title: Public Health Nurses in Israel: A Case Study on a Quality Improvement Project of Nurse's Work Life.
abstract: Public health nurses (PHNs) working in Well Baby Clinic in Israel's Haifa district were voicing great distress to inspectors-the impossibility of meeting their workload, feeling overwhelmed, poor physical, and technological conditions. They were feeling tired and frustrated and burn-out was rising. The district's nursing management took the decision, together with Tel Aviv University's nursing research unit, to conduct a quality improvement project based on issues that arose from meetings with focus groups on the nurses' difficulties. This paper is a case study of a quality improvement project targeting nurses daily working life. One of its chief contributions is as a study of meeting PHNs' frustration by integrating focus groups and round-table brainstorming (involving nurses, clinic managers and nursing inspectors) in order to identify targets for practical intervention. This strategy has been very successful. It has provided the district's nursing management a battery of forcefully argued and realistically grounded proposals for making the work of Well Baby clinics more relevant to their communities and giving nurses (a) the conditions to meet their assignments and (b) greater professional self-respect.
authors.affiliation: Nursing Administration, Rabin Medical Center, Clalit Health Services, Israel.|Nursing Department, Steyer School of Health Professions, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ilya
authors.initials: I
authors.lastname: Kagan
authors.affiliation: The Cheryl Spencer Nursing Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
authors.forename: Sara
authors.initials: S
authors.lastname: Shachaf
authors.affiliation: Advanced Training Center, Rambam Medical Center, Haifa, Israel.
authors.forename: Zofia
authors.initials: Z
authors.lastname: Rapaport
authors.affiliation: Public Health Services, Haifa District, Israel Ministry of Health, Haifa, Israel.
authors.forename: Tzipi
authors.initials: T
authors.lastname: Livne
authors.affiliation: Public Health Services, Haifa District, Israel Ministry of Health, Haifa, Israel.
authors.forename: Batya
authors.initials: B
authors.lastname: Madjar
mesh_terms: D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000523:psychology; D017144:Focus Groups; D006801:Humans; D007557:Israel; D008430:Maternal-Child Health Centers / Q000458:organization & administration*; D064689:Nurses, Public Health / Q000523:psychology*; D019982:Organizational Case Studies; D011637:Public Health Nursing / Q000458:organization & administration*; D058996:Quality Improvement / Q000458:organization & administration*; D013315:Stress, Psychological / Q000523:psychology; D016526:Workload / Q000523:psychology
keywords: Well Baby clinics; case study; conditions of work; public health; public health nurses