Nursing personnel's perceptions of the organizational climate in public and private hospitals in Spain

Evaluation of emergency nurses' knowledge of medical response in nuclear and radiological emergencies : a cross-sectional study

BACKGROUND

Evaluating emergency room nurses' knowledge of radiation protection, health effects, and decontamination procedures is crucial for preparedness in nuclear and radiological emergencies. This study aims to evaluate the level of knowledge among emergency nurses in Saudi Arabia regarding medical responses to nuclear and radiological emergencies.

METHODS

A multicenter cross-sectional study was conducted via a self-structured questionnaire with 15 true‒false questions divided into three domains, namely, radiation protection measures, radiation health effects, and decontamination procedures, each with five items and a possible score of 1 point per correct answer. The collected data were analyzed via descriptive and inferential statistics. The study followed the STROBE checklist for methodological rigor.

RESULTS

A total of 594 emergency nurses participated in this study, with the majority being young (64.50% aged ≤ 30), female (68.69%), bachelor's degree-holding (67.68%), single (63.64%), having ≤ 4 years of experience (56.06%), working in public health facilities (88.89%), and lacking training in medical response (85.35%). The mean knowledge scores for participants were highest for radiation exposure effects (3.27 ± 0.91), followed by radiation protective measures (2.32 ± 0.99), and lowest for decontamination procedures (1.46 ± 1.07). Overall knowledge was measured at a mean score of 7.06 ± 1.68, with 97.47% of the nurses categorized as having poor knowledge level. Nurses in private hospitals scored higher (7.77 ± 1.82) than those in public hospitals (6.97 ± 1.65) on overall mean knowledge (P = 0.034). Concerning findings include emergency nurses' misconceptions about the protection provided by dense materials, the effectiveness of increasing distance from a radiation source, and prioritizing decontamination of victims over life-saving measures. Additionally, they were unaware of the immediate symptoms following radiation exposure and misunderstood that the primary threat in a radioactive bomb event is the explosion rather than the radiation itself.

CONCLUSION

This study revealed poor knowledge among emergency nurses regarding medical responses to radiation emergencies and highlighted the critical need for enhanced and standardized training in radiation emergency preparedness among nurses. The gaps in knowledge identified in this study could significantly impact the effectiveness of healthcare responses in radiation emergency scenarios. Therefore, targeted educational interventions and policy changes are recommended to address these shortcomings.

Nursing Scheduling Mode and Experience from the Medical Teams in Aiding Hubei Province During the COVID-19 Outbreak: A Systematic Scoping Review of 17 Studies

INTRODUCTION

Due to COVID-19 outbreak, since January 24, 2020, national medical teams from across the country and the armed forces have been dispatched to aid Hubei. The present review was designed to timely summarize the existing frontline information about nursing scheduling mode with special focus on the length of shifts with the aim to contribute to improve the nurses' job satisfaction and the quality of nursing services.

METHODS

Articles from Jan 2020 to October 2020 were retrieved from China National Knowledge Infrastructure, Wanfang Data and Weipu Information, with the terms "COVID-19", "designated hospital", "Hubei-assisted", "makeshift hospital", "nursing", "nursing shift", "whole-system takeover" and variations of these, in the title and abstract fields and the Boolean combinations of these words as the retrieval strategy.

RESULTS

Seventeen journal articles have been included in the target field, from the nurses in aiding Hubei Province, four kinds of shift length, 2-hour (h), 3-h, 4-h and 6-h shift have been considered, the main nursing scheduling mode adopted in designated hospitals for COVID-19 patients was dynamic scheduling based on workload, flexible scheduling based on working hours, workload and the number of critically ill patients admitted, humanized scheduling based on the daily reported health status of the nurses, and professional-integrated scheduling according to the professional distribution of nurses on the basis of four-hour shift length, and in makeshift hospitals for mild patients, the scheduling mode was 6-h based correspondingly.

CONCLUSION

The descriptive results of the present systematic review shed light on the challenges and practical solutions of nursing scheduling mode in the context of cross-regional medical assistance. Additionally, the present systematic review could provide the academic community of nurses, nurse managers and administrators with baseline information and scientific productions from the content's points of view in the target field.

Association of Nursing Practice Environment on reported adverse events in private management hospitals: A cross-sectional study

AIMS AND OBJECTIVES

To examine the relationships between nurses' perceptions of their practice environment, other working conditions and reported adverse events in two private management hospitals.

BACKGROUND

Patient safety is influenced by knowledge, available resources and the context in which nursing care is provided. In this sense, it has been found that certain work environments (e.g., workload, nurse turnover level, patient-to-nurse ratio, nurse staffing, nurse manager ability) influence patient outcomes. The association between nursing practice environment and reported adverse events has not been explored in private management hospitals.

DESIGN

A cross-sectional study. The STROBE was selected as the checklist in this study.

METHODS

A total of 219 nurses were included in the study. This study was conducted from June 2018-June 2019 in Spain. Data were collected through questionnaires focusing on work conditions, reported adverse events (falls, medication errors, catheter-related sepsis and pressure ulcer) and Practice Environment Scale of the Nursing Work Index. Binary logistic regression analysis was performed to determine the factors influencing the occurrence of errors.

RESULTS

Nurses reported poor perception of the professional environment, and 62.1% reported having made at least one error in the previous year. Manager support and leadership and nurse-physician relations were the most favourable aspects of work environment. Medical-surgical units, rotating in the same shift and favourable work environment, were associated with more reporting of adverse events.

CONCLUSION

The factors of nursing practice (hospital area workload, staff rotating and perception of work environment) associated with reporting adverse events can be worked upon from the organisation and provided an opportunity for safety culture improvement and safer healthcare services.

RELEVANCE TO CLINICAL PRACTICE

Improving the nurse work environment may reduce adverse patient events in private management hospitals.

Is public healthcare healthy? The role of emotional exhaustion

Purpose

This study analyzes the mediating effect of emotional exhaustion between certain job demands (workload, role conflict, and influence at work) and employees' work attitudes (affective commitment and turnover intention) in public healthcare. Furthermore, it analyzes the moderating effect of possibilities for development and the degree of freedom at work between the above-mentioned job demands and emotional exhaustion.

Design/methodology/approach

A total of 512 healthcare professionals participated in the study. The data were analyzed using structural equation modeling and a hierarchical multiple regression analysis.

Findings

The results show that emotional exhaustion fully mediates the relationship between job demands (workload and role conflict) and work attitudes (affective commitment and turnover intention). Moreover, the possibilities for development and degree of freedom at work moderate the relationship between role conflict and emotional exhaustion.

Practical implications

Strategies should be designed to prevent employees from becoming emotionally exhausted and lead them to feel more motivated, which results in a more effective public healthcare service.

Originality/value

This study stresses the importance of analyzing the role of emotional exhaustion in the public healthcare context. It demonstrates the mediating role of this variable between several antecedents and consequences, and it analyzes whether other relevant variables can moderate the negative effects of emotional exhaustion.

Migration of Spanish nurses 2009-2014. Underemployment and surplus production of Spanish nurses and mobility among Spanish registered nurses: A case study

BACKGROUND

After the financial crisis of 2008, increasing numbers of nurses from Spain are going abroad to work.

OBJECTIVES

To examine the health and workforce policy trends in Spain between 2009 and 2014 and to analyze their correlation with the migration of nurses.

DESIGN

Single embedded case study.

DATA SOURCES

We examined data published by: Health Statistics, Organization for Economic Cooperation and Development (1996 to 2013); Ministry of Education, Culture and Sports (2006 to 2013); Ministry of Employment and Social Security (2009 to 2014); Ministry of Health, Social Services and Equality (1997 to 2014); and National Institute of Statistics (1976 to 2014). In addition to reviewing the scholarly literature on the topic in Spanish and English, we also examined Spanish mobility laws and European directives.

POPULATION

We used the Organization for Economic Cooperation and Development definition of "professionally active nurses" which defines practising nurses and other nurses as those for whom their education is a prerequisite for employment as a nurse. Moreover, we used the term "nursing graduate" as defined by Spanish Ministry of Education to describe those who have obtained a recognized qualification in nursing in a given year, the term "registered nurses" is defined by Spanish law as nurses registered in the Nurses Associations and "unemployed nurses" are those without work and registered as seeking employment.

RESULTS

A transformation of the Spanish health system has reduced the number of employed nurses per capita since 2010. Moreover, reductions in public spending, labour market reforms and widespread unemployment have affected nurses in two ways: first by increasing the number of applicants per vacancy between 2009 and 2013, and second, by an increase in casual positions. However, despite the poor job market and decreasing job security, the number of registered nurses and nursing graduates in Spain per year has continued to grow, increasing the pressure on the labour market.

CONCLUSIONS

Spain is transforming from a stable nursing labour market, to one that is increasingly producing nurses for foreign markets, principally in Europe. With its low birth rate, increased life expectancy and increasing rates of chronic disease, it is critical for Spain to have sufficient nurses now and into the future. It is important that there be continued study of this phenomenon by Spanish policy makers, health service providers and educators in order for Spain to develop health human resources policies that address the health care needs of the Spanish population.