Greg Rickard

Psychosocial safety climate as an antecedent of work characteristics and psychological strain: A multilevel model

Abstract Psychosocial safety climate (PSC) refers to a specific organizational climate for the psychological health of workers. It is largely determined by management and at low levels is proposed as a latent pathogen for psychosocial risk factors and psychological strain. Using an extended Job Demands-Control-Support framework, we predicted the (24 month) cross-level effects of PSC on psychological strain via work conditions. We used a novel design whereby data from two unrelated samples of nurses working in remote areas were used across time (N=202, Time 1; N=163, Time 2), matched at the work unit level (N= 48). Using hierarchical linear modelling we found that unit PSC assessed by nurses predicted work conditions (workload, control, supervisor support) and psychological strain in different nurses in the same work unit 24 months later. There was evidence that the between-group relationship between unit PSC and psychological strain was mediated via Time 2 work conditions (workload, job control) as well as Time 1 emotional demands. The results support a multilevel work stress model with PSC as a plausible primary cause, or “cause of the causes”, of work-related strain. The study adds to the literature that identifies organizational contextual factors as origins of the work stress process.

International partnerships and the development of a Sister Hospital Programme

BACKGROUND Despite some progress in meeting the Millennium Development Goals, there are still major discrepancies in health service provision between developed and developing countries. Nurses are key players to improving the quality of health services. Increasingly, partnerships are being initiated between nurses of different countries to enable those working in developing countries to improve standards of clinical care. AIM This paper describes a partnership between two major teaching hospitals: one in Indonesia and one in Australia, designed to assist in improving standards of clinical care within the Indonesian hospital. METHODS The nature of the partnership, conceptualized as a Sister Hospital Program, is described. The processes and outcomes of the pilot programme conducted in 2011 are outlined. A brief description of the methods used to gain financial support from the Northern Territory Government is provided. The programme offered a skills development programme for selected staff from Sanglah General Hospital in Bali at Royal Darwin Hospital in northern Australia. INSTRUMENTS The paper uses Greens PROCEED-PRECEDE framework both to describe and evaluate the pilot programme. RESULTS The skills development programme was enthusiastically evaluated by staff from both hospitals and has led to major changes in the management of patients within the Emergency Department of Sanglah General Hospital. The success of the pilot has resulted in longer-term funding by the Australian government. WIDER POLICY OUTCOMES: The partnership model described in the paper is submitted as a possible framework for others wishing to build long-term and collaborative relationships between nurses of different nations.

Burn care and rehabilitation in Australia: health professionals’ perspectives

Abstract Objective: To understand health professionals’ perspectives of burn care and rehabilitation. Design: Qualitative and semi-structured interviews. Setting: Australian burn and rehabilitation units. Participants: Twenty-two clinicians working in burns units across disciplines and healthcare settings. Results: The data portrayed the health professionals’ perspectives of burn care and rehabilitation in Australia. Three themes were identified: (1) interprofessional collaboration; (2) integrated community care, and (3) empowering patients to self-care. Conclusion: Burn care and rehabilitation remains a complex and a challenging area of care with limited access to burn services especially in rural and remote areas. Interprofessional training and education of health professionals involved with the complex care of burn injury remains a key element to support and sustain the long-term rehabilitation requirements for patients and their families. Empowering patients to develop independence early in their rehabilitation is fundamental to their ongoing recovery. A burns model of care that embraces a multidisciplinary collaboration and integrated care across the continuum has the potential to positively impact recovery and improve health outcomes. Implications for rehabilitation Burn care and rehabilitation remains a complex and challenging area of care. Managing the rehabilitation phase after burn injury can be as complex as managing the acute phase. Interprofessional collaboration, integrated community care, and empowering patients to self-care are key elements for sustaining the rehabilitation of adults with burn injuries.