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Destrieux L, Yemmas Y, Williams S, Le Meur N. Work Environment Differences Between Outpatient and Inpatient Surgery: A Pilot Study on the Vascular Surgeons' Perceptions. Ann Vasc Surg 2024; 104:156-165. [PMID: 38492724 DOI: 10.1016/j.avsg.2023.12.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/07/2023] [Accepted: 12/14/2023] [Indexed: 03/18/2024]
Abstract
BACKGROUND In France, outpatient endovascular surgical procedures have been slowly implemented in hospitals since 2015. Their development has been heterogeneous across France and is not yet the standard of care despite their benefits concerning patients' outcomes and healthcare professionals' satisfaction. However, since the COVID-19 pandemic, the demand for patient beds has been increasing, while human resources have been decreasing. This encouraged the surgery service reorganization and accelerated the shift from inpatient to outpatient surgery. Consequently, services had to adapt rapidly and this may have caused some strain on the hospital medical workforce. The objectives of this pilot study were to document and analyze the nursing staff (nurses and certified assistant nurses) well-being and workload as perceived by the vascular surgeons working with them. It also wanted to assess the link between the nursing staff's psychosocial stress and the surgeons' concentration and serenity in their workplace, based on the assumption that the well-being of both parties is inextricably linked. METHODS An observational study was conducted using an online questionnaire distributed to the senior members of the French society of vascular and endovascular surgery (n = 490) between October 10 and October 18, 2022. RESULTS In total, 125 surgeons completed the questionnaire (25% response rate). The main finding was that according to 68% of vascular surgeons, the nursing staff's psychosocial stress significantly impaired their serenity and concentration at work and this frequently affected the surgical procedure safety. The main sources of psychosocial stress were the high work pace (64%), demand for flexibility (56%), lack of anticipation of schedule changes (82%), and difficulties encountered in relaying these concerns to hospital managers (44.6%). CONCLUSIONS This study demonstrated that concomitantly with the forced acceleration of outpatient activity implementation, the vascular surgeons' perceptions of their working environment are deteriorating, especially in conventional (inpatient) surgery wards where the workload is increasing and patients have more comorbidities. The worsened psychosocial stress of surgeons and staff affects the care provided.
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Affiliation(s)
- Laurence Destrieux
- Département de chirurgie vasculaire, Clinique Générale, Groupe Vivalto, Annecy, France
| | - Youssra Yemmas
- Department of Biostatistics, Columbia University, New York, NY
| | - Sydney Williams
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - Nolwenn Le Meur
- Univ Rennes, EHESP, CNRS, Inserm, Arènes-UMR 6051, RSMS-U 1309, Rennes, France; Département METIS, Ecoles Des Hautes Etudes en Santé Publique, Rennes Cedex, France.
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Rangel T, Timmerman R, Bock D, Keller M, Long J. Spiritual Support Staff Influence Stress Among Hospital-Based Health Care Personnel: A Cross-Sectional Study. West J Nurs Res 2024; 46:509-516. [PMID: 38655675 DOI: 10.1177/01939459241247802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND Stress negatively affects well-being, relating to poor physical, emotional, and occupational outcomes for health care personnel. Health care professionals faced extreme stressors in the context of the COVID-19 pandemic, making occupational stress relief a top priority for hospital administrators. Many health systems employ specially trained spiritual support staff as one strategy to alleviate work-related stressors. It is unclear whether health care personnels' perceptions of the availability of spiritual care staff influence self-reported stress. OBJECTIVE The purpose of this study was to explore relationships between perceived stress and perceptions of availability of spiritual support among acute care health care personnel. METHODS This study analyzed cross-sectional, survey-based data collected between February and April 2022 from 1352 interdisciplinary health care staff working in a large, nonprofit Catholic health system in the Western United States. Bivariate tests and multivariate linear regression models were conducted to test for factors influencing perceived stress. RESULTS Results support that high stress was prevalent in the sample. Perceived availability of spiritual support staff in the hospital and seeking coworker and professional support for work-related stress all independently influence stress in this population when controlling for confounders. CONCLUSIONS Stress of health care personnel may be influenced by the perceived availability of specially trained spiritual support staff. Hospital administrators should advocate for spiritual support staff availability in all health care settings as one strategy to mitigate occupational stress that health care professionals may experience through providing high-stakes patient care. Further research is warranted to uncover targeted spirituality-related strategies to reduce stress and preserve well-being of health care personnel.
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Affiliation(s)
| | | | - Dawn Bock
- Santa Rosa Memorial Center, Santa Rosa, CA, USA
| | | | - JoAnn Long
- Lubbock Christian University, Lubbock, TX, USA
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Lockwood EB, Schober M. Factors Influencing the impact of nurse practitioners' clinical autonomy: a self determining perspective. Int Nurs Rev 2024; 71:375-395. [PMID: 38651183 DOI: 10.1111/inr.12948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 02/08/2024] [Indexed: 04/25/2024]
Abstract
AIM To explore factors that influence the impact of nurse practitioners' clinical autonomy with a self-determining perspective. BACKGROUND Worldwide, there is a significant demand for healthcare professionals such as the nurse practitioner in meeting some healthcare needs across patients' lifespans. Factors influencing nurse practitioners clinical autonomy can impact the full utilisation of the role in practice. INTRODUCTION Limited evidence exists that describes or researches nurse practitioner clinical autonomy. Instead, there is a focus in the literature on strategic debates, role confusion and nurse practitioners reporting the straddling between nursing, allied heath professionals and medicine in the provision of healthcare services. DESIGN A cross-sectional study design was used in a purposive sample in a national sample of nurse practitioners in Ireland across a full range of healthcare settings. Additionally, the survey included open comments sections to capture qualitative comments by the nurse practitioners themselves. METHODS Self-determination theory is rooted in an organismic dialectical stance. This study used a convenience sample of n = 148 from a total sample of n = 448 (33%) of the population. The Dempster Practice Behavioural Scale and an initially validated advanced nursing practice clinical autonomy scale were used. Open comments were analysed by thematic analysis. STROBE Standards guidelines for cross-sectional studies were followed, and COREQ guidelines were followed for writing qualitative research. RESULTS The study findings demonstrated that the more clinical experience the nurse practitioner had, the higher their levels of clinical autonomy. The previous length of nursing experience did not impact nurse practitioner clinical autonomy levels. However, average experience of nurse practitioner' in this study was 3-10 years. No significant differences existed between the reported gender, nurse practitioners' clinical autonomy and decision-making. 1:40 female and 1:9 male nurse practitioners undertook a doctorate or PhD-level education. No advanced nurse practitioner identified as non-binary. Gender and organisational culture considerations can influence nurse practitioners clinical autonomy. IMPLICATIONS FOR NURSING AND HEALTH POLICY This study highlights intrinsic motivators that support nurse practitioners in providing innovative healthcare: competence, relatedness and clinical autonomy. Countries credentialing, regulations professional standards and healthcare policy positively influence nurse practitioner clinical autonomy. Nurse practitioners' clinical autonomy is championed when health policy and organisational stakeholders intrinsically collaborate. A disconnect between health policy organisational culture extrinsically influences lower levels of nurse practitioners' clinical autonomy. CONCLUSION The findings underline the positive impact of nurse practitioner clinical autonomy. A recommendation of this study is to continue to measure impact of clinical autonomy and develop nurse practitioners' self-determination strategies around the role and integrity of their levels of intrinsic clinical autonomy.
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Affiliation(s)
- Emily B Lockwood
- University Lecturer, School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Madrean Schober
- Schober Global Healthcare Consulting International Healthcare Consultants, Indianapolis, Indiana, USA
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Kim Y, Kim HY. Turnover Rates and Factors Associated With Turnover: A Longitudinal Analysis of the Retention Period of Clinical Nurses in Korea Using National Data. Policy Polit Nurs Pract 2024; 25:83-93. [PMID: 38414406 DOI: 10.1177/15271544241231285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Many countries, including Korea, are struggling with a nursing workforce shortage. This study aimed to identify the actual turnover rate of Korean clinical nurses and the factors affecting the turnover rate, considering the time required for nurses to gain experience at their current medical institution. This longitudinal study followed up on a cohort consisting of all 107,682 nurses from January 1, 2017 to July 30, 2020. Differences in the distribution of retention and turnover according to the medical institutions' and nurses' characteristics were analyzed using the chi-square test. The hazard ratios (HRs) for turnover in each analysis interval were analyzed using multilevel Cox proportional-hazards analysis. The mean turnover rate was 10.0% within 1 year and 33.4% within 3.5 years. Several organizational characteristics (the type and ownership of the hospital, its location, and the bed-to-nurse ratio) and individual characteristics (gender, age, and clinical experience) were found to be associated with turnover risk. Among these factors, compared to hospitals with a bed-to-nurse ratio in general wards of 6.0 or more, those with a ratio of 3.5-3.9 had an HR for 1-year turnover of 0.81 (95% confidence interval [CI] = 0.67-0.98), and those with a ratio of 2.5-2.9 had an HR for 3.5-year turnover of 0.77 (95% CI = 0.66-0.90). The bed-to-nurse ratio is a condition that can be modified through collaboration between government policy-makers and medical institutions. To reduce nurse turnover and retain experienced nurses, appropriate staffing should be implemented.
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Affiliation(s)
- Yunmi Kim
- College of Nursing, Eulji University, Seongnam-si, Republic of Korea
| | - Hyun-Young Kim
- Department of Nursing, Jeonju University, Jeonju-si, Republic of Korea
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Shao Y, Shan X, Li S, Zhang X, Chi K, Xu Y, Wei H. Mediating Role of Rumination in Second Victim Experience to Turnover Intention in Psychiatric Nurses. Nurs Res 2024; 73:E21-E30. [PMID: 38300627 DOI: 10.1097/nnr.0000000000000715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
BACKGROUND Psychiatric nurses often face patient safety incidents that can cause physical and emotional harm, even leading to s econd victim syndrome and staff shortages. Rumination-a common response after nurses suffer a patient safety event-may play a specific role between the second victim experience and turnover intention. Understanding these mechanisms is crucial for supporting psychiatric nurses and retaining psychiatric nursing resources. OBJECTIVES The study aimed to explore the associations among second victim experience, rumination, and turnover intention in psychiatric nurses and confirm how second victim experience influences turnover intention through rumination and its subtypes. METHODS A descriptive, cross-sectional study was adapted to survey 252 psychiatric nurses who experienced a patient safety incident at three hospitals in China between March and April 2023. We used the Sociodemographic and Patient Safety Incident Characteristics Questionnaire (the Chinese version of the Second Victim Experience and Support Tool), the Event-Related Rumination Inventory, and the Turnover Intention Scale. Path analysis with bootstrapping was employed to accurately analyze and estimate relationships among the study variables. RESULTS There was a positive association between second victim experience and turnover intention. In addition, both invasive and deliberate rumination showed significant associations with second victim experience and turnover intention. Notably, our results revealed that invasive and deliberate rumination played partial mediating roles in the relationship between second victim experience and turnover intention in psychiatric nurses. DISCUSSION The negative experience and turnover intention of the psychiatric nurse second victims are at a high level. Our results showed that invasive rumination positively mediated the relationship between second victim experience and turnover intention, and deliberate rumination could weaken this effect. This study expands the knowledge of the mechanisms underlying the effect of the second victim experience on turnover intention. Organizations must attach importance to the professional dilemmas of the psychiatric nurses' second victims. Nurse managers can reduce nurses' turnover intention by taking measures to reduce invasive rumination and fostering deliberate meditation to help second victims recover from negative experiences.
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Baris VK, Yilmaz A, Celik I, Keskin AY, Bektas M, Intepeler SS. The Turkish version of nursing practice readiness scale: Cross-cultural adaptation and psychometric evaluation. Int J Nurs Pract 2024:e13254. [PMID: 38575521 DOI: 10.1111/ijn.13254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/01/2023] [Accepted: 03/10/2024] [Indexed: 04/06/2024]
Abstract
AIM This study aims to adapt the "Nursing Practice Readiness Scale" to Turkish culture, and evaluate its psychometric properties. BACKGROUND New graduates' nursing practice readiness can impact their work adaptation and performance. DESIGN The research employed a methodological design. METHODS Data were collected between May and July 2022. The sample consisted of 436 newly graduated nurses. Content validity, construct validity and criterion validity were evaluated. Reliability was examined with adjusted item-total correlation, Cronbach's a coefficient, composite-reliability and split-half reliability. RESULTS The Turkish version of Nursing Practice Readiness Scale was found to have good content and criterion validity. As a result of confirmatory factor analysis, the original five-factor structure of the scale was also confirmed for the Turkish version. The scale's overall Cronbach's α coefficient was determined to be 0.96, with subscale coefficients ranging from 0.73 to 0.94. The composite reliability values of the subscales were found between 0.75 and 0.94. In split-half reliability, the correlation coefficient between half was 0.952, with a Spearman-Brown Coefficient (Unequal Length) of 0.976. CONCLUSIONS The Turkish version of Nursing Practice Readiness Scale is a valid and reliable measurement tool for evaluating the nursing practice readiness of newly graduated nurses.
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Affiliation(s)
- Veysel Karani Baris
- Nursing Faculty, Nursing Management Department, Dokuz Eylul University, Izmir, Turkey
| | - Aysegul Yilmaz
- Faculty of Health Sciences, Midwifery Department, Selçuk University, Konya, Turkey
| | - Isa Celik
- Health Science Faculty, Nursing Department, Recep Tayyip Erdogan University, Rize, Turkey
| | - Ayse Yildiz Keskin
- Nursing Faculty, Nursing Management Department, Mersin University, Mersin, Turkey
| | - Murat Bektas
- Nursing Faculty, Child Health and Diseases Nursing Department, Dokuz Eylul University, Izmir, Turkey
| | - Seyda Seren Intepeler
- Nursing Faculty, Nursing Management Department, Dokuz Eylul University, Izmir, Turkey
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Çırak Sağdıç B, Bozkul G, Karahan S. Experiences, difficulties and coping methods of female nurses caring for breast cancer surgery patients: A qualitative study. Eur J Oncol Nurs 2024; 69:102511. [PMID: 38354587 DOI: 10.1016/j.ejon.2024.102511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 12/30/2023] [Accepted: 01/14/2024] [Indexed: 02/16/2024]
Abstract
AIM The present study aims to qualitatively explore the experiences, problems, and coping methods of nurses caring for mastectomy patients. METHODS The study employs an exploratory-descriptive design with the participation of 14 nurses serving in a surgical oncology clinic. We gathered the data through semi-structured, face-to-face interviews and analyzed the transcriptions of audio recordings using the thematic analysis method. We then extracted relevant codes and subthemes to achieve the main themes. The main themes are presented in three relevant contexts. RESULTS Participating nurses' experiences are addressed through the themes of 'emotional difficulties,' 'physical difficulties,' and 'positive awareness.' In addition, their coping methods are considered within the themes of 'coping methods' and 'motivation.' The final context is identified as needs, where the themes of 'organizational needs' and 'psychosocial needs' are explored. Our findings highlighted that although participating nurses usually confront physical and emotional challenges, they exert much effort to develop both positive awareness and engage in behavioral changes. Interestingly, we observed that participants remain ineffective in dealing with and have difficulties employing relevant solutions for professional issues. CONCLUSION Overall, even though participating nurses need to deal with the burden of physical and emotional challenges when caring for patients, their coping strategies with these difficulties often remain insufficient. Thus, our humble recommendation may lie in satisfying the organizational and psychosocial needs of surgical nurses to promote their coping skills when fulfilling their demanding tasks with mastectomy patients.
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Affiliation(s)
- Busra Çırak Sağdıç
- Lokman Hekim University, Vocational School of Health Services, Anesthesia Program, Ankara, Turkiye.
| | - Gamze Bozkul
- Tarsus University, Faculty of Health Sciences, Department of Surgical Nursing, Mersin, Turkiye.
| | - Sabri Karahan
- Harran University, Faculty of Health Sciences, Department of Surgical Nursing, Sanliurfa, Turkiye.
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Doyle BR, Smith LM, Marshall JL, Carlisle BA, Perera AC. Consistently Exploring Nurse Staffing and Neurocritical Care Unit Turnover. J Neurosci Nurs 2024; 56:54-59. [PMID: 38232239 DOI: 10.1097/jnn.0000000000000742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
ABSTRACT BACKGROUND: Staffing models within nursing units have long been a hot topic of discussion. The COVID-19 pandemic exacerbated this discussion by straining the national nursing environment and workforce. Before the pandemic, the neuroscience intensive care unit (NSICU) primarily used an acuity-adjusted staffing model and aimed for a nurse-to-patient ratio of 1:1.5. During and after the pandemic, the NSICU was forced to primarily use a centralized staffing model because of the increased turnover in the hospital at large and a rise in patient census. METHODS : Unit census data in an NSICU were tracked before, during, and after the pandemic alongside utilization of a centralized staffing model in the hospital at large. RESULTS : During this time, the NSICU saw a statistically significant increase in average nurse-to-patient ratio and incidences of both floating and tripled assignments. The NSICU simultaneously saw a 180% increase in nursing turnover. CONCLUSION : Although we cannot prove that a centralized staffing model is directly responsible for higher nursing turnover, its utilization led to greater incidence of poor staffing-reflected in deviation from the nurse-to-patient ratio goal of the unit. Nurse staffing concerns play a large role in nurse satisfaction in the workforce: staffing shortages have been described both as a precursor to and as a consequence of increased nursing turnover.
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Kim Y, Lee K, Jung M. Effects of a disincentive policy on behavioral changes by South Korean medical institutions that do not submit official nursing grade data. Int Nurs Rev 2024. [PMID: 38477823 DOI: 10.1111/inr.12956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 02/25/2024] [Indexed: 03/14/2024]
Abstract
AIM This study aimed to determine whether the policy of imposing deductions on medical institutions in South Korea led to increased submission of nursing grade data. BACKGROUND In Korea, medical institutions are required to report data on their nursing workforce; however, many institutions did not comply with this regulation, making it difficult to gauge their level of nurse staffing. Therefore, in 2020, a nursing fee deduction policy was introduced that penalizes medical institutions financially for failing to submit nursing workforce data. METHODS We prospectively collected data on the characteristics, nursing grade, and data submission status of 1,200 hospitals in South Korea from 2015 to 2021. We analyzed the submission rate of data related to nursing grades according to the characteristics of the medical institutions and evaluated the effect of policy change on data submission status using multiple logistic regression. FINDINGS The submission rate of data increased from 50.2% in 2015 to 93.3% in 2021, and 39.3% of medical institutions that had not previously submitted data did so after the policy was introduced. The submission rate of medical institutions unaffected by the policy also increased after its introduction. Compared with 2015, the likelihood of medical institutions submitting data increased by 23.69 times in 2020 and 20.47 times in 2021. CONCLUSION The appropriate use of disincentive policies, such as financial deductions for medical institutions showing inappropriate behavior, was found to be effective in inducing desirable changes in the behavior of medical institutions. IMPLICATIONS FOR NURSING AND HEALTH POLICY Properly planned and implemented policies can contribute to improved quality of medical services and patient safety through effective administrative control.
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Affiliation(s)
- Yunmi Kim
- College of Nursing, Eulji University, Seongnam-si, Republic of Korea
| | - Kyounga Lee
- College of Nursing, Gachon University, Incheon, Republic of Korea
| | - Minho Jung
- Department of Nursing, Seoul National University Hospital, Seoul, Republic of Korea
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Yao X, Wen S, Song Z, Wang J, Shen Y, Huang X. Work-family conflict categories and support strategies for married female nurses: a latent profile analysis. Front Public Health 2024; 12:1324147. [PMID: 38525344 PMCID: PMC10958783 DOI: 10.3389/fpubh.2024.1324147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
Objective To clarify subgroups of married female nurses experiencing work-family conflict (WFC), explore the factors associated with the subgroups, and determine how desired support strategies differ among the subgroups. Methods Data was collected from a sample of 646 married female nurses from public hospitals in Zhejiang Province, China, in December 2021. Latent profile analysis was used to group the participants, and multiple logistic regression was used to identify factors associated with higher WFC. The STROBE criteria were used to report results. Results According to latent profile analysis, there were three distinct profiles of WFC among married female nurses: "low-conflict type," "work-dominant-conflict type," and "high-conflict type." These profiles differed in the number of children, night shifts, family economic burden, childcare during working hours, family harmony, colleague support, and nurse-patient relationships. Nurses with multiple children, higher pressures in childcare during working hours, heavier family economic burdens, lower family harmony, lower colleague support, and poorer nurse-patient relationships are more likely to be classified as "high-conflict type" nurses. Conclusion This study found that married female nurses experience different types of WFCs. The structure of these WFCs and their associated factors suggests that customized intervention strategies can be developed to address the specific needs of married female nurses.
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Affiliation(s)
- Xin Yao
- School of Ophthalmology and Optometry, Biomedical Engineering, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Siqi Wen
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ziling Song
- School of Ophthalmology and Optometry, Biomedical Engineering, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jing Wang
- School of Ophthalmology and Optometry, Biomedical Engineering, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuanyuan Shen
- School of Ophthalmology and Optometry, Biomedical Engineering, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaoqiong Huang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhenjiang, China
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Fields L, Dean BA, Perkiss S, Moroney T. Nursing action towards the sustainable development goals: Barriers and opportunities. NURSE EDUCATION TODAY 2024; 134:106102. [PMID: 38266432 DOI: 10.1016/j.nedt.2024.106102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 01/02/2024] [Accepted: 01/17/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Climate change, poverty, hunger and complex diseases are just some of the many wicked problems impacting human health. The Sustainable Development Goals aim to alleviate these and many other global issues. Although the nursing profession is paramount to successfully achieving the goals, nurses require increased education to maximise their contributions. OBJECTIVES The aim of this study was to determine the impact of education on graduate nurses' action towards the Sustainable Development Goals. DESIGN This study applied a qualitative case study methodology. SETTING The study took place within an Australian Higher Education institution. Graduate nurses working in clinical settings were invited to reflect on the Sustainable Development Goals. PARTICIPANTS Participants included thirteen graduate nurses (n = 13) working in a variety of clinical settings that had completed the final year capstone subject. METHODS Individual semi-structured interviews were undertaken with graduate nurses who undertook education on the Sustainable Development Goals in an undergraduate Bachelor of Nursing capstone subject. The interviews were transcribed and thematically analysed. FINDINGS Data was analysed through two lens focusing on the barriers and opportunities for action towards the Sustainable Development Goals. Three core barriers were identified as 'Drowning'; 'Powerless'; and 'Invisible'. Three key opportunities were designated as 'War on Waste'; 'Front and Centre'; and 'Revolutionary Leadership'. CONCLUSIONS Educating undergraduate nurses on the Sustainable Development Goals had limited impact on specific graduate nurses' action towards the goals due to significant barriers within the healthcare system. However, graduate nurses recognised the importance of contributing to the goals and identified opportunities for future action. Education providers and the healthcare industry should work in partnership to create a more sustainable future for healthcare.
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Affiliation(s)
- Lorraine Fields
- University of Wollongong, Northfields Avenue, Wollongong, New South Wales 2522, Australia.
| | - Bonnie Amelia Dean
- University of Wollongong, Northfields Avenue, Wollongong, New South Wales 2522, Australia.
| | - Stephanie Perkiss
- University of Wollongong, Northfields Avenue, Wollongong, New South Wales 2522, Australia.
| | - Tracey Moroney
- Curtin University, Kent Street, Bentley, Western Australia 6102, Australia.
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Lown BA, Collier J, Manning C, Gareis K. The Healing Healthcare Initiative: Guiding leaders to heal a traumatized workforce. Healthc Manage Forum 2024; 37:74-79. [PMID: 37831518 DOI: 10.1177/08404704231204874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
The COVID-19 pandemic amplified burnout and moral distress among healthcare professionals and accentuated the systemic gaps and limitations of current approaches to workforce well-being. The Schwartz Center for Compassionate Healthcare launched the Healing Healthcare Initiative (HHI) in response to these compounded challenges. Aligned with national recommendations, the HHI framework comprises six key principles and eight implementation domains that foster compassionate and trauma-informed organizational cultures. C-suite level executive teams from six diverse healthcare organizations were selected to participate in the year-long pilot. Organizational and executive team surveys identified siloed well-being efforts and gaps in knowledge and awareness that undermine meaningful progress. The HHI pilot offers executive teams a space for reflection and open conversations, fostering trust within the team, and reinforcing the commitment to employee well-being. The program supports leadership teams in creating a strategy to implement the HHI framework that engages frontline workers in co-designing organizational solutions for a thriving workforce.
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Affiliation(s)
- Beth A Lown
- The Schwartz Center for Compassionate Healthcare, Somerville, Massachusetts, United States
| | - Julie Collier
- The Schwartz Center for Compassionate Healthcare, Somerville, Massachusetts, United States
| | - Colleen Manning
- Goodman Research Group, Inc., Cambridge, Massachusetts, United States
| | - Karen Gareis
- Goodman Research Group, Inc., Cambridge, Massachusetts, United States
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Ring M, Ristolainen H, Tiilikainen E. From Restricted Resources to Ethical Burden-Former Home Care Workers' Reasons for Leaving Their Jobs. J Appl Gerontol 2024:7334648241231404. [PMID: 38354745 DOI: 10.1177/07334648241231404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
The study examines former home care workers' reasons for leaving their jobs from the perspective of reforms in public services and eldercare policies impacted by New Public Management (NPM) in Finland. Written narratives from former home care workers (n = 39) were collected online and analyzed using thematic content analysis. Former home care workers' reasons for leaving their jobs were connected to four interconnecting themes: mismatch between needs and resources, measurement-driven practices, unbalancing work-life, and ethical burden. These reasons reflected critical changes in the organization of care work and the work environment in older adults' home care. Contradictions between needs, resources, and values lead to ethical dilemmas and push away from the workforce in eldercare. To improve care workers' willingness to remain in the eldercare sector, changes are needed in the resourcing and organization of home care, including managerial support in everyday care work.
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Affiliation(s)
- Marjo Ring
- Department of Social Sciences, Faculty of Social Sciences and Business Studies, University of Eastern Finland, Kuopio, Finland
| | - Hanna Ristolainen
- Department of Social Sciences, Faculty of Social Sciences and Business Studies, University of Eastern Finland, Kuopio, Finland
| | - Elisa Tiilikainen
- Department of Social Sciences, Faculty of Social Sciences and Business Studies, University of Eastern Finland, Kuopio, Finland
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Hill L, McNulty A, McMahon J, Mitchell G, Farrell C, Uchmanowicz I, Castiello T. Heart Failure Nurses within the Primary Care Setting. Card Fail Rev 2024; 10:e01. [PMID: 38464555 PMCID: PMC10918528 DOI: 10.15420/cfr.2023.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/27/2023] [Indexed: 03/12/2024] Open
Abstract
Cardiology services within primary care often focus on disease prevention, early identification of illness and prompt referral for diagnosis and specialist treatment. Due to advances in pharmaceuticals, implantable cardiac devices and surgical interventions, individuals with heart failure are living longer, which can place a significant strain on global healthcare resources. Heart failure nurses in a primary care setting offer a wealth of clinical knowledge and expertise across all phases of the heart failure trajectory and are able to support patients, family members and other community services, including general practitioners. This review examines the recently published evidence on the current and potential future practice of heart failure nurses within primary care.
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Affiliation(s)
- Loreena Hill
- School of Nursing and Midwifery, Queen's University BelfastBelfast, UK
- College of Nursing and Midwifery, Mohammed Bin Rashid UniversityDubai, United Arab Emirates
| | - Anne McNulty
- School of Nursing and Midwifery, Queen's University BelfastBelfast, UK
| | - James McMahon
- School of Nursing and Midwifery, Queen's University BelfastBelfast, UK
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University BelfastBelfast, UK
| | - Cathy Farrell
- Errigal Chronic Disease Management Hub, LetterkennyDonegal, Ireland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Wrocław Medical UniversityWrocław, Poland
- Institute of Heart Diseases, University HospitalWrocław, Poland
| | - Teresa Castiello
- Department of Cardiovascular Imaging, King's College LondonLondon, UK
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15
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Smith CM, Horne CE, Wei H. Nursing practice in modern healthcare environments: A systematic review of attributes, characteristics, and demonstrations. J Adv Nurs 2024. [PMID: 38308427 DOI: 10.1111/jan.16088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/04/2024] [Accepted: 01/21/2024] [Indexed: 02/04/2024]
Abstract
AIM To identify Attributes, Characteristics and Demonstrations of nursing practice from both nurses' and people perspectives in today's healthcare environments. A secondary aim was to identify relevant differences between female and male nurses in the context of ACDs. DESIGN This systematic review was informed by the Joanna Briggs Institute Convergent Integrated Approach to Mixed Study Systematic Reviews. METHODS The search included articles ranging from the years 2000 to 2023 across 10 electronic databases and multiple grey literature outlets. McMaster critical review forms and the Mixed Methods Appraisal Tool were used to appraise article quality. The Convergent Integrated Approach to Mixed Study Systematic Reviews was used to guide data synthesis. RESULTS Twenty articles were included in this review, 13 qualitative, five quantitative and two mixed-methods studies. Three themes emerged, including knowledge, practice skills and interpersonal relationships. Differences in Attributes, Characteristics and Demonstrations of professional practice between women and men in nursing were also explored. CONCLUSION Findings suggest that evolving healthcare environments challenge nurses to remain focused on patient-centred and compassionate care. The review also supports nurses caring in a manner that empowers people, increases well-being, and reduces suffering. IMPACT Identified characteristics and attributes of nursing practice, including emphasis on continuous learning, interpersonal relationships and compassion, have a profound impact on nursing. Nurses should remain adaptable, compassionate and patient-focused in an ever-evolving healthcare environment. These foundational care principles are necessary for improving patient outcomes, enhancing trust between people and healthcare providers, and increasing inclusivity and diversity in the nursing workforce. WIDER GLOBAL COMMUNITY Nurses worldwide should strive to embody these attributes to provide high-quality, patient-centred care in an inclusive environment in today's demanding healthcare environment. Gender-specific differences in the perception and expression of professional Attributes, Characteristics and Demonstrations can inform inclusion and diversity efforts in the workplace. REPORTING METHOD This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
| | - Carolyn E Horne
- UNC Charlotte College of Health and Human Services, School of Nursing, Charlotte, North Carolina, USA
| | - Holly Wei
- Texas Tech University Health Sciences Center, School of Nursing, Lubbock, Texas, USA
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16
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Landis T, Barbosa-Leiker C, Clark C, Godfrey N. Professional Identity in Nursing Scale 2.0: A national study of nurses' professional identity and psychometric properties. J Prof Nurs 2024; 50:61-65. [PMID: 38369373 DOI: 10.1016/j.profnurs.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 11/15/2023] [Accepted: 11/22/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND Professional identity is a relatively new concept in the nursing and health care literature. Using the definition of Professional Identity in Nursing (PIN) as its main construct, the authors developed and tested the second iteration of the Professional Identity in Nursing Scale (PINS 2.0) used to measure PIN from two perspectives, self and environment. PURPOSE The purpose of this study was to evaluate the psychometric properties of the PINS 2.0. METHODS To assess psychometric validity and reliability, a split-sample analysis was conducted. An exploratory factor analysis (EFA) was conducted on one half of the sample (n = 322) and a confirmatory factor analysis (CFA) was conducted on the other half of the sample (n = 312). Descriptive statistics were also performed and analyzed. RESULTS According to the EFA pattern of parameter coefficients and CFA fit statistics (PINS-self: χ2(399) =1059.495, p < .001, CFI = 0.934, RMSEA = 0.072, SRMR = 0.032; PINS-environment: χ2(399) =929.019, p < .001, CFI = 0.946, RMSEA = 0.065, SRMR = 0.029), the PINS 2.0 shows adequate psychometric properties for measuring the concept of PIN with the following 4 constructs: 1) values and ethics, 2) knowledge, 3) leadership, and 4) professional comportment. Cronbach's alpha coefficients were: PINS 2.0-self = 0.97 and PINS 2.0-environment =0.98. CONCLUSION We further advance the assessment of the psychometric properties of the PINS 2.0 to measure PIN from the perspective of self and environment.
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Affiliation(s)
- Tullamora Landis
- Washington State University, College of Nursing, Spokane, WA, USA.
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17
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Sabine N, Gibbs TE. Unraveling Healthcare Shortages in Delaware and Charting a Course for Equity and Resilience. Dela J Public Health 2023; 9:14-18. [PMID: 38283716 PMCID: PMC10810289 DOI: 10.32481/djph.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
Affiliation(s)
- Nicole Sabine
- Research Associate, Delaware Academy of Medicine/Delaware Public Health Association
- Executive Director, Delaware Academy of Medicine/Delaware Public Health Association
| | - Timothy E Gibbs
- Research Associate, Delaware Academy of Medicine/Delaware Public Health Association
- Executive Director, Delaware Academy of Medicine/Delaware Public Health Association
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18
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Sun C, Jiang H, Yao Q, Wang X, Wen X, Liu H. Latent profile analysis of nurses' perceived professional benefits in China: a cross-sectional study. BMJ Open 2023; 13:e078051. [PMID: 37918934 PMCID: PMC10626806 DOI: 10.1136/bmjopen-2023-078051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE To identify profiles of nurses' perceived professional benefits as well as their predictors. DESIGN Cross-sectional study. SETTING The study was carried out online in China. METHODS From 6 July to 27 July 2022, a total of 1309 registered nurses participated in the survey by convenient sampling. We collected the Nurses' Perceived Professional Benefits Questionnaire and demographic data. Using latent profile analysis (LPA), subgroups of nurses' perceived professional benefits were identified. Moreover, univariate and multinomial logistic regression analyses were conducted to find the factors that were linked with the profiles. RESULTS The survey was validly completed by 1309 nurses, with a 92.9% effective return rate. The findings of the LPA demonstrated three unique profiles: low-perceived professional benefits (11.8%), moderate-perceived professional benefits (57.1%) and high-perceived professional benefits (31.1%). There was a correlation between marital status, the number of night shifts per month and leadership role. CONCLUSIONS According to our research, registered nurses have three unique professional benefit profiles. In order to sustain the nursing workforce, despite the fact that nurses get a high level of professional benefits, interventions are necessary to increase nurses' perception of their professional value.
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Affiliation(s)
- Changli Sun
- The Third Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Hu Jiang
- The Third Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Qingfang Yao
- The Third Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Xianwei Wang
- The Third Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Xueke Wen
- The Third Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Hanmei Liu
- Zunyi Medical University, Zunyi, Guizhou, China
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Adamis D, Minihan E, Hannan N, Doherty AM, McNicholas F. Burnout in mental health services in Ireland during the COVID-19 pandemic. BJPsych Open 2023; 9:e177. [PMID: 37800182 PMCID: PMC10594181 DOI: 10.1192/bjo.2023.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 07/16/2023] [Accepted: 07/19/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Burnout is a consequence of chronic occupational stress. Specific work-related factors may contribute to burnout experienced by those working in mental health services (MHS), many of which have increased since the COVID-19 pandemic. AIMS To examine personal, work- and patient-related burnout among MHS staff in Ireland during the COVID-19 pandemic, and explore the impact of work-related conditions on burnout. METHOD We conducted a cross-sectional survey of three MHS across Ireland utilising a study-specific questionnaire, the Copenhagen Burnout Inventory and the Effort-Reward Imbalance scale. RESULTS Of 396 participants, 270 (70.6%) were female. Moderate and high personal burnout was experienced by 244 (64.1%) participants; work-related burnout by 231 (58.5%) participants and patient-related burnout by 83 (21.5%) participants. Risk factors for both personal and work-related burnout were female gender, urban service, time spent outside main responsibilities, overcommitment, high score on the Effort-Reward Imbalance scale and intention to change job. Being younger, with high workload and deterioration of personal mental health during the pandemic was associated with higher personal burnout, whereas a lack of opportunity to talk about work-related stress contributed to work-related burnout. Fewer factors were associated with patient-related burnout, namely overcommitment, working in urban services and poorer physical and mental health during the COVID-19 pandemic. CONCLUSIONS High levels of personal and work-related burnout were found among mental health workers. The weak association with COVID-19-related factors suggest levels of burnout predated the pandemic. This has implications for MHS given the recognised additional work burden created by COVID-19.
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Affiliation(s)
- Dimitrios Adamis
- Department of Psychiatry, Sligo Mental Health Services, Ireland; and School of Medicine and Medical Science, University College Dublin, Ireland
| | - Elisha Minihan
- School of Medicine and Medical Science, University College Dublin, Ireland
| | - Noel Hannan
- Department of Psychiatry, Saint John of God – Liffey Region Services, Ireland; and Department of Psychiatry, Saint John of God – Dublin South East Services, Ireland
| | - Anne M. Doherty
- Department of Psychiatry, Mater Misericordiae University Hospital, Ireland
| | - Fiona McNicholas
- School of Medicine and Medical Science, University College Dublin, Ireland; Department of Psychiatry, Children's Health Ireland (CHI) at Crumlin, Our Lady's Children's Hospital, Ireland; and Department of Psychiatry, Lucena Clinic Services, Ireland
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20
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Wei H, Horsley L, Cao Y, Haddad LM, Hall KC, Robinson R, Powers M, Anderson DG. The associations among nurse work engagement, job satisfaction, quality of care, and intent to leave: A national survey in the United States. Int J Nurs Sci 2023; 10:476-484. [PMID: 38020845 PMCID: PMC10667320 DOI: 10.1016/j.ijnss.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 06/30/2023] [Accepted: 09/17/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Employee work engagement, job satisfaction, quality of care, and intent to leave are critical indicators for healthcare organizational performance. This study aimed to analyze the current state of nurses' work engagement and its factors to examine the associations among nurses' work engagement, job satisfaction, quality of care, and intent to leave in the United States (US). Methods This is a quantitative descriptive cross-section design. Data were collected online from the US registered nurses from March to September 2022. Measures comprised the Utrecht Work Engagement Scale, the demographics, and questions regarding job satisfaction, perceived quality of care, and intent to leave. Results Nine hundred nurses participated in the online survey. Among the participants, 79.2% reported holding a specialty certification, 59.4% scored high/very high on job satisfaction, 82.2% expressed high/very high on the perceived quality of nursing care, and 28.4% conveyed likely/very likely to leave in the following year. Nurses' work engagement was positively associated with nurses' job satisfaction and their perceived quality of care but negatively associated with intent to leave. More certified nurses reported high or very high job satisfaction than non-certified nurses. As for demographics, the linear regression analysis showed that nurses who were older, identified as White, and held doctorate degrees reported higher levels of work engagement in comparison to their counterparts. Conclusions This study shows that nurses' work engagement is associated with their job satisfaction, perceived quality of care, and intent to leave. Nurses' work engagement in this study is lower than in other studies, especially before the COVID-19 pandemic, which may indicate a possible association with the COVID-19 impact. Because nurses' work engagement is significantly associated with job satisfaction, nurse leaders need to find ways to promote nurses' job satisfaction and retention.
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Affiliation(s)
- Holly Wei
- East Tennessee State University College of Nursing, Johnson City, TN, USA
| | - Leann Horsley
- Texas A&M University School of Nursing, College Station, TX, USA
| | - Yan Cao
- East Tennessee State University College of Nursing, Johnson City, TN, USA
| | - Lisa M. Haddad
- East Tennessee State University College of Nursing, Johnson City, TN, USA
| | - Katherine C. Hall
- East Tennessee State University College of Nursing, Johnson City, TN, USA
| | - Roslyn Robinson
- East Tennessee State University College of Nursing, Johnson City, TN, USA
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21
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You W, Donnelly F. Greater nurse density correlates to higher level of population ageing globally, but is more prominent in developed countries. PLoS One 2023; 18:e0292371. [PMID: 37773937 PMCID: PMC10540962 DOI: 10.1371/journal.pone.0292371] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 09/19/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Representing over 50% of the healthcare workforce, nurses provide care to people at all ages. This study advances, at a population level, that high levels of nursing services, measured by nurse density may significantly promote population ageing measured by the percentage of a population over 65 years of age (65yo%). METHODS Population level data was examined to explore the correlation between nurse density and 65yo%. The confounding impacts on ageing such as the effects of economic affluence, physician density, fertility rate, obesity and urban advantages were also considered. Scatter plots, bivariate correlation, partial correlation and multiple linear regression analyses were performed for examining the correlations. RESULTS Nurse density correlated to 65yo%; this relationship was independent of other influences such as fertility rate, economic affluence, obesity prevalence, physician density and urban advantages. Second to fertility rate, nursing density had the greatest influence on 65yo%. The predicting and confounding variables explain 74.4% of the total 65yo% variance. The universal correlations identified in country groupings suggest that low nurse density may be a significant global concern. CONCLUSIONS While nurse density might contribute significantly to 65yo% globally, the effect was more prominent in developed countries. Ironically, countries with higher nurse densities and therefore greater levels of 65yo%, were countries with an increased need for more nursing staff. To highlight the profound implications for the role the nursing profession plays especially at a time of global nursing shortage, further study into the effects of long-run elasticity of nurse staffing level on population ageing may be needed. For instance, what percentage of nursing staff increase would be required to meet every 1% increase of an ageing population.
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Affiliation(s)
- Wenpeng You
- Adelaide Nursing School, the University of Adelaide, Adelaide, Australia
- Heart and Lung, Royal Adelaide Hospital, Adelaide, Australia
- Adelaide Medical School, the University of Adelaide, Adelaide, Australia
| | - Frank Donnelly
- Adelaide Nursing School, the University of Adelaide, Adelaide, Australia
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22
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Roth I, Tiedt M, Miller V, Barnhill J, Chilcoat A, Gardiner P, Faurot K, Karvelas K, Busby K, Gaylord S, Leeman J. Integrative medical group visits for patients with chronic pain: results of a pilot single-site hybrid implementation-effectiveness feasibility study. FRONTIERS IN PAIN RESEARCH 2023; 4:1147588. [PMID: 37828973 PMCID: PMC10565345 DOI: 10.3389/fpain.2023.1147588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/24/2023] [Indexed: 10/14/2023] Open
Abstract
Background Approximately 20% of adults in the United States experience chronic pain. Integrative Medical Group Visit (IMGV) offers an innovative approach to chronic pain management through training in mindfulness, nutrition, and other mind-body techniques combined with peer support. To date, there are no studies on IMGV implementation, despite its promise as a feasible non-pharmacological intervention for chronic pain management. In this study, we assessed the feasibility of implementing IMGV and assessing its effectiveness for chronic pain. Methods Implementation Mapping was used to develop and evaluate implementation strategies for IMGV. Strategies included disseminating educational materials, conducting ongoing training, and conducting educational meetings. IMGV was delivered by three healthcare providers: an allopathic physician, registered yoga teacher, and naturopathic physician. The effectiveness of IMGV on patient health outcomes was assessed through qualitative interviews and a Patient-Reported Outcomes Scale (PROMIS-29). Provider perspectives of acceptability, appropriateness, and feasibility were assessed through periodic reflections (group interviews reflecting on the process of implementation) and field notes. Paired t-tests were used to assess changes between scores at baseline and post intervention. Qualitative data were coded by three experienced qualitative researchers using thematic content analysis. Results Of the initial 16 patients enrolled in research, 12 completed at least two sessions of the IMGV. Other than fatigue, there was no statistically significant difference between the pre- and post-scores. Patients reported high satisfaction with IMGV, noting the development of new skills for self-care and the supportive community of peers. Themes from patient interviews and periodic reflections included the feasibility of virtual delivery, patient perspectives on acceptability, provider perspectives of feasibility and acceptability, ease of recruitment, complexity of referral and scheduling process, balancing medical check-in with group engagement, and nursing staff availability. Conclusions IMGV was feasible, acceptable, and effective from the perspectives of patients and providers. Although statistically significant differences were not observed for most PROMIS measures, qualitative results suggested that participants experienced increased social support and increased pain coping skills. Providers found implementation strategies effective, except for engaging nurses, due to staff being overwhelmed from the pandemic. Lessons learned from this pilot study can inform future research on implementation of IMGV.
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Affiliation(s)
- Isabel Roth
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Malik Tiedt
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Vanessa Miller
- Gillings School of Global Public Health, Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jessica Barnhill
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Aisha Chilcoat
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Paula Gardiner
- Department of Family Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Keturah Faurot
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kris Karvelas
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kenneth Busby
- Division of Pediatrics Hematology Oncology, Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Susan Gaylord
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jennifer Leeman
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Williamson GR, Kane A, Evans S, Attrill L, Cook F, Nash K. Student nurses as a future general practice nursing workforce. Implementing collaborative learning in practice: implications for placement learning and patient access. A mixed methods study. BMC Nurs 2023; 22:326. [PMID: 37735375 PMCID: PMC10512636 DOI: 10.1186/s12912-023-01501-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 09/12/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND There is a global shortage of nurses, with particularly acute shortfall in General Practice Nursing in the United Kingdom estimated at as high as 50% vacancy rate by 2031 by some sources. There has previously been reluctance for General Practices to host student nurses on placement, but it has become imperative to increase placement capacity if practices are to be able to recruit a future workforce. Collaborative Learning in Practice is a means of organising placement learning for student nurses using a coaching model, that allows for leadership development, peer support and earlier engagement in patient care, and increases placement capacity. METHODS This was a mixed methods study using qualitative data from focus groups to evaluate the implementation of Collaborative Learning in Practice, and routinely collected audit data on numbers of clinic appointments to investigate the potential impact an increased capacity of student nurses might have on patient access to services. The aims of this study were: to implement and evaluate Collaborative Learning in Practice in General Practice Nursing settings; to explore issues of interprofessional learning; to explore patient access to services related to increased student nurse capacity. RESULTS Our qualitative data indicated the following themes as important to students and staff: Peer Support; Interprofessional Learning; and the Importance of 'own clinics' for students to see patients. The audit data indicated that having students leading their own clinics increased the clinic numbers available by approximately 20% compared to when students were not in placement. CONCLUSIONS This study shows that student nurses increased clinic capacity and improved access for patients. Students valued their placement, felt that they were more 'part of the team' than in other placements and consequently had a greater sense of belonging. This was multifaceted, coming in part from the welcoming practice staff, in part from the opportunities for peer support engendered by the collaborative learning in practice model, and in part from the interprofessional learning opportunities available. General Practice Nursing placements for students are important for future workforce recruitment and can help meet Quality and Outcomes Framework targets for General Practices.
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Affiliation(s)
- Graham R Williamson
- School of Nursing and Midwifery, Exeter Centre, University of Plymouth, Topsham Rd, Exeter, EX2 6HA, UK.
| | - Adele Kane
- School of Nursing and Midwifery, Exeter Centre, University of Plymouth, Topsham Rd, Exeter, EX2 6HA, UK
| | - Sharon Evans
- School of Nursing and Midwifery, University of Plymouth Cornwall Campus, TR1 3HD, Truro, UK
- Strategic Lead for General Practice Nursing, Cornwall & Isles of Scilly Integrated Care Board, Plymouth, UK
| | - Lisa Attrill
- School of Nursing and Midwifery, University of Plymouth Cornwall Campus, TR1 3HD, Truro, UK
| | - Fiona Cook
- School of Nursing and Midwifery, University of Plymouth Cornwall Campus, TR1 3HD, Truro, UK
- Practice Nurse and Nurse Prescriber, Okehampton Medical Centre, Devon, UK
| | - Katy Nash
- School of Nursing and Midwifery, Exeter Centre, University of Plymouth, Topsham Rd, Exeter, EX2 6HA, UK
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Serra N, Botti S, Guillari A, Simeone S, Latina R, Iacorossi L, Torreggiani M, Guberti M, Cicolini G, Lupo R, Capuano A, Pucciarelli G, Gargiulo G, Tomietto M, Rea T. Workload, Job Satisfaction and Quality of Nursing Care in Italy: A Systematic Review of Native Language Articles. Healthcare (Basel) 2023; 11:2573. [PMID: 37761770 PMCID: PMC10531217 DOI: 10.3390/healthcare11182573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/06/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Nursing research is rapidly increasing, yet contributions from numerous countries that may interest the international nursing community are impeded because many research articles are published in authors' native language and not in English. The objectives of this work were to systematically review papers published in Italian related to job satisfaction and the quality of nursing care, and to discuss their findings in light of the international literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used. The Directory of Open Access Journals (DOAJ) and Indice della Letteretura Italiana di Scienze Infermieristiche (ILISI) databases were consulted for eligible studies published from January 2015 to November 2022. Two hundred sixteen papers were identified, 11 of which were selected for review: 8 on job satisfaction, two on workload issues, and 1 on quality of nursing care. The quality of included studies was assessed through the Effective Public Health Practice Project quality assessment tool (EPHPP). The results of our review were in line with those of international literature, and they can help to fill the knowledge gap on the quality of nursing performance in Italian care settings. In addition, the proposed method can provide further elements of discussion among literature providers and reviewers.
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Affiliation(s)
- Nicola Serra
- Biostatistics Unit, Department of Public Health, University Federico II of Naples, 80138 Naples, Italy;
| | - Stefano Botti
- Hematology Unit, Azienda USL-IRCCS of Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Assunta Guillari
- Department of Public Health, University Federico II of Naples, 80138 Naples, Italy; (A.G.); (T.R.)
| | - Silvio Simeone
- Clinical and Experimental Medicine Department, “Magna Graecia” University, 88100 Catanzaro, Italy;
| | - Roberto Latina
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, Università degli Studi di Palermo, 90133 Palermo, Italy;
| | - Laura Iacorossi
- Nursing Research Unit IFO, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Martina Torreggiani
- Research and EBP Unit, Health Professions Department, Azienda USL-IRCCS of Reggio Emilia, 42421 Reggio Emilia, Italy; (M.T.); (M.G.)
| | - Monica Guberti
- Research and EBP Unit, Health Professions Department, Azienda USL-IRCCS of Reggio Emilia, 42421 Reggio Emilia, Italy; (M.T.); (M.G.)
| | - Giancarlo Cicolini
- Department of Precision and Regenerative Medicine and Ionian Area—(DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Roberto Lupo
- San Giuseppe da Copertino Hospital, Local Health Authority, 73043 Copertino, Italy;
| | - Angela Capuano
- Department of Emergency, AORN Santobono-Pausilipon, 80122 Naples, Italy;
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Gianpaolo Gargiulo
- Hematology and Haematopoietic Stem Cell Transplantation Centre, University Federico II of Naples, 80138 Naples, Italy;
| | - Marco Tomietto
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK;
| | - Teresa Rea
- Department of Public Health, University Federico II of Naples, 80138 Naples, Italy; (A.G.); (T.R.)
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Tellson A, Murray C, Boysen C, Dodd J, Maldonado L, Mohl C, Walker J. Closing the Workforce Staffing Chasm by Breaking Boundaries: Innovative Partnerships and Strategies Between Recruitment and Nursing. Nurs Adm Q 2023; 47:217-226. [PMID: 37261410 DOI: 10.1097/naq.0000000000000588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
As hospitals are experiencing a nursing shortage, nursing leaders must build innovative partnerships and strategies between nursing and recruitment to close the workforce gap. One large health care system was experiencing a high vacancy rate. To improve recruitment and retention efforts, nursing leaders partnered with the recruitment department and other key stakeholders to develop strategies. Together, they designed a candidate-centric recruiting and hiring process, designed innovative recruitment campaigns including recruiting former employed nurses, recruitment of traveling nurses into employees, increased graduate nurse recruitment efforts, and implementation of a registered nurse (RN) Ambassador program. The team improved work process efficiency for recruiters and candidates. Retention efforts focused on engaging nurses in the work environment, decreasing nurse leader workload to allow a focus on staff relationships, and improving exit processes in an effort to retain the nurse. The actual vacancy rate was as high as 20.9% in July 2021 to 8% in September 2022, indicating the system is closing the vacancy rate and nearing the goal of 5%.
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Jaekel AK, Rings TM, Schmitz F, Knappe F, Tschirhart A, Winterhagen FI, Kirschner-Hermanns RKM, Knüpfer SC. Urinary and Double Incontinence in Cognitively Impaired Patients: Impacts on Those Affected and Their Professional Caregivers. J Clin Med 2023; 12:jcm12103352. [PMID: 37240458 DOI: 10.3390/jcm12103352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/26/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
Urinary or double incontinence in frail elderly people is common and leads to a reduction in quality of life and an increased burden on the patients' caregivers. Up to now, no special instrument has been available to assess the impact of incontinence on cognitively impaired patients and their professional caregivers. Thus, the outcomes of incontinence-specific medical and nursing interventions for cognitively impaired individuals are not measurable. Our aim was to investigate the impacts of urinary and double incontinence on both the affected patients and their caregivers using the newly developed "International Consultation on Incontinence Questionnaire Cognitively Impaired Elderly" (ICIQ-Cog) tool. The severity of incontinence was measured by incontinence episodes per night/per 24 h, the type of incontinence, the type of incontinence devices used, and the proportion of incontinence care out of total care; all these measures were correlated to the ICIQ-Cog. Incontinence episodes per night and the proportion of incontinence care out of total care showed significant correlations with the patient- and caregiver-related ICIQ-Cog scores. Both items have negative effects on patient quality of life and caregiver burden. Improving nocturnal incontinence and reducing the need for incontinence care overall can decrease the incontinence-specific bother of affected patients and their professional caregivers. The ICIQ-Cog can be used to verify the impacts of medical and nursing interventions.
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Affiliation(s)
- Anke Kirsten Jaekel
- Department for Neuro-Urology, Clinic for Urology, University Hospital Bonn, 53127 Bonn, Germany
- Neuro-Urology, Johanniter Neurological Rehabilitation Center 'Godeshoehe e.V.', 53177 Bonn, Germany
| | - Theresa Maria Rings
- Department for Neuro-Urology, Clinic for Urology, University Hospital Bonn, 53127 Bonn, Germany
| | - Franziska Schmitz
- Department for Neuro-Urology, Clinic for Urology, University Hospital Bonn, 53127 Bonn, Germany
| | - Franziska Knappe
- Department for Neuro-Urology, Clinic for Urology, University Hospital Bonn, 53127 Bonn, Germany
| | - Alix Tschirhart
- Department for Neuro-Urology, Clinic for Urology, University Hospital Bonn, 53127 Bonn, Germany
| | | | - Ruth Klara Maria Kirschner-Hermanns
- Department for Neuro-Urology, Clinic for Urology, University Hospital Bonn, 53127 Bonn, Germany
- Neuro-Urology, Johanniter Neurological Rehabilitation Center 'Godeshoehe e.V.', 53177 Bonn, Germany
| | - Stephanie C Knüpfer
- Department for Neuro-Urology, Clinic for Urology, University Hospital Bonn, 53127 Bonn, Germany
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