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Unit Level (unit + level)
Selected AbstractsStaff opinions about the leadership and organisation of municipal dementia careHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 5 2002L. Albinsson MD Abstract The present study describes the opinions of experienced staff providing direct care to patients with dementia in municipal units in Sweden. The focus is mainly on leadership and other organisational factors. A purposeful sample of 31 staff members employed in municipal dementia care in both urban and rural areas in mid-Sweden were selected. Data were collected within a qualitative paradigm using semi-structured interviews which were tape-recorded and analysed using a modified phenomenographical approach. The nearly unanimous opinions of the interviewees indicated that there was a great lack of daily leadership in the units. Thus, few units had clearly formulated goals and few had regular care planning for their residents. Poorly developed teamwork was reported in the care of people with dementia especially regarding doctors, whose visits to the unit were too infrequent and too short, and did not include a direct exchange of information with other staff. In addition, little or no staff education and guidance/supervision was provided on a regular basis. In conclusion, without any unreasonable increase in cost, measures such as introducing clear leadership at the care unit level, concentrating on multi-professional teamwork, and providing education and guidance/supervision to the staff would probably result in better care for patients with dementia and their families. [source] One Prudential Exchange,The Insurance Giant's Business Literacy and Alignment PlatformHUMAN RESOURCE MANAGEMENT, Issue 3 2001Richard McKnight This article describes how Prudential,in a dramatically changed marketplace,engaged its 55,000 employees as partners in transforming the company's many disparate businesses into one integrated company. Using a combination of large-and small-scale meetings, follow-up actions at the work unit level, and sophisticated performance enhancement processes, OPX (One Prudential Exchange) is helping transform Prudential from a staid insurance company to a modern financial services powerhouse. OPX has introduced the One Prudential vision to the company's 55,000 employees in nearly 300 large-scale meetings in 12 cities, and has institutionalized problem resolution and breakthrough dialogue processes in over 3,500 follow-up work unit meetings. © 2001 John Wiley & Sons, Inc. [source] Financial performance and the long-term link with HR practices, work climate and job stressHUMAN RESOURCE MANAGEMENT JOURNAL, Issue 4 2005Marc van Veldhoven Using data front a large financial services organisation in the Netherlands, this article reports a longitudinal study at the business unit level. The study addresses the question of which longitudinal relations exist between survey data on perceived HR practices, work climate and job stress on the one hand, and prospective and retrospective financial performance on the other. Data from 223 business units were available for this study. Eight scales were selected from an employee survey answered by 18,142 respondents. These were aggregated to mean scores at the business unit level. Financial performance is operationalised by a yearly profits-to-costs ratio. Correcting for employee and business unit characteristics, the eight survey scales predict 22 per cent of the variance in business unit financial performance in the year after the survey.,Co-operation between departments' appears to be the most important predictor. Equally strong evidence was friund for a reverse causation sequence: business unit financial performance in the year before the survey was a significant predictor for four out of eight survey scales, especially for ,co-operation between departments' and ,job security'. The results underline the importance of studying variance in HR and performance variables within large organisatiuns, and the possibilities of using employee surveys in this research context. Limitations and implications of the findings are discussed. [source] An air filter pressure loss model for fan energy calculation in air handling unitsINTERNATIONAL JOURNAL OF ENERGY RESEARCH, Issue 6 2003Mingsheng Liu Abstract Air filters consume a significant part of the fan power in air handling systems. Due to lack of suitable models, the fan energy associated with the filter pressure drop is often estimated based on average airflow and average pressure drop across the filter. Since the pressure drop varies nonlinearly with airflow and the filter resistance varies with dirt build-up, current methods often produce erroneous results. This paper presents a new air filter pressure loss model that has been developed and verified using experimental data. The model projects the pressure losses across the filter for both constant and variable airflows. The inputs to the model are the airflow rate, the time of use, the initial design and final pressure losses at the design flow rate, and the coefficient of a power law regression of pressure loss as a function of airflow rate. The air filter pressure loss model may be implemented in hourly building energy simulation programs that perform hourly simulation at the air handling unit level. Copyright © 2003 John Wiley & Sons, Ltd. [source] Shared governance as vertical alignment of nursing group power and nurse practice council effectivenessJOURNAL OF NURSING MANAGEMENT, Issue 1 2009RICHARD J. BOGUE PhD Aim(s), This study validates an instrument for measuring the effectiveness of nursing practice councils and offers a framework for measuring and understanding shared governance. Background, Empowerment results from the vertical alignment of nursing group power with nursing unit power practices. The field lacks an instrument for measuring nurses' practice of power. Method(s), Two studies (n1 = 119; n2 = 248) are used to validate the Nursing Practice Council effectiveness scale (NPCes). Results, NPCes is a valid and reliable index of nursing practice council effectiveness. This study suggests specific diagnostic tools to understand two levels for actualized power, one at the group or departmental level and one at the unit level. Conclusion(s), NPCes and the Sieloff-King Assessment of Group Power within Organizations (SKAGPO) can be used together to improve examination of shared governance. Examining group power as well as unit-level practices may give a more complete view of barriers to nurse empowerment. Implications for nursing management, Changing nursing power and practices in an organization may be made more effective by engaging and monitoring vertical alignment of strategies fostering power competencies among nurse leaders and simultaneously supporting nursing practice councils as a means of exercising nurse authority at the unit level. [source] Clinician perceptions of personal safety and confidence to manage inpatient aggression in a forensic psychiatric settingJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2006T. MARTIN rpn dn Inpatient mental health clinicians need to feel safe in the workplace. They also require confidence in their ability to work with aggressive patients, allowing the provision of therapeutic care while protecting themselves and other patients from psychological and physical harm. The authors initiated this study with the predetermined belief that a comprehensive and integrated organizational approach to inpatient aggression was required to support clinicians and that this approach increased confidence and staff perceptions of personal safety. To assess perceptions of personal safety and confidence, clinicians in a forensic psychiatric hospital were surveyed using an adapted version of the Confidence in Coping With Patient Aggression Instrument. In this study clinicians reported the hospital as safe. They reported confidence in their work with aggressive patients. The factors that most impacted on clinicians' confidence to manage aggression were colleagues' knowledge, experience and skill, management of aggression training, use of prevention and intervention strategies, teamwork and the staff profile. These results are considered with reference to an expanding literature on inpatient aggression. It is concluded that organizational resources, policies and frameworks support clinician perceptions of safety and confidence to manage inpatient aggression. However, how these are valued by clinicians and translated into practice at unit level needs ongoing attention. [source] Inflammation in end-stage renal disease: The hidden enemy (Review Article)NEPHROLOGY, Issue 1 2006PETER STENVINKEL SUMMARY: Cardiovascular disease (CVD) remains the major cause of morbidity and mortality in end-stage renal disease (ESRD) patients. As traditional risk factors cannot alone explain the unacceptable high prevalence and incidence of CVD in this high-risk population, inflammation (interrelated to insulin resistance, oxidative stress, wasting and endothelial dysfunction) has been suggested to be a significant contributor. Indeed, several different inflammatory biomarkers, such as high sensitivity C-reactive protein (hs-CRP), have been shown to independently predict mortality in ESRD patients. As CRP is so strongly associated with vascular disease it has been suggested that this hepatic-derived protein is not only a marker, but also a mediator, of vascular disease. Although in vitro data from studies on endothelial cells, monocytes-macrophages and smooth muscle cells support a direct role for CRP in atherogenesis, data from studies performed in vivo have been controversial. The causes of the highly prevalent state of inflammation in ESRD are multiple, including inflammatory signals associated with the dialysis procedure, decreased renal function, volume overload, comorbidity and intercurrent clinical events. As the prevalence of inflammation varies considerably between continents and races, dietary and/or genetic factors may have an impact on inflammation in ESRD. Elevated CRP in dialysis patients could be evaluated at three different levels: (i) national/regional level; (ii) dialysis unit level; and (iii) individual patient level. [source] SATISFACTION, CITIZENSHIP BEHAVIORS, AND PERFORMANCE IN WORK UNITS: A META-ANALYSIS OF COLLECTIVE CONSTRUCT RELATIONSPERSONNEL PSYCHOLOGY, Issue 1 2010DANIEL S. WHITMAN This paper offers theoretical development clarifying the structure and function of collective job satisfaction and uses meta-analytic methods (k,= 73) to examine the satisfaction,performance relationship when both constructs are construed at the work unit level. Overall, our results suggest that the relationship between unit-level job satisfaction and unit-level performance is significant (,= .34). Specifically, significant relationships were found between unit-level job satisfaction and unit-level criteria, including productivity, customer satisfaction, withdrawal, and organizational citizenship behaviors (OCB). Furthermore, the satisfaction-performance relationship was moderated by the strength of unit consensus, performance criteria, industry type, and whether the sample was U.S. based. Although these moderators were identified, collective satisfaction positively predicted performance across all levels of moderators. In addition, results indicate that unit-level OCB has a moderately strong relationship with unit-level performance. Only limited support was found for the notion that OCB is a route through which satisfaction has an impact on performance. We elaborate on these findings and attempt to provide a more clear direction for future research in this area. [source] Productivist Welfare Capitalism: Social Policy in East AsiaPOLITICAL STUDIES, Issue 4 2000Ian Holliday The article engages with the literature on the ,East Asian welfare model' by using Esping-Andersen's ,worlds of welfare capitalism' approach to analyze social policy in the region. It describes the main features of a productivist world of welfare capitalism that stands alongside Esping-Andersen's conservative, liberal and social democratic worlds. It then shows that Japan, Hong Kong, Singapore, South Korea and Taiwan are all part of this world, though they divide into sub-groups within it. To account for productivist welfare capitalism in East Asia, the article focuses particularly on bureaucratic politics at the unit level, and on a range of key shaping factors at the system level. It closes by considering the implications of East Asian experience for comparative social policy analysis. [source] Non-Parametric Ecological Regression and Spatial VariationBIOMETRICAL JOURNAL, Issue 6 2003Isabel Natário Abstract Ecological studies aim to analyse the variation of disease risk in relation to exposure variables that are measured at an area unit level. In practice it is rarely possible to use the exposure variables themselves, either because the corresponding data are not available or because the causes of the disease are not fully understood. It is therefore quite common to use crude proxies of the real exposure to the disease in question. These proxies are rarely able to explain the disease variation and hence additional area level random effects are introduced to account for the residual variation. In this paper we investigate the possibility to model the effect of ecological covariates non-parametrically, with and without additional random effects for the residual spatial variation. We illustrate the issues arising through analyses of simulated and real data on larynx cancer mortality in Germany, during the years of 1986 to 1990, where we use the corresponding lung cancer rates as a proxy for smoking consumption. [source] Canadian Approaches to E-Business ImplementationCANADIAN JOURNAL OF ADMINISTRATIVE SCIENCES, Issue 1 2003Rebecca Grant As Web-based business nears the decade mark, it is appropriate to take stock of its progress and the degree to which it has met or fallen short of predictions. This paper examines the extent to which companies have followed the advice of experts when it comes to designing an organizational structure for their e-business initiatives. It compares the prevalence of centralized versus business unit level decision-making in Canadian companies with e-business experience. It also explores who is given responsibility for application development, backend integration, and infrastructure maintenance. The data demonstrate that use of independent contractors has increased. However, outsourcing in general is less prevalent than predicted and implementation driven by business units, rare. Furthermore, the practices of companies with well-established initiatives differ significantly from those of the less experienced, offering important lessons for newcomers to e-business. Résumé Etant donné que le commerce basé sur la toile a presque dix ans, il est temps d'analyser son progrés et l'écart de résultat par rapport aux prédictions. La présente étude analyse quel a été le niveau de suivi des conseils d'expert par les entreprises en qui concerne la programmation des structures de mise en ,uvre de leurs projets de commerce électronique. Elle compare la position dominante des décisions prises au niveau centralisée sur celles prises au niveau de la division spécialisée chez les entreprises canadiennes ayant une expérience en commerce électronique. Elle fait apparaître également à qui a été confiée la responsabilité du développement des logiciels, de l'étape finale de l'intégration et de l'entretien de l'infrastructure. Les données démontrent que l'emploi des entrepreneurs indépendants a augmenté. Cependant, la sous-traitance n'est en général pas aussi forte que prévue et le développement assuré par les divisions spécialisées reste faible. En outre, la pratique des entreprises ayant des activités bien établies se distingue considérablement de celle qui ont moins d'expérience, offrant ainsi des leçons importantes pour les nouveaux venus du commerce électronique. [source] Burnout contagion among intensive care nursesJOURNAL OF ADVANCED NURSING, Issue 3 2005Arnold B. Bakker PhD Aim., This paper reports a study investigating whether burnout is contagious. Background., Burnout has been recognized as a problem in intensive care units for a long time. Previous research has focused primarily on its organizational antecedents, such as excessive workload or high patient care demands, time pressure and intensive use of sophisticated technology. The present study took a totally different perspective by hypothesizing that , in intensive care units , burnout is communicated from one nurse to another. Methods., A questionnaire on work and well-being was completed by 1849 intensive care unit nurses working in one of 80 intensive care units in 12 different European countries in 1994. The results are being reported now because they formed part of a larger study that was only finally analysed recently. The questionnaire was translated from English to the language of each of these countries, and then back-translated to English. Respondents indicated the prevalence of burnout among their colleagues, and completed scales to assess working conditions and job burnout. Results., Analysis of variance indicated that the between-unit variance on a measure of perceived burnout complaints among colleagues was statistically significant and substantially larger than the within-unit variance. This implies that there is considerable agreement (consensus) within intensive care units regarding the prevalence of burnout. In addition, the results of multilevel analyses showed that burnout complaints among colleagues in intensive care units made a statistically significant and unique contribution to explaining variance in individual nurses' and whole units' experiences of burnout, i.e. emotional exhaustion, depersonalization and reduced personal accomplishment. Moreover, for both emotional exhaustion and depersonalization, perceived burnout complaints among colleagues was the most important predictor of burnout at the individual and unit levels, even after controlling for the impact of well-known organizational stressors as conceptualized in the demand-control model. Conclusion., Burnout is contagious: it may cross over from one nurse to another. [source] Therapeutic hypothermia for neonatal encephalopathy: a UK survey of opinion, practice and neuro-investigation at the end of 2007ACTA PAEDIATRICA, Issue 4 2009Andrew Kapetanakis Abstract Background: The 2007 Cochrane review of therapeutic hypothermia for neonatal encephalopathy (NE) indicates a significant reduction in adverse outcome. UK National Institute for Clinical Excellence guidelines are awaited. Objective: To benchmark current opinion and practice to inform future strategies for optimal knowledge transfer for therapeutic hypothermia. Methods: A web based questionnaire (30 sections related to opinion and practice of management of NE) sent to the clinical leads of Level I, II and III neonatal units throughout the UK in November/December 2007. Results: One hundred and twenty-five (out of 195) UK neonatal units responded (response rate 66%). Ten percent, 37.5% and 51.5% responses were from level I, II and III units respectively. Twenty eight percent of all units provided therapeutic hypothermia locally (52% of level III units), however 80% of responders would offer therapeutic hypothermia if there was the facility. Overall, 57% of responders considered therapeutic hypothermia effective or very effective , similar for all unit levels; 43% considered more data are required. Regional availability of therapeutic hypothermia exists in 55% of units and 41% of units offer transfer to a regional centre for therapeutic hypothermia. Conclusion: In the UK in 2007, access to therapeutic hypothermia was widespread although not universal. More than half of responders considered therapeutic hypothermia effective. Fifty-five percent of perinatal networks have the facility to offer therapeutic hypothermia. The involvement of national bodies may be necessary to ensure the adoption of therapeutic hypothermia according to defined protocols and standards; registration is important and will help ensure universal neurodevelopmental follow up. [source] Magnet Recognition and Practice Development: Two journeys towards practice improvement in health careINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 6 2009Zoe Jordan BA MA (Communications Studies) Health service providers continue to struggle with recruitment, retention, evidence-based practice and practice improvement in order to provide high-quality care for the communities they serve. In doing so, they are often required to implement strategies, which require considerable change at both organizational and ward/unit levels. The question remains, how do health service providers instigate processes that will result in positive and sustainable changes to practice and better outcomes for staff and patients? This paper outlines two increasingly used strategies for practice improvement (namely Magnet Recognition and Practice Development), their points of convergence and divergence and makes some broad recommendations for those seeking effective strategies for change that are cognizant of context and culture. [source] | |||||||||||||