Leila Karimi

A randomized‐controlled trial comparing cadexomer iodine and nanocrystalline silver on the healing of leg ulcers

Chronic leg ulcers are a debilitating, often painful, and costly condition. Leg ulcer healing may be impaired by bacterial colonization, which, unless effective intervention is instigated, can lead to infection. Although it is generally agreed that an antimicrobial dressing is clinically indicated when a wound becomes critically colonized, there is currently no agreement on what constitutes the best practice in the use of antimicrobials. This research compared the effectiveness of two commonly used antimicrobials: nanocrystalline silver and cadexomer iodine. A randomized‐controlled trial was conducted in which 281 community nursing clients with leg ulcers compromised by bacterial burden were randomly assigned to have their wounds treated with either silver or iodine dressings. Sixty‐four percent of ulcers healed within 12 weeks. The performance of each of the two antimicrobials was comparable in terms of overall healing rate and the number of wounds healed. However, use of silver compounds was associated with a quicker healing rate during the first 2 weeks of treatment and in wounds that were larger, older, and had more exudate. This trial provides some insights as to circumstances in which one product may be preferred over the other.

The role of team climate in the management of emotional labour: implications for nurse retention

AIMS This article examines the relationships among emotional labour, team climate, burnout, perceived quality of care and turnover intention among nurses in Australia, with the aim of addressing nurse retention and burnout. BACKGROUND Emotional labour refers to the regulation of emotion during interpersonal transactions. It may involve faking unfelt emotions, hiding genuine emotions and deep acting whereby the individuals attempt to influence their inner feelings to induce the appropriate outward countenance. Currently, there is a dearth of literature that investigates the link between emotional labour and perceived quality of care and ultimately turnover intention. The contribution of team climate in the relationship between emotional labour and burnout is still uncertain. DESIGN A cross-sectional quantitative study conducted with self-completed questionnaires. METHODS The study was conducted in 2011 with 201 registered nurses. Validated measures were used to measure the aforementioned constructs. Confirmatory factor analyses were used to examine the factor structure of the measured variables and hypotheses were tested using structural equation modelling. RESULTS The final model demonstrates that faking has a significant negative influence on perceived quality of care. Hiding predicts burnout, leading to an increase in turnover intention. Team climate moderates the relationship between hiding and burnout, which may subsequently influence turnover intention. CONCLUSION The establishment of a strong team climate may help nurses to manage the emotional demands of their role, promote their well-being and retention.

Social identification: linking high performance work systems, psychological empowerment and patient care

This paper examines the mediating effects of social identification on the relationship between high performance work systems (HPWS) and psychological empowerment and the direct relationship between psychological empowerment and clinician perceptions of quality of patient care. We use structural equation modelling on a sample of 254 health professionals from a large regional hospital in Australia. Results demonstrate, first, a strong effect of HPWS on social identification. Second, social identification mediates the relationship between HPWS and psychological empowerment and, third, psychological empowerment has a strong effect on clinician perceptions of quality of patient care. Implications are drawn for management theory and hospital managers.

Interrater and intrarater reliability of silhouette wound imaging device.

OBJECTIVE: The objective of this study was to investigate the interrater and intrarater reliability of a wound imaging and measurement system called SilhouetteMobile. DESIGN: Interrater and intrarater reliability study. SETTING: Community nursing, Victoria, Australia. PARTICIPANTS: Seven community nurses including Wound Management Clinical Nurse Consultants and Wound Resource Nurses. MAIN OUTCOME MEASURE: Average wound surface area of 14 wound images as captured using a wound imaging and measurement system called SilhouetteMobile. MAIN RESULTS: High interrater and intrarater reliability were maintained across different users and different assessments by the same user and were also found to be unaffected by image quality. Reliability was poor when tracing small wounds. CONCLUSION: Silhouette is a highly reliable tool for wound imaging and measurement, although reliability is reduced when annotating small wound areas.

The effects of emotional intelligence and stress-related presenteeism on nurses’ well-being

Emotional intelligence has long been associated with lower levels of stress and enhanced well-being. This paper contributes empirically by examining the direct and moderating effects of emotional intelligence on the presenteeism and well-being relationship. A sample of 312 registered nurses who provide home-based care in an Australian community nursing service were recruited to take part in the study. Results from structural equation modelling revealed that emotional intelligence has direct and moderating effects on well-being. Stress-related presenteeism significantly predicted nurses’ well-being. These findings provide further support for the positive effects that emotional intelligence can have on the effective management of job stress and the enhancement of nurse well-being. We advocate more nursing training on emotional intelligence, and examine the potential benefits of emotional intelligence training and other related HR initiatives.

Transformational leadership and social identity as predictors of team climate, perceived quality of care, burnout and turnover intention among nurses

Purpose The purpose of this paper is to examine the role of transformational leadership (TL) in developing social identity and its subsequent impact on team climate, intention to leave, burnout and quality of patient care among nurses. Design/methodology/approach Data for this cross-sectional study were collected from a sample of 201 registered nurses in Australia through questionnaires. Structural equation modelling was used to test the hypotheses. Findings Results illustrate that social identification appears to be the psychological mechanism through which TL impacts important employee outcomes, including perceived quality of patient care. Practical implications This study provides valuable insights into understanding the critical role of human resource management (HRM) practice and policy in healthcare environments. Findings from this study indicate that human resource managers can assist nurse unit managers to deliver their HRM roles effectively when adequate support and relevant HRM infrastructures are put in place. Originality/value This research considers the role of first-line nurse managers in healthcare organisations. It provides evidence-based knowledge about the type of leadership style required to achieve desirable employee outcomes and the essential HRM opportunities to facilitate this.

Finding brilliance using positive organizational scholarship in healthcare.

PURPOSE Positive organizational scholarship in healthcare (POSH) suggests that, to promote widespread improvement within health services, focusing on the good, the excellent, and the brilliant is as important as conventional approaches that focus on the negative, the problems, and the failures. POSH offers different opportunities to learn from and build resilient cultures of safety, innovation, and change. It is not separate from tried and tested approaches to health service improvement--but rather, it approaches this improvement differently. The paper aims to discuss these issues. DESIGN/METHODOLOGY/APPROACH POSH, appreciative inquiry (AI) and reflective practice were used to inform an exploratory investigation of what is good, excellent, or brilliant health service management. FINDINGS The researchers identified new characteristics of good healthcare and what it might take to have brilliant health service management, elucidated and refined POSH, and identified research opportunities that hold potential value for consumers, practitioners, and policymakers. RESEARCH LIMITATIONS/IMPLICATIONS The secondary data used in this study offered limited contextual information. PRACTICAL IMPLICATIONS This approach is a platform from which to: identify, investigate, and learn about brilliant health service management; and inform theory and practice. SOCIAL IMPLICATIONS POSH can help to reveal what consumers and practitioners value about health services and how they prefer to engage with these services. ORIGINALITY/VALUE Using POSH, this paper examines what consumers and practitioners value about health services; it also illustrates how brilliance can be theorized into health service management research and practice.

Equine-Assisted Psychotherapy for adolescents experiencing depression and/or anxiety: A therapist’s perspective

Animal-Assisted Interventions (AAIs) are thought to overcome some of the limitations of traditional therapies as they do not rely exclusively on language as a medium for change. One such Animal-Assisted Therapy (AAT) approach involves horses as a therapeutic medium. Equine-Assisted Psychotherapy (EAP) comprises a collaborative effort between a licensed therapist and a horse professional working with clients to address treatment goals. The purpose of the present Australian-based qualitative study was to examine EAP facilitators’ perspectives on the biospychosocial benefits and therapeutic outcomes of EAP for adolescents experiencing depression and/or anxiety. The findings suggest a range of improvements within adolescent clients, including increases in confidence, self-esteem and assertiveness, as well as a decrease in undesirable behaviours. The effectiveness of the therapy was thought to be due to the experiential nature of involving horses in therapy. The lack of understanding in the wider community about EAP was seen as a barrier to recognition and acceptance of EAP as a valid therapeutic intervention.

Come Rain or Come Shine: Supervisor Behavior and Employee Job Neglect

Purpose – The purpose of this paper is to investigate the extent to which supervisor behavior is associated with employees’ job neglect. Design/Methodology/Approach – The paper investigates the extent to which supervisor behavior is associated with employees’ job neglect. Findings – Results from hierarchical regression analyses support the hypothesis that both positive and negative supervisor behaviors have significant effects on job neglect. Negative supervisor behavior was more strongly associated with job neglect than positive supervisor behavior. Research Limitations/Implications – Changing the style of supervision might help to reduce job neglect of employees, benefitting the organization by reducing the associated costs of job neglect and counterproductive behavior. Originality/Value – The findings provide additional evidence for the important effects supervisors can have on employees. They also indicate that – in addition to studying abusive supervision – there is a need to consider the effects of a broad spectrum of supervisor behavior.

Stem Cell Therapy for Parkinson's disease: Are Double-Blind Randomized Control Trials the Best Design for Quantifying Therapy Outcomes?

Randomized controlled trials [RCTs] are recognized as the most rigorous method for evaluating the safety and efficacy of novel interventions. The fact that a series of RCTs evaluating cellular therapies for Parkinson’s disease [PD] resulted in negative outcomes has delayed the translation of stem cell research into viable treatments for people with brain damage. At present, there are a variety of strategies being followed to improve outcomes for cellular therapies, including reassessment of the theory and methodology guiding the research program. In this position paper we present an argument based on empirical and theoretical grounds that the use of double-blind, placebo controlled trials are not the best approach for testing the efficacy of cellular therapies for PD. Evidence includes the highly variable effects of neural grafts found in double blind RCTs in comparison to the much larger benefits in open-label trials for people with PD in double-blind RCT. We suggest that the ambiguity and confusion created about the actual nature of the treatment in the context of a double-blind trial compromises the efforts of participants and their Carers to make the best therapeutic use of the grafted cells. The theoretical grounds for rejecting the use of double-bind RCTs is based on the Composite Brain Theory, which postulates that to insure optimal therapeutic outcomes it is essential to integrate the intracerebral grafting of cells with an active program of neurorehabilitation. We are recommending the use of pragmatic RCTs which involve the comparison of cellular transplantation and rehabilitation with best practice pharmacotherapy or Deep Brain Stimulation as comparison groups. Using a pragmatic trial design will ensure optimal outcomes for each of the treatment groups and produce evidence applicable for identifying best available treatments for people with PD.