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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 This paper critically reviews the literature on international collaboration and analyses the collaborative process involved in producing a nursing workforce policy analysis. Background Collaboration is increasingly promoted as a means of solving shared problems and achieving common goals; however, collaboration creates its own opportunities and challenges. Evidence about the collaboration process, its outcomes and critical success factors is lacking. Methods A literature review and content analysis of data collected from six participants (from five European countries) members of the European Academy of Nursing Science Scholar Collaborative Workforce Workgroup, using a SWOT ( Strengths, Weaknesses, Opportunities and Threats) analysis template. Results Two major factors affecting scholarly collaboration were identified: Facilitators, which incorporated personal attributes and enabling contexts/mechanisms, including individual commitment, responsibility and teamwork, facilitative supportive structures and processes. The second, Barriers, incorporated unmet needs for funding; time; communication and impeding contexts/mechanisms, including workload and insufficient support/mentorship. Conclusions The literature review identified a low level of evidence on collaboration processes, outcomes, opportunities and challenges. The SWOT analysis identified critical success factors, planning strategies and resources of effective international collaboration. Implications for Nursing Management Collaboration is an important concept for management. Evidence-based knowledge of the critical success factors facilitating and impeding collaboration could help managers make collaboration more effective. [ABSTRACT FROM AUTHOR]

Aim: To assess the perception of the nursing profession in Armenia from the perspective of multiple stakeholders, including nurses and the general public. Background: Nurses' role perception is a complex phenomenon defined by multiple stakeholders. Methods: The assessment used a convergent parallel mixed‐methods design, with a dominant qualitative status. We conducted the qualitative phase through focus group discussions and in‐depth interviews with 235 people and collected quantitative data in a cross‐sectional telephone survey with 389 participants. Results: The nursing profession has been influenced by medical hierarchy and subordination, and none of the participants recognized nursing as an autonomous health care profession. The quantitative survey findings were largely consistent with the qualitative results. Our findings highlighted empathy and compassion as inherent qualities of nurses in Armenia. Conclusion: To change opinions about the nursing profession and highlight nurses' meaningful contribution to the provision of health care services, it is important to develop a national definition of nursing and introduce higher educational opportunities for nurses in Armenia. Implications for nursing management: The paper highlights the importance of quality education for preparing highly competent nurse managers who can become role models in promoting nurses' roles in health care systems and improving the professional and public image of nursing. [ABSTRACT FROM AUTHOR]

Aim To explore the regulation of advanced nurse practice internationally and to identify differences and commonalities. Background Regulation of advanced practice nursing does not occur in many countries. Ireland is currently in the minority in regulating advanced practice at a national level. Key issues Lack of regulation poses difficulties for national governments and for society due to uncertainty in advanced practice concept and role. Methods A literature review of 510 scholarly nursing papers published in CINAHL, PubMed and MEDLINE between 2002 and 2013 and 30 websites was undertaken. Results There is a lack of consistency in legislative systems internationally. Nursing organisations have recognised advanced nurse practice by regulation in some countries and by voluntary certification in others. Conclusions Research has demonstrated that care delivered by advanced nurse practitioners has enhanced patient outcomes yet regulation of advanced practice is not undertaken in most countries. Implications for nurse manager Nurse managers need to know that criteria for the regulation of advanced practice are in place and reflect the minimum requirements for safe practice. [ABSTRACT FROM AUTHOR]

Aim This paper reviews the Productive Ward: Releasing Time to Care™ literature, identifying and discussing the key characteristics that may contribute to successful implementation. Background It is 5 years since the official UK launch of the Productive Ward, and the Republic of Ireland commenced a phased, national implementation programme in 2011. Thus it is timely to reflect on the implementation lessons learned to date and described in the literature. Evaluation Using taxonomic mapping, this paper evaluates the current state of the literature that pertains to Productive Ward implementation experience; success factors; reports, and assessments. Key issues Seven common contextual characteristics were identified: robust and engaging communication; enabling and empowering roles; appropriate training; project planning and management; leadership; corporate/management engagement and support; and financial and human resource commitment. Conclusion The key characteristics identified have a direct impact on the implementation of the Productive Ward. The interplay between these key characteristics and how this interplay influences successful implementation of the Productive Ward warrants further research. Implications for nursing management Acknowledging and embracing the seven characteristics during implementation will positively improve the progress and success of the initiatives implementation. [ABSTRACT FROM AUTHOR]

Introduction. Little is known about how shifting hospital visitor restrictions issued by national health authorities were communicated, managed, and adapted by hospital charge nurses during the COVID-19 pandemic. Aims. To describe the shifting visitor restrictions and the passing on of restrictions from the national authority level to charge nurses and secondly describe charge nurses' management of the restrictions and their challenges when enforcing them. Methods. The study consisted of a document analysis and a cross-sectional survey including open-ended questions. Descriptive statistics and qualitative content analysis were used. The survey was distributed online to 88 charge nurses in somatic units in a Danish university hospital from March 2020 to April 2021. Results. Restrictions were communicated from national authority level in an effective administrative cascade. The charge nurses led their enforcement in each unit. In total, 71 charge nurses (81%) responded to the survey. For 70%, the wording of the restrictions was clear, while 31% found them challenging to handle. On a weekly or daily basis, 68% of the charge nurses deviated from the restrictions. They identified both upsides and downsides to the absence of relatives. Communication, collaboration, and leadership were experienced as key tools in the ongoing processes of adapting to shifting restrictions. Conclusion. During this severe health crisis, essential information was passed on through well-defined management levels in an effective communication pathway. Charge nurses and their professional values were challenged when balancing shifting national restrictions against individual needs of patients and relatives. Implications for Nursing Management. Charge nurses serve as vital intermediaries between national authorities and frontline nursing practice in managing shifting visitor restrictions during a pandemic. Their experiences can contribute to further qualifying nurse managers' considerations when designing family-centred hospital visitor policies for the future. Also, they may strengthen the handling of future sudden major organizational changes. [ABSTRACT FROM AUTHOR]

The recruitment and retention of in-patient psychiatric mental health registered nurses (PMH-RNs) remains a challenge. This qualitative study sought to identify factors impacting the recruitment and retention of PMH-RNs in acute-care settings. Participants (N = 15) were recruited for focus groups including one with in-patient unit administrators (n = 4), two with current PMH-RNs (n = 7), and two with nursing students (n = 4). Data were analyzed using a directed content analysis approach. Participants were informed about the study's purpose, procedures, potential risks, and benefits, and they provided verbal consent before participating. Administrators emphasized a focus on retention and described a variety of supports they provided PMH-RNs, including formal and informal support and education. PMH-RNs' most prevalent concerns were their safety, co-worker and/or management challenges, and emotional and/or physical exhaustion. Students also expressed concerns about safety in psychiatric settings and desired more interaction with PMH-RNs. They were also interested in learning more about the specialty as they valued the opportunity to see change in patients. All three groups mentioned a need for more interaction between students and PMH-RNs, while safety concerns were expressed by both PMH-RNs and students. Because PMH-RNs play a critical role for in-patient psychiatric care, recruiting and retaining specialist nurses can focus on increasing student engagement with the PMH-RNs, attending to PMH-RNs' management and staffing concerns, and providing additional resources for responding to events that threaten safety in the workplace to prevent burnout. [ABSTRACT FROM AUTHOR]

Aim The purpose of the paper was to compare the prevalence of barriers to optimum postoperative pain management in elderly patients, observed by nurses in a clinical, provincial and municipal hospital in Poland. Background It is currently estimated that the lack of adequate pain management affects 80% of the global population and the phenomenon poses a serious problem in more than 150 countries. Methods A questionnaire-based study of 1602 nurses working at clinical, provincial and municipal hospitals. Results In the clinical hospitals barriers more often related to a poorly organised systems of care and obstacles in discussing pain management within the team. In provincial and municipal hospitals lack of uninform pain measurement was more evident. Conclusions Despite the availability of effective pain treatments in hospitals difficulties continue with communication, poorly organised care and limited access to clinical guidelines. Implications for nursing management Although there are possibilities of pain relief after surgery, they are still used insufficiently. Postoperative pain management in Poland needs considerable improvement. This study can contribute to the improvement of pain management quality by supporting and developing practical guidelines or management algorithms for nurses, facilitating the effective implementation of new pain management practices. [ABSTRACT FROM AUTHOR]

Introduction. During the COVID-19 pandemic, there was a need to promote the most adequate behaviors. It is essential to know what aspects were implemented and what needs to be re-enforced. Objectives. (a) To identify the knowledge and behaviors related with preventive measures, lifestyle habits, sources of information, vaccination, and emotions generated and coping strategies and (b) to explore the personal experiences with respect to the knowledge, attitudes, and practices when facing COVID-19. Design. A convergent mixed method design. Setting and Participants. This study was conducted in the Segrià region (Catalonia, Spain) during the months of January and February 2022, with individuals 18 years old or older. Methods. Based on variables proposed by the WHO and a bibliographic review, an ad hoc electronic survey was utilized for the quantitative part, analyzed through frequency distribution or central tendency and dispersion measurements. For the qualitative part, two focus groups were analyzed through content analysis. Results. The participants (n QUAN = 1,559; n QUAL = 19) were aware about and applied the prevention measures, but when delving into it, deficiencies were detected especially when referring to hand-washing; lifestyles remained healthy; the population trusted the information from professionals (78.8%), but excess of information led to saturation; protection (75.3%) and herd immunity (47.2%) were recognized with vaccination; and the psychological impact (69.5%) was buffered with the activation of positive coping measures (99.1%), although it was maintained in more than half of them. Conclusions. This study showed that prevention measures must be re-enforced, especially hand-washing. Another revealing aspect was psychological impact, which, although coping measures were utilized, was maintained for another two years in most of them. This evidences the need for an intervention centered on this to guarantee the mental health of the population. Implications for Nursing Management. The detection of the current needs of the population provides the information necessary for the design of an adapted intervention and for promoting health education programs to address COVID-19 or other future health situations. [ABSTRACT FROM AUTHOR]

Aim To describe the ethical activity profile of nurse managers ( NM). Background Ethical responsibilities require nurse managers to perform certain ethical activities. In this study, these activities are referred to as an ethical activity profile and are divided into five dimensions: (1) developing one's own ethics knowledge, (2) influencing ethical issues, (3) conducting or implementing ethics research, (4) identifying and (5) solving ethical problems. This paper focuses on the first four dimensions. Methods Survey data were collected in 2011 using a questionnaire (mainly open questions) amongst managers at the ward, middle and strategic levels ( n = 122). The data were analysed using inductive content analysis and quantification. Results The ethical activity profile of nurse managers was high, referring to the identification of various work-related ethical problems [related to staff (31%), the nurse managers themselves (29%), resources (17%), patients (12%), superiors (7%) and organisations (4%)]. However, developing one's own ethics knowledge, influencing ethical issues and conducting or implementing research dimensions of the ethical activity profile were low. Conclusions There is room to improve the ethical activity profile of nurse managers. Implications for nursing management Organisations have to demand that nurse managers meet all their ethical responsibilities and support this via organisational structures. [ABSTRACT FROM AUTHOR]

Aim This paper presents a study that explores how newly qualified registered nurses experience their leadership role in the ward-based nursing care team. Background A nurse's clinical leadership affects the quality of care provided. Newly qualified nurses experience difficulties during the transition period from student to qualified professional and find it challenging to lead nursing care. Methods Twelve nurses were interviewed and the transcribed texts analysed using qualitative content analysis to assess both manifest and latent content. Results Five themes were identified: feeling stranded; forming well-functioning teams; learning to lead; having the courage, strength, and desire to lead; and ensuring appropriate care. The findings indicate that many factors limit nurses' leadership but some circumstances are supportive. Conclusion The leadership prerequisites for newly registered nurses need to improve, emphasizing different ways to create a supportive atmosphere that promotes professional development and job satisfaction. Implications for nursing management To increase nurse retention and promote quality of care, nurse managers need to clarify expectations and guide and support newly qualified nurses in a planned way. [ABSTRACT FROM AUTHOR]

Aim. To evaluate the knowledge, attitudes, and practices of Chinese bedside nurses regarding antimicrobial stewardship, as well as to identify factors that influence nurses' engagement in antimicrobial stewardship. Background. Antimicrobial resistance is a pressing global health threat. Antimicrobial stewardship is crucial in combating this issue. Nurses play a key role in implementing antimicrobial stewardship. However, little is known about the involvement of Chinese nurses in antimicrobial stewardship. Methods. An explanatory sequential mixed-methods design was employed. A self-developed questionnaire was administered between March and August 2021 (N = 463), followed by semi-structured interviews with 17 nurses between March and July 2022. Descriptive statistics and qualitative content analysis were used to analyze the data. Results. The study found that nurses scored 75% in knowledge, 82.8% in attitude, and 84.1% in practice domains. There was a moderate correlation between nurses' knowledge, attitudes, and practices. It revealed that knowing local antimicrobial stewardship programmes information and the frequency of receiving antimicrobial stewardship training had a significant impact on nurses' knowledge scores. The willingness to participate in related training influenced nurses' attitude scores. Being a clinical teacher and the frequency of receiving related training influenced nurses' practice scores. The qualitative phase identified three themes: insufficient knowledge of nurses' engagement, diverse attitudes towards engagement, and limited scopes and absence of standards in nurses' participation. Conclusions. Our findings emphasize the importance of enhancing nurses' perception and involvement in antimicrobial stewardship. While nurses exhibit positive attitudes and practices, addressing the existing knowledge gap is crucial. To achieve this, it is necessary to clarify the role and responsibilities of nurses in antimicrobial stewardship, provide regular training and innovative methods, strengthen communication and collaboration, and foster a positive work environment. Additionally, actively promoting the development of guidelines and evaluation criteria will enable nurses to more effectively participate. Implications for Nursing Management. Regular training of nurses in antimicrobial stewardship needs to be enhanced. Nursing managers should strive to create positive, empowering, and supportive work environments, participate in policy formulation and implementation, and provide clear expectations for nurses' engagement in antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

There is a global nurse shortage, and researchers have made great efforts in trying to unveil the reasons for turnover and how to increase retention. However, such research has had a tendency to study variables related to intention to leave (ITL) or turnover as isolated phenomena. Objective. To simultaneously explore what factors motivate experienced nurses in the workplace and the underlying reasons for strong ITL and high staff turnover within the profession. Design. An inductive qualitative content analysis was used based on data from open-ended survey questions. The data originated from the longitudinal analyses of nursing education/employment/entry (LANE) in work-life study. The qualitative data analyzed in this study were distributed in October 2017–January 2018, to all nurses in three cohorts corresponding to 11-, 13- and 15-year postgraduation. Of the 2,474 nurses answering the survey, 1,146 (46%) responded to one or more of the open-ended questions. Results. The result showed that what motivates experienced nurses, their intention to leave (ITL), and reasons for turnover could be described in the form of five broad categories, namely, organizational characteristics, work characteristics, relationships at work, work recognition, and health issues. There was rarely a one single reason described, rather several reasons needed to be experienced over time for nurses to stay motivated or leave the profession. Conclusions. There is no single reason that makes nurses leave the profession, nor is there one single reason that makes them motivated to stay. Retention and turnover are complex processes and need to be addressed as this, not as a single isolated phenomenon. [ABSTRACT FROM AUTHOR]

Aim(s) The aim of the present study was to analyse nurses' perceptions of the communication qualities that are essential for nurse managers to carry out their jobs effectively. Background An examination of effective communication may help to identify nurse manager behaviours that promote dignity and respect. Method(s) A paper-and-pencil survey collected open-ended data from 1526 nursing professionals ( RNs) representing 22 hospitals in Oman. Qualitative content analysis was conducted first, followed by a quantitative descriptive analysis. Results The participants reported frustration with nurse managers who seemed overly focused on mistakes. Many participants felt there was little to no appreciation for tasks that were well done. Nurses also disliked being disciplined openly in front of colleagues or patients. Conclusion(s) The participants stressed that nurse manager feedback should be shared privately and framed in a positive and constructive tone. Active listening, team collaboration and the avoidance of discrimination/favouritism were also emphasised. Implications for nursing management A supportive and communicative work environment promotes nurses' dignity and respect. Embarrassing nurses in front of other health care professionals may be counterproductive. Instead, the study results suggested privately discussing concerns in a positive, constructive tone is more likely to foster nurse trust and dignity. [ABSTRACT FROM AUTHOR]

Aim The purpose of this paper is to qualitatively explore registered nurse perceptions of off-shift (e.g. nights and weekends) nursing care and quality compared with regular hours. Background Patients admitted to hospitals on off-shifts have worse outcomes than patients admitted on more regular hours. The underlying mechanism for this association is not well understood. Methods In-depth semi-structured interviews of 23 registered nurses and four observer-as-participant observations were conducted on both medical-surgical and intensive care units in two large (>850 beds) tertiary hospitals. Content analysis was used to identify themes. Results Six themes emerged: (1) collaboration among self-reliant night nurses; (2) completing tasks; (3) taking a breather on weekend day shift; (4) new nurse requirement to work at night; (5) mixture of registered nurse personnel; and (6) night nurse perception of under-appreciation. Conclusions Although nurses collaborate, complete more tasks and work with other types of registered nurses, the decreased resources available on off-shifts may affect quality care delivered in hospitals. Implications for nursing management These findings support the importance of management to provide sufficient resources in terms of ancillary personnel and balance less experienced staff. Facilitating communication between night and day nurses may help allay night nurses' feelings of under-appreciation. [ABSTRACT FROM AUTHOR]

Aim. The aim of this article is to report the process and outcomes of codesigning a nursing leadership program for fundamental care. The leadership program is designed to empower nursing leaders, across research, education, clinical practice, and policy, to challenge and change how fundamental care is valued, prioritised, and actioned within health and care systems. Background. Deficits in fundamental care represent an intractable problem adversely impacting care recipients, care providers, and health and care systems globally. These deficits stem from the minimal value placed on fundamental care and its subsequent invisibility across research, education, clinical practice, and policy. Sustainable systems change requires effective nursing leadership; however, existing nursing leadership programs tend to address only one area of health and care systems, typically clinical practice, and do not focus specifically on fundamental care. Methods. The Fundamentals of Care Leadership Program was codesigned with current and emerging nursing leaders using a participatory action research approach. The collaborative codesign process involved two stages: (1) idea generation and preliminary program development via Nominal Group Technique (n = 60 participants from 11 countries) and (2) refinement and trialling of program content and process via a three-day workshop (n = 19 participants from 9 countries). Results. Participants prioritised a program that provided clear understanding of the concept of fundamental care, enabled the development of influencing and negotiating skills to advocate for this care, and offered resources on knowledge translation, implementation, and measurement strategies. Participants also wanted allotted time to design research and quality improvement projects that would allow them to transfer the skills learned to the real-world issues occurring within their respective organisations. Conclusions. The codesign process, embedded within a participatory action approach, enabled the development of a Fundamentals of Care Leadership Program that is shaped by, and meets the needs of, current and emerging nursing leaders. The leadership program will enable nursing leaders to challenge value systems on fundamental care and to champion this care across research, education, clinical practice, and policy, working towards enhanced fundamental care outcomes and experiences. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to examine the opinions of nurses working in surgical wards on recycling and medical waste management. Background: Surgical services and operating rooms are the most waste‐generating parts of health institutions. The primary purpose of waste management is to ensure waste minimization and increase recycling. Method: In this qualitative study, in‐depth interviews were conducted with 15 nurses. The data were analysed by the content analysis method. The COREQ checklist was used in the study. Results: As a result of the study, four main themes were determined: Barriers in medical waste and recycling management, solution suggestions in medical waste and recycling management, waste of medical and consumable materials and the effect of the pandemic process on medical waste and recycling management. Conclusion: Medical waste and recycling management was interrupted due to lack of education, emergencies, hiring of untrained personnel and workload. During the pandemic, medical waste increased, and it could not be recycled. The solution suggestions are training at frequent intervals, monitoring by the responsible nurses and imposing sanctions on those who do not comply. Implications for Nursing Management: Knowing nurses' obstacles in managing medical waste and recycling and putting forward solutions in this regard affects sustainability. Knowing the obstacles to the management of medical waste and recycling by nurses could help in solutions. [ABSTRACT FROM AUTHOR]

Aim: To examine the need for information and communication technology (ICT)‐based nursing care in improving patient management during the pandemic. Background: Maintaining traditional approaches to nursing in the ongoing coronavirus disease (COVID‐19) pandemic predisposes health care systems to a risk of diminished quality of care. Using ICT (real‐time videoconferencing, mobile robots and artificial intelligence) could reduce burnout and infection risks by minimizing face‐to‐face contact. Method: Qualitative descriptive design with content analysis. Results: Overall, 24 participants (14 nurses, six medical/nursing informatics experts and four technology experts) were interviewed. Three main themes were extracted: emerging challenges for nurses due to COVID‐19, impact of new technology on patient and nurse experiences and concerns with implementation of technology. Conclusion: A significant portion of nurses' work was unrelated to professional nursing, causing burnout. ICT could help reduce nurses' burden by facilitating environmental management and non‐contact communication and providing emotional support for patients. Implications for Nursing Management: Establishing an ICT‐based nursing care system that considers the physical environment and communication infrastructure of health care institutions, user's digital health literacy and user safety to effectively manage non‐nursing care‐related activities and undertake tasks that can be delegated may improve the quality of care for quarantined patients and reduce risk of cross‐infection. [ABSTRACT FROM AUTHOR]

Aims: This study aim to capture the most comprehensive evidence‐based dimensions of maternal health literacy, including summarizing the definitions, theoretical frameworks, measuring instruments, and the association between maternal health literacy and health behaviours. Background: Maternal health literacy has been recognized as an important approach to achieving high‐quality maternal and child health; however, little is known about maternal health literacy comprehensively and scientifically. Evaluation: An integrative review retrieved articles from 11 databases, following the methodology of Whittemore and Knafl. Inductive content analysis and narrative synthesis were conducted, guided by the aim of this review. Key issues: A total of 5580 articles were retrieved and 23 articles were finally identified. Existing definitions and theoretical frameworks took less consideration of maternal applicability and failed to summarize maternal health literacy from a dynamic and systematic perspective. Measurement instruments were set up with many items that make it difficult to quickly screen for poor maternal health literacy. Most articles proved the association between maternal health literacy and health behaviours through correlation analysis or regression analysis but less explored the influence pathways between them. Conclusion: The definition and theoretical framework need to focus on maternal applicability and explain the process of individual mothers acquiring and understanding health knowledge and skills from a dynamic and systematic perspective. A rapid instrument for maternal health literacy should be developed and high‐quality empirical research was conducted to understand the associated mechanisms between maternal health literacy and health behaviours. Implications for Nursing Management: It is necessary to strengthen maternal and child health education of primary health care nurses and enhance their ability to help perinatal women use maternal and child health information effectively. [ABSTRACT FROM AUTHOR]

Aim: To describe nurse leaders' and digital service developers' perceptions of the future role of artificial intelligence (AI) in specialized medical care. Background: Use of AI has rapidly increased in health care. However, nurse leaders' and developers' perceptions of AI and its future in specialized medical care remain under‐researched. Method: Descriptive qualitative methodology was applied. Data were collected through six focus groups, and interviews with nurse leaders (n = 20) and digital service developers (n = 10) conducted remotely in 2021 at a university hospital in Finland. The data were subjected to inductive content analysis. Results: The data yielded 25 sub‐categories, 10 categories and three main categories of participants' perceptions. The main categories were designated AI transforming: work, care and services and organizations. Conclusions: According to our respondents, AI will have a significant future role in specialized medical care, but it will likely reinforce, rather than replace, clinicians or traditional care. They also believe that it may have several positive consequences for clinicians' and leaders' work as well as for organizations and patients. Implications for nursing management: Nurse leaders should be familiar with the potential of AI, but also aware of risks. Such leaders may provide betters support for development of AI‐based health services that improve clinicians' workflows. [ABSTRACT FROM AUTHOR]

Aim: We aim to explore the status of nurses' ethical behaviours in clinical practice and what contributes to nurses' unethical behaviours. Background: Nurses' ethical behaviours strongly impact the nurse–patient relationship and the quality of nursing services. Therefore, we must understand the status of clinical nurses' ethical behaviours and the causes of nurses' unethical behaviours. Methods: Focus group and in‐depth semistructured interviews were conducted with 21 head nurses and nine nurses, respectively. The data were analysed by content analysis. Results: The analysis revealed seven themes: lack of awareness of the protection of patients' privacy; violation of patients' autonomy; improper communication; failure to protect the patient's best interests; lack of moral emotion; lack of psychological care for special patients; and causes of unethical behaviour. Conclusions: The present situation of ethical nursing behaviour is not optimistic, and there are still many unethical nursing behaviours in clinical work. There are many reasons for unethical behaviours. Efforts should be made related to nurses, patients, workload, the ethical climate and rules and regulations to improve the situation. Implications for Nursing Management: Nursing managers can improve ethical behaviour by strengthening nurses' ethics studies, enhancing nurses' professional identity and social status, optimizing the allocation of nursing human resources, creating a good ethical climate and improving relevant rules and regulations. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate reasons for unfinished nursing care across the whole levels of the nursing service as perceived by clinical nurses, ward managers and executive nurses. Background: Even though unfinished nursing care has been considered an issue affected by the system, no studies to date have attempted to investigate reasons across the whole levels of the nursing service by involving clinical nurses, ward managers and executive nurses. Method: A descriptive qualitative approach was performed in 2021 according to the COnsolidated criteria for REporting Qualitative research guidelines. A large public health care trust was approached, and a purposeful sample of clinical nurses, ward managers and executive nurses was invited to attend face‐to‐face or online interviews. Twenty‐nine interviews were performed (19 clinical nurses, 7 ward managers and 3 executive nurses) and transcribed verbatim. Then, a content analysis was conducted by considering all narratives together followed by an analytic process to identify themes and subthemes at the clinical, ward manager and executive levels. Results: Reasons for unfinished nursing care have emerged at five levels: system (e.g., poor support towards nursing care), unit (e.g., ineffective models of nursing care delivery), nurse managers (e.g., inadequate nurse manager leadership), nurses (e.g., weaknesses in education) and patients (e.g., increased demand for patients' care). Conclusion: The evidence available should be expanded to include also unfinished nursing care reasons identified at the system and at the ward manager levels, that both can complete the perceptions of the clinical nurses. Implications for Nursing Management: The actors composing the nursing service perceive different reasons and therefore should be involved in detecting and contrasting the unfinished nursing care. The reasons applied or established at the upper level influence the bedside levels: Therefore, strategies to prevent or minimize the unfinished nursing care should be designed at multi‐levels in a system‐inclusive approach. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to reveal the opinions and experiences of male and female nurses concerning the nursing work environment in hospitals. Background: The quality of the nursing work environment greatly impacts the improvement of the patient, nurse and organizational outcomes. Therefore, a better understanding of the experiences of male and female nurses can contribute to the creation of a more positive work environment. Methods: In this descriptive qualitative study, data were collected with semi‐structured interviews conducted in 2020 with 18 nurses who were recruited via purposive and maximum variation sampling. Data was analysed with content analysis. Results: The content analysis revealed two major themes (the effects of gender on workplace practices and the image of nursing and gendered communication in the nursing work environment) and eight subthemes. Conclusion: This study concluded that male and female nurses experience advantages/disadvantages and similarities/differences in the nursing work environment and that both male and female nurses experience challenges regarding workplace relations and the work environment. Implications for Nursing Management: A better understanding of the problems associated with the different experiences of male and female nurses in the workplace may help nurse managers to create a more positive work environment. [ABSTRACT FROM AUTHOR]

Aim: This study aims to explore how nursing services were managed and provided in intensive care units during the COVID‐19 pandemic and clarify the management lessons learned. Background: The surge in the number of patients with COVID‐19 worldwide and the unpredictability of new variants mean the voices of nurse managers who participated in fighting the pandemic in intensive care units must be considered. Health care systems need specific plans to face similar future crises. Method: This is a descriptive, qualitative, narrative study using indirect content analysis. Results: We analysed 37 intensive care unit nurse managers' reflections on lessons learned from the COVID‐19 pandemic. Four themes were extracted: restructuring organisations' resources, issues with family‐centred care, education and training and policy reforms. Conclusions: Promising strategies for Emirati intensive care units in planning for responses to future crises include maximizing organisation resources, boosting family‐centred care, providing in‐service training for nurses and policy reform. Implications for Nursing Management: Our findings will support health care leaders, educators, policymakers and researchers to improve the management of similar pandemic situations. This study presents fundamental data concerning the subjective experiences of intensive care unit nurse managers. These experiences may inform development of multi‐dimensional strategies including: ensuring the adequacy of projected supplies, space and nursing workforce; establishing communication protocols; and reforming existing policies. [ABSTRACT FROM AUTHOR]

Aim: To describe the experiences of nurses regarding strategies to prevent missed nursing care. Background: One of the global challenges is missed nursing care, which includes missed or delayed care. This problem puts patients' clinical outcome at risk, so understanding nurses' experiences of how to prevent or reduce it can help the health care policymakers. Method: In this qualitative descriptive study, 14 nurses were selected by purposive sampling. In‐depth semi‐structured interviews were conducted to collect data. The Graneheim and Lundman's approach of qualitative content analysis was used for data analysis. MAXQDA (version 10) software was used for data management. Results: The extracted codes were summarized into seven categories and one theme. The categories included "empowering nurses," "manpower supply," "supervision," "specializing the activities," "providing resources and facilities," "encouraging teamwork," and "resolving dissatisfaction." The main theme was "missed nursing care prevention strategies." Conclusion: The frequency of missed nursing care can be reduced or prevented using management strategies such as paying attention to nurses "empowerment, increasing nurses" job satisfaction, normalizing nurses' salaries, providing equipment and facilities, and monitoring nurses' performance. Experimental studies are recommended to evaluate the effectiveness of these strategies. Implications for nursing management: Nursing managers can take steps such as workplace improvement, reducing nurses' workload, and empowering nurses to reduce or eliminate missed care. [ABSTRACT FROM AUTHOR]

Aim: This study conducted a bibliometric analysis of nursing publications on the COVID‐19 between 1 January 2020, and 24 October 2021. Background: COVID‐19 has been a hot research topic that has attracted many researchers from various disciplines. One of the ways to combat the COVID‐19 pandemic is to produce knowledge and present it with a holistic approach. Therefore, it is crucial to make bibliometric and content analyses of scientific publications. Scientific data should be evaluated to keep up with the developments in the nursing profession and practices during the COVID‐19 pandemic. Methods: Data were collected from the Web of Science database. The sample consisted of 1280 publications that met the inclusion criteria. The data were analysed using descriptive content and bibliometric analysis. The VOSviewer, a mapping and visualization software program, was used for bibliometric analysis. Results: The United States is one of the countries with the highest number of publications, citations and international cooperation during the pandemic. Of all these publications, 1183 (92.42%) are original articles. The Journal of Nursing Management has the highest number of publications and citations. The publications focus primarily on the topics of COVID‐19, pandemic, nursing, coronavirus and nurses. The current topics that the publications address are online education, online learning, practice, nursing student, perceived stress, stress, fear, quality of life and experience to determine the impacts of the pandemic on mental health nursing education. Conclusions: The COVID‐19 pandemic has an impact on nursing, and the number of publications is increasing worldwide. In the early days of the pandemic, researchers focused on the topics of coronavirus infections, infection control, global health, health policy and nursing policy. Afterward, they addressed current topics, such as education and the psychological effects of the pandemic. Implications for nursing management: Our results will help nurse managers identify issues related to COVID‐19 that have not been researched yet and have not been adequately explained in their own institutions. They will also help them choose appropriate journals to get their studies published, appropriate countries to cooperate with and access information about the studies on the subject matter. Our results will also help them make evidence‐based decisions about mental health and nursing education. [ABSTRACT FROM AUTHOR]

Aim: To develop a leadership and management competency framework applicable to Chinese nurse champions guided by the competency matrix for clinical nurse leader (CNL). Background: As the clinical leaders and future nurse manager candidates in the Chinese clinical setting, nurse champions are in great need of leadership and management competency training, but it is unclear what content should be included in the training curriculum, a guiding framework applicable to Chinese nurse champions was needed to be constructed. Methods: This study used a qualitative descriptive design to explore nurse champions' competency requirements from clinical nurse managers' perspective. Semi‐structure interviews guided by the CNL competency matrix were conducted with 27 clinical nurse managers from six large‐scale tertiary grade A hospitals in Shanghai, China. Interview transcripts were analysed using deductive and inductive content analysis. Results: The data analysis yielded three main categories: nursing leadership, clinical outcome management and care environment management, containing 14 subordinate themes, which represent the leadership and management competencies needed for nurse champions. Conclusions: A leadership and management competency framework for Chinese nurse champion was built in this study, which covering the competencies needed by Chinese nurse champions to lead care teams, improve quality of care for patient outcomes and enhance systems and equipment for the better care environment. This framework will be the direct basis for guiding the development of the nurse leadership curriculum for driving nurse champion to achieve role success. Implications for nursing management: This framework provides a theoretical foundation for clarifying the role of nurse champion in clinical management. Training curriculum guided by this framework will help nurses in their clinical management role and share the burden of clinical nursing managers, as well as promote the development of a clinical nursing management reserve talents and support the future development of nursing staff in health care organisations. [ABSTRACT FROM AUTHOR]

Aim: The aims were to (1) describe nurses' attitudes towards their jobs, (2) identify factors that contribute to nurses' job attitudes and (3) examine how nurses' job attitudes affect their ability to perform their jobs. Background: Nurses' job attitudes affect their ability to do their jobs well. Methods: This was a qualitative descriptive study of 18 semi‐structured interviews with nurses who work in rural health facilities. Interviews were analysed using content analysis. Results: Factors that influenced job attitudes included support from co‐workers, workload, access to material resources, access to information, patient rapport and nurses' personal resilience. Nurses reported that positive attitudes helped them to do their jobs well and negative attitudes diminished their ability to do their jobs well. Conclusions: This study's findings support investment in factors to promote positive nurse attitudes and job performance such as a healthy work environment and self‐efficacy. Implications for Nursing Management: Nurse managers can improve nurses' attitudes by advocating for tangible supports for staff such as appropriate staffing ratios, sufficient equipment, necessary training and work environments that allow safe patient interactions. [ABSTRACT FROM AUTHOR]

suhonen m. & paasivaara l. (2011) Journal of Nursing Management 19, 1028-1036 Nurse managers' challenges in project management Aim To analyse the challenges that nurse managers meet in project management. Background Project management done by nurse managers has a significant role in the success of projects conducted in work units. Methods The data were collected by open interviews ( n = 14). The participants were nurse managers, nurses and public health nurses. Data analysis was carried out using qualitative content analysis. Results The three main challenges nurse managers faced in project management in health-care work units were: (1) apathetic organization and management, (2) paralysed work community and (3) cooperation between individuals being discouraged. Conclusions Nurse managers' challenges in project management can be viewed from the perspective of the following paradoxes: (1) keeping up projects-ensuring patient care, (2) enthusiastic management-effective management of daily work and (3) supporting the work of a multiprofessional team-leadership of individual employees. Implications for nursing management It is important for nurse managers to learn to relate these paradoxes to one another in a positive way. Further research is needed, focusing on nurse managers' ability to promote workplace spirituality, nurse managers' emotional intelligence and their enthusiasm in small projects. [ABSTRACT FROM AUTHOR]

Aim: To describe nurse managers' views of their work in the future. Background: Ongoing reformation of health care organisations includes profound changes to nurse managers' work practices. Method: A qualitative approach was applied to elicit views of nurse managers (n = 133) from eight Finnish specialized medical care hospitals through one open‐ended question about their future work in November 2019. The acquired data were subjected to inductive thematic content analysis. Results: Four themes were identified in the nurse managers' responses, indicating that they anticipated: 1) a shift from hierarchical leadership to shared governance, 2) an increasing focus on proactive and systematic work, 3) development of evidence‐based practices and 4) improvement in the attractiveness and effectiveness of the organisation. Conclusions: Nurse managers envisage their future work will follow the transformational leadership model. Shared governance and multidisciplinary team leading, with a stronger focus on proactive strategic planning will extend their power to influence decision‐making. Administrative supporting systems will free more time from their daily routine work for interactions with staff. Implications for Nursing Management: Clarification of the managers' job description along with administrative support systems is anticipated to strengthen leadership, facilitate management, enhance decision‐making and increase the attractiveness and effectiveness of both health care organisations and nurse managers' work. [ABSTRACT FROM AUTHOR]

Aim: To explore emergency nurses' perceptions of how a nurse‐driven patient needs assessment tool, the synergy tool, influenced their workload management. Background: Quadruple Aim, particularly the fourth aim of improved staff work experiences, served as the conceptual framework to engage nurses in a participatory action research project. This project took place between 2017 and 2020 in two tertiary care emergency departments in one large Canadian city. Method: This study employed a qualitative descriptive component, focus group interviews and nurse comments on two open‐ended survey questions. Results: Use of the synergy tool heightened nurses' awareness of patients' holistic care needs. Nurses also stated how patient needs assessment data helped them identify unsafe workloads. Conclusions: The synergy tool, adapted for emergency department use by nurses, was a means to engage and empower nurses. Patient needs assessment data from the tool identified staffing gaps, resulting in additional nursing staff for both emergency departments. Implications for Nursing Management: A focus on patient needs assessment can be an effective way to address nurses' workload concerns. [ABSTRACT FROM AUTHOR]

Aim: To compare the perceptions of nurses with infection control expertise and ward nurses as to what infection control activities are missed and the reasons why these activities are omitted. Background: Infection prevention activities are viewed as important for reducing health care‐acquired infections (HAIs) but are often poorly performed. Methods: Data were collected through the Missed Nursing Care Infection Prevention and Control (MNCIPC) Survey delivered to 500 Australian nurses prior to COVID‐19. Results: Significant differences were found on the mean scores between infection control and other nurses on ten items. In eight cases, five relating to hand hygiene, infection control specialists viewed the activity as more likely to be missed. Factors viewed as having greater contribution to omission of infection control prevention were as follows: 'Patients have to share bathrooms', 'Urgent patient situation' and 'Unexpected rise in patient volume and/or acuity on the ward/unit'. Infection control nurses were more likely to highlight the role of organisational and management factors in preventing effective infection control. Conclusions: Differences in response between nurses suggest that the extent of omission of infection control precautions may be under‐estimated by ward nurses. Implications for Nursing Management: Infection control specialists are more likely to identify organisational barriers to effective infection control than other nurses. Work demands arising from pandemic management may contribute to infection control precautions being missed. [ABSTRACT FROM AUTHOR]

Aim: To explore the challenges experienced by ICU nurses throughout the provision of care for COVID‐19 patients. Background: The intensive care unit nurses, who are at the frontline of fighting against COVID‐19 and defusing this crisis, are faced with various challenges throughout the provision of care for COVID‐19 patients. Methods: In this qualitative descriptive study, a total of 17 nurses working in intensive care units were selected using purposive sampling. Data were collected using semi‐structured face‐to‐face interviews. After recording and transcribing interviews, the concepts were extracted using the content analysis method. Findings: The nurses reported the four following challenges throughout the provision of care for COVID‐19 patients: 'organization's inefficiency in supporting nurses', 'physical exhaustion', 'living with uncertainty' and 'psychological burden of the disease'. Conclusion: The present study portrayed a clear understanding of the challenges faced by nurses working in intensive care units during the crisis of the COVID‐19 pandemic based on their lived experiences. Implications for Nursing Management: A profound understanding of these challenges in the current critical situation can help health care authorities adopt appropriate measures to resolve these challenges, provide health care facilities, support the health workforce, give accurate and evidence‐based information and perform psychological interventions on how to handle the current crisis. [ABSTRACT FROM AUTHOR]

Aims: To identify the determinants of the quality of nursing care from the perceptions of nursing personnel. Background: The quality of nursing care is often measured with standards, expectations, satisfaction and outcomes, but in developing countries, it relies mostly on negative indicators. Methods: A descriptive qualitative study was used. Semi‐structured interviews based on the critical incident technique were conducted with a convenience sample of 136 nursing personnel who told 225 stories. Results: Seven quality determinants of nursing care were identified as follows: standard of care, triage and assessment, emergency care, communication with the patient or family, communication with colleagues, multidisciplinary teamwork and helping colleagues. The most important one was the standard of care. Conclusion: Quality nursing care is based on the degree of excellence nursing personnel show with regard to their competences in technical care, communication and teamwork. A key attribute of quality nursing care is defined by the related standards, and the focus is mostly on the nursing care process. Implications for nursing management: These findings can increase awareness of the determinants of nursing quality and the qualities of the nursing personnel involved and can help managers to evaluate nursing practice, select new employees and organise teams. [ABSTRACT FROM AUTHOR]

Aim: To describe clinical nurses' experiences with practice change associated with participation in a multi‐site nursing translational research study implementing new protocols for hospital discharge readiness assessment. Background: Nurses' participation in translational research studies provides an opportunity to evaluate how implementation of new nursing interventions affects care processes within a local context. These insights can provide information that leads to successful adoption and sustainability of the intervention. Methods: Semi‐structured focus groups from 30 of 33 participating study hospitals lead by team nurse researchers. Results: Nurses reported improved and earlier awareness of patients' discharge needs, changes in discharge practices, greater patient/family involvement in discharge, synergy and enhanced discharge processes, and implementation challenges. Participating nurses related the benefits of participation in nursing research. Conclusion: Participation in a unit‐level translational research project was a successful strategy for engaging nurses in practice change to improve hospital discharge. Implications for Nursing Management: Leading unit‐based implementation of a structured discharge readiness assessment including nurse assessment and patient self‐assessment encourages earlier awareness of patients' discharge needs, improved patient assessment and greater patient/family involvement in discharge preparation. Integrating discharge readiness assessments into existing discharge care promotes communication between health team members that facilitates a timely, coordinated discharge. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences and perceptions of recent nursing graduates working in emergency departments during the COVID‐19 outbreak. Background: Overcrowding in emergency departments has been one of the most prominent issues arising in these units for more than 20 years. However, it has become even more problematic due to the novelty of the coronavirus pandemic, which has forced hospitals to recruit larger numbers of beginner nursing staff as the number of quarantined health professionals increases. Methods: Sixteen semi‐structured interviews were conducted in Spanish emergency departments, which were analysed and synthesized using content analysis. Results: Three major themes emerged from the data analysis: (a) Fears and concerns, (b) Organisational issues and (c) Support for novice nurses. Conclusions: Our findings may help to understand how shadowing periods as a learning programme for nurses, continuing professional development, evidence‐based apps and better planning are needed to ensure both novice nurses' confidence in emergency departments and expert emergency room nurses' ability to cope with complications in critical situations. Implications for Nursing Management: Training periods that include shadowing expert emergency room nurses, along with evidence‐based technology, provide an opportunity to support novice nurses' transition into the workplace. These measures would provide a safety net and would increase novice nurses' confidence as well as high‐quality care. [ABSTRACT FROM AUTHOR]

Aim: To investigate nurse leaders' experiences and strategies for turnover in relation to culture and work environment in hospital departments with low nurse turnover. Background: Nursing shortage is a global problem, and numerous turnover strategies have been utilized to attempt to address this shortage. Design/Methods: Four regional hospital departments with the lowest nurse turnover were included. Data were constructed with nine nurse leaders through individual interviews and were analysed using directed content analysis. Results: The findings presented in two categories, 'The culture is unique' and 'Maintaining, protecting or re‐establishing a unique culture', summarize how leaders navigated authentically in different contexts, operationalizing clear values and visions both for their departmental culture and in turnover strategies. Conclusion: Even though all the nurse leaders interviewed were concerned about the current recruitment situation, they were confident in their leadership roles, targeted towards supporting the unique culture in their departments. Implications for Nursing Management: Leaders with clear cultural awareness and visions for the context in which they operate may be positively associated with lower turnover of nurses. Including the perspectives of leaders from departments with low turnover of nurses has the potential to create new knowledge about improving nurse retention. [ABSTRACT FROM AUTHOR]

Aim: To examine the journey of safety initiatives from executive hospital management to ward. Background: Hospital management teams are often responsible for identifying safety priorities and ensuring delivery of these. Method: Naturalistic study design within a large NHS Hospital Trust. Using semi‐structured interviews, focus groups and secondary data analysis, the study examines the implementation of safety initiatives. Results: While hospital management developed five safety initiatives, only one of these (falls prevention) was actually seen to permeate all layers of the organisation. Other initiatives stopped one layer down. Both middle management and ward staff added to the list of initiatives developed, resulting in 16 priorities. A range of positive and negative influences to successful implementation are identified. Conclusions: Safety initiatives need positive reinforcement at all levels to be addressed appropriately. The research suggests that a model related to improvement science may prove useful in ensuring that priorities are addressed. Implications for nursing management: Care should be taken to ensure that safety initiatives are successfully implemented at all levels within an organisation. Identifying priorities with staff and sharing values and priorities are a key approach to leading such initiatives. [ABSTRACT FROM AUTHOR]

Aim: To elicit intensive care unit (ICU) nurses' recommendations to prevent nursing errors. Background: Errors are usually induced by faulty systems, and managers play a key role in building a safe health care system. Method: A qualitative research design was used. Semi‐structured interviews with 112 Egyptian ICU nurses were conducted, and responses were analysed using qualitative content analysis. Results: Responses from 108 nurses were analysed. Six themes of recommendations were identified: improvement and better organisation of resources, policy modification, education and training, likeness minimization, use of technology and work environment changes. Conclusion: Nurses' recommendations reflect the poor‐resource context in developing countries. Several recommendations, however, are relatively cheap to implement strategies. Implications for Nursing Management: All reported recommendations are organisational issues. Improvement and better organisation of human and non‐human resources is a priority issue to prevent or minimize nursing errors. Policy modification, education and training, and likeness minimization are relatively cheap, easy‐to‐implement strategies to tackle the occurrence of nursing errors in developing countries. Staff nurses should be actively involved in policy reform. Patient safety education should be supported by adopting modern technology and work environment reform. [ABSTRACT FROM AUTHOR]

Aim: This survey explored caregivers' perceived training needs in 5 European countries (United Kingdom, Greece, Bulgaria, Poland and Italy). Background: Training can enhance the professional capacity of caregivers; however, caregivers' training needs within Europe have not been examined recently. Methods: A survey conducted in 2015 captured data from 550 caregivers using a convenience sampling strategy, through a structured questionnaire and additional open‐ended items and by conducting statistical and content analysis. Results: The results indicated basic nursing skills and specialization, as well as training in psychology‐related skills like time management, emotion regulation, communication and advanced health care systems as the emerging training needs. There were some country differences in specific training need areas. Conclusions: It was concluded that training in basic nursing skills and specialization in nursing specific conditions, in advanced health care systems and in psychology‐related skills could add to the professional capacity of European caregivers employed in health and social care. Implications for nursing management: The findings inform about employed caregivers' training needs in Europe, which may contribute in the provision of quality care and organisational efficiency in health and social care. [ABSTRACT FROM AUTHOR]

Aim: Speaking up about medical errors is an essential behaviour for nurses in pursuit of their goal of maintaining patient safety. This study was designed to understand how a hospital's culture and climate can impact a nurse's active behaviour in this important health care activity. Background: Research shows that while medical errors happen frequently, there is great variability on whether these errors are reported. As such, organizational culture, climate and commitment as well as employee perceptions associated with the reporting process were investigated to determine their impact on participants' intentions to speak up about medical errors. Methods: Focus groups and one‐on‐one interviews were used to collect these data and were analysed using content analysis. Results/Key Issues: Nurses in the hospital perceive and understand both the benefits and barriers to reporting medical errors. Commonly reported benefits include patient safety, promoting education and awareness, and the improvement of internal processes or systems. Barriers include an inefficient reporting system and organizational influences such as perceived consequences and unequal status/position of the individual who made the error and the person reporting the error. Participants are aware that the organization believes that the responsibility to report medical errors falls to everyone. Conclusions: Results indicate that the organization's existing culture does not facilitate the reporting of medical errors and that the organizational climate interferes with the reporting process. Lastly, organizational commitment is not related to the perception of importance given to the reporting of medical errors by the hospital. Implications for Nursing Management: Nurses and nurse managers are an essential part of any hospital. In their role, they can effect change on the organization's culture and climate, but often do not realize the connection between organizational culture and patient safety. Results indicate that promoting organizational commitment to speaking up through the creation of a positive organizational culture can both promote speaking up about medical errors and increase patient safety. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to describe team leaders' experiences of facilitators and barriers of leadership in specialist palliative home care teams. Background: For effective teamwork in specialist palliative care, leadership is crucial; however, defining and agreeing on what leadership comprises may be challenging. In palliative care, teamwork is recognized as imperative for multiprofessional perspectives to meet dying patients' and families' needs. Methods: Qualitative interviews with 13 team leaders in specialist palliative home care were performed, using the Pettigrew and Whipp framework, and analysed with directed content analysis. Results: Team leaders' experiences of conditions influencing the organisation and delivery of specialist palliative home care is multifaceted and leaders seem conflicted in their approach to the multiple levels of leadership, vision and responsibilities. Conclusion: Team leaders in specialist palliative home care described goals of care on differing levels and, for some, fiscal restraints and external pressures influenced their vision and leadership. Team leaders experienced challenges of leadership in relation to organisational issues, feeling burdened by responsibilities, budget restraints and team size. Implications for Nursing Management: Team leadership is demanding and complex. In specialist palliative home care, affirming values and enabling vision during times of fiscal strain and external pressures, is challenging. For successful leadership that develops both individuals and the health care team, leaders are recommended to adapt the leadership style to the present situation surrounding the team. [ABSTRACT FROM AUTHOR]

Aims: To explore registered nurses' perceptions towards the role of advanced practice nurses and to examine registered nurses' interests in becoming advanced practice nurses. Background: Globally, the development and implementation of advanced practice nurses have been deemed propitious. Advanced practice nurses are recruited and developed from the current pool of registered nurses. Empirical research is needed to inform practice on ensuring the sustainability of the advanced practice nurse workforce through the recruitment and development of the current population of registered nurses. Methods: A nationwide cross‐sectional online survey was conducted in Singapore. Registered nurses from all public health care institutions were surveyed. Results: Respondents (n = 1,025) displayed optimism and acceptance towards advanced practice nurses. However, only 30.7% hoped to become advanced practice nurses. Nursing leaders were reported to have a low success rate in identifying registered nurses who were both suitable and interested in the advanced practice nurse role. Conclusions: Registered nurses' positive perspectives towards the role of advanced practice nurses do not translate into interests in the role. The study offers pragmatic applicability in ensuring the sustainability of the advanced practice nurse workforce. Implications for Nursing Management: Advanced practice nurse‐specific residency programmes for pre‐master registered nurses may be facilitative to retaining and recruiting registered nurses for the advanced practice nurse workforce. [ABSTRACT FROM AUTHOR]

Aim: To summarize nurse managers' perceptions of newly graduated nurses' (NGNs) competence and connected factors. Background: Nurse managers recruiting staff are responsible for employing competent nurses to ensure quality care and professional standards. Knowledge of managers' perceptions about the competence of NGNs is needed to understand the expectations of the health care system towards future professionals. Evaluation: A scoping review was conducted. A total of 12 research publications met the inclusion criteria and were analysed using inductive content analysis. Key issues: Managers' perceptions can be divided into three perspectives: NGNs' competence descriptions, assessment of competences and connected factors. The NGNs' level of competence was assessed to be at least satisfactory, and dependent on prior exposure to the work setting, change in the degree of responsibility and lack of confidence. Conclusion: Existing knowledge about nurse managers' perceptions of NGNs' competence is limited and rather fragmented. There is a clear need for rigorous empirical studies with comprehensive views of managers, emphasizing the key role of managers in the evaluation of nurse competence. Implications for Nursing Management: Nurse managers can use the results of this review in recruitment, performance reviews and the development of job orientation programmes aimed at enhancing NGNs' transition to the nurse workforce. [ABSTRACT FROM AUTHOR]

Aims: To describe factors leading to and consequences of nurse presenteeism. Background: Presenteeism is more prevalent among nurses than other occupational groups. Existing literatures focuses on prevalence and consequences of presenteeism for patients, health care organizations, and nurses. However, we lack understanding of nurse perceptions of factors leading to and consequences of presenteeism. Methods: A total of 295 free responses to a cross‐sectional survey were analysed using conventional content analysis. Results: Nurses consider multiple factors in deciding how to respond when presentee. These include illness, staffing, availability of leave time, patients, financial constraints and guilt. Consequences of presenteeism identified were decreased mental acuity and attitude leading to lessened communication both in‐person and in documentation, transmission of illness, and decline in unit culture, patient care, and nurse health and well‐being. Conclusions: Multiple factors lead to nurse presenteeism and there are negative consequences to nurses' health, work environment and patient care outcomes. Implications for Nursing Management: This study leads to key discoveries to the reasons for and consequences of nurse presenteeism. Many of the factors leading to presenteeism can be addressed through culture and policy changes within organizations. The consequences to patient care outcomes and the work environment emphasize the importance of addressing presenteeism. [ABSTRACT FROM AUTHOR]

Aims: To develop a theory that explains students and registered nurses' behaviours when caring for culturally and linguistically diverse patients'. Background: Despite ongoing calls for improvements to the quality of patient care, the continued reports of substandard care to patients from diverse cultural and linguistic backgrounds are concerning. Methods: A classic grounded theory methodology incorporating focus groups (n‐10) and individual interviews (n‐30) with students and registered nurses in one region of Ireland. Findings: Participants resolved their main concern of uncertainty through disengagement (masking, distancing and fitting in), which was sustained by resigned indifference, resulting in gaps in care. Resigned indifference explains how participants were aware of the consequences of disengagement, but became resigned and accepting of substandard care. Conclusion: This study explains how nurses want to provide quality care, but gaps in care to culturally and linguistically diverse patients' are perpetuated through resigned indifference. Implications for Nursing Management: Nurse managers need to understand nurses' behaviours as a means of supporting collective ways of addressing gaps in care for culturally and linguistically diverse patients. Strategic leadership in developing culturally responsive structures is essential. Nurturing nursing values such as commitment, compassion and courage through education and leadership is a priority. [ABSTRACT FROM AUTHOR]

Aim: To describe how new nurses transition into practice in acute care settings. Background: The Institute of Medicine (2010) landmark report, Future of Nursing: Leading Change, Advancing Health recommends implementing nurse residency programs. However, not all organizations in the state have offered them. Evaluation of the effectiveness of them has been weak. Method: A qualitative study using content analysis was conducted. Six focus groups were held 19 educators, 21 nurse residents and 10 chief nursing officers. Co‐investigators reviewed the data separately and then met to analyse common categories to gain consensus. Results: Five major categories were identified: pre‐residency, program structure, preceptor, resident support and evaluation with additional sub‐categories. Although the participants agreed that a residency program was important, the results showed an incongruence between what was needed and what was provided. Conclusion: An adequate supply of nurses for the future in health care systems is needed. Addressing transition to practice models can be one strategy that assists with retention of the new graduate. Implications for Nursing Management: Nurse leaders need to evaluate the effectiveness of their current nurse residency programs. Standardizing curricula and data collection can improve measurement of outcomes. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences of Iranian nurses working in pre‐hospital emergency care services and the strategies used to manage of workplace violence. Background: Pre‐hospital emergency nurses are subject to workplace violence; however, little research addresses their experiences, particularly related to their strategies in dealing with workplace violence. Methods: A descriptive qualitative study that involved nineteen male nurses who were working in pre‐hospital services collected data using semi‐structured interviews and analysed it using qualitative content analysis. Results: Data analysis yielded four descriptive categories including no reaction to violence (tolerance and acceptance as common workplace conflicts), situational management (patient and scene management), confrontation (direct and indirect) and escaping the scene. Patient management was the dominant strategy used and had the best outcomes related to both patient and personnel safety. Conclusion: This study showed that pre‐hospital nurses use different strategies to manage violence and patient management was a common and useful strategy for managing workplace violence. However, the pre‐hospital nurses have little training, insufficient support and are poorly prepared to manage workplace violence. Implications for Nursing Management: The development of context‐based guidelines, continuing education, better‐equipped ambulances that include medical and defence equipment, as well as better coordination of the police force in ambulance operations, can help to reduce workplace violence. [ABSTRACT FROM AUTHOR]

Aim: To explore and analyse diabetes management challenges in the patients visiting a diabetes unit in Iran. Background: Managing a chronic disease like diabetes needs the patients' follow‐up and coherent care delivery system. In fact, it requires a systematic and organised care delivery system with skilful and specialist team. Methods: This qualitative research was conducted at a specialized poly‐clinic of Isfahan insurance organisation in 2016. The research participants were the members of clinic diabetes unit (physician, nurse, secretary, clinic director) and 21 type 2 diabetic patients of the clinic who were selected using purposeful sampling method. Data were collected by semi‐structured interviews and analysed using content analysis. Results: The qualitative findings of this research were obtained in two main categories including the following: (a) weak care delivery system and (b) defective diabetes self‐care. Conclusions: The results of this research have demonstrated that there are system‐centred and patient‐centred challenges in diabetes management, and they can affect the patients' health outcomes. Implications for nursing management: Since diabetes is one of the health system priorities, the findings of this study can be a warning for managers and policy makers to plan seriously to reform diabetes management system infrastructures. [ABSTRACT FROM AUTHOR]

Aims: To provide an overview of the practice patterns of advanced practice nurses and to explore their perceptions of their role in Singapore. Background: Role expansion of advanced practice nurses is increasingly popular in healthcare systems. However, their practice patterns remain variable, thereby introducing role ambiguity. Uncertainty revolves around how advanced practice nurses perceive their practice, competency and readiness for role expansion. Methods: A nationwide survey of advanced practice nurses was conducted in Singapore. Statistical analyses of closed‐ended responses and content analysis of open‐ended responses were undertaken. Results: A total of 87 participants were surveyed (42.8% response rate). Significant discrepancies existed between current practices and their expectations. Readiness for and acceptance of role expansion were discerned but multiple barriers to practice have remained. Conclusion: This pioneering study in Asia provides important evidence to support the call for greater clarity in the role of APNs and for review of existing institutional practice restrictions. It provides insights into healthcare systems in similar developmental stages of advanced practice nursing. Implications for nursing management: When outlining the goals and role priorities of advanced practice nurses APNs, nurse administrators can consider their best contributions in practice. This allows for long‐term sustainability of their role. [ABSTRACT FROM AUTHOR]