فصلنامه مدیریت پرستاری
پیاپی 2 (تابستان 1391)

Work environment is an inseparable element of nursing profession which should be considers in order developing the nursing profession.

This study investigated Iranian nurses’ attitude toward nurses’ clinical environments and its features.

In this cross sectional study with simple random sampling method, 1500 nurses from twenty states of Iran in 2009 received researcher-developed questionnaires which included demographic variables and clinical environment features. The validity of instrument accessed via content validity and internal consistency reliability (Cronbach’s alpha) was (α=0.81). Samples (1500 nurse) selected randomly and one thousand one hundred sixty (1160) questionnaires were returned (response rate 77%) which could be used for statistical analysis. Data were analyzed using descriptive statistics using SPSS14.

Findings showed that in clinical care area more than half of nurses had knew to importance of interdisciplinary communication (61%), autonomous decision making in nursing care (57%) and practice based on ethical values and professional relationships (60%). In description of clinical environment the majority of nurses stated that they consult with colleagues about care problems (85%) and they believed that they provide care based on patients’ needs and care provided are in order to new findings in nursing (80%). %). In nurse’ point of view communicating with nursing students and taking care about them was less important (37%).

Work environment issues and challenges are cornerstones for patients care promotion. These findings could be use to rebuild a work environment by health policy makers that supports nurses in providing comprehensive professional care.

ntroduction: The most important goal of any organization is to achieve the highest level of optimal productivity. Nurses are as one of the most important human resources in hospitals that their job performance are affected by several factors, including spirituality, organizational commitment and general health which can be lead to more commitment, quality improvement in health services and productivity. The aim of this study was to investigate the relationship between spirituality, organizational commitment and general health with job performance of nurses in teaching hospitals of Ahwaz. This was a cross-sectional analytical descriptive study. The samples were 196 nurses in teaching hospitals in Ahwaz who were selected by cluster sampling in two stages, randomly. The instruments were Job Performance Scale (JPS), Spirituality & Spiritual Care Rating Scale (SSCRS), Organizational Commitment Scale (OCS) and General Health Questionnaire (GHQ-28).For all questionnaires internal consistency reliability(Cronbsch’s alpha) was in range (α=0.68 to α=0.98). The data were analyzed by Pearson Correlation and Multiple Regression Analysis by using SPSS 16 software. Findings showed that all variables are significantly predicting nurses’ job performance (P< 0.001). The most positive and significant relationships found between spirituality and organizational commitment (r =0.71), job performance and spirituality(r =0.69) and organizational commitment and job performance(r =0.68) respectively. The Multiple Regression Model showed that job performance and other independent variables could be clarify 47% differences in job performance and also, its linear regression has significant with other response variables(p<0.001). Because of spirituality was the strongest variables predictor for nurses’ job performance; so, it is necessary to provide operational plans by nurse managers to empower this aspect in clinical nurses.

Preparation of nurses plays an important role in nuclear events and reduces the nuclear consequences. Education is an important part of preparation process which is provided in various ways. The lecture method is an effective method of education. In our country, there has not been any educational content about nursing care in a nuclear accident. Also, formal training of nuclear event nursing wasn’t held in nursing education curriculum. Since this study was the first experiment on nursing education of nuclear event, it should be contained a theoretical content and the effectiveness of training on different learning levels should be measured.

The study’s aim was determining the efficacy of nuclear nursing care training by lecture method on cognitive learning levels.

In this quasi-experimental study) 30(nurses of one of teaching hospital in Tehran were selected by purposive sampling method in year 2011. A Multiple choice researcher-designed questionnaire with (30) questions on three levels of cognitive learning (knowledge, comprehension and application) was prepared and the test was done in three stages of before, immediately after and 4 weeks after nuclear nursing care training by lecture method. Reliability of questionnaire was confirmed with the Kuder-Richardson (α=0.72) and Pearson correlation coefficient (r=0.7) tests. Scores were compared by repeated measures ANOVA test using SPSS17.

Knowledge scores’ mean and StD in three stages before, immediately after training and four weeks later were 4.4±2.01, 7.46±1.5, 5.7±2.02, respectively and comprehensive scores’ mean and StD were 3.7±1.8, 7.43±1.8, 5.6±1.45 respectively and application scores’ mean and StDwere 1.96±1.45, 5.9±0.86, 4.4±1.6, respectively. The total score average were 10.03±4. 2, 20.8±3.04, 15.97±3.85 respectively, which showed a significant difference in all stages of study and at all levels of learning (p<0.001).

The effectiveness of lecture was demonstrated by comparing test scores before and after the education. Because lecturing is a cheap, effective and interesting method of education, this method can also be used in nuclear accident nursing care education program in order to prepare nurses for these events in a short time.

Patient safety defines as protection the patient from medical error and iatrogenic event. Many factors cause the patient safety events. One of them is nurse- physician interaction, because any obstacles of this can result in disorder of teamwork and there for put in danger patient safety and quality of care. The aim was to assess the patient safety events and it’s correlation with nurse - physician interaction from nurses’ view point. This is a descriptive cross sectional study on 200 nurses on Tehran University of medical science hospitals. Stratified sampling was used. A three parts questionnaire (demographic data, patient safety events and nurse - physician interaction) was used. Internal consistency reliability (Cronbach’s alpha) was (α=0.8) for patient safety events indicators and it was (α=0.74) for professional interaction. Patient safety events frequencies were identified during last 3 months and then, their relationship with nurse-physician interaction was assessed. Data were analyzed using SPSS 14, and Spearman correlation coefficient, χ2 and multiple regressions were used. The nurses reported the most common patient safety events were medication errors (38.5%); skin and neuromuscular damage (36.7%) and post-operative (16%).And the less common patient safety events were patient’s death following errors(1%) and leaving objects in patient’s body(1%). Majority of nurses rated their interaction with physician good (65.5%). There were significant reverse correlations between patient safety events and nurse- physician interaction (p=0.001, r = -0.274).It means that if interaction between nurse- physician is good, patient safety events will be decrease. Since patient safety events can be related to nurse -physician interaction, improving the nurse -physician interaction as a related factor in patient safety should be consider more seriously.

nurses’ job satisfaction is affected by stress. So it is necessary to stress management programs with preventive and efficient procedure. The aim of this study is to determine the effect of Stress Inoculation Program on nurses’ job satisfaction in psychiatric ward. 60 nurses and Healthcare workers, working in Ebne-Sina psychiatric hospital were enrolled on research population in clinical trial study. They were randomly assigned between 2 groups based on work shifts and job status. Brayfield & Rothe job satisfaction questionnaire was used as data gathering scale, at start point, after 2nd session and 1 month after that. Intervention was tow session for 8 hours with 1 weak interval, including stress Inoculation program training. based on our result S.I.P caused to increase job satisfaction series (61/5 ± 10/4 in pre test to 67/6±11/6 in post test and 69/9±6/5 at follow up) and had a rise trend (p<0/005). The average job satisfaction score in the control group in post test and next month follow up have significantly reduced than pre test (p=0/0000). Also there wasnt significant statistical difference between tow groups in pre test stage; but the stress inoculation program group score has increased significantly than control group during the post test and next month follow up. Since S.I.P is Affordable and effective manner to improve the nurses’ job satisfaction, it is proposed to managers for enhance the job satisfaction and improve the quality of nursing care.

The results showed that the participatory supervision program for nurses improves patients’ satisfaction. Therefore, it is recommended that nurse managers include this program in their plans for improving quality of nursing cares in hospitals. Because, it’s contain is nursing process implementation, supervision, feedback and nurse performance appappraisal. Wilcoxan test showed that patient satisfaction in control group was not significant, in before and after intervention (p=0.31). But results showed that patient satisfaction in case group increased significantly in before and after intervention (p=0.00).Also, Mann- Whitney test showed significant differences between two groups after the intervention (p=0.00).Of course before intervention there was not significant deference between two groups (p=0.06). This is a quasi- experimental study that performed in case and control groups as before and after intervention in 2011. One hundred sixty patients were selected with non-randomized sampling in each stage in one of the selected hospitals in Shiraz city. Data were gathered by two questionnaires: Patients’ demographic information and patient satisfaction questionnaire. This latter had validity and internal consistency reliability (Cronbach’s alpha) was (α=0.9). The Participatory supervision program which was included nursing process, supervision, feedback, and nurses’ performance evaluation implemented by clinical nurses, supervisors and head nurses during 3 months and then, its effect on patients’ satisfaction evaluated. Data collected were analyzed by Wilcoxan and Mann-whitny tests and also the software SPSS 19. This study aimed to determine the effect of participatory supervision program for nurses on patients’ satisfaction in Medical- Surgical Wards. Supervision is the most important steps in management because it complete the management cycle. Today, because of fast growing health care sciences and developing health professionals, we need to accurate techniques of supervision that we could be sure that health care providers have enough knowledge and skills to provide safe patient care.

Effective managers are who can use their emotional possibilities for communicating with their human resources effectively and constructively. In fact, successful managers emphasize on empowering their emotional intelligence, because this can be a good predictor for transformational leader ship behavior. So, relationship between emotional intelligence and transformational leadership style is an indicator for effective managers. The purpose of this study was to determine the relationship between nurse managers’ emotional intelligence and their transformational leadership styles. In this descriptive analytic study, nurse administrators in teaching and non- teaching hospitals (n=39) based on the pilot study were selected by simple random sampling method. Dimensions of emotional intelligence measured by Wesinger Emotional questionnaire, and for transformational leadership style, Warner Burke questionnaire was used. Internal consistency reliability (Cronbach’s alpha) showed that was (α=0.86) for emotional questionnaire and for Warner Burke questionnaire was (α= 0.66). Data analysis was done by descriptive statistic and Pearson correlation analysis by using SPSS 11.5 software. Mean and standard deviation for emotional intelligence were 103.07±10.02 and for transformational leadership style were 27.77±4.1 and for transactional leadership style were 21.91±4.3. There was a positive and significant correlation between emotional intelligence and transformational leadership style (p<0.05).Just two dimensions of five emotional intelligence dimensions which were empathy and social skills, have shown positive and significant correlation with transformational leadership style (p<0.05). Nurse managers had high social skills, self-awareness and empathy in the emotional intelligence dimensions but between emotional intelligence and transformational leadership style there were not found any strong correlation which should be evaluated more deeply.

Verbal abuse is the most common type of violence that can adversely effect on staff professional practice in clinical environments. The aim of this study was assessing frequency and causes of verbal abuse against the clinical staff in hospitals in Iranshahr city. A cross-sectional analytic descriptive design was used. All of the nurses, midwives, operation room and anesthesiologist technicians, and nurse-aids who employed in hospitals in Iranshahr took part in this study (n=145). A two parts questionnaire about demographic data and verbal abuse (include frequency, causes of violence, perpetrator of violence, reactions to verbal abuse and the source of violence reported) and also, Job Violence Questioner that developed by WHO were used. Internal consistency reliability (Cronbach‘s alpha) was (α=0.86). Data were analyzed by χ2 and SPSS 15. Verbal abuse was experienced by 84.4% of the samples during the last year. The most reported reasons fort verbal abuse were: prevention of Patient visit out of settled time for haunt, delay in providing patient care, insufficient facilities and personnel shortage. Women experienced violence more than men, and the risk of being abused was higher in younger staff with less job experience. Also participants who worked in emergency department, operation room, and women surgery wards were experienced more verbal abuse than the other wards. Patient, patients’ companions and physicians were the more reported perpetrators. 77.2% of verbal abuse cases were reported to managers such as supervisors, head nurses and nurse service administrators. The findings showed high frequency of verbal violence against hospital staff which can cause adverse mental or physical effects on abused staff. As most cases reported to nurse managers, they should prepare proper plans to prevent such events.