Occupational Preparedness and Clinical Performance †Free Samples

Question: Discuss about the Occupational Preparedness and Clinical Performance. Answer: Introduction: Registered nurses are expected to demonstrate competence in their profession throughout the career. It is their sole responsibility to remain accountable for the care they provide while maintaining nursing standards and regulations for practice. The term burnout was first used by Freudenberger in 1974 to describe the exhaustion experienced by mental healthcare professionals at their workplace. Maslach gave a comprehensive definition for the term. Burnout was defined as the physical and mental exhaustion that a professional faces while maintaining contact with other people at work. Long stressful working hours give rise to this condition. Emotional exhaustion, personal achievements and depersonalization are three major components of this burnout. The negative effects of burnout affect the organization and create hindrance in the path of providing holistic care to the patients and in ensuring their safety (Pulido?Martos, Augusto?Landa Lopez?Zafra, 2012). Several studies have provided evidence for poor organizational outcome, career dissatisfaction and reduction in patient satisfaction regarding physical and mental health due to frequent burnouts among nurses (Caadas-De la Fuente et al., 2015). This report will critically appraise an empirical research that was carried out to determine the factors influencing job satisfaction, burnout and healthcare quality delivered to patients by new graduate nurses. Given the negative effects of nurse burnout on patient care quality, health infections and avoidable adverse events, several studies have been undertaken to explore the factors that influence the development of such mental and physical exhaustion among nurses. Data obtained from these studies have identified structural empowerment, leadership, staff adequacy and work-life balance as major contributing factors (Allen et al., 2012). The objective of the study was to assess two hypotheses related to work-life balance, leadership and staff adequacy on nurse job satisfaction and burnout (Boamah et al., 2017). 3 hypothesized models were tested on data obtained from a national study carried out in Canada. The hypothesis 1 tested whether the perception of nurses on the authentic leadership behavior of their supervisors created any positive effects on structural empowerment. This hypothesis took into account short or inadequate nurse staffing. Results from previous studies have proved that less number of nursing staff creates stress and increases the work load on the nurses. This makes them twice more likely to suffer from job dissatisfaction and burnout and they intended to leave the job after a year (Fong, 2016). This led to low job turnovers. The first hypothesis proposed that structural new graduate nurses face less burnout due to the positive effect of structural empowerment on reducing voluntary absentees, meeting staff shortage demands and maintaining work-life balance. The second hypothesis was tested on the data from the study conducted in Canada. The second hypothesis had 2 componen ts, which stated that high structural empowerment reduces short staffing frequency and creates less inference between work and life balance (Sexton et al., 2014). The third hypothesis stated that inadequate staffing creates more frequent work-life interference (Wang et al., 2012). Hypothesis 4 was also tested on the data. It proposed that short staff and work-life interference increased the likelihood of nurse burnouts a year later. The other hypothesis also focused on the negative effects of burnouts on nurse job satisfaction and patient care (Lu et al., 2012). Thus, it can be stated that the design was purely built on these 6 hypotheses that tried to establish the association between nurse burnouts and workplace environment and balance. The design aimed to connect job stress and burnout that occurred a year later to short staffing (Appendix 1). The study collected random samples from 400 registered nurses. These samples were selected from 10 Canadian province nursing registry database. The database contained 3,743 results. The inclusion criteria were stringent and included only nurses who had work experience of less than 3 years. Nurses who were directly involved in patient care were encouraged to participate in the study (Boamah et al., 2017). A time period of 3 years was fixed to ensure that the nurses were new graduates and me the primary criteria for the study. 1020 new graduate nurses returned their surveys at Time 1 with a response rate of 27.3% and 406 respondents from Time 1 returned the survey at Time 2 with a response rate of 39.8%. The intervention principally focused on surveys that recorded responses of the nurses with respect to their work life balance and perception on short staffing, leadership qualities and burnouts. The study utilized Dillmans approach for conducting the survey research. This was done to improve the response rates (Dillman, Smyth Christian, 2014). The survey research is a collection of information taken from a sample of target individuals by analyzing their responses to specific questions. The major outcome on which the hypotheses were tested was job satisfaction of new graduate nurses. It referred to the degree to which the nurses enjoyed their job. It included their relation with coworkers and supervisors, work load and scheduling. This outcome was considered an integral part of providing positive healthcare to the patients. The effect of staffing levels, support from supervisors greatly influence job satisfaction as evident from results of various studies (Meng et al., 2015). The outcome measurement got its ethical approval from the University of Western Ontario Health Sciences Research Ethics Board. Structural equation modeling in Mplus software was used to analyse the hypothesized model (Boamah et al., 2017). The outcomes were evaluated using structural empowerment, authentic leadership and burnout as latent variables. Patient care quality and short staffing were modelled as manifest variables. At Time 1 (November 2012 March 2013), eligible nurses were mailed A survey package was mailed to the eligible nurses that included the questionnaire, letter of consent (Adriaenssens, De Gucht Maes, 2015). A second survey package was sent to the non-responders 4 weeks later. Similar procedure was followed during Time 2 for sending the questionnaires to nurses who responded for Time 1. This ensured better response and valid results. Thus, this approach provided a rigorous approach for the research study. The SPSS software was used for the statistical study. Bootstrapping method was repeated 1000 times to measure the indirect effects of mediation and 95% confidence interval. This process thereby allowed accuracy of the measures (Fang Wang, 2012). This was mainly used as an alternative to the statistical inference of the model assumptions. Repeating the process 1000 times gave a histogram, which gave an estimate of the variation of the means. The Tucker-Lewis Index (TLI), Chi-square (v2), Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI) and Standardized Root Mean Square Residual (SRMR) were utilized to assess the hypothesized model. SRMR and RMSEA helped in assessing the degree of badness of fit (McGLYNN et al., 2012). However, 0.90 critical values of TFI and CFI showed the correlation between the data. The questionnaires used to assess the study variables were reliable. Their validity was examined using Cronbachs (Bonett Wright, 2015). A 16 item Authentic Leadership Questionnaire was used to measure the validity of the perception of nurses on the leadership of their managers and supervisors. It was based on a 5 point Likert scale. The Conditions of Work Effectiveness-II scale used for measuring structural empowerment was valid as well as evident from previous studies. The balance between the personal and professional life of nurses was assessed using the Work Interference with Personal Life (WIPL) scale. Cynicism and emotional exhaustion subscales of the Maslach Burnout Inventory General Survey was used to measure burnouts. Cronbachs of 0.85 for work life balance, 0.86 for job satisfaction and 0.92 for emotional exhaustion among nurses. Thus, it can be stated that the study did make use of reliable and valid parameters. 405 registered nurses with an average of 1.17 years of direct clinical experience with patients were recruited in the study. The nurses were 27.67 years old on an average. 92% nurses were female and 94% had a baccalaureate degree in nursing. 52% were placed in the medical or surgical units and 16.3% in critical care units (Boamah et al., 2017). The mean, standard deviation and Cronbachs for short staffing, structural empowerment, emotional exhaustion, job satisfaction, patient care quality and work life interference are shown the Appendix 3. The results obtained on performing statistical analysis supported the hypotheses. 2(223) = 600.085, CFI = 0.93, P = 0.001, TLI = 0.92, SRMR = 0.06 and RMSEA = 0.05. All paths were found to be in the direction of the hypotheses (Appendix 4). Structural empowerment was found to be positively affected by authentic leadership (= 0.63, P0.001). The former on the other hand, had a negative influence on shortage of staff (= -0.30, P0.05) during Time 1. Shortage of staff displayed direct correlation with work life interference. The statistical data revealed that nurses who experienced short staffing and work life interference were more likely to suffer from burnout and reported low patient care quality, when analyzed a year later. Patient care quality was positively affected by job satisfacti on (= 0.17, P0.001) (Boamah et al., 2017). Thus, the indirect effects of structural empowerment and authentic leadership on burnouts experienced by new graduate nurses were statistically significant (Appendix 5). The study had some weakness. The first limitation was in the use of self-reported questionnaires. Data from previous studies have shown that these questionnaires often lead to response biases and the responses are influenced by situational or contextual influences. Anonymous completion of the questions in their own privacy and confidentiality might have reduced all biases (Shahnazdoust et al., 2012). That would have increased the validity of the study. The study focused on patient care quality and shortage of staff as single item measures during the statistical analysis. This was another limitation. Usage as single item measures increased vulnerability to random errors and biases in interpretation (Lee et al., 2013). However, they offered an advantage of reducing common method variances. The low response rate from nurses is another concern for the study. This introduced bias in responses and might have influenced the results. Moreover, the specialty areas where the nurses were placed could influence the level of burnouts among them. This could have altered the results. The results obtained in this study supported the hypotheses that were proposed. The relationship between structural empowerment, leadership, short staffing and worklife interference with job satisfaction, burnout, and patient care were successfully demonstrated. The results were consistent with previous studies and showed that perception of new graduate nurse about authentic leadership of their supervisors was directly related structural empowerment in the hospital settings (Laschinger, Wong Grau, 2013). The statistical results suggested some novel findings that indicated negative correlation of empowerment with worklife interference and short-staffing. This correlation led to an increase in burnout among nurses a year later. In addition, it can be said that care quality and job satisfaction are negatively influenced by burnout (Todaro-Franceschi, 2012). Thus, the findings supported empirical and theoretical links between structural empowerment and leadership (Boamah et al., 2017). Previous studies indicated that authentic leaders are responsible for developing genuine relationships with nurses and bringing out positive work results (Epp, 2012). Thus, the findings were consistent with the indications that leading nurse managers, who provided learning opportunities and access to resources to new graduate nurses, were more successful in reducing mental exhaustion (Rudman Gustavsson, 2012). This was one of the first studies that linked structural empowerment and authentic leadership to burnouts. The results therefore showed significant association between the two. The findings suggest that nurses who are exposed to more work life interference and short staffing are likely develop greater burnout levels a year later (Boamah et al., 2017). Hence, it can be stated that establishment of caring and ethical work environment will create positive outcomes in hospital settings. The results can be applied in future in workplaces. If sufficient nursing staff ratio and improved workplace environment are followed in hospitals, they will lead to better patient care and overall satisfaction (Vargas et al., 2014). Thus it can be concluded that upfront investment in training new graduate nurses and proper address of staff issues can be employed as essential strategies that will create a supportive working environment for the nurses and will help in reducing their mental and physical exh austion. The Canadian Institutes for Health Research Partnerships for Health Systems Improvement (#122182) was the main funding institute for the study. It was supported by other hospitals and registered nurses institutes as well. References Adriaenssens, J., De Gucht, V., Maes, S. (2015). Determinants and prevalence of burnout in emergency nurses: A systematic review of 25 years of research.International journal of nursing studies,52(2), 649-661. Allen, T. D., Johnson, R. C., Saboe, K. N., Cho, E., Dumani, S., Evans, S. (2012). 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