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  • 1.
    Alnes, Rigmor Einang
    et al.
    Department of Health Science, Aalesund University College, Aalesund, Norway; Center for Care Research, Steinkjer, Norway.
    Kirkevold, Marit
    Institute of Health and Society, Department of Nursing Science, University of Oslo, Oslo, Norway; Institute of Public Health, Aarhus University, Aarhus, Denmark.
    Skovdahl, Kirsti
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Health Science, Aalesund University College, Aalesund, Norway.
    The influence of the learning climate on learning outcomes from Marte Meo counselling in dementia care2013In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 21, no 1, p. 130-140Article in journal (Refereed)
    Abstract [en]

    AIM:   To identify factors that affected the learning outcomes from Marte Meo counselling (MMC).

    BACKGROUND:   Although MMC has shown promising results regarding learning outcomes for staff working in dementia-specific care units, the outcomes differ.

    METHOD:   Twelve individual interviews and four focus group interviews with staff who had participated in MMC were analysed through a qualitative content analysis.

    RESULTS:   The learning climate has considerable significance for the experienced benefit of MMC and indicate that this learning climate depends on three conditions: establishing a common understanding of the content and form of MMC, ensuring staff's willingness to participate and the opportunity to do so, and securing an arena in the unit for discussion and interactions.

    CONCLUSION:   Learning outcomes from MMC in dementia-specific care units appear to depend on the learning climate in the unit. Implication for nursing management  The learning climate needs attention from the nursing management when establishing Marte Meo intervention in nursing homes. The learning climate can be facilitated through building common understandings in the units regarding why and how this intervention should take place, and by ensuring clarity in the relationship between the intervention and the organization's objectives.

  • 2.
    Antierens, Alain
    et al.
    CNO, BZIO Rehabilitation Hospital, Ostend, Belgium; Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; School of Health Sciences, University of Surrey, Guilford, UK; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland.
    Verhaeghe, Sofie
    Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Myny, Dries
    CNO, BZIO Rehabilitation Hospital, Ostend, Belgium; CNO, OLV van Lourdes Hospital, Waregem, Belgium.
    Van Hecke, Ann
    Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    How much of Toyota's philosophy is embedded in health care at the organisational level? A review2018In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 26, no 4, p. 348-357Article, review/survey (Refereed)
    Abstract [en]

    AIMS: Identify which of Toyota's principles are reported in health care institutions at the organisational level and to identify the type of reported outcomes related to the effectiveness of lean production reported in these studies.

    BACKGROUND: No scientific research has been conducted to determine which of Toyota's principles are embedded in health care systems. This knowledge is needed to perform targeted adjustments in health care.

    EVALUATION: Sixty studies were identified for the final analysis.

    KEY ISSUE(S): Some Toyota Way principles appear more deeply embedded in health care institutions than others are.

    CONCLUSION: Not all principles of Toyota's philosophy and production system were embedded in the studies in this review. The type of reported outcomes at the organisational level was diverse.

    IMPLICATIONS FOR NURSING MANAGEMENT: This literature review increases our knowledge about how many (and which) of the Toyota Way principles are embedded in health care. This knowledge may support reflection by nursing managers about how the full range of lean management principles could be embedded at the managerial and/or operational level.

  • 3.
    Antierens, Alain
    et al.
    CNO, BZIO Rehabilitation Hospital, Ostend, Belgium; Faculty of Medicine and Health Sciences, Department of public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Ireland.
    Verhaeghe, Sofie
    Faculty of Medicine and Health Sciences, Department of public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium.
    Van Hecke, Ann
    Faculty of Medicine and Health Sciences, Department of public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; Staff member Nursing Department, Ghent University Hospital, Belgium.
    Wanted in health care: Lean experts with a broad perspective2019In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, no 6, p. 1332-1336Article in journal (Refereed)
    Abstract [en]

    AIM: To reflect on Lean experts' perspective on components of Lean management in health care and its implications for practice.

    BACKGROUND: The involvement of Lean experts is one of the key success factors of a sustainable Lean transformation in health care.

    EVALUATION: Thirteen Lean experts participated in two focus groups. They all had experience in the implementation of Lean in healthcare organizations.

    KEY ISSUES: Lean experts all seem to have a unique perspective on Lean management in health care. Experts without a healthcare degree appear to focus more on the entire management system, where experts with a nursing degree seem to concentrate more on the soft Lean principles.

    CONCLUSION: The description of Lean and its components in health care differed between Lean experts. Their professional background appears to have an influence.

    IMPLICATIONS FOR NURSING MANAGEMENT: In selecting a Lean expert, nurse managers may want to gauge what elements the Lean expert tends to emphasize. It seems plausible to opt for a Lean expert without a healthcare degree to accomplish the Lean transformation as they have a broader view on Lean. It may also be useful for managers to involve several Lean experts, all with complementary perspectives and backgrounds.

  • 4.
    Blomberg, Karin
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Isaksson, Ann-Kristin
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Allvin, Renée
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Clinical Skills Centre, Örebro University Hospital, Örebro, Örebro.
    Bisholt, Birgitta
    Department of Nursing, Karlstad University, Karlstad, Sweden.
    Ewertsson, Mona
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Kullén Engström, Agneta
    School of Health, University of Borås, Borås, Sweden.
    Ohlsson, Ulla
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Sundler, Annelie Johansson
    School of Life Sciences, University of Skövde, Skövde, Sweden.
    Gustafsson, Margareta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Work stress among newly graduated nurses in relation to workplace and clinical group supervision2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 1, p. 80-87Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to investigate occupational stress among newly graduated nurses in relation to the workplace and clinical group supervision.

    Background: Being a newly graduated nurse is particularly stressful. What remains unclear is whether the workplace and clinical group supervision affect the stress.

    Method: A cross-sectional comparative study was performed in 2012. Data were collected by means of a numerical scale measuring occupational stress, questions about workplace and clinical group supervision. One hundred and thirteen nurses who had recently graduated from three Swedish universities were included in the study.

    Results: The stress was high among the newly graduated nurses but it differed significantly between workplaces, surgical departments generating the most stress. Nurses who had received clinical group supervision reported significantly less stress. The stress between workplaces remained significant also when participation in clinical group supervision was taken into account.

    Conclusions: Newly graduated nurses experience great stress and need support, especially those in surgical departments. Nurses participating in clinical group supervision reported significantly less stress.

    Implications for nursing management: It is important to develop strategies that help to adapt the work situation so as to give nurses the necessary support. Clinical group supervision should be considered as an option for reducing stress.

  • 5.
    Hägglund, Doris
    Örebro University, School of Health and Medical Sciences.
    District continence nurses' experiences of their continence service in primary health care2010In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 18, no 2, p. 225-233Article in journal (Refereed)
    Abstract [en]

    Aim The aim of the present study was to describe district continence nurses' experiences of providing continence services in primary care. Background It has been stated that there is too little research on the experiences of district care nurses who provide continence services. Method Twenty-two district continence nurses answered a written questionnaire containing three open-ended main questions. A qualitative content analysis method was used to analyse the texts. Results The district continence nurses' feelings of maintaining their professionalism were promoted by scheduled patient encounters, patients who participate in assessment of urinary incontinence (UI) and functioning teamwork. The opposite situation, nurses' feelings of having a lesser degree of professionalism, was associated with not having scheduled patient appointments, patients not participating in assessment of UI and lack of teamwork. Conclusions The district continence nurses lacked the authority to start nurse-led continence clinics because of the lack of collaborative teamwork, an organization that did not enable nurse-led scheduled appointments and nurses' limited view of their own profession. Implications for nursing management Primary health care managers and policy-makers need to provide an environment that enables interprofessional collaboration so that nurses' skills can be used to advance patient services; such initiatives could enable district continence nurses to reach their full potential.

  • 6.
    Kihlgren, Annica
    et al.
    Centre for Nursing Science, Örebro University Hospital, Örebro; Nuerotec Department, Division of Gerontological Caring Science, Karolinska Institutet, Stockholm.
    Forslund, Kerstin
    Örebro University, Department of Nursing and Caring Sciences. Centre for Nursing Science, Örebro University Hospital, Örebro.
    Managements' perception of community nurses' decision making processes when refering older patients to an emergency department2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 6, p. 428-436, article id PMID16919120Article, review/survey (Refereed)
    Abstract [en]

    In Sweden, older adults are living and being cared for under the responsibility of their respective community. Extensive reorganizations in the community led to management having different backgrounds, which may have caused uncertainty among community nurses, especially in decision-making processes. The aim was to understand how 10 nurses, 10 doctors and 10 home care assistants as leaders for the nurses conceptualized the decision-making processes of community nurses, when referring older persons to Emergency Departments, and whether perceptual differences and/or similarities exist. Narrative interviews and content analysis were performed. The managers had differing views, but all felt there was a need to feel secure in order to trust professional decisions as being correct, thus avoiding inappropriate referrals. Management could see nursesexposed position, but had varying solutions. This might lead to different messages being given regarding what is important and might explain why the nurses reported that the managers did not understand them.

  • 7.
    Kihlgren, Annica
    et al.
    Karolinska institutet, Stockholm.
    Forslund, Kerstin
    Örebro University, Department of Health Sciences.
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Managements' perception of community nurses' decision-making processes when referring older adults to an emergency department2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 6, p. 428-436Article in journal (Refereed)
    Abstract [en]

    In Sweden, older adults are living and being cared for under the responsibility of their respective community. Extensive reorganizations in the community led to management having different backgrounds, which may have caused uncertainty among community nurses, especially in decision-making processes. The aim was to understand how 10 nurses, 10 doctors and 10 home care assistants as leaders for the nurses conceptualized the decision-making processes of community nurses, when referring older persons to Emergency Departments, and whether perceptual differences and/or similarities exist. Narrative interviews and content analysis were performed. The managers had differing views, but all felt there was a need to feel secure in order to trust professional decisions as being correct, thus avoiding inappropriate referrals. Management could see nurses' exposed position, but had varying solutions. This might lead to different messages being given regarding what is important and might explain why the nurses reported that the managers did not understand them.

  • 8.
    Persenius, Mona
    et al.
    Faculty of Health, Science, and Technology, Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Hall-Lord, Marie-Louise
    Faculty of Health, Science, and Technology, Department of Health Sciences, Karlstad University, Karlstad, Sweden; Department of Nursing, Gjøvik University College, Elverum, Norway.
    Wilde-Larsson, Bodil
    Faculty of Health, Science, and Technology, Department of Health Sciences, Karlstad University, Karlstad, Sweden; Department of Nursing, Hedmark University College, Elverum, Norway.
    Carlsson, Eva
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Quality and Patient Safety, Lindesberg Hospital, Lindesberg, Sweden.
    Clinical nursing leaders' perceptions of nutrition quality indicators in Swedish stroke wards: a national survey2015In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 23, no 6, p. 705-715Article in journal (Refereed)
    Abstract [en]

    Aim To describe nursing leaders’ perceptions of nutrition quality in Swedish stroke wards.

    Background A high risk of undernutrition places great demand on nutritional care in stroke wards. Evidence-based guidelines exist, but healthcare professionals have reported low interest in nutritional care. The Donabedian framework of structure, process and outcome is recommended to monitor and improve nutrition quality.

    Method Using a descriptive cross-sectional design, a web-based questionnaire regarding nutritional care quality was delivered to eligible participants.

    Result Most clinical nursing leaders reported structure indicators, e.g. access to dieticians. Among process indicator s, regular assessment of patients’ swallowing was most frequently reported in comprehensive stroke wards compared with other stroke wards. Use of outcomes to monitor nutrition quality was not routine. Wards using standard care plans showed significantly better results.

    Conclusion Using the structure, process and outcome framework to examine nutrition quality, quality-improvement needs became visible. To provide high-quality nutrition, all three structure , process and outcome components must be addressed.

    Implications for nursing management The use of care pathways, standard careplans, the Senior Alert registry, as well as systematic use of outcome measures could improve nutrition quality. To assist clinical nursing leaders in managing all aspects of quality, structure, process and outcome can be a valuable framework.

  • 9. Prenkert, Frans
    et al.
    Ehnfors, Margareta
    Örebro University, Department of Nursing and Caring Sciences.
    A measure of organizational effectiveness in nursing management in relation to transactional and transformational leadership: a study in a Swedish county hospital.1997In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 5, no 5, p. 279-87Article in journal (Refereed)
    Abstract [en]

    This paper presents an empirical study of the influences of transactional (TA) and transformational (TF) leadership on organizational effectiveness (OE), measured as the degree of goal attainment and the quality of nursing care (NQ). The study subjects were all head-nurses and assistant head-nurses at a medium-sized hospital in Sweden (n = 23). The methods used were questionnaires and interviews. The multi-leadership questionnaire earlier developed by Bass was modified and named the Leadership Nursing-Effectiveness Questionnaire (LNEQ), comprising 84 items using Likert-type scales. The study showed low mean scores on OE (2.19) and TA (1.05) but high mean scores on NQ (3.17) and TF (3.84). The results suggest that the degree of TA and TF leadership had a low and insignificant connection with OE in this hospital organization. The study did not support the statement that organizational units exposed to a higher degree of TA and TF leadership at the same time show a high degree of OE, as has been shown in studies in other cultural contexts and organizations.

  • 10.
    Silén, Marit
    et al.
    Faculty of Health and Occupational Studies, University of Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    Svantesson, Mia
    Örebro University, School of Health Sciences. Örebro University Hospital. Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
    Impact of clinical ethics support on daily practice: First-line managers' experiences in the Euro-MCD project2019In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834Article in journal (Refereed)
    Abstract [en]

    AIM: To explore first-line managers' experiences of what Moral Case Deliberation (MCD) has meant for daily practice, to describe perceptions of context influence and responsibility to manage ethically difficult situations.

    BACKGROUND: In order to find measures to evaluate MCD, the European Moral Case Deliberation Outcome instrument (Euro-MCD) was developed and is now in the stage of revision. For this, there is a need of several perspectives, one of them being the managerial bird-eye perspective.

    METHOD: Eleven first-line managers at workplaces, participating in the Euro-MCD project, were interviewed and thematic analysis was applied.

    RESULTS: Managers' experiences were interpreted as enhanced ethical climate: a closer-knit and more emotionally mature team, morally strengthened individuals, as well as ethics leaving its marks on everyday work and morally grounded actions. Despite organisational barriers they felt inspired to continue ethics work.

    CONCLUSION AND IMPLICATIONS: This study confirmed, but also added ethical climate aspects, such as morally grounded actions. Furthermore, adding ethical climate as a construct in the Euro-MCD instrument should be considered. First-line managers need clear directives from their managers that ethics work needs to be prioritised for the good of both the staff and the patients.

  • 11.
    Van Hecke, Ann
    et al.
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Goemaes, Regine
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Beyers, Wim
    Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium.
    Decoene, Elsie
    Cancer Centre, Ghent University Hospital, Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Ireland.
    Leadership in nursing and midwifery: Activities and associated competencies of advanced practice nurses and midwives2019In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, no 6, p. 1261-1274Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the practice profile and competencies of advanced practice nurses (APNs) and midwives (AMPs), and factors associated with task non-execution.

    Background: Advanced practitioner roles are increasingly implemented internationally. Unofficial role introduction led to confusion regarding task performance. Studies examining associations between APNs'/AMPs' task performance and competency levels, and factors associated with task non-execution are lacking.

    Method: A cross-sectional study among APNs/AMPs in Flanders (Belgium) explored tasks and competencies in seven domains: clinical/professional leadership, change management/innovation, research, clinical expertise/guidance/coaching, consultation/consultancy, multidisciplinary cooperation/care coordination and ethical decision-making. Task performance and competency level frequencies were calculated. Regression analysis identified factors associated with task non-execution on domain/item level.

    Results: Participants (n = 63) executed tasks in all domains. Task non-execution related to research and clinical expertise was associated with work setting; task non-execution regarding care coordination and ethical decision-making was associated with competency perception. Several tasks were performed by few APNs/AMPs despite many feeling competent. Five of ten tasks performed by fewest participants belonged to the leadership domain.

    Conclusion and implications for nursing and midwifery management: Supervisors could play an important part in APNs'/AMPs' role development, especially regarding leadership and tasks executed by few participants. Future studies should provide in-depth knowledge on task non-execution.

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