Influence of Core Competence on Voice Behavior of Clinical Nurses: A Multicenter Cross-Sectional Study

An integrative systematic review of employee silence and voice in healthcare: what are we really measuring?

The history of inquiries into the failings of medical care have highlighted the critical role of communication and information sharing, meaning that speaking up and employee silence have been extensively researched. However, the accumulated evidence concerning speaking-up interventions in healthcare indicates that they achieve disappointing outcomes because of a professional and organizational culture which is not supportive. Therefore, there is a gap with regard to our understanding of employee voice and silence in healthcare, and the relationship between withholding information and healthcare outcomes (e.g., patient safety, quality of care, worker wellbeing) is complex and differentiated. The following integrative review is aimed at addressing the following questions; (1) How is voice and silence conceptualized and measured in healthcare?; and (2) What is the theoretical background to employee voice and silence?. An integrative systematic literature review of quantitative studies measuring either employee voice or employee silence among healthcare staff published in peer-reviewed journals during 2016-2022 was conducted on the following databases: PubMed, PsycINFO, Scopus, Embase, Cochrane Library, Web of Science, CINAHL and Google Scholar. A narrative synthesis was performed. A review protocol was registered on the PROSPERO register (CRD42022367138). Of the 209 initially identified studies for full-text screening, 76 studies met the inclusion criteria and were selected for the final review (N = 122,009, 69.3% female). The results of the review indicated the following: (1) concepts and measures are heterogenous, (2) there is no unifying theoretical background, and (3) there is a need for further research regarding the distinction between what drives safety voice versus general employee voice, and how both voice and silence can operate in parallel in healthcare. Limitations discussed include high reliance on self-reported data from cross-sectional studies as well as the majority of participants being nurses and female staff. Overall, the reviewed research does not provide sufficient evidence on the links between theory, research and implications for practice, thus limiting how research in the field can better inform practical implications for the healthcare sector. Ultimately, the review highlights a clear need to improve assessment approaches for voice and silence in healthcare, although the best approach to do so cannot yet be established.

Tests on a scale for measuring the core competencies of paediatric specialist nurses: An exploratory quantitative study

AIM

This study aimed to develop a tool to measure paediatric specialist nurses' core competencies and examine the scale's validity and reliability.

DESIGN

An exploratory quantitative study.

METHODS

This study was performed in April 2022 with 302 paediatric specialist nurses in mainland China. Items were created through a literature review, a qualitative interview, and the Delphi method. The data were evaluated using descriptive statistics, independent sample t-test, explanatory factor analysis, Pearson correlation coefficient, Cronbach's alpha coefficient and split-half reliability.

RESULTS

The final scale consisted of five factors and 32 items. The factors were communication, coordination and judgement abilities; professional technology mastery ability; specialist knowledge mastery ability; medical-related processes; and evidence-based nursing competencies. The explained total variance of the five factors was 62.216%. The scale-level and item-level CVI of this scale was 1.00, and the mean CVR of the total scale was 0.788. The Pearson correlation coefficients of each dimension and the total dimension of the scale was 0.709-0.892, and within each dimension, it was 0.435-0.651. The Cronbach's α of this scale was 0.944, and its split-half reliability was 0.883.

A CiteSpace-Based Analysis of the Development Trends Affecting Clinical Research Nurses in China: A Systematic Review

OBJECTIVE

To examine the developmental characteristics and trends affecting clinical research nurses (CRNs) in China and provide a reference for the training and employment of nursing talents in this specialty.

METHODS

Literature pertaining to CRNs published from the year in which the database was constructed to 2020 was searched. The databases used were the China National Knowledge Infrastructure, Wanfang, Chinese Biomedical Literature and Weipu, while CiteSpace software was used to conduct a bibliometric analysis of literature quantity, annual distribution, literature journals and regional distribution, literature authors, subject funding status and literature type and keywords. The characteristics and trends affecting CRNs in China were then evaluated using a descriptive analysis.

RESULTS

A total of 3735 pieces of literature were retrieved, and after deduplication and screening, 199 pieces of literature were retained for this study. Overall, the number of publications increased year-on-year. Of these publications, 17 papers (8.5% of the retained papers) were published in the Chinese Journal of Modern Nursing and 9138 papers (69.3%) were published in the top 10 regions according to the location of the first author (of these, 31 [15.6%] were published in Beijing and 42 [21.1%] were funded by scientific research funds). The research fell mainly in the experience summary category, with 107 articles (53.8%) taking this approach. The top five research hotspots were clinical research, good clinical practice (GCP), research nurses, management and clinical trials. The practice and exploration of CRNs were regionalised, accounting for varying degrees of development. CRNs were found to be at the forefront of developments in oncology specialties.

CONCLUSION

In China, CRNs are currently in a period of rapid development. Research into CRNs mainly involves single-centre studies and lacks financial support. In the future, it will be necessary to increase capital investment, strengthen cross-regional cooperation between authors and institutions to narrow the regional development gap, and promote strict and standardised CRN training models and qualification certification to improve the quality of clinical research nursing.

Operating theatre nurses' with managerial responsibility: Self-reported clinical competence and need of competence development in perioperative nursing

Aim

The aim of this study was to investigate operating theatre nurses (OTNs) with managerial responsibility, and their self‐rated clinical competence and need for competence development in perioperative nursing.

Design

A cross‐sectional study was applied using a modified version of Professional Nurse Self‐Assessment Scale of Clinical Core Competence I.

Method

Data were collected from 303 OTNs in Sweden, 80 of whom indicated that they had managerial responsibility. Statistics analysis was used to identify the relationships between background variables to compare OTNs with and without managerial responsibility and their need for competence development.

Results

OTNs with an academic degree and managerial responsibility self‐rated their clinical competence higher compared with OTNs without an academic degree. It also turned out that OTNs with RN education and 1‐year advanced nursing in theatre care, and master's 60 credits had a lower need for competence development in cooperation and consultation, professional development and critical thinking.