Effective design, implementation and management of change in healthcare.

Changes in healthcare organisations are common, and their implementation is often complex and challenging. Change is often implemented suboptimally, and can have several negative effects on staff turnover, patient care and budget targets. To minimise and avoid negative outcomes, a systematic three-stage change process that comprises preparing for change, implementing change, and evaluating and sustaining change can be followed.

Understanding bullying in healthcare organisations.

Bullying is a pervasive problem in healthcare organisations. Inquiries and reports on patient care and poor practice in the NHS have emphasised the substantial negative effects this behaviour may have on patient care. If bullying is to be addressed, it is crucial we develop clarity about what behaviours constitute bullying and how these behaviours differ from other negative behaviours in the workplace.

The effect of bullying on burnout in nurses: the moderating role of psychological detachment.

Aims: The aim of the study was to examine the relationship between bullying and burnout and the potential buffering effect psychological detachment might have on this relationship.

Background: There is evidence to suggest that bullying is relatively widespread in the nursing profession, with previous studies indicating that bullying is associated with higher levels of burnout. There is, however, limited research focusing on potential moderators of the relationship between bullying and burnout.

Consumption-based approach for assessing the contribution of hospitals towards the load of pharmaceutical residues in municipal wastewater.

Hospitals are considered as major sources of pharmaceutical residues discharged to municipal wastewater, but recent experimental studies showed that the contribution of hospitals to the loads of selected, quantifiable pharmaceuticals in sewage treatment plant (STP) influents was limited. However such conclusions are made based on the experimental analysis of pharmaceuticals in hospital wastewater which is hindered by a number of factors such as access to suitable sampling sites, difficulties in obtaining representative samples and availability of analytical methods. Therefore, this study explores a refined and extended consumption-based approach to predict the contribution of six selected Australian hospitals to the loads of 589 pharmaceuticals in municipal wastewater.

The effect of pre-pregnancy counselling for women with pre-gestational diabetes on maternal health status.

Objective: To assess the impact of pre-pregnancy counselling (PPC) on the health of diabetic women in early pregnancy as compared to their health at the time of PPC.

Study Design: Retrospective cohort study involving all the diabetic women who attended PPC and subsequently become pregnant in the decade 1997-2007. The proforma had two sections: one for the PPC visit and one for the booking visit.