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GGS Resource Portal


This is a page where members can share resources and research with one another. If you have something you would like to share, please click the link below. Check back often for new entries.

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Evaluation of a Laughter-based Exercise Program on Health and Self-efficacy for Exercise

Submitted By: Dr. Jennifer Craft Morgan

Abstract and Requirements for Accessing Full Article

Background: Despite health benefits of physical activity (PA) and risks of physical inactivity, many older adults do not accumulate sufficient levels of PA to achieve associated health benefits. Lack of PA enjoyment may be a barrier to PA participation. Combining simulated laughter and PA for strength, balance, and flexibility is a potential solution for helping older adults maintain independence in activities of daily living through enjoyable participation in PA.

Purpose of the study: The purpose of this study is to assess whether combining simulated laughter exercises with a moderate-intensity strength, balance, and flexibility PA program (i.e., LaughActive) increases participation in PA, health, and self-efficacy for PA among older adults residing in 4 assisted living facilities (ALFs).

Design and methods: The 12-week wait list control pilot study used pre- and 6-week post-intervention comparisons within and between groups identified by paired sample t -test results among those who participated in twice-weekly LaughActive classes ( n = 27).

Results: Significant improvements ( p < .05–.10) were observed in mental health (SF-36v2), aerobic endurance (2-minute step test), and self-efficacy for exercise (OEE). Implications: PA programs that elicit positive emotions through simulated laughter have the potential to improve health, physical performance, and self-efficacy for PA among older adults and may positively influence participant adherence.

Healthcare organization–education partnerships and career ladder programs for health care workers

Submitted By: Dr. Jennifer Craft Morgan

Abstract and Requirements for Accessing Full Article

Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers. Mixed methods data from 291 frontline health care workers and 347 key informants (e.g., administrators, instructors, managers) collected between 2007 and 2010 were analyzed using both regression and fuzzy-set qualitative comparative analysis (QCA). Results suggest that different combinations of partner characteristics, including having an education leader, employer leader, frontline management support, partnership history, community need, and educational policies, were necessary for high worker career self-efficacy and program satisfaction. Whether a worker received a wage increase, however, was primarily dependent on leadership within the health care organization, including having an employer leader and employer implementation policies. Findings suggest that strong partnerships between health care and educational organizations can contribute to the successful implementation of career ladder programs, but workers' ability to earn monetary rewards for program participation depends on the strength of leadership support within the health care organization.

Library and information services: impact on patient care quality

Submitted By: Dr. Jennifer Craft Morgan

Abstract and Requirements for Accessing Full Article

Purpose: The purpose of this paper is to explore library and information service impact on patient care quality.

Design/methodology/approach: A large-scale critical incident survey of physicians and residents at 56 library sites serving 118 hospitals in the USA and Canada. Respondents were asked to base their answers on a recent incident in which they had used library resources to search for information related to a specific clinical case.

Findings: Of 4,520 respondents, 75 percent said that they definitely or probably handled patient care differently using information obtained through the library. In a multivariate analysis, three summary clinical outcome measures were used as value and impact indicators: first, time saved; second, patient care changes; and third, adverse events avoided. The outcomes were examined in relation to four information access methods: first, asking librarian for assistance; second, performing search in a physical library; third, searching library's web site; or fourth, searching library resources on an institutional intranet. All library access methods had consistently positive relationships with the clinical outcomes, providing evidence that library services have a positive impact on patient care quality.

Originality/value – Electronic collections and services provided by the library and the librarian contribute to patient care quality.

Frontline health care workers and perceived career mobility: Do high-performance work practices make a difference?

Submitted By: Dr. Jennifer Craft Morgan

Abstract and Requirements for Accessing Full Article

Background: The use of high-performance work practices (HPWPs) related to career development (e.g., tuition remission, career ladders) is becoming more common in health care organizations, where skill shortages and concerns about quality of care have led to increasing investment in the frontline health care workforce. However, few studies have examined the effectiveness of these policies in shaping the career trajectories of health care workers.

Purposes: The aim of this study is to examine how HPWPs that focus on career development are related to an individuals' perceived mobility with their current employer. We will also examine the relationships between perceived mobility, job satisfaction, and turnover intent.

Methodology/Approach: We use confirmatory factor analysis and structural equation modeling to examine the relationships between HPWPs and perceived mobility in a sample of 947 frontline health care workers in 22 health care organizations across the United States.

Findings: The findings suggest that tuition remission and educational release time positively predict perceived mobility. Measures of perceived organizational support in one's current position (e.g., financial rewards, workload, and autonomy) and perceived supervisor support for career development are also significant predictors of perceived mobility. Finally, perceived mobility is a significant predictor of job satisfaction and intent to stay with current employer.

Practice Implications: Our findings suggest that HPWPs related to career development may be effective tools in improving workers' assessments of their own career potential and improving overall job satisfaction of frontline health care workers. Consequently, HPWPs related to career development may help employers both retain valuable workers and fill worker shortages.

The Value of Library and Information Services in Nursing and Patient Care Libraries are a primary resource for evidence-based practice.

Submitted By: Dr. Jennifer Craft Morgan

Abstract and Requirements for Accessing Full Article

Libraries are a primary resource for evidence-based practice. This study, using a critical incident survey administered to 6,788 nurses at 118 hospitals, sought to explore the influence of nurses' use of library resources on both nursing and patient outcomes. In this article, the authors describe the background events motivating this study, the survey methods used, and the study results. They also discuss their findings, noting that use of library resources showed consistently positive relationships with changing advice given to patients, handling patient care differently, avoiding adverse events, and saving time. The authors discuss the study limitations and conclude that the availability and use of library and information resources and services had a positive impact on nursing and patient outcomes, and that nurse managers play an important role both by encouraging nurses to use evidence-based library resources and services and by supporting the availability of these resources in healthcare settings.

An Evaluation of State-Based Support-for-Service Programs Targeting Nurse Faculty

Submitted By: Dr. Jennifer Craft Morgan

Abstract and Requirements for Accessing Full Article

AIM: The aim of the study was to assess how state-based support-for-service (SFS) programs are used by deans and directors of nursing programs and to evaluate their perceived impact.

BACKGROUND: Given projected nurse faculty shortages, stakeholders are looking for ways to address the maldistribution and shortage of nurse faculty. One state level strategy is the implementation of loan repayment and scholarship programs, which incentivize individuals with, or currently pursuing, graduate degrees to become or remain nurse faculty.

METHOD: This study used a mixed-method and multilevel approach to assess the impact of SFS programs in seven states.

RESULTS: Programs are perceived to affect both recruitment and retention of faculty and play a role in increasing the educational qualifications of current nurse faculty.

CONCLUSION: Nurse educators need to be aware of SFS programs and how best to use them to support nurse faculty.

Retaining Experts: Retirement Plans of Clinical Laboratory Professionals

Submitted By: Dr. Jennifer Craft Morgan

Abstract and Requirements for Accessing Full Article

A survey to assess the retirement plans of clinical laboratory professionals (CLP) and the factors that would influence those plans was distributed to members of the American Society for Clinical Laboratory Science (ASCLS) in May, 2012. A majority of respondents (65%) between 50 – 62 years indicated that there was a greater than 50% chance they would be working after age 62. Only 15.8% of the respondents thought that there was a greater than 50% chance that they would be working full time after they retired from their current job. The retirement option selected most often by respondents was part time work. This was true for respondents in all age groups and job functions. The greatest personal influence on retirement plans was concern about health issues. The results indicate that, if employers can provide part time options, older workers may stay in the workforce as long as they are healthy.

State Repayment Programs for Health Care Education Loans

Submitted By: Dr. Jennifer Craft Morgan

Abstract and Requirements for Accessing Full Article

Repayment of loans for health care education is a popular incentive among states to attract clinicians to underserved areas. As of 1996, 37 states offered loan repayment programs for primary care clinicians, co-sponsored loan repayment programs with the State Loan Repayment Program of the National Health Service Corps (NHSC), or offered both programs. Seven states also offered direct financial incentive programs, which are like loan repayment programs but allow clinicians flexibility in using program funds. In this study, we identified all state loan repayment and direct financial incentive programs for health professionals of all types as of 2010, described changes in program numbers from 2007 to 2010 during the first years of the worldwide recession with tight state budgets, and characterized the disciplines and size of the collective workforce by state.

Home Care Workers Interstate Differences in Training Requirements and Their Implications for Quality

Submitted By: Dr. Jennifer Craft Morgan

Abstract and Requirements for Accessing Full Article

Home care workers, the fastest growing segment of the U.S. direct care workforce, provide nonmedical services that are not reimbursed by Medicare; consequently, requirements for training and supervision are left to the states. The purposes of this study are to compare these state requirements and to identify core competencies for home care workers. Our content analysis of relevant state laws determined that 29 states require a license for home care providers. Of these 29 states, 26 require orientation and 15 require in-service training for home care workers; the duration and content of these programs vary widely across the states. Fifteen states require on-site supervision of home care workers. We believe that in addition to current state training requirements (e.g., activities of daily living (ADLs) and instrumental activities of daily living (IADL) assistance; infection control), other core competencies (e.g., basic medication information; behavioral management) should also be mandatory. More frequent on-site supervision is also necessary to improve home care quality.

The quality of healthcare jobs: can intrinsic rewards compensate for low extrinsic rewards?

Submitted By: Dr. Jennifer Craft Morgan

Abstract and Requirements for Accessing Full Article

Frontline healthcare worker jobs are among the fastest growing occupations in the USA. While many of these are ‘bad jobs' with low pay and few benefits, the intrinsic nature of frontline work can also be very rewarding. This article examines the influence of extrinsic job characteristics (e.g. wages and benefits) versus intrinsic characteristics (e.g. meaningful tasks) on job satisfaction and intent to stay with one's current employer. This article uses a mixed-methods approach, drawing on survey data collected from frontline workers and organizations in a variety of healthcare settings, as well as interview and focus group data from frontline workers to contextualize and interpret the findings in the multi-level models. The results indicate that both intrinsic and extrinsic characteristics are significant predictors of job satisfaction, but only extrinsic characteristics help explain intent to stay with the employer.

Contingency, Employment Intentions, and Retention of Vulnerable Low-wage Workers: An Examination of Nursing Assistants in Nursing Homes

Submitted By: Dr. Jennifer Craft Morgan

Abstract and Requirements for Accessing Full Article

Purpose of the Study: While theories of job turnover generally assume a strong correlation between job satisfaction, intention, and retention, such models may be limited in explaining turnover of low-wage health care workers. Low-wage workers likely have a lower ability to act on their employment intentions or plans due to a lack of resources that serve to cushion higher wage workers. In this study, we examine the relationship between job satisfaction, intention, and retention of nursing assistants in nursing homes and the role that contingency factors play in employment intentions and retention. We conceptualize contingency factors as resource-related constraints (e.g., being a single mother) that likely influence employment trajectories of individuals but can be independent of job satisfaction or intent.

Design and Methods: We use survey data from 315 nursing assistants in 18 nursing homes in a U.S. southern state to model employment intentions and retention.

Results: We find that job satisfaction and other perceived job characteristics (e.g., workload and perceived quality of care) are significant predictors of an individual's intent to stay in their job, the occupation of nursing assistant, and the field of long-term care. However, we find that job satisfaction and employment intentions are not significant predictors of retention. Instead, contingency factors such as being a primary breadwinner and individual characteristics (e.g., tenure and past health care experience) appear to be stronger factors in the retention of nursing assistants. Implications: Our findings have implications for understanding turnover among low-wage health care workers and the use of proxies such as employment intentions in measuring turnover.

States' Experiences With Loan Repayment Programs for Health Care Professionals in a Time of State Budget Cuts and NHSC Expansion

Submitted By: Dr. Jennifer Craft Morgan

Abstract and Requirements for Accessing Full Article

 

Purpose: The landscape of education loan repayment programs for health care professionals has been turbulent in recent years, with doubling of the funding for the National Health Service Corps (NHSC) and cuts in funding for some states' programs. We sought to understand how this turbulence is being felt within the state offices involved in recruiting clinicians to rural and urban underserved communities.

Methods: We conducted key informant telephone interviews with staff of state offices of rural health, primary care organizations, and/or related organizations within 28 diverse states to answer questions about perceived changes and interplay among solely state-funded loan repayment programs, joint state-federal programs, and the NHSC federal program. Interviews were transcribed, formally analyzed, and key issues summarized.

Findings: Informants reported that solely state-funded and joint state-federal loan repayment programs are greatly valued for their ability to target a state's particular needs and to complement the NHSC federal program. However, budgets for state programs have been threatened, reduced, or eliminated entirely in many cases. All informants positively perceived the NHSC's recent growth and changes, which they feel are helping fill important workforce needs for their states. Nevertheless, the much larger NHSC federal program now competes with some states' programs for clinicians and service sites; states' programs are pushed to adjust their operations to maintain a unique “niche.”

Conclusions: States' key recruiters lament reductions in funding for states' loan repayment programs, and welcome the NHSC's recent growth and changes. Better coordination is needed to minimize competition and maximize complementarity between state and federal programs.

A Configurational Approach to the Relationship between High-Performance Work Practices and Frontline Health Care Worker Outcomes

Submitted By: Dr. Jennifer Craft Morgan

Abstract and Requirements for Accessing Full Article

Objective: To identify high-performance work practices (HPWP) associated with high frontline health care worker (FLW) job satisfaction and perceived quality of care.

Methods: Cross-sectional survey data from 661 FLWs in 13 large health care employers were collected between 2007 and 2008 and analyzed using both regression and fuzzy-set qualitative comparative analysis.

Principal Findings: Supervisor support and team-based work practices were identified as necessary for high job satisfaction and high quality of care but not sufficient to achieve these outcomes unless implemented in tandem with other HPWP. Several configurations of HPWP were associated with either high job satisfaction or high quality of care. However, only one configuration of HPWP was sufficient for both: the combination of supervisor support, performance-based incentives, team-based work, and flexible work. These findings were consistent even after controlling for FLW demographics and employer type. Additional research is needed to clarify whether HPWP have differential effects on quality of care in direct care versus administrative workers.

Conclusions: High-performance work practices that integrate FLWs in health care teams and provide FLWs with opportunities for participative decision making can positively influence job satisfaction and perceived quality of care, but only when implemented as bundles of complementary policies and practices.




 

 

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