The role of leadership in overcoming staff turnover in critical care. (41/202)

This commentary discusses Laporta and coworkers analysis of a case study on the causes of and solutions for staff turnover in an intensive care setting. Staff turnover is a significant issue for health care leaders due to the shrinking workforce in Western countries and an increased demand for intensive care services as the population ages. The commentary considers reasons for turnover such as burnout and generational diversity, and highlights the importance of a team work approach to address the issue of turnover.  (+info)

Bench-to-bedside review: dealing with increased intensive care unit staff turnover: a leadership challenge. (42/202)

Critical care leaders frequently must face challenging situations requiring specific leadership and management skills for which they are, not uncommonly, poorly prepared. Such a fictitious scenario was discussed at a Canadian interdisciplinary critical care leadership meeting, whereby increasing intensive care unit (ICU) staff turnover had led to problems with staff recruitment. Participants discussed and proposed solutions to the scenario in a structured format. The results of the discussion are presented. In situations such as this, the ICU leader should first define the core problem, its complexity, its duration and its potential for reversibility. These factors often reside within workload and staff support issues. Some examples of core problems discussed that are frequently associated with poor retention and recruitment are a lack of a positive team culture, a lack of a favorable ICU image, a lack of good working relationships between staff and disciplines, and a lack of specific supportive resources. Several tools or individuals (typically outside the ICU environment) are available to help determine the core problem. Once the core problem is identified, specific solutions can be developed. Such solutions often require originality and flexibility, and must be planned, with specific short-term, medium-term and long-term goals. The ICU leader will need to develop an implementation strategy for these solutions, in which partners who can assist are identified from within the ICU and from outside the ICU. It is important that the leader communicates to all stakeholders frequently as the process moves forward.  (+info)

A conceptual model for recruitment and retention: allied health workforce enhancement in Western Victoria, Australia. (43/202)

Attracting and retaining allied health professionals in rural areas is a recognised problem in both Australia and overseas. Predicted increases in health needs will require strategic actions to enhance the rural workforce and its ability to deliver the required services. A range of factors in different domains has been associated with recruitment and retention in the allied health workforce. For example, factors can be related to the nature of the work, the personal needs, or the way an organisation is led. Some factors cannot be changed (eg geographical location of extended family) whereas others can be influenced (eg education, support, management styles). Recruitment and retention of allied health professionals is a challenging problem that deserves attention in all domains and preparedness to actively change established work practices, both individually as well as collectively, in order to cater for current and predicted health needs. Changes to enhance workforce outcomes can be implemented and evaluated using a cyclic model. The Allied Health Workforce Enhancement Project of the Greater Green Triangle University Department of Rural Health (GGT UDRH) is working towards increasing the number of allied health professionals in the south west of Victoria. Based on themes identified in the literature, an interactive model is being developed that addresses recruitment and retention factors in three domains: (1) personal or individual; (2) organisation; and (3) community.  (+info)

Predictors of early leaving from the cotton spinning mill environment in newly hired workers. (44/202)

OBJECTIVE: This longitudinal study aimed to identify the predictors of leaving during the first year of employment from the cotton spinning mill environment in newly hired workers. METHODS: One hundred and ninety eight consecutively appointed new employees were investigated by questionnaire, lung function test, and skin test. They were examined before employment and at the end of the 1st week, and the 1st, 3rd, 6th, and 12th month after starting work and when possible before leaving their job. 572 personal dust sampling and 191 endotoxin measurements were performed to assess the environmental exposure. For the univariate analysis chi2, Student t tests, ANOVA, and Kruskall Wallis tests were used. Cox proportional hazards analysis was used to identify factors associated with leaving the job. RESULTS: Fifty three per cent of workers left the mill environment during their first working year. Work related lower respiratory tract symptoms reported at the third month were associated with an increase rate of leaving the industry compared to those remaining in the industry (25% v 4.8%; p<0.005). Having respiratory symptoms at the first month of work predicted those leaving the industry at some point in the next 11 months. According to the Cox model, increasing age and having work related lower respiratory tract symptoms were found to be predictors for leaving job at the first working year. Atopic status, dust and endotoxin levels, and lung function changes were not consistently predictive of workers who left the industry in the follow up period. CONCLUSION: This study demonstrated that work related respiratory symptoms can predict workers likely to leave the cotton mill environment during the first year of employment, but atopy or acute lung function changes do not.  (+info)

Dental school vacant budgeted faculty positions: academic year 2004-05. (45/202)

The number of vacant budgeted faculty positions in dental schools has continued to decline, dropping from 296 in 2003-04 to 275 in 2004-05. The number of lost positions declined to twenty-five, from 147 lost positions reported in 2003-04. While the average number of vacancies per dental school was just under five, three-quarters of these vacancies were considered usual and normal to the operation of the dental school. Based on ADEA's annual survey of dental educators, there was approximately a 9 percent faculty turnover between 2003-04 and 2004-05, and according to the 2003-04 and 2004-05 surveys of vacant faculty positions, it is taking longer to fill vacant positions. The greatest challenges influencing the ability of a school to fill a vacancy were salary/budget limitations and lack of response to a position announcement. Still, between 2003-04 and 2004-05, the number of dental school faculty increased from 11,348 to 11,715, including 4,736 full-time, 5,097 part-time, and 1,791 volunteer faculty members. Employment status was not reported for ninety-one individuals. Private practice remains the primary reason for faculty separations and the source of new faculty. In addition, nearly one in four new faculty members entered dental education directly following graduation from a dental or postdoctoral education program. While it may take longer to fill positions and it has become more difficult to fill some vacancies, overall, dental school deans indicated that the number of vacancies was not affecting the quality of dental education. However, between anticipated faculty retirements and current levels of faculty turnover, continued support for and development of faculty recruitment and retention programs remains essential to maintaining a quality dental education workforce.  (+info)

Factors affecting rapid turnover of novice nurses in university hospitals. (46/202)

Rapid turnover of novice nurses eventually results in a shortage of veteran nurses. This study aimed to clarify the factors affecting rapid turnover of novice nurses in a prospective manner. We carried out an investigation in 20 university hospitals whose directors of nursing service departments accepted our request to cooperate with our research program. These hospitals were selected from all of the 102 university hospitals listed in The Hospital Catalog of Japan. The subjects were 1,203 novice hospital nurses who gave their informed consent for participation in our study. The questionnaires, which dealt with burnout, assertiveness, stressful life events, reality shock, ward assignment preference, transfer preference, job satisfaction (workplace, salary, workload, and overtime), social support and coping mechanisms were completed by 923 novice nurses in June 2003. Then, their turnover was investigated in December 2003. Thirty-seven novice nurses (4.0%) quit during this period. Multiple logistic regression analysis showed that the factors affecting rapid turnover were 1) graduation from vocational nursing schools, 2) dissatisfaction with assignment to a ward contrary to their desire, and 3) no peers for support. Assignment of novice nurses to wards they choose as far as possible, avoidance of assigning novice nurses to wards alone, and establishment of a support system for nurses who graduate from vocational nursing schools seem to be important for preventing rapid turnover of novice nurses.  (+info)

Predictors of leaving nursing care: a longitudinal study among Swedish nursing personnel. (47/202)

OBJECTIVES: Despite extensive research on turnover among nursing personnel very little is known about the impact of physical workload and health on leaving. The aim of this study was to find predictors for leaving nursing care with special reference to physical working conditions and musculoskeletal problems. METHODS: This study is based on longitudinal data from a survey of nursing personnel who were employed at various county hospitals in Sweden from 1992-95. A self administrated follow up questionnaire was used to identify their present position in the labour market. The response rate was 73% (n = 1095). RESULTS: The results showed that nursing personnel reporting musculoskeletal problems of the neck/shoulder or knees and those who had limited use of transfer devices were more likely to leave nursing care. CONCLUSIONS: The study highlights the importance of taking musculoskeletal problems and use of transfer devices into consideration in order to retain nursing personnel.  (+info)

Organizational climate partially mediates the effect of culture on work attitudes and staff turnover in mental health services. (48/202)

Staff turnover in mental health service organizations is an ongoing problem with implications for staff morale, productivity, organizational effectiveness, and implementation of innovation. Recent studies in public sector services have examined the impact of organizational culture and climate on work attitudes (i.e., job satisfaction and organizational commitment) and, ultimately, staff turnover. However, mediational models of the impact of culture and climate on work attitudes have not been examined. The present study examined full and partial mediation models of the effects of culture and climate on work attitudes and the subsequent impact of work attitudes on staff turnover. Multilevel structural equation models supported a partial mediation model in which organizational culture had both direct influence on work attitudes and indirect influence through organizational climate. Work attitudes significantly predicted one-year staff turnover rates. These findings support the contention that both culture and climate impact work attitudes and subsequent staff turnover.  (+info)