Nursing Now 2020: the Nightingale Challenge

Technology: A metaparadigm concept of nursing

Undoubtedly, technology continues to permeate the world at an unprecedented pace. The discipline of nursing is not alien to this phenomenon as nurses continue to employ various technological objects and applications in clinical practice, education, administration and research. Despite the centrality of technology in nursing, it has not been recognised as a metaparadigm domain of interest in the discipline of nursing. Thus, this paper sought to examine if technology truly reflected a metaparadigm domain using the four requirements posited by Fawcett. Using these requirements, we examined the onto-epistemology of technology in relation to nursing and conclude that technology potentially represents a distinct domain that intersects with nursing (particularly, from the humanities perspective). Also, technology encompasses some phenomena of interest to the discipline of nursing, demonstrates perspective-neutrality, and is international in scope and substance albeit with some nuances which do not fit well with nursing onto-epistemology. Put together, it is highlighted that technology intersects with the existing metaparadigm domains (person, health, environment and nursing) which positions it as a potential phenomenon of interest to the discipline of nursing requiring further work to articulate its position and role.

The image of nursing in the media: A scoping review

AIM

To systematically review the available evidence from research exploring the image of nurses in the media.

BACKGROUND

Nurses have historically faced many challenges and have received media attention for such efforts. However, the image of nursing traditionally conveyed by media has failed to represent the real character and a positive image of the nursing profession.

REVIEW METHODS

For this scoping literature review, a search was conducted in PubMed, CINAHL, Scopus, PsycINFO, Web of Science and Dialnet to identify studies written in English, Spanish or Portuguese from the earliest date in the databases until February 2022. Four authors were involved in a two-stage screening process. Data were subjected to quantitative content analysis. A decade-by-decade analysis was performed to track the evolution of the research.

RESULTS

Sixty studies were included. The analysis shows (1) an increasing interest in analysing the portrayal of nurses and nursing in media over time, especially from 2000 onwards; (2) a prevailing trend of focusing on one form of media when analysing the portrayal of nurses; (3) qualitative designs as the most frequent method for exploring the image of nursing; and (4) a predominantly negative image conveyed by media.

CONCLUSIONS

There is a notable body of scientific evidence about the image of nurses and nursing portrayed in media. The interest in analysing media depictions of nursing has a long history. The included studies' samples showed heterogeneity, as they were obtained from different media, periods and countries.

IMPLICATIONS FOR NURSING

This scoping review is the first systematic review to provide a comprehensive map of what has been studied thus far regarding media depictions of nursing. It confirms the imperative need for nurses in different settings (academic, assistance or management fields) to maintain a proactive attitude towards addressing images of nursing and ensuring accurate representations.

Nurse Managers' Involvement in Decision-Making and Associated Factors in Selected Government Hospitals, Addis Ababa, Ethiopia: A Cross-Sectional Study

Introduction

In the healthcare system, nurse managers' participation in decision-making was invaluable in preserving cost-effective service and safe patient care. Despite the fact that nurse managers have the power to ensure optimal health care service, their involvement in decision-making has not been well studied.

Objectives

To assess nurse managers' decision-making involvement and associated factors working in selected governmental hospitals in Addis Ababa, Ethiopia 2021.

Methods

A cross-sectional study was conducted among 176 nurse managers from government hospitals in Addis Ababa, with a response rate of 168 (95.5%). The total sample size is assigned in proportion. The technique of systematic random sampling was used. A structured, self-administered questionnaire was used to collect data, which was then checked, cleaned, entered into EPI Info version 7.2, and exported to SPSS software version 25 for analysis. In a binary logistic regression model analysis, a p-value < .25 was used as the cut-off point to consider variables as candidates for multivariable analysis. A p-value of .05 was used to determine the predictor variables with a 95% confidence interval.

Result

The mean age and standard deviation of the 168 respondents were 34.9 ± 4.1 years. More than half, 97 (57.7%), were excluded from general decision-making. Nurse managers in matron positions were 10 times more likely to participate in decision-making than head nurses (AOR = 10.00, 95% CI: 1.14-87.72, p = .038). Nurse managers who received managerial support were five times more likely to participate in good decision-making than nurse managers who did not receive managerial support (AOR = 5.29, 95% CI: 1.208-23.158, p = .027). Nurse managers who received feedback on their decision-making involvement had 7.7 times more good decision-making involvement than those who did not (AOR = 7.70, 95% CI: 2.482-23.911, p = .000).

Conclusion

According to the findings of the study, the majority of nurse managers were not involved in decision-making.

A modified Delphi study on establishing a curriculum content structure for the leadership and management competency cultivation for future nurse managers in China

Background

It is critical to train future nursing managers in advance for the prospective development of healthcare organizations, but a widely recognized curriculum content structure for leadership and management competency development for nurturing future nurse managers was lacking in China.

Objective

To establish a curriculum content structure for the leadership and management competency cultivation for future nurse managers in Chinese healthcare setting.

Methods

A modified Delphi study was conducted. 22 experts who have in-depth knowledge of nursing leadership and management from 4 main geographical regions in China were included. The initial curriculum content structure was constructed based on a previous qualitative study and two team meetings. Subsequently, a two-round Delphi survey was conducted with 22 panelists in the first round and 19 in the second round. Scores of importance and textual comments were collected and used to judge the achievement of consensus.

Results

After the two-round Delphi process, consensus was reached, as each item was rated ≥4 by 84.21-100% of the experts and each one had a coefficient of variance (CV) ≤ 0.174. The finalized curriculum content contains 9 modules and 27 items.

Conclusions

This study formed a curriculum content structure for leadership and management competency training for nurses preparing for managerial roles, which contribute to the establishment of a nursing management talent pipeline to meet the needs of healthcare institutions for contemporary nurse managers.

Calling as a resource for health and occupational wellbeing among the care sector workers in Finland

BACKGROUND

The salutogenic approach in workplace health promotion emphasizes resources to gain and maintain good health and wellbeing. One of these resources could be calling, but its relation to the salutogenic approach is unknown.

OBJECTIVE

To explore the associations between salutogenic measures of health and occupational wellbeing and calling among workers from the care and educational sectors.

METHODS

A cross-sectional survey was conducted in Autumn 2020 among Finnish public and private sector care workers. A total of 7925 workers responded. Descriptive analyses and analysis of variance were used for the data analysis.

RESULTS

Salutogenic measures of health and occupational wellbeing correlated strongly mutually, and both correlated moderately with calling. Workers aged over 55 years, workers acting in the education sector, workers with superior positions and temporary workers had the highest scores on health, occupational wellbeing and calling. When comparing occupational wellbeing dimensions by profession, managers had the highest scores and nurses the lowest.

CONCLUSIONS

This study provides knowledge of promotive factors and health and occupational wellbeing resources for workplace health promotion in the care sector. Perceived calling in work can be considered a salutogenic resource for overall health and wellbeing; however, these connections should be further studied.

Registered nurses' perceptions of their career - an interview study

AIM

To explore registered nurses' perceptions of their career.

BACKGROUND

Career development options have been found to increase attraction to nursing and support nurses' engagement with their organisation and profession.

METHODS

Qualitative individual interviews with 23 registered nurses; data analysed with thematic analysis and reported according to the COREQ criteria.

RESULTS

Three themes emerged: career choices, career engagement, and career development. Participants had chosen a nursing career because they perceived it as humane, people-oriented, meaningful, diverse and secure work. Participants' engagement in their career was connected to the content of the work, in which direct patient care was central. Nurses connected career development with high competency, independence, influence and meaningful working life experience. However, they perceived career development opportunities as minute within direct patient care.

CONCLUSIONS

Career development opportunities for nurses in direct patient care are needed to foster their career engagement and the attractiveness of the nursing profession. Further research is needed on the career planning and development of nurses working in patient care.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers must play a central role in engaging nurses in their careers and promoting their competency and career planning and development in organizations.

Developing a Leadership and Management Competency Framework for Nurse Champion: A Qualitative Study from Shanghai, China

AIM

To develop a leadership and management competency framework applicable to Chinese nurse champions guided by the competency matrix for clinical nurse leader (CNL).

BACKGROUND

As the clinical leaders and future nurse manager candidates in the Chinese clinical setting, nurse champions are in great need of leadership and management competency training, but it is unclear what content should be included in the training curriculum, a guiding framework applicable to Chinese nurse champions was needed to be constructed.

METHODS

This study used a qualitative descriptive design to explore nurse champions' competency requirements from clinical nurse managers' perspective. Semi-structure interviews guided by the CNL competency matrix were conducted with twenty-seven clinical nurse managers from six large-scale tertiary grade A hospitals in Shanghai, China. Interview transcripts were analyzed using deductive and inductive content analysis.

RESULTS

The data analysis yielded three main categories: nursing leadership, clinical outcome management and care environment management, containing fourteen subordinate themes, which represent the leadership and management competencies needed for nurse champions.

CONCLUSIONS

A leadership and management competency framework for Chinese nurse champion was built in this study, which covering the competencies needed by Chinese nurse champions to lead care teams, improve quality of care for patient outcomes, and enhance systems and equipment for the better care environment. This framework will be the direct basis for guiding the development of the nurse leadership curriculum for driving nurse champion to achieve role success.

IMPLICATIONS FOR NURSING MANAGEMENT

This framework provides a theoretical foundation for clarifying the role of nurse champion in clinical management. Training curriculum guided by this framework will help nurses in their clinical management role and share the burden of clinical nursing managers, as well as promote the development of a clinical nursing management reserve talents and support the future development of nursing staff in healthcare organizations.

Mixed methods systematic review: Factors influencing research activity among nurses in clinical practice

AIM

This study aimed to identify, evaluate and summarise current evidence in relation to the factors that influence the conducting of research by nurses in clinical practice.

DESIGN

This study used mixed methods systematic review.

DATA SOURCES

CINAHL, EMBASE, MEDLINE, Scopus and ASSIA, with dates limited from 2015 to 2020, were used to conduct a systematic search of the literature.

REVIEW METHODS

The Joanna Briggs Institute approach was followed, with results reported according to the Preferred Reporting System for Systematic Reviews and Meta-Analyses. The associated checklist for systematic reviews was also used. A standardised data extraction tool was then used, with quality appraisal guided by the Mixed Methods Appraisal Tool, with a subsequent convergent qualitative synthesis.

RESULTS

Sixteen papers were identified for inclusion, nine quantitative, six qualitative and one mixed methods. Four themes were identified: research competence and culture, proactive research mentorship, research resources and making a difference. These were critically discussed in relation to barriers and enablers to the conduct of research by nurses in clinical practice. Commonly cited barriers included a lack of research knowledge, confidence and access to resources, particularly protected time, while enablers such as educational partnerships, identifying research-motivated clinical nurses and access to research role models were also apparent in the literature.

CONCLUSIONS

Globally, nurses in clinical practice are clearly motivated to engage in the research process despite apparent barriers that have a significant impact on productivity. Nevertheless, there are also enablers to building research capacity apparent that offer methodological and structural approaches to empower this group to conduct research.

Obstetric nurse and the factors that influence care in the delivery process

OBJECTIVE

To identify the factors that influence the improvement of obstetric nurse care in the delivery process.

METHODS

Descriptive exploratory study with a qualitative approach conducted at a teaching maternity hospital located in the city of Salvador, Bahia, Brazil with 20 obstetric nurses from the Obstetric Center. Data was collected through semi-structured interviews between June and September 2017 and was then subjected to the Thematic-Categorical Content Analysis proposed by Franco.

RESULTS

Six categories emerged from the analysis, which presented factors that favor the improvement of obstetric care in the delivery process and factors unfavorable to this care. These factors address power and gender relations among health professionals; recognition of obstetric nurses; physical space and bed occupation; interaction between woman/ companion, among others.

FINAL CONSIDERATIONS

The factors indicated by obstetric nurses reveal the need for improvements in the working conditions by managers and changes of behavior and codes of conduct of health professionals.

The construction of contemporary nursing identity from narrative accounts of practice and professional life

OBJECTIVE

To explore the contemporary narrative of nursing identity in Spain.

METHOD

This qualitative study was conducted between 2018 and 2020. Eleven registered nurses were interviewed. The conversations were recorded in audio, were semistructured, and held in a mental health clinic affiliated with a Catholic institution. Narrative analysis of the data was carried out.

FINDINGS

Two themes were identified: How do I construct my professional life?, with the subthemes 'Training and initiation in care practice', 'Ways of living the professional care experience', 'The sculpting of care' and 'Self-image and future projection'; and What do I know about my practice?, with the subthemes 'Nursing experience: shift, days, years', 'Strategy in the field of nursing care', 'Some foundations of caregiving practice', 'The specificity of the gesture of care' and 'Voice and recognition of nursing within the institution'.

CONCLUSION

Contemporary nursing identity is built in reflections on the epistemology of care, confronting the weight of tradition and breaking into new modes of self-image where the profession is legitimized and projected from historical consciousness. This claim can be used to support reflective practice in academic and healthcare settings as well as to promote a paradigm shift.

Interdisciplinary collaboration between nursing and engineering in health care: A scoping review

BACKGROUND

Due to the rapid advancements in precision medicine and artificial intelligence, interdisciplinary collaborations between nursing and engineering have emerged. Although engineering is vital in solving complex nursing problems and advancing healthcare, the collaboration between the two fields has not been fully elucidated.

OBJECTIVES

To identify the study areas of interdisciplinary collaboration between nursing and engineering in health care, particularly focusing on the role of nurses in the collaboration.

METHODS

In this study, a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews was performed. A comprehensive search for published literature was conducted using the PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Web of Science, ScienceDirect, Institute of Electrical and Electronics Engineers Digital Library, and Association for Computing Machinery Digital Library from inception to November 22, 2020. Data screening and extraction were performed independently by two reviewers. Any discrepancies in results were resolved through discussions or in consultation with a third reviewer. Data were analyzed by descriptive statistics and content analysis. Results were visualized in an interdisciplinary collaboration model.

RESULTS

We identified 6,752 studies through the literature search, and 60 studies met the inclusion criteria. The study areas of interdisciplinary collaboration concentrated on patient safety (n = 18), symptom monitoring and health management (n = 18), information system and nursing human resource management (n = 16), health education (n = 5), and nurse-patient communication (n = 3). The roles of nurses in the interdisciplinary collaboration were divided into four themes: requirement analyst (n = 21), designer (n = 22), tester(n = 37) and evaluator (n = 49). Based on these results, an interdisciplinary collaboration model was constructed.

CONCLUSIONS

Interdisciplinary collaborations between nursing and engineering promote nursing innovation and practice. However, these collaborations are still emerging and in the early stages. In the future, nurses should be more involved in the early stages of solving healthcare problems, particularly in the requirement analysis and designing phases. Furthermore, there is an urgent need to develop interprofessional education, strengthen nursing connections with the healthcare engineering industry, and provide more platforms and resources to bring nursing and engineering disciplines together.