Incivility in nursing practice education in the operating room

Prevalence, associated factors, and nursing practice-related outcomes of workplace violence towards nursing students in clinical practice: A systematic review and meta-analysis

OBJECTIVES

To estimate the prevalence of Workplace violence (WPV) among nursing students in clinical practice, and examine the associated factors and nursing practice-related outcomes.

DESIGN

A systematic review and meta-analysis.

REVIEW METHODS AND DATA SOURCES

A comprehensive literature search was performed in nine databases from inception to Mar 2023. Two researchers independently screened studies, extracted data and assessed the quality of included studies. The random-effects model was used to estimate the pooled prevalence of WPV. Separate analyses were conducted by WPV type and source.

RESULTS

57 studies involving 23,451 nursing students were identified. The overall prevalence of WPV experienced and witnessed by nursing students was 45.37 % and 53.76 %, respectively, and 13.73 % were unsure if they had WPV. Psychological violence was the most prevalent form of WPV, but the prevalence of WPV also varied by setting and source, with obstetrics and gynaecology (41.25 %) being the most common settings and patients and their relatives (50.80 %) being the most common sources. When exposed to WPV, 65 % of nursing students did nothing except keep quiet, and 74 % did not report it. Concerning the associated factors of WPV, there were few reports on patient-related factors, and the selected studies focused primarily on nursing student- and occupational-related factors. Regarding nursing practice-related outcomes, WPV had a predominantly negative impact on nursing students' professional practice, but it also had a certain motivating effect.

CONCLUSIONS

This meta-analysis estimates the global prevalence, associated factors, and nursing practice-related outcomes of WPV among nursing students. The findings confirm the high prevalence of WPV; therefore, schools and institutions should prioritize WPV education and training. The hospital should then formulate WPV laws and regulations, enhance the WPV reporting procedure, and protect the rights and interests of nursing students. Finally, hospital administrators should employ individualized intervention strategies for nursing students based on the variables that affect them.

Global prevalence of bullying and associated factors among nursing students during clinical practice: A systematic review and meta-analysis

OBJECTIVE

This meta-analysis aims to estimate the global prevalence of bullying among nursing students during clinical practice and identify associated factors.

DESIGN

Systematic review and meta-analysis.

REVIEW METHODS AND DATA SOURCES

We conducted a comprehensive literature search across ten databases (PubMed, Cochrane, Web of Science, Embase, CINAHL, PsycINFO, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG) from their inception to January 3, 2023. Two researchers independently screened potentially eligible studies, extracted data, and assessed study quality. Data were analyzed using random-effects or fixed-effects models. Subgroup analyses and meta-regression explored the influence of participant and study characteristics on bullying prevalence. Publication bias and sensitivity analyses were also performed.

RESULTS

We included 28 studies (N = 9511) from 13 countries on five continents. The pooled estimate of bullying prevalence among nursing students during clinical practice was 65.60 % (95 % CI 55. 75 to 74.27), with no evidence of publication bias (t = 1.51, p-value = 0.14). Subgroup and moderator analyses highlighted the impact of country, continent, publication year, and assessment tool on bullying prevalence.

CONCLUSION

Nursing students face a high prevalence of bullying during clinical practice. Addressing this issue in nursing education requires prioritizing associated factors, fostering a culture of safety, providing effective training, and promoting individual resilience. These actions can prevent and mitigate bullying, creating a supportive and empowering learning environment for future nurses.

Student nurses' experiences of workplace violence: A mixed methods systematic review and meta-analysis

OBJECTIVES

To identify the prevalence of student-directed violence on clinical placement and description of their related experience during clinical placements.

DESIGN

Mixed methods systematic review and meta-analysis conducted following Joanna Briggs Institute guidelines and reported according to Preferred Reporting of Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

DATA SOURCES

CINAHL, Embase, Medline, Proquest, PsycINFO and Google Scholar.

REVIEW METHODS

Included studies were peer reviewed, published primary studies where pre-registration nursing students were surveyed about their experiences of physical, verbal, or sexual aggression, bullying or racism during clinical placement. Studies were quality assessed but not excluded based on the result. A convergent segregated approach to synthesis and integration was undertaken. Prevalence data were extracted and pooled using both random and quality effects models; separate analyses were conducted by violence type, source, and region. Qualitative data were thematically analysed.

RESULTS

14,894 student nurses from 42 studies were included across the meta-analyses. There was substantial heterogeneity in the included data. Pooled prevalence rates ranged from racism 12.2 % to bullying 58.2 %. Bullying (38.8 %) and physical aggression (10.2 %) were most perpetrated by nurses whereas sexual aggression was perpetrated mostly by patients (64.2 %) and physicians (18.6 %). Qualitative findings identified students' descriptions of reasons for, effects of, strategies for dealing with and higher education establishments' responsibilities with regards to workplace violence.

CONCLUSIONS

Student nurses commonly experience violence during their clinical placements. Given the potential debilitating physical and psychological sequelae of all forms of violence then this study further emphasises the need to use multiple strategies to prevent violence and to better equip student nurses to manage potentially violent incidents, their responses to violence, and to whistle blow or report when they are subject to violence.

Power outage and proactive service performance: the role of patient incivility and job stress

Purpose

Drawing from transactional stress and conservation of resource theories, this study untangles the relationship between power outage, patient incivility, job stress and proactive service performance. Further, this study also explores the mediating role of patient incivility and job stress.

Design/methodology/approach

A questionnaire-based survey was used, and data were collected from 275 healthcare professionals working in various public hospitals in Pakistan through convenience sampling. Structural equation modeling (SEM) via Smart PLS was used for data analysis.

Findings

Results revealed that power outage has significant positive impact on patient incivility and patient incivility has significant direct effect on job stress. Job stress has significant negative relationship with proactive service performance. Findings also confirmed that patient incivility mediates the relationship between power outage and job stress, and job stress mediates the relationship between patient incivility and proactive service performance.

Practical implications

This study helps the health administrators to think about the service standards of the public hospitals. Implications of this study are not limited to health sector. This study is useful for other service sectors where performance of employee affected by power outage. In addition to this, the current research helps to conduct research in other developing and underdeveloped countries which also face the problem of power outage.

Originality/value

This study marks the first step toward establishing power outage as an organizational behavior construct by demonstrating that power outage impacts significantly on proactive service performance. This study also explored the relationship between job stress and proactive service performance which was also not explored before.

The Role of Establishing Neurosurgical Specialist Nurse Working Group in the Recovery and Prevention of Negative Psychological Emotion after Meningioma Surgery

In this research paper, we will explore the role of establishing a neurosurgical specialist nurse working group in the recovery and prevention of negative psychological emotions after meningioma surgery. For this study, 42 meningioma patients who were treated before the establishment of a neurosurgery specialist nurse working group from January 2019 to December 2019. They were selected as the control group. In contrast, 42 meningioma patients admitted after the establishment of the neurosurgery specialist nurse group from January 2020 to December 2020 were selected as the study group. The postoperative recovery (time of stay in the intensive care unit, time of first eating, wakeup time, time of defecation for the first time, and hospitalization time), short-term prognosis, and nursing satisfaction scores of the two groups were calculated, and the post-traumatic stress disorder scale (PTSD-SS), medical coping style questionnaire (MCMQ), and National Institutes of Health Stroke Scale (NIHSS) were compared. Also, the changes in the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) score contributes to the comprehensive analysis of the role of the establishment of neurosurgical specialist nurse working group in the recovery and prevention of negative psychological emotion after meningioma operation. The satisfaction scores in the study group of patients in physical care, receiving information, support, respect, and nursing process were higher than the control group probability (P < 0.05). The first feeding time, defecation time, out of bed, the stay time in the intensive care unit, and the hospitalization time of the study group were shorter than those of the control group (P < 0.05). Before nursing, there was no difference in NIHSS score, SAS score, and SDS scores between the two groups. However, after nursing, the NIHSS score, SAS score, and SDS score of the study group were fairly lower than the control group. Moreover, the Karnofsky functional status scale (KPS) scores of the two groups increased gradually. The KPS scores of the study group at 1 month, 2 months, and 3 months after operation were significantly higher than those of the control group (P < 0.05). Before nursing, there was no significant difference in the scores of post-traumatic stress disorder between the two groups (P > 0.05). After nursing, the scores of subjective evaluation, symptom avoidance, repeated experience, and social dysfunction in the study group were lower than those in the control group (P < 0.05). Before nursing, there was no significant difference in coping scores between the control group and the research group (P > 0.05), but after nursing, the avoidance and compliance scores of the research group were significantly higher than those of the control group (P < 0.05).Similarly, the scores of avoidance and yield in the study group were significantly lower than those in the control group (P < 0.05). In the study group, 1 patient had an incision infection and 1 patient had epilepsy, and the total incidence of postoperative complications was 4.76%. In the control group, 4 patients had incision infection, 1 case of an intracranial hematoma, 3 cases of deep venous thrombosis, and 3 cases of epilepsy. The total incidence of postoperative complications in the study group was 26.19%, while the incidence of postoperative complications in the study group was lower than in the control group (P < 0.05).

The Relationship Between Workplace Incivility and Psychological Distress: The Moderating Role of Servant Leadership

BACKGROUND

The relationship between workplace incivility and psychological distress among nurses has been well-documented in the nursing literature. Management practices to reduce the negative impact are less clear. This study aimed to examine perceived servant leadership as a moderator between workplace incivility and psychological distress among nurses in Chinese hospitals.

METHODS

This study used a cross-sectional design and was conducted between September and October 2020. We recruited 1,604 nurses from 13 Chinese hospitals across different regions in China ranging from 18 to 55 years in age (M = 28.48 years, SD = 6.53 years). Multiple linear regression was used to analyze the data.

FINDINGS

The results showed that workplace incivility (β = 0.40, p < .001) and perceived servant leadership (β = -0.13, p < .001), as well as their interaction (β = -0.11, p = .002), predicted nurses' psychological distress. Perceived servant leadership moderates the relationship between workplace incivility and psychological distress.

CONCLUSIONS/APPLICATION TO PRACTICE

Servant leaders can create an ethical work climate, display empathy and compassion, and facilitate resilience. Our findings can assist hospital management with support from occupational health providers to recruit, train, and assess nursing supervisors. Also, occupational health providers in collaboration with nursing administration can monitor incivility, psychological distress, servant leadership levels, and impact.

Hospital nurses experiencing day-to-day workplace incivility: A diary study on the benefits of daily social support

AIM

The present study investigated the adverse effects of daily experienced incivility and the positive role of daily social support during the workday in predicting daily emotional exhaustion after work and vitality and positive affect at bedtime.

BACKGROUND

Despite the broad knowledge of the impact of experienced incivility in different occupations, little is known about day-to-day nurse incivility, much less in the hospital context.

METHOD

After completing a general questionnaire, hospital nurses (n = 96) completed a diary questionnaire twice a day for five consecutive workdays (n = 480 diary observations). The diary design had two levels: 5-day repeated measures (Level 1, day level) nested in persons (Level 2, person level) using an experience-sampling methodology.

RESULTS

Multilevel hierarchical analyses showed that incivility during the workday increased emotional exhaustion after work (t = 3.00, p = <0.05) and reduced vitality (t = -2.48, p = 0.05) and positive affect (t = -2.23, p = 0.05) at bedtime. However, daily social support during the workday was a crucial job resource that directly benefited hospital nurses' daily wellbeing (t = 5.19, p = 0.01 vitality; t = 4.89, p = 0.01 positive affect) and buffered the adverse effects of daily workplace incivility (t = -2.33, p = 0.05).

CONCLUSION

The within-person approach of our findings suggests that supportive practices can reduce day-to-day incivility spirals.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can promote a civility culture within their units using in service training programmes at work.

An Evaluation of the Use and Effectiveness of Case Management in Clinical Nursing Education

Background

This study aims to evaluate the use and effectiveness of case management in clinical nursing education.

Methods

A sample of 181 nurses at the N3–N5 level were selected for clinical nursing education and divided into two groups using the random number method. The control group (n = 90) received traditional training, and the observation group (n = 91) received a case management model of training. The theoretical knowledge, nursing skills, training satisfaction, job stress, workplace mindfulness, career satisfaction, and job happiness of the two groups were compared. In addition, 50 patients were selected as subjects for each group, and their satisfaction with the nursing care that they received was also measured and compared.

Results

Theoretical knowledge and nursing skills scored higher in the observation group than in the control group (p < 0.05), and overall training satisfaction was higher in the observation group than in the control group (p < 0.05). After training, job stress in the observation group was lower than in the control group (p < 0.05), while workplace mindfulness, career satisfaction, and job happiness were higher in the observation group than in the control group (p < 0.05). In terms of nursing quality, on all indicators, the observation group scored higher than the control group (p < 0.05), and the patients’ nursing satisfaction scores were higher in the observation group than in the control group (p < 0.05).

Conclusion

Case management can improve the professionalism and overall skills of nurses at the N3–N5 levels. It is conducive to reducing job stress, enhancing workplace mindfulness, improving career satisfaction and job happiness, and improving the quality of nursing, thereby providing patients with better nursing care.