Examinando por Autor "Palmieri, Patrick A."
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ArtículoInterruptions and cognitive processes in nursing: Review, analysis, recommendations( 2010-10) DeLucia, Patricia R. ; Ott, Tammy E. ; Palmieri, Patrick A.Nurses spend more time with patients than other health care providers, and patient outcomes are impacted by nursing care quality. Thus, enhancements in nursing performance can lead to improvements in patient safety. Results of our comprehensive literature review (DeLucia, Ott, & Palmieri, in press) indicated that numerous factors affect the performance of nurses. These include cognitive factors (interruptions, cognitive processes), physical factors (musculoskeletal disorders, environment), and organizational factors (work hours, staffing). Here, we focus on cognitive factors. Nurses' work is cognitively demanding. Nursing involves multi-tasking, relies on procedural and prospective memory, and occurs under frequent interruptions. We discuss interruptions and cognitive processes in nursing and provide a conceptual analysis and recommendations. We conclude that the nurses' work system does not accommodate limitations and capabilities of the nurse, particularly limits in cognitive processes. The field of human factors and ergonomics is uniquely suited to redesign the nurses' work system to enhance nursing performance and improve patient safety. Of particular importance for future research is the study of interruptions and cognitive processes in nursing.
ArtículoSafety culture as a contemporary healthcare construct: theoretical review, research assessment, and translation to human resource management(Emerald Group Publishing Limited, 2010) Palmieri, Patrick A. ; Peterson, Lori T. ; Pesta, Bryan J. ; Flit, Michel A. ; Saettone, David M.Through a number of comprehensive reviews, the Institute of Medicine (IOM) has recommended that healthcare organizations develop safety cultures to align delivery system processes with the workforce requirements to improve patient outcomes. Until health systems can provide safer care environments, patients remain at risk for suboptimal care and adverse outcomes. Health science researchers have begun to explore how safety cultures might act as an essential system feature to improve organizational outcomes. Since safety cultures are established through modification in employee safety perspective and work behavior, human resource (HR) professionals need to contribute to this developing organizational domain. The IOM indicates individual employee behaviors cumulatively provide the primary antecedent for organizational safety and quality outcomes. Yet, many safety culture scholars indicate the concept is neither theoretically defined nor consistently applied and researched as the terms safety culture, safety climate, and safety attitude are interchangeably used to represent the same concept. As such, this paper examines the intersection of organizational culture and healthcare safety by analyzing the theoretical underpinnings of safety culture, exploring the constructs for measurement, and assessing the current state of safety culture research. Safety culture draws from the theoretical perspectives of sociology (represented by normal accident theory), organizational psychology (represented by high reliability theory), and human factors (represented by the aviation framework). By understanding not only the origins but also the empirical safety culture research and the associated intervention initiatives, healthcare professionals can design appropriate HR strategies to address the system characteristics that adversely affect patient outcomes. Increased emphasis on human resource management research is particularly important to the development of safety cultures. This paper contributes to the existing healthcare literature by providing the first comprehensive critical analysis of the theory, research, and practice that comprise contemporary safety culture science.