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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]

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

Aim: This study aims at better understanding the relationships between nurses' enacted scope of practice, work environment and work satisfaction, missed care, and organizational indicators of performance. Background: The enacted scope of practice model describes the determinants and consequences of the actual enactment of the nursing scope of practice. Method: A correlational design was used to investigate nurses' enacted scope of practice in five Canadian healthcare centres. Results: Suboptimal enacted scope of practice were found in the current sample. Significant positive correlations were found between the total enacted scope of practice score, use of qualification, control over tasks, decisional latitude and psychological demand as well as role ambiguity. Moreover, a higher enacted scope of practice was correlated with lower organizational indicators of short‐term absenteeism. Conclusion: Results suggest an insufficient deployment of nurses' enacted scope of practice, likely caused by some job characteristics, leading to lower work satisfaction and negative patients and organizational outcomes. Implications for nursing management: Optimizing nurses' enacted scope of practice would be a significant integrated strategy for improving organizational performance, patient care and nurses' satisfaction and well‐being. Nurses and frontline managers must be involved in the decision‐making process necessary to improve nurses' enacted scope of practice. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to understand the experiences of nurse managers during the COVID‐19 pandemic. Background: There is a growing body of knowledge about the experiences of clinical nurses during COVID‐19. However, there is less evidence about the experiences of nurse managers during the pandemic. Methods: Eight nurse managers, from acute care and outpatient settings, completed semistructured interviews about how their roles had changed during the pandemic, how they felt about these changes, and what had gone well or been difficult. Each participant was interviewed once, for 20–60 min. We used thematic analysis methods to analyse the interview transcripts. Findings Nurse managers had to coordinate care in a context of uncertainty and guidance that changed frequently. Participants found that their roles and responsibilities either expanded to include more duties, or they were asked to take on a completely new role, with no orientation or training. Nurse managers were expected to provide support to their staff and patients, but did not necessarily receive support themselves. Participants were expected to plan simultaneously for care during the pandemic and for a return to normal working conditions. These factors contributed to challenging and difficult participant experiences of managing during COVID‐19. Conclusion: Nurse managers' experiences during COVID‐19 are influenced by changes to their roles and the support they received. Nurse managers continue to support high‐quality care despite working a difficult context. Implications for nursing management: Where possible, nurse managers can be supported to extend their roles or receive additional education and support if they are required to take on new responsibilities. Nurse managers require support in order to be a resource for their staff. [ABSTRACT FROM AUTHOR]

Aim: To investigate the role stressors, and how coping strategies cultivated nurse managers' resilience in rural workplaces. Background: A stressful workplace can impair the mental and physical health of nurse managers leading to poor performance. Building and sustaining manager resilience in complex and stressful practice environments is necessary to attract and maintain competent and skilled managers. Method: In this qualitative exploratory inquiry, a purposive sampling method was used to recruit 16 nurse managers in rural western Canada. Results: Coping strategies fostered manager's resilience that made their work meaningful, and included putting out fires, psychologically reframing a situation, serving others and receiving support. Conclusions: Managers brought expertise, knowledge and skill to make their work meaningful and central to ongoing health service delivery in these rural communities. Nurse manager resilience can be strengthened by using evidence‐based strategies in an increasingly complex health care environment. Implications for Nursing Management: Managers need to be supported and encouraged to develop awareness of their own protective factors as they cope with challenging situations. Building resilience through formal education, social support and meaningful recognition is an important focus for nurse leaders in establishing a healthy work environment and maintaining a stable nursing workforce. [ABSTRACT FROM AUTHOR]

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

Aim: Initial testing of England's Safer Nursing Care Tool for adult in‐patient acute care wards in a university‐affiliated Canadian hospital. Background: Safe‐nursing staffing decisions have significant impacts on patients' safety and quality of care. The Safer Nursing Care Tool was developed in England to provide managers with a validated formula for making appropriate nursing staffing decisions. The tool has been widely used and studied in the UK but has yet to be tested in a Canadian context. Method: Ten high service quality acute care wards from a university‐affiliated Canadian hospital tested the use of the Safer Nursing Care Tool. Service quality, patients' dependency/acuity and staff activity data were benchmarked against information collected in 726 comparable UK wards. Results: Higher bed occupancy and patient dependency/acuity mix were found in the 10 Canadian wards compared to their UK counterparts. Overall staff activity was comparable between UK and Canadian wards. Conclusion: The Safer Nursing Care Tool can be applied in this Canadian hospital, and further testing in other hospitals and specialties is required. Implication for Nursing Management: The Safer Nursing Care Tool is a valid staffing tool to use that, when combined with professional judgement, can help managers to properly establish nursing staff in acute care wards. [ABSTRACT FROM AUTHOR]

Aim To describe new graduate nurses' transition experiences in Canadian healthcare settings by exploring the perspectives of new graduate nurses and nurse leaders in unit level roles. Background Supporting successful transition to practice is key to retaining new graduate nurses in the workforce and meeting future demand for healthcare services. Method A descriptive qualitative study using inductive content analysis of focus group and interview data from 42 new graduate nurses and 28 nurse leaders from seven Canadian provinces. Results New graduate nurses and nurse leaders identified similar factors that facilitate the transition to practice including formal orientation programmes, unit cultures that encourage constructive feedback and supportive mentors. Impediments including unanticipated changes to orientation length, inadequate staffing, uncivil unit cultures and heavy workloads. Conclusions The results show that new graduate nurses need access to transition support and resources and that nurse leaders often face organisational constraints in being able to support new graduate nurses. Implications for Nursing Management Organisations should ensure that nurse leaders have the resources they need to support the positive transition of new graduate nurses including adequate staffing and realistic workloads for both experienced and new nurses. Nurse leaders should work to create unit cultures that foster learning by encouraging new graduate nurses to ask questions and seek feedback without fear of criticism or incivility. [ABSTRACT FROM AUTHOR]

Aim The primary aim of this study was to examine the relationships between structural empowerment, psychological empowerment and job satisfaction among staff nurses, after controlling for their leaders' use of empowering behaviours. Background Nurses' job satisfaction is a critical factor in health-care organisations because of its association with nurse turnover and quality of patient care. Nurses continue to report high levels of job dissatisfaction. Methods Cross-sectional data for 1007 Canadian staff nurses were analysed using hierarchical multiple regression. Results Structural empowerment was the strongest independent predictor of job satisfaction, followed by leader empowering behaviours and psychological empowerment. After accounting for the effects of structural empowerment and leader empowering behaviours, the four dimensions of psychological empowerment showed only small independent effects on job satisfaction. Psychological empowerment did not mediate the effects of structural empowerment on job satisfaction. Conclusion Nurses' job satisfaction is most influenced by their access to organisational empowerment structures. Leader empowering behaviours, structural empowerment, and psychological empowerment, operating together, enhance nurses' job satisfaction. Implications for Nursing Management Nurse leaders should use a variety of empowerment strategies that are important to nurses' job satisfaction and potentially to the quality of patient care and nurse turnover. [ABSTRACT FROM AUTHOR]

Aim To describe how actions of nursing unit leaders influenced the long-term sustainability of a best practice guidelines ( BPG) program on inpatient units. Background Several factors influence the initial implementation of evidence-based practice improvements in nursing, with leadership recognized as essential. However, there is limited knowledge about enduring change, including how frontline nursing leaders influence the sustainability of practice improvements over the long term. Methods A qualitative descriptive case study included 39 in-depth interviews, observations, and document reviews. Four embedded nursing unit subcases had differing levels of program sustainability at 7 years (average) following implementation. Results Higher levels of BPG sustainability occurred on units where formal leadership teams used an integrated set of strategies and activities. Two key strategies were maintaining priorities and reinforcing expectations. The coordinated use of six activities (e.g., discussing, evaluating, integrating) promoted the continuation of BPG practices among staff. These leadership processes, fostering exchange and learning, contributed to sustainability-promoting environments characterized by teamwork and accountability. Conclusions Unit leaders are required to strategically orchestrate several overlapping and synergistic efforts to achieve long-term sustainability of BPG-based practice improvements. Implications As part of managing overall unit performance, unit leaders may influence practice improvement sustainability by aligning vision, strategies, and activities. [ABSTRACT FROM AUTHOR]