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Aim: The Organizational Learning Instrument–Development Stages (OLI‐DS) measure hospital units' readiness to engage in organizational learning. This study aimed to translate and evaluate the psychometric properties of the Persian version of this instrument. Background: Organizational learning is crucial for nurses as it enables them to continuously develop their knowledge, skills, and abilities, enhancing the quality of patient care. However, validated instruments are needed to assess organizational learning in Persian‐speaking healthcare settings. Design: The research was carried out using a cross‐sectional design. Methods: This research study involved 319 clinical nurses selected using convenience sampling. The OLI‐DS tool, consisting of 35 items, underwent a forward–backward translation process to Persian before being utilized for a psychometric analysis. The face, content, and construct validity were used to evaluate the tool's effectiveness. The quality and accuracy of the measurements were determined by calculating internal consistency and stability reliability. The data were analyzed using SPSS and AMOS software. Results: The intended meaning and clarity of the original English version were preserved in the Persian rendition of the OLI‐DS instrument. The confirmatory factor analysis (CFA) further confirmed the consistency of the Persian version with the proposed four‐factor model, indicating a good fit. The overall instrument had excellent values for Cronbach's alpha coefficient (α = 0.931), McDonald's omega (ω = 0.921), coefficient H (H = 0.979), and mean interitem correlation (ρ = 0.278). The convergent and discriminant validity of the four latent factors was found to be good. The stability of the overall OLI‐DS instrument was ICC = 0.942 (95% CI, 0.902–0.955). Conclusion: The Persian version of the OLI‐DS has been validated to evaluate hospital units' readiness for organizational learning processes. It is a robust tool for assessing their preparedness to participate in and benefit from organizational learning initiatives. Implications for Nursing Management: The robust psychometric validation of the Persian version of the OLI‐DS instrument equips nursing administrators and leaders with a reliable tool. This tool can assess and monitor organizational learning and development in healthcare settings, empowering them to make informed decisions in critical nursing management activities. [ABSTRACT FROM AUTHOR]

Introduction: Nurses, as frontline healthcare professionals, play a crucial role in ensuring patient safety, making their ability to speak up imperative. However, there are limited studies categorizing nurses based on their speaking‐up behaviors and comparing their organizational characteristics. This study aimed to identify patterns of nurses' speaking‐up behaviors and examine differences in organizational cultures, teamwork climates, and working conditions according to these patterns. Methods: A cross‐sectional survey was conducted, involving 597 nurses directly participating in nursing care in Korean hospitals. The Speaking Up about Patient Safety Questionnaire (SUPS‐Q), Nursing Organizational Culture Questionnaire, and Safety Attitude Questionnaire‐Korean version (SAQ‐K) were employed to measure nurses' speaking‐up‐related behaviors, organizational culture, teamwork climate, and working conditions. Cluster analysis was used to identify clusters of nurses based on their speaking‐up‐related behavior. Differences in nursing organizational culture, teamwork climate, and working conditions among clusters were analyzed using one‐way analyses of variance. Results: Three clusters of nurses were identified based on their speaking‐up‐related behaviors. Cluster 1 (35%) showed high perceived concerns, moderate withholding, and speaking up, while Cluster 2 (37%) had moderate concerns, low withholding, and high speaking up. Cluster 3 (28%) had moderate concerns but low withholding and speaking up. Clinical experience significantly differed among clusters, with less experienced nurses predominantly in Cluster 1. Cluster 2 had the most collaborative culture, best teamwork climate, and working conditions. Conclusion: Ensuring patient safety requires nurses to speak up about patient safety concerns. Creating safe working environments and fostering an organizational culture that prioritizes patient safety are essential steps in promoting nurses' willingness to speak up about patient safety. [ABSTRACT FROM AUTHOR]

Purpose: Nursing is a representative profession with a high prevalence of presenteeism, which is usually associated with negative outcomes. Therefore, it is important to explore the antecedent factors of nurse presenteeism behavior. This study aims to explore the impact and mechanism of head nurses' cognitive preference toward presenteeism on subordinate nurses' presenteeism (SNP), and the mediation effects of subordinate nurses' perception of head nurses' cognitive preference. Patient and Methods: A cross‐sectional study was conducted from July to August 2022. A total of 256 head nurses and 1424 subordinate nurses were recruited from six hospitals located in Zhengzhou, Henan Province, China. The Nurse Presenteeism Questionnaire (NPQ) and Cognitive Preference Questionnaire were used to assess head nurses' cognitive preference toward presenteeism, SNP, and subordinate nurses' perception of head nurse's cognition of presenteeism. We conducted description, multilevel correlation, and multilevel structural equation models for the data analysis. Results: In the past 6 months, 93.4% of nurses experienced presenteeism. Within and between the team, head nurses' cognitive preference toward presenteeism is positively associated with SNP. The mediation effect of nurses' perception of head nurses' cognitive preference was also significant. Conclusion: Head nurses' cognitive preferences are essential predictors of subordinates' presenteeism. In this process, subordinates' subjective initiative plays a crucial role. Implications for Nursing Management: Hospital managers should focus on head nurses' values to formulate multiple interventions of presenteeism and strengthen communication between leaders and subordinates to promote transforming negative outcomes into positive outcomes. [ABSTRACT FROM AUTHOR]

Background: When nurses feel that the learning processes in their organization are fair and just, they are more likely to feel confident about sharing their knowledge, expressing their concerns, and contributing to the learning process. Conversely, suppose employees perceive a lack of organizational justice. In that case, they may be less likely to speak up and share their valuable input due to concerns about unfair treatment or possible negative consequences. Objective: Nurses' silence and organizational learning may have a connection yet to be thoroughly investigated. We are exploring whether organizational justice mediates this relationship by improving nurses' perception of it and reducing silence among them. Methods: A study was conducted in Ardabil, Iran, to analyze the correlation between organizational learning, organizational justice, and organizational silence among 319 healthcare professionals from five hospitals. The study utilized three assessment tools: the organizational learning questionnaire, the organizational justice scale, and the organizational silence scale. The collected data were analyzed using IBM SPSS Statistics, and a structural equation model (SEM) was developed using the bootstrap method in AMOS 24.0 to test the proposed model. Results: Our study found a strong positive relationship between organizational learning and organizational justice and a significant negative correlation between organizational learning and silence. Also, there was a significant negative relationship between organizational justice and silence. SEM showed that organizational learning indirectly affects organizational silence through organizational justice as a mediator, explaining 72.3% of all variance in organizational silence. Conclusion: Our findings indicated that organizational learning is positively associated with justice but negatively associated with silence. When nurses experience organizational justice, they are less likely to remain silent. Encouraging nurses to share their opinions and concerns reduces silence and improves working conditions, morale, and patient care. Further research is needed to understand the complex interplay between organizational learning, justice, and silence in nursing settings. [ABSTRACT FROM AUTHOR]

Nursing staff turnover is an increasing problem for healthcare globally. In Sweden, the shortage of nurses in primary healthcare has increased significantly in recent years. This development is alarming because primary healthcare, both in Sweden and internationally, is responsible for a large part of healthcare. The aim of this study was to explore working conditions (change fatigue, leadership climate, and social support from colleagues) and characteristics of primary care nurses who are discontent with their current job, i.e., those with high turnover intentions and poor job satisfaction in Sweden. This was a cross‐sectional survey of 466 registered nurses working in Swedish primary healthcare. Data were analyzed using descriptive statistics and logistic regression. The results demonstrate that 21.1% of the responding nurses are discontent with their current job and have considered quitting. Being discontent had significant associations with poor leadership climate (p < 0.001), lack of social support from colleagues (p < 0.001), change fatigue (p < 0.001), poor health (p < 0.001), and working more than 40 h per week (p = 0.02). The results have implications for how healthcare organizations structure the work of nurses in primary healthcare and how they can attract and retain future staff to these workplaces. [ABSTRACT FROM AUTHOR]

Aim: This study aims to investigate the influence of medical explainable artificial intelligence (XAI) on the innovation behaviour of nurses, as well as explore the dual‐pathway mediating effect of AI self‐efficacy and AI anxiety and organizational ethical climate as the moderating effect. Background: To address the practical application of medical AI technology, alleviate the scarcity of medical resources and fulfil the medical and health demands of the public, it is crucial to improve the innovation behaviour of nurses through the use of medical XAI. Methods: A cross‐sectional survey was conducted involving 368 Chinese nurses working at tertiary and secondary hospitals in Anhui Province, Jiangsu Province, Zhejiang Province and Shanghai. Results: Implementing medical XAI significantly enhanced the innovation behaviour of nurses. Anxiety and self‐efficacy regarding AI mediated the connection between medical XAI and the innovation behaviour of nurses. Furthermore, the organizational ethical climate positively moderated the relationship between medical XAI and AI self‐efficacy. Conclusion: Medical XAI helps to enhance nurses' AI self‐efficacy and reduce AI anxiety, thereby enhancing nurses' innovation behaviour. An organizational ethical climate enhances the positive relationship between medical XAI and AI self‐efficacy. Implications for Nursing Management: Organizations and technology developers must augment the study about XAI and the system design of human‐centred AI technology. The organizations aim to enhance the education and training of nurses in AI, specifically focussing on boosting nurses' self‐efficacy in utilizing AI technology. Moreover, they want to alleviate nurses' fear of new technological advancements. Hospital administrators and leaders develop strategies to address the ethical atmosphere inside their organization. [ABSTRACT FROM AUTHOR]

Nurses in South Korea experience high work intensity and poor working environments, which worsened during the COVID‐19 pandemic. This study aimed to evaluate the work changes and grievances of nurses who provided direct care for patients at tertiary hospitals during the pandemic. The nurses' perceptions of their organizational culture and its impact on nurses' health were also explored. A three‐round Delphi study was conducted with 36 expert group participants from six South Korean tertiary hospitals. Overall, 36, 35, and 33 participants responded in the first, second, and third rounds, respectively. Nursing work was divided into three categories: "work related to COVID‐19‐positive and close contacts," "work related to COVID‐19 negative patients," and "work related to common nursing tasks." Organizational culture had the highest average for "increased compliance," followed by "increased conflict," "decreased collegiality," and "growing sense of community." The identified health problems of nurses during the pandemic were the highest for physical health, followed by mental and social health. These results showed that the workload and work intensity of hospital nurses increased significantly, and their physical, mental, and social health deteriorated during the pandemic. To overcome the crisis, the nursing organizational culture had a strong inclination to comply with the COVID‐19‐related guidelines with an increased sense of community. As conflicts between employees and departments grew, these were able to be overcome through trust and communication between departments, in which the nursing leadership played an important role. To protect the health and lives of people, it is important to secure skilled nurses in preparation for future disasters. In addition, support is needed to protect the safety and health of nurses and to cultivate effective nursing leadership. [ABSTRACT FROM AUTHOR]

Aims. To identify the factors influencing hospital nurses' workplace bullying experiences (victim and perpetrator aspects) focusing on meritocracy beliefs, emotional intelligence, and organizational culture. Background. Workplace bullying remains a major issue in nursing despite decades of research and policy‐making. Therefore, comprehensively understanding the individual and institutional factors affecting workplace bullying from both the victim and perpetrator perspectives is crucial. Methods. In October 2022, 379 nurses working in South Korean tertiary hospitals were surveyed using a self‐reported online questionnaire. Meritocracy beliefs, emotional intelligence, workplace bullying experiences, and nursing organizational culture were measured using the Meritocracy Belief Scale, Wong and Law Emotional Intelligence Scale, Negative Acts Questionnaire‐Revised, and Positive Nursing Organizational Culture Measurement Tool, respectively. Results. Gamma regression analysis revealed that, for workplace bullying, the factors influencing the victim aspect were the experience of witnessing bullying in the workplace, organizational culture, and meritocracy beliefs. In contrast, the factors affecting the perpetrator aspect were emotional intelligence, meritocracy beliefs, and experience of bullying at work. Conclusion. Decreasing nurses' degree of meritocratic hubris in a positive organizational culture and increasing their emotional intelligence are necessary to prevent and intervene in workplace bullying. Implications for Nursing Management. Targeted approaches are needed to address and mitigate the detrimental effects of factors influencing workplace bullying. These approaches could include interventions that improve nurses' emotional intelligence, assess their level of meritocracy beliefs, and offer opportunities for self‐reflection on meritocratic hubris. Such initiatives may be necessary to effectively tackle workplace bullying and promote a healthier nursing work environment. [ABSTRACT FROM AUTHOR]

Background: Negative leadership behaviour is very common and pervasive in nursing and healthcare, often leading to adverse effects such as nurses' silence, decreased job performance, and turnover. However, there is a lack of systematic reviews that summarize negative leadership types and nurses silencing behaviours. Aim: This systematic review examined the relationship between negative leadership behaviour and nurses' silence. Evaluation: We searched PubMed, Embase, the Cochrane Library, Web of Science, CNKI, VIP, and Wanfang databases from their inception until 30 April 2024 for articles examining the relationship between negative leadership and silent behaviour among nurses. The studies were reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. The risk of bias in the included studies was assessed using the Newcastle–Ottawa Scale. Key Issues: After full‐text analysis, six papers were included in this systematic review. Four of the studies were conducted with nurses, and the remaining two were conducted with all medical staff including nurses. While most studies have shown that negative leadership causes nurses to become increasingly silent, others have shown that appropriate negative leadership behaviour instead reduces nurses' silence. Conclusions: Negative leadership behaviour can affect the silent behaviour of nurses. Implications for Nursing Management: Hospitals need to take the initiative to build a harmonious and safe working environment, correctly recognize and identify negative management behaviour, take appropriate and effective measures to enhance the positive leadership of nurse managers, and make an effort to prevent nursing staff's exposure to the negative management of direct leadership and mental health threats, which is a key point that hospital administrators and health policymakers tend to overlook. This is also effective for enhancing the leadership of hospital administrators. [ABSTRACT FROM AUTHOR]

Background. Second victim experiences have long‐term impacts on the personal and professional well‐being of nurses. Individual‐centered support is necessary to help nurses cope with the various stages of the second victim experience. Objectives. To explore personal and workplace factors that facilitate or hinder coping styles for second victim experiences from the perspectives of both frontline nurses and nurse managers. Design. This was a descriptive qualitative study that incorporated semistructured interviews. Methods. Purposive sampling was employed to enlist a total of eight nurses and seven nurse managers selected from five tertiary hospitals located in Hunan Province, China. The study participants included nurses who had suffered second victim experiences and nurse managers who had grappled with their nurses' second victim experiences. The data were transcribed verbatim and analysed using thematic analysis. Results. The analysis revealed four main themes that influenced nurses' ability to cope with second victim experiences: source of emotional trauma, personal factors, job stress, and support system. In contrast, emotional trauma from patients and relatives, negative personal traits, shadows from the second victim experience, and unsupportive workplace environments were obstacles to coping with second victim experiences. Conclusion. The study highlights facilitators and barriers that nurses cope with second victim experiences, providing insight to develop targeted interventions that support nurses and mitigate the negative impacts of second victim experiences. A comprehensive approach is more effective in supporting nurses in coping with second victim experiences, improving patient safety, and enhancing the quality of care. [ABSTRACT FROM AUTHOR]

Aim. This study investigated the role of cultural, organizational, and managerial support, workplace fun, affective commitment, innovative behavior with innovative output, and also the mediating role of innovative behavior in the framework of a causal model. Background. Innovation is the driving force of development in hospitals, and the quality of healthcare is closely related to hospital innovation. Today, nurses with innovative behaviors are the biggest asset of any hospital because they are involved in any improvement and progress. Methods. This descriptive cross‐sectional correlational study was conducted using causal modeling methods, including path analysis and structural equation modeling. Using the proportional stratified sampling method, 321 nurses from Ardabil teaching hospitals were included in the study. Data were collected by standard demographic characteristics, innovative behaviors, innovative support, workplace fun, and affective commitment questionnaires. Partial least square structural equation modeling (PLS‐SEM) was used to test the conceptual model using PLS‐SMART 2 software. Results. Cultural support had a positive and significant effect on innovative behavior by affecting organizational support and then managerial support. In addition, workplace fun had a positive and significant effect on innovative behavior directly and indirectly through the mediating role of affective commitment. Finally, innovative behavior also had a positive and significant effect on nurses' innovative output. Conclusion. Supervisors and managers can adopt the organizational and managerial support approach to improve the nurses' innovative behaviors. Workplace fun will also improve nurses' innovative behaviors and affective commitment, thereby increasing their innovative output. Implications for Nursing Management. By adopting organizational and managerial support for nurses' innovative behaviors, managers should take measures that promote workplace fun and affective commitment to improve nurses' innovative output by encouraging innovative behaviors. [ABSTRACT FROM AUTHOR]

Background. Emotional responses and the ability to regulate emotions among nurses, especially first‐line nurse managers, can influence various workplace dynamics. However, there is a knowledge gap regarding emotional intelligence, job satisfaction, and organizational commitment among nurses in Qatar, particularly first‐line nurse managers. Objectives. The primary aim of this study is to determine if there is a significant relationship between emotional intelligence, job satisfaction, and organizational commitment among first‐line nurse managers (FLNMs) in Qatar. Design. This is a descriptive cross‐sectional correlational study. Settings. The research took place at Hamad Medical Corporation in Qatar. Participants. A total of 203 first‐line nurse managers participated in the study. Methods. Participants were recruited using a convenience sample method. Data were collected using the Genos Emotional Intelligence Inventory—Concise, the three‐component model Employee Commitment Survey, and the short‐form Minnesota Satisfaction Questionnaire (MSQ). Results. The findings showed that participants had average levels of emotional intelligence, job satisfaction, and organizational commitment. Notably, a significant, moderately positive relationship was observed between emotional intelligence and organizational commitment, as well as between job satisfaction and organizational commitment. A weak positive relationship was identified between emotional intelligence and job satisfaction. Differences in emotional intelligence were observed based on variables such as gender, age, and unit specialty. Organizational commitment varied based on the current position and hospital type, while job satisfaction differed based on the current position and education level. Conclusions. The findings suggest that enhancing the emotional intelligence of first‐line nurse managers can potentially improve organizational commitment, job satisfaction, and, subsequently, healthcare outcomes. There is a need for further research to delve deeper into these factors and devise strategies aiming to boost the emotional intelligence and job satisfaction of first‐line nurse managers. Implications for Nursing Management. The study provides empirical data from Qatar's healthcare system, shedding light on FLNMs' emotional intelligence, job satisfaction, and organizational commitment. [ABSTRACT FROM AUTHOR]

Aim. This study aims to investigate the level of organizational learning within urban Chinese Community Health Centres and reveal its potential association with primary care nurses' work performance and well‐being. Background. Globally, there is a push to establish learning healthcare systems for complex health reform challenges. Existing studies on organizational learning mainly focus on North American and European hospital settings, offering limited insights into primary care environments, particularly in developing countries. Design. Cross‐sectional study. Methods. We recruited 175 nurses from 38 community health centres in four Chinese cities (Shanghai, Shenzhen, Tianjin, and Jinan) using convenience sampling. Trained research assistants conducted face‐to‐face surveys, measuring organizational learning with the Learning Orientation Scale. Nurse‐level outcomes included self‐directed learning, quality of care, organizational commitment, and work stress. Data analysis employed multilevel linear modelling. Results. The 38 community health centres displayed a relatively high level of organizational learning, and there was a positive and significant association between organizational learning within community health centres and nurses' self‐directed learning as well as the quality of care. However, there was no significant association between organizational learning and nurses' organizational commitment or work stress. Conclusion. This study demonstrates a high‐level organizational learning capacity in urban community health centres in China. It provides a new perspective on the potential relationship between CHCs' organizational learning and primary care nurses' well‐being and work performance. Further research is needed to clarify unexpected findings and identify factors promoting organizational learning in primary care settings. Implications for Nursing Management. In China's evolving primary care system, nurses play a vital role amidst physician shortages. Policy should prioritize internal management reform alongside structural changes. This study highlights the importance of fostering organizational learning in primary care settings. Strategic interventions should promote a learning culture in CHCs, which may enhance nurses' self‐directed learning and improve the quality of care. [ABSTRACT FROM AUTHOR]

Background. With projected nursing shortages, an aging workforce, and the imminent retirement of nurse leaders, nursing leadership shortages are a concern. While several studies have indicated the interest of nurses in pursuing leadership positions, limited research has focused on examining the influence of the leadership practice environment on nurses' motivation to lead. Aim. The aims of the study were to (1) assess the relationship between the leadership environment and the motivation of nurses to lead and (2) determine whether there are particular aspects of the leadership environment that influence motivation to lead. Methods. A cross‐sectional research design was used to collect data from 435 nurses working in 16 public and private hospitals in Oman. Leadership Environment Scale and Motivation to Lead Scale were used to assess participants' perceived leadership environment and their motivation to engage in formal leadership roles, respectively. Multivariate linear regression was used to assess the relationship between the perceived leadership environment and the motivation of nurses to undertake leadership roles. Findings. Nurses reported a mean scale value of 3.208 out of 5 (SD = 0.467) for their motivation to lead, which exceeds the midpoint, indicating a strong motivation to engage in formal leadership roles. Nurses reported a mean score of 3.194 out of 4 (SD = 0.661), which exceeds the midpoint, suggesting a favorable perception of leadership environment. The findings showed a significant relationship between the leadership environment and nurses' motivation to lead. Specifically, self‐organization (β = 0.185, p = 0.001, CI = 0.086–0.378), agents (β = 0.221, p = 0.002, CI = 0.124–0.474), and transformative exchange (β = 0.100, p = 0.037, CI = 0.101–0.142) were characteristics of the leadership environment that were associated with greater motivation to engage in leadership. Conclusion. This study emphasizes the importance of cultivating a supportive leadership environment as a potential strategy to attract nurses to assume formal nursing leadership roles. Implications for Nursing Management. Strategies to improve nurses' motivation to lead in a complex healthcare environment include improving nurses' active involvement in their organization, creating a collegial supportive and mentoring leadership culture, and improving transformative exchange by supporting career and educational advancement. [ABSTRACT FROM AUTHOR]

Background. Global nursing shortages have led to the recruitment of culturally and linguistically diverse nurses from various countries. However, nurses face integration challenges in their host countries. Objective. This systematic review aimed to find the most recent evidence of factors associated with integrational strategies and models to support the transition and adaptation of culturally and linguistically diverse nurses to the professional workforce in healthcare settings. Methods. This systematic review used the population, exposure, outcome framework to select studies according to JBI guidelines. Original peer‐reviewed quantitative studies published between 2000 and 2021 were identified. Two researchers independently screened the studies based on eligibility criteria using title, abstract, and full text. The JBI critical appraisal tool assessed the methodology's quality for analytical cross‐sectional studies. Data were extracted, tabulated, and analysed narratively. PRISMA checklist was used in reporting. Data Sources. CINAHL (Ebsco), PubMed, Medic, ERIC (ProQuest), and Scopus. Results. The systematic review encompassed 19 articles and identified multiple factors associated with successful integration. These factors were classified into the following six categories: sociodemographic characteristics, discrimination, social support, organisational support, workplace environment, and acculturation. Conclusions. Comprehensive cultural competency training for healthcare staff, including managers, enhances cultural proficiency in work environments. Clear guidelines addressing bias and discrimination create a supportive environment where culturally and linguistically diverse nurses feel valued and respected, facilitating their adaptation and integration. Relevance to Clinical Practice. Patient care quality can be improved by ensuring sustainable culturally and linguistically diverse nurses' integration into healthcare organisations. Cultural diversity is a unique opportunity to bring a diverse range and experience to clinical settings. The diversity can also help enhance the cultural competence of healthcare staff, allowing them to better understand and cater to the needs of culturally diverse patients. Patient or Public Contribution. Not required for study design. [ABSTRACT FROM AUTHOR]

Aim. To determine Senior Nurse Managers' perceptions of integration of Nurse Practitioner roles in Healthcare Organisations across Ireland and Australia. Background. Introduction of the Nurse Practitioner role in both countries is well established with national policies aimed at developing a critical mass in the health workforce. Current policy requires Senior Nurse Managers to be actively involved in the introduction of and oversight of the integration of Nurse Practitioners across healthcare settings. This is integral in the context of the success and sustainability of the services provided by the Nurse Practitioner. Methods. A quantitative, cross‐sectional cloud‐based survey of senior nurse managers across Ireland and Australia from April to September 2022. Results. Of 300 responses received, 122 were eligible for analysis. Of these, 77% expressed that there should be a specific role to support the integration of Nurse Practitioner roles at local level, and 61% recommended that this should occur at a national level, whilst 48% reported the absence of a standardised governance structure. Three reporting structures were identified: professional, clinical, and operational. Autonomous clinical decision making and prescribing were two Nurse Practitioner functions most identified. Fifty‐five percent reported having performance indicators for Nurse Practitioner roles, with 24% agreeing that performance indicators captured the quality of care provided. Thirty‐five percent of senior nurse managers indicated that there were agreed reporting timelines for performance indicators and a requirement for the provision of an annual report. Conclusion. Whilst some participants reported structure to guide and evaluate the work and value of Nurse Practitioners, the approach was inconsistent across organisations and countries. This paper demonstrates that integration is not broadly established across both countries. Implications for the Profession. The main findings were that Nurse Practitioners were misunderstood and the development of a structured framework to support the integration of Nurse Practitioners would provide long‐term benefits. [ABSTRACT FROM AUTHOR]

Background. Although retaining new nurses is imperative for the future of the nursing profession, it remains a challenging task in the healthcare industry. Understanding the career journey of new graduates as they transition from students to nurses is vital. However, longitudinal studies investigating the factors influencing retention during this period are lacking. Aim. The aim of this study is to identify the influencing factors and develop a longitudinal prediction model for new graduate nurse retention. Methods. A secondary data analysis was conducted using the New Nurse e-Cohort Study dataset from two survey periods, November–December 2020 and February–March 2022. The participants were categorized into either retention or turnover groups based on their turnover experiences. A decision tree based on classification and regression tree (CART) analysis was utilized. Results. Of the total 586 participants, 463 (79%) were in the retention group. The CART model highlighted that new nurses' retention was significantly associated with younger age, higher readiness for practice (clinical problem-solving) during the nursing program, lower transition shock (such as confusion in professional values, loss of social support, and conflicts between theory and practice), and a higher person-environment fit (person-job fit). The predictive accuracy of the CART model was 79.7%. Conclusion. To retain new nurses, nursing educators and hospital managers should collaborate to prepare nursing students for actual practice, offer support during organizational socialization, and foster healthy professional values for competence in the workplace. Implications for Nursing Management. Transforming the educational strategies of nursing programs and hospital management policies is imperative to ultimately enhance the retention of new graduate nurses. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has exacerbated the difficulties nurses face, resulting in higher turnover rates and workforce shortages. This study investigated the relationships between nurses' moral distress, burnout, and turnover intention during the last stage of the COVID-19 pandemic. It also explored the coping strategies nurses use to mitigate moral distress. Utilizing a mixed-method approach, this study analyzed data from 307 nurses caring for patients with COVID-19 in acute care hospitals through an online survey conducted in November 2022. Our data analysis encompassed quantitative methods, including descriptive statistics and path analysis, using a generalized structural equation model. For the qualitative aspect, we examined open-ended responses from 246 nurses using inductive content analysis. The quantitative findings revealed that nurses' moral distress had a significant direct effect on turnover intention. In addition, burnout significantly mediated the relationship between moral distress and turnover intention. Qualitative analyses contextualized the relationships uncovered in the quantitative analyses. The qualitative analysis identified various positive and negative coping strategies. Positive strategies included a commitment to minimize COVID-19 transmission risks, adopting a holistic approach amidst the challenges posed by the pandemic, voicing concerns for patient safety, engaging in continuous learning, and prioritizing self-care. Conversely, negative strategies involved adopting avoidance behaviors stemming from feelings of powerlessness and adopting a passive approach to one's role. Notably, some participants shifted from positive to negative coping strategies because of institutional barriers and challenges. The findings underscore the importance for hospital administrators and nurse managers to acknowledge the impact of the pandemic-related challenges encountered by nurses and recognize the link among moral distress, burnout, and turnover intention. It highlights the essential role of organizational and managerial support in fostering effective coping strategies among nurses to address moral distress. [ABSTRACT FROM AUTHOR]

Background. In addition to the usual difficulty of managing human capital in any organization, healthcare institutions have other problems to solve arising from the circumstances and the very nature of the work they perform, such as the ethical pressure on staff, emotional exhaustion, the distribution of work shifts, or the general shortage for nurses. In many cases, this situation has an impact on the quality of care. Objective. The main objective of this research is to compile, in a single document, human resource practices that help health centre managers improve results in terms of performance and quality of care, as well as avoid the intention of abandoning the job, specifically related to the work of nurses. Methods. To this end, a systematic literature review has been performed based on 229 papers published in the Web of Science database, from which the practical implications for nurses proposed by these authors have been extracted. Results. The main results suggest that developing affective commitment helps to improve organizational performance and enhance patient safety culture. Furthermore, improving communication and meaningfulness of work, recognition by superiors, or job flexibility would improve the quality of outcomes, for the work of nurses. Conclusions and Implications for Nursing. Stimulating normative commitment, reducing excessive control, and paying attention to job burnout and job stress help combat the intention of voluntary turnover or leaving the job, especially in the case of nurses. [ABSTRACT FROM AUTHOR]

Aim. To explore the mediating effect of psychological empowerment in the association between transformational leadership and organizational citizenship behaviors in nursing context. Background. Healthcare organizations worldwide are facing unprecedented challenges, necessitating effective leadership strategies to ensure quality patient care and organizational success. Transformational leadership has emerged as a tool to promote positive workplace behaviors, including organizational citizenship behaviors, among nursing staff. However, the mediating role of psychological empowerment in this relationship remains underexplored. Methods. A cross-sectional survey was conducted from March 2023 until August 2023 involving 305 registered nurses at King Khalid Hospital to investigate the relationship among transformational leadership, psychological empowerment, and organizational citizenship behaviors. Validated scales were used to assess these variables. A single mediation analysis was conducted through processing macro version 3.5 model 4. Results. This study found a strong positive association between transformational leadership and both psychological empowerment (r = 0.507, p < 0.001) and organizational citizenship behaviors (r = 0.445, p < 0.001) among nursing staff. Additionally, psychological empowerment partially mediated the relationship between transformational leadership and organizational citizenship behaviors, with a significant indirect effect (B = 0.110, CI: 0.058–0.166). Conclusions. Transformational leadership positively impacted nurses' feelings of empowerment, which then led to higher exhibition of organizational citizenship behaviors. Implications for Nursing Management. Leadership development programs should prioritize the cultivation of transformational leadership qualities and support the psychological empowerment of nursing staff. This approach can enhance organizational effectiveness, foster positive workplace environments, and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Aim. To systematically map and identify key knowledge on organizational support for nurses' career planning and development. Design. Scoping review. Methods. Systematic electronic searches were carried out with the CINAHL, PubMed, Scopus, and Web of Science databases in May 2022. The searches were limited to scientific, peer-review papers that were published in English from January 2012 to May 2022. Data were extracted and synthetized and are presented in tables and text. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results. We identified 1,400 papers and 28 met the inclusion criteria. Organizations recognized nurses' career planning and development in relation to the individual's professional development and the organization's need to promote high-quality services and workforce engagement. The organizational support included strategic work to ensure there were adequate resources and purposeful vacancies and a structured framework based on objective qualification criteria and equal assessment. Organizations focused on sharing knowledge, structured career planning, and interpersonal support. Support within the nursing profession and multilayered interprofessional collaboration were also important. Conclusion. Nurses' career planning and development was linked to their personal development and the organization's aims and required support from both fellow nurses and other professionals. Implications for the Nursing Management. Identifying the organizational structures and methods that are needed to support nurses' career planning and development can help nursing management to evaluate and develop strategies that improve the attractiveness of a nursing career and nurses' engagement. [ABSTRACT FROM AUTHOR]

Background. Emergency departments suffer from authoritarian and manipulative leadership styles that affect team dynamics, emotional exhaustion, and quality patient care. However, little research specifically explores these toxic leadership effects on conflict management and nurses' organizational commitment. Objectives. This cross-sectional study aimed to assess the correlations between perceived toxic leadership, conflict resolution strategies, and commitment dimensions among emergency nurses while evaluating conflict tendencies as a mediating mechanism. Methods. A cross-sectional design that included multiple regression and mediation analyses was utilized. The sample consisted of 387 emergency nurses from five major Saudi hospitals surveyed using validated scales that measure perceived toxic leadership, conflict styles, and organizational commitment. Results. High prevalence rates for perceived authoritarian (77%), narcissistic (75%), and unpredictable (63%) leadership were reported. Increased toxicity was positively related to dominating and avoiding conflict styles but negatively related to integrating and compromising strategies. Toxic leadership is also associated with lower affective/normative commitment but higher continuance commitment. Conflict management partially mediated the leadership-commitment relationship, which explained 29% of the total effect. Finally, higher experience and education predicted greater perceived toxicity. Conclusions. The significant correlations between destructive leadership, adverse conflict, and reduced commitment in emergency nurses underscore the need for context-specific leadership training. Fostering supportive environments through multifaceted interventions can counteract toxicity impacts, impart constructive communication techniques, improve nurse well-being, and ensure high-quality patient care. As conflict tendencies and nurse characteristics influence susceptibility to detrimental leadership, tailored programs addressing experience levels are vital. [ABSTRACT FROM AUTHOR]

Orientation. Trust is the central part of leadership and organizational culture and can often go unnoticed until it decreases. There is a lack of a comprehensive concept analysis of trust in the healthcare setting. Research Purpose. The research aim was to gather, assess, and synthesize previous empirical evidence from the field of healthcare about the concepts of trust in the leader and trust in the organization. Motivation for the Study. To create a comprehensive and generic concept analysis of trust in the leader and organization for the healthcare sector based on recent empirical studies. Research Design and Method. A concept analysis, which followed the method presented by Walker and Avant, was conducted as a systematic review that adhered to the PRISMA guidelines. A total of eight databases were searched for relevant literature and 42 articles were included. Main Findings. The definitions of trust in the leader and the organization were based on emotion and cognition. Trust in the leader emerged as a core feature of collaborative leader-employee relationships, whereas trust in the organization was a key construct of organizational functioning. Trust in the leader and the organization contributed to commitment, increased work production, enhanced collaboration, and improved workplace well-being. Defense mechanisms were identified as a new contrary concept, while justice was found to be a related concept. Contribution. Both trust in the leader and trust in the organization positively impact an organization, nurse leaders, and employees. Deeper knowledge of trust and its attributes will be critical to the operationalization and estimation of levels of trust in healthcare organizations. Managerial Implications. Trust in the leader and the organization can significantly influence the attractiveness of an organization, retention of personnel, productivity, and work-related well-being. Thus, this aspect should be measured and developed systematically while acknowledging the antecedents of trust building. [ABSTRACT FROM AUTHOR]

Aims. This study was designed to investigate the impact of inclusive leadership on challenge-oriented citizenship behaviors and examine the mediating role of organizational justice on the relationship between inclusive leadership and challenge-oriented citizenship behaviors among nurses. Background. Leaders exhibiting an inclusive leadership style have the potential to create a positive work climate and motivate members of the organization. However, the mechanisms by which organizational justice contributes to this process remain to be explored, particularly in terms of how it motivates challenge-oriented organizational citizenship behaviors. Method. A cross-sectional questionnaire survey was conducted among nurses in China at the end period of the COVID-19 pandemic. A total of 527 registered nurses were enrolled and completed the self-report questionnaires including inclusive leadership scale, organizational justice scale, and challenge-oriented citizenship behavior scale. The hypotheses were tested using hierarchical multiple regression analyses and structural equation modelling. Results. The results of empirical tests revealed that nurse leader's inclusive leadership had a positive relationship on nurses' challenge-oriented organizational citizenship behaviors (β = 0.823, p < 0.001) after controlling several demographic covariates. Meanwhile, inclusive leadership was positively linked to organizational justice (β = 0.747, p < 0.001), and the indirect effect of inclusive leadership on nurses' challenge-oriented citizenship behaviors through organizational justice was statistically significant (β = 0.641, p < 0.001). Furthermore, the model fit indices were χ2/df = 1.952, RMSEA = 0.043, CFI = 0.979, and TLI = 0.977, indicating that the model had high quality. Conclusion. This study could help nurse leaders with inclusive leadership style have a better understanding and taking the advantages of the influence mechanism of organizational justice in inspiring nurses' challenge-oriented citizenship behaviors. While nurse managers can inspire challenge-oriented organizational citizenship behaviors through inclusive leadership, they should also emphasize the evaluative and behavioral-shaping effects of organizational justice. Both leadership and organizational justice are essential to motivate challenge-oriented organizational citizenship behaviors and to foster organizational development. Moreover, managers should focus on the process and conditions of implementing organizational justice to ensure fairness within the organization and to create a conducive environment for challenge-oriented organizational citizenship behaviors. [ABSTRACT FROM AUTHOR]

Background. Work engagement and patient-safety outcomes in nursing practice are critically significant. However, most previous studies evaluating antecedents of work engagement and patient-safety outcomes have used cross-sectional designs. Aims. To investigate the effects of job resources (organizational support and leader empowerment) and core self-evaluation on nurses' work engagement and patient-safety outcomes. Methods. This longitudinal study surveyed 2,618 registered nurses from 17 public hospitals in XuZhou, China. Participants completed self-report questionnaires on organizational support, leader empowerment, and core self-evaluation at baseline. Work engagement and patient-safety outcomes were collected 18 months after the baseline. The mixed linear regression and Johnson–Neyman statistical analysis were used to analyze data. Results. Organizational support was an outsize predictor of nurses' work engagement, followed by core self-evaluation and leader empowerment. Organizational support and core self-evaluation were equally crucial for predicting patient-safety outcomes. Moreover, the positive impact of leader empowerment on patient-safety outcomes became significant when the core self-evaluation score was below 51. Conclusions. This study demonstrated that organizational support, leader empowerment, and core self-evaluation are important determinants of nurses' work engagement and patient-safety outcomes. Implications for Nursing Management. Hospital managers and nurse leaders should consider providing multiple supports to motivate staff nurses to engage in work. When nurses' core self-evaluation is low, empowering training for nurse leaders should be essential to reduce adverse patient events. [ABSTRACT FROM AUTHOR]

Background. The link between organizational culture, organizational trust, job satisfaction, and team-based practice among nurse practitioners (NPs) has not been examined simultaneously. Aim. To identify the effects of organizational culture, organizational trust, and other factors on NPs such as job satisfaction and team-based practice. Methods. We used a cross-sectional design with a national sample. Data were collected using an online survey of 1,100 NPs working in acute care settings. The survey included demographic and working characteristics, the Organizational Culture Scale, the Organizational Trust Scale, the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS), and the NP-physician relations (NP-PR) subscale of the Nurse Practitioner Primary Care Organizational Climate (NP-PCOCQ). Multiple regression analysis with a stepwise selection method explored potential factors that influence job satisfaction and team-based practice. Results. A learning environment, psychological safety, senior leadership support, commitment to the organization, and the organizational culture and trust were positively associated with higher job satisfaction, which accounted for 49.2% of the variance in NPs' job satisfaction. Organizational trust, commitment to the organization, and learning environment promoted better team-based practice significantly. Also, NPs working a fixed shift pattern showed higher levels of team-based practice. These factors accounted for 23.66% of variances in team-based practice. Conclusion. Organizational culture and organizational trust affect the job satisfaction and team-based practice of NPs in acute care practices. Implications for Nursing Management. Acute care hospitals are encouraged to develop policies to enhance a learning environment, a supportive organizational culture, and trust in NPs' practice. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify factors affecting the noise management performance of adult intensive care unit (ICU) nurses in Korea. The ICU environment is exposed to various types of noises due to the use of medical devices for the treatment of critically ill patients. The noise has an adverse effect on nurses' health and their nursing performance, which might potentially threaten patient safety. A cross-sectional study was conducted with a total of 148 nurses working in adult ICUs from two university hospitals in Korea. Data were collected using self-administered questionnaires, which included various aspects such as noise knowledge, response to noise, patient safety culture, and noise management performance. Multiple regression analysis revealed that teamwork (β = 0.33, p = 0.004), patient safety policy, and procedure (β = 0.25, p = 0.037), which were subscales of patient safety culture, as well as frequency of noise experience (β = 0.16, p = 0.030) were significant factors affecting adult ICU nurses' performance of noise management. This study provides a significant basis for promoting adult ICU nurses' performance in noise management. A structured policy and procedure for noise management should be established for reducing noise in adult ICUs. In terms of nursing education, it is necessary to consider and develop team-based training programs to promote noise management performance in the ICU. Nurse managers and nursing organizations should consider how to create conditions in which nurses can recognize the importance of noise reduction and perform well in noise management. [ABSTRACT FROM AUTHOR]

Aim. To bring insights into how healthcare managers and staffing assistants work to achieve sustainable working hours within a participatory scheduling system. Background. Hospital nurses and assistant nurses often work on rotating shifts, which affects their opportunities for sleep, recovery, and work-life balance. In Sweden, a participatory scheduling approach is commonly used, where working hours are planned in collaboration between employees, managers, and staffing assistants. Influence over working hours is related to positive outcomes among shift workers. However, it also places responsibility on the employee to schedule working hours that promote health and patient safety, i.e., sustainable working hours. Accordingly, the organisation has responsibilities to support the employee in this regard. Methods. Semistructured individual interviews were conducted with 11 managers and 9 staffing assistants from four Swedish regions and analysed using thematic analysis. Results. Several key factors for achieving sustainable working hours within the context of participatory scheduling were described: distribution and clarity of responsibilities, allocating time for scheduling, establishing shared responsibility, considering fairness, fostering an individual relationship with the employee, managing dissatisfaction, providing support, clarifying guidelines for sustainable scheduling, managing inconsistencies between employee requests and sustainable working hours, and considering recovery opportunities and the competence mix on shifts. Additionally, contextual factors, such as staffing levels, working procedures, working time arrangements for night work, and technological support, were highlighted as important. Conclusion. Achieving sustainable working hours within participatory scheduling involves considering the interactions between factors at the levels of the organisation, the individual, and the technological systems. Implication for Nursing Management. Nurse managers and staffing assistants must work closely with their employees during participatory scheduling to ensure sustainable working hours. Key goals in this regard include establishing a shared responsibility, clarifying responsibilities and guidelines for sustainable scheduling, and allocating time for the scheduling process. [ABSTRACT FROM AUTHOR]

Aim. We aimed to undertake a systematic review focusing on organisational strategies that specifically advance women nurses in healthcare leadership. Background. Despite nursing being the largest health workforce and being dominated by women, they face significant barriers in career progression and have limited leadership opportunities, with a need to move from a focus on individuals to organisational level change. Methods. Methods for our overarching systematic review are published and follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Databases searched include MEDLINE via OVID; MEDLINE in-process and other nonindexed citations via OVID; PsycINFO; and Scopus. Any study describing a strategy that was not implemented for nurses and all non-peer-reviewed studies were excluded. Included studies were appraised using CASP checklists. A thematic analysis approach was employed to facilitate the systematic generation of themes. Results. Findings were reported under two main themes: leadership barriers and enablers and organisational strategies for advancing women nurses to leadership. The latter included: mentorship, leadership training, career planning and coaching, opportunities for networking, sponsorship, and targeted recruitment processes for increasing gender diversity in leadership roles. Conclusion. This review synthesises organisational-level strategies that advance women nurses in healthcare leadership. Barriers and individual-level strategies for advancing women nurses in healthcare leadership have been extensively studied in the current literature. Systems and organisational strategies are less studied yet show that they can advance women in nursing into healthcare leadership. Implications for Nursing Management. This paper suggests that optimising women nurses' leadership attainment needs to shift focus from individual strategies to systemic level and organisational strategies and use tailored evidenced-based approaches. [ABSTRACT FROM AUTHOR]

Aims. This study examines the importance of senior-leader presence on the "frontline" in times of crisis. Background. The COVID-19 pandemic placed unprecedented demands on nurses charged with delivering critical care. Extant research suggests that the active presence of ward-level leaders has an important role to play in supporting frontline staff and mediating the negative impacts of stress and burnout. There is little evidence on the impact of senior leader presence or absence on the experience of frontline critical care nurses, particularly at times of crisis. Methods. A three-phase qualitative interview study of critical care nurses in the UK and Ireland. A total of 107 semistructured interviews with 54 nurses representing 38 different healthcare units. Results. Senior-leader presence at the time of crisis serves as an important symbol of organisational support. Where senior leaders are not meaningfully present, they risk allowing the necessary pain of difficult work situations to become toxic. Toxicity is manifested with increased staff stress, emotional ills, absence, and turnover. Conclusions. Senior leaders must balance their responsibilities for strategy and structures with the frontline presence required to shape a positive emotional climate. Implications for Nursing Management. Senior managers should consider supplementing their strategic focus with punctuated returns to the floor. Symbolically, leaders who get their hands dirty embody a sense of mutual struggle and practical support. Managerially, time on the floor increases the opportunities for collecting primary data to improve decision-making and support. [ABSTRACT FROM AUTHOR]

Aim. The study's aim was to examine the relationship between transformational leadership, organizational justice, and nurses' quality of work life. Background. There is an increasing emphasis on the welfare of nurses and their influence on healthcare services. There is a dearth of comprehensive studies on the influence of transformational leadership and justice within organizations on work-related quality of life. Understanding these connections is critical for improving workplace dynamics and fostering nurse well-being. Methods. This cross-sectional research included a convenience sample of nurses working in a general hospital. The data were obtained through self-report questionnaires encompassing three reliable and validated scales: the global transformational leadership scale, organizational justice scale, and quality of nursing work-life scale. The data were then analyzed with SPSS 23 and statistical methods (descriptive statistics, Pearson correlation coefficient, and hierarchical linear regression). This study adhered to the STROBE guidelines. Results. A sum of 527 out of 566 nurses responded to the questionnaires (response rate = 93.1%). The nurses had a high perception of transformational leadership behaviors but had a more moderate view of organizational fairness and the quality of their nursing work life. Transformational leadership was significantly associated with organizational fairness. Also, a positive relationship was found between transformational leadership, justice within organizations, and nurses' quality of work life. Conclusions. Nurses who consider their leaders as transformative and have the sense of a fair organizational climate are more likely to have higher levels of quality of work life. Implications for Nursing Management. Nurse managers should strive to develop transformational leadership behaviors and promote organizational justice to enhance the well-being and satisfaction of nurses in their work environments. [ABSTRACT FROM AUTHOR]

Aim. The objective was to investigate the impact of structural empowerment and demographic factors on the psychological empowerment of nurses. Background. The empowerment of nurses plays a crucial role in improving patient care and achieving successful healthcare outcomes. When nurses feel empowered in their work environment, they tend to remain dedicated to their jobs and experience higher levels of job satisfaction and engagement. Methods. This cross-sectional study utilized a convenience sample of 287 nurses recruited from various hospital units, resulting in a response rate of 94.7%. Data were collected through a paper survey consisting of three sections: structural empowerment, psychological empowerment, and demographics. Results. The first hierarchical regression explains 57.0% variance in nurses' psychological empowerment (F = 78.52, p < 0.001). Age (β = 0.37, p < 0.01) and structural empowerment (β = 0.69, p < 0.001) have a positive influence on nurses' psychological empowerment. Conversely, having a bachelor's degree (β = −0.16, p < 0.01) had a negative impact psychological empowerment. The second hierarchical regression clarifies the specific aspects of structural empowerment that influences positively on nurses' psychological empowerment: access to opportunities (β = 0.13, p < 0.01), support (β = 0.13, p < 0.01), resources (β = 0.35, p < 0.001), and informal power (β = 0.12, p < 0.01). Conclusion. This study emphasizes the importance of considering demographic variables, such as age and education, in conjunction with structural empowerment to effectively enhance nurses' psychological empowerment. Implications for Nursing Management. Nursing managers should tailor their empowerment strategies based on the demographic characteristics of their nurses. It is essential to focus on providing nurses with access to opportunities, support, resources, and informal power. These insights provide valuable guidance for nursing managers to enhance nurses' psychological well-being, job satisfaction, and overall quality of life. Ultimately, this contributes to positive outcomes for patients, nursing staff, and healthcare organizations. [ABSTRACT FROM AUTHOR]

There is a global nurse shortage, and researchers have made great efforts in trying to unveil the reasons for turnover and how to increase retention. However, such research has had a tendency to study variables related to intention to leave (ITL) or turnover as isolated phenomena. Objective. To simultaneously explore what factors motivate experienced nurses in the workplace and the underlying reasons for strong ITL and high staff turnover within the profession. Design. An inductive qualitative content analysis was used based on data from open-ended survey questions. The data originated from the longitudinal analyses of nursing education/employment/entry (LANE) in work-life study. The qualitative data analyzed in this study were distributed in October 2017–January 2018, to all nurses in three cohorts corresponding to 11-, 13- and 15-year postgraduation. Of the 2,474 nurses answering the survey, 1,146 (46%) responded to one or more of the open-ended questions. Results. The result showed that what motivates experienced nurses, their intention to leave (ITL), and reasons for turnover could be described in the form of five broad categories, namely, organizational characteristics, work characteristics, relationships at work, work recognition, and health issues. There was rarely a one single reason described, rather several reasons needed to be experienced over time for nurses to stay motivated or leave the profession. Conclusions. There is no single reason that makes nurses leave the profession, nor is there one single reason that makes them motivated to stay. Retention and turnover are complex processes and need to be addressed as this, not as a single isolated phenomenon. [ABSTRACT FROM AUTHOR]

Aim. The aim of this study is to investigate the unique contributions of two distinct dimensions of leaders' narcissism—admiration and rivalry—to nurses' organizational citizenship behavior towards the leader and the mediating role of nurses' challenge appraisal and hindrance appraisal based on the transactional stress theory. Background. Leaders' narcissism is widespread in hospitals, so whether nurses will show organizational citizenship behavior to narcissistic leaders is related to the harmony and stability of the team. Thus, clarifying the positive or negative relationship between leaders' narcissism and nurses' organizational citizenship behavior towards leaders has become a priority. Methods. A cross-sectional survey was conducted at two-time points with 280 Chinese nurses. We used the structural equation model to analyze our data. Results. We found that leaders' narcissistic admiration was positively correlated with nurses' organizational citizenship behavior towards the leader; however, leaders' narcissistic rivalry was negatively correlated with nurses' organizational citizenship behavior towards the leader. Furthermore, mediation analyses revealed that leaders' narcissistic admiration had a significant indirect effect on nurses' organizational citizenship behavior towards leaders via challenge appraisal, and leaders' narcissistic rivalry had a significant indirect effect on nurses' organizational citizenship behavior towards leaders via hindrance appraisal. Conclusion. By introducing two dimensions of narcissistic admiration and rivalry, we resolve previous contradictory findings about the relationship between leader narcissism and organizational citizenship behavior towards the leader. Implications for Nursing Management. Nursing managers need to understand that there are both positive and negative relationships between leaders' narcissism and nurses' organizational citizenship behavior towards the leader, and we can promote the positive effects of leaders' narcissistic admiration and curb the negative consequences of leaders' narcissistic rivalry by taking some specific steps, such as promoting the loving cooperative atmosphere and punishing disruptive behaviors. [ABSTRACT FROM AUTHOR]

Purpose. This study aimed to develop a group organizational learning activity inventory for evidence-based practice (EBP) institutionalized by hospitals and to verify its reliability and validity. Methods. A draft inventory was created after verifying content and face validity of draft items developed based on interview data and materials used in EBP implementation. Construct validity and reliability were assessed cross-sectionally through an anonymous self-administered survey conducted via web and printed questionnaires. Construct validity was confirmed using exploratory and confirmatory factor analyses, and internal consistency and convergent/discriminant validity were verified. Inventory structure was determined using the theoretical model based on the hypothetical constructive concept. Temporal stability was assessed two weeks after the initial survey. Result. A draft inventory comprising 12 factors and 47 items was created based on 95 draft items. Data from 371 nurses across 55 departments in 12 hospitals were analyzed. The inventory comprised 8 factors and 40 items based on the theoretical model. The comparative fit index was 0.86, the Tucker–Lewis index was 0.85, the root mean square error of approximation was 0.09, and standardized root mean square was 0.04. Cronbach's alpha of each factor was ≥0.8, and the temporal stability was moderate. Conclusion. We developed the group organizational learning activity inventory, comprising 8 factors and 40 items. Though construct validity was low, the reliability and concurrent/convergent validities were confirmed. This inventory contains new factors that measure the group activities to ensure EBP's continuation in hospitals: forming common knowledge, understanding the value of EBP in groups, and fostering ownership thereof. Using this inventory, departments that introduced EBP can evaluate the extent of activities leading to nurses' continuation of EBP and find the improvement point. [ABSTRACT FROM AUTHOR]

Aim. We aimed to conceptualise how environmental, institutional, and organisational dynamics of the ED underpin and "moderate" nurses' emotional labour. Background. Around the globe, EDs are struggling to meet rising patient demand including both UK health systems and public services in the US. In spite of these challenges and the intense and distinctive nature of EDs, an exploration of emotional labour is largely missing from current understanding. This is important, in part because emotional labour is established as an indicator of wellbeing including intention to leave, burnout, and compassion fatigue. We understand little of how the environment moderates emotional labour, and our study addressed this problem in the ED. Understanding the moderators of emotional labour, organisational perspective also offers theoretical development. Methods. Ethnography enabled immersion in the ED setting, gathering the lived experiences and narratives of the ED nursing team. This included 200 hours of observation at one District General Hospital and one Major Trauma Centre in the English NHS with 35 semistructured concurrent formal interviews. Results/Conclusions. The ED calls for an extensive spectrum of emotional labour from staff, influenced and moderated by the restrictions on resources, particularly time. We argue that, despite the often short nature of interactions undertaken in ED, the labour required is effortful and gruelling for staff. Understanding the relevance of environmental elements, namely, time, to the emotional labour offers tangible opportunities for improvement. These new understandings can underpin solutions to negative consequences of this work. Suggested measures and interventions to alleviate the impact of emotional labour should be prioritised by policy makers and those tasked with managing, designing, and leading the delivery of care in ED. Implications for Profession and/or Patient Care. The more "sped up" a service is required to be, the higher the likelihood of emotional labour is. In light of the challenges facing healthcare services around the world and the increased throughput through services, particularly in ED, this is important. This is also critical when considering that there are well-established relationships between emotional labour and wellbeing in nursing. Understanding the relevance of the healthcare environment to staff members' experiences of emotional labour is critical in designing solutions which counterbalance the potentially negative consequences of this work. [ABSTRACT FROM AUTHOR]

Aims. This systematic review aimed to identify, evaluate, and synthesise the results of the studies that examine the relationship between nurse managers' leadership practices and staff nurses' work engagement in hospital settings and to provide recommendations for improvement and further research. Background. A lack of supportive leadership is identified as one of the most common reasons nurses leave employment. To meet the global shortage of nurses, nurse managers need to maximise staff retention and work engagement. Evaluation. A systematic review was conducted to identify research published between 2010 and 2021 and registered in PubMed, CINAHL, PsycINFO, Embase, EMCare, and Eric databases. The methodology guidelines outlined in the Joanna Briggs Institute (JBI) Methodology for Systematic Reviews were followed, and the results were reported using the PRISMA 2020 guidelines. The review protocol was registered with PROSPERO (ID CRD42021277463). Key Issue. Eleven (11) studies from 12 articles were included in this review. Three main leadership style themes were identified, and these showed statistically significant direct and indirect relationships with nurses' work engagement: relationally focused, task-focused, and lack of leadership. Work engagement was mainly assessed in terms of dedication, absorption, and vigour. The effects of leadership styles on work engagement were found to be mediated by trust in the leader, environmental resources such as structural empowerment, six work-life areas (workload, control, values, community, rewards, and fairness), person-job fit, organisational support, leader-member exchange, and personal resources such as self-efficacy and decision authority. Conclusion. This review found a significant correlation between positive nurse manager leadership style and the work engagement of registered nurses. Implications for Nursing Management. The results of this review suggest that nursing work engagement can be improved by implementing relational leadership behaviours. The findings of this review will be useful for developing appropriate nurse leaders' leadership styles, improving their workplace environments, and planning leadership training. It is essential to acknowledge the indirect effects of nurse leaders' leadership styles and their mediating factors on work engagement while developing interventions for staff nurses. [ABSTRACT FROM AUTHOR]

Aims. To identify nurses' professionalism, work environment, and communication with healthcare professionals as factors influencing clinical nurses' perception of patient safety culture. Background. Patient safety is a representative indicator of the quality of nursing care. A multidisciplinary approach, including individual and organizational components, is needed to improve patient safety culture. Methods. A cross-sectional study was conducted in January 2021 involving a total of 271 nurses in six tertiary hospitals. Data were collected from participants on nurse professionalism, work environment, communication, and patient safety culture. A multiple regression model was used to analyze variables influencing patient safety culture. Results. Factors affecting patient safety culture were nursing foundations for quality of care (β = 0.230, p < 0.001), nurse manager ability, leadership, support of nurses (β = 0.294, p < 0.001), and collegial nurse-physician relations (β = −0.138, p = 0.026) in the nursing work environment. Accuracy (β = 0.117, p = 0.007), shift communication (β = 0.128, p = 0.026), satisfaction (β = 0.283, p = 0.001), and timeliness (β = 0.239, p < 0.001) of communication between healthcare professionals and nurses have a significant impact on patient safety culture. All these predictors accounted for 59% (R2) of patient safety culture awareness (p < 0.001). Conclusions. Enhancing patient safety culture requires a systematic and organizational approach that considers individual characteristics. Nurse managers play a crucial role in promoting patient safety by employing various communication channels and leading team education and training initiatives to foster collaboration among healthcare professionals. Implications for Nursing Management. The provision of patient safety education directly influences patient safety culture, and continuous education enables nurses to grow within the institution. To ensure effective communication in healthcare settings, nurse managers should prioritize shift communication, evaluate the accuracy of information exchange, and establish diverse communication channels, including social media platforms or business messengers, for internal hospital communication. [ABSTRACT FROM AUTHOR]

Aims. To explore band 5 staff nurses' perceptions of leadership and leadership development and derive insights and recommendations to inform future practice. Background. Band 5 staff nurses are increasingly expected to develop leadership skills but are not always well supported in this. Method. A qualitative methodology situated within a constructivist paradigm explored the shared meanings and understandings of band 5 nurses' leadership development within the context of current organisation, policy, and culture. Results. Three principal themes representing band 5 nurses' perceptions of leadership were identified: defining leadership, opportunities to lead, promoting leadership development. Conclusion. Band 5 nurses' leadership development is highly variable in frequency and quality. Key barriers and facilitators to development are discussed, including the wide provision of formally validated and bespoke leadership programmes that combine practice-based, informal training. Implications for Practice. Nurse leadership development at all levels remains integral to high-quality and safe health care. High rates of senior staff attrition and recent guidelines in England reinforce the need for band 5 nurse leadership. The multiple challenges impeding this are discussed, alongside ways of overcoming them. [ABSTRACT FROM AUTHOR]

Aim. The current article aims to gain insight into (a) what characterises organisational resilience during an unexpected crisis such as COVID-19 and (b) how organisations respond to developments in their environments. Background. In times of societal crises, such as the COVID-19 pandemic, the resilience of the healthcare organisation is tested. Method. This research is based on a case study in a university hospital and a county hospital in Sweden using surveys with both structured and open answers. Results. The result shows ambiguity and "polarised" experiences, emphasising flexibility vs. structure, clear hierarchical information vs. spaces for peer learning through dialogue, and focus on acute care vs. determination to continue with core operations. Conclusion. The article concludes that the pandemic resulted in paradoxes, tensions, and new experiences in organisational processes and interactions. These create opportunities for learning not only during crises but also for improving nursing management in both acute and planned care. Three relations are important in building organisational resilience in crises: resilience capability, resilience capacity, and sustainable resilience practices. Implications for Nursing Management. Organisational resilience under extraordinary circumstances, such as a pandemic, as well as enhancing the previous literature on nursing management that offer a more individually oriented perspective. [ABSTRACT FROM AUTHOR]

Background. Care home managers' leadership is recognised as directly influencing the care received by people living with dementia. What enables care home managers to promote and sustain person-centred care for residents is less well understood. Method. A mixed-methods systematic review synthesised evidence on care home managers' leadership on the delivery of person-centred care for people living with dementia. Electronic databases (PubMed, Scopus, Cochrane Library, CINAHL, and Google Scholar) were searched between 2009-2021. Thematic synthesis identified commonalities, facilitators, and barriers to managers enabling person-centred care. Results. Twenty-one studies met the inclusion criteria. Approaches demonstrated by care home managers that enabled person-centred care for people living with dementia included valuing and recognising staffs' work; involving residents and relatives in decision making; providing feedback to staff; promoting a positive work environment and care culture; and involving staff in organisational changes. Barriers to person-centred care were a lack of organisational support for care home managers; staff shortages; managers not having time to work with staff; manager-staff turnover; limited access to dementia training; and a lack of leadership education and training for care home managers. Conclusion. Care home managers are central to the delivery of person-centred care for people living with dementia. The review identified key resources and activities that support this work. The wide variation in leadership approach and a persistent lack of detail about the frequency of educational and organisational support demonstrate a need to explore what enables care home managers to support their staff to deliver person-centred care. [ABSTRACT FROM AUTHOR]

Aims. The aim of this study was to adapt the Safety Climate Survey and examine its validity and reliability for use in the Turkish healthcare context. Background. Maintaining patient safety is a challenge for healthcare systems world-wide, and healthcare professionals need valid and reliable tools to measure improvements in safety. Methods. The Safety Climate Survey is unidimensional and contains 19 items, which are all five-point Likert-type scales as follows: 1 (totally disagree), 2 (disagree), 3 (neither agree nor disagree), 4 (agree), and 5 (totally agree). Language adaptation of the Safety Climate Survey conducted in accordance with the International Society for Pharma economics and Outcome Research (ISPOR) and expert assessments to calculate the content validity indices was undertaken in the first phase of the study. In phase two, a survey of 434 nurses employed in three hospitals in İzmir (Turkey) was conducted to test the construct validity with confirmatory factor analysis and internal consistency with Cronbach's alpha, split-half reliability, and item-total correlation. The intraclass correlation coefficient was also checked via test-retest reliability for stability. Results. The content validity index score was 0.97 for the scale and above 0.90 for the items, confirming excellent validity. The confirmatory factor analysis showed an adequate fit, and all the factor loadings were positive and greater than 0.30. Cronbach's alpha was 0.90, and Spearman̶–Brown coefficient 0.83, indicating good internal consistency. The item-total correlation coefficients were between 0.33 and 0.70, exceeding the acceptable level. The intraclass correlation coefficient value obtained was 0.84, reflecting a good level for time stability. Conclusion. The Turkish version of the Safety Climate Survey is a valid, reliable, and practical tool which can provide essential data on safety issues for healthcare professionals and administrators. Implications for Nursing Management. The instrument can be used in hospital settings to measure the safety climate among nurses, and the results obtained can be used to inform the development of safety improvement strategies. [ABSTRACT FROM AUTHOR]

Aim. This study aimed to investigate the effects of intensive care unit nurses' personality traits and mentalization on workplace bullying after controlling for organizational culture. Background. Nurses' personality traits and mentalization may significantly influence workplace bullying. Methods. This cross-sectional study collected data from 416 nurses using an online survey in July 2022. Major variables were evaluated using the Pathological Narcissism Inventory, Perfectionistic Self-Presentation and Psychological Distress Scale, Short Dark Triad, Mentalization Scale, Positive Nursing Organizational Culture Measurement Tool, and the Negative Acts Questionnaire-Revised.. A multiple regression analysis was performed. Results. Narcissistic vulnerability, mentalization, and perfectionistic self-presentation significantly influence workplace bullying (victim aspect). Dark personality, mentalization, and perfectionistic self-presentation significantly influence workplace bullying (perpetrator aspect). Conclusions. Individual nurses could become either victims of bullying or perpetrators according to their personality traits. Therefore, it is necessary to determine their personality traits, so that they do not become influencing factors in workplace bullying. Implications for Nursing Management. Efforts at a nursing organization level are crucial to understand nurses' personality traits, enhance their mentalization, minimize the manifestations of the negative aspects of their traits, and positively affect the prevention and alleviation of workplace bullying. [ABSTRACT FROM AUTHOR]

Aim: This review aims to identify the factors influencing the transition and retention of mental health nurses during the initial years of practice, recognize gaps in the literature and propose evidence‐based strategies. Background: Mental health is a challenging specialty; recruitment, transition and retention of mental health nurses are known issues of concern. Evaluation: The present study undertakes a scoping review to identify factors influencing the transition and retention of mental health nurses during the initial years of practice and the gaps in that research domain. A literature search was conducted using electronic databases. To gain an understanding of the topic of interest, the review of the literature extended from 2000 to 2022. Key issues: Existing evidence focuses on specific perspectives of transition. There is limited literature on factors influencing transition and retention among mental health nurses. Findings suggested that personal and professional factors could influence the transition and retention of mental health nurses during the initial years of practice. The main themes identified were personal attributes and professional factors with a number of subthemes. Conclusion: The scoping review identified only a few studies, which showed personal and professional factors related to the transition and retention of mental health nurses at the early stages of their career. Implications for nursing management: Potential benefits of effective transition and support with the understanding of factors influencing transition and retention of early career mental health nurses will enhance staff morale, sustainability of the workforce and better patient outcomes. Additionally, a few recommendations for nurse managers and leaders to improve transitional experiences and retention of early career nurses are highlighted. [ABSTRACT FROM AUTHOR]

Aim: This study aims to examine factors related to the job satisfaction of triaging nurses and their professional capability in the clinical setting. Background: Triage is a complex process that relies on making decisions in favour of the patient and his treatment. The professional capability of a triaging nurse is an important psychological construct of job satisfaction. Methods: The study used a mixed‐method methodology, with data collection based on an explanatory research design. The research instrument in the quantitative part was a survey questionnaire, and in the qualitative part, a semi‐structured interview. The results were integrated using the 'Pillar Integration Process'. Results: There are significant relationships between professional capability and job satisfaction. Six main topics were exposed: characteristics and traits, work organization, safety is the key, burdening circumstances, capability and self‐evaluation. Conclusion: Professional capability is associated with job satisfaction. The necessary managerial changes should be made to achieve job satisfaction and develop professional competence while focusing on already trained and competent triage nurses, as satisfied triage nurses will stay longer in the institution. Implications for Nursing Management: The manager's job is to be aware of the level of job satisfaction, take care to develop their employee's professional capability and take action in case of disrupted balance. [ABSTRACT FROM AUTHOR]

Aim(s): This study aims to investigate care unit managers' perceptions of how the COVID‐19 pandemic influenced their ability to support the nurses. Background: The COVID‐19 pandemic placed extreme pressure on health care organizations. More knowledge regarding how the pandemic influenced care unit managers' ability to support nurses is central to ensuring high‐quality health care in future crises. Method(s): A mixed‐methods study in Swedish hospitals with a survey (n = 128) and interviews (n = 20) with care unit managers. Results: Approximately half of the managers reported having spent more time available to and supporting the nurses. Availability was positively predicted by their perceived organizational support while negatively by their job demands. These job demands concerned meeting staff anxiety and managing organizational restructuring. Full focus on direct patient care and strong professional and social support were important job resources. Conclusion(s): For care unit managers to effectively support the nurses during a crisis, they need proficient job resources and moderate job demands. Managers' perceived organizational support positively affects the quality of their crisis leadership. Creating arenas in which staff collegiality can form and develop is beneficial for the ability to meet future crises. Implications for Nursing Management: This study specifies important job resources that should be acknowledged and reinforced to strengthen the ability of care unit managers to actively support the nurses during a crisis. [ABSTRACT FROM AUTHOR]

Aim: The aim of this work is to explore the influencing factors of nurses' caring behaviour during the COVID‐19 pandemic based on the Capability, Opportunity, Motivation as determinants of Behaviour (COM‐B) theoretical framework. Background: Nurse caring behaviour is vital to reduce and speed up the healing process of COVID‐19 patients. It is important to understand the factors that influence caring behaviour among nurses during the COVID‐19 pandemic. Research suggests that when it comes to understanding behaviour, using a theoretical framework is likely to be most effective, and the COM‐B framework is a recommended approach. Methods: Semistructured interviews with 42 nurses working in 11 Chinese cities were conducted, and their verbatim statements were transcribed and analysed using thematic analysis. The results were mapped to COM‐B framework. Results: Ten key themes emerged: Capability (professional knowledge and skills, emotional intelligence, cross‐cultural care competence); opportunity (resources, organizational culture, social culture); motivation (past experience, character, role, beliefs). Conclusions: Ten factors were found to influence nurses' caring behaviour. This study added two new influencing factors, social culture and past experiences, that further contributed to the understanding of nurses' care behaviours. Implications for Nursing Management: Nurses' caring behaviour is influenced not only by themselves but also by institutions and society, so interventions aiming to improve their caring behaviour should consider these elements. The negative impact of the pandemic on capability factors that influence nurses' caring behaviour should be counteracted as soon as possible. [ABSTRACT FROM AUTHOR]

Aim: This study aims to establish postgraduate students' perceptions of the organizational culture and readiness for evidence‐based practice of their workplaces in the Kingdom of Saudi Arabia. Background: Nurse shortages and a reliance on a transient nurse workforce have long been a challenge in the Kingdom of Saudi Arabia. Developing a home‐grown nurse workforce, a key objective of the Government of Saudi Arabia, can help to address this. Evidence‐based practice offers a mechanism to address this. Evidence‐based practice implementation is heavily reliant on the prevailing organizational culture. Establishing the organizational culture and readiness for evidence‐based practice is crucial for sustainable evidence‐based practice implementation. Methods: A pre‐experimental pilot study collected data from the same participants at three different points. As part of this, a questionnaire measuring organizational culture and readiness for evidence‐based practice was administered twice. Descriptive, inferential and correlational statistics were employed to analyse the data. Results: Results demonstrated improved participant perceptions of the organizational culture and readiness for evidence‐based practice of their workplaces between the first (M = 76.58, SD = 19.2) and second (M = 92.10, SD = 23.68) data collection points, indicating moderate movement towards a culture of evidence‐based practice. Strengths, challenges and opportunities for improvement were identified. Conclusion: This study established participants' perceptions of the organizational culture and readiness for evidence‐based practice of their workplaces, affording insight into context‐specific strategies to embed evidence‐based practice in health care organizations. Implications for Nursing Management: Assessing an organization's culture and readiness for evidence‐based practice (EBP) can afford insight on the strengths, challenges and opportunities that exist to equip nurse managers to advance evidence‐based practice at individual, professional and organizational levels. This study demonstrated the importance of promoting an environment conducive to EBP and putting in place the necessary resources to support evidence‐based practice implementation. Nurse managers can play a central role in this. [ABSTRACT FROM AUTHOR]

Aims: The aims of this work are to (1) investigate the work environment, resilience, burnout, and turnover intention and (2) examine how work environment and personal resilience impact burnout and turnover intention among nurse leaders in the midst of the COVID‐19 crisis. Background: The COVID‐19 pandemic introduced tremendous stressors to nurse leaders, for example, managing the complex staffing situation while balancing patients' and family's needs. Methods: During May to September 2021, an electronic survey was sent out to nurse leaders in Birmingham, Alabama, USA, and surrounding areas. Results: Fifty‐six respondents were included in the study. The composite score of the work environment measure was moderately to highly related to resilience [ρ (rho) =.59] and burnout [ρ = −.63 to −.68] but had small association to intent to leave [ρ = −.30]. The resilience was highly correlated to burnout [ρ = −.53 to −.59] and moderately associated to intent to leave [ρ = −.32]. Conclusions: A better work environment for nurse leaders is related to higher resilience, lower burnout, and lower turnover intention. Resilience impacts burnout and turnover intention among nurse leaders. Implications for Nursing Management: Health care organizations and stakeholders should implement effective strategies to improve the work environment, which could lead to enhanced resilience, reduced burnout, and lower turnover intention of their nurse leaders especially during and following this pandemic. [ABSTRACT FROM AUTHOR]

Aims: To investigate the relationship between organizational support and nurse managers' burnout and the serial multiple mediating effects of leadership and resilience. Background: Nurse managers are at a high risk of burnout, especially during the COVID‐19 pandemic. However, no research has been done to examine the associations between nurse managers' organizational support, leadership, resilience and burnout. Methods: This cross‐sectional study recruited 458 nurse managers from 13 tertiary public hospitals in Jiangsu, China. They completed the Survey of Perceived Organizational Support, the Clinical Leadership Survey, the Resilience Scale and the Maslach Burnout Inventor‐Human Service Survey. The serial mediating effect of individual leadership and resilience was estimated using the structural equation modelling method via Mplus 7.0. Results: There were direct and indirect effects of organizational support on burnout, controlling for work variables. Leadership and resilience serially mediate the association between organizational support and burnout (β = −.051, 95% confidence interval: −0.093 to −0.020). Conclusions: Among nurse managers, organizational support may be sequentially associated with improved leadership first and then resilience, which in turn is related to decreased burnout. Implications for Nursing Management: We recommend that hospital administrators incorporate leadership, resilience and burnout assessment in the routine psychological screening of nurse managers and creatively apply the organizational interventions to decrease nurse managers' burnout. [ABSTRACT FROM AUTHOR]