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Aim: To explore connections between spiritual metaparadigm and the nursing metaparadigm and advocate for a progressive spiritualization of nursing management. Background: Relationship between the spiritual holistic metaparadigm of love, communion and gift and the holonic nursing metaparadigm of care, relationship and practice is not completely understood. Method: The construction of a theoretical explanation on the basis of accumulated knowledge in the fields of nursing and spirituality (especially Christian spirituality) for the purpose of constructing a meaningful description. Results: Deep connectivity between the elements of both metaparadigms: love and care, communion and relationship, and gift and practice. Conclusion: The connection between the spiritual and nursing metaparadigms is real in nursing education, practice and management because of the holistic character of spirituality. In collective intentions and cultural values are the main channels of interaction between the nursing and the spiritual metaparadigms. Implications for nursing management: Spirituality influences nursing management by, among other things, (a) providing meaning and purpose; (b) promoting cohesion in health communities; (c) fostering respect for ethics; (d) stimulating innovation; (e) encouraging leadership; and (f) illuminating the workplace. [ABSTRACT FROM AUTHOR]

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

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 propose a theoretical based model approach to address the nursing shortage problem of recruiting qualified applicants. Background Vital industries such as nursing and trucking face a large labour shortage. Methods A literature review focusing on recruitment and realistic job previews examines relevant theories and an indication of the focus of similar research. Game theory illustrates cooperative and competitive recruitment strategies in vital industries. Results Proposition and model development where cooperative or competitive strategies for recruitment can either increase or decrease the employee applicant pool. Institutional theory states that firms within a population become isomorphic in nature. Firms employing cooperative or competitive strategies for recruitment can change organisational practices through isomorphic processes. Conclusion Industries facing a labour market shortage using cooperative strategy will use realistic job previews accurately to disseminate information about industry jobs. Realistic job previews will increase the applicant pool through individuals self-selecting into, rather than out of, the applicant pool. Implications for nursing management Recruitment in the nursing industry has been examined at the individual applicant and organisational level, yet the overall industry has been ignored. As nursing shortages continue, viewing recruitment at the macro level (the overall industry) is appropriate. Game theory as proposed provides opportunities for current research at the industry level. [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]

(2011) Journal of Nursing Management, 237-245 This paper reports on the implementation of a competency assessment tool for registered general agency nurses working in an acute paediatric setting, using a change management framework. The increased number of registered general agency nurses working in an acute children's hospital alerted concerns around their competency in working with children. These concerns were initially raised via informal complaints about 'near misses', parental dissatisfaction, perceived competency weaknesses and rising cost associated with their use. [ Journal of Organisational Change, 22, 524-548] nine-stage change framework was used to guide the implementation of the competency assessment tool within a paediatric acute care setting. The ongoing success of the initiative, from a nurse manager's perspective, relies on structured communication with the agency provider before employing competent agency nurses. Sustainability of the change will depend on nurse managers' persistence in attending the concerns of those resisting the change while simultaneously supporting those championing the change. These key communication and supporting roles highlight the pivotal role held by nurse managers, as gate keepers, in safe-guarding children while in hospital. Leadership qualities of nurse managers will also be challenged in continuing to manage and drive the change where resistance might prevail. [ABSTRACT FROM AUTHOR]

Purpose. This study aimed to develop a group organizational learning activity inventory for evidence-based practice (EBP) institutionalized by hospitals and to verify its reliability and validity. Methods. A draft inventory was created after verifying content and face validity of draft items developed based on interview data and materials used in EBP implementation. Construct validity and reliability were assessed cross-sectionally through an anonymous self-administered survey conducted via web and printed questionnaires. Construct validity was confirmed using exploratory and confirmatory factor analyses, and internal consistency and convergent/discriminant validity were verified. Inventory structure was determined using the theoretical model based on the hypothetical constructive concept. Temporal stability was assessed two weeks after the initial survey. Result. A draft inventory comprising 12 factors and 47 items was created based on 95 draft items. Data from 371 nurses across 55 departments in 12 hospitals were analyzed. The inventory comprised 8 factors and 40 items based on the theoretical model. The comparative fit index was 0.86, the Tucker–Lewis index was 0.85, the root mean square error of approximation was 0.09, and standardized root mean square was 0.04. Cronbach's alpha of each factor was ≥0.8, and the temporal stability was moderate. Conclusion. We developed the group organizational learning activity inventory, comprising 8 factors and 40 items. Though construct validity was low, the reliability and concurrent/convergent validities were confirmed. This inventory contains new factors that measure the group activities to ensure EBP's continuation in hospitals: forming common knowledge, understanding the value of EBP in groups, and fostering ownership thereof. Using this inventory, departments that introduced EBP can evaluate the extent of activities leading to nurses' continuation of EBP and find the improvement point. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to summarize conceptual models of nurses' organizational well‐being and identify common variables among them. Background: To understand how the characteristics of an organizational context affect workers' well‐being, numerous conceptual models have been developed. Such models have been conceptualized in various working contexts other than health care and not always considering the particularities of the profession of nursing. Evaluation: This integrative review was conducted using the resources of PubMed, CINAHL, Scopus and the Cochrane Library, up until March 2022, and by applying a modified version of Cooper's five‐stage methodology, in accordance with the PRISMA guideline. Key issues: Six reference models focused on different organizational variables and used to evaluate nurses' organizational well‐being were identified: the Effort‐Reward Imbalance (ERI) model; the Job Demands‐Resources (JD‐R) model; the Utriainen et al. model; the Demands‐Resources and Individual‐Effects (DRIVE) model; the Well‐Being, Health‐Promoting Lifestyle and Work Environment Satisfaction (WHS) model and the Nursing Worklife Model (NWM). Conclusion: There is no consensus in the nursing literature on an all‐encompassing conceptual model of nurses' organizational well‐being or on working environment characteristics to be studied or monitored for defining nurses' well‐being. Implications for nursing management: Coming to a consensus on the definition of a nurses' organizational well‐being model and its variables would facilitate nursing management in monitoring and intervening on nurses' work‐life quality and in improving nursing performance and caring outcomes. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to gain insight on how nurse leaders manage a culture of safety for graduate nurses. Background: Current theoretical approaches to safety culture tend towards a checklist approach that focuses on institutional characteristics, failing to examine the quality of interpersonal relationships. These interpersonal interactions are often seen as separate from the institutional realities of resource allocation, nurse–patient ratios, patient acuity or throughput. A theoretical approach is required to illuminate the dialectic between the structure of an organisation and the agency created by nurse leaders to promote patient safety. Design Qualitative exploratory descriptive study. Methods: Semi‐structured interviews were undertaken with 24 nurse leaders from hospital and aged care settings. Thematic analysis and Giddens structuration theory was used to describe the findings. Results: Nurse leaders identified a range of reciprocal communicative and cultural norms and values, decision‐making processes, personal nursing philosophies, strategies and operational procedures to foster patient safety and mentor graduate nurses. The mentoring of graduate nurses included fostering critical thinking, building and affirming formal structural practices such as handover, teamwork, medication protocols and care plans. Conclusions: The study provides insight into how nurse leaders foster a culture of safety. Emphasis is placed on how agency in nurse leaders creates an environment conducive to learning and support for graduate nurses. Implications for Nursing Management: Nurse leadership functions and decision‐making capacity hinges on multiple factors including practicing agency and aspects of the social structure such as the rules for safe communication, and the various institutional protocols. Nurse leaders enforce these forms of engagement and practice through their legitimation as leaders. They have both allocative and authoritative resources; they can command resources, direct staff to attend to patients and/or clinical tasks, mentor, guide, assign, correct and encourage with the authority vested in them by the formal structure of the organisation. In doing so, they sustain the structure and reinforce it. [ABSTRACT FROM AUTHOR]

suhonen m. & paasivaara l. (2011) Journal of Nursing Management 19, 1028-1036 Nurse managers' challenges in project management Aim To analyse the challenges that nurse managers meet in project management. Background Project management done by nurse managers has a significant role in the success of projects conducted in work units. Methods The data were collected by open interviews ( n = 14). The participants were nurse managers, nurses and public health nurses. Data analysis was carried out using qualitative content analysis. Results The three main challenges nurse managers faced in project management in health-care work units were: (1) apathetic organization and management, (2) paralysed work community and (3) cooperation between individuals being discouraged. Conclusions Nurse managers' challenges in project management can be viewed from the perspective of the following paradoxes: (1) keeping up projects-ensuring patient care, (2) enthusiastic management-effective management of daily work and (3) supporting the work of a multiprofessional team-leadership of individual employees. Implications for nursing management It is important for nurse managers to learn to relate these paradoxes to one another in a positive way. Further research is needed, focusing on nurse managers' ability to promote workplace spirituality, nurse managers' emotional intelligence and their enthusiasm in small projects. [ABSTRACT FROM AUTHOR]

Aim: This study aims to examine, through the lens of the Job Demands‐Resources model, the influence of caring for COVID‐19 patients on nurse's perception of chronic fatigue, quality of care, satisfaction at work and intention to leave their organisation and the profession. Background: Studies have examined how fear of COVID‐19 contributes to the mental, physical and work adjustment among nurses. To date, few studies have been conducted examining how caring for patients with COVID‐19 contributes to work outcomes among nurses. Methods: This is a cross‐sectional survey involving 1705 frontline nurses and licensed practical nurses in Quebec, Canada. From these, 782 reported caring for COVID‐19 patients. Results: High chronic fatigue, poor quality of care, lower work satisfaction and higher intention to leave their organisation were found for nurses caring for COVID‐19 patients. Poorly prepared and overwhelmed nurses showed higher turnover intention than those well prepared and in control. Conclusions: There is an urgent need to provide support to nurses during the pandemic, with a long‐term strategy to increase their retention. Implications for Nursing Management: Nurse administrators play an important role in supporting their nurses during a pandemic in the form of education, training and policy development to positively impact quality of care and retention. [ABSTRACT FROM AUTHOR]

Aims: To describe the theoretical procedures for the development of the Professional Nursing Communication Competence instrument, determine the content validity and describe the pilot test application. Background: Measuring instruments must be developed in accordance with the context and communication process by adopting theoretical procedures based on competence structures to support quality patient‐centred care and nursing management. Methods: A methodological study was employed. The instrument was developed by using content‐validated theoretical construct in accordance with 33 communication theories followed by semantic analysis and content validity by experts. The instrument was tested over three phases: before the lecture on professional nursing communication competence, after the simulation scenario experience and after debriefing. Results: The instrument showed an extremely high agreement (CVI = 0.99). Linear regression suggested three domains of the 46‐item content‐validated instrument comprising knowledge (18 items), skills (12 items) and attitudes (16 items). Conclusion: The instrument was found to measure professional communication competence with a high theoretical reliability of the contexts and processes through a simulation strategy. Implications for Nursing Management: Nursing educators, managers and staff can adopt the Professional Nursing Communication Competence (IMC‐CPE) instrument to improve the effectiveness level of knowledge, skills and attitudes to reduce misunderstanding among team members and health care errors. [ABSTRACT FROM AUTHOR]

Aim: To illustrate the value of Checkland's 'Soft Systems' approach to explore and analyse the interaction of human and organisational factors that affect service delivery and patient experience in one specialist epilepsy service. Background: Checkland's approach is underutilized in relation to health service improvement. One epilepsy service in Ireland is used as an example to illustrate the value of his approach to improve service delivery, particularly when what needs to change is not clear. Method: Checkland's 'Soft Systems' seven‐stage approach was used collaboratively to explore patients' and clinicians' experience of service delivery and how to improve it. Results: The research identified the practice of empowerment affected the quality of the service experience. Checkland's concept of a human activity system was particularly pertinent in identifying this issue and providing a 'map' for change. Conclusion: Wider inferences for the use of Checkland's approach by nurse managers are discussed, as is the value of using Checkland's approach to improve services. Implications for Nursing Management: Checkland's 'Soft Systems' is an underutilized approach in health care that could be used by managers to initiate and embed change within a health care service. [ABSTRACT FROM AUTHOR]

Aim: To apply the reflective risk assessment model in a Chinese health care setting to investigate the relationships between professional quality of life and mental health risk profiles. Background: Few studies have connected the quality of work life with contributing and coexisting factors such as depression, anxiety and stress, but none to date in a Chinese health care setting. Method: A cross‐sectional survey of 950 registered Chinese nurses was employed. Results: 299 of 861 participants (34.7%) were categorized into four of five professional quality of life risk profiles, consistent with the reflective risk assessment model. Significant differences were seen with large‐sized effects in the mean scores of stress, anxiety and depression among the participants, with participants of the very distressed profile having significantly higher mean scores in stress, anxiety and depression, followed by the at‐risk profile group. Conclusion: The reflective risk assessment model and professional quality of life five risk profiles are supported by this study. Implications for Nursing Management: The reflective risk assessment model can be used to detect risk factors for mental health in nurses and for the design of interventions that promote nurses' mental health. [ABSTRACT FROM AUTHOR]

Aim: To generate a unique and contemporary leadership theory reflecting the essence of nursing within a complex health care environment. Background: As health care faces unprecedented change and increasing complexity, a nursing leadership theory embedded within complexity science is vital for teams to be innovative, nimble and focused on human‐centred care. Methods: Constructivist grounded theory framed exploration of human issues embedded in nursing leadership. The constructivist approach sought thematic and theoretical sensitivity through the rich co‐creative experience of participants, researchers, literature and data. Focus groups were convened over 18 months with 39 nurse leaders from bedside to boardroom. Results: Constant comparative methods resulted in 15 attributes. Advanced coding positioned the 15 attributes into constructs: Awakener, Connector and Upholder. Definitions emerged through the constructivist process organically connecting attributes and constructs to the potential outcomes identified in the theory as cultures of excellence, trust and caring. Conclusions: The final constructivist process revealed a nursing‐specific theory: human‐centred leadership in health care uniquely suited to assist leaders in addressing structure, process and outcomes. Implications for nursing management: Efforts by nurse leaders to test the theory with metrics related to nursing excellence will result in validation of the theory and validation of the proposed sustained culture change. [ABSTRACT FROM AUTHOR]

Background: Implicit rationing of nursing care is associated with work environment factors. Yet a deeper understanding of trends and variability is needed. Aims: To explore the trends and variability of rationing of care per shift between individual nurses, services over time, and its relationship with work environment factors. Methods: Longitudinal study including 1,329 responses from 90 nurses. Intraclass correlation coefficients (ICC) were computed to examine variability of rationing per shift between individual nurses, services, and data collection time; generalized linear mixed models were used to explore the relationship with work environment factors. Results: Percentage of rationing of nursing activities exceeded 10% during day and night shifts. Significant variability in rationing items was observed between nurses, with ICCs ranging between 0.20 and 0.59 in day shifts, and between 0.35 and 0.85 in night shifts. Rationing of care was positively associated with nurses' self‐perceived workload in both shifts, but not with patient‐to‐nurse ratios. Conclusion: Most variability in rationing over time was explained by the individual. Implications for Nursing Management: Nurse managers and leaders need to develop and implement educational programs on implicit rationing of nursing care to strengthening nurses' skills related to decision‐making, prioritization and time management. [ABSTRACT FROM AUTHOR]

Aims: To describe an implementation programme for an evidence‐based practice (EBP) model in a new Chilean hospital and to analyse the programme evaluation results. Background: Evidence‐based practice is key to professional nursing for improving health care safety and quality. Methods: First, a literature review was performed to develop an institutional EBP model. Second, internal and external analyses contributed to assessing facilitators for and barriers to implementation. Third, a multi‐stage implementation plan was conducted. Fourth, process and outcome indicators were evaluated. Results: The model considered the basic elements of EBP and outlined different decision‐making levels in clinical practice. Several facilitators for implementation were identified. Each implementation stage included activities addressing EBP knowledge, attitude and skills. Outcome indicators showed significant improvement regarding knowledge (p =.038). Providers with formal EBP training, compared with providers without training, showed a significant difference of 8.6% (0.6 points) in the average CPBE‐19 score in knowledge, attitude and application in the last evaluation (p <.01). Conclusion: Having an EBP programme with ongoing implementation strategies improves knowledge over time, and formal training enhances positive results. Implications for nursing management: Nurse managers can build an institutional research culture to improve the quality of care using an EBP programme that fits organisational needs. [ABSTRACT FROM AUTHOR]

Aim: To investigate nurse leaders' experiences and strategies for turnover in relation to culture and work environment in hospital departments with low nurse turnover. Background: Nursing shortage is a global problem, and numerous turnover strategies have been utilized to attempt to address this shortage. Design/Methods: Four regional hospital departments with the lowest nurse turnover were included. Data were constructed with nine nurse leaders through individual interviews and were analysed using directed content analysis. Results: The findings presented in two categories, 'The culture is unique' and 'Maintaining, protecting or re‐establishing a unique culture', summarize how leaders navigated authentically in different contexts, operationalizing clear values and visions both for their departmental culture and in turnover strategies. Conclusion: Even though all the nurse leaders interviewed were concerned about the current recruitment situation, they were confident in their leadership roles, targeted towards supporting the unique culture in their departments. Implications for Nursing Management: Leaders with clear cultural awareness and visions for the context in which they operate may be positively associated with lower turnover of nurses. Including the perspectives of leaders from departments with low turnover of nurses has the potential to create new knowledge about improving nurse retention. [ABSTRACT FROM AUTHOR]

Aim: To examine whether job resources moderate the relationship between job demands and occupational strain, and whether occupational strain mediates the relationship between job demands and job satisfaction. Background: The job demand–resource model suggests that job demands and job resources are related to occupational strain, and occupational strain is associated with job satisfaction. Methods: In 2018, a cross‐sectional study was conducted with a convenience sample of 85 nurses from six haemodialysis units. Linear regression with moderation–mediation analysis was conducted using SPSS software. Results: Under low workload levels, no association between autonomy and occupational strain existed, but under high workload levels, a negative relationship was found between autonomy and occupational strain. Under low workload levels, a negative relationship was found between social support and occupational strain, but under high workload levels, a positive relationship was found. Finally, there was no association between occupational strain and job satisfaction. Conclusion: Job resources are moderators of the relationship between job demands and occupational strain. However, there was no significant association between occupational strain and job satisfaction. Implications for Nursing Management: Nurse leaders should strengthen nurses' autonomy, which can reduce occupational strain. Additionally, sources of support are needed to help nurses cope with the workload and occupational strain. [ABSTRACT FROM AUTHOR]

Aim: This review aimed to elucidate the effectiveness of structured handovers in improving patient outcomes in the wards. Background: Studies have reported that the lack of quality handovers is one of the main causes of adverse effects. Evaluation: A search over six electronic databases: MEDLINE; CINAHL; Web of Science; EMBASE; Scopus; and CENTRAL via Ovid concluded nine studies and synthesized by two independent reviewers based on the Cochrane Handbook for Systematic Reviews of Interventions. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement was used to guide the undertaking of this review and meta‐analysis. All studies published up to February 2019 were considered in this review. Key issues: This review has demonstrated that structured handovers reduced the incidences of patient complications, medication errors and general adverse events. However, the results were not statistically significant. Conclusion: Current structured handover formats were effective in reducing problematic handovers such as omission of information, inaccurate information and documentation errors. Implications for Nursing Management: Although there is limited high‐quality and rigorous research conducted to gain a clearer understanding of the impacts on patient‐related outcomes in nursing care, structured handovers remained effective in reducing the number of mistakes in information transfer. [ABSTRACT FROM AUTHOR]

Aim: An evaluative tool for the antiretroviral therapy programme was developed for use in the primary health care setting of Lesotho. Background: Information on processes followed in the development of standardized and acceptable evaluative tools is not always available to practicing nurses. Methods: Behaviours affecting the antiretroviral therapy (ART) programme were contextualized using the conceptual model for social programmes and Intervention Wheel framework. A convergent parallel mixed‐methods design was used to describe perceptions and explore experiences of nurses and patients. The Instrument Development Construct Validation process was used to develop an evaluative tool that was pre‐tested on 17 respondents. Results were analysed using SPSS (23), and internal consistency using Cronbach's alpha coefficient was.768. Results: The tool collects information on staffing patterns, services offered, patients seen, time spent seeking services, consultation time, Antiretroviral (ARV) availability, staff adequacy, staff competency, equipment adequacy, service efficiency, activity documentation, patient satisfaction, job satisfaction, monitoring and evaluation. Conclusions: The evaluative tool permits identification of factors affecting delivery of the ART programme, hence assisting nurses to improve services provided. Implications for nursing management: This method can be used to develop evaluative tools to assess implementation of public health services and inform successes, challenges and recognize improvement approaches. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study is to demonstrate the impact of intelligent healthscape quality on job outcomes and job satisfaction via the pleasure feeling of nurses, a positive emotion towards the work environment. The moderating effect of innovativeness as a personal trait is also investigated. Background: High quality of intelligent healthscape can improve nurses' job outcomes and satisfaction. Methods: A descriptive, cross‐sectional, survey design was used. A total of 222 experienced nurses from a general hospital were surveyed in their working environment, pleasure feeling, job outcomes and job satisfaction. Structural equation modelling was used to test the theoretical model and hypotheses between constructs. Results: The final model explained 88% of the variance in nurse job outcomes and job satisfaction. The result shows that (a) intelligent healthscape quality had a positive effect on nurse job outcomes and job satisfaction through pleasure feeling, and all the paths of the suggested model were statistically significant. Moreover, (b) a pleasure feeling showed stronger effects on job outcomes in nurses with higher levels of innovativeness. Conclusions: This model provides a better understanding of the mechanisms between perceived nursing work environment, job outcomes and psychological empowerment. Based on these results, nurse managers can facilitate job satisfaction of nurses by establishing a highly advanced and supportive work environment. Implications for Nursing Management: The results of this study provide empirical evidence linking intelligent healthscape quality, pleasure feeling, job outcomes and job satisfaction derived from a theoretical model of intelligent healthscape quality. These findings further elucidate the significance of the technology embedded physical nurse work environment as well as provide new academic approaches by demonstrating novel applications of a theoretical framework. [ABSTRACT FROM AUTHOR]

Aim: To investigate the relationship between leadership style with nurse job stress and anticipated turnover. Background: An appropriate leadership style should promote the efficacy of nurses. Different leadership styles can affect nurse's job stress and the numbers of nurses leaving their workplace or their profession. Methods: In this cross‐sectional correlational study, 1,617 nurses were selected from the governmental hospitals in Iran 2016–2017. Data were analyzed using descriptive and inferential statistics in SPSS20. Results: Nursing Manager's leadership style was transactional leadership. Both transformational and transactional leadership style have a significant relationship with job stress and anticipate staff turnover. A positive relationship was found between a laissez‐faire leadership style with job stress and anticipated turnover. Conclusion: The transformational and transactional leadership styles can reduce nurse's job stress and intention to leave, so nurse leaders can use combination of transformational and transactional leadership for improving job satisfaction and quality of nursing services. Implications for Nursing Management: Leaders should emphasize a clear expression of values, objectives, and mission of the organisation; and try to raise confidence in employees, respecting and caring for them, supporting their views and suggestions, and being optimistic about the future. [ABSTRACT FROM AUTHOR]

Aims: This study sought to contribute to research on entrepreneurial intention by identifying which constructs of the entrepreneurial profile and internal conditions of health care organisations support entrepreneurship and contribute to the entrepreneurial intention of these organisations' employees. Background: In addition to psychological attributes, cognitive processes, motivations, sociodemographic and professional characteristics, and entrepreneurial skills, the literature indicates that internal conditions of organisations also contribute to explaining entrepreneurial intention. Methods: To evaluate this model empirically, the primary data were collected with questionnaires distributed to nurses in two public hospitals—the Trás‐os‐Montes and Alto Douro Hospital Center and the Local Health Unit of the Northeast. A total of 638 nurses filled out the questionnaire. The data were analysed using inferential and regression analyses. Results: The results suggest that the dimensions related to personal attributes, namely, motivation and entrepreneurial skills, are the constructs that best explain the entrepreneurial intention of these professionals within their organisations. Conclusions: A broad discussion is needed about how to implement internal conditions that promote an intrapreneurial and innovative culture in health care organisations. Implications for Nursing Management: Health care organisation administrators need to prioritise intrapreneurship while structuring their management strategies, thereby creating favourable internal conditions (e.g., support, autonomy, rewards, time availability and appropriate organisational procedures) that enhance their nurses' entrepreneurial intention. [ABSTRACT FROM AUTHOR]

Aims: To examine how the process of change prescribed in Kotter's change model applies in implementing team huddles, and to assess the impact of the execution of early change phases on change success in later phases. Background: Kotter's model can help to guide hospital leaders to implement change and potentially to improve success rates. However, the model is under studied, particularly in health care. Methods: We followed eight hospitals implementing team huddles for 2 years, interviewing the change teams quarterly to inquire about implementation progress. We assessed how the hospitals performed in the three overarching phases of the Kotter model, and examined whether performance in the initial phase influenced subsequent performance. Results: In half of the hospitals, change processes were congruent with Kotter's model, where performance in the initial phase influenced their success in subsequent phases. In other hospitals, change processes were incongruent with the model, and their success depended on implementation scope and the strategies employed. Conclusions: We found mixed support for the Kotter model. It better fits implementation that aims to spread to multiple hospital units. When the scope is limited, changes can be successful even when steps are skipped. Implications for Nursing Management: Kotter's model can be a useful guide for nurse managers implementing changes. [ABSTRACT FROM AUTHOR]

Purpose To develop and perform reliability and validity assessments of the international Multidimensional Nursing Generations Questionnaire. Background There are three generations of nurses in the European workforce. There is little research on the characteristics of these generations and the ways in which to manage them professionally, and no instrument has yet been developed to measure these aspects specifically. Methods With results from previous studies, 69 nursing generations-oriented items were created in English, translated into Italian and Finnish, and pretested to form the basis of an instrument that was tested between September and October 2014 on a sample of Finnish and Italian nurses ( n = 1302) using principal component analysis and Cronbach's alpha. Results Fifty-four items and eight components (Cronbach's α range: 0.61-0.81) were identified in the instrument: (1) conflicts between generations; (2) patient safety view; (3) relationships between generations; (4) working as a multigenerational team; (5) orientation to change; (6) presenteeism and job propensity; (7) intention to leave, and (8) flexibility and availability. Conclusions The instrument showed acceptable preliminary psychometric properties and satisfactory internal consistency. Implications for nursing management The Multidimensional Nursing Generations Questionnaire is a useful tool to measure the characteristics of different generations of nurses and to develop management strategies tailored to those generations. [ABSTRACT FROM AUTHOR]

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

Aim To explore the emotion of feeling cared for in the workplace. Background The emotion of feeling cared for drives health-promoting behaviours. Feeling cared for is the end-product of caring, affecting practice, environment and outcomes. Identifying behaviours that lead to feeling cared for is the first step in promoting caring practices in leadership. Method A survey with open-ended questions was designed, validated and electronically distributed. Data from 35 responses were thematically analysed. Results Unit culture and leadership style affect caring capacity in the workplace. First level coding revealed two caring behaviour categories: recognition and support. Themes emerged aligned to Chapman's model of workplace appreciation: words of affirmation, receiving gifts, quality time and acts of service. The importance of being treated as a whole person was reported: being appreciated personally and professionally. Feeling cared for drives outcomes such as feeling valued, important, teamwork and organisational loyalty. Conclusions This study generalises the applicability of Chapman's model developed for workplace appreciation in the health-care setting. Implications for nursing management Concrete examples of how leaders stimulate feeling cared for are provided. Caring leadership behaviours have the potential to improve retention, engagement, the healing environment and the capacity for caring for others. [ABSTRACT FROM AUTHOR]

Aim This study aimed to establish and describe the level of communication satisfaction that professional nurses experience in selected public hospitals in the City of Johannesburg, South Africa. Background The success of any organisation depends on the effectiveness of its communication systems and the interaction between staff members. Method Data were collected by means of questionnaires, based on the Communication Satisfaction Questionnaire ( CSQ), from a sample of 265 professional nurses from different categories, chosen using a disproportionate random stratified sampling method. Results The results indicated poor personal feedback between nurse managers (operational managers) and professional nurses, as well as dissatisfaction among nurse managers and professional nurses with regard to informal communication channels. A lack of information pertaining to policies, change, financial standing and achievements of hospitals was identified. Conclusion Nurse managers should play a leadership role in bringing staff of different departments together by creating interactive communication forums for the sharing of ideas. Implications for nursing management The results emphasise the need for nurse managers to improve communication satisfaction at all levels of the hospital services in order to enhance staff satisfaction and create a positive working environment for staff members. [ABSTRACT FROM AUTHOR]

Aim To discuss selected work hazards and safety concerns for aging nurses. Background Greater numbers of older nurses remain in the workforce. Projections suggest that one-third of the nursing workforce will be over age 50 years by 2015. Employers will struggle to find ways to protect the health and safety of their aging workforce and prevent a massive loss of intellectual and human resources when these experienced nurses exit the workforce. Evaluation Review of recent relevant literature in English language journals. Key issues Repetitive motion injuries, fatigue and slips, trips and falls are three major work hazards older nurses face. We discuss several factors for each hazard, including: the normal physiological aging effects of diminished strength, hearing and vision; workplace variables of work schedules, noise and clutter; and personal characteristics of sleep disturbances, overexertion and fatigue. Conclusions Inconclusive evidence exists to guide best practices for designing safe workplace environments and shift patterns for nursing work. Implications for nursing management There are at least two areas administrators can reduce work hazards for older workers: (1) modification of the workplace, and (2) creating the infrastructure to support the aging workforce to encourage healthy behaviours. [ABSTRACT FROM AUTHOR]

Aims To identify fatiguing tasks and develop a model of sources of fatigue in nursing work. Background Research has identified multiple factors contributing to occupational fatigue; however, comprehensive consideration of diverse factors identified by nurses as contributing to fatigue in nursing work systems is lacking. Methods Content and frequency analyses were performed on previously unpublished data from an online survey of registered nurses. Responses from 100 registered nurses to questions related to the most fatiguing tasks in their work and factors that cause those tasks to be most fatiguing were analysed. Results Physically demanding patient care tasks, and organisation, management and logistics tasks, respectively, were listed as the most frequent physically and mentally fatiguing. Time and multitasking demands were listed frequently as sources of both fatigue dimensions. Conclusions Registered nurses reported working in environments that include physically and mentally fatiguing tasks. They identified factors related to work content demands, including physical and mental task demands as well as time and multitasking demands, as most frequently contributing to fatigue. Implications for nursing management This work and our conceptual model of sources of fatigue provide a framework to support nurses, nursing managers and administrators to develop strategies to reduce fatigue among RNs. [ABSTRACT FROM AUTHOR]

Aim To explore compassion fatigue and compassion satisfaction with the potential contributing factors of anxiety, depression and stress. Background To date, no studies have connected the quality of work-life with other contributing and co-existing factors such as depression, anxiety and stress. Method A self-report exploratory cross sectional survey of 132 nurses working in a tertiary hospital. Result The reflective assessment risk profile model provides an excellent framework for examining the relationships between the professional quality of work factors and contributing factors within the established risk profiles. The results show a definite pattern of risk progression for the six factors examined for each risk profile. Additionally, burnout and secondary traumatic stress were significantly related to higher anxiety and depression levels. Higher anxiety levels were correlated with nurses who were younger, worked full-time and without a postgraduate qualification. Twenty percent had elevated levels of compassion fatigue: 7.6% having a very distressed profile. At-risk nurses' stress and depression scores were significantly higher than nurses with higher compassion satisfaction scores. Implications for nursing managers The employed nurse workforce would benefit from a psychosocial capacity building intervention that reduces a nurse's risk profile, thus enhancing retention. [ABSTRACT FROM AUTHOR]

Aim To examine the relationships among nurses' perceptions of nurse managers' authentic leadership, nurses' overall person-job match in the six areas of worklife and their work engagement. Background Reports have highlighted the impact of demanding and unsupportive work environments on nurses' wellbeing, resulting in a need for strong nursing leadership to build sustainable and healthier work environments. Methods A secondary analysis of data collected from a non-experimental, predictive design survey of a random sample of 280 registered nurses working in acute care hospitals was conducted. Results An overall person-job match in the six areas of worklife fully mediated the relationship between authentic leadership and work engagement. Further, authentic leadership, overall person-job match in the six areas of worklife and years of nursing experience explained 33.1% of the variance in work engagement. Conclusions Findings suggest that nurses who work for managers demonstrating higher levels of authentic leadership report a greater overall person-job match in the six areas of worklife and greater work engagement. Implications for nursing management As nurse managers' play a key role in promoting work engagement among nurses, authentic leadership development for nurse managers focusing on self-awareness, relational transparency, ethics and balanced processing would be beneficial. [ABSTRACT FROM AUTHOR]

Aim To examine the effect of authentic leadership and structural empowerment on the emotional exhaustion and cynicism of new graduates and experienced acute-care nurses. Background Employee empowerment is a fundamental component of healthy work environments that promote nurse health and retention, and nursing leadership is key to creating these environments. Method In a secondary analysis of data from two studies we compared the pattern of relationships among study variables in two Ontario groups: 342 new graduates with <2 years of experience and 273 nurses with more than 2 years of experience. Results A multi-group path analysis using Structural Equation Modelling indicated an acceptable fit of the final model (χ2 = 17.52, df = 2, P < 0.001, CFI = 0.97, IFI = 0.97 and RMSEA = 0.11). Authentic leadership significantly and negatively influenced emotional exhaustion and cynicism through workplace empowerment in both groups. Conclusions The authentic behaviour of nursing leaders was important to nurses' perceptions of structurally empowering conditions in their work environments, regardless of experience level, and ultimately contributed to lower levels of emotional exhaustion and cynicism. Implications for nursing management Leadership training for nurse managers may help develop the empowering work environments required in today's health-care organizations in order to attract and retain nurses. [ABSTRACT FROM AUTHOR]

Aim This study was aimed at describing nursing leadership in an academic hospital in Gauteng, South Africa. Background Nurse managers' leadership styles affect nurses' attitudes, behaviour and work performance. However, little is known about how nurses experience nurse leadership and what leadership styles are found in academic hospitals in Gauteng. Methods The study was based on Maxwell's framework of leadership (relationships, equipping, leadership and attitude). A qualitative design was used in order to describe the experiences of registered nurses and nurse managers. The population of the study was all registered nurses and nurse managers of the hospital in which the study was conducted. In phase one of the study, a discussion group with 35 registered nurses using the nominal group technique was held to respond to the following statement: 'Please explain how you have experienced leadership by nurse managers in this hospital'. In phase two of the study, five nurse managers were interviewed individually, using a semi-structured interview guide. Results Some nurse managers were practising autocratic leadership in this hospital. Implications for nursing management The nurse managers need to be taught about contemporary leadership styles such as transformational leadership and visionary leadership and also about supervision, role modelling and caring. [ABSTRACT FROM AUTHOR]

Aim To examine the influence of senior nurse leadership practices on middle and first-line nurse managers' experiences of empowerment and organizational support and ultimately on their perceptions of patient care quality and turnover intentions. Background Empowering leadership has played an important role in staff nurse retention but there is limited research to explain the mechanisms by which leadership influences nurse managers' turnover intentions. Methods This study was a secondary analysis of data collected using non-experimental, predictive mailed survey design. Data from 231 middle and 788 first-line Canadian acute care managers was used to test the hypothesized model using path analysis in each group. Results The results showed an adequate fit of the hypothesized model in both groups but with an added path between leadership practices and support in the middle line group. Conclusions Transformational leadership practices of senior nurses empower middle- and first-line nurse managers, leading to increased perceptions of organizational support, quality care and decreased intent to leave. Implications for Nursing Management Empowered nurse managers at all levels who feel supported by their organizations are more likely to stay in their roles, remain committed to achieving quality patient care and act as influential role models for potential future leaders. [ABSTRACT FROM AUTHOR]

ravari a., bazargan m., vanaki z. & mirzaei t. (2012) Journal of Nursing Management 20, 522-533 Job satisfaction among Iranian hospital-based practicing nurses: examining the influence of self-expectation, social interaction, and organisational situations Aim The influence of self-expectation, social interaction, and organisational situation on job satisfaction among nurses is examined. Background Understanding determinants and correlates of job satisfaction are important factors that help to reduce the problem of nurse attrition. Methods Utilizing the Hybrid Model of concept development, job satisfaction was examined in three phases: (1) the theoretical phase, a working definition and the dimensions of job satisfaction were established; (2) the fieldwork phase, a qualitative semi-structured interview was employed to capture participants' perceptions of the concept; and (3) the analytical phase, the experiences of nurses were evaluated using the conceptual model. Results The results indicate that personal beliefs, rather than social interaction or organisational situation, constitute the core of job satisfaction. Conclusions Despite the variety of dissatisfaction factors rooted in social interaction and organisational situation, participants achieved the highest job satisfaction when trusting in self-value systems and the spiritual value of their job objectives. Implications Intervention is needed to increase organisational and professional support for nurses. However, highlighting the sacred and spiritual value of the nursing profession, which is rooted in religious values and culture, provides additional reinforcement for enhancing the job satisfaction among this segment of health care providers. [ABSTRACT FROM AUTHOR]

utriainen k., kyngäs h. & nikkilä. j. (2011) Journal of Nursing Management 19, 1037-1046 A theoretical model of ageing hospital nurses' well-being at work Aim To describe the development process of a theoretical model of ageing hospital nurses' well-being at work and the subsequent testing of the model itself. Background Factors evoking well-being at work need to be identified to promote nurses' well-being. Method Qualitative data ( n = 21) from ageing hospital nurses, consisting of interviews, diaries and open data collection forms were collected and analysed using grounded theory method. Based on the finding, a survey was developed. Quantitative data ( n = 328) were collected from hospital nurses born between the years 1948-1962. Explorative factor analysis was used to create the theoretical model. Results The main concepts of the model were nurse-nurse interaction, nurse-patient interaction and patient-care centeredness. Conclusion According to the theoretical model, well-being at work can be described as nurses' experience of collaboration, cooperation and togetherness with other nurses in a supporting and caring work environment. The aim and possibility of high-quality patient care, in a spirit where nurses and nursing are appreciated, were also revealed. Implications for nursing management The importance of nurse-nurse interaction and nurse-patient interaction as well as ageing nurses' patient-care centeredness needs to be taken into account in nursing management and leadership. [ABSTRACT FROM AUTHOR]

riahi s. (2011) Journal of Nursing Management 19, 721-731 Role stress amongst nurses at the workplace: concept analysis Aim The present study explicates the concept of role stress amongst nurses through an analysis adopted from Walker and Avant; Strategies for Theory Construction in Nursing, 4th edn, Prentice Hall, New Jersey, NY. Background Role stress has become a significant problem amongst nurses and has created much distress leading to burnout among many in the nursing profession. It is significant to analyse the concept of role stress and its relative attributes and consequences, in order to recognize the necessary antecedents needed to create better conditions for nurses at the workplace. Evaluation A modified method developed by Walker and Avant was used for this concept analysis. Key issues A model representing the concept of role stress was developed through careful consideration of the attributes, consequences, antecedents and empirical referents of role stress. Conclusion The concept analysis of role stress among nurses at the workplace recognized the vulnerability of the nursing discipline towards burnout and distress in general. Implications for Nursing Management It is critical to be aware of the current state of health care and note the increased workload created for nurses. Nurses are at a greater vulnerability for role stress, making it imperative for health care organizations to critically evaluate and establish preventative measures for the concept of role stress. [ABSTRACT FROM AUTHOR]

(2011) Journal of Nursing Management, 449-460 To test the psychometric properties of a newly developed measure of staff nurse clinical leadership derived from Kouzes and Posner's model of transformational leadership. While nurses have been recognized for their essential role in keeping patients safe, there has been little empirical research that has examined clinical leadership at the staff nurse level. A non-experimental survey design was used to test the psychometric properties of the clinical leadership survey (CLS). Four hundred and eighty registered nurses (RNs) providing direct patient care in Ontario acute care hospitals returned useable questionnaires. Confirmatory factor analysis provided preliminary evidence for the construct validity for the new measure of staff nurse clinical leadership. Structural empowerment fully mediated the relationship between nursing leadership and staff nurse clinical leadership. The results provide encouraging evidence for the construct validity of the CLS. Nursing administrators must create empowering work environments to ensure staff nurses have access to work structures which enable them to enact clinical leadership behaviours while providing direct patient care. [ABSTRACT FROM AUTHOR]

(2010) Journal of Nursing Management 981-992 To test a theoretical model linking selected antecedent variables to intra-group conflict among nurses, and subsequently conflict management style, job stress and job satisfaction. A contributing factor to the nursing shortage is job dissatisfaction as a result of conflict among nurses. To develop strategies to reduce conflict, research is needed to understand the causes and outcomes of conflict in nursing work environments. A predictive, non-experimental design was used in a random sample of 277 acute care nurses. Structural equation modelling was used to analyse the hypothesised model. Nurses' core self-evaluations, complexity of care and relationships with managers and nursing colleagues influenced their perceived level of conflict. Conflict management style partially mediated the relationship between conflict and job satisfaction. Job stress had a direct effect on job satisfaction and core self-evaluation had a direct effect on job stress. Conflict and its associated outcomes is a complex process, affected by dispositional, contextual and interpersonal factors. How nurses manage conflict may not prevent the negative effects of conflict, however, learning to manage conflict using collaboration and accommodation may help nurses experience greater job satisfaction. Strategies to manage and reduce conflict include building interactional justice practices and positive interpersonal relationships. [ABSTRACT FROM AUTHOR]