Research Topics: Study Leadership

A Study on the Significant Effects of Management

Title: A Study on the Significant Effects of Management Style in 3M   Table of Contents:   <li class="MsoNormal" style="line-height: 200%"> Introduction.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Statement of the Problem.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Purpose of the Study.</li> <li class="MsoNormal" style="line-height: 200%"> Review of Related Literature.</li> 5.      Theoretical Framework. 6.       Methodology. ·        Research Design. ·        Participants. ·        Instruments. ·        Data Analysis and Presentation <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Ethical Considerations.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Timescale.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Bibliography.</li>             I. Introduction             This Section aims to impress upon the reader the purpose and importance of the study to the topic. Also, this section aims to point out the relevance of the problem to the selected topic.   I.E. Background            3M has long been recognized by the world to have created and fostered the “creative genius” of each individual employee of the company. Innovation has been the core of their operation ever since McKnight took over in 1916. 3M stands for Minnesota Mining and Manufacturing, which was founded by  in the North shore of Lake Superior in at Two Harbors in Minnesota. Their current headquarters is located at Maplewood. Early innovations created by the company were waterproof sandpaper, masking tape, and Cellophane Scotch tape. It also expanded into the area of board games and later on invested in audio and video.               2. Statement of the Problem             Though it has been the company tradition to hire young minds full of creative genius and entrepreneurship, the yearly figures could not support the coming in of these new hires, thus creating a problem for the company. The purpose of this study is to locate the core problems that existed in 3M which forced them to adopt a management styles implemented now and to expound and illustrate the effectiveness of the current management styles being used.   3. Purpose of the Study             This study was conducted to be able to recognize the management styles used by 3M to lift the company’s are declining state. Also, the problems that surfaced in 3M must be seen and recognized in order for potential entrepreneurs to know the proper approaches needed to remedy and correct the current situation the company is facing and also to be able to recognize and apply the innovative and managerial approaches used by the company to improve its declining state.    Importance               As mentioned above, the major concern of the paper is to shed light on the issues that forced the management of 3M to adopt a management style that was effective enough to successfully save the whole company from a serious fall-out. 3M is now one of the biggest companies in the world.  Due to its adoption of a better and more advanced managerial approach, it was able to withstand and even elevate its state in the business world. We are conducting this research in hopes that we may also be able to apply the ingenious approach adopted by 3M.                                         4. Literature Review             In the article, “3M’s First 100 Years: and how it plans to manage the next 100” by  made mention of the strength and durability of 3M. It has been existing for more than a century and still is going strong. According to its history, 3M was built on a mistake, pertaining to their corundum mineral mistake. Still, few years after that faithful incident, and one more incident though, 3M has become one of the few pioneering western companies to nurture innovative.             It bothered the author why the authors James Collins and Jerry Pores, of the book, Built to Last, said that if they would bet everything on “continued success and adaptability of any single company over the next 50 to 100 years, they would “place that bet on 3M“?”. It was thoroughly understandable. 3M’s managerial approaches had kept the company through times when most companies would already close down. It was able to sustain itself for more than a hundred years, what would make it so difficult to sustain itself for a hundred more?             The person that brought the culture of fostering innovation and new managerial approaches was the lowly bookkeeper-turned-CEO William McKnight. His principles included the freedom for the employees to commit intelligent and innovative mistakes. They were given freedom to do their work without too much interference since it may hinder the productivity of their thoughts. According to 3M‘s chief executive in New Zealand, James Marshall, the HR simply asked the management to keep an environment that encouraged innovative and resourcefulness, initiative, and unbiased opportunity. These thoughts and principles helped shape the current management of 3M. Still, there is more than a hundred years to come; 3M needs to focus on their weak points to keep the good thing going. According to Marshall, from the same article, customers and customer service will be their primary priority. “With the rapid advances in electronic technology a company can lose the human interaction with customers. You can lose sight of a customer’s true needs. While we have embraced technology, we will have to make sure we continue to have face-to-face contact with the end user so we are in a position to deliver the solutions they need.”  So, in order to keep in touch with their customers, they need to work and focus primarily on their customer service. Customer oriented services are much sought after these days. One must keep in mind that customers are one of the key factors that keep the business running. So in order to keep their trust, they must focus on the customers and their needs. That might just be what they need to keep them going for a hundred more years.                   5. Research Methodology Research Design This study will identify factors that made the management shift its management style from one to the other until it was able to find one that worked well with it.  Thus, we must employ the use of case study analysis to fully view the factors that had a part in making the company shift into its current management style. For example, we could conduct a SWOT analysis for the company to be able to evaluate its standing in those times and also, to be able to see if we would arrive at the same conclusion as the strategists then. Primary and secondary data may also be of use in this research. Primary data may consist of the data gathered which would be about the company’s figures during its years of decline while secondary date may be about its current set of figures as it employed its management style. This may be able to explain the relevance of the management style and its affectivity to the current success of 3M. All data gathered must come from interviews on the participants and company records. Participants             Participants may be the employees of the company from 1970 up to the present. High ranking officials may also participate in the said event. Interviews will be conducted in a time which would be convenient to the participants as to not disrupt their working schedules. It may also be of great importance if former employees and high ranking officials be included in the said interview since they may also have vital information and data which may help in the organization of the research. Instruments             Since our only interviews will be conducted to gather data, only necessary materials are needed. The interviewer must have a sheet containing questions that concerns itself on the past events related to the adoption of the new managerial approaches, i. e., “What event, in your opinion, led to the restructuring and reorganization of the company?” Data Analysis and Presentation             The data gathered should be categorized accordingly to when they occurred and to which reorganization efforts they belong to. Also, the data gathered about the problems and factors causing the change should also be grouped together accordingly.             When this has been accomplished, this can pivot the movement for further research about the said topic.         6. Ethical Considerations             The interview procedure must be explained to the participants. Reassurances must be made to them like their answers will be taken in anonymously and that their answers will remain between the participant and the interviewer. Also, questions that they think might not be appropriate for them to answer can be left out if they chose to. All of the activities during the interview will be of free will and their identity and their answers will be shrouded in secrecy.                                                 7. Timescale   Activity Month                                                                                          April May June July Search for Related Literature         Selection of the  Topic         Definition of the Problem         Development of the Objectives         Selection of Methodology         Check the availability of resources         Verify the accessibility of the resources         Write the draft of the proposal         Prepare interview schedule         Secure adviser’s approval         Do the needed revisions         Test research tool validity         Select the study sample         Conduct research proper         Administer research tools         Do the assessment techniques         Gather and analyze results         Do the necessary data presentation         Interpret findings         Preparation of the final report         Formulation of conclusions and recommendations         Preparation of the table of content, appendices         Editing and Final Formatting         Printing         Credit:ivythesis.typepad.com

A Study on the Significant Effects of Management

Title : A Study on the Significant Effects of Management Style in 3M Table of Contents: Introduction. Statement of the Problem...

A Study into the Motivation of Officers and Junior Staff of the Hong Kong Immigration Department after the Asian Financial Turmoil in 1997

A Study into the Motivation of Officers and Junior Staff of the Hong Kong Immigration Department after the Asian Financial Turmoil in 1997     Introduction Change management is basically defined as the formulation and assimilation of change in a methodical process. The major objective of change management is the introduction of innovative means and systems in the work organization. Organizational change is part of and a result of struggles between contradictory forces, also change management practice is related with endeavoring to manage their competing demands. To understand why and how to change organizations, it is first necessary to understand their structures, management and behaviour. According to  (1996) these systems of ideas are crucial to change management in two respects. They provide models of how organization should be structured and managed. Then they provide guidelines for judging and prescribing the behaviour and effectiveness of individuals and groups in an organization.    (1996) believe that modern organizations passed by the guild structures and as organizations grew larger, skills become increasingly fragmented and specialized and positions become more functionally differentiated. It can be said that organizational change is one of the critical determinants in organizational success and failure (1998). The lack of such initiatives can throw an organization into confusion, being stuck in traditional practices that cannot solve or handle the current problems faced. Thus, the lack of such factors stresses the need for a strategic organizational change. It is basically a flexible strategic planning process as opposed to a static form of strategic planning.     In this light, the research project intends to investigate the job satisfaction and morale of immigration officers recruited after Asian Financial Turmoil in 1997 particularly the factors that motivate the junior staff of the Hong Kong Immigration Department after the tremendous changes in the structure of the department that resulted to decreased pay and reduction of other fringe benefits of the officers. As such, the study will operate under the quantitative research paradigm and will utilize the survey method to look into (1) the changes that transpired within the department in 1997, (2) the adaptation strategies made by the officers, and (3) the motivations of the officers and junior staff in attending to their duties and responsibilities as civil servants. The study will likewise use the concepts and theories of change management to give light into the interest of the research activity.       Background of the Study Perhaps the space between the new organization design and implementing it into actuality is the whole coverage of organization change and development. People are adaptive to change. However, certain skills must be present from the initiators of change so as to successfully implement their project. Thus, managers need to have the necessary abilities not only in detecting what needs to be changed but also how to introduce the change effectively. This may include changing the company’s mission, reforming business operations, application of new technologies, major group efforts, or adoption of new programs.  Usually, the organization is encouraged on settling on change management due to external influences, usually termed as the environment ( 2004). Thus, change management can alternately be defined as the response of different business to changes brought about by environmental influences in which organizations have minimal or absolutely no control over.   In line with this,  (2002) indicated that being a change leader requires the willingness and ability to change what is already being done just as much as the ability to do new and different things.  He suggests a set of required policies and practices that make the present create the future. Given the challenges of managing complexity and internal resistance to change, the task of leaders during the implementation of change can be very difficult indeed. Where significant change is involved, effective management is required. The challenge to understanding management becomes one of identifying effective management behaviour in the context of the organizational turbulence stirred up in the change process. So in order to cope with and manage the challenges posed by organisational change, leaders at any level should perform a variety of roles.   Meanwhile  (2002) claimed that the process of making an organization is simultaneously the growth and maintenance of relationships among individuals who are working towards a common goal and the actual accomplishment of tasks, individually and collectively. In this regard, continuous improvement within any business organization can only be realized if good working relationships between and among employees is experienced. To be able to function effectively with clients and customers, organizations should be aware that success is first elicited inside the organization. Good working relationships should be observed first within the organization so that the entirety of the operations can answer to the demands of the public.   In the present day work environment, expectations exceed regarding the workloads and task requirements among employers and employees. Multi-tasking defines the current situation in most of business organizations as advances in technology especially in the use of the computer and the Internet continues. As the Microsoft and other office tools computer programs increase in number, administration management keep on investing on measures like trainings, seminars and conferences that will exhaust the potential of every employee. The improving services of Internet providers and the Internet features in general, likewise add on the far-reaching horizon of the employees’ capability to develop and learn skills available in the workplace that their organization will benefit from.    (2001) highlighted the importance of high work life quality through good supervision, working conditions, pay and benefits as well as challenging and rewarding jobs. She said that these conditions will provide opportunities for employees to contribute in the overall effectiveness of the organization as they become more motivated and productive members of the company’s work force with positive self-esteem and improved morale. Moreover, business organizations offer two-way learning experience within the company between and among the employers and the employees. Employers benefit largely from trainings that they offer to staff and members of the firm given that the expected knowledge and skills were learned through the organizations venture on their human resources. At the best possible results, the organization will gain competitive attitude in the business world by housing in competitive and qualified workers. Employees on the other hand, are given the opportunity to improve on their work capabilities as qualified and productive members of the modern and information age work force.   Employer-provided training is important because studies have found that on-the-job training is strongly associated with wage increases ( 1987;2002). Moreover, training is a form of human capital investment whether that investment is made by the individual or by the firm (1975). A firm has the incentive to invest in the human capital of its workers only if there is an expectation of a return on its investment. (1997) found that firms often delay training to determine whether workers are good matches and therefore have a lower probability of leaving the firm. A strategic approach to training is imperative nowadays for training to be seen to be meeting business needs and adding value ( 2000). For this to happen, the training function needs to examine current and future business needs, and set appropriate priorities for training interventions.     Research Problem The research project intends to investigate the job satisfaction and morale of immigration officers recruited after the Asian Financial Turmoil in 1997. The tremendous changes that occurred within the structure of the Hong Kong Immigration Department resulted to vast shrinking of the business sector. Criticisms became rampant particularly to the members of the civil servant. The Immigration Department has been critiqued with issues on surplus of manpower as well as over payment among its employees. In effect the government decided to lower the pay of the staff of the department along with reductions on the employees’ other fringe benefits.   For the interest of the research study at hand, the following research questions are presented to give light to the change management strategies employed by the Hong Kong Immigration Department focusing on the employees’ satisfaction and morale in performing their duties and responsibilities despite the unpleasant changes that have transpired concerning the salary and benefits of the staff:   1.    What are the changes that occurred in the Hong Kong Immigration Department after the 1997 Asian Financial Turmoil?   2.    What are the reasons behind the changes in the working conditions of the employees of the Hong Kong Immigration Department?   3.    How did the changes affect the work environment and aptitude of the staff and employees of the Hong Kong Immigration Department?   4.    How did the management adapt to the changed working conditions within the Hong Kong Immigration Department?   5.    What motivated the employees of the Hong Kong Immigration Department particularly the junior staff in attending to their duties and responsibilities as public servants?   6.    What are the general levels of job satisfaction and employee morale exhibited by the members of the Hong Kong Immigration Department in terms of: a.    Communication, b.    Leadership, c.    Team work, d.    Training and development, and e.    Compensation and benefits?           Significance of the Study At the turn of the century, human resources managers will have to face new challenges. The economy and markets are different from those of a decade ago. As paradigms have changed, the characteristics affecting human resources management must also be revised such as organizational structure and functions in order to keep up to pace with relevance, latest trends and strategies. In today’s fast and technological modern world, the challenge that the Information Man faces is time’s nature of putting things in order and in place in the best and most effective way. Life has changed since the invention of the computer which dictated man to deal with things in the most efficient way possible. In the world of big international business industries where transactions and other business operations are governed by law, cultural differences and mutual trust, efficiency counts largely as a common entrepreneurial aim.   Organisational change is currently one of major domains of organisational research, and the study of organisational change has become one of the major aspects in being able and helping to measure the organisation performance; efficiency and effectiveness. The effective organisation must be able to meet today’s and tomorrow’s challenges; adaptability and responsiveness are essential to survive and thrive. Today’s organisations are experiencing change like never before as a result of global competition which had created uncertainty for the organisations. Moreover, the pace of change is so rapid, only organisations that can adapt to this changing environment can survive, getting a profile of the current problems can enable organisations to thoughtfully bring the elements of the change into alignment and move forward towards a common ideal.               In this light, the completion of this research activity will enable deeper understanding on the case of the Hong Kong Immigration Department which could be of use to other public institutions in assessing and evaluating their workforce. Other government establishments from different localities can also utilize the findings of the study for the benefit and improvement of their own public service and public management approaches that the study could offer. Moreover, the results and findings of the study will be able to contribute to the bulk of information and relevant literature to the disciplines of public administration as well as human resources management. Lastly, other researchers in the field of public administration and management as well as politics and human resources may find the results of the study relevant to future academic endeavors as well as practical applications.        Research Objectives The tremendous changes that occurred within the structure of the Hong Kong Immigration Department after the Asian Financial Turmoil in 1997 decreased the pay and fringe benefits of the employees of the organization. As such, the study is interested in pursuing investigations that will give light on the motivations of the employees of the department along with the assessment of their job satisfaction and morale.   As such the following objective will be undertaken by the researcher for the successful completion of the research activity at hand:   1.    To find out the changes that occurred in the Hong Kong Immigration Department after the 1997 Asian Financial Turmoil.   2.    To determine the reasons behind the changes in the working conditions of the employees of the Hong Kong Immigration Department.   3.    To provide explanations on how the changes affected the work environment and aptitude of the staff and employees of the Hong Kong Immigration Department.   4.    To learn how the management adapted to the changed working conditions within the Hong Kong Immigration Department.   5.    To present the motivations of the employees of the Hong Kong Immigration Department particularly the junior staff in attending to their duties and responsibilities as public servants.   6.    To determine the general levels of job satisfaction and employee morale exhibited by the members of the Hong Kong Immigration Department in terms of : a.    Communication, b.    Leadership, c.    Team work, d.    Training and development, and e.    Compensation and benefits.              Scope and Limitations             Since the study is geared towards the investigation of several aspects of public management, human resources management, employee motivation, job satisfaction, and employee morale, it is necessary to define the scope as well as limitations of the study being designed.   For instance, the study will be presenting background information and discussions regarding the 1997 Asian Economic Turmoil along with its effects to the entire Hong Kong public administration and the Hong Kong Immigration Department in particular. The Hong Kong Immigration Department will be treated as a case in which detailed discussions of the 1997 Economic Crisis effects to the department will be thoroughly presented. Moreover, the department will be studied according to the adaptation measures employed by the management in order to cope with the inevitable changes that the Hong Kong Government has employed.   More specifically, the academic investigations will focus on the employees by collecting data and information which will present their perspectives as the labor force of the department. Their working conditions will be discussed along with the factors that motivated them in their continuous dedication to public service. The employees, particularly the junior staff’s general levels of job satisfaction and morale will be presented in terms of (a) communication, (b) leadership, (c) team work, (d) training and development, and (e) compensation and benefits. The study will be operating under these categories to limit the scope of the research activity.                     Overview of Methodology In order to complete the purpose and objectives of the study, the quantitative research approach will be applied through the conceptualization and implementation of a survey method. According to  (2000), the quantitative research approach is most appropriate when conducting descriptive and exploratory study in order to quantify data that seem immeasurable, such as feelings, beliefs, and thoughts. This permits a flexible and iterative approach of analyzing and statistically manipulating the collected information. Descriptive and exploratory approaches served as guidelines in logically and comprehensively presentation of the results of the study. Furthermore, cross-sectional studies often employ the survey strategy describing the incidence of a phenomenon and comparing variables at the time of the study (2003).   Surveys are conducted to gather data from the field in order to generalize results from a sample to a larger population ( 2000). The primary purpose and advantage of surveys is generalization of the results (2000). Usually, surveys are interested in gathering data from many than in obtaining intensive, detailed information from a few individuals; therefore, it is seldom for a survey to consist of one or very few individuals (2000). In this light, the survey method will be used for data collection.   A self-administered structured questionnaire, or the type of questionnaire that is usually completed by respondents ( 2003) will be utilized in the study. This questionnaire has two sections: the first part is intended to acquire the demographic profile of the respondents while the second section comprises the set of attitude statements that will determine the level of agreement or disagreement of the respondents using a five-point Likert scale. In the Likert technique, the degree of agreement or disagreement) is given a numerical value ranging from one to five, thus a total numerical value can be calculated from all the responses (2004). In this regard, the responses to questions will be analyzed by determining their corresponding frequency, percentage and weighted mean.   As such, the stratified non-random sampling technique will be utilized to ensure the represenativeness of the respondents in the survey method. This particular sampling technique ensures the validity and reliability of the data based on the number or quantity of the respondents who filled out the survey questionnaires. Stratified non-random sampling technique operates by classifying the target population into group classifications as set by the researcher. The samples are chosen through several selection procedures that usually take several stages depending on the complexity of the characteristics of the possible respondents and the interest of the researcher (2001).      Summary of Actions A data or information analysis plan was prepared to organize the information collected orderly so as to make the presentation of the results more comprehensive as well as to make sure that research objectives are achieved and the research questions were answered. In summary, the researcher will undergo four major phases to complete the study:   Phase 1: Problem Identification for Research             In the first phase, the researcher will identify the specific focus of the problem to be researched. This involved reviewing existing theory, research, and practices from professional literature. This process helped integrate theoretical perspectives and empirical findings with the own understanding of the problem, and discern the aspect of the problem the researcher want to research and learn more about.   Phase 2: Administration of the Instrument             After reviewing literature, the researcher will formulate questions for the survey and makes a set of guide questionnaires for the interview. These are then presented to the adviser for validation purposes. After this the researcher initiated a process of building collaborations with the respondents who participated in the study.   Phase 3: Data Collection and Analysis             In the third phase, the researcher will collect and analyse data for the purposes of identifying critical contextual variables specific to their setting. These data will enable the achievement of a specific understanding of the problem.   Phase 4: Data Synthesis and Generation of Recommendations             In the fourth phase, the researcher will synthesize the findings from the previous phases and relevant previous research. The focus of this stage is to modify existing hypotheses and account for different factors that will transpire during the analysis, as well as generate recommendations based on new understandings. During this phase, practice-based recommendations for action will be generated.             Credit:ivythesis.typepad.com

A Study into the Motivation of Officers and Junior Staff of the Hong Kong Immigration Department after the Asian Financial Turmoil in 1997

A Study into the Motivation of Officers and Junior Staff of the Hong Kong Immigration Department after the Asian Financial Turmoil in 199...

Review of Related Literature: Assessment of the Professional Standards on Restraint and the Actual Restraint Practices of Nursing Staff in a Mental Healthcare Facility

Review of Related Literature: Assessment of the Professional Standards on Restraint and the Actual Restraint Practices of Nursing Staff in a Mental Healthcare Facility   Introduction In the medical arena, it is important that individuals that are involved must have specialization in order to have unparalleled opportunity and capability to address the critical issues that face the world’s current health care system. The role of the nurse as a vital member of the healthcare team through collaborative professional practice must always give priority through caring its patient. The primary goal of being a nurse is to assist individuals in the achievement of an optimal level of wellness. When it comes to mental patients, their special characteristics call for a more sensitive approach in taking care of their needs, hence, nursing practice in the mental institutions demand more from health attendants. Such challenge is experienced in the daily tasks nurses have to accomplish in order to ensure that the needs of these patients are met. The trend in psychiatric nursing involves the use of various methods of restraint to control aggressive behaviour and prevent harm to the person, other patients and hospital staff. Restraint is still practiced despite the fact that there are alternative means of dealing with the aggressive behaviour of patients. The use of restraint became controversial with the number of reported deaths resulting from the use of restraint. This opened-up various issues on the applicability of restraint in present psychiatric procedures, review of the policy and standards of psychiatric professional organizations in considering the provisions of law, review of the policy and actual psychiatric practices of nursing staff in mental health facilities, and the standard of qualification and skills training of hospital staff on restraint. All these issues point to the necessity of evaluating the propriety and continuity of restraint as a psychiatric practice. This research will look into the existing studies on restraint in psychiatric hospitals. The issues tackled, the methods and the theories applied will be noted from the researches and commentaries obtained from journals and books in support of the findings of the study.   Critical Appraisal Nursing is the process of caring for, or nurturing, for an individual known as the “patient”. More specifically, nursing refers to the functions and duties carried out by persons who have had formal education and training in the art and science of nursing. To promote the restoration and maintenance of health in their clients, nurses become more particular in enhancing their knowledge through integrating with health and biological sciences (1993). As an applied discipline, the vocation of nursing evolves within a dynamic body of knowledge. The quality of nursing practice is dependent on the knowledge of individual practitioners as well as their willingness to engage in professional relationships and behaviours. Nurses are required to have the skills and know-how to explore, confirm, and direct the progress of nursing practice. Necessary measures are observed in order to uphold professional development in the field of nursing so as to improve the knowledge base, which is the foundation upon which clinical practice decisions are made, progressive education which comprise of the continuing learning activities that are crafted to benefit the individual and the profession, mentoring and networking which are the professional relationships that are instituted with the intent of supportive growth for the individual as well as the profession, research which is the qualitative and/or quantitative investigation of the factors which affects the professional nursing practice, and lastly career development which are purposeful, planned strategies that are designed to boost short and long term professional goals. In a journal article written by  (1999), a lot of academicians and practitioners of psychiatric medicine have claimed that people in the legal as well as in the psychological communities are until now experiencing difficulties in addressing such scenario with great uncertainty particularly the reality that civil confinement is executed for the dangerous mentally ill patients (I1990; 1992). For the individuals ( 1989;1976; 1985; and 1986) who agreed on involuntary hospitalization of the mentally ill emphasized that the impermanent lack of freedom is a valid response in order to protect the population from the dangers that psychiatric persons may inhibit.   Definition and Concepts                Restraint has been defined by the Health Care and Financing Corporation as “any physical method of restricting a patient’s freedom of movement, physical activity or normal access to his/her body.” (International Organization of Psychiatric-Mental Health Association 2001) There are different kinds of restraint which are: 1) chemical restraint-the use of a drug or medication to control behavior or to restrict freedom of movement; 2) mechanical restraint-use of implements in restraint procedure such as leather or cloth restraints, papoose board, calming blanket, and body carrier; 3) physical restraint-involves a staff member in bodily contact with the patient without the use of any mechanical apparatus; 4) preventive aggressive devices-use of wrist-to-waist and ankle-to-ankle devices that allow a patient to move but limiting his/her ability to harm others; 5) seclusion is one form of restraint where a patient is confined in a room; 6) time-out is also a form of restraint where a patient is given a time to calm down by excluding him/her from the activity causing stress (American Academy of Child and Adolescent Psychiatry 2002).   Standards on the Use of Restraint Caring may be fundamental to the continuance of civilization. In the past, numerous definitions of caring in nursing have been presented. The most commonly accepted of it is that of  He said that the moral idea of nursing consists of transpersonal and human-to-human attempts to protect, enhance and preserve humanity ( 1998).                The International Organization of Psychiatric-Mental Health Association (ISPN) issued its position on the use of restraint and seclusion on psychiatric officials. Selection and restraint should be employed only as a last resort when less restrictive methods no longer ensure the safety of patients, families and hospital staff. The organization also espouse the proper training for psychiatric staff in analyzing situations and delivering good judgment on the proper manner of handling aggressive patients and use all other options before resorting to restraint. There should be immediate evaluation of whether the use of restraint has a beneficial effect on the patient. The use of restraint should also be documented to develop a database of its use and effects.   Beliefs of Nursing Staff on Restraint                     A study conducted to survey the beliefs of staff members on seclusion and restraint on child and adolescent patients in both public and private psychiatric hospitals showed that there is a general belief among staff members regardless of position that there is seldom or occasional positive effect of using seclusion and restraint among the patients. However there is an unexplained significant difference between the response of hospital staff from public and private hospitals. Staff from private hospitals reflected a higher incidence of the positive effects of seclusion and restraint than staff from public hospitals. The hospital staff also distinguished the different aggressive behavior of patients in answering the question of propriety of seclusion and restraint. Physical aggression towards staff, physical aggression towards peers, self-injury, and threats of violence got two digit percentages reflecting the belief that seclusion and restraint are justified in these circumstances with physical aggression towards staff considered as the greatest justification for the coercive practice. Non-compliance with staff directives, hallucinations and hyperactivity are actions which cannot justify seclusion or restraint. The research reflects the lack of sufficient guidelines for the use of seclusion and restraint (Curtis 1996).                A different report on belief is shown in the research paper of (2000) in the first of four generalizations on the use of restraints. First is the use of seclusion and restraint is prevalent in psychiatric hospitals and there is a positive response from the nursing staff interviewed on the use of seclusion and restraint for aggressive patients. The use of restraint is viewed as an effective means of containing an individual, maintaining safety and provides an opportunity to achieve control. Control is seen as the most salient justification of the belief in the use of restraints because the other reasons given can easily be achieved through alternative means while control is easily regained with restraints. Second is that there exist a variety less restrictive means of dealing with aggressive behavior such as time-out, verbal intervention and medication. Third is the presence of inconsistencies in psychiatric nursing practice and clear guidelines or procedures. Fourth is the need to develop theoretical framework on which future studies will be based to help in standardization of psychiatric nursing practices.                In a research conducted by (2004), psychiatric nurses were studied regarding their perceptions about the coercive measures in acute psychiatric setting using the survey method. They found out that the respondents view coercive measures such as forced medication, four-point restraints, and patient seclusion of patients as ethically problematic particularly to the female nurses who work on closed wards. The authors concluded that although the psychiatric ward ethical standards in the country have been closely studied, majority of the nurses who participated in the study perceived that coercive measures employed in the institution are not ethically problematic. They recommended further research on the topic and continuous education among nursing schools and personnel focusing on ethical practices. They likewise challenged the concerned individuals to consider alternative ways of effective and legitimate measures applied in mental institutions which will provide sound ethical decisions and moral reflections.                  The small-scale academic investigation initiated by (2004) explored the claims and statements shared by patients and nurses as approved by the National Health Service Research ethics Board and the Research Ethics Committee of University of East London revealed that the narratives of the nurses and the patients are contradictory. They suggested confirmatory research that will further evaluate and assess the results of their study as well as more training on the part of the nurses in managing violent behavior in the hospital. The study also resulted to the construction of a grounded theory highlighting the concept of control and five other related variables (the construction of identity of the perpetrator of violence; nurses’ dual role of caring and controlling; aspects of parentalism involved in control; following set policies and procedures; and segregation from mainstream society) that influence the characterization and description of the environment of a particular mental institution. The researchers made use of the interview method in order to generate qualitative data for their study so as to provide in-depth analysis of the actual setting in the psychiatric ward they studied.       The literature review conducted by  (2005) regarding the perception and behaviours of nurses toward aggression in health care revealed that most of the studies conducted from the year 1980 analyzed the concept of cognition and attitude from the framework of The Theory of Reasoned Action. Most of the studies also utilized the self-report questionnaire as the most common method to gather data and information on their research endeavours which upon analysis, lacked certain standards of validity. The authors claimed that out of the total 74 researches investigated, two thirds focused on cognitions and only one fourth highlighted the concept of attitudes towards aggression. They further stated that the use of different instruments in the studies they used made it difficult to compare the results generated by the said researches.   Issues on Restraint It cannot be denied that one of the world’s major problems is to ensure the health of millions of people.  Although there are may professionals who are certain about their works and whom can be considered as an exemplary member of the healthcare professionals, there are still issues that can be attached on them professionally.  The individual healthcare professional’s ability to do what is proposed with proper competence, ability and skill is, of course, very crucial in ensuring safe clinical care.  But professional competence is only part of the picture since nobody is perfect.  Good people with good skills and good intentions, sometimes commit mistakes.  As part of this professional issue, to be a nurse is to observe a dynamic based of caring based on a theoretical body of knowledge.                 As a response to the deaths of patients related to restraint procedures the American Academy of Child and Adolescent Psychiatry (2002) made a summary of the causes of these reported deaths and gave recommendations on how further deaths can be prevented. The AACAP found out that 40% of the deaths were caused by asphyxiation when excess weight, towel or sheet is put over the head of a person to prevent spitting or biting that obstructed the air passage of the patients. Strangulation, cardiac arrest or fire account for the other reported deaths. The contributory circumstances include restraining patients with deformities which prevents the proper application of restraint and the lack of continuous observation of the patients. The root cause of the deaths were: 1) inadequate patient assessment; 2) inadequate care planning which do not consider alternative methods to restraint; 3) use of restraints as punishment; 4) inappropriate room or unit assignment; 5) lack of patient observation and monitoring procedures; 6) staff issues in training; 7) inadequate staff levels; 8) staff competency and credentialing problems; 9) equipment failure and improper use of restraint.                The causes of the deaths were within the control and could have been prevented by mental health regulatory bodies and hospital staff. The AACAP (2002) gave the following recommendations: 1) revising patient assessment procedures to consider age, gender and individual situations in employing restraints; 2) promote staff training in alternatives to restraint and the proper application of restraint; 3) revise staffing model; 4) revise the observation and monitoring procedures for patients to constantly keep watch over patients in restraints, modify qualifications or credential requirements to ensure that hospital staff have adequate training and experience in dealing with psychiatric patients; 5) allow patients to rotate when using supine restraints and not cover the entire face during therapeutic holding; 6) discontinue the use of high neck vest and waits restraints; 7) ensure that smoking materials are not accessible to patients in restraint.   Reducing and Minimizing Restraint          The nurse functions in an interpretative and anticipatory nature, where in it involves the patient in making decisions about his/her physical or physiological condition, the personal monitoring of patients that undergoes a life threatening situation and giving service to patients where in their life supporting treatment mechanisms are malfunctioning or underlying a critical process (Zalumas 1995). These practices form a well define perspective is holistic in manner, may the nurse be in a deferent environment, from community to a hospital setting. Clearly the main thrust of nursing is to help clients attain and regain optimal health wellness; in this sense the nurse would be reputable by their accountability.                Accountability of nurses appears as a mode of moral conduct that are foremost in the understanding of those willing to be informed by means of nursing health care and service (Thompson, 1997). When nurses do a health service task, the nurse carries a responsibility performing it.  A registered nurse in practice of the profession is accountable to what was done. Accountability is not just a mere sense of licensed to be achieved but accountability must be an integral and essential element of a responsible practice.                There are several methods of reducing restraint that involves the cooperation of the various aspects of the psychiatric hospital from the organization in general to its heads and then to the nursing and other staff. Reducing the use of restraint requires a change in the policy of the hospital towards restraint. If the hospital will adopt alternative ways of dealing with aggressive behavior then the hospital staff will not employ restraint. The change in policy should be clearly communicated with hospital staff and the staff should be well informed and trained of alternative methods to change the restraint practice of hospital staff. A strong leadership is also needed to affect change in the use of restraint. Giving sufficient training and sharing experience on alternatives to restraint is a form of hospital staff empowerment which results to nursing staff who are in control and aware of their responsibilities. A motivated nursing staff is more likely to employ greater levels of tolerance and is more likely to employ persuasive methods rather than coercive techniques. Hospital staff should have adequate training and the hospital should develop and delineate areas of expertise of the nurses based on experience and skills (Delaney 2001).                Reducing the use of restraint should also consider the point of view of patients and their parents or family members. The hospital should have a record of the situations or objects that cause a particular patient to become aggressive and adjust activities to minimize the patient’s exposure to aggression stimulants or to help the patient deal with the stimulant. Nursing staff should be able to anticipate and prevent or minimize aggression. Hospital staff should also gather document the perception of patients and their family members on restraint and discuss with them the situations of activities which makes them calm (Delaney 2001).          Minimization of the use of restraint is the psychiatric standard currently issued by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Centers for Medicare and Medicaid Services (CMS). Ethical and legal standards also give patients that freedom to be free from restraints. Thus in actual practice restraints should be avoided and these should only be used only if necessary. Because of this discretion given to nursing staff to use restraints only when necessary, nursing staff should be well-equipped with the required knowledge, skills and experience to be able to determine when restraints are necessary and the proper means of employing these restraints (Napierkowski 2002).                Obligations of the nurse to be knowledgeable about the rights of their patients, be it moral and legal, the nurse is also accountable in protecting the patient that is in cause. In assessing the patient’s information, the nurse also is handed out to explain and present the implications of the decisions. Such situations like this, the nurse would act as a surrogate relative to the patient on addressing and understanding the problem. Accountability’s main role in professionalism is to recognize the situation of the patient in a self-determined manner.                (1995) conducted a research study which explored the general attitudes towards the use of physical restraint in psychiatric nursing as well as the contributions of the 1985 Ritchie Report and the 1991 Report of the Committee of Inquiry into Ashworth Hospital regarding the debate on the use of control and restraint within psychiatric institutions. He focused on and evaluated the ethical justifications as well as the ethical and political objections in the use of such methods in managing aggressive and self-injurious behaviors in contemporary mental health nursing practice. The research study found out that the development of new therapeutic approaches which would allow more negotiation between nurses and patients and would recognize the possible benefits of hearing out the claims of clients regarding their perceived unhelpful therapeutic interventions could reduce the difficulty in dealing with the majority of violent situations exhibited by the patients.             An exploratory account of registered nurses’ experience of patients aggression in both mental health and general nursing settings revealed that verbal and ‘minor’ types of aggression are the most problematic, that repeated use of chemical and physical restraint is apparent and that mental health nurses seem to consistently take control of aggressive situations while general nurses tend to rely more heavily upon the input of medical staff, mental health teams and the police when intervening violent and aggressive tendencies and tantrums of patients ( 1999).                A study conducted by (2004) showed that the lack of shared rhythm among patients during therapeutic discussions greatly affect their treatment conditions. They argued that in psychiatric care, although cooperation of the health attendants and the patients’ significant others are considered as one of the most important forms of intervention during group meetings through narratives, participation on the part of the patients should be given primacy. Such one-sided programs within the institutions is characterized and evident in the health care professionals’ controlled facilitation of the meeting where their opinions are more heard as they dictate the direction of the discussion and its overall pacing. The lack of shared rhythm in cooperation could be identified in the health care professionals controlled the storytelling by sticking to their opinions, by giving the floor or by pointing with a finger and visually scanning the participants, by interrupting the speaker or by allowing the other experts to sit passively.              (2000) found out that physical intervention in response to violence and aggression among mental health patients is extremely high and is inversely proportional to the confidence level of the psychiatric staff to control and manage such situations. All staff who participated in the study received training in Strategies in Crisis Intervention and Prevention (SCIP) who after the three-month program felt more confident in the management of risk and crisis, and more supported by their organization. However, although there was no significant effect on the lesser incident of aggressive behaviour among patients after the training, the information gathered showed a greater tendency to use physical intervention in controlling the patients compared to other available techniques of addressing the need to manage the patients accordingly.                  Meanwhile,(2002) studied the subjective effects of restraint among the staff and patients when violence and aggression in psychiatric inpatients units occur using the interview method. Data gathering procedures were conducted after restraint was executed to a particular patient. They found out that patients want the attention of the staff which they feel they do not get as making them feel upset, distressed and ignored before such incidents and then isolated and ashamed afterwards. Postincident debriefing is highly considered but patients are scared of being restrained reawakening distressing memories of past traumatic events.   (1998) continued the study on the past research conducted regarding the development of natural therapeutic holding as a form of non-aversive alternative to control and restraint in managing aggression and violence among people with learning disabilities. In their research study, they showed the programs utilized by mental institutions explaining the core values and importance of such techniques by describing the theories, aims and application of such methods. The case study method was used in order to present the concepts of individual risk management and pro-active intervention strategies analyzing the practical applications of such measures. The case study shows that over a relatively short period of time, an individual with severe learning disabilities who is aggressive and violent learns alternative coping strategies to aggression and violence through the application of natural therapeutic holding.  The authors concluded that the use of natural therapeutic holding as an intervention strategy in aggression and violence management for people with learning disabilities (a) provides staff with safe, professional and ethical skills to manage their clients and patients and that (b) as a therapy, natural therapeutic holding can make patients learn coping strategies which is better and more effective than the violence they exhibit.  The exploratory research investigation undertaken by  (2005) focused on the impact of the use and implementation of physical interventions to people with intellectual disabilities and challenging behaviour through physical intervention techniques as well as how the service users and the staff alike felt regarding such practice. There were eight user/staff pairs who were interviewed about their experiences of physical intervention within a week of mutual involvement in a behavioural incident which required restraint use as the qualitative approach was utilized in order to obtain the opinions and perceptions on a non-pain compliance approach to physical intervention. The results illustrated that the user and the staff experiences were intrinsically intertwined which highlighted the interactional nature of their physical intervention. The results further demonstrated that the experiences during the physical intervention are dependent not solely on the applications of techniques but rather on the interaction among the users and the staff. The authors concluded that the service user and staff experiences were clearly affected by their appraisals of each other’s behaviour throughout the physical intervention process.    (2002) provided a literature review on service-user and professional issues which reviewed studies and researches conducted in the psychiatric and therapeutic communities which showed a range of conducted studies which dealt with advocacy, sexuality, abuse, offending, victimology, emergency, management of behaviour, law, social exclusion, models of disability and research ethics. Lack of studies utilizing the perspective and approaches of economics, ethics treatment and confidentiality, as well as the role of society in deciding for the disabled people is apparent.  (2005) highlighted the importance of revisiting the relevant issues which pertain and addresses the essence of scientific integrity, health care objectives, as well as medical professionalism in the midst of increasing attention to evidence-based medical practices, the continuous advances in medical technologies and the rapid distribution and diffusion of innovative ideas and information. The incidents of harmful medical interventions which resulted to the continuous spread of mental disability among the community calls for a more case-intensive investigations so as to ascertain the exact conditions of the mental health institutions. Such was the subject of  (2005) study in his aim to ensure that long-term health and well-being for patients and the community remains the primary goal of medicine. His critical approach to studying the services and conditions provided to mental health patients he challenged the people in the medical field and profession to be the trustworthy advisors for individual patients and credible advocates of medical practice by subjecting them in the evaluation and assessment of the general population regarding their commercial interests on medical research, medical education and clinical practice.    (2004) in his academic paper suggested and acclaimed the use of nursing-based evidence approach rather than the traditional evidence-based approach in pursuing researches and academic endeavours in mental health nursing. He said that although mental health nursing is dominated with the knowledge borrowed from the disciplines of psychiatry, pharmacology and behavioural sciences which all use the evidence-based approach, a new way of utilizing the nursing-based approach was highlighted and upheld in his study. He argued that the qualitative research and investigative design in mental health cases and practices is more fitting because the specialty’s primary interests  human experiences of illness/health care and human relationships, are most often than not critically researched and investigated using the quantitative research paradigm. In his study, he proved that the qualitative investigation is indispensable in the mental health nursing studies and researches. He highlighted that the work of nurses with clients and the explication of phenomena, referred to as the nursing-based evidence, calls for diverse range of knowledge and thus, diverse research approaches. Such approach values multiple approaches to knowledge development offering a way to articulate its distinct contribution to the health care of people who are suffering from mental incapacity and illness which in the long run could greatly advance the mental health nursing discipline.   Conclusion Being a nurse, privacy, dignity and confidentiality should be maintained. You tend to know the very private information of the patients but you should never break the tradition of having a good impression to nurses. Nursing is such a noble profession. Being in this field, one should be ready to serve, have enough patience and give your wholehearted care to the patients especially in situations where the patients have complicated diseases.  Commitment, dedication, hard work and patience, these are the qualities entwined to the holistic profession of nursing. Nursing as it is being portrayed is primarily a task-oriented profession (1999). Nurses existed and come hand in hand with in the portals of the medical world and health care service. With this kind of profession nursing has been accountable for its distinct kind of professionalization through the form of education and wide dynamism of research. This view has a big recognition on the moral standards and diverse ethics of nursing.  The above literature provides a brief and illustrative look into the previous studies and researchers that were conducted by individuals from the medical field highlighting the concepts and context in which issues, beliefs, perceptions and evaluations on control and restraint physical intervention among patients with mental illness during aggressive and violent incidents were investigated fully alternative ways of addressing the need to meet the demands and requirements of the patients as well as the legal and medical communities were analyzed in order to execute rightful means of providing for the need of the mentally ill individuals. For further studies and researches dealing with the concepts of control and restraint in mental institutions, the critical qualitative approach of looking at the topic in terms of the communication and interplay between and among the patients, staff of the mental hospitals could be an ideal focus of the study. The extent of implementing and executing control and restraint in a mental ward as dictated by the economic, political and cultural environment in the mental nursing institutions will be an interesting field of study. The role of power between and among the nursing staff and the patients could be looked into in order to fully explain and therefore, understand the position and the stakes of both the institution and its patients.         Credit:ivythesis.typepad.com

Review of Related Literature: Assessment of the Professional Standards on Restraint and the Actual Restraint Practices of Nursing Staff in a Mental Healthcare Facility

Review of Related Literature: Assessment of the Professional Standards on Restraint and the Actual Restraint Practices of Nursing Staff i...