Search

Objective This paper describes how the administrative leadership of 1 physical therapy department curated, implemented, and evaluated a culturally responsive administrative support strategy to foster a positive working environment. Participants' perceptions of culturally responsive practices were explored using climate survey data. Methods This case occurred in the physical therapy and rehabilitation science department at an academic medical center in the United States. The department administers 5 educational programs, 3 faculty practices, a community clinic, and a robust research enterprise and employs over 100 employees. After a historic sociocultural event, administrators implemented a series of actions to understand the needs of department employees and to respond in a culturally responsive manner. Interventions included supportive activities, educational opportunities, and community-building events. The department administered an annual climate survey to assess the employees' perceptions of the working climate, perceived impacts of the culturally responsive interventions, and suggestions for improving department climate. Survey analysis included frequency statistics and thematic content analysis with sensitizing concepts from a culturally responsive practice framework previously applied in primary and secondary school settings. Results A total of 131 employees participated in the annual climate survey from 2020 to 2022. Employees' confidence to identify and address microaggressions in working environments showed trends of overall improvement, and overall self-reported experiences with racial discrimination decreased. Participants reported positive trends in addressing discrimination among colleagues but also reported addressing offensive behaviors perpetrated by patients. Conclusion Findings suggest that culturally responsive interventions are associated with positive trends in employee climate. Interventions tailored to the audience and curated to deepen cultural knowledge, enhance self-awareness, and validate others fostered a shared commitment to cultural equity. Impact Administrative leaders have a role in fostering an inclusive climate by capitalizing on culturally significant teachable moments with sound culturally responsive strategy, bidirectional culturally sensitive communication, individual development, and collective action. [ABSTRACT FROM AUTHOR]

Simple Summary: In spite of significant reductions in the numbers of animals entering shelters and being killed there over the last decades, the beliefs that companion animals must be under the direct control of a human guardian, and that capturing and often killing animals is morally justifiable and even necessary, continue to guide animal sheltering practices in the United States. Looking at the historical origins of animal control and sheltering in the US reveals a high level of consistency in ideologies and practices across almost 150 years. In this commentary, two scholars on animal sheltering in the US examine the historical legacies of animal control and sheltering in the US to show how they are problematic and dysfunctional and need to be abandoned to improve the lives of companion animals and the human communities of which they are a part. This paper examines the legacies of the emergence of the animal control and sheltering industry in the United States and their impact on contemporary public animal shelters. While decades of gradual reform have helped substantially reduce the number of animals entering shelters and being killed there, contemporary animal sheltering largely continues to follow the path set when animal sheltering developed in the late 1800s and early 1900s. Three key interrelated legacies of the pound model of early animal control and sheltering enduringly shape sheltering today: (1) the institutional culture of animal shelters grounded in the logics of caging and killing; (2) the lack of visibility and transparency, especially within government shelters; and (3) the economic logics of the pound model, including the disparities in sheltering resources across communities. Examining the origins of animal control and sheltering and identifying the specific legacies of this pound model within contemporary government-funded shelters improves understanding of why such shelters in the US have developed with a particular set of practices and ideologies, and thus provides an important footing for envisioning and enacting radical changes in animal sheltering. [ABSTRACT FROM AUTHOR]

This paper asserts that whiteness is a major ideological framework that is subtlety interwoven into our institutional structures and is a major organizing principle in the workplace. Efforts to increase racial equity, inclusion, and belongingness within the workplace and throughout society at large are ineffectual and virtually impossible without addressing the deleterious effects of whiteness. Addressing these pervasive subtleties in the workplace requires more than changing the complexion of an organization; instead, it also involves devoting ample attention to promoting widespread cultural change by being intentional about dismantling whiteness. An illustrative list of four preliminary steps for shifting the racial paradigm by attending to the ideology of whiteness in the workplace is provided. [ABSTRACT FROM AUTHOR]

Aim: A rigorous examination of the occupational features across cultures helps draw policy recommendations for nurses' quality care practices and good health. This study aimed to explore the differences in work characteristics and health status between Korean and US hospital nurses. Design: For this comparative secondary data analysis study, we constructed a dataset with 304 pairs of nurses from Korea and the United States, matched by age and gender. Methods: We used the data from the 2020 Korean Hospital Nurses Health Behaviors and Health Status study, collected from May to July 2020, and the Nurse Worklife and Wellness Study (NWWS), conducted between November 2020 and February 2021. Results: Compared to nurses in the United States, Korean nurses rated their job‐related conditions much lower, had lower intentions to stay in their current workplace and were less satisfied with their jobs. Korean nurses reported that organizational support and employee health resources were less prevalent and their levels of healthy behaviour practice and health status were lower than their US counterparts. Nurses in Korea require better practice environments and employee health support. Adequate workload and staffing levels are needed to improve job conditions for Korean nurses. Organizational support and employee health resources should always be accessible at nurses' workplaces. [ABSTRACT FROM AUTHOR]

Organizational support represents a critical driver of practice research projects. This analysis includes four international examples of such support (Norway, Finland, Belgium, and USA and China). The four studies capture the similarities and differences between university support and national government support. The analysis is placed within the context of defining practice research and the core components of organizational support. The findings emerged from presentations in a Practice Research Collaborative sponsored by the International Community on Practice Research in Social Work. The conclusion includes a discussion of a cross-case analysis along with the identification of implications for practice research studies in social work and affiliated professional disciplines. [ABSTRACT FROM AUTHOR]

Aim: To determine the association between nurse and institutional characteristics and perceived professional nurse knowledge and self‐efficacy of reporting child abuse and neglect. Design: A sample of N = 166 nurses were recruited to respond to the Reporting of Suspected Child Abuse and Neglect (RSCAN) survey. Methods: A multiple linear regression examined whether nurse characteristics and institutional characteristics were associated with the two RSCAN survey domain scores. Results: Perceived knowledge of a workplace child abuse and neglect protocol was associated with the knowledge subscale. Education and child abuse and neglect expertise were significant predictors of the self‐efficacy subscale. Nurses with a master's or higher degree and those who identified as being either forensic, paediatric or Emergency Department nurses, had less perceived institutional barriers to self‐efficacy of reporting child abuse and neglect. Conclusion: This study provides a preliminary insight into the institutional barriers and facilitators of nurses as child abuse and neglect mandated reporters. Implications for the profession and/or patient care: To encourage innovative education and collaborations to support nurses as fully informed child abuse and neglect mandated reporters. Impact: This research identifies the gaps and facilitators of nurses as child abuse and neglect mandated reporters to inform healthcare professionals and academic institutions on the importance of nurse education and experience in nurse knowledge and self‐efficacy in reporting suspected child abuse and neglect. Reporting methods: The authors of this study have adhered to relevant EQUATOR guidelines: STROBE. Patient or public contribution: There is no patient or public contribution as the study only looked at nurses. [ABSTRACT FROM AUTHOR]

Background: We sought to understand the innovativeness of nurses engaging in innovative behaviors and quantify the associated characteristics that make nurses more able to innovate in practice. We first compared the innovativeness scores of our population; then we examined those who self-identified as an innovator versus those who did not to explore differences associated with innovativeness between these groups. Methods: A cross-sectional survey study of nurses in the US engaging in innovative behaviors was performed. We performed an exploratory factor analysis (EFA) to determine the correlates of innovative behavior. Results: Three-hundred and twenty-nine respondents completed the survey. Respondents who viewed themselves as innovators had greater exposure to HCD/DT workshops in the past year (55.8% vs. 36.6%, p = 0.02). The mean innovativeness score of our sample was 120.3 ± 11.2 out of a score of 140. The mean innovativeness score was higher for those who self-identified as an innovator compared with those who did not (121.3 ± 10.2 vs. 112.9 ± 14.8, p =< 0.001). The EFA created four factor groups: Factor 1 (risk aversion), Factor 2 (willingness to try new things), Factor 3 (creativity and originality) and Factor 4 (being challenged). Conclusion: Nurses who view themselves as innovators have higher innovativeness scores compared with those who do not. Multiple individual and organizational characteristics are associated with the innovativeness of nurses. [ABSTRACT FROM AUTHOR]

Background: The Fire service Organizational Culture of Safety (FOCUS) survey is an assessment tool comprised of psychometrically validated metrics of safety climate, safety behavior, and downstream outcomes (organizational and injury) that are specific to the U.S. fire and rescue service. Methods: This analysis consists of a descriptive summary of two independent survey waves (FOCUS 1.0 and 2.0). The fire departments included in these survey waves were from convenience sampling (n1.0 = 275; n2.0 = 170). In addition to department level characteristics, we examined individual level characteristics for firefighters and EMS providers in participating departments (n1.0 = 22,719; n2.0 = 16,882). We conducted regression analyses to examine the associations between safety climate and safety behaviors, organizational outcomes, and safety outcomes. All analyses were stratified by organization type (career, volunteer). Results: Our analysis indicated that a majority of respondents were males (90.7%FOCUS 1.0; 90.4%FOCUS 2.0), non-officers (68.4%FOCUS 1.0; 66.4%FOCUS 2.0), and non-Hispanic Whites (70.8%FOCUS 1.0; 69.5%FOCUS 2.0). For both samples there was a higher prevalence of injuries among individuals in career departments (nFOCUS 1.0 = 3778 [17.5%]; nFOCUS 2.0 = 3072 [18.7%]) than volunteer departments (nFOCUS 1.0 = 103 [8.8%]; nFOCUS 2.0 = 34 [7.4%]). We observed an approximate 10-point difference between the mean scores of Management Commitment to Safety for career and volunteer departments in both samples. We observed associations for two organizational outcomes, Safety Behavior and Job Satisfaction, with Management Commitment to Safety and Supervisor Support for Safety overall and when stratified by organization type. We observed a decrease in the odds of injuries associated with a one-unit increase in Management Commitment to Safety (OR1.0 overall: 0.98, 95% CI 0.97–0.99; OR2.0 volunteer: 0.90, 95% CI 0.85–0.95) and Supervisor Support for Safety (OR1.0 overall: 0.95, 95% CI 0.93–0.97; OR1.0 career: 0.95, 95% CI 0.92–0.98). Conclusions: From our current study, and a prior analysis of a geographically stratified random sample of U.S. fire departments, we identified that from all the organizational outcomes, job satisfaction was most consistently associated with FOCUS safety climate. Further, firefighters in our samples consistently rated Supervisor Support for Safety higher than Management Commitment to Safety. Future interventions should support fire departments in improving their departmental Management Commitment to Safety and maintaining their Supervisor for Safety. [ABSTRACT FROM AUTHOR]

Given COVID-19's disproportionate impact on populations that identify as Black, Indigenous, and People of Color (BIPOC) in the United States, researchers and advocates have recommended that health systems and institutions deepen their engagement with community-based organizations (CBOs) with longstanding relationships with these communities. However, even as CBOs leverage their earned trust to promote COVID-19 vaccination, health systems and institutions must also address underlying causes of health inequities more broadly. In this commentary, we discuss key lessons learned about trust from our participation in the U.S. Equity-First Vaccination Initiative, an effort funded by The Rockefeller Foundation to promote COVID-19 vaccination equity. The first lesson is that trust cannot be "surged" to meet the needs of the moment until it is no longer deemed important; rather, it must predate and outlast the crisis. Second, to generate long-term change, health systems cannot simply rely on CBOs to bridge the trust gap; instead, they must directly address the root causes of this gap among BIPOC populations. [ABSTRACT FROM AUTHOR]

The article contains a systematic review of the scientific literature on the nurse turnover problem. It is analysed from two perspectives. Firstly, the topic of employees is discussed (increased workload, inconsistency of salary with the amount of work performed, standards for the number of patients assigned to one nurse, job dissatisfaction, limited opportunities for career growth and professional development, professional burnout, unregulated rest time between shifts, etc.). Secondly, medical institution is described (shortage of medical staff leads to a decrease in patient satisfaction, loss of care quality, increased waiting time for services, review of safety and patient care protocols, reduction in the number of patients who can receive medical care or consultation, which causes a decrease in hospital revenue, hinders organisational growth, raises the cost of additional recruitment, leads to medical errors that turn into lawsuits in future, etc.). In addition to personal and financial reasons, the medical staff turnover is often caused by purely organisational imbalances (in particular, the lack of a teamwork atmosphere in the hospital, an ineffective leadership model, an imperfect and stressful working environment, poor working conditions, poor relations between doctors and nurses, etc.). The article represents mechanisms for applying provisions of a number of theories and models to address the nurse turnover problem. Among examples, there are leadership models -- the contingency theory (concepts of adaptation, equivalence, effectiveness and congruence), the organisational culture theory like Hofstede's corporate culture theory (concepts of power distance, uncertainty avoidance, male / female values, collectivism / individualism, long-term / short-term orientation, indulgence / restraint), the change management theory like the Plan-Do-Study-Act cycle theory. Tenet Healthcare, Inc. was selected as a case study. One of the well-known and largest healthcare organisations in the United States, it has been experiencing significant problems with the nurse turnover since 2006, which is currently over 50% and higher than the industry average. Given the size of this organisation and its leading position in the US healthcare market, this problem poses a significant threat to the market as a whole, and Tenet Healthcare, Inc. is in immediate need of a comprehensive plan to address [ABSTRACT FROM AUTHOR]

This content is provided by the American Academy of Family Physicians. [ABSTRACT FROM AUTHOR]

Demand for acute care is forecasted to grow in the United States. To meet this demand, nurse practitioners (NPs) are increasingly employed in acute care settings. Yet, there is concern about an adequate supply of acute care NPs given demand. Further, professional nursing organizations recommend aligning an NP's role with their education, certification, licensure, and practice. Given workforce constraints and the policy environment, little is known about how hospitals approach hiring NPs for acute care roles. The purpose of this study was to explore advanced practice provider (APP) directors' approaches to hiring NPs within the context of alignment and describe factors that influence hiring decisions. We conducted semi-structured interviews with 17 APP directors in hospitals and health systems. Interviews were recorded, transcribed, and coded using an iterative, hybrid inductive and deductive method. Two themes emerged: (1) local factors that inform aligned hiring and (2) adaptive hiring responses to changing environments. Practices around hiring NPs varied across institutions influenced by organization and state policies and regulations, workforce availability, and institutional culture. Most APP directors recognized trends towards hiring aligned NPs for acute care roles. However, they also identified barriers to fully aligning their NP workforce and described adaptive strategies including hiring physician assistants, building relationships with APP schools, and leveraging hospital resources to develop the APP workforce to meet care delivery demands given the current NP workforce supply. Future research is needed to assess widespread practices around acute care NP alignment and the implications of alignment for patient and organizational outcomes. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 social distancing guidelines resulted in a dramatic transition to telephone and video technologies to deliver substance use disorder (SUD) treatment. Before COVID-19, the question was "Will telehealth ever take hold for SUD services?" Now that social distancing guidelines have been lifted, the question is "Will telehealth remain a commonly used care modality?" Objective: The principal purpose of this investigation was to examine the extent to which telehealth use in SUD service settings persisted following the lifting of COVID-19 safety distancing recommendations. Additionally, the study aimed to explore practitioners' perceptions of telehealth convenience and value after its regular implementation during the pandemic. Specifically, the goal of this study was to compare telehealth activity between time intervals: May-August 2020 (during peak COVID-19 safety distancing recommendations) and October-December 2022 (following discontinuation of distancing recommendations). Specifically, we compared (1) telehealth technologies and services, (2) perceived usefulness of telehealth, (3) ease of use of telephone- and video-based telehealth services, and (4) organizational readiness to use telehealth. Methods: An online cross-sectional survey consisting of 108 items was conducted to measure the use of telehealth technologies for delivering a specific set of SUD services in the United States and to explore the perceived readiness for use and satisfaction with telephonic and video services. The survey took approximately 25-35 minutes to complete and used the same 3 sets of questions and 2 theory-driven scales as in a previous cross-sectional survey conducted in 2020. Six of 10 Regional Addiction Technology Transfer Centers funded by the Substance Abuse and Mental Health Services Administration distributed the survey in their respective regions, collectively spanning 37 states. Responses of administrators and clinicians (hereafter referred to as staff) from this 2022 survey were compared to those obtained in the 2020 survey. Responses in 2020 and 2022 were anonymous and comprised two separate samples; therefore, an accurate longitudinal model could not be analyzed. Results: A total of 375 staff responded to the 2022 survey (vs 457 in 2020). Baseline organizational characteristics of the 2022 sample were similar to those of the 2020 sample. Phone and video telehealth utilization rates remained greater than 50% in 2022 for screening and assessment, case management, peer recovery support services, and regular outpatient services. The perceived usefulness of phone-based telehealth was higher in 2022 than in 2020 (mean difference [MD] -0.23; P=.002), but not for video-based telehealth (MD -0.12; P=.13). Ease of use of video-based telehealth was perceived as higher in 2022 than in 2020 (MD-0.35; P<.001), but no difference was found for phone-based telehealth (MD -0.12; P=.11). From the staff's perspective, patients had greater readiness for using telehealth via phone than video, but the staff perceived their personal and organizational readiness for using telehealth as greater for video-based than for phone-based telehealth. Conclusions: Despite lower telephone and video use in 2022 for telehealth services than in 2020, both modalities continue to be perceived positively. Future research may further determine the relative cost and clinical effectiveness of video-based services and thereby help to address some sources of the noted challenges to implementation by SUD organizations. [ABSTRACT FROM AUTHOR]

This essay reflects on the history of napalm and the US anti-war movement to examine the university as both a site of research and development for chemical and biological warfare during the Cold War, as well as a site of abolitionist intervention and struggle. On one hand, napalm represented how war structured the fabric of everyday life in the United States, a condition of total war that overtook institutions of knowledge production within universities, corporations, and laboratories across the nation. On the other hand, napalm was viewed as exceptionally inhumane compared to other tactics of war, prompting movements for outlawing the chemical from military use. This dissonance between organizing against war itself as a perpetual structure of violence and against napalm as an individual technology of war invites consideration of the material stakes of anti-war organizing in an abolitionist vision. As the military–industrial complex only strengthens the entanglements between the university, corporate capitalism, and military expansion, this essay asks: how might we grapple with our place as abolitionist and anti-militarist scholars to interrogate our relationship to knowledge production and the university itself? [ABSTRACT FROM AUTHOR]

This study contributes to the limited literature on the personal branding of knowledge workers by revealing that a culture that incorporates knowledge, learning, and collaboration supports (explicit and tacit) knowledge sharing among employees and that sharing matters for knowledge workers' self-perceived personal brand equity. Analysis of 2,168 cases from the United States and Poland using structural equation modeling (SEM) showed that this knowledge-sharing mechanism differs by country and gender. Findings revealed that in the United States, the knowledge culture and collaboration culture are highly correlated and dominate the learning culture. In both countries, the mistake acceptance component of the learning culture is not supported by knowledge culture as strongly as is the climate component. These findings reveal a bias concerning the acceptance of mistakes as a potential source of learning observed if the culture of knowledge dominates. Moreover, this study uncovers some significant gender differences that might be caused by the gender stereotypes existing in STEM (science, technology, engineering, mathematics). Finally, the study confirms that knowledge workers' personal branding is a potent motive to smoothen and increase the knowledge-sharing flow in knowledge-driven organizations. [ABSTRACT FROM AUTHOR]