Search

ABSTRACT Aims Design Methods Results Conclusions Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To compare nurses' and patients' reports of missed nursing care, explore patients' perspectives and utilise these insights to elucidate discrepancies or congruence between perceptions.A descriptive mixed‐methods design combining quantitative (questionnaires) and qualitative (semi‐structured interviews) methods.In the quantitative phase, 143 nurses and 643 patients completed the MISSCARE and MISSCARE‐Patient surveys. Correlations between their total missed care scores were examined. In the qualitative phase, 68 patients participated in semi‐structured interviews analysed using thematic analysis.The correlation between nurses' and patients' perceptions of missed nursing care was nonsignificant. Qualitative findings revealed three themes: (1) patients' need to preserve individuality; (2) most patients attributed missed care to systemic factors, while some attributed it to nurses' attitudes and (3) emotional responses varied from empathetic understanding, inadvertently enabling more missed care, to frustration and assertiveness to ensure receiving necessary care.This study reveals a significant discrepancy between nurses' and patients' perceptions of missed care. Patient perspectives offer insights into this misalignment, highlighting differences in care priorities and role understanding.Enhancing nurse–patient communication and patient empowerment are crucial. Healthcare institutions should integrate patient feedback into quality initiatives, create supportive work environments and foster a patient‐centred care culture. Effectively marketing nurses' expertise and implementing strategies to manage patient assertiveness are essential.This study addresses the discrepancy in perceptions of missed nursing care between nurses and patients. It reveals how patients' care priorities and attributions influence their experience of missed care. Findings will impact healthcare policymakers, nursing educators and hospital administrators, informing strategies to improve care quality, patient satisfaction and nurse work environments across healthcare settings.The study has adhered to STROBE guidelines for the quantitative component and SRQR guidelines for the qualitative component.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims Design Methods Results Conclusion Implication for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To examine a novel moderated‐mediation model, investigating whether personal accountability moderates the link between nurse workload and missed nursing care and whether missed nursing care mediates the association between workload and moral distress.Nested diary study.Data spanning from February 2019 to February 2023 were collected from 137 nurses working in various inpatient wards in two medium‐sized hospitals. Nurses reported care given to specific patients on three to five occasions across different shifts, establishing nurse‐patient dyads. Validated measures of missed nursing care, personal accountability, moral distress and workload were analyzed using mixed linear models to test the nested moderated‐mediation model.Under high workload conditions, nurses with higher personal accountability reported lower frequencies of missed nursing care compared to those with lower personal accountability. In contrast, under low workload conditions, personal accountability did not significantly influence missed nursing care occurrences. Furthermore, the interaction between workload and personal accountability indirectly affected nurses' moral distress through missed nursing care. Specifically, higher personal accountability combined with lower missed nursing care contributed to reduced levels of moral distress among nurses.The study highlights accountability's dual role—safeguarding against care omissions and influencing nurses' moral distress amid rising workload pressures.Cultivating a culture of accountability within healthcare settings can serve as a protective factor against the negative effects of workload on patient care quality and nurse psychological distress, highlighting the need for organizational interventions to promote accountability among nursing staff.By recognizing accountability's pivotal role, organizations can implement targeted interventions fostering accountability among nurses, including training programs focused on enhancing responsibility/ownership in care delivery and creating supportive environments prioritizing accountability to achieve positive patient outcomes.The study has adhered to STROBE guidelines.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Introduction. Falls among hospitalized patients continue to pose a serious threat to patient safety worldwide. Effective fall-prevention education is considered vital for fall prevention. Nurses' resilience and proactivity may improve the fall-prevention education nurses provide to patients, but how to motivate nurses' proactivity remains unsolved. This study aimed to examine whether (1) nurse's resilience and social capital are jointly associated with nurse proactivity and (2) adherence to procedures further moderates the relationships between nurse proactivity and the fall prevention education provided to patients by the nurse. Methods. A nested (∼3 patients per nurse) cross-sectional observational design has been employed in this study. 101 bedside registered nurses were recruited from fourteen internal and surgical wards at a medium-size hospital. For each nurse, ∼3 of their newly admitted patients were recruited (total of 271 patients). Nurses completed validated questionnaires on personal resilience, social capital, following procedures, and sociodemographic data. Fall-prevention education was assessed via a short-structured interview with patients. Hypotheses were analyzed using the Hayes PROCESS macro. Results. Social capital, nurse resilience, and their interaction were associated with proactive behavior. Proactive behavior, adherence to procedures, and their interaction (β = −0.57, p < 0.01) were associated with patient education for fall prevention given by nurses. The moderated-mediation model was significant under medium and high levels of social capital and low levels of adherence to procedures. Conclusion. The study highlights the importance of nurse proactivity in educating patients about fall prevention, especially when adherence to procedures in the ward is perceived as low. Furthermore, nurses' proactivity can be promoted by nurturing both their resilience and their social capital. Nursing managers should nurture proactivity at the work environment of the 21-century, by fostering resilience and enculturing social capital. Concomitantly, employees should be educated at ways to promote personal resilience and engage in wise proactivity. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to test a moderated-mediation model, explaining how and under which circumstances a process- or an outcome-accountability focus affects performance. Design: Randomized controlled design, using screen-based simulations. Methods: Data were collected during 2021. Two screen-based simulations of medication administration (for low- and high-complexity tasks) were used. Each participant was randomly assigned to one of the six experimental conditions. Nurses completed validated questionnaires on strain levels and their perceptions of the simulated task complexity and accountability focus. Performance was assessed via validated checklists assessing nurses' performance of the simulation. Results: Task complexity significantly moderated the relationship between accountabilityfocus conditions and strain. For the process-accountability-focus condition, strain levels were lower during high-complexity tasks compared with low-complexity tasks, while for the outcome-accountability-focus condition, strain levels were lower during lowcomplexity tasks compared with high-complexity tasks. The highest strain levels were observed under the no accountability-focus condition. Additionally, this interaction had an impact on performance, with nurses' strain playing a mediating role. Conclusions: Any accountability focus reduces strain levels and enhances performance compared with having no accountability focus. The choice of accountability focus should be based on task-complexity considerations. Implications for the Profession and Patient Care: Managers can effectively reduce nurses' strain and improve performance by prioritizing outcome accountability focus for simpler tasks and process accountability focus for complex tasks. Impact: The study addressed previous ambiguous findings regarding the type of accountability focus that better motivates nurses' performance. By considering accountability focus, nurse managers can balance nurses' strain levels with improved performance. Reporting Method: We have adhered to the relevant EQUATOR guidelines: CONSORT. Patient or Public Contribution: There is no patient or public contribution, as the study only concerns the providers of the service, that is the nurses themselves. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To evaluate the relationship between nurse–patient‐initiated participation, nurses' attitudes towards patient's participation, and patients' adherence to treatment. Specifically, to (1) explore nurse–patient participation during haemodialysis and quantify the information into measurable indices; (2) determine the haemodialysis patient's adherence to treatment; (3) describe nurses' attitudes towards patient participation; and (4) establish the relationships between nurse–patient‐initiated participation, nurses' attitudes towards patient participation and patients' adherence to treatment. Background: To improve haemodialysis patients' health, it is crucial to identify nurses' and patients' factors facilitating adherence to treatment. Design: An exploratory‐sequential mixed‐methods (quantitative and qualitative) design. Methods: All nurses working at a dialysis ward (n = 30) and their randomly selected patients (n = 102) participated. Qualitative data on nurse–patient‐initiated participation were derived from transcribed nurse–patient conversations and quantified for further analyses. Nurses' attitudes towards patient participation were collected via questionnaire, and adherence to treatment via observed reduction in prescribed haemodialysis time. [CONSORT‐SPI guidelines]. Results: Content analysis of the conversations indicated that nurse‐initiated participation focused on patient's medical condition, treatment plan and education; while patients initiated more small talk. Non‐adherence to treatment was significant (Mean = 0.19 h; SD = 0.33). Regression analyses indicated that nurses' attitude towards participation was negatively linked to patient adherence, while patient–nurse‐initiated participation was unrelated. Nurses' attitudes towards patient participation moderated the relationship between nurse–patient‐initiated participation and patient adherence: the more positive the attitude towards inclusion the more negative the link between patient or nurse‐initiated participation and patient adherence. Conclusions: The findings provided paradoxical insights: Nurses' positive attitudes towards participation lead them to accept the patient's position for shortening haemodialysis treatment, so that adherence to care decreases. Relevance to clinical practice: Nurses require education on negotiating methods to help achieve patient adherence while respecting the patient's opinion. Patients should be educated how to approach nurses, seeking the information they need. [ABSTRACT FROM AUTHOR]

This study aimed to examine how allied healthcare professionals as informal leaders can lead reforms to improve patient care on an interprofessional team. With 284 interprofessional team members working in 59 geriatric facilities, our findings demonstrated that informal leaders exhibiting more championship behaviors gained higher innovation success scores. In addition, the champion's professional tenure and institutional size were both negatively associated with innovation success. We discuss important implications for this understudied issue in interprofessional team research: how a low-status informal leader can direct reform aimed at improving patient care within a healthcare organization. [ABSTRACT FROM AUTHOR]

Background: Despite calls for interprofessional teamwork to ensure quality care in healthcare settings, interprofessional teams do not always perform effectively. There is evidence that professional stereotypes inhibit effective interprofessional teamwork, but they haven't been explored as a phenomenon that impacts team's performance and quality of care. Objectives: To focus on professional stereotypes emerging in interprofessional teams and examine the contingency effects of interprofessional team's faultlines, professional stereotypes, and leader's championship behaviors on team's quality of care. Methods: A cross-sectional nested sample of 59 interprofessional teams and 284 professionals, working in geriatric long-term-care facilities in Israel. Additionally, five to seven of the residents of each facility were randomly sampled to obtain the outcome variable. Data collection employed a multisource (interprofessional team members), multimethod (validated questionnaires and data from residents' health records) strategy. Results: The results indicated that faultlines are not directly harmful to team's quality of care; instead, they are likely to impact quality of care only when team stereotypes emerge. Furthermore, whereas teams typified by high professional stereotypes require person-oriented championship leadership, for teams typified by low team stereotypes, championship leadership harms the quality of care they provide. Conclusion: These findings have implications for handling interprofessional teams. Practically, leaders must be well-educated to better analyze team members' needs and maintain the appropriate leadership style. [ABSTRACT FROM AUTHOR]

Examines whether principals utilized flexible influence strategies under changing circumstances, based on perceptions of 450 Israeli elementary teachers. Principals acted mainly through an informal, less directive orientation of influence both in ordinary times and in times of change. Principals' leaned toward participatory influence approaches. (Contains 70 references.) (MLH)

Explored the construct of extra-role behavior in schools, examining relationships between extra-role behavior and job satisfaction, self-efficacy, and collective efficacy. Surveys of elementary teachers highlighted three facets of extra-role behavior corresponding to three levels of the school system (student, team, and organization). There were positive relations between job satisfaction and extra-role behavior at all three levels. (SM)

Aim: The aim of this study is to explore ethical dilemmas inherent in two potentially conflicting roles: practising nurse and researcher. Background: Ethical guidelines for practice and research in nursing have been widely discussed. Yet examining ethical dilemmas that emerge from engaging in the dual role of nurse–researcher is rare. Method: A qualitative approach was employed, using semi‐structured interviews with 15 nurse–researchers. Data were analysed using thematic analysis. Results: One theme emerged with three subthemes of nurse–researcher role definitions: primarily nurse, primarily researcher and combined nurse–researcher. Each subtheme had three dimensions: (a) how ethical dilemmas were expressed in encounters with role colleagues, (b) coping strategies and (c) implications for nurse–researchers. Conclusion: Primarily nurses or primarily researchers experienced conflict in encounters with role colleagues, developed less effective coping strategies and reported impaired well‐being. Conversely, combined nurse–researchers said each role nourished the other. Implications for nursing management: Nursing policymakers and managers should support the nurse–researcher role by developing a code of ethics that acknowledges the dual role's inherent dilemmas, assimilate organisational routines and roles that support nursing research and encourage forums for discussing staff dilemmas. [ABSTRACT FROM AUTHOR]

Background: Nurse champions are front-line practitioners who implement innovation and reconstruct policy. Purpose: To understand through a network theory lens the factors that facilitate nurse champions' engagement with radical projects, representing their actions as street-level bureaucrats (SLBs). Materials and methods: A personal-network survey was employed. Ninetyone nurse champions from three tertiary medical centers in Israel participated. Findings: Given high network density, high levels of advice play a bigger role in achieving high radicalness compared with lower levels advice. High network density is also related to higher radicalness when networks have high role diversity. Discussion: Using an SLB framework, the findings suggest that nurse champions best promote adoption of innovation and offer radical changes in their organizations through professional advice given by colleagues in their field network. Healthcare organizations should establish the structure and promote the development of dense and heterogeneous professional networks to realize organizations' goals and nurses' responsibility to their professional employees, patients, and society. [ABSTRACT FROM AUTHOR]

In examining whether a leader's professionalism implies more or fewer helping behaviors for followers, this study designed a model integrating attributional theory explanations with professionalism to predict helping behaviors. Four distinct helping behaviors were conceptualized: supporting, motivating, referral, and rejection. Qualitative methods used in the study consisted of content analysis of interviews with 12 superiors at healthcare organizations concerning their means of helping staff, and the circumstances. Quantitative data were gathered by an experimental design in which four case studies were presented to each of 171 healthcare superiors, who were asked to deal with a distressed staff nurse whose stability and control-lability of the distress were rated either high or low. Superiors' professionalism was assessed. Results indicated that the relationship between professionalism and helping was complex, and critically dependent upon the type of helping behaviors provided, the help provider's professionalism, and attributions of the help seeker's controllability and stability. The qualitative and quantitative results favor attribution explanations, and imply that highly professional superiors provide higher levels of supporting, motivating, and rejecting helping behaviors as means to maintain professionalism of staff.

The present study explored the issue of organizational citizenship behaviour (OCB) as a context-related phenomenon, from a multidimensional perspective. More specifically, it was hypothesized that organizational learning (structures and learning values) would be positively related to (a) OCB that benefited the organization as a whole (OCBO) and (b) OCB that immediately benefited particular individuals (OCBI). The hypotheses identified the school as the unit of analysis; so all variables were aggregates of individual responses to the organizational level of analysis. Justification for aggregation was provided by a within-group similarity index ([r.sub.wg]) and a within- and between-entities analysis (WABA). Results from a sample of 31 schools confirmed the main hypotheses, and generally supported the notion that OCB could be treated as a context-related phenomenon. These results should encourage researchers and practitioners to focus more attention on the organizational context and its characteristics as related to OCB., As working under changing circumstances becomes an essential feature of organizations (Lee, Dedrick, & Smith, 1991), organizations will necessarily become more dependent on individuals who are willing to contribute to [...]

The two studies reported here sought to propose a multidimensional taxonomy for providing social support, and to use an attachment-theory framework to investigate provision of support at work. Additionally, the studies sought to explore the distinct contextual considerations that affect decisions on the type of support provided. In Study 1, case studies were presented to 164 hospital nurses, who, taking the role of the head nurse, were asked to deal with a distressed staff nurse who was either high or low tenured, and whose cause of distress was either personal or job-related. In the second study, 55 nurses with various job tenures described the support behaviors of their superiors. In both studies, support interventions and attachment styles were measured. Results provided partial evidence of the multidimensionality of social support, and indicated that it contains 4 distinct support behaviors: helping, maintenance, referral, and encouragement of self-coping. Furthermore, the distinct support behaviors were affected by different attachment styles and contextual considerations.

Background: The foundation of a safe practice is accountability, especially outcome- rather than process-focused accountability, particularly during pandemics such as COVID-19. Accountability is an essential behavior that promotes congruence between nursing actions and standards associated with quality of care. Moreover, the scant research examining whether one accountability focus is superior in motivating humans to better task performance yields inconclusive results. Aims: Systematically examine the effect of an outcome- vs. process-accountability focus on performance and identify any moderating variables. Design: Systematic review and meta-analysis. Data sources: PsycINFO, Medline, PubMed, Scopus, and CINAHL databases, with all publications to November 2020. Review methods: A systematic search using Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. Statistical analysis and forest plots were performed using MetaXL 5.3. Heterogeneity was presented using I2 statistics and Q tests, and possible publication bias was assessed with a Doi plot and the LFK index. Results: Seven studies representing nine experiments involving 1,080 participants were included. The pooled effect of the nine experiments on task performance failed to show significant differences (mean = −0.09; 95% Confidence Interval [95%CI]: −0.21, 0.03), but a significant moderating effect of task complexity was demonstrated. Specifically, outcome accountability exerts a beneficial effect in complex tasks (mean = −0.48 [95%CI: −0.62, −0.33]) whereas process accountability improves the performance in simpler tasks (mean = 0.96 [95%CI: 0.72, 1.20]). Conclusion: These findings demonstrated that accountability focus by itself cannot serve as a sole motivator of better performance, because task complexity moderates the link between accountability focus and task performance. Outcome accountability exerts a beneficial effect for more-complex tasks, whereas process accountability improves the performance of simpler tasks. These findings are crucial in nursing, where it is typically assumed that a focus on outcomes is more important than a focus on processes. [ABSTRACT FROM AUTHOR]

Aims: To examine nursing students' stress and coping with the coronavirus disease 2019 (COVID‐19) pandemic through an ecological model of resilience. Specifically, to examine the relative contribution of different resilience levels in decreasing nursing students' strain symptoms: at the individual level, resilience trait; at the relational level, students' coping strategies; at the university level, nursing students' perceptions on their university's readiness to handle the virus outbreak; and at the national level, nursing students' trust in policymakers' decisions. Design: The study used a cross‐sectional design. Methods: Undergraduate students of five universities were recruited via an electronic link sent to their emails during the first months of the COVID‐19 outbreak: May–July 2020. Of them, 492 participants completed the research questionnaire. Results: Hierarchical Regression Analysis revealed that nursing students' resilience, as a multi‐level factor, decreased the students' level of strain symptoms above and beyond their stress levels and control variables. Specifically, the nursing students' trait resilience, perceptions of their university's positive response to the pandemic and trust in their national policymakers were negatively associated with their strain symptoms. Conversely, disengagement‐in‐emotion coping strategies was positively associated with the students' strain symptoms. Conclusions: Nursing students' resilience should be seen as a flexible resource that can be developed and influenced by their academic and clinical training, and by the intentions and actions of their university and the nursing administration at the Ministry of Health (MOH). Impact: The findings call for the nursing administration at the MOH and for the university deans and department heads to prepare in advance a crisis plan that could be rapidly and effectively implemented when needed. Furthermore, topics such as developing flexible coping strategies should be integrated into the nursing curricula. These would allow students to prepare and cope better with adversity in their routine and in times of crisis. [ABSTRACT FROM AUTHOR]