Search

BackgroundDue to the rapid digitalization of health care, leadership is becoming more complex. Leadership in digital health services is a term that has been used in the literature with various meanings. Conceptualization of leadership in digital health services is needed to deliver higher quality digital health services, update existing leadership practices, and advance research. ObjectiveThe aim of this study is to outline a concept analysis that aims to clarify and define the concept of leadership in digital health services. MethodsThe concept analysis will be performed using the Walker and Avant model, which involves eight steps: concept selection, determination of aims, identification of uses, determination of defining attributes, construction of a model case, construction of additional cases, identification of antecedents and consequences, and definition of empirical referents. A scoping literature search will be performed following the search protocol for scoping reviews by the Joanna Briggs Institute to identify all relevant literature on leadership in digital health services. Searches will be conducted in 6 scientific databases (CINAHL, MEDLINE, Scopus, ProQuest, Web of Science, and the Finnish database Medic), and unpublished studies and gray literature will be searched using Google Scholar, EBSCO Open Dissertations, and MedNar. ResultsAn initial limited search of MEDLINE was undertaken on October 19, 2020, resulting in 883 records. The results of the concept analysis will be submitted for publication by July 2021. ConclusionsA robust conceptualization of leadership in digital health services is needed to support research, leadership, and education. The concept analysis model of Walker and Avant will be used to meet this need. As leadership in digital health services appears to be an interprofessional and intersectoral collaboration, defining this concept may also facilitate collaboration between professionals and sectors. The concept analysis to be conducted will also expand our understanding of leadership in digital health services. International Registered Report Identifier (IRRID)PRR1-10.2196/25495

BackgroundThe popularity of web-based patient-professional communication over patient portals is constantly increasing. Good patient-professional communication is a prerequisite for high-quality care and patient centeredness. Understanding health care professionals’ experiences of web-based patient-professional communication is important as they play a key role in engaging patients to use portals. More information is needed on how patient-professional communication could be supported by patient portals in health care. ObjectiveThis systematic review of qualitative studies aims to identify how health care professionals experience web-based patient-professional communication over the patient portals. MethodsAbstract and full-text reviews were conducted by 2 reviewers independently. A total of 4 databases were used for the study: CINAHL (EBSCO), ProQuest (ABI/INFORM), Scopus, and PubMed. The inclusion criteria for the reviewed studies were as follows: the examination of health care professionals’ experiences, reciprocal communication between patients and health care professionals, peer-reviewed scientific articles, and studies published between 2010 and 2019. The Joanna Briggs Institute’s quality assessment criteria were used in the review process. A total of 13 included studies were analyzed using a thematic synthesis, which was conducted by 3 reviewers. ResultsA total of 6 analytical themes concerning health care professionals’ experiences of web-based patient-professional communication were identified. The themes were related to health care professionals’ work, change in communication over patient portals, patients’ use of patient portals, the suitability of patient portals for communication, the convenience of patient portals for communication, and change in roles. ConclusionsHealth care professionals’ experiences contain both positive and negative insights into web-based patient-professional communication over patient portals. Most commonly, the positive experiences seem to be related to the patients and patient outcomes, such as having better patient engagement. Health care professionals also have negative experiences, for example, web-based patient-professional communication sometimes has deficiencies and has a negative impact on their workload. These negative experiences may be explained by the poor functionality of the patient portals and insufficient training and resources. To reduce health care professionals’ negative experiences of web-based patient-professional communication, their experiences should be taken into account by policy makers, health care organizations, and information technology enterprises when developing patient portals. In addition, more training regarding web-based patient-professional communication and patient portals should be provided to health care professionals.

Copyright of Hoitotiede is the property of Hoitotieteiden Tutkimusseura HTTS r.y. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction Evidence shows that improving hand-hygiene practices reduces the frequency of health-care-associated infections in hospitals. (1,2) Studies have examined the association between hand-hygiene and health-care-associated infections: some were conducted over [...], Objective To determine changes in hand-hygiene compliance after the introduction of direct observation of hand-hygiene practice for doctors and nurses, and evaluate the relationship between the changes and the incidence of health-care -associated infections. Methods We conducted an internal audit survey in a tertiary-care hospital in Finland from 2013 to 2018. Infection -control link nurses observed hand-hygiene practices based on the World Health Organization's strategy for hand hygiene. We calculated hand-hygiene compliance as the number of observations where necessary hand-hygiene was practised divided by the total number of observations where hand hygiene was needed. We determined the incidence of health-care -associated infections using a semi-automated electronic incidence surveillance programme. We calculated the Pearson correlation coefficient (r) to evaluate the relationship between the incidence of health-care-associated infections and compliance with hand hygiene. Findings The link nurses made 52 115 hand-hygiene observations between 2013 and 2018. Annual hand-hygiene compliance increased significantly from 76.4% (2762/3617) in 2013 to 88.5% (9034/10 211) in 2018 (P < 0.0001). Over the same time, the number of health-care-associated infections decreased from 2012 to 1831, and their incidence per 1000 patient-days fell from 14.0 to 11.7 (P < 0.0001). We found a weak but statistically significant negative correlation between the monthly incidence of health-care-associated infections and hand-hygiene compliance (r = -0.48; P < 0.001). Conclusion The compliance of doctors and nurses with hand-hygiene practices improved with direct observation and feedback, and this change was associated with a decrease in the incidence of health-care-associated infections. Further studies are needed to evaluate the contribution of hand hygiene to reducing health-care-associated infections. Objectif Identifier les changements dans l'application des mesures d'hygiene des mains apres l'introduction d'un systeme d'observation directe des pratiques en la matiere chez les medecins et infirmiers. Evaluer le rapport entre ces changements et le nombre d'infections liees aux soins de sante. Methodes Nous avons effectue un audit interne au sein d'un hopital de soins tertiaires en Finlande entre 2013 et 2018. Les infirmieres chargees du controle des infections ont juge les pratiques d'hygiene en se basant sur la strategie d'hygiene des mains de l'Organisation mondiale de la Sante. Nous avons defini dans quelle mesure le personnel respectait les consignes d'hygiene des mains en divisant le nombre de cas ou le niveau d'hygiene requis etait respecte par le nombre total de cas ou l'hygiene des mains etait necessaire. Nous avons egalement determine le nombre d'infections liees aux soins de sante a l'aide d'un programme de surveillance electronique semi-automatique. Enfin, nous avons calcule le coefficient de correlation de Pearson (r) afin d'evaluer le rapport entre le nombre d'infections liees aux soins de sante et le respect de l'hygiene des mains. Resultats Les infirmieres ont observe 52 115 cas d'hygiene des mains entre 2013 et 2018. La moyenne annuelle du respect des mesures a considerablement augmente, passant de 76,4% (2762/3617) en 2013 a 88,5% (9034/10 211) en 2018 (P < 0,0001). Durant la meme periode, le nombre d'infections liees aux soins de sante a diminue, passant de 2012 a 1831, et leur frequence sur 1000 jours-patients a chute, de 14,0 a 11,7 (P < 0,0001). Nous avons detecte une correlation negative faible mais statistiquement significative entre le taux d'incidence mensuel d'infections liees aux soins de sante et le respect de l'hygiene des mains (r = -0,48; P < 0,001). Conclusion Les observations directes et retours ont encourage les medecins et infirmiers a mieux respecter les consignes d'hygiene des mains. Ce changement a entraine une baisse du nombre d'infections liees aux soins de sante. D'autres etudes sont cependant necessaires pour evaluer l'impact de l'hygiene des mains sur la diminution des infections liees aux soins de sante. Objetivo Determinar los cambios del cumplimiento de la higiene de las manos tras las observaciones directas en las practicas de higiene de las manos que realizan los medicos y las enfermeras, ademas de evaluar la relacion entre los cambios y la incidencia de las infecciones relacionadas con la atencion medica. Metodos Se realizo una encuesta de auditoria interna en un hospital de atencion terciaria en Finlandia de 2013 a 2018. Las enfermeras de control de infecciones observaron las practicas de higiene de las manos segun la estrategia de la Organizacion Mundial de la Salud para la higiene de las manos. Se estimo que el cumplimiento de la higiene de las manos equivalia a dividir el numero de las observaciones en las que era necesario practicar la higiene de las manos por el numero total de observaciones en las que se requeria la higiene de las manos. Se determino la incidencia de las infecciones relacionadas con la atencion medica mediante un programa semiautomatizado y electronico de vigilancia de la incidencia. Se calculo la correlacion de Pearson (r) para evaluar la relacion entre la incidencia de las infecciones relacionadas con la atencion medica y el cumplimiento de la higiene de las manos. Resultados Las enfermeras realizaron 52 115 observaciones de higiene de las manos entre 2013 y 2018. El cumplimiento anual de la higiene de las manos aumento significativamente del 76,4 % (2762/3617) en 2013 al 88,5 % (9034/10 211) en 2018 (P < 0,0001). Durante el mismo tiempo, el numero de infecciones relacionadas con la atencion medica disminuyo de 2012 a 1831, y su incidencia por cada 1000 dias de pacientes se redujo de 14,0 a 11,7 (P < 0,0001). Se encontro una correlacion negativa debil pero estadisticamente significativa entre la incidencia mensual de las infecciones relacionadas con la atencion medica y el cumplimiento de la higiene de las manos (r = -0,48; P < 0,001). Conclusion El cumplimiento de las practicas de higiene de las manos que realizan los medicos y las enfermeras mejoro con la observacion directa y la retroalimentacion, lo que se asocio a una disminucion de la incidencia de las infecciones relacionadas con la atencion medica. Se requieren mas estudios para evaluar la contribucion de la higiene de las manos a la reduccion de las infecciones relacionadas con la atencion medica. [phrase omitted]

Background: Around the world services for families with children are being organised into family centres which aim to increase parental empowerment. Parental empowerment can be seen to manifest at three levels: the individual level in the family itself, in a specific service situation, and in the wider system of services. Aim: To describe the realisation of parental empowerment in family centres and the factors associated with it. Methods: The study used a cross-sectional study design. The parents (n=1447) were recruited from the city in Finland where services for families with children were provided through family centres in February to April 2022. A total of 215 parents with children aged 0-6 responded to the Webropol-survey. Parental empowerment was measured using the Generic Family Empowerment Scale (G-FES). The data were analysed using t-test and one-way analysis of variance. Results: According to G-FES, parental empowerment was high at the family (mean 4.1, SD 0.60) and service situation (mean 4.1, SD 0.60) and moderate at the service system (mean 3.2, SD 0.7) subscales. Challenges in everyday family functionality were statistically significantly associated with decreased parental empowerment, across all levels. At the service situation and service system context adequate access to assistance and experience of families' views having an association increased parental empowerment. Parents' and children's backgrounds were somewhat associated with parental empowerment. Conclusions: Results of this study highlights that the most significant factor shaping parental empowerment, across all levels, is the self-reported everyday functionality of the family. Further attention must be paid to supporting the everyday lives of families, including those who have particular concerns and challenges. [ABSTRACT FROM AUTHOR]

Aim: To describe health and social care managers' perceptions of the factors affecting the competence of managers in knowledge management. Design: A qualitative descriptive study. Methods: A semi‐structured interview was conducted with 15 managers from three public health and social care organizations in Finland. Data were collected in the spring of 2022 and analysed using inductive content analysis. Results: Health and social care managers perceived that the competence of managers working in knowledge management is affected by managers' behavioural and attitudinal characteristics, their interactive network competence in knowledge management, the dimensions of their competence in knowledge management, the knowledge management infrastructure with which they work and the organizational learning culture within which they work. Conclusions: The competence of health and social managers in knowledge management is influenced by various factors, including their personal characteristics, management competence and the infrastructure and culture of the organization for which they work. However, their competence is constrained by an absence of clear processes, structures and resources in knowledge management as well as a lack of systematic support and training for managers working in knowledge management. Impact: The study provides valuable information for improving the competence of managers working in knowledge management in health and social care organizations. The competence of managers working in knowledge management is instrumental for successful implementation and sustaining of knowledge management practices and thus, such competence has a positive impact on the overall performance of an organization. Implications: Clarifying the roles and responsibilities of health and social care managers, as well as establishing organizational structures, is essential for effective knowledge management in organizations. Reporting Method: Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist has been used in the reporting. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: The aim was to explore implementation leadership of the Resident Assessment Instrument in healthcare services for older people from the perspective of specialists. Design: A qualitative descriptive design was used. Methods: Thematic interviews with 21 specialists were conducted between April 2022 and June 2022 in eight health and social, one educational and one research organization in Finland. The data were analysed with deductive–inductive content analysis using the Resident Assessment Instrument implementation leadership framework developed for this study. Results: In implementation leadership of Resident Assessment Instrument, the need for leaders' support and capabilities to ensure that the conditions and supporting structures for implementation are present was emphasized. Regular and continuous basic and advanced training for professionals and leaders' competencies were identified as crucial factors for a successful implementation process of Resident Assessment Instrument. Leading the active implementation of this instrument requires leaders' strong support and regular communication. The importance of frontline leaders and mentors was also stressed in practical implementation, while the responsibility of upper‐level leaders, especially in the use of benchmarking, was underlined for the evaluation and further improvement of organizational operations. In sustaining the implementation, it was emphasized that using the Resident Assessment Instrument is a continuous process that does not end with the implementation itself. Conclusion: Implementation leadership of Resident Assessment Instrument has the potential to increase the success of the implementation process. The Resident Assessment Instrument Implementation Leadership Framework can be a useful tool for describing processes, content and leaders' roles in implementation leadership of the instrument in healthcare services for older people. Impact: This study provides a comprehensive view of implementation leadership of the Resident Assessment Instrument implementation process in healthcare services for older people. Overall, the results indicate the significance of leadership in successful implementation. Patient or Public Contribution: No patient or public contribution. What Does This Article Contribute to the Wider Global Clinical Community?: Successful implementation leadership of Resident Assessment Instrument requires continuous monitoring, supporting and evaluating the implementation process. Organizations that use the Resident Assessment Instrument should strengthen their leaders' knowledge and competencies in implementation leadership to enable the full realization of the instrument's benefits. Leaders and professionals in healthcare services for older people need regular, continuous and correctly targeted basic and advanced training on the Resident Assessment Instrument. [ABSTRACT FROM AUTHOR]

Aim: To describe managers' and professionals' views on the management of digital competence sharing in health care. Design: A qualitative descriptive study. Method s : Managers (n = 22) and professionals (n = 12) from two public primary, one public special and one private health care organization in Finland participated in semi‐structured individual interviews between February and May 2022. Data were analysed using inductive content analysis. Results: Managers' and professionals' views formed six main categories: providing resources and opportunities for digital competence sharing, creating methods and practices for digital competence sharing, managing digital competence, implementing intergenerational learning, creating a friendly and safe digital organizational atmosphere, and promoting digital competence sharing through leadership. Conclusion: The support of management is significant in promoting the sharing of digital competence in health care organizations. The management of digital competence sharing requires a both resources and a commitment to continuous training and development. It also requires the creation of a collaborative culture to promote mutual learning between professionals and people of different generations. Impact: Due to rapid technological advancements and the resulting load, it is important to focus on the development and sharing of digital competence among health care professionals. The study indicated that managers should have the ability to identify the strengths of professionals' digital competence and be able to utilize them in promoting digital competence sharing. It also highlighted the specific competency requirements for managers in this context. The results can be applied to the training of health care managers and professionals, particularly around digital competence. Patient or Public Contribution: No patient or public contribution. Reporting Method: The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used in the reporting. [ABSTRACT FROM AUTHOR]

Aim: To identify evidence on frontline nurse leaders' competences in evidence-based healthcare (EBHC) and the instruments measuring these competences. Design: A scoping review. Data Sources: The search was conducted in June 2021 and complemented in June 2022. The CINAHL, ProQuest, Medline (Ovid), Scopus, Web of Science databases and MedNar along with the Finnish database Medic were searched. Review Method: The scoping review was conducted in accordance with the Joanna Briggs institute methodology for scoping reviews. Titles, abstracts and full-text versions were screened independently by two reviewers according to the inclusion criteria. Deductive-inductive content analysis was used to synthesize data. Results: A total of 3211 articles published between 1997 and 2022 were screened, which resulted in the inclusion of 16 articles. Although frontline nurse leaders had a positive attitude towards EBHC, they had a lack of implementing EBHC competence into practice. Part of the instruments were used in the studies, and only one focused especially on leaders. None of instruments systematically covered all segments of EBHC. Conclusion: There is a limited understanding of frontline nurse leaders' competence in EBHC. It is important to understand the importance of EBHC in healthcare and invest in the development of its competence at all levels of leaders. Frontline nurse leaders' support is essential for direct care nurses to use EBHC to ensure the quality of care and benefits to patients. Leaders must enhance their own EBHC competence to become role models for direct care nurses. It is also essential to develop valid and reliable instruments to measure leaders' competence covering all EBHC segments. The results can be utilized in the assessment and development of frontline nurse leaders' EBHC competence by planning and producing education and other competence development methods. [ABSTRACT FROM AUTHOR]

Background: The importance of work engagement has been emphasised due to the increasing demand for health‐ and social care and the shortage of skilled labour. Improving organisational and managerial factors is important when enhancing professionals' work engagement. The association between management and work engagement has only been established in previous studies at a general level, but the association between appreciative management and work engagement has not received equivalent research interest. Aim: This study aimed to describe the association between appreciative management and work engagement among health‐ and social care professionals. Methods: The study used a cross‐sectional survey design. The data were collected in five health and social services centres in one city in Finland from September to October 2022 using the Appreciative Management Scale 2.0 and the Utrecht Work Engagement Scale‐9. A total of 182 health‐ and social care professionals participated. The data were analysed using correlations, linear regression analyses, independent samples t‐tests and two‐way analyses of variance (ANOVAs). Results: A moderate association was found between appreciative management and work engagement and its dimensions of vigor, dedication and absorption. Systematic management had the strongest association and equality had the weakest association with work engagement. Among the dimensions of work engagement, appreciative management had the strongest association with vigour and the weakest association with absorption. Appreciative management and work type predicted 18% of the variance in work engagement. Full‐time employees reported higher levels of work engagement and all its dimensions than did part‐time employees. Conclusion: The results indicate that appreciative management and full‐time work predict work engagement among health‐ and social care professionals. Due to this positive association, it is important to promote managers' appreciative management skills by educating them to understand how appreciative management enables and supports professionals' vigour, dedication and absorption in health‐ and social care. [ABSTRACT FROM AUTHOR]

Aims: To explore registered nurses' cultural orientation competence profiles for providing culturally and linguistically diverse (CALD) nurses with orientation in the hospital setting, and to identify which factors are associated with cultural orientation competence profiles. Design: A descriptive, explorative cross‐sectional study. Methods: Data were collected from December 2020 to January 2021 using the Preceptors' Orientation Competence Instrument (POCI) and Preceptors' Cultural Orientation Competence Instrument (POCCI). A total of 844 registered nurses from one university hospital district in Finland participated, reflecting a response rate of 10%. A K‐means cluster algorithm was employed to identify different cultural orientation competence profiles. Results: The cluster analysis identified three cultural orientation competence profiles (A, B and C). Nurses in Profile A evaluated their cultural orientation competence the highest, with members of profiles B and C demonstrating the second highest and lowest, respectively, cultural orientation competence scores. Several factors were associated with cultural orientation competence profiles, namely, orientation education and student mentoring education, support from managers and colleagues, motivation, willingness to act as a preceptor, time to provide orientation, sufficient clinical and theoretical nursing skills and current work title. Conclusion: Cultural diversity and acceptance of it can be enhanced by building accepting culture towards new incomers and offering continuing education to improve the cultural competence of staff, which can further benefit patient care of CALD patients. Orientation practices can be improved by rewarding staff and building collaborative teamwork culture. Implications for Profession and/or Patient Care: Organizations can strengthen nurses' cultural orientation competence; for example, by providing adequate orientation education and allocating more time to the orientation process. Reporting Method: The STROBE criteria were used to report the results of the observations critically. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Copyright of Hoitotiede is the property of Hoitotieteiden Tutkimusseura HTTS r.y. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Hoitotiede is the property of Hoitotieteiden Tutkimusseura HTTS r.y. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)