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Aims and objectives: The purpose of this study was to examine the extent to which staffing adequacy predicts nursing teamwork, controlling for demographic and background variables. Background: Findings from former studies indicate that hospital, unit and staff characteristics may be related to nursing teamwork, such as type of hospital and unit, role, gender, age, work experience, type of shift worked, shift length, number of working hours per week, overtime and staffing adequacy. Teamwork as well as staffing is identified as significant contributors to patient and staff safety in hospitals. However, the contribution of staffing to the quality of nursing teamwork is scarcely studied. Design: This was a quantitative descriptive cross‐sectional study using the paper‐and‐pencil questionnaire Nursing Teamwork Survey‐Icelandic. Methods: The study was conducted in 27 inpatient units in eight hospitals in Iceland with a sample of 925 nursing staff members. Participants were 567 registered nurses, practical nurses, unit secretaries and nurse unit managers. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used for this paper. Results: When controlling for unit type, role, experience on current unit and intent to leave, perceived adequacy of staffing alone explains up to 10% of overall teamwork. Unit type, role, years of experience on current unit and perceived staffing adequacy correlated significantly with overall teamwork. Conclusions: The findings of this study indicate that unit and staff characteristics, including perceived adequacy of staffing, are associated with and explain the variability in nursing teamwork on inpatient hospital units. The findings of this study provide important information for clinical nurses, nurse managers, policymakers and instructors in health care. Relevance to clinical practice: The findings underline the importance of adequate staffing for nursing teamwork in inpatient hospital units. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to validate measures of professional self-efficacy for detecting and responding to child abuse and neglect presentations, and then evaluate a clinical training programme for health professionals in a tertiary-level hospital in Vietnam.Design/methodology/approach A prospective, cohort design was used and professional self-efficacy was measured immediately prior to, and shortly after, training 116 nurses and doctors in emergency settings. Longer-term follow-up was measured six months later.Findings Linear mixed modelling showed that there was a statistically significant improvement in efficacy expectations for both suspected and known cases of child abuse and neglect between the pre- and post-test measures at zero and six weeks. These improvements did not persist to the six-month follow-up.Research limitations/implications The training succeeded in improving detection and clinical response to child abuse and neglect presentations but not faith in the provision of ongoing support for children and families.Practical implications Practice change in emergency settings in Vietnam can be achieved using a sustainable theoretically driven training programme.Social implications Building the capacity of health professionals to respond to cases of child abuse and neglect relies on the strength of the community and support services within which the hospital is located.Originality/value Measures of self-efficacy expectations and outcome expectations for responding to child abuse and neglect presentations in emergency settings in Vietnam are now validated. [ABSTRACT FROM AUTHOR]

To identify the patient classification systems used to classify nursing intensity in the assessment of nursing staffing resources currently used in home health care, with a special emphasis on validity, reliability and staff allocation. Scoping review of internationally published and grey literature, based on a methodological framework by Arksey and O'Malley. Searches of the electronic databases Cinahl, Medline, Embase and SweMed, the websites Google and Google Scholar and hand searches of reference lists occurred. Eligibility criteria included (A) a focus on patient classification systems measuring nursing intensity and workload in home health care and (B) published in English between January 2007 and March 2019. In level one testing two team members screened titles and abstracts, in level two testing two team members determined which papers should undergo a full text review. Data were extracted using structured extraction by one team member and verified by two other members. Thirteen peer-reviewed articles and grey literature documents were identified, from Canada, Ireland, the UK, the USA, Scotland, Turkey and the Netherlands. Four patient classification systems had been tested for both validity and reliability. Validity was tested through face validity, predictive validity, concurrent validity or content validity index. Reliability was tested through stability, internal consistency, observer agreement or inter rater reliability. One patient classification system had been tested only for reliability, through interrater reliability and observer agreement. Two patient classification systems had been evaluated through summative evaluation; one qualitatively through focus group interviews and one through semi-structured interviews. Only one patient classification system had been validity and reliability tested and evaluated. Overall, the patient classification systems in the included papers (13) were considered to have benefits and to be appropriate for the measurement of patients' needs, workload and allocation of staff, although specific information was not always given. Little has been published on validity or reliability tested patient classification systems linked to staffing allocation in home health care in the past decade. Limited research was seen where a patient classification system was considered to be fully operational in home health care. [ABSTRACT FROM AUTHOR]

Aims and objectives. This paper is a report of a study conducted to investigate differences between nurse practitioners' perceptions of the importance of required competencies and their self-evaluated existing competencies, and the main factors influencing these differences. Background. The difference between nurse practitioners' perceptions of required competencies and their existing competencies has never been investigated. Therefore, it is still uncertain whether these two competencies differ. Design. A nationwide survey study was authorised by the Department of Health (DOH) in Taiwan. Methods. For this nationwide survey study, the Questionnaire of Competencies in the Nurse Practitioner's Role was mailed to all nurse practitioners who qualified for the first annual national NP licence exam in Taiwan. Of 582 questionnaires distributed, 374 valid questionnaires were returned for a response rate of 64·2%. Results. The scores for required competencies were all higher than existing competencies. The competencies with largest differences were (in increasing order) clinical research, direct care, and leadership and reform. The competencies with smallest differences were (in ascending order) medical assistance, communication and coordination, and ethical decision-making. Differences in the total score between required and existing competencies were significantly influenced by nurse practitioners' age, seniority as nurse practitioner, whether the nurse practitioners' institution had a nurse practitioner advancement system, and the number of patients under their care. Conclusions. Nurse practitioners' perceptions of the importance of their expected role competencies were significantly greater in most cases than their actual competencies. Relevance to clinical practice. These findings could serve as a reference to improve cultivation of the NP system in Taiwan, to strengthen professional competencies in NP training programs. [ABSTRACT FROM AUTHOR]

senneseth m., alsaker k. & natvig g.k. (2012) Health-related quality of life and post-traumatic stress disorder symptoms in accident and emergency attenders suffering from psychosocial crises: a longitudinal study. Journal of Advanced Nursing 68(2), 402-413. Abstract Aims. This paper is a report of a study of health-related quality of life and post-traumatic stress disorder symptoms in patients attending an Accident and Emergency department because of psychosocial crises. Background. Psychosocial crises are commonplace globally, but there is little knowledge about patients attending Accident and Emergency departments because of psychosocial crises. Methods. Data were collected at an Accident and Emergency department in Norway from September 2008 to June 2009. A total of 99 adults participated in the baseline study and 41 of these participated at 2 months follow-up. The Short Form-36 Health Survey and the Post Traumatic Symptom Scale were used to obtain data. Findings. Participants reported significantly lower scores in all health-related quality of life domains at baseline compared with the general Norwegian population. The mental health score was two standard deviations below the norm. Health-related quality of life scores were improved and post-traumatic stress disorder symptoms were reduced after 2 months. High levels of post-traumatic stress disorder symptoms were reported by 78% of the participants at baseline and 59% at follow-up. Participants with high levels of post-traumatic stress disorder symptoms at follow-up also reported low health-related quality of life scores. Conclusion. This study suggests a need for an acute psychosocial intervention and an opportunity to receive follow-up support at Accident and Emergency departments. [ABSTRACT FROM AUTHOR]

HALKETT G.K.B., COX J., ANDERSON C. & HEARD R. (2012) European Journal of Cancer Care 21, 31-40. Establishing research priorities for Australian radiation therapists: what patient care priorities need to be addressed? Much of the research conducted in radiotherapy focuses on technology advances; however, research may also be warranted in the area of patient care. The aims of this paper are to (1) identify patient care-related research priorities in radiation therapy and (2) describe similarities and differences in radiation therapists' responses to research priorities related to patient care by subgroups revealed through cluster analysis. A Delphi process was used, examining problems in research that radiation therapists face. Three hundred and seventy-four problems were identified. These were translated into 53 research areas which were then prioritised. Participant subgroups were identified using a hierarchical cluster procedure. Agreement and disagreement between subgroups for the subscale of 'Patient Care' were analysed with ANOVA and post hoc Scheffe multiple comparisons. The three subgroups had varying degrees of research interest in patient care. The groups agreed on the importance of research in relation to patient care in reducing and managing side effects, patient education and support, and treatment techniques. However, there was disagreement about the importance of conducting research into the role of radiation therapists, radiation therapists communicating and educating patients, and psychosocial support. Further research is warranted to determine radiotherapy patients' priorities and improve evidence-based practice. [ABSTRACT FROM AUTHOR]

meyer k., bjørk i.t. & eide h. (2012) Intensive care nurses' perceptions of their professional competence in the organ donor process. Journal of Advanced Nursing 68(1), 104-115. Abstract Aims. This paper is a report of a study that explored Norwegian intensive care nurses' perceptions of their professional competence to identify educational needs in the organ donor process. Background. Intensive care professionals are requested to consider organ donation each time they care for patients with severe cerebral lesion to ensure donor organs for transplantation. The donor process challenges intensive care nurses' professional competence. Nurses' knowledge and experience may influence their professional competence in caring for organ donors and their relatives. Methods. A cross-sectional survey was conducted in all 28 Norwegian donor hospitals between October 2008 and January 2009. Intensive care nurses ( N = 801) were invited to participate and the response rate was 71·4%. Dimensions of professional competence, learning needs and contextual and demographic variables were explored. Data were analysed using descriptive and inferential statistics. Findings. Few intensive care nurses had extensive experience of or competence and training in organ donation. Nurses working at university hospitals had more experience, but lesser training than nurses in local hospitals. Experience of donor acquisition had an impact on intensive care nurses' perceptions of their professional competence in the donor process. Discussions on the ward and educational input were seen as important for the further development of professional competence. Conclusion. Training provided by experienced colleagues and a culture that encourages discussion about aspects of the donor process can develop nurses' professional competence and communally defined professional practice. Educational input that cultivates various types of knowledge can be beneficial in organ donation. [ABSTRACT FROM AUTHOR]

dickinson t. & hurley m. (2012) Exploring the antipathy of nursing staff who work within secure healthcare facilities across the United Kingdom to young people who self-harm. Journal of Advanced Nursing 68(1), 147-158. Abstract Aims. This paper is a report of a study that compared relevant attitudinal dimensions of Registered Nurses and nursing aides working within a Young Offenders' Institute and two young people's forensic units in the United Kingdom towards young people in their care who self-harm. Background. Nurses caring for young people within secure environments may engage at some point with patients who harm themselves. These staff often experience strong negative emotional reactions which can lead to antipathy and alienation. Methods. Forty seven Registered Nurses and 22 nursing aides completed the Self-Harm Antipathy Scale, which consists of 30 attitudinal self-report items. The data were collected between June 2008 and December 2008, and analysed using spss version 17. Results. Results displayed that age per se, length of service with self-harming clients, and whether the participant was a Registered Nurse or nursing aide, and number of self-harming clients worked with did not influence the Self-Harm Antipathy Scale score or any of its component sub-scores. However, field of nursing the nurse was registered under, previous study of self-harm, year first registered and gender showed significant effects. Conclusions. Given that responses reflect a degree of both empathy and apathy it seems that there is a need to promote greater therapeutic alliances and communication; for example, the use of positive regard to help reduce the incidence of labelling and the negative effects this has upon relationships. There is a significant need for nursing staff working with young people who self-harm to have access to relevant educational programmes. A focus on harm minimization could be key areas for further development. [ABSTRACT FROM AUTHOR]

Aims and objective. The goal of this paper was to evaluate the reliability and validity of the Nursing Work Index-Revised - Brazilian version (B-NWI-R). Background. Some instruments evaluate the presence of certain characteristics in the professional practice environment of nurses. Among them, the B-NWI-R, often cited in the literature and which is examined in the present study. This instrument is composed of 57 items and four subscales: autonomy, control over the work environment, nurse-physician relationships and organisational support. Design. A cross-sectional research design was carried out in three public university hospitals in the State of São Paulo, Brazil. Methods. The sample was composed of 278 nurses. The reliability of the instrument was evaluated through its homogeneity, using the Cronbach's alpha coefficient. The validity of the subscales of the B-NWI-R was evaluated through divergent construct validity and criterion-related validity. For the divergent construct validity, the Brazilian version of the Maslach Burnout Inventory (MBI) was employed, while for the criterion-related validity, variables such as 'satisfaction at work', 'perception of quality of care' and 'nurses' intention to leave work in the following year' were considered. Results. The results showed satisfactory consistency for the total of the items ( α = 0·95) and for the subscales of the B-NWI-R: 'control over practice settings' ( α = 0·75); 'nurse-physician relationships' ( α = 0·75); 'organisational support' ( α = 0·75) and 'autonomy' ( α = 0·63). The divergent validity resulted in significant correlation between the adapted instrument subscales and those of the MBI. In addition, a significant correlation was obtained between the subscales of the B-NWI-R and the variables 'perception of quality of care', 'satisfaction at work' and 'intention to leave work in the following year'. Conclusion. The reliability and validity of the B-NWI-R have been established. Relevance to clinical practice. The B-NWI-R subscales can be used to assess the nurses' perceptions of the work environment. [ABSTRACT FROM AUTHOR]

salanova m., lorente l., chambel m.j. & martínez i.m. (2011) Linking transformational leadership to nurses' extra-role performance: the mediating role of self-efficacy and work engagement. Journal of Advanced Nursing 67(9), 2256-2266. Abstract Aims. This paper is a report of a social cognitive theory-guided study about the link between supervisors' transformational leadership and staff nurses' extra-role performance as mediated by nurse self-efficacy and work engagement. Background. Past research has acknowledged the positive influence that transformational leaders have on employee (extra-role) performance. However, less is known about the psychological mechanisms that may explain the links between transformational leaders and extra-role performance, which encompasses behaviours that are not considered formal job requirements, but which facilitate the smooth functioning of the organization as a social system. Methods. Seventeen supervisors evaluated nurses' extra-role performance, the data generating a sample consisting of 280 dyads. The nurses worked in different health services in a large Portuguese hospital and the participation rate was 76·9% for nurses and 100% for supervisors. Data were collected during 2009. A theory-driven model of the relationships between transformation leadership, self-efficacy, work engagement and nurses' extra-role performance was tested using Structural Equation Modelling. Results. Data analysis revealed a full mediation model in which transformational leadership explained extra-role performance through self-efficacy and work engagement. A direct relationship between transformational leadership and work engagement was also found. Conclusion. Nurses' supervisors with a transformational leadership style enhance different 'extra-role' performance in nurses and this increases hospital efficacy. They do so by establishing a sense of self-efficacy but also by amplifying their levels of engagement in the workplace. [ABSTRACT FROM AUTHOR]

suhonen r., papastavrou e., efstathiou g., lemonidou c., kalafati m., da luz m.d.a., idvall e., berg a., acaroglu r., sendir m., kanan n., sousa v.d., katajisto j., välimäki m. & leino-kilpi h. (2011) Nurses' perceptions of individualized care: an international comparison. Journal of Advanced Nursing 67(9), 1895-1907. Abstract Aim. This paper is a report of a study of internationally-based differences in nurses' perceptions of individualized care in orthopaedic surgical in-patient wards. Background. Individualized care is valued in healthcare policy, practice and ethical statements as an indicator of care quality. However, nurses' assessments of individualized care are limited and comparative cross-cultural studies on individualized nursing care are lacking. Methods. A descriptive comparative survey was used to sample orthopaedic surgical nurses ( n = 1163) working in 91 inpatient wards in 34 acute hospitals in Finland, Cyprus, Greece, Portugal, Sweden, Turkey and the United States of America. Data were collected between March and November 2009 using the Individualized Care Scale-Nurse and analysed using descriptive and inferential statistics. Results. Nurses in different countries perceived that they supported patients' individuality generally and provided individualized care during nursing activities. Although the highest scores were in support of patients' individuality in the clinical situation both through nursing provision and nurses' perceptions of individuality, there were between-country differences within these scores. Generally, the Greek and American nurses gave the highest scores and the Turkish, Cypriot and Portuguese nurses the lowest. Conclusions. Between-country differences found may be attributed to differing roles of nurses, care processes, healthcare systems and/or the ways nursing care is defined and organized. As this was the first time the Individualized Care Scale-Nurse was used in an international context, the results are formative and indicate the need to continue studies in this area. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a descriptive study of nurses' and midwives' clinical leadership development needs. Background. Nurses and midwives are expected to fulfil a leadership role at all levels, yet efforts to strategically support them are often unfocused. An analysis of clinical leadership development needs can provide the foundation for leadership initiatives to support staff. Method. A mixed methods design was used. A questionnaire was sent to 911 nurses and midwives and 22 focus groups comprising 184 participants were conducted. Data were collected between March and June 2009 across all promotional grades of nurses and midwives in Ireland. Repeated measures ANOVA with Greenhouse-Geisser adjustment was used for post hoc pair wise comparisons of the subscale dimensions of clinical leadership. ANOVA with Tukey's post hoc method was used for comparison between grades on each individual subscale. Thematic analysis was undertaken on the focus group data. Results. Results reveal that needs related to development of the profession were the highest for all grades. The staff grade expressed a higher need in relation to 'managing clinical area', 'managing the patient care' and 'skills for clinical leadership' than managers. Qualitative analysis yielded five themes; (1) clinical leadership and leaders from a nursing and midwifery perspective; (2) quality service from a nursing and midwifery perspective; (3) clinical leaders' roles and functions; (4) capital and (5) competences for clinical leaders and leadership and the context of clinical leadership. Conclusion. Clinical leadership concerns quality, safety and effectiveness. Nurses and midwives are ideally placed to offer the clinical leadership that is required to ensure these patient care outcomes. Development initiatives must address the leader and leadership competencies to support staff. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a study of psychometric properties of the Problem-Focused Style of Coping-Chinese version questionnaire. Background. Coping with stress is an important topic in the 21th century, which deserves further attention. Although a variety of instruments have emerged to assess an individual's coping responses to stress, research suggests that numerous problems are associated with the current measurements. Since most coping scales are criticized as lacking valid estimates across occupational samples and cultures, there is an immediate need to develop a reliable and valid coping-style scale. Method. The study used a convenience sample and a sampling frame consisting of 307 nurses from different medical units in two regional hospitals in Taiwan. The data collection period was from May 2009 to June 2009. Exploratory factor analyses and reliability estimates were calculated. Results. The factor analysis revealed three coping factors: reflective, suppressive and reactive. All reliability and validity estimates were satisfactory. Conclusion. The Problem-Focused Style of Coping-Chinese version questionnaire is a valid and reliable measure of nurses' dispositional coping style and can be used for educational training programmes to enhance nurses' stress management skills. [ABSTRACT FROM AUTHOR]

This paper presents the preliminary descriptive findings from an online survey commissioned by the Royal College of Nursing to ascertain members' perceptions of spirituality and spiritual care. There is a professional requirement for nurses to achieve competence in the delivery of spiritual care and to assess and meet the spiritual needs of their patients. Recently, the area of spirituality has come under criticism bringing into question the role of the nurse with regard to the provision of spiritual care. A descriptive online survey was conducted with all Royal College of Nursing members to obtain their perceptions of spirituality and spiritual care in an attempt to identify what action they feel is required with regard to this aspect of nursing practice. An online survey consisting of a five-part questionnaire was developed incorporating the Spirituality and Spiritual Care Rating Scale. Members were asked to complete the survey during a three-week period in March 2010. Overall, 4054 Royal College of Nursing members responded, making this probably the largest UK survey ascertaining nurses' perceptions of spirituality and spiritual care. Descriptive statistics, frequencies and percentages were used to identify key findings. A Cronbach's alpha of 0·80 was obtained for the Spirituality and Spiritual Care Rating Scale. The preliminary analysis confirms that nurses across the full health economy in the United Kingdom consider spirituality to be a fundamental aspect of nursing. The findings indicate that nurses recognise that attending to the spiritual needs of patients enhances the overall quality of nursing care. However, despite all the attention given to the spiritual dimension, the majority of nurses still feel that they require more guidance and support from governing bodies to enable them to support and effectively meet their patients' spiritual needs. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a descriptive comparative pilot study of use of a method that simultaneously tests the content validity and quality of translation of English-to-Chinese translations of two patient satisfaction questionnaires: the La Monica-Oberst Patient Satisfaction Scale and Hospital Consumer Assessment of Healthcare Providers and Systems. Background. Patient satisfaction is an important indicator of the quality of healthcare services. In China, however, few good translations of patient satisfaction instruments sensitive to nursing services exist. Methods. The descriptive pilot study took place in 2009 and used content validity indexing techniques to evaluate the content, context and criterion relevance of a survey question. The expert raters were 10 nursing faculty and 10 patients who evaluated the two patient satisfaction questionnaires. The experts evaluated the relevance of each item on a scale of 1-4 and the research team compared their responses to choose the most appropriate. Only the nurse faculty experts, who were bilingual, evaluated the quality of the translation using a binary rating. Results. The 'Nurse Rater' relevance scores of the LaMonica-Oberst Patient Satisfaction Scale and the Hospital Consumer Assessment of Healthcare Providers and Systems were 0.96 and 0.95 respectively, whereas the patient's overall relevance scores were 0.89 and 0.95. A Mann-Whitney U-test demonstrated that results between the two groups were statistically significantly different (P = 0.0135). Conclusions. Using content validity indexing simultaneously with translation processes was valuable for selecting and evaluating survey instruments in different contexts. [ABSTRACT FROM AUTHOR]

This UK-based empirical research investigates interprofessionalism and personalization to assess their potential to achieve quality care provision for people with long-term conditions. Governmental policies extol the virtues of interprofessionalism and personalization to drive modernization forward, however, change requires the commitment of health and social care professionals. Therefore the complexity of turning policy into practice requires continual review to ensure policy ideals become practice realities rather than speculative rhetoric. This paper examines interprofessional working (IPW) and interprofessional education (IPE) by analysing the experiences and working relationships of professionals from different professions and their potential impact upon personalization initiatives. The conclusion argues that educational providers and professional awarding bodies need to enshrine interprofessionalism into curricula and qualification accreditation thereby instilling collaboration intrinsically into care provision. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to (a) to compare hospitalized patients' and nurses' perceptions of the hospital environment, nurse--physician relationships and quality of care; (b) to determine which factors best predict the quality of care from hospitalized patients' and nurses' perspectives; and (c) to assess the relationships among all variables. Background. Quality of care is a function of many factors and includes elements of the hospital environment and nurse--physician relationships. However, comparisons between patients' and nurses' perceptions are relatively limited. Methods. This was a cross-sectional study, and 575 patients and 220 nurses across 13 units completed questionnaires. Data were collected in 2009 and analysed using descriptive statistics, independent t-tests, stepwise regression and path analysis. Results. Overall, patients' mean scores were statistically significantly higher than those of nurses on perception of hospital environment (3.05 vs. 2.65 points), nurse--physician relationships (7.88 vs. 6.53 points) and quality of care (7.91 vs. 6.63 points) (P < 0.001). Both the hospital environment and nurse--physician relationships were statistically significant predictors of quality of care. Path analysis showed that quality of care was affected by the hospital environment, nurse--physician relationships and years of education for patients (P < 0.05). However, for nurses, quality of care was only directly affected by the hospital environment and nurse--physician relationships (P < 0.05). Conclusion. These findings may help nursing leaders to ensure future excellent patient care by helping them to see which areas need improvement. They may also help nursing leaders to develop strategies to meet patients' and nurses' expectations. [ABSTRACT FROM AUTHOR]

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

Aim. This paper is a report of an evaluation of the implementation of nurse prescribing in an acute care hospital in England. Background. At the time of the study, evaluation of nurse prescribing had taken place in community settings, but little was known about its impact and effectiveness in acute care. Although nurse prescribing has permitted doctor-nurse substitution in acute episodic care, some doctors have expressed concerns about patient safety in relation to nurse prescribing. Methods. A mixed methods single-case study was conducted in 2005-06, using purposive sampling. Semi-structured interviews were carried out with 18 hospital staff, non-participant observation of two nurses and two doctors undertaking 52 patient-prescriber consultations with 47 patients, and a questionnaire survey with 122 patients (response rate 61%: n = 74). Results. Nurse prescribing was found to benefit patients through service delivery improvement and using staff skills differently. Nurse prescribers and their colleagues were positive about role and service changes and their impact on patient care. No differences were found between the ways in which nurses and doctors performed prescribing roles, but there was a statistically significant difference between the medication-related information satisfaction ratings of patients who had seen a nurse prescriber, compared to those seen by a doctor. Conclusion. Nurses and doctors were found to provide equivalent care. Shared vision, local champions, action learning and peer support were the enabling factors that helped to embed the new prescribing roles within the study site. [ABSTRACT FROM AUTHOR]

gardner g., gardner a., middleton s., della p., kain v. & doubrovsky a. (2010) The work of nurse practitioners. Journal of Advanced Nursing 66(10), 2160–2169. Aim. This paper is a report of a study of variations in the pattern of nurse practitioner work in a range of service fields and geographical locations, across direct patient care, indirect patient care and service-related activities. Background. The nurse practitioner role has been implemented internationally as a service reform model to improve the access and timeliness of health care. There is a substantial body of research into the nurse practitioner role and service outcomes, but scant information on the pattern of nurse practitioner work and how this is influenced by different service models. Methods. We used work sampling methods. Data were collected between July 2008 and January 2009. Observations were recorded from a random sample of 30 nurse practitioners at 10-minute intervals in 2-hour blocks randomly generated to cover 2 weeks of work time from a sampling frame of 6 weeks. Results. A total of 12,189 individual observations were conducted with nurse practitioners across Australia. Thirty individual activities were identified as describing nurse practitioner work, and these were distributed across three categories. Direct care accounted for 36·1% of how nurse practitioners spend their time, indirect care accounted for 32·0% and service-related activities made up 31·9%. Conclusion. These findings provide useful baseline data for evaluation of nurse practitioner positions and the service effect of these positions. However, the study also raises questions about the best use of nurse practitioner time and the influences of barriers to and facilitators of this model of service innovation. [ABSTRACT FROM AUTHOR]

rochefort c.m. & clarke s.p. (2010) Nurses’ work environments, care rationing, job outcomes, and quality of care on neonatal units. Journal of Advanced Nursing 66(10), 2213–2224. Aim. This paper is a report of a study of the relationship between work environment characteristics and neonatal intensive care unit nurses’ perceptions of care rationing, job outcomes, and quality of care. Background. International evidence suggests that attention to work environments might improve nurse recruitment and retention, and the quality of care. However, comparatively little attention has been given to neonatal care, a specialty where patient and nurse outcomes are potentially quite sensitive to problems with staffing and work environments. Methods. Over a 6-month period in 2007–2008, a questionnaire containing measures of work environment characteristics, nursing care rationing, job satisfaction, burnout and quality of care was distributed to 553 nurses in all neonatal intensive care units in the province of Quebec (Canada). Results. A total of 339 nurses (61·3%) completed questionnaires. Overall, 18·6% were dissatisfied with their job, 35·7% showed high emotional exhaustion, and 19·2% rated the quality of care on their unit as fair or poor. Care activities most frequently rationed because of insufficient time were discharge planning, parental support and teaching, and comfort care. In multivariate analyses, higher work environment ratings were related to lower likelihood of reporting rationing and burnout, and better ratings of quality of care and job satisfaction. Conclusion. Additional research on the determinants of nurse outcomes, the quality of patient care, and the impact of rationing of nursing care on patient outcomes in neonatal intensive care units is required. The Neonatal Extent of Work Rationing Instrument appears to be a useful tool for monitoring the extent of rationing of nursing care in neonatal units. [ABSTRACT FROM AUTHOR]

Aims and objectives. This paper describes a study that aimed to identify research priorities for the care of infants, children and adolescents at the sole tertiary referral hospital for children in Western Australia. The secondary aim was to stimulate nurses to explore clinical problems that would require further inquiry. Background. Planning for research is an essential stage of research development; involving clinicians in this exercise is likely to foster research partnerships that are pertinent to clinical practice. Nursing research priorities for the paediatric population have not previously been reported in Australia. Design. Delphi study. Method. Over 12 months in 2005–2006, a three-round questionnaire, using the Delphi technique, was sent to a randomly selected sample of registered nurses. This method was used to identify and prioritise nursing research topics relevant to the patient and the family. Content analysis was used to analyse Round I data and descriptive statistics for Round II and III data. Results. In Round I, 280 statements were identified and reduced to 37 research priorities. Analysis of data in subsequent rounds identified the top two priority research areas as (1) identification of strategies to reduce medication incidents (Mean = 6·47; SD 0·88) and (2) improvement in pain assessment and management (Mean = 6; SD 1·38). Additional comments indicated few nurses access the scientific literature or use research findings because of a lack of time or electronic access. Conclusions. Thirty-seven research priorities were identified. The identification of research priorities by nurses provided research direction for the health service and potentially other similar health institutions for children and adolescents in Australia and internationally. Relevance to clinical practice. The nurse participants showed concern about the safety of care and the well-being of children and their families. This study also enabled the identification of potential collaborative research and development of pain management improvement initiatives. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study to investigate the relationships among bone mineral density, demographics, knowledge of osteoporosis, beliefs concerning osteoporosis and preventive behaviours of at-risk females with family histories of osteoporosis. Background. Strong evidence demonstrates that genetics is a significant determinant of peak bone mass, with a heritability of 50–90%. However, few studies have examined the bone mineral density of at-risk females with family histories of osteoporosis, particularly in an Asian population. Design. Telephone survey. Methods. The study population ( n = 2890) was recruited from a radiology department at a national university medical centre in northern Taiwan during 2005–2006. In total, 886 females completed a questionnaire via the telephone; the participation rate was 30·7%. Results. The bone mineral density of at-risk females was close to osteopenia status (T score of −1 to −2·49). Most subjects were aware of osteoporosis-related information; however, few clearly understood osteoporosis. Furthermore, subjects reported difficult implementing strategies to improve bone mineral density. Variation in bone mineral density was correlated with self-rated health ( r = 0·56, p < 0·05), knowledge of osteoporosis ( r = 0·66, p < 0·05) and preventive behaviours ( r = 0·68, p < 0·05). Conclusions. This study is to examine risk factors associated with bone mineral density of females with family histories of osteoporosis. Early identification of risk factors for osteoporosis and development of prevention programmes are required to halt the increasing in the incidence of osteoporosis and improve the bone mineral density of at-risk females. Relevance to clinical practice. Nursing care professionals, who emphasise primary, secondary and tertiary prevention with individuals and families, should develop effective prevention strategies for women with family the history of osteoporosis to protect the health of these vulnerable populations at-risk for osteoporosis. [ABSTRACT FROM AUTHOR]

sun t., zhao x.w., yang l.b. & fan l.h. (2012) The impact of psychological capital on job embeddedness and job performance among nurses: a structural equation approach. Journal of Advanced Nursing 68(1), 69-79. Abstract Aims. The objective of this study was to provide empirical evidence on the relationships between psychological capital, job embeddedness and performance. This paper also seeks to present the theoretical development of psychological capital and job embeddedness in nursing research and their application to nursing practices. Background. Psychological capital was recently identified as a core construct in the literature of positive psychology. However, there is considerably less evidence on its positive effects on job embeddedness and performance among nursing personnel. Methods. Questionnaires were distributed to approximately 1000 nurses employed in five university hospitals in Heilongjiang province in China. Data were collected in November 2009. The response rate was 73·3%. Structural equation modelling was employed to test the proposed relationships. Findings. The results support the hypothesized model. This research outlined a strong relationship between the self-reported psychological capital, job embeddedness and performance of the nurses. The study findings suggest that improving the individual-accumulated psychological state of nurses will have a positive impact on their retention intention and job performance. Conclusions. These findings suggest that higher psychological capital increases the self-reported job embeddedness and performance of these nurses. [ABSTRACT FROM AUTHOR]