PURPOSE: This paper was conducted to examine the effects of transformational leadership behaviors, within the substitutes for leadership model (Kerr and Jermier, 1978). METHOD: Data was collected from 181 staff nurses in 3 general hospitals, with self-reporting questionnaires (MLQ developed by Bass, rd-SLS developed by Podsakoff, et al., and MSQ developed by Weiss, et al.). Descriptive statistics, factor analysis, Cronbach's alpha and moderated regression analysis were used. RESULT: 1) The transformational leader behaviors and substitutes for leadership each had correlations with job satisfaction. 2) The total amount of variance accounted for by the substitutes for leadership was substantially greater than by the transformational leadership behaviors. 3) Few of the substitutes variables moderated the relationships between the transformational leader behaviors and job satisfaction in a manner consistent with that specified by Howell, Dorfman, and Kerr (1986). CONCLUSION: The finding of this study suggest that leaders need to have a better understanding of those contextual variables that influence job satisfaction. Thus future research should focus attention on the moderating effects of substitutes, as well as the things that leaders can do to influence them. In addition, it may be good to examine the effects of substitutes on other criterion variables.
Adult ; Female ; Humans ; *Job Satisfaction ; *Leadership ; Male ; Middle Aged ; Nurses/*psychology ; Nursing Staff, Hospital/psychology ; Nursing, Supervisory ; Personnel Administration, Hospital/methods ; Regression Analysis

PURPOSE: Current increase and complexity of medical tests and surgical procedures at outpatient department (OPD) require OPD nurses to have customer orientation focusing on various customers' interests and needs. The purpose of this study was to identify the factors associated with customer orientation in nurses working at OPD of hospitals. METHODS: The study used a descriptive correlational design with cross-sectional survey. The study settings were four general hospitals in Seoul and its metropolitan area. Data were collected from 138 OPD nurses from general hospitals. Study variables were personal traits, emotional intelligence, internal marketing, service management and customer orientation. RESULTS: Factors associated with customer orientation were identified as conscientiousness from personal traits (β .37, p < .001), emotional intelligence from individual characteristics (β .21, p = .032), and internal marketing from environmental characteristics (β .21, p = .001). CONCLUSIONS: Hospital administrators should support OPD nurses to cultivate sincere and sociable personal traits and emotional intelligence, and to consider employees as internal customers to improve patient-oriented services and satisfaction.
Adult ; Attitude of Health Personnel ; Cross-Sectional Studies ; *Emotional Intelligence ; Female ; Humans ; Male ; Marketing/*methods ; Middle Aged ; *Nurse-Patient Relations ; Nursing Staff, Hospital/*psychology ; Organizational Culture ; Outpatient Clinics, Hospital/*organization & administration ; Outpatients/*psychology ; *Patient-Centered Care ; Seoul ; Surveys and Questionnaires ; Young Adult

INTRODUCTIONDistractions and interruptions of doctor's work, although common and potentially deleterious in the intensive care unit (ICU), are not well studied.

METHODSWe used a simple observational method to describe the frequency, sources and severity of such distractions, and explore at-risk situations in the ICU. Independent paired observers separately shadowed eight residents and three fellows for 38 sessions (over 100 hrs) in a 20-bed medical ICU.

RESULTSIn total, 444 distractions were noted. Interobserver agreement was excellent at 99.1%. The mean number of distractions/doctor/hr was 4.36 ± 2.27. Median duration of each distraction was 2 mins (interquartile range 2-4 mins; range 1-20 mins). The top three initiators of distractions were other doctors (35.1%), nurses (30.4%) and oneself (18.7%). Of the 444 distractions, 107 (24.1%) were prolonged (lasting ≥ 5 mins), 210 (47.3%) led to a complete pause of current activity and 85 (19.1%) led to complete abandonment of the current activity. On multivariate analysis, physician seniority, time of session and day of week did not predict frequency of distraction. After adjusting for time of session, day of week and type of current activity, urgent distractions (to see another patient, perform immediate procedures or administer medications) and physician juniority were associated with major distractions (complete interruption or termination of current activity), while only urgent distractions were associated with prolonged distractions.

CONCLUSIONDistractions are common in the ICU and junior doctors are particularly susceptible to major distractions.

Adult ; Attention ; Attitude of Health Personnel ; Continuity of Patient Care ; Critical Care ; methods ; organization & administration ; Female ; Humans ; Intensive Care Units ; Internship and Residency ; Linear Models ; Male ; Medical Staff, Hospital ; Nurses ; Observer Variation ; Physicians ; Risk Factors ; Time Factors

Enhanced recovery after surgery (ERAS) has been widely used in the world for near 20 years, which should be considered as the milestone of modern medicine advancement, changing the routine perioperative principle, accelerating the recovery speed following operation, minimizing the postoperative pain, and saving the medical resources. Despite the remarkable advance, the quality and application of ERAS in the west China needs further improvement if compared with international level or even some domestic hospitals. The postoperative hospital stay in west China is much longer than the reported 3 to 5 days according to published references. Several suggestions can be help: (1) Based on the published consensus and the successful experiences of ERAS in colorectal surgery, the medical institution should make great effort to extend this technique to change the profound traditional idea in medical staffs and patients. (2) The medical administrations should take the application of ERAS as a key performance index and annual work plan in hospital. (3) Multiple disciplinary team including anesthetist, surgeon, dietitian, and nurses is essential for hospital to promote the quality of ERAS. Undoubtedly, ERAS is going to be the conventional medical care in the western area of China. We may look forward to seeing more researches from western China to update the ERAS consensus.
China ; Clinical Competence ; Colorectal Surgery ; rehabilitation ; Consensus ; Digestive System Surgical Procedures ; rehabilitation ; Health Knowledge, Attitudes, Practice ; Humans ; Length of Stay ; statistics & numerical data ; Patient Care Team ; standards ; trends ; utilization ; Personnel Administration, Hospital ; methods ; Postoperative Care ; methods ; psychology ; standards ; Postoperative Period ; Quality of Health Care ; standards ; trends