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Objectives: to investigate the reasons for low patient safety incident reporting among Indonesian nurses., Methods: this qualitative case study was conducted among 15 clinical nurses selected purposively from a public hospital in Lampung, Indonesia. Interview guidelines were used for data collection through face-to-face in-depth interviews in July 2022. The thematic approach was used to analyze the data., Results: in this present study, seven themes emerged (1) Understanding incident reporting; (2) The culture; (3) Consequences of reporting; (4) Socialization and training; (5) Facilities; (6) Feedback; and (7) Rewards and punishments., Final Considerations: these findings should be considered challenges for the patient safety committee and hospital management to increase patient safety incident reporting, particularly among nurses in the hospital.

Background: This study aimed to investigate the current situation regarding wound care by nurses in eight hospitals in the north of Vietnam, in order to plan the training for nurses to enable them to achieve the National Basic Competency Standards for Nurses., Methods: A cross-sectional descriptive prospective study was conducted from June 2020 to October 2020, with nurses in eight hospitals in four provinces of Northern Vietnam - Hanoi, Quang Ninh, Thai Nguyen and Bac Ninh. Data were collected based on a checklist of direct observation of nurses who provide wound care. The two main indicators were the knowledge score and the practical capacity/competence of the nurses in wound care., Results: A total of 518 nurses participated in the study, the mean age was 32.25±7.31; with 438 (84.6%) being female. Clinical experience of less than 10 years was reported by 63.6%; college education level (diploma) was reported by 58.1%, university level by 28.2%; and post-university level by 4%. The highest mean scores for knowledge were found in the categories of health education for patients, followed by care of clean wounds, communication skills and team work, management and professional development and pressure ulcer wound care. Under the practice domain the highest mean scores were ability to plan wound care, followed by self-evaluation, identification of wound types and implementation of wound care plans., Conclusions and Recommendations: The results showed that when judged against the competency standards, nurses' level of wound care competency needs to be improved. Also that there is a distinct theory-practice gap, which must be addressed. It is recommended that hospitals should conduct training for all nurses using the basic competency standards for Vietnamese nurses to improve the quality of care.

Objective: To understand the role of nurses in field hospitals aimed at patients with Covid-19., Methods: Qualitative research based on Alfred Schütz's social phenomenology. Twenty nurses working in São Paulo were interviewed between May and June 2020. The testimonies were organized and analyzed based on the theoretical-methodological and thematic framework., Results: The following categories emerged: "Nurses' challenges in field hospital care", "Visibility of nursing in the Covid-19 pandemic scenario" and "Covid-19 post-pandemic professional valorization"., Final Considerations: The reflection on the results that emerged in this study may contribute to support improvements in training, working conditions and valuing nurses, considering the importance of this professional category in the scope of health services. New investigations may increase knowledge in the area, providing subsidies for professional role in this and other health situations that require nursing intensity and excellence.

Objective: to describe the health promotion competency domains, performed by nurses, for adolescents, according to the Galway Consensus., Method: a qualitative study based on the Galway Consensus theoretical methodological framework. Fifteen nurses from northeastern Brazil participated. Data were collected between April and May 2017 through pre-structured interviews, submitted to the content analysis technique and analyzed according to the Galway Consensus dimensions., Results: the following competency areas were found: catalyzing changes, leadership, needs assessment, planning, implementation, and partnerships. These competencies were contemplated from embracement of adolescents at health unit, guidance, teamwork, educational activities and lectures, as well as active search., Conclusion: most health promotion domains were observed; however, it is still suggested that there are challenges to an effective performance of health promotion among adolescents because some competency domains in health promotion have not been evidenced.

Background: There is a paucity of Black and minority ethnic group nurse leaders and faculty in the nursing profession, even though the overall number of nurses within this demographic has increased. This study aimed to examine Black nurses' perceptions of the barriers to career advancement in nursing profession in the United States., Procedure: Participants included 30 Black nurses aged 25 to 65 from health care settings across five US states recruited through purposive sampling. The study used a focused ethnographic design with semi-structured interviews to elicit responses about participants perceptions and experiences of seeking leadership and faculty positions., Results: Thematic analysis revealed seven main themes: maintaining white comfort, distrust, no one like me, paving the way, worthy of representation, leadership role not expected of Black nurses, and an advanced degree does not equal advanced opportunities., Conclusion: The findings suggest that Black nurses face significant challenges in entering leadership or faculty positions. They face racial discrimination and lack access to mentorship and support which discourages sufficiently qualified and experienced nurses from applying for high-level positions. Ensuring all nurses are afforded equal opportunity for career advancement is essential for the nursing profession's continued growth., (© 2020 The Authors. Nursing Forum published by Wiley Periodicals LLC.)

Objective: This study intends to analyze how the human condition of the nurse is established in the context of Psychosocial Care Centers (Caps)., Method: theoretical-reflexive study, anchored in three essential parts: 1) Theoretical and philosophical conception of the human condition from Hannah Arendt's perspective; 2) The nurse's work in the Caps; and 3) Human condition to think about the work of the nurse., Results: in the context of the Caps, the work can be represented by the psychic significations; the work, through the production of nurses' practice of care; and the action by the relations established between worker and institution, worker and user., Final Considerations: the understanding of the vita activa allows to reflect on the human condition of the nurse in their work context and (re) considers a better understanding about the impact of the work on the life of these mental health workers in the contemporaneity.

Background: In Taiwan's hospitals, English medical discourse underpins nursing and medical practice. Much patient care work is done through language work, by both text and talk. This means that when nurses start their nursing careers in the hospital context, where English medical discourse is shared to produce knowledge and engage in practice, knowledge of medical discourse and the ability to use it are prerequisites. In the process of learning and using such specialist language, the formation of professional identities is assumed., Objectives: This study aimed to explore nurses' learning journeys relating to medical discourse and the development of their professional identities., Methods: This research adopted a qualitative approach, using data from 10 nurses working in different hospitals in Taiwan., Results: The findings revealed that English medical discourse was employed in Taiwan's hospitals not only for fulfilling professional purposes but also for socialising nurses into the healthcare community. Nurses acquired it through interactions, small talk, relationships, discussions, and nursing tasks. Their professional identities were formed through engaging in meaningful nursing practice based on English medical discourse. However, in the learning process, they encountered difficulties in the areas of listening, speaking, and reading, which raised concerns about patient safety., Conclusion: Sufficient support is needed to ease nurses' difficulties in learning. We propose having primary and secondary preceptors, establishing a mentorship policy, and creating a learning environment that is supportive of nurses' learning experiences., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Care left undone, interchangeably referred to as missed care, unfinished nursing care and task incompletion, is pervasive in contemporary healthcare systems. Care left undone can result in adverse outcomes for the patient, nurse and organization. The rhetoric that surrounds care left undone infers it is a contemporary nursing phenomenon; however, a seventeenth-century Spanish nursing treatise, Instruccion de Enfermeros (Instructions for Nurses), challenges this assumption. Instruccion de Enfermeros was an instructional guide that was written for members of the Congregation of Bernardino de Obregon who worked as nurses at the Madrid General Hospital. The treatise provides a historical commentary on the daily roles, responsibilities and working conditions of the Obregonian nurses. Its content and context suggest the Obregonian nursing resource was consistently time poor due to a confluence of internal and external stressors. Consequently, the Obregonians were under considerable role strain resulting in inferior patient care. This article explores the antecedents of care left undone through a historical lens using exemplars from the 1625 edition of Instruccion de Enfermeros. Factors contributing to care left undone in Obregonian nursing will then be examined to offer insights into the similarities between what a nurse suffered 400 years ago and what exists in contemporary nursing practice., (© 2019 John Wiley & Sons Ltd.)

Background: There is increasing evidence that to improve nursing practice, nurses must embrace lifelong learning. Research indicates that engagement in lifelong learning positively affects the quality of nursing care, improves patient outcomes, and increases nurses' job satisfaction. Both lack of standardized initial education and nurses' limited opportunities for lifelong learning are challenges in Haiti. It is crucial to ensure adequate continuing education in order to support the professional growth and development of Haiti's existing nursing workforce., Objectives: The objectives of this study were to: 1) assess the continuing education nursing needs and desires of practicing Haitian nurses and 2) contribute to the body of knowledge about nursing in Haiti to help inform practice and policy., Methods: A multimodal needs assessment approach was used, with semi-structured focus groups and written surveys. The results were analyzed, and common themes were identified., Findings: The results were analyzed from 100 surveys and four focus groups (n = 33). Overwhelmingly, Haitian nurses desire continuing nursing education. Major themes include: recognition that continuing education is necessary to provide high quality patient care, continuing education saves lives, and more consistent and standardized initial nursing education is needed. Barriers to participation in continuing education opportunities were also identified., Conclusions: This study was one of the first formal studies that addressed continuing education needs of Haitian nurses. By identifying the barriers to important resources, we hope to continue to collaborate with our Haitian nursing colleagues to build curriculum and improve education programs. We also hope that this research will ensure that Haitian nurses voices are heard and will serve to foster change within the Haitian nursing education system. These results were shared with our nurse colleagues in Haiti., Competing Interests: The authors have no competing interests to declare., (© 2019 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.)

Background: The concept of professional commitment is being widely studied at present. However, although it is considered an indicator for the most human part of nursing care, there is no clear definition for it, and different descriptors are being used indiscriminately to reference it., Objective: The aim of this study is to clarify the concept of professional commitment in nursing through the Rodgers' evolutionary concept analysis process., Design: Systematic search using English and Spanish descriptors and concept analysis. Studies published between 2009 and June 2015, front-to-back analysis of the Nursing Ethics journal and manual check of articles cited in studies related to the Nijmegen Professionalism Scale., Research Design: The procedure of concept analysis developed by Rodgers was used., Ethical Considerations: Although the topic was not labeled as sensitive and subject to ethical approval, its realization was approved by the Ethical Committee of Clinical Research of Aragon (CEICA) approved the study on 18 March 2015 and also careful procedures have been followed according to ethics expressed in the Declaration of Helsinki., Findings and Discussion: A total of 17 published studies. A clear definition of the concept was made, and surrogate terms, concept dimension, differential factors related to the concept, sociocultural variations and consequences for nursing practice were identified., Conclusion: There is a need for continuous advancement in the development of the concept, specific actions to encourage this and the improvement of evaluation methods for its study.

A comprehensive understanding of infection prevention and control is essential for nurses when seeking to protect themselves, patients, colleagues and the general public from the transmission of infection. Personal protective equipment (PPE) - such as gloves, aprons and/or gowns, and eye protection - is an important aspect of infection prevention and control for all healthcare staff, including nurses. Its use requires effective assessment, an understanding of the suitability of various types of PPE in various clinical scenarios, and appropriate application. Understanding the role of PPE will enable nurses to use it appropriately and reduce unnecessary cost, while ensuring that the nurse-patient relationship remains central to care. This article defines PPE and its components, outlines when it should be used and details its optimal application., Competing Interests: None declared, (© 2019 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

Aims: To explore the perceptions of Australian nurses working in disability-specific settings and/or roles, about: (a) nursing people with intellectual and developmental disability living in Sydney; and (b) the utility and applicability of professional practice standards designed specifically for intellectual and developmental disability nursing., Design: A qualitative research design was used to guide the study and our analysis utilized the constant comparative approach to thematic data analyses., Methods: Individual in-person interviews were conducted with 18 nurses working in intellectual and developmental disability-specific settings and/or roles across the state of New South Wales between July - December, 2017. Participants described what it is that sets intellectual and developmental disability nursing apart from other nursing specialties, and the rewards and challenges of their role. Questions were also asked about professional practice standards in general and more specifically intellectual and developmental disability professional practice standards. Data were analysed thematically., Findings: Three themes reflected intellectual and developmental disability nurses' perceptions: (a) a unique investment in the nurse/patient dyad; (b) a bridge between disparate systems; and (c) an ambiguous future. Nurses reported variable understanding of professional practice standards designed for intellectual and developmental disability nursing, but also a belief in their importance., Conclusion: The intellectual and developmental disability nurses' experience of care accounts for the specific needs of patients with intellectual and developmental disability and suggests the importance of professional practice standards which acknowledge the changing landscape of care in Australia prompted by the implementation of the National Disability Insurance Scheme., (© 2018 John Wiley & Sons Ltd.)

Compassionate care is fundamental to nursing. However, when delivering compassionate care, the expected emotional state may not always spontaneously arise, risking a dissonance between authentic and displayed emotions. Nurses may therefore be required to engage in some form of emotional regulation strategy, to conform with assumed professional rules on emotional display. In both the dissonance and emotional regulation, there are risks on which nurses need to reflect. In this article, the end of the Trojan War as depicted in Homer's The Iliad and Virgil's The Aeneid is used as an allegory to illustrate the dangers and advantages of using response- or antecedent-focused strategies for emotional regulation. Response-focused strategies are reactive in nature-they could build resilience over time but may leave students and newly qualified nurses feeling exposed. An 'emotional curriculum' to include emotional intelligence in nurse education could equip the students with a more proactive approach to developing resilience rather than defensive practice. Using a narrative as an allegory may help to explore the application of these concepts in nursing practice.

Aims: A meta-analysis was conducted of the prevalence rates of compassion satisfaction, compassion fatigue and burnout to identify the factors influencing these rates., Background: The extents of compassion fatigue and burnout adversely affect nursing efficiency. However, the reported prevalence rates vary considerably., Methods: Data were acquired from electronic databases. Random effects meta-analyses were performed to obtain pooled estimates of the prevalence rates of compassion satisfaction, compassion fatigue and burnout and their respective instrumental scores. Meta-regression analyses were performed to identify factors influencing these rates., Results: Data from 21 studies were used for the meta-analysis. The prevalence rates of compassion satisfaction, compassion fatigue and burnout were 47.55%, 52.55% and 51.98%, respectively. The possession of Bachelor's or Master's degrees by the nurses was significantly inversely associated with the percent prevalence of compassion fatigue (coefficient: -1.187) and burnout (coefficient: -0.810). The compassion fatigue score was also significantly inversely associated with nursing status as registered or licensed practical nurse (coefficient: -0.135)., Conclusion: In nursing, the prevalence rates of compassion fatigue and burnout are high. Better education and training may have a moderating effect on compassion fatigue and burnout and could improve the quality of life of nurses., (© 2018 John Wiley & Sons Ltd.)

Introduction: Nursing handover is a process central to the delivery of high-quality and safe care. We aimed to improve the quality of nursing handover from the emergency department to ward and intensive care unit (ICU)., Methods: A quasi-experimental non-equivalent control group pre-test - post-test design was applied. Handover quality was measured using the Handover Evaluation Scale (HES). A tailored intervention, inspired by appreciative inquiry, was designed to improve the implementation of an existing handover form and procedure., Results: In total 130 nurses participated, 66 before and 64 after the intervention. Initial structure of the HES showed no good fit to our data; the questions were reshaped into 3 dimensions: Quality of information, Interaction and support, and Relevance of information. Following the intervention, mean changes in HES factor scores ranged from -3.99 to +15.9. No significant difference in factor scoring by ward and ICU nurses was found. Emergency department nurses, however, perceived Interaction and support to be improved following the intervention., Conclusion: The intervention did not result in an improved perception of handover quality by ward and ICU nurses. There was improvement in the perception of Interaction and support among emergency department nurses. The intervention positively effected teamwork and mutual understanding concerning nursing handover practice amongst emergency nurses. In order to improve intrahospital nursing handover, hospital-wide interventions are suggested. These interventions should be aimed at creating a generative story, improving mutual understanding, and establishing a supportive attitude regarding standardised procedures to reduce human error., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Humanistic nursing practice which is dominated by technological advancement, outcome measurement, reduced resources, and staff shortages is challenging in the present work environment., Objective: To examine the main concern in humanistic nursing area and how the way it is solved and resolved by Iranian nurses in acute care setting., Research Design: Data were collected from interviews and observations in 2009-2011 and analyzed using classic grounded theory. Memos were written during the analysis, and they were sorted once theoretical saturation occurred. Participants and research context: In total, 22 nurses, 18 patients, and 12 families from two teaching hospitals in Tehran were selected by purposeful and theoretical sampling. Ethical considerations: The research was approved by the Ethics Committee of the university and hospitals., Results: The main concern for the nurses is the violation of their rights. They overcome this concern when there is a synergy of situation-education/learning, that is, a positive interaction between education and learning of values and sensitivity of the situation or existence of care promotion elements. They turn to professional values and seeking and meeting others' needs, resulting in "success and accomplishment" of nurse/nursing manager and patient/family., Conclusion: This theory shows that professional values, elements of care promotion, and sensitivity of the situation have a key role in activation of humanistic approach in nursing. Violation of the nurses' professional rights often leads to a decrease in care, but these factors make the nurses practice in an unsparing response approach. It is necessary to focus on development of professional values and provide essential elements of care promotion as changeable factors for realization of humanistic nursing although there is a context in which the nurses' rights are violated.

Background: Workplace safety has been a concern of workers and managers for decades. Measuring safety climate is crucial in improving safety performance. It is also a method of benchmarking safety perception., Objective: To develop and validate a psychometrics scale for measuring nurses' safety climate., Methods: Literature review, subject matter experts and nurse's judgment were used in items developing. Content validity and reliability for new tool were tested by content validity index (CVI) and test-retest analysis, respectively. Exploratory factor analysis (EFA) with varimax rotation was used to improve the interpretation of latent factors., Results: A 40-item scale in 6 factors was developed, which could explain 55% of the observed variance. The 6 factors included employees' involvement in safety and management support, compliance with safety rules, safety training and accessibility to personal protective equipment, hindrance to safe work, safety communication and job pressure, and individual risk perception., Conclusion: The proposed scale can be used in identifying the needed areas to implement interventions in safety climate of nurses.

Errors are frequent in health care. A specific model was tested that affirms failure in cognitive action regulation to mediate the influence of nurses' workflow interruptions and safety conscientiousness on near-accidents in health care. One hundred and sixty-five nurses from seven Swiss hospitals participated in a questionnaire survey. Structural equation modelling confirmed the hypothesised mediation model. Cognitive failure in action regulation significantly mediated the influence of workflow interruptions on near-accidents (p < .05). An indirect path from conscientiousness to near-accidents via cognitive failure in action regulation was also significant (p < .05). Compliance with safety regulations was significantly related to cognitive failure and near-accidents; moreover, cognitive failure mediated the association between compliance and near-accidents (p < .05). Contrary to expectations, compliance with safety regulations was not related to workflow interruptions. Workflow interruptions caused by colleagues, patients and organisational constraints are likely to trigger errors in nursing. Work redesign is recommended to reduce cognitive failure and improve safety of nurses and patients.

More emphasis on nursing theory in education and practice settings is suggested as an approach to reduce lateral violence in the workplace., (© The Author(s) 2014.)

The author of this article reviews the literature on lateral violence in nursing. This concept was first discussed over three decades ago. Bullying and incivility are concepts similar to lateral violence that have become increasingly utilized in nursing research and scholarly writing. The research on these concepts suggests that the behavior still exists in the nursing workplace, and that few interventions have been developed to change the behaviors or the power dynamics that cause them. Suggestions are included to change practice and scholarship in this area., (© The Author(s) 2014.)

As the creator of her own role, heart failure specialist nurse Jennifer Gow is especially committed to her patient group.

Aim: To examine the moderating roles of job dedication and age in the job insecurity-family-related well-being relationship., Background: As job insecurity is a rather permanent stressor among nurses nowadays, more research is needed on the buffering factors alleviating its negative effects on well-being., Methods: A total of 1719 Finnish nurses representing numerous health care organisations participated in this cross-sectional study. Moderated hierarchical regression analysis was used to examine the associations., Results: Nurses' younger age and low job dedication operated as protective factors against the negative effect of high job insecurity on parental satisfaction. The effect of job dedication on family-related well-being was also age-specific: high job dedication protected younger nurses from the negative effect of job insecurity on work-family conflict and parental stress, whereas among older nurses those who reported low job dedication showed better well-being in the presence of high job insecurity., Conclusions: The most job-dedicated nurses were more vulnerable to job insecurity in relation to parental satisfaction. In addition, high job dedication combined with high age implied more work-family conflict and parental stress in the presence of high job insecurity., Implications for Nursing Management: Managers should seek to boost younger nurses' job dedication and to prevent older nurses' over-commitment., (© 2013 John Wiley & Sons Ltd.)

Unlabelled: Toxoplasmosis, caused by Toxoplasma gondii is an obligate intracellular zoonotic protozoan parasite, with a worldwide distribution particularly in Arab countries including Egypt. The study evaluated toxoplasmosis infection among childbearing age Egyptian females and assessed the military nursing staff knowledge, attitude and compliance to toxoplasmosis prevention and control measures. The study was conductedin a general military hospital., Research Design: CROSS-section descriptive research design was used to conduct this study. The subjects consisted of 14 young females (11 were in-patients undergoing gynecological treatment in a military hospital and 3 were staff nurses. On the other hand, 44 staff nurses were available for assessment who met the inclusion criteria., Tools: 4 tools were used for data collection: first consisted of self-administered questionnaires to assess nurses' socio-demographic data and knowledge, second rating scale to assess nurses' attitude towards toxoplasmosis infection and its prevention, third performance check list to measure nurses' compliance to infection control measures, and fourth measured the anti-Toxoplasma antibodies by commercial indirect hemagglutination test (IHAT). The results showed that almost half of the nurses had satisfactory levels of knowledge, attitude, and compliance to toxoplasmosis infection control measures. 22.2% of the pregnant women and 20% of non-pregnant ones showed antibodies against T. gondii. Thus health education about toxoplasmosis should be tailored to women whether married or single to help in avoiding the risk of infection. Frequent periodic IHAT should be done for people who continuously contact with cats. Adherence to strict infection prevention measures is a must to eliminate exposure to toxoplasmosis infection. Training intervention should be implemented to achieve successful improvement in knowledge, attitude, and compliance of toxoplasmosis control measures.

This article presents coaching, which facilitates the highest form of learning, as a potential strategy for promoting professional development in nursing. In doing so, it sets out what coaching is and highlights its benefits in terms of team building, adaptation to changes, career planning and professional development. Having established the rudiments of coaching and identifying its qualities, the article then sets out strategies of coaching using three models: the 3-D Technique Model, The Practice Spiral Model and The Grow Model. Three case histories are presented to explain how these models could be used to implement coaching and personal learning plans (PLP). Directions are provided where training for coaching is available. It is concluded that coaching can be a powerful tool in enhancing nurses' and other health professionals' ability to contribute to the success of healthcare organisations.

Dementia is one of the most prevalent chronic progressive diseases in older age. The progression of dementia is associated with an increasing demand for patient care. Thus, the nursing profession fulfills important tasks in the supply of care in dementia. Care of dementia patients requires nurses with more specialized professional knowledge. Consequently, the development of new qualification concepts in dementia is needed. Therefore, the German Center for Neurodegenerative Diseases, Rostock/Greifswald, has developed a qualification according to the Dementia Care Management concept. A prospective cross-sectional study identified the tasks and qualifications of nurses as Dementia Care Managers. Overall, 27 tasks and 28 qualification items were identified for a nurse to qualify as a Dementia Care Manager. In the next step, the first version of the Dementia Care Management Curriculum was developed.

Overview: Positive deviance involves an intentional act of breaking the rules in order to serve the greater good. For nurses, the rightness or wrongness of such actions will be judged by other people who are in charge of rules enforcement; but the decision to engage in positive deviance lies solely with the nurse. There is no uniform or consistent definition of positive deviance. This article uses the Walker and Avant method of concept analysis to explore and identify the essence of the term positive deviance in the nursing practice environment, provide a better understanding of the concept, and clarify its meaning for the nursing profession. In turn this led to an operational definition: positive deviance is intentional and honorable behavior that departs or differs from an established norm; contains elements of innovation, creativity, adaptability, or a combination thereof; and involves risk for the nurse. The concept of positive deviance is useful, offering nurses a basis for decision making when the normal, expected actions collide with the nurse's view of the right thing to do.

Background: Workarounds circumvent or temporarily 'fix' perceived workflow hindrances to meet a goal or to achieve it more readily. Behaviours fitting the definition of workarounds often include violations, deviations, problem solving, improvisations, procedural failures and shortcuts. Clinicians implement workarounds in response to the complexity of delivering patient care. One imperative to understand workarounds lies in their influence on patient safety. This paper assesses the peer reviewed empirical evidence available on the use, proliferation, conceptualisation, rationalisation and perceived impact of nurses' use of workarounds in acute care settings., Methods: A literature assessment was undertaken in 2011-2012. Snowballing technique, reference tracking, and a systematic search of twelve academic databases were conducted to identify peer reviewed published studies in acute care settings examining nurses' workarounds. Selection criteria were applied across three phases. 58 studies were included in the final analysis and synthesis. Using an analytic frame, these studies were interrogated for: workarounds implemented in acute care settings by nurses; factors contributing to the development and proliferation of workarounds; the perceived impact of workarounds; and empirical evidence of nurses' conceptualisation and rationalisation of workarounds., Results: The majority of studies examining nurses' workarounds have been published since 2008, predominantly in the United States. Studies conducted across a variety of acute care settings use diverse data collection methods. Nurses' workarounds, primarily perceived negatively, are both individually and collectively enacted. Organisational, work process, patient-related, individual, social and professional factors contribute to the proliferation of workarounds. Group norms, local and organisational culture, 'being competent', and collegiality influence the implementation of workarounds., Conclusion: Workarounds enable, yet potentially compromise, the execution of patient care. In some contexts such improvisations may be deemed necessary to the successful implementation of quality care, in others they are counterproductive. Workarounds have individual and cooperative characteristics. Few studies examine nurses' individual and collective conceptualisation and rationalisation of workarounds or measure their impact. The importance of displaying competency (image management), collegiality and organisational and cultural norms play a role in nurses' use of workarounds.

The aim of the study was to evaluate the effect of an on-line, medication calculation education and testing programme. The outcome measures were medication calculation proficiency and self efficacy. This quasi-experimental study involved the administration of questionnaires before and after nurses completed annual medication calculation testing. The study was conducted in two hospitals in south-east Queensland, Australia, which provide a variety of clinical services including obstetrics, paediatrics, ambulatory, mental health, acute and critical care and community services. Participants were registered nurses (RNs) and enrolled nurses with a medication endorsement (EN(Med)) working as clinicians (n=107). Data pertaining to success rate, number of test attempts, self-efficacy, medication calculation error rates and nurses' satisfaction with the programme were collected. Medication calculation scores at first test attempt showed improvement following one year of access to the programme. Two of the self-efficacy subscales improved over time and nurses reported satisfaction with the online programme. Results of this study may facilitate the continuation and expansion of medication calculation and administration education to improve nursing knowledge, inform practise and directly improve patient safety., (Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.)

The objective of this study was to learn about the central nucleus of the social representations of caring and treating for patients and nurses. This qualitative study was founded on the theoretical-methodological framework of the structural approach of social representations. Participants were 90 subjects, who answered a questionnaire using the free association technique. Data analysis was performed using Evoc software. Results show that the social representations that patients and professionals have of the concepts of caring express an ethical, sensitive, solidary, affective and committed relationship with a loving human life. However, the representations of treating point at different meanings and different expectations. In conclusion, the difference between these representations is rather concerning and deserves special attention. Such discrepancy denounces that the service that the professionals have delivered does not meat the demand and desires of patients.