[Relationships among Non-Nursing Tasks, Nursing Care Left Undone, Nurse Outcomes and Medical Errors in Integrated Nursing Care Wards in Small and Medium-Sized General Hospitals]

A comparative analysis of nurses' reported number of patients and perceived appropriate number of patients in integrated nursing care services

This study aimed to compare the number of assigned and appropriate patients per nurse in integrated nursing care service wards and analyze factors associated with the gap. For this cross-sectional secondary analysis, data were collected from surveys of 2312 nurses and institutional data from their affiliated 106 hospitals in Korea. We used the Wilcoxon signed-rank test and t-test to compare the number of patients assigned to nurses with the number they considered appropriate. We used ratio analysis for measuring the gap between these numbers, and robust regression to evaluate the factors affecting this gap. The results found an average gap of 1.45, indicating that the reported number of assigned patients per nurse was 1.45 times higher than the appropriate number. Gender, employment type, wage satisfaction, workload, overtime work, and hospital level of care were identified as factors associated with the gap. Findings suggest that the current nurse staffing standard should be revised to consider nurses' professional judgments of appropriate staffing levels and adopt policies that reduce nurses' workload.

Exploring the causes and consequences of non-nursing tasks among nurses in Jordan: An in-depth qualitative investigation

AIM

To investigate the perceptions of Jordanian nurses regarding Non-Nursing Tasks (NNTs) and their consequences, as well as the underlying factors that contribute to the occurrence of NNTs.

BACKGROUND

Nurses play a crucial role in providing high-quality patient care, but they often engage in NNTs, which can hinder their ability to deliver care effectively. Western countries have primarily conducted research on NNTs, while Middle Eastern countries such as Jordan have received limited attention. Expanding our understanding of NNTs is essential for improving nursing care.

METHODS

A qualitative-exploratory approach was adopted. The research was conducted at three hospitals in Amman, Jordan. A purposeful sampling approach was used to select the participant and a focus group-interview method was used to gather the data. The derived data were analyzed using a thematic analysis approach.

RESULTS

The final sample of this study included 38 participants. The findings highlighted that nurses often perform NNTs due to staff shortages and limited resources, as well as weaknesses in nursing administration and education. The finding also highlights the consequences of NNTs on nurses' professional lives, including impaired nursing care, physical and mental health strain, and a lack of efficiency and productivity.

CONCLUSIONS

The present study's results provide valuable insights into the impact of NNTs on nurses in Jordan. These findings underscore the need for healthcare stakeholders to actively address the issue of NNTs. It also emphasized the need for more explicit job descriptions and processes, along with support for nurses to fulfilling their responsibilities and prioritizing patient care.

A phenomenological study of the experiences of nurses working in integrated nursing care wards in Korea

BACKGROUND

This study aimed to understand the experiences of nurses working in the integrated nursing care service, a relatively recent addition to the Korean hospital infrastructure, to suggest ways in which to address their grievances and needs and improve their job satisfaction, thereby reducing turnover.

METHODS

This study adopted a qualitative approach to explore subjects' vivid experiences. Data were collected through in-depth interviews with 17 nurses with over one year of experience working in integrated nursing care wards. The main question asked was "Can you describe your experiences in the integrated nursing care ward?" All interviews were recorded, transcribed, and analyzed using Colaizzi's method for phenomenological research.

RESULTS

Six theme clusters were derived from the analysis: "distorted perceptions of the integrated nursing care ward," "challenges owing to distorted perceptions of the integrated nursing care ward," "loneliness and fighting alone," "being ridiculed," "practicing textbook holistic care," and "the satisfaction felt only in the integrated nursing care ward." For the overarching theme, we identified "Satisfaction in providing holistic care despite the challenges."

CONCLUSIONS

While working in the integrated nursing care ward, nurses practiced holistic nursing care, which in turn built their self-esteem. However, they experienced greater levels of stress as a result of misinformation. Therefore, dissemination of accurate information is necessary to correct public misunderstandings of the integrated nursing care wards. Further, adequate compensation and support systems are needed to relieve the stress nurses felt because of such misunderstandings. Additionally, nurses should be motivated to continue to provide quality care for the patients and take pride in their work. Future research should explore the physical and mental concerns of nurses working in integrated care wards.

Effectiveness of a virtual reality application-based education programme on patient safety management for nursing students: A pre-test-post-test study

AIMS

We aimed to develop a virtual reality-based smartphone application that improves patient safety competency among nursing students in terms of knowledge, attitudes and confidence in patient safety management. We also sought to evaluate the effects and utility of the application in improving patient safety competency.

DESIGN

A parallel, randomized controlled pre- and post-test trial was conducted to test the effects of knowledge, attitudes and performance confidence in patient safety management.

METHODS

Participants were randomly allocated to the experimental (n = 22), in which nursing students received a two-week mobile web-based training programme covering key topics in patient safety management or the control group (n = 22), in which nursing students received a training booklet. Participants completed a pre-test and two post-test questionnaires to assess the program's impact. The evaluation tools were patient safety management knowledge, attitude and patient safety management performance confidence scale. Data analysis was performed using descriptive statistics, homogeneity test for pre-test, unpaired t-test and repeated measures ANOVA.

RESULTS

Patient safety competency in the experimental group improved significantly in terms of knowledge (from 11.68 to 18.55, p < 0.000), attitude (from 3.38 to 4.01; p < 0.005) and performance confidence (from 3.93 to 4.52; p < 0.000) compared with the control group. Our findings suggest that mobile app-based education using virtual reality may be effective in enhancing patient safety management in nursing education.

Influence of the Team Effectiveness of Nursing Units on Nursing Care Left Undone and Nurse-Reported Quality of Care

The aim of this study was to identify the influence of nursing unit team effectiveness on nursing care left undone and nurse-reported quality of care. This was a cross-sectional study with a sample of 230 nurses working at general hospitals in South Korea. Data were collected in January 2023 using an online questionnaire. Nursing unit team effectiveness was measured, consisting of the following sub-scales: leadership of the head nurse, cohesion, job satisfaction, competency of nurses, work productivity, and coordination. Multiple regression analyses were used to assess relationships between nursing unit team effectiveness and nursing care left undone and nursing-reported quality of care. Among these sub-domains, the study found that the higher the coordination (β = -0.22, p < 0.001), the significantly lower the nursing care left undone. The higher the competency of nurses (β = 0.26, p < 0.001) and work productivity (β = 0.20, p < 0.001), the higher the nurse-reported quality of care. In addition, nursing care left undone had a negative effect on nurse-reported quality of care (β = -0.15, p < 0.001). Therefore, nursing managers should make efforts to manage team effectiveness in nursing units to improve nurse-reported quality of care.

[Pathway Analysis on the Effects of Nursing Informatics Competency, Nursing Care Left Undone, and Nurse Reported Quality of Care on Nursing Productivity among Clinical Nurses]

PURPOSE

Nursing informatics competency is used to manage and improve the delivery of safe, high-quality, and efficient healthcare services in accordance with best practices and professional and regulatory standards. This study examined the relationship between nursing informatics competency (NIC), nursing care left undone, and nurse reported quality of care (NQoC) and nursing productivity. A path model for their effects on nursing productivity among clinical nurses was also established.

METHODS

Data were collected using structured questionnaires answered by 192 nurses working in a tertiary hospital located in J city, Korea, and analyzed using SPSS/WIN 23.0 and AMOS 21.0 program.

RESULTS

The fit indices of the alternative path model satisfied recommended levels χ² = .11 (p = .741), normed χ² (χ²/df) = .11, SRMR = .01, RMSEA = .00, GFI = 1.00, NFI = 1.00, AIC = 18.11. Among the variables, NIC (β = .44, p < .001), NQoC (β = .35, p < .001) had a direct effect on nursing productivity. Due to the mediating effect of NQoC on the relationship between NIC and nursing productivity, the effect size was .14 (95% CI .08~.24). Meanwhile, nursing care left undone through NQoC in the relationship between NIC and nursing productivity, has a significant mediation effect (estimate .01, 95% CI .00~.03). The explanatory power of variables was 44.0%.

CONCLUSION

Education and training for enhancing NIC should be provided to improve nursing productivity, quality of care and to reduce missed nursing care. Furthermore, monitoring the quality of nursing care and using it as a productivity index is essential.

Clinical Application Value of Group-Sharing Nursing Management Based on Case Analysis

The purpose of this study was to explore the clinical application value of group sharing nursing management based on a case analysis. The archive data of 90 nurses in 15 nursing units of our hospital were analyzed retrospectively. A total of 90 nurses from 15 nursing units in our hospital were retrospectively analyzed: the nurses before the implementation of the “case study-based group shared care management” program from January 2019 to January 2020 were set up as the control group, and the same nurses after the implementation of the program from January 2020 to January 2021 were set up as the study group. The nurses in the study group and the control group corresponded to 9759 and 8973 clinical inpatients, respectively. The overall incidence of medication-related, falling, tube-related, exam-related, and other types of adverse events was lower in the study group (0.52% vs. 1.29%) than those in the control group (P < 0.05); the overall nursing adverse event rating was lower in the study group than that in the control group (P < 0.05). Nurses in the study group scored higher than the control group on the following scales: Perceived Occupational Benefit Scale, General Self-Efficacy Scale, and Karlausk/Miller Satisfaction Scale (P < 0.05). The case study-based group-shared care management model can reduce the risk and harm of adverse events in hospitals and improve nurses' sense of professional benefit and self-efficacy.

Emotional Labor, Burnout, Medical Error, and Turnover Intention among South Korean Nursing Staff in a University Hospital Setting

Nurses are vulnerable to mental health challenges, including burnout, as they are exposed to adverse job conditions such as high workload. The mental health of this population can relate not only to individual well-being but also to patient safety outcomes. Therefore, there is a need for a mental health improvement strategy that targets this population. This cross-sectional survey study investigates emotional labor, burnout, turnover intention, and medical error levels among 117 nursing staff members in a South Korean university hospital; it also analyzes correlations among outcomes and conduct correlation analysis and multiple regression analysis to determine relationships among these factors. The participants had moderate to high levels of emotional labor and burnout, and 23% had experienced medical errors within the last six months. Save for medical errors, all outcomes significantly and positively correlated with each other. These results can be used to improve the mental health outcomes of nurses working in the hospital and their consequences. Specifically, the job positions of nursing personnel may be a major consideration in such a strategy, and job-focused emotional labor and employee-focused emotional labor may be promising targets in ameliorating turnover intention and client-related burnout, respectively.