فصلنامه مدیریت پرستاری
پیاپی 3 (پاییز 1391)

The first and important factor in quality of care improvement is evaluation nursing care provided for patients based on standards and evidences. The aim of this study was to determine the effect of implementation staff development program for clinical supervisors based on evidence on nurses’ practice in internal units. This quasi-experimental study was done in teaching hospital in Birjand in 2012. The samples were all of the nurses who worked in internal units in hospital (24 nurses in case and 19 nurses in control group) that their practices on CVA and COPD patients (50 sapmles in each group before and afther intervention who were selected non-randomely) were measured by observational checklist. Its validity and reliability were assessed by inter rater reliability (r = 90%) and content validity. The interventional program had five stages; design clinical question، searching the best evidences، assessing their reliabilities’، selecting the best of them and implemented it with nurses’ clinical experiences together and the last was evaluation outcomes after implementation. This program was done for four months and in three times data gathered by co-main researcher. And then data were analyzed by SPSS 16 software، using Mann-whitney test. In this study all of the nurses and patients were matched in demographic characteristics (p>0. 05). The nurses’ practice for patients COPD & CVA in two groups after intervention was significant by using Mann-whitney test (p<0. 05). This staff development program for supervisors based on evidence introduced to continuing education managers as an applicable and effective model، because of it had effect on evidence based nursing practice.

In postindustrial age، knowledge management is the newest management approach that knowledge workers are the essential in organizations; so their retention and productivity are the important challenges in human resource management. Also، hospitals are as a knowledge and expertized organization that the majority of personnel are nurses who are knowledge workers that their retention is very important for them. The aim of this study was assessing the effective factors on retention nurses as knowledge workers in hospitals. This study was an applied descriptive study that was done in 2011-2012. By stratified sampling، 388 nurses who worked in teaching hospitals of Tehran university of Medical Sciences were selected randomly. Data were gathered by researcher made questionnaire that it had 52 questions. They assessed statuesque، desirable situation and effective factors (personal، organizational and job). Its reliability was 95% for statuesque and 97% for desirable situation and also content validity was attained by expertized faculty member. Data Analysis was done by dependent t test and Friedman test by SPSS software. Data analyzing showed that effective factors on retention of nurses as a knowledge workers in status currenr and desired situation were as follows ranked. The first priority factor was organizational factors (corporation، motivation، organizational communication، and education and performance management). And then personal factors (power and skill، job satisfaction، competency) as a second priority and finally job factors (meaningfully and challenging of work، freedom، Authority and role clarity) was the latest. It is recommended that hospitals improve necessary conditions for corporation، motivation، organizational communication، and education for nurses. In addition، it is recommended to nurses who are knowledge worker improve their individual skills and team-work capabilities to increase their competence and job satisfaction.

Intention to leave in profession and quality of work life are themes that they are dependent to social contex. So; assessing changes in individual quality of work life (QWL) are necessary which they are related with multiple occupational outcomes such as job satisfaction and commitment، and could be suitable predictor for nurses’ retention in their job. This study was done for assessing the relationship between nurses’ quality of work life and their intention to leave the nursing profession. This descriptive-analytical study was done in 2011 that 167 nurses participated who were selected randomly from Gorgon’s educational and therapeutic centers. Persian version of quality of work-life and intent to leave of nursing profession questionnaires were used for data gathering. Interna consistency reliability (Cronbach’s alpha) was (α =0. 71) for quality of work-life questionair and for intent to leave of nursing profession questionnaire by use test and re- test was 0. 67. Data analysis was done in SPSS16 software with Pearson correlation، one way ANOVA and logestic regression. Data analysing showed that 61. 3% nurses had score greater than mean (47. 7±9. 21) in quality of work life scale. 12. 7% of nurses had very undesirable quality of work life and 28. 2% were in undesirable level. 42. 5% of nurses were reported their quality of work life in desirable and 16. 9% were in very desirable level. Quality of work life had significant correlation with intent to leave of nursing profession (r=0. 362، P=0. 000). 47. 8% of nurses had no intention to leave of their profession and others had some degree of intention to leave. 21. 4% of nurses had high intention to leave of nursing profession. Work experiences in nursing had direct and significant correlation with intent to leave of nursing profession (r=0. 242، P=0. 003). Improving nursing quality of work life could be reduce the rate of intent to leave of nursing profession، but it is not suitable predictor for retaining in nursing because of lack of oppourtunity of employment in our society.

Nursing documentations are signs of nursing care implementation. Follow the principals of documentation could be effective for patients’ safety nurses’ security. This study was done for Assessing quality of nursing documentations and effective factors on it in medical-surgical units. This study was descriptive- corollative that was done in 2010. All of nurses in medical and surgical units in teaching hospitals (170) were in this study and also، 2040 documents selected simple randomly which they were in four domain in nursing; nursing record، check vital signs، intake & output and drugs administration. They were observed by checklist. Reliability was 88% by inter-rater observers. Nurses’ attitude، their knowledge and viewpoints about the quality of effective factors on nursing documentation were assessed by questioners. Reliability of knowledge questioner was 0. 97% by using Kuder Richardson 21. Reliability of attitude questioner was 0. 90% by using test –re test. Also، this test showed that reliability of questioner for assessing quality of effective factors was 0. 91%. Validity all of the questionnaires was assessed by content validity. Data analyzed by Pearson test، One-way-ANOVA and T test by SPSS software. The results showed that 100% of nursing record and vital sign charts had average level of quality، 85. 9% of drug administration and 81. 2% of I&O of fluids domains had good level of quality. 85. 1% of nurses had average level of knowledge and 99. 5% of them had positive attitude toward nursing documents and viewpoint of 78. 4% nurses about quality of management’ factors were average level. There were significant relationships between kind of units، hospital and experience with quality of nursing’ documents (p<0. 001 (gender and quality of nursing’ documents (p=0. 003) and age with nursing’ documents (p=0. 006). It is recommended that hospitals improve necessary conditions for corporation، motivation، organizational communication، and education for nurses. In addition، it is recommended to nurses who are knowledge worker improve their individual skills and team-work capabilities to increase their competence and job satisfaction.

Reward systems are very important in organizations in terms of employees’ satisfaction and effectiveness of the organization. Therefore، managers’ perception from the proper and effective use of reward and recognition programs is essential. the aim of this study was assessing the in-effective factors in rewards for nurses. this study as a case study was done in one teaching hospital in Zanjan provenance in 2011 that all of the nurses in five in-patients units; 9 head nurses and 33 nurses were participated. Data were gathered by two questionairs; 1) questionair for assessing in-effective factors in rewards in seven domainsin reward management based on Likert scale، and 2) questionair for perceived internal and external rewards in nurses’ views based on yes and no scale. Validity in contcent and face were assessed and reliability for two questionairs by α Chronbach was 70%. Interview with head nurses was used. Data analyzing was done by using SPSS 17 and content analysis was used for interviews. The rewards was not enough effectiveness، most of non effectiveness factors from the nurses views were: inadequate rewards، lack of use nurses’ ideas in rewarding، reward criteria not being careful، non allocation of valence rewards frequently with (97%)، lack of fair distribution of rewards and verity of them (94%)، lack of proper relationship between optimal performance and rewards (%78. 8)، lack of proper balance between experience of intrinsic and extrinsic rewards. These factors from head nurses views were lack of appropriate scales for performance apprasial and reward policies. Nurse Managers would be applied strategies that affective on diagnosed factors for effective reward.

Emotional intelligence capabilities play a key role in determining an individual’s success in health care organizations. These skills enable individuals to think properly in difficult conditions and prevent wasting emotions such as anger، anxiety and fear and thus calm themselves and open new gateways for insight and self reflection and creative ideas. Therefore، considering the undeniable role of emotional intelligence in the success of nurses is very important. The purpose of this study is that emotional intelligence and nursing response What is the use? This study is a systematic review، with using key words education، emotional intelligence and nursing، among about 100 research and review papers in Persian and English in the field of nursing and health، has been used electronic databases CINAHL، science direct، Ovid، Scopus، SID، Magiran، Pubmed، Google scholar and 30 article assessed finally. This study has been in 15-year period from 1997 to 2012. Finally، 30 articles in Persian and English، include keywords، which were peer review published in ISI journals، were selected and assessed. The results of this study show that emotional intelligence training is considered as a revolution and vital need in nursing، because it creates a sustainable guideline for developing creativity in the nurse-client relationship and widens personal and professional limits and leads to the wise control of relationships between the nurse and the patient، and causes the nurse to have a human viewpoint about the patient، Hence، emotional intelligence training should be incorporated in nursing programs. Analysis of results of studies indicate that emotional intelligence to gain skills، with a tremendous impact in improving services to patients، families and entire communities will not only prevent loss of financial resources But fundamental changes in perspective and attitude of nurses towards patients، and their jobs as a professional skill، creates، can also promote and enhance the profession. Therefore، to gain emotional intelligence skills for nurses، is need for nowadays nursing and requirements of today’s professional activities related to nursing personnel and other employees in the health system. Nursing managers obtain EQ skills، with a tremendous impact in improving the services provided to patients، families and the entire community will not only prevent the waste of financial and human resources professionals is improving.

A management development program for managers is the priorities to achieve organizational success. Create a favorable clinical environment for the use of the capabilities of nurses and identifying their latent talents، it needs to play leadership role efficiently by supervisors. This study was conducted for assessing the effect of management development program based on ‘concept mapping’ for head nurses on their leadership style and its’ effectiveness. This study was a self-controlled quasi-experimental which was done in one of the educational hospitals in Tehran city that randomly was selected. Samples included all of the staff in hospital (120 nurses) and (25head nurse) and they completed questionnaires in two stages; before and one month after the intervention. Two questionnaires was used for gathering data for determining nurses’ views of their head nurses’ leadership styles (LEAD other) and head nurses questionnaire (LEAD self) based on Hersey-Blanchard leadership Model. Its reliability coefficient were (0/94) in head nurses and (0/95) in the staff nurses questionnaire، and to determine the effectiveness of each style which is selected، if it is fitness with the situation scoring was done based on a questionnaire. Data analyzed by using software SPSS16 with chi square and Wilcoxon tests. The results showed that. headnurses used reasoning (37%) and Directive (36. 5%) before the intervention، after the development، they use (42%) reasoning، (32. 5%) Participative in leadering the wards. also nurses staff mentioned that your head nurse leadership style before the intervention،was been reasoning (37%) and Directive (36. 5%) and after the development، they use reasoning and Participative in the wards، Levels of efficacy Leadership behavior before intervention was low and after moderate. Also statistically significant difference in efficacy of supervisors and nurses before and after the intervention was shown (p<0. 05). According to the effectiveness of conceptual mapping methods in improving the leadership style of head nurses، we recommended using this method for management development or managers training.