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Purpose: To explore staff perceptions of barriers and enablers towards implementing the EQ-5D-5L in community rehabilitation, and develop a theory-informed implementation approach for routine administration of generic patient-reported outcome measures (PROMs) using implementation science frameworks. Materials and methods: A qualitative study was conducted at three sites. Multidisciplinary rehabilitation staff completed individual semi-structured interviews, which were transcribed and coded against the Theoretical Domains Framework (TDF). We identified and selected potentially effective behaviour change techniques using the Behavior Change Wheel. Hypothetical strategies were operationalised. Results: Twenty-one interviews were conducted, and four themes emerged: (1) The Impact of PROMs on patient centered-care; (2) Considerations for validity of PROMs; (3) Service-level impact of embedding PROMs; (4) Practical issues of embedding PROMs within the service. Barriers and enablers were mapped to seven of the TDF domains; relating most to clinicians' "belief about consequences", "reinforcement", and "environmental context and resources". Five hypothetical strategies were developed to overcome identified barriers and strengthen enablers. Key behaviour change techniques underpinning the strategies include: restructuring the physical environment, incentivisation, persuasion and education, enablement, and, social support. Conclusions: Our implementation approach highlights the importance of automating processes, engaging site champions, routinely reporting, and using PROM data to inform service provision. IMPLICATIONS FOR REHABILITATION: Implementation of patient reported outcome measures within multidiscipline rehabilitation settings are likely optimised by establishing infrastructure support e.g., information technology systems to automate the process and minimise manual aspects of data collection. Engaging site champions may be an important enabler for the routine collection of patient reported outcome measures Providing feedback to clinicians on aggregated results of patient reported outcome measures are likely to motivate and encourage routine collection. [ABSTRACT FROM AUTHOR]

Poor sleep during hospitalization can negatively affect patient health, well-being, and satisfaction. This nurse-led quality improvement project aimed to promote quality sleep on an inpatient telemetry medical-surgical oncology unit. Interventions included distributing sleep hygiene kits (eye masks, earplugs, lip balm, and aromatherapy), educating patients and staff, and redesigning workflows to limit sleep interruptions at night. Hospital Consumer Assessment of Healthcare Providers and Systems Survey scores for quietness at night increased from 66% to 76%, with fewer reported cases of delirium postimplementation. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusion Impact Reporting Method Patient or Public Contribution To explore the challenges experienced by Executive Nurse Directors during the COVID‐19 pandemic, and to inform future nursing leadership strategies.A qualitative research project involving interviews with 21 Executive Nurse Directors from England and Wales.Participants were purposively sampled and recruited through Chief Nursing Officers and nursing leadership networks. Semi‐structured interviews were conducted and recorded online via Teams. Braun and Clarke's approach to thematic reflexive analysis was applied to data analysis.Executive Nurse Directors played a critical role during the COVID‐19 pandemic. Six themes are explored: tensions, and adaptive response to personal leadership styles; uncertainty and support at the board level; responding to national political decision‐making; the personal and emotional impact of the role and the sources of effective support; the voice and public profile of nursing; lessons learnt and strategies for future leadership development. Enablers of decision‐making included effective multidisciplinary working, freedom from normal organizational constraints, support for innovation, and the development of stronger bonds with colleagues. Barriers to decision‐making included limited knowledge of the virus and its impact and lack of guidance, particularly at a national level. Priorities, strategies and actions for recovery include recognizing the emotional impact of being in a high‐level decision‐making role, protecting staff from burnout and understanding the long‐term implications of pandemic work for nurse leaders.Future strategies for nursing leadership during public health, national and global emergencies are recommended.This study contributes to the literature exploring the Executive Nurse Director role and their experiences of leading through the COVID‐19 pandemic, and identifies priorities, strategies and actions for recovery and learning for the future of senior leadership.The study adhered to the Consolidated Criteria for Reporting Qualitative Research.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Purpose: Due to increasing cost pressures, and the necessity to ensure high quality patient care while main- taining a safe environment for patients and staff, interest in the capacity for HRM practices to make a difference has piqued the attention of healthcare professionals. The purpose of this papers is to present and test a model whereby engagement mediates the relationship between four HRM practices and quality of care and safety in two different occupational groups in healthcare, namely, nurses and administrative support workers. Design/methodology/approach: Structural equation modeling was used to analyze questionnaire data collected by the National Health Service as part of their Staff Survey .The authors tested the hypotheses for nurs- es and administrative support workers separately. Findings: Training, participation in decision making, opportunities for development, and communication were positively related to quality of care and safety via work engagement. The strength of the relationships was con- ditional on whether an employee was a nurse or administrative support worker. Originality/value: This is the first paper to examine the mediating role of engagement on the relationship between four relevant HRM practices in the healthcare context, and outcomes important to healthcare practi- tioners. The authors also add value to the HRM literature by being among the first to use the job demands re- sources model to explain the impact of HRM practices on performance outcomes. Moreover, the authors provide insight into how HRM practices affect outcomes in the world's largest publicly funded healthcare service. [ABSTRACT FROM AUTHOR]

Objective: There is a need to undertake more proactive and in-depth analyses of general practice accreditation processes. Two areas that have been highlighted as areas of potential inconsistency are the self-assessment and surveyor assessment of indicators. Methods: The data encompass 757 accreditation visits made between December 2020 and July 2022. A mixed-effect multilevel logistic regression model determined the association between attempt of the self-assessment and indicator conformity from the surveyor assessment. Furthermore, we present a contrast of the rate of indicator conformity between surveyors as an approximation of the inter-assessor consistency from the site visit. Results: Two hundred and seventy-seven (37%) practices did not attempt or accurately report conformity to any indicators at the self-assessment. Association between attempting the self-assessment and the rate of indicator non-conformity at the site visit failed to reach statistical significance (OR = 0.90 [95% CI = 1.14–0.72], P = 0.28). A small number of surveyors (N = 9/34) demonstrated statistically significant differences in the rate of indicator conformity compared to the mean of all surveyors. Conclusions: Attempt of the self-assessment did not predict indicator conformity at the site visit overall. Appropriate levels of consistency of indicator assessment between surveyors at the site visit were identified. What is known about the topic? There is a need to undertake more proactive and in-depth analyses of the general practice accreditation process and outcomes to improve the quality and safety within this healthcare sector. What does this paper add? Attempt of the self-assessment does not predict indicator conformity at the site visit overall, and appropriate levels of consistency of indicator assessment between surveyors at the site visit were identified. What are the implications for practitioners? We present empirical evidence as to the consistency of assessment with general practice accreditation to inform future standards and (re)accreditation assessments. [ABSTRACT FROM AUTHOR]

Soul Injury is defined as a wound that separates a person from their real self, caused by unmourned loss and hurt, unforgiven guilt and shame, and fear of helplessness or loss of control. Tools and interventions have been developed to guide people impacted by Soul Injury. This study assessed the effectiveness of 12 tools and interventions provided during a 4-day Soul Injury Leadership Institute. This 2-part investigation included an online survey of participants who had attended a 4-day Institute training and a post-Institute narrative inquiry conducted as virtual structured interviews. Ninety-one professionals completed the online survey, which inquired about the impact of specific Soul Injury tools and interventions on the respondents' personal and professional life. The Anchor Your Heart tool was the most frequently used tool and had the most enduring utilization across time and settings. Qualitative data collected in virtual interviews with 15 volunteers demonstrated the power of the Write/Tell Your Story technique in which storied narratives permit an individual to integrate powerful experiences such as traumatic events, serious illness, and even death, providing further validation that Soul Injury is an important human phenomenon. [ABSTRACT FROM AUTHOR]

Purpose: To examine state Area Agencies on Aging (AAAs) in Pennsylvania for services they provide to older adults regarding extreme events and how readiness can be captured through social networks and policies at the local, state, and federal levels. Method: Using an online survey, 79% of AAA directors answered questions describing perceptions and actions related to social capital and its influence on policy. Results: AAAs acknowledged weather/temperature changes impact the need to prepare for common scenarios of extreme weather, temperature, and flooding. AAAs reported major social connections with county government and one state agency, with limited connections with federal agencies. Conclusion: Multiple opportunities exist for AAAs to consider climate change in expansion efforts, specifically regarding health care. Geriatric nurses can play a key role in expansion, advocacy, and policy development for AAAs that serve older adults in the context of climate change. [Journal of Gerontological Nursing, 50(6), 11–15.] [ABSTRACT FROM AUTHOR]

Background: Stress is a pervasive occurrence within certain professions, including nurses working in emergency and intensive care unit environments. Nurses in these settings often confront various stress-inducing factors, such as unsupportive management and distressing events like patient mortality, and experience notably higher levels of stress. Nevertheless, information is scarce regarding the precise level of stress in Ethiopia, particularly within southern hospitals. Objective: To assess stress levels and associated factors among nurses working in the critical care unit and emergency rooms at comprehensive specialized hospitals in southern Ethiopia, 2023. Methods: A facility-based cross-sectional explanatory sequential mixed-method study was undertaken, involving a total of 239 nurses. For the quantitative component, all nurses working in intensive care units and emergency rooms were included as participants, while a purposive sampling technique was employed to select participants for the qualitative aspect. Data for the quantitative study were gathered through the utilization of self-administered questionnaires, while interviews were conducted using a structured interview guide for the qualitative portion. Quantitative data entry and analysis were performed using EpiDataV4.6 and the Statistical Package for the Social Sciences software, respectively. Thematic analysis of the qualitative data was conducted using the OpenCode software. Results: The level of stress among nurses in the emergency and intensive care units was low (19.3%), moderate (55.9%), and high (24.8%). Workload (Adjusted odds ratio (AOR) = 3.51, 95% confidence interval (CI) (1.17–10.56) and time constraints (AOR = 2.5, 95% CI (1.03–6.07) were significantly associated with moderate stress level, while duty demands (AOR = 3.03, 95% CI (1.17–7.14), availability of medical equipment and supplies (AOR = 1.42, 95% CI (1.18–4.97), and witnessing death and dying (AOR = 2.34, 95% CI (1.13–5.88) were significantly associated with high-stress level. The qualitative data analysis revealed that the participants underscored the significant impact of organizational factors, individual factors, and profession-related factors on the stress levels experienced by nurses in emergency and critical care settings. Conclusion and recommendation: Based on the findings, the participants in this study experienced some level of stress, to varying degrees. Therefore, it is crucial to implement effective strategies such as optimizing staffing and workflow, improving communication and collaboration, providing adequate support and resources, leveraging technology and innovation, emphasizing patient-centered care, and implementing data-driven quality improvement to alleviate the burden. [ABSTRACT FROM AUTHOR]

To explore the experiences of the Namaste Care intervention for persons with advanced dementia (ie, moderate and late-stage) in long-term care (LTC). A qualitative descriptive design was used. Staff Carers (eg, personal support worker, nurse, or activity aide) delivered Namaste Care with the support of volunteers in a small group. Activities provided during the Namaste Care sessions to enhance quality of life included massages, aromatherapy, music, and snacks/beverages. Family carers of residents with advanced dementia, LTC staff, administrators, and volunteers from 2 Canadian LTC homes, located in a midsize metropolitan area, were included. Experiences and acceptability of Namaste Care was assessed through semistructured interviews ranging from 30 to 60 minutes following the 6-month study duration period with family carers, LTC staff, administrators, and volunteers. Thematic analysis was used for interview transcripts. A total of 16 family carers and 21 LTC staff, administrators, and volunteers participated in the study. Namaste Care was found to be acceptable and successful in enhancing the quality of life of residents due to collaborative efforts of all group of participants. Families, volunteers, and staff noted positive responses in residents, such as smiling and laughing. The program environment supported the development of relationships within the LTC community, which included families, residents, staff, and volunteers. Namaste Care was perceived by the LTC community as an acceptable intervention for persons with advanced dementia. It was perceived as offering multiple benefits for residents with advanced dementia such as improved communication and mood. [ABSTRACT FROM AUTHOR]

Aim: To explore how nurses working in general practice experienced remote and technology-mediated working during the COVID-19 pandemic. Design: Exploratory qualitative study with nursing team members working in general practices in England and national nurse leaders. Methods: Data were collected between April and August 2022. Forty participants took part in either semi-structured interviews or focus groups. Data were analysed using Framework Analysis informed by the PERCS (Planning and Evaluating Remote Consultation Services) Framework. University of York ethics approval [HSRGC/2021/458/I] and Health Research Authority approval were obtained [IRAS:30353. Protocol number: R23982. Ref 21/HRA/5132. CPMS: 51834]. The study was funded by The General Nursing Council for England and Wales Trust. Results: Participants continued to deliver a significant proportion of patient care inperson. However, remote and technology-mediated care could meet patients' needs and broaden access in some circumstances. When remote and technology-mediated working were used this was often part of a blended model which was expected to continue. This could support some workforce issues, but also increase workload. Participants did not always have access to remote technology and were not involved in decision-making about what was used and how this was implemented. They rarely used video consultations, which were not seen to add value in comparison to telephone consultations. Some participants expressed concern that care had become more transactional than therapeutic and there were potential safety risks. Conclusion: The study explored how nurses working in general practice during the COVID-19 pandemic engaged with remote and technology-mediated working. It identifies specific issues of access to technology, workload, hybrid working, disruption to therapeutic relationships, safety risks and lack of involvement in decision-making. Changes were implemented quickly with little strategic input from nurses. There is now an opportunity to reflect and build on what has been learned in relation to remote and technology-mediated working to ensure the future development of safe and effective nursing care in general practice. Impact: The paper contributes to understanding of remote and technology-mediated working by nurses working in general practice during the COVID-19 pandemic and indicates to employers and policy makers how this can be supported moving forward. Reporting method: Standards for Reporting Qualitative Research (O'Brien et al., 2014). Patient or public contribution: This was a workforce study so there was no patient or public contribution. Implications for the profession and patient care: The paper highlights specific issues which have implications for the development of remote, technology-mediated and blended working for nurses in general practice, care quality and patient safety. These require full attention to ensure the future development of safe and effective nursing care in general practice moving forward. [ABSTRACT FROM AUTHOR]

Background: Nursing faces increasing pressure due to changing demographics and a shortage of skilled workers. Artificial intelligence (AI) offers an opportunity to relieve nurses and reduce pressure. The perception of AI by nurses is crucial for successful implementation. Due to a limited research state, our study aims to investigate nurses' knowledge and perceptions of AI. Methods: In June 2023, we conducted a cross-sectional online survey of nurses in Bavaria, Germany. A convenience sample via care facilities was used for the questionnaire oriented on existing AI surveys. Data analysis was performed descriptively, and we used a template analysis to evaluate free-text answers. Results: 114 (♀67.5 %, ♂32.5 %) nurses participated. Results show that knowledge about AI is limited, as only 25.2 % can be described as AI experts. German nurses strongly associate AI with (i) computers and hardware, (ii) programming-based software, (iii) a database tool, (iv) learning, and (v) making decisions. Two-thirds of nurses report AI as an opportunity. Concerns arise as AI is seen as uncontrollable or threat. Administration staff are seen as the biggest profiteers. Conclusion: Even though there is a lack of clear understanding of AI technology among nurses, the majority recognizes the benefits that AI can bring in terms of relief or support. We suggest that nurses should be better prepared for AI in the future, e.g., through training and continuing education measures. Nurses are the working group that uses AI and are crucial for implementing nursing AI. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the baseline knowledge of nursing leaders regarding political advocacy and healthcare policy. BACKGROUND: Although there has been considerable attention to the need for nurses' involvement in health policy, there has not been a prior assessment of the political astuteness of nursing leaders. METHODS: Researchers analyzed self-reported data from 101 nursing leaders collected via electronic survey from American Organization for Nursing Leadership members. Descriptive, correlational analysis of data assessing political astuteness and background information was completed. RESULTS: Half of the nurse leader participants demonstrated slight political astuteness. Nurse executives, including those in chief nursing officer, chief nurse executive, and vice president positions, had higher levels of political astuteness than those in nurse director and manager positions. CONCLUSION: Nursing leaders have beginning levels of political astuteness. Formal education is recommended to increase the knowledge base of nurse leaders in the areas of understanding the political and legislative process and the skills needed to advocate regarding healthcare policy, thus increasing their level of political astuteness. [ABSTRACT FROM AUTHOR]

Aims: The aims of the study were to describe the processes used to introduce advanced practice nursing roles and factors that facilitated or hindered role implementation, examine the time advanced practice nurses (APNs) spend in role activities and how these activities relate to domains of advanced practice nursing and examine how implementation processes influenced APN integration within healthcare teams. Design: A multiple case study was conducted. Methods: Five cases were included, representing the four population areas approved for advanced practice nursing in France. Data were collected from January to March 2021 using observation, interview and document analysis methods. Data were examined using thematic analysis. Results: Participants included APNs (n = 5), nurses/allied health providers (n = 5), physicians (n = 5), managers (n = 4) and decision-makers (n = 4). Stakeholder engagement and leadership provided by decision-makers, managers, physicians and APNs facilitated role implementation. Poor stakeholder role understanding, uncertain role funding, and the COVID-19 pandemic hindered role implementation. APNs spent the most time in clinical activities. Participants perceived the integration of APNs within the healthcare team and their impact on patient care to be positive. Conclusion: Stakeholder engagement and organizational and APN leadership facilitated the implementation of the roles, especially related to team-based patient care. Further efforts are needed to strengthen APN involvement in non-clinical activities and address role barriers. Implications for nursing and patient care: Systematic and system-wide approaches are needed to improve role clarity, role autonomy and health systems integration of APNs. Research should examine patient perspectives about APNs in France. Impact: The results highlight how policies can create favourable conditions for advanced practice nursing role implementation in France. Internationally, this study serves as a reminder to APNs and nurse leaders about the strategies for and importance of implementation evaluation to support the optimal development of advanced practice nursing roles. Reporting Method: The study reporting followed the Consolidated Criteria for Reporting Qualitative Research. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

PURPOSE: Electronic patient-reported outcomes (ePROs) are an evidence-based means of detecting symptoms earlier and improving patient outcomes. However, there are few examples of successful implementation in routine cancer care. We conducted a qualitative study to identify barriers and facilitators to implementing ePRO symptom monitoring in routine cancer care using the Consolidated Framework for Implementation Research (CFIR). METHODS: Participants were adult patients with cancer, their caregivers, or health care professionals involved in ePRO monitoring or processes. Focus groups or individual interviews were conducted using a semistructured approach informed by the CFIR. Data were analyzed deductively using the CFIR. Barriers were matched to theory-informed implementation strategies using the CFIR-Expert Recommendations for Implementing Change (ERIC) matching tool. RESULTS: Thirty participants were interviewed: 22 females (73%), aged 31-70 years (28, 94%), comprising patients (n = 8), caregivers (n = 2), medical oncologists (n = 4), nurses (n = 4), hospital leaders (n = 6), clinic administrators (n = 2), pharmacists (n = 2), and information technology specialists (n = 2). Barriers pertaining to four CFIR domains were identified and several were novel, including the challenge of adapting ePROs for different anticancer treatments. Facilitators pertaining to all CFIR domains were identified, such as leveraging acceptability of remote care post–COVID-19 to drive implementation. Conducting consensus discussions with stakeholders to tailor ePROs to the local setting, identifying/preparing individual and group-level champions, and assessing readiness for change (including leveraging technological advances and increased confidence in using remote monitoring post–COVID-19) were the most frequently recommended implementation strategies. CONCLUSION: The CFIR facilitated identification of known and novel barriers and facilitators to implementing ePRO symptom monitoring in routine cancer care. Implementation strategies summarized in a conceptual framework will be used to codesign an ePRO symptom monitoring system for immunotherapy side effects. [ABSTRACT FROM AUTHOR]

The article emphasizes importance for administrative supervisors to possess strong leadership abilities to ensure safe outcomes for both patients and staff when staffing resources may be less than optimal. Topics discussed include responsibilities of administrative supervisors as the sole nurse leaders, explanation on transformational leadership, and components of emotional intelligence (EI).

Introduction: Population aging has opened up a new and broad field of study for health science in which nursing must investigate to guarantee the health autonomy of older people. Objective: To make visible the Gerontological Day Centers (CDG) and the activities of nursing professionals in these centers in Huelva. Methodology: A qualitative investigation has been carried out using questionnaires and interviews directed at the management and nursing staff of several Day Centers in Huelva and the province. Results: The CDG are an intermediate resource with multiple objectives and functions, which offer quality of life for both the elderly and their families. They are made up of a basic team of professionals who work on a non-permanent basis. The role of nursing is essential, but it has a very poor employment situation. Conclusion: These centers provide professional care and allow them to remain in their usual homes, favoring the quality of life and autonomy of this older population. The bibliography on this topic is scarce, so it is considered necessary to deepen its research along with the implementation of programs and improvement proposals that make these sociohealth centers known. [ABSTRACT FROM AUTHOR]

A novice director of nursing education and professional practice started her first formal leadership role in a new hospital and a new organization. This article will discuss tactics used within the first 6 months in the role that helped the director integrate into the hospital and leadership teams, improve team structure and processes, and improve employee engagement scores. [ABSTRACT FROM AUTHOR]

Background: Stress in nurses refers to the reactions nurses experience when faced with work demands that exceed their knowledge, skills, or ability to cope. Nursing, as a profession, is particularly susceptible to work-related stress. Methods: A cross-sectional study was conducted among 405 randomly selected nurses working in Hadiya Zone public hospitals from March 1 to 30, 2023. Data were collected using a pre-tested self-administered questionnaire. The data were entered using Epi-data version 3.1, and analysed using SPSS version 20.0. Multivariable logistic regression analysis was performed to identify factors associated with the level of work stress. Variables with a p-value <0.05 were considered statistically significant. Results: In this study, 56% (95% CI 50.9-61.2) of the participants reported being stressed in their work. Several factors were found to be associated with work stress, including being female (AOR=1.94, 95% CI 1.19-3.16), rotating shifts (AOR=2.06, 95% CI 1.31-3.25), working in the intensive care unit (AOR=3.42, 95% CI 1.20-9.73), and having post-basic training (AOR=0.55, 95% CI 0.34-0.92). Conclusion: The study revealed a high level of work stress among nurses in the study area. The zonal health unit takes measures to address work stress by providing job orientation during the hiring process, rotation, and on-the-job training to help nurses cope with and manage stressful events. Stress in public hospitals and among nurses is an important issue that needs urgent attention. [ABSTRACT FROM AUTHOR]

Introduction: Deaths in care homes and "at home" are anticipated to account for a third of UK deaths by 2040. Currently, palliative and end of life care are not part of statutory training in care homes. Reflective practice is a tool that can facilitate practice‐based learning and support. Following a feasibly study to test "online" supportive conversations and reflection sessions (OSCaRS) to support care home staff in relation to death/dying during the first months of the COVID pandemic, a one‐year practice development follow‐up project was undertaken with the aim to create a team of NHS/specialist palliative care (SPC)‐based facilitators to lead and support OSCaRS provision in up to 50 care homes in one region in Scotland—the focus of this paper. Methods: Forty care home managers attended an on‐line session explaining the project, with a similar session held for 19 NHS/SPC‐based nurses external to care homes. Those interested in facilitating OSCaRS then attended three education sessions. Data collected: records of all activities; reflective notes on OSCaRS organised/delivered; a summary of each OSCaRS reflection/learning points; final interviews with NHS/SPC trainee facilitators. Results: A total of 19 NHS/SPC facilitators delivered one or more OSCaRS in 22 participating care homes. However, as of January 2022 only six trained facilitators remained active. Out of the 158 OSCaRS arranged, 96 took place with a total of 262 staff attending. There were three important aspects that emerged: the role, remit, and resources of NHS/SPC supporting OSCaRS; requirements within care homes for establishing OSCaRS; and, the practice‐based learning topics discussed at each OSCaRS. Conclusion: Attempts to establish a team of NHS/SPC facilitators to lead OSCaRS highlights that end of life care education in care homes does not clearly fall within the contractual remit of either group or risks being missed due to more pressing priorities. [ABSTRACT FROM AUTHOR]

Aim. To explore the perception of executive nurse leaders regarding the implementation of advanced practice nursing in Saudi Arabia. Design. An exploratory, descriptive, and qualitative design was used. Methods. Purposive sampling was used to recruit chief nurse officers and executive nurse directors from government, private, and military health systems in tertiary, secondary, and primary settings. Data were collected from July to November 2022 using virtual semistructured interviews, which were recorded and transcribed. Thematic analysis was conducted manually. Results. Eleven participants were included in the study. The following themes were identified: unique characteristics of advanced practice nursing, impacts of advanced practice nursing in nursing profession, challenges to utilize the advanced practice nursing roles, opportunities to foster the proper implementation of advanced practice nursing, and recommendations to move forward with fitting advanced practice nursing in Saudi health system. Participants characterized advanced practice nursing as specialized, advanced, and autonomous and reported that it increases access to care, provides efficient and cost-effective care, and expands nursing career pathways. The lack of job description, fragmentation of implementation efforts, lack of training programs, and resistance from physicians, nurses, and patients hinder its implementation. The Saudi Vision 2030, gaps in health care, the growing population, and the familiarity of the healthcare system with advanced practice nursing were viewed as opportunities. The following subthemes emerged under recommendations: establish, train, and implement. Conclusion. Executive nurse leaders perceived advanced practice nursing as a promising initiative to improve healthcare delivery and the nursing profession. Several opportunities make "now" the right time to implement it. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the self‐reported leadership practices and behaviours of health professionals following a leadership program and explore factors that impacted leadership style. Design: An online cross‐sectional survey was conducted from August to October 2022. Methods: The survey was disseminated via email to leadership program graduates. The Multifactor Leadership Questionnaire Form—6S was used to measure leadership style. Results: Eighty completed surveys were included in the analysis. Participants scored highest on transformational leadership and lowest on passive/avoidant leadership style. Participants with higher qualifications scored significantly higher in the inspirational motivation scores (p = 0.03). As years in their profession increased, there was a significant decrease in contingent reward scores (p = 0.04). The younger participants scored significantly higher on the management‐by‐exception than older participants (p = 0.05). There were no significant associations with the year the leadership program was completed, gender or profession and Multifactor Leadership Questionnaire Form ‐ 6S scores. Most participants (72.5%) strongly agreed that the program enhanced their leadership development and 91.3% strongly agreed or agreed that they routinely apply the skills and knowledge learnt in the program in their workplace. Conclusion: Formal leadership education is important in developing a transformational nursing workforce. This study found that program graduates had adopted a transformational leadership style. Education, years of experience and age impacted the specific leadership elements. Future work needs to incorporate longitudinal follow‐up to relate changes in leadership with impact on clinical practice. Implications for the Profession: Transformational leadership as a dominant style can contribute to nurses and other disciplines positively contributing to innovative and person‐centred approaches to health service delivery. Summary Statement: What already is known—Leadership amongst nurses and other health professionals impacts patients, staff, organizations and ultimately healthcare culture.What this paper adds—Formal leadership education is important in developing a transformational healthcare workforce.Implications for practice/policy—Transformational leadership can enhance nurses and other disciplines commitment to innovative and person‐centred approaches. Impact Statement: This research identifies that lessons learnt from formal leadership education are retained over time by healthcare providers. This is important for nursing staff, and other healthcare providers, who are leading teams and overseeing care delivery, can ensure leadership behaviours and practices are enacted to influence a transformational workforce and culture. Reporting Method: This study adhered to STROBE guidelines. No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

As winter draws on it is timely to look at ways in which nurses in the community may be faced with problems, expected and unexpected, when their patients are particularly affected by cold conditions and at the precautions which need to be taken to avoid or lessen adverse effects on their health. As in the case of heat-related risks to health, examined in an earlier article, so too in the case of cold those most at risk are elderly patients and those who are vulnerable due to a pre-existing condition affecting health even in a more clement climate. Cold weather attracts extra legal responsibilities which are examined in this article. [ABSTRACT FROM AUTHOR]

PURPOSE: We determine how stakeholders prioritize the importance of oncologic outcomes, patient-reported outcomes (PROs), and cancer-related health care costs. METHODS: A survey was distributed to the National Clinical Trials Network Alliance for Clinical Trials in Oncology cooperative group membership from May 14 to June 30, 2022. Respondents were asked to rate (5-point Likert scale) and rank (1-9) evidence-based value domains: overall survival, treatment toxicities/complications, quality of life (QOL), financial toxicity, access to care, compliance with evidence-based care, health system performance, scientific discovery and innovation, and cost to the health care system. RESULTS:A total of 514 members responded, including researchers (24.7%), nurses (19.5%), medical oncologists (17.9%), administrators (9.3%), surgical and radiation oncologists (9.1%), patient advocates (3.1%), and nonphysician providers (16.4%). Participants represented various practice settings including National Cancer Institute–designated cancer centers (29.8%), university-affiliated academic cancer centers (21%), hospital-owned oncology practices (21.8%), and others (27.4%). There was agreement in how respondents prioritized value domains (W = 0.39, P = 001). Respondents ranked patient QOL (mean rank: 2.6 ± 1.9) as most important above all other metrics including survival (mean rank: 3.5 ± 0.3) and access to care (mean rank: 3.5 ± 2.1; P = .001). Members engaged in direct patient care also ranked access to care of higher importance than nonclinicians (P = 026). Cost to the health care system (mean rank: 7.5 ± 2.1) and health system performance (mean rank: 7 ± 2) were ranked as least important (P < 001). Inclusion of PROs into therapeutic assessment (59.3%) was the most frequently selected priority of future cooperative group initiatives. CONCLUSION: Oncology community stakeholders deemed patient-centered value domains as most important and considered patient QOL the highest priority. Inclusion of PROs into clinical trials was endorsed as an important component of therapeutic assessment. These findings can be taken into consideration when creating a value framework for inclusion in cancer clinical trials. [ABSTRACT FROM AUTHOR]

Purpose: Healthcare workers are exposed to a variety of hazardous chemicals and agents that may have long-term effects on their health. One of the health problems caused by these chemicals and agents is cancer. The aim of this descriptive study is to evaluate the cancers seen in those working in a university hospital between 01.01.2006 and 30.06.2022. Material and Methods: All healthcare professionals diagnosed with cancer between 01.01.2006-30.06.2022 were included in this descriptive study. The age, sex, occupation, working unit, and cancer type of the patients were evaluated. Data were analyzed with the statistical program SPSS-22 (SPSS Inc., Chicago, IL, USA). Data were presented using descriptive statistics (means and standard deviations for continuous variables; numbers and percentages for categorical variables). Results: Between 01.01.2006 and 30.06.2022, 186 people working at Sivas Cumhuriyet University were diagnosed with cancer. Forty-seven point eight percent (n = 89) of them are male; the mean age of those diagnosed with cancer is 46.0 ± 8.9 (min 22, max 62). The most common cancers are thyroid (21.5%), breast (16.7%), head and neck (9.7%), hematopoietic system (9.1%), and urinary system (8.1%) cancers. When evaluated according to occupational groups, 22.6% of them are office workers, 19.9% are academicians, 15.6% are workers, 14.0% are nurses, 10.2% are health technicians, and 8.2% are research assistants. Conclusion: In this institution, which has 2721 personnel, approximately 12 employees are diagnosed with cancer each year. Detailed records of patients diagnosed with cancer, especially healthcare professionals, should be kept. More studies are needed in detail on behaviors related to occupational exposures and cancer risk. [ABSTRACT FROM AUTHOR]

Aim: This study explores the perceptions of hospital discharge coordinators on the issues raised for the post-acute older adult and their family, using the lens of assisted decision-making and advance directives. Background: New legislation has been developed in Ireland to support assisted decision-making and advance directives that is largely consistent with other countries around the world. The Assisted Decision-Making Act of 2015 was fully commeced in April 2023, following lengthy debate. However, there is a lot of professional uncertainty regarding how to support and integrate Advance Healthcare Directives and assisted decision-making into the care of adults and into the role of nurses working in the community. Methods: Utilising a qualitative approach, this study conducted a series of five focus groups, with 23 participants, across the South-East of Ireland. Thematic analysis was used to interpret results. The 32-item consolidated criteria for reporting qualitative research checklist was utilised. Findings: The central finding in this study concerned the locus of control, as well as findings on burden of care and the role of the nurse. A stark incongruence of beliefs among patient, family and State was identified. Conclusion: Nurses must learn to circumnavigate the complex terrain involved in supporting the older adult's advance decision-making and advance healthcare directives. [ABSTRACT FROM AUTHOR]

PURPOSE Financial navigation services support patients with cancer and address the direct and indirect financial burden of cancer diagnosis and treatment. These services are commonly delivered through a variety of frontline oncology support personnel (FOSP) including navigators, social workers, supportive care providers, and other clinic staff, but the perspective of FOSPs is largely absent from current literature on financial burden in oncology. We surveyed a national sample of FOSPs to understand their perspectives on patient financial burden, resource availability, and barriers and facilitators to assisting patients with cancer-related financial burden. METHODS We used Qualtrics online survey software and recruited participants using multiple professional society and interest group mailing lists. Categorical responses were described using frequencies, distributions of numeric survey responses were described using the median and IQR, and two open-ended survey questions were categorized thematically using a priori themes, allowing additional emergent themes. RESULTS Two hundred fourteen FOSPs completed this national survey. Respondents reported a high awareness of patient financial burden and felt comfortable speaking to patients about financial concerns. Patient assistance resources were commonly available, but only 15% described resources as sufficient for the observed needs. A substantial portion of respondents reported moral distress related to this lack of resources. CONCLUSION FOSPs, who already have requisite knowledge and comfort in discussing patient financial needs, are a critical resource for mitigating cancer-related financial burden. Interventions should leverage this resource but prioritize transparency and efficiency to reduce the administrative and emotional toll on the FOSP workforce and reduce the risk of burnout. [ABSTRACT FROM AUTHOR]

Background: Patient-reported outcome measures (PROMs) provide a measure of self-perceived health status or health-related quality of life. They have been used to support provider-patient decisions, healthcare delivery, and value-based healthcare models. A barrier to routine collection of PROMs is the perception that PROMs lack clinical utility. As such, it is important to establish clinicians' acceptability of the PROM prior to large-scale implementation. This study explored the acceptability of the routine use and collection of a generic PROM in healthcare services from the perspective of healthcare staff. Methods: Individual semi-structured interviews were completed from September 2020 to March 2021 with 26 staff from two multi-disciplinary community healthcare services in Melbourne, Australia. Interviews explored their experiences of using the EQ-5D-5L in their routine care. Interviews were recorded and transcribed verbatim. Data were analysed according to a framework approach, using inductive and deductive techniques. Results: Participants discussed the acceptability of the EQ-5D-5L with reference to four themes: practicalities of use; holistic nature; influence on client care; and influence on health service. Participants found the EQ-5D-5L quick and easy to administer, and appreciated that it measured multiple domains of health that were relevant to their clients' care. They believed the EQ-5D-5L helped to identify client problems, and inform service delivery. They also reported features that were less acceptable, including a lack of item specificity to some healthcare disciplines. Participants reported the challenge of managing conflict between their assessment of the client's health and the client's perspective of their own health, leading some to question whether the client could provide an accurate reflection of their own health. Conclusions: The EQ-5D-5L has several features that healthcare staff viewed as acceptable for routine collection and use in healthcare. Training on the validity of the patient reported perspective and broadening the scope of PROMs collection beyond the EQ-5D-5L should be considered to facilitate large-scale implementation. [ABSTRACT FROM AUTHOR]

Glass ceiling is the unseen barrier that prohibits women and minorities in achieving a higher potential in the workplace. This barrier influences the well-being and prosperity of women and minorities resulting to career stagnation and inability to earn a higher income. Despite the abundance of literature on the issue, there is a dearth of comprehensive information that examines the organizational, cultural, and individual factors that contribute to the glass ceiling phenomenon in the healthcare industry. The main goal of this study is to do a full scoping review to find and map all the existing healthcare settings that contribute to the glass ceiling effect. A total of 28,184 hits resulted in the search of the published and grey literature. Nine articles passed the full-text review and were further reviewed. Data were synthesized and interpreted to determine the experiences of nurses about the glass ceiling phenomenon. Findings: Gender discrimination, bias, and stereotyping prevent nurses from learning executive summary skills, maintain the gender wage gap, and lead to unequal treatment of women and men in the health workforce; structural and systemic barriers within healthcare organizations can restrict their access to these higher-level positions; underrepresentation of women in leadership roles leads to lack of mentors; and lack of work-life balance due to limited flexible work arrangements. [ABSTRACT FROM AUTHOR]

Nursing home (NH) residents are vulnerable subjects and highly susceptible to adverse events. Knowledge of patient safety culture (PSC) is essential for an organization to ensure patient safety. However, research on PSC in NHs, and its variability among staff, is still scarce. This study aimed to explore whether and how PSC differed among NH staff (Managers, Nurses, Direct Care Staff, Support Staff, Administrative Staff and Other Providers) in the Autonomous Province of Trento, Italy. This study employed a cross-sectional design and collected data from 1145 NH providers using the Nursing Home Survey on Patient Safety Culture (NHSPSC). Data were analyzed using linear mixed models, with each of the 12 NHSPSC domains as a response variable. The majority of the respondents (61.6%) were Direct Care Staff members. 'Feedback and Communication about Incidents' and 'Overall Perceptions of Resident Safety' were the domains with the highest proportions of positive answers (PPAs). For most staff categories, 'Staffing' was the domain with the lowest PPA. Support Staff showed significantly lower scores in the majority of domains (8/12). Shorter job tenure, fewer weekly working hours, working mostly during the day and working in highly specialized areas were associated with higher scores in several domains. Interventions to improve PSC must consider the differences between professional groups. Further research is needed to explore the relationship between job-related features and perceptions of patient safety among NH workers. [ABSTRACT FROM AUTHOR]

Introduction: The Cardiff model is a data sharing approach that aims to reduce the volume of intoxicated patients in emergency departments (EDs). This approach has not been tested in a rural setting. Objective: This study assessed whether this approach would reduce the number of alcohol‐associated presentations during high‐alcohol hours (HAH) in a regional ED. Design: From July 2017, people over the age of 18 attending the ED were asked by the triage nurse (1) whether they had consumed alcohol in the past 12 h, (2) their typical alcohol consumption level, (3) the location where most alcohol was purchased and (4) the location of the last drink. From April 2018, quarterly letters were sent to the top five venues reported within the ED. Deidentified, aggregated data were shared with local police, licensing authorities and local government, identifying the top five venues reported in the ED and providing a summary of alcohol‐related attendances to the ED. Interrupted time series analyses were used to estimate the influence of the intervention on monthly injury and alcohol‐related ED presentations. Findings: ITS models found that there was a significant gradual decrease in the monthly rate of injury attendances during HAH (Coefficient = −0.004, p = 0.044). No other significant results were found. Discussion: Our study found that sharing last drinks data collected in the ED with a local violence prevention committee was associated with a small, but significant reduction in the rate of injury presentations compared with all ED presentations. Conclusion: This intervention continues to have promise for reducing alcohol‐related harm. [ABSTRACT FROM AUTHOR]

In the effort to eliminate health inequities, collaboration by professional nursing associations is needed to support underrepresented nurses on community boards, councils, and workgroups. Nursing leaders must prioritize diverse board representation to move this trend in the right direction and effect positive change. [ABSTRACT FROM AUTHOR]

Aim: This study explores perceptions of Continuing Professional Development (CPD) opportunities among stakeholders in the profession of nursing in Nepal. Design: Qualitative study using focus group discussions (FGDs). Methods: Eight FGDs were conducted in three major cities of Nepal with nursing stakeholders including nurse managers, matrons and directors/managers of private and public nursing colleges, representatives of nursing organizations, government officials, nursing academics and practitioners from the government and private sectors. The data were analysed thematically using Creswell's six steps of analysis and the Standards for Reporting Qualitative Research (SRQR) guideline was followed. Results: The study generated three major themes: (a) policy level including the national situation of CPD, political influence and training guided by the policy; (b) organizational level incorporating perceptions towards forms of CPD, staff shortage, poor staff retention, seniority for training, financial constraints and lack of continuity of training; and (c) individual level including motivation for training and lack of relevant training. [ABSTRACT FROM AUTHOR]

Objective: The outbreak of COVID-19 brings an overload of physical and mental demands to healthcare professionals. Keeping healthcare professionals sustainable, engaged, and performing at their highest levels becomes critical and nonetheless difficult. The objective of this research is to link the literature on organizational climates, corporate social responsibility, safety science, and work engagement, and propose a research framework that investigates the factors influencing healthcare professionals' engagement during COVID-19. Methodology: We propose that when healthcare workers' career callings are triggered by COVID-19, it influences their perceptions of the work's meaningfulness, which ultimately enhances their work engagement. We argue that creating a social responsibility climate and a safety climate inside the hospital facilitates the process of turning healthcare workers' perceived work meaningfulness into work engagement. We collected data from 112 healthcare professionals, including nurses, doctors, and executive staff, from 16 wards in a public hospital in China to test our hypotheses. Results: Hierarchical linear regression analysis provided empirical support for our research model. We find that healthcare professionals' career callings during COVID-19 enhanced their perceived work meaningfulness, which results in increased work engagement. Moreover, a social responsibility climate and a safety climate strengthens the link between work meaningfulness and work engagement among participants. Conclusions: Creating a social responsibility climate and a safety climate in the workplace are effective management approaches to realize healthcare workers' feelings of work meaningfulness and turn them into work engagement. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the associations between job stressors, COVID-19-related concerns, burnout, and mental health and well-being among school nurses, and whether any of these associations are mediated by burnout. Based on stratified proportional sampling, data collection was conducted by an online questionnaire distributed to 600 school nurses in Taiwan. A total of 256 participants aged between 27 and 62 years (mean = 47.08; standard deviation = 7.28) returned questionnaires. Results showed that burnout was the main mediating variable that fully mediated the relationship between COVID-19-related concerns and mental health and well-being. The effects of job stressors on mental health and well-being included direct negative effects (β = −.29) and indirect negative effects (β = −.67) through mediating factors. School health managers should be more aware of burnout and mental health and well-being among school nurses under the impact of COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: This was a cross-sectional study conducted to determine the relationship between stigmatizing attitudes towards HIV/AIDS patients in relation to job satisfaction of nurses and midwives in Yazd, Eastern Iran. Cases of HIV/AIDS have not been studied. Material and methods: A total of 399 nurses and midwives were enrolled into the study using a multistage cluster method; all participants completed two standard questionnaires regarding health personnel attitudes towards HIV and job satisfaction on their own. Pearson's correlation coefficient and multiple regression analysis were applied to investigate the relationship between stigmatizing attitude and job satisfaction, and to control the effect of confounding variables. Analyzes were evaluated using STATA software, version 11.0. Results: The mean (standard deviation) of stigmatizing attitude score was 17.34 (8.6), which was equal to the mean number (score, 34), and showed the average level of stigmatizing attitudes of midwives and nurses. In total, 24.5%, 52.9%, and 22.6% of the participants presented non-stigmatizing attitude (n < 30), somewhat stigmatizing (n: 39-30), and stigmatizing (n > 39) attitudes towards HIV, respectively. Additionally, the overall mean score of job satisfaction was 53.89, which indicated the average level (38 to 57) of job satisfaction of nurses and midwives. In addition, the overall job satisfaction score was significantly inversely related to the stigmatized attitude of individuals, so that in return for increasing the job satisfaction score in staff, their stigmatizing attitude score decreased (ß = 0.10, p = 0.001). Conclusions: The findings showed an inverse and indirect relationship between job satisfaction and attitude. Accordingly, since nurses and midwives play a key role in the care, diagnosis, and treatment of people living with HIV, it is necessary for health managers and policy-makers to highlight the factors affecting job satisfaction of nurses and midwives. [ABSTRACT FROM AUTHOR]

Have you ever wondered how the National Association of School Nurses (NASN) supports school nursing research and clinical practice degree advancement or how they provide opportunities to strengthen advocacy skills? NASN does this work through an endowment fund which provides annual scholarships and grants to members to support their various professional endeavors. [ABSTRACT FROM AUTHOR]

Aims and objectives: To evaluate acceptability, efficiency, and quality of a new digital care management system in a residential aged care home (RACH). Background: Improving care quality and efficiency in RACH, while simultaneously upgrading data management, is a priority for communities and governments. Design: Participatory action research with mixed methods data collection was employed to evaluate a digital care management system implemented at a 169‐bed RACH. This paper reports qualitative findings of the 2‐year evaluation. Methods: Qualitative data were collected using focus groups with residents, visitors, nurses, managers, care workers, and consultants; resident/visitor and staff hallway interviews and responses to open‐ended questions in online staff surveys. Data were analysed thematically under the four predetermined study objectives. Reporting adhered to COREQ guidelines. Results: 325 data captures from 88 participants, over seven data sources were coded. Findings indicate that the system was acceptable to both residents and staff due to perceptions of time‐saving and improved quality of care. Increased efficiency was perceived through timeliness as well as reduced time spent retrieving and documenting information. Quality of care was improved through care scheduling individualised to resident needs, with reminders to avoid missed care. Relatives were reassured and activities were scheduled to loved one's preferences. The co‐design implementation process was successful through commitment to quality from leadership teams and prioritising the focus on the holistic needs of the residents. Conclusion: A strong emphasis on co‐design with care staff in developing and implementing the digital care system contributed to a system that supported nursing and care work, facilitated reporting and documentation, and improved resident care and well‐being including identification of missed care. Relevance to Clinical Practice: Nurses, carers, administrators, and advocates can support the co‐design creation of information systems that suit the workflow of an organisation and keep the focus on individualised models of care provision. [ABSTRACT FROM AUTHOR]

The transition from student to practitioner for newly graduated nurses is impacted by their physical, social, professional, and practice environments. COVID-19, global insecurity, institutional restructuring, and "acute on chronic" staffing shortages have increased the immediate burden experienced by emerging nurses. As detailed through the historical development of Duchscher's Stages of Transition Theory and Transition Shock Model, theorization of the transition process offers graduates, their educators, and workplace managers key areas of support opportunities for these new practitioners. In part 1 of a 2-part article series, this article explores how novel new graduate supports have been developed and delivered in partnership with nonprofit groups, government bodies, and employers across much of Canada. For nurse stakeholders, theorists, and beyond, support for the transition period of new nurses remains anecdotally, evidentially, and fiscally advisable, with an increasing urgency due to rising human capital pressures. [ABSTRACT FROM AUTHOR]

Background: The momentum to place nurses on boards (NOB) continues to build. An integrative review about NOB was published in 2017 covering 1988 to early 2016. Studies about NOB have been published since but no systematic reviews summarize the research. Objectives: The purpose of the project was to describe the research about NOB from late 2016 to early 2022 framed within the Conceptual Model for Nurses on Boards (CMNOB). Methods: A scoping review was conducted using the preferred reporting items for systematic reviews and meta‐analyses guidelines for scoping reviews. Data Sources: Databases used in the search included PubMed, CINAHL, ProQuest Central, and Academic Search Complete. Eleven records comprised the sample group. Results: Of the six general purposes for the research about NOB, seven studies aimed to explore nurses' board experiences or preparation for board service. The studies' recommendations were classified within the CMNOB concepts: board composition (n = 8), board effectiveness (n = 3), and organizational performance (n = 2). Several studies' recommendations were classified into multiple concepts of the CMNOB. Conclusion: The research about NOB has accelerated since late 2016. Preparing nurses for board service remains central. However, until research demonstrates nurses' impact on board effectiveness and organizational performance, underrepresentation of NOB is likely to continue. [ABSTRACT FROM AUTHOR]

Background: Staff turnover is considered an important indicator of nursing home quality. We used auditable staffing data from the Centers for Medicare & Medicaid Services (CMS) Payroll‐Based Journal (PBJ) system to calculate turnover measures for nurse staff and administrators and examined the relationship between turnover and nursing home quality. Methods: Our analyses included data from 13,631 nursing homes that submitted complete staffing data through PBJ for 2018Q3 – 2019Q4. We identified turnover based on gaps in days worked by eligible employees, allowing us to calculate turnover measures that do not depend on termination dates reported by nursing homes, which are not captured in PBJ. We linked staff turnover measures to nursing home quality measures and star ratings published on CMS' Care Compare website in January 2020 and examined the relationship between turnover and quality of care. We used ordinary least squared models for continuous outcomes and ordered logit models for categorical outcomes, controlling for facility, and county characteristics. Results: Mean annual turnover rates were about 44% for RNs and 46% for total nurse staff. On average, there was one administrator leaving each nursing home during this period although about half of nursing homes had no administrator turnover. Turnover rates varied greatly across nursing homes. For‐profit and larger nursing homes had higher turnover rates. Higher turnover was consistently associated with lower quality of care. Conclusions: Our study highlights the importance of staff turnover due to its relationship to nursing home quality. In January 2022, CMS started posting turnover measures on Care Compare to allow consumers to use this information in their assessment of nursing home quality and to motivate nursing homes to implement innovative strategies to retain staff. While these actions are challenging, they are nonetheless warranted for improving the quality of care for nursing home residents. See related Editorial by Carnahan & Unroe [ABSTRACT FROM AUTHOR]

Policy PointsAs a consequence of mass incarceration and related social inequities in the United States, jails annually incarcerate millions of people who have profound and expensive health care needs.Resources allocated for jail health care are scarce, likely resulting in treatment delays, limited access to care, lower‐quality care, unnecessary use of emergency medical services (EMS) and emergency departments (EDs), and limited services to support continuity of care upon release.Potential policy solutions include alternative models for jail health care oversight and financing, and providing alternatives to incarceration, particularly for those with mental illness and substance use disorders. Context: Millions of people are incarcerated in US jails annually. These individuals commonly have ongoing medical needs, and most are released back to their communities within days or weeks. Jails are required to provide health care but have substantial discretion in how they provide care, and a thorough overview of jail health care is lacking. In response, we sought to generate a comprehensive description of jails' health care structures, resources, and delivery across the entire incarceration experience from jail entry to release. Methods: We conducted in‐depth interviews with jail personnel in five southeastern states from August 2018 to February 2019. We purposefully targeted recruitment from 34 jails reflecting a diversity of sizes, rurality, and locations, and we interviewed personnel most knowledgeable about health care delivery within each facility. We coded transcripts for salient themes and summarized content by and across participants. Domains included staffing, prebooking clearance, intake screening and care initiation, withdrawal management, history and physicals, sick calls, urgent care, external health care resources, and transitional care at release. Findings: Ninety percent of jails contracted with private companies to provide health care. We identified two broad staffing models and four variations of the medical intake process. Detention officers often had medical duties, and jails routinely used community resources (e.g., emergency departments) to fill gaps in on‐site care. Reentry transitional services were uncommon. Conclusions: Jails' strategies for delivering health care were often influenced by a scarcity of on‐site resources, particularly in the smaller facilities. Some strategies (e.g., officers performing medical duties) have not been well documented previously and raise immediate questions about safety and effectiveness, and broader questions about the adequacy of jail funding and impact of contracting with private health care companies. Beyond these findings, our description of jail health care newly provides researchers and policymakers a common foundation from which to understand and study the delivery of jail health care. [ABSTRACT FROM AUTHOR]

The Pacific Islands countries consist of thousands of isolated islands with a combined population of over 10 million people. It is a heterogeneous and diverse region culturally, linguistically economically and politically. Health challenges are considerable and healthcare systems are often overstretched. Framed in the context of the World Health Organisation's strategic directions and policy priorities, this paper describes an account of collaboration across these countries to develop leadership skills in the nursing and midwifery professions. It outlines lessons for nursing leadership, healthcare policy development and the valuable role of Government Chief Nursing and Midwifery Officers. The South Pacific Chief Nursing and Midwifery Officers Alliance (SPCNMOA) is a cooperative partnership, which was formed to improve the quality of healthcare in the region. It acts as an enabler to promote leadership skills and provide a safe space for learning, developing policy and the sharing of good practice. Through mentorship programs, international meetings and strong relationship-building, the SPCNMOA has strengthened partnerships within the region and improved community health services in even the most remote areas. By strengthening leadership and collaboration, these health professionals are now recognised by key policy makers as knowledgeable experts who have a legitimate role in guiding policy development, changing practice and delivering health policy improvements at local, country and international levels. [ABSTRACT FROM AUTHOR]

Purpose: This study developed an in-service training program for patient safety and aimed to evaluate the impact of the program on nurses in the operating room (OR). Methods: A pretest--posttest self-controlled survey was conducted on OR nurses from May 6 to June 14, 2020. An in-service training program for patient safety was developed on the basis of the knowledge--attitude--practice (KAP) theory through various teaching methods. The levels of safety attitude, cognition, and attitudes toward the adverse event reporting of nurses were compared to evaluate the effect of the program. Nurses who attended the training were surveyed one week before the training (pretest) and two weeks after the training (posttest). Results: A total of 84 nurses participated in the study. After the training, the scores of safety attitude, cognition, and attitudes toward adverse event reporting of nurses showed a significant increase relative to the scores before the training (p < .001). The effects of safety training on the total score and the dimensions of safety attitude, cognition, and attitudes toward nurses' adverse event reporting were above the moderate level. Conclusion: The proposed patient safety training program based on KAP theory improves the safety attitude of OR nurses. Further studies are required to develop an interprofessional patient safety training program. In addition to strength training, hospital managers need to focus on the aspects of workflow, management system, department culture, and other means to promote safety culture. [ABSTRACT FROM AUTHOR]