Self-reflection and critical thinking: the influence of professional qualifications on registered nurses

Investigating perceived core disaster competencies of nurses in Iran: A case study of northwest hospitals

AIM

This study was carried out to investigate the perception of the main competencies of disaster management in Iranian emergency department nurses in 2023 in hospitals affiliated with Kermanshah University of Medical Sciences. The present study was conducted to explore the perceived core disaster competencies in nurses of hospitals affiliated with Kermanshah University of Medical Sciences in 2023.

BACKGROUND

Due to the rise in natural disasters, their escalating severity and associated regulatory response necessitate a closer look at the preparedness and core competencies of nursing personnel. The main competencies of nurses are necessary to deal with disasters in unexpected events, and they are expected to use their professional expertise to provide the required nursing services to reduce the risks caused by disasters.

METHODOLOGY

This descriptive-analytical study was conducted cross-sectionally between May and September 2023. In the study, a sample of 384 nurses working in the departments of four hospitals affiliated with Kermanshah University of Medical Sciences was selected through a random stratification. The data collection instrument was a 45-item scale of nurses' perceived core competencies (NPDCC) in handling disasters. The data were analyzed using the Mann-Whitney U-test, Kruskal-Wallis test, and independent samples t-test. The significance level was set at 5%.

RESULTS

The mean total score of perceived core disaster competencies was 139.11 ± 37.65. The technical skills subscale got the highest score (51.81 ± 11.28) and critical thinking skills received the lowest (9.74 ± 3.92). Also, "technical skills" had the highest average and "critical thinking skills" had the lowest average in all three age groups. The results found a significant difference between the scores of nurses in perceived core disaster competencies in age groups, work environments, education degrees, marital statuses, and experiences of attending disaster workshops (p ≤ 0.05).

CONCLUSIONS

The results showed that nurses had different levels of core disaster competencies in the department. There are gaps in the core disaster nursing competencies that need to be filled. Nursing managers should consistently evaluate the core nursing competencies to achieve efficacious disaster preparedness. To this aim, it is recommended that authorities implement training courses and programs to enhance the preparedness of nurses in responding to disasters.

Assessment of Differential Perceptions of Core Nursing Competencies between Nurse Managers and Nursing Graduates: A Cross-Sectional Study

BACKGROUND

The literature review on perceptions of nursing competencies shows a critical shortage of studies addressing this topic.

AIM

To examine and compare perceptions of important nursing competencies of nursing graduates, and nurse managers.

METHODS

A cross-sectional study was conducted among 148 students, who were recent graduates of the nursing school with RN degrees and had completed advanced training lasting 3 months at the Sheba Academic School of Nursing and the Academic School of Tel Aviv-Yafo, and 183 nurse managers with at least one year of seniority in the position in hospitals and community clinics in Israel. The recruitment and data collection of the nurse managers lasted 12 months, from July 2021 to July 2022, and for nursing graduates, two months, from June 2022 to July 2022. An online questionnaire was constructed and validated by five professional and experienced individuals in the research domains for adequate content validity. The questionnaire consisted of 47 items in total. Domains included: (1) professionalism in research; (2) skills for direct treatment; (3) support and communication; (4) professional knowledge; (5) personal abilities; and (6) critical thinking and innovation.

RESULTS

Overall, 331 valid questionnaires were collected (85% response rate). The difference in the nurse's research professionalism index was found to be statistically significant with a higher rating given by nurse managers, p = 0.003. However, the difference in the direct treatment index of nurses was found to be statistically not significant, p = 0.610, between newly graduated nurses and nurse managers. The independent sample t-test indicated a significant difference with a higher rating among nurse managers in the nurse's support and communication index, p = 0.020; professional knowledge index, p < 0.001; personal abilities index, p < 0.001; and critical thinking index, p = 0.006, between newly graduated nurses and nurse managers.

CONCLUSION

Nursing education programs aimed at training future nurses with core competences should include a curriculum designed to promote the acquisition of these six core competences leading to a congruence between the role expectations of nurse managers and those of newly graduated nurses.

The Effect of Holistic Nursing Competence on Work Engagement, Self-Reflection and Insight in Nurses

This study aimed to examine the effects of holistic nursing competence on work engagement, self-reflection and insight in nurses. This descriptive and cross-sectional study was conducted with 309 nurses working in Turkey. Data were collected using the "Descriptive Information Form", "Holistic Nursing Competence Scale (HNCS)", "Utrecht Work Engagement Scale (UWES)", and "Self-Reflection and Insight Scale (SRIS)". Pearson correlation analysis and multiple linear regression analysis were used to analyze the data. We found that the HNCS had a moderate positive relationship (r = 0.411, p < 0.05) with the UWES, and a weak positive relationship (r = 0.324, p < 0.05) with the SRIS. In the model established by multiple regression analysis, the effect of the HNCS, age, marital status, position, and performing the profession willingly on work engagement explained 33.7% of the variance. In another established model, the effect of the HNCS, gender, and having children on self-reflection and insight explained 11.5% of the variance. Our findings revealed the effect of holistic competence on nurses' positive attitudes about their work engagement and self-reflection in practice. We recommended developing awareness-based programs for nurses to increase their holistic nursing competence.

Relationship between Nurses Reflection, Self-efficacy and Work Engagement: A Multicenter Study

Introduction

Reflection is considered an essential element in nurses' practice with different positive outcomes, we decided to determine the level of nurses' reflection and then assess the relationship between nurses' reflection with their self-efficacy and work engagement.

Methods

In this cross-sectional study, a total of 240 nurses were selected from seven educational hospitals affiliated with Tabriz University of medical sciences (Iran). The stratified random sampling method was used to select the participants from hospitals. Data were collected through three questionnaires including Groningen Reflection Ability Scale (GRAS), Sherer's General Self-Efficacy Scale (SGSES), and Utrecht Work Engagement Scale (UWES). Data were analyzed using SPSS version 13.

Results

According to the results, the mean (SD) score of nurses' reflection was calculated as 86.51 (8.17) out of 115. The mean (SD) score of nurses' self-efficacy was 60.89 (11.11) out of 85. Moreover, the mean (SD) total score of nurses' work engagement in a possible range of 0 to 6 was 3.39 (1.36). There was a positive and significant relationship between the total reflection score with work engagement and self-efficacy scores.

Conclusion

According to the results, nurses working in different units showed different scores of reflection. Moreover, the results of the present study showed that nurses' reflection is associated with nurses' work engagement and self-efficacy. Therefore, nurse managers and nurse educators should improve nurses' skills in reflection and they should support the reflective practice in clinical settings.

Medical students' reflective capacity and its role in their critical thinking disposition

BACKGROUND

Developing reflective capacity and critical thinking is one of the prerequisites of education in health professions, especially medicine. This study aimed to determine the reflective capacity of medical students and its role in their critical thinking disposition.

METHODS

In this cross-sectional descriptive research, conducted in 2022, a total of 240 medical intern students were selected using the convenient sampling method. Data were collected using a reflective capacity questionnaire and critical thinking disposition questionnaire and analyzed with descriptive and inferential statistics using SPSS20.

RESULTS

The mean reflective capacity was 4.53 ± 0.50, and mean critical thinking disposition was 127.52 ± 10.85. Among the dimensions of reflection, "active self-appraisal (SA)" and "reflective with others (RO)" had the highest and lowest means, respectively. The dimensions of critical thinking disposition with the highest and lowest means were related to innovation and intellectual maturity, respectively. Reflective capacity and its dimensions were found to have a direct and statistically significant relationship with critical thinking disposition and its dimensions. Regression analysis results showed that reflective capacity accounts for 28% of students' critical thinking disposition.

CONCLUSION

The relationship between students' reflective capacity and their critical thinking disposition has rendered reflection as one of the necessary components of medical education. Thus, determining the learning activities by considering the reflection process and models will be very effective in creating and strengthening critical thinking disposition.

Constructing a critical thinking evaluation framework for college students majoring in the humanities

Introduction

Education for sustainable development (ESD) has focused on the promotion of sustainable thinking skills, capacities, or abilities for learners of different educational stages. Critical thinking (CT) plays an important role in the lifelong development of college students, which is also one of the key competencies in ESD. The development of a valuable framework for assessing college students' CT is important for understanding their level of CT. Therefore, this study aimed to construct a reliable self-evaluation CT framework for college students majoring in the humanities.

Methods

Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Item analysis were conducted to explore the reliability and validity of the CT evaluation framework. Six hundred and forty-two college students majoring in the humanities were collected. The sample was randomly divided into two subsamples (n1 = 321, n2 = 321).

Results

The Cronbach's alpha coefficient for the whole scale was 0.909, and the values of the Cronbach's alpha coefficients for individual factors of the scale ranged from 0.724 to 0.878. Then CFA was conducted within the scope of the validity study of the scale. In this way, the structure of the 7-factor scale was confirmed. Results indicated that the constructed evaluation framework performed consistently with the collected data. CFA also confirmed a good model fitting of the relevant 22 factors of the college students' CT framework (χ²/df = 3.110, RMSEA = 0.056, GFI = 0.927, AGFI = 0.902, NFI = 0.923, and CFI = 0.946).

Discussion

These findings revealed that the CT abilities self-evaluation scale was a valid and reliable instrument for measuring the CT abilities of college students in the humanities. Therefore, the college students' CT self-evaluation framework included three dimensions: discipline cognition (DC), CT disposition, and CT skills. Among them, CT disposition consisted of motivation (MO), attention (AT), and open-mindedness (OM), while CT skills included clarification skills (CS), organization skills (OS), and reflection (RE). Therefore, this framework can be an effective instrument to support college students' CT measurement. Consequently, some suggestions are also put forward regarding how to apply the instrument in future studies.

Critical thinking abilities among newly graduated nurses: A cross-sectional survey study in China

AIM

The aim of this study is to describe critical thinking dispositions among newly graduated nurses with different educational background in China and to explore related factors.

DESIGN

A cross-sectional questionnaire survey.

METHODS

The data were collected using the Chinese Version of Critical Thinking Dispositions Inventory (CTDI-CV). Overall, 588 newly graduated nurses finally completed the survey. Spearman and Pearson's correlation coefficients were used to examine the correlation between the CDTI-CV and nurses' general characteristics.

RESULTS

In terms of open-mindedness, analysis and inquisitiveness subscales, significant differences were found among nurses based on three educational level. When dichotomizing total CTDI scores into high and low, nearly 80% of the respondents fell into low score group. Pressure from workplace was high for 68.4% of them. Significant correlation was found among the new graduated nurses' critical thinking ability and their age, education level, reading habit and attitude towards nursing profession.

Modelling the Effect of Age, Semester of Study and Its Interaction on Self-Reflection of Competencies in Medical Students

Objectives: Accurate self-assessment and -reflection of competencies are crucial skills for all health professions. The National Competence-Based Learning Objectives Catalogue (NKLM) guiding medical faculties in Germany points out reflection as a non-technical skill and competency-based medical education (CBME) as important approaches. In this context, the role and structure of curricula and skills labs evolved. Especially in peer-assisted trainings, reflection of competencies is important to improve self-regulated learning. Traditionally, we assume self-reflection skills to evolve automatically with learners’ experience. This approach aims to find empirical evidence for this assumption and implements self-reflection of competencies in clinical skills education. Here, we quantify the influence of age and semester of study and its interaction on the concordant self-reflection of students’ own competencies. Methods: Investigation was based on a retrospective analysis of evaluation data from peer-assisted “first aid” and “physical examination” courses in the skills labs of the medical faculty at the Ruhr-University Bochum, Germany. Participants were asked for self-assessed competencies before (pre) and after (post) the course. Additionally, they were asked to retrospectively re-rate their “before” competencies after completing the course (post-pre). Differences between pre and post-pre competencies were assessed as the concordant self-reflection in a moderated regression analysis. Group means and standard deviation were depicted using univariate analysis of variance (ANOVA) with post-hoc Tukey HSD testing in IBM SPSS Statistics V.28. Moderated regression and simple slope analyses were conducted to calculate interaction effects of age and semester of study on the concordant self-reflection. Results: As expected, participants (n = 168) showed significant progress in subjective self-assessment (pre vs. post) in all 18 assessed domains in the course (all p < 0.001). Additionally, participants self-assessed their previous competencies after the course (post-pre) differently than before the course (pre) in 11 out of 18 domains. Hereby, the interaction of age and semester of study explained a significant part of variance in the first aid course (∆R2 = 0.008, ∆F (1;1020) = 8.53, p < 0.005) and in the physical examination course (ΔR2 = 0.03, ΔF (1;10,280) = 10.72, p < 0.001). Conclusions: We quantified that interaction of age and semester has a significant influence on concordant self-reflection skills using a moderated regression analysis. Assumed as an indicator, we conclude that advanced and older students show less differences in pre- vs. post-pre-ratings. This has implications for curriculum development, postulating that an exposure to self-reflection as a metacognitive process should be introduced early in order to train competencies in health professionals. Prospective studies with competency-based assessments are necessary to validate findings.

Self-Actualization and the Integration of Psychedelic Experience: The Mediating Role of Perceived Benefits to Narrative Self-Functioning

There is a growing need in the field of psychedelic science for a unifying perspective of overall well-being to join seemingly disparate findings across clinical and non-clinical populations, and account for the unique role of post-psychedelic integration for promoting benefits. According to the eudaimonic perspective of well-being, the stories we create about who we are (self-insight) and who we can become (personal development) are key aspects of narrative self-functioning that either constrain or facilitate well-being. The present paper draws upon this perspective to investigate the relationship between extent of post-psychedelic integration and optimal well-being ( self-actualization), with perceived benefits to narrative self-functioning ( self-insight and personal development) as a mediator. The data for testing this model was collected from roughly 750 participants recruited from websites and social media forums. Because the sample contained clinical and non-clinical individuals, the model was able to be tested with mental health condition as a moderator. Results indicated that perceived benefits to narrative self-functioning is one pathway through which integration of psychedelic experience may promote optimal well-being for both clinical and non-clinical populations. Exploratory analyses indicated that integration techniques that are more self-referential in nature are the ones that indirectly relate to optimal well-being via perceived benefits. The results of the present study should be interpreted as a preliminary model for future longitudinal research to test, as our cross-sectional methods preclude any causal inferences to be made from these mediation analyses.

Quality of nursing care in Saudi's healthcare transformation era: A nursing perspective

BACKGROUND

The Kingdom of Saudi Arabia corporates performance improvement strategies in health sector to transform hospital operations and instituting a culture of quality through performance improvement initiatives. Quality of nursing care (QNC) is a concern for nursing professionals and administration. Donabedian's 'Quality-of-Care' framework plays a vital role in transforming nursing care and determining appropriate intervention development and implementation plans.

AIM

To explore the nurses' perception for the QNC and find their perspectives in achievements and gaps by adopting the Donabedian model.

METHODS

A cross-sectional study was conducted on a convenience sample of 639 nurses from a tertiary hospital in Saudi Arabia using Karen-personnel instrument for measuring QNC. The achievements and gaps in nursing care quality determined by redistributing Karen statements to the three dimensions of the Donabedian structure, process and outcome model.

FINDINGS

The nurses' overall perception of the QNC was positive. According to the Donabedian model, the nurses focussed on care procedures (i.e., process-oriented) and required resources (i.e., structure-oriented), although the transformation era requires nurses' performance to focus on the outcome dimension.

CONCLUSION

To activate the vital roles of nurses in accomplishing health transformation initiatives, there should be collaborative efforts among nursing managers, educators and policy-makers to sustain quality of structure, process and outcome-oriented nursing care and be more outcome-oriented.

Identifying the core competencies of backup nurses in the acute care hospital through a modified Delphi process†

Background

The backup nurses are created to meet emergencies in the case of inadequate nursing staff and emergency circumstances, and there are no clear definitions of the core competencies for training and evaluation of backup nurses in the acute care hospitals in China.

Methods

This study used a modified Delphi process where an initial list of potential competencies is established following a framework of training need analysis (TNA), literature review, and focus groups. This process generated as a list of 47 core competencies, which is presented to an expert panel (n = 20) for consideration in two rounds.

Results

As determined by the survey, a combination of 26 core competencies in three specified categories is identified: professional practice ability, critical thinking ability, and interpersonal skills. A total of 154.99 h is required to complete all 26 core competencies, and each item has a corresponding evaluation method.

Conclusions

The core competencies provide a scientific basis for the hospital nursing managers to train and evaluate backup nurses, and it may ensure consistency in standards across the country.

Development of Critical Reflection Competency Scale for Clinical Nurses

Critical reflection develops nurses’ critical thinking and clinical reasoning competency. It is necessary to develop a validated scale to measure critical reflection competency considering the clinical situation and nursing context. Therefore, this study analyzed the concept of critical reflection, developed a scale to measure critical reflection competency, and verified its validity and reliability. The concept of critical reflection and components of the scale were confirmed through literature review and results of previous studies on content analysis. A total of 64 preliminary items were derived on a 5-point Likert scale. The adequacy of vocabulary and expression was checked, and a content validity test was conducted. An I-CVI value of 0.88–1.00 was computed. Construct validity was conducted through an exploratory factor analysis, and data collected from 296 clinical nurses were analyzed. Five factors and nineteen items were derived, and the explanatory power was found to be 53.02%. Cronbach’s α of the scale was 0.853. Future studies need to develop a critical reflection education program and utilize this concept as an educational strategy. We propose a study to verify the effect of applying an educational program using the critical reflection competency scale developed in this study.

The development of self skills in an authentic learning environment: A qualitative study

Background

The contemporary healthcare environment is an authentic, demanding, challenging and ever-changing environment that requires learners to possess good self skills when they need to engage in meaningful, critical discourse in order to solve authentic problems. However, nurse educators assume that learners already have well-developed self skills at the commencement of their nursing training and as a result do not explicitly teach and develop such skills in the learners.

Objectives

The objectives of this research were to explore and describe nurse educators’ views on how learners’ self skills can be developed within an authentic learning (AL) environment, and to formulate recommendations based on the findings.

Method

A qualitative and contextual research design was used to seek rich, in-depth data from 20 nurse educators who were purposively sampled. Semi-structured individual interviews were conducted, and the data were analysed using Miles, Huberman and Saldaña method.

Results

The three themes that emerged were that nurse educators should (1) ensure an AL environment that promotes self skills, (2) engage learners in activities that will consciously evoke authentic self and (3) evaluate the developed self skills and metacognition.

Conclusion

By developing good self skills, learners should be able to deliver quality patient care, find solutions to complex problems and handle cognitive complexity and authentic conditions whilst creating their own identity.

Nursing students' risk perceptions related to medication administration error: A qualitative study

AIM

The purpose of this study was to explore and describe pre-licensure nursing students' perceptions of risk for medication administration errors in fourth-year baccalaureate student nurses from three campuses at a large central Pennsylvania university.

BACKGROUND

Medication administration errors continue to be a significant safety concern in healthcare settings. Pre-licensure nursing education is a critical time period during which to have an impact on future medication administration practices. Perception of risk influences decision making and behavior, including nursing clinical decision making.

DESIGN

This descriptive, exploratory study involved a qualitative design.

METHODS

A thematic analysis of the qualitative data resulting from 60 individual, in-depth semi-structured interviews was conducted.

RESULTS

The participants offered rich, detailed narratives which revealed the following themes: (1) the nature of risk perceptions, (2) more opportunities to learn, (3) experiences with medication administration error, and (4) intrinsic characteristics influence errors.

CONCLUSIONS

The findings provide a broad description of the nature of student nurse risk perceptions for future medication administration errors. Recommendations for nursing education practice and pedagogy include additional clinical experiences, modified pharmacology curricula and instruction, and expanded simulations involving medication administration error.

Home-based nursing care competencies: A scoping review

AIMS AND OBJECTIVES

To identify and consolidate the available evidence about nursing-related competencies for home-based care.

BACKGROUND

Over recent years, the demand for home-based nursing care has increased because of the need to meet the increasing need for chronic disease care to be delivered in patients' homes. However, knowledge is lacking about the expected competencies for home-based care nurses.

DESIGN

A scoping review was conducted in accordance with Arksey and O'Malley's six-step scoping review framework and the PRISMA-ScR guidelines. The review identified literature using five electronic databases (CINAHL, PubMed, Embase, Cochrane and Scopus) and a hand search for grey literature in relevant home-based care journals and online searches. Key search terms and inclusion and exclusion criteria were used as strategies to identify relevant articles.

RESULTS

Sixty-four articles were eligible for inclusion. Mapping and narrative synthesis of 116 elements related to home-based nursing care competencies identified the following 10 competencies: (1) care assessments; (2) performance of nursing procedures; (3) management of health conditions; (4) critical thinking and problem-solving skills; (5) interpersonal relationships and communication; (6) interdisciplinary collaboration; (7) leadership and resource management; (8) professional development; (9) technological literacy; (10) quality and safety.

CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE

This review provides insight into current knowledge about home-based nursing care competencies. These competencies could be used to evaluate nurses' competence level for home-based care or for development of appropriate professional education. The review also outlines the scope of nursing practice in home-based care, which provides support for some form of standardisation of home-based nursing care expectations across various stakeholders.

Critical thinking among clinical nurses and related factors: A survey study in public hospitals

AIMS AND OBJECTIVES

The study investigated clinical nurses' critical thinking levels in public hospitals and related factors.

BACKGROUND

Since health care environments have become more complex, the critical thinking skills of clinical nurses are more important in daily problem-solving and decision-making processes. However, little research was conducted on this topic among clinical nurses.

METHODS

It was a cross-sectional study at five public hospitals between December 2018 and January 2019. The study followed the STROBE guideline. Data were collected from 559 nurses by a survey consisted of a data form and the Turkish version of the Nursing Critical Thinking in Clinical Practice Questionnaire.

RESULTS

Nurses' mean critical thinking scores were moderate level. Total critical thinking scores of the clinical nurses significantly differed according to education, hospital type, shift work, professional category and role. There was a significant effect on the total critical thinking scores of the clinical nurses according to variables.

CONCLUSION

This study found that critical thinking levels of nurses' working in clinical settings in public hospitals were moderate level. Hospital type, shift work, professional and educational level and role were significantly associated with clinical nurses' critical thinking levels.

RELEVANCE TO CLINICAL PRACTICE

This study provides evidence related to the levels of critical thinking of clinical nurses working in public hospitals. Since the critical thinking scores of the manager nurses, daytime working nurses' and nurses with bachelor's and master's degree education are higher, hospital managers may benefit from the study to implement effective strategies to improve the competence of critical thinking levels of nurses.

The effect of abusive supervision on safety behaviour of Chinese underground miners: a multi-level moderated mediation analysis

Purpose

Prior research has suggested that abusive supervision has negative impacts on various work outcomes. However, little attention has been paid to the relationship between abusive supervision and employees’ safety behaviour. The purpose of this study is, therefore, to address these limitations by developing and testing a theoretically based conceptual model that explicitly considers the underlying mechanism and boundary condition of the relationship between abusive supervision and safety behaviour of underground coal miners in China.

Design/methodology/approach

At Time 1, the authors conducted a survey of 630 employees to assess their supervisors’ abusive leadership behaviours, their own power distance beliefs and their self-reflection. At Time 2, the authros sent questionnaires to the leaders and invited them to evaluate employees’ safety behaviour in the workplace. After cleaning the survey data, the authors tested our model using a multi-level analysis on a sample (n = 458) of underground miners across 96 coal mining sites in China.

Findings

The authors propose that abusive supervision decreases employees’ safety compliance/participation by reducing reflection but strengthening rumination. The authors further find that the linkage from abusive supervision to reflection/rumination to safety compliance/participation is affected by power distance.

Originality/value

To the best of the authors’ knowledge, This is one of the first empirical studies to investigate the mediating effects of a deep cognitive processing variable – namely, self-reflection – and the moderating effects of power distance on the relationship between abusive supervision and safety behaviour.

Storytelling Through Music: A Multidimensional Expressive Arts Intervention to Improve Emotional Well-Being of Oncology Nurses

PURPOSE

Rates of burnout among health care professionals are rising. Oncology nurses are at the forefront of cancer care, and maintenance of their well-being is crucial to delivering high-quality care to people with cancer. The purpose of this pilot study was to implement a novel intervention, Storytelling Through Music, and examine the effects on depression, insomnia, loneliness, self-awareness, self-compassion, burnout, secondary traumatic stress, and compassion satisfaction in oncology nurses.

METHODS

This two-group (intervention and control), quasi-experimental study of a 6-week intervention combined storytelling, reflective writing, songwriting, and stress management skills.

RESULTS

Participants (N = 43) were predominately white (98%), with 27% reporting Hispanic ethnicity, and female (95%); their average oncology experience was 8.5 years. Both groups improved significantly over time on all measures. Compared with the control group, participants in the intervention group also had significantly less loneliness (F[3, 98] = 7.46; P < .001) and insomnia (F[3, 120] = 5.77; P < .001) and greater self-compassion (F[3, 105] = 2.88; P < .05) and self-awareness (F[3, 120] = 2.42; P < .10).

CONCLUSION

There are few opportunities for health care professionals to reflect on the impact of caregiving. The Storytelling Through Music intervention provided a structured space for reflection by participants, individually and among their peers, which decreased loneliness and increased self-compassion. Both factors relate to the burnout that affects the oncology health care workforce.

Factors associated with the critical thinking ability of professional nurses: A cross-sectional study

Aim

To measure the level of critical thinking among Vietnamese professional nurses and to identify the related factors.

Design

A cross‐sectional design was used.

Methods

The total sample included 420 professional nurses. Data were collected from July to September 2019 in three public hospitals located in Southwestern Vietnam. The level of critical thinking was measured using the Vietnamese version of the Nursing Critical Thinking in Clinical Practice Questionnaire. The data were analysed using the independent Student's t tests, ANOVA, Pearson's correlation and regression analysis.

Results

Most of the participants had a low (48.3%) or moderate (45.5%) level of critical thinking. Age, gender, ethnicity, education level, health condition, duration of working as a nurse, duration of working in the current hospital, having heard the term “critical thinking” and work position had an impact on the critical thinking ability. Work position and gender explained 11% of the total variance in critical thinking ability.

Patient safety. Factors for and perceived consequences of nursing errors by nursing staff in home care services

AIM

To identify factors for and perceived consequences of nursing errors by nursing staff in home care services in correlation with qualification, work experience, working hours and trainings.

BACKGROUND

Patient safety has increasingly been brought into focus of politics and care practices over the past few years. However, little evidence has been provided yet on nursing errors in out-of-hospital settings.

DESIGN

A cross-sectional study.

METHODS

Randomized sample of 107 home care services and 656 nurses and nursing assistants recruited from all 16 federal states in Germany.

RESULTS

Missing trainings on error management within the past 2 years were identified to be an important factor for mistakes regarding hygienic measures and medication administration. However, most errors arose in documentation without any significant differences in qualification, work experience, training and working hours.

CONCLUSION

Findings indicate that insufficient hygiene and medication administration might be reduced by implementing error management trainings on a regular basis in home care services.

Levels, antecedents, and consequences of critical thinking among clinical nurses: a quantitative literature review

The purpose of this study was to obtain a more comprehensive understanding of critical thinking within the clinical nursing context. In this review, we addressed the following specific research questions: what are the levels of critical thinking among clinical nurses?; what are the antecedents of critical thinking?; and what are the consequences of critical thinking? A narrative literature review was applied in this study. Thirteen articles published from July 2013 to December 2019 were appraised since the most recent scoping review on critical thinking among nurses was conducted from January 1999 to June 2013. The levels of critical thinking among clinical nurses were moderate or high. Regarding the antecedents of critical thinking, the influence of sociodemographic variables on critical thinking was inconsistent, with the exception that levels of critical thinking differed according to years of work experience. Finally, little research has been conducted on the consequences of critical thinking and related factors. The above findings highlight the levels, antecedents, and consequences of critical thinking among clinical nurses in various settings. Considering the significant association between years of work experience and critical thinking capability, it may be effective for organizations to deliver tailored education programs on critical thinking for nurses according to their years of work experience.

The relationship between perceived difficulty and reflection in the practice of discharge planning nurses in acute care hospitals: A nationwide observational study

AIMS AND OBJECTIVES

To clarify the characteristics and practice of discharge planning nurses in acute care hospitals and to elucidate the relationship between subjective difficulty perceived in practice and reflection.

BACKGROUND

The importance of discharge planning for an effective transition from the hospital to a care facility is increasing. In acute care hospitals, however, it is not clear what discharge planning nurses are doing for patients who are highly dependent on medical treatment, the subjective difficulties they perceive in practical activities, and whether reflection by nurses can be expected to mitigate those difficulties.

DESIGN

Cross-sectional survey.

METHODS

This survey was conducted in 2,379 acute care hospitals in Japan from 1 June-30 June 2018. The survey of discharge planning practice activities examined nine factors. A nurse who answered that he/she did reflect on his/her practices was defined as a self-reflecting nurse. The STROBE statement checklists were completed.

RESULTS

Questionnaires were collected from 760 respondents (response rate = 32.1%). The discharge planning nurses had fewer than 36 months of experience with discharge planning. Among the nurses who had been involved in hospital discharge support for 13 months or more, the self-reflecting nurses had fewer perceived difficulties in their practice activities than the non-self-reflecting nurses did.

CONCLUSIONS

It was shown that discharge planning nurses with 13 months or more of experience and who practiced reflection on their practical activities perceived less subjective difficulty. Reflection in daily practice may mitigate the subjective difficulty of practical activities experienced by discharge planning nurses, and the establishment of an effective training method that promotes such reflection is required.

RELEVANCE TO CLINICAL PRACTICE

In the future, it will be necessary to construct and evaluate an effective education programme for discharge planning nurses that includes self-reflection on practice cases.