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Aim: The present study aimed to examine the effects of a learning programme for nurse managers on connecting learning with their own experiences and fostering competence. Background: In Japan, second‐level programmes for certified nurse administrators represent the main opportunity for formal training for nurse managers. However, it is difficult for nurse managers to transfer second‐level programme learning to their workplace. Methods: This quasi‐experimental study used a two‐group pretest–posttest design with purposive sampling and non‐random assignment of 29 consenting Japanese nurse managers who were participating in a second‐level programme through a prefectural nursing association. The programme provided reflection papers and feedback from a researcher, as well as reflective group sessions. The outcome measure was the Japanese First‐Line Nurse Managers Competence Inventory (JNMCI) score. Results: The intervention group showed significant improvement in JNMCI scores after participating in the programme. A significant difference in JNMCI scores was also observed between the intervention and comparison groups. Conclusion: This learning programme led to improved competency among nurse managers. Implications for Nursing Management: Nurse manager development programmes should include reflection papers and feedback, as well as reflective group sessions, to improve competency among nurse managers. [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]

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

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

Aim: This study aims to design a 100‐h training programme for nursing innovation teams and to evaluate the effect of this training programme using Kirkpatrick's model. Background: The innovative capability of nurses is a powerful driver for the development of the nursing discipline, and it is currently at a low to medium level in China. Innovation competency development has become a research trend in nurses' in‐service education, but only changes in nursing innovation behaviours before and after training have been evaluated. The cascading, continuous assessment tools are rarely used. Methods: This is a quasi‐experimental research design: pretest and posttest design. Totally, 61 clinical nurses from Hangzhou Hospital of Traditional Chinese Medicine were enrolled for innovation training. This innovation team training programme consisted of a 36‐h theoretical training phase and a 64‐h collaborative training phase. The four levels of Kirkpatrick's model, that is, reaction, learning, behaviour, and result, were applied for the evaluation together with questionnaires. Results: At reaction level, the nurses' attendance was over 85% in two phases. The differences between nurse organizational innovation climate scores of tested nurses before and after training were statistically significant (t = −22.559, P <.001). At learning level, there were statistically significant differences between nurses' innovation self‐efficacy scale scores of tested nurses before and after training (t = −16.832, P <.001). At behaviour level, the nursing innovation behaviour scale scores of tested nurses were significantly higher after training (t = −18.950, P <.001) than before the training. At result level, the clinical nurse innovation ability of tested nurses after the training were higher than before the training (t = −26.275, P <.001). The numbers of patent applications, granted patents, application for scientific research projects, sponsored scientific research projects, and papers published by team members after the training were larger than those before training (Z = −2.032, P =.042). Conclusion: Kirkpatrick's model can evaluate the effectiveness of nursing innovation training for clinical nurses. The nursing innovation training is beneficial to improve nurses' innovation capacity, organizational innovation climate and innovation self‐efficacy, and nursing innovation behaviour and promote the output of research and innovation projects. Implications for Nursing Management: Managers can flexibly develop training modules with regional characteristics based on this programme to effectively improve the innovation ability of clinical nurses, thus meeting the urgent demand for innovative nursing talents and the rapid development of nursing disciplines. [ABSTRACT FROM AUTHOR]

Aim: We aim to investigate nurses' perceptions of support after incidences of Workplace Violence. Background: Nurses experience workplace violence daily. Adequate support following incidents of violence can reduce adverse impacts. Current support systems for coping with workplace violence are lacking. Methods: Focus group interviews were conducted with 23 nurses working in a regional Queensland Hospital. Qualitative data was transcribed and thematically analyzed to determine themes. The consolidated criteria for reporting qualitative research checklist was followed. Results: The primary source of support after a violent incident was from other nurses. Support was needed immediately to empower nurses to be able to continue their caring role. Often the support was not provided nor were nurses aware of the support services available. Although personal family and friends were a valuable support, most nurses were reluctant to disclose their experiences to protect them. Conclusions: This paper discusses nurses' experience of support following violence incidents at work as part of findings from a more extensive study that explored the perceptions of nurses regarding violence, strategies and support in a regional Queensland Hospital. Hospital support following a violent incident was perceived as inadequate and nurses felt unsupported immediately following an incident. Implications for Nursing Management: After an incidence of workplace violence, appropriate effective support may mitigate the enduring impacts of experiencing violence. There is the need for hospital management to provide effective support services and improve staff awareness of available support services. [ABSTRACT FROM AUTHOR]

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

Aim: To explore the information‐seeking patterns of care aides who work in nursing homes. Background: Under the direction and supervision of nursing professionals, care aides provide the majority of direct care to nursing home residents. Understanding how, why, when and where they seek information to perform their duties is important for managers, policymakers and stakeholders. Method: Semi‐structured interviews with eight care aides employed in three Canadian nursing homes were analysed using the Braun and Clarke method of thematic analysis. Results: Five prominent information‐seeking patterns emerged as themes. Conclusions: Care aides were motivated to seek information for personal and job‐based reasons that included wanting to avoid mistakes and preparing physically, mentally and emotionally for the work ahead. They described depending on a social hierarchy of verbal information and using personal time (before/after work) to seek the information they needed. Due to time constraints, they relied on established patterns, accessed online information once a day at most and preferred paper‐based sources. Implications for Nursing Management: Programs to enhance care aide communication skills to include the importance of information‐seeking are warranted. Time for formal information‐seeking during working hours should be provided and encouraged. When care aides initiate information‐seeking to improve care this should be recognized and respected by others on the team. Programs to enhance care aide communication skills to include the importance of information‐seeking are warranted. Time for formal information‐seeking during working hours should be provided and encouraged. When care aides initiate information‐seeking to improve care this should be recognized and respected by others on the team. [ABSTRACT FROM AUTHOR]

Aims: To appraise the current instruments available for measuring the nursing work environment and re‐examine the definition and construct of the nursing work environment. Background: A psychometrically sound instrument is fundamental to understanding and improving the nursing work environment. The nursing work environment is a complex construct, and its definition remains inconclusive. None of the instruments available is considered as the gold standard. Evaluation: A comprehensive searching was undertaken in August 2021 in six databases according to PRISMA. The COSMIN and modified GRADE were applied to assess the methodological quality and measurement properties of the instruments. Instruments were categorized into three levels. The definition and construct of nursing work environment were revisited. Key issues: Forty‐one studies (19 instruments) were included. One, fourteen, and four instruments are respectively appraised as A‐, B‐ and C‐level recommendation. Definition and eight labels of nursing work environment are identified. Conclusion: This paper provides recommendations for selecting a proper instrument for the nursing work environment. Implications for nursing management: This study helps nurse managers to select instruments and understand the construct of the nursing work environment. The eight labels can be used as a reference for tailoring policy aimed at creating a favourable nursing work environment. [ABSTRACT FROM AUTHOR]

Aim This paper aims to identify and explore key obstacles preventing ward managers from effectively performing the human resource management (HRM) responsibilities required in their role. Background In the context of increasing costs and the decentralisation of responsibility to ward level, the relevance of the ward manager role within the 'black box' between human resource management and firm performance is becoming increasingly pertinent. Methods This paper presents an intensive case study including 37 interviews across all levels of a hospital where senior management attempted to shift to a high performance model of human resource management. Results The findings indicated that ward managers played a critical role in maintaining and improving employee performance, although they were restricted from effectively performing their responsibilities due to budget pressure and limited managerial skill development. Conclusions Our findings support the contention that hospitals would benefit from focusing on the critical role of the ward manager as the central locus of influence in high performance human resource management (HPHRM) systems. Implications for nursing management Investment into high performance human resource management is discouraged if the hospital cannot adequately enable ward managers who are responsible for implementation. Introduction of managerial skills training to potential and existing ward managers is critical. [ABSTRACT FROM AUTHOR]

Aim: To explore influences on nurses' missed care decision‐making processes in acute hospital paediatric care. Background: Many contemporary studies describe the phenomenon of missed care. It is clear that environment and organizational culture influence the nursing activities; however, what influences their decision‐making processes has not been investigated. Method: A descriptive qualitative inquiry was performed using semi‐structured interviews with paediatric nurses (n = 20) from one Italian paediatric hospital. Findings: Thematic analysis revealed four themes: nurses' value system; hospital logistics, structures and resources; prioritization processes; and the informal caregiver's role. Conclusion: This paper offers insights into the various factors involved in nurses' decision‐making process when contemplating missed care that will be of use to managers when planning care or addressing missed care in the paediatric clinical setting. Implications for Nursing Management: Knowledge and awareness of missed care in children's nursing needs greater exploration, especially in relation to what influences nurses' decision‐making choices around missed care. Overall, a greater understanding of this will help managers to manage situations effectively and ethically so that missed care does not impact on outcomes for children in health care. [ABSTRACT FROM AUTHOR]

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

Aim: This paper explored the general phenomenon and psychological experience of the special background communication in night shift medical staff and provides better reference for night shift communication between doctors and nurses. Background: Physician–nurse communication has always been an important agenda for health care work and an important concept in nursing theory. During night shifts, effective doctor and nurse communication can enhance mutual trust, provide timely and appropriate medical services to patients, reduce adverse events and enhance patient safety. Design: A qualitative study was conducted. Methods: Husserl's descriptive phenomenology method and semi‐structured in‐depth interviews were used to collect data from 8 nurses and 5 doctors. Colaizzi's method was used to analyse data using MAXQDA 12. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was followed (see Appendix S1). Results: Three themes were extracted after sorting out and refining: the need to achieve goals in night‐time physician–nurse communication; obstacles in night‐time physician–nurse communication; and relationship culture in night‐time physician–nurse communication. Conclusion: Attention should be paid to the particularity of night shift and efficiency of achieving the goal of communication between doctors and nurses on night shift, and the hidden obstacles behind communication between doctors and nurses. Managers should pay attention to the cultural construction of night shift communication in the system, form a good night shift communication process and regularly train doctors' and nurses' related communication skills. And they should also study relationship culture rationally to improve the communication efficiency of night shift. Implications for nursing management: The experiences described in this study contribute to a better understanding of obstacles hidden behind night shift physician–nurse communication. This also provides valuable information to professional managers who develop good doctor–nurse relationship culture. [ABSTRACT FROM AUTHOR]

Aim: This paper describes the development and testing of the psychometric property of the Toxic Leadership Behaviors of Nurse Managers (ToxBH‐NM) Scale. Background: Toxic leadership is growing increasingly pervasive in the field of nursing. However, the current literature lacks comprehensive attempts to explain how toxic leadership disrupts work processes in the field of nursing, a reality confounded in part by the absence of a reliable and a valid scale on which to examine toxic leadership behaviours in nurse managers. Methods: An exploratory sequential research design was used to formulate and evaluate the psychometric property of ToxBH‐NM Scale. The content validity was examined by experts in nursing administration. A sample of 313 nurses from selected hospitals was recruited to assess the scale's reliability and validity. The factor structure of the newly developed scale was determined by exploratory factor analysis (EFA). Results: Exploratory factor analysis for ToxBH‐NM Scale revealed 30 items loading on four factors. The overall Cronbach's α coefficient of the scale was 0.975, and Cronbach's α coefficient ranged from 0.895 to 0.965 for the four factors. Corrected item‐to‐total (0.310–0.69) and item‐to‐item correlations (0.47–0.66) were acceptable. The Scale‐content Validity Index was 0.957, and the Item‐content Validity Index ranged from 0.833 to 1.000. The test–retest reliability coefficient of ToxBH‐NM Scale was 0.801, with a reliability coefficient that ranged from 0.745 to 0.911 for the four factors. The four factors explained 71.84% of the observed variance. Conclusions: ToxBH‐NM Scale shows good psychometric properties and can be used to evaluate toxic leadership behaviours among nurse managers. Implications for Nursing Management: The use of ToxBH‐NM Scale can aid nurse managers in better understanding and managing their own leadership behaviours within their organisations and in fostering desirable work outcomes among employees, a positive work climate and overall organisational success. [ABSTRACT FROM AUTHOR]

Aim This paper acknowledges the relationship between resilience and the new managerialism of contemporary nursing. Methods Qualitative portraiture methodology. Discussion The new managerialism in hospital settings results in a rapidly increasing turnover of acutely ill or comorbid patients, which directly relates to retention and quality service. In education settings, the management imperative to recruit more students into the profession combined with financial cutbacks leads to similar tensions. In aged care the trend equates care directly with funding, with the same effect. Yet despite this, many registered nurses remain working. Portraiture explored 'why' nurses remain in workplaces often described as awful. The resilience of nurses is seen through their stories and reframed to highlight resilience as a form of resistance to the new managerialism inherent in contemporary healthcare. Conclusion This paper describes some of the hallmarks of new managerialism where workforce pressures force practices that do not value the 'human resource'. Implications for nursing management The quotes from the field give insight into the nurse's world view and have implications for managers, educators and employers, as well as for consumers of nursing care. [ABSTRACT FROM AUTHOR]

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

Aim: To examine the effect of nurse staffing patterns (nursing staff skill mix and patient classification system) on patient satisfaction with the nursing care received. Background: Evidence about the relationship between the nursing staff structures and patient outcomes in post‐transitional countries is limited. Methods: The research was conducted in three units of one secondary‐care regional hospital in Slovenia over 1 month. This cross‐sectional study used three main data elements exploring nursing staff levels (nursing hours per patient day and skill mix), patient needs (using a classification system), and patients' satisfaction with nursing care; 484 patients participated. Results: Significant positive correlations were found between the patients' satisfaction and the realized percentage of the registered nurse personnel requirements, the level of nursing care hours per patient day, and the proportion of registered nurses in the nursing team. Conclusions: A significant association between the actual and needed staffing levels and patient satisfaction was found. Nurse staffing patterns affect patient outcomes. Implications for Nursing Management: This paper supports a higher proportion of registered nurses and an increased number of overall nursing staff working hours. Managers should consider the results of the patient needs categorization system and the workforce structure characteristics as predictors of patient satisfaction. [ABSTRACT FROM AUTHOR]

Aim: To explore the interplay between the work of nurse managers and the support they receive and provide. Background: Support is the cornerstone of management practices and is pivotal in employees feeling committed to an organisation. Support for nurse managers is integral to effective health sector management; its characteristics merit more attention. Methods: The experiences of 15 nurse managers in rural health institutions in South Australia were explored using structured interviews, observation and document review. Results: Effective decision making requires adequate support, which influences the perceptions and performance of nurse managers, creating an environment in which they feel appreciated and valued. An ideal support system is proposed, the “sandwich support model,” to promote effective functioning and desirable patient outcomes via support “from above” and “from below.” Implications for Nursing Management: The need to support nurse managers effectively is crucial to how they function. The sandwich support model can improve management practices, more effectively assisting nurse managers. Organisations should revisit and strengthen support processes for nurse managers to maximize efficiencies. Conclusion: This paper contributes to understanding the importance of supporting nurse managers, identifying the processes used and the type of support offered. It highlights challenges and issues affecting support practices within the health sector. [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]

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]

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]

Aim To explore nurses' use of the World Health Organization safety checklist in the perioperative setting. Background Promoting quality and safety in health care has received worldwide attention. The World Health Organization surgical safety checklist (2009) is promoted for reducing postoperative morbidity and mortality. The checklist has been introduced in Irish perioperative settings. Method(s) A descriptive, qualitative approach was utilised. A purposeful sample of ten nurses participated in individual, semi-structured interviews. Results Participants were committed to promoting safety in navigating challenges in introducing, complying and accepting the value of the World Health Organization surgical safety checklist in concordance with best practice. Participants moved from task completion to embracing the checklist as an effective surgical safety checking tool. Challenges were identified around roles and responsibilities in overseeing the completion of the checklist. Conclusion(s) The management of processes is critical when implementing any safety initiative. This paper highlights the complexity and challenges in implementing the World Health Organization surgical safety checklist, contributing to global discussions around translating policy into practice. Implications for nursing management The effective implementation of a checklist requires a coordinated management approach in collaboration with team members. These approaches will support learning experiences contributing to a shared understanding of the change being implemented by all team members. [ABSTRACT FROM AUTHOR]

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

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]

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]

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]

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

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

Aims This paper describes the perceptions of nurse managers about their dual role in nursing units as cost centres. Background The tertiary hospital in the Limpopo province is the first institution to appoint nurse managers with a dual role in cost centres. The development of a conceptual framework for a context-specific programme for Cost Centre Managers is the first of its nature in South Africa. Method A qualitative, exploratory, descriptive design was followed. The target population included nurse managers ( n = 35) formally appointed as cost centre managers with a dual role of delivering quality care and cost management. A focus group and individual interviews were conducted until data saturation occurred. Results Personal and professional distress, an empowering potential of being a cost centre manager, and the need for decentralized cost centre management were indicated as barriers for nurse managers that led to a framework for a context-specific training programme. Conclusion There is a need for a context-specific training programme for cost centre managers in a hospital with cost centres. Implications for nursing management The training of cost centre managers for their dual role in cost centres could enhance cost effectiveness, quality care and staff satisfaction. [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]

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]

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]

Aim This paper presents an evaluation of a career development policy in South Australia which increased the number of senior staff nurse positions and provided senior registered nurses with time away from clinical duties to undertake agreed projects. We use Kanter's model of structural power and commitment theory to understand the dimensions of this policy. Background Development strategies for experienced staff who wish to remain at the bedside are needed, especially in smaller health services with limited opportunities for horizontal or vertical mobility. Methods Face-to-face semistructured interviews were conducted with 54 senior staff nurses who participated in the career structure arrangements. Results The policy enhanced the structure of opportunity in three ways: by increasing the number of senior staff nurse positions, the ladder steps were improved; undertaking strategic projects developed new skills; and the job enrichment approach facilitated time out from the immediate pressures of ward work and challenged nurses in a different way. Conclusions Through job enrichment, South Australia has found a novel way of providing meaningful career development opportunities for experienced nurses. Implications for nursing management Methods of job enrichment need to be considered as part of career development policy, especially where movement between clinical facilities is limited and staff wish to remain at the bedside. [ABSTRACT FROM AUTHOR]

Aims This paper compares the perceptions of nurse managers and nurses about self-leadership of professional nurses while taking ownership of capacity building during unit management. Background The Nursing Strategy for South Africa states that the competency of nurses is dependent upon factors that lead to capacity building. Method A quantitative design was followed by conducting a survey. The target population included nurse managers and professional nurses working at an academic public hospital in the Gauteng Province of South Africa. Results The findings indicate shortcomings in relation to advising professional nurses about self-direction while taking ownership of their daily pressures and stresses associated with unit management. Conclusion Professional nurses should develop their confidence by focusing on their self-leadership strengths when managing a unit. Implications for nurse managers Recommendations are made to promote self-leadership while taking ownership of nurses during capacity building of unit management. [ABSTRACT FROM AUTHOR]

Aim This paper describes perceptions of the end users on quality of antiretroviral therapy ( ART) in public health facilities in Nigeria. Background Health care services in Nigeria face challenges of meeting end users' requirements and expectations for quality ART service provision. Method A qualitative design was followed. Unstructured focus group discussions were conducted with end users ( n = 64) in six locations across the six geopolitical zones of Nigeria. Results The findings indicate that end users were satisfied with uninterrupted antiretroviral drug supplies, courtesy treatment, volunteerism of support group members and quality counselling services. Conclusion End users expect effective collaboration between healthcare providers and support group members, to enhance the quality of life of people living with HIV. Implications for nursing management A best practice guideline for the provision of end user focused ART service provision was developed for nurse managers. [ABSTRACT FROM AUTHOR]

Aim This paper reports on the development of an instrument for nurse-led medication monitoring, the West Wales Adverse Drug Reaction profile for respiratory medicines, as part of a strategy to reduce avoidable adverse drug reactions. Background Preventable adverse drug reactions account for 3.7% hospital admissions. Nurse-led medication monitoring may reduce drug-related harm. However, development of medication monitoring strategies is not reported elsewhere. Methods The profile was developed by: (1) cognitive interviews ( n = 4), (2) the content validity index ( n = 10) involving academics, clinicians and service users prescribed respiratory medicines, (3) inter-rater reliability ( n = 48) and clinical gains in a nurse-led outpatient clinic. Results Cognitive interviews prompted more profile changes than either the content validity index or inter-rater reliability testing. Cohen's κ for inter-rater reliability for each item ranged from 0.73-1.00 (good to complete agreement). The profile identified previously unsuspected problems in all participants, including muscular weakness, skin and mouth problems. Conclusions The West Wales Adverse Drug Reaction profile was valid and reliable, and helped to detect and ameliorate drug-related harm. Implications for nursing management The West Wales Adverse Drug Reaction profile offers opportunities to improve care. Medication monitoring provides the structure to concurrently monitor known adverse drug reactions. Practice-based adverse drug reaction profiles benefit from cognitive, content validity and inter-rater reliability testing. [ABSTRACT FROM AUTHOR]

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

Aim This paper reports on a study that looked at the characteristics of exemplary nurse leaders in times of change from the perspective of frontline nurses. Background Large-scale changes in the health care system and their associated challenges have highlighted the need for strong leadership at the front line. Methods In-depth personal interviews with open-ended questions were the primary means of data collection. The study identified and explored six frontline nurses' perceptions of the qualities of nursing leaders through qualitative content analysis. This study was validated by results from the current literature. Results The frontline nurses described several common characteristics of exemplary nurse leaders, including: a passion for nursing; a sense of optimism; the ability to form personal connections with their staff; excellent role modelling and mentorship; and the ability to manage crisis while guided by a set of moral principles. All of these characteristics pervade the current literature regarding frontline nurses' perspectives on nurse leaders. Conclusion This study identified characteristics of nurse leaders that allowed them to effectively assist and support frontline nurses in the clinical setting. Implications for nursing management The findings are of significance to leaders in the health care system and in the nursing profession who are in a position to foster development of leaders to mentor and encourage frontline nurses. [ABSTRACT FROM AUTHOR]

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

Aim This paper documents findings from a service evaluation of clinical managers' ( n = 5) perceptions of the assistant practitioner (AP) training programme in one National Health Service (NHS) Trust in South East England, UK. Background The AP has been identified in England as a means for supporting registered nurses and enhancing patient care. The development of the AP role requires managers to consider how the role will be embedded and how they work with education providers. Methods This service evaluation interviewed five clinical managers who have supported APs in relation to their function for the specialist clinical role. Results The AP role should be defined by competence, boundaries and the skill mix needed for specific clinical team function. Careful recruitment is vital and mentors need clear outcomes for the AP role. Managers need to be involved in all levels of the programme, from liaison with the Higher Education Institute and Trust decisions on role job descriptions and employment. Conclusions Recruitment is vital, individuals have to be flexible and responsive to change and should be used in relation to their clinical competence. A competency framework for all health-care workers was the managers' desire for job descriptions and assessment of practice so that every member of the health-care team was 'fit for purpose'. Implications for nursing management Nurse managers need to work with workforce leads when considering introduction of new roles so appropriate skill mix is achieved and the AP role is embedded. [ABSTRACT FROM AUTHOR]

sparks a.m. (2012) Journal of Nursing Management 20, 451-460 Psychological empowerment and job satisfaction between Baby Boomer and Generation X nurses Aim This paper is a report of a study of differences in nurses' generational psychological empowerment and job satisfaction. Background Generations differ in work styles such as autonomy, work ethics, involvement, views on leadership, and primary views on what constitutes innovation, quality, and service. Method A secondary analysis was conducted from two data sets resulting in a sample of 451 registered nurses employed at five hospitals in West Virginia. One data set was gathered from a convenience sample and one from a randomly selected sample. Data were collected from 2000 to 2004. Results Baby Boomer nurses reported higher mean total psychological empowerment scores than Generation X nurses. There were no differences in total job satisfaction scores between the generations. Conclusion There were significant differences among the generations' psychological empowerment scores. Generational differences related to psychological empowerment could provide insight into inconsistent findings related to nurse job satisfaction. Implications for nursing management Nurse administrators may consider this evidence when working on strategic plans to motivate and entice Generation X nurses and retain Baby Boomers. Although implications based on this study are tentative, the results indicate the need for administrators to consider the differences between Baby Boomer and Generation X nurses. [ABSTRACT FROM AUTHOR]

koivu a., saarinen pi. & hyrkas k. (2012) Journal of Nursing Management 20, 401-413 Does clinical supervision promote medical-surgical nurses' well-being at work? A quasi-experimental 4-year follow-up study Aim The aim of the present paper is to report results of a quasi-experimental study exploring the effects of clinical supervision (CS) on the development of medical-surgical nurses' well-being at work over a 4-year period. Background Effective workplace interventions are needed to prevent stress and burnout. More robust scientific evidence is needed to confirm the restorative effects of CS in nursing. Methods A questionnaire survey on the perceptions of work and health was conducted in 2003 and 2007 on 14 units of a Finnish university hospital where 19 CS group processes had been completed between 2004 and 2007. Results Improvement in job resources as well as reduction in professional inefficacy and psychological distress were found among nurses who received effective CS ( n = 41), but were not present among the nurses who found their CS less effective ( n = 43) or who did not attend CS ( n = 82). Conclusions The results provide robust evidence for the positive effects of CS on medical-surgical nurses' well-being at work. Implications for nursing management Stress is a developmental challenge in the professional growth of individual nurses. One option for management to sustain nurses' well-being at work is to develop a learning organization in the workplace making use of CS. [ABSTRACT FROM AUTHOR]

mcglynn k., griffin m.q., donahue m. & fitzpatrick j.j. (2012) Journal of Nursing Management 20, 260-265 Registered nurse job satisfaction and satisfaction with the professional practice model Aims This paper describes the initial assessment of job satisfaction and satisfaction with the professional practice environment of registered nurses working on units where a professional practice model was implemented and the relationship between these two variables. Background The nursing shortage has been linked to overall job satisfaction and specifically to nurses' satisfaction with the professional practice environment. Initiatives to increase retention and recruitment and decrease turnover have been linked to work satisfaction among nurses. Methods A descriptive, cross-sectional design was used with participants ( N = 101) from four patient care units; this represented a 55% response rate. Results The nurses were moderately satisfied with the professional practice environment but had overall low job satisfaction. There was a significant negative relationship between overall work satisfaction and satisfaction with the professional practice environment ( P < 0.0001). Conclusions The introduction of the professional practice model may have raised awareness of the components of job satisfaction that were not being met. Thus, the nurses may have become more knowledgeable about the potential needs in these areas. Implications for nursing management Nurse managers and leaders must recognize that job satisfaction consists of many dimensions, and each of these dimensions is important to nurse retention. Implementation of a professional practice model may heighten awareness of the missing components within a practice environment and lead to decreased overall satisfaction. A broader understanding of characteristics associated with increased satisfaction may aid in development of organizational change necessary to retain and attract nurses. [ABSTRACT FROM AUTHOR]

tebid r., du plessis d., beukes s., van niekerk v. & jooste k. (2011) Journal of Nursing Management 19, 967-975 Implications for nurse managers arising from immigrant women's experience of midwifery care in a hospital Aim This paper focuses on implications for nurse managers to support midwives in delivering nursing care to immigrant mothers in some government hospitals in Gauteng, South Africa. Background Immigration and poverty in Africa has led to midwives providing nursing care to immigrant mothers in a culturally sensitive environment. This necessitates an environment in which nurse managers should support midwives in caring for these mothers as unique individuals. Method An exploratory, descriptive phenomenological design was followed. The target population included nine immigrant mothers living in the inner centre of Johannesburg who, for the first time, attended, had antenatal clinics, laboured and gave birth at a Government Hospital in the Gauteng province of South Africa. After purposive sampling, phenomenological interviews were conducted until data saturation occurred. Results The findings indicate that nurse managers should ensure that midwifery care of immigrant mothers comply with the ethical-legal context of the South African constitution. Actions should be taken in combating issues related to impaired maternal-midwife relationship, lack of cultural sensitivity and psychological distress. Conclusion The delivery of maternity care to immigrant mothers is below the standard expected in the South African context. Implications for nursing management The nurse manager should support midwives to ensure an environment to care for immigrant mothers in maternity wards. [ABSTRACT FROM AUTHOR]

, (2011) Journal of Nursing Management 133-142 This paper reports on a study undertaken to test the sensitivity, specificity and feasibility of four fall risk assessment tools. Falls risk assessment tools have been developed based on literature and findings from empirical studies, but the instruments often lack further testing in the clinical setting. Four falls risk assessment tools were tested simultaneously in this study. The data was collected in May-June 2006. All assessment tools were completed on a total of 1546 patients. Descriptive statistics were used for data analysis. The use of the instruments was moderately consistent among registered nurses, but the education provided did not entirely eliminate problems with accuracy. The sensitivity of the instruments was 57.1-100% and specificity was 24.9-69.3%. The sensitivity and specificity of the instruments are important factors to consider when choosing an instrument. However, the strategies to educate staff and to intervene appropriately are equally important for an organization undertaking a proactive stance in mitigating the risk of falls. It is important for managers to test instruments in their own organizations and specific populations. It is also critical to carefully assess that the chosen instrument is easy and accurate in use. [ABSTRACT FROM AUTHOR]

Aim. To explore academic and clinical nurses' perceptions and experiences on academic-practice partnership in evidence-based practice. Background. Academic-practice partnership could promote evidence-based practice which is crucial for high-quality care. Academic and clinical nurses are the foundation of the partnerships; however, there is little knowledge of their perceptions and experiences on academic-practice partnership in evidence-based practice. Methods. This is an interpretive description study. Twenty-two eligible participants were interviewed through face-to-face or online videoconferencing meetings. Guiding questions for the interviews focused on the perceptions and experiences of academic-practice partnership in the context of evidence-based practice. Interviews were recorded, transcribed, and checked verbatim. We used constant comparative analysis to analyze the qualitative data. Results. Four themes with fifteen subthemes were generated: necessities, modes, challenges, and benefits of the academic-practice partnership in evidence-based practice. Participants believed that academic-practice partnership was a necessary strategy to promote evidence-based practice and could be built through different modes. Nevertheless, most academic-practice partnerships were superficial because of specific types of challenges. However, a good academic-practice partnership could create a win-win situation for both nursing academia and clinical practice. Conclusion. Academic-practice partnership is a win-win strategy for both the academic side and clinical side to promote evidence-based practice. Different modes of academic-practice partnership provide academic and clinical nurses with more opportunities to promote evidence-based practice with a higher likelihood of successful implementation. However, related challenges require multilevel measures to provide better environments to initiate, build, and maintain intensive collaborations between academic and clinical nurses. Implications for Nursing Management. Academic and clinical organizations, leaders, and individuals should take multilevel measures to initiate, build, and maintain a close academic-practice partnership to promote evidence-based practice, which is crucial for high-quality nursing care, patient safety, and nursing discipline development. [ABSTRACT FROM AUTHOR]