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Continuity of care is a concept that is defined as the uninterrupted and coordinated care provided to a patient and that includes an informational dimension which describes the information exchange between the parties involved. In nursing, the nursing summary is the main instrument to ensure informational continuity of care. The aim of this paper is to present an HL7 Clinical Document Architecture based document standard for the eNursing Summary and to discuss the need for harmonizing these results at international level. The eNursing Summary proposed in this paper was developed on the basis of several internationally accepted concepts, primarily the nursing process, the ISO 18104 Reference Terminology Model for Nursing and various data sets. The standardisation process embraced several phases of involving nursing experts for validating its structure and content. It was finally evaluated by a network of 100 healthcare organizations. We argue that the eNursing Summary is a good starting point for standardising nursing discharge and transfer documents on a global level. However, further work is needed to bring together the different national and international strands in standardisation.
Employee cooperation is fundamental for accomplishing successful organizational change processes. Therefore, it is important to understand how employees' cooperation can be supported in the context of organizational change. Based on the group engagement model, we hypothesized how procedural justice affects organizational identification which in turn should have an affect on employees' cooperation (commitment to change, values-congruence fit, and change-supporting behavior) in the context of organizational change. To test the fit of the proposed model, structural equation models were calculated using both cross-sectional (N = 315) and longitudinal (N = 110) data of academic staff at a German university. Results indicated adequate data fit to our proposed model and revealed that organizational identification mediated the positive effects of procedural justice on affective commitment to change and values-congruence fit. The assumed mediating effect of organizational identification on the positive relationship between procedural justice and change-supporting behavior could only be supported using cross-sectional data.
Purpose
The purpose of this paper is to provide a deeper understanding of how transformational leadership relates to followers' innovation implementation behavior, the psychological mechanisms of this relationship, and the role of individual perceptions of climate for initiative.
Design/methodology/approach
Perceptual data were collected from 198 employees in lower and middle management positions of a multinational automotive corporation. Relationships were tested using hierarchical regression analysis.
Findings
Results demonstrate that transformational leadership was strongly related to followers' innovation implementation behavior and that the nature of this relationship was moderated by followers' levels of perceived climate for initiative. Additionally, commitment to change fully mediated the relationship between transformational leadership and followers' innovation implementation behavior.
Research limitations/implications
The paper is based on a cross‐sectional design. A causal interpretation requires studies with experimental or longitudinal designs.
Practical implications
Companies should invest in transformational leadership training and in the selection of supervisors with this leadership style before initiating the implementation of innovations. Enhancing contextual factors, such as a perceived climate for initiative, should be promoted by integrating them into organizations' reward systems.
Originality/value
The paper is one of the first to investigate the relationship between transformational leadership and followers' innovation implementation behavior. It specifies the organizational contexts under which transformational leadership is most likely related to innovation implementation behavior, and those in which such a relationship is unlikely to occur.
Background: IT adoption is a process that is influenced by different external and internal factors. This study aimed
1. to identify similarities and differences in the prevalence of medical and nursing IT systems in Austrian and German hospitals, and
2. to match these findings with characteristics of the two countries, in particular their healthcare system, and with features of the hospitals.
Methods: In 2007, all acute care hospitals in both countries received questionnaires with identical questions. 12.4% in Germany and 34.6% in Austria responded.
Results: The surveys revealed a consistent higher usage of nearly all clinical IT systems, especially nursing systems, but also PACS and electronic archiving systems, in Austrian than in German hospitals. These findings correspond with a significantly wider use of standardised nursing terminologies and a higher number of PC workstations on the wards (average 2.1 PCs in Germany, 3.2 PCs in Austria). Despite these differences, Austrian and German hospitals both reported a similar IT budget of 2.6% in Austria and 2.0% in Germany (median).
Conclusions: Despite the many similarities of the Austrian and German healthcare system there are distinct differences which may have led to a wider use of IT systems in Austrian hospitals. In nursing, the specific legal requirement to document nursing diagnoses in Austria may have stimulated the use of standardised terminologies for nursing diagnoses and the implementation of electronic nursing documentation systems. Other factors which correspond with the wider use of clinical IT systems in Austria are: good infrastructure of medical-technical devices, rigorous organisational changes which had led to leaner processes and to a lower length of stay, and finally a more IT friendly climate. As country size is the most pronounced difference between Germany and Austria it could be that smaller countries, such as Austria, are more ready to translate innovation into practice.
The last two decades have been characterized by a fundamental change in the approaches, tools and instruments in the quality management at Higher Education Institutions. Comparison of two Higher Education Institutions in the Slovak Republic and Germany highlights similarities and trends in quality assurance. Both case studies show how multifaceted the quality management is, and the needs to be approached if a meaningful progress is to be made. Complexity has to be explicitly recognized and built into the approach chosen. Higher Education Institutions have to develop internal quality assurance processes. Quality culture is key for addressing the challenges.
Health-related quality of life (HRQOL) in parents of children suffering from renal disease is often diminished by the illness burden experienced in daily life and by unfavorable ways of coping. Our aim was to examine the relationship between psychosocial strains perceived by parents, their ways of coping, and HRQOL. In an anonymous cross-sectional study, parents completed a questionnaire concerning psychosocial strains, coping strategies, and HRQOL, as well as sociodemographic and illness parameters. Study participants were recruited in two outpatient dialysis centers. Participating in the study were 195 parents (105 mothers, 90 fathers; age 43 ± 8 years; representing 108 families) of children suffering from renal disease (age 12 ± 5 years). Parents of children with chronic renal failure reported moderate HRQOL with parents of children undergoing dialysis experiencing more limitations in quality of life than parents of children living with a kidney graft and parents of children undergoing conservative treatment. Mothers experienced lower HRQOL and higher psychosocial strains than fathers. HRQOL was predicted by the coping strategies “focusing on child” (β = –0.25), “improving marital relationship” (β = 0.24), “seeking social support” (β = –0.22) and “self-acceptation and growth” (β =0 .19) as well as parents′ perceived limitation by illness in daily life (β = –0.15; explained variance 57%). In the comprehensive care for families with a child suffering from a renal disease, screening for psychosocial strains and ways of coping, along with applying interventions to strengthen adaptive coping strategies, may be a preventative means of improving parents′ quality of life.
To ensure the quality of long-term care services has been one of the key elements of German long-term care insurance since its implementation in 1995. A joint agreement between insurers and service providers served as the baseline for quality assurance. Monitoring and control of quality in institutional and home based long-term care was performed by the insurers’ Medical Board. As a result of problems in some long-term care facilities reported in the media the Long-term Care System Reform Act of 2008 contained several provisions to ensure and improve the quality of services. The obligatory use of expert standards for the performance of particular nursing interventions and the establishment of a system of public reporting were the first measures implemented. The development of quality indicators has also been initiated. These routes to quality, their anticipated effects and remaining challenges will be addressed in this article.
The paper presents and analyses the structure and consequences of limits to growth for the global economy. Apart from the famous report for the Club of Rome, a wide range of related literature, which all caution against the idea of unrestricted growth, is also covered. In presenting side tracks in economics, major differences towards standard economic reasoning are highlighted; these are particularly centred on the concepts of technology, sustainability, and resources. One of the central conclusions is that technological progress alone cannot be the knight in shining armour to save the day amid increasing stress on the sides of sources and sinks of the global system. Further, oil production, consumption, and reserve patterns are discussed, emphasising that a continuous underestimation of the challenges ahead would be distressing. Finally, the development of non-advanced countries is hindered, as the diminishing availability of oil reserves could prove as a significant constraint.