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Taylor C, Maben J, Jagosh J, Carrieri D, Briscoe S, Klepacz N, Mattick K. Care Under Pressure 2: a realist synthesis of causes and interventions to mitigate psychological ill health in nurses, midwives and paramedics. BMJ Qual Saf 2024; 33:523-538. [PMID: 38575309 PMCID: PMC11287552 DOI: 10.1136/bmjqs-2023-016468] [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: 06/23/2023] [Accepted: 02/18/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Nurses, midwives and paramedics comprise over half of the clinical workforce in the UK National Health Service and have some of the highest prevalence of psychological ill health. This study explored why psychological ill health is a growing problem and how we might change this. METHODS A realist synthesis involved iterative searches within MEDLINE, CINAHL and HMIC, and supplementary handsearching and expert solicitation. We used reverse chronological quota screening and appraisal journalling to analyse each source and refine our initial programme theory. A stakeholder group comprising nurses, midwives, paramedics, patient and public representatives, educators, managers and policy makers contributed throughout. RESULTS Following initial theory development from 8 key reports, 159 sources were included. We identified 26 context-mechanism-outcome configurations, with 16 explaining the causes of psychological ill health and 10 explaining why interventions have not worked to mitigate psychological ill health. These were synthesised to five key findings: (1) it is difficult to promote staff psychological wellness where there is a blame culture; (2) the needs of the system often over-ride staff psychological well-being at work; (3) there are unintended personal costs of upholding and implementing values at work; (4) interventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressors; and (5) it is challenging to design, identify and implement interventions. CONCLUSIONS Our final programme theory argues the need for healthcare organisations to rebalance the working environment to enable healthcare professionals to recover and thrive. This requires high standards for patient care to be balanced with high standards for staff psychological well-being; professional accountability to be balanced with having a listening, learning culture; reactive responsive interventions to be balanced by having proactive preventative interventions; and the individual focus balanced by an organisational focus. PROSPERO REGISTRATION NUMBER CRD42020172420.
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Affiliation(s)
- Cath Taylor
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Justin Jagosh
- School of Health Sciences, University of Surrey, Guildford, UK
| | | | - Simon Briscoe
- Exeter Medical School, University of Exeter, Exeter, UK
| | - Naomi Klepacz
- School of Health Sciences, University of Surrey, Guildford, UK
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Karen Mattick
- Exeter Medical School, University of Exeter, Exeter, UK
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Rusli KDB, Chua WL, Ang WHD, Ang SGM, Lau Y, Liaw SY. A hybrid systematic narrative review of instruments measuring home-based care nurses' competency. J Adv Nurs 2024; 80:2647-2671. [PMID: 37849066 DOI: 10.1111/jan.15904] [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: 05/10/2023] [Revised: 08/21/2023] [Accepted: 10/02/2023] [Indexed: 10/19/2023]
Abstract
AIM The aim of the study was to identify and synthesize the contents and the psychometric properties of the existing instruments measuring home-based care (HBC) nurses' competencies. DESIGN A hybrid systematic narrative review was performed. REVIEW METHODS The eligible studies were reviewed to identify the competencies measured by the instruments for HBC nurses. The psychometric properties of instruments in development and psychometric testing design studies were also examined. The methodological quality of the studies was evaluated using the Medical Education Research Study Quality Instrument and COSMIN checklist accordingly. DATA SOURCES Relevant studies were searched on CINAHL, MEDLINE (via PubMed), EMBASE, PsychINFO and Scopus from 2000 to 2022. The search was limited to full-text items in the English language. RESULTS A total of 23 studies reporting 24 instruments were included. 12 instruments were adopted or modified by the studies while the other 12 were developed and psychometrically tested by the studies. None of the instruments encompassed all of the 10 home-based nursing care competencies identified in an earlier study. The two most frequently measured competencies were the management of health conditions, and critical thinking and problem-solving skills, while the two least measured competencies were quality and safety, and technological literacy. The content and structural validity of most instruments were inadequate since the adopted instruments were not initially designed or tested among HBC nurses. CONCLUSION This review provides a consolidation of existing instruments that were used to assess HBC nurses' competencies. The instruments were generally not comprehensive, and the content and structural validity were limited. Nonetheless, the domains, items and approaches to instrument development could be adopted to develop and test a comprehensive competency instrument for home-based nursing care practice in the future. IMPACT This review consolidated instruments used to measure home-based care nurses' competency. The instruments were often designed for ward-based care nurses hence a comprehensive and validated home-based nursing care competency instrument is needed. Nurses, researchers and nursing leaders could consider the competency instruments identified in this review to measure nurses' competencies, while a home-based nursing care competency scale is being developed. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was required in this review.
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Affiliation(s)
- Khairul Dzakirin Bin Rusli
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wei Ling Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Seng Giap Marcus Ang
- Centre for Research in Aged Care, School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Ying Lau
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Chee JMP, Rusli KDB, Tan ZYA, Tan AJQ, Ang SGM, Lau ST, Seah B, Liaw SY. Perceptions of community care among nursing students: A cross-sectional study with implications to nursing workforce. NURSE EDUCATION TODAY 2024; 137:106162. [PMID: 38493587 DOI: 10.1016/j.nedt.2024.106162] [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: 09/29/2023] [Revised: 02/27/2024] [Accepted: 03/10/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND A shift of health care services towards community care has driven the need to develop the community care nursing workforce. However, challenges exist in attracting nursing graduates to a career in community care. AIM To examine perceptions of community care and placement preference among undergraduate nursing students across different years of study in a Singapore university. METHODS This study examined perceptions of community care and placement preference among undergraduate nursing students across different years of study. A cross-sectional study was conducted using the 'Scale on COmmunity care Perceptions' (SCOPE). RESULTS Only 31.3 % of the 501 nursing students who completed the survey preferred community care placement. They rated opportunities for advancement, work status and enthusiastic colleagues in community care with relatively lower scores in the SCOPE. Students' placement preferences and year of study were predictive factors of their perceptions of community care nursing. Students who indicated their placement preference in home-based care (p < 0.001) and intermediate long-term care (p < 0.05) reported significantly positive perceptions towards community nursing as compared to students who indicated acute care as their preferred placement. Despite pre-perceived ideas among the year 1 cohort, the community care placement within their course curriculum had an impact on year 2 to 4 students' perceptions of community care. CONCLUSIONS These findings identified key strategies to increase the community care nursing workforce which include promoting a better understanding of the role of a community nurse, providing quality community placement opportunities supported by preceptors who are good role models and fostering an optimistic career outlook and advancement in community nursing.
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Affiliation(s)
| | - Khairul Dzakirin Bin Rusli
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Clinical Research Centre, Block MD11 Level 2, 10 Medical Drive, 117597 Singapore, Singapore.
| | - Zheng Yang Abel Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Clinical Research Centre, Block MD11 Level 2, 10 Medical Drive, 117597 Singapore, Singapore
| | - Apphia Jia Qi Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Clinical Research Centre, Block MD11 Level 2, 10 Medical Drive, 117597 Singapore, Singapore
| | - Seng Giap Marcus Ang
- Centre for Research in Aged Care, School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia
| | - Siew Tiang Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Clinical Research Centre, Block MD11 Level 2, 10 Medical Drive, 117597 Singapore, Singapore
| | - Betsy Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Clinical Research Centre, Block MD11 Level 2, 10 Medical Drive, 117597 Singapore, Singapore
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Clinical Research Centre, Block MD11 Level 2, 10 Medical Drive, 117597 Singapore, Singapore.
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Maben J, Taylor C, Jagosh J, Carrieri D, Briscoe S, Klepacz N, Mattick K. Causes and solutions to workplace psychological ill-health for nurses, midwives and paramedics: the Care Under Pressure 2 realist review. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-171. [PMID: 38662367 DOI: 10.3310/twdu4109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background Nurses, midwives and paramedics are the largest collective group of clinical staff in the National Health Service and have some of the highest prevalence of psychological ill-health. Existing literature tends to be profession-specific and focused on individual interventions that place responsibility for good psychological health with nurses, midwives and paramedics themselves. Aim To improve understanding of how, why and in what contexts nurses, midwives and paramedics experience work-related psychological ill-health; and determine which high-quality interventions can be implemented to minimise psychological ill-health in these professions. Methods Realist synthesis methodology consistent with realist and meta-narrative evidence syntheses: evolving standards' reporting guidelines. Data sources First round database searching in Medical Literature Analysis and Retrieval System Online Database ALL (via Ovid), cumulative index to nursing and allied health literature database (via EBSCO) and health management information consortium database (via Ovid), was undertaken between February and March 2021, followed by supplementary searching strategies (e.g. hand searching, expert solicitation of key papers). Reverse chronology screening was applied, aimed at retaining 30 relevant papers in each profession. Round two database searches (December 2021) targeted COVID-19-specific literature and literature reviews. No date limits were applied. Results We built on seven key reports and included 75 papers in the first round (26 nursing, 26 midwifery, 23 paramedic) plus 44 expert solicitation papers, 29 literature reviews and 49 COVID-19 focused articles in the second round. Through the realist synthesis we surfaced 14 key tensions in the literature and identified five key findings, supported by 26 context mechanism and outcome configurations. The key findings identified the following: (1) interventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressors; (2) it is difficult to promote staff psychological wellness where there is a blame culture; (3) the needs of the system often override staff well-being at work ('serve and sacrifice'); (4) there are unintended personal costs of upholding and implementing values at work; and (5) it is challenging to design, identify and implement interventions to work optimally for diverse staff groups with diverse and interacting stressors. Conclusions Our realist synthesis strongly suggests the need to improve the systemic working conditions and the working lives of nurses, midwives and paramedics to improve their psychological well-being. Individual, one-off psychological interventions are unlikely to succeed alone. Psychological ill-health is highly prevalent in these staff groups (and can be chronic and cumulative as well as acute) and should be anticipated and prepared for, indeed normalised and expected. Healthcare organisations need to (1) rebalance the working environment to enable healthcare professionals to recover and thrive; (2) invest in multi-level system approaches to promote staff psychological well-being; and use an organisational diagnostic framework, such as the NHS England and NHS Improvement Health and Wellbeing framework, to self-assess and implement a systems approach to staff well-being. Future work Future research should implement, refine and evaluate systemic interventional strategies. Interventions and evaluations should be co-designed with front-line staff and staff experts by experience, and tailored where possible to local, organisational and workforce needs. Limitations The literature was not equivalent in size and quality across the three professions and we did not carry out citation searches using hand searching and stakeholder/expert suggestions to augment our sample. Study registration This study is registered as PROSPERO CRD42020172420. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172420. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129528) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Cath Taylor
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Justin Jagosh
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Daniele Carrieri
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Simon Briscoe
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Naomi Klepacz
- School of Health Sciences, University of Surrey, Guildford, UK
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) Wessex, Southampton, UK
| | - Karen Mattick
- University of Exeter Medical School, University of Exeter, Exeter, UK
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He Y, Guo Y, Guo X, Han N, Xin B, Wu Y, Wan Q, Shi P, Yang S, Ksebe W, Jiang W. Role function and job satisfaction of community nurses in China: A cross-sectional study. Nurs Open 2024; 11:e2109. [PMID: 38391101 PMCID: PMC10830912 DOI: 10.1002/nop2.2109] [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: 10/28/2022] [Revised: 07/11/2023] [Accepted: 01/11/2024] [Indexed: 02/24/2024] Open
Abstract
AIM To evaluate role function and job satisfaction, determine their relationship, and explore the factors influencing job satisfaction among community nurses in China. DESIGN Cross-sectional study. METHODS This study was conducted between March and June 2020 on a cluster random sampling of 302 community nurses from 24 community health centres and stations in Xi'an, China. Self-reported data were collected using the Demographics Questionnaire, Role Function of Community Nurses Questionnaire, and Job Satisfaction of Community Nurses Scale. Descriptive statistics, Pearson's correlation analysis, and multiple linear regression analyses were performed to analyse data. RESULTS Community nurses' main role function was organiser and manager (M = 2.56, SD = 0.987) and coordinator (M = 2.43, SD = 0.971). The lowest job satisfaction was for salary and benefits (M = 3.12, SD = 0.891) and personal development (M = 3.65, SD = 0.738). A positive correlation was found between the roles of caregiver, educator, navigator, and salary and benefits (p < 0.05) among community nurses. Multiple linear regression analyses indicated that monthly income and working experience in nursing explained 61.1% of the variance in job satisfaction.
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Affiliation(s)
- Yuxin He
- School of Nursing, Health Science CenterXi'an Jiaotong UniversityXi'anChina
| | - Yan Guo
- School of NursingShaanxi University of Chinese MedicineXianyangChina
| | - Xiaoyuan Guo
- School of Nursing, Health Science CenterXi'an Jiaotong UniversityXi'anChina
| | - Na Han
- Dongguan South Street Community Health Service CenterXi'anChina
| | - Bo Xin
- School of Nursing, Health Science CenterXi'an Jiaotong UniversityXi'anChina
| | - Yixin Wu
- School of Nursing, Health Science CenterXi'an Jiaotong UniversityXi'anChina
| | - Qiuyuan Wan
- School of Nursing, Health Science CenterXi'an Jiaotong UniversityXi'anChina
| | - Panpan Shi
- School of Nursing, Health Science CenterXi'an Jiaotong UniversityXi'anChina
| | - Shan Yang
- School of Nursing, Health Science CenterXi'an Jiaotong UniversityXi'anChina
| | - Waleed Ksebe
- School of Nursing, Health Science CenterXi'an Jiaotong UniversityXi'anChina
| | - Wenhui Jiang
- School of Nursing, Health Science CenterXi'an Jiaotong UniversityXi'anChina
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Polancich S, Miltner R, Montgomery A, Dick T, Poe T, Brown D, Patrician PA. Quality Matters: Examining the Impact of Nurse Staffing Challenges on Clinical Outcomes. J Healthc Manag 2023; 68:174-186. [PMID: 37159016 DOI: 10.1097/jhm-d-22-00170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
GOAL The purpose of this study was to examine nurse staffing while describing the relationships that exist in staffing and quality associated with nursing care during the COVID-19 pandemic, a significantly challenging time for nurse staffing. We examined the relationship between permanent registered nurse (RN) and travel RN staffing during the pandemic and the nursing-sensitive outcomes of catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSIs), falls, and hospital-acquired pressure injuries (HAPIs) and length of stay and compared the cost of CAUTIs, CLABSIs, falls, and HAPIs in fiscal years 2021 and 2022. METHODS We used a descriptive, observational design to retrospectively examine permanent nurse staffing volume and CAUTI, CLABSI, HAPI, and fall counts from October 1, 2019, to February 28, 2022, and travel nurse volume for the most current 12 months, April 1, 2021, to March 31, 2022. Descriptive statistics, Pearson correlation, and statistical process control analyses were completed. PRINCIPAL FINDINGS Pearson correlation showed a statistically significant, moderately strong negative correlation (r = -0.568, p = .001) between the active registered nurse full-time equivalents (RN FTEs) and average length of stay (ALOS), and a moderately strong positive correlation (r = 0.688, p = .013) between the travel RN FTEs and ALOS. Pearson correlations were not statistically significant, with low to moderate negative correlations for CAUTIs (r = -0.052, p = .786), CLABSIs (r = -0.207, p = .273), and falls (r = -0.056, p = .769). Pearson correlation for active RN and HAPI showed a moderately strong, statistically significant positive correlation (r = 0.499, p = .003). We observed common cause variation in CAUTIs and CLABSIs, with HAPIs and falls showing special cause variation via statistical process control. PRACTICAL APPLICATIONS Despite the challenges associated with the lack of available nurse staffing accompanied by increasing responsibilities including unlicensed tasks, positive clinical outcomes can be maintained by staff adherence to evidence-based quality improvement.
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Affiliation(s)
- Shea Polancich
- University of Alabama at Birmingham School of Nursing and University of Alabama at Birmingham Hospital, Birmingham, Alabama
| | | | | | - Tracey Dick
- University of Alabama at Birmingham School of Nursing
| | - Terri Poe
- University of Alabama at Birmingham Hospital
| | - Daran Brown
- University of Alabama at Birmingham Hospital
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Senek M, Robertson S, King R, Wood E, Ryan T. Should I stay or should I go? Why nurses are leaving community nursing in the UK. BMC Health Serv Res 2023; 23:164. [PMID: 36797705 PMCID: PMC9932396 DOI: 10.1186/s12913-023-09163-7] [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: 10/13/2022] [Accepted: 02/08/2023] [Indexed: 02/18/2023] Open
Abstract
Worsening working conditions for nursing workforce has seen a massive exodus of staff, particularly in community nursing in the UK. AIM The study aim was to map working conditions as well as identify differentiating characteristics of community nurses that intend to leave their profession. DESIGN Eligibility criteria were community nurses working in all 4 UK countries. All data was collected by means of a cross-sectional survey via the largest closed, private community nursing online-forum. Logistic regression was carried out to ascertain the effects of the variables on the intention to leave. RESULTS The total number of respondents was 533. Findings showed that one in two of all community nurses (≈46%) are reporting job dissatisfaction. Length of unpaid overtime per shift (odds increase by 30% for each hour of overtime), manager support, proportion of permanent staff, team size, shift length, travel mileage, worsened conditions in the last year and overall self-rated working conditions were differentiating factors between those that intended to leave the job. The proportion of permanent staff on the team and perceived lack of support from management best predicted the likelihood of leave rates. Our findings imply that low nurse retention will fuel an even higher exodus because job dissatisfaction is highest on teams with lowest permanent staff ratios. Poor management that is inept at supporting frontline staff means that the fundamental retention issues are exacerbated and will not stop the unprecedented crisis that is predicted to lead to a collapse of care provision in community settings. Nurses play a central role and are 'key' to delivering the much- desired patient-centred care' therefore their well-being and job satisfaction should become a priority for policymakers.
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Affiliation(s)
- Michaela Senek
- Division of Nursing & Midwifery, Department of Health Sciences, University of Sheffield, Sheffield, UK.
| | - Steve Robertson
- grid.11835.3e0000 0004 1936 9262Division of Nursing & Midwifery, Department of Health Sciences, University of Sheffield, Sheffield, UK
| | - Rachel King
- grid.11835.3e0000 0004 1936 9262Division of Nursing & Midwifery, Department of Health Sciences, University of Sheffield, Sheffield, UK
| | - Emily Wood
- grid.11835.3e0000 0004 1936 9262Division of Nursing & Midwifery, Department of Health Sciences, University of Sheffield, Sheffield, UK
| | - Tony Ryan
- grid.11835.3e0000 0004 1936 9262Division of Nursing & Midwifery, Department of Health Sciences, University of Sheffield, Sheffield, UK
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Identifying the Top Ten Unanswered Questions in Community Nursing: A James Lind Alliance Priority Setting Partnership in Community Nursing. ADVANCES IN PUBLIC HEALTH 2022. [DOI: 10.1155/2022/2213945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Community nurses deliver comprehensive nursing care to patients living outside of hospital settings and play a crucial role in meeting individual and public health needs. Research is essential in providing evidence-based care for patients; however, most community nurses are not research active, with few relevant studies and little funding for community nursing research. To address this, four National Institute for Health Research senior nurse researchers in England conducted a James Lind Alliance priority setting partnership in community nursing with the aim of raising the international profile of community nursing research through the identification of meaningful research priorities that matter to this community. Community nurses, patients, and carers were integral to the process, which aimed to identify the top ten unanswered questions to inform community nursing practice. The Priority Setting Partnership process utilised a coproduction, mixed-methods approach. It involved consultation meetings with stakeholder partners and nested quantitative surveys. The study ran from March 2020 until September 2021, and numerous unanswered evidence uncertainties were identified. The top ten priority questions included nursing and patient focussed issues, which reflect the complexity of care delivered to patients and the workforce pressures community nurses face. Findings reflect the views of community nurses, patients, and carers and highlight areas that need attention to ensure research is embedded within community nursing settings. Identification of the top ten priorities has provided an international platform for community nursing research. This must be sustained through engagement, collaboration, funding, and innovation and has widespread implications for developing the community nursing workforce and optimising the safety and quality of patient care.
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Sein Myint NN, Kunaviktikul W, Akkadechanunt T, Wichaikhum OA, Turale S. Development and psychometric testing of the Perceived Organizational Climate Scale for nurses. J Adv Nurs 2022; 78:3470-3482. [PMID: 35919016 DOI: 10.1111/jan.15401] [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: 10/21/2021] [Revised: 05/22/2022] [Accepted: 07/22/2022] [Indexed: 11/29/2022]
Abstract
AIM Retaining nurses on the job is vital, and their successful retention is related to the organizational climates (OC) of healthcare settings. The purpose was to develop and test the psychometric properties of the Perceived Organizational Climate Scale (POCS). DESIGN The methodologic research design was used by following the scale development strategies by DeVellis (2017). The conceptual framework for this study was based on the broader theoretical framework of the Competing Value Framework (CVF) of Quinn et al. (2015), the concept analysis and extensive literature review (1939-2018), and combined with the inductive qualitative data. METHODS A two-phase study of scale construction and psychometric testing was conducted for content validation, construct validation and internal consistency reliabilities of the instrument. An expert panel validated the 4-point scale, followed by exploratory factor analysis, the known-group approach and split groups. Data were collected from (1161) registered nurses in eight general hospitals across Myanmar from August 2019 to September 2020. RESULTS The 35 items with four essential dimensions: transformational climate, bureaucratic climate, team climate and strategic climate, explained almost 50% of the variation with all factor loading greater than .40. The internal consistency reliabilities of the instrument showed the Cronbach's alpha coefficient of .93, and the dimensions were from .82 to .85. As hypothesized, the known-group approach demonstrated that experienced nurses had higher mean scores than novices. The internal consistency reliabilities of the scale and dimensions across the splitting groups illustrated the stability. CONCLUSION This evidence supports this instrument as having satisfactory initial psychometric properties with a comprehensive picture of OC by its essential components contributing to an inclusive understanding of this climate globally. IMPACT This instrument can be used as an objective tool for evaluating OC as perceived by nurses in healthcare settings to inform improvements in working environments.
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Affiliation(s)
- Nwe Ni Sein Myint
- Department of Human Resources for Health, Ministry of Health, Nay Pyi Taw, Myanmar
| | | | | | | | - Sue Turale
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
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Webster B, Archibald D. Self-rostering, work-life balance and job satisfaction in UK nursing: a literature review. Nurs Manag (Harrow) 2022; 29:e2048. [PMID: 35880476 DOI: 10.7748/nm.2022.e2048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
Nursing vacancies are high across the UK, with some nurses considering leaving the profession. Evidence suggests that employers, including the NHS, need to be more flexible about working times to support employees' work-life balance and job satisfaction. Self-rostering is one approach that has the potential to enhance nurses' work-life balance and job satisfaction, enabling scope for greater autonomy. This could in turn lead to fewer nurses leaving the profession and contribute to making nursing more attractive as a career. This literature review focused on nurses in the NHS and found that self-rostering had a positive effect on their work-life balance and job satisfaction. However, a move to self-rostering can pose challenges and it should be assessed for suitability before implementation. Given the nursing vacancy crisis in the UK and many nurses' intentions to leave the profession, the potential benefits of self-rostering for nurses cannot be overlooked.
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Affiliation(s)
- Brian Webster
- intensive care, Ninewells Hospital, Dundee, Scotland
| | - Daryll Archibald
- School of Health Sciences, University of Dundee, Dundee, Scotland
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Rusli KDB, Fen OS, Speed S, Seah B, McKenna L, Ying L, Ying LS. Home‐based care nurses’ lived experiences and perceived competency needs: A phenomenological study. J Nurs Manag 2022; 30:2992-3004. [DOI: 10.1111/jonm.13694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/26/2022] [Accepted: 05/14/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Khairul Dzakirin Bin Rusli
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine National University of Singapore Singapore
| | - Ong Shu Fen
- APN & Speciality Nurse Department, Khoo Teck Puat Hospital, Yishun Health Singapore
| | - Shaun Speed
- Faculty of Health and Social Care, University of Chester Wirral University Campus Wirral United Kingdom
| | - Betsy Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine National University of Singapore Singapore
| | - Lisa McKenna
- School of Nursing and Midwifery, College of Science, Health and Engineering La Trobe University Melbourne Victoria Australia
| | - Lau Ying
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine National University of Singapore Singapore
| | - Liaw Sok Ying
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine National University of Singapore Singapore
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Abstract
Primary care (PC) nurses have challenges and barriers to professional development. This article describes how a Doctor of Nursing Practice Executive Leader Student Consulting Team identified PC nurses' challenges to engaging in professional development opportunities in a clinic at Eskenazi Health. The authors spotlighted and made suggestions for modifications of the professional development opportunities for PC nurses in the health care organization. Key points include how the team assessed for challenges, identified stakeholders for the process, and identified and tailored professional development opportunities for the PC nurses. [J Contin Educ Nurs. 2021;52(4):165-167.].
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