Wen Yin Chang

Job satisfaction and perceptions of quality of patient care, collaboration and teamwork in acute care hospitals

AIM This paper is a report of a study conducted to compare levels of job satisfaction and perceptions of the quality of patient care, collaboration and teamwork among healthcare professionals in four acute care hospitals and to determine the factors associated with job satisfaction for physicians, nurses and other healthcare professionals. BACKGROUND Positive inter-professional relationships improve quality of patient care and staff job satisfaction. Understanding how healthcare professionals perceive their relationships with each other, and identifying factors that affect their job satisfaction and perceptions of the quality patient care, inform quality improvements. METHOD This cross-sectional survey study was conducted in four hospitals in Taiwan. Data were collected in 2007 and analysed using descriptive statistics, one-way anova with the Games-Howell post hoc test and stepwise regression analysis. RESULTS The survey was completed by 1475 respondent, giving a response rate of 52.2% (180 physicians, 1019 nurses and 276 other healthcare professionals). Physicians were more satisfied with their jobs (F = 26.75, P < 0.05) than either nurses or other healthcare professionals. Conversely, nurses perceived more positive collaborative relationships than did physicians or other healthcare professionals (F = 279.51, P < 0.05). Stepwise regression analysis demonstrated that perceptions of quality of patient care and collaborative relationships were the most important predictors of job satisfaction for healthcare providers. CONCLUSION These findings provide important clues for improving interdisciplinary collaboration and ensuring quality patient care through good job satisfaction and teamwork among healthcare professionals in acute care hospitals.

Evaluation of work stress, turnover intention, work experience, and satisfaction with preceptors of new graduate nurses using a 10-minute preceptor model

BACKGROUND Preparing new graduate nurses (NGNs) to achieve standards of nursing competence is challenging; therefore, this study developed and evaluated the effects of a 10-minute preceptor (10MP) model for assisting NGNs in their professional development and increasing their retention in hospitals. METHOD A repeated-measures design study, with an intervention and a two-group comparison, was conducted. A total of 107 NGNs participated in the study. At day 7, work stress and work experience were moderately high for the NGNs in both the 10MP and traditional preceptor model (TPM) groups. RESULTS The preceptorship program showed significant differences between groups (p = 0.001) regarding work stress at months 2 and 3 and work experience at months 1, 2, and 3. The 10MP group reported lower turnover intention and higher satisfaction with the preceptors than the TPM group. CONCLUSION The 10MP model is effective at improving training outcomes and facilitating the professional development of NGNs.

Evaluation of an inpatient fall risk screening tool to identify the most critical fall risk factors in inpatients

AIMS AND OBJECTIVES To evaluate the accuracy of the inpatient fall risk screening tool and to identify the most critical fall risk factors in inpatients. BACKGROUND Variations exist in several screening tools applied in acute care hospitals for examining risk factors for falls and identifying high-risk inpatients. DESIGN Secondary data analysis. METHODS A subset of inpatient data for the period from June 2011-June 2014 was extracted from the nursing information system and adverse event reporting system of an 818-bed teaching medical centre in Taipei. Data were analysed using descriptive statistics, receiver operating characteristic curve analysis and logistic regression analysis. RESULTS During the study period, 205 fallers and 37,232 nonfallers were identified. The results revealed that the inpatient fall risk screening tool (cut-off point of ≥3) had a low sensitivity level (60%), satisfactory specificity (87%), a positive predictive value of 2·0% and a negative predictive value of 99%. The receiver operating characteristic curve analysis revealed an area under the curve of 0·805 (sensitivity, 71·8%; specificity, 78%). To increase the sensitivity values, the Youden index suggests at least 1·5 points to be the most suitable cut-off point for the inpatient fall risk screening tool. Multivariate logistic regression analysis revealed a considerably increased fall risk in patients with impaired balance and impaired elimination. The fall risk factor was also significantly associated with days of hospital stay and with admission to surgical wards. CONCLUSIONS The findings can raise awareness about the two most critical risk factors for falls among future clinical nurses and other healthcare professionals and thus facilitate the development of fall prevention interventions. RELEVANCE TO CLINICAL PRACTICE This study highlights the needs for redefining the cut-off points of the inpatient fall risk screening tool to effectively identify inpatients at a high risk of falls. Furthermore, inpatients with impaired balance and impaired elimination should be closely monitored by nurses to prevent falling during hospitalisations.

Original Research: Physical Activity among Chinese American Immigrants with Prediabetes or Type 2 Diabetes

&NA; Background: Although the benefits of aerobic exercise and strength training for patients with type 2 diabetes have been studied extensively, research on physical activity among Chinese American immigrants diagnosed with prediabetes or type 2 diabetes has been limited. Purpose: We sought to learn more about this populations knowledge of physical activity, the types and intensity levels performed, and the barriers to such activity. Design and methods: A concurrent mixed-methods design was used. The short version of the International Physical Activity Questionnaire–Chinese was used to quantitatively measure participants’ levels of exercise intensity. Semistructured face-to-face interviews were conducted to obtain qualitative information regarding participants’ knowledge about physical activity, the types performed, and the barriers to such activity. Results: A total of 100 Chinese American immigrants were recruited for the study from January to July 2012 in New York City. On average, participants had lived with a diagnosis of prediabetes or type 2 diabetes for 3.3 years and had lived in the United States for 21.5 years. Energy expenditure was measured in metabolic equivalent of task (MET) units; intensity was measured in cumulative MET-minutes per week. The mean total intensity score was 2,744 MET-minutes per week. This was achieved mainly through walking. The mean intensity score for walking was 1,454 MET-minutes per week; the mean duration was 79 minutes per day. Vigorous physical activity was least common. The mean intensity score for vigorous physical activity was 399 MET-minutes per week, and the mean duration was 17 minutes per week. Regarding types of physical activity, the most common were housekeeping, walking up stairs, and taking walking or stretching breaks every hour during the workday. Based on the interviews, three themes emerged regarding barriers to moderate or vigorous physical activity: insufficient education about physical activity, health concerns about physical activity, and work-related barriers to physical activity. Conclusions: The majority of Chinese American immigrants with prediabetes or type 2 diabetes do not engage in sufficient physical activity, performing at a rate significantly below that of the general U.S. population. Increases in the intensity and duration of physical activity should be promoted as part of diabetes management for Chinese American immigrants.