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Aims: Identify strategies and resources for nurse leaders to use to lead with empathy and prudence to improve quality of care and to ease the psychological toll on nurses caring for patients with COVID‐19. Background: In a 2020 report, clinicians caring for patients during the COVID‐19 pandemic said their healthcare leaders needed to: ‘hear me, protect me, prepare me, support me, and care for me’. These words provide an action plan for nurse leaders to communicate, educate, and support nurses to practice competently and safely (physically and mentally) in the context of COVID‐19. Design: Discursive paper. Method: Identification and inclusion of relevant international evidence with clinical discussion. Findings: Nurse leaders can mobilise system and individual level strategies and resources to support nurses to manage pandemic‐related issues including: anxiety due to the risk of infection, supporting anxious children, mitigating moral injury; providing safe and quality nursing care for patients with COVID‐19 and end‐of‐life care as needed; supporting relatives who cannot be present with a dying relative, and care for grieving relatives and colleagues. We categorise a selection of evidence‐based, online sources providing current COVID‐19 information, practice updates, and resources to develop personalised self‐care plans to ease anxiety and support renewal and resilience. Conclusions: Nurse leaders must ensure adequate PPE supply, upskill nurses to provide safe, quality care for patients with COVID‐19, and promote restorative self‐care plans.Relevance to clinical practice. The strategic actions nurse leaders take today can positively impact nurses’ wellbeing and ability to provide safe and quality care for patients in the context of COVID‐19. Refereed/Peer-reviewed

The use of standardized nursing languages helps nurses understand patients' needs with precision and speed. This study assessed the knowledge of standardized nursing languages (SNL); how nurses perceive SNL and nurses utilization of SNL. The study adopted a cross sectional research design. Participants were recruited using convenience sampling technique. Data was collected using 5-sectioned self-structured questionnaires whose validity and reliability had been previously ascertained. Data collected was analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results showed that majority of the nurses that participated in the study are female (83.8%). Only 60.0% of the nurses know the number of steps in nursing process while very few (5.4%) can correctly define what SNLs is. Knowledge of SNLs shows that 26.2% have high knowledge; 44.6% moderate knowledge while 29.2% had low knowledge. Utilization of SNL by nurses showed that Majority (83.8%) of the nurses in the study agreed that utilization of SNL help nurses to deliver quality nursing care; 67.7% of nurses agreed that the use of SNL makes nursing practice unique, 55.4% opined that the use of SNL can be cumbersome while only 24.6% often use nursing process for patients' care. Although, participants in this study agreed that the use of SNL is crucial to quality nursing care, with poor utilization.

The therapeutic relationship constitutes the central axis of mental health nursing. The clinical practice environment has been empirically related to the quality of care. However, the relationship between the two constructs is unknown in the setting of mental health units. We aimed to examine whether the practice environment and nurses' characteristics influence the therapeutic relationship in mental health units. Through a cross-sectional design, data were collected via an online form completed by nurses in 18 mental health units. Linear regression was used to examine the relationship between the clinical practice environment and the therapeutic relationship. Questionnaires were completed by 198 participants. The mean age was 33.8 (SD 9.1) years, 71.7% were women, and only 20.2% had a specialist qualification in mental health. The therapeutic relationship was better when there was a more favourable practice environment (B: 3.111; 95% CI: 1.46-4.75). The most influential environment-related factor was the nursing foundations for quality of care (B: 2.124; 95% CI: 0.17-4.07). The factors associated with a high-quality therapeutic relationship were a more favourable practice environment and the presence of more foundations for quality nursing care, coupled with higher academic attainment and longer nursing experience. Institutions should take into account the importance of the nursing practice environment in mental health units. Aspects related to the quality of nursing foundations, such as training, the use of nursing language and taxonomy, and the existence of a common nursing philosophy, are influential for a high-quality therapeutic relationship.

Patient's satisfaction has emerged as a central focus of health-care delivery during the last decades, and nursing care became one significant component of patient's satisfaction. The purpose of this study is to examine patients' satisfaction with quality of nursing care provided in Saudi Arabia. Cross-sectional descriptive correctional design was used to recruit 100 patients from one regional hospital in Saudi Arabia. Data collected using structured interview from patients related to six dimensions of nursing care. Patients had a high level of satisfaction with nursing care provided (86% agreement rate). Language (56% disagreement rate), discharge information (56% disagreement rate) and availability (20% disagreement rate) have been identified with the lowest rates of patients satisfaction. Nursing leaders and health-care administrators need to maintain quality nursing care and develop strategies for improving nursing care emphasizing language as barrier and strategies of information dissemination.

Technology plays a major role in nursing care. Among the challenges for nurses is being able to maintain a patient focus while surrounded by highly complex technology. The provision of high quality nursing care in technologically complex environments is particularly challenging when nurses develop relationships with their patients over an extended period of time. In these environments the potential for intimate relationships can increase. This potential for intimacy is evident in the haemodialysis context where dialysis technology, nurses and patients interface. As nurses and patients can spend up to 20 hours per week together intimate relationships can develop. This paper identifies the challenges these dialysis nurses face and introduces the concept of technological intimacy. Technological intimacy can be defined as physical touching and self disclosure, associated with closeness and knowing, that is undertaken in the full view of others in a healthcare environment dominated by technology. In the haemodialysis context technological intimacy has been scarcely acknowledged and rarely researched. Further research will assist in guiding haemodialysis nursing practice.

Absence of pressure ulcers is increasingly being used as an indicator of quality nursing care, based on the premise that pressure ulcers are preventable. This retrospective study examined the occurrence, presentation, and timing of pressure ulcer development in 150 patients undergoing cardiac surgery. Pressure ulcer incidents were recorded in groups of patients who underwent surgery with use of a standard foam OR bed mattress; use of a fluid, pressure-reducing OR bed mattress; or use of a fluid, pressuring-reducing mattress after a comprehensive educational program on pressure ulcer prevention was presented to RNs. Tcers decreased when the fluid, pressure-reducing OR bed mattresses were used in conjunction with the comprehensive RN education program.

• The aims of the study were to identify indicators of quality of nursing care from the perceptions of patients and nurses, and to determine the congruence between patients' and nurses' perceptions. • The paper is presented in two parts. Part 1 included the background and methods to the study and the findings from the comparison of patients' and nurses' perceptions. Part 2 describes the perceptions of patients and nurses, and draws conclusions drawn from the study as a whole. • Patients and nurses in hospital wards were interviewed using the critical incident technique. • We grouped 4546 indicators of high and low quality nursing care generated from the interview transcripts into 316 subcategories, 68 categories and 31 themes. • The themes were grouped into eight clusters: therapeutic context for care, attitudes and sensitivity, teaching and leadership, motivation to nurse, monitoring and informing, high-dependency care, efficiency and thoroughness, reflection and anticipation. • As shown in Part 1 of the paper, congruence between patients' and nurses' perceptions of quality was high and significant, although there was some difference of emphasis. • The findings support an emerging theory of interpersonal competence and quality in nursing care.

Summary In summary, I advocate continued development of measurement in- struments and criteria, conceptual frameworks applicable for the study of quality, and innovative approaches for delineation of target populations such as trials with tracer methodology. Bailit et al. (1975)state that the most important factor in improvement of the quality of care is that quality is, in fact, being evaluated. It is hoped that continued work will produce findings which can lead us to quality in practice.

Although empathy is regarded as a necessary component of good quality nursing care, defining and measuring empathy have both been fraught with problems. A historical overview helps to explain these difficulties, as nurses have tended to accept the views of psychotherapists uncritically, and have used scales developed for clients in counselling with people who are physically ill. Methodological difficulties combined with the results of studies demonstrating low levels of empathic ability in nurses have culminated in disenchantment with this topic. A framework is used to show why nurses cannot always demonstrate empathic awareness of every patient's need and an alternative approach for exploring the nature of empathy is suggested.

PURPOSE To detect the areas of most need for care and the prevalence of the nursing diagnoses in methadone maintenance programs. METHODS The study was carried out with a sample of 131 subjects (average age 33 years) included in a methadone maintenance program. There was a predominance of males (76%). A high percentage (72%) were disabled or unemployed. The evaluation was done by students in an alcohol and drug dependency nursing course at the School of Nursing of the University of Barcelona, trained and supervised by nurses from the clinical area. Assessments took place in methadone maintenance program units. The Sociodemographic and Assessments of Needs Questionnaire was developed to collect data. NANDA's Taxonomy was used to determine nursing diagoses. FINDINGS Rest and Sleep were the areas that demonstrated the greatest need. Eleven diagnostic labels covered 75% of cases. The six most frequent diagnoses were sleep pattern disturbance, altered nutrition: less than body requirements, constipation, self-care deficit, altered role performance, and self-esteem disturbance. CONCLUSIONS Results obtained in the assessment of needs agreed with NANDA's nursing diagnoses and with the proposed “Standards of Addictions Nursing Practice with Selected Diagnoses and Criteria” by the American Nurses Association, the Drug and Alcohol Nursing Association, and the National Nursing Society on Addictions. Based on the results of this study, we are working to validate the Nursing Intervention Program using NIC for the six prevalent nursing diagnoses identified in patients in the methadone maintenance program.

Although this course is in its infancy, it has become popular among baccalaureate students. Incoming junior students are enthusiastic about an elective course that provides them an opportunity to focus on an aspect of nursing that is no longer available to them in most nursing programs. The morale of the operating room nursing staff, particularly among the preceptors, has increased tenfold. In an era of nursing shortages, creative and innovative methods of recruiting students and retaining experienced nurses in all fields are vital. This unique course may be one of those methods. It is widely known that high morale yields a more productive work environment, lower turnover, and a cohesive work force that provides high quality nursing care in a most cost-effective manner.