Organizational Commitment and Turnover of Nursing Home Administrators

Mental health of nurses involved with COVID-19 patients in Japan, intention to resign, and influencing factors

The purpose of this study was to investigate the association between mental health (posttraumatic stress disorder, depression, anxiety disorder, and burnout) and intention to resign, and influencing factors regarding nurses involved with COVID-19 patients in A Prefecture as subjects.The design is a cross-sectional questionnaire-based study.Methods are conducted between August 4 and October 26, 2020. Basic attributes (gender, age, years of experience, etc.) were examined. Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, Impact of Event Scale-Revised, Maslach Burnout Inventory, "intent to resign," were used to collect data from nurses working at hospitals treating patients with COVID-19 in Japan.As a result, between 20% and 30% of nurses involved with patients with COVID-19 are in a state of high mental distress. Regarding the associations between psychiatric symptoms and intention to resign, "I want to quit being a nurse" was affected by "cynicism" and "professional efficacy"; "I want to change hospitals/wards" was affected by "cynicism"; and "subthreshold depression," "anxiety disorder," and "burnout" affected "I want to continue working as a nurse." The increase in the number of patients with COVID-19 was a factor affecting mental health and intention to resign. When the number of patients increased, anxiety disorders and intention to resign also increased. Damage from harmful rumors increased the severity of every psychiatric symptom. To prepare for a pandemic such as COVID-19, it is necessary in normal times to construct psychological support systems and community systems to prevent damage from harmful rumors.

Assuring Quality in Nursing Homes: The Black Box of Administrative and Clinical Leadership—A Scoping Review

Background and Objectives

Licensed nursing home administrators (NHA) and directors of nursing (DON) are responsible for nursing home quality and assuring optimal performance and job satisfaction/retention of their nursing home workforce. NHA/DON-focused studies have generated important foundational knowledge over the last three decades; yet, targeted research is needed to understand and apply the complexities of the black box of this top management team. This scoping review identifies, reviews, synthesizes, and maps the topical areas of research in NHA/DON positions in U.S. nursing homes.

Research Design and Methods

We conducted searches of 5 databases, yielding 3,479 records; screening/review yielded 88 unique records. We used thematic analysis to code the primary foci of the studies and the variables associated with the concepts of interest.

Results

Most papers (n = 40) focused on role characteristics, 23 examined approaches to management and leadership, 24 focused on perceptions about the role, and the remaining 12 examined role structure. The role-related themes linked to outcomes (n = 42), processes (n = 27), and structures (n = 30).

Discussion and Implications

We highlight important gaps for future research and offer a call to action for research, policy, practice, and education collaborations to accelerate the rate of research and translate the findings into best practices for NHA/DON to lead and manage the nursing home workforce and build capacity to ensure person-centered, high-quality care. Based on foundational descriptive studies, it is time to use what is known to design and implement interventions that enhance the capacity of NHA/DON to improve the structures, processes, and outcomes of nursing homes.

Preceptor characteristics and the socialization outcomes of new graduate nurses during a preceptorship programme

AIM

The purpose of this study was to explore the relationships between preceptor characteristics (emotional intelligence, personality and cognitive intelligence) and new graduate nurse socialization outcomes regarding turnover intent, job satisfaction, role conflict and ambiguity during a preceptorship programme. To date, no studies have explored these relationships.

DESIGN

A cross-sectional and multi-site design with purposeful sampling.

METHODS

Dyads of preceptors and new nurses were recruited at the end of their preceptorship programme. Pearson's correlational analysis was used to examine the relationships.

RESULTS

A sample of 41 preceptors and 44 new graduate nurses participated in this study, making 38 dyads with complete data. The preceptor personality traits of openness, conscientiousness and emotional stability were significantly related to new graduate nurses who reported greater turnover intent, job dissatisfaction, role conflict and ambiguity. No significant relationships were noted between preceptor EI and IQ and the outcome of new graduate nurses.

Athletic trainers' barriers to maintaining professional commitment in the collegiate setting

CONTEXT

Professional commitment simply describes one's obligation to his or her work. For athletic trainers (ATs), the demanding work environment and job expectations may affect their characterization of professional commitment. Our breadth of knowledge regarding professional commitment within athletic training is narrow.

OBJECTIVE

To evaluate the professional commitment of ATs in the collegiate setting.

DESIGN

Qualitative study.

SETTING

Collegiate.

PATIENTS OR OTHER PARTICIPANTS

Thirty-three Board of Certification-certified ATs employed in the collegiate setting (National Collegiate Athletic Association Division I = 11, Division II = 9, Division III = 13) with an average of 10 ± 8 years of clinical experience volunteered. Data saturation guided the total number of participants.

DATA COLLECTION AND ANALYSIS

Online journaling via QuestionPro was completed by all participants. Multiple-analyst triangulation and peer review were conducted for data credibility. Analysis followed a general inductive method.

RESULTS

Four themes speak to the factors that negatively affect ATs' professional enthusiasm and commitment: (1) life stage, (2) work overload, (3) organizational climate, and (4) human resources. The latter 3 speak to the effect the workplace can have on ATs' professional commitment, and the first speaks to the effect outside responsibilities can have.

CONCLUSIONS

Our results suggest that several of the factors that negatively influence the professional commitment of collegiate ATs are modifiable organizational components. Developing resiliency strategies at the individual and organizational levels may help to facilitate improved professional commitment for the AT.

Nursing home administrator self-assessed preparedness

BACKGROUND

Nursing home administrators (NHAs) are in key positions to improve nursing home quality. NHAs require state-level licensure, which involves passing a national NHA licensure examination and fulfilling state-level licensure requirements that vary widely across states. With multiple pathways to NHA licensure, little is known about NHAs' preparation and training to meet the complex demands of this position.

PURPOSE

The aim of this study was to explore NHAs' self-assessed person-job fit based on NHAs' self-rated preparedness and the importance of the activities that supported their preparation.

METHODOLOGY/APPROACH

A descriptive cross-sectional design was used to collect data from NHAs (N = 175) randomly recruited from nursing homes in five states, with a mailed self-administered questionnaire. Data analysis included descriptive statistics, correlations, and t tests/ANOVA.

FINDINGS

Thirty percent of respondents reported they were well prepared, overall, for their first NHA position. The findings suggest NHA preferences for more formalized ways to develop their entry-level competencies, with lower preference for On-the-job training, Previous job experience, and Self-study and higher preference for Administrator-in-training, Bachelor's degree programs, and Mentoring.

PRACTICE IMPLICATIONS

There is an urgent need for NHAs who are well prepared to effectively address our nation's mandates for nursing home quality improvement. With multiple pathways to NHA licensure, this exploratory study provides initial insights about NHAs' self-assessed preparation and training. The findings suggest that NHAs prefer more formalized ways to prepare for the NHA position. Research is needed to identify specific teaching/learning practices and on-the-job training that maximize the NHAs' preparation to meet their job demands.

Surveying multiple health professional team members within institutional settings: an example from the nursing home industry

Quality improvement and cost containment initiatives in health care increasingly involve interdisciplinary teams of providers. To understand organizational functioning, information is often needed from multiple members of a leadership team since no one person may have sufficient knowledge of all aspects of the organization. To minimize survey burden, it is ideal to ask unique questions of each member of the leadership team in areas of their expertise. However, this risks substantial missing data if all eligible members of the organization do not respond to the survey. Nursing home administrators (NHA) and directors of nursing (DoN) play important roles in the leadership of long-term care facilities. Surveys were administered to NHAs and DoNs from a random, nationally representative sample of U.S. nursing homes about the impact of state policies, market forces, and organizational factors that impact provider performance and residents' outcomes. Responses were obtained from a total of 2,686 facilities (response rate [RR] = 66.6%) in which at least one individual completed the questionnaire and 1,693 facilities (RR = 42.0%) in which both providers participated. No evidence of nonresponse bias was detected. A high-quality representative sample of two providers in a long-term care facility can be obtained. It is possible to optimize data collection by obtaining unique information about the organization from each provider while minimizing the number of items asked of each individual. However, sufficient resources must be available for follow-up to nonresponders with particular attention paid to lower resourced, lower quality facilities caring for higher acuity residents in highly competitive nursing home markets.

The relationships among social capital, organisational commitment and customer-oriented prosocial behaviour of hospital nurses

AIMS

This study examines the perceptions of registered nurses of social capital, organisational commitment and customer-oriented prosocial behaviour. Additionally, this study also addresses a conceptual model for testing how registered nurses' perceptions of three types of social capital influence their organisational commitment, in turn intensifying customer-oriented prosocial behaviour, including role-prescribed customer service and extra-role customer service.

BACKGROUND

Customer-oriented prosocial behaviour explains differences in job satisfaction and job performance. However, the critical role of customer orientation in the hospital setting has yet to be explored.

DESIGN

Survey.

METHODS

The survey was conducted to obtain data from registered nurses working for a large Taiwanese medical centre, yielding 797 usable responses and a satisfactory response rate of 86.7%. The partial least squares method was adopted to obtain parameter estimates and test proposed hypotheses.

RESULTS

The study measurements display satisfactory reliability, as well as both convergent and discriminant validities. All hypotheses were supported. Empirical results indicate that registered nurses' perceptions of social capital were significantly impacted the extent of organisational commitment, which in turn significantly influenced customer-oriented prosocial behaviour.

CONCLUSION

By stimulating nursing staff commitment, health care providers can urge them to pursue organisational goals and provide high quality customer service. To enhance organisational commitment, health care managers should endeavour to create interpersonal interaction platforms in addition to simply offering material rewards.

RELEVANCE TO CLINICAL PRACTICE

Nurses act as contact employees for their patient customers in the hospital, and they are required to provide patient safety and service quality. This study shows that nurses with high organisational commitment are willing to provide customer-oriented prosocial activities, which in turn enhances patient satisfaction.

Anger-provoking events and intention to turnover in hospital administrators

PURPOSE

The purpose of this paper is to examine anger associated with types of negative work events experienced by health administrators and to examine the impact of anger on intent to leave.

DESIGN/METHODOLOGY/APPROACH

Textual data analysis is used to measure anger in open-ended survey responses from administrative staff of a Canadian hospital. Multivariate regression is applied to predict anger from event type, on the one hand, and turnover intentions from anger, on the other.

FINDINGS

Person-related negative events contributed to administrator anger more than policy-related events. Anger from events predicted turnover intentions after adjusting for numerous potential confounds.

RESEARCH LIMITATIONS/IMPLICATIONS

Future studies using larger samples across multiple sites are needed to test the generalizability of results.

PRACTICAL IMPLICATIONS

Results provide useful information for retention strategies through codifying respect and fairness in interactions and policies. Health organizations stand to gain efficiencies by helping administrators handle anger effectively, leading to more stable staffing levels and more pleasurable, productive work environments.

ORIGINALITY/VALUE

This paper addresses gaps in knowledge about determinants of turnover in this population by examining the impact of administrator anger on intent to leave and the work events which give rise to anger. Given the strategic importance of health administration work and the high costs to health organizations when administrators leave, results hold particular promise for health human resources.