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Kangasniemi M, Rannikko S, Leino-Kilpi H. Nurses' collegiality: An evolutionary concept analysis. Nurs Ethics 2023:9697330231221197. [PMID: 38108288 DOI: 10.1177/09697330231221197] [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: 12/19/2023]
Abstract
Collegiality is one of the fundamental values of the nursing profession. During the nursing history, collegiality has been described as part of a nurse's relationship with their peers and it influences the quality of care they provide and job satisfaction and commitment to their work. Despite earlier definitions, the concept of collegiality in nursing has remained unclear. The aim of this study was to clarify the concept of collegiality in the nursing profession, using Rodger's evolutionary concept analysis. We carried out electronic searches using the CINAHL, PubMed, Scopus, Web of Science, SocINDEX, PsycINFO and Eric databases and manual searches of the reference lists of the selected papers. The searches were limited to peer-reviewed papers published in English language from the inception of database to November 2022. This identified 25 papers. Based on our analysis, the attributes of the concept of collegiality were achieving mutual goals together with equality, reciprocity, trusted advocacy, powerful self-regulation and engaged belongingness. Antecedents of the concept included existing professional group, connection between professionals and professional self-esteem. The consequences were strengthening nurses' professional status, job satisfaction and their ability to provide the best possible patient care. We found that nurses' collegiality was a value-based concept, with a unique character based on professional connections. The concept brought together ethical and pragmatic strategies to achieve the best possible results for the nursing profession. Provided knowledge can be applied for further development of the concept and applying it in clinical research and practice. The concept of nurses' collegiality should also be studied in the future because both the profession and their working environment are constantly changing.
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Haverhals A. An Educational Intervention to Enhance the Performance of Peer Feedback. J Nurs Adm 2023; 53:319-325. [PMID: 37219883 DOI: 10.1097/nna.0000000000001290] [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: 05/24/2023]
Abstract
OBJECTIVE Offering peer feedback on a routine basis may improve nursing, patient, and organizational outcomes by addressing potentially problematic issues before they occur. BACKGROUND There is limited literature of specific feedback processes, although national agencies support peer feedback as a professional responsibility. METHODS An educational tool was used to train nurses on defining what constitutes professional peer review, reviewing ethical and professional standards, and evaluating the types of peer feedback supported by the literature along with suggestions to use when giving and receiving peer feedback. RESULTS The Beliefs about Peer Feedback Questionnaire was used to evaluate the nurses' perceived value and confidence when giving and receiving peer feedback before and after the implementation of the educational tool. The nonparametric Wilcoxon signed rank test demonstrated overall improvement. CONCLUSIONS When peer feedback educational tools were available to nurses and the environment supports professional peer review, there was a significant improvement in the level of comfort when giving and receiving peer feedback, along with increased perceived value of peer feedback given and received.
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Affiliation(s)
- Amanda Haverhals
- Author Affiliation: Associate Professor of Nursing, Nylen School of Nursing, Morningside University, Sioux City, Iowa
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Womack DM, Miech EJ, Fox NJ, Silvey LC, Somerville AM, Eldredge DH, Steege LM. Coincidence Analysis: A Novel Approach to Modeling Nurses' Workplace Experience. Appl Clin Inform 2022; 13:794-802. [PMID: 36044917 PMCID: PMC9433166 DOI: 10.1055/s-0042-1756368] [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: 03/05/2022] [Accepted: 07/13/2022] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVES The purpose of this study is to identify combinations of workplace conditions that uniquely differentiate high, medium, and low registered nurse (RN) ratings of appropriateness of patient assignment during daytime intensive care unit (ICU) work shifts. METHODS A collective case study design and coincidence analysis were employed to identify combinations of workplace conditions that link directly to high, medium, and low RN perception of appropriateness of patient assignment at a mid-shift time point. RN members of the study team hypothesized a set of 55 workplace conditions as potential difference makers through the application of theoretical and empirical knowledge. Conditions were derived from data exported from electronic systems commonly used in nursing care. RESULTS Analysis of 64 cases (25 high, 24 medium, and 15 low) produced three models, one for each level of the outcome. Each model contained multiple pathways to the same outcome. The model for "high" appropriateness was the simplest model with two paths to the outcome and a shared condition across pathways. The first path comprised of the absence of overtime and a before-noon patient discharge or transfer, and the second path comprised of the absence of overtime and RN assignment to a single ICU patient. CONCLUSION Specific combinations of workplace conditions uniquely distinguish RN perception of appropriateness of patient assignment at a mid-shift time point, and these difference-making conditions provide a foundation for enhanced observability of nurses' work experience during hospital work shifts. This study illuminates the complexity of assessing nursing work system status by revealing that multiple paths, comprised of multiple conditions, can lead to the same outcome. Operational decision support tools may best reflect the complex adaptive nature of the work systems they intend to support by utilizing methods that accommodate both causal complexity and equifinality.
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Affiliation(s)
- Dana M. Womack
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, United States
| | | | - Nicholas J. Fox
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, United States
| | - Linus C. Silvey
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, United States
| | - Anna M. Somerville
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, United States
| | - Deborah H. Eldredge
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, United States
| | - Linsey M. Steege
- School of Nursing, University of Wisconsin–Madison, Madison, Wisconsin, United States
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Jung M, Kim MS, Lee JY, Lee KY, Park YH. [An Analysis of Tasks of Nurses Caring for Patients with COVID-19 in a Nationally-Designated Inpatient Treatment Unit]. J Korean Acad Nurs 2022; 52:391-406. [PMID: 36117301 DOI: 10.4040/jkan.22056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to provide foundational knowledge on nursing tasks performed on patients with COVID-19 in a nationally-designated inpatient treatment unit. METHODS This study employs both quantitative and qualitative approaches. The quantitative method investigated the content and frequency of nursing tasks for 460 patients (age ≥ 18 y, 57.4% men) from January 20, 2020, to September 30, 2021, by analyzing hospital information system records. Qualitative data were collected via focus group interviews. The study involved interviews with three focus groups comprising 18 nurses overall to assess their experiences and perspectives on nursing care during the pandemic from February 3, 2022, to February 15, 2022. The data were examined with thematic analysis. RESULTS Overall, 49 different areas of nursing tasks (n = 130,687) were identified based on the Korean Patient Classification System for nurses during the study period. Among the performed tasks, monitoring of oxygen saturation and measuring of vital signs were considered high-priority. From the focus group interview, three main themes and eleven sub-themes were generated. The three main themes are "Experiencing eventfulness in isolated settings," "All-around player," and "Reflections for solutions." CONCLUSION During the COVID-19 pandemic, it is imperative to ensure adequate staffing levels, compensation, and educational support for nurses. The study further propose improving guidelines for emerging infectious diseases and patient classification systems to improve the overall quality of patient care.
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Affiliation(s)
- Minho Jung
- Department of Nursing, Seoul National University Hospital, Seoul, Korea
| | - Moon-Sook Kim
- Department of Nursing, Seoul National University Hospital, Seoul, Korea
| | - Joo-Yeon Lee
- Department of Nursing, Seoul National University Hospital, Seoul, Korea
| | - Kyung Yi Lee
- Department of Nursing, Seoul National University Hospital, Seoul, Korea
| | - Yeon-Hwan Park
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, Korea.
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Rauman PA. Conflicting Working Relationships Among Nurses: The Intersection of Should Nursing, Double Domination, and the Big Picture. Can J Nurs Res 2022; 55:230-240. [PMID: 35903883 DOI: 10.1177/08445621221115250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Research conducted on conflict between Registered Nurses (RNs) has established that it happens regularly within the hospital setting, that it adversely affects the health and well-being of RNs, impacts the effective functioning of the health care organization, and compromises quality patient care. In this article, the phrase conflicting working relationships (CWRs) is used to represent working relationships between RN peers that are non-collegial, uncaring, and non- supportive, and inclusive of the behaviours associated with incivility, horizontal violence, and bullying, among others. Purpose To examine how nursing, including nursing knowledge and practice, is socially organized within the hospital setting and how this organization is linked to CWRs between RN peers. Methods Interviews were conducted with 17 RNs, followed by text analysis and mapping guided by institutional ethnography (IE) as the research methodology. Results The intersections between should nursing, double domination, and the big picture threads shows work environments where RNs struggle to provide appropriate care and conflict has become institutionalized. The intersection between threads can be used as caution areas for RNs and individuals in leadership positions to reflect on nursing practice when conflict is being experienced. Conclusions The contextual variables surrounding professional nursing practice are very influential with respect to how RNs relate to each other. A new type of dialogue about the organization of nursing practice in the hospital setting is needed to support more relational practices between RNs.
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Affiliation(s)
- Peggy Ann Rauman
- Memorial University Newfoundland and Labrador, 30 Bay Bulls Road, St. John’s, NL, A1G 1A3, Canada
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BLAIR W, COURTNEY-PRATT H, DORAN E, KABLE A. Nurses’ recognition and response to Unsafe Practice by their Peers: A qualitative descriptive analysis. Nurse Educ Pract 2022; 63:103387. [DOI: 10.1016/j.nepr.2022.103387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/02/2022] [Accepted: 06/21/2022] [Indexed: 11/27/2022]
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Morris KY, Jakobsen R. Central venous catheter access and procedure compliance: A qualitative interview study exploring intensive care nurses' experiences. Intensive Crit Care Nurs 2022; 69:103182. [PMID: 34996676 DOI: 10.1016/j.iccn.2021.103182] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 10/15/2021] [Accepted: 10/23/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore intensive care nurses' experiences with and perceptions of using a standardised central venous catheter procedure to prevent bacterial contamination when accessing patients' central venous catheters. DESIGN AND METHODOLOGY This study employed an interpretative qualitative design. Data was collected through semi-structured, individual interviews and Qualitative Content Analysis was used in data analysis. SETTING Seven Norwegian intensive care nurses were recruited using a purposeful sampling strategy. FINDINGS Three main themes were identified. 1). Individualised practice revealed varying knowledge of and commitment to following the central line procedure. 2). Risk desensitisation revealed a continuous use of central lines, acute situations and a lack of information on infections, which affect usage. 3). Professional working culture showed nurse-to-nurse interaction, which promoted compliance with the procedure. Their interplay created a team spirit whereby nurses worked together to improve patient safety. CONCLUSIONS This study shows the diversity and complexity of factors affecting intensive care nurses' procedure compliance when accessing central lines. The themes of Individualised practice and Risk desensitisation pose a substantial threat to healthcare quality and patient safety in the ICU. Exposure to infection risks could be reduced by applying these themes to inform and strengthen continuing education programs and audit processes. The theme of Professional working culture shows the positive influence nurses can have on each other, promoting compliance when accessing central lines. Intensive care nurses should be aware that their voice matters and that challenging poor practice does not have to be confrontational. Leadership should look for ways to encourage this type of nurse-to-nurse interaction.
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Affiliation(s)
- Kent Young Morris
- Division of Emergencies and Critical Care, Oslo University Hospital, Norway.
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Hauhio N, Leino-Kilpi H, Katajisto J, Numminen O. Nurses' self-assessed moral courage and related socio-demographic factors. Nurs Ethics 2021; 28:1402-1415. [PMID: 34100317 DOI: 10.1177/0969733021999763] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Nurses need moral courage to ensure ethically good care. Moral courage is an individual characteristic and therefore it is relevant to examine its association with nurses' socio-demographic factors. OBJECTIVE To describe nurses' self-assessed level of moral courage and its association with their socio-demographic factors. RESEARCH DESIGN Quantitative descriptive cross-sectional study. The data were collected with Nurses' Moral Courage Scale and analyzed statistically. PARTICIPANTS AND RESEARCH CONTEXT A total of 482 registered nurses from a major university hospital in Southern Finland completed the Finnish language version of Nurses' Moral Courage Scale in autumn 2017. ETHICAL CONSIDERATIONS Ethical approval was obtained from the university ethics committee and permission for the data collection from the participating hospital. Ethical principles and scientific guidelines were followed throughout the research process. FINDINGS Nurses' self-assessed level of moral courage was rather high. On Visual Analogy Scale (0-10), the mean value was 8.20 and the mean score of the four dimensional, 21-item Nurses' Moral Courage Scale was 4.09 on a 5-point Likert-type scale. Respondents' gender, present work role, ethical knowledge base, additional ethics education, self-study as a means to acquire ethical knowledge, and frequency of work situations needing moral courage were statistically significantly associated with nurses' moral courage. DISCUSSION Strongest association was found between nurses' higher moral courage level and formal and informal ethics education. Honesty and patient's humane and dignified encounter received the highest scores indicating respondents' internalization of the core values of nursing. CONCLUSION Although nurses were fairly morally courageous, moral courage should be a part of nurses' basic and continuing education thus covering its theoretical and practical learning. Since moral courage is a virtue that can be taught, learnt, and practiced, education is a relevant way to maintain and further strengthen nurses' moral courage.
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Walker FA, Ball M, Cleary S, Pisani H. Transparent teamwork: The practice of supervision and delegation within the multi-tiered nursing team. Nurs Inq 2021; 28:e12413. [PMID: 33886166 DOI: 10.1111/nin.12413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 03/03/2021] [Accepted: 03/12/2021] [Indexed: 11/27/2022]
Abstract
Supervision and delegation are important leadership skills that nurses require when practising within the multi-tiered nursing team. In response to increasing demands globally on healthcare systems, Nursing Assistants are becoming more prevalent members of the nursing workforce in the acute care setting. An exploratory descriptive research design was used to examine supervision and delegation of Nursing Assistants in an acute hospital setting in Victoria, Australia. It was found that supervision and delegation in the context of a multi-tier nursing team required a complex assessment and decision-making process which was influenced by multiple factors. This research promotes developing transparent nursing practices and mutual understanding in the multi-tier nursing team to facilitate effective supervision and delegation based on informed decision-making and culture of openness and trust. Pre-registration education and continuing education and support for nurses are important to build transparent supervision and delegation practices and teamwork, empowering the nursing team to practice to their full scope of practice to provide high-quality patient care.
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Affiliation(s)
- Felicity Ann Walker
- Faculty of Health, Southern Cross University, Bilinga, QLD, Australia.,School of Health & Biomedical Sciences, RMIT University, Melbourne, Vic., Australia
| | - Madeleine Ball
- School of Health & Biomedical Sciences, RMIT University, Melbourne, Vic., Australia.,School of Health Sciences, University of Tasmania, Melbourne, Vic., Australia
| | - Sonja Cleary
- School of Health & Biomedical Sciences, RMIT University, Melbourne, Vic., Australia
| | - Heather Pisani
- School of Health & Biomedical Sciences, RMIT University, Melbourne, Vic., Australia
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Fernandez R, Lord H, Halcomb E, Moxham L, Middleton R, Alananzeh I, Ellwood L. Implications for COVID-19: A systematic review of nurses' experiences of working in acute care hospital settings during a respiratory pandemic. Int J Nurs Stud 2020; 111:103637. [PMID: 32919358 PMCID: PMC7206441 DOI: 10.1016/j.ijnurstu.2020.103637] [Citation(s) in RCA: 379] [Impact Index Per Article: 94.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pandemics and epidemics are public health emergencies that can result in substantial deaths and socio-economic disruption. Nurses play a key role in the public health response to such crises, delivering direct patient care and reducing the risk of exposure to the infectious disease. The experience of providing nursing care in this context has the potential to have significant short and long term consequences for individual nurses, society and the nursing profession. OBJECTIVES To synthesize and present the best available evidence on the experiences of nurses working in acute hospital settings during a pandemic. DESIGN This review was conducted using the Joanna Briggs Institute methodology for systematic reviews. DATA SOURCES A structured search using CINAHL, MEDLINE, EMBASE, PubMed, Google Scholar, Cochrane Library, MedNar, ProQuest and Index to Theses was conducted. REVIEW METHODS All studies describing nurses' experiences were included regardless of methodology. Themes and narrative statements were extracted from included papers using the SUMARI data extraction tool from Joanna Briggs Institute. RESULTS Thirteen qualitative studies were included in the review. The experiences of 348 nurses generated a total of 116 findings, which formed seven categories based on similarity of meaning. Three synthesized findings were generated from the categories: (i) Supportive nursing teams providing quality care; (ii) Acknowledging the physical and emotional impact; and (iii) Responsiveness of systematised organizational reaction. CONCLUSIONS Nurses are pivotal to the health care response to infectious disease pandemics and epidemics. This systematic review emphasises that nurses' require Governments, policy makers and nursing groups to actively engage in supporting nurses, both during and following a pandemic or epidemic. Without this, nurses are likely to experience substantial psychological issues that can lead to burnout and loss from the nursing workforce.
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Affiliation(s)
- Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia; Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia; Center for Evidence Based Initiatives in Health Care: A JBI Center of Excellence, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Heidi Lord
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia; Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia; Center for Evidence Based Initiatives in Health Care: A JBI Center of Excellence, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Ibrahim Alananzeh
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Laura Ellwood
- Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia.
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Womack DM, Hribar MR, Steege LM, Vuckovic NH, Eldredge DH, Gorman PN. Registered Nurse Strain Detection Using Ambient Data: An Exploratory Study of Underutilized Operational Data Streams in the Hospital Workplace. Appl Clin Inform 2020; 11:598-605. [PMID: 32937676 DOI: 10.1055/s-0040-1715829] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Registered nurses (RNs) regularly adapt their work to ever-changing situations but routine adaptation transforms into RN strain when service demand exceeds staff capacity and patients are at risk of missed or delayed care. Dynamic monitoring of RN strain could identify when intervention is needed, but comprehensive views of RN work demands are not readily available. Electronic care delivery tools such as nurse call systems produce ambient data that illuminate workplace activity, but little is known about the ability of these data to predict RN strain. OBJECTIVES The purpose of this study was to assess the utility of ambient workplace data, defined as time-stamped transaction records and log file data produced by non-electronic health record care delivery tools (e.g., nurse call systems, communication devices), as an information channel for automated sensing of RN strain. METHODS In this exploratory retrospective study, ambient data for a 1-year time period were exported from electronic nurse call, medication dispensing, time and attendance, and staff communication systems. Feature sets were derived from these data for supervised machine learning models that classified work shifts by unplanned overtime. Models for three timeframes -8, 10, and 12 hours-were created to assess each model's ability to predict unplanned overtime at various points across the work shift. RESULTS Classification accuracy ranged from 57 to 64% across three analysis timeframes. Accuracy was lowest at 10 hours and highest at shift end. Features with the highest importance include minutes spent using a communication device and percent of medications delivered via a syringe. CONCLUSION Ambient data streams can serve as information channels that contain signals related to unplanned overtime as a proxy indicator of RN strain as early as 8 hours into a work shift. This study represents an initial step toward enhanced detection of RN strain and proactive prevention of missed or delayed patient care.
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Affiliation(s)
- Dana M Womack
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, United States
| | - Michelle R Hribar
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, United States
| | - Linsey M Steege
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Nancy H Vuckovic
- Experience Design, Cambia Health Solutions, Portland, Oregon, United States
| | - Deborah H Eldredge
- Nursing Administration, Oregon Health & Science University Healthcare, Portland, Oregon, United States
| | - Paul N Gorman
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, United States
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Jantzen D. Refining nursing practice through workplace learning: A grounded theory. J Clin Nurs 2019; 28:2565-2576. [DOI: 10.1111/jocn.14841] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 01/07/2019] [Accepted: 02/12/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Darlaine Jantzen
- Nursing Department Camosun College Victoria British Columbia Canada
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13
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Ahlstedt C, Eriksson Lindvall C, Holmström IK, Muntlin Athlin Å. What makes registered nurses remain in work? An ethnographic study. Int J Nurs Stud 2018; 89:32-38. [PMID: 30339953 DOI: 10.1016/j.ijnurstu.2018.09.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/10/2018] [Accepted: 09/11/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Registered nurses' work-related stress, dissatisfaction and burnout are some of the problems in the healthcare and that negatively affect healthcare quality and patient care. A prerequisite for sustained high quality at work is that the registered nurses are motivated. High motivation has been proved to lead to better working results. The theory of inner work life describes the dynamic interplay between a person's perceptions, emotions and motivation and the three key factors for a good working life: nourishment, progress and catalysts. OBJECTIVES The aim of the study was to explore registered nurses' workday events in relation to inner work life theory, to better understand what influences registered nurses to remain in work. DESIGN A qualitative explorative study with an ethnographic approach. METHODS Participant observation over four months; in total 56 h with 479 events and 58 informal interviews during observation; all registered nurses employed at the unit (n = 10) were included. In addition, individual interviews were conducted after the observation period (n = 9). The dataset was analysed using thematic analysis and in the final step of the analysis the categories were reflected in relation to the three key factors in theory of inner work life. RESULTS Nourishment in a registered nurse context describes the work motivation created by the interpersonal support between colleagues. It was important to registered nurses that physicians and colleagues respected and trusted their knowledge in the daily work, and that they felt comfortable asking questions and supporting each other. Progress in the context of registered nurses' work motivation was the feeling of moving forward with a mix of small wins and the perception of solving more complex challenges in daily work. It was also fundamental to the registered nurses' development through new knowledge and learning during daily work. Catalysts, actions that directly facilitate the work, were highlighted as the possibility to work independently along with the opportunity to work together with other registered nurses. CONCLUSION This study has a number of implications for future work and research on creating an attractive workplace for registered nurses. Working independently, with colleagues from the same profession, integrated with learning, visible progress, and receiving feedback from the work itself, contribute to work motivation.
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Affiliation(s)
- Carina Ahlstedt
- Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden.
| | | | - Inger K Holmström
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden; Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden
| | - Åsa Muntlin Athlin
- Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden; Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala, Sweden; Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Adelaide Nursing School, University of Adelaide, Adelaide, Australia
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14
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Taylor RA, Taylor SS. Reframing and addressing horizontal violence as a workplace quality improvement concern. Nurs Forum 2018; 53:459-465. [PMID: 29949182 DOI: 10.1111/nuf.12273] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To reframe horizontal violence as a quality improvement concern. BACKGROUND Although the number of studies exploring horizontal violence has increased, evidence supporting the effectiveness of current interventions is weak and the problem persists. Often framed as an individual or interpersonal issue, horizontal violence has been recognized as a complex phenomenon that can only be understood through an examination of social, individual and organizational factors. As such, interventions to address horizontal violence must be applied systemically and address contributions from all sources. DESIGN This is a discussion paper. DATA SOURCES This discussion is based on results of a study of nurses' perceptions of horizontal violence and review of the literature. IMPLICATIONS FOR NURSING Context is recognized as a contributing factor in human behavior, yet often overlooked in interventions to address horizontal violence. Moving the focus away from the individual and investigating systems contributions to horizontal violence using existing quality improvement frameworks is suggested. CONCLUSION To date, efforts to address horizontal violence have not been proven effective. There is a call for a wider application and investigation of interventions. This reframing provides the system level application suggested and would address a broader range of factors contributing to the perpetuation of the phenomenon.
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Affiliation(s)
- Rosemary A Taylor
- Department of Nursing, University of New Hampshire, Durham, New Hampshire
| | - Steven S Taylor
- Foisie Business School, Worcester Polytechnic Institute, Worcester, Massachusetts
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Froneman C, Wyk NCV, Mogale RS. Enhancing the professional dignity of midwives: A phenomenological study. Nurs Ethics 2017; 26:1062-1074. [DOI: 10.1177/0969733017739781] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: When midwives are not treated with respect and their professional competencies are not recognised, their professional dignity is violated. Objective: This study explored and described how the professional dignity of midwives in the selected hospital can be enhanced based on their experiences. Research design: A descriptive phenomenological research design was used with in-depth interviews conducted with 15 purposely selected midwives. Ethical considerations: The Faculty of Health Sciences Research Ethics Committee of the University of Pretoria approved the study. The research was conducted in an academic tertiary hospital with voluntary participants. Findings: To dignify midwives it is essential to enhance the following: ‘to acknowledge the capabilities of midwives’, ‘to appreciate interventions of midwives’, ‘to perceive midwives as equal health team members’, ‘to invest in midwives’, ‘to enhance collegiality’, ‘to be cared for by management’ and ‘to create conducive environments’. Conclusion: The professional dignity of midwives is determined by their own perspectives of the contribution that they make to the optimal care of patients, the respect that they get from others and the support that hospital management gives them. With support and care, midwives’ professional dignity is enhanced. Midwives will strive to render excellent services as well as increasing their commitment.
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Ingvarsdottir E, Halldorsdottir S. Enhancing patient safety in the operating theatre: from the perspective of experienced operating theatre nurses. Scand J Caring Sci 2017; 32:951-960. [DOI: 10.1111/scs.12532] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 09/05/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Eydis Ingvarsdottir
- Faculty of Graduate Studies; School of Health Sciences; University of Akureyri; Akureyri Iceland
- Akureyri Hospital v. Eyrarlandsveg; Akureyri Iceland
| | - Sigridur Halldorsdottir
- Faculty of Graduate Studies; School of Health Sciences; University of Akureyri; Akureyri Iceland
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A Descriptive Study of Nursing Peer-Review Programs in US Magnet® Hospitals. ACTA ACUST UNITED AC 2017; 47:226-231. [DOI: 10.1097/nna.0000000000000469] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Leidel S, Leslie G, Boldy D, Girdler S. A comprehensive theoretical framework for the implementation and evaluation of opt-out HIV testing. J Eval Clin Pract 2017; 23:301-307. [PMID: 27451938 DOI: 10.1111/jep.12602] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 06/14/2016] [Accepted: 06/16/2016] [Indexed: 11/30/2022]
Abstract
Opt-out HIV testing (in which patients are offered HIV testing as a default) is a potentially powerful strategy for increasing the number of people who know their HIV status and thus limiting viral transmission. Like any change in clinical practice, implementation of opt-out HIV testing in a health service requires a change management strategy, which should have theoretical support. This paper considers the application of three theories to the implementation and evaluation of an opt-out HIV testing programme: Behavioural Economics, the Health Belief Model and Normalisation Process Theory. An awareness, understanding and integration of these theories may motivate health care providers to order HIV tests that they may not routinely order, influence their beliefs about who should be tested for HIV and inform the operational aspects of opt-out HIV testing. Ongoing process evaluation of opt-out HIV testing programmes (based on these theories) will help to achieve individual health care provider self-efficacy and group collective action, thereby improving testing rates and health outcomes.
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Affiliation(s)
- Stacy Leidel
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - Gavin Leslie
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - Duncan Boldy
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - Sonya Girdler
- School of Occupational Therapy and Social Work, Curtin University, Perth, Australia
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Rosser EA, Scammell J, Bevan A, Hundley VA. Strong leadership: the case for global connections. J Clin Nurs 2016; 26:946-955. [PMID: 27572554 DOI: 10.1111/jocn.13562] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2016] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To identify how nurse leaders view and experience the opportunities offered by one of the largest global nursing organisations Sigma Theta Tau International. BACKGROUND Worldwide, nursing leadership is challenged with addressing the complex issues impacting on care delivery. International nursing organisations are a means to bring together individuals to promote leadership and scholarship for nursing practice to promote patient safety and quality care. The newly established all-England chapter of Sigma Theta Tau International is a recent addition to the society in terms of nurse leadership in Europe, as such faces challenges as it establishes its identity and seeks to interpret the organisational vision: to advance world health through nursing leadership and scholarship. Moving forward, members views were sought on the goals of the chapter and how they may be enacted. DESIGN In July 2013, all chapter members at that time had been nominated on the basis of achievement in nurse leadership; all were invited to participate in an online survey. The online questionnaire contained a series of closed and open questions. RESULTS Most respondents joined because they believed in the vision and networking opportunities Sigma Theta Tau International provides. Three themes were extracted from the data: the value of networking and communication, leadership and the development of culturally sensitive organisations and the need for shared scholarship for nursing practice. CONCLUSION Findings indicate the growth of effective leadership at all levels of nursing could be harnessed through successful collaboration and keen support for robust connections between practice and education to promote quality care. RELEVANCE TO CLINICAL PRACTICE Whilst challenging, globalisation presents an opportunity for a nursing society such as Sigma Theta Tau International to work collaboratively to address healthcare issues. A nursing society that explores and resolves its own complex issues by actively promoting leadership and collaborative scholarship reveals a potential to empower the profession to share our collective solutions towards enhancing clinical practice.
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Affiliation(s)
- Elizabeth A Rosser
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Janet Scammell
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Ann Bevan
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Vanora A Hundley
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK.,Centre for Midwifery, Maternal and Perinatal Health, Bournemouth University, Bournemouth, UK
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20
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Carolan CM, Forbat L, Smith A. Developing the DESCARTE Model: The Design of Case Study Research in Health Care. QUALITATIVE HEALTH RESEARCH 2016; 26:626-39. [PMID: 26336896 DOI: 10.1177/1049732315602488] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Case study is a long-established research tradition which predates the recent surge in mixed-methods research. Although a myriad of nuanced definitions of case study exist, seminal case study authors agree that the use of multiple data sources typify this research approach. The expansive case study literature demonstrates a lack of clarity and guidance in designing and reporting this approach to research. Informed by two reviews of the current health care literature, we posit that methodological description in case studies principally focuses on description of case study typology, which impedes the construction of methodologically clear and rigorous case studies. We draw from the case study and mixed-methods literature to develop the DESCARTE model as an innovative approach to the design, conduct, and reporting of case studies in health care. We examine how case study fits within the overall enterprise of qualitatively driven mixed-methods research, and the potential strengths of the model are considered.
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Affiliation(s)
- Clare M Carolan
- University of Stirling (Western Isles Campus), Stornoway, Scotland
| | - Liz Forbat
- Australian Catholic University, Canberra, Australia
| | - Annetta Smith
- University of Stirling (Western Isles Campus), Stornoway, Scotland
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21
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Kangasniemi M, Arala K, Becker E, Suutarla A, Haapa T, Korhonen A. The development of ethical guidelines for nurses' collegiality using the Delphi method. Nurs Ethics 2016; 24:538-555. [PMID: 26754970 DOI: 10.1177/0969733015617342] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Nurses' collegiality is topical because patient care is complicated, requiring shared knowledge and working methods. Nurses' collaboration has been supported by a number of different working models, but there has been less focus on ethics. AIM This study aimed to develop nurses' collegiality guidelines using the Delphi method. METHOD Two online panels of Finnish experts, with 35 and 40 members, used the four-step Delphi method in December 2013 and January 2014. They reformulated the items of nurses' collegiality identified by the literature and rated based on validity and importance. Content analysis and descriptive statistical methods were used to analyze the data, and the nurses' collegiality guidelines were formulated. Ethical considerations: Organizational approval was received, and an informed consent was obtained from all participants. Information about the voluntary nature of participation was provided. RESULTS During the first Delphi panel round, a number of items were reformulated and added, resulting in 32 reformulated items. As a result of the second round, 8 of the 32 items scored an agreement rate of more than 75%, with the most rated item being collegiality means that professionals respect each other. The item with second highest rating was collegiality has a common objective: what is best for patients, followed by the third highest which was professional ethics is the basis of collegiality. CONCLUSION Nurses' collegiality and its content are well recognized in clinical practice but seldom studied. Collegiality can be supported by guidelines, and nurses working in clinical practice, together with teachers and managers, have shared responsibilities to support and develop it. More research in different nursing environments is needed to improve understanding of the content and practice of nursing collegiality.
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Affiliation(s)
| | | | | | | | - Toni Haapa
- University of Tampere, Finland; Hospital District of Helsinki and Uusimaa, Finland; University Hospital, Southern Finland
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Marks D, O'Connor R. Health professionals’ attitudes towards the promotion of breastfeeding. ACTA ACUST UNITED AC 2015. [DOI: 10.12968/bjom.2015.23.1.50] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Dougie Marks
- Lecturer in Mental Health University of the West of Scotland
| | - Rory O'Connor
- Professor, Chair in Health Psychology University of Glasgow
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Padgett SM. ‘Looking like a bad person’: vocabulary of motives and narrative analysis in a story of nursing collegiality. Nurs Inq 2014; 22:221-30. [DOI: 10.1111/nin.12088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2014] [Indexed: 11/26/2022]
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