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Relationship‐oriented human resource management (HRM) contributes to organizational functioning by promoting employee relationships, coordination, and cooperation. We propose unit‐level positive affective climate as a motivational mechanism through which relationship‐oriented HR systems can positively influence unit service quality and relationships with beneficiaries, and prevent individual emotional exhaustion. Moreover, we propose collective occupational calling serves as an alternative motivational source that can substitute for the positive effects of positive affective climate. In analyzing a sample composed of 742 nurses from 48 nursing units of two hospitals in China with data collection at three time points before and after the COVID‐19 outbreak, our results supported the substituting effects of unit‐level collective occupational calling on positive affective climate stemmed from relationship‐oriented HR systems. Our study connects strategic HRM and motivation research by shedding light on an affective mechanism from relationship‐oriented HR systems and the contingencies involving employees' various sources of motivation, such as occupational calling. We further discuss theoretical and practical implications of the research. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal disorders (MSDs) are common among nursing professionals and require effective management strategies. Implementing targeted training programs for nurses is a vital approach to reduce these problems. Aim: This study aimed to evaluate problem‐based learning (PBL) effectiveness in reducing work‐related musculoskeletal symptoms (WMSs) among nurses. Methods: Fifty Iranian nurses participated in this interventional study. Some data were collected by a demographic/occupational questionnaire and a Persian version of the Nordic Musculoskeletal Questionnaire (P‐NMQ). Some other was gathered by Rapid Entire Body Assessment (REBA) and PBL method. Results: The prevalence of WMSs during the last 12 months in the subjects was related to the lower back (76%), wrists/hands (70%), neck (64%), and knee (64%), respectively. The results showed that the prevalence of WMSs decreased significantly only in the subjects' elbow region in the postintervention (p = 0.031). Although the prevalence decreased in the postintervention stage in other regions, this decrease was not statistically significant (p > 0.05). Conclusions: This study showed that the implementation of PBL could reduce the WMSs prevalence and the level of nurses' exposure to risk factors for MSDs. [ABSTRACT FROM AUTHOR]

Aim: To examine the prevalence of dysmenorrhea in the predominantly female nursing profession and investigate the role of occupational characteristics in dysmenorrhea. Background: Studies on working women have mostly examined the effects of dysmenorrhea symptoms on work performance, as opposed to shedding light on the association between work‐related characteristics and dysmenorrhea. Methods: In this cross‐sectional study, we used data obtained from survey 9 of the Korea Nurses' Health Study. The participants were female nurses of childbearing age. Statistical analysis included descriptive statistics and multivariable logistic regression. Results: Data from 6697 participants were analyzed. Of the total sample, 47.3% had dysmenorrhea. After adjusting for confounders to examine the relationship between occupational characteristics and dysmenorrhea, the odds for dysmenorrhea were 1.230 times higher among women who lifted heavy objects at least six times a day compared to those who did not engage in heavy lifting (95% confidence interval: 1.028–1.473) and 1.042 times higher among women with higher physical fatigue (odds ratio: 1.042, 95% confidence interval: 1.023–1.061). Conclusion: The findings clarify the potential for reducing dysmenorrhea through the improvement of work environment factors. Thus, this study may prove useful for developing educational programs and policies that aim to alleviate dysmenorrhea among working women, including nurses. Implications for Nursing Management: Nursing managers and health policymakers need to understand the factors influencing dysmenorrhea and minimize female nurses' physical burden by implementing appropriate nurse–patient ratios and improving their work environment. [ABSTRACT FROM AUTHOR]

Background: Organizational turnover exacerbates the shortage of nurses in the global workforce. However, no study has yet explored how deep structure usage—nurses' integration of electronic patient records into nursing practice delivery—reduces their turnover intention and moderates the impact of affective, continuance, and normative professional commitment on their turnover intention. Aims: To ascertain (1) the linkage between the deep structure usage of electronic patient records and nurses' organizational turnover intention and (2) the moderating role of deep structure usage on the associations between elements of commitment (affective, continuance, and normative) and turnover intention. Methods: Using a cross‐sectional survey and proportionate random sampling by ward unit, we collected data from 417 full‐time nurses via a self‐administered questionnaire. We performed hierarchical regression analyses to test the study hypotheses. Results: Deep structure usage was not directly related to organizational turnover intention (β = −0.07, p = 0.06). However, the results suggested that deep structure usage may enhance the effect of high affective commitment on nurses' organizational turnover intention (β = −0.09, p = 0.04), while potentially mitigating the effect of low continuance commitment on organizational turnover intention (β = 0.10, p = 0.01). Conclusions: Deep structure usage of electronic patient records helps to ease nurses' workload and facilitates their retention, which is particularly due to their affective commitment (attachment) but not their continuance commitment (switching costs). Implications for Nursing Management: Nursing management may advise hospital management that medical records systems need to be improved and fully embedded for nursing care delivery, as a more in‐depth use of these systems can help to retain nurses. [ABSTRACT FROM AUTHOR]

Aim(s): To understand how nurses experience their positioning amidst hospital crises. Background: Nursing leadership literature is predominantly focused on the skills and competencies of nurses and less on the relations in practice with nurses. Nurses are often valued for bedside care but are overlooked in strategic decision‐making during crises. Foundational research emphasizes the need for nurses' equal participation in interprofessional healthcare practices and governance. Methods: We conducted a qualitative interpretive interview and focus group study, amidst the COVID‐19 crisis. We interviewed 64 chairs of nurse councils and deepened our understanding of our initial findings in four focus groups with 34 participants. Results: Nurses differ widely on (a) what is important to them in crisis management, (b) how they can contribute to crisis management, and (c) how they value their involvement or lack of it. Furthermore, we uncovered three relational leadership struggles for nurses concerning (1) navigating, (2) positioning, and (3) collaborating, in crisis management structures. Conclusion: The ailing positioning and representation of nurses in crisis management result from their limited participation in strategic decision‐making, and the lack of intervention on this by board members, physicians, and managers. Implications for Nursing Management: This study highlights the need for agents such as board members, managers, physicians, and nurses themselves to create clear frameworks and policies that define nurses' roles in crisis situations, emphasizing the importance of addressing power dynamics and enhancing communication and collaboration in hospital settings. Effective crisis management requires involving nurses from the start, providing regular training, and promoting a more equal approach to teamwork. Understanding relational leadership and its impact during crises can empower nurses and improve overall hospital crisis response. [ABSTRACT FROM AUTHOR]

Purpose: Nursing is a representative profession with a high prevalence of presenteeism, which is usually associated with negative outcomes. Therefore, it is important to explore the antecedent factors of nurse presenteeism behavior. This study aims to explore the impact and mechanism of head nurses' cognitive preference toward presenteeism on subordinate nurses' presenteeism (SNP), and the mediation effects of subordinate nurses' perception of head nurses' cognitive preference. Patient and Methods: A cross‐sectional study was conducted from July to August 2022. A total of 256 head nurses and 1424 subordinate nurses were recruited from six hospitals located in Zhengzhou, Henan Province, China. The Nurse Presenteeism Questionnaire (NPQ) and Cognitive Preference Questionnaire were used to assess head nurses' cognitive preference toward presenteeism, SNP, and subordinate nurses' perception of head nurse's cognition of presenteeism. We conducted description, multilevel correlation, and multilevel structural equation models for the data analysis. Results: In the past 6 months, 93.4% of nurses experienced presenteeism. Within and between the team, head nurses' cognitive preference toward presenteeism is positively associated with SNP. The mediation effect of nurses' perception of head nurses' cognitive preference was also significant. Conclusion: Head nurses' cognitive preferences are essential predictors of subordinates' presenteeism. In this process, subordinates' subjective initiative plays a crucial role. Implications for Nursing Management: Hospital managers should focus on head nurses' values to formulate multiple interventions of presenteeism and strengthen communication between leaders and subordinates to promote transforming negative outcomes into positive outcomes. [ABSTRACT FROM AUTHOR]

Background: Job satisfaction is the extent to which an employee feels positively or negatively toward their job. Hospitals with high job satisfaction among nurses provide higher-quality nursing care, resulting in higher patient satisfaction. Aims: This study was conducted to determine job satisfaction among nurses in Eastern Mediterranean Region (EMR) hospitals. Methods: This research was a meta-analysis of research on job satisfaction among nurses in EMR hospitals. All studies published in three databases (PubMed, Scopus, Web of Science) and Google Scholar search engine were searched, collected, and assessed for quality. The STROBE checklist was used to determine the quality of the studies. Finally, 13 articles were analyzed using the CMA software. Results: Based on the random effects model, the overall job satisfaction among nurses in EMR hospitals was 17.9% (95% CI (11.9–26.0)). The highest job satisfaction was in hospitals in Palestine. Job satisfaction among nurses was higher in high-income countries than in others. The level of job satisfaction was also higher in private hospitals. Moreover, the results showed that average age and sample size caused heterogeneity between the reviewed studies (p < 0.05). Conclusion: According to the results of this study, about 18% of nurses in EMR hospitals felt satisfied with their job. Therefore, healthcare managers and policymakers in the EMR region must identify and eliminate the causes of dissatisfaction. [ABSTRACT FROM AUTHOR]

Background: Nurse staffing levels are increasingly challenged while pressures on healthcare systems are rising. There is a clear need to optimise efficiency in healthcare delivery in order to deliver safe, effective and quality health care. Aim: To understand how nurses working shifts spend their time and explore opportunities to improve efficiency in care delivery. Method: A time-motion study was conducted on three acute care wards in a district general hospital in West Wales; 13 nurses were observed over 14 shifts, each activity undertaken was recorded in real time. Findings: In all, 109 hours were observed. Approximately half of nurses' time is spent delivering direct patient care, with medications administration taking the majority of time. Conclusion: A number of recommendations are made involving processes and workforce modelling with the aim of improving efficiency and safety. Further research would be required to assess the impact of their introduction. [ABSTRACT FROM AUTHOR]

Background: Palliative and end-of-life care (EoLC) education is available to all community and hospital healthcare staff in one NHS trust in the north-east of England. It is also available to care home and domiciliary care staff within the geographical area of the trust. Aims: This service evaluation assessed the effect of current in-house education on staff confidence levels in delivering palliative and EoLC. It also examined staff perceptions of how attendance at these courses impacted on the palliative and EoLC patients receive across the locality. Method: A mixed-methods approach was undertaken. Anonymous data were collected via surveys (n=238) sent out in March 2023 covering educational courses that were delivered from 1 January to 31 December 2022 with a 13% response rate. Quantitative data were analysed using descriptive statistics. Qualitative data were explored using Braun and Clarke's (2012) six-stage approach to thematic analysis. A second staff member was asked to review the data to increase the trustworthiness of the study. Findings: Staff confidence levels in delivering palliative and EoLC increased by 19% (somewhat confident) and 23% (extremely confident) following attendance at trust education. Staff perceived that those patients received better palliative and EoLC as a result their attendance at these courses. The qualitative data identified five main themes: symptom control, psychological support, holistic care, patient advocacy, and advance care planning. Limitations of the study included the low survey response rate and lack of exploration of patient/carer perceptions directly. Conclusion: Palliative and EoLC education can increase staff confidence levels in care delivery and, as perceived by staff, results in better care for patients receiving palliative and EoLC. These findings provide evidence for the trust to consider making palliative and EoLC training mandatory, which could also be considered more widely regionally and nationally. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown that overall sleep quality among Chinese nurses is relatively low, with a sleep disorder prevalence rate of approximately 66.4%. Against the backdrop of healthcare reforms, China has been striving to improve the mental health and sleep quality of nurses. Stress mindset can influence how individuals respond to stress, but there is limited research on how stress mindset affects nurses' sleep quality. This study aims to explore the impact of stress mindset on sleep quality among nurses, as well as the mediating roles of stress overload and anxiety in this relationship. Methods: The study was conducted online using a questionnaire from February 18 to February 22, 2024. It utilized the Stress Mindset Measure (SMM), the Stress Overload Scale-Short (SOS-S), the Generalized Anxiety Disorder 7-item scale (GAD-7), and the Pittsburgh Sleep Quality Index (PSQI) to survey 441 nurses in three regions of China: Chongqing, Hunan, and Shandong (M = 34.39, SD = 7.82, 95.7% female). A chain mediation model was employed to examine the mediating roles of stress overload and anxiety in the relationship between stress mindset and sleep quality. Results: The participants' average sleep quality score was 7.18 ± 3.47. Nurses' stress mindset was significantly negatively correlated with both stress overload and anxiety, and significantly positively correlated with sleep quality. Stress overload was significantly positively correlated with anxiety and significantly negatively correlated with sleep quality. Anxiety was also significantly negatively correlated with sleep quality. The direct effect of nurses' stress mindset on sleep quality was significant (effect size = -0.10, 95% CI: -0.19 to -0.01), as were the indirect effects through stress overload (effect size = -0.05, 95% CI: -0.11 to -0.01) and anxiety (effect size = -0.09, 95% CI: -0.13 to -0.05), along with their chain mediation effect (effect size = -0.10, 95% CI: -0.14 to -0.06). Conclusion: Our study demonstrates that a higher level of nurses' stress mindset is associated with better sleep quality, with stress overload and anxiety mediating this relationship. A positive stress mindset helps nurses cope more effectively with professional challenges and reduces anxiety, leading to improved sleep quality. Healthcare institutions should therefore prioritize fostering positive stress mindsets in nurses, encouraging regular psychological training and workshops to support the development of effective coping strategies. [ABSTRACT FROM AUTHOR]

Background: Nurses play an essential role as frontline caregivers, particularly in recognizing and responding to patient deterioration. This study addresses nurses' self-leadership in the face of challenging situations such as patient deterioration, emphasizing the importance of self-leadership skills in navigating complex patient care scenarios. Delayed recognition of subtle changes in patient's conditions has been linked to adverse outcomes, necessitating a closer examination of the role of self-leadership in nursing practice. Objective: The objective of this research was to explore and understand the implications of self-leadership among nurses when confronted with challenging situations, specifically focusing on patient deterioration. Methods: A qualitative, exploratory, and descriptive research design was employed, utilizing focus group discussions (FGDs) with nurses from a private hospital in Pretoria, South Africa. Semistructured interview guide facilitated the FGDs, and data saturation was achieved after the eight sessions. The sample included nurses with various qualifications and shifts, offering diverse perspectives on self-leadership in patient care. Rigorous data collection and trustworthiness measures, including member checking and verbatim transcriptions, were employed to enhance the conformability of the study. Results: The findings revealed six overarching themes and 15 subthemes, demonstrating the interconnectedness of self-leadership and nursing practice. Themes included responsibility and autonomy, compassion and care, support and collaboration, learning from experience, teamwork, and appreciation and recognition. These themes explained how nurses actively engaged in self-observation, constructive thought patterns, and natural reward strategies to proactively address patient deterioration. Conclusion: The study underlines the significance of integrating self-leadership principles into nursing practice. Embracing self-leadership in nursing holds promise for improving patient outcomes and nurturing a resilient and competent nursing workforce. [ABSTRACT FROM AUTHOR]

Purpose: To examine the reliability of ADL interview (ADL-I) ability measures when administered by different health professionals (HPs). Materials and methods: Older adults with stable ADL ability were invited to participate in three ADL-I interviews, administered by occupational therapists (OTs), physical therapists (PTs), and nursing staff (NS), respectively. Methods based on classic and modern test theory were applied. Results: Overall, n = 36 older adults and n = 11 HPs participated. Intraclass Correlation Coefficients were acceptable for research purposes (> 0.7), but not for clinical use. Mean differences in ADL ability measures were significant when comparing measures based on interviews by OTs to measures based on interviews by PTs and NS. Further, in 25 to 47% of the individuals, ADL-I ability measures differed significantly across HPs. Limits of Agreement revealed that measures based on interviews by OTs were systematically lower compared to measures based on interviews by PTs and NS. Four ADL-I items displayed Differential Item Functioning based on HP. Conclusion: When using the ADL-I, it is recommended to only involve one profession, to increase the reliability of measures. Results highlight the importance of evaluating reliability of measures based on instruments administered across HPs before implementation in rehabilitation practice and research. IMPLICATIONS FOR REHABILITATION: Evaluations of activities of daily living (ADL) ability conducted in rehabilitation practice by different health professionals may not generate comparable results. When using the ADL-Interview, it is recommended to only involve one profession, to increase reliability of measures. The results of the present study highlight the importance of evaluating if ADL instruments can produce reliable measures in terms of both interrater reliability and measurement error. [ABSTRACT FROM AUTHOR]

Background: The Nipah virus has raised significant concerns in global health security. During the COVID‐19 pandemic, the nursing workforce continues to face numerous challenges, including inadequate preparedness for pandemics, a shortage of nursing personnel, physical, and mental exhaustion. Objective: This rapid review aimed to synthesize existing literature on the Nipah virus and its implications for the nursing workforce. Design: A rapid review was conducted to synthesize the available literature on the Nipah virus, facilitating the provision of timely and pertinent information to policymakers and decision influencers. A systematic search strategy was implemented between January 22 and February 9, 2024, from PubMed, CINAHL (EBSCO), Scopus, and Google Scholar without year limitation. Out of 149 studies, six studies were evaluated using the Joanna Briggs Institute Critical Appraisal Checklists, and one study was excluded based on this evaluation, resulting in five studies being included. Then these were reviewed using narrative synthesis. The study adhered to the preferred reporting items for systematic reviews and meta‐analyses (PRISMA) guidelines. Results: The selected research indicated that the virus was transmitted throughout the community and during hospital admissions, resulting in unexpected mortality. The healthcare staff, especially nurses, had a limited understanding of the infection. Although there is a lack of confidence in policy and decision‐makers, many public health initiatives have been implemented such as providing education on infection prevention and control methods to healthcare personnel, including nurses and support staff. Conclusion: There is a need to integrate continuing professional development programs in both primary health care and specialized medical care to strengthen the preparedness of healthcare personnel for future pandemics. Support systems not only for healthcare staff members, especially nurses, but also for allied personnel working with them to create conducive working environments. [ABSTRACT FROM AUTHOR]

Background: Many nurses join the profession because they have altruistic intentions, but some nurses experience barriers to acting on altruistic intentions which may be a source of job dissatisfaction or burnout. Objective: The purpose of this study was to evaluate construct validity, internal consistency, and convergence reliability of the Nursing Altruistic Execution Scale (NAES), a novel instrument assessing the perceived ability to help others through work. Methods: The NAES was developed based upon a literature review examining altruistic behavior as a motivator for nursing work, with expert feedback for instrument refinement. Participants completed the NAES, Copenhagen Burnout Inventory Work-Related Burnout Scale, and Satisfaction of Employees in Health Care Survey. Exploratory factor analysis examined construct validity and factor loadings. Confirmatory factor analysis verified consistency in factor structure. Linear regression assessed for convergence reliability with burnout and job satisfaction. Results: The sample included 843 acute care hospital nurses surveyed in January-March 2023. Exploratory factor analysis revealed a two-factor solution, named altruistic engagement with work and workplace barriers to altruism. Nine instrument items were retained and demonstrated strong internal consistency (Cronbach's alpha 0.79). There was a significant relationship between both factors of the NAES and both burnout and job satisfaction, demonstrating that greater altruistic execution is associated with lower burnout and greater job satisfaction. Conclusion: Preliminary findings support the use of the NAES as a valid and reliable scale. Findings show there is correlation between altruistic intentions and burnout. Interventions aimed at enhancing altruistic execution may reduce nurse burnout and thereby improve retention. [ABSTRACT FROM AUTHOR]

Background: Play can help paediatric patients cope with hospitalisation. Education on the use of play for healthcare professionals (HCPs) is lacking, with playful interactions often occurring unsystematically without formal training. This scoping review systematically describe the frameworks, design, and evaluation methods of educational programmes for HCPs on the use of play in paediatric clinical practice. Methods: We conducted the scoping review by searching nine databases for white literature and websites for grey literature. Two reviewers independently screened titles/abstracts and reviewed full texts. Kirkpatrick's evaluation model was applied to report the evaluation methods of educational programmes. Results: After identifying 16534 white and 955 grey items we included twenty articles but no grey literature. The educational programmes vaguely defined play for procedural and normalising purposes and mostly targeted mono-professional groups, mainly nurses. The evaluation methods identified in the articles were reported in accordance with Kirkpatrick levels 1: reaction (n = 13); 2a: attitude (n = 7); 2b: knowledge (n = 3); 3: behaviour (n = 6); 4a: organisational practice (n = 1) and 4b: patient outcomes (n = 4). Conclusion: The few educational programmes available on the use of play for HCPs are not uniformly described. Future educational programmes would benefit from integrating the needs of HCPs, patients and parents, and using a theoretical framework and systematic evaluation. [ABSTRACT FROM AUTHOR]

Introduction: The term "cultural humility" is often used, but both society and professionals, including nurses, lack a clear understanding of its meaning. This study examined the relationships, predictors, and differences of nurse leaders' cultural humility in nursing practice, as perceived by hospital nurses. Methodology: A quantitative transverse and correlational study was implemented with a convenience sample of 350 Jordanian registered nurses (RNs). Results: Nurses "agreed" on the presence of nurse leaders' cultural humility in nursing practice, but it was low. Working rotating shifts, holding a Baccalaureate degree in nursing or less, and having graduated from a private university predicted the perceived nurse leaders' cultural humility in nursing practice. Most differences in perceived nurse leaders' cultural humility in nursing practice came from nurses who worked rotating shifts when compared to those who worked day shifts. Discussion: Nurse leaders must practice open communication and embrace a receptive mind-set, as this will help eradicate the tendency of nurse leaders to believe they know "know-it-all." [ABSTRACT FROM AUTHOR]

Purpose: To present the first 14 years' data from 1 academic institution using the American Foundation for Suicide Prevention's online Interactive Screening Program (ISP). The ISP probes suicide risk factors in healthcare workers, utilization of mental health services, levels of engagement, and seeks to reduce barriers to help-seeking. Design: Data from all healthcare system students, medical trainees, physicians, nurses, and staff who completed the ISP's online Stress and Depression Questionnaire between May 1, 2009, and April 30, 2023, were tabulated and analyzed for features related to burnout, depression, suicide risk, treatment, and engagement with program counselors. Results: 5368 individuals engaged in ISP screening. Findings included 39.9% experiencing depression symptoms, 53.9% symptoms of burnout, and 10% suicidal ideation. In this self-selecting group, medical students reported depression symptoms less than physicians in practice, nurses almost 3 times more than physicians, and females more than males. Suicide risk was indicated by multiple domains of distress, with 49.4% in the highest risk tier. At the time of completing the questionnaire, 13.1% were receiving counseling/therapy. After receiving feedback, more than one-quarter of all participants (27.6%) engaged with the program counselors, with an additional 941 individuals who were not already receiving counseling or therapy accepting referrals to mental health providers. Conclusion: The unattended high distress levels throughout the healthcare training and workforce demonstrated the need for safe screening and referral, while the level of engagement and referrals generated by the ISP attested to its effectiveness. [ABSTRACT FROM AUTHOR]

Background: Compassion and moral intelligence occupy a very significant place in ensuring quality in health care services, increasing patient satisfaction, reducing side effects, increasing patient safety and accelerating the healing process. Aim: This study was conducted to determine the relationship between moral intelligence and compassion fatigue in nurses working in intensive care units. Study Design: In this descriptive and cross‐sectional study, 180 nurses working in intensive care units of a hospital comprised the population of the study. Of them, 114 who agreed to participate in the study were included in the study sample. The Personal Information Form, Yakut Moral Intelligence Scale (YMIS) and Compassion Fatigue‐Short Scale were used as data collection tools. The scales and forms used in the study were created on Google Form. Nurses were visited in intensive care units, and the forms were given to them. Then the participating nurses filled in the forms. Results: Of the nurses participating in the study, 69.3% were women and 65.4% had a bachelor's degree. The analysis of the correlation between the scores obtained from the sub‐dimensions of the YMIS by the nurses participating in the study demonstrated that there was a negative, low‐level significant relationship between the self‐control and kindness sub‐dimensions of the YMIS. As the nurses' compassion fatigue levels increased, their self‐control and kindness levels decreased. Conclusions: It can be said that as compassion fatigue levels increase in nurses, their moral intelligence levels decrease. Therefore, diagnosing compassion fatigue in nurses and taking precautions to prevent them from suffering from fatigue are of significant importance. Relevance to Clinical Practice: By determining the healthy intelligence and compensation spending levels of health workers, organizing maid training will increase the service and care provided. [ABSTRACT FROM AUTHOR]

Background: The care processes of cardiac surgery patients are difficult, complex and stressful. Nurses, who have an important role in the care of these patients, may experience burnout or poor quality of work life may be affected because of difficult care processes, and professional difficulties. Aim: This study analysed burnout and quality of work life in cardiac surgery nurses. Study Design: This cross‐sectional study was conducted with 68 nurses in the clinic and intensive care unit of a university hospital's cardiovascular surgery department. Clinical nurses care for inpatients in this department, while intensive care nurses care for patients in the intensive care unit. The 'Sociodemographic and Descriptive Characteristics of Nurses Form', 'Maslach Burnout Inventory' and 'Nursing Work Quality of Life Scale' were used to collect the data. Results: The mean score of emotional exhaustion sub‐dimension of Maslach Burnout Inventory was 15.25 ± 5.08 (min: 7, max: 27), the mean score of the personal accomplishment sub‐dimension was 17.48 ± 4.90 (min: 8, max: 27), and the mean score of depersonalization sub‐dimension was 5.60 ± 2.70 (min: 0, max: 13). The mean scores of the emotional exhaustion sub‐dimension (t: −2.380, p:.020, risk ratio [RR]: 1.67, confidence interval [CI]: [14.21, 18.82]) and the personal accomplishment sub‐dimension (t: −2.604, p:.011, RR: 1.00, CI: [16.08, 19.92]) were higher in intensive care nurses. The mean total score of the nursing quality of work life scale was 107.20 ± 14.60 (min: 72, max: 149). A negative statistically significant relationship was found between the mean scores of emotional exhaustion (r: −0.243, p:.045) and depersonalization sub‐dimension (r: −0.325, p:.007) of the Maslach Burnout Scale and the mean total score of the nursing quality of work life scale. Conclusion: In this study, it can be said that cardiac surgery nurses had moderate levels of emotional burnout, personal accomplishment and quality of work life, and low levels of depersonalization. At the same time, it can be seen that intensive care nurses have higher levels of emotional burnout. The increased emotional burnout and depersonalization in nurses decreased the quality of work life. Relevance to Clinical Practice: This study provided an understanding of burnout and quality of work life of cardiac surgery nurses. Strategies can be developed to reduce burnout and improve the quality of the work life of cardiac surgery nurses. Particular attention should be paid to intensive care nurses who experience more burnout on several sub‐dimensions. This may be a good approach to improving the quality of patient care. [ABSTRACT FROM AUTHOR]

Background: Tracheostomy tube changes are a considerable part of the management of patients with tracheostomy and are necessary for preventing aspiration pneumonia, especially in patients with long‐term tracheostomy. The process of tracheostomy tube changes in many patients may not be timely, safe or efficient. Aim: The objectives were to implement a quality improvement intervention that reduces the incidence of aspiration pneumonia in patients with tracheostomy, improve staff knowledge about tracheostomy tube changes and improve staff adherence to documentation. Methods: A pre‐post intervention design was used in this quality improvement project. We created a change strategy bundle that included identification of the need for and observation determination of the timing of tube changes timing, change assessments, identification of the person and location, preparation, co‐operation and maintenance. A tracheostomy tube change workflow was also created. Then, the intervention was implemented in the clinic after staff training. The incidence of aspiration pneumonia, staff knowledge and staff adherence were compared before and after the intervention. Results: Two hundred and 20 patients were enrolled (105 in the preintervention group; 115 in the postintervention group) with 88 tracheostomy tube change episodes (23 in the preintervention group; 65 in the postintervention group). Thirty‐five staff members completed the training and surveys. The incidence of pneumonia decreased from 43.8% to 27.8% after the intervention (p =.013). The knowledge score of staff increased from 46.57 ± 11.10 to 88.14 ± 6.76, and the implementation rate of the audit increased to 67.32%–100%. Conclusions: This quality improvement project regarding tracheostomy changes reduced the incidence of pneumonia, increased staff knowledge about tracheostomy tube changes and improved staff adherence. Relevance to Clinical Practice: A standardized tracheostomy tube change bundle, education, interprofessional collaboration and culture changes were important to ensure the best outcomes in this quality improvement project. These factors improved the timeliness, efficiency and safety of tracheostomy tube changes. [ABSTRACT FROM AUTHOR]

Background: There is scarcity of data on the incidence and factors associated with the occurrence of ocular lesions in critically ill children. Aim: Test the applicability and utility of an ocular assessment scale and to identify risk factors of ocular lesions. Study Design: Prospective observational study. A tertiary care medical‐surgical Paediatric Intensive Care Unit. 194 children without previous ocular disease who stayed in the Paediatric Intensive Care Unit for more than 48 h. An ocular lesions risk scale was designed including risk factors lagophthalmos, eye dryness, conjunctival hyperemia, slow blinking, intubation, sedation, relaxation, face mask and hemodynamic instability. Patients were classified as high‐, medium‐, and low‐risk patients. Corneal lesions were examined by fluorescein staining according to their risk and were confirmed by an ophthalmologist. Results: 76 patients were examined with fluorescein staining. Thirty‐two ocular lesions were detected by nursing staff, 26 confirmed by the ophthalmologist. 53.6% of the high‐risk patients developed a corneal lesion. Univariate analysis revealed an association between ocular damage and all factors included in the scale, except for face mask. In the multivariate analysis, ocular lesions were associated with lagophthalmos, hyperemia, invasive mechanical ventilation and inotropic support. Conclusions: The scale was useful to detect corneal lesions in critically ill children. The identification of risk factors will enable the development of measures to reduce the incidence of ocular lesions. Relevance for Clinical Practice: A new, non‐validated scale allowed staff to detect eye injuries, study this problem and improve future prevention. [ABSTRACT FROM AUTHOR]

Aim: Quantify disparities and identify correlates and predictors of 'wellness' supplement use among nurses during the first year of the pandemic. Design: Longitudinal secondary analysis of Nurses' Health Studies 2 and 3 and Growing Up Today Study data. Methods: Sample included 36,518 total participants, 12,044 of which were nurses, who completed surveys during the first year of the COVID‐19 pandemic (April 2020 to April 2021). Analyses were conducted in March 2023. Modified Poisson models were used to estimate disparities in 'wellness' supplement use between nurses and non‐healthcare workers and, among nurses only, to quantify associations with workplace‐related predictors (occupational discrimination, PPE access, workplace setting) and psychosocial predictors (depression/anxiety, county‐level COVID‐19 mortality). Models included race/ethnicity, gender identity, age and cohort as covariates. Results: Nurses were significantly more likely to use all types of supplements than non‐healthcare workers. Lacking personal protective equipment and experiencing occupational discrimination were significantly associated with new immune supplement use. Depression increased the risk of using weight loss, energy and immune supplements. Conclusion: Nurses' disproportionate use of 'wellness' supplements during the COVID‐19 pandemic may be related to workplace and psychosocial stressors. Given well‐documented risks of harm from the use of 'wellness' supplements, the use of these products by nurses is of concern. Impact: 'Wellness' supplements promoting weight loss, increased energy, boosted immunity and cleansing of organs are omnipresent in today's health‐focused culture, though their use has been associated with harm. This is of added concern among nurses given their risk of COVID‐19 infection at work. Our study highlighted the risk factors associated with use of these products (lacking PPE and experiencing occupational discrimination). Findings support prior research suggesting a need for greater public health policy and education around the use of 'wellness' supplements. Reporting Method: STROBE guidelines were followed throughout manuscript. Patient or Public Contribution: No patient or public contribution was involved. [ABSTRACT FROM AUTHOR]

Aim: To understand the status quo of multiprofessional and multidisciplinary collaboration for early mobilization of mechanically ventilated patients in Chinese ICUs and identify any factors that may influence this practice. Design: A multi‐centre cross‐sectional survey. Methods: From October to November 2022, the convenience sampling method was used to select ICU multiprofessional and multidisciplinary early mobility members (including physicians, nurses and physiotherapists) from 27 tertiary general hospitals in 14 provinces, cities and autonomous regions of China. They were asked to complete an author‐developed questionnaire on the status of collaboration and the Assessment of Inter‐professional Team Collaboration Scale. A multiple linear regression model was used to analyse the factors associated with the level of collaboration. Results: Physicians, nurses and physiotherapists mostly suffered from the lack of normative protocols, unclear division of responsibilities and unclear multiprofessional and multidisciplinary teams when using a collaborative approach to early activities. Multiple linear regression analysis showed that the number of ICU patients managed, the existence of norms and processes, the attitude of colleagues around them, the establishment of a team, communication methods and activity leaders were significant influences on the level of collaboration among members of the multiprofessional and multidisciplinary early activities. Conclusion: The collaboration of multiprofessional and multidisciplinary early activity members for mechanically ventilated patients in the ICU remains unclear, and the collaboration strategy needs to be constructed and improved, taking into account China's human resources and each region's economic development level. Impact: This study investigates the collaboration status of multiprofessional and multidisciplinary activity members from the perspective of teamwork, analyses the reasons affecting the level of collaboration and helps to develop better teamwork strategies to facilitate the implementation of early activities. Patient or Public Contribution: The participants in this study were multiprofessional and multidisciplinary medical staff who performed early activities for ICU patients. [ABSTRACT FROM AUTHOR]

Aim(s): To evaluate the literature to inform and propose a conceptual definition for dementia friendly in the context of hospitalization. Methods: The Walker & Avant method for concept analysis was utilized for this review. Data Sources (Include Search Dates): Initial search conducted June 2022. Repeated search conducted in February 2023. Databases for the literature search include Scopus, PubMed, CINAHL, PsycINFO, and AGELINE. Results: Five attributes of the concept of dementia friendly in the context of hospitalization were identified including: staff knowledge/education, environmental modification, person‐centred care, nursing care delivery and inclusion of family caregivers. Based on these attributes a conceptual definition is proposed. Conclusion: A clarified definition for dementia friendly in the context of hospitalization will aid in understanding the concept, provide guidance for hospitals seeking to implement dementia‐friendly interventions and benefit researchers aiming to study the impact of such programs. Reporting Method: n/a. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aim: To explore experiences of patients affiliated to a cross‐sectorial outgoing lung team. Background: The outgoing lung team consisted of respiratory nurses from the hospital and community nurses. The lung team offered 24/7 help to patients with advanced chronic obstructive pulmonary disease (COPD) through visits and/or treatment in the patients' home. Affiliation to the lung team reduced both hospitalizations and length of hospital stay due to acute exacerbation of COPD. However, based on questionnaires on health‐related quality of life, no significant differences were found between patients affiliated to the lung team and patients receiving usual care. Design: A qualitative interview study. Methods: In total, 16 patients, aged 61–88 years were interviewed between February 2019 and July 2021. They had been affiliated to the outgoing lung team for 1–3 years. Semi‐structured interviews were conducted in the patients' home and audio‐recorded after informed consent was obtained. The interviews were transcribed verbatim and analysed, inspired by systematic text condensation by Malterud. Findings: Four themes emerged from the analysis: (1) feeling safe, (2) improvements in living with COPD, (3) avoiding hospitalization and (4) satisfied with staying at home. Conclusion: Affiliation to the cross‐sectorial outgoing lung team gave the patients peace of mind and improved their ability to live with advanced COPD. The patients preferred contacting the lung team because they could stay at home and receive treatment, and thus avoid hospitalization. Impact: The findings from this study support that municipalities should consider implementing an outgoing lung team, as it has the potential to bring several benefits, including improving patient self‐management. Reporting Method: The manuscript adhered to Consolidated criteria for reporting qualitative research (COREQ) guideline. Patient or Public Contribution: Patients were interviewed. Additionally, no patient or public contributed to the design or conduction of the study, analysis, or interpretation of the data. [ABSTRACT FROM AUTHOR]

Aim: To explore general nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards. Design: Qualitative action research was used working with nurses as co‐researchers. Methods: Pre‐implementation focus groups were conducted in April 2022 to understand and explore the current strategies nurses utilized to avert, respond to or decrease violence. Following this, two Safewards interventions were modified by the nurses on the wards. Post‐implementation focus groups were conducted in October 2022, to explore the nurses' experience of implementing Safewards interventions and the effect on their nursing practice. Data were analysed using Braun and Clarke's framework for thematic analysis. Results: Three themes emerged from the analysis of the pre‐implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred: 'the space is hectic'; 'it can feel like a battlefield'; and 'the aftermath'. These themes encompass the nurses' experience of violence from patients and their visitors. Following the implementation of two modified Safewards interventions, the analysis of the focus groups reflected a change in nursing skills to avert or respond to violence: 'Safewards in action'; 'empathy and self‐reflection'; and 'moving forward'. Conclusion: Safewards interventions can be successfully modified and used in general hospital wards and influence nursing practice to manage patient and visitor violence. Implications for the Profession: In the interests of safety, successful interventions to reduce violence towards general hospital nurses should be a priority for managers and healthcare organizations. Averting, mitigating and managing violence can decrease the negative professional and personal effect on nurses and ultimately improve well‐being, job satisfaction and retention rates. Furthermore, decreasing violence or aggressive incidents leads to a safer patient experience and decreased number of nursing errors ultimately improving patient experiences and outcomes. Understanding nurses' experiences of violence and working with them to explore and develop contextually relevant solutions increases their capacity to respond to and avert violent incidents. Contextually modified Safewards interventions offer one such solution and potentially has wider implications for healthcare settings beyond the specific wards studied. Impact: This study addressed the implementation of modified Safewards strategies in medical and surgical wards to prevent violence.Three themes emerged from the analysis of the pre‐implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred.Following the implementation of two modified Safewards interventions, the post‐implementation focus groups reported positive changes to their practices using the modified resources to prevent violence from patients and their visitors.Mental health interventions, such as those used in the Safewards model can be modified and provide a tool kit of interventions that can be used by medical and surgical nurses. Reporting Method: This paper has adhered to the COREQ guidelines. Patient or Public Contribution: No patient or public contribution. What Does this Paper Contribute to the wider Global Clinical Community?: This paper outlines and discusses the action research approach undertaken to work with general hospital nurses to modify mental health nurses' Safewards interventions into their clinical practice.This paper provides evidence of the 'real world' application of Safewards interventions by medical and surgical nurses in general hospital wards.This paper presents qualitative findings based on focus group methods to highlight the narratives of general nurses and their experiences of violence. [ABSTRACT FROM AUTHOR]

Aim: To investigate the potential challenges experienced by cardiac intensive care unit (ICU) nurses in the first out‐of‐bed patient mobilization after open‐heart surgery and propose solutions. Design: A qualitative study design using the descriptive phenomenological approach. Methods: Individual face‐to‐face interviews were conducted via a widely used videoconferencing program between 28 July and 22 October 2022, in the tertiary cardiac ICU of a university hospital. Nurses who had at least 1 year of cardiac ICU experience and actively participating in patient care were included. The COREQ criteria and checklist were followed in this investigation and the data were analysed by using the ATLAS.ti 8.0. Findings: Nurses reported that they experience challenges when mobilizing patients, such as patients' fear, reluctance or resistance; nurses having insufficient experience, strength or lack of team members. Despite these challenges, they highlighted some positive outcomes of mobilization, such as feeling happy, reinforced team communication and nurse–patient relationship. The nurses also suggested some facilitators, such as patient motivation and an explanation of the process. Conclusion: Nurses experience various patient‐related and nurse‐related challenges during the first out‐of‐bed mobilization of the patient after open‐heart surgery. It is recommended that healthcare institutions should implement effective strategies to address the staffing shortages and to support nurse motivation to ensure adequate nursing care. Impact: This study provides valuable insights into the existing literature by examining the potential challenges and strategies of the first out‐of‐bed patient mobilization in the cardiac ICU. It shows that patient education and organizational adaptations are effective ways to overcome the challenges. It also suggests that motivating and informing patients before the mobilization can make the process easier. Moreover, it reveals that successful patient mobilization makes nurses happy, improves team communication and strengthens nurse–patient relationship. Patient and Public Involvement and Engagement: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Whistleblowing is an action that particularly requires moral courage. Understanding the relationship between nurses' levels of moral courage and their whistleblowing approaches is important for reducing adverse situations in healthcare services. Objectives: This study aims to understand and analyze the relationship between nurses' levels of moral courage and their whistleblowing approaches. Research design: This is a descriptive and correlational study. Methods: The study sample consists of 582 nurses actively working in a province in northwest Türkiye. Research data were collected using an Information Form, the Nurses' Moral Courage Scale, and the Whistleblowing Scale. Ethical considerations: Ethical approval from the ethics committee, institutional permission, and informed consent from the participants were obtained for data collection. Findings: Nurses were found to perceive their moral courage as high, and their whistleblowing levels were at a moderate level. There was a significant and moderate relationship between participants' levels of moral courage and whistleblowing levels (p <.05). Conclusions: The findings emphasize the importance of promoting moral courage and creating an appropriate environment for exposing ethical violations. This study can contribute to the development of strategies to enhance nurses' moral courage and foster a more ethical working environment in healthcare services. [ABSTRACT FROM AUTHOR]

This research was conducted as a descriptive study in order to examine the effects of the moral problems experienced by nurses working in intensive care clinics on their end of life care behaviors. The data were collected using the Moral Distress Scale and Caring Behaviors Inventory. It was found that 74.5% of the nurses were women and their mean age was 32.60 ± 6.6 years. The frequency of moral distress in the nurses was 44.27 ± 16.25 and total score was 111.02 ± 63.85. There were significant differences in the scores of the concept the use of futile treatment by nurses, the decision not to begin life-support treatment being made only by physicians, and moral distress and discomfort felt by pediatric intensive care nurses (p <.05). A statistically significant relationship was found between total scores of discomfort on moral distress and assurance, knowledge and skills, connectedness, and being respectful on the end of life care behaviors (p <.05). [ABSTRACT FROM AUTHOR]

This study was conducted to determine the good death perceptions of intensive care and oncology inpatient unit nurses, their attitudes toward care of the dying and the correlation between them. The sample of this study consisted of 134 intensive care and oncology inpatient unit nurses. The data were collected using the Frommelt Attitudes Toward Care of the Dying Scale and the Good Death Scale. As the results of the study, the nurses had high good death perceptions. They had moderately positive attitudes toward care of the dying patients. As their good death perceptions increased, their positive attitudes toward care of the dying individual also increased. It is recommended to organize programs to raise awareness of nurses about good death and attitudes toward the dying patients and to strengthen their communication and coping methods. [ABSTRACT FROM AUTHOR]

This review article examines the recent (i.e., since the late-1990s) research on deathbed visions (DBVs). The reviewed material includes the features of DBV experiences, terminology and definitional issues in the literature, and prevalence reports of DBVs by family members/caregivers of dying persons, healthcare professionals, terminally ill patients, hospice palliative care volunteers, and nursing home staff. The impact of DBVs on dying persons, why deathbed visitors appear, and possible explanations for DBVs are also considered. The lessons learned from the literature review include the following: DBVs are common experiences that cannot be easily explained, and they typically have positive impacts on dying persons, not the least of which is lessening the fear of death. The literature review also highlights the need for training and education about DBVs. [ABSTRACT FROM AUTHOR]

Purpose: Coronavirus disease (COVID-19) has challenged leadership in hospitals worldwide. The experiences of leadership during the pandemic changed leadership significantly. This study aims to describe nurse leaders' perceptions of what future leadership in hospital settings in the post-pandemic era needs to be like. Design/methodology/approach: A qualitative descriptive study was used. A total of 20 nurse leaders from the Finnish central hospital were interviewed from June to October 2021. The data were analysed using inductive content analysis. Findings: The analysis revealed five main categories describing nurse leaders' perceptions of future leadership in hospital settings in the post-pandemic era: digitalisation and hybrid working culture, development of sustainable working conditions, moving smoothly to the post-pandemic era, dissolution of traditional regimes of organisation and flexibility in leadership. Practical implications: In the post-pandemic era, the constantly changing demands and challenges currently facing healthcare systems have significantly increased the complexity of hospital organisations. This requires critical evaluation and change to traditional leadership. Enhancing flexibility and authenticity in leadership, strengthening competencies, implementing a wide range of digital resources and increasing the appeal of the nursing profession to build the next generation of nurses – all of these are needed to provide sustainability in future healthcare. Originality/value: The results identify the critical points of leadership that need to be developed for future challenges and for maintaining a sufficient supply of qualified professionals. Acting on this information will enhance flexibility in organisations and lead to acceleration of changes and the development of new kinds of leadership in the future [ABSTRACT FROM AUTHOR]

Purpose: The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden. Design/methodology/approach: Questionnaire data from a longitudinal study of staff working in elderly care were used. Data were collected using the Leadership and Management Inventory. First data collection was for explorative factor analysis (n = 1,149), and the second collection, one year later, was for confirmatory factor analysis (n = 1,061). Findings: The explorative factor analysis resulted in a two-factor solution that explained 70.2% of the total variance. Different models were tested in the confirmatory factor analysis. The final model, a two-factor solution where three items were omitted, showed acceptable results. Originality/value: The instrument measures both leadership and management performance and can be used to continually measure managers' performances as perceived by staff to identify areas for development. [ABSTRACT FROM AUTHOR]

Background: Nurses experience high job demands, which makes recovery particularly necessary to maintain well-being and performance. However, these demands also make recovery challenging. Short mindfulness meditations could potentially help alleviate this paradox. Methods: Two ecological momentary intervention studies were conducted among geriatric nurses (Study 1: break study) and hospital nurses (Study 2: after-work study) to investigate whether short audio-guided mindfulness meditations are beneficial for recovery during breaks and psychological detachment after work. Furthermore, break recovery and after-work detachment were examined as mediators of the associations between mindfulness meditations and after-break/after-sleep mood and attention after respective recovery periods. Multilevel path models were based on a sample of 38 nurses and 208 after-break surveys in the break study and 26 nurses and 192 after-sleep surveys in the after-work study. Results: Compared to breaks spent as usual, breaks that incorporated short mindfulness meditations were associated with higher break recovery, which mediated the positive associations between mindful breaks and after-break calmness, valence, and energetic arousal. Only with certain constraints did mindfulness meditations predict a lower rate of attention failures. In the after-work study, short mindfulness meditations were positively related to psychological detachment, which mediated the positive associations between the intervention and after-sleep valence and calmness. Conclusion/Application to Practice: Both pilot studies showed that short mindfulness meditations aid in recovery among nurses. However, to fully utilize the advantages of recovery-promoting breaks, structural changes are necessary to ensure that breaks of an appropriate duration are consistently implemented. [ABSTRACT FROM AUTHOR]

Background: Promoting safe patient mobility for providers and patients is a safety priority in the hospital setting. Safe patient handling equipment aids safe mobility but can also deter active movement by the patient if used inappropriately. Nurses need guidance to choose equipment that ensures their safety and that of the patients while promoting active mobility and preventing workplace-related injury. Methods: Using a modified Delphi approach with a diverse group of experts, we created the Johns Hopkins Safe Patient Handling Mobility (JH-SPHM) Guide. This diverse group of 10 experts consisted of nurses, nurse leaders, physical and occupational therapists, safe patient handling committee representatives, and a fall prevention committee leader. The application of the tool was then tested in the hospital environment by two physical therapists. Findings: Consensus was reached for safe patient handling (SPH) equipment recommendations at each level of the Johns Hopkins Mobility Goal Calculator (JH-Mobility Goal Calculator). Expert SPH equipment recommendations were then added to JH-Mobility Goal Calculator levels to create the JH-Safe Patient Handling Mobility Guide. JH-Safe Patient Handling Mobility Guide equipment suggestions were compared with equipment recommendations from physical therapists revealing strong agreement (n = 125, 88%). Conclusion: The newly created JH-Safe Patient Handling Mobility Guide provides appropriate safe patient-handling equipment recommendations to help accomplish patients' daily mobility goals. Applications to Practice: The Johns Hopkins Safe Patient Handling Mobility Guide simultaneously facilitates patient mobility and optimizes safety for nursing staff through recommendations for safe patient handling equipment for use with hospitalized patients. [ABSTRACT FROM AUTHOR]

The article discusses research about U.S. nurses' lived experiences during the global COVID-19 pandemic. Topics discussed include the COVID-19 impact on the practice environment, the personal and professional impacts of the pandemic on nurses, and the effects of the pandemic on patient- and family-centered care.

Background: Patient health literacy (HL) affects health and wellbeing on both individual and population levels. The ability to receive, understand, manage and act upon health information can be positively influenced by nurses' use of HL strategies. This study examined the relationship between nurses' use of a HL checklist (intervention) and before and after patient HL scores, and the effects of frequency and types of strategies used in specialty consultations in Spain. Methods: This quasi-experimental, non-randomized study used the HLS19-Q12 to calculate HL scores for 149 patients. Calculations were performed both before and after a nursing intervention that consisted of using a HL checklist. Paired samples t-test assessed the difference between patient HL scores pre- and post-nurse intervention. Frequency analysis and Pearson correlation where used to examine frequencies of nursing HL strategies used and associations with HL scores. Results: The mean difference between the HLS19-Q12 scores before and after intervention was − 9.94, with a standard deviation of 11.50. There was a statistically significant effect of the intervention on HL score (t = -10.00, p < 0.001). No participant had HL classified as 'inadequate' after the nursing intervention. Verbal teach back method was the most frequent strategy used by nurses, and the use of a computer image was the most frequent visual aid. Conclusions: The use of a standardized HL intervention by nurses was shown to have a positive effect on patient general HL scores in specialty consultations in Spain. These results not only suggest that the use of a HL checklist can be an effective HL tool, but also reinforce the potential of nurses to make a positive impact on both individual and population health. Overall, these findings provide data that can be used by health systems, hospitals management, and nurse education programs to adopt strategies to improve patient HL and health outcomes, while potentially lowering costs and ineffective resource utilization related to inadequate HL. [ABSTRACT FROM AUTHOR]

Aim: This study was designed to examine the nurse managers' boundary-spacing leadership's impact on the relationship between nurses' work embeddedness and innovative work behaviors. Background: In today's evolving healthcare environment, innovation is essential for enhancing patient care, optimizing resources, and supporting healthcare professionals. Nurses are pivotal in driving bedside innovation, but cultivating a culture of innovation within nursing teams involves more than just promoting creative ideas. Methods: This is a descriptive correlational study that was conducted at one governmental hospital in Tanta, Egypt. Using Nurse Managers Boundary-Spacing Scale for assessing boundary-spacing leadership, The Global Job Embeddedness Scale for measuring work embeddedness, and Innovative Work Behavior Scale for assessing innovative work behavior, 250 nurses were surveyed. Data analysis was run using descriptive and inferential analysis. Correlation and regression analysis were used to examine the study hypotheses. Results: There is a statistically significant positive relationship between boundary-spacing leadership and work embeddedness (r = 0.615, p < 0.001). Boundary-spacing leadership accounted for 56% of the variance in work embeddedness and 36% of the variance in nurses' innovative work performance. These results highlight the pivotal role of boundary-spacing leadership in both enhancing nurses' work embeddedness and boosting their innovative behaviors. The substantial variance explained by boundary-spacing leadership underscores its critical influence on fostering a supportive and innovative work environment within the nursing field. Conclusion: Boundary spacing leadership style involves connecting internal and external resources, fostering information exchange, and advocating for the nursing team. While work embeddedness positively correlated with innovative work performance, its impact was less significant than boundary-spacing leadership. This suggests that feeling attached to the organization fosters innovation, but leadership style has a stronger influence. Furthermore, the study found a positive and significant correlation between innovative work performance and both work embeddedness and nurse managers' boundary spacing leadership. Practical Implications: The findings emphasize that boundary-spacing leadership is crucial for enhancing both nurses' work embeddedness and innovative behaviors. Healthcare organizations should focus on developing these leadership skills to create a supportive work environment, foster innovation, and improve staff retention [ABSTRACT FROM AUTHOR]

Background: Evidence-based practice is clinical decision-making using the best evidence available in the context of individual patients' preferences and clinical expertise. It is serving as a crucial instrument for the health science disciplines to minimize the theory-practice gap although the level of practice is unknown. Thus, this study aimed to assess nurses' implementation of evidence-based practice in nursing process and its associated factors in South Wollo Zone Public Hospitals. Methods: An explanatory sequential mixed method was employed from April 1 to May 29, 2023, among 419 nurses for the quantitative part and 15 others for the qualitative part. The data were collected using structured, pretested, self-administered questionnaires. Simple random and purposive sampling techniques were used to select participants for the quantitative and qualitative studies, respectively. The bivariable analysis was done primarily, and variables with a p-value < 0.25 were further examined using a multivariable logistic regression model to control con-founders. Then, variables having a p-value less than 0.05 with a 95% CI were used to declare significantly associated factors. The key informants were interviewed using pre-made interview guidelines, and then open code software was utilized to conduct a thematic analysis. Result: Nurses who had poor implementation of evidence-based practice in the nursing process were 228 [54.42%; 95% CI: (49.8–59.3)]. Similarly, the key informants concluded that the implementation of evidence-based practice in the nursing process was low. Participants who were 31– 40 years old [AOR = 0.61, 95% CI: (0.38–0.99)], 41–50 years [AOR = 0.32, 95% CI: (0.15–0.65)], working at general hospitals [AOR = 3.37, 95% CI: (1.39–8.18)] and comprehensive specialized hospitals [AOR = 7.29, 95% CI: (3.06 − 17.31)], lack of training about evidence-based practice (AOR = 2.50, 95% CI: (1.36–4.56)], and lack of internet access [AOR = 2.46, 95% CI: (1.43–4.23)] were factors associated with poor levels of nurses' implementation of evidence-based practice in the nursing process. The absence of computers, libraries, and updated guidelines were other factors identified on the quality analysis. Conclusion: Nurses' implementation of evidence-based practice in the nursing process was low. Age, working in general hospitals, and comprehensive and specialized hospitals, lack of training, and internet access were factors that had significant associations. Hence, hospital managers should give an attention to internet access and training about utilization of evidence-based practice in nursing process, particularly for those aged above thirty years old. [ABSTRACT FROM AUTHOR]

Objectives: To describe the essential competencies required for patient engagement in their own safety. Method: We adopted a phenomenological approach in qualitative research to conduct semi-structured interviews with nurses (n = 14) and adult patients (n = 13) from different departments. By deeply exploring their experiences and feelings about patient engagement in patient safety, we sought to understand their views on the qualities that patients need to possess in order to participate in their own safety. Results: From the interviews, we identified six major themes, including competence of information sharing, competence of taking patient engagement as responsibility and right, competence of making equal communication, competence of maintaining trust relationship with health personnels, competence of accepting non-punitive safety culture, need of resource support, five of them showed essential competences for patients and one of them showed patients' need for promoting their engagement. Conclusion: The findings of this study show necessary competence and needs in patient engagement process of patient, offer a foundational reference for constructing a measurement tool for patient engagement in patient safety competence in the future, so that medical staff and patients can provide reference for the future targeted construction of patient competence improvement programs. At the same time, improving patient competence and engagement to better achieve safety goals requires the joint efforts of patients, medical staff, medical institutions, the government, and society. [ABSTRACT FROM AUTHOR]

Background: Nurses' attitudes towards communication with patients influence the effectiveness of communication, which could reduce patients' negative emotions and improve their adherence to medication and treatment. The aim of this study was to develop a Chinese version of the nurses' attitudes towards communication with the patient (ACO) scale and examined its validity and reliability. Methods: The Chinese version ACO scale was generated using the translation-backward translation method and cross-cultural adaption.The psychometric properties of the scale, including item-to-total correlations, discriminative validity, content validity, structural validity, convergent validity, internal consistency reliability and test-retest reliability, were evaluated. Data were collected from a convenience sample of 610 clinical nurses from four hospitals and were analyzed using both exploratory factor analysis and second-order confirmatory factor analysis. Result: The reliability was demonstrated with item-to-total correlations of greater than 0.40, Cronbach's alpha of 0.946 and intraclass correlation coefficients of 0.879. Content validity was acceptable and discriminative validity showed a significant discriminative ability. Exploratory and confirmatory factor analyses revealed a three-factor model. Convergent validity was confirmed by a moderate relation with a measure for nurses' empathy (r = 0.375, P<0.01).The test-retest reliability was satisfactory within a 2-week interval. Conclusion: The ACO is a reliable and valid instrument to assess nurses' attitudes towards communication with patient in Chinese hospitals. [ABSTRACT FROM AUTHOR]

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

Background: With the surge in China's registered nurse population, defining their rights and responsibilities is crucial for ensuring the quality of medical services. However, challenges such as unresolved medical disputes and unclear duties persist due to the inadequacy and lack of transparency in current nursing laws and policies. This study evaluated nurses' legal awareness, legislative needs, and views on laws and policies affecting their practice, providing insights for future improvements in nursing legislation. Methods: This study employed a descriptive qualitative approach, utilizing purposive sampling to select 16 nurses for in-depth exploration of their experiences. Semi-structured interviews were conducted between December 2023 and March 2024. Data analysis was performed using directed content analysis. Results: A total of 16 nurses with various positions and titles were interviewed. The analysis revealed three main themes and nine sub-themes, focusing on existing issues in the nursing environment, legal training needs, and attitudes towards legislative empowerment. Conclusions: In China, there is a gap in legal knowledge and training among nurses. Enhancing their legal literacy is crucial for elevating their professional status and the quality of their work. Our findings underscore strong support for the enactment of the Nurse Act with a focus on practice conditions, rights protection, and career development. National authorities and experts must expedite this legislation to safeguard the rights of nurses, bolster their professional confidence. [ABSTRACT FROM AUTHOR]

Background: Missed nursing care has become a global health concern because of its impact on patient safety and nursing care quality. It is a critical indicator of nursing care quality and adverse patient outcomes. However, data regarding the magnitude and reasons for missed nursing care is limited in the study area. This study aimed to determine the magnitude and reasons for missed nursing care among nurses working in South Gondar zone public hospitals. Methods: An institution-based cross-sectional study design was conducted among nurses working in South Gondar zone public hospitals from December 12, 2023, to January 20, 2024. The data was collected through self-administered MISSCARE survey tools. The collected data were entered into EpiData V.4.2 and then exported to SPSS V.25 for analysis. The statistical significance of the association between outcome variables and independent variables was declared at a P-value less than 5% (0.05) at 95% CI. Result: The magnitude of missed nursing care in the study area was 51.7% (95% CI: 46.89–55.47%). Medications administered as ordered (69.8%), skin/wound care (69.8%), vital signs assessed as ordered and accordingly (68.8%), and IV/central line site care and assessments according to hospital policy (66.2%) were among the nursing care elements that were frequently missed. Material resource (76.7%), teamwork (69.1%), labor resource (65.5%), and communication (56.3%) were the main reasons for missed nursing care. Inadequate number of staff 2.9 (1.75, 4.75), training (CPD) in nursing care 1.9 (1.16, 3.14), equipment's not available 3.9 (2.16, 6.89), and medication were not available. 4.4 (2.48, 7.76) were associated with missed nursing care. Conclusion: The proportion of commonly missed nursing care was high. After adjusting for demographic variables, labor resources, material resources, and communication were reasons for commonly missed nursing care. Increasing the number of nurses, investing in nurse training, working on equipment availability, and increasing medication availability could minimize frequent omissions of nursing care. [ABSTRACT FROM AUTHOR]

Background: The clinical readiness of newly graduated nurses is crucial in meeting the growing demand for health services. Consequently, it is essential to develop a scale that accurately evaluates the clinical readiness of these novice nurses. Aim: This study aimed to translate and psychometrically evaluate the Persian version of the Nursing Practice Readiness Scale (NPRS) for new graduate nurses. Methods: This methodological and cross-sectional study was conducted on new graduate nurses from June to November 2023 in Kermanshah City, Iran. The translation of the scale was performed using the forward–backward translation method. Construct validity was assessed using Exploratory Factor Analysis (EFA) with a sample of 180 participants and Confirmatory Factor Analysis (CFA) with a sample of 318 participants, both employing the convenience sampling method. The internal consistency of the tool was measured using Cronbach's alpha coefficient. Additionally, the tool's reliability was evaluated using the intraclass correlation coefficient (ICC). The analyses were conducted using SPSS version 27 and LISREL version 8 software. Results: The results of EFA and CFA confirmed the tool's structure, comprising five factors and 35 items. The CFA results showed a well-fitting model (CFI = 0.96, NNFI = 0.96, GFI = 0.893, RMSEA = 0.062, SRMR = 0.049). Pearson's correlation coefficient indicated a significant relationship between the items, subscales, and the main scale. Additionally, the Cronbach's alpha coefficient of the tool was 0.932, and the intraclass correlation coefficient (ICC) was 0.891(0.724–0.957). Conclusion: The Persian version of the Nursing Practice Readiness Scale (NPRS) is a valid and reliable tool, comprising 35 items and five factors. This scale can be effectively used to evaluate the clinical readiness of newly graduated nurses within the Iranian community. [ABSTRACT FROM AUTHOR]

Background: With the evolution of disease patterns and the continuous pursuit of persons for high-quality nursing services, new nurses are the reserve talents of the nursing team and shoulder a major mission. However, due to their low work performance and high turnover rate, this is not conducive to the stable development of nursing teams, and it is urgent to solve this problem. The purpose of this study was to explore the effect of work readiness on the work performance of new nurses, focusing on the mediating role of organizational justice and professional identity. Method: A cross-sectional design was employed. Using convenience sampling methods, 607 new nurses were surveyed in 5 hospitals in Henan Province, China, from January to February 2023. Data were collected using demographic characteristics questionnaire, the Work Performance Scale, the Work Readiness Scale for Graduate Nurses, the Organizational Justice Scale, and the Professional Identity Rating Scale for Nurses. AMOS 26.0 was used for model drawing and mediation path testing, and SPSS 25.0 was used for data analysis. Results: The mediation model shows a good fit (χ2 /df = 2.747, CFI = 0.987, GFI = 0.948, AGFI = 0.926, TLI = 0.984, IFI = 0.987, and RMSEA = 0.054). In this study, we found professional identity is a mediating variable between work readiness and the work performance of new nurses (β = 0.113, P<0.01), organizational justice is a mediating variable between work readiness and the work performance of new nurses (β = 0.269, P<0.01) and Organizational justice and professional identity play a chain mediating role in work readiness and work performance (β = 0.066, P<0.01). Conclusions: The study highlights the importance of improving the work performance of new nurses. To improve work performance, managers should create a fair atmosphere, formulate transparent policies, improve the organizational justice of new nurses, and promote the professional identity and work readiness of new nurses by holding activities or conducting lectures. This will help stabilize the nursing team, improve the medical environment, stimulate the work enthusiasm of new nurses, and contribute to the development of the hospital. [ABSTRACT FROM AUTHOR]

AIMS: This study investigated the status and influencing factors of organizational silence among 624 nurses in general hospitals in eastern coastal cities of China. Methods: This study followed STROBE guidelines. During the period from January to April 2024, the researchers investigated 624 clinical in-service nurses in terms of general information, employee silence behavior, work engagement, and peer support, and analyzed the related factors affecting nurses' organizational silence. Results: The total average score of nurses' organizational silence was (33.88 ± 6.88), and the total score of work engagement was (69.23 ± 10.76); The total score of the colleague support scale was (90.02 ± 13.72), which was at the medium level. Univariate analysis showed that the scores of organizational silence of 610 nurses had statistical differences in departments, employment methods and professional titles (P < 0.05); Pearson correlation analysis showed that nurses' work engagement (r=-0.530, P < 0.05), perceived colleague support a scale (r=-0.530, P < 0.05), colleague support B scale (r=-0.363, P < 0.05) were negatively correlated with organizational silence; Multiple linear regression analysis showed that department (β'value = 0.256, P = 0.001), employment mode (β'value = 0.115, P = 0.001), professional title (β'value = 0.741, P = 0.023), working years (β'value = 1.1110, P = 0.000), work engagement (β'value6.182, P = 0.000), colleague support scale A (β'value = 0.198, P = 0.003), and scale B (β'value = 0.485, P = 0.001) were the main influencing factors of nurses' organizational silence behavior. Conclusions: In this study, nurses' organizational silence is at the medium level, and nursing workers with low outpatient service, contract system, professional title and working years, less work investment and poor support from colleagues are prone to silence behavior. [ABSTRACT FROM AUTHOR]

The bullying of nurses by patients, doctors, and employees is common in the healthcare industry. Nurses who are bullied are more likely to experience burnout, and nurses who experience burnout are more likely to intend to quit. However, few studies investigate how leadership can mitigate workplace incivility and nurse bullying as a way to improve nurse retention. A cross‐sectional study was conducted using a sample of 216 nurses recruited from various regions across the United States from different specialties. A moderated mediation model using path analysis was used to examine the relationships between bullying, burnout, and ethical leadership in predicting intentions to stay. Bullying significantly and positively related to burnout (β = 0.22, p = 0.02), and burnout significantly and negatively related to intent to stay (β = −0.18,p = 0.01). Perceived ethical leadership predicted intentions to stay (β = 0.62, p = 0.00), and ethical leadership moderated the effect of bullying on burnout (β = 0.20, p = 0.03). The results of our study also suggest that nurses are less likely to quit when ethical leadership is present, and ethical leadership weakens the effect of bullying on burnout. [ABSTRACT FROM AUTHOR]

Objective: Burnout is becoming a major problem in medicine, and some articles have pointed to the link between burnout and anxiety. Several factors can contribute to burnout and anxiety, and recognizing each can improve medical education environments. The purpose of this study is to determine the relationship between personal characteristics, anxiety and burnout of orthopedic residents. Method: In this cross-sectional study, the anxiety rate, depression, and burnout were evaluated in 94 orthopedic residents above the second year and orthopedic fellowships in three hospitals. Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and Maslach Burnout Inventory—Human Services Survey (MBI-HSS) were used to measure the levels of depression, anxiety, and burnout, respectively. Multivariate logistic regression analysis was used to evaluate predictor variables for burnout. Results: Severe anxiety and depression were reported in 17% and 12.77% of residents, respectively. The rate of burnout for Emotional Exhaustion (EE), Depersonalization (DP), and low sense of Personal Accomplishment (PA) subscales was 18.09%, 28.72%, and 43.62% of people with high levels of burnout, respectively. Multivariate analysis of logistic regression showed that Works > 60 h per week, Anxiety score > 28, Time spent in the hospital > 9 h per Day, Academic year and Experience being abused by the upstream, Balance between work and life, Feeling the need for support from nurses in the hospital were significantly associated with burnout. Conclusion: stress and anxiety can be considered a severe factor in burnout; this issue can provide a clear perspective of the psychological cycle that ultimately leads to a decrease in the efficiency of the medical system and related services. [ABSTRACT FROM AUTHOR]

Background: The healthcare professional who performs sedation for digestive endoscopy procedures is usually the nurse. Therefore, knowledge and training on the part of the nurse is an important factor for the correct sedation of the patient and may affect, among other factors, the quality of health care and the recovery and well-being of the patient. Objective: To determine the training opportunities and resources available to the specialists involved in digestive endoscopy services in hospitals in Spain in which sedation is performed by the nursing staff. Methods: This was a descriptive cross-sectional study performed in the Digestive Endoscopy Service at Toledo University Hospital and nearby hospitals in central Spain. The sample consisted of 75 nurses who administer sedation in digestive endoscopic procedures. Results: Regarding the training of nurses, the vast majority were generalist nurses, and only a small percentage obtained specialized training through ongoing training. Most had been working in the service for more than two years, and very few had previous experience in sedation, although the vast majority currently applied sedation. Life support training was also critical. There were significant differences in the availability of resources between different hospitals. Conclusions: The training of nurses who perform sedation in digestive endoscopy services could be improved since there is a high proportion of personnel without specific training in sedation before starting to work in the service. It is crucial to implement targeted and ongoing training programs to improve competencies in this area, as they are essential to ensure the safety and effectiveness of the procedure. Given the variability in resources and personnel training that exists between different hospitals, it seems important to establish standards at the institutional level. [ABSTRACT FROM AUTHOR]