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Aim: The purpose of this study was to evaluate the compliance of Jordanian nurses with ventilator‐associated pneumonia prevention guidelines and the barriers to compliance. Method: A descriptive, cross‐sectional design was used. A convenience sample of 294 nurses from nine hospitals in Jordan completed a self‐reported questionnaire. Results: According to the study compliance categories, 45.6% of the participants reported 'insufficient compliance,' 24.8% 'weak compliance' and 29.6% 'sufficient compliance.' Nurses with more experience and previous education on ventilator‐associated pneumonia reported higher compliance scores than their counterparts with less experience and no previous education. Nurses reported several barriers that limited their own compliance, such as lack of education, lack of policies and protocols, lack of resources and the shortage of staff. Conclusion: The compliance of nursing staff with the prevention guidelines was poor. Applying tailored educational programs may help improve their level of compliance. These programs must target new graduate nurses and be conducted in those hospitals with limited resources. SUMMARY STATEMENT: What is known about this topic? Assessment of nurses' compliance with ventilator‐associated pneumonia (VAP) prevention guidelines is essential.Identifying barriers to compliance with VAP guidelines is the first step to improve the practice. What this paper adds? Compliance with VAP prevention guidelines in developing countries, such as Jordan, is still modest.Educational programs on VAP prevention improve the nurses' practice.Incidence of VAP rate should be linked to compliance rate with the prevention guidelines.Several barriers such as lack of resources and policies and shortage of staff interfere with nurses' compliance.Education and training of nurses would help to improve compliance and overcome barriers. The implications of this paper: Educating nurses in the clinical settings is imperative in order to prevent the occurrence of VAP.Providing human resources and supplies would help to prevent VAP. [ABSTRACT FROM AUTHOR]

Introduction: The effects of COVID-19 lockdowns and the discontinued face-to-face clinical practicum had negative consequences on nursing and midwifery students at many levels. The clinical learning environment includes all the training and learning experiences that nursing students undergo during their clinical practicum. Objectives: This study aimed to assess the effects of the COVID-19 lockdowns on the nursing and midwifery students' practicum training in governmental and private universities and academic faculties of nursing in Jordan. Methods: A descriptive cross-sectional study of 1025 nursing and midwifery students from academic faculties of nursing of both governmental and private Jordanian universities was conducted in September 2021. The research group from two Jordanian universities designed and validated a 13-item survey to determine and evaluate the impact of mass lockdowns on nursing and midwifery students' practicum training. The responses were assessed using descriptive and inferential analyses. Results: The findings revealed that the lockdown had a negative impact on nursing and midwifery students' self-confidence and competency in performing nursing procedures. The academic year of the students was a significant independent predictor of their self-confidence and competency levels in performing nursing procedures. Conclusion: The study concluded that nursing and midwifery students were dissatisfied with their clinical education during the COVID-19 pandemic, which led to poor self-confidence in performing nursing procedures. The study group recommended repeating the clinical practicum, incorporating extensive laboratory and hospital courses, and implementing a one-year internship for newly graduated nurses and midwives to address the training gap and enhance self-confidence in clinical procedures. [ABSTRACT FROM AUTHOR]

Background: Evidence-based practice (EBP) has become of great interest to policymakers, health care practitioners, and researchers. Objective: This study aimed at assessing knowledge associated with, attitudes toward, and implementation of EBP among Jordanian registered nurses (RNs) in critical care units. Method: A descriptive, correlational, and cross-sectional study was conducted in 5 hospitals: 3 public and 2 private. A convenience sample of 200 RNs was invited. Data were collected using a paper-based and self-administered questionnaire, in 2 sections; the first section was the demographic and contextual characteristics and the second was the Evidence-Based Practice Questionnaire (J Adv Nurs. 2006; 53(4):454-458) to measure RNs' knowledge, attitudes, and EBP. Results: A total of 187 RNs were included in this study. Findings revealed that Jordanian RNs in critical care units perceived themselves as having a satisfactory level of knowledge and practice of evidence-based interventions. In addition, RNs strongly recognized the value of EBP. There were significant positive associations between EBP and knowledge associatedwith EBP (r = 0.708, P < .001) and attitude toward EBP (r = 0.490, P < .001). Conclusion: Knowledge associated with EBP, a positive attitude toward EBP, higher educational qualifications, and training in EBP all increased the implementation of EBP. It is recommended that continuing education programs on EBP for nurses be conducted. Nursing educators in clinical settings have to consider a number of strategies to improve EBP. A qualitative research design and/or including open-ended questions are encouraged to gain more in-depth views about EBP. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine the impact of demographic variables, organizational commitment levels, perception of health and quality of work on turnover intentions. A self-reported cross-sectional survey design was used to collect data from Jordanian registered nurses who were working between June 2011 and November 2011. The findings showed strong effects of the quality of work, perception of health and normative organizational commitments on turnover intentions. This study sheds the light on the important work outcomes in health-care organizations. Increasing nursing quality of work and normative organizational commitment are good strategies for reducing turnover intentions. [ABSTRACT FROM AUTHOR]

Aim: The aim of the current study was to examine the relationship between work engagement and perceived organisational support and self‐efficacy among registered nurses in Jordanian hospitals. Background: Nurses constitute the backbone of the health care system. Work engagement among nurses is critical due to its various positive outcomes: it enhances job satisfaction, job performance, organisation commitment and emotional health. According to the job demand–resource model, perceived organisational support and self‐efficacy increase work engagement. Method: A cross‐sectional, descriptive and correlational design and multistage cluster sampling were implemented. A total of 186 registered nurses were recruited. Self‐administered questionnaires were used to collect data from the participants. Results: Nurses showed an average level of work engagement. The dedication subscale showed the highest score among the three subscales representing work engagement. The results showed that perceived organisational support and self‐efficacy were positively correlated with work engagement (p <.01). Conclusion: Perceived organisational support and self‐efficacy correlated positively with work engagement. Implications for nursing management: An effort should be made to provide a supportive work environment by offering training programmes, sufficient job resources and positive feedback, which, in turn, improve nurses' work attitudes, self‐efficacy, perception of the work environment and intention to stay in a health organisation. This study is a descriptive study and has an IRB number 766‐2019. [ABSTRACT FROM AUTHOR]

Excessive smartphone use has been found to be associated with dysfunctional social and family relations. While most studies of this phenomenon have focused on adolescent and adult addiction, none has yet to focus on mothers with infants. This study examined the association of excessive smartphone use with mother–infant bonding, maternal mental health, and family functioning in Jordan. The predictive value of the study variables with respect to the level of smartphone use was evaluated. A descriptive correlational cross‐sectional survey design was used. A sample of 114 mothers with infants was interviewed in person and completed a web‐based questionnaire. Approximately 16% reported using smartphones 5 to 14 hours per day; 6.7% described themselves as smartphone addicts. The results suggest that excessive smartphone use may be linked to unhealthy family functioning. No associations were found between smartphone use and mother–infant bonding or maternal mental health. Raising awareness of this linkage and limiting smartphone use are recommended as precautionary measures. Although this study failed to find any association between smartphone use and mother–infant bonding, further studies using empirical methods might have better success. [ABSTRACT FROM AUTHOR]

Medication administration is a critical task of nurses that, if not done appropriately, can lead to fatal errors. New technologies, including barcode medication administration, are intended to decrease medication errors and enhance verification of medication‐administration rights. Therefore, in this study, we examined the effect of introducing barcode medication administration on nurses' satisfaction and identified correlates of nurses' satisfaction with barcode medication administration. A descriptive, cross‐sectional design using self‐reported questionnaires was utilized to recruit 207 nurses from three public hospitals. Participants reported being moderately satisfied with barcode medication administration, especially with its efficacy and safety aspects. Their satisfaction had a significant negative correlation with their age, nursing experience, and experience using barcode medication administration, and a significant positive correlation with barcode medication‐administration training satisfaction, computer competence, comfort with using barcode medication administration, and perceived job productivity using barcode medication administration. This study provides important information about Jordanian nurses' satisfaction with barcode medication‐administration technology and provides greater understanding of different clinical correlates to barcode medication‐administration satisfaction. It is recommended that effective barcode medication‐administration training and computer skills training be provided prior to establishing barcode medication administration in hospitals and that the safety features of barcode medication administration be integrated in clinical education and training. [ABSTRACT FROM AUTHOR]

Background: The work conditions in which the nurses provide care for older adults affect the quality of care. Study aim: (a) To describe the quality of care for older adults as perceived by the nurse; (b) to examine the relationship between occupational stress, work climate, employee development and quality of care for older people; and (c) to determine the predictors of quality of care provided for older adults. Methods: A descriptive correlational design was used in this study. A multi‐strategic sampling technique was used to recruit a sample of 500 nurses providing care for older adults in hospitals and health care centres. Results: Almost 80% of the participating nurses reported that their workplace was insufficiently staffed. Quality of care was significantly associated with occupational stress, nurses' competence and employee development. Significant predictors of quality of care were occupational stress, work climate and employee development. Conclusion: Enhancing nurses' work climate, decreasing occupational stress and increasing chances for employee development would improve the quality of care provided for older adults. Implications for nursing management: Health institutions have the opportunity to implement work environment improvements that increase support for advancing staff knowledge and skills by providing additional support for continuing education regarding the care of older adults. [ABSTRACT FROM AUTHOR]

Abstract: Aim: This study aimed to investigate nurses’ perceptions of the nursing work environment in Jordanian hospitals. Background: Previous research has indicated a strong relationship between nurses’ work environment and their satisfaction at work. However, little is known about the situation in Jordan. Method: A cross‐sectional and descriptive design was used. A sample of 500 nurses was recruited. The study was conducted using the Individual Workload Perception Revised scale (IWPS‐R). Results: A sum of 382 out of 500 nurses from three health care sectors in Jordan responded to the questionnaires (response rate = 76.4%). The results indicate that nurses working in the public hospitals had significantly better perceptions about their work environment than nurses working in private and university hospitals. Older nurses with lower academic qualifications are more likely to be satisfied with their work. Furthermore, nurses who have good perceptions of support from their manager and peers, and a manageable workload are more likely to stay in their jobs. Conclusion: The public hospitals are currently considered a more suitable milieu for nurses in Jordan. Other health care sectors should work to enhance nurses’ working conditions. Implication for nurse manager: Providing a supportive work environment with a manageable workload will encourage nurses to stay in their hospitals. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Physical restraint is mainly used in intensive care units ( ICUs) to prevent delirious or agitated patients from removing tubes and lines connected to them. However, inappropriate use of physical restraint could have many detrimental physical effects on the patient, such as nerve damage, asphyxiation or even death. Aim The aim of the study is to investigate nurses' knowledge, attitude and practice of physical restraint in ICUs in Jordanian hospitals, about which little is known. Design A descriptive and cross-sectional design was used. Methods A convenience sample of 400 nurses working in three public hospitals and one university-affiliated hospital from different geographical regions in Jordan was selected. An Arabic version of the Physical Restraint Questionnaire ( PRQ) was used to collect the data. Results A total of 300 completed questionnaires were returned, with a response rate of 75%. Of the total sample, 51% were males, 65.7% were from public hospitals and 80.3% held a bachelor's degree. The mean score in the knowledge section was 9.7 ( SD =1.7) out of 15; in the attitude section, it was 24.7 ( SD = 4.8) out of 33; and in the practice section, it was 30.9 ( SD = 3.5) out of 42. Nurses who reported previous related education scored higher on the knowledge section (mean = 10.7; SD = 1.4) than nurses who reported no previous related education (mean = 9.1; SD = 1.6; p < .001). However, no significant differences between these categories were found in relation to attitude and practice. Conclusions The study demonstrated some lack of knowledge and unsafe practices regarding physical restraint in ICUs in Jordan. It suggests improving nurses' knowledge, attitude and practices through in-service education on best practice for physical restraint, developing policies/guidelines and providing adequate staff and equipment to maintain patient safety and prevent complications. Relevance to clinical practice Conducting education programmes on physical restraint for ICU nurses and providing other preventive strategies are important in improving nurses' knowledge, attitude and practice. [ABSTRACT FROM AUTHOR]

Assessment and evaluation of the health-related quality of life of industrial workers is an important research focus. This descriptive correlational study identifies the predictors of health-related quality of life using a random sampling of industrial workers ( n = 640) from construction factories in Amman Governorate in Jordan using demographic characteristics, a health and work-related factors questionnaire, and the World Health Organization Quality of Life-Brief scale. Results showed that industrial workers had good physical health but a poor working environment. There was a statistically significant relationship between educational level, conflict between work and individual life and work and social life, working hours, and workload, and all domains of health-related quality of life. Overall, educational level was the main predictor for all domains of health-related quality of life. Such results confirm the need to develop appropriate interventions and strategies to improve workers' health-related quality of life. Furthermore, developing an integrated approach among policymakers, employers, and work organizations to enhance industrial workers' occupational health programs could be effective. [ABSTRACT FROM AUTHOR]

Aims To raise awareness of critical care nurses' cognitive bias in decision-making, its relationship with leadership styles and its impact on care delivery. Background The relationship between critical care nurses' decision-making and leadership styles in hospitals has been widely studied, but the influence of cognitive bias on decision-making and leadership styles in critical care environments remains poorly understood, particularly in Jordan. Design Two-phase mixed methods sequential explanatory design and grounded theory. Setting: critical care unit, Prince Hamza Hospital, Jordan. Participant sampling: convenience sampling Phase 1 (quantitative, n = 96), purposive sampling Phase 2 (qualitative, n = 20). Methods Pilot tested quantitative survey of 96 critical care nurses in 2012. Qualitative in-depth interviews, informed by quantitative results, with 20 critical care nurses in 2013. Descriptive and simple linear regression quantitative data analyses. Thematic (constant comparative) qualitative data analysis. Results Quantitative - correlations found between rationality and cognitive bias, rationality and task-oriented leadership styles, cognitive bias and democratic communication styles and cognitive bias and task-oriented leadership styles. Qualitative - 'being competent', 'organizational structures', 'feeling self-confident' and 'being supported' in the work environment identified as key factors influencing critical care nurses' cognitive bias in decision-making and leadership styles. Two-way impact (strengthening and weakening) of cognitive bias in decision-making and leadership styles on critical care nurses' practice performance. Conclusion There is a need to heighten critical care nurses' consciousness of cognitive bias in decision-making and leadership styles and its impact and to develop organization-level strategies to increase non-biased decision-making. [ABSTRACT FROM AUTHOR]

Aims and objectives This study develops a new instrument, the Spiritual Care Intervention-Provision Scale, and assesses its psychometric properties in an Arab Muslim nurse sample. The Spiritual Care Intervention-Provision Scale was developed to measure the frequency with which nurses provided aspects of spiritual care. Background Most of the available spiritual care instruments were developed in the West and reflect a predominantly Christian tradition. A review of the literature on spiritual care in nursing revealed that no instrument exists for measuring spiritual care interventions provided by nurses to Arab Muslim patients. Design A cross-sectional descriptive and correlational design. Methods Following an extensive literature search, review by an expert panel and a pilot study which included patients' views regarding aspects of spiritual care provided by nurses, the final version of the Spiritual Care Intervention-Provision Scale was tested in a convenience sample of 360 Jordanian Arab Muslim nurses. Correlational and factor analysis were used. Results The internal consistency of the Spiritual Care Intervention-Provision Scale was high, with α coefficient of 0·85. The exploratory factor analysis supported a two-factor structure for the Spiritual Care Intervention-Provision Scale as hypothesised. A significant positive correlation between the Spiritual Care Intervention-Provision Scale and religiosity was in the expected direction though small in magnitude. Conclusions This study initiates the development of an instrument for the provision of spiritual care intervention by nurses that balances the religious and existential dimensions of spirituality. The Spiritual Care Intervention-Provision Scale exhibited acceptable evidence of internal consistency and validity among Jordanian Arab Muslim nurses. Further work was suggested to firmly establish all aspects of this new scale. Relevance to clinical practice This culturally specific instrument contributes to the evaluation of the provision of spiritual care by Jordanian Muslim nurses to their patients, to guide them in providing a comprehensive and appropriate spiritual care interventions and to examine the effect of spiritual care on various aspects of patient's quality of life. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the awareness of the incident reporting system, incident reporting practices and barriers to reporting incidents among Jordanian staff nurses and physicians in accredited and nonaccredited hospitals. Background Reporting medical incidents is an important element of patient safety enhancement and quality of care improvement and it should be an integral part of the organisational culture. Design A descriptive exploratory survey was used for the present study. Methods A modified version of the Incident Reporting Questionnaire was used to collect data from 307 nurses and 144 physicians at seven hospitals (four accredited and three not accredited) in Jordan. The response rate was 28·8% for nurses and 58·8% for physicians. Results Nurses were more aware of the incident reporting system than physicians. Physicians were less likely to report any incident on 50% or more of occasions. The major three barriers to reporting incidents were believing that there was no point in reporting near misses, lack of feedback and fear of disciplinary actions. Conclusion The study showed significant differences between nurses in accredited and nonaccredited hospitals regarding barriers to reporting incidents and reporting practices. Relevance to clinical practice Nurse administrators should modify existing systems for reporting incidents to overcome the barriers as shown in the present study. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Poor nursing adherence to evidence-based guidelines has negative consequences leading to higher mortality rates, delayed recovery and longer length of stay. Evidence-based practice has the potential to minimize complications and discrepancies between nurses. Aim This study aimed to assess nurses' practice and perception of their knowledge and responsibility in relation to enteral nutrition ( EN) in the critically ill. Design and methods This descriptive correlational design was applied to nurses working in intensive care units ( ICUs) from three health care sectors in Jordan (Governmental, Military and Private sectors). Nurses were recruited using a stratified sampling technique. A pre-prepared questionnaire focusing on nurses' practice and perception towards EN was used. Results A total of 253 ICU nurses completed the questionnaire. Nurses revealed a tendency to undertake nutritional care despite the recognition clinical nutrition is a secondary role. In terms of nursing processes, nurses showed greater levels of knowledge and responsibility for 'preventing complications' and 'evaluation' more than 'assessment' and 'identifying goals'. Nurses inadequately assess both gastric residuals and tube placement before feeding. Diarrhoea was the most frequent complication followed by abdominal pain, vomiting, tube dislodgment and weight loss. However, nurses realized that the incidences of complications is less likely when applying evidence-based protocol. Conclusion It is necessary to establish a preliminary assessment for patients' nutritional needs prior to using EN. Aspiration reduction measures are still deficient and need further attention. An evidence-based protocol for EN should be adopted in the critically ill. Relevance to clinical practice This article provides insight into the current practice of Jordanian intensive care nurses in different health care sectors. The study can contribute to redirect the perception of nurses towards nutrition in the critically ill in addition to enhance positive adherence to evidence base. [ABSTRACT FROM AUTHOR]

Aims and objectives To (1) identify the perceptions of Jordanian patients who suffer from coronary artery diseases towards nurse caring behaviours in critical care units; (2) identify the perceptions of Jordanian nurses who work in critical care units towards nurse caring behaviours; and (3) compare the perceptions of both patients and nurses towards nurse caring behaviours in critical care units. Background Caring is an important concept in nursing, when nursing behaviours were perceived by patients as caring behaviours, and thus, their satisfaction with the quality of care can be improved. Therefore, it is important for nurses to be knowledgeable about the caring behaviours as perceived by patients who complained from coronary artery diseases themselves. Design A descriptive comparative design was used. Methods A convenience sample of 150 patients who complained from coronary artery diseases and 60 critical care unit nurses completed the demographic form and the Caring Behavior Assessment scale. Results Patients in critical care units perceived physical and technical behaviours as most important caring behaviours, whereas nurses in critical care units perceived teaching behaviours as most important caring behaviours. Conclusion There were significant differences between patient participants' and nurse participants' perceptions towards four subscales of Caring Behavior Assessment scale that should be considered when caring for patients with coronary artery diseases. Relevance to clinical practice Patients with coronary artery diseases need well-trained and clinically competent nurses to meet their needs. 'Spiritual needs' was an important nurse caring behaviour that should be emphasised in nursing practice. [ABSTRACT FROM AUTHOR]

Arab immigrants in the United States are at risk for heart disease, stroke, and diabetes. We explored health-promoting lifestyle behaviors among Arab immigrants to the United States from the Middle Eastern region of the Levant. In 218 male and female Arab adults surveyed with the revised Health-Promoting Lifestyle Profile (HPLP-II), the mean for the HPLP-II was 2.73 (range 1-4), with spiritual growth and interpersonal relations the most frequently reported practices and physical activity the least frequently practiced dimension of health-promoting behaviors. Multiple linear regression analysis highlighted four determinants of health-promoting lifestyle behaviors: health insurance, acculturation, self-efficacy, and social support. Health promotion programs serving Arab immigrants should take these determinants into consideration. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Understanding sources of knowledge used in everyday practice is very helpful in improving the quality of health care services. There is a consensus in the literature that nurses mostly relied in their practice on experiential knowledge gained through their interactions with other members of health care professionals and patients. The general aim of this study is to explore the sources of knowledge Jordanian registered nurses use during their practice. Method A descriptive correlational design was used to collect data from 539 Jordanian registered nurses from 10 hospitals using a self-administered questionnaire. Results The mean year of experience of the sample was 7.08 years. Of the 615 questionnaires distributed, 555 were returned. This yields a response rate of 87.6%. Results revealed that the top five ranked sources used by Jordanian registered nurses include: the information that nurses learned during nursing education, personal experience in nursing over time, what was learned through providing care to patients, information gained through discussion between physicians and nurses about patients, and information from policy and procedure manuals. Conclusion Jordanian registered nurses recognize the value of research and that research utilization (RU) is an important issue and must not be ignored. The study has many implications for practice, education and research. Health care managers and decision makers need to play a more visible and instrumental role in encouraging RU to improve patients' quality of life. [ABSTRACT FROM AUTHOR]

Aims and objectives. The purpose of this study is to provide insight into the relationship between dietary and fluid non-adherence, depressive symptoms, quality of life, perceived barriers and benefits of exercise, and perceived social support among Jordanian patients with end-stage renal disease receiving haemodialysis using Pender's health promotion model. Background. Non-adherence to dietary and fluid restrictions is a leading cause of treatment failure and poor outcomes in end-stage renal disease. Yet, factors that interfere with the patients' ability to follow their dietary restrictions are unknown. Design. A descriptive, correlational, cross-sectional design was used. Methods. Jordanian patients ( n = 190) with end-stage renal disease receiving haemodialysis from three main Jordanian cities were included. The dialysis diet and fluid nonadherence questionnaire, Beck Depression Inventory-II, Quality Of Life Index, Dialysis Patient-Perceived Exercise Benefits and Barriers Scale, and the Multidimensional Perceived Social Support were employed to measure the key variables. Results. Patients were more likely men with mean age of 48·2 ± 14·9. Only 27% of the patients showed full commitment to diet guidelines and 23% to fluid guidelines during the last 14 days. Depression ( M = 18·8 ± 11·4) had significant negative association with quality of life (importance and satisfaction) ( r = −0·60, r = −0·32, p = 0·001, respectively). Multiple hierarchal regressions revealed a predictive model of only two variables: age ( B = −0·22, p = 0·05) and residual renal function ( B = −0·23, p = 0·012) for dietary non-adherence. Conclusions. Non-adherence to diet and fluid guidelines association with individual characteristics, health perception and psychosocial variables should be investigated in a longitudinal design. Relationship of non-adherence with culture-related factors should deeply be assessed among Jordanian patients with end-stage renal disease receiving haemodialysis. Relevance to clinical practice. Identification of the factors that may worsen dietary and fluid non-adherence may lead to improved therapeutic interventions within the mainstream of medical practice for Jordanian patients with end-stage renal disease receiving haemodialysis. [ABSTRACT FROM AUTHOR]