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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)

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]

To compare the job crafting strategies nurse mentors use when mentoring students versus during periods of respite and to assess the effectiveness of these strategies in reducing instances of missed nursing care (MNC). Nurses who serve as mentors may have to train a group of nursing students on top of their routine nursing duties. The corresponding high workloads and limited resources may force them to decide which nursing care to delay or omit (i.e., MNC). The mentors' initiative and the actions they take to address the multiple job requirements which do not align with the organization's resources are referred to as job crafting strategies. Mentors can use these strategies to shape their role as nurses as well as their role as mentors, depending on their motives and personality. A longitudinal study with data collected at two time points. One hundred nurse mentors completed validated questionnaires assessing job crafting strategies, MNC and work overload while actively mentoring students. Eighty returned for a follow-up during a non-mentoring period three months later. Data analysis included paired t-tests and hierarchical multivariable linear regressions. No significant differences were found in MNC between the two points (1.83 SD 0.6 vs. 1.82 SD 0.75; p=0.942). A decrease in hindering demands was noted during active mentoring compared with respite (2.6 SD 0.97 vs. 2.84 SD 0.96; p=0.038). Enhancing structural job resources was significantly negatively correlated with MNC during active mentoring, while enhancing challenging job demands was positively correlated with MNC during these periods (β=0.48, p=0.18 and β=-0.35, p=0.014, respectively). Nurse mentors can effectively reduce MNC by focusing on enhancing structural resources and limiting challenging demands during mentoring periods. It is essential for healthcare organizations to support nurse mentors with manageable workloads and necessary resources to maintain high-quality care. [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]

Aims: To develop and test the relationship between nurse champions' personal social networks and innovation success in terms of spread. Design: A cross sectional. Method(s): Data were collected on 94 nurse champions at three medium‐large tertiary medical centres from 2015–2016. Data from champions on their personal network were assessed via a standardized and acceptable three‐step network survey. Success in terms of innovation spread was assessed via perceived extent of spread. Network structural and relational characteristics were depicted by level of spread. Multivariate linear regression was used to assess the relationship between network characteristics and innovation spread. Findings: Above and beyond various project and network control variables, network density was significantly and positively related to project spread, tie‐strength diversity was significantly and negatively related to project spread and difference in ethnic origin between champions and alters was significantly and positively related to project spread. Maximum age of network members was marginally significantly related to project spread. Conclusion(s): Our findings show that high‐density personal social networks; networks where tie strength among network members is similar, thus, creating liking and trust among members; having at least one older network member who might have close access to professional and organizational resources acquired throughout their career; and having ties with network members from different ethnic groups to prevent knowledge stickiness, all promote innovation spread. Champions should be carefully nominated based on their ability to engage network members and to build ties with various network members inside and outside the nursing unit; once selected, champions should be aware of their social networks. Impact: The current study explored champions' personal‐network structure, composition and variance measures and their implications for innovation project spread. The findings demonstrated that nursing champions' personal social networks matter for innovation spread. This finding has implications for the nominating and the coaching of champions. [ABSTRACT FROM AUTHOR]

Extensive research has dealt with violence directed at healthcare workers in hospital settings; however, few studies have examined community‐based settings. Furthermore, there is also scant literature regarding the perceptions of healthcare providers who were exposed to violence, compared to those who were not. This study aims to narrow these gaps in the literature by examining community‐based family physicians' (CBFPs) perceptions in a large national Health Maintenance Organisation (HMO) regarding patient‐initiated violence. Using a voluntary online survey, directed at all CBFPs working at the HMO, 412 CBFPs were surveyed on the following issues: exposure to violence initiated by patients or their family members; perceptions of violent occurrences and possible safety measures. The differences between CBFPs who had been exposed to violence and those who had not were compared. The majority of CBFPs reported experiencing verbal attacks (64%), and a small percentage experienced property‐related violence (11.7%) or physical violence (3.4%). Comparing CBFPs who were exposed to violence with those who were not, regarding their perceptions of the 'causes of violence', revealed three differentiating factors: 'waiting time', 'failure to meet the patient's expectations' and 'the nature of the physician‐patient encounter'. Regarding the desired preventive actions, the four differentiating factors were as follows: 'reduction in the number of patients per physician', 'improved queue management processes', 'longer meetings' and 'violence prevention training'. Conducting separate analyses, according to violence type (verbal abuse, vandalism or physical violence), indicated finer differentiations. In terms of Attribution Theory, one might argue that CBFPs who were directly exposed to patients' aggression attributed internal locus to the attacker, and tended to blame the attacker's personal characteristics and cultural values. Conversely, family CBFPs who were not attacked attributed external locus to situational factors such as waiting time, not receiving service, and the nature of the interaction between the attacker and the CBFP. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to examine the mediating role of nurses' personal accountability in the relationships between nurse's personality and missed nursing care. Background: Personal accountability is considered as a core value in nursing, shaped by the nurse's personality, education, socialization into the profession and experience. Personality antecedents may be uniquely suited to predicting accountability, since it reflects variation in individuals' deep‐seated values and beliefs. Personal accountability can be related to the prevalent phenomenon of missed nursing care (tasks that are omitted or delayed). Design: A multicentre cross‐sectional study with 290 nurses from direct‐care nursing wards during 2017. Personality traits were assessed with the 44‐item Big Five Inventory. Personal accountability was assessed with a 19‐item scale. Missed nursing care was assessed with the 22‐item MISSCARE survey. An indirect mediated path analysis was performed and compared with an alternative model with direct effects. Results: Path‐analyses findings supported a full‐mediation model of accountability in the relationships between personality traits and missed nursing care. Conscientiousness, Agreeableness, Openness and Neuroticism, but not Extraversion, were significantly related to personal accountability. In addition, greater personal accountability was significantly related to lower frequency of missed nursing care. Conclusions: Personal traits are important antecedents of personal accountability, which relates to missed nursing care. Findings delineate the profile of the accountable nurse and might help in developing strategies for the selection of nurses with high personal accountability and determining the best means to strengthen accountable behaviours in the workplace. [ABSTRACT FROM AUTHOR]

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Abstract: Aims: The aim of this study was to develop and psychometrically evaluate a three‐dimensional questionnaire suitable for evaluating personal and organizational accountability in nurses. Background: Accountability is defined as a three‐dimensional value, directing professionals to take responsibility for their decisions and actions, to be willing to explain them (transparency), and to be judged according to society's accepted values (answerability). Despite the relatively clear definition, measurement of accountability lags well behind. Existing self‐report questionnaires do not fully capture the complexity of the concept nor do they capture the different sources of accountability (e.g., personal accountability, organizational accountability). Design: A three‐stage measure development. Methods: Data were collected during 2015–2016. In Phase 1, an initial database of items (N = 74) was developed, based on literature review and qualitative study, establishing face and content validity. In Phase 2, the face, content, construct, and criterion‐related validity of the initial questionnaires (19 items for personal and organizational accountability questionnaire) were established with a sample of 229 nurses. In Phase 3, the final questionnaires (19 items each) were validated with a new sample of 329 nurses and established construct validity. Results: The final version of the instruments comprised 19 items, suitable for assessing personal and organizational accountability. The questionnaire referred to the dimensions of responsibility, transparency, and answerability. The findings established the instrument's content, construct, and criterion‐related validity as well as good internal reliability. Conclusion: The questionnaire portrays accountability in nursing, by capturing nurses’ subjective perceptions of accountability dimensions (responsibility, transparency, answerability), as demonstrated by personal and organizational values. [ABSTRACT FROM AUTHOR]

Sleepiness is a common complaint during the night shift and may impair performance. The current study aims to identify bio-psycho-social factors associated with subjective sleepiness during the night shift. Ninety-two female nurses working rotating shifts completed a sociodemographic questionnaire, the Munich ChronoType Questionaire for shift workers, the Pittsburg Sleep Quality Index, and the Pre-sleep Arousal Scale. Subjective sleepiness was measured hourly during two night shifts using the Karolinska Sleepiness Scale, and activity monitors assessed sleep duration 24-h before each shift. Findings showed that increased sleepiness was associated with increased age in nurses with early chronotypes and with more children. High cognitive pre-sleep arousal, but not sleep, was associated with increased sleepiness, especially in late chronotypes. The impact of bio-psycho-social factors on night shift sleepiness is complex, and depends on mutual interactions between these factors. Nurses most prone to increased sleepiness must develop personal strategies for maintaining vigilance on the night shift. Practitioner Summary: This study aims to identify bio-psycho-social factors associated with subjective sleepiness of female nurses during the night shift. Increasing sleepiness was associated with increased age in nurses with early chronotypes and with more children. Increased cognitive pre-sleep arousal, but not sleep, was associated with increased sleepiness, especially in late chronotypes. [ABSTRACT FROM AUTHOR]

Background Missed nursing care is considered an act of omission with potentially detrimental consequences for patients, nurses, and organizations. Although the theoretical conceptualization of missed nursing care specifies nurses’ values, attitudes, and perceptions of their work environment as its core antecedents, empirical studies have mainly focused on nurses’ socio-demographic and professional attributes. Furthermore, assessment of missed nursing care has been mainly based on same-source methods. Objectives This study aimed to test the joint effects of personal and ward accountability on missed nursing care, by using both focal (the nurse whose missed nursing care is examined) and incoming (the nurse responsible for the same patients at the subsequent shift) nurses’ assessments of missed nursing care. Design A cross-sectional design, where nurses were nested in wards. Participants A total of 172 focal and 123 incoming nurses from 32 nursing wards in eight hospitals. Methods Missed nursing care was assessed with the 22-item MISSCARE survey using two sources: focal and incoming nurses. Personal and ward accountability were assessed by the focal nurse with two 19-item scales. Nurses' socio-demographics and ward and shift characteristics were also collected. Mixed linear models were used as the analysis strategy. Results Focal and incoming nurses reported occasional missed nursing care of the focal nurse (Mean = 1.87, SD = 0.71 and Mean = 2.09, SD = 0.84, respectively; r = 0.55, p < 0.01). Regarding the focal nurse's assessment of his/her own missed nursing care, findings showed that, above and beyond nurses’ overload and personal socio-demographic characteristics, higher personal accountability was significantly associated with decreased missed care (β = −0.29, p < 0.01), whereas ward accountability was not (β = −0.23, p > 0.05). The interaction effect was significant (β = −0.31, p < 0.05); the higher the ward accountability, the stronger the negative relationship between nurses' personal accountability and missed nursing care. Similar patterns were obtained for the incoming nurses' assessment of focal nurse's missed care. Conclusions Use of focal and incoming nurses' missed nursing care assessments limited the common source bias and strengthened our findings. Personal and ward accountability are significant values, which are associated with lower missed nursing care, beyond scarce resources. Implementation of local and national education programs for nurses and managers, accompanied with empirical research, might increase personal and ward accountability, thereby decreasing missed nursing care. This might help to create a safety culture and reduce negative outcomes for patients, nurses, and organizations. [ABSTRACT FROM AUTHOR]

Aim To understand how attribution processes (control and stability), which the nurse attributes to parental involvement in maintaining child safety, determine the nurse's response to a safety alert. Background Participation of parents in maintaining their child's safety is shown to reduce the incidence of and risk of clinical errors. Unless nurses respond appropriately to parents' safety alerts, this potential source of support could diminish. Design A 2 (controllability: high vs. low) × 2 (consistency: high vs. low) factorial design. Methods Data were collected during the period 2013-2014 in paediatric wards. Four variants of scenarios were created corresponding to the different combinations of these variables. A total of 126 nurses read a scenario and completed self-report questionnaires measuring their response to the parent's safety alert. Additional data were collected about the manipulation check, safety norms in the ward and demographic variables. Data were analysed using analysis of variance. Findings Results showed a main effect of stability and a significant two-way interaction effect of stability and controllability, on a nurse's tendency to help the parent and fix the safety problem. Furthermore, safety norms were significantly related to nurses' response. Conclusion These findings contribute to the understanding of antecedents that affect nurses' responses to parents' speaking-up initiatives: whether nurses will reject or heed the alert. Theoretical and practical implications for promoting parents' engagement in their safety are discussed. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to test the moderated-mediation model suggesting that nursing teams' accountability affects team effectiveness by enhancing team learning when relevant resources are available to the team. Background Disappointing evidence regarding improvement in nurses' safe and quality care elevate the need in broadening our knowledge regarding the factors that enhance constant learning in nursing teams. Accountability is considered as crucial for team learning and quality of care but empirical findings have shown mixed evidence. Design A cross-sectional design. Methods Forty-four nursing teams participated in the study. Data were collected in 2013-2014: Head nurses completed validated questionnaires, regarding team resources for learning (time availability, team autonomy and team performance feedback), and nursing teams' effectiveness; and nurses answered questionnaires regarding teams' accountability and learning (answers were aggregated to the team level). The model was tested using a moderated-mediation analysis with resources as moderating variables, and team learning as the mediator in the team accountability-team effectiveness link. Results The results of a mixed linear regression show that, as expected, nursing teams' accountability was positively linked to nursing teams' learning, when time availability, and team autonomy were high rather than low, and team performance feedback was low rather than high. Conclusions Nurturing team accountability is not enough for achieving team learning and subsequent team effectiveness. Rather there is a need to provide nursing teams with adequate time, autonomy, and be cautious with performance feedback, as the latter may motivate nurses to repeat routine work strategies rather than explore improved ones. [ABSTRACT FROM AUTHOR]

Studies of missed nursing care suggest that it results from ward-level, patient-related, and task-type factors, while nurses' decision-making style was scarcely studied. Studying the effect of nurses' decision-preference structures, namely a pattern of joint ward and patient factors, on missed care may also contribute to understanding the phenomenon. To examine the relationships between decision-preference structures and missed care and the moderating effects of decision-making styles and task type in these links. A discrete choice experiment with a between- and within-participants design. A sample of 387 registered nurses working in acute medical surgical wards in Israel. Based on the protocol for discrete choice experiments, a survey was developed to assess the decision-preference structure, considering five factors: overload, presence of head nurse, clinical complexity, difficult patient, and presence of relatives. Participants were randomly assigned to four task-type conditions and completed a survey regarding their task. Decision-making style was assessed using a validated questionnaire. Extensive workload (b = − 0.46; p = 0.001), difficult patient (b = − 0.20; p = 0.001), and patient clinical complexity (b = − 0.10; p = 0.006) were negatively linked to the probability of missed care. The interaction between workload and task type (b = 0.252; p = 0.017) indicated that the probability of missed care under extensive compared with regular workload was lowest for developing a discharge plan and highest for providing emotional support. The interaction of patient complexity and task type (b = 0.230; p = 0.013) indicated that the probability of missed care in developing a discharge plan and medication administration was lower for patients having high compared with low clinical complexity. The interaction between difficult patient and task type (b = − 0.219; p = 0.044) indicated that the probability of missed care in emotional support, developing a discharge plan, and patient's mobility was lower for difficult than for non-difficult patients. Finally, the interaction between workload and decision-making style (b = − 0.48; p = 0.001) indicated that the probability of missed care under heavy compared with regular workloads was lower for the dual-preference or the dominantly intuitive styles. This design enabled examining the prioritizing processes nurses use when deciding about whether to miss care. The likelihood of missing more in structured tasks is lower under a heavy overload and when patients appear difficult or clinically complex. Dual-preference styles or dominantly intuitive styles are more suitable for the routine high workload. [ABSTRACT FROM AUTHOR]

Background Given the effort made in today's birthing rooms to increase women's childbirth satisfaction, special attention is directed to midwives’ expressions of authenticity (namely to display emotions that he/she actually experience) in birth encounters. Objectives To explore antecedents and consequences of emotional work strategies expressed in a specific birth encounter, to (1) understand the specific factors in a midwife–birthing woman encounter, namely parity (whether or not it is a first birth), use of epidural analgesia, induction of labor, and instrumental birth that stimulate the use of deep or surface acting; (2) test the link between emotional work strategies and birthing experience, and (3) assess whether associations between the midwife's choice of strategy (deep acting or surface acting), and the woman's childbirth experience is moderated by the birthing woman's perception of the midwife's emotional work strategies. Design A prospective-correlational field study. Participants 104 births, selected by a convenience sampling method—including 24 midwives and 104 birthing women, in one birthing room in Israel. Methods Data were collected by validated questionnaires at two time points: immediately after labor and 48 h after labor. Results Linear mixed model analyses revealed that of the antecedents to emotional work strategies, epidural analgesia was negatively associated with surface acting ( β = −.301, p < .05); primigravida was significantly associated with deep acting ( β = 611, p < .01) and negatively associated with surface acting ( β = −.433, p < .01); induction of birth was not associated with deep or surface acting ( p > .05), and instrumental birth was significantly associated with deep acting ( β = −.590, p < .05) and positively associated with surface acting ( β = .444, p < .05). Regarding consequences of emotional work strategies, the midwife's engagement with surface acting was negatively related to the woman's birthing experience ( β = −.155, p < .05), whereas the relationship between midwife's engagement in deep acting and the woman's satisfaction also depended on the latter's perception that the midwife had engaged in deep acting ( β = −.096, p < .05). Conclusions The midwife–birthing woman encounter is becoming globally significant for improving childbirth outcomes. Therefore, these findings offer empirical support for the importance of the midwife's expression of authenticity toward the birthing woman in improving her childbirth experience, especially when the woman perceives the midwife's emotional work strategy accurately. Also noteworthy are the aforementioned conditions that shape the midwife's engagement in deep acting or surface acting, with important recommendations to improve women's childbirth experiences. [ABSTRACT FROM AUTHOR]

Aims To examine whether the interdependent attachment style of students is positively related to their support-seeking behaviour during supervision and whether their over-dependent and counter-dependent attachment styles are negatively related to it. Second, to determine whether the mentors' attachment styles moderate the relationship between the students' support-seeking behaviours and their professional competence, such that this relationship is stronger when supervisors are characterized by higher independent attachment style . Background The mentor-student encounter during nursing clinical supervision is expected to create a supportive environment aimed at promoting support-seeking behaviours and subsequent positive supervision outcomes. Bowlby's attachment theory suggests that the three attachment styles - independent, counter-dependent and over-dependent - may have implications for clinical supervision. Design A correlative-prospective study. Method One hundred and seventy-eight students and 66 clinical mentors completed questionnaires at the beginning and end of a clinical supervision session during 2012-2013. Results Results demonstrated that high compared with low independent nursing students tended to seek less support. Second, students who seek less support evaluated their professional competence as higher than students who seek more support. Third, mentor's counter-dependent attachment style moderated the relationship between students' support-seeking behaviour and their professional competencies. Conclusions The results allude to the detrimental meaning of support-seeking in the eyes of nursing students. Results can guide administrators in promoting supervision processes that are compatible with the students' independent learning style, while also preventing the negative implications of autonomic learning. Furthermore, as mentors' counter-dependent attachment style can hinder students' support-seeking, attachment styles should be considered in the selection of mentors. [ABSTRACT FROM AUTHOR]

Aims To understand the role of patients' attributions under the attribution theory framework (locus, controllability, stability) in nurses' performance of surface or deep acting, as they unfold in interactions with different patients. Background Regulation of emotions at work, or emotional labour, has been conceptualized in terms of two main strategies: surface acting and deep acting. Most prior research tested for between-subject variation in the search for the factors evoking these strategies in nurses, assuming them to be trait-like characteristics. Only scant research has examined how nurses modify their emotional labour strategies in different patient-nurse encounters. Design A nested cross-sectional design (patients within nurses). Methods Data were collected during 2011-2012 through validated questionnaires from the nursing staff ( N = 41) of two paediatric hospital wards and their randomly selected patients ( N = 239). Questionnaires were administered to nurses multiple times after encounters with different patients. Analyses were conducted using mixed effects models. Results In accordance with attribution theory, different combinations of locus, controllability and stability attributions were related to the choice of surface or deep acting. Nurses' perceptions of patients' controllability were associated positively with surface acting and negatively with deep acting. Interaction terms of stability and locus and of controllability and stability, were distinctively associated with deep and surface acting. Conclusions Findings innovatively introduce the attribution process as an explanatory perspective to nurses' emotional labour and highlight its situational nature, providing a potential tool for emotional labour strategy prediction. Raising nurses' awareness of how they perceive patients may increase control of the strategies employed. [ABSTRACT FROM AUTHOR]

Aim To examine the relation between the strategies the nurses employ during handover and the number and types of treatment errors in patient care in the following shift. Background Patient handover has repeatedly been declared an area of considerable vulnerability to patient safety. This study examined factors that affect treatment errors in patient care, including the use of handover strategies from high reliability organizations. Design Prospective study. Method Data were collected in 2012-2013 from 200 randomly selected handovers in five internal wards. Handover strategies previously adopted from High Reliability Organizations were assessed via observations; treatment errors - dosage discrepancy, order postponed, no documentation - captured from the patient's files and demographical data were collected via questionnaires. Findings On average, in nearly one-fifth of the patient's files, medication dosage given was inaccurate; in nearly one-third a care order was fulfilled late; and in nearly half, documentation was partially missing. Rate of use of handover strategies previously adopted from high reliability organizations varied substantially. Results of negative binomial regression analysis revealed that face-to-face verbal update with interactive questioning, update from practitioners other than the outgoing, topics initiated by incoming and outgoing team, including the latter's stance on care plans and writing a summary prior to handover, were significantly and negatively linked to number of treatment errors ( P < 0·05). Conclusions Nursing handover is an opportunity for nurses to prevent errors and unsafe practice by implementing more risk-aware handover strategies. Implications for facilitating the use of such strategies are discussed. [ABSTRACT FROM AUTHOR]

Aims and objectives In this study, we aimed to understand how nurses manage handovers at shift change and to identify the working strategies they employ to maintain patients' safety. Background Nursing handovers at shift change are potentially hazardous for patients' quality of care. The nurses on the outgoing and incoming shifts need accurate understanding of the patient's current state, under circumstances that are frequently turbulent and time constrained. Design Qualitative study. Method Eighteen nurses working in a central Israeli hospital participated in the study. Data were collected through in-depth semi-structured interviews, conducted over a 10-month period in 2011-2012. The interviews were tape-recorded and transcribed verbatim. Content analysis method was used. Results We revealed three interrelated themes: (1) Adaptation of declared handover goals to goals, which better fit the day-to-day routine of the ward; (2) Contextual turbulent circumstances, and (3) Strategies to optimise care for patients. Nurses on the outgoing shift developed organising strategies, ensuring efficient transmission of all important information; nurses on the incoming shift used cross-checking strategies to verify the accuracy of the received information. Conclusion A nursing handover is both vulnerable and resilient, given its imposed constraints. The handover should be restructured, assuring resilience in patients' care while also limiting the risk for vulnerability. Relevance to clinical practice Handover should be restructured so that it creates opportunities to cross-check the information against as many sources of information as possible. During handover, special time should be devoted to reading written reports and notes, preferably when the outgoing nurses are still on the ward or are accessible via e-mail or telephone. Team discussions should focus on achieving agreement about the order and manner of delivering concise information and facilitating shared understanding and trust among nurses. [ABSTRACT FROM AUTHOR]

Aims To describe the quality and scope of patients' participation in the handover process, in relation to their personal attributes (the big-5 model of personality) and the handover encounter's characteristics (presence of the head nurse, escorts, ward overload-namely nurse-patient ratio). Background The scant research, previously addressing patient participation during a nursing handover, generally indicated that there is stillroom for improvement. Design A quantitative and qualitative cross-sectional design. Method During 2012-2013, we collected data on 100 handovers in five surgical wards. Data on factors of the handover encounter were collected through structured observations of the event and data on personality attributes and demographics were assembled through validated questionnaires; we content-analysed transcriptions of the handover's verbal content for typical content, frequency and quality of the communication. Findings Patient participation proved bi-directional, consisting of patient's initiative and nurse's initiative. Whereas patient's initiative improved when the head nurse and escorts were present and the unit was less loaded, nurse's initiative was facilitated by the presence of escorts and less overload. As for personality attributes, whereas patient's imitative improved with patient's high neuroticism, high agreeableness and low openness to experience, nurse's initiative decreased with patient's high neuroticism, extraversion and conscientiousness. Conclusion Findings illustrated the different communication preferences of patients with different personal attributes, as well as the different approaches by nurses to each of these different personalities. Nurses should be taught about communication and ways to engage patients during handover. Patients' education is also warranted including how and when to approach the different caregivers. [ABSTRACT FROM AUTHOR]

drach-zahavy a. & marzuq n. (2013) The weekend matters: exploring when and how nurses best recover from work stress. Journal of Advanced Nursing 69(3), 578-589. doi: 10.1111/j.1365-2648.2012.06033.x Abstract Aim. This article is a report of a comparative study examining nurses' levels of emotional exhaustion and vigour after a short respite taken on weekends as compared with two midweek days taken off. Background. Recovery from work stress - a respite experience that generates replenishing of psychological and physical resources that have been depleted by meeting effortful demands - is crucial to offset future deleterious consequences to mental and physical health. Design. Longitudinal panel survey. Method. Nurses ( n = 400) completed questionnaires during 2010-2011 on three occasions: (1) Before the respite (weekend or midweek), we measured the timing of the respite and emotional exhaustion and vigour; (2) during the respite we measured respite experiences; and (3) after the respite we re-measured emotional exhaustion and vigour. Results. Nurses' emotional exhaustion was significantly lower and their vigour significantly higher after a short weekend respite than after two-midweek-days taken off. Specific experiences during the respite can compensate for the inferior recovery process on weekdays compared with weekends: emotional exhaustion levels of nurses who experienced high relaxation during their respite did not differ whether the respite was at the midweek or weekend. Vigour levels of nurses who experienced control during their respite did not differ whether their respite was midweek or at the weekend. Conclusions. Insights gained on leisure experiences carry important practical implications for nurses and nursing managers. Staff nurses and their managers should be educated in how to recover from work during leisure time, including preferring weekend on midweek respites and engagement in relaxation and control experiences as much as possible. [ABSTRACT FROM AUTHOR]

ABDELHADI N. & DRACH-ZAHAVY A. (2012) Promoting patient care: work engagement as a mediator between ward service climate and patient-centred care. Journal of Advanced Nursing 68(6), 1276-1287. Abstract Aims. To test a model that suggests the ward's climate of service facilitates nurses' patient-centred care behaviours through its effect on nurses' work engagement. Background. Organizational efforts to promote patient-centred care focused on interventions aimed to improve nurses' communication skills, or to improve patient's participation in the decision-making process. These interventions have been only partially successful, as they do not take the ward context into account; so caring professionals who attend workshops can rarely apply their newly acquired skills due to the daily pressures of the ward. Method. A nested cross-sectional research design (nursing staff within wards) was adopted, with three measures of the care behaviour of nurses. Data were collected in 2009, from 158 nurses working in 40 wards of retirement homes in northern Israel. Nurses' work engagement, ward's climate for service and control variables were measured via validated questionnaires. Patient-centred care behaviours were assessed by structured observations. Results. The findings supported our model: service climate proved a link to nurses' work engagement and patient-centred care behaviours. Nurses' work engagement mediated the service-climate patient-centred care behaviours. Conclusion. The research is pioneering in demonstrating a close relation between ward service climate and patient-centred care. In practice, to improve patient-centred care managers should invest in facilitating ward service climate, highlighting the importance of service to the organization through appropriate rewards, guidance and administrative practices. [ABSTRACT FROM AUTHOR]

Work-induced exhaustion and diminished vigour require recovery periods to offset future deleterious consequences for mental and physical health. It is therefore important to understand the factors that effect recovery. This study sought insight into the roles of the personal trait of mindfulness (which refers to paying attention to present experiences) and situational circumstances (respite experiences) that facilitate recovery during a short period of respite, expressed in decreased exhaustion and increased vigour. Two hundred nursing employees from 27 units of a hospital in the northern part of Israel responded to three sets of questionnaires before, during and after two-day periods of respite. Results showed that the nurses' level of exhaustion decreased and level of vigour increased after the short respite, indicating a successful recovery. Mixed Linear Model analyses identified the nature of respite activities and experiences (fewer non-work hassles and relaxation) and mindfulness as crucial catalysts of the recovery process. Mindfulness moderated the effects of non-work hassles and relaxation experiences on the levels of exhaustion and vigour after the short respites. The theoretical and practical implications of the findings for the recovery process are discussed. [ABSTRACT FROM PUBLISHER]

Psychiatric patient assaults on staff are a serious problem, affecting staff, patients, and organizations. To understand the etiology of aggressive events, researchers have documented characteristics of aggressive patients, their victims, and to a lesser degree, the patient–provider interaction. Missing in the literature is how staff’s different perceptions of aggressive incidents might impact their reactions. In this study, we conducted in-depth, semistructured interviews with 11 health care professionals working in a psychiatric ward in one Israeli psychiatric hospital. Through content analysis, we revealed two main themes: patients’ and providers’ controllability over patients’ aggression. From the intersection of these two themes, four prototypes of the aggressive encounter emerged: the power struggle, the therapeutic encounter, inverse power relations, and victim-to-victim encounters, each distinctively characterized by different emotional, cognitive, and behavioral responses. We discuss our findings in light of attribution theory, which carries important theoretical and practical implications for handling aggression. [ABSTRACT FROM PUBLISHER]

The aim of this study was to test three alternative models – additive, interactive, and reciprocal – of the relationship between personal coping strategies and formal organizational family-friendly supports in mitigating work-family conflict (WFC). Altogether 474 employees in Israel having a partner and children and representing diverse professions and organizations were surveyed. The additive model, that is, personal coping and organizational supports together, were associated with decreased WFC, received support. However, the reciprocal model was also supported, as WFC decreased when individuals perceived the investments between their efforts in personal coping strategies and the organization's efforts in organizational supports as equal. The interactive model, namely personal coping and organizational supports compensate each other in decreasing conflict, received marginal support. Nevertheless, in each model personal coping strategies proved a better approach to mitigating WFC than formal family-friendly supports. The findings suggest that the role of organizational support is important in decreasing WFC when employees lack the personal coping strategies required or when they perceive the organization's efforts to be unfair in relation to their own coping efforts. [ABSTRACT FROM PUBLISHER]