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Aim. To systematically map and identify key knowledge on organizational support for nurses' career planning and development. Design. Scoping review. Methods. Systematic electronic searches were carried out with the CINAHL, PubMed, Scopus, and Web of Science databases in May 2022. The searches were limited to scientific, peer-review papers that were published in English from January 2012 to May 2022. Data were extracted and synthetized and are presented in tables and text. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results. We identified 1,400 papers and 28 met the inclusion criteria. Organizations recognized nurses' career planning and development in relation to the individual's professional development and the organization's need to promote high-quality services and workforce engagement. The organizational support included strategic work to ensure there were adequate resources and purposeful vacancies and a structured framework based on objective qualification criteria and equal assessment. Organizations focused on sharing knowledge, structured career planning, and interpersonal support. Support within the nursing profession and multilayered interprofessional collaboration were also important. Conclusion. Nurses' career planning and development was linked to their personal development and the organization's aims and required support from both fellow nurses and other professionals. Implications for the Nursing Management. Identifying the organizational structures and methods that are needed to support nurses' career planning and development can help nursing management to evaluate and develop strategies that improve the attractiveness of a nursing career and nurses' engagement. [ABSTRACT FROM AUTHOR]

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

Nurses' turnover intention has increased since the COVID-19 pandemic. Emotional labor is reportedly high among nurses in Korea, and a positive psychological capital can help reduce turnover intention. This cross-sectional study investigated the factors influencing turnover intention in nurses during the COVID-19 pandemic. Survey data were collected from 155 nurses caring for patients with COVID-19 at a university hospital in South Korea in March 2022. Self-reported and paper-based questionnaires on emotional labor, positive psychological capital, and turnover intention were employed. The mean values for emotional labor, positive psychological capital, and turnover intention were 54.52/80, 58.03/90, and 38.92/50, respectively, and 77.8% of nurses reported planning to quit working. Turnover intention correlated with emotional labor (r = 0.17; p = 0.041) and had no significant relationship with positive psychological capital. Sex (β = 0.24; p = 0.003) and emotional labor (β = 0.18; p = 0.019) affected turnover intention, with 9% explanatory power. Female nurses caring for patients with COVID-19 had a higher turnover intention than male nurses. Finally, the higher the emotional labor of nurses caring for patients with COVID-19, the higher the turnover intention. To reduce the turnover intention of nurses, hospitals need to help them enhance their emotional labor and positive psychological capital by establishing measures such as emotional coaching programs or psychological capital interventions. [ABSTRACT FROM AUTHOR]

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

Background. Several studies identified that emotional intelligence skills are important indicators for nurse engagement and performance. Issues related to nursing performance in healthcare organizations have been gaining greater attention because they influence the effectiveness of improvement approaches to maintain high-quality care. This study aimed to investigate the relationships between emotional intelligence and nurses' work performance and work engagement. Methods. A quantitative, descriptive, correlational design was used to evaluate the relationships between the study variables. Data were gathered from 150 nurses working at Madinah Cardiac Center, Saudi Arabia. Three scales were used to measure the study variables which were Emotional Intelligence Scale, Job Performance Scale, and Utrecht Work Engagement Scale in addition to demographics. SPSS was used to analyze data. Results. The results of this study showed that emotional intelligence has a total mean of 3.77 (SD = 0.598), nurses' performance 3.65 (SD = 0.503), and work engagement 4.29 (SD = 1.04). The results also showed that there is a positive and significant relationship between emotional intelligence and nurses' work performance (R2 = 0.657, p < 0.001). Also, it was found that emotional intelligence has a positive and significant relationship with nurses' work engagement (R2 = 0.621, p < 0.001). Conclusions. This paper highlights the influence of emotional intelligence in nurses' improved performance and engagement in work. The field of nursing is associated with care and compassion; thus, it needs a high level of emotional intelligence. Nurses need to enhance their emotional intelligence skills by attending workshops. Nurse leaders also have a role in that by building a culture for nurses that is driven by applying emotional intelligence in the workplaces. [ABSTRACT FROM AUTHOR]

Aim. The objective was to investigate the impact of structural empowerment and demographic factors on the psychological empowerment of nurses. Background. The empowerment of nurses plays a crucial role in improving patient care and achieving successful healthcare outcomes. When nurses feel empowered in their work environment, they tend to remain dedicated to their jobs and experience higher levels of job satisfaction and engagement. Methods. This cross-sectional study utilized a convenience sample of 287 nurses recruited from various hospital units, resulting in a response rate of 94.7%. Data were collected through a paper survey consisting of three sections: structural empowerment, psychological empowerment, and demographics. Results. The first hierarchical regression explains 57.0% variance in nurses' psychological empowerment (F = 78.52, p < 0.001). Age (β = 0.37, p < 0.01) and structural empowerment (β = 0.69, p < 0.001) have a positive influence on nurses' psychological empowerment. Conversely, having a bachelor's degree (β = −0.16, p < 0.01) had a negative impact psychological empowerment. The second hierarchical regression clarifies the specific aspects of structural empowerment that influences positively on nurses' psychological empowerment: access to opportunities (β = 0.13, p < 0.01), support (β = 0.13, p < 0.01), resources (β = 0.35, p < 0.001), and informal power (β = 0.12, p < 0.01). Conclusion. This study emphasizes the importance of considering demographic variables, such as age and education, in conjunction with structural empowerment to effectively enhance nurses' psychological empowerment. Implications for Nursing Management. Nursing managers should tailor their empowerment strategies based on the demographic characteristics of their nurses. It is essential to focus on providing nurses with access to opportunities, support, resources, and informal power. These insights provide valuable guidance for nursing managers to enhance nurses' psychological well-being, job satisfaction, and overall quality of life. Ultimately, this contributes to positive outcomes for patients, nursing staff, and healthcare organizations. [ABSTRACT FROM AUTHOR]

Although individual factors play a vital role in determining professional autonomy, their specific impact during the coronavirus disease 2019 (COVID-19) pandemic has not been studied. This study aimed to compare nurses' professional autonomy when caring for patients with COVID-19 and for other patients and explore factors related to autonomy when caring for these patients. A paper-based questionnaire survey was conducted from June to August 2022 among nurses working at a university hospital in Japan. The survey included demographic factors (10 items, including, age, section, years of nursing experience, position, educational background, ladder level, and having certified nurse specialists or certified nurse qualifications) and individual experience factors (4 items: number of COVID-19 patients experienced, frequency and contents of searching for the latest information about COVID-19, frequency of using scientific sources, and frequency of training/study sessions on COVID-19 attended at the hospital). Additionally, basic knowledge of COVID-19 was evaluated. The scale for nurses' professional autonomy was developed based on a previous study. A paired t-test and stepwise multiple linear regression were used for the analyses. Overall, 241 nurses participated in the survey. The average length of nursing experience was 10.3 ± 9.2 years. The total scores for nurses' professional autonomy in all 5 factors 27 items were significantly lower (t = −12.1, p < 0.001) when caring for COVID-19 patients than when caring for other patients. Specifically, Factor 1 (Cognition) exhibited the most decreased scores when caring for COVID-19 patients than when caring for other patients. Factor 4 (Abstract judgment) differed the least between caring for COVID-19 and for other patients, but the average score was the lowest. More years of nursing experience (β = 0.208, p = 0.001) and a higher number of patients with COVID-19 cared for (β = 0.140, p = 0.026) were associated with higher autonomy scores. In conclusion, to enhance professional autonomy during an unprecedented pandemic, nurses must enhance cognition and abstract judgment. In the event of a future pandemic, nurses need to create an environment in which they routinely access and utilize the latest information and scientific evidence to provide high-quality nursing care based on their professional judgment and competence. [ABSTRACT FROM AUTHOR]

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

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

Aim. The aim of this study was to understand the current status of knowledge-attitude-practice of ICU nurses in tertiary care hospitals regarding swallowing disorders after extubation of tracheally intubated patients and to analyse the influencing factors. Design. A cross-sectional study. Background. Most patients admitted to the ICU have an endotracheal tube, which may be the cause of acute and/or chronic problems after extubation. Therefore, training of ICU nurses and early extubation are essential to prevent these problems. Methods. A convenience sample of clinical nurses (n = 627) was selected from Grade A Hospitals in Northwest, North, and Central China as the study population. Survey instruments included the Questionnaire on ICU Nurses' Knowledge, Attitude, and Practice of Postextubation Swallowing Disorders in Patients with Tracheal Intubation. Data Sources. Data were sourced from structured questionnaire responses. Results. A total of 647 ICU nurses participated in this survey, with 627 valid questionnaires. The three dimensions of knowledge, attitude, practice, and the total score of the questionnaire on ICU nurses' knowledge, attitude, and practice of postextubation swallowing disorders in patients with tracheal intubation were (6.46±3.09), (7.53±1.69), (4.89±2.00), and (18.88±5.18), respectively. Multiple linear regression analysis showed that the factors affecting the total score of PED among ICU nurses were age, nationality, professional title, job satisfaction, and mode of employment. Gender, age, nationality, and job satisfaction were the factors that influenced the score of knowledge. The influencing factors of attitude score include gender, age, nationality, section, professional title, job satisfaction, and mode of employment. The influencing factors of the score of knowledge include professional title and job satisfaction. Conclusion. The current status of ICU nurses' knowledge-attitude-practice regarding postextubation dysphagia in tracheally intubated patients is generally at a moderate to low level, and the level of knowledge-attitude-practice needs to be further improved. Implications for Nursing Management. The results of the study showed that the knowledge, attitude, and practice of ICU nurses towards tracheal intubation patients' postextubation dysphagia were in the lower middle level. Therefore, it is necessary to improve the knowledge, attitude, and practice of ICU nurses towards tracheal intubation patients' postextubation dysphagia. This may include, but is not limited to, the development of tools for assessing PED, systematic and professional training, and the development of multidisciplinary collaborative models. [ABSTRACT FROM AUTHOR]

Aims. This study aimed to analyze the effects of the surgery preparation time on patient outcomes. Background. Postoperative complications have a decisive effect on postoperative survival. The anesthesia time is a crucial determinant of such complications. Competent operating room nurses can shorten the surgery preparation time, which is the time from when anesthesia is first administered to the making of the surgical incision. The shortening of this preparation time can shorten the anesthesia time and may reduce postoperative complications. However, discussion of this preparation time is insufficient. Therefore, this study analyzed the effect of the surgery preparation time on patient outcomes. Methods. From electronic health records data, this retrospective cohort study used the data of 1,944 patients who had been immediately admitted to the ICU after their surgery between 2017 and 2020. The patients were divided into two groups: ≥30 minutes preparation time and <30 minutes preparation time groups. We performed chi-squared tests and t-tests to determine differences in preoperation, intraoperation, and postoperation characteristics of the patients and patient outcomes based on the surgery preparation time. Furthermore, we performed a multiple logistic regression by including 12 adjusted variables to determine the influence of the surgery preparation time on patient outcomes. Results. Among the 1,944 patients, 820 were in the ≥30 minutes preparation time group and 1,124 in the <30 minutes preparation time group. The multiple logistic regression analysis showed that the surgery preparation time affects alertness (OR = 1.44; 95% CI: [1.09, 1.90]), ventilator application (OR = 1.32; 95% CI: [1.03, 1.70]), and length of stay in the ICU (OR = 1.69; 95% CI [1.16, 2.47]). Conclusions. The surgery preparation time affects postoperative patient outcomes. The competence of operating room nurses is the most essential aspect of the surgery preparation time. Implications for Nursing Management. It is important to analyze operating room nurses' tasks, standardize the tasks, and educate nurses according to their experience level to reduce the surgery preparation time and improve patient outcomes. [ABSTRACT FROM AUTHOR]

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

Objectives. To examine the effectiveness of a patient-family (carer) partnership intervention on the BP control, self-care and self-efficacy for hypertensive people, and dyadic-relationship quality, depressive and anxiety symptoms, and health-related quality of life for the family dyads (hypertensive people and family carers) in rural communities of mainland China. Design. A randomised controlled trial. Methods. A total of 110 family dyads were randomly recruited from village clinics and randomly allocated to the intervention group (n = 55) or control group (n = 55). Family dyads in the control group received usual care. In addition to the usual care, family dyads in the intervention group received the individual-based, five-session patient-family (carer) partnership intervention. The primary outcomes included SBP, DBP, and the proportion of people with normal controlled BP. EuroQol five-dimensional-five-level (EQ-5D-5L) was adopted to evaluate participants' health-related quality of life. Data were collected at the baseline (T0), one-month (T1), and three-month postintervention (T2). Generalised estimating equation model was adopted to test the study hypotheses on all study outcomes. Results. Compared with the control group, hypertensive people in the intervention group had a greater reduction in SBP by 10.10 mmHg and DBP by 4.66 mmHg and a larger proportion of people with normal BP at T2, as well as statistically significant improvements at T1 and T2 in dyadic relationship, self-care, antihypertensive drug-titration rate, anxiety symptoms, and health-related quality of life. The intervention also had statistically significant positive effects on family carer's dyadic relationship and health-related quality of life at T1 and T2. Conclusion. The patient-family (carer) partnership intervention has the potential to improve hypertensive people's BP control and family dyad's dyadic-relationship quality and mental health at short-to-medium term follow-ups. Implications for the Profession and/or Patient Care. This study provided evidence and direction to support healthcare providers in developing and implementing patient-family (carer) partnership intervention for hypertension care in rural areas. This trial is registered with ChiCTR1900027087. [ABSTRACT FROM AUTHOR]

Background and Objectives. The scarce empirical and scientific information concerning evidence-informed management reports various benefits for nurse managers, including reduced staff turnover, enhanced working environments, and improved patient outcomes and policy implementation. This review summarizes best available evidence on facilitating utilization of evidence-informed management practices by nurse managers in healthcare facilities. The review could assist in a comprehensive overview of determinants that could assist nurse managers' successful utilization of evidence-informed management. Methods. An integrative review of the literature was conducted, including peer-reviewed articles published between 2010 and 2022. The databases used were BioMed Central, CINAHL Complete, MEDLINE Complete, PubMed (via EBSCOhost), the Complimentary Index (Taylor and Francis, Elsevier, Wiley, and Springer), Sabinet, ScienceDirect, and Scopus, followed by a manual search using Google Scholar and a citation search. Johns Hopkins Nursing Evidence-based Practice Research and non-Research evidence tools were used for appraisal. Thematic analysis was used to synthesize the extracted data. Results. Based on thirteen determinants influencing nurse managers' utilization of evidence-informed management practices, three themes were identified from a total of thirteen relevant studies: (1) Nurse manager determinants in utilization of evidence-informed management (Microlevel); (2) Organizational determinants in utilization of evidence-informed management (Mesolevel); (3) External stakeholders and context determinants of utilization of evidence-informed management practices (Macrolevel). Conclusion. The themes were found to be interconnected and interdependent, facilitating the effective utilization of evidence-informed management by nurse managers at micro-, meso-, and macrolevels, but highlight the need for strengthening health systems and support. Future studies are required to provide a more comprehensive understanding of the determinants influencing nurse managers' utilization of evidence-informed management practices. Implications for Nursing Management. For nurse managers to optimally utilize evidence-informed management, executive management and policymakers require to provide resources and support such as continuous education, incentives, effective communication, funding structures, and ownership. [ABSTRACT FROM AUTHOR]

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

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

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]

Aims. This umbrella review aims to comprehensively synthesize and analyze the findings of available systematic reviews on the effectiveness of individual-based strategies for reducing nurse burnout occurring in hospital-based settings. Methods. Following JBI guidelines, an umbrella review was conducted to integrate the effectiveness of various strategies to reduce burnout. Systematic reviews were searched in the Embase, MEDLINE (Ovid), Cochrane Library, CINAHL (EBSCO), Scopus, and WOS databases. Inclusion criteria included studies published in any language from database inception to April 2023. Eligibility assessment involved two independent reviewers who evaluated titles, abstracts, and full texts. The systematic reviews were critically evaluated using JBI SUMARI. The results were narratively synthesized and grouped by strategy. Results. Eleven systematic reviews were included, covering the years 2012 to 2021. The appraisal tools varied, though all included reviews were of high quality. The strategies were categorized into three domains: mental health (51%), physical activities (26%), and professional competence (13%). The interventions most identified were mindfulness-based stress reduction for mental health, yoga for physical activities, and professional competence education. These individual-based strategies were shown to effectively eliminate emotional exhaustion (72.7%), depersonalization (44%), and occupational stress (78%) among nurses in hospital-based settings. Conclusion. Mental health, physical activities, and professional competence are strategies to reduce nurse burnout. Implementing these approaches in healthcare settings can improve emotional exhaustion, depersonalization, and occupational stress of nurses. [ABSTRACT FROM AUTHOR]

Background. Improving the recruitment and retention of healthcare workers in the continuing care sector is critical to ensuring adequate care for older adults, which was highlighted following the COVID-19 pandemic. Purpose. The purpose of this study was to understand the perceptions of prospective registered nurses about working in the continuing care sector and identify workplace attributes that attract prospective nurses to the sector. Methods. A sequential mixed methods study was conducted with nursing students at Ontario Tech University. Focus groups (n = 14) asked students to comment on views about working in the continuing care sector, and job attributes that may attract them to the sector. Focus group data were analyzed using thematic analysis. Subsequently, a cross-sectional survey asked students to respond to elicited choice job scenarios that varied job attributes. The job attributes were shaped by the focus group interview data. To assess respondent's preferences, the survey data (n = 139) were analyzed to generate willingness-to-pay (WTP) values for each job attribute. Results. Focus group interviews suggested that fair compensation, optimal client-to-staff ratios, unionized work environments, comprehensive benefits packages, and flexible work arrangements were important job attributes. In survey results, 18.0% expressed interest in working in the continuing care sector compared to 75.5% in acute care. Regression analysis suggested that higher amounts of paid vacation (WTP: −5.983; 95% CI: −13.749 and −0.037) and higher risk of injury (WTP: 0.684; 95% CI: 0.124 and 1.208) were associated with work in the continuing care sector. Impact. Continuing care workplaces can attract nurses by offering flexible options such as part-time positions and paid vacation and by taking actions that can mitigate the risk of workplace injury, violence, and abuse. Nursing students should be shown the positive aspects of working with older adults and dispel negative perceptions about the continuing care sector. Further research is needed to understand the preferences for work and risk perceptions among currently employed nursing staff. [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]

Background. Violence at work against healthcare professionals is a frequent and pervasive problem. There are growing data that indicate nurses are especially susceptible to experiencing violent acts at work. Resilience helps strengthen nursing competency in the proper management of stressful circumstances, like being exposed to workplace violence. Aim. The aim of the study is to assess the impact of resilience on workplace violence among mental health nurses. Method. A cross-sectional research design was used to conduct this study with a convenience sample of 361 nurses recruited from a governmental psychiatric hospital in Saudi Arabia. Tools. Data were collected using two tools: the first tool was the workplace violence questionnaire, which collected nurses' demographic, job, and workplace violence data, and the second was the resilience at work scale to assess nurses' resilience. Results. This survey found that 70.4% of nurses experienced workplace violence in the last year, and fewer than half were resilient at work. Close to one-third (33.5%) of nurses were terrified and confused after workplace violence. The most violent repercussions were psychological (46.8%): dread, tension, and worry. Additionally, 48.8% of nurses exhibited high work resilience. Conclusion. A considerable percentage of mental health nurses encountered instances of violence during the provision of care inside mental health hospital settings. The variables of nationality (non-Saudi nurses), rotating work shift, educational levels, and exhibiting a lower level of resilience were found to have a statistically significant correlation with instances of workplace violence. Recommendation. Training programs and educational initiatives should be developed and implemented to equip nurses with the necessary knowledge and skills to effectively respond to and prevent workplace violence incidents. By providing comprehensive training, healthcare organizations can empower nurses to address and mitigate workplace violence, ultimately creating a safer and more supportive work environment. [ABSTRACT FROM AUTHOR]

Background. The study investigates critical care nurses' perceptions of medication administration errors (MAEs) in a tertiary hospital in Kelantan, Malaysia, within the unique sociocultural context of East-Coast Malaysia. The research aims to understand the causes and underreporting of MAEs and assess the proportion of reported incidents according to MAE types. Methods. A cross-sectional study involving 424 critical care nurses from Hospital Raja Perempuan Zainab II (HRPZII), Hospital Sultan Ismail Petra (HSIP), and Hospital Tanah Merah (HTM) was conducted. Nurses in administrative roles or unavailable during the survey period were excluded. The study utilized a validated Medication Administration Errors Survey questionnaire to gauge nurses' perceptions on the causes of MAEs, reasons for underreporting, and the percentage of reported incidents based on MAE types. Results. Results indicate that illegible medication orders from doctors were identified as the primary cause of MAEs, while a lack of 24-hour pharmacist availability received the lowest score. The most common reason for not reporting MAEs was identified as the nursing administration's focus on individuals rather than systemic issues when errors occur. The majority of MAEs were non-intravenous, with incorrect timing of administration being the leading cause. Conclusion. The study sheds light on critical care nurses' perspectives on MAEs in a Malaysian hospital setting, highlighting key factors contributing to these errors and barriers to their reporting. Understanding these perceptions is crucial for developing strategies to mitigate MAEs and enhance patient safety in critical care environments. [ABSTRACT FROM AUTHOR]

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

Background. Nurses are one of the largest and costliest groups in healthcare organizations; therefore, it is important to comprehend their scope of practice. Aim. To contribute to the improvement of nursing resource management in medical-surgical and Intensive Care Units by identifying factors that influence the scope of nursing practice. The hypothesis was that the activities carried out by nurses in medical-surgical units and intensive care units are influenced by individual and job-related factors, with job characteristics having an additive and moderating effect on individual characteristics. Materials and Methods. Cross-sectional correlational design to test the relationship between the individual and job characteristics on the nursing scope of practice measured by the Actual Scope of Nursing Practice (ASCOP) questionnaire. The sample consisted of 270 nurses. Linear mixed effects models analysis (LME) was used with the aleatory effect of the intensive care unit (ICU). Results. Belonging to the ICU decreased the scope of practice of nurses. We found a statistically significant effect of psychological demand, practice environment, role ambiguity, and growth need strength on the scope of nursing practice. The models explained a variance up to 24%. Conclusions. Although the survey results revealed the existence of broader scope of practice levels in Spanish hospital units than in the original Canadian study, the use of scope of nursing practice remains suboptimal. Higher levels on the psychological demand, the practice environment and in the individual growth need strength were related with a broader scope of practice. Otherwise, role ambiguity negatively affected the scope of practice. Implications for Nursing Management. This article provides an analysis of the impact of individual and job-related characteristics on the nursing scope of practice. It serves as a valuable resource for both managers and nurses, offering insights to improve nurses' working conditions and obtain more efficient workforces. [ABSTRACT FROM AUTHOR]

Background. Haematology nurses in Singapore experience a highly stressful work environment and increased workload due to the growing number of patients and complex treatment regimens. High job demands can lead to burnout and high staff turnover rates, which compromises the quality of patient care. Aims. To assess perceived work demands, levels of social support from colleagues, professional quality of life (ProQOL), and turnover intentions among haematology nurses and examine whether demographic and occupational characteristics, perceived job demands, and support were associated with ProQOL and turnover intentions. Design. A descriptive, correlational, and cross-sectional design was used in this study. Methods. A convenience sample of 60 haematology nurses working at a tertiary hospital in Singapore completed a self-administered survey. Perceived job demands, support from colleagues, ProQOL, and turnover intentions were measured using the Copenhagen Psychosocial Questionnaire (COPSOQ III), Professional Quality of Life Scale version 5 (ProQOL5), and Turnover Intention Scale (TIS-6). Descriptive statistics, chi-square test, and multiple linear regressions were employed for data analysis. Results. Haematology nurses face high cognitive and emotional demands and receive high levels of support from colleagues at work. The majority of the participants reported moderate to high levels of compassion satisfaction (78.3%), burnout (76.7%), and secondary traumatic stress (81.7%). 53.3% of the participants expressed their intention to leave. Perceived job demands were significant predictors of haematology nurses' ProQOL and turnover intentions. Compassion fatigue also significantly predicts turnover intentions. Conclusion. The high levels of burnout and secondary traumatic stress reported by haematology nurses highlight an urgent need to implement strategies to help nurses cope with the high work demands and reduce their levels of compassion fatigue. Implications for Nursing Management. The findings in this study can help nursing leaders understand haematology nurses' perceived job demands and ProQOL, to develop strategies to improve the workplace environment and retention. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

Existing studies have identified specific factors influencing some dimensions of evidence-based practice (EBP) competence and use. However, the way these factors interact still needs to be clarified. The purpose of the study was to test a model based on the Determinant Frameworks that explain the relationships and the direct pathways between the characteristics of the nurses, the context, and the implementation strategies and the dimensions of EBP competence, attitude, knowledge, skills, and use of EBP. A cross-sectional study was carried out in Spain during January and February 2020, involving 2,370 nurses employed in public health centers across all autonomous communities within the National Health System. An online survey was administered to gather data, addressing various topics related to the nurses' characteristics, the context in which they worked, the implementation strategy, and their competence in evidence-based practice (EBP). As depicted in the conceptual framework, a structural equation model was constructed to test the hypothesized relationships among key study variables. The model obtained showed a good fit (χ2/df = 3.20, p < 0.001 ; RMSEA = 0.030 [90% CI 0.025, 0.036]; CFI = 0.989; GFI = 0.990; TLI = 0.983). The context, more specifically, the dimensions of nurse participation in the center's affairs, nursing foundations for quality of care, nurse manager ability leadership and support of nurses, and implementation strategy have a direct and positive effect on EBP use. Training in EBP, reading scientific articles, and having a doctorate are associated with higher competence and knowledge in EBP. The final fit shows the #Evidencer model for the use of EBP (#EvidencerMUSEBP) with two main components: the contextual and strategic factors that influence the implementation of EBP and the characteristics of the professionals, such as their training and reading of articles, which have an impact on EBP competence. This model could guide healthcare organizations in proposing comprehensive interventions to improve EBP use and the competency of nurses. [ABSTRACT FROM AUTHOR]

Background. Nurses play a critical role in the medical workforce during the COVID-19 pandemic while facing various difficulties and challenges. Grit, social support, and self-esteem are important psychosocial factors influencing job performance. However, few studies have explored the relationships among these factors in nurses. Aim. This study aimed to examine the association between grit and nurses' job performance during the COVID-19 pandemic and to explore the potential chain mediation through perceived social support and self-esteem. Methods. A cross-sectional survey design was employed. From January 2021 to May 2022, a total of 709 Chinese nurses in Chengdu and Kunming completed a web-based cross-sectional survey, which included standard assessments on grit, perceived social support, self-esteem, and job performance as well as Big Five personalities. The chain mediation model was tested using the PROCESS macro program in the SPSS software. Results. There was a moderate-to-large correlation (r = 0.40, p < 0.001) between grit and job performance in Chinese nurses. Furthermore, grit was indirectly linked to job performance through the chain mediating effect of perceived social support and self-esteem (all p < 0.05). These findings persisted even when Big Five personalities were included as additional controlling variables. Conclusions. This study reveals a stable link between grit and job performance among Chinese nurses and highlights the potential role of perceived social support and self-esteem in mediating this link. Implications for Nursing Management. Nursing managers can improve nurses' grit level and provide a supportive organizational environment conducive to enhancing self-esteem and thereby promoting their job performance. [ABSTRACT FROM AUTHOR]

Orientation. Trust is the central part of leadership and organizational culture and can often go unnoticed until it decreases. There is a lack of a comprehensive concept analysis of trust in the healthcare setting. Research Purpose. The research aim was to gather, assess, and synthesize previous empirical evidence from the field of healthcare about the concepts of trust in the leader and trust in the organization. Motivation for the Study. To create a comprehensive and generic concept analysis of trust in the leader and organization for the healthcare sector based on recent empirical studies. Research Design and Method. A concept analysis, which followed the method presented by Walker and Avant, was conducted as a systematic review that adhered to the PRISMA guidelines. A total of eight databases were searched for relevant literature and 42 articles were included. Main Findings. The definitions of trust in the leader and the organization were based on emotion and cognition. Trust in the leader emerged as a core feature of collaborative leader-employee relationships, whereas trust in the organization was a key construct of organizational functioning. Trust in the leader and the organization contributed to commitment, increased work production, enhanced collaboration, and improved workplace well-being. Defense mechanisms were identified as a new contrary concept, while justice was found to be a related concept. Contribution. Both trust in the leader and trust in the organization positively impact an organization, nurse leaders, and employees. Deeper knowledge of trust and its attributes will be critical to the operationalization and estimation of levels of trust in healthcare organizations. Managerial Implications. Trust in the leader and the organization can significantly influence the attractiveness of an organization, retention of personnel, productivity, and work-related well-being. Thus, this aspect should be measured and developed systematically while acknowledging the antecedents of trust building. [ABSTRACT FROM AUTHOR]

Background. Compared to nurses in other hospital departments, intensive care unit (ICU) nurses have more frequent exposure to patient deaths, potentially rendering them more susceptible to experiencing professional grief following patient fatalities. Objective. To explore the coping experiences of ICU nurses following their encounter with professional grief. Methods. This study utilized a qualitative research design based on Heideggerian phenomenology. A purposive sample of 18 ICU nurses was selected from six tertiary hospitals in Guangdong Province, China. Individual semistructured interviews were audio-recorded and transcribed verbatim. The transcribed texts were analyzed using interpretative phenomenological analysis. Results. Two main themes emerged: (1) short-term dual coping with professional grief and (2) long-term cumulative changes from professional grief. These themes reflect the dynamic coping processes experienced by ICU nurses amidst frequent encounters with loss and grief during their clinical work. Conclusions. ICU nurses employ both adaptive and maladaptive coping strategies to address professional grief, significantly impacting their personal and professional well-being. It is advisable to offer targeted education and organizational support systems for ICU nurses to promote positive cumulative growth when they repeatedly encounter patient deaths. [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]

Aims. To explore the mediating effect of cognitive load on the relationship between self-efficacy and task load among intensive care unit (ICU) nurses. Background. Studies related to ICU nurses' self-efficacy, cognitive load, and task load are noteworthy but limited. Methods. A total of 253 ICU nurses from three tertiary hospitals in Beijing were recruited and investigated by the Chinese version of the National Aeronautics and Space Administration-Task Load Index (NASA-TLX), General Self-Efficacy Scale (GSES), and an instrument for Measuring Different Types of Cognitive Load (MDT-CL) scales. SPSS 25.0 was used for Pearson correlation analysis and multiple linear regression analysis and mediation effect analysis using Model 4 in PROCESS (5,000 resamples). Results. Mediation analysis indicated that a partial mediating effect of extraneous cognitive load between self-efficacy and task load among ICU nurses was −0.707 (95% CI: −0.940, −0.504), accounting for 51.64% of the total effect. Conclusion. This study suggests that enhancing ICU nurses' self-efficacy can be a potential strategy to decrease extraneous cognitive load and task load. Implications for Nursing Management. Nursing administrators should actively implement intervention strategies based on influencing the task load pathway of ICU nurses to ensure they can provide safe and high-quality nursing services. [ABSTRACT FROM AUTHOR]

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

Background. The link between organizational culture, organizational trust, job satisfaction, and team-based practice among nurse practitioners (NPs) has not been examined simultaneously. Aim. To identify the effects of organizational culture, organizational trust, and other factors on NPs such as job satisfaction and team-based practice. Methods. We used a cross-sectional design with a national sample. Data were collected using an online survey of 1,100 NPs working in acute care settings. The survey included demographic and working characteristics, the Organizational Culture Scale, the Organizational Trust Scale, the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS), and the NP-physician relations (NP-PR) subscale of the Nurse Practitioner Primary Care Organizational Climate (NP-PCOCQ). Multiple regression analysis with a stepwise selection method explored potential factors that influence job satisfaction and team-based practice. Results. A learning environment, psychological safety, senior leadership support, commitment to the organization, and the organizational culture and trust were positively associated with higher job satisfaction, which accounted for 49.2% of the variance in NPs' job satisfaction. Organizational trust, commitment to the organization, and learning environment promoted better team-based practice significantly. Also, NPs working a fixed shift pattern showed higher levels of team-based practice. These factors accounted for 23.66% of variances in team-based practice. Conclusion. Organizational culture and organizational trust affect the job satisfaction and team-based practice of NPs in acute care practices. Implications for Nursing Management. Acute care hospitals are encouraged to develop policies to enhance a learning environment, a supportive organizational culture, and trust in NPs' practice. [ABSTRACT FROM AUTHOR]

Aims. This study aimed to explore workload whether Nursing Activities Scores on one shift could predict workload for the next shift. Method. This was a retrospective observational exploratory study of cross-sectional design carried out in a postoperative and intensive care unit at a local, nonprofit hospital in Norway. Data were collected from the hospital's internal database from January 1st to June 30th, 2016. Results. A total of 2,695 patients and 5,916 Nursing Activities Scores were included. The model could predict a 55.1% to 66.9% variation in Nursing Activities Scores for the next shift. When the number of patients was added, the model explained up to 80% of the variation. Conclusions. The Nursing Activities Score can be used to predict nursing workload from one shift to another and as an instrument for managers to adjust their staffing requirements. Implications for Nursing Management. Nursing Activities Score assessing nursing workload for all patients in a unit can support the resource planning with accuracy for nurse staffing. [ABSTRACT FROM AUTHOR]

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

The aim of this study was to identify factors affecting the noise management performance of adult intensive care unit (ICU) nurses in Korea. The ICU environment is exposed to various types of noises due to the use of medical devices for the treatment of critically ill patients. The noise has an adverse effect on nurses' health and their nursing performance, which might potentially threaten patient safety. A cross-sectional study was conducted with a total of 148 nurses working in adult ICUs from two university hospitals in Korea. Data were collected using self-administered questionnaires, which included various aspects such as noise knowledge, response to noise, patient safety culture, and noise management performance. Multiple regression analysis revealed that teamwork (β = 0.33, p = 0.004), patient safety policy, and procedure (β = 0.25, p = 0.037), which were subscales of patient safety culture, as well as frequency of noise experience (β = 0.16, p = 0.030) were significant factors affecting adult ICU nurses' performance of noise management. This study provides a significant basis for promoting adult ICU nurses' performance in noise management. A structured policy and procedure for noise management should be established for reducing noise in adult ICUs. In terms of nursing education, it is necessary to consider and develop team-based training programs to promote noise management performance in the ICU. Nurse managers and nursing organizations should consider how to create conditions in which nurses can recognize the importance of noise reduction and perform well in noise management. [ABSTRACT FROM AUTHOR]

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

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

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

Background. Missed nursing care, which has been explored in various acute care settings, results in adverse patient outcomes and job dissatisfaction in nurses. However, little is known about missed care in the operating room. Objective. This study tested a hypothesised model to identify relationships between nurses' age, years of experience in the operating room, job satisfaction, and intention to leave which have direct and indirect effects on the frequency of missed care. The frequency of missed care was hypothesised to be mediated by nurses reported perioperative competence and the reasons for missed care. Design. A cross-sectional design using an online survey of Australian perioperative nurses was undertaken in 2022. Methods. All Australian College of Perioperative Nurses members were invited to participate. Missed nursing care was measured using the MISSCARE Survey-OR. Age, years of experience, and intention to leave were single-item measures. Satisfaction was a three-item scale. Competence was measured by the 18-item Perceived Perioperative Competence Scale-Short Form. Structural equation modelling was used to test our hypothesised model. Results. Of the 5,500 nurses invited, 853 (15.5%) responded, but only 602 (10.9%) participant responses were usable for inclusion in the model. The model demonstrates that participants' age directly predicted the frequency of missed care, nurse role satisfaction, perceived perioperative competence, and reasons for missed care. The reasons for missed care and perceived perioperative competence were mediators that were negatively associated with the frequency of missed care. Conclusions. While the final model explained 22.6% of the frequency of missed care, other variables not identified in this study may influence this outcome. [ABSTRACT FROM AUTHOR]

Aims and Objectives. To evaluate nonpharmacological interventions for preventing patient and visitor-perpetrated violence against healthcare workers within hospital settings. Background. Up to 92% of health workers experience some form of patient-perpetrated violence. The highest risk environments include emergency departments, acute care settings, and mental health units. Given such elevated rates of violence, current interventions have questionable efficacy or implementation challenges. Design. We conducted a systematic review conforming to PRISMA reporting requirements. We searched PubMed, CINAHL, PsycINFO, Scopus, and the Cochrane Library. Studies reporting interventions to prevent patient-initiated violence against healthcare workers in hospitals were included, and findings were synthesised. Results. Based on meeting eligibility criteria, twelve studies were included in the review. Most interventions reported an effect with eleven of the twelve studies describing changes in the incidence of violence postintervention. Most studies were evaluations of education and training programs (n = 7), followed by action plans (n = 2), and a reporting instrument, risk assessment tool, and legislation (n = 1). Conclusions. Insights into effective strategies to prevent hospital patient and visitor-initiated violence are necessary to develop guidelines for better aggression/violence deterrence. Violence prevention requires strong, evidence-based, and clinically applicable interventions that promote the safety and satisfaction of all healthcare workers. Relevance to Clinical Practice. Formulating effective and appropriate strategies that aid in early recognition, prevention, and management of aggression/violence will benefit all health workers. Patient and staff satisfaction will rise; healthcare workers will regain a sense of preparedness, and higher levels of safety will be achieved. Without these effective interventions being established, the magnitude of adverse outcomes from patient-perpetrated violence will continue in healthcare. [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]

Aim. To synthesise and map what is known about second-level nurses' workplace violence experience. Background. Workplace violence has become a topic of focus in nursing over recent years. Research demonstrates that there is a growing body of literature focusing on first-level nurses' workplace violence experiences, but those of second-level nurses, a crucial component of the health workforce in many countries, have not been well explored. Evaluation. A scoping review was conducted from January 2000 up to March 2022 using Arksey and O'Malley's framework and databases, including ABI/Inform Collection, CINAHL, DOAJ, EBSCOhost, and ProQuest Central. Key Issues. Eighteen studies were included in the final review. The review identified three key findings related to second-level nurses' workplace violence experience. (1) They were found to have experienced physical and non-physical violence. Among non-physical violence, they reported experiencing bullying, mobbing, sexual harassment, racial discrimination, nurse-to-nurse conflict, and electronic abuse. (2) They were more likely than first-level nurses to experience physical violence, and (3) often data from second-level nurses were combined with those of first-level nurses; hence, it was difficult to identify the specific experiences of second-level nurses. Conclusion. The review contributes to new knowledge highlighting the second-level nurses' workplace violence experiences worldwide. The review indicated that there are gaps identified and there is a need for greater understandings of workplace violence in second-level nurses to understand the scope of their problem and the nature of their experiences. Implications for Nursing Management. Nurse managers play a critical role to develop and implement effective policies and evidence-based interventions to improve the working conditions of the second-level nurses. The results of this current review can be used to guide nurse managers and organisations in providing adequate support to reduce and prevent WPV and advocate for a positive workplace culture. [ABSTRACT FROM AUTHOR]

Aims. This study examines the importance of senior-leader presence on the "frontline" in times of crisis. Background. The COVID-19 pandemic placed unprecedented demands on nurses charged with delivering critical care. Extant research suggests that the active presence of ward-level leaders has an important role to play in supporting frontline staff and mediating the negative impacts of stress and burnout. There is little evidence on the impact of senior leader presence or absence on the experience of frontline critical care nurses, particularly at times of crisis. Methods. A three-phase qualitative interview study of critical care nurses in the UK and Ireland. A total of 107 semistructured interviews with 54 nurses representing 38 different healthcare units. Results. Senior-leader presence at the time of crisis serves as an important symbol of organisational support. Where senior leaders are not meaningfully present, they risk allowing the necessary pain of difficult work situations to become toxic. Toxicity is manifested with increased staff stress, emotional ills, absence, and turnover. Conclusions. Senior leaders must balance their responsibilities for strategy and structures with the frontline presence required to shape a positive emotional climate. Implications for Nursing Management. Senior managers should consider supplementing their strategic focus with punctuated returns to the floor. Symbolically, leaders who get their hands dirty embody a sense of mutual struggle and practical support. Managerially, time on the floor increases the opportunities for collecting primary data to improve decision-making and support. [ABSTRACT FROM AUTHOR]