Advanced nurse and midwife practitioners' experience of interprofessional collaboration when implementing evidence-based practice into routine care: An interpretative phenomenological analysis

AIM

To understand advanced nurse and midwife practitioners' experience of interprofessional collaboration in implementing evidence-based practice into routine care.

DESIGN

A qualitative interpretative phenomenological analysis.

METHODS

A purposeful sample of 10 Registered Advanced Nurse and Midwife Practitioners from a range of practice settings in the Republic of Ireland participated in semi-structured interviews over a 10-month timeframe. Interviews were transcribed verbatim and data were analysed using a multi-stage approach in line with guidance for interpretative phenomenological analysis.

RESULTS

Six superordinate themes emerged: Understanding of advanced practice; 'Treated as an equal and as a "nurse"'; Nursing management support; 'A voice to implement anything new'; Confidence and Emotional intelligence. These factors impacted interprofessional relationships and the extent to which advanced practitioners could implement evidence-based practice.

CONCLUSION

There is scope to improve advanced practitioners' ability to collaborate with the interprofessional team in implementing evidence-based practice into routine care.

IMPACT AND IMPLICATIONS

The study findings demonstrate that enhancing understanding of the advanced practice role; increasing organizational support for advanced practitioners and augmenting specific practitioner skills and attributes will increase their ability to collaborate effectively and implement evidence-based practice. Supporting advanced practitioners in this important aspect of their role will positively influence health outcomes for patients.

CONTRIBUTION TO THE WIDER GLOBAL CLINICAL COMMUNITY

As numbers of both nurse and midwife practitioners increase globally, this study provides timely evidence from a range of practice settings to guide the design of education programmes and policies governing advanced practice. Study recommendations have broad applicability to all healthcare professionals who are engaged in implementing evidence-based practice into routine care.

REPORTING METHOD

Consolidated criteria for reporting qualitative research (COREQ).

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

"It is Essentially About Treating Each Other Well": Insights from Faculty on Incivility in Nursing Education

STUDY BACKGROUND

Incivility in nursing educational institutions, which may be perpetrated by both students and faculty, is troubling given that such institutions have a mandate to prepare students for caring, relational nursing practice.

PURPOSE

The purpose of this study was to contribute to understanding nursing academic incivility through an examination of nursing faculty's perspectives on student and faculty incivility.

METHODS

The study was conducted using a mixed methods, descriptive, survey design with collection and analysis of quantitative and qualitative data. The sample consisted of 52 faculty members.

RESULTS

A large majority of faculty thought that incivility in the nursing academic environment is a problem, with most considering it to be a mild or moderate problem. Students acted unprofessionally by showing disrespect, displaying superiority, engaging in disruptive behaviors, or not taking responsibility for their role in their learning. Faculty acted unprofessionally by showing disrespect, displaying superiority, or not being supportive. Faculty perceived that stress, personality, failure to deal with incivility, and an attitude of entitlement contributed to incivility. They thought that educational interventions, policies, and an academic environment that is conducive to civility are needed to address the problem.

CONCLUSION

Until evidence is available to support the effectiveness of interventions for academic incivility, nursing educational institutions are encouraged to implement strategies suggested by faculty in this study.

Workplace Violence in Healthcare Settings: A Scoping Review of Guidelines and Systematic Reviews

Workplace violence in healthcare settings is alarmingly common and represents significant financial and human cost. The aim of this scoping review was to identify and summarize evidence on strategies to prevent and/or manage workplace violence in healthcare settings. Searches were limited to evidence-based clinical practice guidelines and systematic reviews published between 2015 and 2021. Multiple databases were searched and screened. Quality of the included guidelines and reviews was also assessed. Three guidelines and 33 systematic reviews were included. Both the Occupational Safety and Health Administration 2015 and Registered Nurses' Association of Ontario 2019 guidelines provided useful recommendations for building a comprehensive prevention program. Evidence-based risk assessment, prevention and management, and education and training are all central components. Regular reassessment and adjustment is required. Included reviews (n = 33) were grouped into five main categories: violence toward nurses (n = 10); violence toward healthcare workers in general (n = 8); violence in the emergency department (n = 5); violence related to mental health (n = 5); and measurement related to workplace violence (n = 5). Multicomponent interventions were often more effective than those applied in isolation. We found consistent support for certain strategies including education and training, post-incident debriefing, multidisciplinary rapid response teams, and environmental modifications; however, the strength of evidence and certainty of conclusions were limited across reviews. This scoping review found that strong leadership that cultivates and enforces a culture of inclusivity, support, and respect is a prerequisite for a successful workplace violence prevention program. Rigorous comparative effectiveness research testing interventions are needed.

Promoting Civility in the Workplace: Addressing Bullying in New Graduate Nurses Using Simulation and Cognitive Rehearsal

This evidence-based practice project implementation aimed to enhance new graduate nurses' abilities to address workplace bullying. A mixed educational methodology was used. Participants indicated applying learned behaviors to improve communication, peer relationships, teamwork, and patient safety and to address bullying. Civility ratings did not significantly increase from before to after the intervention, presumably because of high baseline ratings. Future research should identify sensitive and specific measures to detect bullying behavior changes.

The relationship among faculty-to-faculty incivility and job satisfaction or intent to leave in nursing programs in the United States

BACKGROUND

There have been numerous studies examining student-faculty and faculty-student incivility in nursing programs (Atmiller, 2012; Clark et al., 2021; Clark & Springer, 2010; Eka & Chambers, 2019; Tourangeau et al., 2014). Research on faculty-to-faculty incivility in nursing programs has been lacking.

PURPOSE

The purpose of this study was to determine if there was a relationship among faculty-to-faculty incivility, job satisfaction and intent to leave. Furthermore, this study examined the barriers to addressing incivility, the contributing factors to workplace incivility and strategies to improve workplace incivility.

METHODS

The initial sampling method used was a randomized stratified cluster sampling method. Due to a poor response rate the sampling process was changed to convenience sampling. The researcher collected data using The Workplace Incivility/Civility Survey. Additional questions were added to collect demographic data, incidences of incivility in the workplace, the physical and emotional response to these incidences, job satisfaction and intent to leave.

RESULTS

Data analysis showed that 50 % of the participants believe faculty-to-faculty incivility is a moderate to severe problem in their workplace. Furthermore, there is a negative correlation between faculty-to-faculty incivility and job satisfaction or faculty retention. Additional findings showed that 38.6 % of the participants had minimal to no confidence in addressing workplace incivility. Fear of professional or personal retaliation was the greatest barrier to addressing workplace incivility.

CONCLUSION

The current nursing faculty shortage has created a barrier to addressing the nursing workforce shortage. Universities and nursing programs need to address the factors that lead to decreased job satisfaction and faculty attrition with incivility being one of the factors.

Coworker abuse in healthcare: voices of mistreated workers

PURPOSE

The appalling abuse healthcare workers have endured from patients is long documented in the popular press and social media. Less explored in the healthcare management literature is workplace abuse that professional nurses experience from their coworkers.

DESIGN/METHODOLOGY/APPROACH

The authors use text-based first-hand accounts from nurses posting on Reddit (N = 75) to better understand the types and context of abusive acts endured by their coworkers in the contemporary healthcare setting. Each account is content analyzed using two raters, and thematic analysis is utilized to summarize findings.

FINDINGS

Findings indicate that nurse workplace abuse frequently targets new entrants to a work unit (e.g. recent grads), typically is ongoing, takes verbal and nonverbal forms, mainly stems from coworkers (i.e. lateral mistreatment), and frequently takes place in front of other coworkers, mainly in hospital settings.

PRACTICAL IMPLICATIONS

By applying the lens of mindfulness, healthcare organizations can transform these harmful interactions within the nursing profession. The authors offer administrators and frontline workers practical implications for mitigating workplace abuse, including reshaping the culture, bystander interventions and explicit leadership support.

ORIGINALITY/VALUE

First-hand accounts from nurses in the frontlines of healthcare provide a rich voice that reveals the reality of ongoing verbal and nonverbal peer abuse in hospitals and healthcare settings.

Creating respectful workplaces for nurses in regional acute care settings: A quasi-experimental design

AIM

To examine self-reported exposure and experiences of negative workplace behaviour and ways of coping of nursing staff before and after educational workshops.

DESIGN

A Quasi-experimental design.

METHOD/SETTING/PARTICIPANTS

Data were collected pre- /postworkshops using a structured questionnaire. Nurses (N = 230) from 12 units in four regional acute care hospitals were invited to complete a pre-intervention survey. Educational workshops were then implemented by the organization at two of the hospitals, after which, follow-up surveys were undertaken.

RESULTS

There were 74 responses in the pre-intervention and 56 responses in the postintervention time period. There were 111 participants who attended the educational intervention, 20% (n = 22) completed the follow-up survey. Participants were more likely exposed to work-related bullying acts and they used problem-focused coping strategies and sought social support as a way of coping when exposed to the negative behaviours. Overall, there was a decrease in both bullying and incivility experienced by participants; however, our findings were unable to establish that a statistically significant difference was made due to the implementation of the intervention.

STUDY REGISTRATION

Australian New Zealand Clinical Trials Registry (Registration No. ACTRN12618002007213; December 14, 2018).

The impact of horizontal violence on the individual nurse: A qualitative research study

AIM

Horizontal violence (HV) is a familiar term used in nursing. Certain populations of nurses are more susceptible to HV than others. Graduate nurses (nurses within their first 12 months of practice) are widely considered a vulnerable population in the profession and thus more at risk for HV. The purpose of this qualitative study was to explore how HV affects graduate nurses (GNs).

DESIGN

Inductive thematic analysis was used in the design of this study.

METHODS

Participants included eight Canadian GNs or Registered Nurses (RNs), all of whom had experience with HV in their first 12 months of practice. Data collection was done via one-on-one interviews.

RESULTS

Two main themes were revealed from the data collected - Toxic Nursing Culture and Fear. Several subthemes were also identified - cycle of violence, nurses eating their young, shame, drowning, isolation and vulnerability. The findings indicate that HV is prevalent in the first year of practice and is destructive to the mental health of the individual nurse. Horizontal violence poses a serious challenge for GNs entering nursing and is often touted as the reason new nurses leave the profession altogether.

CONCLUSION

This study highlighted the personal and professional challenges that are heightened for a GN when they experience HV in their first year of practice. These experiences emphasize the impact that HV can have on the mental health of nurses and their ability to deliver safe patient care.