s mental health. However, there is a need for more evidence-based, high quality school intervention programs combined with an accurate evaluation of their general effectiveness and effectiveness of specific intervention methods. The aim of this paper is to present a study protocol of a cluster randomized controlled trial evaluating the “Together at School” intervention program. The intervention program is designed to promote social-emotional skills and mental health by utilizing whole-school approach and focuses on classroom curriculum, work environment of school staff, and parent-teacher collaboration methods.Methods/DesignThe evaluation study examines the effects of the intervention on children’s socio-emotional skills and mental health in a cluster randomized controlled trial design with 1) an intervention group and 2) an active control group. Altogether 79 primary school participated at baseline. A multi-informant setting involves the children themselves, their parents, and teachers. The primary outcomes are measured using parent and teacher ratings of children’s socio-emotional skills and psychological problems measured by the Strengths and Difficulties Questionnaire and the Multisource Assessment of Social Competence Scale. Secondary outcomes for the children include emotional understanding, altruistic behavior, and executive functions (e.g. working memory, planning, and inhibition). Secondary outcomes for the teachers include ratings of e.g. school environment, teaching style and well-being. Secondary outcomes for both teachers and parents include e.g. emotional self-efficacy, child rearing practices, and teacher-parent collaboration. The data was collected at baseline (autumn 2013), 6 months after baseline, and will be collected also 18 months after baseline from the same participants.DiscussionThis study protocol outlines a trial which aims to add to the current state of intervention programs by presenting and studying a contextually developed and carefully tested intervention program which is tailored to fit a national school system. Identification of effective intervention elements to promote children’s mental health in early school years is crucial for optimal later development.Trial registrationClinicalTrials.gov register: NCT02178332.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-1042) contains supplementary material, which is available to authorized users.

Differing perspectives on a role for technology in care homes to improve the lives of older people and the work environment of staff

Purpose – The purpose of this paper is to place the future development of technology within the existing reality of the diversity of care homes. Design/methodology/approach – Using the findings from a learning exercise, the paper illustrates “diversity” in terms of the meaning staff, relatives, and residents attach to the words “care home”. This tri-partite approach provides a basis for exploring types of technology that could, if appropriately introduced, prove to be of benefit to the different users and staff. Findings – Technology is more likely to be “fit for purpose” when it has been developed jointly with those who work, live in, and who visit care homes. Costs and benefits will be issues to be taken into account. Research limitations/implications – A lack of research evidence on the role of technology in care homes was a key limitation. In future, research should adopt a co-production approach to technology development. Practical implications – The authors take a pragmatic stance that if due care is taken in preparations for and the introduction of technology, this would increase uptake of technology to meet different needs. Social implications – The paper makes the points that: older people can learn new technological skills; the concept of care homes as user-led is in accord with increased opportunity to engage residents in new technology. Technology in care homes while posing challenges also could prove to be a major lucrative market. Originality/value – By triangulating the perspectives of residents, relatives, and staff the authors hope to have presented a realistic and evidence-based overview of the potential for technology advancement in care homes.

The relationship between small-scale nursing home care for people with dementia and staff's perceived job characteristics

Over the past few decades, new care models that are more resident-oriented and directed toward small-scale and homelike environments have been developed worldwide. The impact of these care models on the quality of life of residents has been studied. However, little research has been conducted to gain insight into how these new care models influence healthcare staff's work environment. This study focuses on the consequences of small-scale care on staff's perceived job characteristics. Data were derived from a sample of 136 Dutch living arrangements providing nursing home care for people with dementia (2008/2009), in which 1,327 residents and 1,147 staff participated. The relationship between two indicators of small-scale care (small-scale care characteristics and total number of residents with dementia in facility) and staff's job characteristics (job demands, decision authority, coworker and supervisor support) were studied with multilevel regression analyses. All analyses were adjusted for staff, resident, and living arrangement characteristics when needed. Both indicators of small-scale care were associated with job demands; staff perceived less time and work pressure as more characteristics of small-scale care were integrated and the facility had less residents with dementia in total. Only one indicator was associated with decision authority. As more characteristics of small-scale care were integrated, staff's perceived decision authority was higher. No relationship was found with coworker and supervisor social support. Knowing that job demands and decision authority are important predictors of job appraisal and well-being, our findings show that small-scale care could have a beneficial impact on healthcare staff's work environment.

Burnout among nurses in Tabuk military hospital

Background: There is a growing interest in the psychosocial work environment of health care staff since they are at high risk for burnout, role conflict and job dissatisfaction. Burnout, as a type of prolonged response to chronic job-related stressors, has a special significance in health care where staff experience both psychological, emotional and physical stress. Burnout and the other negative aspects of the job of health care staff have major behavioural and health implications. Aims & Objective: The aim of this study was to determine the prevalence of burnout among nursing staff in a military hospital, estimate the level of burnout among those nurses working on inpatient wards and outpatient clinics and to identify the risk factors of burnout that could be linked to personal and working characteristics associated with the syndrome. Materials and Methods: A cross sectional descriptive study has been carried out including all nurses working in North West Armed Force Hospital (NWAFH). An anonymous questionnaires were used for data collection including presence of burnut as a dependent variable and age, gender, nationality, marital status, income, allocation, medical Hx, psychiatric Hx as independent variables. Head nurses of each ward and each clinic had been personally informed about the aims of this study and had been asked to distribute a questionnaire among the staff nurses and collect them after completion. A total of 200 questionnaires had been distributed to the medical nurse staff working in the clinics and wards during October 2012. The questionnaire is divided into two parts: socio-demographic with job characteristics of the population and MBI questionnaire to estimate the job burnout level. Results: The response rates of returned questionnaires from inpatient and outpatient nurses were 79%. 34.8 % of our sample was aged between 35-44 years. 87.9% of all nurses were females. A 55.1 % of our samples were married. A 56.4% of the entire sample was having Philippine nationality. The overall result showed that 75.9% of our sample is having burnout, mainly inpatient staff (P-value 0.03). There are no statistical differences in having high burnout score based on gender, salary or having positive medical or psychiatric illness. Conclusion: In North West Armed Force Hospital (NWAFH), the overall prevalence of burnout among nurses was high (75.9%), and working as inpatient nurse increase the risk of developing burnout more than working in outpatient clinic.