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Staffing
Kinds of Staffing Terms modified by Staffing Selected AbstractsThe Business of Temporary Staffing: A Developing Research AgendaGEOGRAPHY COMPASS (ELECTRONIC), Issue 8 2010Neil M. Coe This paper offers a critical review of the existing literatures on temporary staffing. It argues that while research on both client firm rationales and the experiences and characteristics of temporary agency workers are relatively well advanced, work that explores the temporary staffing industry and its own strategies and expansionary logics is still in its infancy. This is a significant oversight given the increasingly widespread influence of this particular form of labour market intermediary. Grounded in recent work in economic geography, the paper maps a future research agenda. [source] Do Medicaid Wage Pass-through Payments Increase Nursing Home Staffing?HEALTH SERVICES RESEARCH, Issue 3 2010Zhanlian Feng Objective. To assess the impact of state Medicaid wage pass-through policy on direct-care staffing levels in U.S. nursing homes. Data Sources. Online Survey Certification and Reporting (OSCAR) data, and state Medicaid nursing home reimbursement policies over the period 1996,2004. Study Design. A fixed-effects panel model with two-step feasible-generalized least squares estimates is used to examine the effect of pass-through adoption on direct-care staff hours per resident day (HPRD) in nursing homes. Data Collection/Extraction Methods. A panel data file tracking annual OSCAR surveys per facility over the study period is linked with annual information on state Medicaid wage pass-through and related policies. Principal Findings. Among the states introducing wage pass-through over the study period, the policy is associated with between 3.0 and 4.0 percent net increases in certified nurse aide (CNA) HPRD in the years following adoption. No discernable pass-through effect is observed on either registered nurse or licensed practical nurse HPRD. Conclusions. State Medicaid wage pass-through programs offer a potentially effective policy tool to boost direct-care CNA staffing in nursing homes, at least in the short term. [source] An Incenter Nocturnal Hemodialysis Program,Three Years ExperienceHEMODIALYSIS INTERNATIONAL, Issue 1 2003M. Gene Radford We report our experience with a program of long, slow, overnight hemodialysis (HD) performed 3 times a week in an existing dialysis facility. Beginning in April 1999, 14 chairs in one bay of our facility were replaced with beds, subdued lighting was installed, and machine alarms were decreased to minimum volume. Fresenius F60 dialyzers were selected with a QB of 220,300 ml/min and a QD of 400,500 ml/min. Patients dialyze for 7,8 hrs overnight. Staffing is with 1 nurse and 1 PCT for 10 patients. Standard dialysate is used, and heparin is dosed 100 U/kg at treatment initiation and again at mid-treatment. All access types are utilized. The program is open to all patients in our area. A total of 65 patients have participated, with a current census of 20 patients. Participants have tried nocturnal dialysis for a variety of reasons including work/school schedules, excessive interdialytic weight gains, inadequate dialysis (due to poor access function or large body mass), and hemodynamic instability with standard daytime HD. Blood pressure control has improved among the participants in the program, perhaps due to more gentle ultrafiltration and improvement in maintenance of dry weight. Among 31 patients who remained on nocturnal dialysis for over 6 months, 21 started the program on an average of 2.5 antihypertensive agents (AHA). After 6 months, 9 patients no longer needed AHA while 12 patients remain on an average of 1.3 AHA. URR also improved by an average of 4.35 among 13 patients who transferred from standard incenter HD to the nocturnal program. In all, 45 patients have left the program, for reasons which include insomnia/social (15), death (9), transfer to home HD (8), renal transplantation (6), noncompliance (3), moved away (2), and other (2). In conclusion, long overnight HD can be performed in an existing dialysis facility, providing patients with another HD option. Patients who may benefit from this modality include those with daytime jobs, patients with inadequate clearance on standard HD, patients with excessive interdialytic weight gains, and those who poorly tolerate standard HD. [source] Temporary Employment and Strategic Staffing in the Manufacturing SectorINDUSTRIAL RELATIONS, Issue 1 2009MATT VIDAL While prior research has identified different ways of using temporary workers to achieve numerical flexibility, quantitative analysis of temporary employment has been limited to a few key empirical indicators of demand variability that may confound important differences. Our analysis provides evidence that many manufacturers use temporary workers to achieve what we call planned and systematic numerical flexibility rather than simply in a reactive manner to deal with unexpected problems. Although temporary work may provide many benefits for employers, a key function appears to be the provision of numerical flexibility not to buffer core workers but to externalize certain jobs. [source] Technology Trends in Staffing and Assessment: A Practice NoteINTERNATIONAL JOURNAL OF SELECTION AND ASSESSMENT, Issue 2-3 2003John W. Jones This practice note listed and described, from a practitioner's perspective, ten dominant technology trends that are impacting the personnel testing industry. Five trends were classified as ,platform-centric,' and five were classified as ,information-centric.' Platform-centric trends were related to virtual career centers, integrated assessment platforms, media-rich assessments, technology-friendly tests, and the adaptation of personnel tests to emerging technologies. Information-centric trends were related to Internet-age access and fairness concerns, computer-enabled scoring innovations, strategic HR data warehousing and mining, satisfaction with computer-based assessments, and computer-based testing standards. A review of these ten technology trends suggests that the personnel testing industry is keeping pace with rapid technological innovations. [source] Call for Papers for a Special Issue: Technology in Staffing and AssessmentINTERNATIONAL JOURNAL OF SELECTION AND ASSESSMENT, Issue 3 2002Article first published online: 16 DEC 200 No abstract is available for this article. [source] Effective assessment of use of sitters by nurses in inpatient care settingsJOURNAL OF ADVANCED NURSING, Issue 2 2008Huey-Ming Tzeng Abstract Title.,Effective assessment of use of sitters by nurses in inpatient care settings Aim., This paper is a report of the evaluation of the impact of adopting the Patient Attendant Assessment Tool (PAAT) on nurses' requests for sitters, use of restraints, and falls and fall injury rates. Background., Staffing should be the primary issue in eliminating risks of patient falls during hospital stays. Method., Data were collected in two acute adult medical units of a Michigan hospital from August 2005 to February 2007. Data from three sources were merged for analyses: (1) study units' monthly reports; (2) quarterly reports of the National Database of Nursing Quality Indicators and (3) PAAT reports collected from October 2006 to February 2007. The primary outcome variables were the use of sitters, number of restraints ordered and fall and fall injury rates. Independent t -tests and correlation analyses were used for data analyses. The data before and after adopting this tool were compared using independent t -tests. Findings., The PAAT helped improve the fill/request rates for sitters. The use of soft limb holders decreased after adoption of this tool. The results also showed that if the number of sitter requests was higher, the total number of restraints would be lower but the total fall rate would be higher. Conclusion., Hospitals should include a tool similar to the PAAT in guidelines related to provision of constant observation or use of sitters. Further investigations of the optimum combination of staffing patterns and infrastructure are needed to promote safer hospital stays. [source] Nurse absenteeism and workload: negative effect on restraint use, incident reports and mortalityJOURNAL OF ADVANCED NURSING, Issue 6 2007Lynn Unruh Abstract Title.,Nurse absenteeism and workload: negative effect on restraint use, incident reports and mortality Aim., This paper is a report of a study to assess the impact of nurse absenteeism on the quality of patient care. Background., Nurse absenteeism is a growing management concern. It can contribute to understaffed units, staffing instability, and other factors that could have a negative impact on patient care. The impacts of absenteeism on the quality of nursing care have rarely been studied. Method., Retrospective monthly data from incident reports and staffing records in six inpatient units for 2004 were analysed. Dependent variables were the numbers of restraints, alternatives to restraints, incident reports, deaths, and length of stay. Explanatory variables were nurse absenteeism hours, patient days per nursing staff, and interaction between these variables. Controls were patient acuity and unit characteristics. Fixed effects regressions were analysed as regular or negative binomial models. Findings., Neither high Registered Nurse absenteeism nor high patient load was related to restraint use when taken separately. However, high Registered Nurse absenteeism was related to restraint use when patient load was high. Registered Nurse absenteeism was related to a lower use of alternatives to restraints. Incident reports were increased by high patient load, but not absenteeism, or absenteeism given patient load. When both patient load and absenteeism were high, deaths were higher also. Conclusion., Absenteeism alone may not be a strong factor in lowering quality, but the combination of high Registered Nurse absenteeism and high patient load could be a factor. Staffing and absenteeism may be part of a vicious cycle in which low staffing contributes to unit absenteeism, which contributes to low staffing, and so on. [source] The Effects of Staffing on In-Bed Times of Nursing Home ResidentsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2004Barbara M. Bates-Jensen PhD, CWOCN Objectives: To examine the effect of staffing level on time observed in bed during the daytime in nursing home (NH) residents. Design: Descriptive, cross-sectional study. Setting: Thirty-four southern California NHs. Participants: A total of 882 NH residents: 837 had hourly observation data, 777 had mealtime observations, 837 completed interviews, and 817 completed a physical performance test. Measurements: Cross-sectional data collected from participants at each NH site included direct observations (hourly and mealtime), resident interviews, medical record review, and physical performance tests. Results: In multivariate analyses, staffing level remained the strongest predictor of time observed in bed after controlling for resident functional measures (odds ratio=4.89; P=.042). Residents observed in bed during the daytime in more than 50% of hourly observations were observed also to experience increased daytime sleeping (P<.001) and less social engagement (P=.026) and consumed less food and fluids during mealtimes than those observed in bed in less than 50% of observations, after adjusting for resident function (P<.001). Conclusion: In this sample of NHs, resident functional measures and NH staffing level predicted observed time in bed according to hourly observations, with staffing level the most powerful predictor. Neither of these predictors justifies the excessive in-bed times observed in this study. Staff care practices relevant to encouraging residents to be out of bed and resident preferences for being in bed should be examined and improved. Practice recommendations regarding in-bed time should be considered, and further research should seek to inform the development of such recommendations. [source] International Experts' Perspectives on the State of the Nurse Staffing and Patient Outcomes LiteratureJOURNAL OF NURSING SCHOLARSHIP, Issue 4 2007Koen Van den Heede Purpose: To assess the key variables used in research on nurse staffing and patient outcomes from the perspective of an international panel. Design: A Delphi survey (November 2005-February 2006) of a purposively-selected expert panel from 10 countries consisting of 24 researchers specializing in nurse staffing and quality of health care and 8 nurse administrators. Methods: Each participant was sent by e-mail an up-to-date review of all evidence related to 39 patient-outcome, 14 nurse-staffing and 31 background variables and asked to rate the importance/usefulness of each variable for research on nurse staffing and patient outcomes. In two subsequent rounds the group median, mode, frequencies, and earlier responses were sent to each respondent. Findings: Twenty-nine participants responded to the first round (90.6%), of whom 28 (87.5%) responded to the second round. The Delphi panel generated 7 patient-outcome, 2 nurse-staffing and 12 background variables in the first round, not well-investigated in previous research, to be added to the list. At the end of the second round the predefined level of consensus (85%) was reached for 32 patient outcomes, 10 nurse staffing measures and 29 background variables. The highest consensus levels regarding measure sensitivity to nurse staffing were found for nurse perceived quality of care, patient satisfaction and pain, and the lowest for renal failure, cardiac failure, and central nervous system complications. Nursing Hours per Patient Day received the highest consensus score as a valid measure of the number of nursing staff. As a skill mix variable the proportion of RNs to total nursing staff achieved the highest consensus level. Both age and comorbidities were rated as important background variables by all the respondents. Conclusions: These results provide a snapshot of the state of the science on nurse-staffing and patient-outcomes research as of 2005. The results portray an area of nursing science in evolution and an understanding of the connections between human resource issues and healthcare quality based on both empirical findings and opinion. [source] Patients' Desire to Keep Their Babies in Their Rooms: What Does That Mean for Unit Staffing?JOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 2010Professional Issues No abstract is available for this article. [source] Experts Discuss Budgets, Staffing, Safety and MoreNURSING FOR WOMENS HEALTH, Issue 6 2006Mary Henrikson MN First page of article [source] National Health Service Corps Staffing and the Growth of the Local Rural Non-NHSC Primary Care Physician WorkforceTHE JOURNAL OF RURAL HEALTH, Issue 4 2006Donald E. Pathman MD ABSTRACT:,Context: Beyond providing temporary staffing, National Health Service Corps (NHSC) clinicians are believed by some observers to contribute to the long-term growth of the non-NHSC physician workforce of the communities where they serve; others worry that NHSC clinicians compete with and impede the supply of other local physicians. Purpose: To assess long-term changes in the non-NHSC primary care physician workforce of rural underserved counties that have received NHSC staffing support relative to workforce changes in underserved counties without NHSC support. Methods: Using data from the American Medical Association and NHSC, we compared changes from 1981 to 2001 in non-NHSC primary care physician to population ratios in 2 subsets of rural whole-county health professional shortage areas: (1) 141 counties staffed by NHSC physicians, nurse practitioners, and/or physician assistants during the early 1980s and for many of the years since and (2) all 142 rural health professional shortage area counties that had no NHSC clinicians from 1979 through 2001. Findings: From 1981 to 2001, counties staffed by NHSC clinicians experienced a mean increase of 1.4 non-NHSC primary care physicians per 10,000 population, compared to a smaller, 0.57 mean increase in counties without NHSC clinicians. The finding of greater non-NHSC primary care physician to population mean ratio increase in NHSC-supported counties remained significant after adjusting for baseline county demographics and health care resources (P < .001). The estimated number of "extra" non-NHSC physicians in NHSC-supported counties in 2001 attributable to the NHSC was 294 additional physicians for the 141 supported counties, or 2 extra physicians, on average, for each NHSC-supported county. Over the 20 years, more NHSC-supported counties saw their non-NHSC primary care workforces grow to more than 1 physician per 3,500 persons, but no more NHSC-supported than nonsupported counties lost their health professional shortage area designations.Conclusions: These data suggest that the NHSC contributed positively to the non-NHSC primary care physician workforce in the rural underserved counties where its clinicians worked during the 1980s and 1990s. [source] Association of British Clinical Diabetologists (ABCD) and Diabetes-UK survey of specialist diabetes services in the UK, 2006.DIABETIC MEDICINE, Issue 6 2008Abstract Aims To identify the views and working practices of consultant diabetologists in the UK in 2006,2007, the current provision of specialist services, and to examine changes since 2000. Methods All 592 UK consultant diabetologists were invited to participate in an on-line survey. Quantitative and qualitative analyses of responses were undertaken. A composite ,well-resourced service score' was calculated. In addition to an analysis of all respondents, a sub-analysis was undertaken, comparing localities represented both in 2006/2007 and in 2000. Results In 2006/2007, a 49% response rate was achieved, representing 50% of acute National Health Service Trusts. Staffing levels had improved, but remained below recommendations made in 2000. Ten percent of specialist services were still provided by single-handed consultants, especially in Northern Ireland (in 50% of responses, P = 0.001 vs. other nations). Antenatal, joint adult,paediatric and ophthalmology sub-specialist diabetes services and availability of biochemical tests had improved since 2000, but access to psychology services had declined. Almost 90% of consultants had no clinical engagement in providing community diabetes services. The ,well-resourced service score' had not improved since 2000. There was continued evidence of disparity in resources between the nations (lowest in Wales and Northern Ireland, P = 0.007), between regions in England (lowest in the East Midlands and the Eastern regions, P = 0.028), and in centres with a single-handed consultant service (P = 0.001). Job satisfaction correlated with well-resourced service score (P = 0.001). The main concerns and threats to specialist services were deficiencies in psychology access, inadequate staffing, lack of progress in commissioning, and the detrimental impact of central policy on specialist services. Conclusions There are continued disparities in specialist service provision. Without effective commissioning and adequate specialist team staffing, integrated diabetes care will remain unattainable in many regions, regardless of reconfigurations and alternative service models. [source] Addiction research centres and the nurturing of creativity: The Centre for Addictions Research of British Columbia, CanadaADDICTION, Issue 2 2010Tim Stockwell ABSTRACT The Centre for Addictions Research of British Columbia (CARBC) was established as a multi-campus and multi-disciplinary research centre administered by the University of Victoria (UVic) in late 2003. Its core funding is provided from interest payments on an endowment of CAD$10.55 million. It is supported by a commitment to seven faculty appointments in various departments at UVic. The Centre has two offices, an administration and research office in Victoria and a knowledge exchange unit in Vancouver. The two offices are collaborating on the implementation of CARBC's first 5-year plan which seeks to build capacity in British Columbia for integrated multi-disciplinary research and knowledge exchange in the areas substance use, addictions and harm reduction. Present challenges include losses to the endowment caused by the 2008/2009 economic crisis and difficulties negotiating faculty positions with the university administration. Despite these hurdles, to date each year has seen increased capacity for the Centre in terms of affiliated scientists, funding and staffing as well as output in terms of published reports, electronic resources and impacts on policy and practice. Areas of special research interest include: drug testing in the work-place, epidemiological monitoring, substance use and injury, pricing and taxation policies, privatization of liquor monopolies, polysubstance use, health determinants of indigenous peoples, street-involved youth and other vulnerable populations at risk of substance use problems. Further information about the Centre and its activities can be found on http://www.carbc.ca. [source] Graduate Medical Education Downsizing: Perceived Effects of Participating in the HCFA Demonstration Project in New York StateACADEMIC EMERGENCY MEDICINE, Issue 2 2001Linda L. Spillance MD Abstract. Objective: Financial support for graduate medical education (GME) is shrinking nationally as Medicare cuts GME funds. Thirty-nine hospitals in New York State (NYS) voluntarily participated in a Health Care Financing Administration demonstration project (HCFADP),the goal of which was to reduce total residency training positions by 4-5%/year over a five-year period, while increasing primary care positions. The objective of this study was to determine the effect of downsizing on emergency department (ED) staffing and emergency medicine (EM) residency training. Methods: Structured interviews and surveys of NYS program directors (PDs) were conducted in October,December 1999. Simple frequencies are reported. Results: One hundred percent of 17 PDs completed the interviews and seven of 12 participants in the HCFADP returned surveys. Twelve of 17 programs participated in HCFADP and two programs downsized outside HCFADP. Seven of 12 participants lost EM positions. Six of 12 programs were forced to exclude outside residents from rotating in their ED, leading to a need for one participating program and one non-participating program to find alternative sites for trauma. Five of 12 institutions provided resident staffing data, reporting a reduction in ED resident coverage in year 1 of the project of 9-40%. Programs compensated by increasing the number of shifts worked (4/12), increasing shift length (1/12), decreasing pediatric ED shifts (1/12), decreasing elective or research time (2/12), and decreasing off-service rotations (4/12). Six departments hired physician assistants or nurse practitioners, two hired faculty, and two hired resident moonlighters. Six of 12 programs withdrew from HCFADP and returned to previous resident numbers. Eight of 12 PDs thought that they had decreased time for clinical teaching. Conclusions: A 4-5% reduction in residency positions was associated with a marked reduction in ED resident staffing and EM residency curriculum changes. [source] The Business of Temporary Staffing: A Developing Research AgendaGEOGRAPHY COMPASS (ELECTRONIC), Issue 8 2010Neil M. Coe This paper offers a critical review of the existing literatures on temporary staffing. It argues that while research on both client firm rationales and the experiences and characteristics of temporary agency workers are relatively well advanced, work that explores the temporary staffing industry and its own strategies and expansionary logics is still in its infancy. This is a significant oversight given the increasingly widespread influence of this particular form of labour market intermediary. Grounded in recent work in economic geography, the paper maps a future research agenda. [source] Banishing Bureaucracy or Hatching a Hybrid?GOVERNANCE, Issue 2 2000The CanadianFood Inspection Agency, the Politics of Reinventing Government The Canadian Food Inspection Agency (CFIA) is a means to overcoming long-standing bureaucratic politics while attaining some major policy ends.Contrary to some of the new public management bravado of transforming the public sector, the CFIA is not a bureaucratic revolution in reshaping the Canadian State. Changes in scientific staffing, funding, and inspection have been more incremental than fundamental. Moreover, the CFIA is something less than the special and separate operating agency models discussed in the alternative service delivery literature in terms of autonomy and market orientation, but something more autonomous and entrepreneurial than traditional government departments. These organizational and managerial reforms are modest extensions providing a means for achieving economies and enhanced effectiveness in carrying out the mandate of safety, consumer protection, and market access for Canadian food, animal, plant, and forestry products. [source] Older patients and delayed discharge from hospitalHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2000Christina R. Victor BA M Phil PhD Hon MFPHM Abstract Older people (those aged 65 years and over) are the major users of health care services, especially acute hospital beds. Since the creation of the NHS there has been concern that older people inappropriately occupy acute hospital beds when their needs would be best served by other forms of care. Many factors have been associated with delayed discharge (age, sex, multiple pathology, dependency and administrative inefficiencies). However, many of these factors are interrelated (or confounded) and few studies have taken this into account. Using data from a large study of assessment of older patients upon discharge from hospital in England, this paper examines the extent of delayed discharge, and analyses the factors associated with such delays using a conceptual model of individual and organisational factors. Specifically, this paper evaluates the relative contribution of the following factors to the delayed discharge of older people from hospital: predisposing factors (such as age), enabling factors (availability of a family carer), vulnerability factors (dependency and multiple pathology), and organisational/administrative factors (referral for services, type of team undertaking assessments). The study was a retrospective patient case note review in three hospitals in England and included four hundred and fifty-six patients aged 75 years and over admitted from their own homes, and discharged from specialist elderly care wards. Of the 456 patients in the sample, 27% had a recorded delay in their discharge from hospital of three plus days. Multivariate statistical analysis revealed that three factors independently predicted delay in discharge: absence of a family carer, entry to a nursing/residential home, and discharge assessment team staffing. Delayed discharge was not related to the hypothesised vulnerability factors (multiple dependency and multiple pathology) nor to predisposing factors (such as age or whether the older person lived alone). The delayed discharge of older people from hospital is a topic of considerable policy relevance. Our study indicated that delay was independently related to two organisational issues. First, entry into long-term care entailed lengthy assessment procedures, uncertainty over who pays for this care, and waiting lists. Second, the nature of the team assessing people for discharge was associated with delay (the nurse-coordinated team made the fewest referrals for multidisciplinary assessments and had the longest delays). Additionally, the absence of a family carer was implicated in delay, which underlines the importance of family and friends in providing posthospital care and in maintaining older people in the community. Our study suggests that considerable delay in discharging older people from hospital originates from administrative/organisational issues; these were compounded by social services resource constraints. There is still much to be done therefore to improve coordination of care in order to provide a truly ,seamless service'. [source] Patient Advice and Liaison Services: results of an audit survey in EnglandHEALTH EXPECTATIONS, Issue 3 2008David Evans BA MA DPhil FFPH RGN Abstract Objective, To assess the extent national standards for Patient Advice and Liaison Services (PALS) were achieved across England. Context, PALS are an important element of patient and public involvement strategy in England. Seven national standards for PALS were identified. Previous research has not assessed PALS across all trust types in England. Design, Audit survey as part of a mixed method ,realistic evaluation' in which regularities of context, mechanism and outcome are hypothesized and tested. Setting and participants, PALS based in 570 NHS trusts in England between October and December 2005. Main outcome measures, Self reported achievement against PALS national standards. Results, Three hundred and thirty-six valid responses were received, a response rate of 65%. However because some PALS serve more than one trust, this represents an estimated 76% of trusts. Overall, PALS rated themselves highly against all the standards, though somewhat less highly against standard 2 (seamlessness across health and social care) and standard 6 (acting as a catalyst for culture change). There was a wide range of responses with regard to PALS budget, staffing and activity levels, and statistically significant associations between levels of funding and staffing and higher levels of performance. Conclusions, The overall response rate was good so there can be a high degree of confidence in the reliability of the results. The results indicate the challenging context in which PALS are operating. Although the majority of PALS are single trust PALS, there is a high degree of variation in key mechanism factors such as budget and staffing. [source] Swimming against the tide: Outward staffing flows from multinational subsidiariesHUMAN RESOURCE MANAGEMENT, Issue 4 2010David G. Collings Abstract Studying the flows of parent country nationals in multinational enterprises (MNEs) to subsidiary operations has a relatively long tradition. Studying flows of subsidiary employees to other subsidiaries, as third country nationals, and to the corporate headquarters, as inpatriates, however, has empirically much less pedigree. Drawing on a large-scale empirical study of MNEs in Ireland, this paper provides a benchmark of outward flows of international assignees from the Irish subsidiaries of foreign-owned MNEs to both corporate headquarters and other worldwide operations. Building on insights from the resource-based view and neo-institutional theory, we develop and test a theoretical model to explain outward staffing flows. The results show that almost half of all MNEs use some form of outward staffing flows from their Irish operations. Although the impact of specific variables in explaining inter-organization variation differs between the utilization of inpatriate and third country national assignments, overall we find that a number of headquarters, subsidiary, structural, and human resource systems factors emerge as strong predictors of outward staffing flows. © 2010 Wiley Periodicals, Inc. [source] Attracting and selecting: What psychological research tells usHUMAN RESOURCE MANAGEMENT, Issue 4 2004Ann Marie Ryan HR practitioners often have misperceptions regarding research findings in the area of employee selection. This article reviews research on what selection tools work, what recruitment strategies work, how selection-tool use relates to workforce diversity, and what staffing and recruiting processes lead to positive applicant perceptions. Knowledge and implementation gaps in these areas are discussed, and key research findings are presented. © 2004 Wiley Periodicals, Inc. [source] Improvements in early care in Russian orphanages and their relationship to observed behaviorsINFANT MENTAL HEALTH JOURNAL, Issue 2 2005Christina J. Groark This article describes a unique study that attempts to promote positive social-emotional relationships and attachment between caregivers and children in orphanages in St. Petersburg, Russia. The children who reside in these orphanages are typically between birth and 48 months of age; approximately 50% are diagnosed with disabilities, and approximately 60% leave through foreign adoption. Initially, their orphanage caregivers showed a high level of current anxiety and depression and were detached from and communicated little with the children. Likewise, during baseline observations, the children demonstrated poor attachment behaviors such as indiscriminant friendliness, lack of eye contact with adults, aggression, and impulsive behavior. Two interventions were used in a quasiexperimental design: (a) training of caregivers to promote warm, responsive caregiving and (b) staffing and structural alterations to support relationship building, especially increasing the consistency of caregivers. The methodology required that both the training and staffing interventions be provided to one orphanage, only the training to a second, and neither to a third. (At any one time, ns = 80,120 in each condition.) Initial informal observations reveal positive behaviors for both the caregivers and the children, such as increased two-way conversations, animated and enthusiastic emotional responses, and positive social and language interactions. Early data analyses show an increase in the consistency and stability of caregivers and increased scores for caregivers on every subscale of the HOME Scales. Children showed improvements in physical growth, cognition, language, motor, personal-social, and affect, with children having severe disabilities improving the most. The implications of these findings suggest that training staff with modest educational backgrounds and structural changes are effective, can increase socially responsive caregiving behaviors, and improves social interactions of children, at least temporarily. ©2005 Michigan Association for Infant Mental Health. [source] Audit Programs and Audit Risk: A Study of Japanese PracticeINTERNATIONAL JOURNAL OF AUDITING, Issue 1 2006Hironori Fukukawa The current paradigm in audit practice for evidential planning is the Audit Risk Model. However, the notion of relevant risks has broadened with the adoption in recent years of holistic audit approaches encompassing business and process risks and an increased focus on fraud risks. This study examines whether audit planning is ,risk adjusted' using archival data from 235 clients from a well-established audit firm in Japan. We address all four aspects of audit planning (nature, extent, timing and staffing) and examine a wider variety of client risks than prior archival studies in order to reflect the current holistic audit approaches of global auditing firms. The main results indicate that although audit planning is based on the level of and change in assessments of many audit risk variables, the associations between client risks and audit plans are rather modest. In this respect, our findings are consistent with those from prior research. We also find that client risks that comprise business risk and fraud risk affect audit planning to some extent. Finally, we report exploratory results suggesting a substitution effect between audit planning judgments in response to higher client risks such as increasing the extent of validity tests while decreasing the extent of confirmations. [source] Managing people and performance: an evidence based framework applied to health service organizationsINTERNATIONAL JOURNAL OF MANAGEMENT REVIEWS, Issue 2 2004Susan Michie People and their performance are key to an organization's effectiveness. This review describes an evidence-based framework of the links between some key organizational influences and staff performance, health and well-being. This preliminary framework integrates management and psychological approaches, with the aim of assisting future explanation, prediction and organizational change. Health care is taken as the focus of this review, as there are concerns internationally about health care effectiveness. The framework considers empirical evidence for links between the following organizational levels: 1Context (organizational culture and inter-group relations; resources, including staffing; physical environment) 2People management (HRM practices and strategies; job design, workload and teamwork; employee involvement and control over work; leadership and support) 3Psychological consequences for employees (health and stress; satisfaction and commitment; knowledge, skills and motivation) 4Employee behaviour (absenteeism and turnover; task and contextual performance; errors and near misses) 5Organizational performance; patient care. This review contributes to an evidence base for policies and practices of people management and performance management. Its usefulness will depend on future empirical research, using appropriate research designs, sufficient study power and measures that are reliable and valid. [source] Community mental health nursing: Keeping pace with care delivery?INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2008Julie Henderson ABSTRACT:, The National Mental Health Strategy has been associated with the movement of service delivery into the community, creating greater demand for community services. The literature suggests that the closure of psychiatric beds and earlier discharge from inpatient services, have contributed to an intensification of the workload of community mental health nurses. This paper reports findings from the first stage of an action research project to develop a workload equalization tool for community mental health nurses. The study presents data from focus groups conducted with South Australian community mental health nurses to identify issues that impact upon their workload. Four themes were identified, relating to staffing and workforce issues, clients' characteristics or needs, regional issues, and the impact of the health-care system. The data show that the workload of community mental health nurses is increased by the greater complexity of needs of community mental health clients. Service change has also resulted in poor integration between inpatient and community services and tension between generic case management and specialist roles resulting in nurses undertaking tasks for other case managers. These issues, along with difficulties in recruiting and retaining staff, have led to the intensification of community mental health work and a crisis response to care with less time for targeted interventions. [source] Nurse absenteeism and workload: negative effect on restraint use, incident reports and mortalityJOURNAL OF ADVANCED NURSING, Issue 6 2007Lynn Unruh Abstract Title.,Nurse absenteeism and workload: negative effect on restraint use, incident reports and mortality Aim., This paper is a report of a study to assess the impact of nurse absenteeism on the quality of patient care. Background., Nurse absenteeism is a growing management concern. It can contribute to understaffed units, staffing instability, and other factors that could have a negative impact on patient care. The impacts of absenteeism on the quality of nursing care have rarely been studied. Method., Retrospective monthly data from incident reports and staffing records in six inpatient units for 2004 were analysed. Dependent variables were the numbers of restraints, alternatives to restraints, incident reports, deaths, and length of stay. Explanatory variables were nurse absenteeism hours, patient days per nursing staff, and interaction between these variables. Controls were patient acuity and unit characteristics. Fixed effects regressions were analysed as regular or negative binomial models. Findings., Neither high Registered Nurse absenteeism nor high patient load was related to restraint use when taken separately. However, high Registered Nurse absenteeism was related to restraint use when patient load was high. Registered Nurse absenteeism was related to a lower use of alternatives to restraints. Incident reports were increased by high patient load, but not absenteeism, or absenteeism given patient load. When both patient load and absenteeism were high, deaths were higher also. Conclusion., Absenteeism alone may not be a strong factor in lowering quality, but the combination of high Registered Nurse absenteeism and high patient load could be a factor. Staffing and absenteeism may be part of a vicious cycle in which low staffing contributes to unit absenteeism, which contributes to low staffing, and so on. [source] School nursing: costs and potential benefitsJOURNAL OF ADVANCED NURSING, Issue 5 2000Linda Cotton RHV School nursing: costs and potential benefits Background. Previous reports that variations in school nursing resources across the UK had no relationship to deprivation; controversy about the changing role of the school nursing service. Objectives. To measure the resources allocated to school nursing, determine whether the variations can be explained by deprivation, and assess whether the allocation of school nursing time to a range of tasks is in line with current evidence and perceptions of changing needs. Study design. Quantitative economic analysis; qualitative descriptive study. Setting. Detailed study of four English districts with diverse characteristics; staffing and service questionnaire and telephone survey of 62 districts. Main measures. Staff resources and their salaries; measures of population and deprivation; activity statistics. Results. There were wide variations in the cost of the school nursing service, but in contrast to previous reports 24% of the variance was explained by deprivation. There were no clear associations with any other social or educational variables. The greatest allocation of time was in routine screening and surveillance tasks. Relatively little time was allocated to other activities such as health promotion, support of special needs or unwell children, or teenage clinics. The expenditure on school nursing is only loosely related to deprivation and the results of this study offer guidance on what districts should spend to achieve equity of provision. Conclusions. The current allocation of resources to school nursing in between districts comparisons is not equitable and the use of school nursing time is out of step with current evidence of need and effectiveness. [source] Physicians "Missing in Action": Family Perspectives on Physician and Staffing Problems in End-of-Life Care in the Nursing HomeJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2005Renée R. Shield PhD Objectives: To understand the roles of physicians and staff in nursing homes in relation to end-of-life care through narrative interviews with family members close to a decedent. Design: Qualitative follow-up interviews with 54 respondents who had participated in an earlier national survey of 1,578 informants. Setting: Brown University interviewers conducted telephone interviews with participants throughout the United States. Participants: The 54 participants agreed to a follow-up qualitative interview and were family members or close to the decedent. Measurements: A five-member, multidisciplinary team to identify overarching themes taped, transcribed, and then coded interviews. Results: Respondents report that healthcare professionals often insufficiently address the needs of dying patients in nursing homes and that "missing in action" physicians and insufficient staffing create extra burdens on dying nursing home residents and their families. Conclusion: Sustained efforts to increase the presence of physicians and improve staffing in nursing homes are suggested to improve end-of-life care for dying residents in nursing homes. [source] The Effects of Staffing on In-Bed Times of Nursing Home ResidentsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2004Barbara M. Bates-Jensen PhD, CWOCN Objectives: To examine the effect of staffing level on time observed in bed during the daytime in nursing home (NH) residents. Design: Descriptive, cross-sectional study. Setting: Thirty-four southern California NHs. Participants: A total of 882 NH residents: 837 had hourly observation data, 777 had mealtime observations, 837 completed interviews, and 817 completed a physical performance test. Measurements: Cross-sectional data collected from participants at each NH site included direct observations (hourly and mealtime), resident interviews, medical record review, and physical performance tests. Results: In multivariate analyses, staffing level remained the strongest predictor of time observed in bed after controlling for resident functional measures (odds ratio=4.89; P=.042). Residents observed in bed during the daytime in more than 50% of hourly observations were observed also to experience increased daytime sleeping (P<.001) and less social engagement (P=.026) and consumed less food and fluids during mealtimes than those observed in bed in less than 50% of observations, after adjusting for resident function (P<.001). Conclusion: In this sample of NHs, resident functional measures and NH staffing level predicted observed time in bed according to hourly observations, with staffing level the most powerful predictor. Neither of these predictors justifies the excessive in-bed times observed in this study. Staff care practices relevant to encouraging residents to be out of bed and resident preferences for being in bed should be examined and improved. Practice recommendations regarding in-bed time should be considered, and further research should seek to inform the development of such recommendations. [source] | ||||||||||||||||||||||||||||||||||||||||||||||