. 2020 Jul 18;14(3):178–187. doi: 10.1016/j.anr.2020.07.004

Table 3.

Number and Percentage Distribution of Experts Opinions Regarding Items of the Strategy to Solve Nursing Staff's Work-related Problems (Second Round; N = 15).

Item	Agree 3		Need modification 2		Not agree 1
Item	N	%	N	%	N	%
I. Managing stress
a Develop a supportive climate by promoting openness and trust through discussing problem areas with them.	15	100	-	-	-	-
b Try to identify the source of the stress and decide how she or he can reduce or eliminate these sources.	14	93.3	1	6.7	-	-
c Reducing job stress (e.g., by providing more time and more concrete information, adequate staff).	11	73	4	27.0	-	-
d Clarify expectations and explain in detail how they may be expected to be evaluated.	15	100	-	-	-	-
e Went on break and carryout exercises.	15	100	-	-	-	-
f Improving coworker relations (by considering coworker compatibility when scheduled work and/or creating a work team.	14	93.3	1	6.7	-	-
g Recognize effective performance because failure to reward desirable behavior causes stress.	14	93.3	1	6.7	-	-
II. Managing workload
a Support the concept of “self-scheduling as a strategy to the growing nursing shortage”.	15	100	-	-	-	-
b Consider permanent shift assignments according to personal needs.	14	93.3	1	6.7	-	-
c Personnel work schedules made in consideration of the effect of workload, and work hours.	15	100	-	-	-	-
d Provide a sufficient number of off-duty hours to allow an uninterrupted sleep cycle of at least 8 h.	15	100	-	-	-	-
e Ensure the unit has enough staff to handle the workload.	15	100	-	-	-	-
f Negotiate with upper management that the unit needs extra staff for patient care.	14	93.3	1	6.7	-	-
g Orient new hiring staff about on-call strategy.	15	100	-	-	-	-
h Work is assigned fairly and equitably.	14	93.3	1	6.7	-	-
III. Managing absenteeism
a Try to solve transportation problems.	15	100	-	-	-	-
b Enriching the staff nurse's job by increasing its responsibility, variety, or challenge.	15	100	-	-	-	-
cConsidering enough number of staff nurses per shift and overtime.	15	100	-	-	-	-
d There is flexibility to take permission during shift.	14	93.3	1	6.7	-	-
e Being a good role model by rarely taking sick days and attending late.	15	100	-	-	-	-
f Try to solve social problems that contribute to increased absenteeism.	14	93.3	1	6.7	-	-
g Enforcing absenteeism control policies (e.g., carrying through on employee discipline when there is an attendance problem).	15	100	-	-	-	-
h Creating a norm of excellent attendance (e.g., by emphasizing the negative impact of a nurse not coming to work).	15	100	-	-	-	-
i Rewarding good attendance with providing bonus.	15	100	-	-	-	-
j Implement sick leave policy that is strictly understood.	15	100	-	-	-	-
k Consider employee's attendance during the performance appraisal.	15	100	-	-	-	-
IV. Managing conflict among subordinates
a Protect each party's self-respect.	15	100	-	-	-	-
b Deal with a conflict of issues not a personality.	15	100	-	-	-	-
c Do not put blame or responsibility for the problem on the participants.	14	93.3	1	6.7	-	-
d Allow open and complete discussion of the problem from each participant.	14	93.3	1	6.7	-	-
e Maintain equity in the frequency and duration of each party presentation.	15	100	-	-	-	-
f Encourage full expression of positive and negative feelings in an accepted atmosphere.	15	100	-	-	-	-
g Make sure both parties listen actively to each other's words.	15	100	-	-	-	-
h Encourage parties to provide frequent feedback to each other's comments.	15	100	-	-	-	-
i Give positive feedback to participants regarding their cooperation in solving the conflict.	15	100	-	-	-	--
j Follow-up on the progress of the plan to solve conflict.	15	100	-	-	-	--
k Help the conflict parties develop alternative solutions, select a mutually agreeable one, and develop a plan to carry it out.	14	93.3	1	6.7	-	-
V. Managing not empowered staff
a Giving staff authority, tools, and information they needed to do their jobs.	12	80	3	20.0	-	-
b Delegate assignments to provide learning opportunities and allow employees to share in the satisfaction derived from achievement.	15	100	-	-	-	--
c Delegate power and share information.	14	93.3	1	6.7	-	-
d Managers must convey appropriate attitudes and develop the right interpersonal skills.	14	93.3	1	6.7	-	-
e Present the powerful picture to others.	14	93.3	1	6.7	-	-
f Maintaining democracy environment.	15	100	-	-	-	--
g Maintain personal energy.	14	93.3	1	6.7	-	-
h Enhance open communication.	15	100	-	-	-	--
i Maintain a sense of humor.	15	100	-	-	-	--
VI. Managing demotivated staff
a Integrate the staff's needs and wants with the organization's interests and purpose.	15	100	-	-	-	--
b Remove traditional blocks between the employee and the work to be performed.	15	100	-	-	-	--
c Have clear expectations for workers, and communicate these expectations effectively.	15	100	-	-	-	--
d Develop group goals and projects that will build a team spirit.	5	34.0	10	66.0	-	-
e Know the uniqueness of each employee. Let each know that you understand his/her uniqueness.	15	100	-	-	-	--
f Be certain that employees understand the reason behind decisions and actions (e.g., reward and punishment).	15	100	-	-	-	--
g Be consistent in handling undesirable behavior.	15	100	-	-	-	--
h Be fair and consistent when dealing with all employees.	15	100	-	-	-	--
i Provide learning opportunities that promote employees’ growth.	15	100	-	-	-	--
j Provide opportunity for participation and input from all subordinates in decision making.	15	100	-	-	-	--
k Whenever possible, give subordinates recognition and credit.	15	100	-	-	-	--
VII. Managing workplace violence
a Establish and maintain a violence prevention program as part of their facility's safety policy.	15	100	-	-	-	--
b Establishes a plan for maintaining security in the workplace.	15	100	-	-	-	--
c Ensure that nurses receive specific training concerning the content of violence prevention programs and its implementation.	15	100	-	-	-	--
d Decrease the threat to worker safety.	3	26.6	-	-	12	73.4
e Creates and disseminates a clear policy that violence, verbal and nonverbal threats, and related actions, will not be tolerated.	7	46.0	8	54.0	-	-
f Track their progress in reducing work-related assaults.	15	100	-	-	-	--
g Ensures that no reprisals are taken against employees who report or experience workplace violence.	15	100	-	-	-	--
h Encourages prompt reporting of all violent incidents and recordkeeping of incidents to assess risk and to measure progress.	14	93.3	1	6.7	-	-
VIII. Managing poor performance
a Determine obstacles that interfere with good performance.	15	100	-	-	-	--
b Confront nurses who have poor performance privately.	15	100	-	-	-	--
c Counsel the employee privately, verbally and in writing, as well as concerning professional and nonprofessional behavior.	15	100	-	-	-	--
dUse objective and subjective methods for capturing data about staff’s performance.	15	100	-	-	-	--
e Whenever possible engage underperformed nurses in educational seminars, workshops, or clinical educational program.	15	100	-	-	-	--
f Provide the employee with time to complete a self-evaluation during work.	15	100	-	-	-	--
g Follow-up progress of staff performance.	15	100	-	-	-	--
h Evaluate staffs’ performance based on specific standards.	15	100	-	-	-	--
IX. Managing turnover
a Maintain a safe and healthy work environment that makes the nurses feel good about being there.	14	93.3	1	6.7	-	-
b Place nurses in the ideal roles for their talents and interests, for greater job satisfaction and be less likely to burn out or quit.	15	100	-	-	-	-
c Being open about everything related to the unit and hospital to develop enthusiasm.	15	100	-	-	-	-
d Make the work environment more enjoyable for nurses.	14	93.3	1	6.7	-	-
e Advocate for nurses if decisions at the executive level might impact their jobs, duties, or earnings.	14	93.3	1	6.7	-	-
f Provide constructive performance feedback not only from the direct boss but also from several quarters.	14	93.3	1	6.7	-	-
Total		95.2%		3.9%		0.9%