[Effect of using designed program based on [expectancy theory] by head nurses on nurses' job satisfaction]

Introduction: One of the nursing challenges is nurses' motivation and job satisfaction. Applying motivational theories by nurse managers might be an effective strategy

The aim of this study was to determine the effect of using designed program based on [Expectancy Theory] by head nurses on nurses' job satisfaction

Materials and Methods: This study was a quasi-experimental study that was done in two hospitals in Zanjan providence. Data were gathered by [Nurses' Job Satisfaction Questionnaire]

In this study, internal consistency reliability [Cronbach's alpha] of the questionnaire was measured [alpha=0.9]. Method of sampling was census and nurses were selected in the case group [n=20] and nurses in the control group [n 19]

They were matched in two groups. The applied program was based on [Expectancy Theory] that implemented in case group for 6 months. Data were analysed by Mann-Whitney, Wilcoxon Chi-Square and SPSS/16 used

Findings: The nurses in two groups were matched [P>0.05]

Job satisfaction before and after in two groups did not different significantly, it showed by using Wilcoxon test [P>0.05]

But findings showed that nurses' job satisfaction in case group increased 7%

Conclusion: The program based on "Expectancy Motivational Theory" had clearly implementation steps for applying this theory that it would be practical guide for nurse managers. Use of this theory for improving nurses' job satisfaction is suggested

[ effect of retraining program competency based planning on nurses practice in cardiopulmonary resuscitation in emergency department]

Introduction: According to technology progress towards and growth in medical sciences on cardio-pulmonary resuscitation, nursing human-forces training and education in emergency department seem to be necessary. Therefore, the present study was conducted on of retraining program competency based planning for nurses practice on cardio-pulmonary resuscitation in emergency department

Method: This study is semi-experimental type, sampling non-random, carried out on case [15 nurse] and control [15 nurse] groups in training hospital dependent to Golestan University of Medical Sciences. Data gathered by using of nurse practice observational Questionnaire on cardio-pulmonary resuscitation. Re-training program competency based was planning and implemented based on re-training planning principles as well as competency-based training [CBT] basic steps on cardio-pulmonary resuscitation of case group. Data were gathered from two steps including the previous step and 4-month following experiment on case and control groups separately and analyzed in SPSS16 software using descriptive statistics [Frequency, mean, standard deviation] and inferential statistics [Mann-Whitney, Chi-square, Wilcoxon]

Results: Chi-square statistical test showed that no significant differences were found in terms of demographic variables such as age, sex, job experience, … between two groups [P>0.05]. Mann-Whitney test was revealed that nurses performance dimensions on cardio-pulmonary resuscitation was found to be different between two groups [P<0.05]. Also, Mann-Whitney test, showed significant differences between total nurses performance scores on cardio-pulmonary resuscitation between two groups following 4-months duration [P<0.05]

Conclusion: Findings these study to revealed, applying re-training program competency based is effective on the nurses practice on cardio-pulmonary resuscitation and advancement about 40 percent up to the nurses practice emergency department. So it is suggested that re-training program competency based to be applied as nursing human-forces training in emergency department

[ effect of implementing clinical supervision model on the patient education outcomes]

Applying proper supervision model is an important factor in promoting the outcomes of the patient education which improves nursing care. The aim of this study was to assess the effect of Clinical Supervision Model on the outcomes of implementing patient education. [Patients' Attitude Toward Education by nurses, patient satisfaction from nurses' education and quality of patient education documentation]. This quasi-experimental study was conducted using static groups' comparison in which the control and experiment groups were compared by a posttest. Study samples included 72 patients who were matched and assigned into two distinct groups. Clinical Supervision Model was implemented through three steps in 3 wards of Samen-al-Aemme hospital in Mashhad for 6 months. The data were gathered by instruments including patient demographic information, patients' Attitude toward Education by Nurses Questionnaire, Patient Satisfaction from Nurses' Education Questionnaire and Quality of Patient Education Documentation check list. Validity of instruments was measured by content validity and reliability by split half and inter-rater. Data was gathered through interview and observation methods and analyzed by SPSS 11.5 software. The results showed significant difference in the quality of patient education documentation before and after implementing Clinical Supervision Model [P=0/0001]. Furthermore, results showed significant difference between patient satisfaction before and after implementing Clinical Supervision Model [P =0/02]. However there were not any significant differences between patients' attitude toward education before and after implementing Clinical Supervision Model Implementation of Clinical Supervision Model can develop nurses' knowledge and skills in patient education through organizing, implementing, and feedback. More studies are required in order to assess the effect of this model on other aspects of nurses' practice

[Managerial competencies of charge nurses]

The charge nurse role has received little attention in the nursing literature when compared with other nursing leadership positions. Although many hospitals have charge nurse position, there is a lack of clear guidelines concerning the role, competencies needed for optimum role performance, and criteria for evaluating performance. The aim of this study was to determine competencies necessary to be a successful charge nurse A descriptive study was conducted by a questionnaire comprising basic data and charge nurse competencies. The questionnaire was designed based on the literature and 61 competency statements were grouped into the following six categories: clinical/technical, planning, organizing, staffing, directing/leadership and controlling/supervision. Marquis and Huston's framework of the management process model were used to categorize the competency statements of management. The census sampling method was used to recruit the subjects. The questionnaire was returned by 96 subjects including 66 charge nurses, 20 head nurses and 10 supervisors working in selected teaching hospitals in Arak city. Data were analyzed by SPSS 13 and descriptive statistics. All competency items received mean scores of more than 4.05. The items controlling/supervision and directing/leadership were evaluated more important than staffing, planning, organizing and clinical/technical items. The results of this study provide guidelines for management development programs, training, and career planning for charge nurses, and can also provide guidelines for recruiting and selecting effective charge nurses

[ Survey the effect of planned program of health promotion on stress management in middle-aged women]

There are many physiological and psychological stresses in Middle-age, which can have significant effect on mortality and suffering from a disease in women. So considering stress management in the form of a program is very important. This study aims at investigating effect of planned program of health promotion on stress management in middle-aged women. This research was a semi-experimental study and done with two groups of case [50 people] and control [41 people] were selected by convenience sampling. planned program of health promotion was performed on three stages: identification and investigation, supportive planning and evaluation of programs performing and giving feedback. Tools used to data collection in this research included: demographic information questionnaire and health promotion lifestyle profile 2 [HPLP2] questionnaires which completed by the case and control groups before and one and a half months after intervention. The finding showed that before intervention ,no meaningful important statistical difference was observed average numbers of stress management and spiritual improvement between case and control groups [P>0.05]. While after intervention according to independent t-test showed that there is a meaningful statistical difference in average numbers [P<0.05]. This difference was also meaningful before and after intervention in case group. Performing planned program of health promotion has been effective on stress management in middle-aged women and is suggested as a good program in mental health of middle-aged women

[Clinical supervision in rocky roads]

Introduction: Clinical supervision is an essential way of support and advances professional roles of nurses. Clinical supervision includes objectives and positive functions and is an effective support system within many challenges in nursing. The aim of this study was to investigate factors affecting processes of clinical supervision from perspectives of nurses

Methods: In this qualitative and content analysis study, 18 participants including supervisors and nurses were selected purposively. Data were collected using semi-structured interviews, document reviews, and observations. Data were collected from September 2009 to October 2010. Data were analyzed using content analysis method

Results: The results of the study showed that implementation of clinical supervision by supervisors were affected by individual and organizational dimensions. In the individual dimension three themes were emerged: 1] supervisors' individual competencies; 2] supervisees' individual competencies; and 3] interaction between the supervisors and the supervisees. The organizational dimension had four themes: 1] high work load; 2] complex nature of clinical supervision; 3] non-effective organization in supervising; and 4] inappropriate fields for monitoring

Conclusion: According to the findings, several factors influenced clinical supervision including personal characteristics of supervisors and supervisees, complex nature of clinical supervision and environmental factors in hospitals. Understanding the different perceived dimensions of clinical supervision can help nurse managers to implement effective clinical supervision

[Barrier to forming and implementing academic service partnership in nursing; A qualitative study]

Clinical education is the responsibility of all those involved in delivering health care. As an international trend the development and implementing the partnership clinical education models is on the rise. To create a partnership program, it is needed to involve all the stakeholders in the planning and implementing and evaluation of this program so this study was investigate barrier to forming and implementing academic service partnership in nursing from the perspective of the all key stakeholders. This study was based on qualitative research method. A total of 15 nursing students, clinical educator, clinical nurses and nurse managers participated voluntarily in this study. Sampling was started purposefully and continued with snow-ball method. Data was obtained through semi-structured interviews, which recorded and subsequently transcribed. The analysis was carried out by qualitative content analysis method. Findings of the study yielded four significant themes. These include [1] organizational divergency [2] Overemphasizing on theory knowledge [3] Invisible wall. The process of development of the academic service partnership can be facilitated by defining a formal organizational relationship between academic and service institutes, clarifying roles and responsibilities of each staff institute regarding Clinical education, defining the clinical practice roles for nursing faculty members and emphasizing on the importance of nursing clinical practice

[Effect of situational leadership in clinical education on communication competency of nursing students]

Communication is one of the basic concepts which nursing students must learn. Nurse instructors' behaviors have key role on effective clinical education. The aim of this study was to assess the effect of situational leadership model on nursing students' communication competency. In this before-after trial, we recruited the students who had medical and surgical practicum in the second semester and summer of 1385-86 in public hospitals in Arak. They were selected randomly and then allocated to case [n=40] and control [n=35] groups. In the first week of practicum [before], we measured the students' communication competency using a self-structured questionnaire. For intervention, we defined behavioral objectives and designed a diagnosis form for identifying level of maturity and a feedback form for the students. After orientation of the students with behavioral objectives, we accompanied with main instructors based on their maturity levels in caring and applied effective leadership style. Along with the practicum period, we supervised the students' level of maturity in different nursing care skills. In the end [after], we measured the students' competency. We analyzed the data in SPSS, version 13. The results showed that there was significant difference before and after the intervention [P<0.001]. Also, there was significant difference between two groups [P<0.001]. Self-evaluation showed no significant differences between students' competency in two groups [P=0.335]. The situational leadership model would promote nursing students' communication competency

[Effective clinical instructor: a qualitative study]

Nursing is a practicing discipline. Clinical instructors need to acquire competence of an effective clinical instructor in order to make students ready to face the real world of providing care. Such characteristics get affected by socio-cultural background. In spite of many international quantitative studies, such characteristics haven't been defined clearly yet. The present study, therefore, aimed at investigating effective clinical instructor characteristics from the perspective of students and clinical instructors, qualitatively. Using qualitative method, semi-structured interviews were conducted with ten students and clinical instructors. All interviews were reordered and transcribed. The data were analyzed using constant comparative methods through qualitative content analysis method. Following themes were identified in data analysis: [1] recognition; [2] making clinical environments attractive; [3] communication skills; [4] clinical competencies [5] personal trait and [6] role model. Effective clinical instructors attract students to clinical education by identifying effective factors on clinical education, applying innovative methods in education, implement theoretical content in practice and having patient-center approach. They play as a role model for students with regard to their altruism, communication skills and having clinical competencies

[ effect of guided reciprocal peer questioning [GRPQ] on nursing students' critical thinking and metacognition skills]

Fostering critical thinking and Metacognition is one of the most important objectives in nursing education. This study was designed to investigate the effect of guided reciprocal peer questioning on nursing students' critical thinking and Metacognition skills. In this quasi experimental study, the experiment group included 30 nursing students in their 6th semester in Birjand Islamic Azad University. Two credit courses were presented in this group using guided reciprocal peer questioning. In the control group which included 28 nursing students, those two credit courses were presented using the routine lecture method. California Critical Thinking Skills Test [CCTST] [form B] was used for evaluating critical thinking skills, and metacognition was evaluated before and after intervention by metacognitive awareness questionnaire. The statistical analysis was done by SPSS software. Descriptive statistics, t-independent test, paired t-test; Chi-square, Mann Whitney, and Kappa were used in this study. Performing guided reciprocal peer questioning led to a significant increase in critical thinking skills scores in the experiment group compared to the control group. In spite of the increase in the mean score of metacognitive awareness of the experiment group, comparing the mean difference of pre and post tests in the two groups showed no significant difference. Using guided reciprocal peer questioning in the education of nursing students may lead to developing critical thinking skills as one of the important missions of higher education

[Clinical supervision system: a method for improving educational performance of nursing personnel]

Employing supervision methods which focuses on educational aspects may increase the effectiveness of nursing personnel's educational activities, especially patient education. The aim of this study was to investigate the effect of clinical supervision on the effectiveness of nurses' educational performance. This quasi-experimental study was conducted using static groups' comparison in which the control and experiment groups were compared by a post-test. Study samples included 72 patients who were matched and assigned into two distinct groups. Clinical supervision system was implemented through three steps in 3 wards of Samen-al-Aemme hospital in Mashhad for 6 months. The data gathering tool included patient information sheet, patient satisfaction from nurses' educational practice and rating scale of self-care knowledge and practice of patients. Data was gathered through interview and observation methods and analyzed by SPSS software. The mean scores of self-care knowledge and practice of the patients were 30.6 and 57.1 out of 100, in the control and experiment groups, respectively. The mean score of patients' satisfaction from nurses' educational practice was 19.6 in the control group and 20.9 in the experiment group, out of 24. So that, independent t-test showed a significant difference between these two groups. Implementing clinical supervision system through observation, feedback, discussion, and investigation, may develop nurses' knowledge and professional skills in patient education. Therefore, this supervision method could be regarded as an effective model for in-service education. More studies are required in order to investigate the effect of this model on other aspects of nurses' practice

[Organizing "nursing mentors committee": an effective strategy for improving novice nurses' clinical competency]

One of the most significant problems in clinical environment is the unskilled and inexperienced nurses. This is while, most managers are not aware of nurses' proficiency and competency level. Therefore, applying the new strategy of "organizing nursing mentors committee" by managers as well as their orientation in this regard could be considered as a strategy to improve clinical competency. This quasi-experimental study as two group design was performed to assess the clinical competency level of five novice nurses and their performance on 72 patients hospitalized in medical-surgical wards in one of the hospitals in Tehran in 2005. They were divided into two experiment and control groups, and were evaluated before and after the intervention. Data was collected using observational checklists in communicative, cognitive, and psychomotor competency domains as double blinded. Number of patients in the experiment group was 32 and in the control group was 40 which were matched before and after the intervention in each group. The allocation of the novice nurses into groups and wards was done randomly. Data was analyzed by SPSS software. Clinical competency of the novice nurses increased in all three domains in both groups. Paired t-test showed this increase in both groups. Moreover, independent t-test demonstrated that the mean difference in the experiment group was higher than the control group. Novice nurses' clinical competency was in a primary level in both groups before the intervention, but, after 3 months was promoted to the advanced level in the experiment group who were exposed to mentors committee. Organizing "nursing mentors committee" is an effective strategy for nursing managers, in order to help novice nurses who need to acquire clinical competency in different domains in a limited time frame

[ effect of implementing "BARS" method on student nurses' managerial skills in nursing management practicum]

Clinical education is fundamental to nursing science. One of the most important domains in clinical education is clinical evaluation. Today, new methods in evaluation such as "BARS" can measure expected behaviors in specific job better than old methods, because of their structure that focus on specific behaviors of job. So, they may be effective for quality improvement in clinical teaching. The purpose of this study was to examine the effect of implementing "BARS" method on student nurses' managerial skills in nursing management practicum. This was a quasi-experimental study. All students [n=60] was randomly assigned to either experimental or control group. At first, the students in control group were trained and evaluated by their instructors. The next semester, the same instructors applied "BARS" method for experimental group. This method works based on critical events or special behaviors in nursing management practicum. At the end of practicum, students' managerial skills in two groups were measured by checklist. The data were analyzed by SPSS. The findings showed that managerial skills was significantly different between experimental [=113.41] and control [=83.83] group [P=0.005]. Therefore, implementing "BARS" evaluation method is effective on improving managerial skills of nursing students. "BARS" as an evaluation method could evaluate specific and expected behaviors of student nurses in management practicum better than the old ones. Also, it could improve the quality of clinical teaching

Learning groups in training programs for nurse managers: a method to enhance nursing and leadership capabilities

Employing management skills directs staff performance. This study was done to determine the effects of management development programs by learning groups' technique, on the leadership styles of nurse managers as well as staff nurse empowerment. A pre-experimental study was performed as one-group with pre and post-test in a teaching hospital in Tehran during the year 2004. All nurse managers [n=20] and staff nurses [n=111] in that hospital participated in the study. The Leadership Behavior Description Questionnaire [LBDQ] and Workplace Empowerment Questionaire were used for measuring leadership styles and staff empowerment before and one month after intervention. Learning groups were formed through discussion sessions about managerial behavior in case scenarios which had happened in that hospital. The data analysis using descriptive statistics, Paired T, and Mc Nemar was done by SPSS. The Comparative analysis showed that nurse managers rated their own leadership styles similarly before and after intervention, while from staff nurses' viewpoints, it significantly changed. Also, there was a difference between staff empowerment before and after intervention. The management development program with applying "Learning- Groups" method will change leadership behavior in nurse managers and this positive effect could be approved by staff nurses and promote their empowerment. Thus, this method is recommended

effect of coaching role playing by clinical supervisors on staff nurses morale

Currently, the most concern in the clinical nursing practice is the increasing problems related to the low morale in nurses. However, the importance of managerial behaviors and their influence on nurses morale are obvious. Therefore, the objective of this study was to investigate "the effects of coaching role of clinical supervisors on staff nurses morale ". A quasi-experimental research with pre and post-test in two groups [experimental and control] was conducted in one of the teaching hospitals in Tehran; which was selected randomly. There were eight medical-surgical units that randomly allocated in two groups. The study samples included 54 nurses, 27 nurses in each group of experimental and control. Data was gathered in two periods of pre and post intervention by a Staff Nurse Morale Questionnaire. The intervention had two stages; the first was orientation: nursing management development program; and the second was optimizing environment by designing an applied supervision guide for coaching roles of supervisors. After this stage, clinical supervisors played coaching role for 16 weeks as coaching role players. The Chi-square test revealed no significant differences between the two groups of experimental and control regarding individual characteristics [such as age, gender, job]. The mean scores of nursing morales in the experimental group at pre and post-intervention were 59.30 and 71.30 respectively; that the difference was statistically significant [P < 0.001]; whereas in the control group the mean of morale scores at pre and post-intervention were 69.33 and 64.07, that the reduction was significant [P < 0.020]. Therefore, coaching role playing by clinical supervisors resulted to staff nurses morale improvement. One of the approaches for improvement of nursing morale is applying suitable supervision and leadership methods. Thus, according to the study findings, coaching role playing by supervisors as a novel principle of supervision and leadership can be used for nurses' morale promotion

[Management by objective approach in nursing performance appraisal and its impact on quality of nursing care]

Performance appraisal is one of the most important duties for nursing managers. This will improve the quality of nursing care, and it needs suitable approaches and effective strategies in nursing services. The aim of this study is to determine the impact of performance appraisal using management by objective approach on nursing care quality. This was a quasi-experimental and single-blind study that was carried out in two surgical units of an affiliated hospital of Tehran University of Medical Sciences. 80 patients were selected using a randomized sampling. The quality of nursing care were controlled in both experiment and control units before and after the performance appraisal procedure. The procedure was programmed on the basis of management by objective approach for six months in the experiment unit. In the intervention unit, nursing performance appraisal was done three times and in every time head nurse and supervisors participated in giving feedbacks and recommendations for the nurses. At the end of the intervention, quality of nursing care was assessed in both groups blindly. The results were compared and statistically analyzed. Significant difference was found between quality of nursing care in the experiment and control units [P<0.001]. Quality of nursing care was significantly different before and after intervention in the experiment unit [P=0.009]. Performance appraisal using management by objective approach could increase the quality of nursing care. As a result, using nursing performance appraisal plans according to the basis of MBO could be an effective evaluation way to access the quality of nursing care

[ effect of implementing therapeutic communication plan on burned patients' pain]

Pain in burned patients is not only caused by damage to joints and tissues but it is also affected by a variety of reasons that can not be ignored. A number of studies indicate that implementing different supportive approaches could affect pain severity through reduction of fear and anxiety of the patients. Hence, the present study was conducted in order to study the effect of therapeutic communication plan on pain severity in burned patients in Mashhad during 2004. In this quasi-experimental study 60 female burned patients were investigated in two groups of treatment and control. The control and case patients were identical in terms of age, burning agent, and burn surface area. Data collecting tools were patient's demographic information and linear pain scale. For each group pain measurement was carried out once at the beginning of study [48 to 72 hours following the burn] and then once a week for a month [average five times] immediately after dressing. Type, time and amount of sedative and analgesic drugs were recorded each time. For treatment group 7 to 12 therapeutic communication sessions [20 to 45 minutes] were held within four stages. The amount of pain was measured and compared in each group before intervention [the first week], within intervention [during three weeks] and after intervention [the fourth week]. Data analysis was performed through Mann- Whitney and chi[2] tests. The results showed that there was significant difference between pain severity in two groups after intervention [P=0.005] so that before intervention 36.7% of the patients suffered from severe pain, whereas after intervention none of the patients had this type of pain. Moreover, the number of patients suffering from extremely severe pain [36.7%] declined to 16.7% after intervention. The study results indicate that implementation of therapeutic communication plan affects pain severity of burned patients. Hence, we recommend the application of the plan in burned patient care. More research is also suggested

[Factors affecting the process of obtaining clinical competency]

Nurses form the most significant sector of the health care provision and play a fundamental role in providing on-going quality care for patients. To attain clinical competency, it is essential to understand the factors influencing it. Due to the fact that clinical competency is directly affected by specific features of the educational and health care system and the medical training within each country, it is necessary to assess the factors influencing clinical competency. This study was based on the Grounded Theory method. The sample of 36 comprised of clinical nurses, as well as trainers and managers within the Ministry of Health and Medical Training, Nursing and Midwifery faculties, hospitals and members of the Nursing Council in Tehran. Data was obtained through semi-structured interviews, which were recorded and subsequently transcribed. The analysis was carried out by the Straus and Corbin method. In this study, personal factors were identified as one of the contextual factors affecting clinical competency. The respondents branded this category as "the internal and personal factors". This included a significant number of sub-categories such as education and skill, moral values, consciousness responsibility and accountability. Another category was identified as "the external and organizational factors" which included categories such as educational and clinical environments, work license, control and supervision and effective educational system. The clinical competency process resulted from the interaction between three factors; ethics, effective experience and environmental factors