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Aim: To explore the feasibility of applying artificial intelligence in nurse-patient interaction to assist nurses in grasping patient status and reducing their working hours., Background: Artificial intelligence has been reshaping the health care industry and has immense potential in nursing care, but there is still a lack of suitable artificial intelligence methods to improve the efficiency of the nurse-patient interaction that takes much time of nurses., Methods: An artificial intelligence-based intelligent surveillance system was developed to reduce nurses' working hours in nurse-patient interaction, and a two-wave follow-up design was adopted in this study. The data were collected in a nursing home in Guangzhou, China. The first and second waves of data were recorded in the same format on the same patients by the same nurses. The only difference is the deployment of artificial intelligence technology between the two waves of data., Results: Artificial intelligence-based intelligent surveillance can provide statistical health data for nurses to grasp the patients' status more intuitively, reducing the average nurse-patient interaction time per patient from 18 to 10 min. In addition, artificial intelligence's real-time response to the abnormal health status of patients not only avoids more serious secondary injuries for patients but also prevents nurses from consuming energy in detecting emergencies., Conclusion: The application of artificial intelligence has great potential to reduce nurses' working hours in nurse-patient interaction. There are still many limitations in artificial intelligence technology at this stage, and it is not feasible to completely rely on artificial intelligence. However, as a tool to assist decision-making, it can still have beneficial impacts on nursing management., Implications for Nursing Management: Artificial intelligence has great potential in daily nurse-patient interaction, and nursing facility managers and nurses need to be more open to this new technology., (© 2022 John Wiley & Sons Ltd.)

Aims: This study aimed to explore the effectiveness of gong meditation on nurses' perceived stress and occupational burnout during the COVID-19 pandemic., Background: Nurses play an important role in hospitals, and they currently encounter additional stress due to the COVID-19 pandemic., Design and Methods: In this experimental study, participants were provided intervention with seven sections of gong meditation, and each session lasted for approximately 50-60 min. Data were collected from July 2020 to February 2021. Eighty nurses were randomly assigned to the experimental or control group, and 79 completed all the processes of our protocol. Generalized estimating equations (GEE) were used in data analysis., Results: Compared with the control group, the experimental group experienced significant improvements in stress and occupational burnout., Conclusions: Gong meditation can effectively alleviate stress and occupational burnout among nurses during the COVID-19 pandemic., Implications for Nursing Management: Gong meditation can be provided by hospital managers to all nurses to reduce their stress, occupational burnout and subsequent mental health problems. Additionally, we suggest that gong meditation can be used as an effective intervention for individuals in other occupational fields, as it is accessible and inexpensive intervention., (© 2022 John Wiley & Sons Ltd.)

Aims: This study aims to investigate the effects of workload, work stress and social support on nurses' self-perceptions regarding their parenting roles in the Covid-19 pandemic and to examine the effect of nurse parents' sociodemographic characteristics on work stress and workload during the Covid-19 pandemic., Background: The Covid-19 pandemic has brought many challenges in the lives of nurses who are fighting at the forefront of the pandemic., Methods: One hundred ninety-eight nurse parents participated in the study conducted with a relational study design using an online questionnaire spread through social networks. 'The Nurse Parents Descriptive Information Form', 'The Swedish Demand-Control-Support Questionnaire (DCSQ)' and 'The Self-Perception of Parental Role Scale (SPPR)' were used for the study data., Results: A total of 90.9% of the participants are women. A significant difference was found between the spouse's job and the work stress and the work stress and workload (p < .05)., Conclusions: Participants working during the day experienced less work stress and workload than those working at night. Working in the pandemic unit has increased work stress and workload., Implications for Nursing Management: Nurse managers need to plan supportive approach activities so that nurses can use effective methods to manage work stress and heavy workload. In addition, nurse managers should pay attention to developing qualified care and treatment skills in crises such as pandemics, where the workload increases tremendously., (© 2022 John Wiley & Sons Ltd.)

Aim: The aim of this work is to examine whether nurses' pathological narcissism and interpersonal cognitive distortions predict workplace bullying when controlling for organizational culture, work-related factors, and demographic variables., Background: To eradicate workplace bullying, a multifaceted holistic approach to identify potential predictors is needed. Nurses' narcissistic behaviours negatively affect collegial relationships and the organization. Furthermore, interpersonal cognitive distortions have been demonstrated to directly affect bullying and victimization., Methods: Responses from 236 nurses to an online survey were analysed. The Pathological Narcissism Inventory, Interpersonal Cognitive Distortions Scale, Positive Nursing Organizational Culture Measurement Tool, and The Negative Acts Questionnaire-Revised were used to measure the key variables., Results: A multiple regression analysis revealed that pathological narcissism (β = .33, p < .001) had the greatest effect on nurses' workplace bullying, followed by positive organizational culture (β = -.31, p < .001), interpersonal cognitive distortions (β = .17, p = .028), marital status (β = -.15, p = .020), and position (β = -.12, p = .047)., Conclusions: Although prejudice or stigma surrounding narcissistic personalities should be avoided, nurses should be aware of and manage such characteristics so that they do not become a factor in workplace bullying., Implications for Nursing Management: There is a need to protect nurses from workplace bullying and create a positive organizational culture by recognizing narcissistic traits and preparing intervention strategies that support improvement., (© 2022 John Wiley & Sons Ltd.)

Aim: This study aims to explore nurses' perceptions of hourly rounding in Jordanian hospitals., Background: Hourly rounding is a standardized and systematic process conducted by nurses to anticipate and address needs in hospitalized patients. The evidence on hourly rounding is mixed, and research is needed to affirm the benefits of implementing hourly rounding across different contexts., Method: A cross-sectional correlational design was used. A convenient sample of 1378 nurses was recruited from one military hospital, two university-affiliated hospitals, four governmental hospitals and four private hospitals in Jordan. The Hourly Rounding Questionnaire was used to collect data. Descriptive statistics, t test, one-way ANOVA and Kruskal-Wallis H test were used to analyse the data., Results: The highest agreements between nurses were on the items related to the implementation of hourly rounding in terms of 'preventing patient falls' 1211 (87.9%), 'preventing hospital-acquired pressure ulcers' 1201 (87.2%) and 'addressing patients' position' 1199 (87%). The lowest agreements between nurses were on the items related to the involvement of nurses in the decision-making process and sense of ownership 268 (19.4%) and the availability of continued support and resources 239 (17.3%). Female nurses, nurses who often work on a shift rotation, nurses working in private hospitals and respiratory units had a positive perception of hourly rounding., Implications for Nursing Management: Findings will inform nursing leaders and policy developers about the implementation of hourly rounding from nurses' perspectives. A protocol should accompany hourly rounding for robust evaluation to measure the impact of this process change with the involvement of nurses in the decision-making process., (© 2022 John Wiley & Sons Ltd.)

Aims: This study aimed to examine the degree and severity of workplace bullying in nurses and to assess the relationship between bullying and work environment factors., Background: Workplace bullying occurs in nursing at an alarming rate and may escalate with more adverse working conditions., Methods: Online survey data from a nationally representative sample of 1,170 U.S. registered nurses, collected between 2020 and 2021, were analysed. Five items measuring workplace bullying were used to identify bullying subgroups (unbullied, bullied but unrecognized, moderate bullying and severe bullying) using latent profile analysis. Ordinal logistic regression examined relationships between workplace factors and bullying., Results: Over 40% of nurses reported being bullied in the past year. Four bullying subgroups were distinguished. Inadequate staffing, lack of time to get the job done and lack of breaks away from the work area were all significantly associated with severe bullying., Conclusion: Ensuring adequate staffing based on patient needs and nurse competency can mitigate workplace bullying in nurses. Further studies are needed to examine the effectiveness of stress reduction programmes on bullying using longitudinal designs., Implications for Nursing Management: This result indicates a critical need to improve nursing work environments, which could provide many benefits for nursing workforces, including potential to lessen bullying severity that adversely affects nurse well-being., (© 2022 John Wiley & Sons Ltd.)

Aim: To investigate the influence of perceived organisational justice, professional identity and emotional labour on nurses' job performance., Background: Previous studies have not explored the impact of professional identity and emotional labour on the relationship between perceived organisational justice and job performance. However, how to mobilize the enthusiasm of nurses and improve their job performance is the key for nursing managers to realize the sustainable development of hospitals., Methods: A cross-sectional survey design was conducted. A total of 951 nurses from public hospitals in China participated in the survey from March-June 2021. The descriptive statistical approach, Pearson's correlation analysis and the PROCESS Macro Model 4 and 14 in regression analysis were used to analyse the available data., Results: The results showed that nurses' perceived organisational justice, professional identity, emotional labour and job performance were significantly positive correlations between every two variables, with coefficients ranging between .24 and .75. Professional identity played a whole mediating role in perceived organisational justice and job performance, accounting for 98.04% of the total effect; meanwhile, this process was moderated by emotional labour., Conclusions: Perceived organisational justice positively predicted nurses' job performance; as a mediating mechanism with moderating, professional identity and emotional labour further explained how perceived organisational justice promoted the job performance of nurses., Implications for Nursing Management: This study highlighted the moderated mediation role of professional identity and emotional labour between nurses' perceived organisational justice and job performance. Understanding this mechanism has guiding significance for nursing managers to improve nurses' job performance., (© 2022 John Wiley & Sons Ltd.)

Aim: This study aimed to identify the effects of the subfactors of self-compassion on hospital nurse burnout and provide basic knowledge for an intervention programme to prevent nurse burnout., Background: Burnout in nurses has been reported to influence their own and patients' mental health and safety. Enhancing self-compassion can help to prevent burnout., Methods: This study involved descriptive research using a cross-sectional design. Data were collected at H University Hospital in Korea, from January to March 2020. Of the 213 questionnaires collected, 208 were included in data analysis., Results: Burnout was higher when nurses were younger, unmarried, in poor health, general nurses, dissatisfied with their jobs, planning to leave their jobs or receiving low social support from peers. There was a negative correlation between burnout and the self-compassion subscales. Multiple regression analysis showed that isolation and mindfulness among self-compassion, were significantly related to burnout., Conclusions: Since individual variables and self-compassion are major elements impacting nurse burnout, it is important for nursing organizations to investigate nurses' individual variables, including subfactors of self-compassion, to help them prevent burnout., Implications for Nursing Management: Nurse burnout might be prevented by increasing self-compassion. Hospital and nurse managers may employ individualized strategies to enhance nurses' self-compassion., (© 2022 John Wiley & Sons Ltd.)

Aims: To determine the effects of work schedule characteristics on occupational fatigue and recovery among rotating-shift nurses in South Korea., Background: Understanding the effects of work schedule characteristics on occupational fatigue is important to prevent adverse nurse outcomes and to ensure patient safety., Methods: This study used secondary data analysis with a cross-sectional design. Data were collected on 436 rotating-shift nurses in 2018. Nurses' occupational fatigue and recovery were measured using the Occupational Fatigue Exhaustion/Recovery Scale. We used quantile regression models., Results: The scores for acute and chronic fatigue and intershift recovery were 70.40, 73.39, and 29.82, respectively. Overtime hours, number of night shifts, number of consecutive days off, and breaks were significant influential factors in some quantiles of acute fatigue, chronic fatigue, and intershift recovery, while total working hours was only associated with chronic fatigue in the 25th quantile., Conclusions: The quantile and linear regression models revealed different results for work schedule factors that affect occupational fatigue and intershift recovery among rotating-shift nurses., Implication for Nursing Management: These findings have important implications for developing targeted strategies and policies to reduce occupational fatigue and improve intershift recovery for rotating-shift nurses with different levels of occupational fatigue and recovery., (© 2021 John Wiley & Sons Ltd.)

Aim: This study aims at better understanding the relationships between nurses' enacted scope of practice, work environment and work satisfaction, missed care, and organizational indicators of performance., Background: The enacted scope of practice model describes the determinants and consequences of the actual enactment of the nursing scope of practice., Method: A correlational design was used to investigate nurses' enacted scope of practice in five Canadian healthcare centres., Results: Suboptimal enacted scope of practice were found in the current sample. Significant positive correlations were found between the total enacted scope of practice score, use of qualification, control over tasks, decisional latitude and psychological demand as well as role ambiguity. Moreover, a higher enacted scope of practice was correlated with lower organizational indicators of short-term absenteeism., Conclusion: Results suggest an insufficient deployment of nurses' enacted scope of practice, likely caused by some job characteristics, leading to lower work satisfaction and negative patients and organizational outcomes., Implications for Nursing Management: Optimizing nurses' enacted scope of practice would be a significant integrated strategy for improving organizational performance, patient care and nurses' satisfaction and well-being. Nurses and frontline managers must be involved in the decision-making process necessary to improve nurses' enacted scope of practice., (© 2021 John Wiley & Sons Ltd.)

Aim: To determine the impact of workforce engagement factors on nurses' intention to leave their hospital., Background: Nurse retention is important for safe patient care. It is unknown whether meaning and joy in work, occupational fatigue, job satisfaction and unprofessional behaviour experiences predict hospital nurse turnover intentions., Method: This cross-sectional study involved responses from 747 nurses from two south-western hospitals. Measures included surveys to capture meaning and joy in work, job satisfaction, occupational fatigue and unprofessional behaviour exposure/impact., Results: Following correlational analyses, manifest variables significantly correlated with related latent factors. In structural equation modelling, greater chronic occupational fatigue was the strongest and meaning and joy at work (negative direction) the next strongest predictor of turnover intention. Although significant, job satisfaction and acute fatigue were weak predictors. Inter-shift recovery did not predict intent to leave., Conclusion: This is the first study to identify Chronic Fatigue and meaning and joy in work as significant predictors of hospital nurse turnover intentions., Implications for Nursing Management: Employing practices that decrease chronic fatigue and increase meaning/joy in work are recommended to improve nurse retention., (© 2021 John Wiley & Sons Ltd.)

Background. In addition to the usual difficulty of managing human capital in any organization, healthcare institutions have other problems to solve arising from the circumstances and the very nature of the work they perform, such as the ethical pressure on staff, emotional exhaustion, the distribution of work shifts, or the general shortage for nurses. In many cases, this situation has an impact on the quality of care. Objective. The main objective of this research is to compile, in a single document, human resource practices that help health centre managers improve results in terms of performance and quality of care, as well as avoid the intention of abandoning the job, specifically related to the work of nurses. Methods. To this end, a systematic literature review has been performed based on 229 papers published in the Web of Science database, from which the practical implications for nurses proposed by these authors have been extracted. Results. The main results suggest that developing affective commitment helps to improve organizational performance and enhance patient safety culture. Furthermore, improving communication and meaningfulness of work, recognition by superiors, or job flexibility would improve the quality of outcomes, for the work of nurses. Conclusions and Implications for Nursing. Stimulating normative commitment, reducing excessive control, and paying attention to job burnout and job stress help combat the intention of voluntary turnover or leaving the job, especially in the case of nurses. [ABSTRACT FROM AUTHOR]

Aim: We aim to explore healthful leadership practices in nursing and midwifery evident within the COVID‐19 pandemic in the United Kingdom, the contextual facilitators, barriers and outcomes. Background: Globally, the health and care sectors are under pressure and despite nurses and other professionals, demonstrating resilience and resourcefulness in the COVID‐19 pandemic; this has negatively impacted on their health and wellbeing and on patient care. Evaluation: Two searches were conducted in July 2021 and December 2021. Inclusion/exclusion criteria were identified to refine the search, including papers written since the beginning of the pandemic in 2020. A total of 38 papers were included principally from the United States and United Kingdom. Ten were research papers; the others were commentaries, opinion pieces and editorials. MS Teams literature repository was created. A unique critical appraisal tool was devised to capture contexts, mechanisms and outcomes whilst reflecting more standardized tools, that is, the Critical Appraisal Skills Programme and the Authority, Accuracy, Coverage, Objectivity and Date tool for reviewing grey literature to refine the search further. Key issues: Six tentative theories of healthful leadership emerged from the literature around leadership strategies, which are relational, being visible and present; being open and engaging; caring for self and others; embodying values; being prepared and preparing others; and using available information and support. Contextual factors that enable healthful leadership practices are in the main, created by leaders' values, attributes and style. The literature suggests that leaders who embody values of compassion, empathy, courage and authenticity create conditions for positive and healthful relations between leaders and others. Nurse and midwives' voices are however absent from the literature in this review. Conclusion: Current available literature would suggest healthful leadership practices are not prioritized by nurse leaders. Perspectives of nurses' and midwives' about the impact of such practices on their wellbeing is also missing. Tentative theories are offered as a means of identifying healthful leadership strategies, the context that enable these and potential outcomes for nurses and midwives. These will be explored in phase two of this study. Implications for Nursing Management: Nurse leaders must be adequately prepared to create working environments that support nurses' and midwives' wellbeing, so that they may be able to provide high‐quality care. Ensuring a supportive organizational culture, which embodies the values of healthfulness, may help to mitigate the impact of the COVID‐19 pandemic on nurses' and midwives' wellbeing in the immediate aftermath and going forward. [ABSTRACT FROM AUTHOR]

Aim: This paper highlights integrity as a central tenet in the journey of ethical leadership among nurse leaders and dialogue as a way of working within integrity. Background: Nurse leaders play a critical role in ensuring ethically sound, safe patient care by supporting staff and fostering positive working environments. Although there is an abundance of literature on leadership, no universally accepted leadership theory exists. Hence, it can be difficult to apply leadership theory and principals to real‐life clinical practice. Evaluation: From the literature, it is evident that integrity is a crucial aspect of leadership. This paper proposes suggestions for nurturing integrity and fostering open and honest dialogue. Key issues: Globally, public health care is complex and evolving and effective nursing leadership is paramount to meet public health needs and support health care systems. Conclusion: This paper explores integrity with leadership, re‐envisaging personal and professional integrity as a portal to authentic leadership, which has human relationships and dialogue at its core. Implications for Nursing Management: Nurse leaders need support in guiding the nursing profession and promoting ethically sound patient care. The true nature of leadership is dialogue, and nurturing a culture of listening and openness at different levels within an organisation is crucial. [ABSTRACT FROM AUTHOR]

Aim: Through a review of philosophical and theoretical constructs, this paper offers insight and guidance as to ways in which nurse leaders may operationalize advocacy and an adherence to nursing's core ethical values. Background: The US health care system works in opposition to core nursing values. Nurse leaders are obliged to advocate for the preservation of ethical care delivery. Evaluation: This paper draws upon the philosophies of Fromm, Foucault, and Deleuze and Guattari to critically review the functions of nurse leaders within a capitalist paradigm. Key issue: Key emergent issues in the paper include health care and capitalism and the nurse leader's obligations towards advocacy. Conclusion: The nurse leader acts as parrhèsia in viewing truth telling as a duty critical to improving the lives of patients. Ramifications of the decisions by those in power have even greater impact in institutions that serve those with little to no political agency. Implications for Nursing Management: The nurse leader has a freedom and platform that their patients do not and must take the courageous risk of choosing to speak. This paper serves as a call to action for nurse leaders to urgently address the current state of US health outcomes. [ABSTRACT FROM AUTHOR]

Aim. We aimed to undertake a systematic review focusing on organisational strategies that specifically advance women nurses in healthcare leadership. Background. Despite nursing being the largest health workforce and being dominated by women, they face significant barriers in career progression and have limited leadership opportunities, with a need to move from a focus on individuals to organisational level change. Methods. Methods for our overarching systematic review are published and follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Databases searched include MEDLINE via OVID; MEDLINE in-process and other nonindexed citations via OVID; PsycINFO; and Scopus. Any study describing a strategy that was not implemented for nurses and all non-peer-reviewed studies were excluded. Included studies were appraised using CASP checklists. A thematic analysis approach was employed to facilitate the systematic generation of themes. Results. Findings were reported under two main themes: leadership barriers and enablers and organisational strategies for advancing women nurses to leadership. The latter included: mentorship, leadership training, career planning and coaching, opportunities for networking, sponsorship, and targeted recruitment processes for increasing gender diversity in leadership roles. Conclusion. This review synthesises organisational-level strategies that advance women nurses in healthcare leadership. Barriers and individual-level strategies for advancing women nurses in healthcare leadership have been extensively studied in the current literature. Systems and organisational strategies are less studied yet show that they can advance women in nursing into healthcare leadership. Implications for Nursing Management. This paper suggests that optimising women nurses' leadership attainment needs to shift focus from individual strategies to systemic level and organisational strategies and use tailored evidenced-based approaches. [ABSTRACT FROM AUTHOR]

Aims: Nurse managers play key roles in creating and enforcing organisational hair policies and practices. This challenging paper will provoke discussion, debate and hopefully the dismantling of racist hair policies that disproportionately target black students and nurses. Background: Black people have suffered from centuries of hair racism that continues today. Unfortunately, many nurse leaders underestimate the significance of this issue, while perpetuating the injustice. Evaluation: This paper is based on research literature, media reports and authors' lived experiences regarding hair racism experienced by black people and nurses in particular. Key Issues: Nurse managers often create and police organisational hair policies and dress codes. As health services pledge to eradicate racism 'in principle', ending discriminatory hair policies offers nurse managers a practical way to make this principle a reality. Conclusions: Hair racism is real and damaging for many black nurses and has no place in a modern health service. Rather than designing and policing such structural racism, nurse managers can be instrumental in ending it. Implications for Nursing Management: Health service hair policies targeting black nurses especially are not 'neutral'. Nurse managers can challenge this institutional discrimination, demonstrating health services' commitment to ending racism in all of its guises. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to explore the influence of a talent management scheme in an English National Health Service (NHS) Trust on registered nurses' retention intentions. Background: The retention of nurses is a global challenge, and talent management initiatives can play a role in improving retention. Talent management in its broadest sense is a way in which an organization recruits and retains the workforce that it needs to optimize the services it delivers. Methods: In this qualitative study, eight in‐depth semi‐structured interviews were conducted with registered nurses who had participated in a talent management initiative, at an English acute NHS Trust. Data were collected in July 2019. Results: The talent management initiative influenced positive retention intentions. Retention of nurses was facilitated by the creation of networks and networking. Conclusion: Networks and networking can be viewed as a form of social capital, which was a facilitating factor for positive retention intentions for nurses. Implications for Nursing Management: Talent management initiatives for nurses should be developed and directed to include the building of networks and networking to enable development of social capital. Although this talent management scheme is within the NHS, the issue of nursing retention is global. Application of learning from this paper to other health care systems is possible. [ABSTRACT FROM AUTHOR]

Aims: This article reports the results of a scoping review to identify initiatives for improving recruitment and retention of nurses in health care and ascertain their effectiveness. Background: The global shortage of nurses has results in greater competition for vacant posts and an increased need to retain existing post holders. While there are a large number of publications discussing ways to improve recruitment and retention, the effectiveness of these needs to be established. Evaluation: Thirteen papers met the inclusion criteria. There was no literature identified focusing on recruitment and only one paper reported a formal evaluation of a retention initiative. Key issues: Five themes summarized the initiatives for retaining nurses: leadership and support, ongoing professional development, recognition, work environment and flexible scheduling. Conclusion: While strategies have been proposed to retain nurses, there is a dearth of evidence supporting the effectiveness of these. Implications for Nursing Management: Although there is a lack of evaluations of retention strategies, the review identified a number of initiatives that warrant consideration. With the launch of the National Health Service People Plan in England in 2021, which is recommending initiatives identified in this review without robust evidence, an integrated programme of research evaluating this is recommended. [ABSTRACT FROM AUTHOR]

Aim(s): This study aims to present the theory of resigning in supporting nurse managers in dealing with nurses' ethical challenge of caring. Background: In a COVID‐19 era, nurses continue to be ethically challenged in maintaining safe patient care. Nurse managers play a critical role supporting staff in responding to the complexities of working in, under resourced environments. Evaluation: Literature suggests care delivery is compromised in times of staff shortages, lack of resources and increased demands on nurses. Examining caring behaviours through the theoretical lens of the theory of resigning enables nurse managers to understand nurses' behaviours, cultivating supportive working environments. Key issue(s): Nurses strive to provide quality, safe care but are sometimes unable to give the level or type of care they wish, due to the presence of constraints. Conclusion(s): This paper provides suggestions for nurse managers in dealing with nurses' daily moral distress arising from working within constraints while still trying to provide safe care. Implications for Nursing Management: Nurse managers need to develop greater insights into the ethical dilemmas nurses experience and support them to temporarily realign beliefs and values, while continuing to work within constraints. Understanding ethical dilemmas of prioritizing care is required to address and manage this concern. [ABSTRACT FROM AUTHOR]

Aim. This paper aimed to examine the current state of nurse safety behavior, and the effect of work engagement on it, and to explore the mediating effect of self-efficacy between work engagement and nurse safety behavior in specialized cancer hospitals. Background. Nurse safety behavior affects the quality of care and outcomes for patients with cancer. The research proves that self-efficacy is associated with work engagement, but the relationship between self-efficacy, work engagement, and nurse safety behavior needs to be clarified. Methods. This study used a convenience sampling method to survey 957 nurses from January to February 2023. The survey included tertiary specialized cancer hospitals in five provinces in China. Sociodemography information, the Work Engagement Scale, the Self-Efficacy Scale, and the Nurse Safety Behavior Scale were used for the survey. A Questionnaire Star program collected all the data automatically. The Statistical Package for the Social Sciences version 24 was employed for Pearson correlation and multiple regression analysis to examine the association between work engagement, self-efficacy, and nurse safety behavior. Structural equation models were built using Analysis of Moment Structures version 24.0 software. Results. The results showed that the nurse safety behavior was at a high level in specialized cancer hospitals. There was a significant positive relationship between the variables work engagement, self-efficacy, and nurse safety behavior with coefficients ranging from 0.244 to 0.564. The results of structural equation modeling revealed that self-efficacy partially mediated the effect between work engagement and nurse safety behavior, accounting for 25.3% of the total effect. Conclusion. Self-efficacy mediates the relationship between work engagement and nurse safety behavior, and by increasing self-efficacy, nurse safety behavior can be improved, thus ensuring patient safety. Implications for Nursing Management. Managers should promote high work engagement and nurse safety behaviors by fostering nurses' self-efficacy. [ABSTRACT FROM AUTHOR]

Aim: This paper aimed to investigate the relationship between social support and quality of life for nurses in infectious disease departments in China, as well as the function of psychological resilience in mediating this relationship., Background: Nurses in infectious disease departments play a critical role in the prevention and control of infectious diseases and in public health care services in general, and their quality of life can affect the quality of clinical nursing work they do. However, there are few studies on the relationship between nurses' social support networks and their quality of life., Methods: A cross-sectional study was conducted using a sample of 866 clinical nurses from the infectious disease departments of 10 general hospitals in China. Data were collected using a questionnaire survey from January to May 2021. The mediating influence of psychological resilience on social support and quality of life was investigated using structural equation modelling., Results: The score of quality of life was (36.36 ± 7.64). Quality of life was positively correlated with social support and psychological resilience (r 1  = 0.521, r 2  = 0.583; p < .01), and psychological resilience was positively correlated with social support (r = 0.426; p < .01) as well. The mediating effect of psychological resilience between social support and quality of life was 0.233, accounting for 37% of the total effect., Conclusion: The quality of life of nurses working in infectious disease departments is in the middle level. Psychological resilience is a mediating variable between social support and quality of life., Implications for Nursing Management: Managers can improve the quality of life of nurses by both increasing social support and strengthening psychological resilience. Managers should pay attention to the degree of social support provided to nurses and take proactive measures to build psychological resilience so that nurses can effectively manage stress and negative emotions from work and life in order improve their quality of life., (© 2022 John Wiley & Sons Ltd.)

Objectives: This study aims to understand the current situation and multiple factors affecting the core competence specializing in the maternal, neonatal and under-five nursing in China., Background: Highly skilled nurses and midwives are essential worldwide for achieving the Sustainable Development Goals, especially in low- and middle-income countries like China, due to the overwhelming COVID-19 crisis., Method: The 890 nurses and midwives from 12 hospitals were investigated in this cross-sectional study, with two questionnaires: the sociodemographic information and competency inventory for the registered nurses., Results: The participants reported a mean total score of 193.78 (±42.19) out of 220 and lowest in critical thinking and research ability (3.01 ± 0.82). The professional title, level, marital status, relationship quality, highest qualification, experience in specialist nurse training, participation in scientific research projects and publishing papers were the influencing factors (P < .05)., Conclusions: The respondents' core competence needs improvement, especially critical regarding thinking and research ability. In addition, marriage and good or excellent relationship quality are factors that can potentially improve competence., Implications for Nursing Management: Targeted interventions for higher core nursing competence need to be implemented, especially focusing on nurses' marital status and emotional support from partners., (© 2022 John Wiley & Sons Ltd.)

Aims: This paper adopts a gender role socialization theoretical lens to analyze how different types of bullying techniques are heavily influenced by indirect passive aggression strategies usually considered normal 'women's behavior'., Background: Workplace bullying as an organisational phenomenon has so far been examined within gender-neutral parameters. This study tries to overcome this existing lacuna within the literature on gender and workplace bullying., Method: The study integrates dialectical phenomenology and in-depth interviews with nine nurses from the nursing field to examine the gendered nature of workplace bullying., Results: The empirical data reveals that it is possible to interpret workplace bullying as an acceptable practice due to certain societal and cultural conditioning of women, thereby hindering the ability of management to combat and condone it within the health care sector effectively., Conclusion: This study widens perspectives pertaining to power, control, gender and workplace bullying. Insights are provided on how bullying techniques are similar to passive aggressive techniques used by females rendering bullying an integral feature of the nursing profession despite its negative outcomes., Implications for Nursing Management: It might be challenging to erase workplace bullying from the nursing field because of its gendered implications, raising serious ethical considerations for the health care system., (© 2022 John Wiley & Sons Ltd.)

Aim: We aim to investigate the interplay between moral distress and moral injury among nurses working in palliative and oncology wards and to assess its impact on nursing leadership. Background: The past 2 years have been particularly challenging for nurses and nursing leaders in Croatia. The coronavirus disease pandemic and the subsequent earthquakes in the country significantly impacted the work of nurses. Moral distress has been well‐known to nursing professionals, but recent studies warn about cofounding it with moral injury and their possible intercorrelation, deserving more attention from an empirical perspective. Methods: We conducted quantitative cross‐sectional research in palliative and oncology wards in 11 Croatian health care facilities on 162 nurses, using a questionnaire and paper/pencil method over 6 months (1 January 2021 to 1 July 2021). The questionnaire consisted of three parts: sociodemographic data, a Measure of moral distress for health care professionals and Moral injury symptoms scale for health care professionals. The research protocol was approved by the Ethics committee of the Catholic University of Croatia under no. 1‐21‐04. Results: The findings of our study demonstrated that the current average levels of moral distress might be characterized as low, but the moral injury symptoms are severe. The results of our study bring interesting novel insights, such as the strong correlation between moral distress and moral injury, but also in terms of nurses' decision to leave or consider leaving their position. The nurses who experience higher levels of moral distress experience severe symptoms of moral injury, while nurses who score higher in moral distress and moral injury have left, considered or consider leaving their positions. Conclusions: This study highlighted the need to pay attention to the emerging phenomenon of moral injury that has been unaddressed and overshadowed by moral distress, their intercorrelation, and the importance of addressing them timely and adequately within health care organizations with their leadership and management. Implications for Nursing Management: These findings provide a significant insight that may assist nursing managers and leaders to act and respond in time to develop various prevention and mitigation measures and help resolve situations leading to moral distress or moral injury. [ABSTRACT FROM AUTHOR]

Aim: To identify predictors and consequences of violence or aggression events against nurses and nursing students in different work contexts. Background: Workplace violence against nurses and nursing students is a very common and widespread phenomenon. Actions to manage or prevent violent events could be implemented knowing the risk factors and consequences. However, there is a lack of systematic reviews that summarize knowledge on the predictors and consequences of workplace violence. Evaluation: A scoping review was conducted using electronic databases including APA PsycInfo, CINAHL, Cochrane, Ovid Medline, PubMed and Scopus. Key issues: After full text analysis, 87 papers were included in the current scoping review. Risk factors of horizontal violence were grouped into 'personal' and 'Environmental and organizational', and for violence perpetrated by patients into 'personal', 'Environmental and organizational' and 'Characteristics of the perpetrators'. Conclusions: The results of this scoping review uncover problems that often remain unaddressed, especially where these episodes are very frequent. Workplace violence prevention and management programmes are essential to counter it. Implications for Nursing Management: The predictors and the consequents identified constitute the body of knowledge necessary for nurse managers to develop and implement policy and system actions to effectively manage or prevent violent events. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to describe the prevalence and reasons for non-nursing tasks as perceived by nurses., Background: Four types of non-nursing tasks have been identified to date: (a) auxiliary; (b) administrative, (c) expected by allied health care professionals; and (d) medical. However, no studies on a large scale have been performed with the aim of identifying the prevalence of all of these non-nursing tasks, and factors promoting or hindering their occurrence, given that they represent a clear waste of nurses' time., Methods: A cross-sectional study in 2017, following The Strengthening the Reporting of Observational studies. All active nurses registered in an Italian provincial Nursing Board (=1331) willing to participate were involved. A questionnaire survey exploring the nature of the nursing tasks performed in daily practice and the underlying reasons was administered via paper/pencil and e-mail., Results: A total of 733 nurses participated of which 94.5% performed at least one type of non-nursing task, mainly administrative and auxiliary. Auxiliary tasks are less likely among nurses working in a community (odds ratio [OR] 0.43, 95% CI 0.29-0.63, p < .01) or in a residential (OR 0.41, 95% CI 0.23-0.72, p < .01) setting, in critical (OR 0.29, 95% CI 0.16-0.54, p < .01) or surgical (OR 0.37, 95% CI 0.19-0.75, p < .01) hospital settings, and when they deal with unexpected clinical events (OR 0.58, 95% CI 0.44-0.77, p < .01). Greater adequacy of nursing resources decreases the occurrence of auxiliary tasks (OR 0.98, 95% CI 0.97-0.99, p < .01), whereas the need to compensate for a lack of resources (OR 1.44, 95% CI 1.07-1.93, p < .01) increases it., Conclusions: Around one-third of shift time is devoted to non-nursing tasks; working in a hospital, in medical units, with lack of resources and with patients with predictable clinical conditions might increase the occurrence of auxiliary tasks., Implications for Nursing Management: Strategies to increase the time available for nursing care should consider the type of tasks performed by nurses, their antecedents and the value added to care in terms of patient' benefits., (© 2021 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.)

Aim: This study aimed to analyse the treatment cost of a patient, depending on the number of patients treated, patient waiting times, and the number of nurses and doctors employed in an emergency department of a private hospital. Background: Within health systems, changes in health care resources can be very costly, especially if these changes are long‐term. The discrete‐event simulation method described in this paper allows for the monitoring and analysis of complicated changes in real systems by using computer‐based modelling. Method: The discrete event simulation model was derived from nine scenarios according to the number of nurses and doctors, and a comparison was made between the results of the scenarios and the actual results. Results: Among the scenarios, scenario 6 provided the lowest treatment cost for a patient by employing three doctors and two nurses with the best performance. The cost of treatment for a patient varies between ŧ9.00 and ŧ11.00 depending on the value of δ, and the daily cost of these resources to the hospital is ŧ1300.77. Conclusions: This study provides a clear picture of a cost analysis comparison based on changes made about the actual health system in the computer‐based simulated environment. Implications for Nursing Management: The workforce data of nurses and doctors offers enough detail for cost analysis in health care settings to calculate the cost of treatment for a patient. [ABSTRACT FROM AUTHOR]

Aims: This study aims to explore a proposed translational research continuum for nurse practitioners. Background: Nurse practitioners are acknowledged as clinical leaders responsible for transforming health care delivery. It is important that nurse practitioners contribute to health care knowledge using scientific processes for the implementation of evidence‐based practice and evaluation of outcomes of interventions for their patient groups. Evaluation: This paper provides a review of translational research literature including implementation science to align nurse practitioner activities to a modified translational research framework. Key Issues: A translational research framework has the potential to strengthen nursing research in the nurse practitioner role. Adapting an accepted translational research continuum for nurse practitioners places the clinical nursing leaders in an equitable research position with all health care professionals. Implications for Nursing Management: The translational research continuum provides nursing management with a structure to benchmark nursing research. The continuum applies a modern research framework to support research engagement for the nurse practitioner role. [ABSTRACT FROM AUTHOR]

Aim: To identify and summarize evidence of objective achievements and subjective indicators associated with professional success of men in nursing. Background: Despite being a minority group, men in nursing are purported to enjoy hidden advantages. Evaluation: In this integrative review, studies from seven databases were retrieved and independently evaluated using the quality appraisal tools in accordance with PRISMA guidelines. Inductive content analysis and narrative synthesis were conducted, guided by the aim of this review. Key issues: In total, 12 studies published between 1987 and 2021 were included. Two themes with related subthemes supporting or refuting professional success of men were identified. These were (a) evidence of professional success and (b) challenges to professional success. Conclusion: As a minority group, men are highly visible in nursing, which is a double‐edged sword. Although men were overrepresented in senior nursing positions of higher salaries than women, they also experienced gender stereotyping, prejudice, and discrimination, which reduced the duration of men staying in a specific nursing position. Implications for Nursing Management: Findings of this study highlighted the need for nurse leaders to proactively address specific gender issues that are unique to men in the nursing workforce. [ABSTRACT FROM AUTHOR]

Aim(s) To understand how nurse managers facilitate learning in clinical workplaces. Background: Meeting staff learning needs in the complex workplaces of contemporary health care is paramount to the delivery of safe patient care. Hospitals employ a range of strategies to address these needs. However, nurse managers' contribution to staff learning at the unit level is underexplored in contemporary literature. Method(s): A Gadamerian philosophical hermeneutic framework guided data collection and analysis. Thirteen nurse managers from two Australian hospitals each participated in two interviews and a period of observation. Findings Nurse managers' learning facilitation practices were enacted with staff individually, within teams, and through artefacts, and were shaped by their identities, perspectives on staff learning, knowledge of staff performance, and motivations. Power was revealed as a uniquely enacted driver of their learning facilitation practices. Conclusion(s): This paper illuminates an aspect of nurse managers' practice that has been poorly acknowledged in contemporary nursing literature. Nurse managers' learning facilitation practices were found to be complex, fluid, and embedded in their everyday work routines. Implications for Nursing Management: Given current concerns about safety and quality in health care, this research opens up possibilities for definition and enrichment of nurse managers' practice as facilitators of learning. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this paper was to investigate the relationship between high‐involvement human resource management, autonomy, affective organisational commitment and innovative behaviours of nursing staff who care for elderly clients. Background: Nursing teams are increasingly required to demonstrate innovative behaviours that enhance care quality. Nursing leaders need to create environments where nursing staff have sufficient autonomy and feel a sense of commitment to support these behaviours. The appropriate implementation of these processes and practices may lead to greater involvement. Methods: A cross‐sectional survey‐based research design was employed to explore the experiences of involvement practices, autonomy, affective organisational commitment and innovative behaviours of 567 nursing staff workers from four elderly care organisations in the Netherlands. Results: The results demonstrate that a bundle of high‐involvement practices positively influences innovative behaviour and that affective commitment and autonomy fully mediate this relationship. Conclusions: The study highlights the role of autonomy and commitment as routes towards translating involvement practices into nurses' innovativeness. Implications for Nursing Management: To create an innovative environment, leaders need to create a positive climate by providing nurses with opportunities to enhance their competence, relatedness and autonomy through active involvement. Leaders should, therefore, encourage involvement as a mechanism to promote innovation. [ABSTRACT FROM AUTHOR]

Aim: By studying an extreme context, we aim to provide an in‐depth understanding of the expanded nursing role in remote aboriginal communities, its dynamics and the main barriers to its full expansion. Background: While it is recognized that nurses play a major role in remote or rural areas, little is known about the dynamics of the expanded role and the nurses' daily practice and routines. Methods: We conducted 49 in‐depth interviews with nurses and key informants and more than 14 days of observation: two days of pre‐departure training and 12 days in dispensaries and a hospital in Hudson Bay, Québec, Canada. Results: We identified four sub‐roles within the nurses' expanded role: administrative, nursing, medical and community sub‐roles. This typology allowed us to document the evolving and dynamic nature of the role as well as the individual, organisational and community barriers that limit its expansion. Conclusion: This typology represents the first attempt to gain an in‐depth understanding of the enlarged nursing role in northern Québec and of the complexity of the daily nursing routines and dynamics. We believe it to be relevant for other contexts, such as rural areas, even if nurses there do not always take on all four sub‐roles during their nursing experience. Implications for nursing management: Our paper has significant practical implications for different stakeholders—educators, directors of nursing, recruiters, regulators and policymakers—as it may help with identifying the education and training requirements for developing specific sub‐roles, overcoming obstacles to widening the expanded role or better allocating the resources needed based on the predominant sub‐role in different contexts. More broadly, this study shows that, when properly regulated, extending professional nursing boundaries does not put the patient at risk and enables professionals to develop their practice. It represents a textbook case for rethinking our contemporary health care systems. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to understand how the behaviour of focal leaders impacts health care team performance and effectiveness. Background: Despite recent shifts towards more collectivistic leadership approaches, hierarchical structures that emphasize the role of an individual focal leader (i.e., the formal appointed leader) are still the norm in health care. Our understanding of the effect of focal leader behaviours on health care team performance remains unclear. Evaluation: A systematic review was conducted. Five electronic databases were searched using key terms. One thousand forty‐seven records were retrieved. Data extraction, quality appraisal and narrative synthesis were conducted in line with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Key issues: Fifty papers met the criteria for inclusion, were reviewed and synthesized under the following categories: task‐focused leadership, directive leadership, empowering leadership and relational focused leadership. Conclusions: Categories are discussed in relation to team performance outcomes, safety specific outcomes, individual‐level outcomes and outcomes related to interpersonal dynamics. Emerging themes are explored to examine and reflect on how leadership is enacted in health care, to catalogue best practices and to cascade these leadership practices broadly. Implications for Nursing Management: Empowering and relational leadership styles were associated with positive outcomes for nursing team performance. This underscores the importance of training and encouraging nursing leaders to engage in more collaborative leadership behaviours. [ABSTRACT FROM AUTHOR]

Aim: To summarize and evaluate the nursing virtue ethics literature, examine how virtue ethics has been applied to health care teams, offer a new framework to guide understanding and development of virtuous health care teams and offer recommendations to nurse leaders. Background: With the unprecedented levels of incivility and turnover in the post‐COVID‐19 world, virtue ethics may provide an innovative approach for nursing leaders working to rebuild healthy practice environments. Evaluation: An integrative review yielded articles from eight databases using PRISMA guidelines. Level of evidence and quality were assessed using the Johns Hopkins tools. Key Issues: Virtue ethics has been of interest to the health care community predominantly as a concept. Most articles focused on debating whether virtue ethics belongs in nursing. Virtue ethics offers a creative strategy for leaders to attract and retain nurses. Conclusion: There is a dearth of research on virtue ethics and nursing. One study empirically uncovered and validated a framework for virtue ethics in health care teams. Implications for Nursing Management: To rebuild strong health care teams, nurse leaders can model virtue ethics using an empirically derived framework while coaching their teams to do the same. Doing so holds the promise of reengaging staff and rebuilding healthy practice environments. [ABSTRACT FROM AUTHOR]

Aim: To explore nurse leaders' resilience and their role in supporting nurses' resilience during the COVID‐19 pandemic. Background: The COVID‐19 pandemic has challenged health care systems on a global level. Nurse leaders are tasked with ensuring high‐quality care, even during crises, which requires active problem‐solving and confidence in the future—resilience from leaders. Method: A scoping review was conducted using inductive thematic analysis and the PCC (Participants, Concept, Context) framework. The PubMed, Scopus, CINAHL, and PsycINFO databases, as well additional studies and grey literature, were searched from December 2019 to June 2021. Results: The review included 12 studies. Nurse leaders' self‐awareness, self‐reflection, and coping strategies described their resilience during the pandemic. A relational leadership style, supportive and safe work environment, and adequate communication were found to support nurses' resilience. Conclusions: There is scarce research concerning nurse leaders' resilience during the COVID‐19 pandemic. Future research needs to address nurse leaders' personal resilience due to the link with nurses' resilience. Implications for Nursing Management: A healthy work environment is essential for nurses' resilience. During crises, nurse leaders should adopt relational leadership styles and actively interact with nursing staff. [ABSTRACT FROM AUTHOR]

Aim. To identify the barriers and enablers to the implementation of a national policy to increase and develop the advanced nurse practitioner (ANP) workforce in Ireland. Background. The Department of Health (Ireland) introduced a policy to increase the number of ANPs to 2% of the nursing workforce. Evaluation provides information to inform successful policy implementation and development of ANP roles in healthcare services. Methods. Qualitative descriptive design. Twenty candidate ANPs participated in four focus groups. Nine key stakeholders were also interviewed. Results. Analysis identified four barriers: lack of infrastructural resources; delay in releasing and arranging replacements for candidate ANPs; role resistance from administration, allied healthcare professionals and other nurses; and lack of organisational readiness. The five enablers were: supportive physicians; Nursing and Midwifery Practice Development Units; supportive directors of nursing; role awareness and clarity; and educational preparation. Conclusions. This evaluation identifies barriers and enablers to the implementation of a national policy to increase the critical mass of advanced practitioners within the healthcare services. Evaluation at the implementation phase informed the roll-out of future advanced practice initiatives. Implications for Nursing Management. To support advanced practice development, leadership, infrastructure, and resource planning are needed to harness known enablers and address identified barriers to the implementation and sustainability of these posts. [ABSTRACT FROM AUTHOR]

Aims. Building on conservation of resources theory, our study investigates how inclusive human resource management (IHRM) promotes nurses' innovative behavior through job crafting and further examines the moderating role of shared leadership. Background. Nurses' involvement in innovation is essential to improve nursing care delivery and accommodate changing medical environments, especially in the face of crisis events like the COVID-19 outbreak. However, knowledge about the relationship between human resource management and nurses' innovative behavior remains scarce. Methods. We collected three-wave data from 338 on-duty registered nurses at four public hospitals in China from November 2022 to January 2023. We used SPSS 22 to conduct hierarchical regressions to test our hypotheses. Results. IHRM positively predicted innovative behavior of nurses with the mediating role of job crafting. In addition, we found that IHRM was more effective in promoting job crafting and subsequent innovative behavior when nurses perceived high levels of shared leadership. Conclusion. IHRM initiated by the organization and shared leadership style are two collaborative approaches to facilitating nurses' job crafting, thereby responding to the imperative need to foster nurses' innovative behavior. Implications for Nursing Management. The present study emphasizes the important roles of IHRM and shared leadership in promoting nurses' job crafting and subsequent innovative behavior, providing theoretical and practical implications for nursing management in the current dynamic and challenging environment. [ABSTRACT FROM AUTHOR]

Purpose. Healthcare organisations need to define the role of the nurse manager in light of recent global health developments. For this purpose, several core competencies essential for each hierarchical management level need to be assessed. Different measurement instruments have been developed to assess nurse managers' competencies. This systematic review summarises the characteristics and psychometric properties of existing instruments measuring first-, middle-, and top-level nurse managers' competencies. Methods. Following PRISMA guidelines for reporting and COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines, 789 articles were retrieved from PubMed, Scopus, CINAHL, and APA PsycINFO databases with no time limitation. The review protocol was registered on PROSPERO (CRD42023425854). Results. Ten tools were identified, assessing one or more competencies among nurse managers: Competency Elements for Nurse Managers of Tertiary General Hospitals, NICA-NL, HCCI, I-FLNMMCS, NMCI, Chase Nurse Manager Competency Questionnaire, CASHN, Questionnaire for Head Nurses' Managerial Competencies, Nurse Manager EBP Competency Scale, and the Home Healthcare Nurse Manager Assessment Tool. Conclusion. Following the COSMIN assessment, the Chase Nurse Manager Competency Instrument was the most comprehensive among the included instruments, and the CASHN questionnaire scored highest on methodological quality and level of evidence. These instruments can be used in clinical practice to evaluate competencies and as a basis for developing managerial training courses. [ABSTRACT FROM AUTHOR]

Aims. To develop an evidence-based practice (EBP) facilitating strategy informed by the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework and evaluates the strategy's effectiveness on promoting EBP. Background. Nurses are increasingly expected to use research evidence in practice to improve patients' outcomes, but the application of such evidence is still unsatisfactory. The facilitation of EBP in nursing needs the organization and the individual levels. Methods. Based on an analysis of EBP-promoting strategies and expert consultation, the core team of the nursing department developed an EBP group-based and project-oriented strategy under the guidance of the i-PARIHS framework. The strategy was implemented for six years and evaluated by a longitudinal design. The validated Chinese version of the self-reported Evidence Based Practice Questionnaire (EBPQ) was used to assess the attitudes, knowledge, and practice of the nurses. Results. The mean score of the total EBPQ was 4.46 (SD = 0.92) after one year of the EBP strategy, and the scores for knowledge, attitudes, and practice of EBP members were higher than those of general nurses p < 0.05 . After four years, EBP members' scores continued to increase. EBP groups conducted 51 EBP projects in the areas of emergency nursing, surgical and medical nursing, critical care, and so forth. Of these, 33 projects improved nursing practice by changing nursing procedures, upgrading nursing tools, and developing nursing standards, resulting in improved patient outcomes. Conclusion. The EBP group-based and project-oriented strategy can promote EBP. The composition of the EBP group, the annual audit of EBP projects, and the roles of internal and external facilitators were key components of this EBP-facilitating strategy. Implications for Nursing Management. The strategy is an organizational-level EBP-facilitation approach which can improve nurses' academic preparation for EBP through ongoing training and sustained EBP behavior that involves annual projects. [ABSTRACT FROM AUTHOR]

Background. As nursing interns enter challenging clinical settings, evaluating their preparation and readiness is vital for adaptation success. Sufficient real-world experience and patient care are crucial preparation components that enable effective practice and higher competencies. Aim. This study aimed to assess nurse interns' perception of clinical preparation and readiness for clinical internship experiences. Methods. A self-administered questionnaire was distributed, comprising three sections on demographics, clinical preparation requirements, and the Casey–Fink Readiness for Practice Survey. Descriptive statistics as the mean and standard deviation, numbers and percentages, linear regression model, and Pearson correlation coefficient were used for reporting normal distribution, categorical variables, and relationship between a scalar response and one or more explanatory variables and to calculate statistics between two continuous variables. Results. The participants were 130 nurse interns who were involved in an internship between 2016 and 2020, 50% of the nurse interns. They had a moderate level of clinical preparation, and 28.5% of them exhibited a low level. In addition, 53.8% were found to be moderately ready for practice, while 22.3% had a low level of readiness Conclusion. The observed significant positive correlation between perceived preparation and readiness underscores the pivotal role of clinical preparation in influencing practice readiness. Implications. These findings emphasize the importance of targeted interventions aimed at enhancing clinical preparation to directly bolster overall readiness for professional practice among nurse interns. [ABSTRACT FROM AUTHOR]

Background. Few studies have analyzed the negative outcomes of disruptive behaviors in the nurse-physician relationship in patient care and their impact on patient safety. These multicausal studies significantly relate to organizational, institutional, and professional attitudinal risk factors. Aim. Analyze healthcare professionals' perceptions of disruptive behavior and factors associated with patient safety climate in the nurse-physician relationship at the hospital level. Methods. A multicenter cross-sectional study was conducted with a sample of 370 nurses and physicians assigned to different public hospitals in the Murcia/Spain region, applying the adapted and validated Spanish version of the Nurse-Physician Relationship Scale: Impact of Disruptive Behavior on Patient Care. The analysis used proportions or means (standard deviation (SD)), univariate and multivariate linear regression models, and the chi-square test. Results. Disruptive behavior was more prevalent in the ICU (81.6%) and the emergency department (67.8%). Professionals indicate that fear of reprisals is the main barrier to the reporting system. Likewise, stress and frustration are more associated with disruptive behavior and influence the safety climate. Conclusion. Professionals indicate that disruptive behaviors can have a negative impact on clinical outcomes. Age and type of service were identified as the most relevant socio-occupational factors. Stress, frustration, and communication problems are the factors that most influence the safety climate. [ABSTRACT FROM AUTHOR]

The aim was to explore why registered nurses (RNs) in Sweden choose to quit their jobs in hospitals, also in relation to experienced patient safety. Previous research has shown that nurse turnover, especially in hospital settings, is a serious challenge for society and health care globally. Insufficient staffing of RNs is linked to poorer patient outcomes and a general patient safety at risk. It is, therefore, important to continually explore how nurses describe their reasons for quitting their jobs. The study was conducted using a qualitative descriptive design, based on 11 semistructured interviews with RNs. The analysis generated four categories describing the results: Feeling that the profession is not valued; Psychological and physical symptoms related to work; An insufficient and unsupportive organization; and Unsatisfying leadership and teamwork. Specifically, the RNs participating in this study described a range of reasons for quitting, where the feeling of not being valued and treated as a respected and autonomous profession was a common thread throughout the results. RNs experienced that, overall, the insufficient work conditions, also resulting in lower patient safety, ultimately led to their decision to quit. The findings highlight the crucial need for employers to develop working conditions for RNs, to make sure that the profession is valued according to professional standards and provide the potential for autonomous nursing practice. To reduce nurse turnover, and instead attract and retain nurses, leadership and management in nursing need to be adjusted to meet the demands of a modern academic profession. [ABSTRACT FROM AUTHOR]

Introduction. Rural nursing careers offer a multitude of benefits for individuals. Despite this, there continues to be a growing deficit in the number of nurses choosing to practice in rural areas. As the first 12–18 months of a nursing career are fundamental in shaping career location decisions, it is important to explore factors that influence early career nurses' employment decisions. Methods. A phenomenological study was undertaken to explore early career nurses' experiences during their first year of rural practice and describe how the nurses' experiences influenced their decision to remain in rural employment. Data were collected via semistructured interviews and underwent inductive thematic analysis. Results. Seven early career nurses practicing in rural locations were interviewed and described several influences on their career location decisions, particularly related to whether they would stay in or leave their rural employer. The themes derived from the nurses' stories included the effect of their vulnerability entering a new workplace, the importance of connection to person, place, and profession and the nuances of rural nursing rhythms. These had implications on their employment decisions. Conclusion. This research demonstrates the distinct form of nursing practice that occurs in rural areas which was experienced by the early career nurses as a breadth of skills, volume of presentations, and continuity of care. The nurses described the importance of establishing connections to person, place, and their profession. These connections can support nurses through a period of vulnerability entering a new workplace. [ABSTRACT FROM AUTHOR]

Aim. To analyze the literature on nursing administrative actions related to patient education to inform healthcare organizations for the development of patient education and identify the knowledge gaps for future research. Background. Patient education is a patient's right, yet numerous organizational factors can hinder the effective delivery of patient education. Nursing administrative actions can mediate these factors, but little is known about nursing administration in patient education. Evaluation. A systematic integrative review was conducted in October 2022 on five databases (CINAHL (Ebsco), PubMed, Web of Science, ABI/Inform, and Business Source Complete). No time limitations were set. Empirical research articles reporting nursing administrative actions related to educational actions as a main topic were screened and evaluated. The data analysis was based on a constant comparison method. Key Issues. There were 3,110 studies identified, of which five quantitative and four qualitative studies were included. Three main themes were generated from the data describing nursing administrative actions related to patient education: (1) strengthen the commitment to patient education, (2) ensure the necessary resources for patient education, and (3) enhance patient education policies. Conclusion. This review provides insights into nursing administration in patient education, focusing on commitment, resources, and policies. It not only highlights the critical role of nurse administrators but also calls for further research to assess the impact of these actions. Implications for Nursing Management. The findings of this review will be useful for nurse administrators by providing knowledge about nursing administrative actions in patient education and underlining the need for them to pay more attention to it. The implications for nursing management also include supporting further research in the field. [ABSTRACT FROM AUTHOR]

Aims. This study was designed to investigate the impact of inclusive leadership on challenge-oriented citizenship behaviors and examine the mediating role of organizational justice on the relationship between inclusive leadership and challenge-oriented citizenship behaviors among nurses. Background. Leaders exhibiting an inclusive leadership style have the potential to create a positive work climate and motivate members of the organization. However, the mechanisms by which organizational justice contributes to this process remain to be explored, particularly in terms of how it motivates challenge-oriented organizational citizenship behaviors. Method. A cross-sectional questionnaire survey was conducted among nurses in China at the end period of the COVID-19 pandemic. A total of 527 registered nurses were enrolled and completed the self-report questionnaires including inclusive leadership scale, organizational justice scale, and challenge-oriented citizenship behavior scale. The hypotheses were tested using hierarchical multiple regression analyses and structural equation modelling. Results. The results of empirical tests revealed that nurse leader's inclusive leadership had a positive relationship on nurses' challenge-oriented organizational citizenship behaviors (β = 0.823, p < 0.001) after controlling several demographic covariates. Meanwhile, inclusive leadership was positively linked to organizational justice (β = 0.747, p < 0.001), and the indirect effect of inclusive leadership on nurses' challenge-oriented citizenship behaviors through organizational justice was statistically significant (β = 0.641, p < 0.001). Furthermore, the model fit indices were χ2/df = 1.952, RMSEA = 0.043, CFI = 0.979, and TLI = 0.977, indicating that the model had high quality. Conclusion. This study could help nurse leaders with inclusive leadership style have a better understanding and taking the advantages of the influence mechanism of organizational justice in inspiring nurses' challenge-oriented citizenship behaviors. While nurse managers can inspire challenge-oriented organizational citizenship behaviors through inclusive leadership, they should also emphasize the evaluative and behavioral-shaping effects of organizational justice. Both leadership and organizational justice are essential to motivate challenge-oriented organizational citizenship behaviors and to foster organizational development. Moreover, managers should focus on the process and conditions of implementing organizational justice to ensure fairness within the organization and to create a conducive environment for challenge-oriented organizational citizenship behaviors. [ABSTRACT FROM AUTHOR]

Aim. This research study aims to examine the professional quality of life (ProQOL) among healthcare workers (HCWs) in Pakistan during the fourth wave of COVID-19. Background. Under intense pressure to fight the coronavirus disease 2019 (COVID-19) pandemic, HCWs are more likely to experience psychological problems. Numerous investigations carried out in the past at various points during the pandemic have shown that COVID-19 has had important detrimental effects on HCWs. However, there are many unknowns with regard to ProQOL for HCWs. Methods. This is a cross-sectional study conducted with Pakistani HCWs who performed their duties during the fourth wave of COVID-19. Data were collected between January 1 and March 31, 2022. A total of 258 HCWs took part in the study evaluating ProQOL. The significance level was <0.05. Results. Most respondents were males (79.1%), and 20.9% were females. The scores of secondary traumatic stress (STS), burnout (BO), and compassion satisfaction (CS) were 24.03 ± 3.79, 19.18 ± 2.92, and 35.29 ± 4.37, respectively. Compared with higher-income groups, HCWs with lower incomes were significantly (P < 0.001) more likely to experience psychological issues. Males had lower BO and STS than female HCWs (P < 0.001). Similarly, doctors had a lower STS than nurses (P < 0.05). HCWs who worked hours per day longer had a heavier STS (P < 0.001). Conclusion. This study shows low BO levels, moderate CS levels, and STS levels among HCWs. HCWs with lower salary were at a higher risk of mental distress due to the pandemic. HCWs who worked for long hours and had less income had more STS and BO. HCWs who were dissatisfied with their works had poor CS. Implications for Nursing Management. It is supposed that these results may help HCW managers to improve job satisfaction and rewards while reducing working hours and workload to improve the ProQOL of HCWs fighting COVID-19. The government should focus on the mental health of HCWs, enhancing their satisfaction and allocating sufficient resources. [ABSTRACT FROM AUTHOR]

Background. Being a nurse or physician in today's complex healthcare practice involves more than just responsibility for one aspect of care during one episode in a patient's care trajectory. Both professionals are expected to take on a clinical leadership role and contribute positively to the reduction of care fragmentation and help in spanning professional boundaries. Although nurses may be well placed to identify the needs for integration, they may lack the position and status (compared to physicians) to address those needs as leaders. The aim of this study is to analyse similarities and differences between nurses and physicians in clinical leadership roles within a hospital context and explore how this relates to their interdisciplinary collaborative behaviours and perception on their job. Method. A cross-sectional survey among physicians and nurses was conducted to measure clinical leadership, job satisfaction, workload, and interdisciplinary collaborative behaviours. Results. Our results suggest that nurses (n = 329) and physicians (n = 100) show similar clinical leadership behaviours, based on equivalent scores on the clinical leadership scale. However, physicians score higher on the global leadership scale indicating they are more likely to perceive themselves as leaders than nurses. As clinical leaders, both nurses and physicians are more likely to express interdisciplinary collaborative behaviours. Furthermore, physicians who scored higher on the clinical leadership scale reported higher satisfaction with their job, whereas, for nurses, their score on the clinical leadership scale did not relate to their job satisfaction. Conclusion. As nurses in hospitals have the most frequent and direct involvement with patients, it seems inevitable for them to act as clinical leaders to promote patient-centred care. However, nurses less often perceived themselves as clinical leaders while showing suitable behaviours. Future studies should focus on the strategies nurses use to exert their clinical leadership, and for example, if nurses require the use of more dominant strategies to effect change. [ABSTRACT FROM AUTHOR]

Aim. To explore the perception of executive nurse leaders regarding the implementation of advanced practice nursing in Saudi Arabia. Design. An exploratory, descriptive, and qualitative design was used. Methods. Purposive sampling was used to recruit chief nurse officers and executive nurse directors from government, private, and military health systems in tertiary, secondary, and primary settings. Data were collected from July to November 2022 using virtual semistructured interviews, which were recorded and transcribed. Thematic analysis was conducted manually. Results. Eleven participants were included in the study. The following themes were identified: unique characteristics of advanced practice nursing, impacts of advanced practice nursing in nursing profession, challenges to utilize the advanced practice nursing roles, opportunities to foster the proper implementation of advanced practice nursing, and recommendations to move forward with fitting advanced practice nursing in Saudi health system. Participants characterized advanced practice nursing as specialized, advanced, and autonomous and reported that it increases access to care, provides efficient and cost-effective care, and expands nursing career pathways. The lack of job description, fragmentation of implementation efforts, lack of training programs, and resistance from physicians, nurses, and patients hinder its implementation. The Saudi Vision 2030, gaps in health care, the growing population, and the familiarity of the healthcare system with advanced practice nursing were viewed as opportunities. The following subthemes emerged under recommendations: establish, train, and implement. Conclusion. Executive nurse leaders perceived advanced practice nursing as a promising initiative to improve healthcare delivery and the nursing profession. Several opportunities make "now" the right time to implement it. [ABSTRACT FROM AUTHOR]

Aim. To bring insights into how healthcare managers and staffing assistants work to achieve sustainable working hours within a participatory scheduling system. Background. Hospital nurses and assistant nurses often work on rotating shifts, which affects their opportunities for sleep, recovery, and work-life balance. In Sweden, a participatory scheduling approach is commonly used, where working hours are planned in collaboration between employees, managers, and staffing assistants. Influence over working hours is related to positive outcomes among shift workers. However, it also places responsibility on the employee to schedule working hours that promote health and patient safety, i.e., sustainable working hours. Accordingly, the organisation has responsibilities to support the employee in this regard. Methods. Semistructured individual interviews were conducted with 11 managers and 9 staffing assistants from four Swedish regions and analysed using thematic analysis. Results. Several key factors for achieving sustainable working hours within the context of participatory scheduling were described: distribution and clarity of responsibilities, allocating time for scheduling, establishing shared responsibility, considering fairness, fostering an individual relationship with the employee, managing dissatisfaction, providing support, clarifying guidelines for sustainable scheduling, managing inconsistencies between employee requests and sustainable working hours, and considering recovery opportunities and the competence mix on shifts. Additionally, contextual factors, such as staffing levels, working procedures, working time arrangements for night work, and technological support, were highlighted as important. Conclusion. Achieving sustainable working hours within participatory scheduling involves considering the interactions between factors at the levels of the organisation, the individual, and the technological systems. Implication for Nursing Management. Nurse managers and staffing assistants must work closely with their employees during participatory scheduling to ensure sustainable working hours. Key goals in this regard include establishing a shared responsibility, clarifying responsibilities and guidelines for sustainable scheduling, and allocating time for the scheduling process. [ABSTRACT FROM AUTHOR]