QUARTERLY JOURNAL OF NURSING MANAGEMENT
Year:2013 | Volume:2 | Issue:1|Papers Count:7

Introduction: Increased the responsibilities of the professional nurses need to autonomy in their activities. Achievement autonomy in nursing has facing with problems and challenges.Aim: The aim of this study was explored the current challenges in the field of autonomy.Method: An integrative review of evidences based on Broome protocol (2000) conducted in three stage, literature search, data evaluation and data analysis. Databases of SID, Magiran, IranMedex, Irandoc, MEDLINE, EMBACE, EBSCO and CINAHL were searched by key words of professional autonomy and nursing. Of 1230 full text and abstract, finally, 29 articles were chosen based on inclusion criteria: professional autonomy was in text, original research and review studies, internal and outside the country reliable articles, study focuses’ on clinical and professional challenges and access to full text article without any time limit. And exclusion criteria were studies in the field of philosophy, research, education and instrumentation nursing autonomy, and abstract of studies. For data analysis, data extracted from primary sources, after comparing one by one, data integrated, ordered, categorized and summarized.Results: The main challenges were unclear of autonomy definition, use of inappropriate tools for measuring autonomy, absence of a theory related nursing autonomy, poor students education and emphasis on traditional teaching by teachers, failure in collaboration and teamwork, lack of management support and inappropriate management structures, also, hospital size and its impact on organizational structure and the level of nurses’ power.Conclusion: Offered strategies should be ordered to control these challenges. Conducting the extensive researches on reliable tools for accurate diagnosis of challenges in current context and the qualitative research for concept definition and properties are highly effective.

Introduction: Reward systems are very important in organizations for attaining staff satisfaction and organization effectiveness. Therefore, managers’ perception from the effective use of reward system and planning for its effectiveness is essential.Aim: assessing ineffective causes in rewards for nurses from their selves and head nurses’ viewpoints was aim of this study.Method: A case study was conducted in one of the teaching hospital in Zanjan city in 2011 that 9 head nurses and 33 nurses in five in-patients units participated. Data were gathered by two questionnaires; 1) for assessing in-effective factors in rewards with 24 items in 7 domains of rewards management based on Likert scale and the second was internal and external rewards in nurses view points with 17 items that it was yes/no scale. Also, interviews with head nurses were done about how they did rewarding content validity and internal consistency reliability by Alpha- Cronbach were measured that it was more than 0.7%for two questionnaires. Data analyzing was done by descriptive statistics (mean, standard deviation and frequency) and SPSS 17 software. Also, content analysis was used for interviews.Results: Findings showed that rewards were not effective, the majority of nurses believed that rewards were not adequate (97%), did not used their ideas in how rewarding (97%), reward criteria did not careful (97%), non-allocation of valence rewards frequently (96.9%), not considering the variety of rewards (rewards being uniform) (94%), lack of fair distribution of rewards (93.9 %), lack of proper relationship between optimal performance and rewards (78.8%), lack of proper balance between experience of intrinsic and extrinsic rewards.And these cause from the head nurses views were lack of appropriate tools for performance appraisal, reward criteria were overall and subjective and lack of rewards policies.Conclusion: Nurse Managers would be used these findings for releasing the causes as a guideline and for promoting staff motivation and quality of nursing care.

Introduction: The effectiveness of managerial activities and skills of nursing managers have benefits for the health organizations. In this way leadership plays an important role. Studies showed that education is an effective factor on leadership performance and focus on continuous improvement of skills in management.Aim: This study was done to determine the impact of management development program on effectiveness of leadership style of head nurses.Method: This study was a quasi-experimental study of the one group of pre-and post-test design in Amir kabir hospital in Arak. Data were collected by using standard questionnaire LEAD “Leadership Effectiveness and Adaptability Description” with reliability of 0/95.Based on the census, 88 people, that were including19 head nurses and 69 nurses, participated in this study. At first the questionnaires were completed by participants, then The action plan of management development with content of leadership, communication and performance appraisal in methods of lecture, group discussion and presentation of performance scenarios was done and training booklet was given to the head. Second evaluation was performed 2 months after initial assessment. Data analyzing by using SPSS16 and descriptive statistics (frequency, percentage, frequency, mean, standard deviation) and paired t-test analysis was conducted.Results: After the intervention the Mean of effectiveness of leadership style in head nurses through self-evaluation and evaluation by nurses increased; Although paired t test indicated significant differences for effectiveness mean score from nurses, views before and after the intervention (p>0/001); there wasn’t significant differences from head nurses, view.Conclusion: there is a gap between present status and ideal situation that. Defined by scale of effectiveness and adaptability; so, for management development program suggest strategies such as leadership behaviors supervisory, feedback to head nurses, participation of all level of management and modern educational methods.

Introduction: Hemophilia is an inherited bleeding disorder that is sexlinked.Hemophilia has an impact on many aspects of patient and family life. Because of this, need a comprehensive care program and case management.Aim: The evaluation of effect case management program by nurses on quality of life of pre-school children with hemophilia.Method: A semi experimental research was performed at comprehensive hemophilia treatment center during the year 2011-2012.With attention to characteristics of sample 52 pre-school children with hemophilia selected and were randomly divided in two groups (26 case & 26 control).The data collecting tools included the questionnaire of demographic characteristics, hemophilia children’s quality of life (Haemo - Qol).Validity and reliability of the questionnaire were assessed by content validity and alfa-chronbach methods. Quality of life in both groups was assessed before and3months after the intervention in case group. After collecting the pre-intervention data, case management program was performed on the case group based on the five steps of case management process (assessment & problem identification, case plan, implementation, evaluation & follow-up).The data were analyzed using spss16.Results: Test of Chi-Squared revealed that two groups had no significant differences in terms of demographic characteristics (p>0.05). Independent t-test showed that the quality of life total score before intervention hasn’t got a significant difference between two groups (p=0.34). While after intervention the same test indicated a significant difference between the two groups (p=0.00).Paired t-test showed that the quality of life total score before and after intervention in the case group has a significant difference (p=0.00) and the same test hasn’t significant difference in the control group (p=0.26).Conclusion: The findings of study showed that organization, clarity of roles, and follow-up using coordination, management and care roles of nursing result in increased hemophilic children and their parent’s quality of life and it is suggested that in care of patients with hemophilia, this program is applied.

Introduction: Empowerment is a new approach for survival organization in a competitive environment. In order to increase quality and quantity of services which introduce in health care organizations, dimensions of structure in it could be effective on empowering of employees.Aim: The relationship between dimensions of structure of organizational and employees’ psychological empowerment in Mashhad University of Medical Sciences was the aim of this study.Method: This study was a descriptive study that in (2009-2011) in Mashhad University of Medical Sciences was done. All of employees (n=600) in different departments in university (all of teaching hospitals, faculties, health centers and staff deputies) were samples that selected by randomly stratified sampling. For data gather two standardized questionnaires were used; psychological empowerment’s (Spreitzer) and organizational structure’s (Stephen Robbins) that Cronbach’s alpha coefficient was for the first (89.0%) and for dimensions of organizational structure was between (0.71%) to (0.83%).For analysis was used Spearman’s Rank Order correlation coefficient and Kolmogrov Smirnov test by SPSS 11 software.Results: Analysis data showed that there is not any significant relationship between the dimensions of organizational structure and employee empowerment (p=0.28 and r=0.046). Between career and level of education, formalization and sense of meaningfulness of work, formalization and feeling of competence there is a significant relationship (p<0.05).Conclusion: According to results suggests that managers applying strategies for motivating employees who have higher education degree and also, for increasing their empowerment change work environment by job enlargement and enrichment.

Introduction: Patient’s satisfaction is a complicated phenomenon that affected by various factors that the most important of them is nursing care. Various dimensions of nursing care as a fundamental part of health care have an important role on patient’s satisfaction.Aim: The aim of this study was comparison of in- patients’ satisfaction with different domains of nursing care in teaching hospitals at Iran University of Medical Sciences.Method: This descriptive cross-sectional study was conducted on 170 patients in 34 wards of teaching hospitals affiliated to Iran University of Medical Sciences in 2010. Patients were selected randomly. Data were collected by Patient Satisfaction Instrument (PSI). It’s had content validity and internal consistency reliability (Cronbach’s alpha) was 0.90%. Data analyzed using descriptive statistics and ANOVA (Scheffe test), by SPSS15.Results: The findings showed that the highest mean patient’s satisfaction from technical-professional domains was in intensive care wards with the mean 3.90±0.38 of 5, and the lowest value from patient education aspects was in surgical wards with the mean 3.04±0.72 of 5. In relation to other dimensions the“trust” domain between the two groups (surgical and intensive wards) and the ‘technical and professional domain a “between groups (emergency department and intensive ward) there was a statistically significant difference (P<0.05).Conclusion: Although technical-professional care is vital and one of the most important factors in patient’s satisfaction, but it is necessary that nurses for delivering a comprehensive care, based on patients’ needs implement a special caring and educational plans for them by acquiring their trust.

Introduction: The necessary requirements of nursing information systems are nursing classification systems that they have been used for classifying of nursing diagnoses, interventions, and outcomes. But, it is important how these classification systems used in nursing information system.Aim: The aim of this study was application of classification systems in nursing classification systems.Method: This study was an integrative review of literatures that web sites such as the Science Direct, CINAHL, Pubmed, Scirus and Google Scholar databases searched for key word nursing, nursing classification systems, nursing information system, nursing documentation, and nursing informatics.143 articles from 1998 to 2012 were founded. After the initial study, 42 articles were suitable for coating purposes of this study. The inclusion criteria were the relevancy of the articles to the objectives of the study. The content analysis and synthesis of the literature led to organizing this article.Results: The most important applications of classification systems in nursing classification systems were the classifying of nursing-related entities, evidence based decision making, analyzing of the care patterns, building a theoretical body and improving the nursing knowledge. In addition, the classified information could be used for educating, researching, managing, and developing of care approaches and improving the nursing communications.Conclusion: Regarding Classification systems are essential for nursing classification systems should be considered needs of different nursing groups.