Examining workplace safety for remote area nurses in Australia: a cross-sectional descriptive study.

INTRODUCTION: Australia's remote health sector has chronic understaffing issues and serves an isolated, culturally diverse population with a high burden of disease. Workplace health and safety (WHS) impacts the wellbeing and sustainability of the remote health workforce. Additionally, poor WHS contributes to burnout, high turnover of staff and reduced quality of care. The issue of poor WHS in Australian very remote primary health clinics was highlighted by the murder of remote area nurse (RAN) Gayle Woodford in 2016. Following her death, a national call for change led by peak bodies and Gayle's family resulted in the development of many WHS recommendations and strategies for the remote health sector. However, it is unclear whether they have been implemented. The aim of this study is to identify which WHS recommendations have been implemented, from the perspective of RANs. METHODS: A cross-sectional online survey of 173 RANs was conducted during December 2020 and January 2021. The survey was open to all RANs who had worked in a very remote (MM 7 of the Modified Monash (MM) Model) primary health clinic in Australia more recently than January 2019. A convenience sampling approach was used. The survey tool was developed by the project team using a combination of validated tools and remote-specific workplace safety recommendations. Broad recommendations, such as having a safe clinic building, safe staff accommodation, local orientation, and 'never alone' policy, were broken down into specific safety criteria. These criteria were used to generate workplace safety scores to quantify how well each recommendation had been met, and clustered into the following domains: preparation of staff, safe work environment and safe work practices. Descriptive statistics were used and the safety scores between different states and territories were also compared. RESULTS: Overall, the average national workplace safety score was 53% (standard deviation (SD) 19.8%) of recommendations met in participants' most recent workplace, with median 38.5% (interquartile range (IQR) 15.4-61.5%) of staff preparation recommendations, median 59.4% (IQR 43.8-78.1%) of safe work environment recommendations, and median 50.0% (IQR 30.0-66.7%) of safe work practices recommendations met. Within domains, some recommendations had greater uptake than others, and the safety scores of different states/territories also varied. Significant variation was found between the Northern Territory (57.5%, SD 18.7%) and Queensland (41.7%, SD 16.7%) (p<0.01), and between South Australia (74.5%, IQR 35.9%) and Queensland (p<0.05). Last, many RANs were still expected to attend after-hours call-outs on their own, with only 64.1% (n=107/167) of participants reporting a 'never alone' policy or process in their workplace. CONCLUSION: The evidence from this study revealed that some recommended safety strategies had been implemented, but significant gaps remained around staff preparation, fatigue management and infrastructure safety. Ongoing poor WHS likely contributes to the persistently high turnover of RANs, negatively affecting the quality and continuity of health care in remote communities. Variation in safety scores between regions warns of a fragmentation of approaches to WHS within the remote health sector, despite the almost identical WHS legislation in different states/territories. These gaps highlight the need to establish and enforce a national minimum standard of workplace safety in the remote health sector.

Organizational change: challenges for workplace psychosocial risks and employee mental health.

BACKGROUND: Constant organizational change is the norm in many companies today. At present, evidence on the impact of organizational change on psychosocial risks at work and employee mental health is limited. We investigate organizational change and its association with psychosocial risks and mental health in three consecutive surveys covering 12 years. METHODS: The study was based on data from three cross-sectional waves (2006, 2012, 2018) of the German BIBB/BAuA Employment Survey, comprising 53,295 employees. Four change indicators (i.e., introduction of new software, changes in goods and services produced/provided, downsizing and restructuring), five indicators of psychosocial risks (i.e., time pressure, interruptions, multitasking, working to the limits of capability, and working very quickly) and four mental health indicators (i.e., sleep disturbances, nervousness, tiredness and depressive symptoms) were investigated. We applied Poisson regression analysis to examine associations between organizational change, psychosocial risks, and mental health. RESULTS: According to the pooled analysis of all three waves, the majority of employees reported having experienced at least one organizational change, such as downsizing or restructuring, between 2006 and 2018. Organizational change was negatively associated with psychosocial risks (e.g., working to the limits of one's capability, PR: 1.66; 95% CI: 1.48-1.86) and with employee mental health (PR: 1.82; 95% CI: 1.61-2.04). CONCLUSIONS: Organizational change is omnipresent in the modern economy. Our research suggests that transformation processes in organizations can bear risks to employees' health as psychosocial risks increase. Therefore, companies planning organizational change should accompany such processes with occupational health and safety measures.

A Compendium of Radiation Safety Practices That Can Complement Organizational Worker Well-being Initiatives.

ABSTRACT: Organizations are learning that efforts to protect the health and safety of their workers from risks both at work and outside of work yield great dividends in the form of increased productivity, morale, and reduced healthcare costs. This realization has given rise to a variety of worker well-being initiatives that span far beyond the typical boundaries of traditional workplace health and safety programs. Examples include providing information and services on diet, exercise, personal habits, and mental health issues. Interestingly, the radiation safety profession has been historically involved with a series of progressive worker well-being practices that perhaps are not fully appreciated by the broader well-being community. These include the ability to comprehensively track occupational doses, training regarding doses arising from outside the workplace (such as medical procedures and environmental exposures), and fetal protection policies, to name a few. Described here is the shift in perspective from health and safety merely for the workplace to a more holistic approach, but the degree to which the actions may be implemented varies. Included then is a compendium of radiation safety practices that may be possibly folded into the discussion of larger organizational well-being efforts.

Challenges related to the organizational climate of the nursing team in a public hospital - nurses' perception. / Desafios relacionados ao clima organizacional da equipe de enfermagem de um hospital público - percepção dos enfermeiros.

The organizational climate is related to the degree of motivation of its employees. This perception is essentially felt, it is neither seen nor touched, but it is real. This study aims to identify difficulties and potentialities related to the organizational climate of the nursing staff at a public hospital in the Federal District. Methodologically, a descriptive and exploratory study was carried out characterized by a qualitative approach. The thematic content analysis led to three interpretative dimensions: environment and working conditions; communication, interpersonal relationship and work flows; motivation to improve the work environment. The results indicate a deficit of human resources, scarcity of material resources, supplies, precarious physical structure, in addition to interpersonal relationship problems, such as the (de)valuation of professional nurses and nursing. The challenges posed to managers go beyond the technical and structural dimension, the technological complexity of equipment without maintenance, as it unfolds through the human dimension, feelings and unmet needs (of appreciation) of nursing, which needs to be cared for, valued, heard and seen in their care process.

O ambiente organizacional está relacionado com o grau de motivação de seus colaboradores. Essa percepção é essencialmente sentida, não se vê e nem se toca, mas tem uma existência real. Este estudo objetiva identificar as dificuldades e potencialidades relacionadas ao clima organizacional dos servidores de enfermagem de um hospital público do Distrito Federal. Metodologicamente foi realizado um estudo descritivo e exploratório caracterizado por uma abordagem qualitativa. A análise de conteúdo temática conduziu a três dimensões interpretativas: ambiente e condições de trabalho; comunicação, relacionamento interpessoal e fluxos de trabalho; e motivação para a melhoria do ambiente de trabalho. Os resultados apontam para um déficit de recursos humanos, escassez de recursos materiais, insumos, estrutura física precária, além de problemas de relacionamento interpessoal, como a (des)valorização do profissional enfermeiro e da enfermagem. Os desafios postos para os gestores estão para além da dimensão técnica e estrutural, da complexidade tecnológica dos equipamentos sem manutenção, desdobra-se pela dimensão humana, pelos sentimentos e pelas necessidades não atendidas (de valorização) da enfermagem, que precisa ser cuidada, valorizada, ouvida e vista no seu processo de cuidar.

"Exploring the relationship of organizational virtuousness, citizenship behavior, job performance, and combatting ostracism" through structural equational modeling.

BACKGROUND: This theoretical model has been drawn on principles of social exchange theory to scrutinize the connection between organizational virtuousness and job performance with the mediating role of Organizational citizenship behavior and moderating role of workplace ostracism. A survey was conducted in Pakistan, gathering data from 486 employees working for various private and commercial banks. METHOD: Soft and hard questionnaires were distributed to the participants, with social media platforms used for the soft questionnaires and meetings with employees for the hard questionnaires. A 7-point Likert scale was employed in data collection, and measures for the variables were adapted from reliable and valid sources. A demographic analysis was performed to summarize the sample collected from participants. The demographics results were analyzed using SPSS, while the measurement model and path analysis were conducted using Structural Equational Modeling with Smart PLS-4. RESULTS: The study's findings showed a significant and positive relationship between organizational virtuousness and job performance, with organizational citizenship behavior serving as a mediator. Additionally, a negative moderation of workplace ostracism was observed in the mediation of organizational citizenship behavior toward the relationship between organizational virtuousness and job performance. CONCLUSION: The study's results contribute to the implementation of social exchange theory and related concepts in the banking sector of Pakistan, providing practical guidance for implementing virtuous practices within organizations and discouraging ostracism in banks to enhance overall performance. The study suggests that policies regarding the implementation of virtuous practices in organizations can be established, and workplace ostracism can be avoided by providing a platform for social gatherings and training employees. Managers should adopt appropriate leadership styles and relevant communication patterns to impact the organizational climate which can also help reduce the influence of ostracism in the organization. Additionally, a complaint cell should be established with complete confidentiality to reduce ostracism.

Pets at work: integrating pet-friendly initiatives into human resources for enhanced workplace harmony.

AIMS: The representation of companion animals, or pets, has been changing recently. Research concerning how pets influence employees' work-related well-being has also started to take its first steps. This research aimed to analyze (1) how managers perceive pet-friendly practices and their main effects at work, and (2) the impact of such practices on employees' well-being and work engagement. Relying on the social exchange perspective and the self-determination theory it was hypothesized that pet-friendly practices would positively influence employees' well-being and work engagement by satisfying their three basic needs (autonomy, competence, and relatedness). METHODOLOGY: Two studies with mixed methods were conducted. The first and exploratory study resorted to semi-structured interviews with six managers. The second was a two-wave study conducted with a large sample of workers (N = 379). RESULTS: The first study highlighted the primary advantages and disadvantages of pet-friendly practices, along with the various obstacles and limitations, and proposed managerial strategies to overcome them. Managers generally expressed interest and enthusiasm about the topic but also pointed out challenges in implementing a pet-friendly strategy due to the limited number of empirical studies demonstrating its benefits. The second study's findings indicated that pet-friendly practices positively impacted employees' work engagement and well-being by fulfilling their needs for competence, autonomy, and relatedness. ORIGINALITY: Overall, Portugal is seen as having a conservative culture, which slows the dissemination and implementation of these measures. To overcome these challenges, several managerial recommendations have been proposed. Raising awareness and fostering discussion on the topic are crucial steps toward integrating pet-friendly policies into human resources management.

Working Conditions, Worker Rights, and Managerial Domination During the COVID-19 Pandemic: Assessing Their Toll on Precariously Employed Workers and Family Well-Being.

Precarious Employment (PE) is characterized by job, income, and benefit insecurities. Studies surrounding PE and well-being have been predominantly quantitative, leaving a gap in rich descriptions of employment experiences. We recruited a sample of 40 adults aged 25-55 who were involved in PE during the beginning of the COVID-19 pandemic or lost employment due to the pandemic. Semi-structured interviews were administered. Employment and income insecurities were common and had negative impacts on the well-being of participants and their families. Uncertainty about future employment prospects and job and income loss resulted in chronic distress. Other insecurities-access to benefits, violation of worker rights, worker safety-was also reported as impacting well-being. The COVID-19 pandemic deepened insecurities, hardships, and distress among workers with PE conditions. Given the myriad insecurities experienced by those engaged in PE, the focus of precarious work research should also include working conditions, violation of worker rights, and managerial domination.

Nurses' organizational climate of perceived organizational support and its relationships with psychosocial working conditions and psychological contracts: A longitudinal questionnaire study.

OBJECTIVE: The aim of the present study was to investigate the longitudinal relationships between nurses' organizational climate of perceived organizational support (POS-climate) and their psychosocial working conditions and psychological contracts. METHODS: A two-wave longitudinal cohort questionnaire study was carried out among registered nurses employed within six hospitals in two regions in Sweden (n = 711). Two cross-lagged panel models were tested after ensuring scalar factorial invariance of the measurement models. The first model investigated longitudinal relationships between psychosocial working conditions and the POS-climate, while the second model investigated such relationships between the psychological contracts and the POS-climate. RESULTS: The results indicated that influence at work and an ideology-infused psychological contract had positive effects on the nurses' POS-climate. CONCLUSIONS: These results highlight the importance of providing nurses with such influence, and of a shared ideology within the entire health-care organization, centered on the ethical values of the health-care professions.

Workplace Harassment, Cyber Incivility, and Climate in Academic Medicine.

Importance: The culture of academic medicine may foster mistreatment that disproportionately affects individuals who have been marginalized within a given society (minoritized groups) and compromises workforce vitality. Existing research has been limited by a lack of comprehensive, validated measures, low response rates, and narrow samples as well as comparisons limited to the binary gender categories of male or female assigned at birth (cisgender). Objective: To evaluate academic medical culture, faculty mental health, and their relationship. Design, Setting, and Participants: A total of 830 faculty members in the US received National Institutes of Health career development awards from 2006-2009, remained in academia, and responded to a 2021 survey that had a response rate of 64%. Experiences were compared by gender, race and ethnicity (using the categories of Asian, underrepresented in medicine [defined as race and ethnicity other than Asian or non-Hispanic White], and White), and lesbian, gay, bisexual, transgender, queer (LGBTQ+) status. Multivariable models were used to explore associations between experiences of culture (climate, sexual harassment, and cyber incivility) with mental health. Exposures: Minoritized identity based on gender, race and ethnicity, and LGBTQ+ status. Main Outcomes and Measures: Three aspects of culture were measured as the primary outcomes: organizational climate, sexual harassment, and cyber incivility using previously developed instruments. The 5-item Mental Health Inventory (scored from 0 to 100 points with higher values indicating better mental health) was used to evaluate the secondary outcome of mental health. Results: Of the 830 faculty members, there were 422 men, 385 women, 2 in nonbinary gender category, and 21 who did not identify gender; there were 169 Asian respondents, 66 respondents underrepresented in medicine, 572 White respondents, and 23 respondents who did not report their race and ethnicity; and there were 774 respondents who identified as cisgender and heterosexual, 31 as having LGBTQ+ status, and 25 who did not identify status. Women rated general climate (5-point scale) more negatively than men (mean, 3.68 [95% CI, 3.59-3.77] vs 3.96 [95% CI, 3.88-4.04], respectively, P < .001). Diversity climate ratings differed significantly by gender (mean, 3.72 [95% CI, 3.64-3.80] for women vs 4.16 [95% CI, 4.09-4.23] for men, P < .001) and by race and ethnicity (mean, 4.0 [95% CI, 3.88-4.12] for Asian respondents, 3.71 [95% CI, 3.50-3.92] for respondents underrepresented in medicine, and 3.96 [95% CI, 3.90-4.02] for White respondents, P = .04). Women were more likely than men to report experiencing gender harassment (sexist remarks and crude behaviors) (71.9% [95% CI, 67.1%-76.4%] vs 44.9% [95% CI, 40.1%-49.8%], respectively, P < .001). Respondents with LGBTQ+ status were more likely to report experiencing sexual harassment than cisgender and heterosexual respondents when using social media professionally (13.3% [95% CI, 1.7%-40.5%] vs 2.5% [95% CI, 1.2%-4.6%], respectively, P = .01). Each of the 3 aspects of culture and gender were significantly associated with the secondary outcome of mental health in the multivariable analysis. Conclusions and Relevance: High rates of sexual harassment, cyber incivility, and negative organizational climate exist in academic medicine, disproportionately affecting minoritized groups and affecting mental health. Ongoing efforts to transform culture are necessary.

Reasonable Accommodation and Disparate Impact: Clean Shave Policy Discrimination in Today's Workplace.

This article examines Bey v. City of New York - a recent Second Circuit case where four Black firefights suffering from Pseudofolliculitis Barbae (a skin condition causing irritation when shaving which mostly affects Black men) challenged the New York City Fire Department's Clean Shave Policy - with an intersectional approach utilizing legal theories of racial, disability, and religious discrimination.

Human Centered Decision-Making for COVID-19 Testing Center Location Selection: Tamil Nadu-A Case Study.

This paper proposes a blend of three techniques to select COVID-19 testing centers. The objective of the paper is to identify a suitable location to establish new COVID-19 testing centers. Establishment of the testing center in the needy locations will be beneficial to both public and government officials. Selection of the wrong location may lead to lose both health and wealth. In this paper, location selection is modelled as a decision-making problem. The paper uses fuzzy analytic hierarchy process (AHP) technique to generate the criteria weights, monkey search algorithm to optimize the weights, and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method to rank the different locations. To illustrate the applicability of the proposed technique, a state named Tamil Nadu, located in India, is taken for a case study. The proposed structured algorithmic steps were applied for the input data obtained from the government of India website, and the results were analyzed and validated using the government of India website. The ranks assigned by the proposed technique to different locations are in aligning with the number of patients and death rate.

Effect of lean manufacturing tools on sustainability: the case of Mexican maquiladoras.

The Mexican maquiladora industry is applying Lean Manufacturing Tools (LMT) in its production lines; however, few studies have investigated its relationship with sustainability (social, economic, and environmental). This paper presents a second-order structural equation model (SEM) relating 8 LMT integrated into three independent latent variables: continuous improvement (Kaizen and Gemba), supporting tools (Andon, visual management, and Poka-yoke), and machinery and equipment (total productive maintenance, overall equipment effectiveness, and Jidoka) that are related to social, economic, and environmental sustainability as dependent variables. The model is validated with information obtained from 249 companies using partial least squares. Findings show that the application of LMT in the Mexican maquiladora industry avoids the generation of waste and reprocessing. Likewise, the improvement of production processes reduces the waste emitted into the environment and reduces energy consumption. Also, when companies have environmental programs, the work environment is safe, and labor relations are improved, increasing morale and the commitment to work for the company, gaining economic and ecological benefits.

The Role of Participation in and Effectiveness of Shared Governance Councils in the Nurses' Perception of a Professional Practice Work Environment.

OBJECTIVES: The aims of this study were to identify the differences in nurses' perceptions of their professional practice work environment (PPWE) related to their participation in shared governance (SG) councils and to examine the perception of effectiveness of SG councils among nurses who participate in them. BACKGROUND: Research suggests that adopting SG in nursing can lead to significant, positive outcomes, such as patient and nurse satisfaction and enhanced nurse empowerment, engagement, and a PPWE. METHODS: The study used a cross-sectional design in a Magnet®-designated urban Jordanian cancer care hospital. A convenience sample of 580 direct care nurses was used. The data were collected using self-administered questionnaires, the Council Health (CH) instrument, and the Professional Practice Work Environment Inventory (PPWEI). RESULTS: Results demonstrated a significant difference in the total score of PPWE between the SG council members (4.85) and nonmembers (4.68) (t = 2.906, P = 0.004). The results also indicated small to strong correlations of the total overall council health mean and all domain means of council effectiveness with total overall PPWEI mean and all domain means of PPWE (P < 0.05) among nurses who participated in SG councils. CONCLUSION: Findings support involving more staff in SG councils and that enhancing the SG councils' effectiveness positively affects the PPWE.

Organizational Impact on Healthcare Workers' Moral Injury During COVID-19: A Mixed-Methods Analysis.

OBJECTIVE: The aim of this study was to explore relationships between organizational factors and moral injury among healthcare workers and the impact of perceptions of their leaders and organizations during COVID-19. BACKGROUND: COVID-19 placed healthcare workers at risk for moral injury, which often involves feeling betrayed by people with authority and can impact workplace culture. METHODS: Secondary data from a Web-based survey of mid-Atlantic healthcare workers were analyzed using mixed methods. Data were synthesized using the Reina Trust & Betrayal Model. RESULTS: Fifty-five percent (n = 328/595) of respondents wrote comments. Forty-one percent (n = 134/328) of commenters had moral injury scores of 36 or higher. Three themes emerged: organizational infrastructure, support from leaders, and palliative care involvement. Respondents outlined organizational remedies, which were organized into 5 domains. CONCLUSIONS: Findings suggest healthcare workers feel trust was breached by their organizations' leaders during COVID-19. Further study is needed to understand intersections between organizational factors and moral injury to enhance trust within healthcare organizations.

Association between perceived organizational support and COVID-19 vaccination intention: A cross-sectional study.

OBJECTIVES: We examined the association between perceived organizational support (POS) and COVID-19 vaccination intention as well as the influence of the implementation of workplace infection prevention measures. METHODS: We analyzed data from an Internet survey of workers aged 20-65 years conducted in December 2020, during a period of widespread COVID-19 infection in Japan. RESULTS: Of the 23 846 participants in this survey, 1958 (8%) reported very high POS. In the group with very high POS, 836 (43%) workers wanted the COVID-19 vaccination; in contrast 1382 (36%) workers in the group with very low POS wanted the vaccination. POS was associated with COVID-19 vaccination intention (odds ratio [OR] = 1.11). The OR decreased after additional adjustment for the number of workplace infection control measures (OR = 1.06). In the analysis with POS as a categorical variable, very high POS was associated with COVID-19 vaccination intention (reference: very low POS) (OR = 1.34). The OR decreased after additional adjustment for the number of workplace infection control measures (OR = 1.17). High POS was associated with COVID-19 vaccination intention (OR = 1.17) but not with vaccination intention after additional adjustment for the number of workplace infection control measures (OR = 1.05). CONCLUSIONS: High POS during the COVID-19 pandemic increased employees' vaccination intention. The relationship between POS and vaccination intention was strongly influenced by implementation of workplace infection prevention measures. Implementing appropriate workplace infection prevention measures in the event of an emerging infectious disease outbreak may influence the vaccination behavior of employees, which may contribute to the acquisition of herd immunity in the community.

CE: Nurses Are More Exhausted Than Ever: What Should We Do About It?

ABSTRACT: For nurses, the challenges posed by demanding work environments and schedules often lead to fatigue, and this can be exacerbated during crises like the COVID-19 pandemic. In this article, the authors discuss causes and challenges of nurse fatigue and consider several evidence-based strategies and solutions for individual nurses and organizations. Barriers to implementation, including a negative workplace culture and inadequate staffing, are also described, and several resources are presented.

Hospital medicine team perception of diversity and inclusion at work.

BACKGROUND: : Diversity and Inclusion concepts are crucial in healthcare as the patient population we encounter as hospitalist medicine team is diverse. A diverse and inclusive environment for healthcare employees can lead to improved job satisfaction and high-quality medical care of patients. However, hospitalist perspectives on diversity and inclusion in their work environment are not well studied and noted in literature. Understanding hospitalist perspectives of diversity and inclusion is important in promoting organizational culture. METHODS: We conducted an online survey of a large hospitalist group at Mayo Clinic, Rochester, from October-December 2019, as part of Hospital Internal Medicine (HIM) Diversity Council (HIM-DC) inception, to understand the perceptions of its staff about diversity and inclusion at work and facilitate the next best steps for the team. The responses to the survey questions were graded on a likert scale. Descriptive statistics were used to analyze and interpret the data. RESULTS: : Of the 135 team members, 78 responded (58%). Of the respondents, more than 80% never witnessed or experienced discrimination from a colleague, while more than 50% did witness or experience discrimination from a patient/visitor. More than 70% did not report this discrimination. Nearly 90% felt that it was an inclusive environment at work, across different personal attributes. Most of the respondents requested additional cultural education and social events. CONCLUSION: Unfortunately, a higher percentage of discrimination is perceived from patients/visitors. This highlights the need for institutional policies about visitor conduct. A high proportion of HIM staff felt inclusive at workplace. Committees such as HIM-DC can augment cultural education and social events to improve team's perception.

Indoor lighting design for healthier workplaces: natural and electric light assessment for suitable circadian stimulus.

Light, especially daylight, plays a critical role in human health as the main timer for circadian rhythms. Indoor environments usually lack the correct exposure to daylight and are highly dependent on electric lighting, disrupting the circadian rhythm and compromising the health of occupants. The methodology proposed assesses the combination of natural and electric lighting on circadian rhythms for operational environments. The case study chosen examines a 24/7 laboratory area representing an open-plan shift-work area. Several electric lighting scenarios under different sky conditions have been assessed, considering a variable window size and resulting in a spectrum which establishes the indoor circadian regulation performance according to the amount of light perceived. A set of configurations is presented to determine optimal electric lighting configuration based on natural light conditions in order to ensure a suitable circadian stimulus and the electric lighting flux threshold for different scenarios, benefiting occupants' health while also ensuring energy conservation.