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Cha KS, Lee D. Influential factors affecting nursing performance amid COVID-19: A cross-sectional study on nurse preparedness for infectious diseases. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100239. [PMID: 39391566 PMCID: PMC11465199 DOI: 10.1016/j.ijnsa.2024.100239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 08/15/2024] [Accepted: 09/04/2024] [Indexed: 10/12/2024] Open
Abstract
Background The emergence of infectious diseases such as SARS, MERS, and COVID-19 underscores the need for effective nursing preparedness. Objectives This cross-sectional study sought to pinpoint the factors that impact nursing performance during the COVID-19 pandemic, focusing on nurses' self-efficacy, work environment, knowledge, and attitudes. Design The study utilized a cross-sectional design. Settings & participants Between December 13, 2021, and January 21, 2022, an online and offline survey was conducted with 314 nurses who provided in-person care in tertiary and general hospitals throughout South Korea. Methods Using t-tests and ANOVA, the research compared nursing performance based on various demographic and work-related characteristics like age, gender, education, marital status, and other working conditions. A research model was formulated via structural equation modeling, positioning nursing performance as the dependent variable. The independent variables included career experience (indirect effect), work environment (indirect effect), COVID-19 knowledge (indirect effect), attitude toward COVID-19 (direct effect), and self-efficacy (direct effect). Data analysis was carried out using SPSS 26 and AMOS 28. Results The study demonstrated that self-efficacy and attitude toward COVID-19 significantly influence nursing performance, as reflected by robust critical ratios (CR) for self-efficacy (CR = 11.291, p < 0.001) and attitude (CR = 5.133, p < 0.001). They account for 43 % (R 2 = 0.43) of the variability of nursing performance. Self-efficacy was positively predicted by clinical experience (CR = 3.160, p = 0.002) and work environment (CR = 4.328, p < 0.001), while attitude was similarly influenced (CR = 3.557 and 2.926, respectively). However, clinical experience and work environment only explained 8 % (R 2 = 0.08) of self-efficacy and 16 % (R 2 = 0.16) of attitude. Knowledge about COVID-19 exhibited a statistically insignificant influence in the dynamics. Conclusions This study, conducted among Korean nurses during the COVID-19 pandemic, reveals that self-efficacy and attitudes towards COVID-19 are key predictors of nursing performance, overshadowing knowledge's influence. These findings suggest the critical role of psychological factors in healthcare delivery during crises and underscore the need for enhanced focus on developing self-efficacy and positive attitudes in nursing education and professional development. Additionally, demographic and professional variables, including age, clinical experience, educational level, and marital status affect nursing performance.
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Affiliation(s)
| | - Dohyun Lee
- Department of Kinesiology and Recreation Administration, North Carolina Central University, PO Box 19542, Durham, NC 27707, USA
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Ditlopo P, Rispel LC, Van Bogaert P, Blaauw D. The impact of the nurse practice environment, workload, and professional support on job outcomes and standards of care at primary health care clinics in South Africa: A structural equation model approach. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100241. [PMID: 39351496 PMCID: PMC11440313 DOI: 10.1016/j.ijnsa.2024.100241] [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: 11/13/2023] [Revised: 08/02/2024] [Accepted: 09/09/2024] [Indexed: 10/04/2024] Open
Abstract
Background There is substantial evidence on the associations between a positive nurse practice environment and improved nurse and patient outcomes, as well as the factors that mediate these associations, in high-income countries and in hospital settings. The knowledge gaps in African and primary health care settings motivated this empirical study. Objective The objective of this study was to examine the impact of the dimensions of the nurse practice environment, specifically human resource management, foundations for nursing care, and participation in clinic affairs, on job outcomes and standards of care. Design A cross-sectional study was conducted between November 2021 and June 2022. Setting 180 primary health care clinics in two South African provinces of Gauteng and North West. Participants 665 nurses of all categories. Methods A causal model was developed with pathways between the nurse practice environment dimensions and the outcomes of job satisfaction, intention to leave, and standards of care. A set of standardised instruments was used to measure the study variables. Using structural equation modelling, workload and professional support were tested as potential mediators between the nurse practice environment and the outcome variables. Results The nurses scored the domain of foundations for nursing care 71.2 out of 100 on average, indicating high agreement, while the mean scores for nurses' participation in clinic affairs and human resources management were lower at 68.0 and 61.7 respectively. Although nurses expressed moderate satisfaction with professional support (67.7), they were less satisfied with their workload (52.2). The mean score of overall job satisfaction was moderate (58.9), with 53.8 % of the nurses reporting that they intended leaving the clinic where they were working. Thirty-six percent intended leaving the nursing profession, indicating low intention to stay. The final mediation model was judged to fit the data adequately based on goodness-of-fit indices, confirming that workload and professional support had a mediating role between the nurse practice environment dimensions of interest and both nurses' job outcomes and standards of care. Conclusions We have highlighted the value of supportive practice environments, effective workload management, and enhanced professional support in improving nurses' job outcomes and satisfaction with standards of care. Improving nurses' practice environments at primary health care level may have a wide-ranging impact on the performance of the health system. Therefore, primary health care facility managers should ensure that workload is distributed equitably, professional support for nurses is enhanced, and the overall work environment is improved.
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Affiliation(s)
- Prudence Ditlopo
- Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 27 St Andrew's Road, Parktown, 2193, South Africa
| | - Laetitia C. Rispel
- Centre for Health Policy & South African Research Chairs Initiative (SARChI), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 27 St Andrew's Road, Parktown, 2193, South Africa
| | - Peter Van Bogaert
- Centre for Research and Innovation, Workforce Management and Outcome Research in Care, Primary Care Academy, Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken Lokaal D.R.333, Universiteitsplein 1 B-2610 Wilrijk, Belgium
| | - Duane Blaauw
- Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 27 St Andrew's Road, Parktown, 2193, South Africa
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Ernawaty E, Hariati S, Saleh A. Program components, impact, and duration of implementing a new nurse orientation program in hospital contexts: A scoping review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100214. [PMID: 38993995 PMCID: PMC11234109 DOI: 10.1016/j.ijnsa.2024.100214] [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: 12/03/2023] [Revised: 06/02/2024] [Accepted: 06/04/2024] [Indexed: 07/13/2024] Open
Abstract
Background Orientation programs for new nurses play an essential role in preparing them for challenges in clinical practice. Different countries have applied varying program components and durations in organizing these programs. Objectives To explore the program components, impact, and duration of the orientation programs for new graduate nurses in hospital care settings. Method We gathered information from studies conducted in various countries. Searches were conducted on databases including PubMed, Sage Journal, ScienceDirect, EBSCO, and Wiley, with secondary searches from 2018 to 2023 using Arkey and O'Malley's Review Scoping Framework. The inclusion criteria comprised studies with primary data, both qualitative and quantitative, focusing on new nurses undergoing orientation programs in hospitals. Results Of the 989 articles screened, 14 were included. Methods identified included providing hands-on experience, sharing information, reflecting on work experiences, and developing technical skills. Significant findings encompassed increased competence, knowledge, confidence, and satisfaction, as well as professional development and positive organizational impacts. The duration of orientation programs ranged from 2 weeks to 2 years, depending on the program type and new graduate nurse needs. Conclusion This scoping review elucidates program components, impact, and duration of new nurse orientation programs in hospitals, providing valuable insights for hospital management in designing and developing improved programs. Tweetable abstract Exploring program components, impact, and duration of hopitals new graduate nurse orientation programs, revealing insights to enhance patient care and nursing practice@Ns_Ernawaty.
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Affiliation(s)
- Ernawaty Ernawaty
- Faculty of Nursing, Hasanuddin University, Indonesia Pelamonia Hospital, Indonesia
| | - Suni Hariati
- Faculty of Nursing, Hasanuddin University, Jl. Perintis Kemerdekaan KM 10, Tamalanrea, Makassar 90245, Indonesia
| | - Ariyanti Saleh
- Faculty of Nursing, Hasanuddin University, Jl. Perintis Kemerdekaan KM 10, Tamalanrea, Makassar 90245, Indonesia
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Wu SF, Ching CY, Liao HC, Wang RH. Pathways among the nursing practice environment, job burnout, and job satisfaction to intention to leave: a cross-sectional study conducted in Taiwan. Rev Esc Enferm USP 2024; 58:e20240025. [PMID: 39392469 DOI: 10.1590/1980-220x-reeusp-2024-0025en] [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: 01/27/2024] [Accepted: 07/24/2024] [Indexed: 10/12/2024] Open
Abstract
OBJECTIVE The purpose of this study was to explore the pathways among the practice environment, job burnout, and job satisfaction and their relationships with the intention to leave among clinical nurses. METHOD A cross-sectional survey was administered to 310 nursing staff members working in regional teaching hospitals in southern Taiwan. The instruments used included the practice environment, job satisfaction, job burnout, and sociodemographic characteristics questionnaires. RESULTS Structural equation modeling indicated that job satisfaction (β = -0.167) and job burnout (β = 0.361) were significantly and directly associated with the intention to leave, whereas the practice environment was significantly and directly associated with job satisfaction (β = 0.447). The practice environment (βindirect = -0.075) and job burnout (βindirect = 0.060) were significantly and indirectly associated with the intention to leave through job satisfaction. CONCLUSION Job burnout and job satisfaction are directly associated with the intention to leave. Therefore, improving the practice environment and subsequent job burnout could be strategies to improve job satisfaction and decrease the intention to leave.
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Affiliation(s)
- Shu-Fen Wu
- Kaohsiung Medical University, College of Nursing, Kaohsiung, Taiwan
- Yuh-Ing Junior College of Health Care & Management, Department of Nursing, Kaohsiung, Taiwan
| | - Ching-Yun Ching
- Yuan's General Hospital, Department of Nursing, Kaohsiung, Taiwan
| | - Hsiu-Chen Liao
- Yuan's General Hospital, Department of Nursing, Kaohsiung, Taiwan
| | - Ruey-Hsia Wang
- Kaohsiung Medical University, College of Nursing, Kaohsiung, Taiwan
- Kaohsiung Medical University Hospital, Department of Medical Research, Kaohsiung, Taiwan
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Schlak AE, Liu J, Dixon J, Poghosyan L, Lelutiu-Weinberger C, Cato K. The association between nurse practitioner race and ethnicity and intent to leave in primary care practices. Nurs Outlook 2024; 72:102289. [PMID: 39388797 DOI: 10.1016/j.outlook.2024.102289] [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: 03/26/2024] [Revised: 08/07/2024] [Accepted: 09/15/2024] [Indexed: 10/12/2024]
Abstract
BACKGROUND Retaining nurse practitioners (NPs) from diverse racial and ethnic groups is critical to achieving health equity as NPs disproportionately care for minoritized populations. Yet, little is known about intent to leave (ITL) among these NPs. PURPOSE To examine whether NP race and ethnicity were associated with ITL and if this relationship was affected by the work environment. METHODS Survey data from 1,232 NPs across six states were used. NPs completed measures of their ITL, work environment quality, and demographics. Regression models were used to determine if NP race and ethnicity resulted in differential reports of ITL. FINDINGS Minoritized NPs had significantly higher cumulative odds of ITL compared with White NPs. DISCUSSION Minoritized NPs had higher ITL, and the work environment did not demonstrate a protective effect against ITL. Future research should identify work environment features that may help retain a diverse NP workforce.
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Affiliation(s)
| | - Jianfang Liu
- School of Nursing, Columbia University, New York, NY
| | | | | | | | - Kenrick Cato
- School of Nursing, University of Pennsylvania, Philadelphia, PA
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Xu K, Tong H, Zhang C, Qiu F, Liu Y. Psychometric evaluation of the Chinese version of the Nursing Student Contributions to Clinical Settings scale and analysis of factors influencing nurses' perceptions of nursing students' contributions: a cross-sectional study. BMC Nurs 2024; 23:720. [PMID: 39379936 PMCID: PMC11460126 DOI: 10.1186/s12912-024-02398-7] [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: 08/10/2024] [Accepted: 09/30/2024] [Indexed: 10/10/2024] Open
Abstract
BACKGROUND Most medical organizations accept many nursing students each year who gain clinical practice skills under the supervision of clinical nurses. However, there are no assessment tools to measure the contributions nursing students make to the clinical setting during clinical practicum. This study aimed to translate the 'Nursing Student Contributions to Clinical Settings' scale into Chinese and test its reliability and validity from the perspective of Chinese clinical nurses. And to explore whether nurses' personal and professional characteristics are related to nurses' perception of nursing students' contributions to the clinical settings. METHODS The original scale was translated into Chinese following the Brislin translation model. A convenience sample of 935 clinical nurses was selected from January to March 2024 for the survey. The content validity of the scale was assessed by expert consultation and content validity index. Exploratory factor analysis and confirmatory factor analysis were performed to assess the construct validity of the scale. The reliability of the scale was measured using internal consistency, split-half reliability, and test-retest reliability. The measurement quality of the scales was assessed according to the COnsensus-based Standards for the selection of health Measurement INstruments. One-way analysis of variance was used to identify variables related to students' contributions. RESULTS The content validity index of the scale was 0.983. Exploratory factor analysis supported a one-factor structure, and the cumulative variance contribution was 71.177%. Confirmatory factor analysis showed that the model fit indicators were all within the acceptable range. The McDonald's Omega coefficient and Cronbach's alpha coefficient for the scale were 0.983. Nurses perceive that nursing students' contribution to the clinical settings is influenced by nurses' personal characteristics, professional characteristics, and the hospital environment. CONCLUSION The Chinese version of the Nursing Student Contributions to Clinical Settings scale has good reliability and validity and can effectively and reliably measure the contributions of Chinese nursing students to clinical settings.
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Affiliation(s)
- Kaiyan Xu
- Department of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, People's Republic of China
| | - Huijuan Tong
- Shenyang Medical College, No. 146, Huanghe North Street, Yuhong District, Shenyang, 110034, People's Republic of China.
| | - Chunyan Zhang
- Department of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, People's Republic of China
| | - Feng Qiu
- Department of Ophthalmology, Shenyang Fourth People's Hospital, No. 20, Huanghe South Street, Huanggu District, Shenyang, 110031, People's Republic of China
| | - Yaoyao Liu
- Department of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, People's Republic of China
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Parr JM, Slark J, Lawless J, Teo STT. Understanding the Experiences of Nurses' Work: Development and Psychometric Evaluation of an End of Shift Survey. J Clin Nurs 2024. [PMID: 39370546 DOI: 10.1111/jocn.17437] [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: 02/26/2024] [Revised: 08/22/2024] [Accepted: 09/01/2024] [Indexed: 10/08/2024]
Abstract
AIM To explore and validate an end of shift survey with a low response burden, practical application and generated evidence of related associations between workload, quality of work and patient care, missed care and job satisfaction. DESIGN A retrospective cross-sectional survey of the experiences of nursing staff. METHODS Data were collected from 265 nurses who responded to a questionnaire at the end of their shift in 2022. Exploratory factor analysis was undertaken using IBM SPSS v.27 and confirmatory factor analysis was undertaken using IBM AMOS v27. Hypotheses testing was undertaken using IBM SPSS v.27 using multiple regression analyses. RESULTS All of the hypotheses were supported. There was a negative association between workload and quality of work and job satisfaction. Quality of work was negatively associated with workload and missed care and positively associated with job satisfaction. The association between missed care and job satisfaction was negative. CONCLUSION The EOSS is a valid and reliable tool with a low response burden. The tool supports previous research which demonstrated there is a negative relationship between level of workload and shift type with satisfaction, quality of work and potentially nurse retention. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE In the context of a global nursing shortage nursing leaders must ensure that care we provide is of the highest quality. We must take every action to address high workload to reduce the risk that fundamental care is not sacrificed, job satisfaction is improved and nurses remain in the profession. The EOSS gives nurse leaders a reliable, practical, consistent, applied tool that will better enable associations to be observed between resource configuration, workload and critical impacts on nursing and patient care. REPORTING METHOD We have adhered to the relevant EQUATOR guidelines using the STROBE reporting method. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Jenny M Parr
- Faculty of Medical and Health Sciences, School of Nursing, University of Auckland, Auckland, New Zealand
- Te Whatu Ora, Counties Manukau, Auckland, New Zealand
| | - Julia Slark
- Faculty of Medical and Health Sciences, School of Nursing, University of Auckland, Auckland, New Zealand
| | - Jane Lawless
- Insights, Surveillance and Knowledge, Public Health Agency, Massey University, Palmerston North, New Zealand
| | - Stephen T T Teo
- Department of Management and Marketing, La Trobe University, Melbourne, Victoria, Australia
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Jiang D, Kira J. New Nurse Turnover Intention and Related Factors in Japan and China: Focusing on Nursing Practice Environment and Burnout. J Nurs Res 2024; 32:00134372-990000000-00116. [PMID: 39360863 DOI: 10.1097/jnr.0000000000000636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND With rapidly declining birth rates and aging populations worldwide, the demand for nursing care has increased in recent years. High turnover, an important cause of nurse staffing shortages, directly affects the quality of nursing care. However, no comparison studies on turnover intention in East Asia have been published. PURPOSE The purpose of this study was to clarify the relationships among turnover intention, the work environment, and related factors among new nurses in Japan and China. METHODS A self-administered questionnaire survey was used to collect data from nurses employed for < 2 years. This questionnaire included participant characteristics, assessment of desire to become a nurse at the start of employment, current turnover intention, the Practice Environment Scale of the Nursing Work Index, and the Maslach Burnout Inventory-Human Services Survey. The relationship between current turnover intention and, respectively, number of hospital beds, strength of desire to become a nurse at the start of employment, level of participation in hospital affairs, emotional exhaustion (EE), personal achievement, and demographic variables was assessed. RESULTS The number of nurses who intended to leave the hospital was higher in Japan (74.1%) than in China (42.4%). However, of those expressing intention to leave, 46.6% of the nurses in China and only 5.0% of those in Japan indicated intention to quit the nursing profession altogether. In Japan, collegial nurse-physician relations and EE were related to turnover intention, whereas in China, number of hospital beds, strength of desire to become a nurse at the start of employment, participation in hospital affairs, EE, and personal achievement were all related to turnover intention. CONCLUSIONS To enhance retention and reduce turnover intention among nurses, the strength of desire to become a nurse in China and the nurse-physician relationship and EE in Japan should be taken into particular consideration when designing retention strategies and nurse education programs.
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Affiliation(s)
- Dan Jiang
- MS, RN, Doctoral Student, Department of Health Promotion Nursing, Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Junko Kira
- MS, RN, Professor, Department of Nursing, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
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Rosenbaum KEF, Lasater KB, McHugh MD, Lake ET. Changes in Patient Care Experiences and the Nurse Work Environment: A Longitudinal Study of U.S. Hospitals. Med Care Res Rev 2024:10775587241282403. [PMID: 39356144 DOI: 10.1177/10775587241282403] [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: 10/03/2024]
Abstract
Addressing patient experience is a priority in the health care system. Hospital Consumer Assessment of Providers and Systems (HCAHPS) survey results incentivize hospitals to elevate patient experience, a factor in patient-centered care. Although hospital nursing resources have been positively associated with better HCAHPS ratings, it is unknown how changes in nursing resources are associated with changes in HCAHPS ratings over time. This two-period longitudinal study ranked the associations between changes in nurse staffing, skill mix, nurse education, and work environment on HCAHPS ratings and found that changes in the work environment had the strongest associations (β = 2.29; p < .001) with improved HCAHPS ratings. Our findings provide hospital administrators with empirical evidence that may help make informed decisions on how to best invest limited resources to improve HCAHPS ratings, including the potential utility of improving the work environment through enhancing Nursing Quality of Care and Nurse Participation in Hospital Affairs.
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Affiliation(s)
- Kathleen E Fitzpatrick Rosenbaum
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, USA
- Yale University, New Haven, CT, USA
- Yale New Haven Hospital, New Haven, CT, USA
| | - Karen B Lasater
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, USA
| | - Matthew D McHugh
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, USA
| | - Eileen T Lake
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, USA
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Lasater KB, McHugh MD, Aiken LH. Hospital nurse staffing variation and Covid-19 deaths: A cross-sectional study. Int J Nurs Stud 2024; 158:104830. [PMID: 38917747 PMCID: PMC11374491 DOI: 10.1016/j.ijnurstu.2024.104830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/17/2024] [Accepted: 05/30/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND During the Covid-19 pandemic, Covid-19 mortality varied depending on the hospital where patients were admitted, but it is unknown what aspects of hospitals were important for mitigating preventable deaths. OBJECTIVE To determine whether hospital differences in pre-pandemic and during pandemic nursing resources-average patient-to-registered nurse (RN) staffing ratios, proportion of bachelor-qualified RNs, nurse work environments, Magnet recognition-explain differences in risk-adjusted Covid-19 mortality; and to estimate how many deaths may have been prevented if nurses were better resourced prior to and during the pandemic. METHODS This is a cross-sectional study of 87,936 Medicare beneficiaries (65-99 years old) hospitalized with Covid-19 and discharged (or died) between April 1 and December 31, 2020, in 237 general acute care hospitals in New York and Illinois. Measures of hospital nursing resources (i.e. patient-to-RN staffing ratios, proportion of bachelor-qualified RNs, nurse work environments, Magnet recognition) in the pre-pandemic period (December 2019 to February 2020) and during (April to June 2021) were used to predict in-hospital and 30-day mortality using adjusted logistic regression models. RESULTS The mean age of patients was 78 years (8.6 SD); 51 % were male (n = 44,998). 23 % of patients admitted to the hospital with Covid-19 died during the hospitalization (n = 20,243); 31.5 % died within 30-days of admission (n = 27,719). Patients admitted with Covid-19 to hospitals with better nursing resources pre-pandemic and during the pandemic were statistically significantly less likely to die. For example, each additional patient in the average nurses' workload pre-pandemic was associated with 20 % higher odds of in-hospital mortality (OR 1.20, 95 % CI [1.12-1.28], p < 0.001) and 15 % higher odds of 30-day mortality (OR 1.15, 95 % CI [1.09-1.21], p < 0.001). Hospitals with greater proportions of BSN-qualified RNs, better quality nurse work environments, and Magnet recognition offered similar protective benefits to patients during the pandemic. If all hospitals in the study had superior nursing resources prior to or during the pandemic, models estimate many thousands of deaths among patients hospitalized with Covid-19 could have been avoided. CONCLUSIONS Patients with Covid-19 admitted to hospitals with adequate numbers of RNs caring for patients, a workforce rich in BSN-qualified RNs, and high-quality nurse work environments (both prior to and during the Covid-19 pandemic) were more likely to survive the hospitalization. Bolstering these hospital nursing resources during ordinary times is necessary to ensure better patient outcomes and emergency-preparedness of hospitals for future public health emergencies.
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Affiliation(s)
- Karen B Lasater
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States of America; The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States of America.
| | - Matthew D McHugh
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States of America; The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Linda H Aiken
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States of America; The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States of America
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Rothbart K, Leddy J, M Brady C, Kruse DK, Lancaster RJ. Exploring Determinants of Nurse Retention: The Influence of Personal and Professional Values, and Work Environment in Predicting Intent to Leave. Nurs Adm Q 2024; 48:305-316. [PMID: 39213404 DOI: 10.1097/naq.0000000000000654] [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: 09/04/2024]
Abstract
Nurse retention remains a pivotal issue, necessitating urgent strategies aimed at the recruitment and retention of highly qualified nurses. However, there is limited knowledge regarding the influence of nurses' personal and professional values, along with work environment, on predicting intent to leave an organization. Utilizing a secondary analysis approach, this study employed logistic regression to predict intent to leave among registered nurses (n = 671) using results from the Short Schwartz's Value Survey, the Nurses Professional Values Scale-3, and the Practice Environment Scale of the Nursing Work Index. Regression analysis indicates that the work environment including "Participation in Hospital Affairs" (B = -.665, odds ratio = .514), "Nurse Manager Ability, Leadership, and Support" (B = -.448, odds ratio = .639), and "Staffing and Resource Adequacy" (B = -.589, odds ratio = .555) are significant predictors of nurses' intentions to leave. Establishing and maintaining supportive work environments is essential for retention, highlighting the importance of effective leadership.
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Affiliation(s)
- Kristin Rothbart
- Author Affiliations: Magnet and Nursing Excellence, Advocate Condell Medical Center, Libertyville, Illinois (Ms Rothbart); Nursing Education and Professional Development, Advocate Good Samaritan Hospital, Downers Grove, Illinois (Ms Leddy); Pediatric Cardiac Intensive Care Unit, Advocate Children's Hospital, Oak Lawn, Illinois (Ms Brady); Nursing Administration, Advocate Sherman Hospital, Elgin, Illinois (Ms Kruse); and Institute for Nursing Excellence, Advocate Health, Milwaukee, Wisconsin (Dr Lancaster)
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Ogata Y, Sasaki M, Morioka N, Moriwaki M, Yonekura Y, Lake ET. Influence of nurse work environment and psychological distress on resignation from hospitals: a prospective study. INDUSTRIAL HEALTH 2024; 62:295-305. [PMID: 38583955 PMCID: PMC11462404 DOI: 10.2486/indhealth.2023-0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 03/26/2024] [Indexed: 04/09/2024]
Abstract
With the global nurse shortage, identifying nurse work environments that allow nurses to continue working is a common concern worldwide. This study examined whether a better nurse work environment (1) is associated with reducing nurses' psychological distress; (2) reduces nurse resignations; (3) weakens the influence of psychological distress on their resignation through interaction effect; and (4) whether psychological distress increases nurse turnover. Multilevel logistic regression analyses were performed using data obtained in 2014 from 2,123 staff nurses from a prospective longitudinal survey project of Japanese hospitals. The nurse work environment was measured by the Practice Environment Scale of the Nursing Work Index (PES-NWI) consisting of five subscales and a composite, and psychological distress by K6. All the PES-NWI subscales and composite (ORs 0.679-0.834) were related to K6, significantly. Regarding nurse turnover, K6 had a consistent effect (ORs 1.834-1.937), and only subscale 2 of the PES-NWI had a direct effect (OR 0.754), but there was no effect due to the interaction term. That is, (1) and (4) were validated, (2) was partly validated, but (3) was not. As better work environment reduces K6 and a lower K6 decreases nurses' resignation, high-level hospital managers need to continue improving the nurse work environment.
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Affiliation(s)
- Yasuko Ogata
- Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), Japan
| | - Miki Sasaki
- Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), Japan
| | - Noriko Morioka
- Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), Japan
| | - Mutsuko Moriwaki
- Quality Management Center, Tokyo Medical and Dental University Hospital, Japan
| | - Yuki Yonekura
- Graduate School of Nursing Science, St. Luke's International University, Japan
| | - Eileen T Lake
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, USA
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Mason A, Lake ET, Clark RRS. Associations Between Hospital Nursing Resources and Breastfeeding Outcomes: A Narrative Review. J Perinat Neonatal Nurs 2024:00005237-990000000-00047. [PMID: 39325950 DOI: 10.1097/jpn.0000000000000859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2024]
Abstract
PURPOSE To summarize how nursing resources and missed nursing care are associated with hospital breastfeeding outcomes, including human milk provision. BACKGROUND Nurses are the primary providers of breastfeeding support in the hospital. Nursing resources, eg, staffing and the work environment, enable nurses to carry out their work successfully. If resources are constrained, nurses may miss providing breastfeeding support. There is a gap in the literature about the relationships among nursing resources, missed nursing care, and breastfeeding outcomes. METHODS The Cumulative Index to Nursing and Allied Health Literature and PubMed were searched with keywords such as: "nurse staffing," "nurse work environment," "missed nursing care," "breastfeeding," "human milk," and "lactation." We included peer-reviewed studies of US samples in English published between 2014 and 2022. RESULTS Of 312 references, 8 met inclusion criteria: 5 quantitative and 3 qualitative. Better nurse staffing and breastfeeding support were associated with improved breastfeeding outcomes in the qualitative and quantitative literature. Missed care partially mediated the relationship between staffing and exclusive breast milk feeding rates. Better nurse work environments were associated with increased breastfeeding support and provision of human milk. CONCLUSIONS Empirical evidence supports an association between the nurse work environment, nurse staffing, breastfeeding support, and outcomes. Implications for practice and research: Poor staffing may be associated with decreased breastfeeding support and outcomes. Hospital administrators and nurse managers may consider improving nurse staffing and the work environment to improve breastfeeding outcomes. Future research should simultaneously examine staffing and the work environment and address breastfeeding outcome disparities.
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Affiliation(s)
- Aleigha Mason
- Author Affiliations: Center for Health Outcome & Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania (Ms Mason); Center for Health Outcomes and Policy Research Editor, Research in Nursing & Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania (Dr Lake); and Center for Health Outcomes and Policy Research Nurse Scientist, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania (Dr Clark)
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Di Nitto M, Zaghini F, Caponnetto V, Ferraiuolo F, Napolitano F, Alvaro R, Lancia L, Manara DF, Rasero L, Rocco G, Mazzoleni B, Sasso L, Bagnasco A. Development and psychometric properties of an instrument to evaluate missed nursing care in home care: A validation study. Public Health Nurs 2024. [PMID: 39287366 DOI: 10.1111/phn.13414] [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: 02/05/2024] [Revised: 06/19/2024] [Accepted: 08/15/2024] [Indexed: 09/19/2024]
Abstract
OBJECTIVE To develop and validate a questionnaire to evaluate missed nursing care (MNC) in a home care setting. DESIGN A new instrument was developed and tested performing a preliminary analysis of a multicenter cross-sectional study in Italy. Reporting was performed according to COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) guidelines. SAMPLE Eight hundred out of a total of 2549 home care nurses enrolled in AIDOMUS-IT were considered for the validation of the Missed Nursing Care in Home Care (MNC_HC). MEASUREMENTS The MNC_HC instrument was developed by a panel of experts and underwent content and face validation. Exploratory (EFA) and confirmatory factor analyses (CFA) were conducted. RESULTS EFA revealed a one-factor solution, explaining 56% of the total variance for MNC_HC. CFA confirmed excellent structural validity, with a one-factor model showing an exceptional fit (χ2 (27) = 141.39, p < .001, RMSEA = 0.04, SRMR = 0.04, CFI = 0.99, TLI = 0.99, factor loadings > 0.5). MNC_HC also demonstrated high reliability (Cronbach's α = 0.92). The activity with the highest rate of missed care was the documentation of nursing care (77%), while activities related to nursing techniques (e.g., injections, dressings, etc.) were reported to be missed less (33.63%). CONCLUSIONS MNC_HC is a quick-filling, valid, reliable, and psychometrically sound instrument for measuring MNC in home care useful for future research.
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Affiliation(s)
- Marco Di Nitto
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Francesco Zaghini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Valeria Caponnetto
- Department of Life, Health & Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Fabio Ferraiuolo
- Department of Life, Health & Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Francesca Napolitano
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Department of Emergency and Admission, Policlinic Hospital "IRCSS San Martino,", Genoa, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
| | - Loreto Lancia
- Department of Life, Health & Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
| | - Duilio Fiorenzo Manara
- Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
- Center of Nursing Research and Innovation of Milan, Vita-Salute San Raffaele University, Milan, Italy
| | - Laura Rasero
- Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Gennaro Rocco
- Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
- Center of Excellence for Nursing Scholarship c/o Ordine Professioni Infermieristiche (Board of Nursing) of Rome, Rome, Italy
- Degree Course in Nursing, Catholic University "Our Lady of Good Counsel", Tirana, Albania
| | - Beatrice Mazzoleni
- Humanitas University, Milan, Italy
- National Secretary Federazione Nazionale Ordini Professioni Infermieristiceh (Italian Board of Nursing), Rome, Italy
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
| | - Annamaria Bagnasco
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Scientific Committee CERSI-FNOPI, Federazione Nazionale Ordini Professioni Infermieristiche, Rome, Italy
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15
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Pabico C, Park SH, Swartwout E, Warshawsky NE. Path Analysis: Interrelationships Between Nurse Manager Competencies, Practice Environment Perceptions, and Frontline Nurses' Intent to Stay. J Nurs Adm 2024:00005110-990000000-00083. [PMID: 39264992 DOI: 10.1097/nna.0000000000001485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2024]
Abstract
OBJECTIVE To examine the correlation between nurse manager (NM) competencies, work environment (Practice Environment Scale of the Nursing Work Index [PES-NWI]), and frontline nurses' intent to stay; the direct effect of NM competency on frontline nurses' intent to stay; and the indirect effect of NM competency on frontline nurses' intent to stay, mediated by PES-NWI. BACKGROUND PES-NWI and NMs' competency can impact frontline nurses' intent to stay. METHODS Cross-sectional study with secondary analysis of NM Competency and NDNQI® (National Database of Nursing Quality Indicators®) RN Survey data with path analysis for effects of the model's variables. RESULTS Positive, weak correlations between NM competencies and frontline nurses' practice environments were found; NM competencies and frontline nurses' intent to stay were not correlated. Paths were NM competency/PES-NWI (β = 0.20, P = 0.001) and PES-NWI/intent to stay (β = 0.55, P < 0.001); NM competency/intent to stay was not significant. Indirect effect of NM competency on frontline nurses' intent to stay was mediated through PES-NWI (β = 0.11, P = 0.002; 95% confidence interval, 0.05-0.17). CONCLUSIONS Investing in NMs' competency can help create supportive work environments and frontline nurses' intent to stay.
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Affiliation(s)
- Christine Pabico
- Author Affiliations: Sr. Director (Dr Pabico), Pathway to Excellence Program, and Independent Nurse Research Consultant (Dr Swartwout), American Nurses Credentialing Center (ANCC), Silver Spring, Maryland; Associate Professor (Dr Park), University of Kansas School of Nursing; and Nurse Scientist (Dr Warshawsky), Clinical Research, Press Ganey Associates, Chicago, Illinois
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Gordon JS, Niklinski E, Do H, Quinlan P. Impact of a Modified Protocol for Blood Collection on Hemolysis Rates and Nurses' Perceptions About Improving Their Practice Environment. J Perianesth Nurs 2024:S1089-9472(24)00207-7. [PMID: 39230533 DOI: 10.1016/j.jopan.2024.05.023] [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: 01/26/2024] [Revised: 05/16/2024] [Accepted: 05/21/2024] [Indexed: 09/05/2024]
Abstract
PURPOSE In 2019, approximately 5% of blood draws in the postanesthesia care unit (PACU) were hemolyzed compared to 1.1% across other hospital units. A preliminary review showed almost 60% of patients sampled blood employing arterial lines in the unit. The purpose of this quality improvement study was to improve blood drawing practices and reduce the occurrence of hemolysis. A secondary aim was for PACU nurses to lead this unit-based initiative. DESIGN Team members led by PACU nurses used the Deming model of quality improvement as a framework to better the process of specimen collection. METHODS The team employed the Plan-Do-Check-Act procedure to organize their improvement efforts. Specimen collection protocol was modified to include manual aspiration from arterial lines and hemolysis data was retrieved from laboratory generated reports and electronic medical records. FINDINGS By changing blood drawing practices, the hemolysis rate was significantly reduced from 5.2% to 3.6%. Two years postimplementation, rates continue to decline with the current rate at 1.97%. CONCLUSION This nurse-led interdisciplinary improvement initiative identified and trialed evidence-based solutions to reduce blood specimen hemolysis.
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Affiliation(s)
| | - Erin Niklinski
- Post Anesthesia Care Unit, Hospital for Special Surgery, New York, NY
| | - Huong Do
- Clinical Data Core, Hospital for Special Surgery, New York, NY
| | - Patricia Quinlan
- Department of Nursing, Hospital for Special Surgery, New York, NY
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Jain N, DeGuzman P, Figueroa N. The Impact of Nurse-Physician Relationships on Emergency Nurses' Moral Distress. J Emerg Nurs 2024; 50:618-625. [PMID: 38043047 DOI: 10.1016/j.jen.2023.10.010] [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: 07/19/2023] [Revised: 10/23/2023] [Accepted: 10/29/2023] [Indexed: 12/04/2023]
Abstract
INTRODUCTION Moral distress affects registered nurses' job dissatisfaction, and may ultimately be associated with higher rates of turnover. Nurse-physician relationships have been shown to affect moral distress in the intensive care unit setting, but no research has evaluated this impact on emergency nurses. The purpose of this study was to investigate the impact of nurse-physician relationships on the moral distress of emergency nurses. METHODS A quantitative correlational design was used to evaluate the study's aim. Point-of-care nurses currently working in an emergency department were asked to complete the Measure of Moral Distress Scale for Healthcare Professionals and the collegial nurse-physician relations domain of the Practice Environment Scale of the Nursing Work Index. Univariate and multivariate analyses were conducted to determine the impact of nurse-physician relationships on moral distress, controlling for demographic characteristics. RESULTS Thirty-two participants completed the survey. Multivariate regression showed that nurse-physician relationships are associated with moral distress in emergency nurses. Years of experience and gender did not affect moral distress in univariate or multivariate analyses. DISCUSSION Given current staffing shortages and the need to retain expert nurses in high-acuity settings, strategies to improve nurse-physician collaboration opportunities should be explored in ED settings.
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Muir KJ, McHugh MD, Merchant RM, Lasater KB. Left Without Being Seen: Nurse Work Environment and Timely Outcomes in New York and Illinois Emergency Departments. J Emerg Nurs 2024; 50:660-669. [PMID: 38127046 PMCID: PMC11186975 DOI: 10.1016/j.jen.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION This study determined the relationship between the emergency nurse work environment and emergency department patient left without being seen rates and lengths of stay. METHODS Cross-sectional analysis of 215 New York and Illinois emergency departments. The work environment (abbreviated Practice Environment Scale of the Nursing Work Index) was measured by emergency nurses in the 2021 RN4CAST-NY/IL survey and linked with outcomes from Hospital Compare. Regression models estimated the relationship between the nurse work environment and emergency department patient left without being seen rates, median length of stay (in minutes), and median behavioral health patient length of stay. Model coefficients were used to estimate expected additional care minutes gained if emergency department work environments improved. RESULTS "Mixed" work environments had the longest median overall length of stay (3.4 hours) and the highest median left without being seen rates (2.2%), while "poor" work environments had the longest median length of stay for behavioral health patients (6 hours). Improving the emergency department work environment from poor to mixed (and mixed to better) was associated with a 13-minute reduction in overall length of stay (P ≤ .05), a 33-minute reduction in behavioral health length of stay (P ≤ .01), and a 19% reduction in left without being seen rates (P ≤ .01). We estimated 11,824 to 41,071 additional patients could be seen in emergency departments associated with work environment improvements from "poor" to "better," depending on annual patient volumes. DISCUSSION Hospital administrators should consider investing in nurse work environments as a foundation to improve timely outcomes.
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Affiliation(s)
- K. Jane Muir
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, 418 Curie Blvd Philadelphia, PA 19104
- National Clinician Scholars Program, University of Pennsylvania
- Leonard Davis Institute of Health Economics, University of Pennsylvania
- ENA Chapter 118
| | - Matthew D. McHugh
- National Clinician Scholars Program, University of Pennsylvania
- Leonard Davis Institute of Health Economics, University of Pennsylvania
| | - Raina M. Merchant
- Leonard Davis Institute of Health Economics, University of Pennsylvania
- Department of Emergency Medicine, University of Pennsylvania, Perelman Center for Advanced Medicine, 5 floor, C-Suite, Philadelphia, PA 19104
| | - Karen B. Lasater
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, 418 Curie Blvd Philadelphia, PA 19104
- Leonard Davis Institute of Health Economics, University of Pennsylvania
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Gioiello G, Zaghini F, Della Bella V, Fiorini J, Sili A. Measuring Nurses' Organizational Well-Being: A Systematic Review of Available Instruments. Eval Health Prof 2024; 47:261-278. [PMID: 37857313 DOI: 10.1177/01632787231207018] [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: 10/21/2023]
Abstract
This systematic review aimed to identify and compare instruments measuring nurses' organizational well-being, summarise the dimensions measured by these instruments, the statistical analysis performed for validity evidence and identify an instrument that comprehensively investigates nurses' organizational well-being. The JBI Manual for Evidence Synthesis and the PRISMA checklist were used as guidelines. The search was conducted on Medline, CINAHL, Cochrane Library and Scopus. Critical appraisal and data extraction were drawn on the COSMIN checklist. Dimensions were conceptually synthesized by the measurement concepts' similarity. Twenty-two articles were retrieved and they included 21 instruments that measured nurses' organizational well-being. The instruments vary by dimension number (range 2-19), items (range 12-118) and concept elicitation. A plurality of methodologies has been used in instrument development and assessments of evidence for validity. Only four instruments reported a concurrent criterion validity or a measurement comparison with an already tested-for-validity instrument. Similar dimensions were leadership and support, relationships and communication, work-family balance, work demands, violence, control and autonomy, satisfaction and motivation, work environment and resources, careers, and organizational policy. This review underlines the core areas of the instruments that measure nursing organizational well-being. It allows administrators and researchers to choose the appropriate instruments for monitoring this multidimensional concept.
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Yilmaz A, Yilmaz Kocak M. The effect of practice environments and psychological empowerment perceptions of nurses on their care behaviours: A cross-sectional study. J Eval Clin Pract 2024; 30:1102-1112. [PMID: 38961735 DOI: 10.1111/jep.14076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 06/06/2024] [Accepted: 06/21/2024] [Indexed: 07/05/2024]
Abstract
AIM The aim of this study was to examine the effect of professional and individual characteristics, practice environments and psychological empowerment perceptions of nurses on their care behaviours. DESIGN The study used a cross-sectional research design following the STROBE guidelines. METHODS The sample of this descriptive and correlational study consisted of 584 nurses working in a university hospital in Turkey. The data were collected between January and June 2023 using the Nursing Information Form, the Practice Environment Scale of the Nursing Work Index (PES-NWI), the Psychological Empowerment Scale (PES), and the Caring Behaviours Scale-30, and analysed using descriptive statistics, Spearman's correlation and multiple linear regression. RESULTS It was determined that PES-NWI, PES and Caring Behaviours Scale (CBI-30) scores of nurses were higher than the average. The study revealed that certain professional and individual characteristics of nurses, practice environments and psychological empowerment perceptions had an effect on their care behaviours. CONCLUSION The results of the study showed that nurses' PES-NWI, PES and CBI-30 scores were higher than the average, and that certain professional and individual characteristics of nurses, practice environments and psychological empowerment perceptions had an effect on care behaviours. Nursing service managers, in particular, are required to understand the importance of this relationship and create appropriate working conditions which are integrated with psychological empowerment to improve caring behaviours of nurses.
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Affiliation(s)
- Aysegul Yilmaz
- Department of Midwifery, Faculty of Health Sciences, Selçuk University, Konya, Türkiye
| | - Mine Yilmaz Kocak
- Department of Midwifery, Faculty of Health Sciences, Selçuk University, Konya, Türkiye
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21
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Villamin P, Lopez V, Thapa DK, Cleary M. Retention and turnover among migrant nurses: A scoping review. Int Nurs Rev 2024; 71:541-555. [PMID: 37467162 DOI: 10.1111/inr.12861] [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: 11/08/2022] [Accepted: 06/19/2023] [Indexed: 07/21/2023]
Abstract
AIM To map and explore primary research about factors related to retention, turnover and turnover intention among migrant nurses. BACKGROUND Understanding retention and turnover among migrant nurses is essential, especially in the context of nursing shortage. There is a range of factors motivating nurses to emigrate; however, factors related to retention and turnover among migrant nurses in the host country are unclear. METHODS This review utilised Arksey and O'Malley's methodological framework for scoping reviews, and is reported with the PRISMA-ScR checklist. Four electronic databases were searched-CINAHL, PsycINFO, ProQuest and PubMed-to identify primary research published between January 2000 and May 2022. Titles and abstracts were reviewed against the inclusion and exclusion criteria, and then full-text versions were reviewed. Data extracted were summarised, and results synthesised. RESULTS Fifteen studies were included, with studies mainly from the Middle East, the United Kingdom and the United States. Personal, organisational, financial, political and environmental factors were found to influence retention and turnover among migrant nurses. CONCLUSION Retention and turnover rates among migrant nurses vary among host countries. The factors identified are related to each other; hence, retention and turnover among migrant nurses are best understood in the context of their source country, host country and individual circumstances. IMPLICATIONS FOR NURSING POLICY, SOCIAL POLICY, AND HEALTH POLICY: Host countries must promote strategies that foster retention, such as reviewing immigration policies to support long-term immigration and family unity. Organisations employing migrant nurses need to consider the presence of a social network to facilitate adaptation and integration. It is also recommended that source countries address the reasons for emigration and initiate policies encouraging return migration, including providing merit to overseas experience. International nursing organisations should call for an examination of the conditions of migrant nurses to ensure equality across all source countries.
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Affiliation(s)
- Princess Villamin
- School of Nursing, Midwifery and Social Sciences, CQUniversity, Australia
| | - Violeta Lopez
- School of Nursing, Midwifery and Social Sciences, CQUniversity, Australia
| | - Deependra Kaji Thapa
- School of Nursing, Midwifery and Social Sciences, CQUniversity, Australia
- Nepal Public Health Research and Development Center, Kathmandu, Nepal
| | - Michelle Cleary
- School of Nursing, Midwifery and Social Sciences, CQUniversity, Australia
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Johnson C, Delaney KR, Cirpili A, Marriott S, O'Connor J. American Psychiatric Nurses Association Position: Staffing Inpatient Psychiatric Units. J Am Psychiatr Nurses Assoc 2024; 30:886-895. [PMID: 37698389 DOI: 10.1177/10783903231198247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
OBJECTIVE An American Psychiatric Nurses Association (APNA) task force reviewed current staffing research to revise and update the 2011 APNA "Staffing inpatient psychiatric units" position paper and provide recommendations to the APNA Board of Directors on how psychiatric mental health (PMH) nurses might champion the staffing needs of inpatient psychiatric units. METHODS Current research on staffing and nursing practice in inpatient psychiatric units was reviewed as well as variables believed to influence staffing and nursing practice, such as consumer needs and workplace culture. Since current nurse staffing principles emphasize nursing value and how that value is connected to outcomes, the literature search included a focus on staffing and related patient outcomes. RESULTS PMH nurses are critical to the safety and quality of care in inpatient psychiatric units. However, there are little existing data on the relationship between staffing levels and even common adverse events such as staff injury and restraint of patients. Furthermore, there is scant research conducted on inpatient psychiatric units that informs optimal staffing models or establishes links between staffing and patient outcomes. CONCLUSIONS Consistent with current evidence, the universal use of a single method or model of determining staffing needs (e.g., nursing hours per, case mix index, or mandatory ratios) is not recommended. PMH nurses should champion systematic evaluation of staffing on their inpatient units against select patient, nurse, and system outcomes. A data repository of PMH nurse-sensitive outcomes is necessary to benchmark unit performance and staffing.
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Affiliation(s)
- Celeste Johnson
- Celeste Johnson, DNP, APRN, PMH CNS, CMJ Behavioral Health Consulting, LLC, Garland, TX, USA
| | - Kathleen R Delaney
- Kathleen R. Delaney, PhD, PMH-NP, FAAN, Rush University College of Nursing, Chicago, IL, USA
| | - Avni Cirpili
- Avni Cirpili, DNP, RN, Vanderbilt Psychiatric Hospital, Nashville, TN, USA
| | - Suzie Marriott
- Suzie Marriott, MS, RN, PMH-BC, Stony Brook Eastern Long Island Hospital, Port Jefferson Station, NY, USA
| | - Janette O'Connor
- Janette O'Connor, MS, BS, BSN, RN, PMH-BC, New York Presbyterian Hospital, White Plains, NY, USA
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Babaei S, Amini K, Ramezani-Badr F. Unveiling missed nursing care: a comprehensive examination of neglected responsibilities and practice environment challenges. BMC Health Serv Res 2024; 24:977. [PMID: 39180086 PMCID: PMC11344376 DOI: 10.1186/s12913-024-11386-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 08/01/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND The global variable of missed nursing care and practice environment are widely recognized as two crucial contextual factors that significantly impact the quality of nursing care. This study assessed the current status of missed nursing care and the characteristics of the nursing practice environment in Iran. Additionally, this study aimed to explore the relationship between these two variables. METHODS We conducted an across-sectional study from May 2021 to January 2022 in which we investigated 255 nurses. We utilized the Missed Nursing Care Survey, the Nursing Work Index-Practice Environment Scale, and a demographic questionnaire to gather the necessary information. We used the Shapiro‒Wilk test, Pearson correlation coefficient test, and multiple linear regression test in SPSS version 20 for the data analyses. RESULTS According to the present study, 41% of nurses regularly or often overlooked certain aspects of care, resulting in an average score of 32.34 ± 7.43 for missed nursing care. It is worth noting that attending patient care conferences, providing patient bathing and skin care, and assisting with toileting needs were all significant factors contributing to the score. The overall practice environment was unfavorable, with a mean score of 2.25 ± 0.51. Interestingly, 'nursing foundations for quality of care' was identified as the sole predictor of missed nursing care, with a β value of -0.22 and a p-value of 0.036. CONCLUSIONS This study identified attending patient care interdisciplinary team meetings and delivering basic care promptly as the most prevalent instances of missed nursing care. Unfortunately, the surveyed hospitals exhibited an undesirable practice environment, which correlated with a higher incidence of missed nursing care. These findings highlight the crucial impact of nurses' practice environment on care delivery. Addressing the challenges in the practice environment is essential for reducing instances of missed care, improving patient outcomes, and enhancing overall healthcare quality.
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Affiliation(s)
- Somayeh Babaei
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Kourosh Amini
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Mahdavi St., Zanjan, 4515789589, Iran.
| | - Farhad Ramezani-Badr
- Department of Critical Care Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
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Miller MJ, Korbut N, Amador Garcia L, Agazio JB, Cartwright J. Nurse Attrition: Content Analysis of Free-Text Responses From Two Military Nursing Practice Environment Surveys. Mil Med 2024; 189:784-790. [PMID: 39160829 DOI: 10.1093/milmed/usae275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/21/2024] [Accepted: 05/09/2024] [Indexed: 08/21/2024] Open
Abstract
INTRODUCTION Staff nurse attrition negatively impacts readiness of the warfighter and the health and wellbeing of all beneficiaries of the Military Health System (MHS). To promote the retention of a robust nursing workforce, a complete understanding of nurses' perceptions regarding their intent to leave is necessary. The purpose of this study was to explore the free-text responses of 1,438 nurses working among military medical treatment facilities for factors influencing their intent to leave, as an indicator of potential turnover, or attrition. MATERIALS AND METHODS This study employed thematic analysis to investigate the qualitative responses from the 2016 and 2018 Military Nursing Practice Environment Surveys. The study was determined to be exempt from Institutional Review Board review through the Womack Army Medical Center's Human Research Protection Program. RESULTS Findings indicate that leadership and management (n = 647), staffing (n = 353), career opportunities (n = 345), staff outcomes (n = 247), culture (n = 153), quality of care (n = 99), patient care barriers (n = 86), non-patient care activities (n = 79), lack of formal professional development (n = 75), and area or care environment (n = 67) were among the top factors influencing staff nurse intent to leave, respectively. CONCLUSIONS Our findings support the evaluation of retention strategies using implementation science for nurses and nurse resource personnel (e.g., nursing assistants, technicians, medics, and corpsman) to ensure a robust nursing work force throughout the MHS. Staff nurses and resource personnel working among military treatment facilities and embedded in units supporting combat and humanitarian missions ensure access to care and health promotion of the warfighter and all MHS beneficiaries.
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Affiliation(s)
- Melissa J Miller
- Center for Nursing Science & Clinical Inquiry, Tripler Army Medical Center, Honolulu, HI 96859, USA
| | - Nickalous Korbut
- Department of Behavioral Sciences and Leadership, United States Military Academy, West Point, NY 10996, USA
| | - Lidilia Amador Garcia
- Department of Behavioral Sciences and Leadership, United States Military Academy, West Point, NY 10996, USA
| | - Janice B Agazio
- Conway School of Nursing, Catholic University of America, Washington, DC 20064, USA
| | - Joel Cartwright
- Department of Behavioral Sciences and Leadership, United States Military Academy, West Point, NY 10996, USA
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Zaghini F, Calzolari M, Di Nitto M, Longobucco Y, Alvaro R, Cicolini G, Lancia L, Manara DF, Rasero L, Rocco G, Zega M, Mazzoleni B, Sasso L, Bagnasco A. Workload of home care nurses: Italian adaptation, validity, and reliability of the National Aeronautics and Space Administration Task Load Index questionnaire. Public Health Nurs 2024. [PMID: 39092927 DOI: 10.1111/phn.13387] [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: 03/08/2024] [Revised: 06/14/2024] [Accepted: 07/11/2024] [Indexed: 08/04/2024]
Abstract
The aim of this study was to adapt the National Aeronautics and Space Administration Task Load Index (NASA-TLX) to the home care setting and translate and validate it in Italian. An online questionnaire containing the Italian version of the NASA-TLX adapted to the home care setting was administered to home care nurses to measure workload. Content Validity Index, Exploratory, and Confirmatory Factor Analyses were used to measure the psychometric characteristics of the modified NASA-TLX. The modified Italian version of NASA-TLX_HC-IT showed good psychometric characteristics in measuring the workload of home care nurses, with excellent fit indices. The reliability, calculated with Cronbach's alpha, was 0.73, indicating adequate reliability. A negative correlation between workload and job satisfaction among home care nurses, as well as a positive association between high workload and intention to leave the workplace, was verified. The modified Italian version of the NASA-TLX_HC-IT was confirmed to be a valid and reliable instrument to measure workload in home care nursing. Furthermore, the correlation between workload and the intention to leave the workplace among home care nurses was an important result that community nursing managers should consider preventing the shortage of home care nurses.
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Affiliation(s)
- Francesco Zaghini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Marco Di Nitto
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Yari Longobucco
- Department of Health Science, University of Florence, Florence, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Scientific Committee CERSI-FNOPI, Rome, Italy
| | - Giancarlo Cicolini
- Department of Innovative Technologies in Medicine & Dentistry, "G.d'Annunzio" University of Chieti - Pescara, Chieti, Italy
- FNOPI Board Member, Rome, Italy
| | - Loreto Lancia
- Scientific Committee CERSI-FNOPI, Rome, Italy
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, Piazzale Salvatore Tommasi, L'Aquila, Italy
| | - Duilio Fiorenzo Manara
- Scientific Committee CERSI-FNOPI, Rome, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Laura Rasero
- Department of Health Science, University of Florence, Florence, Italy
- Scientific Committee CERSI-FNOPI, Rome, Italy
| | - Gennaro Rocco
- Scientific Committee CERSI-FNOPI, Rome, Italy
- Centre of Excellence for Nursing Scholarship, Rome, Italy
| | - Maurizio Zega
- FNOPI Board Member, Rome, Italy
- Isola Tiberina Hospital - Gemelli Isola, A. Gemelli IRCCS University Hospital Foundation, Rome, Italy
| | | | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Scientific Committee CERSI-FNOPI, Rome, Italy
| | - Annamaria Bagnasco
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Scientific Committee CERSI-FNOPI, Rome, Italy
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Lake ET, Gil J, Moronski L, McHugh MD, Aiken LH, Lasater KB. Validation of a short form of the practice environment scale of the nursing work index: The PES-5. Res Nurs Health 2024; 47:450-459. [PMID: 38669131 PMCID: PMC11236491 DOI: 10.1002/nur.22388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/08/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
The Practice Environment Scale of the Nursing Work Index (PES-NWI) has been utilized for two decades globally to measure nurse work environments. Its 31 items in five domains present a substantial respondent burden, threatening survey response rates. The purpose of this study was to derive and validate a short form: the PES-5. We conducted a cross-sectional, secondary analysis of survey data from nurses in 760 hospitals in six U.S. states in 2016 or 2019. One representative item per subscale was selected by highest item-to-subscale R2 from the original PES-NWI publication. Five psychometric properties of the PES-5 were evaluated. The reproduced structure of the full form was confirmed in the 2016 data by the highest R2 for the selected items. The unidimensional structure of the PES-5 was confirmed through confirmatory factor analysis. The correlation between the composite values of the 28-item and 5-item versions was 0.94. The Cronbach's alpha reliability of the PES-5 was >0.80. The intraclass correlation coefficient (ICC 1, k), which evaluates the stability of aggregated values when data are clustered, i.e., nurses are nested within hospitals, was >0.80 in both datasets, demonstrating satisfactory aggregate properties. Construct validity was supported by the selected items being ranked highly in their respective subscales by an expert panel. Criterion validity was supported by an analysis of variance of the PES-5 mean value across responses to a single-item work environment measure. Similar patterns of relationships with other key variables were identified by statistically significant odds ratios in regression models predicting patient mortality from the PES-5. The classification accuracy of the PES-5 was high, with 88% of hospitals classified identically by both versions. The PES-5 shows promise for measurement of nurses' work environments while maximizing response rate by reducing participant burden.
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Affiliation(s)
- Eileen T Lake
- Department of Biobehavioral Health Sciences, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Jennifer Gil
- Department of Biobehavioral Health Sciences, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Lynne Moronski
- Department of Biobehavioral Health Sciences, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Matthew D McHugh
- Department of Biobehavioral Health Sciences, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Linda H Aiken
- Department of Biobehavioral Health Sciences, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Karen B Lasater
- Department of Biobehavioral Health Sciences, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
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Montgomery AP, Sullivan C, Dick T, Roberson C, Harris LM, Patrician PA. Comparison of Alabama Nurse Experiences Between Practice Areas During the Early COVID-19 Pandemic. Workplace Health Saf 2024; 72:337-344. [PMID: 38660753 DOI: 10.1177/21650799241247077] [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 According to the Total Worker Health® framework, safety culture including a reasonable workload among healthcare workers is essential to the security and well-being of patients, staff, and healthcare organizations. Evaluating the impact of the pandemic on the nursing workforce in different practice areas is critical for addressing workforce health and sustainability. The purpose of this study was to compare work and selfcare experiences among Alabama nurses between practice areas and the early pandemic years (2020 vs. 2021). METHODS A secondary analysis of cross-sectional Alabama State Nurses Association (ASNA) survey data was conducted. Kruskal-Wallis analysis of variance, Wilcoxon rank, and false discovery rates were examined. RESULTS There were 1,369 and 2,458 nurse survey responses in 2020 and 2021, respectively. By 2021, nurses reported worsening staff shortages, a greater need for retired and new graduate nurses to help with the workload burden, and perceptions of heavier emergency department workloads. Lower proportions of nurses reported the ability to engage in self-care activities and satisfaction with state and federal crisis management. Intensive care nurses were more likely to report staffing shortages while also reporting the lowest ability to engage in self-care. CONCLUSIONS Overall, the Alabama nursing workforce perceived worsening work conditions in 2021 compared to when the pandemic began. Practice areas varied greatly in their responses, with acute and intensive care areas perceiving more difficult work conditions. Total Worker Health® programs should be designed to promote and support nurses' well-being based on their experience and the needs of specific practice areas.
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Affiliation(s)
- Aoyjai P Montgomery
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | | | - Tracey Dick
- School of Nursing, University of Alabama at Birmingham
- Birmingham VA Health Care System
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Park JS, Kim HK, Lee M. Experience of violence, social support, nursing practice environment, and burnout on mental health among mental health nurses in South Korea: A structural equation modeling analysis. Appl Nurs Res 2024; 78:151819. [PMID: 39053992 DOI: 10.1016/j.apnr.2024.151819] [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: 08/16/2022] [Revised: 08/16/2023] [Accepted: 06/25/2024] [Indexed: 07/27/2024]
Abstract
AIMS This study examined the relationship between the experience of violence, social support, nursing practice environment, and mental health among South Korean mental health nurses. METHODS Structured questionnaires were distributed to participants who worked in twelve mental health hospitals, each with at least 200 beds, in South Korea. We analyzed 243 questionnaires and used AMOS 25.0 to explore the relationships between the constructs. RESULTS The total and indirect effects of the experience of violence and of social support on mental health were significant. The effects of burnout and of the nursing practice environment on mental health were positively significant. Burnout revealed a mediating association with the relationship between the experience of violence, social support, and mental health. CONCLUSION The study confirmed that the experience of violence negatively affects burnout among mental health nurses, while social support relieves burnout and strengthens mental health. IMPLEMENTATION Our research model shows that the experience of violence could affect burnout and mental health among mental health nurses. Therefore, nursing administrators should develop violence prevention policies and manuals for coping with the violence that can frequently occur in psychiatric wards.
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Affiliation(s)
- Jung Suk Park
- Keyo Mental Health Hospital, 15, Ojeon-ro, Uiwang-si, Gyeonggi-do 16062, South Korea
| | - Hee Kyung Kim
- Department of Nursing, Sangji University, 83 Sangjidae-gil, Wonju-si, Gangwon-do 26339, South Korea.
| | - Mihyoung Lee
- Inha University, 100, Inha-ro, Michuhol-gu, Incheon 22212, South Korea
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Brickner S, Fick K, Panice J, Bulthuis K, Mitchell R, Lancaster R. Professional values and nursing care quality: A descriptive study. Nurs Ethics 2024; 31:699-713. [PMID: 37739396 DOI: 10.1177/09697330231200567] [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: 09/24/2023]
Abstract
BACKGROUND Professional values are important in promoting healthy work environments, patient satisfaction, and quality of care. Magnet® hospitals are recognized for excellence in nursing care and as such, understanding the relationship between nurses' values and Magnet status is essential as healthcare organizations seek to improve patient outcomes. RESEARCH QUESTION/AIM/OBJECTIVES The research question is: are there differences in individual values, professional values, and nursing care quality for nurses and nurse managers practicing in Magnet, Magnet journey, and non-Magnet direct patient care settings? RESEARCH DESIGN This descriptive cross-sectional study is guided and informed by the conceptual framework of the Professional Values Model including individual values, professional values, and nursing care quality. PARTICIPANTS AND RESEARCH CONTEXT Convenience sampling of registered nurses and nurse managers, responsible for direct patient care, was utilized in a non-profit healthcare system in the Midwest region of the United States. ETHICAL CONSIDERATIONS Institutional review board approval was obtained. Participants were informed about the right to self-determine participation and assurance of anonymity. FINDINGS 827 (n = 827) nurses and nurse managers responded to the survey. Significant differences were identified in individual values sub-scale: self-enhancement (p = 0.38), professional values (p = 0.037), practice environment: participation in hospital affairs (p = 0.00), foundations for quality care (p = 0.016), and resources adequacy (p = 0.012) and in nurse sensitive HCAHPS questions: nurses explained things understandably (p = 0.00), got help as soon as wanted (p = 0.00), and treated with courtesy and respect (p = 0.00). DISCUSSION/CONCLUSIONS Findings indicate that fostering individual and professional values may impact nursing practice, regardless of Magnet designation. Promoting professional values may contribute to improved work environments, enhancing patient satisfaction. Study results offer valuable insights for organizations striving to enhance nursing values, impacting quality of care provided to patients. MESH TERMS Cross-Sectional Studies, Respect, Ethics Committees, Patient Satisfaction, Nurse Administrators, and Personal Satisfaction.
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Hur Y, Hickman RL. Psychometric Evaluation of the Decision Fatigue Scale among Korean Registered Nurses. Healthcare (Basel) 2024; 12:1524. [PMID: 39120227 PMCID: PMC11312083 DOI: 10.3390/healthcare12151524] [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: 04/28/2024] [Revised: 07/22/2024] [Accepted: 07/25/2024] [Indexed: 08/10/2024] Open
Abstract
Nurses make decision for patients and the quality of nurses' decision making can affect patient outcomes. For some reason, nurses are experiencing impaired decision making and it can negatively impact patient care. A valid and reliable instrument to assess decision fatigue may let people know about the concept and guide the development of new policies or interventions for Korean nurses' decision fatigue. This study aimed to evaluate the psychometric properties of the Korean version of the decision fatigue scale. The design was a cross-sectional descriptive study and convenience sampling was used to recruit participants. A total of 247 nurses from across South Korea participated in an online survey. The survey consisted of demographic questionnaires, decision fatigue scale, nursing practice environment scale, and compassion fatigue scale. It was validated through confirmatory factor analysis that the Korean version of the decision fatigue scale was a single factor with the same structure as the original scale. The Korean version of the decision fatigue scale showed significant correlations with compassion fatigue, and the scale showed appropriate internal consistency. This study established well enough the psychometric characteristics of the Korean version of decision fatigue.
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Affiliation(s)
- Yujin Hur
- College of Nursing, Dongguk University WISE, Gyeongju 38066, Republic of Korea
| | - Ronald L. Hickman
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA
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Ribeiro OMPL, de Lima Trindade L, da Rocha CG, Teles PJFC, Mendes M, Ribeiro MP, de Abreu Pereira SC, da Conceição Alves Faria A, da Silva JMAV, de Sousa CN. Scale for the environments evaluation of professional nursing practice-shortened version: Psychometric evaluation. Int J Nurs Pract 2024:e13291. [PMID: 39051426 DOI: 10.1111/ijn.13291] [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: 08/04/2023] [Revised: 12/07/2023] [Accepted: 07/10/2024] [Indexed: 07/27/2024]
Abstract
AIM The aim of this study is to test the validity and reliability of the shortened version of the Scale for the Environments Evaluation of Professional Nursing Practice (SEE-Nursing Practice). METHODS This methodological, cross-sectional study was conducted between September and December 2022. The original version of the SEE-Nursing Practice was administered in questionnaire format across 17 hospitals. Exploratory and confirmatory factor analyses were conducted to identify relevant items for the new shortened version of the scale and evaluate its construct validity. RESULTS The study involved 1713 registered nurses from various regions of Portugal. From the exploratory factor analysis, the SEE-Nursing Practice was condensed to 59 items and 3 subscales. In the structure subscale, 14 items were removed, and the remaining 29 items distributed over four factors; in the process subscale, 18 items were removed, and the remaining 19 items organized into three factors; in the outcome subscale, 2 items were removed, and the remaining 11 items distributed over two factors. The Cronbach's alpha for the three subscales exceeded 0.90, indicating high reliability. Confirmatory factor analyses provided support for the validity of the 59-item model. CONCLUSION The shortened version of the SEE-Nursing Practice shows adequate validity and reliability, reducing the burden associated with its longer version.
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Affiliation(s)
| | | | | | | | - Mariana Mendes
- CNPQ Scholarship, Federal University of Santa Catarina, Santa Catarina, Brazil
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Hwang E, Kim M, Lee Y. Factors Affecting the Field Adaptation of Early-Stage Nurses in South Korea. Healthcare (Basel) 2024; 12:1447. [PMID: 39057590 PMCID: PMC11276736 DOI: 10.3390/healthcare12141447] [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: 06/13/2024] [Revised: 07/04/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
Supporting early-stage nurses to adapt to the field and become proficient in nursing is important to improve the quality of patient care. This study aimed to determine the effects of the nursing work environment, nursing practice readiness, and optimism on the field adaptation of early-stage nurses. A descriptive survey was conducted among 209 early-stage nurses with ≤3 years of work experience at hospitals. The collected data were analyzed using descriptive statistics, the t-test, ANOVA, Pearson's correlation coefficients, and regression analysis with the SPSS Program. The participating nurses' mean field adaptation score was 2.90 ± 0.40 (total score = 5) and a significant positive correlation was found between nursing work environment (r = 0.61, p < 0.001), nursing practice readiness (r = 0.41, p < 0.001), and optimism (r = 0.26, p < 0.001). The regression analysis revealed that the nursing work environment (β = 0.38, p < 0.001), job satisfaction (β = 0.33, p < 0.001), nursing practice readiness (β = 0.24, p < 0.001), and turnover intention (β = 0.17, p = 0.001) significantly affect the field adaptation of early stage nurses; the explanatory power was 56.1% (F = 27.55, p < 0.001). The results suggest that to facilitate the field adaptation of early-stage nurses, the nursing work environment, job satisfaction, and nursing practice readiness should be improved. Improvement in the nursing work environment and the development of additional training for field adaptation would enhance the ability of early-stage nurses to adapt to the field and, consequently, improve the quality of nursing care.
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Affiliation(s)
| | | | - Yunkyeong Lee
- Department of Nursing, Wonkwang University, Iksan 54538, Republic of Korea; (E.H.); (M.K.)
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Salas-Bergüés V, Pereira-Sánchez M, Martín-Martín J, Olano-Lizarraga M. Development of burnout and moral distress in intensive care nurses: An integrative literature review. ENFERMERIA INTENSIVA 2024:S2529-9840(24)00027-2. [PMID: 39025685 DOI: 10.1016/j.enfie.2024.02.002] [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: 10/03/2023] [Accepted: 02/24/2024] [Indexed: 07/20/2024]
Abstract
AIMS To describe, through an integrative literature review, the factors contributing to the development of burnout and moral distress in nursing professionals working in intensive care units and to identify the assessment tools used most frequently to assess burnout and moral distress. METHODS An integrative literature review was carried out. PubMed, CINAHL, PsycINFO, SciELO, Dialnet, Web of Science, Scopus, and Cochrane databases were reviewed from January 2012 to February 2023. Additionally, snowball sampling was used. The results were analysed by using integrative synthesis, as proposed by Whittemore et al., the Critical Appraisal Skills Programme for literature reviews, the Strengthening the Reporting of Observational Studies in Epidemiology guidelines for quantitative observational studies, and the Joanna Briggs Institute checklist for qualitative research were used to evaluate evidence quality. RESULTS Forty-one articles were selected for review: 36 were cross-sectional descriptive articles, and five were literature reviews. The articles were grouped into five-factor categories: 1) personal factors, 2) organisational factors, 3) labour relations factors, 4) end-of-life care factors, and 5) factors related to coronavirus disease 2019 (COVID-19). The Maslach Burnout Inventory-Human Services Survey and the Moral Distress Survey-Revised instruments were the most commonly used to measure burnout and moral distress. CONCLUSIONS This review highlights the multiple personal, organisational, relational, situational, and end-of-life factors promoting burnout and moral distress among critical care nurses. Interventions in these areas are necessary to achieve nurses' job satisfaction and retention while improving nurses' quality of care.
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Affiliation(s)
- V Salas-Bergüés
- Clínica Universidad de Navarra, Intensive Care Unit, Pamplona, Spain
| | - M Pereira-Sánchez
- Universidad de Navarra, School of Nursing, Department of Nursing Care for Adult Patients, Pamplona, Spain; Universidad de Navarra, ICCP-UNAV (Innovation for a Person-Centred Care Research Group), Pamplona, Spain
| | - J Martín-Martín
- Universidad de Navarra, School of Nursing, Department of Nursing Care for Adult Patients, Pamplona, Spain.
| | - M Olano-Lizarraga
- Universidad de Navarra, School of Nursing, Department of Nursing Care for Adult Patients, Pamplona, Spain; Universidad de Navarra, ICCP-UNAV (Innovation for a Person-Centred Care Research Group), Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
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Wang X, Liu M, Xu T, Wang K, Huang L, Zhang X. New nurses' practice environment, job stress, and patient safety attitudes: a cross-sectional study based on the job demands-resources model. BMC Nurs 2024; 23:473. [PMID: 38997677 PMCID: PMC11241995 DOI: 10.1186/s12912-024-02135-0] [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: 11/13/2023] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Patient safety is paramount for all healthcare agencies. Health professionals' lack of patient safety competencies threaten patients' lives, and increase patients, families, hospitals, and social burdens. The new nurse-related patient safety issues have particularly attracted much attention. The aim of this study was to examine the impacts of practice environment and job stress on new nurses' patient safety attitudes by employing the job demands-resources model. METHODS The study used a cross-sectional structural equation modeling (SEM). A convenience sample of 370 new nurses was recruited from seven tertiary hospitals in Anhui province, China, from April 2022 to August 2022. Data were collected using self-report questionnaires including the Chinese version of the Nurse Job Stressors Scale, the Practice Environment Scale, and the Safety Attitudes Questionnaire. RESULTS New nurses' patient safety attitudes scores were moderate (126.99 ± 14.39). Practice environment had a significant direct effect on job stress (β = -0.337, t = 6.120), patient safety attitudes (β = 0.604, t = 13.766), practice environment had an indirect effect on patient safety attitudes through job stress (β = 0.066, t = 3.690), and the indirect effect accounted for 9.9% of the total effect. This model was able to explain 48.3% of patient safety attitudes with moderate prediction accuracy. CONCLUSIONS This study emphasizes the importance of improving new nurses' attitudes toward patient safety. Hospital administrators should develop policies and strategies to address job characteristics, and establish a favorable work environment to reduce new nurses' job stress as well as to improve patient safety.
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Affiliation(s)
- Xin Wang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Ming Liu
- Peking University Health Science Center - Macao Polytechnic University Nursing Academy, Macao Polytechnic University, Macao, China
| | - Tao Xu
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Kangyue Wang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Liebin Huang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Xiancui Zhang
- Health Management Center, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China.
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Brooks Carthon JM, Brom H, Maye A, Iroegbu C, Gil J, Rizzo J, Amenyedor K, Montalvo W, Villarruel AM. Burnout and psychological distress among Hispanic nurses across Illinois and New York hospitals: Implications for structural and person-centered solutions. Nurs Outlook 2024; 72:102234. [PMID: 38991236 DOI: 10.1016/j.outlook.2024.102234] [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: 03/06/2024] [Revised: 06/17/2024] [Accepted: 06/22/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Despite high levels of burnout and psychological distress among nurses, few studies have evaluated these outcomes among Hispanic nurses. PURPOSE To evaluate the differences in job-related and psychological well-being outcomes for Hispanic and non-Hispanic White nurses and the association of nurse work environments. METHODS Cross-sectional analysis of the 2021 RN4CAST-New York-Illinois nurse survey. Multilevel logistic regression models examined the association between nurse ethnicity and job-related outcomes and psychological well-being. DISCUSSION Our sample included 798 (10.7%) Hispanic and 6,642 (89.3%) non-Hispanic White nurses in 249 hospitals. In unadjusted models, Hispanic ethnicity was associated with higher odds of burnout (odds ratio (OR) 1.21, 95% confidence interval (CI): 1.03-1.42), which diminished when considering the work environment (OR 1.16, 95% CI: 1.01-1.35) and nurse characteristics (i.e., age) (OR 1.01, 95% CI: 0.83-1.21). CONCLUSION Equity-driven solutions to support the well-being of Hispanic nurses should consider a focus on the needs of young Hispanic nurses and include increased support in work environments.
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Affiliation(s)
- J Margo Brooks Carthon
- University of Pennsylvania School of Nursing, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.
| | - Heather Brom
- University of Pennsylvania School of Nursing, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Alexandra Maye
- University of Pennsylvania School of Nursing, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Christin Iroegbu
- University of Pennsylvania School of Nursing, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Jennifer Gil
- University of Pennsylvania School of Nursing, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - John Rizzo
- University of Pennsylvania School of Nursing, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | | | - Wanda Montalvo
- National Association of Community Health Centers, Bethesda, MD
| | - Antonia M Villarruel
- University of Pennsylvania School of Nursing, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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36
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Mphaphuli LME, Coetzee SK, Tau B, Ellis SM. Nursing categories' perceptions of the practice environment and quality of care in North West Province: a cross-sectional survey design. BMC Nurs 2024; 23:390. [PMID: 38844993 PMCID: PMC11155092 DOI: 10.1186/s12912-024-01998-7] [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: 05/31/2023] [Accepted: 05/07/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND There is a substantial amount of literature on the perception of the practice environment and quality of care as perceived by registered nurses and community services nurses in South Africa and worldwide, but there is little to no research that could be found regarding other categories of nurses, and how these perceptions differ between the different categories. Therefore, the aim of this study is to describe the different nursing categories' perceptions of the practice environment and quality of care and the association between the variables. METHODS This study applied a cross-sectional survey design. Data were collected in April 2021 in the public sector of the North West Province. Multiphase sampling was applied to all categories of nurses who worked in an in-patient unit in the selected hospital for at least 3 months (n = 236). RESULTS All nursing categories perceived the practice environment as negative, regarding nurse participation in hospital affairs; nurse manager ability, leadership, and support of nurses and staffing and resource adequacy. Perceived quality of care and patient safety items were perceived as neutral and good. However, in all instances, the perceptions of community service nurses and registered nurses were most negative, and enrolled nurse assistants most positive. Adverse events towards patients and nurses were perceived to only occur a few times a year. Overall, nurse perceptions of quality of care and patient safety were most correlated with the subscale of nurse foundations of quality of care and nurse manager ability, leadership, and support of nurses. Adverse events towards patients were most correlated with the collegial nurse-physician relationship subscale, while adverse events towards nurses were correlated with the foundations of quality of care subscale. CONCLUSION Improving the practice environment, especially regarding the subscale nurse foundations of quality of care and nurse manager ability, leadership, and support of nurses, is associated with improved quality of care. Nurses with higher qualifications, registered nurses and community service nurses rated quality of care lower than other categories of nurses, contributing to literature that higher qualified staff are more competent to assess the practice environment and quality of care.
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Affiliation(s)
- Lufuno M E Mphaphuli
- NuMIQ Research Focus Area, School of Nursing Science, North-West University, Private Bag X6001, Potchefstroom, South Africa
| | - Siedine K Coetzee
- NuMIQ Research Focus Area, School of Nursing Science, North-West University, Private Bag X6001, Potchefstroom, South Africa.
| | - Babalwa Tau
- NuMIQ Research Focus Area, School of Nursing Science, North-West University, Private Bag X6001, Potchefstroom, South Africa
| | - Suria M Ellis
- Unit for Business, Mathematics and Informatics, North-West University, Potchefstroom, South Africa
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Xie X, Tan J, He J, Du J, He C, Li Z, Liu Y, Chen Y. The moderating role of work environment in the relationship between proactive personality and personal growth initiative among nurses: a cross-sectional study. BMC Nurs 2024; 23:364. [PMID: 38822273 PMCID: PMC11140861 DOI: 10.1186/s12912-024-02040-6] [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: 03/26/2023] [Accepted: 05/24/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUNDS Personal growth initiative (PGI) is regarded as a meaningful concept with potential value at both the individual and organizational levels, but little is known about the factors that contribute to nurses' PGI. This study aimed to explore how proactive personality and hospital work environment affect PGI of clinical nurses. METHODS A cross-sectional study was conducted between September and October 2022 among 4414 nurses from 10 tertiary general hospitals in 10 cities in Sichuan, China, using a two-stage sampling method. Self-reported anonymous online questionnaires, such as sociodemographic information survey, personal growth initiative scale II, the 10-item proactive personality scale, and practice environment scale-nursing work index were used to collect data. Multiple hierarchical regression analyses were performed to examine research hypotheses. RESULTS Among the control variables in this study, nurses' self-perceptions of general health status and professional title positively predicted PGI (β = 0.462, 95%CI = 0.272-0.653; β = 1.078, 95%CI = 0.508-1.648). After adding control variables, both proactive personality (β = 1.143, 95%CI = 1.096-1.190) and work environment (β = 3.391, 95%CI = 2.904-3.879) positively predicted PGI. The work environment positively moderated the association between proactive personality and PGI (β = 0.108, 95%CI = 0.025-0.191). These predictors jointly explained 50.3% of the variance in PGI. CONCLUSIONS Nurses with a greater tendency to have a typical proactive personality have higher levels of personal growth initiative, and this positive effect will be better highlighted in a healthier work environment. Nursing managers should prioritize the employment of people with proactive personality traits, focus on the development and stimulation of proactive personality traits in nurses, and establish a supportive work environment to maximize the personal growth initiative of nurses.
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Affiliation(s)
- Xia Xie
- Department of Nursing, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
- School of Nursing, North Sichuan Medical College, Nanchong, China.
| | - Jie Tan
- Department of Hepatic-biliary-pancreatic Surgery, Deyang People's Hospital, Deyang, China
| | - Jie He
- Department of Nursing, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jiao Du
- Department of Nursing, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Chuan He
- Emergency Department, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Zihao Li
- Department of Nursing, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Youchi Liu
- Department of Nursing, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yuqin Chen
- Department of Nursing, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Griffiths N, Laing S, Spence K, Foureur M, Popat H, Hickey L, Sinclair L. Developmental care education in Australian surgical neonatal intensive care units: A cross-sectional study of nurses' perceptions. Heliyon 2024; 10:e30572. [PMID: 38799751 PMCID: PMC11126797 DOI: 10.1016/j.heliyon.2024.e30572] [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: 11/06/2023] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Background Nurse perceptions of developmental care practices have been researched globally for almost 30 years. Yet, there is a lack of research exploring this subject in the specialised setting of the surgical neonatal intensive care unit (sNICU). This research explores the effect of developmental care education programs on sNICU nurses' perceptions of developmental care. Objective To determine perceptions and attitudes towards developmental care in a specialty neonatal setting. Design Cross-sectional study. Settings Two surgical neonatal intensive care units in Australia. Participants Registered nurses permanently employed at the study sites between May 2021 to April 2022. Methods A modified electronic survey explored sNICU nurse perceptions of developmental care organised around three themes: effects of developmental care on parents and infants, application of developmental care, and unit practices. Associations between site, nurse characteristics, developmental care education and nurses' perceptions were explored using logistic regression [odds ratios (OR) and 95 % confidence intervals (CI)]. Results Of 295 sNICU nurses, 117 (40 %) participated in the survey. Seventy-five percent of respondents had attended a formal developmental care education program. High levels of agreement (>90 %) were reported regarding the benefits of developmental care for parents and infants. Exposure to developmental care education influenced perceptions of its application. Nurses without formal developmental care education were more likely to agree that it was consistently applied [OR:3.3, 95%CI:1.3-8.6], developmental care skills are valued [OR:2.7, 95%CI:1.1-6.8], and that their nursing peers offered support in its application ([OR:2.5, 95%CI:1.1-6.2]. Conclusions The results from our research suggest sNICU nurses have a high level of awareness of developmental care and its positive impacts. Despite differences between the surveyed units' developmental care education programs, the value of developmental care in reducing stress for infants and supporting families was collectively recognised. Future research in this setting should focus on evaluating the application of developmental care in this setting.
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Affiliation(s)
- Nadine Griffiths
- Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, 2145, NSW Australia, Australia
- University of Technology Sydney, Centre of Midwifery, Child and Family Health, 15 Broadway, Ultimo, NSW, 2007, Australia
| | - Sharon Laing
- Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, 2145, NSW Australia, Australia
| | - Kaye Spence
- Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, 2145, NSW Australia, Australia
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
| | - Maralyn Foureur
- Faculty of Health and Medicine, University of Newcastle, Callaghan Campus, 2308, NSW, Australia
| | - Himanshu Popat
- Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, 2145, NSW Australia, Australia
- The University of Sydney, Jane Foss Russell Building Camperdown 2006, NSW Australia, Australia
| | - Leah Hickey
- The Royal Children's Hospital, 50 Flemington Rd, Parkville, 3052, Victoria Australia, Australia
- University of Melbourne, Grattan Street, Parkville Victoria, 3010, Australia
| | - Lynn Sinclair
- University of Technology Sydney, Centre of Midwifery, Child and Family Health, 15 Broadway, Ultimo, NSW, 2007, Australia
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Zhong J, Zhang W, Xu R, Wang H, Zhao J, Huang Y, Chen Y, Chen X, Chen J, Zhang Q, Zou Z, Zhang Y. Development, validation and reliability testing of the hospice care environment scale. BMC Palliat Care 2024; 23:135. [PMID: 38802846 PMCID: PMC11131208 DOI: 10.1186/s12904-024-01450-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 05/03/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND WHO stated the environment is an important factor affecting the development of hospice care. The environment is the sum of factors affecting behavior besides the individual factors. Currently, a scale to comprehensively assess the hospice environment of nurse is still lacking. This study aimed to develop an instrument to investigate the environmental factors affecting hospice care of nurses. METHODS Literature review and a semi-structured interview were conducted to form the items pool of the Hospice Care Environment Scale. Two rounds of Delphi expert consultation were conducted by 16 experts to revise the scale dimensions and entries to form the Hospice Care Environment Scale. A psychometric evaluation was then performed among 530 oncology nurses in a large tertiary oncology hospital in Hubei Province. The 500 valid questionnaires were randomly divided into two groups in a 1:1 ratio, sample 1 (n1 = 250) for item screening and sample 2 (n2 = 250) for quality evaluation of the resulting scale. Item analysis, reliability analysis, validity analysis and acceptability analysis were performed. RESULT The Hospice Care Environment Scale consists of two dimensions and 13 entries. The Cronbach's α coefficient of the Hospice Care Environment Scale was 0.970, and the Cronbach's α coefficient of the two dimensions were 0.952 and 0.969, respectively, with the Item-content validity index and average Scale- content validity index of the scale was both 1.000. The validation factor analysis showed the standardized path coefficients of each item were basically above 0.5, and the factor structure model was stable and suitable. The average completion time of the scale was about 3 min, which had good feasibility. CONCLUSION The Hospice Care Environment Scale to assess the environment of hospice care services, has good content and construct validity and reliability. This scale can provide guidance to evaluate the hospice care environment.
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Affiliation(s)
- Junping Zhong
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
- Minxi Vocational & Technical College, Located on No.8 Caoxi Road, Longyan, Fujian province, 364021, China
| | - Wei Zhang
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
| | - Rong Xu
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
- Department of Obstetrics, Guoyang County People's Hospital, No. 112, Shengli Road, Chengguan Town, Bozhou, Anhui Province, 233600, China
| | - Huifen Wang
- Department of Nursing, Hubei Cancer Hospital, Located on No. 116 Zhuodaoquan South Road, Hongshan District, Wuhan, Hubei province, 430079, China
| | - Jing Zhao
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
| | - Yingjuan Huang
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
| | - Yanlin Chen
- Sir Run Run Shaw Hospital, Affiliated hospital of medical school of Zhejiang University, Hangzhou, Zhejiang province, China
| | - Xiaoli Chen
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
| | - Jianfei Chen
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China.
- School of Medicine, Nankai University, Located on No. 94 Weijin Road, Tianjin, 300071, China.
| | - Qing Zhang
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China.
| | - Zhijie Zou
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China.
| | - Yingzi Zhang
- Magnet Program & Research Department, UT Southwestern Medical Center, 8200 Brookriver Dr., North Tower, 5th floor, Dallas, TX, 75247, USA
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VanFosson CA. A Conceptual Model of Individual Clinical Readiness. Mil Med 2024:usae215. [PMID: 38771701 DOI: 10.1093/milmed/usae215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/17/2024] [Accepted: 04/11/2024] [Indexed: 05/23/2024] Open
Abstract
INTRODUCTION Force readiness is a priority among senior leaders across all branches of the Department of Defense. Units that do not achieve readiness benchmarks are considered non-deployable until the unit achieves the requisite benchmarks. Because military units are made up of individuals, the unit cannot be ready if the individuals within the unit are not ready. For medical personnel, this refers to one's ability to competently provide patient care in a deployed setting or their individual clinical readiness (ICR). A review of the literature found no conceptual model of ICR. Other potential concepts, such as individual medical readiness, were identified but used inconsistently. Therefore, the purpose of this article is to define ICR and propose a conceptual model to inform future efforts to achieve ICR and facilitate future study of the concept. MATERIALS AND METHODS Model development occurred using a 3-step theoretical model synthesis process. The process included specification of key concepts, identification of related factors and relationships, and organizing them into an integrated network of ideas. RESULTS ICR is the clinically oriented service members' (COSM) ability to meet the demands of the militarily relevant, assigned clinical mission. ICR leads to one's "individual clinical performance," a key concept distinct from ICR. To understand ICR, one must account for "individual characteristics," as well as one's "education," "training," and "exposure." ICR and individual clinical performance are influenced by the "quality of exposure" and the "patient care environment." One's "individual clinical performance" also reciprocally influences the patient care environment, as well as the "team's clinical performance." These factors (individual clinical performance, team clinical performance, and the patient care environment) influence "patient outcomes." In the proposed model, patient outcomes are an indirect result of ICR and its antecedents (personal characteristics, education, training, and exposure); one's individual clinical performance may not be consistent with their ICR. Patient outcomes are also influenced by the "patient environment" (external to the health care environment) and "patient characteristics"; these elements of the model do not influence ICR or individual clinical performance. CONCLUSION Force readiness is a Department of Defense priority. In order for military units to be deployment ready, so too must their personnel be deployment ready. For COSMs, this includes one's ability to competently provide patient care in a deployed setting or their ICR. This article defines ICR, as well as identifies another key concept and other factors associated with ICR. The proposed model is a tool for military medical leaders to communicate with and influence non-medical military leaders in the Department of Defense. Future research is needed to further refine the proposed model, determine the strength of the proposed relationships, and identify interventions to improve ICR.
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Lee Y, Hwang WJ. The impact of nurse's sense of calling, organizational commitment, job stress, and nursing work environment on patient safety management activities in comprehensive nursing care service units during the covid-19 pandemic. BMC Nurs 2024; 23:311. [PMID: 38714995 PMCID: PMC11077888 DOI: 10.1186/s12912-024-01929-6] [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: 09/30/2023] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND As the number of COVID-19 patients rises, there has been a notable increase in the workload for nurses. However, medium-sized hospitals lacked standardized protocols or consistent approaches to address the specific working conditions of nurses. Furthermore, concerns about patient care have heightened as the issue of nursing shortages coincides with the expansion of the comprehensive nursing care services project. PURPOSE This study aimed to investigate the factors that influence patient safety management activities, such as calling, organizational commitment, job stress, and nursing work environment, among comprehensive nursing care service unit nurses during the COVID-19 pandemic. METHODS A conceptual framework based on the Job Demand-Resource model and literature review of patient safety management activities was used to develop structured questionnaires that were distributed to 206 participants working in 7 comprehensive nursing care service units of small and medium-sized hospitals with at least 300 beds in the S and K provinces. Data analysis was conducted using descriptive statistics, chi-squared tests, t-tests, ANOVA, and hierarchical regression with the SPSS/WIN 23.0 program. RESULTS The results showed that calling (β =.383, p<.001) and job stress (β= -.187, p=.029) significantly influenced patient safety nursing activities in comprehensive care service ward nurses. The explanatory power of the model was 26.0% (F= 6.098, p<.001). CONCLUSIONS Our findings suggest that comprehensive care service ward nurses' career, income, COVID-19 patient nursing anxiety, calling, and job stress were important factors that influence patient safety nursing activities. Therefore, it was essential to develop calling education programs and improve the nursing work system and establish a fair compensation system during the pandemic situation.
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Affiliation(s)
- YeJi Lee
- College of Nursing Science, Kyung Hee University, Seoul, South Korea
| | - Won Ju Hwang
- College of Nursing Science, Kyung Hee University, Seoul, South Korea.
- College of Nursing Science, Kyung Hee University, East-west Nursing Research Institute, Seoul, South Korea.
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Catania G, Zanini M, Cremona MA, Landa P, Musio ME, Watson R, Aleo G, Aiken LH, Sasso L, Bagnasco A. Nurses' intention to leave, nurse workload and in-hospital patient mortality in Italy: A descriptive and regression study. Health Policy 2024; 143:105032. [PMID: 38460274 DOI: 10.1016/j.healthpol.2024.105032] [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: 06/16/2023] [Revised: 02/19/2024] [Accepted: 02/26/2024] [Indexed: 03/11/2024]
Abstract
Higher nurse-to-patient ratios are associated with poor patient care and adverse nurse outcomes, including emotional exhaustion and intention to leave. We examined the effect of nurses' intention to leave and nurse-patient workload on in-hospital patient mortality in Italy. A multicentered descriptive and regression study using clinical data of patients aged 50 years or older with a hospital stay of at least two days admitted to surgical wards linked with nurse variables including workload and education levels, work environment, job satisfaction, intention to leave, nurses' perception of quality and safety of care, and emotional exhaustion. The final dataset included 15 hospitals, 1046 nurses, and 37,494 patients. A 10 % increase in intention to leave and an increase of one unit in nurse-patient workload increased likelihood of inpatient hospital mortality by 14 % (odds ratio 1.14; 1.02-1.27 95 % CI) and 3.4 % (odds ratio 1.03; 1.00-1.06 95 % CI), respectively. No other studies have reported a significant association between intention to leave and patient mortality. To improve patient outcomes, the healthcare system in Italy needs to implement policies on safe human resources policy stewardship, leadership, and governance to ensure nurse wellbeing, higher levels of safety, and quality nursing care.
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Affiliation(s)
- Gianluca Catania
- Department of Health Sciences, University of Genoa, Via A. Pastore 1 16132, Genoa, Italy
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Via A. Pastore 1 16132, Genoa, Italy.
| | - Marzia A Cremona
- Department of Operations and Decision Systems, Université Laval Research Center, CHU de Québec Quebec G1V 4G2, Canada
| | - Paolo Landa
- Department of Operations and Decision Systems, Université Laval Research Center, CHU de Québec Quebec G1V 4G2, Canada
| | - Maria Emma Musio
- Department of Health Sciences, University of Genoa, Via A. Pastore 1 16132, Genoa, Italy
| | - Roger Watson
- Academic Dean, Southwest Medical University, Luzhou, PR China
| | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Via A. Pastore 1 16132, Genoa, Italy
| | - Linda H Aiken
- Center for Health Outcomes and Policy Research, University of Pennsylvania, 418 Curie Blvd, Philadelphia PA 19104, USA
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Via A. Pastore 1 16132, Genoa, Italy
| | - Annamaria Bagnasco
- Department of Health Sciences, University of Genoa, Via A. Pastore 1 16132, Genoa, Italy
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Joseph ML, Williams M, Reinke K, Bair H, Chae S, Hanrahan K, St Marie B, Jenkins P, Albert NM, Gullatte MM, Rogers DM, Swan BA, Holden T, Woods E, DeGuzman PB, DeGennaro G, Marshall D, Hein M, Perkhounkova Y, Huber DL. Development and Testing of the Relational and Structural Components of Innovativeness Across Academia and Practice for Healthcare Progress Scale. J Nurs Adm 2024; 54:260-269. [PMID: 38630941 DOI: 10.1097/nna.0000000000001422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
OBJECTIVE Using data from 5 academic-practice sites across the United States, researchers developed and validated a scale to measure conditions that enable healthcare innovations. BACKGROUND Academic-practice partnerships are a catalyst for innovation and healthcare development. However, limited theoretically grounded evidence exists to provide strategic direction for healthcare innovation across practice and academia. METHODS Phase 1 of the analytical strategy involved scale development using 16 subject matter experts. Phase 2 involved pilot testing the scale. RESULTS The final Innovativeness Across Academia and Practice for Healthcare Progress Scale (IA-APHPS) consisted of 7 domains: 3 relational domains, 2 structural domains, and 2 impact domains. The confirmatory factor analysis model fits well with a comparative fit index of 0.92 and a root-mean-square error of approximation of 0.06 (n = 477). CONCLUSION As the 1st validated scale of healthcare innovation, the IA-APHPS allows nurses to use a diagnostic tool to facilitate innovative processes and outputs across academic-practice partnerships.
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Affiliation(s)
- M Lindell Joseph
- Author Affiliations: Clinical Professor and Distinguished Scholar in Nursing, and Director of DNP & MSN Health Systems: Administration/Executive Leadership Programs (Dr Joseph), College of Nursing, The University of Iowa; Henry B. Tippie Faculty Research Fellow in Entrepreneurship and Associate Professor of Management and Entrepreneurship (Dr Williams), Tippie College of Business; PhD Student (Reinke), Management and Entrepreneurship Department, Tippie College of Business; Associate Director and Associate Clinical Professor (Dr Bair); and DNP in Anesthesia Nursing Program and Assistant Professor (Dr Chae), College of Nursing, The University of Iowa; Director, Nursing Research and Evidence-Based Practice (Dr Hanrahan), University of Iowa Hospitals and Clinics; and Associate Professor (Dr St. Marie), College of Nursing, The University of Iowa, Iowa City; Associate Dean for Academic Affairs (Dr Jenkins), University of Arizona, Tucson; Associate Chief Nursing Officer (Dr Albert), Research and Innovation, Zielony Nursing Institute; Clinical Nurse Specialist (Dr Albert), George M. and Linda H. Kaufman Center for Heart Failure Treatment and Recovery; and Heart, Vascular & Thoracic Institute and Consultive Staff (Dr Albert), Lerner Research Institute, Cleveland Clinic, Ohio; Corporate Director (Dr Gullatte), Nursing Research and Evidence Based Practice, Emory Healthcare; Adjunct Faculty (Dr Gullatte), Nell Hodgson Woodruff School of Nursing, Emory University; Nurse Scientist (Dr Rogers), DeKalb Operating Unit (DOU), Emory Healthcare; Senior Instructor (Dr Rogers), Nell Hodgson Woodruff School of Nursing, Emory University; and Clinical Track Associate Professor, Dean and Vice President for Academic Practice Partnerships, Executive Director for the Emory Nursing Learning Center and Nell Hodgson Woodruff School of Nursing, and Co-director of the Woodruff Health Sciences Center Interprofessional Education and Clinical Practice Office (Dr Swan), Emory University, Atlanta; Lead Advanced Practice Provider (Dr Holden), Emory Johns Creek Hospital, Johns Creek; and Magnet® Program Director for Emory Orthopedics and Spine Hospital, and Assistant Clinical Professor (Dr Woods), Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia; Nurse Scientist (Dr DeGuzman), University of Virginia Health, Charlottesville; Professor, Academic Director of Clinical Partnerships, and Assistant Department Chair of Acute and Specialty Care (Dr DeGennaro), University of Virginia School of Nursing, Charlottesville; Senior Vice President, Chief Nursing Executive, and James R. Klinenberg, MD, and Lynn Klinenberg Linkin Chair in Nursing in Honor of Linda Burnes Bolton (Dr Marshall), Cedars-Sinai, Los Angeles, California; and Data Manager (Hein) and Statistician Manager (Dr Perkhounkova), Office for Nursing Research and Scholarship, College of Nursing; and Tenured Full Professor Emeritus (Dr Huber), College of Nursing and College of Public Health, The University of Iowa, Iowa City
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Rosenbaum KEF, Lasater KB, McHugh MD, Lake ET. Hospital Performance on Hospital Consumer Assessment of Healthcare Providers and System Ratings: Associations With Nursing Factors. Med Care 2024; 62:288-295. [PMID: 38579145 PMCID: PMC11141206 DOI: 10.1097/mlr.0000000000001966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
OBJECTIVE To determine which hospital nursing resources (staffing, skill mix, nurse education, and nurse work environment) are most predictive of hospital Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS) performance. BACKGROUND HCAHPS surveying is designed to quantify patient experience, a measure of patient-centered care. Hospitals are financially incentivized through the Centers for Medicare and Medicaid Services to achieve high HCAHPS ratings, but little is known about what modifiable hospital factors are associated with higher HCAHPS ratings. PATIENTS AND METHODS Secondary analysis of multiple linked data sources in 2016 providing information on hospital HCAHPS ratings, hospital nursing resources, and other hospital attributes (eg, size, teaching, and technology status). Five hundred forty non-federal adult acute care hospitals in California, Florida, New Jersey, and Pennsylvania, and 11,786 registered nurses working in those hospitals. Predictor variables included staffing (ie, patient-to-nurse ratio), skill mix (ie, the proportion of registered nurses to all nursing staff), nurse education (ie, percentage of nurses with a bachelor's degree or higher), and nurse work environment (ie, the quality of the environment in which nurses work). HCAHPS ratings were the outcome variable. RESULTS More favorable staffing, higher proportions of bachelor-educated nurses, and better work environments were associated with higher HCAHPS ratings. The work environment had the largest association with higher HCAHPS ratings, followed by nurse education, and then staffing. Superior staffing and work environments were associated with higher odds of a hospital being a "higher HCAHPS performer" compared with peer hospitals. CONCLUSION Improving nursing resources is a strategic organizational intervention likely to improve HCAHPS ratings.
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Affiliation(s)
- Kathleen E. Fitzpatrick Rosenbaum
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- National Clinician Scholars Program, Yale University, New Haven, CT, USA
- Yale School of Public Health, Yale University, New Haven, CT, USA
- Yale New Haven Hospital, New Haven, CT, USA
- Yale School of Nursing, Yale University, New Haven CT, USA
| | - Karen B. Lasater
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Mathew D. McHugh
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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Tan AK, Capezuti E, Samuels WE, Backhaus R, Wagner LM. Intent to stay, moral distress, and nurse practice environment among long-term care nurses: A cross-sectional questionnaire survey study. J Nurs Scholarsh 2024; 56:430-441. [PMID: 38169102 DOI: 10.1111/jnu.12953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/07/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Many long-term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed, at least in part, to moral distress and a negative nurse practice environment. OBJECTIVE The purpose of the study was divided into two parts: first, to investigate the relationships among nurse practice environment, moral distress, and intent to stay; second, to explore the potential mediating effect of the nurse practice environment on the intent to stay among those with high levels of moral distress. DESIGN This study was a descriptive, cross-sectional survey using targeted sampling. PARTICIPANTS A total of 215 participants completed the surveys. Participants were nationally representative of long-term care nurses by age, years of experience, employment status, and type of health setting. METHODS This study was an online national survey of long-term care nurses' perceptions of their intent to stay, moral distress level (Moral Distress Questionnaire), and nurse practice environment (Direct Care Staff Survey). Structural equation modeling analysis explored intent to stay, moral distress, and the nurse practice environment among long-term care nurses. RESULTS The mean moral distress score was low, while the mean nurse practice environment and intent to stay scores were high. Moral distress had a significant, moderately negative association with the nurse practice environment (β = -0.41), while the nurse practice environment had a significant, moderately positive association with intent to stay (β = 0.46). The moral distress had a significant, moderately negative association with intent to stay (β = -0.20). The computed structural equation modeling suggested a partially mediated model (indirect effect = -0.19, p = 0.001). CONCLUSION Since the nurse practice environment partially mediates the relationship between moral distress and intent to stay, interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession. CLINICAL RELEVANCE Our study demonstrated that the nurse practice environment mediates moral distress and intent to stay. Interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.
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Affiliation(s)
- Amil Kusain Tan
- The Graduate Center, City University of New York, New York, New York, USA
- Hunter-Bellevue School of Nursing, Hunter College of CUNY, New York, New York, USA
| | - Elizabeth Capezuti
- The Graduate Center, City University of New York, New York, New York, USA
- Hunter-Bellevue School of Nursing, Hunter College of CUNY, New York, New York, USA
| | - William Ellery Samuels
- The Graduate Center, City University of New York, New York, New York, USA
- Hunter-Bellevue School of Nursing, Hunter College of CUNY, New York, New York, USA
| | - Ramona Backhaus
- Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, Netherlands
| | - Laura M Wagner
- University of California San Francisco, San Francisco, California, USA
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Alhalal E, Alharbi JF, Alharbi ST, Alotaibi SS, Albagami NS, Alruwaili SM, Alshammari SA. Impact of authentic leadership on nurses' well-being and quality of care in the acute care settings. J Nurs Scholarsh 2024. [PMID: 38693598 DOI: 10.1111/jnu.12978] [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: 06/17/2023] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/03/2024]
Abstract
INTRODUCTION Both nurses' well-being and quality of care are top priorities of the healthcare system. Yet, there is still a gap in understanding the extent and how authentic leadership influences them. This information is needed to inform the development of effective interventions, organizational practices, and policies. Thus, this study aimed to test the mechanism by which nurses' perception of their managers' authentic leadership impacts nurses' well-being and perception of quality of care, given the role of the nursing practice environment and nurses' psychological capital. DESIGN A cross-sectional design was used. METHODS This study recruited a random sample of 680 nurses from six hospitals in Saudi Arabia. A final sample of 415 completed the surveys, with a response rate of 61%. Structural equation modeling was performed to test the hypothesized model. RESULTS The study showed that nurses' perceptions of authentic leadership in their managers positively and directly affect their perceptions of quality of care but do not directly affect nurses' well-being. Both the nursing practice environment and psychological capital fully mediated the relationship between authentic leadership and nurses' well-being. However, the nursing practice environment partially mediated the relationship between authentic leadership and perceptions of quality of care. CONCLUSION The findings contribute to understanding the crucial role of authentic leaders' style in nurses' well-being and quality of care through its positive impact on the nursing practice environment and psychological capital. CLINICAL RELEVANCE Designing interventions and policies that specifically target nursing managers' authentic leadership style has implications for enhancing nurses' well-being and the quality of patient care. Institutional measures are needed to help leaders practice an authentic leadership style to create a positive nursing practice environment and cultivate nurses' psychological capital, both of which contribute to nurses' well-being and attaining a better quality of care. Further work is required to highlight the outcomes of implementing an authentic leadership style relevant to other leadership styles.
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Affiliation(s)
- Eman Alhalal
- Community and Mental Health Nursing Department, Nursing College, King Saud University, Riyadh, Saudi Arabia
| | - Johara Fahad Alharbi
- Research and Studies Administration, General Directorate of Nursing, MOH Agency for Therapeutic Services, Ministry of Health, Riyadh, Saudi Arabia
| | - Sabah Turyhib Alharbi
- Nursing Director in Maternity and Children Hospital, Ministry of Health, Hafr Albatin, Saudi Arabia
| | - Sarah Saad Alotaibi
- Nursing Improvement Administration, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
| | - Norah Saleh Albagami
- Nursing Shared Governance Department, King Saud Medical City, Ministry of Health, Riydh, Saudi Arabia
| | - Salman Mutarid Alruwaili
- Total Quality Management Director in North Medical Tower, Ministry of Health, Arar, Saudi Arabia
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Wolf L, Delao A, Jodelka FM, Simon C. Individual Attributes and Environmental Conditions of Registered Nurses Working in Freestanding Emergency Departments in the United States: A Descriptive Exploratory Study. J Emerg Nurs 2024; 50:381-391.e2. [PMID: 38506784 DOI: 10.1016/j.jen.2024.02.007] [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: 12/15/2023] [Revised: 02/21/2024] [Accepted: 02/25/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION Freestanding emergency departments (FSEDs) are emergency facilities not connected to inpatient services. The percentage of FSEDs of all EDs grew from 1% in 2001 to 12% in 2017, making FSEDs a substantial subset of US emergency care. The purpose of this study was to describe the individual attributes and environmental conditions of registered nurses working in FSEDs in the US. METHODS A quantitative descriptive exploratory design with cross-sectional survey methodology. RESULTS A total of 364 emergency nurses responded to the survey. Most reported their FSED was open 24 hours/day (99.5%), with board-certified emergency physicians onsite (91.5%) and a mean of 3.6 RNs working per shift. Resources immediately available in more than 50% of FSEDs included laboratory and imaging services, and in fewer than 30% of FSEDs included behavioral health care, MRI, obstetric care, orthopedic care, neurologic care, and surgical consult care. Respiratory therapy was reported by 39.6% of respondents as being immediately available. A significant minority of respondents expressed concerns about adequacy of resources and training and the effect on patient care in both survey (30% of respondents) and open-ended questions (42.5% of respondents). DISCUSSION The practice environment of emergency nurses in FSEDs was reported as having positive elements; however, a substantial subpopulation reported serious concerns. FSEDs adhere to some of the standards put forward by the American College of Emergency Physicians, with notable exceptions in the areas of staffing RNs, staffing ancillary staff, and availability of some resources.
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Yang Z, Zhang M, Guo Y, Wang R, Xie F. Burnout among Nurses: A Bibliometric Analysis of the Global Publications. Psychol Res Behav Manag 2024; 17:1727-1739. [PMID: 38681974 PMCID: PMC11055547 DOI: 10.2147/prbm.s458199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/17/2024] [Indexed: 05/01/2024] Open
Abstract
Objective To investigate the current situation, trending subjects, and future directions in the field of burnout among nurses, and to serve as a resource for researchers conducting related research. Methods The bibliometric analysis was carried out using R package "bibliometrix", bibliometric online analysis platform (https://bibliometric.com/) and VOSviewer (1.6.18). Results The leading countries that had a significant impact on this field were the USA and China. University of Pennsylvania was the most influential institution. Journal of Nursing Management was the top productive journal. Critical care, oncology care, acute care, and infectious disease care were more likely to lead to symptoms of burnout among nurses. "Mental health", "job satisfaction", "stress", and "COVID-19" were the current hot topics in this field. Conclusion Our study not only provides a thorough outline to assist researchers in understanding the leading countries, institutions, journals, and potential collaborators, but it also examines the current and upcoming trends in this field and inspires researchers to select research directions.
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Affiliation(s)
- Zihan Yang
- First Department of Foot and Ankle Surgery, Tianjin Hospital, Tianjin University, Tianjin, People’s Republic of China
| | - Miaomiao Zhang
- Emergency Department, Tianjin Haihe Hospital, Tianjin, People’s Republic of China
| | - Yan Guo
- Administration Department, Tianjin Hospital, Tianjin University, Tianjin, People’s Republic of China
| | - Rui Wang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
| | - Fei Xie
- Nursing Department, Tianjin Hospital, Tianjin University, Tianjin, People’s Republic of China
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Pantha S, Jones M, Moyo N, Pokhrel B, Kushemererwa D, Gray R. Association between the Quantity of Nurse-Doctor Interprofessional Collaboration and in-Patient Mortality: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:494. [PMID: 38673405 PMCID: PMC11050129 DOI: 10.3390/ijerph21040494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/16/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024]
Abstract
The level of nurse-doctor interprofessional collaboration may influence patient outcomes, including mortality. To date, no systematic reviews have investigated the association between the quantity of nurse-doctor interprofessional collaboration and inpatient mortality. A systematic review was conducted. We included studies that measured the quantity of nurse-doctor interprofessional collaboration and in-patient mortality. Five databases (MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Register) were searched. Two researchers undertook the title, abstract, and full-text screening. The risk of bias was determined using the Effective Public Health Practice Project (EPHPP) critical appraisal tool. Six reports from three observational studies met the inclusion criteria. Participants included 1.32 million patients, 29,591 nurses, and 191 doctors. The included studies had a high risk of bias. Of the three studies, one reported a significant association and one found no association between the quantity of nurse-doctor collaboration and mortality. The third study reported on the quantity of nurse-doctor collaboration but did not report the test of this association. We found no high-quality evidence to suggest the amount of nurse-doctor interprofessional collaboration was associated with mortality in medical and surgical inpatients. There is a need for further high-quality research to evaluate the association between the amount of nurse-doctor collaboration and patient outcomes.
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Affiliation(s)
- Sandesh Pantha
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; (M.J.); (N.M.); (B.P.); (D.K.); (R.G.)
| | - Martin Jones
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; (M.J.); (N.M.); (B.P.); (D.K.); (R.G.)
- Department of Rural Health, University of South Australia, Whyalla Norrie, SA 5608, Australia
| | - Nompilo Moyo
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; (M.J.); (N.M.); (B.P.); (D.K.); (R.G.)
- Victorian Tuberculosis Program, Melbourne Health, Melbourne, VIC 3000, Australia
| | - Bijaya Pokhrel
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; (M.J.); (N.M.); (B.P.); (D.K.); (R.G.)
| | - Diana Kushemererwa
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; (M.J.); (N.M.); (B.P.); (D.K.); (R.G.)
| | - Richard Gray
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; (M.J.); (N.M.); (B.P.); (D.K.); (R.G.)
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Maassen SM, Spruit-van Bentvelzen L, Weggelaar-Jansen AMJWM, Vermeulen H, Oostveen CJV. Systematic RADaR analysis of responses to the open-ended question in the Culture of Care Barometer survey of a Dutch hospital. BMJ Open 2024; 14:e082418. [PMID: 38626955 PMCID: PMC11029257 DOI: 10.1136/bmjopen-2023-082418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/01/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVES Systematically measuring the work environment of healthcare employees is key to continuously improving the quality of care and addressing staff shortages. In this study, we systematically analyse the responses to the one open-ended question posed in the Dutch version of the Culture of Care Barometer (CoCB-NL) to examine (1) if the responses offered new insights into healthcare employees' perceptions of their work environment and (2) if the original CoCB had any themes missing. DESIGN Retrospective text analysis using Rigorous and Accelerated Data Reduction technique. SETTING University hospital in the Netherlands using the CoCB-NL as part of the annual employee survey. PARTICIPANTS All hospital employees were invited to participate in the study (N=14 671). In total, 2287 employees responded to the open-ended question. RESULTS 2287 comments were analysed. Comments that contained more than one topic were split according to topic, adding to the total (n=2915). Of this total, 372 comments were excluded because they lacked content or respondents indicated they had nothing to add. Subsequently, 2543 comments were allocated to 33 themes. Most comments (n=2113) addressed the 24 themes related to the close-ended questions in the CoCB-NL. The themes most commented on concerned questions on 'organisational support'. The remaining 430 comments covered nine additional themes that addressed concerns about work environment factors (team connectedness, team effectiveness, corporate vision, administrative burden and performance pressure) and themes (diversity and inclusion, legal frameworks and collective bargaining, resilience and work-life balance, and personal matters). CONCLUSIONS Analysing responses to the open-ended question in the CoCB-NL led to new insights into relevant elements of the work environment and missing themes in the COCB-NL. Moreover, the analysis revealed important themes that not only require attention from healthcare organisations to ensure adequate improvements in their employees' work environment but should also be considered to further develop the CoCB-NL.
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Affiliation(s)
- Susanne M Maassen
- Quality and Patientcare, Erasmus MC, Rotterdam, Netherlands
- Tranzo, Tilburg University Tilburg School of Social and Behavioral Sciences, Tilburg, Netherlands
| | | | | | - Hester Vermeulen
- IQ Healthcare, Radboudumc, Nijmegen, Netherlands
- HAN Faculty of Health and Social Studies, Nijmegen, Netherlands
| | - Catharina J van Oostveen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
- Spaarne Gasthuis Academy, Spaarne Gasthuis, Haarlem, Netherlands
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