Workplace violence towards health workers in hospitals and in mental health units in particular is increasing. The aim of the present study was to explore the effects of exposure to violence, job stress, staff resilience, and post-traumatic growth (PTG) on the life satisfaction of mental health nurses. A descriptive, cross-sectional design was used. The sample consisted of mental health nurses (n = 118) working in a large mental health centre in Israel. Verbal violence by patients was reported by 88.1% of the nurses, and 58.4% experienced physical violence in the past year. Physical and verbal violence towards nurses was correlated with job stress, and life satisfaction was correlated with PTG and staff resilience. Linear regression analyses indicated that life satisfaction was mainly affected by PTG, staff resilience, and job stress, and less by exposure to verbal and physical violence. The present study is the first to show that, although mental health nurses are frequently exposed to violence, their life satisfaction is affected more by staff resilience, PTG, and job stress than by workplace violence. Therefore, it is recommended that intervention programmes that contribute to PTG and staff resilience, as well as those that reduce job stress among mental health nurses, be explored and implemented.
Summary
Background
While glycemic control of hospitalized diabetic patients is straightforward, personalization of management at discharge is challenging. Treatment guidelines base recommendations on the clinical profile of patients. We checked the feasibility of implementing discharge recommendations, based on the clinical profile in the patients' electronic health records (EHR).
Methods
A decision‐making algorithm was devised according to current guidelines. It was incorporated into the EHR. A prospective follow‐up of eligible diabetes patients was done.
Results
During 15 months, 835 patients (HbA1c was 6.9% [6.2%‐7.8%]) met our inclusion criteria. The rate of HbA1c acquisition increased from 55% during Q1 to 85%, 86%, 88%, and 87% thereafter. Also, the rate of incorporating personalized management recommendations to discharge letters increased: from 14.9% during Q1 to 42.9%, 43.0%, 47.2%, and 53.4% thereafter. Fifty‐eight (17.3%) of patients who got personalized recommendations upon discharge were found to have HbA1c values that were over 1% deviating from suggested target HbA1c. They got the most stringent recommendations. Twenty‐nine (50%) of them had available follow‐up HbA1c values showing a significant drop in HbA1c: from 9.1% (8.4%‐10.2%) to 8.5% (7.4%‐9.5%), P = .03.
Conclusions
Personalized, EHR algorithm‐based, management recommendations for diabetes upon discharge from hospitalization are feasible and beneficial.
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