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Nurses' turnover intention has increased since the COVID-19 pandemic. Emotional labor is reportedly high among nurses in Korea, and a positive psychological capital can help reduce turnover intention. This cross-sectional study investigated the factors influencing turnover intention in nurses during the COVID-19 pandemic. Survey data were collected from 155 nurses caring for patients with COVID-19 at a university hospital in South Korea in March 2022. Self-reported and paper-based questionnaires on emotional labor, positive psychological capital, and turnover intention were employed. The mean values for emotional labor, positive psychological capital, and turnover intention were 54.52/80, 58.03/90, and 38.92/50, respectively, and 77.8% of nurses reported planning to quit working. Turnover intention correlated with emotional labor (r = 0.17; p = 0.041) and had no significant relationship with positive psychological capital. Sex (β = 0.24; p = 0.003) and emotional labor (β = 0.18; p = 0.019) affected turnover intention, with 9% explanatory power. Female nurses caring for patients with COVID-19 had a higher turnover intention than male nurses. Finally, the higher the emotional labor of nurses caring for patients with COVID-19, the higher the turnover intention. To reduce the turnover intention of nurses, hospitals need to help them enhance their emotional labor and positive psychological capital by establishing measures such as emotional coaching programs or psychological capital interventions. [ABSTRACT FROM AUTHOR]

Aim. The objective was to investigate the impact of structural empowerment and demographic factors on the psychological empowerment of nurses. Background. The empowerment of nurses plays a crucial role in improving patient care and achieving successful healthcare outcomes. When nurses feel empowered in their work environment, they tend to remain dedicated to their jobs and experience higher levels of job satisfaction and engagement. Methods. This cross-sectional study utilized a convenience sample of 287 nurses recruited from various hospital units, resulting in a response rate of 94.7%. Data were collected through a paper survey consisting of three sections: structural empowerment, psychological empowerment, and demographics. Results. The first hierarchical regression explains 57.0% variance in nurses' psychological empowerment (F = 78.52, p < 0.001). Age (β = 0.37, p < 0.01) and structural empowerment (β = 0.69, p < 0.001) have a positive influence on nurses' psychological empowerment. Conversely, having a bachelor's degree (β = −0.16, p < 0.01) had a negative impact psychological empowerment. The second hierarchical regression clarifies the specific aspects of structural empowerment that influences positively on nurses' psychological empowerment: access to opportunities (β = 0.13, p < 0.01), support (β = 0.13, p < 0.01), resources (β = 0.35, p < 0.001), and informal power (β = 0.12, p < 0.01). Conclusion. This study emphasizes the importance of considering demographic variables, such as age and education, in conjunction with structural empowerment to effectively enhance nurses' psychological empowerment. Implications for Nursing Management. Nursing managers should tailor their empowerment strategies based on the demographic characteristics of their nurses. It is essential to focus on providing nurses with access to opportunities, support, resources, and informal power. These insights provide valuable guidance for nursing managers to enhance nurses' psychological well-being, job satisfaction, and overall quality of life. Ultimately, this contributes to positive outcomes for patients, nursing staff, and healthcare organizations. [ABSTRACT FROM AUTHOR]

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

Aim(s): This paper examined the impact of workplace bullying (WPB) on mild aggressive deviant behaviour, such as knowledge hiding and employee time theft, in Pakistani health care institutions. Additionally, this study investigated the mediating role of negative emotions on the relationship between WPB and its outcomes. Background: Although mild deviant behaviour has been proven to affect the health care sector, its antecedents are still untapped. Method: Data were collected from 233 nurses working in hospitals located across Pakistan via self‐administered questionnaires in three time lags to test both the direct and indirect effects of WPB. The hypothesized correlations were tested using structural equation modelling (SEM). Results: The results revealed that WPB increased knowledge hiding and employee time theft amongst nurses. The indirect effect of negative emotions was established on the aforementioned relationships. Conclusion: This study contributes to the existing literature by concentrating on predictors that trigger deviant behaviour amongst nurses. It also assessed the mediating impact of emotions, wherein such endeavour is essential for researchers and practitioners. Implications for Nursing Management: The study outcomes are significant for the hospital sector to improve their strategies, such as implementing resilience during stressful events to address WPB and deviant behaviour amongst nurses. [ABSTRACT FROM AUTHOR]

Aim This paper used Social Exchange Theory to empirically examine whether perceived organisational support, satisfaction with training and development and perception of discretionary power are antecedents of engagement for registered nurses working in Italian public and private hospitals ( n = 827). Background According to Social Exchange Theory, effective workplace relationships support employees and encourage nurses to use training to enhance their workplace outcomes. Method This research used a cross-sectional design. Data were collected from registered nurses working in six Italian hospitals using a survey-based, self-report strategy. Result Regression analysis found that the variance of process-oriented supervision accounted for 6.9% of Italian registered nurse's perception of engagement, training and development accounted for 26.8% and discretionary power accounted for 2.1%. Conclusion Workplace relationships enhance autonomy and engagement. Effective workplace relationship impacts positively on nurses' outcome. Implications for nursing management This paper confirms the relevance of training to enhance engagement of nurses. It also confirms the importance of workplace relationships in enhancing autonomy and engagement. Previous research has identified the importance of nurses' autonomy in an environment where there are shortages of nurses. This study confirms a similar situation for Italian nurses. The findings underline the relevance of investments in continuous professional development to enhance nurses' engagement in private and public health-care settings. [ABSTRACT FROM AUTHOR]

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

Aim To assess the association between nursing team continuity and quality of care. Background Research on nurse staffing and its effect on quality of care is investigated to different degrees. However, very few studies have observed whether the continuous deployment of nursing staff is associated with quality of care. Methods This study was conducted in two university neonatal intensive care units ( NICUs). We matched nurse schedule data for the NICUs with nursing-sensitive patient outcomes and quality of care, as perceived by parents. We used analysis of variance to analyse differences in nursing team continuity between NICUs and regression analyses to identify associations with the outcome measures. Results There were considerable differences between units in terms of team continuity of nursing staff. Positive associations were found between team continuity and a higher rate of non-invasive respiratory support as well as parents' perceptions of how well they knew their nurse. Conclusions The findings show remarkable differences in staff assignment in the different NICUs. In addition to appropriate staffing levels, scheduling nursing teams continuously would appear to play a role in influencing treatment quality. Implications for nursing management This paper emphasises the importance of carefully considered staff scheduling decisions. [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]

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

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

Aim The aim of this study was to examine the relationships among education, leadership experience, emotional intelligence and transformational leadership of nurse managers. Background Nursing leadership research provides limited evidence of predictors of transformational leadership style in nurse managers. Methods A predictive correlational design was used with a sample of nurse managers ( n = 148) working in varied health care settings. Data were collected using the Genos Emotional Intelligence Inventory, the Multi-factor Leadership Questionnaire and a demographic questionnaire. Simple linear and multiple regression analyses were used to examine relationships. Results A statistically significant relationship was found between emotional intelligence and transformational leadership ( r = 0.59, P < 0.001) explaining 34% variance in transformational leadership. Conclusions Nurse managers should be well informed of the predictors of transformational leadership in order to pursue continuing education and development opportunities related to those predictors. Implications for nursing management The results of this study emphasise the need for emotional intelligence continuing education, leadership development and leader assessment programmes. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore primary health care nurses' coping strategies and evaluate the psychometric properties of the Brief Coping Orientation to Problems Experienced (COPE) scale. Background: Primary health care nurses are experiencing significant COVID‐19‐related psychological impacts. Beyond understanding the impacts, there is a need to explore coping strategies. Methods: This online cross‐sectional survey was completed by 359 Australian primary health care nurses between October and December 2020. Results: Factor analysis revealed seven factors (support, disengagement and venting, humour, positive reframing, acceptance, substance use and spiritual/religious beliefs) (Cronbach's alpha >.69). There was an association between age, years of nursing and years of primary health care nursing and the factors of 'support', 'disengagement and venting' and 'positive reframing'. Years of experience were also associated with the factor 'humour'. Urban respondents had higher scores for the 'support' factor. Conclusions: The Brief COPE scale is a valid and reliable tool for assessing primary health care nurses' coping. As demographic characteristics impact the coping strategies that nurses use, supports need to be tailored to optimize their impact. Implications for Nursing Management: Nurse managers need to consider the workforce demographics when designing and implementing support strategies. The Brief COPE can identify current coping strategies and inform interventions to build coping capacity. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to explore and compare stress, coping, professional identity and work locus of control of new graduate nurses among Shanghai, Hong Kong and Taipei. Background: The transition from a student to a staff nurse role is recognized as a stressful experience and can be a rough journey. Many newly graduated nurses find it challenging to cope with their new roles in their first few months. Methods: A cross‐sectional research was used in the study. This study was completed in Shanghai, Hong Kong and Taipei with newly graduated nurses working in hospitals. A total of 591 graduate nurses who had worked within 1 year in hospitals were recruited using convenient sampling. Data were collected using a structured questionnaire, including demographics, the occupational stress scale, the Chinese trait coping style questionnaire, the nurse professional identity scale and the work locus of control scale (Chinese version). Results: The newly graduated nurses in Shanghai had significantly lower (p < 0.05) work stress score (2.65 ± 0.67) compared with their counterparts in Hong Kong (2.99 ± 0.69) and Taipei (2.94 ± 0.60). Newly graduated nurses in Shanghai tended to choose positive coping to deal with stressful situations, whereas those in Hong Kong would be more likely to adopt negative attitudes (p < 0.05). The newly graduated nurses in Taipei had the lowest level of professional identity (3.25 ± 0.55, p < 0.05), and their work control tended to be external (46.13 ± 6.20). In contrast, those in Shanghai (52.75 ± 6.04) and Hong Kong (59.41 ± 7.29) tended to be controlled internally. Conclusions: The study findings revealed the differences among newly graduated nurses in Shanghai, Hong Kong and Taipei with their level of stress, coping, professional identity and work locus of control. Proper leadership, mentoring for newly graduated nurses, and emphasis on first aid nursing training, emotional management and management of stress in newly graduated nurse transition programmes were suggested. Implications for Nursing Management: By comparing the results in the three regions, we recommend that nursing managers promote the right leadership style. In addition to coaching, nursing managers can assign additional mentors to newly graduated nurses to help them supplement their clinical knowledge and skills with psychological support. These mentors can come from senior nurses or nursing managers working on less demanding tasks. In addition to the existing post transfer training programmes, new graduate nurses should also focus on emergency nursing training, emotional management training and stress management training. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the status quo of nurses' spiritual care competency and their relationship with perceived professional benefit. Background: Spiritual care has always been considered a vitally important part of holistic nursing. Understanding the spiritual care competency of nurses during the COVID‐19 pandemic can help nursing managers understand the weak links in spiritual care practice and improve the quality of nursing service. As a positive emotional experience and cognitive evaluation of the profession, perceived professional benefit can serve to adjust work pressure, relieve job burnout and promote an individual's overall growth. However, the relationship between perceived professional benefit among nurses and spiritual care competency remains unclear. Methods: A total of 372 nurses were recruited from 15 separate Chinese hospitals. An online questionnaire was used to assess nurses' sociodemographic, spiritual care competency and perceived professional benefit. Statistical analyses were performed using Pearson's correlation analysis, t test, analysis of variance (ANOVA) and multiple stepwise linear regression analysis. Results: The total mean score of spiritual care competency (99.43 ± 21.10) among nurses was found to be moderate. Nurses' spiritual care competency was positively correlated with perceived professional benefit (P <.01). The multiple stepwise linear regression model (n = 372) had an explained variance (R2 = 0.218) and showed that perceived professional benefit and the manner of receiving spiritual training were the main influencing factors of nurses' spiritual care competency (P <.001). Conclusion: The study findings indicated that nurses need to improve their spiritual care competency by improving their perceived professional benefit. Implication for nursing managers: Our study evaluated the spiritual care competency of nurses and explored the correlation between perceived professional benefit and spiritual care competency among nurses. The results of this study can help nursing managers to carry out relevant interventions, thus improving nurses' spiritual care competency and optimizing the quality of nursing. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the compassion satisfaction and compassion fatigue among Chinese frontline nurses during the COVID‐19 pandemic in Wuhan, China and to explore the related factors. Background: Frontline nurses undertake a huge nursing workload with a risk of infection, causing great pressure on them and making them face a risk of compassion fatigue during the pandemic. Methods: A cross‐sectional online survey was conducted from 9 March to 15 March 2020. A total of 1582 nurses caring for critical patients with COVID‐19 participated. Compassion satisfaction and compassion fatigue (comprising burnout and secondary traumatic stress) were assessed with the Professional Quality of Life Scale, and resilience was measured with the Chinese 10‐item Connor‐Davidson Resilience Scale. Results: Moderate levels of compassion satisfaction (36.99 ± 6.71), burnout (24.14 ± 5.33) and secondary traumatic stress (24.53 ± 5.24) were experienced by frontline nurses. Resilience and perceived work pressure were the main predictors. Conclusions: Frontline nurses demonstrated a moderate level of compassion satisfaction and compassion fatigue. Implications for nursing management: The compassion fatigue of frontline nurses should be considered. Strategies aiming to reduce stress and enhance resilience, such as training about psychological adjustment, developing professional skills and creating a supportive workplace environment, are several options. The trial is not registered. This study is a cross‐sectional study, and according to China's clinical trial registration standards, such studies are not required to be registered. So the trial is not registered. However, oral consent was obtained from the ethics committee of the hospital before this study was conducted. [ABSTRACT FROM AUTHOR]

Aim: To evaluate nursing leaders' perception of communication and relationship management competencies while using digital platforms during the COVID‐19 pandemic. Background: Nursing leaders can achieve effective leadership by mastering these competencies leading to an overall improvement in the quality of nursing care. The COVID‐19 pandemic has brought numerous challenges in communication, and digital platforms have been widely used in healthcare settings to mitigate contagion. Design: Cross‐sectional. Methods: The study was conducted between February and March 2021. A survey was adopted from the American Organization of Nurse Executives (AONE) and was sent to nursing leaders in Qatar through email. Results: A total of 250 nurse leaders were invited to participate, but only 116 responded (RR 46.4%). The male participants represented a more significant proportion of 64.10%. Influencing behaviour, relationship management and effective communication had the lowest scores, which indicates low competency. Conclusions: Despite obtaining satisfying scores, nursing leaders in Qatar should strive for professional development and knowledge acquisition to improve their communications and relationship management competencies. Implications for Nursing Management: Healthcare organizations must understand that nursing leaders should strive for professional development and knowledge acquisition to improve their communication and management. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to identify the patient and hospital characteristics related to nursing needs and nursing hours in acute hospital settings. Background: To determine appropriate staffing levels, accumulating empirical data through direct observation and surveys reflecting the actual situation is necessary. Methods: In this cross‐sectional study, we conducted direct observations of nurses in acute care hospitals from 1 May to 31 August 2020. Twenty‐six hospitals in five cities participated, and 747 nursing personnel collected 1,681 patients' data while performing nursing activities. The data of 1,605 nurses were analysed using descriptive statistics, t tests, analysis of variance and linear regression. Results: Hospital size, admission day, patients' dependence level, high fall risk and disease diagnoses were variables associated with nursing needs (F = 73.49, P <.001) and nursing hours (F = 57.7, P <.001). Comparing the correlates of nursing needs and nursing hours revealed that, unlike nursing needs, nursing hours were not significantly associated with surgery and certain diagnoses. Conclusion: This study confirmed the variables associated with nursing needs and nursing hours in acute hospitals; based on this, determining appropriate staffing levels, which is an important step in improving inpatients' health outcomes, is necessary. Implications for Nursing Management: In acute hospitals, an increased number of nurse staffing should be employed based on the number of newly hospitalized patients, patients with high dependence levels and specific diagnoses, and those at high risk of falling. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to determine which organisational socialisation contents affect turnover intention in newcomer nurses within their first 2 years of employment. Background Strategies to decrease turnover are a priority for improving organisational stability, reducing costs and enhancing effective nursing care. Materials and methods A cross-sectional design was employed, and standardised scales were used. The sample was divided into three groups: 0-6, 7-12 and 13-24 months of employment. Regression analyses were performed. Results A total of 156 Italian nurses participated in this study. In the 0-6 months group (model 1), the main factors that decreased turnover intention were competence acquisition (β = −0.42, P < 0.01) and comprehension of organisational rules (β = −0.38, P < 0.01). In the 7-12 months group (model 2), workgroup integration was relevant (β = −0.33, P = 0.02) and in the second year (model 3), the main factor was opportunities for professional development (β = −0.30, P = 0.05). Conclusions Newcomer nurses were sensitive to different organisational socialisation contents over time. This result supports planning different on-boarding strategies to enhance organisational socialisation success and to improve nurse retention. Implications for nursing management Useful strategies to improve retention include enhancing task mastery and workgroup integration at the ward level and a professional development plan at the organisational level. [ABSTRACT FROM AUTHOR]

Background: During the COVID‐19 pandemic, there were difficulties in planning the nursing workforce and personal protective equipment. Aim: The purpose of this study was to identify the experiences and views of nurses on personal protective equipment use and nursing workforce planning in Turkey. Methods: This descriptive and cross‐sectional study was conducted between 23 December 2020 and 3 May 2021, among 362 nurses who agreed to participate in this study voluntarily. Results: The findings showed that the satisfaction scores were significantly higher for those nurses who worked in 8‐h shifts, were not assigned to different clinics, were notified by an official letter and 1 week or month in advance before assignment compared with nurses in other categories. Conclusions: The problems that have arisen in the COVID‐19 pandemic process have made it clear that there is a need for a nursing services management model in the event of an epidemic. Implications for Nursing Management: This study reveals the need for the 'Nursing Services Management Model in the Event of an Epidemic' by discussing the problems of nurse workforce planning and protective personal equipment management from the perspective of nurses who experienced these problems at first hand. [ABSTRACT FROM AUTHOR]

Aim: To determine the level of critical cultural competence (CCC) among Chinese clinical nurses and explore its influencing factors. Background: Previous research has only focused on the theoretical model of CCC and the development of assessment tools; however, no large‐scale study has been conducted on the level of clinical nurses' CCC and its influencing factors. Method: Clinical nurses in 14 Level A tertiary hospitals (n = 3858) were surveyed using Almutairi's critical cultural competence scale (CCCS). Descriptive, univariate and multivariate analyses were performed. Results: The mean score of CCC was 4.44 (SD = 0.33). Critical empowerment (M = 4.85, SD = 0.58) and critical awareness (M = 3.57, SD = 0.99) had the highest and lowest scores, respectively. Female nurses, nurses in the nursing department and nurses with higher positions had higher CCC. Conclusion: The CCC of clinical nurses can be strengthened through targeted training, especially considering the fact that male and low‐ranking nurses who had the lower level of CCC work in different departments. Implications for Nursing Management: Hospital administrators should pay attention to the importance of culture and cultural differences among different countries or ethnic groups. Creating an equal and fair nursing environment and encouraging nurses to provide critical cultural nursing is important. [ABSTRACT FROM AUTHOR]

Aims: To identify and describe profiles of nursing resources and compare nurse and patient outcomes among the identified nursing resource profiles. Background: Research linking nurse education, staffing, and the work environment treats these nursing resources as separate variables. Individual hospitals exhibit distinct profiles of these resources. Methods: This cross‐sectional secondary analysis used 2006 data from 692 hospitals in four states. Latent class mixture modelling was used to identify resource profiles. Regression models estimated the associations among the profiles and outcomes. Results: Three profiles were identified (better, mixed and poor) according to their nursing resource levels. Hospitals with poor profiles were disproportionately mid‐sized, for‐profit, and had lower technology capability. Nurse job outcomes, patient mortality and care experiences were significantly improved in hospitals with better resource profiles. Conclusions: Hospitals exhibit distinct profiles of nursing resources that reflect investments into nursing. Nurse and patient outcomes and patients' experiences are improved in hospitals with better nursing resource profiles. This finding is consistent with the literature that has examined these resources independently. Implications for Nursing Management: Nurse managers can identify their nursing resource profile and the associated outcomes. Our results show the advantages of improving one's hospital nursing resource profile, motivating managers to make an informed decision regarding investments in nursing resources. [ABSTRACT FROM AUTHOR]

Aims: To assess the organisational silence and learning levels among nurses of a university hospital and explore the relationship between the socio‐demographics, organisational silence and learning. Background: Organisational learning is an active process needed for improving organisational performance, and silence has a devastating impact on an organisation's capacity to learn. Methods: A cross‐sectional quantitative design was applied using two tools: the organisational silence and the organisational learning scales. Over 3 months, data were collected from 724 nurses. The data were then analysed using suitable statistical methods. Results: The organisational silence level is moderate. The organisational learning level is predominantly moderate. The association between the two scales is a weak negative correlation, yet statistically significant. The multiple regression analysis was better in predicting organisational learning scores. Conclusions: There is a highly statistically significant negative weak correlation between overall organisational silence and overall organisational learning. More researchers are invited to implement of interventions to promote speaking‐up behaviours and organisational learning in nurses. Implications for Nursing Management: Nurse managers and leaders can create a work atmosphere that encourages and promotes open communication among nurses and other health care team members, likewise, creating an environment conducive to translating experiences into organisational learning. [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: The aim of this study is to evaluate the effect of Neurolinguistic Programming practices on organizational citizenship behavior in nursing. Background: Neurolinguistic Programming practices are used for different purposes in many areas, and they can also be used to contribute to the acquisition of organizational citizenship behaviour. Methods: The research is a randomized controlled trial. The sample of the study consisted of 180 nurses. The data of the study were collected through structured face‐to‐face interviews conducted with the nurses in the sample group, Neurolinguistic Programming training group, standard training and control groups between January and April 2020 after Neurolinguistic Programming training was received by the researcher. The Chi‐squared test and the analysis of variance (ANOVA) were used to analyze the collected data. Results: A statistically significant difference was found in the total score of the organizational citizenship behaviour in the Neurolinguistic Programming training group compared with the standard training group and the control group (p <.05). Conclusions: The use of Neurolinguistic Programming practices can be an effective method for nurses to gain organizational citizenship behaviour. Neurolinguistic Programming practices can be used to achieve the desired goals, especially for the acquisition of informing and participation, tolerance and conscientiousness behaviours. Implications for nursing management: Organizational citizenship behaviour exhibited by employees is very important for organisations. With this behaviour, nurses can improve all processes, from the quality of care services they provide to patients, to satisfaction. Findings of this study may be used to increase work satisfaction of nurses and to improve the quality of services received by patients. [ABSTRACT FROM AUTHOR]

Aim Using Social Exchange Theory, this study examines links between supervisor-nurse relationships, teamwork, psychological wellbeing and turnover intentions for nurses in the USA. Background Nurses in the USA comprise the biggest workforce of any country in the world. However, nurses continue to be in short supply even with an aggressive campaign to attract foreign nurses. The shortage of qualified registered nurses has negative implications for patient care and mortality because it affects problem-solving and teamwork as a result of poor communication among nurses. Methods The study uses a cross-sectional design and 730 completed surveys were obtained using a self-report strategy. Results The findings indicate that supervisor-nurse relationships, teamwork and wellbeing explain almost half of nurses' commitment to their hospital and their intentions to leave. Further, there was evidence of a generational effect in that Baby Boomer nurses perceived higher levels of wellbeing and commitment, and lower intention to leave. Implications for nursing management These findings suggest that management must focus on improving the quality of workplace relationship as a first step in retaining skilled nurses. It may be time for management to embed performance indicators for all levels of management, linked to ensuring effective workplace relationships. [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]

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]

sieloff c.l. & bularzik a.m. (2011) Journal of Nursing Management 19, 1020-1027 Group power through the lens of the 21st century and beyond: further validation of the Sieloff-King Assessment of Group Power within Organizations Aim The purpose was to determine the content validity of a semantic revision of items on a reliable and valid instrument, the Sieloff-King Assessment of Group Power within Organizations (SKAGPO). Background Research participants expressed negative perceptions regarding the use of the concept of 'power' in SKAGPO items. The SKAGPO is the only instrument measuring a nursing group's power or outcome attainment. Method Using a survey method, the instrument and grading scale were sent to 12 expert judges. Six participants completed the grading scale. Results The Content Validity Index (CVI) for seven questions was at or above 83% agreement. Overall, the CVI for the eight revised questions was 93.75%. Subsequently, the instrument was renamed the Sieloff-King Assessment of Group Outcome Attainment within Organizations (SKAGOAO). Conclusions The semantic revision demonstrated content validity for the revised SKAGOAO. When used by nursing groups to assess their level of outcome attainment, the instrument should continue to be psychometrically evaluated. Implications for nursing management A nursing group of any size can use the SKAGOAO to both assess the group's level of outcome attainment or empowerment and direct plans to further improve that level. [ABSTRACT FROM AUTHOR]

butler-williams c.,james j.,cox h. & hunt j. (2010) Journal of Nursing Management 18, 789-795 The hidden contribution of the health care assistant: a survey-based exploration of support to their role in caring for the acutely ill patient in the general ward setting Aim To examine the feelings, support and feedback available to health care assistants (HCA) when caring for acutely ill ward patients. Background The role of the HCA continues to evolve with increased responsibility for patient care. Contextual issues that affect their contribution to acute care management of the ward patient have been given limited attention. Methods A survey of HCAs ( n = 131) was conducted within two district general hospitals. Results There were a number of emotions and stressors associated with the care of acutely ill patients. While normal hierarchical systems were in place in order to obtain help HCAs additionally bypassed these normal channels. Support mechanisms included registered nurses, ward doctors, peers and family. Feedback regarding performance was limited. Conclusion HCAs play a significant role in the care of the acutely ill patient. Feedback mechanisms need to be developed and associated emotions recognized. Implications for nursing management HCAs support needs to be more evident and clinical feedback mechanisms need to be reviewed in order to improve care delivery. [ABSTRACT FROM AUTHOR]

Aim: To explore the differences in beliefs on and implementation of evidence‐based practice in nurses working in different types of health care institutions. Background: Optimal organizational context and knowledge are essential to support evidence‐based practice and sustain the use of evidence in professional nursing practice. Method: A cross‐sectional study was conducted. A total of 1,014 nurses from 20 Slovenian hospitals and 29 primary health care centres participated. Variables included the following: Evidence‐Based Practice Beliefs and Implementation Scale, educational and training activities, job satisfaction, job training, perceived research and evidence‐based practice knowledge, and access to databases. Results: Beliefs on evidence‐based practice were explained by evidence‐based practice (β = 0.249) and research (β = 0.162) knowledge, length of employment (β = 0.124), job satisfaction (β = 0.117), training in evidence‐based practice (β = −0.092) and holding a master's degree (β = 0.077). Implementation of evidence‐based practice depended on beliefs (β = 0.306) and the type of health care institution (β = 0.132). The highest implementation result was seen in primary health care centres (<0.001). Conclusion: Training in evidence‐based practice and perceived knowledge of evidence‐based practice significantly influence the beliefs on and implementation of evidence‐based practice. Nurses employed at primary health care centres who had completed a task‐shifting training programme achieved significantly better results for implementation of evidence‐based practice. Implications for Nursing Management: The indirect effects of development training programmes for the implementation of EBP have not yet been studied. Development activities and change implementation processes in nursing foster education and training opportunities, which have significantly influenced the implementation of EBP. [ABSTRACT FROM AUTHOR]

Aims: To discover the level of evidence‐based practice competency of Spanish nurses, to develop a scale of the EBP‐COQ‐Prof© and to analyse the influence of different variables on the level of competency. Background: The evidence‐based practice competency has previously been assessed using a wide variety of instruments, although these have methodological limitations and lack associated scales that allow for the interpretation of the score obtained. Method: Observational, cross‐sectional, national study. Using an online questionnaire, data were obtained between January and March 2020 from nurses working in the National Health System. An ANOVA was performed along with multiple regression analyses. The T‐score and percentiles were calculated to obtain the scale of the EBP‐COQ‐Prof©. Results: 2,942 nurses participated. The score for the evidence‐based practice competency was 130.29 (standard deviation 17.55). The multiple regression analysis showed a model comprised of 8 variables that explained 33% of the variance. Conclusions: The Spanish nurses have a moderate level of evidence‐based practice competency. The scale classifies the subjects into 3 levels: low, moderate and high competency. Implications for Nursing Management: The scale proposed for the EBP‐COQ‐Prof© could be utilized to facilitate the diagnosis of evidence‐based practice competency, and to monitor and plan individual and collective strategies to improve this competency. [ABSTRACT FROM AUTHOR]

Aims: To assess the ability to work of Polish nurses by age groups. Background: The ability to work is widely discussed in the literature in the context of nurses' productivity; thus, it is necessary to identify the ability to work when facing an increasing demand for services. Methods: The observational study involved 349 professionally active nurses aged 46.9 ± 9.7 years, with a length of service of 23.5 ± 9.6 years. The Work Ability Index (WAI) was used to assess the nurses' ability to work. Results: The ability to work decreases with age (rs = −0.324, p <.000) and with seniority (rs = −0.257; p <.000). Nurses with higher education presented higher Work Ability Index scores. Also, the age (B = −0.25, p <.001), work seniority (B = −0.19, p <.001) and education (masters' degree: B = 1.41, p =.012; ref. secondary) affect work ability. Conclusions: The ageing process and seniority of nurses negatively affect their ability to work. A lack of programmes to maintain physical condition for nurses can result in a shortage of staff. Implications for nursing management: Programmes can be developed to create or improve healthy working environments to increase productivity. [ABSTRACT FROM AUTHOR]

Aim: To examine the relative influence of fear of COVID‐19 on nurses' psychological distress, work satisfaction and intent to leave their organisation and the profession. Background: The emergence of COVID‐19 has significantly impacted the psychological and mental well‐being of frontline health care workers, including nurses. To date, no studies have been conducted examining how this fear of COVID‐19 contributes to health, well‐being and work outcomes in frontline nurses. Methods: This is a cross‐sectional research design involving 261 frontline nurses in the Philippines. Five standardized scales were used for data collection. Results: Overall, the composite score of the fear of COVID‐19 scale was 19.92. Job role and attendance of COVID‐19‐related training predicted fear of COVID‐19. An increased level of fear of COVID‐19 was associated with decreased job satisfaction, increased psychological distress and increased organisational and professional turnover intentions. Conclusions: Frontline nurses who reported not having attended COVID‐19‐related training and those who held part‐time job roles reported increased fears of COVID‐19. Addressing the fear of COVID‐19 may result in improved job outcomes in frontline nurses, such as increased job satisfaction, decreased stress levels and lower intent to leave the organisation and the profession. Implications for Nursing Management: Organisational measures are vital to support the mental health of nurses and address their fear of COVID‐19 through peer and social support, psychological and mental support services (e.g. counselling or psychotherapy), provision of training related to COVID‐19 and accurate and regular information updates. [ABSTRACT FROM AUTHOR]

Aims: To assess the effects of nurses' life satisfaction and life orientation on the level of nursing care rationing. Background: Best practice within human resource management argues that striving for a positive orientation within the workforce may create a friendly work environment that could promote the employee's development and job satisfaction in a health care organisation. Methods: A total of 547 nurses were enrolled and assessed using three self‐report scales: the Basel Extent of Rationing of Nursing Care‐R (BERCA‐R), the Satisfaction with Life Scale (SWLS) and the Life Orientation Test (LOT‐R). Then, the data were submitted into bivariate analyses. Results: More pessimistic nurses with low and moderate levels of life satisfaction, and those with a neutral life orientation, presented with significantly higher BERCA‐R scores than those who were more optimistic and who had high levels of life satisfaction. Conclusions: Nursing care rationing depends on psychological factors of life satisfaction and life orientation. Low levels of satisfaction with life and a more pessimistic life orientation negatively contribute towards a higher prevalence of nursing care rationing. Implications for nursing management: Nursing management policies, including intervention management, should consider ensuring positive orientation is in place to increase job satisfaction and optimism in health care workers. [ABSTRACT FROM AUTHOR]

Aims: The aim was to examine whether the level of optimism and job and life satisfaction is a differentiating factor from the level of implicit rationing of nursing care in a sample of Polish registered nurses. Background: Satisfaction with life and job is reflected by greater effectiveness of nurses at work and creates a positive work environment, which in turn may modulate the level of implicit rationing of nursing care. Methods: A cross‐sectional multicentre research design was adopted, employing a representative sample of 1,010 registered Polish nurses identified between the beginning of January and the end of June 2019. Four self‐report scales were used in this study: Basel Extent of Rationing of Nursing Care, Satisfaction with Life Scale, Satisfaction with Job Scale and Life Orientation Test—Revised. The results were analysed using the k‐means method, Student's t test and two‐way ANOVA. Results: Optimistic thinking, and satisfaction with job and life exerted a significant effect on the level of implicit rationing of nursing care among Polish nurses. Nurses from the group 'pessimistic' were at higher risk of nursing care rationing than those from the group 'optimistic'. Conclusion: Strengthening of the personal competencies, providing support and responding to all identified needs might increase job satisfaction of nurses and hence reduce the risk of nursing care rationing. Implications for nursing management: Leadership modelling and training in positive thinking might be the methods to support nurses and to prevent nursing care rationing. [ABSTRACT FROM AUTHOR]

Aim: To measure the association between the nurse work environment (NWE) and missed nursing care on labour and delivery (L&D) units. Background: L&D units provide a sizable fraction of acute hospital services to a unique population that is a national and global priority. L&D nurses are the frontline providers during labour. Maternal morbidity and mortality may be influenced by the NWE and missed care. Methods: This cross‐sectional study utilized secondary data from 1,313 L&D staff nurses in 247 hospitals from a four‐state nurse survey collected in 2005–2008. Results: Half of nurses missed care (range: zero to 100% across hospitals). Nurses on average missed 1.25 of 10 activities. The most commonly missed activities were comforting/talking with patients and teaching/counselling. In better as compared to poor NWEs, the odds and frequency of missed care were significantly lower. Conclusions: L&D nurses routinely miss necessary nursing activities. Labouring women's psychosocial, comfort and educational needs are compromised most often, likely impacting quality and outcomes. Nurse communication with colleagues and managers about missed care is warranted. Implications for Nursing Management: The L&D NWE is modifiable and appears to influence missed care. Managers should discuss missed care with staff and measure their NWE to identify actionable weaknesses. [ABSTRACT FROM AUTHOR]

Background: Few studies have considered functions of nurses' positive personality and behaviours on addressing their turnover intention. Aims: To explore the effects of WeChat‐based 'three good things' (3GT) on burnout nurses' turnover intention and coping styles. Methods: A randomized controlled trial. 73 nurses were included in the intervention group (n = 33) and the control group (n = 40). The intervention group received WeChat‐based 3GT. Turnover intention and coping style were measured before and after the intervention. Results: WeChat‐based 3GT effectively reduced turnover intention and negative coping style (each p <.05). Positive coping style was promoted after the intervention (p <.05). Time effects as well as intervention and time interactions were significant in turnover intention and negative coping style (each p <.05). Conclusion: Benefits of WeChat‐based 3GT on turnover intention and coping style in burnout nurses were found. Nurses experienced lower levels of turnover intention and negative coping style and increased the usage of positive coping style after the intervention. Implications for nursing management: Nurse managers should incorporate 3GT intervention with popular social communication programmes to improve nurses' coping strategies towards clinical issues and maintain the stability of nursing teams. [ABSTRACT FROM AUTHOR]

Aim: To explore the association between work–family conflict and overall well‐being among Chinese nurse leaders. Background: Nurse leaders are constantly busy at the clinical frontline, mostly experience high stress levels at work and have little time to spend with the family. There is little evidence to know about the association between work‐family conflict and overall well‐being, which is essential for high‐quality medical care. Methods: A cluster sampling method was used to recruit 42 nurse leaders. Data were collected using the Chinese versions of the Multidimensional Work–Family Conflict Scale and the General Well‐Being Schedule. Descriptive analyses, independent t tests, ANOVAs and Pearson's correlation were used for the statistical analysis. Results: The mean scores (SD) of work–family conflict and well‐being were 2.17 (0.57) and 4.51 (0.61), respectively. Negative correlations were observed with strain‐based and behaviour‐based work–family conflict and overall well‐being. Conclusion: Stress from work–family conflict is positively correlated with the overall well‐being of Chinese nurse leaders. Implications for Nursing Management: Hospital administrators should be aware of specific risk factors and implement accordingly the interventional strategies to decrease the stress levels and improve the overall well‐being of nurse leaders. [ABSTRACT FROM AUTHOR]

Aim: We sought to examine factors associated with organisational and professional turnover intention among nurse managers. Background: Turnover among nurse managers is an ongoing problem in many health care institutions worldwide. While many studies exist that have examined factors contributing to organisational turnover intention, surprisingly, little is known about which factors contribute to nurse managers' decisions to quit the profession. Methods: This cross‐sectional study involved 240 nurse managers working in 17 hospitals in the central Philippines. Five validated standardized scales were used for data collection. Results: The composite scores of the organisational and professional turnover intention measures were 2.75 and 1.97, respectively (Likert range: 1/strongly disagree to 5/strongly agree). Work–Family Conflict (β = 0.127; p <.05) and job satisfaction (β = −0.315; p <.001) were strongly associated with organisational turnover intention. Job stress was correlated with stronger professional (β = 0.200, p <.01) and organisational turnover intentions (β = 0.281; p <.001). Conclusion: Nurse managers reported a moderate level of organisational turnover intention and a low level of professional turnover intention. Job satisfaction, job stress, and Work–Family Conflict were identified as significant predictors of organisational and professional turnover intentions. Implications for Nursing Management: Turnover intention among nurse managers can be best addressed by exploring organisational measures such as a structured transition programme (e.g. nurse manager orientation, coaching, mentorship or preceptorship), leadership programme for new nurse managers and stress management interventions. Further, through provision of a work‐ and family‐friendly workplace and consistent career growth opportunities, retention of nurse managers may be enhanced. [ABSTRACT FROM AUTHOR]

Aims: To create a cohort of advanced practice nurses from across the UK and to report the initial questionnaire including demographics, work experiences and well‐being. Background: In the UK, advanced nursing practice is not regulated. This has led to the concern that advanced nurses are working in very different ways with different levels of autonomy and support. Methods: Participants were recruited via university and Royal College of Nursing mailing lists, and social media adverts. They completed the initial questionnaire about their background and workplace, work experiences, credentialing and well‐being. Results: A total of 143 nurses were recruited to the cohort and 86 completed the survey. Over 40 job titles were reported, across five pay bands. Job title was not correlated with pay band (p =.988). Participant well‐being was not significantly different from the UK general population, but they reported high rates of work‐related stress (44.2%) compared with the National Health Service national average (37.9%). Conclusion: There is a wide disparity in pay, which is not reflected in title or setting. The high levels of work‐related stress require further exploration. Implications for nursing management: The range of experiences reported here should encourage managers to evaluate whether title, pay and support mechanisms for Advanced Practice Nurses in their organisations align with suggested national standards set by Royal Colleges and government departments. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to explore the characteristics of nursing work and the correlation with the conditions in nurses' work environment. Background: Although the correlation between nurses' work characteristics and the safety of health care provision has been confirmed, nurses continue to work in discouraging environments. Method: A cross‐sectional study was conducted. A total of 1,744 nurses from 16 Slovenian hospitals participated. Variables included the following: work characteristics, ergonomic conditions at work, the prevalence of low back pain and self‐assessment of conditions in the work environment. Results: One nurse was responsible for 17.90 patients per shift (SD = 13.615), shifts were understaffed in 42.9% of cases, and technical assistive devices were available in 30% of cases. Job demands were explained with number of patients/shift (p <.001), job satisfaction (p <.001), availability of assistive devices (p =.001) and the female gender (p =.001). Decision authority was low and explained with a non‐leadership position (p <.001), educational achievement (p <.001), dissatisfaction with the job (p <.001) and the male gender (p =.008). Conclusion: A safe patient‐to‐nurse ratio, job satisfaction, availability of assistive devices and fostering decision authority turned out to be important in our study. Implications for Nursing Management: Europe is facing an increasing shortage of nurses, so actions for reducing nurse overload and encouraging decision authority are extremely important both for nurses and for patients. Participative leadership and ensuring gender equality in nursing are vital. [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: This study aimed to clarify the association between nurses' job satisfaction, interprofessional collaborative competency and other related factors in university hospitals in Japan. Background: Enhancing a team's function in the university hospital setting requires strengthening each professional's competency: high‐level professional competency leads to high job satisfaction. Methods: In 2014, self‐administered questionnaires were sent to all nurses working at two university hospitals in Japan. A multivariate analysis of variance was conducted to evaluate the relationship between job satisfaction as the response variable and interprofessional collaborative competency and other variables as the independent variables. Results: Data from 913 nurses were used in the present analysis (response rate: 60.4%). Two factors from the Chiba Interprofessional Competency Scale 29 (factor 1: attitudes and beliefs as a professional; factor 5: attitudes and behaviours that improve team cohesion) and opportunities for information exchange with other professionals outside the hospital had significant relationships with job satisfaction. Conclusion: Strengthening interprofessional collaborative competency and increasing opportunities for information exchange with professionals outside the hospital would improve nurses' job satisfaction in university hospitals. Implications for nursing management: Interprofessional collaborative competency and opportunities for information exchange with other professionals are worth the attention of nursing administrators. [ABSTRACT FROM AUTHOR]

Aim: To detect possible changes in perception of the nurse work environment, job satisfaction and burnout between the years 2009 and 2014 among nurses working in the Spanish National Health System. Background: The global economic crisis has had a great impact on nurses in the Spanish National Health Service: tougher working conditions, lower pay and a reduction in social benefits. It is not known whether these changes affect the nurses' work environment, job satisfaction and burnout. Method: Comparative, cross‐sectional study performed in seven hospitals in the Spanish National Health System between 2009 and 2014, through 1,454 surveys of nurses working in internal medicine, surgery and intensive care. Results: Nurses participating in the second period (2012–2014) were more satisfied with their current job (p = 0.001), perceived their work environment to be more favourable (p < 0.001) and had lower levels of burnout (p < 0.01). Professional factors as 'autonomy at work,' 'opportunities for advancement,' 'professional status' and 'nursing foundations for quality care,' as well as 'collegial nurse–physician relations' and 'nurse participation in hospital affairs' were the most important variables associated with these topics. Conclusions: Professional factors may influence these changes more than labour conditions and remuneration aspects. Implications for Nursing Management: In times of economic recession, encouraging interpersonal relationships, autonomy and participation in decision‐making may improve the work environment, satisfaction and burnout of nurses. [ABSTRACT FROM AUTHOR]

Aim: This study aims to identify the role that spiritual climate has in reducing burnout and intentions to leave amongst clinical nurses. Background: Both shortages and the high turnover of nurses are challenging problems worldwide. Enhancing the spiritual climate amongst nurses can enhance teamwork, organisational commitment and job satisfaction and can play a role in reducing burnout and turnover intention. Methods: A total of 207 clinical nurses working at a tertiary university hospital were included in this cross‐sectional, single‐site study. Independent‐samples t test and ANOVA, Pearson correlation analysis and hierarchical regression analysis were used to explore the relationships amongst related factors. Results: Most clinical departments showed a moderate spiritual climate (60.24 ± 0.82) with high job burnout (33.62 ± 0.28) and turnover intention (2.37 ± 0.57). A good spiritual climate was correlated with high job satisfaction (r = 0.412, p < 0.01), low burnout and turnover intention (r = −0.423, p < 0.01 and r = −0.292, p < 0.01, respectively). Spiritual climate could also indirectly influence nurses' job burnout and turnover intention (R2 = 10.31%). Conclusions: Different departments have different spiritual climates. The findings from this study indicate that spiritual climate may impact nursing burnout and turnover. Implications for nursing management: Using a spiritual climate scale provides health care decision‐makers with clear information about staff spirituality well‐being. Interventions to improve spiritual climate can benefit teamwork in clinical departments. [ABSTRACT FROM AUTHOR]

Aim: To identify the factors affecting nurses' patient safety competency under the new nursing care delivery model. Background: In Korea, a new model was introduced in 2013 to ensure that nursing personnel provided inpatients with care without relying on guardians. After the launch of this service, there continue to be nurse‐related patient safety incidents. Methods: This is a descriptive study. Data from 132 general hospital nurses were collected during 15–24 February 2017 and analysed using hierarchical multiple regression. Results: Participants' mean patient safety competency score was 3.82 (range 1–5). Clinical career (Pratt index = 47.3%), critical thinking disposition (30.4%), teamwork (24.1%) and critical thinking training experience (7.3%) were found to affect nurses' patient safety competency. Conclusion: Under the new model, new nurses showed a low level of patient safety competency. Clinical career most influenced patient safety competency. Enhanced critical thinking and teamwork training are needed to improve patient safety competency among nurses. Implications for nursing management: Nursing leaders must consider qualitative staffing mix involving appropriate placement of experienced nurses as well as quantitative staffing level to provide patients with high‐quality, safe care and to implement the new model successfully. Regular training on critical thinking and teamwork should be carried out. [ABSTRACT FROM AUTHOR]

Aim: To estimate the occupational disease linked to temporary incapacity (not work‐related illness). Background: The under‐reporting of occupational disease is a recognized problem in Europe. Methods: Cross‐sectional study conducted in Spanish adult population using periods of temporary incapacity recorded in primary care during 2015. Rates of occupational disease were estimated using the García & Gadea study. Results: A total of 130,771 episodes of temporary incapacity were studied from 91,448 people, and 56,092 were women (61.3%). The overall prevalence rate was 2,096 and was higher in women (2,504) than in men (1,665) (p < 0.001). It was estimated that 6,580 (7.2%) could be suffering from an occupational disease. Musculoskeletal complaints were the commonest, affecting 75,165 people (82.2%). For the binary logistic regression, the dependent variable was the existence or lack of incapacity due to a musculoskeletal pathology. Age acts as a protective factor (adjusted OR = 0.978). The periods off work due to musculoskeletal complaints are lower in the first quarter of the year [OR > 1; p < 0.001]. Conclusions: 7.2% of the population was estimated to be off work due to an occupational disease. This estimate reflects the well‐known under‐reporting of occupational diseases which are dealt with by the Public Health System instead of specialized clinics. Implications for Nursing Management: The interdisciplinary role of the occupational health nurse makes it an adequate professional to detect the cases of occupational diseases in primary care settings. Occupational Health Nursing has been recognized by the managers as the most suitable professionals to carry out the screening of occupational diseases in Primary Care. [ABSTRACT FROM AUTHOR]

Aim: To characterize registered nurses' (RNs') perceptions of nurse leaders' transformational leadership (TL) qualities in Finnish university hospitals and identify predictors of positive and negative evaluations. Background: Transformational leadership can improve health care but requires development. Information on TL is typically derived from survey results, which are vulnerable to confounders. Method: Cross‐sectional survey. Registered nurses' perceptions of nurse leaders were measured with the TL scale. Kohonen's self‐organizing map was used to cluster the data based on RNs' opinions and questionnaire items. Logistic regression explained background characteristics' effects on cluster formation. Results: A total of 1,970 RNs participated and evaluated their nurse leaders' TL qualities as moderate. Giving feedback and rewarding clustered separately from other TL qualities. Females and permanent workers evaluated nurse managers more negatively but nurse directors positively. Positive perceptions of nurse managers' TL predicted better TL among nurse directors. Vice nurse managers gave the most positive evaluations. A total of 197 RNs had no opinions about nurse directors' TL. Conclusions: Registered nurses evaluated nurse managers' TL qualities as moderate and were unfamiliar with nurse directors. Background characteristics affecting evaluations differed between leader types. Implications for Nursing Management: Giving feedback and rewarding should be more closely associated with other TL qualities. Transformational leadership requires transformational approaches from both nurse managers and directors. [ABSTRACT FROM AUTHOR]

Aims: To examine the health‐promoting behaviours performed by registered nurses (RNs), as well as workplace factors that influence participation in those behaviours. Background: Nurses have high levels of overweight/obesity and may not be engaging in health‐promoting self‐care. Methods: A cross‐sectional Web‐based survey collected information from 335 RNs regarding their physical activity, sedentariness and fruit/vegetable consumption. Results: More than half were overweight (34.1%) or obese (23.4%), and 80.1% were "sedentary" (≥3 hr sitting/day), particularly those working outside of direct patient care in management, research and education. Only 47.2% consumed 5+ servings of fruits/vegetables daily. Nurses who enjoyed their jobs (higher levels of compassion satisfaction) reported higher levels of physical activity (p = 0.03) and fruit/vegetable consumption (p = 0.02). Conclusion: RNs who work outside of direct patient care might be at increased risk for sedentariness and obesity. RNs who enjoy their jobs may experience less stress and have more energy to exercise and to prepare/consume healthy meals. Implications for Nursing Management: Nurse managers should practice self‐care by engaging in exercise, proper nutrition and demonstrating work–life balance, both to protect their own health and to serve as role models for RNs in direct patient care. [ABSTRACT FROM AUTHOR]