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Aim. To determine Senior Nurse Managers' perceptions of integration of Nurse Practitioner roles in Healthcare Organisations across Ireland and Australia. Background. Introduction of the Nurse Practitioner role in both countries is well established with national policies aimed at developing a critical mass in the health workforce. Current policy requires Senior Nurse Managers to be actively involved in the introduction of and oversight of the integration of Nurse Practitioners across healthcare settings. This is integral in the context of the success and sustainability of the services provided by the Nurse Practitioner. Methods. A quantitative, cross‐sectional cloud‐based survey of senior nurse managers across Ireland and Australia from April to September 2022. Results. Of 300 responses received, 122 were eligible for analysis. Of these, 77% expressed that there should be a specific role to support the integration of Nurse Practitioner roles at local level, and 61% recommended that this should occur at a national level, whilst 48% reported the absence of a standardised governance structure. Three reporting structures were identified: professional, clinical, and operational. Autonomous clinical decision making and prescribing were two Nurse Practitioner functions most identified. Fifty‐five percent reported having performance indicators for Nurse Practitioner roles, with 24% agreeing that performance indicators captured the quality of care provided. Thirty‐five percent of senior nurse managers indicated that there were agreed reporting timelines for performance indicators and a requirement for the provision of an annual report. Conclusion. Whilst some participants reported structure to guide and evaluate the work and value of Nurse Practitioners, the approach was inconsistent across organisations and countries. This paper demonstrates that integration is not broadly established across both countries. Implications for the Profession. The main findings were that Nurse Practitioners were misunderstood and the development of a structured framework to support the integration of Nurse Practitioners would provide long‐term benefits. [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]

Aims: To understand the medication administration process in residential aged care homes. Background: Understanding actual processes that nurses follow is critical to guide improvement efforts and to develop robust systems to ensure safety in medication administration. Methods: Seven nurses were observed for 12 morning medication rounds at two units of a residential aged care home in Australia. Observations were guided by an activity theoretical framework. Results: Nurses followed a common work process to administer medication. This process included actions from preparing medication trolley, locating a resident, preparing and administering medication to this person, documenting the administration, to finally checking medication charts to ensure all residents received medication. We identified 15 process deviations that may hinder safe medication administration. Electronic medication administration records appeared to be able to prevent a deviation associated with the paper‐based documentation process. Conclusions: This study elaborated the medication administration process in a residential aged care home and identified process deviations. It suggests a safety checklist that can be used to evaluate nursing practice and improve medication administration process. Implication for Nursing Management: To develop robust systems for medication safety, nursing managers need to understand the actual nursing process, identify process deviations, and investigate the context in which these deviations occur. [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]

Aim: This study sought to explore how bullying in the nursing profession in Australia has changed over four decades, and why it continues to persist. Background: Bullying in nursing is recognized as a pervasive problem. While much attention has been given to demonstrating the existence and impact of bullying in the nursing profession, little is understood about the evolution of this phenomenon and factors that contribute to its persistence. Methods: This study employed an historical methodology using the testimony method of data collection. Testimonies were collected online and via interview from seventy registered nurses across Australia. Data were analysed using a three‐dimensional analysis to produce a chronological historiography. Results: This study found that the antecedents, manifestations, responses to and impacts of bullying in the nursing profession changed according to context and over time. The findings shed light on the role of nurse managers in the prevention and appropriate management of bullying in the workplace. Conclusion: Prevention and intervention approaches must be developed to combat the complex and changing factors that allow bullying to persist. Implications for Nursing Management: This study shows the role that management plays in tackling the problem of bullying in nursing. It can no longer be acceptable for culture to be used as an excuse for unacceptable behaviour, nor for power to be abused to protect perpetrators of workplace bullying. The findings discussed in this paper reveal that inexperienced nurse managers are often ill‐equipped to identify and manage bullying. Nurses in management positions must recognize and acknowledge this deficit if the problem of bullying is to be effectively tackled. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to explore the process of staff leading change in consumer engagement practice in aged care. Background: Shifting expectations make engagement practice increasingly complex for service providers. This requires adaptive change within organisations. Organisations need to empower and support staff to critically assess practice, identify issues and pursue opportunities for innovation. Method: Data were collected as part of an action research project addressing client engagement practice in Australian aged care. Staff worked together to identify issues for practice, generate solutions and create change within their organisations. Results: Staff identified innovative ways of generating change, demonstrating leadership. However, a range of technical, practical, systemic and philosophical factors impacted their progress. Conclusions: Staff are effective, proactive change agents who can provide valuable insights into directions for their organisations and can lead practice improvement in engagement. However, they require support through the organisational environment. Implications for Nursing Management: Staff in all roles can demonstrate adaptive leadership in changing engagement practice. However, those in traditional roles of authority need to recognize their own roles in showing leadership and supporting adaptive change. This provides a new insight into how managers can support practice change in consumer engagement. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study is to identify and map what is known about workplace violence involving midwives in Australia and New Zealand. Background: Research from the United Kingdom demonstrates that workplace violence within maternity services is a pervasive issue with significant and wide‐ranging clinical, individual and organisational consequences. To date, little is known about this issue within Australian and New Zealand maternity services. Evaluation: A scoping review, guided by Arksey and O′Malley's framework, was conducted. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews checklist. Just one identified study aimed to explore midwives' experiences of workplace violence. A further nine arrived at related results or themes. Key issues: Workplace violence is present in a variety of forms across maternity services in Australia and New Zealand. Its prevalence is, however, yet to be understood. Workplace violence causes physical and mental health issues for midwives, premature workforce attrition, and jeopardizes the quality and safety of maternity care. Conclusions: Workplace violence has been acknowledged as one of the key contributing factors towards premature attrition from the midwifery profession, with new graduate midwives most likely to leave. With the midwifery workforce ageing and evidence of serious clinical implications emerging, workplace violence needs urgent research and organisational attention. Implications for nursing management: Workplace violence is a key contributing factor towards recruitment and retention challenges for managers. To help tackle this, managers have a key role to play in identifying and effectively addressing workplace violence by acting as positive role models, taking a zero‐tolerance approach and fostering collegial relationships. Managers, holding key clinical leadership positions, are pivotal to ensuring all complaints raised are handled with transparency and consistency regardless of one's position within the clinical hierarchy and organisational structure. [ABSTRACT FROM AUTHOR]

Aim: To explore how clinical leadership is perceived by nurses in rural and remote areas of New South Wales, Australia. Background: There are few empirical studies aimed at understanding clinical leadership from a rural and remote perspective. Methods: A qualitative approach, based on interpretive phenomenology, used thematic analysis of recorded and transcribed interviews. Ethical approval was secured, 56 interviews were undertaken, across 14 different rural and remote health facilities, with nurses across the spectrum of practice. Results: Thematic analysis led to five themes and findings that support an understanding of clinical leadership from a rural and remote context. Clinical leaders were seen to considerably impact on the initiation of change and quality of care. They also faced barriers if the health facility was poorly staffed, lacked support and if the community were strongly co‐dependent. Conclusion: In rural and remote areas, clinical leadership is evident to support change, innovation and care quality. Implications for Nursing Management: Managers should be aware that staff shortages and challenges to staff retention or the initiation of change are affected by poor clinical leadership. This paper suggests that managers who facilitate clinical leadership are better able to support professional education and greater efficiencies in the delivery of quality health care. [ABSTRACT FROM AUTHOR]

Objectives: There is an international policy trend for building government hospitals with greater proportions of single‐occupancy rooms. The study aim was to identify advantages and disadvantages for patients and nursing staff of a pending move to 100% single‐room hospital, in anticipation of the challenges for nurse managers of a different ward environment. This paper presents these findings, summarizing potential advantages and disadvantages as well as comparison with findings from similar studies in England. Methods: Mixed method case study design was undertaken in four wards of a large hospital with multi‐bed rooms. Three components of a larger study are reported here: nurse surveys and interviews, patient interviews of their experiences of the current multi‐bedroom environment and expectations of new single‐room environment. Integration was achieved via data transformation where results of the nursing staff survey and interviews and patient interviews were coded as narrative allowing for quantitative and qualitative data to be merged. Results: Four constructs were derived: physical environment; patient safety and comfort; staff safety; and importance of interaction. Conclusion: There are important factors that inform nurse managers when considering a move to an all single‐room design. These factors are important for nurses' and patients' well‐being. Implications for nursing management: This study identified for nurse managers key factors that should be considerd when contributing to the design of a 100% single‐room hospital. Nurses' voices are critically important to inform the design for a safe and efficient ward environment. [ABSTRACT FROM AUTHOR]

Aim To illuminate ways that avoidant leadership can be enacted in contemporary clinical settings. Background Avoidance is identified in relation to laissez-faire leadership and passive avoidant leadership. However, the nature and characteristics of avoidance and how it can be enacted in a clinical environment are not detailed. Methods This paper applied secondary analysis to data from two qualitative studies. Results We have identified three forms of avoidant leader response: placating avoidance, where leaders affirmed concerns but abstained from action; equivocal avoidance, where leaders were ambivalent in their response; and hostile avoidance, where the failure of leaders to address concerns escalated hostility towards the complainant. Conclusions Through secondary analysis of two existing sets of data, we have shed new light on avoidant leaderships and how it can be enacted in contemporary clinical settings. Further work needs to be undertaken to better understand this leadership style. Implications for nursing management We recommend that organizations ensure that all nurse leaders are aware of how best to respond to concerns of wrongdoing and that mechanisms are created to ensure timely feedback is provided about the actions taken. [ABSTRACT FROM AUTHOR]

Contemporary nursing is an increasingly complex concept encompassing and encapsulating wide variation under the broad rubric of the nursing work place. This paper reports on a study that was designed to contribute to understandings of nursing practice by describing what nurses in Australia are doing everyday in various practice and work settings, the type of skills they need, the challenges they face and the interactions nurses have with other health workers. Drawing on the research which informed the National Review of Nurse Education in Australia in 2001, the paper raises issues critical to the management of contemporary nursing practice. Flexible approaches both to the day-to-day management of nurses and nursing, and educational preparation in partnership with key stakeholders, are a necessity if management of nursing is to keep pace with constant change in health care systems as well as facilitating the attraction and retention of nurses in those systems. [ABSTRACT FROM AUTHOR]

A study commissioned by the Australian Nursing Council Inc. sought to develop an approach to the maintenance of continuing competence in nursing that is broadly acceptable to nurses in all States and Territories. The study involved a comprehensive review of the international literature and this paper provides an overview of statutory regulation of professions with particular reference to regulation of the nursing profession. A definition of competence and competencies and a discussion of beginning and continuing professional competence are presented, followed by a review of current indicators of continuing professional competence used by a variety of professions in Australia. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to examine the challenges facing the nurse executive in the 21st century by questioning the traditional attributions of leadership to the nurse executive role.Background Historically, the leadership role in nursing has been assumed by the nurse executive. The predominantly female character of nursing, however, has ensured that demonstrations of leadership amongst nurses have been infrequent and compatible with prevailing male-defined ideologies. Examples of this include career restructuring and educational reforms in Australia. Findings: This paper found that the apparent lack of leadership in nursing was able to be traced back to early management theories which categorized leadership as a function of management. Conclusions: If nurses are to assume leadership positions in the health care system of the 21st century, nurse leaders will have to let go of traditional managerial practices and behaviours. In the emerging health care system of the new century, nurse executive practices will focus on achieving change rather than predictability in organizational outcomes. [ABSTRACT FROM AUTHOR]

Aim To explore the experiences of Australian nurses and midwives who perceived themselves as resilient. The focus of this paper is to report the strategies used by a group of nurses and midwives to develop and maintain their resilience, despite encountering serious workplace adversity. Background Despite the potentially adverse effects of nursing work, many nurses and midwives thrive through exercising self-efficacy and coping skills. The relationship between thriving and resilience is clear, as resilience refers to the ability to cope well with adversity and change. Methods The participants were part of an instrumental, collective case study investigation of personal resilience amongst nurses and midwives. Prior to an innovative, work-based intervention including workshops and mentoring, participants were interviewed to collect baseline perceptions and experiences of personal resilience and workplace adversity. Interview transcripts were analysed thematically. Results Participants attributed their ability to thrive in the workplace to three major influences: support networks, personal characteristics and ability to organise work for personal resilience. Conclusions Participant insights contributed to a deeper understanding of personal resilience and highlight future initiatives to enhance the ability of nurses and midwives to thrive within health organisations and systems. Implications for nursing management It is vital that resilience-enhancing initiatives, such as peer mentoring and tailored work options to increase autonomy, are implemented at earlier career phases. [ABSTRACT FROM AUTHOR]

Aims To explore and identify the core elements of the nurse executive role and the contribution these posts make to health service organisations in terms of quality and performance. Background With the ongoing global reform of health services and, in particular, currently in Australia, this commentary paper explores the available evidence that explains and describes the role that nursing leaders can and do play at executive level in enabling quality services in high performing health-care organisations. Evaluation While the overall literature is limited in relation to the role and function of nurse executives, there are strong and recurrent themes indicating that nurses by virtue of their professional background and experience can provide effective and influential input to executive boards. Executive nurses are well positioned to influence and lead professional governance, quality improvement, service transformation and change and shared governance. Conclusion At a time when the role of nursing executives may be questioned, the evidence supports the positive impact of highly skilled nursing executives in contributing to the implementation of effective health services. Successful health services should be engaging nurse executives who have the high level of expertise, education, the best leadership and management attributes to bring the art and science of nursing to produce outcomes for organisations. Implications for nursing management Nurse executives must remain alert to the ongoing challenges and potential questioning on the value that nurses can bring to an executive board. The framework of nursing executive influence and leadership through professional governance, quality improvement, service transformation and change and shared governance is one possible approach that nurse executives may wish to apply to articulate their contribution and value in remaining at the executive board table. [ABSTRACT FROM AUTHOR]

Aim To identify key issues and factors affecting retention of qualified nurses who care for older people and persons with dementia in Australian acute, subacute, community and residential health-care settings. Background As the number of older people with chronic conditions needing health care continues to increase research is needed to optimize nurse retention. Methods Qualified nurses were surveyed with a set of items derived from four published nurse workforce questionnaires (Cronbach's alpha range 0.75-0.96). There were 3983 complete responses and 10 focus groups with 58 volunteer survey respondents. Results In addition to reporting a number of workplace issues, nurses also reported reasonable levels of satisfaction. Intrinsic factors related to caregiving, work relations and colleague support. Extrinsic factors included professional opportunities and organisational support. Conclusions Altruism is a primary motivation for choosing to nurse older people and persons with dementia. Nurses are most positive when they feel valued and supported by their organisation and colleagues, through education, training, supervision, mentoring opportunities and appropriate remuneration. Implications for nursing management Nursing managers need to take positive steps to address the organisational factors outlined in this paper that either inhibit or promote nurse retention. [ABSTRACT FROM AUTHOR]

bennett p., barlow v., brown j. & jones d. (2012) Journal of Nursing Management 20, 485-490 What do graduate registered nurses want from jobs in rural/remote Australian communities? Aim To explore and describe the needs of new graduate registered nurses in a rural and remote (R&R) setting within Australia. Background Rural practice has distinctive challenges for nurses. Nurses make up the largest and most widely distributed health workforce in Australia, outnumbering doctors 8 : 1 in R&R areas. Evaluation Literature was used to evaluate the graduate registered nurses' needs in R&R communities. Key issues Three main themes emerged: expectations, support and workloads. Themes reflected enablers and disablers of retention of nurses as they transition from student role to new graduate practice. Conclusion New graduates are aware of their limitations as new practitioners. There is an expectation that their employers will provide a supportive learning environment for them to gain the skills necessary to become proficient and valuable employees. Implications for nursing management This commentary paper identifies the need for a structured, supported new graduate programme that recognizes and meets the needs, both clinical and social, of new graduate registered nurses in the R&R context. [ABSTRACT FROM AUTHOR]

wollin j.a. & fairweather c.t. (2012) Journal of Nursing Management 20, 20-27 Nursing education: a case study of a Bachelor of Science Nursing programme in Abu Dhabi, United Arab Emirates Aim The aim of the present study was to report the process and outcomes of a collaborative venture to offer a Bachelor of Science Nursing programme in Abu Dhabi. Background An international educational collaboration between the Abu Dhabi government in the United Arab Emirates (UAE) and Griffith University (GU) Australia, successfully established a College of Health Sciences offering a Bachelor of Science Nursing (pre- and post-registration). Methods The report was written to reflect the chronological order of events as the Bachelor of Science Nursing programme was rolled out in Abu Dhabi commencing in 2007. Results The results of this initiative included the successful delivery of the programme and the gaining of initial accreditation in Abu Dhabi. Conclusion The paper presents important insights into the collaborative nature of the agreement and the unique outcomes; dual awards from UAE and Australia. Implications for nursing management The success of this initiative required ongoing commitment from the collaborating partners. The programme required ongoing support from the School of Nursing and Midwifery in Australia. Griffith University provided the Head of School and Deputy Head of School for Abu Dhabi and the curriculum. The academic and administrative support from Australia was significant and must be incorporated into any business plan when planning such a venture. [ABSTRACT FROM AUTHOR]

dignam d., duffield c., stasa h., gray j., jackson d. & daly j. (2012) Journal of Nursing Management 20, 65-71 Management and leadership in nursing: an Australian educational perspective Aim In this article, we present an Australian perspective on issues influencing management and leadership education in nursing. Background Nurse leaders and managers work in a context of high pressure, uncertainty and rapid change, and face unprecedented challenges on a daily basis. Evaluation and Key Issues In the present paper, we reflect on the issues and challenges facing providers of management education for nursing, and consider these challenges in relationship to current trends and imperatives. Conclusions Collaborative approaches between educational and clinical settings are needed to ensure quality, relevant educational support for managers and leaders, and enhance curriculum integrity. Implications for Nursing Management There is a need for contemporaneous and relevant research to inform innovative models of collaborative education. [ABSTRACT FROM AUTHOR]

Aim: To explore the extent of Australian nurse managers' engagement in clinical care activities. Background: Hybrid nurse manager roles lack clarity in the optimal balance between the clinical and other activities, resulting in stress and challenges in recruiting and retaining nurse managers. Methods: In a national survey using the Advanced Practice Role Delineation tool, Australian nurses self‐assessed their level of engagement in activities across five domains of nursing practice. The subset sample analysed comprised 2,758 registered nurses, 390 clinical (front‐line) nurse managers and 43 organisational (middle) nurse managers. Median domain scores were compared with non‐parametric tests of difference. Results: Clinical nurse managers were in a hybrid role, reporting high levels of engagement across the domains. Lower scores observed for organisational nurse managers highlight the shift to strategy‐focussed activities that occurs as nurses up the management hierarchy. Conclusions: By indicating their engagement in the clinical care domain, respondents demonstrated that clinically focused activities were not entirely lost from either front‐line or middle‐management roles. Implications for Nursing Management: Nurse managers equipped with clinical and management skills, and allowed time to remain engage in clinical care activities are critical for patient‐centred and cost‐effective care in today's complex health care environments. [ABSTRACT FROM AUTHOR]

Aim: This paper outlines the current state of Australian practice nursing, describes the context of general practice and establishes the importance of promoting leadership and management in this setting.Background: Australian general practice nurses have emerged as key stakeholders in primary health care. However, their role in leadership and management has been largely invisible. The reasons for this are multifactorial, including the delay to establish a strong professional organization, their negative power relationships with general medical practitioners, limited nursing leadership and poorly defined roles. To date, the impetus for practice nurse growth has been largely external to the nursing profession. Growth has been driven by the increasing burden of chronic disease and workforce shortages. This has further weakened the control of nurse leaders over the development of the specialty.Conclusions: The Australian practice nurse role is at a crossroads. While the practice nurse role is a viable force to improve health outcomes, the growing strength of the practice nurse challenges traditional professional roles and practice patterns.Implications for nursing management: There is an urgent need to develop practice nurse leaders and managers to not only embrace the challenges of Australian general practice from an operational perspective, but also undertake a clinical leadership role. As clinical leaders, these nurses will need to develop a culture that not only optimizes health outcomes but also advances the status of the nursing profession. [ABSTRACT FROM AUTHOR]

This paper explores casual and temporary work in nursing and other clinical professions in the hospital industry in Australia. Evidence suggests that the use of casual and temporary work has increased in recent years. In turn the growth of non-standard employment has been used to suggest workplace restructuring along the lines of Atkinson's (1984) 'flexible firm' model. However, this article finds that casual and temporary employees are used to fulfil core duties in the hospital industry, casting doubt on Atkinson's model. [ABSTRACT FROM AUTHOR]

This paper reports the findings of a survey undertaken in Queensland, Australia in October 2001. The participants were registered and enrolled nurses and assistants in nursing who were members of the industrial body – the Queensland Nursing Union (QNU), and who were in paid employment in nursing in Queensland. Participants were selected by random sampling from each of the three major employment groups – the aged care, public and private acute sectors. Of the 2800 invited participants, 1477 responded resulting in an overall response rate of 53%. The findings indicate that over 50% of nurses in the aged-care sector, 32% of nurses in the public and 30% of nurses in the private acute sector experience difficulties in meeting patient needs because of insufficient staffing levels. The nurses in this study also believed that there was poor skills-mix, mostly caused by lack of funding, too few experienced staff or too many inexperienced staff. Many nurses in this study expressed their anger and frustration about their inability to complete their work to their professional satisfaction in the paid time available. Further, many nurses also expressed the view that because of this inability they were planning to leave the nursing profession. These findings are consistent with other research into the nursing workforce both within Australia and internationally. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to reliably estimate why midwifery care is missed and to crystallize those factors that have causal links to it. Background: Studies involving the incidences and types of missed midwifery care are sparsely described. The rationales behind these deficits in care are even less well researched. Methods: A non‐experimental, descriptive method using a Likert developed MISSCARE scale was used to measure consensus estimates made by Australian midwives. Data analysis was undertaken using both Rasch analysis and Structural Equation Modeling. Results: Midwives' rationales behind why Australian midwifery care is missed can be quantified based on consensus estimates of participating midwives and the variances in the total scores of how important each contributing factor was in accounting for why midwifery care was missed, can be both explained and predicted. Conclusions: Ten latent variables have significant predictor effects on why midwifery care was missed. These include insufficient human and physical care resources, increased work intensity and issues with workplace communication. These factors are further exacerbated by the midwives' teamwork satisfaction levels, work roster preferences and other midwife demographic variables. The age of midwife, their highest qualification achieved and where they obtained their midwifery credentials had no influence on their consensus estimates as to why midwifery care was missed. Implications for nursing management: While this study confines itself to the Australian midwifery context, outcomes are informative for an international midwifery management audience. While the setting of the midwifery practice (be it private or public hospitals) is not significant in predicting why midwifery care is missed, resource allocation for care of mothers and their babies remains instrumental, as a factor contributing to care omissions. Midwife demographic factors including age, type of midwifery qualification and where the credentials were obtained from exerted no influence as to why care was omitted. Midwifery recruitment should focus instead on re‐dressing skills and skills mix shortages. Teamwork skills within the midwifery sector requires strengthening, as problems arising from workplace communication, coupled with decreased midwifery staffing numbers and increased work intensity, are strongly thought to be significant reason for missed care [ABSTRACT FROM AUTHOR]

Aims: This study aimed to understand midwifery care during labour, particularly decision‐making processes, within Australian health systems. Background: Midwifery, founded on a wellness model of motherhood, is at risk of being medicalized. Whilst medical intervention is lifesaving, it requires judicious use. Governance provides oversight to care. Exploring decision‐making contributes to understanding governance of practices. Method: Straussian grounded theory using semi‐structured interviews. Eighteen Australian registered midwives were interviewed about their practice when caring for women during labour. Results: Midwives were caught between divergent positions; birth as natural versus birth as risk. Experienced midwives discussed focussing on the woman, yet less experienced were preoccupied with mandatory protocols like early warning tools. Practice was governed by midwives approach within context of labour. The final theory: The Coalescence of Perceptions, Practice and Power, comprising three categories: perceptions and behaviour, shifting practice and power within practice, emerged. Conclusions: Coalescence Theory elucidates how professional decision making by midwives during care provision is subject to power within practice, thereby governed by tensions, competing priorities and organizational mandates. Implications for Midwifery Managers: Midwifery managers are well positioned to negotiate the nuanced space that envelopes birthing processes, namely, expert knowledge, policy mandates and staffing capability and resources, for effective collaborative governance. In this way, managers sustain good governance. [ABSTRACT FROM AUTHOR]

The article reflects on the perennial challenge of recruiting and retention of nurses in Great Britain and in other Western countries and Australia. While the disputes of recruitment and retention have long been acknowledged, the solutions suggested and measures adopted do not seem to have had much success in coping with the problems. Papers presented in this issue reinforce and strengthen many of the issues identified in the past decade.

Aim: This study sought to explore nurses' perceptions of clinical handover in a regional health care facility to better understand the local context and identify the most appropriate clinical handover models. Background: Clinical handover is an essential aspect of clinical care, and yet using accurate spoken and written communication can be neglected in nursing, potentially resulting in patient harm. Although much information is available on clinical handover in metropolitan settings, few studies have examined the regional context. Methods: This study was an exploratory qualitative study based at one small regional health care facility located 100 km from a metropolitan Australian centre. The study utilized an Appreciative Inquiry approach to identify how nurses perceive the use of standardized oral and written clinical handover. Focus groups were engaged to explore the perceptions of nurses "handing over" in the smaller regional facility. Results: Through focus group interviews with Registered and Enrolled Nurses, the data revealed that the cultural context of the ward influenced perceptions of clinical handover and that handover served as a light in the dark for all nursing staff; as an evolving communication tool illuminating patient care needs. Conclusion: This study facilitated understanding of the handover needs of smaller Australian regional hospitals. This study identified gaps in perception about handover practices between junior and senior nurses. New graduate nurses develop confidence in supportive clinical environments. A transition to practice programme would need to address the challenges new graduates face in the regional setting. Implications for Nursing Management: Nurse managers in regional facilities can champion supportive senior nurses to mentor new graduate nurses and enhance the transition to practice for the new nurse. [ABSTRACT FROM AUTHOR]

Aims: This study quantifies the types and frequencies of missed care identified by nurses and measures its impact on their capacity to demonstrate mandatory practice standards as future hospital staff. Background: Considerable literature exists as to the nature of missed care but there is a paucity of findings about how missed care impacts on learning firstly as a student and then as a graduate nurse employed in a hospital setting. Additionally, there is little emphasis as to how staff development for nurses exposed to missed care may be implemented. Methods: A non‐experimental research design using self‐audit data was selected to collect information about the types and frequencies of missed care from nurses engaging in clinical experience. A convenience sample of 471 nursing students completing their undergraduate nursing degree programme was explored. A multi‐variate statistical approach was used to apply and then model the consensus scores of undergraduate nurses' beliefs about the frequency of missed care. Implications for their developing competence in critical thinking, therapeutic communication and maintaining capacity for professional practice has been considered. Results: Eight variables directly affect student's total scores underpinning their understanding of missed care and their ability to meet professional standards of practice, given their exposure to care omission. These factors reflect differing nurse attributes, the nature of the clinical venues and shift times, preceptor type, student satisfaction with work teams and staffing adequacy. Conclusions: Modelling outcomes suggest possible changes to hospital staff development learning programme content, learning processes and how it may be better delivered through to minimize episodes of missed care. Implications for Nursing Management: Staff development needs to note that nursing staff believe missed care occurs across all three‐patient acuity domains with patient observation, education, support, and timely medication administration being most frequently omitted. Different clinical venues within the hospital sector and shift times vary in nurses' exposure with missed care. Student nurses' learning and associated development of practice standards is impacted by prior exposure to missed care during clinical placement. Non‐native English‐speaking nurses require greatest learning support in the presence of missed care. As missed care can be predicted, remedial changes to the nurse staff development program content and learning processes can be orchestrated. [ABSTRACT FROM AUTHOR]

Aim To determine which characteristics of academic leadership are perceived to be necessary for nursing deans to be successful. Background Effective leadership is essential for the continued growth of the discipline. Method A qualitative study using semi-structured interviews with 30 deans (academics in universities who headed a nursing faculty and degree programmes) was conducted in three countries - Canada, England and Australia. The conversations were analysed for leadership attributes. Result Sixty personal and positional attributes were nominated by the participants. Of these, the most frequent attribute was 'having vision'. Personal attributes included: passion, patience, courage, facilitating, sharing and being supportive. Positional attributes included: communication, faculty development, role modelling, good management and promoting nursing. Conclusion Both positional and personal aspects of academic leadership are important to assist in developing a succession plan and education for new deans. Implications for nursing management It is important that talented people are recognised as potential leaders of the future. These future leaders should be given every chance to grow and develop through exposure to opportunities to develop skills and the attributes necessary for effective deanship. Strategic mentoring could prove to be useful in developing and supporting the growth of future deans of nursing. [ABSTRACT FROM AUTHOR]

Aim: To explore the lived experience of utilizing peer group supervision in practice for community health nurses. Background: Community health nursing is an autonomous and challenging role where quality clinical supervision has benefits for the registered nurse. The structured New Zealand Coaching and Mentoring model of peer group supervision provides the foundation for this research. Method: An interpretative hermeneutic study explored the experience of peer group supervision in a regional health service in Australia. Qualitative in‐depth interviews were conducted with all levels of nursing staff to gain an understanding of their experience of peer group supervision. Results: Data interpretation through hermeneutic analysis revealed the value and professional sustenance gained by participants. Identified game changers include adherence to rules and the influence of group dynamics. These areas were found to impact the quality of supervision. Conclusions: This research provides different perspectives of peer group supervision that shares the experience of staff immersed in the process. Peer group supervision yields benefits for community health nurses; however, the research has implications for practice. Implications for nursing management: Nurse managers require information when making key decisions regarding workplace implementation. Effective supervision is only possible when balance between benefits and game changers are achieved. [ABSTRACT FROM AUTHOR]

Background Leadership in the clinical practice environment is important to ensure both optimal patient outcomes and successive generations of motivated and enthusiastic clinicians.Aim The present paper seeks to define and describe clinical leadership and identify the facilitators and barriers to clinical leadership. We also describe strategies to develop clinical leaders in Australia. Key drivers to the development of nursing leaders are strategies that recognize and value clinical expertise. These include models of care that highlight the importance of the nursing role; evidence-based practice and measurement of clinical outcomes; strategies to empower clinicians and mechanisms to ensure participation in clinical decision-making.Key issues Significant barriers to clinical leadership are organizational structures that preclude nurses from clinical decision making; the national shortage of nurses; fiscal constraints; absence of well evaluated models of care and trends towards less skilled clinicians.Conclusions Systematic, strategic initiatives are required to nurture and develop clinical leaders. These strategies need to be collegial collaborations between the academic and health care sectors in order to provide a united voice for advancing the nursing profession. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to profile the community nurse in Australia. Background: The need for nurses in the community health care sector is increasing in response to shorter hospital stays, an aging population and chronic disease. The increase in demand has not been followed by appropriate workforce planning, leading to structural issues and lack of qualified nursing workforce in the community sector. Evaluation: MEDLINE and ProQuest Public Health and grey literature were searched for records published between 2010 and 2020 relative to the profile of the community nurse in Australia. Twenty‐five records (21 publications, 2 databases and 2 reports) were included in the review. Abstracted data followed the principles of workforce planning and included demographics, qualifications and roles. Key Issues: Inconsistent definitions, self‐reported data and a focus on practice nurses have contributed to data irregularities. Little is known about the specific aspects of community nursing work. Conclusion: A lack of concrete data has overshadowed a community nursing workforce crisis with implications for patients' health and safety across the lifespan. Implications for Nursing Management: There is urgent need for nurse managers globally to refocus nursing recruitment to the community sector to maintain quality and ensure sustainability of the nursing workforce. [ABSTRACT FROM AUTHOR]

Aim: We aim to determine safety attitudes of nurses and midwives across a Local Health District in Australia and compare results 1 year later following facilitated feedback of results. Background: Positive safety cultures are imperative for positive patient and staff outcomes. Staff member's attitude contribute to an organisations safety culture but can differ between health professional groups and across different subcultures. Method: The Safety Attitudes Questionnaire (SAQ‐Short version) was administered to all nurses and midwives within a Local Health District in NSW, Australia in 2019 and 2020. Results were facilitated back to nursing/midwifery leadership teams with an expectation of developing and enacting an action plan, based on results. Results: Of the six domains in the SAQ‐Short version, five domains scores increased significantly (p <.001) over the time period. Conclusions: Measures over time are important to establish differences in perceptions and feedback on impact of actions. Facilitated feedback of results shows meaning when nursing/midwifery leadership staff have data explained and an opportunity to discuss and plan. Implications for Nursing Management: This study shows that facilitated feedback of quantitative survey results brings improved results when a survey is replicated. Nurse managers should enact a contextualized action plan with teams based on survey results to influence improvement in safety attitudes of staff. [ABSTRACT FROM AUTHOR]

Aims: To examine the perceptions of leadership by leaders within residential aged care and to identify the crucial requirements for successful leadership in this complex industry. Background: As an industry capitalizing on the concept of 'care', one of the critical attributes this research has found to be absent in many aged care leadership approaches is compassion. Methods: A qualitative methodology using thematic analysis was used to explore the construction of leadership attributes needed within residential aged care, as perceived by leaders in these organisations. Results: Senior staff in the aged care industry believe that compassion is both a key component and a gap in the skill set of aged care leadership and leaders. While most studies define good leadership and care in relation to clinical 'safety' and 'efficiency', this research demonstrates that compassionate caring is central to high‐quality care in residential aged care. Conclusions: The aged care industry needs to enhance and encourage compassionate leadership as a cornerstone of humane and dignified care. Implications for Nursing: When developing theoretical explanations for the role of leadership in aged care, researchers should contemplate compassion as a key attribute required in residential aged care leaders. Education and training in this industry must incorporate the attributes associated with compassion, including emotional intelligence and person‐centred leadership. [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 job satisfaction and turnover intentions of general practice nurses and examine factors that influence job satisfaction and turnover intention. Background: Workforce issues such as satisfaction, retention and turnover intention have been explored in acute care. However, increasingly nurses are being employed outside hospitals. General practice is a significantly different work environment to acute care. Understanding workforce issues in community settings is important for employers, managers and policymakers to sustain and grow this workforce to meet consumer demands. Method: A descriptive survey was conducted within a single Primary Health Network in Australia. Results: Having an identified practice nurse leader/manager, feeling that their training and qualifications are used to the full and not feeling isolated, alone or lacking opportunities for mentoring were all significantly correlated with higher job satisfaction. The lowest average satisfaction scores related to pay. 44.9% of participants were unsure whether they would remain working in general practice. The relationship between total job satisfaction and intention to leave was significant. Conclusion: These findings guide managers in developing strategies to recruit and retain nurses in general practice employment. Implications for Nursing Management: Managers must consider factors influencing job satisfaction and turnover intention to maximize recruitment and retention of nurses. [ABSTRACT FROM AUTHOR]

Aims: To explore and analyse the current bed management processes and understand the perspectives of nurse managers on mixed‐gender accommodation in a regional hospital in Australia. Background: Mixed‐gender accommodation was introduced to help manage the increasing demand for hospital beds. Yet, some health services identify same‐gender accommodation better aligns with patient‐centredness. Method: This qualitative research was conducted at a public hospital in regional Australia and focused on the experience in the general wards. Eight nurse managers were selected using purposeful sampling. Data were collected through face‐to‐face semi‐structured interviews and thematically analysed. Results: Three main themes were identified: current admission processes—managing admissions, bed allocation considerations, patient involvement and managing mixed‐gender rooms; impacts on patients—participant views, patient experience and bathrooms; and barriers and facilitators—capacity, infrastructure, safety and risk, bed swapping and organisational factors. Conclusions: The study demonstrates a lack of structure and patient‐centredness with mixed‐gender allocation processes. Local organisational guidelines are suggested to support improvement in patient‐centred inpatient hospital accommodation. Implications for Nursing Management: The findings of this study will help nursing leaders drive positive change concerning bed allocations and support advocacy for patient rights. Future studies should explore the patient perspective of mixed‐gender accommodation. [ABSTRACT FROM AUTHOR]

Aim: To identify the factors influencing employment outcomes and settings for early career nurses. Background: A shortage of nurses attracted to work in out‐of‐hospital settings exists. Despite this, not all nursing graduates can secure work as a nurse. Information on the factors that impact wider graduate employment is available. However, a nursing perspective is missing, especially for hard to recruit to areas. Methods: A prospective cohort study was conducted. Participants were 293 final‐year undergraduate nursing students, recruited from two universities. Data were collected over 12 months, commencing November 2016. Results: English as a first language was the greatest predictor of employment for graduates. Previous health care experience and workplace preferences predicted employment in the out‐of‐hospital setting. Conclusions: Misalignment between English language requirements and industry expectations about language may lead to bias in recruitment of graduate nurses with English as their second language. Recruitment to out‐of‐hospital settings may be promoted by having health care experience and targeting those with a preference. Implications for Nursing Management: Reviewing current employment policies to ensure they reflect the need for cultural diversity in the nursing workforce is critical. Additionally, research that aims to understand how preferences for out‐of‐hospital settings are developed will help target graduate employment strategies. [ABSTRACT FROM AUTHOR]

Aim: To examine nursing care left undone and its relationship with the nursing practice environment and perceived quality of nursing care in small Australian rural hospitals. Background: Nurses in small rural hospitals often work with few resources, limited backup and staff shortages. The relationship between this rural practice environment and care left undone has not been fully explored. Method: A descriptive cross‐sectional survey. Results: Over half participants (n = 241, 62.9%) reported having left some activities undone on their most recent shift. There were moderately significant correlations between care left undone and nursing practice environment and overall quality of care. Nurses who reported leaving care left undone had statistically significant lower perceptions of the nursing practice environment than those who had no care left undone. Conclusion: Nursing care activities are being left undone in rural hospitals. Both care left undone and quality of nursing care may be affected by the nursing practice environment. Implications for Nursing Management: To maximize care quality, rural hospital managers must consider the prevalence of care left undone and may use this information as a predictor of both patient outcomes and staffing and resource requirements. Given the challenges of rural hospitals, rural nurse managers can use this evidence to support their requests for increased staffing and resources. [ABSTRACT FROM AUTHOR]

Aim: To explore the clinical support experiences of new graduate nurses' (NGNs) and how these experiences influenced their learning, job satisfaction and skill development during their new graduate transition. Background: As supervising NGNs is different to other groups, nurse managers must be aware of NGNs' unique needs to successfully transition to practice. Clinical support is crucial, but little is known about what is effective in supporting the learning and development of clinical capability in this critical period. Methods: Using a qualitative exploratory design, semi‐structured interviews were conducted with NGNs working in a tertiary level teaching hospital in Sydney, Australia. Nurses were interviewed upon completing their 12‐month transitional support programme (TSP) in late 2013–2014. Data were thematically analysed. Results: Twenty‐six NGNs were interviewed. Three major themes identified were as follows: (a) clinical support facilitates learning; (b) conditions required for good clinical support; (c) transforming me. Conclusion: Themes identified specific supportive strategies, including informal and formal clinical support to nurture confidence, competence, professional growth and increase satisfaction of NGNs. Implications for Nursing Management: Findings describe essential clinical support practices for fostering successful NGN transition. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the impacts of introducing administrative support for nurse unit managers. Background: Increased administrative load for nurse unit managers causes role stress and reduced opportunities for clinical leadership (state‐wide review, Queensland, Australia). In response, a health organisation implemented a clerical 'Nurse Unit Manager Support Officer' position. Methods: Qualitative descriptive evaluation, convenience sample (37 nurse unit managers and NUM Support Officers) and focus groups (13) provided data that were thematically analysed. Results: Six impacts were identified: (a) improved nurse unit manager well‐being; (b) more time to undertake clinical leadership; (c) greater efficiencies in finance, payroll and HR processes; (d) improved capacity for strategic leadership; (e) increased staff satisfaction and improved unit culture; and (f) improved succession planning. Conclusion: Findings reveal significant gains and benefits from the introduction of administrative support for the nurse unit manager role for the nurse unit manager and the units they manage. Implications for Nursing Management: Nurse unit manager role stress can negatively impact organisational climate, performance outcomes, staff satisfaction and retention. Health organisations need to implement strategies to reduce the administrative burden for nurse unit managers. The introduction of administrative support frees up time for nurse unit managers to engage in clinical leadership, positively impacting organisational climate, performance outcomes, and staff satisfaction and retention. [ABSTRACT FROM AUTHOR]

Aim: To explore new graduate registered nurses' knowledge and attitudes concerning medical error and patient safety, during their first 6 months of professional practice. Background: New graduate registered nurses demonstrate basic skills and levels of performance due to limited exposure and experience in actual situations. There is a concern held for their clinical reasoning skills required to recognize patient deterioration, posing a threat to patient safety. Methods: An online questionnaire was used to survey new graduate registered nurses at three time points during graduate nurse programmes between August 2016 and February 2018. Results: A decrease in self‐reported knowledge and attitudes regarding medical errors was noted over the three time points. These results indicate initial confidence in theoretical knowledge and attitudes upon completion of undergraduate education, and prior to commencing professional practice. Conclusion: Results suggest that a theory practice gap persists with respect to medical error for transitioning new nurses. Impact for Nursing Management: New nurses lack confidence around compromised patient safety situations and a knowledge gap around actions related to medical error. Nurse managers and educators should be made aware of this gap to implement strategies to decrease risk during novice nurse transition. [ABSTRACT FROM AUTHOR]

Aims: The research explores (a) nurses' views of the change to mandatory bedside handovers, and (b) these nurses' perceptions of their skills in managing this new practice in an Australian hospital. Background: In Australia, nursing bedside handovers are now considered essential in many hospitals, although most nurses received minimal training at the time this policy was instituted. This research establishes a unique quantitative tool to investigate nurses' views of, and self‐reported actions related to, bedside handovers. Method: Prior to the implementation of mandatory bedside handovers in a hospital in Canberra, Australia, nurses in two wards (n = 66) were recruited to complete the new Bedside Handover Attitudes and Behaviours (BHAB) questionnaire. Results: Most nurses strongly value bedside handovers and have confidence in their ability to lead this clinical practice. Conclusions: Researchers identified a high level of alignment between the nurses' acceptance of bedside handovers and nurses' self‐reported actions in conducting this communication process. Implications for Nursing Management: Future research should explore the links between nurses' views of, and skills in, the management of bedside handovers, as well as the effects of professional training for this practice. Furthermore, the BHAB questionnaire may be employed in different nursing contexts in future research. [ABSTRACT FROM AUTHOR]

Aim: To determine factors associated with nurses' intent to leave their positions and absenteeism. Background: There is a recognized global shortage of nurses but limited data describing and determining factors associated with nurse absenteeism and intent to leave. Methods: This study involved a secondary analysis of the results from direct‐care registered nurses' responses to the MISSCARE Survey, with data from seven countries included. Multi‐level modelling was used to determine nurse characteristics and working environment factors associated with nurse absenteeism and intent to leave. Results: The level of absenteeism and intent to leave varied significantly across countries, with registered nurses in Lebanon reporting the highest intention to leave within 12 months (43%) and registered nurses in Iceland and Australia the highest level of absenteeism (74% and 73%, respectively). Factors associated with outcomes included perceived staffing adequacy of unit, job satisfaction, and age of the nurse. Conclusions: A significant difference between countries was identified in nurse absenteeism and intent to leave. Increased perception of unit staffing inadequacy, lower job satisfaction, less nurse experience, and younger age were significant contributors to nurse absenteeism and intent to leave. Implications for Nursing Management: These findings suggest that regardless of country and hospital, by ensuring that units are adequately staffed and increasing job satisfaction, younger, less experienced nurses can be retained and absenteeism reduced. [ABSTRACT FROM AUTHOR]

Aim: The aim of this qualitative research was to explore perceptions of organisational change related to the integration of nurse practitioners from key nursing stakeholders. Background: The ongoing delivery of effective and efficient patient services is reliant upon the development and sustainability of nurse practitioner roles. Examination of the factors contributing to the underutilization of nurse practitioner roles is crucial to inform future management policies. A change management theory is used to reveal the complexity involved. Method: Qualitative interviews were undertaken using a purposive sampling strategy of key stakeholders. Thematic analysis was undertaken and key themes were correlated to the theoretical framework. Results: The results confirm the benefits of nurse practitioner roles, but suggest organisational structures and embedded professional cultures present barriers to full role optimization. Complicated policy processes are creating barriers to the integration of nurse practitioner roles. Conclusion: The findings increase understanding of the links between strategic planning, human resource management, professional and organisational cultures, governance and politics in change management. Effective leadership drives the change process through the ability to align key components necessary for success. Sustainability of nurse practitioners relies on recognition of their full potential in the health care team. Implications for nursing management: The results of this study highlight the importance of management and leadership in the promotion of advanced nursing skills and experience to better meet patient outcomes. The findings reinforce the potential of nurse practitioners to deliver patient centred, timely and efficient health care. [ABSTRACT FROM AUTHOR]

Aim: To evaluate characteristics of job‐related meaningfulness, and to assess its potential to moderate the relationship between over‐commitment and emotional exhaustion in nurses. Background: Increased demands on nurses may induce vulnerability to emotional exhaustion, decrease job satisfaction, and increase their intention to quit the job. The experience of job‐related meaningfulness through meaning‐centred logotherapy and counseling could be a resource to prevent emotional exhaustion. Method: Nurses (n = 466; 73% female) at an Austrian tertiary‐care hospital participated in a cross‐sectional survey for assessment of job‐related meaningfulness by the newly developed CERES (Concern, Enthusiasm, Relevance, Efficacy, Satisfaction) scale. CERES was tested for its moderating interaction with over‐commitment (assessed by the Effort‐Reward Imbalance Questionnaire) to prevent emotional exhaustion (as measured by the Maslach Burnout Inventory) by structural equation modelling. Results: The CERES scale consisting of five items has satisfactory internal consistency (Cronbach's alpha:.78). Over‐commitment correlated significantly (p < .001) with emotional exhaustion. A moderating interaction of CERES with over‐commitment on emotional exhaustion was found overall (p < .001), and separately for males (p = .002) and females (p < .001). Conclusions: CERES is suitable for assessing experienced job‐related meaningfulness and it moderates emotionally exhausting effects of over‐commitment in nurses. Implications for Nursing Management: Nursing managers may improve nurses' awareness of job‐related meaningfulness by focusing on meaning‐centred feed‐back and counselling and thereby strengthening perception of concern, enthusiasm, relevance, efficacy, and satisfaction regarding their caring behaviour. [ABSTRACT FROM AUTHOR]

Aim(s): To understand nurses’ experiences of injustice in the workplace and to identify the impact of injustice on well‐being. Background: Little is known about how nurses view injustice or its effects on their well‐being, although research indicates that such perceptions are central to workplace practices such as performance management and outcomes such as employee well‐being. Method(s): A qualitative study was conducted with semi‐structured interviews for nurses employed in Australian public hospitals. Data were analysed using content analysis. Results: Experiences of injustice and unfairness negatively impacted on performance and the personal health of nurses. Unfair treatment was met with reduced effort and commitment. Conclusion(s): This study provides valuable insights into how nurses perceive and experience injustice at work and supports the link between injustice and nurses’ decreased well‐being and effectiveness. Implications for Nursing Management: Implications for nurse managers include the need for managers to engage in regular conversations regarding systemic barriers to performance and implementing performance management as an ongoing dialogue designed for employee voice and relationship management. This process also suggests a need for leadership development in nursing management. Using such steps and strategies would significantly enhance best practice in nursing management. [ABSTRACT FROM AUTHOR]

Aims To measure and model Australian, Cypriot and Italian nurses' beliefs about what care is missed and how frequently it occurs within their settings. Background This study expands on previous MISSCARE research but now applies and predicts missed care within three countries. Methods Multivariate analysis was performed to estimate 1,896 nurses' consensus scores about missed care activities based on Alfaro-Lefevre's conceptual framework of care priorities. Results Five latent variables have direct predictor effects on missed care frequencies. Another four variables including the nurses' age, highest qualifications, absenteeism rate and workplace type, contributed to explaining the overall variance of missed care scores. The nurses' gender had no influence on missed care. Conclusion Cross country comparisons of missed nursing care allow for a more refined identification of strategies for remediation for both managers and clinicians. Implications for Nursing Management Reliable consensus estimates about the types and frequencies of missed care can be scaled with variables identified to predict missed care across three different countries. Comparative international studies build on the foundations for understanding missed care in terms of nursing practices, policies and related social policies. [ABSTRACT FROM AUTHOR]

Background Relationships exist between aged care nurses' perceptions of psychosocial work characteristics, job satisfaction and mental health, suggesting these characteristics may be important for the management of aged care services. Aim An expanded demand-control-support model that included justice perceptions was examined to determine its impact on multiple types of psychological and organisational well-being outcomes (i.e. job satisfaction, psychological distress and depression). Method Data were collected from a sample of 173 aged care nurses using a self-report survey and analysed using hierarchical multiple regression. Results A significant proportion (27-28%) of the variance in aged care nurses' satisfaction, depression and psychological distress was explained by the psychosocial factors included in the model. Job control had the most consistent impact with direct effects on job satisfaction, psychological distress and depression. Informational justice was associated with both psychological distress and depression. Conclusions Targeting job control may provide the biggest response for nurse managers in aged care, as it is likely to influence nurses' job satisfaction, psychological distress and depression. Implications for nursing management Facility managers should implement organisational policies and procedures that promote higher levels of control over how nurses perform their work in order to improve nurse well-being in aged care settings. [ABSTRACT FROM AUTHOR]

Aim To investigate the nature and timing of support available to new graduate nurses within a rural transition to practice programme. Background For new graduates in rural practice successful transition is complicated by the unique role of the rural nurse, staff ratios and resources within rural environments. Little is known about the support needs of graduates working in rural health services, or who is best placed to provide support during their transition. Method This was a qualitative case study, using individual interviews with new graduate nurses at 3, 6 and 9 months milestones during a 12-month rural transition to practice programme plus interviews with experienced rural nurses who were employed in rural health agencies where the new graduate nurses were employed. Results Graduates in rural health services rely on nurse unit managers and nurse managers for feedback, support and debriefing, provision of emotional support, advocacy, openness, encouragement and protection from organisational requests and demands during the transition to rural nursing practice. Conclusions Nurse managers play an important role in rural health services in the provision of support for new graduate nurses. Implications for nursing management As clinical leaders rural nurse managers and nurse unit managers, have an important role in facilitating the successful entry and retention of new graduate nurses into the rural nursing workforce. [ABSTRACT FROM AUTHOR]