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Cathleen Krueger Wilson, Ph.D., and Tim Porter-O'Grady, Ph.D * Aspen Publishers * 484 pages * $49 The second edition of a 1995 book about the role of transformational leaders in [...]

As healthcare organizations deal with changes in the external environment, uncertainty in the internal environment is created. The purpose of this study was to explore the relationships among environmental uncertainty, social climate, and burnout among staff nurses. Multiple regression analysis was used to explore relationships among study variables. Perceived environmental uncertainty predicted burnout among staff nurses, although there was no significant relationship between burnout and objective measures of unit activity. The social climate of the workplace was negatively associated with burnout. The authors concluded that social networks are important during times of change and uncertainty in the work environment; in other words, a supportive workplace can protect against burnout.

This study investigated the relationship between sense of belonging and job satisfaction in the new graduate RN. Ninety-five new graduate RNs answered a survey about demographic information and work setting, as well as their satisfaction and sense of belonging in the work environment. McCloskey-Mueller's Satisfaction Scale and a modified version of the Hagerty-Patusky Sense of Belonging Instrument were used. The conceptual framework was derived from Marlene Kramer's work on Reality Shock (1974). Results showed new graduates were most satisfied with coworkers and least satisfied with professional opportunities for advancement. Sense of belonging and total satisfaction were highest in the home healthcare setting. A Pearson rwas used to determine relationships between sense of belonging, total satisfaction, and satisfaction sub-scales. Sense of belonging had significant positive relationships with total satisfaction, interaction opportunities, praise, control, coworkers, and scheduling. Possible future research suggested examining how orientation and work group numbers may affect job satisfaction and sense of belonging.

The purpose of the two pilot studies described in this article was to develop and evaluate a database for managing patient care information. A retrospective review of medical records for 67 patients was used for capturing nursing information. Three categories of data were obtained (1) patient problems, (2) nursing interventions, and (3) patient outcome achievement. A total of 439 patient problems were identified. A total of 4541 discrete nursing interventions were coded, with assessment and surveillance activities accounting for 26 of the total. The degree to which targeted patient outcomes were achieved was assessed by analyzing documentation of patient outcomes In the medical record. Of 2326 expected patient outcomes identified, only 55 (1272) were documented as “met” in the medical records. Potential uses for the database include outlier analysis and outcomes assessment in specific patient populations.

This article discusses the measurement issues associated with estimating the reliability of patient classification systems (PCSs). Generalizability theory is proposed as an approach to overcome the limitations of traditional methods of estimating reliability of PCSs. The results of a demonstration study in which generalizability theory is used to support the reliability of a PCS are reported. A coefficient of generalizability, analogous to the reliability coefficient, was computed based on the variance components estimated. The generalizability coefficient for the total PCS score was .034, which increased to .650 when one item was deleted. The generalizability coefficient for individual items ranged from .053 to .961. Suggestions for further instrument development are offered.

The Informatics Task Force of the National Nursing Staff Development Organization (NNSDO) conducted a national survey soliciting information about computer use in staff development. More than 600 members responded to the survey, suggesting that informatics and the issues surrounding nurses' use of computers are of concern to many staff development professionals. Responses from focus groups held at the National Nursing Staff Development Organization annual convention provided additional input. The results of the survey and discussion sessions have implications for preparing nurse educators for the specialty practice of staff development in the future.