Engagement at work: a review of the literature.

jenaro c., flores n., orgaz m.b. & cruz m. (2011) Vigour and dedication in nursing professionals: towards a better understanding of work engagement. Journal of Advanced Nursing67(4), 865–875.

Abstract
Aim.  This paper analyses the association between nurses’ individual characteristics, job features and work engagement.

Background.  Current shortage of nurses and turnover justify more research efforts on job satisfaction. Closely associated with job satisfaction is work engagement, a construct which is composed of vigour, dedication and absorption, and requires more empirical evidence supporting its relevance. Most of the studies focus on organizational features, while reducing the relevance of individual characteristics.

Method.  Survey data for this descriptive, correlational study were collected over a 7-month period (2006–2007) from a convenience sample of 412 Nurses. Measures utilized were the Work Engagement Survey, the General Health Questionnaire, and an ad hoc survey.

Results.  Concerning psychiatric morbidity, 49% nurses met criteria for somatic symptoms, 65·5% met criteria for anxiety and insomnia, 4·6% met criteria for social dysfunction and 10% met criteria for severe depression. There were no effects for length of service or professional category. Nurse managers scored significantly higher in several job stressors compared with other groups. Concerning engagement, 33% of the nurses experienced high dedication, 20·4% experienced high vigour and 36·7% experienced high absorption. Predictors of vigour and dedication were satisfaction with job position, higher quality of working life, lower social dysfunction and lower stress associated with patient care.

Conclusions.  Strategies to promote work engagement should be implemented. More attention should be paid to job environments to guarantee job satisfaction. Organizational strategies to reduce the stress associated with patients’ care, and initiatives to improve social and communication skills are also required for nurses to experience vigour and dedication.

Vigour and dedication in nursing professionals: towards a better understanding of work engagement.

210 © 2016 Springer Publishing Company http://dx.doi.org/10.1891/1078-4535.22.3.210 A t a national health care conference I recently attended, a psychologist, Dr. Smith, shared a patient encounter with Mr. Thomas (names changed to protect confidentiality). “When Mr. Thomas, an inmate sentenced for murder told me that he would be going home soon, I was pleased to hear it.” After serving 13 years of his sentence, Thomas was a model prisoner. “Finally, the penal system is doing something right: allowing a rehabilitated man to start over,” I thought. “After my return from a few days off, I walked into the prison to be met with a custody officer’s remarks: ‘Did you hear that Mr. Thomas hung himself?’ Initially I was stunned by the news, then I slowly began to realize that I had not really heard what the inmate had told me during our last visit. ‘Going home’ meant different things to each of us. Why didn’t I listen to him?” Smith admonished himself. “Filled with my own cultural ideas, I assumed he was speaking my language.” The psychologist’s remorse opened his eyes to cultural humility, a concept analyzed by Foronda, Baptiste, Reinholdt, and Ousman in an article published in the Journal of Transcultural Nursing. According to the authors, the term cultural humility is frequently used, but society’s understanding is unclear about the concept— hence their study. In their review of 12 articles that met their search criteria, they uncovered attributes, antecedents, and consequences of cultural humility used in a variety of contexts, from differences in ethnicity, race, gender orientation, and social status to interprofessional roles and health care provider–patient relationships.

Cultural Humility: A Concept Analysis

Aim To test a model linking nurses’ perceptions of their nurse manager’s emotionally intelligent leadership style and nurses’ structural empowerment, and the impact of nurse manager span of control (number of direct reports) on the emotional intelligence/empowerment relationship.

Background  Hospital restructuring in the 1990s resulted in a dramatic reduction in nurse manager positions, yet nurse managers are critical to empowering nurses for professional practice.

Method(s)  A descriptive correlational survey design was used to test the hypothesized model in two community hospitals in Ontario. Two hundred and three nurses from two hospitals retuned useable questionnaires (68% response rate).

Results  Span of control was a significant moderator of the relationship between nurses perceptions of their managers’ emotionally intelligent behaviour and feelings of workplace empowerment.

Conclusion  The results suggest that even managers with strong emotional intelligence may not be able to empower their staff if their span of control is large.

Implications for Nursing Management  Every effort must be made to ensure that managers have reasonable spans of control that allow them to develop and use the leadership skill necessary for empowering their staff to practice to the full scope of their professional role.

The impact of emotional intelligent leadership on staff nurse empowerment: the moderating effect of span of control.

Aims We tested a modification of Leiter and Laschinger’s Nursing Worklife Model by examining the impact of structural empowerment on professional work environment factors that lead to nursing job satisfaction. Background The original model explains how five magnet hospital practice domains described by Lake (2002) interact to influence nurses work lives by either contributing to or mitigating burnout. Methods A non-experimental design was used. Five hundred randomly selected nurses in Michigan were surveyed (response rate 66%, n ¼ 332). Instruments included the Conditions for Work Effectiveness Questionnaire-II, the Practice Environment Scale of the Nursing Work Index, and the Index of Work Satisfaction. Path analysis was used to test the model. Results The final model fit the data well (v 2 ¼ 96.4, d.f. ¼ 10, NFI: 0.90, CFI: 0.43,

/pdf/the-nursing-worklife-model-extending-and-refining-a-new-2jsgl1c4s2.pdf

The Nursing Worklife Model: Extending and Refining a New Theory

Prompted by manager concerns about span of control, a large, integrated health system set out to determine if span of control really mattered. Was there something to it, or was it just an excuse for poor performance? A team of middle managers studied the problem and ultimately demonstrated a strong relationship between span of control and employee engagement. Consequently, it was decided to add 4 management positions to note the effect. One year later, positive changes were observed in employee engagement scores in all 4 areas. This study suggests careful review of manager spans of control to address the untoward effects of large spans of control on employee engagement.

Span of control matters.

Interprofessional education (IPE) and collaborative practice (CP) have been prolific areas of inquiry exploring research questions mostly concerned with local program and project assessment The actual sphere of influence of this research has been limited Often discussed separately, this article places IPE and CP in the same conceptual space The interface of these form a nexus where new knowledge creation may be facilitated Rigorous research on IPE in relation to CP that is relevant to and framed by health system reform in the US is the ultimate research goal of the National Center for Interprofessional Practice and Education at the University of Minnesota This paper describes the direction and scope for a focused and purposive IPECP research agenda linked to improvement in health outcomes, contextualized by health care reform in the US that has provided a revitalizing energy for this area of inquiry A research agenda articulates a focus, meaningful and robust questions, and a theory of change within which intervention outcomes are examined Further, a research agenda identifies the practices the area of inquiry is interested in informing, and the types of study designs and analytic approaches amenable to carrying out the proposed work

/pdf/setting-a-research-agenda-for-interprofessional-education-3dr89rzyst.pdf

Setting a research agenda for interprofessional education and collaborative practice in the context of United States health system reform.

https://www.mdpi.com/2227-9032/3/1/146/pdf

Creating the Evidence through Comparative Effectiveness Research for Interprofessional Education and Collaborative Practice by Deploying a National Intervention Network and a National Data Repository.

According to the Institute of Medicine (IOM, 1999, p 1), "Medical errors can be defined as the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim" The current health care culture is disjointed, as evidenced by a lack of consistent reporting standards for all providers; provider licensing pays little attention to errors, and there are no financial incentives to improve safety (IOM, 1999) Many errors in health care are preventable "Near misses" and adverse events that do occur can offer insight on how to improve practice and prevent future events The aim of this article is to better understand underreporting of errors in health care, to present a model of change that increases voluntary error reporting, and to discuss the role nurse executives play in creating a culture of safety This article explores how high reliability organizations such as aviation improve safety through enhanced error reporting, culture change, and teamwork

Partnerships With Aviation: Promoting a Culture of Safety in Health Care.

A 300-bed acute care community hospital used a 2-day “Rapid Process Improvement Workshop” to identify factors contributing to facility-acquired pressure ulcers (PU). The Rapid Process Improvement Workshop included key stakeholders from all procedural areas providing inpatient services and used standard components of rapid process improvement: data analysis, process flow charting, factor identification, and action plan development. On day 1, the discovery process revealed increased PU risk related to prolonged immobility when transporting patients for procedures, during imaging studies, and during the perioperative period. On day 2, action plans were developed that included communication of PU risk or presence of an ulcer, measures to shorten procedure times when clinically appropriate, implementation of prevention techniques during procedures, and recommendations for mattress upgrades. In addition, educational programs about PU prevention were developed, schedules for presentations were established, and an online power point presentation was completed and placed in a learning management system module. Finally, our nursing department amended a hospital wide handoff communication tool to include skin status and PU risk level. This tool is used in all patient handoff situations, including nonnursing departments such as radiology. Patients deemed at risk for ulcers were provided “Braden Risk” armbands to enhance interdepartmental awareness.

Judith M Pechacek

Papers

Span of control matters.

Setting a research agenda for interprofessional education and collaborative practice in the context of United States health system reform.

Creating the Evidence through Comparative Effectiveness Research for Interprofessional Education and Collaborative Practice by Deploying a National Intervention Network and a National Data Repository.

Partnerships With Aviation: Promoting a Culture of Safety in Health Care.

Decreasing pressure ulcer risk during hospital procedures: a rapid process improvement workshop.