Search

Aims: This study examines the contribution of top management's transformational leadership behaviors on two targets of nurses' turnover intention (organization and occupation) by focusing on the indirect (through vigor and dedication) and conditional indirect associations (involving autonomous motivation as a moderator). Background: Although the issue of nurse turnover has received growing scientific attention, the research is currently silent about the specific targets of turnover intention and more importantly, the potential pathways through which top management's transformational leadership behaviors relate to each target. Method: Cross‐sectional data from a sample of 426 French–Canadian nurses and structural equation modeling were used to test the proposed model. Results: Top management's transformational leadership behaviors distinctly predicted organizational and occupational turnover intention through specific nurses' states of engagement. While perceived transformational leadership positively predicted vigor, its indirect associations (via dedication) with organizational and occupational turnover intention depend on nurses' level of autonomous motivation at work. Conclusion: In times of nurse shortage, the present findings provide insights into how and when top management's transformational leadership behaviors relate to nurses' organizational and occupational turnover intention. Implications for Nursing Management: Healthcare organizations are advised to foster top management transformational leadership behaviors and autonomous motivation to sustain the nursing workforce. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the historical context of the enrolled nurse (EN) and nursing associate (NA) roles • To consider the contribution of roles such as the NA to the overall nursing workforce • To learn about how the experiences of previous roles such as the EN can inform the development of new nursing roles. Background: The enrolled nurse (EN) role (second-level registration) was formalised in the UK in 1961 but phased out from the mid-1980s and training courses leading to second-level registration had ceased completely by 1992. The training and practice experiences of former ENs have garnered interest in recent years due to the similarities between the EN role and the nursing associate (NA) role, which was introduced in England in 2017 to help bridge the gap between healthcare assistants and registered nurses. Aim: To explore the past experiences of former ENs to provide a historical lens through which the contemporary role of the NA can be considered. Method: Semi-structured interviews were undertaken with nine former ENs in learning disability and mental health. Findings: Thematic analysis of interview transcripts generated four main themes – ‘the numbers’, ‘just an enrolled nurse’, ‘a stepping stone’ and ‘considerations for the NA’. Participants valued their EN training and role and believed it had provided them with a foundation on which they could make important contributions to nursing care throughout their careers. However, they also described having a perceived ‘lower status’ than registered nurses, but at the same time were expected to assume responsibilities beyond their scope of practice during workforce shortages. Participants welcomed the concept of the NA role and regarded it as a way of building a strong and reliable nursing workforce but were concerned that NAs could be exploited as a ‘cheaper nursing workforce’ and about the lack of role clarity among the wider nursing and healthcare workforce. Conclusion: Lessons from the historical experiences of former ENs should guide the ongoing development of new roles such as the NA, particularly in relation to ensuring the wider nursing and healthcare workforce are clear about the scope of the role. [ABSTRACT FROM AUTHOR]

The healthcare sector is ubiquitously plagued by workforce shortages in economies around the globe. The fragility of this structural shortage becomes apparent when external shocks, such as the COVID-19 pandemic, exacerbate the lack of workers in clinical practice. In this article, we summarize current trends in healthcare workforce development across the globe, review theoretical concepts of workforce shortages, and discuss policies to address them. In practice, developed countries often address workforce shortages with targeted migration policies. However, targeted workforce migration policies only intensify workforce shortages in low-and middle-income countries. Theoretical macroeconomic models suggest that supply shortages may result from too low wages, supply lagging behind demand, and social perception. Changes in the wage rate cannot sufficiently increase the supply of health professionals as scholars find inelastic wages for physicians and nurses. Nonpecuniary factors such as working conditions, job satisfaction, and intrinsic motivation are at least equally important as financial incentives. In conclusion, increased wages can only be part of a heterogeneous policy plan to address shortages. Migration and retirement levels of health professionals can temporarily mitigate workforce shortages but rarely change the underlying systemic issues. Increasing the number of places available in medical and nursing schools while also improving, both, financial and nonfinancial incentives for employees are long-term structural policy options. [ABSTRACT FROM AUTHOR]

Aims: Globally, the nursing shortage is a growing concern. Much of the research on retention of nurses focuses on the experience of those who left positions. In this study, we set out to listen to critical care nurses (CCRNs) who have chosen to remain in their positions to understand the factors retaining them in critical care. Design: This interpretive descriptive study was guided by the following research question: 'what factors influence CCRN's decision to continue to work in critical care?' Methods: Digitally recorded interviews and a focus group were conducted between July 2022 and January 2023 using a semi‐structured, strengths‐based interview guide with CCRNs from three critical care units at a tertiary hospital in a city in a central Canadian province. Transcribed interviews were analysed using open, axial and selective coding and constant comparative analysis. Results: Twenty‐two CCRNs participated in interviews and three in a focus group. The theme of Respect, demonstrated through the interconnected concepts of Working to Full Scope, Team, Rotations and Compensation was identified. Working to Full Scope was described as providing nursing care aligned with how each nurse envisions what nursing is. Being part of a Team led by strong nurse leaders that provides opportunities and supports the sharing of their perspectives was also found. Respect was also found to be demonstrated through Rotations that recognize that work is one part of these nurses' lives. Compensation that reflects the increased education, knowledge and skills required in critical care was the final concept of Respect. Conclusion: Organizations should focus their efforts across the identified concepts to demonstrate Respect for CCRNs and retain them. Implications for Practice: The findings of this study provide ways to support the retention of CCRNs. Impact: This research will have an impact on nursing leaders by providing tangible ways to retain CCRNs. Reporting Method: Reporting of this work was guided by the Standards for Reporting Qualitative Research. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Moral distress is defined as knowing the right course of action to take but being hindered by institutional constraints. Objective: The purpose of this study was to explore surgical intensive care unit (SICU) nurses' experiences of moral distress, moral residue, coping, and perceived quality of patient care. Method: A descriptive qualitative approach used in-depth, semistructured individual interviews of SICU nurses in a metropolitan, academic medical center until theoretical saturation occurred. Results: Five themes were identified from 21 interviews. Root causes of moral distress were identified including end-of-life care, conflicts with management, staffing, inadequate resources, communication problems, power differentials between physicians and nurses, and working with incompetent providers. Interviews highlighted the torment experienced by participants, which demonstrated that unacknowledged moral distress impacted their quality of patient care and well-being. Accounts provided insight into patient care that was perceived to be wrong. Well-being was affected as 2 participants sought inpatient psychiatric treatment for moral distress, whereas others were looking for new nursing careers, and many were in school to leave the SICU. Discussion: This study is unique because it corroborated Epstein and Hamric's Crescendo Effect framework by providing indepth analyses of moral distress, moral residue, and the crescendo effect and how these concepts developed within SICU nurses when left unaddressed. Interviews revealed that unacknowledgedmoral distress createdmoral residue, which subsequently impacted the quality of patient care and the nurses' well-being. [ABSTRACT FROM AUTHOR]

In the wake of the COVID-19 pandemic, the fluctuating nurse resignation rates highlighted an understudied area in healthcare: post-pandemic challenges in clinical settings. This study, conducted from May to November 2023, employed a qualitative inquiry using focus groups to delve into these challenges. Six focus group sessions, involving 33 nurse participants recruited through snowball sampling from various hospital settings were conducted to explore their clinical experiences during and after the pandemic. Thematic analysis revealed two primary themes: the 'Invisibility of Nurses' within the healthcare system and the 'Moral Duty of Nursing Practice'. These findings illuminate a tension between the overlooked role of nurses and their ethical obligations, underscoring a critical need for policy reassessment. The study advocates for systemic changes, particularly in the undervaluation of the nursing profession and the National Health Insurance system, to address the poor working environment and mitigate long-term nursing shortages. This research deepens understanding of post-pandemic nursing workforce challenges in Taiwan, highlighting the need for policy evolution to enhance recognition and support for the nursing industry. It is suggested to provide tangible compensation to acknowledge nurses' daily care and health education for patients. A healthier working environment can be enhanced by collaborative efforts between healthcare institutions and nurses. [ABSTRACT FROM AUTHOR]

Background: The nursing education sector has felt the impact of the shortage of nursing clinical instructors (CI) or faculty members. This phenomenon became more profound with the pandemic experience along with the global shortage of nurses in the hospitals. Objective: The study was conducted to explore the lived experiences on learning among undergraduate nursing students in a higher education institution amidst the nursing faculty shortage. Methods: The study was undertaken using a descriptive phenomenological design with seven informants, using Colaizzi's approach for data analysis. Findings: The findings of the study generated three main themes: disruptions in the learning process and platforms, responses to learning disruptions, and learners' call to action. It uncovered substantial disruptions in scheduled lectures, activities, and clinical rotations due to the nursing faculty shortage. Conclusion: The findings underscore the critical need for immediate and comprehensive measures to address the nursing faculty shortage. Despite compensatory efforts by the institution, the impact on learning experience remains significant. This study calls for prompt and effective strategies to rectify the nursing faculty shortage, ensuring optimal learning experiences for student nurses. [ABSTRACT FROM AUTHOR]

The worldwide nursing shortage has led to the exploration of using robotics to support care delivery and reduce nurses' workload. In this observational, mixed-method study, we examined the implementation of a robotic nurse assistant (RNA) in a hospital ward to support vital signs measurements, medication, and item delivery. Human–robot interaction was assessed in four domains: usability, social acceptance, user experience, and its societal impact. Patients in a general medicine ward were recruited to participate in a one-time trial with the RNA and a post-trial 75-question survey. Patients' interactions with the RNA were video recorded for analysis including patients' behaviours, facial emotions, and visual attention. Focus group discussions with nurses elicited their perceptions of working with the RNA, areas for improvement, and scalability. Sixty-seven patients aged 21–79 participated in the trial. Eight in 10 patients reported positive interactions with the RNA. When the RNA did not perform to expectations, only 25% of patients attributed fault to the RNA. Video analysis showed patients at ease interacting with the RNA despite some technical problems. Nurses saw potential for the RNA taking over routine tasks. However, they were sceptical of real time savings and were concerned with the RNA's ability to work well with older patients. Patients and nurses suggested greater interactivity between RNA and patients. Future studies should examine potential timesaving and whether time saved translated to nurses performing higher value clinical tasks. The utility of improved RNA's social capability in a hospital setting should be explored as well. [ABSTRACT FROM AUTHOR]

Germany's healthcare sector suffers from a shortage of nursing staff, and robotic solutions are being explored as a means to provide quality care. While many robotic systems have already been established in various medical fields (e.g., surgical robots, logistics robots), there are only a few very specialized robotic applications in the care sector. In this work, a multi-functional robot is applied in a hospital, capable of performing activities in the areas of transport and logistics, interactive assistance, and documentation. The service robot platform HoLLiE was further developed, with a focus on implementing innovative solutions for handling non-rigid objects, motion planning for non-holonomic motions with a wheelchair, accompanying and providing haptic support to patients, optical recognition and control of movement exercises, and automated speech recognition. Furthermore, the potential of a robot platform in a nursing context was evaluated by field tests in two hospitals. The results show that a robot can take over or support certain tasks. However, it was noted that robotic tasks should be carefully selected, as robots are not able to provide empathy and affection that are often required in nursing. The remaining challenges still exist in the implementation and interaction of multi-functional capabilities, ensuring ease of use for a complex robotic system, grasping highly heterogeneous objects, and fulfilling formal and infrastructural requirements in healthcare (e.g., safety, security, and data protection). [ABSTRACT FROM AUTHOR]

Background: Team-based primary care (PC) enhances the quality of and access to health care. The Veterans Health Administration (VHA) implements team-based care through Patient Aligned Care Teams (PACTs), consisting of four core members: a primary care provider, registered nurse (RN) care manager, licensed vocational nurse, and scheduling clerk. RNs play a central role: they coordinate patient care, manage operational needs, and serve as a patient point of contact. Currently, it is not known how varying levels of RN staffing on primary care teams impact patient outcomes. Objective: This study aims to empirically assess how the stability of RN staffing within team-based primary care affects patient access to care. Methods: A retrospective database review using clinical and administrative data from the VHA over 24 months. Participants included 5,897 PC PACTs across 152 VHA healthcare facilities in the United States and its territories. The stability of personnel in the RN role was categorized as: RN continuous churn, RN staffing instability and RN vacancy. All 3 categories were compared to teams with RN stability (i.e., same person in the role for the entire 24-month period). Access measures included: average third-next-available appointment, established patient average wait time in days, urgent care utilization, emergency room utilization, and total inbound-to-outbound PC secure messages ratio. Results: RN continuous churn within PACTs had a significant impact on third-next-available appointment (b = 3.70, p < 0.01). However, RN staffing instability and vacancy had no significant relationship with any of the access measures. Several risk adjustment variables, including team full-time equivalency, team stability, relative team size, and average team size, were significantly associated with access to health care. Conclusions: Teams are impacted by churn on the team. Adequate staffing and team stability significantly predict patient access primary care services. Healthcare organizations should focus on personnel retention and strategies to mitigate the impact(s) of continuous RN turnover. Future research should examine the relative impact of turnover and stability of other roles (e.g., clerks) and how team members adapt to personnel changes. [ABSTRACT FROM AUTHOR]

Background: Burnout affects the quality of work and health, increases the rate of turnover of newly graduated nurses, and leads to a shortage of nurse resources. Perceived organizational support (POS) can mitigate burnout, but the exact mechanism is unclear. The purpose of this study was to explore the mediating roles of psychological capital (PsyCap) and work engagement (WE) in the relationship between POS and burnout. Methods: This is a cross-sectional study. An anonymous investigation with a convenience sampling of nurses was conducted in Sichuan province, southwest China between October 2023 and November 2023. The Perceived Organizational Support Scale, Maslach's Burnout Inventory General Survey, the Psychological Capital questionnaire, and the Utrecht Work Engagement Scale were used to collect data. SPSS 26.0 and AMOS 26.0 were applied for statistical analysis. Results: A total of 995 newly graduated nurses participated in this study. The average burnout score of the nurses was 2.45 (1.06) and the incidence of burnout was 82.6%. Burnout was negatively correlated with POS (r=-0.624, p < 0.05), PsyCap (r = -0.685, p < 0.05) and WE (r = -0.638, p < 0.05). The total effect of POS on burnout (β = 0.553) consisted of a direct effect (β = 0.233) as well as an indirect effect (β = 0.320) mediated through PsyCap and WE. PsyCap and WE have a chain-mediated effect between the POS of newly graduated nurses and burnout (β = -0.056, Bootstrap 95% confidence interval (-0.008, -0.003), which represented 10.12% of the total effect. Conclusions: This study confirms that POS has a significant negative predictive effect on burnout. POS was first associated with a decrease in PsyCap, followed by a sequential decline in WE, which in turn was associated with an increase in burnout symptoms among newly graduated nurses. Hospital managers can reduce the levels of burnout of newly graduated nurses by increasing organizational support and improving PsyCap and WE. [ABSTRACT FROM AUTHOR]

Background: The demand for nursing professionals with advanced education and specialized knowledge is growing, which encourages nursing undergraduates to pursue postgraduate studies. Therefore, an in-depth investigation into the barriers and facilitators affecting the motivation of nursing undergraduates to take postgraduate entrance exams was necessary. This may provide more targeted recommendations for the formulation of relevant policies and the provision of student support. The purpose of this study is to explore the barriers and facilitators affecting the motivation of nursing undergraduates for postgraduate entrance examination. Methods: Data for this study were collected from in-depth semi-structured interviews with 15 nursing undergraduates from Nantong University between October and December 2023. Thematic analysis was employed to analyze the data. Results: Four barriers were identified, including study pressure and internship fatigue, self-doubt and fear of failure, employment pressure, and lack of information and resources. Four facilitators were also identified, including the desire to upgrade academic qualifications and professional skills, career development and transition, escaping clinical work and delaying employment, as well as the power of role models, and social support. Conclusions: The findings may help nursing undergraduates navigate the path to postgraduate entrance exams more effectively and ultimately succeed in their studies and future careers. The study underscores the importance of addressing these barriers and leveraging these facilitators to support the holistic development of nursing students. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Implications for the Profession and/or Patient Care Reporting Method Patient or Public Contribution To explore and validate an end of shift survey with a low response burden, practical application and generated evidence of related associations between workload, quality of work and patient care, missed care and job satisfaction.A retrospective cross‐sectional survey of the experiences of nursing staff.Data were collected from 265 nurses who responded to a questionnaire at the end of their shift in 2022. Exploratory factor analysis was undertaken using IBM SPSS v.27 and confirmatory factor analysis was undertaken using IBM AMOS v27. Hypotheses testing was undertaken using IBM SPSS v.27 using multiple regression analyses.All of the hypotheses were supported. There was a negative association between workload and quality of work and job satisfaction. Quality of work was negatively associated with workload and missed care and positively associated with job satisfaction. The association between missed care and job satisfaction was negative.The EOSS is a valid and reliable tool with a low response burden. The tool supports previous research which demonstrated there is a negative relationship between level of workload and shift type with satisfaction, quality of work and potentially nurse retention.In the context of a global nursing shortage nursing leaders must ensure that care we provide is of the highest quality. We must take every action to address high workload to reduce the risk that fundamental care is not sacrificed, job satisfaction is improved and nurses remain in the profession. The EOSS gives nurse leaders a reliable, practical, consistent, applied tool that will better enable associations to be observed between resource configuration, workload and critical impacts on nursing and patient care.We have adhered to the relevant EQUATOR guidelines using the STROBE reporting method.No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the experience of certified registered nurse anesthetists (CRNAs) choosing to quit their primary place of employment. Interpretative phenomenological analysis is the qualitative framework for this study. Ten CRNAs were interviewed about their experience of quitting their job. Interview transcripts were analyzed for common themes. Common themes were the desire for better work-life fit, the impact of stressful work intensity, and exposure to poor leadership. This study suggests that a focus on ensuring job fit for personal goals outside of work may improve CRNA retention. This study also provides practice implications for hospital leadership, as well as direction for future qualitative and quantitative research. [ABSTRACT FROM AUTHOR]

The article discusses research aimed at examining the efficiency and cost-effectiveness of a patient-care model called Partners in Care (PIC). Cited are the description of the PIC quality improvement (IC QI) model used in the study, the length of model implementation, unique contextual elements, and organizational activities that influenced outcomes, and the implications of designing and implementing new patient-care delivery models.

Background: Canada, like many other jurisdictions worldwide, is facing a nursing shortage. At the same time, high-income countries are facing a rapidly ageing and more complex older adult population. Demands for more responsive health care services are driving systems of care to meet the evolving needs of the ageing population. Internationally-educated nurses (IENs) can help fill gaps in the care of older adults, but may need considerable support to work in new social and health care environments. However, the experiences of IENs within the geriatric care literature have not been comprehensively reviewed. This protocol will outline a scoping review to determine: (1) what is known about the experiences and support needs of IENs in geriatric healthcare settings within high income countries? (2) what are current supportive-pathways for IENs in geriatric practice settings? And (3) what are the research gaps in the existing literature on the experiences and support needs of IENs within the context of geriatrics? Methods: A scoping review will be conducted guided by the methodological framework set out by Arksey and O'Malley (2005) and later advanced by Levac, Colquhoun and O'Brien (2010). The search strategy will be applied to seven databases (MEDLINE, PubMed (non-MEDLINE records), PsycINFO, PsychArticles, CINAHL, Scopus, Web of Science). Grey literature will be searched using Google search engines, targeted websites and consultation with content experts. Articles of any publication date will be included. A two-stage screening process will be conducted in duplicate (i.e., two reviewers per stage) to determine eligible articles. Data from eligible articles will be extracted using a piloted charting form. Extracted data will be analyzed using thematic and descriptive analyses. Discussion: The findings of the upcoming will highlight opportunities and recommendations to inform future research and support training to support IENs working with older adults within high income countries. Publication, presentations and stakeholder meetings will disseminate our findings. [ABSTRACT FROM AUTHOR]

Operation Allies Refuge started in July 2021 with implications for critical care nurses, both military and civilian, serving at the US Army's Landstuhl Regional Medical Center in Landstuhl, Germany. Cultural and logistical concerns and complications were at the forefront of care provided to Afghan evacuees during the operation and were exacerbated by a mass casualty event on August 26, 2021, when a suicide bomber attacked the Abbey Gate of Hamid Karzai International Airport in Kabul, Afghanistan. This article discusses the issues that affected care, including language barriers, supply shortages, cultural differences, mass evacuation during a pandemic, and management of the mass casualty event by the critical care team. The information is compiled into a summary of lessons learned to assist in future management of emergency evacuee care within our military and civilian health care systems. [ABSTRACT FROM AUTHOR]

Background: Centralized scheduling of nursing professionals is regarded as an effective strategy for optimizing workforce allocation and mitigating critical staffing shortages. The aim of this review is to (1) determine the effect of centralized scheduling on unit productivity (ie, overtime, contract labor, and floating), time savings for managers, and staff perceptions and retention and (2) discuss current approaches in the implementation of centralized scheduling in inpatient hospital settings. Methods: This rapid review of the evidence follows methodological guidance from the Cochrane Rapid Reviews Methods Group. Four electronic bibliographic databases were searched for research published from 2013 to 2023. A total of 446 articles were identified and screened, with a total of 12 articles included. Studies and reports were included if they addressed the operational question and were conducted in an inpatient hospital within the United States. Results: Case study reports describe improved labor productivity (ie. less overtime and less contracted labor), more consistently balanced staffing of frontline nursing professionals, less staff reassignment (ie, floating), and increased satisfaction and time savings for managers after transitioning to a centralized scheduling model. These findings were consistent with a computational, experimental study that found centralized scheduling resulted in less labor costs and fewer undesirable shifts from the frontline nurse's point of view compared to decentralized schedul\ng. [ABSTRACT FROM AUTHOR]

The United States health care system is facing an unprecedented nursing shortage, increasing complexity of care, and fewer experienced nurse mentors. These factors contribute to a cycle of burnout, turnover, decreased quality and safety, and a worsening financial bottom line. Improving these contributing factors depends on our ability to mitigate the structural causes of burnout and turnover. The clinical nurse specialist role is essential to improving the work environment, advancing evidence-based nursing practice, reducing turnover, and stabilizing the bottom line. [ABSTRACT FROM AUTHOR]

To examine the association between demographic characteristics (i.e., gender, race, age, and years of experience), burnout, and nurses' intent to leave their jobs during the first wave of COVID‐19 in New Jersey. COVID‐19 has exacerbated burnout and intent to leave among acute care nurses. Nonetheless, little is known about demographic factors contributing to nurses' desire to leave their jobs. A cross‐sectional survey of actively licensed registered nurses who provided direct patient care in an acute care hospital in New Jersey during COVID‐19. Among 2760 nurses, those who reported burnout were 4.78 times more likely to report intent to leave their job within 1 year as compared to nurses who did not report burnout. Black RNs were 2.06 times more likely to report intent to leave as compared to White RNs. Older nurses (aged 40–49) were 36% less likely to report intent to leave as compared to younger nurses (aged 21–29). RNs with 30 years of experience or more were 58% less likely to report intent to leave as compared to RNs with less than 5 years of experience. In addition, Black RNs with 6–12 years of experience were 2.07 times more likely to report intent to leave as compared to White RNs with less than 5 years of experience. Nurses' intent to leave during the first wave of the pandemic was influenced by burnout, race, age, and years of experience. Based on the results of the current study, Black nurses were more likely to report intent to leave their job within 1 year as compared to White RNs. Nurses' intention to leave is one of the most important global issues facing the healthcare system. Findings of the current study demonstrate that burnout, race, age, and years of experience are significant predictors of nurses' intent to leave their jobs. Therefore, organizations should prioritize strategies to reduce burnout and create diverse and inclusive work environments. [ABSTRACT FROM AUTHOR]

Aim: Guided by Benner's framework, From Novice to Expert, this study aimed to identify (1) critical soft skills to be evaluated in nurses and (2) levels of nursing behaviour indicating achievement of soft skills to provide a framework for developing a soft skills rubric. Background/Introduction: Nurse shortages are often attributable to high turnover rates among nurses. To improve this situation, healthcare facilities implement transition programmes and continuing education with a primary focus on developing and maintaining nurses' knowledge and performance (hard skills). However, balancing hard and soft skills (beliefs, values and attitudes) is key to nurses' quality of care and ultimately to their retention. Despite the importance of soft skills, their intangible nature creates problems in evaluating nurses' attainment of these skills and in providing constructive feedback to help them set concrete goals for improving their practice. Methods: This qualitative descriptive study described critical soft skills in the nursing context. A purposeful sampling strategy was used to enrol 13 clinical nurse educators from multiple hospital units; each had more than 2 years of clinical nurse educator experience and had completed preceptor training. One‐to‐one interviews with these individuals were audio recorded, transcribed and subjected to direct content analysis using NVivo 12. The study follows the Consolidated criteria for reporting qualitative research (COREQ) guidelines for qualitative studies. Findings: Five main competencies, comprising 20 subcompetencies, were identified: personal growth, effective interactions, professionalism, teamwork and the caring role. For each subcompetency, four skill levels were delineated using clinical indicators. Conclusion: This study's findings can enhance understanding of clinical nurse educators' perceptions regarding soft skills required of nurses. Implications for the profession and/or patient care: The soft skills identified can be incorporated into a rubric to be used by clinical nurse educators to evaluate and guide nurses' professional development and contribute to improving quality of care. No patient or public contribution is required for this study. [ABSTRACT FROM AUTHOR]

AbstractThe nursing shortage in the US and all over the world continues to skyrocket. An untapped channel of recruitment that some are considering is men in the nursing profession. Currently a large disparity exists in the representation of men in nursing causing issues with quality of care, diversity, and staffing. Research suggests that nursing recruitment should occur before licensure in order to better address gender stereotypes and prejudice. Early exposure is revealed as a defining factor in enticing men into the profession. Further research reveals that issues related to nurse educator staffing must first be considered to include more men into the profession. Without nurse educators, schools are unable to increase class sizes and admit more men into programs. [ABSTRACT FROM AUTHOR]

Background/Objectives: As the elderly population grows, the prevalence of dementia is rising, with 70–95% of patients in hospital settings exhibiting problematic behaviors such as aggression. These behaviors significantly contribute to increased nursing workloads, affecting nurses' well-being and patient care quality. This study aims to review workload-related issues among nurses caring for dementia patients, highlighting the need for targeted interventions to mitigate stress and improve care quality. Methods: A scoping review was conducted using the five-stage framework of Arksey and O'Malley. The literature search covered studies published between 2013 and 2023, focusing on quantitative research about nurses' workload-related stress when managing patients with dementia and problematic behaviors. Databases such as PubMed and PsycINFO were searched, and 13 studies were selected based on predefined inclusion and exclusion criteria. Results: The review revealed that problematic behaviors, particularly aggression, significantly increase nurses' stress and workload. This stress has negative consequences on nurses' physical and mental health, often leading to burnout, decreased job satisfaction, and a decline in care quality. Inadequate staffing and support systems exacerbate these issues. Conclusions: Targeted education, sufficient staffing, and support are essential to reduce the workload and stress experienced by nurses caring for dementia patients. Implementing these strategies can enhance the quality of care provided and improve the well-being of healthcare professionals. [ABSTRACT FROM AUTHOR]

Purpose: Minimizing delays in delivering nursing care is paramount for enhancing the overall quality of care. Certain bottleneck variables restrict the workflow of nurses, resulting in extended shift times. This study is designed to pinpoint and analyze the principal factors contributing to bottleneck issues in nursing workflow, to direct improvement endeavors. This study seeks to provide insights into the key variables contributing to nurses' extended shift times, with the ultimate goal of prioritizing efforts for improvement. Methods: A descriptive multicenter cross-sectional study was conducted. A scale was developed for this study by the authors after conducting a literature review, subsequently validated, and its reliability was assessed. Results: Among the 31 bottleneck variables, 29 were retained under three persistent bottleneck factors: (1) Nurse staffing— This pertains to the availability of sufficient nursing staff at all times across the continuum of care; (2) Working environment and quality of care—This refers to the availability of necessary skills and resources for nurses to perform their duties effectively and; (3) Medical devices— This factor concerns the availability of fully functional medical devices required for providing care. Conclusion: Efforts aimed at enhancing the overall healthcare system should concentrate on addressing persistent bottleneck factors. This may involve the implementation of a healthcare workforce management system, the establishment of standards for a conducive and supportive working environment, and the utilization of a standardized system for the management of medical equipment. The outcomes of this study can be utilized by nurses and policymakers to devise comprehensive strategies for improvement. [ABSTRACT FROM AUTHOR]

Background: The global nursing shortage is driving nursing professionals to migrate from their home countries to other regions of the world, leading to increased diversity in healthcare settings and nursing education across Europe. Although research on the experiences of internationally educated nurses has gained more attention in Norway, a substantial gap remains in understanding the challenges these nurses face when participating in bridging programs and seeking authorisation as registered nurses in the host country. Methods: The aim of the present study is to gain knowledge about the experiences of students in a digitised bridging program for nurses, related to being a nurse educated outside the European Union and a student with a Norwegian as a second language and migrant/refugee background. Oslo Metropolitan University initiated a decentralised education programme in 2021, offering a bridging programme for individuals with a nursing education from countries outside the European Union. This programme was conducted in a decentralised, gathering-based, and predominantly digitised format. The study has a qualitative descriptive design and includes a purposive sample of eight former nursing students enrolled in the programme. Data were collected through individual semistructured interviews conducted between November and December 2023. The data were analysed by employing thematic analysis. The study is reported in accordance with the COnsolidated criteria for REporting Qualitative research (COREQ). Results: Analyses revealed a main theme—the participants' ability to persist in their goal over the long term, maintaining their interest, overcoming challenges, working hard and finishing tasks rather than giving up. This theme is supported by three themes: (i) 'Navigating bureaucratic challenges – The struggle with authorisation and overwhelming requirements, (ii) 'An emotional journey – The ups and downs of participating in the program', and (iii) 'Achieving recognition – The journey to authorisation and professional confidence'. Conclusions: The study underscores the numerous challenges encountered by internationally educated nurses seeking registered nurse' recognition in Norway. Despite these challenges, the participants displayed remarkable hope, passion and perseverance, remaining committed to their goal of becoming registered nurses in Norway. [ABSTRACT FROM AUTHOR]

Nurse well-being is critical for safe and efficient health care delivery, particularly in complex and demanding specialties like nephrology. However, levels of burnout are rising and may relate to a largely unexplored phenomenon: loneliness. This study investigated the phenomenon of nurse loneliness as a potential factor in burnout. A mixed-methods approach was used to investigate burnout and loneliness in a national sample of nephrology nurses. Together with workforce demographics, burnout and loneliness were measured, prevalence was estimated, and correlations were examined. Interpretive descriptive inquiry and analysis was used to develop a richer understanding of nurse loneliness in the context of burnout. In the study population (n = 217), rates of burnout were low, but positively correlated with loneliness. Qualitative interviews reveal that organizational and systemic pressures, recognition and peer support, work environment and demands, and physical and emotional well-being are components of the experience of current nephrology nurses related to loneliness and burnout. [ABSTRACT FROM AUTHOR]

The article focuses on the essential role of global nursing in advancing sustainable development and addressing complex health disparities worldwide. It emphasizes the importance of culturally sensitive care, healthcare policy advocacy, and workforce mobility, highlighting the contributions of nurses in promoting well-being, reducing inequities, and responding to global health challenges.

Introduction: In order to be positioned to address the increasing strain of burnout and worsening nurse shortage, a better understanding of factors that contribute to nursing workload is required. This study aims to examine the difference between order‐based and clinically perceived nursing workloads and to quantify factors that contribute to a higher clinically perceived workload. Design: A retrospective cohort study was used on an observational dataset. Methods: We combined patient flow, nurse staffing and assignment, and workload intensity data and used multivariate linear regression to analyze how various shift, patient, and nurse‐level factors, beyond order‐based workload, affect nurses' clinically perceived workload. Results: Among 53% of our samples, the clinically perceived workload is higher than the order‐based workload. Factors associated with a higher clinically perceived workload include weekend or night shifts, shifts with a higher census, patients within the first 24 h of admission, and male patients. Conclusions: The order‐based workload measures tended to underestimate nurses' clinically perceived workload. We identified and quantified factors that contribute to a higher clinically perceived workload, discussed the potential mechanisms as to how these factors affect the clinically perceived workload, and proposed targeted interventions to better manage nursing workload. Clinical Relevance: By identifying factors associated with a high clinically perceived workload, the nurse manager can provide appropriate interventions to lighten nursing workload, which may further reduce the risk of nurse burnout and shortage. [ABSTRACT FROM AUTHOR]

The article explores key areas which can improve efficiency, increase satisfaction, and build and sustain nurses to response to the aging population around the world. Topics discussed include the nursing shortages worldwide, the need to promote the specialty of gerontological nursing, and the relevance of older person nursing for clinical nursing practice.

Attention-deficit hyperactivity disorder (ADHD) is a mental health condition characterized by inattentiveness, hyperactivity, and impulsivity as well as difficulties with social interaction, learning, and sometimes sleep. A variety of symptoms is possible, and three ADHD presentations have been defined. Owing to healthcare workforce shortages, particularly in mental health care, it is critical for family NPs and other primary care providers to possess accurate understanding of the disorder and its symptomatology, evaluation, diagnosis, and management in children and adolescents. In today's landscape, newer extended-release and long-acting stimulants support better medication administration and adherence, as well as maintain more consistent levels in the body throughout the day, for pediatric patients. This article aims to keep family NPs up to date in the latest in ADHD diagnosis and management to reduce patient barriers to care; it also provides NPs with critical information to convey to pediatric patients, their families, and their teachers during this back-to-school season. [ABSTRACT FROM AUTHOR]

The article discusses an evidence-based practice strategy employed by a rural hospital emergency department to successfully decrease the patients who left without being seen (LWBS) and nurse vacancy rates. Cited are the positive impact of a team-based model of care on emergency department (ED) patient wait times and LWBS rates, the effectiveness of the strategy in resolving the underlying issues impacting care delivery, and the study implications for nurse leaders.

The article discusses research which aimed to capture the innovativeness of nurse leaders in one academic medical center to help guide future leadership development projects in promoting innovativeness among nurse leaders. Cited are the characteristics of the study participants, procedure for data collection, and how innovativeness was measured, study results which were in sharp contrast to prior studies on the innovativeness of nurse leaders, and implications of the study for nurse leaders.

Aim: To communicate how the Dutch postgraduate nursing education landscape was redesigned using entrustable professional activities (EPAs). The goal of this initiative was to reduce training time, enhance transfer across nursing specialities and contribute to a better‐aligned continuum of initial education, postgraduate education and continuing professional development. Background: Nursing shortages continue to worsen worldwide. An approach to address this growing shortage is to create a more flexible postgraduate training structure, offering training in the just‐in‐time and just‐as‐needed models. EPAs can be used as building blocks for training and assessment. Experience with EPAs (i.e. units of professional practice that can be entrusted once a trainee has demonstrated the required competencies) in health professions education, including nursing, is rising rapidly. While EPAs are largely used to create training flexibility within a programme, they can also be used to create flexibility across programmes. In 2018–2022, training hospitals and education institutions in the Netherlands collaborated in the CZO Flex Level Project to redesign the postgraduate nursing education landscape using EPAs. Discussion: The implementation of a flexible postgraduate nursing education model nationwide will face several challenges. An overview of these challenges and suggestions for future research on the effects of the new structure on nursing competence, satisfaction and career development are provided. Conclusion: EPAs can imbue flexibility within and across training programmes. Designing an EPA‐based educational landscape requires nationally coordinated efforts. Implications for nursing policy: Redesigning educational structures to allow for more flexibility is critical to address major societal challenges in healthcare. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the job performance and predictability of job demands, job resources, personal resources, work engagement, job crafting, and the transformational leadership of nurse managers on this among nurses in Myanmar. Background: The ongoing crisis of nursing shortages along with heavy workloads combines to form a major challenge in Myanmar and these affected the job performance of nurses during the COVID‐19 pandemic. Methods: Utilizing a stratified random sample of 474 nurses from tertiary‐level general hospitals in the Republic of the Union of Myanmar, a descriptive predictive analysis was carried out. The Demographic Data Sheet, Job Performance Scale, Work Engagement Scale, Job Demands Scale, Job Resources Scale, Personal Resources Scale, Job Crafting Scale, and Global Transformational Leadership Scale were utilized to collect data. Results: The overall level of job performance was perceived to be high, considering various factors such as job demands, personal resources, work engagement, and job crafting were found as significant predictors of nurses' job performance, explaining 63.30% of the total variance. Discussion: These findings make a valuable contribution toward enhancing nurses' job performance by addressing job demands, fostering work engagement, and nurturing their job‐crafting capabilities. Self‐reporting data collection may not have accurately represented the actual level of study variable. Conclusion: This study highlighted factors that significantly affect nurses' job performance in general hospitals in Myanmar. Implications for nursing and health policy: The findings provide important evidence for nursing administrators and policymakers wishing to develop strategies to enhance the working environment and remain active in helping the performance of nurses. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) estimates that the world needs 4.5 million new nurses by 2030. Nurses are a critical touchpoint of health and social care services. Without them, the services could not exist as we know them. The nurse shortage is a vicious service design problem. [ABSTRACT FROM AUTHOR]

This paper introduces the Delta Coverage (DC) analytics program, an innovative solution to address the nursing shortage crisis. The program designs a new flexible nursing role supported by an accompanying analytics model for dynamic nurse staffing. Using advanced data analytics, the DC program dynamically allocates flexible nurses across multiple hospitals in response to geographical and temporal nurse demand variability. The DC analytics suite integrates a nurse-demand forecast using a deep generative model and a stochastic optimization for optimal on-call and deployment decisions. A pilot study demonstrated that the DC program reduced understaffing incidents by 17% compared to traditional travel nurse solutions, with projected annual savings of $2.5 million for the partner hospital and over $1.5 billion nationally. These results highlights the potential of the DC analytics program to transform nurse staffing practices on a broader scale. Amidst critical levels of nurse shortages, we partnered with Indiana University Health (IUH) to pioneer a novel suite of advanced data and decision analytics to support a new model of nurse staffing. This statewide program leverages a flexible pool of resource nurses who can move between the 16 IUH hospitals located in five diverse regions and serving more than 1.4 million residents. This program breaks the mold of traditional travel and resource nurses by adding flexibility to move nurses between hospitals to dynamically respond to short-term patient census fluctuations. This paradigm shift necessitated the development of analytics to execute these interhospital transfers. Specifically, we develop analytics to create a two-week advance on-call list for travel and a 24- to 48-hour call-in decision. Our Delta Coverage Analytics Suite was launched in October 2021 as a Microsoft PowerBI application and provides an integrated solution that has supported and continues to support this new staffing approach at a statewide scale. The suite contrasts with existing nurse scheduling tools that primarily cater to single hospitals or units. It incorporates (1) a novel patient census forecast based on a deep generative model capturing complex spatial-temporal correlations and avoiding error accumulation occurring in traditional time-series models and (2) a stochastic optimization that prescribes optimal on-call and deployment decisions. The pilot, conducted from May to June 2023, produced a remarkable reduction in understaffing, with estimated annual savings of $2.5 million to IUH and over $1.5 billion on a national scale compared with the conventional solution of hiring travel nurses. As the first program of its kind, our methods establish new benchmarks for evidence-based and data-driven nurse workforce management with the potential to transform how healthcare institutions approach the national nursing shortage crisis. History: This paper has been accepted for the INFORMS Journal on Applied Analytics Special Issue—2023 Daniel H. Wagner Prize for Excellence in the Practice of Advanced Analytics and Operations Research. [ABSTRACT FROM AUTHOR]

In "The Future of Workforce Development in Professional Nursing Practice," Graebe et al. (2022) propose addressing nursing workforce shortages through Recognition of Prior Learning and related frameworks. They argue for a new health care learning model that leverages stackable certificates and accredited professional development to award academic credit, bridging the gap between current qualifications and advanced education. This approach could enhance enrollment and retention in advanced nursing programs, addressing shortages in specialty areas such as academia and leadership. By recognizing experiential learning, these methods create accessible, sustainable career pathways, fostering a more diverse and adaptable nursing workforce. [J Contin Educ Nurs. 2024;55(9):416–420.] [ABSTRACT FROM AUTHOR]

Background: Innovative models are required to maximize nursing student placements in environments of shrinking budgets, increasing hospital demands, and casualization and aging of the workforce. This article reports the success of a service-academic partnership in a dedicated education unit. Method: This cross-sectional observational study in a regional hospital analyzed survey data using validated tools completed by buddy nurses (n = 80) and postplacement evaluation completed by students (n = 102) and the nurse leadership team (n = 17). Results: Postimplementation, nursing student placement days increased, and participants were positive about the partnership. Although most of the nursing students (n = 96) reported they were very or extremely satisfied with their placement, they rated student facilitators higher than their buddy nurses. Conclusion: Increasing enrollments will not solve the nursing workforce shortage unless student placements of quality and quantity are provided. Partnership in support of clinical staff remains critical to create time to provide quality supervision. [J Nurs Educ. 2024;63(9):619–625.] [ABSTRACT FROM AUTHOR]

Background: Quality clinical environments are crucial in bridging the gap between theoretical knowledge and practical skills. This study explored the mediating role of academic burnout in relation to workplace bullying experience, stress hardiness, and occupational identity among nursing students during clinical practice. Method: In this cross-sectional study, an online questionnaire was administered to fourth-year nursing students from four universities. Data were collected in March 2023 and analyzed using descriptive statistics, independent t test, one-way analysis of variance, Pearson's correlation coefficient, and PROCESS Macro Model 4. Results: In the final sample (N = 202), the correlates of occupational identity were stress hardiness and academic burnout; workplace bullying was not statistically significant. Academic burnout completely and partially mediated the relationship between workplace bullying and occupational identity and between stress hardiness and occupational identity, respectively. Conclusion: To strengthen nursing students' occupational identity, active attention and management are required to prevent academic burnout and improve stress hardiness. [J Nurs Educ. 2024;63(9):604–612.] [ABSTRACT FROM AUTHOR]

Introduction: The emergence of COVID-19 caused a sudden, unexpected disruption in the clinical training experiences of nurse trainees at the US Department of Veterans Affairs (VA), the largest clinical training setting in the US for nurses. Purpose: To understand associations between COVID-19 and nurse trainees' satisfaction with their training experiences and the likelihood that they would consider future VA employment. Methods: A cross-sectional design was used to assess 7,890 nurse responses from the VA's Trainee Satisfaction Survey for academic years 2018–2021. Results: After the pandemic, trainees reported decreased training satisfaction (95.06% vs. 93.46%; P =.0028). Willingness to consider future VA employment was unchanged. Patient case mix, the onboarding process, and challenges with other staff were the most common reasons for dissatisfaction. Conclusion: Nurse trainees expressed a small but statistically significant degree of dissatisfaction with their clinical learning environment during this study period but their willingness to seek employment with the VA remained high. [ABSTRACT FROM AUTHOR]

Background: Troubled conscience results from the lack of attention to the voice of conscience. Regarding the fact that ICU healthcare workers are constantly faced with stressful and challenging situations, they often experience a troubled conscience. Aim: This study aimed to explain the factors leading to troubled conscience and identify the consequences of troubled conscience among ICU nurses. Methods: Qualitative content analysis was used to answer the research question. A total of 18 ICU nurses were selected to participate in this study using purposive sampling. Data were collected using face-to-face, semi-structured interviews. Findings: Four categories of "carelessness", "contextual challenges", "non-supportive and unpredictable structure" and "whirlpool of troubled conscience" were shown to constitute the main causes of troubled conscience among ICU nurses. Conclusion: Troubled conscience negatively impacts nurses and is associated with psychological/behavioral changes among them. The identification and explanation of troubled conscience help healthcare providers to confront it and manage its causes. [ABSTRACT FROM AUTHOR]

Aim. This study aims to explore contributing factors, impacts, and strategies to address perioperative nursing shortages. Background. Health facilities worldwide are experiencing nursing shortages, especially in specialty fields such as perioperative nursing. Evaluation. This integrative review is reported according to the PRISMA guidelines. The title, abstract, and full article screening, as well as the quality appraisal process, were performed by two independent reviewers, with a third for disagreement. This review focused on empirical and theoretical research published from 2013 to 2023 using databases including CINAHL, Embase, Emcare (via OVID), Medline (via EBSCOhost), Scopus, Web of Science, ProQuest Dissertations and Theses Global, Overton, and GreyNet. Key Issues. This study thoroughly reviewed 84 articles. The perioperative domain confronts significant staffing challenges due to increased demand, lack of experienced nurses, insufficient new entrants, high turnover, and an aging workforce. Notably significant are the deficiencies in recruiting new nurses and the elevated turnover levels, potentially amendable issues. The shortages negatively impact the remaining nurses, patient care quality, and hospital revenue. Strategies to address perioperative nursing workforce challenges include promoting the specialty to undergraduate nursing students, bolstering recruitment efforts, and retaining experienced perioperative nurses. However, none of the studies examined in this review adopted a comprehensive approach. Furthermore, the effectiveness of these strategies relative to one another remains uncertain due to a lack of reliable measurements. Conclusion. Perioperative nursing faces considerable challenges, including an aging workforce, limited new recruits, and high turnover rates. Present strategies primarily prioritise workforce preparation over supporting current staff. Mitigating the perioperative nursing shortages requires comprehensive approaches integrating preparation, recruitment, retention, and retirement plans. In addition, these strategies must be adapted to the diverse regulatory environments of different countries, recognising the absence of a one‐size‐fits‐all solution to perioperative nursing shortages globally. Implication for Nursing Management. Perioperative nursing managers are vital in reducing shortages. [ABSTRACT FROM AUTHOR]

Background. Severe challenges in recruiting and retaining healthcare workers exist on a global level and are especially noticeable in elderly care services. Previous studies have not assessed how the attractiveness of a job is related to wellbeing at work among licensed practical nurses (LPNs) even though these professionals are vital in providing care to the elderly. Objective. The purpose of this study is to define factors that affect LPNs' attractiveness of work and wellbeing at work. Design. A cross‐sectional survey study. Participants. A large‐scale nationwide sample of 10 848 licensed practical nurses (LPNs) working in Finland. Methods. An online survey for LPNs working in Finland was conducted. Criteria for a good workplace (CFGW), measuring the attractiveness of work and wellbeing at work, were utilized. Descriptive and comparative analyses were performed. Cronbach's alpha values were tested to assess internal consistency (α = 0.739–0.915). An ANOVA or t‐test result which indicated a statistically significant between‐group difference (which was in line with difference ≥0.1) was considered as both statistically significant and significant in practice. Results. The core group, LPNs' wellbeing at work (m = 4.36), is extremely important factor of attractiveness of work. Regarding the subgroups high quality of care (m = 4.61), reconciling of work and private life (m = 4.59) and well‐functioning practices (m = 4.55) were most important. Well‐functioning practices associated with several background variables, e.g., with working for full‐time (p ≤ 0.001, mean = 3.10) and age (p < 0.001). LPNs over 56 years old, especially, regard well‐functioning practices important (p = 3.17). LPNs' who were 56 years old or older (m = 3.12) and those who had work experience 1 year or less (m = 3.19) stated rewarding work most important. Conclusions. The core group, wellbeing, is an exceptionally important for the LPNs attractiveness of work. The LPNs' wellbeing at work is supported by the quality of care and reconciliation of work and private life. [ABSTRACT FROM AUTHOR]

Background: COVID-19 deaths in nursing homes accounted for 30.2% of all COVID-19 deaths in the United States during the early weeks (1-January to 26-July, 2020) of the pandemic. This study presents the geographic diffusion of COVID-19 cases and deaths in nursing homes during this time period, while also providing explanation of regional risk factors. Methods and findings: Nursing home COVID-19 data on confirmed cases (n = 173,452) and deaths (n = 46,173) were obtained from the Centers for Medicare and Medicaid Services. Weekly COVID-19 case counts were spatially smoothed to identify nursing homes in areas of high COVID-19 infection. Bivariate spatial autocorrelation was used to visualize High vs. Low-case counts and related deaths. Zero-inflated negative binomial models were estimated within Health and Human Service (HHS) Regions at three-week intervals to evaluate facility and area-level risk factors. The first reported nursing home resident to die of COVID-19 was in the state of Washington on 28-February, 2020. By 24-May, 2020 there were simultaneous epicenters in the Northeast (HHS Regions 1 and 2) and Midwest (HHS Region 5) with diffusion into the South (HHS Regions 4 and 6) from 15-June to 5-July, 2020. The case-fatality rate was highest from 25-May to 14-June, 2020 (30.9 deaths per 1000 residents); thereafter declining to 24.1 (15-June to 5-July, 2020) and 19.4 (6-July to 26-July, 2020) (overall case-fatality rate 1-January to 26-July = 26.6). Statistically significant risk factors for COVID-19 deaths were admission of patients with COVID-19 into nursing homes, staff confirmed infections and nursing shortages. COVID-19 deaths were likely to occur in nursing homes in high minority and non-English speaking neighborhoods and neighborhoods with a high proportion of households with disabilities. Conclusions: Enhanced communication between HHS regional administrators about "lessons learned" could provide receiving state health departments with timely information to inform clinical practice to prevent premature death in nursing homes in future pandemics. [ABSTRACT FROM AUTHOR]

The nurse scheduling problem (NSP) has been a crucial and challenging research issue for hospitals, especially considering the serious deterioration in nursing shortages in recent years owing to long working hours, considerable work pressure, and irregular lifestyle, which are important in the service industry. This study investigates the NSP that aims to maximize nurse satisfaction with the generated schedule subject to government laws, internal regulations of hospitals, doctor-nurse pairing rules, shift and day off preferences of nurses, etc. The computational experiment results show that our proposed hybrid metaheuristic outperforms other metaheuristics and manual scheduling in terms of both computation time and solution quality. The presented solution procedure is implemented in a real-world clinic, which is used as a case study. The developed scheduling technique reduced the time spent on scheduling by 93% and increased the satisfaction of the schedule by 21%, which further enhanced the operating efficiency and service quality. [ABSTRACT FROM AUTHOR]

Objective Design Setting Participants Results Conclusion There is a shortage of nurses, Aboriginal Health Practitioners, GPs and other staff in remote Australian health clinics. There is also high turnover of staff, leading to questions of ‘who’ is appropriate for remote First Nations practice? The aim of this paper was to identify the characteristics of staff who are likely to work well in remote First Nations settings, from the perspectives of remote health practitioners.This is a qualitative study involving content analysis of interviews.The study is conducted in and with 11 Aboriginal Community Controlled Health Services across northern and central Australia.Eighty‐four staff working in these clinics who spoke about staff qualities suited to remote practice.Participants identified a range of qualities desirable in remote practitioners, which were grouped into three topics: (1) professional qualifications and experience, including cultural skills; (2) ways of working, including holisitic approach, resilience, competence, and being a team player, approachable, flexible and hard‐working; and (3) specific community needs, namely the need for local First Nations staff, male practitioners and returning short‐term staff. The combination of experiences, ways of working, and fit to both the team and community were emphasised.Identifying the characteristics of staff who are likely to work well in these settings can inform recruitment strategies. This study found that a combination of professional qualifications, skills and experience as well as ways of working, individual characteristics and needs of communities are desirable for working in remote, First Nations settings. [ABSTRACT FROM AUTHOR]

Succession planning is a commonly employed term in business strategy, referring to the systematic process of transferring leadership responsibilities to another employee to ensure the seamless continuity of an organization's operations. Today, this concept has acquired importance in various industries, including healthcare, with a specific focus on nursing. Several factors led nurse managers to consider preparing potential leaders for primary leadership roles due to the shortage of nurses, significantly impacting healthcare services and patient safety. Because of the importance of this topic, this present bibliometric analysis aims to analyze research studies conducted on succession planning and leadership development in nursing from 2000 to 2023 to identify research trends, key themes, and the evolution of research during this period. The Elsevier Scopus database was utilized for this analysis. This methodology identified (n = 326) journal studies based on the predefined keywords and timeframe. The data derived from this bibliometric analysis offers a robust foundation for conducting a systematic review, enabling a comprehensive synthesis and evaluation of the evidence in this significant field of study. [ABSTRACT FROM AUTHOR]

Background: The global shortage of nurses is a pressing issue affecting healthcare quality and patient outcomes. Nurse turnover is driven by work-related stress, and job dissatisfaction is persistent. In Saudi Arabia, many diploma-prepared nurses need more bridging programs to convert their diplomas into bachelor's degrees. Educational and organizational issues can limit the provision of quality nursing care. Differences in educational preparation influence nurses' interpretations of patient safety and their roles within healthcare systems. Addressing the need for more policies and regulations regarding nurse turnover and the retention of diploma-prepared nurses is crucial. Thus, a comprehensive exploration of barriers and incentives for diploma-prepared nurses to complete their Bachelor of Science in Nursing (BSN) can lead to transformative institutional strategies, such as tuition compensation and clinical-academic collaborations. This study aims to fill this gap by understanding the current challenges, future trends, and solutions from stakeholders' perspectives and developing tailored career pathways for diploma-prepared Nurses from the stakeholders' perspective. Thus, it contributes to policy development and improved healthcare delivery and fosters a promising future for healthcare. Methods: This qualitative study employed a thematic analysis and grounded theory methodology as we delved into stakeholders' perspectives to generate a substantive framework for overcoming obstacles and cultivating tailored career pathways for diploma-prepared nurses. A purposive sampling technique was used to choose participants, ensuring their rich, relevant, and diverse information based on their expertise, experience, and ability to provide valuable insights. Data were collected using one-on-one semi-structured questions for in-depth interviews. Results: Our findings revealed key concepts that were evident in the data. These concepts formed three main themes and several subthemes essential to understanding the current status of, challenges faced by, and career pathways for diploma-prepared nurses. The three main themes have emerged, and core categories have emerged under each theme accordingly. The results generated a practical framework, offering tangible solutions to overcome challenges and develop career pathways for diploma-prepared nurses. Conclusions: The findings significantly affect policy development and healthcare delivery improvement. This suggests the need for policies that support diploma-prepared nurses in completing their BSN and the development of tailored career pathways that align with their educational background and career goals and the Kingdom's 2030 Vision. [ABSTRACT FROM AUTHOR]

Background: Nursing shortages are an ongoing concern for neonatal units, with many struggling to meet recommended nurse to patient ratios. Workforce data underlines the high proportion of neonatal nurses nearing retirement and a reduced number of nurses joining the profession. In order to recommend strategies to increase recruitment and retention to neonatal nursing, we need to understand the current challenges nurses are facing within the profession. The aim of this study is to investigate current job satisfaction, burnout, and intent to stay in neonatal nursing in England and Wales. Methods: This study has two parts: (1) a systematic review exploring job satisfaction, burnout and intent to stay in neonatal nursing, and any previous interventions undertaken to enhance nurse retention, (2) an online survey of neonatal nurses in England and Wales exploring job satisfaction, burnout and intent to stay in neonatal nursing. We will measure job satisfaction using the McCloskey Mueller Satisfaction Scale (MMSS), burnout using the Copenhagen Burnout Inventory (CBI) and the Nurse Retention Index (NRI) will be used to measure intent to stay. All nurses working in neonatal units in England and Wales will be eligible to participate in the nursing survey. Discussion: Retention of neonatal nurses is a significant issue affecting neonatal units across England and Wales, which can impact the delivery of safe patient care. Exploring job satisfaction and intent to stay will enable the understanding of challenges being faced and how best to support neonatal nurses. Identifying localised initiatives for the geographical areas most at risk of nurses leaving would help to improve nurse retention. [ABSTRACT FROM AUTHOR]