Assessment of the Head Nurses ’ Performance Regarding Staff Management at the Units of Al-Najaf AL-Ashraf City Hospitals "

1 "Assessment of the Head Nurses’ Performance Regarding Staff Management at the Units of Al-Najaf AL-Ashraf City Hospitals" فجنلا ةنيذم تايفشتسم يف نيضرمملا ةرادإب قلعتي اميف ضيرمتلا تاذحو يلوؤسم ءادأ مييقت فرشلاا Ali H. AL-Jazaery * Dr. Muna A. Khaleel ** ةصلاخلا :فذهلا فششلاا فدُنا ثاُفشخسي ٍف ٍُظشًًنا ةسادإب كهعخَ اًُف طَشًخنا ثاذحو ٍنوؤسي ءادا ىُُمح ىه تساسذنا فذه . :ةيجهنملا ُعطمي تساسد ٍهُهحح ىًُصخب ت ةسادإب كهعخَ اًُف طَشًخنا ثاذحو ٍنوؤسي ءادا ىُُمخن تُناحنا تساسذنا للاخ اهصادَا ىح ٍعَشًخنا سداكنا ٍف ثاُفشخسي .فششلاا فدُنا تَُذي جيذخخسا تُدهُي ٍَاثنا ٍَششح ٍي ششع ٌداحنا ٍي ثأذب تساسذنا ِزه .تساسذنا صادَلإ ًٍكنا ذحبنا 5115 صىًح ٍي ٍَاثنا ًنا 5116 . طَشًخنا ٍنوؤسي مك جَاك تساسذهن تفذهخسًنا تُُعنا غنابناو ( ىهدذع 66 ) تساسذناب ىهنىًش ىح ٍَزناو شًنا للاخ ٍي . ىح ,تُُعًنا تمباسنا ثاساسذهن تعُفخسًنا تعخا وؤسي عي تهبامًنا تمَشطبو )ٍبشع تخسَ( سىطًنا ٌاُبخسلاا واذخخسا للاخ ٍي ثاَاُبنا عًُدح ىح .تساسذنا ِزه صادَا ضشغن ٌاُبخسا ىًُصح ٍَزنا طَشًخنا ثاذحو ٍن ح ىح ع ٍي ثأذب ثاَاُبنا عًخ تُهًع . تساسذنا ِزه ٍف ىهًُُ 51 ن سارآ تَاغ 5 ٌاسَُ 5116 مُهحخنا . ٍئاصحلإا حياَشب واذخخساب ىح ثاَاُبهن spss) ثاَاُبنا مُهحح .) ٍَابح مُهحح جًُعح (one way ANOVA), Cronbach Alpha) ٍهخاذنا قاسحلاا( تَابخسلاا تُلاذصي سابخخلا .)ٌىسشُب تللاع(و ) :جئاتنلا تساسذنا حئاخَ ثذخو ناُه ٍكَ ىن ٍُح ٍف ذُخ ٌاك طَشًخنا ٍنوؤسي ءادا ٌاب تللاع بنا ٍُب تُفاشغىًَذنا ثاَاُ ءادأو ٍنوؤسي ناُه ٌاك اًُُب طَشًخنا ىهي غابحسا .ىهعخنا يىخسي عي جاتنتسلاا : ٌاب تساسذنا جدخُخسا ٌىكَ ٍُههؤًنا ٍي طَشًخنا ٍنوؤسي أ سىطح سابخعلاا شظُب زخأَ ايذُع اًَُداك .ٍعَشًخنا سداكنا :تايصىتلا ٍصىح ب تساسذنا يىخسًب ٍُههؤًنا ٍُظشًًنا ًهع ضُكشخنا ,قاشعنا جساخو مخاد تُبَسذح ثاسوذب لىخذناب ىهضُفححو طَشًخنا ٍنوؤسي عُدشخ ثاَىخسي مغشن مللاا ًهع طىَسىناكب ةسادلإا .دلاثنا تُعَشًخنا Abstract Objective(s): The objective of the study to assess the head nurses’ performance regarding staff management at the units of Al-Najaf Al-Ashraf city hospitals. Methodology: Analytic Cross-Sectional study was carried out throughout the present study to assess the head nurses’ performance regarding staff management at the units of Al-Najaf Al-Ashraf city hospitals. Quantitative research design was utilized to conduct the study. This study started from November 11 th 2015 to July 2 nd 2016. The target population for this study was all head nurses (n=86) included at previously mentioned setting (Al-Najaf ALAshraf City Hospitals). Through an extensive review of relevant literature, a questionnaire was constructed for the purpose of the study. The data was collected through the utilization of a developed questionnaire (Arabic version) and by means of interview with each head nurse included in the present study. The data collection process started from March. 20 th , 2016 to April 21 th , 2016. The statistical data analysis were conducted using the statistical package (SPSS).The conducted statistical analysis included analysis of variance (one way ANOVA), Cronbach Alpha to test the reliability of questionnaire (Internal consistency) and Pearson's correlation. Results: The findings of the study found that the head nurses performance was good and there was no significant difference between demographic data and performance of the head nurse whereas there was significant correlation with level of education. Conclusion: The study concluded the head nurses require a higher education level when nursing staff development is taken into consideration. Recommendations: The study recommends that head nurses should be encouraged and motivated for the serious participation in training courses inside and outside of Iraq. Concentration on highly qualified nurses with minimum of baccalaureate degree graduates to fill the three nursing management levels. Keyword: Head nurse, Assessment, Staff management, Performance.


INTRODUCTION
Nurses as managers at the wards within as a part of health care teams and health care systems, are becoming very important.Nursing staff are the health care specialists that are major line of protection for patient, community care and staff.They supporter for patients, communities, staff and comprehend their requirements better than everyone else.Nursing management is becoming a greatly overused term to include numerous skills (1) .
Role of head nurse as a registered nurse spend the whole day responsibility for the administration of an area or unit within a healthcare systems (2) .
Head nurse is a key position in health teams in hospitals, care homes, hospices, and smaller specialty health practices.In discussion with physicians, the nurse manager oversees all patient nursing care in her/ his unit in addition to acting as managing director to the other nursing staff.It is a responsibility that needs management ability as well as progressive skills in nursing (3) .
Management is ability of leading, planning, staffing, organizing, and controlling actions to reach objectives.Planning includes determine of objectives and finding methods to achieve them.Staffing and organizing is the process of confirming that the important physical and human resources are obtainable to attain the objectives of planning.Organizing also includes identify job to the correct individual or team and identifying who has the manager to achieve responsibilities.Managing is effecting others staff to reach the organizations objectives and includes directing, energizing and persuading others staff to reach those objectives.Controlling is comparing real role to a standard and rereading the original strategy as required to reach the objectives (4) .
The performance of head nurse is very significant because of their strong effect on the nurses.They interact with most nurses on an everyday basis and must action like role models, if they role weakly and or be unsuccessful to stimulate their nursing staff, it may affect dramatically the work performance of the nurses may even leave the unit (5) .
Nurse Managers are responsible for having management strategies in place that they promote both safe care for patients and job satisfaction for nursing staff.This includes establishing practice expectations, taking action if practice difficulties occur and establishing a suitable learning environment (6) .

OBJECTIVES AIM OF THE STUDY:
To assess the head nurses' performance regarding staff management at the units of Al-Najaf Al-Ashraf city hospitals.

METHODOLOGY:
Analytic Cross-Sectional study was carried out throughout the present study to assess the head nurses' performance regarding staff management at the units of Al-Najaf Al-Ashraf city hospitals.Quantitative research design was utilized to conduct the study.This study started from November 11 th 2015 to July 2 nd 2016.

Instruments:
Through extensive review of relevant literature and studies, a questionnaire was constructed for the purpose of the study.The final study instrument composed of three major parts.

Data collection:
The data was collected through the utilization of a developed questionnaire (Arabic version) and by means of interview with each head nurse included in the present study.Each interview took approximately (30) minutes.The data collection process started from March.20 th , 2016 to April 21, 2016.

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The statistical data analysis were conducted using the statistical package (SPSS).Statistical analysis included analysis of variance (one way ANOVA), Cronbach Alpha to test the reliability of questionnaire (Internal consistency) and Pearson's correlation.Regarding the training in nursing management, table (2) demonstrates that 49 participants (57%), had experienced training in nursing management while the other 37 participants had not.However, out of the 49 trained participants, 45 (91.8%) had been trained in Iraq and only 4 (8.2%)outside of Iraq, for a median duration of 7 (IQR: 5 -16) days.Regarding the experience in nursing management, only 11 participants (12.8%) practiced nursing management while 75 (87.2%)participants did not.On the other hand, all the participants had worked as head of nursing unit for different durations; 39 participants (45.3%) had experience as head of nursing unit for 1 -5 years, 31 (36%) for 6-10 years and 16 participants for more than 10 years. .Regarding the experience in nursing management, only 11 participants (12.8%) practiced nursing management while 75 (87.2%)participants did not.On the other hand all the participants had been worked as head of nursing unit for different durations; 39 participants (45.3%) had experience as head of nursing unit for 1 -5 years, 31 (36%) for 6-10 years and 16 participants for more than 10 years.The correlation between the overall performance score of the study participants with demographic characteristics are demonstrated in (tables 3), the Pearson's correlation test revealed that the higher level of education was significantly associated with higher performance score (direct association), (R = 0.19, P. value = 0.027).On the other hand no significant correlation had been found between the performance score and other variables, (in all comparison P> 0.05).

DISCUSSION:
Throughout the period of data collection, more than half of the study samples were enrolled from Al-Sader hospital (n= 47; 54.65%).This is because Al Sader hospital is the largest hospital when compared with other hospitals involved in the study.Taking the distribution of the subjects by age into account (as shown in table 1), the findings of the study indicated that half of the units head nurses (50.0% ) were aged between (30 -39) years ,whereas approximately (27%) of the study sample were aged between (40 -49) years.The majority of the participants were aged at 30 years or more.This means the highest percentage of the units' head nurses were within the ideal and productive age group.Regard to the gender, male nurses were 76 who represented (88.4%) of the study participants, while the females were 10 (11.6%) only.The study results are supported byAbo Gadwho had most of their study nurses as male (79.2%), (7) which means that their male participants were almost three times more than their enrolled females.Regarding the marital status, only (7%) of participants was single.A study was conducted in 2011 along with what had in their study sample (i.e.88.1% were married). (8)With respect to the level of education, the researcher found that only 14 nurses (16.3%) had nursing college graduate degree, since 43 of them (50%) graduated from nursing institute and 29 of them (33.7%)graduated from nursing secondary school.This is coming in agreement with (Stewart 2009) who found that most of his study sample had completed their education which ranged from the diploma to the master's level. (9)Another study found about (45.8%) of his study sample were having diploma degree in nursing ,while (15%) of the head nurses hold an academic degrees and 45 % hold diploma. (10)Most of relevant studies in other countries, found that the majority of the head nurses have a BSc degree, these results differ from the present study, this may be due to the shortage of nursing college graduates in our organizations which resulted from lack of the required number of them who are working in the past years.The correlation level between the overall performance score of the study participants with demographic and professional characteristics in this study was seen to be not significant correlation (P>0.05).A previous study, found that there is a non-significant relationship between age, gender, experience and nurse managers' performance. (11)Similarly, found that there was a non-significant correlation between age, gender, years of experience and management performance. (12)Similarly, found no significant association between their administrative task performance and demographic characteristics. (10)The Pearson's correlation test revealed that the higher performance score was significantly associated with higher level of education (direct association), (R = 0.19, P value = 0.027).This result is supported by (Karathanasi 2014) who found that there was a statistically significant correlation between education levels of the respondents to technical skills in leadership. (13)This means that nursing college graduate and postgraduate should give a considerable attention to leadership competencies in contrast to nurses with diploma.

CONCLUSION
The study indicated that Head nurses have a good level of performance relative to their staff management in term of supervising, staffing, directing and evaluating.Head nurses demographic characteristics did not show any influence on their level of performance except the level of education variable has an important impact on the performance regarding staff management.

RECOMMENDATIONS:
The study recommended that: 1. Sustain continuing education program activities for all nursing managers in hospitals and more emphasis to be put on the importance of nursing management specifically on staff management and follow-up should be applied for the determination of their advantages.