Search

Aim: To describe activities and professional characteristics of nurses in expanded roles in acute care in Germany and achieve a greater understanding of the current situation of advanced practice nursing. Background: Advanced practice nursing plays an important role in meeting increased demands in healthcare and promoting high‐quality care. Introduction: In Germany, advanced practice nursing is still at an early stage with a lack of studies describing the scope of practice of nurses in expanded roles. Methods: We conducted a cross‐sectional‐study using a paper‐and‐pencil questionnaire. In a nationwide convenience sample, we surveyed nurses with an academic degree, who work in an acute care hospital and take over expanded roles in direct patient care. Reporting followed the STROBE checklist. Results: Of 108 eligible nurses, 84 (77%) completed the survey. The majority had a Master's degree (63.1%) and the average work experience was 18.2 years. Participants carried out activities in all the domains that were queried (direct clinical practice, guidance and coaching, consultation, leadership and research) with differences within and between domains. Foci were on direct clinical practice and coaching and guidance. Discussion: In Germany, qualifications are nearing the international standard of advanced practice nursing. Results suggest that participants partly undertake activities within the scope of registered nurses' practice that do not correspond fully to their formal qualifications. Conclusion and implications for nursing and/or health policy: In order to foster the role development of expanded practice nurses in Germany, political efforts are needed in terms of training (e.g. specific Master's programmes), funding of corresponding positions in practice and control mechanisms (e.g. professional registration). [ABSTRACT FROM AUTHOR]

Aim: To evaluate a year‐long mentorship program, pairing nurses from different regions across the world to support their global leadership capability, and identifying additional consequences of their participation. Background: Investment in developing nurse leaders continues as a strategic global imperative. Building on the first cohort's recommendations, this second program illustrates continued progress. Program evaluation: Using the logic model of program evaluation, this non‐empirical paper uses data collected from anonymized questionnaires and participants' stories to help improve the program, illustrating innovative practices to develop the confidence and competence of emerging and established nurse leaders globally. Discussion: The value of mentorship was recognized, and there were gains for both mentors and mentees in the development of leadership confidence and competence. Through engagement and collaboration with the whole community, participants were encouraged to understand their own and others' cultures avoiding assumptions and stereotypes. Conclusion: This evaluation illustrates that in addition to helping improve future programs, mentorship has enabled the growth of individuals' skill sets and the confidence to reach out to peers across the world to understand the meaning of global health and to make a meaningful contribution to the challenges they face. Implications for nursing practice: Nurse managers should be encouraged to develop and formalize a mentoring culture to benefit the leadership competence and well‐being of their workforce. Implications for nursing policy: Every nurse has a responsibility to invest in nursing leadership for themselves and others. Mentorship can assist nurse leaders to build workforce capability to lead and contribute to the policy agenda locally, nationally, and internationally. Starting early and at the individual level, global mentorship programs can develop leadership expertise to help nurses find their voice and strengthen their confidence and competence to lead and therefore build the strategic leaders of the future. [ABSTRACT FROM AUTHOR]

Aim: This paper introduces the study on the European Union Project on complementary therapies and discusses project outputs and results. The goal of the European Union Project was to improve the professional knowledge and skills of women's health and oncology nurses regarding CT. Background: The increasing and widespread use of complementary therapies in the women's health and oncology population requires nurses to be educated about their suitable and safe use. Many nurses do not have proper training in complementary therapies and therefore should not inform their patients about them. Methods: The 'Improving the Nursing Care with Best Complementary Therapy Strategies Based on European Union Standards' (BestCARE) project was a strategic partnership within Erasmus plus for vocational education and training. The BestCARE project was coordinated by the Akdeniz University Nursing Faculty and was carried out with six partners from Turkey and Europe. Results: Fifteen nurses from Turkey and Italy were trained in complementary therapies in England. In addition, training courses and seminars were held in Turkey and Italy for women's health and oncology nurses. The BestCARE programme consisted of 14 work packages. The BestCARE programme was implemented via websites, an e‐learning training programme, training videos, reference and handbook, a curriculum proposal on complementary therapies and a simulation laboratory. Conclusion and implications for nursing and/or health policy: The BestCARE project allowed nurses to gain knowledge, experience and skills about complementary therapies and created a cultural awareness and sensitivity towards patients, caregivers and health professionals. [ABSTRACT FROM AUTHOR]

Background: A variety of advanced practice nursing roles and titles have proliferated in response to the changing demands of a population characterized by increasing age and chronic illness. Whilst similarly identified as advanced practice roles, they do not share a common practice profile, educational requirements or legislative direction. The lack of clarity limits comparative research that can inform policy and health service planning. Aims: To identify advanced practice roles within nursing titles employed in New Zealand and practice differences between advanced practice and other roles. Method: Replicating recent Australian research, 3255 registered nurses/nurse practitioners in New Zealand completed the amended Advanced Practice Delineation survey tool. The mean domain scores of the predominant advanced practice position were compared with those of other positions. Differences between groups were explored using one‐way ANOVA and post hoc between group comparisons. Results: Four nursing position bands were identified: nurse practitioner, clinical nurse specialist, domain‐specific and registered nurse. Significant differences between the bands were found on many domain scores. The nurse practitioner and clinical nurse specialist bands had the most similar practice profiles, nurse practitioners being more involved in direct care and professional leadership. Conclusions: Similar to the position of clinical nurse consultant in Australia, those practicing as clinical nurse specialists were deemed to reflect the threshold for advanced practice nursing. The results identified different practice patterns for the identified bands and distinguish the advanced practice nursing roles. Implications for nursing policy: By replicating the Australian study of Gardener et al. (2016), this NZ paper extends the international data available to support more evidence‐based nursing workforce planning and policy development. [ABSTRACT FROM AUTHOR]

Introduction: The development of a nursing practice, improvements in nurses’ autonomy, and increased professional and personal responsibility for the medical services provided all require professional documentation with records of health status assessments, decisions undertaken, actions and their outcomes for each patient. The International Classification for Nursing Practice is a tool that meets all of these needs, and although it requires continuous evaluation, it offers professional documentation and communication in the practitioner and researcher community. Aim: The aim of this paper is to present a theoretical critique of an issue related to policy and experience of the current situation in Polish nursing – especially of the efforts to standardize nursing practices through the introduction and development of the Classification in Poland. Discussion: Despite extensive promotion and training by International Council of Nurses members worldwide, there are still many countries where the Classification has not been implemented as a standard tool in healthcare facilities. Recently, a number of initiatives were undertaken in cooperation with the local and state authorities to disseminate the Classification in healthcare facilities. Conclusions: Thanks to intense efforts by the Polish Nurses Association and the International Council of Nurses Accredited Center for ICNP® Research & Development at the Medical University of Łódź, the Classification is known in Poland and has been tested at several centres. Nevertheless, an actual implementation that would allow for national and international interoperability requires strategic governmental decisions and close cooperation with information technology companies operating in the country. Implications for nursing & health policy: Discussing the barriers to the implementation of the Classification can improve understanding of it and its use. At a policy level, decision makers need to understand that use Classification in eHealth services and tools it is necessary to achieve interoperability. [ABSTRACT FROM AUTHOR]

Background As future health educators, nursing and physiotherapy students will play an essential role in the prevention of smoking. Aim To determine the prevalence of smoking among students and to analyse their knowledge of and attitudes towards smoking. Method This was a descriptive cross-sectional study using an anonymous questionnaire and conducted in a Spanish Faculty of Health Sciences in 2013. Findings 247 nursing and physiotherapy students (82.33%) participated in the study. The global prevalence of smoking (18.2%) was lower compare with the general population group of the same age. We have observed statistical significance in relation to previous studies. Nursing and physiotherapy students showed a low nicotine dependence. We found a lack of knowledge about the harmful effects of cigarette consumption on health. Statistically significant results were also found in relation to degree courses (p < 0.01) as regards students' opinions about their knowledge of strategies and methods to help patients stop smoking. Conclusion Most students started smoking before commencing their university studies; consequently, interventions should focus on cessation programmes. An analysis of university curricula leading to the award of a degree in the health sciences could serve to identify educational deficiencies in order to implement the necessary modifications. Implications for nursing and health policy This paper presents an update in tobacco use characteristics amongst nursing and physiotherapy students. Those results have showed a need to improve the curricula in order to develop specific programmes to improve knowledge, attitudes and beliefs. Measures to prevent smoking must be taken at school. [ABSTRACT FROM AUTHOR]

Aim Use a Delphi Methodology to identify nursing research priorities in Uganda. Background Identifying nursing research priorities, empowering researchers, and encouraging relevant studies can advance attaining global health goals. The Uganda Nurses and Midwives Union identified the need to establish a nursing research agenda. Nurse leaders have a priority of increasing the influence of nurses in practice and policy. This study was conducted as a preliminary step in a long-term strategy to build nurses' capacity in nursing research. Methods A three-round Delphi study was conducted. The 45 study participants were nurses in practice, nurse faculty and members of the Uganda Nurses and Midwives Union. In the initial round, the participants wrote their responses during face-to-face meetings and the follow-up rounds were completed via email. Results Maternal and child morbidity and HIV/AIDS were identified as research priorities. Nurses also identified nursing practice, education and policy as key areas that nursing research could impact. Limitations Demographic characteristics such as length of time in nursing were not collected. Additionally, first round participants completed a pencil-paper survey and the follow-up rounds were done by email. Conclusions Nurse Leaders in Uganda identified areas where research efforts could have the most impact and were most relevant to nursing practice. Implications for nursing and health policy Health policy decisions have historically been made without nursing input. Nursing research can provide evidence to inform policy and, ultimately, improve population health. The focus of nursing research in priority areas can be used to guide nursing contribution in policy discussions. [ABSTRACT FROM AUTHOR]

Aims and objectives: To evaluate demographic and occupational factors of professional life on life satisfaction among nurses in Serbia and Poland. Background: Compassion satisfaction and compassion fatigue, as aspects of a nurse's professional life, may affect their satisfaction with life in general. However, most studies on this topic have been conducted in Asian countries, and because there are differences in health care system performance across countries amid a global shortage of nurses, it is necessary to investigate professional quality of life in the European nursing context. Methods: This multicenter, comparative, and correlational study was conducted on a sample of 669 hospital nurses in Serbia and Poland. The survey data were collected between November 2019 and February 2020 using the Demographic and Occupational Questionnaire (DOQ), Professional Quality‐of‐Life Scale (ProQOL‐5), and Satisfaction with Life Scale (SWLS). STROBE Statement guidelines for cross‐sectional studies were followed. Results: Most nurses from both countries reported having moderate compassion satisfaction, moderate risk for compassion fatigue, and an average life satisfaction. The predictive factors of life satisfaction that most stand out include country of origin, financial situation, education, job satisfaction, and compassion fatigue. Discussion and conclusion: Quality of professional life is significantly affected by shift duration, age, work experience, and job satisfaction. Negative aspects of professional life are significant predictors of life satisfaction. Implications for nursing policy: The findings of this study indicate a need for implementing flexible shift patterns and enhancing interventions that will improve job satisfaction and compassion satisfaction while reducing the risk of compassion fatigue. [ABSTRACT FROM AUTHOR]

Aim: To investigate organizational commitment among Chinese nurses and analyze factors influencing organizational commitment during COVID‐19. Background: Organizational commitment is the most important link between nurses and the organization because it is effective in work retention and the motivation of nurses, especially when addressing the COVID‐19 crisis. However, there has been no empirical study conducted to predict organizational commitment in the field of nursing by combining work values with professional practice environments. Methods: A cross‐sectional predictive study was done with 362 nurses recruited from two tertiary hospitals in China. The Organizational Commitment Questionnaire, the Work Values Scale, and the Practice Environment Scale of the Nursing Work Index were used to collect data. Two factors related to the organizational commitment of nurses were investigated by using binary logistic regression analyses. Results: Increased work values and a professional practice environment were associated with an increased likelihood of higher organizational commitment. Discussion: The COVID‐19 crisis became the utmost challenge to global healthcare systems and professional organizational commitment. Nurses' organizational commitment was directly influenced by the professional practice environment and work values, especially intrinsic work values, in which the spirit of collectivism was consequential. Conclusion and implications for the field of nursing and health policy: Study results provide information for global hospital administrators to promote these organizational commitment predictive factors, including work values and a professional practice environment in nursing practice. This helped foster a stronger organizational commitment among nurses to reduce nurse resource flow during COVID‐19. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the properties of a reduced‐item Healthcare Environment Survey measuring nurses' job satisfaction across eight countries. Background: There is currently no rigorously tested international measure of nurses' job satisfaction that can be used internationally to improve the nurse work environment. Methods: Nursing staff from 11 hospitals in eight countries participated in this study. The original 57‐item, 11‐facet Healthcare Environment Survey was evaluated for reliability, validity, and measurement invariance: Cronbach's alpha was used to test for reliability; construct, discriminate, and convergent testing were used to test validity; and invariance testing including configural, metric, and scalar tests were used to study measurement invariance between the countries. Results: 2,046 nursing staff completed the survey. Reliability was established for all six subscales and the combined composite score. Both validity and measurement invariance were supported in every test conducted. An excellent model fit was found for the final 19‐item, 6‐facet Healthcare Environment Survey that explained 82% of the variance of nurses' job satisfaction. Conclusions: Findings suggest the instrument is an efficient measure of nurses' job satisfaction across multiple countries. Longitudinal testing for invariance will be needed to ensure the model remains a good fit. Testing more countries will also verify model fit. Implications for nursing: The instrument can be used to measure nurse job satisfaction globally. Implications for nursing policy: The instrument can be used to assess interventions to improve the social (patient, unit manager, and coworker) and technical (professional rewards, autonomy, and professional growth) aspects of nurse job satisfaction. [ABSTRACT FROM AUTHOR]

Aim: To explore the impact of the COVID‐19 pandemic on the mental health of nurses working in primary, secondary, and tertiary healthcare centers in Navarre (Spain). Background: Healthcare workers, especially nurses, are at high risk for developing mental health problems during the COVID‐19 pandemic. Introduction: Spain ranks among the European countries with the highest incidence of and mortality from COVID‐19 and has a 31% deficit in the number of nurses compared with the average for the European Union. Methods: This was a cross‐sectional study involving 800 Registered Nurses in Navarre, Spain. Four standardized instruments, along with a self‐administered online questionnaire, were used to measure the impact in terms of depression, anxiety, insomnia, and posttraumatic stress disorder. The STROBE checklist for cross‐sectional studies was used to report this study. Results: Of the 800 nurses, 68% had some level of depression, anxiety, insomnia, and distress, and of these, 38% had moderate or severe symptoms. Those who worked in hospital COVID units and in nursing homes showed a higher impact on their mental health. Discussion: The sustained pressure that nurses have experienced in their work during the COVID‐19 pandemic has negatively affected their mental health. Conclusion: This study found that nurses who worked in hospital COVID units and in nursing homes during the pandemic had worse mental health outcomes. Implications for nursing/policy: Recommendations for nursing policy include the need to implement coaching and emotional programs to support nurses on the frontlines of the pandemic. There is also an urgent need for the implementation of national training programs to strengthen health emergency preparedness, improve response capacity, and increase the resilience of nurses to disasters. [ABSTRACT FROM AUTHOR]

Aim: This study aimed at evaluating the effects of a modified psychological first aid (PFA) training program on nurses' psychological preparedness for emergencies and disasters. Background: Nurses need to be psychologically prepared in order to mitigate the impact of conflicts and disasters. The PFA training could ensure their psychological preparedness in responding to different emergencies and disasters. Design: A nonequivalent controlled group trial was conducted between July 2019 and August 2019. Methods: Nurses working in the trauma units from five hospitals in Palestine were allocated into two arms: a control arm and an intervention arm incorporating a 9‐hour modified PFA training program. Both groups were assessed at start (pretest) and upon completion of the program (post test) using a number of validated self‐reports. Results: Eighty‐four nurses were allocated to each arm, and 75 in each arm completed baseline data (n = 150). The results of generalized estimating equation estimates revealed that PFA training imposed a significant group‐by‐time effect on psychological preparedness (p = 0.013). The mean scores of psychological preparedness showed greater improvement in the intervention group than in the control group at posttest (37.81 vs. 32.64). Improved group‐by‐time effect was further identified in relation to optimism (p = 0.009), self‐esteem (p = 0.008), and self‐efficacy (p = 0.033). The intervention effect was large (Cohen d = 1.41). Conclusion: PFA training may help to build nurses' capacity in being better prepared to respond to psychological issues during and after emergencies and disasters. Implications for Nursing and Health Policy: Nurses should be adequately equipped with knowledge and skills to deal with different emergencies and disasters. Health policy needs to address psychological preparedness for emergencies and disasters of all healthcare workers. Healthcare policymakers and educators could adopt PFA training on a regular basis to consolidate psychological preparedness of nurses. [ABSTRACT FROM AUTHOR]

Aim: To compare the occurrence and the reasons for unfinished care among coronavirus disease (COVID‐19) and non‐COVID‐19 patients as perceived by nurses. Background: The recent pandemic has imposed tremendous changes in hospitals in all countries. Introduction: Investigating the occurrence of and the reasons for unfinished care as perceived by nurses working in COVID‐19 and non‐COVID‐19 units might help to gain insights and to address future pandemics. Methods: A comparative cross‐sectional study based on the STROBE guideline has been conducted during November 2020–January 2021. The Unfinished Nursing Care Survey, comprising part A (elements) and part B (reasons), was administered online to all 479 nurses working in medical and surgical units converted progressively into COVID‐19 and non‐COVID‐19 units. A total of 90 and 200 nurses participated, respectively. Results: No differences in the unfinished care occurrence have emerged at the overall level between nurses caring for COVID (2.10 out of 5; 95% confidence interval [CI], 1.94–2.27) and non‐COVID‐19 patients (2.16; 95% CI, 2.06–2.26). Reasons for unfinished care reported significant higher averages among nurses caring for COVID (2.21; 95% CI, 2.10–2.31) as compared with those caring for non‐COVID‐19 patients (2.07; 95% CI, 2.01–2.14; p = 0.030). Discussion: The overall occurrence of unfinished care was slightly higher compared with pre‐pandemic data in all patients. Conclusions: Reasons triggering unfinished care were slightly different and were due to priority setting and human resources issues, which were perceived at higher significance among nurses working in COVID‐19 compared with non‐COVID‐19 units. Implication for nursing and health policies: A clear map of action has emerged that might be valid in the post‐COVID‐19 era as well as in the case of future pandemics. [ABSTRACT FROM AUTHOR]

Aim: To explore the experience of balancing a career with raising school‐aged children and working three shifts and to suggest working environment changes to balance these roles Background: Female nurses working three‐day shift rotations experience irregular life patterns, parenting conflicts, and confusion over nursing roles. Introduction: This qualitative study examined nurses with early school‐aged children who work three‐day shift rotations in South Korea. Methods: A descriptive phenomenological approach employed in‐depth interviews to collect data from 12 married, female nurses with children aged 4–9 years. Data were analyzed using Colaizzi's phenomenological method, and reporting rigor was demonstrated using the Consolidated Criteria for Reporting Qualitative Research checklist. Findings: Four themes emerged in our findings: (1) challenging phase: facing a great crisis that completely shatters the axis of life; (2) chaos phase: endless inner conflict between work and parenting; (3) solutions for coping phase: struggling to continue a nursing career; and (4) expanding phase: stepping into the expanded world of care. Conclusion: Nurses working three‐day shift rotations try to balance their lives through interactions between nursing and child‐rearing. Further research is needed to create an environment that promotes this balance. Implications for nursing practice and policy: To provide a better work–life balance, policymakers should foster a participatory and supportive management style, ensure adequate nurse staffing, implement a flexible work system, provide clinical career opportunities, encourage professional autonomy and responsibility, and promote in‐service and shared social information or continuing education. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the differences in practices, policies, and perceptions of nurses regarding work‐related utilization of smartphones in acute‐care settings. Background: Mobile devices utilizing emerging technology are widely used in acute‐care settings; however, concerns such as potential distraction, improper use, and negative impact on the nursing image in clinical practice remain valid. Methods: Nurse managers (n = 8) and nurses (n = 181) were enrolled from eight academic tertiary hospitals that have comprehensive electronic medical record systems and mobile versions. Between October 2018 and February 2019, participants completed a questionnaire designed to explore their use of smartphones. The reporting guide for self‐administered surveys of clinicians was applied. Results: Approximately 80% of nurses carried personal smartphones while working, with 70% using their devices for work. The prevalence of work‐related smartphone use ranged from 3% to 43% by functionality, which was lower than that estimated by managers. Frequent uses included taking pictures/videos and internet browsing. Nurses were more positive than managers about the benefits of smartphone use and less burdened by related concerns. Novice and junior nurses were more optimistic than senior nurses. Only one hospital had a policy on nurses' use of personal devices at work. Conclusion: Two unmet needs in the current clinical information system were identified: information supporting task‐related knowledge at the bedside and security of data capture and communication. Implication for nursing policy: The unintended perception gaps between nurses and managers regarding work‐related smartphone use can be closed by nursing leadership. Unmet nursing informatics, particularly for information‐seeking purposes, can be addressed in the context of quality assurance. Nurse leaders can advocate secure and proper use of smartphones in clinical practice. [ABSTRACT FROM AUTHOR]

Background and purpose: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. Materials and methods: An international cross‐sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. Results: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self‐placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self‐accomplishment, and life satisfaction, but negatively predicted loneliness and depression. Conclusions: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. Implications for nursing practice and health policies: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies. [ABSTRACT FROM AUTHOR]

Background: Studies performed in Central European countries showed a high prevalence of missed nursing care in various clinical settings before the COVID‐19 pandemic. Aims: The aim of the study was to investigate which domains of the work environment were significant predictors of missed nursing care activities in Czech hospitals during the COVID‐19 pandemic. Methods: A cross‐sectional study was used. The RANCARE guideline and STROBE checklist were followed for reporting in the study. The sample consisted of 371 nurses from four acute care hospitals. The MISSCARE Survey and the Practice Environment Scale of the Nursing Work Index questionnaires were used to collect data. The data were analyzed using multiple linear and logistic regression analyses. Results: Nurses reporting unfavorable environments consistently describe a higher frequency of episodes of missed care. Prevalence estimates of missed care in Czech acute care hospitals during the COVID‐19 pandemic was predicted from the overtime work, the nurses' perception of the "Nursing foundations for the quality of care," and their satisfaction with their current position. Conclusions: Missed nursing care could be mitigated by improving the nurses' work environment. Domains of the nurse work environment are known as structural modifiable factors and their refinement could be a cornerstone for interventions to reduce the prevalence of missed nursing care. Implications for nursing policy: Monitoring the conditions and aspects of the nurse work environment in hospitals and considering nurses' concerns about the work environment on an ongoing basis are important strategies for nurse supervision as well as for policymakers. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to identify which strategies are being adopted to deal with family restrictions in health units and assess nurses' perceptions of including families in nursing care during the current pandemic. Background: Due to the COVID‐19 pandemic, health organisations limited access for visitors. Introduction: Family centred care needs to be guaranteed, and alternatives for face‐to‐face interaction should be fostered. Therefore, there is an urgent need to rethink the family in nursing care during a pandemic. Methods: We conducted a descriptive exploratory mixed‐method study in Portugal using an electronic questionnaire. The study included 192 nurses recruited using a non‐probabilistic convenience sample. The study was reported using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Results: A total of 41.1% of participants (n = 79) reported that visits to their services were not authorised, and 66.7% (n = 128) reported resorting to video calls because of the restrictions imposed. Regarding attitude assessment, the average score of the scale was 77.9 (SD = 10.0), ranging between 26 and 98. When analysing the different dimensions of the 'Families' Importance in Nursing Care ‐ Nurses Attitudes' scale, family data stand out as a burden. Conclusion: Although a large percentage of participants had a positive attitude towards families and tried to find strategies to maintain family centred care, many nurses still considered the family as a burden. The current COVID‐19 pandemic may have aggravated this perception. Implications for nursing practice, nursing policy and health policy: The continued implementation of family centred nursing practice is essential for child‐well‐being, including during the current pandemic. Therefore, having intervention policies with alternative forms of care is highly recommended. [ABSTRACT FROM AUTHOR]

Aim: To describe the impact of the COVID‐19 pandemic on stress, resilience and depression in health professionals from a public hospital in Barcelona, Spain after the first peak of pandemic. Background: The COVID‐19 pandemic in Spain has pushed boundaries in health systems and, especially, for health professionals. Analysis of resilience as an individual resource and it is essential to understand the mechanisms that make staff react unfavourably to stressors caused by the pandemic. Design: A descriptive cross‐sectional study was designed. Participants: Health professionals supervised by the nursing department, including registered nurses, health care assistants, health technicians, final year nurse student nurses, foreign nurses, and other nurse‐related health workers. Methods: The study complies with the STROBE checklist for cross‐sectional studies. An online survey was administered to all health professionals supervised by the nursing department between 6 and 27 May 2020. The survey included the ER‐14 Resilience Scale, the widely‐used PHQ‐9 depression scale, the Spanish version of the Nursing Stress Scale, and an ad‐hoc questionnaire to obtain sociodemographic and occupational variables. Results: A total of 686 participants answered the survey. Resilience was high or very high in health professionals, with an inverse correlation with stress and depression scores. Personal on fixed shifts showed better resilience. The most stressed health professionals were full‐time registered nurses, followed by health care assistants. Up to 25% of nursing professionals had depression. Conclusion: Our study showed a high degree of resilience among nurse professionals despite the overwhelming nature of the COVID‐19 pandemic. Relevant signs of depression and stress were detected among participants. Occupational factors heavily influenced nurses' resilience, stress and depression. Implications for Nursing & Health Policy: Government policy shifts are needed in Spain to improve nurses' workforce conditions, enhance the ratio of nurses to patient numbers, and avoid workforce losses. Maintaining the resilience of health professionals would assist in improving their health and their capacity to possible future emergency situations. [ABSTRACT FROM AUTHOR]

BATTISTELLI A., PORTOGHESE I., GALLETTA M. & POHL S. (2013) Beyond the tradition: test of an integrative conceptual model on nurse turnover. International Nursing Review 60, 103-111 Aim: This paper aimed to extend research on nurse turnover by developing and testing a theoretical model of turnover intention that includes two emergent key off-the-job constructs, work-family conflict (WFC) and community embeddedness (CE). Background: Nurse turnover is considered one of the most significant issues in health care. There is a considerable body of knowledge that has focused on the study of the on-the-job factors of nurse turnover, showing the important role of job attitudes. Recently, WFC and job embeddedness (JE) have been identified as variables that could help explain levels of nurse turnover. Methods: Using structural equation modelling from a cross-sectional survey, the relationships between the variables were explored in a sample of 440 nurses from an Italian public hospital. The questionnaire measures demographic data and psychosocial factors such as job satisfaction, organizational commitment, WFC, CE and turnover intentions. Results: The findings supported the importance of non-work dimensions in turnover models. Conclusions: The results suggest that when studying turnover phenomena in health organizations, the extra-work domains (WFC and JE) can contribute to a decrease in the intention to leave, in addition to the more typically emphasized attitude dimension. [ABSTRACT FROM AUTHOR]

IOANNIDOU C., GALANIS P., TSOUMAKAS K. & PAVLOPOULOU I.D. (2012) Characteristics of dog bites among nursing students and knowledge about their emergency management. International Nursing Review 59, 245-251 Background: Dog bites represent a significant health concern leading to a variety of consequences. Nursing students should be appropriately educated in order to manage and help prevent such injuries. Aim: This paper is the first to report the lifetime experience and characteristics of dog bites among Greek nursing students and their knowledge in managing the above injuries. Methods: A cross-sectional quantitative study was performed using an anonymous questionnaire distributed to first and fourth year nursing students from April though June 2009. A knowledge score based on key questions was set on a scale from 0 to 7, to assess their competence on bite injuries management. Results: Of 237 nursing students recruited, 56 (23.6%) had experienced a dog bite. Men outnumbered women as dog bite victims [ n = 15 (39.5%) vs. n = 41 (20.6%), P = 0.012]. Mean age at the attack was 11.1 (standard deviation = 5.6) years and legs sustained the majority of injuries ( n = 31; 55.4%). Most bites ( n = 39; 69.9%) involved a dog known to the victim, were provoked ( n = 30; 53.6%) and occurred in a public place ( n = 35; 62.5%). Ten (17.9%) of the victims sustained a moderate or severe injury. The majority (67.9%) of students answered correctly to less than or equal to three out of seven key knowledge questions. After multiple linear regression analysis, previous educational course attendance was the only factor associated with increased score (b = 0.48, standard deviation = 0.17, 95% confidence interval = 0.12-0.84, P = 0.009). Conclusions: Dog bites were common and presented characteristic patterns among nursing students, but knowledge in their management was suboptimal. Improved education should be provided during undergraduate studies. [ABSTRACT FROM AUTHOR]

MANZANO GARCÍA G. & AYALA CALVO J. C. (2011) Emotional exhaustion of nursing staff: influence of emotional annoyance and resilience. International Nursing Review 59, 101-107 Aim: This paper aimed to study the influence of emotional annoyance and resilience on the emotional exhaustion levels of nursing staff. Background: Emotional exhaustion is one of the key factors in understanding both the performance and the quality of care that nurses give to their patients. There is a considerable body of knowledge that has focused on the study of emotional exhaustion in relation to cynicism and professional efficiency. More recently emotional annoyance and resilience have been identified as variables that could help explain levels of emotional exhaustion. Methods: Nine hundred eighty-three nurses who work in five hospitals in the north of Spain were invited to participate in the study. Five hundred questionnaires were distributed, of which 200 were fully completed. The average response rate was 40%. A personal information form, and a questionnaire concerning nurses' emotional annoyance, resilience, professional efficiency and cynicism were used as data collection instruments. To estimate a path model with latent variables, partial least squares was used. Findings: Emotional annoyance and resilience contribute to a better understanding of emotional exhaustion levels of nursing staff. There was a significant association between emotional annoyance and emotional exhaustion (β = 0.26, P = 0.020), while resilience appeared to be protective against emotional exhaustion (β = −0.22, P = 0.004). Conclusion: A more complete explanation and understanding of emotional exhaustion in nursing is achieved when emotional annoyance and resilience is measured in addition elements of burnout, which include professional efficiency and cynicism. [ABSTRACT FROM AUTHOR]

GURKOVÁ E., ČÁP J., ŽIAKOVÁ K. & ĎURIŠKOVÁ M. (2011) Job satisfaction and emotional subjective well-being among Slovak nurses. International Nursing Review 59, 94-100 Purpose: The purpose of this study is to investigate job satisfaction and emotional subjective well-being and the correlations between these two constructs among Slovak nurses. Design: A cross-sectional survey was used to investigate this relationship among nurses ( n = 104) working in seven public hospitals in Slovakia. Methods: Data were collected using a set of questionnaires that included the questionnaire to measure job satisfaction, the Positive Affect Scale, the Negative Affect Scale and a demographics form. Findings: Findings of this study confirmed some general satisfying and dissatisfying elements for the nursing profession across different clinical specialties and different cultures. The results also indicate that there is a positive correlation between positive emotions and job satisfaction of Slovak nurses. Conclusion: The paper has drawn attention to the job satisfaction and emotional well-being among nurses. Further studies in this field, extended to different countries, work settings and nursing specialties, may help to improve subjective well-being of nurses. Study limitations: Participants came from a limited number of hospitals in Slovakia. A larger sample from different hospitals in Slovakia could have enhanced the generalizability of the results and increased the power of the study to detect significant differences and associations. [ABSTRACT FROM AUTHOR]

DOMAJNKO B. & PAHOR M. Mistrust of academic knowledge among nurses in Slovenia. International Nursing Review 57, 305–311 Aim: The paper discusses the negative attitudes of some nursing assistants in Slovenia towards higher nursing education and academic (theoretical and research based) knowledge. Background: The topic is discussed in the context of traditional hierarchical and patriarchal relations in the health-care sector, professionalization of nursing and the evidence-based debate in nursing. Methods: A secondary analysis of data gathered in 2005 was carried out. The topic of the original research was the interprofessional collaboration between medical and nursing care professionals in Slovenia. The secondary study looked closely into the relations within nursing care. Specifically it focused on the nursing assistants' perspective. Five hundred ninety-two answer to two open-end questions (307 from nurses and 285 from nursing assistants) and five semi-structured interviews (with three nurses and two nursing assistants) were re-analyzed (with the new focus), applying inductive qualitative content analysis and the pragmatic approach to interpretation. Findings: In nursing assistants' view, the difference between themselves and graduate nurses was described in terms of the distinction ‘work – non-work’. Higher education was associated primarily with striving for higher social status. Academic knowledge was not perceived to include the right competencies for either practising or improving the quality of nursing care. Conclusions: The mistrust of the academic nurse on the part of some nursing assistants is interpreted as a barrier to full professionalization of nursing care and also interprofessional collaboration in the health-care sector. [ABSTRACT FROM AUTHOR]

Aim: To investigate the nurses' work environment in university hospitals during the COVID‐19 pandemic in Brazil. Background: The COVID‐19 pandemic brought challenging times for nurses worldwide. In Brazil, as well as in several countries, nurses are working hard in hospital settings caring for patients infected with the virus, sometimes with unfavourable work environment conditions. Methods: This study was a convergent embedded mixed methods research. The sample comprised 104 nurses from three Brazilian university hospitals. Data were collected in April–June 2020 from an online questionnaire with a self‐reporting Likert scale survey designed to measure the nurses' perceptions of their work environment. Qualitative data in the form of written comments were also collected through an open question. Data were analysed using descriptive statistics and content analysis. Results: The quantitative results showed that the responses to 'I received training on the correct use of personal protective equipment' and 'I am afraid of being infected' items had the best and worst evaluations, respectively. The qualitative findings revealed five themes: feeling of insecurity, lack of personal protective equipment, lack of diagnostic tests, changes in the care flow and fear of the unknown. Conclusion: The study has highlighted the challenges faced by hospital nurses while caring for patients with COVID‐19. Implications for Nursing and Nursing Policy: The gaps identified will assist the policymakers and hospital managers in developing policies to enhance the support offered to nurses and improve the care provided to patients with COVID‐19 in university hospitals. The results also indicate the need for attention to the mental health of the professionals due to the increasing workload and treatment of an illness hitherto unknown. [ABSTRACT FROM AUTHOR]

Background: Healthcare providers involved in an unexpected adverse patient safety event are affected by negative outcomes of the event and are called 'second victims'. The Second Victim Experience and Support Tool has been introduced as a reliable and valid measure to assess the second victim responses and to support recourses of healthcare professionals. Aim: The core objective of this survey was to assess the psychometric attributes of the scale within Iranian nurse. Methods: Having translated the scale based on the WHO guidelines and assessing its face validity, a board of 8 specialists assessed the content validity of the measure. In order to assess the psychometric characteristics of the questionnaire, a survey was conducted in 5 university‐affiliated hospitals of Urmia. Confirmatory factor analysis is adopted to assess the construct validity. The internal consistency and test–retest reliability of the scale were determined. Results: The Persian version of the scale consists of 29 items and 9 subscales. Confirmatory factor analysis illustrated that the scale reflects a foolproof construct validity. Cronbach α coefficients revealed the reliability of the scale (0.68–0.88). Conclusions: The survey proves to be a reliable and valid measure to evaluate the second victim responses and conceivable support resources of Iranian nurses or other Persian‐speaking healthcare professionals of the region. Implications for health policy and practice: Health policymakers ought to build up large‐scale surveys to determine the degree of second victimization of healthcare professionals so as to offer suitable support systems. Taking the scale into account would improve evaluation of the benefits of second victim support initiatives in nursing practice. [ABSTRACT FROM AUTHOR]

Aim: We developed and psychometrically tested the Japanese version of the Professional Attitude Scale for Nurses (PASN‐J). Background: Nurses must recognize the importance of their professionalism; therefore, it is critical to quantitatively measure nurses' professional attitudes. Introduction: This instrument validation study was designed to generate an itemized scale and examine its content validity/psychometric testing using a sample of Japanese nurses. Methods: Based on a trait approach focusing on the characteristic traits of the nursing profession, a 59‐item draft scale was generated. During November 2017, 2657 nurses from 29 facilities in Japan were surveyed. The questionnaire included demographics, the 59‐item draft scale, and a self‐report scale of nurses' professional behaviour and nursing practice ability. Using exploratory and confirmatory factor analyses, we evaluated the construct, criterion‐related, concurrent, and known‐groups validity, and reliability of the PASN‐J. Results: Data from 1716 participants were analysed. The analyses yielded a 38‐item, 3‐factor scale that adequately fit the data. PASN‐J scores were positively correlated with nurses' professional behaviour and nursing practice ability. Conclusion: The 38‐item PASN‐J has good reliability and validity, making it useful for measuring the current condition of nursing professionalism and evaluating nursing education. Implications for Nursing and Health Policy: This scale can evaluate nursing education and promote nurses' professionalism. The PASN‐J will help identifying the elements of undergraduate nursing education that require further emphasis. Additionally, the PASN‐J could facilitate the development of nursing policies to promote professional development in nurses. Ultimately, evaluating nursing education with the PASN‐J enhances nurses' professional attitudes and subsequently improves their quality of nursing, nursing efficiency and patient outcomes. [ABSTRACT FROM AUTHOR]

Aim: To explore job satisfaction of nurses during the Hajj season 2018 in Saudi Arabia, determine predictors of nurses' job satisfaction and inform future healthcare provision and policy. Background: Mass gatherings of large numbers of people inevitably pose unique public health concerns and challenges for organizers. A mass gathering happens annually in Saudi Arabia during the Hajj pilgrimage. There was a paucity of evidence regarding nurses' experiences during Hajj. This gap in knowledge needed to be addressed. Methods: A cross‐sectional survey was conducted in 198 nurses across 12 healthcare settings along the Hajj pilgrimage route. A 24‐item Nurses' Job Satisfaction Questionnaire was developed exploring six domains: supervision, nature of work, retention, communication, workload and co‐workers. Results: Nurses reported a high level of job satisfaction. All six domains were strong predictors of job satisfaction. Nurses reported the lowest level of job satisfaction when assessed against the items 'multiple policies and procedures that were perceived as complicating nursing work', 'incompetence of other people they work with' and 'too much burden at work'. Conclusion: Job satisfaction levels for nurses during Hajj 2018 appeared higher than during previous Hajj pilgrimages, probably influenced by the additional healthcare measures put in place during Hajj 2018, such as improved technology. Implications for nursing policy and practice: Hajj‐specific skills training must be designed to enhance the knowledge, competencies and capabilities of nurses. Policies and procedures must prevent heavy workloads and avoid complicating nurses' work during Hajj. Improvements to the nurse work environment should focus on evidence‐based interventions promoting effective resource planning, interprofessional relationships and communication, for instance via innovative, technological approaches. These findings can be shared with organizers of other mass gatherings worldwide. [ABSTRACT FROM AUTHOR]

Background: There have been many single cross‐sectional studies on nurse or patient outcomes. However, long‐term evidence on improving nurse and patient outcomes is still limited. The High‐Quality Care Project is a national project in China for improving nurse and patient outcomes by implementing primary nursing. Aim: (1) To assess the long‐term changes in nurse and patient outcomes in the context of the High‐Quality Care Project. (2) To explore the potential influences of primary nursing on nurse and patient outcomes based on this study and broader existing evidence. Methods: The data of two cross‐sectional studies were used for analysis. The two cross‐sectional studies were conducted before (2009) and after (2016) the High‐Quality Care Project. A total of 1376 nurses and 904 patients from 40 units of 10 tertiary hospitals were surveyed. Reliable and validated instruments were used to measure nurse and patient outcomes. Multilevel modelling was the main method for data analysis. Results: Nurses in 2016 were more satisfied than nurses in 2009 with most dimensions of nurse work environment and job satisfaction. However, they were not more satisfied with burnout, global job satisfaction or intention to leave their job. Nurses in 2016 also reported better quality of patient care and patient safety while their patients reported higher patient satisfaction. Conclusion: The analysis of our results based on existing evidence indicates that primary nursing could be considered as a potentially effective way to improve nurse work environment and patient outcomes. More studies with rigorous study design from micro perspectives would be useful to further explore the direct effects of primary nursing on nurse or/and patient outcomes. Implications for nursing and nursing policy: Policymakers, healthcare service leaders and nurse managers should make efforts to provide multi‐level supports to cultivate an encouraging environment for nurses to practice primary nursing, because the implementation of primary nursing may improve the nurse work environment and patient outcomes. Furthermore, improving nurse participation in hospital affairs and developing nursing discipline and education for increasing nursing staff resource and nurses' capacity – which all need policy and management supports – are crucial to further improve nurse and patient outcomes. [ABSTRACT FROM AUTHOR]

Aim: This investigation explored the extent to which nurses' own health is a priority for global National Nursing Associations. Background: There is a growing body of evidence linking staff health and well‐being and key dimensions of service quality, including patient safety, patient experience and the effectiveness of patient care. Introduction: The International Council of Nurses is a federation of more than 130 National Nurses Associations, representing more than 20 million nurses worldwide. Representatives from these Associations attended a Congress in Singapore in 2019 at which a survey was conducted. Methods: A convenience sample of 37 leaders of National Nurse Associations from 33 countries and 61 nurse representatives took part in a survey. Results: The majority of nurse leaders and participants believed that nurses' own health should be a priority to be addressed, principally because a healthy nurse is better able to provide good patient care. All of the examples offered about how these Associations address nurses' own health were about actions to prompt individual health behaviour change. Discussion: The National Nurses Associations did not have a common terminology to talk about nurses' own health. Taking care of one's own health was included as part of the professional role and most nurse leaders thought that working conditions contributed to ill health. Conclusions: There is widespread agreement that nurses' own health matters but for most National Nurses Associations it is not a current priority. Implications for Nursing Policy: Going forward nurse health and wellbeing should be a core principle for health services and professional associations, and additional research is needed that demonstrates if improving working environments contributes to nurse retention and recruitment. [ABSTRACT FROM AUTHOR]

Aims: This study explored concerns among nurses working in the United Arab Emirates associated with the use of electronic health records, including privacy, confidentiality, security and patient safety. Background: Given the widespread implementation of electronic health records, there are concerns about data integrity that could jeopardize healthcare quality. Addressing nurses' concerns about data integrity and safety is critical to inform health policies and promote public trust. Methods: Nurses working in healthcare settings in the United Arab Emirates (N = 562) were invited to share their concerns about data integrity and patient safety using a mixed‐method approach. Data were collected between January and June 2018 via questionnaires and focus group interviews. Following a survey of nurses' concerns about privacy, confidentiality, security and patient safety in electronic health records, six focus groups were held to gain deeper insights about their concerns. Major themes that emerged from the focus groups were extracted to align with the main sections of the questionnaire. Results: Nurses expressed concern over the security of electronic health records (n = 270, 48%). Administrative‐related security, inadequate training and access by unauthorized users were the most frequently reported concerns. The main patient safety concerns were associated with non‐technological factors, including lack of audit by staff, poor communication with technology vendors and length of time required for documentation. The focus group results reflected similar issues, with an additional theme being inconsistency in data integrity policies. Conclusions and implications for nursing/health policy: Frontline nurse managers need to integrate pragmatic policies to support staff compliance with the code of ethics when using online data. Nurses must follow workplace policies that foster reporting of risks to online incident systems to ensure data integrity. A unified health policy based on multidisciplinary partnership is critical to safeguard online data and promote public trust. [ABSTRACT FROM AUTHOR]

Aim: To investigate nurses' knowledge, attitudes and practices related to intimate partner violence among women in Saudi Arabian healthcare settings. Background: There is a global focus on abuse experiences in clinical settings. However, nurses' practice in managing intimate partner violence patients in Saudi healthcare settings has not yet been examined. Introduction: Intimate partner violence is a health issue that can lead to mortality and morbidity. It has recently received attention in an Arabian context. Thus, scrutinizing nurses' role in responding to intimate partner violence patients is needed to fill a current gap. Methods: A cross‐sectional study was conducted with a convenience sample of 114 nurses from two hospitals in Saudi Arabia using a questionnaire. Results: Minimal previous intimate partner violence training was reported, as 63% of nurses had not received training related to intimate partner violence, and 52% believed that they did not receive adequate training to respond to intimate partner violence survivors. The results show that nurses had both low perceived knowledge and low preparedness in managing intimate partner violence, and only had basic intimate partner violence knowledge. Results indicated that nurses did not have appropriate attitudes towards intimate partner violence. The majority were not aware about intimate partner violence protocols or policies in their institutions. Only 2.6% had diagnosed intimate partner violence in the last six months. Conclusion: There were gaps in nurses' perceived preparedness, knowledge, attitudes and behaviours. There was also limited training and preparation for nurses to assess and address intimate partner violence. Implications for nursing and health policy: The study suggests the need for clear institutional health policies related to detecting, responding to, and preventing intimate partner violence. Guidelines about integrating intimate partner violence in nursing curricula and implementing in‐service training should be developed and implemented. A multi‐level intervention that enables nurses to respond to intimate partner violence is also needed. [ABSTRACT FROM AUTHOR]

Aim: This study examined the role of job dimensions, job satisfaction, psychological stress and job burnout in predicting turnover intention at one and five years' time among professional nurses in the Philippines. Methods: A cross‐sectional design was utilized in the study using a convenience sample of 549 registered nurses from six hospitals in the Central Philippines during the period of October 2018 to January 2019. Five self‐report scales were used in this study. Results: Overall, 46.1% (n = 253) and 78.9% (n = 433) of nurses reported planning to leave the organization at one and five years' time, respectively. The type of hospital, job satisfaction and job burnout explained variances for turnover intention at one and five years' time. Separately, hospital bed capacity and job stress predicted turnover intention at five years' time. None of the job dimensions accurately predicted turnover intention in nurses. Conclusion: Higher turnover intention results at one and five years' time were dependent on nurses' psychological stress, job burnout and job satisfaction. Implications for nursing practice and policy: Organizational measures aimed at reducing stress and burnout and increasing job satisfaction in nurses are critically important to enhance the retention of nurses and ensure continued quality of nursing care. [ABSTRACT FROM AUTHOR]

Background: Nursing shortages, the substitution of practical nurses for registered nurses, an ageing workforce, the decreasing number of nurse graduates and the increasing migration of young nurses are important factors associated with the hospital safety climate in Central European countries. Aims: The aim of the study was to investigate nurses' perceptions of the safety climate in four selected central European countries (Croatia, the Czech Republic, Poland and Slovakia) and to determine the relationship between safety climate and unfinished nursing care. Methods: A cross‐sectional study was used. The sample consisted of 1353 European nurses from four countries. Instruments used were the Hospital Survey on Patient Safety Culture and the Perceived Implicit Rationing of Nursing Care. Data were analysed using descriptive statistics and multiple regression analyses. Results: Significant differences were found between countries in all unit/hospital/outcome dimensions. 'Perceived Patient Safety' and 'Reporting of Incident Data' were associated with aspects of 'Organizational Learning' and 'Feedback and Communication about Error'. Higher prevalence of unfinished nursing care is associated with more negative perceptions of patient safety climate. Conclusions: Cross‐cultural comparisons allow us to examine differences and similarities in safety dimensions across countries. The areas with potential for initiating strategies for improvement in all four countries are 'Staffing', 'Non‐punitive Response to Error' and 'Teamwork across Hospital Units'. Implications for nursing and health policy: 'Feedback and Communicating about Error' and 'Organizational Learning ‐ Continuous Improvement' were the main predictors of 'Overall Perception of Patient Safety' and 'Reporting of Incident Data'. Therefore, nurse managers should focus on how to empower nurses in these areas in order to foster a no‐blame culture and effective reporting. In addition, it is important for policymakers to update nursing education standards in order to address patient safety. [ABSTRACT FROM AUTHOR]

Aim: To determine the relationship between knowledge, attitude and the practice of hand hygiene by nursing and midwifery students in Cambodia. Background: Hand hygiene is the most cost‐effective means to prevent hospital‐acquired infections. Techniques of hand hygiene are simple; however, many researchers have found hand hygiene knowledge, attitude and practice to be poor in many healthcare settings worldwide, especially in developing countries. Cambodia is a developing country in Southeast Asia and data regarding hand hygiene are limited. Methods: A cross‐sectional descriptive study was conducted to assess the level of knowledge, attitude and practice of hand hygiene. Students in nursing and midwifery programmes were the target population (n = 300). Survey data were collected from January to May 2017. Descriptive statistics, t‐tests and correlation coefficients were calculated to assess relationships between student knowledge, attitude and hand hygiene practice. Result: The level of knowledge, attitude and practice of hand hygiene in nursing and midwifery students was moderate. A majority of students had received hand hygiene training. There was no significant difference between nursing and midwifery students in knowledge, attitude and practice of hand hygiene. However, a Pearson correlation of attitude and practice had a weak positive relationship. Conclusion: Both nursing and midwifery students demonstrated moderate levels of knowledge, attitudes and practice of hand hygiene. Implication for nursing and health policy: This study identified a need for hand hygiene training. Developing training programmes to improve attitudes about hand hygiene is strongly recommended. Effective training may contribute to change behaviours of hand hygiene (attitude), improve practice and ultimately reduce hospital‐acquired infections. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this project was to analyse the level of satisfaction with life amongst Polish oncology nurses compared to their system of values. Background: There are a large number of scholarly reports on job satisfaction and occupational burnout among oncologic nurses, and hardly any impact on their level of life satisfaction. Introduction: Satisfaction with life, positive feelings and lack of negative feelings are the three important elements of subjective well‐being. Methods: A cross‐sectional survey study design was used. One hundred and forty registered nurses working at oncology centres in Poland were surveyed during the 21st Annual Polish Oncology Nursing Conference. The study used a diagnostic survey method utilizing the Satisfaction With Life Scale, the List of Personal Values and an original survey questionnaire for collecting socio‐demographic data. Results: There was significant relationship between the level of satisfaction with life in oncology nurses and their age, work seniority, the working system and family life. Discussion: Satisfaction with life and work is interconnected, and oncology nursing is characterized by significant physical and mental strain. The level of satisfaction depends on many variables, such as preferred system of values, work organization, age and work seniority. Conclusions: Age and years of work experience affect oncology nurses' satisfaction with life. Working on a shift system and having a second job lower their satisfaction with life. Nurses who identify happiness symbols in the category of happy family life present a higher level of satisfaction with life. Implications for nursing policy and practice: The low level of satisfaction with life among Polish oncology nurses is an important factor in the contemporary threats in nursing, and commitment to the improvement of the quality of life in this professional group should become a priority of shaping the image of the profession. [ABSTRACT FROM AUTHOR]

Background: Understanding how nursing students in European countries perceive their future professional role is an important step in creating awareness of the diversity and similarities between countries. Investigating nursing students' perceptions of their future profession could help in the design of education and the retention of nurses. Aim: To compare nursing students' perceptions of the professional nurse's role between Belarus, Lithuania, Poland and Sweden. Method: A cross‐sectional design was implemented. The study used two scales of the Professional Nursing Image Survey, which has questions about 10 skills and abilities and 14 functions and duties of a nurse. Results: A total of 392 final‐year nursing students in four countries participated in the study. Statistically significant differences were found between countries in terms of all 10 skills and abilities and in the distribution of responses concerning functions and duties of a nurse. Conclusions: Nursing students in Belarus, Lithuania, Poland and Sweden perceive differently the role of a nurse in terms of some functions and responsibilities. This may influence the adaptation of nurses who enjoy freedom of movement among the countries. Implications for nursing policy: The knowledge gained in this study could be beneficial in improving nursing education, as it could illuminate the discrepancy between educational goals and students' perceptions of their future professional role. [ABSTRACT FROM AUTHOR]

Aim: To investigate nurses' knowledge, attitudes and practices related to physical restraint in tertiary hospitals and identify the factors that influence physical restraint use. Background: Physical restraint is used to maintain patient safety. Nurses play an important role in the restraint process. It is important to identify their understanding, feelings and approach regarding the use of physical restraint. Introduction: Physical restraint is widely practiced in hospitals in China. However, it results in a range of serious negative consequences. This article provides a clear description of nurses' knowledge, attitudes and practices related to physical restraint. Methods: A cross‐sectional survey was conducted. The participants were asked to complete a questionnaire examining their knowledge, attitudes and practices related to physical restraint use. A total of 200 questionnaires were distributed in four tertiary hospitals in Hubei Province, China between August and October 2014. Results: The nurses' responses indicated a good level of knowledge regarding physical restraint use. However, they held some misconceptions. The nurses' attitudes towards physical restraint tended to be neutral. The nurses were well experienced in the use of physical restraint. Nurses who had received on‐the‐job training performed better than those who had received no training related to knowledge and practices regarding physical restraint use. Conclusions and implication for nursing/health policy: In‐service training is highly recommended for nursing managers to improve nurses' physical restraint related knowledge and practices. Regulations regarding the use of restraints should be established as soon as possible by healthcare administration system. Implications for nursing: Nurses should be open to evaluate and improve their views and attitudes regarding effective physical restraint use via multidimensional interventions. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the predictors of Saudi nursing students’ attitudes towards the environment and sustainability in health care. Background: With rising temperature and decreasing annual rainfall, Saudi Arabia is threatened by the harmful effects of climate change on its population. In response to these threats, the Ministry of Health adapted sustainable development and environmental preservation in their National E‐Health strategy. Introduction: To implement these policies successfully, healthcare practitioners should be educated on how climate change could impact human health negatively. Methods: A secondary analysis of 280 questionnaires from baccalaureate nursing students of a university in Hail City, Saudi Arabia, was completed. The New Ecological Paradigm (NEP) Scale and Sustainability Attitudes in Nursing Survey 2 (SANS‐2) were used to investigate the predictors of student attitudes towards the environment and sustainable development in health care. Results: The NEP score indicated moderate pro‐environment attitudes, whereas the SANS‐2 mean score showed very positive attitudes towards sustainability in health care. Learning about the environment and related issues in the nursing programme, raising climate change awareness and attending environment‐related seminars and training positively influenced the environmental and sustainability attitudes of nursing students. Discussion: Saudi nursing students moderately manifested pro‐environment attitudes but exhibited extremely positive attitudes towards sustainability in health care. The results support the need to strengthen the education of nursing students about environmental and sustainability concepts and the inclusion of these topics in the nursing curricula. Conclusion: The study underscores the critical role of enriching the awareness of nursing students on environmental issues and concerns and sustainability in health care. Implications for nursing and nursing policy: The findings of this study can support the inclusion of course contents, which deal specifically with environmental health and sustainability practices, in the creation of new policies directed towards curricular revision. [ABSTRACT FROM AUTHOR]

Background: Globally, nurses are undertaking expanded and more specialized roles in healthcare planning and service delivery in response to changing patterns and levels of health service demand. This means the nursing profession is increasingly considered as leaders in health service policy, research and practice. The United Arab Emirates has strengthened nursing governance and practice by establishing a Nursing and Midwifery Council and increasing the activity of nursing specialization, service leadership and research. This study aimed to identify clinically relevant research priorities to facilitate nursing contributions to evidence‐based care and strengthening health services in the country. Methods: A two‐stage Delphi study design was used. Results: The first round involved 783 participants. The second round involved 1116 participants, as more clinical settings were accessed. In total, 58 research priorities across a variety of nursing specialties (paediatrics, emergency care, intensive care, labour and maternity care, operating theatre and long‐term care) were identified as highly important. Conclusion: These identified priorities will guide a more informed programme of research in each nursing specialty, with the aim of strengthening the evidence base to improving outcomes for patients and their families in the United Arab Emirates. Implications for nursing practice, research and policy: The findings provide guidance on key areas for nurses to focus research contributions to enhance evidence‐based care and strengthen health systems. The identified priorities may also guide researchers in academic institutions to conduct research informed by current, clinically relevant issues. The findings may help inform funders and policymakers to support allocation of funding to research that has potential to contribute to enhancing nursing care in specialist areas. [ABSTRACT FROM AUTHOR]

The article discusses research on the role of nurses in providing cost-effective medical care to homeless men in Sydney, Australia. Topics include the impact of multimorbidity on the patients in the study, the role of medication administration as a primary health care (PHC) task in the study, and the need to collaborate with specialists such as mental health professionals through referrals.

Aim: To assess the psychometric properties of the Cultural Capacity Scale Spanish version in Chilean nursing students. Background: The increased diversity in healthcare facilities and the current shortage of local nursing workforce in Chile present a significant challenge to the nursing education to train future competent local nurses. To facilitate cultural competence development among Chilean nursing students, it is necessary to regularly assess their cultural competence, which necessitates a culturally adapted valid and reliable tool. Methods: A convenience sample of 502 Chilean nursing students was surveyed in this cross-sectional study using the culturally adapted scale. Reliability of the instrument was established by internal consistency and stability reliability, while validity was established by content and construct. Results: The Cronbach's α value of the entire scale was 0.95, and the test-retest reliability was 0.85. The Corrected Item-Total Correlations ranged from 0.45 to 0.78. The tool manifested an excellent content and construct validity. The exploratory factor analysis confirmed a single factor of the scale. Discussion: The tool demonstrated evidence of internal consistency, stability reliability, content validity and construct validity. The study provided cross-cultural evidence for the potential application of this scale in Chile and other Spanish-speaking countries. Conclusion: The Cultural Capacity Scale Spanish version demonstrated sound psychometric properties for assessing the cultural competence of Chilean nursing students. Limitations: The sample was restricted to one university, and the tool was only used in Chilean nursing students. Implications for nursing policy: The establishment of the Spanish version of the tool will facilitate accurate and timely monitoring of the cultural competence among Chilean nursing students and other Spanish-speaking nursing students and nurses, which can inform the creation of nursing policies aimed at ensuring cultural competence development. [ABSTRACT FROM AUTHOR]

Background: Smoking rates are higher among adolescents in South Korea than among those in other Asian countries. Researchers have reported associations between the presence of licensed tobacco retailers and adolescent smoking rates. However, few researchers have examined the factors that influence adolescent smoking including those that are intrapersonal, interpersonal or related to the tobacco retailers' environment. Aim: The purpose of this study was to describe factors related to the students, the licensed tobacco retailers and the schools and how those factors are associated with adolescent smoking outcomes such as tobacco marketing receptivity, lifetime smoking and current smoking. Methods: The survey data were gathered from 740 South Korean adolescents, and geographic data for 3488 licensed tobacco retailers were also used. Geographic Information Systems and multilevel modeling were used to describe the variables and determine the factors associated with smoking outcomes in the sample. Results: The factors that influenced receptivity to tobacco marketing included the presence of peers who smoke and the frequencies of licensed tobacco retailers passed on the way to school. The factors that influenced lifetime smoking included gender, perceived economic status, weekly income, the presence of siblings or peers who smoke and frequencies of licensed tobacco retailers passed on the way to school. The factors that influenced current smoking included gender, weekly income, and the presence of siblings or peers who smoke. Conclusions: These factors will guide adolescent tobacco prevention programs and policies. Implications for nursing practice and health policy: The study's implications for nursing practice and health policy are that school nurses and public health nurses need to be encouraged to use retailer-related factors in adolescent smoking-prevention programs. There is also a need for zoning and licensing regulations to restrict licensed tobacco retailers in areas that adolescents frequent, including schools. [ABSTRACT FROM AUTHOR]

Aim: This study examined the level of quality of work life and predictability of years of education, monthly income, years of experience, job stress, organizational commitment and work environment on quality of work life among nurses in tertiary-level hospitals in the People's Republic of Bangladesh. Background: There is an acute shortage of nurses worldwide including Bangladesh. Quality of work life is important for quality of patient care and nurse retention. Nurses in Bangladesh are fighting to provide quality care for emerging health problems for the achievement of sustainable development goals. Methods: We collected data from 288 randomly selected registered nurses, from six tertiary-level hospitals. All nurses were requested to fill questionnaire consisted of Demographic Data Sheet, Quality of Nursing Work Life Survey, Expanded Nursing Stress Scale, Questionnaire of Organizational Commitment and Practice Environment Scale of the Nursing Work Index. Data were analysed by descriptive statistics and multiple regression. Results: The quality of work life as perceived by nurses in Bangladesh was at moderate level. Monthly income was found as the best predictor followed by work environment, organizational commitment and job stress. Discussion: A higher monthly income helps nurses to fulfil their personal needs; positive work environment helps to provide quality care to the patients. Limitation: Quality of work life and predictors measured by self-report only may not reflect the original picture of the quality of work life among nurses. Conclusion and policy implications: Findings provide information for nursing and health policymakers to develop policies to improve quality of work life among nurses that can contribute to quality of nursing care. This includes the working environment, commitment to the organization and measures to reduce job stress. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to investigate the barriers inhibiting the use of spousal presence for childbirth pain relief in health facilities and recommendations from three perspectives: the midwife, the woman, and the spouse. Background Spousal presence is a non-invasive, participatory and inexpensive technique used in pain management during childbirth. Although it contributes to a large extent in relieving childbirth pain, it is underutilized in Nigerian hospitals. Overcoming the challenges impeding spousal presence and participation during childbirth will improve maternal outcome, satisfaction and midwifery care practices. Method A cross-sectional survey conducted in four hospitals in Nigeria involving midwives ( n = 100), women ( n = 142) and their spouses ( n = 142) from June to December 2014 using pretested questionnaires. Results Five themes were identified: poor infrastructural facility, lack of adequate pain management policy, lack of midwife pain management practices, midwives' attitudes towards spousal presence during childbirth and feelings about spousal presence during childbirth pain relief. Conclusion Infrastructural defects in the health facilities resulting in the lack of privacy in maternity units for both spouses and partners negatively influence the presence of a spouse during childbirth and pain relief. Adopting effective strategies such as good infrastructural facilities, staff training and spouse-friendly hospital policies will encourage spouses to fully participate in and contribute to childbirth pain relief. Implications for nursing and health policy This study identified poor staff attitudes towards pain relief and spousal presence during childbirth as barriers. Providing adequate policies on pain management, continuous staff education and orientation on spousal relationship will improve active spousal participation and maternal satisfaction during childbirth. [ABSTRACT FROM AUTHOR]

Aim To determine factors contributing to stress experienced by preregistration nursing students in Pakistan, using the Stressors in Nursing Students scale. The aim was to explore the psychometric properties of this instrument and to investigate the effect of a range of demographic variables on the perception of stressors in nursing students. Background Nursing is a stressful profession, and nursing students may experience more stress due to competing demands and challenges of nursing education, assessment, placements and worries about employment prospects. Methods In this cross-sectional survey, data from 726 nursing students from 11 schools of nursing in Karachi, Pakistan, were collected using a questionnaire. Data were analysed using descriptive as well inferential statistics. An exploratory factor analysis was also conducted. Results There was no apparent factor structure to the Stressors in Nursing Students scale, unlike in previous studies. The total score on the Stressors in Nursing Students scale was related to gender with males scoring higher. The score generally increased over 4 years of the programme, and students in private schools of nursing scored higher than those in public schools of nursing. Conclusion Nursing students in Pakistan do not appear to differentiate between different stressors, and this may be due to cultural differences in the students and to the structure of the programme and the articulation between the academic and clinical aspects. Likewise, cultural reasons may account for differences between stress experienced by male and female students. Implications for nursing and policy The fact that scores on the Stressors in Nursing Students scale increased over 4 years of the programme and males scored higher than females should alert nursing schools and policymakers related to nursing education and workforce to pay attention to prevent attrition from nursing programmes. [ABSTRACT FROM AUTHOR]

Background In Singapore, employees aged 62-65 can continue to be employed if they meet the re-employment eligibility criteria. This policy, coupled with an ageing workforce, calls for age-friendly initiatives, specific to work-related challenges faced by older nurses. Aim To determine work-related challenges faced by older nurses. Methods A mixed method sequential explanatory study was conducted with nurses, aged 50 and above, working in a healthcare cluster in Singapore. In the quantitative phase, a questionnaire was administered to 534 nurses to elicit work-related challenges, then in-depth interviews with 30 nurses were carried out to help explain why certain tasks and work circumstances became harder. Results Results of the survey indicated that the top three challenges were coping with changes, working with computers and reading labels. Place of work, salary range, gender and race were significantly associated with different work-related challenges. Five themes emerged from the qualitative data: physical demands of work and workload, new technology, need for further education, working with younger nurses and in intercultural teams, and changing public expectations and professional image. Discussion and conclusion The study supports the current literature on the challenges older nurses face with technological advancement. However, older nurses in our study reported less aches and pain as compared to that reported elsewhere. There is a need for specific strategies that will address changes in work processes and environment in order to retain older nurses. Implications for nursing and nursing policy When devising age-friendly work improvement initiatives, it is important for nurse leaders to factor in the needs of nurses working in different care environments, who are of different ranks, or are from different ethnic backgrounds. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to identify the most common contributing factors to medication errors in everyday practice of Serbian nurses. Background Nurses have the key role in medication, and it is very important that they understand why errors occur. Methods This research study was a cross-sectional study in five healthcare institutions. The sample was 965 nurses. A specially designed questionnaire was used as the research instrument. Results The most dominant contributing factor of medication errors was insufficient number of nurses. Interestingly other dominant factors given in literature were not recognized in this research study. Discussion The study results confirm that the recommendations we find in literature cannot be simply copied and implemented into the existing system, but can be used as a starting point for further research. Limitation The obtained data were compared with the studies of the countries with different healthcare systems and different educational structures of nurses. Conclusion The results of the study imply that healthcare institutions have to take the initiative and the responsibility for teaching safe medication use during formal education, as well as in clearly planned programmes of continuous education for nurses. Implications for nursing To reduce errors to the least possible level, it is important that nurses clearly define what an error is and recognize the causes and the importance of reporting and analysing them. Implications for health policy Systemic practices are required in the health system in Serbia and the culture of patients' safety accepted as the common goal and imperative of everyday practice. [ABSTRACT FROM AUTHOR]

Aim This study aimed to develop a prenatal nursing care catalogue of International Classification for Nursing Practice. Background As a programme of the International Council of Nurses, International Classification for Nursing Practice aims to support standardized electronic nursing documentation and facilitate collection of comparable nursing data across settings. This initiative enables the study of relationships among nursing diagnoses, nursing interventions and nursing outcomes for best practice, healthcare management decisions, and policy development. The catalogues are usually focused on target populations. Pregnant women are the nursing population addressed in this project. Methods According to the guidelines for catalogue development, three research steps have been adopted: (a) identifying relevant nursing diagnoses, interventions and outcomes; (b) developing a conceptual framework for the catalogue; (c) expert's validation. Results This project established a prenatal nursing care catalogue with 228 terms in total, including 69 nursing diagnosis, 92 nursing interventions and 67 nursing outcomes, among them, 57 nursing terms were newly developed. All terms in the catalogue were organized by a framework with two main categories, i.e. Expected Changes of Pregnancy and Pregnancy at Risk. Each category had four domains, representing the physical, psychological, behavioral and environmental perspectives of nursing practice. Implications for nursing practice This catalogue can ease the documentation workload among prenatal care nurses, and facilitate storage and retrieval of standardized data for many purposes, such as quality improvement, administration decision-support and researches. The documentations of prenatal care provided data that can be more fluently communicated, compared and evaluated across various healthcare providers and clinic settings. [ABSTRACT FROM AUTHOR]

Aim This study assessed the cultural competence of nursing students in a Saudi University. Background With the current situation of immigration in Saudi Arabia, the cultural diversity in healthcare facilities is anticipated to grow. This presents a great challenge to the members of the healthcare team. Methods A cross-sectional study was conducted among 272 nursing students in a Saudi university using a self-administered questionnaire consisting of two parts, namely the respondents' demographics and cultural background information sheet and the Cultural Capacity Scale Arabic version. Results The respondents showed the highest competence in their ability to demonstrate communication skills with culturally diverse patients and lowest in the familiarity with health- or illness-related cultural knowledge or theory. Gender, academic level, clinical exposure, prior diversity training, the experience of taking care of culturally diverse patients and patients belonging to special population groups were significant factors that could likely to influence cultural competence. Discussion The findings suggest that the Saudi nursing students possess the ability to provide culturally appropriate nursing care to patients with a diverse cultural background. Conclusions Despite the good cultural competence reflected in this study, some aspects in ensuring a culturally competent care rendered by Saudi nursing students need to be improved. Implications for nursing & health policy With the country's Saudization policy in health care (replacing foreign nurses with Saudi nurses), the findings can be used in designing training and interventions to meet the needs of Saudi nursing students regarding cultural competence development, which is integral in their preparation to assume their future roles as nurses. Policy guidelines, such as including cultural competency training and foreign languages training as mandatory continuing education for nurses, as well as integrating cultural competency and foreign languages in the prelicensure curriculum, should be developed and implemented in Saudi Arabia and other countries. [ABSTRACT FROM AUTHOR]