Workload Pressures Research Articles

Barriers and facilitators to guideline-recommended care of benign paroxysmal positional vertigo in the ED: a qualitative study using the theoretical domains framework

BackgroundBenign paroxysmal positional vertigo (BPPV) is a common presentation to the ED. Evidence suggests low adherence to guideline-recommended care, but the reasons underlying this are poorly understood. This study used...

Competence, Professionalism, Audit Experience and Auditor's Ability In Detecting Fraud

This study aims to examine the effect of competence, professionalism, and audit experience on the auditor's ability to detect fraud. This type of quantitative research with respondents are inspectors and auditors at the Inspectorate of Batu City. Determination of the number of samples is done by non-probability sampling method with purposive sampling technique. The data in the study used primary data taken directly to the respondents through a given questionnaire. The research data were analyzed using the outer model and inner model tests with the help of the Smart Partial Least Square (PLS) version 3.3.9_64bit software program. The results obtained in this study are competence has a positive and significant effect on the auditor's ability to detect fraud, professionalism has a positive and significant effect on the auditor's ability to detect fraud and audit experience has a positive and insignificant effect on the auditor's ability to detect fraud. Future research is expected to add independent variables from external factors that can affect the auditor's ability to detect fraud such as red flags, workload, and time pressure to obtain valid data.

The Crucial Role of Administrators in Shaping Working Conditions for Teachers of Students With EBD

School administrators make decisions that directly affect the educational context in which teachers work and students learn. In this commentary, we argue that addressing the burnout of individual special educators without attending to school working conditions may do little to improve teachers’ burnout and the outcomes of students with emotional/behavioral disorders (EBD). We review the literature regarding the importance of working conditions, specifically collegial supports, workload and time pressure, professional development and in-service training, and safety, for teachers’ affect and career decisions, and literature showing how administrators’ choices are related to working conditions. Students with EBD are served within schools, not just by special educators acting independently and alone. Improving implementation of evidence-based practices for students with EBD through addressing teacher burnout requires attention to the broader school system and the ways in which administrators make choices that support or constrain the abilities of the teachers within their schools.

Integration of pharmacist independent prescribers into general practice: a mixed-methods study of pharmacists’ and patients’ views

BackgroundSince 2015, the National Health Service (NHS) has funded pharmacists to work in general practice (GP practice) to ease workload pressures. This requires pharmacists to work in new roles and be integrated effectively in GPs. Independent prescribing is a key part of the GP pharmacist role, but little is known about pharmacists’ integration into GP practice as well as patients’ perceptions and experiences of the care provided by GP pharmacists. This study aims to explore the perceptions of pharmacist independent prescribers (PIPs) about their integration into GP practice and gain insight into patients’ perceptions about the care provided to them by pharmacists.MethodsA mixed-methods study comprising semi-structured interviews with PIPs (n = 13) followed by questionnaire-based assessment of patients’ (n = 77) evaluation of pharmacists’ care was conducted between December 2019 and March 2020. Quantitative data were analysed using descriptive statistics. Interviews and open comments of the survey were thematically analysed.ResultsPharmacist independent prescribers reported undertaking a range of patient-facing and non-clinical roles. Lack of understanding about PIPs’ clinical role and working beyond their clinical area of competence were some of the barriers to their integration into GP practice. Most patients were satisfied with the consultations they received from pharmacists and reported confidence in the pharmacist’s recommendations about their health conditions. However, a few patients (14%) felt they would still need to consult a general practitioner after their appointment and 11% were not sure if a further consultation was needed.ConclusionsPharmacist independent prescribers provide a range of clinical services for the management of long-term conditions which appear to be recognised by patients. However, there is a need to address the barriers to PIPs’ integration into GP practice to optimise their skill-mix and patient-centred care.

General practice Electronic Medical Record (EMR) data: exploring patient and healthcare practitioner activity from 2019 to 2021.

General practice (GP) in Ireland is almost entirely computerised. Computerised records hold great potential for large-scale data analyses but existing software packages do not readily provide such analyses. For a profession facing considerable workforce and workload challenges, harnessing GP electronic medical record (EMR) data can facilitate critical analysis of general practice activity and can highlight important trends for service planning. Medical students in the ULEARN network of general practices using the GP EMR 'Socrates' in the Midwest region of Ireland supplied our research team with three reports on consulting and prescribing activity from 1 January 2019 to 31 December 2021. The three reports, anonymised on site using custom software, detailed chart activity (i.e. types of notes recorded in patient charts), consultation types and headline prescribing figures. Preliminary analyses of data from these sites reveal that while consultation activity faltered in the early stages of the pandemic, telephone consultations and prescribing continued apace. Interestingly, childhood vaccination appointments did not falter, whereas cervical smears, which were not allowed due to processing laboratory constraints, stopped for many months of the pandemic. There are differences between how different doctors in different practices record consultation types, which weakens some analyses, particularly when estimating face-to-face consultation rates. GP EMR data have great potential for highlighting workforce and workload pressures being experienced by Irish general practitioners and GP nurses. Small modifications to how information is recorded by clinical staff would further strengthen analyses.

Workload Indicators of Staffing Need (WISN) Method for Midwives Planning and Estimation at Asrade Zewude Memorial Primary Hospital, North west Ethiopia

BackgroundWorkforce is a crucial component of the health service delivery system. Ethiopia faces health workforce challenges when it comes to evidence based health workforce planning.Workforce planning was initially determined by comparing the health worker ratio to the general population number. Later, it was determined by standard staffing schedules for each health facility level. However, neither of these methods addressed the evidence based workload variation issue among the same level facilities all around the country. A workload indicator of staff needs (WISN) method can address these variations. Therefore this research was carried on to determine workload pressure excess or gap in midwives, thereby to promote the WISN use in health facilities, based on WISN results of midwives at Asrade Zewude memorial Hospital.MethodsA cross sectional study using WISN model was used to determine the workload excess and gap pressure in midwives at Asrade Zewude Memorial primary hospital, North West Ethiopia. Midwives were selected based on a priority point scale as outlined in the WISN method.ResultsAccording to the data obtained, midwives worked five days a week and 1030 h per year. This working time was spent on health service activities (58.4%), additional activities (36.6%) and support activities (5%). WISN calculations demonstrated a shortage of five midwives with WISN ratio of 0.8 at Asrade Zewude Memorial primary hospital North West Ethiopia.ConclusionMidwives at the study area were carrying on their routine tasks even though there was a staff gap of 5: thus, the midwives had a workload excess of 20%. Under these conditions, it may be hard for the facility to achieve universal health service goals. Therefore the hospital should institutionalize WISN method planning to objectively employ midwifery professionals. This study had limitations too as it used retrospective annual service statistics and small sample size which affects generalization of the results to other health facilities and other health worker cadres within the study hospital.

The effects of big data analytics and workplace pressures on productivity

This study set out to find out on how big data analytics, workload, work wages, and organizational structure pressures affect employee job performance and overall business performance in the Jordan banking sector in the context of that country's banking sector. 292 samples from the research study were collected, analyzed, and debated to test the study's hypotheses. Employee and company success were found to be affected by workload, compensation, and organizational structure. Workload was reflected by job completion rate, average daily issues, and work completion time, while big data was reflected by external and internal, unique application, indexing, and source correctness. Work compensation, including employee compensation, employee experience and skill, and employee incentives and rewards, is the third primary factor. Communities of practice, group work, and physical infrastructure make up the fourth and last important factor, the organization's structure. The study finds that when dealing with large amounts of data, reducing the workload can improve employee performance, increasing employee motivation through higher wages and bonuses can improve performance, and having an organizational structure that promotes teamwork and work teams can improve employees' abilities to solve problems and improve work performance, which in turn affects overall productivity. This study contributes fresh information to an emerging field that requires more investigation to fully understand the interplay between big data, workload, work wages, and organizational structure pressures. The topic of this study, the Jordan banking sector, is both innovative and highly relevant because it may help financial institutions enhance their operations and provide superior customer service.

Effects of Six-Minute Walk Test on Cardiovascular Variables among Type 2 Diabetics

The study investigated the effects of six-minute walk test on functional capacity, cardiac workload, rate of perceived exertion and selected cardiovascular variables among type 2 diabetic patients. A total of forty (40) patients who had been diagnosed of type 2 diabetes mellitus and are attending the medical outpatient clinic of the Ekiti State University Teaching Hospital Ado-Ekiti were recruited through purposive sampling technique in which twenty (20) formed the experimental group and the remaining twenty (20) were control group. The pretest responses were obtained from both groups while the experimental group was subjected to eight (8) weeks of walking exercise, thereafter, the posttest responses were taken. The results from the study revealed that there was significant effect of six-minute walk test on functional capacity, rate of perceived exertion, systolic blood pressure and heart rate of type 2 diabetic patients but found no significant effect on cardiac workload and diastolic blood pressure. These changes were significant at p< 0.05. Therefore it was recommended that six-minute walk test could be used as home based exercise training designed on a long term basis to constitute a potent exercise therapy for enhancing health related quality of life among Type 2 diabetic patients as well as improve functional capacity, promote independence, and reduces exertion among Type 2 diabetic patients.

Effect of Stress on Employees’ Job Performance of Commercial Banks in Delta State, Nigeria

The purpose of the study is to determine how stress affects the work performance of employees at selected banks in Delta State, Nigeria. The study, anchored on the Selye stress theory, and adopted the survey research design. The study population consists of all staff of six selected commercial banks in Delta State. A sample size of 276 was used for the study. The study's findings showed that while role ambiguity and organizational change had significant negative effects on employees' job performance, workload and time pressure had a significant positive effect. The study comes to the conclusion that workers' job performance at commercial banks in Delta State is impacted by stress, and recommends amongst others that flexible workload should be incorporated into policies of banks to enhance employee productivity and commitment that will increase corporate survival.

Enhancing Medical Diagnosis with AI: A Focus on Respiratory Disease Detection.

Artificial intelligence (AI) is revolutionizing medical diagnosis and healthcare, providing constant support to medical practitioners. Intelligent systems alleviate workload pressure while optimizing practitioner performance. AI and deep learning have also improved medical imaging and audio analysis. This research focuses on predicting respiratory diseases using audio recordings from an electronic stethoscope. A convolutional neural network (CNN) was trained on a Respiratory Sound Database, augmented to generate 1,428 audio files. Techniques such as pitch shifting, time stretching, noise addition, time and frequency masking, dynamic range compression, and resampling were employed to increase the diversity and size of the training data. Features were extracted from mono audio files, creating a four layer CNN with 90% accuracy. The software, developed using the CNN model and Streamlit python library, offers a new tool for early and accurate diagnosis, reducing the burden on medical practitioners and enhanci ng their performance. The study highlights AI's potential in respiratory disease detection through audio analysis. The software, developed using the CNN model and Streamlit python library, offers a new tool for early and accurate diagnosis, reducing the burden on medical practitioners and enhancing their performance.

Challenges and Strengths of Fourth-Generation Accreditation Standards from the Perspective of Nurses at Afzalipour Hospital in Kerman: A Qualitative Study

Background: Accreditation is a team effort to improve service quality. Nurses, as key members of the care team, play an important role in implementing accreditation standards. This study aimed to explain the challenges and strengths of the implementation of fourth-generation accreditation from the perspective of nurses. Methods: The present study was a qualitative one conducted using content analysis. The research population included nurses of Afzalipour hospital in Kerman, Iran. Using purposive and snowball sampling, 5 nurses, 5 head nurses, and 3 supervisors were selected for accreditation. The data were collected through semi-structured interviews. The interviews were transcribed, coded, categorized, and analyzed separately. Then, using content analysis, the data obtained from the interviews were reduced and given a structure and system. Data analysis was performed using MAXQDA software (version 10). Results: The most important challenges in this study were increasing nurses’ workload and working pressure and weakening nurses’ relationship with the patient. Moreover, there was no adequate infrastructure to implement accreditation. The strengths of implementing accreditation standards included increasing nurses’ awareness, improving reporting and documentation, increasing patient safety, and improving organizational processes. Conclusion: The results of this study emphasized the need to implement accreditation standards to integrate working methods and improve the quality of services and patient safety. Solving the existing challenges is a way to ensure the quality and continuous improvement of nursing services. In general, the results of this study provide useful information to policy makers and senior managers of the health system to reform the structure of hospital accreditation.

THE IMPACT OF EMOTIONAL INTELLIGENCE AND PRESSURE ON WORKING STRESS OF ELEMENTARY TEACHERS DURING THE COVID-19 PANDEMIC IN HO CHI MINH CITY

This study was conducted to identify and analyze the impact of emotional intelligence and pressure on working stress of elementary teachers, who had been teaching online during Covid-19 pandemic in Ho Chi Minh City. Qualitative research was conducted through focus group discussions with experts, and quantitative research was conducted through direct interviews with elementary teachers, who lived in Ho Chi Minh city. The results showed that: trait happiness had negative impact on working stress of elementary teachers; workload pressure, time pressure, technology pressure were factors that had possitive impact on working stress of elementary teachers during Covid-19 pandemic in Ho Chi Minh City. Based on these findings, the authors would propose some managerial implications to decrease the working stress of elementary teachers.

Personality Traits and Mental Health among Lebanese Medical Students: The Mediating Role of Emotional Intelligence.

Medical students face daily challenges such as large workload, time commitment and clinical environment pressure leading to a higher risk of psychological distress. The aim of our study was to assess the relationship between personality traits and depression, anxiety, and stress among Lebanese medical students and to evaluate the mediating role of emotional intelligence (EI) in this association. This cross-sectional study was conducted between June and December of 2019. Participants were from seven medical schools in Lebanon. Higher extraversion (B = -0.11), higher neuroticism (B = -0.28) and higher emotional intelligence (B = -0.03) were significantly associated with lower depression. Higher neuroticism (B = -0.29) and higher emotional intelligence (B = -0.03) were significantly associated with lower anxiety. Higher openness to experience (B = 0.07) and higher agreeableness (B = 0.08) were significantly associated with higher stress, whereas higher neuroticism (B = -0.05) was associated with lower stress. EI mediated the association between extraversion and depression and openness to experience and depression. EI mediated the association between extraversion and anxiety and openness to experience and anxiety. The results of this study were different from those previously cited in the literature. This could be secondary to the mediating role of emotional intelligence. This study consequently opens up the possibility of new studies highlighting the role of emotional intelligence in the possible preservation of medical students' mental health.

Community pharmacist perceptions of drug-drug interactions.

Drug-drug interactions are preventable medication errors that can lead to serious negative outcomes for patients. Community pharmacists are uniquely positioned with their medication knowledge and role in prescription clinical assessment. However, workplace pressures and limitations related to computer systems can lead to drug-drug interactions being missed. There is a lack of information as to how community pharmacists assess drug interactions. A qualitative study using key informant interviews of community pharmacists was conducted. Pharmacists were questioned on their perceptions and views of drug interactions. Eight community pharmacists participated. Four main themes were identified from the interviews: 1) pharmacist process of identifying drug interactions, 2) tools that help pharmacists assess and respond to drug interactions, 3) challenges in identifying and responding to clinically important drug interactions and 4) measures to avoid missing interactions. Community pharmacists experience challenges around their lack of access to patient information, which limits their ability to properly assess drug-drug interactions. In addition, increasing workload pressures have affected their ability to ensure their patients receive optimal pharmaceutical care. There is also a disconnect between the community pharmacy computer systems' alerts and their clinical relevancy to their specific patients. The overall burdens can lead to professional abstinence in the assessment of drug-drug interactions. Community pharmacists are in an ideal position to prevent patients from experiencing drug-drug interactions. However, to further enable them to fulfill this role, increased access to patients' health records, decreased workload and better customization of computer alerts need to occur.

Who said there is no place like home? Extending the link between quantitative job demands and life satisfaction: a moderated mediation model

PurposeBased on the job demands and resources (JD-R) model and conservation of resources (COR) theory, this paper aims to develop and test a model that examines the moderating role of daily remote work hours and the mediating role of work–family conflict on the effects of excessive workload and time pressure on life satisfaction due to mandatory remote work arrangements.Design/methodology/approachHierarchical regression analysis was used to analyze data from 400 professionals working in the IT sector in Turkey. Scales developed by previous researchers were used to measure excessive workload, time pressure, work–family conflict and life satisfaction. While these four variables were measured with 19 statements, daily remote work hours were determined with a single question. The collected data were validated using confirmatory factor analysis, and the hypotheses were tested using structural equation modeling. Furthermore, the reliability and validity of the data were confirmed. Finally, PROCESS was applied to examine moderated mediation.FindingsAccording to the analysis results obtained from the above sample data, daily remote work hours moderate the mediating role of work–family conflict in the relationships between (1) excessive workload and life satisfaction and (2) time pressure and life satisfaction. In other words, the findings show that job-related demands arising from workload, time pressure and remote work hours prevent employees from meeting their family obligations, thereby increasing work–family conflict and ultimately affecting life satisfaction.Practical implicationsThe study can help employers, managers, human resource professionals, policymakers and researchers increase employees' life satisfaction due to the changes in job demands experienced by employees in companies that have transitioned to remote work practices. It can provide new approaches for dealing with dissatisfaction arising from work-related conflicts in Turkey's changing environment. The results can greatly facilitate the Turkish companies' efforts to create more innovative work arrangements and make an outstanding contribution to improving employee performance in Turkey's transition to remote work practices by focusing on reducing workload, time pressure and long working hours and creating employee-centered remote work models.Originality/valueAs per World Health Organization, the world will face frequent pandemic in the coming years, and thus organizations should be aware of remote work practices that will become widespread. This study provides a new perspective on the impact of employees' changing job demands on work–family conflict and life satisfaction during organizations' transition to new work arrangements in the face of the social crisis created by the COVID-19 pandemic. The study also contributes to closing the research gap between job demands, work–family conflict and life satisfaction.

The influence of workload during the COVID-19 pandemic on the social life of the nurses

Background: Nurses have been the frontline fighters during the COVID-19 pandemic. This challenge has placed nurses under huge workload pressure, which has in turn affected many aspects of their lives. During the COVID-19 pandemic in Saudi Arabia, many hospitals and healthcare systems have been adversely affected. However, few studies have examined the impact of workload during the COVID-19 pandemic on nurses’ social lives. Objective: This study aimed to examine the relationship between the workload during the COVID-19 pandemic and its impact on the social life of nurses. Methods: A quantitative cross-sectional study was conducted using an online questionnaire. Results: A total of 204 nurses participated in the study. There were 73.53% female and 26.47% male respondents with a mean age of 27.64 ± 10.62 years. The majority of the participants were Saudi (87.25%) and single (52.45%). The mean score of the impact of the COVID-19 pandemic and work pressure on nurses’ social lives was (7.31 ± 1.84) out of 10. There was found to be a significant relationship between workload during the COVID-19 pandemic and the social life of nurses. Conclusion: The study revealed how the workload in hospital during the pandemic period affected the healthcare workers’ social lives, especially nurses. Therefore, it is necessary to provide support to nurses and to know their needs during the pandemic period, which may motivate them and reduce their workload to improve their work/life balance and their performance.

Safeguarding the safeguarders: Improving access to supervision

Current workload pressures have meant that some school nurses have been asked to delay safeguarding supervision, even though it is essential to safe and effective practice. Sharon White explains

Determining staffing needs for improving primary health care service delivery in Kaduna State, Nigeria.

Background: The equitable distribution of a skilled health workforce is critical to health service delivery. Kaduna state has taken significant steps to revamp the primary health care system to ensure access to health care for its populace. However, these investments are yet to yield the desired outcomes due to health workforce shortages and the inequitable distribution of those available. Methods: A Workload Indicator for Staffing Need (WISN) study was conducted at Kaduna state's primary health care level. The study focused on estimating staffing requirements; Nurses/Midwives and Community Health Worker practitioners, Community Health Officers, Community Health Extension Workers, and Junior Community Health Extension Workers in all government-prioritised primary health care facilities. A total of ten focal primary health care facilities in Kaduna North Local Government Area (LGA) were included in the study. Results: Findings from the study revealed a shortage of Nurses/Midwives and Community Health Workers across the study facilities. For the Nurse/Midwife staffing category, nine of the ten PHCs have a WISN ratio < 1, indicating that the number of staff in the Nurse/Midwife category is insufficient to cope with the workload. In two of the ten primary health care facilities, there is an excess in the number of CHWs available; a WISN ratio > 1 was calculated. Conclusion: The WISN study highlights staffing needs in Kaduna State's government-prioritised primary health care facilities. This evidence establishes the basis for applying an evidence-based approach to determining staffing needs across the primary health care sector in the State to guide workforce planning strategies and future investments in the health sector. The World Health Organisation (WHO) WISN tool is useful for estimating staffing needs required to cope with workload pressures, particularly in a resource-constrained environment like Kaduna State.

Demands and Resources of the Work–Family Interface among Micro-Entrepreneurs in Chile

This research was designed to test how the demands–resources model is associated with the work–family interface. The present paper focused on time pressure and workload measured according to self-efficacy and personal autonomy as well as the perceptions of satisfaction with that balance. We developed an interpretative qualitative study of the meaning of the work–family interface by concentrating on the paradoxes that emerge from this relationship and from the bidirectionality. A qualitative methodology was used, and data were obtained through 44 semi-structured interviews with male and female micro-entrepreneurs from Chile who were selected according to inclusion criteria such as sex and type of micro-entrepreneur as well as their work–family balance. The interviewees had different family configurations. The results show that the group developed dual perceptions of the interface, with workload and time pressure becoming resources, and these aspects could be managed in their favor to reinforce the development of other personal resources such as autonomy and self-efficacy. The interviewees also made analytical adjustments to context sequences so that demands could be resolved subjectively by turning them into resources that provide meaning to the actions and give legitimacy to their personal decisions. The study contributes to the literature by providing a better understanding of the perceptions of micro-entrepreneurs regarding the positive connections between family and work and the negative consequences of the conflict to redefine the demands–resources model.

Sustainability of the Collaborative Chronic Care Model in Outpatient Mental Health Teams Three Years Post-Implementation: A Qualitative Analysis.

Our goal was to investigate the sustainability of care practices that are consistent with the collaborative chronic care model (CCM) in nine outpatient mental health teams located within US Department of Veterans Affairs (VA) medical centers, three to four years after the completion of CCM implementation. We conducted qualitative interviews (N = 30) with outpatient mental health staff from each of the nine teams. We based our directed content analysis on the six elements of the CCM. We found variable sustainability of CCM-based care processes across sites. Some care processes, such as delivery of evidence-based psychotherapies (EBPs) and use of measurement-based care (MBC) to guide clinic decision-making, were robustly maintained or even expanded within participating teams. In contrast, other care processes-which had in some cases been developed with considerable effort-had not been sustained. For example, care manager roles were diminished in scope or eliminated completely in response to workload pressures, frontline care needs, or the COVID-19 pandemic. Similarly, processes for engaging Veterans more fully in decision-making had generally been scaled back. Leadership support in the form of adequate team staffing and time to conduct team meetings were seen as crucial for sustaining CCM-consistent care. Given the potential impact of leadership turnover on sustainability in mental health, future efforts to implement CCM-based mental health care should strive to involve multiple leaders in implementation and sustainment efforts, lest one key departure undo years of implementation work. Our results also suggest that implementing CCM processes may best be conceptualized as a partnership across multiple levels of medical center leadership.