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Aim: We aim to explore healthful leadership practices in nursing and midwifery evident within the COVID‐19 pandemic in the United Kingdom, the contextual facilitators, barriers and outcomes. Background: Globally, the health and care sectors are under pressure and despite nurses and other professionals, demonstrating resilience and resourcefulness in the COVID‐19 pandemic; this has negatively impacted on their health and wellbeing and on patient care. Evaluation: Two searches were conducted in July 2021 and December 2021. Inclusion/exclusion criteria were identified to refine the search, including papers written since the beginning of the pandemic in 2020. A total of 38 papers were included principally from the United States and United Kingdom. Ten were research papers; the others were commentaries, opinion pieces and editorials. MS Teams literature repository was created. A unique critical appraisal tool was devised to capture contexts, mechanisms and outcomes whilst reflecting more standardized tools, that is, the Critical Appraisal Skills Programme and the Authority, Accuracy, Coverage, Objectivity and Date tool for reviewing grey literature to refine the search further. Key issues: Six tentative theories of healthful leadership emerged from the literature around leadership strategies, which are relational, being visible and present; being open and engaging; caring for self and others; embodying values; being prepared and preparing others; and using available information and support. Contextual factors that enable healthful leadership practices are in the main, created by leaders' values, attributes and style. The literature suggests that leaders who embody values of compassion, empathy, courage and authenticity create conditions for positive and healthful relations between leaders and others. Nurse and midwives' voices are however absent from the literature in this review. Conclusion: Current available literature would suggest healthful leadership practices are not prioritized by nurse leaders. Perspectives of nurses' and midwives' about the impact of such practices on their wellbeing is also missing. Tentative theories are offered as a means of identifying healthful leadership strategies, the context that enable these and potential outcomes for nurses and midwives. These will be explored in phase two of this study. Implications for Nursing Management: Nurse leaders must be adequately prepared to create working environments that support nurses' and midwives' wellbeing, so that they may be able to provide high‐quality care. Ensuring a supportive organizational culture, which embodies the values of healthfulness, may help to mitigate the impact of the COVID‐19 pandemic on nurses' and midwives' wellbeing in the immediate aftermath and going forward. [ABSTRACT FROM AUTHOR]

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

The retention and recruitment of care providers are ongoing concerns in healthcare globally. Examining intention to leave (ITL) as a measure of retention, the existing literature has focused on nurses working in hospitals, with less attention paid to other care providers and other areas of practice. The purpose of this study was to gain a better understanding of the unique factors influencing ITL among three categories of care providers in home care: registered practical nurses, registered nurses, and personal support workers. This study assessed and compared predictors of ITL, including organizational commitment, job satisfaction, perceived supervisor support, burnout, role stress, work/family conflict, and community satisfaction. A convenience sample of home care staff working in one agency in a Canadian province was sent an electronic survey by e-mail in 2021. Responses (n = 185) underwent data analysis including descriptive statistics, analysis of variance, and multiple linear regression, as well as thematic analysis of two open-ended items. The results of the study indicated that 54% (n = 99) of respondents were considering leaving their job, and respondents were dissatisfied with their salary and benefits. Role stress, work-family conflict, and burnout differed significantly between groups. Several themes emerged for strategies to promote employees to stay with the agency, with the overwhelming strategy being higher wages/salary. Themes for why employees stayed with the agency included love for clients and commitment to their care, as well as fondness for the teams within which respondents worked. The findings of the study lead to several important implications and recommendations for the home care sector. Advocating for wage parity among healthcare sectors and other opportunities for compensation for home care workers is necessary. Additional strategies include supportive and innovative approaches for scheduling, teamwork, and working with staff to identify barriers and solutions in home care. [ABSTRACT FROM AUTHOR]

Aim: The aim of this work is to examine the effect of multicomponent interventions on enhancing the level of confidence of staff nurses with evidence‐based practice in an acute care hospital in the United Arab Emirates. Background: Evidence‐based practice is one of the strategic pillars of nursing practice and a key to organizational success. To effectively implement and sustain evidence‐based practice programmes in clinical sites, well‐designed implementations can promote staff attitude, knowledge, skills, and confidence in translating research evidence into optimal patient care. Methods: Experienced and bachelor prepared nurse managers in collaboration with the clinical resource nurse undertook condensed staff training and interventions for the evidence‐based practice programme, where 70 registered nurses participated. The intervention was conducted over a period of time extending from December 2019 until December 2020. The study design is quasi‐experimental using the pre‐ and post‐Self Efficacy Assessment tool to gauge the nurses' confidence in evidence‐based practice. Also, SPSS software was used to explore the effect of the programme. Results: Higher significant score on the evidence‐based nursing practice self‐efficacy scale postprogramme was noted (t = −7.667 and p value <.001). Conclusion: Participating in a well‐structured evidence‐based practice programme would positively enhance the nurse's confidence in the programme implementation and promote an evidence‐based practice culture in clinical settings. Implications for Nursing Managers: Nurse managers must recognize their critical role in promoting evidence‐based practice among nurses. A focused and well‐designed intervention may assist in establishing a culture of evidence‐based practice to ensure the best patient outcome. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to evaluate health care professionals' perceived organizational support and its effect on their compassion, resilience and turnover intention in the United Arab Emirates. Background: The COVID‐19 pandemic exerted unprecedented pressure on health care systems, professionals and management systems. Health care organizations begin to explore their roles and function in relation to risks and resilience, in addition to ascertain what level of organization support they are providing to their workers. Methods: A cross‐sectional study was conducted with a questionnaire administered to 538 health care workers, to examine their personal resources and organizational support during the pandemic. Results: A total of 37.7% of nurses were found to have a moderate level of resilience, logistic regression showed that being married is a protective factor against resigning from the profession (OR = 0.462, P =.012, 95% CI: 0.254–0.842), and health care workers who perceived higher organizational support were approximately 50% less likely to have a turnover intention (OR = 0.506, P =.009, 95% CI: 0.303–0.845). Multiple linear regression model indicated significantly higher resilience among physicians (β = 0.12, P <.05) and allied health care practitioners (β = 0.12, P =.022). Organizational support had a significant positive relationship with resilience scores (β = 0.20, P <.001); adequate training was significantly related to higher compassion levels (β = 0.11, P <.05) and high organizational support scores were associated with increased compassion scores (β = 0.27, P <.001). Conclusions: Front‐line health care workers reported moderate organizational support during the pandemic, commensurately reflected in moderate levels of personal resilience and self‐compassion. Continued and better support is vital for employee sustainability and the increased health system performance, including quality of care and patient outcomes. Implications for nursing management: Nurse managers should help health care workers improve self‐care strategies by strengthening personal resources, including shortened duty hours, offering adequate break time, providing a safe work climate and purveying adequate personal protective equipment and supplies to combat infections. They should build an empathetic work environment through understanding the needs of staff, helping tackle their work stress and sustaining cultures of compassion through promoting rewarding and flexibility strategies. Moreover, policymakers and nurse mangers should create a rewarding culture for nurses and other health care workers to increase their commitment to their jobs. [ABSTRACT FROM AUTHOR]

Aims: To examine the organisation of the nursing workforce in intensive care units and identify factors that influence how the workforce operates. Background: Pre‐pandemic UK survey data show that up to 60% of intensive care units did not meet locally agreed staffing numbers and 40% of ICUs were closing beds at least once a week because of workforce shortages, specifically nursing. Nurse staffing in intensive care is based on the assumption that sicker patients need more nursing resource than those recovering from critical illness. These standards are based on historical working, and expert professional consensus, deemed the weakest form of evidence. Methods: Focus groups with intensive care health care professionals (n = 52 participants) and individual interviews with critical care network leads and policy leads (n = 14 participants) in England between December 2019 and July 2020. Data were analysed using framework analysis. Findings: Three themes were identified: the constraining or enabling nature of intensive care and hospital structures; whole team processes to mitigate nurse staffing shortfalls; and the impact of nurse staffing on patient, staff and intensive care flow outcomes. Staff made decisions about staffing throughout a shift and were influenced by a combination of factors illuminated in the three themes. Conclusions: Whilst nurse:patient ratios were clearly used to set the nursing establishment, it was clear that rostering and allocation/re‐allocation during a shift took into account many other factors, such as patient and family nursing needs, staff well‐being, intensive care layout and the experience, and availability, of other members of the multi‐professional team. This has important implications for future planning for intensive care nurse staffing and highlights important factors to be accounted for in future research studies. Implications for Nursing Management: In order to safeguard patient and staff safety, factors such as the ICU layout need to be considered in staffing decisions and the local business case for nurse staffing needs to reflect these factors. Patient safety in intensive care may not be best served by a blanket 'ratio' approach to nurse staffing, intended to apply uniformly across health services. [ABSTRACT FROM AUTHOR]

Aim: The main aim of this study was to understand what health and wellbeing initiatives are helpful for health care workers' stress and psychological distress during the Covid‐19 pandemic. Background: Health care workers are at increased risk of poor mental health during health emergencies; understanding support required for health care workers is of paramount importance. Methods: Participants were health care workers at a health and social care organization (N = 159). The study included an online questionnaire including an evaluation of health and wellbeing initiatives and measures of perceived stress and psychological distress. Results: The highest rated resources were counselling, personal protective equipment (PPE) and Covid‐19 testing. Those who accessed yoga reported significantly less stress and psychological distress than those who did not access yoga. Conclusions: Health care workers with higher stress and psychological distress felt less supported by their organization, less listened to and less involved in organizational decisions. Implications for nursing management: Practical implications are discussed such as forward planning for health emergencies (e.g., PPE supply), accessible Covid‐19 testing as well as budgeting for counselling services and exercise classes. In addition, targeted support for those diagnosed with Covid‐19 is recommended, alongside involvement of staff members in organizational decisions. [ABSTRACT FROM AUTHOR]

Aim: We aim to determine safety attitudes of nurses and midwives across a Local Health District in Australia and compare results 1 year later following facilitated feedback of results. Background: Positive safety cultures are imperative for positive patient and staff outcomes. Staff member's attitude contribute to an organisations safety culture but can differ between health professional groups and across different subcultures. Method: The Safety Attitudes Questionnaire (SAQ‐Short version) was administered to all nurses and midwives within a Local Health District in NSW, Australia in 2019 and 2020. Results were facilitated back to nursing/midwifery leadership teams with an expectation of developing and enacting an action plan, based on results. Results: Of the six domains in the SAQ‐Short version, five domains scores increased significantly (p <.001) over the time period. Conclusions: Measures over time are important to establish differences in perceptions and feedback on impact of actions. Facilitated feedback of results shows meaning when nursing/midwifery leadership staff have data explained and an opportunity to discuss and plan. Implications for Nursing Management: This study shows that facilitated feedback of quantitative survey results brings improved results when a survey is replicated. Nurse managers should enact a contextualized action plan with teams based on survey results to influence improvement in safety attitudes of staff. [ABSTRACT FROM AUTHOR]

Aim: To have at hand a reliable and valid questionnaire to assess performed and missed nursing care in a Swiss acute care context. Background: Regular monitoring of performed and missed nursing care is crucial for nurse leaders to make evidence‐based decisions. As foundation, we developed a conceptual definition. Based on this, we decided to translate and adapt the MISSCARE. Method: In this methodological study, our newly developed German MISSCARE and previously used BERNCA‐R were tested in a pilot study using a quantitative crossover design in a sample of 1,030 nurses and midwives in three Swiss acute care hospitals. Data were analysed descriptively, then using exploratory factor analysis and Rasch modelling. Results: We obtained preliminary evidence that the German MISSCARE is sufficiently reliable and valid to measure performed and missed nursing care in our context but would benefit from structural adjustments. In contrast, the BERNCA‐R proved insufficiently reliable for our purposes and context. Conclusion: Our conceptual definition was essential for the development of the German MISSCARE. Our results support the decision to use this questionnaire. Implication for nursing management: The adapted German MISSCARE will allow both monitoring of performed and missed nursing care over time and benchmarking of hospitals. [ABSTRACT FROM AUTHOR]